HomeMy WebLinkAbout15-0276.pdfU010ND BAR,
CITY OF DIAMOND BAR `
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91765
(909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027
BUILDING PERMIT APPLICATION
JOB SITE ADDRESS Z XJ� 7
APN LOT TRACT
OWNER �J4 {? t p�Uj1 a.
ADDRESS Z 3ro� ( 9r�KL-�j�C/s79� OIL r Tom%
CITY i/J Alhy c% /! ZIP TEL16
APPLICANT S9)P 't 7_A-SA-_,1'C4-- TEL.(—
CONTRACTOR ZJgkn } W07X , J
ADDRESS P•6L6QX �?3(Q
CITY Y Lcx4A ZIP 4j 1 TEL. 3Zs627--'ISZ
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 reason(s)
indicated below by the checkmark(s), I have placed next to the applicable item(s) [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 (Chapter 9) Commencing with Section
7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure 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 S500).
U I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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 employees' 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 completion, 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 License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State
License Law.).
U I am exempt from licensure under the Contractor's State License law for the following reason(s):
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 permit,l cannot legally sell a structure that I have built as an
owner -builder 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: http/www.leginfo.ca.gov/calaw.html.
DATE: SIGN:
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 Professions Code, and my license is in full force and effect.
LICENSE CLASS: C LIC. NO.: ro /
DATE: CONTRACTOR:
WORKER'S COMPENSA& 116CLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
I have and will maintain a Certificate of Consent to Self -Insure for 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�— I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for
the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and
Policy Number are: "��
CARRIER 5I-W-r( Kl.
POLICYNUMBER 17&61 3`i !J —a/7 /A/
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS).
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 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 Lab Code, I shall forthwith comply with those provisions.
DATE: ? Z�I4, APPLICANT: _I "
WARNING: Failure to secure Worker's Compensati c emge 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 the compensation,
damages as provided for in section 3708 of the labor code, interest, and attomay's fees.
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:
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 property for inspection purposes.
PERMITTEE NAME (PRINT) / `l 7'Z',f
SIGNATURE OF PERMITTEE DATE
PRESS
FIRMLY
APPLICATION DATE: P/C#�
ISSUE DATE:a / M� PERMIT# ��-
TYPE CONST OCC GROUP:
ZONING SETBACKS
FRONT RW ❑
REAR ❑
SIDE/SIDE STREET RW ❑
SIDE ❑
PROPOSED USE
# DWEL. UNITS # STORIES # BEDROOMS
DESCRIPTION
SQ. FT.
FACTOR PSF
ADJ. AREA/VALUATION
SFR/ADD/REM
Garage/Carport
rn
w
Patio/Deck
w
Pool/Spa
ZRe
-Roof
J
Commercial
t]]
Valuation: Adj. Area:
QUANTITY
DESCRIPTION
FEE
U
2
U
J
w
Z
z
m
rL
I
v
ZUU
_Z
Q
CONSTRUCTION:
PLAN REVIEW:
ELECTRIC:
PLUMBING:
MECHANICAL:
INSPECTION FEE:
ISSUANCE: • �` 7
SMIP:
ENERGY P/C:
ENERGY PERMIT:
RETENTION FEE: a
PRE-ALT FEE:
BSAF:
TOTAL FEES L/
COMMENTS: /
RECEIPT # 7 PAID BY: __ �VALIDATION:
WHITE —Department Copy, YELLOW —Finance Copy, PINK —Assessor Copy, GOLDENROD —File Copy, GREEN —Applicant's Copy
CITY OF DIAMOND BAR
INSPECTION RECORD
SETBACK/LETTER
�OOTINGS�EORIVIS �"
,SLAB ,
UG<PLUMBING
UG: ELECTRICAL,, .
UFER GROUND, -
SEWER LATERAL
MAIN WATER LINE
SEWER CLEANOUT
ROOF SHEATHING
FLOOR SHEATHING
SHEAR WALLS EXTERIOR
SHEAR WALLS INTERIOR
FRAM(NGIVENTING
,ROUGH MECHANICAL
kUGH ELECTRICAL W( ) C ( T
,ROUGH PLUMBING
INSULATION WALL
INSULATION CEILING
DRYWALL
LATH (PRE)
LATH EXTERIOR
LATH INTERIOR _
GAS TEST
SCRATCH COAT
ELECTRIC METER RELEASE
GAS METER RELEASE
SPECIAL INSPECTION
FINAL BUILDING",
FINAL MECIIAMCAL e ,
FINAUELECTRICAL
FINAL PLUMBING d"
Tt�ofOCCUPANGY
COMMENTS:
0 AND LEDGER
TCH GEAR
_
AMERCIAL HOOD
4R
RCEPTER
. MOP/SHOWERPAN
TIC/CESSPOOL
IS REPORT RECEIVED
40LITION
lF DRAINS
IGH CONDUIT
IUSPA
IGH PLUMBING
IGH ELECTRICAL
IGH MECHANICAL
TEST
GUNITE
IL PRE DECK BONDING
SAP
CE / GATE/ ALARM
aL POOL
LLS:
_L FOOTING/STEEL
_L STEEL t-( ) 2N°( ) LIFT
_L BOND BEAM
_L DRAIN/ SEAL
_L FINAL
FRAMING PLANNING APPROVAL
JGH FIRE APPROVAL�
AL FIRE DEPARTMENT
"
AL PLANNING
AL ENGINEERING/ PW
AL COMMUNITY SERVICES
AL HEALTH DEPT.�
a
AL INDUSTRIAL WASTE`
' " "
CERTIFrCATE OF VERIFICATION
CF3R-MCH-20-H
Duct Leakage Diagnostic Test
(Page 1 of 3 )
Project Name: 23611 Golden Springs Dr. #i-7
Enforcement Agency: City of
Diamond Bar
Permit Number: 15-0276
Dwelling Address: 23611 Golden Springs Dr.
