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12-0917 (MECH)P.O: BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 -,Application Number: 12-00000917 -" Property Address: 78665 VILLETA DR APN: 604-144-002-217 -23269 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 6459 Applicant:. Architect or Engineer: 01P -. iht. 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: CARRAHER DANIEL.J 12061 SE MESA LANE HAPPY VALLEY, OR 97086 Contractor: DESERT AIR CONDITIONING, INC. 590 WILLIAMS ROAD PALM SPRINGS, CA 92264 (760) 32.3-3383 Lia. No..: 276586 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/14/12 NU I 20112 CITYY OF LA:WNTiA LICENSED CONTR OR'S DECLARATION WORKER'S COMPENSATION DECLARATION hereby affirm under penalty of perjury that I am licensed u er p ovisions of Chapter 9 (commencing with 1 hereby affirm under penalty of perjury one of the following declarations: ' -. Section 7000) of Division 3 of the Business and Prof si Is C de, and m 'cense is in full force and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C20 -C43 Lic se No.: ' 27 86 - for -by Section 3700 of the Labor Code, for the performance of the work for which this permit is /te ' r Contractor. issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor - e - Code, for the performance of the work for which this permit is issued. My workers' compensation " OWNER -BUILDER DECLARATION .• insurance carrier and policy number are: ' I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the , Carrier EVEREST NATL Policy Number 7600007908111 following reason (Sec. 7031 .5, Business and Professions Code:. Any city or county that requires a permit to_ I certifythat, in the performance of the -work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the .. person in any manner so as to become subjec the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions. of the Contractor's State _ and agree that, if I should become ub' t t th workers' ensation provisions of Section License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code) or 3700 of the Labor' de;' shat ith c I with those pr isions.. 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 ($5001,:- - ate A icanC - , 1 _ 1 I, as owner of the property, or my employees withwagesas their-solecompensation will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILI E TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, - SUBJECT AN EMPLOYER TO.CRIMINAL•PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND - and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE,COST. OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended orofferedfor sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ' one year of completion, the owner -builder will have the burden of proving that he or she did not build or - ' improve for the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT " (_ 1 I, as owner of the property, amexclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of " conditions and restrictions set forth on this application.. - ..property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). _ - whose, benefit work is performed under or pursuant to any permit issued as a result of this application, (_) I am exempt under Sec. ,. B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City " of La Quinta, its officers, agents and employees for any act or omission related to the work being ' performed under or following issuance of this permit. - _ - Date: Owner: 2. Any permit issued as a result of this application. becomes null and void if work is not commenced " within '180 days from date of issuance of such permit, or cessation of work for 180 days will subject " CONSTRUCTION LENDING AGENCY permit to cancellation. Lgre I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and'state that the above information is corr t. to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). ", city and county ordinances and state laws relating to building construc ' n; he b Lthoriz resentatives - of this county to enter upon the above-mentioned prop ins p ton pose Lender's Name: - ate:t—lq J—ZSi ature (Applicant or Agent): Lender's Address`. ' LQPERMIT n Application Number 12-00000917 Permit MECHANICAL Additional desc:-- -Permit Fee 40.50. Plan Check Fee _10-.-13 - -' Issue Date Valuation- -•- 0 _ _- Expiration Date - - - : -.- -- - --Qty.Unit Charge Per Extension - _ -- - BASE FEE 15.00 __ 1.00 9.0000 EA ME.CH FURNACE <=100K 9.00 1.00 16..5000 EA MECH B/C >3-15HP/>100K-500KBTU 16..50 Special Notes and Comments HVAC CHANGE -OUT: REPLACE 5 TON SPLIT SYSTEM AT GROUND LEVEL. 