08-1650 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 4v Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 77777011
INSPECTIONS (760) 777-7153
Date: 10/01/08
Application Number: 0"8-0000.1.650— Owner:
Property Address: 52404 AVENIDA RUBIO ESMERALDA NELDA
APN: 773-253-026-16 -000000- 52404 AVENIDA RUBIO
Application description: MECHANICAL LA QUINTA, CA 92253
kIFINAWIC
Property Zoning: COVE RESIDENTIAL
Application valuation: 10000
OPT c 1 "aos
Contractor:
Applicant: Architect or Engineer: PELL AIR & HEATING, INC.
1495 W. 9TH STREET OFLA QUINTA
DEPT.
UPLAND, CA 91786
.1/ (866)646-8499
(�( Lic. No.: 848196
------------------------------------------------------------------------------------------------'—
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that Iam licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C20 (� A LicenseNo.: 848196
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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 1$500).:
1 _ 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 _ 1 1, -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: Pt ft
LQPERMIT
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
.I7C I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of thework for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier END INS Policy Number WEN00032403
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Codg,4.1911 forthwithSGrnp"th those provisions.
WARNING: FAILURE TO SE RKE 5 PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYE CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
certify that I have read this application and state that the above informs ' n is correct. I agree to comply with all
city and county ordinances and state laws relating to building con , and hereby authorize representatives
of this county to enter upon the above-mentioned property nsp n purgpsae.,
Application Number . . . . . 08-00001650
.--4
Permit MECHANICAL
Additional desc . .
Permit Fee . . . . 51.00
Plan Check Fee
12.75
Issue Date . . . .
Valuation
0
Expiration Date 3/30/09
Qty Unit Charge Per
Extension
BASE
FEE
15.00
2.00 9.0000 EA MECH
FURNACE <=100K
18.00
2.00 9.0000 EA MECH
B/C <=3HP/100K BTU
18.00
----------------------------------------------------------------------------
Special Notes and Comments
CHANGE OUT EXISTING SYSTEM, ADDING 5 TON
15 SEER 80% AFUE, AND 3 TON 15 SEER 80%
AFUE
Fee summary Charged
-----------------
Paid Credited
Due
--------------------
Permit Fee Total 51.00
--------------------
.00 .00
51.00
Plan Check Total 12.75
.00 .00
12.75
Grand Total 63.75
.00 .00
63.75
LQPERMIT
Bin #
City of La 'Quinta
Building & 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: 5zW)Y
L,
Owner's Name: e
l
A.' P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
� �� t
Telephone:
;�'�' '�.� SEEN "
- a "
Address: O'
Z�.
, Project'Descrip[ion:
City, ST, Zip:
Telephone: _6
State Lic. # : City Lic. #:
Arch., Engr., Designer:
�?if� ��✓�8-0,% , �u-t
U'
.Address:
City, ST, Zip:
Telephone:
ConstructioA Type: Occupancy:
State Lic. #:
Project type (circle one): New lAdd'n Alter Repair Demo
Name of Contact Person: 56p, .•r j�
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOWTHISLINE
# Submittal Req'd Ree'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called ContactTmon
Plan Check.Balance
Energy Calcs.
Plans picked.up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2od Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked'up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading .
IN HOUSE:-
'`J Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
a
Called Contact'Person
A.I,P;P.
Pub. Wks. Appr
Date of permit issue
School Fees
1
Total Permit Fees
CERTIFICATE OF COMPLIANCE: RESIDENTIAL
&&Ak0..(8Q I d�
Project Title
zY UPPi idn : PA -t. is
Project Address �j�
Documentation Author
1 of 4) M -IR
Date
Building Permir#
Plan Check / Date
Field Check/ Date
Compliance Method (Prescriptive) Climate Zone Enforcement Agency Use Only
✓ O Alternative Component Package. Method: (check one) � C D D (Alternative)
Package C and Package D choices require HERS rater,field verification and/or diagnostic testing (see CF -I R page 3)
For Package D Alternative see Appendix B Table 151=C Footnotes 7-.14
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) ft2 . Average Ceiling Height: ft
Maximum Allowed West Facing Fenestration Products Per Table 151-13 or 151-C --,- (5% X CFA) W
Maximum Allowed Total Fenestration Products Per Table 151=6 or 151-C ---- (20% X CFA) ft
✓
Ea -,Building Type: (check one or more) z- Single Family Multifamily Addition Alteration
(If adding, fenestration fill out WS=411, Fenestration Maximum.Allowed Area Worksheet and see Section 8.3.2
for Additions and' 8.3.3 for Alterations.)
