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11-0424 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ht 4 4 Q" Application Number: 11-00000424 Property Address: 79175 KARA CT APN: 604-313-016-32 -26188 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 6295 Applicant: LJ Architect or Engineer: Pla ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury thatI am li ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and P �fessionals Code, and my License is in full force and effect. Licen lass: C20 License No.: 686310 ate: A1,81tractor: 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 hundred dollars ($500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the. - ' improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 1 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: ' Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/28/11 Owner: BILL DODDS 79175 KARA COURT LA QUINTA, CA 92253 0� {� 1 Contractor: [:P GENERAL AIR CONDITIO IN CITY OF !_A 1UNTA 31170 RESERVE DRIVE THOUSAND PALMS, CA 9 2-Te3'�' (760)343-7488 . Lic. No.: 686310 ----------------------------------------------- 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 EVEREST NATL Policy Number 7600006147101 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to be me subject to the workers' compensation laws of California, and agree that, if I should beco ubject to the the compensation provisions of Section ��., 33700 of the Labor Code, 1 shall hwith comply with those provisions. - ate: 44 plicant: WARNING: FAI URE TO SECURE WORKV40MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City' of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above in ation is correct. I agree to comply with all city and county ordinances and state laws relating to building cons ction, and hereby authorize representatives of this county to enter upon the above-mentioned property for ins (ion purposes. ,A�ate:4 2$ 1 1 S' ature (Applicant or Agent): Application Number . . . . . 11-00000424 Permit . . . MECHANICAL Additional desc . .Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/25/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 ---------------------------------------------------------------------------- Special Notes and Comments INSTALL NEW FURNACE AND CONDENSING UNIT, 13 SEER. 2010 CODES. -------------------------------------------------------------------7-------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged -------------------- Paid Credited -------------------- Due ----------------- Permit Fee Total 40.50 .00 .00 40.50 Plan Check Total 10.13 .00 .00 10.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total 51.63 .00 .00 51.63 LQPERMIT c nen ?y City of La Quinta . Building 8L Safety Division Permit # ' 1 P.O. Box 1504, 78-495 Calle Tampico Il, a La Qulnta, CA 92253 - (760) 777-7012 Building Perm- it Application and. Tracking Sheet Project Address: Owner's Name: �rS A. P. Number: Address:( •- %J Legal Description: Gig. City, ST, Zip: Contractor: Telephone: ::::,;•>:,:> nMfV.<Jyy;;{} Y\i{S {: Address: 3 Project Description: City, ST, Zip:'— Telephone: .v:w rti ^Y:•.. ref.:.:'.:} Y}:ri:Yz :�� j'ii t r v\• r i-: <,.;t :;«>:.:>.>.»>.:•:. •,..::. r::. •:>.•:>:: State Lic. #: 3 City Lie. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone. ;:•�:w:.:;•>Y::;,y# s 4µ•: • rvz<s<< ;<:«r •Y.:;:vh Y� Construction Type: Occupancy: State Lic. #:;. ,•.;.<::::<..;,:::> y�„•:;:,i,rr: 'gi'''n.>.'>• -v v%w Project type (circle one): New Add'n After Repair Demo Name of Contact•Person: Sq. Ft.: #. Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO. NOT WRITE. BELOW THIS LINE # Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Title 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"d 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 School Fees Total Permit Fees _Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 I Site Address: Enfor ement A ttcy:_ Date •Permit 4: Conditioned Floor. Equipment T e� List Minimum Efficienc Z Duct insolation requirement Area Thermostat ❑ Packaged Unit Over 40 ft of ducts added or urnace ❑ AFUE 80 �o ❑COPSetback replaced in unconditioned space Served by system (/ nor alrend ❑ door Coil ❑SEER ! 3 ❑ HSPF — I y Condensing Unit l7 EER / / ❑ Resistance ❑ R 6 (CZ 10-13) sfpres•ent, nisi be C3 Other 11R 8 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment being installed: if more than one system, use another CF -1 R-SILT-HVACfor each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%,4FUE, 7.7HSPF for h!pical 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 mast 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 SianpA Rpainnina ()rtnhor t 'Min ..e.L- n, - _ I. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH- 21 and fors lits stems) MECH-25 • Condenser Coil and /or • Indoor Coil and/or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Furnace CF -4R forms: MECH- 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: ❑ I. 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 ❑ 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS ducts: (all new ducting and all CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 Dewe ui ment) 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 Replacement Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF -4R forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all equipment changed. For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH For Packa ed Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: • Includes adding replacing more than linear feet ofduct in unconditioned space. CF -6R forms: MECH-04, MECH-2I -HERS CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts stems 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 I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the onn tion documented on other �pplic ompliance forms, worksheets, calculations, plans and specifications submitted to the enforcement a enc fora to al with t e perinit application. Name: Co I �ee'1 u(%Q_�-,s 6V1 Sig ture: Company. - p y. 67&il —(aJ 41 r GoKd! �e`OH t` Date: _ Address:) 317 %< 0 ,aSet'U2 License: l08�o3/b City/State/Zip:—r�� � Phone: 760-33-7'�ff� CaICERTS - CF -1R Registration Hnme hbouc (Js 'C'rniniag Racer Ai rrcrory• Farms Menibmhip Haw its Events 14td'awy Partners News To register for our Monthly newsletter, please click here. httns://www_cal Page 1 of 1 ('�Cf�fiiq;£�?t'er�zrt:.�Tvz►ae Fi�efgy.l��fing,��'rou� 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. Site Address: 79175 KARA COURT La Quinta, CA 92253 CEC Registration: 211-A0020609A-00000000-0000 CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD Assigned Company: IHARRISON ENTERPRISES INC Do you know your HERS Rater? If you do, you may want to send this CF -1 R to them CaICERTS Rater ID: OR My Rater Quick Select:. The Energuy CA LLC_ _ Every CaICERTS rater has a license number. /f you need to find the rater by name [Click HERE] to search our directory. SEND CF -1 R TO HERS RATER [CLICK HERE] to do another Copyright S• '_010 CaICERTS, Inc.. All rights reserved. Revised: Januar 11, ^_010 [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-R8R, (877-437-7787) Fax: 916-985-3402 Contact Us IMF] 4 -o- BBB ` Pind us on FacebookIQ® u ,: rh-.t C I CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: I Enforcement Agenc711-0424 Permit Number: 79175 KARA COURT, La Quinta CA 92253 (System 1) City of La Quinta Enter the Duct System Name or Identification/Tag: Enter the Duct System Location or Area Served: Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing 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 Note:,(One of Options 1, 2, or 3 must be attempted before utilizing Option 4.) Determine nominal rFan,Flow using one of the :followi ng,th ree; calculation methods. ✓ ❑ Cooling system method: Size of condenser in Tons x 400 a k 21.7 ✓ ❑ Heating system method: x( Output Capacity injAusandt of Btu/hr = _CFM CC ,ff��,� y �r ✓❑ Measured systemrairflo using RA3.3 airflow,�testiprocedures: / CFM f Optionj, used then`. i 't`' �• , '- �/ .: ^, L. `� G. t-a�.J. 1 Allowed leakage = Fan Flow _ x 0.15 = _ CFM Actual Leakage = _ CFM 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 Ej Pass n 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. HERS rater must verify (No sampling). No smoke allowed to leak from system. Including ducts, plenums, air handler and door panel. Pass if all accessible leaks have been repaired using smoke ❑ Pass Lj Fail r� • Reg: 211-A0020609A-M2100001A-M21A Registration Date/Time: 2011/06/17 15:41:00 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 79175 KARA COURT, La Quinta CA 92253 (System 1) City of La Quinta 11-0424 ❑ 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. O All supply.andareturn register boots,mustTbeysealed-toxthe dry 6wall :if,smoke!test,is,utilized for compliance - appliesto/duct leakage complianceioption 3 i(leakage reduction -by 60%)`andloptionf4 (ffx alhaccessible leaks described above.'