BRES2014-115278-495 CALLS TAMPICO
;A QUINrA,,CALIFORNIA 9225
I
Application Number:
Groperty
BRES2014-1152
Address:
78002. SAN TIMOTEO
APN:
646160023
Application Description:
4155 SD RESIDENCE
Property Zoning:
Application Valuation:
$271,639.50
Applicant:
WILLIAM MILLER
49020 AVENIDA FERNANDO
LA QUINTA, CA 92201
4 VOICE (760) 777-7125
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
JDate: 2/13/2015
Owner:
WILLIAM MILLER
'49020 AVENIDA FERNANDO
LA QUI NTA, CA 92201
FEB 13 2015
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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 Professions Code,
and my License is in full force and effect.
License Class: _ License No.: :LIC -0102765 n
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
($500).:
( ) 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 ) 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:
Contractor:
DESERT HABITATS GENERAL CONTR
75-161 SAGO LN F-1
PALM DESERT, CA 92211
(760)340-6062
Llc. No.: :LIC -010276S
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
bf the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
$tction 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: _ Policy Number:_
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 Code, I shall forthwith
comply with those provisions. _ _ n /—) /I /^
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 Building Official 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 citAenter h ve-
mentioneb
roperty for. inspection purposes.
a� 0 S' ature (Applicant or Agent).
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Total Paid for PLUMBING FEES: $672.17 $672.17
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101-0000-20308
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2/11/15
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Total Paid forSTRONG MOTION INSTRUMENTATION SMt $35.31 $35.31
TOTALS: $4,312.19 $4,312.19
1
Description: 4155 SD RESIDENCE
Type: BUILDING, RESIDENTIAL Subtype: DWELLING -.SINGLE Status: APPROVED
Applied: 10/27/2014 KHE
FAMILY DETACHED
Approved: 2/9/2015110
Parcel No: 646160023 Site Address: 78002 SAN TIMOTEO LA QUINTA,CA 92253
Subdivision: LA QUINTA GOLF ESTATES 2 . Block: Lot: 30
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $271,639.50 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: NEW 4155 SQ. FQ. SFD. THIS PERMIT DOES NOT INCLUDE POOL,SPA, BLOCK WALLS, DRIVEWAY APPROACH, FIRE -PIT, WATER
FEATURES. HOME IS FIRE SPRINKLED PER 2013 CRC CODES.
HOME WAS DEMOLISHED LAST YEAR, TUMF, MSHCP AND PARTIAL SCHOOL FEES WERE CREDITED TO NEW PERMIT.
Printed: Friday, February 13, 2015 12:41:06 PM 1 of 7
SYSTEMS
'ADDITIONAL
CHRONOLOGYTYPE.
STAFF_NAME.`.'
ACTION DATE CO.IVIPLETION DATE
�� d:'NOTES
s_<
__�
.. ,
_
EMAILED 3RD REVIEW STRUCTURAL CORRECTION LIST TO
E-MAIL
ARMEN ALTOUNIAN
12/18/2014
12/18/2014
CHUCK GARLAND. NO REDLINES. THEY CAN ADDRESS THE
COMMENTS AND RESUBMIT BY SLIP SHEET.
ADDRESS CHANGE APPROVED BY BURT HUNADA BUILDING
'
-
OFFICIAL, CHANGING ADDRESS FROM 49-020 AVENIDA
FERNANDO APN: 646-160-023 LOT 30 TO 78-002 SAN
-LETTER
JIM JOHNSON
1/15/2015
1/15/2015
TIMOTEO
JIM JOHNSON REQUESTED PLANS BE CHANGED TO REFLECT
NEW ADDRESS CHANGE.
`
ANTONIO SANTAMARIA CAME AND SLIP SHEETED NEW
NOTE
PHILIP JUAREZ
1/29/2015
1/29/2015
SHEETS TO REFLECT CORRECT ADDRESS LEFT SHEETS FOR
STRUCTURAL PLANS STILL WITH YOUNG DO TODAY.
NOTE
PHILIP JUAREZ
2/6/2015
2/6/2015
Printed: Friday, February 13, 2015 12:41:06 PM 1 of 7
SYSTEMS
Printed: Friday, February 13, 2015 12:41:06 PM 2 of 7
SYS7EIr1S
PM 10 SUBMITTED BY MICHEAL DOBRENSKY 760-275-3156
NOTE
PHILIP JUAREZ
2/11/2015
2/11/2015
GIVEN TO AMY YU
AMY APPROVED 02-12-2015
NOTE
STEPHANIE KHATAMI
2/11/2015
2/11/2015
Paid, not issued.
PLAN CHECK COMMENTS
FROM CONSULTANT
KAY HENSEL
7/21/2014
7/21/2014
RFC 7/21
RECEIVED
PLAN CHECK COMMENTS
FROM CONSULTANT
KAY HENSEL
11/10/2014
11/12/2014
STRUC RFC 11/10/14
RECEIVED
PLAN CHECK COMMENTS
STRUCTURAL RECIEVED FRON CONSULTANT NOT
FROM CONSULTANT
PHILIP JUAREZ
12/15/2014
.12/15/2014
APPROVABLE.
RECEIVED
PLAN CHECK COMMENTS
FROM CONSULTANT
PHILIP JUAREZ
2/6/2015
2/6/2015
structural approved with cond
RECEIVED
PLAN CHECK PICKED UP
KAY HENSEL
7/29/2014
7/29/2014
PLAN CHECK PICKED UP
PHILIP JUAREZ
11/13/2014
11/13/2014
plans picked up by Antonio Santa Maria
PLAN CHECK SUBMITTAL
KAY HENSEL
6/27/2014
6/27/2014
RECEIVED
RESUBMITTAL
KAY HENSEL
10/24/2014
10/24/2014
RESUBMITTAL
PHILIP JUAREZ
11/25/2014
11/25/2014
PLANS RESUBMITTED BY ANTONIO SANTA MARIA OWD BY
ARMEN
SENT TO PLAN CHECK
KAY HENSEL
6/27/2014
6/27/2014
TO YOUNG DUE 7/18
CONSULTANT
SENT TO PLAN CHECK
KAY HENSEL.
10/27/2014
10/27/2014
2ND CHECK DUE BACK 11/7
CONSULTANT
SENT TO PLAN CHECK
KAY HENSEL
12/1/2014
12/1/2014
STRUC TO YOUNG - DUE 12/15/14
CONSULTANT
Printed: Friday, February 13, 2015 12:41:06 PM 2 of 7
SYS7EIr1S
0S
0
SENT TO PLAN CHECK
KAY HENSEL
1/14/2015
1/14/2015
STRUC TO YOUNG - DUE 1/18/15
CONSULTANT
-PAID DATE RECEIPT #i •-CHECK#-, METHOD"
PAID B
TELEPHONE CALL
ARMEN ALTOUNIAN
11/12/2014
11/12/2014
PLANS READY TO BE PICKED UP. SPOKE TO ARCHITECT.
$179.10
$179.10
2/11/15
R3684
1805
CHECK
CALLED NANCY MILLER TO INFORM HER THAT PLANS ARE
TELEPHONE CALL
JIM JOHNSON
2/9/2015
2/9/2015
READY TO ISSUE AND ADDITIONAL PLAN CHECK FEES ARE
Total Paid forART IN PUBLIC PLACES - AIPP:
$179.10
$179.10
DUE.
TELEPHONE CALL
PHILIP JUAREZ
11/13/2014
-11/13/2014
HOURLY CHARGE -
101-0000-42600
1
$145.00
$145.00
CONDITIONS
R3684
1805
CHECK
MILLER
SKH
BLDG CITY STAFF
CONTACTS
.HOURLY PLAN CHECK -
101-0000-42600
,NAME TYPE
$385.00
ADDRESS1
CITY
STATE
ZIP -PH6Ng'.."
.'FAX
EMAIL
APPLICANT
WILLIAM MILLER
49020 AVENIDA
LA QUINTA
CA
92201 (310)592-6117
FERNANDO
Total Paid forBLDG CITY STAFF - PER HOUR:
$530.00
$530.00
CONTRACTOR
DESERT HABITATS GENERAL CONTR
75-161 SAGO LN F-1
PALM DESERT
CA
92211 (310)592-6117
BSAS SB1473 FEE
101-0000-20306
OWNER
WILLIAM MILLER _F
020 AVENIDA
49FERNANDO
LA QUINTA
CA
92201 (310)592-6117
CHECK
MILLER
SKH
Total Paid forBUILDING STANDARDS ADMINISTRATION
$11.00
$11.00
Printed: Friday, February 13, 2015 12:41:06 PM 3 of 7 cirw.1ySTEMS
HNANUAL
lNl`UkIVIA'HUN
CLTD
,,DESCRIPTION �4d6UNT 4TY AMOUNT-'-_�j AID,i '
-PAID DATE RECEIPT #i •-CHECK#-, METHOD"
PAID B
ART IN PUBLIC PLACES.- 270-0000-43201 0
$179.10
$179.10
2/11/15
R3684
1805
CHECK
MILLER
SKH
RESIDENTIAL
Total Paid forART IN PUBLIC PLACES - AIPP:
$179.10
$179.10
HOURLY CHARGE -
101-0000-42600
1
$145.00
$145.00
2/11/15
R3684
1805
CHECK
MILLER
SKH
BLDG CITY STAFF
.HOURLY PLAN CHECK -
101-0000-42600
5.5
$385.00
$385.00
2/11/15
R3684
1805
CHECK
MILLER
SKH.
YES
Total Paid forBLDG CITY STAFF - PER HOUR:
$530.00
$530.00
BSAS SB1473 FEE
101-0000-20306
0
$11.00
$11.00
2/11/15
R3684
1805
CHECK
MILLER
SKH
Total Paid forBUILDING STANDARDS ADMINISTRATION
$11.00
$11.00
BSA:
Printed: Friday, February 13, 2015 12:41:06 PM 3 of 7 cirw.1ySTEMS
Y ..',,, :.
DESCRIPTION
4rvaYv....e. :..0 ,fir.. . ,.. % apV:..= n
' FACCOLINT :'
"na.'
,`QTY
w.+:, �_
.'
AMOUNT
a •-«y"yp
, r , ,.7777=,>..
""M.PAID
Et
PAID DATES
�-RECEIPT #
-
CHECK # :
p ..:.x?t_,�E.� dez
'.METHODS
.«. zas•�, t� .� zat?• :
� P. AID
;. CLTD
, f
.
,;
W
RESIDENTIAL, EA -
101-0000-42403
0
$61.65
$61.65
2/11/15
R3684
1805
CHECK
MILLER
SKH
ADDITION 1,000SF
RESIDENTIAL, EA
101-0000-42600
0
$25.40
$25.40
2/11/15
R3684
1805
CHECK
MILLER
SKH
ADDITION 1,OOOSF, PC
RESIDENTIAL, FIRST
101-0000-42403'
0
$145.03
$145.03
2/11/15
R3684
1805
CHECK
MILLER.
SKH
1,0008E
RESIDENTIAL, FIRST
101-0000-42600
0
$47.86
$47.86
2/11/15-
R3684
1805
CHECK
MILLER
SKH
1,000SF, PC
Total Paid forELECTRICAL - NEW CONSTRUCTION: $279.94 $279.94
RESIDENTIAL FINISH
101-0000-42600
0
$143.00
$143.00
2/11/15
R3684
1805
CHECK
MILLER
SKH
GRADING PC
-Total Paid forGRADING: $143.00 $143.00
CONDENSER/COMPRES
101-0000-42402
0
$108.78'.
$108.78
2/11/15
R3684
1805
CHECK
MILLER
SKH
SOR
CONDENSER/COMPRES
101-0000-42600
0.
$72.51
$72.51
2/11/15
R3684
1805
CHECK
MILLER
SKH,
SOR PC
EXHAUST HOOD
101-0000-42402
0
$24.18 -
$24.18
2/11/15
R3684
1805
CHECK
MILLER
SKH
EXHAUST HOOD PC
101-0000-42600
0
$9.66
$9.66
2/11/15
R3684
1805
CHECK
MILLER
SKH
FURNACE~
101-0000-42402
0
$108.78
$108.78
2/11/15
R3684
1805
CHECK
MILLER
SKH
FURNACE PC
101-0000-42600
0 '
$72.51
$72.51
2/11/15
R3684
1805
CHECK
'MILLER
SKH
VENT FAN
101-0000-42402 .,
0
$84.63
$84.63
2/11/15
R3684
1805
CHECK
MILLER
SKH
VENT FAN PC
101-0000-42600
0
$33.81
$33.81-
2/11/15
R3684
1805
CHECK
MILLER
SKH
Total Paid for MECHANICAL: $514.86 $514.86
NEW CONSTRUCTION
101-0000-42400
0
$621.89
$621.89
2/11/15
R3684
1805
CHECK
MILLER
SKH
PERMIT
Total Paid for NEW CONSTRUCTION PERMIT: $621.89 $621.89
Printed: Friday, February 13, 2015 12:41:06 PM 4 of 7
CEWsYSTEMS
Printed: Friday, February 13, 2015 12:41:06 PM 5 of 7 cRws
YSTEMS
��I.
7
'CLTD -
.DESCRIPTION"ACCOUNT
TY
T
AMOUNT
PAID DATE
RECEIPT #,
CHECK
:!METH OD'
A.,
NEW CONSTRUCTION
101-0000-42600
0
$1,324.92
$1,324.92
2/11/15
R3684
1805
CHECK
MILLER
SKH
PLAN CHECK
Total Paid forNEW CONSTRUCTION PLAN CHECK: $1,324.92 $1,324.92
BACKFLOW DEVICE
101-0000-42401
0
$12.09
$12.09
2/11/15
R3684
1805
CHECK
MILLER
SKH
BACKFLOW DEVICE PC
101-0000-42600
0
$4.83
$4.83
2/11/15
R3684
1805
CHECK
MILLER
SKH.
BUILDING SEWER
101-0000-42401
0
$12.09
$12.09
2/11/15
83684
1805
CHECK
MILLER
SKH
BUILDING SEWER PC
101-0000-42600
0
$12.09
$12.09
2/11/15
R3684
1805
CHECK
MILLER
SKH
FIXTURE/TRAP
101-0000-42401
.0
$253.89
$253.89
2/11/15
R3684
1805
CHECK
MILLER
SKH
FIXTURE/TRAP PC
101-0000-42600
0
$253.89
$253.89
2/11/15
R3684
1805
CHECK
MILLER
SKH
GAS SYSTEM, S+
101-0000-42401
0
$36.26
$36.26
2/11/15
R3684
1805
CHECK
MILLER
SKH
OUTLETS
GAS SYSTEM, S+
101-0000-42600
0
$24.17
$24.17
2/11/15
R3684
1805
CHECK
MILLER
SKH
OUTLETS PC
WATER HEATER/VENT
101-0000-42401
0
$24.18
$24.18
2/11/15
R3684
1805
CHECK
MILLER
SKH
WATER HEATER/VENT
101-0000-42600
0
$14.50
$14.50
2/11/15
R3684
1805
CHECK
MILLER
SKH
PC'
WATER SYSTEM
101-0000-42401
0
$12.09
$12.09
2/11/15
R3684
1805
CHECK
MILLER
SKH
INST/ALT/REP
WATER SYSTEM
101-0000-42600
0
$12.09
$12.09
2/11/15
R3684
1805
CHECK
MILLER
SKH
INST/ALT/REP PC
Total Paid forPLUMBING FEES: $672.17 $672.17
SMI - RESIDENTIAL
101-0000-20308
0-
$35.31
$35.31
2/11/*15
R3684
1805
CHECK
MILLER
SKH'
Total Paid forSTRONG MOTION INSTRUMENTATION SMk $35.31 $35.31
TOTALS: $4,312.19 $4,312.19
Printed: Friday, February 13, 2015 12:41:06 PM 5 of 7 cRws
YSTEMS
FINAL"
.Printed: Friday, February 13, 2015 12:41:06 PM 6 of 7
CRWSYSTEMS
. .... .... .
PARENTPROJECTS .. .. ....... .. .. -
RtVIEWTYPE,-,',�, REVIEWilln
I..", ... .... ... ... .......... ........ ..... ........
-SENT DATE
REVIEWS . .... .. .... .. ... . ..... . ..
. . . . ......
STATUS ;',pRtMARK ES
DATE'. S
DATE _ft 7
NON-STRUCTURAL
JIM JOHNSON
6/27/2014
7/18/2014
7/25/2014
REVISIONS REQUIRED
1ST PLAN CHECK
STRUCTURAL
JIM JOHNSON
6/27/2014
7/18/2014
7/25/2014
REVISIONS REQUIRED
1ST PLAN CHECK
APPROVED WITH CONDITIONS:
1) THERMOSTAT LOCATION WILL BE MARKED BY
ARMEN
ARCHITECT
ECT
NON-STRUCTURAL
ALTOUNIAN
10/24/2014
11/7/2014
11/4/2014
APPROVED
AD PLAN CHECK
-
2) ARCHITECT WILL ALSO SLIP SHEET CORRECTED
SHEET A-2.
APPROVED.
STRUCTURAL
BUILDINGBUCKET
10/24/2014
11/7/2014
11/12/2014
REVISIONS REQUIRED
2ND PLAN CHECK
RFC
NON-STRUCTURAL
ARMEN
12/1/2014
12/15/2014
12/1/2014
APPROVED
3RD PLAN CHECK
AA APPROVED N/S THIS DATE. KH.
ALTOUNIAN
STRUC TO YOUNG - DUE 12/15/14
EMAILED 3RD REVIEW STRUCTURAL CORRECTION
KATHRYN
STRUCTURAL
12/1/2014
12/15/2014
12/18/2014
3RD PLAN CHECK
LIST TO CHUCK GARLAND'. NO REDLINES. THEY
SAMUELS
CAN ADDRESS THE COMMENTS AND RESUBMIT
BY SLIP SHEET.
STRUC TO YOUNG - DUE 1/28/15
PLANS APPROVED
PLANS STILL WITH YOUNG ANTONIO SANTA
KATHRYN
APPROVED -
STRUCTURAL
1/14/2015
1/29/2015
1/15/2015
ACTUALLY, 4TH P/C
MARIA WANTED TO SLIP SHEET 2 NEW PAGES
SAMUELS
CONDITIONS
LEFT THEM HERE.
STRUCTURAL APPROVED WITH CONDITIONS SEE
TRANSMITTAL.
.Printed: Friday, February 13, 2015 12:41:06 PM 6 of 7
CRWSYSTEMS
EXCESSIVE PLAN CHECK TIME, 3 & 4TH PLAN
KATHRYN APPROVED- CHECK WILL BE CHARGED TO APPLICANT. ALSO 1
` STRUCTURAL SAMUELS 1/14/2015 1/29/2015 1/15/2015 CONDITIONS ACTUALLY, 4TH P/C HR OF STAFF TIME FOR ADDRESS CHANGE ON
• PLANS AND CALCS.
1ST PW GREEN AMY YU 2/12/2015 .'2/20/2015 2/12/201S APPROVED
SHEET
BOND INFORMATION
Printed: Friday, February 13, 2015 12:41:06 PM 7 of 7
. SYS7ENiS
ATTACHMENTS
Attachment Type
CREATED -
-a DOWNER, '*DESGRIPTIQN
4
` PATHNAME
; SUBDIR -
ETRAKIT ENABLED
.
r
:
N/S 2ND REVIEW
49-020 AVENIDA
DOC
11/12/2014
ARMEN ALTOUNIAN
0
COMMNETS.docx
FERNANDO.docx
2ND REVIEW
2ND REVIEW
DOC
12/18/2014
ARMEN ALTOUNIAN
STRUCTURAL
STRUCTURAL
0
COMMENTS.pdf
COMMENTS.pdf
3RD REVIEW
3RD REVIEW
DOC
12/18/2014
ARMEN ALTOUNIAN
STRUCTURALCOMMENT
STRUCTURALCOMMENT
0
S.pdf
S.pdf
N/S 3RD REVIEW
49-020 AVENIDA
DOC
12/18/2014
ARMEN ALTOUNIAN
0
COMMNETS.docx
FERNANDO 2.docx
Printed: Friday, February 13, 2015 12:41:06 PM 7 of 7
. SYS7ENiS
• 12
Bin #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico'
La Quinta, CA 92253 - (760) 777-7012.
5Z Building Permit Application and Tracking Sheet
Permit #
WS0 �� --
Project Address: ' �Z SAN !!I1'1&T
Owner's Name:
A. P. Number:
Address: 98-002— Sig>J Ttf? eTeo
Legal Description:
City, ST, Zip:
Contractor:
Tele hone:
P
Address:
Proojjeect'.Description:
City, ST, Zip:
Telephone:
one•
Nvn o � e
State Lie. # :
City Lie.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: one:
Co nstr ucti n Type: e: anc
Y P Occu P Y:
a
St to Lie. #
o ect type (circle cle one w
Pr J ' e : N Add'n Alto P
Alter Repair Demo
Name of Contact Person: ��� (G
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: �tOl/" 7J ' 3% S(C.;,
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd '
Rec'd
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 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
tad 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:-
'"' 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
I
Riverside County Fire Department Fire Protection Planning Section
Riverside Office: 2300 Market St., Ste. 150, Riverside, CA 92501 Ph. (951) 955.4777 Fax (951) 955-4886
Murrieta Office: 39493 Los Alamos Rd., Ste A, Murrieta, CA 92563 Ph. (951) 60016160 Fax (951) 60016164
Palm Desert Office: 77-933 Las Montanas Rd., # 201 Palm Desert, CA 92211.4131 Ph. (760) 863-8886 (760) 863-7072
Fire Department Clearance/Release
Date: 03-11-16
To: La Quinta B & S
Tract/Parcel Map #:
Permit/Lot #:
Job Site Address:
Miller Residence
LAQ-I5-RS-080
78002 San Timoteo
La Quinta
Approved .a-, ; - r, Residential Fire Sprinkler System
Release For Building Permit(s)
Shell Final Only (No Tenant)
Final For Occupancy
Building Plan Check Fees Paid
Building Plan Check Fees Not Paid
Other Fees
Fees Not Required
If you should have any questions, please contact the appropriate Riverside County Fire Protection
Planning office for further assistance.
Authorizing Sign ure For Release
Form C — Revised 7282014
Thomas Cervantes
Print Name
I
A,
BUILDING ENERGY ANALYSIS REPORT
r..
PROJECT:
New Residence For Mr. William Miller
La Q ta, 6k92253
Project Designer:
f Antonio SantaMaria Design Consultants
74-818 Velie Way Ste.3
Palm Desert, CA 92260
76-625-4563
Report Prepared by:
Sergio H. Garcia Consulting
RECEIVED"_:, I ..........
OCT; 2 4 2014 APIP ®pT:
CITY OF LFA QUINT
COMMUNITY DEVELO ENI LT2 _
Job Number:
T-06-2014
Date:
10/17/2014
The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This, program has approval and is
authorized by the Califomia Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards.
This program developed by EnergySoft, LLC—www.energysoft.com.
EnergyPro 5.1 by EnergySoft User Number. 6079 RunCode: 201410-17T18:09:12 - ID: T-06-2014
TABLE OF CONTENTS
Cover Page
Table of Contents
Form CF -1 R Certificate of Compliance
Form MF -1 R Mandatory Measures Summary
HVAC System Heating and Cooling Loads Summary
EnergyPro 5.1 by EnergySoft Job Number. ID: T-06-2014 User Number. 6079
1
2
3
10
13
1
PERFORMANCE CERTIFICATE: Residential Part 1 of 5
CF -1 R
Project Name
New Residence For Mr. William Miller
Building Type 8/ Single Family 6 Addition Alone
6 Multi Family 6 Existing+ Addition/Alteration 11011712014
Date
Proiect Address _
California Energy Climate Zone
CA Climate Zone 15
Total Cond. Floor Area
4,155
Addition
n/a
# of Stories
1
FIELD INSPECTION ENERGY CHECKLIST
4 Yes 6 No HERS Measures --If Yes, A CF -411 must be provided per Part 2 of 5 of this form.
$ Yes & No Special Features --If Yes, see Part 2 of 5 of this form for details.
INSULATION
Construction Type
Area Special
Cavity Features see Part 2 of 5 Status
Roof Wood Framed Attic R-38 4,155 Radiant Barrier New
wall Wood Framed R-19 4,812 New
Door Opaque Door None 56 New
Slab Unheated Slab -0n -Grade None 4,155 Perim = 455' New
FENESTRATION U- Exterior
Orientation Area Factor SHGC Overhang Sidef ins Shades Status
Front (SIAq 149.2 0.340
0.36 none none Bug Screen New
Front (S) 6.2 0.340
0.36 none none Bug Screen New
Right (SE) 32.0 0.340
0.36 none none Bug Screen New
Left (NW) 80.0 0.340
0.36 8.0 none Bug Screen New
Rear (NE) 141.0 0.340
0.36 none none Bug Screen New
Rear (N) 81.5 0.340
0.36 none none Bug Screen New
Left (N" 144.0 0.340
0.36 12.0 none Bug Screen New
Left (NW) 38.5 0.340
0.36 none none Bug Screen New
Left (W) 86.0 0.340
0.36 none none Bug Screen New
Front (SW) 30.0 0.340
0.36 6.0 none Bug Screen New
Rear (N) 7.7 0.340
0.36 4.0 none Bug Screen New
HVAC SYSTEMS
Ot . Heating Min. Eff
Cooling Min. Eff Thermostat Status
1 Central Furnace 69% AFUE
Split Air Conditioner 14.1 SEER Setback New
1 Central Fumace 69% AFUE
Split Air Conditioner 14.5 SEER Setback New
1 Central Fumace 69% AFUE
Split Air Conditioner 13.0 SEER Setback
New
HVAC DISTRIBUTION
Location Heating
Duct
Cooling Duct Location R -Value Status
Zone -1 Ducted
Ducted Attic, Ceiling Ins, vented 8.0 New
Zone -2 Ducted
Ducted Attic, Ceiling Ins, vented 8.0 New
Zone -3 Ducted
Ducted Attic, Ceiling Ins, vented 8.0 New
WATER HEATING
Oty. Type Gallons Min. Eff Distribution Status
2 Small Gas 50
0.65 All Pipes Ins New
EnergyPro 5.1 by EnergySoft User Number. • 6079
Runcode: 201410-17T18:09:12 ID: T-06-2014
Page 3 of 15
i
PERFORMANCE CERTIFICATE: Residential Part 2 of 5 CF -1 R
Project Name
New Residence For Mr. William Miller
Building Type 6f Single Family 6 Addition Alone
6 Multi Family 6 Existing+ Addition/Alteration
Date
110/1712014
SPECIAL FEATURES INSPECTION CHECKLIST
The enforcement agency should pay special attention to the items specified in this checklist. These items require special written
justification and documentation, and special verification to be used with the performance approach. The enforcement agency
determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of
the special justification and documentation submitted.
The Roof R-38 ROOF CATHEDRAL w/ RADIANT includes credit for a Radiant Barrier that is Continuous meeting eligibility and installation criteria as
spacified in Residential Appendix RA4.2.2.
HERS REQUIRED VERIFICATION
Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a
completed CF -4R form for each of the measures listed below for final to be given.
The Cooling System York YCJF60S41 S2 includes credit for a 12.1 EER Condenser. A certified HERS rater must field verify the installation of the
correct Condenser.
The HVAC System Zone -1 incorporates HERS Verified Refrigerant Charge or a Charge Indicator Display.
The HVAC System Zone -1 includes credit for verified adequate airflow. A certified HERS rater must diagnostically measure airflow of the HVAC
System.
Zone -1 includes a factory sealed air handler unit tested by the manufacturer and cefed to the Commission to have achieved a 2 percent or less
leakage rate. HERS field verification of the AHU model number is required. Duct Leakage cannot exceed 6%.
The Cooling System York YCJF48S41 S2 includes credit for a 12.0 EER Condenser. A certified HERS rater must field verify the installation of the
correct Condenser.
The HVAC System Zone -2 incorporates HERS Verified Refrigerant Charge or a Charge Indicator Display.
The HVAC System Zone -2 includes credit for verified adequate airflow. A certified HERS rater must diagnostically measure airflow of the HVAC
System.
Zone -2 includes a factory sealed air handler unit tested by the manufacturer and certified to the Commission to have achieved a 2 percent or less
leakage rate. HERS field verification of the AHU model number is required. Duct Leakage cannot exceed 6%.
The Cooling System York YCJD30S41 S3 includes credit for a 11.0 EER Condenser. A certified HERS rater must field verify the installation of the
correct Condenser.
The HVAC System Zone -3 incorporates HERS Verified Refrigerant Charge or a Charge Indicator Display.
The HVAC System Zone -3 includes credit for verified adequate airflow. A certified HERS rater must diagnostically measure airflow of the HVAC
System.
Zone -3 includes a factory sealed air handler unit tested by the manufacturer and certified to the Commission to have achieved a 2 percent or less
leakage rate. HERS field verification of the AHU model number is required. Duct Leakage cannot exceed 6%.
EnergyPro 5.1 by EnergySoft User Number. 6079 RunCode: 2014-10.17T18:09:12 ID: T-06-2014 Page 4 of 15
PERFORMANCE CERTIFICATE: Residential Part 3 of 5 CF -1 R
Project Name
Building Type 6r Single Family 6 Addition Alone
Date
New Residence For Mr. William Miller
6 Multi Family & Existing+ Addition/Alteration
110/1712014
ANNUAL ENERGY USE SUMMARY
Standard Proposed Margin '
TDV kBtu/ft2 r
Space Heating 4.87 6.81 -1.94
Space Cooling 60.42 50.92 9.49
Fans 12.09 16.54 -4.46
Domestic Hot Water 8.78 9.45 467
Pumps 0.00 0.00 0.00
Totals 86.15 83.73 2.42
Percent Better Than Standard: 2.8%
BUILDING COMPLIES - HERS VERIFICATION REQUIRED
Fenestration
Building Front Orientation: (S) 180 deg Ext. Walls/Roof Wall Area Area -
Number of Dwelling Units: 1.00 (S) 1,285 185
Fuel Available at Site: Natural Gas (►M 1,319 349
Raised Floor Area: 0 (N) 2,607 230
Slab on Grade Area: 4,155 (E) 454 32
Average Ceiling Height: 11.7 Roof 4,155 0
Fenestration Average U -Factor: a34 TOTAL: 796
Average SHGC: 0.36 Fenestration/CFA Ratio: 19.2%
REMARKS
Copyright 2014 Sergio H. Garcia
STATEMENT OF COMPLIANCE
This certificate of compliance lists the building features and specifications needed
to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the
Efficiency Standards of the California Code of Regulations.
The documentation author hereby certifies that the documentation is accurate and complete.
Documentation Author
Company Sergio H. Garcia Consulting
�
r4/�,,� 10/17/2014
Address Name 5-V"I'0 411
Ci /State/Zi Phon 8o 6 Si ned Date
The individual with overall design responsibility hereby certifies that the proposed building design represented in this set
of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and
with any other calculations submitted with this permit application, and recognizes that compliance using duct design,
duct sealing, verification of refrigerant charge, insulation installation quality, and building envelope sealing require
installer testing and certification and field verification by an approved HERS rater.
