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11-1165 (MECH) 48 P.O. BOX 1504 VOICE(760) 777-7012 78-495 CALLE TAMPICO FAX(760)777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 10/25/11 Application Number: 11-00001165 Owner: Property Address: 49578 AVILA DR WILLIAM KEARNS APN: 646-270-014- - - 49578 AVILA DRIVE 0 Application description: MECHANICAL LA QUINTA, CA 92253 G Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 15000 OCT 241011 Contractor: Applicant: Architect or Engineer: AIR SOLUTIONS OF THE D ERT CITY0#r QUpV TA 42335 WASHINGTON STREE 8 F1M4NCEDEP PALM DESERT, CA 92211 (760)275-4919' Lic. No. : 862106 --- ---------------------- ------------------------ ------------------- ------------- --------- ------- 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 Busine and Professionals Code,and my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided License Class: g2O Li else No.: 862106 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is 1 �/► issued. ivate: V Contractor: _ 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 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 EXEMPT Policy Number EXEMPT following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to 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' shout come 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 bor Cod ,I sh I 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 hundred dollars($500).: ate: Qpplicant: 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: FAIL RE TO SECURE WORKE '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.). APPLICANT ACKNOWLEDGEMENT (_) 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon,and who contracts for the projects with a contractor(s)licensed 1. Each person upon whose behalf this application is made,each person at whose request and for pursuant to the Contractors'State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, I—) 1 am exempt under Sec. 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 or omission related to the work being performed under or following issuance of this permit. Date: Owner: 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit,or cessation of work for 180 days will subject CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correc agree to comply with all work for which this permit is issued(Sec.3097,Civ.C.). Fof nd unty ordinances and state laws relating t building struction,and y authorize representatives co my enter upon the above-mentioned pr r ins action p ses. Lender's Name: nature(Applicant or Agent): Lender's Address: r - LQPERMIT Application Number . . . . . 11-00001165 Permit . . MECHANICAL Additional desc . . Permit Fee . . 66.00 Plan Check Fee 16:50 Issue Date . . . . Valuation . . . . 0 .Expiration Date 4/22/12 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/>100K7500KBTU 33.00 ---------------------------------------------------------------------------- Special Notes and Comments REPLACE (2) COMPLETE SYSTEMS, FURNACES, INDOOR COILS & CONDENSERS, 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 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAIterations CF-IR-ALT-HVAC Climate Zones 10 to 15 William Kearns 2 of 2 Site Address: Enforcement Agency: Date: Permit#. 49-578 .. (min- City of LO 10/25/11 Conditioned Floor Equipment T r List Minimum Efficient Duct insulation requirement Area Thermostat ❑Packaged Unit (kFurnace ❑AFUE 80 ❑COP Over 40 ft of ducts added or Bedrooms Setback cdoor Coil [MEER_I76 ❑HSPF replaced in unconditioned space Served by system (Ifnot already ondensing Unit ❑EER ❑Resistance ❑R 6 (CZ 10-13) 1600 sf present,must be ❑Other 11R 8 (CZ 14-15) installed) 1.Equipment Type:Choose the equipment being installed,if more than one system,use another CF-1 R-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 si ed. Beginning October 1,2010,a registered copy of the CF-1R and CF-6R shall also be on site for final inspection. 1.HVAC Changeout Required Forms: • All HVAC Equipment replaced CF-6R forms: MECH-04,MECH-2I-HERS and(for split systems)MECH-25-HERS CF4R forms: MECH-21 and fors lits stems MECH-25 • Condenser Coil and/or • Indoor Coil and/or CF-6R forms: MECH-2I-HERS and(for split systems)MECH-25-HERS CF4R forms: MECH-21 and(for split systems) MECH-25 • Furnace For Split Systems:Duct leakage<15 percent; RC,CCA>300 CFM/ton(Minimum Air Flow Requirement),TMAH For Packaged Units: Duct leakage<15 percent Exempted from duct leakage testing if- 0 f❑ 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 ducts stems are constructed,insulated or sealed with asbestos ❑2.New HVAC System Required Forms: • Cut in or Changeout with new CF-6R forms: MECH-04,MECH-20-HERS,and(for split systems)MECH-22-HERS,and MECH-25-HERS ducts:(all new ducting and all CF4R forms: MECH 20-,and(for split systems)MECH-22,and MECH 25 new equipment) For Split Systems:Duct leakage<6 percent;RC,CCA>350 CFM/ton,FWD,TMAH,STMS,and either HSPP or PSPP. For Packaged Units:Duct leakage<6 percent ❑3.New Ducts with Replacement Required Forms: • Includes replacing or installing all new ducting CF-6R forms: MECH-04,MECH-20-HERS,and(for split systems)MECH-25-HERS and/or outdoor condensing unit and/or indoor CF-4R forms:MECH-20 and(for split systems)MECH-25 coil and/or furnace. Not all 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 CF4R forms: MECH-21 linear feet of duct in unconditioned space. 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) • 1 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. • 1 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 Cal ifomia 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 andspecifications submitted to the enforcement agency for approval with the ermit application. Name: Walter Nellis Signature: Company: Date: Air Solutions of the Desert Address: 42-335 Washington St St F 418 License862106 City/State/Zip: Palm Desert Ca 92211 Phone: 760 .275 .4919 2008 Residential Compliance Forms March 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-IR-ALT-HVAC Climate Zones 10 to 15 William Kearns 1 of 2 Site Address: Enforcement Agency. Date: Permit#: 49-578 K-t--=s1�1( �2 (,�� City of LO 10/25/11 Conditioned Floor Equipment T ' List Minimum Efficiency2Duct insulation requirement Area Thermostat ❑Packaged Unit 80 Over 40 ft of ducts added or Living Area13:Setback cE;Fled or ❑AFUEER ❑COP replaced in unconditioned space Served b system ndoor Coil DEER�6� ❑HSPF_ p p Y Y (If not already ondensing Unit ❑EER ❑Resistance ❑R 6 (CZ 10-13) 1600 sf present,must be ❑Other ❑R 8 (CZ 14-15) installed) /.Equipment Type:Choose the equipment being installed;ifmore than one system,use another CF-IR-ALT-HVACfor each system. 