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06-1958 (MECH)
P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:0;6`-:0:000 9' 5r' Property Address: .55520 PINEHURST .- _8 `APN: 775 -241 -002 - Application description: MECHANICAL Property Zoning: LOW _DENSITY RESIDENTIAL Application valuation: 9844 Applicant:- ' 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: SHARON HOUGH 55520 PINEHURST LA QUINTA, CA 92253 Contractor: Architect or, Engineer: PALM DESERT AIR CONDITION] 42081 BEACON HILL PALM DESERT', CA 92211 I (760)346-0677 . Lic. No:: .374937 LICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that lam licensedunder provisions of Chapter.9 (commencing with Section 70 00) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: C26 Licens6No.: 374937 D V.: o tor: OWNER -BUILDER DECLARATION . I hereby affirm under penalty of perjury that.1 am exempt from the Contractor'sState.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 (commencing with Section.7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and thebasis 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 fivehundred dollars. 1S5001.: (_ ) I, as owner of the property, or my employees -with wages as'their sole compensation, will do te work, and the structure is not intended:or offered forsale (Sec. 7644, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the'work himself or herself through his or her own employees, provided that the improvements are not intended -or offered for sale. If, however, the building* or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she'did not build or . improve for the purpose'of sale.). . (_ 1 I, as,ownerof 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—) I am exempt under Sec. B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153- Date: 77-7153 Date: 5/11/06 I ; -*MAY 10, 2006 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 perforniance,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 STATE FUND: Policy Number 1795546-2006 certify that, in the performanceof 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. . Ap kcant: . WARNING: FAILURE TO SECURE WORK S' 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 theCity of La Quinta, its officers, agents and employees for any act or'omission related to the work being performed under or following issuance' of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days. from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I.certify that 1 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 upon the above-mentioned property for inspection purposes. �att"i°�Sg r (Applicant or Agent):' Application Number . . . . . 06-00001958 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 73.00 Plan Check Fee 3.75 Issue Date Valuation . . . . 0 Expiration Date 11/07/06 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 4.5000 EA MECH VENT INST/ DUCT.ALT 9.00 2.00 9.0000 EA MECH APPL REP/ALT/ADD 18.00 2.00 6.5000 EA MECH AH <=10K CFM 13.00 ---------------------------------------------------------------------------- Special Notes and Comments REPLACE 2 3.5 TON 12 SEER R-22 PACKAGE SYSTEMS Fee summary Charged --------------------------- ---------- Paid Credited -------------------- Due Permit Fee Total 73.00 .00 .00 73.00 Plan :Check Total 3.75 .00 .00 3.75 Grand Total 76.75 .00 .00 76.75 LQPERMIT Bin # City of La Quinta Building u Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 5556-10 .Owner's Name: LAQVI A. P. Number: Address:•5 f•IYle,f Legal Description: City, ST, Zip: Lo—Qui n C0., qa3 I Contractor: k • �-- ..a l CP Tele hone:l�o0�1' % f �1 Address:,?ueea Cff-1 Project Description: 1aee_a GMCY CAA City, ST, Zip: `rn n&—J_ Telephone2Z4 6.� City Lie. #: S• State Lie. # : , y q 3, Arch., Engr., Designer: Address: City, ST, Zip: Telephone: g s Y si State Lie. #: Name of Contact Person: I . Construction Type: Reso"WOccupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: 1 # Units: Telephone # of Contact Perso : -I (A - 0(,-7-7 Estimated Value of Project: y 4.v,0 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACMG _ PERMTT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading. plan tad Review, ready for correctionsrssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:-. 7r° Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees `y t Installation Certificate P,rescriotive. Methnd - HVAC-n�nlv A'ltpritinn f :F-RR_AI T Project Title: I Date: © 2005 Ca10ERTS Enforcement Agency Use Only Project Address: Climate Zone: Building Ferna#. Installing Contractor: Telephone: Plan Check Date n Company Name: �oa1m De�e�r� �a 1 c Flea check Date IMPORTANT: This'CF-6R form is'only for'use when an'HVAC-only. alteration is made town existing home Use one form for each system being altered. This is system #_�"of systems altered in this house. 