Loading...
11-1153 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00001153 Property Address: 79565 CETRINO APN:. 772 -330 -041 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 18254 Applicant: T4ht 4 4 Q" Architect or Engineer: ptk BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION 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 -C43 License No.: 276586 ate/0 '20`` ontractor: 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, priorto 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 1$5001.: (_) 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.). 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.l. (_ 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: j LQPERMIT Owner: DEAN ANDERSON 79565 CETRINO LA QUINTA, CA 92253 Contractor: DESERT AIR CONDITIONI 590 WILLIAMS ROAD PALM SPRINGS, CA 9226 (760)323-3383 f Lic. No.: 276586 - VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/20/11 QCT 2 0 2011 11. p� !,!! A — — 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. _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the woik for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier EVEREST NATL Policy Number 7600007908111 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 Code, hall forthwith comply with those provisions. epi OLS %cant: 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 Ouinta, 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 buildi construction, and hereby authorize representatives of this county to enter upon the above-mentioned pro e . spection purposes. I3ateay,,!!" �> ignature (Applicant or Agent), er LQPERMIT Application Number 11-00001153 Permit . . . MECHANICAL Additional desc . Permit Fee 66.00 Plan Check Fee 16.50 Issue -Date . . . . Valuation . . . . 0 Expiration Date 4/17/12 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 -----------------------------=---------------------------------------------- Special Notes and Comments REPLACE (2) SPLIT SYSTEMS AT GROUND LEVEL, FURNACE, INDOOR COIL &'- CONDENSER. 2010 CODES. -- - - - - - - - - - - Other Fees: . . . . . . . . BLDG STDS ADMIN (SB1473). - - - - - - - - - - - - - 1.00 Fee summary Charged Paid Credited. Due --------------------------------------------------------- Permit Fee Total 66.00 .00 .00 .66.00 Plan Check Total 16.50 .00 .00 16.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 83.50 .00 .00 83.50 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date, Permit 7 79-565 Centrino Dr 1 of 2 La Quinta, CA 92253 City of La Quinta Oct 18, 2011 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit p Furnace p Indoor Coil 0 AFUE 80% p SEER 16.0 ❑ COP ❑ HSPF ❑ R 6 (CZ 10-1.3) Served by system 0 Setback If not already present, must be p Condensing Unit ❑ EFR [:j Resistance ❑ R 8 (CZ 14-15) 1400 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78°/a 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 -611 and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -111 and CF -611 shall also be on site for final inspection. 10 1. HVAC Changeout Required Forms: • All HVAC Equipment CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF -411 forms: MECH-21 and (for split systems) MECH-25 - • Condenser Coil and /or • Indoor Coil and /or CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS • Furnace CF -411 forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH 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: Ii . Cut inror Changeout with', J '� f ' CF -6R forms: MECH-04, MECH-20i-HERS, and (for split systems) MECH-22-HERS, and new ducts: (all new ducting and all new MECH-25=HERS j CF -4R forms: MECH 20, and (for split systems) MECH-22, and MECH-25 equipment) i11, \ " fir_ � i1 I 'I For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Dud leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Jacqueline Zabik Signature: Jacqueline Zabik Company: DESERT AIR CONDITIONING INC Date: Oct 18, 2011 Address: 590 WILLIAMS ROAD License: 276586 City/State/Zip: PALM SPRINGS / CA / 92264 Phone: (760) 323-3383 Reg: 211-A0054077A-00000000-0000 Registration Date/Time: 2011/10/18 12:21:54 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 79-565 Cetrino 2 of 2 La Quinta, CA 92253 City of La Quinta Oct 18, 2011 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit El Furnace o AFUE 80% ❑ COP ❑ R 6 (CZ 10-13) Served by system 0 Setback 2 Indoor Coil © SEER 16.0 ❑ HSPF C] R 8 (CZ 14-15) 1400 sf If not already present, must be [j3 Condensing Unit ❑ EER [j Resistance installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -611 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 -111 and CF -611 shall also be on site for final inspection. D 1. HVAC Changeout Required Forms: . All HVAC Equipment CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF -411 forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or . Indoor Coil and /or CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS . Furnace CF -4R forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Fee P....1.