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12-1356 (MECH)lP.O. BOX 1504 78-495 CALL TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: - _. ' 12-00001356-1 _ Property Address: 54639 RIVIERA APN: 775-031-015- - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 7800 4 t!'ft�Gv VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Owner: VAN WILLIGEN 54639 RIVIERA LA QUINTA,. CA 92253 Contractor: Applicant: Architect or Engineer: PREC H & A INC P.O. BOX 11090 PALM DESERT, CA.92255 (760)776-1550 L,/ //y Lic. No.: 818759 Date: 11/15/12 tNO Q 0 V 15 20:12 CITY OF LA QUINTA FINANCE DEPT. r ------------------------------------------------- -----------------------------------------------— 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 I.hereby 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 Orovided Lice se Class: C20 C36 License No.: 818759 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: ontractor: _./ r.,4A v Vim— I h �ave 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 OWNER -BUILDER DECLARATION 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 TRUCK INS EXCHN Policy Number N 2008 71 19 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 Code) or 3700 of the Labor Code, shall forthwittycomply 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 hundred dollars ($500).: Date��f�-licant: (_ 1 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, . SUBJECT AN EMPLOYER 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). 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 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.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 1 _ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT APPLICANT ACKNOWLEDGEMENT IMPORTANT. Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives oft county, to enter upon the above-mentioned property for in ection purpose . Date: !! f / ignature (Applicant or Agent) Application Number . . 12-00001356 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 66.00 Plan Check Fee 16.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/14/13 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 ..9.0000 EA MECH FURNACE <=100K 18.00 2.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 -------------------------------------------------------------- ------------- Special Notes and Comments HVAC CHANGE -OUT: INSTALL (2) PACKAGE UNITS. 2010 CODES ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 66.00 .00 .00 66.00 Plan Check Total 16.50 .00 .00 16.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 83.50 00 .00 83.50. LQPERMIT J t Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 54-639 Riviera.La-Quinta, CA 92253 City of La Quinta Nov 15, 2012 .• Dud insulation Conditioned Floor Equipment Type1 • List Minimum Efficiency2 requirement Area Thermostat 10 Package Unit ❑ Furnace E:) Indoor Coil ® AFUE 78% ®SEER 13.0 [3 COP E3 HSPF 13R 6 (CZ 10-13) Served by system ® Setback If not already present, must be [3 Condensing Unit ❑ EER ❑ Resistance - [3 R 8 (CZ 14-15) 1200 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 -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. ® 1. HVAC Changeout Required Forms: . All HVAC Equipment' CF -611 forms: MECH-04, MECH-2I-HERS a^a (fee plat ..,.-«..ms) MEGH 25_14EoS replaced CF -4R forms: MECH-21 -•^a (f^- Split systems) 04EGH 2 . Condenser Coil and /or Indoor Coil and /or I • _y_t_ffis) N_GH-7G-HERS CF -611 forms: MECH-04, MECH-2I-HERS and (frac split.. Furnace r. CF -4R forms: MECH-21 and (09F -^t-` ,�H_25 systems) - For Packaged Units, Duct leakage < 15 percent Exempted.from duct leakage testing if: '❑ 1. Dud 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 [13. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. The-syst6hi'lwill not be Ducted (ie.:Ductless-Mini=Split:Sys. em)(Also.Exempt-from:Refrigerant-Charge) ❑ 2. New HVAC System Required Forms: M J f 11 j . Cut inlor,Changeout with, new ducts: (all new ' *- a CF -6R forms: MECH-04, MECH=20-HERS, and'(for split systems) MECH-22 HERS, and Y ducting And all new . MECH: 25 -HERS '' /' +` CF -4R forms: MECH-20, and (for split systems) MECH-22, and MECH-25 /n e ui ment _ q p ) -a 1 i# i }r �..d ..+ L ..r w .. For Split Systems: Duct leakage < 6 percent; RCS CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units:,Duct leakage < 6percent. r . - ❑ 3. New Ducts with/or without Required Forms: Replacement ;+ . 