'Copies to: Homeowner, HERS Rate' 44n& Building. Deartment Lisfthe specifications for the'newly installed equipment:. These;:must match the installed equipment exactly. Installed`e ui iment must match type/location and meef or exceed" efficienciesiR-values from CF -1 R. Equipment T e Manufacturer ' Model Number Efficiency Load" Capacity— a acit —Furnace Furnace AFUE Heat Exchanger N/A Heat Pump fan coil N/A . Hydronic fan coil N/A . Other FAU Describe Package gas/ACy�. Q ryjp AFUE o �/ ►w•a�"0.�.� SEER. 00 Package heatpump HSPF SEER EER' A/C Condenser SEER Heatpump Condenser HSPF SEER Indoor DX coil EER•. Hydronic coil Provide EER if needed for compliance; (line 24 of-CF'.1 R -ALT): Installer mustprovide adequate documentation to verify EER. In some cases the specific fumace may need to be verified; in orderto achieve"a specific EER. In some cases a time delay relay and/or TXV may nedi to;.ve verified in order to achieve a specific EER. " Loads are sensible for cooling., "• Capacities are sensible at desi ri:conditions for cooling and adjusted altitude, downflow, etc. output for heating.- XV: ❑ If TXV is. required by the CF -1R form (line 23 or CF -1 R -ALT form), it has been installed and access has been provided for visual verification by. HERS rater. Sampling is allowed for TXV verification. Entirely New Duct System: (Line 5 of.CF-1R ALT) ❑ For Entirely new duct systems, the required leakage is 6% rather than 15% for altered systems. The alternative to duct sealingb .increasin the efficiency of the a ui ment.is not an o tion forentirel ;new duct s` stems. I, the undersigned, verify, that.the,equipment listed'above.is:'1) the actual` equipment installed, in the'home;'2) equal to or more efficient than required by the Certificate of Complian`ce.(CF-1 R -ALT Form), and.3);equipmeni that�meets orexceeds the appropriate requirements for manufactured devices (Appliance Efficiency Standards), where applicable. I, the undersigned, verify that diagnostic test results listed on this form were performed in' conformance with the requirements for compliance and that the newly installed orretrofitted mechanical system components. conform with the Mandatory requirements specified in Section 150(m) of. the 2005 Building"Energy Efficiency Standards.' Signed (Installer): Date: Notes: rage i or z .This form can only be used on projects being verified by COCERTS certified raters. www.calcerts.com Installation Certificate Prescriptive Method - HVAC -only Alteration CF -6R -ALT Project Title: Dater 41agjol� ©2005CaICERTS IMPORTANT: This CF -6R fdFM is only for use when an'HVAC-only alteration is made to an existing home Use one form for each system being altered. This is system #1 of.'a� systems altered in this house. Copies to: Homeowner, HERS Rater, and Building Department Duct Leakage test Results If duct testing is required per CF -IR -ALT -form) Step 1 - Pre test: Leakage of the system before any alterations. This test is optional and is only used for the 60% reduction option 1 Pre-test leakage ICFM25 2 Line t ,x-0.4 Farget for 60% reduction Step 2 - Determine Total System Fan Flow: Use any of these methods. Use values fore ui ment after alterations. 3 Cooling: Condenser tonnage: to x 400 CFM/ton = CFM 4 Heating: Furnace output: Stuh x .0217 CFM/Btuh = CFM I 5 6 Measured: (refer to ACM Manual Appendix RE, section 4.1) = 1CFM Measurement method: 0 flow hood ❑ plenum pressure matching ❑ flow grid 7 Totals stem fan flow value to be used: CFM may use highest of lines 3, 4, or 5. Step 3 - Determine Targets: 8a Total System fan flow (line 7 from above) x 0.06 = CFM25 = 6% leakage target (new duct systems) 8b Total System fan flow (line 7 from above) x 0.15 = CFM25 =15% leakage target El 9 Total System fan flow line 7 from above x 0.10'= CFM25 =-10% leakage to outside target Step 4 -Alterations: Must be consistent with the CF -1R form. 10 ❑ Iseal all new connections with approved materials. 11 ❑ INo newt constructed portions of the sAstem can have unducted building cavities to convey system air. 12 ❑ 111 adding or replacing more than 40 feet of duct, insulate new ducts per package,D for that climate zone Step 5 - Final Leakage (regular duct leakage test, for 15% total and 60% reduction) 13 leakage = CFM25 refer to 2005 ACM appendix RC, Sections RC 4.3.1 14a ❑ If line 13 Is less than.line 8a house passes the 6%leaks a re uirement Go to Ste 9. 