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MECH (12-0469)
79695 Mandarina 12-0469 14388 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: 12-00000469 79695 MANDARINA 772 -191 -005 - MECHANICAL LOW DENSITY RESIDENTIAL 7050 T-4wt 4 4 Q" Architect or Engineer: . t)lt BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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. License Class: pC/200 C36 License No.: 906115 ttractor: OWNER -BUILDER DECLARATION I hereby 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).: (_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The 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 improvement is 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.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) 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 Owner: DAVID DONNELLY 79695 MANDARINA LA QUINTA, CA 92253 Contractor: D HYDES 42949 MADIO STREET INDIO, CA 92201 (760)360-2202 Lic. No.: 906115 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/30/12 APR 3 0 2012 D LA WORKER'S COMPENSATION DECLARATION 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. 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 NORGUARD INS Policy Number CEWC243358 _ 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 q7 37000 oft Labor Code, I shall forthwith comply with rowsio gate: % licant: 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 Quima, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize represent lives of this countytoenter upon the above-mentioned property for inspec 'on rposes. 8"ate: `I' / ,,,, ature (Applicant or Agent): or y Application Number . . . . .. 12-00000469 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date . . Valuation . . . . 0 Expiration Date 10/27/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE -OUT. INSTALL NEW FURNACE, CONDENSER, COIL. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 40.50 .00 .00 40.50 Plan Check Total 10.13 .00 .00 10.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total 51.63 .00 00 51.63 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 79-695 Manderina La Quinta, CA 92253 City of La Quinta Apr 26, 2012 Equipment Typel List Minimum Efficiency2 Duct insulation requirement Conditioned Floor Area Thermostat ❑ Package Unit 0 Furnace 0 Indoor Coil 0 AFUE 78% 0 SEER 13.0 ❑ COP [1HSPF ❑ R 6 (CZ 10-13) Served by system '0 Setback If not already present, must be 0 Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) 1400 sf Installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICAT ON SUMMARY Listed below are FOUR HVAC alteration, Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-611 and registered CF-4111 forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-111 and CF-6R shall also be on site for final inspection. 0 1. HVAC Changeout Required Forms: . All HVAC Equipment CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF-411 forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or . Indoor Coil and /or CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS . Furnace CF-4R forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. The tem,ill not be Du ted (ieDuctlessMinl SplitrSystem)(AlsoxExempt,fro miRef,.igera9t,Charge) .,,s ❑ 2. Ne HVAC System Requ%ed.F=orms: VIF *" : . Cut in or Changeout withl + 6Rforms: MECH-04, MECH-20 HERS and (forsplit systems) MECi `=HERS, a'nd new duds: (all new ductiroMAnd all n Vequipment)CF MECH'25-H 4R;form' `s fMECH-20, and (for 5 lit systems) MECH-2 ,and ME612151[ ' For Split Systemss`Duct"leakages5tfi-percent;fRG'mCCAV2_ 350°CFM/to'h,, FWD TMAH, SIMS, and either'HSPP or-PSPP. " For Packaged Units: Duct leakage`.< 6 percent ❑ 3. New Ducts`with/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor Condensing unit CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace.' No or some CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Dud leakage < 6 percent .114. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF-611 forms: MECH-04, MECH-2I-HERS linear feet of dud in unconditioned space. CF-411 forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation Is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design Identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design Identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features Identified on this Certificate of Compliance are consistent with the Information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Mark Hyde Signature: Mark Hyde Company: CERTIFIED COMFORT SYSTEMS INC Date: Apr 26, 2012 Address: 42-949 MADIO STREET License: 906115 City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202 Reg: 212-AO02088OA-00000000-0000 Registration Date/Time: 2012/04/26 17:57:55 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010 Bin # Permit # 1 11 u` Project Address: ? _ A. P. Number: Occupancy: Legal Description: New Add", Alter Repair Demo Contractor: # Stories: Address: "Z City, ST, Zip: Telephone: Rec'd '1713. YG State Lic. # Plan Check submitted Arch., Engr., Designer: ---------------- Address: City, ST, Zip: Telephone: State Lic. #: ------------ Nance of Contact Person: Telephone # of Contact Person: # Submittal Plan Sets Structural Calcs. Truss Cales. Energy Cafes. Flood plain plan Grading plan Subcuntactor List Grant Deed II.