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09-1309 (SFD)1 , P.O. BOX 1504 ' VOICE (760) 777-7012 78-495 CALLE'TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 r " BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 12/29/09 Application Number: 0.9--000.01,30:9 Owner: Property Address: '52285�WHISPERING WY DESERT CHEYENNE, IN APN:- 767-200-999-16 -312024- 78401 HIGHWAY 111 �!D! /Q\ Application description: DWELLING - SINGLE FAMILY DETACHED' LA QUINTA, CA 92253{ Property Zoning: LOW DENSITY RESIDENTIAL (760) 777-9920 f1 Application valuation: 185831 vii 230 2olU Contractor: CIjy,�� U LA Q INTA • Applicant: Architect or Engineer: GJH DEVELOPMENT IN 1=!:�1 �;^�� r3tA�: • 27636 YNEZ ROAD 1-7 TEMECULA, CA 92591 (951)506-1123 - Lic. No.: 916227 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with 1 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 License Class: B License No.: 916227 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is - , issued. Date: Contractor: _ 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 -BUILDER DECLARATION insurance carrier and policy number are: hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EXEMPT Policy Number EXEMPT following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to I certify that,.in the perf nce 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 s 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 sh 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 700 of the Labor Co e! 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).: 1 Jcant: (_ 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 WOR ERS' COMPENSATION COVERAGE 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.). APPLICANT ACKNOWLEDGEMENT as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Cod The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves ther , and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for ., pursuant to the Contractors' State Lic a Law). _ � whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_ 1 I am exempt under Sec. B.&P. . for this reason - the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being _ performed under or following issuance of this permit. - /date: 712 1 4a�Owner: I 2. Any permit issued as a result of this applic becomes null and void if work is not commenced - within 180 days from date of issuance of permit, or cessation of work for 180 days will subject C NSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the - I certify that I have read this application and state that t bove information is correct. I agree to comply with all - work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to buil g construction, and hereby authorize representatives of hi�ty ter upon the above-mentioned prope or inspection purposes.Lender's Name: DateSi ure (Applicant or Agent): Lender's Address: - LQPERMIT Application Number 09-00001309 :.".s Structure Information �-Construction Type . . . TYPE V - NON RATED . Occupancy -Type . . . ... ." DWELLG/LODGING/LONG <=10 Flood Zone . . . . . NON -AO FLOOD ZONE Other struct info ." CODE EDITION 2001 # BEDROOMS 6.00 FIRE SPRINKLERS. NO, GARAGE SQ FTG 486.00 PATIO SQ FTG 183.,00 IRRIDDR OP UPNITE 1 .00 1ST FLOOR SQUARE FOOTAGE 3180.00 -Permit BUILDING PERMIT _ Additional desc Permit Fee 940.50 Plan -Check Fee 611.33 Issue Date . . . . Valuation . . . 185831 Expiration Date 6/27/10 Qty Unit Charge Per, Extension BASE FEE 639.50 86.00 3.5000 THOU BLDG 100,001-500,000 301.00 Permit . . . "MECHANICAL Additional desc . Permit Fee . . . . 127.50 Plan Check Fee 31.88 `Issue Date Valuation . . . . 0 Expiration Date . 6/27/10 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9..00.00 EA MECH B/C <=3HP/100K BTU 27.00- 8.00 6.5000 EA MECH VENT FAN 52.00 1.00 6.5000 EA MECH EXHAUST.HOOD 6.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 136.02 Plan Check Fee 34.01 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/27/10 Qty Unit Charge Per Extension BASE FEE 15.00 3180.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY. -111.30 LQPERAITT DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 18.46 DIF STREET MAINT FAC -RES 67.00 " Application Number 09-00001309 'Permit . . . . . ELEC-NEW RESIDENTIAL _ Qty Unit Charge Per Extension 486.00:: .0200 ELEC.GARAGE OR NON-RESIDENTIAL 9.72 Permit .'. . PLUMBING Additional desc . Permit Fee 206.25 Plan Check Fee 51.56 Issue Date . . . . Valuation 0 Expirations ijace 6/27/10 Qty Unit -Charge Per Extension BASE FEE _.. 15.00. - 21.00 6.0000 EA, PLB.FIXTURE 126.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 2.00 7.5000 EA PLB WATER HEATER/VENT 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9:0000.EA PLB LAWN SPRINKLER SYSTEM 9.00 11.00 .7500 EA PLB GAS PIPE >=5 8.25 1.00 15.0000 EA PLB GAS METER 15.00 Permit . . . GRADING PERMIT Additional desc . Permit Fee 15.00 Plan Check Fee .00 Issue Date . . . Valuation . . 0 Expiration Date 6/27/10 Qty Unit Charge Per Extension BASE FEE 15.00 Special Notes and Comments SFD - LOT 16. PLAN TYPE 4YRA - 3180 S.F.PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. 2007 CODES. DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 18.46 DIF STREET MAINT FAC -RES 67.00 Application -Number 09-00001309 Other Fees - DIF TRANSPORTATION, -'RES 1930'.00 Fee summary- Charged Paid Credited Due -. Permit•Fee Total 1425.2.7 .00 00 1425.27 Plan Check Total 728.78 .00 .00 728.78 Other Fee Total 4562.59 .00 .00 4562.59 Grand Total 6716.64 .00 .00 6716.64 LQkRMIT ' F r • :} ,+ ; ,, INSULATION CERTIFICATE THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE l WITH THE CURRENT.ENERGY REGULATIONS, CALIFORNIA ADMINISTRATION CODE, TITLE 24,- STATE•OF CALIFORNIA, IN THE BUILDING LOCATED ATC' r• SITE ADDRESS 52285 WHISPERING WAYLA QUINTA CR fir: NUMBER STREET CITY STATE BATTS: ' MANUFACTURER CERTAINTEED THICKNESS 12" R=VALUE R38 ` N/A N JA BATTS: MANUFACTURER ' CERTAINTEED. THICKNESS 3 1/2" R/VALUE R13` N/A = N/A BATTS: MANUFACTURER THICKNESS `R!A/ALUE Y , N/A N/A c 4 BATTS: MANUFACTURER THICKNESS RNALUE N/A N/A AIR INFILTRATION: (TITLE 24) t YES XXXXXXXXXX NO , OTHER• , F CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -411 -ENV -20 Building Envelope Sealing (Page 1 of 1) Site Address: 52285 Whispering Way, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of�La Quinta 09-1309 Building Envelope Sealing Diagnostic Testing Results CFM50H = the measured airflow in cubic feet per minute (cfm) at 50 pascals for the dwelling with air distribution registers u.7sealed. SLA = 3.819 x (CFM50 H / Conditioned Floor Area in ft2) per Residential ACM Manual Equation R3-16 Responsible Person's Name:. Building Envelope Leakage CFM50H as measured using a blower door diagnostic device Kevin Reese 187767S 1. Enter the blower door leakage target CFM50H value for compliance from the CF -1R 2288 tested/verified dwelling (cfm). 