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HomeMy WebLinkAboutPR14-4869CITY OF DIAMOND BAR DIEPARTMIEN4 OF COMV&NTTY% DEVELOPMENT SERVICES ` 21810 Copley Drive, Diamond Bar, CA 91765 PRESS ' (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY p // BUILDING PERMIT APPLICATION , JOB SITE ADDRESS 8 lJ d m APN LOT TRACT OWNER'lTU LlT- HSU ADDRESS 94b ,S S(�Aye CITY pjWAH"jAd, f,ar J ZIP 9 1 U TEL. APPLICANT II TEL. CONTRACTOR E_rn Ire 3tJ i 1 @r N ansa �?pyv1 c, 0�i N`1 ADDRESS to IS o 5 �v 1 S t yM c. CITY S, El n'104SAP TEL.J b' ARCH/ENG/DESIGNER Dha ►-leh (.Wew cA!1 [pAY�VAl1R � "h) L ADDRESS 1130 Sirxn aM Sf ��V CITY 2' - zip I f6fTEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reasons) 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 () all of or (, portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law.). U I am exempt from licensure under the Contractor's State License law for the following reason(s): By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at the following Web site: http/www.leginfo.ca.gov/calaw.html. DATE: SIGN: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE CLASS: LIC. NO.: DATE: i0 —z0(S CONTRACTOR: CrnTJjjel YY(&trj vor/l WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number ar CARRIER POLICYNUMBER L S 5 OO G 4 0 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation Laws of California. And agree that if I should become subject to the Worker's Compensation provisions of Section 3700 of the Libor Code, I shall forth comply with those provisions. DATE: 9 — 3 — 15 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 above-mentioned property for inspection purposes. F.L 2 r3 C, �z PERMITT_E ME (PRINT) SIGNAT(TRE OF PERMI E DATE APPLICATION DATE: '::,I a,o I 1q• P/C# F'fk \4- ISSUE DATE: �I3 I \S PERMIT# PY2 �4- 4�Sbq TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT REAR SIDE/SIDE STREET SIDE FW ❑ ❑ RW ❑ ❑ PROPOSED USEt 5 irvillf f5ffi PeQQL4 # DWEL. UNITS # STORIES U_ # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SF AD REM , $l;p •q Q Garage/Carport rn w Patio/Deck LL Pool/Spa ZRe -Roof Commercial m �\ s F \ ���. •ate Valuation's td . Adj. Area: QUANTITY DESCRIPTION FEE a 7oL i Cl 6g Ov I M a-, N ion A w I S t �' ►C Z � J I d ov\ S U Z U D4 U w %2o ' U N CONSTRUCTION: PLAN REVIEW: \ r✓- `t'. �-� a. \ va� \ . y - ELECTRIC: oat- • ��' PLUMBING: 11 MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: 8S . ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: ori S • �i Oo BSAF: TOTAL FEES an -3i . 93 COMMENTS: 3 ass b� Pia Zk lt.. RECEIPT# PAID BY: .S VALIDATION: �YY1 WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy »:, 0 SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING ROUGH PLUMBING s_ _ INSULATION WALL INSULATION CEILING SWITCH GEAR DRYWALL COMMERCIAL HOOD LATH (PRE) LATH EXTERIOR (y, LATH INTERIOR I GAS TEST HOT MOP/SHOWERPAN SCRATCH COAT _ 6 ELECTRIC METER RELEASE DEMOLITION GAS METER RELEASE SPECIAL INSPECTION _ FINAL; FIRE DEPARTMENT'S r CITY OF DI Pii'O owiD%pAR INSPEC`i I0N EFGDRb � GAS TEST°ft" ... PRE GUNITE P000RE DECK BONDING FENCE/GATE/ALARM r� FINAL POOL t. . TRACT AND LEDGER SWITCH GEAR 4 COMMERCIAL HOOD � T-BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED �. . DEMOLITION ROOF DRAINS _ FINAL; FIRE DEPARTMENT'S ROUGH CONDUIT GAS TEST°ft" ... PRE GUNITE P000RE DECK BONDING FENCE/GATE/ALARM r� FINAL POOL t. . WALLS: WALL FOOTING/STEEL 4 WALL STEEL 1S;(_)_2ND( ) LIFT_ i tle—ee— WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL R0: FRAMING PLANNINGAPPROVA �. . ROUGH FIRE °, t ' -. _ FINAL; FIRE DEPARTMENT'S FINAL PLANNING 4 - r r o(c- 16 4 . r City of Diamond Bar SPECIAL INSPECTOR REPORT ✓ODAILY ❑WEEKLY ❑FINAL - TOTAL TIME ON JOB (IN DAYS) 1 BUILDING PERMIT NO. PR14-4869 DISTRICT NO. JOB ADDRESS 846 Adamsgrove Ave. Diamond Bar GENERAL CONTRACTOR SIZE OF BUILDING NO. OF STORIES TYPE OF WALL TYPE OF WORK ❑ REINFORCED CONCRETE ❑ MASONRY ❑HI -TENSILE BOLTING ❑ PRESTRESSED CONCRETE []WELDING p OTHER Epos DESCRIPTION OF WORK INSPECTED Proper installation of 2- #5 footing dowels three locations and #4 slab dowels 16" o.c. with Simpson Set Epoxy. N LOCATION IN SITE/STRUCTURE Foundation Level Rear Addition. REMARKS Inspection Passed. All work on this job to date HAS / HAS NOT been satisfactorily completed to the approved plans and requirem nts of the Los Angeles County Building Code. ISMAEL C RDERO 01234/P014491 10/27/2015 Special Ins actor (PRINT) I. D. Number Date Vh E -: =-� Special I spector (SIGNAL P/bspub/Research/EDB\SIRE REVISED 04-04-05 310-930-5515 Daytime / Cell Phone Number . Y 44, County of Los Angeles DEPARTMENT OF PUBLIC WORKS BUILDING' & SAFETY D!VISIONI Los .Angeles Regional Uniform Code Proor arm STRUCTURAL OBSERVATION REPORT FORM STRUCTURAL OBSERVATION means the ✓isua obser�aricn c%the srru , approved plans and specifications, rons, a: s, -nifica�cnstr ^rorTnance - E ha a! -JS- 8' oo^'plq`ion .or the S; a; y,S,,e, i Structural observation, does not /r7ClUd0!- e .valve 'he resoors b!' i': for he S0eCr C, re uIren C, J°C:,QI?Q8, ??(Q or other sections of the Los Angeres County Bu,id;ng Code. (Sections 105 5. ?'pg Pecc^ :`'c. Z This report includes all constn ctior.. work throueh�day of Project Address: Z 20_L.,& Page No. 6 `ruC ural Observe- of ReCCrd :,Cv-K) IS R PhCne ,ti'G — 5'` f7 I u 13w vnl I Building Permit No.: Structural Observarcr. f Obsertrr Professional perfOrrned by: c Lic.!Reg. No.: Observer Phone No.: � � OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONSt 6z6— 156 — ZR A n �Oncrete Stee: "crne,-7 =ra:� I_ ncrete 7h'r~ /2o��y f MrNI Masonry _ Steel Bracec " me -esiV G,Yt1��5 ocd — C -CSG_ Grade Be s Retai g Foundation - 3 -hers: ! _ _ ers Hi Ide Special Anchors -��� r e Others: Others: n,,�i_ �' d2U�s"t7vsV FOUNDATION oc'.ing. Stem Walls Via, Foundation C: Caisson. Pile . NOTED DEFICIENCIES with the proposed corresponding corrective actions with respect to general conformance with the approved plans or in the load path: (A fflnal reCo,rt by the structural observer which states that all observed deficiencies have been resolved is required before acceptance of the work by the building officials THE RJof= /ari a7 I DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE: 1. I AM THE ENGINEER OR ARCHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE I CHARGE FOR THE STRUCTURAL OBSERVATION !N ACCORDANCE WITH THE REQUIREMENTS OF THE COUNTY OF LOS ANGELES. 