14b ❑ If line 13 Is less than line 8b house asses the 15%a leaks a re utrement Go to Step 9. 15 ❑ If line 131s less than line 2 house passes the 60% reduction re uiremeri continue. 16 ❑ If either of lines 14a, 14b or 15 are checked, HERS verification is, required. Sampling can be used. 17 ❑ If line 15 is checked, but not -14a or 14b, Smoke Test and Visual Inspection of Accessible Duct Sealing is required. Go to Step 8 Step 6 - Leakage to Outside: Similar to a regular duct blaster test butthe.house •is pressurized to 25 pascals at the same time. 18 leakage = .I ICFM25 refer to 2005 ACM appendix RC, Sections RC 4.3.3 19 ❑ If line 18 Is less than line 9 house Passes the 10% leaks a to outside requirement 20 ❑ If line 19 passes, HERS. verification is required. Sampling can be used: Step 7 - If the house does not pass any of lines 14,'15 or 19. 21 ❑ Smoke Test and Visual Inspection of Accessible Duct Sealing is required. See Ste 8. 22 ❑ 11ristall required label per ACM Appendix RC Sections RC.4.3.5. Step 8 - Smoke Test and Visual Verification See 2005 Residential ACM Appendix RC Sections RC 4.3.5-7 23 ❑ Perform smoke test per ACM Appendix.RC, Sections RC 4.3.6. 24 ❑ 1 Perform Visual Ins ection and repair of excessively. damaed ducts per ACM Appendix RC Sections RC 4.3.7. 25 ❑ ISeal register boots to surroundin material per A M'Appendix RC, Sections RC 4.3.7. HERS Verification 26 ❑ If line 14 is checked. 15% leakage to be verified by HERS rater. Sampling is allowed. 27 ❑ If line 15 is checked. 60% leakage reduction to be verified. by. HERS rater (post.test only) AND Smoke Test and Visual Verification to be performed by HERS Rater. Sampling is allowed. 28 ❑ If line 19 is checked. 10% leaks a to outside to be verified by HERS rater. Sampling is allowed. 29 ❑ If none of lines 14, 15 or 19 are checked Smoke Test and fix all accessabie leakes. No sampling allowed. Sampling - Onlyif house passes on lines 14, 15 or 19. 30 ❑ 1.) Homeowner chooses to be put into a group of homes for random third party HERS sampling. 2.) Homeowner, installer and rater must sign the three -party agreement. 3. All above tests must be completed by the installer or their representative not the third party rater. No Sampling - House does not pass by lines 14 15 or 19. OR homeowner chooses notto be part of a sample group 31 ❑ 1.) House to be tested by a third party HERS rater selected by installer. 2.) Homeowner, installer and rater must sign the three -party agreement. , 3.) All above tests may be completed by the installer or their representative, and then verified by a third party rater. OR all above tests may be performed solely by the third party rater. 32 ❑ 1.) House to be tested by third party HERS rater selected by homeowner. 2.) All above tests may completed by the Installer or their representative, and then verified by a third party rater. OR, all above tests may be performed solely by the third party rater.. V V1 awi I uo- I v-vo Page 2 of 2 This form: can only. be used on projects being verified by CaICERTS certified raters. www.calcerts.com Certificate of Compliance Prescriptive Method HVAC -only Alteration . .CF -1 R -ALT Project Jit!p- Date: © CaICERTS 2005 . Enforcement Agency se n Pro'ect AddreSS: Climate Zone: Building Permit # Doc tation uthor: Telephone: 3'fj/. �o Plan Check Date CO�y� a Field Check Date IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only alte ation is made to an existing home Use one form for each system beingaltered. This is system # ' of s stems altered in this house. Check all lines that apply. Check only tines that apply. Scope of Alterations: 1 ❑ An Air Handler is to be installed or replaced. Duct sealing to be determined. "Continue to next line. 2Furnace Heat exchanger is to be installed or replaced. Duct sealing,to be determined. -Continue to next line. 3 n outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 4 ❑ A cooling or heating toll is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 5 ❑ More than 40 feet of new or replacement duct are to be installed in unconditioned Espace: Duct sealing to be determined. ❑ Check here if the gntife duct system is also to be new or replaced.' . Continue to next line. 6 ❑ If none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1:2, 3 4 or 5 are checked: Skip if Line 6 is checked. 7 ❑ This system is in Climate Zone 1, 3, 4, 5, 6, 7, or 8. No duct sealing is required Go to Section 2. 