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MECH (12-0188)r 4�I�IGII�1 . P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 3/01/12 Application Number: C=I2-00000188 Owner: Property Address: 52375 AVENIDA NAVARRO BETTY MANTHEY APN: 773-274-017-6 -000000- 52375 AVENIDA NAVARROQ Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL Application valuation: 10650 n Contractor: Applicant: Architect or Engineer. DIAL ONE'S ONE HOUR A/C & HTG, 2712 E. LA CADENA DRIVE RIVERSIDE, CA 92507" R " 0/? l{ (®i (951)276-9744 _ Lic. No.: 878533 G -i"' ZA LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: vC20 L'cense No.: 878533 Date:Ztractor. � /� i OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that\I'm exempt from the Contractor's State License Law for the . following reason (Sec. 703 1.5. Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 10, the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to'construct the project (Sec. 7044, Business and Professions Code:, The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_ ) I am exempt under Sec. , B.&P.C. for this reason - Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT 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. 16, have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor . Code, for the performance of the work for which this permit is issued. My workers' compensation . insurance carrier and policy number are: Carrier INS CO OF WEST Policy Number WSD500334901 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 qede, I shall forthwith c ply with those provisions. - plicant•. WARNING: FAILURE TO SECURE WORKES' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE LTIE'S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,000).. IN ADDITION TO THE T 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 building construction, and hereby authorize representatives of this c un y to enter upon t e above-mentioned pr arty for inspection pu poses. Xate:�J N� 'nature (Applicant or Agent) Application Number . .". . . 12-00000188 Permit MECHANICAL Additional desc . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue Date Valuation 0 Expiration Date 8/28/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00" 4.5000 EA MECH VENT INST/ DUCT ALT 4'.50 1.00 16'.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 -- ------------ Special. Notes and Comments -------------------------- ------------- HVAC CHANGE -OUT: REPLACE 60,000 BTU FURNACE IN GARAGE, (4)TON A/C,'COIL & DUCTWORK. 2010 CODES.. Other Fees BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 45.00: .00 .00 45.00 Plan Check Total 11.25 .00 .00 .11.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total 57..25 .00 .00 57.25 LQPERMIT t, Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF iR ALT HVAC Climate Zones i0 - 15 52375 AVENIDA NAVARO La Quinta, CA 92253 Equipment Typel , List Minimum Effici City of La Quinta Feb 22, 2012 insulation Conditioned Floor uirement Area Thermostat U. m Furnace ® AFUE 0°/ 113 COP ®Setback ® Indoor Coil 2 SEER 14.0 ❑ HSPF ❑ R 6 (CZ 10-13) Served by systemThe If not backalrear 0 Condensing Unit ❑ EER ❑ Resistance R 8 (CZ 14-15) 600 sf installed Y p esenf, must ® Other > 40' Durts) - - - - -., -• .••_ vyu,y,acnc acing msrauea,• a more than one system, use another Cf -IR -ALT -HVAC for each system. 1. WW;um Equipment Efficlencies: 13 SEER, 78*10 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 -411 forms (no hand filled CF-4Rs allowed) are filled out and signed -Beginning October 1, 2010, a registered copy of the CF -1111 and CF -6R shall also be on site for final inspection. ❑ 1. HVAC Changeout Required Forms! • Aie nvAt. t:quipment CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF -411 forms: MECH-21 Wand (for split systems) MECH-25 • Condenser Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and fors lits stems MECH-25-HERS .Indoor Coil and /or ( p' systems) • Furnace CF -4R forms: MECH-21 and (for split systems) MECH-25 ror spot systems: Duct leakage < iS percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, Insulated or sealed with asbestos ❑ 4. The system will not be Ducted (ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge) ® 2. New HVAC System Required Forms: . Cut in c Changeout with CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and new ducts: (all new MECH-25-HERS ducting illi) all new CF -4R forms: MECH 20, and fors lits stems MECH-22, and MECH-25 equipment) ( split systems) For Split Systems: Duct leakage < 6 percent; RC, CCA >_ PSI 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or Fer-ib,�It,aanrL tom•:•, . •,.._. , ,,._ a ___---- ❑ 3. New Ducts with/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF -411 forms: MECH-20 and (for split systems) MECH-25 equipment chanoed. For Split Systems: Duct leakage _<6 percent; RC, CCA 2 300 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 -611 forms: MECH-04, MECH-2I-HE linear feet of duct in unconditioned space. CF -411 forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed insulated or sealed with asbestos. • I certify that this Certificate of Compliance documentation is accurate and complete.wYv'•'�oaarnenc] • 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. lame: Jim McEligot Signature: Jim McEligot :ompany: VENVEST BALLARD INC Date: Feb 22, 2012 address: 2712 EAST LA CADENA DRIVE :ity/State/Zip: RIVERSIDE / CA / 92507 License: 878533 Reg: 212-A0009427A-00000000-0000 Registration nate/Time: 2012/02/22 11:09:57 HERS Provider.: CdICF,RTS, Inc. 2008 Residential Compliance Forms July 2010 Bin .