2. RCHITECT WH cHAVE DESIGNATED ABOVE AND IS UNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE I, OR ANOTHER ENGINEER OR A I EACH SIGNIFICANT CONSTRUCTION STAGE TO VERITY IF THE STRUCTURE I IS AT II GENERAL CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS: li ALL NOTED DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED ABOVE; I RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE COUNTY OF LOS ANGELES BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE i CORRECTED. i. SIGNATURE OF 6rJRA Version ? .0 (2008 L4060) -'•'- OC S'=cL., ,,rte _ „�ScR'Jc!i; .e' 2^"i? 4 IN CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Dud Leakage Diagnostic Test (Page 1 of 3 ) Project Name: 846 Addamsgrove Ave Enforcement Agency: City of Diamond Bar Permit Number: PR144869 Dwelling Address: 846 Addamsgrove Ave City: Diamond Bar Zip Code: 91789 A. System Information 01 Space Conditioning System Identification or Name System 1 02 Space Conditioning System Location or Area Served Whole House 03 Building Type from CF -111 Single family 04 Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Credit from CF1R? No, credit is not taken 05 Verified Low Leakage Air Handling Unit (VLLAHU) Credit from CF1R? No, credit is not taken 06 Duct System Compliance Category New 4. 1 MCH -20a - Completely Ne%!,Duct�System', ,.r :.� ., . B. Duct Leakage Diagnostic Test 4" -- 1 "1,, • _-J� _ `� � `/ / { 11 01 Condenser Nominal Cooling Capacity (ton) 4 02 Heating Capacity (kBtu/h) 0 03 Conditioned Floor Area served by this HVAC system (ft2) 1600 04 Duct Leakage Test Condition Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor 0.06 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) 96 10 Actual duct leakage rate from leakage test measurement (cfm) 33 11 Compliance Statement System passes leakage test Registration Number: 216-A0348801A-M2000002A-M20A Registration Date/Time: 2016-09-21 07:24:03 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 07:20:11 2013 Residential Compliance Schema Version: 2013.1.007 • 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: �4I%, rew46r Maor Aizenkut i4L Company: Date Signed: Energy Masters 2016-09-21 07:24:03 Address: CEA/ HERS Certification Identification (if applicable): 18130 Clavert Street City/State/Zip: Phone: Tarzana CA 91335 818-292-0172 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Verification is true and correct. 2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater). 3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements specified on the Certificate of Compliance for the building approved by the enforcement agency. 4. The information reported on applicable sections of the Certificates) of Installation (CF2R) signed and submitted by the persons) responsible for the construction or installation conforms to the;requirements specifiedari the Certificate(s) of Compliance (CUR) approved by the enforcement agency. S. I will ensure that a registered copy, of this Certificate of Verification' shall be posted, -or made available with the building permits) issued for the building, and made available to the enforcementagen for all applicable inspections, I understand that a registered 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): J W POWERS HEATING AND AIR CONDITIONING Responsible Builder or Installer Name: CSLB License: John Powers 773136 HERS Provider Data Registry Information Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) Tested HERS Rater Information HERS Rater Company Name: Energy Masters Responsible Rater Name: Maor Aizenkut Responsible Rater Signature: ��"�/ 4Lre.�ic�r Iff4p Responsible Rater Certification Number w/ this HERS Provider: Date Signed: CC2006650 2016-09-21 07:24:03 Digitally signed by CafCERTS. 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: 216-A0348801A-M2000002A-M20A Registration Date/Time: 2016-09-2107:24:03 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 07:20:11 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 1 of 4 ) Project Name: 846 Addamsgrove Ave Enforcement Agency: City of Diamond Bar Permit Number: PR144869 Dwelling Address: 846 Addamsgrove Ave City: Diamond Bar Zip Code: 91789 A. Ducted Cooling System Information 01 System Identification or Name System 1 02 System Location or Area Served Whole House 03 System Installation Type New 04 Nominal Cooling Capacity (tons) of Condenser 4 05 Condenser Speed Type Single Speed 06 Cooling System Zonal Control Type Not Zonal 07 Central Fan Integrated (CFI) Ventilation System Status Not a CFI system 08 System Bypass Duct Status J _. No Bypass Duct ` 09 Date of System Airflow Rate Measurement ; �,� `. 2016-09-03 10 ' Airflow Rate Protocol Utilized',` 1 `;.RA3.3 procedures for airflow rate measurement _ Y 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. 