12-0993 (MECH)F�
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Y
Application Number: 12-00000993
Property Address: '51673 AVENIDA VELASCO
APN: 773-133-020-9 -000000-
Application description: MECHANICAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 4500
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
JANE ANDRADE
51673 AVENIDA VELASCO
LA QUINTA, CA 92253
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C20 C3,15 0L' a No.: 906115
ate: ontractor: - ..
OWNER- ER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the '
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior,to its issuance, 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
anyapplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
( _.) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044 Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or, her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner-builder'will have the burden of proving that he or she did not build or
improve for the purpose of sale.). -
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 _ ) I am exempt under Sec. , B.&P.C. for this reason
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: {d
C
LQPERMIT
Contractor:
HYDES
42949 MADIO STREET
INDIO, CA 92201
(760)360-2202
Lic. No.: 906115
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Daie: 8/28/12
D
AUG 28 2011 D
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations: -
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
X 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 NORGUARD INS Policy Number CEWC356415
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code; I shall I rthwith comply ith th se provisions. '
ate: A cant:
WARNING: FAILU ECUR WO KERS' COMPENSA N 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 information is correct. I agree to comply with all
city and co my ordinances and state laws relating to building construc ' n, and hereby authorize representatives
oft t�ter upon the bove-mentioned property for inspe n p poses.
Da Sign re (Applicant or Agent):
LQPERMn
Application Number ' ' ' ' ' 12-00000993
`
Permit. ' ' MECHANICAL'
' Additional deao
Permit Fee ' ' ' ' 40'50 Plan Check -Fee ' ,
10.13
zoaoe Date ' ' ' ' Valuation ' ' ' '
o .
Expiration Date- ' 2/24/13
'
� Qty Unit Charge ger'
Extension `
BASE rzo
15'00
1'00 9.0000 EA MzCs FURNACE <~100K
9'00
1.00 16'5000 Eu MECo o/C >3,15He/>100z-50VzoBrn
. za'sO
______________________________________________
' opacial Notes and Comments . '
HVAC CHANGE -OUT: INSTALL PACKAGE
`
nmzT/asArPnMP - 2 rOm' 2010 CODES. '
_________----_____-___-__--_--___-________-_-
otber Fees . . ' ' ' ' ' ' ' aLoS GToG xuDMzm <oo1*73>
1_00 '
Fee aoounazy Charged Paid Credited
----------------- ---------- ---------- --- -------
Due
Permit Fee Total 40'50 'oo 'oo
40'50
Plan Check Total �o'z] 'oo 'ou �
10'13
Other nee Total ' 1'00 'oo 'OV
1'00
Grand Total sz'6a 'oo 'oV �
'
sz'ea
'
Simplified Prescriptive Certificate of Compliance: 12008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
51-673 avenida velasco La Qilinta, CA 92253
City of La Quinta
Aug 23, 2012'
Duct insulation
Conditioned -Floor
,
Equipment Typel
List Minimum,Efficiency2
requirement
Area
Thermostat
0 Package Unit
I.
'
❑ Furnace
0 AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
0 Setback -
❑ Indoor Coil
0 SEER 13.0
❑ HSPF
❑ R 8 (CZ 14-15)
800 sf
If not already present, must be
❑ CondensingUnit
❑EER
❑Resistance'
installed )
❑ 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. rEach 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 1, 2010, a registered copy of the CF-IR
and CF-6111 shall also be on site for final inspection. •;•` '
0 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF-6R forms: MECH-04, MECH121-HERS +• ,'�
replaced
CF-4R forms: MECH-21 »a (f9F split systems) P49GH 2 -
• Condenser Coil and /or
CF-6R forms: MECH-04, MECH-2I-HERS
• Indoor Coil and /oraR
CF-4R'forms MECH-21 ;�a (f . Split Systems) MC! lJ 74
• Furnace
-
For Packaged Units: Duct leakage`< 15 percent
Exempted from duct leakage testing,if: ,
,[31. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
t
❑ 2. Duct systems with less than;40 linear feet in unconditioned space, or.
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. Thome,ill not be Ducted„(fe Dtictres ;»Min( SphtSystem) (41 o Exxeropt from5RefrrigerahVCharge)
A.
