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HomeMy WebLinkAboutPR15-2443CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVhOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PR ESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 �FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS —L 1 1 26 Syl ^ AL a 12r APN LOT TRACT OWNER AI&C.r Yc q e.r ADDRESS '7-1 -1 Z G S rA., bk P! CITY Q;i ,0AJ 6-r- ZIP 4'lL76S.TEL. '(Oct -e60^ 4-46°( APPLICANT A 1(tA Lo na.14 o% TEL. qs 1 - 6 313 -3 51-'1 CONTRACTOR ['ti Ii 'C-000117 ADDRESS 61`70 7vr�-,P6k Avf- CITY ZIP raNTEL. `ISI- 6b,�-7352-q 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.). U I am exempt from licensure under the Contractor's State License law for the following reason(s): By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit,) 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.htmi. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, an d my license is in full force and effect. LICENSE CLASS: �— LIC. NO.: iJ 1 S 3 Z 3 DATE: 10/1-1/I5 CONTRACTOR:j0t r%41000A ;%%Ckk5!V C"J (oar WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: _e 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. 1 have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for 5 the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and r� Policy Number are: CARRIER t✓ j GD POLICY NUMBER t,.1W G 3 D R 71 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). 1kcrt fy 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 tome subject to the Worker's Compensation Laws of California. And agree that if I should become subject to the Worker's tampensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. i1ATE: APPLICANT: :'DARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal jaenalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3708 of the labor code, interest, and attorney's fees. '- CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter up the above-mentioned prop rty for inspection purposes. o &Ae'd(A PERMITTEE NAME (Pfllr T- SIGN PERMITTEE TE APPLICATION DA�TE: / D/ l�%� P/C# ISSUE DATE: /g4)�S� PERMIT# : P/ IT— Pr 73 TYPE CONST. eA/ t OCC GROUP: Scope of Work NV a r;. GkaAIP_OU4 {e4E pvw PL� -9 -�Y� �► N tW QUar�1'n q If DWEL. UNITS # STORIES If BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport CO Patio/Deck W W Pool/Spa ZRe -Roof Commercial 7 00 Valuation: -L Z Adj. Area: QUANTITY DESCRIPTION FEE U 2 U w J W z m J a U_ � f 2 U • I CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: o ENERGY P/C: ENERGY PERMIT: b RETENTION FEE: d r GrNJ PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: Ok�!gn1 v CXp • ? '1. -1 V'y Q -j . S$ TOTAL FEES M/1 L/ COMMENTS: 3 J t'a4k.,bAt, 6+, P/C: PAID BY: j VALIDATION: RECEIPT # 2 3 PAID BY: / 9 L77 � VALIDATION: Ift WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy CITY OF DIAMOND BAR INSPECTION RECORD INSPECTIONDATE INSPECTOR SETBACKILETTER 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 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 04 FINAL MECHANICAL 10 • FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY COMMENTS: INSPECTION DATE 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 ,s FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) CF1R-ALT-02-E (Page 1 of 3 ) Project Name: Yeager I Date Prepared: 2015-30-21 A. General Information CF113-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one MR -ALT -02 document for each dwelling unit. 01 Project Name Yeager 02 Date Prepared 2015-10-21 03 Project Location 21726 Santaquin 04 Building Type Single family 05 CA City Diamond Bar 06 Dwelling Unit Name Yeager 07 Zip Code 91765 08 Dwelling Unit Conditioned 2320 �I stalling 1nstalling %Installing Floor Area (ft2) Location or Area by this SC ducted containing system Number of space conditioning entirely new 09 Climate Zone 9 10 (SC) systems in this dwelling 1 component? components? feet of ducts? duct system? unit. Alteration Type B. Space Conditioning (SC) System Information Ol 02 03 04 05 'i 06 07 08 09 10 Is the SC Installing a SC System SC System CFA served system a �' refrigerant KlnstallingnewSC �I stalling 1nstalling %Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type Altered space System 1 Location 1 2320 Yes Yes Yes Yes No No conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib) This section does not apply to this project. Registration Number: 215-A6364888A-000000000-0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: 2015-10-21 08:09:46 Report Version: 2013-1.006 Schema Version: 0.555SDD HERS Provider: CalCERTS Report Generated: 2015-10-21 07:45:05 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 ) D. Altered Space Conditioning System (Sections 150.2(b)lE and F) 01 02 03 04 05 06 07 08 09 10 11 12 Heating Cooling System Heating Altered Heating Minimum Altered Cooling Minimum Required New or Identification System Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct or Name Type Components Type Value System Type Components Type Value Type Duct Length R -Value System 1 Central gas All new heating AFUE 0.8 Central split All new cooling SEER 20 Setback Greater than R-6 furnace components AC components 40 feet Required Documentation: CFZR-MCH-01-E - Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums: R6. CF2R-MCH-20-H & CF311-MCH-20-H — Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced. -Leakage rate compliance: _< 15%, or 5 10% leakage to outside, or seal all accessible leaks. CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow> 300 CFM/ton required when MCH -25 is required. Exceptions: -Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements. -Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH. 23, -or Refrigerant Charge MECH 2S' -Existing duct systems constructed, insulated or sealed with asbestos are exempt -from MCH'' -20 DuctIeakage Testing requiremegis. � E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)lE, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 215-A6364888A-000000000-0000 Registration Date/Time 2015-10-21 08:09:46 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-10-21 07:45:05 Schema Version: 0.555SDD 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. I certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Smith, Eric Company: Signature Date: CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING 2015-10-21 08:09:46 Address: CEA/ HERS Certification Identification (if applicable): 6416 JURUPA AVE City/State/Zip: Phone: RIVERSIDE CA 92504 951-688-3524 Responsible Person'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 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 onathis Certificate of Compliance are consistent with'the information provided on other applicable' compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency fora p val with this building permit application. 