13-0636 (ELEC)52975 Avenida Alvarado
PERFORMANCE CERTIFICATE: Residential (Part 1 of 5) CF-1R
Project Name Building Type Single Family Addition Alone Date
Multi Family Existing+ Addition/Alteration
Project Address California Energy Climate Zone Total Cond. Floor Area Addition # of Stories
FIELD INSPECTION ENERGY CHECKLIST
Yes No HERS Measures -- If Yes, A CF-4R must be provided per Part 2 of 5 of this form.
Yes No Special Features -- If Yes, see Part 2 of 5 of this form for details.
INSULATION Area Special
Construction Type Cavity (ft2) Features (see Part 2 of 5) Status
FENESTRATION U- Exterior
Orientation Area(ft2) Factor SHGC Overhang Sidefins Shades Status
HVAC SYSTEMS
Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status
HVAC DISTRIBUTION Duct
Location Heating Cooling Duct Location R-Value Status
WATER HEATING
Qty. Type Gallons Min. Eff Distribution Status
Wood Framed Attic
5/30/2014Trevor Jones Residence
4
4
52975 Avenita Alvarado La Quinta CA Climate Zone 15 1,502 1
Wood Framed Attic
Wall
Door
Roof
Slab
Roof
Wood Framed
Opaque Door
Unheated Slab-on-Grade
1,420
40
1,703
1,502
175
R-5
R-13
Insul
R-38
R-38 Existing
Existing
New
New
ExistingPerim = 170'
Ext=R-38.0 Radiant Barrier Cool Roof
Ext=R-38.0 Radiant Barrier Cool Roof
0
4
4
Front (E)
Left (S)
Rear (W)
Rear (W)
Right (N)
21.9
37.3
34.0
34.0
29.5
0.550
0.550
0.550
0.550
0.550
0.67
0.67
0.67
0.67
0.67
2.0
2.0
2.0
2.0
2.0
none
none
none
13.0/13.0
none
Bug Screen
Bug Screen
Bug Screen
Bug Screen
Bug Screen
Existing
Existing
Existing
Existing
Existing
13.0 SEER1Central Furnace Split Air Conditioner81% AFUE NewSetback
Attic, Ceiling Ins, ventedHVAC System DuctedDucted New8.0
All Pipes Ins1Small Gas 0.6940 New
ID: 14-277 Page 1 of 5EnergyPro 5.1 by EnergySoft User Number: 8841 RunCode: 2014-05-30T11:29:30
Reg: 214-N0039426A-000000000-0000 Registration Date/Time: 2014/06/02 09:33:34 HERS Provider: CalCERTS, Inc
Electronically Filed by Alexandra E. Winner and Authenticated at CalCERTS.com - 6/2/2014
Electronically Signed at CalCERTS.com by Trevor A Jones (Home Owner Builder) 6/2/2014
PERFORMANCE CERTIFICATE: Residential (Part 2 of 5) CF-1R
Project Name Building Type Single Family Addition Alone Date
Multi Family Existing+ Addition/Alteration
SPECIAL FEATURES INSPECTION CHECKLIST
The enforcement agency should pay special attention to the items specified in this checklist. These items require special written
justification and documentation, and special verification to be used with the performance approach. The enforcement agency
determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of
the special justification and documentation submitted.
HERS REQUIRED VERIFICATION
Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a
completed CF-4R form for each of the measures listed below for final to be given.
The Roof R-38 Roof Attic includes credit for a Radiant Barrier that is Continuous meeting eligibility and installation criteria as specified in Residential
Appendix RA4.2.2.
The Roof R-38 Roof Attic Reflectance = 0.10, Emittance = 0.85 shall be rated and labeled by the Cool Roof Rating Council in accordance with Section
10-113 of the standards.
The Cooling System Bryant 113ANC042-B* includes credit for a 11.0 EER Condenser. A certified HERS rater must field verify the installation of the
correct Condenser.
RunCode: 2014-05-30T11:29:30 ID: 14-277 Page 2 of 5EnergyPro 5.1 by EnergySoft User Number: 8841
5/30/2014Trevor Jones Residence
4
4
The HVAC System HVAC System incorporates HERS Verified Refrigerant Charge or a Charge Indicator Display.
The HVAC System HVAC System incorporates HERS verified Duct Leakage. HERS field verification and diagnostic testing is required to verify that
duct leakage meets the specified criteria.
