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11-1348 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:11=0000-1348'"''1 Property Address: 79885— IGA� APN: 772 -230 -040 - Application description: MECHANICAL Tih . -4 t ' 4 Qf�G1GV - ' BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 25000 Applicant: Architect or Engineer: Iv ` LICENSED CONTRACTOR'S DECLARATION - I hereby affirm under penalty of perjury that Iicerised under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busine an fessionals Code, and my License is in full force and effect. icen Class 20 License No.: 438781 ntractor: 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 ($500)•: 1—) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(S) licensed pursuant to the Contractors' State License Law.). (_) 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 UrCI 2 12 Owner: I 1J KIRK BLACKERBY� 79885 LIGA LA. QUINTA, CA 92253 Contractor: COOL FLO INC 79469 COUNTRY CLUB DR, #H BERMUDA DUNES, CA 92203 (760)345-6606 Lic. No.: 438781 VOICE (760) 777-7012. (760)777-7011 "I TS (760) 777-7153 12/21/.11 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. V, I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier NORGUARD INS Policy Number COWC239005 _ I certify that, in the perform of the work for which this permit is issued, I shall not employ any person in any mann o to become subject to the workers' compensation laws of California, and agree that, ' sh d b come subject to the workers' compensation provisions of Section 3700 of the La all forthwith comply with those rovisions. !/ Applicant: WARNING: FA URE 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, indemnity 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 applica ' becomes null and void if work is not commenced within 180 days from date of issuan f such permit, or cessation of work for 180 days will subject permit to cancellation. I certifypat I hav read this application and at�,,.tl�eiabi:conisnformation is correct. I agree to comply with all citya unty o finances and state laws re ng truction, and hereby authorize representatives of I my to/mer upon a above -menti for inspection purposes. te: !/ 'nature (Applicant r Agent): . LQPERMIT Application Number . . . . . 11-00001348 Permit MECHANICAL Additional desc . Permit Fee 91.50 Plan Check Fee 16.50 Issue Date Valuation 0 Expiration Date 6/18/12 Qty Unit -Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE -OUT REPLACE 3 SYSTEMS - FURNACES, CONDENSERS, INDOOR COILS. 2010 CODES. -----------------_-_-------------------------------------------------------- Other Fees BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due ----------------- ---------- ------------------------------ Permit Fee Total 91.50_ .00 .00 91..50 Plan Check Total .16.50 .00 .00 16.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 109.00 .00 00 109.00 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAIterations CF -IR -ALT -HVAC:] Climate "Zones Site4ddress- Enforcement Agency: Date: Permit Equipment Type List Minimum Efficiency' Conditioned Floor Area Thermostat Li Packaged Unit Furnace AFUE Q COP ndoor Coil ondensing Unit RCC EERj� EER o Served by system 0 I ISPF _ Q Resistance sf 1xSetback (lfnot alrenrh, present. must be installed) ther I. Equipment Type: Choose the equipment being installed if more than one system use another CF -I R -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 three 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 fornms (no hand filled CF-4Rs allowed) are tilled out and signed. Beginning October 1, 2010, a registered copy of the CF -1 R and CF -6R shall also be on site for final inspection. 1. HVAC Changeout Required Forms: • All HVAC Equipment. CF -6R forms: MECH-04. MECH- 25 -HERS replaced CF -4R forms: MECH-25 • Condenser Coil and /or • Indoor Coil and /or CF -6R forms: MECH- 25 -HERS • Furnace CF -4R fornms: ML=CH-25 For Split Systems: RC, CCA > 300 CFM/ton, TMAH For Packaged Units: No testing required 0 2. New HVAC System Required Forms: • Cut in or Changeout with CIT -6R Iomms: MECH-04. MECH- 25 -HERS new ducts: (all new ducting CF -4R forms: MECI-1-25 and all new equipment) For Split Systems: RC, CCA > 300 CFM/ton, TMAH. For Packaged Units: No testing required 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all new CF -6R fornms: MECH-25-HERS ducting and/or outdoor condensing unit CF -4R forms: MECH-25 and/or indoor coil and/or furnace. Not all e ui ment changed. For Split Systems: RC, CCA > 300 CFM/ton, TMA H For Packaged Units: No testing required Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I 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 ol'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 I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the infonmation documented on other applicable compliance fornms, worksheets, calculations. plans and specifications submitted to theenforcementagency for approval with the permita lie tion. Name: to Signatur }�UINIDI Col >Cy0� �� Dale: ' ^.. � Addr/{J License: $'"W`2 City"/State/Zip: Phone: 2008 Residential Compliance Forms A4arch 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF -IR -ALT -HVAC Climate Zones 8 Site 4ddr�ss; EnjorcenrentAge�rch: Dile: Permit #: EquipmentType' List Minimum Efficiency'- Conditioned Floor Area Therniostat Packaged Unit Furnace A F U ndoor CoilEE NaA ondensing Unit ER COP Q I1SPF S rve y system MResistance sf i etback Ifna ah-eadv present. must be insialledj Other L Equipment Type: 0ioose the equipment being installed if more than one system use another CF -I R-AL'f-HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER. 78%AFUE. 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are three 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 tilled out and signed. Beginning October 1, 2010, a registered copy of the CF -1 R and CF -6R shall also be on site for final inspection. HVAC Changeout Required Forms: • All HVAC Equipment CF -6R forts: MECH-04. MECH- 25 -HERS replaced CF -4R fomu: MECH-25 • Condenser Coil and /or • Indoor Coil and/or CF-6Rfonns: MECH-25-HERS CF -4R fornu: MECH-25 • Furnace For Split Systems: RC, CCA > 300 CFM/ton, TMAH For Packaged Units: No testing required 2. New HVAC System Required Forms: • Cut in or Changeout with CF -6R forms: MECH-04, MECH- 25 -HERS new ducts: (all new ducting CF -4R forms: MECH-25 and all new ec ui ment) For Split Systems: RC, CCA > 300 CFM/ton, TMAH. For Packaged Units: No testing required 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all new CF -6R fornis: MECH-25-HERS ducting and/or outdoor condensing unit CF -4R forms: MECH-25 and/or indoor coil and/or furnace. Not all e ui ment changed. For Split Systems: RC, CCA > 300 CFM/ton, TMAH For Packaged Units: No testing required Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • 1 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. • 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 I 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 fornis, worksheets, calculations. plans and specifications submitted to the enforcement agency for approval with the permit applicition. Name: Signature: ryy Col y� 66L.