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10-1081 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: �0• 00� 00-10.81 Property Address: 51230 AVENIDA OBREGON APN: 773-052-026-10 -000000- Application description: MECHANICAL Property Zoning: MEDIUM DENSITY RES Application valuation: 9000 .Applic nt: Architect or -Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT s • LICENSED CONTRACTOR'S DECLARATION I hereby affirm. under penalty ofperjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of- Division 3 of the usiness and Pr fessionals Code, and'my License is in full force and effect. License Classl-C20 it / License"leo 6.86310 Date a _, �ractor.� -'' OWNER -BUILDER DECLARATION: I,hereby affirm underp`enalty, of perjury#hat I am exempt from theContractor'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 t1at 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 I, as owner of he property, or my employees with wages as their,sole compensation, will do the work, and • the struc'ture-is not intended or offered for sale (Sec. 7644, 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 didnot build or improve for the purpose of sale.). 1 _ 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—) I am exempt under Sec. B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 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: LQPE%NlIT Owner: HATCH MARLENE 51230 AVENIDA OBREGON LA QUINTA, CA 92253 (760)564-7215 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/20/10 Coniractor: GENERAL AIR CONDITIONING 31170 RESERVE DRIVE PFC THOUSAND PALMS, CA 92276 (76.0)343-7488T rqLic. No.: 686310 l. 2O 2U10 CITY OF LAQUINY/; _EPT, ——————————————-—-----———————————— 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 3760 of the Labor Code, for the performance of.,the work for which this,permit is issued. Ihave 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'PREFERRED EMPL Policy:Number WKN1295355 _ •Icertify,.that, in [he -performance Of the work for which ,thi$,permit is issued, ) -shall not employ any person in any manner so as to become subject to the.workers' compensation'6ws of California, and agree that, if Is Id becom subject to the worker 'compensation provisions of Section 370 f the Labor o , I shall f hwith comply w th s provisions. ' n D� plicant; WARNI G: FAILURE TO SECURE W KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN CPENALTIES 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*Director of Building and Safety for a permit subject to the conditions and restrictions set forth onthis 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 tq' 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. , certify that I have read this application and state that the above information is correct. I agree tocomply with all city and county ordi`nances'and state laws relating t ilding cfspt� uction;n and her eb a ho iilze rep`rese'ntatives of this bo enter udM the above-mentioned op f r ic ions pufp.ses.K ! A/ v LDa[e//G1//,/2/fi11//�, �/ Sionature fAoolicana 1: /N/'r l_ ! Application Number . . . . . 10-00001081 Permit . . . MECHANICAL • Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/18/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA ," MECH. FURNACE '<=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 Special Notes and Comments HVAC CHANGE OUT 13 SEER 5 TON UNIT 2007 CODES. Other Fees BLDG STDS•ADMIN (SB1473) 1.00 ' Fee summary Charged 'Paid Credited Due Permit Fee Total 33,00 00 00 33.00 Plan Check Total 8.25 .00 .00 8,.25 Other Fee Total 1,.00 ..00 .00 1.00 Grand. -Total 42.25 00 .00 4,2:25 LQPERMIT Simplified Prescriptive CLertifiezite of Compliance: 2008 Rbsid&ntial HVAC Atter6tions CF -IR -ALT -HVAC Climate Zones 10.