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Pees City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet 76i ft t, rl Owner's Name: G V/ nn. Address: (i 5' '"1 City, ST, Zip: Telephone: 'l ,.,, 7(4 Project Description: City Lic. #: 0 Construction Type: ' Occupancy: Project type (circle one): New Add", Alter Repair Demo Sq. Pt.: # Stories: # Units: Estimated Value of Project- APPLICANT: DO NOT WRITE BELOW THIS LINE Rec'd '1713. YG Plan Check submitted PERMIT -ELS Reviewed, ready for corrections Item Amount Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construc(ion Plans resubmitted -- _ Mechanical 2°" Review, ready for corrections/issue Electrical Called Contact Person Plumbing Plans picked up ------_ S.M.I. Plans resubmitted ------ —Grading Grading Review, ready for corrections/issue Developer Impact Fee Called Contact Person A-I.P.P. Date of permit issue Total Permit frees 'i f CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 (System 1) City of La Quinta 12-469 Enter the Duct System Name or Identification/Tag: Enter the Duct System Location or Area Served: Note: Submit one Installation .Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, dse the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. ❑ 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow ❑ 3. Reduce leakage by 60% and conduct smoke and fix all leaks ❑ 4. Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options 1, 2, or 3 must be attempted before utilizing Option 4.) Determine nominal ^Fan; Flow using ope of the following-: three calculation methods. - ✓ ❑ Cooling system method: Size of condenser in Tons x 400 = CFM i ✓ ❑ Heating system method: 2'1.7 x _ Output Capacity in Thousands of Biu/hr = _ CFM ✓ ❑ Measured system airflow using RA3.3 airflowtest, procedures: : CFM Option 1 -used then: 1 Allowed leakage =. Fan Flow x 0.15 = _ CFM - Actual Leakage = _ CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then: 2 Allowed leakage = Fan Flow_ x 0.10 = _ CFM Actual Leakage to outside = _CFM Pass if Leakage Actual is less than Allowed ❑ Pass ❑ Fail Option 3 used then: Initial leakage prior to start of work = CFM _ Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction CFM ((Leakage reduction _/ Initial leakage x 100% _ % Reduction Pass if % Reduction > 60% ❑ Pass ❑ Fail Option 4 used then: 4 All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No smoke allowed to leak from system. Including ducts, plenums, air handler and door panel. Pass if all accessible leaks have been repaired using smoke ❑ Pass ❑ Fail Reg: 212-A0020880A-M2100001A-M21A Registration Date/Time: 2012/05/08 16:19:13 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2011 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 (System 1) City of La Quinta 12-469 ❑ 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. a ❑ All supply andrreturn register boots,mustabe=sealed-to the drywall;if smokeAtest ls-.utilized for compliance - applies.,to.duct leakage compliarnce+option 37(leakage reduction by 60%)' androptlont4°0k all kcessible leaks) described above. ❑ New duct" 'instal lations cannot`util'ize~building cavitiesplenums or platform returns.in• eu of ducts.. . ❑ Mastic and,draw'bandss,must be. used'in`com6lnatlon w' p 6 i . 'th"cloth backed -rub ber adhesve;ducttape.to seal leaks at all new duct connections I DECLARATION STATEMENT; . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater who performed the verification services Identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is Identified on this certificate (the Installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the Installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -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) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: CSLB License: Mark Hyde 1906115 HERS Provider Data Registry Information Sample Group # (if applicable): 302958 ❑ tested/verified dwelling © not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CCl-1798650420 HERS Rater Company Name: Desert H.E.R.S. Raters Responsible Rater's Name: Responsible Rater's Signature: Michael Hyde Michael Hyde Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/11/2012 CC2005602 Reg: 212-A0020880A-M2100001A-M21A Registration Date/Time: 2012/05/08 16:19:13 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 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 Number: 79-695 Manderina, La Quinta CA 92253 City of La Quints 12-469 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in SUDDIV and Return Plenums of Air Handler System Name or Identification/Tag . cIr' j ,: , = ( ti• T 7g System Location or Area Served ❑:Yes 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 land 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 e. STMS - Sensor,on €the Evaporator Coil System Name -'or Identification/Tag ` . cIr' j ,: , = ( ti• T 7g 3 ❑:Yes I No ' The sensor is factory installed, or field -installed according to manufacturer's .. specifications, or islinstalled.by methods/specifications approved by.the Executive ❑ Yes a x, specifications, or is installed by methods/specifications approved by the Executive Director. it a , • - Director. a "4 1. , ., df No L,n The -se-nsor wire is terminated with a,standard mini plug suitable for connection to af- „., 4 ❑ Yes _ .w : ❑ digital thermometer.,The sensor, mini plug is accessible to the installing technician s and the HERS rater without changing the airflow through the condenser coil and,the HERS rater without changing the airflow through the condenser coil 5❑Yes ; v- ❑ No When attached to a digital thermometer, the sensor provides an ind'.cation of the saturation temperature of the coil. Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail ✓ ❑ N/A ✓ Pass ✓ ❑Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ 0 N/A ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail R Reg: 212-A0020880A-M2500001A-M25A Registration Date/Time: 2012/05/08 16:21:17 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 "ERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-2E Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5; Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 City of La Quinta 12-469 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems System Name or Identification/Tag System Location or Area Served Outdoor Unit Serial # Outdoor Unit Make Outdoor Unit Model Nominal Cooling Capacity Btu/hr Date of Verification %.auoratuon or uiagnostuc instruments )ate of Refrigerant Gauge Calibration (must be re -calibrated monthly) )ate of Thermocouple; Calibration (must be re -calibrated monthly) 4easured Temperatures ('F) System Name or Identif'ication/Tag 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) Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db) Reg: 212-A0020880A-M2500001A-M25A Registration Date/Time: 2012/05/08 16:21:17 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 City of La Quinta 12-469 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 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 Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specif=ied 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. 4 Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) .1 System Name or-Identification/Tag " Calculated Minimum Airflow°'Requirement (CFM), ' •- Measured Airflow using RA3.3 procedures (CFM) Passesif measured airflow is greater.thah or equal to the calculated minimum airflow requirement. -: •; - ' Enter Pass or Fail r Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems I System Name or Identification/Tag Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -6°F and +6°F Enter Pass or Fail Reg: 212-A0020880A-M2500001A-M25A Registration Date/Time: 2012/05/08 16:21:17 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 City of La Quinta 12-469 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 Calculate: Actual Subcooling = Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer Calculate difference: Actual Subcooling - Target Subcooling = System passes if difference is between F ., Af' -4°F and +4°F - 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 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range between 3°F and 26°F if manufacturer's specification is not available) _, ; System passes,,if actual superheat is''withiWthe allowable superheat range, / F ., Af' 'Enter' Pass or Fail - Reg: 212-A0020880A-M2500001A-M25A Registration Date/Time: 2012/05/08 16:21:17 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 City of La Quinta 12-469 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 Mark Hyde 1906115 HERS Provider Data Registry Information Sample Group # (if applicable): 302958 System meets all refrigerant charge and airflow 0 not-tested/verified dwelling in la HERS sample group requirements. HERS Rater Company Name: Desert H.E.R.S. Raters Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail Michael Hyde Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/11/2012 CC2005602 Y i • A a y R 4 ryJ DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the Information provided on this form is true and correct. • I am the certified HERS rater who performed the verification services Identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is Identified on this certificate (the Installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the Installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: CSLB License: Mark Hyde 1906115 HERS Provider Data Registry Information Sample Group # (if applicable): 302958 ❑ tested/verified dwelling 0 not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798650420 HERS Rater Company Name: Desert H.E.R.S. Raters Responsible Rater's Name: Responsible Rater's Signature: Michael Hyde Michael Hyde Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/11/2012 CC2005602 Reg: 212-A0020880A-M2500001A-M25A Registration Date/Time: 2012/05/08 16:21:17 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 (System 1) 1 City of La Quinta 12-469 Space Conditioning Systems Heating Equipment Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (AFUE, etc.),, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Split Furnace american standard aud1b080a9481ab 1 80 AFUE Attic R-4.2 60 80 kl3tu Type and EER) (attic, (package ARI # of 1, 3 crawl- Cooling Cooling heat --CEC Certified Mfr. Name Reference Identical (>=CF -1R space, Duct Load Capacity pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split american standard ' 14.5 SEER 4.uu81"9 cuulur"W"E 1.1 prujecr is new cunsrrucuon, see roornores ro JCanaaras laole 151-b ana ladle 1S1 -L ror auct ceiling alternative compliance. " \ 2. ARI Reference Number can be fund by entering the equipment model number at http://www.aridirector-y.orglarilac:php# 3. Listed efficiency on this page must be greater than or equal ( ?) to the value shown on the CF -IR form. 4. When CF -1R is reference it is also applicable to the CF -IR, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM 0 §110-§113: HVAC equipment is certified by the California Energy Commission. 