Loading...
11-0565 (MECH)BUILDING & SAFETY DEPARTMENT - BUILDING PERMIT Owner: FAZZONE DAVE 45580 STONEBROOK COURT LA•QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 _.I ISSE-E C-"PIfl?i S' (7 60 �J -7153 Date: �6 1/11 VA Application valuation: 6245 Contractor: Applicant: Architect or Engineer: HYDES 77825 WILDCAT STREET PALM DESERT, CA 92211 (760)360-2202 PWLic. No.: 906115 LICENSED CONTRACTOR'S DECLARATION # WORKER'S COMPENSATION DECLARATION ' I hereby affirm under penalty, of perjury that I am licensed 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 Pro essionals Code, 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 Licen Class: C20 C36 License No.: 906115 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: Co ractor: 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 OWNER -BUILDER DECLARATION' - insurance carrier and policy number are: - I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier NORGUARD INS Policy Number CEWC133676 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the 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 become 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 I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shallop with comply wi tIf- provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5'by . /� rFi/c/ /x/511 , any•applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: 17 16, ant: c if '1 (_ 1 I, as owner of the property; or my employees with wages as their sole compensation, will do the work, and I . - the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAIL E TO SECURE WORKERS' 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 himselfor-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 3706 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 improvefor the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT 1 _ 1 I, 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 contractor(s) 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, 1 _ 1 I am exempt under Sec. , BAP.C. for this reason 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. Date: • Owner: - _ 2. -Any permit issued as a result of this application becomes null and void if work is not commenced within 160 days from date of issuance of such permit, or cessation of work for 180 days will s lect 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 information is correct. I agree to co ly with.all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and hereby authorize r resentatives of this co ty to nter upon the above-mentioned property forin tion purposes. s , Lender's Name: - �• `- s �/ ' • \ - te: Si ature (Applicant or Agent): J Lender's Address: i! LQPERMIT P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:10:0.00056'.5- Property Address: 45580 STONEBROOK CT APN: 604-404-024-9 -23995-- Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL BUILDING & SAFETY DEPARTMENT - BUILDING PERMIT Owner: FAZZONE DAVE 45580 STONEBROOK COURT LA•QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 _.I ISSE-E C-"PIfl?i S' (7 60 �J -7153 Date: �6 1/11 VA Application valuation: 6245 Contractor: Applicant: Architect or Engineer: HYDES 77825 WILDCAT STREET PALM DESERT, CA 92211 (760)360-2202 PWLic. No.: 906115 LICENSED CONTRACTOR'S DECLARATION # WORKER'S COMPENSATION DECLARATION ' I hereby affirm under penalty, of perjury that I am licensed 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 Pro essionals Code, 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 Licen Class: C20 C36 License No.: 906115 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: Co ractor: 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 OWNER -BUILDER DECLARATION' - insurance carrier and policy number are: - I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier NORGUARD INS Policy Number CEWC133676 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the 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 become 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 I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shallop with comply wi tIf- provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5'by . /� rFi/c/ /x/511 , any•applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: 17 16, ant: c if '1 (_ 1 I, as owner of the property; or my employees with wages as their sole compensation, will do the work, and I . - the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAIL E TO SECURE WORKERS' 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 himselfor-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 3706 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 improvefor the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT 1 _ 1 I, 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 contractor(s) 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, 1 _ 1 I am exempt under Sec. , BAP.C. for this reason 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. Date: • Owner: - _ 2. -Any permit issued as a result of this application becomes null and void if work is not commenced within 160 days from date of issuance of such permit, or cessation of work for 180 days will s lect 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 information is correct. I agree to co ly with.all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and hereby authorize r resentatives of this co ty to nter upon the above-mentioned property forin tion purposes. s , Lender's Name: - �• `- s �/ ' • \ - te: Si ature (Applicant or Agent): J Lender's Address: i! LQPERMIT LQPERMIT - ' Application Number 11-00000565 Permit MECHANICAL Additional desc . Permit Fee . . . . 40.50 Plan Check Fee . 10.13 Issue Date Valuation 0 Expiration Date 11/28/11 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-5.00KBTU 16.50 ---------------------------------------------------------------------------- Special Notes and Comments. INSTALL NEW A/C SYSTEM, FURNACE, CONDENSING UNIT & 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 - ' n t Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-iR-ALT-HVAC Climate Zones 10 - 15 . Site Address: Enforcement Agency: Date: Permit #: 45-580 Stonebrook ct. La Quinta, CA 92253 City of La Quinta May 31, 2011 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 . requirement Area Thermostat ❑ Package Unit �. © Furnace 2 AFUE 78% ❑ COP ❑ R 6(CZ 10-13) Served by system 2 Setback Q Indoor Coil p SEER 13.0 C]HSPF ❑ R 8 (CZ 14-15) 2000 sf Ifnot already present, must be E6 Condensing Unit [-IEER ❑ 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. 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 -611 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 -111 and CF -611 shall also be on site for final inspection. 2 1. HVAC Chan geout Required Forms: . . All HVAC Equipment CF -6R forms: MECH-04; MECH-2I-HERS and (for split systems) MECH-25-HERS - 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 FurnaceFor CF -4R forms: MECH-21 and (for split systems) MECH-25 . .split Systems` Ductlleakage'j<•15 percent; RC, CCA _< 300 CFM/ton (Minimum Air Flow Requirement), TMAH - Exempted from duct leakage testingrif:• ` \Ej 1 Duct°system'was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than>40.linear feet in unconditioned space, or 1 p,3: Existing duct systems are co'nstructed, insulated or sealed with asbestos ❑"4: The system will not be Ducted�(ie,, uctless{Mini-Split Syste[n)t(Also_rExemptrrfrom�Refrigeta�t C-.harge) ❑ 2. N`evv HVAC System i, Required Forms: ! �•' ,bow:i` . Cut i*r,Changeout with? —new ducts..(all new y' '" •' 4 : y ,t <;•.f x r ='Y ; `- �� ._ CF 6R forms ,MECH-04, MECH=20-HERS, and.(for split systems) MECH-22 HERS and-MECH=25 HERS ductiiig'iidd all new CF t4R'.f6rms:`MECH 20, and (for split systems)'MECH 22; and•MECH'25 r equipment) .'+y>`°#It! t� `_ �'� '�" For Split Systems. -,Duct leakage;<r6'percent;-RC„CCA: 2! 350 CFM/ton; FWD;;TMAH, STM., and either,HSPP`or-PSPP. ' For Packaged Units: ❑ 3._New.Ducts with/or without>k Required Forms: -, Replacement --;;r7 •!'`N. lt • , j' • Includes replacing or installing all new ducting and/or outdoor condensingkunit'.5nd/o� indoor CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS coil and/or furnace. No or'some equipment CF -4R forms:, MECH=20 and (for split systems) MECH=25 y 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 ,. repuirements 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 Signature: Mark Hyde , Company: CERTIFIED COMFORT SYSTEMS INC Date: May 31, 2011 Address: 77-825 WILDCAT DRIVE - License: 906115 City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 360-2202 Reg: 211-A0025959A-00000000-0000 Registration Date/Time: 2011/05/31 13:55:57 HERS Provider: CalCERTS, Inc.,. 2008 Residential Compliance Forms - July 2010 Bin # Permit #G Project Address:' A. P. Number: Legal Description: Contractor. r•- 1 e Address: -7 g City, ST, Zip: Telephone: State Lie. # : o Arch•, Engr., Designer- Address: esignerAddress: City, ST, Zip: Telephone: State Lic: #: Name of Contact person: Telephone # of Contact Person: # Submittal Plan Sets Structural Calcs. Truss Calcs Energy Calcs. Flood plain plan Grading plan Sabcontactor List Grant Deed H.O.A. Approval IN HOUSE:- Planning Approval Pub. Wks. Appr School Fees Gity of La Quinta Building 8T Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Pe rmit Application and Tracking Sheet r'sName: Ot v .(%isT, hone: 0— f_ r Project Description: iqZZ vt Lic. #: t-1 g 2 Total Permit Fees Construction Type: Occupancy: ;oj� type (circle one): New Add n Alter ' Rep Demo Sq. Ft: # Stories: # Units: Estimated Value of Project �o Z � APPUCANT: DO NOT WRITE BELOW THIS UNE Recd TRACWNG . . YERIVIIT FEES Plan Check submitted Item Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical 2°d Review, ready for corrections/issue Electrical Called Contact Person Plumbing Pians picked up SALL Plans resubmitted Grading Review, ready for corrections/issue Developer Impact Fee Called Contact Person AyP.P_ Date of permit issue Total Permit Fees INSTALLATION CERTIFICATE CF-6R-MECH-0 l Site Address: 45-580 Stonebrook ct., La Quinta CA 92253 (System ,.. Permit Number: .' City of La Quinta 11-565 Equip Efficiency Location ,Equip r F' , INSTALLATION CERTIFICATE CF-6R-MECH-0 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: 45-580 Stonebrook ct., La Quinta CA 92253 (System Enforcement Agency: Permit Number: .' City of La Quinta 11-565 Equip Space Conditioning Systems Heating Equipment, Cooling Equipment, Efficiency Duct r , Equip Efficiency Location ,Equip r F' , (AFUE, (attic, (package heat CEC Certified Mfr. Name:;. ARI # of etc.)1, 3 crawl- i Duct Heating Heating ,Type (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) Split AMERICAN STANDARD 3� 44 i +` EER f, i R.4'2 "52 : SS kBtu Furnace AUD2C120ACV52AA 6 1 80 AFUE Attic R-4.2 . 100, 120 kBtu ��gt �`��."r<Y kil, ,k %4440`, kik.' A%4440. f5'Y Cooling Equipment, 1. If project is new construction, see Footnotes to Standards Table, 151-8 and Table 151-C for duct ceiling alternative compliance. 2. ARI Reference Number can b4lfound by entering the equipment model number at _ http://www.aridirectory.orglaril6*6.ohp# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R form.f 4. When CF -1R is reference it is also applicable to the CF -IR, CF -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. ' El §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACOA. 2 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 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 is enclosed entirely in conditioned space. t Reg: 211-A0025959A-M0400001A-0000 Registration Date/Time: 2011/06/03 15:28:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 Efficiency F , r , Equip 1. If project is new construction, see Footnotes to Standards Table, 151-8 and Table 151-C for duct ceiling alternative compliance. 2. ARI Reference Number can b4lfound by entering the equipment model number at _ http://www.aridirectory.orglaril6*6.ohp# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R form.f 4. When CF -1R is reference it is also applicable to the CF -IR, CF -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. ' El §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACOA. 2 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 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 is enclosed entirely in conditioned space. t Reg: 211-A0025959A-M0400001A-0000 Registration Date/Time: 2011/06/03 15:28:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 Efficiency Duct Equip (SEER Location Type., r F' , and EER) (attic, (package heat CEC Certified Mfr. Name:;. ARI Reference # of Identical 1, 3 ' (>=CF -1R crawl- space, Duct Cooling Load Cooling . Capacity pump) and Model Number#`',i= Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split J,,0`AMERICAN STANDARD 991; - `i 16 SEER; "`i3 Attic A/C� y .4ATA5061E1000AA 3� 44 i +` EER f, i R.4'2 "52 : SS kBtu ��gt �`��."r<Y kil, ,k %4440`, kik.' A%4440. f5'Y 1. If project is new construction, see Footnotes to Standards Table, 151-8 and Table 151-C for duct ceiling alternative compliance. 