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12-1001 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-.00001001 Property Address: 61030 DESERT ROSE DR APN: 764-270-999-126 -300231- Application description: MECHANICAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 27774 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT rN PIP ------------------------------------------------ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licens d under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes onals Code, and my License is in full force and effect. License Class: C20 License No.: 686310 Date: � �� Co actor: -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 ($5001.: (_) 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.). I—) 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 Owner: CRAIG SIGLER 61030 DESERT ROSE DRIVE LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/30/12 Contractor: GENERAL AIR CONDITIONING 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (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 ZENITH INS CO Policy Number Z071741501 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 b�Orthwith ome subject to the workers' compensation laws of California, and agree that, if I should becosubject to the the compensation provisions of Section �e Labor Code, I she comply with those provisions. / o Date: 3o Applicant: WARNING: FAILURE TO SECUR ORK ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is son at whose request and for whose benefit work is performed under or pursuant y permit iss as - aR lip ca- tion, the owner, and the applicant, each a rees to, and s fend, Inde �i and hol armless th g Y of La Quinta, its officers, agents and employees fo 'i$I-tinti ed t e work bei performed under or following issuance of this per 2. Any permit issued as a result of this application be es null d,! �v,P ,df +if work is not commen e within 180 days from date of issuance of such p t, r c s J'Y�'(�wQk�igr Aj>�;'l�ays w ct permit to cancellation. V I certify that I have read this application and state that the abo a inf r ti n is correct. I agree to compl all city and county ordinances and state laws relating to building onstrua rese tativ �iY.tiZ�1 of this county to enter u h the above-mentioned property for inspec QUINTA Da/te: 3C ignature (Applicant or Agent): ANCE CEpT Application Number . . . . . 12-00001001 Permit MECHANICAL Additional desc . Permit Fee . . . . 66.00 Plan Check Fee 16.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/26/13 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 16.5000 EA MECH B/C >3-15HP/>100K-5.00KBTU 33.00 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE-OUT:.INSTALL (2) SPLIT SYSTEMS, 3 & 4 TONS. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . BLDG SIDS ADMIN (SB1473) 2.00 Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 66.00 .00 .00 66.00 Plan Check, Total 16.50 .00 .00 16.50 Other Fee Total 2.00 .00 .00 2.00 Grand Total 84.50 .00 .00 84.50 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 1S Site Address: Enforcement Agency: Date: Permit #: 61030 DESERT ROSE DRIVE (4 TON) La Quinta, CA 92253 City of La Quinta Aug 29, 2012 Dud insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® Indoor Coil ® AFUE 78% ® SEER 13.0 ❑ COP [3HSPF ❑ R 6 (CZ 10-13) [3 R 8 Served by system 1600 sf ® Setback If not already present must be ® Condensing Unit [3 EER [3 Resistance (CZ 14-15) installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -SR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -611 and registered CF -411 forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -111 and CF -611 shall also be on site for final inspection. B 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 -411 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 [12. 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,systemill not be Ducted (ie Dudless�Mini;SplitSy_stemjx(Also"�Exempt fromERefr�igerant Charge) ❑ 2. Newi MAC System RequirediForms: F "' I �" �! �- � -" 1f *� . Cut in o Ghangeout withi CE-6Rfiorms: MECH-04, ME 20 -HERS, and {for lit systems) MECH?n'='HERS, and — new ducts: (all new ducting�'�p� all new � .- ?;: MECH,.,.-25-HERS CF: MECH-20, nd fors lits stems MECH-2H=25 randIMECe ui ment - For Split Systems: Duct`leakagef<j6,percent; IRC;"CU�2?350,GFM/ton FWD TMAH;ASTMS, and either=HSPP or PSPP. 'percent For Packaged Units: Duct leakage z 6 ❑ 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 -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. . I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Danielle Garcia Signature: Danielle Garcia Company: HARRISON ENTERPRISES INC Date: Aug 29, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 212-A0047986A-00000000-0000 2008 Residential Compliance Forms Registration Date/Time: 2012/08/29 20:05:22 HERS Provider: CalCERTS, Inc. July 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #- 61030 DESERT ROSE DRIVE (3 TON) La Quinta, CA 92253 City of La Quinta Aug 29, 2012 Dud insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® Indoor Coil AFUE o ® 78% ® SEER 13.0 ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) Served system Setback If not present, must be ® Condensing Unit E3 EER ❑ Resistance [3 R 8 (CZ 14-15) sf 1200 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: . All HVAC Equipment CF -611 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 Dulled (ie uctless�Mini,-Split System) j(AlsoyExemptrfrom Refrigerant,Charge) - ❑ 2. Ne jHVAC System RequiredeFbrms: f! ." M` = .> Il< " . Cut in or Changeout withi i.� - new ducts: (all new �+�r� '�'T'i IwWr `- 'n " = GF, 6R forECH-04, MECH-20,.HERSffie�(%M for -split systems) MECH-22-HERS, and f( — dudir'tg�� all new MECH 25 -HERS GF -4R forms: MECH-20, and (for split sECH-22, and'MECH-2 equipment) f moi- ; �ir> For Split Systems: Duct leakages'<j6 percent; �RCfCGAl�'%350 CFM/ton"'FWD�OTMAH; stn.# Ci/ OQuinta Buildhtg 8E Safety Division P.O. Box 1504,"78-495 Calle Tampico La.Quinta, CA 92253 -{760) 777-7012 Building Permit Application and Tracking Sheet Permit # 1� 1 Project Address: ?j me:. A. P. Number. 3 3 . Legal Description: ip:CA 3 Edd Contractor.�� Address: _ cription: City, ST, ZS • o S CA 2 L'1 eo Telephone 6 p f7Ao £ , State tic. #: 6 $ 6 3 City Lie'. #; Arch., Engr., Designer. Address: City., ST, Zip: Telephone: State Lic. #: " ' Name of Contait Person: Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project~ APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal ReVd Recd TRACK NG PERMfT FEES Plan Sets Plan Check submitted Item Amount Structural Calm Reviewed, ready for corrections Plan Check Deposit. . Truss Cales• Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up Construction Flood plain plan Pians resubmitted Mechanical Grading plan V 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 DY HOUSE:- '^' Review; ready for correctionslissae Developer Impact Fee Planning Approval Called Contact Person AXP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Irl CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-1001 ❑ 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. w ❑ All supply and return register boots must be sealed to the drywall if smoke test is utilized for compliance.1 — applies to duct leakage compliance option 3 (leakage reduction by,60%) and option 4 (fix all accessible leaks) described above: ❑ New duct installations cannot utilize building cavities as plenums or platform returns in lieu of ducts. ❑ Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to 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 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 -SR) 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) 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): 348373 tested/verified dwelling P ® not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798687307 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/18/2012 CC2005784 Reg: 212-A0047986A-M2100001A-M21A Registration Date/Time: 2012/09/19 20:34:09 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 1 of 2) Site Address: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-1001 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System'. " Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. ❑ 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 Fan Flow using one of the following three calculation methods.: ✓ ❑ Cooling system method: Size of condenser in Tons ='x 400 = CFM ✓ ❑ Heating system method: 21.7 x _ Output Capacity in Thousands of Btu/hr = ` CFM ✓ ❑ Measured system airflow using RA3.3 airflow test procedures: _ CFM Option 1 used then: 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 Pass U 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% c3 Pass ci 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-A0047985A-M2100001A-M21A Registration Date/Time: 2012/09/19 20:34:09 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: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-1001 ❑ 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 must be,sealed to the drywall if smoke test is utilized for compliance - applies to duct leakage compliance option 3 (leakage reduction by 60%) and option 4 (fix all accessible leaks) described above: -- '" Il-New-dtrct-instaflatiorts-cannot-LttHize-buitdmg-cavities-as-ptenums-or-ptatform-retarns-in li u -of -ducts. ❑ Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to 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 the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 348373 ❑ tested/verified dwelling ® not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798687305 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/18/2012 CC2005784 Reg: 212-A0047985A-M2100001A-M21A Registration Date/Time: 2012/09/19 20:34:09 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 w�. CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance; when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 1 ❑ 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 Fail ✓ ❑ Pass ✓ ❑ Fail STMS - Sensor on the Evaaorator Coil System Name or Identification/Tag: r The sensor is factory installed, or field installed according to manufacturer's 3 ❑ Yes ' ❑ No specifications, or is installed by methods/specifications approved by the Executive j Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 4 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 5 ❑ Yes ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. 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 I System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8[3Yes [3No 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 ✓ [3Pass ✓ [3 Fail applicable. Otherwise enter Pass or Fail Reg: 212-A0047986A-M2500001A-M25A Registration Date/Time: 2012/09/19 20:35:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-2S Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above SS°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 System 1 System Location or Area Served Whole House Outdoor Unit Serial # Outdoor Unit Make Outdoor Unit Model Nominal Cooling Capacity Btu/hr Date of Verification Calibration or L)iagnostic instruments Date of Refrigerant Gauge Calibration (must be re -calibrated monthly) Date of Thermocouple Calibration (must be re -calibrated monthly) Measured Temperatures (°F) System Name or Identification/Tag System 1 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) 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) Reg: 212-A0047986A-M2500001A-M25A Registration Date/Time: 2012/09/19 20:35:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4111-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quints 12-1001 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 (cfm/ton) System Name or Identification/Tag Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 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 Reg: 212-A0047986A-M2500001A-M25A Registration Date/Time: 2012/09/19 20:35:50 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 5) Site Address: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Subcooling = Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer Calculate difference: Actual Subcooling - Target Subcooling = System passes if difference is between _ -4°F and +4°F 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 isnot available) _ System passes if actual superheat is within thei allowable superheat range, ` "r Enter Pass or Fail Reg: 212-A0047986A-M2500001A-M25A Registration Date/Time: 2012/09/19 20:35:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 i INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 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 1686310 HERS Provider Data Registry Information Sample Group # (if applicable):, 348373 System meets all refrigerant charge and airflow ® not-tested/verified dwelling in a HERS sample group requirements. HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/18/2012 CC2005784 t .;t HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia t 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. • 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) 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):, 348373 ❑ tested/verified dwelling ® not-tested/verified dwelling in a HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798687307 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/18/2012 CC2005784 Reg: 212-A0047986A-M2500001A-M25A Registration Date/Time: 2012/09/19 20:35:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 r CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 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 STNS 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 i System Location or Area Served Whole House 1 ❑ Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 ❑ 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 . STMS - Sensor on the Evaporator Coil • ' System Name or Identification/Tag I I ' The sensor is factory installed, or field installed according to manufacturer's 3 ❑ 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 4 ❑ 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 5 ❑ Yes ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. 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 I System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes ❑ 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 ✓ ON /A _T ✓ [3 Pass ✓ [3 Fail applicable. Otherwise enter Pass or Fail Reg: 212-A0047985A-M2500001A-M25A 'Registration Date/Time: 2012/09/19 20:35:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 a CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above SS°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 Svstems System Name or Identification/Tag System i System Location or Area Served Whole House , Outdoor Unit Serial # Outdoor Unit Make Outdoor Unit Model Nominal Cooling Capacity Btu/hr te of Verification F caimration or uiagnostic instruments Date of Refrigerant Gauge Calibration (must be re -calibrated monthly) Date of Thermocouple Calibration (must be re -calibrated monthly) Measured Temperatures (°F) System Name or Identification/Tag System 1 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) 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) Reg: 212-A0047985A-M2500001A-M25A Registration Date/Time: 2012/09/19 20:35:50 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: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 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 (cfm/ton) System Name or Identification/Tag , / Calculated Minimum Airflow Requirement (CFM) s Measured Airflow using RA3.3 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 Reg: 212-A0047985A-M2500001A-M25A Registration Date/Time: 2012/09/19 20:35:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms I March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 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 A r -4°F and +4°F Enter Pass or Fail .,� i 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) A r System passes if actual superheat is within the allowable- superheat range .,� i Enter Pass or Faill JI" Reg: 212-A0047985A-M2500001A-M25A Registration Date/Time: 2012/09/19 20:35:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4111-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 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 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 348373 --T[3 System meets all refrigerant charge and airflow ® not-tested/verified dwelling in la HERS sample group requirements. HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/18/2012 CC2005784 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. • 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 aoencv. Builder or Installer information as shown on the Installation Certificate (CF -6111) 1 HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia 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. • 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 aoencv. 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): 348373 --T[3 tested/verified dwelling ® not-tested/verified dwelling in la HERS sample group HERS Rater Information Ca10ERTS Certificate # CC1-1798687305 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/18/2012 CC2005784 Reg: 212-A0047985A-M2500001A-M25A Registration Date/Time: 2012/09/19 20:35:50 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 27 Site Address: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-1001 Space Conditioning Systems Heating Equipment Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (AFUE, etc.)1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Split Furnace LENNOX XL280UH07OXV36A 1 80 AFUE Attic 54 66 kl3tu Type and EER) (attic, (package ARI # of 1, 3 crawl- Cooling Cooling heat CEC Certified Mfr. Name Reference Identical (>=CF-iR space, Duct Load Capacity pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split ,LENNOX , ~ + , y Cooling Equipment 1. If project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative compliance. 2. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.orglarilac.php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -IR 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 ® §110-§113: HVAC equipment is certified by the California Energy Commission. ® §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. ® §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). ® §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. Reg: 212-A0047985A-M0400001A-0000 Registration Date/Time: 2012/09/13 13:14:00 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 Efficiency Duct Equip (SEER Location Type and EER) (attic, (package ARI # of 1, 3 crawl- Cooling Cooling heat CEC Certified Mfr. Name Reference Identical (>=CF-iR space, Duct Load Capacity pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split ,LENNOX , ~ + , y A/C XC21-036-230-08 , i Attic 3 Tons t I.` 1 I t 1. If project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative compliance. 2. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.orglarilac.php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -IR 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 ® §110-§113: HVAC equipment is certified by the California Energy Commission. ® §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. ® §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). ® §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. Reg: 212-A0047985A-M0400001A-0000 Registration Date/Time: 2012/09/13 13:14:00 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: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-1001 Ducts and Fans §150(m): Duct and Fans ® 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and . ® 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. ® 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. ® 7. Exhaust fan systems have back draft or automatic dampers. ® 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. ® Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. ® 10. Flexible ducts cannot have porous inner.cores. , 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 -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. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: Date Signed: Position With Company (Title): 686310 8/31/2012 Reg: 212-A0047985A-M0400001A-0000 Registration Date/Time: 2012/09/13 13:14:00 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page i of 2) Site Address: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-1001 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing dud 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 Fan Flow using one of the following three calculation methods. , ✓ ® Coolirig system method: Size of condenser in Tons 3 x 400 = 1200 CFM ` ✓ ❑ Heating system method: 21.7 x _ Output Capacity in Thousands of Btu/hr = = CFM ✓ ❑ Measured system airflow using RA3.3 airflow test procedur6s: CFM Option 1 used then: 1 Allowed leakage = Fan Airflow 1200 x 0.15 = 180 CFM Actual Leakage = 110 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 13 Pass 13 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% r3 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 Q Fail Reg: 212-A0047985A-M2100001A-0000 Registration Date/Time: 2012/09/13 13:14:30 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: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-1001 ® 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 must be sealed to the drywall if smoke test is utilized for compliance - applies to duct leakage compliance option 3 (leakage reduction by 60%) and option 4,(fix all accessible leaks) described above. ® New duct installations cannot utilize building cavities as -plenums or.platform returns in lieu of ducts. ® Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to 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 -111 that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: Date Signed: Position With Company (Title): 686310 8/31/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A004798SA-M2100001A-0000 Registration Date/Time: 2012/09/13 13:14:30 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: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 1 ® 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 STMS - Sensor on the Evaporator Coil . f System Name or Identification/Tag System 1 , - The sensor is factory installed, or.field installed according to manufacturer's 3 ❑ 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 4 ❑ 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 5 ❑ Yes 1 ❑ No JTWe 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 ,/ ®N/A ✓ ❑Pass ✓ [3 Fail applicable. Otherwise enter Pass or Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag I System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes 1 ❑ No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ ® N/A ✓ ❑Pass ✓ [3 Fail applicable. Otherwise enter Pass or Fail Reg: 212-A0047985A-M2500001A-0000 Registration Date/Time: 2012/09/13 13:16:31 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: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 1271001 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. • ff 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 Thermocouple Calibration 8/1/12 System Location or Area Served Whole House Outdoor Unit Serial # N/A Outdoor Unit Make LENNOX Outdoor Unit Model XC21036-230-08 Nominal Cooling Capacity Btu/hr 36000 Date of Verification 8/31/12 Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 8/1/12 (must be re -calibrated monthly) Date of Thermocouple Calibration 8/1/12 (must be re -calibrated monthly) Measured Temperatures (°F) System Name or. Identification/Tag - ;System 1 Supply (evaporator leaving) air dry-bulb 59 temperature (T ) supply, db Return (evaporator entering) air dry-bulb 78 temperature (Treturn, db) Return (evaporator entering) air wet -bulb 65 temperature (Treturn, wb) Evaporator saturation temperature 53 (Tevaporator, sat) Condensor saturation temperature 108 (Tcondensor, sat) Suction line temperature (Tsuction) 78 Liquid Line Temperature (Tliquid) 105 Condenser (entering) air dry-bulb 105 temperature (T condenser, db) Reg: 212-A0047985A-M2500001A-0000 Registration Date/Time: 2012/09/13 13:16:31 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 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, 19.00 db - Tsupply,db Target Temperature Split from Table RA3.2-3 18.8 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - 0.2 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 (cfm/ton) System Name or Identification/Tag System 1 Calculated Minimum Airflow