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10-0658 (MECH)P.O. BOX 1504. ,;' 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY -DEPARTMENT BUILDING PERMIT Application Number: 1-00"0.006S� Owner: 0 - Property Address: 50102 AVENIDA VISTA .BONITA BARBEN TED APN: 658-260-049- - - ' 50102 AVE VISTA BONITA Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL (775) 721-6985 Application valuation: 5800 -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION -I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: C20 -C10 License N .: 286936 Date:_Z=)b-)O— C_ntractor. _ OWNER -BUILDER LARATION 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.). (_) 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.). (_) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: "- CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: - LQPERMIT lJ Contractor: CAVANAUGH ELEL'1'RIC:.' & ATP . 83231 HIGHWAY 111 INDIO, CA 92201" (760)347-3608 Lic. No.: 286936 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/-16/10' . JUL . 2 c-2010 ,. ----------------------------------------------- WORKER'S COMPENSATION DECLARATION 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 SOUTHERN INS CO Policy Number WSIO038567-01 _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section /� 3700 of the Labor Code, l shall forthwith comply with those provisions. .DatyO:--_ , Appliant:^, -_ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C ERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL 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. • I 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 building construction, and hereby authorize representatives. - - of this county to enter upon the above-mentioned propert for inspection s. - ate: ._1b_1C) Signature (Applicant or Agent): Application Number 10-00000658 Permit . . MECHANICAL Additional desc Permit Fee 40.50 Plan Check Fee 10.13 Issue Date. :.- ,.: _ Valuation 0 Expiration Date 1/12/11 Qty' Unit Charge Per., w Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 Special Notes and Comments REPLACEMENT "OF ORIGINAI; "AIR CONDITIQNING - -V ' SYSTEM 4.TON 14 SEER SAME LOCATION. I ----------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited -- - - - - - - -------_- - - --- - - - - -- ---- Due - - - - - -- I Permit Fee Total 40.50 .00 .00 40.50 Plan Check Total 10.13 .00 .00 10.13 j Other Fee Total 1.00 .00 .00 1.00 ! Grand Total 51.63 .00 .00 51.63 LQPERMIT i Simp lifted Prescri tive Certificate of Com fiance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones. 10 to 15 Site Address t En o e ent en ry: Date: Petntrlt #: Equipment T t List Minimum Efficienc r Duct insulation requirement Conditioned Floor Area Thermostat O ackaged Unit O Setback Fumace 14 AFUE 90 O COP Over 40 ft of ducts added or In Coil KSEER� O HSPF replaced to unconditioned space Served by system (lfnotalready )iLCondensing Unit O EER O Resistance OR 6 (CZ 10-13) sf present. must be O Other OR 8 (CZ /4-15) installed) 1. Equipment Type: Choose theequipment being installed. ifmore than onesystem, use another CF-liR-ALT-HVACforeach system. 2. Minimum Equipment Effwkncles: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. life 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 -Jtis form was in fad the work completed by the installer. The inspector also verifies that each appropriate CF -611 and registered CF4R forms (no hanc filled CF4Rs allowed) are filledout and si ed. Beginning October 1 2010 a registered copy of the CF -1R and CF -6R shall also be on pile for final hu u. 1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forts: MECH-04, MECH-2l-HERS and (for split systems) MECH- 25 -HERS CF4Rforms: MECH-21 and for Split System). MECH-25 • Condenser Coil and/or • Indoor Coil and/or CF-61kforms: MECH-2I-HERS and (for split systems) MEC` - 25 -HERS • Furnace CF4R forms: MECH- 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted 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 ducts stems are constructed,insulated or sealed with asbestos 0 2. New HVAC System Required Forms: with new • Cut in or Chang outducting ducts: (all new ducting nef all CF -6R forms: MECH-04, MECH-20-HERS,and for lit ( sp sys ins) MECH-22-HERS, and MECH-25-HERS new equipment) CF4R forms: MECH 20-, and (for splitsystems)MECH-22, End MECH 25 For Split Systems: Duct leakage < 6 percent; RC, CCA.