❑ 2. Nevin HVAC System
Requi�red}oirnis-
• Cut in dt,Changeout witlfl
m
,CF 6R fors aMECH-04 MECH 26' HERS and (for split systems) MECH�22 HERS grid
new ducts (all new,
x
- ducting and all newf ,
MECH 25 HE� t•c ;. < �,ty'
RS , .
CF"4R forms MECH2O, (for MECH e f25
equipment)^.,
and split systemMECH-23ad
"i��
For Split System967D'uct leakage <i6 percent,+RC;'CCA” 2}350 CFM/ton>-FWD,";TMAHi7STMS, and,either HSPP oe'PSPP.
For Packaged Units:-Duct leakage 6'percen't . '`
❑ 3.•New;Dicts''with/or without'-A.'%.
Required Forms:
Replacemen
. Includes replacing or installing .611,new
ducting and/or outdoor condensing;unit
CF-611 forms: MECH-04; MECH-20-HERS,'and (for split systems) MECH-25-HERS,
and/or indoor coil and/or furnacec'No or some
CF-4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA z 300 CFM/ton, TMAH °
For Packaged Units: Duct leakage < 6 percent �. t
❑ 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)
e 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 fog 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: Mark Hyde' 4r Signature: Mark Hyde »
Company: CERTIFIED COMFORT SYSTEMS INC Date: Aug 23, 2012
Address: 42-949 MADIO STREET License: 906115=
City/State/Zip: INDIO / CA / 92201. Phone: (760) 360-2202
Reg: 212-AO04647OA-00000000-0000 Registration Date/Time:t2012/08/23 13:56:30 HERS Provider: Ca10ERTS,'Inc.
2008 Residential Compliance Forms July 2010
Bin #
City of La Quinta
Perrnit.#
Building .& Safety Division
nn
P.O. BOX 1504, 78-495 Calle Tampito
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:'
A
C-0
Owner's Name: SCA
A. P. Number:
Legal Description:
Address: 4C 1
Contractor:
44. Y 42
City, ST, Zip:
Telephone:
Address:
Project Description:
City, ST, Zip:7 7 C17
4
Telephone:
State Lic. #: q (JC
#:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Name of Contact Person:
Project type .(circle .one): New Add'n Alter Repair Demo
Telephone # Of Contact Person:
Sq. Ft.:
# St es:
� # Units:
# Units:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Req'd
Rec�d
TRACKING
MG
Plan Sets
Plan Check submitted PERMIT FEES
PlanChe
Check
Structural Cafes.
Mub.ittd
Item
r ' y for corrections t.
------ Amount
Reviewed,
Reviewed, ready for corrections
7rRevi, w d,, ready d e, 'o.s
Trus . s Cafes.
Plan Check Deposit
Called Contact P6rson - --------
Called Co t. t Person
Energy Cafes.
Plan Check Balance
Plans picked up
Flood plain plan
Construction
Plans resubmitted tted
Grading plan,
Mechanical
2" Review, ready for correction slue
&ti
Subcontactor List
Electrical
.
Called Contact Person
Grant Deed
Plumbing
Plans pi . cked up
H.O.A. Approval
- S.M.I.
Plans resubmitted
IN HOUSE:-
Grading
Review, ready for corrections/issue
Fee
Planning Approval
tajDcveLPloper-Impact
Called Contact Person
Pub. Wks. Appr
�.LP.P.
-------------------P
Date of permit issue
School Fees
Total Permit Fees I . , —
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING -- CF-4R-MECH-21
Duct Leakage Test — Existing Duct System (Page 1 of 2)
Site Address:
51-673 avenida velasco, La Quinta CA 92253 (System
Enforcement Agency:
City of La Quinta
Permit Number:
12-993
1)
[3 4 ,Fix al accessible leaks using smoke and HERS rater verify
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. "
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
o 2. Measured leakage to'outside less than 10% of Fan Flow -
❑ 3: Reduce leakage•by 60%;and conduct smoke and fix all leaks
[3 4 ,Fix al accessible leaks using smoke and HERS rater verify
Note:.(One,ofOptions 1, 2, or 3 must be attemptedbefore�utilizing,Option•�4:);, ,;•••�,,,;,5, .
