HomeMy WebLinkAbout14-4287 (8) � '• _.1�">�;,T=`�,,________ C1TY OT DIAMOND BAR '
ii I I I i ' "' DEPARTMENT OF COMMUNITY&DEVELOPMGNT SERVICES I
���iIL� ��- 21810 Copley Drive,Diamond Bar,CA 9176� ,/ PRESS
„ �� ' (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 � FIRMLY
� � '��° " BUILDING PER1�i1T APPLICATION
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g p APPLICATION DATE: � � P/Ck
w JOB SITE ADDRESS ,Q� L/ /�/ p.
a ISSUE DATE: v � 7' �l�7 PERMITtf ��`yd"a 7
z APN LOT TRACT
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o OWNER "►'1 GLT� TYPE CONST. OCC GROUP:
� ADDRESS �� �I �
N CITY_ ZIP TEL ( , 2 S(p ZONING F ONTCKS RW ❑
d APPLICANT ✓ a TEL. REAR ❑
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� ADDRESS ���r5� � Lwi� �
o CITY�u,✓✓1�A ZIP�TEL. aSI �O� D I�O PROPOSED USE I v C�
o ARCH/ENG/DESIGNER
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o ADDRESS
#DWEL.UNITS It STORIES #BEDROOMS
z CITY ZIP TEL.
� DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION
OWNER-BUILDFA DECLANAiION
¢ I hereby amrm under penatty ot Derjury that I am exempt irom the Cantractor's State License Law for the reason(s) SFR/ADD/REM
0
`p intlicated below by Ne checkmark(s�,I have placed next to the apDlipble item�s)[Section 7031.5,Business and Garage/Carport
� Professions Code:Any city or county that requires a permit to construcR alter,improve,demolish,or repair,any
�z structure,prior W its issuance,also requires the applicant for the permit to file a signed statement that he or she y Patio/Deck
a is licensed pursuant to ihe provisions of ihe ConVactor's State License Law(Chapter 9)Commencing with Section W
� 7000 of Oivision 3 of the Business and Prolessions Code]or that he or she is exempt from licensure and the basis for LL Pool/Spa
N the alleged exemption.Any violation ol Section 7031.5 by any appficant for a permit subiecis ihe applicant to a civil penalty �
� ot not more than(ive huntlred dollars(5500). ZQ Re-Roof
o (J I,as awner of the property,or my employees with wages as their sole compensation,will do(_.)all o(or U portions � Commercial
� of the work,and ihe strucNre is no[intended or offered for sale(Section 7044,Business and Professions Code:The m
Z Contractnrs'State License Law does not appty ro an owner of property vfio,through employees'or personal ettort,builds
� or imprwes ihe properry,provided that the improvements are not irRended or ofiered for sale.II however,the building or
� impmvement is soid within one year af completion,the Owner-Buitder will have the burden of proving that it was not buitt
p or improved for the purpose of sale.). -
U
(�I,as owner at the property,am exclusivety co�tracling wiN licensed ConVactors to consUuct the projed(Seclion
0 7044,Business and Professions Cotle:The Contractors'State License Law does not apply to an owner of properry who Valuation: Adj.Afea:
z buildsorimprovesthereon,andwhoconhactsfortheprojectswithalicenseUContractorpursuanitotheContractors'State pUANTITY DESCRIPTION FEE
�
Y License Law.).
