BMCH2015-0259..f
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O15-0259 0
Property Address: 79631 CORTEZ LN R
APN: 600040015 7 1
Application Description: MCINTOSH RESIDENCE HVAC CHANGE OUT LA
Property Zoning:
Application Valuation: $5,000.00
Applicant:
PALOMA AIR CONDITIONING
P 0 BOX 3501
PALM DESERT, CA 92261
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing, with Section 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C20 License No.: 619091.
mate: r'-1 Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to itszissuance, Also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to theprovisions of the
Contractor's State, License Law (Chapter 9 (commencing with Section 7000) of Division 3
of'the Business and Professions Code) or that he,or she is exempt therefrom and the {
basis for the alleged exemption. Any violation of Section 70315 by any applicant for a
permit subjects the.applicant to a civil penalty of not more than five hundred dollars
($500).:
LJ I, as owner of the property, or my employees with wages;as their sole
compensation, will do the work, and the structure is not intended; or,offered.for, sale:
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon; and'who does the work
himself or herself through his or her own- employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have.the burden of proving that
he or did not build or improve for the purpose of sale.).
(_J I, as owner of the property, am exclusively contracting with licensed contractors
to.construct the project. (Sec: 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed, pursuant to
theContractors' State License Law.).
(_ I am exempt underSec. . B.&P.C. for this
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty. of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
T* 1L5,(760) 777-7153
JUL 0 9 2015 11�jte: '2015
QUMA
i NTDEPARThfe'NT
Contractor:
PALOMA AIR CONDITIONING
P 0 BOX 3501
PALM DESERT, CA 92261.
(760)347-1212.
Lic. No.: 619091
WORKER'S COMPENSATION DECLARATION
I;herebyaffirm under penalty of perjury oneof the following declarations:
I have and will maintain a certificate; of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work ,for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 3700'of the Labor Code, for the performance, of the work for which this permit
its issued. My workers' compensation Insurance carrierand polity number are:
Carrier:_ Policy Number:_
I certify that In the performance of the work for which this permit Is Issued, I
shall not employ any person In any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should becomesubject to the
workers' compensation provisions of Section3700 of the Labor Code, l shall forthwith
comply with those provisions
.Dater '— /..Applicant:
WARNING: FAILURE TO SECURE WORKERS, COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER'TO CRIMINAL PENALTIES'AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION; DAMAGES AS PROVIDED FOR IN SECTION3706 OF THE LABOR CODE,
INTEREST,.AND ATTORNEY'S FEES,
APPLICANT, ACKNOWLEDGEMENT
IMPORTANT: Application is hereby madeto the Building Official fora permit subject to
the conditions.and restrictions set forth;on this application.
1. Each person upon whosebehalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application ,the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta,.its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result ofthis application becomes null and void if work,is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 daysmill subject permit to cancellation.
I certifythatl have read this appiicationand statethat.the above information is correct.
l4gree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned
bovemmentio ed property for inspei ;purposes.
Date: �� Signature ('Applicant oe Agent):
Description: MCINTOSH RESIDENCE HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: ISSUED
Applied: 7/9/2015 MFA
Approved: 7/9/2015 MFA
Parcel No: 600040015 Site Address: 79631 CORTEZ LN LA QUINTA,CA 92253
Subdivision: TR 2667 Block: Lot: 15
Issued: 7/9/2015 MFA
Lot Sq Ft: 0 Building Sq Ft:,O Zoning:
Finaled:
Valuation: $5,000.00 • Occupancy Type: Construction Type:
Expired: 1/5/2016 MFA
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT -13 SEER SPLIT SYSTEM 12008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES
Printed: Thursday, July 09, 2015 12:34:02 PM 1 of 2
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HVAC'CHANGEOUT -
SPLIT -SYSTEM
..101-0000-42402
0
$72.52
$72.52
7/9/15
R7593
0025121
CHECK
PALOMA AIR
CONDITIONING
MFA
HVAC CHANGEOUT -
SPLIT -SYSTEM PC.
