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12-0907 (MECH)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 f Date: 8 / 13'/ 12 Application Number: 1-2=-00:00 90-7 Owner: Property Address: 80391 SPANISH BAY r. LARRY LEONG APN: 775-320-023- - 80391 SPANISH BAY Application description: MECHANICAL LA QUINTA, CA 92253 ;III Q Property Zoning: LOW-DENSITY RESIDENTIAL U I� I 'Application valuation: 110.38, tlul r j ALS 1.0 2012 I ` Contractor: i i Applicant: Architect or Engineer: GENERAL. AIR. CONDITIONI7G CITY OF LAQ;jNTA' 31170 RESERVE .DRIVE i P'-iI)Er T THOUSAND PALMS,_CA'92276 (760)343-7488 Lic. No.: 686310 LICENSED CO TRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury that I am licens d under provisions of Chapter 9 (commencing with . I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Profes i pals Co,de, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C20 Licea No.: 686310 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. - /Date:V!34X:ontractor: - _ 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 R•BUILDER DECLARATION insurance carrier and policy number are: hereby_affirm.under.penalty-of_perjury_that-I-am-exe pt-from-the—Contractor's—State—License—Law—for—the—Carrier-ZENfiTH INS -'CO . Jbeo 'y Number Z07174'1'501— - - following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance work for which this' permit is issued, I shall not employ any construct, alter; improve; demolish, or repair any structure, prior to its issuance, also requires the applicant for the • . person in any manner so as to e subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if Ishould becobject to the workers' compensation provisions of SectionLicense Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the abor•Code, I shalwi omply with those provisions. • 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 155001.: at plicant: ' 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and d��. the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The " WARNING: FAILURE TO SECURE ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL - Contractors' State License Law does not apply to an owner of property who builds or improves thereon, - SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND _ and who does the work himself or herself through his or her own employees, provided that the - DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN - improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 37_06 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. ` 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.) ' " - -APPLICANT ACKNOWLEDGEMENT - (_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. - IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractors) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for . pursuant to the Contractors' State license Law.). - ' - whose benefit work is performed'under or pursuant to any permit'issued as a result of this application, (_) I am exempt under Sec. B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City f 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. Date: Owner: 2. Any permit issued as a result of this application becomes null and void if work is not commenced o - - within 180 days from date of issuance of such permit, or ssation of work for 180 days will subject CONSTRUCTION LENDING AGENCY - permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above info tion is correct. I agree to comply with all 'work for which this permit is issued (Sec. 3097, Civ. C.). ` city and county ordinances and state laws relating to building constr con, and hereby authorize representatives • of this unty to enter. upon a above-mentioned property for insp n pu ses. Lender's Name: - g nature (Applicant or Agent): w Lender's Address: LQPERMIT - Application Number 12-00.0.00907. ..Permit . . . MECHANICAL Additional desc _ 'Permit Fee 40.50 Plan Check..Fee. 10.13- 0.13Issue IssueDate 0 Valuation Expiration Date'. 2/09/13 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/>100K-500KBTU 16.50 Special Notes and Comments HVAC CHANGE -OUT: 4 TON SPLIT SYSTEM, FURNACE,CONDENSER, INDOOR COIL. 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 .. - Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations. CF-iR-ALT-HVAC Climate Zones 10 - 15 - Site Address: Enforcement Agency: Date: Permit #: 80391 SPANISH BAY La Quinta, CA 92253 City of La Quinta Aug 12, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit _ ® Furnace ® Indoor Coil ® AFUE 78%' ® SEER 13.0 ❑ COP '13R ❑ HSPF . 