# 0tv ' of :1A Qu1no Building Bt Safety Division P.O. Box 1504,78-495 Calle Tamolco... .:..:...: . LR.Quinta, CA 92253 - (760) 77T7012- 77-7012.Building Permit'Application and Tracking -Sheet Building Perini # Project Address: a 3 ma brier's Name: . A. P. Number. Address: 455 -6 -VS r i Legal Description: Contractor. •` � � ,' � City, ST, Zip: ta a5' q2.,, ,� :"..:,�3f�'Y.<�• ,' Telephoner -IL01) 47AyZ)_tAq Address: Zn\a Project Description: City, $T, Zip: •� %. C L --� e y� 'Con.. Telephone:IN �lU6: State Lie. 4: %-1 q-533Zj City.Lie Arch., Engr., Designer. _ Address: City., ST, Zip: •,:.tom;,.. Telephone: State Lic. #: 'rl '»f��..'. '�. H Construction Type:. Occupancy: Project type (circle one): New Add'n Repair Demo Sq. Ft.: # Stories: # Units: Name of Contact Person: Telephone # of Contact Person: 1.kLA Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE 9 Submittal Req'd Recd TRACICTIVG PERMIT FEES Plan Sets Plan Check submitted. Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance. Title 24 Calcd. Plans picked up Construction -Flood plain plan Plans resubmitted.. Mechanical Grading plan tad Review, ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review; ready for correctionstissue Developer Impact Fee Planning Approval. Called Contact Person A.I.P.P. Pub. Wks. Appr - Date of permit issue School Fees Total Permit Fees CERTIFICATE OF FIELD VERIFICATION &DIAGNOSTIC TESTING CF-411-MECH-21 Duct Leakage Test — Existing Duct System (Page f of 2) Site Address: 52375 AVENIDA NAVARO, La Quinta CA 92253 (System . Enforcement Agency: Permit Number: , 1) City of La Quinta •12-188 ' Enter the Duct System Name or Identification/Tag: System 1 ' Enter the Duct System• Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. ' t This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. ' t P ' iDuct Leakage Diagnostic Test - existing duct system ; Select one compliance method from the following four choices. � •, ®1. Measured leakage less than 15% of fan flow [:12. Measured leakage to outside less than 10% of Fan Flow 1. �. �. * leakage �onduct `• f 4 �' [:13. . Reduce by 60% and smoke and fix all leaks Z,. ❑ 4 Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options, 1, 2, or 3 must be attempted.before;utilizing Option,4.), .-. ;, ,,,, �. �" • _ Determine nominal Fan Flow using o`ne ofcthe following three calculation methods." F ✓0 Cooling -"system method: Size of condenser in Tons 1 4 ' z 400 _ 1600 f'CFM{ ., ; E ✓ ❑ Heating system meff)/thod: 21 16 J.7rjx I Output Capacity in.Thousands'of Btu/hr = _CFMAfI ✓❑ Measureds stem airflow,usm RA3.3°airflow test rocedures: uCFM Option'1 used then: 1 Allowed leakage = Fan Flow 1600 x-0.15 = 240 CFMI Actual.Leakage`=, 60 - CFM ' Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then:'` ! G - A ' 2 Allowed leakage = Fan.Flow x 0.10 = _ CFM , Actual Leakage to outside ,= I CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM J. 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.0/o Reduction > "60% ❑ Pass ❑ Fail Option 4 used then: 4 All accessible leaks repaired using smoke. HERS rater must verify (No sampling)..No smoke allowed to leak from system. Including ducts, plenums, air handler and door panel. ` Pass if all accessible leaks have been repaired using smoke - _ ❑Pass ❑Fail ' `� Reg: 212-A0009427B-M2100001A-M21A Registration Date/Time: 2012/03/07 14:52:21 HERS Provider: CalCERTS, Inc'.. 2008 Residential Compliance Forms + March 2010 I CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4111-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address:' 52375 AVENIDA NAVARO, La Quinta CA 92253 (System 'Enforcement Agency: Permit Number: 1) City of La Quinta 12-188 f '+i S • r J. ® 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/bo and return register ots must be'seal'11ed to't-2 drywall' if, smoke testis utilized for, compliance ; - appliesvto duct leakage compliance option 3 (leakage reductidn,by 60%) and opt Lon 41(fix all accessible leaks) described above: ,- New du ct'installatlons,cann11U, tilize building Jvi��i�s aslplenums or platform returns in lieu of ducts.r r ® Mastic and draw bands'must be used in combination with cloth backed rubber'adhesive duct tape to seal leaks at all.new duct connections. !I J 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. `..a • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). t • 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 Certificates) of Compliance (CF -1R) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) + responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. A,' Builder