MECH (12-1096)77153 Calle Mazatlan
13-1096
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
13-00001096
77153 CALLE
658 -230 -008 -
MECHANICAL
LOW DENSITY
3900
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
MAZATLAN
RESIDENTIAL
Architect or Engineer:
--------------------------------------------------
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.
LicenseeLlass: /C,20 License No.: 619091 ► Ctr cto
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 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.). -
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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 _
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:
LQPER.MIT
Owner:
MURCER BOBBY
5808 CHESTNUT CT
EDMOND, OK 73003
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/03/13
Contractor:
PALOMA AIR.CONDITIONING OA*-
P.O. BOX 3501
PALM DESERT, CA 92261
'(760)347-1212 C/IVOF
Pr
L i c . No.619 0 91 F1NAN U1'04
-----------------------------------------
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.
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 COMPANION PROPT Policy Number CPCA17452
_ 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 I should become subject to the workers' compensation provisions of Section
370R of the Labor Code, I shall forthwith comply with those provisions.
i
.Date:. APPIi t:- -- -
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 1.80 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 u o the above-mentioned grope for inspection purposes.
/P 1/ ) / /,
Date:` Signature (Apel' icant or Agent):
r
'. LQPE ffIT
Application Number . . . . . 13-00001096
Permit . . . MECHANICAL 2013
Additional desc .
Permit Fee . . . . 71.50 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 3/02/14
Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH FURNACE
35.75
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT - 13SEER/78AFUE 2 TON
PACKAGE UNIT (2008 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2010 CALIFORNIA
BUILDING CODES.
--------------------------------------------------------------------------=-
Other Fees . . . .. . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E'
90.57
PLAN CHECK, MECHANICAL
47.66
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 71.50 .00 .00
71.50
Plan Check Total .00 .00 .00
.00
Other Fee Total 139.23 .00 .00
139.23
Grand Total 210.73 .00 .00
210.73
Bin #
City of La Qu►nta
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: G
wner's Name: .P-0
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: i C
telephone: ..a.:
Address: — V_ Y
Project Description:
City, ST, Zip: n n
TeleP hone: 3 t
r
i 4'
State Lie. # : Ci' ( 'O -1 f
City Lie. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
'='`'><<,:,;<,:;:<;<::::::::::<:<; ::::<:::::
>>•'<>;:::'>>':'>;£'<d>>>?><><
:.
Construction Type: Occupancy
State Lic #:
a circleone : New' .Add'n Alter Repair Demo
Project type ( ) P
Name of Contact Person:
Sq: Ft.:Q
#Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:. O "
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKIN
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
tad Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A•I•P•P•
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
I, tAI. dA /A •. -.1 .. As A- .
-
Simplified Prescriptive Certificate of Compliance: 2008 Residential
HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
titI,
Site Address:
77-153 CALLE mazatlan La Quinta, CA 92253
Enforcement Agency:
City of La Quinta
Date:
Sep 3, 2013
Permit #:
Equipment Typel
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
® Package Unit
❑ Furnace
Indoor Coil
[3®
® AFUE L 7 %
SEER 13.0
COP
C[°HSPF
R 6
( 13CZ to -13)
system
Served by y
® Setback
If not already must be
❑ Condensing Unit
❑ EER❑Resistance
❑ R 8 (CZ 14-15)
600 sf
present,
installed)
[3 Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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 fad 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 (09- split
systems) ms) ._G.14
replaced
z29 --ERS
CF -4R forms: MECH-21 and E99- Split systems) MCGli• -
Condenser Coil and /or
. Indoor Coil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and (fa- split systems) MEG! 1 29 HERS
. Furnace
CF -4R forms: MECH-21 and ffwr Split- GyStiai:R_MrLJ ,
) C
For Packaged Units: Duct leakage < 15 percent
Exempted from dud 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. will not be Ducted (ie_oDudless.Mini-Split System) Also Exempt from Refrigerant Charge)
❑ 2. New HVAC System Required Forms: Y
. Cut in c Chanl new with 'CF -6R formsi`MECH-04 MECH-20-HERS and fors lits stems MECH 22 -HERS and
new ducts: (all new ( P y )
,; MECH-25-HERS
ducting and all new,,
equipment). ;- CF -4R forms: MECH-20, (for splitsystems); MECH 22 and MECH-25 *
rand.
