HomeMy WebLinkAboutPR15-0074x
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Di. MOND B�
CITY OF DIAMOND BAR /
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91765 PRESS
(909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-702 FIRMLY
,BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov
OB SITE A DRESS f "1, "-,fir
APN LOT TRACT
OWNER \
ADDRESS
'CITY n ✓ ZIP q 1� TEL.
,(APPLICANT TEL.
CONTRACTOR h
ADDRESS �'L-1 �/ I Cn
',CITY P ZIP 9 '7 7_°' TEL.
ARCH/ENG/
DESIGNER
ADDRESS
CITY ZIP TEL.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s)
indicated below by the checkmark(s), I have placed next to the applicable item(s) [Section 7031.5, Business and
Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair, any
structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she
is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section
7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for
the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty
of not more than five hundred dollars ($500).
U I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions
of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds
or improves the property, provided that the improvements are not intended or offered for sale. If however, the building or
improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built
or improved for the purpose of sale.).
U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State
License Law.).
(� I am exempt from licensure under the Contractor's State License law for the following reason(s):
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one
year prior to completion of the improvements covered by this permiLl cannot legally sell a structure that I have built as an
owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the
applicable law, Section 7044 of the Business and Professions Code is available upon request when this application is
submitted or at the following Web site: http/www.leginfo.ca.gov/calaw.html.
/ LICENSED CONTRACTOR'S DECLARATION
1I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code, and my license is infull force and effect.
LICENSE CLAS : LIC. NO.: \ 16-76
DATE: CONTRACTOR: ,A 1
11tr
WORKER'S COMPENSATION DECLARATI
'r11 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for
the performance of the work for which this permit is issued. My Worker's Compensat n Insurance Carrier and
Policy Number are: �3 `_
CARRIER Q 4. 4 f,' A ON tv
POLICY NUMBER SWC
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOA ONE HUNDRED DOLLARS ($100) OR LESS).
I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to
become subject to the Worker's Compensation Laws of Califomia. And agree that if I should become subject to the Worker's^
Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
.DATE: APPLICANT:
WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal
penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation,
damages as provided for in section 3708 of the labor code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for
which this permit is issued (Sec. 3097, Civ. C.).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and state that the above information is correct. I agree to comply with all city and
county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to
enter upon the abo mentioned property for i p ion pur es.
PERMITTEE NAM P
SIGNATURE OF PERM EE I DATE
APPLICATION DATE: Z O P]/C#
ISSUE DATE: PERMIT# : /6— M?�
TYPE CONST. OCC GROUP:
Scope of Work
X
# DWEL. UNITS # STORIES
# BEDROOMS
DESCRIPTION SQ. FT. FACTOR PSF
ADJ. AREA/VALUATION
SFR/ADD/REM
Garage/Carport
W
Patio/Deck
W
LL
Pool/Spa
ZRe
-Roof
i
Commercial
m
Valuation:
Adj. Area:
QUANTITY DESCRIPTION
FEE
U
U
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CONSTRUCTION:
PLAN REVIEW:
ELECTRIC:
PLUMBING:
MECHANICAL:
INSPECTION FEE:
ISSUANCE:
/
SMIP:
ENERGY P/C:
ENERGY PERMIT:
RETENTION FEE:
PRE -ALT FEE:
''JJ
7i
BASF:
PLOT PLAN:
ZONING CLEARANCE:
TOTAL FEES
COMMENTS:
P/C: PAID BY:
RECEIPT # e1 V_T1 PAID BY:11"S1065
VALIDATION:
VALIDATION:
WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy
o
CITY OP DIAMOND BAR
INSPECTION RECORD
INSPECTION DATE
INSPECTOR
SETBACK/LETTER
FOOTINGS FORMS
SLAB
UG. PLUMBING
UG. ELECTRICAL
LIFER GROUND
SEWER LATERAL
MAIN WATER LINE
SEWER CLEANOUT
ROOF SHEATHING
FLOOR SHEATHING
SHEAR WALLS EXTERIOR
SHEAR WALLS INTERIOR
FRAMINGNENTING
ROUGH MECHANICAL.