8 ❑ This system has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. 9 ❑ This system was previously'sealed and tested, and was certified by a HERS rater. No duct sealing is required. Attach previous CF=4R form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Note: If the entire ducts stem is to be new or replaced,, Lines 11-14 do not apply. 11 ❑ In Climate Zones 2 12 and 16: An 0.92 AFUE furnace will-beinstalled in lieu of duct sealing and'TXV if applicable). 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 AbQEER 12 condenser will be installed with TXV(RCA). AND added duct insulation R-4 wrap on ebstin ducts, R-8 new ducts in lieu of duct sealing. Go to' Section 2. 13 ❑ In Climate Zones 9, 10, 11,13, 14, or 15: An SEER 14 =EER 12 condenser•will be installed with TXV(RCA) AND a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2. 14 ❑ In Climate Zones 2, 9, 11, 12, 14 or 16: An SEER 14.AbIR EER 12 condenser will be installed with TXV(RCA) ND an 0.82 AFUE furnace will be installed with Increased duct Insulation in lieu of duct sealing. Go to Section 2. 15 None of lines 7-14 above are checked. Duct Sealing Is,Requlred. *Continue: Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3). 16 The system being altered is a package unit. No TXV RCA Is required. Go to Section 3. 17 ❑ This system is In Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) Is required. Go to Section 3. 18 ❑ This system Is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) Is required. Go to Section 3. 19.0 This system is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required. Go to Section 3. 20 ❑ This system is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) Is:re ulred: IGo to Section 3. 21 ❑ IThis system is in Climate Zone 2 or 8-15 and line 11, 16 or 17 is not checked. TXV(RCA),Is required. Go to Section 3. Section 3 - HERS Rater verification 22 Ilf line 15 is checked, HERS verification Is required for Duct Sealing. 23 ❑ If line 12, 13, 14, 20 or 21 are checked and not line, 16 or 17, HERS verification Is required for TXV(RCA). lif 24 ❑ line 12, 13 or 14 are checked, HERS verification Is required for 12 EER. I Section 4 - Equipment Efficiencies 25 ❑ lif lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List In Section 6. Section 5- Duct R -Values 26 ❑ If more than 40 feet of duct is bein installed or re laced, ducf R -value must meet or exceed Package D require ments. 27 If less than 40 feet of duct Is being installed or replaced, duct R -value must meet or exceed,R-4.2' Section 6 - see next page Version 03-10-06 Page 1 of 2 This form can only be used on projects being verified by CaICERTS certified raters.. www.calcerts.com Certificate of Compliance Prescriptive -Method - HVAC. -only- Alteration CF -1R -ALT Proje itle:Dale: f ' © CaICERTS 2005 IMPORTANT . This -CF -1R -AL form -Is onlyforuse when an;HVFq✓ onlya eration is made to an existing home . Use one`form'for each system' betng.altered. This is system,# : Certificate of Compliance Prescriptive Method - HVAC -only Alteration U-1 R -ALT Pr 'Rqt Title:: 110&6 Date: ' © CaICERTS 2005 Enforcement Agency Use Only Project Address: -5 Pri&lldn+ Climate one: 1b Building Permit # DRe iongtho : T.elep One: Plan Check Date Co any JVame:�lc� 0, Field Check Date IMPORTANT: This CF -IR -ALT form is only for use wherran:HVAonly teration is made to an existing home Use one form for each system being altered. This is s stem # ofolL systems altered in this house. Check all linea that apply. Check only lines that ar)DIv. Scope of Alterations: 1 O An Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. 2 -E< A Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. 3 ;W An outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 4 ❑ A cooling or heating coil is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 5 ❑ More than 40 feet of new or replacement duct are to be installed'in unconditioned space. Duct sealing to be determined. ❑ Check here if the gnlj g duct system is also to be new or replaced. Continue to next line. 6 ❑ Ili none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. uired. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked. .7 ❑ This system is in Climate Zone.1, 3, 4, 5, 6, 7, or 8. No duct sealing is required. Go to Section 2. 8 D This system has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. 9 ❑ This system was previously sealed and tested, and was certified bya HERS rater. No duct sealing is required. Attach previous CF -4R form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Note: If the entire ducts stem is to be new or replaced, Lines 11-14 do not apply. 