- 15, Site Address: 3 Enfqrbeiinent'AO'ency: Reg.: 2008 Permit #: 51230 AVENIDA OBREGON La Qyihta,: CA 92253 City',pf La. Quinta Oct19,; 200 "i I Equipment Typel', List Mini -Mum Efficiency2 zDuct insulation requirement ;Conditioned Floor. Area Thermostat 0Package'Unit 0 Furnace , 2 AFUE, 80% ❑COP 13 R 6 (CZ jo-j 3) Served by system .2 Setback R.Incloor Coil 0 Condensing Unit ®SEER _121_ C, - 3 EER 0 HSPF 0 Resistance ❑ [:] R 8 (CZ 14-15) sf If not'already.present, must be installed) D Other 1. Equipment Type: Choose the equime t installed; if -more'than one.system, use another CFl R,ALT-H,VAC for each system. Ebg s 2. Minimum Equipment Efflclencle teRinF 78% -AFUE, I 7.7HSPF for,aypick residential systems HERS VERIFICATION SUMMARY, Ligted'Wow are FOUR- HVAC b1teebtibri,00tions. The installef decides what work is being done and picks,one of. the appropriate 0; p6ons; 'Elach-*10 -k' li` h"' ERS'measures,that 'must be"conducted. A ptiQp ists t e'H copy of the forms shall be left onsi=final inspection and a 6py,given'to fh.e°Kdrn&o_wner:,At final, the inspector verifies.that the work listed on this form was in fact.'the work completed by--the-installer ..t,,he,'ingpector also verifies*that completed each appropriat6,.CF-611'ancl registered CF -.4R forms'(no hand filled out and.sighed.Beginning October 1, 2010, a registered copy.of'the­tF-1k-and CF -6R shall also"k4kprii site for final inspection. 0eict I ion. 2 1. HVAC'Changeout Required f6FrWS:, All HVAC Equipment CF -611 forms: .-MECH-04;,MECH-2 1 -HERS 6_nd#6r Split systems) MECH-25-HERS 's') replaced CF -411 fqrm_-� MECH-21 and, (for split-qystem­ MECH-_25' Condenser Coil and /or, Indoor Coil and /or CF -6R -forms:. MECH-04, MEC ('for split.systerns) MECH-25-HERS -,Furnace CF -4R forms: MECH-21 and (f6r splie-systems) MECH-25 For Split Systems: Duct 15 percent; RC, CCA :5 300.,CFM/ton'(Mi ni mum Air, Flow Requirement), TMAH .leakage4F. For Packaged Units:.DUct lealkag'V-*< -15 -percent txempted -fro mi -cluct. 166age teS665f: E] 1. Duct system Was clocum6iitdd to have been previously se6led'and co'n"firmed through HERS verification, or 02. Duct systems with le's§16AM6 li6ear feet in unconditioned -space,. or X'� - - E x ilt 7q�tructed r- �qeAtcs tnsulat ED inT stemszr�",ffo Witt,?',6 Awrsy_ ❑ 2. New HVAC 'W. W ��W Required"I"Fo"' 10 1 WR� 0.1.;.� TM Systemg& —Y. ggft&�A Cut iiftdfh6nge (jut with newj 11 ,aucts: dUc—ting rM -91Ck-04, M UPS 11001 systems)gMECH-22-11, ER-Sngg' ­­ new new :en' i For Split SysfiMs:, Duct 'leakage ' i -6f 5er-cent ,�-,RC����t-CCAq��'-350-CFM/t6ii":- FWD,' TMAH,;; SIMS, and eithe'e-HSPP or PSPP. P leakage For. Packaged Unrts Duct 6 percent 1:13. N`jd-W-­'Zucts1-Wf, thY,.:or withoW Required Forms: Replacement, Includes replacing or inst5iling:611M..." new ducting. and/or 6utc1o6P'i:;. . ..-....... condensing unit .and/or indoor coil CF -6R forms: MECH-04, MECH-20-HERS; and (for systems) MECH-25-HERS "CF *split and/or furnace. No or some -4R forms: MECH-20.and (for systems) MECH-25 equipment changed.. For Split Systems: Duct leakage <.6 percent; RC, CCA a 300 CFM/ton,.TMAH For Packaged- Units: -D uct.leakage.,< 6 percent 0 4. New.Diwicting-6vei-40 feet, Reqyired'Forrhs: Includes adding or'replacing more CF -'61R forms: MECH-04 MECH-21=HERS than 40 linear feet of duct in I unconditioned space. CF -411 forms: MECH-21 For split system or packaged units --Duct leakage.< 15 percent e led [I EXCEPTION:'Existing°duct systems constructed, insulated orsea with, asbestos., Contractor (Documentation Authbr'sii/gesoon6lble,.De-!ii§hdr�speclair6tioiiStatement) • Icertify that this Certificate -of Compliance d6cu mentation is accurate -and complete.• I am eligible -under Division 3 of the -California. Business and Prof6ssibns -Code.to accept responsibility for the. design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design,, identified, on this Certificate of Compliance conform to the requirements of Tide,24, 15arts.1 and 6 of -the California,Co . d . e:of,Regylatlon . s. I . . • The design features identified onthis Certificat'-of Compliance are consistent with the lnfofmation clocumented'on other applicable compliance forms, worksheets, calculations, plans and.speciKituitionssubmiited tothe enforceriientagency for approval with the permit application. �qn_a Name: Danielle Garcia Signature: bani0le Garcia - Company: HARRISON ENTERPRISES -INC Date: Oct 19, 2010 Address: 170 RESERVE DRIVE. STE A License:=686310 L City/State/Zip:, THOUSAND PALMS / CA'/ -9227.6 Phone: (760) 343-7488 Reg.: 2008 210-A0020606A-00000,000-0000 Residential Compliance Forms Registration Date/Time: 2010/10/19 17:30:18. HERS Provider: CalCERTS, March Inc. 2010 Bin # Ptypf.La Quinta Building 8I' Safety;Divlslon P.O. Box 1504, 78-495 Calle Tampico L2 Qi111`14 CA 92253 - (760) 777-7012 Building. Permit Application, and Tracking Sheet Permit # A, \'O Project Address: 0(31�'e t7n . gwner's Name: GL A. P. Number: Address: ,5 a ti'v Q_ Oboe e Legal Description: City-'5T, Zip: (,u-{-teaSa Contractor: >,rf^:r Telephone: !06 ,S(04J--.�a f� ,' ,,,. f ixi , . Address: ProjectDescription; n- City, ST, Zip:'-1/ `►cJV'� t� �.(.-� bOd Telephone:;'r` State Lic. # : 3 City.Lic. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone:?sv- :>:y x. 3� r �t�..<a ; :::w:<•`ff,`!v:%.cr� � w ��.,• . Constructidn.Type: Occupancy: -. Repair Demo typa cicleone : New Addn Alter State Lic. Name of Contact- Person: Sq. Ft.: # Stones: #Units: Telephone # of Contact Person: Bstimated Value of Project: Ul` APPLICANT: DO: NOT WRITE. BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets: Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. - Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan2"" Review, ready for.correctionsAssue Electrical Subcontactor List Called ContactPerson Plumbing Grant Deed • ` Plans picked up. S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"! Review,.ready for corrections/issue Developer Impact Fee Planning Approval : Called Contact Person w A.LP.Y. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 4. ,` lIpYc t4 'STALLATION CERTIFICATE . . Duct Leaka a Test— Eistxti Duct 5 .stem ,Site AVr6:Z . I���� �^Enforcement Agency: _ 30 4Vefk., �a l6Girec_,,J. Perm�6er; $rater the Duct System Nacos or Identification/Tag:� miter the Duct System Location or Area.Served: .1 <,A o [,e Note: Submit one Installation Cert fleate for each duct system that trust demons'&ate compliance in the dwelling This installation certificate is required for compliance for alterations and additions In existing dwellings to space ;onditionIng systems and duct systems, Note. For existing dwellings, a completely.new or replacement duct system can also.Incliude existing parts of the or�lnal duct system' (e.g., .register boots, air handler, coil, plenums,' etc.) ifrhoseparts are aceessible and they can be sealed Fos- a completely new or replacement duct system installed to an existing dwelling, use the Installation Certtf%ate titled "Duct Leakage Test —' Com nletely New, or Replacement Duct System " Duct Leakage Dia ndstic Test— Existing Duct System �%tioaa,00.mpliancemethod from the following four choices. on. Measured leakage less than I5% of Fan Airflow. ❑ Option 2. Measured leakage to outside less than 10% of Fan Airflow. ❑ Option 3. Reduce leakage by 60% or more, and conduct.smoke: test to seal all accessible Ieaks. ❑ Option 4. Fix all accessible Ieaks using smoke test, and HERS rater must verify. Note: (Option I must be attempted before utilizing Option 4) Determin'I nominal Fan Airflow using one of the following three calculation methods. O'CLooling system method: Size of condenser in Tons g x 4.00 CFM ❑ Heating system method: 21.7 x Heating Output Capacity (kBtuh)- = CFM ❑'Measured system.airflow using RA2 3 airflow test procedures: CFM Option 1 used then: Allowed leakage = Fan Airflow .2- ooy x 0.15 = 3 U CFM 1 Actual leakage CFM Option 2 used then; Allowed leakage = Fan Airflow 2 Actual leakage to outside = CFM If Actual leakage Is less than Allowed x 0.10 = CFM r e to outside is less than Option 3 usedBOWL [Yrass O Fail ❑ Pass ❑ Final leakage after sealing all accesst s using smoke test = CFM 3 Initial leakage - Final leakage = Leakage reduction CFM (Leakage reduction /Initial leakage ) x I00% _ % Reduction Pass if %.Reduction> 60% ❑ Pass ❑ Fail Option 4 used