5. 1 will ensure that a registered copy of this Certificate of Compliance shall,be,made available withfthe 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'66,rtificate of Compliance is required to be included with the documentation, the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Smith, Eric Company: Date Signed: CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING 2015-10-21 08:09:46 Address: License: 6416JURUPA AVE 815323 City/State/Zip: Phone: RIVERSIDE CA 92504 951-688-3524 Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Providerresponsibility for the accuracy of the information. Registration Number: 215-A6364888A-000000000-0000 Registration Date/Time: 2015-10-2108:09:46 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-10-21 07:45:05 Schema Version: 0.555SDD Contmetor Ue. # C20-815323 !J, MCI INFIRI Attention: City of Diamond Bar Building and Safety Department RE: extension of permit / Re -instatement Permit# PR15-2443 Address: 21726 Santaquin Dr, Diamond Bar CA 91765 Ph# 909-374-8197 Quality Service Since 1951 6990 Jurupa Avenue • Riverside, CA 92504 1-000 2GET AIR (951) 688-3524 • Fax: (951) 688-3526 www.2getair.com We would like an extension for this permit please. We finally completed the entire project and are ready to have the final mechanical inspection performed. We paid the fee's to your building and safety department today 10/19/2016. Thank you. Tammy Install Coordinator Magnolia Heating & Cooling 6990 Jurupa Ave Riverside, CA 92504 P: 951-688-3524 F: 951-688-3526 CITY OF DIAMOND BAR BUILDING & SAFETYDIVISION 21810 Copley Drive Diamond Bar, CA 91765 (909) 839-7020 SMOKE ALARM AND CARBON MONOXIDE CERTIFICATION In order to help assure the life and safety within existing dwellings, the 2013 California Residential Code (CRC) Section R314 and R315, along with the California Building Code Section 420.5 and 420.6 requires existing dwellings to have smoke alarms and carbon monoxide alarms installed within the upper 12" of the ceiling when a building permit is issued for, worked on, or in a building that is valued at $1,000 or more. Alarms may be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. ' Starting July 1, 2014 all smoke alarms including combination smoke alarms, that are solely battery powered shall contain a non -replaceable, non -removable battery that is capable of powering the smoke alarm for at least 10 years. CARBON MONOXIDE ALARMS REQUIRED IN EXISTING DWELLINGS: • Where a permit is required for alterations, repairs or additions exceeding $1,000. • Existing dwellings or sleeping units that have attached garages or fuel burning appliances. Carbon monoxide alarms shall be installed: • Outside of each separate dwelling unit sleeping area in the immediate vicinity of the bedroom(s). • On every level of a dwelling unit including basements. REQUIRED IN NEW DWELLINGS: Carbon monoxide alarms shall be installed: • Outside of each separate dwelling unit sleeping area in the immediate vicinity of the bedrooms(s). I • On every level of a dwelling unit including basements. Alarms shall receive their primary power from the permanent` building wiring without a disconnecting switch other than as required for overcurrent protection. Battery backup is required. NOTE: Multiple -purpose alarms: • Listed and labeled combination carbon monoxide /smoke alarms are acceptable in new and existing dwellings. Carbon Monoxide Alarms is a requirement that is in addition to required Smoke Alarms. The alarms are required to be installed in the following locations: ❖ Smoke alarms in all sleeping rooms. CO alarms in all sleeping rooms where fuel burning appliances are installed. Smoke alarm and CO alarm in hallways preceding sleeping rooms. ❖ Smoke alarm and CO alarms on each dwelling level including basements and habitable attic rooms. The smoke and CO alarms are required to comply with the above when requesting a final inspection. Please make sure an adult is present to allow the Inspector access to the home to verify compliance with the above requirements. If no one will be available, you may opt to complete the Installation Certification below and leave it with the job card. (Please fill out and tear off this portion to leave with the job card if no one will be available to allow the inspector inside the house.) INSTALLATION CE FWkal opertlog sms d c ignat Relationship to ojJ ❑ Owner ❑ Aaent at - kau YN monoxide alarms have been ed as listed abs Print Name I hereby certify that the required 16 iv — bate (please check one): r Owner ❑ Licensed Contractor ❑ Agent for Licensed Contractor If "Licensed Contractor" or "Agent for Licensed Contractor" is checked, please complete the following: Contractor Contractor's State License Number CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 1 of 1) Project Name: Yeager Enforcement Agency: City of Diamond Bar Permit Number: PRO15-2443 Dwelling Address: 21726 Santaquin City: Diamond Bar Zip Code: 91765 HERS measure was verified using the methodology defined for the untested features included in a sample group. This measure passes through its relationship with the actual one tested and passed. Therefore no data is included on this Certificate of Verification. Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Jason Samaniegoj��j Company: Plus Air Duct Testing Date Signed: Address: CEA/ HERS Certification Identification (i app ica e): 6843 Regal Park Dr. City/State/Zip: Fontana CA 92336 Phone: 909-273-7272 Responsible Person's Declaration statement: -7 I certify the following under penalty of perjury; under the'laws of the State of California: r 1. The information rovided-6i`this Certificate of -Com liance 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) s e n (responsible 4 y...ra }j`tryiS /wna"' ¢� it 3. The installed features, materials, components, manufactured devices, or'system performance-diagnostictresults`that':requiie HERS verification identified on this Certificate of Verification comply with the -applicable requiremen&in Reference Appendices W, RM, and'the requirements specified on the Certificate of Compliance forthe building approved by the enforcement agency. 4. The information reported on applicable sections of the Certificate(s) of Installation (CF2R) signed and submitted by the person(s) responsible for the construction or installation conforms to the requirements specified on the Certificate(s) of Compliance (CF1R) approved by the enforcement agency. 5. 1 will ensure that a registered copy of this Certificate of Verification shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Verification is required to be included with the documentation the builder provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General Contractor, or Builder/owner): CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING Responsible Builder or Installer Name: CSLB License: Eric Smith 1815323 HERS Provider Data Registry Information Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) 216-04192 Not tested HERS Rater Information HERS Rater Company Name: Plus Air Duct Testing Responsible Rater Name: Responsible Rater Signature:�� Jason Samaniego Responsible Rater Certification Number w/ this HERS Provider: Date Signed: 2016-09-07 11:23:28 CC2005629 responsibility for the accuracy of the information. Registration Number: 215-A6364888A-M2000002A-M20A Registration Date/Time: 2016-09-07 11:23:28 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-07 10:55:41 2013 Residential Compliance Schema Version: 0.52SDD CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 1 of 1) Project Name: Yeager Enforcement Agency: City of Diamond Bar Permit Number: PRO15-2443 Dwelling Address: 21726 Santaquin City: Diamond Bar Zip Code: 91765 HERS measure was verified using the methodology defined for the untested features included in a sample group. This measure passes through its relationship with the actual one tested and passed. Therefore no data is included on this Certificate of Verification. Documentation Author's Declaration Statement 1.1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Jason Samaniegorj� Company: Plus Air Duct Testing '.. Date Signed: 7 11-23 Address: CEA/ HERS Certification Identification (i app ica e): 6843 Regal Park Dr. City/State/Zip: Fontana.CA 92336 Phone: 909-273-7272 Responsible Person's Declaration statements certify the following under penalty of perjury";,under the,laws of the State of California: 1. The information provided•onthis Certificate of'C_ompliance 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)., ',. � rf �"'.," , ..R;: +"^""` �'" �rE f`"`r;:#"""a., z• � f r'"`"--�. ,y�°`-" rte. 3. The installed features, materials components, manufactured devices, or+system performance.diagnostic�results that:fequire 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 Certificates) 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): CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING Responsible Builder or Installer Name: CSLB License: Eric Smith 1815323 HERS Provider Data Registry Information Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) 216-04192 Not tested HERS Rater Information HERS Rater Company Name: Plus Air Duct Testing Responsible Rater Name: Responsible Rater Signature: fir% Jason Samaniego Responsible Rater Certification Number w/ this HERS Provider: Date Signed: 2016-09-07 11:23:28 CC2005629 responsibility for the accuracy of the information. Registration Number: 215-A6364888A-M2300002A-M23A Registration Date/Time: 2016-09-07 11:23:28 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-07 11:01:43 2013 Residential Compliance Schema Version: 0.52SDD CERTIFICATE OF VERIFICATION CF3R-MCH-25-H Refrigerant Charge Verification (Page 1 of 1) Project Name: Yeager Enforcement Agency: City of Diamond Bar Permit Number: PR015-2443 Dwelling Address: 21726 Santaquin City: Diamond Bar Zip Code: 91765 HERS measure was verified using the methodology defined for the untested features included in a sample group. This measure passes through its relationship with the actual one tested and passed. Therefore no data is included on this Certificate of Verification. Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Jason SamaniegoXjs' Company: Plus Air Duct Testing Date Signed: 7 14 Address: CEA/ HERS Certification Identification (i app ica e): 6843 Regal Park Dr. City/State/Zip: Fontana CA 92336 Phone: 909-273-7272 Responsible Person's Declaration statements certify the following under penalty of perju'r'y';, under the -laws of the State of California: =' 1. The information provided on -this Certificate of:Compli nke is true and correct.: 2. 1 am the certified HERS Rater who'performed the verification identified and reported on this Certificate of Verification (responsible rater). 3. The installed features, materials components, manufactured devices, orsystem performance.diagnostic'results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and*the requirements specified on the Certificate of Compliance for the building approved by the enforcement agency. 