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11-0902 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00000902._' Property Address: - 44610 SAFFRON CT APN: 604-252-021-41 -24208 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1151'/ Architect or Engineer: plk 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION 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 Profe ionals Code, and my License is in full force and effect. License Class: C20 Y License No.: 686310 Date: b ZLractor: -BUILDER DECLARATION I hereby affirm under perialty of perjury that I am exempt from the Contractor's State License Law for the - following reason (Sec- 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve,, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by - any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.: (_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvementsare not intended or offered for sale. If, however, the building or improvement is sold within one year of completion,.the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 .I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractors) licensed pursuant to the Contractors' State License Law.). ( ) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address:��.l LQPERD1IT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/22/11 Owner: JOE & PAM OWEN 44610 SAFFRON COURT LA QUINTA, CA 92253 _ j ii It ;i Contractor: GENERAL AIR CONDITIO4 N uiu 2 n ?0;9 31170 RESERVE DRIVE I j 1 THOUSAND PALMS, CA 94276 (760) 343-7488 Lic. No.: 686310 ------------------ WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation,. as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier EVEREST NATL Policy Number 7600006147101 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 bject to the workers' compensation laws of California, and agree that, if I should become sub• t to the the compensation provisions of Section XTO abor Code, I shall forth comply with those provisions. /ate: /t: WARNING: FAILURE WORKE ENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 - Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of LaQuinta, 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 I have read this application and state that the above in mation is correct. 1 agree to comply with all city and county ordinances and state laws relating to building co r ction, and hereby authorize representatives oft ' county to enter upon t above-mentioned property for i tion purposes. Date: it ature (Applicant or Agent): Application Number . . . . 11-00000902 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/18/12 Qty. Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECII D/C .3-15IIP/.100K-5iOOKBTU 16.50 ---------=------------------------------------------------------------------ Special Notes and Comments 3 TON HVAC CHANGEOUT, CONDENSER, FURNACE & COIL. 2010 CODES. Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 .Fee summary Charged Paid Credited Due Permit Fee Total 40.50 .00 00 40.50 Plan Check Total 10.13 .00 .00. 10.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total 51.63 .00 .00 51.63 Bin # City of La Quinta -Building 8L Safetyplvlslon 1� Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit -Application and. Tracking Sheet Permit #P.O. (�Q� Project Address: 1. f q 61 D5.0- FFA � Owner's Name A. P. Number: y� Address: 441 v S r r (; Legal Description: Contractor: Address: TD City, ST, Zip: 7 VN0O / Telephone State Lie. # : 3 City Lie. Arch., Engr., Designer: City, ST, Zip: Tee ephone: Project Description: c3TM J74-Vj.G L�7L!%l�Shcit> Address: City., ST, Zip: - Telephone:. .. .;:� ::?'h;�j .:,�k {:.t 'oject - onstruction Type: Occupancy: State Lie. #: a circle one New. Add'n Alter Repair Demo Name of Contact•Person: p (,(c ,� l/i�L5 c7YVq. Ft.: # Stories: TUnits: Telephone # of Contact Person: -Ila O 3 Y73 %''1 ? $ stimated Value of Project: S . Q— APPLICANT: DO. NOT WRITE. BELOW THIS LINE # Submittal Plan Sets Req'd Recd TRACMG Plan Check submitted PERMIT FEES Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Che4k Balance. Tide 24 Cafes. Plans picked up CFinstructon Flood plain plan Plans resubmitted Mechanical Grading plan 2"d Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing . Grant Deed Plans picked up. S.M.I. H.O.A. Approval Plans resubmitted Grading INHOUSE:- 'rd Review,.ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks..Appr. Date of permit issue School Fees Total Pe.-mit Fees Sim .lined-Piescri tive Certificaie of Com fiance: 2008 Residential'HVAC;Alteradons CF -IR -ALT -HVAC Climate Zones 10 to -15 Site Address: 44W6 SaFr (zon Enforcem t Agency: Date: Permit fl: T-'q- Equipment T et List Minimum Efficient Z Duct insulation requirement C6ndilioned Floor Area Thermostat ckaged Unitmace LuFoor ❑AFUESO'% ❑COP Over 40 ft of ducts added or XSetback Coil ❑SEER / 3 ❑ HSPF replaced in unconditioned space Served by system (If not already ndensing Unit ❑ EER / / ❑ Resistance ❑ R 6 (CZ 10-13) sf present, must be ❑ Other ❑ R 8 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R -ALT -HV- C for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form wEs in fact the work completed by the installer. The inspector also verifies that each appropriate CF -611 and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and si ed. Beginning October 1, 2010, a registered copy of the CF -IR and CF -6R shall also be on site for final lis ection. 