Reg: 214-N0039426A-000000000-0000 Registration Date/Time: 2014/06/02 09:33:34 HERS Provider: CalCERTS, Inc
Electronically Filed by Alexandra E. Winner and Authenticated at CalCERTS.com - 6/2/2014
Electronically Signed at CalCERTS.com by Trevor A Jones (Home Owner Builder) 6/2/2014
PERFORMANCE CERTIFICATE: Residential (Part 3 of 5) CF-1R
Project Name Building Type Single Family Addition Alone Date
Multi Family Existing+ Addition/Alteration
ANNUAL ENERGY USE SUMMARY
(kBtu/ft2-yr)
Space Heating
Space Cooling
Fans
Domestic Hot Water
Pumps
Totals
Percent Better Than Standard:
Building Front Orientation: Ext. Walls/Roof Wall Area
Fenestration
Area
Number of Dwelling Units:
Fuel Available at Site:
Raised Floor Area:
Slab on Grade Area:
Average Ceiling Height:
Fenestration Average U-Factor: TOTAL:
Average SHGC: Fenestration/CFA Ratio:
REMARKS
STATEMENT OF COMPLIANCE
This certificate of compliance lists the building features and specifications needed
to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the
Efficiency Standards of the California Code of Regulations.
The documentation author hereby certifies that the documentation is accurate and complete.
Documentation Author
Company
Address Name
City/State/Zip Phone Signed Date
The individual with overall design responsibility hereby certifies that the proposed building design represented in this set
of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and
with any other calculations submitted with this permit application, and recognizes that compliance using duct design,
duct sealing, verification of refrigerant charge, insulation installation quality, and building envelope sealing require
installer testing and certification and field verification by an approved HERS rater.
Designer or Owner (per Business & Professions Code)
Company
Address Name
City/State/Zip Phone Signed License # Date
5/30/2014Trevor Jones Residence
4
4
10.33
28.73
Standard
2.97
27.76
6.21
13.03
0.00
Proposed
2.45
7.93
0.00
-1.72
Margin
0.53
-0.97
2.70
0.00
10.4 %
(E) 90 deg
1.00
Propane
0
1,502
8.5
0.55
(E)
(S)
(W)
(N)
Roof
149
462
322
683
1,878
157
22
37
68
30
0
ID: 14-277 Page 3 of 5EnergyPro 5.1 by EnergySoft User Number: 8841 RunCode: 2014-05-30T11:29:30
49.97 49.43 0.54
SOURCE ENERGY - NOT FOR TITLE 24 USE
0.67
(760) 851-8648
AHP Testing & Design
74998 Country Club Drive # 220-420
Palm Desert, CA 92260
Alexandra E. Winner
760-851-8648
AHP Testing
74998 Country Club Drive. #220-420
Palm Desert, CA 92260
Robert Bachus
1.1 %
Source
5/30/2014
Reg: 214-N0039426A-000000000-0000 Registration Date/Time: 2014/06/02 09:33:34 HERS Provider: CalCERTS, Inc
Electronically Filed by Alexandra E. Winner and Authenticated at CalCERTS.com - 6/2/2014
Electronically Signed at CalCERTS.com by Trevor A Jones (Home Owner Builder) 6/2/2014
CERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF-1R
Project Name Building Type Single Family Addition Alone Date
Multi Family Existing+ Addition/Alteration
OPAQUE SURFACE DETAILS
Surface U- Insulation Joint Appendix
Type Area Factor Cavity Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments
FENESTRATION SURFACE DETAILS
ID Type Area U-Factor1 SHGC2 Azm Status Glazing Type Location/Comments
(1) U-Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value
(2) SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value
EXTERIOR SHADING DETAILS
Window Overhang Left Fin Right Fin
ID Exterior Shade Type SHGC Hgt Wd Len Hgt LExt RExt Dist Len Hgt Dist Len Hgt
0.76
Existing
Wall
Door
Wall
Door
Wall
Wall
Wall
Roof
Slab
Roof
0.102
0.500
0.102
0.500
0.102
0.102
0.102
0.013
0.610
0.013
R-13 4.3.1-A3
Insul
R-13
Insul
R-13
R-13
R-13
R-38
R-5
R-38
38.0
38.0
90
90
0
0
180
270
0
90
0
0
4.5.1-A3
4.3.1-A3
4.5.1-A3
4.3.1-A3
4.3.1-A3
4.3.1-A3
4.2.1-A21
4.4.7-B6
4.2.1-A21
90
90
90
90
90
90
90
18
180
60 Zone 1
Zone 1
Zone 1
Zone 1
Zone 1
Zone 1
Zone 1
Zone 1
Zone 1
Zone 1Existing
Existing
New
Existing
New
Existing
Existing
Existing
New
175
107
20
297
20
425
254
337
1,703
1,502
None
None
Default
Default
Default
Default
Default
0.67
0.67
0.67
0.67
0.67
Default
Default
Default
Default
Default
90
180
270
270
0
Existing
Existing
Existing
Existing
Existing
Double Non Metal Clear
Double Non Metal Clear
Double Non Metal Clear
Double Non Metal Clear
Double Non Metal Clear
