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12-0708 (MECH)P.O' BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000708 Property Address: 51170 "AVENIDA HERRERA APN: 773-064-006-17 -000000- Application description: MECHANICAL Property Zoning: COVE RESIDENTIAL Application valuation: 7600 Tihf " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: �( W ------------------ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I ami ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and fessionals Code, and my License is in full force and effect. License Class: C20 License No.: 968141 /Jpatb: vn 2_6 rZC ractor: / / WNER-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.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: 0 l LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/26/12 Owner: UNGARD SYLVIA JO 51170 AVENIDA HERRERA LA QUINTA, CA 92253 Contractor: DCS AIR CONDITIONING 72078 CORPORATE WAY, #101 THOUSAND PALMS, CA 92276 Sr'4 (760)343-5562 Lic. No.: 968141 -----------------------------------------------7 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a -certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier ZENITH INS Policy Number Z071741501 I certify that, in the performance of the k for which this permit is issued, I shall not employ any person in any manner so as to becom bject to the workers' compensation laws of California, and agree that, if I should become su t to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forth h comply with those provisions. ate l'2 /r 2_—A cant: WARNING: FAILURE TO SECURE WORKER CO ENSATION 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 1 have read this application and state that the above i f t rmation is correct. I agree to comply with all city and county ordinances and state laws relating to building con suction, and hereby authorize representatives offthis county to enter upon he above-mentioned property for in ction purposes. Date: -6/U/ nature (Applicant or Agent): LQPERMIT Application Number . . . . . 12-00000708 Permit I. . . MECHANICAL Additional desc . Permit Fee 40.50 Plan'Check Fee 10.13' Issue Date Valuation . . . . 0 Expiration Date 12/23/12 Qty Unit Charge Per Extension i BASE FEE 15.00 ! 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU L 16.50 --------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE -OUT: INSTALL NEW 3 TON PACKAGE UNIT ON ROOF AT EXISTING LOCATION. 2010 CODES. ---------------------------------=------------------------------------------ Other Fees • . . . . . . . . . • BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited, Due. Permit Fee Total 40.50 .00 .00 40.50 Plan Check Total 10.13 .00 .00 10.13 Other Fee Total 1.00 00 - .00 1.00 Grand Total 51.63 .00 .00 51.63 ' LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 51170 AVENIDA HERRERA La Quinta, CA 92253 City of La Quinta Jun 26, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat 0 Package Unit ❑ Furnace ❑ Indoor Coil ❑ AFUE ® SEER 13.0 ❑ COP ® HSPF 7.7 ❑ R 6 (CZ 10-13) Served by system ® Setback If not already present, must be ❑ Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) 1102 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-1R-ALT-HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-611 and registered CF-4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-IR and CF-6R shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: . All HVAC Equipment CF-6R forms: MECH-04, M�EJC�H-21-HERS and (far split systems) 04EG14 2F3 14ERS replaced MC!`L 2 CF-4R forms: MECH-21 and Eli f-iSplit systems) . Condenser Coil and /or CF-6R forms: MECH-04, MECH-2I-HERS and (f u� Split systems) NEGH-25-WERS 25-WERS .Indoor Coil and /or - �- - �-"��-� � �--� � CF-4R forms' MECH-21 BRd (feF Split systems) NEGH 2& . Furnace For Packaged Units: Duct leakage < 15 percent 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.syst6ff(Mill not be Ducted (ie..Duttless�Mlni-Split-System),(Also Exerript from Refrigerant 'Charge) ❑ 2. Nevi► HVAC Sy9tem Required Forms: rg . Cut in or Changeout with ry CF-6R forms: MECH-04, ECH 2O.-HERS, and (for split systems) MECH=22=HERS, and new ducts: (all new ducting fid_ all new MEC l =251HERS '� n t .. ,y `,•� + -�' *� CF-4R forms: MECH0 and (for spitsystems) MECH-22, and MECH-25 equipment)_ ,, ! w For Split 5ystemsu Duct leakage-,< 6 percent; RC, CCA�Z 350 CFM/ton, FWD;'TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Duds with/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 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: LESLIE ROGAN Signature: LESLIE R0GAN Company: HARRISON ENTERPRISES INC Date: Jun 26, 2012 Address: 72078 CORPORATE WAY #101 License: 968141 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-5566 Reg: 212-AO03340OA-00000000-0000 Registration Date/Time: 2012/06/26 10:58:21 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 Bin # City of La Quinta Building & Safety Dh4slon P.O. Box 1504, 78-495 Calle Tampico !a Quinta, CA 92233 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: Owner's Name: at ' A P. Number: Address: Legal Description: City, ST, Zip: QV253 Telephone. Project Description: Contractor. Address: City, ST, Zip: 3 . Telephone: 6)3 State Lic. # : City Lic. # 7j Arch., Engr., Designer. -- Address: City, ST, Zip: Construction Type: Occupancy: : E Project type (circle one): New Add'n Alter Repair Demo ontact Person: Sq. Ft: I # Stories: # Units: Telephone # of Contact Person: I Estimated Value of Project: `I 6 O O -- APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calces Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Pians picked up Construction Flood plain plan Plans resubmitted . Mechanical Grading plan 2". Review, ready for corrections/issue Electrical Subcoutactor List Called Contact Person Plumbing Grant Deed Plans picked cep S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for eorrectionsliissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 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. " Dud Leakage Diaanostic 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.uiilizing Option:4.), ,,. .. Determine nominal Fan Flow using one ofti-the following three calculation methodt.,^' ✓® Cooling'system method: Size oficondenser in Tons 3" x 400 =ts 1200 - CFM ✓ ❑ Heating system method: 21 7 x _ Output Capacity imThousantls of,8tu/hr CFM s.J i 15 . 4'. ✓ ❑ ; a " Measured,system airflow wtpudures f�(,°.�'•, using'RA3 CFM Option.1 used then: "...... 1 Allowed leakage = Fan Flow 1200 x 0.15 = 180 CFM Actual Leakage = 171 CFM Pass if Leakage Actual is less than Allowed IM Pass Fail Option 2 used then: 2 Allowed leakage = Fan Flow_ x 0.10 = _ CFM Actual Leakage to outside = _ CFM Pass if Leakage Actual is less than Allowed ❑ Pass Fail Option 3 used then: Initial leakage prior to start of work = CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction_CFM ((Leakage reduction _ / Initial leakage x 100% _ Reduction Pass if % Reduction >= 60% r3 Pass 0 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 Q Fail Reg: 212-A0042848A-M2100001A-M21A Registration Date/Time: 2013/01/16 23:26:05 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: 51170 AVENIDA HERRERA, La Quinta CA 92.253 (System Enforcement Agency: City of La Quinta Permit Number: 12-708 1) 1968141 HERS Provider Data Registry Information ® 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 return register l oots�must be!sealed:to the. drywall if;:smoke test is utilized for compliance - applies:to duct leakage compliance option 3 (leakage reduction by 6.0%) and option 4(fix all accessible leaks) described above. ".. #*' a ® New duct installations cannotiutilize, building cavities as`plenums'or;platforlii-- turns In Ileurof ducts: ® Mastic and draw bands must be` used in combination with cloth backed rubber adhesive duct'tape to seal leaks at all new duct connections. DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am 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 -IR) 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 -IR) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License: LESLIE ROGAN 1968141 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 Ca10ERTS Certificate # CCI -1798680591 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Ezequiel Moreno Ezequiel Moreno Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 1/16/2013 CC2005795 Reg: 212-A0042848A-M2!00001A-M21A Registration