o U�am exempt hom licensure under the ConVactnr's State License law for the following reason(s): �
� �
LL By my signature below 1 acknowledge that,except for my personal residence in which I must have resided for at least one W
o year prior M completion of Ne improvemen6 covered by ihis permit,l cannot legally sell a strucWre that I have built as an w
Q owner-builder if ii has not been consWctetl in its entirety by licensed contractors.I understand that a copy otthe applipGle
� law,Section 7044 0(Me Business and Professions Code is available upon request when this application is submitted or at
X the foliowing Web site:http/wvnv.leginfo.ca.gov/calaw.html. Z
o DATE: SIGN: �
F � LICENSED CONTflACTDR'S DECLARATION �
a
w I hereby affirm under penalty of perjury that I am licensed under provisians of Chapter 9(commencing with Section 7000)
m of Division 3 of the Business and Professions Code,and my license is in full torce and ettect. J � � �
�= 7� �o� a
UCENSE CLASS� � UC.NO.: za (/ !� K
o DATE: CONTRACTOR: l,U G N KO � L � �
a WORI(ER'S COMPENSATION OECLARATION �
� I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
0 1 have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided 6y CONSTRUCTION:
� Section 3700 of the Labor Code,for Ne pertormance ot the work for which this permit is issued. p�qN REVIEW:
> I have and will maintain Worker's Compensation Insurance,as repuired by Section 3700 of the Labor Code,for
Z the performance ot the work for which ihis permit is issued.My Wwker's Compensafion Insurance Carrier antl ELECTRIC:
¢ PolicyNumberare: PLUMBING:
� CARBIER �Y�ubl iv
w - - MECHANICAL .�,�
� POLICY NUMBER ('f�. INSPECTION FEE:
� (THIS SECTION NEED NOT BE COMPLEfED IF THE PERMR IS FOR ONE HUNDRED DOLLARS($7(ID)OR LFSSJ. �
� ISSUANCE: �•f'J
� I cerliry mat in ihe pertormance of the wnrk for which ihis permit is issuetl,I shall not employ any person in any manner so as ro SM IP:
become subject o the Wwker's Compensation laws domia.Md agree ihat if I shwltl become subject tn the Woiker's
� Compen tim ovisions Section 3700 of Ihe La6or�,1 I torlhw' compry wifh those pmvisions. ENERGY P/C:
J DATE: APPLICANT:
LL- ENERGY PERMIT:
� WARNING:Failure to ecure Workers Compensation cove a is unlawlul,and shail subjeci an employer to criminal n.
w penatties and civil fines up to one hundred thousand dolla ($100,000),in addition to the cost o1 the compensation, RETENTION FEE: �.yQ
a damages as provided tor in section 3708 ot ihe labor code,interest,and attomey's fees. PRE-ALT FEE:
0
a CONSTAUCTION LENDING AGENCY BSAF:
w I hereby affirm under penalty oi perjury Ihat ihere is a Cons[mction Lending Agency br t�e peAormance of the work for
= which this permit is issued�Sec.3097,Civ.C.�.
� LENDER'S NAME:
� LENDER'SADDRESS:
a I certify that I have read this application and state that the above informatlon is correct I agree fn comply with all ciry and TOTAL FEES
z county ordinances antl state laws relating to building construcdon,and hereby authorize representatives ot this counTy to COMMENTS: �
p enter upon the above-m tioned property far inspeclion purposes.
m a. ��O�q
¢ PERMfTTEE NAME(PRINn
N ���
� p�—
� SIGNATURE OF PERMITf DATE RECEIPT# �d PAID BY: � �
7 VALIDATION:��_
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOND BAR � �
INSPECTION RECORD ' �
� • � . • � - � • � , � � -
� SETBACKI LETTER ` ' ' ; TRACT AND LEDGER
fOdTlNGS FORMS. ; _ ' ' ` '. i. , . :. SWITCH GEAR
SLAB " COMMERGAL HOOD •
iIG.PLUMBING - � ' T-BAR
UG.E�ECTRICAL INTERCEPTER
UFER GROUND � - :• ,° `' HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION �
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
. . , . _ ,
SMEAR WALLS fXTERIOR , ' POOL/SPA . , „�
SHEAR WALLS INTER(OR , . ROUGH PIUMBING , � ' . , •;,-
,:- -.
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FRAMINGNENTING; : , . . . , , . . ROUGH ELECTRICAL �` ,.: - ,. . . ;
ROUGH MECHANICAL ; '_ ;� . ..' . : ROUGH MECHANICAL" , . ,
, , :.. .. � :
ROUGH"ELECTRICAL W( )C(`_) -
GAS TEST '
ROUGH PLUMBING; � PRE GUNITE . '
. . .
