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12-0419 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000419 Property Address: 57095 WINGED APN: 762 -170 -023 - Application description: MECHANICAL Property Zoning: LOW DENSITY Application valuation: 297"53 Applicant: Tiht °F 4 Q" FOOT BUILDING & SAFETY DEPARTMENT BUILDING PERMIT RESIDENTIAL Architect or Engineer: 1A LICENSED NTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am lice ed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prof ionals Code, and my License is in full force and effect. License Class: �C220 cense No.: 686310 Date: Wi_/_L{ /tea Contractor: R -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the, following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)•: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: FOLEY,JOHN J TRUST 57095 WINGED FOOT LA QUINTA, CA 92253 Contractor: GENERAL AIR CONDITIONING 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (760) 343 - 74 88 Lic. No.: 686310 VOICE (760) 777-7012 FAX (760) 777-7011 ' 7/12 APR 171012 CITY OF LA Oil 1,,,. WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier ZENITH INS CO Policy tuber Z071741501 I certify that, in the performance of the w for which this permit is issued, I shall not employ any person in any manner so as to becom ubject to the workers' compensation laws of California, and agree that, if I should become su ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forth th comply with those provisions. � Date: %1/ 1 L Applicant: WARNING: FAILURE TO SECURE WORK CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000)• IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such per i , or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the ab information is correct. I agree to comply with all city and county ordinances and state laws relating to buildin nstruction, and hereby authorize representatives of this county to enter upon the above-mentioned property f nspection purposes. Date: `T %} Signature (Applicant or Agent): Application Number . . . . . 12-00000419 Permit MECHANICAL Additional desc . . Permit Fee . . . . 66.00 Plan Check Fee 16.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/14/12 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 ---------------------------------------------------------------------------- Special Notes and Comments (2) HVAC CHANGE OUTS - 13SEER/78AFUE SPLIT SYSTEMS [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING CODES. April 17, 2012 12:39:16 PM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 2.00 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 66.00 .00 .00. 66.00 Plan Check Total 16.50 .00 .00 16.50 Other Fee Total 2.00 .00 .00 2.00 Grand Total 84.50 .00 .00 84.50 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date Permit #: 57095 WINGED FOOT (SYS 2) La Quinta, CA 92253 City of La Quinta Apr -6, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® Indoor Coil ®.AFUE 78% ® SEER 13.0 ❑ COP [1HSPF ❑ R 6 (CZ 10-13) Served by system ® Setback If not.31ready present, must be ® Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) 1800 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a register -ad copy of the CF -IR and CF -6R shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: • All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-H =RS replaced CF -411 forms: MECH-21 and (for split systems) MECH-25 • Condenser Coil and /or • Indoor Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-H =RS • Furnace CF -4R forms: MECH-21 and (for split systems) MECH-25 age For Split Systems: Duct leak < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requiremerrt), TMAH e 4 15 perreRt Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or [13. Existing duct systems are constructed, insulated or sealed with asbestos [14. The system will not be Ducted (ie. Ductless.Mini-Split_System) (Also Exempt-from;Refrigerant Charge) p ❑ 2. New`HVAC System Required Forms: ) ) .Cut Wor Changeout with; new ducts -'(all new .'" - - _ CF611forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-RS 22 HE, and ductirig,� all ne,w MEC CF - 41 forms: MECH-20, and (for split systems) MECH-22, and MECH-25 equipment For Split Systems: Duct leakage < 6 -percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, SIMS, and either HSPP or PSPP. For Packaged Units: Duct leakage' < 6 percent ❑ 3..New Ducts with/or without Required Forms: Replacement j . Includes replacing or installing all new ducting and/or outdoor condensing unit CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent 114. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -411 forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design icentified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Danielle Garcia Signature: Danielle Garcia Company: HARRISON ENTERPRISES INC Date: 4pr 16, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone (760) 343-7488 Reg: 212-A0018936A-00000000-0000 Registration Date/Time: 2012/04/16 19:53:30 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 Bin # Cit of La Qurnta • Building &r Safety Division Permit # P.O. Box 1504, 78.495 Otte ramp/co lei • 0` 1q [a Qulnta, CA 92253 - (760): 777-7012 Building Perm -it -Application and Tracking Sheet Project Address: vq 13. w• D ,qa fbQ . . Owner's Name: J Q e L A. P. Number: �p 2 ` 0:O 2 3 Address: 57 Q qS y V Legal Description: City, ST, Zip: LQ IVUIn�f'Ii . ! ,Ae q 22 C 3 Contractor: Address: City, ST, Zip:'—�'•� Telephone: • 2 7 Project Description: 11Y 0: 5 t 4 ion Telephone:°°% State Lic. # : Arch., Engn, Designer: a C . CI 1 ClG2 ar. q e .. 3 City Lic. #: 1v0 (10 Address: Telephoner State Lic. #: Name of Contact Person: Construction Type: Occupancy: `, ,: ,. • . '..Project type (circle one): New Aden After Repair Demo p G(e e.,,i Sq. Ft.: 3 CIO U # Stories: # Units: Telephone # of Contact Person: '7!o D• 3 Y-6. Estimated Value of Project: 2 V1 S 3. APPLICANT: DO. NOT WRITE. BELOW THIS LINE' # Submittal Plan Sets• Req'd RWd TRACIMG Plan Check submitted PERMIT FEES Item Amount Structural Cafes. Reviewed, ready for corrections Plan Chedt Deposit Truss Cales. Called Contact Person Plan Check Balance • Title 24 Coles. Plans picked up CiinstrucEon Flood plain plan Plans resubmitted Mechanical Grading plan 2n° Review, ready for corrections/issue Electrical Subcontector List Called Contact Person Plumbing; Grant Deed Plans picked up. S.M.I. H.O.A. Approval Plans resubmitted Grading IN 'r° Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr. Date of permit issue School Rees Total Permit Fees , 1. HVAC Field Data Sheet pg i oft Client Name � L- ,y ' Job # 122-22Date -/Z Address 5-742 94�G�.rr/G�� /526-r Ph # 740.77/ -Z df 7 Techniclan(s) SGd'77— Permit # Gauge/Thermocouple