or Installer information as shown on the Installation Certificate (CF -6111) . -Reg: 212-A0009427B-M2100001A-M21A •Registration Date/Time: 2012/03/07 14:52:21" HERS -Provider: CalCERTS, Inc. 2008 Residential Compliance Forms f 4 i�r )' r March 2010 y 0 Company Name. (Installing Subcontractor or General Contractor or Builder/Owner) - VENVEST BALLARD INC Responsible Person's Name: CSLB License:. , Jim McEligot 1878533 HERS Provider Data Registry Information Sample Group # (if applicable): N/A 0 tested/verified dwelling not-tested/verified dwelling in . a HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798632112 HERS Rater Company Name: r Athens Air + r Responsible Rater's Name: Responsible Rater's Signature:. ' Andrew Pulos Andrew Pulos Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/25/2012 CC2004503• -Reg: 212-A0009427B-M2100001A-M21A •Registration Date/Time: 2012/03/07 14:52:21" HERS -Provider: CalCERTS, Inc. 2008 Residential Compliance Forms f 4 i�r )' r March 2010 y 0 T CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 52375 AVENIDA NAVARO, La Quinta CA 92253 City of La Quinta 12-188 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 fdrm(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement' Sensors (STMS) - Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handier System Name or Identification/Tag System 1 T. 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 1 and 2 is a pass. Enter Pass or Faill v E5 Pass ✓ ❑ Fail STMS - Sensor pn the., Evaporator Coil.. System Na6e7or Identification/Tag . System 1 r f V 3 ❑ Yes ❑ No '• rf The sensor is factory' installed, or,field installed according to manufacturers _ specifications, or islinstalled by methods/specifications approved by the Executive"`-` :+ j Director. 4 '1. ❑.Yes ❑ No .. senso ywire is terminated with a standard mini plug suitable for connection to a- digital the`rmyometer. The sensor.mini•plug is accessibleto'the`installing technician) and the HERS rater without changing the airflow through the condenser coil - 5❑Yes rw ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. - Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not %/ ®N/A ✓ ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag System 1' The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated,with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil _ 8 ❑ Yes ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not❑ ✓ D N/A T✓ ❑Pass ✓ Fail applicable. Otherwise enter Pass or Fail , 'i • _ - ; Reg: 212-A0009427B-M2500001A-M25A Registration Date/Time: 2012/03/07 14:55:34 HERS Provider:•Ca10ERTS, Inc. 2008 Residential•Compliance Forms y March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 . Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 52375 AVENIDA NAVARO, La Quinta CA 92253 City of La Quinta 1.12-188 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) • _ , Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. ! _ . • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. . The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • , If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems r System Name or Identification/Tag System i (must be re -calibrated monthly) System Location or Area Served Whole House r . ,• (must be re -calibrated monthly) Outdoor Unit Serial # " 1201207494 - -+- :r'z.. temperature (Tsupply, db) Outdoor Unit Make Amana . •' Outdoor Unit Model ASX140481 , Nominal Cooling Capacity Btu/hr 48000, + temperature (Treturn, wb) - Date of Verification 2/25/2012 (Tevaporator, sat) * r Calibration of Diagnostic Instruments , f Date of Refrigerant Gauge Calibration 2/1/2012 ,, (must be re -calibrated monthly) l• . ' r . ,• (must be re -calibrated monthly) Supply'(evaporator leaving) air dry-bulb 58 :" - -+- :r'z.. temperature (Tsupply, db) Calibration of Diagnostic Instruments , f Date of Refrigerant Gauge Calibration 2/1/2012 ,, (must be re -calibrated monthly) i tI :. 1. Date of Thermocouple Calibration i� f� 2/1/'2012 ,• (must be re -calibrated monthly) Supply'(evaporator leaving) air dry-bulb 58 :" Measured Temperatures`('F)n,�'�r, ; :. I" System Nme or Ident Air, cat on/Tagg • System 1 i tI :. 1. Supply'(evaporator leaving) air dry-bulb 58 :" - -+- :r'z.. temperature (Tsupply, db) Return (evaporator entering) air dry-bulb , 78 •' temperafure (Treturn, db) t ' `+ , Return (evaporator entering) air wet -bulb '56 temperature (Treturn, wb) - Evaporator saturation temperature 35 (Tevaporator, sat) * r Condensor saturation temperature (Tcondensor, sat) •r, 99 ., • ;, Suction line temperature (Tsuction) 47 _ Liquid Line Temperature (Tliquid) 86 ' Condenser (entering) air dry-bulb 84. �. temperature (T condenser, db)- .Reg: 212-A0009427B-M2500001A-M25A Registration Date/Time: 2012/03/07 14:55:341• HERS'Provider: CalCERTS, Inc. 2008 Residential Compliance Forms P March 2010 . INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: ! 