Designer or Owner (per Business & Professions Code)
Company Antonio SantaMana Design Consultants
Address 74-818 Velie WaySte.3 Name Antonio SantaMaria �,�•
City/State/Zip Palm Desert, CA 92260 Phone 76-6254563 igned License # Date
EnemvPro 5.1 by EnemySoft User Number. 6079 RunCode: 201410-17T18:09:12 /D: T-06-2014 Pa e 5 of 15
CERTIFICATE OF COMPLIANCE:
Residential Part 4 of 5 CF -1 R
Project Name
New Residence For Mr. William Miller
Building Type 6i Single Family 6 Addition Alone
6 Multi Family 6 Existing+ Addition/Alteration
Date
11011712014
OPAQUE SURFACE DETAILS
Surface
Type Area
U- Insulation
Factor Cavity I Exterior Frame Interior Frame Azm
Joint Appendix
Tilt Status 4 Location/Comments
Roof
2,027
0.025 R-38
90
22 New 4.2.1-A21
Zone -1
Wall
45
0.074 R-19
135
90 New 4.3.1 A5
Zone -1
Wall
166
0.074 R-19
225
90 New 4.3.1 A5
Zone -1
Wall
250
0.074 R-19
.180
90 New 4.3.1 A5
Zone -1
Door
32
0.500 None
180
90 New 4.5.1-A4
Zone -1
Wall
136
0.074 R-19
135
90 New 4.3.1 A5 .
Zone -1
Wall
178
0.074 R-19
225
90 New 4.3.1 A5
Zone -1
Wall
256
0.074 R-19
315
90 New 4.3.1 A5
Zone -1
Wall
149
0.074 R-19
45
90 New 4.3.1 A5
Zone -1
Wall
180
0.074 R-19
0
90 New 4.3.1 A5
Zone -1
Wall
169
0.074 R-19
315
90 New 4.3.1-A5
Zone -1
Wall
140
0.074 R-19
225
90 New 4.3.1 A5
Zone -1
Wall
63
0.074 R-19
225
90 New 4.3.1 A5
Zone -1
Wall
59
0.074 R-19
0
90 New 4.3.1-A5
Zone -1
Wall
1 911
0.074 R-19
0
90 New 4.3.1-A5
Zone -1
Wall
1 1131
0.074 R-19
45
90 New 14.3.1 A5
Zone -1
FENESTRATION SURFACE DETAILS
ID
Type
Area U -Factor SHGCz
Azm Status
Glazing Type
Location/Comments
1
Window
4.5 0.340 NFRC 0.36 NFRC
225 New
Milgard Low -E
Zone -1
2
Window
3.1 0.340 NFRC 0.36 NFRC
180 New
Milgard Low -E
Zone -1
3
Window
3.1 0.340 NFRC 0.36 NFRC
180 New
Milgard Low=E
Zone -1
4
Window
32.0 0.340 NFRC 0.36 NFRC
135 New
Milgard Low -E
Zone -1
5
Window
33.8 0.340 NFRC 0.36 NFRC
225 New
Milgard Low -E
Zone -1
6Window
3.8 0.340 NFRC 0.36 NFRC
225 New
Milgard Low -E
Zone -1
7
Window
40.0 0.340 NFRC 0.36 NFRC
315 New
Milgard Low -E
Zone4
8
Window
40.0 0.340 NFRC 0.36 NFRC
315 New
Milgard Low -E
Zone -1
9
Window
48.0 0.340 NFRC 0.36 NFRC
45 New
Milgard Low -E
Zone -1
10
Window
60.0 0.340 NFRC 0.36 NFRC
0 New
Milgard Low -E
Zone -1
11
Window
144.0 0.340 NFRC 0.36 NFRC
315 New
Milgard Lovv-E
Zone -1
12
Window
4.5 0.340 NFRC 0.36 NFRC
315 New
Milgaid Low -E
Zone -1
13
Window
4.5 0.340 NFRC 0.36 NFRC
315 New
Mil aid Low -E
Zone -1
14
Window
4.5 0.340 NFRC 0.36 NFRC
315 New
Milgard Low -E
Zone -1
15
Window
40.0 0.340 NFRC 0.36 NFRC
225 New
Milgard Low E
Zone -1
16
Window
40.0 0.340 NFRC 0.36 NFRC
225 New.
Milgard Low -E
Zone -1
(1) U -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value
2 SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value
EXTERIOR SHADING DETAILS
ID
Window
Exterior Shade Type SHGC Hat Wd
Ove hang Left Fin Right Fin
Len • H t LExt RExt Dist Len H t Dist Len H t
1
Bug Screen
0.76
2
Bug Screen
0.76
3
Bug Screen
0.76
4
Bug Screen
0.76
5
Bug Screen
0.76
6
Bug Screen
0.76
7
Bug Screen
0.76 8.0 5.0
8.0 0.1
8.0 8.0
8
Bug Screen
0.76 8.0 5.0
8.0 0.1
8.0 8.0
9
Buo Screen
0.76
10
Bug Screen
0.76
11
Bug Screen
0.76 9.0 18.0
12.0 0.1 10.0 10.0
12
Bug Screen
0.76
13
Bug Screen
0.76
14
Bug Screen
0.76
15
JBug Screen
0.76
16JBug
Screen
0.76
EnergyPro
5.1 by EnergySoft User Number. 6079 RunCode: 201410-17T18:09:12 ID: T-06-2014
Page 6 of 15
CERTIFICATE OF COMPLIANCE: Residential
Part 4 of 5 CF -1 R
Project Name
New Residence For Mr. William Miller
Building Type 6r Single Family 6 Addition Alone
6 Multi Family _ 6 Existing+ Addition/Alteration
Date
1101171201
OPAQUE SURFACE DETAILS
Surface
Type Area
U- Insulation Joint Appendix
Factor Cavity Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments
Wall
780
0.074 R-19
0
90 New 4.3.1-A5
Zone -1
Door
24
0.500 None
0
90 New 4.5.1 A4
Zone -1
Slab
2,027
0.730 None
0
180 New 4.4.7A1
Zone -1
Roof
1,320
0.025 R-38
225
22 New 4.2.1 A21
Zone -2
Wall
1051
0.074 R-19
135
90 New 4.3.1 A5
Zone -2
Wall
110
0.074 R-19
270
90 New 4.3.1-A5
Zone -2
Wall
105
0.074 R-19
315
90 New 4.3.1 A5
Zone -2
Wall
130
0.074 R-19
0
90 New 4.3.1 A5
Zone -2
Wall
566
0.074 R-19
45
90 New 4.3.1 A5
Zone -2
Wall
26
0.074 R-19
0
90 New 4.3.1 A5
Zone -2
Wall
371
0.074 R-19
0
90 New 4.3.1 A5
Zone -2
Wall
58
0.074 R-19
0
90 New 4.3.1 A5
Zone -2
Slab
1,320
0.730 None
0
180 New 4.4.7-A1
Zone -2
Roof
808
0.025 R-38
225
22 New 4.2.1 A21
Zone -3
Wall
37
0.074,R-19
180
90 New 14.3.1 A5
Zone -3
Wall
36
0.074 R-19 1
225
90 New 14.3.1 A5
Zone -3
FENESTRATION SURFACE DETAILS
ID
Type
Area U -Factor
SHGC
Azm Status
Glazing Type
Location/Comments
17
Window
4.5 0.340 NFRC
0.36 NFRC 0 New
Milgard Low -E
Zone -1
18
Window
4.5 0.340 NFRC
0.36 NFRC 0 New
Milgard Low -E
Zone -1
19
Window
4.5 0.340 NFRC
0.36 NFRC 0 New
Milgard Low -E
Zone -1
20
Window
40.0 0.340 NFRC
0.36 NFRC 270 New
Milgard Low -E
Zone -2 •
21
Window
40.0 0.340 NFRC
0.36 NFRC . 270 New
Milgard Low -E
Zone -2
22
Window
6.0 0.340 NFRC'
0.36 NFRC 45 New
Milgard Low -E
Zone -2
23
Window
25.0 0.340 NFRC
0.36 NFRC 45 New
Milgard Low -E
Zone -2
24
Window
25.0 0.340 NFRC
0.36 NFRC 45 New
Milgard Low -E
Zone -2
25
Window
6.0 0.340 NFRC
0.36 NFRC 45 New
Milgard Low -E
Zone -2
26
Window
25.0 0.340 NFRC
0.36 NFRC 45 New
Milgard Low -E
Zone -2
27
Window
6.0 0.340 NFRC
0.36 NFRC 45 New
Milgard Low -E
Zone -2
28
Window
3.1 0.340 NFRC
0.36 NFRC 225 New
Milgard Low -E
Zone -3
29
Window
30.0 0.340 NFRC
0.36 NFRC 225 New
Milgard Low -E
Zone -3
30
Window
25.0 x340 NFRC
0.36 NFRC 315 New
Milgard Low -E
Zone -3
31
Window
24.0 0.340 NFRC
0.36 NFRC 225 New
Milgard Low -E
Zone -3
32
Window
6.0 0.340 NFRC
0.36 NFRC 270 New
Milgard Low -E
Zone -3
(1) U -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value
2 SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value
EXTERIOR SHADING DETAILS -
ID
Exterior Shade Type SHGC
Window
H t Wd
Ove hanq Left Fin Ri ht Fin
Len H t LExt RExt Dist Len H t. Dist Len H t
17
Bug Screen
0.76
18
Bug Screen
0.76
19
Bug Screen
0.76
20
Bug Screen
0.76
21
Bug Screen
0.76
-
22
Bug Screen .
0.76
-23
Bug Screen
0.76
24
Bug Screen
0.76
'
25
Bug Screen
0.76
26
Bug Screen
0.76
27
Bua Screen
0.76
28
Bug Screen
0.76
29
Bug Screen
0.76
6.0 3.0 6.0 0.1 '6.0 6.0
30
Bug Screen
0.76
31
Bug Screen
0.76
32
Bug Screen
0.76
EnergyPro
5.1 by EnergySoft User Number. 6079
RunCode: 2014=10-17718:09:12 ID: T-06-2014
Pae 7 of 15
CERTIFICATE OF COMPLIANCE: Residential Part 4 of 5 CF -1 R
Project Name
New Residence For Mr. William Miller
Building Type W Single Family 6 Addition Alone
6 Multi Family 6 Existing+ Addition/Alteration
Date
11011712014
OPAQUE SURFACE DETAILS
Surface U- Insulation Joint Appendix
Type Area Factor Cavitv Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments
Wall 137 0.074 R-19
90 90 New 4.3.1-A5 Zone -3
Wall 182 0.074 R-19
225 90 New 4.3.1 A5 Zone -3
Wall 182 0.074 R-19
315 90 New 4.3.1 A5 Zone -3
Wall 16 0.074 R-19
225 90 New 4.3.1-A5 Zone -3
Wall 149 0.074 R-19
270 90 New 4.3.1-A5 Zone -3
Wall 163 0.074 R-19
0 90 New 4.3.! A5 Zone -3
Slab 808 0.730 None
0 180 New 4.4.7-A1 Zone -3
FENESTRATION SURFACE DETAILS
ID Type Area U -Factor SHGC11
Azm Status Glazing Type Location/Comments
33 Window 8.0 0.340 NFRC 0.36 NFRC 0 New Milgard Low -E Zone -3
34 Window 6.0 0.340 NFRC 0.36 NFRC 0 New Milgard Low -E Zone -3
35 Window 1.7 0.340 NFRC 0.36 NFRC 0 New Milgard Low=E Zone -3
(1) U -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value
2 SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value
EXTERIOR SHADING DETAILS
Window
ID Exterior Shade Type SHGC H t Wd
Ove hanq Left Fn Right Fn
Len H t LExt RExt Dist Len H t Dist Len H t
33 Bug Screen 0.76
34 Bug Screen 0.76 2.0 3.0 4.0 0.1 4.0 4.0
35 Bug Screen 0.76 1.5 1.5 4.0 0.1 4.0 4.0
EneigyPfa 5.1 by EnergySoft User Number. 6079
RunCode: 201410-17718:09:12 ID: T-06-2014 Page 8 of 15
}
CERTIFICATE OF COMPLIANCE: Residential Part 5 of 5
CF -1 R
Project Name
New Residence For Mr. William Miller
Building Type 6r Single Family r4 Addition Alone
6 Multi Family 6 Existing+ Addition/Alteration
Date
11011712014
BUILDING ZONE INFORMATION
System Name Zone Name
Floor Area
New Existinq Altered Removed Volume
Year Built
Zone -1 Zone -1
2,027
27,162
Zone -2 Zone -2
11320
13,200
Zone -3 Zone -3
808
8,080
Totals 4,1551 01 01 0
HVAC SYSTEMS
System Name Qty. Heating Type
Min. Eff. Cooling Type Min. Eff. Thermostat Type
Status
Zone -.1 1 Central Fumace
69% AFUE Split Air Conditioner 14.1 SEER Setback
New
Zone -2 1 Central Furnace
69% AFUE Split Air Conditioner 14.5 SEER Setback
New
Zone -3 1 central Furnace
69% AFUE Split Air Conditioner 13.0 SEER Setback
New
HVAC DISTRIBUTION
System Name Heating
Duct
Coolin Duct Location R -Value
Ducts
Tested? Status
Zone -1 Ducted
Ducted Attic, Ceiling Ins, vented 8.0
S(
New
Zone -2 Ducted
Ducted Attic, Ceiling Ins, vented 8.0
F/
New
Zone -3 Ducted
Ducted Attic, Ceiling Ins, vented 8.0
New
S
WATER HEATING SYSTEMS
S stem Name
01by.
Type
Distribution
Rated
Input
Btuh
Tank
Cap.
al
Energy
Factor
or RE
Standby
Loss or
Pilot
Ext.
Tank
Insul. R-
Value
Status
Rheem 41VRP50PT
2
Small Gas
All Pipes Ins
40,000
50
0.65
n/a
n/a
New
MULTI -FAMILY WATER
HEATING
DETAILS
HYDRONIC
HEATING
SYSTEM
PIPING
Control
Hot Water Piping Length
ff
0
_ o
N
<.E
System Name
Pipe
Length
Pipe
Diameter
Insul.
Thick.
QtyTHP
Plenum Outside Buried
6
'
6
rs
EnergyPm 5.1 by EnergySoft User Number- 6079
RunCode: 201410.17718:09:12 ID: T-06-2014
Page 9 of 15
MANDATORY MEASURES SUMMARY: Residential Pae 1 of 3 MF -1 R
Project Name
New Residence For Mr. William Miller
Date
11011712014
NOTE: Low-rise residentialbuildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of
the compliance approach used. More stringent energy measures listed on the Certificate of Compliance (CF -1 R, CF -1 R -ADD, or CF -
1 R -ALT Form) shall supersede the items marked with an asterisk (') below. This Mandatory Measures Summary shall be incorporated
into the permit documents, and the applicable features shall be considered by all parties as minimum component performance
specifications whether they are shown elsewhere in the documents or in this summary. Submit all applicable sections of the MF -1 R
Form with plans.
Building Envelope Measures:
116(a)l: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage.
§116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain
Coefficient SHGC , and infiltration that meets the requirements of 10-111 (a).
117: Exterior doors and windows are weather-stripped; all joints and penetrations are caulked and sealed.
118(a): Insulation's ecified or installed meets Standards for Insulating Material. Indicate type and include on CF -6R Form.
§118(1): The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of §118(1) when the
installation of a Cool Roof is specified on the CF -1 R Form.
*§1 50 a : Minimum R-19 insulation in wood -frame ceiling orequivalent U -factor.
150(b): Loose fill insulation shall conform with manufacturer's installed design labeled R -Value.
*§1 50 c : Minimum R-13 insulation in wood -frame wall orequivalent U -factor.
*§1 50 d : Minimum R-13 insulation in raised wood -frame floor or equivalent U -factor.
150(f): Air retarding wrap is tested, labeled and installed according to ASTM E1677-95 2000 when specified on the CF -1 R Form.
150 : Mandatory Vapor barrier installed in Climate Zones 14 or 16.
§150(1): Water absorption rate for slab edge insulation material alone without facings is no greater than 0.3%; water vapor permeance
rate is no greater than 2.0perm/inch and shall be protected from physical damage and UV light deterioration.
Fireplaces, Decorative Gas Appliances and Gas Log Measures:
150 e 1 A: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox.
§150(e)1 B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is
equipped with a with a readily accessible, operable, and fight -fitting damper and or a combustion -air control device.
§150(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the
outside of the building,are prohibited.
Space Conditioning, Water Heating and Plumbing System Measures:
§110-§113: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified by the Energy
Commission. I -
§113(c)5: Water heating recirculation loops serving multiple dwelling units and High -Rise residential occupancies meet the air release
valve backflow prevention, pump isolation valve and recirculation loop connection requirements of §113(c)5.
§115: Continuously burning pilot lights are prohibited for. natural gas: fan -type central furnaces, household cooking appliances
(appliances with an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool and
spa heaters.
150(h): Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA.
150(i): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c).
§1500)1A: Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped
with insulation having an installed thermal resistance of R-12 or greater.
§1506)1 B: Unfired storage tanks, such as storage tanks or backup tanks for solar water -heating system, or other indirect hot water
tanks have R-12 external insulation or R-16 internal insulation where the internal insulation R -value is indicated on the exterior of the
tank.
§1506)2: First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire length of
recirculatinq sections of hot water pipes are insulated per Standards Table 150-13.
§1500)2: Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot .
water tank shall be insulated to Table 150-B and Equation 150-A.
§1500)2: Pipe insulation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards Table
123-A.
1 50 ' 3A: Insulation is protected from damage, including that due to suMight, moisture equipment maintenance and wind.
§1 506)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in
conditioned space.
§1506)4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation.
EnergyPro 5.1 by EnergySoff User Number. 6079 RunCode: 201410-17T18:09:12 ID: T-06-2014 Page 10 of 15
Y
MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF -1 R
Project Name
Date
New Residence For Mr. William Miller
11011712014
§150(m)1: All air -distribution system ducts and plenums installed, are 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 181 A, or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is
used to seal openings reater than 1/4 inch, the combination of mastic and either mesh or tape shall be used
§150(m)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 ducts.
§150(m)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.
150(m)7: Exhaust fans stems have back draft or automatic dampers.
§150(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated
dampers.
§150(m)9: Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind.
Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar
radiation that can cause degradation of the material.
150 m 10: Flexible ducts cannot have porous inner cores.
§150(o): All dwelling units shall meet the requirements of ANSI/ASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air
Quality in Low -Rise Residential Buildings. Window operation is not a permissible method of providing the Whole Building Ventilation
required in Section 4 of that Standard.
Pool and Spa Heating Systems and Equipment Measures:
§114(a): Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency
Regulations; an on-off switch mounted outside of the heater; a permanent weatherproof plate or card with operating instructions; and
shall not use electric resistance heating ora pilot light.
§114(b)1: Any pool or spa heating equipment shall be installed with at least 36" of pipe between filter and heater, or dedicated suction
and return lines or built-up connections for future solar heating.
114(b)2: Outdoor pools ors as that have a heat pump or gas heater shall have a cover.
§114(b)3: Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or
programmed to run only during off-peak electric demand periods.
150 : Residential pool systems orequipment meet the pump sizing, flow rate, piping, filters and valve requirements of §150
Residential Lighting Measures:
§150(k)1: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies
contained in Table 150-C and is not a low efficacy luminaire asspecified by §150(k)2.
150(k)3: The wattage of permanently installed luminaires shall be determined asspecified by §130(d).
§150(k)4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than
20 kHz.
§150(k)5: Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain
only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and shall not contain a line -voltage socket or line -
voltage lamp holder; OR shall be rated to consume no more than five watts of power as determined by §130(d), and shall not contain a
medium screw -base socket.
§150(k)6: Lighting integral to exhaust fans, in rooms other than kitchens, shall meet the applicable requirements of §150(k).
150(k)7: All switching devices and controls shall meet the requirements of §150(k)7.
§150(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy.
EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 ftz or 100 watts for dwelling units larger than 2,500 ft2 may be
exempt from the 50%'high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant
sensor, dimmer, energy management system (EMCS), or a multi -scene programmable control system; and all permanently installed
luminaries in garages, laundry rooms, closets greater than 70 square feet, and utility rooms are high efficacy and controlled by a
manual -on occupant sensor.
§150(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of
illuminated cabinet.
EnergyPfo5.1 by EnergySoff User Number. 6079 RunCode: 2014-10.17718:09:12 /D: T-06-2014 Page 11 of 15
i
MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF -1 R
Project Name
Date
New Residence For Mr. William Miller
11011712014
§150(k)10: Permanently installed luminaires in bathrooms, attached and detached garages, laundry rooms, closets and utility rooms
shall be high efficacy.
EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by a manual -on
occupant sensor certified to comply with the applicable requirements of §119.
EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a
manual -on occupancy sensor.
§150(k)11: Permanently installed luminaires located in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms,
closets, and utility rooms shall be high efficacy luimnaires. EXCEPTION 1: Permanently installed low efficacy luminaires shall be
allowed provided they are controlled by either a dimmer switch that complies with the applicable requirements of §119, or by a manual -
on occupant sensor that complies with the applicable requirements of §119. EXCEPTION 2: Lighting in detached storage building less
than 1000 square feet located on a residential site is not required to comply with §150 k 11.
§150(k)l2: Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters
Laboratories or other nationally recognized testing/rating laboratory; and have a label that certifies the lumiunaire is airtight with air
leakage less then 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; and be sealed with a gasket or caulk between
the luminaire housing and ceiling.
§150(k)13: Luminaires providing outdoor lighting, including lighting for private patios in low-rise residential buildings with four or more
dwelling units, entrances, balconies, and porches, which are permanently mounted to a residential building or to other buildings on the
same lot shall be high efficacy. EXCEPTION 1: Permanently installed outdoor low efficacy luminaires shall be allowed provided that
they are controlled by a manual on/off switch, a motion sensor not having an override or bypass switch that disables the motion sensor,
and one of the following controls: a photocontrol not having an override or bypass switch that disables the photocontrol; OR an
astronomical time clock not having an override or bypass switch that disables the astronomical time clock; OR an energy management
control system (EMCS) not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2: Outdoor
luminaires used to comply with Exception'! to §150(k)13 may be controlled by a temporary override switch which bypasses the motion
sensing function provided that the motion sensor is automatically reactivated within six hours. EXCEPTION 3: Permanently installed
luminaires in or around swimming pool, water features, or other location subject to Article 680 of the California Electric Code need not
be high efficacy luminaires.
§150(k)14: Internally illuminated address signs shall comply with Section 148; OR not contain a screw -base socket, and consume no
more than five watts of power as determined according to §130(d).
§150(k)l5: Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable
requirements in Sections 130, 132, 134, and 147. Lighting for parking garages for 8 or more vehicles shall comply with the applicable
requirements of Sections 130,131, 134 and 146.
§150(k)16: Permanently installed lighting in the enclosed, non -dwelling spaces of low-rise residential buildings with four or more
dwelling units shall be high efficacy luminaires. EXCEPTION: Permanently installed low efficacy luminaires shall be allowed provided
that they are controlled by an occupant sensors certified to comply with the applicable requirements of 119.
EnergyPro 5.1 by EnergySoft User Number. 6079 RunCode: 2014-10-17718:09:12 ID: T-06-2014 Page 12 of 15
HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY
Project Name
New Residence For Mr. William Miller
Date
10/17/2014
System Name
Zone-1
Floor Area
2,027
ENGINEERING CHECKS
SYSTEM LOAD
Number of Systems
1
COIL COOLING
CFM Sensible
Total Room Loads 1,572 30,091
Return Vented Lighting 0
Return Air Ducts 1,737
Return Fan 01
Ventilation 0 0
Supply Fan 2,557
Supply Air Ducts 1,737
TOTAL SYSTEM LOAD 1 36,122
PEAK COIL HTG.
PEAK
Heating System
Latent CFM
Sensible
Output per System
22,810
2,176 890
27,995
Total Output Btuh
22,810
Output Btuh/ ft
11.3
1,376
Cooling System
0
Output per System
56,500
.0 0
0
Total Output Btuh
56,500
2,176
-2,557
Total Output ons
4.7
1,376
Total Output Btuh/s
27.9
Total Output s on
430.5
28,190
Air System
CFM per System
2,000
HVAC EQUIPMENT SELECTION
Airflow cfm
2,000
York YCJF60S41S2 38,912 8,963
22,810
Airflow (cfm/ft
0.99
Airflow cfm/Ton
424.8
Outside Air°/,
0.0%
Total Adjusted System Output 38,912 8,963
(Adjusted for Peak Design conditions)
I TIME OF SYSTEM PEAK Aug 3 PM
22,810
Jan 1 AM
Outside Air cfm/s 0.00
Note: values above given at ARI conditions
HEATING SYSTEM PSYCHROMETRICS
Airstream Temperatures at Time of Heating Peak
Outside Air
0 cfm
Heating Coil Supply Fan
2,000 cfm
ROOM
COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak
Outside Air
0 cfm
;_
Cooling Coil Supply Fan
2,000 cfm - 47.3% ROOM
A�
EnergyPro 5.1 by EnergySoft
User Number. 6079 RunCode: 201410-17T18:09:12 ID: T-06-2014 Page 13 of 15
HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY
Project Name Date
New Residence For Mr. William Miller
System Name
Zone -2
ENGINEERING CHECKS SYSTEM LOAD
Number of Svstems 1
Output per System
22,810
Total Room Loads L
Return Vented Lighting
Return Air Ducts
Return Fan
Ventilation
Supply Fan
Supply Air Ducts
TOTAL SYSTEM LOAD
Total Output Btuh 22,810
Output Btuh/ ft 17.3
Cooling System
Output per System 46,0001
Total Output Btuh 46,000
Total Output ons 3.8
Total Output Btuh/ 34.8
Total Output s on 344.31
Air System
CFM per System
1,600
HVAC EQUIPMENT SELECTION
Airflow cfm
1,600
York YCJF48S41 S2
Alrflow cfm/s ft
1.21
Airflow cfm/Ton
417.4
Outside Air %
0-0%
Total Adjusted System Output
(Adjusted for Peak Design conditions)
I TIME OF SYSTEM PEAK
Outside Air cfm/s 0.00
Note: values above given at ARI conditions
HEATING SYSTEM PSYCHROMETRICS
(Airstream Temperatures at Time of
10/17/2014
Floor Area
1,320
COIL COOLING PEAK COIL HTG. PEAK
CFM Sensible Latent CFM Sensible
697 13,736 1,756 519 16,326
0
793 802
0 0
0 0 0 0 0
1,727 -1,727
7931 802
17,0491 1,7561 I 1
31,3971 7
22,8101
31,3971 7,5231 1 22,810
Aug 3 PM I Jan 1 AM
Outside Air
0 cfm Heating Coil Supply Fan
1,600 cfm
ROOM
COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak
O - !°
Outside Air
0 cin Cooling Coil Supply Fan
1,600 cfm
47.4% ROOM
EnergyPro 5.1 by EnefgySoft User Number. 6079 RunCode: 201410-17T18:09:12 ID: T-06-2014 Page 14 of 15
,k 4
HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY
Project Name Date
New Residence For Mr. William Miller
System Name
Zone -3
ENGINEERING CHECKS
SYSTEM LOAD
Number of Systems
1
Total Room Loads
Return Vented Lighting
Return Air Ducts
Return Fan
Ventilation
Supply Fan
Supply Air Ducts
TOTAL SYSTEM LOAD
Heating System
Output per System 22,810
Total Output Btuh 22,810
Output Btuh/ ft 28.2
Cooling System
Output per System 29,000
Total Output (Btuh) 29,000
Total Output ons 2.4
Total Output Btuh/s ft 35.9
Total Output s ft/Ton 334.3
Air System
CFM per System
1,000
HVAC EQUIPMENT SELECTION
Airflow cfm
1,000
York YCJD30S41 S3
Airflow cfm/s
1.24
Airflow cfm/Ton
413.8
Outside Air Bio
0.0%
Total Adjusted System Output
(Adjusted for Peak Design conditions)
I TIME OF SYSTEM PEAK
Outside Air cfm/s 0.00
Note: values above given at ARI conditions
HEATING SYSTEM PSYCHROMETRICS
(Airstream Temueratures at Time of F
10/17/2014
Floor Area
808
COIL COOLING PEAK COIL HTG. PEAK
CFM Sensible Latent CFM Sensible
400 7,639 908 343 10,997
0
441 540
0 0
0 0 0 0 0
1,727 -1,727
441 540
19,8591 4,6451 I 22,8101
19,8591 4,6451 1 22,810
Aua 3 PM1 I Jan 1 AM
Outside Air _ -
0 cfm Heating Coil Supply Fan
1,000 cfm
ROOM
COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak
O
Outside Air
0 cJm Cooling Coil Supply Fan
1,000 chn
47.2% ROOM
a - a
EnergyPro 5.1 by EnergySoft User Number. 6079 RunCode: 2014-10-17718:09:12 /D: T-06-2014 Page 15 of 15
HERS TESTING Report
1
CEC Approved 2013 Residential Standards
CF -1 R -PRF -01 REVISED Certificate of Compliance
1 CF -2R -MCH -01-E Certificate of Installation
CF -2R & 3R MCH -20 Duct Leakage Test
1 'CF -2R & 3R MCH -21 Duct. Location
CF -2R & 3R MCH -22 Fan Watt Draw Efficiency
CF -2R & 3R MCH -23 .System Airflow Rate ,
1
CF -2R & 3R MCH -25 Refrigerant Charge Verification
CF -2R & 3R MCH -26 System Equipment Verification
1 CF -2R & 3R MCH -27 Indoor Air Quality Mech Ventilation
1 Project ;
William Miller New Residence /G
49-020 Avenida Fernando;
1 La Quinta, CA 92253
Prepared For Builder.°
Desert Habitats Inc =a4.
1 ;
75-161 Sego .Lane. - F1 � `•:
Palm Desert, CA 92211
1 Pre ared' B -
EMS Energy Management Services
1 Jack LaFontaine
CaICERTS - HERS Rater. CC2004051
1
1 .•
1EMS Energy Management Services
HVAC /Energy Consulting Services
1 41-485 Adams Street, Unit C - Bermuda Dunes, Ca. 92203 "o: (760) 360-4631 f: (760) 360-3074
CSLB C20.C61/D62 License No..315890 - E-mail: iack.cea1(a�gmail.coin
T24 Reports — HVAC Design - CaICERTS HERS Rater - NBC Certified Air/Water Balance Testing - Cabec Certified Energy Analyst.
Ir ..
r .
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD
Project Name: New Residence For Mr. William Miller Calculation Date/Time: 17:20, Tue, Apr 05, 2016
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xmi
CFI R -PRF -01
Page 1 of 13
GENERAL INFORMATION
ENERGY USE SUMMARY
01
Project Name New Residence For Mr. William Miller
04
05
02
Calculation Description Title 24 Analysis
08
Energy Use (kTDV/ft2-yr)
03
Project Location 49-020 Avenida Fernando
Compliance Margin
Percent Improvement
04
City La Quinta
05
Standards Version Compliance 2015
06
Zip Code 92253
07
Compliance Manager Version BEMCmpMgr 2013-3c (710)
08
Climate Zone CZ15
09
Software Version EnergyPro 6.5
10
Building Type Single Family
11
Front Orientation (deg/Cardinal) 180
12
Project Scope Newly Constructed
13
Number of Dwelling Units 1
14
Total Cond. Floor Area (ft2) 4155
15
Number of Zones 3
16
Slab Area (ft2) 4155
17
Number of Stories 1
18
Addition Cond. Floor Aiea N/A
19
Natural Gas Available Yes
20
Addition Slab Area (ft2) N/A
21
Glazing Percentage (%) 19.2%
1 i 1._
[--This complla�analysis-is valid only for permit applications through July 31, 2015
`•'� n .: i mw�, rte•. rt- , r r,
COMPLIANCE RESULTS l I/ t II l i I 1� 11 11 TM 4P4
01 Building Complies with-ComputerOerformanc�., }
02 This building incorporates features.hat require`field'testing and/or verification=by a certified' HERS rater under file supervision of a CEC-approved HERS provider.
ik it # _ * a i W, x A 1-0 VY N *__0 K_
03 This building incorporates one or more Special Features shown below
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016-04-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
ENERGY USE SUMMARY
04
05
06
07
08
Energy Use (kTDV/ft2-yr)
Standard Design
Proposed Design
Compliance Margin
Percent Improvement
Space Heating
3.05
3.52
-0.47
-15.4%
Space Cooling
111.71
104.01
7.70
6.9%
IAQ Ventilation
1.25
1.25
0.00
0.0%
Water Heating
6.18
7.24
-1.06
-17.2%
Photovoltaic Offset
—
0.00
0.00
—
Compliance Energy Total
122.19
116.02
6.17
5.0%
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016-04-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1R-PRF-01
Project Name: New Residence For Mr. William Miller Calculation Date/Time: 17:20, Tue, Apr 05, 2016 Page 2 of 13
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xml
REQUIRED SPECIAL FEATURES
The following are features that must be installed as condition for meeting the modeled energy petformance for this computer analysis.
• Window overhangs and/or fins
HERS FEATURE SUMMARY
The following is a summary of the features that must be field -verified by a certified HERS Rater as a condition for meeting the modeled energy performance for this computer analysis. Additional detail is
provided in the building components tables below.
Building -level Verifications:
• IAQ mechanical ventilation
Cooling System Verifications:
• Minimum Airflow
• Verified EER
• Verified SEER
• Refrigerant Charge
• Fan Efficacy Watts/CFM
HVAC Distribution System Verifications:
• Duct Sealing
• Multiple
• Low -leakage Air Handling Unit
Domestic Hot Water System Verifications:
•
—None--
ri F1, f/-
ENERGY
es
ENERGY DESIGN RATING l.._'n u U U cz� n U U U O
This is the sum of the annual TDV energy consumption for_eriergy use components included in the. performance compliance approach for the Standard Design Building (Energy Budget) and the annual
TDV energy consumption for lighting and components not regulated by Title 24 Part 6 (such as domestic appliances avid consumer electronics) and accounting for the annual TDV energy offset by an
on-site renewable energy system.
Reference Energy Use Energy Design Rating Margin Percent Improvement
Total Energy (kTDV/f2-yr)' 160.74 154.57 6.17 3.8%
' includes calculated Appliances and Miscellaneous Energy Use (AMEU)
BUILDING - FEATURES INFORMATION
01
02
03
04
05
06
07
Number of Dwelling
Number of Ventilation
Number of Water
Project Name
Conditioned Floor Area (ft2)
Units
Number of Bedrooms
Number of Zones
Cooling Systems
Heating Systems
New Residence For Mr. William
4155
1
9
3
0
1
Miller
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016-04-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1 R -PRF -01
Project Name: New Residence For Mr. William Miller Calculation Date/Time: 17:20, Tue, Apr 05, 2016 Page 3 of 13
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xml
ZONE INFORMATION
01
02
03
04
05
06
07
Zone Name
Zone Type
HVAC System Name
Zone Floor Area
(ft2)
Avg. Ceiling
Height
Water Heating System 1
Water Heating System 2
Zone -1
Conditioned
Zone -1 LIVING-KITCHEN1
2027
13.4
DHW Sys 1
Zone -2
Conditioned
Zone -2 BEDROOMS-HALL2
1320
10
DHW Sys 1
Zone -3
Conditioned
Zone -3 MBR-GUEST3
808
10
1 DHW Sys 1
i 4
'C I -- 03- C E
G�
HERS P R OVA DEQ.