6 (CZ 10-13) 1 Served by system ® Setback If not already present,, must be' ® CondensingUnit ❑EER ❑Resistance ❑ R 8 (CZ 14-15) 221 sf installed J ❑ Other 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 installer: The inspector also verifies that each appropriate CF -6R and registered'CF-4R, forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October'l, 2010, a registered copy of the CF -1111 and CF -611 shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: r • All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERB replaced CF -4R forms: MECH-21 and (for split systems) MECH-25 • Condenser Coil and /or • Indoor Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS r Furnace CF -4R forms: MECH-21 and (for split systems) MECH-25 • z. For, Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH , Exempted from duct leakage-testing:if: Ap rtbct system was.documented to have been previously sealed and confirmed through HERS verification, or uct systems, with less than 40: linear feet in unconditioned space; or ` t T12•.Du ,❑ 3 `Existing du,ct`systems are constructed, insulated or sealed with asbestos• ❑ 4 The system will not be Ducted (io ctlesslSp t System),() o Exemptfrom Refrigerrant Charge) ❑ 2. New HVAC System' Requited Forms A. ¢ ' . Cut inlor Changeout with , k ¢ ' . ' r _ CF 6R forms MECH 04 MECH 20 HERS and (for split systems) MECH-22 HERS and .-- new ducts`: (all new ductin all new 9 MECH 25 HERS t "� 25 }� equipment)%...- CF 4R forms fNECH 20 and (for split system's) MECH 22 and:MECH k For Split Systems:Duct leakage < 6 percent, RTC,'CCA'> 350 CFM/ton, FWD, TMAH, STMS, and eitherHSPP or'PSRP For;Packaged Units: Duct leakage < 6 percent _.,.... ct 01..M, ew pus with/or without_,. � Required Forms: � Replcement Includes replacing or installing all,new , ducting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace No or some CF. -4R forms: MECH-20 and (for split systems) MECH-25 r 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 CF -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. - 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 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 application. Name: Danielle Garcia Signature: Danielle Garcia Company: HARRISOWENTERPRISES INC._ Date: Aug 12, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 _ Reg: 212-A0043667A-00000000-0000 Registration Date/Time:.2012/08/12.12•:28:37 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms y July 2010 e►n.# Qty Of La Quints Building &r Safety Division -P.O. Box 1504,78-495 Calle Tampico 14.Qulnta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # • C. 1 �' "�; Project Address: D J, ��15 Owner's Name:. LUY V L-ee n A. P. Number. ?j Z. U 3 Address: • S /l1'� {� Legal Description: City, ST, Zip: LCA Contractor: Telephone:Contractor:. Address: 1� `I p 3 . ( g,E t- Project Description: �. fi but City, ST, Zip: • C Q 2Z 6Soul S Telephone760 343- x i.l State Lic. # : (fj Ca City Lic. #: Arch, Engr., Designer. 'Address: City, ST, Zip: Telephone: P t � :� Construction Type:. occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: �2 5 # Stories: # Unit; -. State Lie. #: Name of Contact Person: Telephone # of Contact Person: Estimated Value of Project: 3 APPLICANT: PO NOT WRITE BELOW THIS UNE # Submittal F"Id Recd TRAQMG PERMIT FEES Plan Sets Plan Check submitted. Item Amount Structural CaIcs. Reviewed, ready for corrections Plan Check Deposit, . Truss Calci. Called Contact Person Plan Check Balance _ Title 24 Calci. Plana picked up Construction Flood plain plan Plans resubmitted. , Mecharilcal Grading plan tad Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SALL H•O•A• Approval Plans resubmitted Gradlo ' IN HOUSE:- '^' Review; ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person AXP.P. Pub. Wks. Appr Date of permit Issue School Fees • Total Permit Fees ;.. CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R41,02) " Duct Leakage Test — Existing Duct System (PaSite Address: Enforcement Agency:712-907 Permit Numbe 80391 SPANISH,bAY, La Quinta CA 92253 (System 1) City of La Quinta ,fir • • ❑ 2. Measured leakage to outside.;less than 10% of Fan Flow 7 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. " 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 '- ,• r - ' ❑ 2. Measured leakage to outside.;less than 10% of Fan Flow ❑ 3. Reduce leakage by 60%o.and conduct smoke and fix all leaks ks'using ❑ 4, Fix all -accessible le sm ke and HERS rater verify, , Note ?.(One.of Options 1, 2, or 3 must be attempted before utilizing Option 4.) Determine nommalFan Flow using one`ofthe,foilowing4threemcalculationrmethods. %0' 13 s Cooling yastemm�uuethod: Size 6-c' onde m /•nser, ,Ton§ uy� x 400 -� C$FM �� ,� � � �°�r `•t -A-4` - .` F �'S^' `� ro` � dl :' +�, r: l` ', �f' .. - t 4y1%�•1• .e # 1 •'� _1 ✓ 13 Heating system method,: 2,1`7 x'=_ Output Capacity m' Thousands of-Btu/hr _ _ CFM ✓ ❑Measured system airflow using RA3 3 airflow testrocedures j CF,M Option" -109-ed then:. -CFMAllowed leaks a Fan Flow '&": 01 15e ..ys Actual Leakage = _ CFM r ta �, 1 .•r Pass if Leakage Actual is less than Allowed Pass j3 Fail Option 2 used then { 2 ' Allowed'leakage' Fan Flow x`0.10 = _ CFM Actual Leakage to outside= 1_ CFM Pass if Leakage Actual is less than All Pass C3 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 ~ " Pass if % Reduction >= 60% ❑ Pass ❑ Fail Option 4 used then: 4 All accessible leaks repaired using smoke. HERS rater must verify.