BMCH2018-0042.7.8-495CAUE. TAMP.ICO
LA CIUINTA; LAt1FORNIA'92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
PALOMA AIR CONDITIONING
83019 AVENUE 45
INDIO, CA 92201
MECHANICAL/
BMCH2O18-0042
48905 WASHINGTON ST ST
646150011
HUSS / HVAC CHANGEOUT - 165EER/81 AFUE SPLIT SYSTEM
$6,000.00
FEB 2 12018
CITY OF Ut QUINTA
COMMUNITY DEVELOPMENT DEPART61ENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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
s� ,J
Date: Contractor: i
T�zz �c C. ►-► w s (►
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).:
(_J 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.).
(1 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 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
VOICE (760) 777-7125
.FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/21/2018
Owner:
JUDY HUSS
48905 WASHINGTON ST
LA QUINTA, CA 92253
Contractor:
PALOMA AIR CONDITIONING
83019 AVENUE 45
INDIO, CA 92201
(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
ofithe ,,work for which this permit is issued.
F-�.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 polity number are:
Carrier: INSURANCE COMPANY OF THE WEST Polity Number: WSD5026841
_ 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: 0-L_-7_i—)R Applicant: 4 6+6" � L
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 actor 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
comenced within 180 days from date of issuance of such permit, or cessation of work .
for 1 0 days will subject permit to cancellation.
I certify'that I have read this application and state that the above information is correct.
1 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 inspection purposes.
Date: f1�Z 2 f" 1 Signature (Applicant or Agent): V?,
Date: 2/21/2018
Application Number:.. .,,BMCH2O18-0042
Owner:
PropertYAddress- "' X8905 WASHINGTON STST.
JUDY HUSS
APN: 646150011
48905 WASHINGTON ST
Application Description: HUSS / HVAC CHANGEOUT - 16SEER/81 AFUE SPLIT SYSTEM
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $6,000.00
Applicant:
Contractor:
PALOMA AIR CONDITIONING
PALOMA AIR CONDITIONING
83019 AVENUE 45'
83019 AVENUE 45
INDIO, CA 92201
INDIO, CA 92201
(760)347-1212
Llc. No.: 619091.
Detail: HVAC CHANGE OUT - 16SEER/81AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
r;r;DESCRIPTION. ACCOUNT • QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$39.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000742600
0
$78.02
Total Paid for CHANGEOUT: $117.03
DESCRIPTION
ACCOUNT
QTY
AMOUNT
Credit Card Fee
101-0000-43505
0
$4.17
Total Paid for Credit Card Fee: $4.17
DESCRIPTION
ACCOUNT
QTY'
AMOUNT
PERMIT ISSUANCE
101-0000-42404
.0
$98.83
Total Paid for PERMIT ISSUANCE: $98.83
DESCRIPTION
ACCOUNT
QTY
AMOUNT •
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: S10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
............
PERMIT #
Address:
PLAN LOCATION:
S
1�3Project Address: _ ��� IU�aS�t �
Project Description: Pool, Remodel, Add't, Elect, Plum ech
APN #:
C L
C� J t A C
6 O
t
S-' e_, :.
Applicant Name: ou,�.`. A/C
Address: O A
City, ST, Zip: CA
City Bus Lic:
Telephone: -} 6 d 3 4T- 1 2 -17
Email:
Valuation of Project $
L
6000
Contractor Name: low G
New SFD Construction:
Address:
g3 _ 1 cA
S
Conditioned Space SF
City, St, Zip
(. w L Ot ZZ.3
Garage SF
Telephone:
6 O
`
Patio/Porch SF
Email:.
Fire Sprinklers SF
State Lic:
f�On�
City Bus Lic:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
��(�'�
Telephone:
Bedrooms:
Stories:
# Units:
Email:
`
State Lic: City`Bus Lic:
Property Owner's .Name:
J J d
{—�J S S
New Commercial / Tenant Improvements:
Address: 9 �� S
��(�'�
s
Total Building SF
City, ST, Zip (� v��.
