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10-0222 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000222 Property Address: 54120 AVENIDA CARRANZA , APN: 774-211-006-19 -000000- Application description: MECHANICAL Property Zoning: COVE RESIDENTIAL Application valuation: 3800 Td�/ 4 4 Q" Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: C20 L' ense : 834471 Y. Date: „/D Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county.that requires a permit 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 155001.: (_ 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 of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT Owner: LA QUINTA REDEVELOPMENT 78495 CALLE TAMPICO LA QUINTA, CA 92253 Contractor: SPEEDY AIR CONDITION 54685 AVENIDA HERRER LA QUINTA, CA 92253 (760)567-0133 Lic. No.: 834471 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 AGENCY 0 y6r_- Date: 3/18/10 ----------------------------------------------- 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. 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 EXEWT Policy Number EXEMPT 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 Code, I hall forthwith cp pl hh thos provisions. te:S plicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby thorize representatives of this county to enter upon the above-mentioned property for i Grpection purp� Rate:.$ •/ ` t` Signature (Applicant or Agent). Application Number . . . . . 10-00000222 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 38.00 Plan Check Fee 9.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/14/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 1.00 6.5000 EA MECH AH <=10K CFM 6.50 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE"OUT:" 3.5T HEAT PUMP SPLIT SYSTEM [13 SEER MINIMUM] - 2007/2008 CALIFORNIA CODES March 18, 2010 2:34:27 PM AORTEGA ---------------------------------------------------------------------------- Other Fees. . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid -----"-------------------------------- Credited -------------------- Due Permit Fee Total 38.00 .00 .00 38.00 Plan Check Total 9.50 .00 .00 9.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 48.50 .00 .00 48.50 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAIterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: 1/ 111 1 Enforcement Agency. Permit #: Conditioned Floor Equipment Type' List Minimum Efficiency2 Duct insulation requirement I Area I Thermostat ❑ Packaged Unit Fo Over 40 ft of ducts added orin❑ AFUE ❑ COP ace Setback door Coil ❑SEERL ❑ HSPF�,. 7 replaced in unconditioned space Served by system (If not already ndensing Unit ❑ EER ❑ Resistance ❑ R 6 (CZ 10-13) /,?00 sf present, must be ❑Other ❑ R 8 (CZ 14-15) 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, 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 sig ed. 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: 10 nazi • 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 (for split systems) MECH-25 F UTT V1— r—M W VKbING & SAFETY DEPT. Requir t , FOR CONSTRUCTION verificatio DATE By—&21. ❑ 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS ducts: (all new ducting and all CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 new equipment) For Split Systems: Duct leakage < 6 percent; RC, CCA >350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakaee < 6 Dercent • Condenser Coil and/or • Indoor Coil and/or CF -6R forms: MECH-2I-HERS and (for split systems) MECH 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 Flo 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 HE ❑ 2. Duct.systems with less`than 40 linear feel in unconditioned space, or r-13 Existin duct s stems are constructed insulated or sealed with asbestos 1 ❑ 3. New Ducts with Replacement I Reauired Forms: i • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF -4R 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, TN AH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 linear feet of duct in unconditioned space. For 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) • 1 certify that this Certificate of Compliance documentation is accurate and complete. • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • 1 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 andspecifications submitted to the enforcement agency for approval with the per9nit application. Name: ; _ _ %, _ r� Signature: Company: �^ V A Date: Address: ale License: I City/State/Zip: Phone:t17612 ° X %-- D/�3 2008 Building Energy Efficiency Standards Residential HVAC Alterations La Quinta, CA (Climate Zone 15) BUSINESS AND PROFESSIONS CODE, SECTION 7110 Willful or deliberate disregard and violation of the building laws, including the California Building Code, and local permit requirements constitutes a cause for disciplinary action from the Contractors State License Board working in conjunction with the local building department. This action may consist of fines up to $5,000 per violation or suspension/revocation of a contractor's license. WHEN IS A PERMIT REQUIRED? A written construction permit shall be obtained from the enforcement agency prior to the erection, construction, reconstruction, installation, relocation, or alteration of any mechanical system, except as permitted in Appendix Chapter 1, Section 112.2 of the 2007 California Mechanical Code. Projects requiring permits include,.but are not limited to: • New HVAC installation 0 Relocation of an existing HVAC unit • HVAC Changeout • Adding or replacing more than 40ft ducting • Replacement of furnace, coil, FAU, or condenser 2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24, Part 6) REOUIREMENTS INCLUDE: 1. Heating equipment must have a minimum 78% AFUE (Exception: Wall & floor furnaces; room heaters). 