Determine riommal Fan Flow using one o�fthefollow'i�ng tFireecalcul ton m,"ethods A
✓ O Cooling system method: Size of condenser in•Tons �a x 400 — CFM *4
, ,,.,...•„`
x
'`'` :.r• +a`�'� �'- c - �,� -. ,•,� , s ` Via.,"`•,
..
✓ ❑ Heatinrrg�system method -21-7 yx * Output Capacity m•,Thousands of Btu/hr > CFM ` j `•` �;�`.
•��
� � k � S.h, �� � �'
��
✓ E3 Measured system airflowfusing RA3 3 ajo1dV jk procedures
Optional used thenow l' i, ��
l
Allowed'leakage; Fan El�x 0 151 'CFM r
r
i
Actual Leakage = CFM
Pass if Leakage Actual is less than Allowed
Pass E3 Fail
Option 2..used then W``-:
2
Allowed: leakage Fan Flow x 0.10 = _ CFM
Actual Leakage to outside,= 81 CFM
Pass if Leakage Actual is less than Allowed
Pass Fail
Option 3 used then:
Initial leakage prior to start'of work = _ CFM
Final leakage after sealing all accessible leaks using smoke test = _ CFM
3
Initial leakage _ - Final leakage _ = Leakage reduction _ CFM
((Leakage reduction _ / Initial leakage x 100% _ % Reduction
Pass if % Reduction >= 60%
Ei 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
13 Pass ❑ Fail
1
a
Reg: 212-A0046470A-M2100001A-M21A Registration Date/Time: 2012/09/28 13:35:50 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
❑ Outside:aie (OA),ducts.for`Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off
during'-j'CFi.'OA`.ducts that utilize controlled motorized dampers; that open only when OA,
ventilation is requiied.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 y
❑ All
,supply reikurn`registei fiboots must be sealed to the drywall�if,sm oke,test�is utilized for compliance
— applies to�duct leakage compliance o tion'3 •leaks -e reduction b9',,6 0 /o and o tion 4 (fix accessible -
leaks) described above P ry P ( 9€ P '� wyse, `fest
NW
fik
❑ New ductInstallatlons cannot
�f.��,utiliz
.e buildinglcavi'ducts tfes as plenums,ortplatform returns inalieu of - '
y��iR,. - YtY 2 i. A ...�. �_ •Y _ e'Pur-j
m1.
❑ Mastic and drawcbands use a used'in combination With !;cloth.backed:rubber adhesive duct tape.X-
V
to seal : .'
leaks at all new:duct connections.,"tit
DECLARATION: STATEMENT,* `n, .
. -I certify under penalty of perjury,'under.the laws of the State of California, the information provided on this form is true and correct.
• ed the verification services identified and reported on this certificate (responsible rater).
I am the certified HERS rater who perfo m
,�i.,,
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 Certificate(s) of Compliance.(CF-.1R) 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 -1R) approved by the
enforcement agency.
Builder or Installer information as shown on the Installation Certificate (CF -6111
)
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21
CERTIFIED COMFORT SYSTEMS INC
Duct Leakage Test — Existing Duct System (Page 2 of 2)
'
Site Address:
51-673 avenida velasco, La Quinta CA 92253 (System
Enforcement Agency:
c
Permit Number:
Sample Group # (if applicable): 351992
1)
City La Quints
12rmit
❑ Outside:aie (OA),ducts.for`Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off
during'-j'CFi.'OA`.ducts that utilize controlled motorized dampers; that open only when OA,
ventilation is requiied.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 y
❑ All
,supply reikurn`registei fiboots must be sealed to the drywall�if,sm oke,test�is utilized for compliance
— applies to�duct leakage compliance o tion'3 •leaks -e reduction b9',,6 0 /o and o tion 4 (fix accessible -
leaks) described above P ry P ( 9€ P '� wyse, `fest
NW
fik
❑ New ductInstallatlons cannot
�f.��,utiliz
.e buildinglcavi'ducts tfes as plenums,ortplatform returns inalieu of - '
y��iR,. - YtY 2 i. A ...�. �_ •Y _ e'Pur-j
m1.
❑ Mastic and drawcbands use a used'in combination With !;cloth.backed:rubber adhesive duct tape.X-
V
to seal : .'
leaks at all new:duct connections.,"tit
DECLARATION: STATEMENT,* `n, .
. -I certify under penalty of perjury,'under.the laws of the State of California, the information provided on this form is true and correct.