(No sampling). No smoke' allowed to leak from system. Including ducts, plenums, air handler and door panel. Pass if all accessible leaks have been repaired using smoke Pass ❑ Fail 4 , r � Reg: 212-A0047905A-M2100001A-M21A Registration Date/Time: 2012/09/04 03:56:39 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: 80391 SPANISH bAY, La Quinta CA 92253 (System 1) City of La Quinta 12-907 r ❑ Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems; shall not'be sealed/taped off during duct leakage testing: GFI 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 ventilation is not required, may -be configured to the closed position` during duct leakage testing. ❑ All As6upply�and ��eturn register boots m ustYtie*sealed*toAhe dryywalllifrsmokettestiisjutilized�for�compliance - appliesxtoyduct,leakage complianceroption 3 (leakage reductwn by 60%)�'andfoptionf,4 (fix all accessible ' leaks) described `above:` / >s"" -R-`` ��^•*•,"., ❑ New ductIristallations cannot,utilize building cavities as plenums or platform ,returnsKin lieu of:`ducts - �1 tt� F;P y 4 ji ,,eU.dNm7'j'•� Ch. e..+- a I' ❑ Mastic andidraw banda.must'be used''in combination with'.cloth backedsrubber`radhesivezduct tapeto'seal> leaksiat all'=new duct connections: " -`Tr��,'"`, DECLARATION STATEMENT/- I TATEMENT I certify under penalty of perjury, under the laws of the State of California, the Information provided on this form is true and correct. . rformed the verification services identified and reported on this certificate (responsible rater). I am the certified HERS rater'who.pe . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable'requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certiflcate(s) of Compliance (CF1R) approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency.: . i Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia " i 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 346590 ❑ tested/verified dwelling © not-tested/verified dwelling in. la HERS sample group HERS Rater Information CaICERTS Certificate # CU -1798687172 HERS Rater Company Name: i The Energuy CA LLC ; Responsible Rater's Name: Responsible Rater's. Signature: Ezequiel Moreno' Ezequiel Moreno Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 8/31/2012 '. CC2005795 Reg: 212-A0047905A-M2100001A-M21A Registration Date/Time: 2012/09/04 03:56:39 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 • i � - it .� .. I n CERTIFICATE OF FIELD VERIFICATION & DIAGN;OSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1, of 5) Site Address: Enforcement Agency: Permit Number: 80391 SPANISH bAY, La Quinta CA 92253 City of La Quinta 127907 �.. ' 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 r any additional systems in the dwelling as applicable. { { r 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 requiredfor 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 1 ❑ Yes ❑ No�11 ti 5/16 I beled accordi g)access to Figure n SectionaRA3 evaporative coil in the return plenum and 2 [3 Yes '11. No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes" to 1-.a;n0.2 is,a.pass.1, f Enter Pass or Fail ✓ ❑ Pass V. ❑ Fail STMS'.w Sensor�onxthg, Evaporator Cml :. w:. - ----- ----- •-- SystemiName or Identification/Tag 1 `711 4¢Y V~ 3 Yes ice` ' p=No The sensor is factory' installed; orfield installed acdording to'rnanufacturer s specifications, or is installed by'm�jetho'ds/specifications'approved by the Executiv"e ❑ Yes *' t Director: Director.- I - . irector.- F:" 4 /r No The sensor wire �s terminated with a standard mini plugsuitablefor connection to a syr.{ . 'e ...,q Ise 1 _.ei l Y � � digital Thesensor-rriini ❑ Yes ❑Yes Eli• Ak, �. ❑ a " `_ ' thermometer• plug is accessible to the;installing�techniciai and the'HERS rater without,chan in the airflow through the'condense coil', 9 9. 9 5 - ❑ Yes,.• - � • ❑ No ,11saturation o a When attached tdigital thermometer, the sensor provides an indication of the i temperature of the coil. Yes,to 3, 4, and 5`is a pass..Enter N/A if STMS are not applicable. Otherwise entei.�Pass or Fail ✓ ❑ N/A ✓ ❑Pass ✓ E3 Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is Inst' Iled by methods/specifications approved by the Executive Director.- I - . irector.- The The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes ❑ No When attached to a digittal thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not I V ® N/A T ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail - . i Reg: 212-A0047905A-M2500001A-M25A Registration Da /Time-.- 2012/09/04 03:59:22 HERS Provider: CalCERTS, Inc. 2008 Residential'Compliance Forms March 2010 ' it � CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency:. Permit Number: 80391 SPANISH bAY, La Quinta CA 92253 City of La,QuintS 12-907 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above SSOF) 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 i (must be re -calibrated monthly) N System Location or Area Served Whole House �_.