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PR17-8292
i �✓ _,._ CITY OF DIAMOND BAR DEPARTMIENT OF COMMUNITY" & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 Vic' PRESS 71— (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building jdi'amondbarca.gov JOB SITE ADDRESS 'f off' r` APN LOT TRACT OWNER � ADDRESS. CITY Dy� q ZIP JUn.TEL, APPLICANTTEL.�W ' CONTRACTOR ADDRESS �8ir CITY lN ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am Exempt from the Contractor's State License Law for the reasons) Indicated below by the checkmark(s), I have placed next to the applicable iteni [Section 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 fChapter 9) Commencing with Section 7000 of Division 3 of the Business and Professions Cade[ or that he or she is exemptfrom licensure and the basis for the alleged exemption Any violation of Section 7031.E by any appl€cantfar a permit subjectsthe applicant to a civil penalty of not more than five hundred dollars ($500). (_j I, as owner of the property, or my employees with wages as their sole compensation, will do (-) all of or O portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code, The Contractors' State License Law does not apply to an owner of property who, through emp€oyees' or personal effort, builds or Improves the property, provided that the Improvements are not intended or offered for sale, If however, the building or improvement Is sold within one year of completlor, the Owner -Builder will have the burden of proving that It was not built or Improved for the purpose of sale,), U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code', The Contractors' State Llcense Law does not apply to an owner of property who builds or improves thereon, and who contractsforthe projects with a licensed Contractor pursuantto the Contractors' State License Law.). U I am exempt from licensure under the Contractor's State License law for the following reason(s]: Date: Sign'. By my signature below I acknowledge that, exceptfor my personal residence in which I must have resided for at least one year prior to completion of the Improvements covered by this permit,l cannot legally sell a structure that I have built as an ownerhui€der If it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at the following Web site: httplwww,leginfo,ca,gov/caiaw,html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 0 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE CLADS Ni LIC. N0,'.°' _ EXP. DATE: 0 CONTRACTOR: WORKER'S COMPENSATION DELLA Al I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF TRE FOLLOWING DEC RATIONS: I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. I have and will maintain Worker's Compensation Insurance, as required by Sectlon 3700 of the Labor Cade, for the performance of the work for whlch this permit is Issued, My Worker's Compensation Insurance Carrier and PCIiCyNumber are: 1A V_ $ CARRIER i POLICY NUMBER THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $160 OR LESS), I certifythat In the performance of the work forwhlch this permit Is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation Laws of California. And agree that if I should become subject to the Worker's j Compensation provisions of Section 3760 of the Labor Code, I shall forthwith comply with those provisions, DATE: APPLICANTS i WARNING: Failure to secure Worker's Compensation coverage 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 at the compensation, i damages as provided for in section 3708 of the labor code, Interest, and attorney's fees. CONSTRUCTION LENDING AGENCY i l hereby aftlrm under penalty of perjury that there Is a Construction Lending Agency for the performance of the work for c which this permit Is Issued (Sec. 3097, Civ, C.). LENDER'S NAME: LENDER'S ADDRESS: - 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 j enter up he above-mentioned property for inspection urpose a PERMITTEE NAME (PRINT) L = SIGNATURE OF PERMITTEE DTE t APPLICATION DATE: P/C# l� SSUL DATE: 11 PERMIT# : 4a i r I TYPE CONST. OCC GROUP: �f Scope of Work' �m ES # DWEL. UNITS # STOR # BEDROOMS DESCRIPTION SQ. FT- FACTOR PSF ADJ. AREA/VALUATION SFWADD/REM Garage/Carport w Patio/Deck W LL Pool/Spa ZRe-Rocf Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE J a U U w J CD y z m w a d v z �i- U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: ' RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: PIC'. PAID BY! VALIDATION: RECEIPT #� PAID BY: r"a t;% d VALIDATION: WHITE --- Department Copy, YELLOW — Finance Copy, PINK --- Assessor Copy SETBACK/LETTER FOOTINGS FORMS SLAB ................... UG. PLUMBING UG. ELECTRICAL- UFER GROUND Sf:WER LATERAL MAIN WATER LINE SI'.VVFFR CLEANOUT ROOF SHEATHING H OOR SIA ATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING INSUI A"HON WAI. L INSULATION CEILING DRYWAI I LATH (PRE) LATH EXTERIOR _ LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RLI.EASE GAS METER RELEASE: SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL -- FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT, of OCCUPANCY WOND BAR )N RECORD 1R!CT ANL) F.LDCER SWITCII (/LAR COMMERCIAL HOOD T -BAR INTERCLFIER HOT MOP/SHOW[RPAN SEPTIC/CESSPOOL HERS REPORT FIFGEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOUSPA ROUGH PLUMBING ROUGH ELECTRICAL m ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP ...... .... FENCE / GATE/ ALARM FINAL POOL WALLS: _ WALL FOOTING/STEEL. WALL STEEL 1sT( ) 2ND( ) I IFF WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL 110. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL. HEALTH DEPT. FINAL INDUSTRIAL WASTE a d' d Yf O ry e-� U Q N U r- 211 m OQ CD O E 4 O O U O @ 0 O � 0 ai 0 a 0 o � 0 s 0 � a � o � w N m CD 0 m N Ul Q >- L: L w w > E L � w Z U LU c aq o bom ai a of u w U z a 0. 0 LLO w Q u u a r -i V `m O IV V IV A od C O C .0 v m CL LA O h C y L a _ w d 7 7 a m S d N t9 C u o0 .`l Z mCL N i p r' O � d V O � 'o � CD p u C m = 14 ci CLOEL LL cu y' 7 s m -4 L G cD � a+ (6 N L O N u Ln eQi •7 T a i rr aj d QJ � tij a s a O � L to u L 0 ch C 7 N G d -t 2 Q O •� u f6 u w �"'� us C N w o °dLn O t NN U (A co h0 u �y C Y a) O c C W oc a N r pp G — GJ CL O 'Ad a w -a m `o -Q y o ~ uwi V �+ �+ L.7 L J CL cry -. ++ -. (D N U L m '� .Q p � l0 V.;� CIO ho =C f° aci a v :�. 