08-1579 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 08-00001579
Property Address: 55300 FIRESTONE
APN: 775 -151 -051 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2800
Applicant:
Tiht 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 nd Professionals �pde, and my License is in full force and effect.
i irp—P rIaSS: C10 C16 C2 LEse do_• 457f554
Date: l//7/LJD Contractor:
\,___O�t INER-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).:
(_) 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.).
1 _ I 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 1 I am exempt under Sec. B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of, perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.I.
Lender's Name: _
Lender's Address:
LQPEPA11T
Owner:
MC NEFF MICHEAL
55300 FIRESSTONE•
LA QUINTA, CA 92253
(
Contractor:
PREFERRED PLUMBING HTG
P.O. BOX 5120
PALM SPRINGS, CA 92263
(760)322-3173
Lic. No.: 457554
VOICE (760) 777-7012
FAX (760) 777-7.011
INSPECTIONS (760) 777-7153
Date: 9/17/08
A/ p „ 0
I c 17 2003
vte:
CITY OF LA QUINTA
FINANCE DEPT.
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 DELOS INS CO Policy Number 01DKRM12002143
1 certify that, in the performance of the work for which this permit is issued, 1 shall not employ any
person in any manner so as o become subject to the workers' compensation laws of California,
and agree that, if I should come subject to the wor ' co pensation provisions of Section
3,7000 of the Labor Code, shalt f rthwi7c p i o provisio(t
Date: 7 C7 It Applicant:
i
WARN NG: FAILURE TO SECURE WORKERS'COMPE S.TION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENATFIES-A D 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 abg o information is corre I ree to comply with all
city and county ordinances and state laws relating to buitdi t3 construction, a r by au o'ze representatives
of this county to enter upon the above-mentioned propert or ins ction urpdJJ��.
Date: / / / Signature (Applicant or Agent): _ �7
nGC�c-�[>�.--�
Application Number . . . . . 08-00001579
Permit . . . . . MECHANICAL
Additional desc .
' Permit Fee. 33.00
Plan Check Fee
8.25
Issue Date . . . .
Valuation
0,
Expiration Date 3/16/09
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
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE EXISTING FURNACE, COIL, AIR
CONDITIONING UNIT 14 SEER
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
LQPR..RMIT +
CERTIFICATE OF COMPLIANCE: RESIDENTIAL age 1 of 1) CF -IR -A
Project Title
Date
Building Pemmit #
I U
Duct systems that are documented to have been previously sealed as confirmed through field verification and diagnostic
testing in accordance with procedures in the Residential ACM Manual.
2
Project Address
6-5600 F I ff.5.T6
3
Documentation Author
Telephone,,
Plan Check-/ Date.`; '
CF -6R pages 3 and 8 of 12
CF -4R page 5 of 8
Field.Check 7 Dafe.;
Compliance Method (Prescriptive —HVAC and/
Climate Zone
Enforcement Agency'Use Only.
or Duct System Alteration - § 152(b)1C, D, and E)
HVAC SYSTEMS
Heating Equipment Type Minimum Distribution Type
and Capacity (furnace, heat Efficiency and Location (ducts,
pump, boiler, etc. (AFUE or HSPF) attic, etc.
Duct or Piping Thermostat Type Configuration
Insulation (setback) (split or package)
R -Value
m a U
5 PL rT-
❑
Duct systems that are documented to have been previously sealed as confirmed through field verification and diagnostic
testing in accordance with procedures in the Residential ACM Manual.
2
❑
Cooling Equipment Type
and Capacity (A/C, heat
pump, eva coolin
Minimum Duct Location Duct Insulation Thermostat Type Configuration
Efficiency (attic, Value
(SEER or EER (c, etc.) R - (setback) (split or package)
-To 03 1 C-1
q 5 a- t176' F115 Li
❑
Duct systems that are documented to have been previously sealed as confirmed through field verification and diagnostic
testing in accordance with procedures in the Residential ACM Manual.