0, 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 Kanomax 03 Model number of Airflow Measurement Apparatus 6710 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: 216-A0348801A-M2300002A-M23A Registration Date/Time: 2016-W21 07:24:03 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 07:20:46 2013 Residential Compliance Schema Version: 2013.1.008 CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 2 of 4 ) MCH -23a Forced Air System Airflow Rate Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed Compressor D. Forced Air System Airflow Rate Measurement The procedures for System Airflow Rate Verification are specified in Reference Residential Appendix RA3.3. 01 Required Minimum System Airflow Rate (cfm/ton) 350 02 Required Minimum System Airflow Target (cfm) 1400 03 Actual System Airflow Rate Measurement (cfm) 1427 04 Compliance Statement: System airflow rate complies E. Additional Requirements Air filters that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in 01 the system during system air flow rate measurement identified on this Certificate of Verification. The airflow rate measurement., apparatus used fo perform the airflow rate measurement�identified on this'Certificke of 02 Verification was calibrated in`accordarice with the apparatus manufacturer's specifications and conforrhs to the ; instrumentation specifications given in RA3 A visual inspection shall confirm that bypass'ducts that deliver'conditioned supply air directly to the space conditioning 03 system return duct airflow are not used on newly constructed zonally controlled systems unless the Performance Certificate of Compliance indicates an allowance for use of a bypass dud. When a bypass dud is accounted for on the Performance Certificate of Compliance, the airflow rate shall conform to the specifications listed on the Certificate of Compliance. 04 All registers were fully open during the diagnostic test. 05 System fan was set at maximum speed during the diagnostic test. 06 If fresh air duct is part of the HVAC system it was not closed during the diagnostic test. 07 Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value. Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan 08 efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air handler fan speed. 09 Verification Status: Pass - all applicable requirements are met 10 Correction Notes: The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met unless otherwise noted in the Verification Status and the Corrections Notes in this table. Registration Number: 216-A0348801A-M2300002A-M23A Registration Date/Time: 2016-09-2107:24:03 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 07:20:46 2013 Residential Compliance Schema Version: 2013.1.008 CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 4 of 4 ) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Maor Aizenkut Company: Date Signed: Energy Masters 2016-09-21 07:24:03 Address: CEA/ HERS Certification Identification (if applicable): 18130 Clavert Street City/State/Zip: Phone: Tarzana CA 91335 818-292-0172 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Verification is true and correct. 2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater). 3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements specified on the Certificate of Compliance for the building approved by the enforcement agency. 4. The information reported on applicable sections of the Certificate(s) of: Installation (CF2R) signed and submitted by the persons) responsible for the construction or installation conforms to the.requirements specified -ori the Certificates) of Compliance (CF.SR) approved by the enforcement agency. S. I will ensure that a registered copyof this Certificate of-Verificationshall be posterior 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): J W POWERS HEATING AND AIR CONDITIONING Responsible Builder or Installer Name: CSLB License: John Powers 773136 HERS Provider Data Registry Information Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) Tested HERS Rater Information HERS Rater Company Name: Energy Masters Responsible Rater Name: Maor Aizenkut Responsible Rater Signature: "" Iff", /QGElr Responsible Rater Certification Number w/ this HERS Provider: Date Signed: CC2006650 2016-09-21 07:24:03 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: 216-A0348801A-M2300002A-M23A Registration Date/Time: 2016-09-2107:24:03 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 07:20:46 2013 Residential Compliance Schema Version: 2013.1.008 f. CERTIFICATE OF VERIFICATION CF3R-MCH-22-H Space Conditioning System Fan Efficacy (Page 1 of 3 ) Project Name: 846 Addamsgrove Ave Enforcement Agency: City of Diamond Bar Permit Number: PR144869 Dwelling Address: 846 Addamsgrove Ave City: Diamond Bar Zip Code: 91789 A. Ducted Cooling System Information 01 System Identification or Name System 1 02 System Location or Area Served Whole House 03 System Installation Type New 04 Nominal Cooling Capacity (tons) of Condenser 4 05 Condenser Speed Type Single Speed 06 Cooling System Zonal Control Type Not Zonal 07 Central Fan Integrated (CFI) Ventilation System Status Not a CFI system 08 System Bypass Dud Status`' -__ No Bypass Duct 09 Date of System Airflow Rate Measurement 2016-09-03 �1_0 Airflow Rate Protocol utilized . Y- - i ? = ;RA3.3 procedures for airflow rate measurement B. Fan Watt Measurement Apparatus and Procedure Information Instrument Specifications are given in RA3.3.1, and system fan watt measurement apparatus information is given in RA3.3.2.2. 1 01 1 Fan Watt Verification Device Used. I Portable watt meter I MCH -22a Forced Air System Fan Efficacy Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed Compressor C. Forced Air System Fan Efficacy Measurement The procedures for System Fan Watt Verification are specified in Reference Residential Appendix RA3.3. 