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SFD (12-0744)51060 Mandarina 12-0744 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: _t 1 12-00000744 51060 MANDARINA 776-210-012- - - DWELLING - SINGLE FAMILY LOW DENSITY RESIDENTIAL 284295 4 BUILDING & SAFETY DEPARTMENT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING PERMIT Owner: CITRUS 18 GROUP, LLC 30-875 DATE PALM DRIVE, STE. C DETACHED CATHEDRAL CITY, CA 92234_ Architect or Engineer: aia -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. L" nse Class: B License No.: 7 0957 Datetractar. OWNER -BUILDER DECLARATION Ihereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvemenYis sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractors) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. , BAP:C. for this reason - Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: - LQPERMIT Date: 8/14/12 F u Contractor: AUG 17 2012 GHA ENTERPRISE, INC. 30875 DATE PALM DRIVE , UI CITY DFA CATHEDRAL CITY, CA 9223 QUINTA (760) 969-1400 EfNANCEOEPT. Lic. No.: 750957 ----------------------------------------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. _V%_I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE'FUND Policy Number 71922311 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'. compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section L Ln 3700 of the Labor Code, I sha forthwith comply with t se provisions. /uate:v pplicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees. for any act or omission related to the work being . performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building co struction, and hereby. authorize representatives of this county to enter upon the above-mentioned pro erty fo spection pur e Oate: Z6 re (Applicant or Agent): Application Number . . . . . 12-00000744 Permit BUILDING PERMIT Additional desc . Permit Fee . . . . 1287.00 Plan Check Fee 836.55 Issue Date . . . . Valuation . . . . 284295 Expiration Date 1/02/13 Qty Unit Charge Per. Extension" BASE FEE 639.50 185.00 3.5000 THOU BLDG 100;001-500,000 647.50 Permit MECHANICAL Additional desc . Permit Fee . . . 118.00 Plan Check Fee ... 25.75 Issue Date Valuation 0 Expiration Date 1/02/13 Qty Unit Charge. Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 .00 9.0000 EA MECH B/C <=3HP/100K BTU .00 2.00 16.5000•EA MECH B/C >3-15HP/>100K-500KBTU 33.00 7.00 6.5000 EA MECH VENT FAN 45.50 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee 37.65 Plan Check Fee 9.41 Issue Date Valuation 0 Expiration Date, 2/02/13 J Qty. Unit Charge Per Extension BASE FEE 15.00 647.00 0350 ---------------------------------------------------------------------------- ELEC NEW RES - 1 OR 2 FAMILY 22.65" Permit . . : PLUMBING INV FEE Additional desc . Permit Fee 400.50 P1an.Check Fee 50.06 Issue Date Valuation . . . . 0 'Expiration Date 2/10/13 Qty Unit Charge Per Extension BASE FEE 30.00 22.00 12.0000 EA PLB FIXTURE 264.00 1.00 30.0000 EA PLB BUILDING SEWER 30.00 Application Number . . . . 12-00000744 Permit . . . . . . •PLUMBING -INV FEE ` Qty Unit Charge 'Per Extension 1.00 15.0000 EA PLB WATER HEATER/VENT 15.00 1.00 6.0000 EA PLB WATER INST/ALT/REP 6.00 ' 1.00 18..0000 EA 'PLB LAWN SPRINKLER SYSTEM 18.00 1.00 6.0000 EA PLB GAS PIPE 1-4 OUTLETS 6.00 1.00 1.5000 -EA PLB GAS PIPE >=5 1.50 1.00 30.0000 EA PLB GAS METER 30.00 Permit . . . GRADING PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee:. .00 Issue Date . . . . R Valuation . . 0 - Expiration Date 1/02/13 Qty Unit,Charge Per Extension BASE FEE 15.00 ------------------------- ---------------------------------------------------- Special Notes and Comments SFD - LOT 18, PLAN 1C, 3115 SF. PERMIT , DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH.INVESTIGATION FEE i ASSESSED PER 1997 UNIFORM ADMINISTRATIVE CODE §304.5 FOR WORK BEGUN WITHOUT BUILDING PERMIT. 2010 CODES. Other Fees . . . . . .. ART IN PUBLIC PLACES -RES 227.18 - BLDG STDS ADMIN (SB1473) 12.00 DIF COMMUNITY CENTERS -RES .104.00 DIF CIVIC CENTER - RES 1089.00 ENERGY REVIEW FEE 83.66 DIF FIRE PROTECTION -RES 612.00 DIF LIBRARIES - RES. 334.00 MULTI -SPECIES (MSHCP) FEE 1254.00 DIF PARK MAINT FAC- RES 51.00 DIF.PARKS/REC - RES 1773.00 • ` STRONG MOTION (SMI) - RES 29.09 DIF STREET MAINT FAC -RES 158.00 DIF TRANSPORTATION =. RES .3592.00 Fee summary Charged Paid Credited Due ----------------- ---------- _--------- Permit Fee Total 1858.15 .00 .00 1858.15 Plan Check Total 921.77 .00 .00 921.77 ' Other Fee Total 9318.93 .00 .00 9318.93 LQPERMIT _ 1 Riverside County Fire Department Fire Protection Planning Section tt 1 Riverside Office: 2300 Markel St., Ste. 150, Riverside, CA 92501 Ph. (951) 955.4777 Fax (951) 955.4886 - Murrieta Office: 39493 Los Alamos Rd., Ste A, Murrieta, CA 92563 Ph. (951) 600.6160 Fax (951) 600-6164 Palm Desert Office: 77.933 Las Montanas Rd., 4 201 Palm Desert, CA 92211.4131 Ph. (760) 863-8886 (760) 863.7072 Fire Department Clearance/Release Date: 1 i To: La Qv9ri i )-A Fax: Tract/Parcel Map #: Perm it/Lot #: L I Z - K S- d 3 r Job Site Address: S I - b b hd,8rtdll J_ a y Final For Recordation Release For Building Permit(s) Shell Final Only (No Tenant) CLe Final For" Sera n k'e Building Plan Check Fees Paid Building Plan Check Fees Not Paid Other Fees Fees Not Required If you should have any questions, please contact the appropriate Riverside County Fire Protection Planning office for further assistance. i Form C — Revised 11/21/2012 r Jdson Yd Print Name Certificate of Occupancy T -Oaf ot xP a" Community Development Department This Certificate is issued pursuant to the requirements of Chapter 1 Section R110 of the California Residential Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 51-060 MANDARINA Use classification: SINGLE FAMILY DWELLING Occupancy Group: R3 Type of Construction: VB Code Edition: 2010 Sprinkler Installed: YES _• • • _•ll_ Building • POST Building Permit No.: 12-0744 Land Use Zone: RL Sprinkler Required: YES Owner of Building: CITRUS 18 GROUP LLC Address: 30875 DATE PALM DR City, ST, ZIP: CATHEDRAL CITY, CA 92234 By: Date: PICUOUS PLACE AJ ORTEGA FEBRUARY 6,'2013 r CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 (System 1) City of La Quinta 18 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: master 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 dud systems installed in new dwelling construction, and also for completely new or replacement dud 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 ducts stem 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 Allowed verified low leakage ducts in conditioned space is shown in the special features section of the CF -111, the Leakage leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4), and 25 CFM must (CFM) be entered for Allowed Leakage. 