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09-1131 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA,. CALIFORNIA 92253 Application Number. "09-00001131 Property Address: 48691 SAN DIMAS ST APN: 646 -130 -005 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 13831 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: GARRETT JOHN 2421 WINDWARD LN NEWPORT BEACH, CA 92660 ( Contractor: Applicant: Architect or Engineer: DESERT AIR CONDITIONING, 590 WILLIAMS ROAD PALM SPRINGS, CA 92264 (760)323-3383 Lic. No.: 276586 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: C20 -C43 ' n LicenseNo.: 276586 Date: • �gContractor. /A' L (� o OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPER114IT VOICE (760) 777-7012 FAX (760) 7.77-7011 INSPECTIONS (760) 777-7153 Date: 10/27/09 O 4 INC. WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this'permit is issued. My workers' compensation insurance carrier and policy number are: Carrier INS CO OF WEST Policy Number WSD216397402 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section ,_I'-3/7_00 of the Labor Code, hall forthwith comply with those provisions. .Date: 1"t -Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or 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 information is correct. I agree to comply with all city and county ordinances and state laws relating to buildin instruction, and hereby authorize representatives of this county to enter upon the above-mentioned property or ] 'r of Date: 16 T-ti%ignature (Applicant or Agent): /�•�� Application Number . . . 09-OOOOli31 Permit . . . MECHANICAL Additional desc . Permit Fee'-•.. . . . 51.00 Plan Check Fee 12.75 Issue Date .. Valuation . . 0 Expiration Date 4/25/10 Qty Unit Charge Per Extension BASE -FEE 15.00 2.00 9.0000 EA ' MECH FURNACE <=100K 18.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 Special Notes and Comments REPLACE (2) 3 TON SPLIT SYSTEMS UNITS LIKE FOR LIKE ; 14 SEER. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN'(SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 51.00 .00 .00 51.00 Plan Check Total 12.75 .00 .00 12.75 Other Fee Total 1.00 .00 .00 1.00 Grand Total 64.75 .00 .00 64.75 LQPERAIIT Bin # City of La Quints Building 8L Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Per ' #' i 2 1` J Project Address: 6 9 A Owner's Name: c , A. P. Number: Address: Af i Aplwaool,Z Legal Description: n �/ �� City, ST, ZipW;Ne 0+' ,I A L L/ r6 (/ Contractor: Desert Air Conditioninq Inc. Telephone;- Address: 590 Wi11iams Rd Project Description: Bepjjr,( 3 b City, ST, Zip: P a l jj e Telephone: ( 7 6 0 3 2 3 — 3 3 8 3 h:;;;»ir:�><::<:>:•:.::�;.•• i.y.:.�;:. iii\iv:{{ii;.•\•i:::;.rY.: v:��:i'J:::i: v}::: },;•: �j! L� C State Lic.#: 276586 City Lic.#; 363 Arch., Engr., Designer- esignerAddress: Address: City, ST, Zip: r Telephone 'kw2::�tiix:'< f i;:.' }M h}::•:•':i.•i�v <'i: �: vvU. }\.y'.Yu!n;»iw;riLv'i;i ;} «.;;;:;..} ::: , ;.;;i>:<>i>;'•^t:'G:#;?>;Er>> }.. ,�..••:':s:i F�••••� • .,.,..::, :'`'r;!�'i.`:'i� f;?jY�:iti..}..I••:ii':%}i}i i:Qk::::'• Construction Type: Occupancy: State Lic. #:.>;; Project type (circle on New Add'n Alter Repair Demo Name of Contact Person: Todd Shaw . Sq. Ft.: #Stories: #Units: Telephone # of Contact Person:( 7 6 0) 3 2 3— 3 3 8 3 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE ' tl Submittal Req'd Recd TRACKING PERMIT 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. Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'" Review, ready for corrections/issue ElecMcal Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' 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 Permit Fees Installation Certificate Prescriptive Method - HVAC -only Alteration C:F-bK-AL I Project Title:: /sA/y % /l /v -4 J Date: {/J /0/0 ✓ / 0 © 2005 CaICERTS Enforcement Agency Use Only Project Address: - ` 3 �; /r14 S Climate Zone: 15 Building Permit # Installing Con ractor: Todd Shaw Telephone: 323-3383 Plan check Date Company Name: Desert Air Conditioning, Inc. Field Check Date IMPORTANT: This CF -613 form is only for use when an HVAC -o ly alt on is made to an existing home Use one form for each system being altered. This is system # of systems altered in this house. Copies to: Homeowner, HERS Rater, and Building Department List the specifications for the newly installed equipment. These must match the installed equipment exactly. . Installed equipment