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 -411 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 ❑ 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: Gerald Dobbins Signature: Gerold bobbins Company: PREC H & A INC - Date: Nov 15, 2012 Address: P O BOX 10991 License: 818759 City/State/Zip: PALM DESERT / CA / 92255 Phone: (760) 776-1550 Reg: 212-A0064439A-000000000-0000 Registration Date/Time:,2012/11/15 11_:26:20 HERS Provider: CalCERTB, Inc: 2008 Residential Compliance Forms + Ju ly 2010 t ' Reg: 212-A0064441A-000000000-0000 Registration Date/Time: 2012/11/15.11:27:26 HERS Provider: CalCERTS,.Inc.` 2008 Residential.Compliance Forms - July 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 ' Site Address: Enforcement Agency: Date: --7Permit #: 54-639 Riviera La Quinta, CA 92253 City of La Quinta Nov 15, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ® Package Unit, , ❑ Furnace ® AFUE 78% ❑ COP ® Setback p Indoor Coil ❑ R 6.(CZ 10-13) Seryed by system ® SEER 13.0 p HSPF If not already present, must be ❑ Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14'15) .32,00 sf installed) ❑ Other - , t 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 -1k 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 (fnr Split systems) P49GH-25-w___ replaced CF -4R forms: MECH-21 �� + ��- �� • •stems) P49GH_2 • Condenser Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS ,Ra io-F ....l:. _ stems) NEGH _-W_^_ • Indoor Coil and /or CF -4R forms: MECH-21 a rc split systems) ,,_. ,_ • Furnace For Packaged Units: Duct leakage < 15 percent 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 than 40 linear feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. The -system will not be Du_cted'(ie.,Ductless,Mini=Split System)T(AIso-Exerript-from -Refrigerant-Charge) ❑ 2. New HVAC System Required Forms: . Cut in'or Changeout with>' r CF 6R forms: MECH-04, MECH-20-HERS, and'(for split systems) MECH'=22=HERS, and' new ducts: (all new MECH,-25 HERS / �' A 1 ducting all new CF -4R forms: MECH-20; and (for split systems) MECH-22, and MECH-25) equipment)�+� ti ; + 4_ti ++ .. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD,.TMAH, STM_S, and either HSPP or PSPP. For Packaged Units Duct leakage < 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement i . 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 ` [3.4. 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 ❑ 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: Gerald Dobbins Signature: Gerald bobbins - Company: PREC H & A INC Date: Nov 15, 2012 , Address: P O BOX 10991' License: 818759 City/State/Zip: PALM DESERT/ CA / 92255 Phone: (760) 776-1550 ' Reg: 212-A0064441A-000000000-0000 Registration Date/Time: 2012/11/15.11:27:26 HERS Provider: CalCERTS,.Inc.` 2008 Residential.Compliance Forms - July 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 ' Site Address: Enforcement Agency: Date: --7Permit #: 54-639 Riviera La Quinta, CA 92253 City of La Quinta Nov 15, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ® Package Unit, , ❑ Furnace ® AFUE 78% ❑ COP ® Setback p Indoor Coil ❑ R 6.(CZ 10-13) Seryed by system ® SEER 13.0 p HSPF If not already present, must be ❑ Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14'15) .32,00 sf installed) ❑ Other - , t 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 -1k 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 (fnr Split systems) P49GH-25-w___ replaced CF -4R forms: MECH-21 �� + ��- �� • •stems) P49GH_2 • Condenser Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS ,Ra io-F ....l:. _ stems) NEGH _-W_^_ • Indoor Coil and /or CF -4R forms: MECH-21 a rc split systems) ,,_. ,_ • Furnace For Packaged Units: Duct leakage < 15 percent 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 than 40 linear feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. The -system will not be Du_cted'(ie.,Ductless,Mini=Split System)T(AIso-Exerript-from -Refrigerant-Charge) ❑ 2. New HVAC System Required Forms: . Cut in'or Changeout with>' r CF 6R forms: MECH-04, MECH-20-HERS, and'(for split systems) MECH'=22=HERS, and' new ducts: (all new MECH,-25 HERS / �' A 1 ducting all new CF -4R forms: MECH-20; and (for split systems) MECH-22, and MECH-25) equipment)�+� ti ; + 4_ti ++ .. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD,.TMAH, STM_S, and either HSPP or PSPP. For Packaged Units Duct leakage < 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement i . 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 ` [3.4. 