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13-0005 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: IL13-00000005„ Property Address: 47900 BOUGAINVILLEA ST APN: 649-480-029-41 -28601 Application description: MECHANICAL Property Zoning: MEDIUM DENSITY RES Application valuation: 5900 Ti&f 4 VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 1/04/13 Owner: 0 G WILLIAMSON GERALD 47900 BOUGAINVILLE q LA QUINTA, CA 9225 JAN 04 2013 7 C17Vrte1e Contractor: DEPT I Applicant: Architect or Engineer: ONE HOUR A/C & HTG 3030 MYERS STREET RIVERSIDE, CA 92503 �� (951)276-9744 ,j Lic. NO.: 878533 -----------------------------1-------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. Li ense Cla'Co ss: C20 � LicenseNo.: 878533 Date: y"f(' 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 155001.: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) 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: I I_ Lender's Address: LQPERMIT WORKER'S COMPENSATION DECLARATION 'I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 INS CO OF WEST Policy Number WVE502266100 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /: pplicant: ' WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS.PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or fallowing issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter pon the above-mentioned property for inspect' etp Date: I Signature (Applicant or Agent): r� m Application Number 13-00000005 1 Permit MECHANICAL Additional desc . Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/03/13 - Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 ---------------------------------------------------------------------------- Special Notes and Comments } HVAC CHANGE -OUT: REPLACE FURNACE & COIL. - 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 24.00 .00 .00 24.00 Plan Check Total 6.00 .00 .00 6.00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 .00 .00 31.00 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: 47900 Bouganvillea Blvd La Quinta Enforcement Agency:,,,,,.,,.",. Date: 1-2-13 Permit#: Conditioned Floor Equipment T e� List Minimum Efficiency Z Duct insulation requirement Area Thermostat Lj �X Packaged Unit Furnace � AFLTEBo% F Q Cpp Over 40 ft of ducts added or � Setback x' Indoor Coil Condensing f� Q B HSPF Resistance re laced in unconditioned space R 6 (CZ 10-13) Served by system 1800 sf (lfnor already present, must be Unit EER installed) Other R 8 (CZ 14-15) 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R-ALT-HVACfor each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFjb1- typical residential systems. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF -111 and CF -6R shall also be on site for final inspection. 1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I -HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH- 21 and fors lits stems MECH-25 • Condenser Coil and /or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • indoor Coil and/or CF -4R forms: MECH- 21 and (for split systems) MECH-25 • Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or C 2. Duct systems with less than 40 linear feet in unconditioned space, or [- 3. Existing ducts stems are constructed, insulated or sealed with asbestos 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS ducts: (all new ducting and all CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 new equipment) For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent 3. New Ducts with/or without Replacement Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor coil CF -4R forms: MECH-20 and (for split systems) MECH-25 and/or furnace. No or some equipment changed. For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent 4. New Ducting over 40 feet Forms: —Required • Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 linear feet of duct in unconditioned s ace. For split s stem or packaged units: Duct leakage < 15 percent EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • 1 certify that this Certificate of Compliance documentation is accurate and complete. • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations, plans andspecifications submitted to the enforcement agency for approval with the permit application. Name: Jane Recktenwald Signature: Company: Dial One Dial Date - -2-2013 Address: 3030 Myers License: 878533 City/State/Zip: Riverside, CA 92503 Phone: 951-276-9744 ?MR F'nr Alf -h Mil) 0 Bin # City of La Quinta Bididing Br Safety Division P.O Box 1504,78-495 Calle Tampico La.Wnta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Pemut # Project Address: dvvaet's Name: i A P. Number — -C) t Address: `A -I L1 C3 �b 1! J Legal Descrippon: Contractor. dnQ City, ST, Zip: U_ t.. t wi+,-, Telephone: Address: 70 tqk,�_ Project Descriptions: [ r City, PT, Zip: C pl Teiepl3flne:� � l0 _ ��4� • . State Lie. #: City Lie. #: Arch., Engr., Designer. Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. M Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft: # Stories: #Units Telephone # of Contact Person: Estimated Valise of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal R"9d. Reed TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calms Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Constraetion Flood plain plan Plans resubmitted Mecbariical Grading plea 2' Review, ready for correctionsfrssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up &bLL H.O.A. Approval Plans resubmitted Grading IN HOUSE.