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11-1241 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253. Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 11700001241' -47565 VIA MONTIGO 643-120-028-256 -26152 MECHANICAL LOW DENSITY RESIDENTIAL 25474 Tuyl 4 4v Q%�K& Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: DUVALL CLARK 47565 VIA MONTIGO LA QUINTA, CA 92253 j Contractor: GENERAL AIR CONDITI VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/17/11 D� 0� T NOW 17 2011 �� Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097; Civ. C.). Lender's Name: ' Lender's Address: LQPERMIT of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. - 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance. of such permibration ion of work for 180 days will subject permit to cancellation. - I certify that I have read this application and state that the above correct. I agree to comply with all city and county ordinances and state laws relating to building conhereby authorize representatives of thisj���re the above-mentioned property for insses. �e: (Applicant or Agent): 31170 RESERVE DRIVE' G1TY�P THOUSAND. PALMS, CA 92276�AQ1Uf1NTq c..— F1fsn�ri���t T (760)343-7488 ^�- Lic. No.: 686310-------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I a icensed 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 an rofessioneIs 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 License No.: 686310 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ,Gate: tt ntractor: /7 issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the insurance carrier and policy number are: 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 - construct, alter, improve, demolish; or repair any structure, prior to its issuance, also requires the applicant for the , _ I certify that, in the performance o he work�for which this permit is issued, I shall not employ any person in any manner so as to ome 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 bec subject to the workers' compensation.rrovisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 3700 of the Labor Code, 1 she rthwi omply with those provisions. tt any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: - ate: pplicant: - (_) I, as owner of the property, or my employees withwages 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 SEC UREJ&tC6KERS4COMPENSATION 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, 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 contractors) 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 Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097; Civ. C.). Lender's Name: ' Lender's Address: LQPERMIT of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. - 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance. of such permibration ion of work for 180 days will subject permit to cancellation. - I certify that I have read this application and state that the above correct. I agree to comply with all city and county ordinances and state laws relating to building conhereby authorize representatives of thisj���re the above-mentioned property for insses. �e: (Applicant or Agent): Application Number '11-00001241 - Permit MECHANICAL Additional desc . Permit Fee. 66.'00 :-Plan Check Fee 16.50...; Issue Date Valuation 0 Expiration Date ,5/15/12 Qty._ Unit;Charge Per Extension BASE FEE 15.00 2.00. 9.0000 EA MECH FURNACE .<=100K 18. 0.0 2.00 16.5000 -EA MECH B/C >3-15HP/>100K-500KBTU 33.00 ------------------------------------ Sp@4181 AT^t4R ?nri-f;nmmon.tc---- - HVAC CHANGE -OUT: 2 5 TON SYSTEMS, CONDENSERS, COILS, FURNACES. 2010 CODES. ---------------------------------------- Other Fees . . . . . . . .. BLDG STDS ADMIN (SB1473) 2.00 - Fee I 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 2.00 .00 .00 2.00• Grand Total 84.50 .00 .00 84.50 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAIterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site ddress/:_ Enforcement Agency: Dates // Permit#: cC� LA 'AOL Conditioned Floor Equipment T e' List Minimum Efficiency z Duct insulation requirement Area Thermostat ackaged Unit Furnace AFUE El COP Over 40 ft of ducts added or [3 Setback door Coil EER HSIre laced in unconditioned space R 6 (CZ 10-13) Served by system sf (If not already present, must be ndensing Unit [JEER Resistance Other R 8 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF71 R -ALT -d VAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are four 14VAC 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 o= 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 i ed. Beginning October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final inspection. U1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) NIECH- 25 -HERS CF -4R forms: MECH- 21 and fors lits stems) MECH-25 • Condenser Coil and/or— CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -ETERS • Indoor Coil and/or CF -4R forms: MECH- 21 and (for split systems) MECH-25 • Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempt d f om duct leakage testing if: 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or