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HomeMy WebLinkAbout15-0351� tit l) HA CITY OF DIAMOND BAIT DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Dave, Diamond Bar, CA 91765 (909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839.7027 BUILDING PERMIT APPLICATION JOB SITE ADDRESS APN k-1 __ LOT TRACT OWNER-. 4_0110 idt * ADDRESS CITY Ir? ZIP TEL APLICANT TEL CONTRACTOR ,�� 4 - , 11 f CT ADDRESS CITY LT _vr&+r"s4 _ZIP01111' TEL ARCH/ENGfUESIGNER _---------- lib/ ADDRESS CITY ZIP_••,... TEL OWNER-BIIG-VE1111 DEICIL RON 1 heresy arty under penaly of Drury plat I ern exempt from the Cont wIlar's State 1.1wrrse taw ter are reawn(a) vdimlad below by the OmOrrrta V0 f love Maud wd ID iha oppilicalble Item(s) It3ecton ?03tA loskom and Probatorrs Code Arty tsly or eala+tt tall rwMres a prerwaf to cons hoc oft, Improa, den Net a rapak, any struftire, plot to No IsaLw", else roeA me to applicant far the permit beBI! a signed slakino Lhat heer she L fkxrrpd puretrartt to fha previfto t f pre CordneclWa State p lower Law (Clapper $ C.odemmw eking w Or Swoon 7000 od Dholislon 3 of ilk frrms[tnei9 atl Prot waiorp f;oda] orthat hew are is aaannpt trom rrcumm and ft basis fw the afbQed mrempaon Wry vatalbn a4 5hztah 7011 5 try any appkhWht for a perrrha suth the spollaw ba ov9 p m* of r rz we tin lira twndrad dollars (SSDO} U 1, as aw bit of the property, or my ampioyeas writ wsoos as their so componsagm will do U all of orU partur" of the work and the ahranure u not nrtaridal oroftv m for sale (S flon 7044 Suaness and Proftrsslons Coda The Caner Mt Stall License taw does net ai to an owner of propety who throrrgrf employees or parWW ~ badkta or improver the property, provided that "e imp are not Intended or offered for sew t hawsver the building or Improwemert Is add WtWn ono year of haampWw, the Omer-Bullder wed have the'airden rk prow" that N was not bryh j or imprwo for the purpose, of rats) U I as Mover of tfe Pro" am exch serely werInKft wt i Ifeensed Contraca" In randw fare p4W (Section 7044 Bush,= av Profaamne 000 The Corttraclo ° Slaw Llcmnta Law does not to an awrer of property, who buddsaImproves therew,endwhouorr sMsfor the wthakansedContractor pureawrdIntheContraetors'UM I==Law) L) I am exempt from under the ContscW t Ste4s fkemmae tar for pre folio" raaaoro)r ` By my slgnahae below I IO Mel;ge that esCept to my pe &Yid residenCe In which I t'W have resided for at lust one year pnor to ampietkn of the urprr+ementa Covered by Us permit I can at legacy sea a ryxfrtttrs pet I have WN as an owner Wider ifnhasnot been cosiltrowdfotoeridirWybyl eaubectaraaunde!stiemthetacaoyettlleapplftaeble faro, Sectan 7044 of the Bed and Prot *ons Cede Is aralable dporh request when this appikation is submMool or st lie tal wng Web site htrpJwwhv fet4rda a gawkslew hhrd DATE 5" LSD CONTRACTOR'S DEECILARIT IN I fly, a" lender penalty of Det ury that I am IrAnsod under pmLIW4 of Chapter R loommenong with Swkrr 7OWr b Oid9ien 3 of the "ness and RVamm Cods. wW my Ilcanr Is in tut torce and effect LiCUM LASS LICNO DATE Z- )1- tg' WNTRAMOR W=ER`S =MSATwN l HEREBY AFFW UNOM PENALTY OF PERA W ONE OFTHEFOUdNyIND DECLWTpt$ _ I time and will maintain a Cer"flws of Conowt W Set Imes for Wbrkert Conpenwhon, as provided by Secbar 37M of the Labor Code for the psrforntam at the work for which this permd is issued I have and will awls to WorWs Compero"m Ire as raored bif Section 3700 of the Lana Code for ow parlorn'mno8 of the work forwhic h tho pemii is Issued fNY WpnverS t�Ihrwarwtart rnsrawzm Carrier anti PoWylilunberare rARR;FR POLICY �� MM SECIION WD NOT BEi> AIEIED IFTFIE PEia4t'f f$ FOR o E KINoFB D _vM gS10fb OR LESS} I t�klY prat in ire pertanrhar� d pre w,ak 4s which due pertwt o tsyaed I sfn:l nc�4 employ enY?ersm kit stay hrswnr sa ae to suojeci b to woryas Crorrghermetor� Laws Cf Chdfohto Art a ftlal If I tthald haute aaarjcect kI pro Wakerb EkfnP Drevhrara d Seli€sr Tt00 d tea labjr cow I "I farghy�f ewgrfj' With oera prim€ CAM �rYI� _APP JCW IS_/., �h. WARN11% Failure to seuae 7hxhmnr'a �ornerege Is u012wr411 and Shan 5010f an empkryer to trimnal pan" and chi 5rra up to one ranp*ed ifmhlsatd rollers (Si DO 000) uh addirquh 0 the cog of the outrun Cannes as prewded for in section 37W of the Wor code, interest