2
❑
SEALED DUCTS, REFRIGERANT CHARGE (TXV) AND EER
Before the permit can be finalized, a signed CF -6R Form and CF -4R Form must be provided to the building department for any of the
followincom liance requirements that are ✓ :
✓ Com liance Requirements
El Sealed Ducts (Climate Zones 2 and 9-16) - Installer testing and HERS Rater field verification required
TXV (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required'
❑ Refrigerant Charge (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required'
❑ ALTERNTAVE to Duct Testing: High EER as indicated in Table 8-3 of the Residential Compliance Manual (SEE Table 8-3 for
additional requirements and available Compliance Options) - Installer testing and HERS Rater field verification required
' The prescriptive requirement for either a refrigerant charge or a TXV does not apply to packaged units.
EXCEPTIONS
If any of the following three exceptions are ✓, the duct system is exempt from sealed ducts.
#
✓
Exceptions
1
❑
Duct systems that are documented to have been previously sealed as confirmed through field verification and diagnostic
testing in accordance with procedures in the Residential ACM Manual.
2
❑
Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos?
3
❑
Duct systems with less than 40 linear feet of ducts in unconditioned space.
z Duct alterations are exempt from duct sealing ONLY if they meet Exception 2 above.
SPECIAL FEATURES REOUIRING HERS RATING VERIFICATION
A ✓ indicates which compliance requirements are part of this project and need HERS rater verification.
✓ . Compliance Requirements
Installer Forms (irappGcable)
HERS Rater Forms (inapplicable)
❑ Duct Sealing
CF -6R pages 3 and 4 of 12
CF -4R page 1 of 8
Thermostatic Expansion Valve (TXV)
CF -6R pages 3 and 5 of 12
CF4R page 3 of 8
Refrigerant Charge
CF -6R pages 3, 5 and 6 of 12
CF -4R pages 3 and 4 of 8
High EER
CF -6R pages 3 and 8 of 12
CF -4R page 5 of 8
s�
Bin #
City of La QuAnta
Building U Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
-Building Permit Application and Tracking Sheet
Permit,#P.O.
Project Address: 55 d� �' Ic C S f�
Owner's Namd: 4 i0•NAEL• UC t� flrf�
A. P. Number:
Address:j�®Q
Legal Description:
City, ST, Zip:
Preferred Air Conditioning dba
Contractor: pre f err ed Plumbincf. H e a t i n & A'tV
Telephone:
Address: p0 Box 5120
Project Description:
City,ST,Zip:pa-lm Springs, CA' 92263
e ' • 1EXIS-066NACQ�
Telephone: ( 760 ) 3 2 2.'3173
/C . (' r
State Lic. #: 4 5 7 5 54 City Lic.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
1 lda
Name of Contact Person: PAIT-1 6
Sq. Ft.: ZO
# Stories: Z,
# Units:
Telephone # of Contact Person:
Estimated Value of Project: s• goo
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING .
FERN= FEES
Plan Sets
Plan Check submitted
Iten
Amount
Structural Calcs.
Reviewed, ready for corrections
PlRr Check Deposit
Truss Calcs.
Called Contact Person
Dar Check Balance
Energy Calcs.
Plans picked up
Con tructlon
Flood plain plan
Plans.resubmitted
Mec apical
Grading. plan•
2"" Review, ready foi'correctionsrssue
Electrical
Subcontactor List
Called Contact Pergon
Plumbing
Grant Deed
Plans picked up
S.M I.
H.O.A. Approval
Plans resubmitted
Gra ing
IN HOUSE:-
"Review, ready for correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I. .P.
Pub. Wks. Appr
Date of permit issue
School Fees
"
Totg I Permit Fees
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 2) CF4R
Project Address [ McNeff, Michael 1
Duct Pressurization Test Results (CFM @ 25 Pa) [ 1
Builder / Installer
55-300 Firestone / La Quinta / CA / 92253
1
Preferred Plumbing, Heating and Air Conditioning
Builder / Installer Contact
Telephone
Plan Number / Permit Number
Jeff Leavens
7603227106
O — %
HERS Rater
Telephone
Sample Group Number
Dave Bricker - CJHJEJEJRJS® ID #CC 9380828
7605419025
l
Compliance Method (Prescrip ' e)
Climate Zone 15
5
Enter Tested Leakage Flow in CFM: Final -Test of New Duct System or Altered Duct' System for Duct
System Alteration and/or"Equipment Change -Out.
