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HomeMy WebLinkAbout14-3917MOND BAR CITY OF DIAMOND BAR01sli DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 11A 21810 Copley Drive, Diamond Bar, CA 91765' � PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION JOB SITE ADDRESS ` � � -4 ►�T LOCI(— - APN LOT TRACT OWNER Azbji OI.0 lw-eml ADDR SS CITY � AAID tae d ZlP TEL901 LIL114 W44 APPLICANT \4-01I IL1S TEL -510 �&SECQI? i CONTRACTORLWQlef,- V1,,-Uy1L ADDRESS ?;I�k Le rA W EIE� PLV" j r CITY CA )w�_. ZIP '9a�32 TEL. 3/ 02&3k 66 i 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) h indicated below by the checkmark(s), 1 have placed next to the applicable item(s) (Section 70315, 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 h is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section h 7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for r r 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). i U 1, 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 stricture Is not intended or offered for sale (Section 7044, Business and Professions Cade: 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. U however, the building or Improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that It was riot built or improved for the purpose of sale.). U I, as owner of the property, am exclusively contracUng 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' Slate License Law.). U I am exempt from licensure under the Contractor's State License law for the following reason(s): By my signature below 1 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 penniLl cannot legally sell a structure that I have built as an owner -builder if It has riot 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: httpAvww.leginfo.ca.gov/caiaw.htmi. 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 thea Business and Professions Code, and my license is in full force and effect. LICENSE CLASS: LIC. NO.: (0 -?q !that 8 DATE: C.e -�S L Lf CONTRACTOR: f XMU yf : l!-,9 7-(C_ 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 Seg -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Cade, for the performance of the work for which this permit is Issued. _ I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER POLICY NUMBER 4 q'i :1.i N 0-71 (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 Workers Compensation Laws of Calitomia. And agree that K I should bec" subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shag forthwith comply with those provisions. DATE 4---; ('GPPLICANT: 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 campy 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. r11JS PERM E NAME (PRINT) SIGNATURE OF PERMITTEE DATE APPLICATION DATE: b -O�� � �Y ) / P/C#[� A ISSUE DATE: b " 14 - ��� PERMIT# I-(- J / /7 TYPE CONST. /'VI ecAa/liCC N= OCC GROUP: ZONING SETBACKS FRONT RW a REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport W Lu Patio/Deck Iwi PooUSpa ZRe -Roof M Commercial M Valuation: Adj. Area: QUANTITY DESCRIPTION FEE c� w z m J d i yu lz4i ACS alt CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: r INSPECTION FEE: ISSUANCE: SM IP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BSAF: TOTAL FEES COMMENTS: RECEIPT q ✓� � PAID BY:.%r3. 7 � VALIDATION: WHITE - Department Copy, YELLOW - Finance Copy, PINK - Assessor Copy, GOLDENROD - File Copy, GREEN - Applicant's Copy CITY OF DIAMOND BAR ` INSPECTION RECORD ' Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF -IR -ALT -HVAC Climate Zones 2, 9 Site Address: I Enforcement Agency: Date: Permit #: Conditioned Equipment T el List Minimum Efficiency Z Floor Area Duct insulation requirement Thermostat Packaged Unit Furnace ❑ AFUE_ COPHSPF Over ft of ducts added or Setback Indoor Coil �SEER�_ 8 Served by system replaced in unconditioned (if not already present, Condensing Unit ❑ EER ❑ Resistance sf space ❑ R 6 (CZ 2 and 9) must be installed) Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final inspection. 1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS CF -4R forms: MECH-21 and fors lits stems MECH-25 • Condenser Coil and/or • Indoor Coil and/or CF -6R forms: MECH-21-HERS and (for split systems)' MECH-25-HERS, CF -4R forms: MECH-21 and (for split systems) MECH-25 • Fumace For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or 2. Duct systems with less than 40 linear feet in unconditioned space, or - 3. Existing ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut in or Changeout with new ducts: (all CF -6R forms: MECH-04, MECH-20-HERS and (for split systems) MECH- 25 -HERS new ducting and all new equipment) CF -4R forms: MECH-20 and (for split systems) MECH-25 For Split Systems: Duct leakage < 6 percent; RC, CCA > 300 CFM/ton, TMAH. For Packaged Units: Duct leakage <6 percent ❑ 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS ducting and/or outdoor condensing unit CF -4R forms: MECH-20 and (for split systems) MECH-25 and/or indoor coil and/or furnace. Not all equipment chan ed. For Split Systems: Duct leakage < 6 percent, RC,CCA > 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -4R forms: MECH-21 For split s stem or packaged units: Duct leakage < 15 percent [EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • 1 certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets calculations plans andspecifications submitted to the enforcement agency for approval with the permit application. Name: IS Signature: � Company: Date: Date: Address: License: �� C City/State/Zip: C.Vwcv— C^ q Phone: 3,o Y 2008 Residential Compliance Forms July 2010 FAX Date: T From: Bruce Smyth, phase Management Services, LLC . Phone: 310 838-0408, Ext. 101 Fax: 310 559.5604 N er of pages that I'm faxing including cover sheet is F4.g0j 2., Thank you 0 4�0 L►� L 0 C x \��0,� � C� 91'7 - TO 39Vd S1IW2Dd P0996990T6 Lb:60 VTOZfL010T INSTALLATION CERTIFICATE CF-6R-MECH-25-HER Refrigerant Charge Verification - Standard Measurement Procedure (Page i of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Sar CA 91765 1 City of Diamond Bar 14-3917 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH.and SIMS are not required for compliance when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3,2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance, unless the TMAH Compliance Option is chosen. SIMS are only required for Completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - errPas Hnion in 5unnly and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 5/16 inch (S mm) access hole 1 upstream of evaporative coil in the ® Yes O Yes ❑ Yes ❑ Yes return plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figure in Section RA3.2.2.2.2. Returnj'i5 de of a duct system iS loca>'6 entirely within.:condi#ionpd 13 Yes © Yes D Yes , ;, 13 Yes 1a spot* and return airf bw Wnp6Mture i Flo;; [1 No ❑ No '` ❑ No to bmo rneasured tho; return rule. m .tr Yom,. ❑ Yes 13 Yes D Yep 2downeaoe supplyy plenum labeledacco ding O No ❑ No D No O No to Figure in Section RA3.2.2.2.2. The TMAH Compliance Option should be checked only if it is physically impossible