Zone 1
Zone 1
Zone 1
Zone 1
Zone 1
1
2
3
4
5
Window
Window
Window
Window
Window
21.9
37.3
34.0
34.0
29.5
0.550
0.550
0.550
0.550
0.550
1
2
3
4
5
Bug Screen
Bug Screen
Bug Screen
Bug Screen
Bug Screen
4.00.76
0.76
0.76
0.76
4.0
4.0
6.0
4.0
4.0
4.0
4.0
6.0
4.0
2.0
2.0
2.0
2.0
2.0
0.1
0.1
0.1
0.1
0.1
2.0
2.0
2.0
2.0
2.0
2.0
2.0
2.0
2.0
2.0
1.0 13.0 0 1.0 13.0 0
5/30/2014Trevor Jones Residence
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4
RunCode: 2014-05-30T11:29:30 ID: 14-277 Page 4 of 5EnergyPro 5.1 by EnergySoft User Number: 8841
Reg: 214-N0039426A-000000000-0000 Registration Date/Time: 2014/06/02 09:33:34 HERS Provider: CalCERTS, Inc
Electronically Filed by Alexandra E. Winner and Authenticated at CalCERTS.com - 6/2/2014
Electronically Signed at CalCERTS.com by Trevor A Jones (Home Owner Builder) 6/2/2014
CERTIFICATE OF COMPLIANCE: Residential (Part 5 of 5) CF-1R
Project Name Building Type Single Family Addition Alone Date
Multi Family Existing+ Addition/Alteration
BUILDING ZONE INFORMATION
Floor Area (ft2)
System Name Zone Name New Existing Altered Removed Volume Year Built
Totals
HVAC SYSTEMS
System Name Qty. Heating Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status
HVAC DISTRIBUTION
Duct Ducts
System Name Heating Cooling Duct Location R-Value Tested? Status
WATER HEATING SYSTEMS
System Name Qty. Type Distribution
Rated
Input
(Btuh)
Tank
Cap.
(gal)
Energy
Factor
or RE
Standby
Loss or
Pilot
Ext.
Tank
Insul. R-
Value Status
MULTI-FAMILY WATER HEATING DETAILS HYDRONIC HEATING SYSTEM PIPING
Control
Hot Water Piping Length
(ft) Add ½” Insulation System Name
Pipe
Length
Pipe
Diameter
Insul.
Thick. Qty. HP Plenum Outside Buried
5/30/2014Trevor Jones Residence
4
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200112,767Room 1 1,502HVAC System
1,502 0 00
Split Air Conditioner 13.0 SEER Setback NewHVAC System 1 Central Furnace 81% AFUE
HVAC System Ducted Attic, Ceiling Ins, ventedDucted 8.0 New
40 Gallon 40 KBTUs 0.67 Energy Factor1 All Pipes InsSmall Gas 40,000 40 0.69 n/a n/a New
4
RunCode: 2014-05-30T11:29:30 ID: 14-277 Page 5 of 5EnergyPro 5.1 by EnergySoft User Number: 8841
Reg: 214-N0039426A-000000000-0000 Registration Date/Time: 2014/06/02 09:33:34 HERS Provider: CalCERTS, Inc
Electronically Filed by Alexandra E. Winner and Authenticated at CalCERTS.com - 6/2/2014
Electronically Signed at CalCERTS.com by Trevor A Jones (Home Owner Builder) 6/2/2014
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-20
Duct Leakage Test - Completely New or Replacement Duct System (Page 1 of 2)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253 (System 1
(HVAC System))
Enforcement
Agency:
City of La Quinta
Permit Number:
Enter the Duct System Name or Identification/Tag: System 1 (HVAC System)
Enter the Duct System Location or Area Served: 1
Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the
dwelling.
This certificate is required for compliance for completely new duct systems installed in new dwelling construction, and also
for completely new or replacement duct systems in existing dwellings. 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.
Duct Leakage Diagnostic Test - completely new or replacement duct system
Enter a value for the Allowed Leakage (CFM) for the duct system leakage verification. The value entered must be the
VLLDCS criteria or one of the three calculated leakage rates described below.
Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Compliance Credit. If compliance credit for
verified low leakage ducts in conditioned space is shown in the special features section of the CF-1R, the
leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4), and 25 CFM must
be entered for Allowed Leakage.
Allowed
Leakage
(CFM)
Allowed leakage calculation – (select one calculation method from this section). Use 6% (leakage factor =
0.06) for calculations. When utilizing Low Leakage Air Handler (LLAH) credit, the allowed duct leakage may be
specified by the CF-1R to be less than 6%, in which case the user-specified leakage rate must be used in the
calculations below. For example, if the user-specified leakage (specified as a percentage of fan airflow) is
reported on the CF-1R as 3%, then use a leakage factor of 0.03 in the calculations below.
