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12-1207 (MECH)P.O:\BOX 1504 A V0 7-7012 78-495'CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING, PERMIT Date: 10/10/12 Application Number: ti:12-0000120 Y`Owner: Property Address: 78637 TORINO DR PHILLIP- KUBIK APN: 609-541-007-7 -28457 78637 TORINO DRIVE Application description: MECHANICAL LA_ QUINTA, CA 92253 D Property Zoning:. LOWDENSITY RESIDENTIAL Application valuation: 13083 Contractor: OCT 1 Applicant: Architect or Engineer: GENERAL AIR CONDITIONING 31170 RESERVE DRIVE, CITYOFI�UIRITQ THOUSAND PALMS, CA.922 FIM -NCE OEPT. . / (760) 343-7488 ( Lic. No.: -686310 --------------------------------- --------- .LICENSED COM CTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION - - I hereby affirm under penalty of perjury.. th t I am licensed n er-provisions of Chapter 9 (commencing with I hereby affirm under penalty of.perjury one of the following declarations: Section 7000) of Division 3 of the Busin s and Professi n 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_ - -I icense No.: 686310 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is . issued. ate:,Q Contracto _V -4 -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 WNER-BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of prjury at I a exempt from the Contractor's State License Law for the _ - Carrier ZENITH INS CO • - Policy Number Z071741501 following reason (Sec:- 7031.5, Bu ine and Professions Code: Any city or county that requires a permit to I certify that, in the performance of the wo for which this permit is issued, I shall not employ any construct, alter, improve,.demolish, repair any structure, prior to its issuance, also requires the applicant for the person_in any manner so as to become sub) ct to the workers' compensation laws of California, permit to file a signed statement that he or she islicensedpursuant to the provisions of the Contractor's State and agr�th�ebor that, if I shout become subject t the w rkers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3 00 oCode I shall Orth ith c mply ith those provisions. that heor she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: : (_ 1 I, as owner, of the property, or my employees with wages as their sole compensation, will do the work, and the strcture is notintended or offered for sale (Sec: 7044, Business and Professions Code: The - WARNING: FAILUR(TO SEC E WO E' C PENSATION COVERAGE IS INLAWFUL, AND.SHALL ' Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO RIMIN 'P ALT S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND • 4 and who does the work himself or herself through his other own employees, provided that the DOLLARS ($100,000). IN AD 0 TOT ST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN - improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - - one year of completion, the owner -builder will have the burden of proving that he or she did not build or . - - , - improve for the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT (_ 1 'I, as owner of the property, am exclusively contracting withlicensed contractors to construct the project (Sec. IMPORTANT 'Application is hereby made to the Director of .Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of ' conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed - 1. Each person upon whose behalf this application is made, each person at whose request and for . pursuant to the Contractors' State License Law.). _ - - whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_ 1 I am exempt under Sec. , BAP.C. for this reason ' the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the.work being _ - performed under or following issuance of this permit. Date: Owner: 2. Any permit issued as a result of this application becomes null and void if work is not commenced - • ' within 180 days from date of issuance of such permit, or cessatio o wf 0 k for 180 days will subject CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the abo information i correct. I agree to comply with all • • work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building nstruction, an her authorize representatives • - of th' cou ty t enter upon the above-mentioned propertIfnspection p s. Lender's Name: v - V atew lt7 /2— Si atura (Applicant or Agent): c Lender's Address: LQPERMIT . - .. Application Number . . . 12-00001207. Permit . MECHANICAL Additional desc Permit Feer-_ . . . 40.50 Plan Check Fee 10.13 Issue Date Valuation 0 ' Expiration Date, 4/08/13 Qty Unit Charge Per Extension BASE .FEE 15:`00 1.00 9.00.00 EA MECH FURNACE <=100K- 9:00 1.00 16'.5000 EA 'MECH B/C'>3-15HP/>100K-500KBTU 16.50 -----Special Notes and Comments HVAC CHANGE-OUT:INSTALL 5 TON SYSTEM, FURNACE, CONDENSER, INDOOR COIL. 2010 CODES.. • -----------------_-_-------------------------------------------------------- Other Fees . . . . BLDG STDS. ADMIN'(SB1473) 1.00 Fee'summary Charged". Paid Credited -.------- Due ----------------- Permit Fee Total 40.50 .00 .00 40.50 Plan Check Total 10.13" .00 .00. 