must match tvpe/location and meet or exceed efficiencies/R-values from CF -1R. Heat Exchanger N/A Heat Pump fan coil N/A, Hydronic fan coil N/A Other FAU Describe Package gas/AC yor 4V AFUE [' SEER 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 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 coolinq and adjusted (altitude, downflow, etc.) output for heating. ❑ If TXV is required by the CF -1R form (line 23 on CF -1R -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 duct systems, the required leakage is 6% rather than 15% for altered systems. The alternative to duct sealing by increasing the efficiency of the equipment is not an option for entirely new duct systems. 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 Compliance (CF -1 R -ALT Form); and 3) equipment that meets or exceeds the appropriate equirements for manufactured devices (Appliance Efficiency Standards), where applicable. 1, the undersigned, verify that dja nostic test results listed on this form were performed in conformance with the requirements for complianceand that wly install d or retrofitted mechanical syste mponents conform with the Mandatory requirements pecified in Se 1 1 (m)ofthe35 Building Energy Efficiency a . ards. Version 03-10-06 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 Project Title: Date: AV © CaICERTS 2005 IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only alt e tion is made to an existing home Use one form for each system being altered. This is system #of systems altered in this house. Section 6 - Minimum Requirem—'-. ' ­ > :,ui nt to be Installed/Altered. Installed equipmP^' ..atch cation and meet or exceed efficiencieslR-values. 28 Configuration: i?bpnt system Er Package Unit 29 ❑ r Handler as furnace, AFUE: OHealpump FAU OHydronic FAU OOlher 30 ❑ Heal Exchan er 31 ' .rCondensi Unit C OHealpumpfficienc SEER/HSPF: EER Are d: 32 cling or heating cod OA/C OHeatpump OHydronic 33 ❑ . Ducts Fc-,t,,n ILength (it): R -value: All mandatory measures apply to any altered component. 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 California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall project responsibility. The undersigned 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: l � Name: Jacqueline D_ Zabik Address: 5. :mR Company Name: Desert Air - Conditionin .Inc City/State/Zip: �q 9a Address: 590 Williams Rd Phone: ' City/State/Zip: Palm Springs, Ca 92264 Phone: 323 : Signature: Signature: ^ Enforcement Agency (Building Department) N s/Comments: Name: Title: Department: Phone #: Fax #: Signature or Stamp: Required forms: CF -1 R -ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to close permit. Copies to home owner, enforcement agency, HERS rater. CF -4R -ALT: by HERS rater. Required to close permit. Copies to home owner, enforcement agency, installer. The CF -4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entire group. Version 03-10-06 Page 2 of 2 This form can only be used on projects being verified by CaICERTS certified raters: www.calcerts.com Certificate of ComDliance Prescrintive Method - HVAC -only Alteration CF -1 R -ALT Project Title: Date: Oc CaICERTS2005 /0/05- 47 9 Enforcement Agency Use -only e Project Address: Climate Zone: Building Permit a Y$-691 Sq 15 Documentation Author: Telephone: Plan Check Date Jacqueline D. Zabik 323-3383 Company Name: Field Check Date Desert Air Conditioning, IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only alteration is made to an existing home tICD Aho fnrm fn• r-,..L� r..r4r.... L...:.... ..11 ..-...J TL:.- :- �. ..s �.— 11 / .0 9 .-. ...�........ ..11..-...! :.. IL.:r Imo.., ,rr of Altaratinnc- 1 ❑ 2 t' 3 (IF 4 I* 5 ❑ 6 ❑ Section 7 ❑ 8 ❑ 9 ❑ n Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. urnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. cooling or heating coil is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. Mare than 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined. ❑ Check here if the en it duct system is also to be new or replaced. Continue to next line. If none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked.) rhis system is in Climate Zone 1, 3 4, 5, 6, 7, or 8. No duct sealing is required. Go to Section 2. rhis system has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. rhis system was previously seated and tested, and was certified by a HERS rater. 