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11-0985 (MECH),C r P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, .CALIFORNIA 92253.. BUILDING & SAFETY DEPARTMENT INSPECTIONS (760),777-7153 BUILDING PERMIT Date: 9/13/11 Application Number: 11-00000985 Owner: Property Address: 79115 VIA CORTA MACDONALD GEORGE A APN: 649-460-012- - - 79115 VIA.CORTA Application description: MECHANICAL LA QUINTA, CA 92253 !!'' Property Zoning: LOW DENSITY RESIDENTIAL i • .Application valuation: 74,00t3 201' Contractor. C#TyCe A QUiN7� Applicant: Architect or Engineer: HYDES Fq=��'+,?!r•^-nom 42949 MADIO STREET „ INDIO, CA 92201 Y,R. (760)360-2202 Lic. No.: 906115 ---- - - - - -— LICENSED CONTRACTOR'S DECLARATION .- WORKER'S COMPENSATION DECLARATION 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 Professionals Code, and,my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers' compensation, as'provided License Class: C20 C36 kens .: 906115 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is C i — issued. Date: i -�l ; - Contractor: s'' ' 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 OWNER-BUILDER DECLARATION insurance carrier and policy number are: Thereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier NORGUARD INS Policy Number CEWC243358 • following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any ' .construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 f the Labor Code, I shall forthw'Ri corral with hose provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031 .5 by ./JP/ / - any. applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ` Date:' Applicant: (_) 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License. Law does not apply to an owner of property who builds or improves thereon,. SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself.or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN ... improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.• _ 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.). APPLICANT ACKNOWLEDGEMENT 1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. ' IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the - 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. - property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). _ _ whose benefit work is performed under or pursuant to any permit issued as a result of this application, - (_ I I am exempt under Sec. B.&P.C. for this reason 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. ' Date: Owner: • 2. Any permit issued as a result of this application becomes null and void if work isnot commenced - within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject CONSTRUCTION LENDING AGENCY permit to cancellation. _ hereby affirm under penalty of perjury that there is a. construction lending agency for. the performance of I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). - - • city and county ordinances and state laws relating.to building construction nd her by authorize representatives of this county to enter upon the above-mentioned property for inspectio urp es. Lender's Name: - • ate: 'I �I z� /Signature (Applicant or Agent): . Lender's Address: - - LQPERMIT - - Application Number . . . . . 11-00000985 . Permit MECHANICAL. Additional desc . Permit Fee 33:00 Plan Check Fee 8.25 Issue Date Valuation 0 Expiration Date 3/11/12 Qty Unit Charge Per Extension BASE FEE 15.'00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9 nnnn FA MECH 8/C :-3HP/100K DTU 9.00 - Special Notes and Comments ------------ - HVAC CHANGE OUT - 16SEER/78AFUE SPLIT SYSTEM [2008 ENERGY] 2010 CALIFORNIA BUILDING CODES. September 13, 2011 12:09:45 PM AORTEGA Other Fees . .' . . . . _. . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit.Fee Total 33.00 .00 _00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee.Total 1.0.0 .00 .00 1.00 Grand Total 42.25 .00 .00 42.25 . C LQPERMIT .. - Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 79-115 Via Corta La Quinta, CA 92253 City of La Quinta Sep 13, 2011 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ' R Furnace p AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system Q Setback 0 Indoor Coil p SEER 13.0 ❑ HSPF ❑ R 8 (CZ 14-15) 1200 sf If not already present,' must be R Condensing Unit ❑ EER• ❑ Resistance installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -111 and CF -611 shall also be on site for final inspection. 1. HVAC Changeout Required Forms: . All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF -4R forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or . Indoor Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS . Furnace CF -4R forms: MECH-21 and (for split systems) MECH-25 .- ,, . For Split Systems: Duct leakagei(< 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from duct leakage testing"if: ,❑ 1.'Duct system'was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less tha6,40 linear feet in unconditioned space, or r p 3. Existing duct systems are constructed, insulated or sealed with asbestos . - ❑;4. The systema ill not be Ducted (ie DuctlessjMin!�split System)r(Also Exempt from Refrigerant Charge) _. ❑ 2. Ney�HVAC Syst@m sG f Required Forms f` r ..:� F •`•` r Y � ..r . ,�ia�� -�-7�•i�x Ai=.CSC S• ^'e�f : .Cut !nfor Changeout with '(all *J7� `i. ,i ` `. ., ha "! Ler. 4`. .. ""r— new ducts new fi ducting and all n.,e�w CF 6Rfo �ms.MECH-04, MECH=20 HERS, and�(for split systems) MECH=22 HERS and•MECH 25 HERS CF-4R'forms: MECH 20 and (for split systems) MECH 22`t and MECH�25 "� r e u! ment , c s c ar�� For Split Systems:.Duct leakage'<=,6 percent, RC,`CCA'>_;350 CFM/ton`FWD, TMAH„SIMS, and either`HSPP=or'PSPP, `°” .,�... .f'-'4. «.Je.