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12-0718 (MECH)P,? O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number.2 OQ~ 78 'i— Property Address: r'5'6: 8S�II-L-LADE DR APN: 764-060-004- - - Application description: MECHANICAL Property Zoning: LOWDENSITY RESIDENTIAL Application valuation: 26260 Applicant: 4 x� .Architect or Engineer:- , k#�_ 4 BUILDING &- SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION - I hereby affirm under penalty of perjury thatqll',Lcense�"dl.u.nder provisions of Chapter 9 (commencing withSection 7000) of Division 3 of the Businessrofes ls Code, and my License is in full force and effect. License Class: B C10 C20 cense No.: 888104 `Date Z. '2 Contractor:, 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 one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). - (_ 1 I, as owner of 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.). - (_ 1 I am exempt under Sec. , BAP.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 VOICE (760) 777-7012 { FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/12/12 Owner: ", ' CAROL KRISHNAN . 56985 VILLAGE DRIVE LA QUINTA, CA 92253 Contractor: D SOLARCITY.CORPORATION inn] 2896 METROPOLITAN PLAC POMONA, CA 91767 ,«L 12 (650)638-1028 LiC. No.: 888104 -------------------------------------------------- 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. - I .have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation - insurance carrier and policy number are: _ Carrier ZURICH AMERICAN Policy Number WC967346703 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 ome subject to the workers' compensation provisions of Section _ 3700 of the Labor Cod all fort) ith comply with those provisions. Applicant: WARNING: FAILURE-T.OiSECURE.WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL - SUBJECT AN EMPLOYER TO CFIIMINAL-PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. - - certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to but construction, and hereby authorize representatives �of.thia count -to enter upon the above mentioned pro for in ection purposes. - ( I L Date: c Signature-IApplicant.'6 Agent) Application Number 12-0.0000718 Permit MECHANICAL Additional desc . Permit Fee 66.00 Plan Check Fee 16.50 Issue Date Valuation 0 Expiration Date 1/08/13" Qty Unit Charqe Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 16'5000 EA 'MECH-B/C >3-15HP/>100K-500KBTU: 33.00 Special -Notes and Comments REPLACEMENT OF (2) GAS -FURNACES & - CONDENSER WITH (2)AIR SOURCE HEAT. PUMPS:DUCT SEALING / ATTIC -INSULATION TO','' .. R-38 PER 2010 CODES. --- -- - - - - - - - - - - - - -- --_----------------------------------------- Other- Fees-. ";. BLDGSTDS ADMIN, (SB1473 ):' ------------ 2.00 Fee summary `Charged -Paid Credited— Due Permit Fee Total 66.00•- .00 .00 66.00." Plan Check Total' 16:50, , .-00' .00 16:.50 Other Fee Total „ 2.00 .00..... .00 '2.00 Grand Total- ' ° - 84.50 .`60 00 84.50 LQPERMIT .. _ - .. ... - .. ... Bin # City of La Quinta Building 8i Safety Division Permit # ` P.O. Box 1504, 78-495 Calle Tampico la Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet >C Project Address: i j Vj (�/}A %vner's Name: a C� L- A. P. Number: �� '1 Address: t , rTe V a Legal Description: V r'✓ lu �- City, ST, Zip: �(�Vl 11V T -,k C -A- 6) Z25 # Submittal Plan Sets Structural Calcs. Truss Calcs. JTitle 24 Calcs. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees Plan Check submitted Reviewed, ready for correctioi ------------ Called Contact Person Plans picked up Plans resubmitted 2nd Review, ready for correctio Called Contact Person Plans picked up Plans resubmitted '`d Review, ready for correction Called Contact Person Date of permit issue lephone: eject Description: '�rUnr i^ e 2 FU 1N4 -L ;��0enas - �1T1� Com) 4(n- YViVV\P 5 y Dor-r 9eAu,4&- c istruction Type: Occupancy: ject type (circle one): New Add'n 4It Repair Demo Ft.: 5t o 0 G 1 # Stories: I # Units: mated Value of Project:Z�ji t 2-60 BELOW THIS LINE iG PERMIT FEES Item Amount is Plan Check Deposit Plan Check Balance Construction Mechanical ns/issue Electrical Plumbing S. M.I. Grading s/issue Developer Impact Fee A. L P. P. Total Permit Fees t Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 56985 VILLAGE DRIVE #2 La Quinta, CA 92253 City of La Quinta Jun 27, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat - ❑ Package Unit * Furnace * Indoor Coil ❑ AFUE @ SEER 16.0 ❑ COP ' p HSPF 7.7 ❑ R 6 (CZ 10-13) Served by system 9 Setback- If not alreadyresent must be p * Condensing Unit [I EER ❑ Resistance [1 R 8 (CZ 14-15) 750 sf installed) ❑ Other r 1: Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. - « 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer -decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -1R and CF -611 shall also be on site for final inspection. D 1.. HVAC Changeout Required Forms: . All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF -411 forms: MECH-21 and (for split systems) MECH-25 Condenser Coil and /or Indoor oil and /or CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS Furnacf, C -4R forms: MECH-21 and (for split systems) MECH-25 . For Split Systems: Duct leakage�<15 percent; RC, CCA :5.300CFM/ton (Minimum Air Flow Requirement), TMAH For- PaekayedQ4446 15 peFeeRk Exempted from duct leakage'testing'if 3❑ 17Duct-system was documented to have been previously sealed and confirmed through HERS verification, or " ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑3..Existing duct systems are constructed, insulated or sealed with asbestos 0'4. -The systemwill not be Ducted'(ie:•DuctlesswMirn S lit 5 stem Also.Exem t from Refri Brant Char e ❑ 2. New HVAC System Required Forms: ` I r 'r•.• r � �, '>7 s ' aw . Cut in{or Chan eout with " g r.•f-e� xr r� a-►. ._ CF 6R forms MECH-04 MECH 20 HERS df(for split systems) MECH-'22 HERS, and new ducts (all new ducting all news" duct N1ECfik25"HERS`'" . �• - �' .' 16ri NE `. e ui rnent )',I`.i!£T,.}tr CF 4R forms )MECH 2O,�and,(for split systems) MECH 22 q P �F� _ cP�a' For Split Systems:;Duct leaka9e< 6 -.percent; RC, CCA > 350 CFM/ton",FWD; TMAH;=STMS and either.HSPP'or'PSPP. For Packaged Umts$_Ducfleakage<'6 ❑ 3., New-buctiiwith/or. without '. Required Forms: _ Replacement' ' "" r _ _ . L . Includes replacing or installing all new ducting and/or outdoor condensing unit -, CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems).MECH-25-HERS and/or indoor coil and/or furnace:: No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 _ equipment'changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH •, For Packaged Units: Duct leakage .< 6 percent. 1. 114. New Ducting over 40 feet; Required Forms: . Includes adding or replacing more than 4.0 CF -6R forms: MECH-04, •MECH-21-HERS linear feet of duct in unconditioned spacer CF -411 forms: MECH-21 For split system orpackaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.' Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. ' • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Patrick Aranda Signature: Patrick Aranda Company: SOLARCITY CORPORATION Date: Jun 27, 2012 Address: 3055 CLEARVIEW WAY License: 888104 City/State/Zip: SAN MATEO / CA / 94402 Phone: (650) 638-1028 Reg: 212-A0034157A-00000000-0000, Registration Date/Time: 2012/06/27 23:12:53 `HERS Provider: CalCERTS'„ Inc., ' .2008 Residential Compliance Forms July 2010 - �. Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-1R-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 56985 VILLAGE DRIVE #2 La Quinta, CA 92253 City of La Quinta Jun 27, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace -134ndeer-Coil-- ❑ AFUE --0 SEER -16;0 — ❑ COP -®-HSPF 7- ❑ R 6 CZ 10-13 —� -- ) -" ❑ R 8 (CZ 14-15) Served b system y yKnot 750 sf- ®Setback already-present,—must-be--" ® Condensing Unit ❑ EER ❑ Resistance Installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVAC for each system. 2. Minimum Equipment EHiciencles: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-411 forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-111 and CF-611 shall also be on site for final inspection. m 1. HVAC Changeout Required Forms: . All HVAC Equipment CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF-4R forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or . Indoor Coil and /or CF-6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH-25-HERS . Furnace CF-411 forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. The ysterf will not be Ducted" (ie D.uetlessu tirl�i ;Split System)-(-AlsoxExempt f o ,k Tigerant e-h�rge) ❑ 2. Ne HVAC System Required F6r"ms:'` = �; l a* '*Cut injorChangeout wit new (all new ` r rte" CF 6 forms MECH-04, MECH-2 HERS and (for split systems) MECHI,22-HERS, and Ducts;: ducts k all new' MEIQ 2' HERS t .. - CF R for s:. MECH-�-O,n (for split s stemsJ=N�ECH-22 aid MECii-25 equipkim r 2t 1:- For SplitSysL ms: Duct leakage < 6 percent;: RC; CCA'2:.350 CFM/ton,. FWD,'TMAH,, STMS, and`eitlier HSPP or`PSPP'. For Packaged Units: Duct leakage .< 6 percent ❑ 3.. New without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit CF-611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF-411 forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA z 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF-6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF-4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent _ ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Patrick Aranda Signature: Patrick Aranda Company: SOLARCITY CORPORATION Date: Jun 27, 2012 Address: 3055 CLEARVIEW WAY License: 888104 City:$tate/Zip: SAN MATEO / CA / 94402 Phone: (650) 638-1028 a Reg: 212-A0034157A-00000000-0000 Registration Date/Time: 2012/06/27 23:12:53 HERS Provider: Ca10ERTS, Inc. .2008 Residential Compliance Forms July 2010 .,.,.sem-•r-,-� ' r - ♦ ilii..// CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING• CF-4R-MECH-21 Duct Leakage Test — Existing Duct System ! (Page 1 of 2) Site Address:' 56985 VILLAGE DRIVE #1,, La Quinta CA 92253 (System Enforcement Agency: Permit Number: r City of La Quinta 12-00000718' ,system method: ut Capacity T�hpousand '° �• ,.mew 1�4 AI ;. P p Y«e , tRtrsofetu/hr _CFM r ✓ O Measured,systemairflow;usmg�RA3�3lairflow,test procedures' • This installation certificate is required for compliance for alterations and additions in existing dwellings to •: space conditioning systems and .duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be "sealed. For a completely ne,w.or replacement duct system installed.in an existing dwelling; = use the Installation Certificate titled "Duct Leakage Test - Completely, New or Replacement Duct System." ` Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices.. ' 1: Measured leakage less than,15%-of fan flow . l7 2. Measured leakage to outside•'less than 10% of Fan Flow ❑ 3 Reduce leakage by.60% and conduct smoke and fix all leaks _ a acc 0 4. Fix I ssible leaks using sm=oke and HERS rater verify Note:(One of Options, l; 2, or 3 must be attempted„_before Determine nominal F56I.Flow using one of the.following three .calculation meth6ds:45~ rr.•.• ✓ 10 Cooling%ystem method: Size of.#ccondenser in Tons 5 � x 400 2000 CFM . i { ; r ❑ Heatm 21;3.k�0ut ,system method: ut Capacity T�hpousand '° �• ,.mew 1�4 AI ;. P p Y«e , tRtrsofetu/hr _CFM r ✓ O Measured,systemairflow;usmg�RA3�3lairflow,test procedures' • Option,l;used then r =�'�r,'Fr }''fir '�`•'3"'�,�> ,� _.,�” �. '":;` �"r, "'��`x� .