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04-8132 (SFD)',rlv : Application description Property Zoning . . . . Application valuation . leaf 4 4 a" PICO )RNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 . .04-00008132 Date 2/02/05 . . . 80704 VIA TRANQUILA- 772-70 -010-36 -311231- . . . DWELLING SINGLE FAMILY DETACHED . . . LOW DENSITY RESIDENTIAL . . . 185736 Owner Contractor ------------------------ VISTA LA QUINTA PARTNERS, ------------------------ LLC WASSERMAN CONSTRUCTION, RA 223 E. DE LA GUERRA 45520 STONEBROOK COURT LA QUINTA CA 92253 LA QUINTA CA 92253 (760) 771-8191 WCC: STATE FUND WC: 1795012. 07/01./05 CSLB: 681660 06/30/06 CCC: B -------------------------- Structure Information -------------=----------- Construction Type . . . ... TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 558.00 PATIO SQ FTG 647.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 2428.00 2ND FLOOR SQUARE FOOTAGE 503.00 ---------------------------------------------------------------------------- Permit BUILDING PERMIT Additional desc Permit Fee . . . . 940.50 Plan Check Fee 152.83 Issue Date . . . . Valuation . . . . 185736 Qty Unit Charge Per Extension BASE FEE 639.50 86.00 3.5000 THOU BLDG 100,001-500,000 301.00 ---------------- 7 ------------------------------------ PermitMECHANICAL ----------------------- Additional.desc Permit Fee . . . . 114.50 Plan Check Fee 4.31 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension .BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 P.O. Box 1504 • ��I� VOICE (760) 777-7012 713-495 CALLE CALIFORNIAO FAX (760) 777-7011 LA QUINTA, IFOR9225344 INSPECTIONS (760) 777-7153 'I BUILDING & SAFETY DEPARTMENT Application Number: Q - g 30� Date: D r Applicant: Architect or Engineer: Applicant's Mailing Address: or No.:�� t3UILUING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Lice„ a is in full force and effect. j O cense Class e(QV No. r Date 'aI [) OBJ ontractor X-1i(v— Oh5�ru* fork.. l no— OWNER•BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 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 (o the Contractors' State License Law.). U 1 amm exempt under Sec. ,,SBA P.C. for this reason Date O� Owner f_ -A, • 1kkzz cy—maA_ WORKERS' COMPENSATION DECLARATION 1 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. _L't 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. workers�r compensation ' nce carier n lic tuber are: �rier ��"t'e_ 1 ng olicy Number ,� l _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. ate 0 L L� 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 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 above information ' correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize re resentatives of this county to ent ab a ed properly for inspection purposes. ate O Signature (Applicant or Agent): Page 2 Application Number . . . . . 04-00008132 Date 2/02/05 Qty Unit., e Per Extension 111 .6.00 6.5000 EA MECH VENT FAN 39.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 141.69 Plan Check Fee 8.86 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2931.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 102.59 1205.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 24.10 ---------------------------------------------------------------------------- Permit PLUMBING �. Additional desc Permit Fee . . . . 179.25 Plan Check Fee 11.20 .Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 19.00 6.0000 EA PLB FIXTURE 114.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 11.00 .7500 EA PLB GAS PIPE >=5 8.25 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Permit . . GRADING PERMIT Additional desc' Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments SFD - LOT 36, PLAN 4BL - .(2 STORY W/ DETACHED CASITA) 2931 SQ.FT. LIVING, R-3 OCC. TYPE V -N CONSTRUCTION, 2001 CODES. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS, OR DRIVEWAY APPROACH. 75% REDUCTION TO PLAN CHECK FEE DUE TO MULTIPLE ISSUANCE OF -SAME PLAN TYPE ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF COMMUNITY CENTERS -RES 97.00 Page 3 Application Number . . . . . 