06-1994 (SFD)P.O. BCP -W 15(W
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
Tjht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
�06-00001994
5-4-018—RIVIERA
775-030-022- -
DWELLING - SINGLE FAMILY DETACHED
.LOW DENSITY RESIDENTIAL
197192
rchitect or Engineer:
C -1 � �_ -4 - �ft 7- V__�7�7 �
Cao,s��
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 Professionals Code, and my License is in full force and effect.
Li a Class: 13 License No .- 760044
Date: ontractor: �.
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).:
(_ 1 1, 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 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.).
1 _) 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:
LQPERAUT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/15/06
Owner:
RIVIERA VILLAS
1651 E 4TH ST NO 228
SANTA ANA, CA 92701
WORKER'S COMPENSATION DECLARATION
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.
1 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 FUND Policy Number W613-4291
_ 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 1 should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthkyith comply with those provisions.
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 Director of Building and Safety 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 unty to ter upon the above-mentioned property for inspection urposes
ate' gnature (Applicant or Agent
Contractor:
FIRST PACIFICA DEV
CORPUL
EF%AkNCL-
171006300
EAST STATE ST,
SUITE 4REDLANDS,
CA 92373
QF(909)798-3688 LA
UIM
QU TA
Lic. No.: 760044
DEP.T.
WORKER'S COMPENSATION DECLARATION
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.
1 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 FUND Policy Number W613-4291
_ 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 1 should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthkyith comply with those provisions.
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 Director of Building and Safety 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 unty to ter upon the above-mentioned property for inspection urposes
ate' gnature (Applicant or Agent
n
r
aw Application Number . . . . . 06-00001994
Permit
. . .
BUILDING PERMIT
Additional-desc
.
Permit Fee
. . . .
982.50
Plan Check Fee
159.66
Issue Date
. . . .
Valuation
197192
Expiration
Date
12/12/06
Qty" Unit Charge
Per•
Extension
BASE
FEE
639.50
98.00
-=--------------------------------------------------------------------------
3.5000
THOU BLDG
100,001-500,000
343.00
Permit
. . .
MECHANICAL
Additional
desc .
Permit Fee
. . . .
83.50
P1an"Check Fee
5.22
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
12/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2.00
9.0000
EA MECH
FURNACE<=100K
18.00
2.00
9.0000
EA MECH
B/C <=3HP/100K BTU
18.00
4.00
6.5000
EA MECH
VENT FAN
26.00
1.00
----------------------------------------------------------------------------
6.5000
EA MECH
EXHAUST HOOD
6.50
Permit
. . ELEC-NEW RESIDENTIAL
Additional
desc .
Permit Fee
. . . .
105.75
Plan Check Fee
6.61
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
12/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2271.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
79.49
563.00
----------------------------------------------------7-----------------------
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
11.26
Permit
. . . PLUMBING
Additional
desc .
Permit Fee
. . . .
166.50
Plan Check Fee
10.41
Issue Date
Valuation . . . .
0
Expiration
Date
12/12/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
16.00
6.0000
EA PLB FIXTURE
96.00
1.00
15.0000
EA PLB BUILDING SEWER
15.00
LQPERMIT
9
LQPERAIIT
dF Application Number .
. . . . 06-00001994
Permit . . . . PLUMBING
Qty Unit Charge
Per
Extension
1.00 7.5000
EA PLB WATER HEATER/VENT
7.50
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00
8.00 .7500
EA PLB GAS PIPE >=5
6.00
1.00 15.0000
EA PLB GAS METER
15.00
Permit . . . GRADING PERMIT
Additional desc .
Permit Fee . . . .
15.00 Plan Check Fee
.00'
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
12/12/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
------------- -- ------------------
Special Notes and Comments
SFD - LOT 8, PLAN 1A,
2271 SF. PERMIT
DOES NOT INCLUDE POOL,
SPA, BLOCK WALLS
OR DRIVEWAY APPROACH.
75% REDUCTION TO
PLAN CHECK FEE DUE TO
MULTIPLE ISSUANCE
OF SAME PLAN TYPE. 2001
CBC, CMC,
CPC, 2004 CEC, 2005 ENERGY CODES
-=--------------------------------------------------------------------------
Other Fees . .. . .