- r' � Date: w w — Add�r/ License:4 S City/State/Zip:fftlm—Phone: 2008 Resiclemial Compliance Forms Alareh 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlter(itions CF -IR -ALT -HVAC Climate Zones Si ,4rtdre Enforcement Agencp: Date: Permit #: Equipment Ty e' List Minimum Efficiency' Conditioned Floor Area Thermostat Li Packaged Unit Furnace 2AFUU091 Indoor Coil EER ondensing Unit EER 0 COP Served by system OIISPF j Q Resistance 1 sf Setback (/fna alreaclrpresenr. nurcl be installed) Other 1. Equipment Type: Choose the equipment being installed if more than one system use another CF- I R -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 three 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 verities that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are tilled out and signed. Beginning October 1, 2010, a registered copy of the CF -1 R and CF -61R shall also be on site for final inspection. 1. HVAC Changeout Required Forms: • All HVAC Equipment CF -6R forms: MECH-04. MECH- 25 -HERS replaced CF -4R forms: MECH-25 • Condenser Coil and/or • Indoor Coil and /or CF -6R forms: MECH- 25 -HERS • Furnace CF -4R forms: MECH-25 For Split Systems: RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: No testing required E12. New HVAC System Required Forms: • Cut in or Changeout with CF -6R I'orns: MECH-04. MECH- 25 -HERS new ducts: (all new ducting CF -4R fon-ns: MECH-25 and all new ec ui ment) For Split Systems: RC, CCA >_ 300 CFM/ton, TMAH. For Packaged Units: No testing required 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all neev CF -6R forms: MECH-25-HERS ducting and/or outdoor condensing unit CF -4R forns: MECH-25 and/or indoor coil and/or furnace. Not all equipment changed. For Split Systems: RC, CCA > 300 CFM/ton, TMAH For Packaged Units: No testing required Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • 1 certify that this Certificate ol'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 I 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 foams. worksheets, calculations. plans and specifications sub n •ttcd to the enforcement agency for approval with the ` m ciit app tic tion. Name:UIN1011 E-1014p3lLik! 1W Signature: A,-,) ConCbno- /� � Date: w w Addr i License: J+310 City/State/Zip:Phone: O - 2008 Residential Compliance f'ornis !larch 2010 .... , Bin #. ... .,, .. ... City of La Quinto Building 8t Safety Division. P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 ' Building Permit Application and Tracking Sheet ':: = Permit # �� Project Address: 5 LI Owner's Name: Address: A. P. Number: Legal Description: .9tY, ST, Zip: Contractor:t.A;,.4.: coo/___ Tele one: r >;M s; Address:o7 Project Description: City, ST, Zip: 14 Telephone:: Qo vs r� r: ; s ?''7 State Lic. # City Lic. #; Arch., Engr., Designer: Address: City, ST, Zip: telephone:L J } �.y x:�:«'>:: ~.>< "•.<4: syr: " ction TY Pe: Occupancy:Constru State Lic. #: Project type (circle one): New Add'n[e Repair Demo Name of Contact Person: %,(i � Sq. FG; # Stories: I # Units. 3 Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE N Submittal Plan Sets Req'd Rec'd TRACMG Plan Check submitted PERMIT FEES Item Amount Structural Calcs. Reviewed, ready for corrections Ptao Check Deposit Truss Calcs: Called Contact Person Plan Check Balance Tide 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan X" Review, ready for correctionsAnue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for torrectionsPissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees ;ERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-2! tefrigerant Charge Verification - Standard Measurement Procedure (Page 1 of S' Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 City of La Quinta 11-1348 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 Suoolv and Return Plenums of Air Handler System Name or Identification/Tag isystem 1 of 3 System Location or Area Served Living area The sensor is factory installed, or}field installed according to manufacturer's 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 V 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 ✓ ✓ Pass ✓ Fail STMS - Sensor.on,the Evaporator Coil System Name'or Identification/Tag f System,1 of 3 ?. ! r s The sensor is factory installed, or field installed according to manufacturer's The sensor is factory installed, or}field installed according to manufacturer's 3 Yes No specifications, or is installe"d by methods/specifications approved by the Executive Director. Director. f f \ f The sensor wire is terminated with a standard mini plug suitable for connection to a 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:insfalling..techniciah ��. and the HERS rater without changing the airflow through the condenser coil and the HERS rater without changing the airflow through the condenser coil 5 Yes No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. 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 of 3 The sensor is factory installed, or field installed according to manufacturer's 6 Yes No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 Yes No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 Yes No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ N/A ✓ Pass ✓ Fail applicable. Otherwise enter Pass or Fail Reg: 211-A0066893A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:43:04 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 :ERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-2! 2efrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5' Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 1 City of La Quinta 11-1348 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 System Name or Identification/Tag System 1 of 3 (must be re -calibrated monthly) Date of The mocouple;Calibration 11/30/11 ., j ),e System Location or Area Served Living area Outdoor Unit Serial # E114010557 -* ` Outdoor Unit Make Day & Night Outdoor Unit Model ICXA660GKA Nominal Cooling Capacity Btu/hr 60000 Date of Verification 12/23/11 w-anoration or uiagnostic instruments Date of Refrigerant Gauge Calibration 11/30/11 (must be re -calibrated monthly) Date of The mocouple;Calibration 11/30/11 ., j ),e (must belre calibrated monthly) 1•ICObUI CU 1 CIII{JCI (Jlu1 Cb V. -r) J : f 1 - J [ % I " "I V System Name or Identififi cation/Tag/ � System 1 of 3 Supply (evaporator leaving) -air dry-bulb` 42.8 -* ` temperature (Tt supply, db) Return (evaporator entering) air dry-bulb 65.4 temperature (T return, db) Return (evaporator entering) air wet -bulb 48 temperature (Treturn, wb)• Evaporator saturation temperature 36 (Tevaporator, sat) Condensor saturation temperature 81 (Tcondensor, sat) Suction line temperature (Tsuction) 52.6 Liquid Line Temperature (Tliquid) 73.1 Condenser (entering) air dry-bulb 74 temperature (Tcondenser, db) Reg: 211.-A0066893A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:43:04 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 1 City of La Quinta 11-1348 Minimum Airflow Reauirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 of 3 Calculate: Actual Temperature Split = Treturn, 22.60 db - Tsupply, db Target Temperature Split from Table RA3.2-3 20.9 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - 1.7 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 Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name e o Identification/Tag f" Calculated Minimum Airfl w Requirement (CFM) j .i . C, Measured,Airflow; s ng ' RA3.3elvr p± ocedu es (CFM)4 r'�l '< / �'' i 't / J•; t• Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -6°F and +6°F ' Enter Pass or Fail Reg: 211-A0066893A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:43:04 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5] Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 City of La Quinta 11-1348 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 of 3 Calculate: Actual Subcooling = 7.9 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 9 Calculate difference: -1.1 Actual Subcooling - Target Subcooling = System passes if difference is between -4°F and +4°F PASS Enter Pass or Fail Y PASS L 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 of 3 Calculate: Actual Superheat = 16.6 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 16.6 between 3°F and 26°F if manufacturer's specification is not,available) System passes°if actual superheat is'within°the allowable superheat rangef ,= Y PASS L .,,r -Enter Pass or Fail Reg: 211-A0066893A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:43:04 2008 Residential Compliance Forms HERS Provider: CalCERTS, Inc. March 2010 INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 City of La Quinta 11-1348 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 of 3 1438781 HERS Provider Data Registry Information Sample Group # (if applicable): N/A System meets all refrigerant charge and airflow not-tested/verified dwelling in la HERS sample group requirements. PASS Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail Walter W Nellis Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 12/23/2011 CC2004361 r e � 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 -IR) approved by the enforcement aaencv. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) COOL-FLO INC Responsible Person's Name: CSLB License: MICHAEL MANGAN 1438781 HERS Provider Data Registry Information Sample Group # (if applicable): N/A tested/verified dwelling not-tested/verified dwelling in la HERS sample group HERS Rater Information Ca10ERTS Certificate # CC1-1798617599 HERS Rater Company Name: Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Walter W Nellis Walter W Nellis Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 12/23/2011 CC2004361 Reg: 211-A0066893A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:43:04 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 Y� \ CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 27 Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 (System 1) City of La Quinta 11-1348 Enter the Duct System Name or Identification/Tag: System 1 of 3 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 Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diaanostic 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 ,i 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 cFan, Flow using one of the,following-three calculation •methods.----. , ✓ V cool i ng system method: Size of condenser in Tons )S ' x 400 = 2000 \CFM system r ✓ Heating method 21.7 xi Output Capacity in Thousands of Bt Jhr = CFM �. _ ✓ /airflk Measured system using RA3.3 airflow,test,procedures: CFM Option 1 used then: is ,,1 ._ s 1 Allowed leakage = Fan Flow • 2000 x 0.15 300 1 CFM Actual Leakage = 1209 CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then: 2 Allowed leakage = Fan Flow 2000 x 0.10 = 200 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 after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _ / Initial leakage_) x 100% _ % Reduction Pass if % Reduction > 60% Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No smoke allowed to leak from system. Including ducts, plenums, air handler and door panel. Pass if all accessible leaks have been repaired using smoke Pass Fail Reg: 211-A0066893A-M2100001A-M21A Registration Date/Time: 2011/12/24 03:40:20 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 (System 1) City of La Quinta 11-1348 v 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. V All supply and°return register boots must °be -sealed -to{the drywall;if-smoke,test:isrutilized°for-compliance - applies}tb,duct leakage compliance4option 3`(leakage reduction by 60%)'"and'optioris4i(fix all accessible leaks) described ab6ve.' v New duct installationof utilize building cavitie as plenums or platform returns in lieu of ducts:,e-% V Mastic andAraw bands,must'be,used in'combination:with,doth backed rubber adhesive duct tape toseal �O 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. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) COOL-FLO INC Responsible Person's Name: CSLB License: MICHAEL MANGAN 1438781 HERS Provider Data Registry Information Sample Group # (if applicable): N/A tested/verified dwelling la not-tested/verified dwelling in HERS sample group HERS Rater Information CalCERTS Certificate # CCl-1798617599 HERS Rater Company Name: Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Walter W Nellis Walter W Nellis Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 12/23/2011 CC2004361 Reg: 211-A0066893A-M2100001A-M21A Registration Date/Time: 2011/12/24 03:40:20 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE* CF-6R-MECH-25-HER9 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency:711-1348 Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 City of La Quinta 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 Supplv and Return Plenums of Air Handler System Name or Identification/Tag System 1 of 3 -3 System Location or Area Served Living room sensor is factory installed, or field installed according to manufacturer's specifications, or is'installed by methods`/specifications approved by the Executive Director. I V. ] I N \� - 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 Fail ✓ -/ Pass ✓ Fail STMS - Sensor_on,the Evaporator Coil System Name -or Identification/Tagg / yr System 1 of 3 -3 ` rThe Yes No ..` sensor is factory installed, or field installed according to manufacturer's specifications, or is'installed by methods`/specifications approved by the Executive Director. I V. ] I N \� - 4 \ Yesd �No I! Thg,sensor wire is terminated. with a standard mini plug suitable for connection to digital thermometer. The 'sensor mini plug is accessible to,the insealling;technician and the HERS rater without changing the airflow through the condenser coil` 5 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 ,i N/A ✓ Pass ✓ Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag I System 1 of 3 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 7- VN/A ✓ Pass ✓ Fail applicable. Otherwise enter Pass or Fail Im Ra Reg: 211-A0066893A-M2500001A-0000 Registration Date/Time: 2011/12/24 02:50:21 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 .NSTALLATION CERTIFICATE CF-6R-MECH-25-HER! tefrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5 Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 1 City of La Quinta 11-1348 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 Conditioninq Svstems System Name or Identification/Tag System 1 of 3 (must be re -calibrated monthly) Date of T rmocouple Calibration { 11/30/11 �, System Location or Area Served Living room Outdoor Unit Serial # E114010557 Outdoor Unit Make Day & Night Outdoor Unit Model ICXA660GKA Nominal Cooling Capacity Btu/hr 60000 Date of Verification 12/23/11 ov�waua. 11�J a1 YIIIGIIaJ Date of Refrigerant Gauge Calibration 11/30/11 (must be re -calibrated monthly) Date of T rmocouple Calibration { 11/30/11 �, must be red -calibrated monthly) 42'8 M� System Name or Identification/Tag, System ,1 of 3 Supply (evaporator leaving),air dry-bulb 42'8 M� temperature (T supply, db) Return (evaporator entering) air dry-bulb 65.4 temperature (Treturn, db) ' Return (evaporator entering) air wet -bulb 48 temperature (Treturn, wb) Evaporator saturation temperature 36 (Tevaporator, sat) Condensor saturation temperature 81 (Tcondensor, sat) Suction line temperature (Tsuction) 52.6 Liquid Line Temperature (Tliquid) 73.1 Condenser (entering) air dry-bulb 74 temperature (Tcondenser, db) Reg: 211-A0066893A-M2500001A-0000 Registration Date/Time: 2011/12/24 02:50:21 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 1 City of La Quinta 11-1348 Minimum Airflow Reauirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 