Loading...
12-1423 (MECH)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 12/11/12 Application Number: 12-00001423 Owner: -e\ t - Property Address: 79700 NORTHWOOD LOGAN DICK D f APN: 762-022-020- - - 79700 NORTHWOOD Application description: MECHANICAL LA QUINTA, CA, 92253 _ 1 19 Property Zoning: LOW DENSITY RESIDENTIAL (760)564-1811. !_ , 1 ZiJ IZ Application valuation: 16000 Contractor: CITY OF LA QUINTA FINANCE SEPT. Applicant: Architect or Engineer. GENERAL AIR CONDITION 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (760)343-7488 Lic. No.: 686310 ---=--------------------------------------------------------------------------------------------- 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 s Code, and my License is in full force and effect. License Class: C20 - ense No.: 686310 Date:/-)-/(( ~� Contractor: OWNER -B ER 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, als6 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.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason L 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: LQPERM IT WORKER'S COMPENSATION DECLARATION hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier ZENITH INS CO Policy Number Z071741502 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 700 of the Labor Code I shall forthwitj omply with those provisions. Date: 1-2 ( __Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPE ATION COVERAGE S UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP T ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspect urposes. Date: ZB ature (Applicant or Agent): Application Number 12-00001423 Permit . . . MECHANICAL Additional desc . Permit Fee 66.00 Plan Check Fee 16.50 Issue Date . . . Valuation 0 Expiration Date 6/09/13 Qty Unit Charge Per Extension. BASE FEE 15-.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 ----------------------------------------------------------------------------- Special Notes and Comments REPLACE (2) GAS/ELECTRIC HVAC PACKAGE UNITS ON ROOF (3) TON (5) TON SAME FOR SAME 2010 CODES.APPROVED PER B.H. --- - --------------------------------------- Other Fees . . . . . . BLDG STDS ADMIN (SB1473)• 1.00 Fee summary Charged Paid Credited Due' -- - - ------ -- - - ------ - - - - ------ - - - - ------ - - - --- Permit Fee Total" 66:00 .00 .00 66.00 Plan Check Total 16.50 .00 .00 16.50 Other Fee Total 1.00 00 .00 1.00 Grand Total 83.50" 00 00 83.50 -LQPERMIT # QtY. of La Quinta Building ST Safety Division P.O. Box 1504,76-495 Calle Tampico La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 7?'700 0 d Owner's Name:. LG< L O A. P. Number. Address: Legal Description: Contractor. f OWL— G $� �� City, ST, Zip: Telephone: .......... Address: 76 `�' �1'� Y Project Description: 4� City, ST, Zip:��t/ US✓¢�i r/ Telephone. �l T % id'g''z s� d A.) State Lic. # City Lie'. M. Arch., Engr., Designer ' Address: City., ST, Zip: Telephone: :a w State Lie. #: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.:#Stories : #Units: Name of Contact Person: Telephone # of Contact Person: Estimated Value of Project 000. —� APPLICANT: DO N T WRITE BELOW THIS UNE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit • Truss Cates. Called Contact Person Plan Check Balance Tide 24 Calci. Plans picked up Construction Flood plain plan Plans resubmitted.. Mecharilcal Grading plan r4 Revlew, ready for correctionsfissue Electrical Subeontaetor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN ROUSE:- '^' Review, ready for correctionslissue Developer Impact Fee Planning Approval. Called Contact Person A.LP.P. Pub. Wks. Appr ' Date of permit issue School Fees Total Permit Fees Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAIterations CF 1R ALT HV, Climate Zones 10 to 15 O U /v t�/e K> p oEnforcement Agency: Date: Permit k: 12 V Equ-ipKent Type' List Minimum Efficiz Conditioned Floor ackaged Unit enc Duct insulation requirement Area Thermostat ❑ FurnacepE $O % ❑ COp Over 40 ft of ducts added or Setback ❑ Indoor Coil EER /3 ❑ HSPF replaced in unconditioned space Served by system (If not already ❑ Condensing Unit ❑ EER ❑ Resistance ❑ R 6 (CZ 10-13) sf present, must be ❑ Other ❑ R 8 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment being installed; iif more than one system, use another CF -1 R -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFU& 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer.The-inspector also verifies that each appropriate CF -6R and registered CF4R forms (no hand filled CF4Rs allowed) are filled out and si e"eginnirig October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final inspection. 