#i-7
City: Diamond Bar
Zip Code: 91765
A. System Information
01
Space Conditioning System Identification or Name
WHOLE HOUSE
02
Space Conditioning System Location or Area Served
WHOLE HOUSE
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 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)
2
02
Heating Capacity (kBtu/h)
24
03
Conditioned Floor Area served by this HVAC system (ft2)
900
04
Duct Leakage Test Condition
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)
120
10
Actual duct leakage rate from leakage test measurement
(cfm)
33
11
Compliance Statement: System passes leakage test
Registration Number: 215-A0031949A-M2000002A-M20A Registration Date/Time: 2015-02-05 09:04:28 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 09:02:51
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
B. Duct Leakage Diagnostic Test
12 Notes:
C. Additional Requirements for Compliance
System was tested in its normal operation condition. No temporary taping allowed.
F0;2
Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage
testing. CFI CA ducts that utilize controlled motorized dampers, that open only when CA ventilation is required to meet
ASHRAE Standard 62.2, and close when CIA ventilation is not required, may be configured to the closed position during duct
leakage testing.
03
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 for this table:
The responsible persons 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.
Registration Number: 215-A0031949A-M2000002A-M20A Registration Date/Time: 2015-02-05 09:04:28 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 09:02:51
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate. of Verification documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
John Kwan
Company:
Date Signed:
J.K. Air Balancing & Duct Testing
2015-02-05 09:04:28
Address:
CEA/ HERS Certification Identification (if applicable):
9040 Telstar Ave #137
3012
City/State/Zip:
Phone:
El Monte CA 91731
626-274-0522
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. I 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 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 Ibuilding 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
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):
ZABATTA HEATING AND AIR CONDITIONING
Responsible Builder or Installer Name:
CSLB License:
John Zabatta
561159
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
J.K. Air_Balancing & Duct Testing
Responsible Rater Name:
Responsible Rater Signature:
John Kwan
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2005646
2015-02-05 09:04:28
Digitally signed by Ca10ERTS. 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: 215-A0031949A-M2000002A-M20A Registration Date/Time: 2015-02-05 09:04:28 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 09:02:51
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION
CF3R-MCH-23-H
Space Conditioning System Airflow Rate
(Page 1 of 4 )
Project Name: 23611 Golden Springs Dr. #i-7
Enforcement Agency: City of
Diamond Bar
Permit Number:
15-0276
Dwelling Address: 23611 Golden Springs Dr.
#i-7
City: Diamond Bar
Zip Code:
91765
A. Ducted'Cooling System Information
O1
System Identification or Name
WHOLE HOUSE
02
System Location or Area Served
WHOLE HOUSE
03
System Installation Type
Alteration
04
Nominal Cooling Capacity (tons) of Condenser
2
05
Condenser Speed Type
Single Speed
06
Cooling System Zonal Control Type
Not Zonal
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
2015-02-05
10
Airflow 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
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.
O1
Airflow Rate Measurement Type used for this airflow rate
Fan Flowmeter according to procedure in RA3.3.3.1.1
verification.
02
Manufacturer of Airflow Measurement Apparatus
TSI
03
Model number of Airflow Measurement Apparatus
ACCU BALANCE 802083
04
Certification Status of the Airflow Measurement Apparatus
Certified by Manufacturer and listed on CEC Website at
Accuracy
http://www.energy.ca.gov/(tbd)
Registration Number: 215-A0031949A-M2300002A-M23A Registration Date/Time: 2015-02-05 09:04:28 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 09:03:20
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 2 of 4 )
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 Airflow Rate (cfm/ton)
300
02
Required Minimum System Airflow Target (cfm)
600
03
Actual System Airflow Rate Measurement (cfm)
638
04
Compliance Statement:
System airflow rate complies
E. Additional Requirements
O1
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
system return duct airflow are not used on new or replacement zonally controlled systems unless the Performance
03
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: 215-A0031949A-M2300002A-M23A Registration Date/Time: 2015-02-05 09:04:28 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 09:03:20
2013 Residential Compliance Schema Version: 0.51SDD
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 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 215-A0031949A-M2300002A-M23A Registration Date/Time: 2015-02-05 09:04:28 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 09:03:20
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
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:
John Kwan
Company:
Date Signed:
J.K. Air Balancing & Duct Testing
2015-02-05 09:04:28
Address:
CEA/ HERS Certification Identification (if applicable):
9040 Telstar Ave #137
City/State/Zip:
Phone:
El Monte CA 91731
626-274-0522
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 on the Certificate(s) of Compliance (CF1R) 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 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):
ZABATTA HEATING AND AIR CONDITIONING
Responsible Builder or Installer Name:
CSLB License:
John Zabatta
561159
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
J.K. Air Balancing & Duct Testing
Responsible Rater Name:
Responsible Rater Signature:
John Kwan
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2005646
2015-02-05 09:04:28
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 215-A0031949A-M2300002A-M23A Registration Date/Time: 2015-02-05 09:04:28 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 09:03:20
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION
CF3R-MCH-25-H
Refrigerant Charge Verification
(Page 1 of 4 )
Project Name: 23611 Golden Springs Dr. #i-7
Enforcement Agency: City of
Permit Number:
15-0276
Diamond Bar
Dwelling Address: 23611 Golden Springs Dr.
