14-875 (AR)e
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: AR -14-875
Property Address: 79160 JACK RABBIT TR
APN: 776011020
Application Description: GUEST RM/ STUDY A
Property Zoning:
Application Valuation: II
Applicant:
NELS CARLSON
79-160 JACK RABBIT TRAIL
LA QUINTA, CA 92253
D VOICE (760) 777-7125
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/12/2014
Owner:
NELS CARLSON
79-160 JACK RABBIT TRAIL
LA QUINTA, CA 92253
AUG 12 2014
CITY OF LA Q())- N— TA ___-'
COMMUNITY DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
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 Professions Code,
and my License is in full force and effect.
License Class: _ License No.::CONV:140528101253019335
Date
Contractor:
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 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/r(, 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.).
(_) I am exempt under Sec. B.&P.C. for this r!a
Date: 6P, - lZ -%'—/ 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: CyV wG
Lender's
Contractor:
NELS CARLSON
79=160 JACK RABBIT TRAIL
LA QUINTA, CA 92253
(760)289-6624
Llc. No.::CONV:140528101253019335
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: Policy Number: _
Icertify 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. _ 11-\
Date: 00-17- —f !f Applicant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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 ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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 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 t building
construction, and hereby authorize representatives of this city tAenter upo h above
mentioned property for inspection purposes. „
Date: 44
Signature (Applicant or Agent)
DESCRIPTION
FINANCIAL .
ACCOUNT
.
QTY AMOUNT
PAID
PAID DATE
ADDITION, EA ADDITIONAL 500 SF
101-0000-42400
0
$61.49
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
ADDITION, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$17.16
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
ADDITION, FIRST 100 SF
101-0000-42400
0
$120.12
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
ADDITION, FIRST 100 SF PC
101-0000-42600
0
$168.74
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forADDITION: $367.51 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $2.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RESIDENTIAL, FIRST 1,OOOSF
101-0000-42403
0
$143.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RESIDENTIAL, FIRST 1,000SF, PC
101-0000-42600
0
$47.19
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $190.19 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
CONDENSER/COMPRESSOR
101-0000-42402
0
$35.75
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$23.83
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
FURNACE
101-0000-42402
0
$35.75
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT ''
QTY
AMOUNT
PAID
PAID DATE
FURNACE PC
101-0000-42600
0
$23.83
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
VENT FAN
101-0000-42402
0
$11.92
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY .
AMOUNT
PAID
PAID DATE
VENT FAN PC
101-0000-42600
0
$4.77
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forMECHANICAL: $135.85 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0
$3.64
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $3.64 $0.00
• ••
Description: GUEST RM/ STUDY ADDITION
Type: BUILDING, RESIDENTIAL Subtype: ADDITION Status: APPROVED
Applied: 6/18/2014
Approved: 7/20/2014 BHA
Parcel No: 776011020 Site Address: 79160 JACK RABBIT TR LA QUINTA,CA 92253
Subdivision: Block: Lot:
Issued:
Lot Sq Ft: Building Sq Ft: Zoning:
Finaled:
Valuation: $28,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: No. Stories: No. Unites:
Details: 319 SF GUEST RM STUDY ADDITION TO EXIST. RESIDENCE. 2013 CRC CODE 2010 ENERGY. THIS PERMIT DOES NOT INCLUDE BLOCK
WALLS, SPA. MECHANICASL EQUIPMENT NOT ALLOWED IN SFT SIDEYARD SETBACK PER LQMC 9.60.075
1 Applied to Approved
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
NELS CARLSON
79-160 JACK RABBIT
TRAIL
LA QUINTA
CA
92253
(
CONTRACTOR
NELS CARLSON
79-160 JACK RABBIT
TRAIL
LA QUINTA
CA
92253
(
OWNER
NELS CARLSON
79-160 JACK RABBIT
TRAIL
LA QUINTA
CA
92253
(
Printed: Tuesday, August 12, 2014 4:26:26 PM 1 of 3
RW.I YS TEM S
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
ADDITION, EA
101-0000-42400
0
$61.49
$0.00
ADDITIONAL 500 SF
ADDITION, EA
101-0000-42600
0
$17.16
$0.00
ADDITIONAL 500 SF PC
ADDITION, FIRST 100 SF
101-0000-42400
0
$120.12
$0.00
ADDITION, FIRST 100 SF
101-0000-42600
0
$168.74
$0.00
PC
Total Paid forADDITION: $367.51 $0.00
BSAS SB1473 FEE
101-0000-20306
1 0
$2.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $2.00 $0.00
BSA:
RESIDENTIAL, FIRST
101-0000-42403
0
$143.00
$0.00
1,000SF
RESIDENTIAL, FIRST
101-0000-42600
0
$47.19
$0.00
1,000SF, PC
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $190.19 $0.00
CONDENSER/COMPRES
101-0000-42402
0
$35.75
$0.00
SOR
CONDENSER/COMPRES
101-0000-42600
0
$23.83
$0.00
SOR PC
FURNACE
101-0000-42402
0
$35.75
$0.00
FURNACE PC
101-0000-42600
0
$23.83
$0.00
VENT FAN
101-0000-42402
0
$11.92
$0.00
VENT FAN PC
101-0000-42600
0
$4.77
$0.00
Total Paid forMECHANICAL: $135.85 $0.00
SMI - RESIDENTIAL
101-0000-20308 1
0
$3.64
$0.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $3.64 $0.00
TOTALS:00
Printed: Tuesday, August 12, 2014 4:26:26 PM 2 of 3 CI"
SYSTEMS
Bin #
City of La - Quinta
Building &r Safety Division
P.O. Box 1504, 78 -495 Calle Tampico co
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking- Sheet
Permit #
Project Address:
Owner's Name: Ct k,,(- 5 0 -AJ
A. P. Number:
Address: :11- Itec) J6Lt✓t6 4bj�
Legal Description:
City, ST, Zip:
CF,2 M J"
Contractor-
Telephone:
Address: -7q to 0 J, -k k46-ri
Project Description:
10A
City, ST, Zip:
Telephone -
State Lic. #C
11117
Ay Lie. #...