INSULATION WALL POOL PRE DECK BONDING ' ' "
INSULATION CEIUNG P-TRAF -
DRYWALL FENCE/GATE/ALARM
_. , , _
LATN(PRE) FINAL POOL �
LATH EXTERIOR WALLS: '
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�T( )2N0( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL ORAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION RO.,FRAMING PLANNINGAPPROVAL
, _. , ... ,-
'� FINAL BUILDING ` ' -'; ROUGH FI,REAPPROVAL
.
fINAL MECHANICAL ':- FINAL FIRE DEPARTMENT '
FINAI:ELEGTRICAL � ' .'; `: FINAL PLANNING ` . . �:
FINAL�PLUMBING , � FINAL ENGINEERING/PW ' . ' .
T:C:of OCCUPANCY FINAL COMMUNITY SERUICES -
`CERT.of OCCUPANCY ` ,', , ; " � FINAL HEALTH DEP7. `
FINAL INDUSTRIAL WASTE ' . ''
COMMENTS:
� ' . � .
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 1 of 4)
Project Name: 11M NAKATA Enforcement Agency: City of Permit Number:
Diamond Bar PR2014-0004287
Dwelling Address: 1341 HONEYHILL DRIVE City: Walnut Zip Code: 91789
A.Duded Cooling System Information
01 System Identification or Name System 1
02 System Location or Area Served Location 1
03 System Installation Type Alteration
04 Nominal Cooling Capacity(tons)of Condenser 5
05 Condenser Speed Type Single Speed
"�:.
06 Cooling System Zonal Control Type y' Not Zonal
07 Central Fan Integrated(CFI)Ventilation System Status Not:a CFI system �, �y
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� ,:. S,_: .i �p s�y` �%� ' ��� "
� OS System Bypass,�Duct Status i � � ��� �� �� No�Bypass Duct����� � � � �
<���:: � �������.�r,M`�,� ,��� �. �,�.� €��� �.
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09 Date of System Airfiow�Rate Measurement� � � 2015 Ol 14 ���� � , € � �,
„a+�.;,�*�� x.r.s= ���.�,"' ,,� '� ��. ��� a.�� � .-� ��� �� � ��-°`�,
�,.:�� N-..�� �.' .,: �� _.,_ ,: z � �� - -> �o.„ft:�., ... , �_, _:.:..
10 Airflow Rate Protocol utifized ` RA33 procedures for airflow rate measurement
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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.
Ol Method used to demonstrate compliance with the HSPP installed and labeled consistent with Figure RA33-1
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 TSI
, 03 Model number of Airflow Measurement Apparatus T51
04 Certification Status of the Airflow Measurement Apparatus Certified by Manufacturer and listed on CEC Website at
Accuracy http://www.energy.ca.gov/(tbd)
Registration Number:214-A0067567A-M2300002A-M23A Registration Date/Time: 2015-01-20 13:45:00 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-20 08:05:50
2013 Residential Compliance Schema Version:0.51SDD
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.
Ol Required Minimum System Airflow Rate(cfm/ton) 300
02 Required Minimum System Airflow Target(cfm) 1500
03 Actual System AirFlow Rate Measurement(cfm) 1520
04 Compliance Statement: System airFlow rate complies
E.Additional Re.quirements �,;,
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 dun�gz5y t m air flow rate�measu em�ent identified on this Certifrcate�ofi_Instalfaiion �.
.���.�.<s.�" �` �`����-�.��,k �`-� ��.. ;�� �: ,x,„.�.. �:.
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The airFlow rate measurement a{�paratus used to perform the airflow rate measurement identified qn this:Certificate of
�+q�A •� . .. i_�.F rwy,a s ' ' �'�*� �.x � �� ' '�"�* a.x. d :'"� �
02 Installation was calibrated in accordanc��with the apparatus,manufacturer s speei#icat�ons and conforms�to the
instrumentation specrfications giV�2n n��'3�1���� � -`k� +�"j; ��� `5' �'�F• ���='°�^`"i + �'�T� ���'�`"�'
-� � - ..vx�.� �s-�< ,
� r� '�;«:,.� ;, a���`
A visual inspection,shall.confirm that bypass ducts that deliver conditioned supply air directly to the space conditioning
system return duct airflow are not used on new or replacement zonally controlled systems unless the Performance
03 Certificate of Compliance indicates�an allowance for use of a bypass duct.When a bypass duct is accounted for on the
Performance Certificate of Compliance,the airflow rate shall conform to the specifications listed on the Certificate of
Compliance.