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 ❑ 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: Gerald Dobbins Signature: Gerald bobbins - Company: PREC H & A INC Date: Nov 15, 2012 , Address: P O BOX 10991' License: 818759 City/State/Zip: PALM DESERT/ Bin.# Oty, of b Qufnta Building SL SafetyDivision P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 -=(760) 777-7012 Building Permit Application and Tracking Sheet Permit # ` Project Address: �-�3 Owner's Name:. A. P. Number. Address: S Legal Description: City, ST, Zip: Contractor. s�> ` Telephone Address:-11d'-7dProject Description: City, ST, Zip: JFrG . Telephone: Q 7 >6_ SJRa State Lic. ft: ,� Arch., Engr., Designer: City Lic. M. Address: City, ST, Zip: Telephone: State Lic. #:. Name of Contact Person:�Q f � f <.,..'r�» Construction Type: . Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: #Stories: # Unit,s: Telephone # of Contact Person: - %f rd Estimated Value of Project d APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Rcq'd ' Rcc'd TRACMG PERMIT FEES Plan Sets Pian Check submitted Item Amount Structural Cities. Reviewed, ready for corrections Plan Check Deposit, Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cala. Plans picked up Construction " Flood plain plan Plans resubmitted.. Mechanical Grading plan 2'4 Review, ready for correctionstissue 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/issoe Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 54-639 Riviera, La Quinta'CA 92253 (System 1) City of La Quinta 12-00001356 Space Conditioning Systems Heating Eauivment Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency AFUE, etc.)1, 3 (>=CF -1R value)4 Duct Location crawl- space, etc.) Duct R -value Heating. Load (kBtu/hr) Heating Capacity (kBtu/hr) ' Package Furnace Rheem RRNL-0361K06X 1 (SEER and EER) Location (attic, R-4.2 56 60 kBtu (package ,heat �;, , ', j-.` CEC Certified Mfr. Name* ARI Reference # of Identical 1, 3 (>=CF -1R crawl- space, Duct Cooling Load Cooling . Capacity pump) and Model Number,:Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Package Rheem z A/C . w RRNL-036]K06X ? 1 „1.3.SEER *4 ttiq 3 Tons rJ Ir. V € Equip " . Efficiency Duct Type { (SEER and EER) Location (attic, (package ,heat �;, , ', j-.` CEC Certified Mfr. Name* ARI Reference # of Identical 1, 3 (>=CF -1R crawl- space, Duct Cooling Load Cooling . Capacity pump) and Model Number,:Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Package Rheem z A/C . w RRNL-036]K06X ? 1 „1.3.SEER *4 ttiq 3 Tons rJ Ir. V € W .4_," ^i•+� '4Z..' 6 � "R': j,� aM'€.�iYuT �t.'�: ., f:r i � 'T'°,�� a*+r�iC'+f .- �':. errs? ..'• I",4y�d y, •;'�S a"..,�_- -fy'xc*: '1 Y�.F a> f e E K f,15 f -- -� •�••��•�� •� �� onu fau,c A-Jl-L.. €ur uuc,t cenrng d€rernarive compliance. %t G 2. ARI Reference Number can be found by entering the equipment model number at http://www. aridirectory. org/ari/ac. php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R form. 4. When CF -1R is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM ® §110-§113: HVAC equipment is certified by the California Energy Commission. ® §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. ® §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). ® §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum requirements of ,Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. r �1 Reg: 212-A0064441A-M0400001A-0000 Registration Date/Time: 2012/11/19 13:52:52 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 01*1 e INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency: Permit Number:, 54-639 Riviera, La Quinta CA 92253 (System 1) City of La Quinta 12-00001356 Ducts and Fans §150(m): Duct and Fans M 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and M 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the d u cts. ® 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. ® 7. Exhaust fan systems have back draft or automatic dampers. M 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers: ® Protection of Insulation.Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating thatl;is,mater retardant and provides shielding from solar radiation that can cause `degradation•of-;the material'};'"; 0.10. Flexible ducts cannot have porous inner cores. _ e,� ....: L..�� . �t ,�_*r+ s, � �s,.