. . . .. ART IN PUBLIC PLACES -RES
20.00
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
480.00
ENERGY REVIEW FEE
15.97
DIF FIRE PROTECTION -RES
140.00
GRADING PLAN CHECK FEE
.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892.00
STRONG MOTION (SMI) - RES
19.71
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1666.00
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total
1353.25 .00 .00
1353.25
Plan Check Total
181.90 .00 .00
181.90
Other Fee Total
3751.68 .00 .00
3751.68
Grand Total
5286.83 .00 .00
5286.83
9
LQPERAIIT
HERS RATER COWLIAN E TATEMENT
The house was: ✓ 11Tested ✓ pproved as part of sample testing, but was not tested
As the HERS rater providing diagno tic testing and field verification 1 certify that the house identified on this form complies with
the diagnostic tested compliance requirements as checked ✓ on this ?z rm. The HERS rater must check and verify that the new
distribution system is fully ducted and correct tape is used before a CF -4R may be released ori every tested building. The HERS
rater must not release the CF -411 until a properly completed and signed CF -6R has been received for the sample and tested
buildings.
.IT The installer has provided a copy of CF -6R (Installation Certificate).
New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts).
O New systems where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in
combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections.
7P!d�u,'es NIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
, for field ver cation and diagnostic testing of air distribution systems are available in RACM, Appendix RC4. 3.
Duct Diagnostic Leakage Testing Results
NEW CONSTRUCTION:
I I Duct Pressurization Test Results (CFM a@, 25 Pa)
1 Enter Tested Leakage Flow in CFM:
2 Fan Flow: Calculated (Nominal: ✓�diCooling ✓ ❑ Heating) or ✓ ❑ Measured
Enter Total Fan Flow in CFM:
3 I Pass if Leakage Percentage 5 6% ( 100 x [(Line # 1) / (Line # 2)1]
ALTERATIONS: Duct System and/or HVAC Equipment Change -Out
4 Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to
Duct System Alteration and/or Equipment Change -Out.
Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System
5 for Duct S stem Alteration and/or E ui ment Change -Out.
Enter Reduction in Leakage for Altered Duct System L
6 (Only if Applicable) _(L e # 4) Minus (Line # 5)]
7 Enter Tested Leakage Flow in CFM to Outside (Only if A e)
8 Entire.New Duct System - Pass if Leakage Pereenta /0
100 x Line # 5 / Line # 2
TEST OR VER1F
IS i '�q-
Measured'
Values 1!.'
✓ .. V/
Dss El Fail
❑ Pass El Fail
KATION SANDARDS• r Altered Duct System and/or HVAC Equipment Change -Out
Use one of the following four Test or V cation Standards for com liance: ✓ ✓
9 Pass if Leakage Percentage < /o [100 x c(Line # 5) /
(Line # 2))] ❑Pass ❑ Fail
10 Pass if Leakage to O de Percentage:5 10% [ 100 xLine # 7
�-----( )' /
(Line # 2)11 El Pass. 13 Fail
Pass if Leaka eduction Percentage >_ 60% 100 x
11 and Veri tion b Smoke Test and Visual Ins ection�-(Line # 6) / (Line # 4)]]
❑ Pass ❑Fail
12 Pas ealin of all Accessible Leaks and Verification bX Smoke Test and Visual Ins tion
of ❑ Pass ❑ Fail
Pass if One Lines # 9 through # 12 p .i,"'`
Residential Compliance Forms '
a=i)'I''. ;�fz; []Pass ❑ Fail
April 2005
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3 of 8 CF -4R
Project Address �. I Builder
59 611K t d 045_ erg otfk kA tV",
Builder Contact
Telephone Plan Number
r�c.ar>
HERS�
Rater 1 Telephone Sample GroupNumber 1
'D J
- �trZ. t 3�5
Compliance Method (Prescriptive) �v 'Z Climate Zone /
Certifying Signatu / nate Sample House Numbed
P L% H S P eider
�4 v
Street Address: 41 Ci /State/Zip /f
C�a�
Copies to: BUILDER, ]HERS PROVIDER AND BUILDING DEPARTMENT 12
HERS,RATER COMPLIANCE STATEMENT
The house was: v"'[1 Tested
fApproved as part of sample testing, but was not tested
As the HERS rater providing diagnostic t and field verification, I certify -that that the h
wi h diagnostic tested compliance requirements as checked on this form house identified on this form complies
✓e installer has provided a copy of CF -611 (installation Certificate).