11 ❑ In Climate Zones 2 12 and 16: An 0.92 AFUE furnace will be installed in lieu of duct sealing and TXV if applicable). 12 ❑ In Climate Zones 10,. 13 and 15: An SEER 14 WMIEER 12 condenser will be installed with TXV(RCA) AND added duct insulation 114 wrap on e)dsting ducts, R-8 new ducts in lieu of duct sealing. Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER 14 &K EER 12 condenser will be installed with TXV(RCA) AND a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section'2. 14 D In Climate Zones 2, 9, 11, 112,14 or 16: An SEER 14 AbQ EER 12 condenser will be installed with TXV(RCA) ND an 0.82 AFUE furnace will be installed with increased.duct insulation in lieu of duct sealing. Go to Section 2. 15 N( None of lines 7-14 above are checked. Duct Sealing is Required. Continue. Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16J< The s stem beino altered is a package unit. No TXV RCA Is required. Go to Section 3. 17 D This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 D This system is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3. 19 ❑ This system is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required.. Go to Section 3. 20 ❑ This system is in Climate Zone 16 and line'14 is checked and not line 16. TXV(RCA) is. required. Go to Section 3. 21 ❑ IThis system is in Climate Zone 2 or 8=15 and line 11, 16 or 17 is not checked. TXV(RCA) Is required. Go to Section 3. Sec>ion 3 - HERS Rater verification 22 ;< If line 15 is checked, HERS verification Is required for Duct Sealing. 23 D lif line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification Is required for TXV(RCA). 24 ❑ 11f line 12, 13 or 14 are checked, HERS verification Is required for 12 EER. Section 4 - E ui ment Efficiencies 25 ❑ If lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List In Section 6. Section 5- Duct R -Values 26 ❑ If more than 40 feet of duct is being installed or replaced, duct.R-value must meet or exceed Package D requirements. 27 If less than 40 feet of duct is being installed or replaced, duct R -value must meet or.exceed R4.2. Section 6 , see next page version us-iu-uti Page 1 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Certificate of Compliance Prescriptive Method HVAC -only. Alteration CF. 1 R -ALT Project Title: '- iA SM Mn A K --III At /I I Date:. ;Iob la © CaICERTS 2005 IMPORTANT Thi"sC -1 =ALT form is only for use when an: HVAC-only_al ation is made to an existing home Use:0ne form for'each s stem'being altered. •This.issystem`# ' of systems altered in this house. Section 6 - Minimum Requirements: for: Equipmentto beInstalled/Altered. Instatled equipment must match typenocation and meet or.exceed eificiencies/R-values.. 28 Configuration:• ❑Split system >Opackage Unit 29 O Ac. Handler'-.'' as furnace„AFUE OHeatpump FAU OHydronic FAU 00ther 30 ❑ Heat Exchanger 31 . ❑ Outdoor Condinsim Unit OA/C OHeatpump btriciency SEER/MSPR I 00 IEER if ie d : 32 ❑ coating or hiiatirg coif ❑A/C ❑Heat ump OH dronic 33 ❑ Duds Location: • ; Length (ft): R -value: All mandatory measure's apply to any altered.com 'bnent';-'See-MF-1 R - ALT form. Compliance Statement: This certificate of compliance lists the building features and .specifications needed to comply with Title 24, Parts.1 and 6 of the Califomia Code of Regulations, and the administrative regulations to implement them. This, certificate has been signed.by the individual with overall project responsibility. Tt4undersigne&recognizes that,compliance using duct sealing, verification of refrigerant charge, and TXV require installer testing and certification, and,verification by an approved.HERS,,rater. . Home Owner or Authorized Agent Documentation Author Name: Name: -cJ Address: Company Name;. /-� ClCity/State/Zip: Address: City/State/Zip' : , cC--- Phone: Phone: ` Signature: Signature: Enforcement Agency (Building Department) Notes/Comments: Name: Title: Department: Phone #: Fax #: Signature or Stamp: Required forms: CF -IR -ALT: by anyone. Required at itime of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor:; Required to close permit Copies to_h' owner, enforcementagency, HERS rater. CF -4R -ALT: by HERS rater. Required to close permit. Copies to'home owner, enforcement: agency,• installer. The CF4R forms for a sample group shall not be released until all testin and verification'is completed and assed'for the entire' rou : vcimvn u"-iu-uu- . . Page 2 of 2 This form can only be used on projects being verified by CaICERT.S. certified raters. www.calcerts.com