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09-1016 (MECH)P'.O. BOX 1504 ,78-495 CALLE TAMPICO LA QUINTA,,CALIFORNIA 92253 Application Number: 0-9-7-000-0.1-- Property -9•-.000.0.11 Property Address: 52952 AVENIDA OBREGON APW 773-315-016-10 -000000- Application description: MECHANICAL Property Zoning:. COVE --RESIDENTIAL Application valuation: 6400 Applicant: Ta�/ .4 rev Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: LEO HUBBARD 7548 OLD SANTA FE SANTA FE, NM 87505 Contractor: CLAYTON AIR 951 HEDGES DIRVE CORONA;>'CA 92880 (714') 3:50-2116 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/21/09 TRAIL O6�0 hyo �`� �• lGSG� �✓ai Lid. No.: 868863 a; Air - -=-- - -- - - - = - ---------- - - ---- - - - - -----=---------- ------ ------------- -=-n- LICENSED CONTRACTOR'S DECLARATION - _ WORKER'S COMPENSATION DECLARATION hereby_ affirm under penalty of perjury that I am licensed urnder-provisions of Chapter 9 (commencing with i;hereby affirm. under penalty of�perjury=one.of the following;declaiations: 'Section'7600)•of;Division 3,of the:Business and Professionals Code,•and my License is,infull force and effect. _ I have`and'will maintain a. certificate of consentto self -insure for workers' compensatwn,'as provided License Class: C20-. License Novi ` 868863 - -for by Section MO of the Latior Code, for the performance, of. the work for which this permit. is issued. Date—u''� ntractor:..�--�"WV - ��wC - i _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performanceof the work for which this permit is issued. :My workers' compensation OWNER-BUILDERMECLARATION - - insurance carrier -and policy number:are: . I hereby affirm under penalty of perjury that'I am exempt. from .,the Contractor's State License Law for the Carrier' EXEMPT � Policy Number EXEMPT 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 workfor 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.lshould become subject to the workers' compensation provisionsof Section '. License Law (Chapter 9{commencing. withSection7000) of, Division 3.of the Business and Professions Code) -or . 3700 of the Labor Code, I shall forthwith comply with those provisions. ' ,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 I hundred dollar's (55001: (_ I 1, as owner of the property,,or my employees with wages -as their sole compensation,. will do the work, and the structure isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAIL RE TO SECURE WORKERS' COMPENSATION'COVERAGE IS UNLAWFUL, AND SHALL Contractors'. State License Law does notapply.to an owner of property who.builds orimproves thereon, SUBJECT AN EMPLOYE_ R TO 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 ($100 000). 'Iill�ADDI,TION TO THE COST. OF COMPENSATION, DAMAGES -AS PROVIDED FOR IN improvements are not interided 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: of completion, the owner -builder will have the burden of proving that he or she did'not build or ' improve for thepurposeof.sale.). �APPUCANT ACKNOWLEDGEMENT , (_) 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 io.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' Stateticense Law.). .. whose benefit work is performed.under or pursuant to any permit issued as a result of this application,. ( 1 I am exempt under Seca B.&P.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 oromission 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 I havereadthis application and state that the above informa ' rrect. 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 cons {' c ' n d h eby authorize representatives of t county to enter upon the above-mentioned propert r in a on ur oses Lender's Name: q ate: '( u'� 'nature (Applicant or Agent): Lender's Address: LQPERMIT Application Number . . . . . 