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05-5031 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: ;Q5--0:000-50'>31 Property Address: 54165 AVENIDA RAMIREZ APN: 774-211-031-9 -000000- Application description: MECHANICAL Property Zoning: COVE -RESIDENTIAL Application valuation: 1000 Ta�/ 4 4 Q -," BUILDING & SAFETY DEPARTMENT BUILDING PERMIT dc—ant: (l Architect or Engineer: NOV. 1 2005 CITY OF LA-QUINTA FINISKICE DEPT, VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: MARTIN DE CLERCQ 54165 AVENIDA MftRTtN-B*&%-,yLM LA QUINTA, CA 92253 Contractor: CRUZ'HEATING & AIR 41799 TRENT PLACE INDIO;, CA 92201 (760)342-2201 LiC. No.: 772700 Date: 11/14/05 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION .I hereby affirm under penalfy of perjurythat) am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following' declarations: Section 7000) of Division.3 of the Busifiess and Professionals Code, and my.License is.in full force.and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided_ . Lrcen a lass:. G10 .C20 Lice a No.: 792700 -.. - '- _ for,by.Section3700 of the Labor Code,'for the performance of the work for which this permit is - .: . _. .,. Da Contractor:: i:'. r v issued. I-haveand will maintain workers' -compensation insurance, as required by Section 3700 of the Labor .. .Code, for the,performance''of the work for which this,permitis issued.'Wy workers' compensation - OWNER -BUILDER DECLARATION, - - - insurance.carrier'and policy number"are: I hereby affirm under penalty of perjury that I am exempt from'the Contractor's State:License Law for;the Carrier EXEMPT. . ` Policy, Number- EXEMPT :> - following reason (Sec. 7031.5, Business and.Professions Code. Any city. or countythat requires a permit to . I certify that, in the performance of.the.wor or which'thisipeqat is issued, I shall,notemploy:any. construct, alter, improve, demolish or, repair -any structure priori&its issuance, also requires the applicant for the _ person. in` anymanner so as to oecom �u�' ct to.tti'e r rs'�'compensation laws of California, permit to file a sighed' statement that tte' or she is licensedpursuanrto the: provisions of the Contractor's State - and:agree.that, if I should become je � to the wor '. compensation provisions of Section . License Law (Chapter 9_(commencing with Section 7000) of Division 3 of the Business and Professions Code) or - 3700 of ihe,Labor Code, I she KIM th comply those provisions. that he,or she is exempt therefrom and the basis for the alleged exemption: Any violation of Section 7031.5. by ' /�� anyapplicant:for a �peimit,subjects the applicentto'a civil penalty of not more than five,hundred dollais IS5001.: Date• '--a Applicant` 1 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 WARNING: FAILURE TO SECURE WORKERS' 6OMPENSATIONqeofAdE,IS UNLAWFUL, AND SHALL Contractors'. State License Law does not apply to.an owner of property who builds or improves thereon, . SUBJECT. AN -EMPLOYER TO CRIMINALPENALTIES AND CIVIL FINES -UP'TO ONE HUNDRED THOUSAND and who:does the work himself or herself through his or her own employees, providedthat the - DOLLARS (S 100,000). IN ADDITION TO THE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN improvements'are.not intended or offered for sale: If; however, the building of improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.).' - - - APPLICANT.ACKNOWLEDGEMENT I, as owner, of the, property, am exclusively contracting with licensed, contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply town owner of - conditionsand restrictions set forth on this application. property who builds or improves thereon, and who contracts'for the projects with a contractorls) licensed- 1. Each person upon whose behalf this application'is made, each person at whose request and for pursuant to the Contractors' State License Law.l. ., whose'benefit work-isperformed under or'pursuant to any permit issued as a result of this application, (_ 1 I am exempt under Sec. ; B.