Loading...
12-0651 (MECH)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/12/12 Application Number:12 0: 00651 Owner: -' Property Address: 51560`-AVENIDA VILLA BIRD MARY R APN: 773-144-004-21 -000000- 51560 AVENIDA V Application description: MECHANICAL LA QUINTA, CA 9. Property Zoning: COVE RESIDENTIAL ADDlication valuation; 5000 t2. 2012 1URU Contractor: Applicant: Architect or Engineer: HYDES Crib ()F ?-A 1: U NTA -42949 MADIO STR ET ��r!'��=%r'•!. ''''�`' INDIO, CA 92201- ��^ (760) 360-2202 IX LiC. NO.: 906115 LICENSED CONTRACTOR'S DECLARATION. WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: - Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C20 C36Licen o.: 906115 for. by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: 6:71 2;-Iontractor: I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier NORGUARD INS Policy Number CEWC243358 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to4ile a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or - 3700 of the Labor Code, I shall frt{1/yyoith compy/.yvith those provisions. that he or she is exempt therefrom and the basis.for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the. applicant to a civil penalty of not more than five hundred dollars ($500).: ate: �^ pplicant: (_ 1 1, as owner of the property, or my employees with wages astheir sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS -UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. one year of completion, the owner -builder will have the burden of proving that he or she did not build or - improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_) I am exempt under Sec. BAP.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City O' d I f I d h kb' 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 of Lo a ma, its officers, agents an emp ogees or any act or omission re ate to a wor emg. performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced - within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, d hereby authorize representatives of th�nty to enter upon the above-mentioned property for inspection poses. e: S' ature (Applicant or Agent): ' Application Number . . . . . 12-00000651 Permit MECHANICAL Additional desc . Permit Fee . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation . . 0 Expiration Date 12/09/12. Qty Unit Charge Per Extension BASE FEE 15.0.0 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: INSTALL NEW 3.5 TON 13 SEER SYSTEM, FURNACE, CONDENSER, INDOOR COIL. 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 LQPERMIT ;amplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Zlimate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 51-560 Avenida Villa La Quinta, CA 92253 City of La Quinta May 9, 2012 Equipment Type1 List Minimum Efficiency2 Duct insulation . requirement Conditioned Floor Area Thermostat ❑Package Unit 0 Furnace m Indoor Coil ® AFUE 78% ® SEER 13.0 ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) Served by system ® Setback not already present, must be (0 Condensing Unit ❑EER ❑Resistance ❑ R 8 (CZ 14-15) 1400 sf in installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-1R-ALT-HVAC fur each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-611 and registered CF-4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-111 and CF-6111 shall also be on site for final inspection. m 1. HVAC Changeout Required Forms: . All HVAC Equipment CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF-4R forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or . . Indoor Coil and /or CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-AERS . Furnace CF-4R forms: MECH-21 and fors lits stems MECH-25 ( P systems) For Split Systems: Duct leakage z15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from duct leakage testing if ' ❑ 1.`buct: system was documented to have been previously sealed and confirmed through HERS vErification, or ❑ 2. Duct systems with less thA6 40 linear feet in unconditioned space, or ❑.3 Existing duct systems are constructed, Insulated or sealed with asbestos 0'4 The yste ,will not be.Duct d (Ie: Ductless Mf I-Spllt�$yte4n ( Iso Exem txfrom Refn er ntC.a.r e) - . «.. ,,. ,P9 9 w ~� ❑ 2. NeWj I' t"Sygtem Requi�redJForms 't ;' � . Cut in or'', han eout with"°" - g * CF 6 forms MECH-04 MECH-20 HERS and {for iE s MEC ,2Z-H,ERS, aind new ducts (all new I p Y ) ducting armed all n w� MECH25 HERS t ^* GF p 4 (� 4 for`ns MECH 20, and fors It_ s, ste , s MECH-2'' , a d MECH=25 e ui ment j Y )- For Split Systems yD.uct?leakage<w6"perGent,SRC;CCA>;350 CMJton; FWDTMAH; STMS, andelther=;HSF�R`or PSPp: For Packaged`Units:'Duct leakage, 6,xpercent 113. ,New=Ducts with/or without:. Replacement.. Required Forms: .Includes replacing or installing alImew ducting and/or outdoor condensing unit and/or indoor coil and/or furnace 'No or some CF-6R forms: MECH-04, MECH-20-HERS, and (for splt systems) MECH-25-HERS 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 (7611 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 Compliance. of • 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: Mark Hyde— Signature: Mark Hyde Company: CERTIFIED COMFORT SYSTEMS INC Date May 9, 2012 Address: 42-949 MADIO STREET License: 906115 City/State/Zip: INDIO / CA/ 92201 Phone: (760) 360-2202 Reg: 212-A0023374A-00000000-0000 2008 Residential Compliance Forms Registration Date/Time: 2012/05/09 14:01:58 HERS Provider: Ca10ERTS, Inc July 2010 Bin # of La .Quanta Building a Safety Division Permit.