Cooling system method:
Nominal capacity of condenser in Tons 4 x 400 x leakage factor = 96 CFM
Heating system method:
21.7 x Output Capacity in Thousands of Btu/hr x leakage factor = CFM
Measured airflow method (RA3.3):
Enter measured fan flow in CFM here x leakage factor = CFM
Enter value for Actual leakage (CFM) in the right column, from measurement using applicable duct leakage
pressurization test procedure from Reference Residential Appendix RA3.1(CFM @ 25 Pa).
Actual
Leakage
(CFM)
List Actual Leakage from duct leakage test(CFM) 80
Pass if Actual Leakage is less than Allowed Leakage Pass Fail
For complete replacement of duct systems only, if the 6 percent leakage rate criteria cannot be met, a smoke
test should be performed to verify that the excess leakage is coming only from a pre-existing furnace cabinet
(air handler cabinet), and not from other accessible portions of the duct system. A HERS rater must verify the
installation (No sampling allowed).
List Actual Leakage from smoke test(CFM)
Pass if all accessible leaks (except for existing air handler) are sealed using smoke Pass Fail
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2000001A-M20A Registration Date/Time: 2014/06/02 13:57:11 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms August 2009
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-20
Duct Leakage Test - Completely New or Replacement Duct System (Page 2 of 2)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253 (System 1
(HVAC System))
Enforcement
Agency:
City of La Quinta
Permit Number:
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
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
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-6R), 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-6R)
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Home Owner Builder
Responsible Person's Name: CSLB License:
Trevor A Jones N/A
HERS Provider Data Registry Information
Sample Group # (if applicable): N/A tested/verified dwelling not-tested/verified dwelling in
a HERS sample group
HERS Rater Information CalCERTS Certificate # CC1-1798864445
HERS Rater Company Name:
Advancing Home Performance, Inc.
Responsible Rater's Name:Responsible Rater's Signature:
Robert Bachus Robert Bachus
Responsible Rater's Certification Number w/ this HERS Provider:Date Signed: 6/1/2014
CC2005695
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2000001A-M20A Registration Date/Time: 2014/06/02 13:57:11 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms August 2009
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-23
Verification of High EER Equipment (Page 1 of 1)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
Verification of High EER Equipment
Procedures for verification of High EER Equipment are described in Reference Residential Appendix RA3.4. For dwelling
units with multiple systems, the procedures must be applied to each system separately. 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.
1 System Name or Identification/Tag System 1 (HVAC
System)
2 System Location or Area Served 1
3 Certified EER Rating of the installed equipment (Btu/Watt-hr) 11
4 Make and Model Number of the installed Outdoor Unit BRYANT
113ANA048-E
5 Make and Model Number of the installed Inside Coil CARRIER
CNPV4821AL
6 Make and Model Number of the installed Furnace or Air Handler. BRYANT
310JAV048090
7 Minimum Equipment EER required for compliance as reported on
the CF-1R 11
When a high EER system specification includes a time delay relay, the installation of the time delay relay must be verified for compliance
credit. Refer to Reference Residential Appendix RA3.4.3 for the Time Delay Relay Verification Procedure.
When installation of specific matched equipment is necessary to achieve a high EER, installation of the specific equipment must be
verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Matched Equipment Verification Procedure.
8
If the Certified EER Rating in row 3 is equal to or greater than the
required minimum EER in row 7, the unit complies.
If the unit complies enter Pass
PASS
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-6R), 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-6R)
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Home Owner Builder
Responsible Person's Name: CSLB License:
Trevor A Jones N/A
HERS Provider Data Registry Information
Sample Group # (if applicable): N/A tested/verified dwelling not-tested/verified dwelling in
a HERS sample group
HERS Rater Information CalCERTS Certificate # CC1-1798864445
HERS Rater Company Name:
Advancing Home Performance, Inc.
Responsible Rater's Name:Responsible Rater's Signature:
Robert Bachus Robert Bachus
Responsible Rater's Certification Number w/ this HERS Provider:Date Signed: 6/1/2014
CC2005695
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2300002A-M23A Registration Date/Time: 2014/06/02 13:57:59 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms August 2009
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 6)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
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, unless the TMAH Compliance
Option is chosen.
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
(HVAC
System)
System Location or Area Served 1
1
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.
Yes
No
Yes
No
Yes
No
Yes
No
1a
Return side of the duct system is
located entirely within conditioned
space and return airflow temperature
to be measured at the return grille.
Yes
No
Yes
No
Yes
No
Yes
No
2
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
No
Yes
No
Yes
No
Yes
No
The TMAH Compliance Option should be checked only if the HERS Rater is able to confirm that it was
physically impossible for the HVAC Installer to drill the TMAH as required by Section RA3.2.2.2.2. Using this
Compliance Option requires the HVAC installer to annotate on the HERS Provider's data registry an
explanation as to why the TMAH cannot be installed on the system, and photographs of the equipment on
which the TMAH cannot be installed. Use of this Compliance Option also requires minimum airflow
verification through the direct measurement of airflow per RA3.3. For more information see
http://www.energy.ca.gov/title24/2008standards/special_case_appliance/
TMAH Compliance Option
Yes to 1 and 2, or Yes to 1a and 2, or
checking the TMAH Compliance Option, is
a pass.