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016-04-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1R-PRF-01
Project Name: New Residence For Mr. William Miller Calculation Daterrime: 17:20, Tue, Apr 05, 2016 Page 4 of 13
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xml
OPAQUE SURFACES
01
02
03
04
05
06
07
08
Name
Zone
Construction
Azimuth
Orientation
Gross Area (ft)
Window & Door Area (ftz)
Tilt (deg)
Front -Wall -S. East 3'x14.8
Zone -1
R-19 Wall
135
- specify -
44.5
90
Front-Wall-S.West 11.5'x1
Zone -1
R-19 Wall
225
- specify -
170.5
4.5
90
Front -Wall -South 24'x12'
Zone -1
R-19 Wall
180
Front
288
38.2
90
Rig ht -Wal l-S.East 13.95'x
Zone -1
R-19 Wall
135
- specify -
167.5
32
90
Front-Wall-S.West 18'x12'
Zone -1
R-19 Wall
225
- specify -
216
37.6
90
Left-Wall-N.West 28'x12'
Zone -1
R-19 Wall
315
- specify -
336
80
90
Rear -Wall -N. East 16.4'x12
Zone -1
R-19 Wall
45
- specify -
197.3
48
90
Rear -Wall -North 20'x12'
Zone -1
R-19 Wall
0
Back
240
60
90
Left-Wall-N.West 21.96'x1
Zone -1
R-19 Wall
315
- specify -
326
157.518
90
Left-Wall-S.West 17.95'x1
Zone -1
R-19 Wall
225
- specify -
180
40
90
Left-Wall-S.West 10.3'00
Zone -1
R-19 Wall
225
- specify -
103.3
40
90
Interior -Wall -North 4'x14
Zone -1
R-19 Wall
0
Back
59.4
90
Interior -Wall -North 6.14'
Zone -1
f R-19 Wall'
01
Back
91.1
90
Right -Wall -N. East 7.61'x1
Zone' -1
r = [ R-19,Wall" ��
X45.
specify'!
113
90
Garage -Wall -North 55.1'x1
Zone11,
-=3 ` L' -R-19 Wall
0"
'Back 817
37.5
90
New Roof
Zone=1,�
R-38 ROOF CATHEDRAL w/,RA' , j) V !
2027
Front -Wall -S. East 10.5'x1
Zone -2
R-19 Wall
135
- specify -
105
90
Left -Wall -West 19'x10' 2x
Zone -2
R-19 Wall
270
Left
190
80
90
Rear-Wall-N.West 10500
Zone -2
R-19 Wall
315
- specify -
105
90
Interior -Wall -North 13'x1
Zone -2
R-19 Wall
0
Back
130
90
Right-Wall-N.East 65.89'x
Zone -2
R-19 Wall
45
- specify -
659
93
90
Interior -Wall -North 2.6'x
Zone -2
R-19 Wall
0
Back
26
90
Interor-Wall-North 3.66'x
Zone -2
R-19 Wall
0
Back
36.6
90
Interior -Wall -North 5.82'
Zone -2
R-19 Wall
0
Back
58.2
90
Roof -Zone -2
Zone -2
R-38 ROOF CATHEDRAL w/ RA
1320
Front -Wall -South 3.7'x10'
Zone -3
R-19 Wall
180
Front
37
90
Front-Wall-S.West 3.89'x1
Zone -3
R-19 Wall
225
- specify -
38.9
3.1
90
Right -Wall -East 13.7'x10'
Zone -3
R-19 Wall
90
Right
137
90
Front-Wall-S.West 21.16'x
Zone -3
R-19 Wall
225
- specify -
211.6
30.006
90
Left-Wall-N.West 20.66'x1
Zone -3
R-19 Wall
315
- specify -
206.6
25
90
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 201604-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CFIR-PRF-01
Project Name: New Residence For Mr. William Miller Calculation Date/Time: 17:20, Tue, Apr 05, 2016 Page 5 of 13
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xml
Front -Wall -S. West 4'x10'
Zone -3
R-19 Wall 225 - specify -
40 24 90
Left -Wall -West 15.5'x10'
Zone -3
R-19 Wall 270 Left
155 6 90
Rear -Wall -North 17.9'x10'
Zone -3
R-19 Wall 0 Back
179 15.701 90
Roof -Zone -3
Zone -3
R-38 ROOF CATHEDRAL w/ RA
808
ATTIC
01
02
03
04
05
06
07
08
Name
Construction
Type
Roof Rise
Roof Reflectance
Roof Emittance
Radiant Barrier
Cool Roof
Attic Zone -1
Attic RoofZone-1
Ventilated
4.84831
0.1
0.85
No
No
Attic Zone -2
Attic RoofZone-2
Ventilated
4.84831
0.1
0.85
No
No
Attic Zone -3
Attic RoofZone-3
Ventilated
4.84831
0.1
0.85
No
No
C(03h CLERTSP nco
HERS PROVIDER
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016-04-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1R-PRF-01
Project Name: New Residence For Mr. William Miller Calculation Date/Time: 17:20, Tue, Apr 05, 2016 Page 6 of 13
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xml
WINDOWS
01
02
03
04
05
06
07
08
09
10
Multipli
Area
Name
Type
Surface (Orientation -Azimuth)
Width (ft)
Height (ft)
er
M2)
U -factor
SHGC
Exterior Shading
Window GG, 3016
Window
Front-Wall-S.West 11.5'x1 (- specify -225)
--
--
1
4.5
0.34
0.36
Insect Screen (default)
Fixed
Window A, 24 Dia.
Window
Front -Wall -South 24'x12' (Front -180)
--
-
1
3.1
0.34
0.36
Insect Screen (default)
Fixe
Window B, 24 Dia.
Window
Front -Wall -South 24'x12' (Front -180)
--
--
1
3.1
0.34
0.36
Insect Screen (default)
Fixed
Window C, 4080 SH.
Window
Right -Wall -S. East 13.95'x (- specify --135)
--
-
1
32.0
0.34
0.36
Insect Screen (default)
Window D, 4080 SH.
Window
Front-Wall-S.West 18'x12' (- specify -225)
--
--
1
33.8
0.34
0.36
Insect Screen (default)
Window E, 4080 SH.
Window
Front-Wall-S.West 18'x12' (- specify -225)
--
-
1
3.8
0.34
0.36
Insect Screen (default)
FrenchDr.#37, 5080
Window
Left-Wall-N.West 28'x12' (- specify --315)
5.0
8.0
1
40.0
0.34
0.36
Insect Screen (default)
Fr.Dr.
FrenchDr.#36, 5080
Window
Left-Wall-N.West 28'x12' (- specify -315)
5.0
8.0
1
40.0
0.34
0.36
Insect Screen (default)
Fr.Dr.
Window F, 6080
Window
.4'x12 s eci 45)
Rear-Wall-N.East 16' (-P - it
'
-��
1
-- F
1
_/
11 48.0
0.34
0.36
Insect Screen (default)
Window G, 6080
Window
_
(Back -0)
Rear -Wall -North 20'x12'Back-0
1
["111
�
1
60.0
0.34
0.36
Insect Screen (default)
Sh.H.
1 \�
Multi-Stack#3, 18.080
Window
Left-Wall'-iN.West 21:96'x1 (- specify 315) �
0 18.0%
`9.0 T-
t 0.889
X144.0
0.34
0.36
Insect Screen (default)
Window , 3016
Window
Left-Wall-N.West 21.96'x1 (-specify -315)
--
--
1
4.5
0.34
0.36
Insect Screen (default)
Fixed
Window BB, 3016
Window
Left-Wall-N.West 21.96'x1 specify
(- -315)
--
--
1
4.5
0.34
0.36
Insect Screen (default)
Fixed
Window CC, 3016
Window
Left-Wall-N.West 21.96'x1 (- specify -315)
--
--
1
4.5
0.34
0.36
Insect Screen (default)
Fixed
FrenchDr.#20, 5080
Window
Left-Wall-S.West 17.95'x1 (- specify -225)
--
--
1
40.0
0.34
0.36
Insect Screen (default)
Fr.Dr.
FrenchDr.#28, 5080
Window
Left-Wall-S.West 10.3'x10 (- specify -225)
--
-
1
40.0
0.34
0.36
Insect Screen (default)
Fr.Dr.
Window FF, 3016
Window
Garage -Wall -North 55.1'x1 (Back -0)
--
-
1
4.5
0.34
0.36
Insect Screen (default)
Fixed
Window EE, 3016
Window
Garage -Wall -North 55.1'x1 (Back -0)
--
-
1
4.5
0.34
0.36
Insect Screen (default)
Fixed
Window DID, 3016
Window
Garage -Wall -North 55.1'x1 (Back -0)
-
--
1
4.5
0.34
0.36
Insect Screen (default)
Fixed
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016-04-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF111-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD
Project Name: New Residence For Mr. William Miller Calculation Date/Time: 17:20, Tue, Apr 05, 2016
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xm
CF1 R -PRF -01
Page 7 of 13
FrenchDr.#21, 5080
Fr.Dr.
Window
Left -Wall -West 19'x10' 2x (Left -270)
-
--
1
40.0
0.34
0.36
Insect Screen (default)
FrenchDrDr. 5080
fr.Dr.
Window
Left -Wall -West 19'x10' 2x (Left -270)
--
--
1
40.0
0.34
0.36
Insect Screen (default)
Window P, 2030 Cmt
Window
Rig ht-Wall-N.East 65.89'x (- specify -45)
--
--
1
6.0
0.34
0.36
Insect Screen (default)
Window Q, 5050 Cmt
Window
Rig ht -Wal l-N.East 65.89'x (- specify - 45)
--
--
1
25.0
0.34
0.36
Insect Screen (default)
Window R, 5050 Cmt
Window
Rig ht-Wall-N.East 65.89'x (- specify -45)
--
--
1
25.0
0.34
0.36
Insect Screen (default)
Window S, 2030 Cmt
Window
Rig ht-Wall-N.East 65.89'x (- specify -45)
--
--
1
6.0
0.34
0.36
Insect Screen (default)
Window T, 5050 Cmt
Window
Right -Wal l-N.East 65.89'x (- specify -45)
-
--
1
25.0
0.34
0.36
Insect Screen (default)
Window U, 3020
Fixed
Window
Rig ht-Wall-N.East 65.89'x (- specify -45)
--
--
1
6.0
0.34
0.36
Insect Screen (default)
Window H, 24 Dia.
Fixed
Window
Front-Wall-S.West 3.89'x1 (- specify -225)
A
--
--
1
3.1
0.34
0.36
Insect Screen (default)
Window 1, 5060 Cmt
Window
Front -Wall -S. West 21.16'x (- specify -225)
3.0
6.0
1.667
30.0
0.34
0.36
Insect Screen (default)
Window J , 5050 Cmt
Window
Left-Wall-N.West 20.66'x1 (-specify -315)
--
--
1
25.0
0.34
0.36
Insect Screen (default)
FrenchDr.#36, 3080Y---
Window `�
�J 1 `--------
Front-Wall-S.West 4'x10'• (- specify -225)
-
--
1
24.0
0.34
0.36
Insect Screen (default)
Fr.Dr.
Window K, 2030 Cmt
Window
0' (Left270) "'
�� `"k�`
'� --^
1y
0.34
0.36
Insect Screen (default)
.Left-Wall-Wesf`15.5'x11
X6.0
Window M, 2040 Cmt
Window
ff' Rear -Wall -North 17,9'z1'0'11(Back-0) ""'
-kD
--
1'
r 8.0
0.34
0.36
Insect Screen (default)
A, �< i s -
�{
Window N, 3020 Cmt
Window
�,� �`+rRear, Wall-Northy17:9'z10' (Back=U)j k ^^�
�' 3:0 �'�
6' L2:0 1.
11 1
- 61.0'
0.34
0.36
Insect Screen (default)
Window 0, 18 Dia.
Window
Rea Wall 17.9 10' Back 0
1.5J
1.5
Fixed
-North
0.756
1.7
0.34
0.36
Insect Screen (default)
DOORS
01
02
03
04
Name
Side of Building
Area (ft2)
U -factor
Door#1, 4080 Sc.
Front -Wall -South 24'x12'
32.0
0.50
Door#10, 3080 Sc.
Garage -Wall -North 55.1'x1
24.0
0.50
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016-04-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1R-PRF-01
Project Name: New Residence For Mr. William Miller Calculation DatelTime: 17:20, Tue, Apr 05, 2016 Page 8 of 13
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xml
OVERHANGS AND FINS
01
02
03
04
05
06
07
Total Cavity
01
02
03
04
05
06
07
08
09
10
11
12 13
14
— r ! ?
Cavity / Frame: no insul. / 2x4 Top Chrd
Overhang
2x4 Top Chord of, Roof Truss @ 24,
Left Fin
I 7
I`0.644
Roof Deck: Wood Siding/sheathing/decking
Attic RoofZone 1
Right Fin
Wood Framed Ceiling)
Window
Depth
Dist Up
Left
Extent
Right
Extent
Flap Ht.
Depth
Top Up
DistL
Bot Up
Depth
Top Up Dist R
Bot Up
FrenchDr.#37, 5080 Fr.Dr.
8
0.1
8
8
0
0
0
0
0
0
0 0
0
FrenchDr.#36, 5080 Fr.Dr.
8
0.1
8
8
0
0
0
0
0
0
0 0
0
Multi-Stack#3, 18.080
12
0.1
10
10
0
0
0
0
0
0
0 0
0
Window 1, 5060 Cmt
6
0.1
6
6
0
0
0
0
0
0
0 0
0
Window N, 3020 Cmt
=4
0.1
4
4
0
0
0
0
0
0
0 0
0
Window 0, 18 Dia. Fixed
4
0.1
4
4
0
0
0
0
0
0
0 0
0
OPAQUE SURFACE CONSTRUCTIONS
01
02
03
04
05
06
07
Total Cavity
Winter Design
Construction Name
Surface Type
Construction Type
Framing
R -value
U -value
Assembly Layers
'__J-1 1 { �1 c 7 , - }
j
— r ! ?
Cavity / Frame: no insul. / 2x4 Top Chrd
2x4 Top Chord of, Roof Truss @ 24,
^�
;
i
I 7
I`0.644
Roof Deck: Wood Siding/sheathing/decking
Attic RoofZone 1
Attic Roofs
Wood Framed Ceiling)
! �� in. O.C,�� + E
none I
i
Roofing: Light Roof (Asphalt Shingle)
f
_
U
_
Inside Finish: Gypsum Board
R-38 ROOF CATHEDRAL w/
Ceilings (below
�--y
C)
>�
Cavity/ Frame: R-9.1 /2x4
RA
attic)
Wood Framed Ceiling
2x4 @ 24 in. O.C.
R 38
0.025
Over Floor Joists: R-28.9 insul.
• Inside Finish: Gypsum Board
• Cavity / Frame: R-19 / 2x6
• Exterior Finish: Wood
R-19 Wall
Exterior Walls
Wood Framed Wall
2x6 @ 16 in. O.C.
R 19
0.069
Siding/sheathing/decking
• Cavity / Frame: no insul. / 2x4 Top Chrd
2x4 Top Chord of Roof Truss @ 24
Roof Deck: Wood Siding/sheathing/decking
Attic RoofZone-2
Attic Roofs
Wood Framed Ceiling
in. O.C.
none
0.644
Roofing: Light Roof (Asphalt Shingle)
• Cavity / Frame: no insul. / 2x4 Top Chrd
2x4 Top Chord of Roof Truss @ 24
Roof Deck: Wood Siding/sheathing/decking
Attic RoofZone-3
Attic Roofs
Wood Framed Ceiling
in. O.C.
none
0.644
Roofing: Light Roof (Asphalt Shingle)
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016-04-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD
Project Name: New Residence For Mr. William Miller Calculation Datell ime: 17:20, Tue, Apr 05, 2016
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xm
CF1 R -PRF -01
Page 9 of 13
SLAB FLOORS
i! NN i rr o sem►
01
02 `�
03 -
A. 1t r- !C'k R
04
V*I% k', e-
SOS
a k I 1, #" k w-
01
02
03
04
05
06
07
Name
Zone
Area (ft)
Perimeter (ft)
Edge Insul. R -value & Depth
Carpeted Fraction
Heated
New Slab -on -Grade
Zone -1
2027
131
None
0.8
No
Slab on -Grade
Zone -2
1320
193
None
0.8
No
Slab -on -Grade 2
Zone -3
808
131
None
0.8
No
BUILDING ENVELOPE - HERS VERIFICATION
01 02 03 04
Quality Insulation Installation (QII) Quality Installation of Spray Foam Insulation Building Envelope Air Leakage CFM50
Not Required Not Required Not Required —
fill
WATER HEATING SYSTEMS /A
01 1/ 1102 03 04 05 06
Name " _ __]System Type'^ ..__ Distribution Type Water Heater Number of Heaters Solar Fraction (%)
DHW Sys 1 - 1/2 DHW > Parallel -Piping 1, DHW Heater 1 2 .0%
1 I / .r" lrT-+. Cl II .I1 71.----- 7F J1 It It l€ VZG._ sl�
WATER HEATERS ���� � ,roi ii \`z, iL_
i! NN i rr o sem►
01
02 `�
03 -
A. 1t r- !C'k R
04
V*I% k', e-
SOS
a k I 1, #" k w-
06
P"%
07
OS
Name
Heater Element Type
t �" "'Y
Tank Type
'� �'
Tank Volume
(gal)
' V W '�"�
Energy Factor or
Efficiency
'�
Input Rating
Tank Exterior
Insulation
R -value
Standby Loss
(Fraction)
DHW Heater 1
Natural Gas
Small Storage
50
0.65
40000-Btu/hr
0
0
WATER HEATING - HERS VERIFICATION
01
02
03
04
05
06
07
Name
Pipe Insulation
Parallel Piping
Compact Distribution
Point -of Use
Recirculation
Control
Central DHW
Distribution
DHW Sys 1 - 1/2
--
--
—
--
--
—
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016-04-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1 R -PRF -01
Project Name: New Residence For Mr. William Miller Calculation Dateffime: 17:20, Tue, Apr 05, 2016 Page 10 of 13
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xml
SPACE CONDITIONING SYSTEMS
01
02
03
04
05
06
SC Sys Name
System Type
Heating Unit Name
Cooling Unit Name
Fan Name
Distribution Name
Zone -1 LIVING-KITCHENI
–
Other Heating and Cooling
System
Heating Component 1
Cooling Component 1
HVAC Fan 1
Air Distribution System 1
Zone -2 BEDROOMS-HALL2
–
Other Heating and Cooling
System
Heating Component 2
Cooling Component 2
HVAC Fan 2
Air Distribution System 2
Zone-3–MBR-GUEST3
Other Heating and Cooling
System
Heating Component 3
Cooling Component 3
HVAC Fan 3
Air Distribution System 3
HVAC - HEATING UNIT TYPES
01
021,�
01
02
03
Name
Type
Efficiency
Heating Component 1
CntrlFurnace - Fuel -fired central furnace
80 AFUE
Heating Component 2
CntrlFurnace - Fuel -fired central furnace
80 AFUE
Heating Component 3,
CntrlFurnace - Fuel -fired -central furnace
80 AFUE
ii II Fr IF ii Ii t f F _
HVAC - COOLING UNIT TYPES f\ C� 1 ( { �i 1 F-1 i F� t i _11i) 11 1I 11 ((
01
021,�
t:., u 03 .� T u 704 — U
u u 05 `� v
06
07
Name
f-
J EfficiencjA kJ d !
�.J C J-1
Multi -speed
Verified Refrigerant
Charge
Name
System Type
EER SEER
Zonally Controlled
Compressor
HERS Verification
Cooling Component 1
SplitAirCond
12.25
14.5
Not Zonal
Single Speed
Cooling Component
1 -hers -cool
Cooling Component 2
SplitAirCond
12.5
15.25
Not Zonal
Single Speed
Cooling Component
1 -hers -cool
Cooling Component 3
SplitAirCond
12.75
15.25
Not Zonal
Single Speed
Cooling Component
1 -hers -cool
HVAC COOLING - HERS VERIFICATION
01
02
03
04
05
06
Name
Verified Airflow
Airflow Target
Verified EER
Verified SEER
Verified Refrigerant
Charge
Cooling Component 1 -hers -cool
Required
350
Required
Required
Required
Cooling Component 2 -hers -cool
Required
350
Required
Required
Required
Cooling Component 3 -hers -cool
Required
350
Required
Required
Required
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016-04-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD
Project Name: New Residence For Mr. William Miller Calculation DatefTime: 17:20, Tue, Apr 05, 2016
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xml
CF1 R -PRF -01
Page 11 of 13
HVAC - DISTRIBUTION SYSTEMS
01
02
03
04
05
06
07
Name
Type
Duct Leakage
Insulation R -value
Duct Location
Bypass Duct
HERS Verification
Air Distribution System 1
DuctslnAll
Specified Lower Leakage
Target
8
Attic
None
Air Distribution System
1 -hers -dist
Air Distribution System 2
DuctslnAll
Specified Lower Leakage
Target
8
Attic
None
Air Distribution System
2 -hers -dist
Air Distribution System 3
DuctslnAllSpecified
Lower Leakage
Target
8
Attic
None
Air Distribution System
3 -hers -dist
HVAC DISTRIBUTION - HERS VERIFICATION
01
02
03
04
05 06
07
08
Name
Duct Leakage
Verification
Duct Leakage
Target (%)
Verified Duct
Location
Verified Duct Buried
Design Ducts
Deeply Buried
Ducts
Low -leakage
Air Handler
Air Distribution System 1 -hers -dist
iReoirecl
6.0
Required
Not Required Not Required
Not Required
Required
Air Distribution System 2 -hers -dist
- _Required ="-�—
_ _ 6.0
J
Required
Not Required Not Required
Not Required
Required
Air Distribution System 3 -hers -dist
�` Required !i
6.0 .,,.-..
t __Required
,,Not Required Not Required
Not Required
Required
I 1 / I .1! larwz% It It Ir . It l! It I\. If nom\ T -_i
HVAC -FAN SYSTEMS♦
02
01
t
x k02
x+-03
04
Name
``�
^- Type ..
V tFann-Power-(Watts/CFM)
HERS Verification
HVAC Fan 1
Required
Single Speed PSC Furnace Fan
0.58
HVAC Fan 1 -hers -fan
HVAC Fan 2
Single Speed PSC Furnace Fan
0.58
HVAC Fan 2 -hers -fan
HVAC Fan 3
Single Speed PSC Furnace Fan
0.58
HVAC Fan 3 -hers -fan
HVAC FAN SYSTEMS - HERS VERIFICATION
01
02
03
Name
Verified Fan Watt Draw
Required Fan Efficiency (Watts/CFM)
HVAC Fan 1 -hers -fan
Required
0.58
HVAC Fan 2 -hers -fan
Required
0.58
HVAC Fan 3 -hers -fan
Required
0.58
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016.04-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1R-PRF-01
Project Name: New Residence For Mr. William Miller Calculation Date/Time: 17:20, Tue, Apr 05, 2016 Page 12 of 13
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xmi
IAQ (Indoor Air Quality) FANS
01
02
03
04
05
06
Dwelling Unit
IAQ CFM
IAQ Watts/CFM
IAQ Fan Type
IAQ Recovery
Effectiveness(%)
HERS Verification
SFam IAQVentRpt
116.55
0.25
Default
0
Required
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016-04-06 13:40:31 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD
Project Name: New Residence For Mr. William Miller Calculation DatefTime: 17:20, Tue, Apr 05, 2016
Calculation Description: Title 24 Analysis Input File Name: 06-2014 MILLER RESIDENCE -REVISED 03-17-2016.xml
CF1 R -PRF -01
Page 13 of 13
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Sergio Garcia
Company:
Signature Date:
Sergio H. Garcia Design Consultants
2016-04-06 13:40:31
Address:
CEA/HERS Certification Identification (If applicable):
49-950 Jefferson St. Ste. 130-219
City/State/Zip:
Phone:
Indio, CA 92201
760-880-6796
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of pedury, under the laws of the State of California:
1: I am eligible under Division 3 of the Business�and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance.
2. 1 certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of
Regulations. \
3. The building design features or system desig\featut�id ified on-thisCertificate of Compliance are consistent with the information provided on other applicable compliance.documents,
worksheets, calculations, plans and specifications submittedto�-the enforcemen agency fo+approval with th.building permit application.
Responsible Designer Name:i
^Rees" on'sible-Designer Signature:
C
Sergio GarciaAi',/
) [ '�ce-�aneui
i`• �t
' " �1
Company:
Date Signed:
04
Sergio H. Garcia Design Consultants
2016 06 113:40:311
Address:
License:
49-950 Jefferson St. Ste. 130-219
A8237398
City/State/Zip:
Phone:
Indio, CA 92201
760-880-6796
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the
information.
Registration Number: 216-N0127396A-000000000-0000 Registration Date/Time: 2016-04-06 13:40:31 1 HERS Provider: CaICERTS inc.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-710 Report Generated at: 2016-04-05 17:22:45
CERTIFICATE OF INSTALLATION
CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans
(Page 1 of 12 )
Project Name: Miller, William Revised
Enforcement Agency: City of La Quinta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
A. General Information
01
Dwelling Unit Name
Unit 1
02
Climate Zone
15
Dwelling Unit Total
Number of Space
034155
Conditioned Floor Area (ft)
04
Conditioning Systems in this
3
Dwelling Unit.
05
Certificate of Compliance
performance (CF1R-PRF)
06
Method used to Calculate
ACCA Manual J
Type
�r �, `,
HVAC Loads
07
Calculated Dwelling Unit-
` —
336 1 -- - _, _
08
Calculated Dwelling Unit
48098
Sensible Cooling Load (Btuh).,
J �_�_
Heating Load (Btuh)
LO9
Dwelling Unit Number of
Bedrooms
i
3�rn
;
ID
E
CF2R-MCH-01a -Space Conditioning Systems Ducts"and Fans'10 use Lw th P rformance Ce tifica a of�Compliwicey
Registration Number: 216-N0127396A-M0100001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:20:28
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 2 of 12 )
B. Design Space Conditioning (SC) System Component Specifications from CF1R
01
02
03
04
05
06
07
08
09
10
it
12
Minimum
Low
Heating
Heating
Heat Pump
Heat Pump
Space
Minimum
Cooling System
Maximum Fan
Minimum Duct
System
Efficiency Type
Leakage
Heating
Heating
Cooling
Cooling
Conditioning
Space
Heating
Cooling
Space
Distribution
Required
Air -Handling
Bypass Duct
Cooling
System
Zone Name
System
Conditioning
System
System Type
Conditioning
System Type
Thermostat
Unit
Status
Zoning Type
Compressor
Identification
System Type
Type
This field or
Fan Type
Type
(LLAHU)
System 1
Speed Type
0.8
or Name
section is not
14.5
12.3
350
0.58
R-8
Status
applicable
applicable
Heating and
Central gas
Central split
PSC
Conditioned
Yes credit is
No Bypass
Zone -1
System 1
cooling system
furnace
AC
Permanent
space-
Setback
taken
Duct
Not Zonal
Single Speed
other
Split Capacitor
entirely
Heating and
rn
Central gas
Central split
PSC
Conditioned
Yes credit is
No Bypass
Zone -2
System 2
coolingsystem
-.. -
furnace
- -
AC-�_-_
Permanent
space-
Setback
taken
Duct
Not Zonal
Single Speed
other
— "� —
Split Capacitor
entirely
-�, `'�
,,r'
� �`"-.w•�
i t ,.+`.'.
,� �.....� �--�•
g�`.`r""t i'"'"^.
is
Zone
System 3
Heating and
r
�/�
CentraEgas
Central split
PSC
t r a
Permanent
Conditioried
t
Setback
.
Yes credit is
y
No Bypass
4
Not Zonal
Single Speed
-3
cooling system
other
�. a
fur c
ACS `
.Split Capacitor
space r
enti�e'ly '
� 'u
taken
Duct, 0
C. Design Space Conditioning (SC) System Compliance Requirements from CF1R
01
02
03
04
05
06
07
08
09
10
Space
Minimum
Conditioning
Heating
Heating
Heat Pump
Heat Pump
Minimum
Minimum
Cooling System
Maximum Fan
Minimum Duct
System
Efficiency Type
Minimum
Heating
Heating
Cooling
Cooling
Airflow Rate
Efficacy
R -Value
Identification or
Efficiency Value
Capacity at 47F
Capacity at 17F
Efficiency SEER
Efficiency EER
(CFM/ton)
(Watts/CFM)
Name
This field or
This field or
System 1
AFUE
0.8
section is not
section is not
14.5
12.3
350
0.58
R-8
applicable
applicable
Registration Number: 216-N0127396A-MO100001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:20:28
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 3 of 12 )
C. Design Space Conditioning (SC) System Compliance Requirements from CHR
01
02
03
04
05
06
07
08
09
10
Space
`_
66 U=
U )07 U
t::�/ 08 U
X 09 f
f 10
Minimum
Conditioning
Heating
Heating
Heat Pump
Heat Pump
Minimum
Minimum
Cooling System
Maximum Fan
Minimum Duct
System
Efficiency Type
Minimum
Heating
Heating
Cooling
Cooling
Airflow Rate
Efficacy
R -Value
Identification or
SC System
Efficiency Value
Capacity at 47F
Capacity at 17F
Efficiency SEER
Efficiency EER
(CFM/ton)
(Watts/CFM)
Cooling
System
Name
Identification
Location or
Served by the
System Type
System Type
Conditioning
System Type
Thermostat
Type
Compressor
(CFI)
or Name
This field or
This field or
Fan Type
Type
System 2
AFUE
0.8
section is not
section is not
iS.3
12.5
350
0.58
R-8
'A�
applicable
applicable
Location
2077
Central gas
Central split
PSC
Permanent
Conditioned
Setback
Not Zonal
This field or
This field or
furnace
AC
System 3
AFUE
0.8 '
section is not
section is not
15.3
12.8
350
0.58
R-8
Central split
PSC
Permanent
Conditioned
applicab�_
;_,applicable
Single Speed
Not a CFI
furnace
AC
Split Capacitor
space -entirely
system
D. Installed Space Conditioning (SC) System Component Information
� n
i
01
02
03;,-
04,'05
`_
66 U=
U )07 U
t::�/ 08 U
X 09 f
f 10
11
i
M %V
RT t L,
s. r
Central Fan
SC System
SC System
Conditioned
Floor Area
Heating
Cooling
Space
Distribution
SC System
Cooling Zoning
Cooling
System
Integrated
Identification
Location or
Served by the
System Type
System Type
Conditioning
System Type
Thermostat
Type
Compressor
(CFI)
or Name
Area Served
System (ft2)
Fan Type
Type
e
Speed Type
Ventilation
System Status
System 1
Location
2077
Central gas
Central split
PSC
Permanent
Conditioned
Setback
Not Zonal
Single Speed
Not a CFI
furnace
AC
Split Capacitor
space -entirely
system
System 2
Location
1270
Central gas
Central split
PSC
Permanent
Conditioned
Setback
Not Zonal
Single Speed
Not a CFI
furnace
AC
Split Capacitor
space -entirely
system
Registration Number: 216-N0127396AW0100001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:20:28
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 4 of 12 )
D. Installed Space Conditioning (SC) System Component Information
01
02
03
04
05
06
07
08
09
10
11
Conditioned
SC System
SC System
Heating�
Cooling
Central Fan
SC System
SC System
Floor Area
Heating
Cooling
Space
Distribution
SC System
Cooling Zoning
System
Integrated
Identification
Location or
Served by the
System Type
System Type
Conditioning
System Type
Thermostat
Type
Compressor
(CFI)
or Name
Area ServedFan
System (ftZ)
W1E5728932
80000
Type
Location
Type
0.8
Speed Type
Ventilation
W1G5886205
64000
System 3
Location
AFUE
0.8
York
TMLX080C16
WIK4081740
64000
System Status
System 3
Location
808
Central gas
Central split
PSC
Permanent
Conditioned
Setback
Not Zonal
Single Speed
Not a CFI
furnace
AC
Split Capacitor
space -entirely
system
FAl
E. Installed Heating Equipment information (not heat pumps)
01
02
03
04--'_—
�� 05
06
07
08
SC System
SC System
Heating�
.��
`h! Heating
Rated Heating
Capacity,
Identification
Location or
Effiuenc
Efficienc
i
Output
or Name
Area Served
jfype
Value
HeatingyUnit Manufacturers
Heating Unit Model Numbers
Heating<Unit serial number
(BTUH)
System 1
Location
AFUE
0.8
York
TMLX100C20
W1E5728932
80000
System 2
Location
AFUE
0.8
York
TMLX080C16
W1G5886205
64000
System 3
Location
AFUE
0.8
York
TMLX080C16
WIK4081740
64000
Notes:
Registration Number: 216-N0127396A-MO100001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:20:28
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 5 of 12 )
F. Installed Cooling System Outdoor Condensing Unit or Package Unit Equipment Information (not heat pumps)
01
02
03
04
05
06
07
08
09
Indoor Coil or Fan Coil Unit serial number
System 1
Location
ADP
CV60006
67015KO0495
System 2
System
ADP
CV60006
6015KO0502
System 3
Location
ADP
CV36006
6014K24073
Rated
Condenser
Cooling
Rated
Capacity at
Nominal
SC System
SC System
Cooling
Cooling
Design
Cooling
Identificatio
Location or
Efficiency
Efficiency
Condenser or Package Unit
Condenser or Package Unit
Condenser or Package Unit
Conditions
Capacity
n or Name
Area Served
SEER
EER
Manufacturer
Model Number
Serial Number
(BTUH)
(ton)
System 1
Location
14.5
12.3
York
YCS601321
W1G5878522
48423
5
System 2
Location
15.3
.12.5
York
YCS48B21S
W1A6267053
40762
4
System 3
Location
15.3-
128 _
York
YCS36B21S
W1M5189576
30507
3
_ _ _
Notes:
n
l I J .- 7 E 4r --X 3 F f F f L __.. 9 F 1 E 7 1 x0. :[ I 3v.. '%, /�.•+,i
I r t " a t !f f..-9 € d t! t I f -- I I! f -., N )i ti, t f 4(
G. Installed Split System Indoor Coil or Fan.Coil Unit Equipment Information japplicable to DX or hydronic heating/cooling coils, or fan coil units).
