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06-3813 (MECH)•�Y P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06-00003813 Property Address: —5.5-67976AK=H-IEL APN: 775-231-021- - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4600 11 !> Applicant:: Architect or. Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: WORKER'S COMPENSATION, DECLARATION M/M RALPH OZORKIEW-' 55679 OAK HILL I n n LA QUINTA, CA 922J _ I have and,will maintain a certificate of consenYto self -insure for, workers' compensation, as provided License Class: _C20 - - License No.: 3.74937 OCT 2 5 2.006 for by Section 3700 of the Lab or.Code,,for the performance of thework for which this permit is A Dater Contractor: � �� - Contractor: issued " I'have and will, maintain workers' compensation insurance, as requiretl by Section 3700 of the Labor ' PALM DESERT AIR �ONDIR' �4 QUINYA 42081 BEACON HILL - OWNER -BUILDER. DECLARATION PALM DESERT, CA 92211 insurance carrier and policy number are: (760)346-0677 Lic. No.:.374931 following reason Mac. 7031.5, Business and,ProfessionSCode: 'Any. city or county that requires a permit to Date: 10/25/06 LICENSED CONTRACTOR'S DECLARATION ... a i a act WORKER'S COMPENSATION, DECLARATION I hereby affirmunderpenalty of perjury that I am licensed under provisions ofChapter9�(commencing;with I hereby affirm under penalty of perjury one of the following declarations: " - Section 7000) of Division 3 of the Business and Professionals Code, and'my License is in full force and effect. _ I have and,will maintain a certificate of consenYto self -insure for, workers' compensation, as provided License Class: _C20 - - License No.: 3.74937 for by Section 3700 of the Lab or.Code,,for the performance of thework for which this permit is A Dater Contractor: � �� - issued " I'have and will, maintain workers' compensation insurance, as requiretl by Section 3700 of the Labor ' s.. _ Code for the performance "of the work for whichthispermit is issued. My workers' compensation - OWNER -BUILDER. DECLARATION insurance carrier and policy number are: I hereby affirm under, penalty of perjury that: am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number. 1795546.-2006 following reason Mac. 7031.5, Business and,ProfessionSCode: 'Any. city or county that requires a permit to I certify.that, in the performance,ofthe work for which this permit:is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the _ persori in any manner so as to become subject,to the workers' compensation laws of California, permit to,filea signed _statementthat,he or she is licensed pursuant to the provisions of•the Contractor's State _ 'and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter.9 (commencing, with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions. " 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).: 1 _ 1 I, as, owner of the property, or my employeeswith wages as their sole compensation, will do the work, and �Daatte:ktll� ,e Appli t: the structure is not intended or offered.for sale. (Sec: 7044, Business'and Professions Code: The WARNING: FAILURE TO SECURE.WORKERS' COMPENSATION COVERAGE &UNLAWFUL, AND SHALL 'Contractors' State LicenseILaw does not'applyto an owner of property who builds or improves'thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FINES UP.TO.`ONE HUNDRED THOUSAND -and-who does the work himself or herself through his or her own employees, provided that the IS1o0,000). DOLLARS IN ADDITION TO'THE CIDST OF. COMPENSATION_DAMAGES AS PROVIDED FOR IN improvements -are not'intended or offered for sale. If,.however, the building or improvement is sold within SECTION 3706 OF THE LA.kF1 CODE, INTEREST, AND'ATTORNEY'S FEES. oneyear.of completion,.theo'wner-builder will have the burden of proving that he or she did not build or' , . . • - . ' , - .improve for the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT 1, as owner -of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT- Application is hereby made to the Director of -Building and Safety for a permit subject -to the '7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s)'licensed 1. Each person upon whose behalf this application is made, each person at whose request and for ' pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, 1 _ ) I am exernpt under Sec. B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta• its officers a ents and em I ees for n r omission related to the work b n 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: LQPERMIT g p lo y o 0 o eg 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 county to enter upon the above-mentioned property for inspection purposes. Application Number . . . . . 06-00003813 Permit MECHANICAL Additional desc . Permit Fee 42.00 Plan Check Fee 10.50 Issue Date . . . .. Valuation . . . . 0 Expiration Date 4/23/07 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 4.5000 EA MECH VENT INST/ DUCT ALT 9.00 2.00 9.0000 EA MECH APPL - REP/ALT/ADD 18.00 --------------------------------------------------------------------------- Special Notes and Comments REPLACE.(1) 5 TON & (1) 4 TON A/C SYSTEM. Fee summary Charged Paid ------------------------------------- Credited -------------------- Due Permit Fee Total 42.00 .00 .00 42.00 Plan Check Total 10.50 .00 .00 10.50 ` Grand Total 52.50 .00 .00 52.50 LQPERMIT Bin # Qf La Qum W., Building 81 Safety Division P.O. Boz -1504, 78-495 Calle Tampico La Qwnta, CA 92253 - (760) 777.-701-2 Building Permit App lication.and,Tracking Sheet Permit # Project Address: r� Owner's Name: Address:. ' : - A. P. Number: Legal Description: ,City, ST, Zi r' Contractor:7 .Telephone: « r _f ', ::�:;c;kS•,'• .�t r:> y S Address: ProjecUDescription: C City, ST, Zip: Telepho - 77' State Lic. # : 3 City,Lic. #: Arch., Engr., Designer: Address: City., ST, Zip: Telephone:`µ �Y}b} � 4 2f }iri�•i}}'}i' �> s `'^•'••s#> ,:..: { f :{:{..::>;::.:..s. {; ,. ;: ,.. ; Construction Type: ccupancy: State Lic. #: Project type (circle one): New Add n Alfer: Repair Demo Name of Contact Person: 7//,7-21.s `e F f �Sq. Ft.: # Stories #. Units: Tele hone # of Contact Person: / n - p 7( / 3 ,. { Value of Projec --- {Estimated . WU, APPLICANT: :DO,NOT,:WRITE BELOW THIS,,LINE .# Submittal Req'd Rec'd., TRACIONG 'PERMIT FEES Plan Sets Plan Check submitted.. { ' 'c? "Item . Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person-' Plan Check Balance Title 24 Calcs. Plans picked.up Construction i Flood plain plan Plans resubmitted Mechanical Grading plan 2"" Review, ready for corricchons/issue Electrical Subcontactor List 'Called Contact Person Plumbing Grant Deed Plans picked up v, S.M.I.. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections tissue Developer Impact Fee Planning Approval 'Called Contact Person AXP.P. Pub. Wks. Appr Date of permit issue School Fees 4 'Total PermitFees Work Order Palm Desert Air Conditioning fir, Heating Company 42-081 Beacon Hill Palm Desert CA 92211 760-346-0677 FAX: 760-346-5200 95-3343831 Service At: Customer # 5049 Bill To: Customer # 9989 Rating: OZORKIEWICZ, MR & MRS 760-771-2041 OZORKIEWICZ, MR & MRS 949-760-1942 RALPH & MARIE RALPH & MARIE 55-679 OAK HILL 1065 GRANVILLE DRIVE LA QUINTA CA 92253 NEWPORT BEACH CA Booked by: KGALINDO 92662 Type: GOLD Open Balance: ($1,744.00) Source: Payment Method: VISA, NET30 Zone: LQ Map: PGA WEST Credit Limit: Skill: Tax: Service Customer Directions FILTERS:24X36X1; 12X18X1=4 NEED MODEL & SERIAL NO. FOR FURNACE Instructions INSTALL ONE (1) AMERICAN STANDARD 5.0 TON COMFORT SYSTEM AND ONE (1) 4.0 TON COMFORT SYSTEM WITH TWO (2) AMERICAN STANDARD THERMOSTATS. PERFORM DUCT TESTING/SEALING. CRANE: AMERICAN CRANE @ 10:00 AM. TOTAL: $19,444.00 - $2,000.00 (GOLD DISCOUNT) _ $17,444.00 08/22/06 SCHED. 