uct systems with less than 40 linear feet in unconditioned space, or J 3. Existing ducts stems are constructed, insulated or sealed with asbestos 2. New HVAC System Required Forms: • Cut in or Changeout with new ducts: (all new ducting and all CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS new equipment) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent 3. New Ducts with/or without Replacement Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (fo: split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor coil CF -4R forms: MECH-20 and (for split systems) MECH-25 and/or furnace. No or some 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 linear feet of duct in unconditioned space. CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split s stem or packaged units: Duct leakage < 15 percent _. EXCEPTION: Existing ducts stems 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 ori 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 informa '110ocumented on o& pplicable compliance forms, worksheets, calc ions plans andspecifications submitted to the enforcement a enc f approvalwith epeArnitapplication. , CC115 n in Name: I 1,,' Signature: 17 n Company: n��/1�/L CIG / / Date: 11_/ 10 G Address:� l _51iZar5e� Licence: City/State/Zip: G'� Phone , b d 2008 Residential Compliance Forms March 2010 _Simplified Prescriptive Certificate of Compliance:' 2008 Residential HVACAIterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site AJdr ss: Epforceme gency: Date: &q/ _ / / Permit N: Conditioned Floor Equipment T et List Minimum Efficient Z Duct insulation requirement Area Thermostat ❑ ackaged Unit umace ❑ AFUE 80% ❑ COp Over 40 ft of ducts added or Setback ndoor Coil ❑SEER 13 ❑ HSPF replaced in unconditioned space Served by system (1j'not already Condensing Unit ❑ EER / / ❑ Resistance OR R 6 (CZ 10-13) sf present, mast be ❑ Other ❑ R 8 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R-ALT-FIVACfur each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor 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. eginning October 1, 201.0, a registered copy of the CF -IR and CF -611 shall also be on site for final inspection. 1. HVAC Changeout I Required Forms: • All HVAC E ui menu re laced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS - q P P 1-17AD 2008 Racidt .t;nl m.,: ,,. r,_ • Condenser Coil and/or • Indoor Coil and/or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Furnace CF -4R forms: MECH- 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA _> 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted tf m duct leakage testing if: Duct system was documented to have been previously sealed and confirmed through HERS verification, or �❑ 0r_7 22.. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut s: Changeout with new ducts: (all l new ducting and all CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS new equipment) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF -4R forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all 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 Re uired Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned space. CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts stems 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 I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the ' onn tion documented on other pplicweompliance forms, worksheets, calculations, plans ands ecifications submitted to the enforcement agency fora pro al with t e Permit application. Name: I (eeh uja_�`-s-bn Si ture: Company: 6terlera( Ar Gortd� •`orf t` Date: Address: 311-70 /2esertle i �t.�� License: to8�3�v City/State/Zip:-1—A_ot,6ar_A ��(�h�5, GP} �aa-%(o. Phone: 760-3,13_-74t�� 2008 Racidt .t;nl m.,: ,,. r,_ CaICERTS - CF -1 R Registration Page 1 of 1 _ Public Home Danielle Garcia logged in [Logout] [Home] Secure Home About Us Training Rater Directory .Forms CONGRATULATIONS Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Site Address: 47565 VIA MONTEGO La Quinta, CA 92253 CEC Registration: 211-A0059823A-00000000-0000 CF-IR-ALT-HVAC:jCLICK HERE TO DOWNLOAD Assigned Com Membership Benefits SON ENTERPRISES INC Do you know your HERS Rater? - LL Events _ --Y _ If you do, you may. want tosend this-CFz I.R-tothem,_ Industry Partners CaICERTS Rater ID: OR _ News --'------—___�___, My Rater Quick Select:' Energy Driven Solutions, Inc.. Every CalCERTS rater has a license number. To register for our Ifyou need to find the rater by name [Click HERE] to search our directory. monthly I SEND -CF 1R T0_HER$ RATER ,,;._; ;,1 newsletter, please click here. [CLICK HERE] to do another Copyright 02010 CaICERI'S: Inc. All rights resen.,ed. Revised: January 1 1.2010 [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 T BBB • findus;on.FBCubookil , https://www.calcerts.com/public—cflR.cfrn?project—id=150301 11/16/2011 CaICERTS - CF -1 R Registration Page 1 of 1 Public Home Secure Home About Us Training Rater Directory Forms Membership Benefits Events Industry Partners News To register for our monthly newsletter, please click here. CEC Danielle Garcia logged in [Logout] [Home] CONGRATULATIONS Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Site Address- 47565 VIA MONTEGO ILa Quinta, CA 92253 lI-A0059824A-00000000-0000 CF-IR-ALT-HVAC:ICLICK HERE TO DOWNLOAD Assigned Company: I HARRISON ENTERPRISES INC Do you know your HERS Rater? If you do, you may want to send this CF -IR to them. CaICERTS Rater ID: OR My Rater Quick Select: i Energy Driven Solutions, Inc. . Every CaICERTS rater has a license number. Ifyou need to find the rater by name [Click HERE) to search our directory. I ; ,�!