2.Minimum Equipment Efficiencies:13 SEER, 78%AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted.A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final,the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-4R forms(no hand filled CF-4Rs allowed)are filled out and signed. Beginning October 1,2010,a registered copy of the CF-1R and CF-611 shall also be on site for final inspection. M 1.HVAC Changeout Required Forms: • All HVAC Equipment replaced CF-6R forms: MECH-04,MECH-2I-1-IERS and(for split systems)MECH-25-HERS CF-4R forms: MECH-21 and(fors lits stems) MECH-25 • Condenser Coil and/or • Indoor Coil and/or CF-6R forms: MECH-2I-HERS and(for split systems)MECH-25-HERS CF-4R forms: MECH-21 and(for split systems) MECH-25 • Furnace For Split Systems:Duct leakage<15 percent; RC,CCA>300 CFM/ton(Minimum Air Flow Requirement),TMAH 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 y ❑3.Existing duct sysItems are constructed,insulated or sealed with asbestos ❑2.New HVAC System Required Forms: • Cut in or Changeout with new CF-6R forms: MECH-04,MECH-20-HERS,and(for split systems)MECH-22-HERS,and MECH-25-HERS ducts:(all new ducting and all CF-4R forms: MECH 20-,and(for split systems)MECH-22,and MECH 25 new equipment) For Split Systems:Duct leakage<6 percent;RC,CCA>350 CFM/ton,FWD,TMAH,STMS,and either HSPP or PSPP. For Packaged Units:Duct leakage<6 percent ❑3.New Ducts with Replacement Required Forms: • Includes replacing or installing all new ducting CF-6R forms: MECH-04,MECH-20-HERS,and(for split systems)MECH-25-HERS and/or outdoor condensing unit and/or indoor CF4R forms:MECH-20 and(for split systems)MECH-25 coil and/or famace. Not all 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 CF4R forms: MECH-21 linear feet of duct in unconditioned space. 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. • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • 1 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 Califomia 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 fora roval with the permit application. Name: Walter Nellis Signature: Company: Date:Solutions of the Desert Date: Address: 42-335 Washington St St F 418 License862106 City/State/Zip: Palm Desert Ca 92211 Phone: 760 .275 .4919 s 2008 Residential Compliance Forms March 2010 Bin# City of La Quinta Building 8T Safety Division Permit# P.O.Box 1504, 78-495 Calle Tampico , La Quinta,CA 92253-(760) 777-7012 Building Permit Application and Tracking Sheet Project Address: 49-578 Avi1a Dr Owner's Name: William Kearns A.P.Number. Address: 49-578 Avila Dr Legal Description: City,ST,Zip: L a Quinta CA 92253 Contractor: Air Solutions of the Desert 949 .233 . 8087 Telephone: Address: 41 . 800 Washington St B105-229 Project Description: City,ST,Zip: Bermuda Dunes CA 92203 Replacement of .both HVAC systems 760 .275 .4919 State Lic.#: 86210 6 City Lie.#: Arch.,Engr.,Designer. Address: City.,ST,Zip: Telephone: YP Construction Type: Occupancy: State Lic.#: :. ,;,..:;:r:;:,:<•;:": ;;;;::;:;.;;>::,.;:.;;;:.. ProJect type circle one). New Add' n Alter Repan Demo Name of Contact Person: Walter Ne l l i s Sq.FL: #Stories: #Units: Telephone#of Contact Person: 760 .275 .4919 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACIMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calm Reviewed,ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction " Hood plain plan Plans resubmitted Mechanical Grading plan 2°°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 correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub.Wks.Appr Date of permit issue School Fees Total Permit Fees e IIIIIIIIVIIIIIIVIIIIIII 49 IE CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test- Existing Duct System (Page 1 of 2) Site Address: 49-578 Avila Dr 1 of 2, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 11-1165 Enter the Duct System Name or Identification/Tag: System 1 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. g-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 Optignsv1, 2, or 3 must be attempted,before.utilizing Option,4)_, Determine/nominal Fan Flow using one of:the following three calculation methods.' ✓2 Cooling system method: Size of condenser in Tons / 4 x 400 - 1600 CFM C ✓❑Heating system method: 21.7 x Output Capacity in Thousands of Btu/hr=_CFM s .� ✓.❑Measured system airflow using RA3.3 airflotest/procedure/S: / CFM. Option 1 used then: 1 Allowed leakage = Fan Flow 1600 x 0.15 = 240 CFM Actual Leakage = 237 CFM Pass if Leakage Actual is less than Allowed M Pass❑Fail Option 2 used then: 2 Allowed leakage = Fan Flow_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 1 x 100% _ % Reduction Pass if% Reduction > 60% ❑Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No `smoke allowed to leak from system. Including ducts, plenums,air handler and door panel. ' Pass if all accessible leaks have been repaired using smoke ❑Pass El Fail r Reg: 211-A0056162A-M2100001A-M21A Registration Date/Time: 2011/10/31 12:14:40 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms �' March 2010 r CERTIFICATE OF FIELD VERIFICATION &DIAGNOSTIC TESTING CF-411-MECH-21 Duct Leakage Test - Existing Duct System I - (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Or 1 of 2, La Quinta CA 92253 (System 1) City of La Quintal 11-1165 _ s R I a 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. 