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13-0086 (MECH)'P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 A�plication Number: 13-��00000086 Property Address: t--50440 SPYGLASS HILL DR APN: 770-060-013-83 -25389 Application description: MECHANICAL Property Zoning: MEDIUM DENSITY RES Application valuation: 13000 . I . VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 1/28/13 Owner: EARL & JANELLE LESLIE 50440 SPYGLASS HILL LA QUINTA, CA 92253 FFD Contractor: Applicant: Architect or Engineer: GENERAL AIR CONDITI 31170 RESERVE DRIVE THOUSAND PALMS, -CA (760) 343 - 74 88 Lic. No.: 686310 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 fcommencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License_Class: C20 LicenseNo.: 686310 ,�teCo7nt, Ror: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or County that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structur is not intended or offered for sale fSec. 7044, Business and Professions Code; The - Contractom? 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, as owner of the property, am exclusively contracting with licensed contractors to construct the project fSec. 7044, Business and Professions Code: The Contiactors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractorls) lic6sed pursuant to the Contractors' State License Law.). 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 JAN 2 9 2013 CITYOFLAQUINTA 276 FINANCEDEPT. - WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier ZENITH INS CO I 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 shall forthwith comply with those provisions. a Awk—ca WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACRINOWLEDGEMENT - 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'a'grees to, and shall defend, indemnity 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 buil . ding construction, and hereby authorize representatives of this county to enter upon the altitive-mentioned property for inspection purposes. _fic a. _— �12 I r!. Signatur�p ant o—,Agent): r Application Number 13-00000086 Permit . . . MECHANICAL Additional de,sc, Permit Fee . . . 66.00 Plan Check Fee 16.50 Issue Date . . . . Valuation 0 Expiration Date 7/27/13 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2A0 16.5000 EA MECH B/C >3-.15HP/>100K-50OKBTU 33.00 ----------------------------------------------------------------------------- Special Notes and Comments REPLACE (2) 3.5'TON AIR CONDITIONING UNITS '& (2) 42k BTV FURNACES'. 2010 CODES. ----------- 7 ----------- 7 -------------- 7 ----------- Other Fees BLDG STDS ADMIN (SB1473) 1.0,0 Fee summary Charged Paid �Credi,ted. - - - - - - - - - - - - - - - - - - - - - Due. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7.- Permit Fee Total 66.00 .00 .00 66-00 Plan Check total 16.50 00 00 16.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 83.50 �.00 .00 83.50. LQPERMIT Perink # PmjcaAdd=. of, La Q *' ta uth REAft &, Sarky DWbn P.O. Box 1504,"78-495 Cage Tampko E4.QLdntaCA?22-53--.(760)777-7012 Building. Permit APPlication'and Tracking Sheet OwneesNam T cxh -a\ e L-��sU-L A- P. Number. Address: _c;OLAL40 Legal Description: Cit�,. ST, Zip: Contractor A Telephone: -7 foO --)-n- 69 t L Now---- M-1 Aftess: ,3�1-70 —Rc-se-14e- K- - ProJect Description: City, �T' Zip-. — 42- 7- 2 Av- Telephone: -7(o0-3`43--7q8-8' State be. #: ( I b ArdL, PAW, Designer. City Lie. N, r 44? V_ Addrc= City. ST. Zip: Telephone: Statel,ic.#: Construction T�pe: Occupancy: Project type (circle one): New Add'n. Alter Repair Demo Name of Coatau Person: Sq. FL: Stories. 