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12-0649 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:12-0000"0"649"1 Property Address: 0—VIA MONTIGO APN: -643-120-058-252 -26152 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1 7680 4-4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: JEFF MASSNICK 47530 VIA MONTIGO LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/12/12 Contractor. Applicant: Architect or Engineer: HYDES 42949 MADIO STREF INDIO, CA 92201 q (760) 360-2202 //�� y f r PIP- Lic. No..: 90613,15 4 - - - - - - - - - - - - - - - - - - - - - - - - -.- -.- - - - - - 7_7 - -•- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . - - - - - - - - - - - LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION �`• . I hereby affirm under penalty of perjury that I am licensed under provisions,of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and, effect._ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C20 C36 Licpse-No.: 906 4 5 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. /. at ` Contractor: �I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor • Code, for, the performance of the work for which this permit is issued. My workers' compensation OWNER -BUILDER DECLARATION insurance carrievand policy number are: 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's. State License Law for the - Carrier NORGUARD INS Policy Number CEWC243358 - following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ .l certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the - person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that,. if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Secliun 7000) of Division 3 of the Business and Profesginns Code) or 3700 of the Labor Code, I shall f wittDcomply with provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by. ��� - any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (55001.: /Date:,.CL�� Applicant: �r,?".6' (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and • - the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that -the DOLLARS ($100,000) IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT 1 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a.permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_) I am exempt under Sec. B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City ` of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. Date: Owner: .2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or.cessation of work for 180 days will subject CONSTRUCTION LENDING AGENCY - permit to cancellation. hereby affirm under.penalty of perjury that there is a construction lending agencyforthe performance of the I certify that I have read this application and state that the above information is correct. 1 agree to comply with all work for which this permit is issued (Sec. 3097,. Civ. C.). city a d county ordinances and state laws relating to building construction, and hereby authorize representatives /ate. s co y to enter up o he above-mentioned property for inspection purposes. Lender's Name: .. e (Applicant or Agent)LendIer'sAddress: pP_ LQPERMIT / Application Number . . . . 12-00000649 ' Permit . . . MECHANICAL Additional desc . Permit Fee 40.50 Plan Check Fee 10.13 Issue Date Valuation 0 • Expiration Date 12/09/12 Qty, Unit Charge Per Extension BASE FEE 15.00 1.00. 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 SDeGjal Notes and Comments HVAC CHANGE-OUT: INSTALL NSW 5 ruiv ld SEER SYSTEM, FURNACE, CONDENSER, INDOOR COIL. 2010 CODES. m:------------------------------------------------------------------ ---------- Other Fees . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 40.50 .00 .00 40:50 Plan Check Total 10.13 .00 .00 10.13 Other Fee Total 1.00 .00 .00 1.00_. Grand Total. .51.63 .00 .00 51.63 LQPERMIT H Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 47-530 Via Montego La Quinta, CA 92253 City of La Quinta ]un 11, 2012 Duct insulation Conditioned Floor •' Equipment Typel List Minimum Efficiency2 requirement Area Thermostat i•'' ❑ Package Unit ; 0 Furnace . 0 Indoor Coil 0 AFUE 78% ® SEER 13.0 - ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) Served by system 01Setback - a If not already present, must be 0 Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) 2000 sf installed)' ❑ Other ` 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. „ x 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 -611 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 -1R and CF -6111 shall also be on site for final inspection. 0 1. HVAC Changeout Required Forms: . All HVAC Equipment y CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25=HERS r -, replaced CF -4R forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or . Indoor Coil and /or, CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS . Furnace CF -4R forms: MECH-21 and (for split systems) MECH-25 ,• ' r For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from duct leakage testing if: ,0 1. Duct system was 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 ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. The system will not be Ducted (ie. -Ductless Mini-Sp!it, System)'(Also_ .Exempt from Refrigerant'Chame) ' ❑ 2. New HVAC System Required Forms: Cut in'or Chan eout with, ducts: 1 CF 611 forms: MECH-04, MECH-20U,(for split systems) MECH-22-HERS, and— "— new (all new ducting and all new. MECH,-25=HERS , � CF -4R forms: MECH-20, and (for split systems) MECH-22, and MECH-25 e ui merit q P )- For Split Systems: Duct leakage < 6 percent; RC, CCA 2t 350 CFM/ton,,FWD, TMAH, STMS, and either HSPP orPSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with/or without 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 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-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 identified on this Certificate of Compliance. . I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. ,; . The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance') -forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Mark Hyde Signature: Mark Hyde Company: CERTIFIED COMFORT SYSTEMS INC Date: ]un 11, 2012 Address: 42-949 MADIO STREET Locense: 906115 City/State/Zip: INDIO / CA / 92201 Pone: (760) 360-2202 tOt +, Ste,• , 1 . . ` `� ,.. 7 .. r � - h � " • .. 1 ,y Reg: 212-A0030033_A-00000000-0000 Registration Date/Time: 2012/06/11 16:15:52 HERS Provider:-CalCERTS, Inc: 2008 Residential Compliance Forms, ,. July.2010 i Bin # Permit # K� I,10 Project Addr4s:' i — A. P. Numberr contractor: -Cl? i �i t ` "d Address: City, ST, Zip: r U Telephone.- State elephone:State Lie. #': Q� Arch., Engr., f 1,esigner Address: City, ST, Zip: I Telephone: State Lic. #: j Name of Con `t Person: Telephone # of rnnrarr�bP, cam„• # Submitta Plan Sets Tresstor EnergHoodGradiSubco Grant Dei H.O.A. Al IN ROUST Planning Pub. Wks. School Fee City of La Quinta Building .& Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Owner's Name: J� S Address: L moo c City, ST, Zip: 7 5 Telephone: r0 . I Project Description: Lic. #: �%r Total Permit Fees Construction Type: Occupancy: Project type (circle one): New ±kdd'n Alter Repair' Demo Sq. Ft.: # Sto ' # Units: Estimated Value of Project: �G 0 APPLICANT: DO NOT WRITE BELOW THIS LINE Recd TRACIUNG PERMIT FEES Plan Check submitted Item Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical 2' Review, ready for correciionsfissue Electrical Called Contact Person Plumbing Plans picked up SALL Plans resubmitted Grading Review, ready for corrections/issue Develclrerlmpact Fee Called Contact Person ALP.?. Date of permit issue Total Permit Fees r; CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING Duct Leakage Test — Existing Duct System Site Address: Enforcement Age 47-530_Via Montego, La Quinta CA 92253•(System 1) 1 City of La Quinta t CF-4R-MECH-21 (Page 1 of 2) Permit Nuniber: 12=t49�, Enter the Duct System Name or Identification/Tag: System 1 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. installation certificate is required for compliance for alta e conditioning systems and duct systems. 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 duct system Select one compliance method from the following four choices. D 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside ,pless-than 10% of Fan Flow r (33. Reduce leakage by 60% and conduct smoke and fix all leaks 13'4_Fix all accessible leaks using smoke and HERS rater verify Note:,(One of Options 1, 2, or 3 must be attempted before utilizing Option 4.) Determine n moral Fa Flow using onee of thefollowing three,calculationvmethods ❑ Cooling method: Size of. condenser in 3TFony� 400 'sysstem. Yt''MA ' '. k:'•+.W '3eE d i �,C 'C�f ✓ ❑ Heatmgrsystem : methj�o_d:: 21 7 x=xA utput Capacity injhousands ofiBtu/hr CFM �� ures ✓ ❑ Meas ured'systeM�airpow using'RA3 3¢ai.rflow test proced-71 Option�i used,�then ^� "�;• � Allowed'jleakage' FaF Iw 1 � CFM 1 : Actual Leakage-_`* u 'CFM,�� •, , Pass if Leakage Actual is less than Allowed Pass Fail Option'2 used;then 2 - ` Allowed'leakage 'Fan Flow ' -,'A'- . x 0.10 = _ CFM - Actual .Leakage to outside ri 7,uCFM Pass if Leakage Actual is less than Allowed 0 Pass❑ Fail Option 3 used then:nriy Initial leakage prior to stari'-N ork = _ 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/+ a 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 Q Fail Reg: 212-A0030033A-M2100001A-M21A Registration Date/Time: 2012/09/28 13:10:46 HERS Fsovider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 a Reg: 212-A0030033A-M2100001A-M21A Registration Date/Time: 2012/09/28 13:10:46 HERS Fsovider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 • • Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC h CSLB License: Mark Hyde 1906115 HERS Provider Data Registry Information Sample Group # (if applicable): 349484 fEtTesed/,erified dwelling ®�not-testecl/\.erifiecl dwelling in CEkTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 47-530 Via Montego, La Quinta CA 92253 (System 1) City of La Quinta 12-649 13Outside air (OA) ducts for CentralFan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct'leakage testing CFII,OA:;ducts that utilize controlled motorized dampers, that open only when OA " ventilation is required .to meetASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing t&� ❑ All%supply and return register boots must be sealed to the drywall if smoke test is utilized for.compliance — applies to duct leakage compliance option 3 �(�leakageireduction by�60%) and o`peion'4 (,fix all accessible leaks described above 9 €4�.:'of ❑ New duct installations cannot utilize tbuiIding-cavities as plenums: or platformfx re4uiy$tu[rns in:ai u of:duct - ,,fpr 4r �•�,,r ,r� }"_xrF v_= ❑ M,astic andzdraw bands must be,,used�in,combinatibn�withgcloth backediru bber adhesive dxt tape�to seal leaks dt all leW duct connections: +t '.E. rg:-n, r + ., r•.•yr 43, •y, f7 - .an�""'s.y-3: DECLARATIO.NISTATEMENT I certify Uhder penalty of perjuryunder the laws of the State of California, the information provided on this form is true and correct. �. -I am the certified HERS raterfwho performed the verification services identified and reported on this certificate (responsible rater). a The installed feature, material, component,. or manufactured device requiring HERS verification that is identified oo 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 applicablesections 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) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: CSLB License: Mark Hyde 1906115 HERS Provider Data Registry Information Sample Group # (if applicable): 349484 fEtTesed/,erified dwelling ®�not-testecl/\.erifiecl dwelling in a sample group HERS Rater Information CaICERTS Certificate # CC1-1798663175 HERS Rater Company Name: Desert H.E.R.S. Raters Responsible Rater's Name: Responsible Rater's Signature: Michael Hyde Michael Hyde Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/11/2012 CC2005602 Reg: 212-A0030033A-M2100001A-M21A Registration Date/Time: 2012/09/28 13:10:46 HERS Fsovider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 !' y CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 ~ Refrigerant Charge Verification - Standard Measurement Procedure • (Pagel of 5) Site Address: Enforcement Agency: Permit Number: , 47-530 Via Montego, -La Quinta CA 92253 City of La Quinta 12-649 Note: If installation of a Charge Indicator Display. (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when.a CID is utilized J for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for w 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. ` a 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 1 [3 Yes s "_ ❑ No • , 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and ❑Yes. ❑ No - t:.:*, 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 ,u` and labeled according to Figure in Section RA3.2.2.2.2. Yes'to hand Z is: apass Enter Pass or Fail ✓ [3 Pass ✓ ❑Fail s ; STMS` Sensor, on t! a Evaporator,Coil System Name;or=Identifcation/Tag '-`,;� � Mol, Yes '� t p No The sensor isfactory installedor field�:installed accordingto>�maan-f3 specifications or isinstalled by method_s/specihcationsAapproved�oy the Executwe f� ❑Yes. ❑ No - specifications, or is installed by methods/specifications approved by the Executive Director. RT 4 + ❑Yes ®No The sensor wire:is terminated with}a standard mmil,plug suitable ibe�eonnection'to'aih digit al,thermorneter,The sensor; mini a cesgi, e:::to,the an _ plugpis instialling�tgc , nic HERS'rater.w ❑ Yes 1 ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the thout changing the`airflow,thro6 h.the.con. ense`r coil 5 ; ❑i _ fes❑ No When attached'to'a,di ital thermometer, theisensor provides an indication of the `• aturation temperature coil. ❑ Yes' ❑ No When attached to a digital thermometer, the sensor provides an iindication of the of the Yes 'to 3Y 4 sand 5 is'a pass:+Enter'N/A:if:STMS are not applicable;.Otherwise: enter:Pass`or, Fail ;� ❑ N/A ✓ ❑Pass ✓ ❑Fail s ✓ [3 Pass ✓ Fail applicable. Otherwise enter Pass or Fail STMS - Sensor on the Condenser:Coil ti System Name or Identification/Tag° ` System 1 � 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 , = t 4 Director. • The sensor wire is terminated with a standard mini plug suitable for connection to a ; 7 ❑ Yes 1 ❑ 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 iindication 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 ✓ Fail applicable. Otherwise enter Pass or Fail Reg: 212-A0030033A=M2500001A-M25A Registration Date/Time: 2012/09/28 13:13:02 HERS Provider: CalCERTS, Inc. , 2008 Residential Compliance Forms i March 2010 • 1 � w • , = t 4 Reg: 212-A0030033A=M2500001A-M25A Registration Date/Time: 2012/09/28 13:13:02 HERS Provider: CalCERTS, Inc. , 2008 Residential Compliance Forms i March 2010 • 1 • 4 1 • _ _ J v Reg: 212-A0030033A=M2500001A-M25A Registration Date/Time: 2012/09/28 13:13:02 HERS Provider: CalCERTS, Inc. , 2008 Residential Compliance Forms i March 2010 • 1 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above SS°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 System 1 - y _ i ;. System Location. or Area Served Whole House mak..'+. �%t=u>v:a.--anx.i.:...-,-<�:a 'oawa+._;.'•S �-,.,.--.--.-.::r.+.rfA Date of ThermocP ou le Calibration �n Outdoor Unit Serial # `# •(must be re calerated monthly) t , _ .• _ a Outdoor Unit Make V Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above SS°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 System 1 - System is _ i ;. System Location. or Area Served Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above SS°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 System 1 - Calibrationof.Diagnostic;.Instruments , System is _ Date of Refrigerant Gauge.Calibrati ni ;. System Location. or Area Served Whole House mak..'+. �%t=u>v:a.--anx.i.:...-,-<�:a 'oawa+._;.'•S �-,.,.--.--.-.::r.+.rfA Date of ThermocP ou le Calibration �n Outdoor Unit Serial # `# •(must be re calerated monthly) t , _ .• _ a Outdoor Unit Make V Outdoor Unit Model Nominal Cooling Capacity Btu/hr e Date of Verification � • � w�,i� i . t - Calibrationof.Diagnostic;.Instruments , Measured Temperatures':(y F) : ft tiV.W vi . .:•y,,.. oj ;ndficatig °'Q System Name or Ideon/TaIM System is _ Date of Refrigerant Gauge.Calibrati ni ;. (must be re -calibrated monthly) ) mak..'+. �%t=u>v:a.--anx.i.:...-,-<�:a 'oawa+._;.'•S �-,.,.--.--.-.::r.+.rfA Date of ThermocP ou le Calibration �n *��� r� `# •(must be re calerated monthly) t , _ .• _ a Return (evaporator entering);air dry;bulb `: V Measured Temperatures':(y F) : ft tiV.W vi . .:•y,,.. oj ;ndficatig °'Q System Name or Ideon/TaIM System is _ � Supply (evaporator leaving) air dry bulb temperature;(Tsupplb) Return (evaporator entering);air dry;bulb `: fi.. temperature (Treturndb),. Return (evaporator entering)`�air wet -bulb temperature (T return, Evaporator saturation temperature';;,: ; P'. (Tevaporator, sat) ' Condensor saturation temperature' (Tcondensor, sat) Suction line temperature (Tsuction) t ' Liquid•Line Temperature (Tliquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db) Reg: 212-A0030033A-M2500001A-M25A Registration Date/Time: 2012/09/28 13:13:02 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms - March 2010 4 INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address:Enforcement Agency: Permit Number: 47-530 Via Montego, La Quinta CA 92253 City of La.Quinta 12-649 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 .; Calculate: Actual Temperature Split =Treturn, db - 4 INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address:Enforcement Agency: Permit Number: 47-530 Via Montego, La Quinta CA 92253 City of La.Quinta 12-649 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 Calculate: Actual Temperature Split =Treturn, db - Tsu I db Target Temperature Split from Table RA3.2-3 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - Target Temperature Split = i Passes if difference is between -4°F and +4°F or, { upon remeasurement, if between -40F and -100°F - Enter Pass or Fail Note: Temperature Split MethodCalculation is not necessary if actual Cooling Coil Airflow is verified using one of the - airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil air -flow is measured, the value must`be equal,to. or greater than the Calculated Minimum Airflow Requirement is the table below. m Calculated:Mimum,Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) • System Name,or Id-entification/Tag•` t � �' ; '" ,r�'=`.' .a x "�:.w . :r-;,a�'`,'�. �' fir: *� yam. M .:itts• '" � " �€'aL Asan .• .. d►'.c rte- 1 - Calculated Minimum Airflow Requirement (CFM) • • r "" 4 ;. *ra t i t + �x �' � c "� ,•, d Measured Airflow using RA3$.3 proceduraes (CFM) . Passes if measured airflow is-greatertthan orr� r to the,calculated minimum airflow.requirement'� " " �"'Y_' x x " n" _. f _ h Enter Pass or Fail l -gid,, .s •s�;"; �,ca- n�s:e:�:,-_. 'r:'r -��::_ • Superheat Charge Metho&Cakuilations for Refrigerant Charge Verification. This procedure is: required to be used for fixed orifice -metering. de`vice systecri's. System Name or Identification/Tagg' , 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 ' Enter Pass or Fail . Reg: 212-A0030033A-M2500001A-M25A Registration Date/Time:-2012/09/28 13:13:02 HERS Provider: CalCERTS, Inc. 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: 47-530 Via Montego, La Quinta CA 92253, City of La•Quinta 12-649' Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Subcooling = Tcondenser, sat - Tliquid - Target Subcooling specified by manufacturer ' � e Calculate difference: Actual Subcooling - Target Subcooling = passes if difference is between , f E-4'and+4°F Ts.. cu•...- d .Sri4 .. r^^"TiYx� Q Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/.Tag,; = , Calculate: Actual Superheat,= s,' � - Tsuction--:Tevaporator, sate ` }' w Enter allowable superheat range from manufacturer's spec-16cations.(or use`renge between 3°F and 26°F if m6hufa'ttu'r'e'rir specificationis not.evailable)K�a System passes�if actual superheat is`5withmfthe!` superheat , f allowe ablrange}��ai'� z.Enter� Pass_o� i .. Ts.. cu•...- d .Sri4 .. r^^"TiYx� Q 1 a � ' a . • t` T V 1 Reg: 212-A0030033A-M2500001A-M25A Registration Date/Time:•2012/09/28 13:13:02 HEFS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 w a � ' a . • t` T V 1 Reg: 212-A0030033A-M2500001A-M25A Registration Date/Time:•2012/09/28 13:13:02 HEFS Provider: 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: 47-530 Via Montego, La Quinta CA 92253 City of La Quinta 12-649 ' Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimun cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actio is were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 1906115 , HERS Provider Data Registry Information Sample Group # (if applicable): 349484 System meets all refrigerant charge and airflow ® not-tested/verified dwelling in la HERS sample group requirements. HERS Rater Company Name: Desert H.E.R.S. Raters Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail Michael Hyde Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/28/2012 CC2005602 I • S' t N �p ap.r•C'br , ; iii... • ~ ti r c 10- r �` � �"�+, �fi r ^*r�,-� � � � � �t r � � �, "�•`� rr�w.�r� �� `" a � .qtr � . .� esJ i..1 �K 'ter -c i '` ,.;� � t ,Y• .:� :..�-� y�-�'"`�. � a r x n4 DECLARATMI*ON:STA\TEMENT z.... . I:certify iincler penalfy of perjuryunnderahe.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 p•esponsible rater). 4 . -The installed feature, material,~comporent; or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted 5y 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 -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC ' Responsible Person's Name: CSLB License: Mark Hyde 1906115 , HERS Provider Data Registry Information Sample Group # (if applicable): 349484 ❑tested/verified dwelling ® not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798663175 HERS Rater Company Name: Desert H.E.R.S. Raters Responsible Rater's Name: Responsible Rater's Signature: Michael Hyde Michael Hyde Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 9/28/2012 CC2005602 Reg: 212-A0030033A-M2500001A-M25A Registration Date/Time: 2012/09/28 13:13:02 HESS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 f , Cooling Equipment �. NSTALLATION CERTIFICATE ::F-6R-MECH-04 ° t ;pace Conditioning Systems, Ducts and Fans (Page 1 of 2) r n Site Address: Enforcement Agency: Permit Number:: ,r p 47-530 Via Montego, La Quinta CA 92253 (System 1) City of La Quinta ' 12;649 Space Conditioning Systems Heating Equipment T , • compliance. Efficiency - r Duct http://www.aridirectory.org/ori/ac:php# s t?" 4. When CF -IR is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT,.; > Efficiency Location s 1 F3qul'p r , ARI # of (AFUE, (attic,- - 1� §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets ,- , Cooling '' T'` e yP,,.. "-CEC Certified Mfr. Name and Model Number k,. ARI # of etc.)1, 3 crawl-" Duct R -value Heating 9 Heating 9 (Okkage- '` CEC Certified Mfr. Name Reference Identical (>=CF• -1R, space, Duct -oad Capacity 6 h�aC,{7ump) and Model Number Number2 Systems y value)4 ) etc.) R -value (k6tu/hr) (kBtu/hr) l•`•Split_ american standard #(►"`iP�-+ �rt `r fi.j 2fd�`+ :+ .Y.. �i. ��f +F Z _ t", - f', Furnace -•,.. aud2c100b9v5vba • 1 80 AFUE Attic R-4.2 HO 100 kBtu �a°r ; ' 'rYr' f ' �` fir.` •y � ��J � � �-•'""'....e w• p�'���t��'t rir' l� .f� �' . ''%p�•r� , is r4ft -let t_ ' 1. Y project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative , • compliance. Efficiency - Duct http://www.aridirectory.org/ori/ac:php# . 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value showdonrthe CF -1P. form. • • Equip 4. When CF -IR is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT,.; > (SEER Location. 1 Type' (package r , ARI # of and EER) 1, 3 (attic, crawl- 1� §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets ; -Cooling , Cooling ,heat pump) "-CEC Certified Mfr. Name and Model Number k,. Reference Number2 Identical Systems (> =CF -IR v6lue)4 space, etc.) • ' Duct R -value Load (tBtu/hr) Capacity ; - (kBtu/hr) Split american standard - 16 SEER. A/C ,4#1W4a:7a5061e1000ba 4586004 1 ,13:EER v Attie rR 4:2 - 53 55 kBtu •• 2008 ResidentialrCompliance Forms r ��� . , _ .-. - " _fid. - ire #(►"`iP�-+ �rt `r fi.j 2fd�`+ :+ .Y.. �i. ��f +F Z _ t", �a°r ; ' 'rYr' f ' �` fir.` •y � ��J � � �-•'""'....e w• p�'���t��'t rir' l� .f� �' . ''%p�•r� , is r4ft -let ' 1. Y project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative , • compliance. ' 2. ARI Reference Number can be found by entering the equipment model number at- •+, http://www.aridirectory.org/ori/ac:php# . 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value showdonrthe CF -1P. form. • e 4. When CF -IR is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT,.; > ALL BOXES MUST BE CHECKED TO BE A VALID FORM 2 §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. ' 0 §150(i): Setback Thermostat on all'applicable heating and/or cooling systems meet the requirements of , §112(c). 1� §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., Reg: 212-A0030033A-M0400001A-0000 Registration Date/Time: 2012/08/06 15:58:45 HERS Provider: Ca10ERTS; Inc. 2008 ResidentialrCompliance Forms r ��� . , _ August .2009 " A INSTALLATION CERTIFICATE CF-61111-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency: Permit rlumber: 47-530 Via Montego, La Quinta CA 92253 (System 1) City of La Quinta 12-649 n Responsible Person's Name: x Mark Hyde Mark Hyde CSLB License: 906115 Date Signed: 16/1/2012 Position With Company (Title): A INSTALLATION CERTIFICATE CF-61111-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency: Permit rlumber: 47-530 Via Montego, La Quinta CA 92253 (System 1) City of La Quinta 12-649 Ducts and Fans _ §150(m): Duct and Fans 1, ;AII air -distribution system ducts and plenums installed, sealed and insulated to meet the i�eGulrernents of CMC Sections 601, 602, 603, 604, 605 and Standard 6 -5; -supply -air and return -air 'tli7cts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in 8 ditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets a� tFie 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 ys of mastic and either mesh 'or tape shall be used; and ❑ 1. Building cavities, support platforms for air,handlers, and plenums,defin'ed 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-sectio-ial area of the ducts.- ❑ 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes -unless such tape is used in combination with mastic and draw bands. ❑ 7. Exhaust fan systems have back draft or automatic dampers. ❑ 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, , manually operated dampers. ' ❑ Protection of InsulationlInsulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or ' painted with a coating that,,is water retardant and'provides shielding from solar radiation that can cause`, •degradation,of-the material!' ti 1 10. Flexible ducts cannot have porous inner cores, rte• ' e J t , `f 4 Of tli N.. 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. s e I am eligible under Division,3 of the Business and Professions Code to accept responsibility for construction, or -an authorized u 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. r t . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that ider¢ifies the specific w requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installalon have been met. , • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I ' understand that a signed copy of this Installation Certificate is required to be included with the docamentation the builder , provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC ' Responsible Person's Name: x Ducts and Fans _ §150(m): Duct and Fans 1, ;AII air -distribution system ducts and plenums installed, sealed and insulated to meet the i�eGulrernents of CMC Sections 601, 602, 603, 604, 605 and Standard 6 -5; -supply -air and return -air 'tli7cts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in 8 ditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets a� tFie 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 ys of mastic and either mesh 'or tape shall be used; and ❑ 1. Building cavities, support platforms for air,handlers, and plenums,defin'ed 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-sectio-ial area of the ducts.- ❑ 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes -unless such tape is used in combination with mastic and draw bands. ❑ 7. Exhaust fan systems have back draft or automatic dampers. ❑ 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, , manually operated dampers. ' ❑ Protection of InsulationlInsulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or ' painted with a coating that,,is water retardant and'provides shielding from solar radiation that can cause`, •degradation,of-the material!' ti 1 10. Flexible ducts cannot have porous inner cores, rte• ' e J t , `f 4 Of tli N.. 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. s e I am eligible under Division,3 of the Business and Professions Code to accept responsibility for construction, or -an authorized u 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. r t . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that ider¢ifies the specific w requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installalon have been met. , • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I ' understand that a signed copy of this Installation Certificate is required to be included with the docamentation the builder , provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC ' Responsible Person's Name: Responsible Person's Signature: , Mark Hyde Mark Hyde CSLB License: 906115 Date Signed: 16/1/2012 Position With Company (Title): i. . Reg: 212-A0030033A-M0400001A-0000 Registration Date/Time: 2012/08/06 15:58:45 _ HERS Provider:.CalCERTS, Inc. 2008 Residential Compliance Forms 2 August '2009 INSTALLATION CERTIFICATE • CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Mumber: 47-530 Via Montego, La Quinta CA 92253 (System 1) 1 City of La Quint a 12-649 Enter the Duct System Name or Identification/Tag: System i Enter the Duct System Location or Area Served: Whole House 10te r.5ubmit one Installation Certificate for each duct system that must demonstrate compliance in the dwel`li»g: isJinstallation certificate is required for compliance for alterations and additions in ex/swellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also includy 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 less 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 Options 1, 2 or 3 must be attempted before utilizing Option 4.) Determine nominal Fan Flow using one of the following three calculation_methods. ✓ D Cooliyn{g+fjsy fte method: Size of condenserin Tons 5x4,00,=I 2000CFM ✓ ❑ Heating system method:�1.7 x Output Capacity in_T,housandJls ofti Bgtu/hr`= VEMeasured system�rairflow using: RA3 3 airFlowttest�procedures: CFM—` -, Option'l useb'.then " " u ' ` °"� ` w•'� `" as y Allowed leakage Airflow. 2000. x 0.15 =,•.-300 CFMw ;....• f 1 ,Fan Actual Leakage = 276 CFM" _�. Pass if Actual Leakage is less than Allowed leakage Pass Fail Option 2 used then: 2 Allowed leakage = Fan Airflow'_ x 0.10 = _ CFM Actual Leakage to outside = CFM Pass if Actual leakage to outside is less than Allowed leakage Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction CFM ((Leakage reduction _ / Initial leakage x 100% _ % Reduction Pass if % Reduction > 60% ❑ 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-A0030033A-M2100001A-0000 Registration Date/Time: 2012/08/06 15:57:14 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 2 Outside air (OA) ducts for Central 'Fan Integrated (CFI) .ventilation systems, shall not be sealed/taped off during duct leakage testing. &I OA ducts that utilize controlled motorized dampers, that open only when OA" ventilation. is -required to meet ASHRAE Standard 62.2, and close when OA ventilation is rot required, may-`� be configured to'the closed position during duct leakage testing. 0 All supply and=return register boots must-Ibe�sealed to the drywall if smoke test is_utilized3for compliance — applies to duct leakage compliance o 43 'ptlon:(leakage*reduction'by„60 /o)7and optionf4 (Ux all accessible Teaks) diestrb6d� above 11 N : D New ductinstallations cannotutilize building cavitiesias•plenums or,', latform returns in liof ducts.R'—""�' Mastic and draw bands mustibe used,l combination lth2cloth backed_rubber,�adheslve duct tape to seal p, ' leaks at a 11, new, duc'con nection's 1 DECLARATION STATEMENT • I'certify under penalty of perjury, under the laws of the State of California, the information provided on this fore is true and correct. ' e- « . 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)' `' o 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 idlantifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also y 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. v _ +•i • I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that idertifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installEtion have been•met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the t building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I'''L understand that a signed copy of this Installation Certificate is required to be included with the doaamentation the builder « ` - provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. , Company Name:' (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC } Responsible Person's Name: Responsible Person's Signature: �- Mark Hyde , Mark Hyde , CSLB License: Date Signed: position With Company (Title): 906115' 6/1/2012 Is this installation monitored by a Third Party Quality. Name of TPQCP (if applicable): Control Program (TPQCP)? • .❑ Yes ❑ No } Reg: 212-A0030033A-M2100001A70000 Registration Date/Time: 2012/08/06 15:57:14' HERS Provider: CalCERTS, Inc. 2008 Residential,Compliance Forms i r March 2010 w w; . „'K �M • V• Reg: 212-A0030033A-M2100001A70000 Registration Date/Time: 2012/08/06 15:57:14' HERS Provider: CalCERTS, Inc. 2008 Residential,Compliance Forms i r March 2010 w w; . „'K INSTALLATION CERTIFICATE* CF-6R-IECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5] Site Address: Enforcement Agency: Permit Number: 47-530 Via Montego, La Quinta CA 92253 City of La Quinta 12-649 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charga verification for compliaace, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate. compliance with Elie ?efrsi6e4nt charge verification requirement. TMAH and SIMS are not required for compliance, whey. a CID is utilized A or cofirpliahce. 4 m ny-as 4 systems in the dwelling can be documented for compliance using this form. Attach an aaditional form(s) for riy adtfitional systems in the dwelling as applicable. 4 t Umperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement gensors (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 completefl 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 i System Location or Area Served Whole House 1 p Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 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 and 2 is a pass. } Enter Pass or Fail ✓ 0 Pass ✓ ❑Fail STMS - Sensor on_the Evaporator,Coil System Nacre,crr Idehtification/Tag % . Sy`ste'm 1 �- q P �- - .fig, Nok ` -1 lam; V-? f M, 3 ❑Yes ,�, The'sensor is factory' installed,'or field, installed according to manufacturer's prtNoF specifications, or isfinstalled by methods /specifications approved by. the Executive The sensor is factory installed, or field installed according to manufacturer's 6 : is i Director: � � . ..•, � �: � _ _ �+•--^•�v+ ,.�, .� .� 4 i, Yes t r/ The sensor wire &terminated with a,atandard mihi plug suitable for connect on oto a`Y,' No digital°thermometer,'Thefsensor,mini plug is,accessible ❑ ^ p ., to,the,irstallingtechnic�an --� and the -HERS rater without changing the airflow through the co idenser coil 5 ❑ Yes ❑ No IThe 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 ✓ p N/A ✓ Pass ❑ ✓ ❑ Fail applicable. Otherwise enter Pass or'Fail 8. ❑ Yes 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 installing technician and the HERS rater without changing the airflow through the condenser coil 8. ❑ Yes 1 ❑ No IThe sensor measures the saturation temperature of the coil wi=thin 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not V p N/A ✓ ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail t - Reg: 212-A0030033A-M2500001A-0000 Registration Date/Time: 2012/08/06 15:56:38 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Humber: 47-530 Via Montego, La Quinta CA 92253 City of La Quinta 12-649 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for , n6padditional systems in the dwelling as applicable. ";'y f ' should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. �ystem must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. ' If o "ate . ,.....- •litd8or air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. 'Conditioning Systems S'ystein Name or Identification/Tag • .pis, : ?� -;?l. System i (must be re -calibrated monthly) ,5-V9t m Location or Area Served, ' Whole House �' 6/1/>2012 ' ` 7 (must be re-,alibrated monthly) t Outdoor Unit Serial # 121928rgig - -,"Not- ' ' Outdoor Unit Make american standard T.. Outdoor Unit Model ` 4a7a5061e1000ba Nominal Cooling Capacity Btu/hr 60000 Date of Verification 6/1/2012 canbration of Diagnostic instruments Date of Refrigerant Gauge Calibration 6/1/2012 (must be re -calibrated monthly) Date of Thermocouple Calibration � �' 6/1/>2012 ' ` 7 (must be re-,alibrated monthly) t Supply (evaporator"leaving)<airdry-bulb'"ti ^-'".* r4easurea i emPeratures-tt r i- is i f ;kC I .. L- fir' .A .I I_ ! V - t:'.,. :ft System Name or Identifitation/Tag., ' r System „1 Supply (evaporator"leaving)<airdry-bulb'"ti ^-'".