and apt mays Im CDAISTRtICTION iEMING AIM I hereby affirm reader penally of 00wy that sere is a Construction Loading Agency ter Ca perfomance of the wore ter which ttds tarrmt is lowed (Sat 3097 Ceir C ) LENDER ►wry LEFWER'S atIBRE9S I comfy that I haw read ids application and state tat ffw inane Inf rmabin Is correct I agree x may with all ay and county ordinances and =0I13ws re>atin to bu0dfng cv utv torte and hereby sh#haiza twos of this oorrr4 b enter upon the abmw motored pmp" for inspectkar p ugxwes ZBhbi 2*04-776— PSI NIME NAME (PRIM) SMTIM OF PERM BATE L�1_►1171_L APPLICATION DATE ' � j PICA ISSUE DATE a I S PERMfT# P'QL TYPE CONST OCC GROUP ZONING SETBACKS j FRONT RW REAF ❑ SIDE/SIDE STREET RW CI SIDE Et - PROPOSED USE r 1 0 DWEL UNITS fit STORIES -- N BEDROOMS DESCRIPTION Sty FT FACTOR PSF ADJ AREA/VALUATION SFFVADD/REM C-981cal"Port 1 v} w Pathoxvick U. Pootr"rpa RtRoor � Comrhuvc7al i Val"ton AdI Area j QUANTITY DESCRIPTION FEE t� { CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE S 5 Ft i SMIP _ ENERGY PAC ENERGY PERMIT RETENTION FEE - . cxn, PRE-ALT FEE BSAF TOTAL FEES COMMENTS I RIECEIPT A PAfEI $VAJJDAT10N IiIn YttltrT€—DvparbnentCapy.YEU.01N-- Finance CgN FINK—AsxsarxCoR ST IXIENR00—FAACophy GFtEEN—Appllaent'sCopy 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 FRAMINGNENTING ROUGH MECHANICAL • ` °~ f ROUGH ELECTRICAL W �f ROUGH PLUMBING e f , INSIILATInN WALL ! + L s as AdV4 r" " 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 CERff. of OCCUPANCY COMMENTS CITY OF DIAMOND BAR INSPECTION RECORD 7TRACT7LEDGER7 COMMERCIAL HOOD T-BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL 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 f GATE/ ALARM FINAL POOL WALLS WALL FOOTING/STEEL WALL STEEL JSr( ) 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 HEALTH OEPT, FINAL INDUSTRIAL WASTE S, tA O 'a W 01 o c ww Fd` n y 0 xy� 1.1 1 CLL z o w LA m _ 6'0 0 � bA O cr c 6 d, G C G c vo iM1 1M1 i � {R T+ 1 it � at �LT4 3 Q 00 A N a or 7 4ii o $ ,�„ Obi 6�Q C a JCL tF �. na N V Al w V a 3 va a a 0 a a i 61 2P N a a Q O Q m z b C m (S SL Z- U 4t eM w H 9 rn tZNu D: *qR I�++ W iO 2 Ia M I 1 S 1Pt CL 66ee77 7 d q' aermCL r 9 @ S � fi a� aa V1 ^ +� 3 ° ;j �o 9j m a �s 3 °0 re .0 3 O Al o g F S g 3 r g a. CA7 W 7 0. ZZ ll n. @ r !fD O w m 7 O v� og 12 X S�' �+a� cr p R ll1 W Pi 1+ �o igX 6 og CL p�a�' D a d A a AD I... lO D A b to 1 LAJ m fBq� = p� avZ q g-- m 0 0 = D W LO Q 2 D10 z 8 a E iD O 2 D o .� g c O p y O xaW� $ O _ G m n _ 3 °S a ' iii 3 GZ1 1 N R 5 Ilk � A FX m $ $ c CL N to $ i j S -&ca m rT O O 01 O L Ss g 9 R � a n $ g 8 A i ,l CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 1 of 3 j Y 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 01 Space Conditioning System Identification or Name., whole house 02 Space Conditioning System Location or Area Served whole house 03 Budding Type from CF-111 Single family 04 Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Credit from CF1R7 No, credit is not taken 05 Verified Low Leakage Air Handling Unit Credit from CF1R7 No, credit is not taken 06 Duct System Compllance�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 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 Building 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-20-H Duct Leakage Diagnostic Test (Page 2 of 3 V B. dud Leakage Diagnostic Test 121 Notes 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 (Cfl) 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 ASHAAE 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 Budding 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 Ali 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 includdd in sample groups for HERS verification compliatice 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 Complies All specified verification protocol requirements on this document are met Registration Number 215-A0040862A-M2000WZA-M20A 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 SS 02 2013 Residential Compliance Schema Version 0 51SUD t CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 3 of 3 ) V Documentation Author's Declaration Statement 1. i certify that this Certificate of Verification documentation 1s accurate and complete. Documentation Author Name Documentation 