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09-0597 (MECH)�� ' 0 P.O. BOX 1504 T4hf � VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/08/09 Application Number: 09-00000597 Owner: Property Address: 78544 SAN MARINO CT BALLETT JAN APN: 609-551-038-29 -28458 - 78544 SAN MARINO Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL ( Application valuation: 5000 Contractor: Applicant: Architect or Engineer: GENERAL AIR CONDITIONING �/ 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (760) 343-7488 O Lic. No.: 686310 L ------------------------------- 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 �//�Licensse; No.: 686310 Date: :%ontractor: &/ [G (i9 N 1� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT WORKER'S COMPENSATION DECLARATI N I hereby affirm under penalty of perjury one of the following declarations: have and will maintain a certificate of consent to self -insure fo workers' coperisa ion, as provided for by Section 3700 of the Labor Code, for the performance f W ork 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 PREFERRED EMPL Policy Number WKN1295354 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Codedlhall.forthwith /lclompply with those provisions. pplicant: J Date:-$-aCy4 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 building construction, and hereby authorize representatives of this county to enter upon the above-mentioned pr pe/r[v��or i pe�cttiiionn purposes. Date: J� ckignature (Applicant or Agerltl: Application Number . . . . . 09-00000597 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/05/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 ---------------------------------------------------------------------------- Special Notes and Comments CHANGE OUT COMPLETE A/C CHANGE SYSTEM 17 SEER /13 EER. ---------------------------------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged --------------------------- Paid Credited Due ---------- Permit Fee Total 33.00 -------------------- .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total 42.25 .00 .00 42.25 LQPERMIT Bin # City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Buiidin Permit Application g and. Tracking Sheet Permit # Project Address: ` 4 Owner's Name: ��,V �� A -,C -i 2 A. P. Number: M 1� Address: Si9 N///e9�Q r.t� 67 % Legal Description: City, ST, Zip: �� 04- ea'f'-, 4 C% Cj 2 2 -S— Contractor: e:,PGn•> 't- ' 'moo; r ? ``; Telephone: . . Project Description: ;� � City, ST, Zip: (l<1 vG�r �v�. Oa �.r .y (�St- �� Z %� �j r4 N 0 Telephone: 76 e2 3 �r .:rc•>' ' , %' ` State Lic. # : Y,O 3.! 0 City Lic. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone: �c�"w:. •f4 `�`' State Lic. #: c:• ;: ! Name of Contact • Person: Construction Type: Occupancy: Project type circle one New Add'n Alter Repair Demo Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO. NOT WRITE. BELOW THIS LINE # Submittal Req'd' Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. 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 V 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 IN HOUSE:- 'rd Reyiew,.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 Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT Project Title: r� Date: � + ©CaICERTS 2005. wh aion is made to an existing home IMPORTANT: This CF -1 R -ALT formis only for use en an HV onlyl erat Use one form for each system being altered. This is system #__L__ of systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipW must match type/location and meet or exceed effciencies/R-valves. 26 Confguratio plit system O Package Unit 29 ❑'r Handler ❑Gas furnace, AFUE: OHeatpump FAU ❑Hydronic FAU ❑Other 30 i9 Heat Exchanger 31 1!!� Outdoor Con densing Unit OA/C OHeatpumpfficien SEER/HSPF: EER d re d 32't . Cooling or heating coil ❑AIC OHeatpump OHydronic 33 ❑ OuGs Location: lLength (ft): 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: Name:�c�C�� Address: 65UAS ` YVWIN' Comp ny Name'. Cii y/StatefZip: � G I` /N� L4 1 10ty/State/Zip: Address: Phone: 1"\a5wLA m<�,, (A qPhone: Signature: Signature: Enforcement A e& (1'ruildipA Department) Notes/Comments: Name: Title: Department: Phone #: Fax #: Signature or Stamp: Required forms: CF -1 R -ALT: by anyone. Required at time of perrYit 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. CF4R-ALT: by HERS rater. 