&P.C: for this reason theowner, and the applicant, each agrees to; and shall defend, indemnify and hold harmless the City 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 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. I 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. ays will subject permit to cancellation. I certify that I have read this application and state that the. above informa is correct. I ee to comply with all city and county ordinances and state laws relating to building constru ' n d -hereby thorize representatives of this county to enter upon the above-mentioned property for i urposes g Application Number . . . . . 05-00005031 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 28.50 Plan Check Fee 7.13 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/13/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 1.00 9.0000 EA MECH APPL REP/ALT/ADD 9.00 ---------------------------7------------------------------------------------ Special Notes and.Comments REPLACEMENT -OF FURNACE/AC/COIL. PRELIM CF -6R RECIEVED Fee summary Charged ----------------- ---------- Permit Fee Total 28.50 Plan Check Total 7.13 Grand Total 35.63 LQPERMIT Paid Credited Due ---------- ---------- ---------- .00 .00 28.50 .00 .00 7.13 .00 .00 35.63 INSTALLATION .CERTIFICATE; 0 e Y ,of I2 CF -6R Site Address 'Ptrmit Number An installation certificate is required to be posted at the bwldtngsite or made available foeaU'approptiate,inspebtions. (The information:provrded on this •fo`rtn is tequlred)AfCer completion, of final iinspection,. a copy:must be -provided to the building department (upon request) acid the buildint owner• at oecupttiidy, persbction 1Q=t03 a . WATER HEATIIV[ -WRTF1vIR Distribution' CEC Certified Type. If Rated Input Extcmal Heater M& Name & (Std, Point- Recirculation, Ta Model Numbet ofUsvIdenlicat (kW of Tank Volume Effiaia Standb)' Insulation •, etc Control :Tyle S same Whr)' Ilons (EF,'RE Loss %R•value' 1 For small gas storage.(rated'input of•less than or equal to 75,000 000-Btu/hr), electric resistance and heat. pump water heaters, list,Encrgy Factor:(EF). For Inrge gas storage:wator?heaters#ated inp-it of grpaterthan 75,000 Btu/hr), list Recovery (119j, Thennal'Efficientiy; Standby Loss and Rated Input. For instaotrtneous:gas water heaters, list 'Thermal Efficiency and Rated Input f 2. R-12 external insulation -is mandatory for storage water heaters with an energy'factor of less than 0.58. Kitchen Piping: If indicated on the CF- l R, all hot water piping ? 3/4 inches in diameter that runs from the hot water source to the kitchen fixtures. 'is' insulated. Faucets & Shower Heads: All faucets and showerheads-installed aro certifced:to the Energy,C6mmission, pursuant to Title 24, Part 6, Section 111. Central Water Heating in Buildings with Multiple Dwelling,Vnits (required for prescriptive) ❑AII hot water piping in main circulating loop is insulated to -requirements of § 1500), ❑Central hot water systems serving:six dr fewer dwelling units which have (1) less than 25' of distribution piping outdoors;. (2) zero distribution piping underground; (3)'no recirculation ptunp:'and (4) insulation on distribution piping that meets the requirements of Scetion 1500) " ❑Central