2010 CODES. - -----------------_------------------------------------- Other Fees. . . . . BLDG STDS ADMIN (SB1473) 1:00 -Fee summary Charged Paid Credited Due 'Permit Fee Total 40.50. .00 .00 40.50 Plan.Check Total 10.13 .00 .00 10.13 Other Fee Total. 1.00 .00 .00 1.00 Grand Total 51.63 .00' .00 51.63 LQPERMIT' Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date:. Permit #: 78-665 VILLETA DR La Quinta, CA 92253 City of La Quinta . Aug 3, 2012, Duct insulation Conditioned Floor EquipmentTypel List MinimumEfficiency2 requirement _ ' Area Thermostat ❑ Package Unit. . ® Furnace ® Indoor Coil ® AFUE 80% ® SEER 15.0 ❑ COP [1HSPF ❑ R 6 (CZ 10-i3) Served by system ® Setback •.- " If not already present, must be ® Condensing Unit ❑ EER ❑ Resistance ❑ R 81(CZ14-15) t 2000 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being installed, if more than one system, use another CF -IR -ALT_ -HVAC for each system. 2: Minimum Equipment Efficiencies: 13 SEER, 178% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to'the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -611 and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October. 1, 2010, a registered copy of the CF -1R and CF -611 shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: .. . All HVAC Equipment - CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF -4R forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or • Indoor Coil and /or CF -611 forms: •MECH-04 MECH-2I-HERS and (for split systems) MECH-25-HERS . Furnace CF -4R forms: MECH-21�and (for split systems) MECH-25 ' r x , For Split Systems: Duct leakage < 15 percent;, RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAHr-OF Paelfaged Units- Duel; leakage -; 15 pereeRt 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 system.will not be Ducted (ie. Ductless,Mini-Sp)it-System)(Also Exempt #rom�Refrigerant Charge) ❑ 2. New HVAC System Require_ d Forms: _ - k, I( • Cut inlor Changeout with"" ducts: � CF -6R forms: MECH-04, MECH-20,HERS, and,'(for split systems) MECH-22-HERS, and new (all new AC, ducting and all new MECHf'-25HERS CF -4R forms:`'MECH-20' and (for split systems) MECH-22, and MECH-25 equ�pm,ent) 0,f ,,.*t � 4 _-4, .� .■.d 1 ,y ' .,t 1A.. For Split Systems: Duct leakage <,6'percent;,RC, CCA.>_ 350-CFM/ton, FWD ,TMAH, STMS, and either HSPP & PSPP.' For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement ,. . Includes replacing or installing all new ; ducting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. Noor 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 " 114. 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 -411 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. - 1 .' , ... . N : - t ` • 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: Jacqueline Zabik Signature: Jacqueline Zabik Company: DESERT AIR CONDITIONING INC Date: Aug 3, 2012 Address: 590 WILLIAMS ROAD _ License: 276586 City/State/Zip: PALM SPRINGS / CA / 92264. Phone: (760) 323-3383, ; Reg: 212-A0042055A-00000000-0000 Registration Date/Time: 2012/08/03 18:21:54 HERS Provider: Ca10ERTS,�Inc. 2008 Residential Compliance Forms s a 9 ; - July. 2010 "P • Bill # Cray. Of La Quanta BulkMg 8L Safety MUM P.O. Box 1504, `78-495 Ca11e Tampico La..Wnta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Perinit # /1 ProjectAddrm: 78-665 VILLETA DRIVE ----------------- Owner's Name:. DAN 8 SUE CARRAHER A. P. Number. Address: 12061 SE MESA LANE Legal Description: City, ST, Zip: HAPPY VALLEY, OR 97086 Contractor. DESERT AIR CONDITIONING, INC Telephone: Address: 590 WILLIAMS RD Project Description: City, ST, Zip: PALM SPRINGS, CA 92264 REPLACE 5 TON SPLIT SYSTEM ON GROUND LIKE FOR LIKE Telephone: 760-323-3383 ON State Lia # : 276586 City Lie. 9.- 363 Arch., Eng., Designer. NA Address: City, ST, Zip: , Telephone: Y Construction Type:. MECH Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.:#Stories:• # Units: State Lia #: , Name of Contact Person: JACQUELINE RATLIFF ' Telephone # of Contact Person: 760-323-3383 Estimated'Value of project $6,459.00 APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACKING PEW= FEES Plan Sets Plan Cheek submitted Item Amount Strudatal Cales. Reviewed, ready for corrections . Plan Check Deposit. . Truss Calcs. . Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted.. Mechanical Grading plea Zid Review, ready for correctionsrissue Electrical Subcoutactor. List Called CoutactPerson Plumbing Grant Deed Plans picked up s1u H.O.A. Approval Plans resubmitted Grading IN ROUSE:- ''d Review; ready for eorrectionsAssue Developer Impaet Fee . Planning Approval Called Contact Person A".P. Pub. Wks. Appr Date of permit Issue School Fees Tota! Permit Fees r , INSTALLATION CERTIFICATE Space Conditioning Systems, Ducts and Fans Site Address: 78-665 VILLETA DR,, La Qui nta CA 922533 -(System 1 Space Conditioning Systems Heatina Eauivment Enforcement Agency: City of La Quinta . i CF-6111-MECH-0 (Page 1 of 2 Permit Number: 12-917 t ' Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (AFUE, etc.)1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Split Furnace LENNOX ML180UH11OXE60C 1 (SEER Location 5 Tons Type (package ARI # of and EER) 1, 3 (attic, crawl- Cooling Cooling heat pump) CEC Certified Mfr. Name and Model Number Reference Number2 Identical Systems (>=CF -1R value)4 space, etc.) Duct R -value Load (kBtu/hr) Capacity (kBtu/hr) i 5 Tons . Coolina Eauiament i _r Efficiency Duct Equip (SEER Location Type (package ARI # of and EER) 1, 3 (attic, crawl- Cooling Cooling heat pump) CEC Certified Mfr. Name and Model Number Reference Number2 Identical Systems (>=CF -1R value)4 space, etc.) Duct R -value Load (kBtu/hr) Capacity (kBtu/hr) i 5 Tons 00, 'w .. `LY..�.7 ira, '° . Z • .1W a Wo i _r F R 1. If project is new construction, see. Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative compliance. w 2. ARI Reference Number can be found by entering the equipment model number at j http://www.aridirectory.orglarilac.php# 3. Listed erhciency on this page must be greater than or equal ( ? ) to the value shown on the CF -IR form. 4. When CF -1R is reference it is also applicable to the CF -1R, CF -IR -AA or CF -1R -ALT, f ALL BOXES MUST BE CHECKED TO BE A VALID FORM 0 §110-§113: HVAC equipment is certified by the California Energy Commission. I 0 §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACOA. 0 §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). 4 0 §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets _ minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely i6 ; _ t conditioned space. w I Reg: 212-A0042055A-M0400001A-0000 Registration Date/Time: 2012/08/30 14:43:00 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms w August 2009 i INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 78-665 VILLETA DR, La Quinta CA 92253 (System 1) City of La Quinta 12-917 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 1818 or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and 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. �. 0 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. 0 Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, ' moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause 'degradation of the material.- _ 0 10. Flexible ducts cannot have porous inner cores. F y, €: ,r . n. c t E 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 reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that Identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation 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 Drovides to the building owner at occuoancv. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) DESERT AIR CONDITIONING INC Responsible Person's Name: Responsible Person's Signature:. Jacqueline Zabik - Jacqueline Zabik CSLB License: Date Signed: Position With Company (Title): 276586 8/10/2012 y Reg: 212-A0042055A-M0400001A-0000 Registration Date/Time: 2012/08/30 14:43:00 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 Reg: 212-A0042055A-M0400001A-0000 Registration Date/Time: 2012/08/30 14:43:00 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 78-665 VILLETA DR, La Quinta CA 92253 (System 1) City of La Quinta 12-917 This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Duct Leakage Diagnostic Test - existing duct system ' Select one compliance method from the following four choices. r ® 1. Measured leakage less than 15% of fan flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow ❑ 3. Reduce leakage by 60% and conduct smoke and fix all leaks 0 4. Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options 1, 2 or 3 must be attempted before utilizing Option 4.) Determine nominal«Fan Flow using one of the .following three;calc.ulationfinethods. ✓ ® Cooling system method Size of condenser in Tons 5, x 400 2000CFM I. ; " ✓ ❑ Heatinggsystem method., 2Q� 7 x =Output Capacityrf 6j-housands of Btu/hr = CFM :.. � s R J N ✓ y g . ❑ Mea��sured s stem nei�rflow Nin RA3 3airflow test�p ocedures: Optii..used then{� P Io ' ' " Allowed' leakage = X300 CFM' ' 1 °Fan Airflow2006.x 0:15 : r Actual Leakage = 296 CFM`'' j Pass if Actual Leakage is less than Allowed leakage j;jPass Fail Option.2 used then: 2 Allowed leakage = Fan Airflow _ x 0.10 = _ CFM Actual Leakage to outside = _ CFM Pass if Actual leakage to outside is less than Allowed leakage Pass Fail' Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage -after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _/ Initial leakage x 100% _ 0/ Reduction Pass if % Reduction >= 60% rl Pass rl Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). • Pass if all accessible leaks have been repaired using smoke Pass Fail ,• . € - a Reg: 212-A0042055A-M2100001A-0000 Registration Date/Time: 2012/09/17 17:23:15 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010' c ' w . . I INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 78-665 VILLETA DR, La Quinta CA 92253 (System 1) City of La Quinta1.12-917 ® 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 N be configured to the closed position during duct leakage testing. . ® All supply and return register toots must,be sfealed-�toAhe drywall�lf smoke test is utilized-for,compliance 1 - applies to�`duct leakage compliance option 3'('leakage'reductlon tiy, 60%;)'ndsoptlon: 4 (fix all accessible , •• leaks) described above.'° iF , ..r . 17, ® New duct installations cannot utlllze;,,building cavities as plem nus m orrplatforreturns in Ileu of ducts , ® Mastic and�draw IbandsAmust4be used I,n�rnr. co:binatlo.nwlthcloth backed rubbeadhesiveducttap:e;to seal. leaks at all n'ew duct connections;- - ti 3. DECLARATION STATEMENT 4. • 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 -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 '. t 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) DESERT AIR CONDITIONING INC Responsible Person's Name: Responsible Person's Signature: Jacqueline Zabik Jacqueline Zabik CSLB License: Date Signed: Position With Company (Title): 276586 9/1/2012 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 212-A0042055A-M2100001A-0000 Registration Date/Time: 2012/09/17 17:23:15 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE* CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 78-665 VILLETA DR, La Quinta CA 92253 City of La Quint, 12-917 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. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 1 ®Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2®Yes Director. � z _' - �r P1.40 . � ❑ No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and 2 is a pass. Enter Pass or Faill ® Pass I ✓ ❑ Fail STMS - Sensor gnthe Evaporator Coil System Name or Identification/ rag' - :- System i _ ) ai.. �T :. a r • .. .,, �,, rid., 3 p. s 47! ®N �r The s1.ensor is factory installed, or field installed according to manufacturer's specifications, or ismstalled'by method's/specifications approved by the Executive ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive - Director. � z _' - �r P1.40 . � No �� Thdlsensor wire is terminated withM,standard mirn plug suitable for conn"ection to a sensor' echniclah" 4. ❑Yes ® digital thermometer The mini 060s: accessible to the;;installi ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing Itechnician and the�HERS"rai without changing the airflow through the condenser toile 5 ❑ Yes -- ❑ No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not ✓ ® N/A 11 ✓ ❑ Pass 1 ✓ ❑ Fail applicable. Otherwise enter Pass or Fail ✓ ❑Pass ✓ ❑ Fail. applicable. Otherwise enter Pass or Fail i •' .. •t s. t, r STMS - Sensor on the Condenser Coil System Name or Identification/Tag I System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive - Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No digital thermometer. The sensor mini plug is accessible to the installing Itechnician and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes ❑ No IThe sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ✓ ® N/A ✓ ❑Pass ✓ ❑ Fail. applicable. Otherwise enter Pass or Fail Reg: 212-A0042055A-M2500001A-0000 Registration Date/Time: 2012/09/2515:12:53 HERS Provider: Ca10E_RTS, Inc. 2008 Residential Compliance Forms August -2009 INSTALLtiATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 78-665 