'Required to close permit. Copies to.home.owner, enforcement.a.gency, installer. The CF -4R forms for 's m le group shall not'be released -until all testin and verification is completed and assed,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 Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT Proje Jov-\ Date: (4191 OCI © CaICERTS 2005 Enforcement Agency Use Only Project Address: Climate Z ne: Building Permit # Docu—n Enta tioln Author: T lephone: l Plan Check Date Company Name: 1J Field Check Date IMPORTANT: This CF -1 R -ALT form is only for use when an HVA -only ilteration is made to an existing home Use one form for each system being altered. This is system # of systems altered in this house. . Check all lines that aggy. Check only lines that apply. Scope of Alterations: 1 ❑ An Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. 2)1 A Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. 3 n outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. cooling or heating coil is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 60 More than 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined. ❑ Check here if the gatirg duct system is also to be new or replaced. Continue to next line. 6 ❑ If none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked. 7 ❑ This system is in Climate Zone 1, 3, 4, 5, 6, 7, or 8. No duct sealing is required. Go to Section 2. 8 ❑ is s stem has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. No duct sealing is required. Attach previous CF -4R form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Note: If the entire ducts stem is to be new or replace-, 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 ANa 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 AhQ EER 12 condenser will be installed with TXV(RCA) D 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 AI1Q EER 12 condenser will be installed with TXV(RCA) ND an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 15 None of lines 7-14 above are checked. Duct Sealing is Required. Continue. Se ion 2 - TXV RCA Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ T7he system bein altered is a package unit. No TXV(RCA) is required. Go to Section 3. 17 ❑ This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 ❑ This system is in Climate Zone 1 3 4J, 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 ❑his s stem is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) is required. Go to Section 3. 21 Whis 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. Se ton 3 - HERS Rater verification 22If line 15 is checked, HERS verification is required for Duct Sealing. 23j If tine 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification Is required for TXV(RCA). 24 C1 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 ord7 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 ❑ lif less than 40 feet of duct is being installed or replaced, duct R-valuemust 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 Certifying Signature �RS provider Firm C�HIEIEIR�S® JC & Associa s CirylState/Zip Address La Quinta /CA /42253 78660 Bradford Circle PROVID�k.R AND BUILDING DEPARTMENT Copies to: BUILDER, TIERS HE RATER COMPLIANCE STATEMENT This house was: ✓ Tested that the house identified on this form complies with the diagnostic As the HERS rater providing diagnostic testing and field verification, I certify that the new distribution system is fully ducted and tested building. The HERS rater must not release the CF -4R until a properly completed tested compliance requirements as checked on this form. The IRS rater must check and verify correct tape is used before a CF -4R may be released on every and signed CF -6R has been received for the sample and tested buildings_ ✓ The installer has provided a copy of CF -6R (Installation Certificate). EI New Ducts are ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). er adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber ❑New ducts with cloth backed, tubb adhesive duct tape to seal leaks at duct connections. ✓ R DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT MINIMUM REQUIREMENTS FOAppendix RC4.3. Procedures for field verification and diagnostic testing of air distribution stems are available in Rr1CM, Duct Diagnostic Leakage Testing Results S1 r vi 1— e 1 of 2) TESTING G (Pages CF -4R OF FIELD VERIFICATION & DIAGNOSTIC