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 aleakage factor of 0.03 in the calculations below. ® Cooling system method: Nominal capacity of condenser in Tons 4 x 400 x leakage factor = 6 CFM y! 17 11Heating system method:. 1 1 21.7 x Output Capacity in T#hofusands of Btu/hr x leakage`factor= CFM ­- ❑ Measured airflow method (RA3.3): Enter measured,fan'flow in'CFM:here x leakage factor Enter value for Actual leakage (CFM) in the right column, from measurement using applicable duct leakage Actual Leakage pressurization test procedure from Reference Residential Apperidix RA3.1(CFM @ 25 Pa). (CFM) List Actual Leakage from duct leakage test(CFM) 72 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 otheraccessible 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 Q Fail Reg: 212-N0035869A-M2000091A-M20A Registration Date/Time: 2013/02/05 16:11:54 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 ! v r CERTIFICATE OF FIELD'VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 (System 1) City of La Quinta 18 A. SSS- . . .' a -t '* . a -A . r - • • aOutside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct kage 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 t during duct leakage testing. ` ® All supply and return register boots must be sealed to the drywall r ® New duct installations cannot utilize building cavities as plenums or platform returns in lieu of ducts. 4. RMastic and draw bands must be.used in combmatiortwith;ClotFi'backed,*rubber adhesive duct tape to seaF leaks at ' E connections. V : ti DECLARATION STATEMENT . I certify under penalty` of perjury, under the laws of the State of Califomia,'the in provided on this forms true and correct. . I am the ceRified,HERS rater who performed the verification services—identified and reported' on this certificate (responsible rater) f . 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-6R),'signed and +submitted by the persons) 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) GHA Companies Responsible Person's Name: CSLB License: ; s Rudy Herrera N/A HERS Provider Data Registry Information J Sample Group # (if applicable): N/A FIN tested/verified dwelling' 0 not-tested/verified dwelling in, la HERS sample group HERS Rater Information CalCERTS Certificate # CCl-1798671620 HERS Rater Company Name: MLC Building Performance Responsible Rater's Name: Responsible Rater's Signature: , a Tom Bachus , Tam Buchus , Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/5/2013 CC2005932 t Reg: 212-N0035869A-M2000091A-M20A Registration Date/Time: 2013/02/05.16:11:54, HERS Provider:•CalCERTS, Inc.. 2008 Residential Compliance Forms ' 'z _ -:August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System - (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 (System 2) City of La Quinta 18 Enter the Duct System Name or Identification/Tag: System 2 Enter the Duct System Location or Area Served: great room kitchen 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 ducts stem 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 Allowed verified low leakage ducts in conditioned space is shown in the special features section of the CF -1R, the Leakage leakage to outside test method must be used to verify duct leakage (refer to,RA3.1.4.3.4), and 25 CFM must (CFM) be entered for Allowed Leakage. 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-iR 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 aleakage factor of 0.03 in the calculations below. ® Cooling system method: Nominal capacityofcondenser in Tons 5 x 400 x leakage factorM= 12o CFM' 4(7 ❑ Heating system method: Ii 21.7 x a Output Capacity`in Thousands of Btu/hr x /e k f r = CFM P_ 1/: ` a age acto --.k ❑ Meansured airflow.: method (RA3.3): -, ! I Enter easured.rfan flow in;CFM.here x leakage factor-=',4'CFM Enter value for Actual leakage (CFM) in the right column, from measurement using applicable duct leakage PP g Actual Leakage(CFM) pressurization test procedure from Reference Residential Appendix RA3.1(CFM @ 25 Pa). List Actual Leakage from duct leakage test(CFM) 112 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 otheraccessible 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: 212-N0035869A-M2000092A-M20A Registration Date/Time: 2013/02/05 16:11:54 * HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 (System 2) City of La Quinta 18 IeaOutside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct kage 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. RMastic and dra bands must be ,used in,combmation with'CIoEF%.backed,°rubber a'dry hese duct tape-to`seal leaks at uct connections. ) DECLARATION STATEMENT,l „ • I certify under penalty of perjury, under the laws of the StZof California, the information provided on this form is true and correct. • I am the certified HERS rater.who performed the verification services identified andreported on this certificate:(responsible rater).-f°,4i° • 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 -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) GHA Companies Responsible Person's Name: CSLB License: Rudy Herrera N/A HERS Provider Data Registry Information Sample Group # (if applicable): N/A --f®tested/verified dwellingQ not-tested/verified dwelling in la HERS sample group HERS Rater Information Ca10ERTS Certificate # CC1-1798671620 HERS Rater Company Name: MLC Building Performance Responsible Rater's Name: Responsible Rater's Signature: Tom Bachus Tom Bachus Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/5/2013 CC2005932 Reg: 212-N0035869A-M2000092A-M20A Registration Date/Time: 2013/02/05 16:11:54 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-22 HSPP/PSPP Installation: Fan Watt Draw Test (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 City of La Quinta 18 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. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP) in the supply plenum When the Certificate of Compliance (CFIR )indicates Cooling Coil Airflow or Fan Watt Draw verification are required, HSPP or PSPP are required to be installed in each air handler in the dwelling. Procedures for installing HSPP and PSPP are described in Reference Residential Appendix RA3.3. This measure requires verification by a HERS rater. Select one method from the two choices below for compliance with the HSPP/PSPP requirement for this dwelling. ® HSPP 1/4 inch (6 mm) hole labeled and located downstream of the evaporator coil in the supply W Diagnostic Fan Flow Using Flow Capture Hood according to the procedures in RA3.3.3.1.3 r System Name or Identification/Tag plenum as shown in the figure in Section RA3.3.1.1. System 2 1/4 inch (6 mm) hole equipped with a permanently installed pressure probe, labeled and located p PSPP downstream of the evaporator coil in the supply plenum as shown in the figure in Section RA3.3.1.1. System Name or Identification/Tag System 1 System 2 Enter the minimum airflow requirement from the CF -1R (CFM/ton). System Location or Area Served master great room kitchen Calculate the target minimum airflow for the test by multiplying the Confirm that a HSPP or PSPP has been CFM/ton criteria specified on the CF -111 by the nominal cooling capacity of installed on the air handler per the PASS PASS the outdoor unit (ton). requirements of RA3.3.1.1. Target (CFM) Enter Pass or Fai Enter the diagnostically tested airflow (CFM). Cooling Coil Airflow Verification When the Certificate of Compliance indicates Cooling Coil Airflow verification is required, the procedures for measuring the cooling coil airflow must be performed as specified in Reference Residential Appendix RA3.3. Results of the cooling coil airflow diagnostic test must be entered in the table, below -This measure requires verification by a HERS -rater. ^y Select one method from the three choices below for'compliance with the Cooling Coil Airflow test requirement for this dwelling; ❑ Diagnostic Fan Flow,Using Plenum Pressure Matching according to the procedures in RA3.3.3.1.1 ! ❑ Diagnostic Fan,Flow Using Flow Grid Measurement according to the procedures in RA3.3.3.1.2 W Diagnostic Fan Flow Using Flow Capture Hood according to the procedures in RA3.3.3.1.3 r System Name or Identification/Tag System 1 System 2 System Location or Area Served System 1 System 2 Nominal Cooling Capacity (ton) of the outdoor unit. 4 5 Enter the minimum airflow requirement from the CF -1R (CFM/ton). 350 CFM/ton 350 CFM/ton Calculate the target minimum airflow for the test by multiplying the CFM/ton criteria specified on the CF -111 by the nominal cooling capacity of 1400 1750 the outdoor unit (ton). Target (CFM) Enter the diagnostically tested airflow (CFM). 1525 1818 Tested (CFM) The system complies if Tested (CFM) is equal or greater than Target (CFM). PASS PASS Enter Pass or Fail Reg: 212-N0035869A-M2200097A-M22A Registration Date/Time: 2013/02/05 16:13:10 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-22 HSPP/PSPP Installation: Fan Watt Draw Test (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 City of La Quint a 18 Fan Watt Draw Verification When the Certificate of Compliance indicates Fan Watt Draw verification is required, the procedures for measuring the Fan Watt Draw must be performed as specified in Reference Residential Appendix RA3.3. Results of the Fan Watt Draw diagnostic test must be entered in the table below. This measure requires verification by a HERS rater. Note: Fan watt draw must be measured simultaneously with cooling coil airflow. The fan watt draw measurement and cooling coil airflow measurement must simultaneously meet or exceed their target criteria specified by the CF -1R for the dwelling. Select one method from the two choices below for compliance with the Fan Watt Draw test requirement for this dwelling. ® Portable Watt Meter Measurement according to the procedures in RA3.3.2.2.1 p Utility Revenue Meter Measurement according to the procedures in RA3.3.2.2.2 System Name or Identification/Tag System 1 System 2 HERS Provider Data Registry Information System Location or Area Served master great room kitchen Enter the air handler Tested (CFM) from the cooling coil airflow test 1525 1818 MLC Building Performance Responsible Rater's Name: table above. Tom Bachus Tom Bachus Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/5/2013 Enter the fan watt draw requirement from the CF -1R (Watt/CFM). .58 .58 Watt/CFM, Watt/CFM Calculate the target maximum Watt draw for the test by multiplying the Watt/CFM criteria specified on the CF -111 by the air handier Tested 884.5 1054.44 (CFM). Target (CFM) Enter the diagnostically tested Watt draw (Watt). 776.25 951.36 Tested (Watt) The system complies if Tested (Watt) is less than or equal to Target (Watt) PASS PASS - Enter. Pass or Fail jr T 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 -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 agencv. Builder or Installer information as shown on the Installation Certificate (CF -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) GHA Companies Responsible Person's Name: CSLB License: Rudy Herrera 7N/A HERS Provider Data Registry Information Sample Group # (if applicable): N/A ® tested/verified dwelling 0 not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate * CC1-1798671620 HERS Rater Company Name: MLC Building Performance Responsible Rater's Name: Responsible Rater's Signature: Tom Bachus Tom Bachus Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/5/2013 CC2005932 t Reg: 212-N0035869A-M2200097A-M22A Registration Date/Time: 2013/02/05 16:13:10: HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-23 Verification of High EER Equipment (Page 1 of 1) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 =City of La Quinta 18 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 dwellinq as applicable. 