• ed the verification services identified and reported on this certificate (responsible rater).
I am the certified HERS rater who perfo m
,�i.,,
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 Certificate(s) of Compliance.(CF-.1R) 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 -1R) approved by the
enforcement agency.
Builder or Installer information as shown on the Installation Certificate (CF -6111
)
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
CERTIFIED COMFORT SYSTEMS INC
Responsible Person's Name:
CSLB License:
Mark Hyde
906115
HERS Provider Data Registry Information
Sample Group # (if applicable): 351992
❑ tested/verified dwelling
IRn ot-tested/verified dwelling in
ERS sample group
HERS Rater Information CaICERTS Certificate # CC1-1798685404
HERS Rater Company Name:
Desert H.E.R.S. Raters.
Responsible Rater's Name:
Responsible Rater's Signature:
Michael Hyde
Michael Hyde
Responsible Rater's Certification Number w/ this HERS Provider:
Date Signed: 9/19/2012
CC2005602
Reg: 212-A0046470A-M2100001A-M21A Registration Date/Time: 2012/09/28 13:35:50 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
Space Conditioning Systems
Heating Equipment
INSTALLATION CERTIFICATE CF-6R-MECH-04
,
Space Conditioning Systems; Ducts and Fans (Page i of 2)
Efficiency
Site Address:
5
51-673 avenida velasco, La Quinta.CA'92253 (System
Enforcement Agency:
'Permit Number:
i•12-993
,Equip
t
City of La Quinta
Efficiency
Space Conditioning Systems
Heating Equipment
Cooling Eaufament
Efficiency
Duct
,Equip
t
Efficiency
Location
Equip
r•
(AFUE;
(attic,
-
Type
.1
ARI
# of
etc.)1, 3
crawl-
Heating
Heating
(package-'
CEC Certified Mfr. Name
Reference
Identical
(>=CF -1R
space,
Duct
Load
Capacity '
heat pump) ..
_
and Model Number
Number2
Systems
value)4
etc.)•
R -value
(kBtu/hr)
(kBtu/hr)
Package
american standard `
"
13 SEERS
1.',11
22
Heat Pump •
4wcc3024b1000ba
4696576
1
7.7.HSPF
Attic
R-4.2
22
24 k8tu
it
�~
Ali
•
'A.e� h `�eq•'" - .•y��w,fr•+
.�" "'- ,K"`
,�,.; �'''
9.-►T-� R":
'_+v.,.N_
ii-`. �"?
', L+�.N
'�v
Cooling Eaufament
1. It project is new construction, see Footnotes to btanaaras ►able lbl-ti ana iaole 151-( ror acct ceiling alternative
compliance: �. { •'
2. ARI Reference Number can be found by entering the equipment model number at
http://www.aridirectory.org/ari/ac.php# t
3. Listed efficiency on this page must be greater than or equal ( ? j to the value shown on the CF -1R form.
4. When CF -1R is reference it is also applicable to the CF -1R, CF -11? -AA or CF -IR -ALT
ALL BOXES MUST BE -CHECKED TO BE A VALID FORM,
0 §110-§113: HVAC equipment is certified by the California Energy Commission.•
0 §150(h): Heating and/or cooling loads calculated in, accordance with ASH -RAE, SMACNA, or ACCA. -
2 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the`requirements of '
§112(c). '
!1 M
0 §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 enclosed entirely in
conditioned space. "
'
Reg: 212-A0046470A-M0400001A-0000 Registration Date/Time: 2012/09/10 12:22:03 HERS Provider:-CalCERTS, Inc..
2608'Residential Compliance FormsAugust 2009
Efficiency
Duct
,Equip
t
(SEER
Location
Type
r•
and EER)
(attic, ,
(package -
.1
ARI
# of
111, 3 •
crawl-
Cooling
Cooling .
heat
CEC Certified Mfr. Name
Reference
Identical
(>=CF -1R
space,
Duct'
'Load
Capacity
pump)
and Model Number t
Number2
Systems
value)4
etc.)
R -value,
(kBtu/hr)
(kBtu/hr)
Split
american standard
"
13 SEERS
1.',11
22
Heat Pump4.,
•✓414wcc3024b1000ab �`,
4696576
1 4 .