2. Central air conditioners & heat pumps less than 65,000 Btu/hr must have a minimum 13 SEER. 3. N�kl ,Anstdjfed or replaced ducts must have a minimum insulation value of R-4.2. When more than 40 ft of ducting will be installed . _.., ed,.t. t re "or reelachepol-ict;?tsulrnust iation-value�be R-6 (CZ 10-13), or R-8 (CZ 14 and 15). 4. A setbacOype-thermostat (24=hr clock with four set points) is required for all alterations. 5. NeWoC dplacemeiitductsimust meet the mandatory requirements of Section 150(m): 1 y • All joints and,openings in the in the HVAC system must be sealed. •.. , Only UL. 181, UL- 18 fA, or ULA 181B approved tapes or mastic shall be used to seal duct openings. �e • -1 .Connections of metals ducts and the inner core of flex ducts shall be mechanically fastened. Flex ducts must be connected usmg a metal'sleeVe/coupling. Flex ducts that are"suspended must be supported every 4ft. max for horizontal runs with no more than 2" of sag between si'�S'ports!Qib ff.*max for,veriical runs. _---— WHEN IS HERS VERIFICATION REQUIRED AND WHAT FORMS ARE REQUIRED? HERS verification is required for all HVAC alterations in Climate Zone 10-15. A HERS rater is a special inspector for the building department. The building inspector may also request to be on site to witness testing by the contractor and/or HERS rater. The installer picks one of the four options on the CF -IR -ALT -HVAC Form that describe the work being conducted. Each option lists the forms required to be at the job site for final inspection. • CF -6R Forms shall be completed and submitted by the installing contractor for final inspection.• • CF -4R Forms shall be completed, registered with an approved HERS Provider (cannot be completed by hand), and submitted by the HERS Rater for final inspection effective January 1, 2010. DESCRIPTION OF HERS TESTS BELOW (Full descriptions found in Residential Appendix RA3 and Residential Manual) Duct sealing — The installer is to insure leakage of the HVAC system is less than 6% for new air conditioning system (new equipment and all new ducts) or 15%, 60% reduction, seal all accessible leaks, etc. for alterations to existing HVAC systems. When the contractor uses the option to seal all accessible leaks, all easily movable objects must be moved to seal existing ducting. New ducting installed by the contractor is not allowed to have any leaks even if it is no longer accessible. In example 3 of the CF -1 R "all new ducts" means that all the ducting was changed. The original boots, plenums, etc. do not need to be changed. Cooling Coil Airflow (CCA) — There are two different minimum air flow requirements that must be met. These are 300 CFM and 350 CFM. The minimum 300 CFM per ton of cooling is required in order to conduct a refrigerant charge test. For new HVAC systems (new equipment and new ducts) the HVAC system must move a minimum 350 CFM of air for each ton of cooling. Refrigerant Charge (RC) — The installer is required to verify the charge is correct. If the outside temperature is below 55 degrees then the weigh in method must be used by the installer. When the weigh in method is used the HERS rater must retest when the temperature is 55 and above. A charge indicator display (CID) can be used in place of conducting an RC; manufacturers are currently developing this device. Temperature Measurement Access Holes (TMAH) — Installer must drill and mark holes to measure temperature split. Hole for the placement of a Static Pressure Probe (HSPP) or Permanently installed Static Pressure Probe (PSPP) — Either the installer must drill and mark holes to measure static pressure or a permanently installed pressure probe must be installed and marked. Saturation Temperature Measurement Sensors (STMS) — Permanently installed type K thermocouple are installed on the indoor and outdoor coil so that the HERS rater can verify charge without attaching gauges. Instructions are found in Ch 4 of the Res. Manual. Fan Watt Draw (FWD) — Installer verifies that the furnace fan watt draw is less than 0.58 Watts/CFM. NOTE: The CF-6R-MECH-04 is required for all HVAC alterations. * For Final inspection ALL compliance forms (CF -IRs, CF-6Rs, and CF-4Rs) shall be registered with an approved HERS Provider for building permit applications submitted on or after October 1, 2010. PROPOSAL . PFOPO$Ajif�,Q� Speedy Ac & Heating I SHEET NO. t• 54685 Avenida Herrera La Quinta, Ca 92253 a DATE Lie # 834471 * � PROPOSAL SUBMITTER:- WORK TO BE PERFORMED AT: NAME ADDRESS� 7-- _ / NO. ADDRESS`` DATE OF PLANS ARCHITECT We hereby propose to furnish the materials and perform the labor necessary for the completion