14-931 (RC)78-495 CALLE TAMPICO ' 0 D A � VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777=7011
COMMUNITY DEVELOPMENT DEPARTMENT FAX
(760) 777-7153
BUILDING PERMIT
Date: 7/7/2014
Application Number: RC -14-931 Owner:
Property Address: 51351 AVENIDA BERMUDAS MONRE /PAFF AKA:SIERRA DESERT.
APN: 773104017 51-351 AVE BERMUDAS
Application Description: TI - ESCROW OFFICE LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $6,000.00
Applicant:
Contractor:
MONRE /PAFF AKA:SIERRA DESERT
MONRE /PAFF AKA:SIERRA DESERT
51351 AVE BERMUDAS
51-351 AVE BERMUDAS
LA QUINTA, CA 92253
LA QUINTA, CA 92253
Llc. No.:
LICENSED CONTRACTOR'S DECLARATION .
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: _ License No.: _
to 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
($560).:
` )-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.).
4� 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: —7 Fi Owh
i
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
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: i f Signature (Applicant or Ag
FINANCIAL INFORMATION
.DESCRIPTION ACCOUNT QTY
AMOUNT PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306 0
$1.00 $0.00
PAID BY METHOD RECEIPT # CHECK # CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HOURLY PLAN CHECK - YES
101-0000-42600
1
$70.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forCITY STAFF - PER HOUR: $70.00 $0.00
i' DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
FIXTURES, FIRST 20
101-0000-42403
1
$23.83
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
FIXTURES, FIRST 20 PC
101-0000-42600
1
$23.83
$0.00
PAID BY
METHOD'
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SERVICES
101-0000-42403
0
$23.83
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNTQTY
AMOUNT
PAID
PAID DATE
SERVICES PC
101-0000-42403
0
$11.92
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for ELECTRICAL: $83.41 $0.00
DESCRIPTION-';
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
CONDENSER/COMPRESSOR
101-0000-42402
0
$107.25
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$71.49
$0.00
PAID BY
METHOD
RECEIPT#
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT. "
QTY
AMOUNT
PAID
PAID DATE
FURNACE
101-0000-42402
0
$107.25
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
'ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
FURNACE PC
101-0000-42600
0
$71.49
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
VENT FAN
101-0000-42402
0
$11.92
$0.00
PAID BYMETHOD"
' f'"
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY,
AMOUNT
PAID
PAID DATE
VENT FAN PC
101-0000-42600
0
$4.77
$0.00
PAID BY
METHOD.
RECEIPT #CHECK
#
CLTD BY
Total Paid forMECHANICAL: $374.17 $0.00
DESCRIPTION
ACCOUNT
QTY"
AMOUNT
PAID
PAID DATE
FIXTURE/TRAP
101-0000-42401
0
$35.76
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY ;
DESCRIPTION
`A ACCOUNT.,_ �
QTY
AMOUNT
PAID
PAID DATE
FIXTURE/TRAP PC
101-0000-42600
0
$35.76
$0.00
PAID, BY
METHOD
RECEIPT, #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY.
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT
101-0000-42401
0
$11.92
$0.00
PAID BY
METHOD
RECEIPT#
CHECK#
CLTD, BY
DESCRIPTION'
ACCOUNT
QTY .
AMOUNT
'PAID'
PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0
$7.15
$0.00
PAID- BYMETHOD
RECEIPT#
CHECK#
CLTD BY
DESCRIPTION
ACCOUNT.
QTY—
AMOUNT
PAID
PAID DATE
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$11.92
$0.00
PAID`BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0
$11.92
$0.00.
PAID BY
METHOD
RECEIPT#
CHECK #
CLTD BY
Total Paid forPLUMBING FEES: $114.43 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$42.90
$0.00
,PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$34.32
$0.00
PAID BY
METHOD
RECEIPT # .
CHECK #
CLTD BY
DESCRIPTION.
ACCOUNT
CITY
AMOUNT
'PAID
PAID DATE
REMODEL, FIRST 100 SF
101-0000-42400
0
$48.62
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION'
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$132.99
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for REMODEL: $258.83 $0.00
TOTALS:•0i 0•
P.O_ Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-4.95 CALLE TAMPICO.