0 All supply,an dreturn register';boots=must bei sealed to the drywalp I i s oketem st is utilized for compliance - applies'to duct leakage compliance option 3 (leakage reduction by.60%) and option 4!1(fix all"'accessible leaks) described above. ! (� C1 - - 0 New duct installations cannot utilize building cavities as plenums°or platform returns In lieu of ducts.,)/ 7„ •.,�!" ; � '• L `µ..rr _.s -�'` �, tits' , 'G.�`�-�'r��`" ;)�� {.+` .. �. _. © Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to seal leaks at all new duct connections I 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 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-111)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. I Builder or Installer information as shown on the Installation Certificate (CF-6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) f AIR SOLUTIONS OF THE DESERT Responsible Person's Name:. CSLB License: Walter W Nellis 1862106 HERS Provider Data Registry Information Sample Group # (if applicable): 262757 litested/verified dwelling ❑not-tested/verified dwelling in la HERS sample group HERS Rater Information Ca10ERTS Certificate# CCI-1798603339 HERS Rater Company Name: Air Experts Air Conditioning Responsible Rater's Name: Responsible Rater's Signature: Paul Van Vlymen Paul Van Vlymen Responsible Rater's Certification Number w/this HERS Provider: Date Signed: 10/27/2011 I CC2004367 I Reg: 211-A0056162A-M2100001A-M21A Registration Date/Time: 2011/10%31 12:14:40 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 i CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification -Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 1 of 2, Lauinta CA 92253 City ty of La Quinta 11-1165 Note:If installation of a Charge Indicator Display(CID)is utilized as an alternative to refrigerant charge verification for compliance,"a MECH-24 Certificate(instead of this MECH-25 Certificate)should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s)for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required_ for completely new or replacement space-conditioning systems that utilize prescriptive compliance method. TMAH-Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Bedrooms 1 p Yes ❑No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2.; 2 p Yes ❑No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and-2 is a pass. Enter Pass or Faill R Pass I ✓ ❑ Fail STMS-Senso_r,on_,the,Evaporator Coil System Name or Identification/Tag'? System 1 T The sensor is factory installed, orlfield installed according to manufacturer's 3 ❑Yes ❑No specifications, or is installed by methods/specifications approved by the Executive r^ I Director. 1 I C N 1--111011%1--111011% C) 1 -1 ) The sensor wire is terminated with a standard mini plug suitable for connection;to a 4 El Yes O No digital thermometer.The sensor mini plug is accessible to the insfallingleclinician' and the HERS rater without changing the airflow through the condenser coil 5 ❑Yes ❑No When attached to a digital thermometer,the sensor provides an indication of the saturation temperature of the coil. Yes to 3,4, and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail ✓ 8 N/A ✓ C]Pass ✓ C]Fail STMS-Sensor on the Condenser Coil System Name or Identification/Tag System i The sensor is factory installed,or field installed according to manufacturer's 6 ❑Yes ❑No specifications,or is installed by methods/specifications approved by the Executive Director. ' The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑Yes ❑No digital thermometer.The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑Yes ❑No When attached to a digital thermometer,the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail ✓ D N/A ✓ C)Pass ✓ E]Fail Reg: 211-A0056162A-M2500001A-M25A Registration Date/Time: 2011/10/31 12:22:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 1 of 2, La Quinta CA 92253 City of La Quinta 11-1165 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2.As many as 4 systems in the dwelling can be documented for compliance using this form.Attach an additional form(s)for any additional systems in the dwelling as applicable. ' • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. •If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems System Name or Identification/Tag System 1 System Location or Area Served Bedrooms Outdoor Unit Serial # WlCI859056 Outdoor Unit Make York Outdoor Unit Model CZF04813CA'W- i Nominal Cooling Capacity Btu/hr 48000 Date of Verification 10/27/11 ti Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 10/6/11 (must be re-calibrated monthly) p f 4 /� j must be'r�calibrated monthly) Date of Thermocouple,Calibration 6/11 t � 10 Measured Temperatures(°F) i i� f ^/ System Name or IdentificaEion/Tag �f System 1 1 Supply (evaporator leaving) air dry-bulb 52 temperature(Tsupply, db) Return (evaporator entering) air dry-bulb 74 temperature (Treturn,db) - Return (evaporator entering)air wet-bulb temperature (Treturn, wb) 54 Evaporator saturation temperature 37 (Tevaporator,sat) Condensor saturation temperature 87 (Tcondensor,sat) Suction line temperature(Tsuction) S5 Liquid Line Temperature (Tliquid) 77 Condenser(entering)air dry-bulb 75 temperature (Tcondenser,db) t Reg: 211-A0056162A-M2500001A-M25A Registration Date/Time: 2011/10/31 12:22:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 1 of 2, La Quinta CA 92253 City of La Quinta 11-1165 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification.The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 Calculate: Actual Temperature Split=Treturn, 22.00 db-Tsupply,db Target Temperature Split from Table RA3.2-3 20 using Treturn, wb and Treturn,db Calculate difference: Actual Temperature Split- 2 Target Temperature Split= Passes if difference is between -4°F and +4°F or, upon remeasurement, if between -4°F and PASS -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verifled using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement(CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System �me or Identification/Tag ` Calculated