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12-1306 (MECH)A. ; -• P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ht- 4 4 Q" Application Number: _ 12-06001306' Property Address: -79425 STONEGATE APN: 772-040-013- - - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: . 11725 Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT hereby affirm under penalty of perjury that I am ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and fessionals Code, and my License is in full force and effect. License Class: C20 License No.: 686310 f^Date: �-,Contractor: WNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundredAollars ($500).: (_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not, apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 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: LQPERMIT Owner: JULIE JONES' 79425 STONEGATE LA QUINTA, CA 92253 (760)771-5602 /�f A VOICE (760) 7 7� 2 FAX (760) 77� a INSPECTIONS (760) 777;1153 Date: 11/02/12 1 Contractor: GENERAL AIR CONDI q 31170 RESERVE DRI THOUSAND PALMS, CA 2 76 (760)343-7488 CITY Lic. No.: 686310 0_ .LAQUINTA WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for, workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier ZENITH INS CO Policy Number Z071741502 I certify that, in the performance of the work for vAich this permit is issued, I shall not employ any person in any manner so as to become subjecolthe workers' compensation laws of California, and agree that, if I should become subject to workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith co y with those provisions. Date: y.t .Z jl+pplicam: WARNING: FAILURE TO SECURE WORKERS' COMPENS ION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalfthis application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or c ssation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above info tion is correct. I agree to comply with all city and county ordinances and state laws relating to building constr on, andhereby authorize representatives of this county to enter upon the above-mentioned property for inspe n purp as. Date: f l 2 - Signature (Applicant or Agentl: LQPERMIT Application Number . . . . . 12-00001306 Permit MECHANICAL Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 , Expiration Date 5/01/13 . Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1..00 9.0000 EA MECH APPL REP/ALT/ADD a 9.00 . Special Notes and Comments HVAC 5 TON COIL AND FURNACE•ONLY. 2010 CODES. -----------------_--------------- - Other Fees . . .'. . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 33.00 .00 .00 33.00 . Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total 42.25 .00 .00 42.25 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 79425 STONEGATE La Quinta, CA 92253 City of La Quinta Nov 1, 2012 Equipment Typel List Minimum Efficiency2 Duct insulation requirement Conditioned Floor Area Thermostat ❑ Package Unit ® Furnace ® Indoor Coil ® AFUE 78% ❑ SEER ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) Served by system ® Setback not already present, must be ❑ Condensing Unit ❑ EER ❑Resistance ❑ R 8 (CZ 14-15) 4478 sf in installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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 -6R 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 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 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 (ie. Ductless.Mini-Split System),(Also :Exempt from. Refrigerant Charge) ❑ 2. New HVAC System Required Forms: F } / ¢. . Cut in or Changeout with,' new ducts: (all new ' ` r ° * / CF -6R forms MECH-04, MECH-20'HERS, and (for split systems) MECH 22=HERS, and ductirig�all new F MECH-25 HERS I V I - •. equipmentf CF -412 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, STMS, and either HSPP or`PSPP. For Packaged Units: Duct leakage < 6, percent ❑ 3. New Ducts with/or without Required Forms: Replacement . 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 -611 forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) . I certify that this Certificate of Compliance documentation is accurate and complete. . I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. . I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. . The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Danielle Garcia Signature: Danielle Garcia Company: HARRISON ENTERPRISES INC Date: Nov 1, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 212-A0061271A-000000000-0000 Registration Date/Time: 2012/11/01 15:27:23 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 uw u Cf ty Of ,a QuInt' a Building &r Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking g Sheet Project Address:--) -1. ACE, Owner's Name: ' A. P. Number: � � � Q�� � Address: —1CA14pG f &46e- (5 Legal Description: City, ST, Zip: U\ Contractor:b�e Telephone: ')(VQ ,'�'�'� ��• `r. s , �•' Address: L Project Description: V'IL 1L, City, ST, Zip: 6K (U State Lic. # : 3 City Lie. C fD® Arch., Engr., Designer: Address: Item Amount City., ST, Zip: Telephone:. State Lic.