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15-0351
I A)l IN0 Coll. CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Dnve, Diamond Bar, CA 91765 (909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839.7027 BUILDING PERMIT APPLICATION JOB SITE ADDRESS 23 APN " I LOT Tf ACT.---- ..... OWNER ADDRESS CITY f ZIP TEL APPLICARii TTrELL CONTRACTOR ADDRESS P-C , jz. ek- CITYZIPTEL Eat" ARCH/ENGfUE SEGNER---------- �%b ADDRESS CITY ZIP TEL OMEII-SUILM VECLARATION l 1 Eby alTrrn under penVy of Wury tot I am exempt from the contacts s Stale Lluame Lew for the reason(al rs3[wW betaw by tha dxckrA IKS) t have placed nevi b the anficallble nemral ;Bastian 7[a3 k lfaskmm and l Prebalmra Gmb Any city at Exieoh MM r"Wres a Vaimil Is ovatrwil, aft, Impm», demaillion, at raph, any F chniminae, plop to its iemove, ataa r hea Me epphlca"t for ft PNMA to IN a imonail aUisrtt a tnat he or she W fbeoW pce uml to Ile poWthggr of tis Canereckrr'e Slate Lori a Law (triepter 2) Caffimonotiot with S xt on 7000 of ©Mort 3 all the 6oalnetb Wind pmfoobmr Code] or ft he of she is esampt tmm ri w"M sid ft basis tur f~o:ect� Arryviale ortVeSeC5Ms743t SlynnyappR ttarapeaM%utr Mthe appiteam too adpanw at nut moreitmisfwndmddobts{ p LJ 1, as owree rdtho praperty, or my smplgws wIM wagins as their sole win do 0 at alar jj portiorW al fire went, and the smmiv Is not ftridacl or offer eei for sale t action TW Ratings and Normans Ctrd® The Canaaelraa Stab UMM taw dbea not wply et an owner of prop" who IftmV e.npbydp or pe� ~ Wkb or improms the pm"ny, proMlded Mirtzrkw tmWownam are not Imerded at altered tat sale It hwmvs( the finding crr lm pr inrl Is Wo wift to one year of +fit' its Dwnar-Guilder w7 him Um burn at proving that t was not bah or improved for III purpose at We) L) I as owner of ft prtgKrtY, am oxc ou" omfticft with 11ceeSed COrdrtrcrore to OnEbuct Ells pied tom€ 7044 Business arrd Pruf mmns Dada The CaPtftkrrV Cute Uwsa Law does not apply to an arvr.ur of property who buddswend who wirk oeatorMe wthelicenwdCori r numntiatheContrattore'S' Irce=Law I L j I am earnpt Tram Hcerwovi under Me Camrevws Sto Lkense sew for the fm" mmr* ' By my signature below t atwteage that except tor mg "tsorril residence In which I il" Isdve me=hi[ at least one yea!' prior M complatian of Ifit koprovwenta covered by Etch perm I carnet WpN san a giro n ttiat t have built as an rimer Wider ifrt tag not been fonsir tedinIfaerdirpy§yIimtwdwukactotalorioleststy!there�pyaftheap(AlCebla 4*, Section 7344 of the BAnatel aW fth_- g ans Gals Is m5albia upon request when the appitabw is eu6m" d or of the talkw'gWet site blew ww[ecia4bZAgtrrlcalewh fA L»0 WNTRAM'S DEMMPM I try a" jHer pen aty a' Der -sty that t aM licarrood undsr pr Isions at Cam 9¢wmmanang oft Seclior 700, of D49ion 3 ztt the Bustnem and Prat ens Code, and my Iloerise Is in tali tsve wW effect c �+ Lli l'ftSE CLASS &Z40 GC NO DATE S 1 - i$' €XWRAMR �'S �SATIOM r HEREISY At led r rOER PENalTY OF PUvJW0W OF THEFOLLVMNFx OKLA? AMNS I have ind wti mainWin a Cur now& of Cw ont on, Still Ir soro iv Wnrk" Carnparinhon, as prrwltlei by Section 37M col tte I sbor Gods for the pplormam of Via work for whFh the perrnd is Issued i have and will rr$ntain SNatW,% CompenaW Its as ragrdred by Section VW of Ow Law Cade for the wforn-w= # the war} forwhO this thimi i is fled My Wprkers 0orriimsation inanioxn Carrier and PCI,;f Nu7109 eta CAFR,ER PnLreyr�rtM�ER '� "" � Mi S S'_CRON 40 NEST BE iXihft'I -M IF 1W PLiM S FOR ONE K14ORE D OaLLFRS W0%OR LEW, tcut dointreeperformarceo fievattarwhichdvsp0-0a(7Jad tsita4ncfampa{anY9emx L anyrraMxersoasto timoars abkd to the Workerx motion Lava of Oftmia. And a Mai If I sham became svW %; at warkerti i'brnPonprtMsrartadSecTtrnT7r7©dtirs Cads Esf�llortlivrttl€wlLhttroseprarsl3r V�U4RI'dr Fat a'a to 48ciae ftkn u Co." LY1xar1oa Ia antmvfW V.trl.aa 60Iad Bn Eiri*01 Aa a ttMtat permi s W cmi bras up to are luae#ed f usard daAam (SIM q(i(P{ ur 3d&*n to the r9 of dunagesaii pmvidaa for in sectan 3MOtne soda' coat, ntertst and atkxseys tvea CONSIt kCTION LENDING ANY I hereby o0m tmdff penalty, of pa4M tat coare a a Coinstuctloin Laidnq icy far me performance of Me wsrx tar when ttde qe rxat is issued (Sac 3097 Orr is ) LENDER'S NAW LENDER'S ADDRESS i cerLry that I have read lids apptraum and state ft Ira Wove Inisrrnation is ratnool. I apes * comply with all ay sold sauumy radirianm and stab taws rebbeg tD buWhV vix%tv�*n and hereby m~n ropr000ftffm of this 0owdy b #riser upon Ihn abase mofflisred property for inspectk)r puroms PUMITEEE x Ail ji5ifl—r T—URE OF PERNI,/,--- BATE APPLICATION DATE i 'S PIG9 ISSUE DATE a � i � IS PEFIM3TA f"Ek TYPE CONST OGG GROUP ZONING SETBACKS FRCWT RA 13 DEAF C] SIDEISIDE STREET RW EI_- SIDE t �-„— PROPOSED