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/Zip Phone El Monte CA 91731 6Z6-274-0522 Responsible Persons 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,Certiflcatt of Compliance for the building approved by the enforcement agency 1�i E? 4 The information reputed on applicable sections of the Certificate(s) of installation (MR) signed and submitted by�the person(sl responsible for the construction or installation copforrns to the requirements specified on the Certiflcate(s) of Compliance (CFiR) ipproved by the enforcement agency 5 1 will ensure that a registered copy,of thls Certificate of verification shall be posted, Or made available with the building permtt(s( issued for the building, and made available to the enforcement agency for,all'applicable inspections I understand that a registered copy of this Certl"cate of Verification is requli' a d w to be Included the documentatfon 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 Rudder/owner) ZABAi`TA HEATING AND AIR CONDITIONING Responsible Builder or Installer Name CSL9 License j 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 Jahn Kwan Responsible Rater Signature Responsible Rater Certification Number w/ this HERS Provider Irate Signed CC2005646 2015-02-23 08 57 00 Digiraffy signed by CaI ERT5 This digitalsignature is provdedm order fo secure the content of thra mgistereddocument and in no wayunpbes Registration Rroyrder resPonsrbdity mr the accuracy of the inFcrmarlon Registration Number 215-A0040862A-M2000002A-M20A Registration Date/Dme 2015-02-23 08 57 00 HERS Provider CaICERTS CA Building Energy Efficiency Standards Report Version 2014-OS-08 Report Generated 2015.02-23 08 55 02 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. 23601 golden springs dr #a-1 Enforcement Agency City of Permit Number. P1115-351 Diamond Bar Dwelling Address. 23601 golden springs dr City. Diamond Bar Zip Code: 91765 #a-1 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 fl5 Condenser Speed Type Single Speed 06 Cooling System Zonal Control Type Not Zonal 07 Central Fan Integrated (CFI) Ventilation System Status,, ' Not a CF[ system OS System Bypass Duct Status j . No Bypass Duct, Date of System Airflow Rate Measurement 2015-02-23 r1o Airflow Rate Protocol utilized RA3 3 procedures for airflow rate measurement B. Hale 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 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 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-A0040862A-M2300002A-M23A Registration Cate/Time 2015-02-23 08 57 00 HERS Provider CaIC£RTS CA Building Energy Efficiency Standards Report Version 2014-05.08 Report Generated 2015-02-23 08 55 39 2013 Residential Compliance Schema Version 0 51SOD , 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 Mutts -Speed Compressor a 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) 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 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 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 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 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. Registration Number 215-A0040862A-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 2025-02-23 08 55 39 2013 Residential Compliance Schema Version 0 51SDD CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditloning 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 j 01 1 Complies All specified verification protocol requirements on this document are met I Registration Number 215-A0040862A-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 51SDD CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Atrflow 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 Jahn Kwan >� Company (late Signed J K Air Balancing & Duct Testing 2015-02-23 08 57 00 Address CEA/ NERDS Certification ldentificatton ()f applicable) 9040 Telstar Ave #137 oty/State/xip 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 j 2 I am the certified HERS stater 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 d The information reported on applicable sections of the Certificates) 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($) 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 C5L8 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 2015-02-23 08 57 00 Digaalfy signed by CafCERTS This digital signature is provided in order to secure the content of this registered document, and rn noway rinpirev Registration Provider responsibility for the accuracy of the information Registration Number 215-A0040852A-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 515DD 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 (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 min{mum 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 atrftow 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 RAI)? 