0308-233 (SFD)H
LICENSED CONTRACTOR 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.
License # Lic. Class Exp..Date
131'4 11 rd
Date0 t Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section B&P.C. for this reason
Date Signature of Owner
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 issu d KAy workers' compensation insurance carrier & policy no. are:
Carrier Policy No:
(This. section need not be completed if the permit valuation is for $100.00 or less).
( ) 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 erosions of Section 3700 of the Labor
Code, I shall forthwith comply with thos 'proyysions.
Date: 12.12 1 Applicant I,
__V,
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indem
& hold harmless the City of La Quinta, its officers, agents and employe
2. Any permit issued as a result of this application becomes null and Vol
work is not commenced within 180 days from date of issuance of su
permit, or cessation of work for 180 days will subject permit to cancellatio
I certify that I have read this application and state that the above information
correct. I agree to comply with all City, and State laws. relating to the buildin
construction, and hereby authorize representatives of this City to enter upo
the above-mentioned property for ipWIction purposes.
Signature (Owner/Agent) Z i'Date
BUILDING PERMIT PERMIT63 213:,
DATE -VALUATION ~ Si149'C{,.Y:Y�.S�i LOT 4 TRACT
JOB SITE 77-` 102 �• NSA � R . SOLAPN
77:3-03fx-013
ADDRESS
OWNER /
CONTRACTOR DESIGNER / ENGINEER
,O)ZI:C & AU, 1.4 V iyr T iRER 'AKS A R OS A k:. (113-D1+R23 il`.� C
74-30) T_R014 COTA.T 7€S-120 FALL!,Eor 8(ATIE 2W
PAL .MD]E,'1Vk[' CA 92260 LA.tdt.!)A1'1'A t';,F.. si2t5's'
(760)5CA-6200 C��Lff 15551
USE OF PERMIT
3WGT Cs 9"AWIY T-W£1:11iNG
..
.. w. ti .- l.t -46EN *401F .r J i1... .
Tlt. XT COMTiIUCi ION 3 big,Otl 10T
PURC_'iir'PATIO 63t3.00 SE
GAR hGFJC RZP0RT 6?' .00 SP
A)C . REMDZ1 141•.1.4 _�038.ii0 SN
EN17KN.fIR.r.- CIC3:I c OF CONSI .LYMOxa
crMS•? RUt:` ION YEE _► 0) „0100.41 B-070 $975.50
Pi,AJ 1 C'14i;C:i; FE_.. i 01.000-431-3 1 u $981.44
FEV MPOSIT 101-000-4329-318 41750.00
[Y!FX,31.AWiCAL P'Lw 10i_000-411_000 $f:tI.50
LIAZCTIZIU1` FF ►01a000.4160-Ca00 $169,33
FLUMINNO F'EE, 101-OZ10-419-1100 $191.00
`T1tuM YiU' IOW. FEE - Rl;:,M 10 1-00(0 241 x000 $19114
ORA.n� 1YI0 FEE 1171-000-42:3-001)
DEVI► lrt7PEd'41,'MPAC:T PKE &:d,44o.an
$YDU.L'p
PRF.C1S)11 P L.Nk1 )01-(300.441-344SFT
OU - CYT L t 0W<,,PP,. 1Cl.(0114 MD PLAM Cln-
�.R 1
A:'71��.,(�
AdiiMS Y']711:.`!"ATD.!'-1X;;
d
"W15().(,x(1
NOW
DEC 2 3 2003
CITY OF LA DUINTA
FINANCE DEPT•
J
RECEIPT
DAT — " ;
BY
D FIN ! ' NSPECTOR
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Stab Grade
Return Air
Steel
Combustion Air
Roof Deck
d
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
i
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
-o
Drywall - Int. lath
Final
Final
POOLS - SPAS
BLOCKWALL
APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
T,�1S�.sn��l'`1
c. /Z• / PA el-' C Olusy. ,f !j -2 3 v` A i
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
44" C� O --
3 g
1 % / P.5-& TAI0 O. BOX 1504 APPLICATION ONLY
Iding 78-495 CALLE TAMPICO
Iress c l LA QUINTA, CALIFORNIA 92253
icv, �Vwtt f OuETV4
C:TA (6&A B(4( [l.CJ.V5 kCf
_i; iz_o c-At- e, -id -a 4o '2-07 1
f41 1`r" J'_( -4 -zoo
State si f 8
. ' 4 1
&.Classif. D
Designers qZ
, ncro Vol D V aL,04 IM 4V S
Address Tel
'
(9-,3s3$
TNALM OP5.v+ F, ILiC.S I
UCENSED CONTRACTOR'S DECLARATION
1 hereby aHlnn that I am Ilcen_sed under provisions of Chapter 9 (commencing with Section
700p)'oI Divisjon a Bus esa and Profeselons Code, and ryt lipa� s�aJn fullll force and
effect.. f/I 8' /D
SIC-NATLR r DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law'for the following
reason: (Sec. 7031.5,9uamess. and Professions Code: Any CRl' or County which requires a.
permit to construct alter. Improve, demolish, or repair any structure, prior to'hS issuance also
requires the applicant for Such perms -to Poe a ed atetenarrt Oral Ae hi Ikenaed pursuant to
the, provisions of the Contractor's License Law, Chapter 9 (tomnrenA 1 Section 7000) of
Division .3 of the Business and Professions Code, or that. he Is exempt therefrom, and the Dosis
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 (1500).
1': I, as owner of the property, or my employees with wages as their compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Bulanass'eM
Professions Code: The Contractor's License 'Law docs' not apply to an owner of property who
builds or Improves thereon and who does Such work himself- or through his own employees,
provided that such Improvements are not Intended or offered for sale. O, however, the building
or .Improvement Is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or Improve for the purpose of Sale.)
["11, as owner of the property, am exclusively contracting with licensed contractors to con-
-;trust the project. (Sec. 7041. Business and Professions Code: The Contractor's License Law
does moi' apply to. an owner o/ progeny who builds or brrprovea thereon; and who contracts for
such projects wah; a contractor(s) Hcensed pursuant to tAe.Contractor's Ucense Law.)
17 I am exempt under Sec. B. ti P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I have a certificate of consent to self -Insure, or a, certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Cade.)
Policy No. Company
n Copy is filed with the city. ❑ Certified copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
.(This section need not be completed If the permit Is for one hundred dollars (8100) valuation
or less.)
1 certify that in the performance of the work. for which this permit Is Issued,, I shall not
employ any pereon In any manner so as ecome subject to the Workers' Compensation
Laws Iifo
Date `moi 9 mer —Ma
NOTICE ANT: N. alter me�ong this Certificate of Exemption you snouts become.
subject to the Workers' CompensaWn provisions of .the Labor Code, you roust forthwith
comply with such provlstons-or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued.(Sec..3087, Civil Code.)
Lender's Name
Lenders Address
This, is abuilding permit when properly filled out, signed and validated, and"is subject to
expiration it workahereunder is suspended for 180 days.
I certify that, have,read this application,and,state thattheabove information Is correct.
1 agree to comply with all city and county ordinances and state Maws relating to building
construcllon, and hereby authorize representatives sof this city to enter the above•
mentioned property for Inspection purposes.
Signature of aQplicant Date
Mailing Address
City, State, Zip
.DING: TYPE -CONST. -OCC. GRP.
T.
Number 2 -7 / - 'L6_0- 00y
II Description 60 / %2 I Z 8
wt Deseription S`�► 145
Sq. Ft. 3 D�� No. / No. Dw.
Size / Stories Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
PERMIT
Plan Chk, Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS __�J
AMOUNT
7�0 • lJ�D
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setbackfrom Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
WHITE o FINANCE YELLOW - APPLICANT PINK o BUILDING DMSION
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garagestcarports, covered patiosMralkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. it has been determined that the above-named owner Is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.14 X 3,038 S.F. or $6,501.32 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Pald By CC/1st Bank - Santa Rosa Builders Check No. 70844
Name on the check Telephone
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by SharQo MCGilvrey Payment Recd®
$6,501:32
Over/Under
Signature c
NOTICE: Pursuant to Govemrment Code Section 66020(d)(1), this will serve to notNy you that the 90 -day approval period in.which you may protest the fees or
other payment identified above will begin to run from the date on which the building or installation permit for this projectis issued, or from the date -on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original- Building Department/Appilcent Copy- Applicant/Receipt Copy - Accounting
Col1�IMMIM
RECORUM REQUESTED DX
z
AND WHEN RECORDED MAA, T0:
IiICCHARD i mTTNF3It
JILL K. RUETTNER
74-301 )SRW STREET
PALM DESERT, CA 92260
e) I ")'7�kIq-'-A�
.N.(- � A 0 Z. o -0t"7
'1"t3Ya30- ,)G -Lt
Order M..
619 340 9446 Pool
000 /8ft 20 02 050415
Pe9e I of a poo 1 Tax PaJA
R000rdRd ln,tlffAalal Records
County of Rlverolde
Gary L. Qrdo
it emssn«, county Clark a R46Qridar
111
oeie
�II��I
PARTNERSHIP GRANT DEE0
THE V"ERSI0NED GRANTOR(#) DBCLA,Rj30).TMT" DOCtlMONTARY TRANSPFR TAX M Coum
[ computed on IbU value of rov�tty com►eyed, 0-'
t[ aompated
on full value les vss�Zue of lieaps or encumbrances remaining at tuna of sale,
uiaiacoItporat@d ma; [ I City of L& QMNTA, and
FOR A VALUABLE CONSIDERATION, teceipt of which is 7hereby acknowledged, � „ t�W .
