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12-0513 (MECH)1 14 . 44 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO'.4 FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING. & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT D G 5/08/12 ' Application Number: 512 000Or Owner. Property Address: 47815- VIA- JARDIN MIKE MCSWEENEY . APN- I 643-130-033-33 -26152 - 47815 VIA JARDIN Application description: MECHANICAL i LA QUINTA, CA 92253�� 08 Zo)2 Property Zoning: LOW DENSITY RESIDENTIAL C! Application valuation: 22874 FNCFtAQU11�] 1 AAI�EDEP P. Contractor: t Applicant: Architect or Engineer: GENERAL AIR CONDITIONING 31170 RESERVE DRIVE ' > THOUSAND PALMS, CA 92276 Pipe(760)343-7488 Lic. No.: 686310 -------------- ---- 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 Profess' als 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 lass: C20 License_ -No.: -68.6310 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Co ctor: 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 OL/IER-BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty o perjury that 1 am exempt from the Contractor's, State License Law for the Carrier ZENITH INS CO Policy Number 'Z071741501 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 forwhichthis 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 Labor Code, 1 s all to comply with those provisions. _ that he or she is exempt therefrom.andthe basis for the alleged exemption. Any violation of Section 7031.5 by c,,/ -..y_ •• .. any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate:/ (2 licant: . • (_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and /jp'/ the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILU EFi TO SE E 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 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.). 5. APPLICANT ACKNOWLEDGEMENT (_) 1, 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 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: a 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 4 CONSTRUCTION LENDING AGENCY - permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correc% 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, and hereby authorize representatives �• _ of this county to enter up n the above-mentioned property for inspectio oses. Lender's Name: q ' - D e! ignature (Applicant or Agent): Lender's Address: LQPERMIT Application Number .. 12-00000513 Permit . . MECHANICAL Additionaldesc .. .. Permit Fee 66.00 Plan Check Fee 16.50 Issue Date . . . Valuation 0 Expiration Date 11/04/12 Qty Unit Charge Per. Extension BASE FEE 15.00 '2.00. 9.0000 EA MECH,FURNACE <=100K J 18.0.0 2.00 16.5000 EA MECH B/C >3-15HP/>100K.-500KBTU 33.00 ----------"---------- Special Notes and Comments HVAC CHANGE -OUT. INSTALL (2) 3.5 TON - SPLIT SYSTEMS. 2010 CODES. Other Fees . . . . . . .. BLDG. STDS ADMIN (SB1413) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 66.00 .00 .00 66.00 Plan Check Total 16.50 .00 .00 16.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 83.50 .00 .00 83.'50 LQPERMIT - - - - CaICERTS - CF -1R Registration Page 1 "of 1 Public Home Danielle Garcia logged in [Logout] (Home] • CONGRATULATIONS . Secure Home a Your CF -1R -ALT -HVAC Registration is complete! About Us You may want to print this page for your records. 47815 VIA JARDIN (SYS 1) Training Site Address:La Quinta, CA 92253 CEC Registration: 212-A0022705A-00000000-0000 Rater pirectory, CF -1R -ALT -HVAC: CLICK HERE TO DOWNLOAD ` ._..... _........................................-..............._....____._....�__._...__.__....._...._........................_...................___.."__.__........................................_.__....................... _.__............. .................................... _.................. Forms' Assigned Company: HARRISON ENTERPRISES INC Membership Benefits Do you know your HERS Rater? If you do, you may want to send this CF -1R to them. Events CaICERTS Rater ID: I �x• OR Industry Partners My Rater Quick Select: I -Select From List w Every CaICERTS rater has a license number. News If you need to find the rater by name Click HfREI to search our dip-ectory. ,;,• •SEND CF -1 RTO HERS RATERS To register for our monthly newsletter, [CLICK HERE] to do another please click here. r Copyright Ccs 2010 CaICERTS, Inc. All rights reserved. Revised: January 11, 2C 10 ! [Terms and Conditions] [Privacy Statement] [Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787) Fax: 916-985-3402 Contact Us a BBB r y Y x i •4' • �_.r i. ' 'S• ' 3 �� fir- t� r . ji . • '•. ♦. �,� I .� �V '��. M t ♦ •r Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterati Alterations Reg: 212-A0022705A-00000000-0000 Registration Date/Time: 2012/05/06 15:25:07 HERS Prodder: CalCERTS, Inc. 2008 Residential Compliance Forms '.e ! July 2010 . Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 47815 VIA JARDIN (SYS 1) La Quinta, CA 92253 .• City of La Quinta May E, 2012 Equipment Type1 ' List Minimum Efficiency2 Duct insulation requirement Conditioned Floor Area Thermostat ❑ Package Unit ® Furnace,- ® Indoor Coil ® AFUE 78% ® SEER 1 3.0 ❑ COP ❑ HSPF ❑ R 6 CZ 10-13 r i. ) - Served by system ® Setiack If not already y present, must be ® Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) ` 1341 sf installed) ❑ Other • - " 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -ALT -WAC -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 -6R 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)iMECH-25-HERS ' ,replaced CF -4R forms: MECH-21 and,(for split systems) MECH-25 • Condenser Coil and /or oil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems). MECH-25-HERS . �. • Furnace C fi-.4R forms:'MECH-21 and (for split systems) MECH-25 ' .r For Split Systems: Duct leakage;<k15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from duct leakage testing;if: p 1:"Duct systemri vas documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned'space, or r 3. Existing dud systems are constructed, insulated or sealed with asbestos ❑'4. The not be Ducted`(ie.•Ductless Mmi Split System) (Also•NExempt,fro Refriger t4C arge)' �system�will ❑ 2. NeWWVAC System Requited Forms � `gr -.� • Cut in(or Changeout with" ducts ;(all .a x " a r r=.- r , CF 6R forms. MECH-04, MECHc20 HERS, and (for split systems) MECH-22 I -ERS, and new new *3 i ducting all new MECH 5'HERS forms: t �� '•-" e ufi rnent CF 4R MECH 20 and (for split systems). MECH=22, and,MECH 25 Par —, For Split Systems. -Duct leakage < 6 percent, RC„ CCAS 350 CFM/ton; FWD, TMAH, STMS, and either HSPP or'PSPP. For.Packaged Units: Duct leakage <'6.percenf ❑ 3. New, Ducts— with/or.without f Required Forms: ` • Includes replacing or installing P 9 9 all'' new •. ' 'ducting and/or outdoor.condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25 HERS and/or indoor coil and/or furnace: No or some CF -4R forms`. MECH-20 and (for split systems) MECH-:5. , equipment changed. For Split Systems: Dud 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_-21-HERS' linear feet of duct in unconditioned space. CF -4R forms: MECH-21 ' For split system or packaged units: Dud 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 i•ientified on this Certificate of Compliance. - - • t • I certify that the energy features and performance specifications for the design identified on this Certificate of Compl ante 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 oermit application. Name: Danielle Garcia • Signature: Danielle Garcia Company: HARRISON ENTERPRISES INC Date: [May 6, 2012 . Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 CF-iR-ALT-.HVAC CaICERTS - CF -1R Registration Page .1 of 1 ' Public Home' Danielle Garcia logged in [Logout]. [Home] CONGRATULATIONS Secure Home Your CF -IR -ALT -HVAC Registration is complete! About Us You may want to print this page for your records. Training Site Address: 47815 VIA JARDIN (SYS 2) La Quinta, CA 92253 CEC Registration: 212-A0022706A-00000000-0000 Rater Directory CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD. ........................... .__ ._ ._._........_....-----...... _....................... _.......... .__.......... _.._._......... _..-.............. —....... ........................................... _.......... ----................................. Forms Assigned Company: HARRISON ENTERPRISES INC • Do you know your HERS Rater? Membership Benefits If you do, you may want to send this CF -1R to them. Events 'CaICERTS Rater ID: OR Industry Partners My Rater Quick Select: LSelect From List Every CaICERTS rater has a license number. News If you need to find the rater by name [Click HERE] to search our directory. SEND CF -1R70 HERS,RATER, To register for our monthly newsletter, [CLICK HERE] to do another please click here. Copyright 2010 CaICERTS, Inc. All rights reserved. Revised: January 11, 2000 (Terms and Conditions) (Privacy Statement] (Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Toll Free: 877 -HERS -11811, (877-437-7787) Fax: 916-985-3402 Contact Us 866(00(60 T 1. ..Thnt ' Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 47815 VIA JARDIN (SYS 2) La Quinta, CA 92253 City of La Quinta May 6, 2012 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® Indoor Coil ® AFUE 78% ® SEER 13.0 ❑ COP —[3 ❑ HSPF R 6 (CZ 10-13) ❑ R 8 Served by system 1400 sf ® Set�ack If not already present, must be ® Condensing Unit [IEER ❑ Resistance (CZ 14-15) installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R -ALT -HVAC foreach 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-H=RS . Furnace CF -4R forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage! < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from duct leakage testing if: ❑ !'