- 3" Review, wady for cornctionsfissne Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. W.ks. Appr Date of permit issue School Fees Total Permit Fees u Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations Page 1 of 5 Project Name: Climate Zone # # of Stories Gerald Williamson 115 1 General Information Site Address: 47900 Bouganvilla Blvd La Quinta CA 92253 Enforcement Agency: La Quinta, City of Date: 12/27/2012 Building Type El Single Family ❑ Multi Family Circle the Front Orientation:®, E, S, W, or degrees Conditioned Floor Area (CFA): 2000 Project Type: ❑� Alterations E] Envelope E] Fenestration ❑Roof []HVAC Tag/ Replacement or Chane Out ❑ Duct Replacement ❑ Water Heater NOTE: This form is not to be used for Newly Constructed Buildings or Additions Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration ❑ Opening of framed cavity alone—Alterations that involve the opening of the framed cavity ofa wall, ceiling, or floor must install the mandatory minimum insulation value per §150for the altered assembly. Fill in Columns A —C and enter mandatory insulation value in Column H. ❑ Replacement of entire assembly— Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component Package- D insulation values in Table 151-C. Fill in Columns A —J. Opaque Surface DetailS For the furred portioned of Mass Walls see Furring Strips Construction Table below. A B I C D E F G I H I I J Proposed see Note Standard Values From JA4 Table Tag/ Framing .�, Thickness, Assembly Name Nlatenall' a" 1 Spacing, %""`.e""I � na '.� (2'e� �-=��"�'a3i U ��7R'�q�1-rj Framed Jp4}Table?� Cavity ' �$'ktl fNi I'6 . Continuous JA4 Proposed Insulation Assembly Assembly " "*� "h'..+w ID L .� or T e and Size or -Other � - factor I ; Numbers" I alue 7, 8 9 R -Value Cell Value U -factor "�, A mil ` ►.;► at 6- OK^ ark, ^6 ;,ft. vim: -1." . --. 4� 1 'wW' 44r'41 flf lk t� "- wr Wi * rte; rl 0 > 0 Final Mass Name or JA4 Table 2 Y 5 E c > Note: For furred assemblies. dcc�ounting for Continuous Insulation R -value, see Rage-JA4-3 and Equation=4-1. For calculating furred walls use the Mass and FurringConstruction table belo>+ ""'i 1( 1 It �'"�� . 1. For Tag/ID indicate'Ihe identification name thatlmatches the buildin°g plans. ,. — +. t'Doors Name rye: geWklls, 2. Indicate the Assembly o Roof/Celli Floors, SlabssCrawl Space, sad a—t... Indicut' a the)Frame'type and Size: For Wood, Metal, Metal Buildings, Mass, enter 2x4,N2x6, or etc.-; see JA4 for other possiblefame type.,asse» ibliess.. 3. Enter the thickness for mass in inches or�Spacing betweenframing members e to r;'1'6 -'-or 24'OC orOther for all!'other assembly description such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc.... 4. Based on the Climate Zone; enter the Standard U factor frotmZablef151-B, C or D for each different assembly-Nme-or-type. 5. Enter the Table number that closely resembles the proposed assembly. 6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0 ". 7. Enter the Continuous Insulation R -value for the proposed assembly; otherwise, enter "0 ". & Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U factor in Column J 9. The Proposed Assembly U factor, Column J, must be equal to or less than the Standard U factor in Column E to comply. Furring Strips Construction Table for Mass Walls Onl A I B IC D E F I G I H I J 1 K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference Joint Appendix Table 4.3.5 4.3.6 4.3.7 Joint Appendix Table 4.3.13 U 0 V a� U 5 Assembly 4 F H$ 0 > 0 Final Mass Name or JA4 Table 2 Y 5 E c > Assembly Thickness' Type' Number; ¢ > x ¢ > U-factorb 7 Comment Registration Number: 312-A0013911A-000000000-0000 Registration Date/Time: 12/27/2012 10:23:19 HERSProvider: CBPCA 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations Page 2 of 5 Project Name: Climate Zone # # of Stories Gerald Williamson 115 1 1. Indicate the type of assembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Etc. Additional assemblies can befound Reference Joint Appendix JA4. 2. This is the U -Factor based on the thickness of the assembly in inches. 3. The R -value of the insulation to be added on the interior or exterior of the assembly. 4. The Calculated R- Value is the R -value of the furred out section of the assembly. -6. The Final Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix JA 4. The equation is the inverse of Column added to Column L Column K is the inverse from column J. 7. Insert the calculated U- actor value on to the Opaque Sur ace Details in Column J FENESTRATION PROPOSED AREAS ❑ Replacing window alone — Replacement windows shall meet the U -Factor and SHGC Value requirements of Component Package D in Table 151-C. The Total Fenestration and West facing Area requirements are not applicable. ❑ Adding 50ft2 or less of window area —Newly installed windows shall meet the U -Factor and SHGC Value requirements of Component Package D in Table 151-C. ❑ Adding more than 50ft2 of window area — Newly installed windows shall meet the U -Factor and SHGC Value and the Fenestration Area requirements of Component Package D in Table 151-C. Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF -IR -ALT Orientation a Fenestratron7T _ e and Frame (North, East ,IPVrbpse, A a Maximum Maxurium NFRC or Default endow, Glass_DoororS li ht ,`{,�- 1 ISouth, West U-factorz"' 3 SHG63," a° Value5 1. Fenestration area is the area of total glazed product(i.e. glass plus frame). Exception:"Whena door is lessT than,50% glass, the fenestration area may be the glass area plus a "2 inch frame around the glass. 2. Enter value from Component Package D Requirements rn Table 151C. - 3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower U factor and/or a lower SHGC value than that specified on the CF -1 R ALT Form. 4. Submit a completed WS -3R Form if a reduced SHGC is calculated with exterior shading. 5.Ifopplicable at this stage enter "NFRC" or NFRC Certified windows or are CEC "Default" valuesfound in Table 116-A or B. ALTERED FENESTRATION ALLOWED AREAS (Complete if more than 50ft2 offenestration is added) A B C D E F G Allowed Existing Fenestration Total Area CFA of Entire % of Fenestration Area Fenestration Allowed Proposed Area Dwelling CFA Area Removed Area Added A x B) (E -D) + C Total Fenestration Area 20 West Fenestration Area (Required In 05 >_ CZ's 2,4&7-15 1. West Fenestration Area includes west -sloping skylights and any skylights with a pitch less than 1:12. 