BMCH2016-016978-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
TA'�t440"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O16-0169
Property Address:
79110 KRISTEN CT CT
APN:
604361009
Application Description:
BUTLER RESIDENCE / HVAC CHANGE OUT
Property Zoning:
Application Valuation:
$10,000.00
Applicant:
PALOMA AIR CONDITIONING
83019 AVENUE 45
INDIO, CA 92201
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 Pd effect.
License Class: C20 If is #
No.: 619091
Date: S ^ 1 l Coni t'� r�or.
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 its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions 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 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(_ _) 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 she did not build or improve for the purpose of sale.).
( ) 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
the Contractors' State License Law.).
( I I am exempt under Sec. . B.&P.C. for this reason
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 Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
1w1LAS Q
ISTEN�
co� t�U�c�P E QUINTA
ECppM
PALOMA AIR CONf
83019 AVENUE 45
INDIO, CA 9.2201
(760)347-1212.
Llc. No.: 619091
Date: 5/19/2016
D
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of 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
is issued. My workers' compensation insurance carrier and policy 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 become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
DaApplicant:
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 SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf 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 of this 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 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree 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 property r inspection purposes.
Daj Signature(Applicant or Agent):
DESCRIPTION:
FINANCIAL `•
ACCOUNT
a.
QTY' AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0 $1.00
$1.00
5/19/16
PAID BY
METHOD
RECEIPT #•<
CHECK #
CLTD BY
PALOMA AIR CONDITIONING
CHECK
R15653
0025621
MFA
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1'.00 $1.00.
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$145.04
$145.04
S/19/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
PALOMA AIR CONDITIONING
CHECK
R15653
0025621
MFA
DESCRIPTION
ACCOUNT
QTY-
AMOUNT
PAID'
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$72.52
$72.52
5/19/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
PALOMA AIR CONDITIONING
CHECK
R15653
0025621
MFA
Total Paid for CHANGEOUT: $217.56 $217.56
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
5/19/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
PALOMA AIR CONDITIONING
CHECK
R15653
0025621
MFA
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
• a$310.41 $310.41
Description: BUTLER RESIDENCE / HVAC CHANGE OUT
Type: MECHANICAL Subtype:. Status: ISSUED
Applied: 5/19/2016 MFA
Approved: 5/19/2016 MFA .
Parcel No: 604361009 Site Address: 79110 KRISTEN CT CT LA QUINTA,CA 92253
Subdivision: TR 27899 Block: Lot: 57
Issued: 5/19/2016 MFA
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $10•,000.00 Occupancy Type: Construction Type:
Expired: 11/15/2016 MFA
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: TWO (2) HVAC CHANGE OUT - 16 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED
PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed: Thursday, May 19, 2016 4:02:43 PM 1 of 2
SYSTEMS
BOND INFORMATION
Printed: Thursday, May 19, 2016 4:02:43 PM 2 of 2 C
SYSTEMS
CLTD'
DESCRIPTION
ACCOUNT . -
CITY '
AMOUNT:
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY.
HVAC CHANGEOUT -
101-0000-42402
0
$145.04
$145.04
5/19/16
R15653
0025621
CHECK
PALOMA AIR'MFA
SPLIT -SYSTEM
CONDITIONING
HVAC CHANGEOUT -
101-0000-42600
0
$72.52
$72.52
5/19/16
R15653
0025621
CHECK
PALOMA AIR
MFA
SPLIT -SYSTEM PC
CONDITIONING
Total Paid for CHANGEOUT: $217.56 $217.56
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
5/19/16
R15653
0025621
CHECK
PALOMA AIR
MFA
CONDITIONING
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
TOTALS: $310.41 i .41
BOND INFORMATION
Printed: Thursday, May 19, 2016 4:02:43 PM 2 of 2 C
SYSTEMS
6fi #
Permit #
Project Address:Y
A. P. Number:
City of La Quinta .
Building 8I• Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet (-)T Q
' ST x . C7" Owner's Name: I
Address:
Legal Description:
City, ST, Zip: t C -tom
Contractor: 1/t/I
/11
ele hone:
"
Address: �� I
��Y5
- Project Description: —2—
City, ST, Zip: jJVV (''� l I �..
V C J � l
Telephone: one:
2 7
State Lie. # :
City Lie. #;
C
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
le ne:
P 0
Construction TY Pe: Occupancy:
:
State Lie. #-
t ty �circle ne)• New Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: or o
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person.