> 350 CFM/ton, FWD,.TMAH, STNS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with Replacement ' 'Regill�d I�rms: • Includes replacing or installingaB new ducting CF -611 forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF4R forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all equipment changed. For Split Systems: Duct leakage .< 6 percent, RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct --leakage < 6 percent 0 4. New ,Ducting over 40 feet R uired Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned space. CF -6R forts: MECH-04, MECH-2I-HERS CF4R 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 cenify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts I and 6 of the California Code of Regulations. • the deign features identified on this Certificate of Compliance are consistent with the information documentedlon other applicable compliance forms, worksheets. calculations, plans and specifications submitted to the enforcement agency for approval with the permit ication. Name: QO . eaVarLq Signature: Company: G al'��Gtq% E-z_ecir) c -Ind h1C Gate: Address: License:/+ 7 1D CLO 6 City/Slatc2ip: D G'/E. 9� �a P.ione: — 3473&08 - 2008 Residential Compliance Forms March 2010 Bin # City of La Quinta Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and `racking Sheet Permit # LL� - LG Project Address:' Owner's Name: 7e- d 6eN A. P. Number: Address: S�— /Q� f}y� • >/S�� �j�j f� Legal Description:11 City, ST, Zip: Z,70plh--� C/4. 1/d a h eC'/• a/Id , {/C Telephone: '775-- 7.9/— 6 99-6- 8AddrContractor: Address: ess: 8 _ 3 I I Project Description: City, ST, Zip: Z)dld�1 Ci�i Re Dzacka,416n t ac B L p�f��C3I Telephone: State Lic. # :G City Lic. #: � Arch., Engr., Designer: 7'4 4 S Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: RA,[ Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: #Stores: # Units: Telephone # of Contact Person: %66— 5'78-� .� Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading. plan F% 2" Review, ready for correctionstissue Electrical Subcoutactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Gr€ding IN HOUSE:- '"' Review, ready for.correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.IJP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Pagel of2) Site Address: I Enforcement Agency: Permit Number: 50-=102Aveni'd'a�°Vistaonita;La Quinta,CA922531 City of La Quints 110-00000658 Enter the Duct System Name or Identification/Tag:-House Zone Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in ex -'sting 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 accessble and they can be sealed For a completely new or replacement duct system installed in an existing dwelling, use the Instillation Certificate titled "Duct Leakage Test — Completely New or Replacement Duct System. " Duct Lenkaue Diaunm is Test — existinu duct system. n .m Select one compliance method fromthe followingtfour-chooiceV ®Option 1. Measured leakage less than 115%,of Fan Airflow. ' . s t� Option 2. Measured leakage to outside less thanl'0% of Fan�Airflow.. n MOP 3. Reduce leakage by 60% or. -more, and,conduct smoke test to seal all accessib�a leaks. i.�---- ✓MOption 4. Fix all accessible leaks using -smoke test, and HERS,rater must verify. r" uti Note: (Option 1 must be attempted before.util in g Option 4) � Determine nominal Fan Airflow using one •of_the'following,three: calculation methods. �ooling system method: Size of condenser in Tons 4 2 x 400 =1600. CFM [D-Ieating system method: 21.7 x 0 )Heating Output Capacity (kBtuh) = CFM Deasured system airflow using RA3.3 airflow test procedures: CFM f I Option 1 used then: � 4—, -- Allowed leakage = an Airflow i`�9C 0:1f— 39 CFM I Actual leakage= 348 CFM: i Pass i Actual leakage is less than Allowed leakage rPasoFail Option 2 used then: Allowed leakage = Fan Airflow x 0.10 = CFM 2 Actual leakage to outside = CFM E6assnail Pass if Actual leakage to outside is less than Allowed leakage Option 3 used then: Initial leakage prior to start of work= 0 CFM Final leakage after sealing all accessible leaks using smoke test = 0 CFM 3 Initial leakage 0 - Final leakage 0 = Leakage reduction 0 CFM (Leakage reduction 0 /Initial leakage 0 ) x 100% = % Reduction Pass if % Reduction > 60% llpass[aail Option 4 used then: All accessible leaks repaired using smoke test. HERS rater must verify (No sampling). 