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MECH (11-1021)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA; CALIFORNIA 92253 Applicant: Architect or Engineer: rl� ------------------ LICENSED CONTRACTOR'S DECLARATION b VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/21/11 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 C38 License No.: 577952 ate:�6ntractor: / OWNER -BUILDER DECLARATION 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 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.). (_ 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason. Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty o 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: JOANNE BUCK .57162 MERION LA QUINTA, CA 92253 Q Contractor. i �- t 2011 PAUL'S AIR COND & HTG CO INC P.O. BOX 1818 f '-"'y OF t CATHEDRAL CITY, CA 92235-188 (760)323-4776 Lic. No.: 577952 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. J I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor 6� Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier SOUTHERN INS CO Policy Number WSI0046869-01 _ 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 3700 of the Labor Co , 1 shall for hwith comply with t ovisions. IicanC _ WARNING: FAILURE TO SECU WORKERS' COMPENSATIO VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($1Q0,000). 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 1 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 bu"a construction and hereby authorize representatives of thisicounty to enter upon eabove-mentioned grope - r inspection purposes. - ate:' nature (Applicant or Agent): Application Number:__ _ , `11-00001021 Property Address: 57162 MERION ­ -\ APN: 762-031-026- - - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 11000 Applicant: Architect or Engineer: rl� ------------------ LICENSED CONTRACTOR'S DECLARATION b VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/21/11 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 C38 License No.: 577952 ate:�6ntractor: / OWNER -BUILDER DECLARATION 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 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.). (_ 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason. Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty o 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: JOANNE BUCK .57162 MERION LA QUINTA, CA 92253 Q Contractor. i �- t 2011 PAUL'S AIR COND & HTG CO INC P.O. BOX 1818 f '-"'y OF t CATHEDRAL CITY, CA 92235-188 (760)323-4776 Lic. No.: 577952 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. J I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor 6� Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier SOUTHERN INS CO Policy Number WSI0046869-01 _ 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 3700 of the Labor Co , 1 shall for hwith comply with t ovisions. IicanC _ WARNING: FAILURE TO SECU WORKERS' COMPENSATIO VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($1Q0,000). 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 1 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 bu"a construction and hereby authorize representatives of thisicounty to enter upon eabove-mentioned grope - r inspection purposes. - ate:' nature (Applicant or Agent): Application Number . . . . . 11-00001021 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 66.00 ..Plan Check. Fee 16.50 " Issue Date . . . . Valuation . . . 0 Expiration Date . 3/19/12 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00, 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33..00 ---------------------------------------------------------------------------- Special Notes and Comments HVAC -CHANGE -OUT (2),COMPLETE SYSTEMS, BOTH 16 SEER.i2010 CODES. -------------------.---------------------- Other Fees . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 66.00 .00 .00 .66.00 Plan Check Total 16.50 .00 _.00 16.50 Other Fee Total 1.00 .00 .00: 1.00 Grand Total 83.50 .00 .00 83.50 LQPERMIT h Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAIterations CF 1R ALT'HVA Climate Zones 10 to 15 .3tte Address- l Z Enforcement Agency: Date: Permit #: Equipment T l ❑Packaged Unit List Minimum Efficiency Duct insulation requirement Conditioned Floor Area Thermostat getback (/jnor already ig-Furnace %.Indoor Coil❑SEER Condensing Unit ❑ AFUE ❑ COP ❑ HSPF Over 40 ft of ducts added or replaced in unconditioned spaceed OR R 6 (CZ /0-/3) b system ❑ EER ❑ Resistance sf present, must be ❑ Other ❑ R S (CZ 14-15) 1 installed) Equipment Type: Choose the equipment being installed: 1. ijmore than onesystem, use anotherCF-1R-ALT-HVACjoreach system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.711SPFjortypical 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 A conducted. 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 CF4R forms (no hand filled CF4Rs allowed) are filled out and sied. Beginning October 1, 2010 a r istered copy of the CF -1R and CF -6R shall also be on site for final Inspection. 1. HVAC Changeout Required Forms:' • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH- 21 and fors lits stems MECH-25 • Condenser Coil and /or • Indoor Coil and /or CF-61tforms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS 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 Fxempied from duct leakage testing if: ❑ I. 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-20for lit ducts: (all new ducting and all ( split systems) MECH-22-HERS, and MECH-25-HERS new equipment) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 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 Replacement- Required,Form : • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-14ERS and/or outdoor condensing unit and/or indoor CF411 forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all equipment changed. For Split Systems: Duct leakage < 6 percent, RC, CCA 2:300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent O 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned space. CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split system 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 certiN, that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the info licable compliance forms, worksheets. calcul lans ands cifications submitted to the enforcement for agency a royal with it application. Name: ilJ V ( (_ Signature: Company: pp �c ,^ l_S f1✓�o �`-i� (� Date: Address: i�`M J s 2 f / License: [Tiy/statc/zip: f fl 2 Phone: 1— 3 Z 2008 Residential Compliance Forms March 2010 Sint li led Prescriptive Cer ' Climate.Zones 10 to I5: Site Address- to of 200E:Resideritia! HVAC Alterations CF-IR-ALS'=HV Enforcement Agency: Date: Permit #: t Conditioned Floor Equipment T List Minimum Efficiency' Duct insulation requirement Area Thermostat ❑ Packaged Unit $.Furnace ❑ AFUE ❑ COP Over 40 ft of ducts added or etback d _door Coil ❑SEER replaced in unconditioned s ace ed b system KE ❑ HSPF P f prose t. ready must .Condensing Unit ❑ EER �_ ❑ R 6 (CZ /0-/3) sf ❑Resistance present. must be ❑ Other. ❑ R 8 (CZ 14-/5) installed) 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, 78016AFUE, 7.7HSPFfortypical 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 -611 and registered CF4R forms (no hand filled CF4Rs allowed) are filled out and sigped. Beiinning October 1,.2010 s registered copy of the CF -1R and CF -611 shall also be on site for final Inspection. t. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Condenser Coil an/or CF -4R forms: MECH- 21 and forsplit ssteins MECH-25 d • Indoor Coil and/or CF -6R fortes: MECH-2I-HERS and (for split systems) MECH- 25 -HERS •. Furnace CF -4R fortes: 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 • 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 40.1inear feet in unconditioned space, or ❑ 3. Existingducts stems re constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms:' • Cut in or Changeout with new ducts: (all new ducting and all CF-61kfortes: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-I4ERS new a ui ent CF -4R forms: MECH 20-, and (for split systettts)MECH-22, and MECH 25 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 ReplacementRequtred-Forms: • Includes replacing or installing all new ducting CF -61K forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF4R forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all 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 linear feet of duct in unconditioned spa ce. CF 6R forms: MECH-04, MECH-2I-HERS 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 certifi• that this Certificate of Compliance documentation is accurate and complete. • jam eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this -Certificate of Compliance. r 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 I and 6 of the Cal ifomia Code of Regulations. • -ihe design features identif ed on this Certificate of Compliance are consistent with the informati calcul tans ands cifications submitted to the enforcement agency fora roust with it a lication. Itcable compliance forms, worksheets. Name: / � J V ! L� signature: Company: , j[}L��s fro 44 r7 C— Date: Address: I l�� ( ( License: Z Cite/Statc2ip: L p^ o"t / t��+- / Z �- Phone: c7 T/— _Zc- 2008 Residential Compliance Forms March 2010 Bin. # Permit #P.O. Project Address: . . City of La Quints Building 8f Safety Division Box 1504,78-495 Calle Tampico ta:Quinta, CA 92253 -1760) 777-7012 Building Permit Application and Tracking Sheet Z Y " l f lb d Owner's Name:. -7J-0 tJNF ��•1C- A. P. Number. Address:— �O 1 � Legal Description: City, ST, Zip: - Contractor: L� t X. l /4i' 1Z Telephone: z Address: d 3 T/2 ' 1 LJ Q 11.J eq Description: City, ST, Zip: t� Telephone: _ State Lic. # : ' � pp���C3 Cr . > -� uq l� s City Lic: #, S �' Arch., Engr., Designer. Address: City., ST, Zip: Telephone: State Lic. #: Name of Contact Person: Construction Type: _Z0 Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units Telephone # of Contact Person: . $ = — C . Estimated Value of Project: .• APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACMG PERMU FEES Plan Sets Plan Cheek submitted Item Amount Structural Catcs. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs, Plans picked up Construction Flood plain plan Plans resubmitted.. Mechariicaf GMIng plan V Review, ready for correctiousirmue Electrical Subeontactor List Called Contact Person Plumbing Grout Deed Plans picked up H-O.A. Approval Plans resubmitted Grading \ IN HOUSE:. 34 Review, ready for correctionslissue Developer Impact Fee Planning Approval. Called Contact Person Ad.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees �i Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date:Permit #: 57162 MERION La Quinta, CA 92253 City of La Quinta Sep 28, 2011 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit * Furnace *Indoor Coil 0 AFUE o p SEER. [:]COP_ El HSPF C]R 6 (CZ 10-13) Served by system If not Setbck present, must be ® Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) 3049 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -ALT -HVAC for each systema 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. 8 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 -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS . Furnace CF -411 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 For- Parskaged-URitso Duet leakage -; 15 peFeeRtr 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. Thi�,system=will not be Ducted 0e.-Ductless,Mini-Split ,System)-(Also-Exempt-fromc Refrigerant -Charge) ❑ 2. New -HVAC System Required Forms: ! . Cut in'or Changeout with_;/.� ducts: and new (all new CF -6R forms: MECH-04, MECH-20 HERS1and (for split systems) MECH-22-HERS, MECH-25-HERS ducting i1ld all new CF-411forms: MECH 20, and (for split systems) MECH-22', and MECH 25 equipment) +f i♦ rli_f .y .1� �r.1 c. �. For Split Systems: Duct leakage < 6 percent; RC, CCA z 350 CFM/ton, FWD, TMAH, STMS, and either HSPP & PSPP. For Packaged Units: Dud leakage < 6 percent ❑ 3. New Ducts with/.or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit and/or indoor CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS coil and/or fumace. No or some equipment CF -411 forms: MECH-20 and (for split systems) MECH-25 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 -61k 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 Tide 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: PAUL VITALE Signature: PAUL VITALE Company: PAUL"S HEATING & AIR Date: Sep 28, 2011 Address: 33482 VIEW POINT DRIVE License: 917502 City/State/Zip: WILDOMAR / CA / 92595 Phone: (760) 644-2475 Reg: 211-A0050344A-00000000-0000 Registration Date/Time: 2011/09/28 15;04:43 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 6 b � ` Y -fir.. ♦ � ���• '� 3 y 4 n Y - f'_ -e ,�" +�w. ' +' y f"•'n � 1TM S ,'��e'f ,�5yl�".Sr ; A� y�.S''X y�j a '_'�` 3 .. `�. . ,i~ i .r - F ,�-,. a� r� . .s1 ,'��.(.�'t ,- 17-,' r � -. i." t Vii' �• J CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-21 Duct Leakage Test - Existing Duct System (Page 1 of .2) Site Address: Enforcement Agency:Permit Number: 57162 MERION, La Quinta CA 92253 (System 1) City of La Quinta 1i-1021 ., X nter the Duct System Name or Identification/Tag: AC-I-UPFLOW . nter the Duct System Location or Area Served: Whole House ote: Submit one Installation Certificate for each duct system that must demonstrate compliance in. the welling. his installation certificate is required for compliance for alterations and additions in existing dwellings to - • _#` pace conditioning systems and duct systems. ote: For existing dwellings, a completely new or replacement duct system can also include existing parts e ie original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible nd they can be sealed. For a completely new or replacement duct system installed in an existing dwelling,' se the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " flirt 1 anirmnP ninnnnctlf TPCY - PYictina duct -cv-ctPm Select one compliance method fromthefollowing four choices. ❑ 1. Measured leakage less than 15% of fan flow . r ❑ 2. Measured leakage to outside less than 10% of Fan Flow ❑ 3. Reduce leakage by 60% and conduct smoke and fix all leaks r 0 4. Fix all accessible leaks using smoke and HERS rater verify r s a Note:,(One of Options 1, 2, or 3 must be attempted before utilizing Option 4.) Determine nominal F�an�Flow using one ofthhe�following,three-calculation methods. -, ; V Cooling system method: Size of condenser in Tons �4 z 400'=•i 1600 CFM �• , ✓ ❑ 21.7 Output Capacity Btu/hr. CFM Heating system method x m;Thousands of _ ✓ El Measured system'airflow using RA3.3 airflow testprocedures: CFM .-�- ^— 17-,' Option`i used then: t- " t,r. ` ".`.f""''. �.F' k< a4w— at`.ti` 1 Allowed leakage = Fan Flow 1600 -'x 0.15 = 240 CFM Actual Leakage = 419 CFM - __- Pass if Leakage Actual is less than Allowed Pass bFail Option 2 used then: 2 Allowed leakage = Fan Flow J 1600 x 0.10 = 160 CFM Actual Leakage to outside = = CFM 4'Pass if Leakage Actual is less than Allowed p 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 > 600 E] 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 M Pass Fail ' 40 f-: • _ 1. .,. , Reg: 211-A0050344A-M2100001A-M21A Registration. Date/Time: 2011/09/28 15:20:22 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms z March 2010 ' .. _ '- � r• � .- + h .f •�;.�"k�'y 1' }rev ' .'i. * 'r • •j. a 10 * 47 •�< r f ' '`.'Y o • a K . .. CF-4R-MECH-21 CERTIFICATE OF FIELD VERIFICATION &DIAGNOSTIC TESTING a Duct Leakage Test — Existing Duct System (Page 2 of 2) •:s:, ; 4, , Site Address: Enforcement A envy: Permit Number: +;• au `� " 57162 MERION, La Quinta CA 92253 (System 1) City of La Quinta 11-1021 ` ,f t 0 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off s� 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 and return register boots must be -sealed to-the.drywall-,if.smoke-,test;is�utilized=for compliance — applies Wo duct leakage complianceoption 3`(leakage reduction by 60%) andfoption}4 (fix all accessible leaks) described above. �(r New ductinstallations�cannot utilize,building cavities as plenumplatfiorm.returns ln,lleu of ducts: f f� 0 Mastic and4draw'bands must be,used in co iiination-.with cloth backed•rtjbber adhesive duct tapek.to seal +fi leaks at all new duct connections" _ -`i •* ' Y 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 -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 f nt a enc en orceme g y• Builder or Installer information as shown on the Installation Certificate (CF -6R) h Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PAUL'S HEATING & AIR Responsible Person's Name: 1917502- CSLB License: PAUL VITALE HERSProvider Data Registry Information ' # Q dwelling ❑ not-tested/verified dwelling in -. la Sample Group (if applicable): N/A tested/verified HERS sample group HERS Rater Information Ca10ERTS Certificate # CCl-1798595561 HERS Rater Company Name: Coast Aire Responsible Rater's Name: Responsible Rater's Signature: r Don DeAngelis Don DeAngelis Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/27/2011 CC2004161 } ` A r Reg: 211-A0050344A-M2100001A-M21A Registration Date/Time:-.2011/09/28'15 1 :20 22 .,,,HERS Provider: CalCERTS, Inc. ' ' - 2008 Residential Compliance Forme .; � w +`�a}• , ,; March 2010'. • • T r � � . ^I �,. _� rat - t` v a. Vis: - �'. +1,:'� j # t''"' # of Identical Systems �:.. r .-" , =': r•,�,. r z- ,�, e.? '. Heating. Capacity (kBtu/hr) Split Furnace 4.