LA QUINTA, CALIFORNIA 92253
BUILDING &'SAFETY DEPARTMENT
Q.6 0) 777-7A 12
FAX (760) 777-7011
lPKAlki RT'Y �O"ER' S PACKAGE
D-iscIosures & Form:, s for Owner -Builders Ap:pl�ing for Co..nstruction P&MRS ,
CM,P1T,N7'! 1!IQCE TQ PRQPERTX OWNER
Dear Property Owner
4n. awlication,for :a:bading permit ,has' Leon-,=b'z fitted . in your natae' listing' yourxelf as ,the builder of the p�oporty
mproxemcnts spocificd at $ i 3 5 t ikoe_,n, ,O./q- Pj(?'
We are providing you with an Owner-BuilderAcknowledgment-and InfbjmatioWVc: ficati<m Foim to make you awam,.of your
'e`sPotnsib'lW`s -and possible risk .ou -
Y may incur by hAVnigibislxxnut issuediu-y-our'uame as ttic � �, ; •, . .-,
owner-Builiier. We-Wdl notissue-a buiicliag;K�mit xntil>you'Iixve read; iiiitia#cd youk,underst nidi ig of eaieh'pruvixion,
;igned, and returned thir form to us at our offlcial address indicated. An agent of thc-owner`cannot execute`t-4iotice
finless you, the property owner, obtain the prior approval of the permitting authority.
Read aril -ircilial ei ick stirlement ' dw'ro signify yyvu irirlerstanii yr veer fy` this info mcit It.
I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
wilding permit that erToneously.implies that the property owner is providing his or her own labor aril material Pet y- I, as
n Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
nd his or her employees while working on my property. My homeowner's insurance may not.provide coverage -for those
ijuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance -coverage for injuries to workers
n my property. s ..
L2. I understand Building permits are not required to -be signed by property owners .unless they are responsible for the
instruction and are not.hiring a licensed Contractor to assume this responsibility.. .
✓3_ I understand as an "Owner -Builder" I,am tie responsible party of record on.the,peruniL I understand ihat I rn�ay protect
cyself from potential financial risk by hiring a licensed Contractor and having the permit filed in his'or her name ivas.(ead of my
—4. I -understand Contractors are required by -law -to -be licensed -and bonded in California and to-list-th&4ieense numbers on
;rmiIs and contracts.
-5'11 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
my construction is at least five hundred dollars ($500), including labor and materials; I may be considered an "employer"
oder state and federal law.
6- I understand if I am considered an "employe*' under state: and federal law, I must register with the state and federal
vernment, . withhold payroll .taxes,- provide workers' compensation disability insurance, and contribute to .unemployment
rupensatioin for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
k.
7. I understand under California Contractors' StateLicense Law, an Owner -Builder -%vho builds single-family residential
uctunes cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
)contractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
ler contract with a licensed general building Contractor.
�8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable. for any
financial or personal. i -juries suscaiued. by any subsequent owneo) that result from' any latent construction defects - in' the
workmanship or materials.
/bl9. I understand I may obtain more information regarding my obligations as an "employee' from the Iuf +ail Revenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California'
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CS -IM)* 1-
800-321-CSLB (2752) or www.cslb.c-a.gov for more information about licensed contractors.
J✓_ 10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
Party legally and financially responsible .for proposed construction activity at .the following address:
1 35 t ilu,oA--c-.r»i)rjAS _..
I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owdor=Builders as'well a employers.
�2. I agree to notify the issuer of this form immediately of any additions; deletions, or changes to any of the informaEtioh I
have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you -Contract with
someone who;does. not41ave.a licenw; theC'*atractors' State. License Bowd=a y -be unable to - " ""s_. .
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be iwavil'Ccxut_ It is. -also
important for you .to.i ndetstand,thatafanuWicenscd Cotitmctororcmployce of that individual or firm is injured*While..working
on your property; you may beheld. tmbk I& damages. if you *Wina:pernut:as.Owner-Builder and: wishla-hirc-Conftvctors,
you. .wiil be .responsMt for. werdfying vvht4w. or.not ,diose Contractors are :properly. licensed and :the status of Aheir workers'
compensation insurance. coverage.