Aict., Engr., Designer: 0-1 A4 Af
L4
Address:
City., ST, Zip:
VTrO
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
late Lic. #:
..........
...... . ......
me of Contact Person: /S
Sq. Ft.:
# Stories: —711
Units:
Telephone #,of Contact Person: 2,2 79 7, &46-bi
Estimated Value of Project:- 1z'n W C..)
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Rcc1d TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
4'h
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
plan
2" Review, ready for corrections/issue
77pGrading
Electrical
Subcontactor List4h
Called Contact kkLOka
4
Plumbing
Grant Dccd
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN I10USE:-
Review, ready for correctionstissue
Developer Impact Fee
I
r
Planning Approval
Called Contact Person
L Y)
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
%I
Total Permit Fees
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 79160 Jack Rabbit Trail .319 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments Guest Room/Bathroom Addition
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $0.00 X 319 S.F. or $0.00 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By Exempt Nels Carlson Check No.
Bank Name/Recipient of Certificate Telephone 760-289-6624
Funding Exempt
BY Dr. Gary Rutherford { = -
Superintendent
Fee collected /exempt 'by Sharo ilv ey Payment Recd ,50.00 c`•T, -
wer/.Under
Signature
NOTICE: Pursua t to Government Code Section 6 020(d)(1), this will serve to n tify you that the 90 -day approval period in which you may protest the fees
or other payment identified above will begin to run f m the to on which the b ding or installation permit for this project is issued, or from the date on
which those amounts are paid to the District(s) or to a r public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID without embossed seal
Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting
CERTIFICATE OF COMPLIANCE
21ED
Desert Sands Unified School District
4�� �o
47950 Dune Palms Road
Q BERMUDA DUNES
Date
8/5/14
La Quinta, CA 92253
V) RANCHO INDIAN WEAN WELLS LSMIRAGd
'ter
No.
32230
(760) 771-8515
LM
�v> P LA UEINTA �y
QINDIO Sp
Owner
Nels & Judy Carlson
APN #
760-011-020
Address
79-160 Jack Rabbit Trail
Jurisdiction
La Quinta
City
La Quinta Zip
Permit #
Tract #
No. of Units
1
Type
Residential Addition
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 79160 Jack Rabbit Trail .319 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments Guest Room/Bathroom Addition
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $0.00 X 319 S.F. or $0.00 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By Exempt Nels Carlson Check No.
Bank Name/Recipient of Certificate Telephone 760-289-6624
Funding Exempt
BY Dr. Gary Rutherford { = -
Superintendent
Fee collected /exempt 'by Sharo ilv ey Payment Recd ,50.00 c`•T, -
wer/.Under
Signature
NOTICE: Pursua t to Government Code Section 6 020(d)(1), this will serve to n tify you that the 90 -day approval period in which you may protest the fees
or other payment identified above will begin to run f m the to on which the b ding or installation permit for this project is issued, or from the date on
which those amounts are paid to the District(s) or to a r public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID without embossed seal
Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting
BUILDING & SAFETY DEPARTMENT
178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
PROPERTY OWNER'S PACKAGE
(760) 777-7012
fAX (760) 777-70171
Disclosures & Forms for Owner -Builders Applying for Construction Permits
MW-QRT-4AT, ► VOTAC . TO PR PERI OWNER
Dear Property Owner
An . application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified at
We are providing you with an Owner -Builder Acknowledgment -and Information Verification Form to make you award of your
responsibilities and possible risk you may incur by halving this permit issued in your name as the
Owner -Builder. We wiii not Issue a building.permit until you !lave read, initi:ied youranderstanding of each'provision,
signed, and returned this form to usat our official address indicated. An agent of the owner cannot execute this notice
unless you, the property owner, obtain the prior approval of the permitting authority.
c,�n�� c�vrro Pcru ante°uruial....each:stiztenit"6eCaw io sign fy you:iendersland or: erffy this information.
l I :uitders"tarrd a :frequent practice of unlicensed persons is 'to .have tite'pcolicrty owner :obtain an "Owner-Bwlde�'`
building.pernmt that crronoously: implies that the property owner is providing leis or her own labor and. material. l�ersrnially.,
an Oweter:Liirilder, may be,licld: liable and subject to serious financial risk for any' injjuries.sastailacd.by an unlicetascd person:
and his or her employees while working on my properly. My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my iusurance,coverage for injuries to workers
on my property.
