Loading...
07-2770 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00002770 Property Address: 79299 CETRINO APN: 772 -110 -044 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 24800 Tiht 4 4 Q" Applicant: �n / Architect or Engineer: e ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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. License Class: C20 Licensini 374937 'Daie:�o-/ Contractor: �4 OWNER -BUILDER ARATION 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 Name: _ Lender's Address: LQPERDIIT ' Owner: MARKER CHRIS 79299 CETRINO LA QUINTA, CA 92253 ( Contractor: PALM DESERT AIR CONDITI 42081 BEACON HILL PALM DESERT, CA 92211 (760)346-0677 - Lic. No.: 374937 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/16/07 --------------------------------------------- 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 STATE FUND Policy Number 1795546-2007 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 war ers' compensation provisions of Section 3700 of the Labor Code,, I sh I orthwith comply h those provisions. Date: �r rte' ,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 1$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 auth ze representatives of this county to enter upon the above-mentioned property for insp n purposes Date: V' / Signature (Applicant or Agent): / r G Application Number . . . 07-00002770 Permit . . .. MECHANICAL Additional desc . Permit Fee . . . 42.00 Plan Check Fee .00 Issue Date Valuation 0 _ Expiration Date 4/13/08 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 ---------------------------------------------------------------------------- Special Notes and Comments REPLACE (1) 3TON,(1)4TON & (1)5 TON HVAC SYSTEMS PER CF -IR -ALT Fee summary 'Charged. Paid Credited Due ------------------------------------- Permit Fee Total. 42.00 -------------------- .00 .00 -42..00 Plan Check Total .00 .00 .00 .00 Grand Total 42.00 .00 .00 42.00 LQPERMIT Bin # City of La Quinta Building 8T 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• - A. P. Number: Address: Legal Description: City, ST, Zi . Contractor • o id CONgITIONING t;CiM, .tib Telephone• ,� :<.:• :<s•:v <: �:��:�'sh.:�< " ��•`,.•'s Address: 42091 BEA — BERT, CA 92211-5107 Project Description City, ST, Zip: (780) Telephone: ,{}r2��11.011 � r' ,i•SL6° :::if;:%).••lt -,'.}Y sr. ,::rr•,'.,:: :. . isi\2i•%•r:isiih%ley^:iv,$iHi�Y.%'r/+:•::i}'r'': �/�:.i State Lic. # : 3 Arch., Engr., Designer: City Lic. #; Address: City., ST, Zip: Telephone: State Lic. #: Name of Contact Person: M1:+%'L?titii; : f::/j.?,A,.?;Ci+l{.�Y •�'r•���,•':•^.l•,Y,.f{,{ ;,;;;:..pry ,;;;,,;•:;,,,,,,.; ,,i.$,; }.:z:� t;;n;;;..<;.<::.>_..::::;;<;y z, ' a - Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: 74,/--3 , 1/�Q6 �%'% pyo. Estimated Value of Projec . p2 pvG�• APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACIGNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2p° Review, ready for corrections/issue 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 rprfifiratP of (mmnliance Prescriptive Method - HVAC-oniv Alteration CF -1 R -ALT Pr ' Title Date:{ n m CaICERTS 2005 n orcementen se n roiect Address. _ Cli ate Zone: Building Permit # Doc nt ition A r: Telephon Plan Check Date Field Check Date IMPORTANT: This CF -1 R -ALT form is only for use when a VAC_ -only alteration is made to an existing home Use one form for each system being altered. This is system # of systems altered in this house. Check all lines that applX. Check only lines that aooly. Scope of Alterations: 1 ❑rnA]randier is to be installed or re laced. Duct Sealin to be determined. Continue to next line. 252ce Heat exchan er is to be installed or re laced. Duct sealin to be determined. Continue to next line. 3 condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. tOoor 4� or heatin coil is to be installed or r laced. Duct Sealin and/or TXV RCA to be determined. Continue to next fine. 5 ❑ 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined. ❑ Check here if the entitg duct system is also to be new or replaced. Continue to next line. 6❑ lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked. 7 O Thiss stem is in Climate Zone 1 3 4, 5, 6 7 or 8. No duct sealing is required. Go to Section 2. 8 ❑ Thiss stem has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. No duct sealing is required. Attach previous CF4R form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct is required. Go to Section 2. Note: -sealing If the entire ducts stem is to be new or replaced, Lines 11-14 do not apply. 11 ❑ In Climate Zones 2 12 and 16: An 0.92 AFUE furnace will be Installed in lieu of duct sealing and TXV if applicable). 