BRES2016-020678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Twit 4 4 Qu&S
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BRES2016-0206
Property Address:
47025 VIA LORCA
APN:
643160033
Application Description:
HAGGERTY RESIDENCE / HVAC / WATER H
Property Zoning:
Application Valuation:
$5,900.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7.153
Date: 7/20/2016
Owner:
_ =MICHAEL HAGGERTY
Ij� ry.47025 VIA LORCA -
FERi LA QUINTA, CA 32253
JUL
21- 2016 J
Contractor:
ALL SEASONS AIR CONDITIONING PLUMBING &
73605 DINAH SHORE DR STE 1310M
PALM DESERT, CA 92211
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C20, C36 License No.: 827420
Va1Z—_:? K0 )tv Coritrec or:
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).:
(_) 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, 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 reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec., 3097, Civ. C.).
Lender's Name:
Lender's Ad
(760)568-2663
Llc. No.: 827420
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.
1 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 insura-)ce carrier and policy number are:
Carrier: Policy Number:
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner !o as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
a
��2zZlleAP:plcant: a�tSd�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,D00). 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 toathe 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 t -)e 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 :)f issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application anc state that the above information is correct.
I agree to comply with all city and county o -dinances and state laws relating to building
construction, and hereby authorize represe itatives of this city to enter upon the
above-mentioned property for inspection pirposes..
Zb ) b S giiaE tufe (Appli nctoor Agent):�9-71zz:� — _�_Z__,
DESCRIPTION
FINANCIAL .••
ACCOUNT
CITY AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0 $1.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID'
PAID DATE
AIR HANDLER
101-0000-42402
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
AIR HANDLER PC
101-0000-42600
0
$12.09
$0.00
PAID BY
METHOD.
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
CONDENSER/COMPRESSOR
101-0000-42402
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
FURNACE
101-0000-42402
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT # CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT PAID
PAID DATE
FURNACE PC
101-0000-42600
0
$24.17 $0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for MECHANICAL: $169.21 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00
PAID' BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
WATER, HEATER/VENT PC
.101-0000-42600
0
$7.25
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $19.34 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0
$0.77
$0.00
PAID BY
METHOD
RECEIPT•#
CHECK #
CLTD BY
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.77 $0.00
TOTALS:00
Description: HAGGERTY RESIDENCE / HVAC / WATER HEATER
Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: APPROVED
Applied: 7/20/2016 MFA
Approved: 7/20/2016 MFA
Parcel No: 643160033 Site Address: 47025 VIA LORCA LA QUINTA,CA 92253
Subdivision: TR 26152 Block: Lot: 159
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $5,900.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
NAME TYPE
Details: HVAC CHANGE OUT - 14 SEER/80AFUE SPLIT SYSTEM AND 50 GALLON GAS WATER HEATER [2008 ENERGY] CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. PER 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
. Applied to Approved
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
Zip
PHONE
FAX
EMAIL
APPLICANT
IE INC
.3122S LA BAYA
WESTLAKE
VILLAGE
CA
91362
(760)5.68-2663
CONTRACTOR
• ALL SEASONS AIR CONDITIONING
PLUMBING &
73605 DINAH SHORE
DR STE 1310M
PALM DESERT
CA
92211
(760)568-2663
OWNER
MICHAEL HAGGERTY
47025 VIA LORCA
I LA QUINTA
CA
92253
(760)568-2663
Printed: Wednesday, July 20, 201610:17:41 AM 1 of 3
SYSTEMS
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
AIR HANDLER
101-0000-42402
0
$36.26
$0.00
AIR HANDLER PC
101-0000-42600
0
$12.09
$0.00
CONDENSER/COMPRES
SOR
101-0000-42402
0.
$36.26
$0.00
CONDENSER/COMPRES
SOR PC
101-0000-42600
0
$24.17
$0.00
FURNACE
101-0000-42402
0
$36.26
$0.00
FURNACE PC
101-0000-42600
0
$24.17
$0.00
Total Paid for MECHANICAL: $169.21 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: • $91.85 $0.00
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00
WATER HEATER/VENT
PC
101-0000-42600
0
$7.25
$0.00
Total Paid for PLUMBING FEES: $19.34 $0.00
SMI - RESIDENTIAL
101-0000-20308
0
$0.77
$0.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.77 $0.00
TOTALS:0•
INSPECTIONS
PARENT PROJECTS
Printed: Wednesday, July 20, 2016 10:17:41 AM 2 of 3 srsiEMS
ATTACHMENTS
Printed: Wednesday, July 20, 2016 10:17:41 AM 3 of 3
CRSYST£MS
Bin.#
CIty, of La Quinta
Building 8L Safety Division
p� P.O. Box 1504,78-495 Calle Tampico
LA.Qulnta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
I
Project Address: 47025 Via Lorca
Owner's Name:. Liz Haggerty
A P. Number
Address: 47025 Via Lorca
Legal Description:
Contractor. All Seasons A/C, Plumbing & Heating
City, ST, Zip; La Quinta, CA :92253 qty Jp
Telephone: 760-568-2663 >. >�: s>:�•
Address: 73605 Dinah Shore Drive #1.310M
ProjectDescription: Install,4ton A/C, 80,)00 BTU Furance, &
City, ST, Zip: Palm Desert, CA 92211
50 Gallon Water Heater
Telephone: 760-568-2663�r>;l'
4 ..,
State Lic. # : 827420
City Lie. #•:
Arch., P.ngr., Designer.