ROUGH ELECTRICAL W( ) C ( }
ROUGH PLUMBING
INSULATION WALL
INSULATION CEILING
DRYWALL
LATH (PRE)
LATH EXTERIOR
LATH INTERIOR
GAS TEST
SCRATCH COAT
ELECTRIC METER RELEASE
GAS METER RELEASE
SPECIAL INSPECTION
FINAL BUILDING
FINAL MECHANICAL D
FINAL ELECTRICAL %0
FINAL PLUMBING
T.C. of OCCUPANCY
CERT. of OCCUPANCY
�.f
INSPECTIONDATE
INSPECTOR
TRACT AND LEDGER
SWITCH GEAR
COMMERCIAL HOOD
T -BAR
INTERCEPTER
HOT MOP/SHOWERPAN
SEPTIC/CESSPOOL
HERS REPORT RECEIVED
DEMOLITION
ROOF DRAINS
ROUGH CONDUIT
POOUSPA
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 1ST( )2 ND( ) LIFT
WALL BOND BEAM
WALL DRAIN/ SEAL
WALL FINAL
R0. FRAMING PLANNING APPROVAL
ROUGH FIRE APPROVAL
FINAL FIRE DEPARTMENT
FINAL PLANNING
FINAL ENGINEERING/ PW
FINAL COMMUNITY SERVICES
FINAL HEALTH DEPT.
FINAL INDUSTRIAL WASTE
COMMENTS: "-cf-y-s-!i V-*,; 1
` •STATE ID �jALIFORNIA
ALTERATIONS - HVAC
LA
EC -CHR -ALT -04-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -1R -ALT -HVAC) (Page 1 of 1)
Site Address: /� A/) -
I h SIIPill2
Enforcement Agency:
Date,Prep r di
Permit#:
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required
Required R -value
Floor Area (sq ft)
'®:Packaged System
Evaporator Coil
COP
❑ R-6 (CZ 2, 8-13) Ducting
Served by system
❑ Setback
13Split System
❑ Condensing Unit
11R-8' (CZ 11, 14, 15) Ducting
sgft
(If not already
El Mini Split
❑ Compressor
SEER
HSPF
❑ R-6 (all CZ's) Plenums
present, must
❑ Furnace
❑ Lineset
EER
11R-5 or R7.5) Lineset 4
be installed )
O TXV
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF1R-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS=
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Air Handler/Furnace2 (Can include new ducting)
Installer Requirement: Duct leakage L159o, or < 10% to outside, or seal all accessible leaks), Air Flow >_ 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
j�L. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
E3 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building
2. New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts' CF1R-ALT-02-E
including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS2
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow 2350'CFM/ton (or alternative), Refrigerant Charge
3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New,DUCtS' and one or more of the following CF1R-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
4. New Ducting over 40 feet I Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' I CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (< 15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
' All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
" R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%", 2.5-3T-2'/<", 3.5 to 4T-2%", 5T-4'/."
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
1 certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR).
4. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the CCR.
S. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Respory pleDesigner Name:
Responsible
Date Sig ed:
License:
74
-L
LY L �-7
Company: /
.` Address:
Cirtat / ip: 6
ZVI
Phone: /
0
vor asslsfance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.'
1� �
CERTIFICATE OF VERIFICATION
CF3R-MCH-20-H
Duct Leakage Diagnostic Test
(Page 1 of 3 )
Project Name: Fermin
Enforcement Agency: Diamond
Bar Building Department
Permit Number:
PR15-0074
Dwelling Address: 1060 Milky Wa PI.
City:
Zip Code:
91765
A. System Information
01
Space Conditioning System Identification or Name
System 1
02
Space Conditioning System Location or Area Served
Housne
03
Building Type from CF -111
Single family
04
Verified Low Leakage Ducts in Conditioned Space
No, credit is not taken
Test final
(VLLDCS) Credit from CF1R?
Duct Leakage Test Method
05
Verified Low Leakage Air Handling Unit Credit from
No, credit is not taken
.15
CF1R?