10/23/06 AND 10/24/06 8-9 AM. KG Contact: Equipment: Assignments Employee RICK NOTE: ENLARGE RETURN DUCT TO REDUCE NOISE IN MASTER BEDROOM. Call Info Job Info Call No.: 127285 Booked by: KGALINDO Job No.: 127285 Taken: 9/1/06 11:13 AM Type: ISACH Booked Date: 10/19/06 Class: REPLACEMENT Taken by: KGALINDO Scheduled: 10/23/06 8:OOAM Sched by: KGALINDO Type: ISACH Cust PO: Pri Level: 5 08/31/2004 Ld Src: SalesPerson: Eq Age: Loc: ROOFTOP LS Ref: Contact: Equipment: Assignments Employee RICK TaskCode Scheduled Time 8:00:00 AM Equipment Warranties Type Sys Mfg Model # Serial # Age Type Parts Ends Labor Ends CUAC 1 CARR 38TRA048330 4698E02497 GOGOLD 7 01 YR-PNL 08/31/2004 08/31/2004 Filters: Loc: ROOFTOP CUAC 2 CARR 38TRA060330 0499E00990 8 O1YR-PNL 08/31/2004 08/31/2004 Filters: Loc: ROOFTOP FAU 1 CAR 58RAV09516 0599AI0274 8 OIYR-PNL 08/31/2004 08/31/2004 Filters:3 12X18X1 Loc: SACH FAU 2 CAR 58RAV11520 4398A18159 7 O1YR-PNL 08/31/2004 08/31/2004 Filters: 1 24X36X 1 Loc: SACH Agreements No Status Sold By Start End Discount Last Visit Next Scheduled 10'/25/2006 10:27 7603465200 PALM DESERT AIR COND C:artifinata of rnmbliance Prescriptive Method -.HVAC-only Alteration PAGE 02 CF -1 R -ALT -r Prot Ti _ Date: ' io CaICERTS 2005 nweament A eic use only Proje Address: c. Climate Zone: Building Permit 9 Doc ume ation Au or-. Telephone: DJ. .3s%�77 Plan Check Date , m n Name: /7 Field Check Date IMPORTANT: This CF -1 R -ALT form ' only for use when an HVAC-9nly alteration is made..to an existing home Use one form for each system beingaltered.- This is s stem #. / o;,, -0 - systems altered.in this house. Check all Imes that aonly- CligigkatilyfingalhatappW' Scope of Alterations:. . 1 ❑ An Air Handier Is to be Installed.Or replaced. :Duct sballn .to be determined; Continue to nehh line. 2 Er A Furnace Heatvxchan or la to be installed or replaced.,, Duct sealing to be datarrilned: Continue to nod line 3 Ef An outdoor condensing unit Ia to be Installed or laced: Duct Sealing and/or TXk/ CA 10 be determined. Continue to next line. 4 .12� A cooling or.Mauna " cop is to be Installed orreplawd,` Duct Sealing and/or TXV RCA to be determined. Continue to nand line. 5 ❑ More than 40 feet of new or, replacement. duct are to be Installed,ln uncabtlBionad spice, Duct"sealln®to be determined. p Check haft If the tati= ducts ern Is also to be riew or *idM. ' -Continue to next One. 6 13 If none of llnes.1-5 are checked; neither Duct -Sealing rhor TXV RCA arerequired.' C-) to Section 5, Section 1 -Duct Sealing (Only if an .of Lines '1 `2 3 4 or 5 are chocked. '-Sl4 , if Llne 6`Is checked. 7 ❑ This system Is In Climate Zone 1 34 5'8 7 or 8. ; No duct sealing is red:Go to section 2. 8 ❑ is system has less than 40 feet of ducts In unconditioned apace. No duct a6sling a Mulred, Go to Section 2. 9 ❑ This system was previously sealed and.temed, and was c e t(fled by a HERS -rater. No duct seallno Is mulred, Attach preWous CF -4R farm. Go to Sectign 2. 10 ❑ This duct system -13 sealed or Insulated with asbestos. �No duct "wall Is required. Cloto Seclkan 2. Note: If the entire ducts stem is,to be new ogre laced'Lines 11-14 do not apply. s 11 ❑ In Climate Zones 2 12 and 18: An 0 92 AFUE rum=e wm beinstalled in lieu of duc: mllnorid TXV. V applicabIpj. 12 0 In Climate Zones 10, 13 and 1'5: An SEER 14 AbaEER 12 omwe'nsw will ba lnatal6ed wfth TXV(RCA) i AND added duct InIsulanon R4 wr4on aidating ducts, R -e new ducts In lieu of du<;t sealing. Go to section 2. 13 O ` In Climate Zones 9, 10. 11, 13;.14, or 15: An SEER 14 AM PER 12 condenser will be Installed with TXV(RCA) D a 0.92 AFUE.fumace wlp be Installed In lieu of duct sealing: Go to Sed'llan 2. 14 ❑ In Climate Zones 2, 9; 11, 12.14 or 18t An SEER 14 A1sh]. EER 12 cond0nsei Willie Installed with TXV(RCA) D an 0.82 AFUE hnaca will be Installed whh'Incressed duet lnsulatlon'In lieu of juct sealing. Go to Section 2. 