12-0134 (MECH)4 P.O. BOX 1504 VOICE (760).777-7012
78495 CALLE TAMPICO FAX (760).777-7011:
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Dater 2/14/12
Application Number: ,12--00000134 Owner:
PropertyAddress: 77390 VISTA ROSA SATHER,GLEN & ANN
APN: 658-220-023- - 77380 VISTA ROSA
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 25000
' 4
tractor:
Applicants Architect or Engineer:ur—,
) 'AL ONE'S ONE HOUR A/C & HTG .
712 E. LA CADENA DRIVE*
trVERSIDE, CA 92507
.�
51)276-9744
It) l G+. � arosSN L11c. No.: 878533
---------------------------------
- LICENSED CONTRACTOR'S DECLARATION
- WORKER'S COMPENSATION DECLARATION
- I hereby affirm under penalty of perjury that I am- licensed under provisions of Chapter 9(commencing with
thereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force -and effect. -
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
.Lice a Class: C20 censeNo.:, 878533
for by Section 3700 of the Labor Code, for the. performance of the work for which this permit is
ate: 2 -A m ontractor: _
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
- - 0 ER -BUILDER DECLARATION'
,' insurance carrier and policy number, are: -
I hereby affirm u der penalty of perjury that I am empt from the Contractor's State Licenselaw for the -
Carrier .INS CO OF WEST Policy Number WSD500334901
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
-
I certify that, in .the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure,,prior to its issuance, also requires the applicant for the
- person in any manner so as -to become subject to the workers' compensation laws of California, -
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workers' compensation provisions of Section-
License Law -(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codel or -
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
3700 of the Labor Code, I shall forthwith comply with those provisions. -
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$500).:
ate: AppP ant:
1—) 1, 6s 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
WARNING: FAIL TO SECURE WORKER MPENSATION COVERAGE IS UNLAWFUL, AND SHALL -
.. Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
•SUBJECT AN E PLOYERTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN '
.- improvements are not intended or offered for sale. If, however, the building or improvement is sold within
. SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
' one year ofcompletion, the owner -builder will have the burden of proving that he.or she did not build or
- --
.- improve for the purpose of sale.).
APPLICANT ACKNOWLEDGEMENT _
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors, to construct the project (Sec.
-
IMPORTANT Application is hereby made to the Director of Building and Safety, for a permit subject to the
7044, Business and Professions Code: The Contractors' State license Law does not apply to an owner of
conditions and restrictions. set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1 . Each person upon whose behalf this application is made, each person at whose request and for - -,
'- pursuant to the Contractors' State License Law.) - -
- whose benefit work is performed under or pursuantto any permit issued as a result of -this application,
1 ) I am exempt under Sec. , BAP.C. for this reason
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.
' Date: Owner:
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
- CONSTRUCTION LENDING AGENCY
permit to cancellation.
' I hereby affirm under penalty of perjury that there is a construction lending agency for the performance.of the
I certify that 1. have read this application and state that the above information is correct. I agree to comply with all .
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
•
of is county to enter upon the above-mentioned pro rt y foC inspection purpos s.
Lender's Name:
V
ate. 1 Sig ture (Applicant or Agent):
- Lender's Address:
V
LQPERMIT
LQPERMIT - _
Application Number . . . . . 12-00000134
Permit MECHANICAL
Additional desc
Permit Fee 117.00 Plan Check Fee
29.25
Issue Date Valuation . .
0
Expiration Date 8/12/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
4.00 9.0000 EA MECH FURNACE <=100K
36.00
4.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU
66.00
Special Notes and Comments
REPLACE (4) 60000 BTU FURNACES, 4 A/C'S
(3 TON & 4 TON) & COILS, SPLIT, SYSTEMS.
2010 CODES.
------------------------------------------------- - - - - --
Other Fees',.,. BLDG STDS`ADMIN•(SB1413)
1.00
Fee summary Charged Paid Credited
Due.
-------------
Permit Fee Total 117.00 .00 .00
117.00 _.:..,
Plan Check Total.. 29.25 .00 •.00
29.25
Other Fee Total 1.00 .00 .00_
1.00
Grand.Total 147.25. .00 .00
147.25
LQPERMIT - _
1
HVAC Alterations CF -1R -ALT -HVAC
Simplified Prescriptive Certificate of Compliance: 2008 Residential
Climate Zones 10 - 15 ,
Site Address:
1 •-
+
Permit #:
77380 VISTA ROSA La Quinta, CA 92253
F `
Feb 9, 2012
Equipment Typel
List Minimum Efficiency2
Duct insulation
-requirement
Conditioned Floor
Area
" Thermostat
[]Package Unit
p Furnace
2 Indoor Coil
O AFUE 80%
2 SEER 14.0
❑ COP -
❑ HSPF
❑ R 6 (CZ 10-13) .
