BMCH2015-0306r .
78-495 CALLE TAMPICO
LA'QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760)777-7125
FAX (760) 777-7011.
INSPECTIONS. (760) 777-7153
BMCH2O15-0306 Owner:
80349 VIA MIRASOL GEOFFREY PALMER
77709004 80349 VIA MIRASOL
EMSIDENC&VAC S SYSTEM CHANGE OUT LA QUINTA, CA 92253
ta Applicant:PALOMAAIR CONDITIONI
P 0 BOX 3501
PALM DESERT, CA 92261
vAUG X 0 2015
Contractor:
CITIOFIAMWMNDEAPARtMENT PALOMA AIR CONDITIONING
IMUNi�`f DEVELD P 0 BOX 3501
PALM DESERT, CA 92261
(76b)347-1212,
Llc. No.: 619091
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 1of the Business and Professions Code,
and my License is in full force and effect.
License Class: C20 License No.: 619091
Date: (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 Division 3
of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged exemption. Anyviolation of Section 7031.5 by any applicant fo
permit subjects the applicant to a civil penalty of not more than five hundred doll s
($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,).
as owner of i 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 contractors) licensed pursuant to
the Contractors' State License Law.).
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 Name:
Lender's Address:
Date: 8/10/2015
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.
Oate:
�� � � 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 forrrmlon purposes.
Date: �� Signature (Applicant or Agent):
FINANCIAL •
E ,,DESCRIPTIONz�f
�.'A000UNT 1« rQTY�'AMOUNT�#' *{PAID �PAIDDATE
BSAS SB1473 FEE
101-0000-20306 0
$1.00 $0.00
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x
RECEIPT#rr {';, kj-11 CHECK# �CLTDBYE
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
FF ' OESCRIP�
�R
!ACCOUNT
s
'
'+aux*PAI
PAID DATE:
HVAC CHANGEOUT - SPLIT-SYSTEM
101-0000-42402
0
$72.52
$0.00
Wx21 01 V1111 `y. �7 r_r..s,:-+.t'r �.-.,f �¢s : c
. ar...`$ PAID. BY? `�.F , _ .i
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gRECEIP,T
DESCRIPTIONK;
z $ ACCOUNT; E,QTY3;
AMOUNT.,
R PAID�'j
PAID-DATE'
HVAC CHANGEOUT - SPLIT-SYSTEM PC
101-0000-42600
0
$36.26
$0.00
.^'' r•'s 4 .t ..�.
PAID BY a k�'
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,:RECEIPT #
€ CHECK #Y
hCLTD BY
Total Paid forCHANGEOUT: $108.78 $0.00
r<''DESCRIPTION;:*, z R•r
ACCOUNT,�� '
QTYrAMOUNT
�fr
PAIDt�PAID.'D�ATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Po•ei
AID MBY ` ,
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CHECK #
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Total Paid forPERMIT ISSUANCE: $91.85 $0.00
• • • •0
Description: PALMER RESIDENCE HVAC SPLIT SYSTEM CHANGE OUT
,
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 8/10/2015 PJU
Approved:
Parcel No: 777090041 Site Address: 80349 VIA MIRASOL LA QUINTA,CA 92253
Subdivision: TR 29894-2 AMEND NO.2 Block: Lot: 2
Issued:
Lot Scl Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $3,000.00. Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0.
Details: C CHANGE OUT CENTRAL SPLIT SYSTEM 13 SEERS TGAS [2013 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ON
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
Printed: Monday, August 10, 2015 10:46:15 AM 1 Of 2
- - R 'SYS7FHIS
PARENT PROJECTS
Printed: Monday, August 10, 2015 10:46:15 AM 2 of 2
SYSTEti1S
Bin #
P
City of La Q uin to
Building 81• Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
Building. Permit Application and Tracking Sheet
Permit #
Project Address:a •^
V I r Jd
Owner's Name:
A. P. Number:
Address: ^ .3 li v I A W/ I YL AJ(11
Legal Description:
City, ST, Zip:
91Z F
Contractor:
hone:�
Telephone: ............................................
Address: (
Project Description:Lj
City, ST, Zip: VU
-(A
A 14 1 W10._
over
Telephone:'
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
t
Address:
City., ST, Zip:
k,
Telephone:
XX
Con aneY
structi n Type: Occupancy:
:
State to Lic: #
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:.
D!
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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.picke'd up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2pd Review, ready forcorrections/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:-
'"' 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
r•
CERTIFICATE OF COMPLIANCE
CFiR-ALT-02-E
Alterations to Space Conditioning.Systems (formerly CF -1R -ALT -HVAC) _ (Page 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
This field or
This field or
Whole.house
furnace
component
section is not
section is not
AC
condensing'
SEER
13
Setback
section is not
section is not
altered
applicable
applicable
.
unit
applicable
applicable
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: 5 15%, 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 2 300 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 requireme ts.
E. Entirely New or Complete Replacement Duct System, with or without'Equ.lpment Chang
eout`(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)1C)
This section does not apply to this project.
Registration Number: 215-A0220908A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-08-10 09:58:25 HERS Provider: CaICERTS
Report Version: 2014-03-31 Report Generated: 2015-08-10 09:58:25
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: EPM/ Palmer Date Prepared: 2015-08-10
A. General Information
CF111-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
EPM/ Palmer
02
Date Prepared
2015-08-10
03
Project Location
80-349 Via Mirasol
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
EPM/ Palmer
07
Zip Code
92253
08
Dwelling Unit Conditioned
1600
Installing
Installing
Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system
Number of space conditioning
entirely new
09
Climate Zone
15
10
(SC) systems in this dwelling
.1
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information
03
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
Whole house
Location 1
1600
Yes
Yes
Yes
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-A0220908A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-08-10 09:58:25
Report Version: 2014-03-31
Schema Version: 0.555SDD
HERS Provider: CalCERTS
Report Generated: 2015-08-10 09:58:25
CERTIFICATE OF COMPLIANCE
CF11R-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
2015-08-10 09:58:25
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. I 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 designor 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
vi
4. The building design features or system design features identified on this Certifice atof Compliance are consistent with'the information provided ori -other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcementagency for;approval`wifh this building permit application.
5. 1 will ensure that a registered copy of this Certificate,bf Compliance shall be>made available with the building pe'imit(s) issued for thebuilding, and`made available'to the enforcement agency for all applicable
inspections. I understand that a registered copy of this"Ce'r'tificate of Comp(iance�is. required to be included with the•documentation the builder provides to.the,building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature:
Paredes, Herman
7TPJ?iffGR�lf/
Company:
Date Signed:
PALOMA AIR CONDITIONING
2015-08-10 09:58:25
Address:
License:
P 0 BOX 3501
619091
City/State/Zip:
Phone:
PALM DESERT CA 92261
(760) 347-1212
Digitally signed by Ca10ERTS. This digital signature is provided i&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-A0220908A-000000000-0000 Registration Date/Time: 2015-08-10 09:58:25 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-08-10 09:58:25
Schema Version: 0.555SDD