15 17 Nona of lines 7-14 above we checked: Dud'SoMng la,Raqutmd;, Cardlnus:` Section 2 - TXV RCA(Only if Lines 3 or 4 are chedked''otherwise of to Sri tion 3)"_ 16 ❑ The s being lee packane unit .No.TXV RCA is'required. Go to Section 3. 17 D This ayetem Is In Climate Zana 8 and a'14 -SEER air conditioner or.0.$2 AFUE furnace Is being Inetelled. No TXV Sk Is uired. Go to Section 3, 18 ❑ This $"tam Is In Climate tone 1 3 4 ti 8 or 7.. No TXV RCA Is ul Go tq S. 19 173 xhis system is in Climate Zone 18 and One 14 Is not checked. ' No TXV RCA Is ulred. Go to Section 3. 20 ❑ iThlaaystem lain Climate Zona 18 and line 14 is chcoked and not line 18: -TXV(RCJ� Is required. Go to Section 3. 21 his system Is In Climate Zone 2 or 8=15 and line 11,' 18 or 17 Is not Checked. TXVIRCA) to required. Go to Section 3. Section 3 - HERS Rater verification 22 0 If One is Is checked ;HERS verMcatlon 1s required for puct'Sealln , 23 110 If One 12. 13; 14, 20v 21 are eheccad and not One 18 or 17; HERS verification' Is iv ulred for TXV RCA , 24 A If Ane 12,13 or 14 are chocked, HERS verification Is roqulred for 12 EER. Section 4 - E ui ment' Efficiencies 25 ❑ If Ones 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are reZtrirad. List ImSectlon 8. Section 5- Duct R -Values 28 0 Ill mkire than 40 feet of duct Is beInjinsfailed or replaced, duct R -value must meet or exceed Package D ulrements. 27 I1'.le3s than 40 feet of dud la being Installed or replaced, duct Rwelue must meet or iumeed R,4,2 Section 8 - see neat page Version 03-10-06Page 1 of 2 This form can only be used on projects being verified by CaICERTS coMfiecl raters. www.calcorts.com 10/25/2006 10:27 7603465200 PALM DESERT AIR COND PAGE 03 !`'►ir.noln of PresCcintive'Method - HVAC -only Alterati6n . CF -1R -ALT ProjecbT -- - - - r _ Det® / , • / ®CaIC@RTS 2005 IMPORTANT: This CF -1R form is ontylor:use When HVAC=gnly. alt6ration:;ls made,to en existing home Use one fonn-for"each"s tem' being;61jerad...This is 6 " teni # < of .3`s -renis altered in thls house. Section 8•- Mlnlmum Requlrements fouftqulpment to_be Inslelled/Altered.' '` WOW equomerd rami met6htyp0!b�1 • ten and meet ar aa exaeeffldemJaUR-vexes•, 28 Cordlpwetbn .B guilt synem 0 Pe kbp Uru1 ' 29ktiA ei Gabfumece.,AFUE - DHekWIPEAU CHOW&FAU 132dier i 30 '6' ' Heat 'r. 31 fr Wdoor'_:drieens MIC 01". EEFhi6PF: 32,0 caourg iWihealimb roti 33 O : DuctP tion Giopth (ft. .. Wawa: All mandato meastare6 a town eltered'com onent : �Iee MF -1 R -"ALT form: Compliance Statement ' This eeAlS to of cortmpnanc:e lists.the building feahires and sPedflcatlbne needed to g6mply.with Tille�24, Parts 1 and 6 of the California, Code'of 'Reguiallons; end the., administrative red 61Wi ns to lrnplemerit them. Tots'certificate has been signed by the Indlvidual.with' overan'.ptojgot responslblllly. The underslgrled`reeognizes that __oo' Ila nce`using-duct sealing, vera icagon of refrigerant E- rater: charge, and TXV require Installeraes{ing and certtflcation odw flcatton by an approvE:d'HE- Home.Owner or Authorized Agent „ Documentation Author Home Name' Address' Na Compa ;nte: : G W Clty/State/Zip: Address: i.. r/ 1 z Phone: C�ltylte' Phona: ' 7 f Signature: Slgn 're:'� Enforcement Agency Build- De artmenl Note's/Cornmentsi Name: Title: Department: . - Phone: Fax C Signature or Stamp: Required forms" CF -1 R -ALT: by anyone. Required, at:tlme of permit application•,Copies,to home owier, enforoemerdt agency, HERS rotor, CF -6R -ALT: by Installing contractor Required to Close permit Coples io home owr"er, enforcement. agency, HERS rater. CF -4R -ALT: by HERS rater Requlr®d to.close permit. Coples to,home owner, enforcement agency,,lnstaner. The CF -4R fortes for a sam legroup-Ahill not be releasedunlll an testi 8nd Je flea n1s om tared and. assedfor the errtite rou . vemlon'03-10-08 t'age z or z This form can only be used omprojects being verified by CaICERTS certified raters. www.calcerts.com 10/25/2006 10:27 7603465200 PALM DESERT AIR COND PAGE 04 Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT Proj T Date: liga 0..