EERr,C
( Attic
R-4:2 ,
,-�
24 kBtu
it
�~
Ali
•
'A.e� h `�eq•'" - .•y��w,fr•+
.�" "'- ,K"`
,�,.; �'''
9.-►T-� R":
'_+v.,.N_
ii-`. �"?
', L+�.N
'�v
1. It project is new construction, see Footnotes to btanaaras ►able lbl-ti ana iaole 151-( ror acct ceiling alternative
compliance: �. { •'
2. ARI Reference Number can be found by entering the equipment model number at
http://www.aridirectory.org/ari/ac.php# t
3. Listed efficiency on this page must be greater than or equal ( ? j to the value shown on the CF -1R form.
4. When CF -1R is reference it is also applicable to the CF -1R, CF -11? -AA or CF -IR -ALT
ALL BOXES MUST BE -CHECKED TO BE A VALID FORM,
0 §110-§113: HVAC equipment is certified by the California Energy Commission.•
0 §150(h): Heating and/or cooling loads calculated in, accordance with ASH -RAE, SMACNA, or ACCA. -
2 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the`requirements of '
§112(c). '
!1 M
0 §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 enclosed entirely in
conditioned space. "
'
Reg: 212-A0046470A-M0400001A-0000 Registration Date/Time: 2012/09/10 12:22:03 HERS Provider:-CalCERTS, Inc..
2608'Residential Compliance FormsAugust 2009
INSTALLATION CERTIFICATE - CF-6R-MECH-04
Space Conditioning Systems, Ducts and Fans. (Page 2 of 2)
Site Address: s
51-673 avenida velasco, La Quinta CA 92253 (System
-
Enforcement Agency:
Permit Number:
1)
City of La Quinta
12-993
Ducts and Fans ,
§150(m): Duct and Fans
❑ 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the I?
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 ?/4 inch, the combination ,'
of mastic and either mesh or tape shall be used; and -
0 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.
'❑ 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.
❑ Protectiori of Insulation. Insulation shall be protected from -damage, including that due to sunlight, -
moisture, equipment maintenarice; and wind. Cellular foam insulation shall be protected as above or
-painted with a coating that is water retardant and provides shielding from solar radiation that can cause
degradation of the material- r
11, ❑ 10. Flexible ducts cannot have porous inner cores
,'� `� - � , �' •.,'�,.� y *�: L �+ rC. � ii. � "� t. r��-rte-' te•' - ..
Y T
DECLARATION STATEMENT
. I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. ,
. I am eligible under Division 3 of the Business 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.
. I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed 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 1
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. •
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
CERTIFIED COMFORT SYSTEMS INC "
Responsible Person's Name:
Responsible Person's Signature:
Mark Hyde
Mark Hyde
CSLB License:
Date Signed:
Position With Company (Title):
906115,
8/23/2012
-
J
•Reg:,•212-A0046470A-M0400001A-0000 ,Registration Date/Time:_2012/09/10 12:22:03 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms August 2009
IJ r. »
H
,� CF-6R-MECH-21-HERS
INSTALLATION CERTIFICATE
m 1. Measured leakage less than 15% of fan flow ,
n
(Page 1 of 2)
Site Address:-
51-673 avenida velascoja Quinta CA 92253 (System
Enforcement Agency:
Permit Number:
1�
City of La Quinta
IJ r. »
H
,� CF-6R-MECH-21-HERS
INSTALLATION CERTIFICATE
m 1. Measured leakage less than 15% of fan flow ,
Duct Leakage Test — Existing Duct System
(Page 1 of 2)
Site Address:-
51-673 avenida velascoja Quinta CA 92253 (System
Enforcement Agency:
Permit Number:
1�
City of La Quinta
12-993'
This installation certificate is required for compliance for alterations and additions in existing dwellings to
` soace conditionina 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
ccessible
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.