(must'be, r6 -calibrate& monthly) Outdoor Unit Serial'# �-A Outdoor Unit Make Outdoor Unit Model Nominal Cooling Capacity Btuffir Return. (evaporator eriterirfg.) air wet -bulb Date of Verification' Evaporator saturation temperature Calibration ofDiagnosticInstruments Date ,8*f Refrigerant Gauge Calibration S tem, 1, (must be re -calibrated monthly) N __*4 %.0,0 Date if�,rhermocouoll�((���libration �_.(must'be, r6 -calibrate& monthly) "(9 �-A Measured Temperatures( -F) -"1/,I X V System Name or Identification/Tag; S tem, 1, __*4 %.0,0 Supply(evaporator leaving),air dry-bulb j -(TS .uiRettim(evaporator-6-htering) temp,erature . I upp b 4,t air dry-bulb' t&6 pef6i_ur� (Treturn', Return. (evaporator eriterirfg.) air wet -bulb temperature (Treturn, wb) Evaporator saturation temperature (Tevaporator, sat) Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) Liquid Line Temperature-(Tliquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db) Reg: 212-A0047905A-M2500001A-M25A Registration Date/Time: 2012/09/04.03:59:22 HERS Provider: CalCERTS,"Inc. 2008 Residential Compliance,Forms March 2010 INSTALLATION CERTIFICATE * CF-4R-MECH-25 Refrigerant Charge,Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 80391 SPANISH bAY, La Quinta CA 92253 "City of•La Quinta - 12-907 Minimum Airflow Requirement r a 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 r Calculate: Actual Superheat = Calculate: Actual Temperature Split = Treturn, db - Tsuction - Tevaporator, sat Tsupply, db Target Superheat from Table RA3.2-2 using Target Temperature Split from Table RA3.2-3 using Treturn, wb and Tcondenser, db Treturn, wb and Treturn, db Calculate difference: Calculate difference: Actual Temperature Split - _ Actual Superheat - Target Superheat = Target Temperature Split System passes if difference is between -6°F and Passes if difference is.between -4°F and +4°F or, +6°F upon remeasurement, if between -4°F and -100°F Enter Pass or Fail - Enter Pass or Fail Note: Temperature Split Method -Calculation is not necessa f if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified, in Reference Residential Appendix RA3.3. If actual cooling coil airtlow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) - 5 System NameTort d tification/Tag t '..�,. YJ .e'"{�'- •• .y�.....iiT 5 � !/ f Calculated Minimum Airflow4Require/me}nt (CFM)r ik.f � YS-' ■ j ?'-'. V - �. '1��+ ,.' '.�� _ Measured Airflow using RA3:3 procedures (CFM) ` S � Passes'if measured airflow is greater,than or.equal.NA to the calculated minimum airflow" requirement.. o Enter Pass or Fail n Superheat Charge MethodCalculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering de,vice'systems System Name or IdentificationJTag;, . 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 -6°F and +6°F Enter Pass or Fail = r • • 3 . Reg: 212-A0047905A-M2500001A-M25A Registration Date/Time: 2012/09/04 03:59:22 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 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 - r Calculate: Actual Subcooling = i Tcondenser, sat - Tliquid Calculate: Actual Superheat.= N Target Subcooling specified by manufacturer. Tsuction - Tevaporator, sat Calculate difference: Enter allowable superheat range from Actual Subcooling - Target Subcooling = , System passes if difference is between -4°F and +4°F , Enter Pass or Fail specification is not available) " 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. 4 - r 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 Identification/Tag - r Calculate: Actual Superheat.= N Tsuction - Tevaporator, sat Enter allowable superheat range from , manufacturer's specifications (or use range between 3°F and 260F if manufectu�er's,,; specification is not available) 4 T System`passesAif actual superheat is within4the allowable`s`uperheat range +. �[ �, R ' 4Ir .: nti Pass or.Fail r� r" �••, '"" " :*;,.;. , i. Reg: 212-A0047905A-M2500001A-M25A Registration Date/Time: 2012/09/04 03:59:22 HERS Provider: CalCERTS,'Inc. 2008 Residential Compliance Forms March 2010 - r i. Reg: 212-A0047905A-M2500001A-M25A Registration Date/Time: 2012/09/04 03:59:22 HERS Provider: CalCERTS,'Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE ' ' CF-4R-MECH-25 Refrigerant Charge,Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: { Enforcement Agency: Permit Number: 80391'SPANISH'bAY, La QuintafCA 92253, . City of La Quinta 12-907. 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 of Identification/Tag , t System 1 HERS Provider Data Registry Information Sample Group # (if applicable): 346590 • ��te ed/verified dwellingTRERS System meets all refrigerant charge and airflow - sample group , HERS Rater Information CalCERTS Certificate # CCS -1798687172 HERS Rater Company Name: requirements. Responsible Rater's Name: Responsible Rater's Signature: ' •. Ezequiel Moreno Ezequiel Moreno Responsible Rater's Certification Number w/ this HERS.Provider: Enter Pass or Fail CC20OS795' -� I , ►..