1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH-21 and for split stems MECH-25 • Condenser Coil and /or • Indoor Coil and /or ICF --6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Furnace CF4R forms: MECH- 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if. ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System I Required Forms: • Cut s: al Chang outducting with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS ducts: (all new ducting and all CF -4R forms: MECH 20-, and fors lit new equipment) ( split systems)MECH-22, and MECH 25 For Split Systems: Duct leakage < 6 percent; RC, CCA 2:350 CFM/ton, FWD, TMAH, SIMS, and either.HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF -4R forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all equipment changed. For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned s ace. CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • 1 certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations plans and specifications submitted to the enforcement agency for approval with the permit licat n Name:(C . / r1 L(D %� 'y Signature: Ii Company`-` Address: City/State/Zip: ?- 7nnR pocirlontinl i'mm�linnno /:nrmc /)u 6 ---1h 1 X1 -L— License: 2 6 Phone: %6 0 ' 7 Aetn—h 7ntn Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF -IR -ALT -HVAC' ' Climate Zones 10 to 15 ,.. i Site rens: Ov ���� oQ Enforcement Agency: f g cy: � L,h e Date: Permit #: U /3 S / v Z ui T List Minimum Efficienc Z Duct insulation requirement Conditione Floor Area Thermostat ed ackaged Unit ❑ Furnace L�FUE ���o ❑ COP Over 40 ft of ducts added or 11—S&back ❑ Indoor Coil ®SEER 73� ❑ HSPF replaced in unconditioned space Served by system (ljnot already ❑ Condensing Unit ❑ EER ❑ Resistance ❑ R 6 (CZ 10-13) ru) 0 sf present, must be ❑ Other ❑ R 8 (CZ 14-15) 3 installed) 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the j1ke inspector also verifies that each appropriate CF -611 and registered CF forms -4R (no hand filled CF-4Rs allowed) are filled out and signeo.-Beginniag October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final inspection. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH- 21 and fors lit stems MECH-25 • Condenser Coil and/or • Indoor Coil and /or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Furnace CF -4R forms: MECH- 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut in or Changeout with new ducts: (all new ducting and all CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS newequipment)( CF -4R forms: MECH 20-, and fors lit stems MECH-22, and MECH 25 P ST ) For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with Replacement ' Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF -411 forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all equipment changed. For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned space. CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forts, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit appit.Wion. Name: I— I C J /q C-on:z Signature: Company- ) W (9 7 AJ C ate: Address: Q � 2- S 9k V� �2 �� License: (0 �% 3 a. ME/State/Zipl_Ho() �_ Phone: 260 3Y-3—PYNTI Finan Tr�auiunnrn a nmmyn-0 Hnrmc mnrrh ?n rn HVAC Field Data Sheet Pg 1 of 2 Ment NameL %c 'e- e- o 2-- f -r> Job #/ 41.3 a % ti, ': )Darla i- /2 Address ?5 lax) W2 "r, ' n a p Q. li Q Ph # Tedmidan(s) -,y4-5—F J Permit # Gauge/Pherm000upleCclibration Daae / 1- - n Split I Padage ) Some Ducts Only j All Ducts Only (Orde