�_ _`` �="' �� _ • 1 Allowed leakage =.Fan Flow 2000 ^x 0 15 300 `CFM i , Actual Leakagdl-'k 345 .' CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then.'- r , 2 Allowed leakage = Fan"Flow'2000 x 0.10 = 200• CFM Actual Leakage to outside, ►►—a CFM , i `• '' Pass if Leakage Actual is less than Allowed ' Pass Fail Option 3 used then: Initial leakage prior to start of work = f CFM Final leakage after sealing all accessible leaks using smoke test=' - ' CFM 3 Initial leakage_- Final leakage _ = Leakage reduction CFM ' r ((Leakage reduction_ / Initial leakage x 100%.= % Reduction r r Pass if % Reduction > 60% ❑ Pass p Fail Option 4 used then: 4 . All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No smoke allowed to leak from system. Including ducts, plenums, air handler and door panel. ` 'Pass if all accessible leaks.have been repaired using smoke Pass p Fail s 1 41 J Reg:•212-A0034155D-M2100003A-M21A Registration Date/Time: 2012/07/16 21:01:49 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms `. March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-21 Duct Leakage Test - Existing Duct System (Page 2.of 2) Site Address:,Enforcement 56985 VILLAGE DRIVE #1 La Quinta CA 92253 (System Agency:. Permit Number: , 1) City of La Quinta 12-00000718 , t - it • - • • ; • • �!. • 0 Outside air. (OA) ducts,for4Centrel Fan Integrated (CFI) ventilation systems, shall not.be sealed/taped off ,'•._, during'duct leakage;festing. CFT 0A'Aucts that utilize controlled motorized dampers, that open only when OA + vent latlon`is,.requir`,e. 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. �:• - { 0 All supply and ret�urn'register boots must be sea ped to'theidrywall-'ifrsmoke',testils`utillzed�for compliance' It - applie to duct leakage compliance option 3 (leakage reduction b`y 60%) and'�option 4�(fi:k all accessible leaks) described above2.046 r ,( i-` �L# 4Q0 New duct.iynstallat'� -ionsot utilize building cavities as plenums oryplatform returns In lieu of ducts r ,< - 0Mastic and;draw,.bands must be,used ln{combinatlon`with.doth,backed rubber:adheslve duct tape to seal l leaks`at all;;new;duct_connections`,►: w; ` 'sv + ` _ DEC'LARATION 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. • •v . . I am the certified HERS rater whorp6ftormed 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) SOLARCITY CORPORATION Responsible Person's Name: CSLB License: - ,! Patrick Aranda- 888104' HERS Provider Data Registry Information Sample Group # (if applicable): N/ATQ tested/verified dwelling ; la ❑ not-tested/verified dwelling in HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798668664 HERS Rater Company Name: Home Energy Rating Service ' Responsible Rater's Name: Responsible Rater's Signature`. Richard Lee Richard Lee • • • , , Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 5/31/2012 CC2005748 <` 'Reg: 212-A0034155D-M2100001A-M21A. Registration Date/Time: 2012/07/16 21:01:49 HERS Provider: CalCERTS,-Inc. ' 2006 Residential Compliance Forms. - March 20i0 r 'Reg: 212-A0034155D-M2100001A-M21A. Registration Date/Time: 2012/07/16 21:01:49 HERS Provider: CalCERTS,-Inc. ' 2006 Residential Compliance Forms. - March 20i0 r 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. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. r " TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 _ System Location or Area Served s Whole House -: „ - 1 p Yes❑ No-. 56 labeledc ccordi h (8 mmg to Figure oineSection RA3 Z upstream of evaporative 2 2ative coil in the return plenum and 2 ar. ❑ No -. • 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. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. r " TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 _ System Location or Area Served s Whole House -: „ - 1 p Yes❑ No-. 56 labeledc ccordi h (8 mmg to Figure oineSection RA3 Z upstream of evaporative 2 2ative coil in the return plenum and 2 p Yes ❑ No -. 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum . and labeled according to Figure in Section RA3.2.2.2.2. Yes to,l�and 2 is a. pass. :' • Enter Pass or Fail ✓ 13 Pass ✓ ❑ Fail t 'STMS,- Sensqr ont th9,Evaporator.Coil 4 w. . System Nam e�&Jden,tification/Tag's 3 The sensor is factory installied, orfieldiinstalled accordirig1b manufacturers , p=No >y specifications, or is installed by methods/`speufications approved by the Executive The sensor is factory installed, or field installed according to manufacturer's 44❑..ly,es _a.` _ �a�t Director. r€.s}'�h,;,,. ;iB��•r�r "�=,:_ �...»:5°'^i".'. 4 rp,Yes The sensor wire is terminatedwith a standard;mirn°plug suitable for congectaon to` at; ' ❑ No digital thermometer xThe'sensorymini plug is accessible to theiinstelUngttechnician - and the,HERS'ratermithout ch anging;the'airflow through the"c6 dense'r coil 5 O, -Yes ° No " When attached-to'a digital thermometer, the sensor provides an indication of the , ❑ The sensor wire is terminated with a standard mini plug suitable for connection to a 7 saturation temperature of the coil.- - Yes to 3, 4, and•5 is a'pass. Enter -N/A if STMS are not applicable.•Otherwise ent ' Pass or Fail ✓ p N/A ✓ El Pass . ✓ ❑Fail }' STMS - Sensor on the Condenser Coil" System Name or Identification/Tag 17 System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by.the Executive' - Director. A. s The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes ❑ No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. - • . 1. r Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not t/ p N/A, ✓ ❑ Pass ' ✓ ❑ Fail applicable. Otherwise enter Pass or Fail . IN Reg: 212-A0034155D-M2500001A-M25A Registration Date/Time: 2012/07/16 21:04:00 HERS Provider: CalCERTS, Inc. • '2008 Residential Compliance Forms . March 2010 r, Standard Charge Measurement Procedure (for use.if outdoor air dry-bulb is above 550F), T Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential'' Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using. this form. Attach an additional form(s) For , any additional systems in the dwelling as applicable. ,. , - • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. t • Space Conditioning Systems ` System Name or Identification/Tag • r • ' (must be re -calibrated monthly) Date of Thermr`mocouple C4bration• `' •+ i + Standard Charge Measurement Procedure (for use.if outdoor air dry-bulb is above 550F), T Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential'' Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using. this form. Attach an additional form(s) For , any additional systems in the dwelling as applicable. ,. , - • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. t • Space Conditioning Systems ` System Name or Identification/Tag • System 1 (must be re -calibrated monthly) Date of Thermr`mocouple C4bration• `' •+ - t 5/3 12 i ' System,Location or Area Served Whole House " ; Outdoor Unit Serial'# 1212EO8O9O 46 r �: ` - Outdoor Unit Make, !BRYANT ' •` } , : Outdoor Unit Model + _ 28OANV060OO • - Nominal Cooling Capacity Btu/hr='r 60000 Return r(evaporator entering) air wet=bulb �o Date of Verification 5/31/12 T7_ Evaporator saturation temperature= 44!`,. •` Calibration bf-Diagnostic Instruments t. Date of Refrigerant Gauge Calibration'•:.♦;. 5/3/12• (must be re -calibrated monthly) Date of Thermr`mocouple C4bration• `' •+ - t 5/3 12 i ' (must bel re .calibrated monthly) " Measuredjd6i eratur9jk% F,) � r :& � = � ...; . , r '%?' r r apo-. '�i "'�' • ^ : ' 4 + t .i$. Af-S' ..Barr.