Air Handling Unit Airflow (AHUAirflow) Determination
Method
06
Duct System Compliance Category
Alteration
0
09
Calculated Target Allowable Duct Leakage Rate (cfm)
MCH -20d -Com ete Replacement o r'Altered Ducti System
Registration Number: 316-A1019113A-M20007602A-M20A Registration Date/Time: 2016-01-20 11:42:51 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2013-1.006 Report Generated: 2016-01-20 11:43:55
2013 Residential Compliance Schema Version: 2013.1.006
B. Duct LeakageDiagnostic Test
01
Condenser Nominal Cooling Capacity (ton) U.S.
Energy Raters Association
02
Heating Capacity (kBtu/h)
10
03
Conditioned Floor Area served by this HVAC system (ft2)
2350
04
Duct Leakage Test Condition
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
.15
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Cooling system method
08
Measured AHUAirflow
0
09
Calculated Target Allowable Duct Leakage Rate (cfm)
300
10
Actual duct leakage rate from leakage test measurement
(cfm)
170
11
Compliance Statement: System passes leakage test
Registration Number: 316-A1019113A-M20007602A-M20A Registration Date/Time: 2016-01-20 11:42:51 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2013-1.006 Report Generated: 2016-01-20 11:43:55
2013 Residential Compliance Schema Version: 2013.1.006
CERTIFICATE OF VERIFICATION
CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature
Jose Cervantez
;.
Date Signed:
Company:
JC HERS RATING
2016-01-20
Address:
CEA/ HERS Certification Identification (if applicable):
136 Half Dome Way
1095730
City/State/Zip:
Phone:
Perris CA 92570
951-217-0805
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
—p-.._..
4. The informatiii'n reported o applicable'sedions of the?Certificate(s) of Install`at on (CF2R)`signed and -submitted by the erso,ns) 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 Uf Verification shall be posted, or made available wlthl the building permits) issued for the
building, �and made available to the enMf^orceme ger�y for,all applicable inspections. I uriderstaiid:that aregistered.copy of this Certificate of
Verification is required to be included with-thethe'builder p' rovides to the building owner at occupancy:— � .
l t 1 n l 3 t ti
Builder Or Installer Information As -Shown On —he Certificate Of Installation Y
_
Company Name (installing Subcontractor, General Contractor, or Builde%+.e.: Energy maters Association
JC HERS RATING
Responsible Builder or Installer Name:
CSLB License:
Jose Cervantez
1095730
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
316-13467
Tested
HERS Rater Information
HERS Rater Company Name:
JC HERS RATING
Responsible Rater Name:
Jose Cervantez
Responsible Rater Signature:
ose Cervantez IJan 20, 2016)
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
1095730
2016-01-20
TM
This digital signature is provided in order to secure
the content of this registered document, and in no
way implies Registration Provider responsibility for
U.S. Energy Raters the accuracy of the information."
Assxiatton
Registration Number: 316-A1019113A-M20007602A-M20A Registration Date/Time: 2016-01-20 11:42:51 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2013-1.006 Report Generated: 2016-01-20 11:43:55
2013 Residential Compliance Schema Version: 2013.1.006
CERTIFICATE OF INSTALLATION
CF2R-MCH-20-H
Duct Leakage Diagnostic Test
(Page 1 of 3 )
Project Name: Fermin
Enforcement Agency: Diamond
Bar Building Department
Permit Number:
PR15-0074
Dwelling Address: 1060 Milky Wa PI.
City:
Zip Code:
91765
A. System Information
01
Space Conditioning System Identification or Name
System 1
02
Space Conditioning System Location or Area Served
Housne
03
Building Type from CF -1R
Single family
04
Verified Low Leakage Ducts in Conditioned Space
No, credit is not taken
Duct Leakage Test Condition
(VLLDCS) Credit from CF1R?
05
05
Verified Low Leakage Air Handling Unit (VLLAHU) Credit
No, credit is not taken
Leakage Factor
from CF1R?
