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07-1652 (MECH)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/05/07 Application Number: 07-00001652 Owner: Property Address: 52190 EISENHOWER DR CRAWFORD DANIEL P APN: 773-231-009-14 -000000- 52190 EISENHOWER DR Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL-------------ktJUNO - --- Application valuation: 6700 Contractor: 62007 Applicant: Architect or Engineer: Owner CfTY OF 6.A QUINTA ------------- pip ----- LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: License No.: 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 (5500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). .() I, asowner 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 111who contracts for the projects wit ontractorlsl licensed pursuant to the Contractors' State License.). 1 1 I am exempt under Sec. B.&P.C. r his reasoy� /i// Date: Owner: TCONSTRUCTION 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 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 !I Policy Number 1 certify that, in the performance the work for which this permit is issued, I shall not employ any person in any manner so as become subI t the worker ' omp sation laws of California, and agree that, if I should ecome su ' workers' ompen tion provisions of Section 3;PO of th labor Cod I hall fo i 11 pl wit ose pr isions. BSte: , Pplicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO 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 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 cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the abov inform ati is r ct. I agre o comp) ith all city and county ordinances and state laws relating to building nstructio , a by auth a repre tatives offtthi/s�lount o ter upon t above-mentioned propert f i spa i All W0 ' nature (Applicant or Agent): Application Number . . . . . 07-00001652 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/02/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 -------------------------7-------------------------------------------------- Special Notes and Comments HVAC CHANGEOUT; HEAT PUMP & CONDENSER Fee summary Charged ----------------- Paid Credited Due ---------- ---------- Permit Fee Total 33.00. ---------- ---------- .00 .00 33-00 Plan Check Total 8.25 .00 .00 8.25 Grand Total 41.25 .00 .00 41.25 LQPERMIT Certificate of ARI -Certified Performance - The following Single Phase, Split System: Heat Pump with Remote Outdoor Unit -Air -Source Outdoor Unit Model Number: E1 RE048S06 combined with Indoor Unit Model: Number: AV/SV'48+TXV manufactured by: YORK; UNITARY PRODUCTS.GROUP'.' under the Trade/Brand Name: Latitude 14 has been rated.in accordance with ARI Standard 210/240-2005, Unitary Air -Conditioning and Air-Source.Heat:Pump Equipment and is certified by the Air -Conditioning. and Refrigeration Institute to meet .: the following product performance ratings: Cooling Capacity (Btuh): 46000 : 4 QULNTA CITY OF �qE` EER Rating (Cooling): 12.ot '` BUILDING &IY DEPT. SEER Rating (Cooling): 14.05:-.. / 4PPRVED Heating Capacity (Btuh) @ 47 °F: 44500FOR CONSUCTION Region IV HSPF Rating (Heating): 8.75 L1ATE�o �"�� ----- —_ BY 1Lbt Heating Capacity (Btuh) @ 17 °F: 27400 Voluntarily revised, unless accompanied with a WAS in which case the change is involuntary. CERTIFIED RATINGS ARE VALID ONLY FOR THE PARTICULAR.COMBINATION OF INDOOR AND OUTDOOR UNITS LISTED IN THE AIR-CONDITIONING AND REFRIGERATION INSTITUTE'i4'/zS DIRECTORY OF CERTIFIED EQUIPMENT: VISIT WWW.ARIDIRECTORY.ORG TO VERIFY THAT THIS COMBINATION IS AN ACTIVE LISTING AND THE DATA LISTED ON THIS CERTIFICATE IS ACCURATE. SEARCH ON THE ARI REFERENCE # TO QUICKLY LOCATE THIS COMBINATION IN THE DIRECTORY. TERMS AND CONDITIONS This Certificate shall be used for individual, personal, and confidential reference purposes only, and may be used only pursuant to the terms and conditions listed. This Certificate and the contents hereof are proprietary products of ARI. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, personal and confidential reference. Contained herein are product information and is certified ratings. ARI does not endorse the product(s) listed in this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed in this Certificate. ARI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data, listed in this Certificate. ... ............................. ARI Reference #: 1283463 We Encourage Today's Date: 05/29/07 Professionalism • Status:; Active CEE Tier 1 (R)' 'through Technician Cerfification byNATE CERTIFIED RATINGS ARE VALID ONLY FOR THE PARTICULAR.COMBINATION OF INDOOR AND OUTDOOR UNITS LISTED IN THE AIR-CONDITIONING AND REFRIGERATION INSTITUTE'i4'/zS DIRECTORY OF CERTIFIED EQUIPMENT: VISIT WWW.ARIDIRECTORY.ORG TO VERIFY THAT THIS COMBINATION IS AN ACTIVE LISTING AND THE DATA LISTED ON THIS CERTIFICATE IS ACCURATE. SEARCH ON THE ARI REFERENCE # TO QUICKLY LOCATE THIS COMBINATION IN THE DIRECTORY. TERMS AND CONDITIONS This Certificate shall be used for individual, personal, and confidential reference purposes only, and may be used only pursuant to the terms and conditions listed. This Certificate and the contents hereof are proprietary products of ARI. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, personal and confidential reference. Contained herein are product information and is certified ratings. ARI does not endorse the product(s) listed in this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed in this Certificate. ARI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data, listed in this Certificate. CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 4) CF -1R Enforcement Agency Use Only ✓ ❑ Alternative Component Package Method: (check one) C D D (Alternative) Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF -1 R page 3) For Package D Alternative see Appendix B Table 151-C Footnotes 7-14 GENERAL INFORMATION Total Conditioned Floor Area (CFA) Z8 j ftz Average Ceiling Height: ft Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-C ---- (5% X CFA��)/�-�//4 ft2 Maximu (lowed Total Fenestration Products Per Table 151-B or 151-C ---- (20% X CFA) � tt ✓ uildmg Type: (check one or more) Single Family Multifamily Addition ---4 Alteration (if adding fenestration fill out WS -411, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2 for Additions and 8.3.3 for Alterations.) Number of Stories: / Numb elling Units: / Floor Construction Type: Slab ised Flo rcle one or both) Front Orientation: /A Nort -/South /East est )All Orientations (input front orientation in degrees from True North and circle one). 1(1/'- ✓ ❑ RADIANT BARRIER (required in climate zones 2,4,8-15) N� OPAQUE SURFACES INCLUDING OPAOUE DOORS Component Type (Wall, Roof, Floor, Slab Edge, Doors) Frame Type Cavity Continuous (Wood Insulation Insulation or Metal) R -Value R -Value Assembly U - factor (for Joint Roof Radiant wood, metal Appendix Barrier frame and mass IV Installed assemblies) Reference Yes or No Location/Comments (attic, ganige, t ical, etc.) 1) See Joint Appendix IV in Section IV.2, IV.3 and IVA, which is the basis for the U -factor criterion. U -factors can not exceed prescriptive value to show equivalence to R -values. Residential Compliance Forms March 2005 FENESTRATION PRODUCTS — U -FACTOR AND SHGC ,/13 FENESTRATION MAXIMUM ALLOWED AREA WORKSHEET WS-4R—must be included for New Construction, Additions and Alterations. Fenestration #/Type/Pos. (Front, Left, Orien- Rear, Right, tation, Area Sk li ht) N, S, E, Wt ft2 U-factof•2 Exterior Shading/OverhangS6' 7 U -factor SHGC ✓ box if WS -311 is Source SHGC4 Sources included Configuration (s lit or packae) 13 H sCEAL 13 13 cxi 13 13 13 13 1) Skylights are now included in West -facing fenestration area if the skylights are tilted to the west or tilted in any direction when the pitch is less than 1:12. See § 151(f)3C and in Section 3.2.3 of the Residential Manual 2) Enter values in this column are either NFRC Rated value or from Standards default Table 116A. 3) Indicate source either from NFRC or Table I I6A, 4) Enter values in this column from NFRC or from Standards Default Table 116B or adjusted SHGC from WS -311. 5) Indicate source either from NFRC or Table I I6B. 6) Shading Devices are defined in Table 3-3 in the Residential Manual and see WS -3R to calculate Exterior Shading devices. 7) See Section 3.2.4 in the Residential Manual. HVAC SYSTEMS Heating Equipment Minimum Distribution ' Type and Capacity Effici Type and Location Duct or Piping (furnace, heat Pum . boiler, etc.) (APur r HSPF (duct.~, attic, etc.) R -Value Thermostat I -y a Configuration (s lit or packae) 9, 4 OAK cs /'esvO650 /o H sCEAL /2�2. cxi Cooling Equipment Type and Capacity (A/C, heat punip, cva . cooling) Minimum Efficiency (SEER or EER) Duct Location Duct 'Thermostat Configuration ('attic, etc.) R -Value Type (split orpackage) Mn H sCEAL /2�2. cxi Residential Compliance Forms March 2005 CERTIFICATE OF COMPLIANCE: RESIDENTIAL Project Title IDate CF -1R SEALED DUCTS and TXVs (or Alternative Measures) A signed CF -4R Form must be provided to the building department for each home for which the following. are required. 7❑ Baled Ducts all climate zones Installer testingand certification and HERS rater field verification required.) TXVs, readily accessible (climate zones 2 and 8-15 only) Installer testin and certification and HERS Rater field verification required.) Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field verification required.) OR ❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14. OR For additions and alterations, duct systems that are not documented to have been previously ❑ sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D. WATER HEATING SYSTEMS Systems serving single dwelling units Water Ileater Type/Fuel Type DisUibution TVpc Number in System Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per ❑ dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is Standby Loss cYo) not allowed. ❑ Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential Manual. No water heating calculations are required, and the system complies automatically. Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved ❑ Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the submittal. ❑ Check box to verify that a time control is required for a recirculating system pump for a system serving multiple units Systems serving single dwelling units Water Ileater Type/Fuel Type DisUibution TVpc Number in System Rated input' lk or BIU/111.) Tank Capacity (gallons) Energy Factor' or Thermal Efficient Standby Loss cYo) Tank External Insulation R -Value System serving multiple d elling units Water Heater Type Distribution Type Number in System Rated Input' (kW or Btu/hr) Tank Capacity (gallons) Energy Factor' or Thermal Efficient Standby Loss (% Tank External Insulation R -Value I . For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btulhr), electric resistance, and heat pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000 Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input and Thermal Efficiencies. Pipe Insulation (kitchen lines > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are /4 inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2 B. Residential Compliance Forms March 2005 CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 4 of 4) CF -411 SPECIAL FEATURES NOT REQUIRING HERS VERIFICATION (add extra sheets if necessary) Indicate which special features are part of this project. The list below only represents special features relevant to the DrescriDtive method. ✓ Feature Required Forms if applicable) Description ❑ Metal Framed Walls CF -1R CF -6R part 6 of 12 ❑ Radiant Barriers CF -1R ❑ Exterior Shades WS4R ❑ Cool Roof N/A; Attach CRRC Label to Forms. ❑ Dedicated Hydronic Heating Performance Calculation System Required; Attach Run to Forms. ❑ Combined Hydronic System Performance Calculation Required; Attach Run to Forms. ❑ Gas Cooling Performance Calculation Required. 01 Buried Ducts N/A; Indicate on building plans. ❑ Kitchen Pipe Insulation See Section 5.6.2 Distribution Systems in Residential Manual. Multiple Water Heaters Per See Table 5-13 or use ❑ Dwelling Unit Performance Calculation and attach Run to Forms. ❑ Central Water Heating System Performance Calculation and Serving Multiple Dwellings attach Run to Forms. ❑ Non-NAECA Large Water CF -IR Heater See Table 5-13 or use ❑ Indirect' Water Heater Performance Calculation and attach Run to Forms See Table 5-13 or use ❑ Instantaneous Gas Water Heater Performance Calculation and attach Run to Forms See Table 5-13 or use ❑ Solar Water l leating System Performance Calculation and attach Run to Forms ❑ Wood Stove Boiler Performance Calculation and attach Run to Forms SPECIAL FEATURES REQUIRING HERS RATER VERIFICATION (add extra sheets if necessary) Indicate to the HERS Rater which credits are part of this project and need verification. ✓1,Feature Required Forms if applicable) Description Duct Seating CF -6R part 4 of 12 ❑ ,Refrigerant Charge CF -6R part 5 of 12 157 Thermostatic Expansion Valve CF -6R part 6 of 12 Residential Compliance Forms March 2005 INSTALLATION CERTIFICATE (Page 3 of 12) CF -6R Site Address Permit Number An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided on this form is required) After completion of final inspection, a copy must be provided to the building department (upon request) and the building owner at occupancy, per Section 10-103(a). HVAC SYSTEMS: Heating Equipment Equip Type (pkg. heat um CEC Certified Mfr. Name and Model Number # of Identical Systems Efficiency� Duct (AFUE, etc.) Location (>_CF -I R value) attic, etc. Duct or Piping R -value Heating Load Btu/hr Heating Capacity (Btu/hr Cooling Capacity Btu/hr W.