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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