1 System Name or Identification/Tag System 1 System 2 CSLB License: Rudy Herrera 2 System Location or Area Served master great room kitchen ❑ not-tested/verified dwelling in la 3 Certified EER Rating of the installed equipment 12.2 12.5 MLC Building Performance Responsible Rater's Name: Responsible Rater's Signature: (Btu/Watt-hr) Tom Bachus Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/5/2013 CC2005932 4 Make and Model Number of the installed Outdoor Unit Day and Night Day and Night NXA648GKA NXA660GKA100 5 Make and Model Number of the installed Inside Coil Aspen Aspen ACE48D44175Lo78 ACE603421L087 6 Make and Model Number of the installed Furnace or Air Day and Night Day and Night Handler. NSMSLO701716A1 NSMSLO902120Al 7 Minimum Equipment EER required for compliance as 12 12 reported on the CF -1R ❑ 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. If the Certified EER Rating in row 3 is equal to or 8 greater than the required minimum EER in row 7, the PASS PASS unit complies.' If the unit complies enter 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) GHA Companies Responsible Person's Name: CSLB License: Rudy Herrera N/A HERS Provider Data Registry Information Sample Group # (if applicable): N/A IN tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CCl-1798671620 HERS Rater Company Name: MLC Building Performance Responsible Rater's Name: Responsible Rater's Signature: Tom Bachus Tom Bachus Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/5/2013 CC2005932 Reg: 212-N0035869A-M2300095A-M23A Registration Date/Time:'2013/02/05 16:15:16 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 a CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address:Enforcement Agency: Permit Nuber: 51060 Mandarin a, La Quinta CA 92247 mCity of La Quinta 18 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 .t 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 2 System Location or Area Served master great room kitchen 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 Faill ✓ ® Pass ✓ ❑Fail STMS - Sensoro' on the Evaporator, Coil •, I f System Name or Identification/Tagf f 7 f System i System Tj F The sensor is factory installed, o5 field installed according to manufacturer's 3 ❑ YesAP, No specifications, or i§ installed by methods/specifications approved by the Executive r .r4 l Director. +1 1 A l I' l 1 J 1 The sensor wire is terminated with a standardimini plug suitable for connection to a 4 ❑ 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 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 ® N/A T ✓ ❑ Pass V. ❑ Fail applicable. Otherwise enter Pass or Fail Y STMS - Sensor on the Condenser Coil F System Name or Identification/Tag System 1 System 2 1 ' 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 V. ®N/A ✓ 13 Pass ✓ El Fall applicable. Otherwise enter Pass or Fail Y Reg: 212-N0035869A-M2500099A-M25A Registration Date/Time: 2013/02/05 16:24:26 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms. March 2010 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 t Appendix RA3.2. As many as 4 systems in the dwelling can be documented for complianceusing 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 2 Date of TermocoupterCalibration } / (` j 2/2/2013 System Location or Area Served master great room kitchen ' Outdoor Unit Serial # E121528O33 E1238O3436 , Outdoor Unit Make Day and Night Day and Night Outdoor Unit Model Day and Night Day and Night Nominal Cooling Capacity Btu/hr+" ",' 48000 60000 } Return (evaporator entering) air wet -bulb „ ,f • Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 2/2/2013 (must be re -calibrated monthly) Date of TermocoupterCalibration } / (` j 2/2/2013 must be re -calibrated monthly) a Date of Verification 2/5/2013 2/5/2013 Measured Temperaturesl('F) I / ) System Name or Identification/Tag System 1 System 2 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 80 78 (Tevaporator, sat) Condensor saturation temperature 78 76 (Tcondensor, sat) . Suction line temperature (Tsuction) 88 88 ' Liquid Line Temperature (Tliquid) 64' 65 ` Condenser (entering) air dry-bulb 72 72 temperature (Tcondenser, db) I t Reg: 212-N0035869A-M2500099A-M25A Registration Date/Time: 2013/02/05 16:24:26„" HERS P_rovider:-Ca10ERTS,.Inc. 2008 Residential'Compliance Forms. + l March 2010 1 , a ' '! '„ 4f ° •'- •` .i ice++ t •_ • INSTALLATION CERTIFICATE CF-4R-MECH-25 ,c Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) z Site Address: Enforcement Agency- Permit Number: ` • z. 51060 Mandarina, La Quinta CA 92247 City of La Quinta .18 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, 1; db - Tsupply, db Target Temperature Split from Table RA3.2-3 using Treturn, 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 Faill , 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) - w System Name or Identification/Tagf Ir System 1 System 2 - Calculated Minimum Airflow Requirement (CFM) 11200-1,141500 Measured Airflow.u§ing RA -3.3 procedures 1525 r!! 1818,, f (CFM) w. Passes if measured airflow is greater than or equal to the calculated minimum airflow PASS PASS 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.' , 1; 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 , Reg: 212-N0035869A-M2500099A-M25A Registration Date/Time: 2013/02/05 16:24:26 ITERS Provider: Ca10ERTS,•Inc. 2008 Residential Compliance Forms _ ` - March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 City of La Quinta 18 + 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 System 2 , Calculate: Actual Subcooling = Tcondenser, sat - Tliquid 14.0 11.0 , Target Subcooling specified by manufacturer 12 12 Calculate difference: 2 -1 Actual Subcooling - Target Subcooling = System passes if difference is between -4°F and +4°F PASS PASS Enter Pass or Fail- System:Passes-if actual superheat is within the j 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 i System 2 f Calculate: Actual Superheat = g,0 10.0 '. Tsuction - Tevaporator, sat Enter allowable superheat range from , manufacturer's specifications (or use range 4-25 3-26 ` between 3°F and 26°F if manufacturer's specification is not -available) t ,r -- r . allowable superheat range PASS EriterrPass or Fail a °"---• :.:., ,, a System:Passes-if actual superheat is within the j a I Reg: 212-N0035869A-M2500099A-M25A .Registration Date/Time: 2013/02/05 1.6:24:26 HERS Provider:,Ca10ERTS, Inc. , 2008 Residential Compliance Forms ` March'2010 17 , - - fit - ."