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BMCH2016-004878-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BMCH2O16-0048 Property Address: 78321 W DEACON DR APN: 770210029 Application Description: CLIFF/ HVAC CHANGE OUT Property Zoning: Application Valuation: $4,000.00 Applicant: PALOMA AIR CONDITIONING 83019 AVENUE 45 INDIO, CA 92201 56 D VOICE (760) 777-7125 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 3/10/2016. Owner: CLIFTON WARREN 2309 PCH NO 201 HERMOSA BEACIt—EA 92263 _ 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. Date: • — o Contractor: D 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 ) 1, 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.). U 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 Name: Lender's Add rJ Z_11� U Contractor: 1,';`q;� 10 L�Uiu PALOMA AIR CO DI iNG--- -= 83019 AVENUE CITV0FLAQUINTA 83019 V 9220 NUE �OIAMUNITYpE1 f7iEIPART;iFENT INDIO, (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. , l nave 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: _ Polity 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. Date: N 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 co my ordinances and state laws relating to building construction, and hereby autho�izeresentatives of this city to enter upon the above-mentioned pro 6y�fo ihsp ion purposes. Date: 5 (J Signature (Applicant or Agen • FINANCIAL •• • DESCRIPTION 'ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 3/10/16 PAID BY " METHOD ' RECEIPT # CHECK # CLTD BY :. PALOMA AIR CONDITIONING CHECK R13772 0025523 RSE Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 . $1.00 • DESCRIPTION ACCOUNT, QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - CONDENSER ONLY 101-0000-42402 0 $36.26 $36.26 3/10/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY PALOMA AIR CONDITIONING CHECK R13772 0025523 RSE DESCRIPTION ACCOUNT QTY . AMOUNT PAID PAID DATE HVAC CHANGEOUT - CONDENSER ONLY PC 101-0000-42600 0 $24.17 $24.17 3/10/16 PAID BY METHOD RECEIPT•# CHECK # CLTD BY PALOMA AIR CONDITIONING CHECK R13772 0025523 RSE DESCRIPTION. ACCOUNT. QTY AMOUNT PAID PAID.DATE HVAC CHANGEOUT - OTHER EQUIPMENT 101-0000-42402 0 $36.26 $36.26 3/10/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY PALOMA AIR CONDITIONING CHECK R13772 0025523 RSE DESCRIPTION ACCOUNT' _ QTY . AMOUNT PAID . PAID DATE HVAC CHANGEOUT - OTHER EQUIPMENT PC 101-0000-42600 0. $36.26 $36.26 3/10/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY PALOMA AIR CONDITIONING CHECK R13772 0025523 RSE Total Paid for CHANGEOUT: $132.95 $132.95 DESCRIPTION ACCOUNT QTY, AMOUNT PAID PAID DATBA PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 3/10/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY PALOMA AIR CONDITIONING CHECK R13772 0025523 RSE Total Paid for PERMIT ISSUANCE: $91.85' $91.85 TOTALS::0 $225.80 Description: CLIFF/ HVAC CHANGE OUT Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 3/10/2016 RSE 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 Scl Ft: 0 Zoning: Finaled: Valuation: $4,000.00 Occupancy Type: Construction.Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 NAME Details: HVAC CHANGE OUT-15.OSEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. DD •%, CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI' CITY STATE ZIP PHONE FAX EMAIL APPLICANT PALOMA AIR CONDITIONING 83019 AVENUE 45 INDIO CA 92201 CONTRACTOR PALOMA AIR CONDITIONING 83019 AVENUE 45 INDIO CA .92201 OWNER CLIFTON WARREN 2309 PCH NO 201 HERMOSA BEACH CA 92253 FINANCIAL INFORMATION Printed: Thursday, March 10, 2016 11:38:19 AM 1 of 2 SYSTEMS' Printed: Thursday, March 10, 2016 11:38:19 AM 2 of 2 NAAF SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 3/10/16 R13772 0025523 CHECK PALOMA AIR RSE CONDITIONING Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: HVAC - 101-0000-42402 .0 $36.26 $36.26 3/10/16 R13772 0025523 CHECK PALOMA AIR RSE CONDENSERENSER ONLY CONDITIONING HVAC CHANGEOUT - 101-0000-42600 0 $24.17 $24.17 3/10/16 R13772 0025523 CHECK ?ALOMA AIR RSE CONDENSER ONLY PC CONDITIONING HVAC CHANGEOUT - 101-0000-42402 0 $36.26 $36.26 3/10/16 R13772 0025523 CHECK PALOMA AIR RSE OTHER EQUIPMENT CONDITIONING HVAC CUT - 101-0000-42600 0 $36.26 $36.26 3/10/16 R13772 0025523 CHECK PALOMA AIR RSE OTHEREQUIPMEQUIPMENT PC CONDITIONING Total Paid for CHANGEOUT: $132.95 $132.95 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 3/10/16 R13772 0025523 CHECK PALOMA AIR RSE CONDITIONING Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS::i $225.80 Printed: Thursday, March 10, 2016 11:38:19 AM 2 of 2 NAAF SYSTEMS Bin # City of La Quinta Building 8i Safety Division Calle Tampico L) 253 - 777-7012 C Building Permit Application6and Tracking Sheet Permit #78-495 Project Address: / • Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: OL 6 G r� A rao r: Cont ct W\ O 1 C telephone: ne• ele ho Address: -- © V4 � Project Description: City, ST, Zip: Telephone: /�'� (Q�-/ n,//� v1 State Lic. # : q City Lic. #: �— Arch., Engr., Designer: ©` Address; City, ST, Zip: Telephone: ................................................ cY: Construction Type: Occupancy: State �circle e)•N w Add'n A1ter RePair Demo Name of Contact Person: Sq. Ft.: # Storie . # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE N 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 I Construction Flood plain plan Plans resubmitted. Mechanical Grading plan 2nd Review, ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. li.O.A. Approval Plans resubmitted Grading IN ROUSE:- '"! Reyiew, 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 l� L CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) CF1R-ALT-02-E (Page 1 of 3 ) I Project Name: Cliff Warren ( Date Prepared: 2016-03-10 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 Cliff Warren 02 Date Prepared 2016-03-10 03 Project Location 78-321 Deacon 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 1000 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? .' duct system? unit. Alteration Type B. Space Conditioning (SC) System Information 01 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 System 1 Location 1 1000 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)Mib) This section does not apply to this project. Registration Number: 216-A0093222A-000000000-0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: 2016-03-10 09:53:06 Report Version: 2013 Rev 1.007 Schema Version: 0.555SDD HERS Provider: CalCERTS Report Generated: 2016-03-10 09:53:11 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 150.2(b)1E and F) O1 02 03 04 05 06 07 08 09 10 it 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 All new Less than or System 1 furnace component section is not section is not AC cooling SEER 13 Setback equal to 40 R-8 altered applicable applicable components feet Reouired 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: <_ 15%, or:5 10% leakage to outside, or seal all accessible leaks. CF2R-MCH-25-H & MR -MCH -25-19 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. 4 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)iDiia and 150.2(b)1E; 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: 216-A0093222A-000000000-0000 Registration Date/Time: 2016-03-10 09:53:06 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-10 09:53:11 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -1R -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 7(/ Company: Signature Date: PALOMA AIR CONDITIONING 2016-03-10 09:53:06 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 Bn 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 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 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 builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: 7�r� " L Paredes, Herman Company: Date Signed: PALOMA AIR CONDITIONING 2016-03-10 09:53:06 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: 216-A0093222A-000000000-0000 Registration Date/Time: 2016-03-10 09:53:06 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-10 09:53:11 Schema Version: 0.S555DD