2. Enter the blower door leakage minimum CFM50H value corresponding to 1.5 SLA 1144 HERS Rater Company Name: from the CF -111 (cfm). Responsible Rater's Name: 3. Enter the measured CFM50H value from the blower door test (cfm) 1487 Responsible Rater's Certification Number w/ this HERS Provider: 4. The leakage test passes if the measured envelope leakage CFM50H value from row is 3 p n less than or equal to the value required for compliance from row 1, otherwise the test Pass a I fails. check/enter Pass or Fail 5. If measured CFM50H from row 3 is less than the minimum CFM50H value corresponding to AS 1.5 SLA from row 2: < 5 check/enter < 1.5 SLA, otherwise check/enter >_1.5 SLAI SLAY SLA "Advisory note to builder and enforcement agency: If row 5 indicates "< 1.5 SLA", it is critical to ensure that combustion ar•d solid -fuel burning appliances in the dwelling are provided with adequate combustion and ventilation air and vented in accordance witl- manufacturers' installation instructions and all applicable codes as specified by ASHRAE Standard 62.2 Section 6.4. Additional information about compliance with this requirement is given in Section 4.6.5 of the Residential Compliance Manual under the topic of Combus>6on and Solid -Fuel Burning Appliances. ll c.+ , ;�. i� '- w .d' y 's"•ly°`"`*f'57 ash n,,.:..fi.�' ;5 Y i .t w k N' t' ` -! ;,,..- ..,'3: r.. <... C ;l. %} Z;w.....�. rt''�A."S.:$•. "+`?•sn., ,.; i'� R � It q;;P 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 -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) appr3ved 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) VISION HEATING & AIR CONDITIONING INC Responsible Person's Name:. CSLB License: Kevin Reese 187767S HERS Provider Data Registry Information Sample Group # (if applicable): N/A tested/verified dwelling ❑ not-tested/veriftied dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CCl-1798540232 HERS Rater Company Name: BCI Testing Responsible Rater's Name: Responsible Rater's Signature: William Irvine William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC2004075 Reg: 210-N0000633A-E2000006A-E20A Registration Date/Time: 2011/02/16 11:15:56 HERS Provider: Ca10ERTSi Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -20 Building Envelope Sealing (Page 1 of 1) Site Address: 52285 Whispering Way, La Quinta CA 92253 (New Enforcement Agency: Permit Number: System) City of La Quinta 09-1309 Building Envelope Sealinq Diagnostic Testing Results CFM50H = the measured airflow in cubic feet per minute (cfm) at 50 pascals for the dwelling with air distribution registers u.2sealed. SLA = 3.819 x (CFM50 H / Conditioned Floor Area in ft2) per Residential ACM Manual Equation R3-16 Responsible Person's Name: Building Envelope Leakage CFM50H as measured using a blower door diagnostic device Kevin Reese 1. Enter the blower door leakage target CFM50H value for compliance from the CF -111 2288 tested/verified dwelling (cfm). 2. Enter the blower door leakage minimum CFM50H value corresponding to 1.5 SLA 1144 HERS Rater Company Name: from the CF -1R (cfm). Responsible Rater's Name: 3. Enter the measured CFM50H value from the blower door test (cfm) 1487 4. The leakage test passes if the measured envelope leakage CFM50H value from row is 3 p �a less than or equal to the value required for compliance from row 1, otherwise the test Pass i1 fails. check/enter Pass or Fail 5. If measured CFM50H from row 3 is less than the minimum CFM50H value corresponding to p Y. _a 1. 1.5 SLA from row 2: < 5 check/enter < 1.5 SLA, otherwise check/enter 2:1.5 SLA SLAT SLA *Advisory note to builder and enforcement agency: If row 5 indicates "< 1.5 SLA", it is critical to ensure that combustion and solid -fuel burning appliances in the dwelling are provided with adequate combustion and ventilation air and vented in accordance with, manufacturers' installation instructions and all applicable codes as specified by ASHRAE Standard 62.2 Section 6.4. Additional information a )out compliance with this requirement is given in Section 4.6.5 of the Residential Compliance Manual under the topic of Combustion and Solid -Fuel Burning Appliances. Y•Y wF�• � i.. u � .., s WI =� '• s1�' i. cy.. '.,`{ a:�,� 1 s ,� s 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 (responsole 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 -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) apprcved by the enforcement acencv. Builder or Installer information as shown on the Installation Certificate (CF -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) VISION HEATING & AIR CONDITIONING INC Responsible Person's Name: CSLB License: Kevin Reese 1877675 HERS Provider Data Registry Information Sample Group # (if applicable): N/A tested/verified dwelling ❑ not-tested/verified dwelling in a HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798540232 HERS Rater Company Name: BCI Testing Responsible Rater's Name: Responsible Rater's Signature: William Irvine William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC2004075 Reg: 210-N0000633A-E2000005A-E20A Registration Date/Time: 2011/02/16 11:15:56 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -21 Quality Insulation Installation (QII) - Framing Stage Checklist (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quinta 09-1309 1. Quality Insulation Installation (QII) - Framing Stage Checklist Air barrier and preparation for insulation verification inspection must be done at framing stage before insulation is installed. Y there are any "No" answers rows not filled out or signatures missing then this is not valid form and cannot be accepted by the building department or HERS rater. If spray foam is used an air barrier is not required NA would be checked. QII credit not allowed if any steel framing or structural: framing in the walls of a conditioned space. FLOOR AIR BARRIER n e � No N All gaps in the raised floor to unconditioned space or to outside larger than 1/8" filled with foam or caulk. (NA if SPF) Yes P 19 All openings on a second floor including under a tub where the drain penetrates the floor in sealed WALLS AIR BARRIER Yes n 0 All gaps in wall exterior sheathing to unconditioned space or to outside larger than 1/8" fi'led with foam or caulk. (NA if SPF) q 5 n j�j No gaps in sheathing against the garage, attic, or covered patio. All gaps larger than 1/8" filled with foam or caulk. (NA if SPF) R Y —es 0NA n❑ All gaps in Rim -joists in interior and exterior walls to the outside including holes drilled fo- electrical and plumbing larger than 1/8" filled with foam or caulk. (NA if SPF) © Yes ❑ No ❑ NA Rope caulk, foam gasket, or caulking bead around the entire sole plate of the home Q Yes PO All gaps around the windows are caulked or foamed (stuffing with fiberglass not acceptable) ATTIC INSPECTION Yes 0 Attic rulers appropriate tothe material installed'evenlythroughout the attic to verify depth. (NA if SPF or batt) �` , '^ i- 1 e �' ❑ IVA Square foot. of attic 2912 / 250 = 11.65 ,minimum.number•of rulers installed ,Must round..up. Number of rulers actually installed13 (NA if SPF ob r att) . ,. Res o F1 i ALL. rulers.visible.from-attic access.