13-1092 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00001092
Property Address: 53420 DEL GATO DR
APN: 770-350-019- -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 66039
Applicant:
Architect or Engineer:
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 U . in full force and effect.
License Class: C20 License N 6310
Dater 3G-0 Contractor -
I hereby affirm under penalty of perjury that I am exe fro a Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Pr ssio ode: Any city or county that requires a permit to
construct, alter, improve, demolish, or repai ny cture, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he r is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing 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.).
(_ 1 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.).
(_ 1 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/30/13
Owner:
CORLISS J. NELSON
53420 DEL GATO
LA QUINTA, CA 92253
(
p ;rY01:
Contractor:
GENERAL AIR CONDITIONINGiLA
�(�13
31170 RESERVE DRIVE r+THOUSAND PALMS, CA 92276
(760)343-7488 CQUIN
Lic. No.: 686310 FINANCED@PT.
-----------------------------------------------
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
foLby Section 3700 of the Labor Code, for the performance of the work for which this permit is
SCI/� sssued.
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 ZENITH INS CO Policy Number Z071741502
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 s orthwith comply with t isions.
�.
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMP COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENAL CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, ST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a peimit 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 county
�tot enter upon the above-mentioned propert ection purposes.
Date:� 4o`[ Aignature (Applicant or Agen
Application Number . . . . . 13-00001092
Permit . . . MECHANICAL 2013•
Additional desc .
Permit Fee . . . . 357.50 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 2/26/14
Qty Unit Charge Per
Extension
5.00 35.7500 EA MECH FURNACE
178.75
5.00 35.7500 EA MECH.CONDENSER/COMP
178.75
--------------------------------------'--------------------------------------
Special Notes and Comments
HVAC CHANGE`OUT - (5) 19SEER/78AFUE
SYSTEMS INCLUDING 2 MINI SPLITS (2008
ENERGY] CARBON MONOXIDE ALARM(S) TO BE
INSTALLED PRIOR TO FINAL INSPECTION.
2010 CALIFORNIA BUILDING CODES.
----------------------------------------------------------------------------
Other Fees . . . ... . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
238.30
Fee summary Charged Paid Credited
------------------------------=--------------------------
Due
Permit Fee Total 357.50 .00 .00
357.50
Plan Check Total .00 .00 .00
.00
Other Fee Total 329.87 .00 .00
329.87
Grand Total 687.37 .00 .00
687.37
9
LQPERMIT
M
k
�.� Citjr ofLa Quinta
llit>
8tT a Safely Diet w
1
P.O. Box 1504,-78-49S Case Tam** 4.Quh" CA 92253 - (760) 777-7012
` Building Permit Application and Tracking Sheet
PtojectAdd!ess: 52830 AVENIDA MEN
DOZA Owaa'sName:. MICHELLE BELIN
A. P. Number Address: 52830 AVENIDA MENDOZA
Legal Desaiptiw+: City, sr, zip: LA QU I NTA, CA 92253
Contractor. GENERAL A/C & HEATING Telephone:
Address: 31170 RESERVE DRIVE PmjedD=dption:
City. LVP: THOUSAND PALMS, CA 92276 CHANGE OUT A/C 4 TON. 18 SEER
Tdepbone- 760-343-7488 FURNACE 90,000 BTU & COIL
State Lic. 9: 686310. City Lic, C.
Arch, Bagr, Designer.
Addtesx
City. ST, Zip:
Tom. Censtrudion'Iype: Oxupaaay:
Stft Lic. 6: Ptojed type (*de one): New Add'n Alter Repair Demo'
Name of Coaract Pam: PATRICK Sq. FL: d Stories: s vnitx
Telephone f of Conrad Prion: F,stimaood. Value of Project 12800.00 .
APPLICANT: DO NOT, WRITE BELOW THIS LINE
N
Sabmltial
Ptaa Seb
Beq'd
Beed
TRACKINGPEt;hIIT FBFS
Plan Cheek submitted Issas Amoat
�+vetaral Cala.
Revkwed, ready for eorreedons Pan Check Deposit
Tlsss Cala.
Called Contact Person Pan Cheek Balance.
