BMCH2015-014278-495 CALLE TAMPICO Ct 0 D �itiN1�Cl/
(760)777-7125
LA QUINTA, CALIFORNIA 92253rm^ t/ / / /-/Vll
COMMUNITY DEVELOPMENT DEPARTMENT 5 7 11 777-7153
BUILDING PERMIT APR �
~ 3 201gat J4/23/2015
Application Number: BMCH2O15-0142 OwnerOOMMU ICITYOFLA.) INTp`��
Property Address: 54065 AVENIDA MENDOZA JASON NNOFVELOPMENTOEPAprrRENT
APN: 774222024 54065 AVENIDA MENDOZA
Application Description: GOFF RESIDENCE/HVAC LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $1,800.00
Applicant:
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD #140-125
PALM SPRINGS, CA 92262
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 Professions Code,
and my License is in full force and effect.
License Class: C20, C38 License No.: 967982
Date: i'�2 5 Contractore�
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).:
(_) 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. (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
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
Lender's
Contractor:
BEST IN THE WESTAIR CONDITION
255 N ELCIELO ROAD #140-125
PALM SPRINGS, CA 92262
(760)343-1002
Llc. No.: 967982
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 bf 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: _ Policy Number: _ —
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 3700 of the Labor Code, ( shall forthwith
comply with those provisions. 1)
Date: 1—t— 2 - — / S Applicant
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 Building Official 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 city to r upon the above•
mentioned property for inspection purposes.
Date:423L/457-
'-1 — Signature (Applicant or Agent):
DESCRIPTION
FINANCIAL • •
ACCOUNTCITY
AMOUNT
PAID
PAID DATE
APPLIANCE REPAIR/ALTERATION
101-0000-42402
0
$12.09
$12.09
4/23/15
PAID BY
METHOD
RECEIPT #
CHECK # `
CLTD BY
BEST IN THE WEST AIR CONDITION
CHECK
R5390
2951
AZA
DESCRIPTION
ACCOUNT -
CITY
AMOUNT
PAID
PAID DATE
APPLIANCE REPAIR/ALTERATION PC
101-0000-42600
0
$4.20
$4.20
4/23/15
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
BEST IN THE WEST AIR CONDITION
CHECK
R5390
2951
AZA
Total Paid forMECHANICAL: $16.29 $16.29
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
• PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
4/23/15
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY:
BEST IN THE WEST AIR CONDITION
CHECK
R5390
2951
AZA
Total Paid forPERMIT ISSUANCE: $91.85 $91.85
TOTALS:•: 0:
Applicant:
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD #140-125.
PALM SPRINGS, CA 92262
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 Professions Code,
and my License is in full force and effect.
License Class: C20, C38 License No.: 967982
Date:
Contractor:
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, 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. (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 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 Na
Lender's Address:
Contractor:
BEST IN THE WEST AIR CONDITION
2SS N ELCIELO ROAD #140-125
PALM SPRINGS, CA 92262
(760)343-1002
LIc. No.: 967982
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: _ Policy Number:
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 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date:
Applicant:
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 Building Official 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 city to enter upon the above-
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
T a(P
VOICE (760) 777-7125
78-495 CALLE TAMPICO
D
(760) 777-7011
LA QUINTA, CALIFORNIA 92253FAX
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/23/2015
Application Number:
BMCH2O15-0142
Owner:
Property Address:
54065 AVENIDA MENDOZA
JASON GOFF
APN:
774222024
54065 AVENIDA MENDOZA
Application Description:
GOFF RESIDENCE/HVAC
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$1,800.00
Applicant:
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD #140-125.
PALM SPRINGS, CA 92262
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 Professions Code,
and my License is in full force and effect.
License Class: C20, C38 License No.: 967982
Date:
Contractor:
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, 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. (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 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 Na
Lender's Address:
Contractor:
BEST IN THE WEST AIR CONDITION
2SS N ELCIELO ROAD #140-125
PALM SPRINGS, CA 92262
(760)343-1002
LIc. No.: 967982
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: _ Policy Number:
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 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date:
Applicant:
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 Building Official 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 city to enter upon the above-
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
DESCRIPTION
FINANCIAL .• 1.