4 Pass if all accessible leaks have been sealed usi ng Smoke Test 1 ✓ as ail Registration Number: 110-88777CFB-0016-1-MECH21 Registration Date/Time: 08/14/2010 14:44 HERS Provider: CHEERS CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECFI-21 Duct Leakage Test — Existing Duct System (Page 2 of 2 Site Address: Enforcement Agency: Permit Number: 50-102 Avenida Vista Bonita,La Quinta,CA92253 City of La Quints 10-00000658 ❑ Outside air (OA) ducts for Central Fan Integrated (CFI.) ventilation systems, shall not je sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motoied dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA`ent lat niss not required, may be corfigured to the closed position during duct leakage testing. ❑ All supply and return register boots must be sealed tokhe drywall if smoke test is utilized for compliance - applies to duct leakage compliance option 3 (leakage,reduction,by 60%) and'ptiori 4, (fix all accessible leaks) described above. •New duct installations cannot utilize buildmg cav�rties as plenums+or platform returns in lieu of ducts. ❑ Mastic and draw bands must be used'rn_1cofbR2i tion with cllo`- ' ra-WeWfubber adhesiv: duct tape to seal leaks at all new duct connections. DECLARATION STATEMENT • I certify under penalty of perjury, under the laws f the State of Caliifomia, the information provided on this form is true and correct. • I am the certified HERS rater who performed the verificahon,servtces.tdentified and reported on this certificate (responsible rater). ba t N t. • The installed feature, material, component, or manufactured:device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requir ments in Reference Residential Appendica:s RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1 R) approved by the local enforcement agency. • The information reported up plicable sections of the stall do Ce catee..(s)_ CF R), signed -,'And submitted by the person(s) responsible for the install hconform to re ui is pecfied oth Cfti, cae(s''of Compliance (CF=1R) approved by the enforcement agency. Builder or Installer informdtibr•as,sh'owh1on th. Installation (fie ificateCF 6R' Company Name: (Installing Subcontra6tor or General[Contractor r Buildedpwner) Cavanaugh Electric & Air Conditioning Responsible Person's Name: CSLB License: Rod Cavanaugh 1286936 ITERS Provider Data Registry Information Sample Group # (if applicable): ✓ ested/verified dwelling not-tested/verified dwelling N/A in a HERS sample group HERS Rater Information HERS Rater Company Name: Anchors Aweigh Energy Responsible Rater's Name Responsible Rater's Signature Bruce Cheney. Bruce Cheney(Signature on File) Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: CCN46564657 8/14/2010 Registration Number: 110-88777CFB-0016-1-MECH21 Registration Date/Time: 08/14/2010 144:44 HERS Provider: CHEERS CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH 25 Refrigerant Charge Verification - Standard Measurement Procedure age 1 of Site Address: _ _Enforcement Agency: Permit Number: 50=1'02 Avenida=Vista Bon ti La Quinta,CA92253 I City of La Quints 110-00000658 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 marry as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional forms) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method TMAH - Access Holes in Supply and Return Plenums of Air Handier System Name or Identification/Tag Zone HVAC, Zone HVAC System Location or Area Served The sensor ig factory installed, or -field installed according to manufacturer's Whdle Oe I 040 Y 1 Yes O O 5/16thch (8 mm)'acce hole upshPearn of evaporative coil in the return plenum and lalieledhaccordingfoTigure in Section RA3.2.2.2.2. 