typeofwork) 6lB i14 , Data ZONE 1 ZON$ ZONE -3 Z01VE4 System Location orArea Swed C u„T r75 7e- d?O . Heating Equipment Make R Heating Equipment Model . P.W510124 P6, 4S” a i '-f/ ARI Reference Number b o 6 S-2. - Heating EquipmentAPQE Dud Location (attic, crawkpaoe, etc.] �c Duct &Value of ducts were installed) Heating Load `7Z Y-0 Heating Equipment Output Capacity e, " Condenser Maheti+ Condenser Model P� Size in Tons v7 SEER&EER %� !1_� Cooling Load (o o o Cooling Capacity 5 f 55,0 3 5"'0 (TO M QI-TA&21 DuctTeSMW Duct leakage pretest result 7- D= Leakage nW Restdt 424CFM/t=tot ass (6% D= rasslM P=MFa P—PM Fara M Duil Lakap FbWRw&-60CFM/rontopassUs%) %31C- P=jFan Paupw Pass using 60% leakage reduction? 2' Pass using smoke and visual inspection? if ON22..or CE25 -C4PbftCoHAbftVwa ' Pan •WauDrni► . Measured Air Volume from Plow Grid or Hood NEW Duds TaveC 350 CFM/ton a Condower?ons CBMGM tR Ta 1pt 300 CFM/tan zcondenseribas Measured air greater than Tar9W (Y/N) Measured Pan Watt Draw Target om watts/measured CFM = Measured Watts less than Target? (Y/N) CoMTW ®2on1 EDS EMM DdVw SadWOM tnc. HVAC Field Data Sheet Pg 2 of 2 Client Name L D G � Job # Date !t!E(Il- Chargees Airflow ZONE 2 ZONBZ ZONE 3 ZONE 4 Condenser Serial Number apsboZ3 t1-11 Supply air dry bulb temperature S Z' Return air dry bulb temperature p ! Remora air wet bulb temperature 67, Evaporator Saturation Temperature 11UA Condenser Saturation Temperature Suction Lane Temperature Liquid Line Temperature Suction Pressure Liquid Pressure Actual Airflow Temperature Split 17 Target Temperatum Split from Table RA3.23 �"j.. M I Passes Edifference is t r ofTxgetTemp (Y/N) c5 Actual Subcooling (t 4- of Target to pass) V - Target Subcooling from M. Actual Superheat (3 to 26- to pass) Outside air dry bulb temperature MECB,26-Wdpph-tn Chmging below 550 . Actual Line Set length (ft) M/� 44 Mfr's Standard Line Set Length (it) Length Difference = Correction Factor (ounces per foot) Target Correction Factor x Length Difference System Charged to Target? #Q OtherData Minimum amps Maximum amps coo Breaker size . Compressor amps g Repan Static Pressure Supply Static Pressure Supply Air Wet Bulb Temperature ••ALLAPPLICABLEBOMONTMSPORMMUSTRECOMPLETBDFOREACKJOR NOEYCEMO NS. + • coryza© Mi WS Sl=U DAv=soh dMv. h- INSTALLATION CERTIFICATE CF-6R-MECH-21-Hf RS Duct Leakage Test - Existing.Duct.System (Page i.of 2) Site Address: Enforcement Agency: Permit Number: 79700 NORTHW.00D, La Quinta CA:92253 (System -1) City:of La Quinta 112-1423 Enter the Duct System Name or Identification/.Tag: 5 TON Enter the Duct System Location or Area Served: DOWNSTAIRS Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also includeexisting parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakaqe Diaqnostic Test - existinq dud system Select one compliance method from the following four choices. ® 1. Measured leakage less than 15% of fan flow O 2. Measured leakage to outside less than 10% of Fari Flow 3. Reduce leakage by 60% and conduct smoke and fix all leaks. 04. Fix all accessible leaks.using smoke and HERS eater.verify' Note: (One of Options 1,2 or 3 must be :attempted before utilizing Option 4i1 Determine nominal Fan Flow using one of the following .three Calculation methods: ✓ ® Cooling system method: Size of condenser in Tons ,. S x. 4,00 = 2000 CFM ✓ O Heating system method: 21.7 x — Output Capacity;in Thousands of Btu%he = CFM ✓ O Measured system airflow using RA3.3 airflow test.; procedures:._ CFM Option 1 used .then; 1 Allowed leakage = Fan Airflow 2000< x 0.15 = 300 CFM Actual Leakage = 230 CFM Pass if Actual Leakage is. less than Allowed leakage IS Pass Fail Option 2_used then: 2 Allowed leakage = Fan Airflow _ x 0.10 = _CFM Actual Leakage to outside = _ CFM Pass If, Actual leakage to outside is less than Allowed leakage E]PassElFail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing.all accessible leaks. using smoke test = _ CFM" 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _ / Initial leakage __.j 'x 1000/6 _ %'Reduction Pass if % Reduction.