14-0670 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
14-00000670
Property Address:
81535 TIBiJRON DR
APN:
767 -523 -001 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
26240 -
Applicant: Architect or Engineer:
• �l v V
---------------------- --------------------
L C ED CONT CTOR'S DECLARATION
I hereby affirm under penalty of perjury th am licensed u er provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busin s a aIs Code, and my License is in full force and effect.
LicenseClass: C20,/ C38 License No.: 967982
ID "� T Con ac of r,:�
T- OWNER -BUILDER DECLARATION
I hereby affirm under penalt perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: _
(_ 1 1, 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.). _
(_) 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
Owner:
JENNIFER WALL
81535 TIBURON
LA QUINTA, CA 92253
(760)619-3418
Contractor:
BEST IN THE WEST AIR COND
255 N.. EL CIELO, 140-125
PALM SPRINGS, CA 92262
(760)343-1002
Lic. No.: 967982
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/20/14
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: -
_ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
J�
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
ave 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 NORGUARD Policy Number BEWC337354
certify that, in the performance oft r which this permit is issued, I shall not employ any
person in any manner so as to ome su •e to the workers' compensation laws of California,
and agree that, if I sho be � me j he workers' compensation provisions of Section
., 3700 of the Labor de, all omply with those provisions.
D.161;;, � _/�icant:.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TOTHE.COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any'act or omission related to the work being .
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or f work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the ab inf mation is c r I agree to comply with all
city and county ordinances and state laws relating to build' h ru , a er y authorize representatives
of thllcounty to enter upon the above-mentioned prope for' s es
Dat el Signature (Applicant or Age
Application Number . . . . . 14700000670
Permit . . . MECHANICAL 2013
Additional desc .
Permit Fee 214.50 Plan Check Fee
.00
Issue Date" . . . . Valuation.
0
Expiration Date.. 11/16/14
Qty Unit Charge Per
Extension
3.00 35.7500 EA MECH FURNACE-.
107.25
3.00 35.7500EA MECH CONDENSER/COMP'
101.25
- - --------------------------------------------------=--------------=-----------
Special Notes Comments
.and
HVAC CHANGE OUT'- (3) 13SEER/78AFUE
SYSTEMS [2008 ENERGY] CARBON MONOXIDE
ALARM(S') TO BE•INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING
CODES. -
----------------------------------------------------------------------------
Other Fees . . . . . . . PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
142.98
Fee summary Charged Paid Credited
Due
----------------- ---- -
1 Permit Fee Total 214.50 .00 .00
214.50
Plan Check Total .00 .00 .00
.00
Other Fee Total 233.55 .00 .00233.55
Grand Total 448.05 .00 .00 _
448.05
LQPERMIT
G
Reg: 214-A0035834A-000000000-0000 Registration Date/Time: 2014/05/19 18:16:26 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: 1111111""`7Permit #:
81535.2 Tiburon La Quinta, CA 92253 City of La Quinta May 19, 2014
Duct insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat `Y
❑ Package Unit
® Furnace ® AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) - Served by system ® Setback
® Indoor Coil ® SEER _1.3.0 ❑ HSPF if not already present, must be
® Condensing Unit ❑ EER p Resistance ❑ R 8 (CZ 14-15) 1600 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 -411
forms (no hand filled CF -411s; allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF -1R
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-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 CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH=25-HERS
• Indoor Coil and /or CF -4R forms: MECH-21 and (for split systems) MECH-25
. Furnace •
For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH, .
FGF Paisk..ged �IROtS. Il.•.•F 1....1.xhP < 15 p At
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
0.4. 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
CF -6R forms MECH 04, MECH 20 -HERS, and (for.sphtsy5tems)'.MECH 22 HERS, and
new ducts (all new y MECH 25 'HERS' �'� rx r ' 4 Pn ductin and:all new. r,.x g CF -4R forms +MECH-20 and (for split systems)CMECH 22MECH 25equipment) ; -- S:• �; AM* � . , 0_1�74't� yt.z.. _.: �
For SplitpSystemsH ct leakage �6 percent; RC, G A > 350 CFM/toh?FWD TMAH; STMS;aand ei.ttier4HSPP.."or !? PP, �A a",fir
For Packaged
_Unit rDuct letrakage< 6perce t '
.. 'SI "*.
