BMCH2018-0401e+�w 44µrw
78-495 CALLE TAMPICO
VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253
FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/24/2018
Permit Type/Subtype:
MECHANICAL/
Owner:
Application Number:
BMCH2O18-0401
JAMES DECASTRO
y
Property Address:
48010 PASO TIEMPO LN
695 SHERIDAN RD
Z
APN:
646350010
WINNETKA, IL 92253
Application Description:
DE CASTRO / (1)16SEER/80AFUE SPLIT SYSTEM
Property Zoning:
m
Application Valuation:
$8,000.00
Q O
T
b
Applicant:
Contractor:
.�
c
TOM BACHUS
ADAM SIMMONS DBA SIMMCF i# COMITIONIN
77825 DELAWARE PL
P 0 BOX 314
00
PALM DESERT, CA 92211
LA QUINTA, CA 92247
(760)863-5254
�
Llc. No.: 780534
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.: 780534
Date: a 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. 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 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:
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.
eill 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: STATE COMPENSATION INSURANCE FUND Policy Number: 9054788
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 th se provisions.
Date 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 -men lone property for inspection purposes.
Date: I Signature (Applicant or Agent .
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:-
TOM_BACHUS
77825 DELAWARE PL'-6
PALM DESERT, CA 92#1
BMCH2018-0401
48010 PASO TIEMPO LN
646350010
DE CASTRO / (1)16SEER/80AFUE SPLIT SYSTEM
$8,000.00
Date: 9/24/2018
Owner:
JAMES DECASTRO
695 SHERIDAN RD
WINNETKA, IL 92253
Contractor:
ADAM SIMMONS DBA SIMMONS AIR CONDITIONIN
P 0 BOX 314
LA QUINTA, CA 92247
(760)863-5254
LIc. No.: 780534
-------------- ------------------------------------------------------------------------------
Detail: HVAC CHANGE QUT-16SEER/80AFUE SPLIT SYSTEM [2016 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
?016-CALIFORNIA BUILDING CODES.
t
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
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$78.02
Total Paid for CHANGEOUT: $117.03
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$98.83
Total Paid for PERMIT ISSUANCE: $98.83
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS:
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVAC)
Project Name:
48010 Paseo Tiempo Ln j Date Prepared:
CFIR-ALT-02-E
(Page 1 of 3)
2018-09-24
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
48010 Paseo Tiempo Ln
02
Date Prepared
2018-09-24
03
Project Location
48010 Paseo Tiempo Ln
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
48010 Paseo Tiempo Ln
Dwelling Unit Conditioned
07
Zip Code
�J2253
08s
Floor Area (ft2)
2000
Number of Space
09
Climate Zone
15
10
Conditioning (SC) Systems in
this Dwelling Unit:
B. Space Conditioning (SC) System Information
O1
02
03
04
05
06
07
08
09
10
Is the SC
Installing a
SC System
SC System
CIA 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
Whole House
2000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
J C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
Registration Number: 218-A020265163A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2018-09-24 08:45:54
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version,: 2018-0.001 Report Generated: 2018-09-24 08ASA8
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE
CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-1R-ALT-HVAC) (Page 2 of 3) I
D. Altered Space Conditioning System (Sections 150.2(b)lE 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
All new
Central split
All new
Less than or
System 1
f urnace
heating
AFUE
80
AC
cooling
SEER
16
Setback
equal to 40
R-8
components
components
feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems
- Duct insulation requirement for the newPortions o` supply -air and returr-air ducts or p!e.n.ums: R6 (CZ 1-10, 12 and 13) and R8 (CZ 11 and 14-16)
CF2R an,: CF3R-V.CH-2C-.. - D-;c, Leakage Test req red when hezt.ng a ccci.ng c mpcnen`s are :nstzl'ec ....,,.cted systems, • when _, re tcan 4C It o` c,,, , :en ' - �" Is rep�.zcep
-Leakage rate compliance: <= 15 percent or <= 10 percent ieakage to outside, or sea! al accessible leaks.