hot water systems serving more than 6 dwelling units - presence of chhei r a time control -.or a time/temperature control ❑ I, the tmdersigtied, verify.,that equipment,listed.above my signature is: l) the actual equiprttent instal}ed; 2) equivalent to or more efficient thmthat speoifccd tn,the certificate of compliartce (Dorm CF-1Rj submitted for compliance with the Energyir�icieney.;Staitdards for residenaat':buildings'and 3) equipmietti that meets or exceeds the appn�priate requirements for manufactured devices (f}om the.4ppli'bnce Efcien6y Rekidationi"or PaR 6)' where applicable. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Signature: - .Date: Copies to: BUILDING DEPARTMENT, HERS RACER (IF A,PPLICAOLE) SUILDINI; OWNER AT OCCUPANCY Residential Compliance Forms . April 2005 i OCT 04,2005 08:43 SEARS HOME I MP 8585869098 Page 2 o�nriq�nn �rcu� ' r, t, AlA tp7J. VV4!V t 1 INSTALL, ATIONCERTIF CAT' t' CIF -6R. Site Addie ' 7 (� ANumber .' An.installation certificate is required to be posted at theabuildtng site or made availeblc for,all appropriate inspections. (The information provided on this form is required) After compktipn of final inspection, a copy trust be5provided to the building department (upon request) and the buildtlig owner at occupancy; per Section 10'-103(a). HVAC SYSTEMS: Heating Equipment ; F -A Equip Type (pkg. heat urn CEC Certified Mfr• tt of Name and Model IdOntical Number S steins, Dr 8fticiency . � t .(AM- cte.) . ' 2Cf IR':vttlue Duct Location attic• etc. .. Duct or, Piping R -value Hcatin g Lead Htulhr Heating Capecity Btuthr - AA ; Coaling Equipment. Equip Type k . heat urn CEC Certified Mfr. 11:of Name tund> Model ldont Ninnber ' S`stcros Efciency {SEER or 8ER)1 bCF-IRQlue Duct Location attic e : Duct R -value . Cooling Load Whr Cooling Capacity Bru/hr - AA ; 1. 4 symbol reads greater than* equal ro what 4. indicatea.on-the CF -IR value, Include both SEER and 'EERlf compllance.Gredlt forhtgh.EER air a4nditionei• is claimed. +�I, the undersigned, verify that;equipment listed -above� is: 1) is the tictual 'equipment Installed, 2) equivalent to or CYmore efficient than thin pacified in the ceriitieate o4'bampliance (Form CF -1 1.0 submitted, for compliance with the Energy Efficiency Standards; for residential-butlduig§, anQn3;) equtpziient thitt meets •;or exceeds the a{ipriipriate requirements for manufactiirsd devices (from the Appiiance.Ejytciency Regulatio)s,or Part 6), where applicable. 0 Installing Subcontract o. N "'OR General Coritndtor'(Co. N O•;:nr> Signature: Date.. Copies to: BUILDING DEFARTM16, HERSAATER (IF APPLICABLE) BU7(LDTNC'OWNER AT OCCUPANCY .Residential Compliance Forms April 2005 OCT 04,2005 08:44 SEARS HOME I MP 8585869098 Page 4 7 _y INSTALLATION CERTI Site Address •'_. •... ...... ... �... .+ n� 'ni l WJ VVJ/ V I I 4 of 12) CF -6R INSTALLER COMPLIANCE STATEMENT FOR DUCT UE�AKAGE INSTALLER COMPLIANCE STATEMENT The building was: T! ❑TcAcd at Final ✓ E3 Tested at Rough -in INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE: O Remove at least.one supply and.one.return register, and verify"that the spaces between the register boot and the interior finishing wall are properly sealed. ❑ If the house rough -in duct leakage test was conducted withoutan air handler installed, inspect the connection points between the aii handler and tho supply and return plenums to verify that the cotiilection points D are properly sealed. Inspect all joints to ensure that no'cloth backed rubber adhesive' duct tape is used ✓ ❑ DUCT LEAKAGE REDUCTION -- - - ..