# ' P.O. BOX 1504, 78-495 Calle Tampico 'La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and TracWn Sheet g Project Addr �` s.` ` Jam/ Fs A u �u Owner's A. P. Number i f Name: IGr/ /� Legal Descrip I Address: , S6© ) 2n Id % c 'on: �• C City, ST, Zip: j Contractor: I (/ Telephone: Address: �1 G 10 Project Description: City, ST, Zip: a C Telephone: I '� iG�Z-Z�� State Lic. # q f7 City Lir. #: 'a 3. 5 pyl i S��e Arch., EnDesigner' gr., ,esigner Address: City, ST, Zip: Telephone: . •Constmction Type: Occupancy: State Lic. #: Name of Con Project type (circle one): New Add'r Alter. Repair Demo `t Person: Telephone # of Sq. Ft: I # Stories: # Units: ContactjPerson. Estimated Value o Project: �OGU APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal TRACEM'iG PERMIT FEES I . j I Req'd Recd7Revieweed, Plan Sets Structura itted Item Amount Falcs. Cal for corrections Plan Check DepositTruss i erson Plan Check BalanceEnergy C Ics. i ' Flood plai Construction 1 plan i Plans resubmitted Grading, Mechanical 1 p Subcoutac a 2qd Review, ready for correcdons/issue Electrical or List Called Contact Person Plumbing ' / Grant Dee I Plans picked up SALL H.O.A. Ap `roval I IN NOUS Plans resubmitted � Grading Planning A 3'Review, ready for corrections(issue Developer Impact Fee proval I Called Contact Person A.LP.P. j Pub. Wks. ppr Date of permit issue School Fees Total Permit Fees I INSTALLATION CERTIFICATE ' CF-611-MECH-04 Space Conditioning Systems, Ducts and Fans Page 1 of 2) Site Address: j Enforcement Agency: Permit Number: t 51-560 Avenida Villa, La Quinta CA 92253 (System 1) 1 City of La Quinta 12-560 a Space Conditioning Systems Heating Equipment cooling Equipment - - e Efficiency Duct, �`'' •+� IH Efficiency Location f c . Equip t,-~ (AFUE, (attic, Voe,z' ARI # of etc.)1, 3 crawl- Heating Heating (package CEC Certified Mfr. Name • Reference Identical (>=CF -1R space, Duct Load! Capacity ^. t eat pump) and Model Number Number2 Systemsvalue)4 value)4 etc.) R -value (kBtu/hr) (kBtu/hr) ;;Split day night 13 SEER Fleat Pump '• fem4p200a 1 9 HSPF ' Attic R-4.2 30 34 kBtu y/ta (,, r Ifirrt.: e cooling Equipment - - t e Efficiency Duct Equip IH (SEER Location f Type and EER) (attic, (package ARI # of 1, 3 crawl- Cooling Cooling heat - •CEC Certified Mfr. Name Reference Identical (>=CF -1R space, Duct Load Capacity pump) and Model Number II. Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split day night 13 SEER Heat Pump ,Nrl n4h342ake _ g�+ l 11�EER �Attiq*. vIR-4:2a"j X40 42 kBtu y/ta (,, Ifirrt.: _.'{, ,+. _ pis baa %i�t� 1�M`9 A-,� _Y.' -,- '4�. .�;,,.. •� --'r; t e IH 1. lr projecc is new conscruccion, see roocnot:es ro branoaras Iaole 1_-)1-b ana Iao►e isi-L ror auct ceiling alternative - compliance. 2. ARI Reference Number can be f �und by entering the equipment model number at http://www.aridirectory.orglarilac.ohp# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -IR forrrr. 4. When CF -1R is reference it is also applicable to the CF -IR, CF -IR -AA or CF -IR -ALT ALL BOXES.MUST BE CHECKED TO BE A VALID FORM 1 10 §110-§113: HVAC equipment is certified by the California Energy Commission. 2 §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE,, SMACNA, or RCCA. , 0 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). V 2 §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 entirel-/ in conditioned space. r Reg: 212-A0023374A-M0400001A--0000 Registration Date/Time: 2012/06/22 12:15:29 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms ' August 2009 Ducts and Fans §150(m): Duct and Fans L. 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. • duets andplenums 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 th'e 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. ❑ 7. Exhaust fan systems have back draft or automatic dampers. , ❑ 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, ' manually operated dampers. ❑ Protection of Insulation jInsulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind., Cellular foam insulation shall be protected as above or j -painted with a coating thaCis water retardant and provides shielding from solar radiation that can cause degradation of.the material:,, ; ❑ 10. Flexible ducts cannot have porous inner cores. y k st 4 w�• A . WDA- ♦ ate - 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) , r conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) • 4 Responsible Person's Signature: Mark Hyde Mark Hyde CSLB License: 906115 ♦ position With Company (Title): Ducts and Fans §150(m): Duct and Fans L. 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. • duets andplenums 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 th'e 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. ❑ 7. Exhaust fan systems have back draft or automatic dampers. , ❑ 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, ' manually operated dampers. ❑ Protection of Insulation jInsulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind., Cellular foam insulation shall be protected as above or j -painted with a coating thaCis water retardant and provides shielding from solar radiation that can cause degradation of.the material:,, ; ❑ 10. Flexible ducts cannot have porous inner cores. y k st 4 w�• A . WDA- ♦ ate - 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) , r conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) • 4 Responsible Person's Signature: Ducts and Fans §150(m): Duct and Fans L. 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. • duets andplenums 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 th'e 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. ❑ 7. Exhaust fan systems have back draft or automatic dampers. , ❑ 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, ' manually operated dampers. ❑ Protection of Insulation jInsulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind., Cellular foam insulation shall be protected as above or j -painted with a coating thaCis water retardant and provides shielding from solar radiation that can cause degradation of.the material:,, ; ❑ 10. Flexible ducts cannot have porous inner cores. y k st 4 w�• A . WDA- ♦ ate - 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) , r conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: Responsible Person's Signature: Mark Hyde Mark Hyde CSLB License: 906115 Date Signed: 5/15/2012 position With Company (Title): 4 - l ] Reg: 212-A0023374A-M0400001A-0000 Registration Date/Time: 2012/06_/22 12:15:29 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms S August' 2009 ' ,•' �4 ❑ 2. Measured leakage to outside less than 10% of Fan Flow conduct fix ❑ 3. Reduce leakage by 60% and smoke and all leaks ❑ 4. Fix all accessible leaks using smoke and HERS rater verify Note:(One of Options 1, 2 or 3 must be attempted before utilizing Option 4.) Determine nominal Fan Flow using one,of.the following three calculation methods ✓ 2 Coolin`g`#s`ysfe metphod: Size of.conden'se m Tons 3y45 k�y400.=`�i400 «CFM , If - Vt A, 1�4r�'.-i.L. y� ? '-F p. •�. T:_fj ✓ ❑Heating system method:42,1.7 x - "Output Capacity in ,T-hbusands of,Btu/hr "_ _ CFM 'CFM" ✓ ❑Measured systemfairflow usmgiRA3 3 airflow,test�procedures: , Optionnl�used'then { *'a __mo�iY� 99 6 t = r1 �iy( 1 Allowed, ,Fan Aid—. , 1400�15a—x210 ••CFM �"', Actual Leakage = 187 CFM.4 , Pass if Actual Leakage is less than Allowed leakage Pass Fail Option 2 used then: - 2 Allowed leakage = Fan Airflow _ x 0.10— —CFM Enter the Duct System Name or Identification/Tag: System i ' Enter the Duct System Location or Area Served: Whole House lllgte,Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwell 99: Pilsinstallation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. �4 ❑ 2. Measured leakage to outside less than 10% of Fan Flow conduct fix Enter the Duct System Name or Identification/Tag: System i ' Enter the Duct System Location or Area Served: Whole House lllgte,Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwell 99: Pilsinstallation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. 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 conduct fix ❑ 3. Reduce leakage by 60% and smoke and all leaks ❑ 4. Fix all accessible leaks using smoke and HERS rater verify Note:(One of Options 1, 2 or 3 must be attempted before utilizing Option 4.) Determine nominal Fan Flow using one,of.the following three calculation methods ✓ 2 Coolin`g`#s`ysfe metphod: Size of.conden'se m Tons 3y45 k�y400.=`�i400 «CFM , If - Vt A, 1�4r�'.