4o duct sealing is required. Attach previous CF -4R form. Go to Section 2. 10 ❑ [This duct system 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 Ar1R EER 12 condenser will be installed with TXV(RCA) AND added duct insulation (R-4 wrap on existing 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 AND 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 AdR EER 12 condenser will be installed with TXV(RCA) D an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 15 JNone of lines 7-14 above are checked. Duct Sealing is Required. Continue. Sectio - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 Thes stem 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 ❑ Thiss stem 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 ❑ his 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. Secti- HERS Rater verification 22 If 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). 24 ❑ If line 12, 13 or 14 are checked, HERS verification is required for 12 EER. Section 4 - Equipment 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 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 -1 R -ALT 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 Project Title: ^U� Date: iD/O S- 47 9 © CaICERTS 2005 Enforcement A ency Use Only Project Address: VS -.6171 s Climate Zone: 15 Building Permit # Documentation Author: Jacqueline I). Zabik Telephone: 323-3383 Plan Check Date Company Name: Desert Air Condition' Field check Date IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only alteration is made to an existing home altered. This is system # of systems altered in this house. . Use one form for each system being_ Check all lines that apply. Check only lines that apply. Scope of Alterations: 1 Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. 2urnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. 3outdoor 401n condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 4ooling or heating coil is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 5 e than 40 feel of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined. ❑ Check here if the en ire 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 ❑ Thiss stem 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 ❑ his duct system 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 nota ply. 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 AN12EER 12 condenser will be installed with TXV(RCA) AND added duct insulation (R-4 wrap on existing 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 AND 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 AND EER 12 condenser will be installed with TXV(RCA) D 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 Required. Continue. Sectio - TXV(RCA) Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 IThes stem beinQ altered is a package unit. No TXV(RCA) is required. Go to Section 3. 17 ❑ his 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 ❑ I Thiss stem is in Climate Zone 1, 3, 4, 5, 6, or 7. No TXV(RCA) is requiied. 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 ❑ Thiss stem is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) is required. Go to Section 3. 21 ❑ This 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. Secticy(3 - HERS Rater verification 22 If 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). 24 ❑ If 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 feel of duct is being installed or replaced, duct R -value must meet or exceed Package D requirements. 27.0 Ilf 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 Project Title: ^� /� `,v 6 -ac� C- CI Date: f.9 /� ©CaICERTS 2005 IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only alte anon is made to an existing home Use one form for each system being altered. This is system # of systems altered in this house. Section 6 - Minimum Requirem--`-• "•r ';Ji nt to be Installed/Altered. Installed equipmP^' ..dtch t cation and meet or exceed efficiencies/R-values 28 Configuration: Li-�,pm system Package Unit 29 ❑ 30 ❑ 06as furnace, AFUE: ❑Heatpump FAU ❑Hydronic FAU ❑Other Heal Exchan er 31 _ : oor condensing unit KC ❑Heatpump fficlenc SEER/HSPF: JEER rf re d : 32 Soling or heating coil ❑A/C ❑Heatpump ❑Hydronic 33 ❑ .Ducts Location: Length (ft): R -value: All mandatory measures apply to any altered component. See MF -1R - 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 California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall project responsibility. The undersigned 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: L �o�c���! Name: Jacqueline D . Zabik Address: 5a;i1rjR Company Name: Desert Air -Conditioning, Inc City/State/Zip: �n e4 Rads Address: 590 Williams Rd Phone: City/State/Zip: Palm.Springs, Ca 92264 Phone: 323 - Signature: Signature: ^ ' 3111 Enforcement Agency (BuildingDepartment) N s/Comments: Name: Title: Department: — — Phone #: -- ------ ---- ----- - ---- --- --- Fax #: — ----- Signature or Stamp: _ Required forms: CF -1 R -ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to close permit. Copies to home owner, enforcement agency, HERS rater. CF -4R -ALT: by HERS rater. Required to Gose permit. Copies to home owner, enforcement agency, installer. The CF -4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entire rou . Version 03-10-06 rage z or z This form can only be used on projects being verified by CalCERTS certified raters. www.calcerts.com Installation Certificate Prescriptive Method - HVAC -only Alteration Lt--bN-HL- I Project Title: /�/tom 1 1(1-4 /� /V -4C �jJ Date: }� % 'V /0 ���q ©2005 CaICERTS Enforcement Agency Use Only Project Address: - ` 3 S Climate Zone: 15 Building Permit a Installing Con ractor: Todd Shaw Telephone: 323-3383 Plan Check Date Company Name: Desert Air Conditioning, Inca Field Check Date IMHUR I ANI This CF -6R form is only for use when an HVAC -ply alt ton is mane to an existing nom e Use one form for each system being altered. This is system # of systems altered in this house. Copies to: Homeowner, HERS Rater, and Building Department List the specifications for the newly installed equipment. These must match the installed equipment exactly. Installed equipment must match type/location and meet or exceed efficiencies/R-vafues from CF -1 R. Equipment T e Manufacturer Model Number Efficiency Load" Ca acit — Furnace I I IAFUE Heal Exchanger Heat Pump fan coil Hydronic fan coil Other FAU Package gas/AC AFUE SEER Package heatpump yoc*- HSPF A/C Condenser I I (SEER coil I I IEER' Hydronic Provide EER if needed for compliance (line 24 of CF -1R -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. O If TXV is required by the CF -1 R form (line 23 on 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) O For Entirely new duct systems, the required leakage is 6% rather than 15% for altered systems. The alternative to duct sealing by increasing the efficiency of the equipment is not an option for entirely new duct systems. I, the undersigned, verify that the equipment listed above is: 1) the actual equipment installed in the home; 2) equal to or more efficient han required by the Certificate of Compliance (CF -1 R -ALT Form); and 3) equipment that meets or exceeds the appropriate equirements for manufactured devices (Appliance Efficiency Standards), where applicable. 1, the undersigned, verify that diagnostic test results listed on this form were performed in conformance with the requirements for [pecified mpliance and that wly install d or retrofitted mechanical syste omponents conform with the Mandatory requirements in Se 1 (m) of the 2 5 Building Energy Efficiency a dards. nstaller): Date: Version 03-10-06 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com L.'J le(roe?-) Installation Certificate Prescriptive Method - HVAC -only Alteration CF -6R -ALT Project Title: Date: ©2005CaICERTS IMPORTANT: This CF -6R form is only for use when an HVAC -only alter Ion is made to an existing home Use one form for each system being altered. This is system #� of T systems altered in this house. Copies to: Homeowner, HERS Rater, and Building Department Duct Leakage test Results If duct testing is required per CF -1 R -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 : CFM25 2 1 Line 1 x 0.4 = target for 60% reduction Step 2 - Determine Total System Fan Flow: use any of these methods. Use values forequipment after alterations. 3 Cooling: Condenser tonnage: tons x 400 CFM/ton = CFM 4 Heating: Furnace output: Btuh x .0217 CFM/Btuh = CFM 5 6 Measured: (refer to ACM Manual Appendix RE, section 4.1) = CFM Measurement method: ❑ flow hood ❑ plenum pressure matching ❑ flow grid 7 Total system 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 = = 6% leakage target (new duct systems) 8b Total System fan flow (line 7 from above) x 0.15 = / [FM25 FM25leakage target 9 Total System fan flow (line 7 from above) x 0.10 ICFM25 = 10% leakage to outside target Step 4 - Alterations: Must be consistent with the CF -1R form. 10 ❑ Seal 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 feel of duct, insulate new ducts per package D for that climate zone Step 5 - Final Leakage (regular duc leakage test, for 15% total and 60% reduction) 13 leakage 5 d J CFM25 refer to 2005 ACM appendix RC, Sections RC 4.3.1 14a ❑ If line 13 is less than line 8� a house passes the 6% leakage requirement, Go to Step 9. 