`�,. �..1 � -�,.�:.� �.�.�.� i.,„.:.........:.�.,+ � ti,► � '�-�-�' f ,� �. a ti.: �*.::,.� ,..�+
01
02
031 E
041 N
05
SC System
Identification or
Name
SC System Location
or Area Served
Indoor Coil or Fan Coil Unit Manufacturer
Indoor Coil or Fan Coil Unit Model
Number
Indoor Coil or Fan Coil Unit serial number
System 1
Location
ADP
CV60006
67015KO0495
System 2
Location
ADP
CV60006
6015KO0502
System 3
Location
ADP
CV36006
6014K24073
Notes:
Registration Number: 216-N0127396AW0100001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:20:28
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 6 of 12 )
H. Installed Heat Pump System - Split System Condensing Unit or Package Unit Equipment Information
This section does not apply to this project.
I. Installed Heat Pump System - Efficiency and Performance Compliance Information
This section does not apply to this project.
I Installed Duct System information
01
02
03
�� 04
05
06
07
08
09
10
11
12
I
Method of
,
Exemption
compliance
y ! -.
from Mini
with duct
Exemption
Can RA3.3
R -Value for
and filter
From Duct
Number of
Airflow,
SC System
SC System
�`'�'
�r
-
�"
Ducts In
[grille sizing,
Leaka a
g
'BypassDuct
Air Filter
Protocols be
Identification
Location or
Supply Duct
Sup Duct
Return Duct"
;Return Duct
3
Conditioned
Req's m.
Requirement"
Devices on
used to test
or Name
Area Served
Location
'rR Valuei
Location,
-
R -Value
Space ��
150:0(m113
sl
Status
System
this system?
�,
ti a
� .
d
�v!
Conditioned
J�HERRS,v��erif
Conditioned[
S
fan efficacyi
i
No
No
No Bypass
System 1
Location
space-
R-8
space-
R-8
Exemption
(W/cfm) and
exemptions
Duct
1
Yes
entirely
entirely
airflow rate
(cfm/ton)
HERS verified
Conditioned
Conditioned
No
fan efficacy
No
No Bypass
System 2
Location
space-
R-8
space-
R-8
Exemption
(W/cfm) and
exemptions
Duct
1
Yes
entirely
entirely
airflow rate
(cfm/ton)
Registration Number: 216-N0127396A-MO100001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:20:28
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 7 of 12 )
J. Installed Duct System information
01
02
03
04
05
06
07
08
09
10
11
12
Determined Design
Method of
Determined Design
Allowable Pressure
SC System
SC System Location or
Air Filter Identification
Air Filter Device
Airflow Rate for Air
Drop for Air Filter
Exemption
compliance
or Name
Air Filter Device Type
Location
Filter Device (cfm)
Device (inch W.C.)
System 1
Location
Filter 1
Furnace Mounted
Furnace RA
from Mini
with duct
Exemption
Location
Filter 1
Can RA3.3
Furnace RA
1644
0.03
System 3
Location
Filter 1
R -Value for
and filter
From Duct
0.03
Number of
Airflow
SC System
SC System
Ducts In
grille sizing
Leakage
Air Filter
Protocols be
Identification
Location or
Supply Duct
Supply Duct
Return Duct
Return Duct
Conditioned
Req's in
Requirement
Bypass Duct
Devices on
used to test
or Name
Area Served
Location
R -Value
Location
R -Value
Space
150.0(m)13
s
Status
System
this system?
HERS verified
Conditioned
Conditioned
fan efficacy
System 3
Location
space-
1
R-8
1
space-
R-8
No
(W/cfm) and
No
No Bypass
1
Yes
entirely
h
entirely
Exemption
airflow rate
exemptions
Duct
y
cfm ton
Notes:
I f f- Y F 1 1 / F 3 1 -- It. J! 1 F %tea.. 1 t i -"-% N .f.rF'_
K. Installed Air Filter Device Information' r� U C-4 U
Mandatory requirements for air filter devices are specified Section 150.0(m)12..
01
02
03
04
05
06
07
Determined Design
Determined Design
Allowable Pressure
SC System
SC System Location or
Air Filter Identification
Air Filter Device
Airflow Rate for Air
Drop for Air Filter
Identification or Name
Area Served
or Name
Air Filter Device Type
Location
Filter Device (cfm)
Device (inch W.C.)
System 1
Location
Filter 1
Furnace Mounted
Furnace RA
1950
0.03
System 2
Location
Filter 1
Furnace Mounted
Furnace RA
1644
0.03
System 3
Location
Filter 1
Furnace Mounted
Furnace RA
1182
0.03
Notes:
Registration Number: 216-N0127396A-MO100001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:20:28
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-03-E
Space Conditioning Systems, Ducts, and Fans (Page 8 of 12 )
L. Air Filter Device Requirements
O1
The system shall be designed to ensure that all recirculated air and all outdoor air supplied to the occupiable space is filtered before passing through the system's
01
thermal conditioning components.
05
The system shall be designed to accommodate the clean -filter pressure drop imposed by the system air filter device(s). The design airflow rate and maximum
07
allowable clean -filter pressure drop at the design airflow rate applicable to each air filter device shall be determined, and all system air filter device locations shall be
02
labeled to disclose the applicable design airflow rate and the maximum allowable clean -filter pressure drop. The labels shall be permanently affixed to the air filter
it
device, readily legible, and visible to a person replacing the air filter media, and the air filter devices shall be provided with air filter media that conforms to these
determined or labeled maximum allowable clean -filter pressure drop values as rated using AHRI Standard 680.
03
All system air filter devices shall be located and installed in such a manner as to allow access and regular service by the system owner.
MCH -22
n
MCH -25
The system shall be provided with air filter media having a designated efficiency equal to or greater than MERV 6 when tested in accordance with ASHRAE Standard
04
52.2, or a particle size efficiency rating equal to or greater than SO percent in the 3.0 to10 micron range when tested in accordance with AHRI Standard 680.
MCH -29
MCH -30
SC System
The system shall be provided with air,filte'r.media that has been labeled by the manufacturer to disclose the efficiency and pressure drop ratings that conform to the
05
required efficiency and pressure drop requirements for:the air filter device.
AHU Fan
AHU
t Jig )t 1i M
The responsible signature on this compliance document affirmsthat applicable requirements in this -table have' nh met.
person's all
J t r" t t It I t F 1.4 I r-- i r -NN 3 t -,%IN 11 it it
EIRK
M. HERS Verification Requirements
i H R 1V 0
O1
02
03
04
05
06
07
08
09
30
it
12
MCH -20
MCH -21
MCH -22
MCH -23
MCH -25
MCH -26
MCH -27
MCH -28
MCH -29
MCH -30
SC System
SC System
Duct
Ducts
AHU Fan
AHU
Refrigerant
Rated SC
IAQ
Return
Supply
Ventilation
Identificati
Location or
Leakage
Location
Efficacy
Airflow
Charge
System
Mechanical
Duct
Duct
Cooling
on or
Area
Test
Verification
(W/cfm)
Rate
Equipment
Ventilation
Design
Surface
Credit
Name
Served
(cfm/ton)
Verification
Table
Area
150.0-C or
R -Value
D
Buried
Ducts
System 1
Location
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
Registration Number: 216-N0127396A-MO100001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:20:28
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 9 of 12 )
M. HERS Verification Requirements
01
02 -
03
04
05
06
07
08
09
10
11
12
MCH -20
MCH -21
MCH -22
MCH -23
MCH -25
MCH -26
MCH -27
MCH -28
MCH -29
MCH -30
SC System
SC System
Duct
Ducts
AHU Fan
AHU
Refrigerant
Rated SC
IAQ
Return
Supply
Ventilation
Identificati
Location or
Leakage
Location
Efficacy
Airflow
Charge
System
Mechanical
Duct
Duct
Cooling
on or
Area
Test
Verification
(W/cfm)
Rate
Equipment
Ventilation
Design
Surface
Credit
Name
Served
(cfm/ton)
Verification
Table
Area
150.0-C or
R -Value
JA
D
Buried
J
Ducts
System 2
Location
Yes
f' Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
System 3
Location
Yes
Yes
-`,Yes- -
wYes
Yes
Yes
Yes
No
No
No
Notes:
HERS PROVIDER
Registration Number: 216-N0127396A-M0100001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:20:28
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 10 of 12 )
N. Space Conditioning Systems, Ducts and Fans -Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be
applicable to only newly installed equipment or portions of the system that are altered. Existing equipment may be exempt from these requirements.
Heating Equipment
01
Equipment Efficiency: All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency
Regulations.
02
Controls: All unitary heating systems, including heat pumps, must be controlled by a setback thermostat. These thermostats must be capable of allowing the occupant
to program the temperature set points for at least four different periods in 24 hours. See Sections 150.0(1), 110.2(b).
03
Sizing: Heating load calculations must be done on portions of the building served by new heating systems to prevent inadvertent undersizing or oversizing. See sections
150.0(h)1 and 2). t
Furnace Temperature Rise: Central forced -air, heating furnace installations must be configured to operate at or below the furnace manufacturer's maximum
04
inlet -to -outlet temperature rise specification. See Section 150.0(h)4.
05
Standby Losses and Pilot Lights: Fan -type central furnaces m y of have a continuously ouslburning ilotlight.�ion 1103and Section 110.2(d).
it �r. tfi'►� f:�
Cooling Equipment �r/•�\ f f� f?
t'1
06
Equipment Efficiency: All coolingequipment must meet th6pinimum efficiency'' requirementsiof-Secti6n,110.lfand Section 110 2(a): and the Appliance Efficiency
� �! �.,.. W, '% � i t i *-,* `!.>r iE 4--o- fit. r a
Regulations.
07
Refrigerant Line Insulation: All refrigerant line insulation in split system air conditioners and heat pumps must meet the R -value and protection requirements of Section
150.0(j)2 and 3, and Section 150.0(m)9.
08
Condensing Unit Location: Condensing units shall not be placed within five (5) feet of a dryer vent outlet. See Section 150.0(h)3A.
09
Sizing: Cooling load calculations must be done on portions of the building served by new cooling systems to prevent inadvertent undersizing or oversizing. See Section
150.0(h)1 and 2.
Air Distribution System Ducts, Plenums and Fans
10
Insulation: In all cases, unless ducts are enclosed entirely in directly conditioned space, the minimum duct insulation value is R-6. Note that higher values may be
required by the prescriptive or performance requirements. See Section 150.0(m)1.
Registration Number: 216-N0127396A-MO300003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:20:28
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-03-E
Space Conditioning Systems, Ducts, and Fans (Page 11 of 12 )
N. Space Conditioning Systems, Ducts and Fans -Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be
applicable to only newly installed equipment or portions of the system that are altered. Existing equipment may be exempt from these requirements.
Connections and Closures: All installed air -distribution system ducts and plenums must be, sealed and insulated to meet the requirements of CMC Sections 601.0,
602.0, 603.0, 604.0, 605.0 and ANSI/SMACNA-006-2006: Supply -air and return -air ducts and plenums must be insulated to a minimum installed level of R-6.0 or
it
enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing in accordance with the requirements of Reference
Residential Appendix RA3.1.4.3.8.
Heat Pump Thermostat
12
A thermostat shall be installed that meets the requirements of Section 110.2(b) and Section 110.2(c).
�t
13
The thermostat shall be installed in accordance with the manufacturers published installation specifications
1 Tt
14
First stage of heating shall be assigned to heat pump heating.
15
Second stage back up heating shall be set to come on only when the indoor set temperature cannot be met.
I ; .— y--. iG If �f Ai it it tr. iI
he responsible person signature on this compliance -document affirms,that all applicable -requirements imthis,table have been met.
_
FT
J i r 1 � k# ro: 0 it ie if"`` i 1i Jt f
ERIS PROVIDER .R
Registration Number: 216-1\10127396AW0100OO1A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:20:28
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 12 of 12
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Jack B LaFontaine
Company:
Signature Date:
Energy Management Services
2016-04-06 15:37:51
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
1760-360-4631
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
r r F
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials,
components, or manufactured devices for the scope of work identified on this Certificate of Installation, and attest to the declarations in this statement (responsible builder/installer), otherwise I am an
authorized representative of the responsible builder/installer."— I!
3. The constructed or installed features, materials,components or manufactureii-devices (tdinstal lation)Jclentified on- Certifica't`elof Installation,conforms,to all.applicable codes and regulations, and the
r* r[ ri ve rr a a s r
installation conforms to the requirements given on the plans and s,pecifications.approved by the enforcement agency.
r .. 1 l hk iG it x\. it i Yt 3
4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the -specific requirements for -the scope oflinstruction or mstallation identified on this Certificate of
Installation, and I have ensured that the requirements that,apply to the construction or mstallation have been met.
^^�, iy f - 'r rw'
S. I will ensure that a registered copy of this Certificate of Installation shall be posted, or,made avr ble with the building permits) issued for the building, and made -available to the enforcement agency for all
applicable inspections. I understand that a registered copyof this Certificate of Installation is re uired to be included with Lhe docu entation the builde ovides i the building owner at occupancy.
PP P g q P g
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature: AjJ�
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Position With Company (Title):
DESERT HABITATS INC
Owner
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
Bermuda Dunes CA 92203
760-340-6062 X123
12016-04-06 15:39:53
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M0100001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:20:28
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Quinta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code: 92253
A. System Information
01
Space Conditioning System Identification or Name
System 1
02
Space Conditioning System Location or Area Served
Location
03
Building Type from CF -1R
Single family
04
Verified Low Leakage Ducts in Conditioned Space
No, credit is not taken
05
(VLLDCS) Credit from CF1R?
Total leakage
05
Verified Low Leakage Air Handling Unit (VLLAHU) Credit
Yes credit is taken
07
from CFiR?
Cooling system method
06
Duct System Compliance Category~, _ _ — _ - - -
New
09
Calculated Target Allowable Duct Leakage (cfm)
120
r+� � sr� a r�+s �►�!+�+r�r � a
MCH -20c - Low Leakage Air Hading UniR(LLAHU)il
01
i
i
f I
rn)
B. Duct Leakage Diagnostic Test R R O A D
01
Condenser Nominal Cooling Capacity (ton)
5
02
Heating Capacity (kBtu/h)
80
03
Conditioned Floor Area served by this HVAC system (ft2)
2077
04
Duct Leakage Test Condition
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
6.0
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Cooling system method
08
Measured AHUAirflow
This field or section is not applicable
09
Calculated Target Allowable Duct Leakage (cfm)
120
10
Actual duct leakage rate from leakage test measurement
(cfm)
109
11
Air Handling Unit Manufacturer Name
York
12
Air Handling Unit Model Number
TMLX100C20
Registration Number: 216-N0127396A-M2000002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:23:56
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
B. Duct Leakage Diagnostic Test
13 Compliance Statement System passes leakage test
C. Additional Requirements for Compliance
The Low Leakage Air -handling Unit Model identified on this compliance document is included in the list of certified Low
01
Leakage Air -Handling Units published on the Energy Commission Website at:
http://www.enerey.ca.gov/title24/2008standards/special case appliance/supplemental listings/Low Leakage Air -
Handling Unit Listing 2012-10-30.pdf
02
System was tested in its normal operation condition. No temporary taping allowed.
Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage
03
testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation
Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required,
may configure the OA damper to the closed position during duct leakage testing.
04
All supply and return register boots were sealed to the drywall.
05
Building cavities were not used as plenums—or platform returns in lieu of ducts: 16
I
06
If cloth backed tape was used it was covered with Masticand draw bands.{��
07
All connection points bet en. the air handler and the -supply and return -plenums are:completely sealed.
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.
Registration Number: 216-N0127396A-M2000002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:23:56
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: /J ,
Jack B LaFontaine
per/
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
r
2. 1 am eligible under Division3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer. �.
3. The constructed or installed features, materials; components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations, and the installation conforms to the requirements given on.the plans and.specifications approved by
.
the enforcement agency. /�J
x't�" ;
h
4. 1 understand that a HERS rater will—c"
ill check the installation to verify compliance, and, that if'such checking identifies defects; I'am required to take
i f+. g—y i td �.? "Ri IImss 7i F t rt an
corrective action at my expense?I understand�that Energy'Commission and HERS Provider representatives will also perform quality a �surance checking
of installations, including iho`e-approved as part'of a;sample group but.not:checked;byfa;HERS:rater.and if those installations fail,to meet theme J'
se r, a+ r- + tNR
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. R S + I
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2000002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:23:56
2013 Residential Compliance Schema Version: 2013.1.007
Reg:
213-N0021824B-M2500011A-M25A Registration Date/Time:
2013/04/14 17:23:51
HERS Provider: CalCERTS, Inc.
2008
Residential Compliance Form
February -2013
_
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Quinta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code: 92253
A. System Information
01
Space Conditioning System Identification or Name
System 2
02
Space Conditioning System Location or Area Served
Location
03
Building Type from CF -111
Single family
04
Verified Low Leakage Ducts in Conditioned Space
No, credit is not taken
05
(VLLDCS) Credit from CF1R?
Total leakage
05
Verified Low Leakage'Air Handling Unit (VLLAHU) Credit
Yes credit is taken
07
from CF1R?
Cooling system method
08
,t
This field or section is not applicable
06
Duct System Compliance Category _J — — - '
New
10
Actual duct leakage rate from leakage test measurement
(cfm)
84
MCH -20c -Low Leakage Ai Handling U 1(LLAHU 4) 1
01
Condenser Nominal Cooling Capacity (ton)
4
02
rr
B. Duct Leakage Diagnostic Test P R 0 V�I
01
Condenser Nominal Cooling Capacity (ton)
4
02
Heating Capacity (kBtu/h)
64
03
Conditioned Floor Area served by this HVAC system (ft2)
1270
04
Duct Leakage Test Condition
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
6.0
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Cooling system method
08
Measured AHUAirflow
This field or section is not applicable
09
Calculated Target Allowable Duct Leakage (cfm)
96
10
Actual duct leakage rate from leakage test measurement
(cfm)
84
11
Air Handling Unit Manufacturer Name
York
12
Air Handling Unit Model Number
TMLX080C16
Registration Number: 216-N0127396A-M2000003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:25:38
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
B. Duct Leakage Diagnostic Test
13 Compliance Statement System passes leakage test
C. Additional Requirements for Compliance
The Low Leakage Air -handling Unit Model identified on this compliance document is included in the list of certified Low
01
Leakage Air -Handling Units published on the Energy Commission Website at:
http://www.energy.ca.gov/title24/2008standards/special case appliance/supplemental listings/Low Leakage Air -
Handling Unit Listing 2012-10-30.0
02
System was tested in its normal operation condition. No temporary taping allowed.
Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage
03
testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation
Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required,
may configure the OA damper to the closed position during duct leakage testing.
04
All supply,`and`return register boots were sealed to_the drywall.
05
Building cavities were not used as plenums or platformlreturns in lieu of ducts: �n}
06
If cloth backed tape was used it was covered with'Mastic and draw.bands.���
t
07
All connection points between the air handler and the supply and returnlplenums are completely sealed.
\1 r -8 V- i"ti. '!! P" M l I 'i/ r it 4
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.
Registration Number: 216-N0127396A-M2000003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:25:38
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: /j p.� 1 ,
0CL��1(iJ
Jack B LaFontaine
� r
Company:
signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
1760-360-4631
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer. -
3. The constructed or installed features, materials; components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations,.and the installation conforms to the requirements.given on -the plans and specifications approved by
the enforcement agency. I-- ^' 'r I f,�""`r `"^� neckinrgidef
4. I understand that HERS w1ill,check the installationto'verifycompliance, if defects; I am
a rater and that such ctifies required to take'
corrective at HERS Provider
Energy-Commission'.A
action my expen�sety understarid that and represen aLves will also perform quality assurance checking
of installations, including those,approved as of a sample'group but_ not-checked:bv?a;HERS,'rater,,and if those in fail.to meet theme 0
part �taIIations
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. U V I
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2000003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:25:38
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Quinta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code: 92253
A. System Information
01
Space Conditioning System Identification or Name
System 3
02
Space Conditioning System Location or Area Served
Location
03
Building Type from CF -1R
Single family
04
Verified Low Leakage Ducts in Conditioned Space
No, credit is not taken
05
(VLLDCS) Credit from CF1R?
Total leakage
05
Verified Low Leakage'Air Handling Unit (VLLAHU) Credit
Yes credit is taken
07
from CF1R?
Cooling system method
06
Duct System Compliance Category - --- _
rs_ -
New
, i
MCH -20c - Low Leakage Ai Haling Urnt(LLAHU
01
IL
, �-.,
I i
raj)
B. Duct Leakage Diagnostic Test HRS P R 0 V-1 E
Registration
01
Condenser Nominal Cooling Capacity (ton)
3
02
Heating Capacity (kBtu/h)
64
03
Conditioned Floor Area served by this HVAC system (ft2)
808
04
Duct Leakage Test Condition
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
6.0
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Cooling system method
08
Measured AHUAirflow
This field or section is not applicable
09
Calculated Target Allowable Duct Leakage (cfm)
72
10
Actual duct leakage rate from leakage test measurement
(cfm)
68
11
Air Handling Unit Manufacturer Name
rk
[To-
12
Air Handling Unit Model Number
MLX080C16
Number: 216-N0127396A-M2000004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:27:04
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
B. Duct Leakage Diagnostic Test
13 Compliance Statement System passes leakage test
C. Additional Requirements for Compliance
The Low Leakage Air -handling Unit Model identified on this compliance document is included in the list of certified Low
Leakage Air -Handling Units published on the Energy Commission Website at:
01
http://www.enerpv.ca.pov/title24/2008standards/special case appliance/supplemental listings/Low Leakage Air -
Handling Unit Listing 2012-10-30.pdf
02
System was tested in its normal operation condition. No temporary taping allowed.
Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage
testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation
03
Cooling Systems, that utilize dampers that open only when CIA is required and automatically close when OA is not required,
may configure the OA damper to the closed position during duct leakage testing.
04
All supply and return register boots were sealed to the drywall.
05
Building cavities were not used as plenums or platform returns in lieu of ducts:, 1
06
If cloth backed tape was used it was covered with Mastic and draw bands.
07
All connection points betwen the air handler and the -supply and return -plenums are completely sealed.
Z fl-�l Ir' I'ti % L- t-'4, � !) 44 L. iI y L"'
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.
Registration Number: 216-N0127396A-M2000004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:27:04
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: /j
� G�B1
Jack B LaFontaine
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
RO8-03-234
City/State/Zip:
Phone:
1760-360-4631
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided'on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer. -
3. The constructed -or installed features, materials, componenis�or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations, -and the installation conforms to.the requirements given on -the plans and. specifications approved by
the enforcement agency. [ '-'� "�
4. 1 understand that a HERS rater will check the installation to'verify'c4m Nance, and that if such checki Ong identifies defects; I am required to take
un derstand' Energy HERS Provider
corrective action at my expennsA,} what Commission and represen `atives will also perform quality assurance checking
of installations, including those,approved as part`of a -sample group but not'checke l'by"a-HERS rater, and if,`those installations fail to meet the;�r 4
requirementsof such quality assurance checking, the required corrective -action and -additional checking/testing, f -other installations in that -HERS
sample group will be performed at my�expense.
P 1 u
..
S. I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2000004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:27:04
2013 Residential Compliance Schema Version: 2013.1.007
EMS SEPARATOR -PAGE
0
CERTIFICATE OF INSTALLATION
CF2R-MCH-21-H
Duct Location
(Page 1 of 2 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Quinta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
A. General Information
Note: Submit one Installation Certificate for each duct system that is taking credit for duct location.
01
Space Conditioning (SC) System Identification or Name
System 1
02
SC System Location or Area Served
Location
03
Status - Less than 12 ft Ducts in Conditioned Space
Not applicable
Performance Credit:
04
Status - Ducts Located In Conditioned Space Performance
True
Credit:
Status :;,All, Ducts Entirely Directly, Conditioned Space
Not Applicable
OS
R -value Exception
B. 12 Linear Feet or Less of_Supply Duct Located Outside of Conditioned Space-"RA3.1:4.1.2
1 r - "0' Fr- j i( Ki" I li xi ii )t ,.s
r� This section,does-not apply to this -project.
C. Ducts Located In Conditioned Space - RA3.1.4.1.3
01 A visual inspection shall confirm the space conditioning system is located entirely in conditioned space.
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.
D. All Ducts Located Entirely in Directly Conditioned Space R -Value Exception - RA3.1.4.3.8
This section does not apply to this project.
Registration Number: 216-N0127396A-M2100002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:28:22
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-21-H
Duct Location (Page 2 of 2 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
L�t9J
Jack B LaFontaine
Company:
signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
I R08-03-234
City/State/Zip:
I Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by
the enforcement agency. i�
r
4. I understand that a HERS rater will check the installation to verify, compliance, and that if such checking identifies defects; I am required to take'
corrective action at my expensed 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 bu't not checked by a HERS rater, and if those installations fail to meet the 5
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.S
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title): IV
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2100002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:28:22
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION
CF2R-MCH-21-H
Duct Location
(Page 1 of 2 )
Project Name: Miller, William Revised
Enforcement Agency:
Quinta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. General Information
Note: Submit one Installation Certificate for each duct system that is taking credit for duct location.
01
Space Conditioning (SC) System Identification or Name
System 2
02
SC System Location or Area Served
Location
03
Status - Less than 12 ft Ducts in Conditioned Space
Not applicable
`N' iI tI. 7
Performance Credit:
Status - Ducts Located in'Conditioned Space Performance
True
04
Credit:
Status �AII Ducts Entirely in Directly Conditioned Space
Not Applicable
05
R -value Exception
C. Ducts Located In Conditioned Space - RA3.1.4.1.3
01 A visual inspection shall confirm the space conditioning system is located entirely in conditioned space.
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.
D. All Ducts Located Entirely in Directly Conditioned Space R -Value Exception - RA3.1.4.3.8
This section does not apply to this project.
Registration Number: 216-N0127396A-M2100003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:29:16
2013 Residential Compliance Schema Version: 2013.1.007
B. 12 Linear Feet or. Less
of Supply Duct Located Outside of Conditioned Space-:RA3.1.4.1.2
J /
1Y#I
`N' iI tI. 7
This section-does:not apply to this;project.
C. Ducts Located In Conditioned Space - RA3.1.4.1.3
01 A visual inspection shall confirm the space conditioning system is located entirely in conditioned space.
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.
D. All Ducts Located Entirely in Directly Conditioned Space R -Value Exception - RA3.1.4.3.8
This section does not apply to this project.
Registration Number: 216-N0127396A-M2100003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:29:16
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-21-H
Duct Location (Page 2 of 2 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: /j
Jack B LaFontaine
W L1�G1
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
I R08-03-234
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
1760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by
the enforcement agency.
4. 1 understand that a HERS rater will check the installation to verify compliance, and that if such checking identifies defects; I am required to take
corrective action at my expensed understand that Energy Commission and HERS Provic of representatives will also perform quality assurance checking
of installations, including those approved as part of a sample group but not checked by 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 i ;, ` j L
`:tea
v
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2100003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:29:16
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION
CF2R-MCH-21-H
Duct Location
(Page 1 of 2 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Qu i nta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
A. General Information
Note: Submit one Installation Certificate for each duct system that is taking credit for duct location.
01
Space Conditioning (SC) System Identification or Name
System 3
02
SC System Location or Area Served
Location
03
Status - Less than 12 ft Ducts in Conditioned Space
Not applicable
Performance Credit:
Status - Ducts Located I Conditioned Space Performance
True
04
Credit:
Status ; All Ducts Entirely�in� Directly Conditioned Space
Not Applicable
05
R -value Exception
rA
B. 12 Linear Feet or�Less of.Supply Duct Located,Outside,of Conditioned Space-RA3.1:4:1.2
This.section does,not apply to this -project. {�
.a 1 ' , I 0
C. Ducts Located In Conditioned Space - RA3.1.4.1.3
01 A visual inspection shall confirm the space conditioning system is located entirely in conditioned space.
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.
D. All Ducts Located Entirely in Directly Conditioned Space R -Value Exception - RA3.1.4.3.8
This section does not apply to this project.
Registration Number: 216-N0127396A-M2100004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:30:05
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-21-H
Duct Location (Page 2 of 2 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: /j W
Jack B LaFontaine
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
1760-360-4631
Phone:
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Instaliation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
confo-ms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by
the enforcement agency.
4. 1 understand that a HERS rater will check the installation to verify compliance, and that if such checking identifies defects; I am required to take
corrective action at my expensed 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 meei 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 A my expense.y �J ` J -
S. I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2100004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:30:05
2013 Residential Compliance Schema Version: 2013.1.007
EMS SEPARATOR PAGE
CERTIFICATE OF INSTALLATION
, CF2R-MCH-22-H
Space Conditioning System Fan Efficacy
(Pagel of 3 )
Project Name: Miller, William Revised
- -
Enforcement Agency:
Quinta
City of La
Permit Number: Y'BRES-2014-1152
Dwelling Address: • • 49-020 Avenida Fernando
City:
La'Quinta
Zip Code: 92253
A. Ducted Cooling System Information y
01
System Identification or Name •
System 1
02
System Location or Area Served
r
Location ,
03
System Installation Type
New
04
Nominal Cooling Capacity (tons) of Condenser
5
05
Condenser Speed Typef � -
Single Speed -
06
Cooling System Zonal"eontrol Type
Not Zonal
07
Central•Fann Integrated (CFI) Ventilation System Status—
Not a CFI system
08
System Bypass Duct StatusNo
Bypass Duct
09
Date of System Airflow Rate Measurement
�•
2016-03-31
J7i.l'
� j � 1 t r....
xs
0,
10
Airflow Rate Protocol utilized - �C.RA3.3
p Deed es fo a0irflo'.ca rate#measuremg�E
B. Fan Watt Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1, and system fan watt measurement apparatus information is given in
RA3.3.2.2.
7
01 1 Fan Watt Verification Device Used. 3 Portable watt meter
MCH 22a Forced Air System Fan Efficacy Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor ;
C. Forced Air System Fan Efficacy Measurement
The procedures for System Fan Watt Verification are specified in Reference Residential Appendix RA3.3
01
Actual Tested Watts
587
02
Actual Tested Airflow from MCH -23 (cfm) �-
1950
03
Required Fan Efficacy (watts/cfm)
0.58 ,
04
Actual Fan Efficacy (watts/cfm) '
0.3
05
Compliance Statement: -
System fan efficacy complies
Registration Number: 216-N0127396A-M2200002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 - Report Generated: 2016-04-06 14:41:36
2013 Residential Compliance -Schema Version: 0.52SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-22-H
Space Conditioning System Fan Efficacy (Page 2 of 3 )
D. Additional Requirements
01
All registers were fully open during the diagnostic test.
02
System fan was set at maximum speed during the diagnostic test.
03
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
04
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
O5
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
06
Zoned cooling air distribution systems with single speed compressors shall meet both the airflow (cfm/ton) and fan efficacy
(Watt/cfm) criteria in every zonal control mode.
The responsible person's signature on this compliance document affirms that all applicable requirements in this table have
been met.
Registration Number: 216-N0127396A-M2200002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:41:36
2013 Residential Compliance Schema Version: 0.525DD
CERTIFICATE OF INSTALLATION CF2R-MCH-22-H
Space Conditioning System Fan Efficacy (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature �es pT 1 ,
Jack B LaFontaine
�/
G�!
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
1760-360-4631
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer. — -
3. The constructed or installed features, materials; components or•manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and re'gulatiori ,.and the installat4ion/c'`onforms.to.the requirements.given plans and, specifications approved by
�o`n_the,
the enforcement agency. -' I� �"'�"� t / e" ° t "'.i �""� necking
�"- �" I/'`i4. 1 understand that aHERS rater will check the installationt-dverifycompliance,
that if identifies defects; I to take
and such•cam regwred
i ..-. r g e. t r—O'. W'. '�.. � z i �:' .- o #i
corrective action at rn expense. I understand' that Energy Commission and HERS Provider representatives will also perform quality assurance checking
nim .ec R '' si 1 'st ` 7 Y t Nh
of installations, including Eh so e,approved as part of a sample group but not checked by a�HERS.rater, and ifthose installations fail.to meet theme
requirements of such quality assurance checking, the required corrective,action and additional checking/testing,of-other installations -in that.HERS
1
sample group will be performed at my,expense. "'� 1.
P .
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky�
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2200002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:41:36
2013 Residential Compliance Schema Version: 0.52SDD
CERTIFICATE OF INSTALLATION
CF2R-MCH-22-H
Space Conditioning System Fan Efficacy
(Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency:
Qu i nta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. Ducted Cooling System Information
01
System Identification or Name
System 2
02
System Location or Area Served
Location
03
System Installation Type
New
04
Nominal Cooling Capacity (tons) of Condenser
4
05
Condenser Speed Type'
Single Speed
06
Cooling System Zonal Control Type
Not Zonal
07
Central Fan Integrated (CFI) Ventilation System Status
Not a CFI system
08
System Bypass Duct Status
No y6 passs Duct;��
09
Date of System Airflow Rate Measurement (E ,J (
`�
H �
2016-03-31
t.t
n U U U Q
10
Airflow Rate Protocol utilized H R
*RA3.3 4 o ed0 es fo irflo "�atemeas�" "ureme''�nt
B. Fan Watt Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1, and system fan watt measurement apparatus information is given in
RA3.3.2.2.
01 1 Fan Watt Verification Device Used. Portable watt meter
MCH -22a Forced Air System Fan Efficacy Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor
C. Forced Air System Fan Efficacy Measurement
The procedures for System Fan Watt Verification are specified in Reference Residential Appendix RA3.3
01
Actual Tested Watts
496
02
Actual Tested Airflow from MCH -23 (cfm)
1644
03
Required Fan Efficacy (watts/cfm)
0.58
04
-
Actual Fan Efficacy (watts/cfm)
0.3
Fo 5
Compliance Statement:
System fan efficacy complies
Registration Number: 216-N0127396A-M2200003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:43:11
2013 Residential Compliance Schema Version: 0.52SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-22-H
Space Conditioning System Fan Efficacy (Page 2 of 3 )
D. Additional Requirements
O1
All registers were fully open during the diagnostic test.
