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MECH (12-0759)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application descriptio Property Zoning: Application valuation: Applicant: 121-7:1Z'0 0,0.0;7,5 9n7_.V 53565 AVENIEI MENDOZA 774-132-014-3 -000000- n: MECHANICAL COVE RESIDENTIAL 5000 T 4-4f 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT - Architect or Engineer: pjr� c LICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am Ii sed under provisions of Chapter 9 (commencing with - Section 7000) of Division 3 of the Business and Pr sionals Code, and my License is in full force and effect, Lice se Class: C20 License No.: 686310 Date: ? to t Contractor. 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 td construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (. ) I, as owner of the property, or my employees with wages as their sole compensation, will do the rwork , 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 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. , B.&P.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: WISKIRCHEN JAMES D 53565 AVENIDA MENDOZA LA QUINTA, CA 92253 Contractor: GENERAL AIR CONDITIONI 31170 RESERVE DRIVE' THOUSAND PALMS, CA 922 (760)343-7488 Lic. No.: 686310: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/10/12 JUL 10 90, 7 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 workerscompensation insurance carrier and policy number are: ' Carrier ZENITH INS CO Policy Number Z071741501 _ I certify that, in the performance of the rk for which this permit is issued, I shall not employ any person in any manner so as to beco subject to the is compensation laws of California, and agree that, if I should becomes ect to the workers' compensation provisions of Section /3700 of a Labor Code, I shall fort ith comply with those provisions. � t Date: i Applicant: ' WARNING: FAILURE TO SECURE WORKERS' CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO.THE COST OF COMPENSATION-, DAMAGES AS PROVIDED FOR IN , SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT - IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being - performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above formation is correct. I agree to comply with all city nd county ordinances and state laws relating to building co ruction, and hereby authorize representatives o this county to enter upon the above-mentioned property for i ection purposes. Date:ignature (Applicant or Agent): LQPERMIT Application Number . . . . . 12-00000759 Permit MECHANICAL Additional desc . Permit Fee . . . . 31.50 Plan Check Fee 7.88 Issue Date Valuation . . . . 0 Expiration Date 1/06/13 Qty Unit.Charge Per Extension BASE FEE 15.00 1.00 .16.5000 EAMECH B/C >3-15HP/>100K-500KBTU 16.50 ----------------------------------------- ---------------------------------- Special Notes and Comments HVAC CHANGE -OUT: 3.5 TON CONDENSER & COIL. 2010 CODES. ------------ - --------------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary. Charged Paid Credited Due Permit Fee Total 31.50 .00 .00 31.50 Plan Check Total 7.88 .00 00 7.88 Other Fee Total 1.00 .00 .00 1.00 - Grand Total 40.38 .00 .00 40.38 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-iR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: - Permit #: 53565 AVENIDA MENDOZA La Quinta, CA 92253 City of La Quinta Jul 9, 2012. Duct insulation Conditioned. Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ❑ Furnace ❑ AFUE ❑ COP ❑ R 6 (CZ 10-13) Served by system ® Setback ® Indoor Coil ® SEER 13.0 ❑ HSPF ❑ R 8 (CZ 14-15) 1290 sf If not already present, must be ® Condensing Unit [3EER [3 Resistance 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 VERIFICATION SUMMARY Listed below are FOUR HVAC alteration. Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-4R forms (no hand filled CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF-111 and CF-611 shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: • All HVAC Equipment CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF-4R 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 FQF Exempted from duct leakage testing:lif: ❑ 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 p 3. Existing duct systems are constructed, insulated or sealed with asbestos 04. Thetsystem,will not be Ducted•(ie.