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O C Y Y U Y 0 N a N t6 0] � � N R i y u m 'C 5 N u ° � Y J y C -O C a � a t o m o ° _c U dfO .v = E a a m v- ° � a a a N c m in Q N J U'�—,, N o u N 0 ° O u _ u -O m a c i C C v 0 N 4J F Q o p u c0 V ° 0 rs O) U m OJ � o ' ° Q ) d a Q_ C C a Q O S. 3— oo a c a °_ ° a m v O N NY O y ° Y > u al O ° Eu v aj a 14 N M li d m M 0] � t h C C a E Ln O 0 V o v N .o O LD Ln cc a U U n acr) `o 0 V L Ul c� 0 O aO E o N a) v =5 on .L ui C > d ° m N > N Vl c -I C (1, m OO ° Er" a m m 0 E S — a 4 N ✓ -o w E -0 t U L Q .- w 1-; roc am u� L m LU io m i U + .. N m � N > O O d � O 2 .. v v N IZ O oj cc O L(1 N m N n O ci O LD O N O E F- C; i � C O 0 b 0 .y C n o a) > Y C hG 0 Q) Q L cr d' t ] cu C O � O Q o E co O m o ai 2 -o O per[ d v CD O O Q N w N p O C: o � Q ? u W `a a L a v W C w O C N � IL [6 a s u CERTIFICATE OF INSTALLATION CF211-MCH-20-1i Duct Leakage Diagnostic Test (Page 1 of 3) Project Name: TRIVEDI Enforcement Agency: Diamond Bar (City of) Permit Number: PR17-8292 Dwelling Address: 972 SUMMITRIDGE DR City: Diamond Bar Zip Code: 91765 A. System Information 01 Space Conditioning System Identification or Name HVAC1 02 Space Conditioning System Location or Area Served 2155 03 Building Type from CF -1R Single family 04 Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Credit from CF1R? No, credit is not taken 05 Verified Low Leakage Air Handling Unit (VLLAHU) Credit from CF1R? No, credit is not taken 06 Duct System Compliance Category Alteration MCH -god - Complete Replacement or Altered Duct System B. Duct Leakage Diagnostic Test 01 Condenser Nominal Cooling Capacity (ton) 5 02 Heating Capacity (kBtu/h) 89 03 Conditioned Floor Area served by this HVAC system (ft)) 2155 04 Duct Leakage Test Conditions Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor 1 0.15 07 Air Handling Unit Airflow (AHUAirflow) Determination Method Cooling system method 08 Measured AHUAirflow This field or section is not applicable 09 Calculated Target Aliowable Duct Leakage (cfm) 300 10 Actual Duct Leakage Rate from Leakage Test Measurement (cfm) 266 11 Compliance Statement: System passes leakage test Registration Number: Registration date/Time: 2017-07-23 23:48:52 HERS Provider: CHEERS 417-A020102464A-004-000-M20000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-23 23:57:32 2016 Residential Compliance Schema Version: rev 03/16 CERTIFICATE OF INSTALLATION CF2R-MCH-20-H Duct Leakage Diagnostic Test (Page 2 of 3) C. Additional Requirements for Compliance 01 System was tested in its normal operation condition. No temporary taping allowed. Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage 02 testing. OA ducts used for Central Fan Integrated (CFI} Indoor Air Quality ventilation systems, or Central' Fan Ventilation Coofing Systems, that utilize dampers that open only when OA is required and automatical#y close when OA is not required, may configure the OA damper to the closed position during duct leakage testing. 03 If a complete replacement, all supply and return register boots were sealed to the drywall. 04 Building cavities were not used as plenums or platform returns in lieu of ducts. 05 If cloth backed tape was used it was covered with Mastic and draw bands. 06 All connection points between the air handler and the supply and return plenums are completely sealed. If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the requirements 07 of Reference Residential Appendix RA3.1.4.3.6. Systems that compfy using smoke test shall not be included in sample groups for HERS verification compliance. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: Registration Date/Time: 2017-07-23 23:48:52 HERS Provider: CHEERS 417-A020102464A-004-000-M2000DA-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-23 23:57:32 2016 Residential Compliance Schema Version: rev 03/16 CERTIFICATE OF INSTALLATION Duct Leakage Diagnostic Test Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Jim McEligot Company: RiRhtime Home Services 965 Ridge lake Blvd, Suite 201 City/state/41p: Memphis TN 38120 Responsible Person's Declaration statement Documentation Author Signature: JL— M auglau Signature Date: 2017-07-23 CEA/ HE R5 Certification Identification (if a Phone: 951-276-9744 CF2R-MCH-20-H (Page 3 of 3) I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am either: a) a responsible person eligible under Division 3 of the Business and Professions Cade in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement, or bi 1 am an authorized representative of the responsible person and attest to the declarations in this statement on the responsible person's behalf. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations and the installation conforms to the requirements given on the Certificate of Compliance, plans, and specifications approved by the enforcement agency. 4. 1 understand that a HERS raterwill checkthe installation to verify compliance and if such checking determines the installation fails to comply, [ am required to offer any necessary corrective action at no charge to the building owner, S. I will ensure that a registered copy of this Certificate of installation shall he 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 registered copy of this Certificate of Installation is required to be included with the documentation the builder providesto the building owner at occupancy. Responsible Builder/Installer Name: Jim McEligot Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Rightime Home Services Address: 965 Ridge lake Blvd, Suite 201 City/State/zip: Memphis TN 38120 Third Party Quality Control Program (TPQCP) Status: Responsible Builder/Installer Signature: J%wv M6EUVat Position With Company ( Contractor/Installer CSLB License: 765074 Phone: 951-276-9744 Name of TPQCP (if applica Date Signed: 2017-07-23 Digitally signed by CHEERS"". This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: Registration