07
06
1 Duct System Compliance Category
Alteration
Measured AHUAirflow
0
09
MCH -20d - Complete Replacements Altere eruct System
B. Duct Leakage'DiaAll
gnostic Tett
01
Condenser Nominal Cooling Capacity (ton) U.S. Energy
Raters Association
02
Heating Capacity (kBtu/h)
10.00
03
Conditioned Floor Area served by this HVAC system (ft2)
2350
04
Duct Leakage Test Condition
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
.15
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Cooling system method
08
Measured AHUAirflow
0
09
Calculated Target Allowable Duct Leakage (cfm)
300
10
Actual duct leakage rate from leakage test measurement
(cfm)
168
11
Compliance Statement
System passes leakage test
Registration Number: 316-A1019113A-M20009534A-0000 Registration Date/Time: 2016-01-20 11:32:16 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2013-1.006 Report Generated: 2016-01-20 11:33:20
2013 Residential Compliance Schema Version: 2013.1.006
CERTIFICATE OF INSTALLATION
Duct leakage Diagnostic Test
CF2R-MCH-20-H
(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
If a complete replacement, all supply and return register boots were sealed to the drywall.
04
Building cavities were not used as plenums or platform returns in lieu of ducts.
05
If cloth backed tape was used it was covered with Mastic and draw bands.
06
All connection points between the air handier and the supply and return plenums are completely sealed.
If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the requirements
07
of Reference Residential Appendix RA3.1.4.3.6. Systems that comply using smoke test shall not be included in sample
groups for HERS verification compliance.
The responsible signature on tWiis document that requirements in.this table have
persons compliance affirms all apphca_ble
been met.
U.S. Energy Raters Association
1/ I ,,
J
Registration Number: 316-A1019113A-M20009534A-0000 Registration Date/Time: 2016-01-20 11:32:16 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2013-1.006 Report Generated: 2016-01-20 11:33:20
2013 Residential Compliance Schema Version: 2013.1.006
H
L
CERTIFICATE OF INSTALLATION
Duct Leakage Diagnostic Test
CF2R-MCH-20-H
(Page 3 of 3 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature.
Jose Cervantez
, f_
Company:
Signature Date:
JC HERS RATING
2016-01-20�
Address:
CEA/ HERS Certification Identification (if applicable):
136 Half Dome Way
1095730
City/State/Zip:
Phone:
Perris CA 92570
951-217-0805
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
conforNjo.a� applicabl codes and ulati� ons,,annd`t_he installation`conforms,to t on the plans, and,specifications approved by
I'
l,requirements.given
the enforcement agency.
4. I understand that a HERS rater will check the installation to verify compliance, and that if Such checking identifies defects,.) am,required to take
corrective action at my expense. I understand,that.Energy Commissionand'HERS Proyider.representatives;will also perform quality assurance checking
of installations, including those approved as parte of a sampl' group but riot, checked by a HERS rater, and'if those mstallkions faii'to meet the
requirementslof such quality assurance checking, the required corrective action and additional checkm_ g/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 by the enforcement agency that identifies the speclfic'requirement's for the scope of
_,_approved
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. (�.$, Energy Raters Association
6. 1 will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the
building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of
Installation is required to be Included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Jose Cervantez
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title): OSe ✓2
Builder/Owner)
HERS RATING',Jose Cervantez (.Ian 20, 2016)
JC HERS RATING
Address:
CSLB License:
136 Half Dome Way
1095730
City/State/Zip:
Phone:
Date Signed:
Perris CA 92570
951-217-0805
12016-01-20
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
r414— "This digital signature is provided in order to secure
the content.of this registered document, and in no
way implies Registration Provider responsibility for
U.S. Energy Raters Assoctatiots fhe accuracy of the information."
O
Registration Number: 316-A1019113A-M20009S34A-0000 Registration Date/Time: 2016-01-20 11:32:16 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2013-1.006 Report Generated: 2016-01-20 11:33:20
2013 Residential Compliance Schema Version: 2013.1.006
CERTIFICATE OF INSTALLATION
CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans
(Page 1 of 9 )
Project Name: Fermin
Enforcement Agency: Diamond Bar Building
Department
Permit Number:
PR15-0074
Dwelling Address: 1060 Milky Wa PI.
City:
Zip Code:
91765
A. General Information
01
Dwelling Unit Name
Fermin
02
Climate Zone
9
Number of space conditioning (SC)
03
Dwelling Unit Total Conditioned Floor
2350
04
systems being altered in this dwelling
1
Area (ft2)
unit.