01 Actual Tested Watts 0.1 02 Actual Tested Airflow from MCH -23 (cfm) 1427 03 Required Fan Efficacy (watts/cfm) 0.58 04 Actual Fan Efficacy (watts/cfm) 0 05 Compliance Statement: System fan efficacy complies Registration Number: 216-A0348801A-M2200002A-M22A Registration Date/Time: 2016-09-21 07:24:03 HERS Provider: CalCERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 07:22:09 2013 Residential Compliance Schema Version: 0.51SDD CERTIFICATE OF VERIFICATION CF3R-MCH-22-H Space Conditioning System Fan Efficacy (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: 4r"6Vr/ Maor Aizenkut 1ff40l Company: Date Signed: Energy Masters 2016-09-2107:24:03 Address: CEA/ HERS Certification identification (if applicable): 18130 Clavert Street City/State/Zip: Phone: Tarzana CA 91335 818-292-0172 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Verification is true and correct. 2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater). 3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements specified on the Certificate of Compliance for the building approved by the enforcement agency. 4. The information reported on applicable sections of the Certificate(s)of Installation (CF214) signed and submittedby the person(s) responsible for the construction or installation conforms to therequirements specified on the Certificates) of Compliance (CFiR),approved by the enforcement agency. S. I will ensure that a registered cop of this Certificate of.Verificationshall be posted; -or made,available with the building permit(s)issued for the building, and made available to` the' enforce mentagency.for all applicable inspections. I understand that a`registe'red 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): J W POWERS HEATING AND AIR CONDITIONING Responsible Builder or Installer Name: CSLB License: John Powers 773136 HERS Provider Data Registry Information Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) Tested HERS Rater Information HERS Rater Company Name: Energy Masters Responsible Rater Name: Maor Aizenkut Responsible Rater Signature: ��� rew46vr/ 1ff4owQ Responsible Rater Certification Number w/ this HERS Provider: Date Signed: CC2006650 2016-09-21 07:24:03 Digitally signed by C910ERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: 216-A0348801A-M2200002A-M22A Registration Date/Time: 2016-09-21 07:24:03 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 07:22:09 2013 Residential Compliance Schema Version: 0.SISDD CERTIFICATE OF VERIFICATION CF3R-MCH-25-H Refrigerant Charge Verification (Page 1 of 4 ) Project Name: 846 Addamsgrove Ave Enforcement Agency: City of Diamond Bar Permit Number: PR144869 Dwelling Address: 846 Addamsgrove Ave City: Diamond Bar Zip Code: 91789 A. System Information HERS Rater to field -verify all system information, discrepancies to be noted by overwriting entry. 01 System Identification or Name System 1 02 System Location or Area Served Whole House 03 Condenser (or package unit) make or brand AC Pro 04 Condenser (or package unit) model number 4AC14L48P7A 05 Nominal Cooling Capacity (tons) of Condenser 4 06 Condenser (or package unit) serial number 1916D37140 07 Refrigerant Type ---- -R-410A 08 Other Refrigerant Type (if applicable) 09 System Installation Type �� New - Charge Indicator Display (CID) Status (Note: Everi systems J This system does not have a CID device installed 10 with a CID must have refrigerant charge verified by installer). Is the system of a type that the minimum airflow can be Yes, this is a ducted system and one of the system airflow 11 verified using an approved measurement procedure (RA3.3 rate measurement procedures in RAM 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 2016-09-20 14 Refrigerant charge verification method used. Subcooling (outdoor temperature must be equal to or greater than 55 degF) 15 Person who performed the Refrigerant Charge Verification HVAC system installer reported on this Certificate of Installation 16 HERS Verification Compliance Requirement Status System qualifies for group sampling 17 Refrigerant charge verification method used by HERS Rater. Subcool Registration Number: 216-A0348801A-M2500002A-M25A Registration Date/Time: 2016-09-21 07:24:03 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 07:23:07 2013 Residential Compliance Schema Version: 2013.1.008 CERTIFICATE OF VERIFICATION CF3R-MCH-25-H Refrigerant Charge Verification (Page 4 of 4 ) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: 1ffwr1 QLre.Yi6V Maor Aizenkut Company: Date Signed: Energy Masters 2016-09-21 07:24:03 Address: CEA/ HERS Certification Identification (if applicable): 18130 Clavert Street City/State/Zip: Phone: Tarzana CA 91335 818-292-0172 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Verification is true and correct. 2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater). 3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements specified on the Certificate of Compliance for the building approved by the enforcement agency. 4. The information reported on applicable sectioris'(6fthe Certificates) of Installation (CF20)signed and submitted.by the persons) responsible for the construction or installation conforms to the requirements speafied ori the Certificate(s) of Compliance (CF1R)_approved by the ;enforcement agency. Z S. I will ensure that a registered copy.of this Certificateof.VerificatioKshall be posted, or made available with fh S.ilding permits) issued fo"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�documentaiion the builder provides to the building owner at`oaupancy. ` r C>r. Builder Or Installer Information As Shown On The Certificate -Installation Company Company Name (Installing Subcontractor, General Contractor, or Builder/Owner): J W POWERS HEATING AND AIR CONDITIONING Responsible Builder or Installer Name: CSLB License: John Powers 773136 HERS Provider Data Registry Information Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) Tested