USE i I# DWEL UNITS 9 STORIES _ . BEDROOMS DESCRIPTION so FT FACTOR PSF ADJ AREVVALUAT40N SFFVADO/REM �erport � Lu Ratna/D xck U r. F? 0- ZZ 11416- Wrim pp Re-RoeR hillin..9 cn � Comn�cial Valetiarl Adl Area j QUANTITY DESCRIPTION FEE 1 �rt c'3 u-i 1 ....... .... - -- ----- CONSTRUCTION PLAN REVIEW ELECTRIC PL.0 MBING MECHANICAL INSPECTION FEE ---------- ISSUANCE. SMIP _ ENERGY P/C ENERGY PERMIT RETENTION FEE PRE-ALT FEE BSAF TOTAL FEES y v Y4 COMMENTS RECEIPT A_ a_3_.N A_15 PAID$Y �N\421 VALIDATION ................. WHFTE—Ueprerfrrrsr€iCopy=YELLOW-Finanee%y PINK —AsaswCo y £ sEf ROD-- MoCspy G EA—Ap0Icent'sCGpey SETBACK/LETTER FOOTINGS FORMS" SLAB UG PLUMBING UG ELECTRICAL UFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAWN&VEN-l"ING ROUGH MECHANICAL , a - ROUGH ELECTRICAL W Cr() ,� ' a ROUGH PLUMBING P , INSULATION WALL t + u s ` INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T C of OCCUPANCY CERi. of OCCUPANCY COMMENTS CITY OF DIAMOND BAR INSPECTION RECORD o� - • TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T-BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTICICESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P-TRAP FENCE / GATE/ ALARM FINAL POOL WALLS WALL FOOTING/STEEL WALL STEEL 1-( ) 2NO( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL RO FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HFALTH DEPT. FINAL INDUSTRIAL WASTE M CL a G 'a a �SQ 25r6"N CL all m 7 ia1 Al X ei E a !ny W Er n INA Crg yy S L S Q K, Tu M tlS lit C CL mz O 1 6 Q m m a a m a a o N7 a �'s �'a O R° LA w wI 1+ a V_i p9 Q7 �`5' a cr 61 Da= zsa�W Db = a to d _ o g n v to Z W 3 Z or z� z G1 �° 33 9 s 3 3 � s asID 3 r sic K�1g�d m $� r- - BL 2 �� s c C CL g 3 r C o Q O 0�0 1p kD �0 iAr p d� lK tocr W j O 2 I a� aIA s ' O 3 n a O c ff 0 v cr V g S e 1 if CERTIFICATE OF VERIFICATION CF3R-MC"-20-H Duct Leakage Diagnostic Test (Rage 1 of 3 ) y Project Name. 23601 golden springs dr #a-1 Enforcement Agency, City of Permit Number. PR15-351 Diamond Bar Dwelling Address 23601 golden springs dr City. Diamond Bar Zip Code- 91765 #a-1 A. System Information O1 Space Conditioning System Identification or Name., whole house ` 02 Space Conditioning System Location or Area Served whole house 03 Building Type from CF-11R Single family Verified Low Leakage Ducts in Conditioned Space No, credit is not taken 04 (VLLDCS) Credit from CF1R7 Verified Low Leakage Air Handling Unit Credit from No, credit is not taken 05 CF1R7 06 Duct System Compliance Category Y ' 3 Alteration I } MCH-20d - Complete Replacement or Altered Duct System l B. Duct Leakage Diagnostic Test O1 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 015 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-A0040862A-M2000002A-M20A Registration Date/Time 2015-02-23 08 57 00 HERS Provider CaICERTS CA Budding Energy Efficiency Standards Report Version 2014-05-08 Report Generated 2015.02-23 08 55 02 2013 Residential Compliance Schema Version 0 51SDD CERTIFICATE OF VERIFICATION CF3R-MCH- tt-tf Duct leakage Diagnostic Test {Page 2 of 3 } w` B. Duct leakage Diagnostic Test nl Notes C. Additional Requirements for Compliance Ol System was tested in its normal operation condition No temporary taping allowed Outside air (OA) ducts for Central Fan Integrated (Cfl) ventilation systems, shall not be seaIeditaped off during duct leakage testing CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet 02 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 Cis if cloth backed tape was used it was covered with Mastic and draw bands 06 All connection pomts between the air handler and the supply and retui n plenums are completely sealed If the system complies using the Smoke jest method;'the smoke test was conducted in accordance with the requirements 07 of Reference Residential,Appendix'RA314 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 QJ Correction Notes for this table 'ihe responsible persons signature on this compliance document affirms that all applicable requirements inthis table have been met unless otherwise noted In the Verification States 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-ACRi40862A-iiti2€ 00002A-MZGA Registration llate/Tirne 2015-02-23 08 57 00 HERS Provider CaiCERTS CAA Building Energy Efficiency Standards ReportVersion 2014-05-08 ]report Generated 201 s-02-23 08 SS £i2 2013 Residential Compliance Schema Version ti 51SI) 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. f Documentation Author Name Documentatlan Author Signature John Kwan Company Date Signed J K Air Balancing & Duct Testing 2015-02-23 08 57 00 Address CEA/ HERS Certification Identification (If applicable) 9040 Telstar Ave #137 3012 City/State/zlp Phone El Monte CA 91731 626-274-0522 Responsibte Person's Declaration