10.13 Other. Fee`Total 1.00. .00 .00 1.00. " 'Grand Total 51.63 00 .00' 51.63, CaICERTS - CF -1R Registration s Page 1 of 1 Public Home Secure Home About Us Training ` Rater Directory Forms Membership Benefits Events Industry Partners Job Placement Resources News [CLICK HERE] to do another OR you can [OPEN and EDIT] this project you just created. To register for our monthly newsletter, please click here. „- Copyright © 2010 CaICERTS, Inc. All rights reserved. Revised: January 11, 2010 [Terms and Conditions] [Privacy Statement] [Class Cancellation Policy] , CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 " Office: 916-985-3400,Toll Free: 877 -HERS -RSR, (877-437-7787) Fax: 916-985-3402 Contact Us 11 BBB. f • 7 n • e ' S t u https:Hwww.calcerts.com/public_cfl R.cfm?project_id=219570 10/10/2012 Danielle Garcia logged in [Logout) [Home] CONGRATULATIONS Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. k Site Address: 78637 TORINO La Quinta; CA 92253, CEC Registration: 212-A0056565A-000000000-0000 CF -1R -ALT -HVAC: CLICK HERE TO DOWNLOAD Assigned Company: HARRISON ENTERPRISES INC Do you know your HERS Rater? 'I If you do, you may want to send this CF -1R to them. i 11 CaICERTS RaterID:' OR My Rater Quick Select: ---Select From List Every CaICERTS rater has a license number. �h If you need to find the rater by name [Click HERE] to search our directory. - ,I„SE„ND�CFx1R TO HERS RATER Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: 7 Permit #: 78637 TORINO La Quinta, CA 92253 City of La Quinta Oct 10, 2012 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system ® Setback ® Indoor Coil ® SEER 13.0 ❑ HSPF [3 R 8 (CZ 14-15) 2730 sf If not already present, must be ® Condensing Unit ❑ EER [3 Resistance installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT. -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -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 -1111 and CF -6111 shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: ' • All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF -4R forms: MECH-21 and (for split systems) MECH-25 • Condenser Coil and /or • Indoor Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS • Furnace CF74R 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 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 duct systems are constructed, insulated or sealed with asbestos ❑ 4. The.system�will not be Ducted`(ieDTactlessMini-split System) -(Also -Exempt from Refrigerant Charge) ❑ 2. New HVAC System Required Forms:"- . Cut Wor Changeout with* 4" ' e If 't ' 4 / ' `-f' '" .4 ' CF 6R forms: MECH-04, MECH-20-HERS, andY(for split systems) MECH-22=HERS, and new ducts: (all new ducting and all new MECH=25 HERS )j ` 4 -`" CF -4R foams: MECH-20, and (for split systems) MECH-22, anis MECH-25 equipment) �7 f . For Split Systems: Duct leakage <16 -percent; RC, CCA >_ 350 CFM/ton; FWD, TMAH SIMS, and'either;HSPP-oir,PSPP. t' For Packaged Units: Duct leakage°< 6!percent ❑ 3. New Ducts with/or without Required Forms: Replacement f *Includes replacing or installing all new ducting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Danielle Garcia Signature: benielle Garcia Company: HARRISON ENTERPRISES INC Date: Oct 10, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 212-A0056565A-000000000-0000 Registration Date/Time: 2012/10/10 12:24:58 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 VIII I! .0ty of La Quinta Building &r Safety Division Permit # ^ P.O. Box 1504, 78-495 Calle Tampico �Q t La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and. Tracking Sheet Project Address:Owner's Name: u� P A. P. Numl ber: (� .-- � Q F v 54 100-1 Address: Legal Description: City, ST, Zip:04 �J Contractor: Telephone: a.. .,. >• viz Address: �,�� �� n Project Description: City, ST, ZiP: [ Ir1Ll� i</1n �) G) k. C+-% 0A 1,Nn' State Lic. #City : Lic. #; ��b t -� . Arch., Engr., Designer: Address: City., ST, Zip: e ep one..YP State Lic. Construction :. ... Type: • .� . :;:�r.,�R,• . �y''•p'' Occupancy: rn,,..'�r...rrF<:' ,• •.ProJs type circle one): New'. Add'n Alter Repair Demo :.�.•',Y.,o,.:, .�:, Name of ContactPerson: �.� (,(r ---I 60rc=65 ZrYU Sq. Ft.: a;L-7,� # Stories: T# Units: Telephone # of Contact Person: -7& O 3 "7 Oi t, Estimated Value APPLICANT: DO. NOT WRITE. BELOW THIS LINE . # Submittal Req Id Rec'•d TRACING PERMIT FEES Plan Sets - Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance. Title 24 Calcs. Pians picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2a° Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up. S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'rd Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P., Pub. Wks. Appr Date of permit issue Schodl Fees Total Permit Fees CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 78637 TORINO , La Quinta CA 92253 (System 1) City of La Quinta 12-1207 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House. Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can. be sealed. For a completely new,or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system ° Select one compliance method from the following four choices. 0 1. Measured leakage less than 15% of fan flow E3 2. Measured leakage to outside, less than 10% of Fan Flow (33. Reduce leakage by 60% and conduct smoke and fix all leaks i Y 4. Fix all accessible.leaks using smoke and HERS rater verify ... '. .. Note:: (One of Options 1, 2, or 3 friust'.be attempted before utilizing Option 4.) ' Determine nominaKano Flow using one:.of the following44three calculation methods ✓ ❑Cooling system ethod. Size o�#fcondenser in Tons �t •' .