Before x building permit can be issued, this form must be completed and signed by the property owner And returned to
the agency responsible for ' ota: Aco 0 ilor pWenyowntr's.driver's 1loertsef forac,xota�r tvn; or
other verification acceptable to the. agancy is iequiied iol be rescriteii;ri�h`tir the permit is: issued to.'rerify the pt�ophty
owner's signature.
Signature of property owner
—
Date: 5-� 2 2 14
Note. The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO ACTON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand. is my personal responsibility, I hereby authorize
-the followiii .pecson(s) to aci army ageui(i) io apply for, sLgn, and file`the documents necessary ib obtaun'an Owner -Builder.
Per mit. for my project
Scope of Construction Project (or Description of Work): �e the (p)�2l_ i ��.�nt u m sit c �-►,ILI
Project Location or Address: 1 5 tJr? �ntA U�'✓� u t��
F_ ll.sa �Xv'�-�a
Name of Authorized Agent: C r� Of- RV � Q �T Tel No ] (
Address of Authorized Agent: Gv 9 SeCt%t>n 5 513 5 c D&-5 ea T- Gt ►3 2 L.
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy. Note:'A copy ofthe owner's driver's license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature.
Property Owner's Signature: Date: 6-
' L -2- • t 4-
.
|/|
��U�-�� ��U� U �� ��U UU���'�� SUB -CONTRACTOR,
f��'~Kk/ ����l �� CITY " ~~" °-^�� �~~°""� " �� `
JOB ADDRESS -] J ` �*`— ��' ^~`^^ PERMIT NUMBER OWNER~BUILDER
This form shall be posted on the *ob with the Building Inspection Card at all times in a consoicuous place.
Only persons appearing on this list or their employees aro authorized to work
on this job. Any changes to this list must be -approved by the Building Division prior to commencement of work. Failure to oonnp|y will result in a stoppage of work and/or the voidance
of building h For h applicable trade,U information d below must be completed by applicant. "On File" is not an acceptable response.
Bin #
City of La Quinta
Building 8L Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # n
IV `�
��
Project Address: S (3.51 -A ve- 0a5
Own is Name: (Aa Ov-D e-
A. P. Number:
fAddress:i
)'5('351 Ave Bv,��b�s
Legal Description:
(City, ST, zip: tp (j?J r� tw G,4q2? S 3
Contractor:
Telephone: `] %
Address: j v
-Project DC Cr$ iption: F
City, ST, Zip:
- ✓1a✓1+ 1✓V1 I'tSJev►'� ✓I�5
Telephone:
A e, s_ ap
State Lic. #:
City Lic. #;
AJD
Arch., Engr., Designer:
l o b p p E, p,,-rrp b n G P46S �tMr.s
Address:LAA--j�Je�,,
4w')t106l"r► 11fa -
City., ST, Zip:
Telephone:
<<::<::?::::>:::<:>»»:::<><`:#'<::::::<::::::
ConstructionT e: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #:
::;:<.:;•:.:<:;::::::::::;::::;.;s:;s:;;:;;;:;:>::
...................
Name of Contact Person: x l7Gtl' Q�
Sq. Ft.:
# Stories:
# U/nits:
Telephone, #:ofContact Person: �� C' V1 �1 24)-76
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
��
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cala.
-
Plans picked up
-Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
t
�s�'
Called Contact Person
Plumbing
Grant Deed
"'
Plans picked up
S.M.1.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
-A
34 Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.1.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
ls%�kty
.W
Cd CC
I
Total P t)Zdf�4.
COMMUN OFLA
QUINT
n' DEVELOPMENT
Ti tf 4 44�rw
COMMUNITY DEVELOPMENT DEPARTMENT
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA' 92253
(760) 777-7125 FAX (760) 777-7011
To: Greg Butler, Building Official To PD: & • A3 • #4
- ---From: Les Johnson,. -CDD -Director -------- -----_ - Due -Date: --•J -__--- .---------
Permit #: 14- Status: 1st
Building Plans Approval
(This is an approval to issue a Building Permit)
Planning has reviewed the Building Plans for the following project:
Description: la444 w
V46"&Ads-
Address or General Location: 5 31 SO 92.0t tVAOWd4odoo'
Applicant Contact:add
-
Planning finds that:
❑ ...these Building Plans do not require Planning approval.