09-00001016 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/20/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00. 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 ---------------------------------------------------------------------------- Special Notes and Comments INSTALL 5 TON PACKAGE HEAT PUMP & REPLACE DUCT'WORK.'2007 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited -- - - - - - - - - - - - - - ------ - - - - ------ - - - - ------ - - - - - - =--------- Due Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1:00 Grand Total 42.25 .00 .00 42.25 LQPERMIT Component':.Assembly Type (Wall, Roof, Floor, Slab Edge, Doors Frame Type - (Wood or; Ivietal • Cavity . J Insulation'' ` "R R-Value U factor (for.:wood; . " Joint:: Continuous metal frame ands Appendix • "Insulation mass IV ..R=Value asse'mlilies)' : Reference < ..: Roof Radiant Barrier -installed 'Yes or No Location Comments (attic,•garage, typidAl, etc. ,t " CERTIFICATE, OF COMPL:IANC•E RESIDENTIALf'a (Page 1. oYaS) CF 1R ... Project Title "'' Date ;' }'• , r'% BuildingPerrnt# Nv6t3AR" 0 D.e Rpt; Project Address A v OU 2FG t;A,�uT 2a G+ 1 aka 7� t;. Plan Ch ckT/Date 3 Documentation Author Telephone, ; r { F e A'd D j Compliance Method (Prescriptive) Climate 2oner _eco/ P Enforce,mentA encUse:Qnl ✓ ❑Alternative Component Package IV1eth'od::(check one) CDD (Alternative) fi, • Package'C and Package D choices`require HERS ratenfield,ve-rificatiori and/or diagnostic testing;(see CF -1R page 3) _ , For Package D Allernalive see'Appendix B' -Table l5•l =C Foo!n'o[es 744 _ GENERAL INFORMATION:. 'nA Total Conditioned Floor'Area (CFA)']('�ftZ Average Ceiling Height: q,0 ft Maximum AIIgwed`West•Facing Fenestration:Products Per Ta1)le 151184.r 151,=C -----(5%X CFA), ftz Maximum Allowed Total Fenestration Products Per Table.151-B1or 15.I'C-T-,-(20%X CFA) _ ft2 ✓ ❑ Building Type: (check one or more) X Single Family:'. Multifamily' Additiom Alteration (If adding fenestration fill :out WS -4R, Fenestration Maximum Allowed;., rea Worksheet -and see -Section 8.3.2 for Additions and, 8.3.3 for Alterations:).:;:•: Number of Stories: ( Number of Dwelling. Units:..::. ' Floor Construction Type: Slab 'aised Floor(ci•rcle one or,both) Front Orientation: North /'South /East / es /All Orientations.(input front orientation in degrees from True North . and circle one). ✓ 0 RADIANTBARRIER 4eguired in.climate zones LA •'8-15) OPAQUE SURFACES INCLUDING-OPAQU'E DOORS.. . Component':.Assembly Type (Wall, Roof, Floor, Slab Edge, Doors Frame Type - (Wood or; Ivietal • Cavity . J Insulation'' ` "R R-Value U factor (for.:wood; . " Joint:: Continuous metal frame ands Appendix • "Insulation mass IV ..R=Value asse'mlilies)' : Reference < ..: Roof Radiant Barrier -installed 'Yes or No Location Comments (attic,•garage, typidAl, etc. 1) See Joint Appendix IV in Section TV 2, TV.3.and'IV.4,,whicli is the.basis for,'the U=factoi•.criterion. U -factors can not exceed prescriptive value to show. ' equivalence to R -values. , Residential Compliance Forms k April 2005 N_t n CERTIFICATE OF COMPLIANCE wi'RESID'EN 1XI, (Page:.2 of 5) CF -1R Project Title BOV-6 A . `f'. ( N Date FENESTRATION PRODUCTS— U-FACTOWAND`.SHGC ✓ ❑ FENESTRATION MAXIMUM ALLOWED'AREA. WORKSHEET WS-4R'—must-be included for New Construction, Additions and Alterations. Fenestration #/Type/Pos. Orien- (Front, Left, tation, Rear, Right, N, S, E, Skylight) W1 Exterior Shading/Overhangs6 Area 0 -factor SHGC ✓ box if WS -3R is (ft) U-factor2=Source3. SHGC4 Sources included Tfiermostat Configuration Type (split or packa e 141EA-r M r j'&PPACKA 6 8 ❑ 13 1) Skylights are now included in West -facing fenestration area if the sky,lights.are=.tilted to the West or tilted in any direction when the pitch is less than 1:12. See § 151(f)3C and in Section 3.2.3 of the Residential Manual 2) Enter values in this column. are either NFRC Rated value or from Standards default Table 116A. 3) Indicate source either from NFRC or Table 116A, . 