04 All registers were fully open during the diagnostic test.
05 System fan was set at maximum speed during the diagnostic test.
06 If fresh air duct is part of the HVAC system it was not closed during the diagnostic test. �I
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:214-A0067567A-M2300002A-M23A Registration Date/Time: 2015-01-20 13:45:00 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-OS-O8 Report Generated:2015-01-20 08:05:50
2013 Residential Compliance Schema Version:0.515DD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
' Space Conditioning System Airflow Rate (Page 3 of 4)
F.Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol
requirements in order for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies:All specified verification protocol requirements on this document are met.
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Registration Number:214-A0067567A-M2300002A-M23A Registration Date/Time: 2015-01-20 13:45:00 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-20 08:05:50
2013 Residential Compliance Schema Version:0.51SD0
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System AirFlow Rate (Page 4 of 4)
Documentation Author's Declaration Statement
1. I certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: �
lan Jacoby c�an�acob,r
Company: Date Signed:
Stratz Permit Service 2015-01-20 08:11:41
Address: CEA/HERS Certification Identification(if applicable):
5858 Dovetail Drive
City/State/Zip: Phone:
Agoura Hilis CA 91301 818-735-7876
Responsible Person's Declaration statement
I certify the following under penalty of perjury,underShe 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 perforrried 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 reqwrements in Reference Appendices RA2 RA3,and the requirements
�� � �-c-� �ra m�*# r���'�
specified on the CerErficate of Complianeefor the�building,approvetl by the enftitcement agency���,< � �,-
� ,:, sJ r-x: �s'��'a .. ��:: � ��'�-�-.-. x a ws� - ���
4. The informat�on;reported'on applicable sect�ons of the Ceitificate(s)of Installation(CP2Rj"signed and submrtted by the person(s)responsible for the
t ti.r� �^� �.s � 1 � � � �. �rz
construction or�nstallaUon conforms to�e reqwrements specr#ied on the Certificate(s�,:of Compliance(CF1R�'�epproved�by the enforcement agency.
�+��,:� a �� �� �• . a ., n .:. ��`' �-�t
5. I will ensure thaf a registered'topy of th�s CeRif�cdte of Verifitation sHafl be posted or made avatlable wrth the.butitl�ng permrt(s)issued foC the
�`z�..,° �s"�"i; � .0 :yx �-a;. .a Y �wm f.,� d .. r✓ � f� � ..�.-x. .�.:i
building,and ma�tle ava�fable to the enfo�rcemelst=agency for�ali applic�ble ir�spect�ons I uriderStand fhat a registered:copy of this Certificate of
,�. . ��ro�- � ����r�a�.� . �.����-� �� :����
Verification is re wred to be<xnclu�ieil'"ini�ih the documentation tfie bui�der proviifes to the.�bwfdirig owner at,occupa�cy.�
4 . . .rt� . �--�;. , -
Builder Or Installer,information As Shown'On The Certificate Of Installation
�;
Company Name(Installing Subcontractor,Genera4 Contractor,or Builder/Owner):
W C HEATING&AIR CONDITIONING INC `�' - �
Responsible Builder or Installer Name: CSLB License:
Rusty Cochran 779604
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: ✓���
Stratz Permit Service lt��'t%!'���i'K/G���+qGd�
Responsible Rater Name: Responsible Rater Signature:
Garrett Williams 2015-01-20 13:45:00
Responsible Rater Certification Number w/this HERS Provider: Date Signed:
CC2006208
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider
responsibiliry for the accuracy of the information.
Registration Number:214-A0067567A-M2300002A-M23A Registration Date/Time: 2015-01-20 13:45:00 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-20 08:05:50
2013 Residential Compliance Schema Version:0.51SDD
� . h
CERTIFICATE OF VERIfICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 1 of 4)
Project Name: JIM NAKATA Enforcement Agency: City of Permit Number:
Diamond Bar PR2014-0004287
Dwelling Address: 1341 HONEYHILL DRIVE City: Walnut Zip Code: 91789
A.System Information
HERS Rater to field-verify all system information,discrepancies to be noted by overwriting entry.