•Ductless,Mmi-Split_System),(Also,Exempt.from�Refrigerant Charge) ❑ 2. New;HVAC S stem Required Fdrms•� .Cut inlor Changeout with'-' ducts: } ' # CF 6R forms MECH-04, MECH 20 HERS, and (for split systems) MECH,22-HERS, and_ _ new (all new �,+ ductin all new 9 P ' MECH 2;5 HERS a ' CF-4R forms MECH-20, and (for split systems) MECW22, and,MECH-25 ��}} equipment) , .t t '►,; rd(+f r. _ g For Split Systerr s:zDuct leakage,<6 percent, RC„CCA >'350 CFM/ton, FWD, TMAH, STMS, and;either.,HSPP of PSPP. For Packaged Units: Duct leakage < 6"perce.nf-`_ ' 03. 1 3.. NewwDucfirwith/or without ,, Required Forms: Replacement'°• d . 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: Duct leakage < 6 percent I, 114. New Ducting over 40 feet Required Forms: - . Includes adding or replacing more than 40 CF-6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF-4R 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: Danielle Garcia Signature: Danielle Garcia Company: HARRISON ENTERPRISES INC Date: Jul 9, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 1 Phone: (760) 343-7488 Reg: 212-A0036219A-00000000-0000 Registration Date/Time: 2012/07/09 15:43:45 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010 B;n # City ..ofla Quinta Buli t &r Safety Division P.O. Box 1504JB-495 Calle Tampico La.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Perinit #1wnn 1 ProjectAddrrss: Cjj RY2fl� Q .t I IeI� V col Owner's Name:. A. P. Number. '� 2 Olt.. Address:CAW Legal Description: Contractor. �y \ City, ST, Zip: L-R 22 53 ,. Telephoner • 62 9' Q Q x Address: 31- 0 �� \ V- . I' Project Description: ft U' g 'S o City, ST, Zip.. 6 l Telephone: C7 zl` State Lic. # 49, 66 -City Lic. #; . Arch., Engr., Designer Address: City., ST, Zip: Telephone: State Lic. #:fi , " ;~ j .• Name of Contact Person: Construction Type:. Occupancy: Project type (circle one): New Add'n. Alter Repair Demo # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd 'Reed TRACKNG PERMIT FEES Plan Sets Pian Cheek submitted Item Amount Structural Coles. Reviewed, ready for corrections Plan Check Deposit. . Truss Coles. Called Contact Person Pian Check Balance Title 24 Coles. Plans picked up Construction Flood plain plan Plans resubmitted.. Mechanical Grading plan 2a° Review, ready for corrections/issue Electrical Subcontactor List Caped Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN ROUSE: '^' 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-411-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 53565 AVENIDA MENDOZA, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1� City of La Quinta 12-759 Enter the Duct System Name or Identification/Tag: Enter the Duct System Location or Area Served: Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diaqnostic Test - existina 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 X.„, 1. ❑ 4.,Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options A, 2, or 3 must be::attempted before utilizing Option -4.), Determine,.norninal Fan” Flow using one of.?,the following three calculation methods 9s t ✓ ❑ Cooling'system method: Size of,condenser in Tons x 400 = J CFM a ✓ EJ Heating system method: 2117 x Output Capacity in Thousa9ds of Btu/hr = CFM r ✓ ❑ Measured system airflow using RA3.3 airflo test CFM; procedures: k r i Option 1 used:then; 1 Allowed leakage = Fan Flow ­,. x 0.15 ='_ CFM Actgal-Leakage""=__ CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then:-, i, 2 Allowed leakage = Fan'F.low i' x 0.10 = _ CFM Actual Leakage to outside-.