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12-1004 (RER)- P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00001004 Property Address: 80092 VIA TESORO APN: 772-250-018-3 -31349 - Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 75000 Tiht 4 4 Q" Architect or Engineer: a/fk/ BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -----------------------------------'-------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busines�andProfes�so�and my License is in full force and effect. License Class: B 677877 Date: d/ �.� / ontractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the 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 permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State 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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within W6 fa„ of uu „plutluia il,e 0 ... im-Loulldei will have uw uwuLii u1 pluuing that ne or sne cia not Build or improve for the purpose of sale.). 1 _) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: BAIN,WILLIAM R & ZORA V 80-092 VIA TESORO LA QUINTA, CA 92253 Contractor: DAVIS RESTORATION OF GREAT, 77833 PALAPAS ROAD PALM DESERT, CA 92211 (760)360-1855 Lic. No.: 677877 VOICE (0) 777-7 12 FAX (76 -7011 INSPECTIONS (760) 777-7153 61 Date: 10/25/12 17C --'W CR -OF! e ,.- �.� e -----------------------------=----------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. _ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier NATIONAL UNION Policy Number 910606 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to or nsation provisions of Section �3700a Labor Coshall fo ith t se pr isions. cant: WARNING:' FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. 1 certify that I have read this application and state that the above informatio ree to comply with all city and county ordinances an state laws relating to building constructio hereb auth n representatives of xhis county to ent/Siature a above-mentioned property f pact' es. Date:/D-Z S �% (Applicant or Agent): Application Number . . . . . 12-00001004 ------ Structure Information FIRE DEAMGE REPAIR TO ENTIRE DWELLING ----- Other struct ---------------------------------------------------------------------------- info . . . . . CODE EDITION 2010 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 121.58 Plan Check Fee 30.40 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/23/13 Qty Unit Charge Per Extension BASE FEE 15.00 3045.00 ---------------------------------------------------------------------------- .0350 ELEC NEW RES - 1 OR 2 FAMILY 106.58 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 527.00 Plan Check Fee 342.55 Issue Date . . . . Valuation . . . . 75000 Expiration Date 4/23/13 Qty Unit Charge Per Extension BASE FEE 414.50 25.00 ---------------------------------------------------------------------------- 4.5000 THOU BLDG 50,001-100,000 112.50 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 148.00 Plan Check Fee 37.00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/23/13 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 3.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 7.00 6.5000 EA MECH VENT FAN 45.50 1.00 ---------------------------------------------------------------------------- G. .5000 DA MECII DICIIAUOT IIOOD 6.10 Permit . . . PLUMBING Additional desc . . MISCELLANEOUS ITEMS ONLY Permit Fee . . . . 34.50 Plan Check Fee 8.63 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/23/13 Qty Unit Charge Per LQPERMIT Extension Application Number . . . . . 12-00001004 Permit . . . . . . PLUMBING Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments FIRE DAMAGE REPAIR TO ENTIRE DWELLING [ENGINEERED] THIS PERMIT DOES NOT INCLUDE ADDITIONAL SQUARE FOOTAGE OR ALTERATION TO PREVIOUSLY PERMITTED FLOOR PLAN. ALL NEW INSTALLATIONS, INCLUDING REPAIRS SHALL COMPLY WITH CURRENT CODE REQUIREMENTS. 2010 CALIFORNIA BUILDING CODES. October 24, 2012 2:30:17 PM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 3.00 ENERGY REVIEW FEE 34.26 STRONG MOTION (SMI) - RES 7.50 Fee summary Charged Paid Credited ----------------------------------------------- Due ---------- Permit Fee Total 831.08 .00 .00 831.08 Plan Check Total 418.58 .00 .00 418.58 Other Fee Total 44.76 .00 .00 44.76 Grand Total 1294.42 .00 .00 1294.42 LQPERMIT Bln.# of La Quinta Building 8L Safety Division P.O. Box 1504,•78-49S Calle Tamplo La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application' and Tracking Sheet Permit # �-� Project Add[ess: y, a- o Z V IA lot-.- Owner's Name:. A P. Number. Address: Legal Description: City, ST, Zip: Contractor. N --r L s cT6 i" Telephone: Address: Project Description: City, ST, Zip: Telephone: Cx , O 6r! e 6 iv ITTj �o t S�taac LLiic�# : CityLic !! "'fib•, DesiilAer b 19 6 JL ii -,j 1,13 6 (2-1 [1 • , Address: City, ST, Zip: P r e i s C A �.c 6 3 o - 4 r$ Telephone: Construction Type:. V8 Occupancy: /e.3 V State Lic. #: 3 o g Project type (circle one): New Add'n AlterRep ' Demo Name of Contsct Person: D A v 6 W 6_g -6Sq. Ft.: jppyo #Stores: # Unitg: % lEstimatod Telephone #pof Contact Person: '7.14- $ 3 $ (, i Value of Project 7 J' a o , APPLICANT: DO NOT WRITE BELOW THIS LINE M Submittal Req'd Recd TRACMNG PERMIT FEES Plan Sets Plan Cheek submitted Tt® Amount Structural Cales. f Reviewed, ready for correction Plan Check Deposit. Truss Cala. � Clued Contact Person a, PLsn Check Balance_ Title 24 Calec Plans picked up Ce ustraction 5� . Flood plain plan Plans resubmitted.. %� ! wwariteal Grading plan 2•' Review, ready for correctioneiissue Electrical Subeontactor list Caned Contact Person P Lk -bang Grant Deed Plans picked up S_%LL H.O.A. Approval Plans resubmitted G:adlu- IN HOUSE: 3" Review, ready for correetlonsllssae Developer Impact Fee Planning ApproY&I Called Contact Person P. Pub. Wks. Appr Date of permit issue School Fees T3tal Permit Fees 9 -�- ��►l, - s� The Management Trust MONARCH GROUP DIVISION October 08, 2012 WILLIAM & ZORA BAIN 80-092 VIA TESORO LA QUINTA, CA 92253 RE: Architectural Submittal for 80-092 VIA TESORO Account #637880 Dear Homeowner: The Architectural Review Committee for MOUNTAIN VIEW HOA has reviewed and APPROVED your architectural submittal for the installation of Rebuild house structure, per the plans submitted. All construction must commence within 120 days of this approval letter. If construction has not been commenced within the 120 days, such approval shall be deemed withdrawn. At the completion of the construction please fill out the form for the inspection to be done by the HOA, and any deposits refunded. ARC approval of plans shall not constitute a representation, warranty, or guarantee that such plans and specifications comply with engineering design practices or zoning and building ordinances, or other governmental agency regulations or restrictions. The ARC shall not be responsible for reviewing, nor shall its approval of any plans or design, be deemed approved from the standpoint of structural safety or conformance with building or other codes. By approving such plans and specifications, neither the ARC, the Members thereof, the Association, any Member thereof, their Board of Directors, any Members thereof, or the Declarant assumes any liability or responsibility therefore or for any defect in the construction or improvement from such plans or specifications. As provided in the CC&R's neither the ARC, the Association, the Board of Directors or the Association or any Members thereof, not the Declarant or Developer shall be liable to any Member, Owner, Occupant, or other person or entity for any damage, loss or prejudice s uffered or claimed on account of (1) the approval or disapproval of any plans, drawings, or specifications, whether or not defective, or (2) the construction or performance of any work whether or not pursuant to the approved plans, drawings, or specifications. Your patience and cooperation with the architectural review process is appreciated. If you have any questions, please contact the association at (760) 776-5100, Extension 333. Sincerely, On behalf of the MOUNTAIN VIEW HOA Architectural Review Committee Heather Yslas I Association Assistant Manager Jamie Hansen The Management Trust - Monarch Group Division Enclosures (1) cc: Board of Directors Unit File RFv :IVSD OCT 0 8 2012 BY: 39755 Berkey Drive, Suite A, Palm Desert, CA 92211 CONNECTING PEOPLE TO THE PROMISE PH: 760.776.5100 FAX: 760.776.5111 www.managementtrust.com MING ENGINEERING SERVICES www.valuengr.com 71-780 San Jacinto Dr. Ste. E2, Rancho Mirage, Ca. 92270 ph. (760) 834-8860 fax (760) 834-8861 To: City of La Quinta 78-495 Calle Tampico La Quinta, CA 92253 Attn: Kay Letter of Transmittal Today's Date: 10-22-12 City Due Date: 10-22-12 Project Address: 80-092 Via Tesoro Plan Check #: 12-1004 ❑ 4th ❑ 5th ❑ Other: By Mail (Fed Ex or UPS) ❑ Your Pickup Submittal: ❑ 15' Descriptions: ® 2nd ® 1 ❑ 3rd We are forwarding: ® By Messenger ❑ Includes: Revised Truss w/Stamp Descriptions: ❑ ❑ Structural Plans Approved Structural Plans ❑ Structural Calculations ❑ ® 1 Truss Calcs ❑ ❑ Soils Report Update Other: ® 1 Structural P/C Responses ® 1 Redlined Structural Plans ® 1 Redlined Structural Calcs ❑ Redlined Truss Calcs ❑ Redlined Soils Reports ❑ 4th ❑ 5th ❑ Other: By Mail (Fed Ex or UPS) ❑ Your Pickup Includes: # Of Descriptions: Copies: ® 1 Revised Struct. Plans ® 1 Revised Struct. Calcs ❑ Revised Truss w/Stamp ❑ Revised Soils Report ❑ Approved Structural Plans ❑ Approved Structural Calcs ❑ Approved Truss Calcs ❑ Approved Soils Report ❑ Other: Comments: Structural content is approvable. I;? TTVE n (^ T 2 i 2017Structural Plan Review Time =1.75 HRS This Material Sent for: $Y, ❑ Your Files ® Per Your Request ❑ Your Review ❑ Approval ❑ Checking ❑ At the request of: Other: ❑ By: John W. Thompson Rancho Mirage Office: ® (760) 834-8860 Other: ❑ BUILDING ENERGY ANALYSIS REPORT PROJECT: Mountain View Country Club 80092 Via Tesoro La Quinta , CA Project Designer: Weber Engineering, Inc. 5450 Orange Ave. Cypress, CA 90630 Report Prepared by: David J. Fruchtman Fruchtman & Associates, Inc. 11315 Washington Place Los Angeles, California 90066 310-915-6110 . RFS=.IVSD AUG 3 0 2012 BY. o BAIN1911.01 Date: 8/24/2012 CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE BY. The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC — www.energysoft.com. Energ Pro 5.1 by Ener Soft User Number: 4469 RunCode: 2012-08-24T11:00:47 ID: BAIN1911.01 . 1 4 I TABLE OF CONTENTS Cover Page 1 Table of Contents 2 Form CF -1 R Certificate of Compliance 3 Form MF -1 R Mandatory Measures Summary 13 HVAC System Heating and Cooling Loads Summary 16 Room Load Summary 19 EnergyPro 5.1 by EnergySoft Job Number: ID: BAIN1911.01 User Number 4469 PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF -1 R Project Name Mountain View Country Club Building Type ® Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Additior/Alteration Date 8/24/2012 Project Address 80092 Via Tesoro La Quinta California Energy Climate Zone CA Climate Zone 15 Total Cond. Floor Area 3,045 Addition n/a # of Stories 1 FIELD INSPECTION ENERGY CHECKLIST ❑ Yes ❑ No HERS Measures -- If Yes, A CF -4R must be provided per Part 2 of 5 of this form. ❑ Yes ❑ No Special Features -- If Yes, see Part 2 of 5 of this form for details. INSULATION Construction Type Area Special Cavity (ft) Features (see Part 2 of 5) Status Wall Wood Framed R-19 2,491 New Roof Wood Framed Attic R-30 2,844 New Slab Unheated Slab -on -Grade None 2,822 Perim = 0' Existing Slab Unheated Slab -on -Grade None 223 Perim = 0' New Wall Solid Unit Masonry None 102 New Door Opaque Door None 20 New Roof Wood Framed Rafter R-19 201 New FENESTRATION U- Exterior Orientation Area(ft) Factor SHGC Overhang Sidefins Shades Status Front (N) 183.0 0.310 0.27 10.0 none Bug Screen New Front (N) 97.2 0.310 0.27 2.0 none Bug Screen New Right (W) 26.7 0.310 0.27 2.0 none Bug Screen New Left (E) 165.0 0.310 0.27 2.0 none Bug Screen New Left (E) 18.6 0.710 0.73 2.0 none Bug Screen New Rear (S) 2.6 0.710 0.73 2.0 none Bug Screen New Left (SE) 14.6 0.710 0.73 2.0 none Bug Screen New Right (W) 4.2 0.710 0.73 2.0 none Bug Screen New Front (NE) 24.0 0.310 0.27 2.0 none Bug Screen New Front (N) 15.0 0.710 0.73 2.0 none Bug Screen New Rear (S) 12.0 0.310 0.27 2.0 none Bug Screen New HVAC SYSTEMS Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status 1 Split Heat Pump 8.10 HSPF SpCt Heat Pump 13.0 SEER Setback New 1 Split Heat Pump 8.00 HSPF Split Heat Pump 13.0 SEER Setback New 1 Split Heat Pump 8.20 HSPF Split Heat Pump 13.0 SEER Setback New HVAC DISTRIBUTION Location Heating Duct Cooling Duct Location R -Value Status SHP 2 Ducted Ducted Attic, Ceiling Ins, vented r,.0 New SHP 1 Ducted Duc;ed Attic, Ceiling Ins, vented 8.0 New SHP 3 Ducted Ducted Attic, Ceiling Ins, vented 1r.0 New WATER HEATING Qty. Type Gallons Min. Eff Distribution Status 1 Instant Gas 0 0.84 Kitchen Pipe Ins New Ener Pro 5.1 by Ener Soft User Number- 4469 RunCode: 2012-08-24T11:00:47 ID: BAIN1911.0 % Page 3 of 21 PERFORMANCE CERTIFICATE: Residential (Part 2 of 5) CF -1 R Project Name Mountain View Country Club Building Type ® Single Family ❑ Addition Alone 1 ❑ Multi Family ❑ Existing+ Additio-i/Alteration Date 1812412012 SPECIAL FEATURES INSPECTION CHECKLIST The enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification to be used with the performance approach. The erforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation submitted. This building is modeled with reduced infiltration. Consequently the homeowner's manual provided by the builder to the homeowner shall include operating instructions for the homeowner on how to use mechanical ventilation to achieve adequate ventilation. Testing for reduced infiltration shall be performed as specified in ASTM E 779-03. This listing shall also report the target -CFM50H required for the blower door test to achieve the modeled SLA and the minimum CFM50H (corresponding to an SLA of 1.5) allowed to avoid backdraft problems. This building is modeled with reduced infiltration. Consequently the homeowner's manual provided by the builder to the homeowner shall include operating instructions for the homeowner on how to use mechanical ventilation to achieve adequate ventilation. Testing for reduced infiltration shall be performed as specified in ASTM E 779-03. This listing shall also report the target CFM50H required for the blower door test to achieve the modeled SLA and the minimum CFM50H (corresponding to an SLA of 1.5 allowed to avoid backdraft problems. This building is modeled with reduced infiltration. Consequently the homeowner's manual provided by the builder to the homeowner shall include operating instructions for the homeowner on how to use mechanical ventilation to achieve adequate ventilation. Testing for reduced infiltration shall be performed as specified in ASTM E 779-03. This listing shall also report the target CFM50H required for the blower door test to achieve the modeled SLA and the minimum CFM50H (corresponding to an SLA of 1.5 allowed to avoid backdraft problems. HERS REQUIRED VERIFICATION Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a completed CF -4R form for each of the measures listed below for final to be given. The Cooling System SHP-3.5 Ton (FX4D/25HCB) includes credit for a 10.4 EER Condenser. A certified HERS rater mist field verify the installation of the correct Condenser. This building has tight construction with reduced infiltration and a target blower door test range between 453 and 0 CFh' at 50 pascals. The blower door test must be performed using the ASTM Standard Test Method for Determining Air Leakage Rate. WARNING - If this building tests below 453 CFM at 50 pascals, the house must either be provided with a ventilation opening that will increase the infiltration to this level (SLA=1.5) OR mechanical supply ventilation must be provided. The HVAC System SHP 2 incorporates HERS Verified Refrigerant Charge or a Charge Indicator Display. Compliance credit for quality installation of insulation has been used. HERS field verification is required. The HVAC System SHP 2 includes credit for verified adequate airflow. A certified HERS rater must diagnostically meazure airflow of the HVAC System. The HVAC System SHP 2 incorporates HERS verified Duct Leakage. HERS field verification and diagnostic testing is squired to verify that duct leakage meets the specified criteria. The Cooling System SHP-5.0 Ton (FX4D/25HCB) includes credit for a 11.0 EER Condenser. A certified HERS rater must field verify the installation of the correct Condenser. This building has tight construction with reduced infiltration and a target blower door test range between 597 and 0 CFAB at 50 pascals. The blower door test must be performed using the ASTM Standard Test Method for Determining Air Leakage Rate. WARNING - If this building tests below 597 CFM at 50 pascals, the house must either be provided with a ventilation op 3ning that will increase the infiltration to this level (SLA=1.5) OR mechanical supply ventilation must be provided. The HVAC System SHP 1 incorporates HERS Verified Refrigerant Charge or a Charge Indicator Display. Compliance credit for quality installation of insulation has been used. HERS field verification is required. Ener Pro 5.1 by Ener Soft User Number: 4469 RunCode: 2012-08-24T11:00:47 ID: BAIN1911.0! Page 4 of 21 PERFORMANCE CERTIFICATE: Residential (Part 2 of 5) CF -1 R Project Name Mountain View Country Club Building Type ® Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date $/24/2012 SPECIAL FEATURES INSPECTION CHECKLIST The enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification to be used with the performance approach. The enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation submitted. HERS REQUIRED VERIFICATION Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a completed CF -4R form for each of the measures listed below for final to be given. The HVAC System SHP 1 includes credit for verified adequate airflow. A certified HERS rater must diagnostically measure airflow of the HVAC System. The HVAC System SHP 1 incorporates HERS verified Duct Leakage. HERS field verification and diagnostic testing is required to verify that duct leakage meets the specified criteria. The Cooling System SHP-2.0 Ton (FX4D/25HCB) includes credit for a 10.5 EER Condenser. A certified HERS rater must field verify the installation of the correct Condenser. This building has tight construction with reduced infiltration and a target blower door test range between 146 and 0 CFM at 50 pascals. The blower door test must be performed using the ASTM Standard Test Method for Determining Air Leakage Rate. WARNING - If this building tests below 146 CFM at 50 pascals, the house must either be provided with a ventilation opening that will increase the infiltration to this level (SLA=1.5) OR mechanical supply ventilation must be provided. The HVAC System SHP 3 incorporates HERS Verified Refrigerant Charge or a Charge Indicator Display. Compliance credit for quality installation of insulation has been used. HERS field verification is required. The HVAC System SHP 3 includes credit for verified adequate airflow. A certified HERS rater must diagnostically measure airflow of the HVAC System. The HVAC System SHP 3 incorporates HERS verified Duct Leakage. HERS field verification and diagnostic testing is required to verify that duct leakage meets the specified criteria. Ener Pro 5.1 by Ener Soft User Number: 4469 RunCode: 2012-08-24T11:00:47 ID: BAIN1911.01 Pa e 5 of 21 PERFORMANCE CERTIFICATE: Residential (Part 3 of 5) CF-1 R Project Name Building Type m Single Family ❑ Addition Alone Date Mountain View Country Club ❑ Multi Family ❑ Existing+ Addition/Alteration 1812412012 ANNUAL ENERGY USE SUMMARY Standard Proposed Margin TDV kBtu/ft2- r Space Heating 2.97 2.75 0.22 Space Cooling 53.02 52.05 0.97 Fans 10.43 14.60 -4.17 Domestic Hot Water 11.98 8.53 3.45 Pumps 0.00 0.00 0.00 Totals 78.39 77.92 0.47 Percent Better Than Standard: 0.6% BUILDING COMPLIES - HERS VERIFICATION REQUIRED Fenestration Building Front Orientation: (N) 0 deg Ext. Walls/Roof Wall Area Area Number of Dwelling Units: 1.00 (N) 1248 319 Fuel Available at Site: Natural Gas (E) 963 198 Raised Floor Area: 0 (S) 248 15 Slab on Grade Area: 3,045 (149 717 31 Average Ceiling Height: 11.3 Roof :1045 0 Fenestration Average U-Factor: 0.35 TOTAL: 563 Average SHGC: 0.31 Fenestration/CFA Ratio: 18.5% REMARKS STATEMENT OF COMPLIANCE This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the Efficiency Standards of the California Code of Regulations. The documentation author hereby certifies that the documentation is accurate and complete. Documentation Author Company Fruchtman & Associates, Inc. Address 11315 Washington Place Name David J. Fruchtman 8/24/2012 City/State/ZipCity/State/Zip Los Angeles, California 90066 Phone 310-915-6110 Signed Date The individual with overall design responsibility hereby certifies that the proposed building design represented in this set of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit application, and recognizes that compliance using duct design, duct sealing, verification of refrigerant charge, insulation installation quality, and building envelope sealing require installer testing and certification and field verification by an approved HERS rater. Designer or Owner (per Business & Professions Code) Company Weber Engineering, Inc. Address 5450 Orange Ave. Name Dave Weber City/State/Zip Cypress, CA 90630 Phone Signed License # Date Ene Pro 5.1 by Ener Soft User Number: 4469 RunCode: 2012-08-24T11:00:47 ID: BAIN1911. )1 Page 6 of 21 CERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF -1 R Project Name Mountain View Country Club Building Type m Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date g�241,' OPAQUE SURFACE DETAILS Surface Type Area U- Insulation Factor Cavity Exterior Frame Interior Frame Azm Joint Appendix Tilt Status 4 Location/Comments Wall 206 0.074 R-19 270 90 New 4.3.1-A5 Zone B Wall 162 0.074 R-19 0 90 New 4.3.1-A5 Zone B Roof 354 0.031 R-30 0 0 New 4.2.1-A20 Zone 8 Slab 354 0.730 None 0 180 Existing 4.4.7-A1 Zone 8 Wall 123 0.074 R-19 270 90 New 4.3.1-A5 Zone B Roof 129 0.031 R-30 0 0 New 4.2.1-A20 Zone B Slab 129 0.730 None 0 180 Existing 4.4.7-A1 Zone B Wall 150 0.074 R-19 270 90 New 4.3.1-A5 Zone 8 Roof 223 0.031 R-30 0 0 New 4.2.1-A20 Zone 8 Slab 223 0.730 None 0 180 New 4.4.7-A1 Zone 8 Wall 115 0.074 R-19 0 90 New 4.3. i -A5 Zone 8 Roof 92 0.031 R-30 0 0 New 4.2.1-A20 Zone B Slab 92 0.730 None 0 180 Existing 4.4.7-A1 Zone 8 Wall 55 0.074 R-19 0 90 New 4.3.1-A5 Zone 8 Wall 60 0.074 R-19 0 90 New 4.3.1-A5 Zone B Wall 130 0.074 R-19 0 90 New 4.3.1-A5 Zone 8 FENESTRATION SURFACE DETAILS ID Type Area U -Factor SHGC Azm Status Glazing Type Location/Comments 1 Window 36.5 0.310 NFRC 0.27 NFRC 0 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone B 2 Window 14.6 0.310 NFRC 0.27 NFRC 0 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone 8 3 Window 14.6 0.310 NFRC 0.27 NFRC 0 New Vinyl/Low-E - u=0.31 sh c=0.27 Zone B 4 Window 1.4 0.310 NFRC 0.27 NFRC 270 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone 8 5 1 Window 1.4 0.310 NFRC 0.27 NFRC 270 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone B 6 Window 4.8 0.310 NFRC 0.27 NFRC 270 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone B 7 Window 4.8 0.310 NFRC 0.27 NFRC 270 