✓ ❑ THERMOSTATIC EXPANSION VALVE (TXV)
Procedures for field verification of rherrnosianc expansion valves are available in RAC.`. Appendix R[
Access is provided for inspection. The procedure shall consist of
✓ ❑ Yes ❑ No visual verification that the TXV is installed on the system and (�
installation of the specific equinment shall be verified.
Yes is a nass.. FOR
✓ ❑ REFRIGERANT CHARGE MEASUREMENT
Verification for Required Refrigerant Charge for Split System Space Cooling Systems without Thermostatic
Valves
tdoor Unit Serial #
Location
Outdoor Unit Make
Outdoor Unit Model
Cooling.Capacity B /hr
Date of Verification
Date of Refrigerant Gauge Calibration lust be c c on 'Y'
Date of Thermocouple Calibration (must be monthly)
Standard Char a Measurement outdoor air d"F and above
Note: The system should be installed and ch ed in accordance with the manufacturer's specifications and installer
verification shall be documented on CF- before starting this procedure. If outdoor air dry-bulb is below 55 T rater shall
use the Alternative Charge Measure cedure
Procedures for Determinin ri Brant Char a usin the Standazd Method are available in RACM A endix RD2.
✓ ❑Yes ❑ No coPY of CF -6R (installation Certificate) has been provided with refrigerant charge
measurement documented.
Forms
April 2005
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 5 of 8) CF -4R
Project Add r S5_1
Bu der Name
Builder Contact Telephone
='ick
Plan Number
•113. of 01
HERS Rater Telephone
Sam le Grou Number
✓ ❑ MAXIMUM COOLING CAPA
Certifying Signature 14,1/aq�_ Date
Sample House Number
racedures or determinin maximum co �n load capacity are available in RAC f Appendix RF3.
J'01-
M F*
HERSProvider
Street Address:
City/State/Zip:
�nnercto Rl.11l.r►FR LIFQCvonv�nco..ire.�.i..
Z>'6I:4AW—s — ?T
HERS RATER COMPLIANCE STTENT
The house was: ✓ 11 Tested ✓ �pprnov as part of sample testing, but was not tested
As the. HERS rater providing diagnostic t sting and field verification, I certify that the house identified on this form complies
wit diagnostic tested compliance requirements as checked on this form.
✓
Ole installer has provided a copy of CF-bR (Installation Certificate).
✓0 ADEQUATE AIRFLOW VERIFICATION
Procedures for field very kationn d d'
ato nostrc teshn a ude uate ailoiv are available in RACM. Append'
Method For Airflow Measurement
[]Yes ❑ No Duct design exists on plans
❑ RE4.1.1 Di nostic Fan Flow Using Flow Capture Hood
❑ RE4.1.2 Diagnostic Fan Flow Usin Pie um Pressure Match'
❑ RE4.1.3 Dia ostic Fan Flow Usin Flo Grid Measur nt
M red Airflow:
EO
Total CFM
Rated Tons:
cfm/ton
Yes ❑ No Measured airflow, is great an th ria in Table
Yes is a pass Pass
Fail
✓ ❑ MAXIMUM COOLING CAPA
Y
racedures or determinin maximum co �n load capacity are available in RAC f Appendix RF3.
I %/❑ Yes ❑ No"', te airflow verified (see adequate airflow credit)
2 V'❑ Yes ❑ N Refriant charge or TX V
3 ✓ ❑ Yes No Duct leakage reduction credit verified
4 ✓ ❑ ❑ No Cooling capacities of installed systems are:5 to maximum cooling
capacity indicated on the Performance's CF- I R and RF -3.
If the cooling capacities of installed systems are> than maximum
5 ❑ Yes ❑ No cooling capacity in the CF R, then
✓
-I the electrical input for the
'�
installed s stems must be 5 to electrical input in the CF -IR.
❑ ❑
Yes to I, 2, and 3; and Yes to either 4 or 5 is a ass
Pass Fail
✓ IGH EER AIR CONDITIONER
edures or veri ication are available in RAC'A4 ,4 endix Rl.