= I_ 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 r3 Pass Fail r. Reg: 212-A0036219A-M2100001A-M21A Registration Date/Time: 2012/08/01 10:15:39 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: 53565 AVENIDA MENDOZA, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-759 ( ❑ Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off duri.rig''duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is requir`ed'to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. ❑ All supply/and return register b-01' �rnust_be seabed to the ft; wall"If smoke testis utilized for compliance - applies'to duct leakage compliance option 3 (leakage reduction b60%) and option 4A(fix all accessible leaks) described above .. ❑ New duct installations.cannot utilize,building.cavities asFplenums or platform returns in lieu of'ducts ❑ Mastic andI raw bands}:must<be ed in,combination.with`cloth;backed rubber.aclhesive duct tape to seal' leaks at all.new duct connectio h ns .; . DECLARATION STATEMENTI • I certify under penalty of perjury, underthelaws 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 -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) ~ HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 331673 ❑ tested/verified dwelling not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CCl-1798671599 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Ezequiel Moreno Ezequiel Moreno ' Responsible Rater's Certification Number,w/ this HERS Provider: Date Signed: 7/31/2012 ' CC200579S < r Reg: 212-A0036219A-M2100001A-M21A Registration Date/Time: 2012_/08/01 10:15:39 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 1 of 5) Site Address: Enforcement Agency: Permit Number: 53565 AVENIDA MENDOZA, La Quinta CA 92253 1 City of La Quinta . 12-759 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. TMAN _ errocc Mnlpc in Cunnly and Return Plenums of Air Handler System Name or Identification/Tag 3 System Location or Area Served p No 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 0 N 'r. 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 Fail ✓ ❑ Pass ✓ ❑ Fail ,i CTMC'_ Concnr nn-tha Fvannratne'_Cnil System Narr eF& Identification/Tag-,' ' , m Y �� rf� � s�� 3 ❑,Ye`'s p No The sensor is factory installed,' orrfield .installed according'to n anufacturer s a specifications, or is installed by methods/specifications approved by, the Executwe 6 ❑ Yes ❑ No Director. The sensor wire is terminated -with a standard mini plug suitable for connection,to a 4 p Yes' F ❑: No digital therm`gi Teter. The -sensor mini plug inaccessible tciihe installing techn_ is n , �` 7 ❑ Yes ❑ No and the HERS. rater without changing the airflow through the condenser coil 5 ❑Yes-- - ❑ No i' When attached to a digital thermometer, the sensor provides an indication of the 8 ❑ Yes j saturation temperature of the coil. Yes to 3, 4, and 5 is apass. Enter N/A if STMS are not ✓ ❑ N/A ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise entei Pass or Fail ✓ ® N/A ✓ ❑ Pass ✓ ❑ Fail CTMC - Concnr nn tho CnndPncpr Cnil 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 ✓ ® N/A ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail Reg: 212-A0036219A-M2500001A-M25A Registration Date/Time: 2012/08/01 10:17:41 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 t CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 53565 AVENIDA MENDOZA, La Quinta CA 92253 1 City of La Quinta 12-759 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. System Name or Identification/Tag (must be re -calibrated monthly) Date of Thermocouple � fir: 3 System Location or Area Served _ �I+ � Outdoor Unit Serial # X. r . Outdoor Unit Make . Outdoor Unit Model Nominal Cooling Capacity Btu/hr"` Date of Verification , Calibration-ot Date of Refrigerant GaugeCalibration ilk (must be re -calibrated monthly) Date of Thermocouple � fir: 3 (fmust be re kcal berated monthly) _ �I+ � Measured Temperatures�(°F) ` •-- F.