^>`SEND_CF-1R;T0 HERS RATER _��:,1 [CLICK HERE] to do another Copyright0 2010 CaICERTS. Inc. All rights reserved. Revised: January 11, ?010 [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 BBB fintJustsra_F4trCb�Tpk®;. https://www.calcerts.com/public—cflR.cfm?proj'ect—id=1503D2 . 11/16/2011 ►n City of La Quinta Building 8t SafetyDivislon P.O. Box 15.04, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Addres Owner's Name:��� A. P. Number: Address: S42 S ' ✓ d �- !'i �� ii !� Legal Description: City, ST, Zip: eI Contractor:co Telephone: ` t�:> ' ks >�xvw{ Y ;:.may ;.:}�; . Address: y City, ST, Zip: O� Project Description: lor C / G: s `�• lir i}�i•A J',y{O {v �:{�>i'\ . f. Telephone : r,:•,•:r • • �. 3 C' s State Lic. # : 3 City Lic. Arch., Engr., Designer: Address: City., ST, Zip: Telephone:* .. 4,.., x,, •>�:�' .•.G�.;�, , .� a's State Lic. ..r1 �::<{<{>:f;..• ,�� . - - -. -• - - - --. .... _.. _._ .__ ,.. . __ _ Construction Type: Occupancy: ,' Project type (circle one): New Add'n .Alter Repair Demo Name of Contact Person: 02,7 4< u;�-s OyV Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: -7& O 3 Y3 74 ' Estimated Value of Project: 4- q 6V APPLICANT: DO. NOT WRITE. BELOW THIS LINE Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person PlanCheck Balance. Title 24 Cafes. Plans picked up Ciiastructiori Flood plain plan Plans resubmitted Mechanical Grading plan 21" Review, ready for eorrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up. S.M.I. H.O.A. Approval Plans resubmitted Grading IN Jrd Review, -ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks..Appr. Date of permit issue , School Fees Total Permit Fees CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System • (Page 1 of 2) Site Address: 47565 VIA MONTEGO, La Quinta CA 92253 (System 1) - Enforcement Agency: City of La Quinta Permit Number: 11-1241 This installation certificate is required for compliance for alterations and additions in existing space conditioning systems and duct systems. r 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 - • Y ❑ 2. Measured leakage to outside less;than 10% of Fan Flow , ❑ 3. Reduce Ieakage,by 60%and conduct smoke and fix all leaks ; ❑ 4:.Fix all accessible leaks using smoke and HERS rater verify a Note :(One of Options 1, 2; or 3 must be=attempteda.6fore;utilizing Optign 4.)� L Determmeriomrial fain Flow using %eoof,tlfollowng three calctllationfinethods m ©Cooling• system ethod: Size of. condenser s in Tonx 400 2000�CFM_'' ❑ Heatingsystem�method r7 Output CapacityirntThousands 2 x� ofhBtu/hr =GFM ✓. ❑ Measuredsyst rn airflowrusmg RA 3jairflow testsproceoures, Option-.- used1hen . ' Allowed leakage = r i — Fan Flow 2000 x 0.15 300 CFM Actual, Leakage,;";=. 107 CFMtu, r Pass if Leakage Actual is less than Allowed. Pass 0 Fail ' Option -2 used then.- s 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: i 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 > 600l0 ❑ Pass p Fail , Option 4 used then: t 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 +Y - - Reg: 211-A0059823A-M2100001A-M21A Registration Date/Time: 2011/12/02 19:32:40 —HERS -provider: CalCERTS: Inc. 2008 Residential Compliance Forms March 2010 L +Y - - Reg: 211-A0059823A-M2100001A-M21A Registration Date/Time: 2011/12/02 19:32:40 —HERS -provider: CalCERTS: Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: 47565 VIA MONTEGO, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 11-1241 w 2 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFIYOA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet A- RAE Standard 62.2, and close when OA ventilation is nit required, may be configured to the closed position. during duct leakage testing. © All supply and re -fu -'en register bootgs�m st'Ui - applies W%@ ct lea4kage compliance option 3 leaks) 'escri.bed above. ;>I` 0 New duct=installatlonsr�cannot,utihzebuild utiUze forr'compliance n 4 {;f x�all accessible "rrA,+`"f ��,.'c:.-'°..'?"" -.,`:' yam''!:•' wxsw 0 Mastic and;draw b'an's must.'be used.=in combination'with cloth backed rubber adhesive'uct 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 fora is true and correct. • I am the certified HERS rater who performed the verification services identified and reported on this certificate iresponsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identifiec on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and tre requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement aQencv. 