CF2R and MR-UCH-25-H Refrigerant Charge ver:ficzticr required when. ref-igerant ,....tam. ng components are !nstaiieq cr a:tered (app: cat ).
=2R and C�3R-MC -23 Airflow Rate >= 300 CFM cer ton eo: red when MCr.-25 s req red.
Exceptions:
Duct systems registered with HERS provider as Previously sealed are exempt from MCA:-20 Duct Leakage Testing requirements.
r.eat:ng-cn:y systems anal A:r Hznd:er F ,_.ace c7.arges do ac+. re:,u:re ver:` catior. o` A:r F.ow VCH-23, or Refr:gerar' C. arge MCr.-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)1C) i
Registration Number: 218-A020265163A-000-000-0000000-0000
s se_*.ordoes nct aocfv ec'
Registration Date/Time: 2018-09-24 08:45:54
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2018-09-24 08:45:48
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVAC)
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate and complete
Documentation Author Name:
Documentation Author Sig: a*u
.�}
Company:
Signature Date:
ADAM SIMMONS
2018-09-24 08:45:54
Address:
CEA/'r'ERS Certification Identification (if applicable):
54440 AVENIDA CARRANZA
City/State/Zip:
Phone:
LA QUINTA CA 92253
760-564-7525
Respofisible Person's Declaration statement c
ce lily the fcllowing under penaity of perjury, under the laws of the State of California!
CF1R-ALT-02-E
(Page 3 of 3)
.n c--mat:on provided on t.^.is Ce.—ica:e of Compl:ance ls'r;e and correct.
2.. I am eig!bie 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).
1 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
re.rnents of Tit:e 24, Part ; and Part 6 of -e Ca!i`orn a Code of Reg 'aLons.
4 The bu`!ding design features or system design `eatures identified on this Ce—Ficafe of Compliance are consistent witlrm.ation provided on other applicable compliance documents, worksheets,
calcuiatlons, plans and specifications submitted to the enforcement agency for approval with this building permit applicatim.
5. w' e-su-e teat a -egste-eo copy o`-is Ce,—:cate of CompPa-�ce s^all De nape aval'ab!e with the ouilciing pe-ma(s) :ssued `o� the bu?'ding, and made avai!aoie to the enforceme age-cy `.o- a'' app'icab e
lnspections. ! understand that a registered copy of this Certificate of Co no!iarce is required to be included with the documentation the builder provides to the building owner at occupancy,
Responsible Designer Name:
Simmons, Donna
Company:
ADAM SIMMONS
Address:
54440 AVENIDA CARRANZA
City/State/Zip:
LA QUINTA CA 92253
Responsible Designer Signature:
Date Signed:
2018-09-24 08:45:54
License:
780534
Phone:
760-564-7525
Digitally signed by CaICERTS. This dtal Signature is provided in order to secure the content of this registered document, and in no way implies
Wgistratron Provider responsibility for the accuracy of the information.
Registration Number: 218-A020265163A-000-000-0000000-0000 Registration Dale/Time: 2018-09-24 08:45:54
Easy to Verify 2]yrJ� [j]
at CaICERTS.com
U.
Y
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.002
Schema Version: rev 20180426
Report Generated: 2018-09-24 08:45:48
ter Qaiwta
-GEM fd-DESERT
PERMIT #
PLAN LOCATION:
Project Address: Vsolp 1 e,4-4P0 Lill
-Project
'•Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
Applicant Name:
Address: j �� e. L
City, ST, Zip: « �2Z//
Telephone: '7& o
Email: /i _ j�,�^ �r ��
Valuation of Project $
Contractor Name: j 7 �'
New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip
Garage SF
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: 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: ' v
New Commercial / Tenant Improvements:
Address: ZI&10 �� '
Total Building SF
City, ST, Zip L e' L/ I ���
j Construction Type: Occupancy:
Telephone: ' 7 r
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000