0 §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. m §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 2 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. A Reg: 212-A0020880A-M0400001A-0000 Registration Date/Time: 2012/05/02 13:27:34 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 Efficiency Duct Equip (SEER Location Type and EER) (attic, (package ARI # of 1, 3 crawl- Cooling Cooling heat --CEC Certified Mfr. Name Reference Identical (>=CF -1R space, Duct Load Capacity pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split american standard ' 14.5 SEER A/C -,W4aZb4042e1000ab -4.388f30 11ZaEER701; ^ AkAtticI: rR 4- 39 kBtu F rF f ff. I S l l S n df wry n4^+lr qj-WeZZ 1-7 y ii SIJ 1.1 prujecr is new cunsrrucuon, see roornores ro JCanaaras laole 151-b ana ladle 1S1 -L ror auct ceiling alternative compliance. " \ 2. ARI Reference Number can be fund by entering the equipment model number at http://www.aridirector-y.orglarilac:php# 3. Listed efficiency on this page must be greater than or equal ( ?) to the value shown on the CF -IR form. 4. When CF -1R is reference it is also applicable to the CF -IR, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM 0 §110-§113: HVAC equipment is certified by the California Energy Commission. 0 §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. m §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 2 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. A Reg: 212-A0020880A-M0400001A-0000 Registration Date/Time: 2012/05/02 13:27:34 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6111-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address. Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 (System 1) City of La Quinta 12-469 Ducts and Fans §150(m): Duct and Fans ❑ 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and ❑ 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. ❑ 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. ❑ 7. Exhaust fan systems have back draft or automatic dampers. ❑ 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. ❑ Protection of Insulation. tInsulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating thatl,is water retardant and provides shielding from solar radiation that can cause degradation of•the material! ❑ 10. Flexible ducts cannot have porous inner cores. DECLA . I certi .Iami repref . I certify that the installed features, rrjeterials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and`regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I reviewed a copy of the Certificate of Compliance (CF -SR) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: Responsible Person's Signature: Mark Hyde Mark Hyde CSLB License: 906115 Date Signed: 4/25/2012 Position With Company (Title): Reg: 212-A0020880A-MQ400001A-0000 Registration Date/Time: 2012/05/02 13:27:34 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 (System 1) 1 City of La Quinta 12-469 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow 3. Reduce leakage by 60% conduct fix leaks ❑ and smoke and all ❑ 4. Fix all accessible leaks using smoke and HERS rater verify Note: ,(One of Options 1, 2 or 3 must be attempted before utilizing Option 4.) Determine nominal,Fan Flow using one of -the -following three calculation methods. ✓ Cooling -system method: Size of condenser in Tons3.5 x,400 - X1400 CFM ✓ ❑ Heafting system method':42/ 7 x _ Output Capacity in Thousands of btu/hr; _ _ CFM '0 ✓ 1 J."r1. ❑Measured systemrairflow using RA3 3 airflow testi procedures: CFM +X„ Option iTus d'theni,f`r Allowed leakage =.Fan Airflow 1'400 1 • x 0.15 = 210 CFM. Actual Leakage = 169 CFM ,-- I Pass if Actual Leakage is less than Allowed leakage M Pass El Fail. Option 2 used then: l— 2 Allowed leakage = Fan Airflo x 0.10 =-_ CFM Actual Leakage to outside = CFM \ i Pass if Actual leakage to outside is less than Allowed leakage El Pass Fail Option 3 used then: j Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reductionCFM ((Leakage reduction _ / Initial leakage__) x 100% _ %o Reduction Pass if % Reduction > 60% ❑ Pass ❑ Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke p Pass ❑ Fail Reg: 212-A0020880A-M2100001A-0000 Registration Date/Time: 2012/05/02 13:25:00 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 (System 1) City of La Quinta 12-469 0 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation.is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. 