❑ 3. New Ducts with -/6r without"? a :�' r+ "• Require&Forms•.
Replacement -
.Includes .replacing,or.installing al,l,,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: Richard'C Weaver Sr Signature: Richard C Weaver Sr
Company: BEST IN THE WEST AIR CONDITIONING & HEATING INC Date: May 19, 2014
Address: 255 N ELCIELO ROAD #140-125 License: 967982
City
/State/Zip: PALM SPRINGS/ CA / 92262 Phone: (760) 343-1002 •
G
Reg: 214-A0035834A-000000000-0000 Registration Date/Time: 2014/05/19 18:16:26 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: 1111111""`7Permit #:
81535.2 Tiburon La Quinta, CA 92253 City of La Quinta May 19, 2014
Duct insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat `Y
❑ Package Unit
® Furnace ® AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) - Served by system ® Setback
® Indoor Coil ® SEER _1.3.0 ❑ HSPF if not already present, must be
® Condensing Unit ❑ EER p Resistance ❑ R 8 (CZ 14-15) 1600 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 -411
forms (no hand filled CF -411s; allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF -1R
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-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 CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH=25-HERS
• Indoor Coil and /or CF -4R forms: MECH-21 and (for split systems) MECH-25
. Furnace •
For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH, .
FGF Paisk..ged �IROtS. Il.•.•F 1....1.xhP < 15 p At
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
0.4. 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
CF -6R forms MECH 04, MECH 20 -HERS, and (for.sphtsy5tems)'.MECH 22 HERS, and
new ducts (all new y MECH 25 'HERS' �'� rx r ' 4 Pn ductin and:all new. r,.x g CF -4R forms +MECH-20 and (for split systems)CMECH 22MECH 25equipment) ; -- S:• �; AM* � . , 0_1�74't� yt.z.. _.: �
For SplitpSystemsH ct leakage �6 percent; RC, G A > 350 CFM/toh?FWD TMAH; STMS;aand ei.ttier4HSPP.."or !? PP, �A a",fir
For Packaged
_Unit rDuct letrakage< 6perce t '
.. 'SI "*.
❑ 3. New Ducts with -/6r without"? a :�' r+ "• Require&Forms•.
Replacement -
.Includes .replacing,or.installing al,l,,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: Richard'C Weaver Sr Signature: Richard C Weaver Sr
Company: BEST IN THE WEST AIR CONDITIONING & HEATING INC Date: May 19, 2014
Address: 255 N ELCIELO ROAD #140-125 License: 967982
City
Simplified Prescriptive Certificate of Compliance:•2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
81535.1 Tiburon La Quinta, CA 92253
City of La Quinta
May 19, 2014
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
19 AFUE 78%
® SEER--13.0
❑ COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback -
If not already present, must be
® Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
2000 sf
installed)
[3 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-611 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
..t _
For Paeltaged URits. QuEt leakage 15
p
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 Ch'angeout%with
t,
CF-6R forms 1MECH 04MECH 2q-HERS, and (for.split systems)•MECH 22 HERS, and
new ducts (.all new .`•
ducting a`nd all new
A f
MECHz25`HERS �``_ ��' ��1F Y J%2,5"
CF-4R
equiprrient)'
formt:: MECH-20, and (for split systems) MECH 22, and'MECH ;.
fa+ia�rxr sr
For-Split Systems: Duct-1e6k6ge�<.6!percent; RC, CCAez,�>`350 CFM/ton'FWD TMAH STMS, and either HSPF or RSFPS max, f -
3�_w
For Packaged Uitts,Dt leakagef< 6 percent x, ^• � ��
.. .. _ Jn uc
t :e..r•r4... -a..._.-vY•, ":Pl. 4 � RIF-'I_Pl
❑ 3. New Ducts vwtFi/or without,ry.k..' ti� °:� g Required Forrims:�: •_ '� : - .:="�_ =. �"` •
Replacement'
. 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-25-HERS
and/or indoor coil and/or, furnace"" No or some CF-411 forms: MECH-20 and (for split systems) MECH-25
equipment changed.n
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-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: Richard C Weaver Sr Signature: Richard C Weaver Sr
Company: BEST IN THE WEST AIR CONDITIONING & HEATING INC Date: May 19, 2014
Address: 255 N ELCIELO ROAD #140-125' License: 967982
City/State/Zip: PALM SPRINGS / CA'/ 92262 Phone: (760) 343-1002
Reg: 214-A0035833A-000000000-0000 Registration Date/Time: 2014/05/19 18:13:44 HERS Provider: CalCERTS, Inc.
