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11-1036 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: x__1.1-00001036 Property Address: 78147 CALLE NORTE APN: 770-011-072- - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 7600 Applicant.: % Architect %or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 o essionals Code, and my License is in full force and effect. license Class: C20 _<W License No.: 963410 Date: t ,Contractor: 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).: 1 _) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) 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 _ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec, 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/23/11 Owner: TOMPKINS BILL 78147 CALLE NORTE LA QUINTA, CA 92253 (714)343-4083 F5'1(�'7CD a a Contractor: BRILLIANT HEATING AND AIR INCti 3 ',g 67782 E. PALM CNYN DR B104-329 11 CATHEDRAL CITY, CA 92234 �t�u (760) 548-0090 ";,,, A i U A Lia. No.: 963410 ---------'-------------------------------------— WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate ofconsent 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 EXEMPT Policy Number EXEMPT 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 7fe.,'11ject a subject to the workers' compensation laws of California, and agree that, if I should bec to the workers' compensation provisions of Section 3700 of the Labor Co , I s Iith comply with those provisions. Date: �<P,pplidant:. WARNING: FAILURE TO SECURE 0 E ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN _ SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, - the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. 1 certify that I have read this application and state that the above infor tion is correct. I agree to comply with all city and county ordinances and state laws relating to building cons cti , and hereby authorize representatives of thiscounty to ente upon the above-mentioned property in ecti purposes. Date:-�ignature (Applicant or Agent): . Application Number . . . . . 11-00001036 Permit MECHANICAL Additional desc . Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date Valuation . . . . 0 Expiration Date 3/21/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>10.OK-50OKBTU .16.50 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE OUT 4 TON 16 SEER 13 EER PER 2010 CODES. ------------------------------------------ ---------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) - ----- 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 40.50 .00 .00 40.50 Plan Check Total 10.13 00 .00 10.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total 51.63 .00 .00 51.63- _ LQPERMIT - Sita lified,Prescri tive. Certificate 41.C6tn Bance: 2008 Resldentui'. HVAC Alterations CF -IR -ALT -HVAC Climate'Zones 10 to 15 Site Addle. ,$ tc r 7 �C�\ �1�r' gk) Enforcenrent•Agenry: Daa :) Perm&.#: —Equipment T O Packaged Unit Minimum List Minimm Emcienc Z Duct insulation requirement Conditioned Floor Area = Thetmostat 911vornace ❑/AFUE `6 0 �b ❑ COP Over 40 ft of ducts added or �� O'Setback Lp9'J�� r Coil I� Cdndensing Unit EER_ O HSPF _ �l� m unconditioned space O R 6 (CZ 10 /3) Served b system (IfnaiOle already EER O Resistance _� sf present must be O Other OR 8 (CZ H-15) installed) 1. Equipment Type: Choose the equipment being installed. if more than one system, use another CF -1 R -ALT --HVAC for each system_ 2. Minimum: Equipment EAScfendes: l3. SEER. 783. AFUE, 7.7HSPF jor typical residential systems. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. the installer decides what work is being date 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 iti' edorverifies that the work listed on this fofm w#s in fi%t the. work, completed:¢y the installer. The inspector also verifies that't�ch appropriate CF -6R and registered CF -4R forms (no hand filled CF4Rs allowed) are filled out and ' siBeginning October 1 2010 a r terisd com of the CF -111 and CF-6R'shall also be on-site for final t MOM 'Gr1. HVAC Changeout Required'Forms: • All HVAC Equipment replaced CF -6R forms: 'MECH-04, MECH•21-HERS and (for split systetns)`MECH- 254MM CF -4R forms: MECH- 2.1 and for 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 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. Ducl system was documented to have been previously sealed and confirmed through HERS verification, or 112. 