to drill the TMAH as required by Section RA3.2.2.2.2. Using this Compliance Option requires the HVAC installer to annotate on the HERS Provider's data registry an explanation as to why the TMAH cannot be installed on the system, and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance Option also requires minimum airflow verification through the direct measurement of airflow per RA3.3 For more information see htto•//www enemy ca aov/title24/20 8standdrds/so cial case appliance/. TMAH Compliance Option ❑ ❑ ❑ ❑ Yes to 1 and 2, or Yes to la and 2, or checking the TMAH Compliance Option,is N Pass 13 Pass 13 Pass O Pass a pass. ❑ Fail El ❑ Fail ❑ Fail Enter Pass or Fail trap: 21,4-AO082968A-M2500001A-0000 Registration Date/Time: 2014/08/26 07:19:43 KP•Rs Provide: Ca10ERTS, Inc. 20011 Residential Compliance Forms March 2013 50 39bd SlIW63d b0996590T6 LP:60 17TOZ/L0/0T INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6) Site Address:.,: Enforcement Agency: Permit Number: 1204 Flintlock'Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 SIMS - Sensor on the Evaporator Coil System Name or System 1 - Identification/Tag Identification/Tag 3 The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed 6 by methods/specificatlons approved by the Executive Director, O Yes 0 No 1 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No by meihods/specifthtiqm approved by the Exe4 jptive Directpe. The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 4 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the 7 airflow through the condenser coil ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 5 IThe sensor measures the saturation temperature of the coil within 1.3 degrees F ❑ Yes ❑ No Cl Yes ❑ No ❑ Yes ❑ No ❑ Yes []No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No []Yes ❑ No Yes to 3, 4, and 5 is a ❑ Yes ❑ No Yes to 6, 7, and 9 is a pass. Enter N/A if STMS are not ® N/A ❑ Pass ❑ N/A ❑ Pass ❑ N/A ❑ Pass ❑ N/A ❑ Pass applicable. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Otherwise enter Pass or ❑ Pass applicable. ❑ fail ❑ Fail Fail ❑ Fail Otherwise enter Pass or cTrMs - A.Amenr nn the Condenser Coll System Name or System 1 Identification/Tag 6 The serisor is factory installed,f or fWd installed 6CCording to.ma'nufocturer'sSpecificatians, or is installed by meihods/specifthtiqm approved by the Exe4 jptive Directpe. 0 Yids ❑ No ❑ Y.es Il Na. '. ❑ Yes.:Cl No L] Yes ❑ No. The S>mF15or wir with . a standard thermometer, tgrii:.& itecfn 7 clam and"tho HERS rater wlthout Chanital i pS 'etd. The sensor rxtrn� lu �s.accessible to Ing the t �g airflow through the condense co ❑ Yes ❑ No Cl Yes ❑ No ❑ Yes ❑ No ❑ Yes []No 8 IThe sensor measures the saturation temperature of the toll within 1.3 degrees F ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes []No ❑ Yes ❑ No Yes to 6, 7, and 9 is a pass. ❑ N/A ❑ N/A ❑ N/A ❑ N/A Enter N/A if STMS are not ❑ Pass ❑ Pass ❑ Pass ❑ Pass applicable. ❑ fail ❑ Fail U Fail ❑ Fail Otherwise enter Pass or Fail Reg: 21,4-A0082968A-M2500001A-0000 Registratl.on Date/71-me:2014/08/26 0?:]9:93 HERS Provider: CAICFRMarchn2013 2008 Residential Comoliance FOM$ a 90 39dd SlIWZi3d b0956550Z9 Lb 60 bZ0Z?L0!0Z INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard MeasureMent Procedure (Page3 of +6) Site Address: I Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 Standard Charge Measurement Procedure (for use If outdoor air dry-bulb temperature is 551F or above) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available In Reference Resldentlal Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form, Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be Installed and charged In accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb temperature Is less than 55°F, the Installer must use the RA3.2.3 Alternate Charge Measurement Procedure (Weigh -In Charging Method). If the Weigh -In Method is used, the dwelling cannot be included in a sample group for HERS verification compliance.) Snace Conditioning Svstems System Name or Identification/Tag System 1 ('must be re -Calibrated monthly) Date of Thermocouple Calibration 6-1-2014 System Location or Area Served Whole House Outdoor Unit Serial # 38HDC06032 Outdoor Unit Make YORK Outdoor Unit Model 1933X80576 Nominal Coolin.g.Capacity 5 Tons Date of V*ification 6-30-2014 ,.. a11hrzd1"n of niadWbAtIliE10StruiVi&ntL Date of RE!M06"riant`Cau a CAbratiori 6=i-2�i'1+ ('must be re -Calibrated monthly) Date of Thermocouple Calibration 6-1-2014 (must be re -calibrated monthly) MaaessroA Tornnorsaturme C*FI System Name or Identification/Tag System 1 Supply (evaporator leaving) alr dry-bulb 51.7 temperature (Tsu I db) 35.7 Return (evaporator entering) air 71-1 dry-bulb temperature (Treturn db) Return (evaporator entering) air 59.5 wet -bulb temperature (Treturn wb) Evaporator saturation temperature 35.7 (Teva orator sat) Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) 46.0 Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb 81.3 temperature (Tcondenser, db) xeg: 214-A0092968A-M2500001A-0000 RegistrAtiOn Date/Time: 2014/09;26 Oi :19:43 HERS Provider: Ca10ER'I'S, 2nC. 2008 RBSS.denti.al Compliance ForM$ March 20.3 20 3Jad SlIWZ13d b0956550T6 2b:60 PTOV2VOT NSTALLATION CERTIFICATE CF-611-MECH-25-1-IERI tefrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6 Site Address: Enforcement Agency:Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 Ylnlr ei a Alrflnm Qaeia.wamant Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or identification/Tag System 1 Calculate: Actual Temperature Split = 19.40 Treturn db - Tsupply, db Target Temperature Split from Table RA3.2-3 19.3 using Treturn wb and Treturn db Calculate difference: Actual Temperature 0.1 Split - Target Temperature Split = Passes if difference is between -3°F and +3°F or, upon remeasurement, if between PASS -3'F and -100°F Enter Pass or Fall Note: Temperature Split Method Calculation Is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nomin4i.Co01fing Capacity (ton) X 300 (cfm/tei*) System iifame or-,id".tif atioii/Tag ::..:... system Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 procedures (CFM) Measurement Method ` Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Reye 214-A008296SA-M2500001A-0000 Regi4t.rati.on Date/T.tme: 2014/06/26 07:19:43 HERS Provider: Cn1cERrS, inc. 'x008 Residential Compliance Forms March 2013 80 30Vd SlIWd3d b0956550T8 Lb:60 bTOZ/20/OT 0 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 41765 City of Diamond Bar 14-3917 Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tog System 1 Calculate: Actual Superheat = 10.3 Tsuction - Teva orator sat Target Superheat from Table RA3.2-2 6 using Treturn wb and Tcondenser, db Calculate difference: 4.30 Actual Superheat - Target Superheat = System passes if difference is between -5°F and +5°F PASS Enter Pass or Fail Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Subcooling = Tcondenser, sat - TII uid Target Subcooling specified by manufacturer Calculate difference: Actual SubcWtng -:Target Subcooling = Systemsses if difference is betwe -3°F an+3°F Linter Paque or Fail Metering Device citations for Wirligerant 2har4e Ve04fica n. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate; Actual Superheat = Tsuction - Teva orator sat Enter allowable superheat range from manufacturer's. specifications (or use range between 4°F and 25°F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range Enter Pass or Fail Req: 214-AOC82968A-M2500001A-0000 Registration Date/Time: 20L4/08/26 07:19:43 HERS Fro%ylder: Ca1CP,RTs, rnc,March 2413 `1.008 Re6z8ential. Compliance Forms 60 39ad SlIWa3d 170996SSOTC Lb :60 bTOZ/20/01 INSTALLATION CERTIFICATE CF-GR-MECH-Q Space Conditioning Systems, Ducts and fans (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 (System 1) 1 City of Diamond Bar 14-3917 Ducts and Fans 9150(m): Duct and Fans ® 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are Insulated to a minimum Installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL. 181A, or UL 1818 or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and ® 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. .® 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. ® 7. Exhaust fan systems have back draft or automatic dampers. ® 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. ® Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam Insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. ® 10. Flexible ducts cannot have porous Inner cores. 015CLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the Information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, Components, or manufactured devices identified on this certificate (the Installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and spWfications approved by the enforcement agency. . I reviewed a copy of the Certificate of Compliance (CF -111) form approved by the enforcement agency that Identifies the specific requirements for the instaliatlon. I certify that the requirements detailed on the CF -1R that apply to the installation have been met, . I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made avallable with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable Inspections. I understand that a signed copy of this Installation Certificate Is required to be Included with the documentation the builder provides to the building owner at accupantY. Company Name' (Installing Subcontractor or General Contractor or Builder/Owner) ORANGE COUNTY SERVICES INC dba GEORGE BRAZIL PLUMBING HEATING AND AIR CONDITIONING Responsible Person's Name: Responsible Person's Signature: LeSlle Diamond Leslie Diamond CSLB License: Date Signed: Position With Company (Title): 679898 6/30/2014 Req; 2:4-A008?.966A-M0400001A-:)C00 Reg'3r.ration Date/Time: 201�/08J25 07:17:10 siFRs Provider: Ca10EK73, Inc. 2008 Regtdential Compliance Forms Augu t 20Cy b0 3DVcl SlIWa3d b0996950Ti= 2tr:60 bTOVLO/OT ,2014 Dear Glenergy Solutions has successfully performed a duct test, seal and verification project at the above address. Glenergy Performed the initial test checked and sealed the duct system for leaks and performed the post verification test and Refrigerant Charge Measurement. We have received verification that the system passed the standards,lor compliance with Title 24 code, enclosed is a copy of the CF-6R and CF-4R certification forms. If you have any questions, please feel free to call our office. Sincerely. Heather Levans 2580 Alicia PI., Hemet, CA 92545 Phone (951) 492-1505 Heather.Lea.Evans@gmail.com 10 39dd SlIW�13d b9956SSOT6 Lb :69 t�T©VZO/OT [NSTALLATION CERTIFICATE CF-611-MECH-09 Space Conditioning Systems, Dycts and Fans (Page 1 of 27 Site Addre65: Enforcement Agency:- Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 (System 1) 1 City of Diami 1 14-3917 Space Conditioning Systems Equip Type (package- heat pump) CK Certified Mfr. Name and Model Number ARC Reference Number2 it of Identical systems Efficiency (AFUE, etc.)1, 3 (s=CF-1R vai4e)4 Duct Location (attic, crawl- space, etc.) Duct R -value Heating Load (kgtu/hr) Heating Capacity (kBtu/hr) Split Furnace York TGLSIZOc2DMp11B 1 80 AFUE Attic 120 120 kstu EQuip Type (package heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 Efflciency (SEER and EER) # of 1, 3 Identical (>=CF -1R systems value)4 Duct Location (attic, crawl -Cooling space, etc.) Duct R -value Load (kBtu/hr) Cooling Capacity (kBtu/hr) 1. It project is new conscrucuon, see ruomores cv - cLWIUarw rows aoi-o a•.V .ate,- — I — �_• •••y ••�•••u••- compliance. 2. ARI Reference Number can be found by entering the equipment model number at httpr//www•andirectory, orylari/aC. php# 3. Listed efficiency on this page must be greater than or equal (?) to the value shown on the CF -IR form. 4. When CF -IR is reference it is also applicable to the CF -IR, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM ® §110-§113: HVAC equipment is certified by the California Energy Commission. ® §150(h): Heating and/or cooling loads calculated In accordance with ASHRAE, SMACNA, or ACCA. ® §1SO(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). H §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditloned space. Reg: tin-A0082968A-M04000C1A-0000 Registration Date/Time: 2014/08/26 07:17:10 HERS Provider: Ca10EkTS, !no, 2008 Residential Compliance Forms Avgvst 2009 CO 39dd SlIW�13d b09SGSSOTE Lb:60 hTOZ/!O/OT INSTALLATION CERTIFICATE CF-6R-MECH-2S-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 Standard Charge Measurement Summary., System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 Leslie blarnond CSLB License:' Date Signed: System meets all refrigerant charge and 679$9$ 6/30/2014 . Is this installation monitored by a Third Party Quality airflow requirements. PASS Enter Pass or Fail N Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55°F and 65°F the return air dry bulb temperature shall be maintained above 70OF during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate. DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the Information provided on this form is true and correct. . t am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am requiredto take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, Including those approved as part of a sample group but not checked by a HERS rater, and if those installatloris.fail to meet the requirements of such quality assurance checking, the required.torrective action and additlonal checking/testing of other installations In that HERS sainple group will be performed at my expense. . I reviewed a copy of the Cectificafie d. compliance (CF -1R) form approved,by the enforcement agency that identifies the specific requirernents.for the -installation. I certify that.the requirem®hts detailed on the CF -1R that apply to the. Installagon have tbeil mot. . I will=l# that#$ C*irt pleltied, signed, cgpy of tN$ installation Certificate soh+aN be posted,, or made available with the huI ding permit(s) issued for the building, and made svailabie to the enforcement agency for all applicable Inspections. I understand that a signed copy of this Installation Certificate is required to be Included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and k-1-1— n,+.,hr i 7ntn f„ .II 1nw rlco rocleir nfial huildines. Company, Name: (Installing Subcontractor or General Contractor or Builder/Owner) ORANGE.COUNTY SERVICES INC dba GEORGE BRAZIL PLUMBING HEATING AND AIR CONDITIONING Responsible Person's Name: Responsible Person's Signature: Leslie.Diarnond Leslie blarnond CSLB License:' Date Signed: Position With mCompany (Title): 679$9$ 6/30/2014 . Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Reg: 2ih-AOCfl2568A-M2$p0001A-0000 Registration D6vQ/Time: 2014/09/26 07:19:43 HERS Provider: Ca10ERTS, inC. 2008 Residdrltt8i Complianoe Forms Match 2013 OT 39dd SiIH�13d b09SGSS0TC Lt:60 VIOVL0r'0T CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-2 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City Of Diamond Bar, 14-3917 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-2S Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems In the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix 8.43.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance, unless the TMAH Compliance Option is chosen. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. rMALA A.+raan Mnfec In Cunnly and Rwturn plenums of Air Handler System Name or Identlfication/Tag System1 System Location or Area Served Whole House 5/16 inch (8 mm) access hole upstream of evaporative coil In the ® Yes ❑ Yes ❑ Yes ❑ Yes 1 return plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figure in Section RA3.2.2.2.2. Rete. :side of the duct system ig IocaEeCt entirely within conditib :', d n © Yes - O.Yes ❑Yes. ❑Yes 1a spaii� and return altfld&i temperature E No .. No ❑ No ❑ No to be measuredtit the return #Hole. / finch C� rnsm� 3e c downstream of evapo native colt iii tFie 19 Yes 13 Yes C3 Yes 13 Yet 2 supply plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figure in Section RA3.2.2.2.2. The TMAH Compliance Option should be checked only if the HERS Rater is able to confirm that it was physically impossible for the HVAC Installer to drill the TMAH as required by Section.RA3.2.2.2.Z. using this Compliance Option requires the HVAC installer to annotate on the HERS Provider's data registry an explanation as to why the TMAH cannot be installed on the system, and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance Option also requires minimum.alrflow verification through the direct measurement of airflow per RA3.3. For more Information see'• httpll/www.engrgy.ca.aov/title?4/2009standgros/`snec"al case a nlaance/; TMAH Compliance Option ❑ ❑ ❑ ❑ Yes to i and 2, or Yes to is and 2, or checking the TMAH Compliance Option, is ® Pass ❑ Pass p Pass ❑ Pass a pass. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Enter Pass or Fall Req: 214-A0062958A-m?,500001A-M25A Registration Date/'Time: 2014/08/26 07:22:2] HERS ProvidAr: Ca1vFkTsFebruary 2013 20Od Residential ccmpli.'ance Fo:.5 TT •3Jt/d SlIWd3d b0996SSOTE 2.V :60 bT0Z/L0/0T CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4111-MECH-2 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 STMS - Sensor on the Evaporator Coil System Name or System 1 Identification/Tag Identificatl6ri/Tag 3 The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed by methods/specifications approved by the Executive Director. ❑ Yes ❑ No I Q Yes ❑ No ❑ Yes ❑ No F ❑ Yes D No by methods/specifications dpprdVod by the ExKv ive Director, The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 4 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the 7 airflow through the condenser coil ❑ Yes ❑ No E3 Yes ❑ No ❑ Yes ❑ No ❑Yes E3 No airflow through the condenser coil When attached to a digital thermometer, the sensor provides an indication of the saturation temperature 5 of the coil. 8 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 3, 4, and 5 is a Yes to 6, 7, and 8 is a pass. ® N/A ❑ N/A ❑ N/A ❑ N/A Enter N/A if STMS are not ❑ Pass ❑ Pass ❑ Pass ❑ Pass applicable. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Otherwise enter Pass or Fail Fail CTFAC ., 4keftcnr nn tha r.nnrCPnRAr ['nll System Name•br Identificatl6ri/Tag The sensor is factory.++ Iled, or; field installed according to.rhanuf icturer'9 specifications, or is installed ti by methods/specifications dpprdVod by the ExKv ive Director, Q Y+�.. D No. ❑Yes ❑;�l:t� ❑ Y��; No .: es o The sensor w re it'tern'ililated wit a :stdndefd';h1hf plug suitable for connection to a digital thermometer. 7 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil ❑ Yes ❑ No D Yes .❑ No ❑ Yes ❑ No D Yes ❑ No When attached to a digital thermometer, the sensor provides an Indication of the saturation temperature 8 of the coil. N 11 ❑ Yes ❑ No ❑ Yes Q No D Yes ❑ No D Yes ❑ No Yes to 6, 7, and 8 is a pass. ❑ N/A ❑ N/A ❑ N/A ❑ N/A Enter N/A if'STMS are not ❑ Pass ❑ Pass ❑ Pass ❑ Pass applicable. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Otherwise enter Pass or Fail Reg: 214-A0082968A-M2500001A-M25A ~Registration Dtte/Time: 2014/08/26 07:22:27 HERS Provider: Ca1CFRT8, Inc. 2008 Rtsiaential Compliance Forma February 2p12 ZT 3!DVd SlIWZtl3d b09S6550T6 Lb:60 bT0Z1'L0/0T INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer`s specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb temperature is less than 550E the installer must use the RA3.2.3 Alternate Charge Measurement Procedure (Weigh -In Charging Method). If the Weigh-in Method is used, the dwelling cannot be included in a sample group for HERS verification compliance.) Snare- Cnndltlnnlna r%wctnmc System Name or Identification/Tag System 1 (must be re -calibrated monthly) Date of Thermocouple Calibration 6-1-2014 System Location or Area Served Whole House Outdoor Unit Serial # YORK Outdoor Unit Make - 38HDCO6032 Outdoor Unit Model 1933X80576 Nominal Cooling Capacity 5 Tons Date of Vsl"ification 6-30-2014 Date of Refrigerant Gauge Calibration 6-1-2014 (must be re -calibrated monthly) Date of Thermocouple Calibration 6-1-2014 (must be re-callbrated monthly) System Name or Identlfication/Tag System 1 Supply (evaporator leaving) air dry-bulb 51.7 temperature (Tsu I db) Return (evaporator entering) air 71.1 dry-bulb temperature (Tretorn db) Return (evaporator entering) air 59.5 wet -bulb temperature (Treturn wb) Evaporator saturation temperature 35.7 (Teva orator sat) Condensor saturation temperature (Tcondensor, sat) Suctlon line temperature (Tsuction) 46.0 Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb 81.3 temperature (Tcondenser, db) RPA: 2:4-AOOP,2968A-M2500001A-MZ5A Registration Data/'Pima: 2014/08/26 07:22:2t HERS Pror.,tder: Ca1CFAY'S, Tnc:. 