JIM DAN D, UC: A► CALTB': LTD, LIAII. CO,
organised Under rthe lawS of the State of CALIIa'ORNIA
hereby ciRANI'(S) to RICHARD HDETT'NER AND JILL RUETI' OR HUSROD A
f WxFE AS JOINT TENANTS
the following described property in the City of LAQUIN'I'A, County of Riverside State o Cal9fox�aia;
Lot 4 4f IYact 28449,1{ City of LA QUINTA, County of Rivccsidet as per map arft=ded In $ook
74 , Qage(e} �j7, Loelusive of A •cellaueous Map+t, in the Office of feta County Rocordar of said
County.
J
PARTNERSHIP GRANT DEED CONTINUED ON NEXT PAGE
Moi! Tax Statements to: SAME AS ABOVE oir Address Noted Below
1 1-1/
.• - —" — • a"" nue rrNER
619 440 9446
UNDER THE PROVISIONS OF GOVERNMENT CODE 2.3761.7. x CERTIFY MDER
THE PENALTY OF PERJURY THAT THE NOTARY SEAT,, ON THE DOCUMENT 70
WHICH THIS STATEMENT IS ATTACHED READS AS FOLLOWS:
NAME OF NOTARY:.
�..
COMMz,SSxON NUMBER
COUNTY WHERE BOND TS FILBD; G I�
STATE WHERE BoND:IS FILED,p%l
DATE COMMISSION EXPIRES
PLACS OF EXECUTION:
DATB:
SIGNATURE:
PRINT NAME: p
LEONARD.
P, 02
I
1 1-1/
.• - —" — • a"" nue rrNER
619 440 9446
UNDER THE PROVISIONS OF GOVERNMENT CODE 2.3761.7. x CERTIFY MDER
THE PENALTY OF PERJURY THAT THE NOTARY SEAT,, ON THE DOCUMENT 70
WHICH THIS STATEMENT IS ATTACHED READS AS FOLLOWS:
NAME OF NOTARY:.
�..
COMMz,SSxON NUMBER
COUNTY WHERE BOND TS FILBD; G I�
STATE WHERE BoND:IS FILED,p%l
DATE COMMISSION EXPIRES
PLACS OF EXECUTION:
DATB:
SIGNATURE:
PRINT NAME: p
LEONARD.
P, 02
Certificate of Occu ancy0P
H
OF Buildings & Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code., certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 77-202 CASA DEL SOL
s°fit
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0308-233
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RM
Owner of Building, DICK & JILL HU'ETTNER Address: 74301 ERIN COURT
City, ST, ZIP: PALM DESERT, CA 92260
By: KIRK KIRKLAND.
Date: DECEMBER 6, 2004
Building Official
POST IN A CONSPICUOUS PLACE
s -
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
78-194 Elenbrook Ct.
Palm Desert, CA 92211.
Off1ce (760) 772-71.92
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
O REINFORCED CONCRETE O trt= STEEL ASSEMBLY
0 POST TENSIONED CONCRETE O ASPHALT
O REINFORCED MASONRY O FIRE PROOFING
OSIT!
HER �d4
JOB LOCATION
19_ ^ 9- CASA � (^ V `��—
•y '(�PERMIT'N0. ` r1
REPORT SEQUENCE NO.
Ty ,5 CT RE
u ee(J'R NeA.- J.es
191 b
DAv OF WEEK
MATERIAL DESCRIPTION Q
ARCHITECT
INS OR
HRS. CHARGED
, T - ^ AA 9�
ENGINE% ��Q (
ASSISTANTS
HRS. CHARGED
INSPECTION 1ON
cT"ENERALw&%tA CA osOg J c 1. coNrn craRS
• el. J i bi
w ss Wec-o
o►� c,�s
IS
iT c,4 L� f► �oec C.4-� t uv�
S � a eLlo iNG•
4(9
COPY SENT TO CLIENT O
CONTINUE ON NEXT PAGE O
PAGE Or
CERTIFICATION OF COMPLIANCE.
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV
KNOWLEDGE ALL OF'THE ABOVE REPORTED WORK UNLESS' OTHERWISE
NOTED I HAVE FOUND THIS,WORK'TO'COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE_ SECTIONS OF THE
GOVERNING BUILDING LAWS.
SIGN TUBE OF REGISTERED MPECTOR
DATE OF REPORT REGISTER NUMBER
9��■fes■�m�s�l
all mill, k
11 IN
]ME lmml
11111 MIS 'oj,o�=�mimi
�W�1
otecials and .ems -coaftm to ULU= momalmanaftLmn>
sm�z
1981 20th. Anniversary 2001
Consulting Electrical Engineers
19031 Mghwoy 18 Ste 200 72330 canyon Lane
Apple Valley, CA 92307 Palm Desert, CA 92260
Phone: (760) 242-3369 Phone: (760) 773-4478
Fax: (760)242-1092 Fax: (760) 242-1092
dreankloe(geharter.net dreamjoegaoLrnm
TITLE 24, JANUARY 2001 ENERGY EFFICIENCY STANDARDS
FOR LOW RISE RESIDENTIAL BUILDINGS
SANTAMARIA
39-038 SQ. FT.
2113103
Energy Budgets for this building were determined using the CALRES VERSION 1.4 certified by the -
California Energy Commission. The Calres analysis attached was conducted using tables from the
Residential Manual for Compliance With the Energy Efficiency Standards (for Low Rise Residential
Buildings) JANUARY 2001, certified by the California Energy Commission.
*** HOUSE COMPLIES ***
"**REFERENCE C -21R PAGE 1***
I hereby certify that the California Energy Commission Conservation Division regulations establishing
Energy Efficiency Standards for Residential Buildings, Title -24, Part 6, have been reviewed and the design
submitted substantially complies with these regulations.
Joseph M. Nolan
N
pod el"I
Electrical Engineer
ATTACHMENTS:
#1 C -2R (4 PAGES)
#2 CF -1 R (3 PAGES)
#3 - MF -1 R Mandatory Measures Checklist: Residential (2 PAGES)
#4 - CF -6R Installation Certificate (13 PAGES)
#5 — FHA FORM J ,Heating and Cooling Calculations (1 PAGE)
CITY 0r LA QLJINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CON RU TION
DATE 0 BY
C:IDocuments and Settingsldesk\DesktoplTITLE 24.docTITLE 24 — RESIDENTIAL PAGE -1
Z7`Z� IrAft A9 sot
COMPUTER METHOD SUMMARY Page 1 C -.2R
Project Title: SANTAMARIA 3038 SQ. FT. Run: 142 13 -Feb -03
Project Address: LOT 4 - CASA DEL SOL SANAMARIA 3.038 SQ. FT.
LA QUINTA, CA 92253
Building Title: SANTAMARIA Building Permit #
Document Author: DREAM ENGINEERING INC. 760 773-4.4.78
Telephone: Plan Check / Date
Compliance Method: CALRES2 1.4.02 Field Check / Date
Climate Zone: 15
ENERGY USE SUMMARY (kBtu/ft2-yr')
Energy Use Standard Design
Space Heating
5.34
Space.Cooling
51.30
Water Heating
9.38
Total
66.0.2
GENERAL INFORMATION
Conditioned Floor Aiea,:
Average Ceiling Height:
Building Type-:
Building Front. Orientation:
Glazing Area, % of Floor Area.:
Average Fenestration U -Value:
Average Fenestration SHGC:
Number of Dwelling Units:
Number_ of Stories:
Floor Construction Type:r
Number- of Conditioned Zones:
Total Conditioned Volume:
BUILDING ZONE INFORMATION
Proposed Design
---------------
4.04
53.85
8..11
-------- Complies
66.00 Yes
3038 ft2
12'0" ft -in.
SFD Single: Family Detached
180 deg (South)
20.7%
0.33
0.33
1.00
1
Slab on grade
1.
364156 .ft3
Floor Vent
Zone Area Volume Thermostat Height
Name (ft2) (ft3) Type- Type (ft)
------------ ------- -------- ------------- ------------ ------
HOUSE 3038 36456 Conditioned CEC Standard 210"
OPAQUE SURFACES
Surface
Area
U-
Insl
Total
Tru
Slr
Construction
Type
(ft2)
factor
Rval
Rval
Azm
Tlt
Gns
Type
Location/Comments
Zone =
HOUSE
Door
24.0
0.330
0
3
0
90
Yes
FRONT
Outside
Door
104.2
0.330
0
3
180
90
Yes
BACK
Outtside
Door
80.0
0.33.0
0
3
90
90
Yes
LEFT
Outside
Door
72.0
0.330
0
3
270
90
Yes
RIGHT
Outside
Wall
1133.3
0.0.65
19
15
0
90
Yes
W19.2x6.16.
Outside
Wall
651.2
0.065
19
15
90
90
Yes
W19.2x6.16
Outside
Wall
888.5
0.065
'19
15
1.80
90
Yes
W19.2x6.16
Outside
COMPUTER METHOD SUMMARY Page 2 C -2R
Project .Title: SANTAMARIA 3038 SQ. FT. Run: 142 13 -Feb -03
OPAQUE SURFACES continued
Surface
Area
U- Insl
Total Tru
Slr Construction
Type
(ft2) factor Rval
Rval Azm
Tlt Gns ,Type Location/Comments
---------- ------
Wall
------ ----
687.8 0..065 19.
----- ---
15 27'0
--- ---------------- -=-----------------
90 Yes W19.2x6.16 Outside
Ceiling 3038.0
0..024 38
4'2 --
0 Yes R38.2x4..24 Attic
Floor 3.038.0
-- 0
-- --
180
No Slabl4'0,C Grade
'PERIMETER LOSSES
Insul
Perimeter
Length
F2
Insul
Depth
Type
(ft.)