of or la� All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifi- cations -submitted for abo e„work and com ted in a substantial workm .nlike rrnner for the sum of �' Dollars ($�C� with payments to be made aXOO lows. ,4G/e G./ Cl ,l�l /_- Respectfully submitted Any alteration or deviation from above specifications involving extra costs 1.01 , Z will be executed only upon written order, and will become an extra charge Per over and above the estimate. All agreements contingent upon strikes, ac- cidents, or delays beyond our control. Note—This proposal may be withdrawn by us if not accepted within ML—days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. I Signature Date / �7 / (O Signature &­ NC 3818-50 PROPOSAL CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 54120 Avenida Carranza, La Quinta CA 92253 City of La Quinta 10-0222 =nter the Duct System Name or Identification/Tag: Main System =nter the Duct System Location or Area Served: Entire House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the 1welling. This installation certificate is required for compliance for alterations and additions in existing dwellings to I space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of Che original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled 'Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakaqe Diaqnostic Test - existing duct system Select one compliance method from the following four choices. 0 1. Measured leakage less than 15% of fan flow O 2. Measured leakage to outside less than 10% of Fan Flow p 3. Reduce leakage by 60% and conduct smoke and fix all leaks O 4. Fix all accessible leaks using smoke and HERS rater verify Note: (Option 1, 2 OR 3 must be attempted before utilizing Option 4) Determine nominal Fan Flow using one of the following three calculation methods. ✓ 10 Cooling system method: Size of condenser in Tons 3.5 x 400 = 1400 CFM ✓ El Heating, sy`stem�method: 21.7 x :+`Output Capacity in TFiousands of Btu/hrr=CFM procedures: / ✓ O Measured system airfl6w using' RA3.3 airflow test Cd- FM-Option 1 Option1 used than: j // i 1'. Allowed leakage =Fan Flow 1400 x 0.115 210 CFM 1 � I' Actual Leakage =-199 CFM \ `�. ` „ , 1.� .._J✓ ��>r`f"t Pass if Leakage Actual is less than Allowed % Pass O Fail Option 2 used then: 2 Allowed leakage = Fan Flow_ x 0.10 = _ CFM Actual Leakage to outside = _ CFM Pass if Leakage Actual is less than Allowed O Pass O 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 > 609/o 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 n Pass Fail I Reg: 210-A0004111A-000000000-M21A Registration Date/Time: 2010104108 21:25:36 HERSPRovider: CaICERTS 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-21 Duct Leakage Test - Existing Duct System s (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 54120 Avenida Carranza, La Quinta CA 92253 City of La Quinta 10-0222 2 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. 0 All supply,and.return register boots must,be,sealed.towthe drywall.if smoke,test,is-utilized-,for compliance - applies,to,duct leakage compliance option 3,(1e6ka4e reduction by 60%)'anis option 4 (fix'611 accessible leaks) described above. / - ��f r� r � 40 0 New duct installationslcannot utilize building cavities:�as plenums or platform returns imlieu of ducts. • Mastic and,draw_bends must be:used.in combination'with.cloth backed; rubber adhesive duct tape.td-seal leaks at all new duct connections _ "S DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) SPEEDY AIR CONDITIONING Responsible Person's Name: CSLB License: Daniel Torrez 1834471 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 CalCERTS Certificate # CC1-1798491128 HERS Rater Company Name: ALDCOAir Responsible Rater's Name: Responsible Rater's Signature: Rafael Aldaz Signature on file at Ca/CERTS, Inc. Responsible Rater's Certification Number w/ this HERS Provider:. Date Signed: 3/31/2010 CC2004690 Reg: 210-A0004111A-000000000-M21A Registration Date/Time: 2010/04/08 21:25:36 HERSPRovider: CaICERTS 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4111-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 54120 Avenida Carranza, La Quinta CA 92253 1 City of La Quint a 10-0222 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag Main System System Location or Area Served Entire 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 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 ✓ © Pass ✓ ❑ Fail STMS - Sensor on the Evaporator Coil System Name or Identification/Tag System 3 p Yes t ❑ No The sensor is'factory'installed, or�fieldlinstalled`according'to manufacturer's specifications? or is' installed by methods/specifications approved bi the Executive 6 ❑ Yes r+ , Director. / / j _ I - . ' 4 ❑ Yes f`"� 'CEI No/ The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. The sensor mini plug is accessible to the installing, technician A and the HERS the through coil 7 ❑ Yes ,` s rater without. changing airflow the condenser 50 Yes.' `- '❑ No. The sensor measures the saturation temperature of the coil within 1.31degrees F V-71Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not N/A ✓ ❑Pass ✓ El Fail applicable. Otherwise enter Pass or Fail ✓ El N/A ✓ ❑Pass ✓ ❑Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag I System 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 I ❑ 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 ✓ El N/A ✓ ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail 001 Reg: 210-A0004111A-000000000-M25A Registration Date/Time: 2010104108 21:35:58 HERSPRovider: CaICERTS 2008 Residential Compliance Forms August 2009 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: 54120 Avenida Carranza, La Quinta CA 92253 1 City of La Quinta 10-0222 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above SS°F) Procedures for determining Refrigerant Charge using the Standard Change 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 forms) 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 Svstems System Name or Identification/ rag Main System (must be re -calibrated monthly) Date of Thermocouple Calibration 03/01/2010 System Location or Area Served Entire House Outdoor Unit Serial # PSD061000160 r / ` 't 't Outdoor Unit Make MAYTAG L` .. f . �. Outdoor Unit Model PSH2BD042K Nominal Cooling Capacity Btu/hr 42000 Date of Verification 03/31/2010 Calibration of Diaonostic Instruments Date of Refrigerant Gauge Calibration 03/01/2010 (must be re -calibrated monthly) Date of Thermocouple Calibration 03/01/2010 (must be re -calibrated monthly) Measures Temperatures (,F) I , f / 1t I y t k ' #F 1 ' ti • t It System Name or IdentificaEionfr g' Main?System Supply,(evaporator leaving) airdry-bulb temperature (Ts -0111, ' 11 +� 49 r / ` 't 't db) ,l P, L` .. f . �. Return (evaporator entering) air dry-bulb 70 temperature (Treturn, db) Return .(evaporator entering) air wet -bulb temperature (Treturn, wb) Evaporator saturation temperature 35 (Tevaporator, sat) Condensor saturation temperature 82 (Tcondensor, sat) Suction line temperature (Tsuction) 44 Liquid Line Temperature (Tliquid) 70 Condenser (entering) air dry-bulb temperature (Tcondenser, db) 0 Reg: 210-A0004111A-000000000-M25A Registration Date/Time: 2010/04108 21:35:58 HERSPRovider: CaICERTS 2008 Residential Compliance Forms August 2009 a INSTALLATION CERTIFICATE CF-4R-MECH-2S Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of S) Site Address: Enforcement Agency: Permit Number: 54120 Avenida Carrania, La Quinta CA 92253 1 City of La Quint a 10-0222 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 Main System Calculate: Actual Temperature Split = Treturn, 21 db - Tsupply, db Target Temperature Split from Table RA3.2-3 19 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - 2 Target Temperature Split = Passes if difference is between -4°F and +4°F or, upon remeasurement, if between -4°F and PASS -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. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name or Identification/Tag #� Calculated MinimurnVirflow Requirement (CFM) l - Measured Airflow using 3.3 procedures (CFM) r� ] Passes if,measured airflow is greater than or,,.--*( �,�� ..t' t. equal to the calculated minimum airflow 1, 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 R Reg: 210 A0004111A-000000000-M25A Registration Date/Time: 2010104108 21:35:58 HERSPRovider: CoICERTS 2008 Residential Compliance Forms August 2009 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 Main System Calculate: Actual Subcooling = 12 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 16 Calculate difference: _4 Actual Subcooling - Target Subcooling = System passes if difference is between -4°F and +4°F PASS Enter Pass or Fail PASS �7 /?77 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 Main System Calculate: Actual Superheat = 11 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 10 between 3°F and 26°F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range Enter Pass -or Fa 1 PASS �7 /?77 Reg: 110-A0004111A-000000000-M25A Registration Date/Time: 1010/04/08 21:35:58 HERSPRovider: CaICERTS 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 54120 Avenida Carranza, La Quinta CA 92253 City of La Quinta 10-0222 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 Main System 1834471 HERS Provider Data Registry Information Sample Group # (if applicable): N/A System meets all refrigerant charge and airflow ot-testedl verified dwelling in a HERS sample group requirements. PASS ALDCOAir Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail Signature on File at CaICERTS, Inc. Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 3/31/2010 CC2004690 f 777 (1 ..' DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) SPEEDY AIR CONDITIONING Responsible Person's Name: CSLB License: Daniel Torrez 1834471 HERS Provider Data Registry Information Sample Group # (if applicable): N/A Q tested/verified dwelling --F-71 ot-testedl verified dwelling in a HERS sample group HERS Rater Information Ca10ERTS Certificate # CCl-1798491128 HERS Rater Company Name: ALDCOAir Responsible Rater's Name: Responsible Rater's Signature: Rafael Aldaz Signature on File at CaICERTS, Inc. Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 3/31/2010 CC2004690 Reg: 210-A0004111A-000000000-M25A Registration Date/Time: 2010/04/08 21:35:58 HERSPRovider: Ca10ERTS 2008 Residential Compliance Forms August 2009