� �• ,��± �.�,�+�i'h �').�:, o +^ 1 80 AFUE Attic 90 kBtu Type Space Conditioning Systems 4 - �„ a Heating Equipment Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (AFUE, etc.)1, 3 (>=CF -111 value)4 Duct Location (attic, crawl- space, etc.) - Duct R -value Heating Load (kBtu/hr) Heating. Capacity (kBtu/hr) Split Furnace AMANA MVC80905CX 1 80 AFUE Attic 90 kBtu Type and EER) (attic, (package ARI # of • 1,3 n Cooling Cooling heat -CEC Certified Mfr. Name Reference Identical (>=CF -1R space, Duct Load Capacity pump) and Model Numbers Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split A/C AMANA .1F_ '11kASXE160481 - - 16:SyyEERIK !Attie , my 48 kBtu camine rauinmenr r 1. If project is new construction, see Footnotes to Standards Table 151-8 and Table 151-C for duct ceiling alternative , compliance. it 2. ARI Reference Number can be found by entering the equipment model number at A http://www.aridirectory.orglari/ac. php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R form. a 4. When CF -IR is reference it is also applicable to the CF -IR, CF -IR -AA or CF -IR -ALT ri ALL BOXES MUST BE CHECKED TO BE A VALID FORM • §110-§113: HVAC equipment is certified by the California Energy Commission. • §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. CEJ §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of . +` §112(c). 0 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets T minimum requirements of Table 150-B and includes a•vapor retardant or is enclosed entirely in.. , conditioned space. ; '{ - • 7 — AJC_ - ' _ � I , • . - ' Reg: 211-A0050344A-M0400001A-0000 Registration Date/Time: 2011/09/28.15-13:55., HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms s.': f, �• K' 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 Numbers Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split A/C AMANA .1F_ '11kASXE160481 - - 16:SyyEERIK !Attie , my 48 kBtu � � •�f � J1+� � �, j 17�,':'_ ta -� - '�I `� ...� �� � Y ,p � � ,.as�..•�, � r 1. If project is new construction, see Footnotes to Standards Table 151-8 and Table 151-C for duct ceiling alternative , compliance. it 2. ARI Reference Number can be found by entering the equipment model number at A http://www.aridirectory.orglari/ac. php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R form. a 4. When CF -IR is reference it is also applicable to the CF -IR, CF -IR -AA or CF -IR -ALT ri ALL BOXES MUST BE CHECKED TO BE A VALID FORM • §110-§113: HVAC equipment is certified by the California Energy Commission. • §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. CEJ §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of . +` §112(c). 0 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets T minimum requirements of Table 150-B and includes a•vapor retardant or is enclosed entirely in.. , conditioned space. ; '{ - • 7 — AJC_ - ' _ � I , • . - ' Reg: 211-A0050344A-M0400001A-0000 Registration Date/Time: 2011/09/28.15-13:55., HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms s.': f, �• K' August 2009 +y ' . , r y 'r `• _ � .fir` ii �, • � Myr � �r � .l -. -. � L y x a, r, '.�, j �!' c�� r `�` it - �• % e v •. r }. }i« r i .r i�, 4 , r. • - �•i a",}•.. 3 c�w `'�.. : -. .• ra'I',i.v fat ;•a 9 �r •,-a r INSTALLATION CERTIFICATE CF-6R-MECH-0 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: r 57162 MERION, La Quinta CA 92253 (System 1) City of La Quinta i1-1021 - 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 4 inch, the combination of mastic and either mesh or tape shall be used; and E6 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 Y ducts. } 0 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. 9 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. b � 0 Protection of Insulation. 'Insulation 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 that is water retardant and provides shielding from solar radiation that can cause degradation of the material. _ 0 10. Flexible ducts cannot have porous inner cores. 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 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 -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. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PAUL'S HEATING IN AIR ' Responsible Person's Name: Responsible Person's Signature: , PAUL VITALE PAUL VITALE ' CSLB License: Date Signed: Position With Company (Title): 917502 9/20/2011 Reg: 211-A0050344A-M040o001A70000 Registration Date/Time: 2011/09/28 15:13:55 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009` ZA tS ■'+.� S R ,� ? h o _ a wjS�?,., '�"`:. - a _k, '^+, "s¢Y''-}r �t' +Xt"S'f o.G i''+;w' s .i.•. A:� ��s3s w ..�'t �rl M1Ja A. '" '�^„hsi +( rya �jt} `. .. w t; -',' � � - ,. .. c. ,K... < .. ','�.� `��•�•, ar• .��,.+' 'j.4�� u+ 6y+�.. ��++�F �.l.�;! �• 1I r����., ,.t y.,l ^ . �'}. .. - � .. .. - - ,1 W 3 ./ ^. -.. ^ � - • 1, _. � .. •l.h ice.,' . �'� ' � � rl�,I!I s'F' ��44 ' t") �7r i'� ��s :a� t-�' • T „ Enter the Duct System.Name or Identification/Tag: AC-I-UPFLOW 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. stallation certificate is required for compliance for alterations and additions in existing conditioning systems and duct systems. to tote: For existing dwellings, a completely new or replacement duct system can also include existing parts o, he 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, fse the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System." Duet Leakage niaanastic 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 '* r s ❑ 3. Reduce leakage by 60% and conduct smoke and fix all leaks ' + •. z• , �� ,` ; . © 4: Fix all accessible leaks using smoke and HERS rater verify w ., 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 Tons 4 _ x 400' 1600 CFM ” �• ✓ ❑ Heating system method:41.7 x : Output Capacity in Thousands of. Btu/hr.- _ CFM ✓ El Measurea system, using RA3 3 airflow,test�procedures: CFM OptionA used then. u'W' 1 Allowed leakage =Fan Airflow'y"1600 x 0.15 = - 240 CFM.' "419 11 Actual Leakage = CFM ' Pass if Actual Leakage is less than Allowed leakage M Pass M Fail Option 2 used then: 2 Allowed leakage = Fan Airflow 1600 x 0.10 = 160 CFM Actual Leakage to outside = t CFM ! Pass if Actual leakage to outside is less than Allowed leakage Pass Feil Option 3 used then: y Initial leakage prior to start of work = _ CFM n 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 > 600 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 i J. Reg: 211-A0050344A-M2100001A-0000 Registration Date/Time: 2011/09/28;15:19:02• HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms - ` a March 2010 o INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 57162 MERION, La Quinta CA 92253 (System 1) City of La Quinta 11-1021 ... - .�, © Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off - during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ` ventilation,is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. © All supply and=return register boots'must-tbe.,sealed=toJthe drywall�f,.smoke?test is utilized for -compliance ' - applies toydi ct leakage compliance,opption 3`4leakage reduction by'60%)*a'ndToptio9'J4,(6 all 'accessible, leaks) � scribed above � .�'�f � � s� Q • . � ;� • New duct installations cannot; utilize building cavities as plenums or platform returns in;lieu'of-ducts 8 Mastic'anii,draw!bands must be used•Inrcombination;wlthrcloth backed,rubber,adhesive�duct.tape to seaL�Q; leaks at all `n�'w ddu+a connections :m• `- '"` " " ` 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. f • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or. an authorized 7- 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. a • I understand that'a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also ` perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the Installation have been met.,, > • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data - registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. T Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PAUL'S HEATING A AIR Responsible Person's Name: Responsible Person's Signature: PAUL VITALE PAUL VITALE CSLB License: Date Signed: Position With Company (Title): 917502 9/20/2011 2008 Residential Compliance Forms Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable):, Control Program (TPQCP)?