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HomeMy WebLinkAboutPR17-0813CITY OF DIAMOND BAR DEPAR'T'MENT OF COMMUNITY & DEVELOPMENT SERVICES f 21810 Copley Drive, Diamond Bar, CA 91765 h PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com buiidingd'iamondbarca.gov :2" J APPLICATION DATE:ZI/oF P/C# cz"( ( i a JOB SITE ADDRESS o APN LOT TRACT o ,L -u OWNERCIO w ADDRESS OL_ Uo CITY `,r-ziP o APPLICANT TEL. Q CONTRACTOR_ ADDRESS f" �C_Itr CD CITY n �'3a,. ZIP &E L. rw. n ARCH/ENG/ z DESIGNER cm ADDRESS m CITY ZIP TEL, 4 OWNER -BUILDER DECLARATION C) I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) oindicated below by the checkmark(s), I have placed next to the applicable items) [Section 70315, Business and z Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, et repair, any structure, prior to its issuance, also requires the applicant for the permit to file a signed statementthal he or she is licensed pursuant to the provisions oithe Contractor's State License law (Chapter 9) Commencing with Section cn 7000 of Division 3 of the Business and Professions Code] orthat he or she is exempt from licensure and the basis for SO the alleged exemption. Any violation of Section 7031.5 by any appllcantfmapermit subjects tire applicantto0civil Penalty °C of not more than five hundred dollars ($500). 0 ® (-) I, as owner of the property, ormy employees with wages as their sole compensation, will de U all of orU portions CJ of the work, and the structure is not intended or offered for sale (Sopron 7044, Business and Professions Code: The w Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds � or Improves the property, provided that the improvements are not intended or offered for sale. If however, the adiding or o improvement Is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). z{-)1, as owner of the property, am exclusively contracting with licensed Contractors 10 construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of properly who toolds or Improves thereon, and who contracts forthe projects with a licensed Contractor pursumullothe Contractors' State OLicense Law.). {_) I am exempt from licensure under the Contractor's State License law for the following reason(s): Date: Sign: z------- By my signature below I acknowledge that, except for my personal residence In which I must have resided for at least one year prior to completion of the improvements covered by this per-nit,l cannot legally soil a structure that I have built as an F' owner-buiider If it has not been constructed In its entirety by licensed contractors. I understand that a copy of the ,x,,, applicable law, Section 7044 of the Business and Professions Code is available upon request when this application is p submitted or at the following Web site: httplwww.leginfo-ca,govicalaw.html. F v LICENSEII CONTRACTOR'S DECLARATION m1 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 Professions Code, and my license is in toil force and effect. N LICENSE CLASS: LIC. NO.: _ .41 EXP.DATE:� NT9ACTOB:6''/1 / o /WORKER'S CONIPENSATfON DECLARATION LU I HEREBY AEE FFl llNO", E TY OF PLRJ➢RY ONE OF THE FOLLOWING DECLARATIONS: o I have and will maintain a Certificate of Consent to Self -Insure for Workers Compensation, as provided by Q 5 n 3700 of the Labor Code, for the performance of the work forwhich this permit is issued. 1have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for . the performance of the work for whh this permit is issued. My Worker's Compensation Insurance Carrier and 4 Policy Number $ _ a CARRIER LU POLICY NDM EA w � {1}115 SECTION NEED NOT BE COMPLETE➢ IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $1 OD OR LESS). I certify that tithe perfomnance ofthe work for which this permit is issued, I shail not employ any person in any in Pnerso to p become subject to the Worker's Compensation Laws of California. And agree that if I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forthwith Complywith those provisions, J M DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal Lu penalties and civil fines up to one hundred thousand dollars {$100,000), in addition to the cast of the compensation, °" damages as provided for in section 3708 of the labor code, interest, and attorney's fees. CD CONSTRUCTION LENDING AGENCY Lu I hereby still under penalty of perjury that there is a Construction Lending Agency for no performance of the work for m which this permit is issued (Sec. 3097, Civ. C.). F- LENDER'S NAME: LENDER'S ADDRESS: 0- 1 certif}'that I have read this application and state that the above inforrratiun is correct. I agree to comply with all city and Z county or finances and state laws relating to building construction, and hereby aull,d,, represenlatives of this county to a enter upo ove-manti oned property for inspection Purposes. m V)PERMBTEE NAME {PRINT} .