�� ® 610ERTS 2005 Enforcement Agency Usp n ProjaefAddre= Climate Zone:- � Building Permit # Docuoptation Au pc Telephone: ) f�6-4;77 Plan Check Date m n Name: Held check Date: IMPORTANT: This CRI R -ACT form ' `only for use when an HVAC.pMy alteration is made to an existing home Use one form for each system bein altered. This is s stem # d[. of A'' s stems altered in this house. Chack all linea that anoly, Ch =c o ly lira$ that06DW- Scope of Alterations:+ 1 ❑1 n Air Handler is to be Installed or laced Duct soalln to be determined. Continue b> next tine. 2 eCJA Furnace Haat exchanger Is to be Installed or replaced, -Duct seating to be determined. Continue to next line. 3 4E n outdoor condensing unit Is to be Installed or'rsplaced:. Duct Sealing and/or TXV(Rt:A to be:determined. • Continua to next line 4 Er A cooling or heating toll into be Installed or aced: Duct`Seatln andlor-TXV RCA to be determined, Continue to neM line, 5 ❑ More than 40 feet of now or replacement duet ere to be Installed in uocndlBomd apace, buct Realing to be determined. ❑ Check here if the pd�j duct system is also tc Abe new orreplai6etl. Continue to ne)d line. 6 EI If none of lines 1.6. are checked' neither, Duct Sselih -hor TXV RCA are required, Go to Sectbn 5. Section'l - Duct Sealin . Only. if any of Lines 1 2 3j'-'4 or 5' are.checked. 'Skip- If Line 6 is checked, 7 ❑ This system is in Climate Zone 1 3.4.5,6,7, or 0 No duet saalln Is ulred: Goto SaL.M 2, 8 ❑ Thls s .tem has less4han 40 fat of ducts In rinooidi'tioned s .-• No duct sealing is rerjuired. Go to Sectlon 2. 9 O This system was previoualy sealed and tested, and was certified by a HERS rater. No duct sealing ie required. Attach previous CF -4R form:` Go to Section2. 10 ❑ This duct wirstem is sealedorinsufated:with asbeslos. No duct sealing is required. Go to Section.2: Note: If the entire duct system is to be new or re laced�Lines 11-14 do not apply. 11 ❑ In Climate zones 2.12 and 76: An 0.92 AFUE furnace will Iia installed in lieu of duct sell and TXV if a iaabla . 12 0 In Climate Zones 10, 13 and 15; An SEER 14 MMEER 12 Condenser will be installed viith TXV(RCA) AND added duct insulatlon R-4 wrap on eAsting ducts R-8 new, ducts in (leu of duct seal . Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 13: An SEER 14 MitEER 12 condenw-will be Inatalled with TXV(RCA) AND a 0.92 AFUE fum=e will be Installed In lieu of duct sealing. Go to. Section 2. 14 ❑ In Climate Zones 2, 9,11, 12; ldor 16: An SEER 14'"X" EER 12 corldellserwill be Inntglled with TXV(RCA) ND an 0,aZ AFUE furnace will be installed with increased duct Insulation In lieu of duct am i0g. Go to Section 2, 15 Norte of lines 7-14.ebwe ane Checked,. Duct Sealing Is Required. Continue Section 2 - TXV(RCA) (only if Lines 3 or 4 are checked; otherwise got to Section 3 16 ❑ The system being altered Is a ka e u tt . No TXV(kdAj In riclulr6d,, Go to Section 3, r 17 ❑ this system Is In Climate Zone a and'a 14 SEER air con_ ditioner or 0A AFl1E furnace 6k being installed. - No TXV(RCA) Isrequired.- Go to section 3. ; 18 O This system Is In Climate Zone 1 3 4,5. 6ar 7. No TXV RCA IS required. Go to SeraIcar 3. 19 ❑ Thiss stem Is In Climate Zone 16 and line 1419 not Checked: No TXV ICA Is regulred, Go.to Seaon 3. 20 ❑ IThIss sten Is In Climate Zane 16 and line 14 i6 Checked and not line 18,' TXV RCA Isrequired. Go to Section 3. 21 his system Is In Climate Zone 2,0r 8-15 and line 11, 16 or -17 Is not checked.` TXV(RCA) Is required. Go to Section 3. Section 3 - HERS Rater verification' 22 ❑ if Tina 15 Is Checked, HERS dorlfleatlon Is required for Duct Sea ling. 23 pd If line .12, 13, 14, 20 or 21 are checked and not line 16, cn 1?,- HERS vertfleatlon Is.req Imd for TXV RCA , 244Z if line 12,13 or 14are checked, MERS verincetlon.Is iequlred for 12 EER, Section 4 - Equipment ffficlencles " 25 ❑ I} lines 11, 12, 13, 14'or17 are checked, upgraded equipment efficiencies are requlrod. List in Section 8. Section 5- Dud R,Values 26 0 I}more than 40 feet of duct Is beinii Installed or replaced, duct R -value must meet of =qed Packs e D requirements. 