BMCH2015-008278-495 CALLE TAMPI D �i(AIUCl/
LA QUINTA, CALIFORNIA 92253
Application Number: BMCH2O15-0082
Property Address: 78321 W DEACON DR
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
APN: 770210029
Application Description: WARNER CLIFF REPLACE CONDESER A/C coil
Property Zoning:
Application Valuation: $4,000.00
Applicant:
D °
PALOMA AIR CONDITIONING MAR Q 2015
P 0 BOX 3501
PALM DESERT, CA 92261 CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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
ate: �r Z 0 _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 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 Divisio 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.).
(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
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
Date: 3/20/2015
Owner:
CLIFTON WARREN
78321 W DEACON DRIVE
LA QUINTA, CA 92253
Contractor:
PALOMA AIR CONDITIONING
P 0 BOX 3501
PALM DESERT, CA 92261
(760)347-1212
Llc. No.: 619091
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.
(
.� r-
Date: �� o 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 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 for insction purposes.
bate: 3 �� Signature (Applicant or Agent
%j/2'3 96
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name: Cliff Warren Date Prepared: 2015-03-20
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. f
01
Project Name
Cliff Warren
02
Date Prepared
2015-03-20
03
Project Location
78321 Decan dr
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Cliff Warren
07
Zip Code
92253
08
Dwelling Unit Conditioned
3000
Installing
Installing
Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system
11 Number of space conditioning
entirely new
09
Climate Zone
15
10
(SC) systems in this dwelling .
1
component?
components?
feet of ducts?
duct system?
1 unit.
Alteration Type
B. Space Conditioning (SC) System Information
01
02
03
04;.
05
.06.
07
OS:
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
System 1
Location 1
1000
Yes
YesYes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 215-A0074131A-000000000-0000 Registration Date/Time: 2015-03-20 06:43:51 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-20 06:43:24
Schema Version: 0.5S5SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) 4Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
05
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
Central gas
No heating
This field or
This field or
Central split
Outdoor
Less than or
System 1
furnace
component
section is not
section is not
AC
condensing
SEER
13
Setback
equal to 40
R-8
altered
applicable
applicable
unit
feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-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: 515%, or 5 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, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow >_ 300 CFM/ton required when MCH -25 is.required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt.from MCH -20 Duct Leakage,Testing requirements.
-Heating-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)lC)
This section does not apply to this project.
Registration Number: 215-A0074131A-000000000-0000 Registration Date/Time: 2015-03-20 06:43:51 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-20 06:43:24
Schema Version: 0.5SSSDD
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. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: 7TPJTifl6CLf(/ �i��liGirTiV
Paredes, Herman
Company:
Signature Date:
PALOMA AIR CONDITIONING
2015-03-20 06:43:51
Address:
CEA/ HERS Certification Identification (if applicable):
P 0 BOX 3501
City/State/Zip:
Phone:
PALM 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 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). '
3. 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 or system.design features identified onthis Certificate of.Compliance are consistent with the information'provided on other applicable compliance documents, worksheets;
calculations, plans and specifications, submitted to the.enforcement agency for approval.with this building permit application.
S. I will ensure that a registered copy of this: Certificate of Compliance shall be.made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builderprovidesto the building owner occupancy.
Responsible Designer Name:
-at
Responsible Designer Signature: 7�1!(R�X//4�1%uf/�iG►
Paredes, Herman
Company:
Date Signed:
PALOMA AIR CONDITIONING
2015-03-20 06:43:51
Address:
License:
P 0 BOX 3501
619091
City/State/Zip:
Phone:
PALM DESERT CA 92261
(760) 347-1212
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A0074131A-000000000-0000 Registration Date/Time: 2015-03-20 06:43:51 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-20 06:43:24
Schema Version: O.SSSSDD
FINANCIAL , 1
DESCRIPTION. ACCOUNT QTY
AMOUNT PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306 0
$1.00 $0.00
PAID BY METHOD RECEIPT # CHECK # CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - CONDENSER ONLY
101-0000-42402
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - CONDENSER ONLY PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - OTHER EQUIPMENT
101-0000-42402
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNTQTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - OTHER EQUIPMENT PC
101-0000-42600
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #.
CLTD BY
Total Paid forCHANGEOUT: $132.95 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #,
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS::0 $0.00
Description: WARNER CLIFF REPLACE CONDESER A/C coil
CONDITIONS
Type: MECHANICAL
Subtype:
Status: UNDER REVIEW
Applied: 3/20/2015 PJU
Approved:
Parcel No: 770210029 Site Address: 78321 W DEACON DR LA QUINTA CA 92253
Subdivision: TR 28611
Block:
Lot: 15
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $4,000.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0
No. Unites: 0
APPLICANT
Details: REPLACE CONDENSER & COIL PER 2013 CALIFORNA MECHANICAL CODES.
P 0 BOX 3501
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE.
ZIP
PHONE
FAX
EMAIL
APPLICANT
PALOMA AIR CONDITIONING
P 0 BOX 3501
PALM DESERT
CA
92261
(
Printed: Friday, March 20, 2015 8:54:03 AM 1 of 2
��SYSTEMS
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
HVAC CHANGEOUT -
101-0000-42402
0
$36.26
$0.00
CONDENSER ONLY
HVAC CHANGEOUT -
101-0000-42600
0
$24.17
$0.00
CONDENSER ONLY PC
HVAC CHANGEOUT -
101-0000-42402
0
$36.26
$0.00
OTHER EQUIPMENT
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
OTHER EQUIPMENT PC
Total Paid forCHANGEOUT: $132.95 $0.00
PERMIT ISSUANCE
101-0000-42404
1 0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS::0 $0.00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
MECHANICAL FINAL" BLD
Printed: Friday, March 20, 2015 8:54:03 AM 2 of 2
RWSYSTEMS
Bin #
Permit #
Project Address:
am ity of La Quanta.
Building Sr Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
vvv La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
U Owner's Name: G L Ilr
A. P. Number:
Address: / 2 1 Y LA V. d C.
Legal Description:
City, ST, Zip: 0� 6 v
Contractor: or:
c �
telephone:
'
Address:
-� O C' �G[ �%
Project Description: t
City, ST, Zip:
L
Telephone:
State Lic. # :
Q a�
City Lia #;.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #
4:1li�n ::<;ii:yi �:iw:+: i:,v'i�i�in:�iv;:;i}�;:
<::;; >:: >_::;>:::;;;
::.;<^... `.='.:;...::.;«:r.::::.:
...
Construction 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:
APPLICANT: 00 NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES•
Plan Sets
PIan Check submitted
Itcm
Amount
Structural Cates.
Reviewed, ready for corrections
an 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
tad Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'rd Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fccs