1we U Cake.
Paw pitted up Conatrwdon
Flood plain pian
Plats resubmitted Mechanical
G-&n plan.
T! Ralew, ready for eorrecdonoretwe Eleeoial
Subeonumr I ist
Called Contact Person Plumbing
Grant Dted
Paw picked up
H.O.A. Approval
Pans resubmitted Gradtag
Q1 HOUSE: -
Review, ready for wrrectionslissae Developer Impact Fee
Panning Appal
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Teta1 Permit Fea
k
�.� Citjr ofLa Quinta
llit>
8tT a Safely Diet w
1
P.O. Box 1504,-78-49S Case Tam** 4.Quh" CA 92253 - (760) 777-7012
` Building Permit Application and Tracking Sheet
PtojectAdd!ess: 52830 AVENIDA MEN
ro
Simplified Prescriptive Certificate of Compliance: -2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
52830 AVENIDA MENDOZA La Quinta, CA 92253 `
City of La Qui nta
Aug 29, 2013
, Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUEa
® SEER
[3COP
❑ HSPF
[3 R 6 (CZ 10-13)
Served by system
If of Setback present, must be
® Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
1388 sf
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -111
and CF -611 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF -61k forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
o Condenser Coil and /or
• Indoor Coil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• Furnace
CF -4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage',<. 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
FGF Paelfaged Units, P-4 leakage < 15
peFeept-
Exempted from duct leakage testing:ifi ' ;
1.,Ductsysterri-iaas documented to have been previously sealed and confirmed through HERS verification, or,
❑ 2. Duct`systems with less than 40 linear feet in unconditioned space, or
❑ 3;.Existing'duct systems are constructed; insulated or sealed with asbestos-
❑ 4. The:system,will not be.Ducted (ie.-Ductless,Mini-Split System),(Also Exempt fromTRefrigerant Charge)
13 2. NeiWHVAC'Syst'm
Requitd&Forms ,, 4 . ` " x.^x r g )5=
• Cut injor, Changeout with
-
(
,new ducts all neZ"Itv,
a , �'. ` .`° + tp r
CF 6R forms: MECH-04, MECH 20 HERS, and (f&,split systems) MECH 22 HERS, and
ducting: Lall ne
Y
MEGs=25 HERS ;'1
4 <>
FSR forms sMECH 20, and (for split systems) MECH 22; and MECH 25
, �'::equipment).
J�'
-. I i ... �r. ! .., r F,_- " .,... r : a .�. ,� r f�j r ,_
�
For Split Systems:'Duct.leakage <)6,percent;.RC, CCA >_:350 CFM/ton; FWD, TMAH; SIMS, and either:'HSPP or PSPP.
F
For Packaged_Units: Duct leakage < 6 percent
❑ 3 New Ducts with/or,without s
Required Forms: +'
Replacement,:,:_-,"'
-:I,ncludes replacing or installing all, new
ducting and/or outdoor c6ndensing unit
CF -6R forms: MECH-04, MECH-20-HERS, and'(for split systems) MECH}25-HERS
and/or indoor coil and/or furnace. No or some
CF -4R forms: MECH-20 and'(for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent -
114. New Ducting over 40 feet
Required Forms:
• Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-21=HERS
linear feet of duct in unconditioned space.
CF -4R forms:.MECH-21 ,
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement), '
.••I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The.design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
,,, forms, worksheets, calculations, plans and specifications submitted to the enforcement agency.for•approval with the permit application.
Name: Danielle Garcia Signature: pnnielle Garcia
Company: HARRISON ENTERPRISES INC Date: Aug 29, 2013
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
,Reg: 213-A0066498A-000000000-0000 Registration Date/Time: 2013/08/29 01:03:35
,2008 Residential'Compliance Forms ;
• f
HERS Provider: CalCERTS, Inc.
July 2010
a
Ll
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-111-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency: Date:
Permit #:
53420 DEL GATO La Quinta, CA 92253
City of La Quinta Aug 29, 2013
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
® Setback
® Indoor Coil
IM SEER 19.0
❑ HSPF
13R 8 (CZ 14-15)
5620 sf
If not already present must be
10 Condensing Unit
E3EER
❑ Resistance
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVAC for each system.