2 QYes DO >.� 5%16 -inch (8 mm) accesdownstream of evaporative coil in the supply plenum s hole � r 1 -) f � t,. - M t i : - --. and'labeledaaccording wFigurein Section RA3.2.2.2.2. Yes to 1 and 2 is a pass. �e- I 11En4errPass?or Fail ✓ E]Pass ✓ DFan STMS - Sensor on the Evaporator Coil) r System Name or Identification/Tag Zone HVAC, The sensor ig factory installed, or -field installed according to manufacturer's 3 ®Yes 040 specifications�Tis installed by'methods/specifications approved by the Executive specifications, or is installed by methods/specifications approved by the Executive Director. 4 Yes �. o The sensor ire is terminated with a standard mini plugtsuitable for connection to a digital th�emiometer- The sensor ini lug islacces�ble'to the installing technician and The sensor wire is terminated with a standard mini plug suitable for connection to a 7 QYes �the8 rater withou� changin the air w Ithco�igh the condenser coil 5 []Yes sens, r rnea':s the saturation t p at a of coil within 1.3 degrees F Yes to 3, 4, and 5 is a pass. Ener ✓ N/A ✓ ©Pass -K []Fail N/A if STMS are not applicable. Otherwise enter Pass or Fail The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter STMS - Sensor on the Condenser Coil System Name or Identification/Tag Zone HVAC 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 QYes UNo 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 UYes 04o The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter E] N/A ✓ OPass ✓ Fail N/A if STMS are not applicable. Otherwise enter Pass or Fail Registration Number: 1'10-F64210A5-0010-1-MECH25 Registration Date/Time: 07/28/2010 10:09 HERS Provider: CHEERS CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure age 2 of Site Address: I Enforcement Agency: Permit Number: 50-102 Avenida Vista Bonita,La Quinta,CA922531 City of La Quints 110-00000658 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 forms) 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. Snnce Conditinnino Svctemc System Name or Identification/Tag Zone HVAC (must be re -calibrated monthly) Date of Thermocouple Calibration t7/'23/20 TO System Location or Area Served Whole House f Outdoor Unit Serial # 211 OE27557 I �; Outdoor Unit Make Carrier F i ..M temperature (Tsu I , db) I" Outdoor Unit Model 24ACE7�48A300 Return (evaporator entering air drylbt lb ' X7# 2 M_ Nominal Cooling Capacity Btu/hr 48000 it.,..,. , temperature (Tretum�-db) I Date of Verification 7/23 01 1n _._ Calibration of Diaenostic Instruments, ! Date of Refrigerant Gauge Calibration � wa 7123/`20x1-0 (must be re -calibrated monthly) Date of Thermocouple Calibration t7/'23/20 TO (must be re -calibrated monthly) Measured Temueratures On 1--) System Name or Identification/Tag Zone HVAC f Supply (evaporator leaving)tr dryAbu _b 5, 1 I �; temperature (Tsu I , db) I" Return (evaporator entering air drylbt lb ' X7# 2 M_ temperature (Tretum�-db) I Return (evaporator entering) air wef-bulb q R 59.8 temperature (Tretum, wb) Evaporator saturation temperature 36 (Teva orator, sat) Condensor saturation temperature 101 (Tcondenson sat) Suction line temperature (Tsuction) 47.7 Liquid Line Temperature (Tliquid) 91.8 Condenser (entering) air dry-bulb 91.6 temperature (Tcondenser, db) Registration Number: 110-F64210A5-0010-1-MECH25 Registration Date/Time: 07/28/2010 10:09 HERS Provider: CHEERS CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF4R-MECI3-25 Refrigerant Charge Verification - Standard Measurement Procedure age 3 of Site Address: I Enforcement Agency: Permit Number: 50-102 Avenida Vista Bonita,La Quinta,CA922531 City of La Quinla 110-00000658 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 Zone HVAC Calculate: Actual Temperature Split = 20.3 Tretum, db - Tsupply, db Target Temperature Split from Table 19.3 RA3.2-3 using Tret,m, wb and Tretum, db Calculate difference: Actual Temperature Split — Target Temperature Split = Passes if difference is between -4°F and +4°F or upon remeasurement, if between mass -4°F and -100°F Enter Pass or Aail note �ecessary i'.ac zQial Cooling Coil Airf ow is verified using one of the Note: Temperature Split Method Calculalion S1, if airflow measurement procedures spec fed in_Reference Residen,,, endix RA3.3. If cctual cooling coil airflow is �,, � ,-ppm-; measured the value must be equal to or greaterthana7he Calcu,,l�ated Minimum Airflow Requirement in the table below. al''Coolm Ca Calculated Minimum Airflow Re uirement CF Nome act ton X 300 cfm/ton 10(6e, System Name or Identification/Tag HVAC �. 