2. West facing glazing area removed cannot be "counted" twice. " In order to distribute the west glazing area removed to the other orientations, input the west glazing area removed in the Total Fenestration Area row, column D. 3. Include the Proposed Area of the West facing fenestration in both Area columns below. 4. To meet compliance, the Pro osed Area must be less than orequal to the Total Allowed Area or BOTH the Total and West Fenestration Areas. Registration Number: 312-A0013911A-000000000-0000 Registration Date/Time: 12/27/2012 10:23:19 HERS Provider.• CBPCA 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations Page 3 of 5 Project Name: Climate Zone # # of Stories Gerald Williamson 115 1 ROOFING PRODUCTS (COOL ROOFS) §151(1)12 When the area of exterior roof surface to be replaced exceeds more than 50% of the existing roof area, or more than 1, 000 ftZ, whichever is less, the new roofing area must meet the roofing product "Cool Roof' requirements of §152(b)1Hi, 152(b)1Hii, or 152(b)1Hiii. Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof' requirements. Note: If any one of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in §118(i) are not applicable. Do not fill table below. ❑ Cool Roofs Not Required in Climate Zones 1-12, 14, and 16 with a Low Sloped. Less or 2:12 pitch. ❑Cool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep -Sloped Roofs (pitch greater than 2:12) and product unit weight less than 51b/112. Alternatives to §152(b)1Hi and §152(b)Hii, Steep -slope roof (pitch > 2:12) ❑ Insulation with a thermal resistance of at least 0.85 hr•ft2•°FBtu or at least a 3/4 inch air -space is added to the roof deck over an attic; or ❑ Existing ducts in the attic are insulated and sealed according to § 151(010; or ❑ In climate zones 10, 12 and 13, with 1112 of free ventilation area of attic ventilation for every 150 ft of attic floor area, and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge; or ❑ Building has at least R-30 ceiling insulation; or ❑ Building has radiant barrier the attic meeting the,requirements of § 151(f2; or o�dcsiior❑ Building has nwiitc aat�e� iilf ❑ In climate zones 1011 .13 and,14 R-3 or greater roof deck insulation above vented attic. s ,� K%, Exception to §I52(b)1Hiii, Low -slope roof (pitch < 2:12)ntr ' As ❑ Building has no ducts in —the 1wISSOC14. Other Exceptions l I V ❑ Roofing area covered by building -integrated; photovoltaic panels and solar thermal pmels_are exempt from the below Cool Roof criteria. ❑ Roof constructions that have -thermal mass over the roof membrane with aiileast 25 Ib/f% is exem t°from the=below Cool Roof criteria. Note: If no CRRC-1 Mbelis available,,;tKis ompliance m6thod cannot be used, use the Performance Appfoath to show compliance, otherwise, Check thea licable box�below'if Exem t fromNhe 0ofin Products "Cool Roof' Re uirement:-�-.,.- j� Roof Slope �ry Product Weight# P oduct Aged -Solar az Thermal CRRC Product ID Number <5 -2:-12"+> 2:4-2 1 < 511i%ft-2�,>_,�51b' + _T e2 .. Plkeflectance3.4`� Emi'ttance SRI ❑ ❑ ❑y ❑ ON ❑ ❑ _ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4 1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolrools.ore/products/search. ph 2. Indicate the type of product is being used for the rooftop, i.e. single ply roof, asphalt roof, metal roof, etc. 3. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same directory and use the equation (0.2+0.7(pinirial - 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4. Check box if the Aged Reflectance is a calculated value using the equation above. 5. Calculate the SRI value by using the SRI- Worksheet at htto:/Avwiv.ener .ca.govhitle24/and enter the resulting value in the SRI Column above and attach atopy of the SRI- Worksheet to the CF -I R. To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in § 118(i)4. Select the applicable coating: ❑ Aluminum -Pigmented Asphalt Roof Coating TO Cement -Based Roof Coating 113 Other Registration Number: 312-AO01 391 1A-000000000-0000 Registration Date/Time: 12/27/2012 10:23:19 HERS Provider: CBPCA 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 4 of 5 Project Name: Climate Zone # # of Stories Gerald Williamson 15 1 HVAC SYSTEMS - HEATING List water heaters oWd boilers for both domestic hot water` (DHW) heaters and hydropic space heating. Individual dwellin"g.DHW heaters must be gas or propane fired, and maynot ex ec ed 50 gallons. Hol water pipe insulation from the DHW heater. to the kitchens) and on all underground Minimum Duct or Piping umber Configuration Heating Equipment Efficiency Distribution Insulation Thermostat (Central, Split, Type and Capacity 1,2.3 AFUE or HSPF Type and Location R -Value Type Space, Package or H dronic Furnace, 80000 80 AFUE Ducted, 8 SetBack Split 1. Indicate Heating Type (Central Furnace, Wall Furnace, Heat pump, Boiler, Electric Resistance, etc) 2. Electric resistance heating is allowed only in Component Package C, or except where electric heating is supplemental (i.e., if total capacity < 2 KW or 7,000 Btu/hr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §151(6)3 exception. 3. Refer to the HERS Verification section on Page 4 of the CF -I R -ALT Form for additional requirements and check applicable boxes. 4. Indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc.) HVAC SYSTEMS - COOLING Minimum Efficiency Duct or Piping Configuration Cooling Equipment (SEER/EER or Distribution Insulation Thermostat (Central, Split, Type and Ca aci '•2 COP) Type and Location R -Value Type Space, Package or H dronic .f4. A *k3i .