Served by system
,
� Setback
If not already present; must be
Condensing Unit
p EER.,
❑ Resistance
El R 8 (CZ 14 15) ' r
6000 sf.
installed)
'
❑ Other '
5"
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -ALT -HVAC for each system.
1
HVAC Alterations CF -1R -ALT -HVAC
Simplified Prescriptive Certificate of Compliance: 2008 Residential
Climate Zones 10 - 15 ,
Site Address:
Enforcement Agency:
Date:
Permit #:
77380 VISTA ROSA La Quinta, CA 92253
City of La Quinta
Feb 9, 2012
Equipment Typel
List Minimum Efficiency2
Duct insulation
-requirement
Conditioned Floor
Area
" Thermostat
[]Package Unit
p Furnace
2 Indoor Coil
O AFUE 80%
2 SEER 14.0
❑ COP -
❑ HSPF
❑ R 6 (CZ 10-13) .
Served by system
,
� Setback
If not already present; must be
Condensing Unit
p EER.,
❑ Resistance
El R 8 (CZ 14 15) ' r
6000 sf.
installed)
'
❑ Other '
5"
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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 -1R
and CF -6R shall also be on site for final inspection. ,
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 11INOand (for split systems) MECH-25 .r,
Condenser Coil and /orIndoor
CF -6R forms: MECH-04,-MECH-2I-HERS and (for split systems) MECH-25-HERS
.'Furnace oil and /or,
CF -4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage'< 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
.. ..4 1. .,-
15
eFee • r
Exempted from duct leakage testing if: -
rthrough
,❑ 1. Duct system was documented to have been previously sealed and confirmed HERS verification, or,
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
0,3. Existing duct systems are constructed, insulated or sealed with asbestos '
❑'4. The systemYwill not be Ducted (ie„DuctlessjMini-Split-System),(Also_.Exempt fromcRefriger�art=Lharge)
112. Ne4HVAC System
Required Forms.
. Cut in or, Changeout with;
,
new ducts:
” " r , r
CF 6R forms: MECH-04, MECH-20-HERS and (for split systems). MECH-22=HERS, and F
(all new
ducting all new,
e ui ment
MECH=ZS'HERS r's' f *—�' '
x. ''i t .—.. �"," .,•° '
CF -4R forms: MEC H 20, and (for split systems) MECH'=22 and MECH-25
For Split Systems: Duct leakage <-6 percent; RC, CCA > 350 CFM/ton; FWD, •TMAH,'STMS, and either HSPP or PSPP.'°
For Packaged Units: Duct leakage' <'6 percent `
❑ 3. New Ducts with_ /or without
Required Forms:
Replacement `_ r
. Includes replacing or installing all new
ducting and/or outdoor condensing unit a'
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems)'MECH-25-HERS
and/or indoor coil and/or furnace, No or some'
CF -4R forms: MECH-20 and: (for split systems) MECH725
equipment changed.
-
For Split Systems: Duct leakage < 6 percent; RC, CCA.>_ 300 CFM/ton,•TMAH
For Packaged Units: Duct leakage < 6 percent','
❑ 4. New Ducting over 40 feet F
Required Forms:.
. Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH 21 -HERS
linear feet of duct in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent' 1 ,,
❑ 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: Jim McEligot Signature: Jim McEligot '
Company: VENVEST BALLARD INC r, Date: Feb 9,-2012 _
Address: 2712 EAST LA CADENA DRIVE License: 878533
City/State/Zip: RIVERSIDE / CA / 92507 Phone: (951) 276-9744
-Reg: 212-A0007288A-00000000=0000; Registration Date/Time: 2032/02/09 17:53:32 HERS Provider: CalCERTSI_ Inc.