Factor
R-val
(in)
Location/Comments
Zone = HOUSE
Exposed
355110"
0.507
--
--
Unconditioned
Exposed
10010"
0.507
--
--
Unconditioned
FENESTRATION
SURFACES
Fenestration
Exterior
Shade
Over -
Fenestration
Area ---------------
Tru -----------------
hang
Name
---------------------
Type
(ft2) U
--------------
-factor
------
SHGC
Azm Tilt Type
--- --------------
SHGC
------
/Fins
------
Zone = HOUSE
FRONT_GLAZ_F
Window
45.5
0.33
0.33
0 .90 BugScrn
0.76
None
FRONT_GLAZ_S
Window
50.0
0.33
0.33
0 90 BugScrn
0.76
None
BACK_GLAZ_F
Window
75.8
0.33
0.33
180 90 BugScrn
0.76
None
BACK_GLAZ_S
Window
184.3
0.33
0.33
180 90 BugScrn
0.76
None
LEFT _GLAZ_F
Window
71.2
0.33
0.33
90 90 BugScrn
0.76
None
LEFT _GLAZ_S
Window
79.5
0.33
0.33
90 90 BugScrn
0.76
None
RIGHT _GLAZ_F
Window
14.6
0.33
0.33
270 90 BugScrn
0.76
None
RIGHT_GLAZ_S
Window
107.6
0.33
0.33
270 90 BugScrn
0.76
None
OVERHANGS
Fenestration
-------------------------- Length Height Left Right
Name Width Height 'H' 'V' Extension Extension
------------ ------ ----- ------ --------- --------- ---------
None
FINS Left Fin Right Fin
Fenestration Dist Dist
-------------------------- Fin Fin Ht from Fin Fin Ht from
Name Height Width Depth Height 'V' fenes Depth Height 'V' fenes
None
COMPUTER METHOD SUMMARY Page 3 C -2R
Project Title: SANTAMARIA 3038 SQ. FT. Run: 142 13 -Feb -03
THERMAL MASS
Vol Cond-
Area Thck Heat duct- Construction Insd
Mass Name (ft2) (in) Cap ivity Type Rval Location/Comments
Zone = HOUSE
INTMAS'S 1800 1.0 19 0.09 Tile 0 Interior
SOLAR GAIN DISTRIBUTION
Fenestration Winter Summer Targetted
Name Fraction Fraction Thermal Mass Comments
-----------= -------= -------- ------------ --------------------------------
None
HVAC SYSTEMS
Refrigerant
Minimum
Charge and
Equipment
Duct Location
System Name System Type
--------------------------------------
Airflow TXV
Efficiency
and R-value
Zone = HOUSE
-----------
----------
-------------
GasFurn..80 Furnace
N/A
0.80 AFUE
Attic R-4.2
ACpkg12 Air cond. - central pckg
No
12.00 SEER
Attic R-4.2
HVAC DISTRIBUTION EFFICIENCY DET"AILS
Duct Leakage
,Supply Target
Duct Surface ACCA Manual D (leakage cfm/
System Name Area Design % of fan cfm) Fan CFM
--------------------------------------------------------------
CEC 100%R4.2 820 No n/a 2127
WATER HEATING SYSTEMS
Distrib Water Water # of Energy Volume
System Name Type Heater Name Heater Type Htrs Factor (gal)
Standard _Gas Standard StandardGas Storage gas 1 0.73 40
Standard_Gas Standard StandardGas Storage gas 1 0.73 40
SPECIAL WATER HEATING SYSTEM CREDITS
Solar savings Wood stove Wood stove
System Name fraction boiler? boiler pump?
Standard_Gas -- No No
Standard Gas -- No No.
,i
COMPUTER METHOD
SUMMARY,
Page
4
C -2R
Project Title,:
SANTAMARIA 3038 SQ. FT.
Run:
14.2
13 -Feb -0.3
SPECIAL WATER HEATER/BOILER DETAILS
Rated Pilot
Water Recovery Input Standby Tank Light.
Heater Name Efficiency AFUE (kBtuh) Loss R -value (`Btuh)
------=-- ------------ ------------------------- ------
StandardGas 76% -- 10.8.00 -- - -
HYDRONIC DISTRIBUTION AND TERMINALS
Pipe. Pipe Insul Insul
System/Name Type Number run (ft) diam (in,) thck (;in) R -value
-------------- ------------- ------ -------- --------- --------- -------
None
SPECIAL FEATURES, REMARKS; AND NOTES
1. Heating "duct register location: Ceiling.
2. Cooling duct register -location: Ceiling.
CERTIFICATE OF COMPLIANCE: Residential
-----------------
Project Title,: SANTAMARIA 3038 SQ. FT.
Project Address: LOT 4 - CASA DEL SOL
LA QUINTA, CA 92253
Building Title': SANTAMARIA
Document Author: DREAM ENGINEERING 'INC.
Telephone:
Page 1 CF -1R
-------------------------------------
Run: 14.2 13 -Feb -03
SANAMARIA 3.038 SQ. FT.
Building Permit #
760 773-4478
Plan Check / Date
Compliance Methods CALRES2 1.4.02 Field Check / Date
Climate Zone: 15
GENERAL INFORMATION
Conditioned Floor Area:
3038 ft2
Average Ceiling Height:
12'0." ft -in
Building Type:
SFD Single Family Detached
Building' Front Orientation:
180 deg (South)
Glazing Area, % of Floor Area:
.20.7%
Average Fenestration U -Value -0,33
Average Fenestration SHGC:
0.33
Number of Stories:
1.
Number of Dwelling Units:
1.00
Floor Cons.truction.Type
Slab on grade
BUILDING SHELL INSULATION
FLOOR TYPES AND AREAS
Construction Type
Cavity
Sheathing
Exterior
Conditions/Descripti
-------------------
.Slab
Component
Insul
Insul
Total
Assembly
FENESTRATION
Type
---------------
R -value
--------
R -value
--------
R -value
--------
U -value
--------
Location/Comments
-----------------------
Door
0
--
3.03
0.330
Outside
Wall
19
0
15.38
0.06.5
Outside
Wall
19
0
15.3,8
0.065
Outside
Wall
19
0
15.38
0.065
Outside
Wall
19
0
15.38
0.065
Outside
Ceiling
38
0
41.67
0.024
Attic
Floor
0
0
3.38
0.295
Grade
Slab Perimeter
0
0
0
0.507
Unconditioned
Slab Perimeter
0
0
0
0.507
Unconditioned
FLOOR TYPES AND AREAS
Construction Type
Area (ft2')
Conditioned?
Exterior
Conditions/Descripti
-------------------
.Slab
------------
--------------
3038
Yes
-------------------------
Grade
FENESTRATION
Area
Fenestration
Fenestration
Exterior
Overhang
Type/Orientation
(ft '2:)
U -factor
SHGC
Shading
and Fins
-----------------
Window North
-----
95.5
------------
0.33
------------
0.34
----------
BugScrn
--------
None
Window South
260.1
0.33
0.34
BugScrn
None
Window East
150.8
0.33
0.:34
BugScrn
None
Window West
122.2
0.33
0..34
BugScrn
None
CERTIFICATE OF COMPLIANCE: Residential Page .2 CF -1R
Project Title: SANTAMARIA 30.38SQ. FT. Run: 142 13 -Feb -03
THERMAL MASS Area Thick
Type Cover (ft2.) (in) Location/Comments
Intmassl ' 1800 1.0 Interior
HVAC SYSTEMS
Type Efficiency
-------------------------- ----------
Furnace 0.80 AFUE
Air cond. - central pckg 12.0.0 SEER
HVAC DISTRIBUTION EFFICIENCY DETAILS
Refrigerant Distribution System
Charge and Location
Airflow TXV and R -value
----------- -------------------
N/A Attic R-4.2
No Attic R-4.2
Duct Leakage
Supply Target
Duct Surface ACCA.Manual D (leakage cfm/
System Name Area Design % of fan cfm) Fan CFM
--------------------------------------------------------------
CEC 100%R4.2 820 No n/a 2127
WATER HEATING SYSTEMS
Distrib
Water
Water
# of
Energy
Volume
System Name Type
Heater Name.
Heater Type
Htrs
Factor
(gal)
------------ --------
Standard Gas Standard
------------
StandardGas
-----------------
Storage gas
-----------
1
0.73
------
40
Standard Gas Standard
StandasdGas
Storage gas
1
0.7.3
40
SPECIAL WATER HEATING SYSTEM CREDITS
Solar savings Wood stove Wood stove
System Name fraction. boiler? boiler pump?
------------ ------------- ---------- -------------
'Standard Gas -- No No
Standard Gas -- No No
SPECIAL WATER HEATER/BOILER DETAILS
Rated Pilot
Water Recovery Input Standby Tank Light
Heater Name Efficiency AFUE CkBtuh) Loss R -value (Btuh)
---------------------- ------------------------- ------
StandardGas 76% -- 108.00 -- -- --
CERTIFICATE OF
COMPLIANCE: Residential
Page
3
CF -1R
Project .Title:
SAN.TAMARIA 3058 SQ. FT.
-------------
Run:
142
13 -Feb -03
HYDRONIC DISTRIBUTION. AND TERMINALS
Pipe
System/Name. Type Number run (ft')
-------------- ------------- ------ --------
None
SPECIAL FEATURES, REMARKS, AND NOTES -
1. Heating duct register location: Ceiling.
2.: Cooling duct register location: Ceiling.
Pipe Insul. Insul
diam (in) thck (in) R -value
--------- --------- -------
COMPLIANCE STATEMENT
This certificate of compliance lists the building features and performance
specifications needed to comply with the Energy Standards in Title 24, Parts 1
and 6, of the California Code of Regulations, and the Administrative regulations
to implement them. This certificate has been signed by the individual with
overall design responsibility. When this certificate of compliance'is submitted
for a single building plan to be built in multiple orientations, any shading
feature that is varied is indicated in the Special Features, Remarks, and Notes
section.
DESIGNER OR OWNER
&tw"Om 4
760.568-3838
Certifica #:
_ 3 0
SignedDa�/
ENFORCEMENT AGENCY /'
Name:
Title:
Agency:
Telephone:
Signed Date
DOCUMENTATION AUTHOR
DREAM ENGINEERING INC. 760 773-4478
Date
1
4270
356.