2. Minimum Equipment Efflciencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-111
and CF-611 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF-4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
. Indoor Coil and /or
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Furnace
CF-4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The4system,will not be Ducted (ie. Ductless;Mini-Split_;System)�(Also7EkemptfromtRe. frigerant Charge)
❑ 2. Ne%WHVAC System
Required Forms:° r` ;t .,,;`- � s.`.. M.. •_ra°, . �` '
. Cut inior Changeout with
x "
CF-6R forms: MECH-04 MECH-207HERS, anti" (for split systems) MECH-22-HERS, and
ducts:,,(all
new ducts:..alt new
ducting and all new �f
HERS
CF-4R fo'rm's:, MECH-20, and -(for split systems) MECH,22,and'MECH-25
equipment)k'
For Split Systems: Duct leakage ;6"percent; RC SCCA'=>_ 350 CFM/ton;'FWD,;TMAH � STMS, and either HSPP or PSPP. -
For Packaged Units: Duct leakage < 6 percent
❑ 3., New Ducts with/or without
Required Forms:
Replacement :
• Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF-4R forms: MECH-20 and (for split systems) MECH-25
-equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4: New Ducting over 40 feet Required Forms:
• Includes adding or replacing more than 40 CF-6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space. CF-4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Danielle Garcia Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC Date: Aug 29, 2013
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 213-A0066529A-000000000-0000 Registration Date/Time: 2013/08/29 02:31:25 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC` Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency: Date:
Permit #:
53420 DEL GATO La Quinta, CA 92253
City of La Quinta Aug 29, 2013
Dud insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
® Setback
® Indoor Coil
® SEER 19.0
❑ HSPF
[3 R 8 (CZ 14-15)
5620 sf
If not already present, must be
® Condensing Unit
❑ EER
[3 Resistance
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-111
and CF-611 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF-4R forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or
• Indoor Coil and /or
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• Furnace
CF-4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if: "
p 1'.°Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
[33. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4: The system-will not be Ducted (ie. Ductless. Mini-Split, System),(Algo•Exempt,from;Refrigerant Charge)
❑ 2. New HVAC System
Required Forms: : { °**} 3 r �!
. Cut inror Changeout with
-
new ducts:`(all new
r ► ' �+ r�^.
CF-6R forms:.MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and
ducting and all new
`
MECH-25�HERS t` j t '
CF-4R forms- MECH-20, and (for split systems) MECH=22, and MECH-25 �+
equipment)
r/ ` ^+. •_ ;,� q r. .
For Split Systems: Duct leakage < 6 percent; RC, CCA 2t 350 CFM/ton, FWD,-iTMAH,.STMS, and either.HSPP or PSPP.
'
For Packaged Units: Duct leakage <6 percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement ,
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF-4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
• Includes adding or replacing more than 40
7F-6R forms: MECH-04, MECH-21-HERS
linear feet of duct in unconditioned space.
CF-4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
°❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
'i I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Danielle Garcia Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC Date: Aug 29, 2013
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
,Reg: 213-A0066531A-000000000-0000 Registration Date/Time: 2013/08/29 02:33:59 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010;
i
F
e
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency: Date:
Permit #:
53420 DEL GATO La Quinta, CA 92253
City of La Quinta Aug 29, 2013
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
H Setback
® Indoor Coil
® SEER 19.0
❑ HSPF
❑ R 8 (CZ 14-15)
5620 sf
If not already present, must be
® Condensing Unit
[3EER
❑ Resistance
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-111
and CF-6R shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms: ;
• All HVAC Equipment
CF-6R forms: MECH-04, MECH-21'HERS and (for split systems) MECH-25-HERS
replaced
CF-4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
Coil
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Indoor and /or
. Furnace
CF-4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakagec< 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
FGF Paekaged Units, _D,_le� leakage r. 15 peFeepk
Exempted from duct leakage testi6g;if:
❑ 1: Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. *Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. Th ,Systemrow,ill not be Ducted (ie,�,Ductless.Mini -Sp lit-System).(Also >Exempt,from,Refrigerant Charge)
❑ 2. New"HVAC 5 stem
Required Forms:
. Cut in",or Changeout with;
-
-new
s • r it .rf
CF-6R forms: MECH 04 MECH-20;HER5, and (for split systems). MECH-22-HERS, and
ducts:^(all new
ducting and all new
MECH-25 HERS f %.