- - " - - _• I Reg: 212-N0035869A-M2500099A-M25A .Registration Date/Time: 2013/02/05 1.6:24:26 HERS Provider:,Ca10ERTS, Inc. , 2008 Residential Compliance Forms ` March'2010 , r a - } 4 t :r. INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure r (Page S, of 5) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 City of La Quinta 18 Standard Charge Measurement Summary: - System shall pass both refrigerant charge criteria, metering device criteria (if applicable), aril 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. w' System 2 HERS Provider Data Registry Information Sample Group # (if applicable): N/AIlktested/verified System meets all refrigerant charge and ❑ not-tested/verified dwelling in a HERS sample group airflow requirements. PASS PASS 7 Responsible Rater's Name: Responsible Rater's Signature:. Enter Pass or Fail Robert Buchus t Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/5/2013 CC2005695 , ` . Ca . -. - r .: ; .... ,ate 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). - r . 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 -6R), signed and submitted by the persori(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) , GHA Companies a, ' Responsible Person's Name: CSLB License: . Rudy Herrera N/A HERS Provider Data Registry Information Sample Group # (if applicable): N/AIlktested/verified dwelling ❑ not-tested/verified dwelling in a HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798671620 HERS Rater Company Name: i MLC Building Performance Responsible Rater's Name: Responsible Rater's Signature:. Robert Bachus Robert Buchus t Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/5/2013 CC2005695 r r f Reg: 212-N0035869A-M2500099A-M25A, Registration Date/Time: 2013/02/05'16:24:26 HERS Provider: C4CERTSa, Inc. 2008 Residential Compliance Forms' k March 2010 i INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS Duct Leakage Test — Completely New or Replacement Duct System (Page 1 of 2) Site Address: ' Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 (System 1) 1 City of La Quinta 18 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: master 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. Dud 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 Duds 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 Allowed CF -1R, the leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4), Leakage and 25 CFM must be entered for 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 -111 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 aleakage factor of 0.03 in the calculations below. ria ,.' £- ,,. •---+ - -- ---- ! ® Cooling system method: ' .- .S ' ` -• ' Nominal capacity of condenser in Tons A x 400 x leakage factor = CFM } j ❑ Heating system method 21.7 x i Output Capacity in Thousands of Btu/hr x leakage factor = CFM T ; ❑ 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 Actual Leakage leakage pressurization test procedure from Reference Residential Appendix RA3.1(CFM @ 25 Pa): (CFM) List Actual Leakage from duct leakage test(CFM) 78 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 p Fail Reg: 212-N0035869A-M2000091A-0000 Registration Date/Time: 2013/02/05 15:45:10 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 Y INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS Duct Leakage Test — Completely New or Replacement Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 (System 1) City of La Quinta 18 Compliance Method This dwelling was: (select one of the following two choices): ® Tested at Final E3 Tested at Rough -in (requires installer to complete the visual inspection at final construction stage described below) visual inspection at Final construction stage (it applicable) After installing the interior finishing wall and verifying that the above rough -in tests was completed, the following procedure must be performed: t ' ❑ For all supply and return registers, verify that the spaces between the register boot and the interior finishing wall are properly sealed. p 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. p 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, 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 atrduct connection fes, 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 -111) 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. Ir 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 reoistry for multiDle orientation alternatives, and beainnina October 1. 2010. for all low-rise residential buildinos. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) GHA Companies Responsible Person's Name: Responsible Person's Signature: Rudy Herrera Rudy Herrera CSLB License: Date Signed: r11/20/2013 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? 