�A'41; _.. �r-w'se•� rtK. ' ss _ f` ase y C ; fi Via ` { :- Aif" _A, � Ml* K& DECLARATION STATEMENT A . I certify under, penaltyof; perjury, under,the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person -respons ble;for construction (responsible person). . I certify that the installed featu'res`nmaterials, components, or manufactured devices identified 'on this certificate (the installation) conforms to all applicable codes and`` regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PREC H & A INC Responsible Person's Name: Responsible Person's Signature: Gerald Dobbins Gerald bobbins CSLB License: 818759 Date Signed: 11/16/2012 Position With Com an Title p y( )' Mc Y: a1L-AVvb4441A-MV400001A-0000 Registration Date/Time: 2012/11/19 13:52:52 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms - August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 54-639 Riviera, La Quinta CA 92253 (System 1) City of La Quinta 12-00001356 Enter the Duct System Name or Identification/Tag: System 2 Enter the Duct System Location or Area Served: Bedrooms Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Dud Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. 0 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow 3. Reduce leakage by 60%'and conduct smoke and fix all leaks ® 4. Fix all accessible leaks using smoke and HERS rater verify Note: .,(One of Options 1, 2 or 3 mint be attempted before utilizing Option 4.) Determine nominal -Fan Flow using one ofAhe following three calculation methods ®Coolmgsystem method: Size of-,4condenser in Tons --3s x 400="1200�CFM t'� p p �"� • �) � � F � �v� t? ^� L � $ *� - ✓ ❑ Heating system method' X21 7 x Output Capanty,in Thousands of Btu/hr� ' CFM n r �> r V0 easured system a�ow usng RA3 3.a.irflow_testlprocedures 7CFM s O tion i used then 19—*0 CFM $w Allowed: leakage Fan:AirFlow x"1200 : x 0 15 F31 1 1 Actual Leakage 201" _CFM< :. < � R,._ .. . , :`°'. - ..w, Pass if Actual Leakage is less than Allowed leakage Pass Fail Option`2 used,then:� , 2 Allowed leakage Fan Airflow" 1200 x 0.10 = 120 CFM Actual Leakage to outside = f' "-CFM ' ,_... ' IPass if Actual leakage to outside is less than Allowed leakage Pass Fail Option 3 used then: Initial leakage prior to start of work = CFM Final leakage after sealing all accessible leaks using smoke test = CFM 3 _ Initial leakage _ = Final leakage _ = Leakage reductionCFM ((Leakage reduction _/ Initial leakage x 100% _ %Reduction .. Pass if % Reduction >= 60% Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using, smoke Pass Fail . �..,,.� March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 54-639 Riviera, La Quinta CA 92253 (System 1) City of La Quinta 12-00001356 ® Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation,is,required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured-to`the closed position during duct leakage testing. ® All supply andxreturn register boots must be.,sealed to the d ywalllif�smoke testis utilized,for- compliance - applies to duct leakage compliance oPtlon 3,(leakage reductlonlby 66% andoption4(fix allaccessible Y. leaks descntied above: �`_ k� Y �a. �w w V � �---,. ®New duct nstallations cannot utilize building cavities_ as -plenums or platformireturns in lieurof:ducAt ts 12 "- ,ems'"me ® mastic and�draw=bands must4be usedh n,combination,wlth,doth backed rubber adhesive,duct tapeyto,sseal .' leaks at all^new duct connections` �"k;"Y ' - N DECLARATI_ON_STATEMENT xU1, „. ;. . I certify under penalty of perjury, unde`r>the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsiblefor construction (responsible person). . I certify that the installed features,..materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives. and heninninn nrtnher i -)ni n rnr �u —A—; , 1.. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PREC H & A INC Responsible Person's Name: Responsible Person's Signature: Gerald Dobbins Gerald Dobbins CSLB License: 818759 Date Signed: 11/16/2012 _ Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0064441A-M2100001A-0000 Registration Date/Time: 2012/11/19 13:55:06 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 54-639 Riviera, La Quinta CA 92253 (System 1) City of La Quinta 12-00001356 - Enter the Duct System Name or Identification/Tag: System 2 Enter the Duct System Location or Area Served: Bedrooms Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation, certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. 1. Measured leakage less than 15% of fan flow 2. Measured leakage to outside less than 10% of Fan Flow 3. Reduce leakage by 60% and or`iduct smoke and fix all leaks IM 4. Fix all accessible,leaks•using smoke and HERS rater verify Note, -.