4) Enter values in this column from NFRC or from Standards Default Table 116B or adjusted SHGC from WS -3R. 5) Indicate source either, from NFRC or Table.] .1 6B. 6) Shading,Devices are defined in Table 3-3 in the Residential Manual and see WS -3R to calculate Exterior Shading devices. 7) See Section 3.2.4 in the Residential Manual. HVAC SYSTEMS Heating Equipment Minimurn Distribution Type and Capacity Efficiency Type and'Location furnace heat pump,boiler .etc. (AFUE or HSPF) (ducts .attic •etc., Duct or,}?iping R-Value :_. Tfiermostat Configuration Type (split or packa e 141EA-r M r j'&PPACKA 6 Cooling Equipment Type and Capacity Minimum (A/C, heat pump, evap.' Efficiency. Duct Location Duct Thermostat Configuration cooling) SEER.or EER) (attic, etc.) R -Value. T'r e' (split or package) 4A'r ouP At*i� a- e acka a Residential Compliance Forms April 2005 s y t, CERTIFICATE. OF WMPLIANCEa;.RESIDENTIAL :.(Page 3'of 5) CF -1R Project Title Date 9 SEALED DUCTS and TXVs (or Alternative^Measures) + A signed CF-4R'Form must be,provided to the Building department for•each• home for which the following. are required. ' ❑ Sealed Ducts all climate zones) installer.testin "and'certificationand HERS,rater field verification required.) ❑ TXVs, readily accessible (climate zones 2 and 8-15 only):' Tank Capacity 1 '(gallons) Installer testing and certification and HERS Rater• field verif cation:re uired. . ❑ Refrigerant Charge (climate zones 2'and 8-15 only) (Installer testing and certification and HERS Rater field ,,. verification required.) OR ❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs,(See Package`D Alternative Package Features for Project Climate Zone in the.RM Appendix B Table 151-C; Footnotes 7-14:, nu . For additions.and'alterations, duct systems thafare not`.documented to have been previously ❑ sealed as confirmed through field verification and diagnostic' ,tesiing:in,accordance with; procedures in the Residential ACM Manual and'duct systems with more than 40 linear feet in unconditioned spaces shall meet the requirements of Section 150(m) and duct insulation 'requirements of Package D. WAILKHLA 111VUlV51L'1VIJ - Iv Svstems serving single dwelling units Water. -Heater Type/Fuel Type Check box if system meets criteria of a "Standard'�systerim. Standard system. is one gas-fired water heater per ❑ dwelling unit. Ifthe.water heater is a storage type, 50'206ns-is.'the maximum capacity and recirculation system is Tank Capacity 1 '(gallons) not allowed. ❑ Check box when using Preapproved Alternative Water�Heating•table, Table 5-4 in Chapter 5 in the Residential Manual. No water heating calculations are required, and'fhe system complies automatically-. Check box if system.does not meet criteria of "Standard',' system;.and does not comply;w th the'Preapproved ❑ Alternative Water Heating table. In this case,,the Performance"M' e'thod must be used and must be included in the submittal ❑ Check box to verify that a time control is required for a recirculating system'.pump for a system serving multiple units < Svstems serving single dwelling units Water. -Heater Type/Fuel Type Distribution Type Number in System Rated input' (kw or 'Btu/hr) Tank Capacity 1 '(gallons) Energy Factor!. orI Thermal Effic iency Standby Loss % Tank. External Insulation R -Value —R Svstem serving multiple dwelling units Water Heater Type Distribution Type Number in System Rated Input' (kw or Btuthr) Tank . .'Capacity (P-allons Energy Factor' or Thermal Efficient Standby Loss % Tank External Insulation -Value —R 1) For small