301-0000-42600
0
$36.26
$36.26
7/9/15
R7593
0025121
CHECK
PALOMA AIR
CONDITIONING
MFA
Total Paid forCHANGEOUT: $108.78 $108.78.
PERMIT ISSUANCE
101-0000-424040
$91.85
$91.85
7/9/15
R7593
0025121
CHECK
PALOMA AIR
CONDITIONING
MFA
Total Paid for PERMIT ISSUANCE:. $91.85 $91.85
PARENT PROJECTS
Printed: Thursday, July 09, 2015 12:34:02 PM 2 of 2 CRWYsTrms
Bin #
City of La Quinta
Building &r .Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
P,rcjeet Address:
C ojeW
Owner's Name: C
A. P. Number:
Address: C
Legal. Description:
City, ST, Zip: '�
Contractor: 0-
r� �—
`� .�.:..: :.
Telephone: �' •'
Address: -�
Q^
�'�-Q Y
Project Description:
City, ST, Zip: b V'
��
�' 1 (.f
Telephone:
State Lie. # :
Arch., Engr„ Designer:
a City Lie.;
i�
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Conduction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact -Person:
Sq. Ft.;
# Stories:
#. Units:
Telephone # of Contact Person:
Estimated Value of Project: V01091
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted.
Item
Amount
Structural Cales.
Reviewed,ready for corrections
Plan Check Deposit
Truss Cults.
Called Contact Person
Plan Check Balance,
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21! Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Planvoicked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
"Review, ready for correction liissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub: Wks. Appr
Date of permit issue
School Fees
Total Permit Fels
CERTIFICATE 011"COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning'Systems (formerly CF -1R -ALT -HVAC) (Pige-1 of 3
Project Name: Roy Mcantosh Date Prepared: 20I5-07-09.
A. General Information
MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one CFIR-ALT-02 document for each dwelling unit.
02
Project Name
Roy Mcantosh
02
Date Prepared
2015-,07.09
03
Project Location
79-631 cortez Ln.
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Roy Mcantosh
07.
Zip Code
92253
08
Dwelling Unit Conditioned
1400
installiqg heo�#
astilliA
9 �
16italli'
ngr
-.'Installing
Floor Area (W)
Identification or
Location or Area
by this -SC
ducted
containing
Number of apace conditioning
-1
more than 40
09
Climate Zone
15
10,
(SC) systems In this dwelling
1
system?
component?
components?
feet of ducts?
unit.
SC system?
B. Space Conditioning (SC) System Information
01
02
03
04
'66
C) 7�-
09
10
Is the SC
Installing a
SC System
SC System
CFA served
s a,
'system
riklK t
installiqg heo�#
astilliA
9 �
16italli'
ngr
-.'Installing
Identification or
Location or Area
by this -SC
ducted
containing
system,
-1
more than 40
;1' '.
entirely new
entirely new
Name
Served
System (W)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
Entirely new or
Mcantosh
Residence
whole house
'1400
No
Yes
Yes
No
No
Yet
complete
replacement space
conditioning, system
C. Extension of Existing Duct System, Greater Than 40 Feet (SectlonlS0.2(b)1Dilb)
This section does not apply to this project.
Registration Number. 215-A0187657A-000000000-0600
CA Building Energy Efficiency Standards -- 2013 Residential Compliance
Registration Date/Time: 2015-07-09 09759:33
Report Version: 2014-03-31
Schema Version: 0:555SDD
HERS Provider: CaICERTS
,Report Generated: 2015-07-09 09:59:56
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 )
D. Altered. Space Conditioning System (Sections 1S0.2(b)IE and F)
This section does:not apply to -this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)IC)
•01
02
03
04
05
06
07
08
09
10
11
Heating
Cooling
System
Heating
Minimum
Cooling
Minimum
Required
Identification or
Heating System
Altered Heating
Efficiency
Efficiency
Cooling
Altered Cooling
Efficiency
Efficiency
Thermostat
New Duct
Name
Type
Component
Type
Value
System Type
one
component
Type
Value
Type
R -Value
�
�
..,
w
q
r :
'ew
t:
fir.
This field
Mcantosh.