��-�•_�« v rrw rusrrrouaon Stems are availabl�itt Je q NEW' -CONSTRUCTION, ,s a e. „RC4 3 dix 1 Duct Pressurization Test Rosuhs (CFM @ 25 Pa) Enter Tested Lcakage Flow in -CFM:. Measured Values i'l '`;' •, , y ,y ;g ay r`I Fan Flow: Caloulaied(Nominal. ✓Cooling D HearIV-'ing) 0 Measured - 2 If Fan Flow is Calculated M 400 cfm/ton x number of tons or as 21.7 cfre/(kBtu/hr) x Heating Capacity In Thousands :of Btu/hr` enter total calculated or treasured fan flow in CFM here: bob 3 Pass if Leakage Percentagc5 6% for Final or 5 4% at Rough -in: 100 x (Line #. 11 / ire # 2 0 Pass 0 Fail ALTERATIONS: Duct System and%r HVAC_ E uiptnent Cha� a =Out aTest o£ExistingEnt r Td Leakage Flow in.CFM from Pm Duct System Prior to Duct System Alteration and/or Equipment Change -Out:.. �' '�� Enter Tested Leakage Flow in CFM from Finnl`Tesf of.1tdj` 5 New puet System or Altorod Duct System for Duct System Alteradon•and/or ur m-nt-CChangea-Out. Enter Reduction in Leakage for Altered Duct System, %v 6 Linc # Y _ 4 Minus Line # 5 Ont ifA licablel �� a` ��'^-"•� ,1<a " I••;,,>„:'•:'; ct' ii i ?,-,, E,sf ' 7 Enter Tested Leakage Flow in CFM `to Outside (Only if Applicable) Entire New Duct System -Pass if Leakage Percentage-!; 6% for Final or 5 44/o;i Rough in $ loo x Line# 5 / Line # 2 TEST OR VERIFICATION STANDARDS: For Altered: Duct System and/or HVAC Equipment Change - Out Use one of the followin fur Test•or Ve fieatioti Standards for eom fiance: Pass 0 Fail 9 Pass if Leakage Percentage 5 15% [100'rc [ � (I:,ine # 5) I _; (� we # 2)jJ Pass El Fail 10 Pass if Leakage to Outside Percentage <—_ 10%1100 x [-(Line # 7) / -__ (Line # 2)]] 0 Pass ❑ Fail Pass if Leakage Reduction Percentage 60°% [100 x ,_._(Line # 6) / �_ (Line # 4)]] and Verification. Smoke Test and Visual Ins ection 0 Pass 0 Fall �11 2:Pass if Sealingof all Accessible Leaks and Verification ti, Smoke Test and.:Vls%. ins ection Pass if One of Lines # 9 thruu # 12 pass • ✓ f,T ° ”°••.I ;;� ; ;,;: ;; ^'"atln•. 0 Pass 0 Fail 0 Pass 0 Fail —••, •--- -••__•.•b••••.., •..•.y u.n. uaa..aVtivc uxuail—ut; IC51 results were pertarrned in conformance with the requirements for compliance credit. I, the undersigned, also cortify that the ncwly�installedor rutrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements speoifled in Section 150 (m) of the 2005 Building Energy Efficiency standards. installing 3ubcontm (Co. • OR General Contractor (Co. N ) Olt w er Signature: Date: Coplea to. BUILDING DEPAR` -Afi T, HERS RATER (IF APPLICABLE) BUILDINC OWNER AT OCCUPANCY Residential Compliance Forme April 2005 OCT 04,2005 08:45 SEARS HOME I MP 8585869098 Page 5 INSTALLATION CERTIFICATE Site Address permit' Number ! ❑ TFIERMOSTATIC EXPANSION VAI,VE- Procedures for field verification of thermostatic expansion valves are available in JUCM, Appendix Rl. 1(rJ V V O/ V 1 1 CF -6R ✓ Q REFRIGERANT C'RARGE MEASUREMENT Verification;fvr Required Refrigerant Chargeand Adequate Airflow for Split Systein Space Cooling Systems without Tifnimnctnfir• Rvwnnci..w V., 1..�- - Outdoor Unit Serial # Access is provided.for inspection; The procedure shall Location °F ✓ consist of visual verificatidwthat the TXV is installod on Yes ❑ No the•system and installation of the specific equipment [j OF Cooling Capacity $tu&r Date of Verification °F Date.oflkefrlgerantGauge Calibration shall bo verified. Date of Thermocouple Calibration(must be ckiecked monthly) --=-� . Yes is a sass. ,Pass' ; Fail 1(rJ V V O/ V 1 1 CF -6R ✓ Q REFRIGERANT C'RARGE MEASUREMENT Verification;fvr Required Refrigerant Chargeand Adequate Airflow for Split Systein Space Cooling Systems without Tifnimnctnfir• Rvwnnci..w V., 1..