12-0742 (MECH)i I IIIIIII ILII III VIII (III 12
P.O. BOX 1504 _ _ _ IE
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
1'2-:00000742.
Owner:
Property Address:
79199 CETRINO
GOZA DENNIS D
APN:
772-110-048-
- -
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
28000
Contractor:
Applicant:
Architect or Engineer:
ALL SEASONS A/C, PLMBG
P.O. BOX 1112
PALM DESERT, CA 92261
(760)568-2663
Lic. No.: 827420
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury t I�a m licensed ;de revisions of Chapter 9 (commencing with
Section 70P0.1 of Division 3 of the Busi ess in d Profession Co e, and my License is in full force and effect.
Licens14��:,ractor: C20C36 Lice. a No.: 827420
/Date:
OWN $ LDER DECLARATION
I hereby affirm under penalty of erjury tha I am axe p( from the Contractor's State License Law for the
following reason (Sec. 7031 .5, B mass d Professi 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 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 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 contractorls) 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/03/12
kJ
UL 0 2012
CITY OF:
QUINTA
FINANCE CEPT.
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier NORGUARD INS Policy Number ALWC124752
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, i I u d ecome subject to the workers' compensation provisions of Section
'2)3700 of the or ode shall f hwi om ly with those provisions.
gate: ( ✓ A icant.
WARNING: FAILURE TO SERE YORKE S' CO ION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TSO CRIMIISf1L PEI S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,000). IN fll0 TO THE 9 T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTERE , 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 bov r�jformation is correc agree to comply with all
city and county ordinances and state laws relating to b din ons ruction, and her y a hwize representatives
of this coup / to enter up the above-mentioned prop rty r n b pros
Date: nature (Applicant or Agent):
Application Number . . . . . 12-00000742
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 91.50 Plan Check Fee
22.88
Issue Date . . . . Valuation . . . .
0
Expiration Date 12/30/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
3.00 9.0000 EA, MECH FURNACE <=100K
27.00
3.00 16.5000 EA ' MECH B/C >3-15HP/>100K-500KBTU
49.50
_----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE -OUT: INSTALL 3 COMPLETE
SYSTEMS, FURNACES, COILS, CONDENSERS.
2010 CODES.
------•----------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 91.50 .00 .00
91.50
Plan Check Total 22.88 .00 .00
22.88
Other Fee Total 2.00 .00 .00
2.00
Grand Total - 116.38 .00 .00
116.38
LQPEIN7IT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
79199 Cetrino (Bedrooms) La Quinta, CA 92253
City of La Quinta
Jul 2, 2012
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
p Furnace
Indoor Coil
2 AFUE78 /o o
SEER
❑ COP
HSPF
❑ R 6 (CZ 10-13)
Served by system
0 Setback
p
p 13.0
❑
❑ R g CZ 14-IS
( )
1600 sf
If not already present, must be
p Condensing Unit
❑ EER
❑ Resistance
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-1111
and CF-611 shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF-4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
• Indoor Coil and /or
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Furnace
CF-4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA _< 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
[14. The system will not be Ducted (iej,Ductless.Mini-Split System) -(Also •Exempt -from ;Refrigerant Charge)
❑ 2. New HVAC System
Required Forms: L
. Cut in or Changeout with,
new ducts: (all new
CF-6R forms: MECH-04, MECH-20 HER and (for split systems) MECH-22-HERS, and
ducting � all new
MECH-25-HERS
CFfor
-4R ms: MECH-20 and (for split systems) MECH-22, and MECH-25
equipment)
, =
.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. '
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF-4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
114. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF-6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF-4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions 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 Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features Identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: David Beale Signature: David Beale
Company: ALL SEASONS AIR CONDITIONING PLUMBING & HEATING INC Date: Jul 2, 2012
Address: 73605 DINAH SHORE DR STE 1310M License: 827420
City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 568-2663
Reg: 212-A0035151A-00000000-0000 Registration Date/Time: 2012/07/02 19:21:21 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:Permit
#:
79199 Cetrino (Great room) La Quinta, CA 92253
City of La Qui nta
Jul 2, 2012
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
p Furnace
p Indoor Coil
@ AFUE 78%
p SEER 13.0
❑ COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
@ Setback
If not already present, must be
m Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
1600 sf
installed)
❑ Other
1. Equipment Type: Choose the equipment being Installed; if more than one system, use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment Efflclencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -611 and registered CF -4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -111
and CF -611 shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -411 forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
• Indoor Coil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Furnace
CF -41R. forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted (ieDuctless.Mini-Split System) -(Also -Exempt from ,Refrigerant Charge)
112. New HVAC System
Required Forms: V f f i v
. Cut in'or Changeout with
"
l
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and
new ducts: all new
ducting=(all new /}
MECH-25=HERS
CF -4R forms: MECH-.20, and (for split systems) MECH-22, and MECH-25 I
equipment) -/� , -/
"/ , 'N J
� - I
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement
• Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF -411 forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
114. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF -411 forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions 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 Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the Information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: David Beale Signature: David Beale
Company: ALL SEASONS AIR CONDITIONING PLUMBING & HEATING INC Date: Jul 2, 2012
Address: 73605 DINAH SHORE DR STE 1310M License: 827420
City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 568-2663
Reg: 212-A0035146A-00000000-0000 Registration Date/Time: 2012/07/02 19:15:07 HERS Provider: CalCERTS, inc.