equipment)
CF-4R forms: MECH-20, and=(for split systems) MECH 22, and MECH-25 JR
For Split Systems: Duct leakage <'6 percent ,'RC,'CCA,>_ 350'CFM/ton„FWD,',TMAH;'.STMS, and either.;HSPP or PSPP.
For Packaged Units: Duct leakage c.6 percent ' +
❑ 3:'New Ducts with/or without
Replacement
Required Forms:
*-Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
equipment changed.
CF-4R forms: MECH-20'and (for split systems) MECH-25
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent -
❑ 4: New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF-6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in, unconditioned space.
CF-4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent .
' p EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for.approval with the permit application.
Name: Danielle Garcia Signature: bnnielle 6arcie
Company: HARRISON ENTERPRISES INC Date: Aug 29, 2013
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
istration Date/Time: 2013/08/29 02:35:56 HERS Provider: CalCERTS, Inc. '
July 20101
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency: Date:
Permit #:
53420 DEL GATO La Quinta, CA 92253
City of La Quinta Aug 29, 2013
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
® Setback
® Indoor Coil
® SEER 19.0
❑ HSPF
13R 8 (CZ 14-15)
5620 sf
If not already present must be
® Condensing Unit
❑ EER
[3Resistance
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -411
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -111
and CF -611 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or
• Indoor Coil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• Furnace
CF -4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage ,< 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from,duct leakage testing:if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4..The systemmill not be Ducted (ie Ductless,Mini-Split System) (Also Exempt;from�Refrigerant Charge)
❑ 2. New HVAC System
Required -Forms:
. Cut inior, Changeout with;
CF -6R forms:+ MECH-04, :H-20THERS,tand (for split systems) MECH-22-HERS, and
new ducts:'(all new
ducting and all new
MECH °25 HERS 3 fit; V f _ A .
t ••' % �' :�
CF -4R forms:: MECH-20, and (for split systems) MECH-22, arid MECH-25
e ui ment )
jv*
q P
4. �Y
For Split Systems: Duct leakage < 6'percent; RC,,CCA•>_ 350;CFM/ton; FWD; TMAH,';STMS, and: either HSPP or PSPP.
For Packaged Units: Duct leakage <'6 percent
❑ 3:.New Ducts with/or without -
Required Forms:
Replacement *, i
Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF -6R forms: MECH-04, MECH-20=HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For.Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Danielle Garcia Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC Date: Aug 29, 2013
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
,Reg: 213-A0066533A-000000000-0000 Registration Date/Time: 2013/08/29 02:38:09 HERS Provider: CalCERTS, Inc.
'2008 Residential Compliance Forms July 2010,
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address: Enforcement Agency: Date:
Permit #:
53420 DEL GATO La Quinta, CA 92253 City of La Quinta Aug 29, 2013
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
® Setback
® Indoor Coil
® SEER 19.0
[3HSPF
❑ R 8 (CZ 14-15)
5620 sf
If not already present, must be
® Condensing Unit
❑ EER
[3 Resistance
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-IR
and CF-611 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF-4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
. Indoor Coil and /or
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Furnace
CF-4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted (ie. Ductless Mini-Split System) (Also Exempt from Refrigerant Charge)
❑ 2. New HVAC System
Required Forms:
. Cut in or Changeout with
new ducts: (all new
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and
ducting and all new,
MECH-25-HERS
CF-4R forms: MECH-20, and (for split systems) MECH-22, and MECH-25
equipment)
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF-4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
• Includes adding or replacing more than 40
CF-6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF-4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Danielle Garcia Signature: panielle Garcia
Company: HARRISON ENTERPRISES INC Date: Aug 29, 2013
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 213-A0066534A-000000000-0000 Registration Date/Time: 2013/08/29 02:40:41 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010