>= 60% Opass p'.Fail Option 4 used, then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible.leaks have been. repaired using smoke j3Passj3Fail Reg: 212-AC071206A-M2100001A-0000 Registration Date/Time: 2013/01/14 17:3'9::56 HERS 'Provider: CalczRTS, Inc. 2008 Residential Compliance Forms 1.1arch 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HER9 Duct Leakage Test - Existing Duct System (Page 2 of.2) Site Address: Enforcement Agency: Permit Number: 79700 NORTHWOOD, La Quinta CA 92253 -(System 1). City of La Quinta 12-1423 ® Outside air (OA) ducts for Central Fan, -Integrated (CFI)? ventilation systems,,shall not.be sealed/taped off during dud leakage testing, CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required -to meet ASHRAE Standard, 6'2.2, and close when OA -ventilation is not required;;may be configured to the closed position during duct leakage testing; ® All supply and return register boots must be. sealed to the drywall if smoke test i5 utilized for compliance - applies to duct leakage compliance option 3 (leakage reducticin by 600%) and option,4 (fix all accessible leaks) described above. ® New duct installations cannot: utilizebuilding cavities as plenums.. or platform returns in lieu of duds. ® Mastic and draw bands must.be used.in com.bination;.with.cloth.backed rubber adhesive duct tape to seal leaks at all new duct connections DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of. the. State of California, the information provided on this,form is true and correct. . i am eligible under Division,3 of the Business,;andiProfesslons Code toaccept responsibility for construction, or authorized representative of the person responsible for construction (responsible person). . I certify that the Installed features, materials, components„ or. manufactured devices Identified on this certificate (the Installation) conforms to all applicable codes and regulations, andtheInstallation Is consistent.with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects,.] am required to take corrective action at my expense. 1 understand that Energy Commission and HERS provide rrepresentatives will also perform quality assurance checking of installations, including those a'p'proved'as part of a sample group but: not, checked by a HERS rater, and if those Installations fail to meet the requirements of such quality assurance checking, the -required corrective action and additional checking/testing of other Installations in that HERS sample, group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcerrient agency that identifies the* specific .requirements' for the installation. I certify that the requirements detailed on the:CF-111-that apply to the installation have been met. . I_ will ensure that a completed, signed copy of this Installation certificate shall be posted; or made available with the building permit(s) issued for the building, and made.available to the enforcement agency for -all applicable inspections. I' understand that a signed copy of this Installation Certificate is required to_be included'.with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning. October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC. Responsible Person's Name: Responsible Person's. Signature: Danielle Garcia Danielle Garcia CSLB Ucense: Date Signed: Position With Company (Title); ' 686310 12/11/2012 Is this installation monitored. by.a Third Party Quality' Name of TPQCP. (if applicable):' Control Program (TP.QCP)? E) Yes' p No Reg: 212-i100a1206A-M2100001A-0000 Reg `_strat ion. Date'/Time:'201'3/01/14 17:'39:50 HERS -Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-21-HERS Duct Leakage Test — Existing Duct System (Page,I of 2) Site Address: Enforcement,Agency: Permit Number: 79700 N0. RTHWOOD,. La Quinta CA 92253 (System 1) :City of La .Quin ta 12-1423 Enter the Duct System,Name or Identification/Tag: 3'T.ON Enter the Duct System Location orArea Served:: UPSTAIRS Note: Submit one Installation. Certificate for each duct system that must dernonstrate. compliance in