of 3 Calculate: Actual Temperature Split = Treturn, 22.60 db - Tsupply, db Target Temperature Split from Table RA3.2-3 20.9 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - 1.7 Target Temperature Split = Passes if difference is between -3°F and +3°F or, upon remeasurement, if between -3°F and PASS -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System ameyor,Identification/Tag 'System 1 of 3 } W Calculated Minimum Airflow Requirement (CFM)! I .0 .i / i . ti is ►'fi r Measured=Airflow,us 9 eRAA`3.3 procedures (CFM) Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. - Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag System 1 of 3 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail R Reg: 211-A0066893A-M2500001A-0000 Registration Date/Time: 2011/12/24 02:50:21 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HER9 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 1 City of La Quinta 11-1348 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 of 3 Calculate: Actual Subcooling = 7.9 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 9 Calculate difference: -1.1 Actual Subcooling - Target Subcooling = System passes if difference is between -3°F and +3°F PASS Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 of 3 Calculate: Actual Superheat = 16.6 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 16.6 between 4°F and 25°F if manufacturer's specification is not available) System passet,if actual superheat is,,Within,the" allowable superheat ,j PASS range.( Pass ,,,.,Enter Reg: 211-A0066893A-M2500001A-0000 Registration Date/Time: 2011/12/24 02:50:21 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 City of La Quinta 11-1348 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 of 3 CSLB License: 438781 Date Signed: 12/23/2011 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 DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) COOL-FLO INC Responsible Person's Name: Responsible Person's Signature: MICHAEL MANGAN MICHAEL MANGAN CSLB License: 438781 Date Signed: 12/23/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? Yes No Reg: 211-A0066893A-M2500001A-0000 Registration Date/Time: 2011/12/24 02:50:21 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 (System 1) City of La Quinta 11-1348 Enter the Duct System Name or Identification/Tag: System 1OF 3 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 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 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 nom inal.Fan,Flow using one of the,follow_ ing,three,calculation.methods. �. ✓ V Cooling system method: Size of conde ser in Tons 5 x 400•=') 2660,'\CFM ✓ Head g system method": 2,1.7 � Output Capacity in-Thousan s of Btu/hr = _ CFM 5 x ✓ Measured system1 irflow using RA3.3'-airflow,�test,procedu es: CFM Option-lused then: •„ k $••,,,.�' ~ . r �r• 1 Allowed leakage= Fan Airflow ''°2000 x0.15 — -300 CFM Actual Leakage = 1209 CFM f Pass if Actual Leakage is less than Allowed leakage Pass Fail Option 2 used then: 2 Allowed leakage = Fan Airflow 2000 x 0.10 = 200 CFM Actual Leakage to outside = _ CFM Pass if Actual leakage to outside is less than Allowed leakage Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction CFM _ ((Leakage reduction _ / Initial leakage _) x 100% _ % Reduction Pass if % Reduction > 600/6 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 v Pass Fail Reg: 211-A0066893A-M2100001A-0000 Registration Date/Time: 2011/12/24 02:18:04 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 1 of 3 , La Quinta CA 92253 (System 1) 1 City of La Quinta 11-1348 v Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. All supply and return register boots must,be,sealed.to,the drywall;if�smoke,,testlis4utilized,for-compliance — applies to�duct leakage compliance option 3'(lealeage reduction by 60%)'-andlolitiolij4 (fix al accessible leaks) described above. f ,• v New duct; installations cannot`utilize"building cavities as plenums or platform returns in lieu of ducts. , V Mastic and.dra.w bands must .be Used,in=combination.,with cloth. backed.rubber,adhesive,duct tape to seal; p + 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. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) COOL-FLO INC Responsible Person's Name: Responsible Person's Signature: MICHAEL MANGAN MICHAEL MANGAN CSLB License: 438781 Date Signed: 12/23/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? Yes No Reg: 211-A0066893A-M2100001A-0000 Registration Date/Time: 2011/12/24 02:18:04 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 'ERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-2E tefrigerant Charge Verification - Standard Measurement Procedure (Page 1 of S; Site Address: Enforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 1 City of La Quinta 11-1348 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/TagSystem 2 of 3 - System Location or Area Served bedrooms 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 No5/16 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 ✓ ✓ Pass ✓ Fail STMS - Sensor onrthe. Evaporator Coil System Norrie or Identification/Tag System 2 of 3 "! f ( I If 3 Yes No.1 The sensor is factory installed, orifield installed according to manufacturer's specifications, or is installed by methods/specifications approved by the Executive Director. 4 \1"Y es *�' �: N o� The sensor wire is terminated with a standard mini plug suitable for.connection.to a+ ` 'V digital thermometer. The sensor -mini plug is accessible to the installingtecfinieiaii t-� and'the HERS rater without changing the airflow through the condenser coil 5 Yes, - No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail ✓ N/A ✓ Pass ✓ Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag I System 2 of 3 The sensor is factory installed, or field installed according to manufacturer's 6 Yes No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 Yes No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 Yes No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ ✓ N/A ✓ Pass ✓ Fail applicable. Otherwise enter Pass or Fail Reg: 211-A0066894A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:48:56 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 A CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 55 Site Address: Enforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 1 City of La Quinta 11-1348 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 System Name or Identification/Tag System 2 of 3 must be re -calibrated monthly) Date of hermocouplejCalibratiiion j r ' r e ,. ' "' 11/30/11 System Location or Area Served bedrooms Outdoor Unit Serial # E11805902 Outdoor Unit Make Day & Night Outdoor Unit Model ICXA648GKA Nominal Cooling Capacity Btu/hr 48000 Date of Verification 12/23/11 L 011uI ODUII U1 YIOUIIu..ILII LII`.ILI UIIICIIL9 Date of Refrigerant Gauge Calibration 11/30/11 j must be re -calibrated monthly) Date of hermocouplejCalibratiiion j r ' r e ,. ' "' 11/30/11 f 1 1/ C 1 f must be`re�-calibrated monthly) ! VICOJUI CU 1 C111{JC1 OLU1 C.b' J`�- r'J J' f- i ■ a J r C 1 N X. System Name or Identificafion/Tagg System 2 of 3 Supply (evaporator leaving)'air dry-bulb" .� 49"� temperature (Tsupply, db) #I Return (evaporator entering) air dry-bulb 70 temperature (Treturn db) j Return (evaporator entering) air wet -bulb 50 temperature (Treturn, wb) I Evaporator saturation temperature 34 (Tevaporator, sat) Condensor saturation temperature 76 (Tcondensor, sat) Suction line temperature (Tsuction) 49.0 Liquid Line Temperature (Tliquid) 70.9 Condenser (entering) air dry-bulb 74 temperature (Tcondenser, db) Reg: 211-A0066894A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:48:56 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 r INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 1 City of La Quinta 11-1348 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 2 of 3 Calculate: Actual Temperature Split = Treturn, 21.