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13-1012 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&ty/ 4 4 a" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 13-00001012 Owner: Property Address: 46845 GOLDEN SANDS PL MIGASI APN: 643-193-008-22 -2117 - 46845 GOLDN SANDS PLACE Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL ( Application valuation: 2500 Contractor: Applicant: Architect or Engineer: PREC H & A INC P.O. BOX 11090 PALM DESERT, CA 92255 (760)776-1550 Lic. No.: 818759 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am lice ed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busines nd P o ssionals Code, and my License is in full force and effect. License Cla s: C 0 C36 License No.: 818759 Date: 2J Contractor: 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 Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The 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(s) licensed pursuant to the Contractors' State License Law.). I—) 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/13/13 P 0 AUG 131013 CITY OF LA QUINTA FINANCE DEPT. WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided As by Section 3700 of the Labor Code, for the performance of -the work for which this permit is ued. 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 TRUCK INS EXCHN Policy Number N 2008 71 19 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 b me subjec o the workers' compensation provisions of Section p 00 of the Labor Code, all forth comply with those provisions. Date: O /`i Applicant: WARNING: FAILURE 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 conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, d hereby authorize representatives of this col t enter upon the above-mentioned property inspectio rposes. Date: 8 �S Signature (Applicant or Agent): It Application Number . . . . . 13-00001012 Permit . . . MECHANICAL 2013 Additional desc . Permit Fee . . . . 35.75 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/09/14 Qty Unit Charge Per Extension 1.00 35.7500 EA MECH CONDENSER/COMP 35.75 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE OUT - (5) TON 13SEER CONDENSOR [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING CODES. --------------7------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK', MECHANICAL 23.83 Fee summary Charged Paid Credited ---------------------------------------- Due --=-------------- Permit Fee Total 35.75 .00 .00 35.75 Plan Check Total .00 .00 .00 .00 Other Fee Total 115.40 .00 .00 115.40 Grand Total 151.15• .00 .00 151.15 LQPERMTT Q Qin # City of La Quinta Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: yb, gy t7 Owner's Name: A. P. Number: Address: y (l - g y 6101067 ylas P I a Legal Description: Contractor: P{e(7i0 N � 9 i✓ City, ST, Zip:L4 VA,( C9. q vz 3 Telephone: Address: f (�. Box I (ego Project Description: City, ST, Zip: alyl1 Z26 CO f r Telephone(7k),77& 1556 11 State Lic. # : M-751 City Lic. Arch., Engr., Designer: Address: City, ST,_ Zip: Telephone: P Construction Type: Occupancy: YP P Y Project type circle one): New Add'n Repair DemoAlter State Lic. #: XX Name of Contact Person:Sq. Ft.: -F# Stories: #Units: Telephone #,of Contact Person: JEstimated Value of Project: 2&o APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing t. Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE: '"' Review, ready for correctionsrssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAtterations CF-IR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit s: 46845 Golden Sands Place La Quinta, CA 92253 City of La Quinta Aug 12, 2013 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 ® SEER 13.0 ❑ HSPF ❑ R 8 (CZ 14-15) 2000 If not already present~ must be IM Condensing Unit [3 EER [3 Resistance installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system use another CF-IR-ALT-HVAC fnr ead� system. 2. Minimum Equipment Effidendes: 13 SEER, 78% AFUE, 7.7HSPF for typical nesidenbal 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-411 form§ (no hand filled CF-411,§ allowed) are filled out and signed.Be4mn_ ing October i, 2010, a registered copy of the CF-1R and CF-611 shall also be on site for final inspection. ® 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-411 forms: MECH-21 and (for split systems) MECH-25 • Condenser Coil and /or • Indoor Coil and /or CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS • Furnace CF-411 forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. The system will not be Ducted (ie. Ductless Mini-Split System) (Also Exempt from Refrigerant Charge) ❑ 2. New HVAC System Required Forms: . Cut in or Changeout with CF-6R forms: MECH-04, MECH-20-411S,�and (foe split systems) MECH-22-HERS, and new ducts: (all new MECH-25-HERS