the dwelling. This installation certificate is required for compliance for alterations: and additions in .existing.dwellings to space conditioning systems and duct.systems. Note: For existing dwellings, a completely newor replacement duct system can, also include existing parts of the original duct system (e.g., register boots, air handler, coil; :plenums; etc.) if those parts are accessible and they can be sealed. For a completely. new or replacement duct system: installed in an existing dwelling, use the Installation Certificate titled "pact Leakage7est - Completely.New°or.Replacement Duct System. Dud Leakage Diaqnostic Test - existinq duct system Select one compliance method from the following four choices. 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow 113. Reduce leakage by 600% and conduct smoke and fix all leaks 4. Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options 1, 2 or 3 must be attempted before utilizing Option;4.) .., Determine nominal.Fan Flow using one of: the following three calculation methods :.' ✓ ® Cooling system method: Size of:conderiser in Tons -,x 400 = 1200 `CFM ✓ ❑ Heating system. method.: ?1..7 x _ Output Capacity in'Thousands of Btu%hr =_'CFM ✓ ❑ Measured system.airflow using RA3.3-airflow" test. procedures: _ CFM :: Option 1 used then: 1 Allowed leakage = Fan Airflow _ x 0.15.-_ CFM Actual Leakage = _ CFM Pass if Actual Leakage is: less than Allowed leakage CITass 0 Fail Option 2 used then: 2 Allowed leakage := Fan.Airflow_. x 0.10 =_—CFM Actual leakage to outside = ,_ CFM, Pass if Actual leakage to outside is less than Allowed leakage 0Pass 13 Fail Option 3 used then: Initial leakage prior to start of work =. 710 CFM Final leakage after sealing all accessible leaks using smoke test= 260 CFM: 3 Initial leakage 10 - Final leakage 260 .= Leakage reduction 450 CFM ((Leakage reduction 4S0 / Initial leakage 10 x 100%.= 63.38 % Reduction Pass if %.Reduction >= 60.P% ®Pass ❑ Fail Option 4 used then: 4 All accessible leaks, repaired using smoke. test. HERS.rater must verify, (No. Sampling). Pass if ali: accessible: leaks have.peen, repaired using smoke E3,Pass.13 Fail. Reg 212-AO071208A-M2100DO1A-0000 Registration.Date/Time: 2013/0184 17:43:42 HERS -Provider: Ca10ERTS,'Inc.. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF;-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 2 of 2): Site Address: I Enforcement Agency: Permit Number: 79700 NORTHWOOD, La Quinta CA 92253 (System.l)l City of La Quinta 12-1423 ® Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems; shall not be sealed/taped off during duct leakage testing. CFI OA :ducts, that utilize controlled motorized dampers,. that open only when OA ventilation Is required to meet ASHRAE Standard 62.2,.and close when -dA ventilation is not required, may be configured to the closed position'during duct leakage testing. ® All supply and return register boots must be. sealed. to,the drywall,if'smoke test is..utilized for compliance — applies to duct leakage compliance option 3 (leakage reduction by 60%) and: 6ptiorr4,(fix all„accessible leaks) described above. ® New duct installations cannot utilize building cavities as plenumsidr: platforrmeeturns:in lieu of ducts. ® Mastic and draw bands must be. used .In combination.with.cloth backed rubber adhesive duct tape to seal - leaks at all new duct connections DECLARATION STATEMENT [certify under penalty of perjury, under the laws of the State of Callfornia, the Information. provided on thls.form is true and correct.: . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for tonstruction;.or an authorized representative.of the person responsible for construcii'06.