VILLETA DR, La Quinta CA 92253 City of La Quinta 12-917 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems System Name or Identification/Tag . System 1 3 (must be re -calibrated monthly) System Location or Area Served Whole House �','� q(must A r,3e calibrated monthly) Outdoor Unit Serial # 1912E12087 Outdoor Unit Make LENNOX Outdoor Unit Model 14ACX-060-230-14 Nominal Cooling Capacity Btu/hr 60000 Date of Verification 9/1/12 ,Laimration OT uiagnostic instruments Date of Refrigerant Gauge Calibration 9/1/12 3 (must be re -calibrated monthly) Date of Thee mo couplCalibration �F '9/1%12 �','� q(must A r,3e calibrated monthly) Measurecl„.Temperatures;(,Fef,�) 11 Pt' f.. System Name or Identification/Ta ?� seml S y. 3 > $ �” �`� Supply (eva'po'rator'. leaving) air dry,bulb 6-q temperature (T ) db supply, , Return (evaporator entering) air dry-bulb 83 temperature (Treturn, db) Return (evaporator entering) air wet -bulb 66 temperature (Treturn, wb) Evaporator saturation temperature 53 (Tevaporator, sat) Condensor saturation temperature 127 (Tcondensor, sat) Suction line temperature (Tsuction) 71 Liquid Line Temperature (Tliquid) 120 Condenser (entering) air dry-bulb 113 temperature (Tcondenser, db) Reg: 212-A0042055A-M2500001A-0000 Registration Date/Time: 2012/09/25 15:12:53 HERS Provider: CalCERTS, Inc. 20.08 Residential Compliance Forms August 2009 G INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification- Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 78-665 VILLETA DR, La Quinta CA 92253 City of La Quinta 12-917 Minimum Airflow Reauirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 Calculate: Actual Temperature Split = Treturn, 22.00 db - Tsupply, db Target Temperature Split from Table RA3.2-3 20.7 using Treturn, wb and Treturn, db Calculate difference: Actual Temperature Split - 1.3 Target Temperature Split = Passes if difference is between -3°F and +3°F or, " upon remeasurement, if between -3°F and PASS =100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name o Identiification/TagSys em 1" AKi . Calculated,Mihimum Airflow Reqxuirement (CFM) OP Measured Airflow using RA3�3 procedures (CFM) F Al Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. ` Enter 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 System 1 Calculate: Actual Superheat = Tsuction - Tevaporator, sat Target Superheat from Table RA3.2-2 using Treturn, wb and Tcondenser, db Calculate difference: Actual Superheat - Target -Superheat_=, System passes if difference is between -5°F and +5°F Enter Pass or Fail r Reg: 212-A0042055A-M2500001A-0000 Registration Date/Time: 2012/09/25 15:12:53 HERS Provider: CalCERTS, Inc; 2008 Residential Compliance Forms August 2009 • 1 INSTALLATION CERTIFICATE I CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: I Enforcement Agency: Permit Number: 78=665 VILLETA DR,,La Quinta CA 92253 City of_La.Quinta 12-917 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 18.0 Tcondenser, sat - Tliquid Target Subcooling specified by manufacturer 6 Calculate difference: 1 Actual Subcooling - Target Subcooling = System passes if difference is between -3°F and +3°F PASS Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for . thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat = 18.0 Tsuction - Tevaporator, sat Enter allowable superheat range from manufacturer's specifications (or use range 4-25 between 4°F and 25°F if manufacturer's specification is not available) System passes;if actual`,superheat is withm,th`e allowable superheat range` PASS ` Enter Pass „or Fail • •,ice. f t `.. r . �` ' • �:' d''�y q.r•+ . ��'',� � •�� `"k e': �, Yrs-. 1 14 Reg: 212-A0042055A-M2500001A-0000 Registration Date/Time: 2012/09/25 15:12:53 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009^' ..' INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 78-665 VILLETA DR, La Quinta CA 92253 City of La Quinta 12-917 Standard Charge Measurement Summary: - System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 CSLB License: 19/1/2012 Date Signed: Position With Company (Title): System meets all refrigerant charge and airflow Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): requirements. PASS Enter Pass or Fail w i�`.. rJ! , ¢? �! 