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: Danielle Garcia 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 267785 Q tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798608367 HERS Rater Company Name: Energy Driven Solutions, Inc. Responsible Rater's Name: Responsible Rater's Signature: David Bricker David Bricker Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 12/1/2011 CC2004131 Reg: 211-A0059823A-M2100001A-M21A Registration Date/Time: 2011/12/02 19:32:40 HER.3 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 1 of 5) Site Address: Enforcement Agency: Permit Number: 47565 VIA MONTEGO, La Quinta CA 92253 City of La Quinta 11-1241 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant cha. ge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Suoolv and Return Plenums of Air Handier System Name or Identification/Tag System i System Location or Area Served Left 1 --- ©Yes - ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in thB return plenum and labeled according -to Figure in•Secdon RA3:2.2.2.2:--_._._._._. 2 p Yes ❑ No5/16 fi: inch (8 mm) access hole downstream of evaporative coil in the supply plenum arid labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and:.2 is a pass. k-- :; Enter Pass or Faill ✓ 0 Pass ✓ ❑ Fail STMS - Sensor-on.,the. Evaoorator Coil._ System.Narri"e orTdentifeation/Tag ' r _ 3 C-0Yes ® �; Th sensor is factor , n.'st filled, or�eld'installed' according to manufacturers . spearications, or is,, nstalled by rnetliods/specifications approved liy the Executive ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. yTffeisensor wire ig�termirnaat�e'd h�a standard m i plug suitable 4 ®Yes K -kr ppxN�o idigital thermometer The sensor mini plug%,is-accessible to the installmgetechnician '15 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the inEtalling technician _ ,.. and the: HER ,,rater -Without changing the a.irflowahrough the"cor-deriser coil 5 ❑Yes ❑ No 'When El attached to a digital thermometer, the sensor provides an indication of the ❑ Yes - ,.•-+>-;�;;.^''r.:s : � tem perature of the coil. Yes to`3;1.4', and 5 is a -pass. Enter N_/A if STMS are not applicable. Otherwise enter Pass oFail ,i 2 N/A ✓ ❑Pass ✓ ❑Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag I System i The sensor is factory installed, or field installed according to marufacturer'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 inEtalling 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 applicable. Otherwise enter Pass or Fail ✓ p N/A ✓ [I Pass ✓ Fail Reg: 211-A0059823A-M2500001A-M25A Registration Date/Time: 2011/12/02 19:34:23 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: 47565 VIA MONTEGO, La Quinta CA 92253 City of La Quint, 11-1241 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 a--? 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 0 is 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 Conditionina Svstems System Name or Identification/Tag System 1 (must be re-c3librated monthly) Date of T_ ermocou le Calibration P x System Location or Area Served Left r t 1 must be re=calibrated month) ( Y) A Outdoor Unit Serial # 5811607477 K ..�� - �rz.::', ... Outdoor Unit Make Lennox Outdoor Unit Model XC21-060-230 Nominal Coolirry-Capacity Btu/hr­-- --- ___5 5G0 Date of Verification 12-1-11 Gallbramn or Diagnostic Instruments Date of Refrigerant Gauge Calibration; 12-1-11 (must be re-c3librated monthly) Date of T_ ermocou le Calibration P x t t r - Y 12 1 11 r t 1 must be re=calibrated month) ( Y) Measures>3Temperatures$�(,:F,)*:1 j? ;. 11IVa",< ; r' •; " i, f",: ° . : . Vf System Name or Identification/Tagt Systemait; t - ,, 1, k ... 12.�N�F: A SuPPIY (evajioratorleaving) air drybulbs'`57sx. K ..�� - �rz.::', ... temperature T' ( supply., db) Return (pyp.porator,`entering) air dry=bulb 69 temperature-. - return, db;). Return (evaporator entering) air wet=bulb 54 temperature (Treturn, wb) Evaporator saturation temperature`,. 30 (Tevaporator, sat) Condensor saturation temperature 82 (Tcondensor, sat) Suction line temperature (Tsuction) 55 Liquid Line Temperature (Tliquid) 76 Condenser (entering) air dry-bulb 66 temperature (T condenser, db) Reg: 211-A0059823A-M2500001A-M25A Registration Date/Time: 2011/12/02 19:34:23 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of S) Site Address: Enforcement Agency: Permit Number: 47565 VIA MONTEGO, La Quinta CA 92253 City of La Quints 11-1241 Minimum Airflow Reauirement 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, 18.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3 21 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - -3 Target Temperature Split = Passes if difference is between -4°F and +4°F or, upon remeasurement, if between -4°F and PASS -100°F Enter Pass or Fail Note: Tem erature S lit Method Calculation is not necessa if actual Coolin Coil Airf%w is veelfi-ed asin one of he ­ airf/ow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equa%Ioc or greater than the Calculated Minimum Airflow Requirement m the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (c'fm/ton) ,;.;... System Narn` e Idem fication/Tag • .y ,9�4%5i4'a'�� .I.