�i f'gt•"�����`� ✓ [3 Heating system method 211 7 x Output Capbdtty inY{YThousarid s of. -Bt U/h r_tC4EM jfT ✓ ❑ Measured system airflow using RA3 3'iairflow�test,pr------ Option i used then �f'e'� =;Fan ` �•�, 1 Allowed leakage Flow x;0 15 �CFM`x-i ;+�� �: y,;,r a Actual Leakage = _ CFM " . Pass if Leakage Actual is less than Allowed E3 Pass Fail Option 2 used°then: fk '•: 2 Allowed leakage =' Fa6 Flow ' 'x 0.10 = _CFM Actual Leakage to outside..= •= CFM Pass if Leakage Actual is less than Allowed Pass 0 Fail Option 3 used then: Initial leakage prior to start of work = CFM } . Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction CFM ((Leakage reduction _ / Initial leakage x 100% _ % Reduction Pass if % Reduction >= 601% 0 Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No sampling). Pass if all accessible leaks have been repaired using smoke U Pass Fail Reg: 212-A0056565A-M2100001A-M21A Registration Date/Time: 2012/11/10 12:53:22 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 �f i Y Reg: 212-A0056565A-M2100001A-M21A Registration Date/Time: 2012/11/10 12:53:22 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 ERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-2 hitt Leakage Test - Existing Duct System (Page 2 of 7 ;ite Address: Enforcement Agency: Permit Number: ?8637 TORINO , La Quinta CA 92253 (System 1) City of La Quinta 12-1207 #i FI ❑ Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off II during duct leakage testing. CFI, -QA ducts that utilize controlled, motorized dampers, that open only when OA ventilation is.required to meetASN.RAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. ❑ All supply andAreturn register boots must be sealed ato�,the dr_ywaI1 if�sm okettestiistutilized?forw�compliance - applies tonduct leakage complianceyoptid 3 (leakage reduction,by 60 /o) andtoptiont4 (KX4- a lfaccessible !, leaks) described abojre f:. t;r ¢',1. t x [3New ductnnstallations cannot utlllze=building cavities as plenums orNplatform returns in'lieu of ducts ❑ Mastic and�draw bands must be used iii"combination with cloth backed=rubtieriadhesive=dOct tap leaks at all ,* c . tai neW dy�uct'conne'ctiongs :; " 4 DECLARATIOK 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 • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The Installed feature, material,component, or manufactured device requiring HERS verification that Is identified on this certificate (the Installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified 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 -111) approved by the enforcement agency. I . Builder or Installer information as shown on the Installation Certificate (CF -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if, applicable): 359701 ❑ tested/verified dwelling ntested/verified dwelling in Pa[EERS sample group HERS Rater Information CalCERTS Certificate # CCI -1798698479 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's'Name: Responsible Rater's Signature: ' William David'Painter William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 11/9/2012 CC2005184 I z Reg: 212-A0056565A-M2100001A-M21A Registration Date/Time: 2012/11/10 12:53:22 HERS Provider: Ca10ERTS, -Inc. 2008 Residential Compliance Forms March 2010 ,y i CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: s Enforcement Agency: Permit Number: 78637 TORINO , La Quinta CA 92253 City of La Quint a 12-1207 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. -STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. r � TMAH = Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or, Area Served Whole House 1 ❑ Yes Y 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. . 2 i CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: s Enforcement Agency: Permit Number: 78637 TORINO , La Quinta CA 92253 City of La Quint a 12-1207 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. -STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. r � TMAH = Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or, Area Served Whole House 1 ❑ Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. . 2 [3 Yes ❑ No±. l41.5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and 2 is a pass. Enter Pass or Faill ✓ 13Pass ✓ ❑Fail STMS - Sensor onthe.Evaoorator`•Coil ;Y .. ... ...� System Name'or Identification/Tag .:OI; 3 es � ❑j No-., The sensor is factory installed„'orifield installed according`: to manufacturer s specifications, or is'mstalled by methods/specifications approved by the Executiv ❑ Yes ❑ No � Director. �.,,i” �Y Y, � wj:�.#i +I . j., J Tfie sensory wire is terminatedtwitfi a standard mini plug suitable for connection�to a� 4 ❑Yes ❑ No- digital thermometer The,sensor;mrn plug is accessible to<the mstalUng technician ❑ Yes :.