4. The information reported on applicable sections of the Certificate(s) of Installation (CF2R) signed and submitted by the person(s) responsible for the construction or installation conforms to the requirements specified on the Certificate(s) of Compliance (CF1R) approved by the enforcement agency. 5. 1 will ensure that a registered copy of this Certificate of Verification shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Verification is required to be included with the documentation the builder provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General Contractor, or Builder/Owner): CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING Responsible Builder or Installer Name: CSLB License: Eric Smith 1815323 HERS Provider Data Registry Information Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) 216-04192 Not tested HERS Rater Information HERS Rater Company Name: Plus Air Duct Testing Responsible Rater Name: Responsible Rater Signature:�� Jason Samaniego Responsible Rater Certification Number w/ this HERS Provider: Date Signed: 2016-09-07 11:23:28 CC2005629 responsibility for the accuracy of the information. Registration Number: 215-A6364888A-M2500002A-M25A Registration Date/Time: 2016-09-07 11:23:28 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-07 11:13:23 2013 Residential Compliance Schema Version: 0.52SDD CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 1 of 7 ) Project Name: Yeager Enforcement Agency: City of Diamond Bar Permit Number: PRO15-2443 Dwelling Address: 21726 Santaquin City: Diamond Bar Zip Code: 91765 A. General Information 01 Dwelling Unit Name Yeager 02 Climate Zone 9 03 Dwelling Unit Total Conditioned Floor 2320 04 Number of Space Conditioning 1 SC System Area (ft2) Is the SC Installing a Systems in this Dwelling Unit. Installing more 05 Certificate of Compliance Type Prescriptive alterations (CF1R-ALT) 06 Method used to Calculate HVAC Loads ACCA_ManualJ 07 Calculated Dwelling Unit Sensible 32731 08 Calculated Dwelling Unit Heating Load 33263 Alteration Type Cooling Load (Btuh) Served System (ft2) (Btuh) containing 09 1 Dwelling Unit Number of Bedrooms 3 system? MCH -01b Prescriptive Alterations - Space Conditioning Systems Ductsrand Fans B. Space Conditioning (SC) System Information` 01 02 03 04 05 06 07 08 09 10 SC System SC System CFA served Is the SC Installing a Installing new SC Installing more Installing Installing Identification or Location or Area by this SC system a sducted refrigerant system than 40 feet of entirely new entirely new SC Alteration Type Name Served System (ft2) containing components? duds? duct system? system? system. component? Altered space System 1 Location 1 2320 Yes Yes Yes Yes No No conditioning system Registration Number: 215-A6364888A-M0100002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:01:31 Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 2 of 7 ) C. Space Conditioning (SC) System Alterations Compliance Information 01 02 03 04 05 06 07 08 09 10 11 12 13 Rated Heating Capacity, Name Heating Efficiency Typ6e � , Value � U Manufac4urer IVlodeI Number � � number^ Output (BTUH) � i Central Fan � System 1 AFUE i,?: k * p� wx 80 x TRANE PAB' ,f TUD2$080ACV32 +, r -n �15115NC91-G 80000 Integrated y Notes: Heating Cooling New or (CFI) System Altered Heating Minimum Altered Cooling Minimum Required Replaced New Ventilation Identification Heating Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Duct Duct System or Name System Type Component Type Value System Type Components Type Value Type Length R -Value Status All new All new System 1 Central gas heating AFUE 80 Central cooling SEER 20 Setback GT40Ft R6 Not a CFI furnace componen split AC components system is D. Installed Heating Equipment Information 01 02 03 _. , .: U4._ . „_ w . --05— 05_v 06 07 System Identification or Ami .. Heating Efficiency; He=,,K,' Heating Unit ;$ Heating:Unit serial Rated Heating Capacity, Name Heating Efficiency Typ6e � , Value � U Manufac4urer IVlodeI Number � � number^ Output (BTUH) � i � System 1 AFUE i,?: k * p� wx 80 x TRANE PAB' ,f TUD2$080ACV32 +, r -n �15115NC91-G 80000 y Notes: Registration Number: 215-A6364888A-M0100002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:01:31 Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 3 of 7 ) E. Installed Cooling Equipment information 01 02 03 04 05 06 07 08 Condenser or Package Unit Condenser or Condenser or Condenser or System Rated Cooling Condenser Rated System Identification Cooling Efficiency Cooling Efficiency Package Unit Package Unit Package Unit Capacity at Design Nominal Capacity or Name Type Value Manufacturer Model Number Serial Number Conditions (BTUH) (ton) System 1 SEER 20 TRANE 4TTV800A3C6A100 15173BUClF 36530 3 Notes: H. Installed Air Filter Device Information This section does not apply to this project. I. Air Filter Device Requirements This section does not apply to this project. Registration Number: 215-A6364888A-M0100002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:01:31 Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 4 of 7 ) J. HERS Verification Requirements 01 02 03 04 05 06 07 08 09 10 MCH2O MCH21 MCH22 MCH23 MCH25 MCH28 Exemption from ..� wlrl: 1r •. 1 t »i ..^ ��i i. Minimum i.::V:¢ .. Exemption R -Value for AHU System SC System From Duct Duct Ducts In Ducts Located AHU Fan Airflow Identification or Location or Area Leakage Leakage Conditioned In Cond Space Efficacy Rate Refrigerant Return Duct Design Name Served Requirements Test Space Verification (W/cfm) (cfm/ton) Charge Table 150.0-C or D System 1 Location 1 No Yes No No No Yes Yes No exemptions Exemption Notes: Registration Number: 215-A6364888A-M0100002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:01:31 Schema Version: 2013.1.007 x ,.r �,';�` � iF!';,"'? �.I a� �^�i•i7 ^,�.�,'; l �;a4`a.�n*y � ..� wlrl: 1r •. 1 t »i ..^ ��i i. Ts i.::V:¢ .. Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:01:31 Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 5 of 7 ) K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the system that are altered. Existing equipment may be exempt from these requirements. Heating Equipment Equipment Efficiency: All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency 01 Regulations. Controls: All unitary heating systems, including heat pumps, must be controlled by a setback thermostat. These thermostats must be capable of allowing the occupant 02 to program the temperature set points for at least four different periods in 24 hours. See Sections 150.0(i), 110.2(b). Sizing: Heating load calculations must be done on portions of the building served by new heating systems to prevent inadvertent undersizing or oversizing. See sections 03 150.0(h)l and 2). Furnace Temperature Rise: Central forced -air heating furnace installations must be configured to operate at or below the furnace manufacturer's maximum 04 inlet -to -outlet temperature rise specification. See Section 150,0(h)4. 05 Standby Losses and Pilot Lights: Fan -type centraGfurnaces4i` YFnot have`a continuously b'urnrng pilot light-Sec#ion 110e5)and Section 110.2(d). Cooling Equipment Equipment Efficiency: All cooling equipment must meet thetminimum efficiency*requirements,of_Sectlon,110 band Section 110 2(a) --and the Appliance Efficiency �'ax 06 Regulations. a i .' IG Refrigerant Line Insulation: All refrigerant line insulation in split system air conditioners and heat pumps must meet the R -value and protection requirements of Section 07 150.0(j)2 and 3, and Section 150.0(m)9. 08 Condensing Unit Location: Condensing units shall not be placed within five (5) feet of a dryer vent outlet. See Section 150.0(h)3A. Sizing: Cooling load calculations must be done on portions of the building served by new cooling systems to prevent inadvertent undersizing or oversizing. See Section 09 150.0(h)l and 2. Air Distribution System Ducts, Plenums and Fans Insulation: In all cases, unless ducts are enclosed entirely in directly conditioned space, the minimum duct insulation value is R-6. Note that higher values may be 10 required by the prescriptive or performance requirements. See Section 150.0(m)l. Registration Number: 215-A6364888A-M0100002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:01:31 Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 6 of 7 ) K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the system that are altered. Existing equipment may be exempt from these requirements. Connections and Closures: All installed air -distribution system ducts and plenums must be, sealed and insulated to meet the requirements of CMC Sections 601.0, 602.0, 603.0, 604.0, 605.0 and ANSI/SMACNA-006-2006: Supply -air and return -air ducts and plenums must be insulated to a minimum installed level of R-6.0 or it enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing in accordance with the requirements of Reference Residential Appendix RA3.1.4.3.8. Heat Pump Thermostat 12 A thermostat shall be installed that meets the requirements of Section 110.2(b) and Section 110.2(c). 13 The thermostat shall be installed in accordance with the manufacturers published installation specifications 14 First stage of heating shall be assigned to heat pump heating. 15 Second stage back up heating:shall be set to come on only when the indoor set temperature cannot be met. The responsible person signature on this'compliance document affirms -that all ipplicablel requirements m this stable have been met:} Registration Number: 215-A6364888A-M0100002A-0000 § bm r r Vice'; ,! . ,,41 e -w 3 . �}".•,-0 .9 �. ; `' : '" ` �:',' i �' - .,, s :.�. '.;.t �,.`•y's k Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:01:31 Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 7 of 7 ) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: rr Smith, Eric Company: Signature Date: CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING 2016-09-07 12:37:33 Address: CEA/ HERS Certification Identification (if applicable): 6416 JURUPA AVE City/State/Zip: Phone: RIVERSIDE CA 92504 1951-688-3524 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 maAfactured.dewces (the installation) identified onthis Certificate of Installationxonfdrm' to allapplicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved+by the enfdreementagency. 4. I the Certificate of Compliance approved by the enforcement agency that the specific requirements for the scope of construction or installation identified on this Certificate of reviewed a copy of -identifies Installation, and I have ensured that the requirements that,apply to the construction or installation have been met. �r 5. I will ensure that a registered copy of this Certificate of Ihstallation shall be posted, or made available with the building permit(s) issued forthebuilding and maae,available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Installation is required to tie included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name: Responsible Builder/Installer Signature: r Smith, Eric Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Position With Company (Title): CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING manager Address: CSLB License: 64161URUPA AVE 815323 City/State/Zip: Phone: 1951-688-3524 Date Signed: RIVERSIDE CA 92504 12016-09-07 12:37:33 Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-A6364888A-M0100002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:01:31 Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-20-H Duct Leakage Diagnostic Test (Page 1 of 3 ) Project Name: Yeager Enforcement Agency: City of Diamond Bar Permit Number: PRO15-2443 Dwelling Address: 21726 Santaquin City: Diamond Bar Zip Code: 91765 A. System Information 01 Space Conditioning System Identification or Name System 1 02 Space Conditioning System Location or Area Served Location 1 03 Building Type from CF -111 Single family 04 Verified Low Leakage Ducts in Conditioned Space No, credit is not taken 05 (VLLDCS) Credit from CF1R? Total leakage 05 Verified Low Leakage Air Handling Unit (VLLAHU) Credit No, credit is not taken 07 from CF1R? Cooling