(One of Options 1, 2, or 3 must be attempted before utilizing Option 4.) Determine nominalifan, Flow using one,of the following three calculation methods. ./I@ Cooling system method: Size of Condenser in Tons'' 3 xx 400' M '• ' ' 1200 CFAMW At } ✓ Heating system method1:7 x Output Capaaty in Thousands of,Btu/hr — CFM" ✓ 13 Me system a�irflow.using'RA3 3,airflow,test�protedures: y OptionA used then , W.'P Allowed leakage Fan Flow 1200 x 0 `_ PIL80 r - 1 15 CFM Actual Leakage.= 201 CFM" Tr . s Pass if Leakage Actual is less than Allowed n Pass ❑ Fail Option 2 used then: 2 Allowed leakage fan:Flow `1200 x 0.10 = 120 CFM Actual Leakage to outside ='_-" CFM m>; ' Pass if Leakage Actual is less than Allowed Pass Fail Option 3 used then: - Initial leakage prior to start of work = CFM _ Final leakage after sealing all accessible leaks using smoke test = CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction CFM ((Leakage reduction _ / Initial leakage x 100% _ '/o Reduction Pass if % Reduction >= 600/6 rl Pass 0 Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No sampling). Pass if all accessible leaks have been repaired using smoke Pass Cl Fail 0 Reg: 212-A0064441A-M2100001A-M21A Registration Date/Time: 2012/11/19.13:58:25 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4111-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 54-639 Riviera, La Quinta CA 92253 (Syste�I)City of La Quints 12-00001356 ® Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI�OA ducts that utilize controlled motorized dampers, that open only when OA ventilation•is,required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to th16 closed position during duct leakage testing. ® All supply and return registerPb ts_must befsealedtoxthe,drywalliif-tsmokettestlisiutilized�fo!j;compliance - applies to�dtict leakage compliance option 3°(leakage reductionby 60%) andoptlon4`(fix alltaccessible leaks) described above x I ® New duct installations cannot utilize building cavities as plenums;or platform returns inaieu of<ducts�� w r rf_41C S' ® Mastic andjdraw;bands i must be usedlin�combinationwithicloth, backed! rub ber adhesive;"duct 1ape,,to',sea1 leaks,k all-n6w duct conn"ections ;t DECLARATION STATEMENT • I certify under penalty -of "perjury, under`the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rate'rwho performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement aaencv. Builder or Installer information as shown on the Installation Certificate (CF -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PREC H & A INC Responsible Person's Name: CSLB License: Gerald Dobbins 1818759 HERS Provider Data Registry Information Sample Group # (if applicable): N/A Jim tested/verified dwelling Tp not-tested/verified dwelling in HERS sample group HERS Rater Information Ca10ERTS Certificate # CCl-1798708524 HERS Rater Company Name: Eddie Hernandez Jr - Responsible Rater's Name: Responsible Rater's Signature: Eddie Hernandez, Jr. Eddie Hernandez, Jr. Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 11/16/2012 CC2004518 meg: 212-Auu64441A-M2100001A-M21A Registration Date/Time: 2012/11/19 13:58:25 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-611-MECH-0, ipace Conditioning Systems, Ducts and Fans (Page 1 of 2 Site Address: Enforcement Agency: Permit Number: 54-639 Riviera, La Quinta CA 92253 (System 1) City of La Quinta 12-00001356 Space Conditioning Systems . Heating Ecuipment Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (AFUE, etc.)1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Package Furnace Rheem RRNL-0361K06X ARI 1 80 AF UE Attic R-4.2 Cooling Cooling .heat pump) -,CEC Certified Mfr. Name and Model Number:- i Reference Number2 Identical Systems (>=CF -1R value)4 space, etc.) Duct R -value Load (kBtu/hr) Capacity (kBtu/hr) Package Rheem A/CRRNL-036JK06X 1. x(,13 SEER'a AtticR=4 2'.p. A*.� `fi':d rr y �c Y a'.,, t"" r',. '�`• ' `". /'nn/inn Fn.•:.....o..♦ �. .i $' jai".: .+*g .,gi7°�'.i .,...•.+ Equip' f. l ,:, }� Efficiency (SEER Duct Location Type (package "'. s = ARI # of and EER) 1, 3 (attic, crawl- Cooling Cooling .heat pump) -,CEC Certified Mfr. Name and Model Number:- i Reference Number2 Identical Systems (>=CF -1R value)4 space, etc.) Duct R -value Load (kBtu/hr) Capacity (kBtu/hr) Package Rheem A/CRRNL-036JK06X 1. x(,13 SEER'a AtticR=4 2'.p. A*.� `fi':d rr y �c Y a'.,, t"" r',. '�`• ' `". �. .i $' jai".: .