•' , :.rj K -" and thesflERS;rater without: changing' the airflo'W6rough the condenser coil 5 ❑Yes ❑ No When'attached to a digital thermometer, the sensor provides an indication of the ❑ Yes ❑ No ,j saturation temperature of the coil. Yes to 3 4 and 5.is a pass. Enter N/A if STMS are not V. ❑ N/A ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter:Pass or:Fail ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail STMS - Sensor on the Condenser Coil i System Name or Identification/Tag System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, -or is installed by methods/specifications approved by the' Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7, and 8 is a.pass. Enter N/A if STMS are not ✓ ® N/A ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail a t Reg: 212-A0056565A-M2500001A-M25A Registration Date/Time: 2012/11/10 12:54:58 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 I 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 1; Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. SDace Conditioninq Svstems System Name or Identification/Tag System 1 (must be re -calibrated monthly) Date of Thermocou Ie Calibration}? 4 System Location or. Area Served Whole House +' E ,f �, �'na 3. :�,'f, .:N.kaY€i Outdoor Unit Serial # .gs -"s sz V. �} ti, Outdoor Unit Make } Outdoor Unit Model Nominal Cooling Capacity Btu/hr Date of Verification'; Calibration of piagnosiac Instruments. Date'of Refrigerant Gauge Calibratioh,`'%� $System 1 (must be re -calibrated monthly) Date of Thermocou Ie Calibration}? 4 (must tie rte calibrated monthly) pg ,:moi`. v...r..t 5 ,.:+..•,a.r `� +' E ,f �, �'na 3. Measured.Tern eraturesr 'F b � ma.?n or "� a ,ter p*-, [ t System Nae Identificatlon/Tag $System 1 .;-e s° x n . -�i� ihY `f�Fr tt CY �tw.•.+�-.+,':':f f2F t..{7�.,. l�r�.-.: pg ,:moi`. v...r..t 5 ,.:+..•,a.r `� +' E ,f �, �'na 3. :�,'f, .:N.kaY€i Supply (evaporator leaving) air dry bulb, .gs -"s sz V. �} ti, temperature Rsupply db) ; Return (evaporatorentering) air dry --bulb temperature (Tretu�n;:`db) Return (evaporator entering) air wet -bulb' temperature (Treturn, wb) Evaporator saturation temperature.".. (Tevaporator, sat) Condensor saturation temperature (Tcondensor, sat) Suction line temperature (T suction) Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db) C • i Reg: 212-A0056565A-M2500001A-M25A Registration Date/Time: 2012/11/10 12:54:58 HERS Provider: CalCERTS,,Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 78637 TORINO ; La Quinta CA 92253. City of La Quinta 12-1207 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 Calculate: Actual Temperature Split = Treturn, db - Tsupply, db Target Temperature Split from Table RA3.2-3 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - * r Target Temperature Split = + Passes if difference is between -4°F and +4°F or, upon remeasurement, if between -4°F and -100°F Enter Pass or Fail ' Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures. specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) �i System Name or�Identification/Tag v F p;;r � � �{i;: �'M� � i.if?R".t`�.• �iG,+z.,;��1k"� :��� .'. �M et��:.l: y '-t'Y. Calculated Minimum AirflowRequiire-mien (CFM) •� ' �, �_ Measured Airflow using RA3 3 procedures (CFM)! .,`rte f Passes if measure&airflow is; greater ,thanlor,equal� to the calculated minimum airflow'requiremerit: Enter; Pass or Fail - .r:, 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 ; Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table.RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: * r Actual Superheat - Target Superheat = System passes if difference is between -60,F and +6°F - j' Enter Pass or Fail r Reg: 212-A0056565A-M2500001A-M25A Registration Date/Time: 2012/11/10 12:54:58 HERS Provider: Ca10ERTS,i.Inc. 2008 Residential Compliance Forms March 2010 �I INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 78637 TORINO , La Quinta CA 92253 City of La Quinta 12-1207 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 Calculate: Actual Subcooling = Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer Calculate difference: Actual Subcooling - Target Subcooling = System passes if difference is between -4°F and +4°F Jnr [& 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 Identification/Tag Calculate: Actual Superheat = Tsuction " Tevaporator, sat Enter allowable superheat range from, manufacturer's 'specifications (or use range between 3°F and 26°F if manufacturJ''s specification is not available) System, pass64 actual; superheat is within the allowable superheat range Jnr [& nterl Pass or Fail :` �' �.� ,a., t ' �: > z `.. •..4 ���:• . - `K. �. �� A� � �,a '.S"' r� . � -�� s 5�.4, ";. � x J.;� �, _. .�'.•�'ti .t,„, � e`,+� jy t t f � l Reg: 212-A0056565A-M2500001A-M25A Registration Date/Time: 2012/11'/10 12:54:58 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure. (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 78637 TORINO , La Quinta CA 92253 City of La Quinta 12-1207 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 i 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 359701 System meets all refrigerant charge and airflow ® not-tested/verified dwelling in la HERS sample group requirements. HERS'Rater Company Name: - The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 11/9/2012 CC20OS784 n e r rfs i t s �F r , DECLARATION STATEMENT•.'