I ✓ ❑ Yes ❑ No EER values of installed systems match the CF -I R
2 ✓ ❑ Yes O No Fors lit --t— indoor coil is matched to outdoor coil
3 ✓
✓
❑Yes ❑ No Time Delay Relay Verified (If Required)
✓
Yes to I and 2; and 3 if Re uired) is a passass
Fail
Residential Compliance / orms
April 2005
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 6 of 8) CE -4R
Project Address ILAl.t}6,tt Builder Na
c A
Builder Contact Telephone
Plan Number
2a. ❑ Yes INo
If Mechanical Ventilation is required on the CF -I R (Yes in line 2), has it been
HERS Rater Telephone
Sample G oup Number f
'b• ❑ Yes / 0
Check this box yes if mechanical ventilation is required (Yes in line 2) and
ventilation fan watts are
Certifying Signature Date
Sample House Number.,,T.
p
�,.
Firmer
C.: t� te-z .tea ae a e�✓t��� _. �S :,.z �.�
H RS rovider
Street Address:
City/State/Zip:
opies to: BUILDER, HERS PROVIDER AND nrin nrnic ncnA m
and house pressure is greater than minus 5 Pascal with all exhaust fans
operatine.
HERS RATER COMPLIANCE STATEMENT v .
The house was: ✓ ❑ Tested ✓ ❑ Approved as part of sample testing, but was not test
its the HERS rater providing diagnostic testing and field verification,.I certify that the se identified on this form complies
with ih'e diagnostic tested compliance requirements as chked on this.form.
✓ ❑ The installer has provided a co y of CF -611 (Install tion Certificat
./13 FAN WATT DRAWIV
l'rvc edures for megsurin the air handler ivall draw re •ail ble in RAI-Af .a endix RE3.2.
✓ Method For Fan Watt Draw Meas ent
❑ RE3.2.1 Portable Meter Measu en nt
❑ RE3.2.2 Uti ' evenue Meter M urement
easured Fan watt Draw: enter watts here) Waw
Measured Fan Flow (Enter total cfm from airflow verification) cfm
Enter results of Watts/cfin: Watts/cfm
✓ ❑Yes
�ONo Calculated an watt/cfm is equal to or lower than the fan
watt/efm draw documented in CF- I R ❑ j]
HERS RATER COM ANCE STATEMENT Yes is a ass Pass Fail
The house was: ✓ ❑ Tested ✓ pproved as part of sample testing, but was not tested
As the HERS rater providing d• gnostic testing and field verification, i certify that the house identified on this
with the diagnostic tested compliance requirements as checked on this form. form complies
✓ WThe installer has provided a copy of CF -6R (Installation Certificate)
✓/❑ MINIMUM REQUIREMENTS FOR INFILTRATION REDUCTION COMPLIANCE CREDIT
Procedures fin field ver0caiion and diagnostic letting afinfiltration redrrclion are available in R4CA4Section 3.5.
Dia nostic Testin Res It
✓ ✓
I es ❑ No
u s
BuildingEnvelope Leakage (CFM 50 Pa) as measured b Rater:
Is measured envelope leakage
2 ❑ Yes o
less than or equal to the required level from CF 1 R?
Is Mechanical Ventilation shown as required on the CF- I R?
2a. ❑ Yes INo
If Mechanical Ventilation is required on the CF -I R (Yes in line 2), has it been
to
installed?
'b• ❑ Yes / 0
Check this box yes if mechanical ventilation is required (Yes in line 2) and
ventilation fan watts are
3. Wres ❑ No
no greater than shown on CF -I R.
Check this box yes if measured building infiltration (CFM (a,) 50 Pa) is
greater than
the CFM (r�r, 50 values shown for an SLA of 1.5 on CF -I R
If this box is checked no mechanical ventilation is required.)