-_Se• .: i::. �,,:a..,,,s r.oii:-.,..g.a+Fq.: :c- .0__.. 9{:x'�-.- For Packaged Units: Duct leakage!< 6 percent- ❑ 3. New -Ducts with/or withmit '. { Required Forms: Replacement •''� _•...,,M ' _ ' . Includes replacing or installing all.new ducting and/or outdoor condensing unit and/or indoor CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS coil and/or furnace. No or some equipment CF -4R forms: MECH-20 and (for split systems) MECH-25 changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent - ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) . I certify that this Certificate of Compliance documentation is accurate and complete. . I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. . I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance ' forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Mark Hyde Signature: Mark Hyde Company: CERTIFIED COMFORT SYSTEMS INC Date: Sep 13, 2011 Address: 42-949 MADIO STREET License: 906115 City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202 Reg: 211-A0047412A-00000000=0000 Registration Date/Time: 2011/09/13 14:15:16 HERS Provider: CalCERTS, Inc., 2008 Residential"Compliance Forms July 2010, Bin # Building :8L Safety Division ox 1504, 78-495 Calle Tampico ta, CA 92253 - (760) 777-70` 2 Permit.# P.O. E nes, La Qui' City, ST, Zip: A4. ZZ Building Perm Project Address:' Vic, A. P. Number: Construction Type: Occupancy: Legal Description: Sq. Ft : #Stories: # Units: Contractor: �2r�1 �1 e(� C 'Or Address: i� �.0 a I0 City, ST, Zip: Plan Chect Balance Telephone: State Lie. City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Telephone # of Contact Person: Developer Empact Fee APPLICANT: DO NOT V # Submittal Req'd Rec'd TRE Plan Sets Plan Check submitted Structural Calm.' Reviewed, ready for cora Truss Calcs. Called Contact Person Energy Calcs. Plans picked up Flood plain plan Plans resubmitted Grading, plan 2" Review, ready for cot Subcontactor List Called Contact Person Grant Deed Plans picked up ILO.A. Approval Plans resubmitted IN HOUSE:- 3' Review, ready for Cort Planning Approval Called Contact Person Pub. Wks. Appr Date of permit issue School Fees ly of La Quints Building :8L Safety Division ox 1504, 78-495 Calle Tampico ta, CA 92253 - (760) 777-70` 2 t Application and Tracking Sheet Owner's Name: G ems/ �– nes, Address: 01— (� i ce City, ST, Zip: A4. ZZ Telephone: J 6 52 3 Project Description: G L► Pott Construction Type: Occupancy: Project type (circle one): New Ad1'n Alter Repair Demo Sq. Ft : #Stories: # Units: Estimated Value of Project: 'RITE BELOW THIS LINE CKING , PERFEES Item Amount actions Plan Chect Deposit Plan Chect Balance Construction Mechauicai rectionsftssue Electrical Plumbing S.M.I. Grading ectionsftssue Developer Empact Fee A.LP.P. Total Permit Fees INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 79-115 Via Corta, La Quinta CA 92253 (System 1) , City of La Quinta 11-0985 ` Space Conditioning Systems Heating Equipment ►, -A Cooling Equipment Equip y+ i Efficiency (SEER Duct ` Type (package;^ 4 " y ARI .. # of Efficiency Location `* Cooling Cooling Equip --sCEC Certified Mfr. Name and Model Number Reference Number2 Identical Systems (AFUE, (attic, Duct R -value Load (kBtu/hr) Capacity (kBtu/hr) Type - ARI •' # of etc.)1, 3 crawl- Heating Heating , (package- CEC Certified Mfr. Name Reference ` Identical (>=CF -1R space, Duct Load Capacity heat pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split american standard ,.J �t''�—` ..: - • Furnace aud2c1080a9v4vba kf 1 80 AFUE Attic R-4.2 60 80 kl3tu ' J,f.e's', • ! ^{ i'.'�i.'.. *'1 •t,�.. t ,�".e' A+4� jy;T if 1 . ; ., 5.-. Y"� >..R,. if� `fes "t••.. ,. fit. .. _ '.�a. Cooling Equipment Equip y+ i Efficiency (SEER Duct Location ` Type (package;^ 4 " y ARI .. # of and EER) 1, 3 (attic, crawl- F` Cooling Cooling heat pump) --sCEC Certified Mfr. Name and Model Number Reference Number2 Identical Systems (>=CF -1R value)4 space, etc.) Duct R -value Load (kBtu/hr) Capacity (kBtu/hr) Split american standard 16 SEER A/C 4s a+ 0}}M4, '43587-19-1 ,13--EER?qyoi�7 R X4:2 j 34 kBtu Anx.rf_ �A-i' � ' �},'?;E'� :i`+i yam#.i,-. r.3: t y32 i. ,.J �t''�—` ..: - • kf J,f.e's', • ! ^{ i'.'�i.'.. *'1 •t,�.. t ,�".e' A+4� jy;T if 1 . ; ., 5.-. Y"� >..R,. if� `fes "t••.. ,. fit. .. _ '.�a. P • 1. If project is new construction, sde Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative compliance.., , 2. ARI Reference Number can be found by entering the equipment model number at = •^., http://www. aridirectory. org/ari/ac. php# G 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R forma , 4. When CF -IR is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT ALL BOXES MUST,BE CHECKED TO BE A VALID FORM �• , ", §110-§113: HVAC equipment is certified by the California Energy Commission.•. ' Pi §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or^ACCA: E §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of ` ,y §112(c). R. §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in. ' conditioned space..` cc - � +.2' ` mak:•, • P ''.. ^ , r -_..` `' , - a � - Reg: 211-A0047412A-M0400001A-0000 ,Registration Date/Time: 2011/09/16 14:03:23 - HERS Provider:_.CalCERTS, Inc. a 2008 Residential.Compliance Forms- ) -, Auguet.2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 - Space Conditioning Systems, Ducts and Fans (Page 2 of 2) , Site Address: Enforcement Agency: Permit Number: 79-115 Via Corta; La Quinta CA 92253 (System 1) City of La Quinta 11-0985 Ducts and Fans - §150(m): Duct and Fans ❑ 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are.insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination f of mastic and either mesh or tape shall be used; and _ t 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 , d u cts. 