3038
12.0
SOUTH
LA QUINTA
113
26
N/A
Consulting Electrical Engineers
191131 Hldlmey 1R Stip 200 72.31711 Cmgen I,Am
Apple Valley, CA 92307
PaLn )ktimt, CA 92260
Phenea (760) 742.3369
Phenes (7") 773-4478
Pai: (700) 243.3,W2
I -us, (760) 242-1092
drmtq)oe({ll #mrftf/1c/
dtawmJee;l*neLeem
FORM J EQUIPMENT LOADS
PROJECT:
34 BTU/SQ FT
DREAM ENGINEERING INC.
19031 HIGHWAY 18 - SUITE 200
SANTAMARIA
3038 SOFT
APPLE VALLEY, CA
(760)242=3369/F1092
LA QUINTA
CA HTM
HTM AREA/ BTU
BTU NUMBER OF FLOORS
CLG
HTG LENGTH CLG
HTG EXPOSED WALL (SQ FT)
GROSS EXPOSED WALLS
FOOTPRINT - PERIMETER (FT)
FIXED WINDOWS
25 0 0
0 BUILDING DIMENSIONS (SQ FT)
SLIDING WINDOWS
26 628 0
16278 CEILING HEIGHT (FT)
WINDOWS &
NORTH 29
260 7655.71
DIRECTION FACING
GLASS DOORS:
EAST 86
122 10505
LOCATION
SOUTH 46
96 4443.74
SUMMER DESIGN OUTDOOR - 78
WEST 86
151 13031.3
WINTER DESIGN OUTDOOR - 68
SKY LIGHTS
0
0 0 0
0 UBC50% OCCUPANCY
OPAQUE DOORS
38
25 280 10640
7000 DISCLAIMER:
NET EXPOSED WALL
R19 1.9
2:0 4270 8112
8539 1.THE BUILDING HEAT LOSS & RESULTING MAXIMUM HEATING
AVE CEILINGS
R38 1.49
0.8 3038 4539
2552 EQUIPMENT OUTPUT CALCULATIONS IN THIS REPORT MEET THE
CEILINGS (R#2)
0
0 CRITERIA OF TITLE 24. THIS MAXIMUM MAY BE EXCEEDED
FLOOR (SLAB - PERIMETER)
0
28.3 356 0
10069 WHEN THE FURNACE IN THE SELECTED PRODUCT LINE MUST BE
FLOOR (RAISED FLOOR)
0
0 0
0 LARGER TO MEET COOLING LOAD AIR FLOW REQUIREMENTS.
SUBTOTAL BTUH LOSS
44438 27HE BUILDING SENSIBLE HEAT GAIN CALCULATED IN THIS
DUCT BTUH LOSS (15%)
5333 REPORT MEETS THE CRITERIA OF TITLE 24.AND MAY BE
HEATING: TOTAL.BUTH LOSS
49770 USED BY THE MECHANICAL CONTRACTOR IN EQUIPMENT
PEOPLE &APPLIANCES
1200
SELECTION. AND SYSTEM DESIGN. THE ARI STANDARD 210
SENSIBLE -BTU GAIN
60127
RATED CAPACITY OF THE EQUIPMENT SELECTED MAY NEED
DUCT -BTU GAIN (15%)
9019
TO BE HIGHER THAN THAT STATED IN THE CALCULATIONS
SUM OF SENSIBLE AND DUCT GAINS
69146
BECAUSE THE DESIGN CONDITIONS FOR THE LOCATION ARE
COOLING: TOTAL BTUH GAIN (TOTAL X 1.3)
89889
DIFFERENT FROM THE TEST CONDITIONS USED IN THE RATINGS.
HTG UNIT SIZING =
BTUH LOSS X 1.3 + 10 X AREA =
85082 BTU HEATING OUTPUT, MINIMUM REQUIRED
CLG UNIT SIZING =
BTUH GAIN X 1.15
=
103373 BTU COOLING SENSIBLE, MINIMUM REQUIRED
1
4270
356.
3038
12.0
SOUTH
LA QUINTA
113
26
N/A
MANDATORY MEASURES CHECKLIST: RESIDENTIAL (Page I of 2) MF -1R
Note. Ldwrise residential buildings:subject to the Standards must contain these measures rerdless of the compliance approach used.
Items manned with an asterisk (•) may be: suga
perseded try more stringent compliance requirements lifted on the Certificate of
Compliance. When this checklist is incorporated into dw permit docutaenta, the-featurea noted droll be conradered by all parties as
minimum component perfarmanc a specificatinm for the mandatory mamures whether they ate shown.elwwheacc in tits documents
or on this checklist only.
Instructions: Chuck or initial applicable boxcs urllcn completed or enter NIA if not applicable.
DESCRIPTION
DESIGNER
ENFORCEMENT
Building. Envelope Measures;
• $150(a): Minimum R-19 extiling'insulstican.
§ 150(b): Loose fnll'insuladoe mmufacturces labeled K Value.
• §15*): Minimum R-13 wall insulation in wand framed walls or equivalent 'U-Factor..ht U W.framc walls
dies rex apply to maerior masa walls
• 0150(d). Mininum R-13 uiced,tlonr ioa deticu ia;5arued ilocss.
§ I W) : Stab cope insulation -water absorption rate no greater than 0.M waterrapor ltatrotainion rate no
greater than 2.0 .
§118: lmuialiar Vvdfied ar installed tncm insulation gmalitysxftdatda. I dicatetypc and form.
#116-17. Fenesuation Products, Exterior Don a. and lnflltratit uffi rfdttstiem Commis
1. tkmn: and windows between oomditione1 and unconditioned spaces destignrd to limit air leakage.
2. Fenestration ptodnew(mapt fielcFfabxic:ated) have label with ocrtitkd U -Factor: certified Solar Hem
Gem Coefficient (SHGC), and iihtation certification..
3. F-ttcnar doors and windows weathasu ipped;;all joints and penetrations caulked and staled
§ 150(g)c Vapor harriers mandatory in Climate Zatac 14 and 16 only.
§ 150(1): Special infiltration bsnicr'installed to comply with § 151:meets Commission quality etandmtta:
Imualerirm of F1npiecav [)woraive Lias Apoiaucee rend Gas;Lgp.
1. Masonry and faedmy-buitt fneplaces ham
a. Closeable metal or pleas door
b. Outside air intake with.daruper and control.
c. Flue danVa and control
2. No continuous buming gas pilot lights allowed
Space Cenditioniog, Water Heating and Plombing System Measures.
§1104113: HVAC egnipmestt. wrote heaters, abowerheads and 4autbt catittied by Ow ConenissicaL
§ I Stl(Frk Heating andlar cooling loads calculated m aceondance with ASNRAF, SMACNA or AMA.
§150&. Selbuck dtermoetat on all applicable heating and/or cooling systems.
JIM& Pipe sad teak iasnlation
1. Sunage gas water hearer: tatedwith an Fnergy Fater ten than OSA nonan be ekwma ly wrapped with
iaaulatirnt droving oat installed tlttxtnatl resietanice oflt t2 orgreets.
I Pird 5 fed of pipes closest to waterheater tank, nnaareenenlating syomms, insulated (R-4 or pestes
3. Rack -up tank+ for Polar "eta, unfired storage tanks, or other indired hot, water tanks have R-12
extentsl insulation or R-16 combined interni/ rna1'imalatitrm
4. Al buried or exposed piping insulated in recirculating sections of hot water aystemat.
5. Cooling,sywem piping below 5r F insulated.
6. Piping insulated between heating ar, - and imdired hotwater tank.
Compliance Forms August 2001 A-5
MANDATORY MEASURES CHECKLIST:.RESIDENTIAL (Pagt:.2of2) MF -IR
Notc: Lowrisc residential buildings subject to the Standards must contain these measures,regardless of the compliance approach used.,
Ttems markcdf wttb an asterisk (•) may be sapetsodcd"by more stringent compliance requirements listed on the CertiScate of
t omplisoce. When4his checkW'is incorporated int&the permit documents,'the'feattars noted shnll be considered by all parties as
minimum component performance specifications for the mandatory measures whether they ane shown elsewhere in the documents
or on this checklist only.
Instructions: Check or initial applicable boxes when completed or entcrN/A if not applicable.
'DESCRIPTION
DESIGNER
ENFORCEMENT
Space Conditioning, Water Hosting and Plumbing System Measures: (continued)
• § I W(mj: Ducts and Fans
1. All daps and picaur a iamelled. seeded and,fnsolaled to atatthe requftu mmt offt,1998 CMC Sections 601,
603, 604. and SacmW 0; ducts insulated to att»aitom iostalled kvel ofR-4.2 or encic id d'andmly in
cuodihoned space. Op mengs shall be seated with roemw. tape, aerosol seely t, or other duct costa ya m
that meals the applicable nqudaaeots of UL 181, UL 181'A. or UL 181B. If amatic or lora is used so steal
opcoiogs greater than 114 inch, 9teconNnation of mastic and either rnmib or UN shall be meed. Building
rnvi6es shall not be wedfuroomryitugeoodi600ed air Joints and seams of duct symeuos and their
components shall not be seoled with d oth,back rubber adhesive dud tapes unless such tape is used"e►
combination witb mostic and drawbaods.
2. Building mAties, support platfotnss Ur air handlers, and plesnu m defined or cotWructedvft materials
other than scaled sheet metal: dud board or flextNe duct .shall no be•wed far conveying cxxtditioned
air. Building cavities and support pladbrow may oontai n ducts. Ducts installod io cavities and supe mt
platfornn.shall not be compressed to cause reductions in the erase-aec;iaoat area of the ducts.