system method 06 Duct System Compliance Category Alteration 09 Calculated Target Allowable Duct Leakage (cfm) 180 MCH -20d - Complete Replacement or Altered Duct:System L > £F t: B. Duct Leakage Diagnostic Test 01 Condenser Nominal Cooling Capacity (ton) 3 02 Heating Capacity (kBtu/h) 80 03 Conditioned Floor Area served by this HVAC system (ft2) 2320 04 Duct Leakage Test Condition Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor 0.15 07 Air Handling Unit Airflow (AHUAirflow) Determination Method Cooling system method 08 Measured AHUAirflow This field or section is not applicable 09 Calculated Target Allowable Duct Leakage (cfm) 180 10 Actual duct leakage rate from leakage test measurement (cfm) 170 11 Compliance Statement System passes leakage test Registration Number: 215-A6364888A-M2000002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:02:13 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-20-H Duct Leakage Diagnostic Test (Page 2 of 3 ) C. Additional Requirements for Compliance 01 System was tested in its normal operation condition. No temporary taping allowed. Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage 02 testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required, may configure the OA damper 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 handler and the supply and return plenums are completely sealed. If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the requirements 07 of Reference Residential Appendix RA3.1.4.3.6. Systems that comply using smoke test shall not be included in sample groups for HERS Verification compliance. w The responsible persons signature on this compliance.document affirms�thatall regKuirements in this table have '-S been met. 4 fry VA ' tk %� ., y �� `� A , '�y s � �.�x s7 ?"�� �. `�.�j � ak ,y✓7�� �r � f � N �''" k'?.^` Registration Number: 215-A6364888A-M2000002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:02:13 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-20-H Duct Leakage Diagnostic Test (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: r�A ,�r,� Eric Smith C �LGG/� Company: signature Date: 2016-09-07 12:37:33 CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING Address: CEA/ HERS Certification Identification (if applicable): 6416 JURUPA AVE City/State/Zip: Phone: RIVERSIDE CA 92504 1951-688-3524 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 theinstallation conforms to the requvements'given on the plans and specifications approved by the enforcement agency. "a 4. [understand that a HERS rater will"check the installation to yenfy compliance and that if'such checking identifies defects I am re`gw to take :- _, corrective action at my expense 6understand That Energy"`Commission and -HERS Providbr representatives will --also perform quality as5urancercliecking of installations, including those approved as part ofia sample group�but,not checked by;a HERS rater:and if those in stallations;fail to-meet.the,, requirements of such quality assurance checking, the required corrective':a�tion and, edditional�checking/testing'of other installations,in that HERS sample group will be performed at my expense. 5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 6. 1 will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name: Responsible Builder/Installer Sign Eric Smith Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): Builder/Owner) manager CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING Address: CSLB License: 6416 JURUPA AVE 815323 2016-09-07 12:37:33 City/State/Zip: Phone: Date Signed: RIVERSIDE CA 92504 951-688-3524 Third Party Quality Control Program (TPQCP) Status: Name of TPQCP (if applicable): Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-A6364888A-M2000002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:02:13 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-23-H Space Conditioning System Airflow Rate (Page 1 of 3 ) Project Name: Yeager Enforcement Agency: City of Diamond Bar Permit Number: PRO15-2443 Dwelling Address: 21726 Santaquin City: Diamond Bar Zip Code: 91765 A. Ducted Cooling System Information Instrument Specifications are given in RA3.3.1.1, and system airflow rate measurement apparatus information is given in RA3.3.2. 01 01 System Identification or Name System 1 RA3.3.3.1.4 02 System Location or Area Served TEC Location 1 Model number of Airflow Measurement Apparatus 03 System Installation Type Certification Status of the Airflow Measurement Apparatus Alteration 04 04 Nominal Cooling Capacity (tons) of Condenser 3 /index.html 05 Condenser Speed Type Multi -Speed 06 Cooling System Zonal Control Type Zonally Controlled 07 Central Fan.lntegrated (CFI) Ventilation System Status Not a CFI system 08 System Bypass Duct Status } ,, No.Bypass Duct, r °, r{ 09 t Date of System Airflow Rate Nleasurement4 a ' 2015 -09-25 i Y ai ". 10 Airflow Rate Protocol utilized �€ ,:: >RA3.3 proceduees fog airflow'ratemeasurement B. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed Static Pressure Probe (PSPP) in the supply plenum. Procedures for installing HSPP or PSPP are specified in RA3.3.1.1. 01 Method used to demonstrate compliance with the HSPP installed and labeled consistent with Figure RA3.3-1 HSPP/PSPP requirement C. Airflow Rate Measurement Apparatus and Procedure Information Instrument Specifications are given in RA3.3.1.1, and system airflow rate measurement apparatus information is given in RA3.3.2. 01 Airflow Rate Measurement Type used for this airflow rate Traditional Flow Capture Hood according to procedure in verification. RA3.3.3.1.4 02 Manufacturer of Airflow Measurement Apparatus TEC 03 Model number of Airflow Measurement Apparatus TRUFLOW Certification Status of the Airflow Measurement Apparatus Certified by Manufacturer and listed on CEC Website at 04 Accuracy http://www.energy.ca.gov/title24/equipment_cert/ama_fas /index.html Registration Number: 215-A6364888A-M2300002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:03:01 2013 Residential Compliance Schema Version: 0.555SDD CERTIFICATE OF INSTALLATION CF2R-MCH-23-H Space Conditioning System Airflow Rate (Page 2 of 3 ) MCH -23a Forced Air System Airflow Rate Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed Compressor D. Forced Air System Airflow Rate Measurement The procedures for System Airflow Rate Verification are specified in Reference Residential Appendix RA3.3. 