(responsibie person). . I certify that the Installed features, materials, components, or manufactured devices identified on this certificate (the Installation) conforms to all applicable codes and regulations, and the Installation is consistent wlth the plans and specifications approved by. -the enforcement agency. . I understand that a HERS rater will check the Installation to verify compllance; andthat,thataf,such checking identifies defects, I am required to take corrective action at my expense.'I:understand that Energy Commission and:HERS provider representatives will also perform quality assurance checking of Installations, Including those approved`as part of a_sample group but not checked by a HERS rater, and If those installations fail to meet the requirements of such.quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed•at my expense. . I reviewed a copy of the Certificate of Compliance (CF-1R).form approved by the enforcement agency.that Identifies the specific requirements for the Installation. I certify.that the requirements detailed onthe;CF-SR that apply to the Installation have been met. . I will ensure that a completed, signed copy ofthis ;Installation certificate shall.be.posted, or made available with the building permits) issued'for the building, and made available to the enforcement agency for: all.applicab.l.e inspections. I understand that a signed copy of this Installation Certificate is required to be included :with..the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 20101. for all:.low-rise'residentlal buildings. Company Name: (Installing Subcontractor.or General, Contractor or-:Builder/,Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSL5 License: Date Signed: Position With Company (Title): 686310 12/13/2012 Is this installation monitored by a Third Party Quality Name of TP.QCP (if applicable,): Control Program (TPQCP)? p Yes p No Reg: 212-A0071208A-M2100001A-0000 Registration Date/Time: 201x3(01/.14 17•:43:42 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION. & DIAGNOSTIC TESTING CF-4R-MECW21 Duct Leakage Test– Existing Duct System (Page 1 of 7) Site Address: Enforcement Agency: Permit Number: 79700 NORTHWOOD, La Quinta_CA 92253 (System 1) City of La Quinta 12-1423 Enter the Duct System Name or Identification/Tag: 5 TON Enter the Duct System Location or Area Served: DOWNSTAIRS Note: Submit one Installation Certificate for each duct System that rust demonstrate compliance in the dwelling. This installation certificate is required .for cOdMpliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register -boots, air handler, coil; plenums, etc.) Ifthose<parts are accessible and they can be sealed. For acompletely new or replacement `duct.system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test- Completely New' or Replacement Duct System." Duct Leakage Diagnostic Test - existing duct.system Select one compliance method from the. following four choices: ®1. Measured leakage less than 15% of fan flow 0 2. Measured leakage to outside less than 109/6 of Fan Flow E3 3. Reduce leakage by 606/6 and conduct smoke and fix all leaks 4. Fix all accessible leaks using smoke and HERS rater verify. Note: (One of Options 1, 2, or 3 must be attempted.before utilizing Option 4;) Determine nominal Fan Flow using.one of the.followin.g three calculation methods.. 1/9 Cooling system method: Size ofxondenser in -Tons 5 x 400 :2000:- -.CFM ✓ O Heating.system method: 21.7 x _.Output` Capacity in Thousands of Btu/hr = _ CFM ✓[ Measured system airflow. using RA3 3:airflow test procedures:.— CFM ,. Option 1 used then; 1 Allowed leakage = Fan Flow 2000 x-0.15 = 300 CFM Actual Leakage = a23 CFM Pass if Leakage Actual Is less than Allowed Pass Fail Option 2 used then: 2 Allowed leakage = Fan Flow _ x 0A0 = _ CFM Actual Leakage to outside = —.CFM Pass if Leakage Actual is less than Allowed Pass• Fair Option 3 used then: Initial leakage. prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test ,= _CFM 3 Initial leakage _ - Final leakage- = Leakage reduction,_ CFM; ((Leakage reduction_/ Initial leakage_) x'100% _ % Reduction Pass if % Reduction>= 60%0 1313ass.C3.Fail Option 4 used then: 4 All accessible leaks:repaired using smoke test. HERS rater must verify. (No sampling). Pass if all, accessible leaks have beep "repaired using smoke p Pass Fail Reg: 212-A0071206A-M2100001A-M21A .Registration Date/Time': 2013/01/:15 19:34.:01 HERS -Provider:: CalCERTS, Inc. 2008 Residential Compliance Forms March 20,10 CERTIFICATE OF FIELD VERIFICATION .