P1 ...these Building Plans are approved by Planning.
❑ ...these Building Plans require corrections. Please forward a copy of the
attached corrections to the. applicant. When the corrections are made
please return them to Planning for review.
Les Johnson, Community Development Department Director Date
77-682 Country Club Dr. Ste. B, Palm Desert, CA 92211 ph. (760) 772-5107 fax (760) 345-762
Letter of Transmittal
To:
City of La Quinta Today's Date:
7-7-14
78-495 Calle Tampico City Due Date:
Z
D
7-8-14
U �
❑ At the request of:
La Quinta, CA 92253 Project Address:
51-351 Avenida Bermudas
Attn:
Angelica Plan Check #:
14-931
Submittal: ® 1St
❑
4th
❑ 2nd
❑
5th
❑ 3rd
❑
Other:
We are forwarding: ® By Messenger ❑ By Mail (Fed Ex or UPS)
❑ Your Pickup
Includes: # Of Descriptions: Includes:
# Of
Descriptions:
Copies:
Copies:
®
1 Structural Plans
❑
Revised Structural Plans
®
1 Structural Calculations
❑
Revised Struct. Calcs
❑
Truss Calculations Floor
❑
Revised Truss
and Roof
❑
Soils Report
❑
Revised Soils Report
❑
Structural Comment List
❑
Approved Structural Plans
❑
Redlined Structural Plans
❑
Approved Structural Calcs
❑
Redlined Structural Calcs
❑
Approved Truss Calcs
❑
Redlined Truss Calcs
❑
Approved Soils Report
❑
Redlined Soils Reports
❑
Other:
Comments: Structural content is approvable.
1 �7
z
as
If you have any questions, please call.
CL
Time= 1 HR
This Material Sent for:
❑ Your Files
❑ Your Review
❑ Checking
Other: ❑
By: Kathryn Samuels
Palm Desert Office: ® (760) 772-5107
Other: ❑
® Per Your Request
Z
D
❑ - Approval
U �
❑ At the request of:
O
12611 Hiddencreek Way Ste #B Cerritos, CA 90703
Client. Name: GaryPaff
Project Manager: Gary Paff
Client Address: 40568 Calle Galisteo Indio,
CA 92203
Client Job Number: No Information Provided
Client Job Location: No Information Provided
BULK ASBESTOS FIBER ANALYSIS
N V(AP Lab Code M79.0
Phone:(562) 860-2201
wwww,alhlab.com
Batch Number: 1400964
Total Samples Submitted: 1
Total Samples Analyzed: 1
Analysis Method: EPA Method
60.0/R-93-116
Analyzed by: Zubair Ahmed
Reviewed by: Zubair Aluned
Signature:`
Signature:
C�
Dates 04-02-2014
Date: 04-02-2014
Limit of Quantification ("LOQ")=1 %. <1 % denotes presence of asbestos below LOQ, ND=None Detected. If the sample was not
collected by AIH Laboratory then the accuracy of the results Is limited 'by the methodology and experience of the sample collector.
Liability limited to cost of samples analysis. This report shall not be reproduced except in full, without written approval of AIH
Laboratory. It shall not be used to claim product endorsement by NVLAP or any other agency of the government.
6/1712014 Mitsubishi Electric US, Inc. Coding & Heating i HVAC
Heat Pump Systems
M -Series Heat Pumps - Outdoor Units (Multi Zone)
MXZ-B
Overview
Total zone control: individually controlled rooms (up to 8) with a single outdoor system
With the MXZ-B multi -zone heat pump system, you can now enjoy ideal levels of comfort in the rooms you use
most while reducing your energy costs. People in different rooms - like the kitchen, master bedroom or living
room - can set temperatures for personalized comfort.