(NA if SPF or batt) ` r ` � '# e � t S , Yes NO n Eave vents baffles installed at all eave vents to prevent air movement under or into insulation. (NA if SPF) Yes IQp ❑ NA Area of eave vent baffle is the same or larger than the net free -ventilation area of the erre vent. (NA if SPF) CEILING AIR BARRIER Yes o All draft stops in place to form a continuous ceiling air barrier no gaps larger than 1/8". @NA if SPF) Y ❑ NA All drops covered with hard covers. Gaps around or in the hard cover larger than 1/8" filed with foam or caulk. (NA if SPF). RP All recessed light fixtures in non conditioned space IC and air tight (AT) PYes All recessed light fixtures are sealed with a gasket or caulk between the housing and the ceiling j�j Openings around flue shafts fully sealed with solid ing or flashing and any remaining gaps sealed with fire -rated caulk or sealant. Yes P Piping shafts openings fully sealed and caulked P Penetrations from wiring in interior walls, electrical boxes, fire alarms etc. sealed with caulk or sealant Yes o All duct chases, fireplace chases, and double walls sealed air tight at the ceiling level. All gaps into shafts larger than 1/8" filled with foam or caulk. Special attention paid to ducts entering shafts from ceiling. 0 Reg: 210-N0000633A-E2100008A-E21A Registration Date/Time: 2011/02/16 11:17:26 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -21' Quality Insulation Installation (QII) - Framing Stage Checklist (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quinta 09-1309 GARAGE ROOF/CEILING AIR BARRIER FOR TWO STORIES (no conditioned space over garage) Jr �[ ,N ,,ww�q��.rv„M'C 9 � 41��rai-- +W l La�'C�I[,•'?9�.Q �j+'!r Srpk. ' 0111 Responsible Person's Name: Air barrier installed at joists in garage to house transition (between floors). No gaps larger than 1/8". If SPF used then air barrier installed gaps not required to be filled. (NA if SPF or conditioned space over garage) GARAGE ROOF/CEILING AIR BARRIER FOR TWO STORIES (conditioned space over garage) n e P kzr If insulation is to be installed at subfloor then subfloor has no gaps over 1/8". Air barrier installed at joists in garage to house transition (between floors). (NA if SPF or no conditioned space over garage) nn e �j If insulation is to be installed at ceiling of garage then ceiling and joists to the outside have no gaps over 1/8". (NA if SPF or no conditioned space over garage.) *k,�ii�,.. ^'7 Jr �[ ,N ,,ww�q��.rv„M'C 9 � 41��rai-- +W l La�'C�I[,•'?9�.Q �j+'!r Srpk. ' 0111 Responsible Person's Name: CSLB License: Kevin Reese ; HERS Provider Data Registry Information kzr Q tested/verified dwelling ❑ not-tested/verifed dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CCI -1798540232 HERS Rater Company Name: BCI Testing Responsible Rater's Name: Responsible Rater's Signature: William Irvine William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC2004075 i5!t,. ym�,.['iF�'F3' 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 -611), signed and submitted by the jerson(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) VISION HEATING & AIR CONDITIONING INC Responsible Person's Name: CSLB License: Kevin Reese 1877675 HERS Provider Data Registry Information Sample Group # (if applicable): N/A Q tested/verified dwelling ❑ not-tested/verifed dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CCI -1798540232 HERS Rater Company Name: BCI Testing Responsible Rater's Name: Responsible Rater's Signature: William Irvine William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC2004075 Reg: 210-N0000633A-E2100008A-E21A Registration Date/Time: 2011/02/16 11:17:26 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -3R -ENV -22 Quality Insulation Installation (QII) - Insulation Stage Checklist (Page 1 of 3) Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quinta 09-1309 QII credit not allowed if any steel framing or structural framing in the walls of a conditioned space. Insulation Stage Checklist FLOOR INSULATION es o All floor joist cavity insulation installed to uniformly fit the cavity side-to-side and end-to-end. (NA if floors slab on grade). Yes No 9 Insulation in full contact with the subfloor, NO gaps. (NA if floors are slab on grade). (] e j[�]j Po [� NA Insulation in contact with air barrier on all five sides. (ends, sides, back). NA if floors are slab on grade. ((��jj P (�j jQo 9 Batts cut to fit around wiring and plumbing, or split (delaminated). (NA if loose fill, SPF, oc slab on grade). Yes Batt insulation has continuous support. (NA if loose fill, SPF, or slab on grade). Insulation R -value same or greater that listed on CF -1R. es No 9 SPF insulation properly adhered to avoid gaps and provide an air seal Ye❑s P SPF (Spray Polyurethane Foam Medium Density) insulation the average thickness is equa. to or greater than that listed on the CF-iR and the minimum thickness shall be no more than 1/2 inch less than the required thickness for the R -value. (NA for other forms of insulation). e❑s P d SPF list the required floor cavity R -value from CF -1R, R- . List tested average depth of insulation in X 5.8R = R this is the installed R -value and must be equal to or greater than listed on CF -IR (NA for other forms of insulation). es j� o 1 9 Measure thicknessof insulation in 6 random measurements Must be within Vs inch of the required depth, a ,' WALL INSULATION /= le Standarddepth cavities insulation fills •cavity and touches,air barrier on; all six.sides (NA if SPF used d' and. meets the required:R-value). es o All double walls and bump -outs, the insulation fills the cavity or additional air barrier installed so that the insulation fills the cavity. Insulation touches all six sides. (NA if SPF used and meets :he required R -value). Behind tub/shower, walls under stairs, and fireplace, insulation touches air barrier on fiva sides. Not required to fill the space. Cavity required to be air tight. es o 10 BATTS, not a single void/depression deeper than 3/4" in ANY stud bay. (NA if loose fill cr SPF) 1 R Yes ❑ No ❑ NA BAITS, voids/depressions less than 3/4" allowed as long as the area is not greater than 10% of the surface area for each stud bay. (NA if loose fill or SPF). Loose Fill no gaps or voids of any depth allowed. (NA if batts or SPF). Ye P Any gaps between studs or insulation larger than 1/8" must be filled with insulation or foam. es o All Rim -joists to the outside insulated. ro(�j Special attention must be paid to corner channels, wall intersections, and behind tub/shower enclosures insulated to proper R -Value. P Po All skylight shafts and attic kneewalls insulated with minimum R-19. ❑ Yes Insulation in full contact with drywall or wall finish of skylight shafts and attic kneewalls. es o Wall insulation same or better than what is listed on the CF -1R. P Po SPF insulation properly adhered to avoid gaps and provide an air seal. a Reg: 210-N0000633A-E2200007A-E22A Registration Date/Time: 2011/02/16 11:20:25 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -22 Quality Insulation Installation (QII) - Insulation Stage Checklist (Page 2 of 3) Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quint a 09-1309 � Yes a � No No SPF (Spray Polyurethane Foam Medium Density) insulation the average thickness is equal to or greater than that listed on the CF -1R and the minimum thickness shall be no more than 1.'2 inch less than the required thickness for the R -value. (NA for other forms of insulation). � Yes � No 0 SPF list the required floor cavity R -value from CF -1R, R- . List tested average depth of insulation in X 5.8R = R this is the installed R -value and must be equal to or greater than listed on CF -1R (NA for other forms of insulation) Y 10 1,9 Measure thickness of insulation in 6 random measurements. Must be within 1/2 inch of th.B required depth CEILING INSULATION BATTS there must not be a single gap/void/depression deeper than 3/4". (NA if loose fill or SPF). BATTS voids/depressions less than 3/4" allowed as long as the area is not greater than 10% of the surface area for each stud bay. (NA if loose fill or SPF). NO gaps or voids allowed for loose fill and SPF. (NA if batts). R YesYes P All ceiling insulation installed to uniformly fit the cavity side-to-side and end-to-end. l�O Insulation in full contact with the ceiling, NO gaps. Y ko Insulation in contact with air barrier on all five sides. Yes PO '19 Batts cut to fit around wiring and plumbing, or split (delaminated). (NA for loose fill or SPF). WBatts Yes t0 NA taller than the trusses must expand so that they touch each other over the trusseE. (NA for loose fill or SPF). Yes P0 SPF the average thickness is equal to or::greater than that listed on thegCF-1R and the minimum thickness.shall be no,rriore than 1/2 inch less than the required thickness for the R -value. (NA if loose fill or batts). .:z. ;., Yeso .. Insulation fully fills cavity below any.plywood platform or cat -walk. If SPF used then min°mum 3 e kq( inches. (NA if no platforms or cat -walks) ti ig ,7 i YesIo ❑ Attic access gasketed Yes nAttic 0 access insulated with rigid foam or batt insulation using adhesive or mechanical fastener. R -value same as ceiling R -value listed on CF -111 Yes o Recessed light fixtures covered full depth with insulation. If SPF used then other forms cf insulation used to cover or enclosed in a box fabricated from 1/2 -inch plywood, 18 ga. sheet meta , 1/4 -inch hard board or drywall W1Yes Wall insulation same or better than what is listed on the CF -1R ❑ NA Loose Fill Insulation at proper depth - insulation rulers visible and indicating proper de�oth and R -value for blown in insulation. (NA for batts or SPF). ©❑ Yes 0 NA Loose Fill Insulation uniformly covers the entire ceiling (or roof) area from outside of all exterior walls. (NA for batts or SPF). Yes Loose -fill mineral fiber insulation meets or exceeds manufacturer's minimum weight and thickness requirement for the target R -value. Target R -value 49_ Manufacturer's minimum required weight for the target R -value .78 (pounds -per -square foot). Sample weight .8o (pounds per sgjare foot). Yes O Manufacturer's minimum required thickness at time of installation 18.5 (inches) Manufacturer's minimum required settled thickness 18.5 (inches). Number of days since loose -fill insulation was installed 10 (days:. At the time of installation, the insulation shall be greater than or equal to the manufacturer's minimum initial insubtion thickness. If the HERS rater does not verify the insulation at the time of installation, and if the loose -fill insulafion has been in place less than seven days the thickness shall be greater than the manufacturer's minimum require.] thickness at the time of installation less 1/2 inch to account for settling. If the insulation has been in place for seven days or longer the insulation thickness shall be greater than or equal to the manufacturer's minimum required netted thickness. Minimum thickness measured (inches). Reg: 210-N0000633A-E2200007A-E22A Registration Date/Time: 2011/02/16 11:20:25 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -27 Quality Insulation Installation (QII) - Insulation Stage Checklist (Page 3 of 3) Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quinta 09-1309 GARAGE ROOF/CEILING INSULATION FOR TWO STORIES(no conditioned space over garage) n e �� ao 10 0: 7 +.a Insulation installed at joists against the air barrier in the garage to house transition. All wall insulation requirements above must be met. (NA if conditioned space over garage). GARAGE ROOF/CEILING INSULATION FOR TWO STORIES(conditioned space over garage) PP HERS Provider Data Registry Information 9 If insulation is to be installed at subfloor then the insulation must also be installed at joists against the air barrier in the garage to house transition. All ceiling and wall insulation requirements above must be met. (NA if no conditioned space over garage). n e P 0 If insulation is to be installed at ceiling of garage then the joists to the outside must be insulated and all the insulation requirements listed above must be met. (NA if no conditioned space over garage). e P 14 SPF insulation properly adhered to avoid gaps and provide an air seal e❑ P 14 SPF (Spray Polyurethane Foam Medium Density) insulation the average thickness is equal to or greater than that listed on the CF -1R and the minimum thickness shall be no more than 1/2 inch less than the required thickness for the R -value. (NA for other forms of insulation). ❑ Ps P d SPF list the required floor cavity R -value from CF -1R, R- . List tested average depth of insulation in X 5.8R = R this is the installed R -value and must be equal to or greater than listed on CF -1R (NA for other forms of insulation) Yes �jMeasure k 1i thickness of insulation in 6 random measurements. Must be within 1/2 inch of the required depth F .t > . .1 ,,,�.FF��,;y4^t+! `te ..y5� :Ja''. h".r. _ ya!' .Y•-� 3e-.tF 0: 7 +.a y w`�'�L HERS Provider Data Registry Information Sample Group # (if applicable): N/A © tested/verified dwelling la �A q, HERS sample group HERS Rater Information CaICERTS Certificate # CCl-1798540232 HERS Rater Company Name: . BCI Testing Responsible Rater's Name: Responsible Rater's Signature: William Irvine William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 iL Y�i m k 1i j fi �5 C'VT, y 4q�y�, r+.d' \:4 ll t'�Y �L �E c ° j1h , Fal zN ,a t �C f � a r Ly M rtF }ty i ' �1 4 } -0t. y ''.+ `e• i `dw' r?E.rr�w, :1}tY,�T. it ,. yiv. J ...; SF"'+1 ,� ..4;M !F •3M 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 -611), signed and submitted by the ?erson(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) Empire Insulation Responsible Person's Name: CSLB License: 1860072 Jennifer Carr HERS Provider Data Registry Information Sample Group # (if applicable): N/A © tested/verified dwelling la ❑ not-tested/verified dwelling in HERS sample group HERS Rater Information CaICERTS Certificate # CCl-1798540232 HERS Rater Company Name: . BCI Testing Responsible Rater's Name: Responsible Rater's Signature: William Irvine William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC2004075 Reg: 210-N0000633A-E2200007A-E22A Registration Date/Time: 2011/02/16 11:20:25 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4111-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page 1 of 2) Site Address: 52285 Whispering Way, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 09-1309 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Living Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This certificate is required for compliance for completely new duct systems installed in new dwelling construction, and also for completely new or replacement duct systems in existing dwellings. 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. nurt 1 Palrnna niannnctie Tact - emmnlPtPly npw nr rPnlar.PmPnt duet cvctam Enter a value for the Allowed Leakage (CFM) for the duct system leakage verification. The value entered must be the VLLDCS criteria or one of the three calculated leakage rates described below. Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Compliance Credit. If compliance credit for Allowed verified low leakage ducts in conditioned space is shown in the special features section of the CF -111, the Leakage leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4), and 25 CFM must (CFM) be entered for Allowed Leakage. Allowed leakage calculation - (select one calculation method from this section). Use 6% (leakage factor = 0.06) for calculations. When utilizing Low Leakage Air Handler (LLAH) credit, the allowed duct leakage may be specified by the CF -1R to be less than 6%, in which case the user-specified leakage rate must be used in the calculations below. For example, if the user-specified leakage (specified as a percentage of fan airflow) is reported on the CF -1R as 3%, then use a/eakage factor of 0.03 in the calculations below. Cooling system method: _ Nominal capacity of condenser in Tons __ x 400; x /eaka a factor = 6= ' CFM" """'"'`e 9 _� �', r A 4 ❑ Heating system method r+ . 21.7 x Output Capacity:in Thousands of Btu/hr x leakage factor ? CFMAl A. ❑ Measured airflow method,.(RA3:3): Enter measured fan flow in CFM here x leakage factor = CFM Enter value for Actual leakage (CFM) in the right column, from measurement using applicable duct leakage Actual Leakage pressurization test procedure from Reference Residential Appendix RA3.1(CFM @ 25 Pa). (CFM) List Actual Leakage from duct leakage test(CFM) 70 Pass if Actual Leakage is less than Allowed Leakage 0 Pass ❑ Fail For complete replacement of duct systems only, if the 6 percent leakage rate criteria cannot be met, a smoke test should be performed to verify that the excess leakage is coming only from a pre-existing furnace cabinet (air handler cabinet), and not from otheraccessible portions of the duct system. A HERS rater must verify the installation (No sampling allowed). List Actual Leakage from smoke test(CFM) Pass if all accessible leaks (except for existing air handler) are sealed using smoke ❑ Pass ❑ Fail 19 Reg: 210-N0000633A-M2000003A-M20A Registration Date/Time: 2011/02/16 11:21:47 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page 2 of 2) Site Address: 52285 Whispering Way, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 09-1309 KP Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off'Auring duct kage 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 dud leakage testing. Q All supply and return register boots must be sealed to the drywall Q New duct installations cannot utilize buildingFcavities as.pienums orplatform returns imlieu„ofeduds ; Mastic and draw bands must be used in combination with Cloth backed; rubber: adhesive duct tape: to seal leaks at uct connections. .: DECLARATION STATEMENT �i; >x4 ” #F ? • I certify under penaity�of.perjury, under the laws;of.therState;' f, Callfornia, theanformation provided on this formeis true.and correct _. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (respon^ible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) VISION HEATING & AIR CONDITIONING INC Responsible Person's Name: CSLB License: Kevin Reese 1877675 HERS Provider Data Registry Information Sample Group # (if applicable): N/A Q tested/verified dwelling la not-tested/verified dwelling in HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798540232 HERS Rater Company Name: BCI Testing Responsible Rater's Name: Responsible Rater's Signature: William Irvine William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC2004075 Reg: 210-N0000633A-M2000003A-M20A Registration Date/Time: 2011/02/16 11:21:47 HERS Provider: CalCERTS, Inc.. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page i of 2) Site Address: 52285 Whispering Way, La Quinta CA 92253 (New Enforcement Agency: Permit Nunber: System) City of La Quinta 09-1309 Enter the Duct System Name or Identification/Tag: New System Enter the Duct System Location or Area Served: Bedrooms Note: Submit one Installation Certificate for each duct system that must demonstrate comp/ianc= in the dwelling. This certificate is required for compliance for completely new duct systems installed in new dwelling construction, and also For completely new or replacement duct systems in existing dwellings. For existing dwellings, a completely rmew 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. nurt I oalcana niannnctir Tract rmmnlatalu now nr ranlaramant rinrt cuctam Enter a value for the Allowed Leakage (CFM) for the duct system leakage verification. The value entered must be the VLLDCS criteria or one of the three calculated leakage rates described below. Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Compliance Credit. If compliance credit for Allowed verified low leakage ducts in conditioned space is shown in the special features section of the CF -1R, the Leakage leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4), and 25 CFM must (CFM) be entered for Allowed Leakage. Allowed leakage calculation - (select one calculation method from this section). Use 6% (leakage factor = 0.06) for calculations. When utilizing Low Leakage Air Handler (LLAH) credit, the allowed duct leakage may .oe specified by the CF -1R to be less than 6%, in which case the user-specified leakage rate must be used in the calculations below. For example, if the user-specified leakage (specified as a percentage of fan airflow) is reported on the CF -1R as 3%, then use a/eakage factor of 0.03 in the calculations below. Cooling system method: Nominal capacity`ofcondenser in `x 40Urx leakage factor = L 0 CFM"' ❑ Heating system method 21.7 x Output Capacity'., -'in Thousands of Btu/hr x leakage factor' CFM ' M1f'C+ {OR y El Measured, airflow method,.(RA3.3): e,'' , ��,.� .. v . Enter measured fan flow in CFM here x leakage factor = CFM Enter value for Actual leakage (CFM) in the right column, from measurement using applicable duct leakage Actual Leakage pressurization test procedure from Reference Residential Appendix RA3.l(CFM @ 25 Pa). (CFM) List Actual Leakage from duct leakage test(CFM) 92 Pass if Actual Leakage is less than Allowed Leakage R Pass ❑ Fail For complete replacement of duct systems only, if the 6 percent leakage rate criteria cannot be met, a smoke test should be performed to verify that the excess leakage is coming only from a pre-existing furnace cabinet (air handler cabinet), and not from otheraccessible portions of the duct system. A HERS rater must verify t7le installation (No sampling allowed). List Actual Leakage from smoke testtCFM) Pass if all accessible leaks (except for existing air handler) are sealed using smoke ❑pass ❑Fail Reg: 210-N0000633A-M2000002A-M20A Registration Date/Time: 2011/02/16 11:21:47 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page 2 of 2) Site Address: 52285 Whispering Way, La Quinta CA 92253 (New Enforcement Agency: Permit Nunber: System) City of La Quinta 09-1309 KK Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct kage 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 Q New duct installations cannot utilize building cavities as plenums or platform-retu�ns:in lieu�of ducts--., o f� ,.W Mastic and draw bands must be used in combination with Cloth backed rubberadhesi a,ducta tpe.to seal leaks at uct connections. 'Ti DECLARATION+;STATEMENT• • I certifyunder enaltydof e."u r��k ,• 'th' 'N �SLf,• '' , ��' Y i. � p p 0 ry;:uniler therlaws.of=the•State,:of California; the:�informatiom�provided on this��form•ns truJ:and correct "`'tU • 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 -611), 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 -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) VISION HEATING & AIR CONDITIONING INC Responsible Person's Name: CSLB License: Kevin Reese 187767S HERS Provider Data Registry Information Sample Group # (if applicable): N/A tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample grcup HERS Rater Information Ca10ERTS Certificate # CCl-1798540232 HERS Rater Company Name: BCI Testing Responsible Rater's Name: Responsible Rater's Signature: William Irvine William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC200407S Reg: 210-N0000633A-M2000002A-M20A Registration Date/Time: 2011/02/16 11:21:47 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-23 Verification of High EER Equipment (Page 1 of 1) Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quinta 09-1309 Verification of High EER Equipment Procedures for verification of High EER Equipment are described in Reference Residential Appendix RA3.4. For dwelling units with multiple systems, the procedures must be applied to each system separately. 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. 1 System Name or Identification/Tag System 1 New System CSLB License: 'W, 2 System Location or Area Served Living Bedrooms ❑ not-tested/verified dwelling in la 3 Certified EER Rating of the installed equipment 11 11 BCI Testing Responsible Rater's Name: Responsible Rater's Signature: (Btu/Watt-hr) William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC2004075 4 Make and Model Number of the installed Outdoor Unit Haeir HC48D1VAE Haeir HC60D1VAE 5 Make and Model Number of the installed Inside Coil Allstyle Allstyle ASFM4821A28 ASFM6021A28 6 Make and Model Number of the installed Furnace or Haeir Haeir Air Handler. GlNSOBT07SD16BL G1N80BT100D16BL , �5; . E 7 Minimum Equipment EER required for compliance as 11 11 reported on the CF -1R 0 When a high EER system specification includes a time delay relay, the installation of the time delay relay must be verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Time Delay Relay Verification Procedure. E5 When installation of specific matched equipment is necessary to achieve a high EER, installation of the specific equipmert must be verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Matched Equipment Verification Procedure. If the Certified EER Rating in row 3 is equal to or 8 greater than the required minimum EER in row 7, the PASS PASS unit complies. If the unit complies enter Pass DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) VISION HEATING & AIR CONDITIONING INC Responsible Person's Name: 1877675 CSLB License: 'W, 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 CalCERTS Certificate # CC1-1798540232 HERS Rater Company Name: BCI Testing Responsible Rater's Name: Responsible Rater's Signature: William Irvine William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC2004075 o j,_ ¢y -:.a , �5; . E .. - .... •-.7 .. ...s Aja r t, aAl DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) VISION HEATING & AIR CONDITIONING INC Responsible Person's Name: 1877675 CSLB License: Kevin Reese 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 CalCERTS Certificate # CC1-1798540232 HERS Rater Company Name: BCI Testing Responsible Rater's Name: Responsible Rater's Signature: William Irvine William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC2004075 Reg: 210-N0000633A-M2300001A-M23A Registration Date/Time: 2011/02/16 11:30:03 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-23 Verification of High EER Equipment (P•3ge i of 1) Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quinta 09-1309 Verification of High EER Equipment Procedures for verification of High EER Equipment are described in Reference Residential Appendix RA3.4. Fo, dwelling units with multiple systems, the procedures must be applied to each system separately. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional s -'stems in the dwelling as applicable. 1 System Name or Identification/Tag System 1 New System r'4•M iYd ,v:u{^'TF ?� w.. Kevin Reese 2 System Location or Area Served Living Bedrooms ❑ not-tested/verifed dwelling in la 3 Certified EER Rating of the installed equipment 11 it a Responsible Rater's Name: Responsible Rater's Signature: (Btu/Watt-hr) William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC200407S 4 Make and Model Number of the installed Outdoor Unit Haeir HC48D1VAE Haeir HC60D1VAE 5 Make and Model Number of the installed Inside Coil Allstyle Allstyle ASFM482IA28 ASFM6021A28 1}.. ` �Kl1; 11.,�. 6 Make and Model Number of the installed Furnace or Haeir Haeir yl �W416-t}•�''S�.Y+�` Air Handler. GINSOBT07SD16BL GlNSOBT10OD16BL M.t�-'iA� 7 Minimum Equipment EER required for compliance as 11 11 reported on the CF -1R R When a high EER system specification includes a time delay relay, the installation of the time delay relay must be verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Time Delay Relay Verification Procedure. 2 When installation of specific matched equipment is necessary to achieve a high EER, installation of the specific equipment must be verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Matched Equipment Verification Prooedure. If the Certified EER Rating in row 3 is equal to or 8 greater than the required minimum EER in row 7, the PASS PASS unit complies. If the unit complies enter Pass .;� .,.� Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) e� L.�`.a,..:� '( X., ..•:v .FV# f T r'4•M iYd ,v:u{^'TF ?� w.. Kevin Reese HERS Provider Data Registry Information Sample Group # (if applicable): N/A Q tested/verified dwelling ❑ not-tested/verifed dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798540232 HERS Rater Company Name: a Responsible Rater's Name: Responsible Rater's Signature: William Irvine William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC200407S `� Y .ark{ 'E *r }�5' t* 1}.. ` �Kl1; 11.,�. h.i :.}. ��•,.:eM"Y _"'.vT:.Ta. <+�'�"'i�..... A. A•"z.µ �.n.:,):{1f{�h, iV� yl �W416-t}•�''S�.Y+�` M.t�-'iA� 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 thie: 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 -IR) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the oerson(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) app-oved 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) VISION HEATING & AIR CONDITIONING INC Responsible Person's Name: CSLB License: 187767S Kevin Reese HERS Provider Data Registry Information Sample Group # (if applicable): N/A Q tested/verified dwelling ❑ not-tested/verifed dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798540232 HERS Rater Company Name: BCI Testing Responsible Rater's Name: Responsible Rater's Signature: William Irvine William Irvine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 2/10/2011 CC200407S Reg: 210-N0000633A-M2300001A-M23A Registration Date/Time: 2011/02/16 11:30:03 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 "ERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-2! Refrigerant Charge Verification - Standard Measurement Procedure . (Page i of 5' Site Address: Enforcement Agency:Permit Number: 52285 Whispering Way,.La Quinta CA 92253 City of La Quinta 09-1309 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge veri=kation 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 CIL 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 SUDDIV and Return Plenums of Air Handler System Name or Identification/Tag System 1 New System System Location or Area Served Living Living 1 0Yes ElNo 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 0 Yes ❑ No 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 System> 1 New -System k The sensor is factory~ installed, or field installed according to manufacturer's 3 ❑`Yes ,0'N6, specifications, or is:installed by methods/specifications approved:by, the Executive Director. The sensor wire is terminated with a stagdard_minr,,plug suitable for�connection to a 4 ElWes - F� f ❑'No digital thermometer: The,*sensor mini pldg' kis accessible to the instalhngaechnician r 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 indiction of the saturation temperature of the coil. Yes to3, 4, and 5 is a pass. Enter N/A if STMS are not ✓ p N/A ✓ E) Pass ✓ El applicable. Otherwise enter Pass or Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag I System 1 1 New System 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 installim technician and the HERS rater without changing the airflow through the condensar 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 ✓ p N/A ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail N4 f Reg: 210-N0000633A-M2500004A-M25A Registration Date/Time: 2011/02/16 11:40:25 HERS ?rovider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quinta 09-1309 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 Referenc? Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additio>>al 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 New System Calibration ,4System System Location or Area Served Living Living (rmust be;re-calibrated ^ Outdoor Unit Serial # AA86LOE020ONKASR0041 AA8620E0200NKASS0106 •�.,:r..,. �.,. � :., � fes. Outdoor Unit Make Haeir Haeir Outdoor Unit Model HC48D1VAE HC60DIVA Nominal Cooling Capacity Btu/hr 48000 60000 Date of Verification 2/10/2011 2/10/2011 cauoranon or waonostic instruments Date of Refrigerant Gauge 1/21/2011 (must be re -calibrated Calibration ,4System _monthly) Date of ThermocoupleCalibration�� fir, `1%21/2011,; F (rmust be;re-calibrated ^ ;. .�x,,:.,,., .sI �,, :; monthly) Measured'jemperature5 [IF) uv< Vis=+_, A;4 1':1144N, 4, System Name or � NewSystem"" = , ,4System Identifcatibn/Tag a. .�,.. r. ^ SuPPIY (evaporator leaving)'air ,... <.., ;._.... ; ,... ,,. . :.:, •�.,:r..,. �.,. � :., � fes. 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 41.5 37.3 temperature (Tevaporator, sat) Condensor saturation 81.3 87.7 temperature (Tcondensor, sat) Suction line temperature 64.1 55.7 (Tsuction) Liquid Line Temperature (Tliquid) 75.7 80 Condenser (entering) air dry-bulb temperature (Tcondenser, db) 5 Reg: 210-N0000633A-M2500004A-M25A Registration Date/Time: 2011/02/16 11:40:25 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)I Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quinta V09-1309 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 Gable below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name or Identification/Tag�'�� v System 1 NeweSystem Y Calculated:r-Minimum Airflow Requirement�(CFM) ;1200 1.500 't''a' `� fi :.`•�<;. .tom--; Measy. red Airflow using RA3:3 procedures �� s '" 1343<k (CFM) *^ Passes if measured airflow is greater than or equal to the calculated minimum airflow PASS PASS requirement. Enter Pass or Fail Ea Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is requied 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: 210-N0000633A-M2500004A-M25A Registration Date/Time: 2011/02/16 11:40:25 HERS :Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (P3ge 4 of 5) Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quinta 09-1309 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 New System Calculate: Actual Subcooling = 5.6 7.7 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 8 10 Calculate difference: -2.4 -2.3 Actual Subcooling - Target Subcooling = System passes if difference is between -4°F and +4°F PASS PASS ` Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 New System Calculate: Actual Superheat = 22,6 18.4 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 3 to 26 3 to 26 between 3°F and 26°F if manufacturer's specification is not available) System passes -if actual superheat is .within the ` allowable superheat range jEnter PassorFail sM� r.:� ��?• �� <'in qtr' pw t Reg: 210-N0000633A-M2500004A-M25A Registration Date/Time: 2011/02/16 11:40:25 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-41-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 1 City of La Quinta" 09-1309 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 we -e taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 New System I` HERS Rater Company Name: BCI Testing . " System meets all refrigerant charge and Responsible Rater's Signature: William Irvine Responsible Rater's Certification Number w/ this HERS Provider: CC2004075 Date Signed: 2/10/2011,. airflow requirements. PASS PASS Enter Pass or Fail t S •;.. ,:.ar rra,,, `'° `h•cr`'"-".a'%^^ak a.- %4A r• x r r 'r �''01 vy8' a !y , .i.``2'e,r�`', — rYa TV •. - 'EY a: r '�i�; j 5,+� '-•, kam�:.,, .6"�` .a•k P9FA • 1 •t�•. -hr � i �;}'9 ,fir k t •yt�� ,iii•'` � .Y ��e ,yR c"+�4 � �� ,�.fT+.a k ir` . �.,•+y� � �. k �` 1' ,... F" �oolro u �,t r :� y r t �' ' y�ai w •c :i w,� uaNn §' r � ± # 3 •iy., R s. 2 4 Hew'• b 'A:7 11:.,a DECLARATION STATEMENT ' t . 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). ,A . 