02
System fan was set at maximum speed during the diagnostic test.
03
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
04
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
OS
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
06
Zoned cooling air distribution systems with single speed compressors shall meet both the airflow (cfm/ton) and fan efficacy
(Watt/cfm) criteria in every zonal control mode.
The responsible person's signature on this compliance document affirms that all applicable requirements in this table have
been met.
Registration Number: 216-N0127396A-M2200003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:43:11
2013 Residential Compliance Schema Version: 0.52SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-22-H
Space Conditioning System Fan Efficacy (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: /J 0Es pT i ,
Jack B LaFontaine
O�'/ GF>��l�J
��
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
1760-360-4631
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulation�s�,.�a�-n-d.r the installation to.the requirements given on the plans and,specifications approved by
c/conforms
�"``�%�-'�' '�
the enforcement agency. ! t if
►r°„„'�4. 1 understand that a HERS rater will check the mstallationtoverify compliance, end that such -checking identifies defects; I am required to take
corrective action at my expensed understand`that Energy Commission and HERS Provider representatives will also perform quality assurance checking
� th
of installations, including o..sea'ppiras part;ofa-sYa.mple.Y gro up b:ut.not;checked_by,ia;i HEReS,rrater', and iftho.se installationsfa# il .to meeteme 0
ioved
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. >
S. I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrenskyy�p�
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2200003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:43:11
2013 Residential Compliance Schema Version: 0.52SDD
1
CERTIFICATE OF INSTALLATION
CF2R-MCH-22-H j
Space Conditioning System Fan Efficacy
•' - _ (Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency:
City of La
Permit Number: BRES-2014-1152
System 3 ,.
Quinta
02
System -Location or Area Served
Dwelling Address: 49-020 Avenida Fernando
City: •
La Quinta,
Zip Code: 92253
A. Ducted Cooling System Information
01 •
Actual Tested Watts
_
01
System Identification or Name
1182' :.
03
System 3 ,.
• '
02
System -Location or Area Served
0.3
05
Location -
System fan efficacy complies
03
System Installation Type
New
t'
04
Nominal Cooling Capacity (tons) of Condenser
3
;
05
Condenser Speed.Type
r
Single Speed -'
.•
06
Cooling System Zonal Control Type
Not Zonal
07
Central Fan Integrated (CFI) Venti`l5t��io System Status-
Not a CFI system
08
System Bypass Duct Status
�r"""
"" las
ZNorr fBypass Duct
09
Date of SystemAirflRate Measurement
�r s
I 'N. _%."ki
�.=
2016 03-3I
+ r~=x it 170 0
10 1 .1Airflow
Rate Protocol utilized
► 4'RA3.3
proced es fo� irflow rate�meas" urem t
3
B. Fan Watt Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1, and system fan watt measurement apparatus information is given in -
RA3.3.2.2.
O1 Fan Watt Verification Device Used.Port able watt meter
MCH -22a Forced Air System Fan Efficacy Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor '
1
C. Forced Air System Fan Efficacy Measurement
The procedures for System Fan Watt Verification are specified in Reference Residential Appendix RA3.3
01 •
Actual Tested Watts
357
02
Actual Tested Airflow from MCH -23 (cfm)
1182' :.
03
Required Fan Efficacy (watts/cfm)
0.58 '
04
Actual Fan Efficacy (watts/cfm)
0.3
05
Compliance Statement:
System fan efficacy complies
Registration Number: 216-1\10127396A-M2200004A-0000
CA Building Energy Efficiency Standards
2013 Residential Compliance ,
Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:44:17
Schema Version: 0.52SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-22-H
Space Conditioning System Fan Efficacy (Page 2 of 3 )
D. Additional Requirements
01
All registers were fully open during the diagnostic test.
02
System fan was set at maximum speed during the diagnostic test.
03
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
04
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
O5
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
06
Zoned cooling air distribution systems with single speed compressors shall meet both the airflow (cfm/ton) and fan efficacy
(Watt/cfm) criteria in every zonal control mode.
The responsible person's signature on this compliance document affirms that all applicable requirements in this table have
been met.
Registration Number: 216-N0127396A-M2200004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:44:17
2013 Residential Compliance Schema Version: 0.52SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-22-H
Space Conditioning System Fan Efficacy (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature��Cs
Jack B LaFontaine
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
1760-360-4631
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations, -and the installation conforms to the requirements given on,the plans and specifications approved by
the enforcement agency. "�'
4. 1 understand that iHERS rater will.check the installation to'verify'com`pliance, and that if such checking identifies defects; I,am requved to t
a, st Art
corrective action at expense Energy Commissio HERS Provide} fives
my understand' mat +and will also perform quality assurance checking
represents}as
of installations, including thoseapproved alsamplegroup but -checked -by if thdse installations fallto meet theme 0
as part,of -not, a;HERS,rater,.and
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 m�Lexpense.H
S. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2200004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:44:17
2013 Residential Compliance Schema Version: 0.52SDD
CERTIFICATE OF INSTALLATION
CF2R-MCH-23-H
Space Conditioning System Airflow Rate
(Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Quinta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
A. Ducted Cooling System Information
01
System Identification or Name
System 1
02
System Location or Area Served
Location
03
System Installation Type
New
04
Nominal Cooling Capacity (tons) of Condenser
5
05
Condenser Speed Type' '�
r
Single Speed
06
Cooling System Zonal Control Type
a
Not Zonal
07
Central Fan Integrated (CFI) Ventilat�'n System Status-
Not a CFI system
08
System Bypass Duct Status </
No Bypass uct!
09
R � � � x
Date of System Airflowr ea
Rate Msuremtent_
2016-03-31
10
Airflow Rate Protocol utilized
H R
'RA3.3 ' ed es for airflow ate"meaasurement
a �► w..
B. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP)
in the supply plenum.
Procedures for installing HSPP or PSPP are specified in RA3.3.1.1.
101 I Method used to demonstrate compliance with theI HSPP installed and labeled consistent with Figure RA3.3-1 I
HSPP/PSPP requirement
C. Airflow Rate Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1.1, and system airflow rate measurement apparatus information is given
in RA3.3.2.
01
Airflow Rate Measurement Type used for this airflow rate
Flow Grid according to procedure in RA3.3.3.1.2
verification.
02
Manufacturer of Airflow Measurement Apparatus
TEC
03
Model number of Airflow Measurement Apparatus
TruFlow
Certification Status of the Airflow Measurement Apparatus
Certified by Manufacturer and listed on CEC Website at
04
Accuracy
http://www.energy.ca.gov/title24/equipment_cert/ama_fas
/index.html
Registration Number: 216-N0127396A-M2300002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:34:29
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-23-H
Space Conditioning System Airflow Rate (Page 2 of 3 )
MCH -23a Forced Air System Airflow Rate Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor
D. Forced Air System Airflow Rate Measurement
The procedures for System Airflow Rate Verification are specified in Reference Residential Appendix RA3.3.
01
Required Minimum System Airflow Rate (cfm/ton)
350
02
Required Minimum System Airflow Target (cfm)
1750
03
Actual System Airflow Rate Measurement (cfm)
1950
04
Compliance Statement:
System airflow rate complies
E. Additional Requirements
01
Air filters that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in
the system during system air flow rate measurement identified on this Certificate of Installation.
rI f,
The airflow rate measurement apparatus used to perform the airflow.rate measurement identified on this Certificate of
02
Installation was calib�at cl in accordance with the apparatus manufacturer's'specifications'and conforms to the' f
instrumentation specifications given in RA3:3-1`�-� �t--"_=- U 0 L C�_ ��� � =j L � �� 0
A visual inspection shall confirm that bypass ducts that deliver conditioned supply air directly to the space conditioning
03
system return duct airflow are not used on newly constructed zonally controlled systems unless the Performance Certificate
of Compliance indicates an allowance for use of a bypass duct. When a bypass duct is accounted for on the Performance
Certificate of Compliance, the airflow rate shall conform to the specifications listed on the Certificate of Compliance.
04
All registers were fully open during the diagnostic test.
05
System fan was set at maximum speed during the diagnostic test.
06
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
07
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
08
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
The responsible person's signature on this compliance document affirms that all applicable requirements in this table have
been met.
Registration Number: 216-N0127396A-M2300002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:34:29
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-23-H
Space Conditioning System Airflow Rate (Page 3 of 3 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: /j �Cr pT�
L�1�1
Jack B LaFontaine
Oma/
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
1760-360-4631
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
r
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer. `- --
3. The constructed or installed features, materials, components o`r manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations,.and the installation conforms.to:the requirements.given on.the plans and specifications approved by
the enforcement agency. `' ""� �''
7
4. 1 understand that a HERS rater will check the installation to'verify compliance, andthat if'such,checking identifies defects; I,am regwred to take
corrective action at my`expense),I understanSthat Energy Commission and HERS Provider representatives will also perform quality assurance checking
of installations, including those•app ved as part ;of a;sample group but checked;by a,HERS.rater,.and if.those installations fail.to meet theme 0
_not
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 rrM expense. I LF
S. I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2300002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:34:29
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF INSTALLATION
CF2R-MCH-23-H
Space Conditioning System Airflow Rate
(Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency:
Quinta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. Ducted Cooling System Information
01
System Identification or Name
System 2
02
System Location or Area Served
Location
03
System Installation Type
New
04
Nominal Cooling Capacity (tons) of Condenser
4
05
Condenser Speed Type
Single Speed
06
Cooling System Zonal Control Type
Not Zonal
07
Central'Fan Integrated (CFI) Ventilation System Status- •
Not a CFI system
08
System Bypass Duct StatusNo /
Bypass uct
09
Date of System Airflow Rate Measurement
lS, _
�, �
, 2016-03-31t.- ,J,i
17
0
10
Airflow Rate Protocol utilize <'RA3.3
proced es fo� irflo�rate meassuureme t
B. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP)
in the supply plenum.
Procedures for installing HSPP or PSPP are specified in RA3.3.1.1.
101I Method used to demonstrate compliance with the I HSPP installed and labeled consistent with Figure RA3.3-1
HSPP/PSPP requirement
C. Airflow Rate Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1.1, and system airflow rate measurement apparatus information is given
in RA3.3.2.
01
Airflow Rate Measurement Type used for this airflow rate
Flow Grid according to procedure in RA3.3.3.1.2
verification.
02
Manufacturer of Airflow Measurement Apparatus
TEC
03
Model number of Airflow Measurement Apparatus
Tru -Flo
Certification Status of the Airflow Measurement Apparatus
Certified by Manufacturer and listed on CEC Website at
04
Accuracy
http://www.energy.ca.gov/title24/equipment_cert/ama_fas
/index.html
Registration Number: 216-N0127396A-M2300003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:37:14
2013 Residential Compliance Schema Version: 0.5555DD
CERTIFICATE OF INSTALLATION CF2R-MCH-23-H
Space Conditioning System Airflow Rate (Page 2 of 3 )
MCH -23a Forced Air System Airflow Rate Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor
D. Forced Air System Airflow Rate Measurement
The procedures for System Airflow Rate Verification are specified in Reference Residential Appendix RA3.3.
01
Required Minimum System Airflow Rate (cfm/ton)
350
02
Required Minimum System Airflow Target (cfm)
1400
03
Actual System Airflow Rate Measurement (cfm)
1644
04
Compliance Statement:
System airflow rate complies
E. Additional Requirements
Air filters that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in
01
the system during system air flow rate measurement identified on this Certificate of Installation.
The airflow rate measurement apparatus used too perform the airflow rate measurement identified on this Certificate of
02
Installation was calibrated in accordance with tKe- apparatus manufacturer's specifications and conforms to the
instrumentation specifications given in RA3.3c1�- -71 U LJ
A visual inspection shall confirm that bypessducts that deliver conditioned supply air directly to the space conditioning
03
system return duct airflow are not used on newly constructed zonally controlled systems unless the Performance Certificate
of Compliance indicates an allowance for use of a bypass duct. When a bypass duct is accounted for on the Performance
Certificate of Compliance, the airflow rate shall conform to the specifications listed on the Certificate of Compliance.
04
All registers were fully open during the diagnostic test.
05
System fan was set at maximum speed during the diagnostic test.
06
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
07
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
08
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
The responsible person's signature on this compliance document affirms that all applicable requirements in this table have
been met.
Registration Number: 216-N0127396A-M2300003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:37:14
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-23-H
Space Conditioning System Airflow Rate (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Signature:
Documentation Author Signature: /j�es
Jack B LaFontaine
Company:
signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
RO8-03-234
City/State/Zip:
Phone:
1760-360-4631
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials; components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations, -and the installation too.the, requirements given on.the , plans and, specifications approved by
the enforcement agency. J� - '-' r 4 /conforms
S "— j ` )) "I r'""'��'-` F 11 — "�
/
4. I understand that a HERS rater will check the installation towerify'compliance, and that if such checking identifies defects; I am reQuired to take
corrective action at my expensA understaridtthat Energ Commission HERS Provide also quality
and representatives will perform assurance checking
of installations, including those approved as pact;of.a-sample.group but notrchecked;by;a;HERS,rater, and ifthose installations faibto meet theme (�
requirements of such quality assurance checking, the required corrective action and additional checking/testing installations.in that.HERS
,ofother
sample group will be performed at my, expense. k--> I U
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-NO127396A-M2300003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:37:14
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF INSTALLATION
CF2R-MCH-23-H
Space Conditioning System Airflow Rate
(Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency:
Qu i nta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. Ducted Cooling System Information
01
System Identification or Name
System 3
02
System Location or Area Served
Location
03
System Installation Type
New
04
Nominal Cooling Capacity (tons) of Condenser
3
0S
Condenser Speed Type
Single Speed
06
Cooling System Zonal Control Type
r 1 1
Not Zonal
07
Central`Fan Integrated (CFI) Ventilation. System Status"
Not a CFI system
08
System Bypass Duct Status-��,.��
Nop s� D ,��
09
Date of System Airflow Rate Measurement
2016-03-31
10
Airflow Rate Protocol utilized'�A H E R �)�RA3.3
proced ru eO'ss for airflow ratemeasurerrient
B. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP)
in the supply plenum.
Procedures for installing HSPP or PSPP are specified in RA3.3.1.1.
Method used to demonstrate compliance with the HSPP installed and labeled consistent with Figure RA3.3-1
01 HSPP/PSPP requirement
C. Airflow Rate Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1.1, and system airflow rate measurement apparatus information is given
in RA3.3.2.
01
Airflow Rate Measurement Type used for this airflow rate
Flow Grid according to procedure in RA3.3.3.1.2
verification.
02
Manufacturer of Airflow Measurement Apparatus
TEC
03
Model number of Airflow Measurement Apparatus
Tru -Flo
Certification Status of the Airflow Measurement Apparatus
Certified by Manufacturer and listed on CEC Website at
04
Accuracy
http://www.energy.ca.gov/title24/equipment_cert/ama_fas
/index.html
Registration Number: 216-N0127396A-M2300004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:39:34
2013 Residential Compliance Schema Version: 0.5555DD
CERTIFICATE OF INSTALLATION CF2R-MCH-23-H
Space Conditioning System Airflow Rate (Page 2 of 3 )
MCH -23a Forced Air System Airflow Rate Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor
D. Forced Air System Airflow Rate Measurement
The procedures for System Airflow Rate Verification are specified in Reference Residential Appendix RA3.3.
01
Required Minimum System Airflow Rate (cfm/ton)
350
02
Required Minimum System Airflow Target (cfm)
1050
03
Actual System Airflow Rate Measurement (cfm)
1182
04
Compliance Statement:
System airflow rate complies
E. Additional Requirements
Air filters that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in
01
the system during system air flow rate measurement identified on this Certificate of Installation.
The airflow rate measurement apparatus used to perform the airflow rate measurement identified on thisCertificate of
02
c % i — �- , r
Installation was calibrated` accordance` with the apparatus manufacturer's specifications and conforms to the
instrumentation specifications given in RA3.31�`�
A visual inspection shall confirm that bypass ducts that ^deliver conditioned supply air directly to the space conditioning
system return duct airflow are not used on newly constructed zonally controlled systems unless the Performance Certificate
03
of Compliance indicates an allowance for use of a bypass duct. When a bypass duct is accounted for on the Performance
Certificate of Compliance, the airflow rate shall conform to the specifications listed on the Certificate of Compliance.
04
All registers were fully open during the diagnostic test.
05
System fan was set at maximum speed during the diagnostic test.
06
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
07
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
08
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
The responsible person's signature on this compliance document affirms that all applicable requirements in this table have
been met.
Registration Number: 216-N0127396A-M2300004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS '
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:39:34
2013 Residential Compliance Schema Version: 0.555SDD '
CERTIFICATE OF INSTALLATION CF2R-MCH-23-H
Space Conditioning System Airflow Rate (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: /i �CrLF>�1LP/
Jack B LaFontaine
Oma/
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
1760-360-4631
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials; components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations,_and the installation conforms.to the requirements given on,the,plans and specifications approved by
the enforcement agency. /V
4. I that HERS rater if "such identifies defects; I
understand a will check the installation to verify compliance, and that -checking am required to take
at
corrective action rn expensA understand't�hat Energy Commission and HERS Providef 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 ifsthose in � allations fail to meet tFie_,$. 0
requirements of such quality assurance checking, the required corrective, action and additional checking/testing.of-other installations.in that HERS
will be at
IV
sample group performed my�expense.� t:U I U YF...
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2300004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:39:34
2013 Residential Compliance Schema Version: 0.555SDD
EMS SEPARATOR PAGE
CERTIFICATE OF INSTALLATION
CF2R-MCH-25-H
Refrigerant Charge Verification
(Page 1 of 4 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Qu i nta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
A. System Information
Each system requiring refrigerant charge verification will be documented on a separate certificate.
01
System Identification or Name
System 1
02
System Location or Area Served
Location
03
Condenser (or package unit) Make or Brand
York
04
Condenser (or package unit) Model Number
YCS60B21
05
Nominal Cooling Capacity (tons) of Condenser
5
06
Condenser .(or .package unit) Serial Number
WiG5878522
07
Refrigerant Type,,,
08
Other Refrigerant Type (if applicable)
# � N1
If"A 11
'# 111
n)
R
F
I #
09
System Installation Type '��'
New
t _.1 9'**0 � t
w Y—* " NL If I R-11* #I -" M
Charge Indicator Display (CID) Status (Note: Even systems
This system does not have a CID device installed
10
with a CID must have refrigerant charge verified by installer).
Is the system of a type that the minimum airflow can be
Yes, this is a ducted system and one of the system airflow
11
verified using an approved measurement procedure (RA3.3
rate measurement procedures in RAU or RA3.2.2.7 can be
or RA3.2.2.7)?
used to verify system airflow rate requirements.
Is the system of a type that approved refrigerant charge
Yes, one of the Refrigerant charge verification procedures
verification procedures can be used to verify compliance
from RA3.2.2 or RAI is applicable to this system and can be
12
with the refrigerant charge verification requirements when
used to verify compliance
temperatures are greater than or equal to 55F (RA3.2.2, or
RAI)?
13
Date of Refrigerant Charge Verification for this system
2016-03-31
14
Refrigerant charge verification method used.
Subcooling (outdoor temperature must be equal to or
greater than 55 degF)
15
Person who performed the Refrigerant Charge Verification
HVAC system installer
reported on this Certificate of Installation
16
HERS Verification Compliance Requirement Status
System qualifies for group sampling
MCH -25b - Refrigerant Charge Verification - Subcooling Method
Registration Number: 216-N0127396A-M2500002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:52:13
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H
Refrigerant Charge Verification (Page 2 of 4 )
B. Metering Device Verification
Subcooling Method can only be used on systems that have a variable metering device.
01
Refrigerant metering device
Thermostatic Expansion Valve (TXV)
02
Subcooling Method applicability status
Subcooling Method is applicable to this system.
C. Instrument Calibration
Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2
01
Date of Digital Refrigerant Gauge Calibration
2016-03-28
02
Date of Digital Thermocouple Calibration
2016-03-28
03
Digital Refrigerant Gauge Calibration Status
Calibration is current
04
Digital Thermocouple Calibration Status
Calibration is current
D. Measurement Access Hole (MAH) Verification
Procedures for installing MAH are specified in Reference Resid nene tial Appendix RA3:2:2:3--
Method used to demonstrate compliance with'thei ' I MAH installed and labeled consistent with Figure 3.2_1
01 -- --y � t f _� �__'_; t� " i._, k-: a i.
Measurement Access Hole (MAH) requirement 1;
I r n rr-, R . "-% rrt, A,%, A n
E. Minimum System Airflow Rate Verification
Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.2.2.7.
01
Minimum Required System Airflow Rate (cfm)
1750
02
System Airflow Rate Verification Status
System complies with minimum airflow rate requirements
F. Data Collection and Calculations
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2.
01
Lowest return air dry bulb temperature that occurred during
72
the refrigerant charge verification procedure (degreeF)
02
Measured Condenser air entering dry-bulb temperature (T
81
condenser, db)
03
Outdoor Temperature Qualification Status
Outdoor temperature is within range for using Subcooling
refrigerant charge verification method
04
Measured Liquid Line Temperature (Thquid) (degreeF)
88
05
Measured Liquid Line Pressure (Pliquid) (pisg)
306
Registration Number: 216-N0127396A-M2500002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:52:13
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H
Refrigerant Charge Verification (Page 3 of 4 )
F. Data Collection and Calculations
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2.
06
Condenser saturation temperature (Tcondensor, sat) from digital
97.3
Measured Suctionline pressure (Ps? -ion) (pP g)
gauge or P -T Table using Line F05 (degree F)
07
Measured Subcooling
9.3
08
Target Subcooling 71-o
26!6,'
09
Compliance Statement: System complies with Subcooling Method - Must also pass metering device verification, next
section
G. Metering Device Verification
Procedures for the verification of proper metering device operation are specified in RA3.2.2.6.2
01
Measured Suction line temperature (Tsuction) (degreeF)
50.6
02
Measured Suctionline pressure (Ps? -ion) (pP g)
145
03
Evaporator saturatio n.temperature (Tev porator, satT:f m
26!6,'
digital gauge or P -T -Table using line G02}(degreeF
_
04
Measured Superheat ER� �i
X24 .,rV ROV"'E
05
Measured Superheat is between 4 and 25 deg F (inclusive)
Passes CEC requirement
06
Measured Superheat is within manufacturer's specifications,
Not known
if known
L07
Compliance Statement: Metering device verification passes
Verification of Charge Indicator Display - CF2R-MCH-25d - CID
H. Charge Indicator Display
Procedures for the Charge Indicator Display Verification are detailed in RA3.4.2
This section does not apply to this project.
I. Charge Indicator Display - Additional Requirements
This section does not apply to this project.
Registration Number: 216-N0127396A-M2500002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:52:13
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H
Refrigerant Charge Verification (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: a (,
0d x1
Jack B LaFontaine
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
:1
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
1760-360-4631
Responsible Person's Declaration statement
1 certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Instailation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by
the enforcement agency.—'J ; I /,,-'[ �� 4 / I
4. 1 understand that a HERS rater will check the installation�to verify compliance, and that if such checking identifies defects; I am required to take
corrective action at my expensed understand that Energy Commission and HERS Provider representatives will also perform quality assurance checking
of installations, including those approved as part of a samole'group 6u't not checked by a HERS'rater, and if.those installations fail to meet the:l /,)
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'~
S. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrenskye
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2500002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:52:13
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION
CF2R-MCH-25-H
Refrigerant Charge Verification
(Page 1 of 4 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Quinta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
A. System Information
Each system requiring refrigerant charge verification will be documented on a separate certificate.
01
System Identification or Name
System 2
02
System Location or Area Served
Location
03
Condenser (or package unit) Make or Brand
York
04
Condenser (or package unit) Model Number
YCS481321S
r
05
Nominal Cooling Capacity (tons) of Condenser
4
06
Condenser -(or package unit) Serial Number
W1A6267053
07
Refrigerant Type"� `�
R -410A
08
Other Refrigerant Type (if appitcable)
11 1((
1
,
09
l .' 'w......+r 1...F1�[ sF �
System Installation Type '�"
v.�* � u, yM M �a�-*� # �' M M
New 3f
`tet, K � !�.. � � �.
Charge Indicator Display (CID) Status (Note: Even systems
� t s 'R 'w.,+►' 'a/' �+ +�«` �.. � �►
This system does not have a CID device installed
10
with a CID must have refrigerant charge verified by installer).
Is the system of a type that the minimum airflow can be
Yes, this is a ducted system and one of the system airflow
11
verified using an approved measurement procedure (RA3.3
rate measurement procedures in RA3.3 or RA3.2.2.7 can be
or RA3.2.2.7)?
used to verify system airflow rate requirements.
Is the system of a type that approved refrigerant charge
Yes, one of the Refrigerant charge verification procedures
verification procedures can be used to verify compliance
from RA3.2.2 or RA1 is applicable to this system and can be
12
with the refrigerant charge verification requirements when
used to verify compliance
temperatures are greater than or equal to 55F (RA3.2.2, or
RA1)?
13
Date of Refrigerant Charge Verification for this system
2016-03-31
14
Refrigerant charge verification method used.
Subcooling (outdoor temperature must be equal to or
greater than 55 degF)
15
Person who performed the Refrigerant Charge Verification
HVAC system installer
reported on this Certificate of Installation
16
HERS Verification Compliance Requirement Status
System qualifies for group sampling
MCH -25b - Refrigerant Charge Verification - Subcooling Method
Registration Number: 216-N0127396A-M2500003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:59:50
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H
Refrigerant Charge Verification (Page 2 of 4 )
B. Metering Device Verification
Subcooling Method can only be used on systems that have a variable metering device.
01
Refrigerant metering device
Thermostatic Expansion Valve (TXV)
02
Subcooling Method applicability status
Subcooling Method is applicable to this system.
C. Instrument Calibration
Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2
01
Date of Digital Refrigerant Gauge Calibration
2016-03-28
02
Date of Digital Thermocouple Calibration
2016-03-28
03
Digital Refrigerant Gauge Calibration Status
Calibration is current
04
Digital Thermocouple Calibration Status
Calibration is current
D. Measurement Access Hole (MAH) Verification _
Procedures for installing MAH are specified in Reference Residential Appendix kA3.2.2:3 f
Method used to demonstrate compliance with tFiei MAH installed and labeled consistent with Figure 3.2-1 ,
01 Measurement Access Hole (MAH) requirement V - J ,+
E. Minimum System Airflow Rate Verification
Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.2.2.7.
01
Minimum Required System Airflow Rate (cfm)
1400
02
System Airflow Rate Verification Status
System complies with minimum airflow rate requirements
F. Data Collection and Calculations
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2.
01
Lowest return air dry bulb temperature that occurred during
74
the refrigerant charge verification procedure (degreeF)
02
Measured Condenser air entering dry-bulb temperature (T
81
condenser, db)
03
Outdoor Temperature Qualification Status
Outdoor temperature is within range for using Subcooling
refrigerant charge verification method
04
Measured Liquid Line Temperature (Tiiquid) (degreeF)
82.8
05
Measured Liquid Line Pressure (Pliquid) (pisg)
247
Registration Number: 216-N0127396A-M2500003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:59:50
2013 Residential Compliance Schema Version: 2013.1.007
F. Data Collection and Calculations
Procedures for.determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2.
01
Condenser saturation temperature (Tcondensor, sat) from digital
93.3
06
gauge or P -T Table using Line F05 (degree F)
07
Measured Subcooling
f
120
08
Target Subcooling
10 ,
03
Compliance Statement: System complies with Subcooling Method - Must also pass metering device verification, next
09
.
section
G. Metering Device Verification
Procedures for the verification of proper metering device operation are specified in RA3.2.2.6.2
01
Measured Suction line temperature (Tsuction) (degreeF)
40.3
r s --�- -
02
Measured Suction line pressure,(Psuaiog) it
120
03
Evaporator saturation temperature (Tevaporator, sat) from
digital
30.2
�..n
gauge or•IP�T-Table-using line G021(degreeF)
04
Measured Superheat
10"1 P { # I D. R
..+^
05
Measured Superheat is between 4 and 25 deg F (inclusive)
" +
Passes CEC requirement
06
Measured Superheat is within manufacturer's specifications,
Not known
if known x
07
Compliance Statement: Metering device verification passes
' Verification of Charge Indicator'Display - CF2R-MCH-25d - CID
Registration Number: 216-N0127396A-M2500003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version 2013 Rev 1.007 Report Generated: 2016-04-06 14:59:50
' 2013 Residential Compliance. Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H
Refrigerant Charge Verification (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
LK�t�I
Jack B LaFontaine
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
1760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Instalation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by
the enforcement agency. ; `` // ;" " J k -�,1 /----`f
4. 1 understand that a HERS rater will check the installation Lo verify compliance, and that if such checking identifies defects; I am required to take
corrective action at my expensed 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 meei the I ')
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 expense.' ; iti V I � r N /� i 7�
p g p p Y P J i% Lb YY _ —�* l
S. I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
40�
Company Name: (installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2500003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 14:59:50
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION
CF2R-MCH-25-H
Refrigerant Charge Verification
(Page 1 of 4 )
Project Name: Miller, William Revised
Enforcement Agency:
Quinta
City of La
Permit Number: BRES-2014-1152
,
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. System Information
Each system requiring refrigerant charge verification will be documented on a separate certificate.
01
System Identification or Name
System 3
02
System Location or Area Served
Location
03
Condenser (or package unit) Make or Brand
York
04
Condenser (or package unit) Model Number
YCS366215
05
Nominal Cooling Capacity (tons) of Condenser
3
06
Condenser (or package unit) Serial Number
WiM5189576
07
Refrigerant Type , - rl
Ot4 erg i7:�NCW�
08
Other Refrigerant Type (if applicable)
09
System Installation Type '�"
New
Charge Indicator
10
Display (CID) Status (Note: Even systems
with a CID must have refrigerant charge verified by installer).
This system does not have a CID device installed
Is the system of a type that the minimum airflow can be
Yes, this is a ducted system and one of the system airflow
11
verified using an approved measurement procedure (RA3.3
rate measurement procedures in RA3.3 or RA3.2.2.7 can be
or RA3.2.2.7)?
used to verify system airflow rate requirements.
Is the system of a type that approved refrigerant charge
Yes, one of the Refrigerant charge verification procedures
verification procedures can be used to verify compliance
from RA3.2.2 or RAI is applicable to this system and can be
12
with the refrigerant charge verification requirements when
used to verify compliance
temperatures are greater than or equal to 55F (RA3.2.2, or
RAI)?
13
Date of Refrigerant Charge Verification for this system
2016-03-31
14
Refrigerant charge verification method used.
Subcooling (outdoor temperature must be equal to or
greater than 55 degF)
15
Person who performed the Refrigerant Charge Verification
HVAC system installer
reported on this Certificate of Installation
16
HERS Verification Compliance Requirement Status
System qualifies for group sampling
MCH -25b - Refrigerant Charge Verification - Subcooling Method
Registration Number: 216-N0127396A-M2500004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:04:57
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H
Refrigerant Charge Verification (Page 2 of 4 )
B. Metering Device Verification
Subcooling Method can only be used on systems that have a variable metering device.
01
Refrigerant metering device
Thermostatic Expansion Valve (TXV)
02
Subcooling Method applicability status
Subcooling Method is applicable to this system.
C. Instrument Calibration
Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2
01
Date of Digital Refrigerant Gauge Calibration
2016-03-28
02
Date of Digital Thermocouple Calibration
2016-03-28
03
Digital Refrigerant Gauge Calibration Status
Calibration is current
04
Digital Thermocouple Calibration Status
Calibration is current
D. Measurement Access Hole (MAH) Verification _
Procedures for installing MAH are specified'in Reference Residential Appendix RA3:2:2'.3-�
Method used to demonstrate compliance with the L MAH.mstalled and labeled consistent with Figure 3.2-101 ,
Measurement Access Hole (MAH) requirement
WV
E. Minimum System Airflow Rate Verification
Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.2.2.7.
01
Minimum Required System Airflow Rate (cfm)
1050
02
System Airflow Rate Verification Status
System complies with minimum airflow rate requirements
F. Data Collection and Calculations
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2.
01
Lowest return air dry bulb temperature that occurred during
70.6
the refrigerant charge verification procedure (degreeF)
02
Measured Condenser air entering dry-bulb temperature (T
80.5
condenser, db)
03
Outdoor Temperature Qualification Status
Outdoor temperature is within range for using Subcooling
refrigerant charge verification method
04
Measured Liquid Line Temperature (Tiiquid) (degreeF)
80.5
05
Measured Liquid Line Pressure (Pliquid) (pisg)
238
Registration Number: 216-N0127396A-M2500004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:04:57
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-25-1H
Refrigerant Charge Verification (Page 3 of 4 )
F. Data Collection and Calculations
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2.
06
Condenser saturation temperature (Tcondensor, sat) from digital
93.6
02
gauge or P -T Table using Line F05 (degree F)
130
07
Measured Subcooling
13.1
08
Target Subcooling
11
09
Compliance Statement: System complies with Subcooling Method'- Must also pass metering device verification, next
section
G. Metering Device Verification
Procedures for the verification of proper metering device operation are specified in RA3.2.2.6.2
01
Measured Suction linetemperature (Tsuction) (degreeF)
44.7
02
Measured Suction line pressure,(Ps�ction) (psig)
130
Evaporator saturation.tempe ature (Tev porator sate om
ngthne
24.9=03
nCO
digital gauge or P, -T Tables G02 (dreg eF
LL=
f7
04
Measured Superheat
X19.8 V v I
05
Measured Superheat is between 4 and 25 deg F (inclusive)
Passes CEC requirement
06
Measured Superheat is within manufacturer's specifications,
Not known
if known
Id
Compliance Statement: Metering device verification passes
Verification of Charge Indicator Display - CF2R-MCH-25d - CID ::1
H. Charge Indicator Display
Procedures for the Charge Indicator Display Verification are detailed in RA3.4.2
This section does not apply to this project.