-.ged I'Pits- r1,...F leakage 4 15 ..f p 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 systemmill not be Ducted (ie..Ductless,Mini-Split System),(Also=Exempt fromiRefrigerant Charge) 112. New HVAC System Required Forms: r J J } ' " V ( Y . Cut inror Changeout with'.'CF-6R new ducts: (all new forms: MECH-04, MECH-20-HERS, split systems) MECH-22-HERS, End ducting and all new MECH=25=HERS L 1 f 1 CF -4R forms: MECH 20, and (for split systems) MECH-22, and MECH-25� equipment) % tI X17 r. r K . �`i —, ,.-, , . J 2, IIIc '� For Split Systems: Duct leakage < 6 percent; RC; CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. - For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Dud 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 linear feet of dud in unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Dud leakage < 15 percent ❑ EXCEPTION: Existing dud systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) . I certify that this Certificate of Compliance documentation is accurate and complete. . I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. . I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. . The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Jacqueline Zabik Signature: Jacqueline Zabik Company: DESERT AIR CONDITIONING INC Date: Oct 18, 2011 Address: 590 WILLIAMS ROAD License: 276586 City/State/Zip: PALM SPRINGS/ CA/ 92264 Phone: (760) 323-3383 Reg: 211-AO05407BA-00000000-0000 Registration Date/Time: 2011/10/18 12:23:44 ITERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 Bin Permit #P.O. 3 \\"�\ Project Address: City of La Quinta Building 8t Safety Division Box 1504; 78-495 Calle Tampico is Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet . Owner's Name: a^ �' (`s0 A. P. dumber: Address:- `,' (;.e ;no 6 Legal Description: Contractor. D&4 City, ST, Zip: Telephone: Address D-- �,-AA--..__ City. ST', Zip: j!� S e/T [aa 6 y y 5le-./1 Telephone: $/ Q c /a 6 '$-6 State Lic. #: -� 7,� City Lie. #; Designer' Address: City, ST, Zip: Telephone: State Lic. fl: F i Construction Type: ex/,—Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Concoct Person: n Sq. 1-1:1 # StoriUnits: Telephone # of Contact Person: ] r1 Estimated Valuc of Project: a Q APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Rec'd TRACISIMG PERMIT FEES Plan Sets Plan Cheek submitted Item Amount Structural Calm Reviewed, ready for sorreetions Plan Check Deposit Truss Calm Called Contact Person Plan Check Balance, Title U Caics. Plana picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan Z'' Review, ready for corrections/issue Electrical Subeontaetor List Called Contact Person Plumbing Grant Deed Pians picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review, ready for eorrections/Ltsue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Feb. Wks. Appr Date of permit Issue Sthodl Fees • Total Permit Fees Air Solutions 7603603277 p.17 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Teat — Existing Duct System (Page i of 2) Site Addros■: 79-565 Centrino Dr 1 of 2, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 11-1153 Enter the Duct System Name or Identification/Tag: System 1 of 2 Enter the Duct System Location or Area Served: Living area Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling.' This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installatlon Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. Duct Leakage Diagnostic Toot - existing duct ■ystem Select one compliance method from the following four choices. M 1. Measured leakage less then 1S% of fan now ❑ 2, Measured leakage to outside less than 100/6 of Fan Flow ❑ 3, Reduce leakage by 600/6 and conduct smoke and fix all leaks ❑ 4, Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options 1, 2, or 3 must be attempted before utilizing Option 4.) Determine nominal Fan Flow using one of the following three calculation methods. 