Calibration Date-/Z-t1fif Package j Some Ducts Only I AR Duds 0* (Circle We Of Volk) AlEC I -Q4 , FgaipmeniData TONE 1 ZON62 ZOAF i ZONB4 System Location or Area Served Heating Equipment Make Heating Equipment Model SG Z. 8 J U d qO X41%0 ARI Reference Number y / S- 6 Heating EquipmentAFUED Duct Location (attic, crawlspace, etc.) r G Duct R Value (if ducts were installed) ; Z— . Z— Heating Load Heating Equipment Output Capacity d vo ®D D 71P, a Condenser Make /- Condenser Model L -o YrLg A6O -2-70 Size in Tons SEER &EER fl, Cooling Load D O D OD a Cooling Capadity '11 1 1-20&21 QuctT&Wft Duct leakage pretest result Dart Leakage fmal Result <m MAvutopass (646) P=IF" PassIFatl t3>Scpff � Duct Leakage Poral Result <60 ClWton to pass (iS%) Pass using 60% leakage reduction? E=PW atm Pass using smoke and visual inspection? WafZ2.6rA9Cil2-S 'CooHn#OWAirflow& Pan.t+YatsDraw . Measured Air Volume from Flow Grid or Hood NEW DUCTS Target: 350 CFM/t w x Condenser Tons ClSANGWIT Target: 300 CFM/tan x condenser Tons Measured air greater than Targets (YIN) Measured Fan Watt Draw Target 0.58 watts/measured CFM = Measured Watts less than Target? (YIN) Copyright 0 2KI EDS EmV Driven Ste, hm HVAC Field Data Sheet Pg 2 of z Client Name �D Z 1:-14e, Job # 1,3j _ _y ate y - / _l �— MNa[ ZS Charge&Afrjlaw ZOMI ZONE ZONB3 ZONB4 Condenser Serial Number 7V tzl Supply air dry bulb temperature v 7 y Return air dry bulb temperature 7Z Return air wet bulb temperature Evaporator Saturation Temperature y Z Condenser Saturation Temperature 6 Suction Line Temperature Z K Liquid Line Temperature Suction Pressure Z ! ! Z Liquid Pressure l / Actual Airflow Temperature Split Z— 2, 3 Target Temperature Split from Table RA32-3 Z (% Z � Passes if difference is t 3' of Target Temp (Y/N) Actual Subcooling (t 4' of Target to pass) `� 3 Target Subcooling fiom Mfr. Actual Superheat (3 to 26' to pass) outside air dry bulb temperature MECMg6,°Wejgh-ln OwVh g below55-. Actual Line Set length (ft) MfYs Standard Line Set Length (ft) Length Difference = Correction Factor (ounces per foot) Target Correction Factor x Length Difference System Charged to Target? (Y/N) Other Daft Min►mum amps 2- 3 l Maximum amps - �l Breaker size Z © �O Compressor amps Return Static Pressure Supply Static Pressure Supply Air Wet Bulb Temperature •: ALL APp"CABLEBOMW ON TMSFORMMUST BBCOMPWM FOR BACNIOR NO ga[CEPTIONS copyrw 0 2011 Em BOATU Ditvm sobdimm. bm N I N F O M A T I O N A L 6 V L L E T N®. Q SMOKE AND CARBON MONOXIDE ALARM RETROFIT New State Building Code Requirement effective January 1, 2011 2010 California Residential Code -sections R314.2 and R315.2 2010 California Building Code Section 420.4 Where a permit is required for alterations, repairs or additidrs exceeding $1000, In- cluding exterlor work; I e, roofing, HVAC change -outs, electr/cal panel upgrades, windows, etc. existing dwelling or sleeping units that have attached garages or fuel burning appliances including fireplaces shall be provided with a carbon monoxide alarm. Smoke and Carbon monoxide alarms shall be installed in the following locations. • In all bedrooms (only require -Smoke Alarms unless bedroo.ns contain a gas app/l- ance then a carbon monoxide alarm is required as well) • Immediately outside of each separate bedroom. (require Smoke and Carbon Mon- oxide Alarms) • 'In each story level of the dwelling, including basements andhabitable attic rooms (require Smoke and Carbon Monoxide Alarms) Power supply. The. carbon monoxide alarms shall receive their primary power f.-om the building wiring and shall be equipped with a battery back-up. Exception: In existing dwelling units the alarms are permitted to be solely bat- tery operated where repairs or alteration do not result in the removal or wall and ceiling finishes or there is no access by means of atic basement or crawl space. , Interconnectlon. Where more than one carbon monoxide alarm is required to to installed within the dwelling unit or within a sleeping unit the alarm shall be intercrnnected in a manner that activation of one alarm shall activate all of the alarms. Exception: Interconnection is not required in existing dweling units where re- pairs do not result in the removal of wall and ceiling finisl;es, there is no ac- cess by means of attic, basement or crawl space. 'he Building Inspector will verify the installatlon of the'smot:e and carbon mon- 1xide alarms during the inspection process or complete and sign.under the pen- Ity of perjury the "Smoke and Carbon Monoxide Alarm Retrofit Verificatlon". r' `1 SMOKE AND CAkBON MONOXIDE ALARM RETROFIT. VERIFICATION l , and I, (Print Property Owner's Name) (Tenant's Name - if sane as Owner write "Same") who own and/or live in the dwelling located at: , (Address). verify that the smoke and carbon monoxide alarms required by the California Residential Code (CRC) have been installed in the dwelling, incompliance with the code and with the manufacturer's instructions and further •that4hey have been tested and dofunction• properly: In an effort to enhance life safety within dwellings, CRC Section R314.6, R315':2 and CBC 420.4 require the re rofit of these alarms in existing dwellings when alterations, repairs or additions requiring a permit and exceeding $1,000 in value are made. Generally, the alarms must be hard wired (I 10 volt) with battery back-up and all alarms are to be interconnected. 'If the installation of the alarms will require the removal of wall or ceiling finishes or there is no access by means of attic, basement or crawl space, then alarms may be solely battery operated and not interconnected. Alarms must be installed in all of the following locations within the existing dwelling: ➢ In all bedrooms (onlyrequire Smoke Alarms) ➢ Immediately outside of:each separate bedroom.. (require Smoke and Carbon Monoxide Alarms) ➢ In each story level of the dwelling, including basements and habitable attic rooms (require Smoke and Carbon Monoxide Alarms) These safety devices must be Installed by the time a final inspection is requested for your project. I understand the above requirements and certify that we now have smoke alarms and carbon monoxide alarms installed that comply. We agree to comply with the CRC. In regards to. smoke alarms, carbon monoxide alarms. yl/y�lY ign reof ner Date ATTENTION OWNER - OCCUPANT: Signature of Tenant Date This is a Voluntary Smoke and Carbon Monoxide Alarm verification procedure. If you prefer a Bullding Inspector to perform the verification, you must arrange to have an adult present at the time of Inspection. NOTE: This Verification is only used when normal access to the Interior of the dwelling by the City of: uilding Inspector Is not achieved during the course of project construction. It is normally used for projects such as re-rooring, re -siding, patio covers, swimming pools and the like. N CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 57095 WINGED FOOT, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-0419 Enter the Duct System Name or Identification/Tag: Enter the Duct System Location or Area Served: Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts a:e accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement DUCt System." Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. ❑ 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow ❑ 3. Reduce leakage by 60% and conduct smoke and fix all leaks 'a ❑ 4. Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options„1, 2, or 3 must _be attempted,before.,utilizing OptionA.), Determinvbminal Fan Flow using one ofithe following three calculation methods:A'r ✓ 13 Cooling system method: Size of.condenser in Tons I x 400 = j CFM -• ✓ ❑Heating d system meth 21.7 x _ Output Cap in Thousands of Btu/hr = _CFM --- "' ✓ ❑ Measured,sy_stem airflow RA3.3 est procedure using airflo tw CFM, Option 1 used then: 1 Allowed leakage = Fan Flow 111 x 0.15 = _ CFM Actua_I,Leakage"=. _ CFM Pass if Leakage Actual is less than Allowed 0 Pass Fail Option 2 used then: 2 Allowed leakage = Fan Flow x 0.10 = _ CFM Actual Leakage to outside•= CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _/ Initial leakage _) x 100% _ % Reduction Pass if % Reduction > 60% Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke. 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 Fail Reg: 212-A0018935A-M2100001A-M21A Registration Date/Time: 2012/06/05 00:19:11 HERS Prouider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4111-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: 57095 WINGED FOOT, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-0419 ❑ 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 -equired, may be configured to the closed position during duct leakage testing. ❑ All supply and return register boots must beisealed to the drywall if smoke test Is utilized for,. compliance - applies"to duct leakage compliance option 3 (leakage reduction by 60%) and option`4�(fix all accessible leaks) described abo;+�- � �- ❑ New duct install"a,tions cannot utilize building cavities asJplenums%r platform returns in Ilea of ducts. L" cz� ❑ Mastic and draw bands must beusedin combination with cloth backed rubber adhesive duct tape to seal leaks at all new duct connection=s DECLARATION STATEMENT, • I certify under penalty of perjury, uA der 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 r--quirements 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 :he person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 303964 ❑ tested/verified dwelling not-tested/%..erified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798647716 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/4/2012 CC20OS784 Reg: 212-A0018935A-M2100001A-M21A Registration Date/Time: 2012/06/05 00:19:11 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT, La Quinta CA 92253 City of La Quinta 12-0419 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 3 System Location or Area Served ❑ Y i 1 ❑ Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 ❑ Yes ❑ No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and 2 is a pass. Enter Pass or Faill ✓ ❑ Pass ✓ ❑Fail STMS - Sensor.on;the EvaporatorCoil - - _ ---- System Narne or Identification/Tag ): 3 Yes (C3 ❑ Y i The sensor is factory installed, orjfield installed according to manufacturers _ specifications, or is°installed.by methods/specifications approved by the Executive Director. 4 ❑ Yes+ ., ❑.No No'' The sensor wire is terminated.with a standard mini plug suitable fonconnection,to'a F digital thermometer. The'sensor mini plug is accessible to the instal ng,technician and the HERS rater without changing the airflow through the'conderser coil 5 p Yes..--� _ — - � ❑ No When attached to a digital thermometer, the sensor provides an indkation of the saturation temperature of the coil. Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise ente' Pass or Fail ✓ ❑ N/A ✓ ❑ Pass ✓ [3 Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the install -ng technician and the HERS rater without changing the airflow through the conderser 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 V ®N/A ✓ ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail Reg: 212-A0018935A-M2500001A-M25A Registration Date/Time: 2012/06/05 00:17:58 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 )4 n 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: 57095 WINGED FOOT, La Quinta CA 92253 City of La Quinta 12-0419 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 Refe. ence 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 phocedure. • 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 (must be re -calibrated monthly) --- Date of berm couple; Calibration r Z' t F System Location or Area Served .J. Outdoor Unit Serial # Outdoor Unit Make Outdoor Unit Model Nominal Cooling Capacity Btu/hr Date of Verification a.anurauion or uiaunosvir instruments Date of Refrigerant Gauge Calibration (must be re -calibrated monthly) --- Date of berm couple; Calibration r Z' t F y t (must be re -calibrated monthly) measurea temperatures -t, -r) ) ) ^ F t r 1 \ f` System Name or Ident fcation/Tag .J. Supply (evaporator leaving) air dry-bulb temperature (Tsupply, db) Return (evaporator entering) air dry-bulb temperature (Treturn, db) Return (evaporator entering) air wet -bulb temperature (Treturn, wb) Evaporator saturation temperature (Tevaporator, sat) Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db) �s 0 Reg: 212-A0018935A-M2500001A-M25A Registration Date/Time: 2012/06/05 00:17:58 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 V INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT, La Quinta CA 92253 1 City of La Quint a 112-0419 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag Calculate: Actual Temperature Split = Treturn, db - Tsupply,db Target Temperature Split from Table RA3.2-3 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - Target Temperature Split = Passes if difference is between -4°F and +4°F or, upon remeasurement, if between -4°F and -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Req1 uirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) _. System Name o"r-Identification/Tag Calculated Minimum Airflow" equirement (CFM) I r i Measured Airflow using RA3 3 procedures (CFM) Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. _- -- Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -6°F and +6°F Enter Pass or Fail Reg: 212-A0018935A-M2500001A-M25A Registration Date/Time: 2012/06/05 00:17:58 HERS Provider: CalCERTS, Inc. 