For Split Systems: Dud 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
and/or indoor coil and/or furnace. No or some
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA Z 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
linear feet of duct in unconditioned space.
CF -6R forms: MECH-04, MECH-2I-HERS
CF -4R forms: MECH-21
For split system or packaged units: Dud 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
Compliance. of
. 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: Herman Paredes Signature: Herman Paredes
Company: PALOMA AIR CONDITIONING Date: Sep 3, 2013
Address: P 0 BOX 3501 License: 619091
City/State/Zip: PALM DESERT / CA / 92261 Phone: (760) 347-1212
Reg: 213-A0067435A-000000000-0000 Registration Date/Time: 2013/09/03 09:41:06 HERS Provider: CalCERTS, Inc.
t 2008 Residential Compliance Forms July 2010
'
t
& Classif..
3783 8
Building
Address
7-153 mF. zat e
Owner
New O Add ❑ .. Alter O Repair 0Demolition- 0
Address
Tel.
' Mailing
City-
Address
P. 0• Box 780'
City
Zip
. ' • La-
iota
, 9221,
Contractor
"• OWNER -BUILDER DECLARATION' ' / .:: ..
I hereby affirm that I am exempt from the Contractor's -License Law for the following
. reason:, (Sec. ,7Q31.5,8usiness and Professions Code: Any. city or county which- requires :a.-:
permit to construct,. alter,-. improve, demolish, or repair any structure, prior: to its issuance•also,r
•• requires the applicant for such permit to file a signed statement that he is. licensed rpursuant. to
the provisions of the Contractor's License Law, Chapter 9.(commencing with,.Sectiom 7000) of
' .Division '3'of'the Buslness and Professions Code; or -that. he is exempt therefrom, and the -basis •
' for the alleged exemption. Any violation of, -Section 7031.5 by 'any 'applicant -for :a permit.,
' subjects'the•applicant to a civil penalty of not more than five hundred dollars ($500).
❑ I, as owner of the, property, or my employees'with wages•as their sole compensation, will
do the work, and the structure is not intended or offered fonsale. (Sec.;7044, Buisness and
. . Professions. Code: The Contractor's License Law -does not apply to an owner of property .who, -.
Estimated Valuation _ q
'• a -
..Address..
.
- , •-
, P,lan. Chk. Bal. a- 04,
Const. r p/n
- • 60 s ii'><J ~
City ...
.... ..... ...
Zip .
La- on,a
92253
P.O. BOX 1504 N O-003731'
78-105 CALLE ESTADO
LA.QUINTA, CALIFORNIA 92253
Venture + BUILDING: TYPE CONST. OCC: -GRP. '-
ROSA Cove,
A.P.,Number Santa
Tel. .a.
aLegal Description
Project Description ' V3 Ld ^ Qldirita
TeI.
State Lic. -
City
& Classif..
3783 8
Lic. #
: d __.
S Ft. No. No. Dw.
Size. . :1-` 2367. Stories. ;. Units ... . .
• Arch: Engr: - . _...... .. _
Designer
New O Add ❑ .. Alter O Repair 0Demolition- 0
Address
Tel.
City-
Zlp
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION ..,
-
I hereby affirm that I am licensed under provisions of Chapter 9 (commencingwith Section'
• 7000) of Division 3 of the Business and Professions Code, and my license'is in full'foice and -
effect
a's. . +?'•e. ; 1 % ' 'r..r!r.L7
SIGNATURE A' "DATE
"• OWNER -BUILDER DECLARATION' ' / .:: ..