Date/Time: 2017-07-23 23:48:52 HERS Provider: CHEERS 417-A020102464A-004-000-M 20004A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-23 23:57:32 2016 Residential Compliance Schema Version: rev 03/16 CERTIFICATE OF INSTALLATION CF2R-MCH-23-H Space Conditioning System Airflow Rate (Page 1 of 3) Project Name: TRIVEDI Enforcement Agency: Diamond Bar (City of) Permit Number: PR17-8292 Dwelling Address: 972 SUMMITRIDGE DR City: Diamond Bar Zip Code: 91765 A. Ducted Cooling System Information 01 System Identification or Name HVACI 02 System Location or Area Served 2155 03 System Installation Type Alteration 04 Nominal Cooling Capacity (tons) of Condenser 5 05 Condenser Speed Type This field or section is not applicable 06 Cooling System Zonal Control Type This field or section is not applicable 07 Central I=an Integrated (CFI) Ventilation System Status Not a CFI system 08 System Bypass Duct Status No Bypass Duct 09 Date of System Airflow Rate Measurement 2017-07-21 10 Airflow Rate Protocol Utilized RA33 procedures for airflow rate measurement B. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently Installed Static Pressure Probe (PSPP) in the Supply Plenum. Procedures for installing HSPP or PSPP are specified in RA3.3.1.1. 01 l Method Used to Demonstrate Compliance with theI HSPP installed and labeled consistent with Figure RA3.3-1 HSPP/PSPP Requirement C. Airflow Rate Measurement Apparatus and Procedure Information Instrument Specifications are given in RA3,3.1.1, and system airflow rate measurement apparatus information is given in RA3.3.2. Airflow Rate Measurement Type used for this airflow rate Fan flowmeter according to procedure in RA3.3.3.1.1 01 verification. 02 Manufacturer of Airfiow Measurement Apparatus minneapolis duct blaster 03 Model number of Airflow Measurement Apparatus DG700 Certification Status of the Airflow Measurement Apparatus Certified by Manufacturer and listed on CEC Website at 04 Accuracy http://www.energy.ca.gov/title24/equipment_cert/ama_fas /index.html Registration Number: 417-A020102464A-004-000-M23000A-0000 CA Building Energy Efficiency Standards 2016 Residential Compliance Registration Date/Time: 2017-07-23 23:55:50 HERS Provider: CHEERS Report Version: 2016.1.006 Report Generated: 2017-07-24 00:04:31 Schema Version: rev 10/16 CERTIFICATE OF INSTALLATION CF2R-MCH-23-H Space Conditioning System Airflow Rate (Page 2 of 3) - MCH -23a Forced Air System Airflow Rate Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed Compressor D. Forced Air System Airflow Rate Measurement The procedures for System Airflow Rate Verification are specified in Reference Residential Appendix RA3.3. 01 Required Minimum System Airfiow Rate (cfm/ton) 300 02 Required Minimum System Airflow Target (cfm) 1500 03 Actual System Airflow Rate Measurement (cfm) 1610 04 Compliance Statement: System airflow rate complies E. Additional Requirements 01 Air filters that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in the system during system air flow rate measurement identified on this Certificate of Installation. The airflow rate measurement apparatus used to perform the airflow rate measurement identified on this Certificate of 02 Installation was calibrated in accordance with the apparatus manufacturer's specifications and conforms to the instrumentation specifications given in RA3.3.1. A visual inspection shall confirm that bypass ducts that deliver conditioned supply air directly to the space conditioning 03 system return duct airflow are not used on newly constructed zonally controlled systems unless the Performance Certificate of Compliance indicates an allowance for use of a bypass duct. When a bypass duct is accounted for on the Performance Certificate of Compf€ante, the airflow rate shall conform to the specifications listed on the Certificate of Compliance. 04 All registers were fully open during the diagnostic test. 05 System fan was set at maximum speed during the diagnostic test. 06 If fresh air duct is part of the HVAC system it was not closed during the diagnostic test. 07 Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value. Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan 08 efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air handler fan speed. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: Registration Date/Time: 2017-07-23 23:55:50 HERS Provider: CHEERS 417-A020102464A-004-000-M 23000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:04:31 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF INSTALLATION CF2R-MCH-23-H Space Conditioning System Airflow Rate (Page 3 of 3) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Jim McEligot A—M`'Er' '- Company: Signature Date: Rightime Home Services 2017-07-23 Address: CEA/ HERS Certification Identification (if applicable): 965 Ridge lake Blvd, Suite 201 City/State/Zip: Phone: Memphis TN 38120 1951-276-9744 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am either: a) a responsible person eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement, or b) I am an authorized representative of the responsible person and attest to the declarations in this statement on the responsible person's behalf. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conformsto all applicable codes and regulations and the installation conforms to the requirements given on the Certificate of Compliance, plans, and specifications approved by the enforcement agency. 4. 1 understand that a HERS rater will check the installation to verify compliance and if such checking determines the installation fails to comply, I am required to offer any necessary corrective action at no charge to the building owner. 5. 