BMCH2019-027978-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: MECHANICAL/
Application Number:
BMCH2O19-0279
Property Address:
54804 SHOAL CREEK
APN:
775141070
Application Description:
SCHENK / HVAC CHANGE OUT 15SEER/ 80AFUE SPLIT
Property Zoning:
Application Valuation:
$7,000.00
Applicant: D
! `�" �0PALOMA AIR CONDITIONING �-� ��
83019 AVENUE 45
INDIO, CA 92201 JUL 12 2019
CITY 4F LA QUINTA 0
DESIGN & 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 70001 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. ' 1 -7 Corftractor:
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 fie 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.).
(_) 1, 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/24/2019
Owner:
A&D SCHENK HOLDING LTD
54804 SHOAL CREEK
LA QUINTA, CA 92253
Contractor:
PALOMA AIR CONDITIONING
83019 AVENUE 45
INDIO, CA 92201
(760)347-1212
Llc. No.: 619091
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one ofthe following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
:ompensation, as provided for by Section 3700 of the Labor Code, for the performance
)f the work for which this permit is issued.
aye and will maintain workers' compensation insurance, as required by
>ection 3700 of the Labor Code, for the performance of the work for which this permit is
ssued. My workers' compensation insurance carrier and policy number are:
:arrier: INSURANCE COMPANY OF THE WEST Policy Number: WSD502684105
I certify that in the performance of the work for which this permit is issued, I
;hall not employ any person in any manner so as to become subject to the workers'
:ompensation laws of California, and agree that, if I should become subject to the
Yorkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
:omply with those provisions.
)ate: / — r ,7 _/ -Applicant
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL,
IND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
)NE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
.OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
NTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
MPORTANT: Application is hereby made to the Building Official for a permit subject to
he conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
equest and for whose benefit work is performed under or pursuant to any permit issued
is a result of this application , the owner, and the applicant, each agrees to, and shall
Iefend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
amployees for any act or omission related to the work being performed under or
ollowing issuance ofthis permit.
2. Any permit issued as a result of this application becomes null and void if work is not
ommenced within 180 days from date of issuance of such permit, or cessation of work
or 180 days will subject permit to cancellation.
certify that I have read this application and state that the above information is correct.
agree to comply with all city and county ordinances and state laws relating to building
:onstruction, and hereby authorize representatives of this city to enter upon the above-
nentioned property for inspe on purposes.
)ate: 77 Signature - (Applicant or Agent):
Date:' - 7/242019
Application Number:
BMCH2O19-0279
Owner:
Property Address:
54804 SHOAL CREEK
A&D SCHENK HOLDING LTD
APN:
775141070
54804 SHOAL CREEK
Application Description.
SCHENK / HVAC CHANGE OUT 15SEER/ 80AFUE SPLIT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$7,000.00
Applicant:
Contractor:
PALOMA AIR CONDITIONING
PALOMA AIR CONDITIONING
83019 AVENUE 45
83019 AVENUE 45
INDIO, CA 92201
INDIO, CA 92201
(760)347-1212
I Llc. No.: 619091
i �. 1
Detail: HVAC CHANGE OUT - 15SEER/80AFUE SPLIT M. CARSON!MONOXIDR(AI ARIVI(S� T4 BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$40.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$80.05
Total Paid for CHANGEOUT: $3,20.07
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.40
Total Paid for PERMIT ISSUANCE: $101.40
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
PERMIT # ("'LC qCAI IFORM
PLAN LOCATION:
Project Address: 1, II;'Ql/ 6lied lliject Description: lu 10
APN #: fA u 114- C G
16 Itpyll 15(61014/L
Address: t l
City, ST, ZiP: ( LJ
Telephone: q ff Z Ykv `Z
Email: Valuation of Project
Ir
4144
• P� rep � P, New SFD Construction:
Address: e-�, oil d cq q�— Conditioned Space SF
City, St, Zip j�,r,�j�\ �, Garage SF
Telephone: 7 Patio/Porch _ SF
Email: Fire Sprinklers SF
State Lic: 6 d _/1 City Bus Lic:
/6495 C:ALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
# Submittal Required Received
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
CERTIFICATE OF COMPLIANCE
CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVAC)
(Page 1 of 3)
Project Name: �� Z Z
Alfred Schenk Date Prepared:
2019-07-12
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
CF111-ALT-02 document for each dwelling unit.
01 Project Name Alfred Schenk
02 Date Prepared 2019-07-12
03 Project Location 54804 shoal creek
04 Building Type Single family
05 CA City La Quinta
06 Dwelling Unit Name Alfred Schenk
07 Zip Code 92253
Dwelling Unit Conditioned
08 1500
Floor Area (ft)
Number of Space
09 Climate Zone 15
10 Conditioning (SC) Systems in 1
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 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 (ft) system? component?
components? feet of ducts? duct system? SC system?
Alteration Type
System 1 Location 1 1500 Yes Yes
Yes No No No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
Registration Number: 219-A020156208A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2019-07-12 10:24:04
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-07-12 10:23:59
Schema Version: rev 20180426
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)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 as All new All new
System 1 g heating AFUE 80 CentralAsplit
furnace Cooling SEER 15 Setback
Less than or
equal to 40 R-8
C
components components
feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6 (CZ 1-10, 12 and 13) and R8 (CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H - Duct Leakage Test 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 percent or <= 10 percent leakage to outside, or seal all accessible leaks.
CF2R and CF311-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2R and CF311-MCH-23 Airflow Rate >= 300 CFM per 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 fJ Air Flow MCH-23, or Refrigerant Charge MCH-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)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
Registration Number: 219-A020156208A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2019-07-12 10:24:04
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-07-12 10:23:59
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:
Paredes, Herman
Company:
PALOMA AIR CONDITIONING
Address:
83019 ave 45
City/State/Zip:
Indio CA 92201
Responsible Person's Declaration statement
Documentation Author Signature:
Signature Date:
2019-07-12 10:24:04
CEA/ HERS Certification Identification (if applicable):
Phone:
760-347-1212
CFIR-ALT-02-E
(Page 3 of 3)
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 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.
5. 1 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:
Paredes, Herman
Company:
PALOMA AIR CONDITIONING
Address:
83019 ave 45
City/State/Zip:
Indio CA 92201
Responsible Designer Signature
Date Signed:
2019-07-12 10:24:04
License:
619091
Phone:
760-347-1212
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of Phis registered document, and in noway implies
Registration Provider responsibility for the accuracy of the information.
Registration Number: 219-A020156208A-000-000-0000000-0000 Registration Date/Time: 2019-07-12 10:24:04
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001
Schema Version: rev 20180426
Easy to Verify 0 ❑�
at CaICERTS.com
M
HERS Provider: CaICERTS
Report Generated: 2019-07-12 10:23:59
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