* y{R'.. �(-,IyA mg 1. Indicate Cooling Type-(A%C, Fledtpu! p,�rEvap.'Cool.ing c) . 2. Refer to the HERS�Verification sectionyon Page 4 of dhe�CFyiR ALTtFor,�for�;addtuonal requirementsaand.check applicable boxes. 3. Indicate Tye or Location–Ducts,.H dt'onic in Floor, Radiators, etc. WATER HEATING"*- J—`JJ JJ er' -\ /'_ . r'� --A List water heaters oWd boilers for both domestic hot water` (DHW) heaters and hydropic space heating. Individual dwellin"g.DHW heaters must be gas or propane fired, and maynot ex ec ed 50 gallons. Hol water pipe insulation from the DHW heater. to the kitchens) and on all underground hot water pipes is required in all com onent acka es -in all climate zones. -40' umber ,+ EnerggyFacF External Tank Water Heater Type/Fuel Distribution ype' NI Inn'—Tank'" for or Insulation Type' (Standard, Recirculatin z g) S stem Ca acit (al) L 1' , ThermalTEfficienc R -Value 3 1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.) 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling units. 3. The external water healing tank and i es shall be insulated to meet the requirements o 150 ' . SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below. These items may require written 'usti tcation and documentation and special verification. NEW ROOF ASSEMBLY - Radiant Barrier The radiant barrier requirement of §151(f)2 does not apply to roof alterations. Slab Edge (Perimeter) Insulation 13 YES M NO YES: In Climate 'Zone 16 in Component Packages D, R-7 insulation is required. Heated Slab Insulation D YES ONO YES: Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards. Raised Slab Insulation Q YES D NO YES: In Climate Zones 1, 2, 11, 13, 14 & 16 R-8 insulation is required; in Climate Zones 12 & 15, R-4 is required under component Package D. Thermal Mass To obtain Compliance Credit for the installation of thermal mass use the Performance Approach. Registration Number: 312-A0013911A-000000000-0000 Registration Date/Time: 12/27/2012 10:23:19 HERSProvider: CBPCA 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 5 of 5 Project Name: Climate Zone # # of Stories Gerald Williamson 115 1 HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this checklist below. A completed and signed CF -41? Form for all the measures specified shall be submitted to the building inspector before final inspection. Duct Sealing & Testing HERS verification is required for this measure. © YES O NO YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned space, the ducts are to be sealed per §I52(b)]Dii and the newly installed ducts are to be insulated per §151(f)10. ❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. ❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the ducts are to be sealed per §152(b)1Di. ❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are to be sealed per §152(b)IE. ❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RA3. ❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Refrigerant Charge - Split System HERS verification is required for this measure. 0 YES El NO YES: In Climate Zonesr2 and 8-1,5, when.the existing HVAC equipment is replacedincluding the replacement of the air Y4 " .wf ra p: air k.: i R r. M , t 41 � • ten. w ww. 11 an�d�le ou�tdWgo�r�c�ond�ens V43 40Wt ok{akspl* system A/�Gor hent pump, coolmg�or l eatin9g; 1, or the furnace heat .rexchaner) a refrigerant charge measuremenrshall'be verified per ,1_52(b)IF. Central Fan Integrated (CFI)YV4entilati4n System , nd FanuW�a' Draw ASSOCIation The ventilation re uirements o'f 150 0 .do?not a 'I to exrstm residential homes. Ducted Split Systems -"Air Conditioners an'd'Heat fumps ­Airtlow _o1HERSverifrcat o is requiredfor this measure. 0 YES [3 NQ YES:Climate-Zones 10 through 1�5, when the existing space -conditioning system (HVAC equipment and ducting) is re laced, the airflow and fan watt draw shallrbe verified per j'52(b)1 Cyto meet.the'ie uir`einents of §151(07B. I I 1 1 I I f I Documentation Author's Declaration Statement • I certify that this Certificate of Com liance4`4ocumentartion is accurate.add*com tete. .*,**',04* � Name: Ruth Debrick {. Signature: Ruth Debrick to.. Company: Venvest Ballard/One Hour Air Date: 12/27/2012 Address: If Applicable [3CEA or 13CEPE 3030 Myers St,Street (Certification #): City/State/Zip: Riverside California 92503 Phone: 951-217-2753 Responsible Building Designer's Declaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Name: Signature: Company: P Y: Date: 12/27/2012 Address: License: 878533 City/State/Zip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: I-800-772-3300. Registration Number: 312-AO01 391 1A-000000000-0000 Registration Date/Time: 12/27/2012 10:23:19 HERS Provider: CBPCA 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2 Site Address: Enforcement Agency: Permit Number: 47900 Bouganvilla Blvd La Quinta CA 92253 La Quinta, City of 13-5 Enter the Duct System Name or Identification/Tag: Enter the Duct System Location or Area Served: Home 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 Leakaue Dinonnstic Test — existino duct system Select one compliance method from the following four choices. El Option 1. Measured leakage less than 15% of Fan Airflow. ❑ Option 2. Me u�red jleakage� to;, (b tsidlless than, 110% oft4q A Z61w.rformame T' o aa, . � . � �A ❑ Option 3. Reduce` 1 'by 60% or more,(' ndrc'onductTsmoke<test'tossealiall acc6 si6le leaks:• ion f 9fiwif ;I WA1011 �It ❑ Option 4' Fix acce Bible leaks HERS,rater all using smoketest; and must.verify... 