�yy+, _.. �r� hhSM 'i� �,� -' f � � a 1', t gl�'�^ CalculatedMmimum Airflow Requirement (CFM) 141, �,x� i w 41 z S• 'M _J: 1-.R'r �,a. r Measured A rflolowIt {r jv.r. s q k-F�'ii�,li.:.. �w..f; F. �i,'... ! W�a•, - 177. n�9 r?` r F Passes if measured airflow is greatergthan'or " equal to the calculated minimum airflow requirement::'-, Enter.„Pass or Fail Superheat Charge Method. Calculations for Refrigerant Charge Verification. This procedure i=- 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: 211-A0059823A-M2500001A-M25A Registration Date/Time: 2011/12/02 19:34:23 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: 47565 VIA MONTEGO, La Quinta CA 92253 1 City of La Quinta 11-12t-1 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 I Calculate: Actual Superheat = Calculate: Actual Subcooling = 6.0 Tsuction - Tevaporator, sat a?: Tcondenser, sat - Tliquid Enter allowable superheat range from :? Target Subcooling specified by manufacturer 3 25 Calculate difference: 3 specification is not available) Actual Subcooling - Target Subcooling = System'passesyd�actual superheat is wit -in,,,- fie, allowable -Au perlSei3t range '.. E ^ PASS:. System passes if difference is between Enter Pass}or Fail Pow ,F -4°F and +4°F PASS Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required tc be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System i Calculate: Actual Superheat = 25.0 Tsuction - Tevaporator, sat a?: Enter allowable superheat range from :? mar iufacturer's specifications (or use range 25 between 3°F and 26°F if manufacturer's' specification is not available) System'passesyd�actual superheat is wit -in,,,- fie, allowable -Au perlSei3t range '.. E ^ PASS:. t: Enter Pass}or Fail Pow ,F .......i�4 ..,..r .'rte �„.. • .Ez� �. a �� Reg: 211-A0059823A-M2500001A-M25A Registration Date/Time: 2011/12/02 19:34:23 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 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 Identificatibn/Tag System 1 1686310 HERS Provider Data Registry Information Sample Group # (if applicable): 267785 System meets all refrigerant charge and airflow ❑not-testeoi/verified dwelling in , f a HERS sample group , requirements. PASS Energy Driven Solutions, Inc. Responsible Rater's Name: Responsible Rater's Signature: • Enter Pass or Fail bovid Bricker Responsible Rater's Certification Number w/ this HERS Provider:. - Date Signed: 12/1/2011 , CC2004131 • • ., • 1 C • � ; \ . . " 1. . � `� . • .-....w. '. �.. •.�.yn -.-u� ..� - - -. - -. ......+ras 1.•. .-r•. �-.•sw-.+ee..<-ar+-�e"-� .. .� �. .. _ -•... , ... -.._ w...- •- ..• - .. rR '$ r947 .csk• C DECLARATION STAT::EMENTnr t I certify under penalty of perjury, urrder,the laws of the State of California, the information provided on -this fore is true and correct. ` I am the certified HERS rater who performed the verification services identified and reported on this certificate oresponsible rater). The installed feature, material;' component, or manufactured device requiring HERS verification that is identifies on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and tre 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 the person(s) M responsible for the installation conforms to the requirements specified on the Certificates) of Compliance (CF -1111) 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): 267785 Q tested/verified dwelling ❑not-testeoi/verified dwelling in , a HERS sample group , HERS Rater Information CalCERTS Certificate # CC1-1798608367 HERS Rater Company Name: Energy Driven Solutions, Inc. Responsible Rater's Name: Responsible Rater's Signature: David Bricker bovid Bricker Responsible Rater's Certification Number w/ this HERS Provider:. - Date Signed: 12/1/2011 , CC2004131 Reg: 211-A0059823A-M2500001A=M25A Registration Date/Time: 2011/12/02 19:34:23 HERS. Provider: Ca10ERTS, Inc. ' 2008 Residential Compliance Forms March 2010' INSTALLATION CERTIFICATE CF-6R-MECH-21-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: p 3. Reduce leakage by 60% and conduct smoke and fix all leaks 47565 VIA MONTEGO, La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 1171241 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Left 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 existi.-7g 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 Diaqnostic Test - existina duct system one compliance method from the following four choices. FSelect 1. Measured leakage less than 15% of fan flow m 2. Measured leakage to outside less than 10% of Fan Flow p 3. Reduce leakage by 60% and conduct smoke and fix all leaks m 4. Fix all accessible leaks using smoke and HERS rater verify Note:;(One of Options 1, 2 or 3 musC be attempted„before utilizing, Opt i_ on Determinefinominal.Fan Flow using one of ttie1611owingyythree calculationtmethods .,✓.4., r, O NR .. t d' 4.! ick t .; I �i0 �.f:• ✓ ©Coolmgtsystem method: Size of, condenser in Tons r`x 400` 2000tCFM' �� ✓ Heatingysystem method' 21 7,xOutput Capacity mxThousands"ofr = CFM r E �- .aYr"+N'eF�?j��S cj. ✓ � Measured