City: Diamond Bar
Zip Code:
91765
#i-7
A. System Information
HERS Rater to field -verify all system information, discrepancies to be noted by overwriting entry.
01
System Identification or Name
WHOLE HOUSE
02
System Location or Area Served
WHOLE HOUSE
03
Condenser (or package unit) make or brand
DAY AND NIGHT
04
Condenser (or package unit) model number
N4H324AKF
05
Nominal Cooling Capacity (tons) of Condenser
2
06
Condenser (or package unit) serial number _
E142820842
07
Refrigerant Type
R-410A
08
Other Refrigerant Type (if applicable)
09
System Installation Type
Alteration
Charge Indicator Display (CID) Status (Note: Even systems
This system does not have a CID device installed
10
with a CID 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
11
verified using an approved measurement procedure (RA3.3
rate measurement procedures in RA3.3 or RA3.2.2.7 can be
or RA3.2.2.7)?
used to verify system airflow rate
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
12
with the refrigerant charge verification requirements when
used to verify compliance
temperatures are greater than or equal to 55F (RA3.2.2, or
RA1)?
13
Date of Refrigerant Charge Verification for this system
2015-02-05
Refrigerant charge verification method used.
Subcooling (outdoor temperature must be equal to or
14
greater than 55 degF)
Person who performed the Refrigerant Charge Verification
HERS rater
15
reported on this Certificate of Installation
16
HERS Verification Compliance Requirement Status
System does not qualify for group sampling
17
Refrigerant charge verification method used by HERS Rater.
I Subcool
Registration Number: 215-A0031949A-M2500002A-M25A Registration Date/Time: 2015-02-05 09:04:28 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 09:03:49
2013 Residential Compliance Schema Version: 0.551SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 2 of 4 )
Standard Charge Verification Procedure - CF3R-MCH-25b - Subcooling Method
B. Metering Device Verfication - 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
2015-02-02
02
Date of Digital Thermocouple Calibration
2015-02-02
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 visually field verify MAH
Procedures for installing MAH are specified in Reference Residential Appendix RA3.2.2.3
01 I Method used to demonstrate compliance with the I 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 RA3.2.2.7.
01
Minimum Required System Airflow Rate (cfm)
600
02
System Airflow Rate Verification Status
System complies with minimum airflow rate requirements
F. Data Collection - 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 during
71
the refrigerant charge verification procedure (degreeF)
02
Measured Condenser air entering dry-bulb temperature (T
60
condenser, db)
Registration Number:,215-A0031949A-M2500002A-M25A Registration Date/Time: 2015-02-05 09:04:28 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 09:03:49
2013 Residential Compliance Schema Version: 0.551SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 3 of 4 )
F. Data Collection - 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
refrigerant charge verification method
04
Measured Liquid Line Temperature (Tiiquid) (degreeF)
64
05
Measured Liquid Line Pressure (Pliquid) (pisg)
236
06
Condenser saturation temperature (Tcondensor, sat) from digital
80
gauge or P-T Table using Line F05 (degree F)
07
Measured Subcooling
16
08
Target Subcooling
13
09
Compliance Statement: System complies with Subcooling Method - Must also pass metering device verification, next
section
G. Metering Device Verfication
Procedures for the verification of proper metering device operation are specified in RA3.2.2.6.2
01
Measured Suction line temperature (Tsuction) (degreeF)
56
02
Measured Suction line pressure (Psuction) (psig)
102
03
Evaporator saturation temperature (Tevaporator, sat) from
digital gauge or P-T Table using line G02 (degreeF)
36
04
Measured Superheat
20
05
Measured Superheat is between 4 and 25 deg F (inclusive)
Passes CEC requirement
06
Measured Superheat is within manufacturer's specifications,
if known
Yes, documentation to be provided upon request
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.