2008 Residential.Compliance Forms March 2010 Is 0 INSTALLATION CERTIFICATE CF-4R-MECH-2E Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5] Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT, La Quinta CA 92253 City of La Quinta 12-0419 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Subcooling = Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer Calculate difference: Actual Subcooling - Target Subcooling = System passes if difference is between y -40F and +4°F Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be ased for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Superheat = Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range between 30F and 260F if manufacturer's specification is not available) __ y System passes^if actual superheat is'within'the allowable superheat range Enter Pass or Fail k Reg: 212-A0018935A-M2500001A-M25A Registration Date/Time: 2012/06/05 00:17:58 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT, La Quinta CA 92253 City of La Quinta 12-0419 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag Danielle Garcia 1686310 HERS Provider Data Registry Information 1 System meets all refrigerant charge and airflow Fgnot-tested/vegified dwelling in RS sample group leg requirements. HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: J Enter Pass or Fail William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/4/2012 CC2005784 1 P�J-? _7 -4C�: _- DECLARATION STATEMENT, • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is t-ue 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 recuirements 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 tha_ 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) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 303964 ❑ tested/verified dwelling Fgnot-tested/vegified dwelling in RS sample group leg HERS Rater Information CalCERTS Certificate # CCl-1798647716 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/4/2012 CC2005784 Reg: 212-A0018935A-M2500001A-M25A Registration Date/Time: 2012/06/05 00:17:58 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 Enforcement Agency: Permil Number: (System 1) City of La Quinta 12-0419 Enter the Duct System Name or Identification/Tag: Enter the Duct System Location or Area Served: Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts a.e accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. 1. Measured leakage less than 15% of fan flow 2. Measured leakage to outside less than 10% of Fan Flow p 3. Reduce leakage by 60% and conduct smoke and fix all leaks 4. Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options,j, 2, or 3 mustbe,attempted.,before..utilizing OptionA.), ,._ -_ _ , Determine nominal Fan Flow using one of.the"following three calculation methods. ✓ O Co/ I ooling system method: Size of condenser in Tons x 400 = f CFM ✓ IJ system Heating method: 21.7 x Output Capacity in Thousands of Btu/hr = _ CFM ✓ ❑ Measured,syste airflow using RA3.3 airflow',test CFM, procedures: _ Option 1 used then:~ 3 1 Allowed leakage = Fan Flow x 0.15 = _ CFM Actual. Leakage`= _ CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then:` 2 Allowed leakage = Fan Flow_ x 0.10 = _ CFM Actual Leakage to outside.= CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _/ Initial leakage x 100% _ % Reduction Pass if % Reduction > 60% Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke. 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 Fail Reg: 212-A0018936A-M2100001A-M21A Registration Date/Time: 2012/06/05 00:19:11 HERS Prcvider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF'-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 Enforcement Agency: Permit. Number: (System 1) City of La Quinta 12-0419 I ❑ 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 ope-i only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. ❑ All supply and return register boots must besealed to the drywall if smoke test` is utilized f -Jr compliance — applies"to duct leakage compliance option 3 (leakage reduction by 60%) and option 4N(fix alVaccessible leaks) described abo��"- / - W..._ --,, ❑ New duct installations cannot utilize building cavities as"plenums� or platform returns in lieu of ducts.. tf TU ❑ Mastic and draw bands must be used in combination with cloth backed rubber adhesive duet tape to 4seal �t leaks at all new duct connections DECLARATION STATEMENTP • 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 :his 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 tie person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 303964 ❑ tested/verified dwelling 0 not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798647717 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William David Pointer Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/4/2012 CC2005784 Reg: 212-A0018936A-M2100001A-M21A Registration Date/Time: 2012/06/05 00:19:11 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-2S Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of S) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 1 City of La Quint a 12-0419 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 charee verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely rew 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 3 System Location or Area Served A p No 1 ❑ Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 ❑ Yes ❑ No 1 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. 1 Enter Pass or Fail ✓ ❑ Pass ✓ ❑Fail i STMS - Sensor.on,the Evaporator Coil System Name or Identification/Tag ( ,• ; ' '- �, 3 (13 Yes A p No The sensor is factory installed, orjfield installed according to manufacturer's . specifications, or is'installed by methods/specifications approved b the Executive' - Director. 