0 All supply andxreeturn register boots-mustybe,sealed.t the drywall) if sm oke test isutilized.for compliance -applies fio duct leakage compliance option '3% reduction by;60 /o) and option 4•(fix all accessible leaks) described above. ff = [ , - R-=: 0 New ductInstallations cannot utilize building cavities as'plenums or.platform returns In Ile&'f_ducts:,- 0 Mastic and drawtbands must,tl'be u ssedtin.combinatlon-wth_cloth.backed_ ,rubber,adhesive duct ta pe'Ctoseal leaks at all new abe 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 -SR) 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) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: Responsible Person's Signature: Mark Hyde Mark Hyde CSLB License: Date Signed: Position With Company (Title): 906115 4/25/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0020880A-M2100001A-0000 Registration Date/Time: 2012/05/02 13:25:00 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE* CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency:712-469 Permit Number: 79-695 Manderina, La Quinta CA 92253 City of La Quinta 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 SIMS 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 SuDDIY and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 1 p Yes [3 No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 p Yes ❑ No 1 j 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 ✓ 0 Pass ✓ ❑ Fail STMS- Sensor on -the Evaoorator<Coil System Namd,or Identification/Tag/` - System 1- . €, • 6y if.. 3 ❑•Yes The°sensor is factory installed; or field installed according to manufacturer's El N specifications, or is installeid by myethods/specifications approved by the Executive - The sensor is factory installed, or field installed according to manufacturer's 6 Director. 4 specifications, or is installed by methods/specifications approved by the Executive The sensor wire is terminated with a standard,mini plug suitable for connection'to, a digital E3 Yes p No ti thermometer. The sensor mini plug is;aecessible to the.installing.6t Ehnic n"R the HERS rater.withoutchanging 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 atpass. Enter N/A if STMS are not applicable. Otherwise enter Pass orFail _T ✓ p N/A ✓ ❑Pass ✓ ❑Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag System 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 1 ❑ No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ p N/A❑ TV Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail r] 0 Reg: 212-A0020880A-M2500001A-0000 Registration Date/Time: 2012/05/02 13:23:09 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 F Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 1 City of La Quinta 12-469 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. SDace Conditionina Svstems System Name or Identification/Tag System i (must be re -calibrated monthly) A System Location or Area Served Whole House /„ ,. 4/25/,2012 -- 9i bVe . fit' . 4 p. !(must be rhe -calibrated monthly) Outdoor Unit Serial # 10301pSu5f ,. " m r #-• Outdoor Unit Make american standard Outdoor Unit Model 4a7a4042e1000ab Nominal Cooling Capacity Btu/hr 4 42000 Date of Verification 4/25/2012 %.auurdiuun ur uiaanubxm instruments Date of Refrigerant Gauge Calibration- 4/25/2012 (must be re -calibrated monthly) A . Date of Thermocouple t /„ ,. 4/25/,2012 -- 9i bVe . fit' . 4 p. !(must be rhe -calibrated monthly) r /— r J --_ m t:asureu.rem Lperacurerpi.i r1._.AF f / ` I r r 1 :r,P±'j 11 1 1 1,. /1, - System Name or Identification/Tag, t Sysem i . 1. ,. Supply (eJaporator'.leaving)-air dry-bulb-, temperature (Tsupply, ,db) --- ,. " m r #-• Return (evaporator --entering) air dry-bulb temperature'(Treturn, db) f Return (evaporator entering) air wet -bulb temperature (Treturn, wb) \ t Evaporator saturation temperature 44 (Tevaporator, sat) Condensor saturation temperature 103 (Tcondensor, sat) Suction line temperature (Tsuction) 56 Liquid Line Temperature (Thquid) _ 93 Condenser (entering) air dry-bulb 80 temperature (Tcondenser, db) Reg: 212-A0020880A-M2500001A-0000 Registration Date/Time: 2012/05/02 13:23:09 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-611-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 City of La Quinta 12-469 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 i 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 Identification/Tag"System Calculated Minimum Airflo R quirement (CFM) 1050 / + 4D I Measured.Airflow,us ng RA -3.3 procedures (CFM) -06'1400'F" J 'A\ Passes if measured airflow is greater than or equal to the calculated minimum airflow 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 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 103 Reg: 212-A0020880A-M2500001A-0000 Registration Date/Time: 2012/05/02 13:23:09 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HER9 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 City of La Quinta 12-469 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Subcooling = 10.0 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 10 Calculate difference: 0 Actual Subcooling - Target Subcooling = System passes if difference is between -3°F and +3°F PASS 1r „ Y Enter Pass or Fail i Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat = 12.0 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 4-25 between 4°F and 25°F if manufacturer's specification is not available) ' System pas{es,if.actual'superheat is- thimthe allowable superheat range,►fl 4 PASS 1r „ Y _,o -,.Enter Pass ar,Fail i 0 Reg: 212-A0020880A-M2500001A-0000 Registration Date/Time: 2012/05/02 13:23:09 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 