• ❑ Yes ❑ No Reg: 211-A0050344A-M2100001A70000' Registration Date/Time: 2011/09/28'15:19:02',, HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms a March 2010 •• ' _ - [ .. u .,4� . Irk r -f ..F--• 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 AC-I-UPFLOW System Location:or Area Served Whole House 1 ® Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 ®,Yes' ❑ No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to, and'21s a,pass. Enter Pass or Faill ✓ o Pass ✓ ❑' Fail STMS - Sensor oq the Evaporator. Coil. .... ._ System Name,or Identification/Tag } j /,� AC=1=UP,FLOWf— - I �• �' � [ �� 3 ! ❑ Yes EI The sensor is factory" installed; or field installed according to manufacturer's specifications, or Oinstalled by my ethods/specifications approved by the Executive` ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive , Director. V ' t I \•--'- ;' It 3 k __�, F I f ''' `7r " tl1 The sensor wire is terminated with a standard'mini plug suitable for connection to ap sensor 4 ❑ Yes p No digital thermometer. The mini plug is accessible to�the installing,techrnciari 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 I ❑ No jThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3; 4, -and 5 is a`pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail V ® N/A' ✓ ❑ Pass ✓ ❑ Fail It i STMS - Sensor on the Condenser Coil System Name or Identification/Tag I AC-I-UPFLOW 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 • I ❑ 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 �/ 0 N/A ✓ F1 Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail Reg: 211-A0050344A-M2500001A-0000 Registration.Date/Time: 2011/09/28 15:18:03 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 .. � - ` . . r .•j•al .,)�r Y _;,.:- `�, ...a ,lpa �i •� 'Y r f�_r }.ht � •�F^L�. •�.,9• '" •t^ . 'i"• �' �� � � � y .'�. a Y�l� �� �r '�' "�„ - � : $ ; '� JL7: "y . � `µ''� -' p� �' �Cr�_ n � r .. - � . ,� :, ` � f � ..�. - � �# ;�� :.� � ,r •� ��,'�` X � � � �• %� �;;��,'� � �; � � fi '�'�(" , � �a "t: '�"�''M. � tip`:. `R� h _. , .. -. w.$y 6 1 r' �� ;•Y cw r�'r 3 � r t j � }. � � 'ii ._�.. e.0.L fi .k� l�►.r ,'�, ~ �+'t' �r },�s 5 � ♦ � �ty+* i�i,h�tt �-f ... AMANA 1 • �N .',"'�1 y t.. 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 i any additional systems in the dwelling as applicable. I _ • 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°For below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems System Name or Identification/Tag AC-I-UPFLOW (must be re -calibrated monthly) IL �g System Location or Area Served Whole House F- . r ,/li' jzmust�be r — 9Yf: t► r calibrated monthly). -� Outdoor Unit Serial # 1108609290 " Outdoor Unit Make AMANA r x Outdoor Unit Model ASXE160481 -' s Nominal Cooling Capacity Btu/hr '' 48000 of Verification - 9/20/11 7rDate • ti cauuration oT omanostic instruments Date of Refrigerant Gauge Calibration 9/1/11 (must be re -calibrated monthly) IL �g F k •,-r *.I V_,fir ' �r r 4_. f Date of Tmocouple�,fCalibration �/''� F- . r ,/li' jzmust�be r — 9Yf: t► r calibrated monthly). AF 1. Measured Temperatures'-(-F).-1I I System Name or Identification/Tag1 AC-1-UPFLOW �' .�. �g F k •,-r *.I V_,fir ' �r r 4_. ,7 1 t AF Supply (evaporator leaving) air dry-bulb -,.756 " temperature (Tsupply, db) - Return (evaporator entering) air dry-bulb 75 s temperature (Treturn, db) ( Return (evaporator entering) air wet -bulb 62 • ti temperature (Treturn, wb) ', . • Evaporator saturation temperature_ 46.7 +. (Tevaporator, sat) Condensor saturation temperature 107.8 2011/09/28 15:18:03* ". 2008 Residential Compliance Forms (Tcondensor, sat) n August 2009 _ ? �'t Suction line temperature (Tsuction) 71 Lav {. F r��r ' Liquid Line Temperature (Tliquid) 101.2 l Condenser (entering) air dry-bulb 100 + temperature (T ) T condenser, db • Reg: 211-A0050344A-M2500001A-0000• Registration Date/Time: 2011/09/28 15:18:03* HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms n August 2009 _ ? �'t > r Lav {. F r��r !T, e NSTALLATION CERTIFICATE CF-611-MECH-25-HER tefrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5 Site Address: Enforcement Agency: Permit Number: 57162 MERION, La Ouinta CA 92253 City of La Quint a 11-1021. Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge �' ��A�.: t; L- , k1 T Z?. 5. �'k•f-+?. L� .. —r.{ .y • y:r i.� 'rt ♦ YF .T-•• _ �{ ..: �[ h' ,.ar 14 A_.; {, .�. � :.-1� Ar 'r'i. {yy R1• �V. � 1, r. .i- , �.+ I* .•' ^> - +.:.' a' :.+xis •F ;,�. b9i;r-.aY. db - Tsupply, db ""' o. n r..�ty « µ� y; *� Target Superheat from Table RA3.2-2 using Target Temperature Split from Table RA3.2-3 f Treturn, wb and Tcondenser, db using Treturn, wb and Treturn, db `} NSTALLATION CERTIFICATE CF-611-MECH-25-HER tefrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5 Site Address: Enforcement Agency: Permit Number: 57162 MERION, La Ouinta CA 92253 City of La Quint a 11-1021. 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 Name or Identification/Tag AC-I-UPFLOW ' Calculate: Actual Temperature Split = Tretum, 19.00 Tsuction - Tevaporator, sat db - Tsupply, db Target Superheat from Table RA3.2-2 using Target Temperature Split from Table RA3.2-3 19.3 Treturn, wb and Tcondenser, db using Treturn, wb and Treturn, db `} Calculate difference: Calculate difference: Actual Temperature Split _0.3' - Actual Superheat - Target Superheat = - Target Temperature Split = ' Passes if difference is between -3°F and +3°F and +5°F or, upon remeasurement, if between -3°F and PASS ` s Enter Pass or Faill -100°F Reg: 211-A0050344A-M2500001A-0000 Registration Date/Time: Enter Pass or Fail, ,HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms , �� 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. _ 1.4 Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) . F � a• • r System Name o IdenAiication/Tag f,r:' / AC 1-U LOW i Iy , Calculated Minimum Airfl�orrw;Requirement' ,;;r (CFM) I [ , • f N - "^- ++fes MeasuretlAirflow using RA3.3 procedures w`--:►` �. L k.`"._ " f.a� �J ` (CFM) , . -}�^ R Passes if measured airflow is greater than or►• equal to the calculated minimum airflow requirement ' jk" ' Enter, Pass or Faill 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 AC-I-UPFLOW Calculate: Actual Superheat = Tsuction - Tevaporator, sat ' Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db `} Calculate difference: A. - Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Faill A. Reg: 211-A0050344A-M2500001A-0000 Registration Date/Time: 2011/09/28 15:18:03 ,HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms , �� t August 2009 '+ 1.4 F � a• • r � •S � , ';' iry µdu. - ..il !-� . � ? �,rte' . h + 4 y. i. INSTALLATION CERTIFICATE CF-6R-MECH-25-HER: tefrigerant Charge Verification- Standard Measurement Procedure (Page 4 of 5; Site Address: Enforcement Agency: Permit Number: 57162 MERLON, La Quinta CA 92253 City of La Quinta 11-1021 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 AC-I-UPFLOW- r Calculate: Actual Subcooling = 6.6 r ` Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer s 9 Calculate difference: -2.4 " Actual Subcooling - Target Subcooling = System passes if difference is between -3°F and +3°F PASS' Enter Pass or Fai s°' ,f .f 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 AC-I-UPFLOW r Calculate: Actual Superheat =. -j24.3 Tsuction - Tevaporator, sat 4 Enter allowable superheat range from manufacturer's specifications (or use range 4-25.ur between 4°F and 25°F if manufacter's specification is not available) System passe§,if actual'superheat is-withinAhe allowable superheat range PA PASS r y EnteraPass or Fai s°' ,f .f f + { C r Y -4- J6 , A. Reg: 211-A0050344A-M2500001A-0000 Registration Date/Time: 2011/09/28 15:18:03 HERS Provider: Ca10ERTS, Inc., 2008 Residential Compliance Forms' k August 2009 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 � . .. .` r... C •�f� CSLB License: Date Signed: ' System meets all refrigerant charge and � • 1 r} � + } ,: Al •,� k � ., ,�i - J5.• • '1-. J '. ,� M•. '+ Y 5 't � a '' a s,. Standard Charge Measurement Summary: - r 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 AC-I-UPFLOW CSLB License: Date Signed: ' System meets all refrigerant charge and 9/20/2011 - Name of TPQCP (if applicable): airflow requirements. PASS Enter Pass or Fail ' .• �Y� ter. .f. ,,- r � •• •' .r.. ; DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. , • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction_ , or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. • I will ensure that a completed, signe& 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) PAUL'S HEATING & AIR Control Program (TPQCP)? E] Yes ❑ No Reg: 211-A0050344A-M2500001A-0000 Registration Date/Time: 2011/09/28 15:18_:03 : HERS Provider- Ca10ERTS, Inc. 2008 Residential Compliance Forms Y - " August 2009" Responsible Person's Name: Responsible Person's Signature: PAUL VITALE PAULL-VITALE CSLB License: Date Signed: Position With Company (Title): 917502 9/20/2011 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): ' Control Program (TPQCP)? E] Yes ❑ No Reg: 211-A0050344A-M2500001A-0000 Registration Date/Time: 2011/09/28 15:18_:03 : HERS Provider- Ca10ERTS, Inc. 2008 Residential Compliance Forms Y - " August 2009" t � #, ,. .