Ol System Identification or Name System 1
02 System Location or Area Served Location 1
03 Condenser(or package unit)make or brand LENNOX
04 Condenser(or package unit)model number XC17-060-230-08
05 Nominal Cooling Capacity(tons)of�ondenser 5
,e
06 Condenser(or package unit)serial number 5814C06867
�, � �����-t:� � ��a...
, s. , .
��Y Y' �'$� �� *�r ;�- i�u �".€_` .-r '"� z� =' � 4.s.„F-, �+ :
07 Refrigerant Type �� � �� �, � = R��410A��� � �� `,�' � ����.
#�.��. �m . `� ����� � ���
��s < ��.� `� . " � � � �
08 Other Refrigerant-TYpe�(if appl�talile) �s ,�� � " �"�,`y �*. ' . .. .�� 4 . � '�"�� ����� � ��
� � �
�.._ ��. � � � � ��._.:�. a ���` �._ �.� ' -
� =�� � �: x �`��--� : � ��� �r� ,, , � �� ,:-.. . .� ��F��� ��` .;- _��.
� �r.�r
09 System Installatiorr,Type �"�' � '��� Alteration
��.�
Charge Indicator�Display(CID)Status(Note:Even systems This system does not have a CID device installed
10 With a CID'must have refrigerant°cha ge 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
il 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
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 j
temperatures are greater than or equal to SSF(RA3.2.2,or
RAS)?
13 Date of Refrigerant Charge Verification for this system 2015-01-14
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 HERS rater
reported on this Certificate of Installation
16 HERS Verification Compliance Requirement Status System does not qualify for group sampling
17 Refrigerant charge verification method used by HERS Rater. Subcool
Registration Number:214A0067567A-M2500002A-M25A Registration Date/Time: 2015-01-20 13:45:00 HERS Provider:CaICERTS
CA Building Energy E�ciency Standards Report Version:2014-05-OS Report Generated:2015-OS-20 08:06:38
2013 Residential Compliance Schema Version:0.5515DD
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 2 of 4)
Standard Charge Verification Procedure-CF3R-MCH-25b-Subcooling Method
B.Metering Device Verfication-HERS Rater is required to visually field verify all information from CF2R
Subcooling Method can only be used on systems that have a variable metering device.
Ol Refrigerant metering device Thermostatic Expansion Valve(TXV)
02 Subcooling Method applicability status Subcooling Method is applicable to this system.
C. Instrument Calibration-HERS Raters are required to calibrate their diag�ostic tools.
Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2
01 Date of Digital Refrigerant Gauge Calibration 2015-01-Ol
� 02 Date of Digital Thermocouple Calibration 2015-01-Ol
� 03 Digital Refrigera,tGauge}Calibration�5�tatus�'�"�`�`���'� Calibratton is�curcent � �
��, � ��;.� �� � ��� � �.
� �� . .�� �`- r d � �' � xw ,• ��..:
04 Digital Thermflcouple Calibcation�Status �� � � Caltbration is currcnt ` ^��
�,"zS,,rF� .��. ��...'`�.+a �� �c,�,ta_. s'�:a,.1. 'K- ' �, -.:--�=''a,x�., . :'.
��'.- ���::�'��c���x '�'zr�:,� s��.. .��w ,<f� k��-��..�� ��,.. �i y F.F:���.,4���,� ..
4-�;,�#h-'". �.n'�,A�. '�•,,..°.,.i.n raa �m; 1 p..� -.:,., t .:�:� 'r�"*'��u_ �:i�;.:; �" '.,:. ";,•�,�,.,.,.»�, ;,.�a..�'�,���.,:�
D. Measurement Access Hole��(MAH)'Verificai�on=HERS Raters are required'to�visuallyfield�verify MAH
Procedures for installing�fdlAH are specified in Reference Residential Appendix RA3.2.2.3 '
01 Method used to demonstrate compliance with the MAH installed and labeled consistent with Figure 3.2-1
Measurement Access Hole(MAM:j requirement
E.Minimum System Airflow Rate Verification
Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.2.2.7.