I Installation Certificate Prescriptive Method - 'HVAC -only Alteration CF -6R -ALT Project Title: Date © 2005 CaICERTS °IC�R Enforcement Agerry AgencyUse Only Project Address: Climate Zone: . Building Perinft # . cps I Installing Contractor: Telephone:- .; . Pian check Date. Li r� 347(0 -lob -1 Com any Name:. Flea Check Date Q, o .1 IMPORTANT: This CF -6R for only for usd`when an,HVAC gnly alter tion is made to an existing home Use one form for each system being altered this' is system # • \ oC — systems altered in this house. Copies to: Homeowner, HERS.Rater, and `Bwldin De artment , List.the specifications for.the newly installed equipment:' <These rnust match the. installed equipment exactly. Installed equipment must match.t a/lo'cation and-meef or exceed.efftciencies/R-values from CFAR. Equipment Ta Manufacturer Model Number; Efficiency Load" Capacity— a acit —Furnace Furnace AFUE Heat Exchanger N/A Heat Pump fan coil N/A Hydronic farrcoil N/A Other FAU Describe Package gas/AC CP,D F,1 1V1 AFUE.; 'ood r �i o1 0 0o SEER .: • . Package heatpump HSPF SEER EER' A/C Condenser SEER Heatpump Condenser HSPF SEER Indoor DX coil EER* Hydronic coil—T. Provide EER if needed for compliance (line 24 of CF -1 R=ALT). ,Installer must provide adequate: documentation to verify EER. In some cases the specific furnace may need to be'verified in order to achieve a specific EER. In some cases a time delay relay and/or TXV may need to ve verified in order to achieve a specific EER. Loads are sensible for cooling.. Capacities are sensible at design conditions for.cooling and adjusted, altitude, downflow, etc. output for heating. XV: ❑ If TXV is required by the CFA R form (line 23 on.CF J R-ALT.form), it has been installed and access has been provided for .visual verification -by HERS.rater. Sampling is allowed:for TXV verification. . Entirely New Duct System: (Line 5 of CF -1 R ALT) ❑ For Entirely new ductsystems, the required leakage is 6%o rather than 150/,Jor'altered systems. The alternative to duct sealinq b :increasinthe`efftcieric iof:the'e ui ment is not an o` tiori for:entirel new. ducts stems. 1, the undersigned, verify that the equipment listed above is:'1) the.actuatequipment installed in the home; 2) equal to or more efficient than required by the.Certificate of Compliance (CF -1'R -ALT Form);;and 3) equipment that meets or exceeds the appropriate requirements for manufactured devices (Appliance Efficiency Standards), where applicable. I, the undersigned, verify that diagnostic -test results listed o'w n.this formere performed�in conformance with the requirements for compliance and that the newly installed or retrofitted mechanical system components conform with the Mandatory requirements specified in Section 150(m) of the 2005 Building Energy Efficiency Standards. Signed nsta ler): Y Date: Notes: version us-tu-uorage t or c This form can only be used on.projects being verified by CaICERTS certified raters. www.cal.ce.rts.com Installation Certificate Prescriptive Method - HVAC -only Alteration CF -6R -ALT Project Title: Date: © 2005 CalCERTS IM RTANT: This CF -6R form is o for use when an HVAC -only alteration is made to an existing home Use one form for each system being altered. This is system # -of o�systems altered in this house. Copies to: Homeowner, HERS Rater, and Building.Department Duct Leakage test Results -(If duct testing is required per CF -IR -ALT form Step 1 - Pre-test: Leakage of the system before any alterations. This test isoptional and is only used for the 60% reduction option 1 Pre-test leakage ICFM25 .2 1 Line'l x 0.4 = [target for 60% reduction Step 2 : Determine Total System Fan Flow: Use any of these methods. Use values for a ui ment after alterations. 3 Cooling: Condenser tonnage: tons x 400 CFM/ton = JCFM 4 Heating: Fumace ou ut: Btuh x.0217 CFM/Btuh JCFM 5 6 Measured: (refer to ACM Manual Appendix RE, section 4.1) = CFM Measurement. method: O flow hood O 'plenum pressure matching Mow grid 7 Total system fan flow value to be used: CFM may use highest of lines 3, 4, or 5. Step 3 - Deternine Targets: 8a Total System fan flow (line 7 from above) x 0.06 = CFM25 = 6% leakage target (new duct systems) 8b Total System fan flow (line 7 from above) x 0.15 = '. ; CFM25 = 15.% leakage target 9 Total System fan flow line 7 from above x 0.10 = CFM25 = 10% leakage to outside target Step 4 - Alterations: Must be consistent with the CF -1 R forth. 10 ❑ ISeal all new connections with approved materials. 