`. • I certify under penalty of perjury; under the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater -Who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material,'compbnent, 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 -SR) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -61k), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the. " enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor,or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 359701 ❑ tested/verified dwelling ® not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CCI -1798698479 HERS'Rater Company Name: - The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 11/9/2012 CC20OS784 Reg: 212-A0056565A-M2500001A-M25A Registration Date/Time: 2012/11/10 12:54:58 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 Space Conditioning Systems Heating Equipment Equip Type (package- heat pump) • CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical, Systems Efficiency (AFUE, etc.)1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct. R -value Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Split Furnace LENNOX SL280UH09OX4060 1 80 AFUE Attic 90 75 kBtu Type r.�,;. ,� and EER) (attic, (package ARI # of 1, 3 crawl- Cooling Cooling heat CEC.Certifiied Mfr. Name, Reference Identical (>=CF -1R space, Duct Load Capacity pump) and Model NumbeG- . Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split LENNOX Cooling Equipment 1. If project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative compliance. .: Z. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.orglari/ac.ohp# 3. Listed efficiency on this page must be greater than or equal(?) to the value shown on the CF -IR form. . 4. When CF -IR is reference it is also applicable to the CF -ZR, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM ® §110-§113: HVAC equipment is certified by the California Energy Commission.. ® §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. ® §150(i): Setback Thermostat on all 'applicable heating and/or cooling systems meet the requirements of §112(c). 1i ® §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brilie lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in a conditioned space. Reg: 212-A0056565A-M0400001A-0000 Registration Date/Time: 2012/11'/05 14:40:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 Efficiency Duct Equip F', (SEER Location Type r.�,;. ,� and EER) (attic, (package ARI # of 1, 3 crawl- Cooling Cooling heat CEC.Certifiied Mfr. Name, Reference Identical (>=CF -1R space, Duct Load Capacity pump) and Model NumbeG- . Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split LENNOX A/C.." 5XC31-060230 5 Tons �'�+g 'x � R jy� • ( �t• j i r� ..' �:w ' r � =44 •+ a 5" �:; i�.�,..i.r . wN 'j�4 :. t - +'4 i-. . t2� . i n 1. If project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative compliance. .: Z. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.orglari/ac.ohp# 3. Listed efficiency on this page must be greater than or equal(?) to the value shown on the CF -IR form. . 4. When CF -IR is reference it is also applicable to the CF -ZR, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM ® §110-§113: HVAC equipment is certified by the California Energy Commission.. ® §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. ® §150(i): Setback Thermostat on all 'applicable heating and/or cooling systems meet the requirements of §112(c). 1i ® §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brilie lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in a conditioned space. Reg: 212-A0056565A-M0400001A-0000 Registration Date/Time: 2012/11'/05 14:40:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 a C INSTALLATION, CERTIFICATE CF -6R -M ECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 78637 TORINO La Quinta CA 92253 (System 1) City of La Quint a 12-1207 Ducts and Fans §150(m): Duct and Fans M 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723: If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and M 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board, or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. ® 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and, draw bands. ® 7: Exhaust fan systems have back draft or automatic dampers. ® 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible,- manually ccessible,manually operated dampers. M Protection of Insulation:`Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that ;is water retardant and provides shielding from solar radiation that can cause degradation, of the material:;::,; ® 10.. Flexible ducts cannot have porous inner cores. • � i d� \h ,, Al * A ice+ 4 ,t rqY � .`�t ,: . . r �4� 3+r 4'L � .�L�J•�•1}v'� � t%- _��. .xil `h'�� :ALS# a. yr�,z"� '',rtj:i 'isi�, ' "*` .:.! ..ra;;e ';.r`t'"•.;n ,;a5: ,_... DECLARATION<STATEMENT y1; • I certify under penalty;of;perjury, under: the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, niiaterials,'components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. ` • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the Installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name; (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC " ,r Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: Date Signed: Position With Company. (Title): 686310 10/10/2012 Reg: 212-A0056565A-M0400001A-0000 Registration Date/Time: 2012/11/05 14:40:50 HERS Provider: Ca10ERTS,,Inc. 2008 Residential Compliance Forms August 2009 ,r F r r Reg: 212-A0056565A-M0400001A-0000 Registration Date/Time: 2012/11/05 14:40:50 HERS Provider: Ca10ERTS,,Inc. 2008 Residential Compliance Forms August 2009 i l� i INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test—,Existing Duct System (Page 1 of 2) Site Address: ' Enforcement Agency: Permit Number: 78637 TORINO , La Quinta CA 92253. (System 1) City of La Quint a 12-1207 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required.for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " T Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. t f! � I . INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test—,Existing Duct System (Page 1 of 2) Site Address: ' Enforcement Agency: Permit Number: 78637 TORINO , La Quinta CA 92253. (System 1) City of La Quint a 12-1207 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required.for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " T Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. ® 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow ❑ 3. Reduce leakage by 60% and conduct smoke and fix all leaks ❑ 4. Fix all accessible leaks using smoke and HERS rater verify f Note; (One of Options 1, 2 or 3 must be attempted before utilizing Option 4.) Determine nominal,Fan,Flow using one of the -follow ng,three calculationsmethods ✓ ® Cooling system method. Size of condenserjri Tons + x 400 2000 CFM ,. ✓ ❑Heating system method +21 Output Capacity in Thousands of Btu/hr� CFM fi k a by ✓ ❑ Mea ured system arflo�:using 12A3 3airflow test rocedu`res-`CFM;;7,. OpUonxi used then '�� '' `* .# Allowed leakage `i Fan Airflow 4 2000 0 15 ' *, 300 1 x i 7CFMkf m� s Actual Leakage = CFMr,:y •.' , 1 `' Pass if Actual Leakage is less than Allowed leakage N Pass Fail Option'2:used then: 2 Allowed leakage = Fan Airflow",: ` x 0.10 = _ CFM Actual Leakage to outside = �M, Pass if Actual leakage to outside is less than Allowed leakage Pass Fail Option 3 used then: Initial leakage prior to start of work = CFM Final leakage after sealing all accessible leaks using smoke test = CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _/ Initial leakages x 100% _ % Reduction Pass if % Reduction >=_ 60% ❑ Pass ❑ Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke C3 Pass Cl Fail c Reg: 212-A0056565A-M2100001A-0000 Registration Date/Time: 2012/11/05 14:44:52 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms r March 2010 d INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERE )uct Leakage Test — Existing Duct System (Page 2 of 2; Site Address: Enforcement Agency: Permit Number: 78637 TORINO , La Quinta CA 92253 (System 1) , I City of La Quinta 12-1207 ® Outside air (OA) ducts:fo'r 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 isnot required, may be configured to the closed position. during duct leakage testing. ® All supply�and.retutrn register boots 'mustibe sealed to the drywallif sm o$kewtest is uilized1for�compliance — applies tofduct leakage compliance option 3 (leakagerreduction by 60 /o)rand option4 (fix=all accessible leaks) described ab'o�e zte' y T y €4 ��ppy"';, i r j Jp ® New duct�lnstallations cannot�utilizerbuilding cavities as plenums oriplatform returns m lieu(of duds Y �� ; g> g�rY y� rt y 4! �: IN Mastic andrydraw�bands roust be used in;combination with cloth backed,rubber,,adh'esive duct tape to seal leaks at all:new;duct;eonneebons +. DECLARATION STATEMENT a • I certify under penalty of perjury,.under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features; materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS'provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I 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 reoistry for multiDle orientation alternatives, and beqinninq October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: j Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: Date Signed: Position With Company (Title): 686310 10/10/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0056565A-M2100001A-0000 Registration Date/Time: 2012/11/05 14:44:52 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms I March 2010 INSTALLATION CERTIFICATE* CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 78637 TORINO , La Quinta CA 92253 1 City of La Quinta 12-1207 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and _Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 1 Is Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 ® Yes ❑ No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to l and 2 is a pass. A A IEnter Pass or Faill ✓ ® Pass ✓ ❑ Fail STMS r Sensor,on,the Evaporator'Coil System.Name:or;Identification/Tag 3 �❑ Yes ❑ No ►,,,`-:. The sensor is factory installed `or�fOd,installed -according to manufacturer's $specifications, oris mstalled by methods/specifications approved by'the Executive Director. a s ;.f 'tee , _.° �'-^ __; �•$ .