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone 8 8 Window 4.8 0.310 NFRC 0.27 NFRC 270 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone B 9 Window 6.0 0.310 NFRC 0.27 NFRC 270 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone B 10 Window 9.0 0.310 NFRC 0.27 NFRC 90 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone 8 11 Window 24.0 0.310 NFRC 0.27 NFRC 90 New Vinylkow-E - u=0.31 shgc=0.27 Zone B 12 Window 9.0 0.310 NFRC 0.27 NFRC 90 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone B 13 Window 31.0 0.310 NFRC 0.27 NFRC 90 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone A 14 Window 31.0 0.310 NFRC 0.27 NFRC 90 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone A 15 Window 31.0 0.310 NFRC 0.27 NFRC 90 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone A 16 Window 44.0 0.310 NFRC 0.27 NFRC 0 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone A (1) 1.1 -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value 2 SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value EXTERIOR SHADING DETAILS ID Exterior Shade Type SHGC Window H t I Wd Ove hang Left Fin Right Fin Len H t LExt I RExt Dist Len H t Dist Len H t 1 Bug Screen 0.76 6.6 11.0 10.0 0.1 10.01 10.0 2 Bug Screen 0.76 7.5 2.0 2.0 0.1 2.0 2.0 3 Bug Screen 0.76 7.5 2.0 2.0 0.1 2.0 2.0 4 Bug Screen 0.76 2.0 1.2 2.0 0.1 2.0 2.0 5 Bug Screen 0.76 2.0 1.2 2.0 0.1 2.0 2.0 6 Bug Screen 0.76 2.5 1.6 2.0 0.1 2.0 2.0 7 Bug Screen 0.76 2.5 1.6 2.0 0.1 2.0 2.0 8 Bug Screen 0.76 2.5 1.6 2.0 0.1 2.0 2.0 9 Bug Screen 0.76 1.6 1.6 2.0 0.1 2.0 2.0 10 Bug Screen 0.76 6.0 1.5 2.0 0.1 2.0 2.0 11 Bug Screen 0.76 6.0 4.0 2.0 0.1 2.0 2.0 12 Bug Screen 0.76 6.0 1.5 2.0 0.1 2.0 2.0 13 Bug Screen 0.76 7.5 3.0 2.0 0.1 2.0 2.0 14 Bug Screen 0.76 7.5 3.0 2.0 0.1 2.0 2.0 15 Bug Screen 0.76 7.51 3.0 2.0 0.1 2.0 2.0 16 Bug Screen 0.76 6.61 11.0 10.0 0.1 10.0 10.0 Ener Pro 5.1 by Ener Soft User Number: 4469 RunCode: 2012-08-24T11:00:47 ID: BAIN1911.01 Pae 7 of 21 CERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF -1 R Project NameBuilding Mountain View Country Club 7❑ Type 10 Single Family ❑ Addition Alone Multi Family ❑ Existing+ Addition/Alteration Date 1812412012 OPAQUE SURFACE DETAILS Surface Type Area U- Insulation Factor Cavity Exterior Frame Interior Frame Azm Joint Appendix Tilt Status 4 Location/Comments Roof 355 0.031 R-30 0 0 New 4.2.1-A20 Zone B Slab 355 0.730 None 0 180 Existing 4.4.7-A1 Zone B Wall 53 0.074 R-19 90 90 New 4.3.1-A5 Zone B Wall 40 0.074 R-19 0 90 New 4.3.1-A5 Zone B Wall 61 0.074 R-19 90 90 New 4.3.1-A5 Zone Wall 82 0.740 None 0 90 New 4.3.6-F5 Zone A Roof 498 0.031 R-30 0 0 New 4.2.1-A20 Zone A Slab 498 0.730 None 0 180 Existing 4.4.7-A1 Zone A Wall 93 0.074 R-19 90 90 New 4.3.1-A5 Zone A Wall 103 0.074 R-19 0 90 New 4.3.1-A5 Zone A Roof 95 0.031 R-30 0 0 New 4.2.1-A20 Zone A Slab 95 0.730 None 0 180 Existing 4.4.7-A1 Zone A Roof 185 0.031 R-30 0 0 New 4.2.1-A20 Zone Slab 185 0.730 None 0 180 Existing 4.4.7-A 1 Zone A Wall 35 0.074 R-19 1351 90 New 4.3.1-A5 Zone A Door 20 0.500 None 1 1351 90 New 4.5.1-A4 Zone A FENESTRATION SURFACE DETAILS ID Type Area U -Factor SHGC Azm Status Glazing Type Location/Comments 17 Window 66.0 0.310 NFRC 0.27 NFRC 0 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone A 18 Window 36.5 0.310 NFRC 0.27 NFRC 0 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone A 19 Window 44.0 0.310 NFRC 0.27 NFRC 0 New Vinyl/Low-E - u=0.31 sh c=0.27 Zone A 20 Window 2.0 0.710 Default 0.73 Default 90 New Double Metal Clear Zone A 21 Window 2.0 0.710 Default 0.73 Default 90 New Double Metal Clear Zone A 22 Window 2.6 0.710 Default 0.73 Default 180 New Double Metal Clear Zone A 23 Window 14.6 0.710 Default 0.73 Default 90 New Double Metal Clear Zone A 24 Window 14.6 0.710 Default 0.73 Default 135 New Double Metal Clear Zone A 25 Window 3.5 0.310 NFRC 0.27 NFRC 270 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone A 26 Window 4.2 0.710 Default 0.73 Default 270 New Double Metal Clear Zone A 27 Window 24.0 0.310 NFRC 0.27 NFRC 90 New VinyllLow-E - u=0.31 shgc=O. 271 Zone C 28 Window 24.0 0.310 NFRC 0.27 NFRC 45 New Vinyl/Low-E - u=0.31 shgc=0.271 Zone C 29 Window 1 15.0 0.710 Default 0.73 1 Default 1 0 New Double Metal Clear Zone C 30 Window 6.0 0.310 NFRC 1 0.27 NFRC 1 90 New Vinyl/Low-E - u=0.31 shgc=0.27; Zone C 31 Window 1 4.0 0.310 NFRC 1 0.27 NFRC 1 180 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone C 32 Window 1 4.0 0.310 NFRC 1 0.27 NFRC 1 180 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone C (1) Ll -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value 2 SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value EXTERIOR SHADING DETAILS ID Exterior Shade Type SHGC Window H t Wd Ove hang Left Fin Right Fin Len H t LExt RExt Dist Len H t Dist Len H t 17 Bug Screen 0.76 6.61 11.0 10.0 0.1 10.0 10.0 18 Bug Screen 0.76 6.6 11.0 10.0 0.1 10.0 10.0 19 Bug Screen 0.76 7.3 6.0 2.0 0.1 2.0 2.0 20 Bug Screen 0.76 1.0 1.6 2.0 0.1 2.0 2.0 21 Bug Screen 0.76 1.0 1.6 2.0 0.1 2.0 2.0 22 Bug Screen 0.76 1.0 1.6 2.0 0.1 2.0 2.0 23 Bug Screen 0.76 7.5 2.0 2.0 0.1 2.0 2.0 24 Bug Screen 0.76 7.5 2.0 2.0 0.1 2.0 2.0 25 Bug Screen 0.76 2.0 1.6 2.0 0.1 2.0 2.0 26 Bug Screen 0.76 2.5 1.6 2.0 0.1 2.0 2.0 27 Bug Screen 0.76 6.0 4.0 2.0 0.1 2.0 2.0 28 Bug Screen 0.76 6.0 4.0 2.0 0.1 2.0 2.0 29 Bug Screen 0.76 7.5 2.0 2.0 0.1 2.0 2.0 30 Bug Screen 0.76 3.0 2.0 2.0 0.1 2.0 2.0 31 JBugr Screen 1 0.761 4.01 1.0 2.0 0.1 2.0 2.0 32 JBug Screen 1 0.761 4.01 1.0 2.0 0.1 2.0 2.0 Ener Pro 5.1 by Ener Soft User Number: 4469 RunCode: 2012-08-24T11:00:47 ID: BAIN1911.01 Page 8 of 21 CERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF -1 R Project Name Mountain View Country Club Building Type m Single Family ❑ Multi Family ❑ Addition Alone ❑ Existing+ Addition/Alteration Date 1812412012 OPAQUE SURFACE DETAILS Surface U- Insulation Type Area Factor Cavity Exterior Frame Interior Frame Azm Tilt Status Joint Appendix 4 Location/Comments Wall 181 0.074 R-19 90 90 New 4.3.1-A5 Zone A Roof 231 0.031 R-30 0 0 New 4.2.1-A20 Zone A Slab 231 0.730 None 0 180 Existing 4.4.7-A1 Zone A Wall 97 0.074 R-19 180 90 New 4.3.1-A5 Zone A Wall 93 0.074 R-19 90 90 New 4.3.1-A5 Zone A Roof 201 0.051 R-19 0 0 New 4.2.2-Al2 Zone A Slab 201 0.730 None 0 180 Existing 4.4.7-A1 Zone A Wall 57 0.074 R-19 135 90 New 4.3.1-A5 Zone A Wall 20 0.740 None 180 90 New 4.3.6-F5 Zone A Roof 145 0.031 R-30 0 0 New 4.2.1-A20 Zone A Slab 145 0.730 None 0 180 Existing 4.4.7-A 1 Zone A Wall 1571 0.074 R-19 90 New 4.3.1-A5 Zone A Roof 123 0.031 R-30 0 New 4.2.1-A20 Zone Slab 123 0.730 None 180 Existing4.4.7-A1 E270 Zone A Wall 51 0.074 R-19 90 New 4.3.1-A5 ZoneA Roof 42 0.031 R-30 0 New 4.2.1-A20 lZone A FENESTRATION SURFACE DETAILS ID Type Area U -Factor SHGC Azm Status Glazing Type Location/Comments 33 Window 4.0 0.310 NFRC 0.27 NFRC 180 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone C 34 Window 24.0 0.310 NFRC 0.27 NFRC 0 New Vinyl/Low-E - u=0.31 shgc=0.27 Zone C (1) U -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value 2 SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value EXTERIOR SHADING DETAILS Window ID Exterior Shade Type SHGC H t Wd Ove hang Len H t LExt RExt Left Fin Dist Len I H t Right Fin Dist Len H t 33 Bug Screen 0.76 4.0 1.0 2.0 0.1 2.0 2.0 34 Bug Screen 0.76 6.0 4.0 2.0 0.1 2.0 2.0 Ener Pro 5.1 by Ener Soft User Number: 4469 RunCode: 2012-08-24T11:00:47 ID: BAIN1911.01 Page 9 of 21 CERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF -1 R Project Name Mountain View Country Club Building Type m Single Family ❑ Multi Family ❑ Addition Alone ❑ Existing+ Addition/Alteration Date 1812412012 OPAQUE SURFACE DETAILS Surface U- Insulation Joint Appendix Type Area Factor Cavity Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments Slab 42 0.730 None 0 180 Existing 4.4.7-A1 Zone A Roof 210 0.031 R-30 0 0 New 4.2.1-A20 Zone C Slab 210 0.730 None 0 180 Existing 4.4.7-A1 Zone C Wall 79 0.074 R-19 90 90 New 4.3.1-A5 Zone C Wall 36 0.074 R-19 45 90 New 4.3.1-A5 Zone C Wall 95 0.074 R-19 0 90 New 4.3.1-A5 Zone C Wall 92 0.074 R-19 90 90 New 4.3. i -A5 Zone C Roof 114 0.031 R-30 0 0 New 4.2.1-A20 Zone C Slab 114 0.730 None 0 180 Existing 4.4.7-A1 Zone C Wall 116 0.074 R-19 180 90 New 4.3.1-A5 Zone C Roof 48 0.031 R-30 0 0 New 4.2.1-A20 Zone C Slab 48 0.730 None 0 180 Existing 4.4.7-A 1 Zone C Wall 27 0.074 R-19 0 90 New 4.3.1-A5 Zone C Wall 24 0.074 R-19 0 90 New 4.3.1-A5 Zone C FENESTRATION SURFACE DETAILS ID Type Area U -Factor SHGC2 Azm Status Glazing Type Location/Comments (1) U -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value 2 SHGC Type: 116-13 = Default Table from Standards, NFRC = Labeled Value EXTERIOR SHADING DETAILS Window ID Exterior Shade T e SHGC HTWd Ove hang Len H t LExt RExt Left Fin Dist Len H t Ri ht Fin Dist Len H t Ener Pro 5.1 by EnerpySoft User Number: 4469 RunCode: 2012-08-24T11:00:47 ID: BAIN1911.01 Pae 10 of 21 CERTIFICATE OF COMPLIANCE: Residential (Part 5 of 5) CF -1 R Project Name Mountain View Country Club Buildinge Type 10Single Family 11 Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Dat 1812412012 BUILDING ZONE INFORMATION System Name Zone Name Floor Area New Existing Altered Removed Volume Year Built SHP 2 Master Bed 354 4,248 Closet 129 1,290 Master Bath 223 Z 230 Bath 92 920 Bed Room 355 3,550 SHP 1 Living Room 498 5,976 Study 95 1,140 Foyer 185 3,145 Kitchen 231 2,541 Dining Room 201 2,412 2000 Hall 145 1,450 Laundry Room 123 1,230 Bath 42 420 SHP 3 Guest 210 2,100 Bath Room 1 1141 1,140 Totals I Z8441 201 01 0 HVAC SYSTEMS System Name Ot . Heating Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status SHP 2 1 Split Heat Pump 8.10 HSPF Split Heat Pump 13.0 SEER Setback New SHP 1 1 Split Heat Pump 8.00 HSPF Split Heat Pump 13.0 SEER Setback New SHP 3 1 Split Heat Pump 8.20 HSPF Split Heat Pump 13.0 SEER Setback New HVAC DISTRIBUTION System Name Heating Duct Cooling Duct Location R -Value Ducts Tested? Status SHP 2 Ducted Ducted Attic, Ceiling Ins, vented 8.0 m New SHP 1 Ducted Ducted Attic, Ceiling Ins, vented 8.0 m New SHP 3 Ducted Ducted Attic, Ceiling Ins, vented 8.0 E) New WATER HEATING SYSTEMS S stem Name Qty. Type Distribution Rated Input Btuh Tank Cap. al Energy Factor or RE Standby Loss or Pilot Ext. Tank Insul. R- Value Status Takagi T -K2 1 Instant Gas Kitchen Pipe Ins 185,000 0 0.84 n/a n/a New MULTI -FAMILY WATER HEATING DETAILS HYDRONIC HEATING SYSTEM PIPING Control Hot Water Piping Length ft 0 _ o -00 c Q — System Name Pipe Length Pipe Diameter Insul. Thick. Qty. HP Plenum Outside Buried ❑ Ener Pro 5.1 by Ener Soft User Number: 4469 RunCode: 2012-08-24T11:00:47 ID: BAIN1911.01 Pae 11 of 21 CERTIFICATE OF COMPLIANCE: Residential (Part 5 of 5) CF -1 R Project Name Mountain View Country Club Building Type Single Family ❑Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Dat e 8/24/2012 BUILDING ZONE INFORMATION System Name Zone Name Floor Area New Existing Altered Removed Volume Year Built Closet 48 480 Totals 2844 201 0 0 HVAC SYSTEMS System Name Qty. Heating Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status HVAC DISTRIBUTION System Name Heating Duct Ducts Cooling Duct Location R -Value Tested? Status ❑ WATER HEATING SYSTEMS S stem Name Qty. Type Distribution Rated Input Btuh Tank Cap. al Energy Factor or RE Standby Loss or Pilot Ext. Tank Insul. R- Value Status MULTI -FAMILY WATER HEATING DETAILS HYDRONIC HEATING SYSTEM PIPING Control Hot Water Piping Length (ft)c 0 ¢ — System Name Pipe Length Pipe Diameter Insul. Thick. Qty. HP Plenum Outside Buried 01 Ener Pro 5.1 by Ener Soft User Number: 4469 RunCode: 2012-08-24711:00:47 ID: BAIN1911.01 Pae 12 of 21 MANDATORY MEASURES SUMMARY: Residential Pae 1 of 3 MF -1 R Project Name Mountain View Country Club Date 1 8/24/2012 NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of the compliance approach used. More stringent energy measures listed on the Certificate of Compliance (CF -1 R, CF -1 R -ADD, or CF - 1 R -ALT Form) shall supersede the items marked with an asterisk (') below. This Mandatory Measures Summary shall be incorporated into the permit documents, and the applicable features shall be considered by all parties as minimum component performance specifications whether they are shown elsewhere in the documents or in this summary. Submit all applicable sections of the MF -1 R Form with plans. Building Envelope Measures: 116 (a)1: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. §116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain Coefficient SHGC , and infiltration that meets the requirements of 10-111 (a). 117: Exterior doors and windows are weather-stripped; all joints and penetrations are caulked and sealed. 118(a): Insulationspecified or installed meets Standards for Insulating Material. Indicate type and include on CF -6R Form. §118(i): The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of §118(i) when the installation of a Cool Roof is specified on the CF -1 R Form. *§1 50 a : Minimum R-19 insulation in wood -frame ceiling orequivalent U -factor. 150(b): Loose fill insulation shall conform with manufacturer's installed design labeled R -Value. *§1 50 c : Minimum R-13 insulation in wood -frame wall orequivalent U -factor. *§1 50 d : Minimum R-13 insulation in raised wood -frame floor orequivalent U -factor. 150(f): Air retarding wrap is tested, labeled, and installed according to ASTM E1677-95 2000 when specified on the CF -1 R Form. 1 50 : Mandatory Vapor barrier installed in Climate Zones 14 or 16. §150(1): Water absorption rate for slab edge insulation material alone without facings is no greater than 0.3%; water vapor permeance rate is no greater than 2.0perm/inch and shall be protected from physical damage and UV light deterioration. Fireplaces, Decorative Gas Appliances and Gas Log Measures: 150 e 1 A: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox. §150(e)1 B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is equipped with a with a readily accessible, operable, and tight -fitting damper and or a combustion -air control device. §150(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the outside of the building, are prohibited. Space Conditioning, Water Heating and Plumbing System Measures: §110-§113: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified by the Energy Commission. §113(c)5: Water heating recirculation loops serving multiple dwelling units and High -Rise residential occupancies meet the air release valve, backflow prevention, pump isolation valve, and recirculation loop connection requirements of §113(c)5. §115: Continuously burning pilot lights are prohibited for natural gas: fan -type central furnaces, household cooking appliances (appliances with an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool and spa heaters. §150(h): Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA. 150(i): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c). §1500)1A: Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped with insulation having an installed thermal resistance of R-12 or greater. §1500)113: Unfired storage tanks, such as storage tanks or backup tanks for solar water -heating system, or other indirect hot water tanks have R-12 external insulation or R-16 internal insulation where the internal insulation R -value is indicated on the exterior of the tank. §1500)2: First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire length of recirculating sections of hot water pipes are insulated per Standards Table 150-B. §1500)2: Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot water tank shall be insulated to Table 150-B and Equation 150-A. §1500)2: Pipe insulation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards Table 123-A. 1 50 ' 3A: Insulation is protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. §1500)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in conditioned space. 150(j)4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation. EnergyPro 5.1 by EnergySoft User Number: 4469 RunCode: 2012-08-24T11:00:47 ID: BAIN1911.01 Page 13 of 21 MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF -1 R Project Name Date Mountain View Country Club 1812412012 §150(m)1: All air -distribution system ducts and plenums installed, are sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R- 4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181 A, or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings reater than 1/4 inch, the combination of mastic and either mesh or tape shall be used §150(m)1: Building cavities, support plafforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. §150(m)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. 150(m)7: Exhaust fans stems have back draft or automatic dampers. §150(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. §150(m)9: Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. 150(m)10: Flexible ducts cannot have porous inner cores. §150(o): All dwelling units shall meet the requirements of ANSI/ASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air Quality in Low -Rise Residential Buildings. Window operation is not a permissible method of providing the Whole Building Ventilation required in Section 4 of that Standard. Pool and Spa Heating Systems and Equipment Measures: §114(a): Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency Regulations; an on-off switch mounted outside of the heater; a permanent weatherproof plate or card with operating instructions; and shall not use electric resistance heating ora pilot light. §114(b)1: Any pool or spa heating equipment shall be installed with at least 36" of pipe between filter and heater, or dedicated suction and return lines, or built-up connections for future solar heating. 114(b)2: Outdoor pools ors as that have a heat pump or gas heater shall have a cover. §114(b)3: Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or programmed to run only during off-peak electric demand periods. 150 : Residential pool systems orequipment meet the pump sizing, flow rate, piping, filters, and valve requirements of §150 Residential Lighting Measures: §150(k)1: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies contained in Table 150-C and is not a low efficacy luminaire asspecified by §150(k)2. 150(k)3: The wattage of permanently installed luminaires shall be determined asspecified by §130(d). §150(k)4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than 20 kHz. §150(k)5: Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and shall not contain a line -voltage socket or line - voltage lamp holder; OR shall be rated to consume no more than five watts of power as determined by §130(d), and shall not contain a medium screw -base socket. §150(k)6: Lighting integral to exhaust fans, in rooms other than kitchens, shall meet the applicable requirements of §150(k). 150(k)7: All switching devices and controls shall meet the requirements of §150(k)7, §150(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 ft2 or 100 watts for dwelling units larger than 2,500 ft2 may be exempt from the 50% high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant sensor, dimmer, energy management system (EMCS), or a multi -scene programmable control system; and all permanently installed luminaries in garages, laundry rooms, closets greater than 70 square feet, and utility rooms are high efficacy and controlled by a manual -on occupant sensor. §150(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated cabinet. EnergyPro 5.1 by EnergySoR User Number: 4469 RunCode: 2012-08-24T11:00:47 ID: BAIN1911. J1 Page 14 of 21 MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF -1 R Project Name Date Mountain View Country Club 1812412012 §150(k)10: Permanently installed luminaires in bathrooms, attached and detached garages, laundry rooms, closets and utility rooms shall be high efficacy. EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by a manual -on occupant sensor certified to comply with the applicable requirements of §119. EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a manual -on occupancy sensor. §150(k)11: Permanently installed luminaires located in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms, closets, and utility rooms shall be high efficacy luimnaires. EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided they are controlled by either a dimmer switch that complies with the applicable requirements of §119, or by a manual - on occupant sensor that complies with the applicable requirements of §119. EXCEPTION 2: Lighting in detached storage building less than 1000 square feet located on a residential site is not required to comply with §150 k 11. §150(k)12: Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or other nationally recognized testing/rating laboratory; and have a label that certifies the lumiunaire is airtight with air leakage less then 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; and be sealed with a gasket or caulk between the luminaire housing and ceiling. §150(k)13: Luminaires providing outdoor lighting, including lighting for private patios in low-rise residential buildings with four or more dwelling units, entrances, balconies, and porches, which are permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy. EXCEPTION 1: Permanently installed outdoor low efficacy luminaires shall be allowed provided that they are controlled by a manual onioff switch, a motion sensor not having an override or bypass switch that disables the motion sensor, and one of the following controls: a photocontrol not having an override or bypass switch that disables the photocontrol; OR an astronomical time clock not having an override or bypass switch that disables the astronomical time clock; OR an energy management control system (EMCS) not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2: Outdoor luminaires used to comply with Exceptionl to §150(k)13 may be controlled by a temporary override switch which bypasses the motion sensing function provided that the motion sensor is automatically reactivated within six hours. EXCEPTION 3: Permanently installed luminaires in or around swimming pool, water features, or other location subject to Article 680 of the California Electric Code need not be hi h efficacy luminaires. §150(k)14: Internally illuminated address signs shall comply with Section 148; OR not contain a screw -base socket, and consume no more than five watts of power as determined according to § 1 30 d . §150(k)15: Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable requirements in Sections 130, 132, 134, and 147. Lighting for parking garages for 8 or more vehicles shall comply with the applicable requirements of Sections 130, 131. 