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12-0806 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 ., BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 12-0000.0806 Property Address: 53720 AVENIDA VILLA APN: > 774-134-011-14 -000000- . Application description: MECHANICAL Property Zoning: COVE RESIDENTIAL Application valuation: 6777 Applicant: Architect or Engineer: �I Ar -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty ofperjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code,. and my License is in full force and effect. Lice a Class: C20 C 6 License No.: 906115 z Z ate: i23 ontractor. b OWNER -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 Busineseand 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).: (_ 1 1, 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.). (_) 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(sl 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: STERLING MEL . 53720 AVENIDA VILLA LA QUINTA, CA 92253 Contractor: HYDES 42949 MADIO STREET INDIO, CA 92201 (760)360-2202 Lic. No.: 906115 VOICE (760) 777-7012 --FAX (760) 777-7011 --------------- - - - WORKER'S COMPENSATION DECLARATION -7153 9/12 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 NORGUARD INS Policy Number CEWC243358 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should. become subject toe workers' compensation provisions of Section 3700 of he Labor Code, I shall f tthwith! ply with those provisions. - /ate: —1 Applicant: WARNING: FAI RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the wndil.iuns 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, indemnity and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit.. - 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building constru ii9D nd hereby au horize representatives of this county to enter upon the above-mentioned property for ins ec on' rposes. ate: ,Sr§nature (Applicant or Agent): / Application Number . . . 12-00000806 Permit MECHANICAL Additional desc . Permit'Fee 40.50 Plan Check-Fee 10.13 Issue Date . . . Valuation 0 - Expiration Date 1/15/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 .16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 Special Notes and,Comments HVAC CHANGE-OUT: FURNACE, CONDENSER. •2010 CODES. ------------------ ------ -------------------------------- Other Fees . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 40.50 .00 .00 40.50 Plan Check Total 10.13 .00 .00 10.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total 51.63- .00- .00 51.63 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC A/teraticns CF-iR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 53-720 Avenida Villa La Quinta, CA 92253 City of La Quinta Jul 18, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit * Furnace ❑ AFUE ❑ COP - ❑ R 6 (CZ 10-13) Served by system Setback ❑ Indoor Coil p SEER 13.0 2 HSPF 7,7 ❑ R 8 (CZ 14-15) 2000 sf If n•)t already present, must be * Condensing Unit ❑ EER ❑ Resistance inst3Ued) ❑ Other I- 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 decices what work isbeing done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -IR and CF -6111 shall also be on site for final inspection. D 1. HVAC Changeout Required Forms: . All HVAC Equipment CF -6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH-25-HERS replaced CF -4R forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or . Indoor Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-2-5-HERS Furnace CF=4R.forms: MECH-21 and (for split systems) MECH-25 . "r ,zi`.'A ;:: For GF Split Systems: Duct leakage l5 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from duct leakage testm;7 f, �❑ 1 ,Duct system was:documented to have been previously sealed and confirmed through HERS verification, or 2.` Duct systems with less than 40s1inear feet in unconditioned space, or E]'3. `Existing duct Systems are constructed, insulated or sealed with asbestos ❑:_,The ystem wilLnot be Ducted (ie: DuctlessMmi-5pm,lso ExemapfromRefeha,rge)n�nC 112. New HVAC st Requid,FosrxF 'sem � ,:fina a r MI-Xv oz f .Cut inlor Changeout with new ducts:=.(all new -: CF 6R'forms fMECH 04', MECHri20 HERS, and (foresplit systems) MECH ,2 HERS and �_ MECH-35 HERS' ductingandall new � R11 CCF 4R'forms MECH 20; andi(for split s2 and MECHequipment)... ..w2w For Split Systems:; Duct leakage'r°6 perce,"nt, RC, CCA1> 350 CFM/ton,1FWD; TMAH, STMS and either HSPP 6VPSPP For Packaged Units Duct. lea kage< 6 percent M,w 113: New=Ducts with/or without °'; Required Forms: Replacement � � � «.