0 Coollria system method: Size of condenser In Tons 4 x 400 = 1sQ2 CFM V ❑ Heating system method: 21.7 x Output Capacity in Thousands of Btu/hr = CFM V Cl Measured cyctem airflow using RA3.3 airflow tact procedures: _ CFM Option 1 used then: 1 Allowed leakage = Fan Flow 162a x 0.15 = 240 CFM Actual Leakage = 195 CFM Pass If Leakage Actual Is less than Allowed R Pass Ej Fall Option Z used then: 2 Allowed leakage = Fan Flow_x b.10 = _CFM Actual Leakage to outside = _ CFM Pass If Leakage Actual Is less than Allowed Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage aftor coaling all accessible leaks using smoke tact — _CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _/ Initial leakage x 100% = s/o Reductlon Paco If 46 Reduction > GO% Pass rj Fail Option 4 used then: 4 All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No smoke allowed to leek from system. Including ducts, plenums, air handler and door panel. Pass it all accessible leaks have been repalreel using smoke F1 Pass rl Fall Reg: 211-A0054077A-M2100001A-M21A Registration Date/Time: 2011/11/04 13:30:09 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forma March 2010 ti Air Solutions 7603603277 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakaue Test — Existino Duct System (Pane 2 of 27 Site Address: 79-565 Centdno Dr 1 of 2, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 11-1153 LI Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall hot 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. 9 All supply and return register boots must be sealed to the drywall if smoke test is utilized for compliance — applies to duct leakage compliance option 3 (lealcage reduction by 600/6) and option 4 (fix all accessible leaks) described above. 9 Now duct installations cannot utilize building cavities as plenums or platform returns in lieu of ducts. ® Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to seal leaks at all new duct connections DECLARATION STATEMENT • I certify under penalty of penury, under the laws of the State of California, the Information provided ori this form Is true and correct, • I am the certified HERS rater who performed the verification s■,vices Identified and reported an thio certificate (responsible rater). e 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 Compllalice (CF -111) approved by the local eliforcement agency, • The Information reported on applicable sections of the Installation Cartlflcate(s) (CF -611), signed and cubmittad by the parcon(c) 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 Concraccor or Dullder/owner) DESERT AIR CONDITIONING INC Responsible Person's Name: CSL8 License: ]acqualina Zabik 270,350 HERS Provider Date Registry Information Sample Group # (If applicable): 259935 Q tesbed/verified dwelling ❑ not-tested/verlfled dwelling In la HERS sample group HERS Rater Information CalCERTS Certificate # CCi-1798600518 HERS Rater Company Name: Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Walter W Nellis Walter W Nellis Responclble Rater',. Cartlficatlon Number w/ We HERS Provider: Data Signed: 10/20/2011 CC2004351 P.18 Reg: 211-A0054077A-M2100001A-M21A Regigtration Date/Time: 2011/11/04 13:30:09 HERE Provider: CalCERTS, Inc. 2008 Residential Compliance Form& Match 2010 Air Solutions 7603603277 :ERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-2E ilefrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5; Site Address: Enforcement Agency: Permit Number: 79-565 Centrino Dr i of 2, La Quints CA 92253 City of La Quints 11-1153 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 14ECH-25 Certificate) should be used to demonstrate compliance with the refrlgerent charge verlRcation requirement. TMAH end STMS are not required for compliance, when a CID Is utilised 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 adaidonal systems In rhe dwelling as appllcaDle. 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 Alr Handler System Name or Idenoflcatlon/Tag System 1 of 2 Systam Location or Area Served Living area i ® Yea ❑ No 5/16 Inch (8 min) access hale upstream of evaporative call In the return plenum and labeled according to Figure in Section RA3,2,2,2,2, 2 0 Yes ❑ No 5/16 inch (6 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 © Pass I V ❑ Fail STMS - Sensor on the Evaporator Coil system Name or Identlflcatloni'Tag System 1 of 2 The sensor Is factory Installed, or field Installed according to manufacturer's 3 ❑ 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 4 ❑ Yes ❑ No digital thermometer. The sensor mini plug Is accessible to the Inswiling technician and the HERS rater without changing the airflow through the condenser coil 5 [3Yes ❑ No When attached to a digital thermometer, the sensor provides an IndIGOtIgn of the saturation temperature of the coil. Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not V p N/A ✓ ❑ Pass ✓ ❑ Fall applicable. Otherwise enter Pass or Fall STMS - Sensor on the Condenser Coil system Name or Identlflcatlon/Tap I System 1 of 2 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 ONO digital thermometer. The sensor mini plug Is accessible to the Installing technician and the HERS rater without changing the airflow through the condenser coil 6 ❑ 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 6 is a pass. Enter N/A if STMS are not ✓ D N/A ❑Pass ✓ ❑Fall applicable. Otherwise enter Pass or Fall P.19 Reg: 211-A0054077A-M2500001A-M25A Registration Date/Time: 2011/11/04 13:33:53 HERS Provider: Ca10ERT6, Inc. 2008 Residential Compliance Forma March 2010 Air Solutions 7603603277 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of S) Site Address: Enforcement Agency: Permit Number: 79-565 Centrino Dr' 1 of 2, La Quints CA•92253 City of La Quinta 11-1153 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 550F) 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. 