I. Charge Indicator Display - Additional Requirements
This section does not apply to this project.
Registration Number: 216-N0127396A-M2500004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:04:57
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H
Refrigerant Charge Verification (Page 4 of 4 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: /i,,-�
Jack B LaFontaine
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
1760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by
the enforcement agency.
4. 1 understand that a HERS rater will check the installation to verify compliance, and 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'installationsfail to meeithe ; )
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 A my expense.'
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2500004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:04:57
2013 Residential Compliance Schema Version: 2013.1.007
a
EMS SEPARATOR PAGE
a
CERTIFICATE OF INSTALLATION
CF2R-MCH-26-H
Rated Space Conditioning System Equipment Verification
(Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Qu i nta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
A. System Information
Procedures for verification of High SEER and EER Equipment are described in Reference Appendix RA3.4. Each HVAC
system requiring verification must use a separate form.
01
System Name or Identification/Tag
System 1
02
System Location or Area Served
Location
03
Status: SEER and EER performance compliance credit check
Both SEER and EER HERS Verification is required
04
Directory used to certify product performance
AHRI
05
AHRI certification number for the installed space
8465332 '
conditi \ing system'from"http://www.ahridirectory.org
06
Does the directory�used to certify, prod u.ct-1.performances
require a specific air handler/furnace make and model?`
Yes
DD C
YCS60621
04
!( iT E �v-y i�.r
Installed Model Number
Does the directory c� ! C I !
used'tolcertify product;performance;,�
-No U 0
07
require a time.delay relay (+TDR)
08
Does the directory used to certify product performance
Yes
ADP
require a TXV (+TXV)?
B. Rated Space Conditioning System Equipment Verification
The data on nameplate of the installed component shall conform to the data for the component as shown in the
Directory used to certify product performance in order to demonstrate compliance.
Data from Nameplate of Installed system
Data from Directory used to certify product
component
performance for the rated system
component
Outdoor Condenser or Package Unit -
01
York
02
York
Installed Manufacturer Name
Outdoor Condenser or Package Unit -
03
YCS60621
04
YCS601321
Installed Model Number
Inside Coil - Installed Manufacturer
05
ADP
06
ADP
Name
Inside Coil - Installed Model Number
07
CV60006
08
CV60006
Air Handler/Furnace - Installed
09
York
10
York
Manufacturer Name
Registration Number: 216-N0127396A-M2600002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:10:19
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 2 of 3 )
B. Rated Space Conditioning System Equipment Verification
The data on nameplate of the installed component shall conform to the data for the component as shown in the
Directory used to certify product performance in order to demonstrate compliance.
Air Handler/Furnace - Installed Model 11 TMLX100C20 12 TMLX100C20
Number
C. Verified Cooling System SEER
01
Required minimum SEER
14.5
02
Installed SEER
14.5
03
Compliance Statement:
System passes SEER verification
Signature by responsible party below certifies that the installed cooling equipment meets or exceeds the required value listed on
the CF1R.
D. Verified Cooling System EER
01
Required minimum EER
j `
12.3
02
Installed EER 1
\— ^'
12.3
n n rr+•
rrw �
r�� w.�. w w � �^ rte.
03
Compliance Statement: ~`
Y
E U
System"passes EER eiification -
Signature by responsible party below certifies that the installed cooling equipment matches the equipment on the AHRI
Certificate.
E. Verified Cooling System Air Handler/Furnace
01 If a specific air handler or furnace is required by the AHRI certificate, the responsible party certifies by signing below that
the installed air handler/furnace matches the equipment on the AHRI Certificate.
F. Verified Cooling System Time Delay Relay
This section does not apply to this project.
G. Verified Cooling System TXV
01 If a TXV is required by the AHRI certificate, the responsible party certifies by signing below that the TXV is properly installed
and has been visually verified, including proper placement of sensing bulb
Registration Number: 216-N0127396A-M2600002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:10:19
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
_
Documentation Author Signature: /J 0d
Jack B LaFontaine
9! �j
GF�BJ
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
1760-360-4631
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials; components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations, and the installation conforms to..the requirements given on.the plans and -specifications approved by
the enforcement agency. ,� r r'""1 ! rd 1 1 t � �'"°
4. 1 understand that a HERS riter will, the(tallation to that if identifies defects; Lam
check venfy'compliance, and such,checking required to take
corrective action at my expensed understand that Energy Commission and HERS Provider representatwes will also perform quality assurance checking
of installations, including th e�•approved as parrof,a,s'a`m I�e4grou;p b u~t not;checked by'a_rHERS1rater,ednd ifthos'et installations "failto meet t`e
�j
requirements of such quality assurankce checking, the required correctiveaction and -additional checking/testing of -other installations.in that HERS
sample group will be performed at Ty, expense. `'r H 1 0 H
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrenskye
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2600002A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:10:19
2013 Residential Compliance Schema Version: 2013.1.007
3. .
41 i
t
' - Reg: 213-N0006495B-M2200003A-M22A Registration Date/Time: 2013/03/21'11:12:26 HERS Provider: CalCERTS, Inc., -
2008 Residential Compliance Form: March 2010
CERTIFICATE OF INSTALLATION
CF2R-MCH-26-H
Rated Space Conditioning System Equipment Verification
(Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Qu i nta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
A. System Information
Procedures for verification of High SEER and EER Equipment are described in Reference Appendix RA3.4. Each HVAC
system requiring verification must use a separate form.
01
System Name or Identification/Tag
System 2
02
System Location or Area Served
Location
03
Status: SEER and EER performance compliance credit check
Both SEER and EER HERS Verification is required
04
Directory used to certify product performance
AHRI
02
AHRI certification number for the installed space
8465247
05
conditioning system from http://www.ahridirecto-ry.org
Does the directory used to certify product performance?
Yes
06
require a specific air handler/�fturnace m ke and;mde? f
Tn
Installed Model Number
--IC
Does the directory used`toi" y product -,performance,
I.S.(+TD
Nom U i U U ti
07
require a time delay relay R) 0
.t
08
Does the directory used to certify product performance
Yes
ADP
require a TXV (+TXV)?
B. Rated Space Conditioning System Equipment Verification
The data on nameplate of the installed component shall conform to the data for the component as shown in the
Directory used to certify product performance in order to demonstrate compliance.
Data from Nameplate of Installed system
Data from Directory used to certify product
component
performance for the rated system
component
Outdoor Condenser or Package Unit -
01
York
02
York
Installed Manufacturer Name
Outdoor Condenser or Package Unit -
03
YCS481321S
04
YCS48621
Installed Model Number
Inside Coil - Installed Manufacturer
05
ADP
06
ADP
Name
Inside Coil - Installed Model Number
07
CV60006
08
CV60006
Air Handler/Furnace - Installed
09
York
10
York
Manufacturer Name
Registration Number: 216-N0127396A-M2600003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:12:50
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 2 of 3 )
B. Rated Space Conditioning System Equipment Verification
The data on nameplate of the installed component shall conform to the data for the component as shown in the
Directory used to certify product performance in order to demonstrate compliance.
Air Handler/Furnace - Installed Model 11 TMLX080C16 12 TMLX080C16
Number
C. Verified Cooling System SEER
01
Required minimum SEER
15.3
02
Installed SEER
15.3
03
Compliance Statement:
System passes SEER verification
Signature by responsible party below certifies that the installed cooling equipment meets or exceeds the required value listed on
the CF1R.
D. Verified Cooling System EER
01
Required minimum EER
q
��
12.5~
I�1�
02
Installed EERY
^' ll
12:5 i 1
03
Compliance Statement:
)System4passe's EER er ficat on
Signature by responsible party below certifies that the installed cooling equipment matches the equipment on the AHRI
Certificate.
E. Verified Cooling System Air Handler/Furnace
01 If a specific air handler or furnace is required by the AHRI certificate, the responsible party certifies by signing below that
the installed air handler/furnace matches the equipment on the AHRI Certificate.
F. Verified Cooling System Time Delay Relay
This section does not apply to this project.
G. Verified Cooling System TXV
01 If a TXV is required by the AHRI certificate, the responsible party certifies by signing below that the TXV is properly installed
and has been visually verified, including proper placement of sensing bulb
Registration Number: 216-N0127396A-M2600003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:12:50
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: / �Cr
Jack B LaFontaine
�/�/ Lf�1
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
1760-360-4631
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulations, andr the installation conforms to the requirements given on,the plans andspecifications approved by
the enforcement agency. / .. f
8
d--,Jrn(rifiies
�
r4. 1 understand that a HERS rater willcheck the installation`to verify'compliance, and that if,such-checking iddefects; I,am required to take
'10 ki
corrective action at my expennse\ understand't*hat Energy -Commission and HERS Provider represent}atives 1sso assurance checking
will perform quality
of installations, including iho a approved as pact;of asample_group but not_checked by-a,HERS_rater, and if those installations fail -to meet theme
requirements of such quality ass France checking, the required corrective, action and -additional checking/testing;of-other installations -in that.HERS
sample group will be performed at-myexpense. e R �d I D E R
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title): 61
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed: -
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2600003A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:12:50
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION
CF2R-MCH-26-H
Rated Space Conditioning System Equipment Verification
(Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Quinta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
A. System Information
Procedures for verification of High SEER and EER Equipment are described in Reference Appendix RA3.4. Each HVAC
system requiring verification must use a separate form.
01
System Name or Identification/Tag
System 3
02
System Location or Area Served
Location
03
Status: SEER and EER performance compliance credit check
Both SEER and EER HERS Verification is required
04
Directory used to certify•product performance
AHRI
02
AHRI certification number for the installed space
8465214
05
conditioning system from'http://www.ahridirectory.org
06
Does the directory used to certify product'performance�
F . ¢ t
require a specific air handler/furnace make andmodel?�
-Yes
YCS361321S
n iC
ff iE �t
Installed Model Number
'1t f(-� 1 y t
Does the directory"used`to certify product performance
!
-No� U (�
07
require a time delay relay (+TDR)?
Inside Coil - Installed Manufacturer
08
Does the directory used to certify product performance
'Yes
ADP
require a TXV (+TXV)?
B. Rated Space Conditioning System Equipment Verification
The data on nameplate of the installed component shall conform to the data for the component as shown in the
Directory used to certify product performance in order to demonstrate compliance.
Data from Nameplate of Installed system
Data from Directory used to certify product
component
performance for the rated system
component
Outdoor Condenser or Package Unit -
01
York
02
York
Installed Manufacturer Name
Outdoor Condenser or Package Unit -
03
YCS361321S
04
YCS36621
Installed Model Number
Inside Coil - Installed Manufacturer
05
ADP
06
ADP
Name
Inside Coil - Installed Model Number
07
CV36006
08
CV36006
Air Handler/Furnace - Installed
09
York
10
York
Manufacturer Name
Registration Number: 216-N0127396A-M2600004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:14:57
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 2 of 3 )
B. Rated Space Conditioning System Equipment Verification
The data on nameplate of the installed component shall conform to the data for the component as shown in the
Directory used to certify product performance in order to demonstrate compliance.
Air Handler/Furnace - Installed Model 11 TMLX080C16 12 TMLX080C16
Number
C. Verified Cooling System SEER
O1
Required minimum SEER
15.3
02
Installed SEER
15.3
03
Compliance Statement:
System passes SEER verification
Signature by responsible party below certifies that the installed cooling equipment meets or exceeds the required value listed on
the CF1R.
D. Verified Cooling System EER
01
Required minimum EER
l� 1 x(�
12.8
02
Installed EER \`` ,;
—� ' LJ
``
12:8 __ ,
`
� e+�.
r
rr r� ...��. n n r e•� rte• e—�,
03
Compliance Statement:
System passes EER verification
Signature by responsible party below certifies that the installed cooling equipment matches the equipment on the AHRI
Certificate.
E. Verified Cooling System Air Handler/Furnace
01 If a specific air handler or furnace is required by the AHRI certificate, the responsible party certifies by signing below that
the installed air handler/furnace matches the equipment on the AHRI Certificate.
F. Verified Cooling System Time Delay Relay
This section does not apply to this project.
G. Verified Cooling System TXV
01 If a TXV is required by the AHRI certificate, the responsible party certifies by signing below that the TXV is properly installed
and has been visually verified, including proper placement of sensing bulb
Registration Number: 216-N0127396A-M2600004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:14:57
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
QT
Documentation Author Signature: /J,,,,� �CsGLp/
Jack B LaFontaine
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to all applicable codes and regulation��s,...a��n,,d..tt the installation conforms to the requirements given on -the -plans and specifications approved by
the enforcement agency. / '` r✓`+"�"t�"" '� neckingidentifies
4. 1 understand that a HERS rater will check the to,verify that if`such�cdefects- I to take
installation compliance, and am regwred
corrective action at my expense..) understand that Energy Commission and HERS Provider representatives will also perform quality assurance checking
%, j i 1� 1.� 1 y i ! 5 �� ] i 3 e < t 1 / .s r' st F f. Y . 'd ti
of installations, including tho'N • roved as part_ of;asample'group but not checked'by a HERS.rater, and if those installations fail to meet they Q
:;
requirements of such quality ass fiance checking, the required corrective -action and, -additional checking/testing of -other installations.in that.HERS
sample group will be performed at my, expense.
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrensky _
GG'iR�
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
1974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2600004A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 15:14:57
2013 Residential Compliance Schema Version: 2013.1.007
EMS SEPARATOR PAGE
CERTIFICATE OF INSTALLATION
CF2R-MCH-27-H
Indoor Air Quality and Mechanical Ventilation
(Page 1 of 5 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Quinta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
Title 24, Part 6, Section 150.0(o) Ventilation for Indoor Air Quality. All dwelling units shall meet the requirements of ANSI/ASHRAE
Standard 62.2. Ventilation and Acceptable Indoor Air Quality in Low -Rise Residential Buildings. Equation and table numbering on
this form corresponds to the numbering for that information in the published ANSI/SHRAE Standard 62.2-2010.
A. Dwelling Mechanical Ventilation - General Information
01
Dwelling unit name
Miller, William Revised
02
Building Type , .
S
Single family
03
Project scope /
Newly constructed building
Total Conditioned Floor Area of Dwelling Unit
4155
04
(For addition projects the conditioned floor area equals
existing area plus addition area.-)'-_.-- "�
05
Number of bedrooms iri dwelling unit
(For addition projects the"number of bedrooms equals the
9 %.!
� Lo
existing bedroom_ s plus addition bedrooms)
p" CII. /y
�l+N
06
Ventilation Operation•Schedule %_,.
Continuous
07
Whole -Building Ventilation Rate Calculation Method
Fan Ventilation Rate Method (4.1.1)
08
Whole Building Ventilation System Type
Standalone - Exhaust
MCH -27a - Continuous Ventilation Airflow - Fan Vent Rate Method
B. Whole -Building Continuous Ventilation - Fan Ventilation Rate Method
A mechanical supply system, exhaust system, or combination thereof shall provide whole -building ventilation with
outdoor air each hour at no less than the rate in equation 4.1a.
01 Required Continuous Whole -Building Ventilation Rate 117
02 Installed Continuous Whole -Building Ventilation Rate 120
C. Compliance Statement
01 Building passes continuous whole -building ventilation rate test
Registration Number: 216-N0127396A-M2700001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 17:18:42
2013 Residential Compliance Schema Version: 2013.1.006
CERTIFICATE OF INSTALLATION CF2R-MCH-27-H
Indoor Air Quality and Mechanical Ventilation (Page 2 of 5 )
D. Local Mechanical Exhaust System - Fan selection and duct design criteria for compliance
Local mechanical exhaust fans shall be installed in each kitchen and bathroom. Delivered local ventilation rates:
• All local ventilation rates have been measured using a flow hood, flow grid, or other airflow measuring device and meet the
requirements of 62.2 Tables 5.1 or 5.2. OR
• The airflow rating at a pressure of 0.25 in. w.c. of a certified fan is assumed because the local ventilation system duct sizing
meets the prescriptive requirements of 62.2 Table 5.3, or manufacturer's design criteria.
Table 5.1
Intermittent Local Ventilation Exhaust Airflow Rates
Application
Airflow
Notes
Vented range hood (including
Kitchen
100 cfm
appliance -range hood combinations)
required if exhaust fan flow is less than 5
ACH.
Bathroom
50 cfm
Table 5.2
Continuous Local Ventilation Exhaust Airflow Rates
Application
Airflow
Notes
Kitchen
�` (�5 ACR - r ���
Based on Kitchen volume.
Bathroom ir'1
1 l 20 cfm
1
Table 5.3
Prescriptive Duct Sizing Requirements\ --• r-, t-- ^r --Z, s^t
Duct Type
Flex Duct" `�' u `'f'
° `� Smooth Duct' "� u
Fan Rating
cfm @ 0.25
50
80
100
125
50
80
100
125
in. w.g.
Maximum Allowable Duct Length (ft)
Diameter,
Flex Duct
Smooth Duct
(in)
3
X
X
X
X
5
X
X
X
4
70
3
X
X
105
35
5
X
5
NL
70
35
20
NL
135
85
55
6
NL
NL
125
95
NL
NL
NL
145
7and above
NL
NL
NL
NL
NL
NL
NL
NL
This table assumes no elbows. Deduct 15 ft of allowable duct length for each turn, elbow, or fitting. Interpolation and extrapolation
in 62.2 Table 5.3 is not allowed. For airflow values not listed, use the next higher value. This table is not applicable for airflow > 125
cfm.
NL = no limit on duct length of this size.
X = not allowed, any length of duct of this size with assumed turns, elbows, fittings will exceed the rated pressure drop.
Registration Number: 216-N0127396A-M2700001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 17:18:42
2013 Residential Compliance Schema Version: 2013.1.006
CERTIFICATE OF INSTALLATION CF2R-MCH-27-H
Indoor Air Quality and Mechanical Ventilation (Page 3 of 5 )
E. Other Requirements
The items listed below (6.1 through 6.8) correspond to the information given in ASHRAE 62.2 Section 6 Other Requirements. Refer
also to Chapter 4.6 of the Residential Compliance Manual (Section 4.6.5) for information describing these Other Requirements. The
signature of the Responsible Person in the declaration statement below certifies that the building complies with these
requirements specified in ASHRAE 62.2 Section 6.1 through 6.9 if applicable.
6.1 Transfer Air Measures shall be taken to minimize air movement across envelope components to occupiable spaces from
01
garages, unconditioned crawl spaces, and unconditioned attics. Supply and balanced ventilation systems shall be
designed and constructed to provide ventilation air directly from the outdoors.
6.2 Instructions and Labeling Information on the ventilation design and/or ventilation systems installed, instructions on
their proper operation to meet the requirements of this standard, and instructions detailing any required maintenance
02
(similar to that provided for HVAC systems) shall be provided to the owner and the occupant of the dwelling unit.
Controls shall be labeled as to their function (unless that function is obvious, such as toilet exhaust fan switches). See
Chapter 13 of Guideline 242 for information on instructions and labeling.
03
6.3 Clothes Dryers Clothes dryers shall be exhausted directly to the outdoors
6.4 Combustion and solid -fuel burning appliances Combustion and solid -fuel burning appliances must be provided with
adequate combustion and ventilation air and vented in accordance with manufacturer installation instructions, NFPA 54
ANSI Z223.1, National Fuel Gas Code"N'FPA 31, Standard for•the Installation.6fb l -Burning Equipment, or NFPA 211,
,. --- *1 Ir i I ' ', i J i i i 4 1 1 rar•-+t,
Standard for Chimneys, Fireplaces,lVents, and Solid Burning Appliances, orjother, q valent accepi the
-Fuel code
I tableto
building official.Where atmos%pherically vented combustion appliances orsolid-fuel burning,appllances are located
inside the pressure boundary, the total,net exhaust -flow of the two largest exhaust fans (not -including a summer cooling
fan intended to be operated only when,windows orother�air inlets are open) shallfiot"exced 15 cfm.peV100 ft2;(7S Lps
per 100 m2 of occupiable spate when in operation at full capacity. If the desi niA total net flow exceeds this limit the
P ) P• P P g ,
net exhaust flow must be reduced by reducing the exhaust flow or providing compensating outdoor airflow.
Atmospherically vented combustion appliances do not include direct -vent appliances
6.5 Garages When an occupiable space adjoins a garage, the design must prevent migration of contaminants to the
adjoining occupiable space. Air seal the walls, ceilings, and floors that separate garages from occupiable space. To be
05
considered air sealed, all joints, seams, penetrations, openings between door assemblies and their respective jambs and
framing, and other sources of air leakage through wall and ceiling assemblies separating the garage from the residence
and its attic area shall be caulked, gasketed, weather stripped, wrapped, or otherwise sealed to limit air movement.
Doors between garages and occupiable spaces shall be gasketed or made substantially airtight with weather stripping.
06
6.6 Ventilation Opening Area Spaces shall have ventilation openings as listed below. Such openings shall meet the
requirements of Section 6.8
6.7 Minimum filtration Mechanical systems that supply air to an occupiable space through ductwork exceeding 10 ft (3 m)
in length and through a thermal conditioning component, except evaporative coolers, shall be provided with a filter
having a designated minimum efficiency of MERV 6, or better, when tested in accordance with ANSI ASHRAE Standard
07
52.2, Method of Testing General Ventilation Air -Cleaning Devices for Removal Efficiency by Particle Size, or a minimum
Particle Size Efficiency of 50 percent in the 3.0-10 micrometer range in accordance with AHRI Standard 680,
Performance Rating of Residential Air Filter Equipment. The system shall be designed such that all recirculated and
mechanically supplied outdoor air is filtered before passing through the thermal conditioning components. The filter
shall be located and installed in such a manner as to facilitate access and regular service by the owner.
' Registration Number: 216-N0127396A-M2700001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 17:18:42
2013 Residential Compliance Schema Version: 2013.1.006
CERTIFICATE OF INSTALLATION CF2R-MCH-27-H
Indoor Air Quality and Mechanical Ventilation (Page 4 of 5 )
E. Other Requirements
The items listed below (7.1 through 7.3) correspond to the information given in ASHRAE 62.2 Section 7Air-Moving Equipment.
6.8 Air Inlets Air inlets that are part of the ventilation design shall be located a minimum of 10 ft (3 m) from known sources
08
of contamination such as a stack, vent, exhaust hood, or vehicle exhaust. The intake shall be placed so that entering air
is not obstructed by snow, plantings, or other material. Forced air inlets shall be provided with rodent insect screens
7.1 Selection Installation. Ventilation deviceand shall be tested listed` specific
(mesh not larger than half an inch).
and equipment and accordance with
standards. Installations ofsystems or,e_quipment shalFbe carried out in accordance with manufacturers design
6.9 Carbon Monoxide Detectors A carbon monoxide alarm shall be installed in each dwelling unit in accordance with NFPA
09
720, Standard for the Installation of Carbon Monoxide (CO) Detection and Warning Equipment 14, and shall be
consistent with requirements of applicable laws, codes, and standards.
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.
F. Air Moving Equipment
The items listed below (7.1 through 7.3) correspond to the information given in ASHRAE 62.2 Section 7Air-Moving Equipment.
Refer also to Chapter 4.6 of the Residential Compliance Manual (Section 4.6.6) for information describing these requirements in
more detail. The signature of the Responsible Person in the declaration statement below certifies that the building complies with
these requirements specified in ASHRAE 62.2 Section 7.1 through 7.3 if applicable.
7.1 Selection Installation. Ventilation deviceand shall be tested listed` specific
01
and equipment and accordance with
standards. Installations ofsystems or,e_quipment shalFbe carried out in accordance with manufacturers design
ctions'. ^' f 1 ' - `� t� `' Y -' 0requirements and installation instru
hinimum `airflow rate'requi erend by
7.2 Sound Ratings for Fans Ventilation fans shall be rat d'for' so at lno less than fe m
this standard, as noted below. These sound ratings shall be at a minimum of 0.1 in. w.c. (25 Pa) static pressure. 7.2.1
02
Whole Building or Continuous Ventilation Fans. These fans shall be rated for sound at a maximum of 1.0 sone. 7.2.2
Intermittent Local Exhaust Fans. Fans used to comply with Section 5.2 shall be rated for sound at a maximum of 3 sone,
unless their maximum rated airflow exceeds 400 cfm (200 L/s). (Some exceptions may apply.)
7.3 Multibranch Exhaust Ducting If more than one of the exhaust fans in a dwelling unit shares a common exhaust duct,
03
each fan shall be equipped with a back draft damper to prevent the recirculation of exhaust air from one room to
another through the exhaust ducting system.
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.
G. Multifamily Buildings -Other Requirements
This section does not apply to this project.
Registration Number: 216-N0127396A-M2700001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 17:18:42
2013 Residential Compliance Schema Version: 2013.1.006
CERTIFICATE OF INSTALLATION CF2R-MCH-27-H
Indoor Air Quality and Mechanical Ventilation (Page 5 of 5 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: /J �CrLGP/
Jack B LaFontaine
Company:
Signature Date: 2016-04-06 15:37:51
Energy Management Services
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
1760-360-4631
Bermuda Dunes CA 92203
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
conforms to.all applicable codes and regulations,.and the installation conforms to the. requirements.given on -the plans and specifications approved by
the enforcement agency. / �'� } �"neckinCgilnCies�4. 1 understand that a HERS reterwill check the installation'tovenfy�compliance,
that if such defects; Irani to take
and crequired
corrective action at my expense..l understand that Energy Commission and HER_ S Provider representatives will also perform quality assurance checking
of installations, including thole,app;oved as part ;of a-sample,group but not"checked;by,a HERS'rater, and if.those in stallations faiLto meet the.yt 0
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 atMyaexpense.ri t
�+r� 8 .
--H
S. I reviewed a copy of the Certificate of Compliance approvedby the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Michael Dobrenskye
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Owner
DESERT HABITATS INC
Address:
CSLB License:
75-161 SEGO LANE F-1
974819
City/State/Zip:
Phone:
Date Signed:
PALM DESERT CA 92211
760-340-6062 X123
2016-04-06 15:39:53
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
' Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider
responsibility for the accuracy of the information.
' Registration Number: 216-N0127396A-M2700001A-0000 Registration Date/Time: 2016-04-06 15:39:53 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-06 17:18:42
' 2013 Residential Compliance Schema Version: 2013.1.006
CF-3R-
Certificate
of Verification Reports
A
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Quinta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code: 92253
A. System Information
01
Space Conditioning System Identification or Name
System 1
02
Space Conditioning System Location or Area Served
Location
03
Building Type from CF -1R
Single family
04
Verified Low Leakage Ducts in Conditioned Space
No, credit is not taken
Test final
(VLLDCS) Credit from CF1R?
Duct Leakage Test Method
05
Verified Low Leakage'Air Handling Unit Credit from
Yes credit is taken
6.0
CF1R?
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Cooling system method
i t }
Measured AHUAirflow
06
Duct System`Compliance Cate So
New
120
10
Actual duct leakage rate from leakage test measurement
(cfm)
� .� r� as •� as at as ai 1r aE _
B. Duct Leakage Diagn�osticTest '� F,`
�I
01
L
Condenser Nominal Cooling Ca acit ton j
5' 0
02
Heating Capacity (kBtu/h)
80
03
Conditioned Floor Area served by this HVAC system (ft2)
2077
04
Duct Leakage Test Condition
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
6.0
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Cooling system method
08
Measured AHUAirflow
This field or section is not applicable
09
Calculated Target Allowable Duct Leakage Rate (cfm)
120
10
Actual duct leakage rate from leakage test measurement
(cfm)
109
11
Air Handling Unit Manufacturer Name
York
12
Air Handling Unit Model Number
TMLX100C20
13
Compliance Statement
System passes leakage test
Registration Number: 216-N0127396A-M2000002A-M20A Registration Date/Time: 2016-04-07 09:57:04 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:15:38
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
B. Duct Leakage Diagnostic Test
14 Notes
C. Additional Requirements for Compliance
The Low Leakage Air -handling Unit Model identified on this compliance document is included in the list of certified Low
Leakage Air -Handling Units published on the Energy Commission Website at:
01
http://www.energy.ca.gov/title24/2008standards/special case appliance/supplemental listings/Low Leakage Air -
Handling Unit Listing 2012-10-30.pdf (provide updated link).
02
System was tested in its normal operation condition. No temporary taping allowed.
Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage
testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation
03
Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required,
may configure the OA damper to the closed position during duct leakage testing.
04
All supply and return register boots were sealed to the drywall.
05
Building cavities were not used as plenums or platform�retums in lieu of ducts., I
06
If cloth backed tape was used it was covered with Mastic and draw bands.
07
1
All connection points between the air handler and the and return plenums are completely sealed. r--
-;08
}supply
08
Verification Status
Pass - all applicable requirements are met
09
Correction Notes for this table
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status and the Corrections Notes in this table..
D. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 1 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-N0127396A-M2000002A-M20A Registration Date/Time: 2016-04-07 09:57:04 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:15:38
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature:
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:04
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate`of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for.the building approved by the enforcement agency.
4. The information reported on applicable s ce tions:of-the CertificaY (s) of16sifillation:(CF2R)'--signed�'a`nd-u6bmifted;by the persons) responsible for the
tr° a ,P8' �# ki +" j.
construction or installation conforms to the requirements"specified,on the Certificates) of Compliance (CF1R) approved by the enforcement agency.
^ bf � s k 0; �--w � �d e � Z t t� C AI A/,
5. 1 will ensure that a registered copy,of this Certificate of Verificatiorrshall be posted, -or made available with the.building permit(s);issued for the
1 �F ",d
�6 yi. a bl
building, and made ivailabl`ko the�enforcement_ agency for all applicable, inspections. (,understand -that a.registe red} -copy of;this,Certiificate of {yam
i : ' r L
t J s t a 14f 14
Verification is required to be included with the documentation the builderprovide"s to the building owner at occupancy.
---
,*_ +.N4 .,M- *-%,. :..w, .a.rw, .\. or " k *---
-17,
Builder Or Installer Information As Shown On The ertif cats Of Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature:pT-
Jack B LaFontaine
�uGK �e�=LGlGP/
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:04
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2000002A-M20A Registration Date/Time: 2016-04-07 09:57:04 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:15:38
2013 Residential Compliance Schema Version: 2013.1.007
EMS SEPARATOR PAGE
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Quinta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code: 92253
A. System Information
01
Space Conditioning System Identification or Name
System 2
02
Space Conditioning System Location or Area Served
Location
03
Building Type from CF -111
Single family
04
Verified Low Leakage Ducts in Conditioned Space
No, credit is not taken
Duct Leakage Test Condition
(VLLDCS) Credit from CF1R?
05
Duct Leakage Test Method
r .
06
Leakage Factor
Verified Low Leakage Air Handling Unit Credit from
Yes credit is taken
05
CF1R?
08
Measured AHUAirflow
This field or section is not applicable
09
06
Duct System Compliance Category.-� �e~'""
New
Actual duct leakage rate from leakage test measurement
(cfm)
84
11
i x — J Ir 1i Ir it �I I I -
B. Duct Leakage Diagnost crest/ €"
f I I
01
Condenser Nomi al Coolie Capacity ton
Cooling p k Y( �-i F R'�
4'
'fit P 0 I
02
Heating Capacity (kBtu/h)
64
03
Conditioned Floor Area served by this HVAC system (ft2)
1270
04
Duct Leakage Test Condition
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
6.0
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Cooling system method
08
Measured AHUAirflow
This field or section is not applicable
09
Calculated Target Allowable Duct Leakage Rate (cfm)
96
10
Actual duct leakage rate from leakage test measurement
(cfm)
84
11
Air Handling Unit Manufacturer Name
York
12
Air Handling Unit Model Number
TMLX080C16
13
Compliance Statement
System passes leakage test
Registration Number: 216-N0127396A-M2000003A-M20A Registration Date/Time: 2016-04-07 09:57:04 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:16:52
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
B. Duct Leakage Diagnostic Test
14 Notes
C. Additional Requirements for Compliance
The Low Leakage Air -handling Unit Model identified on this compliance document is included in the list of certified Low
Leakage Air -Handling Units published on the Energy Commission Website at:
01
http://www.energy.ca.gov/title24/2008standards/special case appliance/supplemental listings/Low Leakage Air -
Handling Unit Listing 2012-10-30.pdf (provide updated link).
02
System was tested in its normal operation condition. No temporary taping allowed.
Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage
03
testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation
Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required,
may configure the OA damper to the closed position during duct leakage testing.
04
All supply'and return register boots were sealed to the drywall.
05
Building cavities were not used as plenums or platform returns in lieu of duct`s: 3{ ` I'1
06
rSI ,iIt f
If cloth backed tape was used it was covered with Mastic and draw bands.'
07
All connection points between the air handler and the supply and return plenums are .completely sealed.
`r. �rry 4 ,` 0 .w' . r ��
08
Verification Status
Pass - all applicable requirements are met
09
Correction Notes for this table
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status and the Corrections Notes in this table..
D. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-N0127396A-M2000003A-M20A Registration Date/Time: 2016-04-07 09:57:04 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:16:52
2013 Residential Compliance Schema Version: 2013.1.007
1
1
1
1
1
1
1
Documentation Author's Declaration Statement P` T
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature:
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:04
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
ti
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631' ,
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided.on this Certificate of Verification is true and correct.
I IL
2. 1 am the certified HERS Raterkwwho performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features; materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply, with_ the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on'the Certificate of Compliance fcr.the building approved by the enforcement agency.
4. The informatioreported on applicable section s.of=the Certificate(s) of Insiallafion.(CF2R) signed"andsubmitii d;by the person(s) responsible for the
oe f 4, pr 0 Y +^
construction or installation conforms to the requirements`specified;on the Certificate(s) of Compliance (CF,1R) approved by the: enforcement,agency.