04-00008132 Date 2/02/05 -------------------------------------------------------------------------'--- Other Fees . . . . . . . . . DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 15.28 DIF FIRE PROTECTION -RES 97.00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 18.57 DIF STREET MAINT FAC -RES 15.00 DIF.TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged ---------- Paid Credited Due Permit Fee Total 1390.94- ------------------------------ .00 .00 1390.94 Plan Check Total 177.20 .00 .00 177.20 Other Fee Total 2438.85 .00 .00 2438.85 Grand Total 4006.99 .00 .00 4006.99 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF -4R Project Address V Measured Duct Pressurization Test Results (CFM @ 25 Pa)�, Builder Name Builder Contact J(►�r Telephone 2 5ti-17Z� Plan Number '"7 HERS Rater G Telephone Sample Group Number 2 Compliance Method (Prescript Climate Zone 5 Certifying Signature Date 0 Sample House Number FirmU Desi- D�� rte, h se� 5 HERS Provide e,,,; �%�/��Rs Street Address: rG �X 3d93 Ci tate/Z �eA-l G.� L,, 04,q4Z35 Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER C, O)IPLIANCE STATEMENT The house was: ✓ Tested ✓ ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the diagnostic tested compliance requirements as checked ✓ on this form. The HERS rater must check and verify that the new distribution system is fully ducted and correct tape is used before a CF -4R may be released on every tested building. The HERS rater must not release the CF -4R until a properly completed and signed CF -6R has been received for the sample and tested b7.'The s. installer has provided a copy of CF -6R (Installation Certificate). New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). cl,Aew systems where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. ✓ "INIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT ocedures for field verification and diagnostic testing of air distribution systems are available in RA CM, Appendix RC4.3. Duct Diagnostic Leakage Testing Results NEW CONSTRUCTION: Measured Duct Pressurization Test Results (CFM @ 25 Pa)�, Values 1 Enter Tested Leakage Flow in CFM: 116 � : rd. 2 Fan Flow: Calculated (Nominal: /Acooling ✓ ❑ Heating) or ✓ ❑ Measured Enter Total Fan Flow in CFM: 6r) ✓ ✓ 3 Pass if Leakage Percentage _< 6% [ 100 xOb (Line # 1)/ (Line # 2)]] 5 $g Pass ❑Fail ALTERATIONS: Duct System and/or HVAC Equipment Change -Out �e W -k y Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to 4 Duct System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct Systemx 5 for Duct System Alteration and/or Equipment Chan e-Out at Enter Reduction in Leakage for Altered Duct System (Line # 4) Minus (Line # 5)]� 6 (Only if Applicable)f 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) ✓ ✓ 8 Entire New Duct System - Pass if Leakage Percentage _< 6% ❑ Pass ❑ Fail 100 x Line # 5 / Line # 2 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 L_(Line # 5) / (Line # 2)]] ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage <_ 10% [100 x [_(Line # 7)./ (Line # 2)]] ❑ Pass ❑ Fail Pass if Leakage Reduction Percentage >_ 60% [100 x [ (Line # 6) / (Line # 4)]] ❑ Pass ❑ Fail 11 and Verification by Smoke Test and Visual Inspection 12 Pass if ealing of all Accessible Leaks and Verification b .Smoke Test and Visual Inspection &I N ❑ Pass ❑ Fail Pass if One of Lines # 9 through # 12 pass ❑ Pass ❑ Fail Residential Compliance Forms April 2005 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF -4R Project Address Builder Name Builder Contact Telephone Plan Number HERS Rater Telephone Sample G oup Number Compliance Method (Prescriptive) Climate Zone Certifying Signature Date Sample House Number Firm HERS Provider Street Address: City/State/Zip: Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was: ✓,Tested ✓ ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the diagnostic tested compliance requirements as checked ✓ on this form. The HERS rater must check and verify that the new distribution system is fully ducted and correct tape is used before a CF -4R may be released on every tested building. The HERS rater must not release the CF -4R until a properly completed and signed CF -6R has been received for the sample and tested buildings. The installer has provided a copy of CF -6R (Installation Certificate). ,New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). New systems where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. ✓ MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Procedures for field verification and diagnostic testing of air distribution systems are available in RACM, Appendix RC4.3. Duct Diagnostic Leakage Testing Results NEW CONSTRUCTION: Duct Pressurization Test Results (CFM @ 25 Pa) MValuesd �x 3�rr "! 