Number of Stories: I Number of Dwelling ,Units:
Floor Construction Type: Slab/Raised Floor (circle one or both)
Front Orientation: North / South./ East / West /.All Orientations (input front orientation in degrees from True
North and circle one).
✓ ❑ RADIANT BARRIER (required in climate'iones.2, 4, 8-15)
OPAQUE SURFACES INCLUDING OPAQUE. DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge,
Doors)
Frame
Type
(Wood
or Metal)
Assembly U -
factor (for.
Cavity Continuous wood; metal
Insulation lnsulation frame and mass'
R -Value R' -Value ` assemblies) '
Joint
Appendix.
IV
Reference
Roof Radiant
-Barrier Location/Comments
Installed (attic, garage,
Yes or No typical, etc.
1) See Joint Appendix IV -,in, Section- IV.2; IV.3 and IVA, which is the basis for the U -factor criterion. U -factors can not .
exceed prescriptive value to show equivalence to R -value's.
Residential. Compliance Forms
March 2005
A
CERTIFICATE OF COMPLIANCE: RESIDENTIAL. (Page 2 of 4) CF -1R
Project Title Date
FENESTRATION PRODUCTS— U -FACTOR AND SHGC
✓ ❑ FENESTRATION MAXIMUM ALLOWED AREA WORKSHEET WS411 —must be included for New Construction,
Additions and Alterations.
Fenestration
Duct Location Duct Thermostat Configuration
R -Value lit or. e
#1Type/Pos.
(Front, Left, Orien- -
Eicterior
Shading/Overhangs6,'
Rear, Right, talion, Area U -factor
Skylight) N S, E, Wi ft U -factor? Source;
SHGC ✓ box if WS -3R is
SHGC4
Sources included -
❑
'a
El
1) SkAiQhk are nnw inrl,vin.i :., W—+ f-- c . ,,...... �_
❑
-..y l,v,- air. -Lou to uie west or uitea in any airection
when the pitch is less than 1:12. See § 151(f)3C and in Section 3.23 of the Residential Manual
2) Enter values in this column. are either NFRC Rated value or from Standards default Table 116A.
3) Indicate source either from NFRC or Table I I6A,
4) Enter values in this column from NFRC or from Standards Default Table 116B or adjusted SHGC from WS -31L
5) Indicate source either from NFRC or Table 116B.
6) Shading Devices are.defined in Table 3-3 in'the Residential Manual and.see WS -3R to calculate Exterior Shading devices.
7) See Section 3.2.4 in the Residential Manual.
HVAC SYSTEMS
He=Capacity
Minimum Distri ution
TyEfficiency Type and Location Duct or Piping Thermostat ConfiDatira6on
fiunaoeAME or HSP , du attic, etc.) R -Value Tvne I __
2
Cooling Equipment Minimum
Type and Capacity Efficiency
A/C heat pump, eva . cool in SEER or EER(attic,etc..
Duct Location Duct Thermostat Configuration
R -Value lit or. e
Residential Compliance Forms March 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -1R
Project Ti
Date
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -4R Form must be provided to the building department for each home for which the following. are
req uired.
OR
0 Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
.No
For additions and alterations, duct systems that are not docurnented to have been previously
❑ sealed as confirmed through. field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WATER HEATING SYSTEMS
Distribution
Type
Number
in System
Sealed Ducts (all climate zones) (Installer testing and certification and HERS rater field verification required.)
❑
TXVs, readily accessible (climate zones 2 and 8-15 only)
installer testing and certification. and HERS Rater field verification required.)