• Individual zone control
• Mix and match flexibility of indoor unit styles and combinations
• A wide range of indoor unit capacities that match the room size and requirements
• Flexible design options to tackle the most challenging multi -room installations
• Simple, quick, and cost—effective installation keeps install costs down on new construction and disruption
to a minimum on renovations and refits
- Efficient systems, including multiple options that meet ENERGY STAR requirements
Model Specifications
MXZ-41536NA-1 •
Power Supply
Phase, Cycle, Voltage
1 Phase, 60Hz, 208/230V'8
Cooling
Rated Capacity
35400 Btu/h (10.38 kW) •t
Capacity Range
12600 - 36400 Btu/h (3.7 - 10.7
kW
Total Input
3940 < 1000 - 4020 > W (3.9 < 1 -
> kW
Energy Efficiency SEER
18
Heating at 47° F
Rated Capacity
36000 / 34400 Btu/h (10.6 / 10.1
W) "2
Capacity Range
11400 - 43000 Btu/h (3.3 - 12.6
W
Total Input
3100 (740 - 3940) W
HSPF (Region IV)
9.3
Heating at 17• F
Maximum Capacity
24600 / 25400 Btu/h (7.2 / 7.4 kW)
COP
2.68 Btu/Btu
Heating at F F
Maximum Capacity
18671 Btu/h (4.8 kW)
Minimum Circuit Ampa city
MCA
23 Ampere '4
Maximum fuse size (time
delay)
MOCP
25 Ampere `4
Recommended
Fuse/Breaker Size
25 Ampere
Refrigerant
Oil Type i
NE022 (29.4)
Type
R41 OA
Charge
8, 13
Compressor
Type
DC INVERTER -driven Twin Rotary
Sound Pressure Level
Cooling
54 dB(A)
Heating
57 dB(A)
Dimensions H x W x D
Height
35-7/16 Inches (900 mm)
Width
35-7/16 Inches (900 mm)
RECEIVED
JUN 2.4 2014
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
hViMmw.rritsubistvpro.corrdeNprofessionallproducm heat- systemslnrseries-rmdti-zone/mseries-heat-pumps---outdoor-units-(mt d-zone)lmcz-b? 1/2
6/17/2014
Mitsubishi Electric US, Inc. Cooling & Heating I HVAC
'
Depth
12-5/8 Inches (321 mm)
Net Weight
153 Lbs. (69 kg)
Refrigerant Pipe Size O.D.
Gas (Low Pressure)
A: 1/2 Inch (12.7 mm) ; B,C,D: 3/8
Inch 9.52 mm
Liquid (High Pressure)
1/4 Inch (6.35 mm)
Mabmum Refrigerant Pipe
Length
230 ft. (70 m)
Number of Indoor Units
2, 3, 4
Maiomum Refrigerant Pipe
Height Difference
If Indoor Unit is Above Outdoor Unit
49 ft. (15 m) `s
If Indoor Unit is Below Outdoor Unit
Inches Meter
33 ft. (10 m)
Mabmum Piping
Length for Each Indoor Unit
82 ft. (25 m)
Refrigerant Piping
Connection Method Indoor /
Outdoor
Flared / Flared
Operation Conditions -
Indoor Intake Air Temperature
Cooling - Mabmum - DB, WB
95°F (35°C) DB, 71-F (22°C) WB
Cooling - Minimum - DB, WB
67-F (19°C) DB, 57-F (14°C) WB
Heating - Ma)omum - DB , WB
80-F (27°C) DB, 67-F (19°C) WB
Heating - Minimum - DB, WB
70°F (21-C) DB, 60°F (16°C) WB
Operation Conditions -
Outdoor Intake Air
Temperature
Cooling - Mabmum - DB, WB
115°F (46°C) DB
Cooling- Minimum - DB, WB
14°F (-10°C) DB
Heating - Mapmum - DB, WB
75°F (24°C) DB, 65-F (18°C) WB
Heating - Minimum- DB, WB
6°F (-14°C) DB, 5-F (-15°C) WB
http:/AmmN.mitsubishipro.com/en/professional/products/heat-pump•sWterrs/rri-series-multi-zonetrr�-series-heat-pumps---outdoor-units-(multi-zone)/rrw-b? 212
6117/201¢ Mitsubishi Electric US, Inc. Cooling & Heating i HVAC
FA
Heat Pump Systems
M -Series. Heat Pumps - Indoor Units (Multi Zone)
MSZ
Overview
Slim, wall -mounted indoor units provide zone comfort control. INVERTER -driven compressors
and electronic LEV's provide higher efficiency with controlled power usage. The outdoor unit
powers the indoor unit, and should a power outage occur, the system is automatically restored
when power returns.
