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08-1808 (MECH)4 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 @ n ate: 11/03/08 Application Number. "08-00001808-- Owner: Property Address: 47790 VIA JARDIN BILL & COOKIE I EN APN: 643-130-046-46 -26152 - 47790 VIA JARD, Application description: MECHANICAL LA QUINTA, CA 2 3 Property Zoning: LOW DENSITY RESIDENTIAL CITYOF OF Application valuation: 21396 FEDE NTA Contractor:�"�-- Applicant: Architect or Engineer: PALM DESERT AIR COND CO INC 42081 BEACON HILL PALM DESERT, CA 92211 (760)346-0677 Lic. Noo..:: 374937 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and 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: C2v0 Li nse No.: 374937 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is / 3 O O � issued. Date: ntractor. '� 1 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: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 238-0004656-07 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 of the L bor Code, I shall forthwith co with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by .,�C / any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars IS5001.: ate: �f Vv plicant (_) 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: FAI RE 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.). (_ 1 I, as owner of theproperty, am exclusively contracting with licensed contractors to construct the project (Sec. 7064 Rrisinr_ss and Prnfr_ssinns Cnde- The Cnntrantnrs' State I inensa I aw dnrs not annly to an nwnnr of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ( 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name:. Lender's Address: LQPERMIT APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the nnnditinns and rnstrintinns snt fnrth nn this annlication, 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 I certify that I have read this application and state that the above information is correct. I*agree to comply with ail city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the bove•mentioned property for inspectionrpur�ptose's- `J/v Date �' ! Si ure (Applicant or Agent)': �� ' ]/� � r• Application Number . . . . . 08-00001808 .. Permit MECHANICAL Additional desc . Permit Fee 51.00 Plan Check Fee 12.75 Issue Date . . . .. Valuation . . . 0 Expiration Date 5/02/09 - ,� Qty Unit Charge Per Extension, BASE ,FEE 15.00 2.00 9.0000 EA MECH FURNACE' <=100K 18.00 2.00 9.0000•EA MECH B/C <=3HP/100K BTU 18.00 Special- Notes and Comments REPLACE (2) EXISTING 3.5 -TON SYSTEMS. WITH (2) 3.5 TON 13.00 SEER SYSTEMS. Fee summary Charged Paid ,Credited Due Permit Fee Total 51.00 00 .00 51.00 Plan Check Total 12.75 .00 .00 12.75 Grand Total 63.75 _ .00 .00 63.75 LQPERMIT - " Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT. Project Title: BILL & COOKIE BENGEN ' Date: 10/30/08 © CaICERTS 2005 ,xx; :zEnforcenient•A enc .Use>Onl :� r•° Project Address: Y• 47-790 VIA JARDIN, Climate Zone: 15 9611ding Pei•md # I, mike € R „x �: ` I'°� ,•� f4k Documentation Author: Kimberly Garcia w Telephone: 619-579-5540 Plan Check DateCt Xk w. Company Name: Palm Desert Air Conditioning & Heating Company, Field Check Date IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only alteration is made to an existing home Use one form for each system being altered. This is system # 2 of 2 systems atered 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 ❑p Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to nex line. 3 17 An outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determir--d. Continue to next line. 4 ❑D 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 gptiM duct system is also to be new or replaced. Coitinue 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 ❑ This system is in Climate Zone 1, 3, 4, 5, 6, 7, or 8. No duct sealing is required. Go to Section 2. 8 ❑ This system has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Sectbn 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 furnace will be installed in lieu of duct sealing and TXV if aD licable . 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 AUD EER 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 AMU EER 12 condenser will be installed with TXVi2CA) 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 AMU EER 12 condenser will be installed with TXV(RrA) ; AND an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 15 ❑� 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 ❑ The system being altered is a package unit. No TXV(RCA) is required. Go to Section 3. _ 17 ❑ e •� 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 ❑ This system is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3. 19 ❑ This system is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required. Go to Section 3.. 20 ❑ hiss stem is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) is required. Go tc Section 3. 21 El This 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 22 O If line 15 is checked, HERS verification is required for Duct Sealing. 23 10 If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification is required for TXV(RCA). 24 ❑ 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 Sectiom 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 R4.2 ` Section 6 - see next page version u3--iu-ub This form can only be used on projects being verified by CaICERTS certified raters. 3 Page 1 of 2 %ww.calcerts.com , t Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1R -ALT Project Title: , BILL & COOKIE BENGEN Date: 10/30/08 i © CaICERTS20 05 IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only alteration is made U an existing home Use one form for each system being altered. 1, This,is system # 2 of 2 systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipment must match typefiocation and meet or exceed efficiencies/R-values. 28 Configuration: 0 Split system ❑ Package Unit 29 ❑ Air Handler mGas furnace, AFUE: aQy ❑Heatpump FAU ❑Hydronic FAU ❑Other _ - 30 0 Heat Exchan er 31 0 Outdoor Condensing Unit ®AIC, ❑Heatpump Efficien SEER/HSPF: 13.011 / N/A- 1EER if re d : 32 0 Cooling or heating coil ®AIC ❑Heatpump, ❑Hydronic 33 ❑ Ducts Location: Length (ft): JR -value:,' All mandatory measures'apply to any altered component. See MF -1R - ALT firm. 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 h as 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 Author . Name: Name: Kimberly Garcia Address: Company Name: Palm Desert Air Conditioning & I -dating Company City/State/Zip: ` Address: 42-081 Beacon Hill Phone: ` City/State/Zip: Palm Desert, CA 92211 Phone: (760)34&0677 . Signature:- Signature - Enforcement Agency (Building Department) Notes/Comm ts: 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 close permit. Copies to home owner, enforcement ac,ency, HERS rater. CF -4R -ALT: by HERS rater. Required to close permit. Copies to home owner, enforcement agency, irstaller. The CF -4R forms for a sample.group shall not be released until all testing and verification is completed and passed for the entre group. version ua-i u-uo This form can only be used on projects being verified by CaICERTS certified raters. rage z of z www.calcerts.com Bin.# r City of La Quinta ' Building 8L Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760)1777-7012 Building Permit Application and Tracking Sheet Permit # 1� Project Address: 47-790 VIA JARDIN Owner's Name: BILL & COOKIE BENGE.N A. P. Number: Address: 47-790 VIA JARDIN Legal Description: Contractor: Palm Desert Air Conditioning & Heating Company City, ST, Zip: LA QUINTA, CA 92253 .�?;F? viii':':'i:•:'�':':i::•i:•?i:?':':S' i:':::::: :?: Telephone: 619-579-5540 Address: 42081 Beacon Hill Project Description: city, ST, Zip: Palm Desert, CA 92211 LACE 2 EXISTING 3.5 TQN._ p 760 346-0677> Telephone: ( ) :iF,.�:G:tii'1.2L4k.:�:G i::+i:::i:i:;'•..}uiiiii'y ::.:.:.:::.:.....::..:..:.:::>>;:;;:.: <; SYSTEMS WITH 2 3.5 TON 13.00 State Lic. # : 374937 City Lic. #; 100886 SEER SYSTEMS . Arch., Engr., Designer: Address:, City., ST, Zip: Telephone: ",>::::::::::.:•>:.;:, ;:::;,.�;,.,.:<:•>:•:. p �>.s'�;:s:<:>:::z:>:.:;.>:�:;r;>:•<•<:>:::M<:•.>,� State Lic. #: : ``ss:s<:«?:s ::;«:;;<; <'v ; ;:: Construction Type: Occupancy: Project type (circle one): New Add' Alter Repair Demo Name of Contact Person: Kimberly Garcia Sq. Ft.: # Stories: # Units: a Telephone # of Contact Person: (760) 346-0677 Estimated Value of Project: $21,396.00 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cates.. 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 Perm& Fees Ca1CjERTS Page 1 of 12 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF -4R eati 47-790 Via Jardin Master Bedrooms - La Ouinta, CA 92253 Contractor Name /Palm Desert / i ense No.ng / 374937 Project Address 09-00001808 Contractor Contact Telephone Permit Number Pa an VI men 760-777-1724 115965 HE 5 ater I Telephone sample Group Number �i November 24, 2008 CC14-1798456544 Date Certificate Number Certifying Signature Firm. Air Experts Air Conditioning HERS Provider: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 CaICERTSO 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 ❑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 ested 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 retums In lieu of ducts). New systems where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used In combination with cloth backed rubber adhesive duct tape to seal leaks at duct connections. f•nCr17T• MMINIMUM REQUIREMENTS FOR DUCT LCA"Uc Kr"Ju%-I &%p ....