1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MEC (- 25 -HERS CF -411 forms: MECH- 21 and fors lits stems MECH-25 • Condenser Coil and /or • Indoor Coil and/or CF-611forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Furnace CF4R forms: MECH- 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if. ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: with new • Cut s: al Clew ducting ducts: (all new ducting and all CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECE-22-HERS, and MECH-25-HERS new equipment) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 For Split Systems: Duct leakage < 6 percent; RC, CCA _> 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split sy,:tems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF -411 forms: MECH-20 and (for split systems) MECH-25 coil and/or fumace. Not all equipment changed. For Split Systems: Duct leakage < 6 percent, RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ductin over 40 feet Re uired Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned space. CF -611 forms: MECH-04, MECH-2I -HERS CFAR fowmts: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identifies on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance corvorm to the requirements of Title,24, Parts I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the ' orm tion documented on other pph ompliance forms, worksheets, calculations, andspecifications plans submitted to the enforcement agency for a to al with t e permit application. Name:Creed UJO-*s6n Si lure: Company: G ,en,e�a.( �� r Corld� f•`o n �` Date : Address: 31110 PeSeroe_ �ti ✓� License: City/State/Zip: - r—� / Phone: %60-,343 % /8. CaICERTS - CF -1R Registration Page 1 of 1 Public Home Secure Home About Us Training Racer Directory Forms Membership Benefits Events Industry Partners News To register for our monthly newsletter, please click here. Danielle Garcia logged in [Logout] [Home] CONGRATULATIONS Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Site Address: ILa 44610 SAFFRON COURT Quinta, CA 92253 CEC Registration: 1211-A0042992A-00000000-0000 CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD Assigned Company: I HARRISON ENTERPRISES INC Do you know your HERS Rater? If you do, you may want to send this CF -1R to them. CaICERTS Rater ID: OR My Rater Quick Select: The Energuy CA LLC Every CaICERTS rater has a license number. If you need to find the rater by name [Click HERE] to search our dir-story. SEND,CF-1 R TO HERS RATER ! [CLICK HERE] to do another Copyright e02010 CaICERTS. Inc. All rights reserved. Revised:.lanuar}• I I.'rM) [Terms and Conditions] [Privacy Statement] [Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Toll Free: 877-HERS-R81z(877-437-7787) Fax: 916-985-3402 Contact Us MET I BBBBBBEtna--Facebook© rvu Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge v.=rification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized , for compliance. , As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and•Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or ` replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes ink Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 ' System Location or Area Served 7 Whole House 1 p Yes ❑ No ,''t., 5/16 inch (8 mm) access hole upstream of evaporative coil in the retirn plenum and labeled according to Figure in Section RA3.2.2.2.2, 2 p Yes ❑ No 4 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure.in Section RA3.2.2.2.2. Yes•to•,1..,a.90..2 is a pass. ;; Enter Pass or, Faill ✓ 0 Pass ✓ ❑Fail STMS.,, Sensat-on�t!I Evaporator Coif" ., System+Name dr° I'd entification/Tag"'V y System 3 ❑ Yes The sensor is factor installed; or•fieldlmstalled according to-rnanufac:turers , ®'4No# specifications, or is installed by methods/specifications approved byy 4he Executive The sensor is factory installed, or field installed according to manufacturer's 6 Director i ". s a i ? Al V �*+� 4 a fix: p Yes The sensor wire is terminated with a�standard'mini plug suitable for connection to a �, __t a p No digital `thermometer The sensor mini plug is accessible totthe in talligechnicn.c HER S:rater.with and�the outchanging;the.airflow,through thecondensercoil 5 ❑ Yes. ❑ No i The sensor"measures the saturation temperature of the coil within 13 degrees F Yes to 3, 4;,;and'S Is'a?pass.'Enter N/A if`STMS are not applicable`Other'wse enter Pass orFail':: ✓ N A / ✓ El ✓ ❑Fail { SIMS Sensor on the CondenserxCoil System Name or Identification/Tag .,. System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by .he Executive Director. The sensor wire is terminated with a standard mini plug suitable