Enter Pass or Fail
Pass
Fail
Pass
Fail
Pass
Fail
Pass
Fail
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-M25A Registration Date/Time: 2014/06/02 13:59:27 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms February 2013
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
STMS - Sensor on the Evaporator Coil
System Name or
Identification/Tag
System 1 (HVAC
System)
3 The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed
by methods/specifications approved by the Executive Director.
Yes No Yes No Yes No Yes No
4
The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer.
The sensor mini plug is accessible to the installing technician and the HERS rater without changing the
airflow through the condenser coil
Yes No Yes No Yes No Yes No
5 When attached to a digital thermometer, the sensor provides an indication of the saturation temperature
of the coil.
Yes No Yes No Yes No Yes No
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
N/A
Pass
Fail
N/A
Pass
Fail
N/A
Pass
Fail
STMS - Sensor on the Condenser Coil
System Name or
Identification/Tag
System 1 (HVAC
System)
6 The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed
by methods/specifications approved by the Executive Director.
Yes No Yes No Yes No Yes No
7
The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer.
The sensor mini plug is accessible to the installing technician and the HERS rater without changing the
airflow through the condenser coil
Yes No Yes No Yes No Yes No
8 When attached to a digital thermometer, the sensor provides an indication of the saturation temperature
of the coil.
Yes No Yes No Yes No Yes No
Yes to 6, 7, and 8 is a
pass.
Enter N/A if STMS are not
applicable.
Otherwise enter Pass or
Fail
N/A
Pass
Fail
N/A
Pass
Fail
N/A
Pass
Fail
N/A
Pass
Fail
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-M25A Registration Date/Time: 2014/06/02 13:59:27 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms February 2013
INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
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 temperature is less than 55°F, the installer must use the RA3.2.3 Alternate Charge Measurement
Procedure (Weigh-In Charging Method). If the Weigh-In Method is used, the dwelling cannot be included in a sample
group for HERS verification compliance.)
Space Conditioning Systems
System Name or Identification/Tag
System 1
(HVAC
System)
System Location or Area Served 1
Outdoor Unit Serial # 3311E16293
Outdoor Unit Make BRYANT
Outdoor Unit Model 113ANA048-E
Nominal Cooling Capacity 4 Tons
Date of Verification 6/1/2014
Calibration of Diagnostic Instruments
Date of Refrigerant Gauge Calibration 6/1/2014 (must be re-calibrated monthly)
Date of Thermocouple Calibration 6/1/2014 (must be re-calibrated monthly)
Measured Temperatures (°F)
System Name or Identification/Tag
System 1
(HVAC
System)
Supply (evaporator leaving) air
dry-bulb temperature (Tsupply, db)
Return (evaporator entering) air
dry-bulb temperature (Treturn, db)
Return (evaporator entering) air
wet-bulb temperature (Treturn, wb)
Evaporator saturation temperature
(Tevaporator, sat) 46.1
Condensor saturation temperature
(Tcondensor, sat) 111
Suction line temperature (Tsuction) 58.2
Liquid Line Temperature (Tliquid) 98.8
Condenser (entering) air dry-bulb
temperature (Tcondenser, db) 95
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-M25A Registration Date/Time: 2014/06/02 13:59:27 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms February 2013
INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
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
Calculate: Actual Temperature Split =
Treturn, db - Tsupply, db
Target Temperature Split from Table
RA3.2-3 using T return, wb and Treturn, db
Calculate difference: Actual Temperature
Split - Target Temperature Split =
Passes if difference is between -4°F and
+4°F or, upon remeasurement, if between
-4°F and -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 Identification/Tag System 1 (HVAC
System)
Calculated Minimum Airflow Requirement
(CFM) 1200
Measured Airflow using RA3.3 procedures
(CFM) 1227
Measurement Method Flow Hood
Passes if measured airflow is greater than or
equal to the calculated minimum airflow
requirement.
Enter Pass or Fail
PASS
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-M25A Registration Date/Time: 2014/06/02 13:59:27 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms February 2013
INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
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 T condenser, db
Calculate difference:
Actual Superheat - Target Superheat =
System passes if difference is between -6°F
and +6°F
Enter Pass or Fail
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 (HVAC
System)
Calculate: Actual Subcooling =
Tcondenser, sat - Tliquid 12.2
Target Subcooling specified by
manufacturer 15
Calculate difference:
Actual Subcooling - Target Subcooling = -2.8
System passes if difference is between
-4°F and +4°F
Enter Pass or Fail
PASS
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 (HVAC
System)
Calculate: Actual Superheat =
Tsuction - Tevaporator, sat 12.1
Enter allowable superheat range from
manufacturer's specifications (or use range
between 3°F and 26°F if manufacturer's
specification is not available)
3-26
System passes if actual superheat is within
the allowable superheat range
Enter Pass or Fail
PASS
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-M25A Registration Date/Time: 2014/06/02 13:59:27 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms February 2013
INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
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 (HVAC
System)
System meets all refrigerant charge and
airflow requirements.