�. �; ';��• 4Includescreplacing or installing all new .ducting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace•,No or some CF -411 forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: - . Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -4R forms: MECH-21 ' For split system or packaged units: Duct leakage < 15 percent , ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with -asbestos. ' Contractor (Documentation Author's /Responsible Designer's Declaration Statement) . I certify that this Certificate of Compliance documentation is accurate and complete. . I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. . I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. . The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms,'worksheets; calculations, plans and specifications submitted to the enforcement agency for approval with &-e permit application. Name: Mark Hyde Signature: Mark Hyde Company: CERTIFIED COMFORT SYSTEMS INC Date: Jul 18, 2012 Address: 42-949 MADIO STREET License: 906115 City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202 Reg: 212-A0038148A-00000000-0000 Registration Date/Time: 2012/07/18 13:17:38 HERS Provider: CalCERTS, Inc. 2008 Residential'Compliance Forms July 2010 S. Bin # City Of La Quinta Building 8T Safety Division Permit.# P.O. Box _1504, 78-495 Calle Tampico 4" La Quinta, CA 92253 - (760) 777-712 Building Permit Application and Trazkin Sheet g Project Address:' 5.3 —r] Z(9 Owner's Name: kA 2 l eY -P-Nb ' Legg Des? ripion: Address: v Y E2 City, ST, Zip: e- -c Telephone: 1 5Pn5A•% �t>� — Z3of� % " lC, d Project Description: ty, ST, Zip: /CJ A Cl4. ZZ d l YI'etephone: 6 c, ;:Slate Lic. #: q 0c, l City Lic. #: ZZ Erch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: p �' State Lic. #: Name of Contact Person: Project type (circle one): New N d n Alter Repair' � eP Demo Telephone # of Contact Person: # Stories: # Units: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACKIlYG Plan Sets PERMTT FEES Plan Check submitted ,TIte Structural Calcs. Reviewed, ready for corrections Amount Calcs.Called DepositTruss Contact PersonalanceEnergy Calcs. Plans picked upFlood plain plan Plans resubmitted Grading plan god Review, ready for corrections/issue Subcontactor List Electrical Called Contact Person Grant Deed Plumbing ans picked up SALL AOA Approval tted 4PIa Grading IN ROUSE: dy for corrections/issue Developer- Impact Fee Planning Approval Called Contact Person Pub. Wks. Appr A.LP.P Date of permit issue School Fees Total Permit Fees 1 --1 .. _. * ,Al INSTALLATION CERTIFICATE -F-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1of 2) Site Address: Enforcement Agency: Permit Number: • . 53-720 Avenida Villa,_La Quinta CA 92253 (System 1)I City of La Quinta 1 1 12-806 " f y ' Space Conditioning Systems ' Heating Eauipment Cooling Equipment Equip Typeand (package _ heat _ pump) d . �- '-,CEC Certified Mfr. Name and Model Numbert ARI Reference Number2 • # of Identical Systems Efficiency (SEER . EER) 1, 3 (>=CF -1R value)4 Duct , Duct R -value } r Cooling Capacity (kBtu/hr) Split Heat Pump,0004a.6h3060a1000bb american standard yrig.s Efficiency Location ��gR4:2 36 58 kBtu ,'Equip '.','Equip 0 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of �. y (AFUE, (attic, minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entrely in ' Type ARI # of etc.)1, 3 crawl- Heating Heating ��(package- , CEC Certified Mfr. Name Reference Identical (>=CF -1R space,-. Duct Load. Capacity beat pump) and Model Number Number2 Systems value)4 etc.) 6 R -value (kEU/hr) (kBtu/hr) Split american standard , Heat Pump 4tec3f60b1000aa 1 8 HSPF Attic R-4.2 �6 48 kl3tu Cooling Equipment Equip Typeand (package _ heat _ pump) d . �- '-,CEC Certified Mfr. Name and Model Numbert ARI Reference Number2 • # of Identical Systems Efficiency (SEER . EER) 1, 3 (>=CF -1R value)4 Duct , Location (attic, crawl- space,- etc.) , Duct R -value Cooling Load (kEtu/hr) r Cooling Capacity (kBtu/hr) Split Heat Pump,0004a.6h3060a1000bb american standard yrig.s 13 SEER 11aEER4 -*Attic ��gR4:2 36 58 kBtu 0 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of �. y 0 §150(j)2: Pipe insulationfor cooling system refrigerant suction, chilled water and brine I nes meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entrely in ' conditioned space. �26 -'mak ' pd ••Fs:g.x*f Reg: 212-A0038148A-M0400001A-0000• Registration Date/Time: 2012/07/31 14:43:34- HERS Provider: CalCERTS; Inc. August 2009 1. !f project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct cefing alternative . �• ., . compliance. 