134 and 146. §150(k)16: Permanently installed lighting in the enclosed, non -dwelling spaces of low-rise residential buildings with four or more dwelling units shall be high efficacy luminaires. EXCEPTION: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by an occupant sensors certified to comply with the applicable requirements of 119. EnergyPro 5.1 by EnergySoft User Number: 4469 RunCode: 2012-08-24711:00:47 ID: BAIN1911.01 Page 15 of 21 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name Mountain View Country Club Date 8/24/2012 System Name SHP 2 Floor Area 1,153 ENGINEERING CHECKS SYSTEM LOAD Number of Systems 1 COIL COOLING CFM Sensible Total Room Loads 391 7,225 Return Vented Lighting 0 Return Air Ducts 417 Return Fan 0 Ventilation 74 2,958 Supply Fan 875 Supply Air Ducts 417 TOTAL SYSTEM LOAD 1 11,892 PEAK COIL HTG. PEAK Heating System Latent CFM Sensible Output per System 42,000 200 419 6,921 Total Output (Btuh) 42,000 Output Btuh/s ft 36.4 265 Cooling System 0 Output per System 40,500 1,423 74 3,447 Total Output (Btuh) 40,500 1,623 -875 Total Output (Tons) 3.4 265 Total Output (Btuh/sgft) 35.1 Total Output s ftrron 341.6 1 10,022 Air System CFM per System 1,400 HVAC EQUIPMENT SELECTION Airflow cfm 1,400 SHP-3.5 Ton (FX4D/25HCB) 30,568 4,112 26,232 Airflow (cfm/s ft) 1.21 Airflow (cfm/Ton) 414.8 Outside Air (%) 5.3% Total Adjusted System Output 30,568 4,112 26,232 (Adjusted for Peak Design conditions) TIME OF SYSTEM PEAK Aug 3 PM I Jan 1 AM Outside Air (cfm/sgft) 1 0.06 Note: values above given at ARI conditions HEATING SYSTEM PSYCHROMETRICS (Airstream Temperatures at Time of Heating Peak) 26 OF 68 Outside Air 74 cfm 70 OF OF 85 OF ^^ 86 OF fns — Heating Coil Supply Fan 1,400 cfm 86 o F ROOM 70 OF 4 COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak 112/78°F Outside Air 74 cfm 74 / 62 OF 76/63°F 56/55°F 56/55°F Cooling Coil Supply Fan 57 / 55 OF 1,400 cfm jI - - - 49.3% f ROOM 74 162 OF EnergyPro 5.1 by EnergySoff User Number: 4469 RunCode: 2012-08-24T11:00:47 ID: BA/N1911.01 Page 16 of 21 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name Mountain View Country Club Date 8/24/2012 System Name SHP 1 Floor Area 1,520 ENGINEERING CHECKS SYSTEM LOAD Number of System 1 COIL CFM Total Room Loads 892 Return Vented Lighting Return Air Ducts Return Fan Ventilation 97 Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COOLING PEAK COIL HTG. PEAK Heating System Sensible Latent CFM Sensible Output per System 60,000 17,373 400 848 14,180 Total Output (Btuh) 60,000 0 Output Btuh/s ft 39.5 1,003 542 Cooling System 0 0 Output per System 59,500 3,822 2,019 97 4,536 Total Output (Btuh) 59,500 1,591 1,003 1 24,791 2,419 -1,591 Total Output (Tons) 5.0 542 Total Output (Btuh/s ft) 39.1 Total Output s ft/Ton 306.6 1 18,209 Air System CFM per System 2,000 HVAC EQUIPMENT SELECTION Airflow (cfm) 2,000 SHP-5.0 Ton (FX4D/25HCB) 46,613 4,110 37,474 Airflow (cfm/s ft) 1.32 Airflow (cfm/Ton) 403.4 Outside Air (%) 4.9% Total Adjusted System Output 46,613 4,110 (Adjusted for Peak Design conditions) TIME OF SYSTEM PEAK Aug 3 PM 37,474 Jan 1 AM Outside Air (cfm/sqft) 0.06 Note: values above given at ARI conditions HEATING SYSTEM PSYCHROMETRICS (Airstream Temperatures at Time of Heating Peak) 26 OF 68 Outside Air 97 cfm 70 OF OF 85 OF 86 OF Heating Coil Supply Fan 2,000 cfm 86 OF ROOM 70 OF COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak 112/78°F Outside Air 97 cfm 75/61 OF 77/62°F 55/54°F 56/54°F Cooling Coil Supply Fan 56 / 54 OF 2,000 cfm 46.7% [ ROOM 75/61 OF i EnergyPro 5.1 by EnergySoft User Number: 4469 Run Code: 2012-08-24T11:00:47 /D: BA/N1911.01 Page 17 of 21 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name Mountain View Country Club Date 8/24/2012 System Name SHP 3 Floor Area 372 ENGINEERING CHECKS SYSTEM LOAD Number of Systems 1 COIL CFM Total Room Loads 306 Return Vented Lighting Return Air Ducts Return Fan Ventilation 24 Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COOLING PEAK COIL HTG. PEAK Heating System Sensible Latent CFM Sensible Output per System 24,000 5,457 0 206 3,731 Total Output (Btuh) 24,000 0 Output Btuh/s ft 64.5 315 143 Cooling System 0 0 Output per System 22,6001 955 462 24 1,112 Total Output (Btuh) 22,600 875 F 462 -875 Total Output (Tons) 1.9 315 143 Total Output (Btuh/sqft) 60.8 Total Output (s ftrron) 197.5 7,917 4,253 Air System CFM per System 800 HVAC EQUIPMENT SELECTION Airflow (cfm) 800 SHP-2.0 Ton (FX4D/25HCB) 16,749 2,456 14,990 Airflow cfm/s ft 2.15 Airflow (cfm/Ton) 424.8 Outside Air (%) 3.0% Total Adjusted System Output 16,749 2,456 (Adjusted for Peak Design conditions) TIME OF SYSTEM PEAK Au3 3 PM 14,990 Jan 1 AM Outside Air (cfm/sgft) 0.06 Note: values above given at ARI conditions HEATING SYSTEM PSYCHROMETRICS (Airstream Temperatures at Time of Heating Peak) 26 OF No Outside Air 24 cfm AL 70 OF 69 OF 86 OF 87 OF Heating Coil Supply Fan 800 cfm 87 o F ROOM g4 70 OF COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak 112/78°F Outside Air 24 cfm 74/62°F 75/62°F 56/55°F 57/55°F Cooling Coil Supply Fan 57 / 55 OF 800 cfm � `��i 49.3% ROOM M 74/61°F EnergyPro 5.1 by EnergySoft User Number: 4469 RunCode: 2012-08-24T11:00:47 /D: BAIN1911.C1 Page 18 of 21 ROOM LOAD SUMMARY Project Name Date Mountain View Country Club 8/24/2012 System Name Floor Area SHP 2 1,153 ROOM LOAD SUMMARY PAGE TOTAL TOTAL' 3,911 7,2251 ROOM COOLING PEAK COIL COOLING PEAK COIL HTG. PEAK Zone Name Room Name Mult. CFM Sensible Latent CFM Sensible Latent CFM Sensible Zone Master Bed 1 134 2,459 0 134 2,459 0 156 2,578 Closet 1 30 581 0 30 581 0 37 615 Master Bath 1 64 1,1821 01 64 1,182 0 65 1,070 Bath 1 1 24 449 0 24 449 0 41 679 Bed Room 1 1 139 2,5531 2001 1391 2,553 2001 120 1,979 PAGE TOTAL TOTAL' 3,911 7,2251 200 419 6,921 391 7,2251 200 419 6,921 Total includes ventilation load for zonal systems. Ener Pro 5.1 by Ener Soft User Number: 4469 RunCode: 2012-08-24T11:00:47 to: BAIN1911.01 Pae 19 of 21 ROOM LOAD SUMMARY Project Name Date Mountain View Country Club 8/24/2012 System Name Floor Area SHP 1 1,520 ROOM LOAD SUMMARY PAGE TOTAL TOTAL* 892 17,373 ROOM COOLING PEAK COIL COOLING PEAK COIL HTG. PEAK Zone Name Room Name Mult. CFM Sensible Latent CFM Sensible Latent CFM Sensible Zone A Living Room 1 396 7,478 0 396 7,478 0 407 6,798 Study 1 64 1,280 0 64 1,280 0 82 1,366 Foyer 1 36 711 0 36 711 01 48 806 Kitchen 1 169 3,363 400 1691 3,363 400 85 1,428 Dining Room 1 159 3,179 0 159 3,179 0 150 2,504 Hall 1 13 252 0 13 252 0 12 198 Laundry Room 1 1 33 666 0 33 666 0 43 725 Bath I 1 22 4431 0 22 443 01 21 354 PAGE TOTAL TOTAL* 892 17,373 400 848 14,180 892 17,373 400 848 14,180 ' Total includes ventilation load for zonal systems. Ener Pro 5.1 by Ener Soft User Number: 4469 RunCode: 2012-08-24711:00:47 ID: BAIN1911.01 Page 20 of 21 ROOM LOAD SUMMARY Project Name Date Mountain View Countty Club 8/24/2012 System Name Floor Area SHP 3 372 ROOM LOAD SUMMARY PAGE TOTAL TOTAL ' 306 ROOM COOLING PEAK COIL COOLING PEAK I COIL HTG. PEAK Zone Name Room Name Mult. CFM Sensible Latent CFM Sensible Latent CFM Sensible Zone C Guest 1 192 3,434 0 192 3,434 0 116 2,094 Bath Room 1 74 1,322 0 74 1,322 0 60 1,078 Closet 1 391 701 0 39 701 0 31 559 PAGE TOTAL TOTAL ' 306 5,457 0 206 3,731 306 5,457 0 206 3,731 Total includes ventilation load for zonal systems. Ener Pro 5.1 by Ener Soft User Number: 4469 RunCode: 2012-08-24711:00:47 ID: BAIN1911.01 Page 21 of 21 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING SUMMARY Printed: 4/14/2013 17:24 Addresses in this Summary Label Address (Zip Code) Permit Plan/CF-1R Lot 80092 Via Tesoro (92253) 12-1004 Bain 1911-01 CF -611 Summary Required CF-4R's HERS Provider: CalCERTS, Inc. HERS Rater: Jack LaFontaine CF -6R -ENV -2I -HERS CC2004051 Builder/ Developer: Paul Davis Restoration & Remodeling of Greater Palm CF-6R-MECH-20-HERS Springs Project: Bain 1911-01 Phase Phase 1 CA Climate Zone: 15 City/State/Zip: La Quinta, CA 92253 Sample Group: N/A Submission Status:Complete Addresses in this Summary Label Address (Zip Code) Permit Plan/CF-1R Lot 80092 Via Tesoro (92253) 12-1004 Bain 1911-01 CF -611 Summary Required CF-4R's Required CF -611's Lot CF -6R -ENV -20 -HERS Done CF -6R -ENV -2I -HERS Done CF -6R -ENV -22 -HERS Done CF-6R-MECH-20-HERS Done CF-6R-MECH-22-HERS Done CF-6R-MECH-23-HERS Done CF-6R-MECH-RCA-HERS Done CF -4R Summary Required CF-4R's Lot CF -4R -ENV -20!" Tested 4/12/2013 CF -4R -ENV -21 Tested 4/12/2013 CF -4R -ENV -22 Tested 4/12/2013 CF-4R-MECH-20 Tested 4/12/2013 CF-4R-MECH-22 Tested 4/12/2013 CF-4R-MECH-23 Tested 4/12/2013 CF-4R-MECH-RCA Tested 4/12/2013 2008 Residential Compliance Forms August 2009 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page 1 of 2) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 1 (SHP Enforcement Agency: Permit Number: 2)) City of La Quinta 12-1004 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Living Spaces Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This certificate is required for compliance for completely new duct systems installed in new dwelling construction, and also for completely new or replacement duct systems in existing dwellings. 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. dart 1 oalrano niannnctir Tact - rmmnlotoly now nr ronlaromont dart custom Enter a value for the Allowed Leakage (CFM) for the duct system leakage verification. The value entered must be the VLLDCS criteria or one of the three calculated leakage rates described below. Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Compliance Credit. If compliance credit for Allowed verified low leakage ducts in conditioned space is shown in the special features section of the CF -1R, the Leakage leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4), and 25 CFM must (CFM) be entered for Allowed Leakage. Allowed leakage calculation — (select one calculation method from this section). Use 6% (leakage factor = 0.06) for calculations. When utilizing Low Leakage Air Handler (LLAH) credit, the allowed duct leakage may be specified by the CF -1R to be less than 6%, in which case the user-specified leakage rate must be used in the calculations below. For example, if the user-specified leakage (specified as a percentage of fan airflow) is reported on the CF -1R as 3%, then use aleakage factor of 0.03 in the calculations below. ® Cooling system method: Nominal capacity of condenser in Tons 5 x 400 x leakage factor = 120 ' CFM ' ❑ Heating system method: 21.7 x Output Capacity in Thousands of Btu/hr x leakage factor = CFM ❑ Measured airflow method (RA3.3): Enter measured fan flow in CFM here x leakage factor = CFM Enter value for Actual leakage (CFM) in the right column, from measurement using applicable duct leakage Actual Leakage pressurization test procedure from Reference Residential Appendix RA3.l(CFM @ 25 Pa). (CFM) List Actual Leakage from duct leakage test(CFM) 72 Pass if Actual Leakage is less than Allowed Leakage ® Pass ❑ Fail For complete replacement of duct systems only, if the 6 percent leakage rate criteria cannot be met, a smoke test should be performed to verify that the excess leakage is coming only from a pre-existing furnace cabinet (air handler cabinet), and not from otheraccessible portions of the duct system. A HERS rater must verify the installation (No sampling allowed). List Actual Leakage from smoke test(CFM) Pass if all accessible leaks (except for existing air handler) are sealed using smoke ❑ Pass ❑Fail Reg: 213-N0021824B-M2000006A-M20A Registration Date/Time: 2013/04/14 16:58:54 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page 2 of 2) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 1 (SHP Enforcement Agency: Permit Number: 2)� City of La Quinta 12-1004 10 1 Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct eakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position ' during duct leakage testing, ® All supply and return register boots must be sealed to the drywall ® New duct installations cannot utilize building`cavities'as plenums or,platform.returns in lieu'of ducts. -Z'—, 'lucMastic a d draw bands must be used in combination with Cloth backed, rubber adhesive duct tape to seal leaks at t connections. DECLARATION; STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form'is true and correct. ,�,';" ' . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. ' . The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: CSLB License: Rod Pankratz 1677877 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ® tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798746942 HERS Rater Company Name: Energy Management Services Responsible Rater's Name: Responsible Rater's Signature: Jack B LaFontaine Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/12/2013 CC2004051 ' Reg: 213-N0021824B-M2000006A-M20A Registration Date/Time: 2013/04/14 16:58:54 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Farms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page 1 of 2) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 2 (SHP Enforcement Agency: Permit Number: 1)) City of La Quinta 12-1004 Enter the Duct System Name or Identification/Tag: System 2 Enter the Duct System Location or Area Served: Master Bedroom Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This certificate is required for compliance for completely new duct systems installed in new dwelling construction, and also for completely new or replacement duct systems in existing dwellings. 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. Duct Lpakanp niannnctic TPct - rmmnlPtplw npuv nr rPnlacPmpnt duct cvctPm Enter a value for the Allowed Leakage (CFM) for the duct system leakage verification. The value entered must be the VLLDCS criteria or one of the three calculated leakage rates described below. Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Compliance Credit. If compliance credit for Allowed verified low leakage ducts in conditioned space is shown in the special features section of the CF -111, the Leakage leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4), and 25 CFM must (CFM) be entered for Allowed Leakage. Allowed leakage calculation - (select one calculation method from this section). Use 6% (leakage factor = 0.06) for calculations. When utilizing Low Leakage Air Handler (LLAH) credit, the allowed duct leakage may be specified by the CF -111 to be less than 6%, in which case the user-specified leakage rate must be used in the calculations below. For example, if the user-specified leakage (specified as a percentage of fan airflow) is reported on the CF -1R as 3%, then use aleakage factor of 0.03 in the calculations below. ® Cooling system,method: Nominal capacity7"6f c6ndenser in Tons 3.5- z 400 x leakage facto 84, CFM ❑ Heat g system method: 21. Output Capacity in Thousands of Btu/hr x leakage factor, = CFM \ •/ ❑ Measured airflow method RA3.3 ': 1 ( J_ 1 ' -� Enter measured fan flow in CFM here x leakage factor = CFM Enter value for Actual leakage (CFM) in the right column, from measurement using applicable duct leakage Actual Leakage pressurization test procedure from Reference Residential Appendix RA3.1(CFM @ 25 Pa). (CFM) List Actual Leakage from duct leakage test(CFM) 82 Pass if Actual Leakage is less than Allowed Leakage ® Pass ❑ Fail For complete replacement of duct systems only, if the 6 percent leakage rate criteria cannot be met, a smoke test should be performed to verify that the excess leakage is coming only from a pre-existing furnace cabinet (air handler cabinet), and not from otheraccessible portions of the duct system. A HERS rater must verify the installation (No sampling allowed). List Actual Leakage from smoke test(CFM) Pass if all accessible leaks (except for existing air handler) are sealed using smoke ❑ Pass ❑ Fail Reg: 213-N0021824B-M2000007A-M20A Registration Date/Time: 2013/04/14 16:58:54 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 Z CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page 2 of 2) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 2 (SHP Enforcement Agency: Permit Number: 1)� City of La Quinta 12-1004 ' FOutside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct eakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position ' during duct leakage testing. ® All supply and return register boots must be sealed to the drywall ® New duct installations cannot utilize building'cavities'as plenums or platform •returns'in lieu of ducts`�'-- ,.N ; 1 • - Mastic and draw bands must be used.in combination with Cloth backed, rubber adhesive duct tape to seal leaks at uct connections. DECLARATION! STATEMENT 1 Yf / / ' . I certify under -penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. ' . The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: CSLB License: Rod Pankratz 1677877 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ® tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798746942 HERS Rater Company Name: Energy Management Services Responsible Rater's Name: Responsible Rater's Signature: Jack B LaFontaine Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/12/2013 CC2004051 ' Reg: 213-N0021824B-M2000007A-M20A Registration Date/Time: 2013/04/14 16:58:54 HERS Provider: CalCERTS, inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page 1 of 2) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 3 (SHP Enforcement Agency: Permit Number: 3)) City of La Quinta 12-1004 Enter the Duct System Name or Identification/Tag: System 3 Enter the Duct System Location or Area Served: Casita Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This certificate is required for compliance for completely new duct systems installed in new dwelling construction, and also for completely new or replacement duct systems in existing dwellings. 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. Duct Lpakaap niannnstic Test - rmmnlptply new nr rpnlacpmpnt duct systpm Enter a value for the Allowed Leakage (CFM) for the duct system leakage verification. The value entered must be the VLLDCS criteria or one of the three calculated leakage rates described below. Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Compliance Credit. If compliance credit for Allowed verified low leakage ducts in conditioned space is shown in the special features section of the CF-lR, the Leakage leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4), and 25 CFM must (CFM) be entered for Allowed Leakage. Allowed leakage calculation - (select one calculation method from this section). Use 6% (leakage factor = 0.06) for calculations. When utilizing Low Leakage Air Handler (LLAH) credit, the allowed duct leakage may be specified by the CF -1R to be less than 6%, in which case the user-specified leakage rate must be used in the calculations below. For example, if the user-specified leakage (specified as a percentage of fan airflow) is reported on the CF -1R as 3%, then use aleakage factor of 0.03 in the calculations below. ❑ Cooling system .method: — Nominal capacity -of condenser in Tons, r x'400 z leakage factor = ' CFM Ir ® Heating system method:' 1 /C 21.7 x { 56 OutputCapacity in Thousands of Btu/hr x leakage factor = 72.91 ❑ Measured airflow method (RA3.3): Enter measured fan flow in CFM here x leakage factor = CFM Enter value for Actual leakage (CFM) in the right column, from measurement using applicable duct leakage Actual Leakage pressurization test procedure from Reference Residential Appendix RA3.1(CFM @ 25 Pa). (CFM) List Actual Leakage from duct leakage test(CFM) 62 Pass if Actual Leakage is less than Allowed Leakage ® Pass ❑ Fail For complete replacement of duct systems only, if the 6 percent leakage rate criteria cannot be met, a smoke test should be performed to verify that the excess leakage is coming only from a pre-existing furnace cabinet (air handler cabinet), and not from otheraccessible portions of the duct system. A HERS rater must verify the installation (No sampling allowed). List Actual Leakage from smoke test(CFM) Pass if all accessible leaks (except for existing air handler) are sealed using smoke ❑ pass ❑ Fail I Reg: 213-N0021824B-M2000008A-M20A Registration Date/Time: 2013/04/14 16:58:54 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-20 Duct Leakage Test - Completely New or Replacement Duct System (Page 2 of 2) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 3 (SHP Enforcement Agency: Permit Number: 3)) City of La Quinta 12-1004 �Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct akage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation s required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position ' during duct leakage testing. ® All supply and return register boots must be sealed to the drywall ® New duct installations cannot utilize building 'cavities,as-plenums or platform, retufrns1in, lieu r of ducts'" i / _ � A Mastic and draw bavnds must be used in combinatlion' with Cloth backed�, rubber a�dhesive duct tape to seaE leaks at ' uct connections. DECLARATION; STATEMENT I !I I certify under.perialty of perjury; under the laws of the State of California, the information provided on this form is true and correct. cco ' . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: CSLB License: Rod Pankratz 1677877 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ®tested/verified dwelling ❑ not-tested/verified dwelling in a HERS sample groin HERS Rater Information CaICERTS Certificate # CC1-1798746942 HERS Rater Company Name: Energy Management Services Responsible Rater's Name: Responsible Rater's Signature: Jack B LaFontaine Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/12/2013 CC2004051 ' Reg: 213-N0021824B-M2000008A-M20A Registration Date/Time: 2013/04/14 16:58:54 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 :ERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-2: ISPP/PSPP Installation: Fan Watt Draw Test (Page i of 2; Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 �7City of La Quinta 12-1004 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. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP) in the supply plenum When the Certificate of Compliance (CF1R )indicates Cooling Coil Airflow or Fan Watt Draw verification are required, HSPP or PSPP are required to be installed in each air handler in the dwelling. Procedures for installing HSPP and PSPP are described in Reference Residential Appendix RA3.3. This measure requires verification by a HERS rater. Select one method from the two choices below for compliance with the HSPP/PSPP requirement for this dwelling. ® HSPP 1/4 inch (6 mm) hole labeled and located downstream of the evaporator coil in the supply ❑ Diagnostic Fan Flow Using Flow Capture Hood according to the procedures in RA3.3.3.1.3 System Name or Identification/Tag plenum as shown in the figure in Section RA3.3.1.1. System 2 System 3 1/4 inch (6 mm) hole equipped with a permanently installed pressure probe, labeled and located ❑ PSPP downstream of the evaporator coil in the supply plenum as shown in the figure in Section (SHP 3) RA3.3.1.1. System Name or Identification/Tag System 1 System 2 (SHP System 3 (SHP Spaces Bedroom 1) 3) Nominal Cooling Capacity (ton) of the outdoor unit. System Location or Area Served Living Spaces Master Bedroom Casita Enter the minimum airflow requirement from the CF -1R (CFM/ton). Confirm that a HSPP or PSPP has been 350 350 installed on the air handler per the PASS PASS PASS Calculate the target minimum airflow for the test by multiplying the requirements of RA3.3.1.1. CFM/ton criteria specified on the CF71R by the nominal cooling Enter Pass or Fail 1225 700 capacity of the outdoor unit (ton). Cooling Coil Airflow Verification When the Certificate of Compliance indicates Cooling Coil Airflow verification is required, the procedures for measuring the cooling coil airflow must be performed as specified in Reference Residential Appendix RA3.3.,Results of, the cooling coil airflow diagnostic test must be entered in the table below. This measure'requires veriflcation by a HERS rater. Select one method from the three choices below for compliance with the Cooling Coil Airflow test requirement for this dwelling. /f / ; p Diagnostic Fan Flow Using Plenum;Pressure Matching according to the procedures in RA3.3.3.1.1 ® Diagnostic Fan'Flow Using Flow Grid Measurement according to the procedures in RA3.3.3.1.2'�- ❑ Diagnostic Fan Flow Using Flow Capture Hood according to the procedures in RA3.3.3.1.3 System Name or Identification/Tag System i System 2 System 3 (SHP 1) (SHP 3) System Location or Area Served Living Master Casita Spaces Bedroom Nominal Cooling Capacity (ton) of the outdoor unit. 5 3.5 2 Enter the minimum airflow requirement from the CF -1R (CFM/ton). 