6
Certifying Signature
/ O _ V Date
Sample House Number
Firm
Enter New Duct System - Pass if Leakage Percentage < 6% [ 100 x [ Line #5 / Line #2 ] ] O Pass ❑ Fail
HERS Provider
Energy Driven Solutions Inc.
Pass if Leakage Percentage < 15% [ 100 x [ Line #5 / Line #2 ] ]
CJHJEJEJRJS®
Address
10
City/State/Zip
P.O. Box 6705
❑ Pass ❑ Fail
La Quinta /CA /92248
Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT
HERS RATER COMPLIANCE STATEMENT
This house was: / Tested
As the HERS rater providing diagnostic testing and field veril
tested compliance requirements as checked on this form. The
correct tape is used before a CF -4R may be released on every
and signed CF -6R has been received for the sample anditestec
The installer has provided a copy of CF -6R
C3New Ducts are fully ducted (i.e., does notu
.i
Cl New ducts with cloth backed, rubber adhesi
adhesive duct tape to seal leaks at duct connec
,/ MINIMUM REQUIREMENTS FOR DUCT
the house identified on this form complies with the diagnostic
ck and verify that the new distribution system is fully ducted and
ETERS rater must not release the CF -4R until a properly completed
ities as plenums or platforrh returns in lieu of ducts).
installed mast c and draw bands used in combination with cloth backed, rubber
COMPLIANCE
Procedures for field verification and diagnostic testing of air distribution'systemsare available in RACM, Appendix RC4.3.
Duct Diagnostic Leakage Testing Results
System # 1
n R r
NEW CONSTRUCTION:
Duct Pressurization Test Results (CFM @ 25 Pa) [ 1
Measured Values
j
1
Enter Tested Leakage Flow in CFM
2
Fan Flow: Calculated (Nominal: v/ Cooling ❑ Heating O Measured)`
Enter Total Fan Flow in CFM: �-
2000
3
Pass if Leakage Percentage < 6% [ 100 x [ Line #1 / Line #2 ] ]
_
❑ Pass ❑ Fail
ALTERATIONS: Duct System and/or HVAC Equipment Change -Out I i`K)
4
Enter Tested Leakage Flow, in CFMTrom CF -6R: Pre -Test of Existing,Duct System Prior to -Duct,
System Alteration and/or Equipment Change -Out.
----------
5
Enter Tested Leakage Flow in CFM: Final -Test of New Duct System or Altered Duct' System for Duct
System Alteration and/or"Equipment Change -Out.
6
Enter Reduction in Leakage for Altered Duct System [ Line #4'Minus Line -#5] (Only,,if Applicable). j ti
7
Enter Tested Leakage Flow in CFM to Outside (Only if Applicable). I I
8
Enter New Duct System - Pass if Leakage Percentage < 6% [ 100 x [ Line #5 / Line #2 ] ] O Pass ❑ Fail
TEST 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
9
Pass if Leakage Percentage < 15% [ 100 x [ Line #5 / Line #2 ] ]
14.35
v/ Pass ❑ Fail
10
Pass if Leakage to Outside Percentage < 10% [ 100 x [ Line #7 / Line #2 ] ]
❑ Pass ❑ Fail
11
Pass if Leakage Reduction Percentage > 60% [ 100 x [ Line #6 / Line #4 ] ] and Verification by Smoke
Test and Visual Inspection
❑ Pass ❑ Fail
12
Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection
❑ Pass ❑ Fail
Pass if One of Lines #9 through #12 Pass
I
❑ Pass ❑Fail
Residential Compliance Forms Generated by CJHJEJEJRJS® http://www.CHEERS.org December 2005
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 2 of 2) CF -4R
Project Address [ McNeff, Michael j Builder / Installer
55-300 Firestone / La Quinta / CA / 92253 Preferred Plumbing, Heating and Air Conditioning
v/ THERMOSTATIC EXPANSION VALVE (TXV)
Procedures for field verification of thermostatic expansion valves are available in RA CM, Appendix RI.
System # I
Yes ❑ No
Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed on the system and
installation of the specific equipment shall be verified.