/ fjJ �. ❑ New duct installations cannot utilize building cavities as plenums or platform, returns in:lieu of ducts: ❑ Mastic and.clra.w bands,must be used,in•combination:with'cloth backed�rtjbber�adhesivetduVl apesto seal O leaks at all new duct connections 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 -111) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) 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): 221680 ❑ tested/verified dwelling R not-tested/verified dwelling in a HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798557150 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Patrick Thomas Patrick Thomas Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/1/2011 CC2005746. Reg: 211-A0020609A-M2100001A-M21A Registration Date/Time: 2011/06/17 15:41:00 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 79175 KARA COURT, La Quinta CA 92253 City of La Quinta 11-0424 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 r /*/r` 14' 1 ] j i /F r System Location or Area Served / ❑Yes 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 E] Yes ❑ No 4 and 6labeledng to Figure in Section RA3 2mm) ccess hole downstream of a2 evaporative coil in the supply plenum Yes to -Land 2 is a pass. Enter Pass or Faill ✓ ❑ Pass ✓ ❑Fail .. I STMS '= Sensor.on�the, Evaporator Coil System Name or Identification/Tag 7 r /*/r` 14' 1 ] j i /F r 3 / ❑Yes y, p -No / The sensor is factory installed, orjfield installed according to manufacturer's specifications, or is'installed by m+ethods/specifications approved liy the Executive Director. 1 It ` 4 p.Yes: j � 97 , ..f p,No The sensor rwife is terminated with a standard mini plug suitable for connection al, digital the`rmomker..Thesensor.mini plug°is accessible to theJnstalling;technician Director. and the HERS rater without changing the airflow through the condenser coil 5 ❑Yes - -- Elyes El No When attached to a digital thermometer, the sensor provides an indication of the temperature of the coil. s to 3, 4, and 5 is a pass. Enter N/A if STMS are not [applicable.Otherwise enter Pass or Fail ✓ ❑ N/A ✓ El Pass ✓ EI Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag 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 C] 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 ✓ L-] Pass ✓ E) Fail applicable. Otherwise enter Pass or Fail 101 Reg: 211-A0020609A-M2500001A-M25A Registration Date/Time: 2011/06/17 15:41:20 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-2E Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5; Site Address: Enforcement Agency: Permit Number: 79175 KARA COURT, La Quinta CA 92253 -7City of La Quinta 11-0424 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 Conditioninq Svstems System Name or Identification/Tag (must be re -calibrated monthly) Date ofermocouplejCalibration � J r. 1 �. d System Location or Area Served Outdoor Unit Serial # -- Outdoor Unit Make Outdoor Unit Model Nominal Cooling Capacity Btu/hr Date of Verification %.allorailon or ulagnosxic lnsirumenis Date of Refrigerant Gauge Calibration (must be re -calibrated monthly) Date ofermocouplejCalibration � J r. 1 �. d r r must be'ricalibrated monthly) r,eaSureu l emoeraLures•l r-) 1 1 1 1 - 1 i S. 1 \ i� k tf' � F System Name or Identifications g� ll r ,+'F 01/ t uta Supply (evaporator leaving)'air dry -bulb` -- temperature (Tsupply, db) Return (evaporator entering) air dry-bulb temperature (Treturn, db) Return (evaporator entering) air wet -bulb temperature (Treturn, wb) f Evaporator saturation temperature (Tevaporator, sat) Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db) J Reg: 211-A0020609A-M2500001A-M25A Registration Date/Time: 2011/06/17 15:41:20 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: 79175 KARA COURT, La Quinta CA 92253 1 City of La Quinta 11-0424 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 - 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 (dm/ton) System :Namef(rld nene tification/Tagv 7.- /r r r Calculate Minimum Airflow,RequirLement (CFM) Measured Airflow using RA;3.3 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 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 +6°F Enter Pass or Fail Im Reg: 211-A0020609A-M2500001A-M25A Registration Date/Time: 2011/06/17 15:41:20 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of S) Site Address: Enforcement Agency: Permit Number: 79175 KARA COURT, La Quinta CA 92253 City of La Quinta 11-0424 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 V u- JiTA -4°F and +4°F f , y, ij 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 Calculate: Actual Superheat = Tsuction - Tevaporator, sat ±. Enter allowable superheat range from manufacturer's specifications (or use range between 3°F and 26°F if manufacturer's specification is not available) '� V u- JiTA System` passes -if actual superheat it within1he allowablsuperheat range� f , y, ij t Enter, ass or Fail 4 Reg: 211-A0020609A-M2500001A-M25A Registration Date/Time: 2011/06/17 15:41:20 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: 79175 KARA COURT, La Quinta CA 92253 -7 City of La Quinta 11-0424 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 Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 221680 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 Patrick Thomas Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/1/2011 CC2005746 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 -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 -111) 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): 221680 ❑ tested/verified dwelling not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798557150 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Patrick Thomas Patrick Thomas Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/1/2011 CC2005746 Reg: 211-A0020609A-M2500001A-M25A Registration Date/Time: 2011/06/17 15:41:20 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 79175 KARA COURT, La Quinta CA 92253 (System 1) 1 City of La Quinta 11-0424 Space Conditioning Systems Heatina Eauipment Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (A.FUE, 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 LENNOC .�' " 3722780�� 1 14.5 SEER j 12 EER,,"y Attic R-4.2 f 60' *7 5 Tons 1 y _ rit i ,t t moi. cooling cquipmenc Equip Type (package 4: heat pump) ' CEC.Certified Mfr. Name and Model Number, ARI Reference Number2 # of Identical Systems Efficiency (SEER and EER) 1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Cooling Load (kBtu/hr) Cooling Capacity (kBtu/hr) Split A/C14ACX:-0100-230-12 LENNOC .�' " 3722780�� 1 14.5 SEER j 12 EER,,"y x4Atticf, ;-R=4:2y^ f f 60' *7 5 Tons 1 y _ rit i ,t t moi. i A. a NtuJcLa tD new LU/IbLfULLlufl, see ruucnuces cu >cdnUdrus taote 1.D1 -v ana ,ao/e 1-51-L roroucrtellingai ernative compliance. ' 2. ARI Reference Number can be found by entering the equipment model number at http://www. aridirectory. org/ari/ac. php # 3. Listed efficiency on this page must be greater than or equal ( ?) to the value shown on the CF -1R form. 4. When CF -1R is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM 0 §110-§113: HVAC equipment is certified by the California Energy Commission. §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. 2 §150(1): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 0 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. R Reg: 211-A0020609A-M0400001A-0000 Registration Date/Time: 2011/05/11 12:09:22 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency:711-0424 Permit Number: 79175 KARA COURT, La Quinta CA 92253 (System 1) City of La Quinta Ducts and Fans §150(m): Duct and Fans 0 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 0 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the d u cts. . 0 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. 2 7. Exhaust fan systems have back draft or automatic dampers. © 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. 2 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: C 10. Flexible ducts cannot have porous inner cores. DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance (CF -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 Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 4/30/2011 Position With Company (Title): Reg: 211-A0020609A-M0400001A-0000 Registration Date/Time: 2011/05/11 12:09:22 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 79175 KARA COURT, La Quinta CA 92253 (System 1) 1 City of La Quinta 11-0424 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 1welling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow ❑ 3. Reduce leakage by 60% and conduct smoke and fix all leaks ❑ 4. -Fix all accessible leaks using smoke and HERS rater verify Note:jOne of Options 1, 2 or 3 must be attempted before utilizing Option 4.) Determine nominallFan Flow using one of.the,following,three,calculation.methods. ✓ Cooling system method: Size of condenser in Tons5.�400— 2000 \CFM ✓ El Heating system methgtl't�1.7 x Output Capacity in Thousands of.Btu/hr = CFM �. r ✓ , ElMeasured systema' irtlo ,fusing RA3.3 airflow Aestiprocedures: CFM JI } I Option f used then:' f ( ^• :' '-, .�j ,, 1`' - , � •7 �-� , ti\,�r 1 Allowed'leakage Fan Airflow 2000 x 0.15 = 300 CFM ++. Actual Leakage = • 190 CFM 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 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: 211-A0020609A-M2100001A-0000 Registration Date/Time: 2011/05/11 12:09:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms 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: 79175 KARA COURT, La Quinta CA 92253 (System 1) City of La Quinta 11-0424 R 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. 1 © All supply andareturn register boots,musttbe,sealed.to-the drywall.•if.smoke,test is-utilizedxfor.compliance — applies 6o 46ct leakage compl'ia a option 3'(leakage reduction by`60%)%andl+option1,4 (fix all accessible leaks) described above. ,+¢1 { R New duct installations cax nnolutiJlize buildingcavitie as plenums or platform returns inl�lieuof ducts: i _d l. 1 ,�� ,gip_ i �t 0 Mastic and,drawi;bands must,be us6d,inacombination,with, cloth backed,rubber,adhesive,ductitape",seal { leaks:at all new duct connections" 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 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) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 4/30/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 211-A002060.9A-M2100001A-0000 Registration Date/Time: 2011/05/11 12:09:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms 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: 79175 KARA COURT, La Quinta CA 92253 1 City of La Quinta 11-0424 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 Suoolv and Return Plenums of Air Handler System Name or Identification/Tag System i System Location or Area Served Whole House 1 0 Yes ❑ No 1. 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 0 Yes ❑ No t , 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 land 2 is a pass. I . Enter Pass or Faill ✓ 2 Pass ✓ ❑Fail STMS4- Sensor on.,the Evaporator Coil System'Name.or Identification/Tag') eeSystem 1 I ' f ` 'j lr ! Y ( 1P 3 1 ❑ Yes p_No "of. �1 ; i The sensor is factory installed, orifield installed according to manufacturer's specifications, or is installed by methods/specificat'ions approved by the Executive Director. I V `, ,,t ON 4 0 Yes .`QED No � V ` The sensor o }wire is terminated with a standard mini plug suitable for connection to f digital thermometer. The sensor.mini plug is accessible to the.installing te'chnicia`n and the HERS rater without changing the airflow through the condense coil` 5 ❑Yes ❑ No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3, 4; and 5 is a'pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail 0 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 ❑ 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 8Y es ❑ 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 ✓ 0 N/A ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail J, M Reg: 211-A0020609A-M2500001A-0000 Registration Date/Time: 2011/06/02 14:57:23 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) Site Address: Enforcement Agency: Permit Number: 79175 KARA COURT, La Quinta CA 92253 1 City of La Quinta 11-0424 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 System Name or Identification/Tag System 1 (must be re -calibrated monthly) Date of The irnocoupWCalibration ,r'', 4/1111 �j v System Location or Area Served Whole House Outdoor Unit Serial # 1911C01523 - `- '"r_ - _' '••= -� <- "V u Outdoor Unit Make LENNOX Outdoor Unit Model 14ACX-0100-230-12 Nominal Cooling Capacity Btu/hr 58000 Date of Verification 4/30/11 7- Laimration OT uiaonostic instruments Date'of Refrigerant Gauge Calibration 4/1/11 (must be re -calibrated monthly) Date of The irnocoupWCalibration ,r'', 4/1111 �j v (must be re -calibrated monthly) mea urea ) emperatures;u r) 1 ! I I ---'T 7 --F I X ! ► i/ d r l'/ System Name or Identification/Tag, r � System 1 f y p Supply (eJapoCtor leaving) -air dry-bulb ` +.r - - ---f u 49.5 - `- '"r_ - _' '••= -� <- "V u temperature (T supply, db) Return (evaporator entering) air dry-bulb 70.3 temperature (Treturn, db) Return (evaporator entering) air wet -bulb 48.9 temperature (T return, wb) - , Evaporator saturation temperature 42 (Tevaporator, sat) Condensor saturation temperature 93 (Tcondensor, sat) Suction line temperature (Tsuction) 60 Liquid Line Temperature (Tliquid) 86 Condenser (entering) air dry-bulb temperature (Tcondenser, db) .6 Reg: 211-A0020609A-M2500001A-0000 