statement I certify the hollowing under penalty of perjury under the laws of the State of California T 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 on Reference Appendices RA2, RA3, and the requirements specified on the,Certlflcate'of Compliance for the building approved by the enforcement agency lu d The information reported ixi applicable sectloris of the Certificate(s) of installation ICFZR) signed and submitted by the persons) responsible for the construction of installation toltforms; to the requirements specified on the Certiflcate(s) of Compilatice (CFIR) �ppro"d by the enforcement agency S 1 will ensure that a registered copy,of this Certificate of Verification shall be posted, or made available with the Wilding permits) Issued for the burlding, and made avallable to the enforcement agency for,all'appIK8bie inspections I undeistend that a registered copy of tfils Certificate of Verification is requlFeil to be Inciudect'vrifh the documentallon the builder provides to the building owner at occupancy Builder Or Installer Information AS Shown On The Certificate Of Installation Compamr Name (installing Subcontractor, General Contractor, or guilder/owner) ZABATTA HEATING AND AIR CONDITIONING Responsible Builder or Installer Narne CSLB License John Zabaitta 561159 HERS Prt eider Data Registry information Sample Group Number (A applicable) Dwelling Test Status in Sample Group (if applicable) Tested HERS Raster Information HERS Rater Company Name J K Air Balancing & Duct Testing Responsible Rater Name John Responsible Rater Signature Kwan Responsible Rater Certification Number w/ this HERS Provider Date Signed CC2005646 2015-02-23 08 57 DO Digitally signed by CaICERTS This digital signature is pmvrded in Dialer to secure the content of this registered document and rm rw way umpires ReWstraimn Provider responsibility for the amracyof the mlixrmorlen Registration Number 215-Ai 040862A-M2t3T 0002A-M20A Registration Date/Time 20IM2-23 08 57 00 HERS Provider CaICERTS CAA Building Energy Effictency Standards Report Version 2014-0S-08 Report Generated 201S-02-23 08 55 02 2013 Residential Compliance Schema Version 0 SJSDID CERTIFICATE OF VERIFICATION C17311-MCH-23-Ii Space Conditioning System Airflow Rate (Paige 1 of 4 } Project Name. 23601 golden springs dr #a.1 Enforcement Agency City of Permit Number. PR15-351 Diamond Bar Dwelling Address, 23601 golden springs dr City. Diamond Bar Zip Code, 91765 #a-1 A Ducted Cooling System Information tl1 System Identification or Name whole house 02 System Location or Area Served whole house 03 System Installation Type Alteration 09 Nominal Cooling Capacity (tons) of Condenser 2 A5 Condenser Speed Type .Single Speed 06 Cooling System Zonal Control Type Not Zonal 07 Central Fan Integrated JCFI) Ventilation System Status,, Not a Ci l system a,F 08 System Bypass Duct Status E No Bypass Duct, , W 09 Hate of Systems Airflow hate Measurement 2015-02-23 1Ci Airflow Rate Protocol utilized RA3 3 procedures for airflow rate measurement 8. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently Installed Static Pressure Probe (PSPP) in the supply plenum. Procedures for instalting HSPP or PSPP are specified in RA3 3 11 01 1 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 11, and system airflow rate measurement apparatus Information is given in RA3 3 2 01 Airflow Rate Measurement Type used for this airflow rate Flow Grid according to procedure in RA3 3 3 12 verification 02 Manufacturer of Airflow Measurement Apparatus TEC 03 Model number of Airflow Measurement Apparatus DG700 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-A00408i12A-M230 2A-M23A Registration Date/Time 2015-02-23 08 57 44 HERS Provider CaICERTS CA Building Energy Efficiency Standards Report Version 2014-05 08 Report Generated 2015-02-23 08 55 39 2013 Residential Compliance Sr-hema Version 0 51SDD , CERTIFICATE OF VERIFICATION space Conditioning System Airflow Rate (Page 2 of 4 ) MCN-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 bate (cfm/ton) 300 02 Required Minimum System Airflow Target (cfm) 600 03 Actual System Airflow Rate Measurement (cfm) 656 04 Compliance Statement System airflow rate complies E. Additional Requirements 01 Air filters that meet the applicable requirements of Standards Section 150 0(m)12 or ISO 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 Q 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 (cfrn/ton) and fan 08 efficacy (Watt/cfm) with system operatfng 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 Mates 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•A004Q862A-M2300002A-M23A Registration Date/Time 2015-02-23 08 57 00 HERS Prmder CaICERTS CA Building Energy Efficiency Standards Report Version 2014-05-08 Report Generated 