Date/Time: 2013/01/16 23:26:05 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-0 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: AVENIDA HERRERA, La Quinta CA 92253 (System Enforcement Agency: City of La Quinta Permit Number: 12-708 )1170 Dud R -value Heating Load (kBtu/hr) 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.) Dud R -value Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Package Furnace AMANA APH1536M41AB 1 80 AFUE Attic Type and EER) (attic, (package ARI # of 1, 3 crawl- Cooling Cooling heat CEC Certified Mfr. Name Reference Identical (>=CF -1R space, Dud Load Capacity pump) and Model Number Number2 Systems value)4 etc.), R -value (kBtu/hr) (kBtu/hr) Package - » . AMANA `Attic Cooling Equipment 1. if project is new construction, see Footnotes to standards /able 151 -ti and !able 151-C for duct ceiling alternative compliance. 2. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.org/ari/ac. php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -IR 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 RCCA. ® §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: 212-A0042848A-M0400001A-0000 Registration Date/Time: 2013/01/16 23:23:57 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 -1R space, Dud Load Capacity pump) and Model Number Number2 Systems value)4 etc.), R -value (kBtu/hr) (kBtu/hr) Package - » . AMANA `Attic A/C APH1536M41AB p1'.p 35 SEER ti °« 36 3 Tons �+ ri 1. if project is new construction, see Footnotes to standards /able 151 -ti and !able 151-C for duct ceiling alternative compliance. 2. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.org/ari/ac. php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -IR 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 RCCA. ® §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: 212-A0042848A-M0400001A-0000 Registration Date/Time: 2013/01/16 23:23:57 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: 51170 AVENIDA HERRERA, La Quinta CA 92253 (System Enforcement Agency: City of La Quinta Permit Number: 12-708 1) CSLB License: —76/14/2012 Date Signed: 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. I ® 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. ® Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. ® 10. Flexible.ducts cannot have porous. inner. cores.- ... '- '.t, ;-_»"y. "'^Mss •"_",^ # 74 DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible' person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: LESLIE ROGAN LESLIE ROGAN CSLB License: —76/14/2012 Date Signed: Position With Company (Title): 968141 Reg: 212-A0042848A-M0400001A-0000 Registration Date/Time: 2013/01/16 23:23:57 , 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: 51170 AVENIDA HERRERA, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-708 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 O 2. Measured leakage to outside less than 10% of Fan Flow p 3. Reduce leakage by 60% and conduct smoke and fix all leaks O 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 ofthe following three calculation methods. ✓ ® Cooling system method: Size of condenser in Tons 3_' x,400 = 1200 CFM ✓ O Heating system method: :21 7 x _Output Capacity in ih ousands of Btu/hr = =CFM ✓ O Measured system airflow using RA3 3'airfl9w test procedures CFM •. �w = _LLL Option 1 used then: w 1 Allowed leakage = Fan Airflow 1200 x 0.15 = 180 CFM ' Actual Leakage = 171 CFM Pass if Actual Leakage is less than Allowed leakage Ig Pass O Fail Option 2 used then: 2 Allowed leakage = Fan Airflow _ x 0.10 = _ CFM Actual Leakage to outside = CFM Pass if Actual leakage to outside is less than Allowed leakage O Pass 13 Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _ / Initial leakage _) x 100% _ % Reduction Pass if % Reduction >= 60% [3 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 C3 Fail Reg: 212-A0042848A-M2100001A-0000 Registration Date/Time: 2013/01/16 23:24:33 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: 51170 AVENIDA HERRERA, La Quinta CA 92253 (System Enforcement Agency: Permit Number: LESLIE ROGAN City of La Quinta 12-708 1) Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): ® 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 return register boots must be;seale,d to the drywall if;smoke test is utilized for compliance -applies to duct leakage compliance option 3 (leakage reduction by 60%) and option 4 (fix all accessible leaks) described above._- -Y• ;' ® New duct installations"cannot utilize building cavities as plenums or platform returns in lieu'of ducts:Y .•. ® Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to seal leaks at all new duct connections DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (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 wilt 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 beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: LESLIE ROGAN LESLIE ROGAN CSLB License: 968141 Date Signed: 6/14/2012 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No . Reg: 212-A0042848A-M2100001A-0000 Registration Date/Time: 2013/01/16 23:24:33 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 HVAC field Data Sheet Pg 1 of 2 Client Name + V(Gi �r �Job # Date P, �2 Address 5-11-7,6 At le n i �Gl 1�r`� (-CI Ph # Technician(s) -� Permit # Gauge/Thermocouple Calibration Date Split I Package I Some Ducts Only I All Ducts Only (Circle type of work) System Location or Area Served Heating Equipment Make Heating Equipment Model RP# t r-,4hM41 ARI Reference Number Heating Equipment AFUE go Duct Location (attic, crawlspace, etc.) A rrI c Duct R -Value (if ducts were installed) Heating Load Heating Equipment Output Capacity Condenser Make Condenser Model 4pH 15 3 bt"f l Size in Tons - fon SEER & EER Cooling Load Cooling Capacity Duct leakage pretest result Duct Leakage Final Result <24CFM/ton to pass (696) ail PasslFail PassjFail PasslFail Duct Leakage Final Result <60 CFM/ton to pass 05%) o,, Passig) PasslFail PasslFail PassIFad Pass using 60% leakage reduction? Pass using smoke and visual inspection? M� Measured Air Volume from Flow Grid or Hood Emi NEW DUCTS Target: 350 CFM/ton x Condenser Tons CHANGEOUT Target: 300 CFM/ton x condenser Tons Measured air greater than Target? (Y/N) Measured Fan Watt Draw Target: 0.58 watts/measured CFM = Measured Watts less than Target? (Y/N) Copyright 0 2011 EDS Energy Driven Solutions, Inc HVAC Field Data Sheet Pg 2 of i Client Name S \ U 1 u N6 ;A-Wr7 job # 23�9 `'/Vtr- Date 6/ % Z iY Condenser Serial Number /10-7 5,50031 Supply air dry bulb temperature 10 0. S Return air dry bulb temperature $S o Return air wet bulb temperature b o b Evaporator Saturation Temperature Condenser Saturation Temperature Suction Line Temperature Liquid Line Temperature Suction Pressure Pressure Liquid Pressure Actual Airflow Temperature Split 9 Target Temperature Split from Table RA3.2.3 2 - Passes if difference is:t 3' of Target Temp (Y/N) Passes '/ Actual Subcooling (± 4° of Target to pass) Target Subcooling from Mfr. Actual Superheat (3 to 26° to pass) _— Outside air dry bulb temperature Actual Line Set length (ft) % D Mfr's Standard Line Set Length (ft) Length Difference = Correction Factor (ounces per foot) Target: Correction Factor x Length Difference System Charged to Target? (Y/N) Minimum amps , Maximum amps Breaker size a Compressor amps 4 1 ya Return Static Pressure Supply Static Pressure Supply Air Wet Bulb Temperature * * ALL APPLICABLE BOXES ON THIS FORM MUST BE COMPLETED FOR EACHJOB. NO EXCEPTIONS. * • Copyright O 2011 EDS Energy Driven Solutions, Inc DUCT TESTING FORM INFORMATION CLIENT NAME: j'L (/iALW C,,4 LO—B# 232408 ADDRESS: 5//7,o ZONE ZONE 2 MODEL# P H I � 6 M 4 I MODEL# SERIAL# 11 0 "1 5 S p 0 31 SERIAL# MAKE: MAKE: OUTSIDE TEMPERATURE: / 6 OUTSIDE TEMPERATURE: DISCHARGE PRESSURE: O9. Z PSI DISCHARGE PRESSURE: PSI DISCHARGE TEMPERATURE: DISCHARGE TEMPERATURE: DISCHARGE SATURATION: DISCHARGE SATURATION: SUCTION PRESSURE: i -; Z PSI SUCTION PRESSURE: PSI SUCTION TEMPERATURE: SUCTION TEMPERATURE: SUCTION SATURATION: SUCTION SATURATION: RETURN DRY BULB: RETURN DRY BULB: RETURN WET BULB: D RETURN WET BULB: rr SUPPLY DRY BULB: SUPPLY DRY BULB: SUPPLY WET BULB: ��-'� SUPPLY WET BULB: MINIMUM AMPS: -2 b -7 MINIMUM AMPS: i MAXIMUM AMPS: 4 a MAXIMUM AMPS: BREAKER SIZE: ti BREAKER SIZE: AMPS: lb. -7 AMPS: COMPRESSOR AMPS: f - 417 COMPRESSOR AMPS: DUCT TEST FINAL LEAKAGE: CFM DUCT TEST FINAL LEAKAGE: CFM