+*g .,gi7°�'.i .,...•.+ •n: r,. x. E -5_ „ nTk } compliance: ,ou,c 1J1 -L.. iur uucL cemng airernaove 2. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.orglarilac.'php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown -on the CF -IR form. 4. When CF -1R is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BEtCHECKED TO BE A VALID FORM ® §110-§113: HVAC equipment is certified by the California Energy Commission. ® §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. . ® §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). ® §150(j)2: Pipe insulation'for cooling system refrigerant suction, chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. 4 Mte9: Z1t-Auub44J9A-M0400001A-0000 Registration Date/Time: 2012/11/19 13:43:45 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 I INSTALLATION CERTIFICATE-CF-6R-MECH-04 Space Conditioning -Systems, Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 54-639 Riviera, La Quinta CA 92253 (System 1) 1 City of La Quinta 1 12-00001356 Ducts and Fans §150(m): Duct and Fans ® 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or.other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and ® 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. ® 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. ® 7. Exhaust fan systems have back draft or automatic dampers. , - ® 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. ® Protection of Insulation3Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating thatlis"water retardant and provides shielding from solar radiation that can cause )degredation•of•the materiaF ,4' ® 10. Flexible ducts cannot have -porous inner cores. �"'3 DECLARATION, STATEM ENT . I ceJ underpenalty,.. of a 'u r* fli iperjury, ry, under, the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division..3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes'and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency." ':4,' . I reviewed a copy of the Certificatelof Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PREC H & A INC Responsible Person's Name: Responsible Person's Signature: Gerald Dobbins Gerald Dobbins CSLB License: Date Signed: 818759 11/15/2012 Position With Company (Title): Reg: 212-A0064439A-M0400001A-0000 Registration Date/Time: 2012/11/19 13:43:45 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test.— Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 54-639 Riviera, La Quinta CA 92253 (System 1) City of La Quinta 12-00001356 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. ® 1. Measured leakage less than 15% of fan flow 2. Measured leakage to outside less than 10% of Fan Flow • i C1 3. Reduce leakage by 60% and conduct smoke and fix all leaks 4. Fix all accessible leaks using smoke and HERS rater verify Note::_(One of, Options 1, 2.or 3 mus lbe. attempted before utilizing Option 4.) Determine nominal -,Fan Flow using one of the M V ®Cooling system method: Size of c hdense in Tons' z400,="p 12g00 CFVJ O Heating system method": 21 7 xf Output Capaaty,in,Thousands B[u/hr 91 of 41 - ✓.' P "i'$' �, l �t•:; bf t� .a4Y '�,R s y 4 Measured system,iairflo-- using RA3 3 airflow,test�procedures Option•i�used then i� , I , Allowed leakage Fan Airflow` F ' 1 0 15 _ Actual Leakage - 176 CFM V x Pass if Actual Leakage is less than Allowed leakage Pass Fail 10ption .2 used then, z 2 Allowed leakage ,Fan Airflow "- x 0.10 = CFM _ Actual Leakage to outside ='.`14 CFM tPass if Actual leakage to outside is less than Allowed leakage Pass Fail Option 3 used then: �• aI „. Initial leakage prior to start of work = CFM _ Final leakage after sealing"all accessible leaks using smoke test = CFM _ 3 Initial leakage _ - Final leakage _ = Leakage reduction CFM ((Leakage reduction _ / Initial leakage x 100% _ % Reduction Pass if % Reduction >= 600/c Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke Pass Fail Reg: 212-A0064439A-M2100001A-0000 Registration Date/Time: 2012/11/19 13:44:44 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 1 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 54-639 Riviera, La Quinta CA 92253 (System 1) City of La Quinta 12-00001356 ® Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OiA ducts that utilize controlled motorized dampers, that open only when OA ventilation,is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured`to'th& closed position during duct leakage testing. ® All supply and return register boots<mustibe,sealed- o�the drywall-�f,,smoke test�is�utilizedxfor,compliance - applies to duct leakage compliance optioni3 (leakage reduction;by:60%) and�option�40x alll'accessible leaks described above.