HERS Rater Information HERS Rater Company Name: Energy Masters Responsible Rater Name: Maor Aizenkut Responsible Rater Signature: /�iirB'?iQ�EB 9rj Responsible Rater Certification Number w/ this HERS Provider: Date Signed: CC2006650 2016-09-21 07:24:03 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: 216-A0348803A-M2500002A-M25A Registration Date/Time: 2016-09-2107:24:03 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 07:23:07 2013 Residential Compliance Schema Version: 2013.1.008 CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Project Name - 846 Addamsgrove Ave I Date Prepared: CF1R-ALT 02-E (Page 1 of 3 ) 2016-09-21 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 MR -ALT -02 document for each dwelling unit. 01 Project Name 846 Addamsgrove Ave 02 Date Prepared 2016-09-21 03 Project Location 846 Addamsgrove Ave 04 Building Type Single family 05 CA City Diamond Bar 06 Dwelling Unit Name 846 Addamsgrove Ave 07 Zip Code 91789 08 Dwelling Unit Conditioned 1600 Floor Area (ft2) SC SC System SC System CFA served '-�System a 'r' Igerant Number of space conditioning E Installing 09 Climate Zone 9 10 (SC) systems in this dwelling 1 ducted) contalning system V m re than 40 unit. L entirely new B. Space Conditioning (SC) System Information 01 02 03 04 05 _ 06 1 07 08 09 30 ` ; v,Is the SC ' `Installing a' -- SC SC System SC System CFA served '-�System a 'r' Igerant _Installing'new-SC E Installing Installing dnstalling Identification or Location or Area by this SC ducted) contalning system V m re than 40 en -' ly new L entirely new Name Served System (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type Entirely new or System 1 Whole House 1600 Yes Yes Yes Yes Yes Yes complete replacement space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section1S0.2(b)iDiib) This section does not apply to this project. Registration Number: 216-A0348801A-000000000-0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: 2016-09-21 05:34:36 Report Version: 2013 Rev 1.008 Schema Version: 0.555SDD HERS Provider: CaICERTS Report Generated: 2016-09-21 05:33:20 CERTIFICATE OF COMPLIANCE CF111-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: Powers, John Company: Signature Date: J W POWERS HEATING AND AIR CONDITIONING 2016-09-21 05:34:36 Address: CEA/ HERS Certification Identification (if applicable): 7452 GAZETTE AVE City/State/Zip: Phone: CANOGA PARK CA 91306 1818-612-1716 X123 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, c: mponents, 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-,cf Compliance are consistent -with the Information.provided on +thei.applicable-compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permifapplication. S. I will ensure that a registered copy of this Certlficate of.Compliance shall be'ma`de available with the building permit(sj,issued for'the_buildfng, and made available.tothe enforcement agency for all applicable Inspections. I understand that a registered copy of this Certificate of Compllance,Is,required to be_.included with the,documentatlon*the,bullder provides to -the building owner at occupancy. Responsible Designer Name: til i _J C� Responsible Desig`n'er Signature: Powers, John p"/ii�ik/PJtO� Company: Date Signed: J W POWERS HEATING AND AIR CONDITIONING 2016-09-21 05:34:36 Address: License: 7452 GAZETTE AVE 773136 City/State/Zip: Phone: CANOGA PARK CA 91306 1818-612-1716 X123 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: 216-A0348801A-000000000-0000 Registration Date/Time: 2016-09-2105:34:36 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 05:33:20 Schema Version: 0.555SDD CERTIFICATE OF INSTALLATION CF2R-MCH-25-H Refrigerant Charge Verification (Page 1 of 4 ) Project Name: 846 Addamsgrove Ave Enforcement Agency: City of Diamond Bar Permit Number: PRI44869 Dwelling Address: 846 Addamsgrove Ave City: Diamond Bar Zip Code: 91789 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 Whole House 03 Condenser (or package unit) Make or Brand AC Pro 04 Condenser (or package unit) Model Number 4AC14L48P7A 05 Nominal Cooling Capacity (tons) of Condenser 4 06 Condenser (or package unit) Serial Number 1916D37140 07 Refrigerant Type -" .. -; R -410A 08 Other Refrigerant Type (if applicable) 09 System Installation Type 'i New Charge Indicator Display (CID) Status (Note: Even systems This system does not have a CID device installed 10 with a CID must have refrigerant charge verified by installer). Is the system of a type that the minimum airflow can be Yes, this is a ducted system and one of the system airflow 11 verified using an approved measurement procedure (RA3.3 rate measurement procedures in RA3.3 or RA3.2.2.7 can be or RA3.2.2.7)? used to verify system airflow rate 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 RAI is applicable to this system and can be 12 with the refrigerant charge verification requirements when used to verify compliance temperatures are greater than or equal to 55F (RA3.2.2, or RAI)? 