4C 2. I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a Licensed Contractor to assume this responsibility -
3. " 3. I understand as an "Owner -Builder" I aim" the responsible party of record on the permit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
4'LA-4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
$44e-5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, 1 may be considered an "employer"
under state and federal law.
I understand if I am considered an "employee" under state and federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
risk.
MtL7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
8. I. utiderslarid as an O.wne-r=Builder if I sell the property for which this peri IR is issued, I may be he'd liable. for any
f`.nantial or personal;i Vuries rjstariiid'by any subsequent owner(s) that result from any latent construction defects in the
workx ►2ne upbir'mterials.
4214t-9. 1 understand I may obtain more information Ycgardrng i'y'oliligations as an "em"loyci" fr9'ru the Internal I cvcnue
Service, the United States Small Business Administration, thc;Califoniia DcpartmIdnt of Benefit Payments, and the Calrforniw
Division of industrial Accidents. I also understand I iA '..coniact,the Calitomia Contractors"State License'13oard (C"Lllj;at; l
800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors.
10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party legally and financially responsible ,for proposed construction activity at the following address:
11. I agree that, as the party legally and financially responsible for this proposed construction activity, i will abide by all
applicable laws and requirements that govern Owner -Builders as well as employers.
12. I agree to notifj the issuer of this form immediately of any additions, deletions, or changes to any of the infvrmatiob I
have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a lieense, the Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint Your only remedy against unlicensed Contractors may be in'civil court_ It is also
important for you tounderstand that if an unlicensed Contractor or employee'of that individual or firm is injured while wodang
on your property; you maybe W& liaW f6r dauia&ts;Af.you obtain a:,pdfiiit:as Ow0ac Buildct iauo wish to: hire Contractors,
you will be respowililo for v'erifyuig *bedw—:orrtot triose t onttactors are'ptoperly licaisoii aryl *6 stx+tiis.of their workers'
Compensation insure noe'ooverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issue: t wpermit. Nota. A co y of -d" -property own 's diiver'slicense, farm nodrdcwhm or
other verrfrcatiox acceptable to the agt+i�/fis req to , presented when the permit is inued to verify the property
owner's signature.
Signature of property owner L 1��`===v�f6 " Date:
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHO.RIZA'I I.O.N ( AGEN`l4'TO ACT ON PROPERTY OWNIEWS..BEHALF
Excluding the Notice to Property Owner, the execption of which I understandds my personal responsibility, I hereby authorize
-the following person(s) to act as: my agents) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that 1 am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy. Note:'A copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature.
Property Owner's Signature: Date:
f `
BUILDING ENERGY ANALYSIS REPORT
RECEIVED
Job Number:
JUN 2 3 2014
} CITY OF LA QUINT A
Date: COMMUNITY DEVELOPMENT
I
6/22/2014
The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is
' authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards.
i
This program developed by EnergySoft, LLC — www.energysoft.com.
` 1 Enery Pro 5.1 by EnergySoft User Number: 6712 Run Code: 2014-06-22714:34:32 /D:
i
PROJECT:
Carlson Residence Addition
79160 Jack Rabbit Trail
La Quinta, CA 92253
Project Designer:
r N.E. Carlson Construction
79160 Jack Rabbit Trail
La Quinta., CA 92253
(760) 289-6624
CITY OF:�AQUItVTA
Report Prepared b
P P Y
BUILDING ETY 13EPT.
Tim Scott
AP PVED
N
Scott Design and Title 24, In
FO COUCTI
77-085 Michigan Drive
l Palm Desert, Ca 92211
DA
(760) 200-4780
AR- t A 91*
RECEIVED
Job Number:
JUN 2 3 2014
} CITY OF LA QUINT A
Date: COMMUNITY DEVELOPMENT
I
6/22/2014
The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is
' authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards.
i
This program developed by EnergySoft, LLC — www.energysoft.com.
` 1 Enery Pro 5.1 by EnergySoft User Number: 6712 Run Code: 2014-06-22714:34:32 /D:
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PERFORMANCE, CERTIFICATE: Residential Part 1 of 5
CF -1 R
Project Name
Carlson Residence Addition
Building Type m Single Family m Addition Alone
❑ Multi Family ❑ Existing+ Addition/Alteration
California Energy Climate Zone Total Cond. Floor Area Addition
CA Climate Zone 15 319 319
Date
6/22/2014
# of Stories
1
Project Address
79160 Jack Rabbit Trail La Quinta
FIELD INSPECTION ENERGY CHECKLIST
❑ Yes ❑ No HERS Measures -- If Yes, A CF -4R must be provided per Part 2 of 5 of this form.
❑ Yes ❑ No Special Features -- If Yes, see Part 2 of 5 of this form for details.