4 p Yes I ❑ No The sensor wire is terminated.with a standard mini plug suitable fo connection,to a digital thermometer. The sensor mini plug is accessible to the installing,tecFinician and the HERS rater without changing the airflow through the condenser coil' 5❑Yes --- _ . ❑ No i } When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail V ❑ N/A ✓ ❑ Pass ✓ ❑ Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag The sensor is factory installed, or field installed according to manutacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved bi the Executive Director. The sensor wire is terminated with a standard mini plug suitable fcr connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ ®N/A ✓ ❑Pass ✓ Fail applicable. Otherwise enter Pass or Fail I Reg: 212-A0018936A-M2500001A-M25A Registration Date/Time: 2012/06/05 00:17:58 HERS Erovider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 a CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 1 City of La Quinta 12-0419 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 Refe-ence Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an acditional 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 p-ocedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioninq Svstems System Name or Identification/Tag (must be re -calibrated monthly) Date of Thermocouple Calibration ' System Location or Area Served Outdoor Unit Serial # a Outdoor Unit Make Outdoor Unit Model Nominal Cooling Capacity Btu/hr Date of Verification ;.aimravon oT Ulagnostic instruments Date of Refrigerant Gauge Calibration (must be re -calibrated monthly) Date of Thermocouple Calibration ' (must be re -calibrated monthly) measurea temperatures (rr) I System Name or Identification/Tag /r P f ., Supply (evaporator leaving) air dry-bulb a temperature (Tsupply, db) Return (evaporator entering) air dry-bulb temperature (Treturn, db) Return (evaporator entering) air wet -bulb temperature (Treturn, wb) Evaporator saturation temperature (Tevaporator, sat) Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db) Reg: 212-A0018936A-M2500001A-M25A Registration Date/Time: 2012/06/05 00:17:58 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 1 City of La Quinta 12-0419 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 col' airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. I Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfn-/ton) System Name or-Identification/Tag /` Calculated Minimum Airflow,Requirement (CFM)'. Measured Airflow using RA3.3 procedures (CFM) Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or. Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -6°F and +6°F Enter Pass or Fail Reg: 212-A0018936A-M2500001A-M25A Registration Date/Time: 2012/06/05 00:17:58 HERS Erovider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 0 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 1 City of La Quinta 12-0419 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is recuired to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Subcooling = Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer Calculate difference: Actual Subcooling - Target Subcooling = System passes if difference is between 1. -4°F and +4°F N "- � ` ", \ °' -) `- - $ f ' e Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Superheat = r Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range between 3°F and 26°F if manufacturer's specification is not available) 1- 1. System passes if actual superheat is'Within',the ! N "- � ` ", \ °' -) `- - $ f ' e allowable superheat range ,e -#'Enter Pass or Fail ,gyp j Reg: 212-A0018936A-M2500001A-M25A Registration Date/Time: 2012/06/05 00:17:58 HERS Prcvider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 a INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 City of La Quinta 12-0419 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 303964 System meets all refrigerant charge and airflow 0 not-tested/verified dwelling in la HERS sample group requirements. HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail William David Pointer Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/4/2012 CC2005784 DECLARATION STATEMENT, • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -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 aciencv. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 303964 ❑ tested/verified dwelling 0 not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CCl-1798647717 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William David Pointer Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/4/2012 CC2005784 Reg: 212-A0018936A-M2500001A-M25A Registration Date/Time: 2012/06/05 00:17:58 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE Cl=-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: 57095 WINGED FOOT, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-0419 Space Conditioning Systems Heating Equipment Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (AFUE, etc.)1, 3 (>=CF -IR value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Heating LoEd (kBturhr) Heating Capacity (kBtu/hr) Split Furnace LENNOX SL280UH09OXV60C 4358917 1 80 AFUE I Attic R-4.2 86 70 kBtu j! Cooling Eautoment Equip Type (package heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (SEER and EER) 1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Cooing Lo.ed (kBtUhr) Cooling Capacity (kBtu/hr) Split A/C �r " �-7FLENNOX �'']� XC21 0/48-230 % , ��^ "7 / -, - �. t 1 14'SEER- 13 EER ` (� f'� I { 4E�7 4 Tons j! 1. It project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceilirg alternative compliance. 2. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.orglarilac.php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R for -n. 4. When CF -1R is reference it is also applicable to the CF -IR, CF -IR -AA or CF -ZR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM 0 §110-§113: HVAC equipment is certified by the California Energy Commission. 0 §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, o- ACCA. 0 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 0 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine limes meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entir=ly in conditioned space. 2 Reg: 212-A0018935A-M0400001A-0000 Registration Date/Time: 2012/05/02 12:33:03 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: 57095 WINGED FOOT, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-0419 Ducts and Fans §150(m): Duct and Fans 2 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and 2 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. 10 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. 2 7. Exhaust fan systems have back draft or automatic dampers. 0 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. 0 Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. 0 10. Flexible, ducts cannot have porous. inner, cores.—, DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 4/13/2012 Position With Company (Title): Reg: 212-A0018935A-M0400001A-0000 Registration Date/Time: 2012/05/02 12:33:03 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 57095 WINGED FOOT, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1� City of La Quinta 12-0419 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement DXuct System. " Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. 0 1.'Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow ❑ 3. Reduce leakage by 60% and conduct smoke and fix all leaks ❑ 4. Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options 1, 2 or 3 must be attempted,before_utilizing,Option 4.)_ Determine nominal Fan'Flow using one of the'followirng three calculation methods.�r' r ( ✓ 0 Cooling,system method: of condenser in Tons 1_ x� 400 =1 1606 CFM Size ✓ ❑ x Thlousan1ds sof Hea`ting system m}ertho" d: 21.7 Output Capa j ty in B%hr = _ CFM A // X.r��f Y' i If _ ✓❑ Measured _system airflow -using RA3.3 airflow,testprocedures: CFM 't Option 1 used then: 1 Allowed leakage = Fan Airflow 1600 x 0.15 = 240 CFM Actual Leakage = 240 CFM Pass if Actual Leakage is less than Allowed leakage g Pass Fail Option 2 used then: 2 Allowed leakage = Fan Airflow _ x 0.10 = _ CFM Actual Leakage to outside = _ CFM Pass if Actual leakage to outside is less than Allowed leakage QPass Fail Option3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _ / Initial leakage _) x 100% _ % Reduction Pass if % Reduction > 600/a ❑ Pass ❑ Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke ❑ Pass ❑ Fail Reg: 212-A0018935A-M2100001A-0000 Registration Date/Time: 2012/05/02 12:33:35 HERS Fsovider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-NECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: 57095 WINGED FOOT, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-0419 0 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. .►. .-�''7`�'`� .c"'..� .7 �-.�„,r��"? All supply and return register'boots must be sealed to the drywall if smoke test Is utilized 2or,compliance — applies'to duct leakage compliance option 3 (leakage reduction by 0%) and option 41(fix all accessible leaks) described above: l 0 New duct installations, cannot utilize building cavities as;plenumsior platform returns in lief of ducts .1 _-.1, . J -1 C 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 eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (tre installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifie3 the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation; have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made avai.able with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildinqs. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: Date Signed: Position With Company (Title): 686310 4/13/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0018935A-M2100001A-0000 2008 Residential Compliance Forms Registration Date/Time: 2012/05/02 12:33:35 HERS Provider: CalCERTS, Inc. March 2010 INSTALLATION CERTIFICATE* CF-6R-MECH-2S-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of S) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT, La Quinta CA 92253 1 City of La Quinta 12-0419 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 1 0 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 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 ✓ 0 Pass ✓ ❑ Fail STMS - Sensor on.the Evaeorator Coil System Name, or Identification/TaglI ,,' , 'I System 1 jrj , `• /,. ' / r I ' ` 3 /' J ❑ Yes ,� j ❑ No' / The sensor is factory installed, or field installed according to manufacturer's specifications, or is'installei by methods/specifications approved by the Executive 6 ( j ! Director. 1 ,rf t / r., �_, .. 4 �'❑ Yes_4 ❑ No The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. The sensor mini plug is accessible tothe installing,EecKnician, - 7 ❑ Yes ❑ No and the HERS rater without changing the airflow through the condenser coil- 5 1 ❑ Y;`sj ❑ No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not ✓ O N/A ✓ [3 Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail ✓ 0 N/A ✓ ❑ Pass ✓ ❑ Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 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 ✓ 0 N/A ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail D Reg: 212-A0018935A-M2500001A-0000 Registration Date/Time: 2012/05/02 12:35:57 HERS 3rovider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-14ECH-25-HER; tefrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5' Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT, La Quinta CA 92253 City of La Quinta 12-0419 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 acditional 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 P-ocedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioninq Svstems System Name or Identification/Tag System i (must be re -calibrated monthly) Date of ThermocoupleyCalibration J' % / 4/1/2012) >rF System Location or Area Served Whole House Outdoor Unit Serial # 58IIA12731 Outdoor Unit Make LENNOX Outdoor Unit Model XC21-048-230 Nominal Cooling Capacity Btu/hr 49500 Date of Verification 4/13/2012 Calibration ot_Diagnostic Instruments Date of Refrigerant Gauge Calibration 4/1/2012 (must be re -calibrated monthly) Date of ThermocoupleyCalibration J' % / 4/1/2012) >rF (tmust be, re -calibrated monthly) Measured Temperatures'(TF) 1 ; 3 ` 1 --'7 1 1 \ e% rI 1 ,r System Name or Identification/Tag t . System 1 f"r"-" ) /'' Supply (evaporator leaving) air dry-bulb - 49 temperature (Tsupply, db) Return (evaporator entering) air dry-bulb 71 temperature (Treturn, db) Return (evaporator entering) air wet -bulb 55 temperature (Treturn, wb) Evaporator saturation temperature 42 (Tevaporator, sat) Condensor saturation temperature 68 (Tcondensor, sat) Suction line temperature (Tsuction) 52 Liquid Line Temperature (Tliquid) 64 Condenser (entering) air dry-bulb 68 temperature (Tcondenser, db) Reg: 212-A0018935A-M2500001A-0000 Registration Date/Time: 2012/05/02 12:35:57 HERS Pr --)eider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT, La Quinta CA 92253 1 City of La Quinta 12-0419 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Ref6 igerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System i Calculate: Actual Temperature Split = Treturn, 22.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3 20.4 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - 1.6 Target Temperature Split = Passes if difference is between -3°F and +3°F or, upon remeasurement, if between -3°F and PASS -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coi 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 (drn/ton) System ame`or Idenrtification/Tag j %ice ! System 1 Calculated Minimum Airflow Requirement (CFM) Measured Measured.Airflou�si RA3 3 procedures (CFM) 1!�rY/ � i 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 recuired to be used for fixed orifice metering device systems System Name or Identification/Tag System 1 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail a Reg: 212-A0018935A-M2500001A-0000 Registration Date/Time: 2012/05/02 12:35:57 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-14ECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT, La Quinta CA 92253 1 City of La Quinta 12-0419 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Subcooling = 4.0 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 4 Calculate difference: 0 Actual Subcooling - Target Subcooling = System passes if difference is between -3°F and +3°F PASS j Enter Pass or Fail / I Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat = 10.0 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturdr's specifications (or use range 3-26 between 4°F and 25°F if manufacturer's specification is not available) System passes,if actual superheat iswithimthe" allowableuperheat range E' l 'y V r PASS j Enter Pass or Fail / I 1 Reg: 212-A0018935A-M2500001A-0000 Registration Date/Time: 2012/05/02 12:35:57 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT, La Quinta CA 92253 City of La Quinta 12-0419 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 CSLB License: Date Signed: Position With Company (Title): System meets all refrigerant charge and airflow 4/13/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): requirements. PASS Enter Pass or Fail DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identties defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not chzcked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installatio• have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data reoistry for multiple orientation alternatives, and beoinnino October 1, 2010, for all low-rise residential buildinas. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: Date Signed: Position With Company (Title): 686310 4/13/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0018935A-M2500001A-0000 Registration Date/Time: 2012/05/02 12:35:57 HERS Provider: CalCERTS, Inc. 2008,Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: 57095 WINGED FOOT (SYS 2), La QLlinta CA 92253 Enforcement Agency: Pern-12-0 t Number: (System 1) City of La Quinta 12-019 Space Conditioning Systems Heating Equipment Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (AFUE, etc.)1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Heeting Lcad (kBt:j/hr) Heating Capacity (kBtu/hr) Split Furnace LENNOX SL280UH09OXV60C 4358967 1 80 AFUE I Attic R-4.2 83 70 kBtu 1 1-4 cooung rqui'pmenr Equip Type (package heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (SEER and EER) 1,3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc..) Duct R -value Cooling Load (kB'u/hr) Cooling Capacity (kBtu/hr) A/C XC21split -71-ENNOX16 -060-230 , "�/� �� 1 r -. SEER 112.5 EERY 1 ,fes I 4/ ifl� o)7 5 Tons i. jr projecc is new conscrucnon, see roornores ro 5ranaaras iao/e 151-b ana iaole 151-c. ror auct ceil~•ng alternative compliance. 2. ARI Reference Number can be found by entering the equipment model number at http://www. aridirectory. org/ari/ac. php # 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -IR fc:rm. 4. When CF -IR is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM 0 §110-§113: HVAC equipment is certified by the California Energy Commission. 0 §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. 0 §150(1): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 0 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed ent rely in conditioned space. c4 Reg: 212-A0018936A-M0400001A-0000 Registration Date/Time: 2012/05/02 12:52:27 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-0419 Ducts and Fans §150(m): Duct and Fans © 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and 0 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. © 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. 0 7. Exhaust fan systems have back draft or automatic dampers. 0 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. 0 Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted -with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. 0 10. Flexible ducts cannot have porous. inner.cores..._.1 F r DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. - • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: Date Signed: Position With Company (Title): 686310 4/13/2012 Reg: 212-A0018936A-M0400001A-0000 Registration Date/Time: 2012/05/02 12:52:27 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-611-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 Enforcement Agency: Perm t Number: (System 1) City of La Quinta 12-0419 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include =xisting 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 &uct System. " Duct Leakage Diagnostic Test - existing dud system Select one compliance method from the following four choices. © 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow ❑ 3. Reduce leakage by 60% and conduct smoke and fix all leaks ❑ 4..Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options 1, 2 or 3 must be attempted, beforeutilizing, Option 4.)_ Determine{nominal Fan Flow using one o�the'following three calculation methods.,// ✓ 1B Cooling system method: Size of condenser in Tons 1_ x 400 =1 2000 CFM tr ,, ✓ E321.7 r Th Heatingsystem method: x Output Capacity in usands of Btu/hr = / CFM J ✓ ❑ Measured system airflow,u4sing RA3.3 airflow -test procedures: CFM _ j /ti, If. , � 14 X, L Option 1 used then: 1 Allowed leakage = Fan Airflow 2000 x 0.15 = 300 CFM Actual Leakage= 295 CFM Pass if Actual Leakage is less than Allowed leakage g Pass Fail Option 2 used then: 2 Allowed leakage = Fan Airflow _x 0.10 = _ CFM Actual Leakage to outside = _ CFM - Pass if Actual leakage to outside is less than Allowed leakage 0 Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction CFM ((Leakage reduction _ / Initial leakage _) x 100% _ % Reduction Pass if % Reduction > 60% Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke Pass ❑ Fail 9 0 Reg: 212-A0018936A-M2100001A-0000 Registration Date/Time: 2012/05/02 12:52:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance.Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 Enforcement Agency: Permit Number: (System 1) City of La Quinta 12-0419 0 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. 10 All supply,and return register°boots,must be sealed to the drywall if smoke test is utilized -or compliance — applies'io duct leakage compliance option 3 `(leakage reduction by 60%) and option 4,(fix all accessible leaks) d�tescribed above. --e""'', 1 f 0 New duct in�lation cannot utile building C vities as -,plenums or platform returns in lief of ducts. m Mastic and draw bands must be used in combination with cloth backed rubber adhesive dLct`tape to seal leaks at all new duct connections DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifes defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider represe-itatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corre=tive action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: Date Signed: Position With Company (Title): 686310 4/13/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0018936A-M2100001A-0000 Registration Date/Time: 2012/05/02 12:52:59 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE* CF-6R-MECH-2S-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of S) Site Address: Enforcement Agency: Permit