systern3airflowtusin �YRA3'�3�airflow'�test rocedures .,� CFM - �, �� All leakage Airflow>- 2000 ` 0.15 300 'CFM 1 –Fan x Actual LeakageyF 190 CFM : •. x� 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 Ej Pass I] 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 reductionCFM ((Leakage reduction _ / Initial leakage___) x 100% _ /b Reduction Pass if % Reduction > 60a/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 smo<e E] Pass 0 Fail Reg: 211-A0059823A-M2100001A-0000 Registration Date/Time: 2011/12/02 18:58:47 HERS Provider: Ca10ERTS, 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: Responsible Person's Signature: Danielle Garcia 47565 VIA MONTEGO, La Quinta CA 92253 (System Enforcement Agency: Permi•: Number: 1) City of La Quinta 11-1241 0 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet AS;HRAE Standard 62.2, and close when OA ventilation is rot required, may be configured to the closed positio"n,during duct leakage testing. All supply and`return register boots muse sealed to theme drywall�i`f smoke test�isutilized for compliance - applies M.8leakage comp ianre 1, 'tion 3 (leakage reduction by 60%) and option 4. (,nxsall alccessible leaks) desc#ifi'ed above r fNew 2 duct<,installationscannot utilize6uildir�q cavities assplenumFatform r,4Eeturns, in lieu of<d.ucts r c nation Mastic Arid draw -band's must beusedan com'biwlth''cloth'backed rubberadhesiv,,,e duct tap�,' �,-' e 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 fore is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not zhecked 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 -1R) 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 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 app;icable 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 beoinnina October 1. 2010. for all low-rise residential huildin❑•.. 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: 11/18/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 211-A0059823A-M2100001A-0000 Registration Date/Time: 2011/12/02 18:58:47 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE* CF-62-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency:Permi- Number: 47565 VIA MONTEGO, La Quinta CA 92253 City of La Quinta 11-1241 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant cha ge 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, wh =n 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 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 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 1 System Location or Area Served Left 1 p Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in tl-e return plenum and Iabeled,ar._cording toFigure.in Sertion.RA3,2..2.2.2. 2 p Yes ❑ No5/16 41 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 ✓ 0 Pass ✓ ❑ Fail STMS- Sensor on -the Evaporator=Coil. System `Name or>Identification/Tagg, f'r:System;iri s i; e—V -,eF, T 3 ❑::Yes �q ®,Nod `They ensor'is factoryinstal�ed"or field installed according to mufacturer s a} ° 6 a s Y specifications, or islmstalled by me�th3ods/specifications4approvey by<the Executive ❑ Yes iri ., _? Director. sP 3 x. A. F 1,.� 7 -; 4 pYes ❑p Nom The sensor wire is terminn'rd ith>aFstandard mmi lu suitable for4eonnectidri to a digitalthermometer �Thesensor�rnmrplugjis accessible to xher�stallmglech�nic�an' The sensor wire is terminated with a standard mini plug suitable for connection to a andthe#HERS airflow,thr'diigh coil ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician rater without c6angmg=the the'caidenser 5 ❑ Yes ❑ No : The: sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3;,4. and'51s 6 -:Pass. Enter N/A -if STMS are not applicable. Otherwise enter Pass or4Fail ✓ p N/A ✓ ❑ Pass ✓ C] Fail STMS - Sensor on the Condenser.:'Coil System Name or Identification/Tag 'I ystem 1 The sensor is factory installed, or field installed according to menufacturer'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 The sensor measures the saturation temperature of the coil witiin 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ 2 N/A ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail Reg: 211-A0059823A-M2500001A-0000 Registration Date/Time: 2011/12/02 19:00:13 HER; Provider: Ca10ERTS, 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 Number: 47565 VIA MONTEGO, La Quinta CA 92253 City of La Quinta 11 -1241 - Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above S5°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 Conditioninq Svstems System Name or Identification/Tag System 1 (must be re -calibrated monthly) Date of The.rrnocouple Calibration W ` �t11 4411 _ # System Location or Area Served Left ; 'w-� '+i'' Outdoor Unit Serial # 5811607477 Outdoor Unit Make Lennox Outdoor Unit Model XC21-060-230 Nominal Cooling Capacity Btu hr of Verification -+;: F 11-18-11 %.auvrauun ur.uiawnosc1c instruments Date of Refrigerant Gauge Calibration' : 11-4-11 (must be re -calibrated monthly) Date of The.rrnocouple Calibration W ` �t11 4411 _ # ' be rei*bra�tecl monthly) rmeasurcalt!.emperatures�il,5;r7).,, q. s.:rr,,r J k« .w ril � r :;;:. & System Name or Id�edntifial%cation/Tb $:�� System 1 0?