1 01 1 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 215-A0031949A-M2500002A-M25A Registration Date/Time: 2015-02-05 09:04:28 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 09:03:49
2013 Residential Compliance Schema Version: 0.551SDD
1 � 1
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:
John Kwan
Documentation Author Signature:
Company:
Date Signed:
1.K. Air Balancing & Duct Testing
2015-02-05 09:04:28
Address:
CEA/ HERS Certification Identification (if applicable):
9040 Telstar Ave #137
3012
City/State/Zip:
Phone:
El Monte CA 91731
626-274-0522
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 on the Certificate(s) of Compliance (CF1R) 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 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):
ZABATTA HEATING AND AIR CONDITIONING
Responsible Builder or Installer Name:
CSLB License:
John Zabatta
561159
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
J.K. Air Balancing & Duct Testing
Responsible Rater Name:
John Kwan
Responsible Rater Signature:
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2005646
2015-02-05 09:04:28
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 215-A0031949A-M2500002A-M25A Registration Date/Time: 2015-02-05 09:04:28 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 09:03:49
2013 Residential Compliance Schema Version: 0.551SDD
T
CERTIFICATE OF INSTALLATION
CF2R-MCH-20-H
Duct Leakage Diagnostic Test
(Page 1 of 3 )
Project Name: 23611 Golden Springs Dr. #i-7
Enforcement Agency: City of
Diamond Bar
Permit Number: 15-0276
Dwelling Address: 23611 Golden Springs Dr.
#i-7
City: Diamond Bar
Zip Code: 91765
A. System Information
01
Space Conditioning System Identification or Name
WHOLE HOUSE
02
Space Conditioning System Location or Area Served
WHOLE HOUSE
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-20d - Complete. Replacement or Altered Duct System
B. Duct Leakage Diagnostic Test
01
Condenser Nominal Cooling Capacity (ton)
2
02
Heating Capacity (kBtu/h)
24
03
Conditioned Floor Area served by this HVAC system (ft2)
900
04
Duct Leakage Test Condition
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 (cfm)
120
10
Actual duct leakage rate from leakage test measurement
(cfm)
33
11
Compliance Statement: System passes leakage test
Registration Number: 215-A0031949A-M2000002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 08:53:36
2013 Residential Compliance Schema Version: 0.51SDD
y
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) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage
02
testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet
ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct
leakage testing.
03
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 comply using smoke test shall not be included in sample
groups for HERS verification compliance.
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.
Registration Number: 215-A0031949A-M2000002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 08:53:36
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3 )
Documentation Author's Declaration Statement
1. I certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature_
L=JV
John Zabatta
0#6%-iLW
Company:
Signature Date: 2015-02-05 09:05:17
ZABATTA HEATING AND AIR CONDITIONING
Address:
CEA/ HERS Certification Identification (if applicable):
PO BOX 9368
City/State/Zip:
Phone:
ALTA LOMA CA 91701
1(909) 989-9200
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 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 (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
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 plans and specifications approved by
the enforcement agency.
4. 1 understand that a HERS rater will check the installation to verify compliance, and that if such checking identifies; defects; I am required to take
corrective action at my expense. I understandthat Energy Commission and,HERS Provider representatives will also perform quality assurance checking
of installations,.including those approved as part of a_sample group but not checked by a HERS rater, and if those installations fail to meet the
requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS
sample group will be performed at my expense.
S. I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 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 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:
John Zabatta
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
OWNER
ZABATTA HEATING AND AIR CONDITIONING
Address:
CSLB License:
PO BOX 9368
1561159
City/State/Zip:
Phone:
Date Signed:
ALTA LOMA CA 91701
(909) 989-9200
2015-02-05 09:05:17
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 215-A0031949A-M2000002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 08:53:36
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF INSTALLATION
CF2R-MCH-23-H
Space Conditioning System Airflow Rate
(Page 1 of 3 )
Project Name: 23611 Golden Springs Dr. #i-7
Enforcement Agency: City of
Diamond Bar
Permit Number:
15-0276
Dwelling Address: 23611 Golden Springs Dr.
#i-7
City: Diamond Bar
Zip Code:
91765
A. Ducted Cooling System Information
01
System Identification or Name
WHOLE HOUSE
02
System Location or Area Served
WHOLE HOUSE
03
System Installation Type
Alteration
04
Nominal Cooling Capacity (tons) of Condenser
2
05
Condenser Speed Type
Single Speed
06
Cooling System Zonal Control Type
Not Zonal
07
Central Fan Integrated (CFI) Ventilation System Status
Nota CFI system
08
System Bypass,,Duct Status
No Bypass Duct
09
Date of System Airflow Rate Measurement
2015-02-05
10
Airflow 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 I Method used to demonstrate compliance with the I 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 Airflow Measurement Apparatus
TSI
03
Model number of Airflow Measurement Apparatus
ACCU BALANCE 802083
04
Certification Status of the Airflow Measurement Apparatus
Certified by Manufacturer and listed on CEC Website at '
Accuracy
http://www.energy.ca.gov/(tbd)
Registration Number: 215-A0031949A-M2300002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 08:54:50
2013 Residential Compliance Schema Version: 0.51SDD
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 Airflow Rate (cfm/ton)
300
02
Required Minimum System Airflow Target (cfm)
600
03
Actual System Airflow Rate Measurement (cfm)
638
04
Compliance Statement:
System airflow rate complies
E. Additional Requirements
Air filters that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in
O1
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
system return duct airflow are not used on new or replacement zonally controlled systems unless the Performance
03
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.