5. 1 will ensure that a registered copyof this Certificate of Verification shall be posted; or made available with the,building permit(s) issued for the
building, and made SvailabI6t dinclut }elenforcem6nt age cy for all applicable i�pernons. (_understand L ata egis�ter *d copy of�thi Cerf fcate�o
+'at
Verification is �equved to be ded with the documentation the builder providers to the building owner occupancy.
l I � �. 4 ��' - � a,"'M P!,+•N. PMki.,, �d,Y4.. R J+ M M•+Nt, 1."�• A'X�
Builder Or Installer Information As Shown On The Certf cate Of Installation �`%,
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC h '
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky'
t �•
HERS Provider Data Registry Information
Sample Group Number (if applicable): -
Dwelling Test Status in Sample Group (if applicable)
s
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Jack B LaFontaine
Responsible Rater Signature:
K
,��a/GliT!%�GfifGP/
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed: , ► s
CC2004051 -
2016-04-07 09:57:04
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
4
Registration Number: 216-N0127396A-M2000003A-M20A Registration Date/Time: . 2016-04-07 09:57:04 ' . HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007,, 4 Report Generated: 2016-04-07 09:16:5.2
' 2013 Residential Compliance Schema Version: 2013.1.007
EMS SEPARATOR PAGE
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Quinta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code: 92253
A. System Information
01
Space Conditioning System Identification or Name
System 3
02
Space Conditioning System Location or Area Served
Location
03
Building Type from CF -111
Single family
04
Verified Low Leakage Ducts in Conditioned Space
No, credit is not taken
04
(VLLDCS) Credit from CF111?
Test final
05
Verified Low Leakage Air Handling Unit Credit from
Yes credit is taken
05
CF1R?
t�
6.0
06
Duct System Compliance Category --r— _
New
08
Measured AHUAirflow
This field or section is not applicable
B. Duct Leakage DiagnosticTes`t4A\
01
Condenser Nominal Cooling Capacity (ton.) R
3'" V F
02
Heating Capacity (kBtu/h)
64
03
Conditioned Floor Area served by this HVAC system (ft2)
808
04
Duct Leakage Test Condition
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
6.0
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Cooling system method
08
Measured AHUAirflow
This field or section is not applicable
09
Calculated Target Allowable Duct Leakage Rate (cfm)
72
10
Actual duct leakage rate from leakage test measurement
(cfm)
68
11
Air Handling Unit Manufacturer Name
York
12
Air Handling Unit Model Number
TMLX08OC16
13
Compliance Statement
System passes leakage test
Registration Number: 216-N0127396A-M2000004A-M20A Registration Date/Time: 2016-04-07 09:57:04 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:17:46
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
B. Duct Leakage Diagnostic Test
14 Notes
C. Additional Requirements for Compliance
The Low Leakage Air -handling Unit Model identified on this compliance document is included in the list of certified Low
Leakage Air -Handling Units published on the Energy Commission Website at:
01
http://www.energy.ca.gov/title24/2008standards/special case appliance/supplemental listings/Low Leakage Air -
Handling Unit Listing 2012-10-30.pdf (provide updated link).
02
System was tested in its normal operation condition. No temporary taping allowed.
Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage
testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation
03
Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required,
may configure the OA damper to the closed position during duct leakage testing.
04
All supply and return register boots were sealed to the drywall.
05
Building cavities were not used as plenums—or platform returns in lieu of ducts:
06
If cloth backed tape was used it was covered with Mastic and draw bands.
07
All connection between"-, the air handler and the supply and return plenums are completely sealed.
points i--
08
Verification Status
Pass - all applicable requirements are met
09
Correction Notes for this table
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status and the Corrections Notes in this table..
D. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-N0127396A-M2000004A-M20A Registration Date/Time: 2016-04-07 09:57:04 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:17:46
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature:
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:04
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate`of Verification'comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance foi the building approved by the enforcement agency.
4. The information reported on applicable sections'6f-the Certificat (s) of iiistallaticin`(CF2R)-signed"ai d-submitted:by the person(s) responsible for the
ii fd" ki xi r4 a.a
construction or installation conforms to the requirements-specified,on the Certificates) of Compliance (CF1R) approved by the enforcement'agency.
- � r
5. I will ensure that a,re registered co"" r r 4 f ' r � I . ' `" k — f i. } leti * /
g' py of this Certificate of Verification 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 -registered copy oftthis Certificate of
I c w " A e t . 1 4 x a. ,' x/ L 1 .i3 5r
Verification is required to beincluded with the documentation the builder provides to the building owner at occupancy.
t t [ R w.w. l"�4e ..+•�+ xFR. iMP. ...Ii'4. A. A ►. A�I.,f MMY.
Builder Or Installer Information As Shown On The Certif tate Of Installation
Company
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature:pT-
Jack B LaFontaine
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:04
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2000004A-M20A Registration Date/Time: 2016-04-07 09:57:04 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:17:46
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION
CF3R-MCH-21-H
Duct Location
(Page 1 of 2 )
Project Name: Miller, William Revised
Enforcement Agency:
Qu i nta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. General Information
Note: Submit one Installation Certificate for each duct system that is taking credit for duct location.
01
Space Conditioning (SC) System Identification or Name
Verification Status
02
SC System Location or Area Served
Correction Notes
03
Status - Less than 12 ft Ducts in Conditioned Space
Not applicable
Performance Credit:
04
Status - Ducts Located In Conditioned Space Performance
True
Credit:
Status -,All Ducts Entirely in Directly Conditioned Space
No Exemption
R -value Exception
-------------
B. 12 Linear Feet or Less of,Suppfy Duct Located,Outside?of Conditioned Space-,RA3.1:4�1.2 I I.
is 1 Jr.)I — 11, 1 a ,.
�f ""'......R wa... .'�.� "�..-.,.r .w.........r .1
l This.section,does-not apply to this:projeet. 7f
C. Ducts Located In Conditioned Space - RA3.1.4.1.3
01
A visual inspection shall confirm the space conditioning system is located entirely in conditioned space.
02
Verification Status
Pass - all applicable requirements are met
03
Correction Notes
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status and the Corrections Notes in this table.
D. All Ducts Located Entirely in Directly Conditioned Space R -Value Exception - RA3.1.4.3.8
This section does not apply to this project.
E. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-N0127396A-M2100004A-M21A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:20:29
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-21-H
Duct Location (Page 2 of 2 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature:
�RC���LGlGP/
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections of the Certificate(s) of Installation (CF2R) signed grid `submitted by the person(s) responsible for the
construction or installation conforms to the requirements specified on the Certificate(s) of Compliance (61R) approved by the enforcement agency.
5. 1 will ensure that a registered coy' of this Certificate of.Verification{shall be osted; or made available with the building � r
g copy' p g permits) issued for the
building, and made available to the enforcement agency forall applicable inspections. I'understand that a registered copy of this Certificate of
Verification is required to be included with thedocunentafioln the builder provides to the building owner at occupancy.
Builder Or Installer Information As Shown On`The Certificat Of Installation L L",.4 t 'u
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature:O=-
Jack B LaFontaine
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider '
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2100004A-M21A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:20:29
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION
CF3R-MCH-22-H
Space Conditioning System Fan Efficacy
(Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency:
Qu i nta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. Ducted Cooling System Information
01
System Identification or Name
System 1
02
System Location or Area Served
Location
03
System Installation Type
New
04
Nominal Cooling Capacity (tons) of Condenser
5
05
Condenser Speed Type' ''
Single Speed
06
Cooling System Zonal Control Type
Not Zonal
07
Centra, Fan Integrated (CFI) Ventilation System Status
Not a CFI system
08
System Bypass Duct Statuses
No ss Duct
BypBypaa
09
Date of SystemAirflow Rate Measurement,,
2016-03-31
10
Airflow Rate Protocol utilize E I
)RA3.3 proced� es foro..-o o".�ate�meas�ureme�' —
B. Fan Watt Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1, and system fan watt measurement apparatus information is given in
RA3.3.2.2.
101 I Fan Watt Verification Device Used. I Portable watt meter
MCH -22a Forced Air System Fan Efficacy Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor
C. Forced Air System Fan Efficacy Measurement
The procedures for System Fan Watt Verification are specified in Reference Residential Appendix RA3.3.
01
Actual Tested Watts
587
02
Actual Tested Airflow from MCH -23 (cfm)
1950
03
Required Fan Efficacy (watts/cfm)
0.58
04
Actual Fan Efficacy (watts/cfm)
0.3
05
Compliance Statement:
System fan efficacy complies
Registration Number: 216-N0127396A-M2200002A-M22A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:35:15
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-22-H
Space Conditicning System Fan Efficacy (Page 2 of 3 )
D. Additional Requirements
01
All registers were fully open during the diagnostic test.
02
System ft n was set at maximum speed during the diagnostic test.
03
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
04
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
05
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
06
Zoned cooling air distribution systems with single speed compressors shall meet both the airflow (cfm/ton) and fan efficacy
(Watt/cfm) criteria in every zonal control mode.
07
Verification Status
Pass - all applicable requirements are met
08
CorrectioYNotes
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
f'�
been met unless otherwise noted in the Verification' Statusf,andf A,fhe Corrections Notes in this.table.
E. Determination of HERS Verification ComplianceLl
.,
All applicable sections of this document shall ind ac to compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 1 Complies: All specified verification protocol requirements on this document are met.
Registration NumbEr: 216-N0127396A-M2200002A-M22A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building EnergyEfficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:35:15
2013 Residential Ccrnpliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-22-H
Space Conditioning System Fan Efficacy (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature:
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty'of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HER Rater'.who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate'of Verification comply.with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance foFthe building approved by the enforcement agency.
4. The information reported on applicable s ce tions":of;fhe Certificate(s) of Inst`allation:.(CF2R) signed.a`nd submitted:by the perso(s) responsible for the
�s a i rr ii 4, ++
construction or installation conforms to the.requirements,specified on the Certificate(s) of Compliance (CF1R) approved by the enforcement'agency.
-.—y � 'w.
- - ^ S i 1 � t / s # i �, ,.a / x 4 1 I; . � ( 1. f 'e'r,
5. 1 will ensure that a registered copy=of this Certificate of,{Verification:shall be posted, -or made available with the,building permit(s)!issued for the
'4e k.a
YK is
fI?Y applicable
building, and made available to the'enforcement.agency, for all , cable_in sp ecUons. I understand.that axegstetred copy o�fyyth syCerEificate.of pY■
� !1 n il rbc
? } i l t e'
. 4' fi !'
cc * n ,1.f
Verification is required to be`included with the documentation the builder�provides to the building owner at occupancy.
o
* A ww- *I%, 14 . � �. �,w. w. x * .r..r► +rte a.w
Builder Or Installer Information As Shown On The Certif cats Of Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature:
QQT�
Jack B LaFontaine
�CrL�lGe%
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2200002A-M22A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:35:15
2013 Residential Compliance Schema Version: 0.51SDD
EMS SEPARATOR PAGE
CERTIFICATE OF VERIFICATION
CF3R-MCH-22-H
Space Conditioning System Fan Efficacy
(Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency:
Quinta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. Ducted Cooling System Information
01
System Identification or Name
System 2
02
System Location or Area Served
Location
03
System Installation Type
New
04
Nominal Cooling Capacity (tons) of Condenser
4
05
Condenser Speed Type
Single Speed
06
Cooling System Zonal Control Type
Not Zonal
07
Central'Fan Integrated (CFI) Ventilation. System Status
Not a CFI system
08
System Bypass Duct Stas �^ ,'
No B ass Duct
09
Date of System`Airflow Rate Measurement j�
��:
�201�6 I
` 0
10
Airflow Rate Protocol utilize
RA3.3 p o ed� es four airflow rate meas""uurr eme t
B. Fan Watt Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1, and system fan watt measurement apparatus information is given in
RA3.3.2.2.
01 I Fan Watt Verification Device Used. I Portable watt meter I
MCH -22a Forced Air System Fan Efficacy Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor
C. Forced Air System Fan Efficacy Measurement
The procedures for System Fan Watt Verification are specified in Reference Residential Appendix RA3.3.
01
Actual Tested Watts
496
02
Actual Tested Airflow from MCH -23 (cfm)
1644
03
Required Fan Efficacy (watts/cfm)
0.58
04
Actual Fan Efficacy (watts/cfm)
0.3
05
Compliance Statement:
System fan efficacy complies
Registration Number: 216-N0127396A-M2200003A-M22A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:36:01
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-22-H
Space Conditioning System Fan Efficacy (Page 2 of 3 )
D. Additional Requirements
01
All registers were fully open during the diagnostic test.
02
System fan was set at maximum speed during the diagnostic test.
03
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
04
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
05
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
06
Zoned cooling air distribution systems with single speed compressors shall meet both the airflow (cfm/ton) and fan efficacy
(Watt/cfm) criteria in every zonal control mode.
07
Verification Status
Pass - all applicable requirements are met
08
Correction Notes
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status and the Corrections Notes in this table.
E. Determination of HERS Verification Compliance_ �. ;• 0 �, ,.� '�' ,�
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 1 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-N0127396A-M2200003A-M22A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:36:01
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-22-H
Space Conditioning System Fan Efficacy (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name: '
Jack B LaFontaine
Documentation Author Signature:
��Q�:FsGG1Le%
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C z
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement j
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rates who performed the verification identified and reported on this Certificate of Verification (responsible rater).
t
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification complywith_the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance foi,the building approved by the enforcement agency.
4. The information` reported on applicable se�ctiohs;o'f:the Certifica e(s) of Insiallafion'(CF2R)`signed_ands`Ubmitied,by the persons) responsible for the
OF, t ie, r,- ,rr ea r r_
construction or installation conforms to the requirements specified;on the Certificates) of Compliance (Cf1R) approved by the enforcement -agency.
5. 1 will ensure that a registered co y, s ed, o ¢ av i e u f o/
g py:of this Certificate ofVerification be posted or made available with the.building permit(s) issued for the
building, and made available tort theenforcement agency for all applicable inspections. I Aderkstand that a.registered copy of,this'Certificate,of p�
�,. aR .
Verification is required to be incyluded with the documentation the builderprovides to the building owner at Occupancy.
Shown O cat Of
Builder Or Installer Information As The Certif Installation=
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky -
-
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable) +
Tested -
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature: p=
Jack B LaFontaine
-
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
t
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider '
responsibility for the accuracy of the information..
Registration Number: 216-N0127396A-M2200003A-M22A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards , Report Version: 2013 Rev 1 007 • Report_ Generated: 2016-04-07 09:36:01
2013 Residential Compliance Schema Version: 0.51SDD
EMS SEPARATOR PAGE
CERTIFICATE OF VERIFICATION
CF3R-MCH-22-H
Space Conditioning System Fan Efficacy
(Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency:
Quinta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. Ducted Cooling System Information
01
System Identification or Name
System 3
02
System Location or Area Served
Location
03
System Installation Type
New
04
Nominal Cooling Capacity (tons) of Condenser
3
05
Condenser Speed Type
Single Speed
r
06
Cooling System Zonal Control Type
Not Zonal
a �
07
Central Fan Integrated (CFI) Ventilation System Status,
Not a CFI system
08
System Bypass Duct Status,No
Bypass Duct
09
Date of System/Airflow Rate Measurement. �,�
20A-03-31 j
10
Airflow Rate Protocol utilized 4RA3.3
pcedes foairfloatemearmt'o� ��
B. Fan Watt Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1, and system fan watt measurement apparatus information is given in
RA3.3.2.2.
01 I Fan Watt Verification Device Used. I Portable watt meter
MCH -22a Forced Air System Fan Efficacy Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor
C. Forced Air System Fan Efficacy Measurement
The procedures for System Fan Watt Verification are specified in Reference Residential Appendix RA3.3.
01
Actual Tested Watts
357
02
Actual Tested Airflow from MCH -23 (cfm)
1182
03
Required Fan Efficacy (watts/cfm)
0.58
04
Actual Fan Efficacy (watts/cfm)
0.3
05
Compliance Statement:
System fan efficacy complies
Registration Number: 216-N0127396A-M2200004A-M22A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:36:41
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-22-H
Space Conditioning System Fan Efficacy (Page 2 of 3 )
D. Additional Requirements
01
All registers were fully open during the diagnostic test.
02
System fan was set at maximum speed during the diagnostic test.
03
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
04
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
O5
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
06
Zoned cooling air distribution systems with single speed compressors shall meet both the airflow (cfm/ton) and fan efficacy
(Watt/cfm) criteria in every zonal control mode.
07
Verification Status
Pass - all applicable requirements are met
08
Correction Notes
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status.and the Corrections Notes in this table.
E. Determination of HERS Verification Compliance ; � R"9 I,,> � %17 L1 C r'"_1�zy
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-N0127396A-M2200004A-M22A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:36:41
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-22-H
Space Conditioning System Fan Efficacy (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature:Or-
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty' of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate'of Verification comply.with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance f6Fthe building approved by the enforcement agency.
4. The information reported on applicable section�'&.'the Certificate(s) of Insfallaiion`(CF2R)sig`�n ed:a }d-iubmitied:by the peri on(s) responsible for the
construction or installation conforms to the requirements,specified,on thertifi
Cecate(s) of Compliance (CF1R) approved by the enforcement:agency.
5. 1 will ensure that a registered copytof this Certificate of Verificatiowshall 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 axegistered,copy ofthis,Certificate.of �y
`t, + .} i. y \. - ',� * "' f.
-+ 5 ,i , x.% _ _,p i
Verification is`required to be included with the documentation the builder provides`to the building owner at occupancy.
� t � � ,.w �-, x� r+r►_ r.w.. ,w.`... a. x'".
Shown On Certifcate'Of
Builder Or Installer Information As Th Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature: OpTT-�
Jack B LaFontaine
��e�lLGILP/
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2200004A-M22A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:36:41
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION
CF3R-MCH-23-H
Space Conditioning System Airflow Rate
(Page 1 of 4 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Qu i nta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
A. Ducted Cooling System Information -
O1
System Identification or Name
System 1
02
System Location or Area Served
Location
03
System Installation Type
New
04
Nominal Cooling Capacity (tons) of Condenser
5
05
Condenser Speed Type'
Single Speed
06
Cooling System Zonal Control Type
Not Zonal
07
Central Fan Integrated (CFI) Ventilation Sys m Status-
Not a CFI system
08
System Bypass Duct Status,,"'-
NoB p ss Ducts
09
Date of System/Airflow Rate NMeasurement Q--
�,
10
Airflow Rate Protocol utilize
eA3.3 proced� es foy airflo ate meas""�`ureme""nt
B. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP)
in the supply plenum.
Procedures for installing HSPP or PSPP are specified in RA3.3.1.1.
01 Method used to demonstrate compliance with theI HSPP installed and labeled consistent with Figure RA3.3-1 I
HSPP/PSPP requirement
C. Airflow Rate Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1.1, and system airflow rate measurement apparatus information is given
in RA3.3.2.
O1
Airflow Rate Measurement Type used for this airflow rate
Flow Grid according to procedure in RA3.3.3.1.2
verification.
02
Manufacturer of Airflow Measurement Apparatus
TEC
03
Model number of Airflow Measurement Apparatus
TruFlow
Certification Status of the Airflow Measurement Apparatus
Certified by Manufacturer and listed on CEC Website at
04
Accuracy
http://www.energy.ca.gov/title24/equipment_cert/ama_fas
/index.html
Registration Number: 216-N0127396A-M2300002A-M23A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated.: 2016-04-07 09:21:38
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 2 of 4 )
MCH -23a Forced Air System Airflow Rate Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor
D. Forced Air System Airflow Rate Measurement
The procedures for System Airflow Rate Verification are specified in Reference Residential Appendix RA3.3.
01
Required Minimum System Airflow Rate (cfm/ton)
350
02
Required Minimum System Airflow Target (cfm)
1750
03
Actual System Airflow Rate Measurement (cfm)
1950
04
Compliance Statement:
System airflow rate complies
E. Additional Requirements
Air filters -'that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in
01
the system during system air flow rate measurement identified on this Certificate of Verification.
The airflow rate measurement apparatus used top perform the airflow low -rate metasurementr identified on this Certificate of
02
Verification was calibrated in accordance with the apparatus manufacturer's`specifications and conforms to the
instrumentationspecificatonsgiven in RA3:3+1��' U ��� L-= :J X L
`
` I G'--ij f r- F,-� r w !).<, Ii it %,y 11`S -
v I i .1(r
A visual inspection shall confirm that bypass ducts that deliver conditioned supply air directly to the `space conditioning
system return duct airflow are not used on newly constructed zonally controlled systems unless the Performance Certificate
03
of Compliance indicates an allowance for use of a bypass duct. When a bypass duct is accounted for on the Performance
Certificate of Compliance, the airflow rate shall conform to the specifications listed on the Certificate of Compliance.
04
All registers were fully open during the diagnostic test.
05
System fan was set at maximum speed during the diagnostic test.
06
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
07
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
08
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
09
Verification Status
Pass - all applicable requirements are met
10
Correction Notes
The responsible person's signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status and the Corrections Notes in this table.
Registration Number: 216-N0127396A-M2300002A-M23A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS '
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:21:38
2013 Residential Compliance Schema Version: 0.555SDD '
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 3 of 4 )
F. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
�Y1 aLa
,.._
rc
s-+
Registration Number: 216-N0127396A-M2300002A-M23A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:21:38
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature:
���/G1L�RfifGP/
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections of the Certificate(s) oflnstallatici (CF211) signed and submitted by the person(s) responsible for the
construction or installation conforms to the requirements specified on the Certifica_te(s) of Compliance (CFiR) approved by the enforcement agency.
l � l
5. 1 will ensure that a registered copy of this Certificate of,Verification shall be posted, -or made available with the building permits) r issued1 for1" the
building, and made available to the enforcement agency.for all applicable inspections. I'understand that a registered copy of this Certificate of, r\
Verification is required to be included with the documentation th'e builder provides to the building owner at occupancy.
Builder Or Installer Information As Shown On'The'Certificate-'Of Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature:
Jack B LaFontaine
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2300002A-M23A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:21:38
2013 Residential Compliance Schema Version: 0.555SDD '
EMS. SEPARATOR PAGE
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
CERTIFICATE OF VERIFICATION
CF3R-MCH-23-H
Space Conditioning System Airflow Rate
(Page 1 of 4 )
Project Name: Miller, William Revised
Enforcement Agency:
Quinta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
-City:
La Quinta .
Zip Code: 92253
A. Ducted Cooling System Information
01
System Identification or Name
System 2 -
02
System Location or Area Served
Location
03
System Installation Type
New,
04
Nominal Cooling Capacity (tons) of Condenser .
4
05
Condenser Speed Type \
Single Speed
06 ,
Cooling System Zonal Control Type
,r tt
Not Zonal _
07
Central Fan Integrated (CFI) Ventilation System Status!-
Not a CFI system
08
System BypassDuct Status�/�
t '
Noss D cts
V L_
09
Date of System fAirflow Rate Measurement
2016-03-31
10
Airflow Rate Proiocol utilize 1$.)R
A3.3 p o'ceds fo airflow,jate"meaemt
B. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP)
in the supply plenum. ,
Procedures for installing HSPP or PSPP are specified,in RA3.3.1.1.
01 Method used to demonstrate compliance with the HSPP installed and labeled consistent with Figure RA3.3-1
HSPP/PSPP requirement -
C. Airflow Rate Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1.1, and system airflow rate measurement apparatus information is given
in RA3.3.2. •'
01
Airflow Rate Measurement Type used for this airflow rate
Flow Grid according to procedure in RA3.3.3.1.2
verification.
02
Manufacturer of Airflow Measurement Apparatus
TEC 4
03
Model number of Airflow Measurement Apparatus
Tru -Flo
Certification Status of the Airflow Measurement Apparatus
Certified by Manufacturer and listed on CEC Website at
04
Accuracy
http://www.energy.ca.gov/title24/equipment_cert/ama_fas
=
/index.html
Registration Number: 216-N0127396A-M2300003A-M23A Registration Date/Time: 2016-04-07 09:57:05 ` HERS Provider: CaldRTS
CA Building Energy Efficiency Standards, Report Version: 2013 Rev 1.007 - Report Generated: 2016-04-07 09:22:39
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 2 of 4 )
MCH -23a Forced Air System Airflow Rate Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor
D. Forced Air System Airflow Rate Measurement
The procedures for System Airflow Rate Verification are specified in Reference Residential Appendix RA3.3.
01
Required Minimum System Airflow Rate (cfm/ton)
350
02
Required Minimum System Airflow Target (cfm)
1400
03
Actual System Airflow Rate Measurement (cfm)
1644
04
Compliance Statement:
System airflow rate complies
E. Additional Requirements
01
Air filters that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in
the system during system air flow rate measurement identified on this Certificate of Verification.
The airflow rate measurement apparatus used to perform the airflow rate measurement,identified on this Certificate -'-of
02
S, ,.— , r —.1 t� �i
Verification was calibrated in accordance, with th—e apparatireus manufacturr---er's specifi�cation�s and conforms� to the
instrumentation specifications given in RA3:3' i1`
A visual inspection shall confirm bypass ducts that liver conditioned supply air directly to the space condition ng
03
system return duct airflow are not used on newly constructed zonally controlled systems unless the Performance Certificate
of Compliance indicates an allowance for use of a bypass duct. When a bypass duct is accounted for on the Performance
Certificate of Compliance, the airflow rate shall conform to the specifications listed on the Certificate of Compliance.
04
All registers were fully open during the diagnostic test.
05
System fan was set at maximum speed during the diagnostic test.
06
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
07
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
08
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
09
Verification Status
Pass - all applicable requirements are met
10
Correction Notes
The responsible person's signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status and the Corrections Notes in this table.
Registration Number: 216-N0127396A-M2300003A-M23A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:22:39
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 3 of 4 )
F. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
:yam
a� ti
Registration Number: 216-N0127396A-M2300003A-M23A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:22:39
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature:
��Q�:FsLfifLP/
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections of the Certificate(s) of,lnstallati6K(CF2R) signed and submitted by the person(s) responsible for the
construction or installation conforms to the.requirements specified on the Certificate(s) of Compliance (6111) approved by the enforcement agency.
� r i � F 1 i � � s � r
5. I will ensure that a registered copy of this Certificate of,Verification shall be posted;o'r made available with the building permits) issued for the
building, and made available to the enforcement agen `yfor ell applicable inspections. I'u�nderstandthat a registered copy of this Certificate of,
a t i - ♦
\ J
Verification is required to be included with the` documentation the builder provides to the building ownert at occupancy.
N, l rr� erg. �^ a�� e•.�. �+r. a w ' w er►:.
Builder Or Installer Information As Shown On`The Certi cate Of Installation ''� L b
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable),
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature: pT
Jack B LaFontaine
_
��e�=LfiJGPi
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2300003A-M23A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:22:39
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF VERIFICATION
CF3R-MCH-23-H
Space Conditioning System Airflow Rate
(Page 1 of 4 )
Project Name: Miller, William Revised
Enforcement Agency:
Quinta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. Ducted Cooling System Information
01
System Identification or Name
System 3
02
System Location or Area Served
Location
03
System Installation Type
New
04
Nominal Cooling Capacity (tons) of Condenser
3
05
Condenser Speed Type 1�
Single Speed
Certification Status of the Airflow Measurement Apparatus
r
04
06
Cooling System Zonal Control Type
Not Zonal
r �
07
Central Fa ilnt grated (CFI) Ventilation System Status
Not a CFI system
08
System Bypass Duct Status-" r
No Bypass ,
09
Date of System Airflow Rate MeasurementQ
fl �
2016-03-31 4
U, U U k��'
r,
0
10
Airflow Rate Protocol utilized '
%A H E- R
*RA3.3 p oced ru es for'airflo^ r` t 'imeasu ement
�
Z
t I w.. �iM I *W*- Iii—
B. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP)
in the supply plenum.
Procedures for installing HSPP or PSPP are specified in RA3.3.1.1.
01 I Method used to demonstrate compliance with the I HSPP installed and labeled consistent with Figure RA3.3-1 I
HSPP/PSPP requirement
C. Airflow Rate Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1.1, and system airflow rate measurement apparatus information is given
in RA3.3.2.
01
Airflow Rate Measurement Type used for this airflow rate
Flow Grid according to procedure in RA3.3.3.1.2
verification.
02
Manufacturer of Airflow Measurement Apparatus
TEC
03
Model number of Airflow Measurement Apparatus
Tru -Flo
Certification Status of the Airflow Measurement Apparatus
Certified by Manufacturer and listed on CEC Website at
04
Accuracy
http://www.energy.ca.gov/title24/equipment_cert/ama_fas
/index.html
Registration Number: 216-N0127396A-M2300004A-M23A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:23:40
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 2 of 4 )
MCH -23a Forced Air System Airflow Rate Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor
D. Forced Air System Airflow Rate Measurement
The procedures for System Airflow Rate Verification are specified in Reference Residential Appendix RA3.3.
01
Required Minimum System Airflow Rate (cfm/ton)
350
02
Required Minimum System Airflow Target (cfm)
1050
03
Actual System Airflow Rate Measurement (cfm)
1182
04
Compliance Statement:
System airflow rate complies
E. Additional Requirements
01
Air filters that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in
the system during system air flow rate measurement identified on this Certificate of Verification.
The airflow rate measurement apparatus used to perform the airflow rate measurement1clentified on this Certificateof
02
c t -
Verification was calibrated in accordan'cc e with theapP aratusr' man ufa-ctur-er,s_p s ecifications�an\d conforms to the { �
instrumentation specifications given in RA3.3:1��—
A visual inspection shall confirm that bypass ducts that deliver conditioned supply air directly to the space conditioning
03
system return duct airflow are not used on newly constructed zonally controlled systems unless the Performance Certificate
of Compliance indicates an allowance for use of a bypass duct. When a bypass duct is accounted for on the Performance
Certificate of Compliance, the airflow rate shall conform to the specifications listed on the Certificate of Compliance.
04
All registers were fully open during the diagnostic test.
05
System fan was set at maximum speed during the diagnostic test.
06
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
07
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
08
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
09
Verification Status
Pass - all applicable requirements are met
10
1 Correction Notes
The responsible person's signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status and the Corrections Notes in this table.
Registration Number: 216-N0127396A-M2300004A-M23A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:23:40
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 3 of 4 )
F. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
�� � � . F �� :'� cam'' � r �•' v �� �:�_..1� �/� L'' f ��V '.� .—� � % U.
Registration Number: 216-N0127396A-M2300004A-M23A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:23:40
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature: pT
��a�:�LG1GPi
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
R08-03-234
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections of the Certificates) of. In`stallatio`n (CF2R) signed and submitted by the person(s) responsible for the
construction or installation conforms to the requirements specified ori the Certificate(s) of Compliance (CF1R) approved by the enforcement agency.
5. 1 will ensure that a registered copy of this Certificate of,Verificationrshall be osted, or made available with the buildin t l , f
g copy p g permits) issued for the
building, and made available to the enforcement agency.for ell applicable inspections. I understand,that a registered copy of this Certificate of
Verification is required to to 'included with the docume`ntatio'n the builder provides to the building owner at oc upancy. `j
i l .+.. w+.. �+ .+.ti r.+,. !+ • e ' • fig, w+.. n.w
V-- I imp % ..ov !Y L LOP L: L It
Builder Or Installer Information As Shown OnThe`Certificate Of Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature:
Jack B LaFontaine
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by WCERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2300004A-M23A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:23:40
2013 Residential Compliance Schema Version: 0.555SDD
CERTIFICATE OF VERIFICATION
CF3R-MCH-25-H
Refrigerant Charge Verification
(Page 1 of 4 )
Project Name: Miller, William Revised
Enforcement Agency:
Quinta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. System Information
HERS Rater to field -verify all system information, discrepancies to be noted by overwriting entry.
01
System Identification or Name
System 1
02
System Location or Area Served
Location
03
Condenser (or package unit) make or brand
York
04
Condenser (or package unit) model number
YCS60621
05
Nominal Cooling Capacity (tons) of Condenser
5
t
06
Condenser (or package unit) serial number
WiG5878522
07
Refrigerant Type,. ]}�( /�jr
■ L f i
R -410A
A i A ♦\ �1 { ! l 1.
08
Other Refrigerant Type'(f applicable)
IL
(�
t
iia t`
09
System Installation Type +.,"
s U a Q � ::.,� l �' U uJ Q
New [�
M M 011% ,f IE �"�a.. 1C",• �'"�►
10
y ..
Charge Indicator Display (CID) Status (Note: Even systems
M 0 14 '+_./' v v
This system does not have a CID device installed
with a CID must have refrigerant charge verified by installer).
Is the system of a type that the minimum airflow can be
Yes, this is a ducted system and one of the system airflow
11
verified using an approved measurement procedure (RA3.3
rate measurement procedures in RA3.3 or RA3.2.2.7 can be
or RA3.2.2.7)?
used to verify system airflow rate requirements.
Is the system of a type that approved refrigerant charge
Yes, one of the Refrigerant charge verification procedures
verification procedures can be used to verify compliance
from RA3.2.2 or RAI is applicable to this system and can be
12
with the refrigerant charge verification requirements when
used to verify compliance
temperatures are greater than or equal to 55F (RA3.2.2, or
RAI)?
13
Date of Refrigerant Charge Verification for this system
2016-03-31
14
Refrigerant charge verification method used.
Subcooling (outdoor temperature must be equal to or
greater than 55 degF)
15
Person who performed the Refrigerant Charge Verification
HVAC system installer
reported on this Certificate of Installation
HERS Verification Compliance Requirement Status
System qualifies for group sampling
E176
Refrigerant charge verification method used by HERS Rater.