^.`` q. `s•L .�, L.� Supply eva oratorcleavm `pair dr 'bulbc`s PP Y ( � P 9)` Y- s•� rte" 54s ; 'w-� '+i'' temperature (TsupPl� �.. Return (evaporator -,entering) air dry bulb temperature (T4`,�:` }; :: return, db) 75 Return (evaporator entering) air wet=bulb 53 temperature (T return, wb) ,�'�'• Evaporator saturation temperature, 38.3 (Tevaporator, sat) Condensor saturation temperature 79.6 (Tcondensor, sat) Suction line temperature (Tsuction) 53 Liquid Line Temperature (Tliquid) 77 Condenser (entering) air dry-bulb 67 temperature (Tcondenser, db) Reg: 211-A0059823A-M2500001A-0000 Registration Date/Time: 2011/12/02 19:00:13 HERE Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-61-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Age7711-12,41 Permi- Number: 47565 VIA MONTEGO, La Quinta CA 92253 City of La Quinta Minimum Airflow Reauirement 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, 21.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3 23 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: Tempers-Nme -Split Method-Eafeulai'or , miot nacessary-if•actual Cooling Coih-A;rflow -is verified vsing-one-ohthe- airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equalyto;or greater than the Calculated Minimum Airflow Requirement :n the table below. Calculated Minimum Airflow Req+uirement (CFM) = Nominal Cooling Capacity (ton) X 300 (.-fm/ton) System Name o Ide rcation/Ta gX System 1 �, y AUX* off" `� is g .%. 0 1 x:� CalculatdMiiiimum Airflow .Re uirement(CFM) �t't'%' A r } rtN- p "'�. `°..e'i'•»r j .,d Measured 'Arrflowusi ngRAr3 3Yprocedures (CFM)" �1sF` r4+ ��'• � �I ' �'i{Y �'�,x" r;r':.c'i.AP'�"c �3�4 �q�r. r y 2 V .. k 2� i!i`t' ���• 'f� Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement:°;'' Ent V.Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure i_= 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 RA3.272 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail Reg: 211-A0059823A-M2500001A-0000 Registration Date/Time: 2011/12/02 19:00:13 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6A-MECH-2S-HER5 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of S) Site Address: Enforcement Agency: Permi`. Number: 47565 VIA MONTEGO, La Quinta CA 92253 City of La Quinta 11-1241 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 Calculate: Actual Subcooling = 14.7 Tcondenser, sat - Tliquid 2.6 Target Subcooling specified by manufacturer 3 Calculate difference: -0.4 - Actual Subcooling - Target Subcooling = 25 System passes if difference is between -3°F and +3°F PASS Enter Pass or Fail � § PASS ' s 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_= 14.7 Tsuction - Tevaporator, sat Enter allowable superheat range from ` - manufacturer's Specifications (or use;ra:nge 25 between 4°F and 25°F if manufactur'&'s ... specification is not available) System passes—�if actual'superheat istwithinA11 ,,F allowable range�� } superheat � § PASS ' s '"`� ' Enter Pass or Fail �- Reg: 211-A0059823A-M2500001A-0000 Registration Date/Time: 2011/12/02 19:00:13 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS. Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 47565 VIA MONTEGO, La Quinta CA 92253 City of La Quinta 11-1241 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: 11/18/2011 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 .41 pt. + i .r..•.. DECL'ARATION`STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 1of-the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices Identified on this certificate (the installation) conforms to all applicable codes and regulations, and the Installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met. • I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives. and beainninn Ortnher 1. 2n1 n- fnr Al Inw-rico rpcirlanNA hiiilrlinnc 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: 11/18/2011 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 211-A0059823A-M2500001A-0000 Registration Date/Time: 2011/12/02 19:00:13 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 • r Y ' GENERAL 4 -k Air Conditioning &, Heating ,Dear Homeowner, We want to thank you.again'for your patronage and loyalty with our company. It is now time to schedule for an Air Conditioning Inspection with your City. It is important to have this done,as ' quickly as possible to get the permit signed off and closed. If your unit is located in'the attic or , .�2th�.r90 .you will needio_pro_vid.e-a.ladd.er.._fo.r tbe-city_inspe_cto.r....Encloseid..i.n.xhis-packet.Js:. t your IID application, the permit card and the required forms needed by the city to close your permit out. Since you are a part of the IID A/C trade up program, once your permit• is signed off, you will need to make a copy of your permit and attach it to the IID application enclosed` and mail inAhe envelope provided. I have enclosed and highlighted your IID application, please sign_where indicated. It is important to do this as soon as possible, applications must -be received in IID's office by January 5,.2012 to be processed. Thank you for your cooperation and< f please do not hesitate to call us at.