01 Required Minimum System Airflow Rate (cfm/ton) 300 02 Required Minimum System Airflow Target (cfm) 900 03 Actual System Airflow Rate Measurement (cfm) 1265 04 Compliance Statement: System airflow rate complies E. Additional Requirements Air filters that nieet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in 01 the system during system air flow rate measurement identified on this Certificate of Installation. The airflow rate measurement.a aratu used to'� erf6H the airfl`o'w rate'measuremidentified onithis'.Certificafe-'of PP P 02 1.ent Installation was calibrated in accordance,with the apparatus manufacturerzs specifications�and conforms to instrumentationspecificati&n iven in A visual inspection shall confirm that bypass ducts�that deliverconditioned supply air directly to the space conditioning system return duct airflow are not used on newly constructed zonally controlled systems unless the Performance Certificate 03 of Compliance indicates an allowance for use of a bypass duct. When a bypass duct is accounted for on the Performance Certificate of Compliance, the airflow rate shall conform to the specifications listed on the Certificate of Compliance. 04 All registers were fully open during the diagnostic test. 05 System fan was set at maximum speed during the diagnostic test. 06 If fresh air duct is part of the HVAC system it was not closed during the diagnostic test. 07 Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value. Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan 08 efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air handler fan speed. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: 215-A6364888A-M2300002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:03:01 2013 Residential Compliance Schema Version: 0.555SDD CERTIFICATE OF INSTALLATION CF211-11VICH-23-H Space Conditioning System Airflow Rate (Page 3 of 3 ) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: ��� Eric Smith Company: signature Date: 2016-09-07 12:37:33 CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING Address: CEA/ HERS Certification Identification (if applicable): 6416JURUPA AVE City/State/Zip: Phone: RIVERSIDE CA 92504 1951-688-3524 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 a ,- , � -- conforms to all applicable codes and regulations, and the.installatio conforms t'o the requirements qn the an&specificatlons by givenplans approved the enforcement agency. 4. 1 understand that a HERS rater will"check the�installation tos4enfq compliance, and that R such checking identifies defects I:aim required to'take corrective action at my expense Wnderstand that En erg`y,Commissiori and-HERS-Providet rep resentaLves'will also perform quality assurance cheCKing of installations, including those -approved as part ofla sample group�but;not checked,by a HERS.rater,and if those installationssfail to meet the, requirements of such quality assurance checking; the required co�rectwe action and,additionakchecking/testing of other ih_ stallations'in that•HERS sample group will be performed at my expense. 5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 6. 1 will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name: Responsible Builder/Installer Sign (j Eric Smith Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): Builder/Owner) manager CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING Address: CSLB License: 6416 JURUPA AVE 815323 2016-09-07 12:37:33 City/State/Zip: Phone: Date Signed: RIVERSIDE CA 92504 951-688-3524 Third Party Quality Control Program (TPQCP) Status: Name of TPQCP (if applicable): Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-A6364888A-M2300002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:03:01 2013 Residential Compliance Schema Version: 0.555SDD CERTIFICATE OF INSTALLATION CF2R-MCH-25-H Refrigerant Charge Verification (Page 1 of 4 ) Project Name: Yeager Enforcement Agency: City of Diamond Bar Permit Number: PR015-2443 Dwelling Address: 21726 Santaquin City: Diamond Bar Zip Code: 91765 A. System Information Each system requiring refrigerant charge verification will be documented on a separate certificate. 01 System Identification or Name System 1 02 System Location or Area Served Location 1 03 Condenser (or package unit) Make or Brand TRANE 04 Condenser (or package unit) Model Number 4TTV8036A1000AC 05 Nominal Cooling Capacity (tons) of Condenser 3 06 Condenser (or package unit) Serial Number 15173BUC1F 07 Refrigerant Type 08 Other Refrigerant Type (if applicable) i at 09 System Installation Type �' Alteration'} y s } 2 A i � to ' 3. r, Charge Indicator Display (CID) Status (Note: Even systems This system does not have a CID device installed 1 10 with a CID must have refrigerant charge verified by installer). Is the system of a type that the minimum airflow can be Yes, this is a ducted system and one of the system airflow 11 verified using an approved measurement procedure (RA3.3 rate measurement procedures in RA3.3 or RA3.2.2.7 can be or RA3.2.2.7)? used to verify system airflow rate requirements. Is the system of a type that approved refrigerant charge Yes, one of the Refrigerant charge verification procedures verification procedures can be used to verify compliance from RA3.2.2 or RA1 is applicable to this system and can be 12 with the refrigerant charge verification requirements when used to verify compliance temperatures are greater than or equal to 55F (RA3.2.2, or RA1)? 