for ,_onnection to a •7 ❑ Yes []No digital thermometer. The sensor mini plug is accessible to the installing technician -' and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes ❑ No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ CEJ N/A ✓ El Pass ✓ p Fail applicable. Otherwise enter Pass or Fail ,. Reg: 211-A0042992A-M2500001A-0000 Registration Date/Time: 2011/09/27 12:18:0.7 HERS Provider: CalCERTS, Inc.' 2008 Residential Compliance Forms August 2009 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an adff'tional form(s) for, any additional systems in the dwelling as applicable. e • The system should be•installed and charged in accordance with the manufacturer's specifications before starting this procedure. , • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems System Name or Identification/Tag System 1 (must be re -calibrated monthly) .... System Location or Area Served Whole House �„""'ST 'f,'.. rr �" 8/v1/2011 1r .+ii ".i �li�',j�' 4�` '� •kc !f` (ymust{be re calibrated monthly) Outdoor Unit Serial # r 5811D06980 ^- t k it=d� .. rr #. Outdoor Unit Make Lennox m Outdoor Unit Model XC21-036 Nominal Cooling Capacity Btu/hr I 36800 Date of Verification8/22/2011 63 ` • •s : . Cali bration'of:Diagnostic Instruments Date of Refrigerant Gauge Calibratio h• 8/1/2011 (must be re -calibrated monthly) .... fF nr:S�+Y.4"+� Date of Th(ermo�cpo�uple Calibration. �„""'ST 'f,'.. rr �" 8/v1/2011 1r .+ii ".i �li�',j�' 4�` '� •kc !f` (ymust{be re calibrated monthly) Supply (evaporator leaving) air dry-bulb -, ;4' temperature +(Ts�Pp ^{ • «64f„'.� Measured Tem eratuees� ° , ,:;` k - t 7 ,tim'"+ System Name'or Identifi%�cation a System.l F� ; Supply (evaporator leaving) air dry-bulb -, ;4' temperature +(Ts�Pp ^{ • «64f„'.� ^- t k it=d� .. rr #. Ydb)',:� ,crF m Return (evaporator=entering) air dry bulb�' tempe'rature (Tretu n 85 db). Return (ei"porafor entering) air wet bulb temperature (Tretorn, wb) 63 Evaporator saturation temperature "' " 56 (Tevaporator, sat) , Condensor saturation temperature 120 ' (Tcondensor, sat) Suction line temperature (Tsuction) 78 Liquid Line Temperature (Tliquid) 116 Condenser (entering) air dry-bulb 109 temperature (Tcondensor, db) F Reg: 211-A0042992A-M2500001A-0000 Registration Date/Time: 2011/09/27 12:18:07 HERS_ Prcvider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 T INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 44610 SAFFRON COURT, La Quinta CA 92253 1 City of La Quinta 11-902 Minimum Airflow Reauirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 Calculate: Actual Temperature Split = Treturn, 21.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3 22 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - -1 Target Temperature Split = Passes if difference is between -3°F and +3°F or, upon remeasurement, if between• -3°F and PASS -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must: be equiFto`or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (dm/ton) Systerr{Name, of de �tifcation/Tag',• ` 7 } ystem;i` l Calculated Minimum Airflow Requi ement Measured,Airflow.. Sing RA3 3 procedures (CFM) _�✓ J'" r_ ref Passes if measured-airflow`is:greate'r than or equal to the calculated minimum airflow.,.::' ` +. requirement Enter Pass or Fail Superheat Charge Method,:Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device,systems System Name or Identification/Tag System i Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail Reg: 211-A0042992A-M2500001A-0000 Registration Date/Time: 2011/09/27 12:18:07 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag r r System i ; • Calculate: Actual Subcooling = 4.0 Tcondenser, sat - Tliquid r Target Subcooling specified by manufacturer 2.5 manufacturer s specifications (or use range 4-26 ; Calculate difference: 1.5 Actual Subcooling - Target Subcooling = ate,gR ' System passes if difference is between -3°F and +3°F ' PASS A Enter Pass or Fail ► Metering Device Calculations for Refrigerant Charge Verification: This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 ; • Calculate: Actual Superheat Tsuction - Tevaporator, 22.0 satin r Enter allowable superheat range fr6m*,�,j manufacturer s specifications (or use range 4-26 ; between 4°F and 25°F if manufacturers i specification is not available) �?.• System passe,a� 's ff actual'superheat is wfthinrthe� .• 4 . F,. allowable superheat r�..,ange'��ASS ate,gR Enter Pass or Fafl Reg: 211-A0042992A-M2500001A-0000 Registration Date/Time: 2011/09/27,12:18:07 ( HERS Provider: CalCERTS, Inc. 2008•Residential Compliance Forms y August 2009 .'r • ,C 4 Reg: 211-A0042992A-M2500001A-0000 Registration Date/Time: 2011/09/27,12:18:07 ( HERS Provider: CalCERTS, Inc. 2008•Residential Compliance Forms y August 2009 INSTALLATION CERTIFICATE P CF-6R-MECH-25-HERS Refrigerant Charge Verification -Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 44610 SAFFRON COURT, La Quinta CA 92253 1 City of La Quinta 11-902 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation: If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or`Identification/Tag System 1 CSLB License: 686310 Date Signed: 8/22/2011 Position With Company (Title): System meets all refrigerant charge and airflow Name of TPQCP (if applicable): Control Program (TPQCP)? ' ❑ Yes ❑ No 4. requirements. PASS Enter Pass'or Fail � � � 7"s,, 1F•L' � 9"� �r ' �'y 5ear , �, - ` /', t�.:. } � L t.. ria _ nrt!VRH+��• ' ... !';. •' yae Ew � vJ'9J Ai,. 