1 Enter Tested Leakage Flow in CFM: 2 Fan Flow: Calculated (Nominal: ✓ Cooling ✓ ❑ Heating) or ✓ ❑ Measured gee, Enter Total Fan Flow in CFM: ✓ 3 Pass if Leakage Percentage < 6% [ 100 x Sd (Line # 1) / (Line # 2)]] 41, 5 ass ❑ Fail ALTERATIONS: Duct System and/or HVAC Equipment Change -Out z�& 4 Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to� e Duct System Alteration and/or Equipment Chan a -Out. F Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct Systems " 5 for Duct System Alteration and/or Equipment Chan e -Out. h<9x. ME 6 Enter Reduction in Leakage for Altered Duct System (Line # 4) Minus (Line # 5)] (Only if Applicable) �� 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) 8 Entire New Duct System - Pass if Leakage Percentage < 6% ❑ Pass ❑ Fail 100 x Line # 5 / Line # 2 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)]] ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage <_ 10% [100 x [_(Line # 7)./ (Line # 2)]] ❑ Pass ❑ Fail Pass if Leakage Reduction Percentage >_ 60% [100 x r (Line # 6) / (Line # 4)]] ❑ Pass ❑ Fail 11 and Verification by Smoke Test and Visual Inspection 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Ins ection ❑ Pass ❑ Fail Pass if One of Lines # 9 through # 12 pass 11ry} ❑Pass ❑Fail Residential Compliance Forms April 2005 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3 of 8) CF -4R Project Address Builder Name Builder Contact Telephone Plan Number HERS Rater Telephone Sample Group Number Compliance Method (Prescriptive) Climate Zone Certifying Signature Date Sample House Number Firm HERS Provider Street Address: City/State/Zip: Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was:Tested ✓ ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies witLht>e diagnostic tested compliance requirements as checked on this form. ✓The installer has provided a copy of CF -6R (Installation Certificate). ✓�I THERMOSTATIC EXPANSION VALVE (TXV) Procedures for field verification of thermostatic expansion valves are available in RACM, Appendix R1. ✓ ❑ REFRIGERANT CHARGE MEASUREMENT Verification for Required Refrigerant Charge for Split System Space Cooling Systems without Thermostatic Expansion Valves tdoor Unit Serial # Location ✓ ✓ Outdoor Unit Model Cooling Capacity Access is provided for inspection. The procedure shall consist of Btu/hr Date of Verification ✓ XYes ' ❑ No visual verification that the TXV is installed on the system and ;El' ❑ (must be checked monthly) installation of the specific equipment shall be verified. Yes is a pass 1 Pass 1 Fail ✓ ❑ REFRIGERANT CHARGE MEASUREMENT Verification for Required Refrigerant Charge for Split System Space Cooling Systems without Thermostatic Expansion Valves tdoor Unit Serial # Location Outdoor Unit Make Outdoor Unit Model Cooling Capacity Btu/hr Date of Verification Date of Refrigerant Gauge Calibration (must be checked monthly) Date of Thermocouple Calibration (must be checked monthly) Standard Charge Measurement (outdoor air dry-bulb 55 °F and above): 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 below 55 °F rater shall use the Alternative Charge Measure Procedure Procedures for Determining Refrigerant Charge using the Standard Method are available in RACM, Appendix RD2. ✓ ❑ Yes ❑ No A copy of CF -6R (Installation Certificate) has been provided with refrigerant charge measurement documented. Residential Compliance Forms April 2005 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF -4R Project Address Builder Name Builder Contact Telephone Plan Number HERS Rater Telephone Sample Group Number 0-1) Compliance Method (Prescriptive) Climate Zone Certifying Signature Date Sample House Number Firm HERS Provider Street Address: City/State/Zip: Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was: VA Tested ✓ ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the diagnostic tested compliance