1 will ensure that a registered copy of this Certificate of installation 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 registered copy cf this Certificate of Installation is required to be included with the documentation the builder providesto the building owner at occupancy. Responsible Builder/Installer Name: Responsible Builder/Installer Signature: Jim McEligot J'M"M`EL`90V Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): Builder/owner} Contractor/Installer Rightime Home Services Address: CSLB License: 965 Ridge lake Blvd, Suite 201 765074 City/State/Zip: Phone: Date Signed: 12017-07-23 Memphis TN 38120 951-276-9744 Third Party Quality Control Program (TPQCP) Status: Name of TPQCP (if applicable): Digitally signed by CHEERS—. This digital signature is provided in order to secure the content ofthis registered document, and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: Registration Date/Time: 2017-07-23 23:55:50 HERS Provider: CHEERS 417-A020102464A-004-000-M23000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:04:31 2016 Residential Compliance Schema Version: rev 10/16 CF2R-MCH-25-H CERTIFICATE OF INSTALLATION Refrigerant Charge Verification (Page 1 of 4) Project Name: TRIVEDI Enforcement Agency: Diamond Permit Number: PR17-8292 Bar (City of) Dwelling Address: 972 SUMMITRIDGE DR I City: Diamond Bar I Zip Code: 91765 A. System Information Each system requiring refrigerant charge verification will be documented on a separate certificate. Is the system of a type that the minimum airflow can be stm Identification or Name 12 verified using an approved measurement procedure (RA3.3 402Sys,tpem Location or Area Served used to verify system airflow rate requirements. Is the system of a type that approved refrigeraqre odenser (or package unit) Make or Brand 04 Condenser (or package unit) Model Number i 05 Nominal Cooling Capacity (tons) of Condenser 06 Condenser (or package unit) Serial Number Date of Refrigerant Charge Verification for this7-21 07 Refrigerant Type 08 Other Refrigerant Type (if applicable) This field or section is not applicable greater than 55 degF) Liquid Line Filter Drier Installed According to Manufacturers Yes 09 ecifications (if applicable) 16 4Fauit stem Installation Type Alteration HERS Verification Compliance Requirement Status Indicator Display (FID) Status (Note: Even systems with This system does not have a FID device installed Registration Number: Registration FID must have refrigerant charge verified by installer). 417-A420102464A-004-000-M25000A-0004 CA Building Energy Efficiency Standards Report Version: Is the system of a type that the minimum airflow can be Yes, this is a ducted system and one of the system airflow in RA3.3 or RA3.3.3 can be 12 verified using an approved measurement procedure (RA3.3 rate measurement procedures or RA3.3.3)? used to verify system airflow rate requirements. Is the system of a type that approved refrigeraqre of the Refrigerant charge verification procedures verification procedures can be used to verify cA3.2.2 or RA1 is applicable to this system and can be i3 with the refrigerant charge verification requireo verify compliance temperatures are >= 55°F (RA3.2.2, or RA1)? 14 Date of Refrigerant Charge Verification for this7-21 Refrigerant charge verification method used. Subcooling (outdoor temperature must be equal to or 15 greater than 55 degF) Person who performed the Refrigerant Charge Verification HERS rater 16 reported on this Certificate of Installation 17 HERS Verification Compliance Requirement Status System does not qualify for group sampling Registration Number: Registration Date/Time: 2017-07-23 23:56:23 HERS Provider: CHEERS 417-A420102464A-004-000-M25000A-0004 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017 07-24 00:05:04 2016 Residential Compliance Schema Version: rev 4/7/2017 CERTIFICATE OF INSTALLATION Refrigerant Charge Verification MCH -25b - Refrigerant Charge Verification - Subcooling Method B. Metering Device Verification Subcooling Method can only be used on systems that have a variable metering device. 01 + Refrigerant metering device 02 I Subcooling Method applicability status CF2R-MCH-25-H Thermostatic Expansion Valve (TXV) Subcooling Method is applicable to this system. C. Instrument Calibration Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2 01 Date of Digital Refrigerant Gauge Calibration 2017-07-01 02 Date of Digital Thermocouple Calibration 2017-07-01 03 Digital Refrigerant Gauge Calibration Status Calibration is current 04 Digital Thermocouple Calibration Status Calibration is current D. Measurement Access Hole (MAH) Verification Procedures for installing MAN are specified in Reference Residential Appendix RA3.2,23 (Page 2 of 4) 01 Method Used to Demonstrate Compliance with theI MAH installed and labeled consistent with Figure 3.2-1 Measurement Access Hole {MAH) Requirement E. Minimum System Airflow Rate Verification Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.3.3. 01 1 Minimum Required System Airflow Rate (cfm) 02 System Airflow Rate Verification Status 1500 System complies with minimum airflow rate requirements Registration [Number: Registration Date/Time: 2017-07-23 23:56:23 HERS Provider: CHEERS 417-A020102464A-004-000-M25000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:05:04 2016 Residential Compliance Schema Version: rev 4/7/2017 CERTIFICATE OF INSTALLATION CF2R-MCH-25-H Refrigerant Charge Verification (Page 3 of 4) F. Data Collection and Calculations Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in Reference Residential Appendix RA3.2.2. 04 Measured Liquid Line Temperature (Tiiquid) (°F) 81.2 05 Measured Liquid Line Pressure (Piiq.id) (psig) 286.4 Evaporator Saturation Temperature (Tevaporator, sat) from Condenser Saturation Temperature (Tcondenser, sat) from 92.5 06 Digital Gauge or P -T Table using Line F05 (°F) 04 07 Measured Subcooling (Line F06 - Lilne F04 (°F) 11.3 08 Target Subcooling from Manufacturer (°F) 11 (inclusive) System complies with Subcooling Method - Must also pass 09 Compliance Statement: metering device verification, next section G. Metering Device Verification Procedures for the verification of proper metering device operation are specified in RA3.2.2.6.2 01 Measured Suction Line Temperature (Tsuction) (°F) 63.2 02 Measured Suction Line Pressure (Psuction) (psig) 116.1 Evaporator Saturation Temperature (Tevaporator, sat) from 38.7 03 Digital Gauge or P -T Table using Line G02 (°F) 04 Measured Superheat (Line G01- Line G03) (°F) 24.5 Measured