4` .Yi DECLARATION STATEMENT . I certify under penalty of pejury under the laws of the State of California, the information provided on this form is true and correct. ,. . I am eligible under Division36f,,the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsltilefor construction (responsible person). . I certify that the installed features;materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. `. I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific + requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met.- 1 et.I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I • understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or. General Contractor or Builder/Owner) - HARRISON ENTERPRISES INC Responsible Person's Name: • Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 8/22/2011 Position With Company (Title): Is this installation monitored_ by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ' ❑ Yes ❑ No 4. � � � 7"s,, 1F•L' � 9"� �r ' �'y 5ear , �, - ` /', t�.:. } � L t.. ria _ nrt!VRH+��• ' ... !';. •' yae Ew � vJ'9J Ai,. 4` .Yi DECLARATION STATEMENT . I certify under penalty of pejury under the laws of the State of California, the information provided on this form is true and correct. ,. . I am eligible under Division36f,,the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsltilefor construction (responsible person). . I certify that the installed features;materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. `. I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific + requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met.- 1 et.I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I • understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or. General Contractor or Builder/Owner) - HARRISON ENTERPRISES INC Responsible Person's Name: • Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 8/22/2011 Position With Company (Title): Is this installation monitored_ by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ' ❑ Yes ❑ No ' 4 Reg: 211-A0042992A-M2500001A-0000 Registration Date/Time: 2011/09/27 12:1.8:07 HERS Provider: CalCERTS, Inc.' 2.008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct,Leakage Test — Existing Duct System (Page 1 of 2) Site Address:' 44610 SAFFRON COURT, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1� City of La Quinta 11-902 Enter the Duct System Name or Identification/Tag: Enter the Duct System Location'or Area Served: Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. - This installation certificate is required for compliance for alterations and ai space conditioning systems and duct systems. in existing dwellings to Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, -air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existlrg dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System.:' Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. ❑ 1. Measured leakage less than .15% of fan flow 1:12. Measured leakage to outside less..than 10% of Fan Flow ' :•~ R Reduce leakage'by.:.60% and conduct smoke and fix all leaks , 45tFix all accessible leaks using smoke and HERS rater verify _ k Note >(One of Options;,l, 2, or 3 must be:attemptedbbefore,utilizing Option 4.-)„s .•E`-: Determmyommal-Fan FI,'ow using one ofathe followin ttiree calculation methods V Coohngfsystem method: Sizeofcondenser in Tons` F z 400 tCFM ✓� Heating,system method:: 21.�7px _ Ou]tput Capacity in Thousands of Btu/hr =CFM ' .�n.w+r ',1t tNNNprocAer+durles: kFM� �+.,�- ✓El Measuredrsystem airflow usingfRA3 3 airflow6 S Opti6h-,.vused then+ 'A lowed leakage'—'Fan Flow dx O'15'�`CFM l ActualYLeakage'= _ CFM` ..= Pass if Leakage Actual is less than Allowed , Pass ❑ Fail Option PL'Flow � x 2•. eakageh 0.10 = _ CFM Actual Leakage to out side°= -atCFM Pass if Leakage Actual is less than Allowed Pass Fail Option 3 used then: Initial leakage prior to start of work '= _ CFM „ Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ -. Final leakage _ = Leakage reduction_ CFM ((Leakage reduction _ / Initial leakage _) x 100% _ % Reduction ' Pass if % Reduction > 60% Pass Ej Fail Option 4. used then: 4 All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No smoke allowed to leak from.system. Including ducts' plenums, air handler and door panel. Pass if all accessible leaks have been repaired using smoke Pass Fail L Reg: 211-A0042992A-M2100001A-M21A Registration Date/Time: 2011/10/03-20:04:52 ',HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 20101 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-21 Duct Leakage Test — Existing Duct System. (Page 2 of 2) Site Address: 44610 SAFFRON COURT, La Quints CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 11-902 • ❑ Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during du ct',lea,kage•'testing. CFI OA, ducts that utilize controlled motorized dampers, that open cnly when OA,. ventilation is required to meet A�SH:RAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed posit--i�'o:n during duct leakage testing ❑ All supply and�retaurn;register boots must be sealed!to the"drywalFif,smo_ke test'i's utilized fort. ompliance r - applies toduet leakage compliance option 3 "(leakage reduction,byb0%).and option 4(fix all accessible leaks) dj{�escribed above. y r' Ir N ❑ New ductrinstallafio�nis cannot utilize building.