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) 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/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 56 27 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 8. 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 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 Method used to demonstrate compliance with the MAH installed and labeled consistent with Figure 3 2-1 Measurement Access Hole (MAH) requirement E Minimum System Airflow Rate Verification Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3 2 2 7 01 Minimum Required System Airflow Rate (ctm) 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 65 the refrigerant charge verification procedure (degreeF) 02 Measured Condenser air entering dry-bulb temperature (T 73 condenser A) Registration Number 215-A0040862A-M2S00002A-M25A Registration Date/Time 2015-02-23 08 67 00 HER$ Provider CaICERTS CA Building Energy Efficiency Standards Report Version 2014.05.08 Report Generated 2015-02 23 08 56 27 2013 Residential Compliance schema Version 0 5515DD CERTIFICATE OF VERIFICATION CF3R-MCH-ZS-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 (Tilgiiid) (degreeF) 62 05 Measured Liquid Line Pressure (Puglia) (ping) 203 06 Condenser saturation temperature (Tcondensor mot) from digital 72 gauge or P-T Table using Line FOS (degree F) 07 Measured Subcooling 10 j 3 3 08 Target Subcooling 13 09 Compliance Statement System complies with Subcooling Method - Must also pass metering device verification, next section i 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 (Tsvown) (degreeF) 56 02 Measured Suction line pressure (Psuction) (prig) 102 03 Evaporator saturation temperature (Teaapoator, sat) from digital gauge 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 t07 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. j 01 1 Complies All specified verification protocol requirements on this document are met I Registration Number 215 A0040862A-M2500002A-M25A 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 56 27 2013 Residential Compliance Schema Version 0 S51SDD 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 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/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 Certificates) 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 Jahn Kwan Responsible Rater Certification Number w/ this HERS Provider Date Signed CC2005646 2015-02-23 08 57 00 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-A0040862A-M2500002A-M25A Registration Date/Time 2015-02-23 08 57 00 HERS Provider CaICERTS 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-20-H Duct Leakage Diagnostic Test (Page 1 of 3 ) 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 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 (tan) 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 Leakage to the outside 06 Leakage Factor '01 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 Wm) 33 11 1 Compliance Statement System passes leakage test Registration Number 215-A0040862A-M2000002A-0000 Registration Date/Time 2015-02.23 08 56 08 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 515oD CERTIFICATE OF INSTALLATION CF2R-MCH-20-H Duct Leakage Dlagnostic 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 (CA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage 02 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 CA ventilation is not required, may be configured to the closed positron 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 CFZR-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 Name Documentation Author Signature ++��►► � John Zabatta i�.l' Company Signature ©ate 