+ y i r+ 'r e1 t y ���� �r �a� 2 �, ' .b:..•� �� '.c�' ��....7a`�sri-'••''•. 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 the verification services identified and reported on this certificate (responsible rater). ,The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified fon the Certificate(s) of Compliance (CF -111) approved by the loca['enforcement agency. , r The information reported on applicable sections of the Installation,Certificate(s) (CF -611), signed and submitted by the person(s) ' S responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. - f - 4 . Builder or Installer information as shown on the Installation Certificate (CF -6R) ` .. •. ; Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) • F HARRISON ENTERPRISES INC Responsible Person's Name:' CSLB License:, Danielle Garcia 1686310 _ HERS Provider Data Registry Information Sample Group # (if applicable): 346590 • ��te ed/verified dwellingTRERS not-tested/verified dwelling in sample group , HERS Rater Information CalCERTS Certificate # CCS -1798687172 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: ' •. Ezequiel Moreno Ezequiel Moreno Responsible Rater's Certification Number w/ this HERS.Provider: Date Signed: 8/31/2012 CC20OS795' -� I , F Reg: 212-A0047905A-M2500001A-M25A Registration Date, 2008 Residential Compliance Forms . F 2012/09/04'03:59:22 HERS Provider: CalCERTS,'Inc. March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: r , , " • Enforcement Agency: Permit Number: 80391 SPANISH bAY, La Quinta CA 92253 (System 1) City of La Quint a 1,12-907 Space Conditioning Systems Heating Equipment Equip•(AFUE, Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of� Identical Systems Efficiency etc.)1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Split Furnace LENNOX SG28009OXV06C '4339420 1 80 AFUE Attic ' 90 4 kBtu Type , 4 and EER) (attic, (package.' sheat - aa:.: ;. f t "--CEC_Certified Mfr. Name ARI Reference # of Identical 1, 3 (>=CF-iR crawl- space, Dud Cooling' Load Cooling Capacity pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split A/C , LENNOX ,r XC16048-230; 1 15 SEER . "j 126 EER,* riAttic`'; t � 43 t4 4 Tons �.iry • ... cooling Equipment ..+ r Efficiency Dud Equip(SEER Location ' Type , 4 and EER) (attic, (package.' sheat - aa:.: ;. f t "--CEC_Certified Mfr. Name ARI Reference # of Identical 1, 3 (>=CF-iR crawl- space, Dud Cooling' Load Cooling Capacity pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split A/C , LENNOX ,r XC16048-230; 1 15 SEER . "j 126 EER,* riAttic`'; t � 43 t4 4 Tons �.iry • ... Ay4 -r.. fes, .FAa-'; A A. jr �y I 1. If project is new construction,' see Footnotes to Standards' Table 151-B and Table 151,C for duct ceiling alternative R compliance. , 2. ARI Reference Number can be found. by entering the equipment • model number at http://www.airidirectory.orglarilic.php# ' 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R form. 4.'When CF -IR is reference it is also applicable to the CF-1RCF-IR-AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM • , ''., _ ® §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). • 11 1 ® §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets 4 minimum requirements of Table 150-B and includes a vapor retardant or is'enclosed entirely in conditioned space. r Reg: 212-A0047905A-M0400001A-0000 .Registration Date/Time: 2012/08/29 16:37:08 HERS'Provider: CalCERTS,±Inc. 2008 Residential Compliance Forms August 2009 y INSTALLATION CERTIFICATE CF-6R-MECH-04 , Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: . 80391 SPANISH bAY, La Quinta CA.92253 (System 1) City of La Quinta 12-907 Ducts and Fans. ry . §150(m): Duct and Fans ® 1. All air -distribution system ducts and plenums installed, sealed and insulated'to.meet the a 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 1/4 inch, the combination' of mastic and either mesh or,tape shall be used; and 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 d u cts. ® 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. ® 7. Exhaust fan systems have back draft or automatic dampers. -® 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. ® Protection of InsulationlInsulation 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.coeting thatlis water retardant and provides shielding from solar radiation that can•cause degradatiowof-ahe.mi aterial: `0 10. Flexible ducts cannot'have'porous inner cores. v IF • . r _ -*q nit- i ry . epi � -^,t' 4 y? „",,.. • �.r _ ,,... r • DECLARATION, STATEMENT i - • I c rt fy under penalty of`pe6ury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible underrDivision 3 of the Business and Professions Code to accept responsibility for construction, or an 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, and the installation is consistent with the plans and specifications approved by the enforcement