'D 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. ❑ 7. Exhaust fan systems have back draft or automatic dampers. ❑ 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible; manually operated dampers. ❑ Protection of Ihsulation.lInsulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or ' painted with a coating that?is water retardant and provides shielding from solar radiation that can cause degradation of.the material! 0 10. Flexible ducts cannot have porous inner cores. a - J� t � � r '.: � � sir .+r ••`.:' C♦�` � .�� :..—. . SFr / .,� �,� `� •1 ; ! y-• e � fir` � ' �•. `�.�:�.--.. ,y, �, '. .� i.. -' DECLARATION STATEMENT - , N . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. ` • I am eligible under Division -3 of the Business and Professions Code to accept responsibility for construction, or an authorized ' representative of the person responsible for construction (responsible person). ' • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation Is consistent with the plans and specifications approved by the n enforcement agency. ' • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder Provides to the building owner at occuoancv. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: Responsible Person's Signature: , Mark Hyde Murk Hyde CSLB License: 906115 + Date Signed: 9/8/2011 Position With Company (Title): t ' ' Reg: 211-A0047412A-M0400001A70000 Registration Date/Time: 2011/09/16. 14:03:23 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 ` Enter the Duct System Name or Identification/Tag: System 1 -- Enter the Duct System,Location or Area Served: bedroom } Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. F :' Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. 10 1. Measured leakage less than 15% of fan flow ' .. 0 2. Measured leakage to outside less than 10% of Fan Flow - 0 3. Reduce leakage by 60% and conduct smoke and fix all leaks ' ❑ 4. Fix all accessible leaks using smoke and HERS rater verify Note` -.,(One of Options 1, 2 or 3 must be attempted before utilizing Option 4.) Determine nom�aVann Flow using one of,the�following three calculation -methods. ✓ G✓ Cooliinngf�sysFtem method:.Size of (conydefnser in Tons,2CF,.M �r Oiu7tput Capacity in T•housan s of,Btuu,/hr r= _ CFM ✓ ❑ Heating,system met�h�o•`d>42�1ywZ JxyPfa ✓ ❑Measured systemfairflow using RA3.3 airflow testlprocedures: rCFM Option 1 used then: + '"f'°„ rf r#, +�• °� d j y 1 Allowedileakage" Fen Airflowit 1200 -x 0:15 f* -i 80 CFM 4,! ` - •, +- x Actual Leakage = ` 149 CFM! Pass if Actual Leakage is less than Allowed leakage Pass Fail Option.2 used then: Y 2 Allowed leakage = Fan Airflow _ x 0.10 = _ CFM Actual Leakage to = J - CFM _outside `,. Pass if Actual leakage to outside is less than Allowed leakage . i Pass Fail ' Option 3 used then: �J 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 r ((Leakage reduction _ / Initial leakage x 100% _ % Reduction Pass if % Reduction > 60% '' fl Pass fi Fail, Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke Pass Fail Reg: 211-A0047412A-M2100001A-0000 Registration Date/Time: 2011/09/16 14:00:49 HERS Provider:' Ca10ERTS,•-Inc. 2008 Residential Compliance Forms i March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HER; )uct Leakage Test —,Existing Duct System (Page 2 of 2 Site Address: Enforcement Agency: Permit Number: 79-115 Via Corta, La Quinta CA 92253 (System 1) City of La Quinta 11-0985 TF . y - r ti. - �� - , .�, •' •rte ry. ., FT., �. A- .. .. - 2 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off y 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 s'`• be configured to the closed posiiion'during duct leakage testing. 9 All supply and.r-eturn register boots must-,betsealed:to the drywall ifsmoke test is utilized for compliance ` applies tq duct leakage complia ce optlon,3~'`(leakag eduction b"y;60%)ta•nd opt n�'4'"(fx all accessible leaks) described abov c � ><`� ri ," , 6 s, -a '� •�: f e �- is w.+'^•;'M' ,...... 0 New duct mstallatlons cannotl/utllrze,building cavities as plenums orrplatform returns m llewof.ducts., u y Mastic and drawabands must be used4ln combinatlon wiith cloth backed rubber adhesive duct tape�to.sealcg leaks at all*new duct"conneetlori§"'�` .. +. DECLARATION STATEMENT ` • I certify under penalty of perjury, under the laws of the State of California, the Information provided on this form is true and correct.' • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized ` representative of the person responsible for construction (responsible person). . I certify that the installed features; •materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the Installation is consistent with the plans and specifications approved by the enforcement agency. , '� ' • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS. - rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and ' + additional checking/testing of other installations in that HERS sample group will be performed at my expense. _ y • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met.. ' • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the a 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) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: L . y - r ti. - �� - , .