11" Calculated Minimum Airflow Requirement (CFM) (, Measured Airflow using 1 procedures (CFM) Passes if measured airflow is greater than I I 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 fined orifice metering device systems System Name or Identification/Tag Zone HVAC Calculate: Actual Superheat = Tsuction — Teva orator sat Target Superheat from Table RA3.2-2 using Tretum 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 Registration Number: 110-F642IOA5-0010-1-MECH25 Registration Date/Time: 07/28/2010 10:09 HERS Provider: CHEERS CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5 Site Address: I Enforcement Agency: Permit Number: 50-102 Avenida Vista Bonita,La Quinta,CA922531 City of La Quinta 110-00000658 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 Zone HVAC Calculate: Actual Subcooling = 9.2 y Tcondwser, sat — Thquid .L^ Target Subcooling specified by 0 manufacturer 2'6 {deg F) Calculate difference: Actual Subcooling — Target Subcooling = -0.799999999999997 System passes if difference is between Pass -4°F and +40F Enter Pass or Fail �P{a Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expanston valve (EXV) systems. System Name or Identification/Tag ZoneHVAC Calculate: Actual Superheat 11 7 Tsuction —Teva orator, sat Enter allowable superheat range from3 2'6 {deg F) manufacturer's specifications (or use rang between 3°F and 26°F if manufacturees i" specification is not available)""' System passes if actual superheat is within`"` �P{a the allowable superheat range Enter Pass or Fail ss Registration Number: 110-F64210A5-0010-1-MECH25 Registration Date/Time: 07/28/2010 M09 HERS Provider: CHEERS CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-WCH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of Site Address: I Enforcement Agency: Permit Number: 50-102 Avenida Vista Bonita, La Quinta,CA922531 City of La Quints 110-00000658 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 Zone HVAC 1286936 HERS Provider Data Registry Information Sample Group # (if applicable): System meets all refrigerant charge and Pass N/A in a HERS sample group airflow requirements. Enter Pass or Fail HERS Rater Company Name: Anchors Aweigh Energy Responsible Rater's Name Responsible Rater's Signature DECLARATION STATEMENT • 1 certify under penalty of perjury, under the laws otffthe°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 d vice requir)ng HERS velification that is identified on this certificate (the installation) complies w`► h the applicablep�'req�t rqi"ieTnts'`in efe a jtesiwd retial Appenndi' ibEs RA2 and RA3 and the requirements specified on the Certificafe(s) of Comp iianceT' F-� a rovbyathe 10 21 enfUr m ret agency. • The information reported "applic "bl sectiones ofith6 stall ion rtifi: ) (' 6 ), sil ed and submitted by the person(s) responsible for the installation conf Crms to the regwrements specrlied on li.he Certificatl (s) of Compliance (CF -1 R) 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) Cavanaugh Electric & Air Conditioning Responsible Person's Name: CSLB License: Rod Cavanaugh 1286936 HERS Provider Data Registry Information Sample Group # (if applicable): P tested/verified dwelling not-tested/verified dwelling N/A in a HERS sample group HERS Rater Information HERS Rater Company Name: Anchors Aweigh Energy Responsible Rater's Name Responsible Rater's Signature Bruce Cheney Bruce Cheney(Signature on File) Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: CCN46564657 7/28/2010 Registration Number: 110-F64210A5-0010-1-MECH25 Registration Date/Time: 07/28/2010 10:09 HERS Provider: CHEERS