gas storage water heaters (rated inputs of less.than or'equal to, 75,000 Btu/hr),'electric resistance, and heat pump' water, heaters, list'Energy Factor. For large gas storage water: heaters (rated input of greater than 75,000 Btu/hr), list Rated Input, Recovery:Efficiency, Thermal Efficiency and Standby'. Loss. For instantaneous gas water heaters, list Rated Input and Thermal Efficiencies. Pipe Insulation (kitchen lines > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are '/4 inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2 B. Residential Compliance Forms April 2005 CERTIFI.CATE:OF COMPLIANCE'::RESIDENTIAL - :.(Page 4 of 5) Project Titlei- u a�aa� R€s IDF,tlC cr _ Date "� = 2 (- U SPECIAL FEATURES NOT.,REOUIRING: HERS. VERIFICATION Gadd extrasheets if neo Indicate which special features are,part of this project. 'The list below "represents special; features relevant to the and Performance Method-. - CF=1R ve ✓ Feature Re uired Forms if applicable) Description ❑ Metal Framed Walls CF -IR s ❑ . Radiant Barriers CF -1R ❑ Exterior Shades WS -4R N/A; Performance Calculation' ❑ Cool Roof Required.,Attach•CRRC Label to Forms. ❑ Dedicated Hydronic Heating Performance Calculation,. System Required-, Attach Run,toForms. ❑ Combined Hydronic System Performance Calculation Required; Attach Run to Forms, ❑ Gas Cooling N/A; Performance'Calculation Required. ❑ Buried Ducts N/A; Indicate: ori- 6uildin -, .laris ❑ Kitchen Pipe Insulation See Section -5 6 2 -Distribution Systems iri.•ResidentiZManual. Multiple Water Heaters, Per See Table 5-X13"6r'use ❑ Dwelling Unit performance Calculation and attach Run to Forms'. ' ❑ Central Water Heating System PerformanceCalculation•and s Serving Multiple Dwellings attach Run to Forms.;" ❑ Non=NAECA Large Water CF -IR Heater See Table 5-13 or use.,: ❑ Indirect Water Heater Performance Calculation,and� attach Run tosForms,- 'See Table -5-13 oruse ❑ Instantaneous Gas Water Heater Performance Calculation and .attach Run t6 -Forms See Table 5-13 or use • ❑ Solar Water Heating System. Performance Calculation and attach`Run.to*Forms ❑ Wood Stove Boiler Performance Calculation and attach' Run to Forms SPECIAL FEATURES REOUIRING, HERS RATER•' VERIFICATION (add extra sheets if necessarv),Indicate to the HF"RC Rater which creriitczarP nn' -4`;f:'thiElnrniect nnrl npprl itPrif—tinn ✓ Feature Re uired`Forrris`'`ifa' "licable"'^' Descri'tion ❑ Duct.Sealing ' CF -6R pah 4 : f•l2 ❑ Refrigerant Charge CF -611 part 5 --of 12 ` ❑ Thermostatic Expansion Valve CF -6R` ait 6 of 12• - Residential Compliance Forms September 2005 CERTIFICATE OF COMPLIANCE PRESIDENTT, (Page 545) CF -1R`` Project Title e ar z"^ Date' COMPLIANCE STATEMENT This certificate of compliance'lists the building:features=andspecification's needeU't�o comply with Title 24, Parts l and 6 of the Cal ifornia:Code of Regulations, aril the'adnihistrattye regulations to implement them. -This certificate hasbeen signed by the i.ndivtdual'wrth oveiall design responsibility. The undersigned recognizes that compliance using duct design, duct sealing, venfication of refrigerant charge and TXVs, insulation'installation,quality, and 66ildmg,envelope sealing regtiire`installertesting,and certification and:field verification by.an approved HERS rater. :. Designer or Owner (per Business and Professions Code),Documentation' Author Name:Name: lt�GNAR�` G 14 .. .• Title/Firm: ThlF rm . Address:RZUIES DZ, �cJ i �6�^- Address . y CA­.i'Lp Telephone: Tel'e'phone: License #: CA (signature) - 00). (dke), (signature) (date) Enforcement Agency April 2005 61 Bin # City .Of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tarnpico La Quinta, CA 92253 - (760) 777-7012 Building Pe rmi ' ' n and Tracking Sheet Permit # `� ' Project A r s: Jr -2q 5 2 N Eli I lA OBPE60A-� Owner's Name: A. P. Number: Address: 'IS t{%- OL'D . Sa✓TF1 F� -ra•Af 1, L tion:I If City, ST, Zip: SA StA EJ M s-7 SOS ractor: l i Tele n e ho e. 7 A ,� 6 z � t o � is A P L:t;e ss: °ts l VV ES DR . Project Description; pt p ca�►DtTIcuJ iii City, ST, Zip: COP40A CA; a2$8a 5 Tt?t) tkeAT PS2ap.PEStDENT(`g4. 