Registration Date/Time: 2011/06/02 14:57:23 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2S-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of S) Site Address: Enforcement Agency: Permit Number: 79175 KARA COURT, La Quinta CA 92253 1 City of La Quinta 11-0424 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, 20,8 db - Tsupply, db Target Temperature Split from Table RA3.2-3 20.9 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - -0.1 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 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 (dm/ton) v Y System Id n fication a77 9 /;" System I 1 . Calculated Minimum Airflow Requirement (CFM) I / I '#_ ,/ I I I l Measured,Airflow.using RA3.3 procedu es (CFM) Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement: l l Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag System 1 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail 20 Reg: 211-A0020609A-M2500001A-0000 Registration Date/Time: 2011/06/02 14:57:23 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: 79175 KARA COURT, La Quinta CA 92253 City of La Quinta 11-0424 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 = 7 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 7 Calculate difference: 0 Actual Subcooling - Target Subcooling = System passes if difference is between -3°F and +3°F PASS 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 1 Calculate: Actual Superheat = 18 Tsuction - Tevaporator, sat Enterallowable 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 actual' superheat is*within=the` allowable superheat range) r PASS " ,^Ente;Pass •• 1 Reg: 211-A0020609A-M2500001A-0000 Registration Date/Time: 2011/06/02 14:57:23 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 79175 KARA COURT, La Quinta CA 92253 1 City of La Quinta 11-0424 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: 686310 Date Signed: 4/30/2011 Position With Company (Title): System meets all refrigerant charge and airflow Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No requirements. PASS Enter Pass or Fail 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 -SR) 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) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 4/30/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 211-A0020609A-M2500001A-0000 Registration Date/Time: 2011/06/02 14:57:23 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 HVAC Field Data Sheet Pg 2 of 2 Client Named// D.-Iti-AS Job # / 171 qr Date MECH-2S L'harge &Airflow * ZONE l ZONE 2 ZONE 3 ZONE 4. Condenser Serial Number / 1140 t!57Z Supply air dry bulb temperature Return air dry bulb temperature Return air wet bulb temperature y , Evaporator Satu ai�tron-Temperature--W-- - � -- - - -- - - - - - - - - Condenser Saturation Temperature 9.3 Suction Line Temperature Liquid Line Temperature 86 Suction Pressure l Zs LiquidPressure—_ _ __-•, _ 3,. _- -. - -_-___... 7 - Actual Airflow Temperature Split Actual . $ Target Temperature Split from Table RA3.2:3 Z I Passes if difference is ± 3' of Target Temp (Y/N) ly Actual Subcooling (± 4" of Target to pass) Target Subcooling from Mfr.. 7 Actual Superheat (3 to 26" to pass) ZZ Outside air dry bulb temperature MECH 26 '.Weigh-fn.Charging below 55' Actual Line Set length (ft) Mfr's Standard Line Set Length (ft) Length Difference = Correction Factor (ounces per foot) Target Correction Factor x Length Difference System Charged to Target? (Y/N) . -Other Data . Minimum amps 34/. e Maximum amps. D Breaker size $� Compressor amps 2 Return Static Pressure Supply Static Pressure Supply Air Wet Bulb Temperature *ALL APPLICABLEBOXES ON THIS FORMMUST BE COMPLETED FOR EACH%OB. NO EXCEPTIONS. Copyright Q'2011 EDS Energy Driven Solutions, Inc HVAC Field Data Sheet 2i1- }do2D&Dq A Pg1of2 S-2Date �0 ta Client Namjob #e i It �O 1 Address—I Ph # Technician(s). �'�va l .'5��� a Permit # Gauge/Thermocouple Calibration Date Split Package Some Ducts Only I All Ducts Only (Circle type of work) MEGH=04; System Location c Heating Equipmel Heating,Equipme ARI Reference Nu Heating Equipmei Duct Location (at Duct R -Value (if d Heating Load Heating Equipme: Condenser Make Condenser Model Size in Tons SEER & EER Cooling Load Cooling Capacity MESH -20 d Duct leakage pre Duct Leakage Final R Duct Leakage Final R Pass using 60% li Pass using smoke MECH 22 or MEd Pa Measured Air Volui NEW DUCTS Target CHANGEOUT Target Measured air gre Measured Fan W; Target: 0.58 wat Measured Watts t