2008 Residential Compliance Forms' .•:, i July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 = 15
Site Address:,
Enforcement Agency:
"I •
Permit #:
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 = 15
Site Address:,
Enforcement Agency:
Date:
Permit #:
77380 VISTA ROSA La Quinta,,CA 92253
City of La Quinta
Feb 9, 2012
Equipment Type1 •
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
;
p Furnace
• Indoor Coil
p AFUE 80%
p SEER 14.0
❑COP
❑ HSPF •
❑ R 6 (CZ 10-13)
Served by system
0 Setback
If not already present, must be
• Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ�14-15)+ + +.
6000 sf
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. 1 • .
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 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 -6R shall also be on site for final inspection.',
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-21'111NOand (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
CF -4R forms: MECH=21'and (for split systems) -25-25 .
For Split Systems: Duct leakage <' 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if: r
❑ 1. 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 duct systems are constructed, insulated or sealed with asbestos `
❑ 4, Thesystemwwill not be Ducted (ie. Ductless;Mini-Split System)•(Also Exempt from Refrige ant=Charge)
.�
❑ 2. New HVAC System -
Requited Forms:. r �' • "' '� * �i < , .
. Cut injor,Changeout with""
new ducts: (all new '��
'} " r
CF 6R forms.,MECH-04, MECH-20 HERS,tand?(for split systems) MECH-22=HERS, and
w
ductin ,
meall ne
MECH=25'HERS P
CF-4R"forms: MECH 20, and (for split systems)MECH-22,"and MECH-25`
e ui
For Split Systems: Duct leakage <•6'percent; RC; CCA 2! 350 CFM/ton; FWD, TMAH,`ST,MS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent°' ''"' ' i" "«
113. New Ducts with/or without
Required Forms:
Replacement 't
"
Includes replacing or installing all new,
ducting and/or outdoor condensing unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or fur=nace. No or some.
CF -4R forms: MECH-20 and (for split systems) MECH-25 ..
equipment changed.
For Split Systems: Duct leakage -< 6 percent; RC, CCA > 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
114. New Ducting over 40 feet
Forms:
lRequired
Includes adding or replacing more than 40CF-6R
forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.CF-4R
forms: MECH-21
For split system or packaged. units: Duct leakage < 15 percent '
❑ EXCEPTION: Existing duct systems'consfructed, 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: Jim McEligot Signature: Jim McEligot +, ,
Company: VENVEST BALLARD INC _ , Date: Feb 9, 2012. ;
Address: 2712 -EAST LA CADENA DRIVE License: 878533 -
City/State/Zip: RIVERSIDE / CA / 92507 •. - Phone: (951) 276-9744
Reg: 212-A0007289A-00000000-0000. Registration'Date/Time: 2012/02/09 17:55:03 - HERS Provider: CalCERTS, Inc.
'2008.Residential Compliance Forms ;_ July 2010
Reg:-212-A0007291A-00000000-0000 Registration Date/Time: 2012/02/09'17:56:28 r HERS Provider: CalCERTS, Inc: ti
2008 Residential Compliance Forms ° r July 2010
r + . f"i • i .,:�, 5 , . ' t,. v is a ~ . _ , + I + '
Simplified Prescriptive Certificate of Compliance: 2008 -Residential HVAC Alterations CF -111 -ALT -HVAC
Climate Zones 10 - 15
Site Address- Enforcement Agency: Date: Permit #:. .'
77380 VISTA ROSA La Quinta, CA 92253 • '. City of -La Quinta -Feb 9, 2012
r Duct insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat
❑ Package Unit ` - .
2 Furnace [0 AFUE 80% ❑ COP ❑ R 6 (CZ 10-13) � Served by system @ Setback' - ,
@ Indoor Coil • p SEER 14.0 ❑ HSPF r If not already present must be
R Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) 6000 sf ; installed) r
,❑ 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 ihspectoF 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 -1111 +
and CF -6R shall also be•on site for final inspection. -•
D 1. HVAC Changeout Required Forms: ;
. AII,HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced CF -4R forms: MECH-21 111NOand (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 -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
,,e<
pereeRk
, M
Exempted from duct leakage testing if: 1' '
❑ 1" Duct system was documented to have been previously sealed and confirmed through HERS--verification,f or -
❑ 2. Duct systems with less than 4.0 linear feet in unconditioned space, or
3, Existing duct systems are constructed, insulated or sealed with asbestos '
[1'4. The ,,will not be Ducted (ieDuetlessMini-Split.:5ystem) (Also Exempt:fromlRefrige�antCharge)
❑ 2. New HVAC System Required Forms:.' I!, )f s - ' =* . ;�• •; +I
. Cut in or:Changeout with' � � r . _ r r.- P - + ..� -
CF 6R forms MECH-04, MECH-20-HERS, tand'(for.splitsystems) MECH ZZ -HERS and
new ducts: (all newt ..