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready for corrections/issue
Electrical
Subcontactor List
Called_ Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A.'Approval
Plans resubmitted
Grading
IN HOUSE:-
Jrd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
CF1R-ALT-02-E
(Page 1 of 3 )
bILL bUTTLERE Date Prepared: 2016-05-18
A. General information
CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one CF1R-ALT-02 document for each dwelling unit.
01
Project Name
bILL bUTTLERE
02
Date Prepared
2016-05-18
03
Project Location
79110 kRISTEN CT
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
bILL bUTTLERE
07
Zip Code
92253
08 .
Dwelling Unit Conditioned
Installing new SC
Installing
Installing
Installing
Floor Area (ft2)
2500
09
Climate Zane
15
system
Number of space conditioning
entirely new
entirely new
Name
10
(SC) systems in this dwelling
2
component?
components?
'
duct system?
unit:
Alteration Type
B. Space Conditioning (SC) System Information
Ol
02
03
04
05
06
07
08
09
10
Is the SC
Installing a
SC System
SC System
CFA served
.'*system a
refrigerant
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
4 TON LIVING
Location 1
1400
Yes
Yes
Yes
No
No'
No
Altered space
conditioning system
3 TON BEDROOMS
Location 2
1100
Yes
Yes
Yes
FNo
No
No
Tconditioning
Altered space
system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 15f1.2(b)1Diib)
This section does not apply to this project.
Registration Number: 216-A0185873A-000000000-0000 Registration Date/Time: 2016-05-18 14:56:28 HERS Provider: CaICERTS
CA Building Energy. Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-18 14:56:53
Schena Version: 0.5555DD
V
ki
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 )
0. Altered Space Conditioning System (Sections 1S0.2(b)1E and F)
01
02
03
04
0S
06
07
08
09
10
11
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New or
Identification
System
Heating
Efficiency
Efficiency '
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
New Duct
or Name.
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Duct Length
R -Value
4 TON LIVING
Central gas
Gas furnace
AFUE
Centralsp t II
All new
Less than or
furnace
AHU
0.78
AC
cooling
SEER
13
Setback
equal to 40
R-8
components
feet
3 TON
Central gas
' Gas furnace
Central split
All new
Less than or
BEDROOMS
furnace
AHU
AFUE
0.78
AC
cooling
SEER
13
Setback
equal to 40
R-8
components
Meet
Reouired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
'
-Duct insulation requirement for new plenums: R6.
-
CF2R-10CH-20-H & CF3R.MCH-20-H — Duct Leakage testing required when heating or cooling components are installed
in ducted systems, or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: s 15%, or < 10%leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components
are installed or altered (applicable in CZ 2, 845).
CI:2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2 300 CFM/tan required when MCH -25 is required.
Exceouom,
-
-Duct systems registered withHERSprovider as previously sealed are exempt from MCH -20 Duct leakage Testing requirements.
-Healing-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-25.
Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)lE, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)iC)
This section does not apply to this project.
Registration Number: 216-A0185873A•000000000.0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
I
Registration Date/Time: 2016-05-18 14:56:28 HERS Provider: CaICERTS
Report Version: 2013 Rev 1.007 Report Generated: 2016-05-18 14:56:53
Schema Version: 0.555SDD
CERTIFICATE, OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1. t certify that this Certificate of Compliance documentation is accurate and complete.
DocumesAuthor Name:
Pared
Paredes,, Herman
Documentation Author Signature:
7TPlL1!
Company:
Signature Date:
PALOMA AIR CONDITIONING
2016-05-18 14:56:28
Address:
P 0 BOX 3501
CEA/HERS Certification Identification (if applicable):
City/Stale/Zip:
PALM DESERT CA 92261
Phone:
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 information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
s. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance
conform to the
requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations.
4. The building design features oisystem design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency fm.approval with this building permit application.
S. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with.the building permits) issued for the building, and made available to the errfurcennent agency for all applicable
inspections.
t understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at or upancy.
Responsible Designer Name:
Responsible Designer Signature:
Paredes, Herman �7�Gyl�v /'A'fiellP4
Company:
Date Signed:
PALOMA AIR CONDITIONING
2016-05-18 14:56:28
Address:
P 0 BOX 3501
License:619091
City/State/Zip: - r
PALM DESERT CA 92261
Phone:
760-347-1212
• Digitally signed by CalCERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Prdvider responsibility for the accuracy of the information.
Registration Number: 216-A0185873A-000000000-0000 Registration Date/fime: 2016-05-18 14:56:28 - _ HERS Provider: CaICERTS
CA Building Energy Efficiency Standards'- 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016.05-18 14:56:53
Schema Version: 0.555SDD
1
1