13-1070 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA.;.CALIFORNIA 92253
Application Number: _13-00001070
Property Address: 79475 TORONJA
APN: 772--340;051=• - -
Application description: MECHANICAL -
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation:- 38940
Tit
BUILDING &SAFETY DEPARTMENT `
BUILDING PERMIT
Applicant: Architect or Engineer:
Owner: ,
CURT ASKELSON
79475 TORONJA
LA QUINTA, CA 92253
(760)831-7439
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/26/13
Contractor:
DESERT AIR CONDITIONING,.
590 WILLIAMS ROAD
PALM SPRINGS, CA.92264
(760)323-3383
Lic. No..: 276586
--------------------------=----------------------
LICENSED CONTRACTOR'S DECLARATION - ,
------=----------------------------------------—
t
.. - ;WORKER'S COMPENSATION DECLARATION —
' I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations: '
Section 7000) of Division 3 of the Business a Professionals Code, and my License is in full force and effect.
- - I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C20 -C43 License No.: .276586.
for. by Section 3700 of the Labor Code, for the performance of the work for which this permit is
� -
Date: '. �• �•.� Contractor: -
issued.
I have and will maintain workers' compensation insurance,.as required by Section 3700 of the Labor -
"I V
Code, for the performance of the work for which this permit is issued. My workers' compensation, ,
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the
Carrier EVEREST NATL . Policy Number 7600007908121.
following reason (Sec. 7031.5, Business and�Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance; also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she islicensedpursuant to the provisions of the Contractor's State
and agree that, if I should ecome subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
_ 3700'of the Labor CodeI sh forthwith comply with those provisions.
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).:
O.ate:�, J(,— r Applicant:'
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The . i
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL ,
Contractors' State License Law does not apply to an owner of_property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). 'IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN - -
- - improvements are not intended or offered for sale. If, however, the building' or improvement is sold within .
-SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. ,
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
- - -
.
_ improve for the purpose of sale.).
APPLICANT ACKNOWLEDGEMENT -
(- 1 I, as owner of the property, am exclusively. contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of ,
conditions and restrictions set forth on this application. - -
property who builds or -improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). -
whose benefit work is performed under or.pursuant to any permit issued as a result of this application,
(_ 1 1 am exempt under Sec. •, B.&P.C. for this reason _C>
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.
Date: Owner: •
' 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 suchpermit, or cessation of work for 180 days will subject
- CONSTRUCTION LENDING AGENCY -
permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the abov information is correct. I agree to comply with all
work for which this permit is issued ISec. 3097. Civ. C.I.
city and county ordinances and state laws relating to building nstruction, and hereby authorize representatives
of this county, to enter upon the above-mentioned property spec ' n purposes. •' '
Lender's Name:
•
�� _--� r
Date: ��+ -� Signature IApplicant or Agent):
Lender's Address:
LQPERMIT • .
Application Number `. 13-00001070
Permit MECHANICAL 2013
Additional de"s.c-",
Permit Fee 214.50'. Plan Check Fee
.00
Issue Date Valuation
0
Expiration Date— 2/22/14
Qty Unit Charge Per
Extension
3.00 35'.7500 -EA MECH FURNACE
107.25
3.00 35.7500 EA MECH CONDENSER/COMP
107.25
Special Notes and Comments
HVAC CHANGE OUT_- 23 SEER/'80 AFUE,,(3)'..2
TON SPLIT SYSTEMS [2008 ENERGY) CARBON
MONOXIDE ALARM(S) TO BE INSTALLED,PRIOR
TO FINAL INSPECTION. 2010 CALIFORNIA
BUILDING. CODES.
--------------"---------------------------------------------------------------
Other Fees . BLDG STDS ADMIN (SB147.3)
1:00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
47.66
Fee summary Charged :Paid Credited
Due
Permit Fee Total 214.50 .00 .00
214.50
Plan Check Total .00 .00 .00•
.00
Other. Fee Total 139.23 .00 .00
139.23
Grand Total 353.13 .00 00
353.73
LQPERMIT
.
Bin. #
City.Of, %a Qui:
Building a Safety Division
P.O. Box 1504,78-495 Caife Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Applicatlon and Tracking Sheet
Permit #
1 lop.
Project.Address: 7 On
Owner's Name:. �� S
A. P. Number.
Address: [ _ 7 5 0 V G v9 ^
Legal Description:
City, ST, Zip:
Contractor. DESERT AIR CONDITIONING, INC
Tel hone:` V
Address: 590 WILLIAMS RD
Project Description: VC to a
City, ST, Zip:PALM SPRINGS, CA 92264
Telephone: 760-323-3383
"'O.