4x 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 -111) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation 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 reolstry for multiDle orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) DESERT AIR CONDITIONING INC Responsible Person's Name: Responsible Person's Signature: Jacqueline Zabik Jacqueline Zabik CSLB License: 19/1/2012 Date Signed: Position With Company (Title): 276586 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No v Reg: 212-A0042055A-M2500001A-0000 Registration Date/Time: 2012/09/25 15:12:53 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009, i- v Reg: 212-A0042055A-M2500001A-0000 Registration Date/Time: 2012/09/25 15:12:53 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009, :ERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-2: )uct Leakage Test - Existing Duct System (Page 1 of 2 Site Address: Enforcement Agency: Permit Number. 78-665 VILLETA DR, La Quinta CA 92253 (System 1) City of La QL 1 12-917 anter the Duct System Name or Identification/Tag: System 1 anter the Duct System Location or Area Served: Whole House Jote: Submit one Installation Certificate for each duct system that must demonstrate compliance in the (welling. his installation certificate is required for compliance for alterations and additions in existing dwellings to pace conditioning systems and duct systems. Jote: For existing dwellings, a completely new or replacement duct system can also include existing parts of he original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible ind they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, ise the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. ❑ 1. Measured leakage less than 15% of fan Flow ❑ 2. Measured leakage to outside less than 10% of Fan Flow ❑ 3. Reduce leakage by 60% and conduct smoke and fix all leaks ❑ 4. Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options 1, 2, or 3 must be attempted before utilizing Option 4.) Determine nominal*Fan#Flow using one of the following three calculation methods. [3Cooling system method: Size of condenser in Tons x 400 ✓ ❑ Heatmgsystem method.:0-utput Capacity m Thousands 6613tu/hr ✓ M.' �x ❑ Measured system"rflowusinRA3 3tairflowtestkprocedures:'C �K. �z J Option =.used then 01 CIO' �.r 1 Allowed leakage ='Fan Flow _ x 0.15 = _ CFM Actual Leakage = _ CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then: 2 Allowed leakage = Fan Flow_ x 0.10 = _ CFM Actual Leakage to outside = _ CFM Pass if Leakage Actual is less than Allowed ❑ Pass Fail Option 3 used then: Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = _ CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _ / Initial leakage x 100% _ % Reduction Pass if % Reduction >= 600/0 Cl Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No sampling). Pass if all accessible leaks have been repaired using smoke ❑ Pass Fail Reg: 212-A0042055A-M2100001A-M21A Registration Date/Time: 2012/10/09 18:41:45 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 78=665 VILLETA DR, La Quinta CA 92253 (System 1) 1 City of La.Quinta 1 12-917 1 ❑ 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 supplyW,an&return register boots must besea ledtoAhe drywalfiif�sm ke�test�lsau�tilized�fo! compliance ' - applies,tojduct leakage compllanceeoption 3 (leakag;e reduction by,60 /o) and-optionl4l(flx all'accessible leaks) descibed above.t.° x �a' . , r� El 'New duct'Anstally9ations canynot u.tlllze�building cavltles as plenums o ,platform eturns; in lleu•of clucts r ' ❑Mastic and draw bands mushbe. used in com:binatlon withA.cloth backed-rubbee,�adhesive.duct`aape-ito seah " ° . leaks,at all new ductconnections 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). a 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 -SR) 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) DESERT AIR CONDITIONING INC Responsible Person's Name: CSLB License: 1276586 Jacqueline Zabik HERS Provider Data Registry Information Sample Group # (if applicable): 338741 []'tested/verified dwelling ® not-tested/verified dwelling in la F HERS sample group_ HERS Rater Information Ca10ERTS Certificate # CC1-1798679323 ❑ 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 supplyW,an&return register boots must besea ledtoAhe drywalfiif�sm ke�test�lsau�tilized�fo! compliance ' - applies,tojduct leakage compllanceeoption 3 (leakag;e reduction by,60 /o) and-optionl4l(flx all'accessible leaks) descibed above.t.