0 Yes p No Reg: 212-N0035869A-M2000091A-0000 _Registration Date/Time: 2013%02/05 15:45:10_' HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-611-MECH-22-HERS HSPP/PSPP Installation; Cooling Coil Airflow & Fan Watt Draw Test (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 City of La Quinta 18 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 Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP) in the supply plenum When the Certificate of Compliance (CF1R )indicates Cooling Coil Airflow or Fan Watt Draw verification are required, HSPP or PSPP are required to be installed in each air handler in the dwelling. Procedures for installing HSPP and PSPP are described in Reference Residential Appendix RA3.3. This measure requires verification by a HERS rater. Select one method from the two choices below for compliance with the HSPP/PSPP requirement for this dwelling. ® HSPP 1/4 inch (6 mm) hole labeled and located downstream of the evaporator coil in the supply in RA3.3.3.1.3 System Name or Identification/Tag plenum as shown in the figure in Section RA3.3.1.1. System 2 1/4 inch (6 mm) hole equipped with a permanently installed pressure probe, labeled and ❑ PSPP located downstream of the evaporator coil in the supply plenum as shown in the figure in Section RA3.3.1.1. System Name or Identification/Tag System 1 System 2 Enter the minimum airflow requirement from the CF -1R (CFM/ton). System Location or Area Served master great room kitchen Calculate the target minimum airflow for the test by multiplying the CFM/ton criteria specified on the CF -1R by the nominal cooling capacity of the outdoor unit (ton). Target (CFM) Confirm that a HSPP or 1750 Enter the diagnostically tested airflow (CFM). ' Tested (CFM) PSPP has been 1811 The system complies if Tested (CFM) is equal or greater than Target (CFM). Enter Pass or Fail installed on the air PASS T 1 handler per the PASS PASS requirements of RA3.3.1.1. _ Enter, Pass or Fai *--I Goofing Coil Airflow.Verification .. When the Certificate.of Compliance indicates Cooling Coil Airflow verification is required, the procedures fld 1, q measuring the cooling coil airflow must be performed as specified in Reference Residential Appendix RA3.3. ' Results of the co'o'ling coil airt7ow diagnostic test must, be entered in.the table below. This rrieasur'e require&5 verification by a HERS rater. Select one method from the three choices below for compliance with the Cooling Coil Airflow test requirement for this dwelling. ❑ Diagnostic Fan Flow Using Plenum Pressure Matching according to the procedures in RA3.3.3.1.1 ❑ Diagnostic Fan Flow Using Flow Grid Measurement according to the procedures in RA3.3.3.1.2 ® Diagnostic Fan Flow Using Flow Capture Hood according to the procedures in RA3.3.3.1.3 System Name or Identification/Tag System 1 System 2 System Location or Area Served System 1 System 2 Nominal Cooling Capacity (ton) of the outdoor unit. 4 5 Enter the minimum airflow requirement from the CF -1R (CFM/ton). 350 350 Calculate the target minimum airflow for the test by multiplying the CFM/ton criteria specified on the CF -1R by the nominal cooling capacity of the outdoor unit (ton). Target (CFM) 1400 1750 Enter the diagnostically tested airflow (CFM). ' Tested (CFM) 1542 1811 The system complies if Tested (CFM) is equal or greater than Target (CFM). Enter Pass or Fail PASS PASS F Reg: 212-N0035869A-M2200097A-0000 .Registration Date/Time: 2013/02/05 16:02:41 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 Fan Wa Enfo City verificati dentia/ A sure requ ow. The et criter e with th ures in RA dures in w test t CFM). tiplying ested Target Te ( Target r Pass o Ca tlifomia, to accep ble perso ufactured on is cons compliant t Energy approve ch quality ple group proved b tailed on on Certif le to the is requ at all Inst r 1, 2010 ctor or Respo Rudy H Positio Name e/Time: INSTALLATION CERTIFICATE CF-6R-MECH-22-HERS HSPP/PSPP Installation; Cooling Coil Airflow & tt Draw Test (Page 2 of 2) Site Address: rcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 of La Quint a 18 Fan Watt Draw Verification When the Certificate of Compliance indicates Fan Watt Draw on is required, the procedures for measuring the Fan Watt Draw must be performed as specified in Reference Res i ppendix RA3.3. Results of the Fan Watt Draw ' , diagnostic test must be entered in the table below. This mea fres verification by a HERS rater. Note: Fan watt draw must be measured simultaneously with cooling coil airfl fan watt draw measurement and cooling coil airflow measurement must simultaneously meet or exceed their taro is soecified by the CF -1R for the dwellino. Select one method from the two choices below for compliant a Fan Watt Draw test requirement for this dwelling. M Portable Watt Meter Measurement according to the proced 3.3.2.2.1 El Utility Revenue Meter Measurement according to the proce RA3.3.2.2.2 System Name or Identification/Tag System 1 System 2 CSLB License: Date Signed: 1/20/2013 System Location or Area Served master great room kitchen Control Program (TPQCP)? ❑ Yes ❑ No Enter the air handler Tested (CFM) from the cooling coil airfloable 1542 1811 above. Enter the fan watt draw requirement from the CF -1R (Watt/ .58 .58 Calculate the target maximum Watt draw for the test by mul the Watt/CFM criteria specified on the CF -1R by the air handler 894.36 1050.38 t (CFM). CFM) Enter the diagnostically tested Watt draw (Watt). 814.25 956.75 a T Watt) The system complies if Tested (Watt) is less than or equal to (Watt) PASS PASS . Ente r Fail DECLARATION STATEMENT ` • I certify under penalty of perjury, under the laws of the State of C he information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code t responsibility for construction, or an authorized , representative of the person responsible for construction (responsi n), • I certify that the installed features, materials, components, or man devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installati istent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify e, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand tha Commission and HERS provider representatives will also perform quality assurance checking of installations, including those d as part of a sample group but not checked by a HERS rater, and If those Installations fall to meet the requirements of su assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sam will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -SR) form ap y the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements de the CF -1R that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installati irate shall be posted, or made available with the building permit(s) issued for the building, and made availab enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate ired to be included with the documentation the builder provides to the building owner at occupancy. I will ensure th allation Certificates will come from a HERS provider data ' registry for multiple orientation alternatives, and beginning Octobe , for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contra Builder/Owner) GHA Companies Responsible Person's Name: risible Person's Signature: Rudy Herrera errera CSLB License: Date Signed: 1/20/2013 n With Company (Title): Is this installation monitored by a Third Party Quality of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No 1. Reg: 212-N0035869A-M2200097A-0000 Registration Dat 2013/02/05 16:02:41 - HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-23-HERS Verification of High EER Equipment (Page 1 of 1) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 City of La Quinta 18 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 anv additional systems in the dwellina as aoolicable. 1 System Name or Identification/Tag System 1 System 2 Rudy Herrera Rudy Herrero 2 System Location or Area Served master great room kitchen Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No 3 Certified EER Rating of the installed equipment 12.2 12.5 (Btu/Watt-hr) 4 Make and Model Number of the installed Outdoor Unit Day and Night Day and Night NXA648GKA100 NXA660HKA 5 Make and Model Number of the installed Inside Coil Aspen Aspen ACE48D441751-078 ACE6034210L087 6 Make and Model Number of the installed Furnace or Air Day and Night Day and Night Handler. N8MS11.00701716A1 NSMSL0902120AI 7 Minimum Equipment EER required for compliance as 12 12 reported on the CF -1R ❑ 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. the Certified EER Rating in row 3 is equal to or T eater than the required minimum EER in row 7, the PASS PASS it complies. If the unit complies enter Pass 1 C-,2 ' f 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 -111) 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 beginninq October 1, 2010, for all low-rise residential buildings. 4 Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) f GHA Companies Responsible Person's Name: Responsible Person's Signature: Rudy Herrera Rudy Herrero CSLB License: Date Signed: 1/20/2013 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-N0035869A-M230009SA-0000 Registration Date/Time: 2013/02/05 16:03:34 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE* CF-6R-MECH-25-HERS r Refrigerant Charge Verification - Standard Measurement Procedure (Page f of 5) } Site Address: Enforcement Agency: Permit Number: i , 51060 Mandarina, La Quinta CA 92247 City of La Quinta 18 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. ie 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 Suppiv and Return Plenums of Air Handler System Name or Identification/Tag SYSTEM 1 System 2 System Location or Area Served master great room kitchen 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 Faill ✓ ® Pass . ✓ ❑Fail STMS - Sensor on the Evaporator, Coil System Name or Identification/Tagi / / I I SYSTEM 1 I System12 I - ( s- 3 ❑Yes ( p Noy The sensor is factory installed, or field installed according to manufacturers specifications, or is installed by methods/specifications approved by the Executive 6 ❑ Yes #• JJj Director. ,4 14 The sensor wire is terminated with a standard,mini plug suitable for connection to a_ Z 4 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician 7 ❑ Yes ❑ No and the HERS rater without changing the airflow through the condenser coil 5 ❑ Yes ❑ No The 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 V N/A ' ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail ✓ ®N/A ✓ p Pass ✓ ❑Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag I SYSTEM 1 I System 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 1 ❑ No IThe sensor measures the saturation temperature of the coil within 1.3 degrees Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ ®N/A ✓ p Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail Reg: 212-N0035869A-M2500099A-0000 Registration Date/Time: 2013/02/05 16:06:11 S 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: 51060 Mandarina, La Quinta CA 92247 City of La Quinta 18 z 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. r. ' • 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 2 ` r System Location or Area Served master great room kitchen Outdoor Unit Serial # E126523578 E1234SSS654 - '-~ t.~ ir:,+ Outdoor Unit Make Day and Night Day and Night Outdoor Unit Model' NXA648GKA100 NXA660GKA100 , Nominal Cooling Capacity Btu/hr 48000 60000 ' Return (evaporator entering) air wet -bulb ' + • , , Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 1/1/2013 (must be re -calibrated monthly) Date of T rmocouple Calibration 17 r '_1 f- Al, rye y must be re -calibrated monthly) - L1%i%2013 Measured Temperatures"OF) 11 1 J VZ1,ty , + j t • System Name or Identification/Tag SYSTEM 1 System 2. ) A .+r• r c. "s •. rr , " +r , r ,r . Supply (evaporator leaving) air dry-bulb' - - -s t :`_ - •^ ^ - '-~ t.~ ir:,+ temperature (Tsupply, db) Return (evaporator entering) air dry-bulb , temperature (Treturn, db) ' Return (evaporator entering) air wet -bulb temperature (Treturn, wb) Evaporator saturation temperature 81 68 (Tevaporator, sat) Condensor saturation temperature 78 78 (Tcondensor, sat) Suction line temperature (Tsuction) 90 90 ' Liquid Line Temperature (Tliquid) 64 66 Condenser (entering) air dry-bulb 69 70 - temperature (Tcondenser, db) _ 1 Date of Verification 1/22/2013 1/20/2013 • Reg: 212-N0035869A-M2500099A-0000• Registration Date/Time:^2013/02/05 16:06:11 HERS Provider: CalCERTS,-Inc. 2008 Residential Compliance Forma August 2009 CF-611-MECH-25-HERS ' t Procedure (Page 3 of 5) ` :ement Agency: Permit Number: f La Quinta 18 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 i System 2 Calculate: Actual Temperature Split = Treturn, , db - Tsupply, db Target Temperature Split from Table RA3.2-3 using Treturn, 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 Id ri ification/Tag SYSTEM 1 System 2 3 ] ,' 1 ! Calculated Minimum Airflovi-Requirement 1200 .. ' 500 (CFM) I 1 Il I Measured Airflow using RA3.3 procedures JJ ,. ,% 1542- 1 1811 l 1 (CFM) . .L L C C,. .- - - ., a . ., .. . r :, ;+I. a4r:..Ai Passes if measured airflow is greater than or . equal to the calculated minimum airflow PASS PASS 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 1 System 2 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 -5°F and +5°F = Enter Pass or Fail s • Reg: 212-N0035869A-M2500099A-0000 Registration Date/Time: 2013/02_/05 16:06:11 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms % August 2009 01 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: i 51060 Mandarina, La Quinta CA 92247 City of La Quinta 18 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 ., System 2 Calculate: Actual Superheat .,= 9.0 22.0 Calculate: Actual Subcooling = 14.0 12.0 . x Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 12 ,'. 12 between 4°F and 25°F if manufacturer's a Calculate difference: 2 Actual Subcooling - Target Subcooling = f`• i ..... 1', PASS - ,', ;:" PASSE- " "> , ,.. System passes if difference is between .+F ` , -3°F and +3°F PASS a ` 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 System 2 Calculate: Actual Superheat .,= 9.0 22.0 Tsuction - Tevaporator, sat' Enter allowable superheat range from manufacturer's specifications (or use range 4-25 4-25 between 4°F and 25°F if manufacturer's t specification is not available) u a he •-' teal owable'suf at superheat is within p at range // f`• i ..... 1', PASS - ,', ;:" PASSE- " "> , ,.. . Enter Pass or Fail .+F ` , r' F • . y System p // j" 4,UIr Reg: 212-N0035869A-M2500099A-0000. Registration Date/Time:-2013/02/05 16:06:11 HERS Provider: CalCERTS, Inc. - 2008 Residential Compliance Forms August 2009 r , _ f - . {'tet; - E • c•. y,:. INSTALLATION CERTIFICATE CF-6R-MECH-25-HER: tefrigerant Charge Verification - Standard Measurement Procedure (Page of 5 Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 City of La Quinta 18 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 ' Y System 2 Date Signed: 11/20/2013 Position With Company (Title): - System meets all refrigerant charge and Control Program (TPQCP)? p Yes p No • y airflow requirements. PASS PASS • Enter Pass or Fail '. 4 .7- 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 -SR) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -SR 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 n _ 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) ' y Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Reg: 212-N0035869A-M2500099A-0000 Registration Date/Time: 2013/02/05 16:06:11 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms '? August 2.,009 <<. E GHA Companies Y Responsible Person's Name: Responsible Person's Signature: , Rudy Herrera Rudy Herrera CSLB License: Date Signed: 11/20/2013 Position With Company (Title): - Control Program (TPQCP)? p Yes p No • y Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Reg: 212-N0035869A-M2500099A-0000 Registration Date/Time: 2013/02/05 16:06:11 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms '? August 2.,009 <<. E s INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS Duct Leakage Test — Completely New or Replacement Duct System (Pagel of 2) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 (System 2) City of La Quinta 18 Enter the Duct System Name or Identification/Tag: System 2 Enter the Duct System Location or Area Served: great room kitchen 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 • y 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 Allowed CF -1R, the leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4), Leakage and 25 CFM must be entered for 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 aleakage factor of 0.03 in the calculations below. ® Cooling systeem method: Nominal capacity of condenser in Tons §Ix 4 eakage facto ,?QCFM all r _ ❑ Heating system method, f ' j E .. `,,. , .•..... - 21.7 x IO jurtput Capacity in Thousands o fiBtu/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 Actual Leakage leakage pressurization test procedure from Reference Residential Appendix RA3.1(CFM @ 25 Pa).. (CFM) List Actual Leakage from duct leakage test(CFM) 111 - 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: 212-N0035869A-M2000092A-0000 Registration Date/Time: 2013/02/05 16:01:34 ' HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-611-MECH-20-HERS Duct Leakage Test — Completely New or Replacement Duct System (Page of 2) Site Address: Enforcement Agency: Permit Number: 51060 Mandarina, La Quinta CA 92247 (System 2) City of La Quinta 18 Compliance Method rhis dwelling was: (select one of the following two choices): M Tested at Final Tested at Rough -in (requires installer to complete the visual inspection at final construction stage described below) visual inspection at Anal construction stage (Ir applimaDle) After installing the interior finishing wall and verifying that the above rough -in tests was completed, the following procedure must be performed: p For all supply and return registers, verify that the spaces between the register boot and the interior finishing wall are properly sealed. E3 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. IN 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 anddraw ands must b used combination with Cloth back d,!i r`ubber adhesi a duct tape to seal leaks at &ct connections. --07 1 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 -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -SR 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 beoinnino October 1. 2010, for all low-rise residential buildinas. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) GHA Companies Responsible Person's Name: Responsible Person's Signature: Rudy Herrera Rudy Herrera CSLB License: Date Signed: 1/20/2013 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes p No Reg: 212-N0035869A-M2000092A-0000 Registration Date/Time: 2013/02/05 16:01:34 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009