3. Joints and smmq ofdoct systetas and their eonVoemtts,shatl not.be soled with doth back rubber
Whe*m duct tapes unless such tapt is used in combination with wastic and dmwbet i&
4. Exhaust far systema have bade draO or automatic dampers.
5. GrAvity vratitattng system solving cauditione dspace have eilha aukinstic or rem* accessible,
manually operated dettsptp.
6: Protection oflmnlatlon. hnstdation shalt be protected ft= dsmmge, Including tient due to sunligh4
unisons, eeququnat madtaensaw. and wind but not liumte d tb the following: Imulatka exposed to
"weather eeltall lee suitable for outdoux service e.g,. protected by ala n*wAe, sheet metal, painted canvas,
or plastic sumer. Cdbdw foam insulation shag be psolected as above repainted with a coating that is
want retardant and pmwidles ddeldnn from solar radiation that can arae onof the matexiA
1114: Pool and Spa Heating Systan said 1•iquipmeot.
t. System is certified with 79% d==1 cffiiciancy, on-off switch, wmtlesproof opeta ft nstructiom so
electric resistance hating and no pilot light.
2. Systernis instal, led with
a. At least W of pipe between fitter and heater for futue-solar hating.
h. Cover for arditor, pools earotmloor spas.
3. Pool sysoent las dire dwd inlets am a cira> WM PUMP that ndba .
if 15: Gas fired ondta) fitrnaaea, pool heaters, spa heaths or boas loud eooking appliaawa hove no
'iotlf igmt tried with < I5013tt ft
1119(f): Cant Roof mmerial'taeet hipee iced anafa
Lightinq�Meosares:
1150MI.: Luusinaicearl;tr gcnaal tightittg iu kilcions sba8 hove lu pa with an efficacy of 40 haaeos/wau
or getatet for gmcal 8gftipg in kitchow That gametal lighting AW1 be oomallad by a switch an a vas ty
accessible ' at ao manors is the tltcinen
$1 SOQc)I. Raatnes with a shower or bathtub mum have either at least roe hodoaim with lamps with an
efficacy of 401ameaulavatt ev greeter twitched at the entrance to doe taom ex one of the alternatives to. this
regtmer»mt allotted in ¢ISO(k)2; and moaradness
oent reced ceiling fbnmrm ata 1C (insulation Dover)
approved -
Compliance Forms August 2001 A-6
INSTALLATION CERTIFICATE (Page 1 of 13) CF -6R
Site Address Permit Number
An installation certificate is required to be posted at the building site or trade available for all appropriate inspections. (Thc
information provided on this form is required; however, use ofthis form to provide the information is optional.) After
completion offinal inspection, a copy,must be provided to thcbuilding dcparhnent(upon request) and the building owner at
occupancy, per Section I0=I03(b).
RVAC SYSTEMS:
Hurtling Egtt"tent
Equip- k of Efficiency Duct Duct or Heating Heating
Type 0*& C -W Certified Mfr.Name Identical (AFufi; de.)' Locatim Piping Loud Capacity
heatouinm and Modd Number Svatema PzCF:ITLnh el faftic_ etc.l R -value IBtL" IBM&d
Coai7ing Eq&*ment
l quip. CEC Certified Compremm H of
Type (pkg. Unit Mfr Now and identical
Mciency Duct Cooling t'twtlirg
(SEER, ctc:)' Location. Duct Load Capacity
1. > reads greater than or equal to.
I, the undersigned, verify that equipment listed above is_ 1) is the actual equipment imulled, 2) equivalent to or more
efficient than that specified in the certificate of compliance (Form CFAR) submitted for compliance with the Energy
E•,(liciency Standards for residential buildings;:and 3) equipment that meets or exceeds the appropriate requirements for
manufactured devices (from the Appliame Efficiency Regulations or Part 6), where applicable.
Signature, Date Installing Subcontractor (Co..Name)
OR General Contractor (Co. Name) OR Owner
WATER HEATING SYSTEMS:
Distn'butiau if liedr- 0 of Rated= Tank Effl- Fstemel
Heater UC Catified Mfr Type (S* culatiott, idm8cal bqm (kW Vohttue creno Standbyz Insulation
Type_ Naine a; Model'Nnn%a t ora-of:Use) Ca®uol Tbae Svetew or Btufir) feallotM (FF. RFS Lm (%) R -value'
2 For suan pas sterpge (zated input of km than or equal m 75,000.BUYIA atsetrie resWome and heat pump watt' hmteis, list Fttergy Factor.
For targe t(as star V warn hater (rated input of Feaw than 75,000 BtuAv)j list Rmwery E idea y, Smndby1 qwx am Rated bq aL
For Boas pis wirer, beaten, list Rwumy E ideocy and Rated loput
3. R-12 wemal,insalatimis mandatory for alwage watu heazps with an eatcgy faetwof jean than oSg.
Fanedit & Shower Heads:
All fauoels and showenccads installed are certified to the Commission, pursuant to Title 24, Partb, Section 111.
I,.the undersigned, verify that equipment listed above my signature is: 1) the actual equipment installed; 2) equivalent to
or more efficient than that specified in the certificate of compliance (Norm MIR) submitted fear compliance with the
1•:nergy Eficimcy Smia&w& for residential buildutgs; and 3) equipment that meets or exceeds the appropriate
requirements for manufaatuued devi m (*om the Applkwce Efik*ncyRegulations,or Part 6), where applicable -
Signature, Date
COPY TO: Building Department
HERS Provider (if applicable)
Building:Owner at Occupancy
Installing Subcontractor (Co. Name) OR
General Contractor (Co. Name) OR Owner
Compliance Forms Atlgust.2001 A:23
INSTALLATION CERTIFICA T, E (Page 2 of 13) CF -6R
Site Address Permit Number
FENESTRATION/GI AZING:
Total
QUM*
Of t.;loi:
n of Product
2.
3.
5.
T.
Exterior Shading
Square rkvke or Commen /Locatiaw
' Manufactured'fenestrationproducts use the values from the product label.. Field:fabric:ated fenestration products use the
default values from Section 116 of the Energy Efficiency Standards.
' Installed U-Factorm ist be less than or equal to values from CF -IR. Inamlled SHOO must be less than or equal to values
from CF -IR, or a shading device (exterior or overhang) is installed as specified on the CF -1 R. Alternatively, installed
weighted average U -Factors for the total fenestration area are less than or equal to values from.CF-11L
1, the undersigned, verify that the lienestratiordglaung listed above my, signature: 1) is the actual fenestration product
installed; 2) is equivalent to or has a louver U -Factor and lower SHOC then that specified in the certificate of compliance
(Form CF -1R) submitted for compliance with the Energy E,lic:lemy &mdm* for residential buildings; and 3) the
product meets or exceeds the appropriate requuoments for matudactured devices (from Part ). where applicable.
Item #s Signature. Date Tnstalling Subcontractor (Co. Name) OR
(if applicable) General Contractor (Co. Name) OR Owner
OR Window Distributor
Item #a Signature, Date Installing Subcontractor (Co. Name) OR
(if applicable) General Contractor (Co. Name) OR Owner
OR Window Distributor
Two #s Signature, Date Installing Subcontractor (Co., Nam) OR
(if applicable) General Contractor (Co. Name) OR Owner
OR Window Distributor
COPY TO: Building Department
HERS.Provider (if applicable)
Building Owner at Occupancy
Compliartoe Forms
August 2001
A-24
INSTALLATION CERTIFICATE (Page 3 of 13) CF -6R
Site Address Permit Number
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
❑ DUCT LEAKAGE REDUCTION
Pressurization Test Results (CFM ® 25 PA)
Test Leakage (CFM)
Fan Flow
If Fan Flow is Calculated as 400 cfm/tonx number of tons, or as 21.7 x Heating Capacity
in Thousands of Btu/hr, enter calculated value here.
If fan flow is measured, enter measured value here
Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) =
Pass if leakage fraction 5 0.06 ❑ ❑
Pass Fail
❑ For AEROSOL TYPE SEALANTS ONLY - The following diagnostic testing was completed:
Dud Fan Pressurization at rough -in measured leakage (CFM)
CHECK AFTER FINISHINGWALL:
0 Yes. ❑ No ❑ Pressure: pan test or House pressurization test
❑ Yes ❑ No ❑ Visual Inspection of Duct Connections ❑ ❑
Pass Fail
❑ THERMOSTATIC EXPANSION VALVE (TXV)
❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is
provided for inspection ❑ ❑
Yes is a pass Pass Dail
❑ DUCT DESIGN
I.
❑ Yes ❑ No ACCA Manual D Design calculations have been
completed, Duct Design is on4he plans and duct installation
matches plasis:
2. ❑ Yes ❑ No TXV is installed or Fan;flow has been verified. If no TXV,
verified fan flow matches design from CF -1R
Mmmrcd Fan Flow
Yes for both 1 and 2 is a Pass
❑ ❑
Pass Fail
❑ L.the undersigned, verify tbat the above•diagnostic test results and the work 1perfarated associated with the test(s) is in
ct nformance with the requirements for compliance credit. [The builder shall provide the HERS provider a copy of the CF -6R
signed by the builder employees or sub -contractors certifying that diagnostic testing and installation meet the requirements
for compliance credit.]
Tcsts Signature, Date Installing Subcontractor (Co. Namc) OR
Performed General Contractor (Co. Name)
COPY TO: Building Deparimew
HERS Provider (if applicable)
Building Owner at Occupancy
Compliance Forms August 2WI A-25
INSTALLATION CERTIFICATE (Page 4 of 13) CE -6R
Site Address Permit Number
REFRIGERANT CHARGE AND AIRFLOW MEASUREMENT
Verification for Required Refrigerant Chargc and Adequate Airflow for Split System Spacc.Cooling Systems without
Thermostatic Expansion Valves
Outdoor Unit Serial #
Outdoor Unit Make
Outdoor Unit Model
Cooling Capacity
Date of Verification
Date of Refrigerant Gauge Calibration
Date of Thermocouple Calibration
Btulhr,
(must be checked monthly)
(must be checked monthly)
Standard Charge and Airflow Meastament (outdoor air dry-bulb:55: OF and above):
Note: The system should be installed and charged in accordance with the manufacturer's specifications before starting this
procedure.