0 Ua14: Telephone 0 of Contact Person: Est Estimated Value of Project: 13, 000 APPLICANT: N Submittal Rq'd Reed DO NOT WPJU BELOW THIS LINE TRACMG PERMITFEES- Plan Sets Plan Check Submitted Amount stmdural CRIM Rlevlcw4 MAY for corrections Phu Check Deposit. Truss Cato. Called Contact Person Plan Check Ralance. Tide 24 Cdcls� Plans picked up' Construction Flood plain plan Plans rmbml . Red. Mechaikal Gi,ading plan 2" R"iew, rc'dY for correctiousirissue Elecalcal Subcontactor Lbt Called Contact Person Ptu�'Mblng Grant Deed Plans lilcktd up ShLL ILO -k Approval Plans resubmitted Gradin 9 IN HOUSE-, Wvitw. ready for correction&'Issuc Dev'eloper Impact Fee Plgaulng Approval Called . . Contact person Pub. Wks. Appr Date of permit Issue School Fees ------ Total Peratit Fees Simplified Prescriptive Cerldficate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC Climate Zones 10 - 15 S",WmAddress- Enforcement Agency: ate: Permit #: 501!,40 SPYGLASS HILL La Quinta, CA 92253 City of La Quinta I ]an 26, 2013 Duct insulation Conditioned Moor Equjj . pment Typel List Minimum Efficiency2 requirement Area Thermostat E3 Package Unit M F6mace I I.9door Coil 0 AFUE 78% N SEER 13_0 E3COP_ [3 HSPF [3R6(CZ10-13) R 8 Served by system uss sf M Setback If not already present, must be a Condensing Unit [3 EER_ [3 Resistance [3 (CZ 14-15) installed) 13 Other I I I 1* E4uipment Type: Choose the equipment being installed; if more than one System, use another CF -IR -ALT -WAC for each System. 2. Mpimum Equipment Efficiencies: 13 SEER, 78016 AFUE, Z 7HSPF f or typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done and iicks 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 fbrm:; was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forr�s (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -1R and'.*.CF-GR shall also be on site for final inspection. H T. HVAC Changeout Required Forms: All HVAC Equipment CF -6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH-25-HERS rq�laced CF -4R forms: MECH-21 and (for split systems) MECH-25 Condenser Coil and /or CF -6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH-25-HERS hi.door Coil and /or CF -4R forms: MECH-21 and (fbr split systems) MECH-25 Fu*mace For itSystems: Duct lelka' `�c 15 percent; RC, CCA:5 300 CFM/ton (Minimum Air Flow Requirement), TMAH get "Aftl Duet. Exetfipted m. duct leakage t t6stjntF-!f. :. 1 Ej - system -Was documebtitid to have been previously sealed and confirmed through HERS verification, or :13 '2.'Duct.spten1s wi,th. less d440 linear feet in unconditioned space, or . .. are Ubristructed, insulated or sealed with asbestos U-1. Exls6hg:d6ct systems. ` . "�-: 't3 Th!j5y 11 no be:Du -)r -Vw pArg4p rg e) _ACI Reqdift 0 CAA in 15,11hiingeout'-with, -ME E _pd. d61 _Jzms_VECH-04, R5 plit iRS,4 SRI GW.Ekali r u 11 nej. d ` ctim -a . P" _ff`'�7: ECH- W_ for 9 'it equip ff S 0 F—W ,V � RgR ForSplWSVS AK__,_jP For Package" Unjtj-. DUcX.. eakagio&` t- [3 la" N' ft:'Diiiiift-0 ith/or Witho F� Required Forms: Includes replacing or installing. I e dbcting and/or outdoor 66n.dep i,--- -unit CF -6R forms: MECH-04, MECK-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or -hiena: ci or some CF -411 forms: MECH-20 and (fbr 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 13 4. New Ducting over 40 feet Required For ns: Includes adding or replacing more than 40 CF -611 forms: MECH-04, MECH-21-HERS 1CF-4R linear feet of duct in unconditioned space. forms: MECH-21 For'split system or packaged units: Duct leakage < 15 percent El 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 reouirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • Th e design features identified on this Certificate of Compliance are consistent with the Information docurnented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Danielle Garcla ISignature: 9—mielle Gwci, Company: HARRISON ENTERPRISES INC Date; Jan 26, 2013 Address: 31-170 RESERVE DRIVE STE A License: 686310 ,City/State/Zip: THOUSAND PALMS / CA/ 92276 Phone: (760) 343-7488 Reg::: 213-AO005645A-000000000-0000 Registration Date/Time: 2013/01/26 10:38:55 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 N Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zoner. 