-cavitie's'as plenums or pia m returns, inrlieu of ducts. r . ew PIN ❑ Mastic anal draw:bandsmust:be used in combination with,i`cloth backed;.rubber,adhesive':duct'e to seal leaks at all new duct connections DECLARATION STATEMENTf, . I certify under penalty of perjury, underEthe laws of the State of California, the information provided on this form is true and correct. Vis* }`: . I am the certified HERS raterwFio performed the verification services identified and reported on this certificate (responsble rater). . The installed feature, material; component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requir_ments specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. .'The information reported on applicable sections�of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) apprcved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R) ' Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible, Person's Name: CSLB License: Danielle Garcia 686310 HERS Provider Data Registry Information Sample Group # (if applicable):•246828 ❑ tested/verified dwelling 0 not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798585861. HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 10/3/2011 CC20OS784 0 Reg: 211-A0042992A-M2100001A-M21A Registration Date/Time: 2011/10/0320:04:52 HERS Provider: CalCERTS, Inc. . 2008 Residential Compliance Forms March 2010 Note: If installation of a •Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, ,a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. . As many as 4 systems in the dwelling'can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only. required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. a TMAH - Access Holes in Supply and Return Plenums of. Air Handler System Name or Identification/Tag System Location or Area Served 1 ❑ Yes ❑ No, '' - 5/16 inch (8 mm) access hole upstream of evaporative coil in the retu-n plenum and V,.�A labeled according to Figure in Section RA3.2.2.2.2. 2 E] Yes ❑'No j 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Ye5to-1.and...2.is A: pass. Enter Pass or Faill ✓ 3 Pass ✓ ❑ Fail . STMS; Senso&onthe, Evaporator Co91= a: System:Nam'e'orldentification/ Tag ,,� Rk '' � „; Vl � "'( � x''; + " 3 i ❑Yes=No The The sensor is.factory` installed; or 'field.installed'ace'ording to manufactsrers •' speafications, or isinstalled by methods/specifications'approved by th>° Executive 4 } p Yes 5 No ,, The sensorrwjre�s terminated with a standard mini plug suitable for c�9nection�to a digital thermometer �_Th' sensor. mini plug is accessible to the iiistallmgNtechnician t and the,HERS,rater,without changing he airflow through the condenser coil' 5r ❑ Yes ❑ No ' When attached to a digital thermometer, the sensor provides an indication of the "saturation temperature of the coil. Yes�to 3 4 :and. 5 is:a pass. Enter N/A'if STMS are not applicable, Otherwise entePass of,,Fail ✓ [I N/A ✓ El Pass ✓ •❑ Fail STMS - Sensor on the Condens&.jCoil Reg: 211-A0042992A-M2500001A-M25A' Registration Date/Time: 2011/10/03 20:07:39 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms j March 2010 System Name or Identification/Tag The sensor is factory installed, or field installed according to manufacturer's - 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by th=_ Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 C] Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil - 8 C] Yes E] No When attached to a digital thermometer, the sensor provides an indicaition of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not applicable. , Otherwise enter Pass or Fail V ©N/A ✓ Pass ✓ El Fail Reg: 211-A0042992A-M2500001A-M25A' Registration Date/Time: 2011/10/03 20:07:39 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms j March 2010 System Name or Identification/Tag The sensor is factory installed, or field installed according to manufacturer's - 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by th=_ Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 C] Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil - 8 C] Yes E] No When attached to a digital thermometer, the sensor provides an indicaition of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not applicable. , Otherwise enter Pass or Fail V ©N/A ✓ Pass ✓ El Fail CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 44610 SAFFRON COURT, La Quinta CA 92253 1 City of La Quinta 11-902 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 -systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditionina Svstems System Name or Identification/Tag (must be re -calibrated monthly) ofThemooule System Location or Area Served Outdoor Unit Serial # Outdoor Unit Make Outdoor Unit Model Nominal Cooling Capacity Btu/hr Date of Verification Laiibration of magnostic Instruments Date:"Of Refrigerant Gauge Calibration. (must be re -calibrated monthly) ofThemooule m ei:monthly) �aaDatec measurea temperatures-t-�,rj :l , . 