��is11EiF-z System Name or Identification a� /T 9 „"'S'd tem 1 �, Y. `� _- t Ys`^�rS ; Su p ply;eva orator,leavin) lair dr bulb I^' Measuredjd6i eratur9jk% F,) � r :& � = � ...; . , r '%?' r r apo-. '�i "'�' • ^ : ' 4 + t .i$. Af-S' ..Barr.��is11EiF-z System Name or Identification a� /T 9 „"'S'd tem 1 �, Y. `� _- ; Ys`^�rS ; Su p ply;eva orator,leavin) lair dr bulb I^' 46 r �: ` -- temperature (i supply, db) , ,�"� ' •` } , : Return(ev�a.porator entering) air dry-bulb temperature (Treturr%db)'`' Return r(evaporator entering) air wet=bulb temperature (Treturn, wb) `' Evaporator saturation temperature= 44!`,. •` (Tevaporator, sat) Condensor saturation temperature ` 113 (Tcondensor, sat) Suction line temperature (Tsuction) 63 , Liquid Line Temperature (Tliquid) 106 '. Condenser (entering) air dry-bulb 107.4 temperature (T condenser, db)- . ^ Reg: 212-A0034155D-M2500001A-M25A Registration Date/Time: 2012/07/16 21:04:00,' HERS'Provider:,Ca10ERTS,, Inc:= 2008 Resident" 1 Compliance Forms March 2010 .: 1 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. y Calculate: Actual Temperature Split = Treturn, db - Tsupply, db ' Target Temperature Split from Table RA3.2-3 using Treturn, wb and Treturn, db , Calculate difference: Actual Temperature Split - Target Temperature Split = Passes if difference is between -4°F and +4°F or, Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag Calculate: Actual Temperature Split = Treturn, db - Tsupply, db ' Target Temperature Split from Table RA3.2-3 using Treturn, wb and Treturn, db , Calculate difference: Actual Temperature Split - Target Temperature Split = Passes if difference is between -4°F and +4°F or, upon remeasurement, if between -4°F and - -100°F " + Enter Pass or Fail i Note: -Temperature Split Method,Calcu/ation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedureg. 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 Minimuir Airflow Requirement_ (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name; Idem fication/Tag - 74 Systre1� • -•_ '4 i or PR •'I g�' F� $ { J�•i � Calculated Mmlmum Airflow Re uirement CFM ) Q«': f�t3 t ;�ia4, acs y<�aE�. x'�."'C �� i"i..li4E �' � it_f, Measured Airflu5icng RA3 3procedures (CFM) ,1 �� . Pi r. `' f cc1865� -, 3A a y'F�'k t ��'ih.^i �' �• f (�� y )•. .f X¢'07' _ _.+ •'T:ti.i,.. z�'i .ee ,a„-`. ;r•:'s wr_ e ' r : ac aFis...;.. -s •:.:. �... ; '< . i ,._ .; r �; . -: Passes if measured -:airflow is greater -.than or,. equal•to the calculated minimum airflow "+ requirement's PASS Ente Pass or Fail , Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for.fixed orifice metering device systems ! System Name or Identification/Tag " Calculate: Actual Superheat .= Tsuction -Tevaporator, sat` ' Target Superheat from Table RA3.2-2 using . Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat'- Target Superheat = System passes if difference is between -61F and +6°F Enter Pass or Fail V Reg: 212-AO034155D-M2S000O1A-M25A Registration Date/Time: 2012/07/16 21:04:00 HERS Provider: Ca10ERTS, Inc.' ' 2008 Residential -Compliance Forms F March 2010 , Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion Valve (EXV)systems. System Name or Identification/Tag - System 1 Calculate: Actual Subcooling = 7.0 r fr , Tcondenser, sat - Tliquid 19.0 + Target Subcooling specified by manufacturer, 10 •_ ,' _ Enter allowable superheat range from , Calculate difference: _3 t Actual Subcooling - Target Subcooling = passesif difference is betweend E-4y!+4°F ' PASS' - MCA T•allowable ,r ` Enter Pass or Fail zE. 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 fr , Calculate: Actual Superheat— 19.0 + Tsuction•- Tevaporator, sat Enter allowable superheat range from , manufacturer's`specifications (or use range , - 3-26 t between 39F and 261F if manufacturer's specification is not -available) System passe'sbif,actual superheat is with(h;the superheat range 3 t , PASS ns- - MCA T•allowable ,r ass orrFail zE. � �t.. '. � t ff.i �$'dz7 i :�� '�n:. �" •i ` � 1,rw, y� � `., .1. • f �¢ '�•�+ Ey �{- ., :ft•n'� �,:� "".s.Dz�MM' f'..g7.4'�'1ilt'�•! 671•Tgsi'{- i�caa.e+ .•"�,j ,. - . •y y •w. - tl r w + ,Reg:.212-A0034155D-M2500001A-M25A Registration Date/Time: 2012/07/16 21:04:00 'HERS Provider: CalCERTS, Inc. - 2008 Residential Compliance Forms y March 2010' r fr , � �t.. '. � t ff.i �$'dz7 i :�� '�n:. �" •i ` � 1,rw, y� � `., .1. • f �¢ '�•�+ Ey �{- ., :ft•n'� �,:� "".s.Dz�MM' f'..g7.4'�'1ilt'�•! 671•Tgsi'{- i�caa.e+ .•"�,j ,. - . •y y •w. - tl r w + ,Reg:.212-A0034155D-M2500001A-M25A Registration Date/Time: 2012/07/16 21:04:00 'HERS Provider: CalCERTS, Inc. - 2008 Residential Compliance Forms y March 2010' r i INSTALLATION CERTIFICATE. CF-4R-MECH-25 Refrigerant Charge Verification -Standard. Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 56985 VILLAGE DRIVE #1 , La Quinta CA 92253 City of La Quinta 12-00000718 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 1888104 HERS Provider Data Registry Information - Sample Group # (if applicable): N/A System meets all refrigerant charge and airflow ❑ not-tested/verified dwelling in a HERS sample group requirements. PASS Home Energy Rating Service Responsible Rater's Name: Responsible Rater's Signature: Enter Pass or Fail Richard Lee Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 5/31/2012 CC2005748 • z'e`j}. za ! f�� rZ.: 5 44 i 4r '�' .� — f�Tl. y � e$ ''"' mor••---;."'"''' i ON, W. r • . • r� �... <" t �-r. g' - .<' ER+ra.7.. �v' r `,'..4-;J-:.� _ �' Yc- � ': ...:_'+`" .`. _1, DECLARATION'STATEMENT '- . I certify under penalty of, perjury; under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed'the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -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) SOLARCITY CORPORATION Responsible Person's Name: < , CSLB License: - Patrick Aranda 1888104 HERS Provider Data Registry Information - Sample Group # (if applicable): N/A Q tested/verified dwelling ❑ not-tested/verified dwelling in a HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798668664 HERS Rater Company Name: y Home Energy Rating Service Responsible Rater's Name: Responsible Rater's Signature: Richard Lee Richard Lee Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 5/31/2012 CC2005748 Reg: 212-A0034155D-M2500001A-M25A Registration Date/Time: 2012/07/16 21:04:00 HERS Provider: Ca10ER_TS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space -Conditioning Systems, Ducts and Fans (Page.1 of 2) Site Address: 56985 VILLAGE. DRIVE #1 La Quinta,CA 92253 (System Enforcement Agency:. Permit Number: , 1) City of La Quinta 12-00000718 Space Conditioning Systems Heating Equipment? - Equip Type (package-" heat pump) CEC Certified Mfr. Name, and Model Number' ARI. Reference Number2 # of Identical Systems Efficiency (AFUE, etcJ1', 3 (>=CF -1R- • value)4 Duct Location (attic, crawl- space, . etc.) Duct R -value Heating Load (kBtu/h'r) Heating Capacity (kBtu/hr) Split Heat Pump BRYANT FE4ANB006 ARC 1 100 HSPF (attic, crawl- Cooling 60 kBtu +feat • -CEC Certified Mfr. Name Reference Identical (>=CF -1R space, ` Duct . Load Capacity pump) , and Model Number' Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split BRYANT f !q ,� Heat Pump ;? r 280ANV06000 ;:rw ?' • : , • 1 , r ;.13 SEER °<W 5 Tons AR w tOt � �••`f Ay j,•w�f+r Cooling Equipment Equip - ?"" t •,5•` Efficiency (SEER Duct Location' Type (package '"^y`` , '•, ARC # of and EER) 1, 3 (attic, crawl- Cooling ,Cooling +feat • -CEC Certified Mfr. Name Reference Identical (>=CF -1R space, ` Duct . Load Capacity pump) , and Model Number' Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) Split BRYANT f !q ,� Heat Pump ;? r 280ANV06000 ;:rw ?' • : , • 1 , r ;.13 SEER °<W 5 Tons AR w tOt � �••`f Ay j,•w�f+r �•-A '¢ i ? y.'4+}(�.