C_4 OL22,5
Construction Type: Occupancy:
:
F
78495 CALLE TAMPICO ,
LA QUINTA, CA 92253
760-777-7000
#
Submittal
Req'd
:Rec'd
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM 10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval \
School Fees
Burrtec Debris Plan
J
Planning approval
Public Works approval
Fire approval
City Business License
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 1 of 7)
Project Name: 48905 Washington St.
Enforcement Agency: City of La Quinta
Permit Number:
Dwelling Address: 48905 Washington St.
City: La Quinta
Zip Code: 92253
A. General Information
01
Dwelling Unit Name
48905 Washington St.
02
Climate Zone
15
07
Dwelling Unit Total Conditioned Floor
09
30
Number of Space Conditioning
03
Area (ft)
Installing a
04
Systems
Systems in this Dwelling Unit.
1
05
Certificate of Compliance Type
. Prescriptive alterations (CFiR-ALT)
06
Method Used to Calculate HVAC Loads
NotApplicableEquipmentChangeout
07
Calculated Dwelling Unit Sensible
aThis field or section is not applicable
08
Calculated Dwelling Unit Heating Load
This field or section is not applicable
Identification or
Cooling Load (Btu/h) _ �
, 5
ducted
(Btu/h)
system
09
Dwelling Unit Number of Bedrooms
2
Name
Served
(ftZ)
system?
component?
components?
duds?
system?
MCH -01b - Space Conditioning Systems,Ducts and Fans Prescriptive Alterations If .
(C
B. Space Conditioning (SC) System"Information < .
01
02
03
04
05
06
07
08
09
30
CFA served
Is the SC
Installing a
Installing
SC System
SC System
by this SC
system a
refrigerant
Installing new SC
Installing more
entirely
Installing
Identification or
Location or Area
System
ducted
containing
system
than 40 feet of
new duct
entirely new
Name
Served
(ftZ)
system?
component?
components?
duds?
system?
SC system?
Alteration Type
Altered space
System 1
Location 1
1368
Yes
Yes
Yes
No
No
No
conditioning
system
Registration Number: 218-A020044086A-000-001-MO1001A-0000
Registration Date/Time: 2018-02-12 12:18:53
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2018-02-12 12:16:15
Schema Version: rev 4/7/2017
A
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 2 of 7)
C. Space Conditioning (SC) System Alterations Compliance Information
01
02
03
04
05
06
07
08
09
10
11
12
13
He Ling U it
Model Number
Heati g Unit Serial
Number
Rated Heating Capacity,
Output (Btu/h)
System 1
AFUE
81
GOODMAN
GME80805DXAA
1710358467
64000
Notes:
Central Fan
Integrated
Heating
Cooling
New or
(CFI)
SC
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
Replaced
New
Ventilation
Identification
Heating
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Dud
Dud
System
or Name
System Type
Component
Type
Value
System Type
Component
Type
Value
Type
Length
R -Value
Status
This
field
All new
All new
N/A - no
or
Central gas
heating
Central
sectio
Not a CFI
System 1
furnace
componen .
; j AFUE
81
split AC
cooling
SEER
16
Setback
ducts
n is
system
is '
` `.
t
components
replaced
not
applic
able
.. .,n
r
; f•
D. Installed Heating Equipment Information'
,+ "- 0
11 (C.,
01
02 �`*,�0'
03 - - , .