11 ❑ No newly constructed portions of the system can have unducted building cavities to convey system air. 12 ❑ If adding or replacing more than 40 feet of duct, insulate new ducts per package D for that climate zone Step 5 - Final Leakage ( ular duct leakage test, for 15% total and 60% reduction) 13 leakagie = ' CFM25 refer to 2005 ACM appendix RC, Sections RC 4.3.1 14a ❑ If line 13 Is less than line 8a house passes the 6% leakage requirement, Go to Step 9. 4b ❑ If line 13 Is less than line 8b house passes the 15% leakage requirement Go to Step 9. 15 ❑ If line 13 Is less than line 2 house passes the 60% reduction requirement continue. 16 - ❑ If either of lines 14a, 14b or 15 are checked HERS verification is required. Sampling can be used. 17 ❑ 1 If line 15 is checked, but not 14a or 14b, Smoke Test and Visual Inspection of Accessible Duct Sealing is required. Go to Step 8 Step 6 - Leakage to Outside: Similar to a regular duct blaster test but the house is pressurized to 25 pascals at the same time. 18 leakage ICFM25 refer to 2005 ACM appendix RC, Sections RC 4.3.3 19 ❑ If line 181s less than line 9 house passes the 10% leakage to outside re uirement. 20 ❑ If line 19 passes, HERS verification is required. Sampling can be used. Step 7 - If the house does not pass any of lines 14, 15 or 19. 21 ❑ [smoke and Visual Inspection of Accessible Duct Sealing is required. See Step 8. 22 ❑ 1 Install required label per ACM Appendix RC Sections RC.4.3.5. Step 8 - Smoke Test and Visual Verification See 2005 Residential ACM Appendix RC Sections RC 4.3.5-7 23 ❑ IPerform smoke test per ACM Appendix RC Sections RC 4.3.6. 24 ❑ IlPerform Visual Ins edion and repair of excessively damaged ducts per ACM Appendix RC Sections RC 4.3.7. 25 ❑ l8eal register boots to surrounding material perACM Appendix RC, Sections RC 4.3.7. HERS Verification 26 ❑ If line 14 is checked. 15% leakage to be verified by HERS rater. Sampling is allowed. 27 ❑ If line 15 is checked. 60% leakage reduction to be verified by HERS rater (post test only) AND Smoke Test and Visual Verification to be performed by HERS Rater. Sampling is allowed. 28 ❑ If line 19 is checked. 10% leakage to outside to be verified by HERS rater. Sampling is allowed. 29 ❑ If none of lines 14, 15 or 19 are checked Smoke Test and fix all accessable leakes. No sampling allowed. Sampling - Only if house passes on lines 14, 15 or 19. 30 ❑ 1.) Homeowner chooses to be put into a group of homes for random third party HERS sampling. 2.) Homeowner, installer and rater must sign the three -party agreement. 3. All above tests must be completed by the installer or their representative, not the third party rater. No Sampling - House does not pass by lines 14 15 or 19d OR homeowner chooses not to be part of a sample proup 31 ❑ 1.) House to be tested by a third party HERS rater selected by installer. 2.) Homeowner, installer and rater must sign the three -party agreement. 3.) All above tests may be completed by the installer or their representative, and then verified by a third party rater. OR all above tests may be performed solely by the third party rater. 32 ❑ 1.) House to be tested by third party HERS rater selected by homeowner. 2.) All above tests may be completed by the installer or their representative, and then verified by a third party rater. OR, all above tests may be performed solely by the third party rater. Version 03-10-06 Page 2 of 2 This form can only be used on projects being verified by CalCERTS certified raters. www.calcerts.com Ca10ERTSj Certificate:,- �$A . rw. t Treats t �v. CERTIFICATE_OF FIELD VERIFICATION R DIAGNOSTIC TE: 'I a i-16- s—' yste Paul Van HERS Rat Palm Desert A/C - Heating / 374937 Contractor Name / License No. 06-00001958 Permit Number -777-1724 25014 Telephone Sample Group Number 006 CC14-1798365591 Date Certificate Number Page 8 of 11 Firm: (_11 Air Experts Air Conditioning HERS Provider:CalCERTS Street Address: PO Box 94 City/State/Zip:La Quinta / CA / 92247 Copies to: Homeowner, HERS Provider and Buildin4 Deuartment CF -4R This CF -4R has been registered with the CaICERTS® registry in accordance with the Title 24 & Title 20 of the CCR. CaICERTSO is an approved.HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was ❑ Tested © Approved as part of sample testing, but was -not tested. As the HERS rater. providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution system Is fully ducted and correct tape is used before a CF -412 may be released.,on every tested building. The HERS rater must not release the CF -411 until a properly completed and signed CF -611 has been received for. the