Ideal for applications such as bedrooms, home offices, living rooms,'dining rooms, bonus
rooms, basements, kitchens, guard houses, and more. Rated capacities range from 9,000 to
33,200 Btu/h.
• Sleek, flat panel design
• Hot -start technology
• Quiet operation
• i -see Sensor technology available
• Enhanced filtration system available
Hand-held wireless remote; optional MHK1 backlit wall -mounted wireless remote controller
Model Specifications
MSZ-GE09NA-8 •
Power Supply
Phase, Cycle, Voltage
1 Phase, 60FIz, 208/230V 4
Cooling
Rated Capacity
9000 Btu/h (2.64 kW),
Capacity Range
3800 - 12200 Btu/h (1.1 - 3.6 kW)
Total Input
660 < 205 - 1200 > W (0.7 < 0.2 -
1.2 > kW
Energy Efficiency SEER
21
Sensible Heat Factor
0.82
Heating at 47° F
Rated Capacity
10900 Btu/h (3.2 kW) 42
Capacity Range
4500 - 14100 Btu/h (1.3 - 4.1 kW)
Total Input
760 (255 - 1200) W
HSPF (Region IV)
10
Heating at 17° F
Mabmum Capacity
8700 Btu/h (2.5 kW)
COP
2.76 Btu/Btu
Heating at 5° F
Mapmum Capacity
7061 Btu/h (4.8 kW)
Minimum Circuit Ampacity
MCA
1 Ampere
Recommended
Fuse/Breaker Size
15 Ampere
Refrigerant
Type
R41 OA
Airflow
Cooling: DRY
145-170-237-321-399 CFM (4-5-7-
m'/min
Cooling: WET
1093134-201-286-364CFM (3-4-6-
10 m /min
Heating: WET
1453170-233-321-406 CFM (4-5-7-
-11 m /min
Sound Pressure Level
Cooling
19-22-30-37-43 dB(A)
Heating
19-22-30-37-43 dB(A)
httpJMmw.mitsubishipro.corWen/professional1producMAieat-pump•systems/m-series-nndd-zone/rr}series-heat purtps---indoor-units-(mutd-zone)fmsz? 1/2
6/17/2014
Mitsubishi Electric US, Inc. Cooling & Heating I HVAC
`
Dimensions H x W x D
Height
11-5/8 Inches (295 mm)
Width
31-3/8 Inches (799 mm)
Depth
9-1/8 Inches (232 mm)
Net Weight
22 Lbs. (10 kg)
Refrigerant Pipe Size O.D.
Gas (Low Pressure)
3/8 Inch (9.52 mm)
Liquid (High Pressure)
1/4 Inch (6.35 mm)
Field Drainpipe Size O.D.
5/8 Inch (15.88 mm)
Refrigerant PipingConnection
Method Indoor /
Outdoor
Flared / Flared
Operation Conditions -
Indoor Intake Air Temperature
Cooling - Mapmum - DB, WB
90°F (32°C) DB , 73°F (23°C) WB
Cooling - Minimum - DB , WB
67°F (19°C) DB , 57°F (14°C) WB
Heating - Mapmum - DB, WB
80°F (27°C) DB, 67°F (19°C) WB
Heating - Minimum - DB, WB
70°F (21-C) DB, 60°F (16°C) WB
Operation Conditions -
Outdoor Intake Air
Temperature
Cooling - Mapmum - DB, WB
115°F (46°C) DB
Cooling- Minimum - DB, WB
14°F (-10°C) DB
Heating - Mapmum - DB, WB
75°F (24°C) DB, 65°F (18°C) WB
Heating - Minimum - DB, WB
-4°F (-20°C) DB, -5°F (-21-C) WB
http:/AmAw.Mtsubishipro.conVen/professional/products/heat-pump-systems/m series-multi-zone/m series -heat -pumps --- indoor-units-(multi-zone)/rrsz? 212
r f. STIEBEL ELTRON
Simply the Best
SMALL, EFFICIENT AND RELIABLE
• • •
ini TM Series
POINT -OF -USE
TANKLESS ELECTRIC WATER HEATERS
iso 9 ED SA, �E
c 1� � WAT�E
_ CEATIE/ED MONEY
Mtertek
800.582.8423
tm
RECEIVED
JUN 2 4 2014
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
) PROVEN RELIABILITY
) EXCLUSIVE DESIGN PREVENTS DRY FIRING
) COMPACT DESIGN SAVES SPACE
) MAJOR ENERGY SAVINGS
) UNLIMITED SUPPLY OF HOT WATER
www.stiebei-eltron-usa.com
r
For all point -of -use water heating applications!