1I I i I � System Name.or Ident ficaton/Tag J J ' Supply (e..vaporator;;leaving) ,air dry-bulb temperature:(Tsupply, db) , Return (evaporator --entering) air dry' -bulb temperature",(Tretur`n; db,, Return (evaporator entering.) air wet -,bulb temperature (T return, wb) Evaporator saturation temperature (Tevaporator, sat) Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db) Reg: 211-A0042992A-M2500001A-M25A Registration Date/Time: 2011/10/03 20:07:39 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 44610 SAFFRON COURT, La Quinta CA 92253 City of La Quinta 11-902 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag Calculate: Actual Temperature Split = Treturn, db - Tsupply, db Target Temperature Split from Table RA3.2-3 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - Target Temperature Split = Passes if difference is between -4°F and +4°F or, . upon remeasurement, if between -4°F and -100°F Enter Pass or Fail Note: Temperature Split Method. Calculation is not necessary if actual Cooling Coil Airflow is verified using o, -re of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal, to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (dm/ton) System<,Name or Id ntification/Tag' rt Calculated Minimum Airflow,Requirement (CFM) �- f r3 Measured Airflow using RA -3.3 proceduresff Passes if rri INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page. 4 of 5) Site Address: Enforcement Agency: Permit Num Ser: 44610 SAFFRON COURT, La Quinta CA 92253 City of La Quintaw 11-902 . Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is requi-ed to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Subcooling Tcondenser, sat - Tliquid Target Subcooling'specified by manufacturer - Calculate difference.: ` Actual Subcooling -,Target Subcooling = System passes if difference is between {Wy 7/1, „ ` „ .�-1 -4°F and +4'F ' ;`�_ '.=w•.• Enter Pass or Fail ,e/ r Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/TagL Calculate: Actual Superheat.= Tsuction - Tevaporator, satf`.• Enter -allowable superheat range from•; manufacturer's specifications (or use ange between 30F and 26°F if manufacture Ws specification is not available)',.. System;passd'slif actual superheat is within+the ""'Y ,superheat rangel` �• allowable41 {Wy 7/1, „ ` „ .�-1 or,Fa�l}_ ;`�_ '.=w•.• ,,.+"Enter,;Pass ,e/ r INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page S of 5) Site Address: Enforcement Agency: Permit Number: 44610 SAFFRON COURT, La Quinta CA 92253 City of La Quinta 11-902 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 246828 System meets all refrigerant charge and airflow 0 not-tested/verified dwelling in la HERS sample group requirements. HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail William bavid Pointer Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 10/3/2011 CC2005784 r, 7,_�L 7V DECLARATION STATEMENTS ; • I certify under penalty of perjury under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS raterwho performed the verification services identified and reported on this certificate (responsble rater). • The installed feature, material�cornponent, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requir--ments specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 246828 ❑ tested/verified dwelling 0 not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798585861 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William bavid Pointer Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 10/3/2011 CC2005784 Reg: 211-A0042992A-M2500001A-M25A Registration Date/Time:, 2011/10/03 20:07:39 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: 44610 SAFFRON COURT, La Quinta CA 92253 (System c Enforcement Agency: Permit Number: ' 1) ' City La Quints , 11-902 Space Conditioning Systems Heating Equipment Duct ency Location , Cooling Equipment Efficiency Duct Equip Efficiency Location Equip ARI # of (AFUE, (attic, Cooling Cooling Type + , ARI # of etc.)1, 3 crawl- Duct R -value Heating Heating (package- CEC Certified Mfr. Name. Reference Identical (>=CF -1R space, Duct Loac Capacity heat pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/br) (kBtu/hr). Split Lennox, Furnace SL280UH070XV36A 4341983 1 80 AFUE Attic R-4.2 66 58 kBtu r ' ..sy r �� +,u•�r ,�: 3i'r`s..zr "y-,'�T_' +.y3 i'�'",+py '�b{'"', �'Y �>''`{ Cooling Equipment •1. If project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative compliance.