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3 20.9 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - 0.1 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 Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) ---------- ......... ._— System Name or Identification/Ta Calculated Minimum Airflow Requirement (CFM) Measured*Airflow°usii gSRA3.3 procedures (CFM) Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. J Enter Pass or Fail U 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 i Reg: 211-A0066894A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:48:56 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms I March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-2! tefrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5' Site Address: Enforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 City of La Quinta 11-1348 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 2 of 3 Calculate: Actual Subcooling = 5.1 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 8 Calculate difference: -2.9 Actual Subcooling - Target Subcooling = System passes if difference is between -4°F and +4°F PASS Enter Pass or Fail PASS Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (,'-:XV) systems. System Name or Identification/Tag System 2 of 3 Calculate: Actual Superheat = 15.0 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 15 between 3°F and 26°F if manufacturer's specification is not available) System passes if actual superheat is within -the allowable, Superheat range ` PASS i ,~ Enter Pass or Fail / + Reg: 211-A0066894A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:48:56 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 1 City of La Quinta 11-1348 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 2 of 3 438781 HERS Provider Data Registry Information Sample Group # (if applicable): N/A System meets all refrigerant charge and airflow not-tested/verified dwelling in la HERS sample group requirements. PASS Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail Walter W Nellis Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 12/23/2011 CC2004361 i 1 ' 4 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 -111) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) COOL-FLO INC Responsible Person's Name: CSLB License: MICHAEL MANGAN 438781 HERS Provider Data Registry Information Sample Group # (if applicable): N/A tested/verified dwelling not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CCS -1798617600 HERS Rater Company Name: Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Walter W Nellis Walter W Nellis Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 12/23/2011 CC2004361 Reg: 211-A0066894A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:48:56 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 (System 1) 1 City of La Quinta 11-1348 Enter the Duct System Name or Identification/Tag: System 2 OF 3 Enter the Duct System Location or Area Served: Bedrooms 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 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 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. ✓ V system Tons )4 � Cooling method: Size condenser in xAdO = 1600 CFM oo�if Heating system methodj' 21 7 x _ Output Capacity in Thousands of Btu/hr = CFM ✓ Measured system airflow using RA3.3'airflow,test, procedures: CFM ;` j Option 1 -used then: , n, 1 Allowed leakage = Fan Flow 1600 x 0.15 = 240 CFM— FM Actual Actual Leakage = 767 CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then: ' 2 Allowed leakage = Fan Flow 4600 x 0.10 = 160 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 z 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 , r � Pass if a/o Reduction > 60% 1 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: 211-A0066894A-M2100001A-M21A Registration Date/Time: 2011/12/24 03:45:18 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 1 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 (System 1) 1 City of La Quinta 11-1348 V 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. v All supply and return register boots must,be,sealed-to=the drywall If-smoke,test�,is, utilized 'for -compliance — applies,to,duct leakage complianceroption 3 (leakage reduction by60%)land'optioi f4'(fix all accessible leaks) described above. v New duct installations cannot utilize building cavities as plenums or platform returns. in lieu of ducts. v Mastic andidraw"bands.. must be, used, in'combination:with cloth backed -rubber adhesive, duct tape..to seal_S'a leaks at all new duct connections 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. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) COOL-FLO INC Responsible Person's Name: CSLB License: MICHAEL MANGAN 1438781 HERS Provider Data Registry Information Sample Group # (if applicable): N/A tested/verified dwelling not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798617600 HERS Rater Company Name: Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Walter W Nellis Walter W Nellis Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 12/23/2011 CC2004361 Reg: 211-A0066894A-M2100001A-M21A Registration Date/Time: 2011/12/24 03:45:18 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 � f INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 (System 1) 1 City of La Quinta 11-1348 Enter the Duct System Name or Identification/Tag:'System;2'of_3 Enter the Duct System Location or Area Served: Bedrooms 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 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 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 Fa , Flow using one of thle,following,three calculation methods. � Cooling�ystem ethod: Size of Cond ser in Tons X14 r, -x--40'0,= 1600 --% CFM ' ✓ ..' Heating system method: 21 7 x Output Capaci y in...TThousan s of Bt /hr = _ CFM � t � 81. ✓ r� Measured s stem airflow using' RA3.3�airflow,test procedurrSes: CFM Y 9 P l t Option`l used then:' T ,a ':�,�.• ..-%- ,, i +c'_, fi �: =Fan I-1600 * 1 Allowed leakage Airflow x 0.15 = - 246-' CFM .. - Actual Leakage = 767 CFM i Pass if Actual Leakage is less than Allowed leakage Pass Fail Option 2 used then: 2 Allowed leakage = Fan Airflow 1600 x 0.10 = 160 CFM Actual Leakage to outside = CFM Pass if Actual leakage to outside is less than Allowed leakage Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction CFM ((Leakage reduction _ / Initial leakage _) x 100% _ % Reduction Pass if % Reduction > 60% Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke Pass Fail 11 Reg: 211-A0066894A-M2100001A-0000 Registration Date/Time: 2011/12/24 02:53:28 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 (System 1) 1 City of La Quinta 11-1348 V 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. I V All supply and -return register boots mustibe,sealed-to,the h,—drywall_.if.smoke test.i:s.,utilizedafor compliance - applies to`duct leakage compliance option 3'(leakage,reduction b' %o),andfoption(4 (fix all,accessible leaks) described above., ' New duct installatio�ns, cannot.utilize building cavities as plenums or platform returns in lieu of ducts. Q v Mastic 'and.dra:w bands must be used ,inrcombination with cloth, backed, rubberradhesive.duct tape to seal, r leaks at all new duct connections T` 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. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -SR) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) COOL-FLO INC Responsible Person's Name: Responsible Person's Signature: MICHAEL MANGAN MICHAEL MANGAN CSLB License: 438781 Date. Signed: 12/23/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? Yes No Reg: 211-A0066894A-M2100001A-0000 Registration Date/Time: 2011/12/24 02:53:28 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 I INSTALLATION CERTIFICATE* CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 City of La Quinta 11-1348 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 SuoDly and Return Plenums of Air Handler System Name or Identification/Tag System 2 of 3 System Location or Area Served Bedrooms 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 Fail ✓ ✓ Pass ✓ Fail s STMS - Sensor on,.the EvaDorator Coil System Name;dr Identification/Tag"j / fV I System,2 of 3 If 1 r. A, tIje 3 Yes,No if 1 x The sensor is factory -installed, or,field installed according to manufacturer's specifications, or islinstallei by methods/specifications approved by the Executive Director. 4 Yes f f f. No C" 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 L ~ and the HERS rater without changing the airflow through the condenser coil` 5 1 Yes INo IThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3, 4,•and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or. Fail ,/ ✓ N/A ✓ Pass ✓ Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag I System 2 of 3 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 The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not N/A ✓ Pass ✓ Fail applicable. Otherwise enter Pass or Fail Reg: 211-A0066894A-M2500001A-0000 Registration Date/Time: 2011/12/24 02:57:27 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HER9 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 53 Site Address: Enforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 1 City of La Quinta 11-1348 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 Conditionina Svstems System Name or Identification/Tag System 2 of 3 (must be re -calibrated monthly) Date of Thermocouple, Calibration77 11/30/11 System Location or Area Served Bedrooms t 4 Outdoor Unit Serial # E11805902 Outdoor Unit Make Day & Night Outdoor Unit Model ICXA648GKA Nominal Cooling Capacity Btu/hr 48000 Date of Verification 12/23/11 a.a1101auon or v1agno51L1c anscrumenzs Date of Refrigerant Gauge Calibration 11/30/11 (must be re -calibrated monthly) Date of Thermocouple, Calibration77 11/30/11 (must be re -calibrated monthly) t 4 measures aemperaiuresq, r) 1,( q 1 __�j f I k ,� J% System Name or Identification/Tag, System 2 of 3� Supply (evaporator.leavin air dry-bulb 49 temperature (Tsupply, db) Return (evaporator entering) air dry-bulb 70 temperature (Treturn, db) Return (evaporator entering) air wet -bulb 50 temperature (Treturn, wb) Evaporator saturation temperature 34 (Tevaporator, sat) Condensor saturation temperature 76 (Tcondensor, sat) Suction line temperature (Tsuction) 49.0 Liquid Line Temperature (Tliquid) 70.9 Condenser (entering) air dry-bulb 74.0 temperature (T condenser, db) IM, tJ Reg: 211-A0066894A-M2500001A-0000 Registration Date/Time: 2011/12/24 02:57:27 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HER9 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 City of La Quinta 11-1348 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 2 of 3 Calculate: Actual Temperature Split = Treturn, 21.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3 20.9 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - 0.1 Target Temperature Split = Passes if difference is between -3°F and +3°F or, upon remeasurement, if between -3°F and PASS -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Nameor 'r Identification/Tag y 1 Sy/sterm 2 of 3 \ 11P � ii ] ` Calculated Minimum Airflow Requirement (CFM) Measured Airflooww,,using RA3.3 procedures (CFM)114 Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement.'-. Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag System 2 of 3 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail * 0 Reg: 211-A0066894A-M2500001A-0000 Registration Date/Time: 2011/12/24 02:57:27 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HER9 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency:Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 1 City of La Quinta 11-1348 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 2 of 3 Calculate: Actual Subcooling = 5.1 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 8 Calculate difference: -2.9 Actual Subcooling - Target Subcooling = System passes if difference is between -3°F and +3°F PASS G Enter Pass or Fail � f �, Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 2 of 3 Calculate: Actual Superheat = 15.0 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 15 between 4°F and 25°F if manufacturer's specification is not available) System passes -if -actual superheat is�within the.- allowable superheat range J{ F, y T --v 1� PASS w' G j ,,�.�Enter Pass or Fail � f �, P Reg: 211-A0066894A-M2500001A-0000 Registration Date/Time: 2011/12/24 02:57:27 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: IEnforcement Agency: Permit Number: 79-885 Liga 2 of 3, La Quinta CA 92253 1 City of La Quinta 11-1348 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 2 of 3 CSLB License: 438781 Date Signed: 12/23/2011 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 DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) COOL-FLO INC Responsible Person's Name: Responsible Person's Signature: MICHAEL MANGAN MICHAEL MANGAN CSLB License: 438781 Date Signed: 12/23/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? Yes No e Reg: 211-A0066894A-M2500001A-0000 Registration Date/Time: 2011/12/24 02:57:27 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE* CF-6R-MECH-25-HERS tefrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5; Site Address: Enforcement Agency: Permit Number: 79-885 Liga 3 of 3, La Quinta CA 92253 City of La Quinta 11-1348 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 Suooly and Return Plenumc of Air ManrllPr System Name or Identification/Tag ,System 3 of 3.e / .es`j System 3 of 3"1,1' el I r 3 System Location or Area Served - Casitas The sensor is factory installed, or�field installed according to manufacturer's specifications, or is4inst6llea by methods/specifications approved by the Executive No 1 V 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 Pass ✓ Fail STMS - Sensor on.the Evaoorator Coil, _. System Name.or Identification/Tag) / .es`j System 3 of 3"1,1' el I r 3 Yes -A The sensor is factory installed, or�field installed according to manufacturer's specifications, or is4inst6llea by methods/specifications approved by the Executive No specifications, or is installed by methods/specifications approved by the Executive Director. V a. �. �' r , The sensor wire is terminated, with a standard mini plug suitable for connection to 4 Yes a No digital thermometer. The sensor mini plug is. accessible to the installin technician -, No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the co'ndens'ercoil 5 Yes No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3, 4;,and 5 is a`pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or; Fail ,/ ✓ N/A ✓ Pass ✓ Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag I System 3 of 3 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 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ N/A ✓ Pass ✓ Fail applicable. Otherwise enter Pass or Fail Reg: 211-A0066895A-M2500001A-0000 Registration Date/Time: 2011/12/24 03:05:48 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 3 of 3, La Quinta CA 92253 City of La Quinta 11-1348 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 Conditionina Svstems System Name or Identification/Tag System 3 of 3 (must be re -calibrated monthly) Date of Thermocou Ie,Calibration `` rv 11 /30/11 System Location or Area Served Casitas r- f -t �. Outdoor Unit Serial # E113310643 Outdoor Unit Make Day & night Outdoor Unit Model ICXA636GKA Nominal Cooling Capacity Btu/hr 36000 Date of Verification 1 12/23/11 Date of Refrigerant Gauge Calibration 11/30/11 (must be re -calibrated monthly) Date of Thermocou Ie,Calibration `` rv 11 /30/11 (must be re -calibrated monthly) 'Y r- f -t Y. cY • Gn �YG� aLY1 �.O'bs r i .