�� , ,� ` = E SIGNATURE OFPER DATE E H ISSUE TYPE CONST ERMIT# : Ee — %�.. OCC GROUP: Scope of Work — Tv #`t 1 C. # DWEL. UNITS # STORIES # BEDROOMS co Ul Lu LL0 z O cc In U W a V z z DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport Patlo/Deck Pool/spa Re -Roof Commercial E�E� — — valuation: Adj. Area: QUANTITY DESCRIPTION FEE CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: O SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: 4 71e e P/C: PAD BY: VALIDATION: RECEIPT # .✓-�1q l PAID BY: _� � u� '1 VJ � VALiQAT10N: WHITE — Department Copy, YELLOW —Finance Copy, PINK— Assessor Copy UUPORALN 1 6., CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 1 of 4) Project Name: EDWARD SANDS Enforcement Agency: Diamond Bar (City of) Permit Number: PR17-0813 Dwelling Address: 2653 Wagon Train Ln City: DIAMOND BAR Zip Code: 91765 A. Ducted Cooling System Information 01 System identification or Name SYSTEM 1 02 System Location or Area Served WHOLEHOUSE 03 System Installation Type Alteration 04 Nominal Cooling Capacity (tons) of Condenser 3 05 Condenser Speed Type This field or section is not applicable 06 Cooling System Zonal Controi Type This field or section is not applicable 07 Central Fan 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 RA3.3.3.1.5 Alternative to Compliance with Minimum System Airflow Requirements B. Hole for the placement of a Static Pressure Probe (HSPPI, and Permanently Installed Static Pressure Probe (PSPP) in the Supply Plenum. Procedures for installing HSPP or PSPP are soecified iri 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 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 Flow Grid according to procedure in RA3.3.3.1.2 01 verification. 02 Manufacturer of Airflow Measurement Apparatus ALNOR 03 Model number of Airflow Measurement Apparatus EBT731 Certification Status of the Airflow Measurement Apparatus Certified by Manufacturer and listed on CEC Website at 04 Accuracy http:/Ywww.energy.ca.gov/title24/equipment—cert/ama—fas /index.htmi Registration Number: Registration Date/Time: 2017-07-25 09:13:22 HERS Provider: CHEERS 417-A020090176A-005-000-M 2300CA-M23A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-25 09:13:22 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION CF311-MCH-23-1­1 Space Conditioning System Airflow Rate (Page 2 of 4) MCH23c Forced Air System Airflow Rate Measurement - Alternative to Compliance with Minimum System Airflow Requirements for Altered Systems D. Alternative to Compliance with Minimum System Airflow Requirements for Altered Systems The HERS Rater shall review the information submitted on the installation certificate and perform follow-up communications with the HVAC installer or the homeowner. The system complies if the HERS Rater determines the remedial actions have been performed, and the information reported on the installation certificate is valid as specified in RA3.3.3.1.5 02 Determine that the air filter media is clean. If the air Completed 01 filter media is dirty, then replace it with clean filter 710 04 media The measured Airflow Rate reported on this document is the best airflow rate attainable for compliance utilizing the procedures given in RA3.3.3.1.5. This system shall not be included in a sample group for HERS verification compliance Open all registers and dampers and remove any Completed 02 obstructions. Replace/Repair all accessible crushed, blocked, Completed 03 restricted, remove excess length, and sharp bends in_.:-; ducts. Supported every 4 ft max. with a max 2 in.sag Clean the evaporator coil according to the manufacturer Completed 04 and ensure the coil is not obstructed. Air handler fan speed set to high and blower wheel and Compieted 05 motor are operating properly. = If determined to be too small, replace the return duct Completed: 06 with a larger one and/or add a second return.dudt If determined to be too small, replace the return grille Completed 07 with a larger area grille. 08 Verification Status: System complies 09 Correction Notes: 10 Optional Notes: E. Forced Air System Airflow Rate Measurement - Rest Airflow Rate Attainable 01 Required Minimum System Airflow Rate (cfm/ton) 300 02 Required Minimum System Airflow Target (cfm) 900 03 Actual System Airflow Rate Measurement (cfm) 710 04 Compliance Statement: The measured Airflow Rate reported on this document is the best airflow rate attainable for compliance utilizing the procedures given in RA3.3.3.1.5. This system shall not be included in a sample group for HERS verification compliance Registration Number: Registration Date/Time: 2017-07-25 09:13:22 HERS Provider: CHEERS 417-Ao 20090176A-005-000- M 2 3000 A -M 2 3A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-25 09:13:22 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION Space Conditioning System Airflow Rate E. Forced Air System Airflow Rate Measurement - Best Airflow Rate Attainable 05 1 HERS Sample Group Eligibility F. Additional Requirements CF3R-MCH-23-H Not Eligibie for HERS Sample Group for Airflow (Page 3 of 4) 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 05 System fan