2,308 RBsidenti5l Complianoe Forms February 20'3 6T 39VJ SiIWa3cl P0996SSOTE Lb:60 1?T0Z/L0/0T INSTALLATION CERTIFICATE CF-411-MECH-2 Refrl ertnt Charge Verification - Standard Measurement Procedure (Page 4 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identificatlon/Tag System 1 Calculate: Actual Temperature Split = 19.40 Tretum db - TSupply, db Target Temperature Split from Table RA3.2-3 19.3 using Treturn wb and Tretum db Calculate difference: Actual Temperature 0.1 Split - Target Temperature Split = Passes if difference is between -4°F and +4°F or, upon remeasurement, if between PASS -4°F and -100°F Enter Pass or Fal Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the alrflow measurement procedures specified in Reference Residential Appendix RA3.3. Zf actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below, Calculated Minimum Airflow,:Requitement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/toter) System `Ndme,.or Iditaptificratign/Tag Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 procedures (CFM) Measurement Method Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Rpq: 214-nU0fl2968A-M2500001A-M25A Regi°"•ration page/'rime: 2014/08/2,6 0?:22:7.7 HERS ProuiclPr: Celt.'f:RFa [ar 200x{ Residanc.3-a1 Compl.tance Form VT 20. bT 39VJ S1IWJ3d P09969SOT£ Lb:60 bT0Z/L8/0T NSTALLATION CERTIFICATE CF-411-MECH-2! tefrigerant Charge Verification - Standard Measurement Procedure (Page S of 6 Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, biamond Bar CA 91765 City of Diamond Bar 14-3917 Superheat Charge Method Calculations for Refrigerant Charge Verificiption. This procedure is required tb be used for Fixed orifice metering device systems System Name or Identification/Tag System 1 Calculate: Actual Superheat = 10.3 Tsuction - Teva orator sat Target. Superheat from Table RA3.2-2 6 using Treturn wb and Tcondenser, db Calculate difference: 4.30 Actual Superheat - Target Superheat = System passes If difference is between -6°F and +6°F PASS Enter Pass or Fail Subcooling Charge Method Calculations for Refrigerant Charge Verificatlon. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Subcooling = Tcondenser, sat - Tli uid Target Subcooling specified by manufacturer Calculate diff+erenda: Actual Sub.600iing - Target Subcoiolin ,, System.leisses if differ ::is between -4°F anti!>.+4017 Enter P' Illus or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Superheat = Tsuction - Teva orator sat Enter allowable superheat range from manufacturer's specifications (or use range between 3°F and 26°F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range Enter Pass or Fail Req: 214-rU(7R2.968A-hi2500001A-M2fiA RegiSt,ratiorl p3r.e1'Pima_; 2014/09/26 0;:22:21 HERS Provider: Ca10ERTS, Inc. ?pOH Regidentiel Compli8nr..e So mS PebYuary 2013 9T 39dd SlIWd3d PO996SSOTE Lb:6O bTOZ/LO/OT [NSTALLATION C RTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement procedure (Page 6 of 61, Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 r Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation, if corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 679898 HERS Provider Data Registry Information Sample Group # (if applicable): N/A System meets all refrigerant charge and dwelling Ta HERS sample group HERS Rater Information CaICERTS Certificate # CCIL-1798898968 HERS Rater Company Name: airflow, requirements. PASS Responsible Rater's Signature: Raymond Moreno Raymond Moreno Enter Pass or Fail Date Signed: 6/30/2014 Provider: L CC2006075 ® Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55°F and 65OF the return air dry bulb temperature shall be maintained above 70°F during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate_ DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am the Certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The Installed feature, material, component, or manufactured device requiring HERS verificatipn that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -11%) approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the Installation conforms to the requirements specified on the Certiflcate(s) of Compliance Builder or Installer information a4 shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) ORANGE COUNTY SERVICES IN.16 Responsible PersoIWs'Narti CSL5 License: Leslie Diamond 679898 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ®tested/verified dwellingnot-tested/verified dwelling Ta HERS sample group HERS Rater Information CaICERTS Certificate # CCIL-1798898968 HERS Rater Company Name: 2nd to None HERS Ratings Responsible Rater's Name: Responsible Rater's Signature: Raymond Moreno Raymond Moreno Responsible Rater's Certification Number w/ this HERS Date Signed: 6/30/2014 Provider: L CC2006075 0 R,iq: 2:14-A.0082968A-M2500001A-M25A P.eq'_strat.ion rata/'Time: 2014/08/26 07:22:21 HE Provider: 7al2-ERTS, Tnc:. 2008 Re$idential COmpliar.ee sOrm.s February 2`.113 9T 39bd SlIWd3d b0956550TE Lb:60 PTOZ/L0/0T INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 (System 1) City of Diamond Bar 14-3917 Space Conditioning Systems Equip Type (package- heat pump) CEC Certified Mfr. Name and Model Number ARI Reference Number2 # of Identical Systems Efficiency (AFUE, etc.)1, 3 (>=CF -1R value)4 Duct Location (attic, crawl- space, etc.) Duct R -value Heating Load (kBtu/hr) Heating Capacity (kBtu/hr) Split Furnace York TGLS120C20MP11B 1 80 AFUE Attic 1 120 120 kBtu Type and EER) (attic, (package ARI # of 1, 3 crawl- Cooling Cooling heat CEC Certified Mfr. Name Reference Identical (>=CF -1R space, Duct Load Capacity pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) 1. it projecr is new conscrucrion, see raornuees w Dianualw ICUIC dJA- alru iauic �, �w y �• ••�•-- compliance. 2. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory. org/ari/ac. php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R form. 4. When CF -1R is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM ® §110-§113: HVAC equipment is certified by the California Energy Commission. ® §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. ® §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). ® §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets - minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. Reg: 219-A0082968A-M0400001A-0000 Registration Date/Time: 2014/08/26 07:17:10 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 Efficiency Duct Equip (SEER Location Type and EER) (attic, (package ARI # of 1, 3 crawl- Cooling Cooling heat CEC Certified Mfr. Name Reference Identical (>=CF -1R space, Duct Load Capacity pump) and Model Number Number2 Systems value)4 etc.) R -value (kBtu/hr) (kBtu/hr) .. .. a r ®® F tr... x. v 77, 1. it projecr is new conscrucrion, see raornuees w Dianualw ICUIC dJA- alru iauic �, �w y �• ••�•-- compliance. 2. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory. org/ari/ac. php# 3. Listed efficiency on this page must be greater than or equal ( ? ) to the value shown on the CF -1R form. 4. When CF -1R is reference it is also applicable to the CF -1R, CF -IR -AA or CF -IR -ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM ® §110-§113: HVAC equipment is certified by the California Energy Commission. ® §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. ® §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). ® §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets - minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. Reg: 219-A0082968A-M0400001A-0000 Registration Date/Time: 2014/08/26 07:17:10 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 o Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 (System 1) City of Diamond Bar 14-3917 Ducts and Fans §150(m): Duct and Fans M 1. All air -distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and ® 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. ® 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. ® 7. Exhaust fan systems have back draft or automatic dampers. ® 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. ® Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. ® 10. Flexible ducts cannot have porous inner cores. DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate 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 signed copy of this Installation Certificate is required to be Included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) ORANGE COUNTY SERVICES INC dba GEORGE BRAZIL PLUMBING HEATING AND AIR CONDITIONING Responsible Person's Name: Responsible Person's Signature: Leslie Diamond Leslie Diamond CSLB License: 679898 Date Signed: 6/30/2014 position With Company (Title): "4�1'�e DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met. . I will ensure that a completed, signed copy of this Installation Certificate 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 signed copy of this Installation Certificate is required to be Included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) ORANGE COUNTY SERVICES INC dba GEORGE BRAZIL PLUMBING HEATING AND AIR CONDITIONING Responsible Person's Name: Responsible Person's Signature: Leslie Diamond Leslie Diamond CSLB License: 679898 Date Signed: 6/30/2014 position With Company (Title): neg: a y-1WU0LybbA-MU4000UlA-0000 Registration Date/Time: 2014/08/26 07:17:10 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS lefrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 6', Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 1 City of Diamond Bar 14-3917 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance, unless the TMAH Compliance Option is chosen. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. 'ruAu - A ----- u-1— :e. C.annly and Rniurn Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 5/16 inch (8 mm) access hole upstream of evaporative coil in the ® Yes ❑ Yes ❑ Yes ❑ Yes 1 return plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figure in. Section RA3.2.2.2.2. ,_..- ._. x>• . Returnn,side of the duct system iso' R' , a 1a located entirely within conditioned, ❑ Yes ❑ Yes No i❑ Yes' ❑ No, ❑Yes ❑ No space and return aiF low temperature ❑;Noy � to be measured,at the',eeturn grille. 5/16 inch (8mm)raccesshole downstream of evaporative coil,in.the®Yes ❑Yes` ❑ Yes'^ ❑Yes 2 supply plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figure in Section RA3.2.2.2.2. The TMAH Compliance Option should be checked only if it is physically impossible to drill the TMAH as required by Section RA3.2.2.2.2. Using this Compliance Option requires the HVAC installer to annotate on the HERS Provider's data registry an explanation as to why the TMAH cannot be installed on the system, and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance Option also requires minimum airflow verification through the direct measurement of airflow per RA3.3 For more information see http:l/www.eneray,ca-ciov/title24/2008standards/special case appliance/ TMAH Compliance Option ❑ ❑ ❑ ❑ Yes to 1 and 2, or Yes to la and 2, or checking the TMAH Compliance Option, is IN Pass ❑ Pass ❑ Pass ❑ Pass a pass. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Enter Pass or Fail Reg: 214-A0082968A-M2500001A-0000 Registration Date/Time: 2014/08/26 07:19:43 HERS Provider: CaICERTS, Inc. 2008 Residential Compliance Forms March 2013 ENSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 1 City of Diamond Bar 14-3917 STMS - Sensor on the Evaporator Coil System Name or System 1 F I I I Identification/Tag , The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed by methods/specifications approved by the Executive Director. ❑ Yes ❑ No 1 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No �," The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 4 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the 7 airflow through the condenser coil ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 5 IThe sensor measures the saturation temperature of the coil within 1.3 degrees F ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 3, 4, and 5 is a Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ® N/A ❑ N/A ❑ N/A ❑ N/A applicable. ❑pass ❑Pass ❑Pass ❑Pass Otherwise enter Pass or ❑ Fail ❑ Fail ❑ Fail ❑ Fail Fail STMS - Sensor on the Condenser Coil System Name or Identification/,Tag=— System 1 - --„ r _ 6 The sensor is factory installed0ftor,fleld installed according to man ufactu rer'sfspecificati6ns, or is installed � ' b methods s ecifications a ` """ Y / P pproved, by the Executive Director:. �," '-' �.' ?❑Yes. ❑ No T; ❑ Yes ❑ No ? ❑ Yes, =,p No ,ll0 Yes ❑ No The sensor, wire Wter, 'inated'.with:a standard 'mini plug suitable for_ connection to addigitacl hermometer. 7 The sensor rriin� plug<i's accessible°to,theminstalling technicians"and the,HERS,'�ater without changing'ttie airflow through the condenser coiC ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 8 IThe sensor measures the saturation temperature of the coil within 1.3 degrees F ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ❑ N/A ❑ N/A ❑ N/A 13 N/A applicable. ❑ Pass E3Pass ❑ Pass ❑ Pass Otherwise enter Pass or ❑ Fail ❑ Fail ❑ Fail ❑ Fail Fail Reg: 214-A0082968A-M2500001A-0000 Registration Date/Time: 2014/08/26 07:19:43 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb temperature is 55°F or above) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb temperature is less than 55°F, the installer must use the RA3.2.3 Alternate Charge Measurement Procedure (Weigh -In Charging Method). If the Weigh -In Method is used, the dwelling cannot be included in a sample group for HERS verification compliance.) Space Conditionina Svstems System Name or Identification/Tag System 1 E. iu4Fy'$.' %w , (must be re' c6Iibrated monthly) " Date of Thermocouple Calibration 6-1-2014 System Location or Area Served Whole House Outdoor Unit Serial # 38HDC06032 Outdoor Unit Make YORK Outdoor Unit Model 1933X80576 Nominal Cool ing;,((;apacity 5 Tons Date of Verification 6-30-2014 Calibration of Diagnostic InstrurnPnts,-�:::' �!•'" ��'�� Date of Ref g`erant°Gauge'Calif anon i t# ..x,49VP a '" 6=1-2014 E. iu4Fy'$.' %w , (must be re' c6Iibrated monthly) " Date of Thermocouple Calibration 6-1-2014 (must be re -calibrated monthly) Measured Temneratures 10Fl System Name or Identification /Tag System 1 Supply (evaporator leaving) air dry-bulb 51.7 temperature (Tsu I db) Return (evaporator entering) air 71.1 dry-bulb temperature (Treturn db) Return (evaporator entering) air wet -bulb temperature (Treturn wb) 59.5 Evaporator saturation temperature (Teva orator sat) 35.7 Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) 46.0 Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db) g1.3 neg: 214—AUUb2y68A—M2500001A-0000 Registration Date/Time: 2014/08/26 07:19:43 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 ;NSTALLATION CERTIFICATE CF-6R-MECH-25-HER'_ 2efrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6, Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 1 City of Diamond Bar 14-3917 1-11111111-.