'telephone: 7 t 0-21 L 3S to Efpll uC rc.xrP-k State Lic. # : $(o&k(o3 City Lic. #; Arch., Engr., Designer: Address: City, ST, Zip: h ne: Telephone: P Cori truc ' s trop Type: e: Ocuan c cY• P State Lic.* #. 0P oJ ect type �crrcleone : New A dd'n Alter Repair r Dem Name of Contact Person: S' tones: #Units: Telephone # of Contact Person: Estimated Value of Project: fo L(GQ - "v APPLICANT: DO NOT NE # 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 Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted J.Me6anical Grading plan 2°" 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 lel CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF -411 52-952 Avenida Obergon - La Ouinta, CA 92253 LINE CONSTRUCTION INC 1868869 Project Address Contractor Name / License No. Clayton Aire 09-1016 Contractor Contact Telephone Permit Number P I Van Vlymen 760-777-1724 136230 H Rater Telephone sample Group Number September 25, 2009 CC14-1798476812 Date Certifying signature V Cert ncate Number HERS Provider:CalCERTS, Inc. Firm: Air Experts JrAConditioning City/State/Zip:La Quints / CA / 92247 Street Address: PO Box 94 Copies to: Homeowner HERS Provider and Building Department This CF -4R has been registered with the CaICERTS@ registry in accordance with the Title 24 & Title 20 of the CCR. CaICERTS@ is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was 0 Tested approved as part of sample testing, but was not tested. As the house with the diagnostic tdiagnosticHES rater providing testing verification, on ested comp) an erequirrem ntsas checked o tsorm The HERS reIdentified atermust check and I verify that he news formlies distribution system Is fully ducted and correct tape is used before a CF -411 may be released on every tested building. The HERS rater must not release he CF -411 until a properly completed and signed CF -611 has been received for he sample and tested buildings. The Installer has provided a copy of he CF -611 (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; lubber adhesive duct tape is Installed, mastic and drawbands are used in combination with cloth backed rubber adhesive duct. tape to'seal leaks at duct connections.-_-. ^^-.�• T-�^c i+e�n.T. L,6MINIMIJM RE UIREMENTS F.OR DUG V Le415Kw2c Mcaiaia Fay.. a....-•� �-�-•---- _.____ _ _ NEW CONSTRUCTION Measured Duct Pressurization Test Results (CFM @ 25 Pa) Values N/A 1 - 2 Fan Flow: Calculated (Nominal � Cooling',_) Heating) or'--_•' Measured 2000 Enter Total Fan Flow In CFM: 3 N/A N/A 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 Duct 4 System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Dud System for 96 5 Dud System Alteration and/or Equipment Change -Out. Enter Reduction in Leakage for Altered Dud System 6 [Line 4 - 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°% [ 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: 4.80% ©Pass El Fall 9 Pass if Leakage Percentage < 15°% [ 100 x ( Line 5 / Line 2 )]: 10 Pass If Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: ❑ Pass ❑ Fall Pass If Leakage Reduction Percentage >= 60°% [ 100 x ( Line 6 / Line 4 )j ❑ Pass ❑Fail 11 and Verification by Smoke Test and Visual Inspection 0 Pass El Fail 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection Pass if One of Lines #9 through #12 pass 0 Pass ❑ Fail https://www.calcerts.com/certificate_print.cfm?lots=0,136230&UseCF4R=1&cert type_id... 9/25/2009 __JL_ A! is ornarrinf;wn IU afhnA _ 14VAC.nnly