2015-02-23 08 55 39 2013 Residential Compliance Schema Version 0 51SDD CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditloning System Alrflow hate (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 whale to be determined to be in compliance j 01 1 Complies Ail specified verification protocol requirements on this document are met [ Registration Number 215-A0040862A-M2300002A-M23A Registration Date/Time 201"2-23 08 57 00 HERS Provider CaICERTS CA Building Energy Efficiency Standards Report Version 2014 05-08 Report Generated 2015-02.23 08 55 39 2013 Residential Compliance Schema Version 0 5150O CERTIFICATE OF VERIFICATION CF3R-MCN-23-H Space Conditioning System Atrflow Rate (Page 4 of A ) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name John Documentation Author Signature Kwan Company Date Signed J K Air Balancing & Duct Testing 2015.02.23 08 57 00 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 1 certify the following under penalty of perjury, under the taws 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 E 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 d The information reported on applicable sections of the Certiflcateis) of installation (CUR) signed and submitted by the persons) 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 Venfication shall be posted, or made available with the building permit(s) issued for the buiiding, 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 fume (Installing 5ubcontractor, General Contractor, or Builder/Owner) ZABAiTA HEATING AND AIR CONDITIONING Responsible Builder or Installer Name MR License John Zabatta 561159 HERS Provider Data Registry Information Sample Group Number (if appbcabie) Dwelling Test Status in Sample Group (if applicable) Tested HERS stater Information HERS hater Company Name 1 K Air Balancing & Duct Testing Responsible Rater fume John Kwan Responsible Rater Sinature Responsible Rater Certification Number w/ this HERS Provider date Signed CC2005646 2015-02-23 08 57 00 flrgiratfy signed by CoICERTS This ragrtal signature is provided in order to secure the content of this registered docament and in noway rrnphes Regwration Provider responsibility for the accutacy of the information Registration Number 215-A0040882A-M2300002A-M23A Registration Date/Time 2015-02-23 08 57 00 HERS Provider CaICERTS CA Building Energy Efficiency Standards Report Version 2014-05-08 Report Generated 2015-02-23 08 55 39 2013 Residential Compliance Schema Version 0 5150D CERTIFICATE OF VERIFICATION CF3R•MCH-25-H Refrigerant Charge Verification (Page 1 of 4 ) Project Name 23601 golden springs dr #a-1 Enforcement Agency City of Diamond Bar Permit Number PR15-351 Dwelling Address 23601 golden springs dr #a-1 City Diamond Bar Zip Code 91765 A System Information HERS Rater to field -verify all system information, discrepancies to be noted by overwriting entry. 01 system Identification or Name whole house 02 System Location or Area Served whole house 03 Condenser (or package unit) make or brand DAY AND NIGHT 04 Condenser (car package unit) model number N41-1324AKF200 O5 Nominal Cooling Capacity (tons) of Condenser 2 06 Condenser (or package unit) serial number E145001873 07 Refrigerant Type R-410A 08 Other Refrigerant Type (if applicable) 09 System Installatton Type Alteration 10 Charge indicator Display (CID) Status (Neste Even systems This system does not have a CID device installed 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 systems 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 3 3 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 RAl 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 RAI)-) 13 j Date of Refrigerant Charge Verification for this system 2015-02-23 14 Refrigerant charge verification method used Subcooling (outdoor temperature must be equal to or greater than 55 degF) 15 Person who performed the Refrigerant Charge Verification HVAC system installer reported on this Certificate of installation 16 HERS Verification Compliance Requirement Status System qualifies for group sampling 17 Refrigerant charge verification method used by HERS Rater Subcool Registration Number 215•A0040862A-M2500002A-M25A Registration Oate/Tirne 2015-02.23 08 57 00 BIERS Provider CaICE TS CA Building Energy Efficiency Standards Report Version 2014-05.08 Repeat Generated 2015 02-23 08 56 27 2013 Residential Compliance Schema Version 0 5515DD 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 CF211 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 Od 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 m reference Residential Appendix RA3 2 2 3 01 1 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 Atrflow state Verification Status System complies with minimum airflow rate requirements F. Data