Measured Temperatures
Supplw(evaporator leaving) air dry-bttlb temperature (Tsupply, db)
_ OF
Return (cvapora for entering) air dry-bulb temperature (Trctum, db)
IV
Rcturn (evaporator entering) air wet -bulb tempamture (Tretum. wb)
OF
Evaporator saturation temperature (Tcvaporator, sat)
OF
Suction line temperature (Tsuction, db)
7
Condenser (entering) air dry-bulb tcmpcmtuw (Toondenser, db)
OF
Superheat Charge Metho&Calculations for Refrigerant Charge
Actual, Superheat = Tsuction, db — Tevapomtor, sat
OF
Target Superheat (from Table 1)
OF
Actual Supcnccat — Target Superheat
OF
(System passes if between -5 and +50F)
Temperature Split Method, Calculations for Adequate Airflow
Actual Temperature Split =T return, db Tsupply, db OF
Target Temperature Split (from Table 2) OF
Actual Temperature Split - Target Temperature Split °F
(System passes if between -3"F and +31F or,.upon
rcmcasuicmcat, if between +3°F and -25°F)
Standard Charge and Airflow Measurement Summary:
System shall pass both refrigerant charge and adequate airflow calculation criteria from
the same measurements. If corrective action's were taken, both criteria must'bc
rvneasured and recalculated
System Passes
yes or no
Compliance Forms August 2001 _.� A-26
INSTALLATION CERTIFICATE (Page 5 of p), CF -6R
Site Address Permit Number
Alternate Charge and Airflow Measurement (outdoorair dry-bulb below 55 °F)
Weigh-In Charging Method for Refrigerant Charge
Actual liquid line length:' R
Manufacturers Standard liquid line length: ft•
Difference (Actual — Standard): ft
Manufacturers correction (ounces per foot) x difference in length = ounces
(+ = add) (- remove)
Measured Airflow Method for Adequate Airflow
Airflow criterion:'Cooling Capacity X 0:032 = CFM
Measured Airflow is CFM and passes since it is greater than the criterion.
Alternate Charge and Airflow Measurement Summary:
System charge shall be corrected and it shall also pass imeasurcd adequate airflow criterion_
System Passes yes or no
Compliance Forms August 2001. 1 A-27
1
INSTALLATION CERTIFICATE (Rage G of 13) CF -6R
Site"Addren Permit Number
Table K-1: Target Superheat (Suction Line Temperature - Evaporator Saturation Temperature)
Compliance Forms - August 2001 A-28
ReWn Air Wet -Bulb Temperature (IF) -
50
51
52
1 53
54 It 55
56
57
58
119
60
1 61
1 62
63
64
65
1 66
67
68
1 64
70
71
72
73
74
1 73
1 76
55
8.8
10l
"-'12.8
14.2 r 15.6
17:1
18:5
200
21.5
.23.1
1 24A
26.2
27.8
29,4"
31.0
132.4
33.8
35.1
364
! 37.7
39.0
402
41.5
42.7
43.9
! 45.0:
56
8.6
9.9
11.2.
12.6
14.015.4
16:8
181
19:7
21.2
22.7
'24.2
25.7
27.3
'28.9
30.5
31.8
331
34.6
35.9
37:2
38.5
39.7
41.0
42.2
43.4
44.6
57
8.3
9.6
1.1.0
12:3
13x7
15.1
16.3
17.9
t9.4
,208
22.3
23.8
25.3
26:8
'283
29.9
3.1.3
32:6
34;0
35.3
36.7
38.0
39.2
40,5
41.7
"43.0
44.2
58
7,9
9.3
.10.6'
12.0
13:4
14.8
16.2
17.6
19.0
20.4
21.9
213
24.8
26.3
27:8
29.3
.30.7
32.1
33.5
34.8
36 t
37.5
39,7
40.0
41.3
415
417
59
7.5
8.9
102
11.6
13.0
14.4
154
17.2
18.6'
20.0
"21.4
229
24.3
253
272
28:7
30.1.31'.5
32.9
34.3
35.6
369
38.3
39.5
°40:8
42.1
43.3
60
7.0
8:4
9.8
111
12.6
14.0
.15.4'
16:8
182
i96
21.0
22.4
23.8
252
266
28.1
:Z9.6
31.0
32.4
33.7
35.1
36.4
.-37.8
39.1
40A
41.6
42.9
61
6.5
19
9.3
10.7
12.1
13.5
14.9
16.3
17.7
191
20.5
219
23.3
24,7
26.1
27.5
29.0
30.4
31.9
33.2
34.6
35.9
373
38.6
.39:9
41;2
42.4
62
6.0
7A
8.8
10.2
11.7
13.1
14.5
13.9
173
18.1
.20.1
21A
22.8
24.2
2S.5
27.0
28.4
29.9
31.3
32.7
34.1
35.4
3618'
38.1
39.4
40.7
42.0
.63
5.3
6.8
83
9.1
11.1
12.6
14.0
15.4
16.8
18.2
19.6
20.9
22.3
23.1
25:0
26.4
.27.8
29.3
30.7
32.2
33.6
34.9
36:3
'37.7
"39.0
40.3,
41.6
b4
-
61
7.6
9.1
10.6
12.0
13.3
14;9
16.3
17.7
" 19.6
20.4
21.7
23.1
24.4
25.8
273
28.7
30.2
31.6
33.0
34.4
33:8'
37.2
.383
39.9
41.2
65
5.4
7,0
83
10.0
11.5
IZ9
14.3
15.8
1 17.1
18.51
19.9
21,2:
22.5
23.8
251
26,7
128.2
29.7
31.1
32.5
:33.9
35.3
36.7
38.1
39.4
40.6
4 66
-
63
7:8'
9.3
10.8
12:3
13:8
15.2
16.6
1&0
19.3
20.7
22.0
23:2
24,6
26.1
27.6
29.11:30,61,32.0
33.4
3449
36.3
37.6
39;0
, 40.4
�' 67
S.5
7.1
63
10.2
11.7
13.2'
14,6:
1&0
17.4
18.8
20.1
21.4
22.7
24:1
25:6
.27:1
28.6
30.1
31.5
33;0
34.4
33;8
37.2
38.6
39.9
68
-
.
63
&0
9.5
11.1
I2.6"
14.0
ISIS
16.8
18.2
19.5
20.9
22.1
23:5
25:0
26.5
28.0
29.5
31.0
32.5
33.9
35.3
36.8
38.1
39.5
69
5.5
7.2
8.8
104
11.9
13.4
14.8.
16:3
17.6
19.0
20.3
21.5
22.9
24.4
26.0
27.5
29.0
30.5
32:0.
33.4
34;9
36.3
37.7
39.1
70
6A
8.1
9.7
112
12.7
14.2
15.7
17.0
18.4
19:7
20.9
22:3
23.9
25.4
27:0.28.5
.30.0
31.5
33.0
34.4
35.9
37.3
139.7,
F 71
-
-
-
5.6
7.3
8.9
10.5
12.1
13.6
15.0
16.4
11.8
19.1
20.3
'21.7
23.3
`24:9
26.4
.28:0..
29.5
31.0
32.5
34.0
35.4
36.9
38.3
72
-
-
-
-
64
8.1
9,8
1:1:4
129
14.4
f5,8
17.2
18.5
19:7
21,2
22.8
"24.3
25:9'
27;4"
29.0
30.5
32:0
33.$
35.0
36.5
37.9
73
-
-
-
-
5.6
73'
9.0
10.7
12 2;
13.7
.15,2
16.6
17:9
19.2
20.6
22.2
23:8
25.4
26.9
28:5
300
31.5
33:1
34.6
36.0
37.5
Q 74
-
-
-
6.5
&2
9.9
1 I
13.1
14.5
15.9
17.3
"18:6
21.6
23:2
24:8
26.4
28.0
29.5
31.1
32.6
34.1
35.6
'37.1
}� 75
5.6
7.4
9.2
108
12.4
13,9
133
16.7
IBA
,20,0
21,1
' 22:7
24.3
23.9 °
27.5
29.1
30.6
32:2
33.7
331
36.7_
d 76
-
-
-
-
-
6.6
8.4
10.111
11.7
13.2
14.7
16.1
17.4"
18:9
20.5
22.1
23.8
25.4
27:0
28.6
30.1
31.7
33.3
34.8
36.3
77
-
-
5.7
7.5
9.3
11.0
U.S.
14.0
LSA
16:8.
16.3
20.01-21.6
23:Z.
24.9
Z6.5
28.1
29.7
31.3
32.8
"34.4
36.0
78
67
8.5
10.2
11.8
13.4
14.8
16.2
17.7
19,4
,21.1
22.7
24.4
26.0
27.6
291
30.8
32,4
340
"x35,6
79
5.9
7:7
9.5'
11.1
12.7
14.2
15.6
17.1
IRA
203
212
23:8
25.5
27.1
28.8
30.4.32.0
.33.6
35:2
V _80
6.9
8.7
10.4
12.0
13.5
15.0
16.6
183
20.0
21.T
23.3
25:0
26.7
28.3
29.9
31.6
332
34.8
6:0
7.9
93
11.3
12.9
14.3
16.0
7.7
17:27"
19.4
21:1
22.1
24.5
26.2
21.9
29:5
31.2
32.8
34,4
82
-
-
-
-
-
-
-
-
5.2
7.1
8,9
10.6
12:2
13:7
15.4
17;2.