agency. r • 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 1 i 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 License: Date Signed: Position With Company (Title): 686310 8/1/2012 Reg: 212-A0047905A-M0400001A-0000 Registration Date/Time: 2012/08/29 16:37:08. HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 This installation certificate is required for compliance for alterations and additions in existing dwellings to ,. space conditioning systems and duct 'systems. fa 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. ❑ 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow conduct ® 3. Reduce leakage by 60°/ and smoke and fix all leaks smoke ❑ 4. Fix>all accessible leaks using. and HERS rater verify •. Note:k(One of Options 1, 2 or 3 mint be attempted before utilizing Option 4.) Determine Fan Flow one -the following three;calculationrmethods: nominal using -of - ✓ ® Coolingsyste method: Size of JcondeJnserr in.Tons`Jj Jx 4010 =� 16%00 (CFM fi t " a /fir v_ e'Si [ (a.fL,'•b.. -'t- •:tJ f F __ y' I C"r- }�" �! ,. y •- .-I. ._ ✓ ❑Heating system method: 21. xOI utput Capacity in Thousands ofaBtu/hr — CFM _ ✓❑Measured_systemairflow using RA3 3 aklowftestjprocedures CFM Option 1.uus6d -then:'(r leakage Airflowx0.15 1 Allowed $Fan CFM Actual Leakage = _ CFM ^- _ } _ Pass if Actual Leakage is less than Allowed leakage 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 El Pass 0 Fail Option 3 used then:.I Initial leakage prior to start of ork = ' 1600 CFM Final leakage after sealing all accessible leaks using smoke test = 126 CFM ' 3 Initial leakage - 1600 - Final leakage - 126 = Leakage reduction 1474 CFM ((Leakage reduction 1474 / Initial leakage 1600 1 x 100% = 92.13 % Reduction. Pass if % Reduction >= 600/a ® Pass 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 ❑ Pass p Fail Reg: 212-A0047905A-M2100001A-0000 Registration Date/Time:2012/08/29 16:37:38 HERS Provider: Ca10ERTS,.Inc. _ 2008 Residential Compliance Forms - March 2010 h , Responsible Person's Name: Responsible_ Person's Signature: Danielle Garcia Danielle Garcia }. CSLB License: 686310 , Date Signed: 8/12/2012 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? , ❑ Yes []No INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct. Leakage Test — Existing Duct System , (Page 2 of 2) ; Site Address: ,` z• Enforcement Agency: Permit Number: 80391 SPANISH bAY,•La Quinta CA 92253 (System 1) City of La Quinta '12-907 ® 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 i ventilation;is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured t -o t6 closed position during duct leakage testing: - a }-a F ® Allssupply and return. registe"r boots must b, sealed.to�the drywall f, m oke test is utilized for compliance - applies to duct,leakage compliance option 3 (leakage reduction by;'60 /o)�a�option4 `(fix all accessible 'leaks d'e'scribed above" �/ �, _� - 13 New ductmstallations cannot�util¢e building;cavities as plenums or platform returns in lieu ofrducts 0 Mastic andjdrawabands mustbee sed:inYcombinat�idn 4ifh"cloth backed rubber adhesive4duct tape to,seal , Ieaks,St 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 bf the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person regponsible'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, and the installation is consistent with the plans and specifications approved by the t enforcement agency: • - ; • I understand that a HERS rater will check the Installation to verify compllance, 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 -1R) form approved by the enforcement agency that identifies the specific _ 1 requirements for the installation. I certify that the requirements detailed on the CF -1R 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 License: 686310 , Date Signed: 8/12/2012 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? , ❑ Yes []No *� Reg: 212-A0047905A-M2100001A-0000 Registration Date/Time: 2012/08/29 16:37:38 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: " 80391 SPANISH,bAY, La Quinta CA 92253 City of La Quinta 12-907 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. r 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 +W—hole House 1 ® Yes , ❑ NoX�t la/beled16 caccording to Figure h (8 mm) access �n Section RA3.2.upstream of evaporative 2 2ative coil in the return plenum and 2 0 Yes ❑ No y • 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes 1o.* nand 2 is a pass:-- ; ;. Enter Pass or Faill ✓ ® Pass ✓, ❑ Fail STMS ; Sensor 9p t e Evaporator Cotl • SystemxNami§. o& Identification/Tag' j�,_,* 3 . C�, ❑Yes ) The sensor -is factory installed, orifield;installed according to rhanufacturers_ „ ❑=No � 'specifications,m or is instilled by ethods/specifications'approved by the Executive The sensor is factory installed, or field installed according to manufacturer's 6 F Director 4❑Yes specifications, or is installed by methods/specifications approved by the Executive - l aTFie sensor. wife is terminated_ with a; tandard: mini plug suitable for connection to a ❑ No s digital thermometer The sensor, Installing , mini plug is accessible to4thetechrneian and the HERS rater without changing the airflow through th'ec ndenser coil` 5 { ❑Yes . ❑ No , „ The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes`to 3, 4 and 5 is a'pass:.Enter N/A,if STMS are not i applicable Otherwise enter Pass or. Fail. ; .