14b ❑ If line 13 is less than line 8b, house passes the 15% leakage requirement. Go to Stop 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 ❑ 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 akae CFM25 refer to 2005 ACM appendix RC, Sections RC 4.3.3 19 ❑ f ne 8 iess han line 9 house asses the 10% leakage to outside requirement. �llfeiiiiiinegll9=psasises,,tHERS 20 ❑ 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 Step 8. 22 ❑ linstall 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 ❑ IPerformt smoke test per ACM Appendix RC, Sections RC 4.3.6. 24 ❑ JPerforrn Visual Inspection and repair of excessively damaged ducts per ACM Appendix RC, Sections RC 4.3.7. 25 ❑ Iseal register boots to surrounding material per ACM 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 ❑ =Homeownerooses to be put into a group of homes for random third party HERS sampling staller and rater must sign the three -party agreement. 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 not to be part of a sample roup 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 CaICERTS certified raters. www.calcerts.com Red rDomS Installation Certificate 'Prescriptive Method - HVAC -only Alteration CF -6R -ALT Project Title: Date: s/ ©2005CaICERTS IMPORTANT: This CF -6R form is only for use when an HVAC -only alter ion is made to an existing home Use one form for each system being altered. This is system #__,L of r� systems altered in this house. Copies to: Homeowner, HERS Rater, and Building Department Duct Leakage test Results (If duct testing is required per CF -1 R -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 -lest leakage ICFM25 2 Line 1 x 0.4 = target for 60% reduction Step 2 - Determine Total System Fan Flow: Use any of these methods. Use values fore ui menI after alterations. 3 Cooling: Condenser tonnage: tons x 400 CFM/ton JCFM 4 Heating: Furnace output: Btuh x .0217 CFM/Btuh JCFM 5 6 Measured: (refer to ACM Manual Appendix RE, section 4.1) = CFM Measurement method: ❑ flow hood ❑ plenum pre sure matching ❑Flow grid 7 Total system 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 (low (line 7 from above) x 0.15 = / CFM25 = 15% leakage target 9 Total System fan flow (line 7 from above) x 0.10 = ICFM25 = 10% leakage to outside target Step 4 - Alterations: Must be consistent with the CF -1R form. 10 ❑ Seal all new connections with approved materials. 11 ❑ Non ewly constructed portions of the system can have unducted building cavities to convey system air. 12 ❑ If adding or replacing more than 40 feel of duct, insulate new ducts per package D for that climate zone Step 5 - Final Leakage (regular duct leakage (est, for 15% total and 60% reduction) 13 leak ge',� tl Iw L itt� CFM2 refer to 2005 ACM appendix RC, Sections RC 4.3.1 4a ❑ If line 13 is less than line 8a house passes the 6% leakage requirement, Go to Step 9. 14b ❑ 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 ❑ llf 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 = I CFM25 refer to 2005 ACM appendix RC, Sections RC 4.3.3 19 ❑ If line 18 is less than line 9 house passes the 10% leakage 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 ❑ IPerform smoke test per ACM Appendix RC, Sections RC 4.3.6. 24 ❑ JPerform Visual Inspection and repair of excessively damaged ducts per ACM Appendix RC, Sections RC 4.3.7. 25 ❑ ISeal register boots to surrounding material per ACM 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 ❑ =H.meow.e,ooses to be put into a group of homes for random third party HERS sampling. staller and rater must sign the three -party agreement. must be completed by the installer or their representative, not the third party rater. No Sampling - House does trot pass by lines 14, 15 or 19; OR homeowner chooses not to 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 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 CaICERTS certified raters. www.calcerts.com