was set at maximum speed during the di 06 If fresh air duct is part of the HVAC system it was no 07 Airflow rate and fan watt draw shall be simultaneou ng the diagnostic test. irements when used to calcuiate 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 opratirig in cooling mode at_the maximuna;compressor speed and the maximum air handler fan speed. For altered systems that do not comply with the;;minim.um.300'cftn per foni:airflow rate requirement but opt to comply 09 using the remedial actions on this MCH -23 compliance document according to Section RA3.3.3.1.5 the system's thermostat shall conform to the specifications in Reference Joint Appendix JA5 and shall be capable of receiving and responding to Demand Response Signals prior to final approval of the building permit by the enforcing agency (Section 150.2(b)1Fia). 10 1 Verification Status: I Pass - all applicable requirements are met 11 I 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. G. 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 Complies: All specified verification protocol requirements on this document are met. Registration Number: Registration Date/Time: 2017-07-25 49:13:22 HERS Provider: CHEERS 417-A020090176A-005-000--M 23000 A -M 2 3A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-25 09:13:22 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: IGarrett Williams clow eww n41 Company: Date Signed: I Permit E Raters 2017-07-25 Address: CEA/ HERS Certification Identification (if applicable): 31225 La Baya Drive RCN13056 City/State/zip: Phone: Westlake Village CA 91362 818-735-7876 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 orsystem performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicabie requirements in Reference Appendices RA2, RA3, and the requirements specified on the Certificate of Compliance for the building, approved'bythe enforcement agency. 4. The information reported on applicable sections of the Certifrcate(S)'of Installation (CF2R) signed and submitted by the person(s) responsible for the construction or installation conforms to the requlrementsspecified,on the Certificates) of Compliance (CFIR) approved by the enforcement agency. 5. 1 will ensure that a registered copy of this Certificate of Verlficationishali 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 f3ui�der 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) Service Champions - Responsible Builder or installer Name:CS LB License: Austin Smith 798170 HERS Provider Data Registry Information Sample Group Number (if applicable): HERS Rater Information HERS Rater Company Name: I Permit E Raters Dwelling Test Status in Sample Group (if applicable) N/A Responsible Rater Name: Responsible Rater Signature: Garrett Williams (,arrewwaua.rnk Responsible Rater Certification Number w/ this HERS Provider: Date Signed: RCN 13056 2017-07-25 Registration Number: 417-A020090176A-005-000-M23000A-M 23A I CA Building Energy Efficiency Standards 2016 Residential Compliance Registration Date/Time: 2017-07-2.5 09:13:22 HERS Provider: CHEERS Report Version: 2016.1.006 Report Generated: 2017-07-25 09:13:22 Schema Version: rev 10/16 CERTIFICATE Of VERIFICATION CF3R-MCH-25-H Refrigerant Charge Verification (Page 1 of 4) Project Name: EDWARD SANDS Enforcement Agency: Diamond Permit Number: PR17-0813 Bar (City of) Dwelling Address: 2653 Wagon Train Ln I City: DIAMOND BAR I 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 SYSTEM 1 02 System Location or Area Served WHOLEHOUSE 03 Condenser (or package unit) make or brand LENNOX 04 Condenser (or package unit) model number ML14XC1-036-230806 05 Nominal Cooling Capacity (tons) of Condenser 3 06 Condenser (or package unit) serial number1917010069 07 Refrigerant Type A.410A 08 Other Refrigerant Type (if applicable) This field or section is not applicable anufacrF&rs,.< Liquid Line Filter Drier Installed According to Mtts Yes 09 Specifications (if applicable) 10 System Installation Type Alteration fault Indicator Display (FID) Status (Note: Even systerris with This system does not have a FID device installed 11 a FID must have refrigerant charge verified by.insraller) 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 RA13 or RA3.3.3 can be or RA3.3.3)? 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 RA1)? 