Enter Pass or Fail
PASS
Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55°F and 65°F the
return air dry bulb temperature shall be maintained above 70°F during the Standard Charge Measurement
Procedure. The signature of the Responsible Person in the declaration statement below certifies this
requirement has been met for all applicable system verifications reported on this certificate.
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-6R), 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-6R)
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Home Owner Builder
Responsible Person's Name: CSLB License:
Trevor A Jones N/A
HERS Provider Data Registry Information
Sample Group # (if applicable): N/A tested/verified dwelling not-tested/verified dwelling
in a HERS sample group
HERS Rater Information CalCERTS Certificate # CC1-1798864445
HERS Rater Company Name:
Advancing Home Performance, Inc.
Responsible Rater's Name:Responsible Rater's Signature:
Robert Bachus Robert Bachus
Responsible Rater's Certification Number w/ this HERS
Provider:Date Signed: 6/1/2014
CC2005695
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-M25A Registration Date/Time: 2014/06/02 13:59:27 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms February 2013
INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS
Duct Leakage Test – Completely New or Replacement Duct System (Page 1 of 2)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253 (System 1
(HVAC System))
Enforcement
Agency:
City of La Quinta
Permit Number:
Enter the Duct System Name or Identification/Tag: System 1 (HVAC System)
Enter the Duct System Location or Area Served: 1
Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the
dwelling.
This certificate is required for compliance for completely new duct systems installed in new dwelling
construction, and also for completely new or replacement duct systems in existing dwellings. 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.
Duct Leakage Diagnostic Test - completely new or replacement duct system
Enter a value for the Allowed Leakage (CFM) for the duct system leakage verification. The value entered must be the
VLLDCS criteria or one of the three calculated leakage rates described below.
Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Compliance Credit. If compliance
credit for verified low leakage ducts in conditioned space is shown in the special features section of the
CF-1R, the leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4),
and 25 CFM must be entered for Allowed Leakage.
Allowed
Leakage
(CFM)
Allowed leakage calculation – (select one calculation method from this section). Use 6% (leakage
factor = 0.06) for calculations if tested at "final" or 4% (leakage factor = 0.04) if tested at "rough."
When utilizing Low Leakage Air Handler (LLAH) credit, the allowed duct leakage may be specified by the
CF-1R to be less than 6%, in which case the user-specified leakage rate must be used in the
calculations below. For example, if the user-specified leakage (specified as a percentage of fan airflow)
is reported on the CF-1R as 3%, then use a leakage factor of 0.03 in the calculations below.
Cooling system method:
Nominal capacity of condenser in Tons 4 x 400 x leakage factor = 96 CFM
Heating system method:
21.7 x ________ Output Capacity in Thousands of Btu/hr x leakage factor = ________ CFM
Measured airflow method (RA3.3):
Enter measured fan flow in CFM here ________ x leakage factor = ________ CFM
Enter value for Actual leakage (CFM) in the right column, from measurement using applicable duct
leakage pressurization test procedure from Reference Residential Appendix RA3.1(CFM @ 25 Pa).
Actual
Leakage
(CFM)
List Actual Leakage from duct leakage test(CFM) 80
Pass if Actual Leakage is equal to or less than Allowed Leakage Pass Fail
For complete replacement of duct systems only, if the 6 percent leakage rate criteria cannot be met, a
smoke test should be performed to verify that the excess leakage is coming only from a pre-existing
furnace cabinet (air handler cabinet), and not from other accessible portions of the duct system. A HERS
rater must verify the installation (No sampling allowed).
List Actual Leakage from smoke test(CFM)
Pass if all accessible leaks (except for existing air handler) are sealed using smoke Pass Fail
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2000001A-0000 Registration Date/Time: 2014/06/02 12:38:13 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS
Duct Leakage Test – Completely New or Replacement Duct System (Page 2 of 2)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253 (System 1
(HVAC System))
Enforcement
Agency:
City of La Quinta
Permit Number:
Compliance Method
This dwelling was: (select one of the following two choices):
Tested at Final
Tested at Rough-in (requires installer to complete the visual inspection at final construction stage described below)
Visual Inspection at Final Construction Stage (if applicable)
After installing the interior finishing wall and verifying that the above rough-in tests was completed, the following
procedure must be performed:
For all supply and return registers, verify that the spaces between the register boot and the interior finishing wall are
properly sealed.