350 350 350 CFM/ton CFM/ton CFM/ton Calculate the target minimum airflow for the test by multiplying the CFM/ton criteria specified on the CF71R by the nominal cooling 1750 1225 700 capacity of the outdoor unit (ton). Target (CFM) Enter the diagnostically tested airflow (CFM). 1861 1370 834 Tested (CFM) The system complies if Tested (CFM) is equal or greater than Target (CFM). PASS PASS PASS Enter Pass or Fail ' Reg: 213-N0021824B-M2200009A-M22A Registration Dare/Time: 2013/04/14 17:01:29 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-27 HSPP/PSPP Installation: Fan Watt Draw Test (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 1 City of La Quint a 12-1004 :an Watt Draw Verification When the Certificate of Compliance indicates Fan Watt Draw verification is required, the procedures for measuring the Fan Watt Draw must be performed as specified in Reference Residential Appendix RA3.3. Results of the Fan Watt Draw diagnostic test must be entered in the table below. This measure requires verification by a HERS rater. Note: Fan watt draw must be measured simultaneously with cooling coil airflow. The fan watt draw measurement and cooling coil airflow measurement must simultaneously meet or exceed their target criteria specified by the CF -1R for the dwelling. Select one method from the two choices below for compliance with the Fan Watt Draw test requirement for this dwelling. ❑ Portable Watt Meter Measurement according to the procedures in RA3.3.2.2.1 ❑ Utility Revenue Meter Measurement according to the procedures in RA3.3.2.2.2 System Name or Identification/Tag CSLB License: Rod Pankratz 1677877 HERS Provider Data Registry Information System Location or Area Served ® tested/verified dwelling ❑ not-tested/verified dwelling in la Enter the air handler Tested (CFM) from the cooling coil airflow test table above. HERS Rater Information CaICERTS Certificate # CC1-1798746942 HERS Rater Company Name: Energy Management Services Responsible Rater's Name: Enter the fan watt draw requirement from the CF -1R (Watt/CFM). Jack B LaFontaine Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/12/2013 Calculate the target maximum Watt draw for the test by multiplying the Watt/CFM criteria specified on the CF -1R by the air handler Tested (CFM). Target (CFM) Enter the diagnostically tested Watt draw (Watt). Tested (Watt) The system complies if Tested (Watt) is less than or equal to Target (Watt) Enter Pass or Fail DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -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 -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) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: CSLB License: Rod Pankratz 1677877 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ® tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798746942 HERS Rater Company Name: Energy Management Services Responsible Rater's Name: Responsible Rater's Signature: Jack B LaFontaine Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/12/2013 CC2004051 ' Reg: 213-N0021824B-M2200009A-M22A Registration Date/Time: 2013/04/14 17:01:29 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-23 Verification of High EER Equipment (Page 1 of 1) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Q 1 12-1004 Verification of High EER Equipment Procedures for verification of High EER Equipment are described in Reference Residential Appendix RA3.4. For dwelling units with multiple systems, the procedures must be applied to each system separately. 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 dwallinn as annlicahle_ 1 System Name or Identification/Tag System 1 System 2 (SHP 1) System 3 Rod Pankratz 2 System Location or Area Served Living Spaces Master Bedroom Casita 3 Certified EER Rating of the installed 11.0 11.0 11.0 Responsible Rater's Name: Responsible Rater's Signature: equipment (Btu/Watt-hr) Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/12/2013 CC2004051 Make and Model Number of the installed Day & Night Day & Night Day & Night 4 Outdoor Unit N4A360AKC300 N4A342AKA300 N4A324AKA200 5 Make and Model Number of the installed AllStyle AllStyle AllStyle Inside Coil ASFM602120Al ASFM4821A28E ASLB36126A28E 6 Make and Model Number of the installed Day & Night Day & Night Day & Night Furnace or Air Handler. NSMSL0902120AI N8MSL0701716A1 NSMSL07014282 7 Minimum Equipment EER required for 10.4 it 10.5 compliance as reported on the CF -1R ® When a high EER system specification includes a time delay relay, the installation of the time delay relay must be verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Time Delay Relay Verification Procedure. ® When installation of specific matched equipment is necessary to achieve a high EER, installation of the specific equipment must be verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Matched Equipment Verification Procedure. If the Certified EER Rating in row 3 is equal to $ or greater than the required minimum EER in PASS PASS PASS 7, the unit complies. ,If If the unit complies enter Pass C, ' DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the ' installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -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 aaencv. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: CSLB License: Rod Pankratz 1677877 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ®tested/verified dwelling not-tested/verified dwelling in la HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798746942 HERS Rater Company Name: Energy Management Services Responsible Rater's Name: Responsible Rater's Signature: Sack B LaFontaine Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/12/2013 CC2004051 ' Reg: 213-N0021824B-M2300010A-M23A Registration Date/Time: 2013/04/14 17:08:11 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 6) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quinta 1 12-1004 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge ' verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. ' As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement ' Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance, unless the TMAH Compliance Option is chosen. ' 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 2 System 3 System Location or Area Served Living Spaces Master Bedroom Casita 5/16 inch (8 mm) access hole upstream of evaporative coil in the H Yes H Yes ® Yes ❑ Yes 1 return plenum.and labeled _ ❑ No ❑'No*N. �`' _] ❑ No�� ` ❑ No according to Figure in Section / RA3:2.2.2.2. Return side of the'duct system is located entirely, within conditioned ^ " la space and return t '� ❑ Yes /� ❑Yes J ❑ Yes ❑,Yes 1 .airflow` temperature to be measured at the ❑ No ❑'No ! ❑'No_J. ❑ No.-, - return grille. 5/16 inch (8 mm) access hole downstream of evaporative coil in ® Yes ® Yes ® Yes ❑ Yes 2 the supply plenum and labeled ❑ No ❑ No ❑ No ❑ No according to Figure in Section RA3.2.2.2.2. The TMAH Compliance Option should be checked only if the HERS Rater is able to confirm that it was physically impossible for the HVAC Installer to drill the TMAH as required by Section RA3.2.2.2.2. Using this Compliance Option requires the HVAC installer to annotate on the HERS Provider's data registry an explanation as to why the TMAH cannot be installed on the system, and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance Option also requires minimum airflow verification through the direct measurement of airflow per RA3.3. For more information see httD://www.energy,ca.ciov/title24/2008standards/special case appliance/ TMAH Compliance Option ❑ ❑ ❑ ❑ Yes to 1 and 2, or Yes to la and 2, or checking the TMAH Compliance Option, ® Pass ® Pass ® Pass ❑ Pass is a pass. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Enter Pass or Fail h ' Reg: 213-N0021824B-M2500011A-M25A Registration Date/Time: 2013/04/14 17:23:51 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6) Site Address: I Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quinta 1 12-1004 STMS - Sensor on the Evaporator Coil System Name or System 1 (SHP 1 System 2 (SHP 1 System 3 � Identification/Tag 2) 1) 1 t Tby he sensor is factory installed, or field installed according to manufacturer's specifications, or is installed methods/specifications approved by the Executive Director. ❑ Yes ❑ No 1 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 4 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes []No 5 When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not ® N/A ® N/A ® N/A ❑ N/A applicable. ❑ Pass ❑ Pass ❑ Pass ❑ Pass Otherwise enter Pass or ❑ Fail ❑ Fail ❑ Fail ❑ Fail Fail STMS - Sensor on the Condenser Coil System Name,or�7 System•1,(SHP" 4 `System 2 (SHP'' 1 S tem 3� ysi � Identification/Tag j; /2)' t` 1) 1 t e sensor is factoryjinstalied; or field installed according to' manufacturer's specifications, or is installed Tby methods/specifications approved by the Executive' Director. #/ t .f/ 11.1 ❑ Yes ❑ No? , ❑ Yes ❑ No ❑ Yes ❑ No) , ❑ Yes ❑ No't The sensor wire'is terminated with a standard mini plug suitable for connection to'a digital thermometer. 7 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 8 When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ❑ N/A ❑ N/A ❑ N/A ❑ N/A applicable. ❑ Pass ❑ Pass ❑ Pass ❑ Pass Otherwise enter Pass or ❑ Fail ❑ Fail ❑ Fail ❑ Fail Fail Reg: 213-N0021824B-M2500011A-M25A Registration Date/Time: 2013/04/14 17:23:51 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 [NSTALLATION CERTIFICATE CF-4R-MECH-2! tefrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6; Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quinta 1 12-1004 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 compliaice 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 sta, ting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb temperature is less than 55°F, the installer must use the RA3.2.3 Alternate Charge Measurement Procedure (Weigh -In Charging Method). If the Weigh -In Method is used, the dwelling cannot be included in a sample group for HERS verification compliance.) Space Conditioninq Svstems System Name or Identification/Tag System 1 System 2 System 3 4/01/2013 System Location or Area Served Living Spaces Master Bedroom Casita Outdoor Unit Serial # A123718837 A124216018 A127791673 Outdoor Unit Make Day & Night Day & Night Day & Night Outdoor Unit Model N4A360AKC300 N4A342AKA300 N4A324AKA200 Nominal Cooling Capacity 5 Tons 3.5 Tons 2 Tons Date of le irficationt/ / /j'/4/12'/'201'3' [� 4/1'2/2013 /,� X4/12/2013 Calibration of Diagnostic Instruments A 4 1 i 1 1 `fit! D Date of Refrigerant Gauge 4/01/2013 (must be re -calibrated mon Calibration thly) Date of Thermocouple Calibration 4/01/2013 (must be re -calibrated monthly) Measured Temperatures (°F) System Name or Identification/Tag System 1 System 2 System 3 Supply (evaporator leaving) air 54.8 53.2 56.7 dry-bulb temperature (Tsu I db) Return (evaporator entering) air 76.0 76.0 76.0 dry-bulb temperature (Treturn db) Return (evaporator entering) air 56.9 56.4 61.2 wet -bulb temperature (Treturn wb) Evaporator saturation temperature 32.2 36.8 39.0 (Teva orator sat) Condensor saturation temperature 101.4 98.1 101.0 (Tcondensor, sat) Suction line temperature (Tsuction) 44.8 49.1 52.8 Liquid Line Temperature (Tliquid) 89.4 86.4 90.7 Condenser (entering) air dry-bulb 82.0 82.0 82.0 temperature (Tcondenser, db) t Reg: 213-N0021824B-M2500011A-M25A Registration Date/Time: 2013/04/14 17:23:51 HERS Provider: CalCERTS, inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quinta 1 12-1004 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 System 2 System 3 Calculate: Actual Temperature Split = 21.20 22.80 19.30 Treturn db - Tsupply, db Target Temperature Split from Table RA3.2-3 using Treturn, wb and Treturn, 22.4 23.4 20.4 db Calculate difference: Actual Temperature -1.2 -0.6 -1.1 Split - Target Temperature Split = Passes if difference is between -4°F and +4°F or, upon remeasurement, if PASS PASS PASS between -4°F and -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in irrflowRequirementin the table below_. P77 �77 Calculated Minimum Airflow Requirement (CFM) Cooling Capacity (ton) X 300+ .=''Nominal ' 1 A t +! 1/ System Name or Identification/Tag Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 procedures (CFM) Measurement Method Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail I Reg: 213-N0021824B-M2500011A-M25A Registration Date/Time: 2013/04/14 17:23:51 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quinta 1 12-1004 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 System 2 System 3 System 2 Calculate: Actual Superheat = 12.0 11.7 10.3 12.3 Tsuction - Teva orator sat Tsuction - Teva orator sat Target Superheat from Table RA3.2-2 using 10.0 10.0 10.0 Treturn wb and Tcondenser, db manufacturer's specifications (or use Calculate difference: 2 -` Fi 7~ �!` ' r -0.3rr 3-26 Actual Superheat - Target Superheat = ► r j , l System passes if difference is between -6°F available) and +6°F PASS Z, ,� ! PASS } 1 ! PASS\ Enter Pass or Fail Ewith=theallowable superheat range PASS PASS 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 System 2 System 3 System 2 Calculate: Actual Subcooling = 12.0 11.7 10.3 12.3 Tcondenser, sat - Tli uid Tsuction - Teva orator sat Target Subcooling specified by 10.0 10.0 10.0 manufacturer manufacturer's specifications (or use Calculate difference:' � f 2 -` Fi 7~ �!` ' r -0.3rr 3-26 Actual Subcooling -Mrget Subcooling = ► r j , l System passes if difference is between available) -4°F and +4°F / I /n'ter,Pa�s"s or Fail PASS Z, ,� ! PASS } 1 ! PASS\ 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 System 2 System 3 Calculate: Actual Superheat = 12.6 12.3 13.8 Tsuction - Teva orator sat Enter allowable superheat range from manufacturer's specifications (or use range between 3°F and 26°F if 3-26 3-26 3-26 manufacturer's specification is not available) passes if actual superheat is Ewith=theallowable superheat range PASS PASS PASS Enter Pass or Fail Reg: 213-N0021824B-M2500011A-M25A Registration Date/Time: 2013/04/14 17:23:51 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quinta 1 12-1004 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 System 2 System 3 Sample Group # (if applicable): N/A System meets all refrigerant charge and not-tested/verified dwelling lin a HERS sample group airflow requirements. PASS PASS PASS Responsible Rater's Signature: Enter Pass or Fail Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Date Signed: 4/12/2013 Provider: ® Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55°F and 65°F the return air dry bulb temperature shall be maintained above 70°F during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate. DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -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 spe6fied on•the Cert�fic te(s),of Compliance (CF-1R),a60oved'by the enforcement agency. i ' ) 1 ` ' Builder,or Installer information as shown on,the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) ' Paul Davis Restoration & Remodeling of,Greater Palm Springs ', t Responsible, Person's Name: ` - —" ` CSLB License: Rod Pankratz 1677877 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ® tested/verified dwelling not-tested/verified dwelling lin a HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798746942 HERS Rater Company Name: Energy Management Services Responsible Rater's Name: Responsible Rater's Signature: Jack B LaFontaine Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Date Signed: 4/12/2013 Provider: CC2004051 Reg: 213-N0021824B-M2500011A-M25A Registration Date/Time: 2013/04/14 17:23:51 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -20 Building Envelope Sealing (Page 1 of 1) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 1 (SHP Enforcement Agency: Permit Number: 2)) City of La Quinta 12-1004 Building Envelope Sealing Diagnostic Testing Results CFM50H = the measured airflow in cubic feet per minute (cfm) at 50 pascals for the dwelling with air distribution registers unsealed. SLA = 3.819 x (CFM50 H / Conditioned Floor Area in ft2) per Residential ACM Manual Equation R3-16 Responsible Person's Name: Building Envelope Leakage CFM50H as measured using a blower door diagnostic device f �/ 1. Enter the blower door leakage target CFM50H value for compliance from the CF -1R 574 ® tested/verified dwellingTRERS (cfm). 2. Enter the blower door leakage minimum CFM50H value corresponding to 1.5 SLA 490 HERS Rater Company Name: from the CF -1R (cfm). Responsible Rater's Name: 3. Enter the measured CFMSOH value from the blower door test (cfm) 380 4. The leakage test passes if the measured envelope leakage CFM50H value from row is 3 CC2004051 less than or equal to the value required for compliance from row 1, otherwise the test Pass Fail fails. check/enter Pass or Fail 5. If measured CFM50H from row 3 is less than the minimum CFM50H value corresponding to <T.5 2R.5 1.5 SLA from row 2: check/enter < 1.5 SLA, otherwise check/enter >_1.5 SLAI SLA* SLA *Advisory note to builder and enforcement agency: If row 5 indicates "< 1.5 SLA", it is critical to ensure that combustion and solid -fuel burning appliances in the dwelling are provided with adequate combustion and ventilation air and vented in accordance with manufacturers' installation instructions and all applicable codes as specified by ASHRAE Standard 62.2 Section 6.4. Additional information about compliance with this requirement is given in Section 4.6.5 of the Residential Compliance Manual under the topic of Combustion and Solid -Fuel Burning Appliances. i DECLARATION STATEMENT • I certify under penalty of perjury, uncer the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -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) 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) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: CSLB License: Rod Pankratz 1677877 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ® tested/verified dwellingTRERS not-tested/verified dwelling in sample group HERS Rater Information Ca10ERTS Certificate # CCi-1798746942 HERS Rater Company Name: Energy Management Services Responsible Rater's Name: Responsible Rater's Signature: Jack B LaFontaine Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/12/2013 CC2004051 Reg: 213-N0021824B-E2000003A-E20A Registration Date/Time: 2013/04/14 15:57:25 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -20 Building Envelope Sealing (Page i of 1) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 2 (SHP Enforcement Agency: Permit Number: 1)) City of La Quinta 12-1004 Buildinci Enveloue Sealin4 Diagnostic Testing Results CFM50H = the measured airflow in cubic feet per minute (cfm) at 50 pascals for the dwelling with air distribution registers unsealed. SLA = 3.819 x (CFM50 H / Conditioned Floor Area in ft2) per Residential ACM Manual Equation R3-16 Responsible Person's Name: Building Envelope Leakage CFM50H as measured using a blower door diagnostic device Rod Pankratz 1. Enter the blower door leakage target CFM50H value for compliance from the CF -1R 702 ® tested/verified dwelling (cfm). 2. Enter the blower door leakage minimum CFM50H value corresponding to 1.5 SLA 395 HERS Rater Company Name: from the CF -1R (cfm). Responsible Rater's Name: 3. Enter the measured CFM50H value from the blower door test (cfm) 512 4. The leakage test passes if the measured envelope leakage CFM50H value from row is 3 CC2004051 less than or equal to the value required for compliance from row 1, otherwise the test Pass Fail fails. check/enter Pass or Fail 5. If measured CFM50H from row 3 is less than the minimum CFM50H value corresponding to A.5 1.5 SLA from row 2: <a.5 check/enter < 1.5 SLA, otherwise check/enter >_1.5 SLA SLA.* SLA *Advisory note to builder and enforcement agency: If row 5 indicates "< 1.5 SLA", it is critical to ensure that combustion and solid -fuel burning appliances in the dwelling are provided with adequate combustion and ventilation air and vented in accordance with manufacturers' installation instructions and all applicable codes as specified by ASHRAE Standard 62.2 Section 6.4. Additional information about compliance with this requirement is given in Section 4.6.5 of the Residential Compliance Manual under the topic of Combustion and Solid -Fuel Burning Appliances. DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the ' installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -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) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the enforcement aaencv. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: CSLB License: Rod Pankratz 1677877 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ® tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798746942 HERS Rater Company Name: Energy Management Services Responsible Rater's Name: Responsible Rater's Signature: Jack B LaFontaine Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/12/2013 CC2004051 ' Reg: 213-N0021824B-E2000004A-E20A Registration Date/Time: 2013/04/14 15:57:25 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -20 Building Envelope Sealing (Page 1 of 1) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 3 (SHP Enforcement Agency: Permit Number: 3)) City of La Quinta 12-1004 Buildinq Envelope Sealinq Diagnostic Testing Results CFM50H = the measured airflow in cubic feet per minute (cfm) at 50 pascals for the dwelling with air distribution registers unsealed. SLA = 3.819 x (CFM50 H / Conditioned Floor Area in ft2) per Residential ACM Manual Equation R3-16 Responsible Person's Name: Building Envelope Leakage CFM50H as measured using a blower door diagnostic device Rod Pankratz 1. Enter the blower door leakage target CFM50H value for compliance from the CF -111 312 ® tested/verified dwelling (cfm). 