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: 2017-07-25 49:13:43 HERS Provider: CHEERS 417-A02009017 6A-005-000-M25000A-M 25A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-07-25 09:13:43 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 1 Refrigerant metering device 02 I Subcooling Method applicability status Thermostatic Expansion Valve (TXV) 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 Digital Thermocouple Calibration 20.17-07-01 03 Digital Refrigerant Gauge Calibration Status Calibration is current 04 Digital Thermocouple Calibration Status Calibration is current D. Measurement Access Hole (MAH) Verification HERS Raters are required to visuallyfield,verify MAH..procedu;res for.insta.11 ng MAH are specified in Reference Residential Appendix RA3.2.2.3 01 Method Used to Demonstrate Compliance with the 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 Minimum Required System Airflow Rate (cfm) 900 System complies using the alternative remedial actions 02 System Airflow Rate Verification Status specified in RA3.3.3.1.5. This System does not qualify for group sampling 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 I Lowest Return Air Dry Bulb Temperature that Occurred 73 II During the Refrigerant Charge Verification Procedure (°F) Registration Number: 417-A020090176A-005-000-M 250o0A-M 25A CA Building Energy Efficiency Standards 2016 Residential Compliance Registration Date/Time: 2017-07-25 09:13:43 HERS Provider: CHEERS Report Version: 2016.1.006 Report Generated: 2017-07-25 09:13:43 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 02 Measured Condenser Air Entering Dry -Bulb Temperature (Tccndenser, db) 03 1 Outdoor Temperature Qualification Status 04 Measured Liquid Line Temperature (liquid) (°F) 05 1 Measured Liquid Line Pressure (Pliquid) (psig) 06 Condenser Saturation Temperature (Tcondenser, sac) from Digital Gauge or P -T Tabie using Line F05 (`F) 07 Measured Subcooling (Line F06 - Lilne F04 ('F) 72 Outdoor temperature is within range for using Subcooling refrigerant charge verification method 74 235 79 5 08 Target Subcooiing from Manufacturer ('F) System complies with Subcooling Method - Must also pass 09 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(Tsuction) (F):: 02 Measured Suction Line Pressure (Psuction)`(psig) 03 Evaporator Saturation Temperature (Tevaporatcr, sat) from Digital Gauge or P -T Table using Line G02 (°F) 04 Measured Superheat (Line G01- Line G03) (°F) 05 Measured Superheat (Line G04) is between 3'F and 26°F (inclusive) 06 Measured Superheat (Line G04) is within Manufacturer's Specifications ( if known) 07 j Compliance Statement: 35 13 Passes CEC requirement Yes, documentation to be provided upon request 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 Complies: All specified verification protocol requirements on this document are met. Registration Number: Registration Date/Time: 2017-07-25 09:13:43 HERS Provider: CHEERS 417-A020090176A-005-000-M25000A-iv125A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017 07-25 09:13:43 2016 Residential Compliance 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: Garrett Williams Q"a"rettw' UamY Company: Date Signed: I Permit E Raters 2017-07-25 Address: CEA/ HERS Certification Identification (if applicable): 31225 La Baya Drive RCN13056 City/State/Zip: Phone: Westlake Village CA 91362 818-735-7876 Responsible Person's Declaration statement I certify the fallowing under penalty of perjury, under the laws of the State of California: 1. The information provided or this Certificate of Verification is true and correct. Z. 1 am the certified HERS Raterwho performed the verification identified and reported on this Certificate &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't6e gppliO066equirements in Reference Appendices RA2, RA3, and the requirements specified on the Certificate of Compliance ferthe building:, approvriforcement agency. 4. The information reported on applicable sectionsof the C'ettrfiCate{ )iof Installation (CE2R) signed and submitted by the person{s) responsible for the construction or installation conforms to the requirements spec ek ,66 thei,Cuttficate(s) of Compliance (MR) approved by the enforcement agency. S. I will ensure that a registered copy of this Certificate of Veri:i, onishall he posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency fora.] appl calale inspections. I understand that a registered copy of this Certificate of Verification is required to be included with the documentationthe,bi,jil'der pravides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General COnfractar ar Builder/Owner) Service Champions Responsible Builder or Installer Name: CSLB License: Austin Smith 799170 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: I Permit E Raters Responsible Rater Name: Responsible Rater Signature: Garrett Williams (5arrettwauam4, Responsible Rater Certification Number w/ this HERS Provider: Date Signed: RCN13056 2017-07-25 Registration Number: Registration Date/Time: 2017-07-25 09:13:43 HERS Provider: CHEERS 417-A020090176A-005-000-M25000A-M25A CA Building Energy Efficiency Standards Report Version: 2016.1..006 Report Generated: 2017-07-25 09:13:43 2016 Residential Compliance Schema Version: rev 10/16 L: � E z § E \ � A 0 / § ) > § § E E � e G $ 2 0 @ 4 c {cu c § ra o § / p L: � E z § E \ � A 0 / § ) > § § E E � \ S 2 § cL o 0 / \ cu / \ 2 a> § E2§ / / - k E Ln k c E- 0 ba ¢�E 0 \ 7 § \ t k LU §f § f ba E t u c IA \2 2 77= 2 \ U.1 / 41 U V) % o \ S 2 cL o 0 / cu / \ 2 a> E2§ §ƒ/. k E c ba ¢�E @ 7 § \ t k §f E t IA \2 2 77= 2 / 41 ¥ . 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