^y : 2. ARI Reference Number can tie'.fo'und by entering the equipment model number at T http://www.aridirectory. orglarijacrphp# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -IR form. 4. When CF -1R is reference it is also applicable to the CF -1R, CF -IR -AA or CF -ZR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM 0 §110-§113: HVAC equipment is certified by the California Energy Commission. CEJ §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or RCCA. - 0 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of .§112(c). ' 0 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant oris enclosed entirely in conditioned space. Reg: 211-A0042992A-M0400001A-0000 Registration Date/Time: 2011/09/27 11:53:13 HERS Pro%ider: CalCERTS, Inc. 2008 Residential Compliance.Forms August 2009 Efficiency Duct Equip (SEER Location ("package ARI # of and EER) 1, 3. (attic, crawl- Cooling Cooling heat pump) CEC Certified Mfr. Name and Model Number;_ Reference Number2 Identical Systems (>=CF -1R value)4 space, etc.) Duct R -value Loac (kBtu/F.r) • Capacity (kBtu/hr) Split a Lennox �. i•"` `20 SEER EER "�• .. •- )f � ` A/C;� ry XC71-036 t 1 x'13 , Attie „ ,• R-4 2 �) 36.i. �'. 3 Tons ..sy r �� +,u•�r ,�: 3i'r`s..zr "y-,'�T_' +.y3 i'�'",+py '�b{'"', �'Y �>''`{ •1. If project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative compliance.^y : 2. ARI Reference Number can tie'.fo'und by entering the equipment model number at T http://www.aridirectory. orglarijacrphp# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -IR form. 4. When CF -1R is reference it is also applicable to the CF -1R, CF -IR -AA or CF -ZR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM 0 §110-§113: HVAC equipment is certified by the California Energy Commission. CEJ §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or RCCA. - 0 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of .§112(c). ' 0 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant oris enclosed entirely in conditioned space. Reg: 211-A0042992A-M0400001A-0000 Registration Date/Time: 2011/09/27 11:53:13 HERS Pro%ider: CalCERTS, Inc. 2008 Residential Compliance.Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: 44610 SAFFRON COURT, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 11-902 Ducts and Fans §150(m): Duct and Fans © 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and © 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the d u cts. © 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. 0 7. Exhaust fan systems have back draft or automatic dampers. 0 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers © Protection of Insu.lation.Insulation shall be protected from damage, including that due to sunlight, moisture, equipment mainteh; ince, and wind. Cellular foam insulation shall be protected as above or painted withk6:coating that water retardant and provides shielding from solar radiation that can cause :degradation of the material.,, 2*10. Flexible ducts cannot h�avei,.Porous=inner cores. DECLARATION ATEMENT • I certify underpenalty of.`perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3'of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person' responsible: for construction (responsible person). . I certify that the installed features; materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and,:regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: Date Signed: Position With Company (Title): 686310 8/22/2011 Reg: 211-A0042992A-M0400001A-0000 Registration Date/Time: 2011/09/27 11:53:13 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 44610 SAFFRON.000RT, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1� City of La Quinta 11-902 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in space conditioning systems and duct systems. 4 ellings to Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system - Select one compliance method from the following four choices. 1. Measured leakage less than_ 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow ' F-1 3. Reduce leakage by 60% and conduct smoke and fix all leaks ❑ 4 -Fix all accessible leaks using smoke and HERS rater'verify ��(One Note of Options1, 2 or 3 mu be attempted,,before utilizing, Option Determine nommal''Fan Flow using one of4he following three calculation methods ' e K o es ✓ © Cooling system method Size or condenser in Tons 11 4 1 31 40v-0 =f� 1200 CFM' I ✓ ❑Heating 21.7 = ]y +Output Capacity systemy method x iin Thousa nFd sr"off�Btu/hr _ CFM � ✓❑Measured system airflow using RA3. 3'alrflowAe"stprocedures: CFM " gym; x 1 Option 1 usedthen sem*, Allowed leakage . Fan Airflow 1200x 01580'CFM�'' 1 , Actual Leakage X168 CFM (,A ' Pass if Actual Leakage is less than Allowed leakage 0 Pass ❑ Fail Option .2:us'e'd then *',, 2 Allowed leakage FanMirflow . x 0.10 = _ CFM Actual Leakage to outside=:CFM `':Pass if Actual leakage to outside is less than Allowed leakage Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = = CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction • CFM ((Leakage reduction _ / Initial leakage _) x 100% _ /6 Reduction Pass if % Reduction > 60% . 