INSULATION i Area Special
Construction Type Cavity f Features see Part 2 of 5
Status
Roof Wood Framed Attic R-38 319 Radiant Barrier
New
Wall Wood Framed R-21 426
New
Slab Unheated Slab -on -Grade None 319 Perim = 76'
New
FENESTRATION U- Exterior
Orientation Area(ft) Factor SHGC Overhang Sidefins Shades
Status
Front (S) 64.0 0.360 0.29 none none Bug Screen
New
Left 15.0 0.720 0.46 none none Bug Screen
New
HVAC SYSTEMS
Ot . Heating Min. Eff Cooling Min. Eff Thermostat
Status
1 Split Heat Pump 11.30 HSPF Split Heat Pump 19.7 SEER Setback
New
HVAC DISTRIBUTION Duct
Location Heating Cooling Duct Location R -Value
Status
HVAC Ducted Ducted Conditioned 8.0
New
WATER HEATING
Ot . Type Gallons Min. Eff Distribution
Status
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EnergyPro 5.1 by EnergySoft User Number: 6712 RunCode: 201406-22714:34:32 /D:
Page 3 of 10
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PERFORMANCE CERTIFICATE: Residential Part 2 of 5 CF -1 R
Project Name
Carlson Residence Addition
Building Type m Single Family m Addition Alone
1 ❑ Multi Family ❑ Existing+ Addition/Alteration
Date
6/22/2014
SPECIAL FEATURES INSPECTION CHECKLIST
The enforcement agency should pay special attention to the items specified in this checklist. These items require special written
justification and documentation, and special verification to be used with the performance approach. The enforcement agency
determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of
the special justification and documentation submitted.
The Roof R-38 Roof Attic includes credit for a Radiant Barrier that is Continuous meeting eligibility and installation criteria as specified in Residential
Appendix RA4.2.2. '
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HERS REQUIRED VERIFICATION
Items in this section require field testing and/or verification by,a certified HERS Rater. The inspector must receive a
completed CF -4R form.for each of the measures listed below for final to be given.
The Cooling System Fujitsu 18RLFCD includes credit for a 14.0 EER Condenser. A certified HERS rater must field verify the installation of the correct
Condenser. i
The HVAC System HVAC has Ducts, Plenums and the HVAC unit located totally within Conditioned space. A certified HERS rater must visually verify
the installation of the HVAC unit and all Ducts and Plenums.
The HVAC System HVAC incorporates HERS verified Duct Leakage. HERS field verification and diagnostic testing is required to verify that duct
leakage meets the specified criteria. •
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EnerqyPro 5.1 by EnerqySoft User Number. 6712 RunCode: 2014-06-22714:34:32 /D: Pa e 4 of 10
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PERFORMANCECERTIFICATE: Residential Part 3 of 5 CF -1 R
Project Name Building Type 10 Single Family 10 Addition Alone Date
Carlson Residence Addition ❑ Multi Family ❑ Existing+ Addition/Alteration 6/22/2014
ANNUAL ENERGY USE SUMMARY
Standard Proposed Margin
TDV kBtu/ft2- r
Space Heating 7.56 3.59 3.97
Space Cooling 66.57 56.41 10.16
Fans 13.87 20.05 -6.18
Domestic Hot Water 0.00 0.00 0.00
Pumps 0.00 0.00 0.00
Totals 88.00 80.05 7.95
Percent Better Than Standard: 9.0%
BUILDING COMPLIES - HERS VERIFICATION REQUIRED
Fenestration
Building Front Orientation: (S) 180 deg Ext. Walls/Roof Wall Area Area
Number of Dwelling Units: 0.10 (S) 125 64
Fuel Available at Site: Natural Gas 255 15
Raised Floor Area: t' 0 (N) 125 0
Slab on Grade Area: 319 (E) 0 0
Average Ceiling Height: 10.0 Roof 319 0
Fenestration Average U -Factor: 0.43 TOTAL: 79
Average SHGC: 0.32 Fenestration/CFA Ratio: 24.8%
REMARKS
t
STATEMENT OF COMPLIANCE
This certificate of compliance lists the building features and specifications needed
to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the
Efficiency Standards of the California Code of Regulations.
The documentation author hereby certifies that the documentation is accurate and complete.
Documentation Author
Company Scott Design and Title 24, Inc,
6222014
Address 77-085 Michigan Drive Name Tim Scott
City/State/Zip Palm Desert,:Ca 92211 Phone (760) 200-4780 Signed Date
The individual with overall design responsibility hereby certifies that the proposed building design represented in this set
of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and
with any other calculations submitted with this permit application, and recognizes that compliance using duct design,
duct sealing, verification of refrigerant charge, insulation installation quality, and building envelope sealing require
installer testing and certification and field verification by an approved HERS rater.