52375 AVENIDA NAVARO, La Quinta CA 92253 City of La Quinta 12'188 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 System 1 ' 7 r . Calculate: Actual Temperature Split=Treturn,20.00.`• " Calculate: Actual Superheat = db - Tsu I db � � Tsuction - Tevaporator, sat Target Temperature Split from Table RA3.2-3 23.9 _- using Treturn, wb and Treturn, db , Treturn, wb and Tcondenser, db + Calculate difference: Actual Temperature' Split - -3'9 r Calculate difference: Target Temperature Split = - �. . Passes if difference is between -4°F and +4°F or, `v „ Y ! upon remeasurement, if between -4°F and PASS -100oF Enter Pass or Fail J -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'. `X Calculated Minimum Airflow Requirement (CFM) '= Nominal Cooling Capacity (ton)300 (cfm/ton) + 4 4 • , System eo'Identification/Tag F: x• �i y -'. Calculated: Minimum Airflow Requirement (CFM) r-- MeasuredAAirflow�usirig Rd3 3 procedures (CFM) w44MY � Passes if measured airflow is greater than -or equal to the calculated minimum airflow „t, -, 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 r S Target Superheat from Table RA3.2-2 using , Treturn, wb and Tcondenser, db + r Calculate difference: Actual Superheat - Target Superheat = `v „ Y System passes if difference is between -6°F and +6°F Enter Pass or Fail _ Reg: 212-A0009427B-M2500001A-M25A Registration Date/Time: 2012/03/07 14:55:34• ;HERS Provider: Ca10ERTS,1Inc. 2008 Residential Compliance Forms r + t, March 2010 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 i System 1 Calculate: Actual Subcooling = 13.0 Tcondenser, sat - Tliquid ' - Target Subcooling specified by manufacturer 12 ti Calculate difference: 1 c ++ Actual Subcooling - Target Subcooling _ 1 ' System passes if difference is between ., -4°F and +40FPASS M; ' y Enter Pass or Fail -PASS r Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for ' thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat.= 12.0 Tsuction - Tevaporator, sats ` . Enter allowable superheat range from manufacturer's specifications (or use range 12 between 3°F and 26°F if manufacturer's 1 specification is: not available)_ System Ipasses^if actualsuperheat is'within^the^ superheat M; allowable range•' �'" -PASS f • ^Enter Pass or Fai r ' Reg: 212-A0009427B-M2500001A-M25A Registration'Date/Time: 2012/03/07 14:55:34 HERS Provider: Ca10ERTS „ Inca 2008 Residential Compliance Forms - March 2010 Y I6 INSTALLATION CERTIFICATE CF-4R-MECH-2! Refrigerant Charge Verification = Standard Measurement Procedure (Page 5 of 5' Site Address: Enforcement Agency: Permit Number: 52375 AVENIDA NAVARO, La Quinta CA 92253 City of La Quinta 12-188 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, meteringdevice criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. ' System Name or. Identification/Tag 'System 1 1878533 . HERS Provider Data Registry Information R System meets all refrigerant charge and airflow ❑ not-tested/verified dwelling in a HERS sample group - requirements. PASS Athens Air Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail Andrew Pulos Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/25/2012 ` � r , «;fir . ,y - � ' 7• s Y C +F. 777777. .; Cd sA "!!�• " �.. s � . i. t DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater): • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the ' installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s)'(CF-611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the 4, enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R)' Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) • , VENVEST BALLARD INC - Responsible Person's Name:CSLB License: - Jim McEligot 1878533 . HERS Provider Data Registry Information Sample Group # (if applicable): N/AQ tested/verified dwelling ❑ not-tested/verified dwelling in a HERS sample group - HERS Rater Information CaICERTS Certificate # CC1-1798632112 HERS Rater Company Name: Athens Air Responsible Rater's Name: Responsible Rater's Signature: Andrew Pulos . Andrew Pulos Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/25/2012 CC2004503 .V A a " •' �� ,'; Reg: 212-A0009427B-M2500001A-M25A Registration Date/Time: 20.12/03/07 14:55:34 'HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms ; ; March 2010 • INSTALLATION CERTIFICATE CF-6111-MECH-04 Space Conditioning Systems, Ducts and Fans (Pagel of 2) Site Address: ' - - 52375 AVENIDA NAVARO, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-188 Space Conditioning Systems Heating Equipment i a F t 1. If project is new construction, see Footnotes to Standards Table. 151-B and Table 151-C for duct ceiling alternative _ ,: - compliance. 2. ARI Reference Number can be`found by entering the equipment model number at , s http://www.aridirectory.orglarilac.php# 3. Listed efficiency on this page 'must be greater than or equal ( ? ) to the value shown on'the CF -IR form. i x 4.'Whe6 CF -1R is reference it is also applicable to the CF -IR, CF=1R-AA or. CF -1R -ALT ALL BOXES MUST BE CHECKED TO BE A' VALID FORM 0 §110-§113: HVAC equipment is certified by the California Energy Commission. ' 0 §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. 