10-1235 (MECH)--'..P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: <1_0--00003235.-_�
Property Address: 48705 VIA SIERRA
APN: 658-200-015- -
Application description: MECHANICAL
Property Zoning: 'LOW DENSITY RESIDENTIAL
Application valuation: 13000
Applicant: 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 o the Business and Professionals Code, and my License is in full force and effect.
Lig se Class: C20 License No.: 619091
Zl"Date: ntra// Wctor: '* f O 0 W (C
OWNER -BUILDER DECLARATION '
Ihereby 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 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,
r 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.l•
(_) 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.).
(_ 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.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
OLDS JOHN T
'48-705 VIA SIERRA
SLA QUINTA, CA 92253
Contractor:
PALOMA AIR CONDITIONI
P.O. BOX 3501
PALM DESERT, CA 92261
(760)347-1212
Lic. No.: 619091
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/10/10
------------------
WORKER'S COMPENSATION DECLARATION
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 SOUTHERN INS CO Policy Number WSIO02303402
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in an manner so as to become subject to the workers' compensation laws of California,
and agr�1�. , if I should become subject to the workers' compensation provisions of Section
1 �7{OQa� c abor Code, 1 shall
forthwith comply
�, with those provisions.
ate: 1I L `J APPlicant: 6L po MW 'K • _6 '
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 1$100,0001• 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 t is Ebplication and state that the above information is correct. I'agree to comply with all
city an county or�j^a d state laws relating to building construction, and hereby authorize representatives
of sjp��=
e above-mentioned property for inspection purposes.
Date: (Applicant or Agent):
Application Number 10-00001235
Permit MECHANICAL
Additional desc, ..
Permit Fee 87.00 Plan Check Fee
... 21.75
Issue Date . . . . Valuation
0
Expiration Date 5/09/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
4.00 9.0000 EA MECH FURNACE <=100K
36.00
4.00 9.0000 EA MECH B/C <=3HP/100K BTU
36.00
Special Notes and.Comments
INSTALL (4) NEW. HVAC SYSTEMS. 2007. _
CODES.
--------------------------------------------- ------------------------------
Other Fees -BLDG STDS ADMIN (SB1473)
1.00
Fee-summary Charged. Paid Credited
Due
Permit Fee Total 87.00 .00 .00
87.00
Plan Check Total 21.35" .00. .00
21.75
Other Fee Total 1.00 .00 .00
1.00
Grand Total 109.75 .00 .00
109.75
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF-lR-ALT-HVAC
Alterations
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
m0m
Date:
Permit #:
48705 via sierra system 1 La Quinta, CA 92253
ICity of La Quinta
Nov 10, 2010
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
PlFurnace
® AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
® Setback
0 Indoor Coil
® SEER 13.0
❑ HSPF
❑ R 8 (CZ 14-15)
1400 sf
If not already present,
® Condensing Unit
❑ EER
❑ Resistance
must be installed)
❑ Other
1. Equipment Type: Choose the equipment being Installed; If more than one system, use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment EHlciencles: 13 SEER; 78016 AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is
being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A
copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector
verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that
each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning
October 1, 2010, a registered copy of the CF -1R and CF -611 shall also be on site for final inspection.
21. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
• Indoor Coil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• Furnace
CF4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage `<. 1:5 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
For Packaged. Units: Duct leakage <45 percent
Exempted"from duet leagage testing if: ;
[31. Duct system was documented`:to. have been previously sealed and confirmed through HERS verification, or
❑'2.:Duct systems.with less tharr401inear feet. in unconditioned space, or
E13 Ekistin dq4. - terns are cofistructed; insulateA ori sealed with asbestos . ,� r k:.
❑ 2 New'HVAC":_ g
Required Forms .
SystemIr ,a�
. Cut ut or Changeout
(lf
CF 6R fOfmS 'MECH 04MECH 20 HERS and (for split systems) .MECH-22 HERS and,
netw tluctng and x
MECH`25tHERS M. ¢ { r F ' ,��.
-4R and MECH 22, MECH 25;,x, fr`
new.:equipment)'.' �"
forms (for spilt systems) and r�
,CF tMEcH20,
ForSplit;Systemsa Duct leakage < 6¢percent, RC :CCA'z.350' CFM/ton;=FWD, TMAH;'STMS; and either HSPP or PSPP.
For. Packaged Units r Duct leakage < 6:per6ent
03 NewlDucts:withyorwith_out, :`
Required Forms:
Re,placement
.Includes replacing or installing all`
new ducting and/or outdoor :.
condensing unit and/or indoor coil
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or furnace. No or some
CF -411 forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; --RC, CCA z-300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more
CF -611 forms: MECH-04, MECH-2I-HERS
than 40 linear feet of duct in
CF -411 forms: MECH-21
unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions.Code to accept responsibility for the design identified on this
Certificate of Compliance.
. I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to
the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
. The design features Identified on this Certificate of Compliance are consistent with the Information documented on other applicable
compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit
application.