�'.:i..�..�Y:: a• 1. If project is new construction;: see Footnotes to Standards Table 151-8 and Table 151-C for duct ceiling alternative. compliance. - 2. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.orglarilac.php# . 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R form. 4. When CF -1R is reference it is also applicable to the CF;IR, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A -VALID FORM �. 0 §110-§113: HVAC equipment is certified by the California Energy Commission. 0 §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. 0 §150(i): Setback Thermostat on,all applicable heating and/or cooling systems meet the requirements of .*. §112(c). 0 §1500)2:' Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum. requirements. of Table 150-B and includes a vapor retardant or is enclosed entirely in, conditioned space. t r • . Reg: 212-A0034155D-M0400001A-0000 Registration Date/Time: 2012/07/16 20:55:17, HERS Provider: CalCERTS,• Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE. CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans •7(Page 2 of 2) Site Address: 56985 VILLAGE DRIVE #1 , La Quinta CA 92253 (System Enforcement Agency: Permit Number: 1) City of La Quinta 12-00000718 { Ducts and Fans §150(m): Duct and Fans 0 1. All air -distribution system ducts and plenums installed, sealed'and insulated to'meet the requirements of CMC Sections 601; 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ' ` ducts and plenums are. insulated to a minimum installed level of R-4.2 or enclosed entirely in , conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A; or UL 181B or aerosol sealant that meets the i requirements of UL 723. If mastic or tape is used to seal openings greater than ?/4.inch, the combination of mastic and either mesh or tape shall be used;'and • " 0 1. Building cavities, support platforms for air handlers, and plenums defined, or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying ' conditioned -air. Building cavities and support' platforms may contain ducts. Ducts installed in cavities , and support platforms shall not be compressed to cause reductions in the cross-sectional area of the, ducts. . - . '. 0 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. 0 7. Exhaust fan systems have back draft or automatic dampers. E3 8. Gravity ventilating systems serving conditioned space have either•automatic or readily accessible,, r ' manually.operated dampers.: , -10 Protection of Insulation:FInsulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be,protected as above or ' y ,painted wlth•a,coating that is water retardant and provides shieldind'from solar radiation that can cause ti ` degradation of..the material -` b+10 Flexible ducts cannot have por_ousonner coTes ".tijrr ,�'+`?' -.rr�, k }t'^"if:3,..,r_�. v,,a.,, iS�. .•'YJV., g - , DECLARATION STATEMENT . I certify undenpenalty'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 -s'+ 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 reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specificl + 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. ; Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) ; SolarCity Responsible Person's Name: Responsible Person's Signature: T Patrick Aranda • . Patrick Arando CSLB License: 888104 Date Signed: 5/25/2012 Position With Company (Title): Reg: 212-A0034155D-M0400001A-0000 Registration Date/Time: 2012/07/16 20:55:17 HERS -Provider: CalCERTS, Inc.'. 2008 Residential Compliance Forms August 2009 .,