•} .f ' Enforcement Agency:•Date: �+� ,y , C } r+ �, 1^ z + „� _ . k � a>± .,p • 4 42 d ;- h � � � i•� moi' a � � F �r • � •j y' � / r e �. �� , F V ..' A. µ t jj��jj`i.Y, .- �.. �. 6 f�.c N" � C � + .w 1 ' - ,.�jl ,� T `�' i� a 4 .awl .^� .� " 1 47 ,1.n..d• , �,.y ❑ Package Unit - ' - ® Furnace Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency:•Date: Permit #: 57162 MERION La Quinta, CA 92253 City of La Quinta Sep 28, 2011 Dud insulation-- Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit - ' - ® Furnace g AFUE 78% ❑ COP El R 6 �� IO -13) Served by system 0 Setback 0 Indoor Coil p SEER 13.0 ❑ HSPF ❑ R 8 CZ14-15 � � 3049 sf If not already present, must be , 0 Condensing Unit El EER E] 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 -6R shall.also be on site for final inspection. ® 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 -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=41k forms: MECH-21 and (for split systems) MECH-25 I „ For Split Systems: Duct leakage < 1S 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 system,will not be Ducted'(ie Ductless, Mini -SDI it-System)-(Also-Exempt-from�Refrigerant=Charge) ❑ 2. New HVAC System Required Forms: k .Cut in'or Changeout with; duds: am / ,, y, new (all new ducting &CA all new CF -6R forms MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and MECH 25 -HERS - CF -4R forms:'MECH 20, and'(for split systems) MECH722, and,MECH 25' f equipment). vier For Split Systems: Duct leakage <16 percent; RC, CCA z 350 CFM/ton; FWD„TMAH, STMS, and either HSPP orPSPP. ' 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 and/or indoor CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS coil and/or furnace. No or some equipment CF -4R forms: MECH-20 and (for split systems) MECH-25 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-21-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: PAUL VITALE Signature: PAUL VITALE Company: PAUL"S HEATING & AIR Date:. Sep 28, 2011 Address: 33482 VIEW POINT DRIVE i License: 917502 City/State/Zip: WILDOMAR / CA / 92595 Phone: (760) 644-2475 Reg: 211-AO05035OA-00000000-0000 Registration Date/Time: 2011/09/28 15:25:12 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms r- * �.,.. July 2010 f SA 1. Measured leakage less than 15% of fan flow - r` •>� s ❑ 2. Measured leakage to outside less than 10% of Fan Flow • .k " i % �"-`' ,•,.,e. �,F i c k , - i f .lz , 1,. i x r. - r„ a 2 C`- . - � � ` '� � 3 . ,,� „.OM1' � �',� � �. r..• f;s . f system�airfl RA3.3 a irflowatestfprocedures: CFM r;lF 4A Option'1_used then: t,,• 't-�` y r.+�tt�� k• M.� �•,+- . b. 1 Allowed leakage = Fan Flow 1600 x,0.15,= 240 CFM :ERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING j CF-411-MECH-21 )uct Leakage Test — Existing Duct System (Paged of: 2) Site Address: I Enforcement Agency: Permit Number: 57162 MERION, La Quinta CA .92253 (System 1)- City of La Quint a 11-1021 t: x'rti '_ nr.. � Enter the Duct System Name or Identification/Tag: AC-2-HORZ ` 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. cote: For existing dwellings, a completely new or replacement duct system can also include existing parts o tie original. duct system (e.g., register boots, air handler, coil, plenums, etc.) if those. parts are accessible nd they can be sealed. For a completely new or replacement duct system installed -in an existing dwelling, se the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existinq duct system Select one compliance method.from the following four choices. 1. Measured leakage less than 15% of fan flow - r` •>� s ❑ 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 no finaPF,an�Flow using one of thhe, following,three-calculation methods. ✓ © Cooling system method: Size of con%denser in Tons )4 ' x 400 = 1600 ✓ ❑ Heating system method: 2'1.7, x I Output Capacity in Thousands of Btuyhr = CFM - _ ✓ ❑ Measured w�using system�airfl RA3.3 a irflowatestfprocedures: CFM r;lF 4A Option'1_used then: t,,• 't-�` y r.+�tt�� k• M.� �•,+- . b. 1 Allowed leakage = Fan Flow 1600 x,0.15,= 240 CFM Actual Leakage = 117 CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then: 2 Allowed leakage = Fan Flow 1 x 0.10 = _ CFM ' Actual Leakage to outside = { CFM f 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 f ((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 r S. Reg: 211-A0050350A-M2100001A-M21A Registration Date/Time: 2011/09/28 15:32:17 t HERS'Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms •..- — March 2010 a - .. . 1. - • c ?' r.rr :z .i �' w - -�+µ M ey It, 1 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 dud leakage testing. 0 All supply,,andyreturn register boots must'befsealedAoAhe d_yywallzif}smoke�test:isautilizedifor-.compliance - applies.to,7duct leakage compliance*option,3 (leakage reduction by 60%),andtoptionfC.(fix all,accessible- leaks) describe_ d above / iR c 0 New dud installations cannot utilize building cavities as plenums or platform returns In,lleu of ducts (1A- i _�f , �' - 0 Mastic and draw`bands.must"be,used'in com6inatiorrwith'cloth backed*rubber.'adhesive duct tapeFto seaCc leaks at all new dud connections DECLARATION STATEMENT 4 • 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). ` <A • 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. J _, • 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 -SR) approved by the enforcement agency. 1 + Builder or Installer information as shown on the Installation Certificate (CF -611 ). _ J f11Q ✓ ) IF .A y� .� .'t .��. f_.• .': j. -fir_ • �'. '�' F} - T 4�` '•i, "'�i . t 4 ' `. .t" y �a j • J • �. A •1/ Sample Group #- (if applicable): N/A Q tested/verified dwelling ❑ not-tested/verified dwelling in la ' _ �� ./ r • �'' +..• `'' :� t ,i •S. `1 ray .,Yj }}} •♦.i (r p. f• Coast Aire Responsible Rater's Name: Responsible Rater's Signature: }, Don DeAngelis M ey It, 1 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 dud leakage testing. 0 All supply,,andyreturn register boots must'befsealedAoAhe d_yywallzif}smoke�test:isautilizedifor-.compliance - applies.to,7duct leakage compliance*option,3 (leakage reduction by 60%),andtoptionfC.(fix all,accessible- leaks) describe_ d above / iR c 0 New dud installations cannot utilize building cavities as plenums or platform returns In,lleu of ducts (1A- i _�f , �' - 0 Mastic and draw`bands.must"be,used'in com6inatiorrwith'cloth backed*rubber.'adhesive duct tapeFto seaCc leaks at all new dud connections DECLARATION STATEMENT 4 • 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). ` <A • 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. J _, • 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 -SR) approved by the enforcement agency. 1 + Builder or Installer information as shown on the Installation Certificate (CF -611 ). _ Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PAUL'S HEATING & AIR Responsible Person's Name: CSLB License: , 1917502 PAUL VITALE 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-1798595568 HERS Rater Company Name_ Coast Aire Responsible Rater's Name: Responsible Rater's Signature: }, Don DeAngelis Don DeAngelis Responsible Rater's Certification Number w/ this HERS Provider: , Date Signed: 9/27/2011 CC2004161 Reg: 211-A0050350A-M2100001A-M21A' Registration Date/Time:•2011/09/28a15:32:17 HERS Provider: CalCERTS, Inc 2008 Residential Compliance Forms: ; ` 1 ' March 2010 Vr CERTIFICATE OF FIELD VERIFICATION 8t DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure - (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 57162 MERION, La Quinta CA 92253 City of La Quint a 11-1021 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. r ' TMAH - Access Holes in Supply and Return Plenums of Air Handler _ S stem Name or Identification a • Y /T 9 AC-2-HORZ System Location or Area Served Whole House 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 R Yes ❑ No t 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 Fail ✓ 0 Pass ✓ ❑ Fail • -•��a, ,., �� - � �' - ' ' •may: 4 ri w- � � ` � 1 c� t , � � c_� a CERTIFICATE OF FIELD VERIFICATION 8t DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure - (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 57162 MERION, La Quinta CA 92253 City of La Quint a 11-1021 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. r ' TMAH - Access Holes in Supply and Return Plenums of Air Handler _ S stem Name or Identification a • Y /T 9 AC-2-HORZ System Location or Area Served Whole House 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 R Yes ❑ No t 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 Fail ✓ 0 Pass ✓ ❑ Fail Z - STMS - Sensor on_the, Evaporator Coil–, .