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 AND EER 12 condenser will be installed with TXV(RCA) D added duct insulation R-4 wrap on existing ducts, R-8 new ducts In lieu of duct sealing. Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER 14 Aba EER 12 condenser will be installed with TXV(RCA) D a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2. 14 ❑ In Climate Zones 2, 9, 11, 12, 14 or 16: An SEER 14 AbM EER 12 condenser will be Installed with TXV(RCA) D an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 15 %1 JNone of lines 7-14 above are checked. Duct Sealing Is Required. Continue. Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ Thes stem being altered is a package unit. No TXV(RCA) is required. Go to Section 3. 17 O This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 ❑ Thiss stem is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3. 19 ❑ Thiss stem is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required. Go to Section 3. 20 )R lThis system is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) Is required. Go to Section 3. 21 IThis system is in Climate Zone 2 or 8-15 and line 11, 16 or 17 Is not checked. TXV(RCA) Is required. Go to Section 3. Sedition 3 - HERS Rater verification 22 If line 15 Is checked, HERS verification Is required for Duct Sealing. 23 If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17. HERS veriflcation Is required for TXV(RCA). 24 ❑ If line 12, 13 or 14 are checked, HERS verification Is required for 12 EER. Section 4 - Equipment Efficiencies 25 ❑ if lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List In Section 6. Section 5- Duct R -Values 26 ❑ if more than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed Package D requirements. 27 ❑ Ili less than 40 feet of duct Is being installed or replaced, duct R -value must meet or exceed R-4.2 Section 6 - see next page Version 03-10-06 Page 1 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1R -ALT nPro' Tit „ Date: /A / / -T 0 CaICERTS 2005 IMPORTANT: This CF -1 R -ALT form is only for use when an H A only a ration is made to an existing home Use one form for each s stem being altered. This is system # I of si2tems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipment must match type/location and meet or exceed etTiciencies/R-values. 26 Configuration: Split system 0 Package 29 O -Unit Air Handler as Unice, AFUE: CHeatpump FAU CHydronie FAU 00ther 30►21Heat Exchanger 31 'i Outdoor CondensingUnit C OHeatpump flit SEERMSPF: EER if d 32 & Cooing or heatirg coif tIMC DHeat 01-lydroric 33 0 Ducts Location: ILerigth (ft): R -value: - All mandatory measures apply to any altered component. See MF -1 R - ALT form. Compliance Statement: This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall project responsibility. The undersigned recognizes that compliance using duct sealing, verification of refrigerant charge, and TXV require Installer testing and certification and verification by an approved HERS rater. Home Owner or Authorized Agent Documentation A or Name: Name: Address: Company Name: COMPANY City/State/Zip: Address: VALffl 42081 BEACON HILL PALM DESERT, CA 92211-5107 Phone: City/State/Zip: Phone: Signature: Sign Enforcement Agency (Building Department) Notes/Com nts: Name: Title: Department: Phone #: Fax #: Signature or Stamp: Required forms: CFAR-ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to close permit. Copies to home owner, enforcement agency, HERS rater. CF4R-ALT: by HERS rater. Required to Gose permit. Copies to home owner, enforcement agency, installer. The CF4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entire group, version UJ-! U -V6 Page 2 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcens.com rPrtificatP of Cmmnfiance Prescrintive Method - HVAC -only Alteration CF -1 R -ALT Pr ' Title, Date: /j (J ® CaICERTS 2005 Enforcement A en se n roject Address: - Cli ate Zone: Building Permit # Dotation)!�q1TApr, Telephon Plan check Date Co n ame: � / � �. Field Check Date IMPORTANT: This CF -1 R -ALT foam/ is only for use when a V C -only Iteration is made to an existing home Use one form for each system being altered. This is system #A=PZ of s stems altered in this house. Check all lines that annly. Check only lines that anoly. Scope of Alterations: 1 ❑ n Alr Handler is to be installed or replaced. Duct sealingto be determined. Continue to next line. 2 $a Furnace Heat exchanger is to be installed or replaced. Duct sealingto be determined. Continue to next line. 3 n outdoor condensing unit is to be Installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 4-4T cooling or heatingcoil is to be installed or replaced. Duct Sealingand/or TXV(RCA) to be determined. Continue to next line. 5 ❑ More than 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined. ❑ Check here if the gpl[g duct system is also to be new or replaced. Continue to next line. 6 ❑ If none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked. 7 ❑ Thiss stem is in Climate Zone 1 3 4 5, 6 7 or 8. No duct sealing Is required. Go to Section 2. 