10 - 15 Site Address: Entiorcement Agency: ate: Permit #: 50440 SPYGLASS HILL La Quinta, CA 92253 City of La Quinta ]an 26, 2013 Duct insulation Conditioned Floor Equio.ment Typel list Minimum Effidency2 requirement Area Thermostat [3 Package Unit • Furnace • Indoor Coil R AFUE 78% a SEER 13.0 [3 COP E3 HSPF 0 R 6 (cz io-i3) Served by system 8 Setback If not already present, must be • Condensing Unit [3 EER 0 Resistance E3 R 8 (CZ 14-15) 1158 sf installed) 13 Other_ 1. Equipment Type. e equipment being installed; ff more than one system, use another CF -1R -ALT -HVAC` for each system. 2. '8% AFUE, 7.7HSPF for typical residerlbal 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 -1R and CF -GR shall also he on site for final inspection. 1. 1 HVAC Changeout Required Forms: AII.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 Indoor Coil and /or CF -6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH-25-HERS Furace CF -411 forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leak6l 15 percent; RC, CCA:5 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from i dud: leakage testingt. If Ste 'W'' been previously sealed and confirmed through HERS verification, or -Duct s 'm as documeF6d..to have mswith less tl;ii&�'46 linear feet in unconditioned space, or El: 2.- Duct S�ste - N.�- ' ' - ' -.0 d st vstmcted, insulated or sealed with asbestos - 3-.*.' . FXI!.Aing..uct sy ems are eer 0 '4.'T1htkysten wg t bebu6�_'6-(ie- K in IP -5 ,%WseQxerE[p1_,,rnR iger e) % ,illno E3 Z: Nqr syWm ReqW� RS EC rid new 611 ne dud q1 e Ul -.W ii -mm 7- Iffin F 01%14 i 4m- r For Split S,'ah axift W_dHSWbFfP5PP. For #ackag"*'U'jjjts�-,.Duct Wakag .-percent-.-. --bew"o, Required Fo s: .1,#�- In dUdes:.replacing or irigtallirig AlFhew i ducting and/or ClUtdoo�_&ndenAl unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS ani:i/or indoor coil and/or fumo&.�.--No or some CF -411 forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage-ic 6 percent; RC, CCA a: 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent [3 4: New Ducting over 40 feet Required Forms* InLludes adding or replacing more than 40 CF -6R fiorms: MECH-04, MECH-21-HERS I linear feet of duct in unconditioned space. CF -411 forms: MECH-21 For ; lit system or packaged units. Duct leakage < 15 percent SP E3 B(CEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Authoes /Responsible Designees 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 re4uirements of Title 24, Parts I and 6 of the Califomia Code of Regulations. The design features Identified an this Certificate of Compliance are consistent with the information documented on other applicable compliance "S, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Narhe: Danielle Garcia ISignature: 9—mielle Garda Company: HARRISON ENTERPRISES INC jDate: Jan 26, 2013 Add' s: 31-170 RESERVE DRIVE STE A - lUcense: 686310 TS L City/State/Zip. THOUSAND PALMS / CA / 92276 jPhone: (760) 343-7488 Reg:� 213-AO005646A-000000000-0000 Registration Date/Time: 2013/01/26 10:41:25 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 Simplified Prescriptive Certifficate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Clim0te Zones 10 - 15 Address- Enforcement Agency: Date: Permit #: 504,40 SPYGLPSS HILL La Quinta, CA 92253 City of La Quinta Jan 26, 2013 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat [3 Package Unit W Furnace a I W AFUE 78% ESEER 13.01 [3 COP E3HSPF [3 R 6 (CZ 10-13) Served by system Sf a Setback ff not already present, must be Lo' N . I r= g Unit [3 EER 0 Resistance [3 R 8 (CZ 14-15) 1158 Installed) [3 Clther_ . r4allifflinmiewnt Type choose the equipment befiv installedF; if more than one system, use anoUw CF-lR-ALT-HVAC for each system. 