2. Enter the blower door leakage minimum CFM50H value corresponding to 1.5 SLA 228 HERS Rater Company Name: from the CF -1R (cfm). Responsible Rater's Name: 3. Enter the measured C1FM50H value from the blower door test (cfm) 195 4. The leakage test passes if the measured envelope leakage CFM50H value from row is 3 CC2004051 less than or equal to the value required for compliance from row 1, otherwise the test Pass Fail fails. check/enter Pass or Fail 5. If measured CFM50H from row 3 is less than the minimum CFM50H value corresponding to 1.5 SLA from row 2: <T.5 >75 check/enter < 1.5 SLA, otherwise check/enter >_1.5 SLA SLA* SLA *Advisory note to builder and enforcement agency: If row 5 indicates "< 1.5 SLA", it is critical to ensure that combustion and solid -fuel burning appliances in the dwelling are provided with adequate combustion and ventilation air and vented in accordance with manufacturers' installation instructions and all applicable codes as specified by ASHRAE Standard 62.2 Section 6.4. Additional information about compliance with this requirement is given in Section 4.6.5 of the Residential Compliance Manual under the topic of Combustion and Solid -Fuel Burning Appliances. "5-- f ti DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. • The information reported on applicable sections of the Installation. Certificate(s) (CF -611), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agencv. Builder or Installer information as shown on the Installation Certificate (CF -611) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: CSLB License: Rod Pankratz 1677877 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ® tested/verified dwelling ot-testedl verified dwelling in FIR3nRS sample group HERS Rater Information CalCERTS Certificate # CC1-1798746942 HERS Rater Company Name: Energy Management Services Responsible Rater's Name: Responsible Rater's Signature: Jack B LaFontaine Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/12/2013 CC2004051 Reg: 213-N0021824B-E2000005A-E20A Registration Date/Time: 2013/04/14 15:57:25 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Fcrms August 2009 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -21 Quality Insulation Installation (QII) - Framing Stage Checklist (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quinta 12-1004 Quanty insuiation instananon (Qii) - Framing stage cnecKnst Air barrier installation and preparation for insulation must be done at framing stage before insulation is installed. If there are any "No" answers, rows not filled out, or a signature missing then this is not a valid form and cannot be accepted by the building department or HERS rater. SPF insulation can be considered an air barrier when the bottom and top plates of vertical framing and both ends of horizontal framing, including band and rim joists, are sprayed to completely fill the cavity adjacent to and in contact with the framing to a distance of 5.5 inches away from the framing for open cell SPF (ocSPF) or 2.0 inches away from the framing for closed cell SPF (ccSPF). SPF can be considered as an air barrier with less than the above thickness when a product data or specification sheet is provided that shows the product meets an air permeance no greater than 0.02 L/s-m2 at 75 Pa pressure differential when tested in accordance to ASTM E2178 or ASTM E283. All structural framing areas shall be insulated in a manner that resists thermal bridging of the assembly separating conditioned from unconditioned space. Structural bracing, tie -downs, and framing of steel, or specific framing used to meet structural requirements of the CBC are allowed and must be insulated. These areas shall be called out on the building plans with diagrams and/or specific design drawings indicating the R -value of insulation and fastening method to be used. FLOOR AIR BARRIER es o ® NA All gaps in the raised floor to unconditioned space or to outside larger than 1/8" filled with foam or caulk. (NA if SPF meets conditions above) es o 19 All openings in the raised floor including second floors, such as under a tub where the drain penetrates the floor are sealed. (NA if slab on grade) WALLS AIR BARRIER es o „ All.gaps to outside larger than.l/8” filled with.foam or -caulk. (NA.if_SPF meets conditions above) -1- i -- , • � . N I -, , le, 11 ' . ' All openings in top and bottom plate to the outside in interior and exterior walls, including holes drilled for electrical and plumbing larger than 1/8" filled with foam or caulk. (NA if SPF meets conditions above) / �l P ��--� IVo —1, Rope caulk, foam gasket, or caulking bead under,exterior sole plate of the home. , ../ �•, a ® e ❑ f o All gaps around windows and doors caulked or foamed. Low expanding foam recommended if allowed 1by window manufacturer. (Stuffing with fiberglass not acceptable) ATTIC INSPECTION es o 19 Attic rulers appropriate to the material installed are evenly distributed throughout attic to verify depth. (NA if SPF or batt) es o 19 Number of rulers installed Attic area (sgft) - 250 = minimum number of rulers installed. Must round up. (NA if SPF or batt) Yes No NA ALL rulers visible from attic access.(NA if SPF or batt) es o 19 Eave vents baffles installed at all eave vents to prevent air movement under or into insulation. (NA if JSPF) CEILING AIR BARRIER es o ❑ IQA All draft stops in place to form a continuous ceiling air barrier no gaps larger than 1/8". (NA if SPF meets conditions above) es o 9 All dropped ceilings/soffits covered with hard covers. Gaps around or in the hard cover larger than 1/8" filled with foam or caulk. (NA if no drops) PP I Openings around flue shafts fully sealed with flashing and caulked. (NA if no flue shafts) ' Reg: 213-N0021824B-E2100001B-E21A Registration Date/Time: 2013/04/14 15:59:10 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms May 2012 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -21 Quality Insulation Installation (QII) - Framing Stage Checklist (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quint: 12-1004 e P NA Piping shaft openings fully sealed and caulked. (NA if no pipe shafts) M® s ❑ Imo j❑'j NA Penetrations through the ceiling air barrier from electrical boxes in the ceiling, fire alarm boxes, etc. sealed with caulk or foam. (NA if no penetrations) 19 Po Pn❑ e All duct chases, fireplace chases, and double walls sealed air tight at the ceiling level. All gaps into larger than 1/8" filled with foam or caulk (NA if none of the above or SPF meets conditions es es o HERS Rater Information CalCERTS Certificate # CC1-1798746942 above) GARAGE ROOF/CEILING AIR BARRIER FOR TWO STORIES (no conditioned space over garage) ❑ e ❑ Imo ® IRA Air barrier installed at joists in garage to house transition (between floors). No gaps larger than 1/8" allowed. (NA if SPF meets conditions above) GARAGE ROOF/CEILING AIR BARRIER FOR TWO STORIES (conditioned space over garage) Pes Po 19 If insulation is to be installed at subfloor then subfloor has no gaps over 1/8". Air barrier installed at 1 joists in garage to house transition (between floors). Use of SPF meeting conditions above as the air barrier satisfies the requirement to seal the gaps. Pn❑ e n�"'� P If insulation is to be installed at ceiling of garage then ceiling and joists to the outside have no gaps lover 1/8". (NA if SPF meets conditions above or no conditioned space over garage.) DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -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) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6111) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: CSLB License: Rod Pankratz 1677877 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ® tested/verified dwelling ❑ not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798746942 HERS Rater Company Name: Energy Management Services Responsible Rater's Name: Responsible Rater's Signature: Jack B LaFontaine Jack 8 LaFontaine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/12/2013 CC2004051 ' Reg: 213-N0021824B-E2100001B-E21A Registration Date/Time: 2013/04/14 15:59:10 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms May 2012 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -22 Quality Insulation Installation (QII) - Insulation Stage Checklist (Page 1 of 3) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quinta 12-1004 All structural framing areas shall be insulated in a manner that resists thermal bridging of the assembly separating conditioned from unconditioned space. Structural bracing, tie -downs, and framing of steel, or specialized framing used to meet structural requirements of the CBC are allowed and must be insulated. These areas shall be called out on the building plans with diagrams and/or specific design drawings indicating the R -value of insulation and fastening method to be used. SPF insulation can be considered an air barrier when the bottom and top plates of vertical framing and both ends of horizontal framing, including band and rim joists, are sprayed to completely fill the cavity adjacent to and in contact with the framing to a distance of 5.5 inches away from the framing for open cell SPF (ocSPF) or 2.0 inches away from the framing for closed cell SPF (ccSPF). SPF can be considered as an air barrier with less than the above thickness when a product data or specification sheet is provided that shows the product meets an air permeance no greater than 0.02 Us -m2 at 75 Pa pressure differential when tested in accordance to ASTM E2178 or ASTM E283. Closed cell and open cell manufacturers claim various R -values per inch. In California the maximum R -value that can be claimed for ccSPF is an R -value of 5.8 per inch and for ocSPF is an R -value of 3.6 per inch. Higher R -values per inch cannot be claimed even with manufacturer data. Insulation Staoe Checklist FLOOR INSULATION P �''� P ® NA All floor joist cavity insulation installed to uniformly fill the cavity side-to-side and end-to-end, NO gaps. (NA if slab on grade) es o 19 Insulation in full contact with the subfloor, NO gaps. (NA if slab on grade) Pes Po Imo ® NA Batts: cut to fit around wiring and plumbing, or split (delaminated). (NA if loose fill, SPF, or slab on grade) ❑ e P ® NA Batts: shall be properly supported to avoid gaps, voids, and compression. (NA for other forms of insulation) es o 19 Insulation R -value same or greater than listed on CF -1R. (NA for slab on grade) Y �j�� iV0 ® 19 Gaps between studs larger than /8" the cavity must be.filled with insulation or foam. (NA for slab on grade)' / 1 Pesffor o 7 r SPF: list the required floor cavity R -value from CF -111, R- . Determine, required thickness ccSPF (required R -value / 5.81k) =,I inches), or.'required thickness for ocSPF (required R -value / 3.6= inches). (NA for other forms of insulation) � WALL INSULATION A® ❑ Io ❑ NA Batts, loose fill mineral fiber, mineral wool, and cellulose: fills cavity and is in contact with air barrier. ocSPF: shall completely fill cavities of 2x4 inch framing or less. Cavities greater than 2x4 inch framing dimensions must be filled to the thickness calculated above. ccSPF: insulation is not required to fill the cavities of framed assemblies provided the installed thickness of insulation conforms to the thickness calculated above. ® Yes ❑ No ❑ NA Double walls and bump -outs- insulation fills the cavity or additional air barrier installed in the cavity so that the insulation fills the cavity and in contact with the air barrier. (NA if SPF meets conditions above and meets the required R -value) ® e P j❑'j NA Insulation installed in exterior walls adjacent to tub/shower, walls under stairs, and fireplace. Insulation required to fill wall cavity. Cavity required to be air tight. (NA if none of the above) es o All gaps around windows and doors filled with insulation or filled with low expanding foam. ® e ❑ Imo R Batts: no voids/depressions greater than 3/4" in ANY stud bay. (NA for other forms of insulation) es Imo NA Batts: voids/depressions less than 3/4" allowed as long as the area is not greater than 10% of the surface area for each stud quay. (NA for other forms of insulation) es o Loose Fill: no gaps or voids. Insulation completely fills the cavity. (NA for other forms of insulation) to Gaps between studs larger than 1/8" the cavity must be filled with insulation or foam. Reg: 213-N002182413-E2200002A-E22A Registration Date/Time: 2013/04/14 16:03:56 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms May 2012 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -22 Quality Insulation Installation (QII) - Insulation Stage Checklist (Page 2 of 3) Site Address: 80092 Via Tesoro, La Quinta CA 92253 Enforcement Agency: City of La Quinta Permit Number: 12-1004 ®❑ Yes Imo 0 All Rim -joists to the outside insulated. (NA if no Rim -joists) NrNe—s o I o Insulation installed at corner channels, wall intersections, and adjacent to tub/shower enclosures insulated to proper R -Value. CM es o o All skylight shafts and attic kneewalls insulated with minimum R-19. (NA if no skylights, kneewalls or in conditioned attic) ® Yes No No Insulation in full contact with air barrier or wall finish for skylight shafts and attic kneewalls. (NA if no skylight or kneewalls) es o Installed wall insulation R -value equal to or greater than what is listed on the CF -1R. ❑ e Imo ® IN SPF: insulation installed without gaps and to provide an air seal when specified as an air barrier. (NA for other forms of insulation) ` s Po "" o SPF: list the required wall cavity R -value from CF -1R, R- 19.0 . Determine required thickness for ccSPF (required R -value 19,0 / 5.8R) = 3,3 inches), or required thickness for ocSPF (required R -value 19.0 / 3.6 = 5,3 inches). (NA for other forms of insulation) e ® NA SPF: measure thickness of wall insulation in 6 random areas. Minimum thickness for ccSPF shall be no more than Y2 inch less than the required thickness listed above. Minimum thickness for ocSPF shall be no more than 1 inch less than the required thickness listed above. (NA for other forms of insulation) CEILING/ROOF INSULATION es o Gaps between studs larger than 1/8" the cavity must be filled with insulation or foam. YCels Po 9- Batts: no gaps/voids/depressions greater than 3/4". (NA for other forms of insulation) YCg es Po f -,ITA Batts: voids/depressions less than 3/4" allowed as long as the.area is not greater than'10% of the surface area for.'each{stud bay. (NA for other forms'of insulation) t ❑ Yes IVo ® NA Loose Fill: NO gaps or voids allowed. (NA for other forms of insulation) Zf I f - I I I f ti _ �PoT , ,,/ 7 i NI // 7 1/ 7 ' / All ceiling/roof insulation installed to uniformly fit the cavity side-to-side and.end-to-end. )Pegs IGo Po " Insulation in full contact with the ceiling/roof, NO gaps. es o Insulation in contact with air barrier. es o Batts: cut to fit around wiring and plumbing, or split (delaminated). (NA for other forms of insulation) es o P Batts taller than bottom chord must expand over the bottom chord or additional insulation installed so bottom chord not visible. (NA for other forms of insulation) e® P ❑ NA Batts cut to fit around ALL webbing. No gaps allowed between webbing and batts. (NA for other forms of insulation) Y ❑ P ® NA SPF: list the required ceiling R -value from CF -1R, R- 19.0 . Determine required thickness for ccSPF (required R -value 1 0 / 5.8R) = 3,3 inches), or required thickness for ocSPF (required R -value 19.0 / 3.6 = 19.0 inches). (NA for other forms of insulation) Y[e]s Imo ® NA SPF: measure thickness of ceiling insulation in 6 random areas. Minimum thickness for ccSPF shall be no more than 1/2 inch less than the required thickness listed above. Minimum thickness for ocSPF shall be no more than 1 inch less than the required thickness listed above. (NA for other forms of insulation) IM es o R HVAC Platform and Catwalks - insulated to R -value equal to ceiling R -value listed on CF -1R. If less insulation installed then called out on CF -1R. (NA if no platform or catwalks) e P NA Attic access gasketed. (NA of no attic access) ® e P ❑ NA Attic access insulated with rigid foam or batt insulation using adhesive or mechanical fastener. Attic access door R -value equal to ceiling R -value listed on CF -1R. If less insulation installed then called out on CF -1R. (NA if no attic access) es o IR Recessed light fixtures covered full depth with insulation. If SPF used then other forms of insulation used to cover or enclose fixture in a box fabricated from 1/2 -inch plywood, 18 ga. sheet metal, 1/4 -inch hard board or drywall. SPF or other insulation then covers light fixture to full depth. (NA is no recessed light fixtures) RX es I No ITA All recessed light fixtures in non conditioned space are IC rated and air tight (AT). (NA if no recessed light fixtures) ' Reg: 213-N0021824B-E2200002A-E22A Registration Date/Time: 2013/04/14 16:03:56 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms May 2012 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF -4R -ENV -22 Quality Insulation Installation (QII) - Insulation Stage Checklist (Page 3 of 3) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 1 City of La Quinta 12-1004 ® ❑ ❑ All recessed light fixtures are sealed with a gasket or caulk between the housing and the ceiling. (NA Yes No No if no recessed light fixtures) eP ® tested/verified dwelling ❑aot-tested/verified dwelling in Ceiling insulation equal to or greater than what is listed on the CF -1R. a HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798746942 Loose Fill: Minimum thickness required to meet the stated R -value listed on CF -1R. Insulation rulers YO es o o visible for verifying the installed R -value for blown in insulation. (NA for other forms of insulation) es No ® No Loose Fill: insulation uniformly covers the entire ceiling (or roof) area from outside of all exterior walls. (NA for other forms of insulation) Weight of Mineral -Fiber Loose -fill (Fiberglass, Rock wool) - Target R -value from CF -1R) Yes ❑ No ® IF Minimum weight from insulation bag label to meet target R -value (Ib./ft2) . Weight of insulation from coring tool (lb). Area of coring tool (ft2). Sample weight = (Ib./ft2). Is sample weight (Ib./ft2) the same as or greater than required weight (Ib./ft2) (NA for other forms of insulation) Thickness - ALL Loose -Fill Insulation - Target R -value (from CF -1R) Required thickness from insulation bag label to meet Target R -value for (Installed Thickness (in)), and (Settled es o o Thickness (in)). Average Installed thickness (in). Is Installed Thickness the same as or greater than Required Thickness? (NA for other forms of insulation) GARAGE ROOF/CEILING INSULATION FOR TWO STORIES(no conditioned space over garage) es I o I R Insulation installed at joists against the air barrier in the garage to house transition. All wall I insulation requirements above must be met. (NA if conditioned space over garage). GARAGE ROOF/CEILING INSULATION FOR TWO STORIES(conditioned space over garage) PNo ❑ ® NA If insulation is to be installed at subfloor then the insulation must also be installed at joists against the air barrier in the garage to house transition. All ceiling and wall insulation requirements above must be met. (NA if no conditioned space over garage). P of If,insulation is to be installed at ceiling of garage then the joists to the outside must be insulated and all the insulation'requireinents listed above must be met. (NA if no conditioned space over garage). DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the certified HERS rater who ;'oerformed the verification services identified and reported on this certificate (responsible rater). • The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. • The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: CSLB License: Rod Pankratz 1677877 HERS Provider Data Registry Information --[ Sample Group # if applicable): N A P P (/ ® tested/verified dwelling ❑aot-tested/verified dwelling in a HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798746942 HERS Rater Company Name: Energy Management Services Responsible Rater's Name: Responsible Rater's Signature: Jack B LaFontaine Jack B LaFontaine Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 4/12/2013 CC20040S1 Reg: 213-N0021824B-E2200002A-E22A Registration Date/Time: 2013/04/14 16:03:56 HERS Provider: CalCERTS, inc. 2008 Residential Compliance Forms May 2012 INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS Duct Leakage Test — Completely New or Replacement Duct System (Page 1 of 2) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 1 (SHP Enforcement Agency: Permit Number: 2)) City of La Quinta 12-1004 Enter the Duct System Name or Identification/Tag: System i Enter the Duct System Location or Area Served: Living Spaces Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This certificate is required for compliance for completely new duct systems installed in new dwelling construction, and also for completely new or replacement duct systems in existing dwellings. 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. Duct Leakage Diagnostic Test - completely new or replacement duct system Enter a value for the Allowed Leakage (CFM) for the duct system leakage verification. The value entered must be the VLLDCS criteria or one of the three calculated leakage rates described below. Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Compliance Credit. If compliance credit for verified low leakage ducts in conditioned space is shown in the special features section of the Allowed CF -1R, the leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4), Leakage and 25 CFM must be entered for Allowed Leakage. (CFM) Allowed leakage calculation — (select one calculation method from this section). Use 6% (leakage factor = 0.06) for calculations if tested at "final' or 4% (leakage factor = 0.04) if tested at "rough." When utilizing Low Leakage Air Handler (LLAH) credit, the allowed duct leakage may be specified by the CF -1R to be less than 6%, in which case the user-specified leakage rate must be used in the calculations below. For example, if the user-specified leakage (specified as a percentage of fan airflow) is reported on the CF -1R as 3%, then use aleakage factor of 0.03 in the calculations below. J ® Cooling system method: Nominal capacity of condecnseF in Tons 5 x 400 x leakage factor= M CFM i i ❑ Heating system method: 21.7 x Output Capacity in Thousands. of Btu/hr x leakage factor = CFM ❑ Measured airflow method (RA3.3): Enter measured fan flow in CFM here x leakage factor = CFM Enter value for Actual leakage (CFM) in the right column, from measurement using applicable duct Actual Leakage leakage pressurization test procedure from Reference Residential Appendix RA3.l(CFM @ 25 Pa). (CFM) List Actual Leakage from duct leakage test(CFM) 72 Pass if Actual Leakage is equal to or less than Allowed Leakage ® Pass ❑ Fail For complete replacement of duct systems only, if the 6 percent leakage rate criteria cannot be met, a smoke test should be performed to verify that the excess leakage is coming only from a pre-existing furnace cabinet (air handler cabinet), and not from other accessible portions of the duct system. A HERS rater must verify the installation (No sampling allowed). List Actual Leakage from smoke test(CFM) Pass if all accessible leaks (except for existing air handler) are sealed using smoke ❑ Pass ❑ Fail Reg: 213-N0021824B-M2000006A-0000 Registration Date/Time: 2013/04/13 18:43:30 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS Duct Leakage Test — Completely New or Replacement Duct System (Page 2 of 2) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 1 (SHP Enforcement Agency: Permit Number: 2)) City of La Quinta 12-1004 Compliance Method This dwelling was: (select one of the following two choices): ® Tested at Final ❑ Tested at Rough -in (requires installer to complete the visual inspection at final construction stage described below) Visual Inspection at Final Construction Stage (if applicable) After installing the interior finishing wall and verifying that the above rough -in tests was completed, the following procedure must be performed: ❑ For all supply and return registers, verify that the spaces between the register boot and the interior finishing wall are properly sealed. ❑ If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points between the air handler and the supply and return plenums to verify that the connection points are properly sealed. ❑ Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used. ® Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. ® All supply and return register boots must be sealed to the drywall ® New duct°installations cannot utilize, building cavities as plenums or platform returns in"lieu of ducts. ® Mastic and draw bands'niustibe used in combination with Cloth backed, rubber adhesive duct tape to seal leaks at duct connections. / DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • 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 applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: Responsible Person's Signature: Rod Pankratz Rod Pankratz CSLB License: 677877 Date Signed: 4/11/2013 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 213-N0021824B-M2000006A-0000 Registration Date/Time: 2013/04/13 18:43:30 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS Duct Leakage Test — Completely New or Replacement Duct System (Page 1 of 2) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 2 (SHP Enforcement Agency: Permit Number: 1)) City of La Quinta 12-1004 Enter the Duct System Name or Identification/Tag: System 2 Enter the Duct System Location or Area Served: Master Bedroom Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This certificate is required for compliance for completely new duct systems installed in new dwelling construction, and also for completely new or replacement duct systems in existing dwellings. 