- _ –wave— System ate System Narrie"or Idehtification/Tag`) f'- /`/* AC-2-HORZ I ' • -1 "` _t �41 I r'" t ,( ( I 'Y The sensor is factor' installed, orifield installed according to rimanufacturer's-- 3 ❑`Yesp-No, I specifications, or is installed by rriethods/specificattions approved by the Executive'- e Director. [ i p _ – -... -- - :i4• «,t°r .� r t.• The sensor wire is termina_ted.with astandard mini plug suitable for connection .to a The 'the 4p Yes, p No digital,thermometer. sensor mini plug is accessible toinsfalling•.tec`linician and the HERS rater without changing the airflow through the condenser coil 5 ❑ Yes _–^ - ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature the of coil. Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not ,V applicable. Otherwise enter Pass or Fail 0 N/A ✓ ❑Pass ✓ ElFail STMS - Sensor on the Condenser Coil System Name or Identification/Tag I AC-2-HORZ 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 HE 5krater without changing the airflow through the condenser coil 8 ❑ Yes ❑ No When alta ed to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not V p N/A ✓ ElPass ✓ ❑Fail applicable. Otherwise enter Pass or Fail i . Reg: 211-A0050350A-M2500001A-M25A Registration Date/Time: 2011/09/28,15:35:00 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms 4 March 2010 - S(y': ... ; K ..* �i'f� �. .•�'_ - iVi #-��t' Tr ..;� � Q} _ •,4 ' i� _t � !. ,;p F • �' ; 12 • ,t ti • fi �!. I'� '4kf " 7 h F': "p i . V .W /���p��r�%y'f Outdoor Unit Serial # y x 1 • •' Outdoor Unit Make AMANA ` ♦ -' Outdoor Unit Model ASCX16048 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 f' 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. • M 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 AC-2-HORZ (must be re -calibrated monthly) _. `—' System Location or Area Served Whole House { i9/1/li 41e N (must be re -calibrated monthly) /���p��r�%y'f Outdoor Unit Serial # 1108670739 • •' Outdoor Unit Make AMANA ` ♦ -' Outdoor Unit Model ASCX16048 " Nominal Cooling Capacity Btu/hr 48000 Date of Verification ; 9/27/11 Gaiioratlon OT Ulagnostic instruments Date of Refrigerant Gauge Calibration • 9/1/11 (must be re -calibrated monthly) _. `—' . _. Date of Thermocou le Calibration r { i9/1/li 41e N (must be re -calibrated monthly) /���p��r�%y'f Supply (eva orator leavindry-bulb- P 9)�air �. MCdbUVCa 1Cm0CrOLYfC5`I`: rd ■ t f ,r ;=z_e / — C, I 1 '%, t . i]t ` System Name or Iden001 AC-2-HORZ .p- - `—' 'ttification/Tag /���p��r�%y'f Supply (eva orator leavindry-bulb- P 9)�air �. temperature (T56=_ Jab). supplyI Return (evaporator entering) air dry-bulb 77 temperature (Treturn, db) ! Return (evaporator entering) air wet -bulb 65 temperature (Treturn wb) Evaporator saturation temperature 42.7 (Tevaporator, sat) Condensor saturation temperature 103.6 (Tcondensor, sat) Suction line temperature (Tsuction) 67.1 Liquid Line Temperature (T ) 93 7 liquid � `• . Condenser (entering) air dry-bulb , 92 temperature (Tcondenser, db) • - Reg: 211-A0050350A-M2500001A-M25A Registration Date/Time: 2011/09/28 15:35:00 HERS Provider: Ca1CHRTS, Inc. 2008 Residential Compliance Forms March 2010, 3• • ,- +, ¢ '�. `x= ' a ,. ! - a NSTALLATION CERTIFICATE CF-4R-MECH-21 ;efrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5 Ate Address: Enforcement Agency: Permit Number: 57162 MERION, La Quinta CA 92253 City of La Quinta 11-1021 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 AC-2-HORZ { Calculate: Actual Temperature Split = Tretum, 21.00 tk , Target Temperature Split from Table RA3.2-3 18.3 '��;� L�{,. �. ~�. �. P using Treturn, wb and Treturn, db F w a, iA � � . .f �f. ' i .x]��il �'•'' i i'y'.a.i �� - :Ilw - .,+ ' r{' Target Temperature Split = Passes if difference is between -4°F and +4°F NSTALLATION CERTIFICATE CF-4R-MECH-21 ;efrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5 Ate Address: Enforcement Agency: Permit Number: 57162 MERION, La Quinta CA 92253 City of La Quinta 11-1021 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 AC-2-HORZ { Calculate: Actual Temperature Split = Tretum, 21.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3 18.3 . using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - 2.7 r Target Temperature Split = Passes if difference is between -4°F and +4°F n or, upon remeasurement, if between -4°F and PASS ` -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 Calculated Minimum Airflow Requirement (CFM) Measured{Airflow. gRRA3.3.procedures (CFM)4� Passes if measured airflow is 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: 211-A0050350A-M2500001A-M25A Registration Date/Time: 2011/09/28.15:_35:00.1^HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms, March 2010 W, � _. _ J ;� �` iu ;6.. . v r .! c � s i'. .- *y C * .� t! v -� ''ff• j • � �" }. +'r - ., '• �`� '..�• '-; � aY r _ter^{ �✓` Lf`'�•� .� � i` i. �- � �•Ja , i INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: • Permit Number: 57162 MERION, La Quinta CA 92253 City of La Quinta 11-1021 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 AC-2-HORZ Calculate: Actual Subcooling = 9.9 Tcondenser, sat - Tliquid ' Target Subcooling specified by manufacturer 8 Calculate difference: 1.9 Actual Subcooling - Target Subcooling = mpasses if difference is betweenand +4°F F PASS, • , Enter Pass or Fail- Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. - System Name or Identification/Tag AC-2-HORZ Calculate: Actual Superheat = 24.4 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 4-25 between 3°F and 26°F if manufacturer's specification is rot available) System passes if actual superheat is-within1h& allowable su erheat r'a'nge � �• f" <<- W PASS Enter Pass or Fail ` " . Reg: 211-A0050350A-M2500001A-M25A Registration Date/Time: 2011/09/28 15:35:00 HERS,Provider: CalCERTS,,Inc. 2008 Residential Compliance Forms, - , March 2010 Al ­; V z� Al 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 AC-2-HORZ 917502 HERS Provider Data Registry Information Sample Group # (if applicable): N/A System meets all refrigerant charge and airflow Elnot-tested/verified dwelling in a HERS sample group requirements. PASS. ti Responsible Rater's Name: Responsible Rater's Signature: - Enter Pass or Fail bon DeAngelis Responsible Rater's Certification Number wl this HERS Provider: Date Signed: 9/27/2011. CC2004161 A. DECLARATION STATEMENTS • I certify under penalty of pedury, 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 ((;F -IR) 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. - I . . . Builder or Installer information as shown on the Installation Certificate (CF -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)- PAUL'S HEATING & AIR Responsible Person's Name: C_SLB License: PAUL VITALE 917502 HERS Provider Data Registry Information Sample Group # (if applicable): N/A tested/verified dwelling Elnot-tested/verified dwelling in a HERS sample group HERS Rater Information CaICERTS Certificate # CCI -1798595568 HERS Rater Company Name: Coast Aire Responsible Rater's Name: Responsible Rater's Signature: - Don DeAngelis bon DeAngelis Responsible Rater's Certification Number wl this HERS Provider: Date Signed: 9/27/2011. CC2004161 Reg: 211-A0050350A-M250000IA-M25A Registration Date/Time: 2011/09/28,15:35:00 -HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms." March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-0 i.,•. `,Y. , Space Conditioning Systems, Ducts and Fans (Page 1 of 2) t�•: i Site Address: Enforcement Agencyd Permit Number: 57162 MERION, La Quinta CA 92253 (System 1) City of La Quinta 11-1021 Space Conditioning Systems Heating Equipment Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number x. 3 - # of Identical Systems ,i f�: Tom• Duct. R -value ' Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Split Furnace AMANA MVC80905CX 1 80 AFUE - �'3 90 kBtu • , + ♦ `i 1.M , pit+♦- 1.�r�.,t L r. �J K • F t .' 1 fi' y F 3• 1 . 1�� � Cooling Cooling heat '^ CEC Certified Mfr. Name . Reference Identical '(>=CF -1R space, Duds A x „rl ,Sad' INSTALLATION CERTIFICATE CF-6R-MECH-0 i.,•. `,Y. , Space Conditioning Systems, Ducts and Fans (Page 1 of 2) t�•: i Site Address: Enforcement Agencyd Permit Number: 57162 MERION, La Quinta CA 92253 (System 1) City of La Quinta 11-1021 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.)1, 3 (>=CF -1R value)4 Duct - Location (attic, crawl- space, etc.) Duct. R -value ' Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Split Furnace AMANA MVC80905CX 1 80 AFUE Attic 90 kBtu (package ARI # of 1,3 crawl- Cooling Cooling heat '^ CEC Certified Mfr. Name . Reference Identical '(>=CF -1R space, Duds Load - Capacity pump) and Model Number, Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split A/C AMANA .