Superheat (Line G04) is between 4°F and 25°F Passes CEC requirement 05 (inclusive) Measured Superheat (Line G04) is within Manufacturer's Yes, documentation to be provided upon request 06 Specifications ( if known) 07 Compliance Statement Metering device verification passes MCH -25d - Refrigeration Charge Verification - Fault Indicator Display (FID) H. Fault Indicator Display This section does not apply to this project. I. Fault Indicator Display Additional Requirements This section does not apply to this project. Registration Number: Registration Date/Time: 2017-07-23 23:56:23 HERS Provider: CHEERS 417-A020102464A-004-040-M 25000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:05:04 2016 Residential Compliance Schema Version: rev 4/7/2017 CERTIFICATE OF INSTALLATION CF2R-MCH-25-H Refrigerant Charge Verification (Page 4 of 4) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Jim McEligot JL4MMCEU4ot Company: Signature Date: Rightime Home Services 2017-07-23 Address: CEA/ HERS Certification Identification (if applicable): 965 Ridge lake Blvd, Suite 201 City/State/Zip: Phone: Memphis TIN 38120 951-276-9744 Responsible Person's Declaration statement I certify the following under penalty of perjury, underthe laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am either: a) a responsible person eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility forthe system design, construction, or installation of features, materials, components, or manufactured devices forthe scope of work identified on this Certificate of Installation and attest to the declarations In this statement, or b) I am an authorized representative of the responsible person and attest to the declarations in this statement on the responsible person's behalf, 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations and the installation conforms to the requirements given on the Certificate of Compliance, plans, and specifications approved by the enforcement agency. 4. 1 understand that a HERS raterwill check the installation to verify compliance and if such checking determines the installation fails to comply, I am required to offer any necessary corrective action at no charge to the building owner. 5. 1 will ensure that a registered copy ofthis Certificate of Installation 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 registered copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name: Responsible Builder/Installer Signature: Jim McEligot JIa4VM-EUY0c" Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): Builder/owner) Contractor/Installer Rightime Home Services Address: CSLB license: 965 Ridge lake Blvd, Suite 201 765074 City/State/Zip: Phone: Date Signed: Memphis TN 38120 951-276-9744 2017-07-23 Third Party Quality Control Program (TPQCP) Status: Name of TPQCP (if applicable): Digitally signed by CHEERST'". This digital signature is provided in order to secure the content of this registered document,' and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: Registration Date/Time: 2017-07-23 23:56:23 HERS Provider: CHEERS 417-A020102464A-004000-M 25000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:05:04 2016 Residential Compliance Schema Version: rev 4/7/2017 CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct leakage Diagnostic Test (Page 1 of 3) Project Name: TRIVEDI Enforcement Agency: Diamond Bar (City of) Permit Number: PR17-8292 Dwelling Address: 972 SUMMITRIDGE DR City: Diamond Bar Zip Code: 91765 A. System Information 01 Space Conditioning System Identification or Name HVAC1 02 Space Conditioning System Location or Area Served 2155 03 Building Type from CF -113 Single family 04 Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Credit from CF1R? No, credit is not taken 05 Verified Low Leakage Air Handling Unit Credit from CF1R? No, credit is not taken 06 Duct System Compliance Category Alteration MCH -20d - Complete Replacement or Altered Duct System . B. Duct Leakage Diagnostic Test 01 Condenser Nominal Cooling Capacity (ton) 5 02 Heating Capacity (kBtu/h) 89 03 Conditioned Floor Area served by this HVAC system (ft2) 2155 04 Duct Leakage Test Conditions Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor 0.15 07 Air Handling Unit Airflow (AHUAirflow) Determination Method Cooling system method 08 Measured AHUAirflow This field or section is not applicable 09 Calculated Target Allowable Duct Leakage Rate (cfm) 300 10 Actual Duct Leakage Rate from Leakage Test Measurement (cfm) 266 11 Compliance Statement: System passes leakage test 12 Notes: Registration Number: Registration Date/Time: 2017-07-23 23:58:36 HERS Provider: CHEERS 417-A020102464A-004-000-M 2000CA-M 20A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:07:16 2016 Residential Compliance Schema Version: rev 03/16 CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 2 of 3) C. Additional Requirements for Compliance 01 System was tested in its normal operation condition. No temporary taping allowed. 02 Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required, may configure the OA damper to the closed position during duct leakage testing. 03 If a complete replacement, all supply and return register boots were sealed to the drywall. 04 Building cavities were not used as plenums or platform returns in lieu of ducts. 05 If cloth backed tape was used it was covered with Mastic and draw bands. 06 All connection points between the air handler and the supply and return plenums are completely sealed. 07 If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the requirements of Reference Residential Appendix RA3.1.4.3.6. Systems that comply using smoke test shall not be included in sample groups for HERS verification compliance. 08 Verification Status: Pass - all applicable requirements are met 09 Correction Notes: The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met unless otherwise noted in the Verification Status and the Corrections Notes in this table. D. Determination of HERS Verification Compliance All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order for this Certificate of Verification as a whole to be determined to be in compliance. 