Address:
City., ST, Zip:
Tele hone:
P
State Lia #:LIN
^wjr
Construction type: , Occupancy:
Project type (circle one): New Add'n Alter Repair limo
Name of Contact Person: StevenSchnierer
Sq. Ft: #Stories:
#Units:
Telephone # of Contact Person: 818-735-7876
Estimated value of project: $5,900.00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACENG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calci.
Reviewed, ready for corrections
Plan Check Eeposit_
Truss Cates.
Called Contact Person
Plan Check Salance
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mecharilcal
Grading plan
V Review, ready for correctionsrrssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review; ready for correctionsrissue
Developer Expact Fee
Planning Approval.
Called Contact Person
AXP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC)
Project Name:
LIZ HEAGGERTY I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3 )
2016-07-19
A. General Information
MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one MR -ALT -02 document for each dwelling unit.
01
Project Name
LIZ HEAGGERTY
02
Date Prepared
2016-07-19
03
Project Location
47025 VIA LORCA
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
LIZ HEAGGERTY
07
Zip Code
92253.
08
Dwelling Unit Conditioned
2005
Floor Area (ft2)
SC System
SC System
CFA served
'-,,system a'1- -y
refrigerant #
Number of space conditioning
� Installing J
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ducted
co taining
system
more than 40
unit.
entirely new
B. Space Conditioning (SC) System Information
01
02
03
04� `�
.+ 05
06 �
01 t
i 08 i
09
10
1
'Is the SC-
'Installing a
SC System
SC System
CFA served
'-,,system a'1- -y
refrigerant #
.Installing new SC
� Installing J
InstaIIi g
Installing
Identification or.
Location or Area
by this SC
ducted
co taining
system
more than 40
enn ely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
2005
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extensioh of Existing Duct System, Greater Than 40 Feet (Section 15O.2(b)1Diib)
This section does not apply to this project.
Registration Number: 216-A0267524A-000000000-0000
Registration Date/Time: 2016-07-19 20:10:46
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-07-19 20:11:03
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
05
06
07
08
09
10
11
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New or
Identification
System
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
New Duct
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Duct Length
R -Value
Central gas
All new
Central split
All new
Less than or
System 1
furnace
heating
AFUE
80
AC
cooling .
SEER
14
Setback
equal to 40
R-8
components
components
feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH720-H & CF3R-MCH-20-H — Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: 5 15%, or 510% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2 300 CFM/ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23 or Refrigerant Charge MECH-25."
Yr
Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH=20 Duct Leakage Testing requirements.
i
E. Entirely New or Complete Replacement Duct System, with or without,Equipment Changeout (Sections 150.2(b)1Diia and. 150.2(b)1E, F)
�� •, t SLC: ��, �..✓ ;wr ;� �! �F.if` 1! i �i ,`mak
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 216-A0267524A-000000000-0000 Registration Date/Time: 2016-07-19 20:10:46 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-07-19 20:11:03
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: �!
Jacoby, Ian
cyan �aco'
Company:
Signature Date:
i PERMIT E RATERS
2016-07-19 20:10:46
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362
1818-735-7876
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials, components; and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24, Part i and Part 6 of the California Code of Regulatlons:
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
S. I will ensure that a registered copy of this Certifica a of.Compliance shall be made available with the building permits) issued for the building, and made available to ttieenforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Desigrier Signature: "t.3' E
Jacoby, Ian
cyan 9W70bJr
Company:
Date Signed:
ALL SEASONS AIR CONDITIONING PLUMBING & HEATING INC
2016-07-19 20:10:46
Address:
License:
73605 Dinah Shore Drive, Suite 1310M
827420
city/500/Zip:
Phone:
Palm Desert CA 92211
760-568-2683
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 216-A0267524A-000000000-0000 Registration Date/Time: 2016-07-19 20:10:46. HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-07-19 20:11:03
Schema Version: 0.555SDD
STATE.OFCALIFORNIA"
RESIDENTIAL ALTERATIONS — WATER HEATER
CEC-CFIR-ALT-01-E (Revised 06!14) . CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E WATER HEATER
I.Prescriptive.Residential Alterations for Water Heater (Page 1 of 2)
A. GENERAL -INFORMATION
Site address: tt7� ZS ° `/t �arCO�
—T
Building Types Single Family Dwelling
E1. N ulti Family Dwellings.
City, Zip Code: QZ Z 3
Climhate Tone:' '" $
G. WATER HEATING SYSTEMS Section 150.2 b 1'G .. • '
01
02
03
•04
05
06
07
08
'09
10 :,
11
12
13
'14
15
Water
Water
Water'
• Hof
Water
Fuel
Rated
hated
Heating
Heating
Standby
Exterior
Back -Up
Central
Dwelling
Heating
Heating
Heater
Water
Heater
Type
Input
Input
Efficiency
Efficiency
'Loss'(%)
Insul.