- •. ..."—........ ..- Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 Calculate: Actual Temperature Split = 19.40 Treturn db - Tsupply, db Target Temperature Split from Table RA3.2-3 19.3 using Treturn wb and Treturn db Calculate difference: Actual Temperature 0.1 Split - Target Temperature Split = Passes if difference is between -3°F and +3°F or, upon remeasurement, if between PASS -3°F and -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated M nimum Airflow,Req rement< (CFM) — Nominal Cooling Capacity' (Yon) X 300 (cfm/tont)" System'Name or4Identification/Tag- s System Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 procedures (CFM) Measurement Method Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Reg: 219-A0082968A-M2500001A-0000 Registration Date/Time: 2019/08/26 07:19:93 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HER9 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag System 1 Calculate: Actual Superheat = 10.3 Tsuction - Teva orator sat Target Superheat from Table RA3.2-2 6 using Treturn wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = 4.30 System passes if difference is between -5°F and +5°F PASS w, Enter Pass or Fail Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Subcooling = Tcondenser, sat - Tli uid Target Subcooling specified by ' manufacturer Calculate difference: Actual Subcooling Target Subcooling,,,7 ! A` System passes if difference is between -3°F and»+30F a-, w, �E to Pass or Fail 9�� fl � q , Meterin -Device Calcutiorts for'Refrigeraii't:;Charge Verification. This procedure is%"re uired to be used for thermostatic expansion"`valve (TXV) and electronic expansion valve(EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat = Tsuction - Teva orator sat Enter allowable superheat range from manufacturer's specifications (or use range between 4°F and 25°F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range Enter Pass or Fail a Reg: 214-A0082968A-M2500001A-0000 Registration Date/Time: 2014/08/26 07:19:43 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 Leslie Diamond CSLB License: 679898 ate Signed: [6/30/2014 System meets all refrigerant charge and Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No airflow requirements. PASS Enter Pass or Fail ® Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 550F and 65°F the return air dry bulb temperature shall be maintained above 70°F during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate. DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). . I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. . I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample.gro p�b�ut not checked,,by a HERS rater, and;ifthose installations fail Ifo meet,the requirements of such quality assurance checking, the required correctiJe action„and additional,:checking/testmg,of otheriinstallations in that HERS sarriple group will be performedt;my expense ,,, . I reviewed a copy of the Certficate of Compliance (CF iR) form approved,tiy the enforcement agencythat identifies the specif&t� quirements for the installation,: I certify that�the requirements detailed on the CF -1R that apply to the,, installation have been metes-, '. . I will ensure that?'a completed;'signed copy gf;this InstallationiCertificat shall,be posted, or ma le,available with the building `permit(s) issued forthe building,°,and made available to the enforcer 'ent agency for'all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) ORANGE COUNTY SERVICES INC dba GEORGE BRAZIL PLUMBING HEATING AND AIR CONDITIONING Responsible Person's Name: Responsible Person's Signature: Leslie Diamond Leslie Diamond CSLB License: 679898 ate Signed: [6/30/2014 Position With Company (Title): Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑ Yes ❑ No Rey: t14-AUUbZL1bdA-M2500001A-0000 Registration Date/Time: 2014/08/26 07:19:43 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2013 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond E 1 14-3917 Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance, unless the TMAH Compliance Option is chosen. STMS are only required for completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Sunniv and Return Dlsannmc of Air 41=nAlor System Name or Identification/Tag System 1 System Location or Area Served Whole House 5/16 inch (8 mm) access hole 1 upstream of evaporative coil in the ® Yes ❑ Yes ❑ Yes ❑ Yes return plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figurein,,Section RA3.2.2:2.2. f-.. Returfi side of the duct system la located entirely within conditionetl ❑ Yes ev ❑Yes - E3 Yes,,',,, �. ❑Yes space and return airflow temperature❑"N'o��v No ❑ No _ 0 No to be_measured at the return elle. 9 - i 5/16 iinch(W`m`m)11access`4hole downstream of evaporative •coil m tYie E�: ® Yes ❑'Yes �.., " ` 2 ❑ Yes ❑'Ys supply plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figure in Section RA3.2.2.2.2. The TMAH Compliance Option should be checked only if the HERS Rater is able to confirm that it was physically impossible for the HVAC Installer to drill the TMAH as required by Section RA3.2.2.2.2. Using this Compliance Option requires the HVAC installer to annotate on the HERS Provider's data registry an explanation as to why the TMAH cannot be installed on the system, and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance Option also requires minimum airflow verification through the direct measurement of airflow per RA3.3. For more information see bUr)://www.ene-ray.ca.aov/tjtJe24/2008standards/sL)ecmal case appliance/ TMAH Compliance Option ❑ ❑ ❑ ❑ Yes to 1 and 2, or Yes to la and 2, or checking the TMAH Compliance Option, is IN Pass ❑ Pass ❑ Pass ❑ Pass a pass. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Enter Pass or Fail Reg: 219-A0082968A-M2500001A-M25A Registration Date/Time: 2019/08/26 07:22:21 HERS Provider: CaICERTS, Inc. 2008 Residential Compliance Forms February 2013 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 STMS - Sensor on the Evaporator Coil System Name or System I Identificatio''n/Tag Identification/Tag ry or is installed Tby e sensor is facto installed' or geld installedLaccording t methods/specifications approved b the Executive) `omanufacturersspecifications, 3 The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed �,; ❑ YY❑ Yes,? No Q:Yes ❑ N by methods/specifications approved by the Executive Director. ❑ Yes ❑ No 1 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 7 The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 4 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No airflow through the condenser coil ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No F ❑ Yes ❑ No 5 When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not ❑ N/A pass. Enter N/A if STMS are not ® N/A ❑ N/A ❑ N/A ❑ N/A applicable. ❑ pass ❑ Pass ❑ Pass ❑ Pass Otherwise enter Pass or ❑ Fail ❑ Fail ❑ Fail ❑ Fail Fail STMS - Sensor on the Condenser Coil System Namel�or ` System i ` 4 Identificatio''n/Tag ry or is installed Tby e sensor is facto installed' or geld installedLaccording t methods/specifications approved b the Executive) `omanufacturersspecifications, �,; ❑ YY❑ Yes,? No Q:Yes ❑ N The sensorewire`is'terminated with`°a°'staridard�mini``plug suitable'fd connection to a"'digital th`ermom'eter.