Central gas
All new heatifig
'�
Central split
All' coollilg'y
r
5etbaekTher
or section
Residence
furnace
componerSjs ?
y
AE4,,,
`AC
ponants .r
SER y
13.
mostat
is not
applicable
Reauired Documentation: "
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R & CF3R-MCH-20-H Duct Leakage Verification required.
-leakage rate compliance: 56%.
CF211 & CF3R-MCH-22 Fan Efficacy Verification
CF2R & CF3R-MCH-23 System Air Flow Rate Verification
-Compliance: Fan Efficacy15 0.58 W/cfm and.System Airflow's 350 cfm/ton.
- Alternative Compliance: CF2R & CF3R-MCH-28 Return Duct Design Verifications an alternative to MCH -22 and MCH -23 verification.
CF2R & CF3R-MGH-25-H Refdgerant:Charge Verification required when refrigerant containing components are Installed or altered (applicable in CZ 2, 8-15).
Exceptions:.
Heating -only systems are exempt from the 0.58 W/cfm and 350 cfrn/ton.requirements.
ate:
An "entirely new or replacement duct system" means at least 75 percent of the duct system Is new duct,material; fromthe up to 25 percent may consist of reused parts frothe dwelling unit's existing duct system (e.g:;
registers, grilles, boots, air handler, coil, plenums, duct material) if the reused parts are accessible and can be sealed to prevent leakage
Registration Number: 215-A0187657A-000000000=0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-07-09 09:59:33
Report Version: 2014-03-31
Schema Version: 0.555SDD
HERS Provider: CaICERTS
Report Generated: 2015-07-09 09:59:56
CERTIFICATE OF COMPLIANCE _ CFiR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC)(Page 3 of -3 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance. documentation Is accurate and complete..
Documentation Author Name:
Documentation Author Signature: --
Paredes, Herman
Company,:
Signature Date:
PALOMA.AIR CONDITIONING
2015-07-09 09:59:33
Address:
CEA/ HERS Certification Identification (if applicable):
P 0 BOX 3501
City/State/Zip:
Phone:
PALMI DESERT CA 92261
(760) 347-1212
Responsible Person's Declaration statement
I,certify the following under penalty of perjury, under the laws of the State of California:
1. The.informatlon provided on this Certificate of Compliance is true and correct.
2: Lam eligible under Division 3 of the Business,and Professions Code to accept responsibilityfor the building design or system design Identified on this 'Certificate ,of.Compliance (responsible designer).
3: That the energy features and performance specifications, materials, components, and Manufactured devices for the building design or system designidentified on this Certificate of Compliance conform'to the
requirements of Title 24, Part.1 and Part 6 of the California Code of 110ju atfons
_
y
3Kr JF a ,i b''h
4. The building design features orsystem design features Identified orbthis Certlfi eiof Compliance ares-. istentt iji*the 1i%jormatlgr+ rovided or th@rappliobie compliance documents; worksheets,
calculations, plans and specifications submitted to the in' gency fo�ppr`ova1,'*Kh tthis bulling perrA)t applicatigp. j
S. I will ensurethat a registered copy of this Certiflcateo ,Compliance s aliil?eoi tlwayailable h3the baiiding permit(sj: issued fore b llding, and'�a&:avallabli•W,.theTenforeement agency for all applicable
inspections. I understand'that a registered copy of thise�;rfiicate of Coinplaance.is.required to be included viith the,dowmentationthe biilider provides t .xhe.buildi,ng owner at occupancy.
I - =
Responsible Designer Name:, - -
4.
Responsible Designer Sijnafure:
yfPJIMA'/ lvid
Paredes, Herman
company:
Date Signed:
PALOMA AIR CONDITIONING
2015-07-09 09:59:33
Address:
license:
P 0 BOX 3501
619091
City/State/Zip:
Phone:
PALM DESERT CA 92261
(760) 347-1212
Digitally signed by CalCERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A0187657A-000000000-0000 Registration Date/Time: 2015-07-09 09:59:33 HERS:Provider:.CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03731 Report Generated: 2015-07-09 09:59:56
Schema Version: Q.S55SDD
Ile
Co icTt�. rJ