Collection - HERS Raster 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 C11 Lowest return air dry bulb temperature that occurred during 65 the refrigerant charge verification procedure (degreeF) fl2 Measured Condenser air entering dry-bulb temperature (T 73 condenser d6) Registrat€on Number 215-A0041D862A-M2500002A-M25A Registration Date/Time 201"2-23 0 $7 00 HM Provider UCERTS CA Building Energy Efficiency Standards Report Version 2014.05.08 Report Generated 2015-02 23 06 56 27 2013 Residential Compliance Schema Version 0 5515DD 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 to Reference Residential Appendix RA3 2 2 and RA3 2 2 2 03 Outdoor Temperature Qualification Status Outdoor temperature is within range for using Subcoolmg refrigerant charge verification method 04 Measured liquid Line Temperature (Thquid) (degreeF) 62 05 Measured Liquid Line Pressure (Pig, ) (pisg) 203 06 Condenser saturation temperature (Tcondenscu ter) from digital 72 gauge or P-T Table using line FOS (degree F) 07 Measured Subcooling 10 08 Target Subcooling 13 09 Compliance Statement System complies with Subcooling Method - Must also pass metering device verification, next section E 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 (Tsucrron) (degreeF) 56 02 Measured Suction line pressure (Psucuon) (psig) 102 03 Evaporator saturation temperature fTevawatot, sat) from digital gauge or P-T Table using line G02 (degreeF) 32 04 Measured Superheat 24 05 Measured Superheat is between 4 and 2S deg F (inclusive) Passes CEC requirement 06 Measured Superheat is within manufacturer's specifications, if known Yes, documentation to be provided upon request t07 Compliance Statement Metering device verification passes H Determination of HEMS 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 A0040862A-M250W02A-M25A Registratton Date/Tirne 2015-42-23 08 57 00 HERS Provader CaICFRTS CA 8uiWing Energy Efficiency Standards Report Version 2014-05.O8 Report Generated 2015-02-23 08 56 27 2013 Residenttal Compliance Schema Version 0 551SDD 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 John Kwan Company Date Signed 1 K Air Balancing & Duct Testing 2015-02-23 08 57 00 Address CEN 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 Certificateis) 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 budding, 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 Budder/Owners 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 1 K Air Balancing & Duct Testing Responsible Rater Name Responsible Rater Signature John Kwan Responsible Rater Certification Number w/ this HERS Provider Date Signed CC2005646 2015-02-23 08 57 00 Digifafly 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-A0040862A-M2500002A-M25A Registration Date/Time 2015-02-23 08 57 00 HERS Provider CaICERT5 CA Building Energy Efficiency Standards Report Version 2014-05-08 Report Generated 201S-02-23 08 56 27 2013 Residential Compliance Schema Version 0 5515DD CERTIFICATE OF INSTALLATION CFZR-MCH-2ti-H Duct Leakage Diagnostic Test (Page 1 of 3 ) Project Elaine 23601 golden springs dr #a-1 Enforcement Agency City of Permit Number PR15-351 Diamond Bar Dwelling Address- 23601 gulden springs dr City. Diamond Bar Zip Code 91765 #a-1 A System Information 01 Space Conditioning System Identification or Name whale 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 net taken 05 Verified Low Leakage Air Handling Unit (VLLAHU) Credit from CF1R? No, credit is not taken i 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 (kgtu/h) 24 03 Conditioned Floor Area served by this HVAC system (it2) 900 04 Duct Leakage Test Condition Test final 05 Duct Leakage Test Method Leakage to the outside 06 leakage Factor "0 1 07 Air Handling Unit Airflow (AHUAirflow) Determination Method Default air flow method 08 Measured AHUAirflow This field or section is not applicable 09 Calculated Target Allowable Duct Leakage (cfm) 45 10 Actual duct leakage rate from leakage test measurement (cfm} 33 11 1 Compliance Statement System passes leakage test Registration Number 215-A 40862A-M2t fi2A- Registration Date/Time 2015-02-23 08 58 48 HERS Provider CaICERTS CA Building Energy Efficiency Standards Report Version 2014-05-08 Report Generated 2015-02 23 08 47 31 2013 Residential Compliance Schema Version 0 S1SDD 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 14 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-A0040862A-M2000002A-0000 Registration Date/Time 2015-02-23 08 58 08 HERS Provider CalCERTS CA Building Energy Efficiency Standards Report Version 2014-05-08 Report Generated 2015-02-23 08 47 31 2013 Residential Compliance Schema Version 0 51SDD CERTIFICATE OF INSTALLATION CF2R-MCH-20-H Duct Leakage Diagnostic Test (Page 3 of 3 1 Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Installation documentation is accurate and complete, Documentation Author flame Documentation Author Signaturt John Zabatt, Company signature Date 2015-02-23 08 56 08 ZARATTA HEATING G 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 t The information provided on this Certificate of installation is true and correct 2 1 am eligible sender 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 rdentified on this Certificate of Installation and attest to the declarations in this statement (responsUe builder/installer), otherwise I am an authorized representat a of the responsible budderfinstaller 3 The constructed or installed features, materials, components or manufactured devices (the Installation) identified an this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements Risen 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 representat ves 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 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 I Installation have been met 6 t will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with the building permits) issued for the building, and made available to the enforcement agency for all applicable inspections I understand that a registered t€ipy of this Certificate of installation is required to be included with the documentation the builder provides to the building owner at occupancy Responsible 0udder/Installer Name Responsible Budder/installer Signature John Zabatta Company Name (Installing Subcontractor or General Contractor or Piaisition Witfs Company (Title) Rudder/Qwnerl OWNER 2-'ABAT'1'A HEATING AND AIR CONDITIONING Address C5L8 License PO BOX 9368 1561159 City/state/Zip Phone Date Signed ALTA LOMA CA 91701 (909) 989-9200 201 -t32-23 08 58 08 Third Party Quality Control Program {TPQCP) Status Fame of TPQCp (if applicable) Digit-Wy signed by UCr<RTS This di9ttat signature is provided in order to secure the co ment of this registereddocirmenl, and in no way rrsi hes Regrstratio; provider €es parrsrbilrty for the accuracyof the information ReglstrationNumber 215-A0040862A-M2000002A0000 RegistrattonDate/Time 2016-02-23085808 HERS Provider CaICERTS CA Building Energy Efficiency Standards Report Version Z014-05-08 Report Generated 2015-02.23 08 47 31 2013 Residential Compliance Schema Versic ri 0 SSSOD CERTIFICATE OF INSTALLATION CF2R-MCH-23-H Space Conditioning System Airflow Rate (Page 1 of 3 ) Project Name, 23601 golden springs dr #a-1 Enforcement Agency City of Diamond Bar Permit Number PR1S-3S1 Dwelling Address 23601 golden springs dr #a-1 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 Not a CFI system 08 System Bypass Duct Status No Bypass Duct 09 Date of System Airflow Rate Measurement 2015-02-23 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 11 O1 IMethod 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 11, and system airflow rate measurement apparatus information is given inRA3 32 01 Airflow Rate Measurement Type used for this airflow rate Flow Grid according to procedure in RA3 3 3 12 verification 02 Manufacturer of Airflow Measurement Apparatus TEC 03 Model number of Airflow Measurement Apparatus DG700 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-A0040862A-MZ300002A-0000 Registration Date/Trme 2015-02-23 08 58 08 HERS Provider CaICERT5 CA Building Energy Efficiency Standards Report Version 2014-05-08 Report Generated 2015-02-23 08 49 05 2013 Residential Compliance Schema Version 0 S15DD CERTIFICATE OF INSTALLATION CF2R-MCH-23-H Space Condltloning 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 (CfmAon) 300 02 Required Minimum System Airflow Target {cfrn 600 03 Actual System Airflow Rate Measurement (cfm) 656 04 1 Compliance Statement System airflow rate complies E. Additional Requirements 01 Air filters that meet the applicable requirements of Standards Section 150 0(m)12 or 150 0jm)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 31 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 coaling systems or variable speed compressor systems shall verify air flow (cfm/tonl and fan OR efficacy (Wattjcfm) 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-AO040862A-M2300002A-0000 Registration Date/Time 2015.02-23 08 56 08 HERS Pravtder CaICERTS CA Building Energy Efficiency Standards Report Version 2014-05-08 Report Generated 2015-02-23 08 49 05 2013 Residential Compliance Scherna Version 0 S1SDD CERTIFICATE OF INSTALLATION CFZR-MCH-23-H Space Conditioning System Airflow Rate (Rage 3 of 3 ) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Installation documentation Is accurate and complete. Documentation Author Name Documentation Author Signature John Zabatta ��?