requirements as checked ✓ on this form. The HERS rater must check and verify that the new distribution system is fully ducted and correct tape is used before a CF -4R may be released on every tested building. The HERS rater must not release the CF -4R until a properly completed and signed CF -6R has been received for the sample and tested build' S. The installer has provided a copy of CF -6R (Installation Certificate). New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). ,New systems where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. ✓ MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Procedures for field verification and diagnostic testing of air distribution systems are available in RA CM, Appendix RC4.3. Duct Diagnostic Leakage Testing Results NEW CONSTRUCTION: Duct Pressurization Test Results (CFM @ 25 Pa) Measured Values�� W� 50 . I Enter Tested Leakage Flow in CFM: 0-1) 70 0 2 Fan Flow: Calculated (Nominal:, ✓ ❑ Cooling ✓ ❑ Heating) or ✓ ❑ Measured 12,00 Enter Total Fan Flow in CFM: ✓ ✓ 3 Pass if Leakage Percentage <_ 6% [ 100 x(Line # 1) / (Line # 2)]] -amass ❑ Fail ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to 4 Duct System Alteration and/or Equipment Change-Out.Enter Mill- Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System Duct S stem Alteration and/or E ui ment Chan e -Out., k5for Is" Enter Reduction in Leakage for Altered Duct System L_(Line # 4) Minus —(Line 5)] 6 .# (Only if Applicable) s 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) ✓ ✓ 8 Entire New Duct System - Pass if Leakage Percentage <_ 6% ❑ Pass ❑ Fail 100 x Line # 5 / Line # 2 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 L_(Line # 5) / (Line # 2)]] ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage < 10% [100 x _(Line # 7)./ (Line # 2)1] ❑ Pass ❑ Fail Pass if Leakage Reduction Percentage >_ 60% [100 x r (Line # 6) / (Line # 4)]] ❑ Pass ❑ Fail 11 and Verification by Smoke Test and Visual Inspection 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 00 ❑ Pass ❑ Fail Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE (Page 3 of 12) CF -6R Site Address /�36 160 ,� y ,lPermit 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 stems>_CF-1 Efficiency � (AFUE, etc.) R value) Duct Location attic, etc. Duct or Piping R -value Heating Load tu/hr(Btu/hr) Heating Capacity I t7' SbUGZfiU 4/)Ijj 1 GU G "�Z Iwo / A& l7 ,- ,,, ),).e IC, X36 Nd158 �t 4(L ooU y,> k Ozll W613 Z iz- t Cooling Equipment Equip Type (pkg. heat um CEC Certified Mfr. Name and Model Number # of Identical Systems Efficiency (SEER or EER) >_CF -1R value) Duct Duct Location (attic, etc.) Duct R -value Cooling Load Btu/hr Cooling Capacity Btu/hr tv 026060 y Ili�iC/ ��'I1G yTi On) 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. ✓gI, 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 e�ORN Contractor (C e) OR er Signatur : Date: ,0%:;,- L- — Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE (Page 4 of 12) CF -6R Site Address Permit Number L,va- 3G INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE 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 etween the air handler and the supply and return plenums to verify that the connection points are properly sealed. spect all joints to ensure that no cloth backed rubber adhesive duct tape is used New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platforms returns in lieu of ducts). ✓ ❑ DUCT LEAKAGE REDUCTION Procedures for field verification and diagnostic testing, of air distributions stems are available in RACM A endi- RC4 3 NEW CONSTRUCTION: Duct Pressurization Test Results (CFM @ 25 Pa)� Measured# zsM Valuesr f,x 1 Enter Tested Leakage Flow in CFM:'` 6. 