® N/A ❑Pass ✓ ❑Fail r .STMS - Sensor on the Condenser Coil ' System Name or Identification/Tag � . 4 1 System,1 : , I.. . The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive - Director. - The sensor wire is terminated with a.standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician - and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes ❑ No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ ® N/A .❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail , Reg: 212-A0047905A-M2500001A-0000 Registration Date/Time: 2012/08/29 16:40:44 HERS Provider: CalCERTS, Inc. 2008 Residential,Compliance Forms August 2009 r INSTALLATION. CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification --Standard Measurement Procedure (Page 2,of 5) Site Address: Enforcement Agency: Permit Number: 80391 SPANISH bAY, La Quinta CA 92253 • City of La Quinta 12-907 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°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 be re -calibrated monthly) Y) System Location or Area Served Whole House , •8/1/12^• ' (must be re-calibratedymonthly) e Ij f' i Outdoor Unit Serial # 5812602853 -� L k ►° � t,, Outdoor Unit Make LENNOX Outdoor Unit Model XC16-048-230 - Nominal Cooling Capacity Btu/hr g ` 48000 a ' Return (evaporator entering).air wet -bulb c 67 Date of Verification 8/12/12 Evaporator saturation temperature, , 60 Calibratiomof Diagnostic Instruments Dat ,of Refrigerant Gauge Calibration 8/1/12must be re -calibrated monthly) Y) Date of Therrnocou le•Calibration "�' a p , •8/1/12^• ' (must be re-calibratedymonthly) e Ij f' i , 4 7 + $ >.. rxw' ^b Nc s Measured Temperatures .,^' j 4,.e... /ids.--11�` '!�j R I,..;' System Name or Identification/Tagf t �„;•; Y„, • System.) r fo�� tom:-.+•- Supply)'(edaporator.leaving) air dry -bulbi temperature {Tsuppljr `* 66 ?�--• 'fes:i -� L k ►° � t,, db) Return (evaporator -entering) air dry-bulb,, ' 83 - temperaturev(Treturn, db) a ' Return (evaporator entering).air wet -bulb c 67 temperature (Treturn; wb) ` Evaporator saturation temperature, , 60 (Tevaporator, sat) ` Condensor saturation temperature 126 " (Tcondensor, sat) - Suction line temperature (Tsuction) 68 - Liquid Line Temperature (Tliquid) 121 Condenser (entering) air dry-bulb 111 temperature (Tcondenser, db) Reg: 212-A0047905A-M2500001A-0000 Registration Date/Time: 2012/08/29 16:40:44 HERS -Provider: CalCERTS,' Inc.- 2008 Residential Compliance'Forms August 2009 W . INSTALLATION CERTIFICATE .CF-611-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 80391 SPANISH bAY, La Quinta CA 92253 City of La Quinta '` 12-907 Minimum Airflow Requirement 4 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. * ` Y i n System i W . INSTALLATION CERTIFICATE .CF-611-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 80391 SPANISH bAY, La Quinta CA 92253 City of La Quinta '` 12-907 Minimum Airflow Requirement 4 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 i Calculate: Actual Temperature Split = Treturn,Y•+ 17.00 db - Tsupply, db r Target Temperature Split from Table RA3.2-3 19.9 using Treturn, wb and Treturn, db. Calculate difference: Actual Temperature Split - -2.9 , Target Temperature Split = Passes if difference is between -3°F and +3°F or, , upon remeasurement, if between -3°F and PASS -100°F Enter Pass or Fail XI Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is'verilied using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is' measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Cal ulatedMinimu Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (dm/ton) n' Sstem Name or Identificatioan/T y -z? Sys tem�i'".1 '� �� 9 , Calculated Minimum Airflow Requirement (CFM) 9 - y Measured,Airflowsusing RA3.3 procedures (CFM) +� Passes if measured airflow: isgreater than or r equal to the calculated minimum airflow requirement """ �^ Enf r Pass or Fail Superheat Charge Method: Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering devicesystems System Name or Identification/Tag' System 1 Calculate: Actual Superheat = Tsuction - Tevaporator, sat ' r Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db - Calculate difference: , Actual Superheat - Target Superheat = Superheat Charge Method: Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering devicesystems System Name or Identification/Tag' 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 rf ry j •' a Reg: 212-A0047905A-M2500001A-0000 Registration Date/Time: 2012/08/29 16:40:44 HERS Provider: CalCERTS, Inc. ,2008. Residential