05
Certificate of Compliance Type
Prescriptive alterations (CFiR-ALT)
06
Method used to calculate HVAC loads
ASHRAE_Handbook
07
Calculated dwelling unit Sensible
60000
08
Calculated Dwelling Unit Heating Load
10000
Cooling Load (Btuh)
(Btuh)
09
Dwelling Unit Number of Bedrooms
4
- -- -
MCH -01b Prescriptive Alterations-' ace-Con—ditioning Systems,Ducts and Fans–,
U.S. Energy Raters Association
Registration Number: 316-A1019113A-1V10113268A-0000 Registration Date/Time: 2016-01-20 11:30:17
I' CA Builenergy Efficiency Standards - 2013 Residential Compliance Reposion: 2013-1.006
t Schema Version: 2013.1.006
HERS Provider: USERA
Report Generated: 2016-011:31:21
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 9 of 9 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Jose Cervantez�
Company:
Signature Date:'
JC HERS RATING
2016-01-20
Address:
CEA/ HERS Certification Identification (if applicable):
136 Half Dome Way
1095730
City/State/Zip:
Phone:
Perris CA 92570
1951-217-0805
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials,
components, or manufactured devices for the scope of work identified on this Certificate of installation, and attest to the declarations in this statement (responsible builder/installer), otherwise I am an
authorized representative of the responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the
installation conforms to the requirements given on the plans and specifications approved by the enforcement agency.
4. 1 reviewed•a-copy of the Certificate of Compliance.approved by#he-enforcement agency -that -identifies the specific requirements for the scope of construction or installation identified on this Certificate of
Installatio' n, and I have ensured that:the requirements That apply to.the construction';or installation have been met. } 1
S. I will ensure that a registered copy of this Certific e of Installation shall be posted, or made available'withfthe building permii(s) issued for the building, and made available to the enforcement agency for all
applicable inspections. I u lde'rstand that a registere `opy of this Certificafe of Installation -is required to b e included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name: ) 1 -
Responsible Builder/Installer Signature:
Jose Cervantez
Company Name: Installln Subcontractor or General,Contractor & Builder/Owner 1,
Position_ With Company (Title):- "y
JC HERS RATING
',Jose Cervantez Jan 20, 2016
Address: U.S.
eras c
136 Half Dome Way
1095730
City/State/zip:
Phone:
Date Signed:
Perris CA 92570
1951-217-0805
12016-01-20
Y TM
This digital signature is provided in order to secure
the content of this registered document, and in no
way implies Registration Provider responsibility for
U.S; Energy Raters Aswdatton the accuracy of the information."
Registration Number: 316-A1019113A-M0113268A-0000 Registration Date/Time: 2016-01-20 11:30:17
CA Buil 40ergy Efficiency Standards - 2013 Residential Compliance Repoesion: 2013-1.006
Schema Version: 2013.1.006
HERS Provider: USERA
Report Generated: 2016-011:31:21
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page i of 3 )
Project Name: Fermin Date Prepared: 2016-01-20
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)SDiib)
This section does not apply to this project.
Registration Number: 316-A1019113A-000000000-0000 Registration Date/Time: 2016-03-20 11:15:58 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2016-01-20 11:17:02
Schema Version: 0.55SSDD
0
A. General Information
MR -ALT -02 is applicable to multiple space conditioning
systems contained within
a single dwelling unit. When multiple dwelling units must be documented,
use one CF111-ALT-02 document for each dwelling unit.
O1
Project Name
Fermin
02
Date Prepared
2016-01-20
03
Project location
1060 Milky Wa PI.
04
Building Type
Single family
05
CA City
06
Dwelling Unit Name
Fermin
07
Zip Code
91765
08
Dwelling Unit Conditioned
2350
Floor Area (ft2)
Number of space conditioning
09
Climate Zone
9
10
(SC) systems In this dwelling
1
unit.
Space Conditioning (SC) System Information
O1
02
03
04
0S
06
07
08
09
30
`
r_
r Ith
s e SC-,.
(nn'stallinga,_
SC System
SC Sys m
CFA served.'
system a
refrigerant
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
by Phis SCS
tducted'" `"
.1J
j containing--^
—'4 system
pore than 40
entirely new
entirely new
Name �',
Served
�System'�(M)`)
system.
component?-
\components?
feet of.ducts?
duct system?