then: All accessible leaks repaired using smoke test. HERS ratermust verify (No sampling), 4 Pass if all accessible leaks have been sealed using Smoke Test ❑ Pass ❑ Fail ri INS LI,ATION CER TV CI` 6R MLCITI1'r3 act Leaks a Test--�stcn >D.uct'5 sierii e 2 lie Address; . j Enforcemant Agency:. Permit Number ©-.outside air (OA) ducts for Central Fan Integrated (CFI) ventilation'systams shall not be sealed/taped off during duct leakage testing, CFI OA ducts.thit�utilize controlled MoW'riied dampers, that open onlywhen OA ventilation is required to .meet.ASEIRA$ Standard 62,2, and close when OA ventilation is notrequired, may be configured to the closed position " during•duct leakage testing, 123""All supply and return register'boots must be sealed to`thedrywall if smoke test is utilized for compliance- applies to duct leakage compliance option 3 (leakage reduction by 60%).and option 4 (fix all accessible leaks) described above. LAN w duct installations cannot utilize building- cavities as plenums orplatform returns in lieu of ducts, C Mastic and draw bands must be used in combination with cloth backed rubber adhesive. duct tape to seal leaks at all new duct connections, DECLARATION STATEMENT I certify under penalty of perjury, under the laws of the State of California,, the Information provided on this form is true and correct. • I am eligible under Division 3of the Business and Professions Code'to accept responsibility for construction; or an authorized representative of the person responsible for construction (responsible person), • I certify that the installed features, materials, components, -or manufactured devices identified on this certificate (the Installation) conforms to all applicable codes and regulations, and the.instaIlation is consistent with the plans and specifications approved by the enforcement agency, e I understand that a. HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective'action at my expense, I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not a checked by HERS rater, and if those installations fail to meet the requirements of such quality assurance, checking, the required corrective action and additional checking/testing of otherInstallations In that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF-1R)'form approved by the enforcement agency that identifies the specific requirements for the Installation. I certify that the'requirements detailed on the CF -IR tbat'applyto the installation have been met, • I will ensure that completed, signed copy of this Installation* Certificate shall be posted, or made available with the building permit(s) Issued for the building, and made available fo: the enforcement agency for all applicable Inspections. I understand that a signed copy of this Iasfallation.Certlficate is required to be. included with the documentation the builder provides to the building owner at occupancy,' I will ensure that'all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and•begtnni October 1, 2010,.for'afl low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) L t-VCiL Responsible Person's Name: Re'sponsible.Pe son's Signature: CSLB License: Date Signed; Position With Company (Title): Is this installation monitored. by a Third Party Quality Control Name of TPQCP.(if applicable): Program (TPQCP)9 0Yes Peoo'" rINSTALLATION CERTIFICATE CF-6R-MECH-25- I Itefri Brant Charge - Standard: Measurement Procedure. a e.3 of Site Address:. Enforcement Agency: Permit Namber: A 10 yunimum Airflow Regairement i Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference.Residential Appendix RA3.2. System Name or Identification/Tag I -* f Calculate: Actual Temperature Split= Tretum, db - Tsupply, db Target Temperature Split.from Table RA3.2-3 using Tretum, wb and Treturii, db Calculate difference: Actual Temperature Split - Target Temperature Split = Passes if difference is between =3°F and +3'F or, upon remeasurement, if between SSS -3°F and -100°F Enter Pass or Fail Mote.