* - -,"Not- ' ' temperature temperature (Tsupply, d T.. Return (evaporator,entering) air dry-bulb temperature (Treturn,'db) Return (evaporator entering) air wet -bulb temperature (Treturn, wb) ti I Evaporator saturation temperature 49 (Tevaporator, sat) Condensor saturation temperature 115 (Tcondensor, sat) Suction line temperature (Tsuction) 59 Liquid Line Temperature (Tliquid) 108 Condenser (entering) air dry-bulb 105 temperature (Tcondenser, db) ' Reg: 212-A0030033A-M2500001A-0000 Registration Date/Time: 2012/08/06 15:56:38 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 t INSTALLATION CERTIFICATE CF-611-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure . (Page 3 of 5) Site Address: Enforcement Agency: Permit Dumber: 47-530 Via Montego, La Quinta CA 92253 1 City of La Quinta 12-649 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge ViWhtation. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag Sj3st'em Name or Identification/Tag System 1 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Calculate: Actual Temperature Split = Treturn, Target Superheat from Table RA3.2-2 using djb,,,-.Tsupply, db Treturn, wb and Tcondenser, db 1 arget Temperature Split from Table RA3.2-3 Calculate difference: ling Treturn, wb and Treturn, db Actual Superheat - Target Superheat = C61culate difference: Actual Temperature Split - em passes if difference is between -5°F and System TaPget Temperature Split = +5°F Passes if difference is between -3°F and +3°F or, Enter Pass or Fail Upon remeasurement, if between -3°F and -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 n the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Nam olden fication/Tagj �e Y System 1' ry y' y Calculated Minimum Airflo R quirement (CFM) } 150 i ? 0 ,/,, /.: 1 r ` Measured,Airflow using RA3.3 procedures (CFM) -1725 ° �+ • Passes if measured airflow is greater than or equal to the calculated minimum airflow PASS requirement -- N4, Enter Pass or Fail I Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag System 1 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = em passes if difference is between -5°F and System +5°F Enter Pass or Fail 10 .11 Reg: 212-A0030033A-M2500001A-0000 Registration Date/Time: 2012/08/06 15:56:38 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 •l i \ '- alt �� INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement,Procedure '. (Page 4,of 5) Site Address: Enforcement Agency: Permit Number: 47-530'Via Montego, La Quinta CA 92253 City of La Quint a 12-649- Subcooling,Charge Method Calculations for Refrigerant Charge Verification: This procedure.is -equired to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. �-yst6m Name or Identification/Tag' System i , Calculate: Actual Superheat = , 10.0 .r ' Calculate: Actual Subcooling = cdh7.0 denser, sat liquid . ' a Target Subcooling specified by manufacturer 8 t , manufacturer's specifications (or use range between 4°F and 250F if manufacturer's 4-25 ' -tgIculate difference: Actual Subcooling - Target Subcooling = PASSJ r "" System passes if difference is between ;;jar ��� � >'.bF and +3°F PASS "1 Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 , Calculate: Actual Superheat = , 10.0 .r ' Tsuction - Tevaporator, sat- ' a Enter allowable superheat range from t manufacturer's specifications (or use range between 4°F and 250F if manufacturer's 4-25 ' specification is not available) _ System passes, if.idtudi'superheat is-withinrthe allowable supe`rtieat range"i'f,� PASSJ r �Enter.Pass oraFail ;;jar ��� � + ♦i 6 r .r r. - a f. ...ice, . •� �� _ - •c^ .z•. s i o - v • ' , k,. r. s � 'r tib ; . '+ti ,9 - 1 + x f Reg:,212-A0030033A-M2500001A-0000 Registration Date/Time: 2012/08/06,15:56:38 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms - "x%August 2009 . .r + ♦i 6 r .r r. - a f. ...ice, . •� �� _ - •c^ .z•. s i o - v • ' , k,. r. s � 'r tib ; . '+ti ,9 - 1 + x f Reg:,212-A0030033A-M2500001A-0000 Registration Date/Time: 2012/08/06,15:56:38 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms - "x%August 2009 . a T + ♦i 6 r .r r. - a f. ...ice, . •� �� _ - •c^ .z•. s i o - v • ' , k,. r. s � 'r tib ; . '+ti ,9 - 1 + x f Reg:,212-A0030033A-M2500001A-0000 Registration Date/Time: 2012/08/06,15:56:38 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms - "x%August 2009 . INSTALLATION CERTIFICATE CF-611?-MECH-25=HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 47-530 Via Montego, La Quinta CA 92253 City of La Quinta 12-64S 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 S ,. 0,1, 61d verification criteria must be re -measured and/or recalculated. Pi? 59stem Name or Identification/Tag System 1 CSLB License: Date Signed: 16/1/2012 Position With Company (Title): System meets all refrigerant charge and airflow Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): requirements. PASS Enter Pass or Fail DECLARATION STATEMENT IIJJ . I certify under penalty of perjury, under the laws of the State of California, the information provided on this for -n 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 specificatbns approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking ideentifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . 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 -1R that apply to the installz,tion have been met. . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come frorrna HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CERTIFIED COMFORT SYSTEMS INC Responsible Person's Name: Responsible Person's Signature: Mark Hyde Mork Hyde CSLB License: Date Signed: 16/1/2012 Position With Company (Title): 906115 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0030033A-M2500001A-0000 Registration Date/Time: 2012/08/06 15:56:38 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009