❑
Refrigerant Charge (climate zones 2 and.8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
OR
0 Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
.No
For additions and alterations, duct systems that are not docurnented to have been previously
❑ sealed as confirmed through. field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WATER HEATING SYSTEMS
Systems serving single dwelling units
Water Heater
Type/Fuel Type
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
❑
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Standby'.
Loss %)
not allowed.
❑
Check box when using Preapproved Alternative Water.Heating table, Table 5-4 in Chapter 5 in the Residential
Manual. No water heating calculations are required, and the system complies automatically.
Check box if systern does not meet criteria of "Standard" system, and does not comply with the Preapproved
❑
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
❑
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
Systems serving single dwelling units
Water Heater
Type/Fuel Type
Distribution
Type
Number
in System
Rated .
Input'
(kW or
Btu/hr)
Tank
Capacity
(gallons)
Energy
Factor' or'
Thermal
Efficienc
Standby'.
Loss %)
Tank
External
Insulation
R -Value
System serving multiple d elling units
Water Heater
Type.
Distribution
T . e
Number
in System
Rated
Input'
(kW or
Btu/hr(gallons)
Tank
Capacity
Energy
Factor' or
Thermal
Efficiency
Standby
Loss %
Tank
External
Insulation
R -Value
1. For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
Pipe Insulation (kitchen lines > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are 3/a
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2 B.
Residential Compliance Forms March 2005
i
CERTIFICATE OF COMPLIANCE:
Protect Title .
ENTIAL (Page 4 of
�o
Date
n
CF -1R
SPECIAL FEATURES NOT REQUIRING ITERS VERIFICATION (add extra sheets if neve.
Indicate which special features are part of this project. The list below only represents special features relevant to
Drescrintive methm
SPECIAL FEATURES REQUIRING HERS RATER VERIFICATION-----------
(add extra sheets if necessarx) Indicate to the HERS Rater which credits are part of this project and need
verification..
Feature Required Forms. da livable • Descri tion
0 Duct Seah CF -6R part 4 of 12
❑ Refrigerant Charge CF -6R part 5 of 12
Thermostatic Expansion -
Valve CF -=61Z pad 6 of 12
'Residential Compliance. Forms
March 2005
Feature
Re uired lena livable Desch tion
O
Metal Framed Walls
CF -IR
❑
RadiantBarriers
CF -IR
❑
Exterior Shades
WS -4R
❑
Cool Roof
r.
N/A; Attach CRRC Label to
Forms.
❑
Dedicated Hydropic Heating
stem
Combined Hydronic System
Performance Calculation
R uired• Attzch Run to Forms.
Performance Calculation.
R uired .Attach Run to Fomrs.
IF
O
Gas Cooling
Performance Calculation
SPECIAL FEATURES REQUIRING HERS RATER VERIFICATION-----------
(add extra sheets if necessarx) Indicate to the HERS Rater which credits are part of this project and need
verification..
Feature Required Forms. da livable • Descri tion
0 Duct Seah CF -6R part 4 of 12
❑ Refrigerant Charge CF -6R part 5 of 12
Thermostatic Expansion -
Valve CF -=61Z pad 6 of 12
'Residential Compliance. Forms
March 2005
V
50
to1!bIlatimn rPr4if r -A P_
Preserintive Method -HVAC-only Alteration CF -6R -ALT
Pr4ct Title:
Date:
® 2005 CaICERTS
Effmcemert Use
(. d Address:
Climate Zone:
s
tuns Perms r
Oil& -1 �
n's Iling Contractor. ,.
Telephone: - I&b ":
Pmn check nam
pany Name:
Field Check Date
IMPORTA
Use one fom
This CF -6 :form-isonly for us&when an HVAC -on alteration is made to an existing home
i for eadi.system being altered. This: is system aT of i" systems altered In this house.
copies to: Homeowner. HERS Rater, and BWdft Department - L
List thecations
Installed
forthe newly installer equipment Thesesh6st match the"installed:equipment exactly.
. ui o mint must match tvWlocBflon and meat or exceed efficiencies/R-values from CF -1R.
i Equipment -Type
Manufacturer Model Number Efficie Load— Ca ad "-
Furnace
AFUE
s Heat Exchanger
NIA
I I leatPump fan cod
NIA
[Hydrunic fan coil
NIA
Other FAU
wribe
i Package gas/AC
i
.