1 kji— 2. Minimarm Equipnwnt Efflciende& 13 SEE& 78% ARJE, 7.7t5PF for typical restderftl systems. HER$ VERMCATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done I 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 b . was in fact the work completed by the installer. The Inspector also verifies that each appropriate CF -6R and registered CF -4R f rm: fbrff� (no hand filled CF-4Rs allowed) are filled out and signed.Beginning CWtober 1, 2010, a registered copy of the CF -1R and'.'CF-6R shall also be on site for final Inspection. l;. HVAC Changeout Required Forms: • All HVAC Equipment CIF -611 forms: MECH-04, MECH-21-HERS and (for split systems) MECH-25-HERS rq i placed CF -411 forms: MECH-21 and (for split systems) MECH-25 • Condenser Coil and /or • Indoor Coil and /or cF-6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH-25-HERS . FAirnace CF -4R forms: MECH-21 and (for split systems) MECH-25 For it Systems: Duct lea IL :15 percent; RC, CCA!5 300 CFM/ton (Minimum Air Flow Requirement), TMAH FAF- need Unksm guet. : - . � ; % - .: —7-.. i�4 __ i;-�-Mpted rn duct leakag�e-tb�sdngli;i:, system:was docurnefitiA to have been previously seated and confirmed through HERS verification, or tF2. Duct, s�Vsfems with less th" linear feet in unconditioned space, or . . . . M-3. Existi6g:*dOct syst ems, are Z bristructed, insulated of sealed with asbestos p#. Thij5pbela I no be -Dud -(ie�� e2 e) Will no _�gl 4! �q _W _.- - - VL_ t Ne "SyMn IRequi#O.M ft; witw - RS it s: ME o Cut I Pangeout' -CH-04, new C new dticti all ME( ir 5. W - ) equip -s o. - For I c 0W,,MM�6WM -and!. -1—SPO'," PPSFIP V. M. F cki linits: uct ka- 6-ki For,pa lea. -ge -Wrcent-- 13 3'&__N0'wjD1YcW�-Aw` li64-g C /or witl Required Forms: .,,W" Rep] Iriclubles replacing or iris;WIling-40--new d0dinig and/or outdoor. bodinden s"ifin: I - g unit CF -611 fbrms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS arid/Or indoor coil and/or f0ria'&'No or some CF -411 fbrms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systeirris: Duct leaFage < 6 percent; RC, CCA 2� 300 CFM/ton, TMAH For Packaged Units. Duct leakage < 6 percent El Ali. New Ducting over 40 feet Required Forms: e Includes adding or replacing more than 40 CF -611 forms: MECH-04, MECH-21-HERS 1CF-4R lipear feet of duct in unconditioned space. forms: MECH-21 For'split system or packaged units: Duct leakage < 15 percent 1 [3 EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Authoes /Responsible Designees 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 re4.uirements of Title 24, Parts 1 and 6 of the Callfomia Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the Information documented on other applicable compliance foirms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name-. Danielle Garcia ISIgnature: bwjefle Garcia Company: HARRISON ENTERPRISES INC Date: Jan 26, 2013 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg:: 213-AO00564SA-000000000-0000 Registration Date/Time: 2013/01/26 10:38:55 HERS Provider: CaICERTS, Inc. 2008 Residential Compliance Forms July 2010 0 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zoner. 