#: 4fy 'hkiii� o� 1 yp`r �o..•<.�`•x" .�' Construction Type: Occupancy. Project type (circle one): New Add'n Alter Repair Demo Name of Contact• Person: �. p G(r -e-1 GUec*5 c7YL, Plan Check Deposit . Truss Calcs. Sq. FL: �� # Stories: # Units: Telephone # of Contact Person -7& O 3'C3 APPLICANT: # Submittal Req Id Recd DO. NOT WRITE. BELOW THIS LINE TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance • Tide 24 Calcs. Plans picked up - Construction Flood plain plan Plans resubmitted Mechanical Grading plan 20" 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 7rd Review,.ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School. Fees Total Permit t e � _ i • i 1 - 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: 79425 STONEGATE , La Quinta CA 92253 (System 1) City of. La Quinta 12-1306 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. " • - istallation certificate,is.required for compliance for alterations and additions in existing dwellings to 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. " Select one compliance method from the following four choices. , ® 1. Measured leakage less than 15% of fan flow + a ❑ 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, , Note: (One of Options 1, 2, or 3 must be attempted before utilizing. Option 4.) Dtermine nominalAF,�an,Flow using one of theifollowing,threeTcalculation.methods. ® Cooling system method: Size of condenser in'Tons 5 "-x 460'= 2000 CFM ✓ ❑ Heating system method; 21 7. xtl Output Capacity m Thousands of Btu/hr'= CF m ✓❑ T Measured systemTa'irflow using RA3.3'airflow,testfprocedures: CFM Opti'ontidusedthen'.R 1 Allowed leakage'- Fan Flow 2000x 0.15 = '300 'CFM` Actual Leakage = 287 CFM ' .. , .. 1 `-,% ' .' : Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then: 2 Allowed leakage = Fan Flow —x 0.10 = = CFM ` Actual Leakage to outside = ' CFM - Pass if Leakage Actual is less than Allowed Pass Fail Option 3 used then: Initial leakage prior to start of work = CFM - Final leakage after sealing all accessible leaks using smoke test'= _ CFM r " 3 Initial leakage _ - Final leakage_ = Leakage reduction _ CFM ((Leakage reduction _ / Initial leakage ' ) x 100% _ % Reduction Pass if % Reduction >= 60% ❑ Pass ❑ Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No sampling). ' Pass if all accessible leaks have been repaired using smoke Pass ❑ Fail Reg: 212-A0061271A-M2100001A-M21A Registration Date/Time: 2012/12/13-23:55:58 HERS Provider: CalCERTS,•Inc. 2008 Residential Compliance Forms, 1' March 2010 3 - ti i r Reg: 212-A0061271A-M2100001A-M21A Registration Date/Time: 2012/12/13-23:55:58 HERS Provider: CalCERTS,•Inc. 2008 Residential Compliance Forms, 1' March 2010 ® 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. } IN All Supply�an&return register boots must'}be•sealed toTthe dr_ywalljif.smokeTtest-lisirutilizedtfor compliance ' - appliesto�duct leakage complianceroptton 3 (I'eakage`reductlo�n by=60%)ndoption4 (fix a1'1 accessible • leaks) de sc rkbed abov� � - � _` � ,_ � �#F ,�' { *.r � � • ,�� - t r , � ' ® New ductinstallations cannot utllizebuilding cavities as plenums or platform returns,in.11eu of du�c/ts: ®Mastic and draw bands must be usedtirn,comtiination wlth cloth backed;r_Iabber�adhesive�duct taperto.seal . leaks at all"new duct•connections:a "mow "�"" DECLARATION STATEMENTS ; . I certify under,penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified ` on the Certificate(s),of Compliance (CF -111) 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-1R)'approved by the , enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) _ t Company Name: (Installing Subcontractor or General. Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name:7----TC—SLB License: Danielle Garcia 686310 ' HERS Provider Data Registry Information Sample Group # (if applicable): 363855 ®tested/verified dwelling ❑not-tested/verified dwelling in a HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798704437 HERS Rater Company Name: Energy Driven Solutions, Inc. Responsible Rater's Name: Responsible Rater's Signature_: David Bricker - David Bricker Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 11/29/2012 CC2004131 Reg: 212-A0061271A-M2100001A-M21A Registration Date/Time:-2012/12/13 23:55:58_ HERS Provider: Ca10ERTS, Inc. k. 2008 Residential Compliance Forms '' ♦ 4 March 2010 ' CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification -,Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 79425 STONEGATE , La Quinta CA 92253 City of La Quint a 12-1306 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 SIMS 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 or [field; The sensor is factory installed, or field installed according to manufacturer's 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 ® Yes ❑ No5/16 . 