27 4 Ilf leas then 40 feet of duct Is being Installed or reIaeed;,duct R -Valu® must meet or ekcsel R-4,2 Section 8 . see next page Version 03-10-06 Page 1 of 2 This form can only be used on projects being verified by CaICERTS certified rats. www.caloerts.com 10/25/2006 10:27 76034.65200 PALM DE.SERTAIR COND r'Prtifit-.qfP of rnmnfi;4nce' . Pres6rintive Method = HVAC-ofily. Alteration CF -1R -ALT PAGE 05 Proj"T, 1-7 Date:' ,/ pgle Q CaICERTS 2005 IMPORTANT; ThisCFAR-' form is,ontyfl�UseVO.e I n 11 nly'aftorsti6nIs;made .to eh existing home lJae 'Wbi�'ln'w�.�ite-red';,Thls'is7system 1 9 bne,,`fo�n for eneh,M2W lol' i4kfed.ln this Mouse. Section 6 - MInImurn'Requiremants for Equipment to.be InstalledlAfteired".' lrj9tS#W CjqUfpMOMjnjet rnatth typ&ftcatlon juW meet or'oxmd 28. Pedc4ge' Unit - 29 0 -00se Wwo, A-FUE-,.==.,OH9WOOp 17AU'DI-lydrunIc FAU 0 Qtlier_ 30 l2r- . Host Exe at' 31 Er DtA&W'r Cmdenshu'Prilk LER IN recid); 32 )2r Coo 2nl;i-*rhea":Coil TAC. OHOStPUMP O 33 Q Ducts' - '.to an" �,'SaaIVIF-IR,-ALT form; —t 'All mandatory rneas7restply yaltdr6d.componerit Compliance Statement; 9 tions,rfkdedito C;"�P�.. ith Title 24, Parts I end 6 of the This certificate ,O complian ce; lists tie building featurei:and spe�ca W California Code of Reguliti6ni, and;'Ihe admlnlstiative r6qu I lakni-t6, linplem6ml*hem. rhis certificate hd's been signed by the individual with overall orblect"risp6risibility.,The'ugdar's'"Idned, reqogni;ces using ductsealing, vedflcation of refrigerant d 6itificatlon a m'sipprove-d HERS rater. charge, and TXV require Installer t sting-�r_l c nd v6tifictition by a Home Owner or AuthoriZed'Aelent i DocumtaLstion' uthor Name; Nam Address; CompMe: City/State/Lip: Address: Phone: Cityl t*' Phon'e';, -77 Signature: lee_ Enforcement Aaency (BuildiM Department) Notes/Comments: Name: Title: Department: Phone #: Fax V! Signature or Stamp; 4 Required forms; CF -IR -ALT; by anyone, Required at lime "of perm'R application. Copies to home owner, enforcement agency. HERS rater. CP -6R -ALT: by Installing -contractor.., Required -to closej` , - it Ciiples to homelownei'. enforcennerit 6gericy, HERS rater. ., I perm L stakr. The CF -4R forms for a oe�Mit. Cobjiii h_ re(61".. -Rqquirefloclois permit: . gme:owner, enforcement-agency,installer. CF -4R -ALT-. . by HtOSL' Gose I . — : .. . Irl . Ikample aroup shall not be-reliased until all,testIfin and verIfIcali6n ls`cornpleted'and. pEisse�'for the entlrejQrouD. version us-iu-uo. . . �. i This form can only be used an projects being verified by CaICERTS cartifind raters: rage x 01 x www.calcorts.com I..II1l.�IC 1►7 ' I.CIlI1lt:tlLG iC%%,ivic CERTIFICATE OF FIELD VERIFICATION R DIAGNOSTIC TESTING (Page 1 of -8) CF -411 55679 Oak Hill - La Quinta, CA 92253 Palm Desert A/C - Heating / 374937 Project Address Contractor Name / License No. 06-00003813 Contractor,etrnktac4 Telephone Permit Number Paul Vatf VI me 760-777-1724 45602 HERS ter Telephone Sample Group Number November 6, 2006 .CC14-1798386184 Cajvfy/n IgnatureDate CertiAcate Number Firm: Air Experts Air Conditioning HERS Provider:Ca10ERTS.. Street Address: PO Box 94 City/State/Zip:La Quinta / CA / 92247 Copies to: Homeowner, HERS Provider and Building Department This CFS -411 has been registered with the CaICERTS@ registry in accordance with the Title 24 & Title 20 of the CCR. CaICERTS@ is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was 9 Tested ❑ Approved as part of sample testing,, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution system Is fully ducted and correct tape Is used before a CF -411 may be released on every tested building. The HERS rater must not release the CF -411 until a properly completed