=: System Name or Identification/Tag �I+ � Supply:(evaporator_leaving) air drybulb X. r . � Return (evaporator"entering) air dry-bulb+ temperature (T _` ) " return, db ; < Return (evaporator entering) air wet -bulb Reg: 212-A0036219A-M2500001A-M25A Registration Date/Time: 2012/08/01 10:17:41 HERS Provider:'CalCERTS, Inc. March 2010 2008 Residential Compliance Forms , Supply:(evaporator_leaving) air drybulb temperature-(Tsupply,'" ae) Return (evaporator"entering) air dry-bulb+ temperature (T _` ) " return, db ; < Return (evaporator entering) air wet -bulb , temperature (Treturn, wb) t 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-A0036219A-M2500001A-M25A Registration Date/Time: 2012/08/01 10:17:41 HERS Provider:'CalCERTS, Inc. March 2010 2008 Residential Compliance Forms , INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 53565 AVENIDA MENDOZA, La Quinta CA 92253 City of La Quinta 12-759 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. is Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System, Name orItlentification/Tagg: m Ir Calculate Minimum Airflow"Requirement (CFM)-- r � a Measured Airflow using.W.3 procedures (CFM) A 4 'T� Passes if measured airflowis greater than or equal - to the calculated minimum airflow requirement: - Enter: Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -6°F and +6°F Enter Pass or Fail Reg: 212-A0036219A-M2500001A-M25A Registration Date/Time: 2012/08/01 10:17:41 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-2! Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5; Site Address: Enforcement Agency: Permit Number: 53565 AVENIDA MENDOZA, La Quinta CA 92253 City of La Quint a 12-759 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 -4°F and +4°F 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 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 iso within'the aIIowa blesup erheat range i � -Enter Pass or Fail -4 1✓ Reg: 212-A0036219A-M2500001A-M25A Registration Date/Time: 2012/08/01 10:17:41 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4111-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 53565 AVENIDA MENDOZA, La Quinta CA 92253 1 City of La Quinta 12-759 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 Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 331673 System meets all refrigerant charge and airflow not-tested/verified dwelling in la HERS sample group requirements. HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail Ezequiel Moreno Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 7/31/2012 CC2005795 DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 331673 ❑ tested/verified dwelling not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798671599 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Ezequiel Moreno Ezequiel Moreno Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 7/31/2012 CC2005795 Reg: 212-A0036219A-M2500001A-M25A Registration Date/Time: 2012/08/01 10:17:41 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION.CERTIFICATE CF-6111-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: # of Identical Systems Efficiency (AFUE, etc.)l, 3 (>=CF -1R value)4 53565 AVENIDA.MENDOZA, La Quinta CA 92253 (System Enforcement Agency: Permit Number: - + 1) City of La Quinta 12-759 - 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.)l, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Type (packaged ' , , ARI # of and EER) 1, 3 (attic, , crawl- Cooling Cooling Peat ,pump) CEC Certified Mfr. Name;, and Model Number ' r;; Reference Number2 Identical Systems (>=CF -IR value)4 space, etc.) Duct R -value Load (kBtu/hr) Capacity (kBtu/hr) 'Split A/C- Goodman S5X140421C ,p� :zfyi ,ri12xEERj 14.5 SEER '>' X42;y, ;, 3.5 Tons • • IiFG , If I � g� �N Equip Efficiency (SEER' Duct Location Type (packaged ' , , ARI # of and EER) 1, 3 (attic, , crawl- Cooling Cooling Peat ,pump) CEC Certified Mfr. Name;, and Model Number ' r;; Reference Number2 Identical Systems (>=CF -IR value)4 space, etc.) Duct R -value Load (kBtu/hr) Capacity (kBtu/hr) 'Split A/C- Goodman S5X140421C ,p� :zfyi ,ri12xEERj 14.5 SEER '>' X42;y, ;, 3.5 Tons • IiFG , If I � g� �N f '41 P. �•�"+ Yn 7L� i lir ! .ry, r ,a "'z• i '-�y'°'�""'`."'.xx„�q`' ,5` i• a :, �,. �"arQF+/'tt�vt,�n'..