CERTIFICATE Project Address 1 Barrett, Jan I General Air Conditioning & Hen ' 78544 San Marino Ct. / La Quinta / CA / 42253 Telephone Plan Number / Permit Number �D Builder / installer Contact 7603437488 n — 7 - Jim Lange Telephone Sample Group Number 6 , AUG/1UU HERS Rater James Carmody - CIHIEIEIRIS® ID #CCNJC353361 7602185723 27 Cate Zone 15 I CITY Compliance Method (Prescriptive)le Date Sample house Number DINGAND Certifying Signature �RS provider Firm C�HIEIEIR�S® JC & Associa s CirylState/Zip Address La Quinta /CA /42253 78660 Bradford Circle PROVID�k.R AND BUILDING DEPARTMENT Copies to: BUILDER, TIERS HE RATER COMPLIANCE STATEMENT This house was: ✓ Tested that the house identified on this form complies with the diagnostic As the HERS rater providing diagnostic testing and field verification, I certify that the new distribution system is fully ducted and tested building. The HERS rater must not release the CF -4R until a properly completed tested compliance requirements as checked on this form. The IRS rater must check and verify correct tape is used before a CF -4R may be released on every and signed CF -6R has been received for the sample and tested buildings_ ✓ The installer has provided a copy of CF -6R (Installation Certificate). EI New Ducts are ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). er adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber ❑New ducts with cloth backed, tubb adhesive duct tape to seal leaks at duct connections. ✓ R DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT MINIMUM REQUIREMENTS FOAppendix RC4.3. Procedures for field verification and diagnostic testing of air distribution stems are available in Rr1CM, Duct Diagnostic Leakage Testing Results S1 r vi 1— Installation Certificate Prescriptive Method - HVAC -only Alteration CF -6R -ALT Project Title: BAFZRE-� Date: � WQ ©2005 CaICERTS IMPORTANT: This CF -6R form is only for use when an HVA -gnly alte`ation is made to an existing home Use one form for each system being altered. This is system # / of 1 systems altered in this house. Copies to: Homeowner, HERS Rater, and Building Department Duct Leakage test Results If dud testing is required per CF -1 R -ALT form tion Step 1 - Pre-test: Leakage of the system before any alterations. This test isoptional and is only used for the 60% reduction option 1 Pre test leakage: CFM25 2 Line 1 x 0.4 1 ZS 2- • 41 Itarget for 60% reduction Step 2 - Determine Total System Fan Flow. Use -any of these methods. Use values for equipment after alterations. 3 Cooling: Condenser tonnage: tons x 400 CFM/ton =po0 CFM 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 pressure matching ❑ flow grid 7 Total system fan flow value to be used: I Z,oav JCFM may use highest of lines 3, 4, or 5. Step 3 - Determine Targets: Ba Total System tan flow (line 7 from above) x 0.06 = 28FM25 = 6% leakage target (new duct systems) Bb Total System fan flow (line 7 from above) x 0.15 = 300 FM25 = 15% leakage Target 9 Total System fan flow (line 7 from above) x 0.10 = FM25 = 10% leakage to outside target Step 4 -A erations. Must be consistent with the CF -1 R forth. 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 feet of duct, insulate new ducts per package D for that climate zone Step 5 - Final Vakage (regular duct leakage test, for 15% total and 60% reduction) 13 I kage = / CFM25 refer to 2005 ACM appendix RC, Sections RC 4.3.1 4a ❑ fif line 13 Is less than line 8a house passes the 6% leakage re uirement Go to Step 9. 4b FV 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 ❑ 17 ❑ If either of lines 14a, 14b or 15 are checked, HERS verification is required. Sampling can be used. 1 If line 15 is checked, but not 14a or 14b, Smoke Test and Visual Inspection of Accessible Duct Sealing is required. Go to Step 8' Step 6 - Leakage to -Outside:. Similar to a regular duct blaster test but the house is pressurized to 25 pascals at the same time. 1;8 n ieaka e-= :o 1777.7 •.JCFM25 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 ❑ Perfo smoke test per ACM Appendix RC. Sections RC 4.3.6. 24 ❑ Perf Visual Insoection and repair of excessively damaged ducts per ACM Appendix RC, Sections RC 4.3.7. 25 ❑ S96i register boots to surrounding material per ACM Appendix RC. Sections RC 4.3.7. HERS V rification 26 If line 14 is checked. 15% leakage to be verified by HERS rater. Sampling is allowed. 