18.9
20.6
12.3
24.0
25.7
'27.4
'29.1
30.7
32.4
34.0'
83
-
-
-
-
53
8.2
9.9
11.6 '
13.1
.14.9
16.6
18.4
26.1
21.6
23.5
251
26.9
28.6
30:3
32.0
317
84
-
-
-
-
-
5.5
7:4
9.2
10.9
12:5
,14;3
16.1
I7:8,
19.6
213
23.0
24.8
26.5
28.2
29.9
31.6
33.3
85
'
6.6
8.5
.10.3.11.9.
43.7
15:5
l7J
19.0
20.8
22.6
24.3
26.0
27.8
r29.5 1
312 132.9
86
_
1
-
5;8
73
9.6
113
73.2
15.0
16:7
d9.5
20.3
21.1
23.8
25.6
27.3
29.1
30.8
32.6
87
_
..
5.0
7.0
' 8.9
10:6
12.6
14:4
16.2
18.0
19.8
21.6
23;4
25.1
26:9
28.7
30:4
32.2
h3
8.2
l0.0
12.0
i3.9
15.7
17.5
.19:3
21.1
22.9
24.7
263
28:3
30.1
3 LS
89
-
-
-
-
-
-
-
-
5-5
7.5 l
9.4
11.5
13.3
15.1
17.0
199
20.6
22.4.
24:3
26.1
27.9
29.7
31.5
90
6:8
8.8
10.9_
12.8
14.6
1"6.5
183
20.1
22;0
23.8
25.6
275
29.3
31.1
Compliance Forms - August 2001 A-28
INSTALLATION CERTIFICATE (page 7 of 13) CF -6R
Site Address Permit Number
Table K-1: Target Superbeat (Suction Line Temperature - Evaporator Saturation Temperature) (continued)
Compliance Forms August 2001 A:29
PAtum Air Wet -Bulb Temperature (°F)
50
51
32
1 53
54
53
46
37
38
39
60
61
62
1 63
64
.63
66
6768
69 70
71
72.
73
74
75
76
91
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
- -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
6.1
S.4
-
-
8.1
7.5
6.8
6.2
5.6
10.3
9.8
9.2
8.7
81
12.2
I F7
11.1'
10.6
10.0
14.1
13:5
13.0
12.5
12.0
15.9 117.S: 19.7
15.4 ' 17.3 19.2
14.9 16.8 18:7
14.4 16.3 18.2
'13,9 13.8 117.8
21.5
21.1
20.6
20.2
19.7
23.4
22.9
22.5
22.1
21.6
23.2
24.8
24.4
24.0
23.6
27:1
26.7
:26.3
25:4
,25.5
28,91
28:3
28.2
27.8
27.4
30.8
30.4
30.1
29.7
'29.4
92
93
94
95 _
47
96
-
-
-
-
-
-
-
-
•
-
-
-
-"
-
-
_
-
-
-
-
-
-
-
7.5
7.0
6.4
5.8
5.3
9..5
8.9
8.4
7.9
7:3
11.4
10.4
10.4
9.9
1 9.3
13:4
12.9
12.4
11.9
11.4
15.3
14.9
14.4
13.9
13.4
17.3
16.8
16.4
13.9
15.41
19.2
18.8
18.3
17.9
17.51
212
,10.8
20.3
19.9
19.5
23.2
22.7'
22.3
21.9
11.5
25:1
'24:8
24.3
24.0
23.6
27.1
26.7
263"
26.0
27.6
29.0
28;7
283
,26.0
17:7' -
100
04
-
-
-
6.8
6.2
5.7
5.2
8.8
8.3
7,8
7.2
6.7
10:9
10.4
9:9
" 9.3"
8.8
12,9
12.4
11.9
11.5
11.0
15.0
14.5
14.0
13.6
13.1
17:0
16.6
16.1
13.7
152
19.1
MA
" 182'
17.8.
17.4
"21.1
20.7
20.J
19;9
19.5
23.2
Z2:8
22:4
22. L
20
25:3
24.9
14.
124.25
218 126.0
27.3
2T,0
26.1
26;3
l05
V
106
!07
-
-
_
-
-
-
I
- ,
-
•
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
6:2
5.1
5.2
93
7.9
7.4
6.9
6.4
10.5
10.0
9.5
9.1
12.6
12.2
11.7
11.3
10,8
14;8
14.4
13:9
" 133
13.1
8:6
17A
16.6
16.1
15.7
15.3
19,1
18.7
18.4
18.0
17.6
21.3
214
20.6
20.2
19.9 122A
23S
23.2
22.8
22.5
.25.T
25.4
25.1
24.7
24.4
1118
109
110
111
-
-
_
-
-
-
-
-
-
_
-
-
_
-
-
_
-
-
-
_
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
39
5.4
-
-
B:I
7.6
7.2
6.7
6.2
10.4
9.9
9.3
9:0
8.6
126
12.2
.1.1.8
11:4
10.9
l4.9
14.5
14.1
13.7
13.3.
17,2
16.8
16.4
16,1
15.7
19.5
19.1
'18.8
18.4
18.1
21.8
21.5
21.1
20.8
203
24.1
23.8
23.3
23.2
22.9
112
113
114
I1S
Compliance Forms August 2001 A:29
INSTALLATION CERTIFICATE (Page 8 9f 13) CF -6R
Site Addren Permit Number
Table K-2: Target Temperature Split (Return Dry -Bulb- Supply Dry -Bulb)
Return
Air Wet
-Bulb. f" ) fT �,,,,,,b)
50
51
152
53
154
55
156
57
58
59
60
161
1 62
63
1 64
1 65
66
67
1 68
69
70
1 71
72
73
74
75
76
70
20.9120.71:20.6
20.4
20.1
19.9
19.5
19.1
18.7
18.2
17.i
17.2.
16.5
15.9
115.21
14:4
13.7
12.6
11.9
11.0
10.0
9.0
7.9
6.8
5.7
4.5
3.2
71
21.4
21.3
211
20.9
20.7
20.4
20.1
19.7
19.3
18.8
18.3
17.7
17.1
16.4
15.7
15.0.14.2
13.4
12.5
11.5
10.6
9.5
8.5
7:4
6.2
5.0
3.8
d
21.9
21.8
21.7
21.5
21.2
20.9
20.6
20.2
19.8
19.1
18.8
19.2
17.6
MO
163
15.5
14.7
13.9
13.0.12.1
11.1
10.1
9.0
7.9
6.8
5.6
4.3
72
73
215
22.4
22.2
22.0
21.8
21.5
21.2
20.8
203
199
19.4
18.8
18.2
17.5
16.8
16.1
15.3
14.4
L3.67
12.6.
11.7
10.6
9.6
8.5
7.3
6.1
4.8
74
23.0
'22.9
22..8
22A
223
22.0
21.7
21.3
20.9
201.4
19.9
193
16.7
18.1
17.4
16.6
15.8
15.0
14.1
13.2
12.2
112
10.1
9.0
7.8
6.6
5.4
75
23.6
23J
23.3
23.1
22.9
22:6
22.2
21.9
21.4
'21:0
20.4
19.9
193
18.6
17.9
17.2'
16.4
15.5
14.7
13.7
12.7
11:7
10.7
9.5
8.4
7.2
5.9
a
76
24.1
-
24.0
24.6
23.9
24,4
233
24.2
23.4
24:0
23.1
'23:7
22.8
,23.3
22.4
22.9
22.0
22.5.
21.5:"21.0
22.0
21.5
20.4
21.0
19.8
20.4
19.2
1947
18.5
19.0
17.7
18.3
16.9
17:57
16:1
16.6
15.21-14.3
15.7
14.8
.13.3
13.8
129'
118
11.2
11.7
10.1
10A.
8.9
9.5
7.7
83
6.5
7.0
77
78
-
24.7
244
24.2'
23.9
23.5
23.1
22.6,'22.1
21.5
20.9
.20.2
19.5
18.8'
18.0
17.2
16.3
154
14.4
13.4
12.3
11.2
10.0
8.8
7.6 !
Q
-
-
-
-
-
24.8
24.4
24.0
23.6
23.1
22,6'
22.1
21.4
20.6
20.1
19.3
18,5
17.7
16.8
15.9
14.9
13.9
12.8
11.7
10.6
9.4
8.1
79
-
-
-
-
-
-
25.0
24.6
24.2
23,7
23.2
2246
22.0
21,3
20.6
19.9.
19.1
18.3
i7.416.4
15.5
14.4
13.4
I23
11.1
9.9
8.7
BO
a
81
82
83
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
25.1
-
-
24.7'24.21
25.2
-
24.8
253
23.7'
24.2
'24.8;
23.1
23.7
243
22.5
23.1
23.6
21.9
22.4
23.0
.21.2
21.7
22.3
20.4
21.0
21.5
19.6
20.2
20.7
18.8
19.3
19.9
17.9
18.5
19.0
17.0
17.5
18.1
16.0
16.6
17.1
15.0
15.5
,16.1
139
14.5
15.0
118
13.4
,13.9
11.7
12.2
12.7
10.4
11.0
11.5
9.2
9.7
10.3
-
-
-
-
-
-
-
-
-
25.9
25.3
-24.9,24.2123.5
22.8
22.1
21.3
20.4
19.5
18.6
17.6
16.6
15.6
14:4
13.3
12.1
10.8 j
84
Compliance Forms August 2001 A-30
INSTALLATION CERTIFICATE- (Page 9 of 13) CF -6R
Sltc. Address Permit'Number
DUCT LOCATION AND AREA REDUCTION DIAGNOSTICS
❑ DUCT IN CONDITIONED SPACE
❑ Yes ❑ No Duct in conditioned space criteria.matches CFA R
❑ ❑
Yes is a Pass Pass Fad
❑ REDUCED DUCT SURFACE AREA _
Measured dud exterior surface area in the following unconditioned duct,locadons (square feet):
Attics
Crawlspaces
Basements
Other (e.g., garages, etc.)