Designer or Owner (per Business & Professions Code)
Company N.E. Carlson Construction
Address 79160 Jack Rabbit Trail Name Ne/s Carlson
City/State/Zip La Quinta, CA 92253 Phone (760) 289-6624 Signed License # Date
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CERTIFICATE OF COMPLIANCE: Residential
Part 4 of 5 CF -1 R
Project Name Building Type m Single Family
Carlson Residence Addition ❑ Multi Family
OPAQUE SURFACE DETAILS
10 Addition Alone Date
❑ Existing+ Addition/Alteration 6/22/2014
Surface Ll- Insulation
Type Area Factor Cavity Exterior Frame Interior Frame Azm Tilt Status
Joint Appendix
4 Location/Comments
Roof 319 0.026 R-38 0 0 New
4.2.1-A9 Addn.
Wall 125 0.069 R-21 0 90 New
4.3.1-A6 Addn.
Wall 61 0.069 R-21 180 90 New
4.3.1-A6 Addn.
Wall 240 1 0.069 R-21 270 90 New
4.3.1-A6 Addn.
Slab 3191 0.730 None 0 180 New
4.4.7-A1 Addn.
FENESTRATION SURFACE DETAILS
ID Type Area . LI -Factor SHGC2 Azm Status Glazing Type Location/Comments
1 Window 64.0 0.360 1 NFRC 0.29 NFRC 180 New Milgard Classic Low -E Vinyl Addn.
2 Window 15.0 0.720 NFRC 0.46 NFRC 270 New Glass Block Addn.
I
(1) 1.1 -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value
2 SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value
EXTERIOR SHADING DETAILS
Window Ove hanq
ID Exterior Shade Type SHGC H t Wd Len H t LExt RExt
Left Fin Right Fin
Dist Len Hot Dist I Len H t
1 Bug Screen 0.76
2 Bug Screen 0.76
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EnergyPro 5.1 by EnergySoft User Number: 6712 RunCode: 2014-06-22T14:34:32
/D: Page 6 of 10
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CERTIFICATE OF COMPLIANCE: Residential Part 5 of 5
CF -1 R
Project Name
Carlson Residence Addition
Building Type ❑ Single Family m Addition Alone
❑ Multi Family ❑ Existing+ Addition/Alteration
Date
6/22/2014
BUILDING ZONE INFORMATION
System Name Zone Name
Floor Area
New Existinq Altered Removed Volume Year Built
HVAC Addition
319
3,190
Totals 319 0 01 0
HVAC SYSTEMS
System Name Qty. Heating Type
Min. Eff. Cooling Type Min. Eff. Thermostat Type Status
HVAC 1 Split Heat Pump
11.30 HSP Split Heat Pump 19.7 SEER Setback
New
I
HVAC DISTRIBUTION
System Name Heating
Duct
Cooling Duct Location R -Value
Ducts
Tested? Status
HVAC Ducted
Ducted Conditioned 8.0
m New
WATER HEATING SYSTEMS
S stem Name
Qty.
Type
Distribution
Rated
Input
Btuh
Tank
Cap.
al
Energy
Factor
or RE
Standby
Loss or
Pilot
Ext.
Tank
Insul. R-
Value
Status
CEC Standard
MULTI -FAMILY WATER
HEATING
DETAILS
HYDRONIC
HEATING SYSTEM
PIPING
Control
Hot Water Piping Length
ft
0
0
i�
75
—
System Name
Pipe
Len th
Pipe
Diameter
Insul.
Thick.
Qty. HP
Plenum Outside
Buried
❑
EnefgyPro 5.1 by Ene Soft User Number: 6712
Run Code: 2014-06-22T14:34:32 /D:
Page 7 of 10
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MANDATORY MEASURES SUMMARY: Residential Pae 1 of 3 MF -1 R
Project Name
ailson Residence Addition
Date
6/22/2014
NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of
the compliance approach used. More stringent energy measures listed on the Certificate of Compliance (CF -1 R, CF -1 R -ADD, or CF -
1 R -ALT Form) shall supersede the items marked with an asterisk (') below. This Mandatory Measures Summary shall be incorporated
into the permit documents, and the applicable features shall be considered by all parties as minimum component performance
specifications whether they are shown elsewhere in the documents or in this summary. Submit all applicable sections of the MF -1 R
Form with plans.
Building Envelope Measures:
116(a)l: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage.
§116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain
Coefficient SHGC and infiltration that meets the requirements of 10-111 (a).
117: Exterior doors and windows are weather-stripped; all joints and penetrations are caulked and sealed.
118(a): Insulationspecified or installed meets Standards for Insulating Material. Indicate type and include on CF -6R Form.
§118(1): The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of §118(1) when the
installation of a Cool Roof is specified on the CF -1 R Form.
*§1 50 a : Minimum R-19 insulation in wood -frame ceiling orequivalent U -factor.
150(b): Loose fill insulation shall conform with manufacturer's installed design labeled R -Value.
150(c): Minimum R-13 insulation in wood -frame wall orequivalent U -factor.
150(d): Minimum R-13 insulation in raised wood -frame floor orequivalent U -factor.
150(f): Air retarding wrap is tested, labeled and installed according to ASTM E1677-95 2000 when specified on the CF -1 R Form.
150 : Mandatory Vapor barrier installed in Climate Zones 14 or 16.