ducting bad all new, , equipment) CF-411 forms: MECH-20, and (for split systems) MECH-22, and MECH-25 For Split Systems: Duct leakage < 6 percent; RC, CCA 2 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit CF-611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF-411 forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA 2 300 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 the permit application. Name: Gerald Dobbins TSignabire: Bnrdd bobbins Company: PREC H &A INC Date: Aug 12, 2013 Address: P O BOX 10991 License: 818759 City/State/Zip: PALM DESERT/ CA/ 92255 Phone: (760) 776-1550 Reg: 213-A0062174A-000000000-0000 Registration Date/Time: 2013/08/12 19:36:03 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 46845 Golden Sands Place, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 13-1012 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 - existinq duct system Select one compliance method from the following four choices. ® 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow [:13. Reduce leakage by 60% and conduct smoke and fix all leaks ❑ 4. Fix all accessible leaks using smoke and HERS rater verify t Note: (One of Options.l, 2, or 3 must be attempted,before,utilizing Option,4 ).-_ Determine nominal Fan,Flow using one of,the following three calculation methods:af° ✓ ® Cooling system method Size in Tons VS x-400- 4 2000 CFM t !ij ■/offcondenser ✓❑ Output Heating system mfethod 21{7 xf=' Capajcyity in Thousa/n)ds of Btu/hr = CFM, ✓ ❑ Measured.system aklow.using RA3.3 airflow test procedures: • CFM Option i`used then: _ 1 Allowed leakage = Fan Flow 2000 x0.15 = 300 CFM Actual Leakage = 297 CFM . x Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then: , 2 Allowed leakage = Fan Flow _ x 0.10 = _ CFM Actual Leakage to outside = ' CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 3 used then: Initial leakage prior to start of work = CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction CFM ((Leakage reduction _/ Initial leakage x 100% _ % Reduction Pass if % Reduction >= 600/c 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 O Reg: 213-A0062174A-M2100001A-M21A Registration Date/Time: 2013/08/18 17:00:35 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: 46845 Golden Sands Place, La Quinta CA 92253 (System Enforcement Agency: Permit Number: Gerald Dobbins City of La Quinta 13-1012 1) ® tested/verified dwelling ❑ not-tested/verified dwelling in la ® 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 ® All supply�and,ret�urn register boots `must be.sealed to the:drywall ifm �soke testis utlllz'ed for compliance — appliesMto=duct leakage.. compliance option 3 (leakage reduction by.60%):and option 4ffflx all accessible leaks) described above yfy jjj - ?.. ® New duct installations cannot utilize 6ullding cavlttes as plenums rriplattfoo in' ', urns in lieu of ducts . ®Mastic anddravv,bands�must le�used�ln corribl'nation with''cloth,b'acke`drubberadhesive_,ducftape to seal leaks at all new duct connection's:.: DECLARATION STATEMENT.' I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement aoencv. Builder or Installer information as shown on the Installation Certificate (CF -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PREC H & A INC Responsible Person's Name: CSLB License: Gerald Dobbins 1818759 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ® tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CCl-1798786289 HERS Rater Company Name: Eddie Hernandez Jr Responsible Rater's Name: Responsible Rater's Signature: Eddie Hernandez, Jr. Eddie Hernandez, Jr. Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 8/13/2013 CC2004518 Reg: 213-A0062174A-M2100001A-M21A Registration Date/Time: 2013/08/18 17:00:35 HERS Provider: Ca10ERTS, 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 6) Site Address:Enforcement Agency: Permit Number: 46845 Golden Sands Place, La Quinta CA 92253 City of La Quinta 1 13-1012 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance, unless the TMAH Compliance Option is chosen. 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 jag System 1 System Location or Area Served Whole House 5/16 inch_(8 mm) access hole upstream of evaporative coil,in the ❑ Yes ❑ Yes ❑ Yes ❑ Yes 1 return plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figure in-4Section RA3.2:2.- Return'�side'of the ducts stem iso r Y located entirely withincondtioned t a �..' ®Yes k r #ti z" l7Yes �4r17 Yes - ❑Yes c la v spaarid returnairflow temperature ce, ❑ No Ax,: Y. p No's;`❑ No -� ".:,. ❑ No—- �.» to,be:omeasuredT at,thowreturn grille: v, ,;; »" ;� r • > . 5/16inch(8mrn) aecessshole'' 40 . ¢�, az fi `❑ r ' � ` 2 downstream' evaporativei,,, rn�the ': ®Yes Yes ❑Yes . Yes supply plenum and labeled according.' `--- ❑ No `" ` "" ❑ No� ❑ No '" ❑ No to Fig ur_e,in,eSection RA3.2.2 2:2: The TMAHCompliance,.Option should be checked only if the HERS Rater is able to confirm that it was physically impossible'for,,the .H.VAC Installer to drill the TMAH as required by Section RA3.2.2.2.2. Using this Compliance Option requires the HVAC installer to annotate on the HERS Provider's data registry an explanation as to why the TMAH"cannot be installed on the system, and photographs of the equipment on which the TMAH cannot be iista.11ed. Use of this Compliance Option also requires minimum airflow verification through the direct measurement of airflow per RA3.3. For more information see http://www.enerciv.ca.gov/title24/2008standards/special case appliance/ TMAH Compliance Option ❑ ❑ ❑ ❑ Yes to 1 and 2, or Yes to la and 2, or checking the TMAH Compliance Option, is ® Pass ❑ Pass ❑ Pass ❑ Pass a pass. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Enter Pass or Fail Reg: 213-A0062174A-M2500001A-M25A Registration Date/Time: 2013/08/18 17:02:05 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms February 2013 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25. Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6)' Site Address: Enforcement Agency: Permit Number: 46845 Golden Sands Place, La Quinta CA 92253 City of La Quinta 1 13-1012 STMS - Sensor on the Evaporator Coil System Name or System 1 Identification/Tag 6 TT�e sensor is factory installed, or field installed according to manufacturer's specifications, or is installed methods/specifications approved by the Executive Director. []Yes ❑ No 1 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 4 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 5 When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 3, 4, and 5isa pass. Enter N/A if STMS are not ® N/A ❑ N/A ❑ N/A ❑ N/A applicable. ❑ Pass ❑ Pass ❑ Pass ❑ Pass Otherwise enter Pass or,. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Fail STMS - Sensor on the Condenser Coil System Nam r9'=r, ste 1Identification F7Y aJ 6 The sensor is factoryi;instelled; or;field installedtaccording temanufacturer's specifications, or is installed— by methods/specifications approvedby the ExecutivelDirector;- . #� �'❑ Yes',❑°No.? I ❑'Yes`�❑ No t' "t ❑Yes ❑Noy^J�'� The sensor Iwire'is terminated with a"standard mini plug suitable for,"connection to'a4gital thermometer:; 7 The sensor mini plug is accessible to the installing technician and the`HERS rater without changing the airflow through the condenser coil - k ❑ Yes 11 No ❑ Yes ❑ No Yes ❑ No ❑Yes ❑ No 8 When attached to a,digital thermometer, the sensor provides an indication of the saturation temperature of the coil. \ 11 '1 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 6, 7, and 8isa pass. Enter N/A if STMS are not ❑ N/A ❑ Pass ❑ N/A ❑ Pass ❑ N/A ❑ Pass ❑ N/A ❑ Pass applicable. Otherwise enter Pass or ❑ Fail ❑ Fail ❑ Fail ❑ Fail Fail A Reg: 213-A0062174A-M2500001A-M25A Registration Date/Time: 2013/08/18 17:02:05 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6) Site Address: Enforcement Agency: Permit Number: 46845 Golden Sands Place, La Quinta CA 92253 City of La Quinta 1 13-1012 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb temperature is less than 55°F, the installer must use the RA3.2.3 Alternate Charge Measurement Procedure (Weigh -In Charging Method). If the Weigh -In Method is used, the dwelling cannot be included in a sample group for HERS verification compliance.) Saace Conditionina Svstems System Name or Identification/Tag System 1 (must be re=calibrated monthly) Date of Thermocouple Calibration 8/1/2013 System Location or Area Served Whole House Outdoor Unit Serial # 2013 Outdoor Unit Make 1 Payne Outdoor Unit Model/I' PA13NRO6000G Nominal Cooling Capacity 5 Tons Date of Verification �} ' 8 /13/20131`, ('( k J # r o Calibration of Diagnostic Instruments ,>i @ # 'k J Date of Refrigerant Gauge Calibration .- - T ' 8/1/2013 (must be re=calibrated monthly) Date of Thermocouple Calibration 8/1/2013 (must be re -calibrated monthly) a Measured Temperatures"(°F)' System Name or Identification/Tag System 1 Supply (evaporator leaving) air dry-bulb temperature (Tsu I db) Return (evaporator entering) air dry-bulb temperature (Treturn db) Return (evaporator entering) air 69 wet -bulb temperature (Treturn wb) Evaporator saturation temperature 51 (Teva orator sat) Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) 61 Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb 105 temperature (Tcondenser, db) C�' Reg: 213-A0062174A-M2500001A-M25A Registration Date/Time: 2013/08/18 17:02:05 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6) Site Address: Enforcement Agency: Permit Number: 46845 Golden Sands Place, La Quinta CA 92253 7City of La Quinta 1 13-1012 Minimum Airflow Reouirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag Calculate: Actual Temperature Split = Treturn db - Tsupply, db Target Temperature Split from Table RA3.2-3 using Treturn wb and Treturn db Calculate difference: Actual Temperature Split - Target Temperature Split = Passes if difference is between -4°F and +4°F or, upon remeasurement, if between -4°F and -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. 9 r•7 iF Calcullated'Minimum Airflow] — Nommal:�oling Capacity X 300 (cfm/ton) 1^011 Requirement (CFM) (ton) 4 � � `, •.� ., Wit. ,� System Name or)Identification/Tag ;.. System'1l 11 A Calculated Minimum Airflow Requirement 1500 (CFM) Measured Airflow using RA3.3 procedures 1821 (CFM) 4 Measurement Method Flow Hood Passes if measured airflow is greater than or equal to the calculated minimum airflow PASS requirement. Enter Pass or Fail Reg: 213-A0062174A-M2500001A-M25A Registration Date/Time: 2013/08/18 17:02:05 HERS Provider: CalCERTS, inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) Site Address: Enforcement Agency: Permit Number: 46845 Golden Sands Place, La Quinta CA =City of La Quinta 1 13-1012 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 System Name or Identification/Tag Calculate: Actual Superheat = 10.0 Tsuction - Teva orator sat Calculate: Actual Superheat=';' Target Superheat from Table RA3.2-2 10 Tsuction - Teva orator sat using Treturn wb and Tcondenser, db Enter allowable superheat range from Calculate difference: 0.00 manufacturer's specifications (or use range Actual Superheat - Target Superheat = between 3°F and 26°F if manufacturer's System passes if difference is between specification is not available) -6°F and +6°F PASS System passes if actual superheat is within Enter Pass or Fail r W,:�, the allowable superheat range Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification`/Tag systems. System Name or Identification/Tag Calculate: Actual Subcooling =. `k Calculate: Actual Superheat=';' Tcondenser, .sat - Tli quid �:- Tsuction - Teva orator sat Target Subcooling specified by. manufacturer Enter allowable superheat range from manufacturer's specifications (or use range Calculate difference. between 3°F and 26°F if manufacturer's Actual Subcooling-Target Subcoolmg=k.; specification is not available) Systemjpas`ses if difference,is betwee"h `"' -40Fand +4°F>' �F� A A1UZ 0 System passes if actual superheat is within Enter�Pass or Fail r W,:�, the allowable superheat range :m Enter Pass or Fail p w .r rE: +.,. � ` o -x=, � . s.cu__...'., . +J A."+�.�awa3a, �i4�i^�?✓ � � :=.. �S.ti _... �. �.� '� ^•e pK - . r., . ,,. �' . rr:::-, w'" a: Metering .Device::Calculations for Refrigerant Charge Verification. This procedure is required to be used:for th"ermosta-66 expansio6 valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Superheat=';' Tsuction - Teva orator sat Enter allowable superheat range from manufacturer's specifications (or use range between 3°F and 26°F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range Enter Pass or Fail Reg: 213-A0062174A-M2500001A-M25A Registration Date/Time: 2013/08/18 17:02:05 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6) Site Address: Enforcement Agency:Permit Number: 46845 Golden Sands Place, La Quinta CA 92253 City of La Quinta 13-1012 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 Gerald Dobbin, � * `.x' 8187�59�:- HERS Provider;Data RegistrytInformation- System meets all refrigerant charge and ® tested/verified dwelling ❑ not-tested/verified dwelling airflow requirements. PASS HERS Rater Company Name :%-`< Eddie Hernandez Jr Responsible Rater's Name: Enter Pass or Fail Eddie Hernandez, Jr. Eddie Hernandez, Jr. Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 8/13/2013 ® Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55°F and 65°F the return air dry bulb temperature shall be maintained above 70°F during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate. DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3'and the.requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. . They information reported on applicable sections of the Installation Certificate(s) (CF 6R), signed and submitted by the person(s)responsible ,for the inst illation�onforms totthe requirements specified: on the Certificate(s)�of Compliance (CF-iR) approvetJ by>the enforcement agency ,; , � p 'JOKII ; P l :. Builderior-tInstaller''.infor-mation4a`s';sh'own`on,the Installation,Certificate„(CF=6R;) �. .0 Company `Name: (Install ng1Subcontractor or Gen'eraL;Contractorjor,Bu�lder/Owner) #r , P R E C H!Bc A INC,�,� %`t '«�..`��z . A- �. €�arr��._ . Responsible Persohzs,Name �a A CSLBLicense' Gerald Dobbin, � * `.x' 8187�59�:- HERS Provider;Data RegistrytInformation- ” ('' Sample Group #'(if applicable) "N/A ® tested/verified dwelling ❑ not-tested/verified dwelling in a HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798786289 HERS Rater Company Name :%-`< Eddie Hernandez Jr Responsible Rater's Name: Responsible Rater's Signature: Eddie Hernandez, Jr. Eddie Hernandez, Jr. Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 8/13/2013 CC2004518 Reg: 213-A0062174A-M2500001A-M25A Registration Date/Time: 2013/08/18 17:02:05 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: 46845 Golden Sands Place, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 13-1012 Space Conditioning Systems Heating Equipment Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (AFUE, etc.)1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Equip (SEER Location Type _ �$ and EER) (attic, (package ARI # of 1, 3 crawl- Cooling Cooling heat CEC Certified Mfr. Name Reference Identical (>=CF -SR space, Duct Load Capacity pump) and Model Number, Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split A/C , Payne %"'PA13NR06000G `` c;1""- "" 13 SEER -7, "•Attic �—" y`R4:2 54W � P 5Tons Cooling Equipment 1. If project is new construction, see Footnotes to Standards Table 151-8 and Table 151-C for duct ceiling alternative compliance. 2. ARI Reference Number can `be found by entering the equipment model number at http://www.aridirectory.orglarildc:php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R form. 4. When CF -1R is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM ® §110-§113: HVAC equipment is certified by the California Energy Commission. ® §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. ® §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). ® §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 entirely in conditioned space. Reg: 213-A0062174A-M0400001A-0000 Registration Date/Time: 2013/08/18 16:56:57 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 Efficiency Duct Equip (SEER Location Type _ �$ and EER) (attic, (package ARI # of 1, 3 crawl- Cooling Cooling heat CEC Certified Mfr. Name Reference Identical (>=CF -SR space, Duct Load Capacity pump) and Model Number, Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split A/C , Payne %"'PA13NR06000G `` c;1""- "" 13 SEER -7, "•Attic �—" y`R4:2 54W � P 5Tons _ ] �.'k^ 1. If project is new construction, see Footnotes to Standards Table 151-8 and Table 151-C for duct ceiling alternative compliance. 2. ARI Reference Number can `be found by entering the equipment model number at http://www.aridirectory.orglarildc:php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R form. 4. When CF -1R is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM ® §110-§113: HVAC equipment is certified by the California Energy Commission. ® §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. ® §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). ® §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 entirely in conditioned space. Reg: 213-A0062174A-M0400001A-0000 Registration Date/Time: 2013/08/18 16:56:57 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: 46845 Golden Sands Place, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 13-1012 Ducts and Fans §150(m): Duct and Fans ® 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and ® 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 damp6s', ® Protection of Insulation.Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with•a,coating that is` "water retardant and provides shielding from solar radiation that can cause degradation of the material4f, 4 ® 10. Flexlble,ducts cannot have.porous Inner cores it _ xe..:L+-r.-- 6''4'ss's54 ..... .: ��' _ - br`:•5x ii / 1. DECLk • I certi •Iam( repres • I certi confoi _ 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) PREC H & A INC Responsible Person's Name: Responsible Person's Signature: Gerald Dobbins Gerold Dobbins CSLB License: 818759 Date Signed: 8/13/2013 Position With Company (Title): Reg: 213-A0062174A-M0400001A-0000 Registration Date/Time: 2013/08/18 16:56:57 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 46845 Golden Sands Place, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 13-1012 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 2. Measured leakage to outside less than 10% of Fan Flow ❑ 3. Reduce leakage by 60% and conduct smoke and fix all leaks 4',Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options 1, 2 or 3 must.be attempted, before utilizing_.Option 4.)_ Determine nominal Fan' Flow using one of the following three calculation methods ✓ � ... _ i r w ;. ® Coolingsystem method: S¢e ofcondenser. in Tons 5 x 400.= ` 2000 k CFM w��T • sem'' '„.._"� E.,. &.. r.o.-..._4,-,�..►.w.... ✓ _FM ;` ❑ Heating system method 21.Tx L Output Capacity, in Thousands of Btu% rC f �4- `"CFM ✓O Measured system airfloWusingjRA3 3.;airfloWtest procedures:`" �_y� ;r` � Option,.1 used then:,_j, # . 1 Allowed'leakage —'Fan Airflow 1 2000 "="x 0:15 300 `• CFM Actual Leakages= 297 CFM° rV, Pass if Actual Leakage is less than Allowed leakage t@ Pass Fail Option 2 used then: ,^ 2 Allowed leakage=`Fan'Airflow •Q -r . x 0.10 = _ CFM Actual Leakage to outside,= = UCFM -wIa.Pass if Actual leakage to outside is less than Allowed leakage n 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 >= 600/6 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 0 Fail Reg: 213-A0062174A-M2100001A-0000 Registration Date/Time: 2013/08/18 16:57:38 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: 46845 Golden Sands Place, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 13-1012 ® Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage,,te'sting: CFF`OA ducts that utilize controlled motorized dampers, that open only when OA ventilation`is'required to meet:A�SH_RAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed positi4n;;during duct leakage testing. ® All supprly a d return register boots ust besealed'tothedrywall.ifsmok etesrts ut Ilzed,for compliance - applies to duct leakage complia ce oqt on 3 (leakag.e reduction by;60%) and option 4 (fix all,accgssiblp leaks) descrltied above -�- ® New duct,,mstallatlons cannot utlllze bullding cavities as plenums or�iplatform return's i Ileuaof d ct`s��' V t ® Mastic and draw bands rust 6e usedfmiscomDinatlon with cloth backedsrubber`adhesrve duct tape to seal ... _.,.,✓. . , . fv. .. F .upx ..:.. ,w.+. .. __leaksat all .new duct connections Y JG% &Mf%P%,� . I certify under penalty of per jury,: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'th�e:,Rusiness and Professions Code to accept responsibility for construction, or an authorized representative of the person respofisil le for construction (responsible person). . I certify that the installed features `mat&ials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking 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 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 beainnina October 1. 2010. for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) PREC H & A INC Responsible Person's Name: Responsible Person's Signature: Gerald Dobbins Gerald Dobbins CSLB License: Date Signed: Position With Company (Title): 818759 8/13/2013 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No . Reg: 213-A0062174A-M2100001A-0000 Registration Date/Time: 2013/08/18 16:57:38 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 6) Site Address: Enforcement Agency: Permit Number: 46845 Golden Sands Place, La Quinta CA 92253 1 City of La Quinta 13-1012 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance, unless the TMAH Compliance Option is chosen. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area 'Served '1,1 Whole House 5/16,inch (8 mm) access hole., 1 upstreamV evaporative coil`in the `according ❑ Yes ❑ Yes ❑ Yes ❑ Yes return plenum and labeled ❑ No ❑ No ❑ No ❑ No to Figure,:in,Section RA3.2.2 22 :.<; la Return`side of the`duct system ism' � IocaEed entirely within conditioned V a �f",.`�' ti®.Yes❑,Yes ,;.❑Yes ''f �. r *Z <.;.❑,Y.es. ',; space and return airflow;temperature Ali N64� -4 No � ❑ No, ,, ❑ No' to be:measuredjat ttie return'g"n e: 5/16'inch 8imm raccess hole'e _. , . ), downsEreamiof evaporative;coil the®Yes ;< ❑Yes ❑ Yes 2 �n "❑;Noa ,� x❑,Yes i, supply plenum and' labeled`accordirig T� -` :rte ❑ No, � ❑ N6-.. ❑ No to -Figure in,Section RA3.2.2.2 2. The-TMAH Compliance Option should be checked only if it is physically impossible to drill the TMAH as required by Section RA3.2.2.2.2.:Using this Compliance Option requires the HVAC installer to annotate on the HERS Provider's data regisfry.an explanation as to why the TMAH cannot be installed on the system, and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance Option also requires minimum airflow verification through the direct measurement of airflow per RA3.3 For more information see httD://www.energy.ca.gov/title24/2008standards/special case angliance/ TMAH Compliance Option ❑ ❑ ❑ ❑ Yes to 1 and 2, or Yes to 1a and 2, or checking the TMAH Compliance Option, is 19 Pass ❑ Pass ❑ Pass ❑ Pass a pass. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Enter Pass or Fail Reg: 213-A0062174A-M2500001A-0000 Registration Date/Time: 2013/08/18 16:59:37 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6) Site Address: Enforcement Agency: Permit Number: 46845 Golden Sands Place, La Quinta CA 92253 City of La Qu 1 13-1012 STMS - Sensor on the Evaporator Coil System Name or System 1 Identification/Tag 6 sensor is factory installed, or field installed according to manufacturer's specifications, or is installed 3 7The by methods/specifications approved by the Executive Director. ❑ Yes ❑ No 1 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 4 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 5 IThe sensor measures the saturation temperature of the coil within 1.3 degrees F ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 3, 4, and 5 is a z pass. Enter N/A if STMS are not ® N/A ❑ N/A ❑ N/A ❑ N/A applicable. ❑ Pass ❑ Pass ❑ Pass ❑ Pass Otherwise enter Pass or ❑ Fail ❑ Fail ❑ Fail ❑ Fail Fail` ` STMS - Sensor'on the Condenser Coil System Name or tSystem 1 Identificationaa9 J► 6 The sensor is factory installed,`'or field installed,according-to�manufacturer,s,specifications, or is installed by methods/specifications approved ey the Executive�Director j . _'j ;;i❑.;Yes.3O No , .❑ Yes, ❑ No.'s; ❑ Yes ❑ No °, ' ❑ Yes ❑,No; a The sensor wire i`s terminated with=a standardrmini,plug.suitable for connection to a digital; thermometer.;' 7 The sensor#mini tplug, is accessible,to +the installing technician,and`=the3HERS rater without chengingitfi6l� airflow through the condenser coil"` r.� ❑.Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No r ❑ Yes ❑ No 8 The"sensor measures the saturation temperature of the coil within 1.3 degrees F J ❑ .Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 6, 7, and 8 is a z pass. Enter N/A if STMS are not ,Y ❑ N/A ❑ N/A ❑ N/A ❑ N/A applicable. ❑ Pass ❑ Pass ❑ Pass ❑ Pass Otherwise enter Pass or ❑ Fail ❑ Fail ❑ Fail ❑ Fail Fail M Reg: 213-A0062174A-M2500001A-0000 Registration Date/Time: 2013/08/18 16:59:37 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6) Site Address: Enforcement Agency: Permit Number: 46845 Golden Sands Place, La Quinta CA 92253 City of La Quinta 13-1012 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb temperature is 55°F or above) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb temperature is less than 55°F, the installer must use the RA3.2.3 Alternate Charge Measurement Procedure (Weigh -In Charging Method). If the Weigh -In Method is used, the dwelling cannot be included in a sample group for HERS verification compliance.) Space Conditioning Systems System Name or Identification/Tag System 1 (must be re-calibreted monthly) p System Location or Area Served Whole House 8/1/2013 (must be re -calibrated monthly) i Outdoor Unit Serial # 2013X70272 Outdoor Unit Make 1 Payne Outdoor Unit Model, ', PA13NRO6000G Nominal Cool ing,Capacity 5.T_ons. Date of Verifications* i t 1 T f ?'� 8/'13/2013 ,i► * e Calibration of Diagnostic Instruments ,t Date of Refrgerant'Gauge Calibration:" 8%1/2013 r �" (must be re-calibreted monthly) p Supply (evaporator leaving) air dry-bulb Date of Thermocouple Calibration 8/1/2013 (must be re -calibrated monthly) i temperature (Tsu I db) 51 Measured Temperatures (°F.) System Name or Identification%Tag System 1 Supply (evaporator leaving) air dry-bulb temperature (Tsu I db) 51 Return (evaporator entering) air dry-bulb temperature (Treturn db) Return (evaporator entering) air 69 wet -bulb temperature (Treturn wb) Evaporator saturation temperature 51 (Teva orator sat) Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) 61 Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb 105 temperature (Tcondenser, db) Reg: 213-A0062174A-M2500001A-0000 Registration Date/Time: 2013/08/18 16:59:37 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6111-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6) Site Address: Enforcement Agency: Permit Number: 46845 Golden Sands Place, La Quinta CA 92253 1 City of La Quinta 13-1012 Minimum Airflow Reauirement 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 System 1 ; 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 -3°F and +3°F or, upon remeasurement, if between -3°F and -100°F Enter Pass or Fail Note: Temperature Split:'�lethod ;'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; airf/ow isymeasured )ie value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below , > y: _+fes f.-^?�'S}^v� ��f5' �F.' :,mac�}} ai5" . 11 S t, Y $Sql X 300 Calculated Minimum Airflow Requirements*(CFM) . Nominal Coolmgh ,apac�ty�(ton) (cfm/ton)' �� Ne t tAN System.' ame orldentification�ag System 1 W sgx� mul I(� Calculated"'Minimum Airflow Requirements"�r�-:- -.1500.... .''' '� (CFM) A Measured' 6111ow`using RA3 3 procedures 1821 (CFM),, Measurement Method r;Y. ,,,$:� Flow Hood Passes if measured airflow is.*. ter than or equal to the calculated minimum airflow PASS requirement. Enter Pass or Fail Reg: 213-A0062174A-M2500001A-0000 Registration Date/Time: 2013/08/18 16:59:37 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) Site Address: Enforcement Agency: Permit Number: 46845 Golden Sands Place, La Quinta CA 92253 1 City of La Quinta 13-1012 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 System Name o Identification/Tag r System 1 Calculate: Actual Superheat = 10.0 x Tsuction - Teva orator sat Calculate:,'Actual Superheats`. Target Superheat from Table RA3.2-2 10 ., Tsuction -Teva orator 'sat .,: using Treturn wb and Tcondenser, db Enter allowable. Superheat'ran'ge from Calculate difference: 0.00 €;.. n, _ .. Y r. a,:., Actual Superheat - Target Superheat = y f g �� r6-5. v I System passes if difference is between specification is not available) -5°F and +5°F PASS System passes if actual superheat is within Enter Pass or Fail the allowable superheat range Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/.Tag System 1 System Name o Identification/Tag r System 1 Calculate: Actual Subcooli'ng'= x Tcondenser, sat - Tli uid J. Calculate:,'Actual Superheats`. Target:Subcooling specified by ., Tsuction -Teva orator 'sat .,: manufacturer Enter allowable. Superheat'ran'ge from Calculate difference Actual Subcooli gTarget Subcooling `,_ €;.. n, _ .. Y r. a,:., System p`assesif difference is between ' -31F and-,,,* y f g �� r6-5. v I a�� Fa specification is not available) _Enter��,Passor System passes if actual superheat is within �_ 1 '1, ,P°��4'`'.� dam. .. Metering D�ev ce Calculatior%s for Refr�g x g r xy p -require used for thermostatic,ezpansionvalve(TXV):,andelectroriic:expansionvalVe.(EXV) systecris... System Name o Identification/Tag r System 1 x Calculate:,'Actual Superheats`. ., Tsuction -Teva orator 'sat .,: Enter allowable. Superheat'ran'ge from manufacturer's specifications(or<use range between 4°F and 25°F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range Enter Pass or Fail erantCh`a`re'Verif�cationThis rocedureisre oiled tolie :.14 Reg: 213-A0062174A-M2500001A-0000 Registration Date/Time: 2013/08/18 16:59:37 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6) Site Address: Enforcement Agency: Permit Number: 46845 Golden Sands Place, La Quinta CA 92253 1 City of La Quinta 13-1012 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 CSLB License: Date Signed: 18/13/2013 Position With Company (Title): System meets all refrigerant charge and Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): airflow requirements. PASS Enter Pass or Fail ® Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55°F and 65°F the return air dry bulb temperature shall be maintained above 70°F during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate. 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 o the Business and Professions Code to accept responsibility for construction, or an authorized representative of.theyperson responsible for construction (responsible person). . I certify that the installed •teatbres,` materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a';HERS rater will`6eck the installation to verify compliance, and that that if such checking identifies defects, I am required to take corzective action at my expense. I understand that Energy Commission and HERS provider representatives will also "perfbrm.quality assurance checking of installations including those approved as part of a sample�group�=but not checkedby aH,ERS raters and if�those installationsofailto meet the requirements of such quality, assurance checking the required ¢orrectiJe action and additional checking/testing :of other installations in that HERS sample :group will be�perforrnedat my expense r ��- . I reviewed�a;copy of the Certificate of Compliance (CF 1k)Jorm approved by the enforcement agency7that identifies the— -•_ specific requirements for the installationh I, certify that the;!requirements detailed on,the CF 1R that apply to they'" installation have been Fn— a l c r } t ti a max- _4. # . I will ensuretMat a+completed,: signedcopy,ofthis InstallationCertificateshall.be posted,�or maderavailable¢ with the building permit(s)!issued for t'he building, End made a va.ilable.to,the` "enforcement agency fo�`all applicable inspections: I understand that a igned`copy''of this Iristallation'Certificate is`required to be included with the documentationithe builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will coti`e`from a HERS provider data registry for multiple orientation alternatives, and beginning'0ciober 1;,2010, for'all-low-rise residential buildings. Company Name: (Install_ing Subcontractor or General Contractor or Builder/Owner) PREC H & A INC ^+3 x Responsible Person's Name;''�x' ` : Responsible Person's Signature: Gerald Dobbins Gerald bobbins CSLB License: Date Signed: 18/13/2013 Position With Company (Title): 818759 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 213-A0062174A-M2500001A-0000 Registration Date/Time: 2013/08/18 16:59:37 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013