--A'ASXE160481 ,fes. atlwq 11.16-S ER 48 kBtu `f `'' # i j■1 t I- t' V-UU#I u cou/pf"C"L 3f a - ' r.. 1. If project is new construction, see Footnotes to Standards Table 151-8 and Table 151-C for duct ceiling alternative compliance. i 2. ARI Reference Number can be found by entering the equipment model number at_ z ` http://www.aridirectory.org/ari/ac.php# 3. Listed efficiency on this page must 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 BEA VALID FORM - • 9 §110-§113:.,HVAC equipment is certified by the California Energy Commission. ' 0 §150(h):JH ting and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. 9 §1501(();?Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 9 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets J minimum requirements of.Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. Reg: 211-A0050350A-M0400001A-0000 Registration Date/Time: 2011/09/28 15:27:45 HERS Provider:.CalCERTS, Inc.- 2008 Residential Compliance Forms y August 2009 r t. x f' Efficiency Dud Equip Type �' t (SEER and EER) Location (attic, , (package ARI # of 1,3 crawl- Cooling Cooling heat '^ CEC Certified Mfr. Name . Reference Identical '(>=CF -1R space, Duds Load - Capacity pump) and Model Number, Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split A/C AMANA .--A'ASXE160481 ,fes. atlwq 11.16-S ER 48 kBtu `f `'' # i j■1 t I- t' n 6At- vr..�, 3f a - ' r.. 1. If project is new construction, see Footnotes to Standards Table 151-8 and Table 151-C for duct ceiling alternative compliance. i 2. ARI Reference Number can be found by entering the equipment model number at_ z ` http://www.aridirectory.org/ari/ac.php# 3. Listed efficiency on this page must 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 BEA VALID FORM - • 9 §110-§113:.,HVAC equipment is certified by the California Energy Commission. ' 0 §150(h):JH ting and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. 9 §1501(();?Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 9 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets J minimum requirements of.Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. Reg: 211-A0050350A-M0400001A-0000 Registration Date/Time: 2011/09/28 15:27:45 HERS Provider:.CalCERTS, Inc.- 2008 Residential Compliance Forms y August 2009 r t. x INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 57162 MERION, La Quinta CA 92253 (System 1) City of La Quinta 11-1021 Ducts and Fans §150(m): Duct and Fans r D 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 i 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 1818 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 t ducts. « 0 21). 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. © 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. 0 Protection of Insulation.; Insulation 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 that'is water retardant and provides shielding from solar radiation that can cause' - degradation -of the material: " 0 10. Flexibleducts cannot have porous inner cores. " f '• "+ DECLARATION STATEMENT i • 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). ' y • 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 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 -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. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PAUL'S HEATING & AIR Responsible Person's Name: Responsible Person's Signature: PAUL VITALE PAUL VITALE CSLB License: Date Signed: "' position With Company (Title): ' - 917502 9/20/2011 Reg: 211-A0050350A-M0400001A-0000 Registration Date/Time: 2011/09/28 15:27:45. HERS Provider_: CalCBRTS, Inc. 2008 Residential Compliance Forms z August 2009 . - • � �• � `� , ., �. . �. x � � ., j : c • �r..� of INSTALLATION CERTIFICATE* CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 57162 MERION, La Quinta CA 92253 City of La Quinta 11-1021 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 ST14S are not required for compliance, when a CID is utilized for compliance. F ; 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. STNS are only required for completely new or replacement space -conditioning systems that utilize prescrlo Live compliance .method. TMAH - Access Holes in Supplv and Return Plenums of Air Handler System Name or Identification/Tag AC -2 HORZ System Location or Area Served Whole House ! ®Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 ® Yes ❑ No ! 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and 2 is a pass. - Enter Pass or Faill ✓ R Pass ✓ ❑ Fail STMS'- Sensor_on-the Evaporator. Coil System Name -dr Identification/Tagl AG2 HORZ-- !' - .. t Y V 3 ❑rYes #El No The sensor is factory" installed, orfiield installed according to manufacturer's specifications, or Oinstalled by methods/specifications approved by the Executive - ❑ Yes ❑ No fl • l� JJJ I Director. , —'y► -..« �+a .++ 4 j r� The sensor wire is terminated, with a standard'mini plug suitable for connection ;to At, digital ❑Yes.. - p No thermometer. The's`ensor,mini plug is accessible to,i e-installing,technicianfy(l.I ❑ Yes ❑ No • -1 and the HERS rater without changing the airflow through the condenser coil = 5 ❑ Yes 1 ❑ No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3, 4, -and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail ✓ 2 N/A ✓- ❑ Pass ✓ ❑ Fail f STMS - Sensor on the Condenser Coil System Name or Identification/Tag I AC -2 HORZ 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 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 ✓ 0 N/A ✓ ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail Rea: 21.1.-AU05U3bUA-M25000UlA-0000 Reoi.str-ation Darei'a'ime: 2011iu9i2e 11E Provider: CaiC! BRTS. 1^c. 2.006 nesidei2Li31 .....^.:x.!12_^.'^e a - _- - -; —US.- .... ..- ' R .•.A s� ti INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) - Site Address: Enforcement Agency: Permit Number: 57162 MERION, La Quinta CA 92253 City of La Quinta - 11-1021 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for deterinfining 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 Afternat asuremenr Procedure. f - y e Charge Me_ � • Space Conditioning Systems System Name or Identification/Tag CSC -2 HORZ 9/1/11 + (must be re -calibrated monthly) System Location or Area Served Whole House 9/1;/iT ~ (must be re -calibrated month) Outdoor Unit Serial # 7, 1108670739 "� �' - S Outdoor Unit Make AMANA - Outdoor Unit Model ASXE160481 Nominal Cooling Capacity Btu/hr 48000 Date of Verification 9/20/11 t.duurdtion up wiaanosoc instruments Date of Refrigerant Gauge Calibration AC -2 HORZ 9/1/11 (must be re -calibrated monthly) Date of T� rmocouple Calibration '>! - 9/1;/iT ~ (must be re -calibrated month) riedsureo i emueratures-tr r i # f f , .7•:...ter t i t t. ra. System Name or Identifcat on/T g, v AC -2 HORZ - Supply (evaporator` leaving) -air dry-bulb-"-- •' 56- --- "� �' - S temperature (TsupplY, db) - Return (evaporator entering) air dry-bulb 77 temperature (Treturn db) Return (evaporator entering) air wet -bulb 65 temperature (Treturn, wb) - %1 Evaporator saturation temperature 42.7 (Tevaporator, sat) " Condensor saturation temperature 103.6 (Tcondensor, sat) Suction line temperature (Tsuction) 67.1 Liquid Line Temperature (Tliquid) 93.7 Condenser (entering) air dry-bulb 92 temperature (Tcondenser db) Reg: 2ii-AOOSu's5ua-ri25uu00iA-uuuu, Registration Date"i.me: 2u5.li09/2n 3.5:31;03 ERS vrovi-der:' CaiCERTS, inc. 2008 Residential Compliance Forms, August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2S-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of S) Site Address: Enforcement Agency: Permit Number: 57162 MERION, La Quinta CA 92253 City of La Quinta 11-1021 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 AC -2 HORZ Calculate: Actual Superheat = Calculate: Actual Temperature Split = Treturn, db 21.00 Tsuction - Tevaporator, sat - Tsupply, db Target Superheat from Table RA3.2-2 using Target Temperature Split from Table RA3.2-3 18.3 using Treturn, wb and Treturn, db Actual Superheat - Target Superheat = Calculate difference: Actual Temperature Split - 2.7 System passes if difference is between -5°F and Target Temperature Split = +5°F Passes if difference is between -3°F and +3°F or, Enter Pass or Fail, upon remeasurement, if between -3°F and -100°F 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 Name,or�Identification/Tag,rrF " �y AC-2-HORZ m / I v 3 > 7 Calculated Minimum Airflow,lkequireM ! t (CFM) r Measured Airflow usingRA3.3'procedures (CFM) 4 - Passes if measured airflow'is 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 AC -2 HORZ 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, 0. Reg: 211-AUU5U350A-M2500001A-0000 Registration Date/'rime: 2011/09/28 15:31:03 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 •�, il. .,. � f .j y .1 �. y` �,.