AFUE "
SEER -
ackage heatpump
HSPF
SEER .
EER*
AIC Condenser
SEER
atpump Condenser
HSPF
SEER
Indoor DX coil
EER'
Hydronic coo
rovide EER if needed # r•complianee Qine 24. of CFA R ALT). Installer must provide adequate documentation to verity EER.
i In some cases spedfic furnace may need to be.verified in order to'a"chieve a specific EER.
I In some cases .time delay 'relay and/or TXV may need;to ve verified in order to achieve a specific EER.
oads are sensibie for _ offing.
Ca 'aciti are sensib 'at design conditions for cooling and adjusted altitude downflow; etc outjiut for hea '
j Ii TXV Is requlr Eby the CF -1 R form (line 23 on CF -1 R -ALT form), it has been installed and access has been provided for
visa verificati nby HERS rater. Sa i is allowed for TXV verification:
tiFely New Duct. System (tine 5.of CF -1R ALT)
O For Entirely' duct systems, the required leakage is 6% rather than 15% for altered systems. The alternative to duct
sealin in sin ' the efficien Li of the a meet is'not an option for- entire) new duct systems.
e undersigned, verify at the equipment listed ebove is: 1) the adual equipmectt installed in the home; 2) equal to or more efficient
n required by the Cert' cafe of:Compliance (CF -1 R=ALT Fortn);'and 3) equipment that meets or exceeds ttte appropriate
uirements for manufa aril devices (Appliance Efticlentyy Standards), where applicable.`
he undersigned. verify at diagnostic test results listed on this fonn.were perfonned in coMonnanceMwithan the requirements for
Man
mpliance and that the wly installed or n trofitted mechanical system components ooMorm with the Mandatory requlremenls
al tied in Section 150( ) of the 2005 Building Energy Efficiency Standards.
3-30•-0�
ned Ins
bate:
tes:
Paae 1 of 2
l rsion 03-10-Ub
is form can only be usi d on projects being verified by CaICERTS certified raters.
39Vd S 3 M S
www.calcerts.com
LZ66686606 10:11 600Z/00/Z0
90 3EIVd
Installation Ce iftcate
Prescriptive Method - HVAC-oniv Alteration CF -6R -ALT
Project Title: Date:
O 2005 CaICERTS
A splsoloq
IMPORTANT: This CF -8R form is only for use when an HVAC -only alteration is made to an existing home
Use one form fc r each system being altered. This is system # of systems altered in this house.
Copies.to: Homeowner, HERS Rater, and Building DeE2rtment
Duct Leakage tet Results If duct testing is requireder CF -1 R -ALT form
Step 1 - Pre-test Leakaqe of the system before any alterations. This test is optional and is only used for the 60% reduction option
1
Pre-test I kage : ICFW5
2
1 Line 1 x 0.4 =et for 601E reduction
tep 2 - Determine
T tal Svstem Fan Flow Use any of these methods. Use values for eearWiD after alterations.
3
Cooling: ndenser ton e: tons x400 CFMlton = FM
4
Heating- umaoe ouliput 8tuh x.0217 CiFNUatuh CFM
5
5
Measured (refer to ACM Manual Appendix RE, section 411) CFM
Measurement method: ❑ flow hood O plenum pressure matching O flow grid
7
Totals fan flow value to be used:FM ma use highest of lines 3, 4. Or S.
Step 3 - Determine T eta:
88
JTotal Sy0m fan flow (line 7 from above) x 0.06 = FM25 = 6% leakage target (new duct systems)
8b
ITotal sysf4m tan flaw (line 7 from above) x 0.15 = FM25 = 15% leakage target
9
Toll Syst6m ten.ftow line 7 from above x 0.10 = JCFM25 - 10% leakage to outside target
Step 4 - Alterations:
Aust be consistent with the CF -1R form.
10 ❑.
Seal all cormactions with approved materials.
11 E3Non
111
cted 'one of the s can have unducted build cavitiesAo co s m air.