L4 C• INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 79-695 Manderina, La Quinta CA 92253 City of La Quinta 12-469 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 CSLB License: Date Signed: Position With Company (Title): System meets all refrigerant charge and airflow 4/25/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): requirements. PASS Enter Pass or Fail r 0 DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of.the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I 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. l • 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. r • 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) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: Responsible Person's Signature: Mark Hyde Mark Hyde CSLB License: Date Signed: Position With Company (Title): 906115 4/25/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0020880A-M2500001A-0000 Registration Date/Time: 2012/05/02 13:23:09 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 N v I Building 79-695 Handarina, Address (;&.ti t 4 4QU4 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 v—VI J.1-1. Peters I Address P.O. Box 7150 CityZip Newport Beach CA 9265 Contractor Cal. forma. Pools & Spas Ad4p§10 Boardwalk A-2 Palm Desert, V4A 92211 statei. C53 "65612$ & Classit. Arch., Engr., Designer Address City lZip No. 14338 ILDING: TYPE CONST. - OCC. GRP. Number ('114) 854-2500 Legal Description Project Description Pool and Spa T440-9000 City 355 Lic. # el. State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirmitbat I amJf ensed under provisions of Chapter 9 (commencing with Section 7000) of ivislon 3''pjjhAe''Business and Professions Code, and my license is in full force and V OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a Sq. Ft. No. No. Dw. Size Stories - Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation permit to construct, after, improve, demolish, or repair any structure, prior to its Issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 o/ the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged Any Section 7031.5 by 'any /or Plan Chk. Dep. exemption. violation of applicant a permit subjects the applicant to a civil penalty or not more than five hundred dollars ($500). Plan Chk. Bal. r 75 O 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, Buisness and Const. Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, Mech. 7) provided that such improvements are not intended or offered for sale. If, however, the building or Improvement is sold within one year o/ completion, the owner -builder will have the burden Electrical 5—.0 of proving that he dist not build or inprove for the purpose o/sale.) O I, as owner of the property, am exclusively contracting with licensed contractors to con.- Plumbing 27.00 struct the project. (Sec. 7044, Business and.Prolessions Code: The Contractor's License Law does not apply to an owner o/ property who builds or improves thereon, and who contracts for S. M. 1. - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am exempt under Sec B. & P.C. for this reason Driveway Enc. Date Owner Infrastructure `J WORKERS' COMPENSATION DECLARATION I hereby affirm tPatIrthave a certificate of consent to self -insure, or a certificate of Worker's Comp on Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy Company 'Copyis Pled with the city. O Certified copy is hereby furnished. _ TOTAL 316-75 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS'COMPENSATIONINSURANCE (This section need not be completed i/ the permit Is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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. Date Owner NOTICE TO APPLICANT. ff, after making this Certificate of Exemption you should become ZONE: BY: subject rN permitshensation 6edeemedrevoked.Laborrovisions of the Code, you must forthwith ply - comply withsuchprovisionso Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Cente 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, Side Setback from Property Ll DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES. FINAL DATE` INSPECTO is is a uildmg permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 160 days. I certify that I have read this application and state thatthe above information is correct. Issued by: Date P_ 1 agree to comply with all city and county ordinances and state laws relating to building s construction, and hereby authorize representatives -of this city to .enter the above-. mentioned property for inspection purposes. Validated by: y Signature of applicant —Date— Mailing ateMailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING. FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. S0. FT. GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. ® OTHER APPJEOUIP. DRINKING FOUNTAIN SO. FT. ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP., GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ®1 V. c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® VAc HOUSE SEWER LATHING - GAS PIPING ' PERMIT FEE PERMIT FEE JELECT.FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus -x$-=$ LUMBER GR. FINAL INSP., FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING INAL INSPECTION01 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL