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10-0433 (MECH)
r� P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000433 Property Address: 52608 AVENIDA DIAZ APN: 773-282-005-19 -000000- Application description: MECHANICAL Property Zoning: COVE RESIDENTIAL Application valuation: 3900 Applicant: Architect or Engineer: 0 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: LA QUINTA REDEVELOPMENT AGENCY 78495 CALLE TAMPICO LA QUINTA, CA 92253 R 66 CA 92247 EXEMPT C20 Date: 5/19/10 ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided ense Class: - - - - - - - - - - cense No.: C20 Date: J ��1 Contractor: 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 OWNER-BUILD9(11 DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EXEMPT 05/31/113olicy Number 796186 _ following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, shall forthwith comply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Dater-,�-�a Applicant: (_ 1 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 WARNING: FAILURE TO SECURE ORKERS' COMPENSATIO OVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ I 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 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 APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each, person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives this county to enter upon the above-mentioned property for inspection purpo�ses5, Date:./ �-/O Signature (Applicant or Agent): V Application Number . . . _ . 10-00000433 Permit . . . . . MECHANICAL Additional desc " Permit Fee 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/15/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000,EA MECH APPL REP/ALT/ADD 9.00 1.00 9.0000 EA MECH - B/C <=3HP/100K BTU 9.00 ---------------------------------------------------------------------------- Special Notes and Comments ------- --- ----- ----- ---HVAC CHANGEOUT [14"SEER/8.5 HSPF --SPLIT HEAT PUMP] 2008 CALIFORNIA ENERGY CODE. May 19, 2010 12:28:03 PM AORTEGA ---------------------------------------------------------------------------- Other-Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total. 33.00 .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total 42.25 .00. .00 42.25 LQPERMIT BUDGET -AIR HEATING AND AIR-CONDITIONING Lic. #796186 Proposal Bill To: City aJ La Quetta Date April 16, 2010 Address: _ P.O 'Box 1504/78=495 Calle Tampico, La Quinta. CA 92247-104 Job name and address: City 1 La Quinta 52608 Avenida Diaz I 'La Quinta, CA 92253 Budget Air offers to install: 1. Install one 4 ton 14 seer Maytag heat pump split system which includes: outside condenser & air handler, with a digital 7 -day programmable thermostat, & copper tubing condensate line. Includes disposal of old unit. Please note; This unit has a 12 yr warranty on compressor & parts. This contract includes duct leak testing. . Total: - S 3,900.— Seller ,900.—Seller 113/Wl o Date L -d LL9 L -LLL -09L `e - / C , %7 Date zenbze^ N'8 f e0E:90 0L 9L AV 05/18/2019 88:49 7607777011 LA QUINTA BLDG DEPT PAGE 01/01 i' Sir[ Addrer� &/medadtI AV -,y: bar 1 am& 3 S2 -1,o Aw-- 01 La 01-,: Y:ta, CA aus3 10 • Coadit m Floor FApipment Type, List Mentum EfFoiea Duct insulation requirement Ara Thermostat D Packaged Unit fit fomace O AFUE O COP Over 40 Rofducts added or Wetback X ((door Coil 05EER t H . O O HSPF B5 O R 6 in unconditioned0-3spew Swed by SySlan pec �•# be P Ise t. musty Condensing Unit O EER t X. (c ❑ Resist nee OR 9 (LZ 14-15 J iarfnlfeQ O (hhcr 1. Egsdpment Type; Chows[ theequonsm being installed; ifaaore than oa[sysrern, vw wWkwCF-I8-ALT-HYAC%reach symenc 2. WdMuaa Egsrfpaeearats deaeses: /3 SEER 78%AFUE, 7.7KSPFfortypiilcal residendalsyatems- HERS VIERIFICATION SUMMARY Listed below am rafts HVAC allcrslion options. The in uiler dedds what wadi is bang dare and pica one of the appropriate Optio s& Each Option lists the HERS atezaaea, dwt muss be wndude& A Copy of dte Manns shall be left on site for final ii ! ciion mhd a copy ti -en to the homeowner. At field the inspector vaifia thet tine wwlk usmd on this farts was in 8ct the wwk completed by the installer. The inspcetor also ve:ri&es that each appropeiete C'F-6R and fcgistered CF -4R !fleas (no hand filled CF -41s allowed) we filled put and $c rain Oembea 1 2010 a r of doe CF -IR sail CT -61k shall abo be on site for final 1. HVAC Chanpout iced Fortes: ■ All I4VAC Equipment rt platzd CC-0li 6xvns: MECH-04, MEEK -2l -HMS and (for spur synesm) MECH- 25 -BIERS CF -41t foams: MECH- 21 and far tit MECH-25 ■ Cam denser Coil and /or CF41K fatttas: MF.QI.21•ilFRS mid (for split systmtc) MEC1� 2S -HERS • Indoor Coil and /or CF -4R fortes: MECH- 21 and (For split systems) MECH-25 • Furnace. For Split Systems: Date leakage < 13 percent; RC, CCA ':� 300 CFMAm(Mhdrnvm Air Flow Requimnent). TMAH For Psgkaged Units: Duct leakage < IS percent Fxgmpted from duet leakap teWng if 131 Duct system was documented to have: been ptevioaaly sealed and eoedh ed //sough ITERS verifica iom. or ❑ 2, bun syatcrw with less than 40 linear feet in rrnaoaditioned spaoe, or ' 0 3. Exintinst duct systerns. eonsbnm;tvd insulated or seated with asbestos 112. New HVAC System Re"hic4l Forms. ■ Cut in or Chamgeow with new CF -6R forms: MECIR44. MECH-20-HERS jwd (for split systems) ME6H 22 -HERS. and MECH-25-HERS ducts (all near duc*S end all new CFAR foams: WMCH 20•- and (fiorsplet ttystaw)MECK,?Z and MECH 25 For Split Systanx Duct kakage <6 pavem RC, CCA > 350 CFN wo. FWD, TMAH, SIMS, and either HSPP or PSPP. For Packaged Ueits: Dart I <6 0 3- New Ducts witb Reliftc!mant Regatmd Forms: • Ividades replacing or iastsll-hng on new ducting CF -6R fm= MECR-04- NECK-20-HERS,and (for splitsyAmm) WOMR-25-HERS and/or outdoor oondatsing unit wtdkr indoor CF -4R forms: MECH•20 arta (£or split systems) NECH-25 coil and/or furnace. Not all eq t c6eaged. For Split Systems: Duct kWwp < 6 pa cat, RC, CCA >_ 300 CFiWtory TMAH For. Packand Unite Duct lealcmae <6 ❑ 4. New Dueling over 40 fed Rcqukvd Farrar: ■ Includes: adding or replacing more than 40 CF•61k fortes: MECII-04, MECV-214HE115 CFAR forms: MECH-21 linear foci of dad in wwonWtionod For split system or pultaged unfts: Duct leakage < 15 percent ❑ EXCEPTION: Exbtine duet systam eoruphn insulated or sealed with asbestos. Cotltraclo? (Dominemateon Amt bores /RespontlMe Aesiptes Deelaisdion Statetmertt) • I Caw dmft ccrtiri avercamplianwdoem citation is asaamaz wad eampka- • f am eligible miner t)ivision 3 ofere Cblifmnia Basiness and rMfbssimt Code to seep tespansibliry for rte design mcgirmd on this ce niriieate orComplianoe• • I cerlifv that the enew fe etwes and pufarmaace specifcadams for &e de3ign identified on this Cantle of Compliance nonfarm to the requirements of Tidd 24• I'ar{s 1;snd6aftkCalifamhCode orRegulations. • 11wde,rgnrcmunsidentifodanthis CcnifcftofCamplianoeareeonsWentwith dteinfarmstiondocumawdoutoderayplicatreaorrvlirdarcforms.worksb=M astmluions. p6ra and tksdores wbmimedto ttra enf rmne u ft7 wish the kation. Name. D& 1 me- VGLZ(:a O ezZ Sigtlattme ° , Company; i3u d ek I v- nate: 6 j I g 1201 o Address Jt.2-70 0- kkc' 3YQLC_i-ifY 6C'L' Iscesue iQ (A 18(o ci(ytStStCIlip: 'ntu GZz 15 Pbetne: L -7(o0 ) Belli- I (vo 2008 Residesuial Ovmpliance Forms vT� a yr a_r-ee�'r� March d010 BUILDING & SAFETY DEPT. /APPROVED FOR CONSTRUCTION DATE 5 L'd LL8 L -LLL -09L zenbzBA N �g r BLV IO 0 l 6 L AeW Bin #City Of %a Quints Building 8T Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # I0. py33 Project Address: i•0. i Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: (� ,: Y ; ux' N-101,111.-f ; •: Address: P . x (� ` Project Description: City, ST, Zip: Lem d c7i z6 Telephone:4SS 12 State Lic. # : City Lic. #: Arch., Engr., Designer- esignerAddress: Address: City., ST, Zip: Telephone: State Lic. #: �:.. ; . 4>nhYy / £ Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sel-%. rwe.. VgL 5 U C Z_ Sq. Ft.: # Stories: # Units: Telephone # of Contact Person:° Estimated Value of Project: o e Roo - APPLICANT: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Tide 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2od Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 7d Review, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees do Total Permit Fees sin I,., . e6w -W 1 *506 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 52608 AVE DIAZ, La Quinta CA 92253 1 City of La Quinta 10-433 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 MAIN I System Location or Area Served HOUSE 1 p 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 p 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 ✓ 0 Pass ✓ ❑ Fail STMS - Sensor.on,the Evaporator Coil ..,.n., __ System Narne'or Identification/Tag-7 f LMAIN I z, p" I 1 U / { V 3 (O'Yes ,tenThe E No ,1 i sensor is factory installed, orfield installed according to manufacturer's specifications, or is'installed by methods/specifications approved by the Executive Director. I v r 1 I \ �` .n_* "o 4 \. p.Yes I VI !. ?' p No .. The sensor wire is terminated with a standard mini plug suitable for connection to a1 digital thermometer. The sensor mini plug is accessible to the installing.teclinician L� Director. and the HERS rater without changing the airflow through the condenser coil 5 1 Yes I No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail 2 N/A ✓ ❑ Pass ✓ ❑ Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag I MAIN 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 The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ p N/A ✓ ❑Pass ✓ ❑Fail applicable..Otherwise enter Pass or Fail Kal 7 Reg: 210-A0007274A-000000000-M25A ',Registration Date/Time: 2010/06/03 00:09:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 51 Site Address: Enforcement Agency: Permit Number: 52608 AVE DIAZ, La Quinta CA 92253 1 City of La Quinta 10-433 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 551F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems System Name or Identification/Tag MAIN (must be re -calibrated monthly) Date of Thermocouple; Calibration "' 5/1/2010 �_ ; System Location or Area Served HOUSE , Outdoor Unit Serial # PSDO806024SB _-' �, - 7 Outdoor Unit Make MAYTAG Outdoor Unit Model PSH4BE048K Nominal Cooling Capacity Btu/hr 48000 Date of Verification 5/27/2010 Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 5/1/2010 (must be re -calibrated monthly) Date of Thermocouple; Calibration "' 5/1/2010 �_ ; r N r (must be re -calibrated monthly) , Measurea Temperatures`( -F) I / I >I -_Zz") I —(- I i \ '\ 4 System Name or Identification/Tag MAINfj Supply (evaporator leaving)'air dry-bulb - 51''"� _-' �, - 7 temperature (Tsupply, db) Return (evaporator entering) air dry-bulb 71 temperature (Treturn, db) Return (evaporator entering) air wet -bulb 58 temperature (Treturn, wb) Evaporator saturation temperature 38 (Tevaporator, sat) Condensor saturation temperature 96 (Tcondensor, sat) Suction line temperature (Tsuction) 48 Liquid Line Temperature (Tliquid) 90 Condenser (entering) air dry-bulb temperature (Tcondenser, db) >o 701 Reg: 210-A0007274A-000000000-M25A Registration Date/Time: 2010/06/03 00:09:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 52608 AVE DIAZ, La Quinta CA 92253 City of La Quinta 10-433 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 Identificationl-rag MAIN Calculate: Actual Temperature Split = 20 Treturn, db - Tsupply, db Target Temperature Split from Table 19.3 RA3.2-3 using T and T return, wb return, db Calculate difference: Actual Temperature Split - Target Temperature Split = 0.6999999999999993 Passes if difference is between -4°F and +4°F or, upon remeasurement, if between PASS -40F and -100°F Enter Pass or Fai 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 o Identification/Tag Calculated Minimum Airco �qu �m �nt (- iI \\ i �� A CFM {` ` . Measured, Airflow using RA3.3 procedures '*.-✓ i,. 4-`. `mss'" [/' (` (CFM) f 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 Tretum, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -6°F and +6°F Enter Pass or Fail, _01 Reg: 210-A0007274A-000000000-M25A Registration Date/Time: 2010/06/03 00:09:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance. -Forms August 2009 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 52608 AVE DIAZ, La Quinta CA 92253 1 City of La Quinta 10-433 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 MAIN Calculate: Actual Subcooling = 6 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 10 Calculate difference: -4 Actual Subcooling - Target Subcooling = System passes if difference is between -4°F and +4°F PASS ,1' (! Enter Pass or Fail , `_.;, f{ ` 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 MAIN Calculate: Actual Superheat = 10 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 8-14 between 3°F and 26°F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range/ 1/ ) �6 M PASS ,1' (! tEnter,Pass or FailI , `_.;, f{ ` W/V -, ZIO 2f co Reg: 210-A0007274A-000000000-M25A Registration Date/Time: 2010/06/03 00:09:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 52608 AVE DIAZ, La Quinta CA 92253 City of La Quinta 10-433 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 MAIN 1796186 HERS Provider Data Registry Information Sample Group # (if applicable): N/A System meets all refrigerant charge and airflow ❑ not-tested/verified dwelling in la HERS sample group requirements. PASS All About Air Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail Roman Diaz Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 5/27/2010 CC2004535 C;o DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) BUDGET - AIR Responsible Person's Name: CSLB License: JAIME VASQUEZ 1796186 HERS Provider Data Registry Information Sample Group # (if applicable): N/A © tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CCi-1798496300 HERS Rater Company Name: All About Air Responsible Rater's Name: Responsible Rater's Signature: Roman Diaz Roman Diaz Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 5/27/2010 CC2004535 Reg: 210-A0007274A-000000000-M25A Registration Date/Time: 2010/06/03 00:09:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 52608 AVE DIAZ, La Quinta CA 92253 (MAIN) City of La Quint a 10-433 Enter the Duct System Name or Identification/Tag: MAIN Enter the Duct System Location or Area Served: 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. R 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: (Option 1, 2 OR 3 must be attempted before utilizing Option 4) Determine nominal Fan; Flow using one, of the �following�thre (calculation methods. , ✓ d CoolingSys tem method: Size U cond ser in Tons l4 x 400 1600 N CFM I ✓ ❑ Heating g system method: 1.7'x( Output Capacity in Thousands of -Biu = _CFM p, ,� U '. ✓ `usi�g / ❑ Measured systemairfl RA3.3 airFlow,test,procedures: �- �{ Ii _CFM Optional -used then: (. J' ' '�.�� + '-, >+ r �, a,G•'(1 C>L 1 Allowed leakage = Fan Flow 1600 x 0.15 = 240 CFM Actual Leakage = 120 CFM Pass if Leakage Actual is less than Allowed M 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 El Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _/ Initial leakages x 100% _ % Reduction Pass if % Reduction > 600/a ❑ Pass ❑ Fail Option 4 used then: 4 All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No smoke allowed to leak from system. Including ducts, plenums, air handler and door panel. Pass if all accessible leaks have been repaired using smoke ❑ Pass El Fail Reg: 210-A0007274A-000000000-M21A Registration Date/Time: 2010/06/03 00:01:40 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 52608 AVE DIAZ, La Quinta CA 92253 (MAIN) City of La Quinta 10-433 R Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configuredrto}.the closed position during.fduct leakage,testin.g. 7 0 �{ �` i © All supply and return registeriboots,must be sealed to the drywall if smoke test is utilized for compliance - applies to duct leakage compliance option 3 (leakage reduction byr60%) and option 4 '(fiz all accessible leaks) described above. 0 New duct�installations.cannot utilize building. cavities:as plenums or platform returns,in. lieu of,ducts. �co -- 0 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 -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) BUDGET - AIR Responsible Person's Name: CSLB License: ]AIME VASQUEZ 1796186 HERS Provider Data Registry Information Sample Group # (if applicable): N/A Q tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798496300 HERS Rater Company Name: All About Air Responsible Rater's Name: Responsible Rater's Signature: Roman Diaz Roman Diaz Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 5/27/2010 CC2004535 Reg: 210-A0007274A-000000000-M21A Registration Date/Time: 2010/06/03 00:01:40 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 t 05f=x8/2010 08:49 7607777011 LA QUiNTA BLDG DEPT PAGE, 01-/01 r t. Site Addrrst r� Eirjorcaratrrl Agenry_ tY Dalt R ,-2-1&0 %h2. VICE LR (PL4rria CA QZZ65 1 w 7 C60ditio ed Floor EquMmcqlT t tial Minimum M ' Duct insulation requirerneat iirerinoatat Packaged Unit-�� IS Furnace 0 AFUE� © COP Ova til ofduda added or )S.Sdback Xi Indoor Coil OSEER 1 q • o D HWF " rroaued inn unconditioned spaoc Served by systtm 17ftrat01rMdv KCondensing Unit 0 EER 1 y-, L- O Resistance D R'6 (CZ 10-13) sf presenf. m■si br O Other O R 8 ru m-1 S) iro-Had) 1. Corn AmmtType: Chocsrth4eequiymaubringin Valkd; ijmamthan or, eSystem, ram another CF- JR-ALT-NYACf. readitlestenr. I. MWanrnae L'gn;parnrt teiteQo: 13 SFMt 18X AFlX 7.7KSPFjar ty kW rezidencaf systemxL HERS V IERiFFCATFON SUMMARY Listed below we four HVAC alteration Optiooaa. Dar installer decides what nosier is being done and pick: one of the appropriate Options. Eads Caption lids the FWRS abeastm that must be conducted. A copy of tit f tuns shat l be left as site for final inspection and v copy given m the homeowner. At final, the inspector verifies that the work listed on this form was; in fstt dw worker completed by the installer. The i tspcstor also verities dug each appropriate CFAA and rctiered CF -4R foetus Cm hand filled CF -4R9 allowed) am filled out and sied Beciffalas October 1 2010 s reelate cam of the CF -1R Iuu1 CF -M shall aloe be vn site for lind F1. HVACChaugmut Remired Forms: ■ A I I HVAC Equipencrtt Rptaaed Cr -6R forms: MECH-4D4, MECM214FM and (for split systestu) MECH- 2544ERS CF -4R forms: MECH-21 acrd for aLlit MECH-25 • Condenser Coil and /or • indoor Coil and/or mm rw.. MECi1-21-})ERRS a,td (for apfi[ sysoetns) MECit- 25-F3ER.S CF -4R fayre: MECH- 71 and (torsphesysterns) MECH-25 • Fumace For Split Sysbeats: Duct leakage < 15 percent•, RC, CCA ? 300 CIN/M(Matimum Air Flow Requiretnerd), TMAH For P,ftkaged Uoits: Duct leakage < l5 pe mctt Evemp" from duct leakage testing if r 01 Uuct systen was documented m have beer[ ptevlawly staled and confirmed 6sough HERS verificalion. or E3 2. lira systow with less th m 40 sinter (tet in unconditioned space, or Q 3. ExL%Linu duct systaras are swtml iosuleud at sealed with asbestos O 2. New HVAC Syxftin Required Formsc' • Cut in (aCttategmo ti with ttew dews (ell star ducting %ams: MEM -04. MECH-MHERS wW (far split systans) M1;CFs 2Z -HERS. and MECH-25-HERS tg all a CF-4Fi forms: MECH 20% end fi (bs split 9ysDems)MECH-22, std M6CN 75 new a ai For Split Systeaw Duct kakage < 6 pace RC, CCA > 350 CFMlton, FWD, TMAH, SIMS, and either HSPP or PSPP. For Packaged Units: Duct kzkagc <6 percent 0 3. New Ducts with Repttuea ant Require Berms: # • trtdudes replacing or insaltiM all mw ducting CF -6R Farms MECid-W. MECH-20-HERS,and (far s kwist min) MECK-25-HERS and/or outdoor owulcusing urtit and/or indoor CF -4R fvreets: MECH 20 and (fdr split systeYns) MECH-25 Coil and/or furnace. Not *9 cquipnwa tdmaged_ ' For Split Systema: Duct leakage < 6 paverd, RC, CCA 2 300 CFM/lon, TMAH For Pa Unity_Duct -c6 pericew O 4. New Ducting over 40 fleet R Forms: ■ Includes adding or replacing too a than 40 CF -6R forms: Ml cv-off MECH-2i4cros CF -4R torsos: MECH-21 linear feet of dere! in tmeotutitepncd For split slew or packaged units: Duct leakage < 15 yet nt 0 HXC EfrnON: Exisfingdactsyslerm con3UyetC4 irsalatod or staled with asbestos. Contractor (Documentation Author's /Responsible l esiper s Declurat7otr St■te: meat) • 1 certify :kit this Cenir-cw orCowv1 ante docunum, anon is ansate and compkr- • tarn eligible ands: Division 3 vrthe Califmav Bwisess and Pevrmskm Coft." tectal resp* wsibitiay Fpr the design idoaifiad on this C ntifimee of Comptiaeoe. • 1 ccrtiF that the anergia reatraer and pQfonaMnce spoofiantiores for the design identified an this Cotifieatc of Complianwoonfonn Io tht negeriremcuts ofTitla 24. l:Ir d t wW 6 of the Calirarnia Code of Regulations. • 'alter rle+-gn feawrrs ideatired an this Cerrifroale OM—Pliaaoe mecoashunt with ddc inromtation documented on 011ier apptiatble compliants forms, worksheets mkvrxiona, PlansaM ifs9rfaesgibdsitord10theenfaltxaMnl agetgcy rot lOealwithtbepamut smicasion. Name-�pt-i 1'Y12� ti Q1Z' c7Q� S;Fpaaat:: � Company; t�,l CO c e- I r' Dau ->1 1 C1 201 O r • �u•ua. SI Zi O Cla-1 �Ci S�,c Forms L • d LL21-LLL-09L l.teeam: -7q co fi g cap o 74�U� t9G- a i APPROVED FOR CONSTRUCTION r DATE 5 15 uw 8Y .-� Joe Mamh 2010 zenbzen N v r e0Z:L0 0 6 6 L f\eW CITY OF LA QUINTA BUILDING & SAFETY DEPARTMENT (760) 777-7O INSPECTION REQ EST F'y OF'CNt'° (7 60) 777-71 _30 Owner LQ REDEVELOPMENT A Yl Contractor BUDGET AIR Permit Numbe� 0-0,433 — m % o POST ON JOB IN CONSPICUOU�L� INSPECTOR MUST SIGN ALL APPLICAB E S JOB ADDRESS 52-608 AVENIDA 41AZ HVAC CHANGEOUT [14 SEER/8.5 HSPF - SPLIT HEAT PUMP] 2008 CALIFORNIA ENERGY CODE. S ` TYPE OF INSPECTION DATE INSP. TEMPORARY POWER SETBACKS U/G PLUMBING / WASTE U/G ELECTRICAL/ GROUNDING FOOTINGS / STEEL CONCRETE SLAB i DO NOT POUR CONCRETE UNTIL ABOVE SIGNED nwr rvruL / rn r%VAV Tr%%AIMAM v . t 4+i I-NAMINU (t UIVIbINHIIUN) I I oni irnu CA crlymlil COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP. BD. DRYWALL EXTERIOR LATH GAS TEST SEPTIC ABANDONMENT SEWER CONNECTION SEPTIC / GREASE INTERCEPTOR MASONRY INSPECTIONS FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE / SETBACKS U/G PLUMBING U/G GAS U/G ELECTRICAL PRE -PLASTER ALARMS / BARRIERS DECK BONDING FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER ELECTRICAL PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT COMMUNITY DEVELOPMENT DEPT. FINAL / JOB COMPLETED ABOVE APPROVALS DO NOT INCLUDE RIGHT TO -_TURN ON UTILITIES OR OCCUPY BUILDING �y