Minimum Airflow Requirement(CFM) fi r„ Measured•Airflow,using RA3.3 procedures(CFM) J J f-+ Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification.This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag Calculate: Actual Superheat= Tsuction -Tevaporator,sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser,db Calculate difference: Actual Superheat-Target Superheat = System passes if difference is between -6°F and +6°F Enter Pass or Fail i e Reg: 211-A0056162A-M2500001A-M25A Registration Date/Time: 2011/10/31 12:22:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms r March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 1 of 2, La Quinta CA 92253 City of La Quint a 11-1165 Subcooling Charge Method Calculations for Refrigerant Charge Verification.This procedure.is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV)systems. System Name or Identification/Tag System 1 Calculate: Actual Subcooling = Tcondenser,sat-Tliquid 10.0 Target Subcooling specified by manufacturer 10 Calculate difference: 0 Actual Subcooling -Target Subcooling = System passes if difference is between -4°F and +4°F PASS Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification.This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat= 18.0 Tsuction -Tevaporator,sat Enter allowable superheat range from manufacturer's specifications (or use range 18 between 3°F and 26°F if manufacturer's specification is not available) _ System passes if actual superheat is within the I allowable superheat range i I PASS --Enter Pass or Fail 4 Reg: 211-A0056162A-M2500001A-M25A Registration Date/Time: 2011/10/31 12:22:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification -Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 1 of 2, La Quinta CA 92253 City of La Quinta 11-1165 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable),and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re-measured and/or recalculated. System Name or Identification/Tag System 1 System meets all refrigerant charge and airflow l requirements. PASS Enter Pass or Fail ' �. � 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 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-111)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) AIR SOLUTIONS OF THE DESERT Responsible Person's Name: CSLB License: Walter W Nellis 1862106 HERS Provider Data Registry Information Sample Group # (if applicable): 262757 Q tested/verified dwelling ❑not-tested/verified dwelling in la HERS sample group HERS Rater Information Ca10ERTS Certificate#CCl-1798603339 HERS Rater Company Name: Air Experts Air Conditioning Responsible Rater's Name: Responsible Rater's Signature: Paul Van Vlymen Paul Van Vlymen Responsible Rater's Certification Number w/this HERS Provider: Date Signed: 10/27/2011 . CC2004367 Reg: 211-A0056162A-M2500001A-M25A Registration Date/Time: 2011/10/31 12:22:59 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 1 of 2) Site Address: 49-578 Avila Dr 2 of 2, La Quinta CA 92253 (SYSTEM 2 OF Enforcement Agency: Permit Number: 2 � City of La Quinta 11-1165. Enter the Duct System Name or Identification/Tag: Enter the Duct System Location or Area Served: 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_i, 2, or 3 must be attempted,before,utilizing Option-4.)` Determine/nominal Fan Flow using one of=the following three calculation methods. = ✓❑Cooling system method: Size of condenser in Tons i x 400 = a CFM " r ✓El Heating system method: 21.7' x Output Capacity in Thousands of Btu/hr= CFM ✓❑Measured,s stem airflow usingRA3.3 airflow esti procedures: � CFM � Option 1 used then: 1 Allowed leakage = Fan Flow_x 0.15 =_CFM f Actual Leakage =_CFM Pass if Leakage Actual is less than Allowed ❑Pass p Fail Option 2 used then: 2 Allowed leakage = Fan Flow_x 0.10 =_CFM I 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 i 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 > 60% ❑Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke. HERS rater must verify(No sampling). No smoke allowed to leak from system. Including ducts, plenums, air handler and door panel. :. Pass if all accessible leaks have been repaired using smoke Pass Fail Reg: 211-A0056164B-M2100001A-M21A Registration Date/Time: 2011/10/31 12:14:40 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: 49-578 Avila Dr 2 of 2, La Quinta CA 92253 (SYSTEM 2 OF City of La Quinta 11-1165 2 ) ❑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 d return register boots must be sealed to the drywall if smoke test is utilized for compliance — applies to duct leakage.compliance option 3 (leakage reduction by 60%) and option 4 (fix all accessible leaks) described abov r / ❑ New duct installations cannot utilize building cavities as plenums or platform returns in lieu of ducts. ❑ Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to seal leaks at all new duct connections 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 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-iR)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) AIR SOLUTIONS OF THE DESERT Responsible Person's Name: CSLB License: Walter W Nellis 1862106 HERS Provider Data Registry Information Sample Group # (if applicable): 262757 F0tested/verified dwelling not-tested/verified dwelling in la HERS sample group HERS Rater Information Ca10ERTS Certificate# CCI-1798603341 HERS Rater Company Name: Air Experts Air Conditioning Responsible Rater's Name: Responsible Rater's Signature: Paul Van Vlymen Paul Van Vlymen Responsible Rater's Certification Number w/this HERS Provider: Date Signed: 10/27/2011 CC2004367 Reg: 211-A0056164B-M2100001A-M21A Registration Date/Time: 2011/10/31 12:14:40 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: - 49-578 Avila Dr 2 of 2, La Quinta CA 92253 City of La Quinta 11-1165 Note: If installation of a Charge Indicator Display(CID)is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate(instead of this MECH-25 Certificate)should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s)for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space-conditioning systems that utilize prescriptive compliance method. TMAH-Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System Location or Area Served 1 ❑Yes ❑No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 ❑Yes ❑No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and 2 is a pass. Enter Pass or Fail ✓ ❑ Pass ✓ ❑ Fa:i:l:::j STMS-Sensor_on";the,Evaporator Coil y,:�.