The responsible person's signature on this compliance document affirms that all applicable requirements in this table have
been met.
Registration Number: 215-A0031949A-M2300002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 08:54:50
2013 Residential Compliance Schema Version: 0.51SDD
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:
I
Documentation Author Signature:
John Zabatta
Company:
Signature Date: 2015-02-05 09:05:17
ZABATTA HEATING AND AIR CONDITIONING
Address:
CEA/ HERS Certification Identification (if applicable):
PO BOX 9368
City/State/Zip:
Phone:
ALTA LOMA CA 91701
(909) 989-9200
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 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 (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
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 plans and specifications approved by
the enforcement agency.
4. 1 understand that a HERS rater vvill check the installation to verify compliance, and that if such checking identifies defects; I am required to take
corrective action at my expense. I understand that Energy Commission and HERS Provider representatives will also perform quality: assurance checking
of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the
requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS
sample group will be performed at my expense.
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 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 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:
John Zabatta
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
OWNER
ZABATTA HEATING AND AIR CONDITIONING
Address:
CSLB License:
PO BOX 9368
561159
City/State/Zip:
Phone:
Date Signed:
ALTA LOMA CA 91701
(909) 989-9200
2015-02-05 09:05:17
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 215-A0031949A-M2300002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 08:54:50
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF INSTALLATION
CFZR-MCH-25-H
Refrigerant Charge Verification
(Page 1 of 5 )
Project Name: 23611 Golden Springs Dr. #i-7
Enforcement Agency: City of
Permit Number: 15-0276
Diamond Bar
Dwelling Address: 23611 Golden Springs Dr.
City: Diamond Bar
Zip Code: 91765
#i-7
A. System Information
Each system requiring refrigerant charge verification will be documented on a separate certificate.
01
System Identification or Name
WHOLE HOUSE
02
System Location or Area Served
WHOLE HOUSE
03
Condenser (or package unit) make or brand
DAY AND NIGHT
04
Condenser (or package unit) model number
N4H324AKF
05
Nominal Cooling Capacity (tons) of Condenser
2
06
Condenser (or package unit) serial number
E142820842
07
Refrigerant Type
R-410A
08
Other Refrigerant Type (if.applicable)
09
System Installation Type
Alteration
Charge Indicator Display (CID) Status (Note: Even systems
This system does not have a CID device installed
10
with a CID 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
11
verified using an approved measurement procedure (RA3.3
rate measurement procedures in RA3.3 or.RA3.2.2.7 can be
or RA3.2.2.7)?
used to verify system airflow rate
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
12
with the refrigerant charge verification requirements when
used to verify compliance
temperatures are greater than or equal to 55F (RA3.2.2, or
RA1)?
13
Date of Refrigerant Charge Verification for this system
2015-02-05
Refrigerant charge verification method used.
Subcooling (outdoor temperature must be equal to or
14
greater than 55 degF)
Person who performed the Refrigerant Charge Verification
HERS rater.
15
reported on this Certificate of Installation
16
HERS Verification Compliance Requirement Status
System does not qualify for group sampling
Registration Number: 215-A0031949A-M2500002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 08:59:09
2013 Residential Compliance Schema Version: 0.551SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H
Refrigerant Charge Verification (Page 2 of 5 )
Standard Charge Verification Procedure - CF2R-MCH-25b - Subcooling Method
B. Metering Device Verfication
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
Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2
O1
Date of Digital Refrigerant Gauge Calibration
2015-02-02
02
Date of Digital Thermocouple Calibration
2015-02-02
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 MAH are specified in Reference Residential Appendix RA3.2.2.3
O1 IMethod used to demonstrate compliance with the I 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 RA3.2.2.7.
01
Minimum Required System Airflow Rate (cfm)
600
02
System Airflow Rate Verification Status
System complies with minimum airflow rate requirements
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.
01
Lowest return air dry bulb temperature that occurred during
71
the refrigerant charge verification procedure (degreeF)
02
Measured Condenser air entering dry-bulb temperature (T
60
condenser,db)
Registration Number: 215-A0031949A-M2500002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 08:59:09
2013 Residential Compliance Schema Version: 0.551SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H
Refrigerant Charge Verification (Page 3 of 5 )
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.