I hereby affirm that I am exempt from the Contractor's -License Law for the following
. reason:, (Sec. ,7Q31.5,8usiness and Professions Code: Any. city or county which- requires :a.-:
permit to construct,. alter,-. improve, demolish, or repair any structure, prior: to its issuance•also,r
•• requires the applicant for such permit to file a signed statement that he is. licensed rpursuant. to
the provisions of the Contractor's License Law, Chapter 9.(commencing with,.Sectiom 7000) of
' .Division '3'of'the Buslness and Professions Code; or -that. he is exempt therefrom, and the -basis •
' for the alleged exemption. Any violation of, -Section 7031.5 by 'any 'applicant -for :a permit.,
' subjects'the•applicant to a civil penalty of not more than five hundred dollars ($500).
❑ I, as owner of the, property, or my employees'with wages•as their sole compensation, will
do the work, and the structure is not intended or offered fonsale. (Sec.;7044, Buisness and
. . Professions. Code: The Contractor's License Law -does not apply to an owner of property .who, -.
Estimated Valuation _ q
'• a -
:• .• ,. -- ,. - - - - - "
.... PERMIT •• .- AMOUNT* -'
.^-- -
- - -
• Plan'Chk.:bep.." - .. .- -. •'
- , •-
, P,lan. Chk. Bal. a- 04,
Const. r p/n
- • 60 s ii'><J ~
'Mach. .. _q.;(•
S •
builds or improves thereon and who does such work himself.'or-through his own employees,
. provided that ;such 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.did not build or improve for the purpose,of sale.) ' • .
.
Electrical '
a 5.5
Plumbing. 104F 10 -
.O 1, as owner of the property, am exclusively contracting with Iicensed.contractors to con-
- struct the, -project. (Sec: -7044, Business and Professions Code, The Contractor's License Law
• does not apply to. an owner of property who builds or Improves thereon, and who contracts for
• such projects with a contractors) licensed pursuant to the Contractor's License Law.) - •-
his reason ..
. O I am exemptunder Sec. • - ._ .. B. & P.C. for,this
_ -,
- : S.M.I, • •, .. ^. - • • '. •. , y ..
11 •73
.. ••
Grading
,
Driveway Enc.
D ate owner
Infrastructure " 3t779.64
WORKERS' COMPENSATION DECLARATION
' .1 hereby affirm that I' have a'certificate'of'"consent to self•insure,'or a certificate of
Worker's Compensation Insurance, or a certified copy thereof.. (Sec. 3800, Labor Code.)
+.{-
.. `
-
Policy No. ... ... . ,Company ,. .. ,.
' ❑ Copy is filed with the city.. ❑ Certified copy is hereby furnished.
-
TOTALJ.+Ar„
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS c
-. - , ,.,. • ' . . ,
(This section ' need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
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.
i1Y 3ir3f ayg i x _, % 7;
-,;- .tfi 3' `tri' fis . 4'('.ti= ' rtR
_.. - - .
-
DateWher
NOTICE TO APPLICANT: If, after making . this Certificate of*. Exemption you should become : '
" subject 'to the Workers' 'Compensation provisions of the 'Labor Code,-, you must -forthwith
comply with such provisions or this permit shall be deemed revoked. - -
ZONE: BY: - - •' - _
_.
Minimum Setback Distances: •' - - ,
Front Setback,fTom. Center. Line
-Rear Setback from Rear Prop. Line"
CONSTRUCTION LENDING AGENCY-.
hereby affirm that there is'a c'onstidction lending agency for the:performance of the
workforwhich this permit is issued.:(Sec. 3097, 001 Code.),
Side Street•Setback from•Center'Line '
Side Setback from Property Line
Lender's Name
FINAL DATE INSPECTOR
_
ISSUed by: Date Permit
,
Validated by:
- Lender's Address p p y g
This is a' building. permit when' ro erl filled out,'si ned and validated; and' is'subject to
expiration if work thereunder is suspended for 180 days.
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 city, to enter the above-. -
mentioned property for inspection purposes.