�- - Outdoor Unit Serial # - Location °F Outdoor Unit Make OF Outdoor Unit Modcl OF Cooling Capacity $tu&r Date of Verification °F Date.oflkefrlgerantGauge Calibration (iniisfbecheckedmonthly) i Date of Thermocouple Calibration(must be ckiecked monthly) --=-� . Standard Charge -Meas wte,rqe �ntProcedu Procedures for Dererrnining Refrigerant -charge using't Note: The system should be installed and pharged in procedure. Measured Temoeratures )r air dry-bulb.55T and above): Meth6d sire availai)le In RACM, Appendix RDl. with the manufacturer's specificaiions before starting this Supply (evaporator leaving) air dry. -bulb tem- perature;(Tsupply, db).. °fy Return (evaporator cintering);air dry-bulb tem' erature' Tretorn, db)' °F Return (evaporator entering)'air wet -bulb, temperafure (Tietum, A) OF Evaporator saturation temperature (Tcvaporaiorsat) OF Suction line tem4cratuee (Tsuction, db) OF Condenser (entering) air dry-bulb temperature'(Tcondenser, db) °F iu erheat Charge Method Calculations for Refrigerant Che Actual Superheat = Tsuction, db-'Tevaporator, sat °F Target Superheat (from Table RD -2) °F Actual Superheat - Target Su erheat (Systein passes itbetweon.•5 and +5 Temperature Split Method Calculations for Aciequate Airflow. Actual Temperature Temperature Split =t retia dli'Tsupply db °P Target Temperature Split (from Ta61e R03) OF Actual Temperature'Split Target Temperature Split, (Systein passes if between - 3°F and +3°F or, upon remeasuremem, if between -3°F and -1000P Residential Compliance Forms OCT 04,2005 08:46 SEARS HOME I MP 8585869098 9 pril 2005 Page 6 V V I! V I[ INSTALLATION CERTIFICATE:''.a e 6 of 12j CY+-612 Site Address Per»titNumber Standard'Charge Summary: System shall pass boih, refrigerant charge and adequate airflow calculation criteria from the same measurements. If corrective actions were°taken,'both`criteria roust be remeasured andrecalculated. ✓ ❑ Yes ❑ No `.Systein.Passes t Alternate Charge Measurement Procedure (outdoor airrdry-bulb beiow.55-°P) Note: The system slibuld;be-installeil._and charged in accordance with theenanufachuer's specifications and installer verification shall be documented on CF -6K 666re starting this procedure. If outdoor air dry-bulb is 55'oF or above, installer shall use the Standard Charge Measure Procedure: f Proceduresfor Determining Refrigerahl Charge using the Alternate Method are available in RA CM, Appendix RD3. Wei h -In Charging'M®thadfor.Ricfri Brant CharSc Actual liquid line lengthi _ ft , Manufacturer's Standard liquid line length: ' ft Difference (Actual,- Standard): ft Manufacturer's correction (ounces per foot) _ x difference in length _ _ounces (+- Baa).( =remove) 4easurcd Airflow Method,for Adequate Airflow Verifkation available in ]Wk Appendix: RQ2:6 . CalculatedAirflow Cooling Capaciry'(BtuYhr} :.'9C 0.033-(cfiti�Bi:u-hr) _ _ 5 CFM Measured Airflow is CFM, (Measured airticw must be greater than:ttre calculated airflow). Altcmate Charge Measurement Summary: System shall pass both refngerant'eharge and adequeto airflow calculation criteria from the same measurements. If corrective action'swere taken'' both criteria:.mumoasued•and recalculated. ✓ C Yes ❑.'No . S`item P2rses... Installing Subcontractor (Co. Name) OR. Gencral Contractor (Co. Name) OR Owner' Signature: T Date; Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY r Residential Compliance Forms OCT 04,2005 08:47 SEARS HOME I MP April 2005 Page 7 ✓ ❑ Alternative :Component Package Method (check one) C D D (Alternative) Package C and Package D;choicesrequire HERS rater field• verification and/or diagnostic'testing (see CF -1R page 3) For Package D Alternative see