2. AR! Reference Number can be found by entering the equipment model number at s • http://www.aridirectory.org/ari/ac.php# y `„ "• f• F 9 ALL BOXESMUST BE CHECKED TO BE A VALID FORM 71 0 §110-§113:.HVAC equipment is certified by the California Energy Commission. 4.. © §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. 0 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of �. y 0 §150(j)2: Pipe insulationfor cooling system refrigerant suction, chilled water and brine I nes meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entrely in ' conditioned space. 1. !f project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct cefing alternative . �• ., . compliance. 2. AR! Reference Number can be found by entering the equipment model number at s • http://www.aridirectory.org/ari/ac.php# y `„ "• 3. Listed efficiency ori this page must be greater than or equal ( ? ) to the value shown on the CF -1R form. 4. When CF1R is reference it is also applicable to the CF -IR, CF -IR -AA or CF -IR -ALT . L " 9 ALL BOXESMUST BE CHECKED TO BE A VALID FORM 71 0 §110-§113:.HVAC equipment is certified by the California Energy Commission. 4.. © §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. 0 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of �. y 0 §150(j)2: Pipe insulationfor cooling system refrigerant suction, chilled water and brine I nes meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entrely in ' conditioned space. Reg: 212-A0038148A-M0400001A-0000• Registration Date/Time: 2012/07/31 14:43:34- HERS Provider: CalCERTS; Inc. • 2008 Residential Compliance Forms �, ,' August 2009 INSTALLATION' CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency: Permit N7umber:j i .53-720 Avenida Villa, La.Quinta CA 92253 (System 1) 1 City of La Quinta 12-806- Ducts 2-806- Ducts and Fans §150(m): Duct and Fans y r ❑ 1.'AII air -distribution system ducts and plenums installed, sealed and insulated to meet the IR'' requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air y 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 111. Building cavities, support platforms for air handlers, and plenums defined or const-ucted 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 instaWed in cavities , and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. , ❑ 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back , rubber adhesive duct tapes unless.such tape is used in combination with mastic and draw bands. ' ❑ 7. Exhaust fan systems have back draft or automatic dampers. ' ❑ B. Gravity ventilating systems serving conditioned space have either automatic`or readily accessible, ' manually, operated dampers: ❑ Protection of Insulation.iInsulation 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 Js water retardant and provides shielding from solar radiation that can cause ' degradation of the material". ❑ 10. Flexible ducts cannot have porous inner cores. ) " DECLARATION STATEMENT r . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form s 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 r.r. requirements for the installation. I certify that the requirements detailed on the CF -SR 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 c , 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) CERTIFIED COMFORT SYSTEMS INC Responsible Person's'Name: Responsible Person's Signature: } Mark HydeMark . Hyde CSLB License: , 906115- Date Signed:, 7/16/2012 position With Company (Title): Reg: 212-A0038148A-M0400001A-0000 Registration Date/Time: 2012/07/31 14:43:34 HERS Provider: CalCERTS, Inc. 2008 -Residential Compliance Forms ' August 2009 • INSTALLATION CERTIFICATE CF-6R-IECH-2I-HERS ' Duct Leakage Test —.. Existing Duct System (Page 1 of 2) -Site Address: Enforcement Agency: Permit plumber: t 53-720 Avenida Villa, La Quinta CA 92253 (System 1) City of La Quinta 12-806 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or, Area Served: Whole House Note' Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. , This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems.' ; Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of , the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely. New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system , Select one compliance method from the following four choices. ; © 1. Measured leakage less than. 15% of fan flow b 2. Measured leakage to outside less than 10% of Fan Flow tia - }conduct ❑ 3. Reduce leakage by 60% and smoke and fix all leaks 4 ❑ 4: Fix all accessible leaks using smoke and HERS rater verify ?. Note:,.(One of Options 1, 2 or 3 must be attempted before utilizing OptiorY4.) Determine nominal -Fan Flow using one-of,the following three calculation methods. ✓ Cooling+system method: Size of condenser,m TonsS400==2000 CFM -; os' { IY "";est'' _. �• :.'�t'-, � ^"•:4�. ❑Heating system method:2=1.7 x Output Capacity in;rThousands of,Btu/hr = CFM - -- - �-•-r _ s- �/ El Measured systemlairflow using+RA3 3 airflow testlprocedures: CFM +,�,,.,x . r _,.", . 'of Option*1 used';then s' ( "ad u. ..x300 ' CFMr� v!� Allowed leakage Airflow"2000.-max 0.15; " ; 4V 040 1 ,Fan Actual Leakage =' 288' CFM ' P Pass if Actual Leakage is less than Allowed leakage Pass Fail Option 2 used then: 2 Allowed leakage = Fan Airflow x 0.10 = _ CFM Actual Leakage_ to outside= I—, CFM •13Pass Pass if Actual leakage to outsideis less than Allowed leakage Fail Option 3 used then: �r Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM a 3 Initial leakage _ - Final leakage _ = Leakage reduction CFM , -•, ((Leakage reduction=/ Initial leakage_) x 100% _ % Reduction rt T� Pass if % Reduction .> 60oro ❑ Pass ❑ Fail Option 4 used then: • 4 All access ible'leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke p Pass p Fail - '.i'.. �.� ,. • , ,ori • •Y t - JI .,Reg: 212-A0038148A-M2100001A-0000 Registration Date/Time: 2012/07/31 14:41:22,''HERS Provider:,,,CalCERTS,'Inc. 2008 Residential Compliance Forms- it March 2010 1 /��',", `.ice. �� 1 .. ,♦ . hf 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 y be configured to the closed position during duct leakage testing. © All supply a.nd*return register boots, mustabe„sealed Rto the drywalyf,smoke test isutilized.forcompliance - appliestquct leakage compliance option'3(leakage reduction by;60%)a'nd optionj4-(fix allaccessible = • ' leaks) described above �f a tL �t . . 0 New ductJnstallationJJs cya[[fnnot,utilize building cavities as plenums or,platforhmlreturns in lieu -ducts 777 ­ leaks at all'newt du b connect o sesed,i_nYcwombin�atiowi elo, backedrubbeadhesivesducttape'dto seal --�' DECLARATION STATEMENT , • I certify under penalty of perjury, and r 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) ' ,� r;r conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the ,. . r 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' r 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 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 ;t 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) 1 P - •I Mark Hyde Mark Hyde ` /��',", `.ice. �� 1 .. ,♦ . hf 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 y be configured to the closed position during duct leakage testing. © All supply a.nd*return register boots, mustabe„sealed Rto the drywalyf,smoke test isutilized.forcompliance - appliestquct leakage compliance option'3(leakage reduction by;60%)a'nd optionj4-(fix allaccessible = • ' leaks) described above �f a tL �t . . 0 New ductJnstallationJJs cya[[fnnot,utilize building cavities as plenums or,platforhmlreturns in lieu -ducts 777 ­ leaks at all'newt du b connect o sesed,i_nYcwombin�atiowi elo, backedrubbeadhesivesducttape'dto seal --�' DECLARATION STATEMENT , • I certify under penalty of perjury, and r 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) ' ,� r;r conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the ,. . r 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' r 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 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 ;t 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) CERTIFIED COMFORT. SYSTEMS INC = Responsible Person's Name: Responsible Person's Signature: Mark Hyde Mark Hyde ` CSLB License: " 906115 Date Signed: 7/31/2012 position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes • ❑ No t'+ Y� i Reg:•212-A0038148A-M2100001A-0000 Registration Date/Time: 2012/07/31 14:41:22 HERS Provider: CalCERTS,> Inc. 2008 Residential- Compliance Forms » March 2010 ' INSTALLATION CERTIFICATE* CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: • 53-720 Avenida Villa, La Quinta CA 92253 City of La Quinta 12-806 - 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 Elie refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized fo'r compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an adeitional 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 cha-ge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely- new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System i System Location or Area Served Whole House 1 p Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the -eturn plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 p Yes ❑ No ` 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and 2 is a pass, , Enter Pass or Faill ✓ o Pass ✓ ❑ Fair STMS - Sensor on -the Evaaorator`Coil. System Narne,orr Identification/Tag er , System 1?^ ;l' — -) &t]%, Nth`[, I &:,! Y- ? • 3 4 { ❑,Yes p'No /,Thq'se'ns6r is factory installed, or field.ingtalled according to manufacturer's pecifications, or isdmstalled by methods/spedfications`approved t.y the Executive 6 ~fix r Director. I -: + ` ) ^ 4 ❑,Yes . { ;,, p_No 'fy[^t The sensor wife is'terr-ninated with a -standard -mini plug suitable for connection'to°a" digital'thermometer. The sensor mini plug is accessible to,the>inst311ing �tech4nician' and the HERS rater„without changing the airflow through thetondenser coil 5 ❑ Yes ❑ No The sensor measures the saturation temperature of the coil within 1.3 degrees F , Yes to 3, 4; and 5 is a"pass. Enter N/A if STMS are not applicable, Otherwise enter Pass ori Fail _F ✓ p 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 f)r 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 concenser coil 8 ❑ Yes I No IThe sensor measures the saturation temperature of the coil withir 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ ®N/A ✓ p Pass ✓ Fail applicable. Otherwise enter Pass or Fail .0 PAF 1 A Reg: 212-A0038148A-M2500001A-0000 Registration Date/Time: 2012/07/31 14:40:28 HERS ?rovider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS 1 Refrigerant Charge Verification - Standard Measurement Procedure. (Page 2 of 5) Site Address: Enforcement Agency:, Permit Number: 53-720 Avenida Villa, La Quinta CA 92253 City of La Quinta 12-806 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 Nhp additional systems in the dwelling as applicable. a ,`The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. r 1'he system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. oIf outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning System's System Name or Identification/Tag System 1 (must be re -calibrated monthly) `, t System Location or Area Served Whole House' • ' r �' , Outdoor Unit Serial # 110727312f ,� ; �•° `d4' h"'' ' temperature (TsuPPIY, db) ,.-r,e ., Outdoor Unit Make american standard ' Outdoor Unit Model " 4a7a3060a1000bb �. Nominal Cooling Capacity Btu/hr 60000 temperature (Treturn, wb) \ • Date of Verification 7/16/2012 ` Calibration of Diagnostic Instruments . I I I • Date of Refrigerant Gauge Calibration, 7/16/2012 (must be re -calibrated monthly) `, • IeCelibration Date ofTherrnocIt "`;f 7116/20126''"'t 8(must be re--tcal�brated monthly) _404ou Supply (eJaporator leaving••),air�dry-bulb .� 4 ' S stem 1 r y�k. ',ice `, • Measured,Temperaturesj(F). ok./ NSK System Name or Identification Ta s Y�9 S stem 1 r y�k. � t : '��"a i�'• — '-�r�'r, �'��',' �,sdlit-; . �F Supply (eJaporator leaving••),air�dry-bulb .� ,� ; �•° `d4' h"'' ' temperature (TsuPPIY, db) ,.-r,e ., Return (eva porator. entering) air dry-bulb ' temperature (T ' return, db) ' Return (evaporator entering) air wet -bulb temperature (Treturn, wb) \ Evaporator saturation temperature r •`48 (Tevaporator, sat) ` Condensor saturation temperature 109 (Tcondensor, sat)' • ' +. Suction line temperature (Tsuction) X59 Liquid Line Temperature (Tliquid)`r 98 Condenser (entering) air dry-bulb 96 temperature (T ) , _ condenser, db *;-' ` •�• t � � t -} 4' `�; t: •S r' �Reg:d212-A0038148A-M2500001A-0000 Registration Date/Time: 2012/07/31 14:40:28 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms r , August 2009. 1 Minimum Airflow Requirement - Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is r=quired to be used 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 . t System 1 t Calculate: Actual Superheat = t, Tsuction `Tevaporator, sat Calculate: Actual Temperature Split = Treturn, ... Target Superheat from Table RA3.2-2 using db - Tsupply, db - - Treturn, wb and Tcondenser, db Target Temperature Split from Table RA3.2-3 , Calculate difference: t using Treturn, wb and Treturn, db ' I . A' Calculate difference: Actual Temperature Split -. + System passes if difference is between -5°F and Target Temperature Split = t +5°F Passes if difference is between -3°F and +3°F or, Enter Pass or Fail upon remeasurement, if between -3°F and t - -100°F ��•� Enter Pass or Fail ' Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified us,,ng one of the airflow measurement procedures specified in Reference. Residential Appendix RA3.3: If actual cooling coil airflow is measured,;the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cf;r/ton) , System NameIdentification/Tag µa t�' System i' '• ., ` �(" yp Calculated-, Minimum AirflowRequirement (CFM) 1500 t � ' tr� 4 ` t .i.ai? ;,�I'" f ;if �+ i � Ifl4k � ti.'. �r��., � �1i . y� {; ' :.# ��'`• �--•� '��:.s��4.; .,,ir Measured+Airflow us ng RA3 34procedures (CFM)4 �1�600 ' r'All j r. Passes if measured airflow is greater than equal- to the calculated minimum airflow requirement:"' PASS f , Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is r=quired to be used for fixed orifice metering device systems System Name`or Identification/Tag System'i t Calculate: Actual Superheat = t, Tsuction `Tevaporator, sat Target Superheat from Table RA3.2-2 using - ;• Treturn, wb and Tcondenser, db Calculate difference: t ' I . Actual Superheat - Target Superheat = + System passes if difference is between -5°F and +5°F Enter Pass or Fail t - •i , r f }? ,t z• ail, T �. .. --µµ. �,- � - .• rr. a- 1� , -� i Reg: 212-A0038148A-M2500001A-0000 Registration Date/Time: 2012/07/31 14-:40:28 HERS Provider: CalCERTS,' Inc. -, '2008 Residential Compliance Forms -.y" r �s ; August 2009 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is r-2quired to be used for thermostatic expansion valve (TXV).and electronic expansion valve (EXV) systems. ± System Name or Identification/Tag System 1 r Calculate: Actual Subcooling = 11.0 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 10 manufacturer's specifications (or use range'" 4-25 Calculate difference:,.,' 1 ' Actual Subcooling - Target Subcooling = System passes if difference is between # PSSA " , -3°F and +3°F PASS �Ir{r Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV)'and electronic expansion valve (EXV) systems. - System Name or Identification/Tag System 1 r Calculate: Actual Superheat = Tsuction - Tevaporator, 11.0 Enter allowable superheat range from manufacturer's specifications (or use range'" 4-25 between 4°F and 25°F if manufactufer'sr ' specification is not available) System passes if actual'Fsuperheat is wpithinttW--FV allowable superheat range V PSSA Yjj ,Enter Pass or,-Fafl;�� �Ir{r • ;-�•ir„�,r !.o.x�+- y- � F fir. s�.-�sF. revs Axa !� s�; _..:h `" . � ;a.,,, 1 ' ' . x.'; �' � •, • F '+ _ ,'V , 1 f• -ir' J, aux � ' 1 .. a y�:. •A .. ( '� 1 r �` - ' Reg: 212-A0038148A-M2500001A-0000 Registration Date/Time: 2012/07/31 14:40:28 HERS Provider: Ca10ERTS „ Inc. -+2008 Residential Compliance Forms - ry� - #',_, - .r August 2009 r • ;-�•ir„�,r !.o.x�+- y- � F fir. s�.-�sF. revs Axa !� s�; _..:h `" . � ;a.,,, 1 ' ' . x.'; �' � •, • F '+ _ ,'V , 1 f• -ir' J, aux � ' 1 .. a y�:. •A .. ( '� 1 r �` - ' Reg: 212-A0038148A-M2500001A-0000 Registration Date/Time: 2012/07/31 14:40:28 HERS Provider: Ca10ERTS „ Inc. -+2008 Residential Compliance Forms - ry� - #',_, - .r 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: 53-720 Avenida Villa, La Quinta CA 92253 City of La Quinta 12-806 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 ap"'j3litati'le verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 CSLB License: 906115 Date Signed: 7/16/2012 Position With Company (Title): System meets all refrigerant charge and airflow Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No requirements. PASS Enter Pass or Fail f s, N`i F DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form istrue 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 (&e 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 the ked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. . • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: Responsible Person's Signature: Mark Hyde Mark Hyde CSLB License: 906115 Date Signed: 7/16/2012 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0038148A-M2500001A-0000 Registration Date/Time: 2012/07/31 14:40:28 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 This installation certificate.is required for compliance for alterations and additions in existing dwellings to• space conditioning systems and duct systems. F ,. Duct Leakage Diagnostic Test - existing, duct system n ' Select,one compliance method:from the following four choices. ' 1: Measured leakage less than, 15%'of fan flow 2. Measured leakage to outs de�less than 10% of Fan Flow , ` f' [3 3 Reduce leakage by 60°/ and'co duct smoke'and fix all leaks a w h r ❑ 4 Fix;allIaccessble lea s using�s�moke and HERS rater verify Note of 0 tions�l 2 b 3 mugst be attem ted. before utilizing Option.4.) (.... P ,One ,,.. . P Deter_"mine nominaIiE Flow using one 'f'th' II ow g threePcalculaton m., 6 ✓ ❑ --I methodmethod Size o condenser mTon='z 400 ✓ ❑Heating system method: 21 7 x Output Capacity in 111buussands H ' x 3 You' 3t'"�'Sf S XIX` ❑ Measured system airflow_ usng12A3 3airflowtest pro�ce'dues CFM ..,..gym:. 1 Option mused then, k a� Allowedleakag Fan Flower 01. >15 _ CFM x a w � ° 4 ' t Actual Leakage CFM' .::Pass if Leaka a Actual s less than x W I�`.:: _. .. P an Allowed k.x rt... 9 Pass Fail + Option 3used then r. Allowed leakage FanFlow x 0 10 = _CFM r r2 ' "Actual Leakage:to outside? Leakage Pass if Actual is less than Allowed ,Pass O Fail Option 3 -used then s , Initial leaka=ge prior to startof CFM Final leakage after sealing all:accessible leaks using smoke test= 3 Initial leakage _ - Final leakage _ ='Leakage reduction _CFM ((Leakage reduction /'Initial leakage's x,100%,= % Reduction .` . . . h Pass if -0/6, Reduction >= 60'% Cl Pass [3 Fails ption 4 used then:l E[A accessible leaks repaired using smoke., HERS rates must verify (No sampling).No §mokel6wed,to leak from system. Including ducts, plenums, air handler and door panel, Pass if, all accessible leaks have been repaired using smoke' Pass a Fail S � � ViA • Reg: 212-A0038148A-M210000,1A-M21A .Registration Date/Time: 2012/09/13 13 53:44 HERS Provider:,Ca10ERTS, Inc.'' ! °2008•Residentia1Compliance Forms ;March'2010 {'' r + y y.. y • - e r 1 4 ❑ Outside air (OA) aucts�for-Central Fan Integrated (CFI) ventilation systems,, shall not be sealed/taped off a dur n;g duct leakage testing CFI OA ducts, that utilize controlled motorized dampers, that open only when OA f: ventilationis required to meetASHRAE Standard 62:2, and close when OA ventilation is not required, may n be configured to the closed position during duct leakage testing 'V , 1 ❑ All supply _and retyurn register boots^rmust�be'sealed toithud,rywall if smokettest s uH ize�dlfor compliance a applies tc ucf leakag- compliance opti in 3� le�dkage red ctlon by 6--w, and option 4 (flx�all accessible leaks) described abo�v�e � � ��" ,� - ��k ❑ New duct installationnsMcannot utilize building cavlties.Aas plenums or platform, retu Jri, )4 u of du -IS. .• :',K-.& �„R�' � "§ ,��� :fir• r ❑Mastic and draw bands must beused'in combination with clothtiackedru'bberadhesiued�ct to eto Seal leaks-. aIF new duct connections vsL Y.y r^ . l DWz EGLARrATION STAyTEMEN: � Y P Y purl ry s ,' 3 L I ::Ce, if Mnder emit P e u un�tler the laws: of the State of California; the information provided'on this form s true Arid correct �a. .:I am the, certified HERS rater who performed the verification services identified and -reported'.on.this certificate: (responsible rater). �. e The installed feature, material mponent co;or manufactured device requiring HERS verification that is identified o,-, this certificate (the installation) complies with th..... ,c,, requirements in Reference Residential Appendices RA2 and RA3 and the.-equirementsspecified on the Certificateces) of'Complian(CF,1R) approved by the local enforcement agency'.' , The information reported on app licable:sections of. the Installation: Certificate(s).(CF-6R), signed and submitted b} the person(s) > responsible for the'installation conforms to the requirements specified on the Certificate(s) of Compliance (CF 111) approved by the enforcement agency., Builder or Installer information as shown on the Installation Certificate. (CF -6R) - Company Name:, (Installing Subcontractor or,General Contractor: or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC z Responsible Person's Name: CSLB License: Mark Hyde. f 906115 HERS Provider Data Registry Information Sample Group # (if applicable): 343560 Q tested/verified dwelling ® not-tested/verified dwelling m -, a.HERS sample group, HERS Rater Information CalCERTS Certificate•#;CCI-1798674274 HERS.RaterCompany Name`. " d Desert H.E.R.S. Raters Responsible Rater's. Name,: Responsible Rater's Signature: Michael ,Hyde Michael ,Hyde Responsible Rater's Certification Numberw/ this HERS Provider:.. Date Signed: -.,8/,P/2012 CC2005602' a , 4 4 _ r !•CDTTCTrATF nC CTC1 n VFDTCTf ATTn1U S nTAGIUACTTr TCCTTNG rC_AD_ucru_•]C Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: EnforcementAgency: Permit N umber:, 53-720 Avenida Villa, La'Quinta CA 92253 City of La Quinta 12-806 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 SIMS are not required for compliance, when•a CID is utilized F 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 completel} new or ' replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 1 ❑ Yes ❑ No "z 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 0�140 ,.:: 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 a;nd Z is a'pass ."