01 Minimum Required System Airflow Rate(cfm) 1500
02 System Airflow Rate Verification Status System complies with minimum airflow rate requirements
F.Data Collection-HERS Rater must independently collect all data in this section.
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2 and RA3.2.2.2
Ol Lowest return air dry bulb temperature that occurred during 74
the refrigerant charge verification procedure(degreeF)
02 Measured Condenser air entering dry-bulb temperature(T 56
condenser,db)
Registration Number:214-A0067567A-M2500002A-M25A Registration Date/Time: 2015-01-20 13:45:00 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-OS-O8 Report Generated:2015-01-20 08:06:38
2013 Residential Compliance Schema Version:0.551SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 3 of 4)
F.Data Collection-HERS Rater must independently collect all data in this section.
Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in
Reference Residential Appendix RA3.2.2 and RA3.2.2.2
03 Outdoor Temperature qualification Status Outdoor temperature is within range for using Subcooling
refrigerant charge verification method
04 Measured Liquid Line Temperature(Tuq��d)(degreeF) 62
05 Measured Liquid Line Pressure(Prq��e)(pisg) 185
06 Condenser saturation temperature(T�o�de�5o�,5ac)from digital 65
gauge or P-T Table using Line F05(degree F)
07 Measured Subcooling 3
08 Target Subcooling 5
09 Compliance Statement:System complies with Subcooling Method-Must also pass metering device verification,next
SeCLl0�1 ,.� �'a+' . , x � .,.. �yti��c� a_�=yt��_ . �x-����,�-az�- <
�.�. .. ....,.;- '.v� .�.,u .>.�+:: ��..�:�.,�4x ��._.�-�:,.� f : ..����..
_ � �_ � � - _ � .
���.�� ° .�'� ,�,t�38'r<!; � ���'� .i ae"<�,,.�.e �.y a.c
,x � .-*t�� �' �n +"� �
es x'�.�' 'S¢ �xf �qr,." .
C7. MQtePl�lg�QVICB�/QP'FICBtIQT1 �r�^�,�e`. Ih�� _ �arze� �� � � � �� � � �"� *�
;�+ _��r �? ��_ � m <,� a .�� �'r� �,
� �%�a` .,�. F '� '�� .�� ��,r; � 'a ` �
Procedures for the ve�ifrcation�of pro'per metenng�cJeviee operat+on are�pecified in RA3 2 2'�6:2�'�= - �� �
� ,
��_ _ :
- ,:
01 Measured Suction��line temperature(Ts��c�o�)(degreeF) 37
02 Measured Suction line pressure(PSu�i�or,)(psig) 95
03 Evaporator saturation temperature(Te�aPoaco�,:ac)from 29
digital gauge or P-T Table using line G02(degreeF)
04 Measured Superheat 8
05 Measured Superheat is between 4 and 25 deg F(inclusive) Passes CEC requirement
06 Measured Superheat is within manufacturer's specifications, Not known
if known
07 Compliance Statement: Metering device verification passes
H. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol
requirements in order for this Certificate of Verification as a whole to be determined to be in compliance.
Ol Complies:All specified verification protocol requirements on this document are met.
Registration Number:214-A0067567A-M2500002A-M25A Registration Date/Time: 2015-01-20 13:45:00 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-OS-O8 Report Generated:2015-01-20 08:06:38
2013 Residential Compliance Schema Version:0.5515DD
i f , • ' I
_.. '____�—_'—_____.._..'_.".__ ..... .. .
CERTIFICATE Of VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 4 of 4)
Documentation Author's Declaration Statement
1. I certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: �
lan Jacoby �an�acobJr
Company: Date Signed:
Strat2 Permit Service 2015-01-20 08:11:41
Address: CEA/HERS Certification Identification(if applicable):
5858 Dovetail Drive 10059
City/State/Zip: Phone:
Agoura Hills CA 91301 818-735-7876
- 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 thistertificate of Verification is true and correct.
2. I am tRe certified.HERS Rater who perfor'med the verification identified and reported on this Certificate of Verification(responsible reter).