ductmgjk all new MECH'25iAw�HER5 'i _y
e ui ment CF -4R forms:;MECH 20,`and'(for split systems) MEC and MECH 5 i �:r i
For Split Systems: Duct leakage <'6 percent,•RC; CCA >_.350 CFM/ton ;'FWD, TMAH, STMS, and either HSPP or`PSPP }
For Packaged Units: Duct leakage —< 6 percent- +:
❑ 3.,New Duds with/or without' . Required Forms:' -
Replacement
i
t
. Includes replacing or, installing all new.
ducting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace.. No or some CF -4R forms:. MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH -
For Packaged Units: Duct leakage < 6 percent ,
❑ 4. New Ducting over 40 feet Required Forms:
. Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned, space. - CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent . r
.❑ 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 certifythat 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: Jim McEligot • . Signature: Jim McEligot
Company: VENVEST BALLARD INC . Date: Feb 9, 2012
Address: 2712 EAST
�'
LA CADENA DRIVE License: 878533
City/State/Zip:, RIVERSIDE / CA / 92507 Phone: (951) 276-9744 ,.
Reg:-212-A0007291A-00000000-0000 Registration Date/Time: 2012/02/09'17:56:28 r HERS Provider: CalCERTS, Inc: ti
2008 Residential Compliance Forms ° r July 2010
r + . f"i • i .,:�, 5 , . ' t,. v is a ~ . _ , + I + '
Simplified Prescriptive Certificate of Compliance: 2008 -Residential HVAC Alterations CF -111 -ALT -HVAC
Climate Zones 10 - 15
Site Address- Enforcement Agency: Date: Permit #:. .'
77380 VISTA ROSA La Quinta, CA 92253 • '. City of -La Quinta -Feb 9, 2012
r Duct insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat
❑ Package Unit ` - .
2 Furnace [0 AFUE 80% ❑ COP ❑ R 6 (CZ 10-13) � Served by system @ Setback' - ,
@ Indoor Coil • p SEER 14.0 ❑ HSPF r If not already present must be
R Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) 6000 sf ; installed) r
,❑ 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 ihspectoF 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 -1111 +
and CF -6R shall also be•on site for final inspection. -•
D 1. HVAC Changeout Required Forms: ;
. AII,HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced CF -4R forms: MECH-21 111NOand (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 -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
,,e<
pereeRk
, M
Exempted from duct leakage testing if: 1' '
❑ 1" Duct system was documented to have been previously sealed and confirmed through HERS--verification,f or -
❑ 2. Duct systems with less than 4.0 linear feet in unconditioned space, or
3, Existing duct systems are constructed, insulated or sealed with asbestos '
[1'4. The ,,will not be Ducted (ieDuetlessMini-Split.:5ystem) (Also Exempt:fromlRefrige�antCharge)
❑ 2. New HVAC System Required Forms:.' I!, )f s - ' =* . ;�• •; +I
. Cut in or:Changeout with' � � r . _ r r.- P - + ..� -
CF 6R forms MECH-04, MECH-20-HERS, tand'(for.splitsystems) MECH ZZ -HERS and
new ducts: (all newt ..
ductmgjk all new MECH'25iAw�HER5 'i _y
e ui ment CF -4R forms:;MECH 20,`and'(for split systems) MEC and MECH 5 i �:r i
For Split Systems: Duct leakage <'6 percent,•RC; CCA >_.350 CFM/ton ;'FWD, TMAH, STMS, and either HSPP or`PSPP }
For Packaged Units: Duct leakage —< 6 percent- +:
❑ 3.,New Duds with/or without' . Required Forms:' -
Replacement
i
t
. Includes replacing or, installing all new.