.'Duct,system was documented to have been previously sealed and confirmed through HERS verfication, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or p 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. Thersystem will not be Ducted` (ie Ductless Mini-Split-5ystern) (Also Exempt from; Refrigerant Charge) ❑ 2. New HVAC System Required, Forms.' . Cut in'`orC,hangeout with new ducts:" (all new " I r CF 6R forms MECH-04, MECH-20 HERS, and (for split systems) MECHg22 HERS, and dudin9 all new MECH-25 HERS Y J CFS R forms 4 in (for split systems) MECH=22, and •MECH-25 equipment) 14 ` ;MECZO, _ _ 350: CFM/ton .FWD, TMAH; SIMS, and.either'HSPP'onPSPP. - — For Split Systems: Duct leakage, < 6 percent; ;RC; CCA >- �'TMAH,., For Packaged Units: Duct leakage: >< 6 percent` ❑ 3.,New-Duc . with/or withoLit Required Forms: Replacement ; . Includes replacing or installing All new ducting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for splill systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design dentified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compiance 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 ocher applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Danielle Garcia Signature: Danielle Garcia Company: HARRISON ENTERPRISES INC Date: May 6, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 212-A0022706A-00000000-0000 2008 Residential Compliance Forms Registration Date/Time: 2012/05/06 15:25:57 HERS Prcvider: CalCERTS, Inc. July 2010 f Work Order IIIIIIIIIIIIIIIIIII GENERAL AIR CONDITIONING Job No: 132534 www.callthegeneral.com 31170 RESERVE DR t THOUSAND PALMS CA 92276 760-343-7488 FAX: 760-343-7494 LIC# 686310 Service At: Customer # 114897 Bill To: Customer #'114897. Rating: MCSWEENEY, MIKE 760-775-1785 HOME MCSWEENEY, MIKE 760-775-1785 HOME 47815 VIA JARDIN L 47815 VIA JARDIN LA QUINTA CA 92253 LA QUINTA CA 92253 Type: RES Source: TV ABC Open Balance: Zone: 3 LQ Map: Payment Method: MASTER CARD Subdivision: LAKE LA QUINTA Credit Limit: Skill: Tax: RIV Installation Customer Directions Instructions BRIAN SOLD (2) XC21 COMPLETE UPFLOW IN ATTIC 3.5 TON $22874.00 $2000.00 LNX REBATE $1015.00 IID REBATE INSTALL DATE OF 5/10 PER AMBER Work Sugg Work Done - •i Call Info r Job Info . Call No.: 132534 Booked by: -Anne Job No.: 132534. Taken: 5/4/f2'5:18 PM Type: GASAC A Booked Date: 5/10/12 Class:. REPLACEMENT Taken by: Anne Scheduled: 5/10/12 ,7:OOAM Sched by: AMBER Type: GASAC Cust PO: Pri Level: 5 Ld Src: TECHM SalesPerson: BRIANW Eq Age: LS Ref: Contact: Equipment: Assignments Employee TaskCode Scheduled Time JULIOC 7:00:00 AM JUANR 7:00:00 AM CARRIE 7:00:00 AM Equipment Warranties Type Sys Mfg Model # Serial # Age Type Parts Ends Labor Ends MINI FUJ AOU24RLXFW .KTN000624 1 IYR LAB ' 04h9/2042_ Filters: Loc: 2 YR PARTS 04/19/2013 Size: 2 TON ` SYR COMP 04/19/2017 MINI FUJ ASU24RLF KTA000292 l 1 1 Y LAB 04/19/2012 Filters: Loc: ; 2 YR PARTS 04/19/2013 Size: 2 TON 5YR COMP 04/19/2017, Service History 1 Call # Date Tech Type Status Bal'. Due Job # 131086' 131086 05/04/2012 JEFFH MAINT Instructions: (10-12) COLL FOR NEW SP3 MONTHLY (CLIENT HAS MONTHLY APPL ALREADY) $26.59, COOLING MAINT. Work Done: COMPLETED 3 A/C MAINTENANCE. COLLECTED SP3 Work Sugg: 2 UNITS 16 YRS,OLD (1) UNIT IS 1 YRS. DUAL RUN CAPACITOR, RUN CAPCITOR. COMPRESSOR SAVERS, BLOWER CLEANING, DUCT CLEANING , Call # Date Tech Type Status Bal. Due Job # 132507 132507 05/04/2012 BRIANW EST Instructions: LTO JEFF EST NEW SYSTEM HAS 2 UNITS 16YRS OLD HUSBAND IS ILL AND ON OXYGEN VERY INTERESTED IN FILTRATION SCH 5/4 3-4PM Bin 0# City Of %a Quin ---�--- Bu11d1ng &r Safety Divlslon Permit #�`� P.O. Box 1504, 78.495 Calle 7amplco ��' La Qulnra, Ca 92253 - (760) 777-7012 Building Pe. rml Application and Tracking Sleet I J a (d lEP Project Address: 1411 Q 15 Us"M . Owner's Name: M I ve M c5w e en(' A. P. Number: Address: q 1l 1 Ej V U A c� q Legal Description: City, ST, Zip: L�, 223 Contractor: Telephone: Plan Check Deposit Address: 3 Y City, ST, Zip:'—�. Project Description: 10 a �j t. �V� C S S Gh (� U fi. '. �) Telephone: S U y f , State Lic. #: 3 City Lic. #; lod {o Plan Check Balance. Title 24 Calcs. Arch., Engr., Designer: Plans picked up CiinstrueNon Address: Flood plain plan Plans resubmitted Mechanical Telephoner Y Construction Type: Occupancy: ' f ••,s � ,. yp : State Lic. #: ,yh p>oject type circle one): New Add'n Alter Repair Demo -7 Name of Contact Person: �p Sq. Ft.: 214 # Stories: # Units: Telephone # of Contact Person: -7&0 3'1-6 % 4 ?80 Estimated Value of Project: Z 2 APPLMANT• nn IUnT. WmTe ncu nu► vuin i uim f/ Submittal Pian Sets. Req Id' Recd TRACICIIVG Plan Check submitted PERMIT FEES Item Amount Structural Caics. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up CiinstrueNon Flood plain plan Plans resubmitted Mechanical Grading plan 2"" Review, ready for corrections4ssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up. S.M.I. H.O.A. Approval Plans resubmitted Grading IN 7rd Revtew,.ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr. Date of permit Issue School. Fees Total Permit Fees . • � G SUS 1 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: 47815 VIA JARDIN.. (SYS 1), La Quinta CA 92253 (System Enforcement Agency: Permit 4umber: 1) City of La Quinta 12-513 ❑ Outside air (OA) ductsrfoe Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during`duct leakage testing. CFIOA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASH.RAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing �: .. ,r -•zip ,� , r:. p ❑ All supply -and return register boots trust tie sealledito,the drywall'if, smoke testis utilized for. mpliance. -,appliestoduct leakage .compliance option 3 (leakagereduction by: 60%)"'and option 4 (:fix a 1 -accessible - leaks) described above `* w ❑ New duct Installations cannot utilizeFbuilding,cavities asplenurnsoraplatfi5rm`returns (n^lieuaof ducts i ,? , b' ¥e useedrr, " ncoma,aw�at'.i.on+wew ihi `clot$h°6ackedrubbeadhes:Plveucta' pe to seal❑Mastic axb Pabin" leaks at all new duct connections DECLARATION STATEMENTI,j< z . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is -rue and correct. , . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by tre person(s) , responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) a )proved by the ` enforcement agency. - Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC , Responsible Person's Name: CSLB License: Danielle Garcia 686310 ' HERS Provider Data Registry Information Sample Group # (if applicable): 311592 ❑ tested/verified dwelling not-tested/verified dwelling in. a HERS sample group , HERS Rater Information CalCERTS Certificate # CCI -1798653040 HERS Rater Company Name: - The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Ezequiel Moreno Ezequiel Moreno Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/21/2012 , CC2605795 Reg: 212-A0022705A-M2100001A-M21A Registration Date/Time: 2012/06/29 03:16:40 HERS Provider: Ca10ERTS, Inc. - r 2008 Residential Compliance Forms March 2010 r - _ T r' Reg: 212-A0022705A-M2100001A-M21A Registration Date/Time: 2012/06/29 03:16:40 HERS Provider: Ca10ERTS, Inc. - r 2008 Residential Compliance Forms March 2010 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 ::ID 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 Hole1. s in Supply and Return Plenums of Air Handier' { System Name or Identification/Tag System Location or Area Serv STMS'. Sensor ongthe• Evaporator°Coil �.,-..,, - --< System Nam -6 tjdentification/Tag a ,ft ed x 1 ❑ Yes ❑ No •labeled 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and according to Figure in Section RA3.2.2.2.2.. 2, ''❑ Yes [3 -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` ` Enter Pass or Fail ✓ ❑ Pass ✓ ❑ STMS'. Sensor ongthe• Evaporator°Coil �.,-..,, - --< System Nam -6 tjdentification/Tag a ,ft 3 x The sensor is factory installed, or field installed according to manufacturer's The sensor is factory instaled,'ortfieldin ❑ stalled'according to'manufa_turers spfications, or is installed by methods/specifications approved by he Executive71 µ ❑ Yes X;Yes 54edNo Director. 4 4 ❑;Yes ..- Zjr ❑ No The sensor wire is terminated„with a"standard mint plug suitable for onnection to a digital d ter The plug accessible: to the install an The sensor wire is terminated with a standard mini plug suitable for connection to a ther"" sensor mini is ngtteclinic ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and theHERSsdater.witFiout:changing the'airflow`through the`conderser coil - 5 f,¥ �'❑ Yeses ''❑ N” o . When attached to a digital thermometer, the sensor provides an indication of the . ❑ Yes • : , - When attached to a digital thermometer, the sensor provides an ind'cation of the saturation temperature of the coil. Yes to 3; .4j and 5 is a pass. Enter N/A if STMS are not applicable. Otherwise ente`r>Pass or: Fail ✓ ❑ N/A ✓ ` ❑ Pass ✓ • ❑ Fail STMS - Sensor on the Condensertoil System Name or Identification/Tag I I I - x 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 ❑ Yes ❑ No When attached to a digital thermometer, the sensor provides an ind'cation of the saturation temperature of the coil. 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 r x RCtj: L1G-HVVLG NDH-C1L7VVUUlN-CIL7H fKe9i5LraLlon uaLe/lime: LUlL/Ub/.&V Ub:1t$:t)U HERS vrovicler: Ca10ERTS, Inc. ' 2008 Residential Compliance Forms t March•2010 - r y RCtj: L1G-HVVLG NDH-C1L7VVUUlN-CIL7H fKe9i5LraLlon uaLe/lime: LUlL/Ub/.&V Ub:1t$:t)U HERS vrovicler: Ca10ERTS, Inc. ' 2008 Residential Compliance Forms t March•2010 Standard Charge Measurement Procedure for use if outdoor air d g ( ry-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. • 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 System Name or Identification/Tag '"s��"3 (must be re -calibrated monthly) •, Date of Th�germocoupleCalibration System Location or Area Served 4 `tM.}•...tie:.".. -... Outdoor Unit Serial # ,s» ._ ... R E�, ` _ ' Outdoor Unit Make ' temperature (T) return`, db r S Outdoor Unit Model ; r Nominal Cooling Capacity Btu/hr Date of Verification Calibration`of Diagnostic Instruments Date of Refrigerant Gauge Calibration`' '"s��"3 (must be re -calibrated monthly) •, Date of Th�germocoupleCalibration ,(must be re -calibrated monthly) '• 4 `tM.