4)� Note: (Option 1 must be attemptd before -utilizing Option -'*s 't r �. Determine nominal Fan Airflow'ousing one ofpthe following three calculation methods:'` or El Cooling system method: Size of condenser in Tons 3-50�x 400 = 1400.00 "" CFIv1 ❑ Heating system method: 21.7x= .1,4eating Output Ca acit 0tuh =' CFM ❑ Measured system airflow using RA3.3 airflow tMst proedures: CFM ,+a Option 1 used then: �I` Allowed leakage = Fan Airflow 1400.00 X0.15= 210.00 CFM 1 Actual leakage= 125.00 CFM Pass if Actual leakage is less than Allowed leakage El Pass ❑ Fail Option 2 used then: Allowed leakage = Fan Airflow x 0.10 = CFM 2 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: All accessible leaks repaired using smoke test. HERS rater must verify (No sampling). 4 Pass if all accessible leaks have been sealed using Smoke Test ❑ Pass ❑ Fail Registration Number: 312-A0013911A-M2113948A-M21A Registration Date/Time: 01/10/2013 10:02:04 HERS Provider: CBPCA 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2 Site Address: Enforcement Agency: Permit Number: 47900 Bouganvilla Blvd La Quinta CA 92253 iLaQuinta,Cityof 113-5 El Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing.. CFI O�A ducts that ,utilize-co�ntrollledd motorized dampers, that open only when to ventilation is required to meet ASHRAE:Staridard;62 2,,and close en�OA vgntilaUon snot required m`ay be eonfigtq.6 zd &the closed position during duct leakage`testing: D All supply' and return register boots mus tybe sealed to the alt. if srhoke testis �uhhzed.for�comphance applies to duct leakage compliance ption's (leakage eduction by 60%)sand option 4_(fix all accessible leaks) described above. O New duct installations cannotutilize building cavities sa plenum orfor sin lieu of ducts. El Mastic and draw banns must be used i�in combination with cloth backedrubber adh&sive-duct tape to seal leaks at all new duct connections.,.,,.-.- DECLARATION onnections.,,.-.-DECLARATION STATEMENT i • I certify under penaltyof erI'u ry, under the aws,of the State�of California;;the information f�o��tion provided on -this form is true and correct. • I am the certified HERS rater who performed the venficati n services identified and reported on this.cceertificate (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 -IR) 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 -1 R) 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) Venvest Ballard/One Hour Air Responsible Person's Name: CSLB License: Ruth Debrick 1878533 HERS Provider Data Registry Information Sample Group # (if applicable): 0 tested/verified dwelling ❑ not-tested/verified dwelling in a HERS sample group HERS Rater Information HERS Rater Company Name: Athens Air Inc. Responsible Rater's Name Responsible Rater's Signature Andrew Pulos Andrew Pulos Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 1095886 1/10/2013 Registration Number: 312-A0013911A-M2113948A-M21A Registration Date/Time: 01/10/201310:02:04 HERSprovider: CBPCA 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5 Site Address: Enforcement Agency: Permit Number: 47900 Bouganvilla Blvd La Quinta CA 92253 La Quinta, City of 13-5 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to ref zgerant charge verif cation for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verifcation 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 documentedfor compliance using this form. Attach an additional forms) 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 Rheem System Location or Area Served Home The sensor is factory installed, or field installed according to manufacturer's 6 1 DYes ❑No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and 3 ❑Yes y ;� "labeled according"oto .ye:i Sec,JR—A3 2 2�2 2 , *5/16 nch't(8tW n)�acc°ess�liol'e downstream of`evapo alive coil in the supply plenum 2 l7Yes --*,ON N 14 ^ ,� A � � f a a. and,(labeled;accordingtto Figure�in Section,RA3.2 2 2 2 #p j 4 ❑Yes ❑No digital thermometerr�The sensor mini plug is accessible.to-the'installing technician and Yes to 1 andfi2 is a ass. Enter Pass or Fail ✓ D Pass ✓ ❑Fail STMS - Sensor on the Evaporator Coil System Name or Identification/Tag Rheem 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 The sensor is factory installed, or fieldkinstalled acco_01 to manufacturer's 3 ❑Yes ❑No 1Prding specifications,: or is install ethods tns'appr } by the Executive The sensor wire is terminated with a standard mini plug suitable for connection to a �.. P f I Directior ❑Yes ❑No digital thermometer. The sensor mini plug is accessible to the installing technician and The sensor wire is terminated with a standard mini3plug suita6le�for connection to a 4 ❑Yes ❑No digital thermometerr�The sensor mini plug is accessible.to-the'installing technician and ❑Yes ❑No The sensor measures the saturation temperature of the coil within 1.3 degrees F 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 ✓ El N/A ✓ ❑ Pass ✓ ❑ Fail N/A if STMS are not applicable. Otherwise enter Pass or Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag Rheem 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 ✓ El N/A ✓ ❑ Pass ✓ ❑ Fail N/A if STMS are not applicable. Otherwise enter Pass or Fail Registration Number: 312-AO013911A-M2513949A-M25A 2008 Residential Compliance Forms Registration Date/Time: 01/10/2013 10:05:28 HERSProvider: eePCA August 2009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5 Site Address: Enforcement Agency: Permit Number: 47900 Bouganvilla Blvd La Quinta CA 92253 La Quinta, City of 13-5 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 forms) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starling 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. Snare (nnditinnino Cvctvmc System Name or Identification/Tag Rheem (must be re -calibrated monthly) System Location or Area Served Home IL . f 12/2013 1 � ( i(m` ust bye rye calibrated monthly) Outdoor Unit Serial # 5971FZ99917371 51.00 Outdoor Unit Make Rheem Outdoor Unit Model FAFF043JAZ 75.00 Nominal Cooling Capacity Btu/hr •. or tt iW 42000.00 tK, 4i M , .