01 1 Complies: All specified verification protocol requirements on this document are met. f Registration Number: Registration Date/Time: 2017-07-23 23:58:36 HERS Provider: CHEERS 417-A020102464A-004-000-M20000A-M 20A CA Building Energy Efficiency Standards Report Version: 2015.1.006 Report Generated: 2017-07-24 00:07:16 2016 Residential Compliance Schema Version: rev 03/16 CERTIFICATE OF VERIFICATION Duct leakage Diagnostic Test Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Joe Salas Company: JC HERS Services, LLC Address: 11390 Doverwood Drive City/state/Zip: Riverside CA 92505 Responsible Person's Declaration statement Documentation Author Signature: JooSata4, Date Signed: 2017-07-23 CEA/ HERS Certification Identification (if applicable): RCN13122 Phone: 951-217-0805 CF3R-MCH-20-H (Page 3 of 3) I certify the following under penalty of perjury, under the laws ofthe State of California: 1. The information provided on this Certificate of Verification is true and correct. 2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsibke rater). 3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements specified on the Certificate of Compliance for the building approved by the enforcement agency. 4. The information reported on applicable sections of the Certificate(s) of Installation (Cr211) signed and submitted by the person(s) responsible for the construction or installation conforms to the requirements specified on the Certificate(s) of Compliance (CF1R) approved by the enforcement agency. S. I will ensure that a registered copy of this Certificate of Verification shall be posted, or made available with the building permits) issued for the building, and made available to the enforcement agency for all appkicable inspections. I understand that a registered copy ofthis Certificate of Verification is required to be included with the documentation the builder provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General Contractor, or Budder/owner): Rightime Home Services Responsible Builder or Installer Name: Jim McEhgot HERS Provider Data Registry Information Sample Group Number (if applicable): HERS Rater Information HERS Rater Company Name: JC HERS Services, LLC Responsible Rater Name: Joe Salas Responsible Rater Certification Number w/ this HERS Provider: RCN13122 CSLB License: 765074 Dwelling Test Status in Sample Group (if applicable) N/A Responsible Rater Signature: JbVsa.%ay Date Signed: 2017-07-23 Digitally signed by CHEERS". This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: Registration Date/Time: 2017-07-23 23:58:36 HERS Provider: CHEERS 417-A020102464A-004-000-M 20000A -M 20A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:07:16 2016 Residential Compliance Schema Version: rev 03/16 CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 1 of 4) Project Name: TRIVEDI Enforcement Agency: Diamond Permit Number: PR17-8292 03 Bar (City of) Alteration Dwelling Address: 972 SUMMITRIDGE DR City: Diamond Bar Zip Code: 91765 A. Ducted Cooling System Information 01 System Identification or Name HVAC1 02 System Location or Area Served 2155 03 System Installation Type Alteration 04 Nominal Cooling Capacity (tons) of Condenser 5 05 Condenser Speed Type This field or section is not applicable 06 Cooling System Zonal Control Type This field or section is not applicable 07 08 Central Fan Integrated (CFI) Ventilation System Status System Bypass Duct Status Not a CFI system No Bypass Duct 09 Date of System Airflow Rate Measurement 2017-07-21 [HtElow Rate Protocol Utilized RA3.3 procedures for airflow rate measurement B. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP) in the Supply Plenum. Procedures for installing HSPP or PSPP are specified in RA3.3.1.1. 01 Method Used to Demonstrate Compliance with the HSPP installed and labeled consistent with Figure RA3.3-1 HSPP/PSPP Requirement I 1 C. Airflow Rate Measurement Apparatus and Procedure Information Instrument Specifications are given in RA3.3.1.1, and system airflow rate measurement apparatus information is given in RA3.3.2. Airflow Rate Measurement Type used for this airflow rate Fan Flowmeter according to procedure in RA3.3.3.1.1 01 verification. 02 Manufacturer of Airflow Measurement Apparatus minneapolis duct blaster 03 Model number of Airflow Measurement Apparatus DG700 Certification Status of the Airflow Measurement Apparatus Certified by Manufacturer and listed on CEC Website at 04 Accuracy htLp://www.energy.ca.gov/title24/equipment—cert/ama fas /index.html Registration Number: Registration Date/Time: 2017-07-23 23:59:13 HERS Provider: CHEERS 417-AO70142464A-404-000-M 23000A -M 23A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:07:53 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION Space Conditioning System Airflow Rate CF3R-MCH-23-H (Page 2 of 4) MCH -23a Forced Air System Airflow Rate Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed Compressor E. Additional Requirements 01 Air filters that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in the system during system air flow rate measurement identified on this Certificate of Verification. The airflow rate measurement apparatus used to perform the airflow rate measurement identified on this Certificate of 02 Verification was calibrated in accordance with the apparatus manufacturer's specifications and conforms to the instrumentation specifications given in RA3.3.1. A visual inspection shall confirm that bypass ducts that deliver conditioned supply air directly to the space conditioning 03 system return duct airflow are not used on newly constructed zonally controlled systems unless the Performance Certificate of Compliance indicates an allowance for use of a bypass duct. When a bypass duct is accounted for on the Performance Certificate of Compliance, the airflow rate shall conform to the specifications listed on the Certificate of Compliance. 04 All registers were fully open during the diagnostic test. 05 System fan was set at maximum speed during the diagnostic test. 06 If fresh air duct is part of the HVAC system it was not closed during the diagnostic test. 07 Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value. Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan 08 efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air handler fan speed. 09 Verification Status: Pass - all applicable requirements are met 10 Correction Notes: The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met unless otherwise noted in the Verification Status and the Corrections Notes in this table Registration Number: Registration Date/Time: 2017-07-23 23:59:13 HERS Provider: CHEERS 417-A020102464A-004-000-M 23000A -M 23A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:07:53 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 3 of 4) F. Determination of HERS Verification Compliance. All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order for this Certificate of Verification as a whole to be determined to be in compliance. 01 1 Complies: All specified verification protocol requirements on this document are met. Registration Number: Registration Date/Time: 2017-07-23 23:59:13 HERS Provider: CHEERS 417-A020102454A-004-000-M 23000A -M 23A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:07:53 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION MR -MCH -23-1-1 Space Conditioning System Airflow Rate (Page 4 of 4) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Joe Salas .Taps"Iaa Company: Date Signed: JC HERS Services, LLC 2017-07-23 Address: CEA/ HERS Certification Identification (if applicable): 11390 Doverwood Drive RCN13122 City/State/Zip: Phone: Riverside CA 92505 951-217-0805 Responsible Person's Declaration statement I certifythe following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Verification is true and correct. 2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater). 3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements specified on the Certificate of Compliance for the building approved by the enforcement agency. 4. The information reported on applicable sections of the Certificate(s) of Installation (CFZR) signed and submitted by the person(s) responsible for the construction or installation conforms to the requirements specified on the Certificate(s) of Compliance (MR) approved by the enforcement agency. 5. 1 will ensure that a registered copy of this Certificate of Verification shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all appE[cable inspections. I understand that a registered copy of this Certificate of Verification is required to be included with the documentation the builder provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General Contractor, or Builder/owner): Rightime Home Services Responsible Builder or Enstaller Name: CSLB License: Jim McEligot 765074 HERS Provider Data Registry Information Sample Group Number (if applicable}: Dwelling Test Status in Sample Group (if applicable) N/A HERS Rater Information HERS Rater Company Name: JC HERS Services, LLC Responsible Rater Name: Responsible Rater Signature: Joe Salas J&e�Sat" Responsible Rater Certification Number w/ this HERS Provider: Date Signed: RCN13122 2017-07-23 Digitally signed by CHEERS—. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: Registration Date/Time: 2017-07-23 23:59:13 HERS Provider: CHEERS 417-AO20102464A-004-000-M230ODA- M23A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:07:53 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION CF3R-MCH-25-H Refrigerant Charge Verification (Page I of 4) Project Name: TRIVEDI Enforcement Agency: Diamond Bar (City of) Permit Number: PR17-8292 Dwelling Address: 972 SUMMITRIDGE DR City: Diamond Bar Zip Code: 91765 A. System Information HERS Rater to field -verify all system information, discrepancies to be noted by overwriting entry. 01 System Identification or Name HVAC1 02 System Location or Area Served 2155 03 Condenser (or package unit) make or brand RHEEM 04 Condenser (or package unit) model number RA1460AJlNA 05 Nominal Cooling Capacity (tons) of Condenser 5 06 Condenser (or package unit) serial number W251733925 07 Refrigerant Type R -410A 08 Other Refrigerant Type (if applicable) This field or section is not applicable Liquid Line Filter Drier Installed According to Manufacturers Yes 09 Specifications (if applicable) 10 System Installation Type Alteration Fault Indicator Display (FID) Status (Note: Even systems with This system does not have a FID device installed 11 a FID must have refrigerant charge verified by installer) Is the system of a type that the minimum airflow can be Yes, this is a ducted system and one of the system airflow 12 verified using an approved measurement procedure (RA3.3 rate measurement procedures in RA3.3 or RA3.3.3 can be or RA33.3)? used to verify system airflow rate requirements. Is the system of a type that approved refrigerant charge Yes, one of the Refrigerant charge verification procedures verification procedures can be used to verify compliance from RA3.2.2 or RA1 is applicable to this system and can be 13 with the refrigerant charge verification requirements when used to verify compliance temperatures are >= 55°F (RA3.2.2, or RAI)? 14 Date of Refrigerant Charge Verification for this system 2017-07-21 Refrigerant charge verification method used. Subcooling (outdoor temperature must be equal to or 15 greater than 55 degF) Person who performed the Refrigerant Charge Verification HERS rater 16 reported on this Certificate of Installation 17 HERS Verification Compliance Requirement Status System does not qualify for group sampling 18 Refrigerant charge verification method used by HERS Rater. Subcooling Registration Number: Registration Date/Time: 2017-07-24 00:00:14 HERS Provider: CHEERS 417-A020102464A-004-000-M250DOA-M 25A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:08:55 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION CF3R-MCH-25-H Refrigerant Charge Verification (Page 2 of 4) MCH -25b - Refrigerant Charge Verification - Subcooling Method B. Metering Device Verification HERS Rater is required to visually field verify all information from CF2R. Subcooling Method can only be used on systems that have a variable metering device. 