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. RequfTed' Forms: • Cut in or Changeotti with new CF -6R forms- MECH-04, MECH•20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS duds: (all new ducting And all new et) CF -4R forms: MECH 2O-, and (for split systettts)MECH-22, and MECH 25 For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFMhon, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leak -age < 6 rcent El 3'. New Ducts with Re lacement Required Forms: • Includes replacing or installing all new ducting and/di 6utdoot condensing unit indoor CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS CF forms: and and/or -4R MECH-20 (for split systems) MECH-25 coil and/or furnace. Not all equipment changed. For Split Systems: Dia leakage < 6 percent, RC, CCA 2:300 CFMhon, TMAH For Patka edl Units: Duct' I e < 6. scent ❑ 4. New Ducting over 46 feet R ufired )Forms: • Includes adding or replacing more than linear feet of duct in tiiiconditioned space. e CF-611 forms: MECH-04, MECH-2I-HERS CF -4R fortes: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing dud 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 deign features identified on this Certificate of Compliance are consistent with the information ted on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with,dwm ligation.. Name:c� Signature: u_ Company: L \` 1A,t►�J p �� Date: O• _�'? _ � �-.Loll [?663:1c„(�� Address: 11'7 License: ( City/State/7ip:� Phone: 50 qf —a 0 2008 Residential Compliance Forms March 2010 Bin.# Cit}/ Of %a Quintd Butldtng 8r Safety Division P.O. Box 1504,78-495 Calle Tampico La.Qutnta, CA 92253 -:(760) 777-7012 Building Pe it Application and Tracking Sheet Permit. # 1 l Project Address: \ ` . Owner's Name:. Q l A P. Number. Address: .-7$ I -L? Legal Description: Contractor: Yl ` Fp LY1 Ci ST Zip: ty, p Telephone: Address: &% j$LE Onlot, Project Description: City, ST, Zip: C 1 Telephone: U State'Lic.#:31(,-A)q[U CityLic.#; h l 2 Arch., Engr., Designer. Address: City., ST, Zip: Telephone: State Lic. #: p " v Construction Type: h& Occupancy: t - Project type (circle one): New Add'n ter Repair Demo Sq. Ft.; # Stories: # Unit;; Name of Contact Person: 5 wv Telephone # of Contact Person: 0 o Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd ' Rcc'd" . TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Chcek Deposit. . Truss Calcs. Called Contact Pelson Plan Check Balance Title 24 Cabs. Plans picked up Construction Flood plain plan Plans resubmitted..'. Mechanical Grading plan 2•' Review, ready for correctionstasue Electrical Subcontactor Lief Called Contact Person Plumbing Grant Deed Plans picked up S M.I, H.O.A. Approval Plans resubmitted Grading M HOUSE:- ''" Review; ready for corrections/issuc Developer Impact Fee Planning Approval. Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees INSTALLATION CERTIFICATE CF-611-MECH-0 Space Conditioning Systems, Ducts and Fans (Page iof2) Site Address: 78-147 Calle Norte Road, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta . 11-1036 Space Conditioning Systems Heating Equipment Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (AFUE, etc.)1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Dud R -value Heating Load (kBtu/hr) _ Heating Capacity (kBtu/hr) Split Furnace Lennox ML180UH09OXE48B 4690616 1 80 AFUE Attic R-4.2 72 •90 kBtu W.Uunng cquipmenc z 1. II ,,. _, _ -..s new coi._ notes to Standards Table 151-8 and Table 151 -C.for duct ceiling alternative compliance. \ ' 2. ARI Reference Number u "4 •y entering the equipment model number at http://www.aridirectory.orgl;.. 3. Listed efficiency on this page t ,- ve greater than or equal ( ? ) to the value shown on the CCF -IR form. . 4. When CF -IR is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM 2 §110-§113: HVAC equipment is certified by the California Energy Commission. • §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. • §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 2 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. Reg: 211-A0052119A-M0400001A-0000 Registration Date/Time: 2011/10/13 13:05:56 HERS Provider:'CalCERTS, Inc. 2008 Residential Compliance Forms - f August 2009 INSTALLATION CERTIFICATE CF-611-MECH-0 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: 78-147 Calle Norte Road, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 11-1036 z Ducts and Fans _ §150(m): Duct and Fans 1711. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater.than 1%a inch, the combination of mastic and either mesh or tape shall be used; and 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in,the cross-sectional area of the ducts. ❑ 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. 