BMCH2015-041478-495 CALLE TAMPICO Q.�i ���! I IIIIII'IIII II'I I"I VOICE ( )760 777-7125
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LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING -PERMIT
Date: 10/26/2015
Application Number: BMCH2O15-0414%11 "�� yiO, ner:
Property Address: 49030 VISTA ESTRELLA �#JAMES TANNER
n
APN: 602240005 _ ��'�� 49030 VISTA ESTRELLA
Application Description: TANNER RESIDENCE / HVAC CHANGE OUTS VLA QUINTA, CA 92253
Property Zoning:
Application Valuation: $65,033.00 4
Applicant: Contractor:
IE INC HARRISON ENTERPRISES INC DBA GENERAL AIR
31225 LA BAYA 31170 RESERVE DRIVE
WESTLAKE VILLAGE, CA 91362 THOUSAND PALMS, CA 92276
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C20. C36 License No.: 68631.0
Date: 10Zb L! Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(_)1, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that
he or she did not build or improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
(_) I am exempt under Sec. . B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's
Lender's
(760)601-3500
Llc. No.: 686310
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: Policy Number: _
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner 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, I shall forthwith
comply with those provisions.
Date: 10 b Applicant:
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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless 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 is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: 10 i Signature (Applicant or Agent):
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT . PAID.
PAID DATE
BSAS SB1473 FEE = 101-0000-20306 0 $3.00 $0.00
SAID BY METHOD RECEIPT #:. CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $3.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$290.08
$0.00
PAID BY
= METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$145.04
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for CHANGEOUT: $435.12 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
Description: TANNER RESIDENCE / HVAC CHANGE OUTS
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 10/26/2015 MFA
Approved: 10/26/2015 MFA
Parcel No: 602240005 Site Address: 49030 VISTA ESTRELLA LA QUINTA,CA 92253
Subdivision: TR 29457-1 Block: Lot: 81
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $65,033.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
NAME TYPE
Details: (4) HVAC CHANGE OUT- 14 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. PER 2013 CALIFORNIA BUILDING CODES.
__j Applied to Approved
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
IE INC
31225 LA BAYA
WESTLAKE
VILLAGE
CA
91362
(760)564-0296
CONTRACTOR
HARRISON ENTERPRISES INC DBA
GENERAL AIR
31170 RESERVE DRIVE
THOUSAND
PALMS
CA
92276
(760)564-0296
OWNER
JAMES TANNER
49030 VISTA ESTRELLA
LA QUINTA
CA
92253
(760)564-0296
FINANCIAL INFORMATION
Printed: Monday, October 26, 2015 10:17:50 AM 1 of 2 0r#? _
' SYSTEMS
BOND INFORMATION
Printed: Monday, October 26, 2015 10:17:50 AM 2 of 2
SYSTEMS
CLTD
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$3.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $3.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$290.08
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$145.04
$0.00
SPLIT -SYSTEM PC
Total Paid for CHANGEOUT: $435.12 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
BOND INFORMATION
Printed: Monday, October 26, 2015 10:17:50 AM 2 of 2
SYSTEMS
Bin.#
Crty of La Quina
Building u Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Permit' Application and Tracking Sheet
Permit #
Project Address: 49030 Vista Estrella
Owner's Name:. Jim Tanner
A- P. Number.
Address: 49030 Vista Estrella
Legal Description:
Contractor. General Air Conditioning
City, ST, Zip: La Quinfa, CA 92253
Telephone: 760-564-0296 ` MFS">g'�
epone: yrs• �
Address: 31170 Reserve Drive
Project Description: Replace 4 HVAC Systems - (1) Ston
City, ST, Zip: Thousand Palms, CA 92276
A/C, Coil, & 70,000 BTU Furnace, (2) 4ton A/C, Coil,
Telephone: 760-343-7488
4 ,A'`
& 90,000 BTU Furnace, 1 2.5ton Heat Pump & Air
State Lic. # : 686310
City Lie'. 9.