STIEBEL ELTRON Mini'" tankless electric water heaters are the ideal choice for all
point -of -use applications in the following settings:
Commercial > Industrial > Institutional
> Office buildings
> Stores
> Malls
Warehouses
> Restaurants
> Gas stations
> Schools
> Hotels/Motels
Commercial condominiums
> Manufacturing facilities
The Stiebel Eltron Mini'" tankless water heaters
are designed for installation at the point -of -use.
The Mini" heats water instantaneously as it flows
through the unit. Stand-by heat -losses are com-
pletely eliminated.
The efficient heating elements are controlled by a
flow switch. Additionally, all Mini' water heaters
are equipped with a safety high -limit with manual
reset. The combination of meticulous German
engineering and the best available materials
ensure that every Mini`p is of the highest quality
and designed for many years of trouble-free
service. Nobody can compare with our exceptional
reliability record and customer support services!
All models ship with a pressure compensating
flow-reducer/aerator that fits most faucets and
must be installed. The Mini' 2-1, 2.5-1, and 3-1
models ship with a 0.5 GPM aerator. The Mini'
3.5-1 and 4-2 models ship with a 0.66 GPM
aerator. The Mini' 6-2 model ships with a 1.0
GPM aerator. No pressure relief valve, drains, or
circulating pumps are needed.
.SAVE ?1 -�
"ENERGY
WATER
MONEY `r'
1 V�
Residential
> Bathroom sinks
> Kitchen sinks
> Laundry areas
Cabins/cottages
Safety pressure cut-out Nichrome heating system
Hot water Cold water
connection connection
:h
Engineer's Specifications: The tankless electric water heater shall be equipped
with a bare wire nichrome type heating element housed in fiberglass reinforced
high temperature plastic containment. The housing of the unit shall be made of
high impact polycarbonate plastic. The flow switch that operates the heating
element shall be of the mechanical pressure differential type. The unit shall be
equipped with a safety high -limit switch with manual reset. The water
connections shall be designed for standard 3/8" O.D. flexible braided stanless
steel hose type connectors. The unit shall be mounted with water connections
facing either top or bottom only. The units shall ship with a AWG #12 wire
harness with a length of 2 ft.
Mini"' Series Tankless Electric Water Heaters
RMADE IN
Technical Data .0%. Conform'
to ANSI/UL Std. 499 The Mini series is tested and certified by WDA 150 9001 THE USA
Certified to CAN/CSA E335-1 & E335-2-35 against NSF/ANSI 372 for lead free compliance. c eRTr r r e o
Intertek Co.
Item Number
1 231045 i 232098 1 220816
232099
Phase- 60/50 HE_ _
_,,.single- 1�single single R
._single^
Voltage
i 120 v 120 v 120 v,
1 120 v
i
Wattage
h1.8 kw ;_2A4 kw 3.0 kw r
5 kw
Amperage Draw (see below for recommended breakei size) 16 A 21 A ( 25 A 7
31A
Required circuit breaker size'
;420 a '-30 A 30 A
40 a
Required wire size'
i 12 AwG ! 10 AWG 10 AWG
i 10 AWG
Minimum water flow to activate unit
10.21 GPM / 0.8 I/min 0.40 GPM / 1.51/min 0.40 GPM i_15 7717-400M
Degree of protection according to IEC 529
IP 24 f"
Weight
3 44 Ibs /_1.56 kg
Dimensions (Height/Width/Depth)
161/2` (16.5 cm) / 71/2" (19.0 cm) / 31/4" (8.2 cm)
Woking Pressure
i15_0 psi / 10 bar
Tested to Pressure
i 300 psi / 20 bar
Volume of water in unit
j 0.026_gal. ! 0_1 I
Water connections'
I for 3/8" O.D. flexible braided stainless steel hose connectors
Mini 2.1 models are internally restricted to 0.32 Gpm.