}•...tie:.".. -... measurea•upmperaturesµtyry y Yy IX ;�•. ,sem ,.# •��,�,%rs S stem Name or Identification ag P,r '"s��"3 �• ,Y „ , v 4 Supply (evaporator leaving) "air dry=bulb.- temperature'(Tsupply db) .. I° .A ,s» ._ ... R E�, ` _ ^ F" , F ;�•. ,sem ,.# •��,�,%rs S stem Name or Identification ag P,r '"s��"3 �• ,Y „ , 4 Supply (evaporator leaving) "air dry=bulb.- temperature'(Tsupply db) .. I° .A ,s» ._ ... R E�, ` _ ^ F" , F Return (evaporator entering) air dry bulb temperature (T) return`, db r S Return (evaporator entering) air wet=bulb temperature (Treturn, wb) .-'• Evaporator saturation temperature F,' (Tevaporator, sat) r t. Condensor saturation temperature , (Tcondensor, sat) Suction line temperature (Tsuction) Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db). r � , e , t 7 d, t A Reg: 212-A0022705A-M2500001A-M25A Registration Date/Time: 2012/06/29 03:18:50 HERS Provider: Ca10ERTS,'Inc. 2008 Residential Compliance Forms ` ' March 2010, INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 47815 VIA JARDIN (SYS 1), La Quinta CA 92253 City of La Quinta 12-513 Minimum Airflow Requirement 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. F . 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 , Noie: 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 airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Req)uirre•ment (CFM) Nominal Cooling Capacity tY (ton) X 300 (cfm/ton) System Name or Identification/Tag ''� Calculated Minimum Airflow-ORequirement (CFM) u e -T Measured Airflow using RyA�3:3� i6cbdbres (CFM) SAIF ` r : X Nsn pg' 4t g { 8`. i ^ ... fir•` X q . R W. Passes°if measured airflow:is-greater;than or`equal to the calculated minimum airflow'requirement,xy - 'Enter Pass or Fail Superheat, Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering deuice systems System Name or Identification/Tag " ' 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 -6°F and +6°F Enter Pass or Fail , , Reg: 212-A0022705A-M2500001A-M25A Registration Date/Time: 2012/06/29.03:18:50 HERS,Provider: Ca10ERTS,rInc. 2008 Residential Compliance Forms March -2010 ,r LJ , , Reg: 212-A0022705A-M2500001A-M25A Registration Date/Time: 2012/06/29.03:18:50 HERS,Provider: Ca10ERTS,rInc. 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: •47815 VIA )ARDIN.(SYS 1), La Quinta CA 92253 City of La Quinta 12-513 �t ti eq aired to be used .. ` Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is r 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 } '' Enter allowable superheat range from' manufacturer's'specifications (or use range ;. Calculate difference: , Actual Subcooling - Target Subcooling g' `� System passes if difference is between L -4°F and +4°F I Al * Enter Pass or Fail - Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be jsed for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag - Calculate: Actual Superheat,,= a Tsuction - Tevaporator, saE', Enter allowable superheat range from' manufacturer's'specifications (or use range ;. between'3°F and 260F if.manufacture?s,. specification is not available).G , System passes -if actual superheat is"withinfthe allowable superheat range? .*� g' `� Enter Pass or. Fail c . ,,,s F"''i� - �•-^'x- .. �' '%� -z#Rx ," d '"(.'.`"s fe ♦ cwt ,az'. _' . '• - -•'fir. h x�EyE� � &•'t. �r A .. ' { .• � � - � • - � ,. _ r tN � ; � ..'.e ,• 4 •i •♦ ` - ,r '.t,. a r' .• � rt' . j r y L 'r Vii_. !' , ,� r i. . �_ • c tie 77.3 Reg: 212-A0022705A-M2500001A-M25A Registration Date/Time:'2012/06/29 03:18:50 HERS Pnvider: Ca10ERTS,�Inc. 2008 Residential Compliance'Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 47815 VIA JARDIN (SYS 1), La Quinta CA 92253 City of La Quinta 12-513 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 Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 311592 System meets all refrigerant charge and airflow not-tested/verified dwelling in la HERS sample group requirements. HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail Eiequiel Moreno Responsible Rater's Certification Number w/ this HERS Provider: Date Signed_: 6/28/2012 ' CC2005795 ' � , �` �� j,, � � res ;�s�` �,,�� ,�1. �f"<�� , <„--•xj `r �. .. NE44.f 1 � , DECLARATION STATEMENT . I certify under penalty of perjury, under:the laws of the State of California, the information provided on this form is true and correct. .- I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -IR) approved by the local enforcement agency. r . 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 -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: CSLB License`. Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 311592 ❑ tested/verified dwelling not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798653040 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Ezequiel Moreno r "' Eiequiel Moreno Responsible Rater's Certification Number w/ this HERS Provider: Date Signed_: 6/28/2012 ' CC2005795 Reg: 212-A0022705A-M2500001A-M25A 'Registration Date/Time: 201240.6/29 03:18:50 HERS PnDvider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 4 a h a Reg: 212-A0022705A-M2500001A-M25A 'Registration Date/Time: 201240.6/29 03:18:50 HERS PnDvider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 4 0 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test- Existing Duct System (Page 1 of 2) Site Address: 47815 VIA JARDIN (SYS 2), La Quinta CA 92253 (System Enforcement Agency: Permit Vumber: 1) City of La Quinta 12-513, Enter the Duct.System Name or Identification/Tag: Enter the Duct System Location or Area Served: Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for space conditioning systems and duct systems.' tions and additions in existing dwellings to Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing dud system Select one compliance method from the following four choices. 0 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 f 0 4 F Fix all accessible leaks using smoke and HERS rater verify Note:.(One ofOptipps j;.2, or 3 mutt, be:attempted,oefor,.e.utilizing Option 4;°), Determine nominal Fan,F,-low using one ofithe following three calculation methods ystem method: Size of in Tons x 400 = - ✓ 0 Cooling scondenser .� �� -iw^y ✓ 0 7ixk Heatingsgystem method:i,2 Output Capacity m;Thousands u nr CFM ✓ 0 Measured system airflow using`RA3 3 airflowftest procedures; Option Vusedthen ,--,'w* , F F :: � , �. , �, •, , 1 Allowed leakage Fan Flow x 0 15'- CFM } Actual ActualyLeakag^C'- _ CFMz0.. -...,....«.�.>.. k Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then:,, ;. �: 2 Allowed leakage'Fan-'Flow `x 0.10 = CFM Actual Leakage to outside;,=_ CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 3 used then: Initial leakage prior to start of work = CFM Final leakage after sealing all accessible leaks using smoke test = CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction CFM ((Leakage reduction _ / Initial leakage _) x 100% _ % Reduction t , Pass if % Reduction > 60% Pass 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: 212-A0022706A-M2100001A-M21A Registration Date/Time: 2012/06/29 03:16:40 HERS Provider: Ca10ERTS,"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: 47815 VIA ]ARDIN (SYS 2), La Quinta CA 92253 (System Enforcement Agency:, Permit Number: 1) City of La Quinta s CERTIFICATE OF FIELD VERIFICATION'& DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: 47815 VIA ]ARDIN (SYS 2), La Quinta CA 92253 (System Enforcement Agency:, Permit Number: 1) City of La Quinta 12-513 - r ' HARRISON ENTERPRISES INC Responsible Person's Name:CSLB 77686310 A ,f ❑ 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 requi6ed o meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position• during duct leakage testing. ❑'All supply and return register boots mu§t tie sealed to the dryw6Wif smoke test is utlllzed�for�compliance c — applies,duct leakage compliance option 3 (leakage reduction by`60%)and op low 4 (fix all accessible ti leaks) desc i6ed above ` ;" r ^� _ i x ❑ New duct rnstallatlolis cannot utilize bulldin"g cavities aspl.enumso� platform returns inrlleuof`ducts 1 ❑ Mastic and draw bands must be used;in combination,wlth cloth'backed,rubber adhesive tluct tape,to seal - leaks at all new duct connections", �. DECLARATION STATEMENT] r -k . I certify under penalty of perjury, under the laws'of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who, performed the verification services identified and reported on this certificate (responsible rater). t . 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 -111) 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 -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name:CSLB 77686310 License: Danielle Garcia HERS Provider Data Registry Information Sample Group # (if applicable): 311592 ❑ tested/verified dwelling not-tested/verified dwelling in; la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798653041 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: Ezequiel Moreno Ezequiel Moreno Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/21/2012 CC2005795 r x- I , Reg: 212-A0022706A-M2100001A-M21A 'Registration Date/Time: 2012/06/29 03:16:40 HERS Provider: Ca10ERTS, Inc: Y„ 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC.TESTING CF*-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page i of 5) Site Address: Enforcement Agency: Permit Number: 47815 VIA JARDIN (SYS 2), La Quinta CA 92253 City of La Quinta 12-513 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 :ID is utilized for compliance. { As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additl7nal form(s) for s 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 1 ❑Yes ❑ Noy p 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. ';,'' Enter Pass or Faill ✓ ❑ Pass ✓ ❑ Fail f. STMS Sensor onthe Evaporator Coil System:Nameor.ldentification/Tag• _ `^ - 4 I 3 ❑ Yes ` p No , The sensor is factory mstalled,-orifield'installed acc1.ording to'manufa turers specifications, or is,installed by methods/specifications approved by he Executive ❑ Yes: �s=fir specifications, or is installed by methods/specifications approved by the Executive Director: f +• t i. 4 ❑Yes ❑.No The sensor wire is to€minted.rwith a,`standard minia plug suitable for onnection"to a digital thermometer The `plug is`accessible ngttechmcian The sensor wire is terminated with a standard mini plug suitable for connection to a sensor mini to the install ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and tlie;HERS rater without changing the airflow.:throGgh the°c6ndemer coil 5 f' ❑Yes .. p No When attached to a digital thermometer, the sensor provides an indication of the ❑ Yes ,g When attached to a digital thermometer, the sensor provides an indication of the [saturation saturation temperature of the coil. ' Yes to 3;,4,-and,5 is a pass. Enter N/A:if STMS are not applicable. Otherwise enterPass o" Fail V ❑ N/A ✓ ❑ Pass ✓ ❑ Fail STMS - Sensor on the Condenser'Coil f System Name or Identification/Tag 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 ❑ 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 ✓ ® N/A ✓ [3 Pass ✓ [3 Fail applicable. Otherwise enter Pass or Fail . i !_ Reg: 212-A0022706A-M2500001A-M25A Registration Date/Time: 2012_/06/29 03:18:50 HERS Provider: CalCERTS,-Inc.- 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement- Procedure -:(Page 2 of 5) Site Address: Enforcement Agency:, Permit Number: 47815 VIA JARDIN (SYS 2), La Quinta CA 92253 1 City of La Quinta 12-513 aaanaaru a{narge measurement rruVeuure krur use it ouzuuur air ury-ouio is aoove *o -r) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Refermce Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an adcitional 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, Space Conditioning Systems System Name or Identification/Tag `.0 (must be re -calibrated monthly) a• aaanaaru a{narge measurement rruVeuure krur use it ouzuuur air ury-ouio is aoove *o -r) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Refermce Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an adcitional 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, Space Conditioning Systems System Name or Identification/Tag � Y' (must be re -calibrated monthly) a• dvx.. • l%' .�"`^ �X �, „» T.4 System Location or Area Served �: �r Outdoor Unit Serial # 5 rs a° l? i c:.., . Outdoor Unit Make I Outdoor Unit Model r' Return (evaporator entering) air,wet=bulb Nominal Cooling Capacity Btu/hr Evaporator saturation temperature =- aIN Date of Verification ��"'''` " • • Condensor saturation temperature Calibratio'n'of Diagnostic Instruments I Date of Refrigerant Gauge Calibration � Y' (must be re -calibrated monthly) `3- #� t.,, Date of Ther iocouple�Calibration rc dvx.. • l%' .�"`^ �X �, „» T.4 YP 'sa' F,(must be re-calibrated:monthl " dF Measured -Tem eraturee` °F ""-,.f 'W" .; P (k. ) . «• �Iz System NameorIdentificng , $•,'.ri"; �: �r Supply'(evaporator leaving);air dry-bulb-,,' < tem erature Tsupply,%db ( ) rs a° l? i c:.., . Return•(eyaporator;entering) air dry, -bulb I temperature (Treturn, db! r r' Return (evaporator entering) air,wet=bulb temperature (Treturn, wb) Evaporator saturation temperature =- aIN (Tevaporator, sat) ' Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) ' Liquid Line Temperature (T • liquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db) } Reg: 212-A0022706A-M2500001A-M25A 'Registration Date/Time: 2012/06/29 03:18:50 HERS Pr-�vider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 1 r . - INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 47815 VIA JARDIN (SYS 2), La Quinta CA 92253 City of La Quinta 12-513 Minimum Airflow Requirement Temperature Split Method Calculations for determining�Minimum Airflow Requirement for Refrigerant Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System Name or Identification/Tag Calculate: Actual Superheat = Calculate: Actual Temperature Split = Treturn, db - , Tsuction - Tevaporator, sat Tsu I db Target Superheat from Table RA3.2-2 using Target Temperature Split from Table RA3.2-3 using Treturn, wb and Tcondenser, db Treturn, wb and Treturn, db Calculate difference: Calculate difference: Actual Temperature Split - - Actual Superheat - Target Superheat = ' Target Temperature Split = System passes if difference is between -6°F and Passes if difference is between -4°F and +4°F or, +6°F upon remeasurement, if between -4°F and -100°F Enter Pass or Fail Enter Pass or Fail 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 airflow 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 (cfm/ton) System,Nemetor Identification/Tag j • r s.� rte";. Minimum AirfloWRequirement 11ACalculated Measured Ai#flow u/ssting,RA3}:3 procedures (GFM) � Passes if measdred airfloWl's- greater:'1than or`equal j- - to the calculated minimum airflow requirement. Enter`Pass or Fail Charge i rl ' 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 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 -6°F and +6°F Enter Pass or Fail Reg: 212-A0022706A-M2500001A-M25A Registration Date/Time: 2012/06/29 03:18:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms 'March 2010' Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is req fired 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 r Calculate difference: Actual Subcooling - Target Subcooling = passesif difference is between E-VFd +40F t } r• r �� Enter Pass or Fail l�" r� `'" •—: .: . ,. Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be 'jsed for thermostatic expansion valve (TXV) and'electronic expansion valve (EXV) systems. System Name or Identification/Tag'. Calculate: Actual Superheat:= Tsuction -Tevaporator, sat` Enter allowable superheat range from r manufacturer's specifications (or uselrange between 3°F and 260F if manufacturers specification is not available)_ System passes;if,,actual superheat is'lwithin�fhe+ allowablesuperheat range . � v or t } r• r �� : ^tEnter P s Fail l�" r� `'" •—: .: . ,. Reg: 212-A0022706A-M2500001A-M25A Registration Date/Time: 2012/06/29 03:18:50_ HERS Pr-)vider: CalCERTS,•Inc. , 2008 Residential Compliance Forms March. 2010 ` INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: - 47815 VIA JARDIN (SYS 2), La Quinta CA 92253 City of La Quinta 12-513 + 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 Danielle Garcia 686310 HERS Provider Data Registry Information Sample Group # (if applicable): 311592 ' System meets all refrigerant charge and airflow 0 not-tested/verified dwelling. in • a HERS sample group requirements. HERS Rater Company Name: The Energuy CA LLC , - Responsible Rater's Signature: Enter Pass or Fail .. Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/28/2012 CC2005795 5, mix r!. s•y '. _ e •N . ,z»y r'Alr. - J ��'� y .� i�+'k'k� yt�-•";*'- ,T � , � fie.`':. �+�"`� "kF v,ri. .. ,:;: '_'�ta +�x�y " 9 �.#��" �".; . w T�.• i t. ..DECLARATION STATEMENT" . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is tue and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). " + " . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on Geis certificate (the W installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified ' on the Certificate(s) of Compliance (CF -111) 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 enforcement agency. �+ Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's.Name:CSLB License:. I Danielle Garcia 686310 HERS Provider Data Registry Information Sample Group # (if applicable): 311592 ' ❑tested/verified dwelling 0 not-tested/verified dwelling. in • a HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798653041 HERS Rater Company Name: The Energuy CA LLC , Responsible Rater's Name: Responsible Rater's Signature: Ezequiel Moreno - Ezequiel Moreno - Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 6/28/2012 CC2005795 r e r ..r . r i Reg: 212-A0022706A-M2500001A-M25A Registration Date/Time: 2012/06/29 03:18:50 HERS Provider: CalCERTS,"Inc. 2008 Residential Compliance Forms ' March 2010 K INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of.2) Site Address: 47815 VIA ]ARDIN (SYS 1), La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) I ' City of La Quinta 12-513: y u e t Efficiency Duct - , r Space Conditioning Systems Heating Equipment e, F u e Efficiency Duct - c^ Equip` Type - n Efficiency Location Equip k'• ' ARI # of (AFUE, (attic, ` Coofng Cooling Type CEC Certified Mfr Name and Model Number ARI # of etc.)1, 3 crawl- Duct R -value Heating Heating (package- CEC Certified Mfr. Name Reference Identical (>=CF -1R space, Duct Loaj Capacity heat pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split Lennox ..'s"; ftiT?.'� .•+^.+. Furnace S12800H090XV60C 4358915 1 80 AFUE Attic 88 70 kBtu .♦y� j�,'S� •.R'�' t •ff�.,,�.,. 'N""TZ �g': 'rji`t,�jZy�G}:':;, Rte- ,11.�.;y«.i 'v,z y�,.�� .,�,''bT"h `a'?' :.�,,i x,,,,.r r2:m, .ASlet�,. 3.yj F u e Efficiency Duct a c^ Equip` Type : r a' K n n r s Location (attic, Cooling Equipment t • �a r 1. If project is new construction see Footnotes to Standards Table 151-8 and Table 151-C for duct ceiling alternative , compliance. a _L 2. ARI Reference Number can be"found by entering the equipment model number at , http://www. aridirectory. orglarilac. php # r 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -IR forn. 4. When CF -IR is reference it is also applicable to the CF -1 R, 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. 0 §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or. ACCA. 2 §150(1): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). Y 2 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets x minimum requirements of Table 150'-B and includes a vapor retardant or is enclosed entirEly in conditioned space. - -.•�� Reg: 212-A0022705A-M0400001A-0000 Registration Date/Time: 2012/05/24 19:04:53 HERS Pnvider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 u e Efficiency Duct Equip` Type : r a' K n n (SEER and EER) Location (attic, (p"ackage k'• ' ARI # of 1, 3 crawl- Coofng Cooling :heat pump) _ CEC 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 A/C Lennox Xe21 048 r j� �' 1^. 18 SEER"4 13 EERY X48_; ►d c2y, _ 49 kBtu ..'s"; ftiT?.'� .•+^.+. •� t ir:�' M�.iFr .♦y� j�,'S� •.R'�' t •ff�.,,�.,. 'N""TZ �g': 'rji`t,�jZy�G}:':;, Rte- ,11.�.;y«.i 'v,z y�,.�� .,�,''bT"h `a'?' :.�,,i x,,,,.r r2:m, .ASlet�,. 3.yj t • �a r 1. If project is new construction see Footnotes to Standards Table 151-8 and Table 151-C for duct ceiling alternative , compliance. a _L 2. ARI Reference Number can be"found by entering the equipment model number at , http://www. aridirectory. orglarilac. php # r 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -IR forn. 4. When CF -IR is reference it is also applicable to the CF -1 R, 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. 0 §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or. ACCA. 2 §150(1): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). Y 2 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets x minimum requirements of Table 150'-B and includes a vapor retardant or is enclosed entirEly in conditioned space. - -.•�� Reg: 212-A0022705A-M0400001A-0000 Registration Date/Time: 2012/05/24 19:04:53 HERS Pnvider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: 47815 VIA JARDIN (SYS 1), La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1)^ City of La Quinta 12-513 Ducts and Fans §150(m): Duct and Fans 2 1: All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and; return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and © 1. Building cavities, support platforms for air handlers, and plenums defined or constru=ted 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. 2 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. 0 7. Exhaust fan systems have back draft or automatic dampers. 8. Gravity ventilating.systems serving conditioned space have either automatic or read ly accessible, manually operated dampers: 0 Protection of Ins6lation.'Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or' painted with�a coating that;is.water retardant and provides shielding from solar radiation that can cause Aegradation of the material:; 010. Flexible.ducts cannot have porous inner cores a TR � � t It f' , Ftp,• � _ - n` ►fes* `rys.. DECCLARATION STATEMENT • I certify. under.penalty of perjury, under the laws of the State of California, the information provided on this form is tree and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an autiorized 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 aproved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies Oe specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. • I will ensure that 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 applicabl: inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder .provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 5/10/2012 Position With Company (Title): Reg: 212-A0022705A-M0400001A-0000 Registration Date/Time: 2012/05/24 19:04:53 HERS Prcvider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 47815 VIA ]ARDIN (SYS 1), La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-513 Enter the Duct System Name or Identification/Tag: System i . Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the } dwelling. This installation certificate is required for compliance for alterations and additions, in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. 1. Measured leakage less than;l5% of fan flow ❑ 2. Measured leakage to outside{less than 10% of Fan Flow conduct ❑ 3. Reduce leakage by;.60% and smoke and fix all leaks ❑ 4s',Fix all acc ssi61 eaks using smoke and HERS rater verify f Note: `(,One of Options_1, 2 or 3 must be;attempted�before-utilizing tion •4..) Determine nominal',Fan Flow using one of the°following three calculation methods: A, f -.�' % "h " YC f S { / M( h iia r°j• i•A•' �.. 3 ✓ 0 Cooling system method: Size of condenser in Tons �_f x 400° 1600 CFM-,' ✓ f6 u/hr ❑ Heating system method 21:7 x Output Capacity)n Thousands of = CFM rf ifs a' * *:"' � s� ✓ ❑ Measure`d� system Sirflow,usmgT.RA3 3"airflow test procedures CFM `„ _° ,aw 0ption}14u§ed';then � • � : �^ � � 1 Allowed leakage Fan'Airflow.. 1600' x 0:15 240 CFM Actual.. Leakage. -I' 7 CFM ' r` ,h Pass if Actual Leakage is less than Allowed leakage B Pass Fail Option 2 used then N� a k.: 2 Allowb&leakage Fan Airflow x 0.10 = _ CFM Actual Leakage to outside.= t + CFM a-=- .;Pass if Actual leakage to outside is less than Allowed leakage Pass Fail Option 3 used then: ". Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ -Final leakage = Leakage reduction CFM ' _ ((Leakage reduction_/ Initial leakages x 100% _' % Reduction Pass if % Reduction > 600/6 ❑ Pass Fail Option 4 used then: , 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have•been repaired using smoke Pass ❑Fail - Y Reg: 212-A0022705A-M2100001A-0000 Registration_ Date/Time: 2012/05/24 19:05:26 HERS Provider: CalCERTS, Inc. , 2008 Residential Compliance Forms 0h'201 INSTALLATION CERTIFICATE CF-6R-14ECH-2I-HERS , Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: 47815 VIA ]ARDIN (SYS 1), La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-513 :• - ? To 0 Outside air (OA)ducts for Central; Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during ductaeakage testing. CFI OAAucts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHk'AE Standard 62.2, and close when OA ventilation is not r--quired, may be configured to the closed positi6n'during duct leakage testing. 0 All supplytand`retrurn register boots must be�seal�ed=to therdrydwalljf,sm,oke test is utilized far compliance - applies to_duct'leaka`ge compliance o¢ptlon"3 (leakage reduction by60%o)�and o,`ptlon 4"(fix`ail accessible c leaks) described above1 !, 0 New ciucthinstallation71117 nnot utilizetbuilding cavities as plenums, or platf-oirml�r" urns in lieu of ducts; "di • 's.,, .t . a :-�_ �'tv.+ t "' .r „ro+• .. e f fr�dF•.c••.r+.'+,. > t ' �'"'�Wr �•�'.'?�' 0 Mastic hind 66' '-n ds°must be used In combination with:cloth+backed "rubber:..adhesive duct tape to seal leaks`at all new• duct connections DECLARATION'STATEMENT ' . I certify under penalty of perjury, under.the laws of the State of,California, the information provided on this form is t-ue and correct. • I am eligible under Division -3-61%. the Business and Professions Code to accept responsibility for construction, or an au_horized " representative of the person responsiblefor construction (responsible person). . I certify that the installed features,"materials, components, or manufactured devices identified on this certificate (the installation) y 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 chected by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. , . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies :he specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation I -ave 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 applicab:e inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder r provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data , registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 5/10/2012 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0022705A-M21000o1A-0000 Registration Date/Time: 2012/05/24 19:05:26 HERS Provider: Ca10ERTS,_Inc. r 2008'Residential Compliance Forms- March 2010 f y Reg: 212-A0022705A-M21000o1A-0000 Registration Date/Time: 2012/05/24 19:05:26 HERS Provider: Ca10ERTS,_Inc. r 2008'Residential Compliance Forms- March 2010 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 c3mpliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized " a for compliance. v As many as 4 systems in the dwelling can be documented for compliance using this form: Attach an addiEonal forms) 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 chard 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 1 , System Location or Area Served Whole House I . - 1 0 Yes 311 Nod j 5/16 inch (8 mm) access hole upstream of evaporative coil in the re' =urn plenum and labeled according to Figure in Section RA3.2.2.2.2. 0. p 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 a_nd.2 is. a, pass.G' ' Enter Pass or Faill ✓ 0 Pass ✓ ❑ Fail �$ O;Yes �,.;p Noy The sensor}wire is terminatedrwith a standard mimlplug suitable for,connectonAtora digital thermometer The sensor�mmi plug;is,acc`essible tob e_,instaling�te6 an,> 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 c3mpliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized " a for compliance. v As many as 4 systems in the dwelling can be documented for compliance using this form: Attach an addiEonal forms) 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 chard 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 1 , System Location or Area Served Whole House I . - 1 0 Yes 311 Nod j 5/16 inch (8 mm) access hole upstream of evaporative coil in the re' =urn plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 p 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 a_nd.2 is. a, pass.G' ' Enter Pass or Faill ✓ 0 Pass ✓ ❑ Fail ,x4. ? ' STMS `-, Sensor,,on�the Evaporator Coil.�,�u �,,•, 5 _ ,� �}< , ' System"Nameror Iiientification/Tag'System ;L ;k—, '; I- _' • 1, i 'f, : 3 .4s*' . ❑ Yies. ,- ❑.,No The sensor is factory,installed,'tor�fieldistalled according to manufacturers, specifications, or is installed by meth' "s/"-" approved by the Executive < • ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director:, -w" 4 �$ O;Yes �,.;p Noy The sensor}wire is terminatedrwith a standard mimlplug suitable for,connectonAtora digital thermometer The sensor�mmi plug;is,acc`essible tob e_,instaling�te6 an,> 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 install ng technician and the HERS! riter. without changing the airflow,through the conderser coil` 5 .r ❑ 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 applicabler�Qtherwise enter Pass or.Fail .',. ,/ m N/A ✓ ' ❑Pass ✓ ❑Fail n .K' 4, STMS - Sensor on the Condenser'Coil \ System Name or Identification/Tag;':'; 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 install ng technician and the HERS rater without changing the airflow through the conder:ser coil • 8 ❑ Yes 1 ❑ 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 ', ✓ p N/A✓ ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail 4 Reg: 212-A0022705A-M2500001A-0000 Registration Date/Time: 2012/06/12 14:01:06 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August'2009 Reg: 212-A0022705A-M2500001A-0000 Registration Date/Time: 2012/06/12 14:01:06 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August'2009 i r u '� f`i f , ,../ . r c T• • f t fM�'• r T ' J . J ' 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 Refe.-ence Residential = Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an aoditional 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. Space Conditioning Systems • ' System Name or Identification/ Tag System i (must be re-calitrated monthly) i((1.� .. r �.tv:. 'M� 4:. x'.i ' System Location or Area Served Whole House 5/1/2012 4 -.t�tyJ' (must bel re-caht�rated monthly) .. Outdoor.Unit Serial # ' 5812A11568 « .,`'.,'","a' 4s G ,!6;; '', Outdoor Unit Make k Lennox - Outdoor Unit Model XC21-148 ' Nominal Cooling Capacity Btu/hr . 49000 , Return (evaporator entering) air wet bulb 60 temperature (Treturn, wb)� Date of Verification 5/10/2012 (Tevaporator, sat) ' Calibrati6Wo' f.•Dia4h6stic Instruments Date of Refrigerant Gauge Calibration 5/1/2012 (must be re-calitrated monthly) i((1.� .. r �.tv:. 'M� 4:. x'.i •.L..�.L_... - . . T y Date ofTher/rno}couple Calibration tFTri �1 5/1/2012 4 -.t�tyJ' (must bel re-caht�rated monthly) .. F)J}, 1 f Q• QST ! f� �;Y. �� 0 �•-1 of �� •.Yk. :�-..4 f 4� Measured ETemperatures.+( F)'.;; •;" i - y �M'' 4 �-:''`�.'.�, �.'' ;�' •�°'� =,� kis. ' �,: ��-�-;,, 1'": rte?` �'fR'.or• f" •,P System Name or Icleynytifiicaatiioh/�TFag, System l " 5 ,{� .:-- ;,.ir,,. 'C.^•�'•':• ,t y S i- r•� I �.�' :f '4: A"C V. Supply`(evaporator"leaving)iairdry-bulb +�'"".r,•'",56" n41 « .,`'.,'","a' 4s G ,!6;; '', temperatugdrs plY; db) z. � r y q. :, i - Return (evaporator entering) air dry bulb ' 76 temperature.(Treturn' db)._ . `_r , Return (evaporator entering) air wet bulb 60 temperature (Treturn, wb)� Evaporator saturation temperature+- 43 (Tevaporator, sat) ' Condensor saturation temperature 101 (Tcondensor, sat) Suction line temperature (Tsuction) 48 ' Liquid Line Temperature (Tliquid) 97 Condenser (entering) air dry-bulb 127 temperature (Tcondenser, db) Reg: 212-A0022705A-M2500001A-0000 Registration,Date/Time: 2012/06/12 14:01:06_ HERS P:=ovider: CalCERTS,, Inc. , 2008 Residential Compliance Forms August 2009.,. f INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency:. Permit Number: 47815 VIA'JARDIN (SYS 1), La Quinta CA 92253 1 City of La Quinti 12-513 Minimum Airflow Requirement Temperature Split Method'Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 _ Calculate: Actual Temperature Split = Treturn, 20.00 , db - Tsupply, db r Target Temperature Split from Table RA3.2-3 22, using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - _2 . Target Temperature Split = Passes if difference is between -3°F and +3°F or, upon remeasurement, if between -3°F and PASS -100°F ` Enter Pass or Fail 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 airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in th? table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm; ton) System Name or'Identification/Tag. System Calculated Min;imum AirflowRequirement (CFM)' hl�znl •b _ .i'ri It ~l .+.s MeasuredtAirflow using RA3:3 procedures�(CFM) Passes if n'i asured airflow.is greater than'or --t •',R ,_ ; `i ' - equal to the calculated minimum airflow: requirement.•~� :r Enter, or Fail Superheat Charge Methodtalc"ulations for Refrigerant Charge Verification. This procedure is req•jired to be used for fixed orifice metering device •systems System Name or Identification/T667.' System 1 Calculate: Actual Superheat = ` , Tsuction - Tevaporator, sat r Target Superheat from Table RA3.2-2 using ,i 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 ` t.k ' Reg: 212-A0022705A-M2500001A-0000 Registration Date/Time: 2012/06/12 14:01:06 HERS Prc•vider: CalCERTS, Inc. 2008 Residential Compliance Forms f August 2009 rr s ` • ,i t.k ' Reg: 212-A0022705A-M2500001A-0000 Registration Date/Time: 2012/06/12 14:01:06 HERS Prc•vider: CalCERTS, Inc. 2008 Residential Compliance Forms f August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure .(Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 47815 VIA ]ARDIN (SYS 1), La Quinta CA 92253 City of La Quinta 12-513 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 L ,. Calculate: Actual Subcooling = 4.0 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer .. 4 Calculate difference: 0 Actual Subcooling - Target Subcooling = 3 System passes if difference is between "IT � �� ` { N�k -3°F and +3°F PASS �5 Enter Pass or Fail ♦ ♦ � 1 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 L ,. Calculate: Actual Superheats 5.0 Tsuction - Tevaporator, sat"- Enter allowable superheat range from ' manufacturer's'specif'ications (or use range between 4°F and 25°F if manufacturers ' 3-26 specification is not available)«t ,. M Systemxpasses.if actual'superheat is-withindther allowabe' :sr rh4.eatrngeuR;a "IT � �� ` { N�k bpR Enter Pass orFai � �5 r L Reg: 212-A0022705A-M2500001A-0000 Registration Date/Time:'2012/06/12 14:01:06 HERS Provider: Ca10ERTS, Inc., 2008 Residential Compliance Forms AugusC2009 L Reg: 212-A0022705A-M2500001A-0000 Registration Date/Time:'2012/06/12 14:01:06 HERS Provider: Ca10ERTS, Inc., 2008 Residential Compliance Forms AugusC2009 M r 1 ♦ ♦ � 1 Reg: 212-A0022705A-M2500001A-0000 Registration Date/Time:'2012/06/12 14:01:06 HERS Provider: Ca10ERTS, Inc., 2008 Residential Compliance Forms AugusC2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 47815 VIA JARDIN (SYS 1), La Quinta CA 92253 City .of La Quinta 12-513 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 CSLB License: 686310 Date Signed: 5/10/2012 Position With Company (Title): System meets all refrigerant charge and airflow Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No requirements. PASS Enter Pass or Fail - � •:. `�•%,�M,, 6N" G.�" i«� Sri. ✓.�"''a. -. °"�"3_ � P-gf 7.r, � .�.e a . .it .. . ' n� `� . � "' � t, 'ty� J 1 �' Y , f+.� � h.ka Mrjy"/�'(M,.�.''•w.` .rw. .SunLl * - ' � 7.. . ik'} 'j t[v y�F'. '-�`y :.i Tb ' J^ I,w�•31r�.ea�^'b.r.'!+• ,.F ,. �i �4' f,, a };t-2"r'ilnOt "�'�""�'ve•,�{-�, 7: j t�� - E r a r r E r,.. 2•+11 - le ' �. T r �- • - DECLARATION' STATEMENT . I certify under penalty of,pelrjury, 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) f 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 checleed by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required correct°ve action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. r . 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 applicabL- inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data, registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia . CSLB License: 686310 Date Signed: 5/10/2012 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0022705A-M2500001A-0000 Registration Date/Time: 2012/06/12 14:01:06 HERS'Provider: Ca10ERTS,,,Inc., ` 2008 Residential Compliance Forms August 2009 Space Conditioning Systems Heating Equipment Equip Type (package- heat pump) INSTALLATION CERTIFICATE CF-6111-MECH-04 } Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Efficiency (AFUE, -etc.)1, 3 (>=CF -1R value)4 Site Address: 47815 VIA ]ARDIN (SYS 2), La Quinta CA 92253 (System Enforcement Agency: Permit Number. Heating' Capacity (kBtu/hr) Split Furnace 1) City of La Quinta 12-51? e Space Conditioning Systems Heating Equipment Equip Type (package- heat pump) ' A CEC Certified Mfr. Name and Model Number - j ARI .4 Reference Number2 # of Identical Systems Efficiency (AFUE, -etc.)1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value HeatFng Load (kBtu hr) Heating' Capacity (kBtu/hr) Split Furnace Lennox SL280OH09OXV60C ARI i .1 80 AFUE Attic 88 70 k8tu r CEC Certified Mfr. NameYf Y 1 Identical , (>=CF -SR space, Duct Load Capacity pump) and Model Number';' ;Y> Number2 Systems value)4 etc.) R -value (kBtu,hr) (kBtu/hr) Split Lennox a '�` �-• # 18`SEER+ "48= 2008 Residential Compliance Forms' August 2009 A/C I. ?1 i 13 EER' ; ,fy , Y 49 kBtu i'•S.�'.. rz Z4 Cooling Equipmentw� Equip Typed Y} ` s ^ t. 1 Efficiency (SEER Duct Location 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R forn. 4. When CF -IR is reference it is also applicable to the CF -1 R, CF -IR -AA or CF-1R=ALT (package Y ARI i # of and EER) 1, 3 (attic, crawl- CooL'ng Cooling r CEC Certified Mfr. NameYf Y 1 Equip Typed Y} ` s ^ t. 1 Efficiency (SEER Duct Location 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R forn. 4. When CF -IR is reference it is also applicable to the CF -1 R, CF -IR -AA or CF-1R=ALT (package ,, r f' ARI i # of and EER) 1, 3 (attic, crawl- CooL'ng Cooling ,. heat CEC Certified Mfr. NameYf Y Reference Identical , (>=CF -SR space, Duct Load Capacity pump) and Model Number';' ;Y> Number2 Systems value)4 etc.) R -value (kBtu,hr) (kBtu/hr) Split Lennox a '�` �-• # 18`SEER+ "48= 2008 Residential Compliance Forms' August 2009 A/C ;; -XC23 048 ' ?1 i 13 EER' ; ,fy , Y 49 kBtu i'•S.�'.. rz Z4 .� --------------- �!2. :P .- Fri`. "••+15{:7f1z z .M �yC ayrid ,�!�y„q'y`.^'!y'?y . Y. 7�,��,y.. ,1�aa-�l•.�_"if'+BP�` i'�rrw`:5. ,7 ��: Y' r `nly-�-` ..`" +ilG++•e.T'�'y ,aAa:^^.,. '•r•a• "•1' 65$•�P,�M7�' - T,r "F iS ...F'•(•f �.' I nt +3.�S . `�`. _F L i p X M%•"sY •ii'•"A .i Y_..f... 1: If project is new construction see Footnotes to Standards Table 151-8 and Table 151-C for duct ceiling alternative compliance. ';• �ri,,:: •2. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.orglarilae.pho# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R forn. 4. When CF -IR is reference it is also applicable to the CF -1 R, CF -IR -AA or CF-1R=ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM 2 §110-§113: HVAC equipment is certified by the California Energy Commission. .2 §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, orACCA. 0 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of ' §112(c)• . . , ' .0 §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.t 1 , r • 4 � ��, � • ./• .. . ' ,,r,4 � � • . +, M R y ice{ , ' . Reg: 212-A0022706A-M0400001A70000 Registration Date/Time: 2012/05/24 19:10:35 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms' August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: 47815 VIA JARDIN (SYS 2), La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-513 Ducts and Fans §150(m): Duct and Fans 0 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, tie combination of mastic and either mesh or tape shall be used; and 10 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. 0 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. 0 7. Exhaust fan systems have back draft or automatic dampers. 0 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. 0 Protection of Insulation.'Insulation shall be protected from damage, including that due to sunlight, -moisture;. equipment maintenance, and wind. Cellular foam insulation shall be protected as above or 'painted with-a,coating thatIs water retardant and provides shielding from solar radiation that can cause degradation of the material.', :0110. Flexible. ducts cannot have porous inner cores T,,,771 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 anneligible under Division3;of the Business and Professions Code to accept responsibility for construction, or an au-horized representative of the persoh.responsible for construction (responsible person). . I certify that the installed features;.materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies -.he specific requirements for the installation. I certify that the requirements detailed on the CF -IR that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made availaile with the building permit(s) issued for the building, and made available to the enforcement agency for all applicabe inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: 686310 Date Signed: 15/10/2012 Position With Company (Title): Reg: 212-A0022706A-M0400001A-0000 Registration Date/Time: 2012%05/24 19:10:35 HERS Pr-jvider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: 47815 VIA JARDIN (SYS 2)La Quinta CA 92253 (System Enforcement Agency: Permit Number: ,1) 1", .City of La Quinta 12-513 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House ti Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to' space conditioning systems and duct systems. ; Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, . use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. Duct Leakage Diagnostic Test - 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 leis than 10% of Fan Flow ❑ 3;; Reduce leakage by 60% and conduct smoke and fix all leaks 4;�Fix all accessible leaks using smoke. and HERS rater verify - Note :,(One of Op.tiohs 1,2 or 3 must be`attempted befo[e utilizing Option 4,)_ r Determine nominal-.FamFlow using 'oine of the'following three calculation methods: �x a i t X -'e a y is ) ✓ D Coolingrsystem method Size of condenser in Tons,rx 400. )` 1600 /CFMA. ✓ g system usan B u/hr ❑ Heats method: 21,J xOutput Capacity sty i s of = tCFM y " • k , f # ',WU r k $ : r�... +;. Ly`� "'t, • a .. '"",�,` r z^• y;,P ,+ fir' ✓ MeasuredMaystem airflow,usingrRA3 3'airflowttesr procedures CFM ' r , Option. 1 used:',then w - r N"', �„ .`'T'' ;:,a ,gin, leakage Fan'Airflow: 1600 F ,•, 1 ;Allowed Actual: Leakage,102 CFM es f, ` Pass if Actual Leakage is less than Allowed leakage 13 Pass Fail Option 2 used then , h W._'x 2 Allowed leakage F Airflo 0.10 = _ CFM Actual Leakage to outside•_= 1.-+' ' CFM ' .,Pass if Actual leakage to outside is less than Allowed leakage Pass Fail Option 3 used then: Initial leakage prior.to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = CFM 3 _ Initial leakage _ - Final leakage _ = Leakage reduction_CFM ' ((Leakage reduction _ / Initial leakage x 100% _ Reduction _ . Pass if % Reduction > 600/o Pass Fail Option 4 used then: . 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke Pass Fail Reg: 212-A0022706A-M2100001A-0000 Registration Date/Time: 2012/05/24 19:11:05 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms '' ,• March 2010 INSTALLATION CERTIFICATE _ CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: 47815 VIA )ARDIN (SYS 2), La Quinta CA 92253 (System Enforcement Agency: PermitlNumber: 1) City of La Quinta 12-51_ ' , .. . •r T } "r '. • • 1, ^` • • S= • , i :. ` -, � - r n• • ref •r.[ _ • ! 0 Outside air (OA)ducts for Central, Fan Integrated (CFI) ventilation, systems, shall not be sealed/taped off t� during duct leakage;':testing. CFI'OA;ducts that utilize controlled motorized dampers, that open only when CA 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. �`tp r`:f �. , 0 All upply and.Wturn register¢bootskmust be' sealed;to the drywall, If{smoke t l lizedAfir compliance — applles4o duct leakage compliance. option' 3 (leakage reductlon)by 60%),and optlonl4'�(fl ccessible leaks) described abo�Jle„` ��RTM > V� 0 New duct€Installations cannot itlllze,tiullding cavltles:as plfen,u�[ms or platform returns in 6f ducts,, 0 Mastic a,nd draw bands must be used rn combinationtwith:cloth;backed rubber adhesive dw_t tape to seal leaks at all neW dUCr.connections n DECLARATION STATEMENT t . 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 featuresi,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 aaproved 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 represertatives will also perform quality assurance checking of installations, including those approved as par of a sample group but not chec<ed by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and ! ' additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -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 Pave been meta, . 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 applicatle inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General -Contractor or Builder/Owner) HARRISON ENTERPRISES INC t Responsible Person's Name: Responsible Person's Signature_: Danielle Garcia Danielle Garcia CSLB License: 15/1/2012 Date Signed: Position With Company (Title): 686310 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable):. Control Program (TPQCP)?, ❑ Yes ❑ No . fir. _� • - � • - Reg: 212-A0022706A-M2100001A-0000. Registration Date/Time: 2012j05/24 19:11:05 HERS Provider: CalCERTS;-Inc.' 2008 Residential Compliance Forms 1 March 2010 Note: If installation of a Charge Indicator Display•(CID) is utilized as an alternative to refrigerant charge ferification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate cgmpliance with } the refrigerant charge verification requirement. TMAH and STMS are not required forcompliance, 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 chard 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 r System Name or Identification/Tag System i System Location or Area Served Whole House 1 [il 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 M Yes ❑`No l'[ 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. t Yes•to l and_2..is a pass. 40:.,, Enter Pass or Fail ✓ 0 Pass ✓ ❑ Fail •l .t r STMS =; Sensor on !I Evaporator Coil System�Name,?or Identification/Tag'' i ifs e�` Systein_i I tom, , 1 - ih ' h'+ 3 .71 °SPS' ❑,Yes ❑"Nod { iThe sensor:is factory" instaled`or�field,installed accordingao°manufacturers specifications; or installed, by methods/specifications approved by the Execufwe ❑ Yes • # r Dlreetor. 4 ❑,Yes -_ p No The sensor} ire is terminated with a standard`inimkplug suitable for connectidff tp sf{ digit al;;thermometer �Tfie sensor�mini p'lug�is, accessible. to bie instaIli %g�echnician. r Rd;the'HERS rater without changing the airflow through the conderser coil 5 . ❑Yes ❑ No .. The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes: to 3, 4;•and 5 isa"pass. Enter N/A'if`STMS are not V p N/A ✓ [3 Pass ✓ [3 Fail appl cable.?Otherwise enter Pass orxFail`:: 1 ❑ 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 S � The sensor is factory installed, or field installed according to manufa=turer's - 6 ❑ Yes • r , 4 r4 STMS - Sensor on the Condenser: Coil System Name or Identification/Tag.: ": ` System i The sensor is factory installed, or field installed according to manufa=turer's - 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive 4 Director. The seon nsor wire is terminated with a standard mini plug suitable for zonnectito a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the install ng technician and the HERS rater without changing the airflow through the conderser coil 8 ❑ Yes 1 ❑ 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 ✓ D N/A ❑Pass ✓ []Fail applicable. Otherwise enter Pass or Fail r' Reg: 212-A0022706A-M250000iA-0000 Registration Date/Time: 2012/06/12 14:04:17 HERS Prcvider: CalCERTS, Inc. 2008 Residential Compliance Forms s August 2009 • 4 r' Reg: 212-A0022706A-M250000iA-0000 Registration Date/Time: 2012/06/12 14:04:17 HERS Prcvider: CalCERTS, Inc. 2008 Residential Compliance Forms s August 2009 r.- • (must be re -calibrated monthly)' X fir•—'m' ": J System Location or Area Served ' £�` '8/1/2012 �� ,Trit - r , Outdoor Unit Serial # 5812A11559 Outdoor Unit Make Lennox Return (evaporator°entering) air dry-bulb-,'_ ` 80 Outdoor Unit Model .. r� XC21-048 s Nominal Cooling Capacity Btu/hr' Y_ 48000 ; Date of Verification;rte r 5/10/2012 Evaporator saturation temperature_ ..•'” 49 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 Refe-ence Residential' Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an adyitional form(s) for any additional systems in the dwelling as applicable. j • The system should be installed and charged in accordance with the manufacturer's specifications before starting this p.,ocedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. f. , • If outdoor air dry-bulb is SS°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems - r. i s. System Name or Identification/Tag System i Cali bration'of;Diagnostic Instruments Date of Refrigerant Gauge Calibration.,`s"!' (must be re -calibrated monthly)' X fir•—'m' ": J System Location or Area Served Whole House £�` '8/1/2012 �� ,Trit must bere-calibrated month) Y) r , Outdoor Unit Serial # 5812A11559 Outdoor Unit Make Lennox Return (evaporator°entering) air dry-bulb-,'_ ` 80 Outdoor Unit Model .. r� XC21-048 s Nominal Cooling Capacity Btu/hr' Y_ 48000 ; Date of Verification;rte r 5/10/2012 s. System Name or Identification/Tag System i Cali bration'of;Diagnostic Instruments Date of Refrigerant Gauge Calibration.,`s"!' s 5/1/2012 (must be re -calibrated monthly)' X fir•—'m' ": J '{,4i • . It 1)- .) t JE �' •e - Date of,Therrnocouple Calibration v,k � £�` '8/1/2012 �� ,Trit must bere-calibrated month) Y) r , �'�� `r F. s. System Name or Identification/Tag System i Cali bration'of;Diagnostic Instruments Date of Refrigerant Gauge Calibration.,`s"!' s 5/1/2012 (must be re -calibrated monthly)' X fir•—'m' ": J '{,4i • . It 1)- .) t JE �' •e - Date of,Therrnocouple Calibration v,k � £�` '8/1/2012 �� ,Trit must bere-calibrated month) Y) ; �'�� `r F. 4 Measured,TertiperaturesS °F ' M'f •r: �. +af�.:. ,iA' ••.."� $ ' ,� ��,d �' System Name or Identificatioktn/I_$Ild k It }`?'fw'y �'• .: ••� + - 4 ^ ..w.., " , • fir•—'m' ": J '{,4i • . It 1)- .) t JE �' •e - �Systeri�'1 � . FJ_ ;,.'' �' ?` _. AF jfj - S' -• (F t ny .F� Supplyi'(eJaporatorf�a�vin9)-air:br _=bulb •, a temperature,(TsupplY, •ter • 6 db)" Return (evaporator°entering) air dry-bulb-,'_ ` 80 temperature„(Treturn "db) I. r s Return (evaporator entering) air wet,bulb 61 temperature (Treturn, wb! x °s•. Evaporator saturation temperature_ ..•'” 49 (Tevaporator, sat) Condensor saturation temperature" , 102 (Tcondensor, sat) , Suction line temperature (Tsuction) J 54 Liquid Line Temperature (Tliquid) 97 Condenser (entering) air dry-bulb 95 temperature (Tcondenser; db) . s Reg: 212-A0022706A-M2500001A-0000 Registration.Date/Time: 2012/06/12 14:04:17 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 � 1 I INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 47815 VIA JARDIN (SYS 2), La Quinta CA 92253 1 City of La Quinta 1 12-513 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 • 1 Calculate: Actual Temperature Split = Treturn,20.00j. � c db - Tsu I db Target Temperature Split from Table RA3.2-3 . 2� , using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - -2 Target Temperature Split _ " Passes if difference is between -3°F and +3°F or, upon remeasurement, if between -3°F and PASS ^ -100°F ` Enter Pass or Fail 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 airflow is measured, the value must be equalgtoor greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (dm-fton) System Name or Identification/Tag r �r System 1~� ,r?r (� Calculated Minimum Airflow, Requirea ment (CFM) � .Fde� y � ,,, ,, ifrx�i =x w" .• -i,,' T �„d;•,,,r, � Measured+Airflow using RA3:3 procedures(CFM)• •ff� 41 Passes if measured'airfl'ow is'g"reate`rthan equal to the calculated minimum airflow G... Enter -Pass or Fail ! i for fixed orifice metering device'sysfems System Name or Identification/Tag System 1 • 1 Calculate: Actual Superheat = � c Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device'sysfems 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 r . ^ Enter Pass or Fail ` • .J T t1k t • 1 i Reg: 212-A0022706A-M2500001A-0000 Registration Date/Time:•2012/06/12 14:04:17 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance -Forms ? f August 2009 ' 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 ` .f i - Calculate: Actual. Subcooling = 5.0 , Tcondenser, sat - Tliquid , Target Subcoolingspecified by manufacturer- 4 ' Calculate difference: 1 Actual Subcooling - Target Subcooling = j', :,g"PAS' ~ System passes if difference is between -3°F and +3°F PASS t Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to- be: used for. _ Z System Name or Identification/Tag'- System 1 i - Calculate: Actual Superheat, Tsuction - Tevaporator, sats 5.0 , 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, Tsuction - Tevaporator, sats 5.0 , Enter allowable superheat range from,.-,.' , manufacturersspecifications(or.use,range between 4°F, and 250F if manufactufer 5 3-26 specification is not available) T System�passes,•ffactual'superheat is=wfthinithe�., allowable superheat -ran 4 j', :,g"PAS' ~ Enter Pass or,Fa�l ♦ '1 r •r�� i � ,� �'k.�. , �' s � 7,d. �� T f ifk � +�,r�'.,+�,�p""°'n � y� 'r °•'`�� °� . • i ywE.-.. .ii •3a r� Fc 4� i,.rr,�*?ya'r��"'y F,r r. I Y�'+ '";rf t� }""�" •+a y'S � : F �� :t _,. * tea': ',C (r` -i'"t` ' S i • 6, . r ^ , r , . , jj •+ a. . 1'] 1 r • b • ., .. •�t 1 •`t r _ i '"a ( .. - .'jay -, S.__ '� Reg: 212-A0022706A-M2500001A-0000 Registration Date/Time: 2012/06/12 14:04:17 HERS Provider: Ca10ERTS,.Inc. 2.008 Residential Compliance Forms August 2009• INSTALLATION CERTIFICATE CF-6R-NECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: ' Enforcement Agency: Permit Number: 47815 VIA ]ARDIN (SYS 2), La Quinta CA 92253 City of La Quinta 12-513 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum :ooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actionE were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 CSLB License: r 686310 Date Signed: 5/10/2012 Position With Company (Title): System meets all refrigerant charge and airflow Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No ' requirements. PASS Enter Pass or Fail _.� • SCJ _ I � e � ' , �' y Y t t 4 aJ 5= rte r}�":f� if4,_ •� .t,." R ".r ?f ..N. r .,�., DECLAt�=EMENT I certof.perrjury, untlerthe 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 Commiss on 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. 1 . I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific r , requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the ` buildingpermit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I r P C )- 9. 9 Y PP P understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) HARRISON ENTERPRISES INC Responsible Person's Name: Responsible Person's Signature: Danielle Garcia Danielle Garcia CSLB License: r 686310 Date Signed: 5/10/2012 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No ' Reg: 212-A0022706A-M2500001A-0000 .Registration Date/Time: 2012/06/12,14:04:17 HERS Prcvider: CalCERTS,. Inc. 2008 Residential Compliance Forms ` August 2009 .F a r, r Reg: 212-A0022706A-M2500001A-0000 .Registration Date/Time: 2012/06/12,14:04:17 HERS Prcvider: CalCERTS,. Inc. 2008 Residential Compliance Forms ` August 2009 HVAC Field. Data Sheet. Pg 1 of 2 Client Name Job # Date 10 Address L4 q '1 S \I i az In -vk 0 Ph # Technicians) Permit # Gauge/Thermocouple Calibration Date 4 -AG -A S41 Package I Some Ducts Only ( AR Ducts Only `` -- (Gude type of work) =p4 F4alpmeriiDatn ! Z01VE 1 ZOld .i. r.Z00.1 ZONE 4 System Location or Area Served ) o� S Y PJ2 >, ; : h Heating Equipment Mahe' - Heating Equipment Model 1 1 Set s d l o q x v c pG ARI Reference Number Heating EquipmentAFUE 5o ° o 10 Duct Location (attic, crawlspace, etc) Duct R -Value (if ducts were installed) Heating Load �Q Heating Equipment Output Capacity Condenser Make 404 -Oh UO Condenser Model X C 9,- O X. X ca 1- O Size in Tons SEER & EER 3 Cooling Load �i� Uv'U `� 000 Cooling Capacity 4,00-0 :A 'L'fi-20.& 21 Duct Tesdgg Dud leakage pretest result Duet Leakage Irmall Result <M M/Watopass (6%) E PasslFaU PassIFan PawlFaff � Dud Leakage Final Result <60 CFM/am to pass (15%) Pas IFA rassIFA FIFA Pass using 60% leakage reduction? Pass using smoke and visual inspection? MECH 22. or:AOM-2S to'oB- g- O l AL flOW A Pan.•fVatEDrnw . Measured Air Volume from Flow Grid or Hood . NEW DUCTS Target 3S0 CFMADn x Condenser Tons CnMGEOUT Target 300 CFM/ton x condenser Tons Measured air greater than Target? (YM Measured Pan Watt Draw Target 0.58 watts/measured CFM = Measured Watts less than Target? (YM Copyright® 2011 EDS EzmV Driven Solations, lac HVAC Field Data Sheet Pg 2 of 2 Client Name A C_S UJ QD i✓I 0 Job # 1 Date 5 ` k D Aa Aoy h7yn)&/ �i V,-05, r� +Oki ki MNar ZS Charge & Airflow Condenser Serial Number Supply air dry bulb temperature WWI QALANksd ZONE 2 SWAAMSSS 60 ZONE 3 ZONF 4 Return air dry bulb temperature 910 Return air wet bulb temperature Evaporator Saturation Temperature 3 Condenser Saturation Temperature p Suction Line Temperature R6p AL Liquid Line Temperature GP Suction Pressure Liquid Pressure 3aR3`zJ LAn Actual Airflow Temperature Split Target Temperature Split from Table RA323 Passes if difference is t 3' of Target Temp (Y/N) Actual Subcooling (t 4' of Target to pass) Target Subcooling from Mfr. Actual Superheat (3 to 26° to pass) }' Outside air dry bulb temperature 0S Mat 26,'WeBh-1n pa ghig below SS' Actual Line Set length (ft) Mfes Standard Line Set Length (ft) Length Difference = Correction Factor (ounces per foot) Target Correction Factor x length Difference System Charged to Target? (YIN) Other Data Minimum amps , S o5 Maximum amps IS,S Breaker size Compressor amps S l . Return Static Pressure Supply Static Pressure Supply Air Wet Bulb Temperature * • ALL APPLICABLE BOXES ON T IISFORMMUST BE COMPLETED FOR HACEJOR NOEKEPTIONS- • • CopyrW 0 2011 EDS Rangy DrWW So1M OM hm