Yes is a pass v/ Pass ❑ Fail
Residential Compliance Forms Generated by CJHJEJEJRJS® http://www.CHEERS.org December 2005
. -P
INSTALLATION CERTIFICATE
I Site Address
INSTALLER CO
4 of 121 CF -6R
Permit
-L I V0—I� t
STATEMENT FOR DUCT LEAKAGE
INSTALLER COMPLIANCE STATEMENT
The building was: ✓ OTested at Final ✓ 0 Tested at Rough -in
INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE:
0 Remove at'least one supply and one return register, and verify that the spates between the register boot and the interior
finishing wall are properly sealed.
0 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.
0 Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used
✓ DUCT LEAKAGE REDUCTION
Procedures for field verification and diaenostic testhw of air dWribudon systems are available in RACM. Annnnd/x RC4 3
NEW CONSTRUCTION:
Duct Pressurization Test Results (CFM cQ 25 Pa)
Measured
specific equipment shall be verified.
Yes is a pass Pass
Values
1
Enter Tested Leakage Flow in CFM:
Fan Flow: Calculated (Nominal: ✓ Iff Cooling ✓ 0 Heating) or ✓ 0 Measured
,2
If Fan Flow is Calculated as 400 of n/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:
V L
✓ ✓
3100
Pass if Leakage Percentages 6% for Final or:5 4% at Rough -in:
O Pass O Fail
x (Line # I / _____(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 CFM from Final Test of New Duct System or Altered Duct
5
System for Duct System Alteration and/or Equipment Change -Out.
Enter Reduction in Leakage for Altered Duct System
ine # 4) Minus ire # 5 — Ont if Applicable)
Enter Tested Leakage Flow in CFM to Outside (Only if Applicable)
✓ ✓
rTSF—,S;T
Entire New Duct System - Pass if Leakage Percentage:9 6% for Final or 5 4% at Rough -in
0 Pass 0 Fail
100 x ine # 5 / Line # 2)11
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:
9
Pass if Leakage Percentage 515% [100 x [ (Line # 5) / (Line # 2)]]
q.
- Pass O Fail
10
Pass if Leakage to Outside Percentage 5 10% [100 x L_(Line # 7) / (Line # 2)]]
0 Pass 0 Fail
Pass if Leakage Reduction Percentage z 60% [100 x L_(Line # 6) / (Line # 4)]]
O pass O Fail
11
and Verification b Smoke Test and Visual Inspection
12
Pass if Sealine of all Accessible Leaks and Verification by Smoke Test -and Visual Inspection
D pds 0 Fail
Pass if One of Lines # 9 through # I2 ass
Er Pass 0 Fail
✓ W_ THERMOSTATIC EXPANSION VALVE (TXV)
Procedures for field verification -of thermostatic expansion valves are available in RACM, Appendix RI. ✓ ✓
Access is provided for inspection. The procedure shall consist of visual
✓ Yes 0 No verification that the TXV is installed on the system and installation of the
specific equipment shall be verified.
Yes is a pass Pass
Fail
✓ 01, the undersigned, verify that the above diagnostic test results were performed in conformance with the requirements for
compliance credit. 1, 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.
Installing Subcontractor (Co. Name) OR General
Contractor(Co. Na ) Owner
Signature: Date: 10 L D g
. j'.
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
S tems?CpF--IRvalue)
Efficiency�
(AFUE, etc.)
Duct
Location
(attic, etc.)
Duct or
Piping
R -value
Hearing
Load
Btu/hr
Heating
Capacity
tv/hr
KA l/C
i�Ci
a
2S U 9
J
V
T
Cooling Equipment
Equip Type
(Pkg. heat um
CEC Certified M&.
Name and Model
Number
# of
Identical
Systems
Efficiencyt
(SEER or EER)
?CF -1R value)
Duct
Location
attic, etc.
Duct
R value
Cooling
Load
Btu/hr
Cooling
Capacity
Btu/hr
P
a
J
V
1. > symbol reads greater than or equal to what is indicated on the CF -IR value.
Include both SEER and EER if compliance credit for high EER air conditioner is claimed.
✓ 01 1, 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 -1R) submitted for compliance with the
Energy Efficiency Standards for residential buildings, and 3) equipment that meets or exceeds the appropriate
requirements for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable.
Installing Subcontractor (Co. Name) OR General
Contractor (Co. Name R Owner
Signature: VDate:
d
V v _v v .
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms
April 2005