Mini 2-1.2.5-1,3-1 ship with a 0.5 Gm pressure compensating flow-reducer/aerator
that must be installed.
Mini 3.5-1, 4-2 ship with a 0.66 epm pressure compensating flow-reducerlaerator that must be installed.
Mini` 6-2 model ships with a 1.0 cpm pressure compensating flow-reducer/aerator that must be installed.
' This is our recommendation as the manufacturer. Check local codes for compliance if necessary. Tankless water heaters are considered a non -continuous load.
'Copper must be used. Conductors should be sized to maintain
a voltage drop of less than 3% under load.
' For use with cold water supply only
90
80
70
60
U. 50
a2
a 40
E
r"
30
20
10
Temperature Rise vs. Flow Rate
Mini" 2-1
13
0i I
0.25 0.32 0.5
Distributed by:
Mini' 2-1,'2.5-1, 3-1, 3.5-1 @ 120 V
Mini" 4-2, 6-2 @ 240 V & 208 V
I
222039
i 220817
single-
single�
240 v or 208 v
la240 v or 208 v
.5 kw ' 2.9 kw
3 .j - --r'
1 5.7 kw 47 kw
3`777 -
15.2A l 13.8A
124.7a 22.4A
20 A
30A
12 AWG
• 10 AWG
0.40 GPM / 1.51/min
i__,�...
10.77 GPM / 2.91/mii
Super -compact dimensions!
t -�a-......tea..
6.5"
I
I
7.5"
7 years leakage/
3 years parts.
YEAR Complete warranty online.
w�OR ho!
-�� Mini' 6-2
Mini" 4-2
Mini" 3.5-1
Mini" 3-1
Mini" 2.5-1
0.66 0.75 0.77 1.0 1.25 1.5 1.75 2.0
Flow Rate GPM
17 West Street
West Hatfield, MA 01088
TOLL FREE 800.582.8423
PHONE 413.247.3380
Fax 413.247.3369
info@stiebel-eltron-usa.com
www.stiebei-eltron-usa.com
Due to our continuous process of engineering and technological
advancement, specifications may change without notice.
Printed on recycled chlorine -free paper with soy -based inks. "18-4.2014
}
,�
Mini' Tankless Electric Water Heater Sizing Guide
MINI' MODEL
Flow GPM Mini' 2-1* Mini' 2.5-1 Mini" 3-1 Mini" 3.5-1 Mini' 4-2 Mini" 6-2
e Ultra -Low 0.32
Standard 0.50
a Standard 0.66
3
High 1.0
*Mini" 2-1 is internally restricted to 0.32 GPM.
Mini" 2-1, 2.5-1, 3-1 ship with a 0.5 GPM pressure compensating flow reducer/aerator that must be installed.
Mini" 3.5-1, 4-2 ship with a 0.66 GPM pressure compensating flow reducer/aerator that must be installed.
Mini" 6-2 ships with a 1.0 GPM pressure compensating flow reducer/aerator that must be installed.
'These recommendations are for 240 V units installed at that voltage. Increase one model size if unit will be installed with 208 V service.
�� � __ _ F.✓yam
k
Stiebel Eltron's main plant in Holzminden, Germany
* ��# c t7 us
YEAR t
N E .o., SCUSA
•wp�N` Intertek
7 years leakage/ Conforms to The Mini" series is tested
3 years parts. ANSUUL Std. 499 and certified by WQA
Complete warranty online. Certified to CAN/CSA against NSF/ANSI 372 for
E335-1 & E335-2-35 lead free compliance.
ISO 9001
CERTIFIED
Cool (Northern) Climate
Inlet water 45°F - 55°F
N. 'A V
Warm (Southern) Climate
Inlet water 55°F - 70°F
MADE IN
THE USA
www.stiebel-eltron-usa.com