§150(1): Water absorption rate for slab edge insulation material alone without facings is no greater than 0.3%; water vapor permeance
rate is no greater than 2.0 erm/inch and shall be protected from physical damage and UV light deterioration.
Fireplaces, Decorative Gas Appliances and Gas Log Measures:
150 e 1 A: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox.
§150(e)1 B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is
e quipped with a with a readily accessible operable, and tight -fitting damper and or a combustion -air control device.
150(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the
outside of the building, are prohibited.
Space Conditioning, Water Heatingand PlumbingSystem Measures:
§110-§113: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified by the Energy
Commission.
§113(c)5: Water heating recirculation loops serving multiple dwelling units and High -Rise residential occupancies meet the air release
valve backflowprevention' pump isolation valve and recirculation loop connection requirements of §113(c)5.
§115: Continuously burning pilot lights are prohibited for natural gas: fan -type central furnaces, household cooking appliances
(appliances with an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool and
spa heaters.
150(h): Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA.
§1500): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c).
§150(j)1 A: Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped
with insulation having an installed thermal resistance of R-12 or greater.
§150(j)l B: Unfired storage tanks, such as storage tanks or backup tanks for solar water -heating system, or other indirect hot water
tanks have R-12 external insulation or R-16 internal insulation where the internal insulation R -value is indicated on the exterior of the
tank.
§150(j)2: First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire length of
recirculating sections of hot water pipes are insulated per Standards Table 150-B.
§150(j)2: Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot
water tank shall be insulated to Table 150-B and Equation 150-A.
§150(j)2: Pipe insulation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards Table
123-A.
150(0)3A: Insulation is protected from damage, including that due to sunlight, moisture equipment maintenance and wind.
§150(j)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in
conditioned space.
§150(')4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation.
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MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF -1 R
Project Name Date
arison Residence Addition 6/22/2014
§150(m)l : All air -distribution system ducts and plenums installed, are sealed and insulated to meet the requirements of CMC Sections
601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-
4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the
applicable requirements of UL 181, UL 181 A, or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is
used to seal openings reater than 1/4 inch the combination of mastic and either mesh or tape shall be used
§150(m)1: Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed
sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may
contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area
of the ducts.
§150(m)2D: Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes
unless such tape is used in combination with mastic and draw bands.
150(m)7: Exhaust fans stems have back draft or automatic dampers.
§150(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated
dampers.
§150(m)9: Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind.
Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar
radiation that can cause degradation of the material.
150 m 10: Flexible ducts cannot have porous inner cores.
§150(o): All dwelling units shall meet the requirements of ANSI/ASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air
Quality in Low -Rise Residential Buildings. Window operation is not a permissible method of providing the Whole Building Ventilation
required in Section 4 of that Standard.
Pool and Spa Heating Systems and Equipment Measures:
§114(a): Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency
Regulations; an on-off switch mounted outside of the heater; a permanent weatherproof plate or card with operating instructions; and
shall not use electric resistance heating ora pilot light.
§114(b)1: Any pool or spa heating equipment shall be installed with at least 36" of pipe between filter and heater, or dedicated suction
and return lines or built-up connections for future solar heating.
114(b)2: Outdoor pools ors as that have a heat pump or gas heater shall have a cover.
§114(b)3: Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or
ro rammed to run only during off-peak electric demand periods.
150 : Residential pool systems orequipment meet the pump sizing, flow rate, piping, filters, and valve requirements of §150
Residential Lighting Measures:
§150(k)1: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies
.contained in Table 150-C and is not a low eff icacy luminaire asspecified by §150(k)2.
150(k)3: The wattage of permanently installed luminaires shall be determined asspecified by §130(d).
§150(k)4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than
20 kHz.
§150(k)5: Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain
only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and shall not contain a line -voltage socket or line -
voltage lamp holder; OR shall be rated to consume no more than five watts of power as determined by §130(d), and shall not contain a
medium screw -base socket.
150(k)6: Lighting integral to exhaust fans, in rooms other than kitchens, shall meet the applicable requirements of §150(k).
150(k)7: All switchingdevices and controls shall meet the requirements of §150(k)7.
§150(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy.
EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 ft2 or 100 watts for dwelling units larger than 2,500 ft2 may be
exempt from the 50% high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant
sensor, dimmer, energy management system (EMCS), or a multi -scene programmable control system; and all permanently installed
luminaries in garages, laundry rooms, closets greater than 70 square feet, and utility rooms are high efficacy and controlled by a
manual -on occupant sensor.
§150(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of
illuminated cabinet.
EnergyPro 5.1 by EnergySoff User Number: 6712 RunCode: 2014-06-22T14:34:32 ID: Page 9 of 10
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MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF -1 R
Project Name
Date
arlson Residence Addition
6/22/2014
§150(k)10: Permanently installed luminaires in bathrooms, attached and detached garages, laundry rooms, closets and utility rooms
shall be high efficacy.
EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by a manual -on
occupant sensor certified to comply with the applicable requirements of §119.
EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a
manual -on occupancy sensor.
