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10-0735 (DSF)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: 10-00000735 51645 EISENHOWER DR 773-134-018-6 -000000- DEMO - COMML/OTHER COVE RESIDENTIAL 0 Tay/ 4 4 Q" Architect or Engineer: PIA BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: DAVID HANSEN 51645 EISENHOWER DRIVE LA QUINTA, CA 92253 Contractor: DAVIS RESTORATION OF GREAT, 77833 PALAPAS ROAD PALM DESERT, CA 92211 (760)360-1855 Lic. No.: 677877 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 U Date: 8/06/10 ------------------------------------------------------------------------------------------------— LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Profession and my License is in full force and effect. _ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: B o�l, ,/ LicensgrNo- 677877 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is 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).: 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT w issued. IX I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor V" Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier NAT'L UNION Policy Number 4880392 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject o ompensation provisions of Section 3700 of the La or Co shall frt it m wit hose provisions. 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 15100,0001. 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 inform correct. I agree to comply with all city and county ordinances and state laws relating to buildi nstruc ' , an her t rize representatives of this Ry to e/n�ter upon t above-mentioned grope msp on p ;of �o !CJ ' nature (Applicant or Agent(: Application Number . . . . . 10-00000735 Permit . . . DEMO PERMIT Additional desc . . Permit Fee . . . . 45.00 Plan Check Fee.00 Issue Date . . . . Valuation . . . . . 0. Expiration Date . . 2/02/11 Qty Unit Charge Per Extension -BASE FEE 45.00 ---------------------------------------------------------------------------- Special.Notes and Comments REMOVE FIRE DAMAGED DRYWALL, FRAMING, TRUSSES, INSULATION, ELECTRICAL, PLUMBING, ROOFING, HVAC, WINDOWS, FLOORING AND DOORS IN PREPARATION FOR RE -MODEL PERMIT. Fee summary Charged Paid -------------------- Credited ---------- ---------- Due ----------------- Permit Fee Total 45.00 .00 .00 45.00 Plan Check Total .00 .00 .00 .00 Grand Total ' 45.00 .00 .00 45.00 LQPEEMIT Bin # (7�Q� City of La Quinta Building &r Safety Dlvlslon Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 •• Building Permit Application and Tracking Sheet Permit #P.O. l U 1 Project Address: > 1/5 Owner's Name: bAUjp Address: 5 c.I'AHnAjE I? S A. P. Number: Legal Description: City, ST, Zip: lJ i tJT,4 '�'% Z Z5 3 Contractor: L Do/lS A) Address:. FPtAf Telephone: Project Description: o is City, ST, Zip: FACM Telephone: 760 -30 _ (b 5-T State Lic. #: City Lic. #: 4'73 - Arch., Engr., Designer: J-0swi¢ �) ALN l ✓� Q?n1 ' /� /L' :f 1L_i��1 Address: po B0 q -041y City, ST, Zip: -M b,5c t?Lf e7 Z Z �o Telephone: 7(Po- 77(P - (p$ Construction Type: i-,RfOccupancy:'K t i q2 State Lic. #: j Z -7 Project type (circle one): New Add'n Alter epau o Name-of Contact Person: P—©1D PA JF-JK4-r7i . Sq. Ft.: I qCj'O #Stories: #Units: Estimated Value of Project: pp Oa Telephone # of Contact Person: % - - APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Ree'd TRACMG PERMTT FEES Plan Sets Plan Check submitted Item Amount Structural Cases. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance. Tide 24 Calcs. Plans picked rap Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'! Review, ready for correctioas/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'a Review, ready for correctionsiissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees 4, Total Permit Fees To tssvl: Sent By: DH or GW; 650 329 1047; Jul -2-10 4:14PM; Page 1/2 o ®P�4 L DAVIS Resto tfon&Remod ling 77833 Palapas Roa Palm Desert. A- 92211 Phone (760) 360-1 55 Pax (760) 360-6884 CA Lic nse #677877 Authorization to RePalr and Direction to Pa The property `rowner(s) or Representative", listed bislow, authorize Paul Davis Restoration acid Remodeling (Paul Davis) to proceed iAith the work on the premises listed for'any and all repair work necessary for the type of loss listed. Owner agrees that hd or she is acceptant of the services rendered, and that Paul Davis Restoration acid Remodeling is their "C ntractor of choice". If Insurance related, the owner agrees to direct the r insurance company to pay Paul Davis forthe work directly or iii lude Paul Dav's Restoration and Remodeling as a joint.payee on any draft, note, oil check writtei for services rendered. Owner should report Proof of Loss prom ly to the insurance company so payments can be issued.: Type Of Loss: ( ) Water ( I Fire( )IMold ( ) Wind ( ) Other {I Services to be:completed: (V Temp Pi Temp Fencing (� L (% - Demolition out ( ,(� Structural Cle Asbestos/Lead P Agreed upon by :Owner or Representative: Tenant Property Address : 'J%O scw,� City, State & zip: 1.4 QUWA- Mailing Address � City, State & zip:e-0 AWS Home Phone r Roard Up ( Dry Down ( ✓ ) Cetect/Repa r ( /Contents Cleaning/Pack ( ✓) Structural Rebuild Abatement Phone #: I �' • - t Sent By: DH or GW; Insurance Company:' !� Signature: Date-., (owner/owners) 650 329 1047; Jul -2-10 4:14P.M; Page 2/2 Claim # W Signature: 4 �.% L=ZCA Z --L A::to T (Poul Davis 'Reoreaentative) Paul Davis Restoration & Remodeling i 1 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 HANSEN-FIRE-DEMO Main Level Main Level DESCRIPTION QNTY 74. Dumpster load - Approx. 40 yards, 7-8 tons of debris 3.00 EA 75. General Demolition - per hour 24.00 HR Additional labor to clean up debri from grounds, cart and dump. 180. Temporary power - hookup 1.00 EA 182. Temporary fencing 30.00 LF 183. Warning Signs and or Cones 1.00 EA Due to the proximity of the property to a main road, (the driveway runs directly into a main traffic area) we may need addional signage, cones, warnings for egress into the property. 401. Temporary toilet (per month) 6.00 MO NOTES: Missing Wall: DESCRIPTION Garage ' 622.00 SF Walls 1084.86 SF Walls & Ceiling 51.43 SY Flooring 91.75 LF Ceil. Perimeter 1 - 16'X 7' Opens into Exterior 1. Demolishlremove - garage/room (up to 200 sf) Demolish all interior finishings, drywall, insulation to framing for inspection. 8. Clean with pressure/chemical spray - Heavy HANSEN-FIRE-DEMO Height: 8' 462.86 SF Ceiling 462.86 SF Floor 75.75 LF Floor Perimeter Goes to Floor QNTY 462.86 SF 462.86 SF 8/6/2010 Page:2 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 CONTINUED - Garage DESCRIPTION 13. Overhead door & hardware - 16'x T- High grade 15. Water heater - 100 gal residential grade - Gas 16. Heating and cooling unit - 2 ton, 80 MBH 391. Ductwork system - hot or cold air - 1200 to 1599 SF home 389. Exterior door - metal - insulated - flush or panel style 398. Steel door, 3' x 7' -fire rated NOTES KadM„ Laundry Room 126.67 SF Walls 1— 4'5' —F. T , T 141.07 SF Walls & Ceiling m m 1.60 SY Flooring 1 15.83 LF Ceil. Perimeter 5'5' I I QNTY 1.00 EA 1.00 EA 1.00 EA 1.00 EA 1.00 EA 1.00 EA Height: 8' 14.40 SF Ceiling 14.40 SF Floor 15.83 LF Floor Perimeter DESCRIPTION QNTY 18. Demolishlremove - kitchen/laundry 14.40 SF Remove all finishings, doors, cabinets, drywall, insulation to expose framing. NOTES: HANSEN-FIRE-DEMO 8/6/2010 Page:3 Paul Davis Restoration & Remodeling 1 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 7 4" Kitchen Missing Wall: 1- 7' 413/16" X 8' Missing Wall: 1- 4' 7 7/16" X 8' DESCRIPTION 291.80 SF Walls 407.47 SF Walls & Ceiling 12.61 SY Flooring 40.90 LF Ceil. Perimeter Opens into FAMILY Opens into ROOM2 Height: Sloped 115.68 SF Ceiling 113.53 SF Floor 33.17 LF Floor Perimeter Goes to Floor/Ceiling Goes to Floor/Ceiling QNTY 19. Demolish/remove - kitchen/laundry 113.53 SF Remove all finishings, doors, cabinets, drywall, insulation to expose framing. NOTES: Family Room 374.86 SF Walls 652.92 SF Walls & Ceiling 30.49 SY Flooring 69.86 LF Ceil. Perimeter Missing Wall: 1 - 6' 1111/16" X 8' Opens into ENTRY Missing Wall: 1- 12' 1/8" X 8' Opens into ROOM2 Missing Wall: 1- 3'3 3/16" X 8' Opens into ROOM2 Missing Wall: 1- 7' 413/16" X 8' Opens into KITCHEN HANSEN-FIRE-DEMO Height: Sloped 278.06 SF Ceiling 274.43 SF Floor 39.60 LF Floor Perimeter Goes to Floor/Ceiling Goes to Floor/Ceiling Goes to Floor/Ceiling Goes to Floor/Ceiling 8/6/2010 Page: 4 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax 1D: 33-0576487 Lic # 677877 DESCRIP'T'ION QNTY 20. Demolish/remove - bedroom/room (up to 200 sf) 274.43 SF Remove all finishings, doors, cabinets, drywall, insulation to expose framing. NOTES: t -Xi� Dining Room Height: Sloped 289.68 SF Walls 116.12 SF Ceiling ' 405.80 SF Walls & Ceiling 115.06 SF Floor "- 12.78 SY Flooring 25.18 LF Floor Perimeter 40.70 LF Ceil. Perimeter Missing Wall: 1 - 12' 1/8" X 10' Opens into FAMILY Missing Wall: 1 - 3' 3 3/16" X 10' Opens into FAMILY Missing Wall: 1- 4' 7 7/16" X 10' Opens into KITCHEN DESCRIPTION Goes to Floor/Ceiling Goes to Floor/Ceiling Goes to Floor/Ceiling QNTY 21. Demolish/remove bedroom/room (up to 200 sf) 115.06 SF Remove all finishings, doors, cabinets, drywall, insulation to expose framing. NOTES: HANSEN-FIRE-DEMO 8/6/2010 Page:5 Paul Davis Restoration & Remodeling ' 1 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 Entry/Foyer 116.38 SF Walls 171.84 SF Walls'& Ceiling 6.07 SY Flooring 32.67 LF Ceil. Perimeter Missing Wall: 1- 9' 71/8" X 11' Opens into LIVING Missing Wall: 1- 2' 7 118" X 11' Opens into LIVING Missing Wall: 1- 2' 17/8" X 11' Opens into LIVING Missing Wall: 1- 3'6" X 11' Opens into HALL Missing Wall: 1- 6' 1111/16" X 11' Opens into FAMILY Subroom 1: OFFSET 62.90 SF Walls i ' ^ 70.62 SF Walls & Ceiling • 0.86 SY Flooring ,• . 11.81 LF Ceil. Perimeter Missing Wall: 1- 3' 113/8" X 8' ' Opens into ENTRY Height: Sloped 55.46 SF Ceiling 54.60 SF Floor 7.26 LF Floor Perimeter Goes to Floor/Ceiling Goes to Floor/Ceiling Goes to Floor/Ceiling Goes to Floor/Ceiling Goes to Floor/Ceiling Height: 8' 7.72 SF Ceiling 7.72 SF Floor 7.86 LF Floor Perimeter Goes to Floor/Ceiling DESCRIPTION QNTY 22. Demolish/remove - bedroom/room (up to 200 sf) 62.32 SF Remove all finishings, doors, cabinets, drywall, insulation to expose framing. NOTES: HANSEN-FIRE-DEMO 8/6/2010 Page:6 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 Living Room 428.35 SF Walls = b b 673.18 SF Walls & Ceiling 5 26.51 SY Flooring 62.44 LF Ceil. Perimeter - H -T s -I vs „•-� Missing Wall: 1 - 2' 17/8" X 8' Opens into ENTRY Missing Wall: 1- 2'7 1/8" X 8' Opens into ENTRY Missing Wall: 1- 9'7 1/8" X 8' Opens into ENTRY DESCRIPTION Height: Sloped 244.83 SF Ceiling 238.56 SF Floor 47.44 LF Floor Perimeter Goes to Floor/Ceiling Goes to Floor/Ceiling Goes to Floor/Ceiling QNTY 23. Demolish/remove - bedroom/room (up to 200 sf) 238.56 SF Remove all finishings, doors, cabinets, drywall, insulation to expose framing. . NOTES: FPL T — 5'2" —� I DESCRIPTION 113.88 SF Walls 122.58 SF Walls & Ceiling 0.97 SY Flooring 14.24 LF Ceil. Perimeter 247. Fireplace, zero Once, wood burning, w/ venting HANSEN-FIRE-DEMO Height: 8' 8.69 SF Ceiling 8.69 SF Floor 14.24 LF Floor Perimeter QNTY 1.00 EA 8/6/2010 Page:7 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 CONTINUED - FPL DESCRIPTION QNTY NOTES: �r 2,,.i Bedroom -1 T a N T , 0 Fara Fara 1 2' 4' 384.00 SF Walls 499.33 SF Walls & Ceiling 12.61 SY Flooring 43.02 LF Ceil. Perimeter Subroom 1: CLST 195.00 SF Walls 213.11 SF Walls & Ceiling 1.96 SY Flooring 22.11 LF Ceil. Perimeter Height: Sloped 115.33 SF Ceiling 113.53 SF Floor 42.67 LF Floor Perimeter Height: Sloped 18.11 SF Ceiling 17.67 SF Floor 21.67 LF Floor Perimeter DESCRIPTION QNTY 25. Demolish/remove - bedroom/room (up to 200 sf) 131.19 SF Remove all fmishings, doors, cabinets,. drywall, insulation to expose framing. NOTES: HANSEN-FIRE-DEMO 8/6/2010 Page:8 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 T- i N [V J 1 DESCRIPTION Coat Height: 8' 64.00 SF Walls 4.00 SF Ceiling 68.00 SF Walls & Ceiling 4.00 SF Floor 0.44 SY Flooring 8.00 LF Floor Perimeter 8.00 LF Ceil. Perimeter QNTY 26. Demolish/remove - bedroom/room (up to 200 sf) 4.00 SF Remove all finishings, doors, cabinets, drywall, insulation to expose framing. NOTES: 43:'2r 1 f3'Y H 411' 4-F3'9' 1-8. 1•� 1-3'T-1 I�,as 2'71 I12'6I '1 1ra, 1 DESCRIPTION Bedroom -2 Height: Sloped 420.94 SF Walls 128.23 SF Ceiling 549.17 SF Walls & Ceiling 126.22 SF Floor 14.02 SY Flooring 47.00 LF Floor Perimeter 47.36 LF Ceil. Perimeter Subroom 1: CLST Height: 8' 180.00 SF Walls 18.50 SF Ceiling 198.50 SF Walls & Ceiling 18.50 SF Floor 2.06 SY Flooring 22.50 LF Floor Perimeter 22.50 LF Ceil. Perimeter QNTY 27. Demolish/remove - bedroom/room (up to 200 sf) 144.72 SF Remove all finishings, doors, cabinets, drywall, insulation to expose framing. HANSEN-FIRE-DEMO 8/6/2010 Page:9 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 DESCREMON NOTES: 4'7* 0 4's T �ry m Mst CIA CONTINUED - Bedroom -2 195.27 SF Walls 230.91 SF Walls & Ceiling 3.96 SY Flooring 24.41 LF Ceil. Perimeter QNTY Height: 8' 35.63 SF Ceiling 35.63 SF Floor 24.41 LF Floor Perimeter DESCRIPTION QNTY 28. Demolish/remove - bedroom/room (up to 200 sf) 35.63 SF Remove all finishings, doors, cabinets, drywall, insulation to expose framing. NOTES: HANSEN-FIRE-DEMO 8/6/2010 Page: 10 Paul Davis Restoration & Remodeling 1 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax LD: 33-0576487 Lic # 677877 �I A=I— Hallway r -sr it - r--rr�rrt 1r 285.71 SF Walls 341.39 SF Walls & Ceiling 6.19 SY Flooring 35.71 LF Ceil. Perimeter Height: 8' 55.68 SF Ceiling 55.68 SF Floor 35.71 LF Floor Perimeter Missing Wall: 1- 3'6" X 8' Opens into ENTRY Goes to Floor/Ceiling DESCREMON QNTY 29. Demolish/remove - bedroom/room (up to 200 sf) 55.68 SF Remove all finishings, doors, cabinets, drywall, insulation to expose framing. NOTES: Bathroom 295:98 SF Walls 357.06 SF Walls & Ceiling 6.79 SY Flooring 37.00 LF Ceil. Perimeter Jam* Subroom 1: LINEN ilia, lt*.� 9.33 LF Ceil. Perimeter n HANSEN-FTRE-DEMO Height: 8' 61.08 SF Ceiling 61.08 SF Floor 37.00 LF Floor Perimeter Height: 8' 4.75 SF Ceiling 4.75 SF Floor 9.33 LF Floor Perimeter 8/6/2010 Page: ll I to m 74.65 SF Walls 79.40 SF Walls & Ceiling C4unIn 0.53 SY Flooring ilia, lt*.� 9.33 LF Ceil. Perimeter n HANSEN-FTRE-DEMO Height: 8' 61.08 SF Ceiling 61.08 SF Floor 37.00 LF Floor Perimeter Height: 8' 4.75 SF Ceiling 4.75 SF Floor 9.33 LF Floor Perimeter 8/6/2010 Page: ll Paul Davis Restoration & Remodeling 1 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 DESCRIPTION QNTY 30. Demolish/remove - bathroom (up to 50 sf) 65.83 SF Remove all Hnishings, doors, cabinets, drywall, insulation to expose framing. Remove tub for evaluation -clean and re -use if possible. Remove plumbing fixtures and clean and re -use if possible. NOTES: Missing Wall: Master Bedroom 1- 4' 11" R 8' 505.05 SF Walls 683.41 SF Walls & Ceiling 19.31 SY Flooring 51.32 LF Ceil. Perimeter Opens into VANPI'Y DESCRIPTION 32. Demolish/remove - bedroom/room (up to 200 sf) Remove all finishings, doors, cabinets, drywall, insulation to expose framing. NOTES: Height: Sloped 178.36 SF Ceiling 173.79 SF Floor 50.44 LF Floor Perimeter Goes to Floor/Ceiling QNTY 173.79 SF HANSEN-FIRE-DEMO 8/6/2010 Page: 12 Paul Davis Restoration & Remodeling 1 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 i T Master Bath 3' -42.6' 6P .T 2 T zn u;'St" 1 185.33 SF Walls 218.86 SF Walls & Ceiling 3.73 SY Flooring 23.17 LF Ceil. Perimeter Height: 8' 33.53 SF Ceiling 33.53 SF Floor 23.17 LF Floor Perimeter DESCRIPTION QNTY 31. Demolish/remove - bedroom/room (up to 200 sl) 33.53 SF Remove all finishing&, doors, cabinets, drywall, insulation to expose framing. Remove tub for evaluation -clean and re -use if possible. Remove plumbing Sutures and clean and re -use if possible. NOTES �6. Vanity Area/Room Height: 8' `s �o• 134.00 SF Walls 28.68 SF Ceiling 162.68 SF Walls & Ceiling 28.68 SF Floor 1 3' -42' 6 js' 3.19 SY Flooring 16.75 LF Floor Perimeter wom M.12 16.75 LF Ceil. Perimeter Magee nme. BaM Missing Wall: 1- 4' 11" X 8' Opens into MSTRBDRM Goes to Floor/Ceiling DESCRIPTION QNTY 33. Demolish/remove - bedroom/room (up to 200 sl) 28.68 SF Remove all 6nishings, doors, cabinets, drywall, insulation to expose framing.. Remove plumbing fixtures and clean and re -use if possible. HANSEN-FIRE-DEMO 8/6/2010 Page: 13 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 DESCRIPTION NOTES Whyma DESCRIPTION Linin CONTINUED - Vanity Area/Room 122.65 SF Walls 133.98 SF Walls & Ceiling 1.26 SY Flooring 15.33 LF Ceil. Perimeter QNTY Height: 8' 11.33 SF Ceiling 11.33 SF Floor 15.33 LF Floor Perimeter QNTY 447. Demolish/remove - bedroom/room (up to 200 sf) 11.33 SF Remove all finishings, doors, cabinets, drywall, insufflation to expose framing. NOTES: HANSEN-FIRE-DEMO 8/6/2010 Page: 14 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax ID: 33-0576487 Lie # 677877 Patio Height: 8' 270.00 SF Walls 245.46 SF Ceiling 515.46 SF Walls & Ceiling 245.46 SF Floor 27.27 SY Flooring 33.75 LF Floor Perimeter 33.75 LF Ceil. Perimeter Missing Wall: 1 - 22' 10" X 8' Opens into Exterior Goes to Floor/Ceiling Missing Wall: 1- 10' 9" X 8' Opens into Exterior Goes to Floor/Ceiling DESCRIPTION QNTY 357. Clean with pressure/chemical spray 245.46 SF Remove all finishi:ngs, doors, cabinets, drywall, insulation to expose framing. Walkway Missing Wall: 1- 23' 6 1/2" X 8' Missing Wall: 1- 5' 101/2" X 8' DESCRIPTION HANSEN-FIRE-DEMO 267.33 SF Walls 417.06 SF Walls & Ceiling 16.64 SY Flooring 33.42 LF Ceil. Perimeter Opens into Exterior Opens into Exterior Height: 8' 149.72 SF Ceiling 149.72 SF Floor 33.42 LF Floor Perimeter Goes to Floor/Ceiling Goes to Floor/Ceiling QNTY 8/6/2010 Page: 15 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 760.360.1855 -- office Tax ID: 33-0576487 Lic # 677877 CONTINUED - Walkway DESCRIPTION 342. Clean with pressure/chemical spray Clean soffit and Walk way for sealing and or paint. NOTES Footprint Exterior Exterior QNTY 299.45 SF DESCRIPTION QNTY 359. Wood fence 5'- 6' high - cedar 16.00 LF NOTES: East Elevation L� 220.00 SF Walls 220.00 SF Long Wall 21.54 LF Ceil. Perimeter Formula Elevation 20' x 9' x 4' 20.00 LF Floor Perimeter 220.00 SF Short Wall HANSEN-FIRE-DEMO 8/6/2010 Page: 16 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 Subroom 1: Entry 209.00 SF Walls 209.00 SF Long Wall 20.62 LF Cei1. Perimeter DESCRIPTION Formula Elevation 19'x 9' x 4' 19.00 LF Floor Perimeter 209.00 SF Short Wall QNTY 80. Metal lath & stucco 267.00 SF Walls include gable ends minus doors and windows, All wall surface is listed due to the removal of stucco to replace heat damaged insulation, There is little left of the walls once demo for windows and doors are implemented. 85. Rigid foam insulation board -1" 267.00 SF NOTES: 0 DESCRIPTION South Elevation 396.00 SF Walls 396.00 SF Long Wall 44.00 LF Ceil. Perimeter Subroom 1: Back Patio 207.00 SF Walls 207.00 SF Long Wall 23.00 LF Ceil. Perimeter Formula Elevation 44'x 9' x 0" 44.00 LF Floor Perimeter 396.00 SF Short Wall Formula Elevation 23' x 9' x 0" 23.00 LF Floor Perimeter 207.00 SF Short Wall QNTY HANSEN-FIRE-DEMO 8/6/2010 Page: 17 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 CONTINUED - South Elevation DESCRIPTION QNTY 361. Metal lath & stucco 403.00 SF Walls include gable ends minus doors and windows, All wall surface is listed due to the removal of stucco to replace heat damaged insulation, There is little left of the walls once demo for windows and doors are implemented. NOTES: Roof Roof DESCRIPTION QNTY 72. Tile roofing - Concrete - "S" or flat tile 2.00 SQ 71. Tile roofing - Concrete - "S" or flat tile 16.13 SQ It is our attempt to replace only the broken tiles and re -move and reset existing salvageable tiles and weave in new tiles to match, install appropriate felt paper. If we cannot match the existing tiles then we will need to replace all tiles. 404. Truss - 4/12 slope 260.00 LF Trusses over Garage. 179. Sheathing - plywood - 1/2" CDX 900.00 SF 443. Carpenter - General Framer - per hour 20.00 HR Additional labor to cut out and remove trusses and sheeting, remove gable end and hip trusses, set up, clean top plate and prep for new trusses. Roof over Residence. 73. Truss - 4/12 slope 200.00 LF 440. Sheathing - plywood - 1/2" CDX 616.00 SF 441. Carpenter - General Framer - per hour 20.00 HR 442. Framing hurricane tie 18.00 EA 444. Tile roofing - Concrete - "S" or flat tile 20.00 SQ HANSEN-FIRE-DEMO 8/6/2010 Page: 18 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 DESCRIPTION NOTES: Grand Total Areas: 10,595.37 SF Walls 4,400.26 SF Floor 2,072.42 SF Long Wall 4,400.26 Floor Area 3,799.95 Exterior Wall Area 2,956.17 Surface Area 69.50 Total Ridge Length CONTINUED - Roof 4,454.33 SF Ceiling 488.92 SY Flooring 2,072.42 SF Short Wall 4,629.17 Total Area 447.67 Exterior Perimeter of Walls 29.56 Number of Squares 18.31 Total Hip Length 15,049.70 SF Walls and Ceiling 1,174.53 LF Floor Perimeter 1,295.95 LF Ceil. Perimeter 8,522.95 Interior Wall Area 317.94 Total Perimeter Length QNTY HANSEN-FIRE-DEMO 8/6/2010 Page: 19 LEIPaul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 760.360.1855 — office . Estimated Total: 2,956.17 2956 HANSEN-FIRE-DEMO 8/6/2010 Page:4 Tax ID: 33-0576487 Lic # 677877 Sketch Roof Annotations Roof Face Square Feet Number of Squares Slope - Rise / 12 Fl 413.69 4.14 4.00 F2 378.89 3.79 4.00 F3 706.14 7.06 4.00 F4 1,008.68 10.09 4.00 F5 269.96 2.70 4.33 F6 89.35 0.89 4.00 F7 89.46 0.89 4.00 Estimated Total: 2,956.17 2956 HANSEN-FIRE-DEMO 8/6/2010 Page:4 Paul Davis Restoration & Remodeling 77-833 Palapas Road Palm Desert, CA 92211 ® 760.360.1855 — office Tax ID: 33-0576487 Lic # 677877 Insured: ' Hansen, David Property: Eisenhower La Quinta, CA Claim Rep.: Cheri Molnar Estimator: Rod Pankratz Contractor: Company: Paul Davis Restoration Business: 77833 Palapas rd Palm Desert, CA 92211 Cellular: (760) 413-8756 Claim Number: Policy Number: Type of Loss: Date Contacted: 6/3/2010 Date of Loss: 6/3/2010 Date Received: 6/3/2010 Date Inspected: 6/10/2010 Date Entered: 6/9/2010 9:24 AM Price List: CAPP7X JIJN10 Restoration/Service/Remodel Estimate: HANSEN-FIRE-DEMO The Purpose for this scope of work is to help Identify the fire damages associated with a fire that started in the garage and extended into the attic space of the said property listed above. All interior finishing will be removed along with drywall and inulation down to the framing in order to evaluate and better assist in identifying any hidden damages and create a scope of work required for the reconstruction and restoration of the structure. Rod Pankratz Large Loss Associate Paul Davis Restoration & Remodeling. Main Level 46' 10' 10* y Remove fire damaged framing T-1 r—ftjt—a % F9,0—R— 9�lliCeom D � OJ 21aSSCLI�tdAf91� — — •�.5. ylOfttlalt� �s•e• / T �'— j Powerwash 9,0—R— Powerwash walls and concrete walkway. W2" ------------- 77, 1A6 As listed In mom by room specificAtIQnse N121 Remove all fire damaged finishinas. cabinets, M doors. windows. ofumbing, electirical fixtures. V Olt Remove fire . damaged doors lor 2. 7' - drywall and Insulation down to framing to Instie and windows and evaluate any additional fire damaae, I Ll:rl 1 J.'A 1i.Ri 11../It.rlm 7 u><1.tgi to ,;T. IT Main Level HANSEN-FIRE-DEMO 8/6/2010 Page: 1 o c C34 0 r. 0 N 0\0 Roof IF 9r, G,q 1 Roof HANSEN-FIRE-DEMO 8/6/2010 Page:3 06/10/2011 15:46 FAX 17607733702 u , ALL VALLEY AIR CONDITION [a 001 Prescriptive Certificate of Compliance: Residential C)MR,-ALT Residential Alterations Page l of 5 Project Name: Climate Zone # # of Stories Manson Mr. 115 1 General Information 51- 5 Site Address: 4449& Eisenhower La Quinta CA 92253 Enforcement Agency: La Quinta, Clty of Date: 6/10/2011 Building Typc 0 Single Family Q Multi Family Circle the Front Orientation: N,e S, W, or degrees Conditioned Floor Area (CFA): 1900 Prgjeet Type: Alterations Envelope Fenestration Roof HVAC ---^--- Replacement or Chan a OutQ Duct Replacement Water Heater NOTE. This farm is not to he used for Newly Constructed Buildings or Additions Insulatiwr Valuer For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration ❑ Opening of framed cavity alone—Alteratinns that involve the opening ofthe£named cavity ofa wall, ceiling: orfloor must install the mandatory minimum insulation value per §130 for the altered assembly. rill in Columns A -: and enter mandatory Insulation value in Column H. ❑ Replacement of entire assembly— Replacement of an entire wall, ceiling, or flonr• assembly requires the installation of Component Package- D insulation values in !able 131-C. Fill in Columns A —J. O 9 Ue Surface Details For the furred nrtioned of Mass Walls see Furring Strips Construction 'Cable below, A 8I C D E F C I R I I J Proposed bo Noto Standard Values From JA4 Tablc Framing Thickness, Framed Continuous JA4 Proposed To Assembly Nomc Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly TA or Type' and Size or Other' factor° Numbers R -value` R -Value' Cell Value' U -factory Nulr: /"ur fxrrxd assrmblirs, accurwlingfur Cuntinrruus lruvlatiun R-vulur, sr� Pagr JA4-3 urtd Egxutlon 4-1. For ealevioung furred walls use the Mass and E=Ing Construction table below. 1. For P7g/11) indicate the identlficalion name that matches the building plans. 2, Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc... indicate the Frame type and Size: For Wood, Metal, Metal Bulldingt, Mass, enter 2x4, 2z6, or etc... see JA4 for other passible frame type assemblies. 3. Enter the thickness for mass in Inches er SoncMg between framing members enter; 16 "or 24 "OC; or Other for all other assembly description .such as ConcreteSandwich Panel, Spandrel Panel, logs, ,Straw Bale Panel and etc.... 4. Based on the Climate Zone; enter the Standard U factor from Table 15 J -B, C or D for each different assembly Name or type. S. Enter the Table number that closely resembles the proposed assembly. 6. Enter the R -value that is being installed in the wall cavity or between the framing: otherwise, enter "0 7. Enter the Continuous Insulation R -value for the proposed assembly; otherwise, enter "0 ". 8. Enter the row and column of the U faclor value bused on Column F Table Number and enter the Assembly U factor In Column J 9. The Prupaxed Assembly U faclor, Column J, must he equal to or less than the Standard U faclor in Column E to comply. Furring Strips Construction Table for Mass Walls C+nl A I D I C I D E F G I H I 1 I J I K L M Proposed Properties of Masonry and Concrete Walls From Reference Joint Appendix Tabic 4.3.5.4.3.6 4.3.7 Added Interior or Exterior Insulation in Furring Space from Reference Joint Aupendix Table 4.3.13 Final Assembl�Y U -facto!""' Comment Mass Thickness' Assembly Name or T JA4 Table Number' U K d > p a c - >° o u ai Q Registration Number: .._._............_. _..__.._.._.-...W.�—_..__ Registration Date�me: 2008 Residential Compliance Forms HE'RSProvider: CBPCA Augus! 2009 06/10/2011 15:46 FAX 17607733702 ALL VALLEY AIR CONDITION [a 002 Prescriptive Certificate of Compliance: Residential CF - R -ALT Residential Alterations !t e Z of 5 Project Name: Climate Zone # # of sturics Hanson Mr. 115 fans and Furring StrIps Construellon Loot—notes) 1. Indicate the type oj'assembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Etc. Additional rise blies can befound Reference Joint Appendix JA4. . This & the U -Factor based on the thickness of the assembly In inches. 3. Ac R -value of the insulation to be added on lite interior or exterior of the assembly. 4. The Calculated R- Value is the R -value of the, flirted out welion of the assembly. 4 The Final Assembly Is calculated using Equation 4-2 or Equation 4-4gf the Reference Joint Appendix JA4, The equation is the inverse of Colum! added to Column L Column K is the inverse from column .1. 7. insert the calculated U- actor value ort W the 0 ue Su face Details in Column J FENESTRATION PROPOSED AREAS ❑ Replacing window alone — Replacement window* shall meet tire U -Factor and SHGC Value requirements of Compnnent Package D in Tahle 151-C. The Total Fenestration and West facing Area requirements are not applicable. Q Adding SOW or less of window area — Newly installed windows shall meet the U -Factor and S'11GC Value requirements of Component Package D InI'able 151-C. ❑ Adding more than 50fe of window area — Newly installed windows shall meet the U -Factor and SHGC Value and the Fenestration Area requirements of Component Package D in Table 151-C. Complete the Altered Fenestration Allowed Area Table on Page 2 ofthe CF -/It -ALT Orientation E F Fenestration Type and Frame (North, East, PropsedArca' Maximum indow, Glass Door WS light) South West) tie U-facto>z• 1 Muxirnwn SFICC2•3• ° NFRC or Default Vuluc' Allowcd Existing Fcncutrution Total Area CFA of Enda %of Fencstraliun Arca Fcncstratiun Allowed 1. Fenestration area Is the area oj'total glazed product (t e, glass plus frame). Exception: When a door is less than 50% glass, the fenestration area may be the glass area plus a "2 inch frame " around the glass. 2. Enter value from Component Package D Requirements In Table 151-C. 3. Actual fenestration products installed and as indicated In CF -6R -ENV Form shall be equivalent to or have a lower U factor and/or a loWer SHGC value than that specked on the CF -1 R ALT Form, 4_ Submit a completed WS -3R Form Ora reduced SHGC is calculated with exterior shading. 5.1fopplicable at this stage enter "NhRC"for Nh'RC Cert ed windows or are CEC. " quit" values ound in Tahle I 1 b -A or [t. ALTERED FENESTRATION ALLOWED AltEA5 Ca tete W more than 5 t' of o testration is added A B C 1 0 E F G Allowcd Existing Fcncutrution Total Area CFA of Enda %of Fencstraliun Arca Fcncstratiun Allowed Proposed Areae Dwollina CFA Arca Removed Arca Addcd A x B -D + C Total Fenesstaration Area > ZO West Fenestration Area (Required in 05 CZ's 2, 4&7 -IS 1. West Fenestration Area includes west -sloping skylights and any skylights with a pitch less than 1:12. 2. West facing glazing area removed cannot be "counted" twice. " In order to distribute the west glazing area removed to the other orientations, input the west glazing area removed in the Total Fenestration Area row, column D. 3. Include the Proposed Area of the West facingfenestration in both Area columns below. 4_ To meet compliance. the FrttposedArea must be less than orequal to the Total Allowed Area or BOTH the 'Total and West Fenestration Areas. Registration Number: _ . 1Zeglstratlon DateMme: 2008 Residential Compliance Forms HERS provider: CBPCA August 2009 06/10/2011 15:47 FAX'17607733702 ALL VALLEY AIR CONDITION 1@003 Prescriptive Certificate of Compliance: Residential CF -1 -ALT Residential Alterations Page 3 of 5 Project Name: Climate Zone ti q of Stories Hanson Mr. 115 1 ROOFING PRODUCTS (COOL ROOFS) §151(t)12 When the area of exterior roofsurface lobe rep/aced exceeds more than 50% of the existing roof area, or more than 1,000 f , whichever /s less, the new roofing area trust meet the roofing product "Cool Roof' requirements of§112(b)IM4152(b)IHII, or 152(b)l iii. Check applicable atternadve or exception below lf'the raofalteration is exemptfrom the roofing product "Cool Roof'requirements. Note: If any one of the alternatives or exception below is checked the Aged Solar Reflectance and Aermal Emlttanee requirements for roofing products in §118(1) are not applicable. Do not fill table below. [3 Cool Rwfs NQJ Rcquirrd in Climate Zones 1-12,14, and 16 with a Low Slopcd. Less or 2:12 pitch. ClCool Roofs &A Required in Climate Zones 1 through 9 and 16 with a Steep -Sloped Roofs (pitch greater than 2:12) and product unit weight less than 51b/ft Alternatives to §152(b)l Hi and §152(b)HU, Steep -slope roof (pitch > 2:12) ❑ insulation with a thermal resistance of at least 0.851rr•ff'•°F/Btu or at least a 3/4 inch airspace is added to die roof deck over an attic; or Existing ducts in the attic are insulated and sealed according to § 15l(f)10; or O In climate zones 10, 12 and 13, with 1 ii' of R= ventilation aces of attic ventilation for every 150 W of attic floor arca, and whom at least 30 percent of the f% ventilation arca is within 2 feet vertical distance of the roofridge; or ❑ Building has at least R-30 ceiling insulation; or ❑ Building has radiant barrier in the attic meeting the roquirements of § 151(f)2 or ❑ Building has no ducts in the attic; or ❑ In climate zones 10, 11. 13 and 14, R-3 or greater roof deck insulation above vatted attic. Exception to §152(b)lHiii, Low -slope roof (pitch <_ 2:12) ❑ Building has no ducts in the attic. Other Exceptions ❑ Roofing area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria - 0 Roof constructions that have thermal mass over the roof membrane with at least 25 Ib/ft' is exempt from the below Cool Roof criteria. Note: if no CRRC-1 label is available, this compliance method cannot be used, use the Pcrformanw Approach to show compliance, otlierwisc, Chests the ap2licable box below if Ex t from the RoofinP Products "Cool Roof' Re uirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product tD Number' _< 2:12 > 2:12 < 51W >_ 5lb/Ra Type2 Reflectance 3'4 Rmittance SRIs i7 Ci ❑ i3 ❑4 ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4 13 ❑ ❑ ❑ 04 1. Ike CRRC Product ID Number can be obtained from the Cool WAaUng Council Is Rated Product Directory at new-w.coolroofs.ora/eroducls/seArch Aa 2. Indicate the bps of product to being wed for thr roof fuµ i.e. single ply roof, asphalt rogf ruetal roof, etc. ff the Aged Reflectance is trot available in the Cool Roof RatlMg Council's Rated Product Directory then sot uhr Initial Ruvlectance value from the same directory and use the equation (0.2+0, 7(p1m111ol — 0.2) to obtain a calculated aged value. Where p Is the buttal Solar Reectance. . Check box If the Aged Reflectance is a calculated value using the equation above. Calculate the SRi value by using the SRi-• Worksheet at hfw. Mvwmenergy.ca.W20ide2a/amf enter the resulting value In the SRi Column above and attach atopy of the SRI- ivarksheet to the CF -JR. To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surtace and meet the dry mil thickness or coveruoe commended by the coatings manufacturer and meet minimum performaneo requirements listed in § 118(i)4. Select the applicable *outing; ❑ Aluminum-Pigmentod Asphalt Roof Coating ❑ Ccmcnt-Based hoof Coating Other Registration Number: _ Registration i)ate/Tlme. _ HERSProvider: CBPCA 2008 Residential Compliance Forms August 2009 06/10/2011 15:47 FAX 17607733702 ALL VALLEY AIR CONDITION (a 004 Prescriptive Certificate of Compliance: Residential CF -1 -ALT Residential Alterallons age 4 of 5 Project Name: Climate Zone 0 # of Stories Hanson Mr. 15 1 HVAC SYSTEMS - HEATING List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DMV heaters must be gas or propane flred, and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kitchen(v) and on all underground Minimum Duct or Piping Configuration Heating Equipment Typc and Ca city""' Efficiency AFUE or HSP Distribution Type and Location ° Insulation Thermostat (Central, Split, R -Value Type Saw Pac a or drone Fumaee, 60000 78 AFUE Ducted, SetBaek Split Energy Factor or Insulation Type' Standard, Recirculatin 2 L Indicate Heating 734e (Central Furnace, Wall F}trnace, !feat pump, Boiler, F,lecbic Resistance, etc.) 2. Electric resistance heating is allowed only in Component Package C, or except where electric heating is supplemental (i.e., (f total capacity 2 KW or 7,000 BWbr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §131(b)3 exception. 3. Refer to the HERS Verification section on Page 4 of the CF -IR ALT Form for additional requirements and check applicable boxes. 4, Indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc.) HVAC SYSTEMS - COOLING Minimum Efficiency Duct or Pipins 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements n§130(► . 77ae Prescriptive requirements do Contiggration Cooling Equipment Type and Ca aci '') (SEER/EER or COP) Distribution and Location) Insulation R -Value Thermostat Tm (Central, Split, Spam Packs c or H dronic AlrConditloner, 36000 13 SEER Ducted, Setl3ack Split 1. Indicate Cooling Type (A/C, Heat pump, livap. Cooling, etc) 2. Refer to the HERS Verf cation section on Page 4 of the CF -IR -ALT Form for additional requirements and check applicable boxes. 3. Indicate Tjqm or location Putts, lldronic in Floor, Radiators, etc, WATER HEATING List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DMV heaters must be gas or propane flred, and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kitchen(v) and on all underground hot waterApEs is required in all nom nent cka es in all climate zones. External Tank Water Heater Type/Fuel DiWbution Typc Number In Tank Energy Factor or Insulation Type' Standard, Recirculatin 2 System Capacity Thennal Efficient R -Value 1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, eta.) 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements n§130(► . 77ae Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling units. 3. The external water heattn.g tank and es shall be Insulated to meet the requirements o 1 SO . SPECIAL FEATURES 'Che enforcement agency should pay special attention to the Special Features specified in this checklist below. These items mcyreguine written just' cation and documentation and special ver' teation. NEW ROOF ASSEMBLY - Radiant .Barrier Tate radiant borricr re uimmcnl of §151 2 docs not gRI to roof alterations. Slab Edge. (Perimeter) Insulation ❑ YE9 ONO YES: in Climate Zone 16 in Component Packages D, R-7 insulation is required. Heated Slab Insulation ❑ YES ONO YES: Slab cd c insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards. Raided 8bb Insulation O YES © NO YES: In Climate Zones 1 2 11, 13, 14 & 16,,R-8 insulation is r uitrd• in Climate Zones 12 & 15 K-4 isrequired under component Package D. Thermal Mass To obtain Com liance Credit for the installation of thermal mass use We Performance Approach. Registration Number_ Registration fW077me: 2008 Residential Compliance Forms HERS provider: CBPCA August 2009 06/10/2011 15:48 FAX 17607733702 ALL VALLEY AIR CONDITION 0 005 Prescriptive Certificate of Compliance. Residential 'CF -1`4 -ALT Residential Alterations Page S of S Project Name: Climate Zone q 0 of Stories Manson Mr. 15 _ L - HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS iyeavares spee!/!ed In this checklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before fimtl inspyclion. Duct Sealing & Testing HERS verif cation is required for this measure, m YES 0 NO YEAR: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned space, the ducts are to be sealed per § 152(b)1 Dii and the newly installed ducts are to be insulated per §151(f)10. Cl EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or staled with ashestos. 0 YES Q NO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the ducts are to be sealed per §152(b)lDi. ❑ YES ❑ NO YFS: in Climate Zones 2 and 9-16, if the existing I IVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system, cooling or healing coil, or the furnace heat exchanger) the ducts are to be sealed per §I52(b)IE. 0 EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RA3. M EXCEP'T'ION: Duct systems with less than 40 Uncar feet in unconditioned space. O EXCEP'T'ION: Existing ducts stems constructed insulated or sealed with asbestos. Refrigerant Charge - Split System HERS ver cation Is required for this measure. 0 YES ❑ NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the fumae: heat ,exchanger),a refrigerant charge mcasurcmcnt shall be verified per § 152 i F. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation • uircmcnts of §150(o) do not apply to existing rusidontial homes. Ducted Split Systems -Air Conditioners and )heat Pumps: Airflow HERS verification is required for this measure. ❑ YES ❑ NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (IIVAC equipment and ducting) is re luccd, the airflow and fan watt draw shall be verified per ' 152 lCi to meet the requirements of § 151 7B. Documentation Author's Declaration Statement • I cerk that this Certificate of Compliance documentation Is accurate and complete. Name: Daniel McIntire Signature' Daniel McIntyre Company: All Valley Air Conditioning Date: 8/10/2011 Address' 81300 Avenita Alamitos Avo,Avenuo if Applicable C[ A or CEPS (Certification #): City/State/'Lip: La Quinta California 92201 Phone: 7607733628 Responsible Building Designer's Declaration Statement • l am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance, t certify that the energy features and performancc specifications for the building design identificd on this Certificate of Compliance conform to the requirements of Title 24, Part, I and 6 of the California Code of Regulations, • The building design foahtres identified on this Certificate of Compliance are consistent with die information provided to document this building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agenEZ for aperoval with this buildinA permit application. Name: Daniel McIntire Signature' Daniel McIntyre Company_ All Valley Air Conditioning Date: 6/10/2011 Address: 81300 Avenita Alamitos Ava Avenue License: 1213 City/State/Zip: La Quinta California 92201 Phone' 7607733629 For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300. Registratlon Number; Registration Data/Time: HERS Provider: CBPCA 2008 Residential Compliance Forms August 2009 06/10/2011 15:48 FAX 17607733702 ALL VALLEY AIR CONDITION [a 006 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page I of 2 Site Address: Enforcement Agency: Permit Number. 51465 Elsenhower Le Quints CA 92253 La Qulnta, City of Space Conditioning Systems Healing Equipment cuoungCy M1yn: W :5 t., t CA 6.r L%,J7 I +, r -k tih ti: V.,t 4.' a'. n:w lw.; `+<s! t F F. . Duct Equip Efficiency Location fsquip Type 1Pc ARI # of (AFUE, etc,)" (attic, crawl- attic Heating heating (package- heat um CEC Certified WE Namo and Model Number Rcfcrcncc Number 7 Identical systems I (zCF-IR value 4 space, etc.) Duct R-value(Btu/hr) Load Capacity (Btu/hr) Furnace dayMphr N8MBL0701719A1 CEC Certified Mti. Ntne:' 1 79 Wholn Hau■e 0 9000o Capacity Pump) and Model NumbiWk ~ tUit Cr g{pttje+ ' 1 vtilud tti/hr Btu/hr Alrcdndhioner clay &Ki9htCA3042VKA0 ,. 1 13 WloleHduie a ,.,. ,..'',0.` 98000 cuoungCy M1yn: W :5 t., t CA 6.r L%,J7 I +, r -k tih ti: V.,t 4.' a'. n:w lw.; `+<s! t F F. . Equip 1Pc . _ attic (package Cooling heat CEC Certified Mti. Ntne:' Tfnot'; :_3denticer:s ::( Duct„: - brill Capacity Pump) and Model NumbiWk ~ tUit Cr g{pttje+ ' 1 vtilud tti/hr Btu/hr Alrcdndhioner clay &Ki9htCA3042VKA0 ,. 1 13 WloleHduie a ,.,. ,..'',0.` 98000 1. Ifvrolect is new construction. see Footnotes to Standards Table 151-B and Table 151-C for duct ceiline alternative compliance. 2. AR1 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 -1 R form. 4. When CF -JR is reference it is also applicable to the CF -1 R, CF- IR -AA or CF -11? -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM 0 § 110-§ 113: HVAC equipment is certified by the California Energy Commission, ID §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or RCCA. m §150(1): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 0 § 1500)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 entirety in conditioned space. 2008 Residential Compliance Forms August 2009 06/10/2011 15:48 FAX 17607733702 ALL VALLEY AIR CONDITION 1@007 INSTALLATION CERTIFICATE Cf4k-MEC11-04 Space Conditioning S stems Ducts and Fans (Page 2 of 2 Site Address: Enforcement Agency: Permit Number: 51465 Bsenhower Le Quints CA 82253 La Quinta, City of Ducts and Fans §I50(m): Duct and Fans 21 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, U[. 181 A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and 0 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. ❑ 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. .✓n. 7. Exhaust fan systems have back draft or automatic dampers. 21 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operate s'., p�.s s :u e a.�� © 9. Proteet op;of,lnisulatioll:ln$ula qn shall b protect d.from damage including that due to sunlight, moisture, equipment,main ► i ecp a;►d tivlaids Ce y u�*ig�, J t?eF;otA i.4 ypfi j4i't ,0 lit oating that is water re*ftflind p' I d"es sl ieldjng from solar radiation that can cause degradation of the material. ✓❑ I 0 -TWiible ducts ca,11101 av :Pgrous',inaer carts.: 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. • 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person re�punttible for cunstructiurn (resporisiblc person). • 1 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. • 1 reviewed a copy of the Certificate of Compliance (CF -IR) form approved by the enforcement agency that identifies the specific requirements for the installation. I eertilj that tine requirements detailed on the CF- IR 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. 1 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 Qenerul Contractor or Builder/Owner) All Valley Air Conditioning Responsible Pmon's Name: Responsible Person's Signature: Danlal McIntire Danial McIntire CSLB License: Date Signed: Position With Company (Title): 941213 16/10/2011 owner 2008 Residential Compliance Forms August 2009 06/10/2011 15:49 FAX 17607733702 ALL VALLEY AIR CONDITION [a 008 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4W' CH -21 Duct Leakage Test — Existing Duct System (Page 1 of 2 Site Address: Enforcement Agency: Permit Number: 51465 Elsenhower La Quinta CA 92253 la Qulnta, City of Enter the Duct System Name or ldentificationfFag: 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 fur alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: 1%or 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. " hurt i.aakaap nisannetle Tpcf Rirktina duct wate-m Select one compliance method f om the following four choices. G3 Option 1. Measured leakage less than 15%ofFun Airflow. ❑ Option 2�+ �@ Ga B A id lff Ab -fl, 13Option 3. Radiate t'igtftge.¢y 6ff°J!o on l,�{vr an �,vy.,. 6J�1u'g7C[Q�t call ►e eakq;�' •.r`?j';, '[>': '4.d' �,u� `.rr-':�y. e, r. ;n:;,.%f{' YI 6„rw,'%.,a• 3. laJ' 4i T•�Drr u...9 J' ti.. x�i K ❑ Option 4"TN"."'sll accessible desk rnolcC.tcbt,.and 1-IERS..rater m t Note: OptlAr rl'?nust be attclnpt�scl;b3'o 1iil : 'tleii'4 Determine no '91ba ",Raeiti li?11aw-, ow. ¢ne of;tlf fQlI Wing three:chtfion methods. M Cooling system method: Sizc`U!0" Lien @ ` prix ? 11:400:0.00 c F. ❑ Heating system method: 21.Tiz 'Heiifipg Output ❑ Measured system airflow using RA3.3 airflow tss .,...cedures: CFM;;`;?:. -- ; Option t used then: Allowed leakage = Fan Airflow 1400,00 x 0.15 = 210.00 CFM I Actual leakage = 130.00 CI"M Pass if Actual leakage Is less than Allowed leakaSte 0 Pass ❑ Fail Option 2 used then: Allowed leakage = Fan Airflow x 0.10 _ CFM 2 Actual leakage to outside = CFM Pass if Actual leakage to outside is less than Allowed leakage ❑ Pass ❑ Fail Option 3 used then: Initial leakage prior to start of work= CFM Final leakage after sealing all accessible leaks using smoke tests Cl, -,M 3 Initial leakage - Final leakage Leakage reduction CFM (Leakage reduction I Initial leakage ) x 100% = % Reduction Pass It ala Reduction >60% ❑ Pass ❑ Dai l Optiun 4 used then: All accessible leaks repaired using smoke tesL. HERS rati,-r must verify (No sampling). 4 Pass if all accessible leaks have been sealed using Smoke Test ❑ Pass ❑ Fail Registration Number: 31140005562A•M2104.227A•M21A Registration Date/l'ilne: 06/10/201114!21!38 HF,RS Provider: 011KA 2008 Residential Compliance Forms August 2009 06/10/2011 15:49 FAX 17607733702 ALL VALLEY AIR CONDITION 0 009 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF4R-MECH-21 Duct Leakage Test — Existing Duct S stem (Page 2 of 2 Site Address: Enforcement Agency:Permit Number: 51465 Eisenhower La Quinta CA 92253 La Qulnta, City of ' 0 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped ott'during duct leakage test g. III a ducts that utili� c��,ntroll�d motorized dampers, t o en only when OA ventilation is required to mecl ASH IAB >!i. 2 Z, a'�c� ¢I6sei�vflcl�t A$ f{s,�t�l�t EAS n r� 4 tiaIaRzac closed position during duct leaktEsgeting... :. El All supply".",> ?CJ$!#ter:l> *,ind§j�b lryd Q "ifs&k�"*&�% > C�'dic��E I iappliesto r.. k.. duct leakage�oi)i�>liance d)Sifon 3 (l --okige reduction by 60%) and option 4 fix all accessible leaks) described above. G3 New duct<itibWlations cannot.4111i $'oildin %rnVitie9,a '111i3tiiiili5, s in lieu of ducts. Mastic antl,��ltay!�§ands=(iiu,4t ttitaeii in coryiittionwith clothbo trubber'iifiesive,dyoC toseal leaks at all new duct DECLARATION STATEMENT • I certify under penalty of perjury,'er the liiws i f tirti:9tiifo of t prq Wd oti ihi9jtoIDTas true and correct. • I am the certified HERS rater who performed the vedfiCAiion services idantiticd and mportc#,kri piis ccrti"tp.°,(iosponsible rater). • The inb'talled feuture, material, component, or manufactured device requiring HERS vctificatitAl t>ii i t7cntffied 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. • The inrormation reported on applicable sections of the Installation Certificates) (CF -611), signed and submitted by the person(s) n;ppcmaiblc for the installation conforms to the requirements specified on the Ccrificatoc(s) of Compliance (CF -1 R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate CF -6R Company Name: (installing Subcontractor or Ceneral Contractor or Ruildcr/Owner) All Valley Air Conditioning Responsible Person's Name: CSLB License: Danial McIntire 1941213 HERS Provider Data R 1st Information Sample Group # (if applicable): 0 tested/verified dwelling 0 not-tested/vcrified'dwelling in a WMS sample group HERS Rater Information HERS Rater Company Name: MLC Home Performance Responsible Rater's Name Responsible Rator's Signature John D Henry John Henry Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 1095756 6/10/2011 Registration Number: 311-A0005952AW2104227AW21A Registration nataMme: 06/10/2011 14:21:38 I4F,RS Provider: CSPCA 2008 Residential Compliance Forms August 2009 06/10/2011 15:50 FAX 17607733702 ALL VALLEY AIR CONDITION 0 010 INSTALLATION CERTIFICATE CF-6R-M.I;C1i-21-11ERS Duct Leakage Test — g_*#ng Duct System (Palte 1 of 2 Site Address: I Enforcement Agency: Permit Numbcr: 51465 Eisenhower La Quinta CA 92253 La Qutnta, City of Enter the Duct System Name or Identification/Tag: 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 certocale is required for compltance for alterations and additions in existing dwellings to space conditioning.systems and duel systems. Note: For existing d►vellings, 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 nety or replacement duct system installed in an existing dwelling use the Installation Certificate titled "Duct Leakage Test — Completely New or Replacement Duct System. " nnrt t patraao MannAcNe Toot , F.xictino name* Rwtnm Select one compliance method from the following four choices. El Option L Measured leakage less than 15%orFan Airflow. D Option 2w** 1 o , A"* ❑Option 3. W,gCe 1gebY GQti::@r tt°auooltett� cal # tbl • ; :, .. 1 '.° s ti, x mai 0Option4 ; ? 11 accessible' letik .using,smoke test,;and HERS.rater nK: Note: (Opti Qil must be . .... Qptiori< )` �F Determine norm►l p^Ali+flbw;:idsin &ne of -J. QbjlbWittg three>. ; ion methods. x " El Cooling system method: Sizc;q iilttle . se ' 'orAs: 9 X 4U p 1=Ivt g system method: ❑ Hcatin 21.7 'x ' < : i9eatiti :iDu ill: ; a ..Cap t _.:' `ti?'i.ls: 0 Measured system airflow using RA3.3 airflow test..proeedures: CFM:;; :::`.... . Option 1 used then: Allowed leakage = Fan Airflow 1400 x 0.15 = 2i0 1 ,CFM Actual leakage - 130 CFM Pass If Actual leakage is less than Allowed leakage p Pass Fail Option 2 used then: Allowed leakage= Fan A irflow x 0.10 CFM 2 Actual leakage to outside = CFM Pass'if Actual lealkaste to outside Is less than Allowed leakage ❑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 ).x 100% = % Reduction Pass it % Reduction ? 60% ©Pass ❑Fail Option 4 used then: All accessible leaks repaired using smoke test HERS rater must verify (No sampling). 4 Pass if all accessible leaks have been sealed using Smoke Test I ❑ Pass []Fail RegistrQtion Number.- 311-A0006852A_M2104227A.0000 Re$/ytrafivn Date/Time: 06110/201114:2020 HERS Provider: CaF-CA 2008 Residential Compliance Fornts August 2009 06/10/2011 15:50 FAX 17607733702 1 ALL TALLEY AIR CONDITION [a 011 INSTALLATION CERTIFICATE CIF-M-MECA-2I-ETERS Duct Leakage Test — Existing Duct System (Page 2 of 2 Site Address: Enforcement Agency: permit Number: 51465 Eisenhower La Quinta CA 92253 La Quinta, City of © Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be scalcd/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. PP �'gg r�t�r s� V s o f I' is fiance --applies to duct eak1. V 12 e t ort l ca cfi h 0°/a nd pNon 4 f all e sj gescribed above. D New duct,iiltl; ;toit:i�i3nnot<ti#r bldr4eiiii�s tlOrlatf i6i14ih6ditS' Mastic aisi;{aw bands must bac e duct tape to seal leaks at all new duct eottne�EiGi�s DECLARATION !di ` CN7 A1% I certify under penalty ofperjury;;.4tli:file„�avpl;Af2y:St�tC:of.Cafif0Yided'on this;oYp�i1; true and correct. • I ani eligible under Division 3 of eBlislq $' pi(lprotegglM9_ "Ode torepresentative of Ute person rtispunsble for coeglnwllQp:(ceg}xrnyi�le persu. I certify that the installed features, materials, cornponeiits;tif.manuthetured devices identified'oiliiia-<i¢ent;(jlie installation) conforms to all applicable codes and regulations, and tlie'-iristallation is conlsistcnt with the plena d d 6t e$ificAt em's•approved by the enforcement agency. • 1 understand that a HERS rater will check the installation to verify wmpliunw, and (but that if such checking identifies dcfmts, I am required to lake corrective action at my expense. I undcrsland that Energy Commission and HERS provider rcprascntativcs will also perform quality assurance checking of installations, including Ihosc approved as part of a sample group but not chcckcd 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. • 1 reviewed a copy of the Certificate of Compliance (CF -IR) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -IR that apply to the installation have been mel. • 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) All Valley Air Conditioning Responsible Person's Name: Responsible Person's Signature: Danial McIntire Dania[ McIntire CSLB License: Date Signed. Position With Company (Title): 941213 16/1012011 Is this installation monitored by a Third Party Quality Control Name of TPQCP (if applicable): Program (TPQCP)? OYes MNo Regir"tionNumber: 311-A0005852A-M2104227A-0000Registration Date/I'Ime: 06/10/201114;20:20 HERSProvider: 08PCA 2008 Residential Compliance Forms Au'pat 2009 06/10/2011 15:51 FAX 17607733702 ALL VALLEY AIR CONDITION 121 012 Note: If installatiun of a Charge Indicator Display (GID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH--24 Cert f cafe (instead of this MGCI1:25 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 (STNS) Procedures for installing TMAH are specified in Reference Residential Appendix R43.2_ /f refrigerant charge verlJication is required far compliance, TMAH are also required for compliance. STMS are only required for completely new nr replacement space -conditioning systems that utilize prescriptive compliance method TMAH - Access Holes in Supply and Return plenums of Air Handier STMS - Sensor on the Condenser Coil System Name or Identificationfl'ag System 1 The sensor is factory installed, or field installed according to manufacturer's 6 [:]Yes ❑No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 OY'es ❑No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 C1Ycs []No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Fnter 0 N/A ✓ UPass I ✓ ❑ Fail N/A if STMS are not applicable. Otherwise enter pass or Fail Regisuatien Nwnber: 311-A0006GVA-M2W4228A40no Registration natelTime: 08/1ot2o11 14'12:4B HERSProvider: CBPCA 2008 Residential Compliance Forms August 2009 06/10/2011 15:51 FAX 17607733702 ALL VALLEY AIR CONDITION IN 121013 INSTALLATION CERTIFICATE CF-6R-MECH-2 -HERS Refrigerant Cha a Verification - Standard Measurement Procedure Map 2 of S Site Address: Enforcement Agency: Permit Number: 51465 Eisenhower Le Qulnto CA 92253 La Quints, City of 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 R43.2. As many as 4 systems in tire dwelling can be documented for compliance wring this form. Attach an addltlonal forms) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's speeffications before .rtarting thlp procedure. • The system must meet minimum airflow requirements as pnerequislie for a valid refrigerant charge test. • If utt/door air dry-bulb Is 55 °For below, the installer must use the Alternate Charge Measurement Procedure. Rnaca ("nndiflonine-ivstem¢ System Name or Identification/Tag System 1 (must be re -calibrated monthly) Datc of ThermoisQ,q'„(e::G bi`atio(i',;;,^`'' pN 6/1/26 '4.11 .o- System Location or Area Served Whole House Outdoor Unit Serial 1/ L893691105 Outdoor Unit Make Day & Night Outdoor Unit Model CA3042VKAO Nominal C!nf, $tu/hr 73.00 .911aci tem erature TMM, ) fi2.00 Date of Vcrification 6/9/011 Tevaorator, set) 75.00 . - = h..Y H + x Y- 1 9.Y. 'Qd P.. 4.n L H' h •:Jr +�. �t,.F t..J N 6v6 h.. 7. �1w� 0 11 Callbratinerria�letmnstic Dace of Rcti3gerint Gaugo.Calibt'Atipnr;°°= 6/1120'11;., (must be re -calibrated monthly) Datc of ThermoisQ,q'„(e::G bi`atio(i',;;,^`'' pN 6/1/26 '4.11 .o- mliiit.a':re �ii�ibrated month[ Y) ll ! IZ � ' i'. rt Mh;a�S.•r�'�,�i')yaiirt:T System Name or Identification/Tag System.:1 Supply (evaporator leaving) air dry-bulb 522.0.0 0 temperature (Tsupply, db) Return (evaporator entering) air dry-bulb to erature T , 73.00 Return (cvaporator entering) air wet -bulb tem erature TMM, ) fi2.00 Evaporator saturation temperature Tevaorator, set) 75.00 Condensor saturation temperature 60.00 (T d n n u Suction line temperature (Tsuction) 88.00 Liquid Line Temperature (Tligsid) 49.00 Condenser (entering) air dry-bulb temperature T 72.00 Registration Number: 311-A000tia52A-M200422BA-0000 Registration UateMme: 05/10/201114:12:48 HERS Provider: CBPCA 2008 Residential Compliance Forms August 2009 06/10/2011 15:52 FAX 17607733702 ALL VALLEY AIR CONDITION 11014 INSTALLATION CERTIFICATE CF-6R-MECH-25,-HERS Refrigerant CharXe Verification - Standard Measurement Procedure (Page 3 of S Site Address: Enforcement Agency:Permit Number: 51485 Elsanhower La Qulnta CA 82253 La Qulnta, City of Wmla asm &1&41nw Damdramant 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 uz 21.00 Treturn, db - Tsupply. db Target Temperature, Split from Table 18.20 RA3.2-3 using Tteturu, wb and Treturn, db 'Calculate difference: Actual Temperature 2.80 Split – Target Temperature Split = Passes if difference is between -3°F and Pass +3°F or, u sre�� lit'" tr'�c 1 0°� er a & 1'a 1 q b' °� ci II I f, k `j 7 -3°F and Note: Tem er`C : lit> ethocl' - tilC ilatiefl lip ti J acts li a'Ctii)l ~! isgv i ed�rSi one of the airflow meaSYl OW', ni prviceAlut is jte C( i1 ia:RgferVngt Resickniial Appe j. if actual cooling coil airflow is measured t%valae must be equirement in the table below. Calculated Miniii", • tq�Y il' V;j it cement' Nomiriill:G Capacity tqn ,:-3QQ:, cfin/ton •aci. ,tM)-�` g P ty ( �t..:: ) System Name or Tderttification/ a'g ;' ; 06/10/2011 15:52 FAX 17607733702 ALL VALLEY AIR CONDITION Z015 INSTALLATION CERTIFICATE CF -6R -ME it It -2 -HERS Refrigerant Chame Verification - Standard Measurement Procedure Pa e 4 of Site Address: Enforcement Agency: Fcrmit Number: 51465 Eisenhower La Quints CA 92253 La Quints, City of 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 Calculate: Actual Subcooling ;- 1 C GE T – Tev 11.00 Tm - T i uid - Target Subcooling specified by 10.00 manufacturer Calculate difference: 1.00 Actual Subcooling -Tar et Subcooling= System passes if difference is between Pegs -3°F and +3°F Enter pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: ;- 1 C GE T – Tev Enter allowab id".R. - manufactureC'' ficaiitiris`(iir i18B;xiiu o 5' between 4° .',-.j �l;25-F if man s ecificatio,._, availab�p System passes, -k'tijalsu i�atasvvini the allowable su'06llit age Enter 1?as''oit;l�iitl:: Registration Number: 311-A00058S2 "425D4226A-W00 Registration Date/rime: 06/10/20111412:48 11RR.S Provider: CBPCA 2008 Residential Compliance Forms August 2009 06/10/2011 15:53 FAX 17607733702 ALL VALLEY AIR CONDITION 0 016 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure age S of 5 Site Address: Enforcement Agency:Permit Number: 31465 Eisenhower La Qulnta CA 92263 La Qulnta, City of 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(rag System 1 System meets all refrigerant charge and Pass airflow r ulrements. Enter Pass or Fail U Ci .',' TZM>mNT DECLARATI01M ' • I certify, under penalty of perjuryryp lrr>tktc:luy�4;:Q ,ilie:9ti to of.(;aiiftni' frnm lead on this:Pomi: a tn,e and cvrn ck • 1 am eligible under Division 3 of tbetaiiieiT_':@ititkt�iofe�.9ions`ode;o for stttiicho�b ar mu authorized representative of the person rosponske'for c6mgtruetiolii{iosponsible person). • 1 certify that the installed features, materials, compone i%i brmanufactured devices identifiedoi#?tF►i9::CeeH ii te.(flie installation) conforms to all applicable codes and regulations, and ilie"iiistallation is consistent with the plan slia'8p'ecificaition..approved by the enforcement agency. • I understand that u HERS rater will check the installation to verify compliance, turd that that if such checking identifies defects, l am required tv take cotrcctivo action at my expense. I understand that Energy Commissiun 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 aedon and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • 1 reviewed a copy of the Certificate of Compliance (CF -111) form approvod by the enforcement ageney 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 it 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 euroreeme6t 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, f will ensure that all Installation Certifleatcs will oome from a HERS provider Batu rcgisby 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) All Valley Air Conditioning Responsible Person's Name: Responsible Person's Signature: Danial McIntire Denial Mclntlre CSLB License: Date Signed: Position.With Company (Title): 941213 16/10120111 owner Is this installation monitored by a Third PartQualityControl Name of TPQCP (if applicable): Program (TPQCP)? ]Yes E]No Registration Number: '"-A a0a *2A-MZW2Z6A-0000 Registration Date/time: 06/10/2011 14:12:40 HERS Provider: CBPCA 2008 Residential Compliance Forms August 2009 06/10/2011 15:53 FAX 17607733702 ALL VALLEY AIR CONDITION [a 017 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure One 1 of Site Address: Enforcement Agency: Permit Number: 51465 Eisannowar La Qulnta CA 92253 La Quinta, City of Note: If installation of a Charge Indicator Display (CIA) is utilized as an alternative to refrigerant charge .verification for compliance, a MECI-1--24 Certificate (instead of this MECH-23 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STNS 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 on additional forms) for any additional systems in the dwelling as applicable. Temperature Measurement Access holes (TMAH) and Saturation Temperature Measurement Sensors (S'I'NS) Procedures for installing TMAH are specified in Reference Residential Appendix R43.2. if refrigerant charge verification is requtredfor compliance, TM411 are also required for compliance. STNS are only requlredfor completely new or replacement space -conditioning .systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handier System Name or Identification/Tog System 1 System Location or Area Served Whole House 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and 1 D s ❑No a � ►gVc L 2 OYes� C]No < h5/1 'inch ( mm do access: ole "nest M 8f a v &fh the supply plenum ;end sli Iia, i F nyect' Yes to 1 and;2??i9zjiass. Enter Pass or rail ✓ Pass ✓ D Fail CTMC . Reriaiti�einn f6e F.vnnnrntAYwC'iSll�`:�;>°,�,•�!e;'C"r>.: System Nameb Idantlflc'606' fig .; Sf The sensor is factory installed, or field installed according to manufacturer's 6 OYes ��.':Fe•':sen->�isfii�t6 stalltid :.or instal '"-,", �;, se •, i`y^ip ;.. " ftiimg to m urn's 3 OYes 1 No .sp patiotla' i,.asiristalled;,tryi ons }gyp t ed;bY eExecutive Director. l7irectoY•``�' _ The sensor wire is terminated with a standard mini plug suitable for connection to a 7 OYcs The sensor wire:is-lettrtinatcd with a standard mini �.SU table:: Connection to a 4 OYes ONo digital thermometer: 7'he sensor mini plug is acccssibl'e trftliC in telling technician and the I IERS rater without changing the airflow through the