and signed CF -611 has been received for the sarriple and tested buildings. The installer has provided a copy of the CF -611 (Installation Certificate). New Distribution system Is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). New systems where cloth backed, rubber adhesive duct tape is Installed, mastic and drawbands are used In combination with cloth backed rubber adhesive duct tape to seal leaks at duct connections. J-0 ncr%211 Tif1M rnUor TeNCF CRPnTT! LJMARLMUM KC ' ViKCt9G/V I. - -- --�- -- - --- -- --- -- - - -- NEW CONSTRUCTION Measured Duct Pressurization Test Results (CFM @ 25 Pa) Values 1ew N/A 2 Fan Flow: Calculated (Nominal'•O' Cooling'-_~' Heating) or'--_. Measured 1600 Enter Total Fan Flow. In CFM: 3 N/A N/A ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct 4 System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Duct 404 5 System Alteration and/or Equipment Change -Out. Enter Reduction In Leakage for Altered Duct System 6 [Line 4 - Line 5] - (Only if Applicable) 7 Enter Tested Leakage Flow in CFM to outside (Only if Applicable) 8 Entire New Duct System -Pass if Leakage Percentage < 6% [ 100 x ( Line 5 / Line 2 )]: ❑ Pass ❑ Fall TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 25.25% Fall 9 Pass If Leakage Percentage <= 15% [ 100 x ( Line 5 / Line 2 )]: Pass ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: Pass If Leakage Reduction Percentage >= 60% ( 100 x ( Line 6 / Line 4 )] ❑ Pass ❑ Fail 11 and Verification by Smoke Test and Visual Inspection Pass ❑ Fall 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection Pass if One of Unes S9 through 812 pass Pass ❑Fall i t-aik- mt 13 - Leruncate rage z or z CERTIFICATE. -OF FIELD.. VERIFICATIOW&WAGNostic TESTING, (Pa9e,3!!4._of CF -4R This CF -411 has been registered -With- I with the Title'24 & CaICERT5Q9 is an:approveo:HtKb.;E viaer..o ssion. HERS RATER comp.UANCE STATEMENT , , , - * The house was Rtested-E1Ap � — pro-1ved as part of scimpkAesting, but was not. tested. As the HERS rater providing dlagn6stic testlng'and 'field ie'�l'i6tion-,'I certify that the house Identified on this form compiles with the diagnostic tested compliance requirements as . cfiecked'onthis form. The Installer has pr&li!6d a copy of the CF -6R (Installation Certificate). L%&HERMOSTA-ftC.EkOANkdNVALVE (tXV): Access is provided for ins"' ' - i The e proce'dur',e shall consist of visual verificatiorfWat the TXV is installed pection-1. h 1 .1- 1 . _: on the system and installation,of the,,specific 6OL; iprhent,'shall..'be- verified - HVAC "S R Paw 0 Fall System TXV 55679 Oak Hill - La Quintb,.CA 92253 P61rn Desetit.,A/C 374937 Project Address Contractbi'1114me /License No.. 06-00003813 Contractor ntact Telephone Per7rii0vuhiber Paul Van men _760'=777-1724 45602' HERS Rater 'Tilepo6ne Sample Group Number Novembier-6, 2006 C-C1447463li-LA Certifying Signature ceriir,6it;6,lVu fiber Firm: Air Experts Air Conditioning HERS Pr6v*i66r.:611C iRT"S. Street Address: PO'Bbx.94 ;City/State/Zip La:.QUinta / CA 92247 This CF -411 has been registered -With- I with the Title'24 & CaICERT5Q9 is an:approveo:HtKb.;E viaer..o ssion. HERS RATER comp.UANCE STATEMENT , , , - * The house was Rtested-E1Ap � — pro-1ved as part of scimpkAesting, but was not. tested. As the HERS rater providing dlagn6stic testlng'and 'field ie'�l'i6tion-,'I certify that the house Identified on this form compiles with the diagnostic tested compliance requirements as . cfiecked'onthis form. The Installer has pr&li!6d a copy of the CF -6R (Installation Certificate). L%&HERMOSTA-ftC.EkOANkdNVALVE (tXV): Access is provided for ins"' ' - i The e proce'dur',e shall consist of visual verificatiorfWat the TXV is installed pection-1. h 1 .1- 1 . _: on the system and installation,of the,,specific 6OL; iprhent,'shall..'be- verified - HVAC "S R Paw 0 Fall System TXV T CalcEm's - Lernrlcare CERTIFICATE OF FIELD VERIFICATION R DIAGNOSTIC