13 Date of Refrigerant Charge Verification for this system 2015-09-25 Refrigerant charge verification method used. Subcooling (outdoor temperature must be equal to or 14 greater than 55 degF) Person who performed the Refrigerant Charge Verification HVAC system installer 15 reported on this Certificate of Installation 16 HERS Verification Compliance Requirement Status System qualifies for group sampling MCH -25b - Refrigerant Charge Verification - Subcooling Method Registration Number: 215-A6364888A-M2500002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:04:25 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-25-H Refrigerant Charge Verification (Page 2 of 4 ) B. Metering Device Verification Subcooling Method can only be used on systems that have a variable metering device. 01 Refrigerant metering device Electronic Expansion Valve (EXV) 02 Subcooling Method applicability status Subcooling Method is applicable to this system. C. Instrument Calibration Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2 01 Date of Digital Refrigerant Gauge Calibration 2015-09-01 02 Date of Digital Thermocouple Calibration 2015-09-01 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 specifiedrin Reference; Residential Appendix 'RA3'22-53,-`z n 01 Method used to demonstrate comp liance_withvthe`.� N MAH installed and h F labeled consistent wrtigure}3:2 1 Measurement Access Hole (MAH) requirement 4. E. Minimum System Airflow Rate Verification Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.2.2.7. 01 Minimum Required System Airflow Rate (cfm) 900 F System Airflow Rate Verification Status System complies with minimum airflow rate requirements F. Data Collection and Calculations Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in Reference Residential Appendix RA3.2.2. 01 Lowest return air dry bulb temperature that occurred during 71 the refrigerant charge verification procedure (degreeF) 02 Measured Condenser air entering dry-bulb temperature (T 81 condenser, db) 03 Outdoor Temperature Qualification Status Outdoor temperature is within range for using Subcooling refrigerant charge verification method 04 Measured Liquid Line Temperature (Tiiquid) (degreeF) 85 05 Measured Liquid Line Pressure (Pliquld) (pisg) 287 Registration Number: 215-A6364888A-M2500002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:04:25 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-25-H Refrigerant Charge Verification (Page 3 of 4 ) 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. 06 Condenser saturation temperature (Tcondensor,Sat) from digital 92 Measured Suction line pressure (Psucnon) (psig) gauge or P -T Table using Line F05 (degree F) 07 Measured Subcooling 7 08 Target Subcooling 8 09 Compliance Statement: System complies with Subcooling Method - Must also pass metering device verification, next section G. Metering Device Verification Procedures for the verification of proper metering device operation are specified in RA3.2.2.6.2 01 Measured Suction line temperature (Tsuction) (degreeF) 57 02 Measured Suction line pressure (Psucnon) (psig) 115 Evaporator saturation temperature (Tevaporator, from 38"- 03` sat) digital gauge or P-TTable,,using line G02 (de t 104 Measured Superheat u xX`;. 19 I t p'� — F st 05 Measured Superheat is between 4 and 25 deg F (inclusive) Passes CEC requirement Measured Superheat is within manufacturer's specifications, Not known 06 if known 07 Compliance Statement: Metering device verification passes Verification of Charge Indicator Display - CF2R-MCH-25d - CID H. Charge Indicator Display Procedures for the Charge Indicator Display Verification are detailed in RA3.4.2 This section does not apply to this project. I. Charge Indicator Display - Additional Requirements This section does not apply to this project. Registration Number: 215-A6364888A-M2500002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:04:25 2013 Residential Compliance Schema Version: 2013.1.007 c CERTIFICATE OF INSTALLATION CF2R-MCH-25-H Refrigerant Charge Verification (Page 4 of 4 ) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: ��� ,may Eric Smith C �"z2v Company: Signature Date: 2016-09-07 12:37:33 CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING Address: CEA/ HERS Certification Identification (if applicable): 6416JURUPA AVE City/State/Zip: Phone: RIVERSIDE CA 92504 1951-688-3524 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 Divisionof the Business and Professions Code in the applicable classification to accept responsibility for the system design, 13 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 regulation"s, and the.installation conforms 4o the requirements.given on the plans and specifications approved by the enforcement agency. . eqik 4. 1 understand that a HERS rater wiltcheck the ihstallation to veracompliance and that if'checking identifies:defects I am required Ota corrective action at my expense hunderstand"that.tneriy C8 fission andIHERS Provider representatives will alsokperform.quality assurance cfiecking of installations, including those approved as part of�a sample grou�p,but,not checked-bya HERS rater, and if thosei stallat onsjail to meet:the, requirements of such quality assurance checking;"the required corrective.action and. additional,checking/testing of other in st_allations;in ttat-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 permits) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of 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 Sign Eric Smith Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): Builder/Owner) MANAGER CYR HEATING AND COOLING INC dba MAGNOLIA HEATING & COOLING Address: CSLB License: 6416 JURUPA AVE 815323 2016-09-07 12:37:33 City/State/Zip: Phone: Date Signed: RIVERSIDE CA 92504 951-688-3524 Third Party Quality Control Program (TPQCP) Status: Name of TPQCP (if applicable): Digitally signed by COURTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-A6364888A-M2500002A-0000 Registration Date/Time: 2016-09-07 12:37:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-08-17 15:04:25 2013 Residential Compliance Schema Version: 2013.1.007 � Zb� r� Q�L ��, h s Y;