13 Date of Refrigerant Charge Verification for this system 2016-09-03 14 Refrigerant charge verification method used. Subcooling (outdoor temperature must be equal to or greater than 55 degF) 15 Person who performed the Refrigerant Charge Verification HVAC system installer reported on this Certificate of Installation 16 HERS Verification Compliance Requirement Status System qualifies for group sampling MCH -25b - Refrigerant Charge Verification - Subcooling Method Registration Number: 216-A0348801A-M2500002A-0000 Registration Date/Time: 2016-09-21 05:50:30 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 05:48:36 2013 Residential Compliance Schema Version: 2013.1.008 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 Thermostatic Expansion Valve (TXV) 02 Subcooling Method applicability status Subcooling Method is applicable to this system. C. Instrument Calibration Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2 01 Date of Digital Refrigerant Gauge Calibration 2016-09-01 02 Date of Digital Thermocouple Calibration 2016-09-01 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 specified -in Reference Residential Append x RA3 2 2:3 Method used to demonstrate,complianee.with �the- MAH installed and labeled consistent with Figure 3.2-1 , 01\. r Measurement Access Hole (MAH) requirement i 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) 1400 02 System Airflow Rate Verification Status System complies with minimum airflow rate requirements F. Data Collection and Calculations Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in Reference Residential Appendix RA3.2.2. 01 Lowest return air dry bulb temperature that occurred during 71 the refrigerant charge verification procedure (degreeF) 02 Measured Condenser air entering dry-bulb temperature (T 76 condenser, db) 03 Outdoor Temperature Qualification Status Outdoor temperature is within range for using Subcooling refrigerant charge verification method 04 Measured Liquid Line Temperature (T6quid) (degreeF) 81.3 05 Measured Liquid Line Pressure (Pllquid) (pisg) 319.5 Registration Number: 216-A0348801A-M2500002A-0000 Registration Datefrime: 2016-M21 05:50:30 HERS Provider: CalCERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 05:48:36 2013 Residential Compliance Schema Version: 2013.1.008 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: /J_ /_ John Powers O�/i/ti1r /1V Company: Signature Date: 2016-09-21 05:50:30 J W POWERS HEATING AND AIR CONDITIONING Address: CEA/ HERS Certification Identification (if applicable): 7452 GAZETTE AVE City/State/Zip: Phone: CANOGA PARK CA 91306 818-612-1716 X123 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. �' _ ,/ __ /r. 4. 1 understand that a HERS rater will,check the installation to verifytompliance, and that if such checking identifies defects; I am required to take" corrective action at my expense? I understandthat Energy Commission and HERS Provider representatives will also perform quality assurance checking of installations, including those approved as part of a sampie group but not'checked by a HERS rater, and if thoseiristallations fail to meet toe "'- , ,I requirements of such quality assurance checking, the required corrective: action and additional checking/testing of other installations in that,HERS sample group will be performed atmy expense: �— -tet ?' Q 5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 6. 1 will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name: Responsible Builder/Installer Signature. John Powerso. Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): Builder/Owner) Owner J W POWERS HEATING AND AIR CONDITIONING Address: CSLB License: 7452 GAZETTE AVE 773136 City/State/Zip: Phone: Date Signed: CANOGA PARK CA 91306 818-612-1716 X123 2016-09-21 05:50:30 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 no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: 216-A0348801A-M2500002A-0000 Registration Date/Time: 20164)9-2105:50:30 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 05:48:36 2013 Residential Compliance Schema Version: 2013.1.008 CERTIFICATE OF INSTALLATION CF2R-MCH-22-H Space Conditioning System Fan Efficacy (Page 1 of 3 ) Project Name: 846 Addamsgrove Ave Enforcement Agency: City of Diamond Bar Permit Number: PR144869 Dwelling Address: 846 Addamsgrove Ave City: Diamond Bar Zip Code: 91789 A. Ducted Cooling System Information 01 System Identification or Name System 1 02 System Location or Area Served Whole House 03 System Installation Type New 04 Nominal Cooling Capacity (tons) of Condenser 4 05 Condenser Speed Type Single Speed 06 Cooling System Zonal Control Type Not Zonal 07 Central Fan Integrated (CFI) Ventilation System Status Not a CFI system 08 System Bypass Duct Status No Bypass Ducie 09 Date of System Airflow Rate Measurement _� �. �� _ 1016::09-03 10 Airflow Rate Protocol utilized\ ; -;z? ,,-RA3.3 procedures for airflow'rate'measurement ; B. Fan Watt Measurement Apparatus and Procedure Information Instrument Specifications are given in RA3.3.1, and system fan watt measurement apparatus information is given in RA3.3.2.2. 01 1 Fan Watt Verification Device Used. I Portable wattmeter MCH -22a Forced Air System Fan Efficacy Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed Compressor . C. Forced Air System Fan Efficacy Measurement The procedures for System Fan Watt Verification are specified in Reference Residential Appendix RA3.3 01 Actual Tested Watts 0.1 02 Actual Tested Airflow from MCH -23 (cfm) 1427 03 Required Fan Efficacy (watts/cfm) 0.58 04 Actual Fan Efficacy (watts/cfm) 0 05 Compliance Statement: System fan efficacy complies Registration Number: 216-A0348801A-M2200002A-0000 Registration Date/Time: 2016-W21 05:50:30 HERS Provider: CalCERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 05:47:05 2013 Residential Compliance Schema Version: 0.52SDD CERTIFICATE OF INSTALLATION CF2R-MCH-22-H Space Conditioning System Fan Efficacy (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: /J�� John Powers Company: Signature Date: 2016-09-2105:50:30 J W POWERS HEATING AND AIR CONDITIONING Address: CEA/ HERS Certification Identification (if applicable): 7452 GAZETTE AVE City/State/Zip: Phone: CANOGA PARK CA 91306 818-612-1716 X123 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on.the plans and specifications approved by the enforcement agency. 4. 