-• �Mx�,ax °v ,� �� +• a yryjcI-LIZ new c,v1uuutuu1i, >rc-.ruuuivtes io ->canoaros mole 151-cs ana Tawe 151-c, ror auct cemng alternative 2. ARI Reference Number can be found by entering the equipment model number at, http://www.aridirectory.orgli�V. c plip# 3. Listed efficiency on this page'ni6 :be greater than or equal ( ? ) to the value shown on the CF -1R form. 4. When CF -1R is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM , 2 §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. © §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. Reg: 212-A0036219A-M0400001A-0000 Registration Date/Time: 2012/07/19 12:22:18^ HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms _ -August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: Responsible Person's Signature: Danielle Garcia 53565 AVENIDA MENDOZA, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-759 Ducts and Fans §150(m): Duct and Fans 0 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 0 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 d u cts. 2 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. 0 7. Exhaust fan systems,have back draft or automatic dampers. enforcement agency. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name`. Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 7/9/2012 Position With Company (Title): Reg: 212-A0036219A-M04OOOOIA-0000 Registration Date/Time: 2012/07/19 12:22:18 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: AVENIDA MENDOZA, La Quinta CA 92253 (System Enforcement Agency: Permit Number: )3565 City of La Quinta 12-759 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 compliant space conditioning systems and duct systems. and additions in existing dwellings t 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 Leakaqe Diagnostic Test - existing duct system Select one compliance method from the following four choices. 0 1. Measured leakage less than,15% of fan flow 0 2. Measured leakage to outside} ess 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 mut be ai m!nptedjbefore utilizing;Opti� on 4,)� Determine,nommal,Fan Flow using one'o�the1dlowing,-three calculation methods: ✓0 Coo/hngsystem method: S¢e.of�Icondenser m Tons 3'S x 400 FMI ( F ��� �1y400 ✓ O Heating system method j)J21.7 x�yj Orutput Capacity'in Thousandsf�offf Btu/hr = CFM i••k a'� CL. X'P',% CFM_ M P ✓f� i. Option 91'used,then s; K• ::: ' ,. - 1 _Allowed leakage —Fan Airflow 1400' x•0.15 210 ;S,' Actual. Leakage- = 116 CFM co Pass if Actual Leakage is less than Allowed leakage Pass Fail Optioni2 used then 2 Allowed leakage Fan -Airflow r�. x 0.10 = _ CFM Actual Leakage to outside f_ CFM ;;Pass if Actual leakage to outside is less than Allowed leakage 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 test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke Pass ❑ Fail zv1 /V//17 rizxb rroviaer: calcr;x•rs, 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: Responsible Person's Signature: Danielle Garcia 53565 AVENIDA MENDOZA, La Quints CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-759 0 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakag! ytesting. CFIrOA. ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHF3AE Standard 62.2, and close when OA ventilation is not required, may ` be configured to the closed position during duct leakage testing. All supply an rn!:register'boots„mus ale�the'd!X wall, moke tes lize” d'o compliance r .� h. « , o — applies to duct` leakage compliance option 3 (leakage reduction by 60 /o) and opti6nf4)(flx all accessible leaks) described above1-4�r m New ductAnstallations cannot utilize buildin9,cavlties.as plenums oriplatform returnsln lieu of ducts., / ^ � x.T ® Mastic and,draw?bandsmust.be used.m combination with cloth,ba'cked_rubber adhesive duct�ta a to leaks at all"new'clucticon'nection's sY x"z'` p DECLARATION STATEMENT .F e I certify under penalty of perjury, under. the laws of the State of California, the information provided on this form is true and correct. 3; . I am eligible under Division bf;the ;Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsiblefor construction (responsible person). . I certify that the installed features '.m`aterials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for.the installation. I certify that the requirements detailed on the CF -111 that apply, to the installation have been meta . I will ensure that a completed, signed copy of this Instal lation.