Solar
DHW,System.
Unit DHW
System
System
Type
Heaters
Storage
Type
Value
Type
Value
R.Vafue
SavingsDi;Vibution
System
Identification
Type
in
Volume
"' '
Fraction
Type
Distribution
ar'
system •
(gal):
Type
Name
W
.Gc S
'q.50D-)
1 Fa•ta_.
.:58
7N
�e
N
Slaws
.-,qD
.
WATER HEATING SYSTEMS
Water heating compliance'for ari'alteratfon is-cl serlbed in Section 15b.2(b)1G. For single dweiJinga.gas or propar?e waterh'eater,with a storage tank of 60 gallpds maximum
br instantaneous (tankless) can be used.. Dwelling,Unit distribution systems are,limited to Standard trunk and branch,or demand recirculaflon for gas or propane water.
�l ziter..Demand recirculation is not allowed for electric water heater. If there is no natural gas connected to the building, an electric water heater maybe replaced with
another electric water heater.. However, changtng1rorn gas to electric is not allowed. Mufti -family central systems must use certified equl.pmentas defined;under Section
• �x1o.3'andlid:3. --... f ..
NOTE: If the proposed installation -does not meetthe requirements allowed specifically for alterations, use form CF1R-NCB=01 to document the water heater alterq Jon,
Instruclio^ s for sections with column numbers are'aiven below:
1. Water Heating System Identification or Name: enter a unique name for the Water Heating System
2. Water heating system type: Domestic Hot Walter (DHW), Hydronic, Combined Hydronic, or•CentraL DHW is for domestic hot Water, hydronic is'a water heating -
cyctem ucod for rr?rq hearing nnly;, rnmhlnpri hydrnnlr, are'whehthe water heater will proy)de both space conditioning,and domestic hot water.
3. Water heater type: For non -central systems only Small Storage or Small Instantaneous are allowed. For central systems pick from .Large Storage, Small Storage,
Heat Pump, Boiler, Large Instantaneous, Small Instantaneous or Indirect.
CERTIFICATE OF COMPLIANCE CRR -ALT -01-E WATER HEATER
Prescriptive Residential Alterations for Water Heater (Page 2 of 2)
4. Number of water heaters in system: In single-family.and multi -family with water heaters in each dwelling.units the valueJs 1. For multi -family central'systems
serving multiple dwelling units enter the total number of water heaters.
5. Water heater volume (gal): tank capacity in gallons. For individual water hekers for a dweliA unit this wilf be 60 gallons or less. If instantaneous, enter n/a• For.
multi -family central systems enter the total storage volume:
6. Fuel Type: Gas,,Propane, Electric (Only if natural gas is not available)
7.. Rated Input Type: Enter the equipment input rating type; for gas.or propane fired units are Btuh, for electric fired systenfthe iiriits are'kW. _
8. Rated input Value: Enter the numeric value of rated Input.
9. -Heating Efficiency Type: Energy Factor, AFUE, dr -Thermal Efficiency. From product Iiteratdfe bra Californla Energy Commission directory..
10. Heating Efficiency Value: Enter the.value from product literature or a California Energy Cominission directory
11, Standby Loss (percent); Applies only to largestorage water heaters, Enter n/a for small sCorage or instantaneous water heaters.
12. 'Exterior inguiation R -Value: Enter the R -value if exterior. insulation on the storage tank is installed ,
13. Back -rip solar saliidgS fraction: If compliance requires a back-up Snlai system, indicate the solar contribution (e.g., 0.30). External calculations are.required. -
14. Central DHW Distribution System: For multi -family buildings with using a central distribution system a demand recirculation system'wlfh at feast two distribution
loops must be Installed. This requirement applies to any building with eight or more units. If the system Is'non-central,or project is individual. units enter n/a: ,
15, 0�veflf g&Uriit.DHW Distribution Type: For a Central DHW this field shall be Standard. If non -central then pick from Standard, Demand Recirculation — Manual .
Control, Demand Recirculation—Sensor Control. if non -central electric water heater this must be Standard, no recirculation system shall be Installed.
DOCUMENTATION AUTHOR'S DECIARATIO`N STATEMENT
• I certify.that this'Certificate•of'Cbmpliahce documentation is accurate and complete. ..
Name: '60wner•Futhoriied agent ❑Contractor
ever. Sc1•:+r.:.ea'er- .
Signature:
ure:u,,,.rL �t : • . .
Company: •S sov-ss: t? %.)w0oiY� i4ec_Vir '= A'C
Gontrattorlicgnse#: W,420
Address: % S�,Cm br, '#k 1310 M
Phone: Tfoii Sbg—z(o fo 3 ,
City/State/Zip:• � �
r-w�rr, )�)te_seA, LA 92211
L)ateC '
-1 zo( 1to
For assistance 0rquestions.regardingthe Energy. Stan dards, contact the Energy Hotline at:,1-BI10-772-33b.0, -