If the house rough-in duct leakage test was conducted without an air handler installed, inspect the connection points
between the air handler and the supply and return plenums to verify that the connection points are properly sealed.
Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used.
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
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 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)
Home Owner Builder
Responsible Person's Name:
Trevor A Jones
Responsible Person's Signature:
Trevor A Jones
CSLB License:Date Signed:
6/1/2014 Position With Company (Title):
Is this installation monitored by a Third Party Quality
Control Program (TPQCP)? Yes No
Name of TPQCP (if applicable):
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2000001A-0000 Registration Date/Time: 2014/06/02 12:38:13 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-MECH-23-HERS
Verification of High EER Equipment (Page 1 of 1)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
Verification of High EER Equipment
Procedures for verification of High EER Equipment are described in Reference Residential Appendix RA3.4.
For dwelling units with multiple systems, the procedures must be applied to each system separately. 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.
1 System Name or Identification/Tag System 1
(HVAC System)
2 System Location or Area Served 1
3 Certified EER Rating of the installed equipment (Btu/Watt-hr) 11
4 Make and Model Number of the installed Outdoor Unit BRYANT
113ANA048-E
5 Make and Model Number of the installed Inside Coil CARRIER
CNPV4821AL
6 Make and Model Number of the installed Furnace or Air Handler. BRYANT
310JAV048090
7 Minimum Equipment EER required for compliance as reported on the
CF-1R 11
When a high EER system specification includes a time delay relay, the installation of the time delay relay must be verified for compliance
credit. Refer to Reference Residential Appendix RA3.4.3 for the Time Delay Relay Verification Procedure.
When installation of specific matched equipment is necessary to achieve a high EER, installation of the specific equipment must be
verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Matched Equipment Verification Procedure.
8
If the Certified EER Rating in row 3 is equal to or greater than the
required minimum EER in row 7, the unit complies.
If the unit complies enter Pass
PASS
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)
Home Owner Builder
Responsible Person's Name:
Trevor A Jones
Responsible Person's Signature:
Trevor A Jones
CSLB License:Date Signed:
6/1/2014 Position With Company (Title):
Is this installation monitored by a Third Party Quality
Control Program (TPQCP)? Yes No
Name of TPQCP (if applicable):
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2300002A-0000 Registration Date/Time: 2014/06/02 12:52:54 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS
Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 6)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
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, unless the TMAH Compliance
Option is chosen.
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
(HVAC
System)
System Location or Area Served 1
1
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.
Yes
No
Yes
No
Yes
No
Yes
No
1a
Return side of the duct system is
located entirely within conditioned
space and return airflow temperature
to be measured at the return grille.
Yes
No
Yes
No
Yes
No
Yes
No
2
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
No
Yes
No
Yes
No
Yes
No
The TMAH Compliance Option should be checked only if it is physically impossible to drill the TMAH as
required by Section RA3.2.2.2.2. Using this Compliance Option requires the HVAC installer to annotate on
the HERS Provider's data registry an explanation as to why the TMAH cannot be installed on the system,
and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance Option
also requires minimum airflow verification through the direct measurement of airflow per RA3.3
For more information see http://www.energy.ca.gov/title24/2008standards/special_case_appliance/
TMAH Compliance Option
Yes to 1 and 2, or Yes to 1a and 2, or
checking the TMAH Compliance Option, is
a pass.
Enter Pass or Fail
Pass
Fail
Pass
Fail
Pass
Fail
Pass
Fail
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-0000 Registration Date/Time: 2014/06/02 13:55:04 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2013
INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS
Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
STMS - Sensor on the Evaporator Coil
System Name or
Identification/Tag
System 1 (HVAC
System)
3 The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed
by methods/specifications approved by the Executive Director.
Yes No Yes No Yes No Yes No
4
The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer.
The sensor mini plug is accessible to the installing technician and the HERS rater without changing the
airflow through the condenser coil
Yes No Yes No Yes No Yes No
5 The sensor measures the saturation temperature of the coil within 1.3 degrees F
Yes No Yes No Yes No Yes No
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
N/A
Pass
Fail
N/A
Pass
Fail
N/A
Pass
Fail
STMS - Sensor on the Condenser Coil
System Name or
Identification/Tag
System 1 (HVAC
System)
6 The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed
by methods/specifications approved by the Executive Director.
Yes No Yes No Yes No Yes No
7
The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer.
The sensor mini plug is accessible to the installing technician and the HERS rater without changing the
airflow through the condenser coil
Yes No Yes No Yes No Yes No
8 The sensor measures the saturation temperature of the coil within 1.3 degrees F
Yes No Yes No Yes No Yes No
Yes to 6, 7, and 8 is a
pass.
Enter N/A if STMS are not
applicable.