ducting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace.. No or some CF -4R forms:. MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH -
For Packaged Units: Duct leakage < 6 percent ,
❑ 4. New Ducting over 40 feet Required Forms:
. Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned, space. - CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent . r
.❑ 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 certifythat 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: Jim McEligot • . Signature: Jim McEligot
Company: VENVEST BALLARD INC . Date: Feb 9, 2012
Address: 2712 EAST
4{
Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1111 -ALT -HVAC '
5 10 -'15 . '
Simplified P
Climate Zone
Site Address:
Enforcement Agency:
Date:
Permit #:
77380 VISTA ROSA La Quinta, CA 92253,.-,. •'
City of La Quinta
-Floor
Feb 9, 2012
Equipment Typel
List knimumEfficiency2
Duct insulation
requirement
Conditioned
Area
Thermostat
❑ Package Unit
, 1
0 Furnace
D Indoor Coil
0 AFUE 80%
p SEER 14.0
❑ COP •
❑ HSPF
❑ F2 6 (CZ 10 13) ..•
Served by system
0 Setback
If not already present, must be
0 Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
6000 sf
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 -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 -6R 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 I11NOand (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 - -
CF -4R forms: MECH-21 and (for split systems) MECH-25
• .
For Split Systems: Duct leakage ,< 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Gr.- s-r.leage l .r
Unit Duct lealtasge'i 19 .. ... R♦ .l r
Exempted from duct leakage testing if: ` • ,` -
,❑ 1: Duct system was"documented to have been previously sealed and confirmed through HERS verification,'or•
❑ 2. Duct systems with less th6n,40 linear feet in unconditioned space, or ,
❑,3. Existing,duct systems are constructed, insulated or sealed with asbestos ,
❑'4. The system,w�ill not be Ducted'(iejDuctless-,_Mini-Split System).{Also Exempt-fromtRefrijerant=Charge)
~'"
❑ 2. New HVAC System
Required Forms: }, .
`_Y 1
s
Cut intor-Changeout with'
new ducts:`,(all new
A4 i X t �.� w �
CF 6R forms MECH-04, MECH.-20 HERS,land (for split systems) MECH 22 HERS, and '-.+►
ducting � all new
_,equip'
MECH 25 HERS, i�
+� = <. ref'►
CF -4R forms: MECH 20 and (for split systems) MECH=22 and MECH-25. E
For Split System's: Duct leakage <;6 percent; RC, CCA 2t 350'-CFM/ton; FWD, TMAH,-STMS, and either HSPP"or PSPP
For Packaged Units: Duct leakage' < 6 percerit
❑ 3. New Ducts with/or without
Required Forms: '
Replacement' , r
• '' .
. Includes replacing or installing all new
ducting and/or outdoor. condensing unit : R
CF -6R forms: MECH-04,•MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace.. No or some
CF -4R forms: MECH-20 and (for, split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage <' 6 percent;'RC, CCA 2_•_300 CFM/ton; TMAH .
For Packaged Units: Duct leakage < 6 percent °
P
114. New Ducting over 40 feet .'
Required Forms:
. Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-2I-HERS -
linear feet of duct in unconditioned space.'
,r•
CF74R forms: MECH-21
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) Y
. I certify that this Certificate of Co.mpliance'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 - • - : ` • • - -
. 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 Ceirtificate 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: Jim McEligot Signature: Jim McEligot
Company: VENVEST BALLARD INC w Date: Feb 9, 2012
Address: 2712 EAST LA CADENA DRIVE r:� License: 878533 '
City/State/Zip:, RIVERSIDE / CA / 9250.7 - Phone: (951) 276-9744
Reg: 212-A0007292A-00000000-0000 ;Registration Date/Time: 2012/02/09'17:57:46 HERS,.Provider: CalCERTS,yInc.• .
2008 Residential Compliance,Forms r '� l f• July 2010
. '. a ,. `4. •I _ , w - • ♦'1
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
'11•?,90 Building Permit Application and Tracking Sheet
Permit #
�'�-• °�
Project Address: , f
V \-j
Owner's Name: G £
A. P. Number: (.0r3 $ a O
Address:
Legal Description:
City, ST, Zip: 5
Contractor: ��
Address: -
Telephone: �� f ••aas�d
Project Description:
City, ST, Zip:
s��ie Ca- a; 4.0�dux
(� 1 gym.: y: >' :<>3;}ra ;.; ;>•,
Telephone:"1CJ� �1�'i x f %? ? ^;3
State Lic. # : cj City Lic.
'1 `
S S
Arch., Engr., Designer. A.
Address:
City., ST, Zip: ---+
� -bX- 5 SIE
Telephone:
State Lic. #: 4� 1...„ Y.f,Z
Name of Contact Person:
Construction T e: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
#Zk'jUnits:
Telephone # of Contact Person: 0i ,'a1 , q1
Estimated Value of Project: 25, QM
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
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
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A,I,P,P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees