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05-5521 (SFD)
P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05-00005521 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Property Address: -81795-GOLDEN STAR WY APN: 764-280-999-79 -300235- Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 239196 Applicant:chitect or Engineer: nn (LCL ZAV-4 01 ------------------ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I amlicensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the eus'ness and Professionals Code, and my License is in full force and effect. License Class: I B License No.: 672285 ate: ntractor: 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 155001.: (_ 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.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The, Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 1 _ 1 I am exempt under Sec. , BAP.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: SHEA LA QUINTA C/O JEFF MCQUEEN 8800 N GAINEY CENTER 350 SCOTTSDALE, AZ 85258 Pe Q Co �j ?0 81 ES, INC. VENUE 62 NTA, CA 92253 777-6005 No.: 672285 VOICE (760) 777-7012 FAX (760) 777-7011 . INSPECTIONS (760) 777-7153 ------------------ WORKER'S COMPENSATION DECLARATION Date: 12/21/05 I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. KI have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: - Carrier AMERICAN HOME Policy Number 1247619 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 bject to the workers' compensation laws of California, and agree that, if I s uld become sub' t to the workers' compensation provisions of Section 0 of the Labo�r`'.TJ\,s',iall ft.,qith comply with those provisions. itP✓/ . I Y/ a plicant: / I 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 Ouinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that t e above information is correct. I agree to comply with all city and co ty ordinances and state laws relating to b i constructs and hereby authorize representatives of'h un t enter upo the above-mentioned prop fo insp n urposes. at ' �� ignature (Applicant or Agent) Application Number . . . . . 05-00005521 ------ Structure Information LOT 156.PLAN 6420C;W/CASITA ----- Construction Type . . . . . TYPE V - NON RATED Occupancy.Type . . . . DWELLG/LODGING/CONG <=10 Other struct info . . . . . CODE EDITION 2001 # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 615.00 PATIO SQ FTG 323.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 2758.00 --------------------------------------------------------------------------=- Permit . .. Additional desc . Permit Fee . . . . Issue Date Expiration Date . BUILDING PERMIT 1129.50 6/19/06 Plan Check Fee 734.18 Valuation . . . 239196 Qty Unit Charge Per Extension BASE FEE 639.50 140.00 --------------------------------------------7------------------------------- 3.5000 THOU BLDG 100,001-500.,000 490.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 108.00 Plan Check Fee 27.00 Issue Date . . . . Valuation 0 Expiration Date 6/19/06 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 5.00 6.5000 EA MECH VENT FAN 32.50 1.00 ---------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . Additional desc Permit Fee . . Issue Date Expiration Date . Qty Unit Charge 2758.00 .0350 615.00 .0200 LQPERMIT ELEC-NEW RESIDENTIAL 123.83 Plan Check Fee . Valuation . 6/19/06 Per BASE FEE ELEC NEW RES - 1 OR 2 FAMILY ELEC.GARAGE OR NON-RESIDENTIAL 30.96 0 Extension 15.00 96.53 12.30 ibw Application Number . . . . . 05-00005521 Permit . . . . PLUMBING Additional desc . Permit Fee 177.00 Plan Check Fee 44.25 Issue Date . . . Valuation . . . . 0 Expiration Date . . 6/19/06 Qty Unit Charge Per Extension BASE FEE 15.00 18.00 6:0000 EA PLB FIXTURE 108.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 6.00 .7500 EA PLB GAS PIPE >=5 4.50 1.00 15.0000 EA ---------------------------------------------------------------------------- PLB GAS METER 15.00 Permit• GRADING PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . .. 0 Expiration Date 6/19/06 Qty Unit Charge Per Extension BASE FEE 15.00 --------------------------------- Special Notes and Comments ----------------------------- -------------- SFD - Plan 6420C Lot 79 w/Casita (255sf), Box Bay (26sf), 2758 sf total.. Permit does not include block wall, pool or driveway approach. ----------------------------------------------------------'------------------ Other Fees . . . . . . ART IN PUBLIC PLACES -RES 97.99 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 480.00 ENERGY REVIEW FEE 73.42 DIF FIRE PROTECTION -RES 140.00 GRADING.PLAN.CHECK FEE .00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 23.91 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1666.00 Fee summary Charged Paid Credited Due LQPERMIT ' La Application Number . . . . . ----------------- ---------- Perm - Fee Total 1553.33 Plan Check Total 836.39 Other Fee Total 3891.32 Grand Total 6281.04 LQPERMIT 05-00005521 .00 .00 1553.33 .00 .00 836.39 .00 .00 3891.32 .00 .00 6281.04 JCM Inspections 39725 Garand Lane Suite F f I Palm Desert, CA 92211 ' P E C T i O N S Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS REINFORCED CONCRETE INSPECTION REPORT Dates: Noted Below Project Name: Project No: Trilogy @ La Quinta - Shea Homes 02-1109 Project Address: City: 60-800 Trilogy Parkway La Quinta, CA ❑✓ IBC ❑ Title 24 Other: Client: Sub -Contractor: Shea La Quinta, LLC DCCCC General Contractor: Architect: Structural Engineer: Shea Homes for Active Adults Bassenian Lagoni Borm & Associates, Inc./ Suncoast Post Tensi Slump (inches): (Q, pp Supplier:, Superior Time Sampled: C� ; s Mix Design: D83625P Time in Mixer (min.): %� Specified Strength (PSI): 4000 Water Added @ Jobsite (gals.):— Addmixture: POZZ 322N Concrete Temperature (F): Truck #: aL- 0 Ticket M-70 "C-0 Ambient Air Temperature (F): _., 1 Field ID Marking: Set A - 4 cylinders Weather: Unresolved Items: ®-None ❑ See Below Location of Sample: �� a n G t r — M e- c •c .r c.r ""'o y , . ❑ No Samples Taken (.ir ption of Work Inspected: Pse Lot# 5©� Product 3 Plan L5t7 L r• 1) Received mill certifications for rebar and tendons placed. 2) Typical exterior Footings including Garage Footings/Door (11,12,13/SD-1), Tie Beams (20/SD-1), Typical Interior Footings/Rib including step (15,18/SD-1), Seven Strand Tendons (4,10,12,13,16/SD-1), Simpson Strong Walls (24/SD-1), Anchor and H`oldowns (6,7,8/SD-1), Pad Footings and additional ^Bolts rebar placed as per these details and as noted ona W� "A'C,i\m r Also, typical details 2, 3/SD-1 and Notes on SNA apply. Checked rebar for grade, size, placement, coverage and splices. Rebar and tendons were securely tied and supported off the earth. Accepted for concrete placement. 1) The placement of concrete for areas noted above except Garage Interior Footing and Slab on Grade. Total cubic yards placed: approx A mechanical vibrator was used to consolidate the concrete. Approved #4 rebar slab dowels were placed.@ 18" o.c. 2) Molded 4 cylinders for compression tests with breaks at 7 days (1), 28 days (2) and one for holding purposes. 1) The placement of concrete for Garage Interior Footings and Slab on Grade Total cubic yards placed: approx Verified correct mix design. I certify that I have inspected all of the above work, unless otherwise noted, and to the best of my ability I have found this work to comply with the approved plans, specifications _applicable building laws. Final report issued at project completion. �_._ Inspector: Jack C. Millin ICC Certification No: 0842216-80 Coonntract�o�s Represe7ti.,.er Copy 1 JCM Inspections Copy 2 Project Superintendent Copy 3 Governing Agency Page ` of ' Ld P E C T I O N S JCM Inspections 39725 Garand Lane Suite F Palm Desert, CA 92211 Phone: 760-345-5554 - Fax: 760-772-3895 F INSPECTIONS PRESTRESSED CONCRETE INSPECTION REPORT Date: Project Name: Trilogy @ La Quinta - Shea Homes Project No: 02-1109 Project Address: 60-800 Trilogy Parkway City: La Quinta, CA ❑✓ IBC Title 24 Other: Client: Sub-Contractor: Shea La Quinta, LLC Sun Coast Tensioning General Contractor: Shea Homes for Active Adults Architect: Structural Engineer: Bassenian Lagoni Borm & Associates, Inc./ Suncoast Post Tensi Size and Type of Tendons: 1/2" Diameter Seven Strand Stress-Relieved Tendons Jack Machine Calibration: Received Sheet from Sun Coast-:Gage Pressure in psi to Machine Load in kips Sr 4 ot, psi to 33.04 kips/33,000 lbs Calibration Date: Machine # !QAQ� 4 I n Product3 Plan a n C C11i C_70UQ n S_�n r WnAA Phase kqNLot#t76'22 Weather: Unresolved1t ms: [in None ❑ See Below Description of Work Inspected: Lot # Location Actual EI e gation (in) Specified Complies within 7% +/- of specified elongation. Tendons Elongation (in) Reference 11 h/SN2. $�Q Yes No [7' ❑ ©r' ❑ 9.1 f A'\ LT �/ ❑ \� n"n'.k- RnXCO Ei/ ❑ Tf �jr+n J ❑ y V/ W 1 R t1�.J '.`r i,J 1 LJ ❑ Vi 1G ; r \ 1_ _ �IVUL L1 Je 1 -19%41 ED- ❑ C a s'c� --1 S; rQ S ► N 21' ❑ Co El� El y certify that I have inspected all of the above work, unless otherwise noted, and to the best of my ability I have found this work to comply with the approved plans, specifications _applicable building laws. Final report issued at project completion. Inspect r: Jack C. Millin ICC C rtif�ica ion No: 0842216-89 Contractor' Represen �tive: Copy 1 JCM Inspections Copy 2 Project Superintendent Copy 3 Governing Agency / Page _(_ of JCM Inspections f 139725 Garand Lane Suite F Palm Desert, CA 92211 E C T I O N S Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS COMPRESSION STRENGTH TEST RESULTS Client: Shea La Quinta, LLC Date: 5130106 Project: Trilogy @ La Quinta - Shea Homes Project No: 02-1109 60-800 Triolgy Parkway La Quinta, CA 92253 Set ID Structure Age of Test Compression Strength JCM ID Location Date Cast Cylinder ID (days) (psi) Set A Phase 14A - Lot # 5079 Slab on Grade 3-1-06 Concrete 273-676 Master Bedroom Required psi: 4000 2868 7 .3830 2869 28 5210 2870 28 5250 CERTIFIED: • • Page 1 of 1 JCM Inspections supplies the service of compression strength test results only. Per ASTMC39 . INSULATION CERTIFICATE This is to certify that insulation has been installed in conformance with the current energy regulation, California Administrative Code, Title 24, State of California, in the building at 81-795 GOLDEN STAR WAY, LOT 5079, PHASE 14A, LA QUINTA, CA CEILINGS: TYPE: BLOW MANUFACTURER: Cocoon THICKNESS: R-38 WALLS: TYPE: BATTS MANUFACTURER: Borate THICKNESS: W-13 GENERAL CONTRACTOR: SHEA HOMES LICENSE # BY: TITLE: 7PARAGO SCHMID BUILDING PRODUCTS A MASCO Company LICENSE # 221517 9&Gam(/ TITLE: ACCOUNT REPRESENTIVE DATE: 6",3U t • 90 39dd GIWHOS NOONVd Zb8ZLP609LT 90:80 900Z/0£/90 JUN 12,2006 16:35 BCI*TESTING,ri1 s 0 IFICATE OF FIELD VERT 000-000-00000 7 T STING (Page 1 of 8) Project Addles M Builder Name 817951Golden Star Way A Shea Homes, Inc. &rilder`�onFail Telephone Plan Number HERS Rater William Henson CF -4R 6420 Casita telephone Sample Grou t ;Y if applicable) 602-625-1994 26223` 079 — Climate Zone 15 7 Dale Certff/cateNumber June 12,2006 CC3-1798366805 Firm: BCI Testing 1 tERS Provider. CaICERTS _ Street Address: 77-760 Country Club Drive ste I City/State/Zip-Palm Desert / CA / 92211 u CoDles to: BUILDER. HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was J Tested'. Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the housa idantified on thi& form complies with the diagnostic tested compliance requirement, m thPcked on this form. The HERS rater must check and verify that the new distribution system is fully ducted and correct tape is used before o CF -4R may be released on every tested building. The HERS rater must not release the CF -4R until a properly completed and signed CF -6R has been received for the sample and tested buildings. The installer has provided a ropy of the CF -6R (Installation Certificate). 7 New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). 7 New systems where cloth backed, rubber adhesive duct tape is installed, mastir. and drawbands are used in combination with cloth backed rubber adhesive duct tape to seal leaks at duct connections. MlTNTMUM REOUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT_ Main Svstem NEW CONSTRUCTION Duct Pressurization Test Results (CFM (u1 25 Pa) Measured Values 1 Enter Te:ted leakage Flow in CFM: 59 2 Fan Flow: Calculated (Nominal' Cooling'.. Heating) or'., Measured 1400 Enter Total Fan Flow in CFM: 3 Pass If leakage Percentage % = 60/b [ 100 x ( Line 1 / Line 2 )); 4.211/a 517 -Pass r Fail ALTERATIONS: Duct System and/or HVAC Equipment Change -Out 4 Enter Tested Leakage Plow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. 5 Enter Tested Leakage Flow in CFM; Final Teta of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change -Out. 6 Enter Reduction in Leakage for Altered Duct System (Line 4 - Line 51 - (Only if Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) B Entire New Duct System - Pass if Leakaqe Percentage <= 6% [ 100 x ( Line S / Line 2 )I: 1 : Pass i . fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pas. If I.eekagr Petc"tage ::= 15"A. 1 100 x ( Line S / Line 2 )): i : Pass Fail 10 Pass if Leakage to Outside Percentage •: 10% 100 x Line 7 / Line 2 9 9 [ ( )1'• f Pas; L.-. Fail 11 Pass if Leakage Reduction Percentage >= 600A, ( 1.00 x ( Linn 6 / I ince 4 )1 and Verification by Smoke Test and Visual Inspection i Pass Fail 12 Pass if Sealingof all Accessible Leaks and Verification b Smoke Test and Visual Inspection y P • Pess L_ Fail Pass if One of Lines 49 through Ji 12 pass r Pass : Fail !✓-vi- ? � Page 2 JUN 12,2006 16:35 BCI*TESTING,ri1 000-000-00000 • • CERTIFICATE OF FIELD VERIFICATION 8L DIAGNOSTIC TESTING (Page 1 of 8) CF -4R Project Address Builder Name 81795 Golden Star Way Builder Contact HERS Rater William Henson Comoliance Method Shea Karnes, Inc. Telephone Plan Number _ 6420 Casita Telephone Sample Group Number/ Lot 0 (if applicable) 602-625-1994 26223/ 079 Climate Zone 15 Date Certificate Number //f/6C//I%-�'; f'r "� lune 12, 2006 CC3-1798366805 Firm: ki-'sting HFRS Provider:610ERTS Street Address: 77-760 Country Club Drive eta I City/State/Zip:Palm Desert / CA / 92211 Copies to; BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was . Tested : Approved as part of sample testing, but was not tested. A: the HERS rater providing diagnostic testing and field verifiC;Ahan, L CeAdy that the house identified on this form complies with the diagnostic te'up compliance requirements as checked on this form. The HERS rater mutt check and verity that the new distribution system is fully ducted and correct tape is used before a CF -4R may be released on every tested building, The ITERS rater mu,t not release the CF -4R until a properly completed and signed C:I -6R has been received for the sample and tested buildings. ;V The installer has provided a copy of the CF -611 (Installation CPrtlflcate.). 17 New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). J7. New systems where cloth backed, rubber adhesive duct taps i5 ihStalled, mastic and drawbands are used in combination with cloth backed rubber adhesive duct tape to seal leaks at dud connections. .M7Pa7mnm RFOuTnFMFNTS FOR nur-T LEAKAGE RFDtl=ON COMPLIANCE CREDIT: New Svstem NEW CONSTRUCTION Duct Pressurization Tnni Rwatlt!: (CFM (a 25 Pa) Measured Values 1 Enter Tested Leakage Row in CFM: 51 2 Fan Flow: Calculated (Nominal' .• Cooling Heating) or Measured 1200 Enter Total Fan Flow in CFM: 3 Pass if Leakage Percentage •;-• 6% ( 100 x ( Line 1 / Line 2 )J; 4,15% IV Pass I Fail ALTERATIONS: Duct System and/or HVAC Equipment Change -Out 4 Enter Tested Leakage Flow in CFM from CF -GR: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. 5 F.nter Tested Leakage Row in CFM: Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change -Out, 6 Enter Reduction in Leakage for Altered Duct System (Line 4 - Line 51 - (Only if Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) 8 Entire New Duct System - Pass if Leakage Percentage •= -•6% ( 100 x ( Linc 5 / Line 2 )): r L Pass C Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for Compliance: 9 Pass if Leakage Percentage <= 151% ( IOU x ( Line 5 / Line 2 )J: Pass ._ Fail 10 Pass if Leakage to Outside Percentage •: 10% ( 100 x ( Line 7 / Line 2 )J: I Pass Fail 11 Paso It Leakage Reduction Percentage > - 60% ( 100 x ( Linc 6 / Linc 4 )J r pass Fail and Verification by Smoke Test and Visual Inspection , 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection Pass . Fail Pass if One of Lines #9 through #12 pass I— Pass fail Page 3 JUN 12,2006 16:35 BCI*TESTING,ri1 000-000-00000 CERTIFICATE.OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 81 CF -4R •Project Address — f3rrllcfcr Name, — 8179S Golden Star Way Shea Homes, Inc. tirrilrlvf Cwutdt i Telephone Plan Number 6420 Casita _ HERS Rdter Telephone Sample Group Number/ Lot 4 (if applicable) • William Henson Method 602-625-1994 26223 / 079 Climate Zone 15 Date Certiricate Number `"' June 12 2t706 C_C3-1798366805 Firm: 661 Testing HERS Provider:CaICERTS Stro.Pt Address: 77-760 Country Club Drive ste 1 City/State/Zlp:Palm Desert/ CA/ 9221 t Coates to: BUILDER. HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was rYA, bested Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution system is fully ducted and correct Idpe is used before a CF -4R may be released on every tested building. The HERS rater roust not release the CFAR until a properly completed and signed CF -611 has been received for the sample and tested buildings. k% The installer has provided a copy of the CF -611 (Installation CcrtifiCatc). New Distribution system v. fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts), New system; where cloth bdt,kcd, lubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed rubber adhesive duct tape to seal leaks at duct connertinnti. MINIMUM REOUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT: New Svstem NEW CONSTRUCTION Duct Pressurization Test Results (CFM til) 25 Pa) Measured Values 1 Enter Tested Leakage Flow in CFM: 24 2 Fen Flow: Calculated (Nominal - • Cooling Heating) or • • Measured Boo triter Total Fan Flow in CFM: 3 Pass if Leakage Percentage <= 6`yn 1 300 x ( Line 1 / Line 2 )j: 3.000/0 Pass r Fail ALTERATIONS: Duct System and/or HVAC Equipment Change -Out 4 Enter Testcd Lcakagc Flow in CFM from CF -6R; Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. 5 Enter Tested Leakage Flow in CFM: Final Tent of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change -Out. 5 Enter Reduction in Leakage for Altered Duct System [Line 4 - Line 51 . (Only if Applicable) 7 Enter Tested Leakage_ Flow in CFM to Outsidc (Only if Applicable) 8 Entire New Duct System - Pass if Leakage Percentage <= 6% [ 100 x ( Line 5 / Line 2 )1: I . Pass i Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pass if Leakage Percentage .= 15"A, 1 100 x ( Line 5 / Line 2 )): , Pass Fail 10 Pass if Leakage to Outside Percentage <- 100/n [ 100 x ( Line 7 / Line 2 )): L_.: Pass I Fail 11 Pass if Leakage Reduction Percentage :>= 60% [ 100 x ( Line 6 / Linc 4 )J r and verification by .mnke fest and visual Inspectlon _ Pass Fail 12 Pasr, if Sealing of AT Accessible Leaks and Verification by Smoke Test and Visual Inspection i : Pass i Fail Pass if One of Linos 49 through #11 pass r Nass r I•ail L&4- �I Page 4 JUN 12,2006 16:36 BCI*TESTING,ri1 .000-000-00000 Page 5• CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (PaSe 3-4 of 8 CF -4R •Project Address Builder Name 81795 Golden Star Way Shea Homes, Inc. Suikfcr Cu+r(a�t Telephone Plan Number 6420 Casita _ 11IR5 Rater Telephone Sample Group Number/ Lot 4 (if appliwbk) William Henson 602-625-1994 262234079 _ Compliance Method Prescri five) / Climate Zone 15 Certifying Signature`�� t7ate Certificate Number June 12, 2006 CC3-1798366805 Firm: lift Testing HERS Provider;CaICERTS Streot Address: //-160 Country Club Drive ste I City/State/Zip:Palm Desert / CA / 92211 Copies to: BUILDER HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was fq -i ested i . Approved as part of sarnfilp testing, but was not tested. A, the HFR , r.,tr•.r providing diagnostic testing and field verification. 1 certify that the houoe idenlifit d on this form complies with the diag$nostic tested compliance raqurremenU a5 checked on this form. r/ The installer has provided a copy of the CF -614 (Installation Certificate). ✓THERMOSTATIC EXPANSION VALVE (TXV): Main System Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed on the system and installation of the specific equipment shall be verified. Main System 11VAC System `I•XV I Ly'Pass 1. • Fail • JUN 12,2006 16:36 BCI*TESTING,ri1 000-000-00000 Page 6 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 8) CF -41R •Projed Addrer Builder Name 91795 Golden Star Way Shea Homes, Inc. Builder Contact Telephone Plan Number 6420 Casita HERS Rater telephone Sample Group Number/ Lot; (i/ applicable) William Henson 602-625-1994 26223 / 079 C:om liarlce MethodPrescri Live Climate "Lone 15 Certifying Signaturelir Date Certificate Number June 12, 2006 CC3-1798366805 . Firm: loci Testing _ HLHS Provider:Ca10ERT$ _ Street Address: 77-760 Country Club Drive ste i City/State/Zip:Palm Desert / CA Es • Cooies to: BUILDER. HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The hougp was Y Tested It Approved as part of sample testing, but was not tested. As the HERS rater providing diaynostic testing and field verification, I certify that the house identified on this form complies with the die nostic tested compliancc reUuiremPnts as checked on this form. The installer has provided a ropy of the CF -611 (Installation Certificate), HERMOSTATIC EXPANSION VALVE TXV : New System Access is provided for inspection. The procedure shall consist of visual verification that the TXV Is Installed on the systern and installation of the specific equipment shall be verified. New System HVAC System TxV1 7 Dass Fail -79 5� % JUN 12,2006 16:36 BCI*TESTING,ri1 000-000-00000 Page 7 • 0 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 8) CF -4R Project Address Ruilder Name 81795 Golden Star Way Shea Homes, Inc. . SudderContact. Telephone Plan Number 6420 Casita HERS Rater _ T Telephone Sample Group Number/ Lot 4 (if npph(:ablr) William Henson 602-625-1_994 26223/.079 Compliance Method (Prescriptive) Climate zone 15 Certifying Signaturer -// Date Cert�cate Number /2`rJ /i� -d't tY�1' June 12, 2006 CC3-1798366805 Firm: tsCI testing HERS Provider:C310ERTS __ Street Address: 77-760 Country Club Drive ste 1 City/State/Zip: Palm Desert( CA f 92211 Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was 111;0'Tested': Apprnvpd as part of sample testing, but was not tested, As the HERS rater providing diagnostic testing and field verification, I certify that thr ljuusr identified on this form complies with the dra nostic tcAud complianre requirements as checked on this form. The installer has provided o envy of the CF -6R (Installation Certificate). ✓THERMOSTATIC EXPANSION VALVE (TXV): New System Access is provided for Inspection. The procedure shall consist of visual verification that the lXV is installed on the system and installation of the specific equipment shall be verified. New System HVAC System TXV l;4A Pass :Fail L 04- -7 6t JUN 12,2006 16:36 BCI*TESTING,ri1 000-000-00000 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 5 of 8) CF -4R •Pro)ect Address ' Builder Namc 61795 Golden Star Way Shea Homes, Inc. Builder Contact I Telephone Plan Number 11 6420 Casita HERS Rater Telephone Sample Group Number/ Lot f (if applicable) William Henson 602-625-1994 262_23 / 079_ Compliance Method (prescriptive) Climate Zone 15 Certifying Signature ," „•-r Date Certificate Number June Firm: BC1 Testing Street Address: 77-760 Country Club Drive ste I 2, 2006 CC3-17983668D5 ITERS Provider:CaICERTS Qty/State/Zip.Palm .Desert / CA / 92211 Codes to:.BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT I he house was I ested •. Approved as part of sample testing, but was not tested. A--, the HFR5 rater providing diagnnrhr, tr.;trng and fintd verification, t certify that the house identified on this form complies with the cl. nostic tested compliance requirements as checked on this form. The installer has provided a copy of the CF GR (Installation Certificate). :HIGH EER AIR CONDITIONER: Main Systern Procedures for verification are available in RACM Appendix Rl. 1 Pass ` : Fail EER values of installed systems match the CF -1R 2Piss Fail For split systems, indoor coil is matched to outdoor coil J Pass Fall Time Delay Rclay verified (if Required) Yes to I and 2; and 3 (It Required) is a pass 117 .. Pass f : Fail WHIGH EER AIR CONDITIONER: New System Procedures for verification are available in RACM, Appendix Rl. 1 'V Pass E Fail EER values of installed systems match the CF -1R 2 i Pass i : rail For split systems, indoor coil is matched to outdoor coil .3 ;... Pas.,; :r'tail Time Delay Relay Verified (If Required) Yes to 1 and 2; and 3 (If Required) is a passj Pass . : Fall -,HIGH EER AIR CONDITIONER: New System Procedures for verification are available in RACM, Appendix R1. 1 i.Pass i Fail EER values of installed systems match the CF -111 z Pass F: Fail For split systems, indoor coil is matched to outdoor coil 7 — Pass L Fail Time Delay Relay Verified (If Required) Yes to 1 and 2; and 3 (If Required) is a pas ; Pass i Fail Page 8