� 't N. ��i .y� !- � _ � •R !ij • '. �. F *.. , } c ' ,t Sx 4*11rwR- •, f 1 1 u '. �• } `L s,`r� i,• ,,�� „�I•£ '? ar' `. • �`• Y ,� L�:*;ypr X4�'�_I y: �� �.^ycy n ..J� '�? Mi+ �",''.�- y ... f + `f _'.� ytt�'"� • INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure - (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 57162 MERION, La Quinta CA 92253 City of La Quinta 11-1021 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This is g g g p required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag AC -2 HORZ L , Calculate: Actual Subcooling = ' 9.9 - ^ Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer "+ 8 Calculate difference: i•9 , Actual Subcooling - Target Subcooling = NA System passes if difference is between L -3°F and +3°F PASS r - Enter Pass or Fail ,f t s• i" ^ ""•. _��-,— _ Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for r thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. a System Name or Identification/Tag AC -2 HORZ L Calculate: Actual Superheat =. ..1 24.4 Tsuction - Tevaporator, sat i Enter allowable superheat range from manufacturer's specifications (or use range . 4-25 between 4°F and 25°F if manufacturer's NA specification is not available) i System passes ifactuaf superheat is -within -the` allowable superheat range/ `PASS r - r .Enter Pass or Fail'' ,f t s• i" ^ ""•. _��-,— _ r410 NA Reg: 211-A0050350A-M2500001A-0000 Registration Date/Time: 2011/09/28.15:31:03 HERS Provider: Ca10ERTS,_Inc. 2008 Residential Compliance Forms i August -2009 ?:' Y:i •.. �.••. � J'• � ' ,.,ice X4.1 'j ayy � +. u:. 1"f� s L.' Yrt ..>v � .- i System Name or Identification/Tag AC -2 HORZ- ., µ. i> •�Jt.. -Q'S �T S i± *,•`fr J�• System meets all refrigerant charge and airflow ~ ,' • •, r, , � r1• -.G. � , T '� ~' ,• �", , 4 a, � r -� e ' i �iti . '"„ ' K ! A... .:}'.' .!, _ - r.. Enter Pass or Fail' J'= r a '' r� � •�.� # Jr w � � � - • yJ�,. INSTALLATION CERTIFICATECF-6R-MECH-25-HERS ^t'• o, , -P Y Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: y 57162 MERION, La Quinta CA 92253 City of La Quinta 11-1021 • 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,'rnaterials, 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 -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 yr 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 renistry fnr mnItiniP nriantatinn nit—t-h a —I Y.nni.,.,i— fN r. k— I -In— e-- -n I_..• -:__ ___:�__.: _. �..:•�:___ ` . r Reg: 211-A0050350A-M2500001A-0000 Registration Date/Time: 2011/09/28 15:31:03'., HERS.Provider: Ca10ERTS, Inc. ' 2008 Residential Compliance Forms', .'r August.2009 Yom, i. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PAUL'S HEATING & AIR Responsible Person's Name: Responsible Person's Signature: . PAUL VITALE PAUL VITALE CSLB License: Date Signed: 917502 9/20/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Contro 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. t. System Name or Identification/Tag AC -2 HORZ- L System meets all refrigerant charge and airflow l Program (TPQCP)? p Yes ❑ No • •, requirements. PASS , Enter Pass or Fail' Q l Program (TPQCP)? p Yes ❑ No • •, Q Building; � '- • ' Address 51.152 Herion Owner ` sfmise cs$if7i pay Mailing Address 42.8600 Cook City zip, 'Pam DPseyit- Contractor UaHtam 1 "d A M Address T4 ' P.O. BOX 1504 No. 07659, ,• 78-105 CALLE ESTADO, LA QUINTA, CALIFORNIA 92253 .. n BUILDING: TYPE CONST. OCC:.GRP. lite 200 1 A.P. Number - ' Tel.- �� 2828 Legal Description ' TraC'`.2 99- •` w Project Description PhaSe . ilei Plan IM City Zip Tel.: J ,r «• State Lic. - City t & Classif. Lic. # Sq. Ft. M9 No . , �No. Dw. t, Size - Stories Units Arch., Engr., Designer"'.• �r . , r New ❑ Add ❑ Alter ElRepair ❑ , Demolition ❑ Address 's�.fti ' { Tel. 7 City Zip' State i Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section `•' �, ' Y 7000) orDivision,,3 of the Business and.Professions Code, and my license is in full,force and SIGNATUREt.'•:"•.'`r°'<•i•.'y"..- •.d -- -�C^-• • :f" - + ATE tygp OWNER -BUILDER DECLARATION I h reby affirm1that I am"exempt from the Contractor's License Law for the following Estimated Valuation �Y�2 f?sJ ` {� r reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, 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 o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 the Business end Professions -Code, that. he is •• o/ or exempt therefrom, and the basis for the alleged exemption. -Any violation' of Section 703 1. 5 by -any applicant for Plan. Chk. Dep. - . a permit, subjects the applicant to a civil penalty of not more than five hundred dollars f$SOOJ. ; Plan Ch k. Bal: r - $ 58 ❑ 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, Buisness and Professions Const. \ 2..i�o Code: The Contractor's. License Law does not apply to an owner, of property who,, builds or improvesthereon anis who does such work himself or through his. own employees,-. Mech. �`' �• `� •° 00 provided that' such 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 Electrical - - 132.71 of proving thathe did not build or improve for the purpose of sale*.) , t ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-, Plumbing 168.50 ' structsthe project. (Seca.. 7044,'Business and Professions Code:, The Contractor's-Licerise Law - _ - 68. • •does not apply toan owner of 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 •' ❑ I am exempt under Sec. ' ' B. 8 P.C. for this reason ` Driveway Enc: Date-4,835.,77Owner Infrastructure { /► X17.89 rr 2.417.89 . WORKERS' COMPENSATION DECLARATION - '' L1/9 $9 2,417,89- I hereby affirm that4 have;a certificate of•consent to self -insure, or a certificate of Worker's Compensation Insurance; or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. " "Company ❑ Copy is filed with•the city , . .Certified copy is hereby furnished. ❑ <. + ... TOTAL "; 407.73 1 4-4 CERTIFICATE OF EXEMPTION FROMi REMARKS ! WORKERS' COMPENSATION INSURANCE' .i (This secilon, need not be: co-_ eted,if-the permit is for one hundred dollars ($100)' valuation • •- + ,�"'�'' _ �F�f. 1`dl."i! fT.�.3"(h or less.) �. •• - - - _ - I certifythat in the performance of thg work for which this permit is issued, I shall not ^emCompensation- - - ' ploy any person in any manner so as to become subject to the Workers' Compensation 7-1! j.: Laws of California. „ •71. • Datewrie NOTICE TO APPLICANT.t if after making this Certificate of Exemption you should become ZONE: BY: • 's subject to the Workers' Compensation provisions of the Labor,, Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Setback Distances: •` Minimum S - _• Front Setback from Center Line' Rear Setback from Rear Prop. Line { CONSTRUCTION LENDING AGENCY Side Street Setback frorn Center Line I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued_: (Sec. 3097, Civil Code.) _ Side SetbaCk•frOm Property. Line Lender's Name - + ; Lenders' Address FINAL DATE -INSPECTOR This is a building permit when propeily filled out, signed and validated, and is subject to- expiration expiration if work thereunder is suspended for 180 days: - J��� r I certify that I have read this application'and state that. the above information is correct. Issued by: Date' Permit I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 'representatives -of this city to enter the above-: mentioned property for inspection purposes. Validated by: Signature of applicant Date Mailing Address -Validation: City, State, Zip' `. ;'.. .• '.t {^•�...` .t^� • �'. G t1Y + 1C "' 1,.4, aL + 1 S. . M.C. f 'N'• ,i Y `•tT k .: -'i ^* ; zF J.t-' ,, - �' - •x +. t.• h- r. -.. y., f�-. ti` AF� r,•: 'V r [ `,,•S+P �.. V„� r ;>••.,`+ .. f 1, nr .- �, CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SQ. FT. ® CAR P. SO. FT. WALL SO. FT. ® SQ FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation ;ROUGHPLUMB. FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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. SQ. FT. ® c BATH TUB BOND BEAM SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11% c SEWAGE DISPOSAL LUMBER GR. SO.FT.GAR ® 3/ac HOUSE SEWER RAMING ff FINAL INSP. GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING R AIR COND. SOLAR SETBACK OUND PI -4A ( drA UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ;ROUGHPLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS WER OR SEPTI .*A ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL So2"5--v GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. plus x$ =$ LUMBER GR. INAL INSP. RAMING ff FINAL INSP. ,eWOOFING -7—,? 0 -qQ . ^ � ' � �—� ^ � REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR FIREWALL /GAR. U.ATHING7� �v MESH SULATION/SOUND-;20 -� FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL