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08-1288 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 'Application Number: „ 08-00001288 Property Address: 78805 LIMA APN: 772-080-009- - Application description: MECHANICAL r Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 18000 Applicant: L2&_ -cam Architect or Engineer: k'✓orV BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: C20 J_jce nse No.: 374937 \' Date: 2 0 e Contractor:' OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 1, 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. , BAP.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: TYTEL BUD 78805 LIMA LA QUINTA, CA 92253 ( Contractor: PALM DESERT AIR COND CO INC 42081 BEACON HILL PALM DESERT, CA 92211 (760)346-0677 Lic. No.: 374937 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 N Date: 7/30/08 II � JUL 3 206 CIT( OF LA QUINTA . -C nCDT. 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 STATE FUND Policy Number 238-0004656-07 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 to thew rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith co with those provisions. , Date: ?"3 c Applicant: Z� c� / WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made.to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and cdu ty ordinances and state laws relating to building construction, and hereby tlfhorize representatives of this cyoun7y mer upon the above-mentioned property for inspection purposes Date: ( / o Signature (Applicant or Agent):` Application Number . . . . . 08-00001288 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/26/09 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 ---------------------------------------------------------------------------- Special Notes.and Comments REPLACE (2)5 TON EXISTING SYSTEMS 15.00 SEER (ATTIC & GROUND) Fee summary Charged ----------------- Paid. Credited Due -------------------- Permit Fee Total 33.00 -------------------- .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Grand Total 41.25 .00 .00 41.25 c LQPERMIT zlo Certificate of Compliance Prescriptive Me -HVAC-only Alteration CF -1R -ALT t Pr oj Title: Date: � f7 C/ (/ © CaICERTS 2005 Enforcement Agency se Only Pro)ect Ad ress: — Climate Zone: /L5 Building Permit # Doc, enation uthor: Telephone* �D� 7; Plan Check Date Co ny ame: ��11� Q C' 1.ee , Field check Date IMPORTANT: This CF -1 R -ALT form is only for use when an HVA9-only alteration is made to an existing home Use one form for each system being altered. This is system # I of v� systems altered in this house. Check all lines that anoly. Check only lines that apply. Scope of Alterations: 1 ❑ An Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. 2 Z> A Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. 3(� An outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 4121 A cooling or heating coil is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 5 ❑ More than 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined. ❑ Check here if the entim duct system is also to be new or replaced. Continue to next line. 6 ❑ If none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked. 7 ❑ Thiss stem is in Climate Zone 1, 3, 4, 5, 6 7, or 8. No duct sealing is required. Go to Section 2. 8 O Thiss stem has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. No duct sealing is required. Attach previous CF4R form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Not If the entire ducts stem is to be new or replaced, Lines 11-14 do not apply. 11 ❑ In Climate Zones 2 12 and 16: An 0.92 AFUE furnace will be installed in lieu of duct sealing and TXV if applicable) . 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 AM EER 12 condenser will be installed with TXV(RCA) AND added duct insulation R4 wrap on existing ducts, R-8 new ducts in lieu of duct sealing. Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER 14 AMU EER 12 condenser will be installed with TXV(RCA) AND a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2. 14 ❑ In Climate Zones 2, 9, 11, 12, 14 or 16: An SEER 14 AdQ EER 12 condenser will be Installed with TXV(RCA) ND an 0.82 AFUE fu mace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 15 $ JNone of lines 7-14 above are checked. Duct Sealing Is Required. Continue. Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ Thes stem being altered is a package unit. No TXV RCA is required. Go to Section 3. 17 ❑ This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 ❑ Thiss stem is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3. 19 ❑ Thiss stem is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required. Go to Section 3. 20 ❑ Thiss stem is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) Is required. Go to Section 3. 21 his system is in Climate Zone 2 or 8-15 and line 11, 16 or 17 is not checked. TXV(RCA) Is required. Go to Section 3. Section 3 - HERS Rater verification 22P If line 15 is checked. HERS verification Is required for Duct Sealing. 23If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification Is required for TXV(RCA). 241/0 If line 12, 13 or 14 are checked, HERS verification Is required for 12 EER. Section 4 - Equipment Efficiencies 25 ❑ If lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List In Section 6. Section 5- Duct R -Values ❑ If more than 40 feet of duct is bein installed or re laced, duct R -value must meet or exceed Packa e D r uirements. k26 ❑ If less than 40 feet of duct is bein installed or r laced, duct R -value must meet or exceed R-4.2 ion 6 - see next page Version 03-10-06 Page 1 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1R -ALT 6 Project e: Date: -F oi_ © CaICERTS 2005 IMPORTANT is CF -1 R -ALT form is only for use when an HVAC -only alteration is made to an existing home Use one fo for each system being altered. This is system k__J of systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equ p ant must match type/location and meet or exceed efric encies/R-values. 26 Configuration: plit system O Package Un' 29t` ❑�� AV Handler as furnace, AFU OHeatpump FAU OHydrork FAU OOther 3047 Heat Exchan er 31 e.�I* Outdoor Condensing Unit, C OHeatpump ki'lliciency SEER/HSPF EER if re d : 32 e?P Cooling or heating coil C OHeat um OH dronic 33 ❑ Ducts Location: Length (ft): R-vatue: All mandatory measures apply to any altered component. See MF -1 R - ALT form. Compliance Statement: This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall project responsibility. The undersigned recognizes that compliance using duct sealing, verification of refrigerant charge, and TXV require installer testing and certification and verification by an approved HERS rater. Home Owner or Authorized Agent Documentation AYthor Name: Name: Address: Company Name:, City/State/Zip: Address: PALM DESERT AIR CONDITIONING COMPANY Phone: City/State/Zip: PALM DESERT, CA 92211-5107 (760) 346.0677 Phone: Signature: Signature: Enforcement Agency (Building Department) Notes/ o ments: Name: Title: Department: Phone #: Fax #: Signature or Stamp: Required forms: CFAR-ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to close permit. Copies to home owner, enforcement agency, HERS rater. CF -4R -ALT: by HERS rater. Required to close permit. Copies to home owner, enforcement agency, installer. The CF -4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entire group. Version 03-10-06 Page 2 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Certificate of Compliance Prescriptive Me - HVAC -only Alteration CF -1 R -ALT l) Pr oj Title:Date: 7 v © CaICERTS 2005 Enforcement Agency Use Only Project Address: _ Climate Zone: Building Permit # Docu eptationuthor* G Telephone, �di %71 Plan Check Date CO ny ame: / Field Check Date IMPORTANT: This CF -1 R -ALT form is only for use when an HV -only alteration is made to an existing home Use one form for each system being altered. This is system # f systems altered in this house. Check all lines that apply. Check only lines that apply. Scope of Alterations: 1 ❑ An Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. 2^ &D Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. 3(� An outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. cooling or heating coil is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 5 ❑ More than 40 feet of new or replacement duct are to be installed in unmridjljonedspace. Duct sealing to be determined. ❑ Check here if the 4111 M duct system is also to be new or replaced. Continue to next line. 6 ❑ If none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked. 7 ❑ Thiss stem is in Climate Zone 1, 3, 4, 5, 6, 7, or 8. No duct sealing is required. Go to Section 2. 8 ❑ Thiss stem has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. No duct sealing is required. Attach previous CF -4R form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Note: If the entire ducts stem is to be new or replaced, Lines 11-14 do not apply. 11 ❑ In Climate Zones 2,12 and 16: An 0.92 AFUE fumace will be installed in lieu of duct sealing and TXV if a livable . 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 AhMEER 12 condenser will be installed with TXV(RCA) AND added duct insulation R-4 wrap on existing ducts, R-8 new ducts in lieu of duct sealing. Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER 14 Aba EER 12 condenser will be installed with TXV(RCA) AND a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2. 14 ❑ In Climate Zones 2, 9, 11, 12, 14 or 16: An SEER 14 AdQ EER 12 condenser will be Installed with TXV(RCA) AND an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 15 -4�a- None of lines 7-14 above are checked. Duct Sealing Is Required. Continue. Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ Thes stem being altered is a package unit. No TXV(RCA) is required. Go to Section 3. 17 ❑ This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 ❑ Thiss stem is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3. 19 ❑ Thiss stem is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required. Go to Section 3. 20 ❑hissystem is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) Is required. Go to Section 3. 21 his system is in Climate Zone 2 or 8-15 and line 11, 16 or 17 is not checked. TXV(RCA) Is required. Go to Section 3. Section 3 = HERS Rater verification 22P If line 15 is checked, HERS verification is required for Duct Sealing. 2If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification Is required for TXV(RCA). 2 ❑ If line 12, 13 or 14 are checked, HERS verification Is required for 12 EER. Section 4 - Equipment Efficiencies 25 ❑ If lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List in Section 6. Section 5- Duct R -Values 26 ❑ If more than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed Package D requirements. 27 ❑ Ilf less than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed R-4.2 Section e - see next page Version U3 -1U -U6 Page 1 of This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1R -ALT Project e: Date: L��2L'?©CaICERTS 2005 IMPORTANT: is CF -1 R -MLT form is only for use when an HV ly eration is made to an existing home Use one fo for each system be ng altered. This is qv -,tem #_ f systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipant must match type/location and meet or exceed efficiencies/R-values. 28 Configuratiom-Lplit system ❑ Package Unit 29t` ❑� AV Handler as furnace, AFU ❑Heatpump FAU ❑Hydronic FAU 00ther 30 7 ? Heat Exchan er 31 e.�I' Outdoor Condensing Unit f&VC ❑Heatpump kfrciency SEER/HSPF • JEER if re d : 32 CW Cooling or heating coil 2MC ❑Heatpump ❑H dronic 33 ❑ Duds Location: Length (ft): R -value: All mandatory measures apply to any altered component. See MF -1 R - ALT form. Compliance Statement: This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall project responsibility. The undersigned recognizes that compliance using duct sealing, verification of refrigerant charge, and TXV require installer testing and certification and verification by an approved HERS rater. Home Owner or Authorized Agent Documentation Aitthor Name: Name: Address: Company Name: City/State/Zip: Address: PALM DESERT AIR CONDITIONING COMPANY Phone: City/State/Zip: PALM DESERT, CA 92211-5107 (760) 346-0677 Phone: Signature: Signature: Enforcement Agency (Building Department) Notes/ o ments: Name: Title: Department: Phone #: Fax #: Signature or Stamp: Required forms: CF -1 R -ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to Gose permit. Copies to home owner, enforcement agency, HERS rater. CF -4R -ALT: by HERS rater. Required to close permit. Copies to home owner, enforcement agency, installer. The CF -4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entire group. Version 03-10-06 Page 2 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com JZi Bin # Qty of La Quinta Building 8L Safety Division IrQ P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: F Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zi . Contractor: Palm Desert Air Conditioning & Heating Company Address: 42081 Beacon Hill T '"' > < <>v <??s>•`:<"'.'>.??>`•`•'•<>'': Project Description: a City, ST, Zip: Palm Desert, CA 92211 Telephone: (760) 346-0677 �'4i�>?j+;:., • :F:}"}:•}!}iii.?xy'} State Lic. # : 374937 City Lic. #: 100886 Arch., Engr., Designer: 01 Address: City., ST, Zip: Telephone: P � w;.;::;•;�;,:;.:•;;;>..::::::.:::..::. State Lic. # y: . Name of Contact Person: Kimberly Galindo Construction Type: Occupancy: -Project type circle one): New Add' Alter Repair Demo Sq. Ft.: # Stories: #Units: p2 Telephone # of Contact Person: (760) 346-0677 Estimated Value of Project. l/40A APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Title 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Ca10ERTS Page 1 of 14 ;, . CERTIFICATE OF FIELD VERIFICATION St DIAGNOSTIC TESTING (Page 1 of 8) _ CF -4R 78-805 Lima #1 - La Quinta, CA 92253 Palm Desert AJC - Heating / 374937 Project Address Contractor Name/ License No. Contractor Contact Telephone Paul Van VI men 760-777-1724 R Rater. -Telephone i August 14, 2008 C rtWing Signature Date Firm: Air Experts Air Conditioning Street Address: PO Box 94 08-1288 Permit Number 104129 Sample Group Number CC14-1798444.709 Certificate Number HERS Provider:CaICERTS, Inc. City/State/Zip:La Quinta / CA / 92247 Copies to: Homeowner, HERS Provider and Building Department This CF -411 has been registered with the CaICERTS@ registry In accordance with the Title 24 & Title 20 of the CCR. CalCERTS® is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was []Tested 0 Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this forth complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater mukcheck and verify that the new distribution system is fully ducted and correct tape is used before a CF -411 may be released on every tested building. The HERS rater must not release the CF -4R until a properly completed and signed CF -611 has been received for the'sample and tested buildings. The Installer has provided a copy of the CF -611 (Installation Certificate). New Distribution system is fully ducted (Le., does not use building cavities as plenums or platform returns in lieu of ducts). New systems where cloth backed, rubber adhesive duct tape is installed, mastic andlArawbands are used In combination with cloth backed rubber adhesive duct tape to seal leaks at duct connections. �......r..,w mum swaurim ewPnTT- LM.IMINIMUM KC UAKCr1Cn a rwi% wui -aNEW CONSTRUCTION Duct Pressurization Test Results (CFM @ 25 Pa) Measured Values 1 N/A 2 Fan Flow: Calculated (Nominal ' •' Cooling :? Heating) or *---..'Measured Enter Total Fan Flow In CFM: Not Tested 3Line f beekage Peree,itage -e 6% f !88N/A N/A ALTERATIONS: Duct System and/or HVAC Equipment Change 'Out 4 Enter Tested Leakage Flow In CFM from CF -611: Pie -Test of Existing Duct System! Prior to Duct System Alteration and/or Equipment Change -Out. ; Not Tested 5 Enter Tested Leakage Flow in CFM: final Test of New Duct System or Altered Duet System for Duct System Alteration and/or Equipment Change -Out. Not Tested 6 Enter Reduction In Leakage for Altered Duct System [Line 4 - Line 5] - (Only if Applicable) Not Tested 7 Enter Tested Leakage Flow In CFM to Outside (Only If Applicable) Not Tested 8 Entire New Duct System - Pass if Leakage Percentage < 6% [ 100 x ( Line 5 / Lim 2 )]: Not Tested ❑ Pass ❑ Fall TEST. OR VERIFICATION STANDARDS: For Altered Duct System, and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pass If Leakage Percentage <= 15% [ 100 x ( Line 5 / Line 2 )]: Not Tested ❑ Pass ❑ Fall 10 Pass if Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: Not Tested ❑ Pass ❑ Fall 11 Pass if Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )] and Verification by Smoke Test and Visual Inspection Not Tested ElPass El Fall 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail Pass If One of Lines #9 through *12 pass ❑Pass ❑Fall ,AA1` 7 ,nn,I)Q inn»A 1nal)a Ind R/75/70M L Ca10ERTS Page 2 of 14 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page,3-4 of 8) CF -411 78-805 Lima #1 - La Quinta, CA 92253 Palm Desert A/C - Heating / 374937 Project Address Contractor Name( License No. 08-1288 Contractor Contact Telephone Permit Number PApl Van VI men 760-777-1724 104129 ER Rater Telephone Sample Group Number gust 14, 2008 CC14-1798444709 Certifying Signature Date Certificate Number Firm: Air Experts Air Conditioning HERS Rrovider:CaICERTS, Inc. Street Address: PO Box 94 City/State/Zip:La Quinta / CA / 92247 Copies to: Homeowner, HERS Provider and Building Department This CF -411 has been registered with the CaICERTS®-registry In accordance with the Title 24 & Title 20 of the CCR. raICERTSCI is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was ❑Tested ® Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the diagnostic tested compliance requirements as checked on this form. W The Installer has provided a copy of the CF -611 (Installation Certificate). Access is provided for inspection. The procedure shall consist of visual verification that the TXV is I installed on the system and installation of the specific equipment shall be verified. TXV ❑ Pass ❑ Fall CaICERTS ''' ' Page 3 of 14 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page i of 8) CF -411 78-805 Lima #2 - La Quinta, CA 92253 Palm Desert A/C - Heating / 374937 Project Address Contractor Name % License No. 08-1288 Contractor Contact Telephone Permit Number Potki Van VI men 760-777-1724 104129 H R Rater Telephone sample Group Number 4 2008 CC14-1798444710 Certifying signature Date CertUicate Number Firm: Air Experts Air Conditioning HERS Provider:CaICERTS, Inc. Street Address: PO Box 94 City/State/Zip:La Quintal / CA 192247 Copies to: Homeowner, HERS Provider and Building Department This CF -4111 has been registered with the CaICERTS® registry in accordance with the Tide 24 & Title 20 of the CCR. CaICERTSO is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was ❑Tested 0 Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must'check and verify that the new distribution system Is fully ducted and correct tape is used before a CF -411 may be released on every- i building. The HERS rater must not release the CF -411 until a properly completed and signed CF -611 has been received for the sample and tested buildings. The installer has provided a copy of the CF -611 (Installation Certificate). New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). New systems where cloth backed, rubber adhesive duct tape Is Installed, mastic and fdrawbands are used in combination with cloth backed rubber adhesive dud tape to seal leaks at duct connections. Tutu. �u nv %v mrnrueurc erin ni ver 1 oerAGC QCn"rTTnm rnmDl. *AMCF CRFnTT! NEW CONSTRUCTION Dud Pressurization Test Results (CFM @ 25 Pa) Measured Values 1 N/A i •. 2 Fan Flow: Calculated (Nominal • ::' Cooling ',._.% Heating) or'-,-.,' Measured Not Tested Enter Total Fan Flow in CFM: g N/A N/A ALTERATIONS: Duct System and/or HVAC Equipment Change -Out 4 Enter Tested Leakage Flow in CFM from CF -611: Pyre -Test of Existing Dud System :Prior to Not Tested Dud System Alteration and/or Equipment Change -Out. I I 5 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System Not Tested for Dud System Alteration and/or Equipment Change -Out. 6 Enter Reduction In Leakage for Altered Duct System Not Tested [Une 4 - Line S] - (Only If Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only If Applicable) Not Tested B Entire New Dud System - Pass If Leakage Percentage < 6% [ 100 x ( Line 5 / Line 2 )]: Not Tested ❑ Pass ❑ Fall TEST OR VERIFICATION STANDARDS: For Altered Duct Systemi.and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pass if Leakage Percentage <= 15% [ 100 x ( Line 5 / Line 2 )]: Not Tested ❑ Pass ❑ Fall 10 Pass If Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: Not Tested ❑ Pass ❑ Fall it Pass If Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )] Not Tested ❑ Pass ❑ Fail and Verification by Smoke Test and Visual Inspection 12 Pass If Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fall Pass If One of Lines *9 throup6 #12 passI ❑ Pass ❑ Fail 1AA11117 1AA110 1r1A111L 1nAlnif 1AA 0/11C/11AA0 CaICERTS = Page 4 of 14 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC_ TESTING (Page,3-4 of 8) CF -411 78-805 Lima #2 - La Quinta, CA 92253 Palm Desert A/C - Heating / 374937 Project Address Contractor Name license No. 08-1288 Contractor Contact Telephone Permit Number Paul Van VI men 760-777-1724 104129 H R Rater 1 Telephone Sample Group Number _ „ .. �' \1, , , : August_ 14, 2008 CC14-1798444710 Certifying signature uace Leroncare mumver Firm: Air Experts Air Conditioning HERS Provider:Ca10ERTS, Inc. Street Address: PO Box 94 City/State/Zip:La Quinta / CA / 92247 Conies to: Homeowner, HERS Provider and Building Department This CF -411 has been registered with the CaICERTS@ registry in accordance with the Title 24 & Title 20 of the CCR. CaICERTSO Is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was aested R1 Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the diagnostic tested compliance requirements as checked on this form. R The Installer has provided a copy of the CF -611 (Installation Certificate). L�THERMOSTATIC EXPANSION VALVE TXV : Access is provided for inspection. The procedure shall consist of visual. verification that the TXV is installed on the system and installation of the specific equipment sh Of be verified. HVAC Svstem TXV❑ Pass ❑ Fail