cundcnser coil 8 OYes the HERS rater without changing the airflow through the condenser coil 5 Dyes i3No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3, 4, and 5 is a pass. Enter N/A ✓ 4 Nass ✓ O Fail N/A if STMS arc not applicable. Otherwise enter Pass or Fail STNS - Sensor an the Condenser Call System Name or Identification fag system t The sensor is factory installed, or field installed according to manufacturer's 6 OYes ONo specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 OYcs ONo digital thermometer. The sensor mini plug is aeeessiblc to the installing technician and the I IERS rater without changing the airflow through the cundcnser coil 8 OYes I ONo The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not applicable. Otherwise enter Pass or Fail ®N/A ✓ O Pass ✓ O 1 ai l Registration Number: 311-Ao005852A-M2 2NA M25A _ Registration Date/Tirne: 06/10/201114:18:51 HERS Provider: eBPCA 2008 Residential Compliance Forms August 2009 06/10/2011 15:54 FAX 17607733702 ALL VALLEY AIR CONDITION CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4k-mEcH-25 Refrigerant CharLe Verification - Standard Measurement Procedure (page 2 of Site Address: )Enforcement Agency- Permit Number: 51465 Elsorkhmer La Q%ilnta CA 92253 La Quints, City of I Standard Charge Measurement Procedure (for use if outdoor air dry-bulb Is above 55 OF) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure am available in Reference Residential Appendix RA3.2, A.y many as 4 systems in the dwelling can be documented far compliance using this form. Attach an additional form(s)for any additional systems in the dwelling as, applicable, 0 The system should be installed and charged in accordance with the manufacturer's specifications before starting ibis procedure. 0 The system must meet minimum airflow requirements as prerequisite, ar a valid refterani charge test. 0 tfoutdoor air dry-bulb is 55 *For below, the installer must use the Alternate Charge Measurement Procedure. Rnare Conditionino Civ.dem-t System Name or Idcntification/Tag System I re -calibrated (must be -calibrated monthly) Date of'ner1�, 13' fi"(1ti 0 AM& 6 1 System Location or Area Served Whole House Outdoor Unit Serial # L893891105 Outdoor Unit Make Day & Night Outdoor Unit Model CA3042VKAO Nominal Coi'pg Ctpnfty Btu/hr3600P'00 . .11 .. ., A 1. ..", . .. 3"," ge 14A 1 Date of verificatto n 62.00 41, ill L V q.A 'i , -Z Vy R N'> Y."% 16,J %'h & (U L I T-4 E I Gwnn.qtk�:-T&Q'irm . i . mob& rfilibratif'n-Af-M Date of Itefnigiiiit Gaup. C a System re -calibrated (must be -calibrated monthly) Date of'ner1�, 13' fi"(1ti 0 AM& 6 1 ..-"Rrate d monthly) R" System Name or identification/Tag System Supply (evaporator leaving) air dry-bulb temperHture (T supply, db) 62.00 Return (evaporator entering) air dry-bulb tem (Treturn, dh) 73.00 Return (evaporator entering) air wet -bulb temperature (Tisairm wb) 62.00 Evaporator saturation temperature (Tevaorator.sot) 75.00 Condensor saturation temperature (T R2 adsixwu 0 60.00 Suction line temperature (Tsu&ion) 88.00 Liquid Line Temperature (I'liquid) 49.00 Condenser (entering) air dry-bulb tLMperatUre (Teonde"Sr ,r, db) 72.00 Registration Number, 31 I-A0005852A-M28D422dA4A2dA Registration Date/Time: 06/10/2011 14:16:51 JJEASprovider: COMA 2008 Residential CampfianWForms___ Augrtsl 2009 06/10/2011 15:54 FAX 17607733702 ALL VALLEY AIR CONDITION 16019 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4R MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of Site Address: Enforcement Agency: Permit Number: 51465 Eisenhower La Quints CA 92253 La Quints, City of Minimum Airflow Renuirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Change Verification, The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 Calculate: Actual Temperature Split = Trctum, db - T30ply, db ' 29.00 Target Temperature Split from 'rable T RA3.2-3 using return wb and Tretum, db 18'20 Calculate difference: Actual Temperature 2,80 Split — Target Temperature Split = Passes if difference is between -4°F and +4°F or upon remeasumment, if between Pass -411-'and -I(V5Ryr12mnFa#3j S g 4 r� 4 !=. t Nota' Tem eratu !!t' ethod;"dltulato"IJ t, c ss poli Col! tr Ve e1i une ofthe P ?.tW:..>. 14R meastti'elite-plah�espie,i"l�eee�ll��entia`lliperd9J �1iictiidl�dling airflow cwvrlr�ln►v is measured, tht ;yaltle must ..,than the,Ca1Culated Mln/ oW Requirement in the table below. " ~iiftRMentiE *ton Calculated M >buum A1>c�jo;Yz ®NomiuQl Co. a X 300 cfm/ton c ,.,,.i:::.::.:. ( ) ( ) Vii: GR n:- System Name or ldentification/T .:::r::i;:`J-:. "''fsfa r '::.•.:..;•. a' „ r Calculated Minimum Airflow Reyuircment (CFM) .5 Measured Airflow using RA3.3 procedures (CFM) Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement.. Enter Paas or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag 8yatam 1 Calculate: Actual Superheat = Tsyrogn—T 13.00 Target Superheat from 'fable RA3.2-2 using T and T co denser db 10.00 Calculate difference: 3.00 Actual Superheat — Target Superheat = System passes if difference is between -6°F and •+6°F ' Enter Pass or Fail Faso Reglsiradon Number: 311-^00e5s52A-M250422BA-M2dA Registration Date/77me.• 06/10/2011 14:18:61 HERSProvider; CBPCA 2008 Residential Compliance Forms August 2009 06/10/2011 15:54 FAX 17607733702 ALL VALLEY AIR CONDITION 020 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4R MECH-1 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of Site Address: (Enforcement Agency: Permit Number. 51465 Eisenhower La Quinte CA 92253 La Quints, City of Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is rcquirgd to be used for thermostatic expansion vulve (TXV) and electronic expansion valve (EXV) systems. y t 1 ry iz Calculate: Aaual:Su#lerheat System Name or Identification/Tag System 1 . �^ �' v,?' ,F'"�k �� :.�' i,.t' �s !• k;, a„ ` ti., � '3 Enter allowabljagilperheat'rattge frpai;: Calculate: Actual Subcooling = manuf'acturei. Iications (or between 3°>;iis4i;26°r i u@ i -baa uv—&-- sat — Ti . .—TecifizationS o ..aailablD' System passesii—I-[iperheat Target Subcooling specified by the allowable superheat range manufacturer ' Calculate difference: Actual Subcooling -- Target Subcooling = System passes if difference is between -4°F and +401' linter Pass or Fall Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and eleetrunic expansion valve (EXV) systems. System Nall'02t ak '. y t 1 ry iz Calculate: Aaual:Su#lerheat TsKton B `8 � _ bL �.. ,F . �^ �' v,?' ,F'"�k �� :.�' i,.t' �s !• k;, a„ ` ti., � '3 Enter allowabljagilperheat'rattge frpai;: manuf'acturei. Iications (or between 3°>;iis4i;26°r i u@ i -baa .—TecifizationS o ..aailablD' System passesii—I-[iperheat the allowable superheat range Enter Pwsi or aif'` ' e Registration Number: 3'1-A0005es2an20042zm-M25A RegfstrationDateTime: 06/10/201114:19;51 HE'RSProvider: ce>'cn 2008 Residential Compliance Forms August 2009 06/10/2011 15:55 FAX 17607733702 ALL VALLEY AIR CONDITION 0 021 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refri erant Charge Verification - Standard Measurement Procedure (page 5 of Site AddreA9; Enforcement Agency: Permit Number: 51465 Eisenhower La Quints CA 92263 La Qulnta, City of Standard Charge Measurement Sumrnary: System shall pass both rethgerant 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 941213 HERS Provider Data RexisyZ Information Sample !hoop # (if applicable), System meets all refrigerant charge and Pass in a VERS sample group airflow requirements. Enter Pass or Fail BERS Rater Company Name: MLC Home Performance Responsible Rata's Numc Responsible Ruler's Signabire k.tPaa9to rr—iu?„� ...:....... •.:....: .: e.. DECLARATION STATEMENT w • I certify under penalty of perjury;.;ustdd#:.tt{elayvi;pXtli�,o 3tate OfC81if0ii r, ori!dfi3 1 we er�d co :.y.. ry dQd,, tomd1 correct, • I am the certified HERS rater who performv the verifi"dation services identified and reported bio tw8; oeriitilsisfe (te�punsible rater). The installed feature, material, component, or manufacfutedAevice requiring FIF.RS vcrifica6*6jW&is 9enti&al this ccrtificato (the installation) complies with the applicable requirements in Reference Residential Appendices' and RA3 and the requirements specified on the Certificate(s) ol'Compliance (CF -1R) approved by the local enforcement agency. 'fee information reported on applieablo sections of the Installation Certificatc(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the CattiScate(s) of Compliance (CF- I R) approved by the enforcement agency. Ituilder or Installer information as showu on the Installatlon Certificate CF -6R Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) All Valley Alr Conditioning Responsible Person's Name: CKS License: Daniel McIntire 941213 HERS Provider Data RexisyZ Information Sample !hoop # (if applicable), 0 testcd/vcrifi A dwelling—70 not-tested/vcrified dwelling in a VERS sample group HEALS Rater Information BERS Rater Company Name: MLC Home Performance Responsible Rata's Numc Responsible Ruler's Signabire John D Henry John Henry . Responsible Ratces Certification Number w/ this HERS Provider: Datc Signed: 1095756 .6/10/2011 Registration Number: 3cc-AOW5852”-M250°zzea-M26A Registration DatelTime: 06/10/2011 14,18:61 REIdprcvider: ceacA 2008 Residential Compliance Farntc August 2009