4• 0 e 'ONO
Check this boxyes if measured building infiltration (CFM c@ 50 Pa) is less than the
CFM a, 50 values shown for an SLA of 1.5 on CF -1 R, mechanical ventilation is
installed
and house pressure is greater than minus 5 Pascal with all exhaust fans
operatine.
j Pass if, a) Yes in line I and line 3, or b) Yes in line I and line2, 2 ✓ ✓
I line 4, Otherwise Fail. a, and 2b, or c)Yes in line I and
❑
Residential Compliance /•Orn7b ass Fail
4pri/ 2005
I
war «,.: � •
-Nov 13 2007 8:3919119 KISSINGER RC
r. 909-595-6357 P•4
INSTALLATION CERTIFICATE Pa 1 cFOR
Site Addmw 54018 RMERA WAY Permit Number
An Installation CerlNicste Is required to he posted at the building site of made available toren appn0pd5% bqx4wm
(The Information provided on thk form Is ABU completion of final Inspection, a copy num be t1
mvMed
to the bump deparbneM (upon mqueo and the building owner at occupancy, per Section io-la (e)
HVAC BYBTEk%3:
fieeflne
Equip TVs
Frost
CEC aer4fied mtr
Name and Modal Na
Number
# of
Identical
3
e"wency
(AFUE, etci
F1 R value
Duct
Looatlon
eta
Duct or
Plphq
R Value
Hoeft I
Load
Btulh
Heatlrr0
AIRE FLO
AFSOMPA05OB3
so%
ATTIC
4.2
40,000
50,000
AIRE FLO
AFSf>{1APAO50B3
so%
Arncl
4.2
40000
1 50,000
SEASON
CCACM13
13.0 / 11.0
'38.00
36.00
ALL STYLE
ASL338-22A35
Coofift w
Equip Type
fit
CEC certified M&
Name and Model No.
Number
#01
identical
a
Efflclency
(SEER or EER,etc)
1R value
Dud
Location
Dud or
POMO
R -Value
. Hm*v
Load
(0111M
Haadrg
Cam.
Joluffir)
SEASON
CCAG3613
13.0/11.0
36 000
38,000
ALL STYLE
ASLB38-22A35
SEASON
CCACM13
13.0 / 11.0
'38.00
36.00
ALL STYLE
ASL338-22A35
12! symbol mads greater then orequel to what is indicated on the CFAR vaicie.
Include balk SEER and EER if conipllence Gadd for high EER air Conditioner is Claimed.
❑ I, the r Wwaloned, verty that aqulpm m Hated above Is: 1) is the actual equipment instageQ 2) equivalent to or
more efficient then that specified In Ute oerttttaete of compilance (Form CF -1 R) sutxntitad for compliance with true
Energy df bncy Stwxbr* fbr reeidentlai buildings, and 3) equipment that meats or exceeds ftte appropriate
requirements for manutadtured devises (From the Appffance Eil#ency Regulations or Part (8) wham app[rcabte.
Installing Subcontractor (Co Name) OR General
c«taactor Co
Kissinger Air Conditioning, Inc.
°sem
Tuesday, November 13 2007
Oopiee f1f.` OUI DING MPARTMENT, a RATER OF APPLICABLF-) BUILDING OWNER AT OCCUPANCY
Residential Compfa, Forms Aptp 200
V i,e_e-UUY U:,3WHN KISSINGER.. RC.
909-595-63571
fps r. 4'
y!
INSTALLATION ICE-RTIFICATE
Pam 2 CF8R
�jtiiT
54-018 RMERA WAY Pm* Nix," I I
I.INSTAL, 4el
a HIP
LER C(AWL
"'
IANCE STATEMENT FOR DUCT LEAKAGE'
- -.-Adkd9W%%~fflPlLJA0=WATBlEW
.,lbmi ova" u=
-VTodw at Fal Cl TwAmd at ftwown
"'OWALLJER%ISLIALMPCCTIMATFWMCXMgyp4j=N STAGE:'13 PArnm stismatimm sup* wd
wdmai
amMe returnM918fal. and " thatspawd bowW ft gglat, boot arm the dulw,
pmp*
j113 ffftft
NOVI '"m wb'b gm m4bdOW bmvm cmftcted Wicid sk hander bwAid. kepea me =mmn pdft
Nl ft air hodu and ft up* and MbM pbnUftn fa " thatthe CMr
n pokft WOPMP" _ "I � 11 4 ,
- J'j—
Al'El "ed 410ift tO emm "M fm ISM ACW
Mck-d bbr niffiesims duct tMm Is wm&
"&CW (La. does not use bundhg C&Valles pignmia or PWV=m
ductel muIn lm Nu of
U DUCT lwu6ianREMMOW—
for
MM AmPma ICU 15"
I
I I DOVMWAMM � lvw6.