Signature of applicant-' Date
' Mailing Address
Validation:
.r -
City, Stat e, Zip r _
r. HARDCOPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
(ROUGH) _-_z 'D
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM, B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
P.
v
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
VENTILATION
GAS PIPING
PERMIT FEE
FIRE ZONE ROOFING
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. / 1 4
d
(ROUGH) _-_z 'D
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
AS FINAL) / C {v-
V
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
—c.. yd.
$ plus x$
_$
LUMBER GR.
P.
v
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
INIS GRADING
ECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
.i
05ii"•10 ! 3/:3/ •i '/iI/or
Att.dchment D
PREPARED FOR:
Glenn Bradley Enger, A.I.A. Form 2
73-960 El Paseo,.,Suite 5 (Pevised 3/34)
Palm Desert, California 92260 Cl inate zones 4, c, and G-15
COMPLIANCE CHECKLIST G-3 LAQUINTA by LaQuinta Joint Venture
For Low -Rile Residential Buildings
(except hotels and motels)
Step 1: Enteron the form the values for each measure from your building plan
and specifications sheet.
Step 2: Enter points on this page while working through the point system
Buildino Shell, Mei•st!re Points
*Total floor Area . . .. . ZjEtLft2
1. Slab -on -Ground; Perimeter ft., Deoth in: R- O _ }
2. Raised Floor n -Value. n_ , O
3. Ceiling Insulation or ConstruCtion Assembly , R-49—
O
Attic,•Percent of Roof Over'Conditioned Space IDD:
2/ 5Of t` 4
4, Wall Insulation or Construction Assembly. . R- 14 - o
Glazing; Total S Floor Area Single Double Triple
5. :1.rth-Facing. (, s ft2 14 I ft ft -(o
6. East -Facing ft ft' ' 2
1, 'South -facing, ft2 - :f t2 ft
-
8, West -Facing . 1 ft 2 ft2 ft2 Q
9. Skylight. . . . 0% ft. O. ft ft
10, Shading Coefficient.
(excluding overhang)'
a. East V,efmc 4- 6L, 40) D, O SC
b. South. %Qll .ar . QLINp 3p_`I
_fTO_SC Q
e. west tv",° - . 4Ur!o) Q'.Q.SC
d. North. :Cu6RTI4 . l riD D SC
e. SkylightSC . . . . . . . . . . . .N4a 3
11. Horizontal South Overhang Length. 2 ft o
12. Movable Insulation, S Floor Area. ; O
13. Infiltration (indicate Standard, NPdium or light).•
14, Thermal Mass
Exterior Wall Thermal Mass
Area. Heat Capacity, R -Value . . . . . . , ft 2. HC, R -
Interior Thermal Mass
Area, Heat Capacity, R -Value . 561 ft 2, G1HC, R.-tIZ
HVAC System** 561 ,-7-3-
j
2150
15. Gas Furnace without Refrigeration -Cooling
(Seasonal Efficiency) •. . . . . . . . . . N SF. D
16, Heat Pump (Energy Efficiency Ratio) N o; EER p
17. Gas Furnace. with Refrigeration Cooling
Seasunal Efficiency and. Seasonal
Energy Efficiency RatioSE Q S Sr'R +12
18. Active Solar .(Net Solar Fraction, d
19. Zonally Controlled Electric
Resistance Space Heating . . . . . . . , (Yes/No)
wo
Domestic Water Heating*!
20'Solar With Gas Backup (get Solar Fraction, Z) , _ :ySF
21. Other Water Heating (Describe type) G AS p -
Point Systern Cemoliance Total. . . . . . . ... . . . . . .
*Cnec.l ist iter-;; not a point system neasure,
"Attach documentation for effiCiencies and 11S:,
PREPARED BY:
Joseph N.,Cicchini, Civil Engineer, Inc.
44267 Monterey Avenue, Suite B
Palm Desert, California 92260 (.619)-341-2273'-