Appendix B Table151-C Footnotes'? -14 GENERAL. INFORMATION' Total Conditioned Floor Area,(CFA) ft2 Average Ceiling Height: ft, Maximum Allowed West Facing Fenestration Products Per Table .151-B or 151-C ---- (5%.X CFA). ft Maximum Allowed Total Fenestration Products Per. 151-B or 15.1LC'-n--(20% X CFA) ft ✓ ❑ Building Type: (check one, or more) Single_Family Multifamily Addition Alteration (If adding fenestration fill,out+,WS-',W Maximum Allowed Area Worksheet and see Section 8.3.2 for Additions and 8.33'for Alterations:) Number of Stories: Number of Dwelling Units: Floor Construction. Type: Slab/Raised Floor:(circle:one or both) - Front Orientation: North./ South:/ East / West / All Orientations (input front orientation in degrees from True North and circle.one). ` ✓ ❑ RADIANT BARRIER:(reguired in.cliinate'xones OPAQUE SURFACES INCLUIDING OPAQUE 15 0-0R-' Component Type (Wall, . Frame Roof, Floor, Type Slab Edge, (Wood,or Doors Metaf)' Cavity Insulation `R=Vlalue . 'Assembly U - `f 6i,!(for'wood, Continuous tltnetal:frarne and'. Insulation t;-; mass R- Value as§emblies -' Joint Appendix IV - Reference' 4 Roof•Radiant Location Barrier Comments Installed (attic, garage, Yes or No typical, etc. 1) See Joint Appendix 1V in Section .IV.2, 1V.3 and 1V-4;,which is the basis for ttle,Urtactor criterion. U -tactors cannot exceea prescriptive value to show equivalence to.R-Values. . Residential Compliance Forms April 2005 CE,KrTIF;ICATTE OF C.OId P ,I, CE:;:,RESIDEN-TIAL(Page`2.0 5) CF -112 Project Title Date g l� FENESTRATION PRODUCTS—:U-FACTOWAND SHGC ✓ FENES.TRATION. MA)UMUM ALL AREA WORKSHEET WS;4R Lnust be included for New Construction,. Additions' and Alterations. Fenestration Minimum ' Distribution Efficiency'- Type'and Location . Duct or Piping' Thermostat Configuration AFUE or HSPF :+ ducts attic etc. R.Value Type (split or package Configuration (split or package) g l� ITypeLPos: Origin- Exterior (Front, Left; ' . 'tation, Shading/Overhangs6•' Rear, Right, N, S, E, Area- ' U=factor ` SHGC ✓ box if WS -3R is Skylight)W ftz U,facioi-2 Source, SHGC4 Sources included ❑ a 13 2 13❑ 1) Skylights are now 'includedin West -facing fenestration area if the skylights amtilted to the west or tilted in any direction when the pitch is less than 1 12:''.See §151(f)3C and in Section,12.3 of the Residential Manual 2) Enter values in this column are either NERC Rated value or from Standards default :Table 116A. 3) Indicate source either from NFRC or Table 116A, 4) Enter values'in this column ' -from. NERC or from. Standards Default Table 116B or adjusted SHGC from WS -3R. 5) Indicate source either from NERC or Table 116B. 6) Shading Devices are defined in Table 3-3 in the Residential -Manual and see WS -3R to calculate Exterior Shading devices. ' 7) See Section 3.2.4 in the Residential Manual. >I HVAC SYSTEMS Heating Equipment Typeand Capacity. (ftRace,`h um , boiler, etc. Minimum ' Distribution Efficiency'- Type'and Location . Duct or Piping' Thermostat Configuration AFUE or HSPF :+ ducts attic etc. R.Value Type (split or package Configuration (split or package) g l� Cooling,Equipmenf Type and Capacity (A/C,, heat, pump, evap.' coolie • Minimum Efficiency Duct Location Duct Therinostat . SEER or attic, etc.). ..R -Value Type. - Configuration (split or package) Residential Compliance Forms: April 200' CEit�IFIGA 'E',OF .COM -Pg I_A-NCE. RESIDEN, - AIL(Page 3 of 5) CF-lR Project Title . g r Date a , SEALED',IDUCTS and TXVs-(or.