9 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. a If outdoor air dry-bulb is 55"F or below, the installer must use the Alternate Charge Measurement Procedure. Saace Conditioning Svstem■ System Name or Identiflcatlon/Tag System 1 of 2 (must be re-callbrated monthly) Date of Thermocouple Calibration 10/20/11 System Location or Area Served Living erne Outdoor Unit Serial # 3411E12895 Outdoor Unit Make CARRIER Outdoor Unit Model 24ABC64SAO031010 Nominal Cooling Capacity Btu/hr 46000 Date of Verification 10/20/11 eanbrntton ar oisanosiie instruments date of Refrigerant Gauge Calibration 10/20/11 (must be re-callbrated monthly) Date of Thermocouple Calibration 10/20/11 (must be re -calibrated monthly) Measured Temberatures {"r i System Name or Identiflcatlon/Tag System 1 of 2 Supply (evaporator leaving) air dry-bulb 59 temperature (Tsupply, db) Return (evaporator entering) air dry-bulb e4 temperature (Treturn, db) Return (evaporator entering) air wet -bulb 63 temperature (Treturn, Wb) Evaporator saturation temperature 46 (Tevaporator, sat) Condensor saturation temperature 114 (Tconaensor, sat) Suction line temperature (Tsuction) 62 Liquid Line Temperature (Tliquid) 104 Condenser (entering) air dry-bulb 95 temperature (Tcondonoor, db) p.20 Reg: 211-A0054077A-M2500001A-M25A Registration Date/Time: 2011/11/04 13:33:53 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance FOLM9 March 2010 Air Solutions 7603603277 INSTALLATION CERTIFICATE CF-4R-MECN-25 Refrigerant Charge Verification - Stand ard'Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: - 79-565 Centlino Dr 1 of 2, La Quinta CA 92253 City of La Quinta 111-1153 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verlflcatlon. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identiflcatlon/Tag System 1 of 2 Calculate: Actual Temperature Split = Treturn, 25.00 db - Tsupply, db Target Tomporaturo Split from Table RA3.2-3 23 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 -40F and PASS -100OF Enter Pass or Faill Note; Temperature Split Method Calculation is not necessary If actual Cooling Coll 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. Colculated Minimum Alrflow Requirement (CFM) Nominal Cooling Copaclty. (ton) X 300 (ofm/ton) System Name or Identlflcatlon/Tag Calculated Minimum Alrflow Requirement (CFM) Meacured AlrfIQw ucing QA3.3 procedures (CFM) Passes If measured alrflcw Is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Idehdflcatlon/Tag Calculate: Actual Superheat = Tsuctlon - 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 +60F Enter Paso or Fall p.21 Reg: 211-A0054077A-M2500001A-M25A Registration Date/Time: 2011/11/04 13:33:53 HERS Provider: CalCERT6, Inc. 2008 Regidential Compliance FOLM9 I March 2010 Air Solutions 7603603277 p.22 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Pane 4 of 5) Site Address:Enforcement Agency: Permit Number., 79-565 Centrino Dr 1 of 2, La Quinta CA 92253 City of La Quinta 11-1153 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 Identiflcatlon/Tag System 1 of 2 Calculate: Actual Subcooling = 10.0 Tcondenser, sat - Tllquld Target Subcooling speclfled by manufacturer 10 Calculate difference: 0 ' Actual Subcooling - Target Subcooling = System passes If difference Is between -4°F and +40F PASS ' Enter Pass or Fall PASS 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 Identlflcatlon/Tag System 1 of 2 Calculate: Actual Superheat = 16.0 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 16 between 3°F and 26OF If manufa<turer'c specification is not available) System passes If actual superheat Is within the allowable superheat range PASS enter Pass or dal Reg: 211-A0054077A-M2500001A-M25A Registration Date/Time: 2011/11/04 13:33:53 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 Air Solutions 7603603277 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Pane 5 of 5) Site Address: Enforcement Agency: Permit Number: 79-565 Centiino Dr 1 of 2, La Quinta CA 92253 City of La Quinta 11-1153 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling toll 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 Identiflcatlon/Tag System 1 of 2 12763BG HERS Provider Data Registry Information Sample Group # (If applicable): 250936 Systam mootc all rafrlgcrant charge and airflow ❑ not-tested/verified dwelling