Outdoor temperature is within range for using Subcooling
03
Outdoor Temperature Qualification Status
refrigerant charge verification method
04
Measured Liquid Line Temperature (Tiiquid) (degreeF)
64
05
Measured Liquid Line Pressure (Piiquid) (pisg)
236
Condenser saturation temperature (Tcondensor, sat) from digital
80
06
gauge or P-T Table using Line F05 (degree F)
07
Measured Subcooling
16
08
Target Subcooling
13
Compliance Statement: System complies with Subcooling Method - Must also pass metering device verification, next
09
section
G. Metering Device Verfication ,
Procedures for the verification of proper metering device operation are specified in RA3.2.2.6.2
01
Measured Suction line temperature (Tsuction) (degreeF)
56
02
Measured Suction line pressure (Psuction) (psig)
102
03
Evaporator saturation temperature (Tevaporator, sat) from
digital gauge or P-T Table using line G02 (degreeF)
36
04
Measured Superheat
20
05
Measured Superheat is between 4 and 25 deg F (inclusive)
Passes CEC requirement
06
Measured Superheat is within manufacturer's specifications,
if known
Yes, documentation to be provided upon request
07
Compliance Statement: Metering device verification passes
Verification of Charge Indicator Display - CF2R-MCH-25d - CID
H. Charge Indicator Display
Procedures for the Charge Indicator Display Verification are detailed in RA3.4.2
This section does not apply to this project.
Registration Number: 215-A0031949A-M2500002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 08:59:09
2013 Residential Compliance Schema Version: 0.551SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H
Refrigerant Charge Verification (Page 4 of 5 )
I. Charge Indicator Display Additional Requirements
This section does not apply to this project.
Registration Number: 215-A0031949A-M2500002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 08:59:09
2013 Residential Compliance Schema Version: 0.551SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H
Refrigerant Charge Verification (Page 5 of 5 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature
`=v"
John Zabatta
GW i
Company:
Signature Date: 2015-02-05 09:05:17
ZABATTA HEATING AND AIR CONDITIONING
Address:
CEA/ HERS Certification Identification (if applicable):
PO BOX 9368
City/State/Zip:
Phone:
ALTA LOMA CA 91701 1(909)
989-9200
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 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 (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
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 plans and specifications approved by
the enforcement agency.
4. 1 understand that a HERS rater will check the installation to verify compliance, and that if such,checking identifies defects; I am required to take
corrective action at my expense. I understand,that Energy Commission and HERS Provider representatives will also perform quality assurance checking
of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the
requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS
sample group will be performed at my expense.
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 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 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:
John Zabattajfj
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
OWNER
ZABATTA HEATING AND AIR CONDITIONING
Address:
CSLB License:
PO BOX 9368
1561159
City/State/Zip:
Phone:
Date Signed:
ALTA LOMA CA 91701
(909) 989-9200
2015-02-05 09:05:17
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 215-A0031949A-M2500002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-02-05 08:59:09
2013 Residential Compliance Schema Version: 0.551SDD
CERTIFICATE OF INSTALLATION
CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans
(Page 1 of 7 )
Project Name: 23611 Golden Springs Dr. #i-7
Enforcement Agency: City of Diamond Bar
Permit Number:
15-0276
Dwelling Address: 23611 Golden Springs Dr. #i-7
City: Diamond Bar
Zip Code:
91765
A. General Information
01
Dwelling Unit Name
23611 Golden Springs Dr. #i-7
02
Climate Zone
9
Number of space conditioning (SC)
03
Dwelling Unit Conditioned Floor Area
900
04
systems being altered in this dwelling
1
(ft2)
unit.
05
Certificate of Compliance Type
Prescriptive alterations (CF1R-ALT)
06
Method used to calculate HVAC loads
NotApplicableEquipmentChangeout
Calculated dwelling unit Sensible
08
Calculated Dwelling Unit Heating Load
07
Cooling Load (Btuh)
(Btuh)
MCH-01b Prescriptive Alterations -'Space Conditioning Systems Ducts and Fans
B. Space Conditioning (SC) System Information
01
02
03
04
05
06
07
08
09
10
Are all of the
system's
components
and ducts
CFA served
Is the SC
Installing a
Installing
new or
SC System
SC System
by this SC
system a
refrigerant
Installing new SC
Installing more
entirely
replaced?
Identification or
Location or Area
System
ducted
containing
system
than 40 feet of
new duct
(entirely new
Name
Served
(ft2)
system?
component?
components?
ducts?
system?
system)
Alteration Type
Altered space
WHOLE HOUSE
WHOLE HOUSE
900
Yes
Yes
Yes
No
No
No
conditioning
system
Registration Number: 215-A0031949A-M0100002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-02-05 08:52:56
Schema Version: 0.551SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 2 of 7 )
C. Space Conditioning (SC) System Alterations Compliance.lnformation
01
02
03
04
05
06
07
08
09
10
11
12
Heating
Cooling
New or
New
System
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
Replaced
Duct
Identification
Heating
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Duct
R-
or Name
System Type
Component
Type
Value
System Type
Component
Type
Value
Type
Length
Value
WHOLE HOUSE
Central split
All new
heating
HSPF
7.7
Central split
Outdoor
condensing
SEER
13
Setback
LTE40Ft
R6
HP
components
HP
unit
D. Installed Heating Equipment information
01
02
03
04
05
06
07
System Identification or
Name
Heating;.Efficiency Type
Heating Efficiency
Value
Heating Unit
Manufacturer
Heating Unit
..Model Number
Heating Unit serial
number
Rated Heating Capacity,
Output (BTUH)
WHOLE HOUSE
HSPF
7.7.