- ) , :' Enter Pass or Fail ✓ ❑ Pass ✓ ❑ Fail STMS Sensor on the Eva orat r. -Co I System-,Nameor Iden.'tification/Tag' 3 Y.es R F ' : ❑3No The sensor is factory m'staled, or�5field'iristalled `accordirig to roanfacturer s ;;,- Executive specifications, or is installed by methods/specifications approved �y the x ❑ No specifications; or is installed by methods/specifications approved;by the Executive a� Director. {; G The sensor wire s terminated�w th,a standard,min plug suitable o ,,onne�ct, ori to af: 4 , ® ❑Nom 'digital thermometer` The sensor�mini•plug is accessible;to'thenns�alling,�.technician and the HERS rater without changing the airflow through the condenser coil a,- w _ the'HERS rater without than m +the airflow: thiou h the.con�ienser,coil .' 9 ,9 .9 5 ❑ Yes,- k E3 No eter, the -sensor provides an: dication of the saturation temperature of the coil. rr 1• . Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not 1.0 atu6att temperature:o-loflthe coil. Yes to 3:'4-,1.' d 5 is'a°pass ,Enter N/A if STMS are not applicable Otherwise.enter,.Pass or�Failx V [I N/A ✓ ❑pass ✓ ❑Fail r r 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 When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. rr 1• . Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ,/ M N/A ✓ ❑ Pass ✓ [3Fail applicable. Otherwise enter Pass or Fail • • - Reg: 212-A0038148A-'M2500001A-M25A Registration Date/Time:,2012/09/13 13:55:19 HERS Provider: CalCERTS, Inc. 2008"Residential Compliance Forms I March 2010 a .. . �,. i .�-. � '�,- � _ , '. . .. .: Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site, Address: Enforcement Agency: Permit Number: 53-720 Avenida Villa, La Quinta CA 92253 1 City of La Quinta 1 12-806 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minim'u`m"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 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 (cfin/ton) System Namefor Id ntification/Tag Calculated Minimum Airflow Requirement (CFM) - ,.. j '<� c 5 � r Measured Airflow using RA3 3 procedures (CFM) a A: Passes'ifmeasured airflowris;-greaterAhan,orequal'-:to the calculated minimum airflow requirement. p- - 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 =61F and +6°F Enter Pass or Fail Reg': 212-A0038148A-M2500001A-M25A Registration Date/Time: 2012/09/13 1.3:55:19 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 53=720 Avenida. Villa; La Quinta CA'92253 City of La Quinta 1,12-806 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is _equired 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 = em passes if difference is between rst F and .+4°F' Enter Pass or Fail � t H 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 Superheatyri� Tsuction-- Tevaporator, sats'" Enter allowable superheat range from >- manufacturer's specifications (or use ragge between 3'F'and 26°F if. manufacturers specification isnot available) g% ? System passes�if actual superheat is within the allowable's erheat `ranOF � t H E€ Enter;Pass.orFa�l r 'w Reg: 212-A0038148A-M2500001A-M25A Registration'Date/Time: 2012/09/13 13:55:19 HERS Provider: Ca10ERTS, inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE 4 CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Vumber: 53-720 Avenida Villa, La Quinta CA 92253 City of La Quinta 12-806• 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 i 1906115 HERS Provider Data Registry Information Sample Group # (if applicable): 343560 System meets all refrigerant charge and airflow ® not-testediverified dwelling in la HERS samplie group . requirements. HERS Rater Company Name: Desert H.E.R.S. Raters Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail Michael Hyde Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 8/23/2012 CC2005602 X P 15 VIV .^�.,+: .. e+ c y, Yhra R 1 •� w'+. DE' CLARATION=STATEMENT . I certify under penalty of perjuryunder 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 )n this certificate (the installation) complies with the appl , e. requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -:1R) approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: CSLB License: Mark Hyde 1906115 HERS Provider Data Registry Information Sample Group # (if applicable): 343560 7E]tested/,erified dwelling ® not-testediverified dwelling in la HERS samplie group . HERS Rater Information CalCERTS Certificate # CC1-1798674274 HERS Rater Company Name: Desert H.E.R.S. Raters Responsible Rater's Name: Responsible Rater's Signature: Michael Hyde Michael Hyde Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 8/23/2012 CC2005602 Reg: 212-A0038148A-M2500001A-M25A Registration Date/Time: 2012/09/13 13:55:19 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance.Forms March 2010