12 �r Fan Flow: Calculated (Nominal: ✓ ❑ Cooling v'❑ Heating) or ✓ ❑ Measured 2 If Fan Flow is Calculated as 400 cfm/ton x number of tons or as 21.7 cf n/(kBtu/hr) x Heating ti Capacity in Thousands'of Btu/hr output, enter total calculated or measured fan flow in CFM her :21M11D ✓ ✓ 3 Pass if Leakage Percentage<_ 6% for Final or :5 4% at Rough -in: I l 5'� -pass ❑Fail 100 x Line # 1 OXY/ / Line # 2 ALTERATIONS: Duct System and/or HVAC Equipment Change -Out '�, s 4 Enter Tested Leakage Flow in CFM from Pre -Test of Existing Duct System Prior to Duct�r4 System Alteration } �. and/or Equipment Change -Out. 5 Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct �',m' System for Duct System Alteration and/or Equipment Chan e -Out. 6 Enter Reduction in Leakage for Altered Duct System Line # 4 Minus(Line # 5 -(Only if Applicable) ,7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) V, Entire New Duct System - Pass if Leakage Percentage :5 6% for Final 8 100 x Line # 5 / Line # 2 ❑ Pass ❑ Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change- V/ V,Out Use one of the followingfour Test or Verification Standards for compliance: 9 1 Pass if Leakage Percentage 5 15% [100 x [ (Line # 5) / (Line # 2)]] ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage <_ 10% [100 x _(Line # 7) / (Line # 2)]] ❑ Pass ❑ Fail Pass if Leakage Reduction Percentage >_ 60% [100 x _(Line # 6) / (Line # 4)]] 11 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 Ins ection ❑ Pass ❑ Fail Pass if One of Lines # 9 throu h # 12 ass '? ❑ Pass ❑ Fail ✓ UI, 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. Installing ame ) OR General �ijgna�ure: Date: �� Q — e2 re Copies DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms September 2005 INSTALLATION CERTIFICATE (Page 4 of 12) CF -6R Site Address Permit Number INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE INSTALLER COMPLIANCE STATEMENT The building was: ✓,®Tested at Final ✓ ❑ Tested at Rough -in INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE: ,>�femove 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. �f 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 >_�Tew Distribution system is fully ducted (i.e., does not use building cavities as plenums or platforms returns in lieu of ducts). DUCT LEAKAGE REDUCTION lures for field verification and diaQnnstir testing nfair di.ctrihntinn .cvctemc are avaitah/o NEW CONSTRUCTION: Duct Pressurization Test Results (CFM @ 25 Pa) Measured Values ,�� 1 Enter Tested Leakage Flow in CFM: ) �RIM ,.. 4 vada ' Fan Flow: Calculated (Nominal: ✓ Cooling ✓ ❑ 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 output, enter total calculated or measured fan flow in CFM herd: G(/� ✓ ✓ 3 Pass if Leakage Percentages 6% for Final ors 4% at Rough -in: G I l 5 a ass ❑Fail 100 x Line # 1/ Line #.2 ALTERATIONS: Duct System and/or HVAC Equipment Change -Out ' 't`L' IN 4 Enter Tested Leakage Flow in CFM from Pre -Test of Existing Duct System Prior to Duct System Alteration a and/or Equipment Change -Out. µ: 5k��' Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Chan -Out. 6 Enter Reduction in Leakage for Altered Duct System Line # 4 Minus Line # 5 —(Only if Applicable) a 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) Entire New Duct System - Pass if Leakage Percentage <_6% for Final 8 100 xLine # 5 / Line # 2 ❑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)]] ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage <_ 10% [100 x [(Line # 7) / (Line # 2)]] ❑ Pass ❑ Fail Pass if Leakage Reduction Percentage >_ 60% [100 x [(Line # 6) / (Line # 4)]] 11 and Verification b Smoke Test and Visual Inspection ❑pass ❑Fail �C2Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection "`� ��,k ❑Pass ❑Fail Pass if One of Lines # 9 through # 12 ass it M ❑Pass ❑Fail ✓ L h, 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. Installing Subcontrac ame Genera Contractor ame) OR O Signatu a{e; Q� Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms September 2005 INSTALLATION CERTIFICATE (Page 4 of 12) CF -6R Site Address Permit Number /0-�-. INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE INSTALLER COMPLIANCE STATEMENT The building was: ✓�sted 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 Wishing wall are properly sealed. If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points etween the air handler and the supply and return plenums to verify that the connection points are properly sealed. spect all joints to ensure that no cloth backed rubber adhesive duct tape is used ew Distribution system is fully ducted (i.e., does not use building cavities as plenums or platforms returns in lieu of ✓ P3 DUCT LEAKAGE REDUCTION ' Procedures for field verification and diaonnctir toot;no nrn;r d;etr;h,d;nn evetome nro nvn;Inhl. *- AAr71J A.... ..d:. nne a ____ ______________ _ �__ �_—___—_��_—__——�—.._..