01 Refrigerant metering device Thermostatic Expansion Valve (TXV) 02 Subcooling Method applicability status Subcooling Method is applicable to this system. C. Instrument Calibration HERS Raters are required to calibrate their diagnostic tools. Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2 01 Date of Digital Refrigerant Gauge Calibration 2017-07-01 02 Date of Dfgital Thermocouple Calibration 2017-07-01 03 1 Digital Refrigerant Gauge Calibration Status Calibration is current 04 Digital Thermocouple Calibration Status Calibration is current D. Measurement Access Hole (MAH) Verification HERS Raters are required to visually field verify MAH. Procedures for installing MAH are specified in Reference Residential Appendix RA3.2.2.3 1 01 I Method Used to Demonstrate Compliance with the MAN installed and labeled consistent with Figure 3.2-1 IEI Measurement Access Hole (MAH) Requirement E. Minimum System Airflow Rate Verification Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.3.3. 01 Minimum Required System Airflow Rate (cfm) 1500 02 System Airflow Rate Verification Status System complies with minimum airflow rate requirements F. Data Collection and Calculations HERS Rater must independently collect all data in this section. Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2 01 Lowest Return Air Dry Bulb Temperature that Occurred 70 During the Refrigerant Charge Verification Procedure ('F) 02 Measured Condenser Air Entering Dry -Bulb Temperature 87.6 (Tcondenser,db) Registration Number: Registration Date/Time: 2017-07-24 00:00:14 HERS Provider: CHEERS 417-A020102464A-004-000-M 25000A -M 25A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:08:55 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION CF3R-MCH-25-H Refrigerant Charge Verification (Page 3 of 4) F. Data Collection and Calculations HERS Rater must independently collect all data in this section. Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2 03 Outdoor Temperature Qualification Status Outdoor temperature is within range for using Subcooling 02 Measured Suction Line Pressure (P5uctfon) (psig) refrigerant charge verification method 04 Measured Liquid Line Temperature (Tilqu d) ('F) 81.2 05 Measured Liquid Line Pressure (Pliquld) (prig) 286.4 06 Condenser Saturation Temperature (Tcondenser, Sar) from 92.5 05 Digital Gauge or P -T Table using Line F05 (°F) Passes CEC requirement 07 Measured Subcooling (Line F06 - Lilne F04 (°F) 11.3 08 Target Subcooling from Manufacturer (°F) 11 09 Compliance Statement: System complies with Subcooling Method - Must also pass 07 Compliance Statement: metering device verification, next section G. Metering Device Verification HERS Rater must independently collect all data in this section, Procedures for the verification of proper metering device operation are specified in RA3.2.2.6.2 01 Measured Suction Line Temperature (Tsuctfon) (°F) 63.2 02 Measured Suction Line Pressure (P5uctfon) (psig) 116.1 03 Evaporator Saturation Temperature (Tevapoiatur, sat) from 38.7 Digital Gauge or P -T Table using Line G02 (°F) 04 Measured Superheat (Line G01- Line G03) (°F) 24.5 05 Measured Superheat (Line G04) is between 3°F and 26°F Passes CEC requirement (inclusive) 06 Measured Superheat (Line G04) is within Manufacturer's Yes, documentation to be provided upon request Specifications ( if known) 07 Compliance Statement: Metering device verification passes H. Determination of HERS Verification Compliance All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order for this Certificate of Verification as a whole to be determined to be in compliance. 01 1 Complies: All specified verification protocol requirements on this document are met. Registration Number: 417-A020102464A-004-000-M 25000A -M 25A CA Building Energy Efficiency Standards 2016 Residential Compliance Registration Date/Time: 2017-07-24 00:00:14 HERS Provider: CHEERS Report Version: 2016.1.006 Report Generated: 2017-07-24 00:08:55 Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION CF3R-MCH-25-H Refrigerant Charge Verification (Page 4 of 4) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Joe Salas Joasa cu, Company: Date Signed: JC HERS Services, LLC 2017-07-24 Address: CEA/ HERS Certification Identification (if applicable): 11390 Doverwood Drive RCN13122 City/State/Zip: Phone: Riverside CA 92505 951-217-0805 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Verification is true and correct. 2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater). 3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements specified on the Certificate of Compliance for the building approved by the enforcement agency. 4. The information reported on applicable sections of the Certificate(s) of Installation (CF2R) signed and submitted by the person(s) responsible for the construction or installation conforms to the requirements specified ori the Certificate(s) of Compliance (Cr1R) approved by the enforcement agency. S. I will ensure that a registered copy of this Certificate of Verification shall be posted, or made available with the building permits) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Verification is required to be included with the documentation the builder provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General Contractor, or Builder/Owner): Rightime Home Services Responsible Builder or Installer Name: CSLB License: Jim McEligot 765074 HERS Provider Data Registry Information Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) N/A HERS Rater Information HERS Rater Company Name: JC HERS Services, LLC Responsible Rater Name: Responsible Rater Signature: Joe Salas Joe.Sa Ak Responsible Rater Certification Number w/ this HERS Provider: Date Signed: RCN 13122 2017-07-24 Digitally signed by CHEERSI". This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: Registration Date/Time: 2017-07-24 00:00:14 HERS Provider: CHEERS 417 -AO 2 0102 464A-004-000- M 25000A- M 25 A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-24 00:08:55 2016 Residential Compliance Schema Version: rev 10/16