Handler
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone:
State Lic. #:vFj y
Name of Contact Person: Steven Schnierer
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft: #Stories: # Units:
Telephone # of Contact Person: 818-735=7876 x 1
Estimated Value of Project $65,033.00.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACICYIVG
PERMIT FEES
Plan Sete
Plan Check submitted
Item Amount
Structural Calci.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calm
Called Contact Person
Pian Check Balance
Tide 24 Calci.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Giading plan
2i1 Review, ready for correctionstissue
Electrical
Subcoetactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IM HOUSE:-
''" Review; ready for corrections/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr '
Date of permit Issue
School Fees
Total Permit Fees
STATE OF CALIFORNIA
ALTERATIONS - HVACJS�en=,
,'CEC-CF1R-ALT-04-E Revised 03/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF111-ALT-04-E
Alterations -.HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Pagel of 1)
Site Address:
qq 02,0 V ; E__�V aco,
Enforcement Agency:
Dae Prepared:
Permit#:
ska
C L46, 0iD
s
Equipment Type
Equipment Efficiency
New bucting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (s ft)
❑ Packaged B[Evaporator Coif
System JB(Compr Condensing Unit
t AFUE COP
fl R"6 (CZ 2, 8-13) Ducting
Served by system
❑ Setback
(Split System ❑ Compressor
SEER HSPF
❑ R-8' (CZ11, 14, IS)Ducting
4,2-40 sgft
(Ifnotalready
❑ Mini Split ❑
❑ R-6 (all CZ's) Plenums
present, must
($Furnace ❑ TXV
TXV
EER
❑ R-5 or R7.5) Uneset°
be Installed)
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site:
;X1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF1R-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20•HERS,. MECH-(23 or 24)' -HERS, MECH-25-HERS=
Compressor, TXV, Uneset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS=, MECH-25-HERS=
Air Handler/Furnace' (Can include new ducting)
Installer Requirement: Duct leakage (< 15%.or < 10% to outside, or seal all accessible leaks), Air Flow 2 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, Insulated or sealed with asbestos (list manufacture date of building _ 1
❑ 2. New HVAC System
Required Compliance Documents, to be. left on site for Final:
All new equipment and All New Ducts'
CFiR-ALT-02-E
including Mini Split
CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS'
Mini Splits require CF1R-ALT-02-E,'CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow a 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement
Required. Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following
CF1R-ALT-02-E
replaced: Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace'
CF3R: MECH-20-HERS, MECH-(23 of 24)-HERS,.MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet
Required Compliance Documerits to be left on site for Final:.
New ducting but less than All New Ducts'
CFIR-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (< 15% or, <10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
'All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
' Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
' All New Ducts is'when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material) -
4 R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 Inch. Most mfg will require Suction line Diameter
with Insulation as the following 1.547-26/e", 2.5-3T-2%", 3.5 to 4r-2%", ST -4%"
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and Correct.
2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document.
3. 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 (CCR).
4. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the CCR.
5. The building design features or system design features identified on this Certificate of Compliance are consistent with the information .
on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement
provided
agency forApproval with this building permitaplication.
Date Signed: Ucense:
Re5pon5lble Designer Name: Re ansible Designer Si nature:
�— iD�z,li5 (0$(0310
Company: Address: G�c /State/Zip: Phone:
�ex�er �� A�� �d:F�av,ic� 31� 7v 12e scxv�r (housa.cl a�rns 9227 _7roo-l3-��+8fi
_.1:_..... , _Qnn_-777_aann
For assistance or questions regaramgcne energyawnuc1��, �..••w�• •••� �••�•d. ••--
STATE OF CALIFORNIA
ALTERATIONS - HVAC Q
I'
CEC-CF1 R -ALT -04E Revised 03/15 CALIFORNIA ENERGY COMMISSION T
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly. CF -SR -ALT -HVAC) (Page 1 of 1)
Site Address:
v-% Esi-c a,,
Enforcement Agency:
Dae Prepared:
Permit#:
qq 030 S�-:X
!DL7lS
Equipment T
Type
Equipment Efficiency
New ucting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged
XEvaporator Coil
261 AFUE
COP
❑ R-6 (CZ 2, 8-13) Ducting
Served by system
11 Setback
System
1K Split System
3B[ Condensing Unit
❑ Compressor
14
❑ R -8t (CZ 11, 14, IS) Ducting
� O
X24 sgft
(Ifnotalready
❑ Mini Split
❑ Lineset
SEER
HSPF
11R-6 (all CZ's) Plenums
present, must
be Installed)
i$Fumace
11 TXV
EER
❑ R-5 or R7.5) !!Wesel°
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final ins ection=all forms are to be registered (no hand filled forms allowed) and a copy left on site.
91. HVAC Changeout/Repai.r
Required Compliance Documents to be left on site. for Final:
All Equipment,
CF1R-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS2
Compressor, TXV, Uneset,
CF3R: MECH-20-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS
Air Handler/Fumace2 Can include new ducting
Installer Requirement: Duct leakage (515%, or < SO% to outside, or seal all accessible leaks), Air Flow 2 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct In unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building )
❑ 2. New HVAC System
Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts'
CF111-ALT-02-E
including Mini Split
CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HER52, MECH-25-HERS2
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage:5 6%, Fan Efficacy (.58W/CFM), Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
113. All New Ducts with Replacement
Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following
CF1R-ALT-02-E
replaced: Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Uneset, Furnace2
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage:5 6%, Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from dud leakage testing if: ❑ 1. Existing duct systems are constructed, Insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Dud leakage (< 15% or, < 30%to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing dud systems constructed, insulated or sealed with asbestos.
' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
' All New Duds is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
° R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%", 2.5-3T-2%", 3.5 to 4T-2%", 5T-4%"
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document.
3. 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 (CCR).
4. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part -6 of the CCR.
5. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement
agency forapproval with this building permit application.