(�
State Lic. # : 276586
City Lie'. M 363
Arch., Engr., Designer. NA
Address:
City., ST, Zip:
Telephone: r °Gonstruction
State Lie. #: : .
Type:. MECH Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name ofContactPerson: JACQUELINE RATLIFF:
Sq. Ft.: # Stories: #Units,
Telephone # of Contact Person: 760-323-3383
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
'Ree'd
TRACICTIVG PERMIT FEES
Plan Sets
Pian Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Platt Check Balance
Title 24 Calca.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2id Review, ready for correctionsfrssue
Electrical
Subcontactor list
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7id Review, ready for correctionsfissuc
Developer Impact Fee
Planning Approval
Called Contact Person
Ad -P -P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address:Enforcement
Agency:
Date::
Permit #:.
79-475 TORONJA 1 OF 3 LA' QUINTA, CA 92253
City of La Quinta
Aug 16, 2013
Duct insulation :
Conditioned Floor
Equipment Type'
List Minimum Efficiency2
requirement
Area _
Thermostat.'
[]Package Unit
-
® Furnace
® AFUE 80%
❑ COP '
❑ R 6 (CZ 10-13)
Seryed by system
® Setback.
IM Indoor Coil
® SEER 23.0
[3HSPF
® R'8 (CZ 14-15)
1500 sf
If not already present, must
® Condensing Unit
[3 EER -
[3 Resistance
be installed)
® Other > 40' Ducts
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 -6111 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. _ "' �•
❑ i. HVAC Changeout
Required'Forms:
. All HVAC Equipment
CF -6111 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 F
.Condenser Coil and /or
CF -6R forms:,MECH-04, MECH-2I=HERS and (for split systems) MECH-25-HERS
. Indoor Coil and /or
. 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
For Packaged Units: Duct leakage < 15 percent
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,mill not be Dined (ie. Ductless MiniSplit,S.ystem)T(AisorExemp-,Ifrtom=Refrige ant Charge)
® 2. NeWHYAC system Requir"ed Forms
. Cut in�kor;Ghangeout with
{"'� -v f
CF 6Rfo Tms 3MECH-04, MECH 201 HERSand7(for split systems) MECH 224HERS, and
new ducts all new
Budin an new
9— new
MECH�25 HERS t -X z •` w ;} k
Cf MECH
equipment)
4R:forms 20, and (for split systems) MECH-221,MECH-25
�r
ia4{eiw-° "Pa_k:`fiz�'3wf` _44 6s
For Split Systems: Duct leakage1<K6,percent„RC CCA >,350 CFM/ton; FWD; TMAH SIMS, and either HSPP'onPSPP.
., 1 ,
Rt
_7 PeFeei.-
❑ 3. New Ducts with/or„without
Required Forms:
Replacement '
a
t
. Includes replacing or installing all new
�. .
ducting and/or outdoor condensing unit'
CF -611 forms: MECH-04; MECH-20-HERS, and (for split systems) MECH-257HERS
and/or indoor coil and/or furnace. No or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
1
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 -611 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: Jacqueline Zabik Signature: 7acqueline Zabik '
Company: DESERT AIR CONDITIONING INC Date: Aug 16; 2013
Address: 590 WILLIAMS ROAD . License: 276586
City/State/Zip: PALM SPRINGS / CA / 92264 Phone: (760) 323-3383
Reg: 213-A0063537A-000000000-0000 Registration Date/Time: 2013/08/16 16:31:40 HERS'Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
'F J
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 30 - 15
Site Address: s
Enforcement Agency:
'Date: "r _ l
'Permit #:
79-475 TORONIA 2 OF 3 LA QUINTA:,' CA 92253
City of La Quinta _
Aug 16, 2013 . .
Equipment Type?
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area,
`
Thermostat
❑ Package Unit
® Furnace r
10 Indoor Coil
® AFUE 80%'
® SEER 23.0
❑ COP
ElHSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback '
If not already present,'must
® Condensing Unit
❑ EER®
❑Resistance
R 8 (CZ 14-15)
1400 sf
be installed)
® Other > 40' Ducts
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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 -1R
and CF -611 shall also be on site for final inspection. '
❑ 1. HVAC Changeout
Required Forms:
. AII.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
6F -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25=HERS
. Indoor Coil and /or
. 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 AirFlow Requirement), TMAH,
For Packaged Units: Duct•leakage < 15'percent
Exempted from'duct leakage testinglf: �• ,
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less th6n-40 linear feet in unconditioned space, or
[13. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The syshem will not be Ducted (ie Ductless Mirn,Split:;Sy�stem) (AlsorExempt from_jRefrrii,gerrant Charge)
® 2. New`�HVAC System Required forms. )r xas �
... r
r H .ae� req a z,- .
. Cut inlorrCtiangeout with, 3"9
i CF 611forms kMECH-04, MECH 20 HERS, and(for split systems) MECH,.22 HERS, and
du '!:(all
new ,t new r Y
MECH 25HER5^s(s.i z ,. r
ducting and all new 'CF 4R forms MECH 20, systems)'MECH-22, MECH 25 'n,:.7
and (for split aannd
equipment) l�':�` o, . `' ii ; .4 A, -.r ' ' t '9tt: :. r . s ...s tit_,rv`
For Split Systems:'Duct leakage <;6'percent;:RC CCA>_" 350-CFM/ton; FWD, TMAH`�STMS, and'either HSPP or`PSPP. '— `
FGF Pa
❑ 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: s
. Includes adding or replacing more than 40 CF -6R forms: ME H-04, MECH-2I-HERS --
linear feet of duct in unconditioned space. CF -411 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. s
• 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: Jacqueline Zabik Signature: Jacqueline Zabik
Company: DESERT AIR CONDITIONING INC Date: Aug 16, 2013
Address: 590 WILLIAMS ROAD I License: 276586
City/State/Zip: PALM SPRINGS / CA / 92264 Phone: (760) 323-3383
• ,
Reg: 213-AO06353BA-000000000-0000 Registration Date/Time: 2013/08/16 16:35:39 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 #:
79-475 TORONJA 3 OF 3 LA QUINTA, CA 92253
City•of La Quinta
,Aug 16, 2013
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area, a
Thermostat
❑ Package Unit
IM Furnace
[3Indoor Coil
❑ AFUE
®SEER �'
❑ COP'®
IM HSPF 7
❑ R 6 (CZ 10-13)
Served by system
sf
Setback
If not already, present, must
®Condensing Unit.
[I EER
�7
❑ Resistance
[1R 8 CZ 14-15)
( ,
800
be installed)
® Other <= 40' Ducts
i
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-lR-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
,�,4 21,141gg EXEMPTED and (for split systems) MECH-25-HERS -
CF -6R forms: MECH-04, ^4,_G
replaced
CF -4R forms: ^"=,, ,i1 EXEMPTED and (for split systems), MECH-25
. Condenser Coil and /or
CF -6R forms: MEC H -04,,.,x,4 21'H€ S EXEMPTED and (for split systems) MECH-25-HERS
. Indoor Coil and /or
CF -4R forms: prem -2i EXEMPTED and (for split systems) MECH-25 t
. Furnace i
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
leakage 19
FGF Paekaged URRSO Duet _Q peFeePA-
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
[13. Existing duct systems are constructed,. insulated or sealed with asbestos
❑ 4. The3systeinswill not be Ducted (ie.rDucfless.tMini:Split System)i(Also'ExernptfromrRefrngerant'Charge)
❑ 2. NewHVAC System
reorms: P`
Reqwd F ��
.Cut in or,Chan eout with;`
9
* z v` ^ �s,�4����
C -F forms MECH-04, ,,=„.EXEMPTED and (for split systems MECH 22 HERS, and;��
new ducts; (all new
ductmgand all new
-6R
MECH2'SfHERS ova''` ,� a �`� -
22,:andMECH=25
CF 4R forms ^^r, mt-w=� EXEMPTED,andr,(forysplifsystems)<MECH
equipment)_..�vka%rfF,w
For Split Systems: Duct leakage <r6'percent`-RC,`CCArz 350`CFM/tdn', FWD, TMAH;`STMS, and either HSPP or PSPP.
For Packaged.Units: Duct leakage '<_ 6 percent
❑ 3. New. Ducts with/or without
Required Forms: 1
Replacement
. Includes replacing or installing all
new ducting and/or outdoor ,
CF -6R forms: MECH-04,^�_���-;€ ;� EXEMPTED, and (for split systems) MECH-25-HERS
condensing unit and/or indoor coil
CF -4R forms: ^4� 29 EXEMPTED and (for split systems) MECH-25
and/or furnace. No or some
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage <.6 percent j
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more
CF -611 forms: MECH-04, p4EGH 21 l4gRo EXEMPTED +
than 40 linear feet of duct in
CF -41k forms: ^"� 21 EXEMPTED '
unconditioned space.
`
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) Y
• 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: Jacqueline Zabik Signature: Jacqueline Zabik.
Company: DESERT AIR CONDITIONING INC Date: Aug 16, 2013 ="
Address: 590 WILLIAMS ROAD • " License: 276586
City/State/Zip: PALM SPRINGS / CA-/ 92264 Phone: (760) 323-3383
Reg: 213-A0063593A-000000000-0000 'Registration Date/Time: 2013/08/16 18:23:23 HERS Provider: CalCERTS, Inc:
2008 Residential Compliance Forms July.2010