- l A1010*L 4Z Ave- 27 401W fl"t/ tri/sv fB �✓ Cooling Equipment Equip Type (pkg. heat um CEC Certified Mfr. Name and Model Number k of Identical Systems Efficiencyi (SEER or EER) (>_CF -I R value) Duct Location attic, etc. Duct R -value Cooling Load (Btu/hr Cooling Capacity Btu/hr 66 Ave- I 5%. Z evo tri/sv fB �✓ 1. > symbol reads greater' lhem or equal to n•hat is indicated nn the C'F'-/ R vuluc. Include both SEER and EER if compliance credit for high EER air conditioner is claimed. I, the undersigned, verify that equipment listed above is: 1) is the actual equipment installed, 2) equivalent to or more efficient than that specified in the certificate of compliance (Form CF -I R) submitted for compliance with the EnerV ..ficiency Standards for residential buildings, and 3) equipment that meets or exceeds the appropriate requirements for manufactured devices (from the Appliance E%licieney Regulations or Part 6), where applicable. Signature, Date COPY TO: Building Department HERS Rater (if applicable) Building Owner at Occupancy Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Residential Compliance Forms March 2005 INSTALLATION CERTIFICATE (Page 4 of 12) CF -6R Site Address Permit Number INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE Copies to: Builder, HERS Rater, Building Owner at Occupancy and Building Department INSTALLER COMPLIANCE STATEMENT The building was: ✓ []Tested at Final ✓ ❑ Tested at Rough -in INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE: ❑ Remove at least one supply and one return register, and verify that the spaces between the register boot and the interior finishing wall are properly sealed. ❑ If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points between the air handler and the supply and return plenums to verify that the connection points are properly sealed. ❑ Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used ✓ ❑ DUCT LEAKAGE REDUCTION Procedures for field verification and diagnostic testing of air distribution systems are available in RA CM, Appendix RC4.3 NEW CONSTRUCTION: Duct Pressurization Test Results (CFM n 25 Pa) Measured Values 1 Enter Tested Leakage Flow in CFM: �• Fan Flow: Calculated (Nominal: ✓ ❑ Cooling ✓ D Heating) or ✓ ❑ Measured 2 If Fan Flow is Calculated as 400 cfm/ton x number of tons or as 21.7 cfm/(kBtu/hr) x Heating Capacity in Thousands of Btu/hr, enter total calculated or measured fan flow in CFM here: ✓ ✓ 3 Pass if Leakage Percentage<_ 6% for Final or 5 4% at Rough -in: ❑Pass ❑Fail l00 x Line # 1 / Line # 2 ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow in CFM from Pre -Test of Existing Duct System Prior to Duct 4 System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow in CEM from Final Test of New Duct System or Altered Duct 5 S stein for Duct System Alteration and/or Equipment Chan e -Out. Enter Reduction in Leakage for Altered Duct System 6 Line # 4) Minus (Line # 5) - (Only if Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) ✓ ✓ Entire New Duct System - Pass if Leakage Percentage = 60,40 for Final or S 4%, at Rough -in D Pass ❑ Fail S rioo x r (Line 1/ 5) / Line # 2)11 : EST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out ✓ Use one of the following four Test or Verification Standards for compliance: Pass if Leakage Percentage S15% [ 100 x [ (Line #'5) / (Line # ')J] D Pass ❑Fail 10 Pass if Leakage to Outside Percentage <_ 10% [100x [ (Line # -..) / (Line # ..)J] D Pass ❑ Fail Pass if Leakage Reduction Percentage'>_ 60% [ 100 x [_(Line # 6) / (Line # 4)J] D Pass ❑Fail I I and Verification b Smoke Test and Visual Inspection 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Ins ection 13 Pass ❑Fail Pass if One of Lines # 9 through # 12 ass D Pass ❑ Fail ✓ ❑ I, the undersigned, verify that the above diagnostic test results were performed in conformance with the requirements for compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 150 (m) of the 2005 Building Energy Efficiency Standards. Signature Date Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) Residential Compliance Forms March 2005 INSTALLATION CERTIFICATE (Page 5 of 12) CF -6R Site Address Permit Number ✓ ❑ THERMOSTATIC EXPANSION VALVE (TXV) Procedures,for,field verification of thermostatic expansion valves are available in RA CM, Appendix R!. ✓ ✓ Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed on Return (evaporator entering) air dry-bulb temperature (Treturn, db) ✓ ❑ Yes ❑ No the system and installation of the specific equipment ❑ ❑ shall be verified. Yes is a gass Pass 1 Fail v'0 REFRIGERANT CHARGE MEASUREMENT Verification for Required Refrigerant Charge and Adequate Airflow for Split System Space Cooling Systems without Thermostatic Expansion Valves Outdoor Unit Serial # Location Return (evaporator entering) air dry-bulb temperature (Treturn, db) Outdoor Unit Make T Outdoor Unit Model Cooling Capacity Btu/hr Date of Verification OF Date of Refrigerant Gauge Calibration (must be checked monthly) Date of Thermocouple Calibration (must be checked monthly) Standard Charge Measurement Procedure (outdoor air dry-bulb 55°F and above): Procedures,for Determining Refrigerant Charge using the Standard Method are available in RACM, Appendix RD2. Note: The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. Measured Temperatures Supply (evaporator leaving) air dry-bulb temperature (Tsupply, db) OF Return (evaporator entering) air dry-bulb temperature (Treturn, db) T Return (evaporator entering) air wet -bulb temperature (Treturn, wb) OF Evaporator saturation temperature (Tevaporator, sat) OF Suction line temperature (Tsuction, db) Condenser (entering) air dry-bulb temperature (Tcondenser, db) il Superheat Charge Method Calculations for Refrigerant Charge Actual Superheat = Tsuction, db — Tevaporator, sat OF Target Superheat (from Table RD -2) j Actual Superheat — Target Superheat (System passes if between -5 and +5°F) Temperature Split Method Calculations for Adequate Airflow ' lit Method Calculation is not necessary i 'Ade uate Air ow credit is taken Actual Temperature Split = T return, db Tsupply, db OF Target Temperature Split (from Table RD3) OF Actual Temperature Split Target Temperature Split (System passes if between - 3°F and +3°F or, upon remeasurement, if between -3°F and -100°F) OF Residential Compliance Forms March 2005 INSTALLATION CERTIFICATE (Page 6 of 12) CF -6R Site Address Permit Number Standard Charge Measurement Summary: System shall pass both refrigerant charge and adequate airflow calculation criteria from the same measurements. If corrective actions were taken, both criteria must be remeasured and recalculated. ✓ 113 Yes 113 No I System Passes Alternate Charge Measurement Procedure (outdoor air dry-bulb below 55 °F) Note: The system should be installed and charged in accordance with the manufacturer's specifications and installer verification shall be documented on CF -6R before starting this procedure. If outdoor air dry-bulb is 55 OF or above, installer shall use the Standard Charge Measure Procedure: Procedures for Determining Refrigerant Charge using the Alternate Method are available in RACM, Appendix RD3. Weigh -In Chargine Method for Refrigerant Charge Actual liquid line length: ft Manufacturer's Standard liquid line length: ft Difference (Actual — Standard): ft Manufacturer's correction (ounces per foot) x difference in length = ounces I (+ = add) (- = remove) leasured Airtlow Method for Adequate Airtlow Verification available in RACM, Appendix RD2.6 Calculated Airflow: Cooling Capacity (Btu/hr) X 0.033 (cfm/Btu-hr) = CFM Measured Airflow is CFM (Measured airflow must be greater than the calculated airflow). Alternate Charge Measurement Summary: System shall pass both refrigerant charge and adequate airflow calculation criteria from the same measurements. If corrective actions were taken, both criteria must be remeasured and recalculated. ✓ ❑ Yes 10 No I System Passes Signature, Date COPY "r0: Building Department HERS Rater (if applicable) Building Owner at Occupancy Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Residential Compliance Forms March 2005 Bin #* City of La Quinta Building &r Safety Division Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #P.O. 01, Project Address: �� /9Q SEiV !(/L�'� � Owner's Name: ,(j/O A. P. Number: Address: Legal Description: City, ST, Zip: G" 1,VM gi Contractor: Telephone: r' Address: e 2 Project Description: City, ST, Zip: • Telephone: State Lie. # : / (Z Z City Lie. #.. Arch., Engr., Designer: Address: •�jV �L6s�� City, ST, Zip: Q,e� Ar/,eSO esI& Telephone: Construction Type: Occupancy: : Lie. #• Project tYPa (circle one): New Add'n Alter Repair DemoStoto Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Caics. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Tide 24 Calcs. Plans picked up Construction ' Flood plain plan Plans resubmitted Mechanical Grading plan 21d Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees TELEPHONE (760) 777-7012 FAX (760) 777-7011 OWNER/BUILDER INFORMATION 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. For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City or County. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the State and Federal Government as an employer and you are subject to several obligations include State and Federal income tax withholding, federal social security taxes, worker's compensation insurance, disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contracts are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 (760) -7012 FAX 60) 7 ,7- ER'S ;I6NA-iURE4DATE PROPERTY ADDRESS &- /60 -c2- PERMIT d2PERMIT NUMBER(S)