8 O Thiss stem has less than 40 feet of ducts in unconditioned space. No duct sealing Is required. Go to Section 2. 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. . No duct sealing is required. Attach previous CF4R form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Not If the entire ducts stem is to be new or replaced, Lines 11-14 do not apply. 11 ❑ In Climate Zones 2 12 and 16: An 0.92 AFUE furnace will be Installed in lieu of duct sealing and TXV if applicable). 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 AbIQ EER 12 condenser will be installed with TXV(RCA) 0 added duct insulation R-4 wrap on existing ducts, R-8 new ducts In lieu of duct sealing. Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER 14 AM EER 12 condenser will be installed with TXV(RCA) D a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2. 14 ❑ In Climate Zones 2, 9, 11, 12, 14 or 16: An SEER 14 AbIQ EER 12 condenser will be installed with TXV(RCA) D an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to section 2. 15 70 None of lines 7-14 above are checked. Duct Sealing Is Required. Continue. Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 O Thes stem being altered is a package unit. No TXV(RCA) is required. Go to Section 3. 17 ❑ This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 ❑ This system is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3. 19 ❑ This system is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required. Go to Section 3. 20)P his system is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) Is required. Go to Section 3. 21 is system is in Climate Zone 2 or 8-15 and line 11, 16 or 17 is not checked. TXV(RCA) Is required. Go to Section 3. Se ion 3 - HERS Rater verification 22If line 15 is checked, HERS verification is required for Duct Sealing. 23 It line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification Is required for TXV(RCA). 24 ❑ If line 12.13 or 14 are checked. HERS verification Is required for 12 EER. Section 4 - Equipment Efficiencies 25 ❑ If lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List in Section S. Section 5- Duct R -Values 26 ❑ If more than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed Package D requirements. 27 ❑ Ilf less than 40 feet of duct is being installed or replaced. duct R -value must meet or exceed R4.2 Section 6 - see next page Version 03-10-06 Page 1 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Certificate Of COmnliance Prescriptive Method - HVAC -only Alteration CF -1R -ALT P ro' Tit 7/� Date: © CaICERTS 2005 IMPORTANT: This CFA R -ALT form is only for use when an H94rconly alration is made to an existing home Use one form for each system beingaltered. This Is system # of systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipment must match type/location and meet or exceed effrciencies/R-values. 28 Configuration: ASplit system O Package Unit 29 O Ai Handier as furnace, AFUE: OHeatpump FAU OHydroNc FAU OOther 30►$ Heat Exchanger 31 ll!l' Outdoor Condensing Unit C OHeatpump kfficiency SEER/HSPF: JEER if red : 32 49* coorng or heating coil <MC 01-leatpump OH rank 33 O Ducts Location: Length (ft):JR-value: All mandatory measures apply to any altered component. See MF -1 R - ALT form. Compliance Statement: This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall project responsibility. The undersigned recognizes that compliance using duct sealing, verification of refrigerant charge, and TXV require installer testing and certification and verification by an approved HERS rater. Home Owner or Authorized Agent Documentation A or Name: Name: Address: Company Name: MPAW City/State/Zip: Address: PALM42081 BEACON HILL PALM,DESERT, CA 92211-5107 Phone: City/State/Zip: Phone: Signature: Sign Enforcement Agency Buildin Department) Notes/Com nts: Name: Title: Department: Phone #: Fax #: Signature or Stamp: Required forms: CF -1 R -ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to Close permit. Copies to home owner, enforcement agency, HERS rater. CF4R-ALT: by HERS rater. Required to Gose permit. Copies to home owner, enforcement agency, installer. The CF4R forms for a sam le rou shall not be released until all testing and verification Is completed and passed for the entire group. vrrbion oo- i u-vo Page 2 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Certificate of Compliance Prescriotive Method - HVAC -only Alteration CF -1 R -ALT Pr ' Title, Date: © CaICERTS 2005 Enforcement Agency Use Oni roject Address: x1-9 >-3 go';Ap�� Cliniate Zone: /C - I Building Permit # Doc ntation A r: Telephon Plan Check Date 6/ Field Check Date IMPORTANT: This CF -1 R -ALT form is only for use when a VAC -only alteration is made to an existing home Use one form for each system being altered. This is system # of 3 systems altered in this house. Check all lines that aR2v. Check only lines that apply. Scope of Alterations: 1 ❑ An Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. 