`Alternative,Measures) A I I ed CF-4RT ` inu" - ., I I _d•.fo'the,building department for each home for which the following. are re aired. Sealed Ducts alt climate zones nsiallec,testihi,and-.c'e`rtification and HERS rater field verification required.) ❑ TXVs, readily accesstlle (climate zones2 and 8`15 only) staller testi and certification and HERS.Riter field"verification re aired: r ❑ Refrigerant CharIe.(climate.zones 2 and'8=I5 "or►ly) (Installef testing and;certification and HERS Rater field verification -rd uired. OR- Alternative R Alternative to Sealed Ducts and Refrigerant Charge /TXVs (SeePackage.D Alternative Package Features for ProjectClunate'Zorie in the RM Op endix B'.Tabl'6 i5;1 -C, Footnotes 7-14. vas . For addition's *rid alterations, duct systems that,aie not,d'ocunierited:to-.haVe been previously ❑ sealed -as confirmed through field venfic,ahon and diagnostic testing;in accordance with procedures in the Residential ACM-1vlanual and duct system`sIwtth`moie than 40'linear'feet in unconditioned spaces shall meet the•requirements of Sectron�du I (m):and.ct.in"sulation requirements ofPackage D. WATER HEATING SYSTEMS Qv Ck.—e war r.nrt C1nRIP Awnllina:naitc Water, Heater Type/Fuel Type `. Check ,box if system meets criteria of a;,`Standard'•' system.. ' Standard system is one gas-fired water heater per ❑ dwelling'unit: If the water heater is a-storage.type, SO gallons is the maximum'capacity and recirculation system is Tank Capacity . not allowed. ` Standby' Loss % Check box when using Preapproved Alternative Water. Heating table, .Table 5-4 jn Chapter 5 in the Residential ❑ Manual.'No`water'heatin `calculation's are re uired; and'.the.s stem_com lies_automaticall . Check.box if system does not meet criteria of,"Standard" system; arid'does, not comply with; the Preapproved ❑ . eating table. In this the Performance Method must be `used and must be included in the Alternative Water Hn this submittal. Check box,to verify. that a time control: is required for a' recirculating system pump for a system serving multiple ❑ units Qv Ck.—e war r.nrt C1nRIP Awnllina:naitc Water, Heater Type/Fuel Type `. Distribution Type Number in System stem Rated Input (kw or Btuft) Tank Capacity . Energy Factor' or Thermal Efficiency Standby' Loss % Tank External Insulation R -Value System serving multi Ie dwelfing units Rated h Energy Tank InputTank Factor' or External Water Heater Distribution ' Number(kw'or •Capacity Thermal Standby Insulation Type T e in System Btu/hr) (gallons Efficiency Loss % R -Value 1) For small gas storage water:heaters (rated inputs of less than or equal to' 25,000 Btu%hr), electric resistance, and heat pump'waier heaters, listEne�gy Factor: For'large gas -storage waterrheaters'(rated'input of greater than 75,000 Btu/hr), list Rated Input, Recovery Efficiency;, Thermal Efficiency and Standby.Loss. For instantaneous gas water heaters; list Rated Input and T hernial Efficiencies: Pipe Insulafion (kitchen lines >- 3/4,inches) All -hot water. pipes. from the'hearing sourceeto the kitchen fixtures that are 3/4 inches or greater in:diametershall be thermally insulated as specified-•by.Section 150 0) 2 A or 150 0) 2 B. Residential..Conipliance Forms April 200. CERTIFICATED :CONOLIANCE: RES ENT:IAL (Page 4 of 5) Project Title I Date SPECIAL FEATURES'NOT RkOUHUNG TIERS •VERIFICATION (add extra`sheets if necessar Indicate which special; features are part of this project.