12 11
adding 4 replacing more than 40 feet of duct insulate new ducts per package D for that dirnale zone
Step 5 - Final Lea r ular duct leakage test, for 15% total and 60% reduction
13
leakage -I I Z ICFM25 refer to 2005 ACM appenclix RC, Sections RC 4.3.1
4a ❑
Ilse 13 less thanline 8a,
a houseipjsSeS the 6% r leakage rectutinerpent Go to 9.
4b 1,W
If line 1316 teas than line 8b, house passes the 16% leakage requiretnenit. Go to Step 9.
15 ❑
If line 131 less than line 2 house pasws the 60% reduction irequirement, continue.
16 ❑
If either of ines 14a, 14b or 15 are cheeked,'HERS verification is uired. Sam Gn can be used.
17 ❑
If line 15 i checked, tart not 14a or 14b, Smoke Test and Visual Ins of Accessible Duct Sealing is required. Go to Step 8
Step 6 - Leakage to utside: Similar toe regular duct blaster test but the house is pressurized to 25 pascals at the same time.
18
e = CFM25 reftrto 2005 ACM ix RC, Sections RC 4.3.3
19 ❑
M One 18 less than fine 9 house the 10% lea to outside requirement.
20 ❑
If line 19 , HERS verification is required. Sampling can be used.
Step 7 - If the housenot pass of lines 14, 15 or 19.
21 ❑
d Visual Inspection of Accessible Duct Sealingis required. See St 8.
moke TTired
22 13
Install rlabel ACM Appendix RC Sections RC.4.3.5.
Step 8 -Smoke
Test nd Visualverification See 2005 Residential ACMAjnmdiKRC. Sections RC 4.3.5-7
23 ❑
Performs a Lest perACM A ndix RC Sections RC 4.3.6.
24 ❑
Perform I Inspection and repair of excessively -dame ed duct WACM Appemfix RC. Sections RC 4.3.7.
25 ❑
Seal regisier boots to surrounding material per ACM Appendix RC, Sections RC 4.3.7.
HERS V
n ca
26
If line 14 i checked. 16% leakage to be verified by HERS rater. Sam G is allowed.
27 ❑
If fine 15 i checked. 60% leakage reduction to be verified by HERS rater (post test only) AND
Smoke Tiand Visual Verification.to be performed by HERS Rater. Sampling is allowed.
28 ❑
If line 19 i checked. 10QA leakap to outside to be verified by HERS rater. SamphM is allowed.
29 ❑
If none of 'nes 14,15 or 19 are checked Smoke Test and fix all accessable leakes. No sampling allowed.
Sampling- I if on lines 14,15 or 19.
30
1.) Home er ohooses to be put into a group of homes for random third party HERS sampling.
2.) installer and rater must sign the three -party agreement
3. A11 a e tests must be completed the installer or their re resenlabve not the third rater.
No Sampli
- Ho does not pass by fines 14.15 or 19. OR horneownar chooses not to be part of a sample aroup
31 ❑
1.) House n be tested by a third party HERS rater selected by installer.
2J Homec sner, installer and rater must sign the three-part agreement.
3.) All atic re tests may be completed by the installer or their representative, and then verified by a third party rater.
OR all above tests may be performed solely by the third party rater.
32 ❑
1.) house be tested by third party HERS rater selected by homeowner,
2.) All a e tests relay be completed by the installer or their representative, end then verified by a third party rater.
OR at aboire tests may be performed so the third party rater.
version us -i rage z or z
This form can onl V be used on projects being verified by CaICERTS certified raters. www.calCerts.com
S 3 M S LZ6668£606 10:11 600Z/00/Z0
In' llatin*n r-tartifinalla, Prescrio6e -Method - HVAC -o nIvAlteration CF -6R -ALT
r64ct
,
T�e:
Date:
®2005 CaICERTS
III !
46 �A
i
Erffidicernent Aperty Use ONY
_G
Climate Zond:
Btadkv Pem%p
ns
Hing Contractor.