TESTING (Page 1 of 8 CF -4R 55679 Oak Hill - Uinta CA 92253 Palm Desert A/C -Heating / 374937 Project AddreContractor Name / License No. 06-3813 Contractor ontac Telephone Permit Number Paul Van VI men 760-777-1724 50844 HERS Rater Telephone Sample Group Number vi December 18, 2006 CC14-1798391427 Date Certificate Number Certifying Rater ure HERS Provider:CaICERTS, Inc. Firm Air Experts Air Conditioning City/State/Zip:La Quinta / CA / 92247 Street /Address• Po Box 94 is CF -411 has been registered with the registry in accordance with the ifornia Energy Commission. the CCR. HERS RATER COMPLIANCE STATEMENT The house was ❑Tested © Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution system is fully ducted and correct tape is used before a CF -411 may be released on every tested building. The HERS rater must not release the CF -411 until a properly completed and signed CF -611 has been received for the sample and tested buildings. The installer has provided a copy of the CF -611 (Installation Certificate). New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). New systems where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed rubber adhesive duct tape to seal leaks at dud connections. ..........0 oenrrrr:FMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT: NEW CONSTRUCTION Duct Pressurization Test Results (CFM @ 25 Pa) 1 _ ' 2 Fan Flow: Calculated (Nominal':°.Cooling Heating) or'._: Measured Enter Total Fan Flow in CFM: 3 W. Measured Values N/A Not Tested N/A N/A ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Dud System Prior to Dud Not Tested 4 System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow in CFM: Final Test of New Dud System or Altered Duct System for Not Tested 5 Dud System Alteration and/or Equipment Change -Out. Enter Reduction in Leakage for Altered Dud System Not Tested 6 [Line 4 - Line 5) - (Only if Applicable) Not Tested 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) EJ Fail New Dud System -Pass If Leakage Percentage < 6%[ 100 x (Line 5 /Line 2 )]: Not Tested Pass 8 Entire VERIFICATION STANDARDS: For Altered Duct System and/or HVAC TEST OR Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: Not Tested 0 Pass El Fail Pass if Leakage Percentage <= 15% [ 100 x ( Line 5 / Line 2 )]: ❑ ❑ Fall Pass If Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )J:Not Tested PassPass E10ll if Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )J Not Tested ❑ Pass ElFail and Verification by Smoke Test and Visual Inspection ❑Pass El Fail 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection 0 ❑Fail Pass if One of Lines #9 through #12 pass Pass 1/8/2007 https.//calcerts.com/cf4r_print—certificate. cfm?lots=0, 50848,50846, 50843, 50845,50847, 508... CaICERTS - Certificate CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 8 CF -4R Palm Desert A/C - Heating / 374937 5567JV uinta, CA 92253 Contractor Name / License No. Project 06-3813 Contrane Permit Number Paul V 760-777-1724 50844 HERS Telephone Sample Group Number December 18, 2006 CC14-1798391427 Certlfyre Date Certificate Number Air Experts Air Conditioning HERS Provider:Ca10ERT5 Inc. Firm: City/State/Zip_La Quinta / CA / 92247 Stree�daress:-PO-Box' -----------._-.--. Co ies to: Homeowner HERS Provider and Buildin Department erg wo k— Haan �anistered with the CaICERTS® registry in accordance with the Title 24 &Title 20 of the CCR. CaICERTS® is an approves ritrca HERS RATER COMPLIANCE STATEMENT The house was Tested 0 Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The installer has provided a copy of the CF -611 (Installation Certificate). HERMOSTATIC EXPANSION VALVE (TXV): Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed on the system and installation of the specific equipment shall be verified. HVAC System TXV ©Pass El Fail https://cal certs. com/cf4r_print certificate. cfm?lots=0, 50848, 50846, 5 0843, 50845, 50847, 508... 1/8/2007