Responsible Designer Name:
�} S'
GV G C Yl\ 2C'�
Res onsible Designer Signature:
' �
wt.tirL �
Date Signed:
Ifl�24IIS
License:
10$(0310
Company:
Address:
S�mState/tp:
Phone:
Genexc,\ r- Cox d:� iotnir�
Ai
311-10 e_s", e- �r
llnousov. c.� 9zz7
%(00— 3c} 3 7� 8�
For assistance or questions regarding the Energy standards, contact the energy moame at: i-auu-i it.-»uu
STATE OF CALIFORNIA I„}
ALTERATIONS - HVAC
CEG-CFIR-ALT-04E Revised 03/1 — CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address: ` I
'49 • V 03 i --k G 3 k, e, C
Enforcement Agency:
eiO4' La. Qom.)
Date Prepared:
1 D zi- 1 S
Permit#:
Equipment Type
Equipment Efficient Y
New Ducting, Plenums, Lineset.
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged
g
Evaporator Coil
COP
❑ R-6 (CZ 2, 8-13) Ducting
Served by system
Setback
System
❑ Split System
$Condensing Unit
❑ Compressor
_AFUE
I';
-7--7
0R-8' (CZ 11, 14, 15)Ducting,
'+,24D sgft
(if not already
❑ Mini Split
❑ Lineset
SEER
HSPF
❑ R-6 (all CZ's) Plenums
present, must
❑ Furnace
❑ TXV
EER
❑ R-5 or R7.5) Lineset°
be installed)
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final Inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
X1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF111-ALT-024
Condenser Unit, Evaporator Coil,
CF2R: MECH-OS, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS2
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Air Handier/Furnace' Can include new ducting)
Installer Requirement: Duct leakage (:S.15%, or < 10% to outside, or seal all accessible leaks), Air Flow 2 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There Is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building -1
❑ 2. New HVAC System
Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts'
CF111-ALT-02-E
including Mini Split
CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Mini Splits require CF1R-ALT-02-E; CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage:5 6%, Fan Efficacy (.58W/CFM), Air Flow z 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Duds with Replacement
Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following
CF111-ALT-024
replaced: Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Uneset, Furnace'
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing If: ❑ 1. Existing dud systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (5_15% or,: 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
' All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the.
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
° R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5 -2T -2:a", 2.5-3T-2%", 3.5 to 4T-2%", 5T-4%"
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document.
3. 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 (CCR).
4. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the CCR.
5. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents, worksheets; calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Responsible Designer Name:
Responsible Designer Signature:
Date lgned:
license:
ev r� V-�e�
_w �
to z� tS
j�g(o3tc�
Company:
l5eine-rs\ /air
Address:
31
CI 5 ate/Zip:
Phone:
760--3143--74'88
i
\70iZ v
v .L,
For assistance or questions regarding the Energy Standards, contact the tnergy notune at: i-auu-i is-33uu
STATE OF CALIFORNIA
ALTERATIONS - HVACsylexy-1 ~
-7
CEC-CFIR-ALT-04E Revised 03/15 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPUANCE CFlR-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) : (Page.1 of 1) -
Site Address:
Est-cemc,
Enforcement Agency:
Dae Prepared:
Permit#:
qct p3o
C-
6a LS
Equipment Type
Equipment Efficiency
New ucting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑Pack' ed
Packaged
$Eva orator Coil
p
�� AFUE
COP
❑ R-6 (CZ Z, 8-13) Ducting
Served by system
❑Setback
System
gCondensing Unit
+
❑ R-8 (CZ 11, 14, 15)Ducting
4 0 s qft
(if not already
WL Split System
❑ Compressor
14 SEER
HSPF
❑ R-6 (allCz's) Plenums
X24
present, must
❑ Mini Split
❑ Linesetbe
EER
❑ R-5 or R7.51 Lineset°
installed)
NFurnace
❑ TXV
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
J:1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF1R-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS' ,
Compressor, TXV, Uneset,
CF3R: MECH-20-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Air Handler/Furnace= Can include new ducting)
Installer Requirement: Duct leakage (< 15%, or < 10% to outside, or seal all accessible leaks), Air Flow z 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing If:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, Insulated or sealed with asbestos (list manufacture date of building
❑ 2. New HVAC System
Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts'
CF1R-ALT-02-E
including Mini Split
CF2R: MECH-O3, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy .58W/CFM), Air Flow z 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following CF1R-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace2 CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if. O 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feetRequired
Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts'
I CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (< 15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
I All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. Thisincludesin walls, between floors etc.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
' All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
° R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5 -2T -25/a", 2.5 -3T -2V4", 3.5 to 4T-2%", ST -4%"
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
1 certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document.
3. 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 and6 of the California Code of Regulations (CCR).
4. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the CCR.
S. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Responsible Designer Name:
�evG Sc�r,�exer
Res onsible Designer Signature: ^,
u � res---
Date Signed:
tflf 2-61 IS
Ucense:
(9a(o310
Company:
Address:
9—q/—StateRp:
Phone:
6ex,�r�1A��Gc�r ack�ov,in
3t\-fC> e-sexxve--1 r
92x1
-7coo-343-7488
For assistance or questions regarding the Energy btanaaras, contact the energy nowne di: i-ovu-i.