� wwa• wroBi w� u w• ;•► +� Date of Verification 1/9/2013 56.00 Calibration of Diagnostic4nstruments Date of Refrigerant Gaug Calibr tion 1/2/2013„ (must be re -calibrated monthly) Date of Thet mocouple Ca` tbrat j IL . f 12/2013 1 � ( i(m` ust bye rye calibrated monthly) temperature (Tsu 1 , db) 51.00 Measured Temnerahures t°Fl s,Y Afk System Name or Identification/Tag Rheeml I Supply (evaporator leaving) air dry-bulb IL . f temperature (Tsu 1 , db) 51.00 Return (evaporator entering) air dry-bulb temperature (Tretu, db) m 75.00 Return (evaporator entering) air wet -bulb temperature (Tretum, wb) 56.00 Evaporator saturation temperature (Teva orator, sat) 39.00 Condensor saturation temperature (Teondensor, sat) 92.00 Suction line temperature (Tsuction) 58.00 Liquid Line Temperature (Tliquid) 82.00 Condenser (entering) air dry-bulb temperature T tem p ( condenser db) 75.00 Registration Number: 312-AO013911A-M2513949A-M25A 2008 Residential Compliance Forms 01 /10/2013 10:05:28 Registration Date/7'ime.• HERS Provider: CBPCA August 2009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5 Site Address: Enforcement Agency: Permit Number: 47900 Bouganvilla Blvd La Quinta CA 92253 La Quinta, City of 113-5 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 Rheem Calculate: Actual Temperature Split = 24.00 Tretum, db - Tsupply, db Target Temperature Split from Table RA3.2-3 using Tretum, wb and Tretum, db 22.20 Calculate difference: Actual Temperature 1'80 Split — Target Temperature Split = Passes if difference is between -4°F and +4°F or upon -remeasurement, if between . 4°F and -10 F��1.Ii 1a -10 MMs ° Fail Pass+ _ } ail ii 1 Note: Temperature' SplitAfeth�od _ Calcu tatioi tis n t ne�"c ssaq f ac�tua�lcCoolinp Coil ofw� is�ver f �ustn�g one of the in Referdhce Residdntial RA ' If airflow measurement procedurdsspec ,d _ > measured, the value must be equal Y d ed pp"endiz actual cooking coil airflow is to orlgreater,than�the-Calculated Minimum Airflow Requirement in the table below. iR 1•.i+' �. P �. Calculated 'Minimum Airflo Requirement 4 (CFM) = Nominal Cooling'Capacity (ton) X.3.0_.0 (cfm/ton) System Name or Identifiocat o /Tig helm Calculated Minimum Airflow 1, Requirement (CFM) Measured Airflow using RA3.3 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 Rheem Calculate: Actual Superheat = Tsuction — Teva orator sat Target Superheat from Table RA3.2-2 using Tretum wb and Tcondensel db Calculate difference: Actual Superheat — Target Superheat = System passes if difference is between -6°F and +6°F Enter Pass or Fail Registration Number: 312-AGO1391 IA-M2513949A-M25A 2008 Residential Compliance Forms RegistrationDate/Time: 01/10/201310:05:28 HERSprovider. csacA August 2009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5 Site Address: Enforcement Agency: Permit Number: 47900 Bouganvilla Blvd La Quinta CA 92253 La Quinta, City of 13-5 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 Rheem Porformanct,% Calculate: Actual Subcooling = r to,. d ati Tcondenser, sat — Tli uid 10.00 � it Target Subcooling specified by 10.00 Enter allowable superheat range from ' use manufacturer manufacturer's specifications (or rang 1b between 3°F and 267 if; manufacturer's s ecificatiort is not available) 3.00 - 26.00 Calculate difference: System passes if actual,supeTheat'is within Actual Subcooling — Target Subcooling = 0.00 the allowable superheat range Pass , System passes if difference is between Enter Pass or Fail. -4°F and +4°F 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 (EXV) systems. System NamR�.+r * 10 1�f K W x : RE i41Id ints, Porformanct,% Calculate: Acttuual.Superhea"t = r to,. d ati Tsuction —Teva orator -sat t, � it l I Enter allowable superheat range from ' use manufacturer's specifications (or rang 1b between 3°F and 267 if; manufacturer's s ecificatiort is not available) 3.00 - 26.00 System passes if actual,supeTheat'is within the allowable superheat range Pass , Enter Pass or Fail. Registration Number: 312-AO013911A-M2513949A-M25A 2008 Residential Compliance Forms Li t Registration Date/Time: 01/10/2013 10:05:28 HERSProvider: cBPCA August 2009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5 Site Address: Enforcement Agency: Permit Number: 47900 Bouganvilla Blvd La Quinta CA 92253 La Quinta, City of 13-5 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/I'ag Rheem 878533 HERS Provider Data Registry Information Sample Group # (if applicable): System meets all refrigerant charge and Pass in a HERS sample group airflow requirements. Enter Pass or Fail HERS Rater Company Name: Athens Air Inc. Responsible Rater's Name Responsible Ratees Signature Bjuildlng*r" Contircalctors, 0 0 DECLARATION STATEMENT • I certify under penalty of perjury; undeAhe laws of the State�of California„the information.provi=Ifi is form is true and correct. • I am the certified HERS rater who performed the verification services identified awn d re rt on cate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verificatio _, that is identified n_ this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 a'�i1d RA3 andand 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) Venvest Ballard/One Hour Air Responsible Person's Name: CSLB License: Ruth Debrick 878533 HERS Provider Data Registry Information Sample Group # (if applicable): m tested/verified dwelling ❑ not-tested/verified dwelling in a HERS sample group HERS Rater Information HERS Rater Company Name: Athens Air Inc. Responsible Rater's Name Responsible Ratees Signature Andrew Pulos Andrew Pulos Responsible Ratees Certification Number w/ this HERS Provider: Date Signed: 1095886 1/10/2013 Registration Number: 312-AO013911A-M2513949A-M25A 2008 Residential Compliance Forms RegistrationDate/Time: 01/10/201310:05:28 HERSProvider: cBPCA 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: 47900 