� Company Signature Date 2015-02-23 08 58 08 ZABATTA HEATING AND AIR CONDITIONING Address CEA/ HERS Certification Identification (€f applicable) PO BOX 9368 City/State/Zip 1(909) phone ALTA .OMA CA 91701 989-9200 Responsible Person's Declaration statement I certify the following tinder penalty of penury, under the laws of the State of California I The information provided on this Certificate of InstallatiOn is true and correct 2 1 am eligible under Division 3 of the business and Professions Cade in the applicable classification to accept responsibility for the systems design, Con5trVttion, or installation of features, materials, components or manufactured devices for the scope of work identified on this Certificate of installation and attest to the dedarat€tans in this statement (responsible builder/installer), otherwise I am an authorized re prese ntauve of the responsible builder/installer 3 The constructed or installed features, materials, components or manufactured devices (the lnstallatronl identified on this Certificate of Installation conformsto 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 +nstaliations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fait to meet the [ requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS samplegroupwili be performed at myexpense 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 instatation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met 6 f 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 suspect ions 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 fluslder/InstalierSignature Jahn Zabatta Company Name (installing Subcontractor ar 6crieral Contractor or Position With Company (Title) Builder/Owner) OWNER ZABATTA HEATING AND AIR CONDITIONING Address CSLB License p0 BOX 9368 1561159 City/State/Zip Phone Hate Signed ALTA LdOMA CA 91701 (909) 989-9200 2015-02-23 08 58 08 Third Party Quality Control Program {TPQCP) status Name of TPQCP (if applicable) 0igi1ally srgried by Ca10ERTS This digital signature is provided in €rrder to secure the conleril of this registered dortrmerrt and in noway inwhes Registration Prow*r responsiWay f" the aiccuracyril the rriforrnatwn Registration Number 215 A0040862A-M2300002A-0000 Registration Date/Time 2015-02-23 08 58 013 HERS Provider CaICERTS CA Bunting Energy EffTctency Standards Report Version 2014-05-08 Report Generated 201.5-02-23 08 49 05 2013 Residential Compliance Schema Version 0 515DD CERTIFICATE OF INSTALLATION CFZR-MCH-ZS-H Refrigerant Charge verification (Page 1 of 5 ) Project Name 23601 golden springs dr #a-1 Enforcement Agency City of Permit Number PR15-351 Diamond Bar Dwelling Address 23601 golden springs or City Diamond Bar Zip Code- 91765 #a-1 A System Information Each system requiring refrigerant charge verification will be documented can 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 FIGHT 04 Condenser (or package unit) model number N4H324AKF200 05 Nominal Cooling Capacity (tons) of Condenser 2 06 Condenser (or package unit) serial number E145001873 07 Refrigerant Type R-410A 08 Other Refrigerant Type (if applicable) 09 System Installation Type Alteration 10 Charge Indicator Display (CID) Status (Note Even systems This system does not have a CID device installed 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 i 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 S5F (RA3 2 2, or RAl);- 13 Date of Refrigerant Charge Verification for this system 2015-02--23 14 Refrigerant charge verification method used 5ubcooling (outdoor temperature must be equal to or greater than 55 degF) 1 Person who performed the Refrigerant Charge Verification HVAC system installer reported on this Certificate of Installation 16 HERS Verification Compliance Requirement Status System qualifies for group sampling Registration Number 215-A0040862A-M2500002A-0000 Registration Date/Time 201 a-02-23 08 58 08 HERS Provider CaiCERTS CA Building Enemy Efficiency Standards Report Version 2014-05.08 Report Generated 2015-02.23 0$ S2 4B 2013 Residential Compliance Schema Version 0 551SDD CERTIFICATE OF INSTALLATION Refrigerant Charge Verification Standard Charge Verification Procedure - CF2R-MCH-25b - Subcooling Method CFZR-MCH-25-H Ipage2cif5) S. Metering Device Verfication Subcociling Method can only be used on systems that have a variable metering device 01 Refrigerant metering device Thermostatic Expansion Halve (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 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 Procedures for installing MAH are specified in Reference Residential Appendix RA3 2 2 3 Method used to demonstrate compliance with the MAH installed and labeled consistent with Figure 3 2-1 01 Measurement Access Hole (MAH) requirement E. Minimurn 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 65 the refrigerant charge