-i.L. y� ? '-F p. •�. T:_fj ✓ ❑Heating system method:42,1.7 x - "Output Capacity in ,T-hbusands of,Btu/hr "_ _ CFM 'CFM" ✓ ❑Measured systemfairflow usmgiRA3 3 airflow,test�procedures: , Optionnl�used'then { *'a __mo�iY� 99 6 t = r1 �iy( 1 Allowed, ,Fan Aid—. , 1400�15a—x210 ••CFM �"', Actual Leakage = 187 CFM.4 , Pass if Actual Leakage is less than Allowed leakage Pass Fail Option 2 used then: - 2 Allowed leakage = Fan Airflow _ x 0.10— —CFM Actual Leakage to outside =_• CFM ' Pass if Actual leakage to outside is less than Allowed leakage I 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 Reg: 212-A0023374A-M2100001A-0000 Registration Date/Time:.2012/06/22.12:13:31 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 r ' y INSTALLATION CERTIFICATE CF-6R-ME'CH-2I-HERS Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 51-560 Avenida Villa, La Quinta•CA 92253 (System 1) City. of La Quinta 12-560 CERTIFIED COMFORT SYSTEMS INC t Responsible Person's Signature: INSTALLATION CERTIFICATE CF-6R-ME'CH-2I-HERS Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 51-560 Avenida Villa, La Quinta•CA 92253 (System 1) City. of La Quinta 12-560 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.. 0 All supply annclaeturn register boots..must-sbeksealed,to�the #ywall,,ifsmoke gtest i�is�utilized;for compliance - applies to ,, -d leakage compliance. option'3�(leakage'reduction by.,60%),Pend ' 'tlon)4 (fix alb accessible leaks) dee•��scribed above y �t f yt V'+rr't ,d .�YT �w,,..i. ...- 0 New duct lnstallatlo s,cannotr,utlllze bwlding cavities as;plenums or,platform;returns m_'lieulof.ducts. Ti, .x+ )ted ttwr , "1"4''1�i� •F ,. L.�.y,.mT,� '.'r"`4 ".". .5 y .�r r'74 .,ry - , 0 Mastic anddraw bands muPst4bremu-sed in1combin�at�aon ,.-",,clo�h`ba, k� -rubber{adher a ducI*,-- to seal . leaks at all new duct connections; 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 i istallation) 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 4 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 tl-e specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation ha+e been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made availab•e 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: IS/IS/2012 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No .. - •�... I 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.. 0 All supply annclaeturn register boots..must-sbeksealed,to�the #ywall,,ifsmoke gtest i�is�utilized;for compliance - applies to ,, -d leakage compliance. option'3�(leakage'reduction by.,60%),Pend ' 'tlon)4 (fix alb accessible leaks) dee•��scribed above y �t f yt V'+rr't ,d .�YT �w,,..i. ...- 0 New duct lnstallatlo s,cannotr,utlllze bwlding cavities as;plenums or,platform;returns m_'lieulof.ducts. Ti, .x+ )ted ttwr , "1"4''1�i� •F ,. L.�.y,.mT,� '.'r"`4 ".". .5 y .�r r'74 .,ry - , 0 Mastic anddraw bands muPst4bremu-sed in1combin�at�aon ,.-",,clo�h`ba, k� -rubber{adher a ducI*,-- to seal . leaks at all new duct connections; 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 i istallation) 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 4 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 tl-e specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation ha+e been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made availab•e 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: IS/IS/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-A0023374A-M2100001A-0000 Registration Date/Time: 2012/06/22 12:13:31 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March'2010 t INSTALLATION CERTIFICATE* + CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure .(Page 1 of 5) Site Address: Enforcement Agency: Permit Number: - 51-560 Avenida Villa, La Quinta CA 92253 City of La Quinta 12-560 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 fhf'6'#tge'rant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized W compliance. A:s.: »6A -y as 4 systems in the dwelling can be documented for compliance using this form. Attach an additicnal form(s) for j',additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) "I - 11. 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 ne •v 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 0Yes ❑ 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 j ❑ No ' V 5/16 inch (8 mm) access hole downstream of evaporative coil in the Eupplyplenum and labeled according to Figure in Section RA3.2.2.2.2.' Yes to 1 and•2 is a pass. t Enter Pass or Faill ✓ 0 Pass, ✓ ❑ Fail STMS'- Sensor on the Evaporator.Coil— System Narneo'r,Identification/Tag'��`r��+,/� - 'Sy`stem 1�••-', ;`i, W- -�` ,,�'+��:�,,� t� �.��.• �',,`�- '�►'i, 3 ,Yes 6:1, :; �p Nh`' 3 Thesensor is factory installed, or field -installed according to manufacturer's specifications, or isoinstalled by methods/specifications approved by tie Executive'- Director. ' t "r`:Y,1C: µ � �t �i�' ! �#1�•^•- 4 ❑Yes /k e t r'�❑ Noy v The sensor wire is'terminated with a,standard mini plug suitable for connect onItda' '• digital thermometer:+The sensor,miriirplug is,ac_c'essible torthe_installiig technic an and the, HERS; rater, without changing the airflow through the condenser coif 5 ❑Yes • []No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3, 4,rand 5 is alpass. Enter N/A if STMS are not applicable. Otherwise enter Pass ort Fail ✓ 0 N/A ✓ ❑ Pass ✓ ❑Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag System 1 r The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by t=ie 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 conden_er coil 8 ❑ Yes 1 ❑ No IThe sensor measures the saturation temperature of the coil within. 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not 0 N/A ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail , .t Reg: 212-A0023374A-M2500001A-0000 Registration Date/Time: 2012/06/22 12:12:41 HERS provider: CalCERTS„ Inc. + 2008 Residential Compliance Forms , August 2009 4 INSTALLATION CERTIFICATE - 'CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: r 51-560 Avenida Villa, La Quinta CA 92253 City of. La Quinta 12-560 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 Refere:7ce Residential k' 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 'ny'Ndditional systems in the dwelling as applicable. %,The �y5tem should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. Slica'`systrij must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. i 6.'# DutdOof air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. + � -`A_-' Conditioning Systems 9yO rri"Name or Identification/Tag System 1 (must be re-calibr.—ted monthly) M+ �"+r � system Location or Area Served Whole House y r° --.}.i. � ,fit 5/15/,20121 ' act• "�1. 'for V_41 (must beire-calibr..ted monthly) 1�[f' :Outdoor Unit Serial # e120401832 Outdoor Unit Make w day night Outdoor Unit Model n4h342ake Nominal Cooling Capacity Btu/hr ' 42000 Date of Verification 5/15/2012 Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 5/15/2012 (must be re-calibr.—ted monthly) M+ �"+r � ""'f .; ' ; , •-` 'x!' f Date of Thermocouple•Calibration y r° --.}.i. � ,fit 5/15/,20121 ' act• "�1. 'for V_41 (must beire-calibr..ted monthly) 1�[f' Supply (eJap6rator,1eavm4),�3ir dry-bulb s Measured Temperatures(;F):� ;, fv�+ Tot A:�i� pu gym , i< '16A System Name or Id,e�+ntifica�pti�on/Tag .i y`y,� ;< • 5. v -_y 'r System9l I I �`•t<(r }� yjyis r M+ �"+r � ""'f .; .. •LY'h ,A - 7C�""."t'1'..', " •,,i a • 1�[f' Supply (eJap6rator,1eavm4),�3ir dry-bulb temperature Tsu 1 db P ( PPy, )' Return (evaporator entering) air dry-bulb temperature'(Tretum, db) (.. Return (evaporator entering) air wet -bulb temperature (Treturn, wb) V. + Evaporator saturation temperature 39 !- (Tevaporator, sat) Condensor saturation temperature 101 • ' (Tcondensor, sat) Suction line temperature (T ) suction 53' Liquid Line Temperature (Tliquid) 90 a Condenser (entering) air dry-bulb 95 temperature (Tcondenser,'db) Reg: 212-A0023374A-M2500001A-0000 Registration Date/Time: 2012/06/22 12:12:41 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: Enforcement Agency: Permit Number: 51-560 Avenida Villa, La Quinta CA 92253 ' City of La Quinta 12-560, Minimum Airflow Requirement i Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verlficafion. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System Name or Identification/Tag System i J Calculate: Actual Superheat = INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 51-560 Avenida Villa, La Quinta CA 92253 ' City of La Quinta 12-560, Minimum Airflow Requirement i Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verlficafion. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System Name or Identification/Tag System i Calculate: Actual Superheat = Calculate: Actual Temperature Split = Treturn, Tsuction - Tevaporator, sat' db - Tsupply, db Target Superheat from Table RA3.2-2 using Target Temperature Split from Table RA3.2-3 Treturn, wb and Tcondenser, db using Treturn, wb and Treturn, db Calculate difference: Calculate difference: Actual Temperature Split - 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 .. 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 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.' Caleulated Minimum Airflow Requirement (CFM) Nominal Cooling Capacity ty (ton) X 300 (cfm/ton) System NamId nt fication/Tag,� ,/� , System i�r~ Calculate d,Minimum Airfl�(ow'Requiirreme�nt (CFM) `710-5,40 } Measured,�Airflow using RA33rocere 3 - � vs y1 Passes if measured airflow is greater than or equal to the calculated minimum airflow. requirement;*- T- • Enter Pass or Fail PASS Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag System 1 Calculate: Actual Superheat = Tsuction - Tevaporator, sat' Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F .. Enter Pass or Fail Reg: 212-A0023374A-M2500001A-0000 Registration Date/Time: 2012/06/22 12:12:41 HERS Provider:. CalCERTS, Inc. 2008 Residential Compliance Forms , ,; August'2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure i Page 4 of 5) Site Address: Enforcement Agenc772-560 ermit Number: 51-560 Avenida Villa, La Quinta CA 92253 City of La Quinta 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. 5: System Name or Identification/Tag System i 'Ca -M late: Actual Subcooling = 11.0 <cihdenser, sat - Tliquid Tar'geC Subcooling specified by manufacturer 10 Caleiflate difference: 4-25 AUi,i61 Subcooling - Target Subcooling = 1 system passes if difference is between '610F and +3°F PASS Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat = 14.0 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 4-25 between 4°F and 25°F if manufacturer's specification is not available) System pas�ses;if actual"superheat is-withinAhe allowable superheat range �. PASS f ,,*Enter Pass or Fail Reg: 212-A0023374A-M2500001A-0000 Registration Date/Time: 2012/06/22 12:12:41 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: .a 51-560 Avenida Villa, La Quinta CA 92253 1 City of La Quinta 12-560 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 'lltble verification criteria must be re -measured and/or recalculated. _ ystem Name or Identification/Tag System 1 Mark Hyde CSLB License: 906115 Date Signed: 5/15/2012 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No System meets all refrigerant charge and airflow requirements. PASS Enter Pass or Fail N. ';71 t`:v. ���My ;.r• t'.ry'. A}j�7�ySipr+ i:i:—irr .• wt CIO .7 . 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 iistallation) conforms to all applicable codes and regulations, and the Installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and ' additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation ha+e been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made availab.e 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: 5/15/2012 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-A0023374A-M2500001A-0000 Registration Date/Time: 2012/06/22 12:12:41 HERS Pro -.rider: CalCERTS, Inc. 2008 Residential Compliance Forms " August 2009 j ' • s CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4111-MECH-21 Duct Leakage Test — Existing Duct System :(Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 51-560 Avenida Villa, La Quinta CA 92253 (System 1) City of La Quinta 12-560 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 complia-rce in the dwelling. This installation certificate is required for compliance for alterations and additions in existing cweHings.t 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 Dirt 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 ,< a 0 3. Reduce leakage by 60% and conduct smoke and fix all leaks 04:'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 nominalzFan�,Flow using one;of,thhe�followinng threezcalculation,methods ✓ Cooling system method: Size ofcondenser m Tons x 400 tCFM ' ' �¢ a- _ ,f"F t = -: , ,,=7P ✓ ❑ Heating system method: 21 7fx� Output Capacity'in Thousands of Btu/hr_ �,z '!� ✓ Measured system airflow usmg'RA3 3,airflowtestprocedures •. Optibn i,used Then k • e A. 1 Allowed leakage �Fan'Flow xY0 15CFM,�+' T,.°sY Actual Leakage ,= CFM ZZ Pass if Leakage Actual is less than Allowed 0 Pass 0 Fail Option2 used then " 2' AllowbOeakage Fan Flow ° x 0;10 = _CFM Actual Leakage to outside.=" -,F -':CFM Pass if Leakage Actual is less than Allowed 0 Pass ❑ Fail Option 3 used then: ^ ;� Initial leakage prior to startbf;work = _CFM Final leakage after sealing allaccessible 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 p 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 p Pass p Fail 0 Reg: 212-A0023374A-M2100001A-M21A Registration Date/Time: 2012/08/20 13:24:26 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 , r Reg: 212-A0023374A-M2100001A-M21A Registration Date/Time: 2012/08/20 13:24:26 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION &'DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System ;Page 2 of 2) .Site Address: Enforcement Agency: Permit Number: 51-560 Avenida Villa, La Quinta CA 92253 (System 1) 1 City of La Quint a 12-560 ❑ Outside air (OA) ducts.:,for Central;Fan Integrated (CFI) ventilation systems, shall not be sewed/taped off during duct leakage testing °CFI�,OA ducts that utilize controlled motorized dampers, that open only when OA ventilation•'is required'to meet ASH.RAE Standard 62.2, and close when OA ventilation is not required, may be conflgu�ed to the closed position during duct leakage testing' ❑ AlVsupply and -return register' boots mustAbe sea led4 the dry'vwa l if>smokettest issutilized-ffo compliance — applies%to�duct leakage compliance option 3 �(deakage reduction by:60%) andfoption .4l( fix.alliaccessible leaks) descrRbed'atove ,. e. 1:1 New ducEinstallations.cannot,utilize building:cavities as plenums or p tformireturns inlieu of ducts-- t ' Akil [I Mastic andrdraw`bands must be.used inycombi ionswith;cloth backed rubber adheslveiduct tripe to seal leaksaII neW duct COnf12CtIOnS` ,at ` � � � - D E C LARATIO. N. STATEMENT" : t I certify under penalty of perjury u rider 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 the certificate (the installation) complies with the;appli''cable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF=112) 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 -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC � CSLB License: Y CERTIFICATE OF FIELD VERIFICATION &'DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System ;Page 2 of 2) .Site Address: Enforcement Agency: Permit Number: 51-560 Avenida Villa, La Quinta CA 92253 (System 1) 1 City of La Quint a 12-560 ❑ Outside air (OA) ducts.:,for Central;Fan Integrated (CFI) ventilation systems, shall not be sewed/taped off during duct leakage testing °CFI�,OA ducts that utilize controlled motorized dampers, that open only when OA ventilation•'is required'to meet ASH.RAE Standard 62.2, and close when OA ventilation is not required, may be conflgu�ed to the closed position during duct leakage testing' ❑ AlVsupply and -return register' boots mustAbe sea led4 the dry'vwa l if>smokettest issutilized-ffo compliance — applies%to�duct leakage compliance option 3 �(deakage reduction by:60%) andfoption .4l( fix.alliaccessible leaks) descrRbed'atove ,. e. 1:1 New ducEinstallations.cannot,utilize building:cavities as plenums or p tformireturns inlieu of ducts-- t ' Akil [I Mastic andrdraw`bands must be.used inycombi ionswith;cloth backed rubber adheslveiduct tripe to seal leaksaII neW duct COnf12CtIOnS` ,at ` � � � - D E C LARATIO. N. STATEMENT" : t I certify under penalty of perjury u rider 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 the certificate (the installation) complies with the;appli''cable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF=112) 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 -6R) 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): 334944 ❑ tested/verified dwelling not-tested/verified dwelling in la HERS sample grwp HERS Rater Information CaICERTS Certificate # CC1-1798654092 HERS Rater Company Name: Desert H.E.R.S. Raters _ Responsible Rater's Name: Responsible Rater's Signature: Michael Hyde t Michael Hyde , Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 7/23/2012 CC2005602 Reg: 212-A0023374A-M2100001A-M21A Registration Date/Time: 2012/08/20 13:24:26 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: 51-560 Avenida Villa, La Quinta CA 92253 City of La Quinta 12-560 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 for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in SUDDIV and Return Plenums of Air Handler System Name or Identification/Tag System i 141n; �.$I� - System Location or Area Served Whole House (. ❑Yes ` 1 ❑ Yes ❑ No, n'�'_ ;,. ;.4,; 5/16 inch (8 mm) access hole upstream of evaporative coil in the ret�jrn plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 ❑Yes ❑:No Aja o. y<; 5/,16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. YesAo sT.and.2 is a.pass >' . Enter Pass or Fail ✓ ❑ Pass ✓ ❑ Fail STMS Sensoron the, Eva orator..Coil'`_ w .. Ax � D � .aua'',w ;.>.-.,..^.,. ._ ... :.. :mss ,'' ::...,.. .•,,;;ter,:, System Name'6r,Identification/Tag'. ' y �. STMS —Sensor on the ConderiserCoil System Name or Identification/Tag I System 1 141n; �.$I� - 3 (. ❑Yes ` "The p No sensor is..factory:installed,``orlfield;i�nstalled!according to'manufacturer s specifications, or ismstalled by methods/speafications'approved by the Executive p ❑ Yes L + , �, � Y * $ ' M4,,,The pdigital sensor wirels,terminated with alstandird mini plug suitable for connectionsto a14 ®.Yes The sensor wire is terminated with a standard mini plug suitable for connection to a t thermometer The sensor mini plug is accessible,to the iristalh ig techrncan� ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installigg technician _. _ and the' HERS`rater_w.lthoutchangirigthe airflow through the condenser coil:` 5 ❑Yes, ° ❑ No When; attached to a digital thermometer, the sensor provides an indication of the ❑ Yes ❑ No f) saturation temperature of the coil. Yes to 3, 4 and 5 isfa Oass:lEnter N/A if: STMS are not ✓ ❑ N/A ✓ ❑ Pass ✓ ❑ Fail applicable: Otherwise enter„Pass or Fall ✓ ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail STMS —Sensor on the ConderiserCoil System Name or Identification/Tag I System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installigg 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 A Reg: 212-A0023374A-M2500001A-M25A Registration Date/Time: 2012/08/20 13:26:26 HERS Projider: CalCERTS, Inc. 2008 Residential Compliance Forms + March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure ;Page 2 of 5) Site Address: Enforcement Agen7712-560 Permit Number: 51-560 Avenida Villa, La Quinta CA 92253 City of La Quinta 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 add'tional 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 prcredure. , • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems , System Name or Identification/Tag System 1 (must be re -calibrated monthly) yY 7.4 System Location or Area Served Whole House r r° f° ;,*, - .: d+•m iYM1l•'6 Outdoor Unit Serial # C s Outdoor Unit Make ,+n x Outdoor Unit Model + Nominal Cooling Capacity Btu/hr. Date of Verification 1-aupration oT uiagnostic instruments Date of Refrigerant.Gauge Calibrati ,,,, . :. b (must be re -calibrated monthly) yY 7.4 �.•C fy,.y11��M1A14Y� ' Date of Thermocou le Calibration aAS r r° f° ;,*, 7 (m,ust bePre-calibrated monthly) .: d+•m iYM1l•'6 s5.....x.'•+s':'a.�r �... •iy}: '' 1"'#`� C Measured Temperatures(°F)�`� �� t "` fi- m SysteName or IdertiTg `�' T3' r t }'F � x Si'y,' t{ eXm yY 7.4 �.•C fy,.y11��M1A14Y� ' �s 541. ry . p Su I eva orator,leavin air d -bulb"'"` 1` �„ " c -zg �;,,, C s �,- temperature'(Tsupply db) tiF' `Y ,+n x , Return (evaporator;entering)air dry -bulbs" temperature'(T ) s return id Return (.evaporator entering)air wetbulb temperature (Treturn, w ) - b 4s�� Evaporator saturation temperature ''r (Tevaporator, sat) L Condensor saturation temperature ` (Tcondensor, sat) Suction line temperature (Tsuction) Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb, temperature (Tcondenser, db) Reg: 212-A0023374A-M2500001A-M25A Registration Date/Time: 2012/08/20 13:26:26 HERS Prowider: Ca10ERTS, 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: 51-560 Avenida Villa, La Quinta CA 92253 City of La Quinta -12-560 - 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 proceducesspecified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) =Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name=or Ida"ntifcation/Tag �t •, A..44 • �'' ,' , Ck cwr Calculated Minimum Airflow (CFM) ra ' =a n�y Qin esu 's a,tia� �'� - i� n l.� ,.a`. �Oyff X,0 ,yi:;4aA Measured Airflow usih RA3:3 roeedures CFM7. ) ...`I19£$ is Passes`if; measured a'irflow•isgreater;than or.equal r ' _► A; -i to the calculated minimum airflow requirement�w•�'�._. ,,. - a •.'�_ `, {r?; Enter Pass`or Fail '"-e •fir ®'.w . '':: ��::€- `=f."..,� ,. Superheat Charge Methodtalculations for Refrigerant Charge Verification. This procedure is regared to be used for fized.or fice metermg.dewice systems System Name or Identificatio %Tagg 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 f Reg: 212-A0023374A-M2500001A-M25A Registration Date/Time: 2012/08/20 13:26:26 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 r - INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 51-560 Avenida Villa, La Quinta CA 92253 City of La Quinta 12-560 Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is reqs fired to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Subcooling = Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer Calculate difference: Actual Subcooling - Target Subcooling = System passes if difference is between -4°F and +4°F Enter Pass or Fail ( 9f r , _ �f Metering Device Calculations for Refrigerant Charge Verification. This procedure is.required to be Lsed for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag'ti.. Calculate: Actual Superheat = K T - T suction., ...evaporator, sat Enter allowable superheat range from manufacturer's specifications'(or-useIrange between 36,F,and 269F if;manufacturers . spe6fication is not available)' Jx System passesrif actual superheat is 'Withmfthe ✓... .y ..k allowable superheatrange� ( 9f r , _ �f ' Entepi Pass•or, Fail � F�° � r � ,« ,. a t BTW i� P A.; Reg: 212-A0023374A-M2500001A-M25A Registration Date/Time: 2012/08/20 13:26:26 HERS Pro✓ider: CalCERTS, Inc. 2008 Residential Compliance Forms 'March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure I.Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 51-560 Avenida Villa, La Quinta CA 92253 City of La Quinta 12-560 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum ccoling 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): 334944 System meets all refrigerant charge and airflow not-tested/verified dwelling in la HERS sample 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: 7/23/2012 CC2005602 ;i J z t 7, x"i`' -fix' .... ♦ s ' i tk ..: 5 'r.,;;, � �� �� iYy,R � .." - � .F 2 �.,.,R,° � � is+�A`,,o! � k.i w•.r '�+ •" °. Sr , n' } j,'`� ^'ix , r .�.y„a 4• i - °�2' `_ t DECLARATION'STATEMENTz` " . 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 (respo•-isible rater). • The installed feature, material, component; or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) 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 Responsible Person's Name: CSLB License: Mark Hyde 1906115 HERS Provider Data Registry Information Sample Group # (if applicable): 334944 ❑ tested/verified dwelling not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798654092 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: 7/23/2012 CC2005602 Reg: 212-A0023374A-M2500001A-M25A Registration Date/Time: 2012/08/20 13:26:26 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 5ic^