Bouganvilla Blvd La Quinta CA 92253 La Quinta, City of 13-5 Enter the Duct System Name or Identification/Tag: Enter the Duct System Location or Area Served: Home 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 Leaknoe. Diaonnctic Tect — Rxistino Duct fivctem Select one compliance method from the following four choices. ❑� Option 1. Measured leakage less than 15% of Fan Airflow. w�+ r ❑ Option 2Mea4kaeo,�ot0 u %; A s � ceseAan**o._bi ,o ❑ Option 3. Reduce l 'by 60°% o mo a,.fand�oRductlsmoke,test,rtd,seal all accessible*leaks +Mtbyri`i' dt'Il�M W tioln Aix e ❑ Option all accessible gaks usinsmokeArt; andI�HERS-rate ustxverify... Note: (Option 1 must be attempted before -utilizing Option 4) Determine nominal Fan Airflow`using one of, following three calculation methods. t El Cooling system method: Size of condenser in Tons 3 5 x 400 = 1400 �1' ""CF1v1 ❑ Heating system method: 21.7x. .•. Heating Output Cap city (� Btuh)� _ (-CFM ❑ Measured system airflow RA3.3 airflow test CFM using procedures: Option 1 used then: Allowed leakage = Fan Airflow 1400 x 0.15 = 210 CFM 1 Actual leakage= 125 CFM Pass if Actual leakage is less than Allowed leakage ❑� Pass ❑ Fail Option 2 used then: Allowed leakage = Fan Airflow x 0.10 = CFM 2 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: All accessible leaks repaired using smoke test. HERS rater must verify (No sampling). 4 Pass if all accessible leaks have been sealed using Smoke Test ❑Pass ❑Fail Registration Number: 312-A0013911A-M2113948A-0000 Registration Date/Time: 01/10/201309:57:16 HERSProvider. CBPCA 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 2 of 2 Site Address: Enforcement Agency: Permit Number: 47900 Bouganvilla Blvd La Quinta CA 92253 1 La Quinta, City of 113-5 13 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. 0 All duct le • New du t installatios nsic utilize�building�'cavrties asTplenumslor=pl'atf6r—m eti • Mastic and draw bands must be used,in mbinahon with cloth=backed°rubber ad] duct connections. DECLARATION=STATEMENT • 1 certify under penalty of perjury; under the -laws of the'StatOfCaflfbmia,,the infer ahoy • I am eligible under Division 3 ofithe Business and Erofessions Code to accept responsibili representative of the person responsible for construction (responsible person)' • I certify that the installed features, materials, components, orlmanufactured devices identif conforms to all applicable codes and regulations, andhthe-installation is consistent with the enforcement agency. fob compliance– applies to >le leaks) described above. lieu1ofaduet duct tape to seal leaks at all new ied-o' n this form is true and correct. ondo , or an authorized this certifc ate (the installation) and -specifications -approved by the • 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) Venvest Ballard/One Hour Air Responsible Person's Name: Responsible Person's Signature: Ruth Debrick Ruth Debrick CSLB License: Date Signed: Position With Company (Title): 878533 11/10/2013 Is this installation monitored by a Third Party Quality Control Name of TPQCP (if applicable): Program (TPQCP)? ❑Yes ONo Registration Number: 312-A0013911A-M2113948A-0000 Registration DatelTime: 01/10/201309:57:16 HERSProvider: CBPCA 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5 Site Address: Enforcement Agency: Permit Number: 47900 Bouganvilla Blvd La Quinta CA 92253 La Quinta, City of 13-5 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 forms) 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 �. Rheern Rheem g System Location or Area Served Home 6 ❑Yes ❑No 1 (]Yes , izQlabeledlaecordirig 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and toKFigure in SectionRA3:2 2�2w2. 2 • .* -aitr e� ❑ es r• yr .� w w :r.+, ❑N k �t a ee .sr gr n V. . �� •tiac 4r w wW ri eu * r u� r �,� 5/16 mch (8 mm) access=hole downstream of evaporative coil in the supply plenum andlla eb led acco dm"g#to Figs a infSection.Zk3�2 2 2i2�i; is j t..� �. Yes to 1 and 2 is a pass., Enter Pass or Fail ✓ O Pass ✓ ❑ Fail 1 STMS -Sensor on the Evaporator Coil System Name,orr Identi aton/Ta �. Rheern g 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 is factory irtstall'ed, or field'installed ac o ding,to_manufacturer's 3 ❑Yes ❑No Lspecifications,or. is installed bytmethods/speciRfi�cations approved by thle Executive QNo digital thermometer. The sensor mini plug is accessible to the installing technician and Director. the HERS rater without changing the airflow through the condenser coil 8 The sensor wire is terminated with a standard min6jug suit'able;for connection to a 4 ❑Yes ❑No digital thermometer: -The sensor mini plug is accessible -to -the installing technician and ✓ ❑ Pass ✓ ❑ Fail N/A if STMS are not applicable. Otherwise enter Pass or Fail 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 ✓ 01 N/A ✓ ❑ Pass ✓ ❑ Fail N/A if STMS are not applicable. Otherwise enter Pass or Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag Rheem 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 I❑Yes QNo 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 ❑IYes []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 ✓ p N/A ✓ ❑ Pass ✓ ❑ Fail N/A if STMS are not applicable. Otherwise enter Pass or Fail Registration Number: 312-AO013911A-M2513949A-0000 2008 Residential Compliance Forms Registration Date/Time: 01/10/2013 10:00:44 HERSProvider: CBPCA 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: 47900 Bouganvilla Blvd La Quinta CA 92253 La Quinta, City of 13-5 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 forms) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55 °F or below, the installer must use the Alternate Charge Measurement Procedure. Snace Conditioning Svstems System Name or Identification/Tag Rheem (must be re -calibrated monthly) System Location or Area Served Home (12/1/'2012 (must be re -calibrated monthly) Outdoor Unit Serial # 5971 FZ99917371 Outdoor Unit Make Rheem Outdoor Unit Model FAFF043JAZ Nominal Cooling Capacity B"I r; W1. ,t�F ii' te1b ,#t 442000.00 i91 ,II>>d tt �b�y '.