2008 Residential Compliance Forms July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
79199 Cetrino (Casita system) La Quinta, CA 92253
City of La Quinta
Jul 2, 2012
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
p Furnace
p Indoor Coil
p AFUE 780/,
p SEER 13.0
❑ COP
❑ HSPF
❑ R 6 PCZ 10-13)
Served by system
2 Setback
If not already present, must be
p Condensing Unit
❑ EER
❑ Resistance
❑ R gCZ 14-15 )
So sf
—�
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-1111
and CF-6111 shall also be on site for final Inspection.
1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF-411 forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or
. Indoor Coil and /or
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• Furnace
CF-4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage,< 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing If:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The system-will not be Ducted (ieyDuctless,Mini-Split System),(Also_,Exempt,from[Refrige`ant Charge)
❑ 2. New HVAC System
Required Forms: [<
• Cut in or Changeout with,''
new ducts: (all new
" "}')As:' # 1t '— ' i k
CF-6R fMECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and
,
ducting � all new
MECH 25--HERS W
I ! Q
CF-4R forms:;MECH-20, and (for split systems) MECH-22, and MECH-25 '}
equipment)
P )
-l1 t✓r \ ti ! . � :.J ! .x / ti f` rrE
For Split Systems: Duct leakage <'6 percent; RC, CCA-.z 350 CFM/ton, FWD,-TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage` < 6 percent '
113. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF-4R forms:'MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
114. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF-6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF-411 forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions 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 Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: David Beale Signature: David Beale
Company: ALL SEASONS AIR CONDITIONING PLUMBING & HEATING INC Date: Jul 2, 2012
Address: 73605 DINAH SHORE DR STE 1310M License: 827420
City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 568-2663
Reg: 212-A0035144A-00000000-0000 Registration Date/Time: 2012/07/02 19:11:56 HERS Provider: CaICERTS, Inc.
2008 Residential Compliance Forms July 2010
Bin #
City of La Quintd
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:
Owner's Name: DeV-L� 1--t>-6
A. P. Number:
Address: -M I in.. G'P+-f;?-i V1 0
Legal Description:
City, ST, Zip: L4 0 W vLfx ) 64 I'ZZG
Contractor: 'u
A ! /(,suV1_S
Telephone: -
........ . .
Address: ]No0C-?Dir YAY15V1VY?(?,-DJ..2 -+Y-1-7>)0Y)11
Project Descr iption:
City, ST, Zip: F�J 16 0!'(--Pu&-
CA 11 Z2-1
Telephone:
State Lic. 4-
City Lic. Lp 31
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
... .. ....
...........
............
.. .......... ..
............ ..........
I .............
........... . ..............
..............
........... .
.......... . . . ...........
Coil truction Type:. Occupancy:
State Lic.
Project type (circle one): New Ad 'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
4 Stories:
11 Units:
Telephone # of Contact Person:
Estimated Value of Project: g?'>C)DOD
APPLICANT: DO NOT. WRITE BELOW THIS LINE
Submittal
Req'd
Rec1d
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount:
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked tip
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"'' Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact [lei-son
Plumbing
Grant Deed
Plans picked up
S.M.I.