+•-•. -- -•---_ _ ___ - NEW CONSTRUCTION Measured Duct Pressurization Test Results (CFM @ 25 Pa) Values N/A 1 2 Fan Flow: Calculated (Nominal '••_ . Cooling ' _• Heating) or'-...,' Measured Not Tested Enter Total Fan Flow in CFM: N/A N/A 3 ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow In CFM from CF -6R: Pre -Test of Existing Duct System Prior to Not Tested 4 Duct System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System Not Tested 5 for Duct System Alteration and/or Equipment Change -Out. Enter Reduction In Leakage for Altered Duct System Not Tested 6 [Line 4 - Line 5] - (Only if Applicable) 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 / Line 2 )]: Not Tested ❑ Pass ❑ Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pass If Leakage Percentage < 15% [ 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 ❑ Fail Pass If Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )] Not Tested ElPass El Fall 11 and Verification by Smoke Test and Visual Inspection 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail Pass if One of Lines #9 through #12 pass ❑ Pass LJ Fall caICERTs Page 2 of 12 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 8) CF -411 47-790 Via 3ardin- Master Bedrooms - La Ouinta, CA 92253 Palm Desert A/C - Heating / 374937 Project Address Contractor Name / License No. 08-00001808 Contractor Contact Telephone Permit Number PWW Van VI men 760-777-1724 115965 HfRJ Rater Telephone Sample Group Number v� ' v November 24, 2008 CC14-1798456544 Certifying Signature Date Certificate Number Firm: Air Experts Air Conditioning HERS Provider:Ca10ERTS, 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 CalCERTSO registry in accordance with the Title 24 & Title 20 of the CCR. CaICERTS@ is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was ❑Tested Q 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 dia nostic tested compliance requirements as checked on this form. The Installer has provided a copy of the CF -6R (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 shall be verified. HVAC System 'F C1 Pass ❑Fail f , f Ca10ERTS Page 3 of 12 CERTIFICATE OF FIELD VERIFICATION S DIAGNOSTIC TESTING (Page 1 of 8) CF -4R 47-790 Via Jardin-Living & Bedrooms - La Quinta, CA 92253 Palm mractr Name / Desert erase eating / 374937 Project Address 08-00001808 Contractor Contact Telephone Permit Number P Van Vlymen 760-777-1724 115965 H R Rater Telephone Sample Group Number l November 24, 2008 CC14-1798456543 C rtiiying Signature Date Certi lcate Number Firm: Air Experts Air Conditioning HERS Provider:CaICERTS, Ina P� _La Quinta / CA / 92247 ---Street_Address�_P_O_B.ox9_4--.---- _..._._. _......_ .-.----•-- �Y�a.._�_ Copies to: Homeowner HERS Provider and Building Department --This CF -4R been-registered-with-t-he-ERT-€F�TS,@-Fegistr-y-in-accordance-with the iitle_24.8�TitLe.20�f h_esCR. CaICERTSO is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was ❑Tested 9 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 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 (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 drawbands are used In combination with cloth backed rubber adhesive duct tape to seal leaks at dud connections. MINIMUM REQUIREMENTS FOR VOLA LCARlnuc ncvva..+.........-•• •-- -- - ------ NEW CONSTRUCTION Measured Dud Pressurization Test Results (CFM @ 25 Pa) Values N/A 1 EnterTested beakege Flow in 2 Fan Flow: Calculated (Nominal '•: Cooling -_•' Heating) or •_•' Measured Not Tested Enter Total Fan Flow In CFM: N/A N/A 3 ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow In CFM from CF -6R: Pre -Test of Existing Dud System Prior to Not Tested 4 Dud System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow In CFM: Final Test of New Dud System or Altered Dud System Not Tested 5 for Dud System Alteration and/or Equipment Change -Out. Enter Reduction in Leakage for Altered Dud System Not Tested 6 [Une 4 - Line 5] - (Only If Applicable) 7 Enter Tested Leakage Flow In CFM to Outside (Only if Applicable) Not Tested 8 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 System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: if Leakage Percentage < 15% [ 100 x ( Line 5 / Line 2 )]: Not Tested ❑ Pass ❑ Fail Pass If Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: Not Tested Pass ❑Fail Pass If Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )J Not Tested ❑ Pass El Pass r12Pass and Verification by Smoke Test and Visual Inspection Pass If Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fall Pass if One of Lines #9 through #12 pass ❑ Pass ❑ Fail Ca10ERTS Page 4 of 12 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 8) CIF-411' 47-790 Via 3ardin-Living & Bedrooms - La Quinta, CA 92253 Palm Desert A/C Contras Name / license Noing / 374937 Project Address 08-00001808 Contractor Contact Telephone Permit Number ` papi, Van VI men 760-777-1724 115965 H 5 ater. Telephone Sample Group Number v\ J J November 24, 200- CC14-1798456543 C certifying Signature Date Certificate Number Firm: Air Experts Air Conditioning HERS FrovIder:CalCERTS, 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 CaICERTSO 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 ❑T'ested © 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 di a nostic tested compliance requirements as checked on this form. The installer has provided a copy of the CF-611 (Installadon Certificate). HERMOSTATIC EXPANSION VALVE (;;—M): Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed on the system and installation of the specific equipment shall be verified. HVAC System TXV ❑ Pass ❑ Fall • Y cni,% i i cnei i 1 cnnAc t t co<a 1 1 C 1 /1 Z/7nnU