► `i�P 4r 1� >�1ii ,tae m W 1,W 19 W wiw ria Date of Verifi cation -+-- r �r %N M �eaW!W,,N W, V 12/21/2012V W. loop it 1a � W W W�16"W rr *or,*, R _ ,��""g ► � %WAll wr. 1%ft"RW'WMW- IN 14-0" 1W _",WMW'110F W-:%01� 411, -"ham.- W Calibration of Diagnostic -1 n0ruments-00 r►. -�.. t Date of Refrigerant Gauge,C-alibration v 1,21,1/2012,1 SW (must be re -calibrated monthly) Date of Thermocouple a-fti on (12/1/'2012 (must be re -calibrated monthly) Supply (evaporator leaving) air dry-bulb p � Measured Temneratures (OF) c... 'k _..� System Name or Identification/Tag Rheem 11 i Supply (evaporator leaving) air dry-bulb p � temperature (Tsu i , db) 51.00 Return (evaporator entering) air dry-bulb temperature T tem P ( return> db) 77.00 Return (evaporator entering) air wet -bulb temperature (Treturn, wb) 56.00 Evaporator saturation temperature (Teva orator, sat) 39.00 Condensor saturation temperature (Tcondensor, sat) 92.00 Suction line temperature (Tsuction) 55.00 Liquid Line Temperature (Tliquid) 83:00 Condenser (entering) air dry-bulb tem temperature T P ( condenser db) 75.00 Registration Number: 312-AO01 391 1A-M2513949A-0000 2008 Residential Compliance Forms Registration Date/Time: 01/10/2013 10:00:44 HERS Provider: CBPCA 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: 47900 Bouganvilla Blvd La Quinta CA 92253 La Quinta, City of 13-5 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 Rheem Calculate: Actual Temperature Split = 26.00 Treturm 'db - Tsupply, db Target Temperature Split from Table 23.30 RA3.2-3 using Tretum, wb and Tretum, db Calculate difference: Actual Temperature Split — Target Temperature Split = 2.70 Passes if difference is between -3°F and Pass As+3°F or, upon remeaurement;�istweeil giftrfortnance- -37 and -1007 Enter PsoFFa Note: Tempe ature� Method Calcu s--not)ne es dry; ac ail oling Co X4i flow-is'-veerr f d' lul gone plit jatiion^' f of the airflow measurement procedures,specified,in Reference.Residential Appendix-RA3.3. !f actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated�Minimum Airf o Requirement in the table below. Calculated Minimum A flo,4equir mj(CFM) = N al Cooling Ca' paact�ty ton)p 0 (fm/ton) %'—o System Name or Identification/Tg ---,,Rheem;,�� t Calculated Minimum Airflow LJ Requirement (CFM) ( ) Measured Airflow using RA3.3 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 Rheem Calculate: Actual Superheat = Tsuction — Teva orator sat Target Superheat from Table RA3.2-2 using Tieturn, 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 Registration Number: 312-A0013911A-M2513949A-0000 2008 Residential Compliance Forms RegistrationDate/Time: 01/10/201310:00:44 HERSprovider: CBPCA August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refri erant Charge Verification - Standard Measurement Procedure (Page 4 of 5 Site Address: Enforcement Agency: Permit Number: 47900 Bouganvilla Blvd La Quinta CA 92253 La Quinta, City of 13-5 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 Rheem Calculate: Actual Subcooling = it * -A a 00 iOW, AN rr a"(;La Tsuction — Teva orator ]r�~~i. dll}f 9.00 Tcondenser, sat — Tli uid 0 VV X"' ' X- 4.00 - 25.00 1 , r 0 0041 09 0 Target Subcooling specified by 10.00 manufacturer Calculate difference: -1.00 Actual Subcooling — Target Subcooling= Pass System passes if difference is between Pass -3°F and +3°F 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 Rheem .qW►. +�1 a ai v Vii.. Calculate: Attu Superb at `--"' �, it * -A a 00 iOW, AN rr a"(;La Tsuction — Teva orator ]r�~~i. dll}f t► ., . A Enter allowable superheat range from '0* 0 VV X"' ' X- 4.00 - 25.00 1 , r 0 0041 09 0 manufacturer's specifications -(dr use range. ci between 4°F 2,5°F if and manufacturer's specification is not available `41 e- N System passes if actual superh6f is witHin the allowable superheat:range j� Pass Enter Pass or Fair a Registration Number: 312-A0013911A-M2513949A-0000 2008 Residential Compliance Forms Registration Date/'Time: 01/10/2013 10:00:44 HERSprovider: CBPCA 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: 47900 Bouganvilla Blvd La Quinta CA 92253 La Quinta, City of 7 13-5 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 aDDlicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag Rheem System meets all refrigerant charge and Pass airflow requirements. Enter Pass or Fait r1: -lid Performamce 'S ontla, Wr As ,v%* Ion DECLARATIOWST, ATEMENT • I certify under penalty of perjury; under ttie-laws of the State of.Califomia, the information prpvided4 this form is true and correct. • I am eligible under Division 3 ofthe Buusinessstrand �Professions Code to representative of the person responsible for construction (responslble'p • I certify that the installed features, materials, components, ormanufactured devices identif conforms to all applicable codes and regulations, adthe-installation is consistent with the enforcement agency. or this certificate (the installation) and:specifications approved by the • 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 -IR) 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) Venvest Ballard/One Hour Air Responsible Person's Name: Responsible Person's Signature: Ruth Debrick Ruth Debrick CSLB License: Date Signed: Position With Company (Title): 878533 1/10/2013 owner Is this installation monitored by a Third Pa Quality Control Name of TPQCP (if applicable): Program (TPQCP)? LJYes ❑/ No Registration Number: 312-AO01391 I A-M2513949A-0000 2008 Residential Compliance Forms Registration Date/Time: 01/10/2013 10:00:44 HERSProvider: CBPCA August ZUU9