2015-02.23 08 58 08 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 s 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/enstallerl, 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 pormit(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 flame Responsible Budder/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 CSL8 License PO BOX 9368 1561159 City/State/Zip Phone Date Signed ALTA LOMA CA 91701 (909) 989-9200 2015-02-23 08 58 08 Third Party Quality Control Program {TPQCP) Status Name of TPQCP (if applicable) DigilOy signed by CafCERTS This digital signature is provided in order to secwe the consent of this registereddocumenk and raw way impAes Registratron Provider responsibifity for the accuracy of the information Registration Number 215-A0040862A•M2000002A0000 RegistrationDate/Iime 2015-02-23085808 HERS Provider CaICERTS CA 8uildrng Energy Efficiency Standards Report Version 2014-05-09 Report Generated 2015-02-23 08 47 31 2013 Residential Compliance Schema Version 0 SISDD 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-M2300002A-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 49 05 2013 Residential Compliance Schema Version 0 515DD 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 Atrflow 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) 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 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 tit 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 tooling 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•A0040862A-M2300002A-0000 Registration Date/Time 2015.02-23 08 58 08 HERS Provider CaICERTS CA 8uiiding Energy Efficiency Standards Report Version 2014-05-08 Report Generated 2015-02-23 08 49 05 2013 Residential Compliance Schema Version 0 51SDD CERTIFICATE OF INSTALLATION CFZR-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 completeTT// Documentation Author Name ��� Documentation Author Signatured�'1:v��� John Zabatta Company Signature Date 2015-02-23 08 58 08 ZABATTA HEATING AND AIR CONDITIONING Address £EA/ HERS Certification Identification (if applicable) PO BOX 9368 City/statobp 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 an this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builderlinstaller 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 I requirements of such quality assurance checking, the required corrective action and additional checking/testrngof 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 an 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 buridmg, 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 Budder/installer Name Responsible Buildertinstaller Signature John Zabatta Company Name (installing Subcontractor orGeneral 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 Oate Signed ALTA LOMA CA 91701 (909) 989-9200 2015-02-23 08 58 08 Third Party Quality Control Program (TPQCP) Status Name c f TPQCP (if applicable) INgrta#y signed byCaICERTS This drgrtaf signature is provided in order to secure the content of this registered document and m noway mtplms Registration provider responsibility far the accuraeyof the rnformatton Registration Number 215 A0040862A-M2300002A-0000 Registration Date/Time 2015-02-23 08 58 06 HERS Provider CaICERTS CA Building Energy Efficiency Standards Report Version 2014-05-08 Report Generated 2035-02-23 08 49 05 2013 Residential Compliance Schema Version 0 51500 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 Diamond Bar Permit Number PR15-351 Dwelling Address 23601 golden springs dr #a-1 City Diamond Bar Zip Code- 91765 A System Information Each system requiring refrigerant charge verification will be documented an a separate certificate O1 System Identification or Name whole house 02 System Location or Area Served whole house 03 Condenser (or package unit) make or brand DAY AND NEGHT 04 Condenser (or package unit) model number N4H324AKF200 05 Nominal Cooling Capacity (tons) of Condenser 2 06 Condenser (or package unit) serial number E1.45001873 07 Refrigerant Type R-410A OR 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)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 RAl)7 13 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 Registration Number 215-A0040$62A-M2500002A-0000 5 CA Building Energy Efficiency Standards 2013 Residential Compliance Registration Date/Time 2015-02-23 08 58 08 HERS Provider CaiCERTS Report Version 2014-05.08 Report Generated 2015-02.23 08 52 48 Schema Version 0 551SDD CERTIFICATE OF INSTALLATION CF2R-MCH-25-H Refrigerant Charge Verification (Page 2 of S ) Standard Charge Verification Procedure - CF2R-MCH-25b - Subcooling Method S. 