ummum rl�' in %Wrm:
Fan Flow, calcukw
ff 4m 1 -- r LJUsssiifed
r, 1Fan Flow Is CWWkW me 400 din/W x number of lona or as 21.7 clhW(kBtulhr) x Hwft
In Thousand of sWMr OLftuL
Polls it Laam" PaRm"s, s 6% for FINI or S 4-96 at RaQh4n:
%n—r
12M
1 4.0896
13 1. tha tmdwWgned. mffy 9W no above diag
r=ft IM results were PwFmir ad Wconflommart" Vft do foqL*Wnwft
for OWN"1108 creft 1, ft undiW84ned, also camy
Fans nOW19d Alr-DftftuVw SysUM Duft pbrKwng and
OwVYuft Mandalay mqWmnwo SPOCIfiadr8=1(m) of alm
2005 19ukft EmW Eftmricy etmdwdL
0 114 ' I "ii
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M
0 THEMOWATC EVANsm VALVE am
at RACK AAow? ft M
w" Is PmVkW fbr ms
SW at %ftLW Veff=&m OMfxy13 hft%d an
syftm WW bilit"00111 Of the 8Pscftsqu*ffwnt
u6. -
113 MH EER ALR Commilow-R
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,t3i,2007 6:40RH
KISSINGER RC
. . 909-595-6357
jkj41f,`T1'JWALLM v°-TE19ENTThs Bukft 01tFilMil 0 Teded of R*Whb
r-4 VOLIAL 11411PECTKIN AT FN& CONSTRUCT KM STAGE:
p •
13 Rmwm id mm ons aprop pp* and am rahm vagmw, and vwffY QW aealsd opmood bebNeen On nigher bad and the k"jo;
N
N" hmm Mugllb-M 04wtbdOOP telt was GmWucbd wi#md an adr handier butdod. Inspeaft
aup* and 113111111 P18mum bverffy tW theca PoIntoompulaml 0
M` IF
111- 4111jakdolocnewoYMnOdOMW C'rmd AlIftradhembedAmItepe loused.
V 13 -t';,
"WOMMAD11 SYSIMMIsfullycluchid 0.& does not use WWh19 CMUM plenums or pMMbm,4
"ftm In au of
t
U IXXTLEAKAOe REDLCTXNF--
for
V41 DST - mommured
prewAnt Results (CFM ft 25 Pi) 2 1 UPSTAIRS' v ' Am
1. Effler Teem w
2 Fan Flow.
Heating) or EJWI�ured
�
11 Fen FIcw bcalbAted as 400 cftftn x Meow of Um 21.7 chW(ketulm) x Hbaft 1200
Cftkgv In ThousandsdRhofiw — or"
04 tOrtOWCOICUlated9r."wKwured fan flodnr In CFU
FhM*r!9W%a1RcuWWn!
UWA MW
Ak_
fbr _DWrIbutkm Sydem IN 1
14 ;,Had Quet, Plenum ads
FaC*W4* With MWWd0tXY fSqWMWdMtB 8POcIfled In aeclion 150 (M) of the 2005 lqu
NOV Energy Efthmw slandmift
U IMMOMMIMATIC EMANSM VALVE (TXV)
PfUMORM AW POW van*vam Of RWMWMft aVanstm v&kva are avOM19 of RACM, AAwm* PJ
so is pnn4dw far 11191186OW The �pmmftm "a
3W of visas! vsfffic&tcn that On TXV to hoded on
walamenQi mmumbon of ft spvft eww"
HM EER AIR CONOTMER
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to CF -1 R
to Ouww Dail
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Air Condtfioning. inc
d?IY, November 13, 2007
i
- Certificate.of OccupancY
4
Lvcaaou7m4��
G� of�w Building & Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
'
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
i
BUILDING ADDRESS: 54-018 RIVIERA
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 06-1994
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: RIVIERA VILLAS Address: 1651 E. 4th ST.
City, ST, ZIP: SANTA ANA, CA 92701
By: STEVE TRAXEL
Date: MARCH 31, 2008
Building Official
POST IN A CONSPICUOUS PLACE
_
M.