ACCOUNT QTY AMOUNT
PAID. , '
PAID DATE
APPLIANCE REPAIR/ALTERATION
101-0000-42402
0
$12.09
$12.09
4/23/15
PAID BY ..
METHOD
RECEIPT #
CHECK #
CLTD BY
BEST IN THE WEST AIR CONDITION
CHECK
R5390
2951
AZA
- DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
APPLIANCE REPAIR/ALTERATION PC
101'0000-42600
0
$4.20
$4.20
4/23/15
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
BEST IN THE WEST AIR CONDITION
CHECK
R5390
2951
AZA
Total Paid forMECHANICAL:. $16.29 $16.29.
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID ' .
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
4/23/15
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
BEST IN THE WEST AIR CONDITION
CHECK
R5390
2951
AZA
Total Paid forPERMIT ISSUANCE: $91.85 $91.85
TOTALS:0:$108.14
Description: GOFF RESIDENCE/HVAC
CONDITIONS
Type: MECHANICAL . Subtype:
Status: ISSUED
Applied: 4/23/2015 MFA
Approved: 4/23/2015 MFA
Parcel No: 774222024 Site Address: 54065 AVENIDA MENDOZA LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: 296
Lot: 4
Issued: 4/23/2015 MFA
UNIT 27
CONTACTS
Lot Scl Ft: 0 Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $1,800.00 Occupancy Type:
Construction Type:
Expired: 10/20/2015 MFA
No. Buildings: 0 No. Stories: 0
No. Unites: 0
STATE
Details: COMPRESSOR CHANGE OUT - 13 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
FAX
EMAIL
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESS1
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD
#140-125
PALM SPRINGS
CA
92262
CONTRACTOR
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD
#140-125
PALM SPRINGS
CA
92262
OWNER
JASON GOFF
54065 AVENIDA
MENDOZA
LA QUINTA
CA
92253
FINANCIAL INFORMATION
Printed: Thursday, April 23, 2015 12:11:24 PM 1 of 2
J?SYSTEhiS
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE,
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
APPLIANCE
101-0000-42402
0
$12.09
$12.09
4/23/15
R5390
2951
CHECK
BEST THE WEST AIR
AZA
REPAIR/ALTERATION
CONDITION
C
APPLIANCE
101-0000-42600
0
$4.20
$4.20
4/23/15
R5390
2951
CHECK
BEST IN THE WEST AIR
AZA
REPAIR/ALTERATION PC
CONDITION
Total Paid forMECHANICAL: $16.29 $16.29
PERMIT ISSUANCE
101-0000-42404
F 0
$91.85
F$91.85
4/23/15
R5390
2951
CHECK
BEST IN THE WEST AIR
AZA
CONDITION
Total Paid forPERMIT ISSUANCE: $91.85 $91.85
TOTALS:•: 0: .14
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
MECHANICAL FINAL" BLD
Printed: Thursday, April 23, 2015 12:11:24 PM 2 of 2
SYSTEMS
Bin. #
Pt}r Of. La Quinta
Bldlding 8L Safety Dfvfsion
P.O. Box 1504,78-495 Calle Tampico
La.Qldnta, CA 92233 -=(760) 777-7012
Building Permit Application -and Tracking Sheet
Permit #
d
Project Address: 5 yO I f/e 1�
Name:. CO Q'
A P. Number.
: ,r� — (�fo�j !/� OLegal
Description:
ST , °�� line:
TAdd
, Zip:Contractor.
Address: ��S %�l�i C,'�%Pi�B % -I2Description:
1%.e 10
City, ST, Zip:G /; 7L
11
Telephone: (a(1 --3
3 q-3- I Uo Z °
% , CP COW-4 /` Okif
t e f tv1 7— Z "f P 4
State Lia # : �� % City Lie. #;
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone: Construction Type: - PA? Occupancy:
State Lic. #: Project type (circle one): New Add'n Repair Demo
Name of Contact Person: ? (G Sq. Ft : #Stories: # Unitp:
Telephone # of Contact Person: Estimated Value of Project: pLw
APPLICANT: DO NOT WRITE BELOW THIS UNE
9
Submittal
Req'd
Beed
TRACKING
PERMITFEES-
Plan Sets
Pian Cheek submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cala.