�w ,, System Name or Identification/Tag The sensor is factory installed, orfield installed according to manufacturer's _. 3 ❑Yes ❑No specifications, or is installed by methods/specifications approved by the Executive - - �J Director. I -- + 0 // The sensor wire is terminated with a standard mini plug suitable for connection,to a t 4 El Yes El No digital thermometer.The sensor mini plug is accessible to'the installing.technician�� and the HERS rater without changing the airflow through the condenser coil ` 5, ❑Yes ❑No When attached to a digital thermometer,the sensor provides an indication of the saturation temperature of the coil. Yes to 3,4, and 5 is a pass. Enter N/A if STMS are not ✓ applicable. Otherwise enter Pass or Fail El N/A ❑Pass ✓ C]Fail STMS-Sensor on the Condenser Coil System Name or Identification/Tag The sensor is factory installed,or field installed according to manufacturer's 6 ❑Yes ❑No specifications,or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑Yes ❑No digital thermometer.The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow,through the condenser coil 8 ❑Yes ❑No When attached to a digital thermometer,the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7,and 8 is a pass. Enter N/A if STMS are not ✓ 2 N/A ✓' ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail Reg: 211-A0056164B-M2500001A-M25A Registration Date/Time: 2011/10/31 12:23:00 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 2 of 2, La Quinta CA 92253 City of La Quinta 11-1165 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable),and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken,all applicable verification criteria must be re-measured and/or recalculated. System Name or Identification/Tag System meets all refrigerant charge and airflow requirements. Enter Pass or Fail nr- 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 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-111)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-111)approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF-6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) AIR SOLUTIONS OF THE DESERT Responsible Person's Name: CSLB License: Walter W Nellis 1862106 HERS Provider Data Registry Information Sample Group # (if applicable): 262757 Ftested/,erified dwelling ©not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate#CCi-1798603341 HERS Rater Company Name: Air Experts Air Conditioning Responsible Rater's Name: Responsible Rater's Signature: Paul Van Vlymen Paul Van Vlymen Responsible Rater's Certification Number w/this HERS Provider: Date Signed: 10/27/2011 CC2004367 Reg: 211-A0056164B-M2500001A-M25A Registration Date/Time: 2011/10/31 12:23:00 HERS Provider: CalCERT3, Inc. 2008 Residential Compliance Forms March 2010 1 IIIIIIIIIIIIIIIIIIIIIl 50 IE INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test— Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 2 of 2, La Quinta CA 92253 (SYSTEM 2 OF 2 ) City of La Quinta i1-1165 Enter the Duct System Name or Identification/Tag: SYSTEM 2 OF 2 Enter the Duct System Location or Area Served: Living area 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. 0 1. Measured leakage less than 15%of fan flow O 2. Measured leakage to outside less than 10%of Fan Flow C]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 Determine nominal Fan Flow using one of the following three'calculation methods.lr / ✓2 Cooling system method: Size of condenser in Tons / 4 x 400 =1 1600 CFM ✓❑Heating system method: 21.7 x_Output Capacity in Thousands of Btu/hr= CFM I f i t - .'.'�`f %0'0 Measured system airflow using RA3.3 airflow test procedur s:-CFM Option 1 used then: ` 1 Allowed leakage = Fan Airflow 1600 x 0.15 = 240 CFM Actual Leakage = 234 CFM Pass if Actual Leakage is less than Allowed leakage 0 Pass Fail Option 2 used then: 2 Allowed leakage = Fan Airflow_x 0.10 =_CFM Actual Leakage to outside = CFM Pass if Actual leakage to outside is less than Allowed leakage E]Pass p 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% _ % Reduction Pass if%Reduction > 600/a Pass El 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: 211-A0056164B-M2100001A-0000 Registration Date/Time: 2011/10/28 03:07:35 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms 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: 49-578 Avila Dr 2 of 2, La Quinta CA 92253 (SYSTEM 2 OF 2 ) City of La Quinta 11-1165 ®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. 2 All supply and return register boots must be sealed to the drywall if smoke test is utilized for compliance - applies to duct leakage compliance option 3 (leakage reduction by,60%) and option 4 (fix all accessible leaks) described above.! 0 New duct installations cannot utilize building cavities as plenums or platform returns in lieu of ducts. 