SC system?
Alteration Type
6
'
Entirely new or
System 1
Housne
2350
y:k�
U.
'Q
er ' R
Y
ters Asso
Y s
iat(6n
Yes
Yes
complete
replacement space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)SDiib)
This section does not apply to this project.
Registration Number: 316-A1019113A-000000000-0000 Registration Date/Time: 2016-03-20 11:15:58 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2016-01-20 11:17:02
Schema Version: 0.55SSDD
0
0
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
This section does not apply to this project.
E. Entirely New or Complete Replacement Dud System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)IE, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
01
02
03
04
05
06
07
08
09
10
11
Heating
Cooling
System
Heating
Minimum
Cooling
Minimum
Required
Identification or
Heating System
Altered Heating
Efficiency
Efficiency
Cooling
Altered Cooling
Efficiency
Efficiency
Thermostat
New Duct
Name
Type
Component
Type
Value
System Type
Component
Type
Value
Type
R -Value
JF
System 1
Central gas
All new heating
AFUE
80.00
Central split
All new cooling
SEER
14
SetbackTher
R-6
furnace
components
AC
components
mostat
Required Documentation:
CF211-MCH-01-E -Space Conditioning y�yste s Ducts and
-Duct insulation requirement for new plenums: R6.
CF2R & CF3R MCH -20-H Duct Leakage Verification regwred.
-Leakagerate 5 6%.
compI [,e
CF2R & C13R-MCH-22Fan'Efficary verification
CF2R & CF3R-MCH-23 System Air Floy Rate VerifcatA
-Compliance: Fan Efficary 5 0 56'Whfmrand System Airfliiw'2 350'efm/ton. " -
gn
-Alternative Compliance CF2k&'CF3f2-MCH-28 Retu ri DucfDe Veriflcatlon Is an alt' to MCH -22
and MCH verification.
CF2R & MR -MCH -25-H Refrigerant Charge Verification required when rpc jg f�y�R tea pdielIV p� 8-15).
Exceotions: U.S.liJ`'� j it N�.7��+IQI��+r r
Heating -only systems are exempt from the 0.58 W/cfm and 350 cfm/ton requirements.
Note:
An "entirely new or replacement duct system" means at least 75 percent of the duct system is new duct material, and up to 2S percent may consist of reused
parts from the dwelling unit's existing duct system (e.g.,
registers, grilles, boots, air handler, coil, plenums, duct material) If the reused parts are accessible and can be sealed to prevent leakage
Registration Number: 316-A3019113A-000000000-0000 Registration Date/Time: 2016-03.20 11:15:58 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2016-03-20 11:17:02
Schema Version: 0.55SSDD
L J
•
4
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature Jar
Jose Cervantez
Signature Date:
Company:
1C HERS RATING
2016-01-20
Address:
CEA/ HERS Certification Identification (if applicable):
136 Half Dome Way
1095730
City/State/Zip:
Phone:
Perris CA 92570
951-217-0805
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
5. I will ensure.,that a registened'copy, of this Certlficate.of Compliance shall be made ava lable�wlth the building permit(s),issuedlfor the building, and made available to the enforcement agency for all applicable
inspections:I understand that atregistered.copyof this 2ertiflcate of.Compliance is required.to be induded,with the do' merrtation the builder provides to the building owner at occupancy.
Responsible Designer Name: ._. .,,t
`� �—
Respo s`ible Designer Signature:
lose Cervantez �.
�" � case ✓a.r.rez
Company: s I I `Date
`�
Signed: %
1C HERS RATING "" r✓ 7.-
2016 O1y20`
Address:
136 Half Dome Way U.S. Energy Ra
License*
Qti"ssociation
City/State/Zip:
Phone:
Perris CA 92570
951-217-0805
U *S r_if�l R Z%T"
U.S. Energy Raters AssWatlon
Registration Number: 316-A1019113A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
[
I
"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 Date/Time: 2016-03-20 11:15:58
Report Version: 2013-1.00E
Schema Version: 0.5S5SDD
HERS Provider: USERA
Report Generated: 2016-01-20 11:17:02