� 4 F . ❑ Yesr k = :.,+ �' ,, ``,. N , ,+ �Vr The sensor wire,is"terminated with a standard mini plug suitable for conhection to a digital thermometer The sensor mini plug is accessible`to the msEalUng,techrncien and.the HERSrater without changing the-airflowi'through the condensercoil 5 ❑ Yes ❑ No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes. to 3;;,4,and 5iis.'a. pass. Enter N/A'if STMS are not applicable:: Otherwise enter Pass or:';Fail ✓ . ® N/A ✓ [3 Pass ✓ ❑ Fail Hv. STMS - Sensor on the Condenser'Coil System Name or Identification/Tag j I System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes 1 ❑ No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ ® N/A ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail Reg: 212-A0056565A-M2500001A-0000 Registration Date/Time: 2012/11/05 15:09:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification-- Standard Measurement Procedure (Page 2 of 5) r Site Address: Enforcement Agency: Permit Number: 78637 TORINO , _La Quinta CA 92253 City of La Quinta 12-1207 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems it System Name or Identification/Tag s System i (must be re -calibrated monthly) System Location or Area Served Whole House r 10/10/2012 e� s.(must lYib be re carated monthly) Outdoor Unit Serial # S8121T090EO ,. �s x °: '� �r Outdoor Unit Make, LENNOX Outdoor Unit Model XC21-060230 Nominal Cooling Capacity Btu/hr i 60000 Date of Verification 10/10/2012 calibration of magnostic Instruments Date.of Refrigerant Gauge Calibration,;, 10/10/2012 (must be re -calibrated monthly) pName Date ofThermocouplel!Calibration7 r 10/10/2012 e� s.(must lYib be re carated monthly) Supply (evapofato� tlea4ing) air:` dry bulb a{ _ E Measur6d'TiiMperatUre,sj4QFy,t:,.,I�.teI �A. System or Identification/TagT Systemic�ts pName Supply (evapofato� tlea4ing) air:` dry bulb a{ H� n 56 Y ,. �s x °: '� �r temperature (Tsupply;'db)-. r Return_ (evaporatorentering) air dry-bulb r 76 temperatur:e'(Trefur`,n, db) Return (evaporator entering) air wet=bulb 60 temperature (Treturn, wb) ' ! Evaporator saturation temperature' 40 (Tevaporator, sat) r Condensor saturation temperature 98 (Tcondensor, sat) Suction line temperature (Tsuction) 54 Liquid Line Temperature (Tliquid) 94 Condenser (entering) air dry-bulb 84 temperature (Tcondenser, db) n ii Reg: 212-A0056565A-M2500001A-0000 Registration Date/Time: 2012/11/05 15:09:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 78637 TORINO , La Quinta CA 92253 City of La Quinta 12-1207 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2: System Name or Identification/Tag System 1 _ Calculate: Actual Temperature Split = Treturn, 20.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3, 21 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - _1 Target Temperature Split = Passes if difference is between -3°F and +3°F or, upon remeasurement, if between -3°F and, PASS -100°F Enter Pass or Fail r Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures Specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equalto or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) . r 5 ...1ti* nl e o.ation/Ta System Namr Identificg Ati i'^F,4'9P+``F•+a` System x i M 1 'a,� .�'t f 2 fie;. s':. ? Calculated Minimum, Airflow Reqwrement (CFM) af� r • � %d -k a3-., '3. r,oc,#�'+ Measured Airfl}owNusmg RA.3�r3 procetlures (CFM:) � �^ {t .:. ., x,.. 4 d .. ''•:• ...%Y Passes if mea§ured`airflow is`greater, th6 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 Identification/Tag System'i • .i Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser; db Calculate difference: Actual Superheat - Target Superheat = l System passes if difference is between -5°F and +5°F • Enter Pass or Fail r ` tl Reg: 212-A0056565A-M2500001A-0000 Registration Date/Time: 2012/11/05 15:09:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS " Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 78637 TORINO ; La Quinta CA 92253 City of La Quinta 12-1207 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and. electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Subcooling = r 4.0 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 3 Calculate difference: i 1 ' Actual Subcooling - Target Subcooling' = System passes if difference is between -3°F and +3°F PASS f Enter Pass or Fail h Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual.Superheat = ;' ; 14.0 Tsuction - Tevaporator, sat Enter allowable superheat range from. manufacturer's specifications (or use range 4.25 ' between 4°F and 25°F if manufacture'r's specification is not available) System passes if actual; superheat is within the"u allowable. allowable superheat range,'; �,� Y37t- �z S f M , ,Enter�Pass Xi ct �� t tsy,�i' i.�^a `E s:� r•�r �' ?s. #:t ' � '-,,,a,«w ..�. aw "'. iafgrE c7�'+.��': ,�.- ,:.,` 1 .az_ •_t#�,. � .. : �.,A.y "w,F+f ;: -s [ �`r. ,,f.� ' F f r , A , 1 + r Reg: 212-A0056565A-M2500001A-0000 Registration Date/Time: 2012/11/05 15:09:59 HERS Provider: Ca10ERTS, Inc. 2008 Residential.Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2S-HER: tefrigerant Charge Verification - Standard Measurement Procedure (Page S of S Site Address: Enforcement Agency: Permit Number: 78637 TORINO., La Quinta CA 92253 City of La Quinta 12-1207 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 CSLB License: Date Signed:. Position With Company (Title): System meets all refrigerant charge and airflow 10/10/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): requirements.PASS Enter Pass or Fail o. DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features; materials, "components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by,a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -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 reoistry for multiple orientation alternatives, and beoinninq October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: Date Signed:. Position With Company (Title): 686310 10/10/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No 0 r Reg: 212-A0056565A-M2500001A-0000 Registration Date/Time: 2012/11/05 15:09:59 HERS Provider: Ca10ERTS,�Inc. 2008 Residential Compliance Forms August 2009 ?ted l -6*60 s40S(�i5'� HVAC Field Data Sheet Pg 1 oft Client Name kki U -k -P KO 4 O�— ' - Job # Date�- Address Ph Technician(s)t �>� Permit # Gauge/Thermocouple Calibration Dawj/2Z /� Package I Some Ducts Only I AR Ducts Only (Circle type of work) MEW -04, FgLfphtentDaI ZONE 1 ZONE 2 Z.O1VE3 ZONB4 System Location or Area Served VA Heating Equipment Make - Heating Equipment Model �ko W. ARI Reference Number Ajm o . - .j, Heating Equipment AFUE Duct Location (attic, crawlspace, etc.) 4-7 . `C— Duct R -Value (if ducts were installed) Heating Load Heating Equipment Output Capacity f� Condenser Make Condenser Model -c6c,0D Size in Tons SEER & EER Cooling Load 1 Cooling Ca :M 2O&ZI DuctT&WhW Duct leakage pretest result Dart Leakage Ermal Result 4.4CFM/toa to pass (6%) FasslFaf! PassIFA FasslFail Pasoftfl Duct Leakage Final Result -60 CFM/am to paw (Z%) IFafl P=IM pmpw 1 Pass using 60% leakage reduction? Pass using smoke and visual inspection? MEdiZ. or.mrB, ;S 'CoWbWConAbflowa Parr.ifatEDraw . Measured Air Volume from Flow Grid or Hood 1t' NEW DUCTS Target 3S0 CFM/tm a CondenserTons CItMGEOUT Targe 300 CFM/tin x condenser Tons Measured air greater d= Target? (Y/N) Measured Fan Watt Draw Target: 0S8 watts/measured CFM = Measured Watts less than Target? Copyright C Zoll IDS &ems Drt= Solations„ Inc HVAC Field Data Sheet Pg 2 of 2 Client Name (W "R job # 140 Oq 3 Date MEGN ZS Charge & Airflow ZOAFE 1 ZONE 2 ZONE 3 ZONE 4 Condenser Seridl Number Supply air dry bulb temperature Return air dry bulb temperature �f Return air wet bulb temperature. ( : Evaporator Saturation Temperature Condenser Saturation Temperature Suction Line Temperature IS y Liquid Line Temperature Suction Pressure Liquid Pressure 3 L Lt Actual Airflow Temperature Split Target Temperature Split from Table RA32-3 Passes if difference is t 3° of Target Temp (Y/N) G� Actual Subcooling (t 40 of Target to pass) Target Subcooling from Mfr. Actual Superheat (3 to 26° to pass) Outside air dry bulb temperature MEuLMH26 'We(gh-1n oa ging below 550. Actual Line Set length (ft) Mfr's Standard Line Set Length (it) Length Difference = Correction Factor (ounces per foot) Target: Correction Factor x Length Difference System Charged to Target' (YIN) OtherDaca Minimum amps q c Maximum amps 50 Breaker size Compressor amps 5 Return Static Pressure WX Supply Static Pressure Supply Air Wet Bulb Temperature + • ALL APPLICASUDOIMON "MFORMMUST DECOMPLETED FOR EACllJOD-N0 EXCEPTIONS: • • copyrW 0 2011 EDS &mV nrivm Solutions„ bv- r GE�RAL . Dear Homeowner, We want to thank you again for your patronage and loyalty to ourcompany. It is now time toschedule an Air Conditioning inspection with your City. It is important to have this done as soon as possible to get the permit closed. Enclosed in this packet is your permit card and the required forms needed by the inspector to close your permit. At the end of this letter, you will find the inspection office phone numbers for your city; Please contact them in order to schedule your inspection. In addition, please find below the type, of equipment we installed at your residence. ❑ Roof -top Package Unit/Condenser❑ Water Heater Split System Upflow 0 Other: ❑ Split System horizontal or upflow;in the attic* * Requires ladder; 4 When the inspectorarrives, he may,�need`a,ladder to access your equipment. If you do not have an appropriate ladder, General A/C will provide one for you. If yourequire us to deliver a ladder, please contact us as soon as you have an inspection date and we will deliver one beforehand. After your inspection is complete and your permit has been closed, please call our sales office and let 'us know so that we may note it in your file. Thank you for your cooPeration and please do not hesitate to call us at,(760) 343-7488 if you have any questions. ti Sincerely, The General's Sales Department Enclosed: Copies of form CF -411 for your records. Please give the Inspection Card (and CF forms, if so requested) to the city inspector. !F To schedule your inspection please calf City of Le Quinta: (760) 777-7000 City of cathedral City: (760) 770-0340 City of Palm Desert: (760) 776-6420 City of Coachella: (760) 398-3502 City of Palm Springs: (760) 323-8243 City -of Desert Not Springs: (760) 329-6411 X244 .i City of Rancho Mirage: (760) 324-4511 City of Indian Wells: (760) 346-2489 County of Riverside: (951) 955-1800 City of Indio: (760) 391-4001 Town of Yucca Valley: (760) 365-1339 i ri