0 Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to seal leaks at all new duct connections 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 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-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 beginning October 1,2010,for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Air Solutions of the Desert Responsible Person's Name: Responsible Person's Signature: Walter W Nellis Walter W Nellis CSLB License: Date Signed: Position With Company(Title): 862106 10/26/2011 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? []Yes ❑No Reg: 211-A0056164B-M2100001A-0000 Registration Date/Time: 2011/10/28 03:07:35 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE* CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 2 of 2, La Quinta CA 92253 City of La Quinta 11-1165 Note:If installation of a Charge Indicator Display(CID)is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate(instead of this MECH-25 Certificate)should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s)for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space-conditioning systems that utilize prescriptive compliance method. TMAH-Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag SYSTEM 2 OF 2 System Location or Area Served Living area 1 0 Yes ❑No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 ©Yes ❑No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and 2 is a pass. Enter Pass or Fail ✓ 0 Pass ✓ ❑ Fail STMS-Sensor on the Evaporator Coil System Name or Identification/Tag- SYSTEM 2 OF 2 t r The sensor is factory installed, or field installed according to manufacturer's 3 ❑Yes ❑No specifications,or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 4 ❑Yes-''r' ❑No digital thermometer.The sensor mini plug is accessible to-the installing technician - and the HERS rater without changing the airflow through the condenser coil 5 ❑Yes I ❑No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F ✓ Yes to 3,4, and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail _T 9 N/A ✓ ❑Pass ✓ E]Fail STMS-Sensor on the Condenser Coil System Name or Identification/Tag SYSTEM 2 OF 2 The sensor is factory installed,or field installed according to manufacturer's 6 ❑Yes ❑No specifications,or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑Yes ❑No digital thermometer.The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑Yes ❑No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ applicable. Otherwise enter Pass or Fail R N/A ✓ ❑Pass ✓ ❑Fail Reg: 211-A0056164B-M2500001A-0000 Registration Date/Time: 2011/10/28 14:18:42 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 2 of 2, La Quinta CA 92253 City of La Quinta I 'll-1165 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2.As many as 4 systems in the dwelling can be documented for compliance using this form.Attach an additional form(s)for any additional systems in the dwelling as applicable. •The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. •The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. •if outdoor air dry-bulb is SS°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems ` System Name or Identification/Tag SYSTEM 2 OF 2 I System Location or Area Served Living area I Outdoor Unit Serial # WiF1079018 Outdoor Unit Make York j Outdoor Unit Model CZF04813CA Nominal Cooling Capacity Btu/hr 48000 Date of Verification 10/27/2011 Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 10/5/2011 (must be re-calibrated monthly) Date of Thermocouple Calibration I // 10/5/2011 f (must be re-calibrated monthly) 1 r 1 I r . t Measured Temperatures I(OF) / �" ^� ? System Name or Identification/Tag 4 SYSTEM 2 OF 2 f a D Supply (evaporator leaving) air dry-bulb 54 temperature(Tsupply, db) Return (evaporator entering) air dry-bulb temperature (Treturn db) 76 Return (evaporator entering) air wet-bulb temperature (Treturn, wb) 56.5 Evaporator saturation temperature 36 (Tevaporator,sat) Condensor saturation temperature 85 (Tcondensor,sat) Suction line temperature(Tsuction) 53 i Liquid Line Temperature (Tliquid) 75 ! liquid Condenser(entering) air dry-bulb temperature (Tcondenser,db) 75 i ' I 1 s Reg: 211-A0056164B-M2500001A-0000 Registration Date/Time: 2011/10/28 ,14:18:42 HERS Provider: CalCERT3, Inc. 2008 Residential Compliance Forms August 2009 r INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 2 of 2, La Quinta CA 92253 City of La Quinta 11-1165 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification.The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag SYSTEM 2 OF 2 Calculate: Actual Temperature Split=Treturn, 22.00 db-Tsupply, db Target Temperature Split from Table RA3.2-3 using Tretum, wb and Tretum, db 22 Calculate difference: Actual Temperature Split- 0 Target Temperature Split= Passes if difference is between -3°F and +3°F or, upon remeasurement, if between -3°F and PASS -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow.measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement(CFM) = Nominal Cooling Capacity(ton) X 300 (cfm/ton) System Name or IdenJ�ification/Tag`} rSYSTEM 2'0F 2� w Rre Calculated Minimum Airfloequiment(CFM) Measured Airflow,using RA3.3 procedures (CFM)f f Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail • Superheat Charge Method Calculations for Refrigerant Charge Verification.This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag SYSTEM 2 OF 2 Calculate: Actual Superheat= Tsuction -Tevaporator,sat Target Superheat from Table RA3.2-2 using Tretum, wb and Tcondenser,db Calculate difference: Actual Superheat-Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail Reg: 211-A0056164B-M2500001A-0000 Registration Date/Time: 2011/10/28 14:18:42 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification -Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 2 of 2, La Quinta CA 92253 City of La Quinta 11-1165 Subcooling Charge Method Calculations for Refrigerant Charge Verification.This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve(EXV)systems. System Name or Identification/Tag SYSTEM 2 OF 2 Calculate: Actual Subcooling = 10.0 Tcondenser,sat-Tliquid Target Subcooling specified by manufacturer 10 Calculate difference: 0 Actual Subcooling -Target Subcooling = System passes if difference is between -3°F and +3°F PASS Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification.This procedure is required to be used for thermostatic expansion valve (TXV)and electronic expansion valve (EXV)systems. System Name or Identification/Tag SYSTEM 2 OF 2 Calculate: Actual Superheat= 17.0 Tsuction -Tevaporator,sat Enter allowable superheat range from manufacturer's specifications (or use range 17 between 4°F and 25°F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range PASS Enter Pass or Fail A Reg: 211-A0056164B-M2500001A-0000 Registration Date/Time: 2011/10/28 14:18:42 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: F113rcement Agency: Permit Number: 49-578 Avila Dr 2 of 2, La Quinta CA 92253 of La Quinta 11-1165 Standard Charge Measurement Summary: 1 System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system.operation. If corrective actions were taken, all applicable verification criteria must be re-measured and/or recalculated. System Name or Identification/Tag SYSTEM 2 OF 2 l System meets all refrigerant charge and airflow requirements. PASS Enter Pass or Fail - . s • i i 0 0, 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 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 k •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 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-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. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives,and beginning October 1,2010,for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) 4 Air Solutions of the Desert Responsible Person's Name: Responsible Person's Signature: Walter W Nellis Walter W Nellis CSLB License: Date Signed:10/27/2011 Position With Company (Title): 862106 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑Yes ❑No , • k i • � t Reg: 211-A0056164B-M2500001A-0000 Registration Date/Time: 2011/10/28.14:18:42 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms + August 2009 r INSTALLATION CERTIFICATE CF-6111-MECH-21-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 1 of 2, La Quinta CA 92253 (System City of La Quinta 11-1165 1) . Enter the Duct System Name or Identification/Tag: System 1 of 2 Enter the Duct System Location or Area Served: Bedroom Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. k 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 attem ted,before utilizing Option 4. Determiner nominal Fan Flow using one of the following three calculation methods./I.- ✓ Cooling system method: Size of condenser in Tons 14 x 400 =f 1600 CFM f ✓❑Heating system method: 21.7 x Output Capacity in Thousands of Btu/hr=_CFM ✓❑Measured system a i ow us ng R 3.3 airflow test procedures:_CFM Option 1 used then: -J 1 Allowed leakage = Fan Airflow 1600 x 0.15 = 240 CFM Actual Leakage = 237 CFM Pass if Actual Leakage is less than Allowed leakage p Pass❑Fail Option 2,used then: 2 Allowed leakage = Fan Airflow_x 0.10 =_CFM } Actual Leakage to outside = CFM Pass if Actual leakage to outside is less than Allowed leakage ❑Pass❑Fail Option 3 used then: t 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 0/6 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 Ej Fail i 4 i Reg: 211-A0056162A-M2100001A-0000 Registration Date/Time: 2011/10/28 03:08:38 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms I March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test- Existing Duct System (Page 2 of 2) Site Address: 49-578 Avila Dr 1 of 2, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 11-1165 9 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 and return register boots must be sealed to the drywall if smoke test is utilized for compliance - applies to duct leakage compliance option 3 (leakage reduction by 60%) and option 4 (fix all accessible leaks) described above.--, 0 New duct installations cannot utilize building cavities as plenums or platform returns in lieu of ducts. 0 Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape'to seal leaks at all new duct connections 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 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-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. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives,and beginning October 1,2010,for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Air Solutions of the Desert Responsible Person's Name: Responsible Person's Signature: Walter W Nellis Walter W Nellis CSLB License: Date Signed: Position With Company (Title): 862106 10/26/2011 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? []Yes ❑No Reg: 211-A0056162A-M2100001A-0000 Registration Date/Time: 2011/10/28 03:08:38 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE* I CF-6R-MECH-25=HERS Refrigerant Charge Verification -Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 1 of 2, La Quinta CA 92253 City of La Quinta 1111165 Note: If installation of a Charge Indicator Display(CID)is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate(instead of this MECH-25 Certificate)should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s)for any additional systems in the dwelling as applicable. ; Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space-conditioning systems that utilize prescriptive compliance method. TMAH-Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 of 2 ; System Location or Area Served Bedroom 1 p Yes ❑No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 p Yes ❑No 5/16 inch (8 mm)access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and 2 is a pass. Enter Pass or Fail ] ✓ Pass ✓ ❑ Fail STMS-Sensor on the Evaporator Coil ,, System Name or Identification/Ta95 I System 1 of 2 The sensor is factory installed, or field installed according to manufacturer's 3 Yes p No specifications,or is'installed by methods/specifications approved by the Executive' - /f j Director. I ,� The sensor wire is terminated.with a standard mini plug suitable for connection to a 4 ❑Yes ❑No digital thermometer.The sensor mini plug is accessible to the installing tectinician' a and the HERS rater without changing the airflow through the condenser coil ' 5 ❑Ye_s__T ❑No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F . Yes to 3,4, and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail ✓ N/A ✓ ❑Pass ✓ ❑Fail STMS-Sensor on the Condenser Coil 4 1 System Name or Identification/Tag System 1 of 2 - The sensor is factory installed,or field installed according to manufacturer's 6 ❑Yes ❑No specifications,or is installed by methods/specificati6ns approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑Yes ❑No digital thermometer.The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑Yes I ❑No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ applicable. Otherwise enter Pass or Fail N/A ✓ C]Pass ✓ ❑Fail l I } Reg: 211-A0056162A-M2500001A-0000 Registration Date/Time: 2011/10/28 14:17:24 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms ; August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification -Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 1 of 2, La Quinta CA 92253 City of La Quinta 11-1165 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2.As many as 4 systems in the dwelling can be documented for compliance using this form.Attach an additional form(s)for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. •The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. •If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems System Name or Identification/Tag System 1 of 2 System Location or Area Served Bedroom Outdoor Unit Serial # WlClSS9056 Outdoor Unit Make York Outdoor Unit Model CZF04813CA Nominal Cooling Capacity Btu/hr 48000 Date of Verification 10/27/2011 Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 10/5/2011 (must be re-calibrated monthly) Date of Thermocouple Calibration / 10/5/201 1 �f (must be.re-,calibrated monthly) Measured Temperatures-(°F) r System}Name or Identification/Tag System 1 of 2 % J7 i T/ ,r /. I f Supply (evaporator leaving) air dry-bulb 52 `^ -= •� u'+. t_ �. temperature (Tsupply, db) Return (evaporator entering)air dry-bulb 74 temperature (Treturn, db) Return (evaporator entering) air wet-bulb temperature (Treturn, wb) 54 Evaporator saturation temperature 37 (Tevaporator,sat) Condensor saturation temperature 87 (Tcondensor,sat) Suction line temperature(Tsuction) SS Liquid Line Temperature(Tliquid) 77 Condenser(entering) air dry-bulb temperature(T 7S condenser db) Reg: 211-A0056162A-M2500001A-0000 Registration Date/Time: 2011/10/28 14:17:24 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 t INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification -Standard Measurement Procedure (Page 3 of 5) Site Address: I Enforcement Agency: Permit Number: 49-578 Avila Dr 1 of 2, La Quinta CA 92253 City of La Quinta 11-1165 Minimum Airflow Requirement + Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification.The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag h System 1 of 2 Calculate: Actual Temperature Split=Treturn, 22.00 db-Tsupply, db Target Temperature Split from Table RA3.2-3 20 using Treturn, wb and Treturn,db Calculate difference: Actual Temperature Split- 2 { Target Temperature Split= Passes if difference is between -3°F and +3°F or, upon remeasurement, if between -30F and PASS -100°F Enter Pass or Fail i Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement(CFM) = Nominal Cooling Capacity(ton) X 300 (drn/ton) System Name or Identification/Ta g S stem 1 of 2 t f t Calculated Minimum Airflow Requirement(CFM) Measured Airflo�w�us+ng RA3.3 procedures (CFM) _J Yj7— L Passes if measured airflow is greater than or f equal to the calculated minimum airflow requirement. Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification.This procedure is required to be used for fixed orifice metering device systems l System Name or Identification/Tag System 1 of 2 i Calculate: Actual Superheat = Tsuction -Tevaporator,sat Target Superheat from Table RA3.2-2 using Tretum, wb and Tcondenser,db Calculate difference: Actual Superheat-Target Superheat System passes if difference is between -5°F and +5°F Enter Pass or Fail } i ' r • I Reg: 211-A0056162A-M2500001A-0000 Registration Date/Time: 2011/10/28 14:17:24 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 f INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 1 of 2, La Quinta CA 92253 City of La Quinta 11-1165 Subcooling Charge Method Calculations for Refrigerant Charge Verification.This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve(EXV)systems. System Name or Identification/Tag System 1 of 2 Calculate: Actual Subcooling = 10.0 Tcondenser,sat-Tliquid F Target Subcooling specified by manufacturer 10 Calculate difference: 0 Actual Subcooling -Target Subcooling = System passes if difference is between -3°F and +3°F PASS Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification.This procedure is required to be used for thermostatic expansion valve(TXV) and electronic expansion valve (EXV)systems. System Name or Identification/Tag System 1 of 2 Calculate: Actual Superheat= 18.0 Tsuction -Tevaporator,sat Enter allowable superheat range from manufacturer's specifications (or use range 18 + between 4°F and 25°F if manufacturer's specification is not available) System passes.if actual superheat is within-the- allowable ithin the"allowable superheat range / / PASS f Enter Pass or Fail f of Reg: 211-A0056162A-M2500001A-0000 Registration Date/Time: 2011/10/28 14:17:24 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 49-578 Avila Dr 1 of 2, La Quinta CA 92253 City of La Quinta 11-1165 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil ' airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken,all applicable verification criteria must be re-measured and/or recalculated. System Name or Identification/Tag System 1 of 2 System meets all refrigerant charge and airflow requirements. PASS Enter Pass or Fail 4 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 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-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. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives,and beginning October 1,2010,for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Air Solutions of the Desert Responsible Person's Name: Responsible Person's Signature: Walter W Nellis Walter W Nellis CSLB License: Date Signed: Position With Company (Title): 862106 10/27/2011 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑Yes ❑No Reg: 211-A0056162A-M2500001A-0000 Registration Date/Time: 2011/10/28 14:11:24 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009