2%9 Fumace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. 3 n outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. t 4;& A cooling or heating coil is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 5 ❑ More than 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined. ❑ Check here if the $ntilg duct system is also to be new or replaced. Continue to next line. 6 ❑ If none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked. 7 ❑ Thiss stem is in Climate Zone 1, 3 4, 5, 6 7, or 8. No duct sealing is required. Go to Section 2. 8 ❑ Thiss stem has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. 9 ❑ This system was previously sealed and tested, and was Certified by a HERS rater. No duct sealing is required. Attach previous CFAR form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Note: If the entire ducts stem is to be new or replaced, Lines 11-14 do not apply. 11 ❑ In Climate Zones 2 12 and 16: An 0.92 AFUE furnace will be installed in lieu of duct sealing and TXV if applicable). 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 Ab Q EER 12 condenser will be installed with TXV(RCA) D added duct insulation IRA wrap on existing ducts, R-8 new ducts in lieu of duct sealing. Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER 14 AM EER 12 condenser will be installed with TXV(RCA) D a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2. 14 ❑ In Climate Zones 2, 9, 11, 12, 14 or 16: An SEER 14 AbM EER 12 condenser will be installed with TXV(RCA) D an 0.82 AFUE furnace will be installed with increased duct insulation In lieu of duct sealing. Go to Section 2. 15 rl JNone of lines 7-14 above are checked. Duct Sealing Is Required. Continue. Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ Thes stem being altered is a package unit. No TXV(RCA) is required. Go to Section 3. 17 ❑ This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 ❑ Thiss stem is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3. 19 O This system is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required. Go to Section 3. 20 hiss stem is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) Is required. Go to Section 3. 1& 21 W rrhis system is in Climate Zone 2 or 8-15 and line 11, 16 or 17 is not checked. TXV(RCA) Is required. Go to Section 3. Se ion 3 - HERS Rater verification 22 W If line 15 is checked, HERS verification Is required for Duct Sealing. 23 If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification Is required for TXV(RCA). 24 ❑ Ilf line 12, 13 or 14 are checked, HERS verification Is required for 12 EER. Section 4 - Equipment Efficiencies 25 ❑ If lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List In Section 6. Section 5- Duct R -Values ❑ If more than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed Package D requirements. 126 27 ❑ lif less than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed R-4.2 Section 6 - see next page Version 03-10-06 Page 1 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT Pro' Tit ,� Date: / 2 © CaICERTS 2005 IMPORTANT: This CF -1 R -ALT form is only for use when an H only al eration Is made to an existing home Use one form for each system b Ing altered. This is system # of systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipment must match typellocation and meet or exceed effwiencies/R-values. 28 Cortriguration: Split system ❑ Package Unit 29 ❑ Air Handler 4daGas furnace, AFUE: ❑Heatpump FAU ❑Hydronic FAU ❑Other 30s$ Heat Exchan er 31 bT Outdoor Condensi Und C ❑HealpumpEf iicien SEER/HSPF: 1EER IN re d : 32 6' cooling or heating coil C ❑Heal um [31-lydronic 33 ❑ Duds Location: Length (ft):JR-value: All mandatory measures apply to any altered component. See MF -1 R - ALT form. Compliance Statement: This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall project responsibility. The undersigned recognizes that compliance using duct sealing, verification of refrigerant charge, and TXV require installer testing and certification and verification by an approved HERS rater. Home Owner or Authorized Agent Documentation A or Name: Name: Address: Company Name: COMPANY City/State/Zip: Address: rALIVI 42081 BEACON HILL PALM DESERT, CA 92211-5107 Phone: City/State/Zip: Phone: Signature: Sign