._ 04
05 � m .R
m. ... 06
07
SC Identification or Name
Heating Efficiency Type
Heating,Effic envy
Value
Heating!U it
Manufacturer
He Ling U it
Model Number
Heati g Unit Serial
Number
Rated Heating Capacity,
Output (Btu/h)
System 1
AFUE
81
GOODMAN
GME80805DXAA
1710358467
64000
Notes:
Registration Number: 218-A020044086A-000-001-MO1001A-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2018-02-12 12:18:53
Report Version: 2016.1.006
Schema Version: rev 4/7/2017
HERS Provider: CalCERTS
Report Generated: 2018-02-12 12:16:15
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 3 of 7)
E. Installed Cooling Equipment Information
01
02
03
04
05
06
07
08
Condenser or Package Unit
SC Identification or
Name
Cooling Efficiency
Type
Cooling Efficiency
Value
Condenser or
Package Unit
Manufacturer
Condenser or
Package Unit
Model Number
Condenser or
Package Unit
Serial Number
System Rated Cooling
Capacity at Design
Conditions (Btu/h)
Condenser Rated
Nominal Capacity
(ton)
System 1
SEER
16
GOODMAN
GSX160481FF
1702009615
48000
4
Notes:
F. Extension of Existing Duct System, GreaterThan 40 Feet
:__�::' __ , `� This sectiondoes not apply to this project.
G. Installed Duct System information,; '4„2x�
frU 'U. \t=:� 0
This section does not apply -to this project.
it aE *— t 't 2 aIt �s � � � •
H. Installed Air Filter Device Information
This section does not apply to this project.
I. Air Filter Device Requirements
This section does not apply to this project.
Registration Number: 218-A020044086A-000-001-MO1001A-0000 Registration Date/Time: 2018-02-12 12:18:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2018-02-12 12:16:15
Schema Version: rev 4/7/2017
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 4 of 7)
J. HERS Verification Requirements
01
02
03
04
05
06
07
08
09
10
Exemption
MCH -20
from
MCH -23
Minimum
MCH -22
MCH -25
Exemption
R -Value for
MCH -21
AHU
MCH -28
SC System
SC System
From Duct
Duct
Ducts In
AHU Fan
Airflow
Identification or
Location or Area
Leakage
Leakage
Conditioned
Dud Location
Efficacy
Rate
Refrigerant
Return Duct Design
Name
Served
Requirements
Test
Space
Verification
(W/dm)
(dm/ton)
Charge
- Table 150.0-13 or C
Altered duct
system has
(less than 40 ft
Not
System 1
Location 1
i
of duct in
No
applicable
No
No
Yes
Yes
No
_
;unconditioned
__
__....
spaces
Notes:
14z�:O- L-= n. U, fl D U �W'6
R
Registration Number: 218-A020044086A-000-001-MO1001A-0000 Registration Date/Time: 2018-02-12 12:18:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2018-02-12 12:16:15
Schema Version: rev 4/7/2017
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Duds, and Fans (Page 5 of 7)
K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the
system that are altered. Existing equipment may be exempt from these requirements.
Heating Equipment
01
Equipment Efficiency: All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency
Regulations.
02
Controls: All unitary heating systems, including heat pumps, must be controlled by a setback thermostat. These thermostats must be capable of allowing the occupant
to program the temperature set points for at least four different periods in 24 hours. See Sections 150.0(i), 110.2(b).
Sizing: Heating load calculations must be done on portions of the building served by new heating systems to prevent inadvertent undersizing or oversizing. See sections
03
150.0(h)1 and 2).
04
r
Furnace Temperature Rise: Central forced -air, heating furnace installations must be configured to operate at or below the furnace manufacturer's maximum
inlet -to -outlet temperature rise pecification.See`Section 150.0(h)4. W.,....
05 1 Standby Losses and Pilot Lights: Fan type central furnaces -11
may not have, a contmuously�burnipilotjVight:�5ection 110 5iand Section 110.2(d).
aid 1 f I 1 f.... € > I1L_ J.r` '
-
Cooling EquipmentAx 11%,-, I if
- . ; f
06
Equipment Efficiency: All cooli�g'equipment must eet thesminimum efficiency iequirements of Section 110.1fa d Section 110t2(a) and the Appliance Efficiency
� " > � f' " L A.
Regulations. ,
07
Refrigerant Line Insulation: All refrigerant line insulation in split system air conditioners and heat pumps must meet the R -value and protection requirements of Section
150.0(j)2 and 3, and Section 150.0(m)9.
08
Condensing Unit Location: Condensing units shall not be placed within five (5) feet of a dryer vent outlet. See Section 150.0(h)3A.