sample and tested buildings. The installer has provided a copy of the CF -611 (Installation Certificate). ~ - New Distribution system is fully ducted (i.e., does not use building cavities as, plenums or platform returns in lieu of ducts). New systems where cloth backed, rubber adhesive duct tape"is Installed;'•mastic_ and drawbands are used In combination with cloth backed. rubber adhesive duct tape to seal leaks at duct connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION.:COMPLIANCE CREDIT: Main System NEW CONSTRUCTION Duct Pressurization Test Results (CFM @ 25 Pa) Measured Values 1 N/A 2 Fan Flow: Calculated (Nominal V Cooling Q Heating) or 0 Measured Enter Total Fan Flow in CFM: Not Tested 3 N/A N/A ALTERATIONS: Duct System and/or HVAC Equipment Change -Out 4 Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. Not Tested 5 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change -Out. Not Tested 6 Enter Reduction in Leakage for Altered Duct System [Line 4 - Line 5] - (Only If Applicable) Not Tested 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) Not Tested 8 Entire New Duct System - Pass If Leakage Percentage <= 6% ( 100 x ( Line 5 / Line 2 )]: Not Tested ❑ Pass ❑ Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pass if Leakage Percentage <= 15% [ 100 x ( Line 5 / Line 2 )]: Not Tested 0 Pass ❑ Fail 10 Pass if Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )): Not Tested ❑ Pass ❑ Fall li Pass if Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )] and Verification by Smoke Test and Visual Inspection Not Tested ElPass ElFail 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail Pass if One of Lines #9 through #12 pass Pass ❑ Fail h4://www.calcerts.com/cf4r_print_certificate.cfin?lots=25013,25007,25011,25012,25009... 5/23/2006 w Ca10ERTS-ertificate Page 9 of 11 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF -411 55520 Pinehurst s tem #2 Palm Desert A/C - Heating / 374937 Project Address Contractor Name / License No. 06-00001958 Contractor ( Paul Van V HERS Rater ephone Permit Number -1724 25014 Telephone Sample Group Number May 23, 2006 CC14-1798365592 Certifying Sign ure Date Certificate Number Firm: Air Experts Air Conditioning HERS Provider:CalCERTS Street Address: PO Box 94 City/State/Zip:La Quinta / CA / 92247 Copies to: Homeowner, HERS Provider and Buildinq Department This CF -411 has been registered with the CalCERTS8 registry in accordance with the Title 24 & Title 20 of the CCR. CaICERTS® is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was ❑ Tested 2 Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution system is fully ducted and correct tape Is used before a CF -4R may be released on every tested building. The HERS rater must not release the CF -411 until a properly completed and signed CF -611 has been received for the sample and tested buildings. The installer has provided a copy of the CF -611 (Installation Certificate). New Distribution system Is fully ducted (i.e., does not use building cavities as plenums or platform returns In lieu of ducts). New systems where cloth backed, rubber adhesive duct tape Is Installed, mastic and drawbands are used In combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT: Main System NEW CONSTRUCTION Duct Pressurization Test Results (CFM @ 25 Pa) Measured Values 1 N/A 2 r� Fan Flow: Calculated (Nominal 0 Cooling 0 Heating) or Q Measured Enter Total Fan Flow in CFM: Not Tested 3 N/A N/A ALTERATIONS: Duct System and/or HVAC Equipment Change -Out 4 Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. Not Tested 5 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change -Out. Not Tested 6 Enter Reduction in Leakage for Altered Duct System [Line 4 - Line 5] - (Only if Applicable) Not Tested 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) Not Tested 8 Entire New Duct System - Pass if Leakage Percentage <= 6% [ 100 x ( Line 5 / Line 2 )]: Not Tested ❑ pass ❑ Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pass If Leakage Percentage <= 15% [ 100 x ( Line 5 / Line 2 )]: Not Tested R Pass ❑ Fall 10 Pass if Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: Not Tested ❑ Pass ❑ Fall 11 Pass if Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )] and Verification by Smoke Test and Visual Inspection Not Tested Pass Fall 12 Pass if Sealing of all Accessible Leaks and Veriflcatlon by Smoke Test and Visual Inspection ❑ Pass ❑ Fail Pass If One of Lines *9 through *12 pass Pass ❑ Fail S http://www.calcerts.com/cf4r_print_ceit�ti ,;` ::. 7,25011,25012,25009... 5/23/2006