DAY AND NIGHT
FEM4P24000A
A143068415
24000
Notes:
E. Installed Cooling Equipment information:
01
02
03
04
05
06
07
08
Condenser or Package Unit
Condenser or
Condenser or
Condenser or
System Rated Cooling
Condenser Rated
System Identification
Cooling Efficiency
Cooling Efficiency
Package Unit
Package Unit
Package Unit
Capacity at Design
Nominal Capacity
or Name
Type
Value
Manufacturer
Model Number
Serial Number
Conditions (BTUH)
(ton)
WHOLE HOUSE
SEER
13
DAY AND
N4H324AKF
E142820842
24000
2
NIGHT
Registration Number: 215-A0031949A-M0100002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-02-05 08:52:56
Schema Version: 0.551SDD
CERTIFICATE OF INSTALLATION CFZR-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 3 of 7 )
E. Installed Cooling Equipment information:
01 02 03
04 05 06
07 08
Condenser or Package Unit
System Identification
or Name
Cooling Efficiency
Type
Cooling Efficiency
Value
Condenser or
Package Unit
Manufacturer
Condenser or
Package Unit
Model Number
Condenser or
Package Unit
Serial Number
System Rated Cooling
Capacity at Design
Conditions (BTUH)
Condenser Rated
Nominal Capacity
(ton)
Notes:
F. Extension of Existing Duct System, Greater Than 40 Feet
This section does not apply to this project.
G. Installed Duct System information
This section does not apply to this project.
H. Installed Air Filter Device Information
This section does not apply to this project.
I. Air Filter Device Requirements
This section does not apply to this project.
Registration Number: 215-A0031949A-M0100002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-02-05 08:52:56
Schema Version: 0.551SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 4 of 7 )
J. HERS Verification Requirements
01
02
03
04
05
06
07
08
09
10
MCH2O
MCH21
MCH22
MCH23
MCH25
MCH28
Exemption
from
Minimum
Exemption
R-Value for
AHU Fan
AHU
SC System
SC System
From Duct
. Duct
Ducts In
Ducts Located
Efficacy
Airflow
Identification or
Location or Area
Leakage
Leakage
Conditioned
In Cond Space
(W per
Rate (cfm
Refrigerant
Return Duct Design
Name
Served
Requirements
Test
Space
Verification
cfm)
per ton)
Charge
Table 150.0-C or D
WHOLE HOUSE
WHOLE HOUSE
No
Yes
Not
No
No
Yes
Yes
No
exemptions
applicable
Registration Number: 215-A0031949A-M0100002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-02-05 08:52:56
Schema Version: 0.551SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 5 of 7 )
K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the
system that are altered. Existing equipment may be exempt from these requirements.
Heating Equipment
Equipment Efficiency: All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency
01
Regulations.
Controls: All unitary heating systems, including heat pumps, must be controlled by a setback thermostat. These thermostats must be capable of allowing the occupant
02
to program the temperature set points for at least four different periods in 24 hours. See Sections 150.0(i), 110.2(b).
Sizing: Heating load calculations must be done on portions of the building served by new heating systems to prevent inadvertent undersizing or oversizing. See sections
03
150.0(h)1 and 2).
Furnace Temperature Rise: Central forced -air heating furnace installations must be configured to operate at or below the furnace manufacturer's maximum
04
inlet -to -outlet temperature rise specification. See Section 150.0(h)4.
05
Standby Losses and Pilot Lights: Fan -type central furnaces may not have.a continuously burning pilot light. Section 110.5 and Section 110.2(d).
Cooling Equipment
Equipment Efficiency: All cooling equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency
06
Regulations.
Refrigerant Line Insulation: All refrigerant line insulation in split system air conditioners and heat pumps must meet the R-value and protection requirements of Section
07
150.0(j)2 and 3, and Section 150.0(m)9.
08
Condensing Unit Location: Condensing units shall not be placed within'five (5) feet of a dryer vent outlet. See Section 150.0(h)3A.
Sizing: Cooling load calculations must be done on portions of the building served by new cooling systems to prevent inadvertent undersizing or oversizing. See Section
09
150.0(h)1 and 2.
Air Distribution System Ducts, Plenums and Fans
Insulation: In all cases, unless ducts are enclosed entirely in directly conditioned space, the minimum duct insulation value is R-6. Note that higher values may be
10
required by the prescriptive or performance requirements. See Section 150.0(m)1.
Registration Number: 215-A0031949A-M0100002A-0000
Registration Date/Time:
2015-02-05 09:05:17
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-02-05 08:52:56
Schema Version: 0.551SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 6 of 7 )
K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the
system that are altered. Existing equipment may be exempt from these requirements.
Connections and Closures: All installed air -distribution system ducts and plenums must be, sealed and insulated to meet the requirements of CIVIC Sections 601.0,
602.0, 603.0, 604.0, 605.0 and ANSI/SMACNA-006-2006: Supply -air and return -air ducts and plenums must be insulated to a minimum installed level of R-6.0 or
it
enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing in accordance with the requirements of Reference
Residential Appendix RA3.1.4.3.8.