Enforcement Agency (Building Department) Notes/Comments: Name: Title: Department: Phone #: Fax #: Signature or Stamp: Required forms: CF -1 R -ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to close permit. Copies to home owner, enforcement agency, HERS rater. CF -4R -ALT: by HERS rater. Required to Gose permit. Copies to home owner, enforcement agency, installer. The CF -4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entire group. version 03-10-06 Page 2 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com uatut.K i 1 aso 1 v1 1 1 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF -411 79-299 Cetrino - Ston - La Quinta, CA 92253 Palm Desert A/C - Heating 1374937 Project Address Contractor Name / Ucense No. 07-00002770 Contractor Contact Telephone Permit Number Paul Van V) men 760-777-1724 80715 TEl RaterTelephone Sample Group Number r Q \JC�N September 24, 2007 CC14-1798421281 C alfying Signature Date Certlflcate Number Firm: Air Experts Air Conditioning HERS Provider:CalCERTS, Inc. Street Address: PO Box 94 City/State/Zip:La Quinta / CA / 92247 Copies to: Homeowner, HERS Provider and Building Department This CF -4R has been registered with the CaICERTS® registry in accordance with the Title 24 & Title 20 of the CCR. CaICERTS@ is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was LJTested U Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form compiles with the diagnostic tested compliance requirements as checked on this form. 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 on every tested building. The HERS rater must not release the CF -411 until a properly completed and signed CF -611 has been received for the sample and tested buildings. The Installer has provided a copy of the CF -611 (Installation Certificate). New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns In lieu of ducts). New systems where cloth backed, rubber adhesive duct tape Is Installed, mastic and drawbands are used In combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. IVIMINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT: NEW CONSTRUCTION Duct Pressurization Test Results (CFM @ 25 Pa) Measured Values 1 N/A 2 Fan Flow: Calculated (Nominal ',..•' Cooling '- _ - Heating) or-.-.-' Measured Enter Total Fan Flow in CFM: Not Tested 3 N/A N/A ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow In CFM from CF -6R: Pre -Test of Existing Duct System Prior to 4 Duct System Alteration and/or Equipment Change -Out. Not Tested Enter Tested Leakage Flow In CFM: Final Test of New Duct System or Altered Duct System 5 for Duct System Alteration and/or Equipment Change -Out. Not Tested 6 Enter Reduction in Leakage for Altered Duct System [Une 4 - Line 5] - (Only if Applicable) Not Tested 7 Enter Tested Leakage Flow in CFM to Outside (Only If Applicable) Not Tested 8 Entire New Duct System - Pass If Leakage Percentage < 6% [ 100 x ( Line 5 / Line 2 )]: Not Tested ❑ Pass ❑ Fall TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pass If Leakage Percentage <= 15% [ 100 x ( Line 5 / Line 2 )]: Not Tested ❑ Pass ❑ Fall 10 Pass If Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: Not Tested ❑ Pass ❑ Fall 11 Pass If Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )] and Verification by Smoke Test and Visual Inspection Not Tested ❑ Pass ❑ Fall 12 Pass If Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pau ❑ Fall Pass If One of Lines #9 through #12 pass ❑ Pass ❑ Fall - - ----- -n 4f -7'1n 0 1 1 /c/')1)07 vwav�..ia\1 U Page 2 of 11 cERTIFicATE of FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 8) CF -411 79=299 Cetrino - Ston - La Quinta, CA 92253 Palm Desert AIC - Heating / 374937 Project Address Contractor Name / License No. 07-00002770 Contractor Contact Telephone Permit Number Paul Van V men 760-777-1724 80715 H Rater ` Telephone Sample Group Number CC14-1798421281 rtify/ng signature Date Certificate Number Firm: Air Experts Air Conditioning HERS Provider:Ca10ERTS, Inc. Street Address: PO Box 94 _ City/State/Zip:La Quinta / CA / 92247 Copies to: Homeowner, HERS Provider and Building Department This CF -411 has been registered with the CaICERTS@ registry In accordance with the Title 24 & Title 20 of the CCR. CaICERTS@ is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was Tested R Approved as partof sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, 1 certify that the house Identified on this form complies with the di a nostic tested compliance requirements as checked on this form. The installer has provided a copy of the CF -6R (Installation Certificate). VE Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed on the system and installation of the specific equipment shall be verified. HVAC System TXV I ❑ Pass ❑ Fail i