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. Duct Leakage Diagnostic Test - completely new or replacement duct system Enter a value for the Allowed Leakage (CFM) for the duct system leakage verification. The value entered must be the VLLDCS criteria or one of the three calculated leakage rates described below. Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Compliance Credit. If compliance credit for verified low leakage ducts in conditioned space is shown in the special features section of the Allowed CF -1R, the leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4), Leakage and 25 CFM must be entered for Allowed Leakage. (CFM) Allowed leakage calculation - (select one calculation method from this section). Use 6% (leakage factor = 0.06) for calculations if tested at "final' or 4% (leakage factor = 0.04) if tested at "rough." When utilizing Low Leakage Air Handler (LLAH) credit, the allowed duct leakage may be specified by the CF -1R to be less than 6%, in which case the user-specified leakage rate must be used in the calculations below. For example, if the user-specified leakage (specified as a percentage of fan airflow) is reported on the CF -1R as 3%, then use aleakage factor of 0.03 in the calculations below. r ® Cooling system method: ' Nominal capacity of condenser in Tons x 400 x leakage factor = 84 CFM ❑ Heating system method: 21.7 x Output Capacity in Thousands of Btu/hr x leakage factor = CFM []Measured airflow method (RA3.3): Enter measured fan flow in CFM here x leakage factor = CFM Enter value for Actual leakage (CFM) in the right column, from measurement using applicable duct Actual Leakage leakage pressurization test procedure from Reference Residential Appendix RA3.1(CFM @ 25 Pa). (CFM) List Actual Leakage from duct leakage test(CFM) 82 Pass if Actual Leakage is equal to or less than Allowed Leakage ® Pass ❑ Fail For complete replacement of duct systems only, if the 6 percent leakage rate criteria cannot be met, a smoke test should be performed to verify that the excess leakage is coming only from a pre-existing furnace cabinet (air handler cabinet), and not from other accessible portions of the duct system. A HERS rater must verify the installation (No sampling allowed). List Actual Leakage from smoke test(CFM) Pass if all accessible leaks (except for existing air handler) are sealed using smoke ❑ Pass ❑ Fail Reg: 213-N0021824B-M2000007A-0000 Registration Date/Time: 2013/04/13 18:44:38 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS Duct Leakage Test — Completely New or Replacement Duct System (Page 2 of 2) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 2 (SHP Enforcement Agency: Permit Number: 1)) City of La Quinta 12-1004 Compliance Method This dwelling was: (select one of the following two choices): ® Tested at Final ❑ Tested at Rough -in (requires installer to complete the visual inspection at final construction stage described below) Visual Inspection at Final Construction Stage (if applicable) (After installing the interior finishing wall and verifying that the above rough -in tests was completed, the following I Drocedure must be performed: ❑ For all supply and return registers, verify that the spaces between the register boot and the interior finishing wall are properly sealed. ❑ If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points between the air handler and the supply and return plenums to verify that the connection points are properly sealed. ❑ Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used. ' ® Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. ' ® All supply and return register boots must be sealed to the drywall ® New duct installations cannot utilize,building cavities as plenums or platform returns in -lieu of ducts. f ' ® Mastic and draw bands must=be used in combination with Cloth backed, rubber adhesive duct tape to seal leaks at duct connections. DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). ' . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also ' perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . 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 applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: Responsible Person's Signature: Rod Pankratz Rod Ponkratz CSLB License: 677877 Date Signed: 4/11/2013 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 213-N0021824B-M2000007A-0000 Registration Date/Time: 2013/04/13 18:44:38 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS Duct Leakage Test - Completely New or Replacement Duct System (Page 1 of 2) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 3 (SHP Enforcement Agency: Permit Number: 3)) City of La Quinta 12-1004 Enter the Duct System Name or Identification/Tag: System 3 Enter the Duct System Location or Area Served: Casita Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This certificate is required for compliance for completely new duct systems installed in new dwelling construction, and also for completely new or replacement duct systems in existing dwellings. 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. Duct Leakaqe Diaqnostic Test - completely new or replacement duct system Enter a value for the Allowed Leakage (CFM) for the duct system leakage verification. The value entered must be the VLLDCS criteria or one of the three calculated leakage rates described below. Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Compliance Credit. If compliance credit for verified low leakage ducts in conditioned space is shown in the special features section of the Allowed CF -1R, the leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4), Leakage and 25 CFM must be entered for Allowed Leakage. (CFM) Allowed leakage calculation - (select one calculation method from this section). Use 6% (leakage factor = 0.06) for calculations if tested at "final" or 4% (leakage factor = 0.04) if tested at "rough." When utilizing Low Leakage Air Handler (LLAH) credit, the allowed duct leakage may be specified by the CF -111 to be less than 6%, in which case the user-specified leakage rate must be used in the calculations below. For example, if the user-specified leakage (specified as a percentage of fan airflow) is reported on the CF -1R as 3%, then use aleakage factor of 0.03.in the calculations below. ❑ Cooling system method: I Nominal.capacity of condenser in Tons x 400.x leakage factor = CFM ® Heating system method: 21.7 x 56 Output Capacity in Thousands of Btu/hr x leakage factor = 72.91 CFM ❑ Measured airflow method (RA3.3): Enter measured fan flow in CFM here x leakage factor = CFM Enter value for Actual leakage (CFM) in the right column, from measurement using applicable duct Actual Leakage leakage pressurization test procedure from Reference Residential Appendix RA3.1(CFM @ 25 Pa). (CFM) List Actual Leakage from duct leakage test(CFM) 62 Pass if Actual Leakage is equal to or less than Allowed Leakage ® Pass ❑ Fail For complete replacement of duct systems only, if the 6 percent leakage rate criteria cannot be met, a smoke test should be performed to verify that the excess leakage is coming only from a pre-existing furnace cabinet (air handler cabinet), and not from other accessible portions of the duct system. A HERS rater must verify the installation (No sampling allowed). List Actual Leakage from smoke test(CFM) Pass if all accessible leaks (except for existing air handler) are sealed using smoke ❑ Pass ❑ Fail Reg: 213-N0021824B-M2000008A-0000 Registration Date/Time: 2013/04/13 18:46:13 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS Duct Leakage Test — Completely New or Replacement Duct System (Page 2 of 2) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 3 (SHP Enforcement Agency: Permit Number: 3)) City of La Quinta 12-1004 Compliance Method This dwelling was: (select one of the following two choices): ® Tested at Final ❑ Tested at Rough -in (requires installer to complete the visual inspection at final construction stage described below) Visual Inspection at Final Construction Stage (if applicable) After installing the interior finishing wall and verifying that the above rough -in tests was completed, the following procedure must be performed: ❑ For all supply and return registers, verify that the spaces between the register boot and the interior finishing wall are properly sealed. ❑ If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points between the air handler and the supply and return plenums to verify that the connection points are properly sealed. Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used. ' ® Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. ' ® All supply and return register boots must be sealed to the drywall ® New duct installations cannot utilize, building cavities as plenums or platform returns in'lieu of ducts. j ' ® Mastic and draw bands must±be used in combination with Cloth backed, rubber adhesive duct tape to seal leaks at duct connections. ' DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). ' . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . 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 applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: Responsible Person's Signature: Rod Pankratz Rod Ponkratz CSLB License: 677877 Date Signed: 4/11/2013 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No ' Reg: 213-N0021824B-M2000008A-0000 Registration Date/Time: 2013/04/13 18:46:13 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-22-HERS HSPP/PSPP Installation; Cooling Coil Airflow & Fan Watt Draw Test (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 1 City of La Quinta 12-1004 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 ' Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP) in the supply plenum When the Certificate of Compliance (CFZR )indicates Cooling Coil Airflow or Fan Watt Draw verification are ' required, HSPP or PSPP are required to be installed in each air handler in the dwelling. Procedures for installing HSPP and PSPP are described in Reference Residential Appendix RA3.3. This measure requires verification by a HERS rater. Select one method from the two choices below for compliance with the HSPP/PSPP requirement for this dwelling. ® HSPP 1/4 inch (6 mm) hole labeled and located downstream of the evaporator coil in the supply System Name or Identification/Tag System 1 plenum as shown in the figure in Section RA3.3.1.1. System 3 1/4 inch (6 mm) hole equipped with a permanently installed pressure probe, labeled and ❑ PSPP located downstream of the evaporator coil in the supply plenum as shown in the figure in Nominal Cooling Capacity (ton) of the outdoor unit. Section RA3.3.1.1. System Name or System 1 System 2 (SHP 1) System 3 350 Identification/Tag 350 Calculate the target minimum airflow for the test by multiplying the System Location or Area Living Spaces MASTER BEDROOM Casita 1750 Served 700 of the outdoor unit (ton). Confirm that a HSPP or Target (CFM) PSPP has been Enter the diagnostically tested airflow (CFM). 1861 installed on the air 834 Tested (CFM) handler per the PASS PASS PASS requirements of I (CFM). PASS RA3.3.1.1. Enter. Pais—or, Fail PASS Enter Pass or Fail Cooling Coil Airflow -Verification ' When the Certificate�of Compliance indicates Cooling Coil Airf/o�w verification is required, the procedures for, measuring the cooling coil airflow must be performed as specified in Reference Residential Appendix RA3.3. Results of the cooling coil airflow diagnostic test must be entered in the table below. This measure requires verification by a HERS rater. Select one method from the three choices below for compliance with the Cooling Coil Airflow test requirement for this dwelling. ❑ Diagnostic Fan Flow Using Plenum Pressure Matching according to the procedures in RA3.3.3.1.1 ® Diagnostic Fan Flow Using Flow Grid Measurement according to the procedures in RA3.3.3.1.2 ❑ Diagnostic Fan Flow Using Flow Capture Hood according to the procedures in RA3.3.3.1.3 System Name or Identification/Tag System 1 System 2 (SHP 1) System 3 System Location or Area Served Living Spaces MASTER BEDROOM Casita Nominal Cooling Capacity (ton) of the outdoor unit. 5 3.5 2 Enter the minimum airflow requirement from the CF -1R (CFM/ton). 350 350 350 Calculate the target minimum airflow for the test by multiplying the CFM/ton criteria specified on the CF -1R by the nominal cooling capacity 1750 1225 700 of the outdoor unit (ton). Target (CFM) Enter the diagnostically tested airflow (CFM). 1861 1370 834 Tested (CFM) The system complies if Tested (CFM) is equal or greater than Target (CFM). PASS PASS PASS Enter Pass or Fail ' Reg: 213-N0021824B-M2200009A=0000 Registration Date/Time: 2013/04/13 19:06:23 HERS Prcvider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-22-HERS HSPP/PSPP Installation; Cooling Coil Airflow & Fan Watt Draw Test (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 1 City of La Quint a 12-1004 Fan Watt Draw Verification When the Certificate of Compliance indicates Fan Watt Draw verification is required, the procedures for measuring the Fan Watt Draw must be performed as specified in Reference Residential Appendix RA3.3. Results of the Fan Watt Draw diagnostic test must be entered in the table below. This measure requires verification by a HERS rater. Note: Fan watt draw must be measured simultaneously with cooling coil airflow. The fan watt draw measurement and cooling coil airflow measurement must simultaneously meet or exceed their target criteria specified by the CF -1R for the dwelling. Select one method from the two choices below for compliance with the Fan Watt Draw test requirement for this dwelling. ❑ Portable Watt Meter Measurement according to the procedures in RA3.3.2.2.1 ❑ Utility Revenue Meter Measurement according to the procedures in RA3.3.2.2.2 System Name or Identification/Tag Rod Pankratz Rod Pankrotz CSLB License: Date Signed: System Location or Area Served 677877 4/11/2013 Is this installation monitored by a Third Party Quality Enter the air handler Tested (CFM) from the cooling coil airflow test table above. Control Program (TPQCP)? ❑ Yes ❑ No Enter the fan watt draw requirement from the CF -1R (Watt/CFM). Calculate the target maximum Watt draw for the test by multiplying the Watt/CFM criteria specified on the CF -1R by the air handler Tested (CFM). Target (CFM) Enter the diagnostically tested Watt draw (Watt). Tested (Watt) The system complies if Tested (Watt) is less than or equal to Target (Watt) Enter Pass or Fail I DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -SR) 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 applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: Responsible Person's Signature: Rod Pankratz Rod Pankrotz CSLB License: Date Signed: Position With Company (Title): 677877 4/11/2013 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 213-N0021824B-M2200009A-0000 Registration Date/Time: 2013/04/13 19:06:23 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-23-HERS Verification of High EER Equipment (Page 1 of 1) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quinta 12-1004 Verification of High EER Equipment Procedures for verification of High EER Equipment are described in Reference Residential Appendix RA3.4. For dwelling units with multiple systems, the procedures must be applied to each system separately. 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. 1 System Name or Identification/Tag System 1 System 2 System 3 Rod Pankratz 2 System Location or Area Served Living Spaces MASTER BEDROOM Casita 3 Certified EER Rating of the installed 11.0 11.0 11.0 equipment (Btu/Watt-hr) 4 Make and Model Number of the installed Day & Night Day & Night Day & Night Outdoor Unit N4A36OAKC300 N4A342AKA300 N4A324AKA200 5 Make and Model Number of the installed AIIStyIe . AIIStyIe AIIStyIe Inside Coil ASFM6021A33E ASFM482IA28E ASLB3616A28E 6 Make and Model Number of the installed Day & Night Day & Night Day & Night Furnace or Air Handler. NSMSL0902120AI NSMSL0701716AI NSMSL07014282 7 Minimum Equipment EER required for 10.4 11 10.5 compliance as reported on the CF-iR ® When a high EER system specification includes a time delay relay, the installation of the time delay relay must be verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Time Delay Relay Verification Procedure. ® When installation of specific matched equipment is necessary to achieve a high EER, installation of the specific equipment must be verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Matched Equipment Verification Procedure. If the Certified EER Rating in row 3 is equal to $ or greater than the required minimum EER in PASSPASS PASS row 7, the unit complies. If the unit complies enter Pass 1 DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . 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 applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: Responsible Person's Signature: Rod Pankratz Rod Pankratz CSLB License: Date Signed: Position With Company (Title): 677877 4/11/2013 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes p No Reg: 213-N0021824B-M2300010A-0000 Registration Date/Time: 2013/04/13 19:09:00 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 1 11 Certificate of Product Ratinas AHRI Certified Reference Number: 4239049 Date: 4/10/2013 Product: Split System: Air -Cooled Condensing Unit, Coil Alone Outdoor Unit Model Number: N4A360A(G)KC* Manufacturer: DAY & NIGHT Indoor Unit Model Number: ASF*6021A33E+D+V Manufacturer: ALLSTYLE COIL CO., INC. Trade/Brand name: AIRSTAR, TFC, MERIDIAN Manufacturer responsible for the rating of this system combination is ALLSTYLE COIL CO., INC. Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air -Conditioning and Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (Btuh): 56500 EER Rating (Cooling): 11.00 SEER Rating (Cooling): 13.00 * Ratings followed by an asterisk (*) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any forth or manner or by any means, except for the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org, A "IM' Air -Conditioning, Heating, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on A" ON ,/ and Refrigeration Institute which the certificate was issued, which is listed above, and the Certificate No., which is listed below. ©2013 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130101080994374050 Certificate of Product Ratings AHRI Certified Reference Number: 4239046 Date: 4/10/2013 Product: Split System: Air -Cooled Condensing Unit, Coil Alone Outdoor Unit Model Number: N4A342A(G)KA* Manufacturer: DAY & NIGHT Indoor Unit Model Number: ASF*4821A28E+D+V Manufacturer: ALLSTYLE COIL CO., INC. Trade/Brand name: AIRSTAR, TFC, MERIDIAN Manufacturer responsible for the rating of this system combination is ALLSTYLE COIL CO., INC. Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air -Conditioning and Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (Btuh): 43000 EER Rating (Cooling): 11.00 SEER Rating (Cooling): 13.00 * Ratings followed by an asterisk (*) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any forth or manner or by any means, except for the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org, A "IM' Air -Conditioning, Heating, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on A..0 ,/ and Refrigeration Institute which the certificate was issued, which is listed above, and the Certificate No., which is listed below. ©2013 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130101082240852093 Certificate of Product Ratings AHRI Certified Reference Number: 4239050 Date: 4/10/2013 Product: Split System: Air -Cooled Condensing Unit, Coil Alone Outdoor Unit Model Number: N4A324A(G)KB* Manufacturer: DAY & NIGHT Indoor Unit Model Number: AS36A343E+D+V Manufacturer: ALLSTYLE COIL CO., INC. Trade/Brand name: AIRSTAR, TFC, MERIDIAN Manufacturer responsible for the rating of this system combination is ALLSTYLE COIL CO., INC. Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air -Conditioning and Air -Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (Btuh): 23400 EER Rating (Cooling): 11.00 SEER Rating (Cooling): 13.00 * Ratings followed by an asterisk (*) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any forth or manner or by any means, except for the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org, A RAM' Air -Conditioning, Heating, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on A. ■� ,' and Refrigeration Institute which the certificate was issued, which is listed above, and the Certificate No., which is listed below. ©2013 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130101083782503387 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page i of 6) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quint: 12-1004 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance, unless the TMAH Compliance Option is chosen. ' STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Suppler and Return Plenums of Air Handler System Name or Identification/Tag System 1 System 2 System 3 System Location or Area Served Living Spaces MASTER BEDROOM Casita 5/16 inch (8 mm) access hole upstream of evaporative coil in the ® Yes ® Yes N Yes ❑ Yes 1 return plenum.and labeled ❑ No ❑ No " 13 No,--- ❑ No according to Figure in Section RA3.2.2.2.2. ' Return side of the,duct system is located entirely within conditioned ❑Yes ❑Yes ❑Yes ❑Yes la space and return airflow ❑ No ❑ No ❑ No ❑ No temperature to be measured at the return grille. 5/16 inch (8 mm) access hole downstream of evaporative coil in ® Yes ® Yes N Yes ❑ Yes 2 the supply plenum and labeled ❑ No ❑ No ❑ No ❑ No according to Figure in Section RA3.2.2.2.2. The TMAH Compliance Option should be checked only if it is physically impossible to drill the TMAH as required by Section RA3.2.2.2.2. Using this Compliance Option requires the HVAC installer to annotate on the HERS Provider's data registry an explanation as to why the TMAH cannot be installed on the system, and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance Option also requires minimum airflow verification through the direct measurement of airflow per RA3.3 For more information see http://www.ener(iv,ca.gov/title24/2008standards/special case appliance/ TMAH Compliance Option ❑ ❑ ❑ ❑ Yes to 1 and 2, or Yes to la and 2, or checking the TMAH Compliance Option, ® Pass ® Pass 11 Pass ❑ Pass is a pass. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Enter Pass or Fail Reg: 213-N0021824B-M2500011A-0000 Registration Date/Time: 2013/04i13 19:12:28 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 1 City of La Quint a 12-1004 STMS - Sensor on the Evaporator Coil System Name or Identification/Tag System 1 System 2 System 3 3 The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed by methods/specifications approved by the Executive Director. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Tby The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 4 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the 1 ff _' ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No • ❑ Yes ❑ No. airflow through the condenser coil ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No T ❑ Yes ❑ No 5 IThe sensor measures the saturation temperature of the coil within 1.3 degrees F The sensor mini plug is accessible to th6 installing technician and the HERS rater without changing the ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 3, 4, and 5 is a ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No pass. Enter N/A if STMS are not ® N/A ® N/A ® N/A ❑ N/A applicable. ❑pass ❑Pass ❑Pass ❑Pass Otherwise enter Pass or ❑ Fail ❑ Fail ❑ Fail ❑ Fail Fail ❑ Fail ❑ Fail ❑ Fail ❑ Fail STMS - Sensor on the Condenser Coil System Name or _ T, stem.i �System 2 System.3�,Identification/Tag`" k, Tby e sensor is factory installed, or field installed according to manufacturer's specifications, or is installed methods/specifications approved by the Executive.Director. 1 ff _' ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No • ❑ Yes ❑ No. The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 7 The sensor mini plug is accessible to th6 installing technician and the HERS rater without changing the airflow through the condenser coil ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 8 IThe sensor measures the saturation temperature of the coil within 1.3 degrees F ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ❑ N/A ❑ N/A ❑ N/A ❑ N/A applicable. ❑ Pass 4 ❑ Pass ❑ Pass ❑ Pass Otherwise enter Pass or ❑ Fail ❑ Fail ❑ Fail ❑ Fail Fail i Reg: 213-N0021824B-M2500011A-0000 Registration Date/Time: 2013/04/13 19:12:28 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 1 City of La Quinta 12-1004 I Standard Charge Measurement Procedure (for use if outdoor air dry-bulb temperature is 55°F or above) 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 temperature is less than 55°F, the installer must use the RA3.2.3 Alternate Charge Measurement Procedure (Weigh -In Charging Method). If the Weigh -In Method is used, the dwelling cannot be included in a sample group for HERS verification compliance.) Space Conditioning Systems System Name or Identification/Tag System i System 2 System 3 4/11/2013 System Location or Area Served Living Spaces MASTER BEDROOM Casita Outdoor Unit Serial # A123718837 A124216018 A127791673 Outdoor Unit Make Day & Night Day & Night Day & Night Outdoor Unit Model N4A360AKC300 N4A342AKA300 N4A324AKA200 Nominal Cooling,Capacity 5 Tons, _ --, 3.5" Tons 2 Tons �i � r ..-.-� � l � � ;'? �•. [Date oVerificationf I i 4/11/2013 ~ 4/11/2013 V4/11/2013 90.7 f 82.0 82.0 82.0 V Calibration of Diagnostic Instruments a f w / i r Date of Refrigerant.Gauge Calibration 4/11/2013 I rr 'rt ' (must be re -calibrated monhlt y)' Date of Thermocouple Calibration 4/11/2013 (must be re -calibrated monthly) Measured Temperatures (°F) System Name or Identification/Tag System i System 2 System 3 Supply (evaporator leaving) air dry-bulb 54.8 53.2 56.7 temperature (Tsu I db) 32.2 36.8 39.0 Return (evaporator entering) air 76.0 76.0 76.0 dry-bulb temperature (Treturn db) 101.4 98.1 101.0 Return (evaporator entering) air 56.9 56.4 61.2 wet -bulb temperature (Treturn wb) Evaporator saturation temperature 32.2 36.8 39.0 (Teva orator sat) Condensor saturation temperature 101.4 98.1 101.0 (Tcondensor, sat) Suction line temperature (Tsuction) 44.8 49.1 52.8 Liquid Line Temperature (Tliquid) 89.4 86.4 90.7 Condenser (entering) air dry-bulb 82.0 82.0 82.0 temperature (Tcondenser, db) Reg: 213-N0021824B-M2500011A-0000 Registration Date/Time: 2013/04/13 19:12:28 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quinta 12-1004 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 System 2 System 3 Calculate: Actual Temperature Split = 21.20 22.80 19.30 Treturn db - Tsupply, db Target Temperature Split from Table RA3.2-3 using Treturn, wb and Treturn, 22.4 23.4 20.4 db Calculate difference: Actual Temperature -1.2 -0.6 -1.1 Split - Target Temperature Split = Passes if difference is between -3°F and +3°F or, upon remeasurement, if PASS PASS PASS 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 in the table below. Calculated Minimum A_ irflow' Requirement (CFM) =Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name or Identification/Tag System 1 System 2 System 3 Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 procedures (CFM) Measurement Method Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Reg: 213-N0021824B-M2500011A-0000 Registration Date/Time: 2013/04/13 19:12:28 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quint a 12-1004 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 System 2 System 3 System 2 Calculate: Actual Superheat = 12.0 11.7 10.3 12.3 Tsuction - Teva orator sat Tsuction - Teva orator sat Target Superheat from Table RA3.2-2 10.0 10.0 10.0 using Treturn wb and Tcondenser, db manufacturer's specifications (or use Calculate difference: , 2 iJ, -- 0.3 - 4-25 Actual Superheat - Target Superheat = manufacturer's specification is not System passes if difference is between available) -5°F and +5°F PASS PASS PASS Enter Pass or Fail EwSyitshthe allowable superheat range PASS PASS 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 System 2 System 3 System 2 Calculate: Actual Subcooling = 12.0 11.7 10.3 12.3 Tcondenser, sat - Tli uid Tsuction - Teva orator sat Target Subcooling specified by 10.0 10.0 10.0 manufacturer manufacturer's specifications (or use Calculate difference: , 2 iJ, -- 0.3 - 4-25 Actual Subcooling -:-Target Subcooling,= manufacturer's specification is not System passes if difference is between available) -3°F and +3°F PASS PASS PASS /Enter Pass or Fail EwSyitshthe allowable superheat range PASS PASS 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 System 2 System 3 Calculate: Actual Superheat = 12.6 12.3 13.8 Tsuction - Teva orator sat Enter allowable superheat range from manufacturer's specifications (or use range between 4°F and 25°F if 4-25 4-25 4-25 manufacturer's specification is not available) passes if actual superheat is EwSyitshthe allowable superheat range PASS PASS PASS Enter Pass or Fail Reg: 213-N0021824B-M2500011A-0000 Registration Date/Time: 2013/04/13 19:12:28 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 City of La Quinta 12-1004 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 System 2 System 3 Position With Company (Title): System meets all refrigerant charge and Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No airflow requirements. I PASS PASS PASS Enter Pass or Fail ' ® Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55°F and 65°F the return air dry bulb temperature shall be maintained above 70°F during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate. DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. ' . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked.by a HERS rater; and'if,those installations -fail to'meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed 'at my expense./ j / . I reviewed a copy of the'Certificete 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•- rr - installation have been met. . I will ensure that a'c6rhpleted, signed copy of this Installation Certificate shall be posted,.or made availableoa with the building-permit(s) issued for the building, and made available to -the enforcement agency foeall applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: Responsible Person's Signature: Rod Pankratz Rod Pankratz CSLB License: 677877 Date Signed: 14/11/2013 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 213-N0021824B-M2500011A-0000 Registration Date/Time: 2013/04/13 19:12:28 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF -6R -ENV -20 -HERS Building Envelope - Sealing (Page 1 of 3) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 1 (SHP Enforcement Agency: Permit Number: 2)) City of La Quinta 12-1004 BUILDING ENVELOPE SEALING Two methods are available to the installer for demonstrating compliance with the building envelope sealing requirement: 1) Rough Frame Inspection Checklist and Final Inspection Checklist, or 2) Building Envelope Leakage Diagnostic Test utilizing a blower door diagnostic test instrument. Note: HERS verification of the actual envelope leakage is required to be performed using the Building Envelope Leakage Test. In order to receive credit for the Building Envelope Sealing measure, the dwelling must comply with the HERS verification requirements. Completion of the Rough Frame Inspection Checklist and Final Inspection Checklist does not insure that the envelope will meet the requirements of the HERS verification procedure. Ia. Rough Frame Inspection Checklist Sole Plate ® Entire sole plate of the home is either Rope caulk, foam gasket, or with caulking bead sealed. Too Plate ® All electrical penetrations between conditioned and unconditioned spaces sealed with foam ® All piping penetrations between conditioned and unconditioned spaces sealed with foam Ceiling ® Ceiling forms a continues air barrier and any gaps or openings are filled with foam ® All recessed light fixtures in unconditioned space are IC (Insulation Contact) and AT (Air tight) rated and a gasket or sealing material is installed. ® All duct chases, fireplace chases, and double walls sealed air tight at the ceiling level. All gaps into shafts must be filled with foam or caulk. ® Openings around flue shafts fully sealed with solid ing or flashing and any remaining gaps sealed with fire -rated caulk or sealant. ® Penetrations from wiring sealed with caulk or sealant Floor Air Barrier 3 N/A All gaps in the raised,floor•between conditioned and unconditioned space (or to outside) filled with foam or caulk ® All openings under a tub where the drain penetrates the floor sealed ® Garage band joist must be air tight at bays adjoining conditioned space Walls ® All gaps around the windows caulked ® All gaps in exterior wall sheathing between conditioned and unconditioned space (or to outside) filled with foam or caulk ® All gaps in sheathing between conditioned space and the garage, attic, or covered patio filled with foam or caulk ® All other penetrations or cracks between conditioned and unconditioned space (the exterior of the home) sealed with foam or caulk HVAC Ensure that the following are sealed with an approved UL 181 mastic or tape: Duct Work ® All register boot seams ® Return seams ® Return and supply collars ® Duct collars ® Duct board, T and Y seams Furnace ® FAU seams ® FAU door ® Coil box is air tight including seams, condensate line, knockouts, and lineset. ® Supply and return plenums ' Reg: 213-N0021824B-E2000003A-0000 Registration Date/Time: 2013/04/13 18:38:45 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF -6R -ENV -20 -HERS Building Envelope Sealing (Page 2 of 3) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 1 (SHP Enforcement Agency: Permit Number: 2)) City of La Quinta 12-1004 lb. Final Inspection Checklist All gaps and penetrations in the drywall must be caulked or gasketed. All gaps and penetrations in the exterior sheathing must be caulked or gasketed. Some examples are: Ceiling Penetrations ® All HVAC register boots are sealed to the drywall with caulking or tape ® All returns are sealed to the drywall ® All lighting fixtures are sealed to the drywall with a gasket, caulking or tape ® Any other penetrations to the drywall (for example fire sprinklers, whole house fans, surround sound speakers, ceiling outlet box etc.) are sealed with caulk or tape ® Attic access door is installed with weather stripping Wall Penetrations ® All electrical outlets and switches are installed and sealed ® Any other penetrations to the drywall or exterior walls are sealed General Inspections ® Flooring is installed ® Weather stripping is installed on doors and windows ® Exhaust fan dampers for kitchen and bath fans installed and working ' Reg: 213-N0021824B-E2000003A-0000 Registration Date/Time: 2013iO4/13 18:38:45 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF -6R -ENV -20 -HERS Building Envelope Sealing (Page 3 of 3) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 1 (SHP Enforcement Agency: Permit Number: 2�) City of La Quinta 12-1004 2. Building Envelope Leakage Test Diagnostic Testing Results CFM50H = the measured airflow in cubic feet per minute (cfm) at 50 pascals for the dwelling with air distribution registers unsealed. SLA = 3.819 x (CFM50 H / Conditioned Floor Area in ft2) per Residential ACM Manual Equation R3-16 Responsible Person's Signature: Building Envelope Leakage CFM50H as measured using a blower door diagnostic device Rod Pankratz 1. Enter the blower door leakage target CFM50H value for compliance from the CF -1R Position With Company (Title): 677877 (cfm). 2. Enter the blower door leakage minimum CFM50H value corresponding to 1.5 SLA Control Program (TPQCP)? ❑ Yes ❑ No from the CF -111 (cfm). 3. Enter the measured CFM50H value from the blower door test (cfm) 4. The leakage test passes if the measured envelope leakage CFM50H value from row is 3 p less than or equal to the value required for compliance from row 1, otherwise the test Pass ail fails. check/enter Pass or Fail 5. If measured CFM50H from row 3 is less than the minimum CFM50H value corresponding to 1.5 SLA from row 2: < .5 >_ .5 check/enter < 1.5 SLA, otherwise check/enter >_1.5 SLAI SLA* SLA *Advisory note to builder and enforcement agency: If row 5 indicates "< 1.5 SLA", it is critical to ensure that combustion avid solid -fuel burning appliances in the dwelling are provided with adequate combustion and ventilation air and vented in accordance with manufacturers' installation instructions and all applicable codes as specified by ASHRAE Standard 62.2 Section 6.4. Additional information about compliance with this requirement is given in Section 4.6.5 of the Residential Compliance Manual under the topic of Combustion and Solid -Fuel Burning Appliances. DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is tru 2 and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that identifies ti -e 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 beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: Responsible Person's Signature: Rod Pankratz Rod Pankratz CSLB License: Date Signed: Position With Company (Title): 677877 12/8/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No ' Reg: 213-N0021824B-E2000003A-0000 Registration Date/Time: 2013/04/13 18:38:45 HERS P=vider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 J, ' INSTALLATION CERTIFICATE CF -6R -ENV -20 -HERS Building Envelope - Sealing (Page i of 3) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 2 (SHP Enforcement Agency: Permit Number: ' 1)) City of La Quinta 12-1004 BUILDING ENVELOPE SEALING ' Two methods are available to the installer for demonstrating compliance with the building envelope sealing requirement: 1) Rough Frame Inspection Checklist and Final Inspection Checklist, or 2) Building Envelope Leakage Diagnostic Test utilizing a blower door diagnostic test instrument. Note: HERS verification of the actual envelope leakage is required to be performed using the Building Envelope Leakage Test. In order to receive credit for the Building Envelope Sealing measure, the dwelling must comply with the HERS verification requirements. Completion of ' the Rough Frame Inspection Checklist and Final Inspection Checklist does not insure that the envelope will meet the requirements of the HERS verification procedure. la. Rough Frame Inspection Checklist Sole Plate ® Entire sole plate of the home is either Rope caulk, foam gasket, or with caulking bead sealed. Too Plate ® All electrical penetrations between conditioned and unconditioned spaces sealed with foam ® All piping penetrations between conditioned and unconditioned spaces sealed with foam 4 Ceiling ® Ceiling forms a continues air barrier and any gaps or openings are filled with foam ® All recessed light fixtures in unconditioned space are IC (Insulation Contact) and AT (Air tight) rated and a gasket or sealing material is installed. ® All duct chases, fireplace chases, and double walls sealed air tight at the ceiling level. All gaps into shafts must be filled with foam or caulk. ® Openings around flue shafts fully sealed with solid ing or flashing and any remaining gaps sealed with fire -rated caulk or sealant. ® Penetrations from wiring sealed with caulk or sealant - - Floor Air Barrier N/A All gaps in the raised floor between conditioned and unconditioned space (or to outside) filled with foam or caulk ® All openings under a tub where the drain penetrates the floor sealed ® Garage band joist must be air tight at bays adjoining conditioned space Walls J ® All gaps around the windows caulked ® All gaps in exterior wall sheathing between conditioned and unconditioned space (or to outside) filled with foam or caulk ® All gaps in sheathing between conditioned space and the garage, attic, or covered patio filled with foam or caulk ® All other penetrations or cracks between conditioned and unconditioned space (the exterior of the home) sealed with foam or caulk HVAC Ensure that the following are sealed with an approved UL 181 mastic or tape: Dud Work ' ® All register boot seams ® Return seams ® Return and supply collars ' ® Duct collars ® Duct board, T and Y seams Furnace ® FAU seams ® FAU door ® Coil box is air tight including seams, condensate line, knockouts, and lineset. ® Supply and return plenums Reg: 213-N0021824B-E2000004A-0000 Registration Date/Time: 2013/04/13 18:40:04 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF -6R -ENV -20 -HERS Building Envelope Sealing (Page 2 of 3) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 2 (SHP Enforcement Agency: Permit Number: 1�) City of La Quinta 12-1004 1b. Final Inspection Checklist All gaps and penetrations in the drywall must be caulked or gasketed. All gaps and penetrations in the exterior sheathing must be caulked or gasketed. Some examples are: Ceiling Penetrations ® All HVAC register boots are sealed to the drywall with caulking or tape ® All returns are sealed to the drywall ® All lighting fixtures are sealed to the drywall with a gasket, caulking or tape ® Any other penetrations to the drywall (for example fire sprinklers, whole house fans, surround sound speakers, ceiling outlet box etc.) are sealed with caulk or tape ® Attic access door is installed with weather stripping Wall Penetrations ® All electrical outlets and switches are installed and sealed ® Any other penetrations to the drywall or exterior walls are sealed General Inspections ® Flooring is installed ® Weather stripping is installed on doors and windows ® Exhaust fan dampers for kitchen and bath fans installed and working i Reg: 213-N0021824B-E2000004A-0000 Registration Date/Time: 2013/04/13 18:40:04 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF -6R -ENV -20 -HERS Building Envelope Sealing (Page 3 of 3) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 2 (SHP Enforcement Agency: Permit Number: 1)) City of La Quinta 12-1004 2. Building Envelope Leakage Test Diagnostic Testing Results CFM50H = the measured airflow in cubic feet per minute (cfm) at 50 pascals for the dwelling with air distribution registers unsealed. SLA = 3.819 x (CFM50 H/ Conditioned Floor Area in ft2) per Residential ACM Manual Equation R3-16 Responsible Person's Signature: Building Envelope Leakage CFM50H as measured using a blower door diagnostic device Rod Ponkrotz 1. Enter the blower door leakage target CFM50H value for compliance from the CF -111 Position With Company (Title): Is this installation monitored by a Third Party Quality (cfm). Control Program (TPQCP)? ❑ Yes ❑ No 2. Enter the blower door leakage minimum CFM50H value corresponding to 1.5 SLA from the CF -1R (cfm). 3. Enter the measured CFM50H value from the blower door test (cfm) 4. The leakage test passes if the measured envelope leakage CFM50H value from row is 3 p Fail less than or equal to the value required for compliance from row 1, otherwise the test Pass fails. check/enter Pass or Fail 5. If measured CFM50H from row 3 is less than the minimum CFM50H value corresponding to ❑ 1,5 SLA from row 2: <Y.5 >_3 .5 check/enter < 1.5 SLA, otherwise check/enter >_1.5 SLAI SLA* I SLA *Advisory note to builder and enforcement agency: If row 5 indicates "< 1.5 SLA", it is critical to ensure that combustion and solid -fuel burning appliances in the dwelling are provided with adequate combustion and ventilation air and vented in accordance with manufacturers' installation instructions and all applicable codes as specified by ASHRAE Standard 62.2 Section 6.4. Additional information about compliance with this requirement is given in Section 4.6.5 of the Residential Compliance Manual under the topic of Combustion and Solid -Fuel Burning Appliances. IF T - J DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • 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 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 beoinnina October 1. 