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 beoinninn Octnher 1. ?ni n_ fnr all Inw-rlcP rPciei—finl hidi in— Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 17/9/2012 position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0036219A-M2100001A-0000 Registration Date/Time: 2012/07_/19 12:22:55 HERS Provider: CalCERTS, Inc. 2008 Residential. Compliance Forms March 2010 ISTALLATION CERTIFICATE* CF-6R-MECH-25-11­11N =frigerant Charge Verification - Standard Measurement Procedure (Page 1 of! ite Address: Enforcement Agency: Permit Number: 3565 AVENIDA MENDOZA, La Quinta CA 92253 City of La Quinta 12-759 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 . Q Yes ❑ No „ Y; 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 k.,5/16 ❑ 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,l and 2;is.a,pass. �V`; Enter Pass or Faill ✓ 0 Pass ✓ ❑Fail STMS -Sensor on the Evaporator -Coil .-_'' System Namero'r'Identification/Tag� "�"Sy"stem i:�'- c. -f? •;(> r Y; - 3 ❑Yes b The sensor is factory" instalied7or4field iristalied according to: manufacturers • ;:, f p,Nol specifications, or isinstalled.by method's/specificationsapproved by the Executive � The sensoris factory installed, or field installed according to manufacturer's 6 DirectoF: � r �� � � i? �:� � x '� ` •� l �,� �''"a �. r� t°".:��" � «4a 4 ?' ❑,Yes ' '� .� The sensorwire is terminated With a standard mini plug suitable for connectonxto a[ ; ❑ No `digital thermometer. sensor mini plug is accessible to tFieyinstalling'�techrncian -The and;the•HERS;rater without changing the airflow through the condenser coil` 5 • ❑ Yes'-,"", ❑ No ' Tt a sensor measures the saturation temperature of the coil within'1.3 degrees F Yes;to.3; 4—dhdj5 is a�pass. Enter N/A'_if`STMS are not applicable:;Otherwise enter Pass or,Failr= ✓ N/A ✓ . ❑Pass ✓ ❑Fail STMS -Sensor on the Co Qn,e'r. Coil System Name or Identification/Tag:;5 '_: System 1 The sensoris factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No' specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes ❑ No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ 0 N/A +/ [3 Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail Reg: 212-A0036219A-M2500001A-0000 Registration Date/Time: 2012/07/19 12:24:34 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 Si o INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 53565 AVENIDA MENDOZA, La Quinta CA 92253 1 City of La Quinta 12-759 Standard Charge Measurement Procedure (for use if outdoor air dry, -bulb is above SS°F) + Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure, Space Conditioning Systems System Name or Identification/Tag System 1 (must be re -calibrated monthly) Date bfiThermocouple Calibration s 7/1/2012 System Location or Area Served Whole House e l ` ..,_: � �" �"x. ;.• Outdoor Unit Serial # 1204069131 -�•� F •�.� .--�..ar,� � '��`' Outdoor Unit Make Goodman Outdoor Unit Model SSX140421C K'.. Nominal Cooling Capacity Btu/hr. 42000 V1.2: , Date of Verification +: • 7/9/2012 f a.auurauun-vr-lJldg"UbVIC ans[rumen[s Date of Refrigerant Gauge Calibrati n 4 7/1/2012 (must be re -calibrated monthly) Date bfiThermocouple Calibration s 7/1/2012 must be re -calibrated month) "G Y) i` ` J P e l ` ..,_: Measured•,Temperaturesri(, F)`;�:I / `01 r ..�1, y4�>. _uo'..,✓C �..,t?`at �.Lf`) a.�..f�,� �x '.'s✓/ .'%`+' ...� .:� t .� : '4 �. �'• � �" �"x. ;.• Supply,(evaporator'leaving)aair dry-bulb��-. "°� �•` '� 64 -�•� F •�.� .--�..ar,� � '��`' temperature (Tsu pI db) * w Return (evaporator entering) air dry"' bulb 88 K'.. System Name or Identification/Tag� 1F� System � �+, � ..�1, y4�>. _uo'..,✓C �..,t?`at �.Lf`) a.�..f�,� �x '.'s✓/ .'%`+' ...� .:� t .� : '4 �. �'• � �" �"x. ;.• Supply,(evaporator'leaving)aair dry-bulb��-. "°� �•` '� 64 -�•� F •�.� .