` . I =�. S.. .•� ra ® New duct installationsca nn o"t utilize building ® Mastic�an draw bands leaks.at all ';new 'duct c6nnei DECLARATION STATEMENT . I certify under penalty of perjury, unde ..the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features; materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiole orientatinn aitprnAt-i— ani K—.,..i..,. nom« . , — ,__ _„ ,. _:__ - -.. .... Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PREC H & A INC Responsible Person's Name: Responsible Person's Signature: Gerald Dobbins Gerald Dobbins CSLB License: Date Signed: 818759 11/16/2012 Position With Company Title p Y( ) Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ,❑ Yes ❑ No Reg: 212-A0064439A-M2100001A-0000 Registration Date/Time: 2012/11/19 13:44:44 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 54-639 Riviera, La Quinta CA 92253 (System 1) . City of La Quint a 12-00001356 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. ® 1. Measured leakage less than 15% of fan flow 2. Measured leakage to outside less than 10% of Fan Flow 3. Reduce leakage by 60% and conduct smoke and fix all leaks 4. Fix;all accessible leaks using smoke and HERS rater verify Note:+(One of Options 1; 2, or 3 must be attempted before utilizing Option 4.) Determine nominalxFan,Flow using one of the following=three calculation4methods ✓®Cooling system method: Size of condenser in Tons''"" x 400` 4t1200ACF_M iX^ ,4i - KY �'^. R� y.�•,$�K •' Y if' ro-.'c.�'l Y�°i6 ��• A'k ➢"�" P Y.a�'vn""i'"k—vj.:...y. ✓❑Heating system method`Q211p'7 , Output Capacity�in.Thousands of Btu/hr c v` R yyt P> Jy� f t d k k G s`T'•",y„ _ p Y ✓ 0 Measured system airflow usi�g,RA3 3.6irfi6wtestiprocedures: yhvFp`.* _� _ Optron', used then. ct fa a 1 Allowed leakage Tari Flow 12o0 x 0 15 x`180^ CF S''� 4 "'MY ° a ., Actual Leakage = , 176 Pass if Leakage Actual is less than Allowed ta Pass Fail ' Option 2 used1hem, - 2 Allowed leakage Fan.Flow F .x 0.10 = _ CFM Actual Leakage to outside =_:: CFM `' Pass if Leakage Actual is less than Allowed Pass Fail Option 3 used then: Initial leakage prior to start of work = CFM _ Final leakage after sealing all accessible leaks using smoke test = CFM 3 _ Initial leakage _ - Final leakage _ = Leakage reduction CFM ((Leakage reduction _/ Initial leakage x 100% _ '/o Reduction Pass if % Reduction >= 600/a rl Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No sampling). Pass if all accessible leaks have been repaired using smoke Pass Fail Reg: 212-A0064439A'M2100001A-M21A Registration Date/Time: 2012/11/19 13:45:35 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 54-639 Riviera, La Quinta CA 92253 (System 1) City of La Quinta 12-00001356 ® Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFIOA ducts that utilize controlled motorized dampers, that open only when OA ventilation-is.required to meet.ASHRAE Standard 62.2, and close when OA ventilation is not required, may be co11 nfigured to the'closed position during duct leakage testing. ® All supply and return register boots•must'berse6ledytorthe.dry wallxifvsmoke�test is utilized for; -compliance - appllestoduct leakage compliance.optlon 3 (leakage reduction by 60%)andFoption4 (fix all accessible leaks) described "above §� kms,_ x . ® New ductlnstallatlons cannot, building cavities as plenums or platform returns In;lleg�u off ducts ® Mastic andfdraW,bandsrmus be,used4m domtilnatlon with cloth backed ruYbber,ad�heslveiduct tap�e't seal leaks.at all-new duct connections DECLARATION STA . I certify under penalty of.•perjury, under,the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater', who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material; component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PREC H & A INC - Responsible Person's Name: CSLB License: Gerald Dobbins 818759 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ® tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798708523 HERS Rater Company Name: Eddie Hernandez Jr Responsible Rater's Name: Responsible Rater's Signature: Eddie Hernandez, Jr. Eddie Hernandez, Jr. - Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 11/16/2012 CC2004518 Reg:212-A0064439A-M2100001A-M21A Registration Date/Time: 2012/11/19 13:45:35 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010