�, •' •rte ry. ., FT., �. A- .. .. - 2 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off y 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 s'`• be configured to the closed posiiion'during duct leakage testing. 9 All supply and.r-eturn register boots must-,betsealed:to the drywall ifsmoke test is utilized for compliance ` applies tq duct leakage complia ce optlon,3~'`(leakag eduction b"y;60%)ta•nd opt n�'4'"(fx all accessible leaks) described abov c � ><`� ri ," , 6 s, -a '� •�: f e �- is w.+'^•;'M' ,...... 0 New duct mstallatlons cannotl/utllrze,building cavities as plenums orrplatform returns m llewof.ducts., u y Mastic and drawabands must be used4ln combinatlon wiith cloth backed rubber adhesive duct tape�to.sealcg leaks at all*new duct"conneetlori§"'�` .. +. DECLARATION STATEMENT ` • I certify under penalty of perjury, under the laws of the State of California, the Information provided on this form is true and correct.' • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized ` representative of the person responsible for construction (responsible person). . I certify that the installed features; •materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the Installation is consistent with the plans and specifications approved by the enforcement agency. , '� ' • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS. - rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and ' + additional checking/testing of other installations in that HERS sample group will be performed at my expense. _ y • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met.. ' • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the a 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) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: Responsible Person's Signature: F Mark Hyde Mark Hyde CSLB License: - i, 906115 - • Date Signed: 9/8/2011 position With Company (Title): Is this installation monitored by a Third Party Quality. Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 211-A0047412A-M2100001A-0000 Registration Date/Time: 2011/09/16 14:00:49 HERS Provider:.Cal_CERTS,­Inc. J 2008 Residential Compliance Forms { * t ^, March 2010 y r � r j Ax � • Reg: 211-A0047412A-M2100001A-0000 Registration Date/Time: 2011/09/16 14:00:49 HERS Provider:.Cal_CERTS,­Inc. J 2008 Residential Compliance Forms { * t ^, March 2010 y INSTALLATION CERTIFICATE* CF-611-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 79-115 Via Corta, La Quinta CA 92253 City of La Quinta 11-0985 , Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is . required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler 4N System Name or Identification/Tag 'System 1 System Location or Area Serv STMS: Sensor on the Evaporator`Coil —_ _ r System.Namenc(r,Identification/Tag=j , `,r! System 1 �; d,---- ?_ \41'. ias V, ? (r- 111 3 ed bedrooms 1 p Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 R Yes ❑ No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and 2 is a pass. { Enter Pass or Fail ✓ D Pass ✓ ❑ Fail STMS: Sensor on the Evaporator`Coil —_ _ r System.Namenc(r,Identification/Tag=j , `,r! System 1 �; d,---- ?_ \41'. ias V, ? (r- 111 3 ❑Yes Q.No } The"sensor is factory' installed, or field installed according to manufacturer's - specifications, or isiinstalled by methods/specifications approved tiy,the Executive' _ 6 ❑Yes 1K specifications, or is installed by methods/specifications approved by the Executive 4 1 ❑Yes j f Q No, The sensor wire is terminated with a;standard'mini plug suitable forconnection'to`a' s �5 - .+.-.ter- r t J -, by digital thermomefer�The sensor plug is. to the,instaliing,technicianI. , mini accessible 7 "� `; -• = • �I- andahe HERS<ratei,;without changing the airflow through the condenser coil 5 ❑ Yes ❑ No 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 if STMS are not applicable. Otherwise enter Pass or'Fail ✓ p N/A ✓ . E3 Pa ✓ El Fail STMS -Sensor on the Condenser Coil System Name or Identification/Tag I 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 ❑ Yes ❑ 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 1 ❑ Yes ,❑ No IThe 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 © N/A ✓ ° ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or.Fail Reg: 211-A0047412A-M2500001A-0000 Registration Date/Time: 2011/09/16 13:59:45 HERS Provider: CalCERTS,'Inc. 2008 Residential Compliance Forms c August 2009 r r - .a ' j �. A J .Lt• , F •�l` _ ` � ' � .1 .+• .. • t tf •^t � .. Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2.•As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for ; any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. t. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. ? • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. +. Space Conditioning Systems h' System Name or Identification/Tag System 1 +' y l •. Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2.•As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for ; any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. t. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. ? • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. +. Space Conditioning Systems h' System Name or Identification/Tag System 1 (must monthly) •. • .. �� I r System Location or Area Served bedrooms k r °" 9/8/2011 �bye�re-calibrated T -e (must be r{e-calibrated monthly) } • � Outdoor Unit Serial # .' i a :. 1. 1126313s5f '�»,?►'�" • ��r ► �„a ,�y. -� >., ,� 4r: r a ._'.`� it Outdoor Unit Make 1 american standard temperature (Treturn,'db� Outdoor Unit Model , 4a7a5O36e1OOOab , Nominal Cooling Capacity Btu/hr ° . 36000 Evaporator saturation temperature 55 Date of Verification; 9/8/2011 Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 9/8/2011 (must monthly) •. • .. �� I r /6th aii''� +"^#1}'*��l ", �. 1 ^. 7,' R- Date of Ther/mocouple.Calibration k r °" 9/8/2011 �bye�re-calibrated T -e (must be r{e-calibrated monthly) } • � Supply (edaporator;leaving'),air dry, -bulb= �:"ii'..:- P—C-1 �, --�" measurea,iemperacuress(yr)Zllf f• Uy System Name or Identification/Tag.R!ySys em:1 • ` g l �• Pei. -,,# ' •. • .. �� I r /6th aii''� +"^#1}'*��l ", �. v r- � c � } • � Supply (edaporator;leaving'),air dry, -bulb= �:"ii'..:- P—C-1 �, --�" '�»,?►'�" • ��r ► �„a ,�y. -� >., ,� 4r: r temperature'(TsupplY db) .. r ._'.`� it Return (evaporator entering) air dry=bulb temperature (Treturn,'db� Return (evaporator entering) air wet -bulb , temperature (Tretum, wb)., Evaporator saturation temperature 55 (Tevaporator, sat) Condensor saturation temperature 130 ` (Tcondensor, sat) P Suction line temperature (Tsuction) - 78 t - _ Liquid Line Temperature (Tliquid) 122 Condenser (entering) air dry-bulb - '119 temperature (Tcondenser, db) ' •. • .. �� I r ` '• � � � • ^ � . • � `i� . ±� 1 . . , � , '{ ; J '. it l + Reg: 211'-A0047412A-M2500001A-0000 Registration Date/Time: 2011/09/16 13:59:45 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms -August 2009 , ♦ k 1. E i � F � . , • `• Minimum'Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refr•gerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System i ` Calculate: Actual Temperature Split = Treturn, , db - Tsu I db E Target Temperature Split from Table RA3.2-3 . using-Treturn, wb and Treturn, db: , ' Calculate difference: Actual Temperature Split - Target Temperature Split = Passes if difference is between -3°F and +3°F or, upon remeasurement, if,between -3°F and i -100°F - q ` Enter Pass or Fail 4 . Reg: 211-A0047412A-M2500001A-0000,• Registration Date/Time: Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil air low is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) =Nominal Cooling Capacity (ton) X 300 ton) ' (cfm; SystemNameoor nfication/Tag . ` ystemi� ,.S �t . .,r :r d :.�., r,t.� .'f'" ,:k'. I•': ^i ►-=_ ",��.• 4 ,may y Calculated Minimum Airflow -.Requirement (CFM) . Measured sing RA•3.3 r; Ao0f-4 iF' I ' �' 4k -using procedures (CFM) �:j'*�!'ri�reP�'""A`�2?"�°"ti.4 :`'�"unaes^.�.r,-`•i�Y+ -�°"""�""'""'. 6:r.h.�«. �.r� � r Passes if measured airflow is greater,than or- equal equal to the calculated minimum airflow requirement;-"— PASS Enter Pass 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 System 1 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using , Treturn, wb and Tcondenser, db ' Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail 4 . Reg: 211-A0047412A-M2500001A-0000,• Registration Date/Time: ... y. ice, .. i . . � `_ e� •• - .- ' 4 Reg: 211-A0047412A-M2500001A-0000,• Registration Date/Time: 2011/09/16 13:59:45 HERS PrDvider: Ca10ERTS,'Inc. 2008 Residential Compliance Forms' Au ust 2009 _ T � + L'• t r L 77. 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 17. Calculate: Actual Subcooling = 8.0 ar - Tcondenser, - Tliquid f " sat J. Target Subcooling specified by manufacturer ' 8 4 Calculate difference: :• - ` 0 Actual Subcooling - Target Subcooling = • + System passes if difference is between -•.. i PASS ' *� 6 = T ir' s y -3°F and _ } .. PASS n � �` .•rF :"�- ,+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: Actual Superheat = 23.0 ar Tsuction.- Tevaporator, sato r " Enter allowable superheat range from manufacturer's specifications (or use range 4_25 between 4°F and 25°F if manufacturer's specification is not available)' System passes',if actual'superheat is withimthe - allowable superheat range �'� .'' -•.. i PASS ' *� 6 = T ir' s y .Enter.Passor:Fail ,,:4a„ d n � �` .•rF :"�- .,l . ' f .,l . ar ik F if A. Reg: 211-A0047412A-M2500001A-0000 Registration Date/Time: 2011/09/16 13:59:45 ,HERS Provider: Ca10ERTS, Inc.- '2008 Residential Compliance Forms ,�r August 2009- 311 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 79-115 Via Corta, La Quinta CA 92253 City of La Quinta 11-0985 Standard Charge Measurement Summary: . System shall pass both refrigerant charge criteria,, metering device criteria (if applicable), and minimum cooling coil - airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System.Name or Identification/Tag , System 1 •ti Date Signed: - - 19/8/2011 Position With Company (Title): System meets all refrigerant charge and airflow Name of TPQCP (if applicable): - Control Program (TPQCP)? C] Yes ❑ No d requirements. PASS Enter Pass or Fail ` ry f ,� Iii 4 � •.� ! • '. pYt ,.. . .1 • ` t is 'r` SJ f'. �'a '� '{• r _ rR�+ y� ... _ ,+' r ' X. • "r,. it S .��rA r e�. g�' •f"".-= f+. ,,,, ,n�,.,,i . 4 , �}.n l� �s �;4 e' _ */�yr1 �L.� '•'°rar^i �'� s. SIS, 'a""'• ,�,,..f•-•+"�'�i-••-'"' , - Y .. + r ':'!� r r i•�` "-�'` + t'�K _ �,.,w. Yom,- � f r���yy,,� ,i� i - 1. C }{• l - � �-•G����Fx '�-_,� .^! M�7� � •JT�1'. • � r.Lya.�ti .-.•1., •'f y•},•ri:{t; i6''�, . !+- 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. 3 I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). I I , . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the Installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the • enforcement agency. i t' • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects,• I am ` required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS s rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and✓' a. additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met. , • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the " 1 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. c 4 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) CERTIFIED COMFORT SYSTEMS INC r Responsible Person's Name: Responsible Person's Signature: rf ' •ti Date Signed: - - 19/8/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): - Control Program (TPQCP)? C] Yes ❑ No d f ,� Iii 4 � •.� ! • '. pYt ,.. . .1 • ` t is 'r` SJ f'. �'a '� '{• r _ rR�+ y� ... _ ,+' r ' X. • "r,. it S .��rA r e�. g�' •f"".-= f+. ,,,, ,n�,.,,i . 4 , �}.n l� �s �;4 e' _ */�yr1 �L.� '•'°rar^i �'� s. SIS, 'a""'• ,�,,..f•-•+"�'�i-••-'"' , - Y .. + r ':'!� r r i•�` "-�'` + t'�K _ �,.,w. Yom,- � f r���yy,,� ,i� i - 1. C }{• l - � �-•G����Fx '�-_,� .^! M�7� � •JT�1'. • � r.Lya.�ti .-.•1., •'f y•},•ri:{t; i6''�, . !+- 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. 3 I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). I I , . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the Installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the • enforcement agency. i t' • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects,• I am ` required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS s rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and✓' a. additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met. , • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the " 1 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. c 4 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) CERTIFIED COMFORT SYSTEMS INC r Responsible Person's Name: Responsible Person's Signature: Mark Hyde Mark Hyde CSLB License_ : _ ;," _. 906115 Date Signed: - - 19/8/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): - Control Program (TPQCP)? C] Yes ❑ No d 2008 Residential Compliance Forms August 2009 ' - CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING t CF-4111-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 79-115 Via Corta, La Quinta CA 92253 (System 1) City of La Quinta 11-0985 iter the Duct System Name or Identification/Tag: iter the Duct System Location or Area Served: )te: Submit one Installation Certificate for each duct system that must demonstrate compliance in the veUing. alterations and additions in existing dwellings to f, )te: For existing dwellings, a completely new or replacement duct system can also include existing parts of e original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible t �d they can be sealed.' For a completely new or replacement duct system installed in an existing dwelling, `S " e the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " This installation certificate is required for compli space conditioning systems and duct systems. Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. ❑ 1. Measured leakage less than 15% of fan flow , ❑ 2. Measured leakage to outside less than 10% of Fan Flow, i sand ❑ 3. Reduce leakage by 60°%Conduct smoke and fix all leaks ❑ 4,'`Fix aliac�cessible leaks using smoke and HERS rater verify Note ,(One of Options 1, 2,'or 3 mu'strbe attempted before utilizing Option 4.) . Determine nominalaFan4Flow using one of the2followmgrfthree calculatlon4methods x ,� V Cooling,sy temm '; ethod: Size of,condenser !n TonsW '� x"` Cr— ✓ ❑ HeatmgSsystem method.:;21 7 x;•Output Capauty ousan in Thds of Btu"; hr . CFM s" ���*'�'r�h�°; ,�.1'B+'Tf-�' 1 Y '�'rr `�`�'�'•'• �. i�' �• •M�'•,z�' ui`�` ✓ ?-"���4 ❑Measured system airfirflow,using,RA3.3,airflow testgpiocedures CFM Optional used then 'rt,�g7A '.Yh Y S l ,�+FK spa 0 ��'W-1� �tlc� moi? � 1 Allowed,`leakage,--,Fan iFlow'-z ,WN�M 15 = �' T' �rNdy� r�lY� r. Actual Leakage __CFM _ "" w ~ k _,' , ' Pass if Leakage Actual is less than Allowed E] Pass ❑ Fail Option, 2`used";then t- F 2 Allowed leakage — Fan'Flow z•�' x 0.10 = _ CFM Actual Leakage to outside = r2f.-•CFM °°'• Pass if Leakage Actual is less than Allowed ❑ Pass ❑ Fail Option 3 used then: ` "'Y `> , 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 leakages x.100% _ 0/6 Reduction Pass if % Reduction > 60% ❑ Pass n Fail Option 4 used then: 4 All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No smoke allowed to leak from system. Including ducts, plenums, air handler and door panel. Pass if all accessible leaks have been repaired using smoke ❑ Pass Fail Reg: 211-A0047412A-M2100001A-M21A Registration Date/Time: 2011/09/23 13:36:33 HERS Provider: CalCERTS,•Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 79-115 Via Corta, La Quinta CA 92253 (System 1) City of La Quinta 11-0985 ❑ Outside air (OA)'ducts'for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI.OA ducts that utilize controlled motorized dampers, that open only when OA ventilation-is.required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may 'be configured to the closed position during duct leakage testing, ❑ All supply andireturn'reglster b ots'm. ustTbe sealed•toithe drywall�'If smokeztest-iisxutilizedifor-compliance — applies,to-,duct-leakage compliance{option 3 (leakage:reduction1by60%)�`and>�optlon�[4 (fiz all accessible leaks) dy�ersc�Nr'bed above. /a � r�' *;s kr; t` �` � `` I 9 PI�YIK�Y.,'kCy`rt3 r ' �.;� ❑ New duct.,installations�cannot-;utlhzetbuilding cavities ;as "plenums or`platform'returns_In,lle�u.6C ucts 7"'""' tti't�e ' s f ri: at t4 -'g TIT ❑Mastic nd•draw�;bandsrmustTbe'usedvin com6inatlon'with cloth backed�rubber,�adheslvexduct t 11 leaks,at alllnew•duct connections' DECLARATION STATEMENT , . I certifyunder penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. ; . I am the certified HERS rates who performed the verification services identified and reported on this certificate (responsible rater). - . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. . The information reported -on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the :3 enforcement agency. Builder or Installer information as shown on the Installation Cert ificate (CF -6R) _ t CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: CSLB License: Mark Hyde , �. 1906115 HERS Provider Data Registry Information Sample Group # (if applicable): 251071 ' ❑ tested/verified dwelling ® not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798591659 HERS Rater Company Name: ' Desert H.E.R.S. Raters Responsible Rater's Name: Responsible Rater's Signature: Michael Hyde Michael Hyde Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/13/2011 T i CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 79-115 Via Corta, La Quinta CA 92253 (System 1) City of La Quinta 11-0985 ❑ Outside air (OA)'ducts'for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI.OA ducts that utilize controlled motorized dampers, that open only when OA ventilation-is.required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may 'be configured to the closed position during duct leakage testing, ❑ All supply andireturn'reglster b ots'm. ustTbe sealed•toithe drywall�'If smokeztest-iisxutilizedifor-compliance — applies,to-,duct-leakage compliance{option 3 (leakage:reduction1by60%)�`and>�optlon�[4 (fiz all accessible leaks) dy�ersc�Nr'bed above. /a � r�' *;s kr; t` �` � `` I 9 PI�YIK�Y.,'kCy`rt3 r ' �.;� ❑ New duct.,installations�cannot-;utlhzetbuilding cavities ;as "plenums or`platform'returns_In,lle�u.6C ucts 7"'""' tti't�e ' s f ri: at t4 -'g TIT ❑Mastic nd•draw�;bandsrmustTbe'usedvin com6inatlon'with cloth backed�rubber,�adheslvexduct t 11 leaks,at alllnew•duct connections' DECLARATION STATEMENT , . I certifyunder penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. ; . I am the certified HERS rates who performed the verification services identified and reported on this certificate (responsible rater). - . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. . The information reported -on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the :3 enforcement agency. Builder or Installer information as shown on the Installation Cert ificate (CF -6R) _ Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: CSLB License: Mark Hyde , �. 1906115 HERS Provider Data Registry Information Sample Group # (if applicable): 251071 ' ❑ tested/verified dwelling ® not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798591659 HERS Rater Company Name: ' Desert H.E.R.S. Raters Responsible Rater's Name: Responsible Rater's Signature: Michael Hyde Michael Hyde Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/13/2011 CC2005602 , 1 f. Reg: 211-A0047412A-M2100001A-M21A Registration Date/Time: 2011/09/23 13:36:33 HERS Provider: CalCERTS,' Inc.., 2008 Residential Compliance Forms March 2010 L Reg: 211-A0047412A-M2100001A-M21A Registration Date/Time: 2011/09/23 13:36:33 HERS Provider: CalCERTS,' Inc.., 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 79-115 Via Corta, La Quinta CA 92253 1 City of La Quinta 11-0985 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance; when a CID is utilized for compliance. r, As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System Location or Area Served t❑ Yes 1 ❑ Yes p Non , ;* 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2❑ ❑Yes No - ', 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to�l.and_2 is a pass. I x' Enter Pass or Faill ✓ ❑ Pass ✓ ❑ Fail STMS Sensor onithe, Evaporator Coil.:- , System Name'or Identification/Tag 3 t❑ Yes ❑ Thesensor is factor",installed, or�field-installed according to-manufacturer.'s - specifications, or is�mstalled. by methods/specifications; approved'by the Executive Director. 4 r` r'i�i ❑'Yes+ _ r, TNo The -tensor wire is terminated Swith a staniiard mini plug suitable for, connecttionjto ar digital,thermometer The"sensor -mini plug is accessible to the m5tallmg technician and.the`HERS 'rate rwithout'changing-the aiMow.through the condenser coil 54 ❑Yeses^ ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 3, _4`; and 5 is a,pass. Enter N/A if STMS are not applicable. Otherwise enter'pass or` .ail V El N/AT ✓ El Pass ✓ ❑ Fail SIMS - Sensor on the Condenser Coil System Name or Identification/Tag I I . _The sensor is factory installed, or field installed according to manufacturer's 6 ElYes ❑ 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 ❑ Yes ❑ 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 ❑ Yes ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not _T ✓ N/A ✓ El Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail Reg: 211-A0047412A-M2500001A-M25A Registration Date/Time: 2011/09/23 13:39:41 HERS Provider: CalCERTS, Inca 2008 Residential Compliance Forms March 2010 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 Refereace Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an addit+onal form(s) for `any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before'starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. - • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. s Space Conditioning Systems System Name or Identification/Tag rY•ri �' err 4.. (must be re-calibra`ed monthly) .`.: �i`G.Y,. Date of Th�jermocouple Calibration a •• ks'� - t 44 �p.0 0€.A a,$... k �I � System Location or Area Served �•d„�J,�" .t-�1 i �"F - .s.� � 7 � •P.•.� Yt`'✓ w{'��•� ! _ sr 7•w.s-.��`•X'1"'6.-rJ.'^a1�'�,.�' 1..,,�..... _ Outdoor Unit Serial # - wr,,+ Outdoor Unit Make t ` Outdoor Unit Model , Nominal Cooling Capacity Btu/hr • ;� Date of Verification ; Tirrit Cali bration"of-Diagnostic Instruments Date of Refrigerant Gauge Calibration" :,k rY•ri �' err 4.. (must be re-calibra`ed monthly) .`.: �i`G.Y,. Date of Th�jermocouple Calibration a •• ks'� - t 44 �p.0 0€.A a,$... k �I � -f"`': ((must••be re-calibra ed. monthly) �•d„�J,�" .t-�1 i �"F - .s.� � 7 � •P.•.� Yt`'✓ w{'��•� ! _ sr 7•w.s-.��`•X'1"'6.-rJ.'^a1�'�,.�' 1..,,�..... _ MeasuredTe'mperatures?(=x FF) i•�5`�'P";i• :I?,"ir{ i"'',sRr s Ln : ?, ,s�?'i. System Name or Identification/Tag x i rY•ri �' err 4.. "1i �iG = '�'• � 'e"re.'� i .K, MeasuredTe'mperatures?(=x FF) i•�5`�'P";i• :I?,"ir{ i"'',sRr s Ln : ?, ,s�?'i. System Name or Identification/Tag x i rY•ri �' err 4.. "1i �iG = '�'• � 'e"re.'� C7��t .K, _ Supply (evaporat&,1'eavm Fain 9).n} drytiUlb temperature wr,,+ (Tsupply, Return (eevap&ator'entering) air dry-bulb , temperatu_re:(Treturn, db) ' Return'(evaporator entering) air wet.bulb �� ; temperature T p ( return, wb) -'�. Evaporator saturation tem_pei•ature',i,',: + (Tevaporator, sat) 'rt Condensor saturation temperature (TCondensor, sat) ,� ! Suction line temperature (Tsuction) ` Liquid Line Temperature (Tliquid) y Condenser (entering) air dry-bulb temperature (Tcondenser, db) i =77 t Reg: 211-A0047412A-M2500001A-M25A :Registration Date/Time: 2011/09/23 13:39:41•. HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms € ; March 2010 INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 79-115 Via Corta, La Quinta CA 92253 City of La Quinta 11-0985 Minimum Airflow Requirement ' y Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag Calculate: Actual Temperature Split = Treturn, db - Tsupply, db ' Target Temperature Split from Table RA3.2-3 using Treturn, wb and Treturn, db ' Calculate difference: Actual Temperature Split - Target Temperature Split = Passes if difference is between -4°F and +4°F or, upon remeasurement, if between -4°F and -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using cne of the airflow measurement procedures •specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equajl. to or greater than the Calculated Minimum Airflow Requirement in the cable below. • 'fid. '1:.,. - Calc\ulated Minimum Airflow ReqLuirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System; Name or Identification/Tag.—it { ` �,y* CalculatediMinimum AirflowfRequirement (CFM) Y fi'- ` ,k"�ta'N•�`' .^r,rJk- ! j• :.15a f. ' j"'r„'z"low usingiMRa l •A3.3;-rpAa j":y.,,s Measured y+Yy.`A*�irir�qfrocedures (CFM) } � �. �,�*�"'• { f 'tn'%�.•fi1 l.� `Y �Js�iiL C� Y1y. .W. fi R 4.•� -~b.1 J �atii y �-� v: � Passes if measured airflow is greaterYhan or-equal� + ,� �+� ►� > s{ # 5;N .._.. to the calculated minimum airfloww requirement , _ -- - � Enter. Pass or Fail t 6w-ff r F i Reg: 2117A0047412A-M2500001A-M25A Registration Date/Time: 2011/09!23 13:39:41 HERS Prov` -der: Ca10ERTS,'Inc.s 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 79-115 Via Corta, La Quinta CA 92253• City of La Quinta 11-0985 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 Calculate: Actual Subcooling = Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer _ Calculate difference: - Actual Subcooling - Target Subcooling = , passesif difference is betweend +_ F-4P+4°F T _ �. __ _�••_ , _ Enter Pass or Fail Fa rte' f"R r�_? 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 <f , t. Calculate: Actual Superheat,= ., z Tsuction - Tevaporator, sat;" Enter allowable superheat range from;. - manufacturer.'s specifications (or use -range - between 3°F and 26°F if manufactu'rer's +_ specification is notavailable)„� ;• _ T _ �. __ _�••_ T.__ _ _ System!passes°if actival'•superheat is:withinfthet allowable superheat range *` x� Fa rte' f"R r�_? f'` ,Enter.! Pass or.Fail� 3';E. Mt= INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 79-115 Via Corta, La Quinta CA 92253 City of La Quinta 11-0985 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag ' Mark Hyde 1906115 HERS Provider Data Registry Information Sample Group # (if applicable): 251071 System meets all refrigerant charge and airflow 0 not-tested/verified dwelling in la HERS sample group requirements., HERS Rater Company Name: Desert H.E.R.S. Raters Responsible Rater's Name:` Responsible Rater's Signature: Enter Pass or Fail Michael Hyde Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/13/2011 CC2005602 ,+ • 1.�_ rT '., iy. `:;w FLs ��4� .ri r^ »h„=✓y,.asr - ..Kr.. � - _ -tl .. r� ^� T a..*'" ,„ ,,,,•' • �e 7:r, -+ =!- ..'"�:? r� .-' *q_a 'So �' 3.. '!:, i• a .�� Y -2 �-=.�!-F•. ;?" 4 »r�.,>r DECLARATION STATEMENT . I certify under penalty of perjury, up -e the laws of the State of California, the information provided on this form is true and correct. I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). h o . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. .,The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. , Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC ' Responsible Person's Name: CSLB License: Mark Hyde 1906115 HERS Provider Data Registry Information Sample Group # (if applicable): 251071 ❑ tested/verified dwelling 0 not-tested/verified dwelling in la HERS sample group HERS Rater Information Ca10ERTS Certificate # CC1-1798591659 HERS Rater Company Name: Desert H.E.R.S. Raters Responsible Rater's Name:` Responsible Rater's Signature: Michael Hyde - Michael Hyde Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/13/2011 CC2005602 Reg: 211-A0047412A-M2500001A-M25A Registration Date/Time: 2011/09/23 13:39:41 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance'Forms March 2010 ro