Heat Pump Thermostat
12
A thermostat shall be installed that meets the requirements of Section 110.2(b) and Section 110.2(c).
13
The thermostat shall be installed in accordance with the manufacturers published installation specifications
O
14
First stage of heating shall be assigned to heat pump heating.
15
Second stage back up heating shall be set to come on only when the indoor set temperature cannot be met:
The responsible person signature on this compliance document affirms that all applicable requirements in this table have been met.
Registration Number: 215-A0031949A-M0100002A-0000
Registration Date/Time:
2015-02-05 09:05:17
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-02-05 08:52:56
Schema Version: 0.551SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 7 of 7 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Zabatta, John
Company:
Signature Date:
ZABATTA HEATING AND AIR CONDITIONING
2015-02-05 09:05:17
Address:
CEA/ HERS Certification Identification (if applicable):
PO BOX 9368
City/State/Zip:
Phone:
ALTA LOMA CA 91701 1(909)
989-9200
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 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 (responsible builder/installer), otherwise I am an
authorized representative of the responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of.lnstallation conforms to all applicable codes and regulations, and the
installation conforms to the requirements given on the plans and specifications approved by the enforcement agency.
4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of
Installation, and I have ensured that the requirements that apply to the construction or installation have been met.
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 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:
Zabatta, John
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Position With Company (Title):
ZABATTA HEATING AND AIR CONDITIONING
OWNER
Address:
CSLB License:
PO BOX 9368
561159
City/State/Zip:
Phone:
12015-02-05
Date Signed:
ALTA LOMA CA 91701
(909) 989-9200
09:05:17
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A0031949A-M0100002A-0000 Registration Date/Time: 2015-02-05 09:05:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-02-05 08:52:56
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC)
Project Name:
23611 Golden Springs Dr. #1-7 I Date Prepared:
CFIR-ALT-02-E
(Page 1 of 3 )
2015-01-31
A. General Information
CFIR-ALT 02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one CF11R-ALT-02 document for each dwelling unit.
01
Project Name
23611 Golden Springs Dr. #i-7
02
Date Prepared
2015-01-31
03
Project Location
23611 Golden Springs Dr. #i-7
04
Building Type
Single family
05
CA City
Diamond Bar
06
Dwelling Unit Name
23611 Golden Springs Dr. #i-7
07
Zip Code
91765
08
Dwelling Unit Conditioned
900
Floor Area (ft2)
Number of space conditioning
09
Climate Zone
9
10
(SC) systems in this dwelling
1
unit.
B. Space Conditioning (SC) System Information
01
02
03
04
05
06
07
08
09
10
Is the SC
Installing a
SC System
SC System
CIA served
system a
refrigerant
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
WHOLE HOUSE
WHOLE HOUSE
900
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section1S0.2(b)iDiib)
This section does not apply to this project.
Registration Number: 215-A0031949A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-01-31 20:13:27
Report Version: 2014-03-31
Schema Version: 0.551SDD
HERS Provider: CaICERTS
Report Generated: 2015-01-31 20:13:40
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)lE and F)
01
02
03
04
05
06
07
08
09
10
11
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New or
Identification
System
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
New Duct
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Dud Length
R-Value
WHOLE HOUSE
Centrals lit
P
All new
heating,
HSPF
7.7
Central split
All new
cooling
SEER
13
Setback
Less than or
equal to 40
R-6
HP
components
HP
components
feet
Reauired Documentation:
CM-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of dud length is replaced.
-Leakage rate compliance: 515%, or 510% leakage to outside, or seal all accessible leaks.
CFZR-MCH-25-H & MR-MCH-25-11 Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
MRMR-MCH-23 & MR-MCH-23 Air Flow a 300 CFM/ton required when MCH-25 is required.
Exceptions:
-Dud systems registered with HERS provider as previously sealed are exempt from MCH-20 Dud Leakage Testing requirements.
-Heating-only systems and Air-Handler/Furnace changes do not require verification of Air Flow MCH-23, or Refrigerant Charge MECH-25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH-20 Duct Leakage Testing requirements.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 215-A0031949A-000000000-0000 Registration Date/Time: 2015-01-31 20:13:27 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014.03-31 Report Generated: 2015-01-31 20:13:40
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF-iR-ALT HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
L I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: g
Zabatta, John
l..i� �Lr�yy�
UG�ir�
Company:
Signature Date:
ZABATTA HEATING AND AIR CONDITIONING
2015-01-31 20:13:27
Address:
CEA/ HERS Certification Identification (if applicable):
PO BOX 9368
City/State/Zip:
Phone:
ALTA LOMA CA 91701
(909) 989-9200
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 Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be 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 Compliance is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature:
Zabatta, John
Company:
Date Signed:
ZABATTA HEATING AND AIR CONDITIONING
2015-01-31 20:13:27
Address:
License:
PO BOX 9368
561159
City/State/Zip:
Phone:
ALTA LOMA CA 91701
(909) 989-9200
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A0031949A-000000000-0000 Registration Date%rme: 2015-01-31 20:13:27 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-01-31 20:13:40
Schema Version: 0.551SDD