Requirement (CFM) i a Measured Airflow using RA3.3 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 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 Reg: 212-A0047985A-M2500001A-0000 Registration Date/Time: 2012/09/13 13:16:31 HERS Provider: Ca10ERTS, 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: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Qui nta 12-1001 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 = 3.0 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 4 Calculate difference: -1 Actual Subcooling - Target Subcooling = System passes if difference is between -3°F and +30F PASS Enter Pass or Fail PASS,o :' 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 = 2S.0 Tsuction - Tevaporator, 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 actual superheat is within the allowable superheat range PASS,o :' r' Enter Pass or Fail `-. ` Reg: 212-A0047985A-M2500001A-0000 Registration Date/Time: 2012/09/13 13:16:31 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: 61030 DESERT ROSE DRIVE (3 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 CSLB License: Date Signed: Position With Company (Title): System meets all refrigerant charge and airflow 8/31/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): 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 -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: Date Signed: Position With Company (Title): 686310 8/31/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0047985A-M2500001A-0000 Registration Date/Time: 2012/09/13 13:16:31 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-1001 Space Conditioning Systems Heating Equipment Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (AFUE, etc.)1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Split Furnace LENNOX SL28061409OXV60C 1 80 AFUE Attic 4 Tons r , Cooling Equipment Equip Type (package heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (SEER and EER) 1, 3 (>=CF-iR value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Cooling Load (kBtu/hr) Cooling Capacity (kBtu/hr) Split A/C - LENNOX XC21-048-230-08 1 Attic. 4 Tons r , 1. If project is new construction, see Footnotes to Standards Table 15178 and Table 151-C for duct ceiling alternative compliance. 2. ARI Reference Number can be found by entering the equipment model number at http://www. aridirectory. orglari/ac. php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -IR form. 4. When CF -1R is reference it is also applicable to the CF -IR, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM ® §110-§113: HVAC equipment is certified by the California Energy Commission. IN §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. ® §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). ® §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. Reg: 212-A0047986A-M0400001A-0000 Registration Date/Time: 2012/09/13 13:18:15 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: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-1001 Ducts and Fans §150(m): Duct and Fans ® 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or. UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and ® 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. ® 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. 1117. Exhaust fan systems have back draftor automatic dampers. ® 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. ® Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. ® 10. Flexible ducts cannot have porous inner cores. 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 -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. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: Date Signed: Position With Company (Title): 686310 8/31/2012 Reg: 212-A0047986A-M0400001A-0000 Registration Date/Time: 2012/09/13 13:18:15 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: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-1001 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System:" Duct Leakage Diaanostic Test - existinq 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 Fan Flow using one of,the.following three calculation methods. ✓ IN Cooling, system method: Size of condenser in Tons J4 x 400 = 1600 CFM r ✓ ❑ Heating system method: 21.7 x _ Output Capacity in Thousands of Btu/hr = _ CFM ✓ ❑ Measured systern airflow using RA3.3 airflow test procedures: CFM Option i used then: 1 Allowed leakage = Fan Airflow 1600 x 0.15 = 240 CFM Actual Leakage= 140 CFM. Pass if Actual Leakage is less than Allowed leakage jj 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 13 Pass Q 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 __j x 100% _ % Reduction Pass if % Reduction >= 60% a Pass r3 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 Q Pass 0 Fail Reg: 212-A0047986A-M2100001A-0000 Registration Date/Time: 2012/09/13 13:18:36 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: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-1001 ® 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 must besealed to the drywall if smoke test,is titiliied for compliance — applies to duct leakage compliance option 3 '(leakage reduction by 60%) and option 4 (fix all accessible leaks) described above.:. f ® New duct installations cannot utilize building cavities as,plenums or platform returns in lieu of ducts. ® Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to 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: Date Signed: Position With Company (Title): 686310 8/31/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0047986A-M2100001A-0000 Registration Date/Time: 2012/09/13 13:18:36 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: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 1 ® 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 ✓ I@ Pass ✓ ❑ Fail STMS - Sensor on the Evaporator Coil System Name or Identification/Tag System 1 The sensor is factory installed, or field installed according to manufacturer's 3 ❑ 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 4 ❑ 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 5 ❑ Yes ❑ No IThe 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 ✓ ® 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 1 ❑ Yes ❑ No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ ® N/A ✓ ❑ Pass✓ I [3Fail T applicable. Otherwise enter Pass or Fail Reg: 212-A0047986A-M2500001A-0000 Registration Date/Time: 2012/09/13 13:20:24 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: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 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) J Date of Thermocouple Calibration 8/1/12 System Location or Area Served Whole House Outdoor Unit Serial # N/A Outdoor Unit Make LENNOX Outdoor Unit Model XC21-048-230-08 Nominal Cooling Capacity Btu/hr 48000 Date of Verification -7 8/31/12 Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 8/1/12. (must be re -calibrated monthly) J Date of Thermocouple Calibration 8/1/12 (must be re -calibrated monthly) 60 Measured Temperatures (°F) t System Name or Identification/Tag . ' System 1 Supply (evaporator leaving) air dry-bulb 60 temperature (Tsupply, db) Return (evaporator entering) air dry-bulb 80 temperature (Treturn, db) Return (evaporator entering) air wet -bulb 64 temperature (Treturn, wb) Evaporator saturation temperature 55 (Tevaporator, sat) Condensor saturation temperature 106 (Tcondensor, sat) Suction line temperature (Tsuction) 67 Liquid Line Temperature (Tliquid) 101 Condenser (entering) air dry-bulb 105 temperature (Tcondenser, db) Reg: 212-A0047986A-M2500001A-0000 Registration Date/Time: 2012/09/13 13:20:24 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of S) Site Address: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 Calculate: Actual Temperature Split = Treturn, 20.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3 20.6 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - -0.6 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 (cfm/ton) System Name or Identification/Tag System 1 Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 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 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 Reg: 212-A0047986A-M2500001A-0000 Registration Date/Time: 2012/09/13 13:20:24 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: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA Enforcement Agency: Permit Number: 92253 City of La Quinta 12-1001 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 = 5.0 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 4 Calculate difference: 1 Actual Subcooling - Target Subcooling = System passes if difference is between , - • .. -' I - j; -3°F and +3°F PASS Enter Pass or Fail PASS Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat = 12.0 Tsuction - Tevaporator, 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) , - • .. -' I - j; System passes if actual superheat is within the allowable superheat range —.— i PASS Enter Pass or Fail l Reg: 212-A0047986A-M2500001A-0000 Registration Date/Time: 2012/09/13 13:20:24 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: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA Enforcement Agency: Permit Number: 92253, City of La Quinta 12-1001 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 CSLB License: Date Signed: Position With Company (Title): System meets all refrigerant charge and airflow 8/31/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): 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 -111) 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: Date Signed: Position With Company (Title): 686310 8/31/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0047986A-M2500001A-0000 Registration Date/Time: 2012/09/13 13:20:24 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 HVAC Field Data Sheet Pg 2 of 2 Client Name Job # Date MSCI f -ZS Charge & AfrJlow ZONE 1 ZONE2 ZONE 3 ZONE 4 Condenser Serial Number Supply air dry bulb temperature 5_2 LO Return air dry bulb temperature 9-1 ZQ Return air wet bulb temperature .5— .Evaporator Evaporator Saturation Temperature -Z- ZCondenser CondenserSaturation Temperature /or o Suction Line Temperature 7 Liquid Line Temperature p Suction Pressure Liquid Pressure -5- -3S-0 Actual Airflow Temperature Split 19 Z o Target Temperature Split from Table RA3.2.3 Passes if difference is t T of Target Temp (YIN) yels. e S Actual Subcooling (t 4° of Target to pass) .3 Target Subcooling from Mr. C Actual Superheat (3 to 26° to pass) .Z 61 j Z Outside air dry bulb temperature QS- 1KEC926 'W h -In 6%arging below 55° Actual Line Set length (ft) Mfr's Standard Lime Set Length (ft) Length Difference = Correction Factor (ounces per foot) Target Correction Factor x Length Difference System Charged to Target? (YIN) OtherData Minimum amps Maximum amps Breaker size 3O Compressor amps Return Static Pressure Supply Static Pressure Supply Air Wet Bulb Temperature �• AAPPLIMUBOXW ON iMSFORNMUSTBECOMPUM FORBACK109 NOEJCLBP7TON� LL • • toff tght 0 2011 WS ftaV Deb= SoWWW, Inc. HVAC Field Data Sheet Pg 1 of 2 Client Name S Job # 13 111 Date - z AddressG.wan n,��,�,C�-j2asr*La amu_.,,,t,� bewwe VL vK o7p V �Z8' d Y Ph # 7(.. �ZS -7?/cam Technicians) /)/,a' fe n r A' i Permit # Gaup/Thermocouple Calibration Date-(( SpUt Package Some Ducts Only I All Ducts Only (Cir& Ow ofwork) AiisCH�Q4 , EqufpmertiDaW WWI ZONE2 ZOAW2 ZONE4 System, Location or Area Served ,' C Heating Equipment Make Heating Equipment Model L ARI Reference Number bewwe VL vK o7p V �Z8' d Y Heating EquipmentAFUE o 0 Duct Location (attic, crawls)ace, etc.) 4 C A C Duct R Value (if ducts were installed) 'IV//O- 1 ti Heating Load 2 yoO Heating Equipment Output Capacity d,4 8-8-040 Condenser Make Lewwwnx Condenser Model Size in Tons SEER & EER Cooling Load Cooling Capacity vo Z0.& 21 Duct TWOW Duct leakage pretest result Duct l eal®ge Final Result -a4cw/tm topass (6%) 240 3 09 PasslFall PaastFA Pass(Fail Passliail Duct Imkt.-e Final Result <6o CFM/tan to pass (15%) PassIFae PasaJFail Pass using 60% leakage reduction? Pass using smoke and visual inspection? MEW 22or.i &W, CootiggC A197owa Pca.flaiEDrnw .VIA Ae IA - Measured Air Volume from Plow Grid or Hood MW DUCTS Target: 350 CFM/tm a Condenser Tons CIE[MGBOUT Targe 300 CFM/tun s condenser Tons Measured air greater than Target? (YM Measumd Fan Watt Draw Target: 0S8 watts/measured CFM = Measured Watts less than Target? (Y/N) Cap9rW® 2011 IDS ftaUDriven Solottotslnc a CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 61030 DESERT ROSE DRIVE (4 TON), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-1001 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and,they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existinq 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 Fan Flow using one of.the following three calculation methods. ✓ ❑ Cooling system method: Size oficondenser in Tons % x 400 = CFM , _ ✓ ❑ Heating system method:. 21.7 x _ Output Capacity in Thousands of Btu/hr = _ CFM ✓ ❑ Measured system airflow using RA3.3 airflow test procedures: _ CFM Option 1 used then: 1 Allowed leakage =.Fan Flow_ x 0.15. = _ CFM Actual Leakage = _ CFM Pass if Leakage Actual is less than Allowed 0 Pass 13 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 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _ / Initial leakage _) x 100% _ % Reduction Pass if % Reduction >= 60% Pass c3 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-A0047986A-M2100001A-M21A Registration Date/Time: 2012/09/19 20:34:09 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 DUCT TESTING FORM INFORMATION Client name: ZONE 1 -Model# �LZI `U36 2�0 Serial# Make: Outside Temp: l� Discharge Pressure: 3,s PSI Discharge Temp: /OF j- y Actual Temp- to J a'� Suction pressure: v PSI Suction temp: SZ' -�z 6 Actual temp: % F Return Air: Supply air: Wet bulb: Dry bulb: Minimum amps: Zi 1 Maximum amps: Breaker size: 70 Amps: Compressor amps: )3, Line set length: ��ft. Duct test final leakage: CFM CFM Number:. Motor amps: Watts: Job# ZONE2-Model# Serial# Make: Outside Temp: /b Discharge Pressure: 3'b PSI Discharge Temp: ld 6 Actual Temp: Suction pressure: (S PSI Suction temp: 5-51 Actual temp: 67 Return air: g� Supply air: Wet bulb: b Dry bulb: Minimum amps: 2.� ' Maximum amps: L%S Breaker size: Amps:_ Compressor amps: Line set length: /"" ft. Duct test final leakage: Number: —� Motor amps: � Watts: V -Tj < Z 70 m O Z —I o r m v, n � m m O c) OU) v 7Dc ao _ 6> _C 0 7\ Prooertv of npQart i mnrfa . . 1 .1��........ w_ww__w�___w__ww__w�___w_________w____u___ww_w�a__w____n•_,_,_, Qwrj-j�j�j�j�j�j�j�j�j�j�j-______-_ - ��-��-1-�-1-1-0-�I !�I N1�1M1 ___ i1�1�1�11��+��1�1�1�1�1�1�1�11�1�1 �'•,�,•�•',,�',,��•,•',,•'�,•'w.'•,•',,'',i r- WWm � 0 A DOr-m �o-u A m— O -q X -{ Om� z�= (n Z 6 G m Z m 0