In a. HERS sample group requirements. PASS Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fall Walter W Nellis Responslble Rater's Certlflcatlon Number w/ this HERS Provider: Date Signed: 10/20/2011 CC2004361 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 an 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 Certlfitate(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 persoh(s) responsible for the Installation conforms to the requirements specified on the Certificate(s) of compliance (CF -111) approved by the enforcement aaencv, Builder or Installer information an shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Bullder/Owner) DESERT AIR CONDITIONING INC Responsible Person's Name: CSLB License: 3acqu4iline 2abik 12763BG HERS Provider Data Registry Information Sample Group # (If applicable): 250936 0 tesbed/verified dwelling ❑ not-tested/verified dwelling In a. HERS sample group HERS Rater Information CaICERTS Certificate St CC1-1798600318 HERS Rater Company Name: Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Walter W Nellls Walter W Nellis Responslble Rater's Certlflcatlon Number w/ this HERS Provider: Date Signed: 10/20/2011 CC2004361 u p.23 Reg: 211-A0054077A-M2500001A-M25A Registration Date/Time: 2011/11/04 13:33:53 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance FOMS I March 2010 Air Solutions 7603603277 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test – Existing Duct System (Page 1 of 2) Site Addramm: 79-565 Cetrino 2 of 2, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 11-1153 Enter the Duct System Name or Identification/Tag: Enter the Duct System Location or Area Served: Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following foul• choices. 1. Measured leakage less than 150/6 of fan now 2. Measured leakage to outside less than 10% of Fan Flow 3. Reduce leakage by 60% and conduct smoke and fix all leaks 4. Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options 1, 2, or 3 must be attempted before utilizing Option 4,) Oetermine nominal Fan Flaw using one of the following three calculation methods. ✓ ❑ Coalln0 system method: Size of condenser In Tons —x 400 = —CFM ✓ ❑ Heating system method: 21.7 x _Output Capacity in Thousands of Btu/hr = _CFM ✓ ❑ Measured cyatam alrflow ucing RA3,3 alrflow tact procadurec: _ CFM Option 1 used then: 1 Allowed leakage = Fan Flow_x 0.15 = _CFM Actual Leakage = CFM Pass If Leakage Actual is lass than Allowed rl Pass rj Pall Option Z used then: 2 Allowed leakage = Fan Flow _ x 0.10 = _ CFM Actual Leakage to outside = _ CFM Pass If Leakage Actual Is lass than Allowed rj Pass 0 Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final loakago aftor coaling all accocclbla loako uoing omoko tact - _CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction % CFM ((Leakage reduction _/ Initial leakage x 100% = a/o Reduction Paso If RVb Roductlon a GO% Paco El 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 rl Pass rl call p.24 Reg: 211-A0054078A-M2100001A-M21A Registration Date/Time: 2011/11/04 13:30:10 FERE Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forma March 2010 Air Solutions 7603603277 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: 79-565 Cetlino 2 of 2, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 11-1153 EI 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. C] All supply and return register boots must be sealed to the drywall if smoke test is utilized for compliance — applies to duct leakage compliance option 3 (lealcage reduction by 600%) and option 4 (fix all accessible leaks) described above. EI New duct installations cannot utilize building cavities as plenums or platform returns in lieu of ducts. ID 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 pel:alty of pejury, under the laws of the State of California, the Information provided on this form Is true alld correct, I am the eertin.d HERs rater who performed the verifleatlan cervices 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 Cel'tlfleate(s) of Compliance (CF -111) approved by the local enforcement agency, The Information reported on applicable sections of the Installation Cartlfleate(e) (CF -SR), signed and submitted by the percon(c) responsible for the Installation conforms to the requirements specified on the Certlflcate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (1nsralling Subcontractor or General Contractor or CUIICIer/Owner) DESERT AIR CONDITIONING INC. Responsible Person's Name: CSLB License: , ]acqualin■ zabik 1270350 HERS Provider Data Registry Information Sample Group # (If applicable): 239936 ❑ tesbed/verified dwelling 0 not-tested/verlfled dwelling In a HERS somple group HERS Rater Information CeICERTS Certificate # CCi-1798600319 HERS Rater Company Name: Alr Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Walter W Nelllm Walter W Nellis Rosponclble Rater'c Cortlficatlon Number w/ thlo HERS Provider: Data Slgriad: 10/20/2011 CC2004351 p,25 Reg: 211-A0054078A-M2100001A-M21A Regifitration Date/Time: 2011/11/04 13:30:10 FERE Provider Ca10ERTS, Inc. 2008 Residential Compliance Forma March 2010 Air Solutions 7603603277 :ERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-2" Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5, Site Address: Enforcement Agency: Permit Number: 79-565 Cetrino 2 of 2, La Quinta CA 92253 City of La Quinta 11-1153 Note: If installation of a Charge Indicator Display (CID) Is utilized as an alternative to refrigerant charge verlAcatlon for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the reMoerent charge ver1f7eatlon requirement. TMAH and SIMS are not required for compllonce, when a CID Is udlized 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 adaaiclonal systems In rhe dwelling as appliCOPIe. 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 Identiflcatlon/Tag Syatam Location or Araa Served 1 ❑ Yes ❑ No 5/16 Inch (8 min) access hole upstream of evaporative toll In the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 ❑ YQc ❑ No 5/16 inch (6 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Flgure In Sectlon RA3.2.2.2.2. Yes to 1 and 2 is a pass. Enter Pass or Faill V ❑ Pass V ❑ Fail STMS - Sensor on the Evaporator Coil System Name or IdentIflcatlon/Tap The cantor Ic factory Installed, or field Inctalled according to rnanufa4:wrer'c 3 ❑ 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 4 ❑ Yes ❑ No digital thermometer. The sellsor minl plug Is accessible to the Installing technician and the HERS rater without changing the airflow through the condenser coil S ❑ Yes ❑ No When attached to a dlgltal 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 ✓ El Pass ✓ ❑Fall applicable. Otherwlse enter Pass or Fall STMS - Sensor on the Condenser Coil System Name or Idendflcatlon/Tap Tho cantor Ic factory Inctallod, or flold Installed according to manufacturor'c 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 dlgltal thermometer. The sensor mini plug Is accesslble to the Installing technician and the HERS rater without changing the airflow through the condenser coil e ❑ Yes ❑ No When attached to a dlgltal thermometer, the sensor provides an Indlcatlon of the saturation temperature of the coil. Yes to 6, 7, and 6 is a pass. Enter N/A if STMS are not 0 N/A ✓ ❑ Pass ✓ ❑ Fall applicable. Otherwlse enter Pass or Fall p.26 Reg: 211-A0054078A-M2500001A-M25A Registration Date/Time: 2011/11/04 13:33:54 FERE Provider: Ca10ERTE, Inc. 2008 Residential Compliance FoLma March 2010 Air Solutions 7603603277 INSTALLATION CERTIFICATE CF-4R-MECH-25 ammammas Refrigerant Charae Verification - Standard. Measurement Procedure (Pane 5 of 5) Site Address: =Enforcement Agenc711-1153 Permit Number: 79-565 Cetdno 2 of 2, La Quinta CA 92253 of La Quints Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling toll airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all. applicable verification criteria must be re -measured end/or recalculated. System Name or,Idendflcatlon/Tag 3acqualine Zabik 1276585 HERS Provider Data Registry Information Sample Group # (If applicable): 259936 System moots all refrigerant charge and airflow 0 not-tested/verlfled dwelling In a HERS sample group requirements. HERS Rater Company Name: Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's. Signature: Enter Pass or Fell Walter W Nellis Responsible Rater's Certlflcatlon Number w/ this HERS Provider Date Signed: 10/20/2011 CC2004361 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 an this certificate (the Installation) complies with the applicable requirements In Reference Residential Appendices RA2 and RA3 and the requirements specified on the Cartlflcate(s) of Campllance (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 -IR) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installlno Subcontractor or. General Contractor or Bullder/Owner) DESERT AIR CONDITIONING INC Responsible Person's Name: CSLB License: 3acqualine Zabik 1276585 HERS Provider Data Registry Information Sample Group # (If applicable): 259936 JE] tested/verified dwelling 0 not-tested/verlfled dwelling In a HERS sample group HERS Rater Information CeICERTS Certificate # CC1-1798600319 HERS Rater Company Name: Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's. Signature: Walter W Nellls Walter W Nellis Responsible Rater's Certlflcatlon Number w/ this HERS Provider Date Signed: 10/20/2011 CC2004361 p.27 Reg: 211-A0054078A-M2500001A-M25A Registration Date/Time: 2011/11/04 13:33:54 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forma , March 2010