� � a r ....-e a .r,�^- • a �,.. x. System Name or Identification%Tagg System 3 of 3� / Supply (evaporator leaving) ;air dry-bulb= temperature (T supply, db) f 46 --* r- TMF .,�" �. Return (evaporator entering) air dry-bulb 69 temperature (Treturn, db) ' Return (evaporator entering) air wet -bulb 48 temperature (Treturn, wb) Evaporator saturation temperature 40 (Tevaporator, sat) Condensor saturation temperature 85 (Tcondensor, sat) Suction line temperature (Tsuction) 53.3 Liquid Line Temperature (Tliquid) 76 Condenser (entering) air dry-bulb 74 temperature (Tcondenser, db) Reg: 211-A0066895A-M2500001A-0000 Registration Date/Time: 2011/12/24 03:05:48 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 3 of 3, La Quinta CA 92253 1 City of La Quinta 11-1348 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 3 of 3 Calculate: Actual Temperature Split = Treturn, 23.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3 20.9 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - 2.1 Target Temperature Split = Passes if difference is between -3°F and +3°F or, upon remeasurement, if between -3°F and PASS -100OF Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name or Identification/Tager '�' 1 System 3 of 3 Calculated Minimum AirflowRequieement (CFM) Measured Airflow using RA3.3 procedur'es (CFM) - Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag System 3 of 3 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail Reg: 211-A0066895A-M2500001A-0000 Registration Date/Time: 2011/12/24 03:05:48 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5; Site Address: Enforcement Agency: Permit Number: 79-885 Liga 3 of 3, La Quinta CA 92253 City of La Quinta 11-1348 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 3 of 3 Calculate: Actual Subcooling = g.0 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 10 Calculate difference: -1 Actual Subcooling - Target Subcooling = System passes if difference is between -3°F and +3°F PASS 4,r Y 4 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 3 of 3 Calculate: Actual Superheat = 13.3 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 13.3 between 4°F and 25°F if manufacturer's specification is not available) System passes if"ectual'superheat is-withinathe allowable superheat range 1.o"" //1PASS 4,r Y 4 Enter Pass or Fail• Reg: 211-A0066895A-M2500001A-0000 Registration Date/Time: 2011/12/24 03:05:48 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 3 of 3, La Quinta CA 92253 City of La Quinta 11-1348 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 3 of 3 CSLB License: 438781 Date Signed: 12/23/2011 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 CC DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) COOL-FLO INC Responsible Person's Name: Responsible Person's Signature: MICHAEL MANGAN MICHAEL MANGAN CSLB License: 438781 Date Signed: 12/23/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality PF Name of TPQCP (if applicable): Control Program (TPQCP)? Yes No Reg: 211-A0066895A-M2500001A-0000 Registration Date/Time: 2011/12/24 03:05:48 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 3 of 3, La Quinta CA 92253 (System 1) 1 City of La Quinta 11-1348 Enter the Duct System Name or Identification/Tag: System 3 Of 3 Enter the Duct System Location or Area Served: casitas 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 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 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 n�in.ahFFan Flow using one -of the following three calculation,methods. Cooling system method: Size o`f.condenser in Tons 3. -x 400 = % 1260'\ CF ✓ Heating system method'iIT1.7 x Output Capacity in Thousands of.Btu/hr = _CFM ` Measured system airflow usingRA3.3'airflow�lest:procedures: CFM ._ — +,.�zr Option mused then: F,, ,, ,,,.• �° .. `.. r Allowed —= Airflow 1 leakage Fan -/`1200 x 0.15 —180 CFM' Actual Leakage = 174 CFM I Pass if Actual Leakage is less than Allowed leakage v Pass Fail Option 2 used then: ! 2 Allowed leakage = Fan Airflowx 0.10 = _ CFM Actual Leakage to outside = ; CFM I 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% _ %o Reduction Pass if a/o Reduction > 600/a Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke Pass Fail .6 Reg: 211-A0066895A-M2100001A-0000 Registration Date/Time: 2011/12/24 03:02:35 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 3 of 3, La Quinta CA 92253 (System 1) 1 City of La Quinta 11-1348 V 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. I V All supply�andxr._eturn register boots mustibe,sealed.to.the drywall�if smoke test}istutilizedxfor compliance —applies to dlSct leakage compliance option 3' leakage reduction by 60%).randfoptionf`4 (fix alllaccessible leaks described above. t New duct installations ca n of utilize building cavitie as plenums r latform returns in.lieu``of ducts v Mastic and,dra_w bands must°be used �in,�combination-With cloth backed rubber, adhesive AOct tape.to seal �!p 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. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features; materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildinas. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) COOL-FLO INC Responsible Person's Name: Responsible Person's Signature: MICHAEL MANGAN MICHAEL MANGAN CSLB License: 438781 Date Signed: 12/23/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? Yes No Reg: 211-A0066895A-M2100001A-0000 Registration Date/Time: 2011/12/24 03:02:35 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 fy f 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: 79-885 Liga 3 of 3, La Quinta CA 92253 1 City of La Quinta 11-1348 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 3 of 3 System Location or Area Served Casitia 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 ✓ ✓ Pass ✓ Fail STMS = Sensor on-Ahe Evaooratoi Coil System Narhelor Identification/Tag�jj ! �'� System 3 of 3'11' f '14 � r The sensor is factory installed, or field installed according to manufacturer's The sensor is factory installed, or field installed according to manufacturer's 3 Yes No • specifications, or is'instalfi d by methods/specifications approved by the Executive f ) Director. f :' . `' The sensor wire is terminated with a standard mini plug suitable for connection;to a ' 4 Yes N oil digital the' 64ter.'The sensor -mini plug is accessible to`the ins[alling:technician�,;, and the HERS rater without changing the airflow through the condenser coil and the HERS rater without changing the airflow through the condenser coil 5 Yes -- No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. 