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: Responsible Person's Signature: Rod Pankratz Rod Ponkrotz CSLB License: 677877 Date Signed: 12/8/2012 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No ' Reg: 213-N0021824B-E2000004A-0000 Registration Date/Time: 2013/04/13 18:40:04 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 ' INSTALLATION CERTIFICATE CF -6R -ENV -20 -HERS Building Envelope - Sealing (Page 1 of 3) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 3 (SHP Enforcement Agency: Permit Number: ' 3)) City of La Quinta 12-1004 BUILDING ENVELOPE SEALING ' Two methods are available to the installer for demonstrating compliance with the building envelope sealing requirement: 1) Rough Frame Inspection Checklist and Final Inspection Checklist, or 2) Building Envelope Leakage Diagnostic Test utilizing a blower door diagnostic test instrument. Note: HERS verification of the actual envelope leakage is required to be performed using the Building Envelope Leakage Test. In order to receive credit for the Building Envelope Sealing measure, the dwelling must comply with the HERS verification requirements. Completion of ' the Rough Frame Inspection Checklist and Final Inspection Checklist does not insure that the envelope will meet the requirements of the HERS verification procedure. la. Rough Frame Inspection Checklist Sole Plate ® Entire sole plate of the home is either Rope caulk, foam gasket, or with caulking bead sealed. Too Plate ' ® All electrical penetrations between conditioned and unconditioned spaces sealed with foam ® All piping penetrations between conditioned and unconditioned spaces sealed with foam Ceiling ® Ceiling forms a continues air barrier and any gaps or openings are filled with foam ' ® All recessed light fixtures in unconditioned space are IC (Insulation Contact) and AT (Air tight) rated and a gasket or sealing material is installed. ® All duct chases, fireplace chases, and double walls sealed air tight at the ceiling level. All gaps into shafts must be filled with foam or caulk. ' ® Openings around flue shafts fully sealed with solid ing or flashing and any remaining gaps sealed with fire -rated caulk or sealant. ® Penetrations from wiring sealed with caulk or sealant Floor Air Barrier ' N/A All gaps in the raised floor between conditioned and unconditioned space (or to outside) filled with foam or caulk ® All openings under a tub where the drain penetrates the floor sealed 10 Garage band joist must be air tight at bays adjoining conditioned space Walls ® All gaps around the windows caulked ® All gaps in exterior wall sheathing between conditioned and unconditioned space (or to outside) filled with foam or caulk ® All gaps in sheathing between conditioned space and the garage, attic, or covered patio filled with foam or caulk ' ® All other penetrations or cracks between conditioned and unconditioned space (the exterior of the home) sealed with foam or caulk HVAC Ensure that the following are sealed with an approved UL 181 mastic or tape: ' Duct Work ® All register boot seams ® Return seams ® Return and supply collars ' ® Duct collars ® Duct board, T and Y seams Furnace ® FAU seams ® FAU door ® Coil box is air tight including seams, condensate line, knockouts, and lineset. ® Supply and return plenums Reg: 213-N0021824B-E2000005A-0000 Registration Date/Time: 2013/04/13 18:41:13 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF -6R -ENV -20 -HERS Building Envelope Sealing (Page 2 of 3) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 3 (SHP Enforcement Agency: Permit Number: 3)) City of La Quinta 12-1004 lb. Final Inspection Checklist All gaps and penetrations in the drywall must be caulked or gasketed. All gaps and penetrations in the exterior sheathing must be caulked or gasketed. Some examples are: Ceiling Penetrations ® All HVAC register boots are sealed to the drywall with caulking or tape ® All returns are sealed to the drywall ® All lighting fixtures are sealed to the drywall with a gasket, caulking or tape ® Any other penetrations to the drywall (for example fire sprinklers, whole house fans, surround sound speakers, ceiling outlet box etc.) are sealed with caulk or tape ® Attic access door is installed with weather stripping Wall Penetrations ® All electrical outlets and switches are installed and sealed ® Any other penetrations to the drywall or exterior walls are sealed General Inspections ® Flooring is installed ® Weather stripping is installed on doors and windows ® Exhaust fan dampers for kitchen and bath fans installed and working '�' ' Reg: 213-N0021824B-E2000005A-0000 Registration Date/Time: 2013/04/13 18:41:13 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF -6R -ENV -20 -HERS Building Envelope Sealing (Page 3 of 3) Site Address: 80092 Via Tesoro, La Quinta CA 92253 (System 3 (SHP Enforcement Agency: Permit Number: 3)) City of La Quinta 12-1004 2. Building Envelope Leakage Test Diagnostic Testing Results CFM50H = the measured airflow in cubic feet per minute (cfm) at 50 pascals for the dwelling with air distribution registers unsealed. SLA = 3.819 x (CFM50 H / Conditioned Floor Area in ft2) per Residential ACM Manual Equation R3-16 Responsible Person's Signature: Building Envelope Leakage CFM50H as measured using a blower door diagnostic device Rod Pankratz 1. Enter the blower door leakage target CFM50H value for compliance from the CF -1R Position With Company (Title): Is this installation monitored by a Third Party Quality (cfm). Control Program (TPQCP)? ❑ Yes ❑ No 2. Enter the blower door leakage minimum CFM50H value corresponding to 1.5 SLA from the CF -1R (cfm). 3. Enter the measured CFM50H value from the blower door test (cfm) 4. The leakage test passes if the measured envelope leakage CFM50H value from row is 3 p Pass Fail less than or equal to the value required for compliance from row 1, otherwise the test fails. check/enter Pass or Fail 5. If measured CFM50H from row 3 is less than the minimum CFM50H value corresponding to Y.5 1.5 SLA from row 2: r >R.5 check/enter < 1.5 SLA, otherwise check/enter >_1.5 SLA SLA* SLA *Advisory note to builder and enforcement agency: If row 5 indicates "< 1.5 SLA", it is critical to ensure that combustion and solid -fuel burning appliances in the dwelling are provided with adequate combustion and ventilation air and vented in accordance with manufacturers' installation instructions and all applicable codes as specified by ASHRAE Standard 62.2 Section 6.4. Additional information about compliance with this requirement is given in Section 4.6.5 of the Residential Compliance Manual under the topic of Combustion and Solid -Fuel Burning Appliances. DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • 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 -SR 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 beainnina October 1. 2010. for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: Responsible Person's Signature: Rod Pankratz Rod Pankratz CSLB License: 677877 Date Signed: 12/8/2012 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 213-N0021824B-E2000005A-0000 Registration Date/Time: 2013/04/13 18:41:13 2008 Residential Compliance Forms HERS Provider: CalCERTS, Inc. August 2009 INSTALLATION CERTIFICATE CF -6R -ENV -2I -HERS Quality Insulation Installatior (QII) - Framing Stage Checklist (Page i of 2) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 1 City of La Quinta 12-1004 Quality Insulation Installation (QII) Framing Stage Checklist Air barrier installation and preparation for insulation must be done at framing stage before insulation is installed. If there are any "No" answers, rows not filled out, or a signature missing then this is not a valid form and cannot be accepted by the building department or HERS rater. SPF insulation can be considered an .air barrier when the bottom and top plates of vertical framing and both ends of horizontal framing, including band ar.d rim joists, are sprayed to completely fill the cavity adjacent to and in contact with the framing to a distance of 5.5 inch Rs away from the framing for open cell SPF (ocSPF) or 2.0 inches away from the framing for closed cell SPF (ccSPF). SPF can be considered as an air barrier with less than the above thickness when a product data or specification sheet is provided that shows the product meets an air permeance no greater than 0.02 L/s-m2 at 75 Pa pressure differentia when tested in accordance to ASTM E2178 or ASTM E283 All structural framing areas shall be insulated in a manner that resists thermal bridging of the assembly separating conditioned from unconditioned space. Structural bracing, tie -downs, and framing of steel, or specific framing used to meet structural requirements of the CBC are allowed and must be insulated. These areas shall be called out on the building plans with diagrams and/or specific design drawings indicating the R -value of insulation and fastening method to be used. FLOOR AIR BARRIER ❑ e ® NA All gaps in the rased floor to unconditioned space or to outside larger than 1/8" filled with foam or caulk. (NA if SPF meets conditions above) es R 119 All openings in tf-e raised floor including second floors, such as under a tub where the drain penetrates the floor are sea ed. (NA if slab on grade) WALLS AIR BARRIER All gaps to outside larger than 1/8" filled with foam or caulk. (NA if SPF meets conditions above) IresNO ❑ All openings in top and bottom plate to the outside in interior and exterior walls, including holes drilled for electrical-ana plumbing larger than 1/8" filled with foam or caulk. (NA if SPF meets conditions above)' ®❑ Y ISO Rope caulk, foam gasket, or caulking bead under exterior sole plate of the home. �"'� P All gaps around windows and doors caulked or foamed. Low expanding foam recommended if allowed by window manufacturer. (Stuffing with fiberglass not acceptable) ATTIC INSPECTION ❑ e P ® NA Attic rulers appropriate to the material installed are evenly distributed throughout attic to verify depth. (NA if SPF or batt) es Number of rules installed Attic area (sgfti _ 250 = minimum number of rulers installed. Must round up. (NA if SPF or batt) es o R Ventilation baffles installed at all eave vents to prevent air movement under or into insulation. (NA if SPF meets conlitions above)(NA if unvented attic) es I o I R Net free -ventilation area of the eave vent maintained from eave vent, past insulation, to attic space. (NA if no eave vents or SPF) CEILING AIR BARRIER es o All draft stops in place to form a continuous ceiling air barrier no gaps larger than 1/8". (NA if SPF meets conditions above) es o R All dropped ceilings/soffits covered with hard covers. Gaps around or in the hard cover larger than 1/8" filled with foam or caulk. (NA if no drops) PP I? Openings aro -nd flue shafts fully sealed with flashing and caulked. (NA if no flue shafts) Piping shaft openings fully sealed and caulked. (NA if no pipe shafts) Reg: 213-N0021824B-E210000=B-0000 Registration Date/Time: 2013/04/13 18:31:28 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms May 2012 INSTALLATION CERTIFICATE CF -6R -ENV -2I -HERS Quality Insulation Installation (QII) - Framing Stage Checklist (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 1 City of La Quinta 12-1004 ® `res ❑ Imo j''� Ind Penetrations through the ceiling air barrier from electrical boxes in the ceiling, fire alarm boxes, etc. sealed with caulk or foam. (NA if no penetrations) ® P ❑ NA All duct chases, fireplace chases, and double walls sealed air tight at the ceiling level. All gaps into shafts larger than 1/8" filled with foam or caulk (NA if none of the above or SPF meets conditions e If insulation is to be installed at subfloor then subfloor has no gaps over 1/8". Air barrier installed at joists in garage to house transition (between floors). Use of SPF meeting conditions above as the air barrier satisfies the requirement to seal the gaps. Pn above) GARAGE ROOF/CEILING AIR BARRIER FOR TWO STORIES (no conditioned space over garage) ❑ e �''� Ido ®Air NA barrier installed at joists in garage to house transition (between floors). No gaps larger than 1/8" Jallowed. (NA if SPF meets conditions above) GARAGE ROOF/CEILING AIR BARRIER FOR TWO STORIES (conditioned space over garage) PP Date Signed: ® IN If insulation is to be installed at subfloor then subfloor has no gaps over 1/8". Air barrier installed at joists in garage to house transition (between floors). Use of SPF meeting conditions above as the air barrier satisfies the requirement to seal the gaps. Pn �''� Po ® NA If insulation is to be installed at ceiling of garage then ceiling and joists to the outside have no gaps over 1/8". (NA if SPF meets conditions above or no conditioned space over garage.) --,. %- --- - , - 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. • All rows in this document have been checked and all answers are yes or NA • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • 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 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 beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: Responsible Person's Signature: Rod Pankratz Rod Pankrotz CSLB License: Date Signed: Position With Company (Title): 677877 12/8/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No ' Reg: 213-N0021824B-E2100001B-0000 Registration Date/Time: 2013/04/13 18:31:28 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms May 2012 INSTALLATION CERTIFICATE CF -6R -ENV -22 -HERS duality Insulation Installation (QII) - Insulation Stage Checklist (Page i of 3] Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 1 City of La Quinta 12-1004 All structural framing areas shall be insulated in a manner that resists thermal bridging of the assembly separating conditioned from unconditioned space. Structural bracing, tie -downs, and framing of steel, or specialized framing used to meet structural requirements of the CBC are allowed and must be insulated. These areas shall be called out on the building plans with diagrams and/or specific design drawings indicating the R -value of insulation and fastening method to be used. SPF insulation can be considered an air barrier when the bottom and top plates of vertical framing and both ends of horizontal framing, including band and rim joists, are sprayed to completely fill the cavity adjacent to and in contact with the framing to a distance of 5.5 inches away from the framing for open cell SPF (ocSPF) or 2.0 inches away from the framing for closed cell SPF (ccSPF). SPF can be considered as an air barrier with less than the above thickness when a product data or specification sheet is provided that snows the product meets an air permeance no greater than 0.02 Us -m2 at 75 Fa pressure differential when tested in accordance to ASTM E2178 or ASTM E283. Closed cell and open cell manufacturers daim various R -values per inch. In California the maximum R -value that can be claimed for ccSPF is an R -value of 5.8 per inch and for ocSFF is an R -value of 3.6 per inch. Higher R -values per inch cannot be claimed even with manufacturer data. Insulation Stage Checklist FLOOR INSULATION es o IN All floor joist cavity insulation installed to uniformly fill the cavity side-to-side and end-to-end, NO gaps. (NA if slab on grade) es o Insulation in full contact with the subfloor, NO gaps. (NA if slab on grade) Pes Po ® NA Batts: cut to fit around wiring and plumbing, or split (delaminated). (NA if loose fill, SPF, or slab on grade) P P ® NA Batts: shall be properly supported to avoid gaps, voids, and compression. (NA for other forms of insulation) es Po IN Insulation R -value same or greater than listed on CF -1R. (NA for slab on grade) Pn I o 0 Gaps between studs larger than 1/8" the cavity must be filled with insulation or foam. (NA for slab on grade) ❑ e P ®/ NA' SPF: list the required floor cavity R -value from CF -1R, R- Determine required thickness for ccSPF (required R -value / 5.8R) = inches), or required thickness for ocSPF (required R -value / 3.6 = inches). (NA for other forms of insulation) es o IN SPF insulation properly adhered to avoid gaps and provide an air seal (NA for other forms of insulation) V'WALL INSULATION IRS o Batts, loose fill mineral fiber, mineral wool, and cellulose: fills cavity and is in contact with air barrier. ocSPF: shall completely fill cavities of 2x4 inch framing or less. Cavities greater than 2x4 inch framing dimensions must be filled to the thickness calculated above. ccSPF: insulation is not required to fill the cavities of framed assemblies provided the installed thickness of insulation conforms to the thickness calculated above. ® e ❑ NA Double walls and bump -outs - insulation fills the cavity or additional air barrier installed in the cavity so that the insulation fills the cavity and in contact with the air barrier. (NA if SPF meets conditions above and meets the required R -value) es o R Insulation installed in exterior walls adjacent to tub/shower, walls under stairs, and fireplace. Insulation required to fill wall cavity. Cavity required to be air tight. (NA if none of the above) e NO I All gaps around windows and doors filled with insulation, or filled with low expanding foam. PBATTS no voids/depressions greater than 3/4" in ANY stud bay. (NA for other forms of insulation) es 0 ❑ NA Batts: voids/depressions less than 3/4" allowed as long as the area is not greater than 10% of the surface area for each stud bay. (NA for other forms of insulation) P Imo ® IF Loose Fill: no gaps or voids. Insulation completely fills the cavity. (NA for other forms of insulation) Gaps between studs larger than 1/8" the cavity must be filled with insulation or foam. Reg: 213-N0021824B-E2200002A-0000 Registration_ Date/Time: 2013/04/13 18:34:35 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms May 2012 INSTALLATION CERTIFICATE CF -6R -ENV -22 -HERS Quality Insulation Installation (QII) - Insulation Stage Checklist (Page 2 of 3) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 1 City of La Quint a 12-1004 Pes o All Rim -joists to the outside insulated. (NA if no Rim -joists) P Insulation installed at corner channels, wall intersections, and adjacent to tub/shower enclosures insulated to proper R -Value. P P R All skylight shafts and attic kneewalls insulated with minimum R-19. (NA if no skylights, kneewalls, or in conditioned attic) ® e P ❑ NA Insulation in full contact with air barrier or wall finish for skylight shafts and attic kneewalls. (NA if no skylight or kneewalls) es o Installed wall insulation R -value equal to or greater than what is listed on the CF -111. P❑ Imo ® NA SPF: insulation installed without gaps and to provide an air seal when specified as an air barrier. (NA for other forms of insulation) ❑ e ® IN SPF: list the required wall cavity R -value from CF -1R, R-�0 . Determine required thickness for ccSPF (required R -value 19.0 / 5.8R) = 3,3 inches), or required thickness for ocSPF (required R -value 19.0 / 3.6 = 5.3 inches). (NA for other forms of insulation) ❑ e P ® NA SPF: measure thickness of wall insulation in 6 random areas. Minimum thickness for ccSPF shall be no more than 1/2 inch less than the required thickness listed above. Minimum thickness for ocSPF shall be Po more than 1 inch less than the required thickness listed above. (NA for other forms of insulation) V CEILING INSULATION Gaps between studs larger than 1/8" the cavity must be filled with insulation or foam. es o Batts: no gaps/voids/depressions greater than 3/4". (NA for other forms of insulation) Yes o . Batts: voids/depressions less than 3/4".allowed as long,as the area isnot greater,than.10% of the surface area for each stud bay. (NA for other forms of insulation) - ❑ Yes !t,-�7 iso 1K4�1 R Loose Fill:'NO gaps or voids allowed. (NA for other forms of insulation) es o i All ceiling insulation installed to,uniformly fit the cavity side-to-side'and end-to-end. ® e Po � 5 � Insulation in full contact with the ceiling, NO gaps. ® e I -o Ido Insulation in contact with air barrier. es o Batts: cut to fit around wiring and plumbing, or split (delaminated). (NA for other forms of insulation) 10 es P P Batts taller than bottom chord must expand over the bottom chord or additional insulation installed so bottom chord not visible. (NA for other forms of insulation) Yes No ❑ NA Batts cut to fit around ALL webbing. No gaps allowed between webbing and batts. (NA for other forms of insulation) ❑ e P ® NA SPF: list the required ceiling cavity R -value from CF -1R, R- 19.0. 30.0 . Determine required thickness for ccSPF (required R -value 19.0. 30.0 / 5.8R) = inches), or required thickness for ocSPF (required R -value / 3.6 = inches). (NA for other forms of insulation) PP ® NA SPF: measure thickness of ceiling insulation in 6 random areas. Minimum thickness for ccSPF shall be no more than 1/2 inch less than the required thickness listed above. Minimum thickness for ocSPF shall be no more than 1 inch less than the required thickness listed above. (NA for other forms of insulation) RX ItTes' P R HVAC Platform and Catwalks - insulated to R -value equal to ceiling R -value listed on CF -1R. If less insulation installed then called out on CF -111. (NA if no platform or catwalks) e P NA Attic access Basketed. (NA of no attic access) P P ❑ NA Attic access - insulated with rigid foam or batt insulation using adhesive or mechanical fastener. Attic access door R -value equal to ceiling R -value listed on CF -111. If less insulation installed then called out on CF -111. (NA if no attic access) es o R Recessed light fixtures covered full depth with insulation. If SPF used then other forms of insulation used to cover or enclose fixture in a box fabricated from 1/2 -inch plywood, 18 ga. sheet metal, 1/4 -inch hard board or drywall. SPF or other insulation then covers light fixture to full depth. (NA is no recessed light fixtures) es o ❑ NA All recessed light fixtures in non conditioned space are IC rated and air tight (AT). (NA if no recessed light fixtures) t Reg: 213-N0021824B-E2200002A-0000 Registratior_ Date/Time: 2013/04/13 18:34:35 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms May 2012 INSTALLATION CERTIFICATE CF -6R -ENV -22 -HERS Quality Insulation Installation (QII) - Insulation Stage Checklist (Page 3 of 3) Site Address: Enforcement Agency: Permit Number: 80092 Via Tesoro, La Quinta CA 92253 1 City of La Quinta 12-1004 P Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: All recessed light fixtures are sealed with a gasket or caulk between the housing and the ceiling. (NA if no recessed light fixtures) N0 Rod Pankratz CSLB License: Ceiling insulation equal to or greater than what is listed on the CF -1R. e Imo ® 0 Loose Fill: Minimum thickness required to meet the stated R -value listed on CF -1R. Insulation rulers visible for verifying the installed R -value for blown in insulation. (NA for other forms of insulation) ❑ e P ® NA Loose Fill: insulation uniformly covers the entire ceiling (or roof) area from outside of all exterior walls. (NA for other forms of insulation) es o IN Loose Fill: meets or exceeds manufacturer's minimum weight and thickness requirements for the target R -value. List target R -value . List minimum required weight for target R -value (Ibs/ft2). List minimum required thickness at time of installation . List minimum required settled thickness . (NA for other forms of insulation) GARAGE ROOF/CEILING INSULATION FOR TWO STORIES (no conditioned space over garage) ® e ("� Insulation installed at rim joists against the air barrier in the garage to house transition (between floors). (NA if conditioned space over garage or single story). ✓ GARAGE ROOF/CEILING INSULATION FOR TWO STORIES(conditioned space over garage) ❑ Fes P 9 If insulation is installed at subfloor above garage - then insulation must also be installed at joists against the air barrier in the garage to house transition (between floors) and to R -value as specified on CF -1R. (NA if no conditioned space over garage or single story) ❑ e P ® NA If insulation is installed on ceiling of garage - then the joists to the outside (front, and both sides) must be insulated to the R -value specified on CF -1R. (NA if no conditioned space over garage or single story) Y 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. • All rows in this document have been checked and all answers are yes or NA • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. • 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 applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Paul Davis Restoration & Remodeling of Greater Palm Springs Responsible Person's Name: Responsible Person's Signature: Rod Pankratz Rod Pankratz CSLB License: Date Signed: Position With Company (Title): 677877 12/18/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No ' Reg: 213-N0021824B-E2200002A-0000 Registration Date/Time: 2013/04/13 18:34:35 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms May 2012