§150(k)l 1: Permanently installed luminaires located in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms,
closets, and utility rooms shall be high efficacy luimnaires. EXCEPTION 1: Permanently installed low efficacy luminaires shall be
allowed provided they are controlled by either a dimmer switch that complies with the applicable requirements of §119, or by a manual -
on occupant sensor that complies with the applicable requirements of §119. EXCEPTION 2: Lighting in detached storage building less
than 1000 square feet located on a residential site is not required to comply with §150 k 11.
§150(k)12: Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters
Laboratories or other nationally recognized testing/rating laboratory; and have a label that certifies the lumiunaire is airtight with air
leakage less then 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; and be sealed with a gasket or caulk between
the luminaire housing and ceiling.
§150(k)l3: Luminaires providing outdoor lighting, including lighting for private patios in low-rise residential buildings with four or more
dwelling units, entrances, balconies, and porches, which are permanently mounted to a residential building or to other buildings on the
same lot shall be high efficacy. EXCEPTION 1: Permanently installed outdoor low efficacy luminaires shall be allowed provided that
they are controlled by a manual on/off switch, a motion sensor not having an override or bypass switch that disables the motion sensor,
and one of the following controls: a photocontrol not having an override or bypass switch that disables the photocontrol; OR an
astronomical time clock not having an override or bypass switch that disables the astronomical time clock; OR an energy management
control system (EMCS) not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2: Outdoor
luminaires used to comply with Exceptionl to §150(k)l3 may be controlled by a temporary override switch which bypasses the motion
sensing function provided that the motion sensor is automatically reactivated within six hours. EXCEPTION 3: Permanently installed
luminaires in or around swimming pool, water features, or other location subject to Article 680 of the California Electric Code need not
be high efficacy luminaires.
§150(k)l4: Internally illuminated address signs shall comply with Section 148; OR not contain a screw -base socket, and consume no
more than five watts of ower as determined accordingto 130(d).
150(k)15: Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable
requirements in Sections 130, 132, 134, and 147. Lighting for parking garages for 8 or more vehicles shall comply with the applicable
requirements of Sections 130, 131 134 and 146.
§150(k)l6: Permanently installed lighting in the enclosed, non -dwelling spaces of low-rise residential buildings with four or more
dwelling units shall be high efficacy luminaires. EXCEPTION: Permanently installed low efficacy luminaires shall be allowed provided
that they are controlled by an occupant sensors certified to comply with the applicable requirements of 119.
EnergyPro 5.1 by EnergySoft User Number: 6712 RunCode: 2014-06-22T14:34:32 /D: Page 10 of 10
t ' System 18RLFCD Submittal
t AOU18RLFC, ARU18RLF
Compact Duct
Job Name:
;f
Location:
Engineer:
Submitted to:
Submitted by:
4611. e
Hybrid Flax Invertor
Approval:
Construction:
Unit #:
Drawing #:.
Reference:
Outdoor Unit Power
208-23ONAC-1 Ph-60Hz
Available Voltage Range
187-253VAC
Fuse Size, Max.
20A
MCA
173A
Compressor Inverter Driven Variable Speed DC Rotary
No. used
1
Output
1000W
Lubrican Oil
POE (RB68)
Fan type
Propeller
Motor Output
115W
Airflow Rate Cooling/Heating
(High) 1457 / 1407CFM
Refrigerant
410A
Outdoor Unit
2lbs 14oz
Contrlol
Electronic Expansion Valve
O.D. Discharge (in)
1/4"(Flare)
O.D Suction (in)
1/2"(Flare)
Dimensions
H x W x D
Uncrated (in)
24-1/2 x 31-3/32 x 11-11/32
(mm)
(620 x 790 x 290)
Crated (in)
28-1/16 x 37-7/32 x 15-9/16
(mm)
(713 x 945 x 395)
Weight
Outdoor
Net
86lbs (39kg)
Gross Shipping
93lbs (42kg)
Cooling
Rated Capacity
18,000BTU/h
Min -Max Capacity
3,100-20,100BTU/h
Rated Power Input
1.50kw
Max. Power Input
2.15kw
SEER
19,7
Outdoor Sound Rating,
54dB
Heating
Rated Capacity
21,600BTU/h
Min -Max Capacity
3,100-25,600BTU/h
Rated Power Input
1.67kw
Max. Power Input
2.60kw
HSPF
11.3
Outdoor Sound Rating
55dB
Piping Lengths
Max. Piping Length (Total)
66ft
Max. Pipe Height Difference
49ft
Connection method
(Flared)
Operating Range
Cooling 14°F -115°F DB
Heating -5°F -75°F DB
Top Yin
00
FuJiTsu
Date:
FUJI TSU _ `
froet vier
Side vier
RECEIVED
Fujitsu General America, Inc.
Fairfield, NJ 07004
Toll Free: 1-888-888-3424
li JUN
v i 4
2.3
Fax: (973) 836-0447 Fujitsu produc► are subject to continuous improvements. Fujitsu reserves the right to modify product design, specifications and
www.fujitsugeneral.com information in This data sheet without notice and without incuring any obligations.