Called Contact Person
Pbsa Check Balance.
Title 24 Cal&
Pians picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Giadiag plan
2`! Review, ready for correctiousliissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
H.O.A. Approval
Plans resubmitted
Grading -
IN HOUSE:-
2" Wvlew, ready for eorrecdonsAssne
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Feet
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
CF1R-ALT 02-E
(Page 1of3)
Project Name: Goff.54065.2 I Date Prepared: 2015-04-23 1
A. General Information
CRR -ALT 02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one CF1R-ALT 02 document for each dwelling unit.
01
Project Name
Goff.54065.2
02
Date Prepared
2015-04-23
03
Project Location
54065.2 Avenida Mendoza
04
Building Type
Single family
05
CA City
La 4uinta
06
Dwelling Unit Name
Goff.54065.2
07
Zip Code
92253
08
Dwelling Unit Conditioned
2000
Installing I
Installing
i�
Installing
Floor Area (ft2)
Location or Area
b this SC
y
`'ducted
cW
ontainin g
' ti
system
Number of space conditioning
w—
entrirely new
09
Climate Zone
15
10
(SC) systems in this dwelling
1
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information �, l d�'�� r•
01
02
03
04,
r5 OS
1-661,��
07))
08 l
09
10
� FIs the SC`"
' Installing a
ff
SC System
SC System
CFA served
system a+
re rf igerant (xlnstalling
new SC
Installing I
Installing
i�
Installing
Identification or
Location or Area
b this SC
y
`'ducted
cW
ontainin g
' ti
system
more than 40
w—
entrirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 2
Bedrooms
2000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A0106706A-000000000-0000
Registration Date/Time:
2015-04-23 10:28:29
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-04-23 10:28:24
Schema Version: 0.S55SDD
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)lE and F)
01
02
03
04
05
06
07
08
09
10
it
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New or
Identification
System
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
New Duct
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Duct Length
R -Value
Central gas
No heating
This field or
This field or
Central split
This field or
This field or
System 2
furnace
component
section is not
section is not
AC
Compressor
SEER
13
Setback
section is not
section is not
altered
applicable
applicable
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: 5159 , or 510% leakage to outside, or seal all accessible leaks.
CUR -MCH -25-1-1 & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2 300 CFM/ton required when MCH -25 is required.
Exceotions:—
-Duct systems registered with HERS provider as previously sealed are exempt from�20 Duct Leakage -T ste ni g requirerments f
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-25
f / /
Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requiremen its.
I t i
E. Entirely New or Complete Replacement Duct System, with or without Equ pment C ah ng out (5 tions 150.20 Diia andf150.2(b)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 215-A0106706A-000000000-0000 Registration Date/Time: 2015-04-23 10:28:29 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-04-23 10:28:24
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: rr���
Hansen, Jamie
Jamie (:; ansen
Company:
Signature Date:
Best in the West Air Conditioning & Heating Inc
2015-04-23 10:28:29
Address:
CEA/ HERS Certification Identification (if applicable):
31225 Plantation Dr
City/State/Zip:
Phone:
Thousand Palms CA 92276
(760) 343-1002
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24; Part 1 and Part 6 of the California Code of Regulations � I
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information.provided on othetapplicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency forpa proval'with this building permit application.
5. I will ensure that a registered copy of this Certificate of.,Compliance shall be made available withth"e building permit(s).issued forahe building, and made available to the—enforcement agency for all applicable
inspections. I understand that a registered copy of this -Certificate of Compliance is required to included with the documentation�the builder provides to the building owner at occupancy.
_be
Responsible Designer Name: i D ll.. -
Responsible Designer Signature: V Q4.� r�� 1
Hansen, Jamie
Ja.mie o ansen
Company:
Date Signed:
Best in the West Air Conditioning & Heating Inc
2015-04-23 10:28:29
Address:
License:
31225 Plantation Dr
967982
City/State/Zip:
Phone:'
Thousand Palms CA 92276
(760) 343-1002.
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A0106706A-000000000-0000 Registration Date/Time: 2015-04-23 10:28:29 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-04-23 10:28:24
Schema Version: 0.555SDD