m 1. Measured leakage less than 15% of fan flow ,
❑ 2. Measured leakage to outside less than 10% of Fan Flow
❑ 3. Reduce leakage by 60%" and conduct smoke and fix all leaks r
❑ 4. Fix all accessible leaks using smoke and HERS'rater verify
Note: (One of Options 1, 2 or 3 must. be;attempted before_ utilizing Option 4.)_, -------
�
Determine nominal Fan°Flow using one' of the;following three`caiculation methods.,IF�'_
Determine
s .. y . 6 r; x 400 = � 0 it i' � -� Ii
0 Cooling -system method: Size of condenser in Tons �� �(�
.CFM • ,
.44
❑ Heating system method: 21 7 x • Output Capacity in,Thousands of Btu/hr – CFM r
y' c 4<ss• w
fj
V ❑ Measured s stem airflow•usm �RA3 3 airflow,,test procedures: CFM, i
Option 1 used then: " ' ,. _ •, -, __,• r_.—
•
f
1
Allowed leakage = Fan Airflow 1?800 x 0.15 = 120 CFM
r
Actual Leakage= 96 CFM ,
' '` �• - Pass if Actual Leakage is less than Allowed leakage
Pass Fail,
Option 2 used then: . 1 -+ . - ,
.2
Allowed leakage = Fari Airflow _x 0.10 = —CFM
Actual Leakage to outside•= r• • CFM
Pass if Actual leakage to outside is less than Allowed leakage
Pass Fail'.,,
Option 3 used then:_ .
Initial leakage prior to start of work = ' CFM
Final leakage after sealing all accessible leaks using smoke test = CFM
3
Initial leakage _ - Final leakage '" = Leakage reduction _ CFM ,
((Leakage reduction _ / Initial leakage _) x 100%,= � Reduction
Pass if % Reduction >= 60%
p Pass ❑Fail _.
Option 4 used then:
*r
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: 212-A0046470A-M2100001A-0000 Registration Date/Time: 2012/09/10.12:15:41. HERS'Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
1
r
-
Reg: 212-A0046470A-M2100001A-0000 Registration Date/Time: 2012/09/10.12:15:41. HERS'Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
1
r •
F
f
1
r
Reg: 212-A0046470A-M2100001A-0000 Registration Date/Time: 2012/09/10.12:15:41. HERS'Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
INSTALLATION CERTIFICATE'. . ..
-
CF-6R-MECH-2I-HERS
Duct Leakage Test — Existing Duct System
Mark Hyde
(Page 2 of 2)
Site Address: • ..-
51-673 avenida velasco, La Quinta CA 92253 (System
Enforcement Agency:
City of La Quinta
Permit Number: ;
12-993 '
z,
8/23/2012
-
0 Outside air (OA) ducts for. Centra l; Fan'Integrated (CFI) ventilation systems; shall not be sealed/taped off
during duct leakage testing. CFI OArducts 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.
0 All supply and register'b ots•must.besealed to the.dry.wall,if smoke.test.is'utlllzed forcompliance
— appliesao�duct.leakage compliance option 3 (leakage reduction by 60%) and.optiorN4 (fix:alllaccessible
leaks) described above. -
��- r f
� .. { •' ,`•- � j ; � °; . , .� .-. �,
0 New duct,lnstallatlonsycannot,utlllze,bulldi.n+g cavities as plenums or.�platform ieturns m Ileu.of,ducts:
r T � - � --, . •[wsr� y.,.. ' tib«. .' '�.a'+i.a. ; ;►► •
0 Mastic and!draw bands must,be used;in combination with cloth backed rubber adhesive duct -tape to seal
leaks_ at all new duct connections-
DECLARATION
onnections
DECLARATION STATEMENT ' • ' ,
• I certify under penalty of perjury, under -the laws of the State of California, the information provided on this form is true and correct. „
. I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or ani 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)
I 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 -1R) form approved by the enforcement agency that identifies the specific ,
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... s ,
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
CERTIFIED COMFORT SYSTEMS INC `
Responsible Person's Name:
Responsible Person's Signature:
Mark Hyde
Mork Hyde'
CSLB License:
Date Signed:
Position With Company (Title):
906115
8/23/2012
-
Is this installation, monitored by a Third_ Party Quality
Name of TPQCP (if applicable):
Control Program (TPQCP)? ❑ Yes ❑ No
,
Reg: 212-A0046470A-M2100001A-0000 'Registration Date/Time: 2012/09/10 12:15':41 HERS Provider: Ca10ERTS,s'Inc. '
2008 Residential Compliance; Forms March 2010
4
,
Reg: 212-A0046470A-M2100001A-0000 'Registration Date/Time: 2012/09/10 12:15':41 HERS Provider: Ca10ERTS,s'Inc. '
2008 Residential Compliance; Forms March 2010