Name: Herman Paredes Signature: Herman Paredes
Company: PALOMA AIR CONDITIONING Date: Nov 10, 2010
Address: P 0 BOX 3501 License: 619091
City/State/Zip: PALM DESERT / CA / 92261 Phone: (760) 347-1212
*Reg: 210-AO02439SA-00000000-0000 Registration Date/Time: 2010/11/10 12:06:09 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF -IR -ALT -HVAC
Alterations
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:Permit
#:
48705 via sierra system 2 La Quinta, CA 92253
City of La Quinta
Nov 10, 2010
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
RIFurnace
® Indoor Coil
® AFUE 78%
0 SEER 13.0
❑ COP
❑ HSPF
O R 6 (CZ 10-15)
Served by system
® Setback
If not already present,
® Condensing Unit
❑ EER
❑ Resistance
O R 8 (CZ 14-15)
1000 sf
must be installed)
❑ Other
1. Equipment type: Choose the equipment being installed, if more than one system, use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.711SPF for typical residential systems.
HERS. VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is
being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A
copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector
verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that
each appropriate CF -611 and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning
October 1, 2010, a registered copy of the CF -1R and CF -6111 shall also be on site for final Inspection.
0 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• Indoor Coil and /or
CF -4R forms: MECH-21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct:leaka.ge < .15 percent; RC, -CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
For..Packaged Units: Duct leakage..z :15 percent
Exempted'from. ductleagage testingif:
p.i.. Duet system was documented to. have been previously sealed and confirmed through HERS verification, or
❑2. Duct systems with less than.40 linear feet. in unconditioned space, or
E]'3. Exist duct systems are. constructed; insulated or sealed::, with asbestos , t G µ M .:
O 2 NeviI VAG 1
Re qcared
System;.ti`.
. Cut i rtor Change outCF
new ducts (ally
6R forms MECH 04, MECH 20 HERS, ai�d�(fdr split systEms) MECH
with
*` :Y
new dotting and�all
MECH25 HERS,y
3 '. 3h. ,q/v .+y f �.
itCHMECH 22,vane MECHx25•
new, equipment)':„
GFR`forms MECHr20sand
'•� • x y .
For:Split:Systems; Duet leakage.. 6,0ercent, RC CCA Z 350 CFM/ton; FWD,TMAH, SIMS, and either HSPP or PSPP.
For.'Packaged Units Duct leakage <. 6.percent
❑:3 NeW Ducts i+vith/ot without .
Required Forms:
Replacement:
. Includes replacing or instalhM1ng
new ducting and/or outdoor
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
condensing unit and/or indoor coil
CF -411 forms: MECH-20 and (for split systems) MECH-25
and/or furnace. No or some
equipment changed.
For'Split Systems: Duct leakage < 6 percent; RC, CCA 2: 300 CFM/ton, TMAH—
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet Required Forms:
. Includes adding or replacing more CF -611 forms: MECH-04, MECH-2I-HERS
than 40 linear feet of duct in CF -4R forms: MECH-21
unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this
Certificate of Compliance.
• I certify that the energy features and performance specifications for the design Identified on this Certificate of Compliance conform to
the requirements of Tide 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the Information documented on other applicable
compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit
application.
Name: Herman Paredes Signature: Herman Paredes
Company: PALOMA AIR CONDITIONING Date: Nov 10, 2010
Address: P 0 BOX 3501 License: 619091
City/State/Zip: PALM DESERT / CA / 92261 Phone: (760) 347-1212
Reg: 210-A0024397A-00000000-0000 Registration Date/Time: 2010/11/10 12:10:30 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF-IR-ALT-HVAC
Alterations
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:Permit
#:
48705 via sierra system 3 La Quinta, CA 92253
City of La Quinta
Nov 10, 2010
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
0 Setback
® Indoor Coil
® SEER 13.0
❑ HSPF
El R 8 (CZ 14-15)
3000 sf
If not already present,
® Condensing Unit
El EER
❑ Resistance
must be installed)
❑ Other
i. Equipment Type: Choose the equipment being installed; If more than one system, use another CF-IR-ALT-HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is
being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A
copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector
verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that
each appropriate CF-6R and registered CF-4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning
October 1, 2010, a registered copy of the CF-111 and CF-6111 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF-4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Indoor Coil and /or
CF=4R forms; MECH-21 and (for split systems) MECH-25
. Furnace
For Split Systems: Duct-.leakage 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Fo.r Packa.ged.Units: Duct leakage: < 15 percent
Exempted `from.duct leagage testing if: .
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
0 2.. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3: Exiskr - duct ptems. are constructed, ihsulattdior sealed with asbestos
❑ 2 NOWAVAC1
g
RequiredForms+t�'` ,a #
SY stem ''AW'.
. Cut irk or Changeout
4,
�� t:; s s� �� h h x
CF 6Rforms MECH 04, MECH 20 HERS; nd)(for split systems) MECH-22 HERS, and
with ne'wducts (all, �*
new ducting and ally
MECH-25 HERS?