❑ Yes ❑ No Duct surface area matches CF -1 R? [] 13
Yes is a Pass Pass: Fail
❑:I, the undersigned, verify that the duct.surface area and duct locations claimed for duct surface area reductions and duct
location itnprovemtnta beyond those covered by default assumptions:match those on the plans. '[The builder shall provide
the HERS provider a copy ofthe CF-6R:signed by the builder employees or:sub-contractors certifying that diagnostic testing
and installation meet the requirements for compliance credit]
Tests Signature, Date Installing Subcontractor (Co. Namc) OR
Performed Genual Contractor (Co. Name)
COPY TO: Building Department
HERS Provider (if applicable)
Building Owner at'Occnpancy
Compliance f=orms August 2001 A-31
INSTALLATION CERTIFICATE (Pagy 19 of 13) CF -6R
Cite.Address Permit Number
BUILDING ENVELOPE LEAKAGE DIAGNOSTICS
❑ ENVELOM SEALING INFR.TRATION RMUCTION
Diagnostic TestinR..Results
Ruildin Envelopc Leakage (CFM i`c+? 50 Pa) as measured by Ratcr
1. ❑
❑
is measured envelope leakage less than or equal to,the required levet fmm
Yes
No
CF -IR?
2. ❑
0
1s Mechanical Ventilation shown as required on thc,CF-IR?
Y cc
No
2a. ❑
❑
If Mechanical Ventilation is required on: the CFA R (Yesin line 2). has it
.Yes
No
been installed?
2b. ❑
0
Check this box yes if mechanical ventilation is required (Yea in line. 21
Yes
No
and ventilation fan watts are no greater than shown on C'F-1R.
Measured Watts =
3. ❑
❑
Check this box yesif measured building inf ltration.(CFM, c@ 50'Ps) is
Yes
No
greater thnn the CFM @ 50 values:Shown for on SLA of 1.5 on CF - 1R
(If thisbox is checked no, mechanical ventilation is required.)
4. ❑
[]
Check this box yes if measured building infiltration (CFM @ 50 Pa) is less
Yes
No
thau.-the CIM g 50 values shown for an SLA of 3.5 cm Cr- I R,
mechanical ventilation is installed and house pressure is gneatcrthan
minus..5 Pascal with all exhaust.fana operating.
Pass it Pas_ s Fail
d. Yes in line. 1 and lint 3, or
C. Yes in Linc 1 end line2, 2a, and 2b, or
f. Yes in line l and Ycs•in line 4.
Otherwise fail,
❑ .1, the undersigned, verify that the building envelope leakage meets the requirements claimed for building leakage
roducfirnr below default assumptions as used for eorttptianee on the CF -I R. This is to certify that the above diagnostic test
results and the work 1 performed aiwciated with the test(s) is in confbnnancc with the requirements for compliance credit.
[The builder shall provide the HERS provider a copy of the CF -6R signed by the builder employees or sub -contractors
certifrring that diagnostic tenting and installation meet the requirements for compliance: credit.]
Test 1'erfmwed Signature Date Testing Subcontractor (Co. Name) OR
General Contractor (Co. Namc)
COPY TO: Building' Department
HERS Provider (if applicable)
Building Owner at Occupancy
Com.plianoe Forms - August 2401 _—A-32
INSTALLATION CERTIFICATE (Page 11 of 13) CF -6R
Site Address permit Number
The fnilmuing'is ad explanation of many of the input values required on thisform:
HV.kC SYSTEMS
Ucaling Equipment Type must be one of the following:
Furnace:
Crm (including Liquefied Petroleum Gases) or oil -tired central fuftacc &
space heater
Boilcr:
Cas or oil -fired boiler
Pckgi•ieatPump:
Packaged central heat pump
SplitHeatilump:
Split central heat pump
RoomHcatPump:
Room heat pump
I.gPk9'RcatPump:
Large packaged heat pump (>_:65,000 Btuftbutput)
Electric:
Electric -resistance heating (fixed USPF = 3 A 13); radiant electric resistance
(fixed HSPF = 3.55)
ContbinedHydm:
Reference water heater under water heating systems below
CEC Certified Manufacturer Name & Model Number from applicable Commission approved appliance directory.
# of Identical Systems.is for those systems with the; same efficiency, duct location, duct R -value And capacity.
Efficiency front applicabte Commission,certitied appliancc:directory.
Duct (or Piping) Location is,attic, crawl space, CVC crawl space, conditioned space, unconditioned space or none:
Duct (or Piping) WVnlue.. finan Directory of Certified Insulation Materials and/or manufacturces data.
Heating,FCooling load refer to Commission approved Ioad calculation procedure.
Heating/Cooling Capacity from the applicable Commission certified appliance directory. Note: location.elevations over
2.000 R above sca level require a derating of output capacity (refer to manufacturer's literature).
Conlin F,etuiument Tmc must be one of the fellowitts:
SplitA-irCond:
Split system air conditioner
PckgAirCond:
Packaged air conditioner
Split Heat Pump:
Split systiem heat pump
Pckgueatpump:
Packaged heat•pump
RoomHeatPump:
Room heat pump
L9Pkg1icfftPump:
Large packaged heat purnp (z 65.010 Btuihr output). Substitute EER for SEER
when SEER, is not available
RoomAirCond:
Room air conditioner. Minimum SEER varies*
LgPk9AKond:
Large packaged air conditioner (z 65,000 Dtuthr output). Substitute F_ER for
SEER when SEER is not available
EvapDhect:
Direct evaporative oaoiing system For compliance calculation purposes, fixed
values: SEER = 11.0; duct location — attic; duct insulation.R value. = 4.2
Evapindirect-
Indirect evaporative cooling system. For compliance calculation purposes. fixed
values: SEER =13.0; duct location — attic; duct insulation.R-value = 4.2
tccrcr m.tnergy Commission publication Appliance Ejficienoi Regulations, P400-92-029
Compliance Forms Augusf2001 A-33
iNSTAL;LATION CERTIFICATE (Page 12 of 13) CF -6R
Site Address Permit Number
'M follo"ving is. an explanation of many orthe iuput values required onahis form:
WATER HEATING SYSTEMS
Distn''bution Systems Refer to Residential Manual for more details:
Standard:
Standard — Supply.pressure based system, no pumps -�—
Pipe Insulation:
Pipe -Insulation on all 314 -inch pipes
POUIHWR:
Point -of UselHot Water Recovery System
Reeirc/NoControk
Recirculation loop with no controls
RccirclTitncr:
Recirculation loop with a timer
Recirc/Terrtp:
Recircalation.loop with temperature control'
RCcitc1Tirne+Tcmp:
Recircuiation,loop with a timer and "erature control
Recirc/Demand:
Recirculation loop writh demand control
WAtcr,Ncatcr ypc
Windows, sliding glass doors. French doors, skylights, garden windows. and
Information Needed
any door with more than one square foot of glass
Operator Type,
Energy Factor
Recovery Efficiency
Standby 1.6as
Rated It
Storage Cas, Oil or Electric
Yes
No
No
No
Hent Pump
Yes
No
No
No
Instantaneous Gas
No
Yes
No
No
Instantaneous Electric
Yes
No
No
No
1 -arse stmugrc Gas
No
Yes
Yes
Yc*t
Indirect Gas (Boiler)
No
Yes (AFUE)
No
Yes
h 1,N F.STRAT T0N/GLAZING
Fenestration:
Windows, sliding glass doors. French doors, skylights, garden windows. and
any door with more than one square foot of glass
Operator Type,
Slider, hinged, fixed
U -Factor:
Installed U -Factor must be less than or equal to value from CF -IR
OR
Installed vt eightcd a-%mrage'U-Factor for the total fenestration area is less than
or caust to value from CF -1R
SHGC:
installed SHGC rust be less than or equal to value from CF -1 R
OR
Installed weighted SHGC'for the total fenestration area is less than or equal to
value from CF -1R
OR
An interior shading device; overhang, or exterior shading device is instalied
consistent with the CF -IR
Shading Device:
Include when the building complied using an ewerior shading: drvicc: urovcn
sunscreen. louvered sunscreen. low sun angle sunscreen, toll -down awnin&
roll -down blinds or Mats (do not'list.bug screen),,or an overhang (include
d h in feet
Compliance Forms August 2001 A-34
0.1
INSTALLATION CERTIFICATE (page 13 of 13) 1
Sitc Address
Permit'Number
The 11611(ming is an rmlanation.of many, of the input values requited on the Diagnostic portion of this form (page ?
TYPE OF CREDIT
Refer to Residential rbfumial Chapters 4 and 5 for more details:
Rcduccd Duct Surface Ara:
Calculated -as the outside area of the duct_. Areas must he measured and
verified by a HERS rater.
lm1woved Duct Location:
Supply duct located-in.othcr than attic, as verified by location of registerF
(docs.not require HERS rater verification).
Catastrophic.Lealmge:
Pmssrac pan test readings must be less then 1.5 Pascal at a hrnlse pressure of
25 Pascal.
TXv:
Access cover required to facilitate verification.
Infiltration Reduction:
Infiltration is: measumd without mechanical ventilation operating.
Mechanical ventilation is requited fnir very tight house construction when
credits for infiltration reduction using diagnostic.testing are being used for
achieving compliance. These very -tight houses are defined as those with SI.A.
of less than 1S. The compliance documentation (CF -1R) will contain the
measured CFM target value.from a blower door test at 50 Pascal pressure
difference that represents this SIA of I.S. Mechanical ventilation is also
required if the builder chooses to design the building to use mechanical
ventilation and claims a credit for infiltration below an SLA of 3.0. The
compliattce documentation (CF -IR) will contain the measured CFM target
value that repressknts this 3.0 SLA. if the builder claims credit in a design for
infiltration reduction that is at an SLA of 3.0 or higher, and the actual
measured SLA is 1.5 or greater, then mechanical ventilation is not required.
If the SLA in this case were below t__S, then mitigation (such as mechanical
ventilation) would'be:required.
Compliance Forms August 2001 — A-35