Alteration CF -6R -ALT --- Paged Title: _ Date: ® 2005 CalCERTS CC- kc( zs Q 1climedzon riouiilert : use Project Address: . BunePemlas 5 2q s2 A�� (► Installing Contractor. Telephone: Plan deck Date CIL op A to Ch4APj_) CU�qim__� �ta13so- zu� Company Name: FIM Gledi Date IMPORTANT: This CF -6R form is only for use when an HVAC -only afteroon is made to an existing home Use one form for each system being aftwed This is system #_ j_ of systems altered in this house. Copies to-- Homeowner, HERS Rater, and Building Department List the specifications for the newly installed equipment. These must match the installed -equipment exactly: Installed equipment must match typeiflocation and meet or exceed efficiencies/R-values from CFAR - Equipment T Manufacturer Model Number Efficien Load" Ca a Furnace AFUE Heat Exchanger NIA Heat Pump fan coil MIA Hydronic fan coil NIA Other FAU Describe Package gas/AC AFUE SEER SEER Padcageheatpump Rf4EmcAJA S-rNJDAPt) WC* TOtzcA HSPF too K �J SEER EER' A/C Condenser SEER Heatpump Condenser HSPF SEER Indoor DX col EER' Hydronic coil Provide EER if needed for compliance (fine 24 of CFARAM. Installer must provide adequate documentation to verify EER in some cases -the specific furnace may need lobe verified in order -to achieve a specific EER In some -cases a time delay relay and/or TXV may.need to ve verified. in order to achieve a.specific EER. Loads are sensible for cooling. Capacities are sensible at design conditions for cooling and adjusted altitude, downflow, etc.) output for heating. TW O If TXV is required by the CFA R form (fine 23 on CFAR-ALT form), it has been installed and access has been provided for visual verification by HERS rater. Sampling is allowed for TXV verification. EntireIy New Dud System: (Line 5 of CF -1 R ALT) J� ' For Entirely new dud systems, the required leakage is 6% rather than t5% for altered systems_ The aftemative to dud sealingby increasing the efficiency of the equipment is not an o tion for entire new dud I, the undersigned; verify that the -equipment. listed above is. 1) the actual•equipment installed in the home; 2) equal to.or more efficient than required by the Certificate of Compliance (CF1R-ALTform);.and3) equipment that meets or exceeds the appropriate requirementsfor manufactured devices (Appliance Efficiency Standards), where applicable. I, the undersigned, verify that diagnostic test results fisted on this form were performed in conformance with the requirements for compliance and that the newly installed or retrofitted mechanical system components conform with the Mandatory requirements specified in A50(m) of the 2005 Building Energy Efficiency Standards_ i Installer Notes: version 03_1U_ b . • oy- • � This form can only be used on projects being verified by Ca10ERTS cert"med raters. www.calcerts.com 0. Installation Certificate Prescriptive Method - HVAC -only Alteration CF -6R -ALT Project Tide: �{) t3t34�R�17 • RE5 i t � i3CE Date 0.2005 LaICERT.S IMPORTANT: This .CF -6R form is only for use when an HVAC -only a teration.is made.to an_existing bowie Use one form for- each. system being. altered. This is.system # of systems- altered in- this Boase_ Copies to: Homeowner, HERS Rater, :and Buildmg Department Duct Leaks test -Results duct testing. is.required.perCF 1 R-1LT form step 1 -Pretest Leakage of the Wtern before any mons This testis and is used for.the 60%4educlion option 1 Pre4e'stleakage' ICRA25 2 Line a x O4 = for60%redndion Step 2 - petermineTotal 3 Fan taarit Use any ofthese methods: Use values for eaul atter alterations. Cooling: Condenser tannage: tons.x400 CFMfton = 7-1-22 4. Heating: Furnace BWh x.0217 CFKtMWh = 5 6 Measured: (mferto ACM Manual Appendix RE, section 4.1) = CFM Measurement method: - 0 flow hood 0- plenum pressure matching Dflow grid' 7 Total system fan flow value to be used: use•hi est of lines 3, 4 . orb. Step 3 - Determine T 8a Total -System fan flow fine 7 from above) x o.os = FM2S = 6% leakage target (new duct -systems) 8b Total System fan.tiow (lire 7 trait above) x 0.15 = = 15% leakage target 9'Total System fan flow Oine 7 from above x 0.10 = ICFM25 =10% leakage to outside target Step 4 - Attetations: 10 ❑ Must be consistent with the CF -IR form. Seal all new,conneclons with approved materials. 