(760) 343-7488 if you have any questions. Sincerely; The General's Sales Department ` Enclosed: Copies of form CF -4R for your records. Please give the Inspection Card (and CF forms, if so requested) to the city inspector, they will sign it off and return it to you for yourrecords. r HVAC Field Data Sheet 1 A -80S 1Tp--Y.4- Pg 1of2 Client Name Lx=j=- c /JaaV6�tZ Z, - job # 1 L� Date / Address /-/,754-5-Vie, MO.-, � 9?1- -3 Ph # Technicians) ln� - Permit # Gauge/Thermocouple Calibration Date // y// j Package ( Some Duc:s Only I All Ducts Only (Circle type of work) ME61-04 , entftta ZONE 1 ZOAFE ZONE ZONE4 System Location or Area Served J� i Heating Equipment Make k n n &x 26,4 Ke Heating Equipment Model sI ca/f eoC- ARI Reference Number Heating-Equipumeng:AFUl3:----s_ - DB Duct Location (attic, cravAspace, etc) U Duct R Value (if ducts were installed) 1,49 Heating Load Ale -4!5:10 gt�o Heating Equipment Output Capacity 7D . oo `7O Da Condenser Make n -no Condenser Model %CC? I - 060 Z& 2 X62 -060 -KK Size in Tons Toh n SEER & EER / /3-0® Toa Z. SG Cooling Load S-/, 000 Cooling Capacity Cl -20 & 21 Duct T&WhW Dud leakage pretest result 72 Duct Leakage Final Result 424CFM/boa to pass (6%) P=IFA PasslFa PassIFA Pa-ifau Duct Leakage Final Result 40 CFM/tontopass (15%) /t G!RW eassIPA Pass using 60% leakage reduction? Pass using smoke and visual inspection? IiIECH2Z.OI.- HZS CooHngCofl°AtrjTow& Pae. iVa Draw . Measured Air Volume from Flow Grid or Hood NEW DUCTS Target 350 CFM/ton x CondenserToas CHANGEOUT Target 300 CFM/tan x condenser Tons Measured air greater than Target? (Y/1) Measured Fan Watt Draw Target OS8 watts/measured CFM = Measured Watts less than Target? (YIN) Copyright a zotl EDS Ener® Dttm Sohn OM hrc HVAC Field Data Sheet Pg 2 of 2 (xient Name &r- K a% vo-L& job # r �. Date —4�01 —/ MEQ[ -ZS Charge &Aird Condenser Serial Number Supply air dry bulb tempe Return air dry bulb tempe Return air wet bulb tempe Evaporator Saturation Tec Condenser Saturation Tem Suction Line Temperature Liquid Line Temperature Suction Pressure Actual Airflow Temperature Split Target Temperature Split from Table RA3.2.3 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 MEW 96,'WeVh4p Qtargdng below 55' Actual Line Set length (ft) Mfr's 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 ZONE 1 e Z.. 0 Minimum amps 13LI • / Maximum amps 5Z7 so Breaker size Compressor amps 1/,7 • Return Static Pressure Supply Static Pressure Suvviv Air Wet Bulb Temperature ZONE 3 • I ZONE 4 s • ALL APPLICABLE BOXES ON TMSPORMMUST BE COMPLETED FOR EACHICA NO EXCEPTION S • copyrW ® 2011 KDS fter® Drtvm Sohrttow, I= SMOKE AND CARBON MONOXIDE ALARM RETROFIT VERIFICATION I, C 16br K 1 ir,�,V CL__i.i, and I, (Print Property Owner's Name) (Tenant's Name - if same as Owner write "Same") who own and/or live in the dwelling located at: , (Address verify that the smoke and carbon monoxide alarms required by.the California R'easidential Code (CRC) have been installed, in the dwelling, incompliance with the code and with the manufacturer's instructions and further = that -they have'been-tested--ar-.d-d�r-fur.ctiio-n ro erl Y p p y.:..-.____... In an effort to enhance life safety within dwellings, CRC Section R314.6, R315.2 and CBC 420.4 require the retrofit of these alarms in existing dwellings when alterations, repairs or additions requiring a permit and exceeding $1,000 in value are made. Generally, the alarms must be hard wired'(110 volt) with battery back-up and all alarms are to be interconnected. if the installation of the alarms will require he removal of wall or ceiling finishes or there is no access by means of attic, basement or crawl space, then alarms may be solely battery operated and not interconnected. Alarms must be installed in all of the following Jocations within the existing dwelling: ➢ In all bedrooms (only require Smoke Alarms) ➢ Immediately outside of:each separate bedroom. (require Smoke and Carbor-.Monoxide Alarms) ➢ In each story level of the dwelling,' including basements and habitable.attic rooms (require Smoke and Carbon Monoxide A/arms) These safety devices must be installed by the time a final inspection is requested fo- your project. I understand the above requirements and certify that we now have smoke alarms and carbon monoxide. alarms installed that comply. We agree to. comply with the CRC. in .regards `6. smoke alarms, carbon monoxide alarms. Signature of O ner Date Signature of Tenant Date ATTENTION OWNER - OCCUPANT: This is.a Voluntary Smoke and Carbon Monoxide Alarm verification procedure- If you prefer a Building Inspector to perform the verification, you must arrange to have an adult present at the time. of inspection. NOTE: This Verification is .only used when normal access to the interior of the dwelling by the Cityof : uilding Inspector is not achieved during the course of project construction. It is normally used for projects such as re= oonng, re -siding, patio covers, swimming pools and the like..