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) r02 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 o1 I Method used to demonstrate compliance with the I 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 hate (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, dig) Registration Number 215-A0040862A-M2500002A-0000 Registration Date/Time 2015-02-23 08 58 08 HERS Provider CaICERTS CA Budding 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 (Toquid) (degreeF) fit 05 Measured Liquid Line Pressure (Pliqu,d) (pisg) 203 06 Condenser saturation temperature (Tcandenwr, sai) from digital 72 gauge or P-T Table using Line F05 (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 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 (Tsucaon) (degreeF) 56 02 Measured Suction line pressure (Psuction) (prig) 102 03 Evaporator saturation temperature (Tevapo* w sat) from digital gauge 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 t07 Compliance Statement Metering device verification passes Verification of Charge Indicator Display - CF2R-MCH-25d - CID H. Charge indicator misplay Procedures for the Charge Indicator Display Verification are detailed in RA3 4 2 This section does not apply to this project Registration Number 215-A0040862A-M2500002A-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 085248 2013 Residential Compliance Schema version 0 551SDD CERTIFICATE OF INSTALLATION CFZR-MCH-25-H Refrigerant Charge Verification (Page 4 of S ) I I Charge indicator Display Additional Requirements I I This section does not apply to this project Registration Number 215-A0040862A-M2500002A-0000 Registration Date%Tirne 2016-02.23 06 58 08 HERS Provider CaICERTS CA Building Energy Efficiency Standards Report Version 2014-OS-08 Report Generated 2015.02-23 08 52 48 2013 Residential Compliance Schema Version 0 SSISDD CERTIFICATE OF INSTALLATION CFZR-MCH-25-H Refrigerant Charge Venficatlon (Page 5 of 5 Documentation Author's Declaration Statement 1.1 certify that this Certificate of installation documentation Is accurate and complete. Ocicumentatton Author Name Aocumentation Author Signature � John Zabatta Company Signature Date 2015-02-23 08 58 08 ZABATTA HEATING AND AIR CONDITIONING Address CEA/ HERS Certification Identification (if applicabie) PO BOX 9369 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 taws of the State of California 1 The information provided on this Certificate of Installation is true and correct Z 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 budder/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 checliing, 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 F 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 budding 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) Bustler/Owner) OWNER ZABATTA HEATING AND AIR CONDITIONING Address C5LS License PO BOX 9368 561159 City/statra/Ztp Phone pate Signed ALTA LOMA CA 91701 (909) 989-9200 2015-02-23 08 58 08 Third Party duality Control Program (TPQCP) Status Name of TPQCP (if applicable) Digitally signed by CaICERTS This digital signature is provided in order fo secure the content of this registered document and in no way implies Registration Pi owder responsibility for the aceuracyofthe information Registration Number 215-A0040862A-MZ500002A-0000 Registration DatejTirne 2015r02-23 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 Schema Version 0 5515DD $ « t k � $ # � 0 � $ � % � & a \ � , � \ �� # � , ® % % � � . � � � $ � � I ##� � \ � § t � \ %� k � � � � �1 �\� $ \ 3 \ � � � : � � k \ \ i ( k & f % @ # � � \ k % � a \ t 2 � \ � � � k � N c LL V c "o z o a S lA Z s_ D o QW ILI V C w CL p v ro U tA ° "c z c > o l� ZH u a E > cr w a E' w C= C a a o E a 3 �r ro Vto 0o G 0) CL w W = m w 81 G 33 C30 C <t a c E E V C !i to E `_ t.i 'Lj c to O 3 C L. c a +; E a = x W CF v ttD � c a, S! 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