° x �a' . , r� El 'New duct'Anstally9ations canynot u.tlllze�building cavltles as plenums o ,platform eturns; in lleu•of clucts r ' ❑Mastic and draw bands mushbe. used in com:binatlon withA.cloth backed-rubbee,�adhesive.duct`aape-ito seah " ° . leaks,at all new ductconnections 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). a 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 -SR) 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) DESERT AIR CONDITIONING INC Responsible Person's Name: CSLB License: 1276586 Jacqueline Zabik HERS Provider Data Registry Information Sample Group # (if applicable): 338741 []'tested/verified dwelling ® not-tested/verified dwelling in la HERS sample group_ HERS Rater Information Ca10ERTS Certificate # CC1-1798679323 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 10/9/2012 CC2005784 Reg: 212-A0042055A-M2100001A-M21A Registration Date/Time: 2012/10/09 18:41:45 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification-, Standard Measurement Procedure (Page 1 of 5) ; Site Address: Enforcement Agency: Permit Number: 78-665 VILLETA DR, La Quinta CA 92253 City of La Quinta 12-917 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 t Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential_Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handier System Name or Identification/Tag System i System Location or Area Served Whole House 1 ❑ Yes ❑ No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in Section RA3.2.2.2.2. 2 ❑ Yes ❑ No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and 2 is a pass. Enter Pass or Fail ✓ ❑- Pass ✓ ❑ Fail STMS - Sensor�onw;the. Evaporator Coil ' System Nameror Identification/Tag`• T, '� :, �#--' oo� s ( 3 ❑ Yes 674�1' ❑`No sor is factoryinstalled, or field'installed according to manufacturer's specifications, or isginstalled by methods/specificationsapproved by the Executive ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. �� ' . >. .._ ;. ' , •'. * V, • i- suitable for connection to ar 4 Y es ❑ No �� is ..., .. F"` ems; , d gital thermon etere;�The seens6 mmi� plug sa cess bug f' le to the,installing°tech`nicfa"n" ❑ Yes ❑ No, ' '`'and the HERS`ratel''without'changing the airflow through the condenser coil ❑ Yes • ❑ No When attached to a digital thermometer, the sensor provides an indication of the ❑ Yes p No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. ; 4, and 5 is a pass. Enter N/A if STMS are not 4acable. T✓ ❑ N/A ✓ p Pass ✓ ❑ Fail Otherwise enter Pass or. Fail ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive , F• System Name or Identification/Tag System 1 The sensor is factory installed, or field installed according to manufacturer's 6 ❑ Yes ❑ No specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 7 ❑ Yes ❑ No, digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 8 ❑ Yes p No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ® N/A ✓ ❑ Pass ✓ ❑ Fail applicable. Otherwise enter Pass or Fail Reg: 212-A0042055A-M2500001A-M25A Registration Date/Time: 2012/10/09 18:43:09 HERS Provider: CalCERTS, Inca 2008 Residential Compliance Forms March -2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5) Site Address: Enforcement Agency: Permit Number: 78-665 VILLETA DR, La Quinta CA 92253 City of La Quinta 12-917 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is•above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. - The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. - The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. - If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Systems System Name or Identification/Tag System 1 (must be re -calibrated monthly) Date of Thermocouple; Calibration r System Location or Area Served Whole House ice'` fir R`4 '. .� , se's ..: R , Outdoor Unit Serial # v.,u�a w .. :: _ .. • -•_.: Outdoor Unit Make r Outdoor Unit Model Nominal Cooling Capacity Btu/hr Date of Verification Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration System" (must be re -calibrated monthly) Date of Thermocouple; Calibration r (must be re -calibrated monthly) . .rs _.�' ^r •.,.,,,.+ ice'` fir R`4 '. .� , se's ..: R nieasurea T.emoeratures-(.,�r). tia" x.;r x it rlaTT-:4�."F"a. W System Name or Identification/ i R System" x'Y"' :. .rs _.�' ^r •.,.,,,.+ ice'` fir R`4 '. .