- Temperature Split Method Calculation is not necessary if actual Cooling Coil X irflow is verified using one of the airflow measurementprocedures specified in. Reference Residenda[Appendix R43.3. factual cooling coil airflow is measured the value must be'equal to'orgr^eater than the CalculatedMinimum Xirflow Requirement in the table below, Calculated Minimum Airflow Requirement (CFM) Nominal Cooling Capacity (ton) X 300 (cfin/ion) System Name or Identification/Tag Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RAM. procedures.(CFM) Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This,procedure is required to be used for' fixed orifice metering device systems System Name or. Identification/Tag Calculate: Actual Superheat = Tsuction — Teva orator. sat Target Superheat from Table RAJ.2-2 using Tfeburn, wb and Tcondenser, db Calculate difference: Actual Superheat — Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail IN STALLATION'CERTIFICATE CF-6R-IVIEC R4 .1 IRS Refrzerant Char e'(�eriiictin- Standard MeasurementProcedure a.e4rp te Address: / Enforcement Aeeho: Permit Number, Subcooling Charge Method Calculations for Refrigerant Charge Verification. This for thermostatic expansion'valve procedure is required to beusect (TXV) and electronic expansion valve (EXv) systems. System Name or Identification/Tag�,�� j Calculate: Actual Subcooling = Toondew sat - Tii uid Target SubcooIing specified by manufacturer I Calculate difference: Actual Subcoolin — Target Subcoolin = r System passes if difference is between -3 OF and +3 OF Enter Pass or Fail Metering Device Calculations for Refrigerant Charge .Verification. This procedure is required to be used for thermostatic expansion valve (TXV). and electronic expansion valve (EXV) systems. System Name or Identification/Tag CaIculate:. Actual Superheat = Tsuction — Z ev oreior sat / Enter allowable superheat range from manufacturer's specifications (or use range between 4°F and 25°F if manufacturer's 4 - specification is not available System passes if actual superheat is within the allowable superheat range S Enter Pass or Fail 1P INSTALLATION CE. gefrigerant Charge V Site Address: 5/7-30' Ave tion - Standard NTeamiramPn �1 Enforcement Ag( ------------- CF-6R-MEC_ H-15-�T Permit Number: f /07;0 ------------- Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling OR airflow criteria based on meas uirements taken concurrently during system operation. If corrective actions were taken, all a licable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System meets all refrigerant charge and airflow requirements.' Enter Pass or Fall DECLARATION STATEMENT • I certify under penaltyof perjury, under the:Iaws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept'responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency, I understand that it HERS rater will check the installation to verify compliance, and that that If such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations,. including those approved as part,of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance, checking, the required corrective action and additional checkiag/testing of other installations in that HERS sample group will be performed.at my expense. C Lreviewed a copy of the Certificate of Compliance (CF -1R) foiin,approved'by the. enforcement ageney that identifies the specific requirements for the installation, I certify that the requirements detailed on the CF -IR that apply to the installation have been met. e I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or 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 signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives ,:and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General. Contractor or. Builder/Owner) Gem.¢ C�r2 Responsible Person's Name: Responsible Person's Signature: is�J• clime' e L c3� r.� � •���r��--l! CSLB License: Date Signed Position With Com as (atle) Y Y Is this installation monitored by a Third Party Quality Contrroo Name of TPQCP (if applicable): Program (TPQCP)7 Oyes o