0 §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' minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. • * { A -k .. • +; _-y .fir, ,,, * l •. ;� f � `. .`' � • �� ' _ ' � ` ' - � _ .. �' ash ' ,• ', f Reg:'212-A0009427B-M0400001A-0000 Registration Date/Time: .2012/03/07 14'48:_10 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms ` t, August 2009 Duct , .'Efficiency Location Equip , (AFUE, (attic, Type ARI # of etc.)1, 3 crawl- Heating sHeating (package- CEC Certified Mfr. Name Reference Identical (>=CF -1R space,' Duct Load -• Capacity heat pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr), Split Amana , Furnace AMVC80604BX 1 80 AFUE ° Attic -R-8 48 60 kBtu Cooling Equipment j $ Efficiency Duct �, c Equip (SEER Location • Type- and EER) • (attic, ,(package ARI .# of , 1,'3 crawl- S , Cooling Cooling- oolingheat heat CEC Certified Mfr. Name Reference Identical (>=CF -1R space, Duct ` Load . Capacity pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split �� Amana 'y�, . '*T—. r +p4 -�`v A/C', , SX140481' 1 14 SEER Attic. _ R-8' 32 4 Tons } ��;,.,,� - �,.�.; • q.., , �,..-�- �"�'�,:..: �;•�-- . �,,.,. �_ � �N �• �.. fir•` -�,, r;,�; �,° i a F t 1. If project is new construction, see Footnotes to Standards Table. 151-B and Table 151-C for duct ceiling alternative _ ,: - compliance. 2. ARI Reference Number can be`found by entering the equipment model number at , s http://www.aridirectory.orglarilac.php# 3. Listed efficiency on this page 'must be greater than or equal ( ? ) to the value shown on'the CF -IR form. i x 4.'Whe6 CF -1R is reference it is also applicable to the CF -IR, CF=1R-AA or. CF -1R -ALT ALL BOXES MUST BE CHECKED TO BE A' VALID FORM 0 §110-§113: HVAC equipment is certified by the California Energy Commission. ' 0 §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. 0 §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' minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. • * { A -k .. • +; _-y .fir, ,,, * l •. ;� f � `. .`' � • �� ' _ ' � ` ' - � _ .. �' ash ' ,• ', f Reg:'212-A0009427B-M0400001A-0000 Registration Date/Time: .2012/03/07 14'48:_10 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms ` t, August 2009 INSTALLATION CERTIFICATE CF -6R -ME -CH -04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address:. ' 52375 AVENIDA NAVARO, La Quints CA 92253 (System Enforcement Agency: Permit Number: ' 1) City?of La Quinta 5- 12-188 Position With Company (Title): ' ` Ducts and Fans ` .. §150(m): Duct and Fans` r a 0 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air 'ducts and plenums are -insulated to a•minimum installed level of -R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4,inch; the combination of mastic and either mesh or tape shall be used; and = , ,` . • , 0 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying -' conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities 00 and support platforms shall not be compressed to cause reductions.in the cross-sectional area of the a 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_. 4 . •. ` r' 0 7. Exhaust fan systems have back draft or automatic dampers. ' 0 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, r ymoisture, equipment maintenance, and wind. Cellular foaminsulation shall be protected as above or-,,' --7 •painted with,a coating that is water retardant and provides shielding from solar radiation that can cause: } degradation of the material: 210. Flexible;•ducts cannot haveporous inner cores.- VT j LLL ( • � T � • / . *� �� tom" F � . 7.. '•'•, �.._..r - � �,.. •�, '[-• � 7_,.t: raw. _. a __ 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. ' `t . 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). s'+ . 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 -1R) form approved by the enforcement agency that identifies the specific • requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. ' ± . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the = building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. . Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) - VENVEST BALLARD INC dba DIAL,ONE'S ONE HOUR AIR CONDITIONING AND HEATING Responsible Person's Name: Responsible Person's Signature: . Ruth Debrick Ruth bebrick •i CSLB License: 878533 Date Signed: 12/13/2012 Position With Company (Title): ' ` Reg: 212-A0009427B-M0400001A-0000 .Registration Date/Time: 2012/03/07 14:48:10 -HERS Provider: CalCERTS,•Inc. 2008 Residential Compliance Forms . `� August 2009 E Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each -duct system that must demonstrate compliance in the dwelling. [sT-hinstallation certificate is required for compliance for alterations and additions in existing dwellings to is pace conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible. and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system _ Select one compliance method from the following four choices. INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS w, ' f Duct Leakage Test - Existing Duct System (Page 1 of 2) ❑ 2. Measured leakage to outside less than 10% of Fan Flow , Site Address: 52375 AVENIDA NAVARO, La Quinta CA 92253 (System Enforcement Agency: Permit Number: . 