Subcool
' Registration Number: 216-N0127396A-M2500002A-M25A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
' CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:37:54
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 2 of 4 )
MCH25b - Refrigerant Charge Verification - Subcooling Method
B. Metering Device Verification - HERS Rater is required to visually field verify all information from CF211
Subcooling Method can only be used on systems that have a variable metering device.
01
Refrigerant metering device
Thermostatic Expansion Valve (TXV)
02
Subcooling Method applicability status
Subcooling Method is applicable to this system.
C. Instrument Calibration - HERS Raters are required to calibrate their diagnostic tools.
Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2
01
Date of Digital Refrigerant Gauge Calibration
2016-03-28
02
Date of Digital Thermocouple Calibration
2016-03-28
03
Digital Refrigerant Gauge Calibration Status
Calibration is current
04
Digital Thermocouple Calibration Status.,---_---) i f
Calibration is current
D. Measurement Access Hole:(MAH) Verification=HERS Raters'are required to visually field verify MAH
Procedures for installing MAH are:specified-in Reference'Residential Appendix RA3:2.2.3r^-
�� ,
01 Method used to demonstrate compliance with the MAH installed and labeled consistent with Figure 3.2-1
Measurement Access Hole (MAH) requirement
E. Minimum System Airflow Rate Verification
Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.2.2.7.
01
Minimum Required System Airflow Rate (cfm)
1750
02
System Airflow Rate Verification Status
System complies with minimum airflow rate requirements
F. Data Collection - HERS Rater must independently collect all data in this section.
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2 and RA3.2.2.2
01
Lowest return air dry bulb temperature that occurred during
72
the refrigerant charge verification procedure (degreeF)
02
Measured Condenser air entering dry-bulb temperature (T
81
condenser, db)
03
Outdoor Temperature Qualification Status
Outdoor temperature is within range for using Subcooling
refrigerant charge verification method
Registration Number: 216-N0127396A-M2500002A-M25A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:37:54
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 3 of 4 )
F. Data Collection - HERS Rater must independently collect all data in this section.
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2 and RA3.2.2.2
04
Measured Liquid Line Temperature (Tiiquid) (degreeF)
88
05
Measured Liquid Line Pressure (Pliquid) (pisg)
306
06
Condenser saturation temperature (Tcondensor, sat) from digital
97.3
Measured Suction line p essure�(Psuction) (psig' iU N ~
gauge or P -T Table using Line F05 (degree F)
07
Measured Subcooling
9.3
08
Target Subcooling
10
digital gauge or P -T Table using line G02 (degreeF)
Compliance Statement lSystem complies with Subcooling Method - Must also pass metering device verification, next
09
section / '.
24
05
G. Metering Device Verification_
Procedures for the verification of prope r_metering device operation are specified in RA3.2.2.6.2
01
Measured Suction line t mpe ature (T (ion) (degreeF)
5 0! 6Vn)
02
Measured Suction line p essure�(Psuction) (psig' iU N ~
145 U t4 Lj t=�/ 0 U U
Evaporator saturation temperature (Tevaporator, sat) from "`
26.6 I 9
03
digital gauge or P -T Table using line G02 (degreeF)
04
Measured Superheat
24
05
Measured Superheat is between 3 and 26 deg F (inclusive)
Passes CEC requirement
06
Measured Superheat is within manufacturer's specifications,
Not known
if known
07
Compliance Statement: Metering device verification passes
H. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-N0127396A-M2500002A-M25A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:37:54
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature: p�
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections of the Certificates) of nstallation (CF2R)`signed and submitted by the person(s) responsible for the
construction or installation conforms to the requirements specified on the Certificates) of Compliance (CFiR) approved by the enforcement agency.
S. I will ensure that a registered copy of this Certificate of,Verificationtshall be posted; or made available with the building per'mit(s) issued for the
building, and made available to the enforcement agency,for all applicable inspections. I understand that a registered copy of this Certificate of
Verification is required to be included with the documentation the builder provides to the building owner at occupancy.
Builder Or Installer Information As Shown On The`Certificate Of Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature: pT
Jack B LaFontaine
��QL.RGlGP�
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2500002A-M25A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:37:54
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION
CF3R-MCH-25-H
Refrigerant Charge Verification
(Page 1 of 4 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Qu i nta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
A. System Information
HERS Rater to field -verify all system information, discrepancies to be noted by overwriting entry.
01
System Identification or Name
System 2
02
System Location or Area Served
Location
03
Condenser (or package unit) make or brand
York
04
Condenser (or package unit) model number
YCS481321S
05
Nominal Cooling Capacity (tons) of Condenser
• 5
4
06
Condenser (or package unit) serial number
W1A6267053
07
Refrigerant Type ' �! -� ,.
�R-410A
08
Other Refrigerarit Type (if applicable)
09
System Installation Type
New
Charge Indicator Display (CID) Status (Note: Even systems
This system does not have a CID device installed
10
with a CID must have refrigerant charge verified by installer).
Is the system of a type that the minimum airflow can be
Yes, this is a ducted system and one of the system airflow
11
verified using an approved measurement procedure (RA3.3
rate measurement procedures in RA3.3 or RA3.2.2.7 can be
or RA3.2.2.7)?
used to verify system airflow rate requirements.
Is the system of a type that approved refrigerant charge
Yes, one of the Refrigerant charge verification procedures
verification procedures can be used to verify compliance
from RA3.2.2 or RA1 is applicable to this system and can be
12
with the refrigerant charge verification requirements when
used to verify compliance
temperatures are greater than or equal to 55F (RA3.2.2, or
RA1)?
13
Date of Refrigerant Charge Verification for this system
2016-03-31
14
Refrigerant charge verification method used.
Subcooling (outdoor temperature must be equal to or
greater than 55 degF)
15
Person who performed the Refrigerant Charge Verification
HVAC system installer
reported on this Certificate of Installation
16
HERS Verification Compliance Requirement Status
System qualifies for group sampling
17
Refrigerant charge verification method used by HERS Rater.
__
Subcool
Registration Number: 216-N0127396A-M2500003A-M25A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:38:53
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 2 of 4 )
MCH25b - Refrigerant Charge Verification - Subcooling Method ::1
B. Metering Device Verification - HERS Rater is required to visually field verify all information from CF2R
Subcooling Method can only be used on systems that have a variable metering device.
01
Refrigerant metering device
Thermostatic Expansion Valve (TXV)
02
Subcooling Method applicability status
Subcooling Method is applicable to this system.
C. Instrument Calibration - HERS Raters are required to calibrate their diagnostic tools.
Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2
01
Date of Digital Refrigerant Gauge Calibration
2016-03-28
02
Date of Digital Thermocouple Calibration
2016-03-28
03
Digital Refrigerant Gauge Calibration Status
Calibration is current
04
Digital Thermocouple Calibration Status-___.�
--Calibration'is'current=7� r'
N
D. Measurement Access Hole.(MAH) Verification ;;-HERS Raters'are�requirecl to visually field verify MAH, •
Procedures for installing MAH are.specified'in,Reference'Residential Appendix RA3:2.2.3 D ✓, ' ,a '1
01 Method used to demonstrate compliance with the MAH installed and labeled consistent with Figure 3.2-1
Measurement Access Hole (MAH) requirement
E. Minimum System Airflow Rate Verification
Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.2.2.7.
01
Minimum Required System Airflow Rate (cfm)
1400
02
System Airflow Rate Verification Status
System complies with minimum airflow rate requirements
F. Data Collection - HERS Rater must independently collect all data in this section.
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2 and RA3.2.2.2
01
Lowest return air dry bulb temperature that occurred during
74
the refrigerant charge verification procedure (degreeF)
02
Measured Condenser air entering dry-bulb temperature (T
81
condenser, db)
03
Outdoor Temperature Qualification Status
Outdoor temperature is within range for using Subcooling
refrigerant charge verification method
Registration Number: 216-N0127396A-M2500003A-M25A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:38:53
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 3 of 4 )
F. Data Collection - HERS Rater must independently collect all data in this section.
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2 and RA3.2.2.2
04
Measured Liquid Line Temperature (Tiiquid) (degreeF)
82.8
05
Measured Liquid Line Pressure (Pflqufd) (pisg)
247
06
Condenser saturation temperature (Tcondensor, sat) from digital
93.3
{ t ! I
gauge or P -T Table using Line F05 (degree F)
Measured Suction line pressure (Psuction) (psig)
07
Measured Subcooling
10.5
08
Target Subcooling
10
X30.2 '"'
Compliance Statement !System complies with Subcooling Method - Must also pass metering device verification, next
09
section -
I
G. Metering Device.Vefification_ �- _ • _ __,
_
Procedures for the verification of proper;metering device operation are specified in RA3.2.2.6.2
01
Measured Suction line -temperature (4 ion) (degr eF)I
40!3=
[Inn
I
i,.%\ 1�
{ t ! I
02
Measured Suction line pressure (Psuction) (psig)
120
• r . 1R A W~ pR-,. .;
> 1•�Y., MP'fy.. .wP"'l•. R :M M Mr"hti r►M 'r4y
Evaporator saturation temperat a (Tevap6rator,r, sat) rom ` "`
X30.2 '"'
03
digital gauge or P -T Table using line G02 (degreeF)
04
Measured Superheat
10.1
05
Measured Superheat is between 3 and 26 deg F (inclusive)
Passes CEC requirement
06
Measured Superheat is within manufacturer's specifications,
Not known
if known
07
Compliance Statement: Metering device verification passes
H. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
O1 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-N0127396A-M2500003A-M25A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:38:53
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature:
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections of the Certifica—te(s) of Installation (CF2R) signed and submitted by the person(s) responsible for the
construction or installation conforms to the requirements specified ori the Certifica_te(s) of Compliance (CE1R) approved by the enforcement agency.
/5 I f I t L l 1 �-••� t " l l /
S. I will ensure that a registered copy of this Certificate of,Verification 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 registered copy of this Certificate of.
Verification is required to be included with the documentation ttie builder provides to the building owner at occupancy.
Builder Or Installer Information As Shown On The Certificate Of Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature:
Jack B LaFontaine
��a1LfilLP/
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2500003A-M25A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS '
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:38:53
2013 Residential Compliance Schema Version: 2013.1.007 '
CERTIFICATE OF VERIFICATION
CF3R-MCH-25-H
Refrigerant Charge Verification
(Page 1 of 4 )
Project Name: Miller, William Revised
Enforcement Agency:
Quinta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. System Information
HERS Rater to field -verify all system information, discrepancies to be noted by overwriting entry.
01
System Identification or Name
System 3
02
System Location or Area Served
Location
03
Condenser (or package unit) make or brand
York
04
Condenser (or package unit) model number
YCS36621S
05
Nominal Cooling Capacity (tons) of Condenser
3
06
Condenser (or package unit) serial number
W1M5189576
07
Refrigerant Type--�
_Other
08
Other Refrigerant Type if applicable)
N/Aim--�
,
09
'0 �,. '
System Installation Type
::1c _..""fit U ki U �.�. j � tj U U V
New it
10
n r 1... t
Charge Indicator Display (CID) Status (Note: Even systems
'A " % '*Wr *...OK 0L_ IL�►
This system does not have a CID device installed
with a CID must have refrigerant charge verified by installer).
Is the system of a type that the minimum airflow can be
Yes, this is a ducted system and one of the system airflow
11
verified using an approved measurement procedure (RA3.3
rate measurement procedures in RAU or RA3.2.2.7 can be
or RA3.2.2.7)?
used to verify system airflow rate requirements.
Is the system of a type that approved refrigerant charge
Yes, one of the Refrigerant charge verification procedures
verification procedures can be used to verify compliance
from RA3.2.2 or RA1 is applicable to this system and can be
12
with the refrigerant charge verification requirements when
used to verify compliance
temperatures are greater than or equal to 55F (RA3.2.2, or
RA1)?
13
Date of Refrigerant Charge Verification for this system
2016-03-31
14
Refrigerant charge verification method used.
Subcooling (outdoor temperature must be equal to or
greater than 55 degF)
15
Person who performed the Refrigerant Charge Verification
HVAC system installer
reported on this Certificate of Installation
16
HERS Verification Compliance Requirement Status
System qualifies for group sampling
17
Refrigerant charge verification method used by HERS Rater.
Subcool
' Registration Number: 216-N0127396A-M2500004A-M25A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:39:47
' 2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 2 of 4 )
MCH25b - Refrigerant Charge Verification - Subcooling Method
B. Metering Device Verification - HERS Rater is required to visually field verify all information from CF211
Subcooling Method can only be used on systems that have a variable metering device.
01
Refrigerant metering device
Thermostatic Expansion Valve (TXV)
02
Subcooling Method applicability status
Subcooling Method is applicable to this system.
C. Instrument Calibration - HERS Raters are required to calibrate their diagnostic tools.
Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2
01
Date of Digital Refrigerant Gauge Calibration
2016-03-28
02
Date of Digital Thermocouple Calibration
2016-03-28
03
Digital Refrigerant Gauge Calibration Status
Calibration is current
04
Digital Thermocouple Calibration Statuses -' ,
Calibration is current_—/�7-
D. Measurement Access Hole (MAH) Verification= -HERS Raters'are required to visually field.'verify MAH
Procedures for installing MAH a`re.specifiedlin Reference Residential Appendix RA3:2.2.3
01 Method used to demonstrate compliance with the MAH installed and labeled consistent with Figure 3.2-1
Measurement Access Hole (MAH) requirement
E. Minimum System Airflow Rate Verification
Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.2.2.7.
01
Minimum Required System Airflow Rate (cfm)
1050
02
System Airflow Rate Verification Status
System complies with minimum airflow rate requirements
F. Data Collection - HERS Rater must independently collect all data in this section.
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2 and RA3.2.2.2
01
Lowest return air dry bulb temperature that occurred during
70.6
the refrigerant charge verification procedure (degreeF)
02
Measured Condenser air entering dry-bulb temperature (T
80.5
condenser, db)
03
Outdoor Temperature Qualification Status
Outdoor temperature is within range for using Subcooling
refrigerant charge verification method
Registration Number: 216-N0127396A-M2500004A-M25A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:39:47
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 3 of 4 )
F. Data Collection - HERS Rater must independently collect all data in this section.
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2 and RA3.2.2.2
04
Measured Liquid Line Temperature (Tiiquid) (degreeF)
80.5
05
Measured Liquid Line Pressure (Pliquid) (pisg)
238
06
Condenser saturation temperature (Tcondensor, sat) from digital
93.6
gauge or P -T Table using Line F05 (degree F)
�����.-��-r���t glyy.�,
!! r` 1k, N, N 'R:r..,.+,,'t+..re'�.5�.� U' mow,.
Measured Suction line pressure (Psuction) (psig)
07
Measured Subcooling
13.1
08
Target Subcooling
11
09
Compliance Statement:' System complies with Subcooling Method - Must also pass metering device verification, next
digital gauge or P -T Table using line G02 (degreeF)
section %
04
l
G. Metering Device Verification Y_
Procedures for tli ` erification of proper, met g device operation are specified in RA3.2.2.6.2
01
Measured Suction line temperature (Tsucnon)(deg e)�
444'--=i11
nn
7l t4
9i
02
�����.-��-r���t glyy.�,
!! r` 1k, N, N 'R:r..,.+,,'t+..re'�.5�.� U' mow,.
Measured Suction line pressure (Psuction) (psig)
ikY� 3p/ /g 1( r �y
;�1 t 1j 1 Lt tZe } ( 3.t fr.�" %,i a..r
130
r/ \ X e 0-
fl
t A -ft, Ar w+•w
Evaporator saturation temperature (Tevapor�sat) `from "
X24.9 '�"" rN
03
digital gauge or P -T Table using line G02 (degreeF)
04
Measured Superheat
19.8
05
Measured Superheat is between 3 and 26 deg F (inclusive)
Passes CEC requirement
06
Measured Superheat is within manufacturer's specifications,
Not known
if known
07
Compliance Statement: Metering device verification passes
H. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-N0127396A-M2500004A-M25A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:39:47
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature: OT -
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections of the Certificates) of Installation (CF2R) signed and'submitte'd by the person(s) responsible for the
construction or installation conforms to the requirements specified ori the Certificates) of Compliance (CE1R) approved by the enforcement agency.
, i -,
5. 1 will ensure that a registered cop.y of this Certificate of,Verification 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 registered copy of this Certificate of -�
Verification is required to be included with the docurne`ntafion i e builder provides to the building owner at occupancy.
Builder Or Installer Information As Shown On The Certificat Of Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature: pT
Jack B LaFontaine
_
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by CaXERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2500004A-M25A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:39:47
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION
CF3R-MCH-26-H
Rated Space Conditioning System Equipment Verification
(Page 1 of 4 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Qu i nta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
A. System Information
Procedures for verification of High SEER and EER Equipment are described in Reference Appendix RA3.4. Each HVAC
system requiring verification must use a separate form.
01
System Name or Identification/Tag
System 1
02
System Location or Area Served
Location
03
Status: SEER and EER performance compliance credit check
Both SEER and EER HERS Verification is required
04
Directory used to certify product performance
AHRI
05
AHRI certification number for the installed space
8465332
conditioning system from'http://www.ahridirectory.org
06
Does the directory used to certify product performances
require a specific air handler/furnace m ke and;m�odea
No j
}
EDDYC
YCS60621
F
YCS601321
Installed Model Number
Does the directory'used t ertify product'1performance.t
-No� U (�
07
require a time'delay relay (+TDR)k
Inside Coil - Installed Manufacturer
08
Does the directory used to certify product performance
Yes
ADP
require a TXV (+TXV)?
B. Rated Space Conditioning System Equipment Verification
The data on nameplate of the installed component shall conform to the data for the component as shown in the
Directory used to certify product performance in order to demonstrate compliance.
Data from Nameplate of Installed system
Data from Directory used to certify product
component
performance for the rated system
component
Outdoor Condenser or Package Unit -
01
York
02
York
Installed Manufacturer Name
Outdoor Condenser or Package Unit -
03
YCS60621
04
YCS601321
Installed Model Number
Inside Coil - Installed Manufacturer
05
ADP
06
ADP
Name
Inside Coil - Installed Model Number
07
CV60006
08
CV60006
Air Handler/Furnace - Installed
09
York
10
This field or section is not applicable
Manufacturer Name
Registration Number: 216-N0127396A-M2600002A-M26A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:46:11
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 2 of 4 )
B. Rated Space Conditioning System Equipment Verification
The data on nameplate of the installed component shall conform to the data for the component as shown in the
Directory used to certify product performance in order to demonstrate compliance.
Air Handler/Furnace - Installed Model 11 TMLX100C20 12 1 This field or section is not applicable
Number
C. Verified Cooling System SEER
01
Required minimum SEER
14.5
02
Installed SEER
14.5
03
Compliance Statement:
System passes SEER verification
Signature by responsible party below certifies that the installed cooling equipment meets or exceeds the required value listed
on the CF2R.
D. Verified Cooling System EER
01
01
Required minimum EER
j1 4
12.3
02
Installed EER `
`
e e r�r••. e+t. w
12:3`
e*-� rf+r ,��., a n � n erg. es+ r-�►
03
Compliance Statement:
L`+
System'passes EER verification IL.i L' L
Signature by responsible party below certifies that the installed cooling equipment matches the equipment on the AHRI
Certificate.
E. Verified Cooling System Air Handler/Furnace
This section does not apply to this project.
F. Verified Cooling System Time Delay Relay
This section does not apply to this project.
G. Verified Cooling System TXV
01
If a TXV is required by the AHRI certificate, the responsible party certifies by signing below that the TXV is properly installed
and has been visually verified, including proper placement of sensing bulb
02
Verification Status
Pass - all applicable requirements are met
03
1 Correction Notes for this table
Registration Number: 216-N0127396A-M2600002A-M26A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:46:11
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 3 of 4 )
H. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
1
Registration Number: 216-N0127396A-M2600002A-M26A Registration Date
/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
' CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:46:11
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature: pT
��aLLfilGP/
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
Bermuda Dunes / CA / 92203
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections of the Certificaie(s) oflnstallation (CF2R)-signed and submitted by the person(s) responsible for the
construction or installation conforms to the requirements specified on the Certificate(s) of C_dmpliance (CF1R) approved by the enforcement agency.
5. 1 will ensure that a registered copy of this Certificate of,Verification'shall be posited, -or made available with the building permit(s) issued for the
building, and made available to the'enforceme'nt agency.for ell applicable inspections. I understand that a registered copy of this Certificate of
Verification is required to be included with the documentation the builder provides to the building owner at occupancy.
1 L' -I' iC �'�l �'' L'`g �`,J'' IV L � it LA
Builder Or Installer Information As Shown On The'Certificate Of Installation "'
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature:
Jack B LaFontaine
��Q�:EsLGlLP/
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by CafCERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2600002A-M26A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:46:11
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION
CF3R-MCH-26-H
Rated Space Conditioning System Equipment Verification
(Page 1 of 4 )
Project Name: Miller, William Revised
Enforcement Agency:
Quinta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. System Information
Procedures for verification of High SEER and EER Equipment are described in Reference Appendix RA3.4. Each HVAC
system requiring verification must use a separate form.
01
System Name or Identification/Tag
System 2
02
System Location or Area Served
Location
03
Status: SEER and EER performance compliance credit check
Both SEER and EER HERS Verification is required
04
Directory used to certify'product performance
AHRI
02
AHRI certification number for the installed space
8465247
OS
conditioning system from'http://www.ahridirectory.org
06
Does the directory used to certify, product -performance' --Yes
require a specific air haandl r/f mace € ke and mode,?� rr
I C: DD 7C
YCS481321S
04
Installed Model Number
#
Does the directory used`tocertify product- ar ! f
rf�
:N o
07
require a time delay relay (+TDR)`
0 0 0""N C
08
Does the directory used to certify product performance
Yes
ADP
require a TXV (+TXV)?
B. Rated Space Conditioning System Equipment Verification
The data on nameplate of the installed component shall conform to the data for the component as shown in the
Directory used to certify product performance in order to demonstrate compliance.
Data from Nameplate of Installed system
Data from Directory used to certify product
component
performance for the rated system
component
Outdoor Condenser or Package Unit -
01
York
02
York
Installed Manufacturer Name
Outdoor Condenser or Package Unit -
03
YCS481321S
04
YCS481321
Installed Model Number
Inside Coil - Installed Manufacturer
05
ADP
06
ADP
Name
Inside Coil - Installed Model Number
07
CV60006
08
CV60006
Air Handler/Furnace - Installed
09
York
10Fork
Manufacturer Name
Registration Number: 216-N0127396A-M2600003A-M26A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:48:50
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 2 of 4 )
B. Rated Space Conditioning System Equipment Verification
The data on nameplate of the installed component shall conform to the data for the component as shown in the
Directory used to certify product performance in order to demonstrate compliance.
Air Handler/Furnace - Installed Model 11 TMLX080C16 12 TMLX080C16
Number
C. Verified Cooling System SEER
01
Required minimum SEER
15.3
02
Installed SEER
15.3
03
Compliance Statement:
System passes SEER verification
Signature by responsible party below certifies that the installed cooling equipment meets or exceeds the required value listed
on the CF2R.
D. Verified Cooling System EER
01
If a specific air handler or furnace is required by the AHRI certificate, the responsible party certifies by signing below that
the installed air handler/furnace matches the equipment on the AHRI Certificate.
02
Verification Status
01
Required minimum EER
1 Correction Notes for this table
02
Installed EER 1\
12'.5--
e r--•
e�w �
•'mow rte►. �:. n n n • �� .F-- .-�.
03
Compliance Statement: V
C
System passes EER verification
Signature by responsible party below certifies that the installed cooling equipment matches the equipment on the AHRI
Certificate.
E. Verified Cooling System Air Handler/Furnace
01
If a specific air handler or furnace is required by the AHRI certificate, the responsible party certifies by signing below that
the installed air handler/furnace matches the equipment on the AHRI Certificate.
02
Verification Status
Pass - all applicable requirements are met
03
1 Correction Notes for this table
F. Verified Cooling System Time Delay Relay
This section does not apply to this project.
G. Verified Cooling System TXV
01 If a TXV is required by the AHRI certificate, the responsible party certifies by signing below that the TXV is properly installed
and has been visually verified, including proper placement of sensing bulb
Registration Number: 216-N0127396A-M2600003A-M26A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:48:50
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 3 of 4 )
G. Verified Cooling System TXV
02
Verification Status
Pass - all applicable requirements are met
03
Correction Notes for this table
H. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-N0127396A-M2600003A-M26A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:48:50
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature: OT _
�s�e�=LfilG�'i
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
Bermuda Dunes / CA / 92203
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections of the Certificate(s) oflnstallation (CF2R) signed and submitted by the person(s) responsible for the
construction or installation conforms to the requirements specified on the Ceriificate(s) of Compliance (61R) approved by the enforcement agency.
5. 1 will ensure that a registered copy of this Certificate of verification 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 registered copy of this Certificate of
Verification is required to be included with the documentation the builder provides to the building owner at occupancy.
Builder Or Installer Information As Shown On IThe Certificate -Of Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature:
Jack B LaFontaine
facw ilGP/
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2600003A-M26A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:48:50
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION
CF3R-MCH-26-H
Rated Space Conditioning System Equipment Verification
(Page 1 of 4 )
Project Name: Miller, William Revised
Enforcement Agency:
Qu i nta
City of La
Permit Number: BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City:
La Quinta
Zip Code: 92253
A. System Information
Procedures for verification of High SEER and EER Equipment are described in Reference Appendix RA3.4. Each HVAC
system requiring verification must use a separate form.
01
System Name or Identification/Tag
System 3
02
System Location or Area Served
Location
03
Status: SEER and EER performance compliance credit check
Both SEER and EER HERS Verification is required
04
Directory used to certify product performance
AHRI
02
AHRI certification number for the installed space
8465214
05
conditioning system from' hitp://www.ahridirectory.org
06
Does the directory used to certify, prod uct_performance
require a specific air handler/furnace ke and,
:Yes
YCS361321S
odea?.
s
Installed Model Number
�
Does the directory used -to certify prod uct,performance, �
�No, U 1 U t=�) Ti U U U {7
07
require a time delay relay (+TDR)k
D 0
LO8
-r ♦ Fw— �. 4
Does the directory used to certify product performance
v � k Iwai^ M v trf.- ems. r +.
Yes
require a TXV (+TXV)?
B. Rated Space Conditioning System Equipment Verification
The data on nameplate of the installed component shall conform to the data for the component as shown in the
Directory used to certify product performance in order to demonstrate compliance.
Data from Nameplate of Installed system
Data from Directory used to certify product
component
performance for the rated system
component
Outdoor Condenser or Package Unit -
01
York
02
York
Installed Manufacturer Name
Outdoor Condenser or Package Unit -
03
YCS361321S
04
YCS36621
Installed Model Number
Inside Coil - Installed Manufacturer
05
ADP
06
ADP
Name
Inside Coil - Installed Model Number
07
CV36006
08
CV36C6
Air Handler/Furnace - Installed
09
York
10
York
Manufacturer Name
Registration Number: 216-N0127396A-M2600004A-M26A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:50:56
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 2 of 4 )
B. Rated Space Conditioning System Equipment Verification
The data on nameplate of the installed component shall conform to the data for the component as shown in the
Directory used to certify product performance in order to demonstrate compliance.
Air Handler/Furnace - Installed Model 11 TMLX080C16 12 TMLX080C16
Number
C. Verified Cooling System SEER
01
Required minimum SEER
15.3
02
Installed SEER
15.3
03
Compliance Statement:
System passes SEER verification
Signature by responsible party below certifies that the installed cooling equipment meets or exceeds the required value listed
on the CF2R.
D. Verified Cooling System EER
01
If a specific air handler or furnace is required by the AHRI certificate, the responsible party certifies by signing below that
the installed air handler/furnace matches the equipment on the AHRI Certificate.
02
Verification Status
Pass - all applicable requirements are met
03
1 Correction Notes for this table
01
Required minimum EER n
; j ��
i
12.8
�-
1
02
Installed EER \
12:8
Z
t*h s
+ ^t. •� -rte►
� e
�.-� w— r �.
03
Compliance Statement: V
J
' J
ti `
�Systerri passes EER verification
Signature by responsible party below certifies that the installed cooling equipment matches the equipment on the AHRI
Certificate.
E. Verified Cooling System Air Handler/Furnace
01
If a specific air handler or furnace is required by the AHRI certificate, the responsible party certifies by signing below that
the installed air handler/furnace matches the equipment on the AHRI Certificate.
02
Verification Status
Pass - all applicable requirements are met
03
1 Correction Notes for this table
F. Verified Cooling System Time Delay Relay
This section does not apply to this project.
G. Verified Cooling System TXV
01 If a TXV is required by the AHRI certificate, the responsible party certifies by signing below that the TXV is properly installed
and has been visually verified, including proper placement of sensing bulb
Registration Number: 216-N0127396A-M2600004A-M26A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:50:56
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 3 of 4 )
G. Verified Cooling System TXV
02
Verification Status
Pass - all applicable requirements are met
03
Correction Notes for this table
H. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-N0127396A-M2600004A-M26A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:50:56
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-26-H
Rated Space Conditioning System Equipment Verification (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature:
�l�Gi� �c/GlL�RfilLt%
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
Bermuda Dunes / CA / 92203
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections of the Certificates) of.lnstallation (CF211) signed and submitted by the person(s) responsible for the
construction or installation conforms to the requirements specified ori the Certificate(s) of Compliance (6111) approved by the enforcement agency.
5. 1 will ensure that a registered copy of this Certificate of,Verification 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. l understand'that a registered copy of this Certificate of—
Verification is required to be included with the documentation the builder provides to the building owner at occupancy.
!:' _
Builder Or Installer Information As Shown On The-CerttificaWOf Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature: p=
Jack BLaFontaine
-
��e�=GfifLP/
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by CaiCERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2600004A-M26A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:50:56
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION
CF3R-MCH-27-H
Indoor Air Quality and Mechanical Ventilation
(Page 1 of 3 )
Project Name: Miller, William Revised
Enforcement Agency: City of La
Qu i nta
Permit Number:
BRES-2014-1152
Dwelling Address: 49-020 Avenida Fernando
City: La Quinta
Zip Code:
92253
Title 24, Part 6, Section 150.0(0) Ventilation for Indoor Air Quality. All dwelling units shall meet the requirements of ANSI/ASHRAE
Standard 62.2. Ventilation and Acceptable Indoor Air Quality in Low -Rise Residential Buildings. Equation and table numbering on
this form corresponds to the numbering for that information in the published ANSI/SHRAE Standard 62.2-2010.
A. Dwelling Mechanical Ventilation - General Information
01
Dwelling unit name
Miller, William Revised
02
Building Type
Single family
03
Project scope �� %
Addition greater than 1,000 ft2
Total Conditioned Floor Area.of Dwelling Unit (For addition
4155
04
projects the conditioned floor area equals existing area plus
addition area.)
OS
N 1. 1 .
Number of bedrooms in dwelling unit (For addition projects
the number bedrooms``equals the bed�om Is,
9
of existing pl
addition bedrooms �
)
{ % t__.J t"
06
Ventilation Operation Schedule F #_Continuous
` K
07
Whole -Building Ventilation Rate Calculation Method
Fan Ventilation Rate Method (4.1.1)
08
Whole Building Ventilation System Type
Standalone - Exhaust
MCH -27a - Continuous Ventilation Airflow - Fan Vent Rate Method ::1
B. Whole -Building Continuous Ventilation - Fan Ventilation Rate Method
01
Required Continuous Whole -Building Ventilation Rate
117
02
Installed Continuous Whole -Building Ventilation Rate
120
C. Compliance Statement
01 Building passes continuous whole -building ventilation rate test
' Registration Number: 216-N0127396A-M2700001A-M27A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:52:47
2013 Residential Compliance Schema Version: 2013.1.006
CERTIFICATE OF VERIFICATION CF3R-MCH-27-H
Indoor Air Quality and Mechanical Ventilation (Page 2 of 3 )
D. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 1 Complies: All specified verification protocol requirements on this document are met.
Registration NumbEr: 216-N0127396A-M2700001A-M27A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CalCERTS
CA Building Energy e=fficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:52:47
2013 Residential Compliance Schema Version: 2013.1.006
CERTIFICATE OF VERIFICATION CF3R-MCH-27-H
Indoor Air Quality and Mechanical Ventilation (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jack B LaFontaine
Documentation Author Signature:Or-
Company:
Date Signed:
Energy Management Services
2016-04-07 09:57:05
Address:
CEA/ HERS Certification Identification (if applicable):
41-485 Adams St Unit C
Bermuda Dunes / CA / 92203
City/State/Zip:
Phone:
Bermuda Dunes CA 92203
760-360-4631
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections_of1he Certificate(s)�oflnsfallation:(CF2R)`sig`ned a dsu6mitted:by the persons) responsible for the
construction or installation conforms to the requirements specified,on the Certificate(s) of Compliance (CF1R) approved by'the enforcement' agency.
5. 1 will ensure that a registered copy of this Certificate of Verification shall be posted -,or made,available with the,building permit(s) issued for the
building, and made available to the- nforcem M.agency,for all applicable inspections. I understand'`that a registered copy of;this'Certificate.of
Verification is required to be included with the documentation the builderprovides tothe building owner at occupancy.
r -w P.w. .-rte+.. + x k er+»a, ,x— r•w
Builder Or Installer Information As Shown On The ertifcat Of Installation '
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
DESERT HABITATS INC
Responsible Builder or Installer Name:
CSLB License:
Michael Dobrensky
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Services
Responsible Rater Name:
Responsible Rater Signature:
Jack B LaFontaine
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2004051
2016-04-07 09:57:05
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-N0127396A-M2700001A-M27A Registration Date/Time: 2016-04-07 09:57:05 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-04-07 09:52:47
2013 Residential Compliance Schema Version: 2013.1.006