27 ❑ If line is checked. 60% leakage reduction to be verified by HERS rater (post test only) AND Smo a Test and Visual Verification to be performed by HERS Rater. Sampling is allowed. 28 ❑ if f e 19 is checked. 10% leakage to outside to be verified by HERS rater. Sampling is allowed. 29 ❑ 1 one of lines 14, 15 or 19 are checked Smoke Test and fix all aocessable leakes. No sampling allowed. Sampling Only if house passes on lines 14, 15 or 19. 30 Homeowner chooses to be put into a group of homes for random third party HERS sampling. r3.12 Homeowner, installer -and rater must sign the three -party agreement All above tests must be completed by the installer or their representative. not the third party rater. No Sampling - House does not pass by lines 14, 15 or 19: OR homeowner chooses not to be part of a sample group 31 ❑ t' 1.) House to be tested by a third party HERS rater selected by installer. ?.)_Homeowner,,installer ano 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 sole) b the third a 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 w Installation Certificate Prescriptive Method - HVAC -only Alteration CF -6R -ALT Date: ® 2005 CaICERTS rojed Title: -- �— )Z tZ E I! ly (p f 0 O 1 Enforcement a Use On roject Address: Climate Zone: sued ny P�T"d r79- 5 q4l SAfv 1#AP' iNo CUr 15 o - 55-1 Telephone: Plan Check Date nstalling Contractor. fe A 3y3 Feld Check Date Lenora l Ar 0,1J) 7)oA►n5 made to an existing home IMPORTANT: for This CF -6R m is only fo use when an 8VAC-0nly alteration is terns altered in this house. Use one form for each system being altered. This is system #� _ of I— Ys Copies to: Homeowner, HERS Rater, and Buildin I Department List the specifications for the newly installed equipment. These must match the installed equipment exactly. Installed equipment must match ellocation and meet or exceed efficiencies/R-values frLoadom F -1R. Manufacturer Model Number Efficien Equipment T AFUE 7 Furnace NOUN V- G-OiU' e ^ WA Heat Exchanger, WA Heat Pump fan coil Package heatpump SEER EER' A/C Condenser / SEER `Qnn�,o xc I 06G Z)U i HSPF Heatpump Condenser SEER EER' Indoor DX coil 1ennux LC�z 60 qr Hydronic coil 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 verged in order to achieve a speck EER. Loads are sensible for cooling. Capacities are sensible at design conditions for coolingand adjusted (attitude, downflow, etc. output for heatin . -1 R -ALT form), it has been installed and access has been provided for ❑ If TXV is required by the CF -1 R form (line 23 on CF visual verification by HERS rater. Sampling is allowed for TXV verification. Entirety New Dud System: (Line 5 of CFA R ALT) ❑ For Entirely new dud systems, the required leakage is 6% rather than 15% for altered systems. The aftemative to duct sealin b increasingthe efficien of the ui ment is not an o tion for entire new duct s stems. ual to or more efficient the undersigned, verify that the equipment listed above is: 1) the actual equipment installed in the home; 2) eq ham required by the Certificate of Compliance (CF -1 R -ALT Form); and 3) equipment that meets or exceeds the appropriate ere applicable. equirements for manufactured devices (Appliance Efficiency Standards), wh I, the undersigned, verify that diagnostic test results listed on this forth were performed in conformance with the requirements for ompliance and that the newly installed or retrofitted mechanical system components conform with the Mandatory equirements r pecified in Section 150(m) of the 2005 Building Energy Efficiency Standards. Lig ..._. , Date: red (Installer):__ ores: Version 03-10-06 This form can only be used on projects being verified by CaICERTS certified raters. www.calce s.com CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 2 of 2) CF4R Project Address [ Barrett, Jan j 78544 San Marino CL / La Quinta / CA / 92253 Builder / Installer General Air Conditioning & Heating / THERMOSTATIC EXPANSION VALVE OXV) Procedures fbrfwld verification of thermostatic expansion valves are available in RACM, Appendix RI. Svstem # 1 V Yes ❑ No Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed on the system and installation of the specific equipment shall be verified. Yes is a pass �/ Pass ❑ Fail Residential Compliance Forms Generated by CIHIEIEIRISO bttpl/www.CHEERS.org December 2005