--�..ar,� � '��`' temperature (Tsu pI db) * w Return (evaporator entering) air dry"' bulb 88 tem peratu�e,,(Treturn db) 1 Return (evaporator entering) air wet bulb 62.7 temperature (T? return,wti) .`. Evaporator saturation temperature;,,' 53 (Tevaporator, sat) '';y Condensor saturation temperature 128 (Tcondensor, sat) Suction line temperature (Tsuction) 68 Liquid Line Temperature (Tliquid) 121 Condenser (entering) air dry-bulb 112 temperature (Tcondenser, db) Reg: 212-A0036219A-M2500001A-0000 Registration Date/Time: 2012/07/19 12:24:34 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 53565 AVENIDA MENDOZA, La Quinta CA 92253 City of La Quinta 12-759 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 Calculate: Actual Temperature Split = Treturn, 24.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3 23.5 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split -0.5 Target Temperature Split = Passes if difference is between. -3°F and +3°F or, uponremeasurement, if between -3°F and -100oF PASS 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 4Name o Id nt fication/Tag tz `� S} stem 1 u..�'ryl Calculated Minimum Airflow, Requireypments(CFM) �. r� ij� pr t' `t .it�• �+s � f �� C... S � +C+ i; . A0 y(•C1iF. F ' �1 P g +ir. ` tr.= MVb r.�ar...�1` aA-�?'A�M. :..+F Meas eAirfow�usingR'A'3?.3F procIF.et' dtud res M)/ .f �t Passes if mii asuredairflow'is'greater than or -t-,, equal to the calculated minimum airflow v :" 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/Tay''` 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 Reg: 212-A0036219A-M2500001A-0000 Registration Date/Time: 2012/07/19 12:24:34 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms - August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 53565 AVENIDA MENDOZA, La Quinta CA 92253 City of La Quinta 12-759 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 o 7.0 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 53565 AVENIDA MENDOZA, La Quinta CA 92253 City of La Quinta 12-759 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 = 7.0 Tcondenser, sat - Tliquid 15.0 Target Subcooling specified by manufacturer 7 Calculate difference: 0 Actual Subcooling - Target Subcooling = 3=26 System passes if difference is between -3°F and +3°F PASS f Enter Pass or Fail d i' • { F' 3x 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, 15.0 Tsuction - Tevaporator, sat' Enter -.allowable superheat range from . manufacturer's`specif cations (or use range between 4°F and 256F if manufacturer "i".. 3=26 specification is not. available)s .., Systemlpasssesrif actual superheat is,witthinAhe� allowable superheah'range �! Y'PASSY � f .; me Pass,or Fail;..- �Er d i' • { F' 3x �� 4_ _ r r+ .. ',.`I• X � tk. eqt �bP !F'['�..l+�i''.,#'`YY s ' �� k �, 1 y+.;� rn, �y ..�[ •„Y. , •r"R.:t?;'� �.p+.,y�,.�� ;r%”' . Reg: 212-A0036219A-M2500001A-0000 ARegistration Date/Time: 2012/07/19,12:24:34 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 • Y• ISTALLATION CERTIFICATE CF-6R-MECH-25-HEI efrigerant Charge Verification - Standard Measurement Procedure (Page 5 of to Address: Enforcement Agency:Permit Number: 3565 AVENIDA MENDOZA, La Quinta CA 92253 City of La Quinta T12-759 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 -. Date Signed: 7/9/2012 Position With Company (Title): System meets all refrigerant charge and airflow Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No requirements. PASS ' Enter Pass or Fail r _l `.'? r- .tja .s �!, ."� *.;,M 3+rk� s`r ♦ 7 DECLARATION STATEMENT 5}. • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of:the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features;"materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the, enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiDle orientation alternatives. and heninninn nrtnher 1 . 7M n fnr all Inw-rico—ci`iontini hi iilrlinne Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 7/9/2012 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0036219A-M2500001A-0000 Registration, Date/Time: 2012/07/19 12:24:34 HERS Provider:• CalCERTS, Inc. 2008 Residential Compliance Forms August 2009