Telephone:
PW Check Dace
LU
05hy Name:
Field Check Date
IMPORTANI: This CF -6R form is only for,usk wh6nan WAC -o* afidpation is made to an existing home
Use one form or each system being altered., This is iystem #_[__•<i�-systems altered in this house.
CoDiei to: Homeowner, HERS R6ter. and Building Reartment
Listthe specA cations for the newly: installed equipment. These must mat& the installed equipment exactly.
.
Installed e gui�ent must mat ch allocation and , meet or exceed efficiencie&R-values from CF -1 R.
Fouioment
Type manufacturer Model Number, Efficiency Load" capacity—
Furnace
AFL
a
eat Exchanger
WA
at Pump fan cod
N/A
i
I
ionic fan coil
WA
Other FAU
t
be
gas/AC7
AFUF.
I
rckage
SEER 1 W
ckage heatpUmp
HSPF. -
SEER
EER*
rC Condenser
SEER
4
tpump Condenser
HSPF
SEER
Indoor DX coil
EER*
Hydronic coil
_F
vide EER if needed for compliance Vine 24 of CF -1R -ALT). Installer must provide adequate documentation to verifyE
In some;cases th specific furnace may. need to be verified in order to achieve a specific EER.
, Cases a "me delay reliy'and/or TXV may need to ve verified. in order to achieve a specific EER.
In soiree
I
*i
ads are sensible for cc Dling
-Toacities
' ign conditions for cooling and adjusted (altitude, downflow, etc,) out eutfor heating_
are sensible I , des
CF -1R form e -1 R -ALT. form), it has. been installed and access has been provided for
If TXV is requirec by the CF (lin, 23 omCF
visual verificatioi jj HERS rater. Sam lin is allowed for TXV verification.
New Duct System (Line 5 of CF -1R ALT)
.']rely
0 For Entirely new. uct systems, the required leakage is 6% rather than 115%.for altered systems. The alternative to duct
•
r systems-
sealino. bv increea ing the efficienc� of thi,eq6 iviriani Wnot an option for entirely new duct
11
undersigned, verifyj I the.equipmi brit-lieted;above js: 1) the actual equipment installed In the home; 2) equal to or more efficient
t I
ti
required by the C-ertifi to of CompliaiiCe (CFARALT'FoTm); and 3) equipment that meets or exceeds the appropriate
irements for. ma luf devices (Appliance Effidency, Standards), where appikable.
r
i1h t.iliagnostic. test. resWts list6d'on,this form were performed in ccnformance with the requirements for
undersignedi verify
n retrofitted with the mandatory requirements
pliance and that lh6 ne installed or I , mechanical system components conform
cifidd in Section 150(m) of the 2005 Building Energy Efficiency Standards.
3 -3 0 -0c(
c1hed
fladaller): Date:
-Paae 172
me sion 03-10-Jb
Tih r, form can only be used an projects being verified by CaICERTS certified raters.. www.calcerts.com
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LZ66686606 10:11 600Z/00/Z0
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Installation Ce ficate
Prescriptive Method - HVAC -only Alteration CF -6R -ALT
Project Title:
Date:
2005 CaICERTS
IMPORTANT: is CF -6R form is only for use when an HVAC=only alteration is made to an existing home
Use one form for ch system being altered. This is system # l of -,.2 systems altered in this house.
Copies to: Homeowner, HERS Rater, and Building Department
Dud Leaks e.test Results if duct testing is reuired, r CFAR-ALT form
Step 1 - Prete Leakdge of the system before any aftetations. This test is optiorial and is only used for the 60% reduction option
1
Pre-test ge I ICFM25
2 1
1 Line 1 x 0.4 = t for 60% reduction
Step 2 - Determine
Totb System Fan Flow. Use any of these methods. Use valueslibrequipmerd afteralteration&
3
Cooling: CiVenser tonna e: tons x 400 CFMlton = FM
4
Heating: Fu ace 0 atuh x .0217 CFM/Btuh = FM
5
6
Measured:( efartoACM Manual Appendix RE. secbon4.1)= FM
Measurement method: O flow hood - O plenum pressure matching O flow grid
7
TOialsYsten fart flow value to be usedr. use highest or tines 3, 4, or 5.
ep 3 - Determine
Tar ets:
6a
Total Sys fan flow (line.7 from alcove) x 0.06 ICFM25.6% leakage target (new duct systems)
Bb
Total Systerp fan flow (One 7 from above) x 0.15 100 JCRQ5 =15% leakarge target
9
Tocol SvsbA fan flow 6ne 7 from shove x 0.10 = I ICFM25 = 10% le~ to outside target
Step 4 - Alterations
be consistent with the CF -1R form.