-' Tt e',hit below'only represents'special' features relevant to the rescri tive method. p ✓ Feature Required Forms. if i lkiible Description ❑ Metal Framed Walls CF -IR ' ❑ Radiant Barriers CF -1'R ` ❑ Exterior Shades WS -4R . . ❑ Cool Roof N/A; Attach'CRRC Label to Forms. ❑ Dedicated Hydronic Heating - Performance Calculation System Re uir`ed• Aftach Run to. Forms. ❑ Combined Hydronic System Performance Calculation • Required Attach.Run toForms. Performance Calculafion ❑ Gas Cooling - - Required-.' ❑ Buried Ducts N/A; Indicaie':on buildin tans. ❑ Kitchen Pipe. Insulation See Section 5.6.2 Distribution'•` Systems in -Residential Manual. See Table543 or use •Perfor Multiple Water Heaters Per ` ❑ mance Calculation and' Dwelling Unit attach Run to Forms. ❑ Central Water Heating Systeme Perforinance Calculation and Serving Multiple -Dwellins attach Run to Forms. ❑ Non-NAECA.Large Water CF -1R Heater `See'Table'5-13 oiuuse: ❑ Indirect Water Heater .Performance, Calculation and attach Run.to Forms See Table 5-13 or use. ❑ Instantaneous Gas Water Heater `Performance Calculation and attach Run'to Forms See Table 5' 13 or use* . ❑ Solar Water Heating System Performance Calculation and attach Run toTorms 13Wood Stove.Boiler Perforiiance Calculation and attach Run'to,Forms SPECIAL. FEATURES REOUIRING,HERS.•RATEReVERIFICATION nrniect and need verification. ✓ Feature Re mred;Forms' if a ' licalle Description Duct -Sealing CF -6R: ait4:of 12 Refrigerant Charge CF=6R `art`5�of•1'2 ❑ Thermostatic Expansion Valve CF-6R'part-6 of 12' Residential Compliance Forms April 2005 SPECIAL. FEATURES REOUIRING,HERS.•RATEReVERIFICATION nrniect and need verification. ✓ Feature Re mred;Forms' if a ' licalle Description Duct -Sealing CF -6R: ait4:of 12 Refrigerant Charge CF=6R `art`5�of•1'2 ❑ Thermostatic Expansion Valve CF-6R'part-6 of 12' Residential Compliance Forms April 2005 CERTI�+ICE'TE AN : R SID.EN NAL, (Page 5 of 5) CF -1R 'Project Title Date COMPL AN.CE' S'TATEIVIENT , This certificate of compliance lists the`buildmg featu'res-and specifications needed to comply with Title 24, Partsa and 6 ofahe California Code of°•Regulations, and the administrative regulations to implement them. This:certificate;has been signed by the mdividual'wrth�overall design responsibility. The undersigned recognizes that compliance using. duet design, duct sealing, verification of refrigerant charge and TXVs, in''sulatioii-:installation;qualtty,;and building -envelope sealing require installer testing and certification and field verification by an approved HERS -rater.' F.nfnreement Agency Bin# City of La Quin a Building & Safety. DivWon P.O. Box' 1504)"7$-495 Calle. Tampico La Qumta CA'92253 - (760) 77T-7012 Building Permit fAp`pl c' Jtion ati Tracking Sheet Permit # J Address: Owner's Name:' �"(@'j clProject C ��G A. P. Number: Address: Legal Description: ' Contractor: �/� 2 . ( ". City, ST, Zip: Telephone:^s Address: 1-11-7 0 q 'RProject Description: City, ST,Zip: Telephon �2)3 C13_ t State Lic. #: - C? O 'City, Lic #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: a s Construction Type: Occupancy: State Lic. #: &roject type (circle one)'. New':.. Add'n Alter Repair Demo Name of Contact Person: . _ 'Sq. Ft.: 7 #Stories: #Units: Telephone # of Contact Person: Estimated -Value of Project: i APPLICANT DONOT _WRITE. BELOW THIS'LINE # Submittal Req'd • , Recd ., TRACKING . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, rcatly ,or corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check- Balance Energy Calcs. 'Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading.plan' 2'..° Review,:ceady for corrections/issue Electrical SubcontactorList * . •' `Called.Contact.Person Plumbing Grant Deed Plans picked up - S.M.I. H.O.A. Approval Plans resubmitted Grading-, IN HOUSE:- 3H Review, ready for corrections/issue Developer Impact Fee Planning Approval Called-ContactTerson A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees