The URL can be used to link to this page

13-0046 (MECH)'P.O. BOX 1504 78-495 CALLE TAMPICO, LA QUINTA, CALIFORNIA 92253. 0 0 _.. _ Application Number.,C"'�13=O.OA00046� Property Address: 79850 TANGELO; APN: 772 -230 -012 - Application description: MECHANICAL." Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 7400' TdY-4 w_ - BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: STEVE SAIRS 79850 TANGELO LA QUINTA, CA 92253 Z5 y3w" VOICE (76 77 - FAX (760) 11 INSPECTIONS (760) 777-7153 Date: 1/15/13 Date: Owner: CONSTRUCTION LENDING AGENCY 1 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 of is Ouinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. Z. 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. certify that I have read this application and state that the above information is o rect. I agree to comply with all city and county ordinances and state laws relating to building construction, an h eby authorize representatives oft county to �enteruponhe above-mentioned g;�n,- LQPERMIT or ' tion pur os;oft Date:` ��'e (Applicant or Agent)- ' Contractor: Applicant: Architect or Engineer: L1 SOUTHERN AIR CONDITIONIN )eq HE 2050 JASON COURT �/ u PALM SPRINGS, CA 92262 (760)P92-0296 JAN N Lic. No.: 953452 CITY OF LA QUI TA - FINANCE DEPT 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 3of the Business and Profqqonals 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 License Class: C20 License No.: 953452 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date:ntract 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 EX •MPT Policy Number' EXEMPT 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 f r 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 s je t 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 l should become subje t 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 s VII farthw' 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 ($500).: _ Date: 15 plicant: (�) I, as owner of the property, or my employer=c with -ages as their sole compensation, will do the work, and r the structure is not intended or. offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE 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 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. one year of completinn, 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 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, _ I—) 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 Date: Owner: CONSTRUCTION LENDING AGENCY 1 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 of is Ouinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. Z. 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. certify that I have read this application and state that the above information is o rect. I agree to comply with all city and county ordinances and state laws relating to building construction, an h eby authorize representatives oft county to �enteruponhe above-mentioned g;�n,- LQPERMIT or ' tion pur os;oft Date:` ��'e (Applicant or Agent)- ' Application Number . . . . . 13.-00000046 Permit . . . MECHANICAL Additional desc . Permit Fee . . . 48.00 Plan Check Fee 12.00 Issue Date Valuation . . . 0 Expiration Date 7/14/13 Qty Unit Charge Per Extension BASE FEE 15.00- 2.00, 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 Special Notes and Comments. HVAC CHANGE OUT REPLACE 2 CONDENSING UNITS.OUTSIDE 5 TON 16 SEER. 2010 CODES ------------------------------------------------------------------------ Other Fees . . . BLDG STDS ADMIN (SB1473) --- 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 48.00 .00 .00 48.00 Plan Check Total 12.00 .00 .00 12.00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 61.00 .00 .00 61.00 Bin. # Q, . of La Quinta Building sf Safety Dwo' n P.O. Box 1504,78-495 Cate Tampko La •Quinta, CA 92253 - (760) 777-7012 Building Permit Application• and Tracldng Sheet Permif # --AU Project Addmw. Owner's Name:. S • A- P. Number. Address: f �I Legal Description: 9� City, ST, Zip: LCA vi Contractor. Telephone: J bD1 L Address' b L�rl • L Project Description: n City. ST, zip: m Telephone: D O OJ State Lic. # : City Lic. #; F) Arch.. Bag, Designer r 00 Address: City. ST. Zip: Telephone: State Lta #. Name of Comet Person: Construction Type: L _ Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.. # Stories: #Unit$: Telephone # of Contact Pelson Estima W Value of Project APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd ' Reed " TRACIanvG PERMIT FEES Paan Sets Plan Check submitted Item Amount Stractaiaa Cates Reviewed, ready for corrections Plan Check Deposit. . . Trutt Cala. Called Coataet Person Plan Check Ralauce. Title 24 Cake. Playa picked up Canstrnctlon Flood plata plan Pians resubmitted.'. Meebaeilcal Grading plan 2'! Review, ready for correctioastissue Electrical Subcontaetor List Called Contact Person Plumbing Grant Dud Plans picked up S2-1LL ILO.A. Approval Plans resubmitted Gradlag Ik tIOUSB'- ''' Rev[cw, ready for correctionsr4sue Devdoper Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub WW. Aper Date of permit issue School Fees " Total Permit Fees bimplitted Frescril Climate Zones 10 to IS Site Address: Certificate of Compliance: 2008 Residential IYVACAIterations CF -111 -ALT -HV. Enforcement Agency: I Date: Permit #: Equipment T 'Conditioned Floor List Minimum Efficiency' Duct insulation requirement Packaged Unit Area Thermostat ❑• ❑ Furnace ❑ AFUE ❑ COP Over 40 ft of ducts added or �l Setback ❑ Indoor Coil SEER�� ❑ HSPF replaced in unconditioned space Served by system pjnotalready 19 Condensing Unit ❑ EER Et Resistance ❑ R 6 (CZ 10-13) sf present, must be. ❑ Other ❑ R 8 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment being installed; ijmore than one system, use another CF -1 R -ALT -HVAC jor each system. 2. Mlnirnum Equipment Efficieneles: 13 SEEP; 78% AFU& 7.7HSPF jor 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 1, 2010, a registered copy of the CF -IR and CF -6R shall also be on site for final inspection ®1 HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -4R forms: ECH- 21 and fors lit stems MECH-25 • Condenser Coil and/or M • Indoor Coil and /or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Furnace CF -4R forms: MECH- 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed though HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut s: or (all new ducting and all Chang with new ducts: CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS new equipment) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, SIMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with Replacement fRequired Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF -4R forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all eauinment chnnaM I . For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH For Packaged Units: Duct leakage <,6 percent ❑ 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned s ace. CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • 1 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 Txle 24, Parts I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the annit Alication Name:/')i- Company: I City/State/Zip: Date: License: �S3�Sa- Phone: w', .1 .n ?nnR Roci,%ntinlC^mnllnn,o F^v—, AWn—h 7nin Sim lifted Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: Enforcement Agency: Date: Permit #: } Equipment Type' List Minimum Efiicienc 2 Duct insulation requirement Conditioned Floor Area Thermostat. ❑ Packaged Unit ❑ Furnace ❑ AFUE_ ❑ COP Over 40 ft of ducts added or igetback ❑ Indoor Coil 01SEER1(L ❑ HSPF replaced in unconditioned space Served by system (If not already lieCondensing Unit ❑ EER '"esistance ❑ R 6 (CZ 10-13) sf present, must be ❑ Other I I ❑ R 8 (CZ 14-15) installed) 1: Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEEP, 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 CF4R forms (no hand filled CF4Rs allowed) are filled out and signed. Beginning October 1, 2010,a registered copy of the CF -1R and CF -611 shall also be on site for final inspection. AUPWAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-14ERS and (for split systems) MECH- 25 -HERS CF4R forms: MECH- 21 and fors lit stems MECH-25 - • Condenser Coil and/or • Indoor Coil and /or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Furnace CF4R forms: MECH- 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-:HERS ducts: (all new ducting and all CF4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 new equipment) For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, SIMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF4R forms: MECH-20 and (for split systems) MECH-25 coil and/or f imace. Not all equipment changed. For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4: New Ducting over 40 feet Required Forms: • Includes adding or replacing more than linear feet of duct in unconditioned space. CF-6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split system or packaged units: Duct leakage ,< 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I and 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 Tice 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 lication. Name: ► r Signature: Company: Date: Address: !1.�� License: �� City/State/Zip: U1 ,� r 2 7 Phone: -760 0 O 7nnR Porii%ntinl t,.nu""n o Rnrmr AAnrrh )n to s INSTALLATION CERTIFICATE. - CF-6R-MECH-25-HERS Refrigerant Charge Verification -. Standard Measurement Procedure (Page I of 5 Site Address: Enforcement Agency: Permit Number: 79850 Tangelo La Quinti CA 92253 La Quinta, City of 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. ; w 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 RA 3.2.- 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 Systemi1 System Name or Identification/Tag ' = System 1 Y 'System Location or Area Served . The sensor is factory installed, or field installed according to manufacturer's Bedrooms :The sensor is factory; installed, or field*installed a o ding to;manufacturer's .3 ❑Yes 1 O�XesM] ' ONo 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and ' I' ,�, d mArn 11abe djacco diri lfj igure i�Section RA3 2n2:A: . -,U.+ 'Ar"Y 1A OYes L pif __. Y+ -Pht Y'\ ❑No i.! +e ms: K 7 4- 'Ye_ Y d. w !it' Y lY A+ � Y Y Vk'Y hi \� W -5/1166 i Bch (8 mm) access�hole downstre of ev�aporahve coiI in supply plenum 2 digital thermometer.�The sensor mini plug is accessible-to•the nstalling technician and - :and(labeled according, or iguie[m Sec- RA3 2 2 2F2?! tion L Yes to I and 2 is a pass.�1. -? . ° ,Enter Pass or Fail y 4✓ O Pass ✓ ❑ Fail STMS -Sensor on the Evanorator Coil',� t System Nameor�I.dentlf at�on� g -` Systemi1 System Name or Identification/Tag ' = System 1 t The sensor is factory installed, or field installed according to manufacturer's t :The sensor is factory; installed, or field*installed a o ding to;manufacturer's .3 ❑Yes ❑No specifications or is installed by aethods specifircation as pproved by thle Executive : ' Director. a _ The sensor wire is terminated with a standard mini plug suitable for connection to a 7 The sensor wire is terminated with a standard mini plug suittaagle for connection to a 4, []Yes ❑No digital thermometer.�The sensor mini plug is accessible-to•the nstalling technician and - the HERS rater without changing the airflow through the condenser coil - 8 the HERS rater without changing the airflow through the condenser 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 ✓ C1 Pass V, ❑Fail . N/A if STMS are not applicable. Otherwise enter Pass or Fail STMS - Sensnr nn the Candencer Cnil Registration�Number: Stsnoo�a�ssA-Mzstatsee-0000 RegistrationDate/Time..01/241201319:27:43 HERS Provider: CBPCA + 2008 Residential Compliance Forms ! .August 2009 System Name or Identification/Tag ' = System 1 t 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 DYes ®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 l The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. - ' r Enter ✓ p N/A ✓ []Pass' ✓ ❑ Fail N/A if STMS are not applicable. Otherwise enter Pass or Fail Registration�Number: Stsnoo�a�ssA-Mzstatsee-0000 RegistrationDate/Time..01/241201319:27:43 HERS Provider: CBPCA + 2008 Residential Compliance Forms ! .August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure age 2 of 5 Site Address: Enforcement Agency: Permit Number: 79850 Tangelo La Quinta CA 92253 1 a Quinta, City of Standard Cbarge 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 documentedfor compliance using this form. Attach an additional forms) 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 °For below, the installer must use the Alternate Charge Measurement Procedure. Space Conaitioning a seems i --_� 1/-1/2013 , __. (must be re -calibrated monthly) Date Thermocoupl C tt ' '. " 1/1/2013 8 System Name or Identification/Tag System 1 System Location or Area Served Bedrooms 'Outdoor Unit Serial # W122221307 Outdoor Unit Make York Outdoor Unit Model CF20601307 ' Nominal Cooling Capacity. Btu/hr • ;60000:00 Date of Verification. -- •sw r r r 1/24/2013lie "pow - r r r r u r sir. vrs Evaporator saturation temperature .. usnoration OI JUKH nOMIC iubu uwcuwr Date of Refrigerant Gauge Calib&tion --_� 1/-1/2013 , __. (must be re -calibrated monthly) Date Thermocoupl C tt ' '. " 1/1/2013 8 ry must be re -calibrated monthly) of Iib _. Supply (evaporator leaving) air dry-bulb 50.00 ' �4 r n f'a �•-s Measurea lem eratures -r I.. :I System '1 - System Name or Identification/Tag Supply (evaporator leaving) air dry-bulb 50.00 ' temperature (Tsu 1 , db) Return (evaporator entering) air dry-bulb . 71.00 temperature (Tretorn, db) Return (evaporator entering) air wet -bulb 65.00 temperature (Treturn, wb) Evaporator saturation temperature 76.00 sat) ' _(Tevavoritor, Condensor saturation temperature • 51.00 - (Tcondensor, sat) Suction line temperature (Tsuction) - 88.00 - Liquid Line Temperature (Tliquid) 40.00 , Condenser (entering) air dry-bulb 65.00 temperature (Tcondenser db) w r>, i ' n 313-A0014183A-M2514158B-0000 Registration Date/Time: 01/24/2013 19:27:43 HERS Provider: CBPCA Registration Number: g 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification -'Standard Measurement Procedure (Page 3 of 5 Site Address: Enforcement Agency: Permit Number: " 79850 Tangelo La Quinta CA 92253 La Quinta, City of ' ' a Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag C k. System 1 Calculate: Actual Temperature Split Treturn, db - Tsupply, db Target Temperature Split from Table RA3.2-3 usingT and T C . retum� wb retunv db ' Calculate difference: Actual Temperature Calculate difference: Split – Target Temperature Split = Actual Superheat – Target Superheat = Passes if difference is between -3°F and - r System passes if difference is between 1, +3°F or, upon rremeasurement,, i&between ~ � � nd Pedd + ' °Fi g to er P ss44rh -3°F and -100e,, � !` �" w it M }I i hF= * k i K ;N. t"?. � � �. A 7i 0- ' 0 .�. � 0 If in. W Note: Temper'ature Split Methoy d�Calculatiori' isnot necessary; factual Cooling Coil4A:rflow_iswenfiedlustng.one of the airflow measurement procedures,specied in Reference. -Residential Appendix.RA3.3. If actual cooling coil airflow is measured the value must be equal to or �edter than the. 'Calculated'Mi mum Airflow,Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 0(cfm/ton) ,System Name or IdentificatiorL/T System�i Calculated Minimum Airflow 1500.00— Requirement (CFM) ! Measured Airflow using RA3.3 1678.00 procedures (CFM) Passes if measured airflow is greater than Pass ' or equal to the calculated minimum I r airflow requirement. Enter Pass or Fail 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 Tretum, wb and Tcondensen db Calculate difference: , Actual Superheat – Target Superheat = System passes if difference is between 1, r -5°F and +5°F Enter Pass or Fail ' Registration Number: 313-A0014153A-M251415ae-0000 Registration Date/Time: 01/24/2013 19:27:43 HERS Provider: CBPCA 2008 Residential Compliance Forms August 2009 4 ;TALLATION CERTIFICATE CF-6R-MECH-25-HI ri erant Char a Verification -Standard Measurement Procedure (Page 4 i Address: Enforcement'Agency: Permit Number: _ Tangelo La Quinta CA 92253 a La Quinta, City of r 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 IdentificatiorLTag System .1 , Calculate: Actual Subcooling = U I 1 00' re r�0 rj fI d Irl Ue Tsuction — Tev "rator' sa' t`^`*� i""'i of .11.00 x , Tcondenser, sat - ThQuid >r a '1 ! 'to •. 4.00 - 26.00 I .''' Target Subcooling specified by 8.00 t - manufacturer y' Calculate difference: 3.00 '" '� f'°'�- r • Actual Subcoolin — Target Subcoolin = *,Pass System passes if difference is between pass -3°F and +3°F Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or IdentificationrTag System 1,WWP4 Calculate: ' ' ctual Superh aiI a .0 U I 1 00' re r�0 rj fI d Irl Ue Tsuction — Tev "rator' sa' t`^`*� i""'i of . a. .. A--- --,.Enter x Enterallowable superheat range from,,` "'� >r a '1 ! 'to •. 4.00 - 26.00 I .''' manufacturer's specifications (or use range t - between 4°F and 25°F if manufacturer'st"' specification is not`available)'"'•rf'�.'_ -��"' fix` •� � r�""� '" '� f'°'�- • • System passes if actual -superheat is within the allowable superheat range} 4: *,Pass Enter Pass or Fail— Y S^ •• 1 • .. ; •fir ." - � �t � �-` • 't .• . ` ' "_ - . s Registration Number:- 3ta�`ootats3a-rvi25tat5a50000 RegistrationDate/Time: 01/24/201319:27.43 HERSProwder:_? CBPCA ~ 2008 Residential Compliance Forms ' '' August 2009 a INSTALLATION CERTIFICATE ICF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure . - (Page 5 of 5 Site Address: - t Enforcement Agency: Permit Number: 79850 Tangelo La Quinta CA 92253 La Quinta, City of 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 System meets all refrigerant charge and pass airflow requirements. Enter Pass or Fail CE-Mif6mia Building Pe rf onniftl ante -7] 1W4%, oft Conti tOr i .Aft N40 DECLARATION -STATEMENT �. • I certify under penalty of perjury underthe-laws of the State of California, the inf�o_r�mation provided on this form is true and correct. • I am eligible under Division 3 o?the Business and Professions Code to accept responsibility or"concon�ction, or an�authorized representative of the person responsible for construction (responsible person)"' Y • I certify that the installed features, materials, components, or�manufactured device's identified on this certif tate (the installation) conforms to all applicable codes and regulations, and'the-installation is consistent with the plans and.specifiAtions-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 -IR) 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. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) r Souttiem Air Responsible Person's Name: _ Responsible Person's Signature: - Christopher A Ginn Christopher A Ginn CSLB License: Date Signed: Position With Company (Title): 953452 11[2412013 owner + Is this installation monitored by a Third Party Quality Control Name of TPQCP (if applicable): Program (TPQCP)7 L]Yes E✓ No ' Registration Number: stsAoo�aissa-nnzetaisea�000 Registration Dat%Time: 01/241201319:27:43 HERS Provider: CBPCA .2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5 Site Address:Enforcement Agency: Permit Number: 79850 Tangelo La Quinta CA 92253 I.La Quinta, City of " Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verfication 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 forms) 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 y replacement space -conditioning systems that utilize prescriptive compliance method. TMAH -Access Holei in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 2 System 2 System Location or Area Served Living room, Kitcr 6 y❑Yes . ❑No 1 ❑ es A t 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and lab ed a co i " � i ¢ „ „d ng to Figure In SectionflIK-A 2:2:2 2 u1" ACS, 2 ..'S7"r• §ieril ❑Yes ',' w ti.' !d M Y'W'l ' "�" (]No h' W Yt VF,I � ii1 , i.2 h ^-; +i' 84' �5/l6 inch (8 mm) accessihole downstream of evaporative colt �r�the supply plenum I K �, and IlatSeled aceordln' g�to Figure(miSectlon RA32 2 2.`2' lA .. Yes to 1 anS2 is a,sassas .N,..- ' :_ iti Enter Pass or Fail 21 Pass ✓ ❑ Fail STMS - Gencor nn tha FvannrQfnr!`nil " System Naa etior Ide ification/Tag • -• System 2 The sensor is factory installed, or field installed according to manufacturer's 6 y❑Yes . ❑No specifications, or is installed by methods/specifications approved by the Executive , a The sensor is factory. installed, or field*installed according toymanufacturer's 3 ❑Yes ❑No specifications; or is install methodss slp� ations pproved by thle Executive The sensor wire is terminated *with a standard mini plug suitable for connection to a .Dtrecto�`r'"`` r I I ❑Yes ®No digital thermometer. The sensor mini plug is accessible to the installing technician and The sensor wire is terminated with a standard mini plug suitable,for connection to a 4 ❑Yes ' ❑No . digital thermometer.—The sensor mini plug is accessible -to -the stalling technician and ❑Yes ®No ' The sensor measures the saturation temperature of the coil within 1.3*degrees F the HERS rater without changing the airflow through the condenser coil 5 ❑Yes ❑No.* 1, The sensor measures the saturation temperature of the coil within 13,degrees F Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail "j Cg N/A " ✓ ❑Pass ✓ ❑Fail STMS - Sencnr nn the ('nndencer Cnil S System Name or Identificition/Tag System -2 The sensor is factory installed, or field installed according to manufacturer's 6 y❑Yes . ❑No specifications, or is installed by methods/specifications approved by the Executive , a + 1 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 applicable. Otherwise enter .Pass or Fail ✓ p N/A ✓• ❑ Pass ✓ ' ❑ Fail Registration Number: 313-A00i41s4A-M2514160M000 _ Registration 01/24/201319:35:59 HER Provider: CBPCA 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE . CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5 Site Address: i - 'I Enforcement Agency: Permit Number: 79850 Tangelo La Quinta CA 92253 La Quinta, City of ' 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 star, ting this procedure. • The system must meet minimum airflow requirements as prerequisite fora valid refrigerant charge test µ- • If outdoor air dry-bulb is 55 'For below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems System Name or Identification' Tag System 2 (must be re -calibrated monthly) + •�, r ► , System Location or Area Served Living room, Kitct. ` 1/1/2013 ?(mustt be re -calibrate monthly) , Outdoor Unit Serial # W1 L2221308'' --� Outdoor Unit Make York - Outdoor Unit Model , CZF06013CA ; Nominal Cooling Capacity Btu/hr • M ow 640"W".-046000000 t1 . !� +car r r Zr r,rvr r�.r Date of V e�ification �* k� r i4 w� 1 /24/2013 9. +*W M V� kv b I W *M V 4 *tow, s • � O'`'+' � , �"� � �' � w w �, r �x � r�. w +� .r-�•� �+ r,wr � w ww. � rr v...* r� Calibration of Dia nostic'Instrumerits_,.4r'"'°+w.— r --•f: Date of Refrigerant Gauge Calib ation ;# ,1/12013 (must be re -calibrated monthly) + •�, r ► , Date of Thermocouple Calibration :.:: ` 1/1/2013 ?(mustt be re -calibrate monthly) , 'Supply (evaporator leaving) air dry-bulb-� Measured Temnerntures t°Fl 5 .' `moi System Name or Identification/Tag System 2 y , p 4 'Supply (evaporator leaving) air dry-bulb-� --� temperature (Tsu l , db) 50.00 - Return (evaporator entering) air dry-bulb temperature (Tretum, db) 71.00 Return (evaporator entering) air,wet-bulb temperature (Trete, wb) 65.00 Evaporator saturation temperature (Teva raton sat) 75.00 . Condensor saturation temperature .. (Tcondensor, sat) 50.00 Suction line temperature (Tsuction) 86.00- 6.00-Liquid LiquidLine Temperature (TligWd) 42.00 ' Condenser (entering) air dry-bulb temperature (Tcondenser db) 65.00 Registration Number: 3�3noo�atsan-nnzs�a�soa0000 RegistrationDate/Time: 01/24/201319:35:59 HERS Provider: CBPCA 2008 Residential Compliance Forms - August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25=HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5 Site Address: _ Enforcement Agency: " Permit Number: 79850 Tangelo La Quinta CA 92253 La Quinta, City of Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or IdentificationPTag System 2 , Calculate: Actual Temperature Split = - Treturn, db " Tsupply, db .'• Y f Target Temperature Split from Table . using Tretum, wb and Tcondenser, db 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, upon remeasurrement;1if-between o "o°L�IYFi"4+ ��E+4� -3, F and -100 F Enter Pass or Fail � ii ' 1 11 X51 Tlll�1 - de - +,r -4 ^4-=,�. " � wd 1Ml Mf It Note: Temperature$ plit Metho� d Calculation" ismot necessary if'actual CoolingCoil�Aarflowxis� venfied'usmg:one of the airflow measurement procedures specied.in Reference,Residential�Appendix-RA3.3. �'If actual cooling coil airflow is measured, the value must be equa'I to or greater than the Calculated Min um Airflow,.Requirement in the table below. _ Calculated Requir Minimum A�trflo,w mejo(CFM)Nominal Cooling Capacity ton) X' 300—(c-fin/ton) System Name or Identification/T, 9 System 2 Calculated Minimum Airflow + 1500.00 Requirement CF .- M Measured Airflow using RA3.3 ._ , procedures (CFM) 1678.00 Passes if measured airflow is greater'than Pass or equal to the calculated minimum. ` airflow requirement. Enter Pass or Fail .. Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or IdentificationiTag System 2 Calculate: Actual Superheat= - Tsuction -Teva 'razor, sat , Target Superheat from Table RA3.2-2 . using Tretum, 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 ` Registration Number: 313-A0o14164A-M251416oa-0000 Registration Date/Time: 01/24/2013.19:35:W • HERS Provider: CBPCA 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: PermitNumber: _ 79850 Tangelo La Quinta CA 92253 La Quinti, City of 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 2 _ 'r Calculate: Actual Superb atJ �' f 11.00 i Calculate: Actual Subcooling = X ... .�. A _.. r . L „f -� ,fi , , Tcondenser sat — Tli uid 8.00 I,;v I. 4 0 1r t� • Target Subcooling specified by 8.00. f manufacturer r a Calculate difference: f -Passr • t 3 �_ Actual Subcooling— Taz et Subcoolin 000 . �• ' System passes if difference is between t ' -3"F and +3°F Enter Pass or Fail Pass . •♦ 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 2POW _ 'r Calculate: Actual Superb atJ �' f 11.00 i Tsuction — Teva zor'ras "'"'"'I AW X ... .�. A _.. r . L „f -� ,fi , Enter allowable superheat range from i t i 461W 0 M'� k, �:r>1' 4.00-25.00 I,;v I. 4 0 1r t� manufacturer's s ecifications of use P,_ ( range, between 4°F and 25°F if Y manufacturer'ste. s ecification is not,available ""A ^ " Q _ a System passes if actual superheat is within the allowable perheat•range ,, f -Passr • t 3 Enter e Pass or Fail!- YS a • r k • Registration -Number: 313-A0014164AW2514160A•xW0 RegistrationDatelTime: 01/24/201319:35:59 HERS Provider:'CBPCA - 2008 Residential Compliance Forms 7 August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refri erant Charge Verification - Standard Measurement Procedure - (Page 5 of 5 Site Address: • Enforcement Agency: 7miNumbcr: 79850 Tangelo La Quinta CA 92253 La Quinta, City of 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 systein'operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or ldentificationtiag System 2' System meets all refrigerant charge and Pass ' airflow requirements. Enter Pass or Fail '. Caftlifo�nia Building Performance .. Contractors association DECLARATION -STATEMENT • I certify under penalty of perjury; under the -laws of the State of California, the informah no provided-on�form i ' true and correct. • I am eligible under Division 3 ofthe Business and Professions Code to accept responsibility f r go ;cttruction, or an authorized �.,s i .� ��# a "n r representative of the person responsible for construction (responsible person . {fir . • I ceitify that the installed features, materials; components, or�manufactured devices identified,on this certificate (th! installation) �F -conforms to all applicable codes and regulations, and•the installation is consistent with the plans'and.specifications-approved by the enforcement agency. i • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, Iam 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 -IR) 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. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Southern Air Responsible Person's Name: Responsible Person's Signature: Christopher A Ginn Christopher A Ginn CSLB License: Date Signed: Position With Company (Title): 953452 1/24/2013 owner Is this installation monitored by a Third ParIfiQuality Control Name of TPQCP (if applicable)-,, Program (TPQCP)? - Yes [Z]No Registration Number: ass r+oora1san neze1a1son-0000 2008 Residential Compliance Forms RegistrationDate/Time: 01/24/201319:35:59 HERSProvider: CBPCA August 2009 . CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page I of 5 it Number: Site Address: Enforcement Agency: Perm 79850 Tangelo La Quinta CA 92253 La Quinta, City of 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 documentedfor compliance using this form. Attach an additional forms) 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 ref zgerant 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 Bedrooms The sensor is factory installed, or field installed according to manufacturer's 6 1 MY es .13No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and 3 ❑Yes �,�labeledaaccoditigto Figure nSectionRA3,2;2- ""f�" t Li' V' r It d "Sfl�6 nch�(8�mm)�acces hole downstrea of`mevap ative coil -in the supply plenum ' 2 ❑ or– —PNo �r-, and jlabeled, acco_ rding�,to Figgq inLSectio_n R_A3 2 2 ^2a,., � �� 1 Yes to 1 and'2 is a pas's"1, '�< `�J' h+ .y. .2 4` M"a •.y.. '•'�'�I N �' y' .w'+�,y-w•' � . 4'-h�•,'y Enter Pass or Fail ✓ O Pass ✓ ❑ Fail ' v STMS - Sensor on the Evanorator Coil°. System Name or Ide ificationlTag ystem`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 The sensor is factory installed, or field,installed according to manufacturer's 3 ❑Yes ❑No specifications frror is installed by methods/ p cifications,app ed bythe Executive The sensor wire is terminated with a standard mini plug suitable for connection to a `Dir�ector.� I Oyes ❑No digital thermometer. The sensor mini plug is accessible to the installing technician and The sensor wire is terminated with a standard minPplug suitable for connection to a 4 ❑Yes ❑No digital thermometer: The sensor mini plug is accessible-to,thefiinstalling technician and ❑Yes `❑No The sensor measuies the saturation temperature of the coil within 1.3 degrees F the HERS rater without changing the airflow through the condenser 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 ✓ El N/A ✓ ❑ Pass ✓ ❑ Fail N/A if STMS are not applicable.. Otherwise enter Pass or 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 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 Oyes ❑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 measuies the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass.. _ Enter V 0 N/A s ✓ ❑Pass ✓ ❑Fail N/A if STMS are not applicable. Otherwise enter Pass or Fail , Registration Number: 313-AO014153A-M2514158A-M25A Registration Date/Time: 01/24/2013 19:25:38 yERSProvider: CBPCA 2008 Residential Compliance Forms , August 2009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4R MECH=25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of Site Address: Enforcement Agency: Permit Number: 79850 Tangelo La Quinta CA 92253 La Quinta, City of 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 forms) 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 SS *For below, the installer must use the Alternate Charge Measurement Procedure. Space ConditioningSystems ' System Name or Identification/Tag System 1 (must be re -calibrated monthly) -Calibration System Location or Area Served Bedrooms " - (must --byre- calibrated monthly) . Outdoor Unit Serial # W122221307 Outdoor Unit Make York Outdoor Unit Model + CF20601307 Nominal Cooling Capacity Btu/hr. 60000.00 4 � 0 ii-6� P*P^ P+ *P45 OR A yi K rt s P44� omow ok 'Oft, 40%. oil. ,� V L Mrd g g * 1f • li.� *400%414,�I - " M '� I! 1 •li l 'il g t Date of Verification 1/24/2013 F !`nl:hnn4:nn ns T:on� rine*:n•7neFrnmun*e �_• .�._. r Date of Refrigerant Gauge 1/1/2013 (must be re -calibrated monthly) -Calibration Supply (evaporator leaving) air dry-bulb Date of Th ti Caalib t n, 1+1/2013` - (must --byre- calibrated monthly) . temperature (Tsu i , db) 50.00 j Mnacnrn�i Tmmnnraturpc l�F1 � ; . A System Name or IdentificationlTig System/ r Supply (evaporator leaving) air dry-bulb .Ai. temperature (Tsu i , db) 50.00 Return (evaporator entering) air dry-bulb - temperature (Treturm db) 71.00 Return (evaporator entering) air wet -bulb temperature (Tretum, wb) 65.00 ' , Evaporator saturation temperature " (Teva orator sat) 76.00 _ Condensor saturation temperature (Tcondenson sat) 51.00 Suction line temperature (Tsuction) 88.00 Liquid Line Temperature (Ttiguid) 40.00 Condenser (entering) air dry-bulb temperature (Tcondenser. db) 65.00 Registration Number: 313-A0014163A-M2514158A-M25A Registration Date/Time: 01/24/2013 19:25:38 HERS Provider: CBPCA 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING • CF -4R MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5 Site Address: Enforcement Agency: 7mit Number: 79850 Tangelo La Quints CA 92253 - La Quints, City of Minimum Airflow Re uirement 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 .. ti •• A CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING • CF -4R MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5 Site Address: Enforcement Agency: 7mit Number: 79850 Tangelo La Quints CA 92253 - La Quints, City of Minimum Airflow Re uirement Temperature Split Method Calculations'for determining Minimum'Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. ' - System Name or Identification/Tag System 1 " 4 Calculate: Actual Temperature Split = "` Tretum, db : Tsupply, db Target Temperature Split from Table RA3.2-3 using Tretum" wb and Tretum, db Calculate difference: Actual Temperature , Split — Target Temperature Split = ; Passes if difference is between Z4°F and +4°F or upon—rremeas�urement, if between, -4°F and -1CoF li � 10W 1°� 0Uil _ i�l_ t y 1 ' Note: Temper�atu e Sp tLleth d Calc`ulat� o isrrtot n c ssary,:if1b �tua4C'ooling�C,mot?4i�o�w4s7veri end using�one of the ' specified4n Reference Restdentral.Appendix RA3.3. 1f actual'cooling coil -airflow is airflow measuremenrot pr �edures measured, the value must be equal to or�greater,than the -Calculated Minimum -Airflow Requirement in the table below. Calculated MinimurnAirllowlequirem nt (CFM) =s Nominal Cooling�Capaci (ton) X 300 (efm/ton) System Name or IdentificationrTag, . System Calculated Minimum Airflow Requirement - 1500.00 - x (CFM) Measured Airflow using RA3.3 1656.00 ' procedures (CFM) - Passes if measured airflow is greater than or equal to the calculated minimum Pass airflow requirement. Enter Pass or Fail 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 — Teva orator. sat ' Target Superheat from Table RA3.2-2 using Tretum,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 Registration Number: 313-a00tatE3A-M2stat58A Mzsn Registration Date/Time: 01/241201319:25:38 HERS Provider: ceacn 2008 Residential Compliance Forms y �y w August 2009 s CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4R MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of Site Address: Enforcement Agency: Permit Number: 79850 Tangelo La Quinta CA 92253 La Quinta, City of 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 " I� � � � . . Calculate: Actual Subcooling = �w � p� }r� � i _ Tsuction .— Tev razor _sat . �k 11.00 1 r� �i "' Twnd,, sat — Tli uid Target Subcooling specified by 8.00 - manufacturer t - Calculate difference: 3.00 Actual Subcooling = Target Subcooling = System passes if difference' is between "' nor pass -4°F and +4°F Enter Pais Fail ` Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name orrldentification,! ag 10 � WI.09W . � System 1 '� ISM � Mk � � � " I� � � � . . Calculate: ActuaLSuperheat = �w � p� }r� � i _ Tsuction .— Tev razor _sat . �k J t� 1 ' 'tai 1 r� �i "' Enter allowable superheat range from.�— manufacturer's specifications (or use range ; between 3°F and 2h6*Fif if 3.60- 26.00 t s ecificationis not avatlable �' t - System passes if actual -superheat is within the allowable superheat range Enter Pass or Fail_" Registration Number: stiaootats3n nnistatsea-M25A Registration Date/Time: 01/24/2013 19:25:38 HERS Provider: CBFCA • 2008 Residential Compliance Forms k August 2009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5 Site Address:Enforcement Agency: Permit Number: 79850 Tangelo La Quinta CA 92253 La Quinta, City of 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 , HERS Provider Data Registry Information Sample Group # (if applicable): System meets all refrigerant charge and Pass in a HERS sample group airflow requirements. 'Enter Pass or Fail HERS Rater Company Name: a - MLC Home Performance - Responsible Rater's Name Responsible Rater's Signature act, s ,SO or 'As DECLARATION STATEMENT • I certify under penalty of perjury, underthe 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 ertificate (responsible rater). iF • 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 a d 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 -6R), signed and submitted by the person(s) responsible, for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -IR) approved by the enforcemet agency. Builder or Installer information as shown on the Installation Certificate CF-611 Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Southern Air _ Responsible Person's Name: CSLB License: Christopher A Ginn 953452 HERS Provider Data Registry Information Sample Group # (if applicable): 0 tested/verified dwelling ❑ not-tested/verified dwelling in a HERS sample group HERS Rater Information HERS Rater Company Name: a - MLC Home Performance - Responsible Rater's Name Responsible Rater's Signature Tom Bachus Tom Bachus ” Responsible Rater's Certification Number w/ this HERS Provider: , Date Signed:. F .- 1095794 1/24/2013 f , Registration Number: 313-AO014163A-M251415EA-M25A Registration Date/Time: 01/24/2013 19:25:38 HERS Provider: CBPCA 2008 Residential Compliance Forms August 2009 x, A 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 ver ficaaon 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 forms) 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 specked in Reference Residential Appendix RA 3.2.. 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 system's that utilize prescriptive compliance method. TMAH - Access Holes in Supply and !Return Plenums of Air Handler System Name or Identification/Tag CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4R MECH-25 System 2 _ Refrigerant Charge Verification ' Standard Measurement Procedure (Page 1 of 5 System Location or Area Served Site Address: s Enforcement Agency- Permit Number: ❑Yes ❑No 79850 Tangelo La Quinta CA 92253 OY_es La Quinta, City of 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and ❑Yes 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 ver ficaaon 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 forms) 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 specked in Reference Residential Appendix RA 3.2.. 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 system's that utilize prescriptive compliance method. TMAH - Access Holes in Supply and !Return Plenums of Air Handler System Name or Identification/Tag i System 2 _ System Location or Area Served z�: Living room, Kitchen 6 ❑Yes ❑No 1 OY_es ❑No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and ❑Yes ❑No r n=wk, A d ,14beledjaccording�to Figure in Sect on?RA3,2:2.2;2 a . The sensor wire is terminated with a standard mini plug suitable for connection to a 7, 9 4 tA"5/1-6-inch � N m)oaoc w� or i e will (8 mm) access hole downstream of`evaporatw evaporative the supply plenum 2 OYes� _' 13No and(labeled Figure{in SectiogRA_ 3 ❑Yes ❑No digital thermometer-. =The sensor mini plug is accessible -to the`innstalling technician and accordingltO Yes to l and 2 is a pass.. Yes to 6, 7, and 8 is a pass. ` : Enter � i Enter Pass or. Fail ✓ 0 Pass �✓ ❑ Fail- 5 ❑Yes ❑No STMS . y 1 STMS -Sensor an the F.vannrAtnr Cnil A;'° ' System Name oar IdentificatnlTg �1 - SNY stem 2 z�: 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 The'sensor is factory installed, or fiel&installed according'to manufacturer's 3 ❑Yes ❑No specifications',6r is installed by methods p cificatioons app ed by th+e Executive The sensor wire is terminated with a standard mini plug suitable for connection to a 7, 'Dile torr ❑No digital thermometer. The sensor mini plug is accessible to the installing technician and The sensor wire is terminated with a standard mini#plug s`uitabie for connection to a 4 ❑Yes ❑No digital thermometer-. =The sensor mini plug is accessible -to the`innstalling technician and ❑No Tte sensor measures the saturation temperature of the coil within 1.3 degrees F .. Yes to 6, 7, and 8 is a pass. ` : Enter � the HERS rater without changing the airflow through the condenser 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 ✓ O N/A ✓. ❑ Pass ❑ Fail F N/A if STMS are not applicable. Otherwise enter Pass or Fail .✓ STMS - Sensor on the Condenser Coil System Name or Identification/Tag System 2 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 Tte sensor measures the saturation temperature of the coil within 1.3 degrees F .. Yes to 6, 7, and 8 is a pass. ` : Enter � ' ✓ O N/A ✓ ❑Pass T•✓ Fail. if STMS are not applicable. Otherwise enter Pass or Fail .0 Registration Number: 313-A°014164A-M251416oA-M25A Registration Date/Time: 01/24/2013 19:37:42. HERS Provider: cBPCA 2008 Residential Compliance Forms. Y August 2009 ' 'Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55T) 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 forms) for any additional systems in the dwelling as applicable. e 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 °For below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems System Name or Identification/Tag ' Cnlihration of niaonn t r-inctriimpntc System 2 (must be re -calibrated monthly) System Location or Area Served Living room, Kitchen. 1;1/2013` , , a W (m be re -calibrated monthly) Outdoor Unit Serial # WIL2221308 50.00 - ' Outdoor Unit Make, York Outdoor Unit Model CZF06013CA 71.00 - , Nominal'Cooling Capacity Btu/hr 60000.00 s ' , A # fwoit*f rt rt"00"I" Date of VerificIn ati.. x/24/201 � `+�' �.s.. �.It it M �.. 1 #4;tA 11 i -..r r.�`.M Date of Refrigerant Gauge,Calibration . v - V �e 1/1/2013 +. (must be re -calibrated monthly) Date of Thermocouple Calibratto . 1;1/2013` , , a W (m be re -calibrated monthly) temperature TsuI. db) Measured Temperatures OF) System Name or Identification/Tag Systemt2 Supply (evaporator leaving) air dry-bulb temperature TsuI. db) 50.00 - ' Return (evaporator entering) air dry-bulb erature (T temperature db) " 71.00 - Return (evaporator entering) air wet -bulb. s ' , A tem temperature T P ( return. wb) 65.00 Evaporator saturation temperature - (Teva orator sat) 76.00 Condensor saturation temperature - (Tcondensor, sat) 51.00 Suction line temperature (Tsuction) 88.00 Liquid Line Temperature (Thquid) - 40.00 ' Condenser (entering) air dry-bulb temperature (Tcondenser. db) 1 65.00 . j . 4 Registration Number: 313-AO014164A-M251416OA-M25A Registration DateMme: 01/24/2013 19:37:42 HERS Provider: csPCA 2008 Residential Compliance Fors August 2009 f CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4R MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5 Site Address: Enforcement Agency: Permit Number: 79850 Tangelo La Quinta CA 92253. La Quinta, City of Minimum Airflow Requirement Airflow Requirement for Refrigerant Charge • • Residential Appendix RA3.2.. ' Temperature Split Method Calculations for determining Minimum Verification. The temperature split method is specified in Reference Res System Name or Identification,Tag System 2 1, R' ` s Calculate: Actual Temperature Split = ' Tretum, db - TsupplY, db j Target Temperature Split from Table RA3.2-3 using Tretorn, wb and Tretum, db Calculate difference: Actual Temperature Split — Target Temperature Split = t Passes if difference is between -4°F and +4°F or upon -remeasurement, if between -4°F and -10W i a Pital�tIi °r�Far�.t 11 d i n ft � �I +t:i . _A Note: Temperatures Split Method Calculation,is,not necessary if `bctual,CoolinR Coil.Airflow,_is'ver, ifiev ing-one of the �s specifredwin' Referee a 3 �c of ng c "birflow airflow measurement.procedu ResidentialyAppendix RA If actual l is measured, the value must e�bl to or greater -than -the CalculatedMinimumAirflow Requirement in the table below. i Calculated'Minimum Airt1 `Requirement (CFM) = Nominal 60ting`Capa, city (ton) X 300 (cfm/ton) , System Name or Identification/Tag. System 2 . Calculated Minimum Airflow 1500.00 Requirement (CFM) Measured Airflow using RA3.3 1656.00 procedures (CFM) Passes if measured airflow is greater than or equal to the calculated minimum Pass airflow requirement. Enter Pass or Fail 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 2 1, s Calculate: Actual Superheat Tsuction —Teva orator, sat j Target Superheat -from Table RA3.2-2 using Tretum wb and Tcondenser. db Calculate difference: Actual Superheat — Target Superheat = t System passes if difference is between -6°F and +6°F Enter Pass or Fail - Registration Number: 313-AO014164A-M2514160A M25A • Registration Date/Time: 01/24/2013 19:37:42 HERS provider: CBPCA 2008 Residential Compliance Forms August 2009 Y `• F-4R-MECH-25 ' Me!!!!!! F FIELD VERIFICATION AND DIAGNOSTIC TESTING �u�N ae 4 ofa Verification -Standard Measureme E P'oe nt Agency: Permit umber: La'Quinta, City ofta CA 92253 - Subcooling Charge Method Calculations for Refrigerant Charge Verification. procedure is required to be used Sub g for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems.` System Name or Identification/Tag System 2 Calculate: Actual Subcooling = 11.00 I condenser sa — TIi uid Target Subcooling specified by 8,00 manufacturer Calculate difference: 3.00 - Actual Subcooling — Target Subcooling = System passes if difference is between pass , -4°F and +4°F Enter Pass or Fail t ns for Refrigerant Charge Verification. This procedure is required to be used for Metering Device Calculatio` } thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Na i °rte w i g o Orli g► i S i w N tn n a n n- A Calculate Acl.Superheat #oontra_},•, Mu 0 Tsuction Teva orator -sat y Enter allowable superheat range from manufacturer's specifications (or ,use range - 3.00 42600 !s• 3 between YE and A -F if manufacturers specification -is not as ailable i System passes if actual,superheati is within the allowable superheat range Pass / +r Enter Pass or 01/24/201319:37:42 HERS Provider: cBx_ A__: Registration Number: • 313-A0014164A-M2514i60A-M25A Registration Date/Time: August 2009 - r, 2008 Residential Compliance Forms CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING x; CF-4R-MECH-21 Duct Leakage Test — Existifig Duct System (Page 1 of 2 Site Address: Enforcement Agency: Permit Number: 79850 Tangelo La Quinta CA 92253 La Quinta, City of Enter the Duct System Name or' Identification/Tag: Enter the Duct System Location or Area Served: - Note: Submit one Installation Certif tate 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. i Note: For existing dwellings, a completely new orreplacement 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 Fora 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. 4. Duct Leakage Diagnostic Test — existing ducts stem Select one compliance method from the following four choices. •: D Option 1. Measured leakage'less than 15% of Fan Airflow. ' id, ,❑Option 2Mewago�usidlethnIl-% oFAoak, • r. damMd OR. I *"il an c e Wr ❑ Option 3. Reduce l ge�by 60% or mo e,Rand-conduct#smoke�test'to-sea1Fa11 accessible leaks._ ❑ Option 4. Fix all accessible leaks using-smoke.test,-and HERS later must verify. - mum 4.) Note: (Option 1 attempted befo e.utiltzing Option Determine nominal�Fan �Ai flflow'using ne ofthe'followintg three calculation methods.'° 0 Cooling system method: Size of condenser in.Tons 5.00�, jx 400 = 2000.00 r""'CFNI 13Heating system method: 21.714,'X v., ating utput Capacity (�kBtuh) / CFM e � ❑ Measured system airflow using RA3.3 airflow test CFM, procedures: , Option 1 used then: Allowed leakage = Fan Airflow 2000.00 x 0.15 = 300.00 - CFM • = } 1 Actual leakage = 261.00• CFM - ` Pass if Actual leakage is less than Allowed leakage 0 Pass ❑ Fail Option 2 used then: - Allowed leakage = Fan Airflow x 0.10 = - CFM- FM a 2 2 Actual leakage to outside = CFM -" T 4 - Pass if Actual leakage to outside is less than Allowed leakage ❑ Pass ❑ Fail Option 3 used then: I Initial leakage prior to start of work= CFM J Final leakage after'sealing all accessible leaks using smoke test = wCFM a , 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: , All accessible leaks repaired using smoke test. HERS rater must verify (No sampling).. 4 Pass if all accessible leaks have been'sealed using Smoke Test ❑ Pass ❑ Fail Registration Number: 313-A0014163A-M2114159A-M21A Registration Date/Time: 01/24/2013 19:28:52 HERS Provider: CBPCA '2008 Residential Compliance Forms August 2009 _ CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2 Site Address: - I 1 - Enforcement Agency: Permit Number: 79850 Tangelo La Quirita CA 92253 La Quinta, City of • - O 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 utilizre controlled motorized dampers, that open only when OA ventilation is required to meet AS.HR�AE S a'nda"�rd'62�2%! c ose�w"°hen OAS enhla ons no q i ed y Abe confige'd"fo the closed position during duct leakage testing.",, ❑ All supply and return egister boots must be sealedjto the drywap if smoke -tests uhhzed�for compliance 'applies to , duct leakage compliance option 3 (leakage reduction by 60%),and option 4 (fix all accessible leaks) described above. El New duct installations ,cannOt utilize building cavities as or platfo mreturns in lieu of ducts. , El Mastic and draw bands must be usedin c'olhbutation with oth backed iub� ber adhes ve-duct tape to seal leaks at all new duct connections.;�. DECLARATION STATEMENT • -1 certify under penalty` of perjuryunderr thelaws,o the State,of Califo a, the information provided on -this form is true and correct. • I am the certified HERS rater who performed the vehficati services identified and reported on th s.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 2 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 -6R), signed and submitted by the person(s) responsible for the installation conforms`to the requirements specified on the Certificate(s) of Compliance (CF -IR) approved by the , enforcement agency. Builder or Installer information as shown on the Installation Certificate CF-611 Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Southern Air - Responsible Person's Name: CSLB License: Christopher A Ginn 1953452 HERS Provider Data Registry Information Sample Group # (if applicable): i + ❑ tested/verified dwelling ❑ not-tested/verified dwelling i in a HERS sample group HERS Rater Information I I HERS Rater Company Name: F MLC Home Performance' Responsible Ratees Name i Responsible Ratees Signature Tom Bachus Tom Bachus Responsible Ratees Certification Number w/ this HERS Provider: Date Signed: 1095794 k '1/24/2013 Registration Number: 313-A0014163A-M2114159A-M21A Registration Date/Time: 01/24/201319:28:52 HERSProvider: CBPCA 2008 Residential Compliance Forms '_ August 2009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test Existing Duct System ° (Page 1 of 2 Site Address: Enforcement Agency: Permit Number: 79850 Tangelo La Quinta CA 92253 La Quinta, City of ' Enter the Duct System Name or IdentificationfFag: Enter the Duct System Location or Area Served: 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 ducts stem Select one compliance method from the following four choices.. . 0 Option 1. Measured leakage less than 15% of Fan Airflow., '� —.k;gP ' — . " r r I ol, q '�4 ,ray ❑ Option 2. Meawsurad,leakage to ou side�ess th ice% of F n:Ai'rflo n Q Option 3. Reduce leakage by 60% or more�andtonduet=smoke•test•to=sealrall accessible leaks' ❑ Option 4. Fix all accessible leaks using -smoke testi-and HERS rater must -verify. Note: (Optiyon1 must beyattempted beforrerutilizing Option 4) Determine nominal Fan Airflow' using one o , e following three calculation methods. 0 Cooling system method: Size.of condens r m Tons s o0_- IfX 400 2000.00 /► CFM ❑ Heating system method: 21.71x,--:- ` �H ating Out Capacity (kl3tuh)�- CFM ❑ Measured system airflow using RA3.3 airflow test procedures: CFM, } Option 1 used then: Allowed leakage = Fan Airflow 2000.00 x 0.15 = 300.00 CFM ' 1 ' Actual leakage = 261.00 CFM ` Pass if Actual leaks a is less than Allowed leakage 0 Pass ❑ Fail Option 2 used then:: 4. , Allowed leakage =Fan Airflow x 0.10 - CFM 2 Actual leakage to outside = CFM r 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 4 Initial leakage - Final leakage f= Leakage reduction CFM (Leakage reduction 1 Initial leakage ) x 100% = % Reduction a - Pass if % Reduction > 60% ❑ Pass ❑ Fail Option 4 used then: 1. 1', ' All accessible.leaks repaired using smoke test: HERS rater must verify (No sampling). 4 3. r. - Pass if all accessible leaks have been sealed using Smoke Test ❑ Pass ❑ Fail Registration Number: 313-A0014164A-M2114161A-M21A Registration Date/Time: 01/24/2013 19:39:23 HERSProvider: eePCA 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4R MECH-21 Duct Leakage Test - Existing Duct System a e 2 of 2 Site Address: l Enforcement Agency: Permit Number: 79850 Tangelo La Quinta CA 92253 La Quinta, City of El Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct. leakage testing CELOA ducts that utilize -controlled motorized dampers, that open only when OA ventilation is required to _ meet ASHf&EStandard62r2!a7'd1 close when:�QAlvent la oris ri �e ui ed', m'a be co�f Pre to the closed position 9 Y L � k. during duct leak age`testing.�'� O All supply and re eg�sterboust be sealedto the drywall if smoke testis hzed�forcomphance w; applies to duct leakage compliance option 3 (leakage reduction by 60%) and option 4 (fix all accessible leaks) described above. ❑ New duct installations cannot utilize building cavities '��Y ��` i g plenums or platform returns in Leu of ducts. El Mastic and draw bands must be used' in combination with cloth backedjrubber-adhesive-duci tape to -seal leaks at all new duct connections. j,` 3 DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of"the State ofd fori&,.the information ormation provided_on-this form is true and correct. • 1 am the certified HERS rater who performed the vei fication services identified and reported on ths,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 on the Certificate(s) of Compliance (CF -IR) approved by the local enforcement agency: • The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -IR) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate CF -6R Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Southern Air ; Responsible Person's Name: CSLB License: Christopher A Ginn 1953462. ; HERS Provider Data Registry Information ' Sample Group # (if applicable):) 77[ff_i7ested/verified dwelling ❑ not-tested/verified dwelling in a HERS sample group HERS Rater Information ' HERS Rater Company Name: MLC Home Performance Responsible Ratees Name Responsible Ratees Signature. Tom Bachus - Tom-Bachus Responsible Ratees Certification Number w/ this HERS Provider: Date Signed: 1095794 1/24/2013 Registration Number: 313-A0014164A-M2114161A-M21A Registration Date/time.. 01/24/201319:39:23 HERSprovider: CBPCA 2008 Residential Compliance Forms t August 2009 ' INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test —Existing Duct System (Page 1 of 2 Site Address: . , Enforcement Agency: Permit Number: 79850.Tangelo La Quinta CA 92253 La Quinta, City of " Enter the Duct System Name or Identification/Tag: • - Enter the Duct System Location or Area Served: Note: Submit one Installation Certif tate 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 fr om the following four choices. ' r 0 Option 1. Measured leakage less than 150/6 -of Fan Airflow. nP1, Ak,' ^.fF, P*'Ff4 -�.. A r a1 �^{ .�,y, - 'J ❑ Option 2 Measured le�alcage tACoutslde less�than I10 /o ofQFaa�n A rflo°w� ' " � ❑ Option 3. Reduce leakage -by 60% or more; and conduct- smoke,test'tose0a I accessible�16aks:: �`."" ► r Y '�+ �+ ' i o IE ❑ Option ix leaks usmng_smoke�teyst; must,verify.` all accessible andHERS-rater � Note: (Option 1 m `st be attempted before,.utihzitig'Option 4) ` ~ Determine nominal Fan Airflow using one of the'following three calculation methods. ""-�'..�-"` � ... � � - 5 � � — 2000 l7 Cooling system method: Size of condenser m Tons . x 400 - �'�`+CF1VI ❑ Heating system method: 21 7 x- .\t—' ;IxA ting Output Capacityy(kBtuh)r= . CFM J ❑ Measured system airflow using RA3.3 airflow test procedures: CFM_ Option 1 used then: Allowed leakage = Fan Airflow 2000 x0.15= 300 CFM - 1 M Actual leakage = 261 CFM Pass if Actual leaks a is less than Allowed leakage Pass ❑ Fail• Option 2 used then: t Allowed leakage = Fan Airflow x 0.10,= CFM 2 Actual leakage to outside = CFM - Pass if Actual leaks a 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 Initial leakage - Final leakage = Leakage reduction - CFM (Leakage reduction / Initial leakage ) x 100% = % Reduction -r Pass if % Reduction > 60% ❑Pass ❑Fail Option 4 used then: ' All accessible leaks repaired using smoke test.* HERS rater must verify (No sampling). . �• ' 4 Pass if all accessible leaks have been sealed using Smoke Test ❑Pass ❑Fail Registration Number: 313-A0014163A-M2114159A-0000 Registration Date/Time: 01/24/201319:28:26 HERSProvider: CePCA , 2008 Residential Compliance Forms August 2009 T • T- . INSTALLATION CERTIFICATE • CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 2 of 2 Site Address: Enforcement Agency: Permit Number: 79850 Tangelo La Quinta CA 92253 La Quinta, City of 0 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation"systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2_ ; and close when OA ventilation is not required, may be configured to the closed position ' during duct leakage testing. El All supply an retic. *; reg, W ,bo� m �b$se l�eedto ttie vvalllif�smoke�tes�t iks I d=fo o�mpliance —applies to duct leakage comphanceophon 3 (leakage reduction by 60 /o):and option 4 (fix all accessible leaks) described above. 0 New duct<installations cannot utilize builds gleavities izenum or,platformtreturn'sdn 11 euiowts+fin 0 Mastic and draw bands b used in combination with'cloth`backed,rubber°adhesive duct tape to•seal leaks at all new duct connections.'` DECLARATION -STATEMENT K, •' I certify under penalty of perjury, under the -laws of the State of -California, the inf anon prov�ded•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 identifies 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 copyof 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. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) • , Southern Air _ Responsible Person's Name: Responsible Person's Signature: Christopher A Ginn Christopher A Ginn' CSLB License: Date Signed: Position With Company (Title): 953452 11/24/2013 - . Is this installation monitored by a Third Party Quality Control Name of TPQCP (if applicable): Program (TPQCP)? OYes ONo Registration Number: 313-A0014163A-M2114159A-0000 Registration Date/Time: 01/24/2013 19:28:26 HERSProvider: CBPCA 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF- 6M-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2 Site Address: Enforcement Agency:' Permit Number: 79850 Tangelo La Quinta CA 92253, La Quints, City of , 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 S stem , Select one compliance method from the following four choices. 0 Option .1. Measured leakage less than 15% of FanAirflow. IWA ❑Option 2euredle kage toouslde, less�t14 han i10 /y ofFan Ai�rflPP 0 gw'�' ❑ Option 3. Reduce�leak g by 60-//ooror mo e; and`conduct>smoke,test'to-sealrll accegsible+leaks.- + r r , ai PiA fir , ' . ❑ Option 4, Fix allaccessible leaks -smoke test; HERS xater using and must -verify. Note: (Option 1 must be attempted before:utilizi6j Option 4) Determine nominal Fan Airflow using one of the following three calculation methods. El Cooling system method Sizeof condens �,in Tons 5z 400 = 2000 ❑ Heating system method: 21 7x_...-^ • =Heating Output Capacity(kBtulh)r- CFM ❑ Measured system airflow using RA3.3 airflow test CFM procedures: Option 1 used then: Allowed leakage = Fan Airflow 2000 x 0.15 = 300 CFM 1 Actual leakage = 2fi1 CFM a 5 Pass if Actual leakage is less than Allowed leaks a QPass ❑ Fail Option 2 used then: Allowed leakage = Fan Airflow X0.10= CFM 2 _ Actual leakage to outside = CFM Pass if Actual leaks a to outside is less than Allowed leaks a El Pass []Fail Option 3 used then: Initial leakage prior to start of work= CFM r Final leakage after sealing all accessible leaks using smoke test = CFM Initial leakage - Final leakage = Leakage reduction - CFM (Leakage reduction / Initial leakage ) x 100% = % Reduction Pass if % Reduction > 60% ❑Pass ❑Fail Option 4 used then: All accessible leaks repaired using smoke test.. HERS rater must,verify (No sampling). 4 Pass if all accessible leaks have been sealed using Smoke Test ❑Pass ❑Fail Registration Number:. 313-A0014164A-M211416 A-0000 Registration Date/Time: 01/24/2013 19:38:51 HERSProvider: CBPCA 2008 Residential Compliance Forms • f August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 2 of 2 Site Address: , Enforcement Agency: Permit Number: ; 79850 Tangelo La Quinta CA 92253 la Quinta, City of t 0 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. D All sup '%;w 00 c f W r91;" istaer�bo� �b a l�d to tl-1 � 1.1, if0 p 91 �s1} M A K*'.II.N � f14 V�pliance —applies to duct leakage compliance, option 3 (leakage reduction by 60%).' ;and option 4 (fix -all accessible leaks) described above. r ,� +0 O.i� . A , t# ` + Pr y D New duct installations cannot utilize bw_ldmg cavities as�plenums or platform•returnsn lieu�of duct§4 121 Mastic and draw bands must e, used.in'combination.with cloth=b�ed°rubber-adhesive duct tape to seal leaks at all new . duct connections. DECLARATION -STATEMENT ., • • I certify under nal of r' under the-lawslof the State of-Califomi the inform bon rovid�t is f true and correct. - fY penalty perjury, _ a, p • I am eligible under Division 3 of{the Business and Professions Code to accept responsibility or construction or an authorized . } .� x. representative of the person responsible for construction (responsible person)' • I certify that the installed features, materials, components, or�manufactured devices identified o 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. _ • 1 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. e, Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Southern' Registration Number. 313-A0014164A-M2114161A-0000 RegistrationDate/Time: 01/24/201319:38:51 HERSPro_eider: CBPCA 2608 Residential Compliance Forms # -August 2009 Air Responsible Person's Name: Responsible Person's Signature: - Christopher A Ginn Christopher A Ginn CSLB License- Date Signed: Position With Company (Title): 953452 1 /24/2013 . Is this installation monitored by a Third Party Quality Control Name of TPQCP (if applicable): ,Program (TPQCP)? , It DYes ONo Registration Number. 313-A0014164A-M2114161A-0000 RegistrationDate/Time: 01/24/201319:38:51 HERSPro_eider: CBPCA 2608 Residential Compliance Forms # -August 2009