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 I System 3 of 3 The sensor is factory installed, or field installed according to manufacturer's 6 Yes No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 Yes No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 Yes No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ ✓ N/A ✓ Pass ✓ Fail applicable. Otherwise enter Pass or Fail Reg: 211-A0066895A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:53:16 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms 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: 79-885 Liga 3 of 3, La Quinta CA 92253 City of La Quinta 11-1348 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 Conditionina Svstems System Name or Identification/Tag System 3 of 3 (must be re -calibrated monthly) Date of e m couple /Calibration / #r F ~` 11/30/11 System Location or Area Served Casitia •� Outdoor Unit Serial # E113310643 Outdoor Unit Make Day & Night Outdoor Unit Model ICXA636GKA Nominal Cooling Capacity Btu/hr 36000 Date of Verification ) 12/23/11 Date of Refrigerant Gauge Calibration _. 11/30/11 (must be re -calibrated monthly) Date of e m couple /Calibration / #r F ~` 11/30/11 ki a r. e' - r (must b'recalibrated monthly) 48 •� System Name or Identificat on/Tagg System 3 of Supply (evaporator leaving)-air:dry-bulb- 48 temperature (Tsupply, db) I . Return (evaporator entering) air dry-bulb 69 temperature (Treturn, db) } Return (evaporator entering) air wet -bulb 4s temperature (Treturn, wb) I Evaporator saturation temperature 40 (Tevaporator, sat) Condensor saturation temperature 85 (Tcondensor, sat) Suction line temperature (Tsuction) 53.3 Liquid Line Temperature (Tliquid) 76 Condenser (entering) air dry-bulb 74 temperature (Tcondenser, db) 0 Reg: 211-A0066895A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:53:16 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 I; r INSTALLATION CERTIFICATE CF-4R-MECH-2E Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of S' Site Address: I Enforcement Agency: Permit Number: 79-885 Liga 3 of 3, La Quinta CA 92253 City of La Quinta 11-1348 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 3 of 3 Calculate: Actual Temperature Split = Treturn, 21.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3 20.9 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - 0.1 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 Fail Note: Temperature Split Method Calculation is not necessary if actuai 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 1# f .•_ Calculated Minimum Airflow .Requirement (CFM) Measured"Airflow _using RA3 3 procedures (CFM)4 Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement_ Enter Pass or Fail I Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -6°F and +6°F Enter Pass or Fail Reg: 211-A006689SA-M2500001A-M25A Registration Date/Time: 2011/12/24 03:53:16 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 3 of 3, La Quinta CA 92253 City of La Quinta 11-1348 1 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 3 of 3 Calculate: Actual Subcooling = g.0 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 10 Calculate difference: -1 Actual Subcooling - Target Subcooling = System passes if difference is between -4°F and +4°F PASS Enter Pass or Fail " Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 3 of 3 Calculate: Actual Superheat = 13.3 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 13.3 between 3°F and 26°F if manufacturer's specification is not available) _ System passesfif actual superheat is`within'the allowable superheat superheat ra"nge � � + ] PASS ,Enter Pass or Fail " -72 Reg: 211-A006689SA-M2500001A-M25A Registration Date/Time: 2011/12/24 03:53:16 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency:Permit Number: 79-885 Liga 3 of 3, La Quinta CA 92253 City of La Quinta 11-1348 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 3 of 3 1438781 HERS Provider Data Registry Information Sample Group # (if applicable): N/A System meets all refrigerant charge and airflow not-tested/verified dwelling in la HERS sample group requirements. PASS Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail Walter W Nellis Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 12/23/2011 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 on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement aaencv. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) COOL-FLO INC Responsible Person's Name: CSLB License: MICHAEL MANGAN 1438781 HERS Provider Data Registry Information Sample Group # (if applicable): N/A Fteted/,erifi'ed dwelling not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CCI -1798617601 HERS Rater Company Name: Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Walter W Nellis Walter W Nellis Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 12/23/2011 CC2004361 0 Reg: 211-A0066895A-M2500001A-M25A Registration Date/Time: 2011/12/24 03:53:16 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4111-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 3 of 3, La Quinta CA 92253 (System 1) 1 City of La Quinta 11-1348 Enter the Duct System Name or Identification/Tag: System 3 of 3 Enter the Duct System Location or Area Served: Casitia 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 - existina duct system Select one compliance method from the following four choices. 1. Measured leakage less than 15% of fan flow 2. Measured leakage to outside less than 10% of Fan Flow 3. Reduce leakage by 60% and conduct smoke and fix all leaks l 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 cFa rn Flow using one of the followingrthree;:calculation•methods. ✓ ✓ Cooling system method: Size of ondenin Tons �3 ""x'4:0= 1 NCFM ser 0 1200 ✓ Heating system method"'`21.7'x Output Capacity in -Thousands of a u%hr= _CFM E. ✓ `— N AW Measured system/air2 using RA3.3 airflowJtestfprocedures: _ CFM — ,s • then: k_- t-- '.;, 1 10ption'l-used Allowed leakage = Fan Flow 1200 • x 0.15 = 180.. CFM Actual Leakage = 174 CFM j Pass if Leakage Actual is less than Allowed v Pass 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 Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _ / Initial leakage _) x 100% _ % Reduction Pass if % Reduction > 600/a 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: 211-A0066895A-M2100001A-M21A Registration Date/Time: 2011/12/24 03:50:48 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 c+. CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 79-885 Liga 3 of 3, La Quinta CA 92253 (System 1) [City of La Quinta 11-1348 V 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. V All supply and return register boots mustibe-sealed-to7the drywall if�smokeitest;islutilized-for-compliance - applies}to duct leakage compliance option 3 (leakage reduction by 60%) end optYon_(4 (fix all accessible leaks) described above. V New duct installations cannot'utllize building cavltles as plenums or platform returnsin lieu'of ducts^ V Mastic and.draw`bands,must be;use "In.combination=with."cloth backed�rubber-adhesiveiduct*tape,to seal —L;00 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. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) COOL-FLO INC Responsible Person's Name: CSLB License: MICHAEL MANGAN 1438781 HERS Provider Data Registry Information Sample Group # (if applicable): N/A Ftested/Terified dwelling not-tested/verified dwelling in la HERS sample group HERS Rater Information Ca10ERTS Certificate # CC1-1798617601 HERS Rater Company Name: Air Solutions of the Desert Responsible Rater's Name: Responsible Rater's Signature: Walter W Nellis Walter W Nellis Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 12/23/2011 CC2004361 Reg: 211-A0066895A-M2100001A-M21A Registration Date/Time: 2011/12/24 03:50:48 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010