2008 Residential'Compliance Forms July 2010
1
i
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
81535.3 Tiburon La Quinta, CA 92253
City of La Quinta
May 19, 2014
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
-
I@ Furnace
H AFUE 78%
❑ COP
❑ R 6 (CZ 10-13) -
Served by system
® Setback
® Indoor Coil
® SEER � 13.0
❑ HSPF
❑ R 8 (CZ 14-15)
1200 sf
If not already present, must be
® Condensing Unit
❑ EER
❑ 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 -611 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 -411 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
Q. 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 Ch'angeouUWith
� ,`
C1 -6R forms M. 04MECH 20 -HERS °'and (for.• split systems) MECH 22 HERS and
new ducts (all new t;
ducting and .all new
MECH 2§` HERSaY' ` °� _ � ° � - "��, A -
, K,� y .. ;. �. ' K �«� t pf u r
.
CF=4R forms iMECH-20 and (for split.system s)�M,ECH 22; and MECH 25 7
equipment)
4��1#�:`,°s,•,r.;a�s?#�v • :' r ..
For Split systems Dila-ieakage�< 6Ftpercent; RC, CCAS X350 CFM/€on,�FWD�TMAH STMS ,and5eith'er HSPP`or PSPP =z `
*a u k
pts Duct leakage*< 6fpercerit ,_
For Packaged .m
❑ 3.:New Ducts with/or without"" '5 °" P
Required;Forms -. '• "*"` =%`: " `'
Replacement';;°
. Includes:reptacingor installing all new
K.
d6ding'and/or outdoor condensing unit, -
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/6r indoor coil and/or furnace; No ors ome
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 1. .
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 Vand 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: Richard C Weaver Sr . Signature: Richard C Weaver Sr
Company: BEST IN THE WEST AIR CONDITIONING & HEATING INC Date: May 19, 2014
Address: 255 N ELCIELO ROAD #140-125 License: 967982
City/State/Zip: PALM SPRINGS / CA / 92262 Phone: (760) 343-1002
Reg: 214-A0035836A-000000000-0000 .Registration Date/Time: 2014/05/19 18:18:54 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
eta.#
Cid Of. La Quinta
Building 8r Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
.14- - (; 0
ProjectAddress: ` I burem
Owner's Name:.
A. P. Number.
Address: le/ S T v 2C)
Legal Description:
Contractor: t? Osf
City, ST, Zip: L "7,2�
Telephone: r)
Address: S
Project Description:
City, ST, Zip:. n S
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Telephone: V -37q. 2
State Lic. # : City Lir #;
ch, Engr., Designer.
Address:
City., ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: Z /
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: nit;:
Telephone # of Contact Person: , p — Oo?/
Estimated Value of Project: Z "L
APPLICANT: DO NOT WRITE BELOW THIS UNE
IE
Submittal
Req'd
Rev'd
TRACKING
PERMITFEES
PIP Sets
Plan Check submitted
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plaa Check Balance
Title 24 Cales.
Plans picked up
Contraction
Flood plain plan
Plans resubmitted _ .
Mecharilcal
Grading plan
2' Review, ready for correctiomMiissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Groot Deed
Plans picked up
S.M.L
H.O.A. Approval
Plani resubmitted
Grading
IN ROUSE:-
3" Review; ready for correedonsAssue
Developer Impact Fee
Planning Approval
Called Contact Person
Y
A I P.P.
Pub. Wks. Appr '
Date of permit issue
School Fees
Total Permit Fees