Otherwise enter Pass or
Fail
N/A
Pass
Fail
N/A
Pass
Fail
N/A
Pass
Fail
N/A
Pass
Fail
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-0000 Registration Date/Time: 2014/06/02 13:55:04 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2013
INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS
Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
Standard Charge Measurement Procedure (for use if outdoor air dry-bulb temperature is 55°F or
above)
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 temperature is less than 55°F , the installer must use the RA3.2.3 Alternate Charge Measurement
Procedure (Weigh-In Charging Method). If the Weigh-In Method is used, the dwelling cannot be included in a sample
group for HERS verification compliance.)
Space Conditioning Systems
System Name or Identification/Tag
System 1
(HVAC
System)
System Location or Area Served 1
Outdoor Unit Serial # 3311E16293
Outdoor Unit Make BRYANT
Outdoor Unit Model 113ANA048-E
Nominal Cooling Capacity 4 Tons
Date of Verification 6/1/2014
Calibration of Diagnostic Instruments
Date of Refrigerant Gauge Calibration 6/1/2014 (must be re-calibrated monthly)
Date of Thermocouple Calibration 6/1/2014 (must be re-calibrated monthly)
Measured Temperatures (°F)
System Name or Identification/Tag
System 1
(HVAC
System)
Supply (evaporator leaving) air dry-bulb
temperature (Tsupply, db)
Return (evaporator entering) air
dry-bulb temperature (Treturn, db)
Return (evaporator entering) air
wet-bulb temperature (Treturn, wb)
Evaporator saturation temperature
(Tevaporator, sat) 46.1
Condensor saturation temperature
(Tcondensor, sat) 111.0
Suction line temperature (Tsuction) 58.2
Liquid Line Temperature (Tliquid) 98.8
Condenser (entering) air dry-bulb
temperature (Tcondenser, db) 95
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-0000 Registration Date/Time: 2014/06/02 13:55:04 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2013
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-0000 Registration Date/Time: 2014/06/02 13:55:04 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2013
INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS
Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
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 (HVAC
System)
Calculate: Actual Temperature Split =
Treturn, db - Tsupply, db
Target Temperature Split from Table
RA3.2-3 using T return, wb and Treturn, db
Calculate difference: Actual Temperature
Split - Target Temperature Split =
Passes if difference is between -3°F and
+3°F or, upon remeasurement, if between
-3°F and -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 Identification/Tag System 1 (HVAC
System)
Calculated Minimum Airflow Requirement
(CFM) 1200
Measured Airflow using RA3.3 procedures
(CFM) 1227
Measurement Method Flow Hood
Passes if measured airflow is greater than or
equal to the calculated minimum airflow
requirement.
Enter Pass or Fail
PASS
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-0000 Registration Date/Time: 2014/06/02 13:55:04 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2013
INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS
Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
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 1
(HVAC System)
Calculate: Actual Superheat =
Tsuction - Tevaporator, sat
Target Superheat from Table RA3.2-2
using Treturn, wb and T condenser, db
Calculate difference:
Actual Superheat - Target Superheat =
System passes if difference is between
-5°F and +5°F
Enter Pass or Fail
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 (HVAC
System)
Calculate: Actual Subcooling =
Tcondenser, sat - Tliquid 12.2
Target Subcooling specified by
manufacturer 15
Calculate difference:
Actual Subcooling - Target Subcooling = -2.8
System passes if difference is between
-3°F and +3°F
Enter Pass or Fail
PASS
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 (HVAC
System)
Calculate: Actual Superheat =
Tsuction - Tevaporator, sat 12.1
Enter allowable superheat range from
manufacturer's specifications (or use range
between 4°F and 25°F if manufacturer's
specification is not available)
4-25
System passes if actual superheat is within
the allowable superheat range
Enter Pass or Fail
PASS
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-0000 Registration Date/Time: 2014/06/02 13:55:04 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2013
INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS
Refrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6)
Site Address:
52-975 Avenida Alverado, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
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 (HVAC
System)
System meets all refrigerant charge and
airflow requirements.
Enter Pass or Fail
PASS
Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55°F and 65°F the
return air dry bulb temperature shall be maintained above 70°F during the Standard Charge Measurement
Procedure. The signature of the Responsible Person in the declaration statement below certifies this
requirement has been met for all applicable system verifications reported on this certificate.
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)
Home Owner Builder
Responsible Person's Name:
Trevor A Jones
Responsible Person's Signature:
Trevor A Jones
CSLB License:Date Signed:
6/1/2014 Position With Company (Title):
Is this installation monitored by a Third Party Quality
Control Program (TPQCP)? Yes No
Name of TPQCP (if applicable):
_____________________________________________________________________________________________________________________
Reg: 214-N0039426A-M2500003A-0000 Registration Date/Time: 2014/06/02 13:55:04 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2013