�.—.-..r.r.r�r. ••tvaa..ar1��1 G/�MI.A1l liTJ NEW CONSTRUCTION: Duct Pressurization Test Results (CFM @ 25 Pa) d Measure,��,,� Values 6N, 1 Enter Tested Leakage Flow in CFM: Fan Flow: Calculated (Nominal: ✓ ❑ Cooling ✓ ❑ Heating) or ✓ ❑ Measured 2 If Fan Flow is Calculated as 400 cfin/ton x number of tons or as 21.7 cfin/(kBtu/hr) x Heating s Capacity in Thousands of Btu/hr output, enter total calculated or measured fan flow in CFM here: ✓ ✓ 3 Pass if Leakage Percentage<_ 6% for Final or <- 4% at Rough -in: 100 � ' -pass ❑Fail x �— Line # 1 / Line # 2 ALTERATIONS: Duct System and/or HVAC Equipment Change -Outer 4 Enter Tested Leakage Flow in CFM from Pre -Test of Existing Duct System Prior to Duct��- System Alteration and/or Equipment Change -Out. el 5 Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Chan a -Out. I 6 Enter Reduction in Leakage for Altered Duct System�1 Line # 4 Minus Line # 5 -(Only if Applicable) , 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) V/ Entire New Duct System - Pass if Leakage Percentage 56% for Final 8 100 x Line # 5 / Line # 2 ❑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% [100x [ (Line # 5) / (Line # 2)]] ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage :5 10% [ 100 x [(Line # 7) / (Line # 2)]] ❑ Pass ❑ Fail Pass if Leakage Reduction Percentage >- 60% [100 x [(Line # 6) / (Line # 4)]] 11 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 Ins ection �,�_ ❑Pass ❑Fail Pass if One of Lines # 9 through # 12 pass 1 ❑Pass ❑Fail ✓ LJ 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. Installing Subcontr ame) O eral Contracto o. Name) OR O Signa e: Date: Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms September 2005 ' . INSTALLATION CERTIFICATE (Page 5 of 12) CF -6R Site Address -7 Permit Number �roceduresTHERMOSTATIC EXPANSION VALVE (TXV) for field verification of thermostatic expansion valves are available in RA CM, Appendix Rl. ✓ ❑ REFRIGERANT CHARGE MEASUREMENT , Verification for Required Refrigerant Charge and Adequate Airflow for Split System Space Cooling Systems without Thermostatic Expansion Valves Outdoor Unit Serial # Access is provided for inspection. The procedure shall Return (evaporator entering) air dry-bulb temperature (Treturn, db) Outdoor Unit Make OF consist of visual verification that the TXV is installed on ✓ Yes ❑ No the system and installation of the specific equipment ❑ Suction line temperature (Tsuction, db) Date of Refrigerant Gauge Calibration shall be verified. (must be checked monthly) Date of Thermocouple Calibration OF Yes is a pass I Pass I Fail ✓ ❑ 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 OF Outdoor Unit Model Cooling Capacity Evaporator saturation temperature (Tevaporator, sat) Btu/hr Date of Verification Suction line temperature (Tsuction, db) Date of Refrigerant Gauge Calibration OF (must be checked monthly) Date of Thermocouple Calibration OF (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 RA CM, 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) OF Return (evaporator entering) air wet -bulb temperature (Tretum, wb) OF Evaporator saturation temperature (Tevaporator, sat) OF Suction line temperature (Tsuction, db) OF Condenser (entering) air dry-bulb temperature (Tcondenser, db) OF Superheat Charge Method Calculations for Refrigerant Charge Actual Superheat = Tsuction, db — Tevaporator, sat OF Target Superheat (from Table RD -2) OF Actual Superheat — Target Superheat (System passes if between -5 and +5°F) OF Temperature Split Method Calculations for Adequate Airflow Split Method Calculation is not necessary ifAdeauate Airflow 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 April 2005 • Certifica to of OccupancyO �w4 G� OFT9� Building & Safety Department M N This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. fl P BUILDING ADDRESS: 80-704 VIA TRANQUILA p A Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-8132 �1 Occupancy Group: R3 Type of Construction: V-N Land Use Zone: RL Owner of Building: VISTA LA QUINTA PARTNERS, LLC Address: 223 E. DE LA GUERRA City, ST, ZIP: SANTA BARBARA, CA 93140 By: STEVEN WILLETT Date: MARCH 12, 2006 Building Official POST IN A CONSPICUOUS PLACE