CF ,4R forms MECH>20, and (for�ysplit systems) MECH Z2;� and MECH 25'` �, g
new:equpmerit)
,.. ,
For SPht Systeitis::D NO leakage: z,6,0 nt;RC; CCA``Z`350=CFM/tong FWD, TM'AHSTMS, and either HSPP or PSPP.
For.. Packaged;llnits: Duct leakage,<, 6. percent
❑:3 New Ductsowifli without .
Required Forms:
Replacement
. Includes replacing or instaihrig alFir
new ducting and/or outdoor: "'
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
condensing unit and/or indoor coil ..
CF-4111 forms: MECH-20 and (for split systems) MECH-25
and/or furnace. No or some
equipment changed.
- For Split Systems:- Duct leakage < 6 percent; RC, CCA 2 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more
CF-611 forms: MECH-04, MECH-2I-HERS
than 40 linear feet of duct in
CF-411 forms: MECH-21
unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
. I certify that this Certificate of Compliance documentation Is accurate and complete.
. I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this
Certificate of Compliance.
. I certify that the energy features and performance specifications for the design Identified on this Certificate of Compliance conform to
the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
. The design features Identified on this Certificate of Compliance are consistent with the information documented on other applicable
compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit
application.
Name: Herman Paredes Signature: Herman Paredes
Company: PALOMA AIR CONDITIONING Date: Nov 10, 2010
Address: P 0 BOX 3501 License: 619091
City/State/Zip: PALM DESERT / CA / 92261 Phone: (760) 347-1212
Reg: 210-AO02440OA-00000000-0000 Registration Date/Time: 2010/11/10 12:13:32 HERS Provider: C'a10ERTS, Inc.
2008 Residential Compliance Forms July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF-lR-ALT-HVAC
Alterations
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
48705 via sierra system 4 La Quinta, CA 92253
City of La Quinta
Nov 10, 2010
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE 78%
® SEER 13.0
❑ COP
❑ HSPF
❑ R 6 PCZ 10-13)
R 8
Served by system
00 sf
0 Setback
If not already present,
0 Condensing Unit
[I EER
E] Resistance
❑ (CZ 14-15)
must be installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is
being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A
copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector
verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that
each appropriate CF -6R and registered CF -411 forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning
October 1, 2010, a registered copy of the CF -111 and CF -611 shall also be on site for final Inspection.
8 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Indoor Coil and /or
CF=40;forms: MECH-21 and (for split systems) MECH-25
. Furnace
For Split Systems: Duct: leakage;<„15:percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
For,Packaged.Units Duct`le'akage .<:15 percent
Exempted from duct,leagage testing.if:
❑ i. ;Duct system was.documented to have been previously sealed and confirmed through HERS verification, or
❑ 2 Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3 Existing systems are constructed, insulated,}orsealed: wltt asbestos
;duct ,y ,
fr s
❑ 2 NewIVAG '
Re uir i1 Fprms
q e- ,
Syste.
Cut in ogu angeout�
CF 6R forms MECH-04 MECH 2'0 HERS, nd (for split systems) MECH 22 HERS and �.:
a4 w
with nbWducts (al r
t
d,
;�
MECH
£F �~ }
s).:MECHF.22, and ` `
new.equipmen
.
•:ECH25�.new
'”f
.,:
For Spht;Systems; Duct; leakage -5., 6 percent; RC, CCA 2:350' CFM/ton% FWD, TMAH SIMS, and either HSPP or PSPP.
For Packaged Units Duct leakage < 6 percent
❑:3 New Ducts vvith/orwlthout
Required Forms:
Replacement s', ..
. Includes replacing or installing :alli:
new ducting and/or outdoor-.`,; ;. •`
CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
condensing unit and/or indoor. 66il
CF -411 forms: MECH-20 and (for split systems) MECH-25
and/or furnace. No or some
equipment changed.
For Split Systems: Duct -leakage < 6 percent; RC, CCA z 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet Required Forms:
• Includes adding or replacing more CF -6R forms: MECH-04, MECH-2I-HERS
than 40 linear feet of duct in CF -4R forms: MECH-21
unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this
Certificate of Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to
the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable
compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit
application.
Name: Herman Paredes Signature: Herman Paredes
Company: PALOMA AIR CONDITIONING Date: Nov 10, 2010
Address: P 0 BOX 3501 License: 619091
1
City/State/Zip: PALM DESERT / CA / 92261 Phone: (760) 347-1212
!. T
Reg: 210-A0024403A-00000000-0000 Registration Date/Time: 2010/11/10 12:19:03 ITERS .Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
Bin #
Oty of La QuiCita
Building 8L Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Penna #
O , 1
Project Address:7
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Owner's Name:
A. P. Number:
Address: 7 D S V`—
Legal Description:
City, ST, Zip: a Co,
Contractor:'
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Address: 11bper%
n Gil!n
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(1-eS .
Telephone:
Project Description:
City, ST, Zip: L l/� M
s V " . -7 A
Telephone:
State Lie. # :
3 Z
Q
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CityLic. i!•:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
A
:;:
Construction Type: Occupancy:
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Project a circle one New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
u-,
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 Calcs.
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
2°" Review, ready for corrcctions/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:
''d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A,LP,P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
0