`-' 7 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 8 When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Yes to 6, 7, and 8isa pass. Enter N/A if STMS are not ❑ N/A ❑ N/A ❑ N/A ❑ N/A applicable. ❑pass ❑Pass ❑Pass ❑Pass Otherwise enter Pass or ❑ Fail ❑ Fail ❑ Fail ❑ Fail Fail 91 Reg: 214-A0082968A-M2500001A-M25A Registration Date/Time: 2014/08/26 07:22:21 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamc 1 14-3917 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. • If outdoor air dry-bulb temperature is less than 55°F, the installer must use the RA3.2.3 Alternate Charge Measurement Procedure (Weigh -In Charging Method). If the Weigh -In Method is used, the dwelling cannot be included in a sample group for HERS verification compliance.) Space Conditionina Svstems System Name or Identification/Tag System 1 (must be re -calibrated monthly) Date of Thermocouple Calibration 6-1-2014 System Location or Area Served Whole House Outdoor Unit Serial # YORK Outdoor Unit Make 38HDC06032 Outdoor Unit Model 1933X80576 Nominal Cooling Capacity 5 Tons Date of Verification 6-30-2014 ca .,r Calibration of Diagnostic Ins "truments- Date of Refrigerant Gauge^Calibration ` ., 6-1-2014 ' (must be re -calibrated monthly) Date of Thermocouple Calibration 6-1-2014 (must be re -calibrated monthly) Measured Temperatures (OF) System Name or Identification/Tag System 1 Supply (evaporator leaving) air dry-bulb 51.7 temperature (Tsu I db) Return (evaporator entering) air dry-bulb temperature (Treturn db) 71.1 Return (evaporator entering) air wet -bulb temperature (Treturn wb) 59.5 Evaporator saturation temperature 35.7 (Teva orator sat) Condensor saturation temperature (Tcondensor, sat) Suction line temperature (Tsuction) 46.0 Liquid Line Temperature (Tliquid) Condenser (entering) air dry-bulb temperature (Tcondenser, db) g1.3 Reg: 214-A0082968A-M2500001A-M25A Registration Date/Time: 2014/08/26 07:22:21 HERS Provider: CaICERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 Minimum Airflow Reauirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 Calculate: Actual Temperature Split = 19.40 Treturn db - Tsupply, db Target Temperature Split from Table RA3.2-3 19.3 using Treturn wb and Treturn db Calculate difference: Actual Temperature 0.1 Split - Target Temperature Split = Passes if difference is between -4°F and +4°F or, upon remeasurement, if between PASS -4°F and -1000F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. �r Calculated Minimum Airflow Requirement'(CF ) = Nominal Cooling Capacity (ton) X300 (cfm/ton):>�j��`� r System Name or Identification$/Tag Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 procedures (CFM) Measurement Method Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Reg: 214-A0082968A-M2500001A-M25A Registration Date/Time: 2014/08/26 07:22:21 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd. Diamond Bar CA 91765 City of Diamond Bar 14-3917 Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System Name or Identification/Tag System i Calculate: Actual Superheat = Calculate: Actual Superheat = 10.3 Tsuction - Teva orator sat Tsuction - Teva orator sat Enter allowable superheat range from Target Superheat from Table RA3.2-2 6 manufacturer's specifications (or use range using Treturn wb and Tcondenser, db between 3°F and 26°F if manufacturer's Calculate difference: 4.30 specification is not available) Actual Superheat - Target Superheat = 4Frym r �: System passes if difference is between the allowable superheat range a - -6°F and +6°F PASS Enter Pass or Fail Enter Pass or Fail Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System Name or Identification/Tag Calculate: Actual Superheat = Calculate: Actual Subcooling = Tsuction - Teva orator sat Tcondenser, sat - Tli uid Enter allowable superheat range from Target Subcooling specified by manufacturer manufacturer's specifications (or use range Calculate difference:`" between 3°F and 26°F if manufacturer's Actual Sut5'c6oling447arget Subcooling_'= gym' specification is not available) Systemvpasses if difference#is between--' ., 4Frym r �: -4°F and -+4°F Enter Pass or Fail the allowable superheat range a - ,s Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Superheat = Tsuction - Teva orator sat Enter allowable superheat range from manufacturer's specifications (or use range between 3°F and 26°F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range Enter Pass or Fail Reg: 219-A0082968A-M2500001A-M25A Registration Date/Time: 2019/08/26 07:22:21 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 :NSTALLATION CERTIFICATE CF-4R-MECH-2`. tefrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6' Site Address: Enforcement Agency: Permit Number: 1204 Flintlock Rd, Diamond Bar CA 91765 City of Diamond Bar 14-3917 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System 1 Leslie Diamond 1679898' HERS Provider Data RegistryInformation System meets all refrigerant charge and ® tested/verified dwelling not-tested/verified dwelling airflow requirements. PASS HERS Rater Company Name: 2nd to None HERS Ratings Responsible Rater's Name: Enter Pass or Fail Raymond Moreno Raymond Moreno Responsible Rater's Certification Number w/ this HERS Date Signed: 6/30/2014 ® Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55°F and 65°F the return air dry bulb temperature shall be maintained above 70°F during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate. DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s) (CF -6R), signed and submitted by the person(s) responsible for the installation conforms to the.requirements-specified on the Certificates) of, Compliance Ir -C_1 DA :,.,ori li:, fhn —fn—a c f ananry Builder,or;Installer information as`shown on th` e Installation Cdrtificate;,(,CF-6RTft CompanyAame: (Installing>Subcontractor or General Contractor 6r Builder/Owner) , p ORANGE,COUNTYa`SERVICES INC' ResponsiblePerson s. Name. fi' ,° CSLB¢License Leslie Diamond 1679898' HERS Provider Data RegistryInformation Sample Group # (if applicable): N/A ® tested/verified dwelling not-tested/verified dwelling in a HERS sample group HERS Rater Information CaICERTS Certificate # CC1-1798898968 HERS Rater Company Name: 2nd to None HERS Ratings Responsible Rater's Name: Responsible Rater's Signature: Raymond Moreno Raymond Moreno Responsible Rater's Certification Number w/ this HERS Date Signed: 6/30/2014 Provider: CC2006075 Reg: 214-A0082968A-M2500001A-M25A Registration Date/Time: 2014/08/26 07:22:21 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013