2. ARI Reference Number can b4lfound by entering the equipment model number at _ http://www.aridirectory.orglaril6*6.ohp# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R form.f 4. When CF -1R is reference it is also applicable to the CF -IR, CF -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. ' El §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACOA. 2 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 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 is enclosed entirely in conditioned space. t Reg: 211-A0025959A-M0400001A-0000 Registration Date/Time: 2011/06/03 15:28:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE - CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) # Enforcement Agency: INSTALLATION CERTIFICATE - CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: 45-580 Stonebrook ct., La Quinta CA 92253 (System Enforcement Agency: Permit Number: City of La Quinta 11-565 1) Ducts and Fans §150(m): Duct and Fans " ❑ 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 -inch, the combination of mastic and either mesh or tape shall be used; and ❑ 1. Building cavities,. support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may.contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the i ducts. ❑ 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back ti 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 Insulation. ,Insulation shall be protected from damage, including that due to sunlight, - moisture, equipment maintenance, and wind. -Cellular foam insulation shall be protected as above or ,painted with•a.•coating thatis water retardant and provides shielding from solar radiation that can cause 'degradation of the material Y • r 0,,10 Flexible ducts cannot haveporousinner cores , k� ,,. r•..�w � � • p;��'w. '' ,..�+ .71;x" � a � �! Y 1 -ti 4 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). r. I I . 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 k enforcement agency. . 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 Cl -11Z 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 occupancv. Y Reg: 211-A0025959A-M0400001A-0000' Registration Date/Time: 2011/06/03 15:28:59 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 l Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC f Responsible Person's Name: Responsible Person's Signature: Mark Hyde Mark Hyde CSLB License: Date Signed: 15-/26/2011 Position With Company (Title): ` 906115 Y Reg: 211-A0025959A-M0400001A-0000' Registration Date/Time: 2011/06/03 15:28:59 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 l INSTALLATION CERTIFICATE :CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System . (Page 1 of 25 Site Address: 45-580 Stonebrook ct., La Quinta CA 92253 (System Enforcement Agency: City of La Quinta Permit Number: 11-565 l - V.1 - .1-❑ Enter the Duct System Name or Identification/Tag:,System 1 . Enter the Duct System Location or Area Served: Whole House ,r ` 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 ❑ 2. Measured leakage to outside 'less than 10% of Fan Flow l - V.1 - .1-❑ F -13. Reduce leakage by160% and conduct smoke and fix all leaks , ❑ 4:,Fix all cc sibleielaks using smoke'and HERS rater verify — i, , • Note- (One of Options 1, 2 or 3 must be attempted,rbeforq utilizing Option�4.),µ Determine nominal Fan;Flow using and ofzttie following three",calculation methods ✓ 8 Cooling: system method: Size of condenser in Tons �jAZ.x 400 20001 -CFM_ � .:., � • _,�� "' hsands Btu/hr Heating system met 1 7,x Output Capacity, Jn,Tou of _CFM ❑od 2 ✓ ElMeasured system airflowyusmg;RA3 3 airflow=test procedures: Option l used then:' 1 Allowed leakage Fan Airflow 2000 x 0.15 — 300 CFM Actual Leakage ,=• 1194 CFM- ;,•:'; .;', Pass if Actual Leakage is less than Allowed leakage g Pass ❑ Fail Option 2 used then: :' *-' CFM ' 2 Allowed leakage = Fan,Airflow x 0.10 _ _ , 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%1❑ Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke test HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke ❑ Pass Fail y , s' r . y Reg: 211-A0025959A-M2100001A-0000 Registration Date/Time; 2011/06/03-,15:27:15 HERS Provider: Ca10ERTS,•Inc. 2008 Residential Compliance Forms i March 2010' J INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS ' Duct Leakage Test — Existing Duct System _ (Page 2 of 2) ; Site Address: Enforcement Agency: Permit Number: - 45-580 Stonebrook ct.' La Quinta CAt92253 (System City of La Quinta 11-565 1) _ D Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during°duct leakage,,testing. CFI .0A 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 isnot required, may be configured to the closed positiori'during duct leakage testing. i 2 All supply and return register4boot�s ;must,besealedao the�dry�wall;if sm oke testi utlllzed for compliance — applies to,duct le2kage comp) once• otlon 3 (leakage r`eductlon,by;60 /o)'and option 4V(f x allfaccessible , leaks) described above 1 �y4 ''C r 2 New duct$installatlons cannot utllrze.bullding c vltles as plenums oriplatform returns in,lieu of ducts,• © Mastic and draw, baridsAmust,be use&in combination with cloth backed rubber adheslve,duct=tape to seal leaks at all new ductconnectidns � X 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 understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, -I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or -made available with the , building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder • - provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor. or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC _ 1' Responsible Person's Name: Responsible Person's Signature: , Mark Hyde Moi^k Hyde CSLB License: Date Signed: , Position With Company (Title): 906115 5/26/2011, . Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No y Reg: 211-A0025959A-M2100001A-0000 Registration Date/Time: .2011/06/03J5:27:15 HERS Provider:.CalCERTS, Inc. 2008 Residential Compliance Forms - March 2010 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 I for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form_ . Attach an additional form(s) for any additional systems in the dwelling as applicable.-. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler_ System Name or,Identification/Tag System 1 -7 System Location or Area Served Whole House 1 • ®Yes E] No s- 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and 4 ®Yes ',) ❑;No labeled according,to Figure in Section RA3.2.2.2.2. 2 `Q Yes, ❑Not' s'` 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,l;and 2 is a ass. • Enter Pass or Faill ✓ 0 Pass ✓ ❑ Fail STMS'A - Sensor n..the Evaporator �Coil System'Narne or Identification/Tag's c System.`1 :tea ') ; ' 3 • ❑Yes •" p No r s The sensor is facto installed;'or field innstalled according to4manufacturer s specifications, or rs installed by methods/specifications approved by the Executi4e `� Director: �• l '� �> .� ��;'xa,;z • ,��`,s«ti:, t.,x�-�+►.,��` 4 ®Yes ',) ❑;No The sensor wire is terminated with a ^Standardrmim plugsuitable, for connection to a�,t drgrtaf;therniometer The sensor;mui� plug is accessible tocthe installing techriic a',n and the HERS'�rater without changing.the airflow.tlirough the condenser coil 5 ❑ Yes. ❑ No ' • ' .The sensor measures the saturation temperature of the coil within'l.3 degrees F _T Yes to..3; 4;an'd 5 is a.tpass. Enter N/A if STMS are not .Other'wise!enter Pass or�Fail' applicable. I V ® N/A ✓ ❑ Pass ✓ ❑Fail .r' 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 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, V . 9 N/A ✓ ❑ Pass ✓, ❑ Fail applicable. Otherwise enter. Pass or Fail i 1 .t Reg: 211-A0025959A-M2500001A-0000 Registration Date/Time: 201x/06/03 15:26:46 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 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. . I I ` • 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. I • 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 • l 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. . I I ` • 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. I • 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 H ' j r V -� Date ofThermocoupl Calibration a r;-+�..; � 5/26/2Oi: r VN war 1 . (must be re•calibr�ated monthly) x System Location or Area Served Whole House Outdoor Unit Serial # ' - 111155712t t. Return (evaporator, entering) air dry-bulb - Outdoor Unit Make AMERICAN Return (evaporator entering) air wet -bulb STANDARD Outdoor Unit Model rs 4A7AS061EI000AA ' Evaporator saturation temperature'�r - 42 - Nominal Cooling Capacity Btu/hr I' 60000 _ Date of Verification ' . J 5/26/2011 (Tcondensor, sat) M1 t Calibratiomof,Diagnostic Instruments Date o�f.Refrigerant Gauge Calibration # r ` 5/26/2011 ' • , H ' u r V -� Date o�f.Refrigerant Gauge Calibration # r ` 5/26/2011 ' • , (m uet be re -calibrated monthly) i _,• u r V -� Date ofThermocoupl Calibration a r;-+�..; � 5/26/2Oi: r VN war 1 . (must be re•calibr�ated monthly) x Supply; (evaporator leaving) air dry -,bulb , 'Alt Measured,Temperaturesi(.,OF)Ki iii ,r«. ;:. `-s Ar n"Jr,_?: 17o, r, -V- V'', f System Name or I dentification/Ta6 `_ �}r> Sy stem 1 t 9if .pf-.I�"g'rssbl`�;#. 5'r�rt,Ea-.... .�'. ,ter .!f,•°.,."`"^"fA"''uy' "}: e x Supply; (evaporator leaving) air dry -,bulb , 'Alt temperature'(TsuPPIY, dti) :cam r r ..:y„ + _ t. Return (evaporator, entering) air dry-bulb - temperatu"re"(Treturn db) T Return (evaporator entering) air wet -bulb temperature (Treturn, wb) ? s ' Evaporator saturation temperature'�r - 42 - (Tevaporator, sat) Condensor saturation temperature 102 (Tcondensor, sat) M1 t Suction line temperature (Tsuction) 66 Liquid Line Temperature (Tliquid) 90 Condenser (entering) air dry-bulb'' S temperature (Tcondenser, db) J � Reg: 211-A0025959A-M2500001A-0000 Registration Date/Time: 2011/06/03 15:26:46 HERS Provider: Ca_10ERTS, Inc. 2008 Residential Compliance Forms August 2009 , 1 The temperature split method is specified in Reference Residential Appendix RA3.2. 1 System 1. i Calculate: Actual Temperature Split = Treturn, db - Tsupply, db INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 45-580 Stonebrook ct., La Quinta CA 92253 City of La Quinta 11-565 ! Minimum Airflow Requirement Temperature Split Method Calculation - , s for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1. Calculate: Actual Temperature Split = Treturn, db - Tsupply, db - Target Temperature Split from Table RA3.2-3 using Treturn, wb and Treturn; db .. Calculate difference: Actual Temperature Split - Target Temperature Split = ; Passes if difference is between -3°F and +3°F or, t , upon remeasurement, if between -3°F and F -100°F a . Enter Pass or Fail - Note: Temperature Split Method Calculation is not necessary 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 airflow 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) System, Name or Ide tification/Tag, y is em 1 4.� 'Ye". Y. �; '' y' .. .,. x.' X .p{�''l.•: ..3' X'�. $`y� .'e"f•N yy.'�,�i y54,•�{ lRT " x'.4v 4'iPs�3`' yr.; Calculated Minimum Airflow Requirement (CFM) '_ .:$ 1500 `•._ ''•:. ".`.. .�_4; Measured�Airflow using RA3 3 procedures (CFM) ;, s 1725 `�.�,f„.� Passes if measured airflow is greater than, or.�`,z ; >•... ,. �=° ' "�' equal to the calculated minimum airflow I PASS requlrement:0'�Z477+= Enter Pass or Fail I ,r System Name or,Identification/Tag System 1 Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device'systems 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 t +5°F Enter Pass or Fail 1 Reg: 211-A0025959A-M2500001A-0000 Registration Date/Time: 2011/06/03 15:26:46 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4'of 5) Site Address: Enforcement Agency: Permit Number: 45-580 Stonebrook ct., La Quinta CA 92253 City of La Quinta 11-565 Subcooling Charge Method Calculations'for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. ' System Name or Identification/Tag System 1 Calculate: Actual Subcooling = 12 , Tcondenser, sat - Tliquid ) Target Subcooling specified by manufacturer 10 Calculate difference: 2 ti Actual Subcooling - Target Subcooling = System passes if difference is between -3°F and +3°F PASS � r Enter Pass or Fail t 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 System 1 Calculate: Actual Superheat = t .:. 14 Tsuction - Tevaporator, sat ) Enter allowable superheat range from: manufacturer's specifications (or use range 4_25 ti between 40F and 25°F if manufacturer's specification is not available) System passes if;actualsuperheat is-withinrther allowable superheat range wx PASSx � r at ,x°fEnter�Pass t t , Reg: 211-A0025959A-M2500001A-0000 Registration Date/Time: 2011/06/03 15:26:46 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 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 Mark Hyde ' CSLB License:, 15/26/2011 Date Signed: System meets all refrigerant charge and airflow 906115 r Is this installation monitored by a Third Party Quality ; requirements. PASS ' Enter Pass or Fail r r • ., P,. r 717 4' 3 k.v ff Y r , DECLARATION STATEMENT . I certify under penalty of perjury, und6r the laws of the State of California, the information provided on this form is true and correct. . I am eligible under -Division 3 pfthe 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 understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am i 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) farm 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.. 9 et.- . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the a building permits) 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 rpnictry fnr midtinle nrientation alternatives. and beoinnino October 1. 2010. for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC r _ Responsible Person's Name: Responsible Person's Signature: Mark Hyde Mark Hyde ' CSLB License:, 15/26/2011 Date Signed: Position With Company (Title): 906115 Is this installation monitored by a Third Party Quality ; Name of TPQCP (if applicable): ' • Control Program (TPQCP)? E) Yes C1 No Reg: 211-A0025959A-M2500001A-0000 Registration Date/Time: 2011/06/03 15:26:46 HERS•Provider: Ca10E_RTS, Inc. 2008 Residential Compliance Forms August 2009 s