1) City of La Qui nta 12-188 ✓ ' 'CFM Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each -duct system that must demonstrate compliance in the dwelling. [sT-hinstallation certificate is required for compliance for alterations and additions in existing dwellings to is pace conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible. and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system _ Select one compliance method from the following four choices. ® 1. Measured leakage less than 15% of fan flow ` ❑ 2. Measured leakage to outside less than 10% of Fan Flow , ❑3. Reduce leakage by 60% and conduct smoke and fix.all leaks ❑ 4`�Fix ll accessibleleaks using s�moke'and HERS rater verify Note: (One of Options 1, 2 or 3 must be attempted,before utilizing Option,4..), V,. __ _ _�;�,,•_ . Determine nominal Fan Flow using one of the°followng three' calculatioh methods: tw" ,/13 Cooling system method: Sizef condenser in Tonsi.14 _ x 400 =1 1600 � CFM ✓ ' 'CFM [3Heatind'system method: 21 7 z •' II Output Capacity in Thousands of Btu/hr`= ✓❑Measured system irflovi using! RA3.3airflowst"procedure : CF Option 1 used then::. .# _ ^• . Y. � Allowed leakage = Fan Airflow i 1600"' x 0.15 = 240 'CFM ` 1 Actual Leakage'= 6_ CFM r `` "r Pass if Actual Leakage is less than Allowed leakage Pass Fail. Option 2 used then: 2 Allowed leakage = Fan Airflow _ x 0,10 = _ CFM Actual Leakage to outside= 1 CFM ; �J Pass if Actual leakage to outside is less than Allowed leakage Pass Fail , Option 3 used then: Initial leakage prior to start of work = _ CFM ' Final leakage after sealing all accessible leaks using smoke test = CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction - CFM ((Leakage reduction _/ Initial leakage _) x;100% _ 0 Reduction �- Pass if % Reduction > 60% ❑ Pass ❑ Fail Option 4 used then:, 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). ' • Pass if all accessible leaks have been repaired using smoke Pass p Fail Reg: 212-A0009427B-M2100001A-0000 ,Registration Date/Time: 2012/03/07.14:48:44 HERS Provider: CalCBRTS, Inc.' 2008 Residential Compliance Forms r' �* March 2010, INSTALLATION CERTIFICATE CF-611-MECH-21=HERS Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: 52375 AVENIDA NAVARO, La Quinta CA 92253 (System Enforcement Agency: Permit Number: ' 1) • City of La Qui nta 12=188 .f r I F • � << a .� • •* .s , •- � - .�. r t. 0 Outside air (OA) ducts for Central Fan'Integrated (CFI) ventilation systems, sliall 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 c6nfigured'to the closed position during duct leakage testing. j m All supply,,and return register'boots4ust be sealed to the-dryfwall'if smoke testis utilized for1compliance — applles'to duct leakage compliance option 3 (leakagereduction by 50%) end option 4 (fix all accessible rw leaks) described above.. �` _..__,;,. »... . 0 New duct installations,cannot utilize !building Jvitie'�a��s?plenums or platform returns in lieu.of ducts :� ® Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct"tape to seal leaks -at all new duct connections _.' DECLARATION STATEMENT , . I certify under penalty of perjury; under the laws of the State of California, the information provided•on this form is true and correct. 1 ' . 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 v ` enforcement agency. j - • , . 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 ,r 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) VENVEST BALLARD INC dba DIAL ONE'S ONE HOUR AIR CONDITIONING AND HEATING Responsible Person's Name: Responsible Person's Signature: + }• Ruth Debrick CSLB License: Date Signed: Position With Company (Title): ' 878533 2/13/2012 Is this installation monitored by a Third Party Quality Name of TPQCP•(if applicable): .f r I F • � << a .� • •* .s , •- � - .�. r t. 0 Outside air (OA) ducts for Central Fan'Integrated (CFI) ventilation systems, sliall 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 c6nfigured'to the closed position during duct leakage testing. j m All supply,,and return register'boots4ust be sealed to the-dryfwall'if smoke testis utilized for1compliance — applles'to duct leakage compliance option 3 (leakagereduction by 50%) end option 4 (fix all accessible rw leaks) described above.. �` _..__,;,. »... . 0 New duct installations,cannot utilize !building Jvitie'�a��s?plenums or platform returns in lieu.of ducts :� ® Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct"tape to seal leaks -at all new duct connections _.' DECLARATION STATEMENT , . I certify under penalty of perjury; under the laws of the State of California, the information provided•on this form is true and correct. 1 ' . 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 v ` enforcement agency. j - • , . 