017. Exhaust fan systems have back draft or automatic dampers. ❑ 8. Gravity ventilatin• s serving conditioned space have either automatic or readily accessible, manually operated r.,' ❑ Protection of Ir ../ ition shall be protected from damage, including that due to sunlight,01 - �� f •e, and wind. Cellular foam insulation shall be protected as above or er retardant and provides shielding -from solar radiation that can cause • . r 3ws of the State of California, the information provided on this form is true and correct. . I o.. .. j ,.ewer uivt, and Professions Code to accept responsibility for construction, or an authorized representative of the per_, construction (responsible person). • I certify that the installed fe_ \;, components, or manufactured devices identified on this certificate (the Installation) conforms to all applicable coo. ;ions, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate or Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation 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 occuoancv. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) - BRILLIANT HEATING AND AIR INC Responsible Person's Name: Responsible Person's Signature: Sara Hart Sara Hart CSLB License: 963410 Date Signed: 9/27/2011 Position With Company (Title): e Reg: 211-A0052119A-M0400001A-0000 Registration Date/Time: 2011/10/13 13:05:56 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 1 of 2) Site Address: 78-147 Calle Norte Road, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 11-1036 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance. in the. dwelling. This installation certificate is required for compliance for alterations and additions in 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. " uuct LeaKage uiagnostic Test - existing duct system Select one compliance method from the following four choices. ® 1. Measured leakage less thar y.' of fan flow ❑ 2. Measured leakage to c -an 10% of Fan Flow ❑ 3 n -J - a 1, akage h•• -./ 4 t smoke and fix all leaks , ❑ �� and HERS rater verify N0. 11N07i— rintinn 4.) DetE a - . u, V ❑ Hei 4& r f Pass if Actual Leakage is less than Allowed leakage R Pass ❑ Fail 2 _ Hoyt 0.10 = _ CFM Actual Leakage to c. M if Actual leakage to outside is less than Allowed leakage ❑ Pass ❑ Fail Option 3 used then: _ Initial leakage prior to start , ..00rk = _ 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% L Pass ❑ Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke ❑ Pass ❑ Fail Reg: 211-A0052119A-M2100001A-0000 Registration Date/Time: 2011/10/13 1.3:09:48 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: 78-147 Calle Norte Road, La Quints CA 92253 (System Enforcement Agency: Permit Number:- 1) City of La Quints 11-1036 R Oli+�i�+� air (OA) d' . =an IntegratedCFI ventilation systems shall not be sealed/taped off dull, ' ucts that utilize controlled motorized dampers, that open ony hen OA ve �`'E Standard 62.2, and close when OA ventilation is not required, may be ring duct leakage testing. R AI.� a _ - ipliance _ - app leaks) R New 4 i R Mi +. - a: AJ` ; -• r Viz': r h t r�r� Ne W bCal leaso - , x DE • I eei..., ..wer penaltyaws of the State of California, the, information provided on this form is true and correct. • I am eligible under Divislu, ; and Professions Code to accept responsibility for construction, or an authorized representative of the persor, ,y construction (responsible person). • I certify that the installed feat. Is, components, or manufactured devices identified on this certificate (the installation) r conforms to all applicable codes a..--,ations, and the installation is consistent with the plans and specifications approved by the enforcement agency. 4 • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of Installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations In that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that Identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation 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 beainnino October 1. 2010. for all law -rise rPcirlPntial huilrlinnc Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) BRILLIANT HEATING AND AIR INC Responsible Person's Name: Responsible Person's Signature: Sara Hart Sara Hart , CSLB License: 963410 Date Signed: 9/27/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes E] No .. Reg: 211-AO052119A-M21000O1A-0000 Registration Date/Time: 2011/10/13 13:09:48 . HERS Provider:•Ca10ERTS, Inc. 2008 Residential Compliance Forms ' March 2010 INSTALLATION CERTIFICATE* CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 78-147 Calle Norte Road, La Quinta CA 92253 1 City of La Quinta 1 11-1036 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. ' TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 10 Yes ❑ No S/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and eled according to Figure in Section RA3.2.2.2.2. 2 0 Yes r/ i inch (8 mm) access hole downstream of evaporative coil in the supply plenum * labeled according to Figure in Section RA3.2.2.2.2. Enter Pass or Fail ✓ 0 Pass ✓ ❑ Fail ins are not STMS - Sensor on the Cs, .__... _.........sopceature v, -e coil wig .... i.3 degri Reg: 211-A0052119A-M2500001A-0000 Registration Date/Time: 2011/10/13 13:16:19, HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 78-147 Calle Norte Road, La Quinta CA 92253 City of La Quinta 11-1036 F Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above SS°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems In the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems System Name or Identification/Tag System 1 System Location or Area Served Whole House Outdoor Unit Serial # 1911303097 Outdoor Unit Make v Lennox Outdoor Unit Model 14ACX-047-230-02 Nominal Cooling Capacity Btu/'-., Date of Verification 48000 (Tcondensor, sat) 10/12/2011 - Suction line temperature (Tsuction) Di. Date Measu System Supp' tem; i 10/12/2011 I (must be re -calibrated monthly) ' • - -� - — ronthly) Afw f. �<< „•lip . - r. • .., tip• t. ., aww,..., s ,, 77 Re. teml.,. return, 62 Evaporator saturation tem, 46 (Tevaporator, sat) Condensor saturation temperatuw 104 (Tcondensor, sat) Suction line temperature (Tsuction) 63 Liquid Line Temperature (Tliquid) 96 Condenser (entering) air dry-bulb 97 temperature (Tcondenser, db) • Reg: 211-A0052119A-M2500001A-0000 Registration Date/Time: 2011/10/13 13:16:,19 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms .. August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 78-147 Calle Norte Road, La Quinta CA 92253 City of La Quinta 11-1036 Minimum Airflow Requirement ' Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 Calculate: Actual Temperature Split = Tretum, 24.00 db - Tsupply, db Target Superheat from Table RA3.2-2 using Target Temperature Split from Table RA3.2-3 21, using Tretum, wb and Tretumdb ' Calculate difference: Actual Temperature Split - . 3 Target Temperature Split = System passes if difference is between -5°F and Passes if difference is between -30F and +3°F or, +5°F uponremeasurement, if between -3°F and PASS ' -100oF Enter Pass or Fail Note: Temperature Split Metl•. tion is not necessary if actual Cooling Coil "Airflow is verified using one of the airflow measurement proci- r -d in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value muc.r greater than the Calculated Minimum Airflow Requirement in the table below. " ! C: ent (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) f Syst, Calculai. 40 MeaSL" Pass -^. �:y .. ,_:.9w, .»t K, .r - ac. . ti .'• . eq, re ry ` s or Fail N.- 1, Superheat Charge Met. \, fis for Refrigerant Charge Verification. This procedure is required to be used for fixed & \4 orifice metering System Name or Identification/— System 1 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail n Reg: 211-A0052119A-M2500001A-0000 Registration Date/Time: 2011/10/13..13:16:19 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: I Permit Number: 78-147 Calle Norte Road, La Quinta CA 92253 City of La Quinta 11-1036 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Subcooling = 8.0 , Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 6 . Calculate difference: 2 Actual Subcooling - Target Subcooling = m passes if difference is between F-�VOSFnd +3°F PASS Enter Pass or Fail . •, , Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identificationrr?, System 1 Calculate: Actual Superheatc' , 170 - Tsuction - Tevaporator, .,`� Ent m.-�`:..fJ b 17 r e sp. . Sys allow. 4W 7q- '• _ �I i _ Reg: 211-A0052119A-M2500001A-0000 Registration Date/Time:'2011/10/13 13:16:19' HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms _;?= .� August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 78-147 Calle Norte Road, La Quinta CA 92253 1 City of La Quinta 11-1036 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil - airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 CSLB License: 963410 Date Signed: 9/27/2011 position With Company (Title): System meets all refrigerant charge and airflow Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No requirements. PASS Enter Pass or Fail T 1, i Dk • I I ......., aws of the State of Califomia, the information provided on this form is true and correct. • I am tingible under Divis., ; and Professions Code to accept responsibility for. construction, or an authorized representative of the perso, construction (responsible person). • I certify that the installed fea. til s, components, or manufactured devices Identified on this certificate (the installation) conforms to all applicable codes -tions, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking Identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation 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 beqinninq October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) BRILLIANT HEATING AND AIR INC Responsible Person's Name: Responsible Person's Signature: Sara Hart Sora Hart CSLB License: 963410 Date Signed: 9/27/2011 position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 211-A0052119A-M2500001A-0000 Registration Date/Time: 2011/10/13 13:16:19 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009