I-I.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Jrd Review, ready for corrections/issue
Developer Impact Fee,
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
INSTALLATION CERTIFICATE CF-6R-MECH-03
Pool And Spa Heatingstems (Page 2 of 2
Site Address: ' Enforcement Agency: Permit Number.
lb
System Piping i
1. ne suction side pipe is straight for at least 4 pipe diameters before entering the pump (See table below for the
required straight run lengths for various pipe sizes).
2. The design uses low pressure drop fittings (sweep%'s). "
r i
Pipe Diameter Required Pipe Length
inch leadinginto um inch
1.5
6
2
2.5
8
10
3
12
Filtration Equipment
❑ 1. If a backwash valve is used: The diameter of the backwash multi -port valve is 2 inches or as large as the
circulation pipe, whichever is greater
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.
• 1 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 deplans an"d'specificetions approved by the
enforcement agency. i
I reviewed a copy of the Certificate of Compliance (CF -I R) form approved by the enforcement agency that identifies the specific
requirements for the. installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met.
• l 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.
Company Name: (Installing Subcontractor. or General Contractor or Builder/Owner)
Lt►,IA '5 Zcr.
Responsible Person's Name: _ Responsible Person's signature:
CSLB License: Date Signed:
2008 Residential Compliance Forms
August 2009
INSTALLATION CERTIFICATE CF-6R-MECH-03
Pool And Spa Heating Systems (Page 1 of 2
Site Address: Enforcement Agency: Permit Number.
Pool and Spa Heating Systems requirements
§114(x): Systems and Equipment.
Ak 1. Heater has a thermal efficiency that complies with the Appliance Efficiency. Regulations.
,$ 2. Has a readily accessible on-off switch mounted outside of the heater.
Q 3. Weatherproof plate or card containing operating instructions for the pool or spa heater.
4. No electric resistance heating except for listed package units that has fully insulated enclosures and tight fitting
covers that are insulated to at least R-6. Or if documentation is provided that at least 60 % of the annual heating
energy is from site solar energy or recovered energy. .
5. Heating system has no pilot light.
§114(b):. Installation.
"IX 1. System is installed with at least 36" of pipe between the filter and heater, or dedicated suction and return lines,
or built-in or built-up connections for future solar heating.
(W 2. A cover for outdoor pools or spas that have a heat pump or gas heater.
CK 3. Pool system has directional inlets to adequately mix the pool water
j� 4. Time switch which will allow the pump to be set or programmed to run during off: peak periods only
§150(p) Pump Sizing and flow rate specification -
1. The pump specified is listed in the CEC database of certified pool pumps.
2. The pump flow rate shall be calculated based on pool sizing table below.
3. The pump is capable of operating at 2 or more speeds (not applicable if pump is less than 1 horsepower).
k4. Each auxiliary pool load is served by either a separate pump, or the system is served by a multi -speed pump.
Pool sizing (Values are based on a maximum allawahle turnover rate of 6- hnursl
Max Pool
Volume
(gallons)
Min Pipe D or Greater
inches)
Min Filter Area or more
(sqare feet
Max Pump
Flow m
Return
Suction
Cartridge Sand
DE
13,000"
.1.5
1.5
100 2.4
20
1 36
17,000
1.5
2
130 3.1
25
47
21,000
2
2
160 3.9
30
58
28,000
2
2.5
210 5.2
40
78
42,000
2.5
3
320 7.8
60
117
48,000
3
3
360 8.9
70
133
v4ote: r or pumps greater inan i np. [ ne maximum Pump Plow is the Lowest speed dejautt pUratton..
❑ 5. Calculated volume of pool 70,0414:0 (gallons).
❑ 6. Return Pipe Diameter '11�.(inches):
❑ 7. Suction Pipe Diameter (inches). _. .
❑ 8. Filter Type y 2-0 (Cartridge, Sand, DE).
❑ 9. Filter Surface Area q 20 (SO
❑ 10. Max Pump Flow x0' (gpm)
2008 Residential Compliance Forms August 2009