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 ,r 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) VENVEST BALLARD INC dba DIAL ONE'S ONE HOUR AIR CONDITIONING AND HEATING Responsible Person's Name: Responsible Person's Signature: Ruth Debrick Ruth Debrick CSLB License: Date Signed: Position With Company (Title): ' 878533 2/13/2012 Is this installation monitored by a Third Party Quality Name of TPQCP•(if applicable): Control Program (TPQCP)? , ❑ Yes ❑ No , ,AReg: 212-A0009427B-M2100001A-0000 Registration Date/Time: 2012/03/0.7 14:48:44 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms ;z March 2010 r-� 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 (SIMS)` Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance' method. TMAH- Access Holes in Supply and Return Plenums of Air Handler. j System Name or Identification/Tag System 1 , System Location or Area Served Whole House 1 p Yes ❑ No '• 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 p Yes . ❑ No 4 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum j and labeled according to Figure in Section RA3.2,2.2.2. Yes to.1.and 2 is a pass.. Enter Pass or Fail ✓ ® Pass ✓ ❑ Fail STMS:-. Sensor on;the Evaporator Coil System'Narre"or Identification/Tag*y. t• pP�rlj System I- :!_J' 3 ✓ ❑ Yes p.No The sensor is factory' installed, or,field,installed according to manufacturer's specifications, or is�installe l by methods/specifications approved by the Executive ""-' j: Director. f .The sensor wire is' terminated with a standard' mini plug suitable for connection'to a k 4 ❑Yes p No '�' digital thermometer: The sensor, mini plug is accessible to the installing ,technician_ and the HERS rater without changing the airflow through the condenser coil 5.0 Yes ❑ No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3;-4,, and 5 is a°pass. Enter N/A if STMS are not. applicable. Otherwise enter Pass or;Fail ti V m N/A ,✓ .❑ Pass -4 [3Fail STMS - Sensor on the Condenser Coil �. a System Name or Identification/Tag System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No . digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil . 8 ❑ Yes ❑ No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ p N/A ✓ Pass ✓ e [3Fail applicable: Otherwise enter Pass or Fail - .:❑ . . Reg: 212-A0009427B-M2500001A-0000 ,Registration Date/Time: 2012/03/07 14:50:42 -HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 �- `1 lei (must be re -calibrated monthly) �--t l„ ' System Location or Area Served �•' t; 21/2012 r ��+ .�'_- fi 60 J Outdoor Unit Serial # a1201207494 .. ; ,� Outdoor Unit Make Amana. -•' , Outdoor Unit Model ASX140481 v - Nominal Cooling Capacity Btu/hr48000 '60 V_ ��., #_ , ,�.� 2/13/2012» - Evaporator saturation temperature 36 ' (Tevaporator, sat) r Condensor saturation temperature 96 96 - `+ (Tc sat) • l• Suction line temperature (Tsuction) INSTALLATION CERTIFICATE ' CF-6R-MECH-25-HERS ' Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 52375 AVENIDA NAVARO, La Quinta CA 92253 City of La Quinta 12-188 - Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. y The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. The system must meet minimum airflow, requirements as prerequisite for a valid refrigerant charge test. , If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. '' • �' Space Conditioning Systems • - System Name or Identification/Tag System 1 (must be re -calibrated monthly) �--t l„ ' System Location or Area Served Whole House t; 21/2012 r (must be re -calibrated monthly) Supply,(evaporator leaving) -air dry -bulli 60 Outdoor Unit Serial # a1201207494 .. ; ,� Outdoor Unit Make Amana. • ; Outdoor Unit Model ASX140481 v - Nominal Cooling Capacity Btu/hr48000 '60 V_ Date of Verification 2/13/2012» Calibration of Diagnostic Instruments. - Date `of Refrigerant Gauge Calibration 2/1/2012 (must be re -calibrated monthly) �--t ��li►�:�ffr. f Date of Th ocouple!Calibration t; 21/2012 r (must be re -calibrated monthly) Supply,(evaporator leaving) -air dry -bulli 60 Measured Temperatures"(°F)., � /, j%'F;,: ' iii. ' ;, -._•—*.,» > , ' System Name or Identification/Tag :; .* � System 1 � �--t ��li►�:�ffr. f t .- � � Supply,(evaporator leaving) -air dry -bulli 60 Measured Temperatures"(°F)., � /, j%'F;,: ' iii. ' ;, -._•—*.,» > , ' System Name or Identification/Tag :; .* � System 1 � �--t ��li►�:�ffr. .8 ..i I � a/1 _ ar)F,� �f` .,r � ..� � � Supply,(evaporator leaving) -air dry -bulli 60 temperature7(TsupplY; .. ,� Return (evaporator entering) air dry. -bulb ,80' • ; temperature (Treturn, db) f r. Return (evaporator entering) air wet -bulb, "N '60 temperature temperature (Treturn, wb) Evaporator saturation temperature 36 ' (Tevaporator, sat) r Condensor saturation temperature 96 96 - `+ (Tc sat) • l• Suction line temperature (Tsuction) 48 l�' ►' i; ,. Liquid Line Temperature (Tliquid) 84 Condenser (entering) air dry-bulb 88 temperature (Tcondenser, db) " µ � , •a l r . r � i - •' � tri l • ",s-` .3 '}•r '. s• •l, . ^"` '- Sl ` Reg: 212-A0009427B-M2500001A-0000 'Registration Date/Time: 2012/03/07 14:50:42;' HERS Provider: Ca10ERTS, Inc., 2008 Residential Compliance Forms -:t 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: 52375 AVENIDA NAVARO, La Quinta CA 92253 City of La Quinta 12-188 , Minimum Airflow Requirement s•- ' 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 - System 1' , Calculate: Actual Superheat e J` Calculate: Actual Temperature Split =,Treturn, t 20.00 • Target Superheat from Table RA3.2-2 using db - Tsu I db , Target Temperature Split from Table RA3.2-3 • 'r 23.2 ' using Treturn, wb and Treturn; db. Actual Superheat - Target Superheat Calculate difference: Actual Temperature Split - -3.2 r > ; System passes if difference is between -5°F and Target Temperature Split = +5°F r Passes if difference is between -3°F and +3°F or, Enter Pass or Fail upon remeasurement, if between -3°F and PASS 4 " -100°F' .