verification procedure (degreeF) 02 Measured Condenser air entering dry-bulb temperature (T 73 condenser, db) Registration Number 215-AO040862A-M2500002A-0000 Registration Date/Time 2015-02-23 08 58 € 8 HERS Provider CalCERTS CA Building Energy Efficiency Standards Report Version 2014.05-08 Report Generated 2015-02-23 08 52 48 2013 Residential Compliance Schema Version 0 551SDD CERTIFICATE OF INSTALLATION CFZR-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 03 Outdoor Temperature Qualification Status Outdoor temperature is within range for using Subcooling refrigerant charge verification method 04 Measured Liquid Line Temperature (Tiiquid) (degreeF) 62 05 Measured Liquid Line Pressure (Phqu.d) (ping) 203 06 Condenser saturation temperature (Tcandensw, sat) from digital 72 gauge or P-T Table using Line FOS (degree F) 07 Measured Subcooling 10 08 Target Subcooling 13 09 Compliance Statement System complies with Subcooling Method - Must also pass metering device verification, next section 6 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 ( 'suction) (degreeF) 56 02 Measured Suction line pressure (Psuaico) (prig) 102 03 Evaporator saturation temperature (Tevapacaw, sat) from digital garage or P-T Table using line G02 (degreeF) 32 04 Measured Superheat 24 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 - CFZR-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 2 5-AD040862A-M25OW02A-0000 Registration Date/Time 2015-02-23 08 58 08 HERS Provider CaICERTS CA Building Energy Efficiency Standards Report version 2014.05.08 Report Generated 2015-02.23 08 52 48 2013 Residential Compliance Sc#iema versisan 0 551SDD CERTtFICATE OF INSTALLATION MR-MCH•25-1i Refrigerant Charge Verification (Page 4 of 5 ) i Charge Indicator Display Additional Requirements This section does not apply to this project Regfstmtron Number 215-AO040862A-M250DO02A-0000 Registration Date/TEme 2016-02-23 08 58 08 HERS Provider CaICERTS CA Building Energy Efficiency Standards Report Version 2014-D5-€78 Report Generated 2015-02-23 08 52 48 2013 Residential Compliance 5c ema Version 0 5515DD CERTIFICATE OF INSTALLATION CF2R-MCH-25µH Refrigerant Charge 1lerlfication (Page 5 of 5 ) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Installation documentation Is accurate and complete. DQCumentarfori Author Name Documentation Author Signature John Zabatta ��� Company Signature Bate 2015-02-23 08 58 08 ZABATTA HEATING AND AIR CONDITIONING Address CEr HERS Certification Identification (if applicable) PO BOX 9368 City/state/Zip Phone ALTA LOMA CA 91701 (909) 989-9200 Responsible Person Declaration statement it certify the following under penalty of perjury, under the taws of the State of Cahlo€nta 1 The information provided on this Certificate of Installation is true and correct 2 1 am eligible under 0ivision 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 jinstalter), otherwise t 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 A 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 arose installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HER$ sample group will be performed at my expense 5 1 reviewed a copy cif the Certificate of Compliance approved by the enforcement agency that identifies the .specific requirements for the scope of construction or installation identified can this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met i 5 I 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 budding, 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 ifauider/Installer Name Responsible guilder/instaliersignature John Zabatta Company Name (Installing Subcontractor or General Contractor or Position With Company (Title) guilder/Uwrter) OWNER ZABATfA BEATING AND AIR CONDITIONING ,address CSLB License PO BOX 9368 561159 C #y/State/Zip Phone Hate Signed ALTA LOI A CA 91701 (909) 989-9200 2015-02-23 08 58 08 Third Party Quality control Program (TPQCP) Status Name of TPQCP (€f applicable) Diplafby signed by CaICERTS Tins digital signature is provided in order to secure the contenl of t!>ts registered document and tit no way implies Rettrai€abon Provider responsibility for the accuracy at the information Registration Number 215-AOG40862A-MZ500002A-0000 Registfation Date/Time 2015r02-23 08 58 08 HERS Provider CaICERTS CA Building Energy Efficiency Standards Report Version 2014-€35.08 Report Generated 2015-02-23 08 52 48 2013 Residential Compliance Schema Version 0 5515DD s _.-.T---� LA ��, �� S r 0 C. o *"= c OB d s 3 N w 3 a s r 1 1 2 07 17. tin un O ss 7 o w � d w u I tic ca I � l � w W � ty — P Q a to cc z 0 CL a w m a m E EL cr vi ca E o o °1 �+ ro as go c a CLw a j cc V ui w C TJ aD a � oa w n c ps E te C � � Ca :� VRrl C a C C� C E ;. 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