0 Pass El Fail Option 4 used then: 4. All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). ' Pass'if all accessible leaks have been repaired using smoke ❑ Pass Ej Fail . f Reg: 211-A0042992A-M2100001A`-0000 Registration Date/Time: 2011/09/27 11:58:00 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: 44610 SAFFRON COURT, La Quinta CA 92253 (System , Enforcement Agency: City of La Quinta Permit Number: 11=902 1) CSLB License: 686310 Date Signed: 8/22/2011 2 Outside air (OA) ducts for -Central Fan Integrated (CFI) ventilation systems, shall.not be sewed/taped off dueing duct a.eakage,-.testing. CFIibA ducts that utilize controlled motorized dampers, that open only when OA ventilation Is required to meet ASsHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. D All supply/and return registee�boot mus a}ed�to� the'dryw� alll'if smokke to t is,.0 liied compliance — applies toduct leakage compliance option 3 (leakage reduction by 60%) and option 4 (flxtall:accessible leaks) described above.^ - 0 New ducuinstallatlons cannot!utilize`iWlding,cavities as plenl;N.or-platform returns in�lleu 6t duct D Mastic anravba d ymust_be used In combination wlth,clothbacked rubber'adhesive duct tape fo seal' leaks • at all new duct'connectio"n's sA :, J DECLARATION'STATEMENT • F . I certify under penalty of perjury, under, the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of1he Business and Professions Code to accept responsibility for construction, or an autl-orized representative of the person responsible:for construction (responsible person). . I certify that the installed features 6te'rials, components, or manufactured devices identified on this certificate (the i istallation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies: defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS ' rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation ha -.,e been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made availab a with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or,General Contractor, or Builder/Owner) Reg:'211-A0042992A-M2100001A-0000 Registration Date/Time: 2011/09/27 11:58:00 HERS Provider: CalCERTS, Inc., 2008 Residential Compliance Forms March 2010 ' HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 8/22/2011 position With Company (Title): Is this installation monitored by a Third Party Quality Name.of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No I - Reg:'211-A0042992A-M2100001A-0000 Registration Date/Time: 2011/09/27 11:58:00 HERS Provider: CalCERTS, Inc., 2008 Residential Compliance Forms March 2010 ' 1 V SMOKE AND CARBON MONOXIDE ALARM RETROFIT VERIFICATION. :l no,/ � �i c�� , and 1, (Print Property Owner's Name) (Tenant's Name - if same as Owner write "Same") who own and/or live in the dwelling located at: `lg 10 S®. T 4cjn C77 - L m 0 ()/,*1A ?2 2S� (Address) . verify that the smoke and carbon monoxide alarms required by the California Residential Code (CRC) have been installed in the dwelling, in.compliance'with the code and w161he manufacturer's instructions and further that they have been tested and do -function properly. - - - In an effort to enhance life safety within dwellings, CRC Section R314.6, R315.2 and CBC 420.4 require the retrofit of these alarms in. existing dwellings when alterations, repairs or additions requiring a permit and exceeding $1,000 in value are made. Generally, the alarms must be hard wired (I 10 volt) with battery back-up and all alarms are to be interconnected. If the installation of the alarms will require the`re-moval of wall or ceiling finishes or there is no access by means of attic, basement or crawl space, then alarms may be solely battery . operated and not interconnected. Alarms must be installed in all of the following local_ ions within the existing dwelling: ➢ In all bedrooms (only require Smoke Alarms) ➢ Immediately outside of each separate bedroom. (require Smoke and Carbon Mcnoxide Alarms) ➢ In each story level of the dwelling, including basements and habitable attic room (require Smoke and Carbon Monoxide Alarms) These safety devices must be installed by the time a final inspection is requested for your project._ 1 understand the above requirements and certify that we now have smoke alarms and carbon monoxide alarms installed that comply. We agree to comply with the CRC in regards to. smoke alarms, _ carbon mon 'de alarms. Signaore of Owner Date Signature of Tenant Date ATTiNTION OWNER OCCUPANT: This is a Voluntary Smoke and Carbon Monoxide Alarm verification procedure. Ifyou prefer a Building Inspector to perform the verification, you must arrange to .have an adult pr --sent at the time of inspection. NOTE: This Verification is only used when normal access to the interior of the dwelling by the City of : uilding Inspector is not achieved during the course of project construction. It is normally used for projects such as re-roorng, re -siding, patio covers, swimming pools and the like.