09
Liquid Line Filter Drier: If applicable, a liquid line filter drier shall be installed according to the manufacturer's specifications. Section 150.0(h)3B
10
Sizing: Cooling load calculations must be done on portions of the building served by new cooling systems to prevent inadvertent undersizing or oversizing. See Section
150.0(h)1 and 2.
Air Distribution System Ducts, Plenums and Fans
Registration Number: 218-AO20044086A-000-001-MO3003A-0000
Registration Date/Time: 2018-02-12 12:18:53
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2018-02-12 12:16:15
Schema Version: rev 4/7/2017
CERTIFICATE OF INSTALLATION CF211-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 6 of 7)
K. Space Conditioning Systems, Duds and Fans Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the
system that are altered. Existing equipment may be exempt from these requirements.
11
Insulation: In all cases, unless ducts are enclosed entirely in directly conditioned space, the minimum duct insulation value is R-6. Note that higher values may be
required by the prescriptive or performance requirements. See Section 150.0(m)1.
Connections and Closures: All installed air -distribution system ducts and plenums must be, sealed and insulated to meet the requirements of CMC Sections 601.0,
12
602.0, 603.0, 604.0, 605.0 and ANSI/SMACNA-006-2006: Supply -air and return -air ducts and plenums must be insulated to a minimum installed level of R-6.0 or
enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing in accordance with the requirements of Reference
Residential Appendix RA3.1.4.3.8.
Heat Pump Thermostat�rk
13
A thermostat shall be installed that meets the requirements of Section 110.2(b) and Section 110.2(c).
14
The thermostat shall be installed -in accordance with`the manufacturers published installation specifications
15
First stage of heating shall be assigned to heat pump heating.
. �"5a , I
16
' b' `.I'---- 4
Second stage backup heating shall be`set:xo corne on only when the in Opo set temperature cannot be met.
The responsible person's signature on this compliance document a mis tthat=all ap"plicable requirements�in this"Statile have—Woen met.
1i X" 'if -A ii
Registration Number: 218-A020044086A-000-001-MO1001A-0000 Registration Date/Time: 2018-02-12 12:18:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2018-02-12 12:16:15
Schema Version: rev 4/7/2017
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 7 of 7)
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
-�
Documentation Author Signature: 7��i�GRJff/
Herman Paredes
Company:
Signature Date:
PALOMA AIR CONDITIONING
2018-02-12 12:18:53
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 Installation. is true and correct.
2. 1 am either: a) a responsible person=eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of
features, materials, components or manufactured devices..for thewscope of work identified on this Certificate of Installation, and attest to the declarations in this statement, or b) I am an authorized
representative of the responsible person and attest _to:the declara � s inthis statement�,t e' `resp Ae rn-sible pe � o ?"s-behal f
3. The constructed or installed features, materials, components or manufactured -devices (the;mstallation).identified o <this Certificate.of Installation, co m to ai applicable codes and regulations and the
installation conforms to the requirements given ori theCertificate�of Complian eplaris; a tl specificationspproved5by the enforc ment agency. f
� ? t k%, t0 t 1e 1v .f q� } s .._
4. I will ensure that a registered copy of this Certifica-t�e:of�l�n �allation shalbbe-po�sted�or'made-ava, �lableth�the; btuildi.ng per�mrt(s) fsed for�the bu�ltlmg, and made�av�aila�ble to the enforcement agency for all
applicable inspections. I understand that a registered.copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
HERS PR%CfV*1,DER
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Herman Paredes
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Position With Company (Title):
PALOMA AIR CONDITIONING
OWNER
Address:
CSLB License:
P 0 BOX 3501
619091
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92261 1760-347-1212
12018-02-12 12:18:53
Digitally signed by Ca10ERTS. 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: 218-A020044086A-000-001-MO1001A-0000 Registration Date/Time: 2018-02-12 12:18:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2018-02-12 12:16:15
Schema Version: rev 4/7/2017