Nimber: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 1 City of La Quinta 12-0419 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 adortional 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 change 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 2 System Location or Area Served Whole House 1 0 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 0 Yes ❑ No 5/16 inch (8 mm) access hole downstream of evaporative coil in tl-e 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"j l' 1Z System 2 11 1 1 1 1 1' if t( V 3es (P"Y PThe p No /Director.Direor. sensor is factory installed, orfield installed according to manufacturer's specifications, or isoinstalled by methods/specifications approved hY the Executive 6 ❑ Yes ,I f j l` v ( V 4 13 Yes id!i t l+ ❑ No The sensor wire is terminated with a standard mini plug suitable for connection.to aF digital thermometer. The sensor, mini is accessible to the installing technician e r , plug and the HERS rater without changing the airflow through the Gond=--nser coil" 5 [3Yes ❑ No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3, 4 n , and 5 is a pass. Enter N/A if STMS are ot ✓ 0 N/A ✓ 13 Pass ✓ [3 Fail applicable. Otherwise enter Pass or Fail 8 ❑ Yes STMS - Sensor on the Condenser Coil System Name or Identification/Tag I System 2 The sensor is factory installed, or field installed according to manLfacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved Ly 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 inst3lling 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 ✓ 0 N/A ✓ ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail Reg: 212-A0018936A-M2500001A-0000 Registration Date/Time: 2012/05/02 12:56:13 2008 Residential Compliance Forms 0 ij HERS ?rovider: CalCERTS, Inc. August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 1 City of La Quinta 12-0419 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems System Name or Identification/Tag System 2 (must be re -calibrated monthly) Date of Thermocouple Calibration ]� ` 4/1/2012(must System Location or Area Served Whole House Outdoor Unit Serial # 5812A10423 t ' Outdoor Unit Make LENNOX Outdoor Unit Model XC21-060-230 Nominal Cooling Capacity Btu/hr 59500 Date of Verification 4/13/2012 %.auorazion or uiagnosnc inszrumenzs Date of Refrigerant Gauge Calibration 4/1/2012 (must be re -calibrated monthly) Date of Thermocouple Calibration ]� ` 4/1/2012(must be re -calibrated monthly) measures iemperazures t. -r) / f 'r 1 l C System ?Name or Identifcation/Teg System 2 �.i Supply (evaporator leaving) -air dry-bulb 49 t ' temperature (Tsupply, db) Return (evaporator entering) air dry-bulb 72 temperature (Treturn, db) Return (evaporator entering) air wet -bulb 55 temperature (Treturn, wb) Evaporator saturation temperature 36 (Tevaporator, sat) Condensor saturation temperature 74 (Tcondensor, sat) Suction line temperature (Tsuction) 46 Liquid Line Temperature (Tliquid) 71 Condenser (entering) air dry-bulb 68 temperature (Tcondenser, db) Reg: 212-A0018936A-M2500001A-0000 Registration Date/Time: 2012/05/02 12:56:13 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: I Enforcement Agency: Permit Number: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 City of La Quinta 12-0419 Minimum Airflow Requirement i Temperature Split Method Calculations for determining Minimum Airflow Requirement for Re-rigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 2 Calculate: Actual Superheat = Calculate: Actual Temperature Split = Treturn, 23.00 Tsuction - Tevaporator, sat db - Tsupply, db Target Superheat from Table RA3.2-2 using Target Temperature Split from Table RA3.2-3 20.9 Treturn, wb and Tcondenser, db using Treturn, wb and Treturn, db Calculate difference: Calculate difference: Actual Temperature Split - 2.1 Actual Superheat - Target Superheat = Target Temperature Split = System passes if difference is between -5°F and Passes if difference is between -3°F and +3°F or, +5°F upon remeasurement, if between -3°F and PASS Enter Pass or Fail -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified usng 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 :he table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (din/ton) System Name or Identification/Tagj� / r • f System 2 II f "` I � Calculated Minimum Airflow ReqFuiremefnt (CFM) Measured.Airflow.us g RA3.3,procedures (CFM) Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag System 2 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail i] ►M Reg: 212-A0018936A-M2500001A-0000 Registration Date/Time: 2012/05/02 12:56:13 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HER! Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5' Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 1 City of La Quinta 12-0419 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 2 Calculate: Actual Subcooling = 3.0 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 3 Calculate difference: 0 Actual Subcooling - Target Subcooling = System passes if difference is between -3°F and +3°F PASS Enter Pass or Fail PASS Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 2 Calculate: Actual Superheat = 10.0 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 3-26 between 4°F and 25°F if manufacturer's specification is not available) System passes.if actua►'superheat is,within,the' allowable superheat range f PASS ,,Enter Pass or Fail I r �, Reg: 212-A0018936A-M2500001A-0000 Registration Date/Time: 2012/05/02 12:56:13 HERS P-ovider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 L 4 • INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 57095 WINGED FOOT (SYS 2), La Quinta CA 92253 1 City of La Quinta 12-0419 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 2 CSLB License: Date Signed: Position With Company (Title): System meets all refrigerant charge and airflow 4/13/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): requirements. PASS Enter Pass or Fail t DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an auchorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications a0proved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements o` such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicabae inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documertation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HEF.S provider data registry for multiple orientation alternatives, and beginnino October 1, 2010, for all low-rise residential buildinas. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: Date Signed: Position With Company (Title): 686310 4/13/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0018936A-M2500001A-0000 Registration Date/Time: 2012/05/02 12:56:13 HERS PrDvider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009