� {, • • Enter Pass or Faill Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is, measured, the value must be equal to or greater than'the Calculated Minimum Airflow Requirement in the table below. `Requirement Calculated Minimum Airflow (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System FNme oo Ideification/Tag~ cyst m 1 Calculated Minimum Airflo R quirement (CFM) '. *a r -•-:... Measured Airflow;[us ng R 3 3,pro edu es (CFM) Passes if measured airflow is greater than or equal to the calculated. minimum_ airflow requirement!"' N Enter Pass or Fai ` • ' Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be.used for fixed orifice metering device systems System Name or Identification/Tag System i , Calculate: Actual Superheat T T suction - evaporator, 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 r Enter Pass or Fail r a y • h _r4 l 0- H 4 , y . a Reg: 212-A0009427B-M2500001A=0000 Registration Date/Time: 2012/03/07 14:50:42 HERS Provider: CalCERTS,,:Inc 2008 Residential Compliance Forms y _r August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: -, 52375 AVENIDA NAVARO, La Quinta CA 92253 City of La Quinta 12-188 , Subcooling Charge Method Calculations for Refrigerant Charge Verification.•This procedure is required to be used for thermostatic expansion valve (TXV) and'electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 , Calculate: Actual Subcooling =- 12.0 i Tcondenser, sat - Tliquid i 1 , Target Subcooling specified by manufacturer 12 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: -, 52375 AVENIDA NAVARO, La Quinta CA 92253 City of La Quinta 12-188 , Subcooling Charge Method Calculations for Refrigerant Charge Verification.•This procedure is required to be used for thermostatic expansion valve (TXV) and'electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 , Calculate: Actual Subcooling =- 12.0 i Tcondenser, sat - Tliquid 1 , Target Subcooling specified by manufacturer 12 Calculate difference:. 12 t ' Actual Subcooling - Target Subcooling'= 0 ; , System passes if difference is between' -3°F and +3°F -PASS YS r e • � i � ._ Enter Pass or Fail •' ' ; Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV).and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat = 12.0 i Tsuction " Tevaporator, sat , Enter allowable superheat range from manufacturer's specifications (or use range 12 t ' between 4°F and 25°F if manufacturer's specification is not available) _ System passes,if `actual superheat is*withimthe' allowable superheat range 1 rb PASS YS r e • � i � � _ :• ' Enter Pass or. Fail ' k x s .�L .-.. `....r.• .�.ee•'r`�: ..• "* ^I .P•a��•!'1 5�'.•5:.� - - �.- .• •� t- +{ ' f �'� •h ., •: ' ,+ •fes. �?'r' � s 4. • , y �. Reg: 212-A0009427H-M2500001A-0000 Registration Date/Time:-2012/03/07 14:50:42 • HERS Provider: Ca10ERTS; Inc. 2008 Residential Compliance Forms .F �, August 2009 a NSTALLATION CERTIFICATE CF-6R-MECH-25-HER; tefrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5 Site Address: Enforcement Agency: Permit Number: 52375 AVENIDA NAVARO, La Quinta CA 92253 City of La Quinta 12-188 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil' airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 CSLB License: 878533 Date Signed: 2/13/2012 Position With Company (Title): , ' . System meets all refrigerant charge and airflow Name of TPQCP (if applicable):. Control Program (TPQCP)? ❑ Yes ❑ No requirements. . PASS Enter Pass or Fail ' t.j r H' w t 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 l • ,' �' 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. 1 ; . 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 renictry fnr midtinlp nriantatinn altprnativac And hpninninn Ortnhar 1 int n fnr all In --rice hr,ilAinnc Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) VENVEST BALLARD INC dba DIAL ONE'S ONE HOUR AIR CONDITIONING AND HEATING Responsible Person's Name: Responsible Person's Signature: Ruth Debrick Ruth Debrick CSLB License: 878533 Date Signed: 2/13/2012 Position With Company (Title): , ' . Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable):. Control Program (TPQCP)? ❑ Yes ❑ No • ! :� - - S. r Reg: 212-A0009427B-M2500001A-0000 •Registration Date/Time:.2012/03/07 14:50:42 HERS'Provider:,Ca10ERTS, Inc'. 2008 Residential Compliance Forms August 2009 f