1 understand that a HERS rater will check the installation to venfycompliance, and that,if such checking identifies defects; I am required to take corrective action at my expense., I understand that Energy Commission and HERS Provider rep'r'esentatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not ehecked'by,a HERS rater, and ifahose installations fail to meet the " i requirements of such qualityassurariice checking, the required corrective action and additional checking/testing of other installations.in that HERS sample group will be performed at my expense: 5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 6. 1 will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name: Responsible Builder/Installer Signature: John Powers, Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): Builder/Owner) Owner 1 W POWERS HEATING AND AIR CONDITIONING Address: CSLB License: 7452 GAZETTE AVE 773136 City/State/Zip: Phone: Date Signed: CANOGA PARK CA 91306 818-612-1716 X123 2016-09-21 05:50:30 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: 216-A0348801A-M2200002A-0000 Registration Date/Time: 2016-09-2105:50:30 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 05:47:05 2013 Residential Compliance Schema Version: 0.52SDD CERTIFICATE OF INSTALLATION CF2R-MCH-23-H Space Conditioning System Airflow Rate (Page 1 of 3 ) Project Name: 846 Addamsgrove Ave Enforcement Agency: City of Diamond Bar Permit Number: PR144869 Dwelling Address: 846 Addamsgrove Ave City: Diamond Bar Zip Code: 91789 A. Ducted Cooling System Information 01 System Identification or Name System 1 02 System Location or Area Served Whole House 03 System Installation Type New 04 Nominal Cooling Capacity (tons) of Condenser 4 05 Condenser Speed Type Single Speed 06 Cooling System Zonal Control Type Not Zonal 07 Central Fan Integrated (CFI) Ventilation System Status Not a CFI system 08 System Bypass Duct Status i' ' ; No Bypass Duct 09 Date of System Airflow Rate Measurement �,., �, 2016-709-03 D 10 Airflow Rate Protocol Utilized`,��� r` >RA3.3 piocedures forairflow �ate;measurement B. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently Installed Static Pressure Probe (PSPP) in the Supply Plenum. Procedures for installing HSPP or PSPP are specified in RA3.3.1.1. 01 I Method Used to Demonstrate Compliance with theI 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 Kanomax 03 Model number of Airflow Measurement Apparatus 6710 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: 216-A0348801A-M2300002A-0000 Registration Date/Time: 2016-09-21 05:50:30 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 05:46:26 2013 Residential Compliance Schema Version: 2013.1.008 CERTIFICATE OF INSTALLATION CF2R-MCH-23-H Space Conditioning System Airflow Rate (Page 3 of 3 ) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author John Powers Company: Signature Date: 2016-09-21 05:50:30 J W POWERS HEATING AND AIR CONDITIONING Address: CEA/ HERS Certification Identification (if applicable): 7452 GAZETTE AVE City/State/Zip: Phone: CANOGA PARK CA 91306 818-612-1716 X123 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. iF- erifycompliance, 4. 1 understand that a HERS rater will check the installation t and that if such checking identifies defects; I am required total;" corrective action at my expense.1 understand'that Energy Commission and HERS Provider representatives wili'also perform quality assurance checking of installations, including those approved as part of a sample group buT not:checked by a:HERS rater, and if those installations fail to meet tFe. - requirements of such quality assurance checking, the required corrective; action and additional checking/testing of other installations in that HERS sample group will be performed atmy, expense, 5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 6. 1 will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name: Responsible Builder/Installer Signature: John Powers Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): Builder/Owner) Owner J W POWERS HEATING AND AIR CONDITIONING Address: CSLB License: 7452 GAZETTE AVE 773136 City/State/Zip: Phone: Date Signed: CANOGA PARK CA 91306 818-612-1716 X123 2016-09-21 05:50:30 Third Party Quality Control Program (TPQCP) Status: Name of TPQCP (if applicable): Digitally signed by CafCERTS. 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: 216-A0348801A-M2300002A-0000 Registration Date/Time: 2016-09-21 05:50:30 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 05:46:26 2013 Residential Compliance Schema Version: 2013.1.008 CERTIFICATE OF INSTALLATION CF2R-MCH-20-H Duct Leakage Diagnostic Test (Page 1 of 3 ) Project Name: 846 Addamsgrove Ave Enforcement Agency: City of Diamond Bar Permit Number: PR144869 Dwelling Address: 846 Addamsgrove Ave City: Diamond Bar Zip Code: 91789 A. System Information 01 Space Conditioning System Identification or Name System 1 02 Space Conditioning System Location or Area Served Whole House 03 Building Type from CF -111 Single family 04 Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Credit from CF1R? No, credit is not taken 05 Verified Low Leakage Air Handling Unit (VLLAHU) Credit from CF1R? No, credit is not taken 06 Duct System Compliance Category New MCH -20a - Completely New Duct,System' B. Duct Leakage Diagnostic Test' 01 Condenser Nominal Cooling Capacity (ton) 4 02 Heating Capacity (kBtu/h) 0 03 Conditioned Floor Area served by this HVAC system (ft) 1600 04 Duct Leakage Test Condition Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor 0.06 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) 96 10 Actual duct leakage rate -from leakage test measurement (cfm) 33 11 Compliance Statement: System passes leakage test Registration Number: 216-A0348801A-M2000002A-0000 Registration Date/Time: 2016-09-2105:50:30 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 05:45:40 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: .A.1D.