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 Fail ✓ ® Pass ✓ ❑ Fail STMS - Sensor on,the. Evaporator Coil ■,,,�.� - y_ ,,,_ System Narne'or Identification/Tag) j ,r',f System 1 � ' - I ' j -140-1 f t.,, "ll, _ f. I I( o or [field; The sensor is factory installed, or field installed according to manufacturer's 3❑£Yes ❑ No p� ;. specifications; or is°installed by by the Executive Director. Director.' 4 [3 Yes f J ! El, No ,The sensor wire is terminatedwith a;standard mini plug suitable for connection to' a digital'thermorneter. The plug isl to,theijnstaIli ng technicieA,,,. ❑ Yes s ,c sensor -mini accessible and the HERS rater without changing the airflow through the condenser coil and the HERS rater without changing the airflow through the condenser coil 5❑Yes.- ❑ No ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. saturation temperature of the coil. 1. Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not ✓ ® N/A ✓ ❑Pass ✓ ❑Fail 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 ❑ 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 ✓ [3 Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail Reg: 212-A0061271A-M2500001A-M25A Registration Date/Time: 2012/12/13.23:59:17 HERS Provider: CalCERTS, Inc. - 2008 Residential Compliance.Forms +March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: . 79425 STONEGATE , La Quinta CA 92253 City of. La Quint a 12=1306 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 - ; t 1 System Name or Identification/Tag System 1 - (must be re -calibrated monthly) Date ofTheIe Calibration ' : a + p + •, _ System Location or Area Served Whole House _ � . � .44 Outdoor Unit Serial # 5812E04576 ' ;•',• Outdoor Unit Make Lennox '. A y Outdoor Unit Model XC21-060 ' Nominal Cooling Capacity Btu/hr 60000 Date of Verification _ 11-29-12 calibration of Diagnostic Instruments Date.of Refrigerant Gauge Calibration �`' 11-15-12 (must be re -calibrated monthly) Date ofTheIe Calibration ' : a + p 1 1 15 -12 FE {# must b e (e,r-calibrated monthly) � - Fes• � _ � . � measures Temperaturesi(, F);,,1l: I 1; tem 1.� � w� � •'� � � �r �%�� � - - ,I • —�-Q- { _ ' ,,� ,r •...e_ r�. 5 �-+"a' � . � ,�,; a�., . yam, .� y� System Name or Identification/Tag ` Sys Supply (evaporator, leaving)` air. dry;bulb'?>�„„� temperature (T47 supply, db) '. Return (evaporator entering) air dry-bulb 69 T Return (evaporator entering) air wet -bulb temperature (Treturn,''wb) tem 1.� � w� � •'� � � �r �%�� � - - ,I • —�-Q- { _ ' ,,� ,r •...e_ r�. 5 �-+"a' � . � ,�,; a�., . yam, .� y� System Name or Identification/Tag ` Sys Supply (evaporator, leaving)` air. dry;bulb'?>�„„� temperature (T47 supply, db) System Name or Identification/Tag ` Sys Supply (evaporator, leaving)` air. dry;bulb'?>�„„� temperature (T47 supply, db) '. Return (evaporator entering) air dry-bulb 69 temperature (Treturn, db) `_ Return (evaporator entering) air wet -bulb temperature (Treturn,''wb) Evaporator saturation temperature 1 31` y I (Tevaporator, sat) Condensor saturation temperature 83 (Tconderisor, sat) Suction line temperature (Tsuction) 50 Liquid Line Temperature T i q p (• Ilquid) 81 • j Condenser (entering) air dry-bulb temperature (Tcondenser, db) 73' Reg: 212-A0061271A-M2500001A-M25A Registration Date/Time-: 2012/12/13.23:59:17 HERS Provider: CalCERTS, Inc. 200'8 Residential Compliance Forms' s March"2010 INSTALLATION CERTIFICATE �� CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure '-(Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 79425 STONEGATE , La Quinta CA 92253 City of La Quinta 12-1306 r 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,', 22.00 s db - Tsupply, db Target Temperature Split from Table RA3.2-3 _ 19 using Treturn, wb and Treturn, db - Calculate difference: Actual Temperature Split.- 3 , - • M Target Temperature Split = Passes if difference is between -4°F and +40F or, upon remeasurement, if between -4°F and PASS w :' -100°F ' Enter Pass or Fail k INSTALLATION CERTIFICATE �� CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure '-(Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 79425 STONEGATE , La Quinta CA 92253 City of La Quinta 12-1306 r 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,', 22.00 s db - Tsupply, db Target Temperature Split from Table RA3.2-3 _ 19 using Treturn, wb and Treturn, db - Calculate difference: Actual Temperature Split.- 3 , - Target Temperature Split = Passes if difference is between -4°F and +40F or, upon remeasurement, if between -4°F and PASS w :' -100°F ' Enter Pass or Fail k Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow, is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) =.Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name or Identification/Tag Calculated Minimum Airflo�Requirement (CFM) f 14f Measured'fAirflow*using RA3.3 � r procedures (CFM) Passes if measured airflow is greater than 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 ' s Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db - Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -6°F and w :' +6°F Enter Pass or Fail k Reg: 212-A0061271A-M2500001A-M25A Registration Date/Time: 2012/12/13 23:59:17• HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Subcooling = - 2.0 Tcondenser, sat-•,Tliquid Target Subcooling specified by manufacturer 3 ' Calculate difference: _1 Actual Subcooling - Target Subcooling = - " System passes if difference is between - -4°F and +4°F -PASS t 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 System IL Calculate: Actual Superheat.= 19 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 3_26 between 3°F and 26°F if manufacturer's " specification is not available) _ - System passes4,actual superheat is withinathe allowable superheat range(' PASS `V`'•^ t :rEnter Pass or Fail .a, { ;.,,,ter' .. 'X�P�©:,�a -mf=' �-�'�:- .:,,r,:-• ; ,-.a„!-.ds-..; ,. .. .. ,• .. Reg: 212-A0061271A-M2500001A-M25A Registration Date/Time: 2012/12/13.23:59:17 HERS Provider: CalCERTS,.Inc. 2008 -Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification = Standard Measurement Procedure (Page -S of 5) Site Address: Enforcement Agency: Permit Number: . 79425 STONEGATE , La Quinta CA 92253 City of La Quinta 12-1306 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 686310 i Sample Group # (if applicable): 363855 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification = Standard Measurement Procedure (Page -S of 5) Site Address: Enforcement Agency: Permit Number: . 79425 STONEGATE , La Quinta CA 92253 City of La Quinta 12-1306 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 686310 HERS Provider Data Registry Information Sample Group # (if applicable): 363855 System meets all refrigerant charge and airflow ❑ not-tested/verified dwelling in • HERS sample. group requirements. , PASS Energy Driven Solutions, Inc. Responsible Rater's Name: Responsible Rater's Signature: , Enter Pass or Fail David Bricker' Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 11/29/2012, CC2004131 '+ ,.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, 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. j ".. ., 'i . The information reported on applicable sections of the Installation Certificates) (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 -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 686310 HERS Provider Data Registry Information Sample Group # (if applicable): 363855 ® tested/verified dwelling la ❑ not-tested/verified dwelling in • HERS sample. group HERS Rater Information CalCERTS Certificate # CC1-1798704437 HERS Rater Company Name: Energy Driven Solutions, Inc. Responsible Rater's Name: Responsible Rater's Signature: , David Bricker David Bricker' Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 11/29/2012, CC2004131 e.. Reg: 212-A0061271A-M2500001A-M25A. Registration Date/Time: 2012/12/13 23:59:17 HERS Provider: CalCERTS,-Inc. 2008 Residential Compliance Forms` March 2010 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 ycompletely 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. r ® 1. Measured leakage less than 15% of fan flow 0 2. Measured leakage to outside less than 10% of Fan Flow 0 3. Reduce leakage by 60% and conduct smoke and fix all leaks 4: Fix all accessible leaks using smoke and HERS rater verify, " Note: (One of Options -1, 2 or 3 must be attempted before utilizing Option 4.) i Determine nominal Fan Flow using one of thegfollowiing three calculation,methods. ~ ✓ ® Cooling+system method: Size df condenser m Tons S ► x 400 _ 2000NCF,M y ✓ ❑ Heatingsystemmethod :21.7 x II Output Capacity in T.h"ousands of;Btu/hr = CFM i R � ✓ � .� �+` �� ❑ Measured system airflow using RA,3.3 airflow test procedures: • CFM Option ,,mused then 'c f j ru.?y'y, , �, "` ` ' ; , . r, V'4 1 Alloweiiaeakage' •Fan Airflowfr"2000• x,_0.15„=-- 300 CFM.»*.400 Y Actual Leakage = 295 CFM , k Pass if Actual Leakage is less than'Allowed leakage Pass Fail Option 2 used then: 2 Allowed leakage = Fan Airflow _ x 0.10.= _ CFM ' Actual Leakage to outside = CFM Pass if Actual leakage to outside is less than Allowed leakage Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM , Final leakage after sealing all accessible, leaks using smoke test = CFM - 3 Initial leakage _ -'Final leakage _ = Leakage.reduction _ CFM ((Leakage reduction _/ Initial leakage___) x 1000% _ % Reduction. Pass if % Reduction >= 60% Pass b Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke Pass ❑ Fail Reg:,212-A0061271A-M2100001A-0000 Registration Date/Time: 2012/11/27-20:29:38 HERS•Provider: CalCERTS, Inc. 2008 Residential Compliance Forms r „, March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 2,of 2) ,Site Address: Enforcement Agency:. Permit Number: 79425 STONEGATE , La Quinta CA 92253 (System 1) City of La Quinta . 12-1306 - • . M ? ` 1 ® 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. } ® All supply and return register boots .musttbetsealed„to the drywall if smoke test is utilized..,for compliance f ' - applies to -'duct leakage compliance option 3�(leakage reduction by:60%)rand optlon�4 (fix all accessible _ • .leaks) described above�e• ”. l � '�'- ® New duct installations cannotl'utlllzelbuilding cavities as plenums or•platform returns in lieu5of.ducts_ ® Mastic and dra'w�:bands must be sed "Inicombination,wit cloth backed rlabber�adhesiv duct tape to seal leaks at all 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 i additional checking/testing of other installations in that HERS sample group will be performed at my expense. , • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder • •� provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. ' Company Name:, (Installing Subcontractor or General Contractor or.Builder/Owner) s HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia • bonielle Garcia CSLB License: _ 7777111/2/2012 Date Signed: Position With Company. (Title): 686310 . Is this installation. monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No - A, Reg: 212-A0061271A-M2100001A-0000 Registration'Date/Time: 2012/11/27 20:29:38 HERS Provider:,CalCERTS, Inc. ,2008 Residential Compliance Forms March 2010 . Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and SIMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented fo; 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 I • 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 ® 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 1 and 2 is a pass. Enter Pass or Faill ✓ ® Pass ✓ ❑Fail i STMS - Sensor on the Evaporator Coil�� System Narne of Identification/Ta ' S 'stem i f.. 3 fThe ❑ Yes O wo :'f f sensor is factory installed, or field installed according to manufacturer's specifications, or isfinstalled by methods/specifications approved by the Executive ` Director. €'. ❑ Yes �Ye� 4e , f' p Noir ,• The sensor wire is terminated with a standard mini lu suitable for connection`to a4 digitali'thermometer. The-- _sensor mini plug is,.aecess ble to the.installingrtechoicienr and the HERS•ratertiwifhout changing the airflow through the"condenser coil- .5 ❑ Yes ❑ No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F rYesto. 3, 4, and 5 is a"pass. Enter N/A if STMS are not 71�. plicble: Otherwise enter Pass or Fail ®N/A ✓ ❑ Pass ✓❑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 ❑•Yes [3 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 [3 Yes [3 No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ ®N/A ✓ ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail 2uuu xesiaentiai Compliance Forms August 2009 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) c Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential , Appendix RA3.2. As man as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional forms for PP Y Y 9 p 9 O any additional systems in the dwelling as applicable. c ; • • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. If outdoor air'dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure.. Space Conditioning Systems ° System Name or Identification/Tag System 1. (must be recalibrated monthly)' ' , 11-1-12 - �. t System Location or Area Served Whole House ttr:. wm.. ' •?' Outdoor Unit Serial # 5812EO4576 t ^ Outdoor Unit Make Lennox ' Outdoor Unit Model XC21-060 - Nominal Cooling Capacity Btu/hr 60000 Date of Verification 11=2-12 ` , canoration or uiagnostic instruments - Date of Refrigerant Gauge Calibration 11-i-12 (must be recalibrated monthly)' ' J Date of Thermocouple Calibration77 11-1-12 - �. t (must be re -calibrated month) 0 t�: -1 tit Y) Measured Temperatures�(OF) I / .1 L, swf fir= lr-4 -,-,_,., .t i.>- - -`- 1%�,. - A � t �. �+ "" System Name or Identification/Tag-? g. System l" �. �+ "" ( -91 1 a`'. j F...aFJ f lJf' �i `a J�{ / z ttr:. wm.. ' •?' Supply (evaporator leaving),air,dryw�." [ r. °bulb q _--^� n. . �«�. 4tX49 temperature (Tsupply, db) Return (evaporator entering) air dry-bulb 69 temperature (Treturn, db) Return (evaporator entering) air wet -bulb 54 temperature (Treturn, wb) . Evaporator saturation temperature '30 (Tevaporator, sat) Condensor saturation temperature 78 (Tcondensor, sat) Suction line temperature (Tsuction) 47 Liquid Line Temperature (Tliquid) 75 Condenser (entering) air dry-bulb 70 temperature (Tcondenser, db) s .v .. t. • it t+ _ - Reg: 212-A0061271A-M2500001A-0000 Registration Date/Time: 2012/11/27 20:31:4.7 HERS Provider: CalCERTS, Inc. r 2008 Residential Compliance Forms August 2009 t INSTALLATION CERTIFICATE CF-611-MECH-25-HERS Refrigerant Charge Verification'- Standard Measurement, Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 79425 STONEGATE , La Quinta CA 92253 City of La Quinta 12-1306 Minimum Airflow Reauirement 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 - su I db t Target Temperature Split from Table RA3.2-3 20 using Treturn, wb,and Treturn, db i' �+ Calculate difference: Actual Temperature Split - 0 Target Temperature Split = , Passes if difference is between -3°F and +3°F or, t upon remeasurement, if between -3°F and PASS' -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. r Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Namedent fication Ta � Sys t m :1:- _1 Calculated Minimum Airflow Requirement (CFM) Measured,Airflowausing RA3.3 procedures (CFM.)- j Passes if measured airflow is greater than or equal to the calculated minimum airflow - requirement:;: r Enter Pass or Fail t , for fixed orifice metering device systems System Name or Identification/Tag 4 Calculate: Actual Superheat = 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 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db �+ Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -5°F and t +5°F Enter Pass or Fail ". Y r � Reg: 212-A0061271A-M2500001A-0000 Registration Date/Time: 2012/11/27 20:31:47 HERS Provider: Ca10ERTS, Inc., 2008 Residential Compliance Forms r August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant ChargeVerification -,Standard Measurement Procedure '(Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 79425 STONEGATE , La Quinta CA 92253 City of La Quinta • t 12-1306 ._ 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 w Calculate: Actual Subcooling = 3.0 Tcoridenser; sat - Tliquid Target Subcooling specified by manufacturer 3' Calculate difference: , .. 0 Actual Subcooling - Target Subcooling = passes if difference is between jf� PASS Est d +30F PASS ' Enter Pass or Fail Vii: $ i. #~. 1 gyp,e gy; r /gyp •• ` _ ' ''4�!" R.+.J'� l!€ ��3«.?c!� T+n; - .,'.�.'z.'t � � r ' . �At3fT� ""•ll--"'���... ,.",'?�,,,- "S .: r,� -. _ * '` p a• ..' `• M - ' ....:gill'', ,. Reg:.212-A0061271A-M2500001A-0000 Registration Date/Time: 2012/11/27 20:31:47 HERS,Provider:-CalCERTS,.Inc. }r 2008 Residential Compliance Forms August 2009,'= 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 = 17.0 suction -,evaporator, sat Enter allowable superheat range from ! manufacturer's specifications (or use range 4-25 between 4°F and 25°F if, manufacturer's specification is not available) - System passes,.if actu,al'superheat is-withinwthe �,�% allowable superheat ` h1 w ,range �"�� �f" jf� PASS • � �%'') �,g,Enter Pass or Fail Vii: $ i. #~. 1 gyp,e gy; r /gyp •• ` _ ' ''4�!" R.+.J'� l!€ ��3«.?c!� T+n; - .,'.�.'z.'t � � r ' . �At3fT� ""•ll--"'���... ,.",'?�,,,- "S .: r,� -. _ * '` p a• ..' `• M - ' ....:gill'', ,. Reg:.212-A0061271A-M2500001A-0000 Registration Date/Time: 2012/11/27 20:31:47 HERS,Provider:-CalCERTS,.Inc. }r 2008 Residential Compliance Forms August 2009,'= 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 = 17.0 suction -,evaporator, sat Enter allowable superheat range from ! manufacturer's specifications (or use range 4-25 between 4°F and 25°F if, manufacturer's specification is not available) - System passes,.if actu,al'superheat is-withinwthe �,�% allowable superheat ` h1 w Vii: $ i. #~. 1 gyp,e gy; r /gyp •• ` _ ' ''4�!" R.+.J'� l!€ ��3«.?c!� T+n; - .,'.�.'z.'t � � r ' . �At3fT� ""•ll--"'���... ,.",'?�,,,- "S .: r,� -. _ * '` p a• ..' `• M - ' ....:gill'', ,. Reg:.212-A0061271A-M2500001A-0000 Registration Date/Time: 2012/11/27 20:31:47 HERS,Provider:-CalCERTS,.Inc. }r 2008 Residential Compliance Forms August 2009,'= 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 = 17.0 suction -,evaporator, sat Enter allowable superheat range from ! manufacturer's specifications (or use range 4-25 between 4°F and 25°F if, manufacturer's specification is not available) - System passes,.if actu,al'superheat is-withinwthe �,�% allowable superheat INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure 4 (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 79425 STONEGATE , La Quinta CA 92253 1,City'of La Quinta 12-1306 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: T11/2/2012 Position With Company (Title): System meets all refrigerant charge and airflow s Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): requirements. PASS , Enter Pass or Fail v ' t. � ri�,. r f< <�s�. ~' 'fir .';. :y • , , � . 4� •.Z._ S'%.'� -� .._e iR+.t,_ .. n.�;F+ 8. •T' �Y . rt1�'^'{-_� I+w 4 DECLARATION STATEMENT • I certify under penalty of perjury, under -the laws of the State of California,. the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). o • 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 registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. ; M' Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) s HARRISON ENTERPRISES INC - Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: ' Date Signed: T11/2/2012 Position With Company (Title): 686310 s Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control, Program (TPQCP)? . [I Yes [3 No t % , Reg: 212-A0061271A-M2500001A-0000 Registration Date/Time: 2012/11/27 20:31:47 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 s 'dNERAL 0 f - Dear Homeowner, We want to thank you again for your patronage and loyalty to our company. It=is-now-time-to-schedule-an Air Conditioning inspection,with,your City: Itis- mp artt tohave,this:done`as-soon-as-possible-to.gefhthe permits , a 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 hone numbers.f r ' _ P o your city. please -1 contact them in: order -to schedule our ins ection. - it + In addition, please find below the type of equipment we installed at your residence. t' ° i ❑ Roof -top Package Unit/Condenser* ❑ Water Heater,. ;t ❑ Split System U flow ,P Y P O C►ther: • ❑ Split System horizontal or upflow in the attic* *.Requires ladder . When the inspector arrive"s, 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 you require 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) 343-7488if you'have any questions.. - Sincerely, The General's Sales Department Enclosed: Copies of form CF -4R for your.records. Please give the Inspection Card (and CF forms, if so requested) to the city inspector. ° To schedule vour inspection Please call• city o` quip ;jQ60)„ 7�-7op�; -- Y _ 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 Hot Springs: (760) 329-6411 X244 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� HVAC Field Data Sheet PgIof2 i Client Name a -Z S l �� � S job # �( Date , Address �c'I �- 5" �a1.1— CEJ - L�o���..� c � RPh it c1 Tecunician(s) SU`P�\^Z Permit # d Gauge/Themxmuple Calibration Date LLAjjkLfadcW Some Ducts Only ( AB Ducts Only (Code 4w of www) ME q p4 , .Data ZONE 1 XONE2 ZOJAWW ZONE4 System Location or Area Served 91 G ti Heating Equipment Make Lct3�3 r) Heating Equipment Model S L v t� e 'o IA ARI Reference Number 5� C�8 Heating EquipmentAFUE Duct Location (attic,.crawlspace, etr-) Duct R Value (if ducts were Installed) Heating Load 00a Heating Equipment Output Capacity 00 Condenser Make Lt`biL Condenser Model t� Eo - Size in Tons SEER & EER Cooling Load CoolingCapadty'Me w-ZO&21 Duct TWtlnig Dud leakage pretest result Dost imloge Renal Result QACF Vt=W pass 16%) FIFA PMIFA Dud I.eatage FiWA Pewit <60 CIWt=bopaw (x996) S 0�5I" Paw1w Pass using 60% leakage reduction? P=te >�� Pawl Pass using smoke and visual inspection? MECll22. or.1 CHZ5 'C pbft COAb*w& Pan.iVatEDnaw . Measured Air Volume from Flow Grid or Hood NEW DUCTS Tarte 3so CFM/ton a CondowerTons CHAN(3:OM Targt 300 GU/ton x condenser Tons Measured air greater than Target? (Y/N) Measured Fan Watt Draw Target 058 watts/measured CFM = Measured Watts less than Target? (Y/l� CopyrW @ 2KI EDS E=W DrW= Solflons, b= HVAC Field Data Sheet Pg 2 of 2 Client Name Job # Date Mrar ZS CftaWe & A&f(ow ZONE 1 ZONB2 ZONE 3 ZONE 4 Condenser Serial Number �S Supply air dry bulb temperature Return air dry bulb temperature Return air wet bulb temperature Evaporator Saturation Temperature Condenser Saturation Temperature Suction line Temperature rl Liquid Line Temperature Suction Pressure Liquid Pressure Actual Airflow Temperature Split Target Temperature Split from Table RA32-3 Passes tf dftreace is* T ofTargetTemP (YIN) Actual Subcooling (t C of Target to pass) Target Subcooling from Mit. Actual Superheat (3 to 26' to pass) Outside air dry bulb temperature �( MEC996•'Wefgh-fn Qi&WhW belowW W. �{ Actual Line Set length (R) M&s Standard line Set Length (ii) Length Difference= Correction Factor (ounces per foot) Target Correction Factor a Length Difference system charged to Target? (YM odmrDaw Minimum amps -34, Maximum amps 50 Breaker size 5-0 Compressor amps gc Return Static Pressure Supply Static Pressure Supply Air Wet Bulb Temperature �• ALL APPLICABLE DOW ON TRfSFORK MUST BECOMPLEM FOR E4af f0R NOEKUMONS, +' topyrW 0 2011 EDS EnaV Div® SchdIO r. hm r 7 .. . • UtNT City of p01, nom Department of Building and Safety Phone: (760) 346-0611 www.citvofoalmdesert.org SMOKE AND. CARBON MONOXIDE ALARM RETROFIT VERIFICATION and I, / (Print.Property Owner's Name) (Tenant's Name - if same as Owner write "Same") who own and/or live in the dwelling located at: , ' n `k4:5 1 C� R L� ,$�� �� LP • i (Address) verify that the smoke and carbon monoxide alarms required by the California Residential Code.