10 ❑
Seal ail n connections with a roved materials.
11 ❑
Non structed of the tem can have unducted buildingcavities t0 s air.
12 111f
addin or placing more than 40 feet of duct, insulate new duos e D for that Climate zone
Steps - Final a ular duct test. for 15% total and 60% reduction
13
leakage ICFM25 refer to 2005 ACM a RC. Sections RC 4.3.1
4a ❑
If Una 13 is ess than line 8a house the --- I rement. Go to Stop 8.
4b pW
H One 13 )s ass than lime §6 house pasm the 16% leakage neclulneimrit. Go to Stop IL
15 ❑
If line 19 is than line 2, house passims the 60% reduction requilremerit continue.
16 ❑
H either of es 14a 14b or 15 are checked,HERS verification is owed: Samf can be used.
17 ❑
If line 15 is but rot 14a or 14b, Smoke Test and Visual Ins n of Accessible Duct Sealing is required. Go to Step 8
Step 6 - Leak$ge.to de: Similar to a regular duet blaster test but the horse is pressurized to 25 pascals at the same time.
18
leaks 8 =FM25 refer to 2005 ACM nc RC, Sections RC 4.3.3
19 C3Heine
18Is than One 9 house passes the 10% leakage to outside rewdromeft
20 ❑
H One 19 HERS ved0catlon is required Sampling Can be used.
Step.7 - H the house d not pass of lines 14, 15 or 19.
21 13Smoke
T and Visual inspection of Accessible Dud Seating is required. SeeStWS.
22 ❑
Install requi6d label par ACM A dix R Sections RC.4:3.5.
Step 8 - Smoke Test Ad Visual Verification See 2005 Residential ACM Appendbc RC Sections RC 4.3.5-71
23 ❑
Perform smiike test 0erACM Amendix RC Sections RC 4:3.6.
24 ❑
Perform vi al Inspoction and repair of excessivelydanuined ducts wACM App,endixRC. Sections RC 4.3.7.
25 11
Seal Mlitstdr boots to surrounding materiel off ACM Appendix RC, Sections RC 4.3.7.
HERS V
fication
26 Rine
-14 is ..15% leakage to be verified, HERS rater. Sam i is allowed
27' ❑
If line 15 Is . 60% leakage reduction to be verified by HERS rater (post test only) AND
Smoke Tes and Visual Verification to be performed HERS Rater. n Is allowed.
28 C3
If One 19 is edced. 10% a to outside to be verified. HERS rater. Sampling.Is aflowed.
29 ❑
Itf none of li 14 15 or 19 arechecked Smoke Test and fix all acoessable leakes. No sampling allowed.
Sampling if hou on lines 14.15 or 19.
30)
H chooses to be put into a,g�p of homes for random third party HERS sampling.
Hom er, installer and rater must sign the thieeparty went
�3")All abo tests must be completed by the installer or Uteir represenWdve. not the third party rater.
N0 Samplin - House not lines 14 15 or 19v OR a chooses not to be of a Sam to Group
31 C31.)
House be tested by a third party HERS refer selected by installer.
2.) r, Installer and rater must sign the three -party agreement
3.) All a tests may be,comp by the installer or their representative, and then verified by a third party rater.
O all tests be mied solely the third rater.
32 C31
J House be tested by third party HERS rater selected by homeowner.
2.) Ali a tests may be completed by the installer. or their representative. and then verified by a third party rater.
allbove tests be nowsalel the third rater:
o...�so
version urlu-uo This form can ON be used on projects being verified by CaICERTS certified raters. wwvw.calcerts.com
S 3 M S
LZ6668£606 10:11 6002/00/Z0