E TTY OF: i A �ti;UI -IA
_.
u {'� ear
DEVIELl1PMENT
� J W�YRLNf•
i
E
Power
V/Hz/P
230/60/1 Cooling Capacity
(BTU/h)
18,000
Fan type
Sirocco Moisture Removal
Dt/h (1/h)
4.2(2.0)
6.tat;
6P as
]
No. Motors
(W)
3 (96) Heating Capacity
(BTU/h)
20,000
CFM [.10 in.WG]
(Hi,Me,Lo,Qu
554/518/483/442
E—
Sound Pressure Level
db (Hi,Me,Lo,Qu�
32/31/30/29 Temperature Setting Range
—
�P n�,wo
i�rA ti[
F.L. A.
(A)
47 Cooling
°F(°C)
64-90(18-32)
Refrigerant
0.,52 (80)
410A Heating
°F(°C)
60-88 (16-31)
O.D. Discharge
in (mm)
01/4" (6.35) Drain Pipe Size"
OD in
01-1/16
O.D. Suction
in (mm)
01/2" (12 7)_
Dimensions
(50
H x W x D
ID in
03/4
0.16 4
( 0)
Uncrated
(in) 7-25/32 x 35-7/16 x 24-13/32 Remote Control Type
Wired
'012 (30)
(mm)
(198 x 900 x 620) Electrical Connection'
AWG
14/3 with ground
Crated
(in)
(mm)
10-7/8 x 46 x 29-3/4 .Power and communication are fed from the outdoor unit.
(276 x 1168 x 756)
Weight
w
"Adapter to 3/4" PVC included
with unit.
(800) (900)
Net
lbs. (kg)
50 (23)
Air Flow [CRA (aft)]
Gross Shipping
lbs. (kg)
63 (29)
OAA (1'i0) I
J11.1
E
0.40 (10aj ' 9
wa t5p o w QM
D -s6 (9tY/
�
j
6.tat;
6P as
]
0.40 (1 OM
LU
i
E—
0.24 (61Jj [— -
—
�P n�,wo
i�rA ti[
a..as (sa)
0,20(50)McrrnalSP
1
0.,52 (80)
(�
Das (N;gaa1 W
a , t74a
N
0,12, (30)
,_...
�:tt+( �;m �r�
�
0.24 (60)
m aoa11(x1)) wrgarEEndr�
(50
ut 0,04 teat 7ZUBWt
lif (5Pnueatt�i
_ —
0.16 4
( 0)
0 ( f�'asaunfSFi)
w
'012 (30)
353 412
471 530
Sag 647 706
w
0.013(20)
(600) (70D)
(800) (900)
(1000) (1100) (1"0)
4.04 (10)
Air Flow [CRA (aft)]
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353 412 471 530 580 647 706
(600) (700) (800) (900) (1000) 0 f00) (1200)
Air Flow [CFM (m'IYtU
Note:
Specifications are based on the following conditions.
Power source of specifications : 230V
Cooling: Indoor temperature of 80'F(26.67°C)DB / 67°F(19.44°C)WB, and outdoor temperature of 95°F(35°C)DB/75"F(23.89°C)WB.
Heating: Indoor temperature of 70°F(21.11°C)DB / 60'F(15.56°C)WB, and outdoor temperature of 47°F(8.33°C)DB/43°F(6.11 °C)WB.
Standard Static Pressure: 0.10in.WG (25Pa)
Pipe length : 16.4ft. (5m) [Outdoor unit - Branch box], 9.8ft. (3m) [Branch box - Indoor unit]
Height difference : 0 ft.(0m) [Outdoor unit - Indoor unit]
Fujitsu General America, Inc.
Fairfield, NJ 07004
Toll Free: 1-888-888-3424
Fax: (973) 836-0447 Fujitsu products are subject to continuous improvements. Fujitsu reserves the right to modify product design, specifications
www.fujitsugeneral.com and information in this data sheet without notice and without incuring any obligations.
ear
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mom
a !mmom.
353 412 471 530 580 647 706
(600) (700) (800) (900) (1000) 0 f00) (1200)
Air Flow [CFM (m'IYtU
Note:
Specifications are based on the following conditions.
Power source of specifications : 230V
Cooling: Indoor temperature of 80'F(26.67°C)DB / 67°F(19.44°C)WB, and outdoor temperature of 95°F(35°C)DB/75"F(23.89°C)WB.
Heating: Indoor temperature of 70°F(21.11°C)DB / 60'F(15.56°C)WB, and outdoor temperature of 47°F(8.33°C)DB/43°F(6.11 °C)WB.
Standard Static Pressure: 0.10in.WG (25Pa)
Pipe length : 16.4ft. (5m) [Outdoor unit - Branch box], 9.8ft. (3m) [Branch box - Indoor unit]
Height difference : 0 ft.(0m) [Outdoor unit - Indoor unit]
Fujitsu General America, Inc.
Fairfield, NJ 07004
Toll Free: 1-888-888-3424
Fax: (973) 836-0447 Fujitsu products are subject to continuous improvements. Fujitsu reserves the right to modify product design, specifications
www.fujitsugeneral.com and information in this data sheet without notice and without incuring any obligations.
ear
�.„ .
W 0Af1�MTl