10 - 15 Site Addresm Enforcement Agency: Date: Permit 50440 SPYGLASS HILL La Quinta, CA 92253 City of La-Quinta ]an 26, 2013 Duct insulation Conditioned Floor Equipment Typel List Minimum EfficlenCV2 requirement Area Thermostat [3 Package Unit W Furnace W AFUE 78% [3 COP [3 R 6 (cz lo -13) Served by system W Setback • Indoor Coil W SEER 13.0 [3 HSPF [3 R 8 (CZ 14-15) 11 58 sf If not already present, must be • Condensing Unit [3 EER_ 13 Resistance Installed) [3 Other_ . 1. Equipment Type: Choose the equipment being installed, If more than one system, use another CF-lR-ALT-HVAC for each system. 2. Min-inmm Equipment Effic;encim 13 SEER, 78% AME, 7.7HSPF for typical residential systems. HERS VERMCATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer70�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 fbrms 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*as in fact the work completed by the installer. The inspector also verifies that each appropriate CF -611 and registered CF -4R fbrms� (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered. copy of the CF -IR and CF -6R shall also be on stbe for final inspection. H 1.'! HVAC Changeout Required Fornw. AII.HVAC Equipment CF -611 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 Coll and /or j,rid oor Coil and /or CF -6R forms: MECH-04, MECH-2- 1 -HERS and (for split systems) MECH-25-HERS Furnace CF -411 forms: MECH-21 and (for split systems) MECH-2S For Split Systems: Duct lealc6l' i. 15 percent; RC, CCAS 300 CFM/tDn (Minimum Air Flow Requirement), TMAH F8F &.62-n — Padeaged4l Exerripted from duct Ieakag,etest_W4*` :.to -tj_-1'.-Mkts.ystenvw me have been previously sealed and confirmed through HERS verification, or M 2. -Duct systems i linear feet in unconditioned space, or 1.ExIsting duct' st cted, insulated or sealed with asbestos 0*4'.'ThSky,stmW,iII not lie- MiRt, ew%~ejq r&_ReWL e) �.S t 13 2:: Nd lRequi 7 CAJt i 1 u W H-04, M RS M new new _tn dudu ..all n d EC r. -s eq u p VH For Split 5 -P andXrd"VKW--bFP5PP. Duct IL 65��-4 For g m;akag 13 a vr�w I ut. Required Forms: _gp, Indddes"repladng.dr iri§talli*ng zill'bew - ,5 clucting and/or outdoor c'6h0eniin§' unit CF -6R forms: MECH-04, MECH-213-HERS, and (fbr split systems) MECH-25-HERS rnip!�;:i and/or indoor il and/or fu- " n� No or some CF -411 forms: MECH-20 and (for split systems) MECH-25 acno equipment ch ged, For Split Systems: Duct leakage. -� 6 percent; RC, CCA ;_* 300 CFM/ton, TMAK For Packaged Unito Duct leakage < 6 percent 13 4,; New Ducting over 40 feet uired Forms - Includes adding or replacing more than 40 CF -6R forms; MECH-04, MECH-21-HERS 1CF-4R lin�lear feet of duct in unconditioned space. forms: MECH-21 For split system or packaged units: Duct leakage < IS percent Q B(CEPTION: Existing duct systerns constructed, insulated or sealed with asbestos. Contractor (Documentation Authoes /Responsible Designees Declaration Statement) • I certify that this Certificate of Compliance documoVation 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 certifV that the energy features and Performance specifications for the design Identified on this �)ertlficate of Compliance conform to the re4uirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features Identified an this Certificate of Compliance are consistent with the Information documented on other applicable compliance fo!ms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Narrie: Danielle Garcia ISignature: bankfle Garcia Company: HARRISON ENTERPRISES INC Date: ]an 26, 2013 Addi,vss: 31-170 RESERVE DRIVE STE A - License: 686310 lPhone: .75ty/State/Zip. THOUSAND PALMS / CA / 92276 (760) 343-7488 Reg;. 213-AO005646A-000000000-0000 Registration Date/Time: 2013/01/26 10:41:25 HERS Provider: CaICERTS, Inc. 2008 Residential Compliance Forms July 2010