(CRC) have been installed in the dwelling, incompliance with the code and with the manufacturer's instructions and further that they have been tested and do function properly. In an effort to enhance. life safety within dwellings, CRC Section R314.6, R315.2 and CBC 420.4 require the retrofit of these alarms in. existing dwellings when alterations, repairs or additions requiring a permit and exceeding $1,000 in value are made. Generally, the alarms must be hard wired (110 volt) with battery back-up and all alarms are to be interconnected. If the installation of the alarms will require the removal. of wall or ceiling finishes or there is no access by means of attic, basement or crawl space, then alarms may be'solely battery operated and not. interconnected. Alarms must be installed -in all of the following locations within the existing dwelling: ➢ .In all bedrooms (only require Smoke Alarms) „ ➢ Immediately outside of each separate bedroom. (require Smoke and Carbon Monoxide Alarms) ➢ In each story level of the dwelling, including basements and habitable attic rooms (require Smoke and Carbon Monoxide. Alarms) These safety devices must be installed by the time a final inspection is requested for your project. I understand the above requirements and certify that we now have smoke --alarms *and carbon monoxide alarms installed that complly. We agree to comply with the CRC in regards to. smoke alarms, carbon r--- / Owner Date Signature of Tenant . Date . ATTENTION OWNER - OCCUPANT: This is a Voluntary Smoke and.Carbon Monoxide Alarm verification procedure, lf.you prefer a Building Inspector to perform the verification, you must arrange to have an adult present at the time of inspection. NOTE: This Verification is only used when. normal access to the interior of the dwelling by the City of Palm Desert Building Inspector is not achieved during the course of project construction.. It is normally used for projects such as re -roofing, re -siding, patio covers, swimming pools and the like. IA -P CITY OF -PALM -GE Building & Safety Department 73510 Fred Waring Drive Palm Desert, CA 92260 Phone: (760) 776-6420 Fax: (760) 776-6392 www.cityofpalmdesert.com SMOKE AND CARBON MONOXIDE ALARM RETROFIT New State Building Code Requirement effective January 1, 2011 2010 California Residential Code sections R314.2 and R315.2 2010 California Building Code Section 420.4 Where a permit is required for alterations, repairs or additions exceeding $1000, in- cluding exterior work, l.e. roofing, HVAC change -outs, electrical panel upgrades, windows, etc. existing dwelling or sleeping units that have attached garages or fuel burning appliances including fireplaces shall be providelwith a carbon monoxide alarm. Smoke and Carbon monoxide alarms shall be installed in the following locations: • In all bedrooms (only require -Sm, oke Alarms unless bedrooms contain a gas appli- ance then a carbon monoxide alarm is required as well) • Immediately outside of each separate bedroom. (require Smoke and Carbon Mon- oxide Alarms) • . In each story level of the dwelling, including basements and habitable attic rooms (require Smoke and Carbon Monoxide Alarms) Power supply. The carbon monoxide alarms shall receive their primary power from the building wiring and shall be equipped with a battery back-up. Exception: In existing dwelling units the alarms are permitted to be solely bat- tery operated where repairs or alteration do not result in the removal or wall and ceiling finishes or there is no access by means of attic basement or crawl space. Interconnection. Where more than one carbon monoxide alarm is required to be installed within the dwelling unit or within a sleeping unit the alarm shall be interconnected in a manner that activation of one alarm shall activate all of the alarms. Exception: Interconnection is not required in existing dwelling units where re- pairs do not result in the removal of wall and.ceiling finishes, there is no ac- cess by means of attic, basement or crawl space. The Building Inspector will verify the installation of the smoke and carbon mon- oxide alarms during the inspection process or complete and sign.under the pen- alty of perjury the "Smoke and Carbon Monoxide Alarm Retrofit Verification"