11 ❑ No nevAy coknstnicted portions. of the system can have unduded building caves W convey system air. Ilf 12 P addmg or mplacing more than 40 feet of duct, insulate new ducts per package b for that dmnate Zane step 5 -Final leakage dud teakage.test. for 16% total and 60% reduction) 13 leakage Wo LCFWS refer to 2005 ACM appendix RC, Sections RC.4.3.1.. 4a ❑ if fl hes than line house passes the 6% leaks uireme Go.to 9. 4b W if line 13 is less than line W house passes the 16%.leaka enL.Go to, .9. 15 ❑ K tine 131s less than tine house passes the 60% reduction requirement. continue. 16 ❑ Y If either of fipes 14a, 14b or 15 are checked. HERS verification is required. Sampft can be.used. 17 ❑ If One 15 is checked; but not 14a or t4b, Smoke Test and Visuar inspection of Accessible Duct Sealing is required. Go to.Step e Step 6 -Leakage to Outside: Similar to a regular duet blaster test but the house is pressufted to 25•pascais at the same time: 18 leakage ICFM25 refer to 2005 ACM appervcnk RC Sections -RC 4.3.3 19 ❑ H line.18.1s.tess.than Bite house passes.the 10%leakage to outsWrectuirentent. 20 ❑ If fine 19 passes, HERS verification is.reguired. Samp ing.can be.used. Step 7 - It the house.does. notpass any of lines 14, 15 or 18. 21 ❑ Smoke Test and Visual Inspection.ofAccessible DuctSeafinq Isfecluired. SmStepS. 22 Q nstail.requked Label per ACM RC Sections RC.435. Step 8 - Smoke Test and Vsual Verification fSee 2005 Residentiai.ACM dons RC -4.3.5-7) 23 ❑Perform smoke test per ACM Appendix RC SectiaeRC 4.3.6. .24 ❑ Perfmon Visual. and of 4wis •ACM Seedo=,RC 4:3.7. 25. ❑ Seat boots tosuffounding, material- AM RC. Sections RC 4:3_?. HERS V ' tion 26 IE line 14's checked: 15% leakagetabe vaffie&by HERS rater is allowed. 27 17 ' !f Gne 15 is4hedked. 6o%4eakage reduction -to be verified byHERs rater fposttestoray) AND Smoke -Test and Visual-Verifikatiarto be ed by HERS Rater. Sampling is allowed 28 13 iffine 19 is.chedked 10% leakage -to oatsideto be, verified by 0ERS rater. 'Sampling isakowed. 29 Q Knone, offines 14, 15 or 19 am-checked-SmokeTest-and-fix all acoessable leakes. No sampfing allowed Sampling - On QJwuse passes on fates 14,15 or 49. 3a Q 12.) IJ -Homeowner chooses to be put into a group of homes for random third party HERS sampling. Homeowner, MS611erarnd ratermust sign the three -party agreement 3.),Alt above tests must be completed by the installer or their representative, not the third party. rater. NoSampli -Mousedoes- not pass by firm 14.15 or19' ORitomeowner chooses- not to be pan of a sample group 31 t.)- House to be tested by a third party HERS rater selected by installer. 2.) Homeowner, inslaDerand ratermustsignthet mee-party agreement 3.) Alt above tests may be completed by the installer or their representative, and then verified by a third party rater. OR all above tests ww beperformed theWrd party rates 32 ❑ 1.) House to be tested by third party HERS rater selected by homeowner. 2-) All above tests may bemmp6ted.,byttie-instafferoriheir representative, and then verged by a third party rater. OR all above tests may be performed solely by the thin! party rater_ Version ,03-10-06 Page 2 of 2 This form can only be used on projects being verified by CaICERTS certified raters: www.calcerts.com