� , se's ..: R + $,.a. wr. Supply (evaporatorleaving)�"air dry bulb � v.,u�a w .. :: _ .. • -•_.: temperature (T )'"" . supply, db Return (evaporator entering) air dry-bulb temperature (Treturn, db) Return (evaporator entering) air wet -bulb temperature (Treturn, wb) Evaporator saturation temperature (Tevaporator, sat) Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db) Reg: 212-A0042055A-M2500001A-M25A Registration Date/Time: 2012/10/09 18:43:09 HERS Provider: CalCERTS, Inc. J. 2008 Residential Compliance Forms March 2010. r - Reg: 212-A0042055A-M2500001A-M25A Registration Date/Time: 2012/10/09 18:43:09 HERS Provider: CalCERTS, Inc. J. 2008 Residential Compliance Forms March 2010. INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5) Site Address: Enforcement Agency: Permit Number: 78-665 VILLETA DR, La Quinta CA 92253 City of La Quinta 12-917 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 Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (dm/ton) System Name -or Identification/Tag, "7 Calculated Minimum AirflowA,Requirement4(CFM) s` 1' illP i 1' I Measured Airflow using RA3 proceduresj(CFM) A 3 * �*; 4 ��. �_� is ,T� ?� • Passes if measured airflow is`greaterthan,o"r'equah $ to the calculated minimum airflow requirement. Enter 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 -6°F and +6°F Enter Pass or Fail Reg: 212-A0042055A-M2500001A-M25A Registration Date/Time: 2012/10/09 18:43:09 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 r r c . INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) ' Site Address: Enforcement Agency: Permit Number: 78-665 VILLETA DR, La Quinta CA 92253 City of La Quint 12-917 , 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 • r F Calculate: Actual Subcooling = Tcondenser, sat - Tliquid - Target Subcooling specified by manufacturer 1 1 4 manufacturer's specifications (or use range ' 4 Calculate difference: f Actual Subcooling,- Target Subcooling =� _ System passes if difference is between _ (-7 -4°F and +4°F � Enter Pass or Fail _ . • thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. a • r F Calculate: Actual Superheat.= Tsuction - Tevaporator, sat - Enter allowable superheat range from � 1 4 manufacturer's specifications (or use range between 3°F and 26°F if manufacturer's Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag • � t F Calculate: Actual Superheat.= Tsuction - Tevaporator, sat - Enter allowable superheat range from 4 manufacturer's specifications (or use range between 3°F and 26°F if manufacturer's f specification is'not..a_vailable) _ System passes -'if actual superheat is:within the allowable superheat range t* (-7 Enters,' Pas or Fail � 1�o _ . • 4 ' . , . ,•,._`: _: k '..'1 :+`.€`, .,rr aj.- fust a.t .�^.. a.fx, ` `.r A , ,, a i •. „Cl it .;:� _ - . 'A, M y . , ``. - - l - • '^ i' + ^ Y,- ... _r-,'' sem: •. .f r. i .- . .v, :� .Reg: 212-AO042055A-M2500001A-M25A Registration Date/Time: 2012/10/09 18:43:09 HERS Provider:'Ca10ERTS,'Inc.. 200.8 Residential Compliance Forms `` March 2010 • � t F , • 4 ' . , . ,•,._`: _: k '..'1 :+`.€`, .,rr aj.- fust a.t .�^.. a.fx, ` `.r A , ,, a i •. „Cl it .;:� _ - . 'A, M y . , ``. - - l - • '^ i' + ^ Y,- ... _r-,'' sem: •. .f r. i .- . .v, :� .Reg: 212-AO042055A-M2500001A-M25A Registration Date/Time: 2012/10/09 18:43:09 HERS Provider:'Ca10ERTS,'Inc.. 200.8 Residential Compliance Forms `` March 2010 r INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 78-665 VILLETA DR, La Quinta CA 92253 1 City of La Quinta 12-917 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 1276586 HERS Provider Data Registry Information Sample Group # (if applicable): 338741 System meets all refrigerant charge and airflow ® not-tested/verified dwelling in la HERS sample group requirements. HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: ' Enter Pass or Fail William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 10/9/2012 , ' tt 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. . 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. c' . 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 Certlficate(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) DESERT AIR CONDITIONING INC Responsible Person's Name: CSLB License: Jacqueline Zabilk 1276586 HERS Provider Data Registry Information Sample Group # (if applicable): 338741 ❑ tested/verified dwelling ® not-tested/verified dwelling in la HERS sample group HERS Rater Information CalCERTS Certificate # CC1-1798679323 HERS Rater Company Name: The Energuy CA LLC Responsible Rater's Name: Responsible Rater's Signature: William David Painter William David Painter Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 10/9/2012 CC2005784 Reg: 212-A0042055A-M2500001A-M25A Registration Date/Time: 2012/10/09 18:43:09 HERS Provider: CalCERTS, Inc. , 2008 Residential Compliance Forms ` March 2010