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-lR) 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) r Responsible Person's Name: CSLB License: 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 # CC1-1798540232 HERS Rater Company Name: BCI Testing . " Responsible Rater's Name: • William Irvine Responsible Rater's Signature: William Irvine Responsible Rater's Certification Number w/ this HERS Provider: CC2004075 Date Signed: 2/10/2011,. i ti t i Reg:'210-N0000633A-M2500004A-M25A Registration Date/Time: 2011/02/16 11:40:25 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: . 52285 Whispering Way, La Quinta CA 92253 City of La Quinta 09-1309 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge veretcation for compliance, a MECH724 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 New System System Location or Area Served Living ILiving 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 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 System Name'or Identification/Tag.r System.l. New -,System F" r The sensor is factory installed, or field installed according to manufacturer's 3 p:Yes El No- specifications, or is installed by methods/specifications approvedby the Executive Director. Director. n 4d , 4.. The sensor wire is terminated with a standard mini_: plug suitable for connection to at 4 ❑'Y.es '' p'No ` " digitalahermometer The°sensormini plug is accessible to tlie,-installing technician k and the HERS rater without changing the airflow through the condenser coil and the HERS rater without changing the airflow through the condenser coil 5 ❑ Yes ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. saturation temperature of the coil. Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not ✓ D N/A ✓ E] Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag System 1 New System 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 ✓ 0 N/A ✓ El Pass F ✓ ❑Fail I applicable. Otherwise enter Pass or Fail Reg: 210-N0000633A-M2500004A-M25A 2008 Residential Compliance Forms t "N 10 Registration Date/Time: 2011/02/16 11:40:25 HERS ?rovider: CalCERTS, Inc. March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quinta 09-1309 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 additicnal 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 1 New System %: M1X - .�:.. .. g F System Location or Area Served Living Living (must be `e -calibrated Outdoor Unit Serial # AA86LOE0200NKASR0041 AA8620E0200NKASS0106 Outdoor Unit Make Haeir Haeir Outdoor Unit Model HC48D1VAE HC6001VA Nominal Cooling Capacity Btu/hr 48000 60000 Date of Verification 2/10/2011 2/10/2011 a•auuramun ur viaunustnc instruments Date of Refrigerant Gauge Calibration 1/21/2011 (must be -e-calibrated %: M1X - .�:.. .. g F manthly) Date of Thermocouple Calibration yr t7 F21/2'011 � € `"� (must be `e -calibrated x : mcnthly) measureu) iemperatures't-r:) i' y as -S ew",:t %t*.t., _f .r,. 14**Vn. System Name or Identification/Tag .. , �a °� = i �yy System i ,At '?Str+.; iy .t. t�4Yw New, System �' F :•'i:' .�'^Mcr i %: M1X - .�:.. .. g F Supply (evaporator leaving)'air dry-bulb temperature (T supply, db) Return (evaporator entering) air dry-bulb temperature (Treturn, db) Return (evaporator entering) air wet -bulb temperature (Treturn, wb) Evaporator saturation 41.5 37.3 temperature (Tevaporator, sat) Condensor saturation 81.3 87.7 temperature (Tcondensor, sat) Suction line temperature 64.1 55.7 (Tsuction) Liquid Line Temperature (Tliquid) 75.7 80 Condenser (entering) air dry-bulb temperature (Tcondenser, db) Reg: 210-N0000633A-M2500004A-M25A Registration Date/Time: 2011/02/16 11:40:25 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 Si Site Address: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quinta 09-1309 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 ane of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil ai-flow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the Lable below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name For Identification/Tag ! 7 Systeme i 'New System {2 }k� Calculated: Minimum Airflow Requirement (CFM) 1200 rt i"��1500 '�L' L dv W. Measured Airflow using,RA3 3;pr6ceduresJr k,V jr 41f (CFM)c1343,." Passes if measured airflow is greater than or equal to the calculated minimum airflow PASS PASS 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: 210-N0000633A-M2500004A-M25A Registration Date/Time: 2011/02/16 11:40:25 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-2S Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of S) Site Address: Enforcement Agency: Permit Numt•er: 52285 Whispering Way, La Quinta CA 92253 City of La Quinta 09-1309 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 i New System '.i�?SS k C Calculate: Actual Subcooling = 5.6 7.7 ty Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 8 10 Calculate difference: -2,4 -2.3 Actual Subcooling - Target Subcooling = System passes if difference is between -4°F and +4°F PASS PASS Enter Pass or Fail PASS)' PASSs*.` 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 New System '.i�?SS k C Calculate: Actual Superheat = 22,6 18.4 ty Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 3 to 26 3 to 26 between 3°F and 26°F if manufacturer's specification is not available) System passes1f actual superheat isXwithmwthe allowable superheat range !` PASS)' PASSs*.` e-:Enter.Pass;or Reg: 210-N0000633A-M2500004A-M25A Registration Date/Time: 2011/02/16 11:40:25 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 Nrt. '.i�?SS k C }}'.W � yJ•�VF ty Reg: 210-N0000633A-M2500004A-M25A Registration Date/Time: 2011/02/16 11:40:25 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: Enforcement Agency: Permit Number: 52285 Whispering Way, La Quinta CA 92253 City of La Quint a 09-1309 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum codling 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 New System HERS Rater Information CaICERTS Certificate # CCl-1798540232 HERS Rater Company Name: BCI Testing System meets all refrigerant charge and Responsible Rater's Signature: William Irvine Responsible Rater's Certification Number w/ this HERS Provider: CC2004075 Date Signed: 2/10/2011 airflow requirements. PASS PASS Enter Pass or Fail Pillvas w e g #+� d g i ti t�v e,e f"L its fib y ka /• ;�;i s,r' ,Tx x'a'� i!+"' r��" 3. 1TI—. tt y„ r., -r'. !}{"'Y` .•uF +` •.. ;e• "` Fra a �' ,t� �'� h��`. t �<`�.-,"tiN•>?4'�eti��f''',,,„a'� � � : "b �.,�',.,s o; � ��tMWt+.e� ��;. �rN �;;x�r^�W+ek g•�U�,�� m'�t�-?`�5+�'�; "�`.'`' 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 thi's 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 -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) Responsible Person's Name: CSLB License: 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 CaICERTS Certificate # CCl-1798540232 HERS Rater Company Name: BCI Testing Responsible Rater's Name: William Irvine Responsible Rater's Signature: William Irvine Responsible Rater's Certification Number w/ this HERS Provider: CC2004075 Date Signed: 2/10/2011 Reg: 210-N0000633A-M2500004A-M25A Registration Date/Time: 2011/02/16 11:40:25 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010