� John Powers O�'/ Company: Signature Date: 2016-09-2105:50:30 J W POWERS HEATING AND AIR CONDITIONING Address: CEA/ HERS Certification Identification (if applicable): 7452 GAZETTE AVE City/State/Zip: Phone: CANOGA PARK CA 91306 818-612-1716 X123 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 understand that a HERS rater will check the installation to verify compliance, and that if such checking identifies defects; I am required to take corrective action at my expense`,1 understand that Energy Commission and HERS Provider representatives will also perform quality assurance checking of installations, including those approved as part of -6 sample group 6ut:not checked'by.a HERS rater, and if those'installations fail to meet t6 requirements of such quality assurance checking, the required corrective action and. additional checking/testing of other installations ,intkat HERS sample group will be performed at -my expense,') ` S. I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and 1 have ensured that the requirements that apply to the construction or installation have been met. 6. I will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name: Responsible Builder/Installer Signature: John Powers Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): Builder/Owner) Owner J W POWERS HEATING AND AIR CONDITIONING Address: CSLB license: 7452 GAZETTE AVE 773136 City/State/Zip: Phone: Date Signed: CANOGA PARK CA 91306 818-612-1716 X123 2016-09-21 05:50:30 Third Party Quality Control Program (TPQCP) Status: Name of TPQCP (if applicable): Digitally signed by CafCERTS. 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: 216-A0348801A-M2000002A-0000 Registration Date/Time: 2016-09-2105:50:30 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 05:45:40 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 1 of 8 ) Project Name: 846 Addamsgrove Ave Enforcement Agency: City of Diamond Bar Permit Number: PR144869 Dwelling Address: 846 Addamsgrove Ave City: Diamond Bar Zip Code: 91789 A. General Information 01 Dwelling Unit Name 846 Addamsgrove Ave 02 Climate Zone 9 06 Dwelling Unit Total Conditioned Floor 08 04 Number of Space Conditioning 1 03 Area (W)1600 Is the SC Installing aInstalling Systems in this Dwelling Unit. Installing more 05 Certificate of Compliance Type Prescriptive alterations (CF1R-ALT) 06 Method used to Calculate HVAC Loads NotApplicableEquipmentChangeout 07 Calculated Dwelling Unit Sensible This field or section is not applicable 08 Calculated Dwelling Unit Heating Load This field or section is not applicable Alteration Type Cooling Load (Btuh) Served System (ftZ) (Btuh) containing 09 Dwelling Unit Number of Bedrooms 4 system? MCH -01b Space Conditioning Systems Ducts and Fans - Prescriptive Alterations B. Space Conditioning (SC) System Information �� U s ~ D) I`r,' u l 5 tl r� 01 02 03 04 05 06 07 08 09 30 SC System SC System CFA served Is the SC Installing aInstalling new SC Installing more Installing Installing Identification or Location or Area by this SC system a refrigerant system than 40 feet of entirely new entirely new SC Alteration Type Name Served System (ftZ) ducted containing components? ducts? duct system? system? system? component? Entirely new or complete System 1 Whole House 1600 Yes Yes Yes Yes Yes Yes replacement space conditioning system Registration Number: 216-A0348801A-M0100002A-0000 Registration Date/Time: 2016-09-2105:50:30 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-21 05:45:07 Schema Version: 2013.1.008 CERTIFICATE OF INSTALLATION Space Conditioning Systems, Ducts, and Fans CF2R-MCH-01-E (Page 8of8) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Installation documentation Is accurate and complete. Documentation Author Name: John Powers EF9E Author Signature: Company: J W POWERS HEATING AND AIR CONDITIONING Address: 05:50:30 7452 GAZETTE AVE Certification Identification (if applicable): City/State/Zip: CANOGA PARK CA 91306 Phone: Responsible Person's Declaration statement 818-612-1716 X123 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. I 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 ma^ actured-devlces (the,instaliatlon) Identified on this Certificate .of Installation conforms to alLapplicable codes and regulations, and the Installation conforms to the requirements given on the plans and p\ ificatlons"approved`by the enforcement agency 4. I reviewed a copy of the Certificate of a require ncee approved by the enforcement agency that identifies the specific requirements for scope of construction or`installatlon Identified on this Certificate of Installation, and I have ensured that the requirements thaf;apply to the construction or Installation have been met. S. I will ensure that ti registered copy of this Certificate of Installation shall -be pos ed or ade available with the building permits) Issued for the building and made available to the enforcement agency applicable inspections. I understand that a registered copy of this Certificate of Installation is req'u'ired to tie Included"with`the documentation the builder-prbvides to the building owner at occupancy. forall Responsible Builder/Installer Name: John Powers Responsible Builder/Installer Signature: Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)�ino� J W POWERS HEATING AND AIR CONDITIONING Position Wlth Company (Title): Address: Owner 7452 GAZETTE AVE CSLB License: City/State/Zip: 773136 CANOGA PARK CA 91306 Phone: 818-612-1716 X123 Digitally signed by CalcERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: 216-A0348801A-M0100002A-0000 Registration Date/Time: 2016-09-2105:50:30 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 2013.1.008 Rev 18 --- Schema Version: 201 Report Generated: 2016-09-21 05:45:07