Compliance Forms 4 August 2009 d INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of -5) Site Address: Enforcement Agency: Permit Number: 80391 SPANISH'bAY, La Quinta CA 92253 City of La Quinta 12-907 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. C System Name or Identification/Tag System 1 • - r Calculate:'Actual Subcooling = 5.0 it Tcondenser, sat : Tliquid 8.0 Target Subcooling specified by manufacturer' 6. Calculate difference: .. , Actual Subcooling - Target Subcooling = 4-25 System passes if difference is between , -3°F and +3°F PASS ' , -• Enter Pass or Fail PASS` iT is x 4 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 Identification/Tag. 7 c • - r r • it 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 Identification/Tag. 7 System_ 1 • = . =...f Calculate: Actua4Superheatt., 8.0 T F. suction - Tevaporator, sat ,• ; .. Enter: allowable superheat range from .. , manufacturer`s specifications (or use range 4-25 between 4°F and.25°F if manufacturer's •'' specification is not available); ?, ; ,' ' -• System passes;if actual superheat isiwithin4the allowable:;sulpeheat rage PASS` iT is x 4 1 y.Enter Pass or a -( *•'e. •'�''^;, '+.+. �rl,�,� �. ,y,.r L ...r•5•.,iy�i, y?,:`.. .fi ,t '' ..moi `, r 41 J. Reg: 212-A0047905A-M2500001A-0000 Registration Date/Time: 2012/08/29 16:40:44 HERS Provider: CalCERTS, Inc. . 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE r CF-61k-MECH=25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 80391 SPANISHbAY, La Quinta CA 92253 City of La Quinta - 12-907 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: , position With Company (Title): System meets all refrigerant charge and airflow 8/12/2012 ' Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): requirements. PASS Enter Pass or Fail . a. y 4. , t F F 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,U4. business and Professions Code, to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). e 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 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 r requirements for the installation. I certify that the requirements detailed on the CF -1R 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 License: Date Signed: position With Company (Title): 686310 8/12/2012 ' Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0047905A-M2500001A-0000 Registration Date/Time: 2012/08/29 16:40:44 HERS Provider: CalCERTS, Inc. - 2008 Residential Compliance Forms August 2009 HVAC Field Data Sheet Pg 1 of 2 Client Name �����' Job # JIL Date 6 Z- 1 Z Address S-0391 S &w t ,s Ph # -71 Y - 111 S 319 Tedniclan(s) _F����N� Permit # Gauge/Thermocouple Calibration Date Ut I ad wge I Some Ducts Only I AN Ducts Only (ardehpeofwo*) MEW -Q4 . F rrfpmentData ZONE 1 ZO uz ZDN,E3 ZOAFE4 System Location or Area Served Heating Equipment Malde 7� Heating Equipment Model d p c ARI Reference Number t Sn V Z Heating Equipment AFUE D G Duct Location (attic, crawlspace, etc.) Duct R Value (if ducts were instated) Heating Load Heating Equipment Output Capacity — Condenser Make L Condenser Model ?-30 . Size. in Tons SEER & EER Cooling Load Cooling Capacity 19�-20&21 DuctTW&W "I yo v Duct leakage pretest result b3 Duct Leakage Final Result Q*7N/toa to pass (6%) PPasasss�swafl PassIM Pastjfaff slTafl Duct Leakage Final Result <4 cWton to pass(M) Pass using 60% leakage reduction? Pass using smolm and visual inspection? Z (o passIfto passpw MECfl22.6r-J df.'6^ooMWCoi►Alrflow& l�oa.#VLrnw . Measured Air Volume from Flow Grid or Hood AJ IA - NEW DUCPS Target: 350 CFMADn a Condenser Tons CBM GMUT Target: 300 CFM/t4n s condenser Tons Measured air greater than Target? (YM Measured Fan Watt Draw Target 0.58 watts/measured CFM = Measured Watts less than Target? (YA Copyright ®2011 EDS Eaep Driven Solutions, Inc HVAC Field Data Sheet Pg 2 of 2 Client Name Job # Date MEQ ZS Qhmgg&Ah iow ZONBI Condenser Serial Number Z Z Supply air dry bulb temperature ZONB2 ZONE3 ZONE Return air dry bulb temperature Return air wet bulb temperature 67 Evaporator Saturation Temperature Q Condenser Saturation Temperature L Suction Line Temperature Liquid Line Temperature 1 Z Suction Pressure Liquid Pressure Actual Airflow Temperature Split Target Temperature Split from Table RA3.2.3 H , Passes if difference is t T of Target Temp (Y/l) y �_ Actual Subcooling (f 4° of Target to pass) Target Sub000ling from Mfr. Actual Superheat (3 to 26° to pass) Outside air dry bulb temperature MECH 26 °We h-ta 0w phV below 55° . Actual Line Set length (ft) Mfr's Standard Line Set Length (ft) Length Difference = Correction Factor (ounces per foot) Target: Correction Factor x Length Difference System Charged to Target? (YIN) Other Data Minimum amps Maximum amps Breaker size Compressor amps Return Static Pressure Supply Static Pressure Supply Air Wet Bulb Temperature "ALL APPMCABLED&W ON TMSPORMMUST BECOMPLETED FOR EACHJOB, NO E=PTIONS;' • CopyrWO 2011 EDS EnaU Ddm Sotattona, Ina