& DIAGNOSTIC TESTING CF-41K-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: •. - Permit Number: 79700 NORTHWOOD, La Quinta CA 92253 (System 1) City. of La Quinta - 12-1423 ® Outside. air (OA) ducts for Central Fan Integrated (CFI) ventilation, systems, shall not be sealed/taped off • during duct leakage testing. CFI OA ducts<that utilize,controlled.motorized dampers, that open only when OA ventilation is required to meet ASHRAIE Standard 6ZI, and close when OA -ventilation: is. not required, mays be configured to the closed position during duct leakage testing. ® All supply and return register boots must be;sealed to theArywoll if,smoke test is utilized for -compliance — applies to duct leakage compliance optiow3 ('leakage reductionand=option'4,(fix all'accessible leaks) described above. a ' IN New duct installations cannot utilize building cavities as plenums'orl�platform`returns:in lieu.of ducts. ® Mastic and draw bands must be used -in combination.with •cloth backe&rubber adhesive duct tape to seal leaks at all new duct connections.' . DECLARATION STATEMENT I certify under penalty of perjury, under the laws of the State of California, the Information: provided: on this form is true and correct. . I am the certified HERS rater who performed, theverification services identifled:end reported on this 6ertificatd-0esponsible rater). The installed feature, material, component, or manufactured device; requiring HERS,verlficatlon:that Is Identified onahis certificate ;(the installation) complies with the: applicable:requimments in'Reference Residential Appendices Wand Wand the requirements, specified on the Certificate(s) of Compliance' (CF SR) approved.by the local enforcement agency. . The Information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and :submitted bythe persons) responsible for installation conforms to the requirements specified on the Certificates) of Compliance (CF-iR) approved by the t enforcement a°encv. Builder or Installer information as shown onthe Installation Certificate (CF -6111) _ Company Name: (Installing Subcontractor or General Contractoror Builder/Owner) , HARRISON ENTERPRISES INC Responsible Person's. Name: CSLB' License: Danielle Garcia 686310 ` HERS Provider Data Registry. Information Sample Group # (if applicable): 376392 ® tested/verified dwelling not-tested/verified dwelling in TERS-sample group HERS Rater Information CaICERTS Certificate # CCI -1798716974 HERS Rater Company Name: Stratz Permit Service Responsible Rater's Name: Responsible Rater's Signature: w .. Garrett Williams Garrett Williams Responsible Rater's Certification Number wj this HERS Provider: Date Signed: 1/10/2013 CC2006208 J ' Reg: 212-A0071206v-M2100001A-M21A Registration'DateyTime: 2013/01•d15'19r34.01 HERS'Provider: Ca10ERTS,'Inc. 2008 Residential Compliance Forms 'y = y -March 2010 n CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF=4R-1MECH-21 Duct Leakage Test — Existing' Duct System (Page i of 2) Site Address:Enforcement Agency: Permit'Number: 79700 NORTHWOOD, La Quinta CA 92253 (S.ystem 1) City of La Quin ta 12-1423 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate, compliance in the dwelling. This installation certificate is required for compliance for alterations. and addition"s in existing dwellings to: space conditioning systems and duct. systems. Note: For existing dwellings, a completely new or. replacement duct system can also include existing.parts of the original duct system (e, g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct.Leakage :Test - Completely New or Replacement Duct System. Duct Leakage Diagnostic Test - existing duct system Select one compliance method from. the:folloWing four choices. p 1. Measured leakage less than 15% Reg: 212-A0071208A-M2100001A-M21A 'Regi:stration:Date/Time.: 2013/01/15 1:9:::34;:0.1 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 of fan flow ❑ 2. Measured leakage to outside less than 10916 of Fan Flow ❑ 3. Reduce leakage by 60% and conduct smoke and fix,all'.leaks 0 4. Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options 1,. 2, or 3 must be attempted before utllliing.Option 4.) Determine nominal Fan Flow using one of: the following three. calculation methods. ✓ ❑ Cooling system method: Size of condenser in Tons x 400 = _ CFM; ✓ ❑ Heating system method: 2 1. 7 x _ Output Capacity In. Thousands of Btu/hr = _ CFM ✓ ❑ Measured system airflow using RA3.3 alrfiow,test procedures: CFM Option 1 used then: 1 Allowed leakage = Fart Flow_ x 0.15 = _CFM Actual Leakage = _ CFM Pass if Leakage Actual is less than Allowed Pass Fall Option 2 used then: 2 Allowed leakage = Fan Flow_ x 0.10 _ _CFM Actual Leakage to outside = _ CFM Pass if Leakage Actual Is'less.than Allowed O.Pass Fail Option 3 used then: Initial leakage prior to start of work _ CFM Final leakage after sealing all accessible leaks:using smoke test= CFM 3 Initial leakage_- Final leakage_ = Leakage reduction CFM ((Leakage reduction _/ Initial leakage ) x .100% _ _=,Reduction Passif:%Reduction::>=60% oPassp'Fail Option 4 used then: 4 All accessible leaks repaired using.smoke test. HERS rater must verify (No sampling). Pass if all accessible leakshave been repaired using smoke ❑ Pass 0 Fail Reg: 212-A0071208A-M2100001A-M21A 'Regi:stration:Date/Time.: 2013/01/15 1:9:::34;:0.1 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION &..DIAGNOSTIC TESTING CF-4R-MECH.-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number 79700 NORTHWOOD, La Quinta CA 92253 (System.l)l City of La Quinta 12-1423 0 Outside air (OA) ducts for Central Fan Integrated (M) ventilation systems, shall not be sealed/taped off during duct leakage testing: CFI OA- ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA.ventilatlon is not required, may be configured to the closed position during duct leakage testing. O All supply and return register boots must be sealed to the drywall If smoke testis utilized for compliance - applies to duct leakage compliance option 3 (leakage reduction by 60%) and nption 4 (fix all accessible leaks) described above. 0 New duct installations cannot utilize building cavities as plenums'or, platform; returns in lieu of ducts. 0 Mastic and.draw bands must be. used: in combination` with cloth backed rubber adhesive d'ucttape.to seal, leaks at all new, duct connections. DECLARATION STATEMENT • I certify under penalty of perjury; under theilaws of the State of California, the information provided on this form Is true and correct. • I am the certified HERS rater who performed'theverification services Identified and reported. on, this. certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring:HERS verlfication'th6t:ls Identified on this certlfi'cate (the Installation) complies with the applicable requirements in Reference Residential Appendices RA3 and RA3.;and the requirements specified on the Certificate(s) of Compliance(CF-111) approved:bythe local. enforcement, agency. • The Information reported on applicable sections.ofthe .Installation :Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the Installation conforms to the: requirements specified. on the Ceitificate(s);pf Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown.on the Installation Certificate (CF -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner): HARRISON ENTERPRISES. INC Responsible Person's Name: CSLB License: Danielle Garcia 686310 HERS Provider Data Registry Information Sample Group # (if applicable): 3763.92 ❑tested/verified dwelling ® not:tested/verified dwelling in la -HERS sample group HERS Rater Information CaICERTS:Certificate.#:CCL-1798716976 HERS Rater Company Name: Stratz Permit Service. Responsible Rater's Name: Responsible Rater's Signature: Garrett Williams Gairett Williams Responsible Rater's Certification Number w/ this HERS Provider:: Date Signed; 1/10/2013 CC2006208 Reg: 2.12-A0071208A-M2100001A-M21A Registration Date/Time:: 2013!01/15 19:34,:01 HERS.Provider': CalCERTS, Inc.. 2008 Residential Compliance Forms March ..2010