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10-0971 (MECH)53105 Avenida Martinez 10-0971 P.O. BOX 1504 7&495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Al 10-00000971 53105 AVENIDA MARTINEZ 774-061-017-5 -000000- MECHANICAL COVE RESIDENTIAL ' 5200 Ta t 4 atP Q" Architect or Engineer: a11"), ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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: C20 -C36 LicenseNo.: 818759 ) Date: ~CI r7 Bntramor: 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 _ 1 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 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.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State'License Law.). 1 _) 1 am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 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: P1Lender's Address: LQPERMIT Owner: HEBB GERALD 53105 AVENIDA MARTI LA QUINTA, CA 92253 Contractor: PREC H & A INC P.O. BOX 11090 PALM DESERT, CA (760)776-1550 Lic. No.: 818759 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS .(760) 777-7153 Date: 9/21/10 92255 ----------------------------------------------- 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 FARMERS INS Policy Number N 2008 71 19 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 0 337700 of the Labor Code, I/spllll forthwith /cpurply with those provisions. 1'6.te -17P pplic.nt: 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 ($100,0001. 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 apel county ordinances and state laws relating to building construction, and hereby authorize representatives oliountytoenter upon the above-mentioned property forinspection purpoDa 1 r Si cure (Applicant or Agent): Application Number . . . . . 10-00000971 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/20/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGEOUT, NEW 15 SEER CONDENSER, COIL, HEATPUMP. 2007 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary. Charged ------------------------------------- Paid Credited -------------------- Due Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total _ 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 .Grand Total 42.25 .00 .00 42.25 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: 5310.5 /i v e61 r ] i t /T ( j w ormwent Agency: Date. a n' I Permit 2 Conditioned Floor Equipment T ' List Minimum Efficienc Duct insulation requirement Area Thermostat ckaged Unit AFUE COP®Setback Over 40 ft of ducts added orrace laced in unconditioned space Served by system (/f door Coil i EER HSPF R 6 (CZ 10-13) sf not already present, must be ondensing Unit ®EER Resistance R 8 (CZ 14-15) installed) ther 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -I R -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERMCATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final inspection. a1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -411 forms: MECH- 21 and fors lits stems MECH-25 • Condenser Coil and/or CF -611 forms: MECH-2I-11ERS and (for split systems) MECH- 25 -HERS • Indoor Coil and/or CF -4R forms: MECH- 21 and (for split systems) MECH-25 • Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or 2. Duct systems with less than 40 linear feet in unconditioned space, or 3. Existing ducts stems are constructed, insulated or sealed with asbestos ® 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS ducts: (all new ducting and all CF -4R fomes: MECH 20-, and (for split systems)MECH-22, and MECH 25 new equipment) For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent © 3. New Ducts with/or without Replacement Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor coil CF -4R forms: MECH-20 and (for split systems) MECH-25 and/or furnace. No or some equipment changed. For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 linear feet of duct in unconditioned space. For splits stem or packaged units: Duct leakage < 15 percent EXCEPTION: Existing ducts stems 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 Cal ifomia Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Pfftsiovn IL -at r Signature: Company:C Ki r DD I_f s Oi1L)ao Date: Address: P -6 go License: City/State/Zip: Pt2im a w'1 I Ch q2l,55Phone: - 9G` tsb 2008 Residential Compliance Forms March 2010 Bin # City of La Quetta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: g 7 - I0.17 A-Y , LQ Owner's Name: Gerald 4tb b A. P. Number: Address: 5;-1 Olj Me Legal Description: City, ST, Zip: &L %CA 4 '12 59 Contractor: PPE Qt (A'S Telephone: , Address: P10 . &pxp ( Project Description: WA-G S X11 City, ST, Zip: Palm DeSP.Vf GSI gll2 5 gilt Telephone: ' ( (o- j5 5 ' . : .. •ag City Lie. C State Lic. # g Arch., Engr., Designer. Address: City., ST, Zip: 4 Telephone: State Lic. #: Name of Contact Person: 6%a((L Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: #Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: ( • APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2i° Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE: '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 53-105 Avenida Martinez; La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 10-00000971 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 Leakaae 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 Optipns,l, 2, or 3 must be attempted.,before,utilizing Option.4.)__ Determinelnominal Fan Flow using one o&the following three calculation methods. 4r' ( t ✓ © Cooping system method: Size in Tons ) 3.5 ,x 400,1= 1400 CFM' yof.conde'nser ✓ ❑ I Heay(ting system method: 21.7 x Output Capacity in Thousands of. Btu/hr = CFM ,. ❑ Measured.sy5tem airflow using RA3.3 airflow test procedures: CFM, Option 1 used then: 1 Allowed leakage = Fan Flow 1400 x 0.15 = 210 CFM Actual.Leakage = 198 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% _ "/o Reduction Pass if % Reduction > 600/a F1 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 p Fail 9 Reg: 210-A0017737A-000000000-M21A Registration Date/Time: 2010/09/29 13:41:58 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms - March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: 53-105 Avenida Martinez, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 10-00000971 0 Outside air (OA)ductsfor Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFIiOA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASH RAE, Stand ard,62-.2,;,andlclosetiwhen OAg _ventilation -is not*required, may be configuredlto therclosed position during duct'leakage testing? EN N;' t All supply and return register b s m ust be sea d,to*the drywall;if smoke test is utiliied'for compliance'— --- y — applies to duct leakage `compliance option 3 (leakage reduction by'60%) and option 4,(fix all -accessible' J. leaks described above. (` t 2 New duct installations cannotutilize building cavities as plenums or.platform returns in lieu of ducts. © Mastic,and,draw bands must be used in combination with cloth backed rubber adhesive duct tape to seal leaks`at all new duct`connectiolis 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 -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PREC H & A INC Responsible Person's Name: CSLB License: Gerry Dobbins 1818759 HERS Provider Data Registry Information Sample Group # (if applicable): N/A --f0 tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798512813 HERS Rater Company Name: Eddie Hernandez Jr Responsible Rater's Name: Responsible Rater's Signature: Eddie Hernandez, Jr. Eddie Hernandez, Jr. Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/28/2010 CC2004518 Reg: 210-A0017737A-000000000-M21A Registration Date/Time: 2010/09/29 13:41:58 HERS Provider: C'a10ERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of SJ Site Address: Enforcement Agency: Permit Number: 53-105 Avenida Martinez, La Quinta CA 92253 City of La Quinta 10-00000971 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. ' TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 1 a Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 p Yes ❑ No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2:2.2.2. Yes to -land 2 is a pass. Enter Pass or Faill ✓ 0 Pass ✓ ❑ Fail STMS Sensor „onrthe,Evaporator Coil System Narrie'or Identification/Tag -) f f%' System 1 1, f r l V 3 ❑ Yes ❑moo / -.11 / The sensor is factory installed, or field installed according to manufacturer's •specifications, or Oinstalled by methods/specifications approved by the Execut e Director. t' i _ ' ti t" r► 4 El Yes f , et i j 0 No The sensor wire is terminated.with a standard mini plug suitable for connection to digital thermometer. Thesens& mini plug is accessible to the" insfallingctechriicia6a Director. and the HERS rater without changing the airflow through the condenser coil` 5 ❑ Yes y - El No ]When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail ✓ O N/A ✓ ❑Pass ✓ ❑ Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag I 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 ❑ 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✓ p N/A ✓ ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail Reg: 210-A0017737A-000000000-M25A Registration Date/Time: 2010/09/29 13:47:30 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 53-105 Avenida Martinez,.La Quinta CA 92253 1 City of La Quinta 10-00000971 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 Conditionina Svstems System Name or Identification/Tag System 1 (must be re -calibrated monthly) .s••f ! t System Location or Area Served Whole House Y !9/1'/10 I (must be re -calibrated month) Y) '4A Outdoor Unit Serial # 7257 M1509 08580 Outdoor Unit Make Rheem Outdoor Unit Model RPQL042JAZ Nominal Cooling Capacity Btu/hr 42000 Date of Verification 9/28/10 cauoratuon OT uiagnostic instrumems Date of Refrigerant Gauge Calibration 9/1/10 (must be re -calibrated monthly) .s••f ! t A le Date of Thermocou Ie Calibration j` Pa rt Y !9/1'/10 I (must be re -calibrated month) Y) '4A s I i ..- ._. measurea i emperatures-V, rj r! t I t i -- i I N 11 Va i i System Name or Identifcation/Tag - tSystem 1a r .s••f ! t 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 45 (Tevaporator, sat) Condensor saturation temperature 114 (Tcondensor, sat) Suction line temperature (Tsuction) 56 Liquid Line Temperature (Tliquid) 104 Condenser (entering) air dry-bulb temperature (Tcondenser, db) Reg: 210-A0017737A-000000000-M25A Registration Date/Time: 2010/09/29 13:47:30 HERS Provider: Ca10ERTS, 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: 53-105 Avenida Martinez; La Quinta CA 92253 1 City of La Quint a 10-00000971 Minimum Airflow Reauirement 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 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) P, t System Name` or Identification/Tag f System i I` I Calculated Minimum Airflow Requirement (CFM) "1050 Measured'AiTow using,RA3.3 procedures (CFM) f . 1356* - F Passes if measured airflow is greater than or equal to the calculated minimum airflow PASS requirement. j Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -6°F and +6°F Enter Pass or Fail Reg: 210-A0017737A-000000000-M25A Registration Date/Time: 2010/09/29 13:47:30 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of S) Site Address: Enforcement Agency: Permit Number: 53-105 Avenida Martinez, La Quinta CA 92253 1 City of La Quinta 10-00000971 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 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 10 Calculate difference: 6 Actual Subcooling - Target Subcooling = System passes if difference is between - } ' ! '• - I r -4°F and +4°F PASS # Enter Pass or Fail 1 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 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 3-26 between 3°F and 26°F if manufacturer's specification is n_ot available) System passes,if actual superheat is Wt iin' he - } ' ! '• - I r allowable superheat range f Y PASS # -Ehte.r Pass or Fail 1 Reg: 210-A0017737A-000000000-1425A Registration Date/Time: 2010/09/29 13:47:30 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 S) Site Address: Enforcement Agency: Permit Number: 53-105 Avenida Martinez, La Quinta CA 92253 1 City of La Quinta 10-00000971 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 18187S9 HERS Provider Data Registry Information Sample Group # (if applicable): N/A System meets all refrigerant charge and airflow ❑ not-tested/verified dwelling in la HERS sample group requirements. PASS Eddie Hernandez Jr Responsible Rater's Name:. Responsible Rater's Signature: Enter Pass or Fail Eddie Hernandez, Jr. Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/28/2010 CC2004518 17 7 `\ i 15,1 DECLARATION STATEMENTf • 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 aaencv. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PREC H & A INC Responsible Person's Name: CSLB License: Gerry Dobbins 18187S9 HERS Provider Data Registry Information Sample Group # (if applicable): N/A Q tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CCl-1798512813 HERS Rater Company Name: Eddie Hernandez Jr Responsible Rater's Name:. Responsible Rater's Signature: Eddie Hernandez, Jr. Eddie Hernandez, Jr. Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/28/2010 CC2004518 Reg: 210-A0017737A-000000000-M25A Registration Date/Time: 2010/09/29 13:47:30 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010