3. The installed features,materials,componerrts;manufactured devices,or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable reqwrements in Reference Appendices RA2 RA3,and the requirements
�'W,+W> ' E 0 a6`E '4 v��.^J"a. F� � �$t
specified on the Cer[ficate of Compliance for the buildingapproved by the enforcement agenty���„�� �°� �;,.
�'"_- $��:,',+ „k�� �p.: �. �. ,a ����: ku«si a"2�.,.' a :.
4. The informatian reported on'applicable sections of the Certificate(s)of�Installa�i�o�n(C�2Rj_signed�and submrtte�d by tFie person(s)responsible for the
construction or�installaUon cortform3 t4,�tF�e requirements spec fied o�the Certficate(s};of Compliance(CF1R)�app�rovedaby the enforcement agency.
. �' n`...�'. .,"�':mP s,�` .�.�'`"-_.. . . . . __
5. I will ensure�that a registered'�copy of t�is Cett�ficate of V�erif�cati�on°shall be p�osted,or�made au�ar�able with the�il�dmg�per"�mit(s)�sued fo�the
��. ��� � � � � aa �
building,and made ava�able�to th enfortement agency for alicapplicable mspectians I understand thata registered�co{�y of this Certificate of
,�� �-��i� � . -����� v� ��:��.�-� � ;�. �,���.
Verification is requi�ed to be=lnclueied�-withrthe�doiumeotation the�bwider provid`es Lo�the'���buifding�owner.at o.ccupa�cy. �
�F � � �.� < .-�.... - - .� `
�:_ .
Builder Or Installer,information As Shown On The Certificate Of Installation
Company Name(Installing Subcontractor,Generel Contrector,or Builder/Owner):
W C HEATING&AIR CONDITIONINGiNC '''
Responsible Builder or Installer Name: CSLB License:
Rusty Cochran 779604
HERS Provider Data Registry Information
Sample Group Number(if applicable►: Dwelling Test Status in Sample Group(if applicable) I
Tested
HERS Rater Information
HERS Rater Company Name: ���
Stratz Permit Service A�L'2%!.'i��'K/GE��,�IGd�
Responsible Rater Name: Responsible Rater Signature:
Garrett Williams 2015-01-20 13:45:00
Responsible Rater Certification Number w/this HERS Provider: Date Signed:
CC2006208
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered documen�and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number:214-A0067567A-M2500002A-M25A Registration Date/Time: 2015-01-20 13:45:00 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-20 08:06:38
2013 Residential Compliance Schema Version:0.55150D
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems,Duds,and Fans (Page 1 of 7)
Project Name: JIM NAKATA Enforcement Agency: City of Diamond Bar Permit Number: PR2014-0004287
Dwelling Address: 1341 HONEYHILL DRIVE City: Walnut Zip Code: 91789
A.General Information
01 Dwelling Unit Name JIM NAKATA 02 Climate 2one 9
Dwelling Unit Conditioned Floor Area Number of space conditioning(SC)
03 (ft2� 2645 04 systems being altered in this dwelling 1 _
unit.
05 Certificate of Compliance Type Preseriptive alterations(CF1R-ALT) 06 Method used to calculate HVAC loads NotApplicableEquipmentChangeout
Calculated dwelling unit Sensible � Calculated Dwelling Unit Heating Load
�� Cooling Load(Btuh) �, ' 08 (Btuh)
w��'r ��;: .�'�~ �:' �°�.�,.. �� �,.' �� � ;� �':����. ��:.
�.� ,��. � ����,�_.-�_ �; , � � � � �� : ��;�*�� �;a
MCH-01b Prescriptive Alterat�ons=��Space Cond�tiomng Systems Ducts�'ndsFans� ��� �.�� �� ` � � � �
���� a'�-�„�„�,��,� �*,�a� R�1 4. �"+� *�".�� .y.h._ `i.'�,.-�
< r. ,
q.� c `�. �`.�i �, a;� � :,��„�, .a.` .�i-at;'t: � ....�..��.�" , . a�_s e �sW;��» �y=,. ,, �`- - ,
2a_ 'w�
� � � �.�. ��.,�t..r�<, � " "�i�`�F''���r�,��r , , "����..v�.� �,:.:*t�� ��:y�x r� �=: a�'`#.
�B.Space Conditioning(SC)System�lnfo�rriati�n' "°`�� �, �. � ���� � ��-� ' �
01 02 ;„, �`z-03'"-�_, 04� 05 06 07 08 09 10
�` . Are�of the
- system's
components
and duds
CFA served Is the SC Installing a Installing new or
SC System SC System by this SC system a refrigerant Installing new SC Installing more entirely replaced?
Identification or Location or Area System ducted containing system than 40 feet of new duct (entirely new
Name Served (ft2) system? component? components? ducts? system? system) Alteration Type
Altered space
System 1 Location 1 2645 Yes Yes Yes No No No conditioning
system
Registration Number:214-A0067567A-M0100002A-0000 Registration Date/Time: 2015-01-20 08:04:37 HERS Provider:CaICERTS
' CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-05-13 Report Generated:2015-03-20 08:01:51
Schema Version:0.5515DD
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E �
Space Conditioning Systems,Ducts,and Fans
(Page 2 of 7) �
�
C.Space Conditioning(SC)System Alterations Compliance Information
i
O1 02 03 04 05 06 07 08 09 10 il 12
Heating Cooling New or New
System Altered Heating Minimum Altered Cooling Minimum Required Replaced Duct
Identification Heating Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Duct R-
or Name System Type Component Type Value System Type Component Type Value Type Length Value
This
All new All new N/A-no field or
System 1 Central gas heating AFUE gp Central split cooling SEER 13 Setback ducts section
furnace components A� components replaced is not
applica
ble
-�" '�k�r: ��" ���..� �, �,..� �,��t� �� �j� .r.� �ga �� '� �,
D. Installed Heating Equipment information,�� �-. 3� �;� �ti „ ,s �, ,�
���,�. � ::�. � � � ��_ �i.
- � .. ;
Ol �::"`.-;02 ��� �: .. z-p3 ��� `: ; k���.�- ; t ��:"�' 05��:. _06 07
��� �� 3�:� ;� �, � p"a�,� m. ' `hp�m�' " �°r� '' ,�� `�_:
System Identification or �x �",�� � �Heati�g Efficiency . � Heat�n�U�it ��Heating Unit ;, �Heating Unit serial Rated Heating Capacity
.�' ' � a �.`� a�=,� �- �' ' +"� y��. � � *� `��`E �=a '� ax�s�`� �-_ ��� �
Name Heating�Efficien'cyType`;� ��,�� 1lalue , ..-,. Manufacfurer .�,Model.�Number number Output(BTUH)
� ;�;�_, -
��"�° � SL280UH090XV60
System 1 �'���'AFUE ��: 80 LENNOX C-03 5914E05705 90
�.:
Notes:
Registration Number:214-A0067567A-M0100002A-0000 Registration Date/Time: 2015-01-20 08:04:37 HERS Provider:CaICERTS
• CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-05-13 Report Generated:2015-01-20 08:01:51
Schema Version:0.551SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems,Duds,and Fans (Page 3 of 7)
E. Installed Cooling Equipment information:
01 02 03 04 05 06 07 08
Condenser or Package Unit
Condenser or Condenser or Condenser or System Rated Cooling Condenser Rated
System Identification Cooling Efficiency Cooling Efficiency Package Unit Package Unit Package Unit Capacity at Design Nominal Capacity
or Name . Type Value Manufacturer Model Number Serial Number Conditions(BTUH) (ton)
System 1 SEER 13 LENNOX XC17-0080-230- 5814C06867 60000 5
Notes:
F. Extension of Existing Duct System,Greater Than 40 Feet
-�'_�� a��%..,.r� „���.�.M»� � :.�,., _ .�•kr� .� �:x
�_ � � � � m.�� �a� �� ���: �" '� �':� �.�
��� This section;does not apply to�ihis project ���
�; ��. �- s�` �`��k��",:� �r �
'�:- �C .� ��.. �.�a � ,�'�'Cx�'_:'r .:°�r'': � 5 .�_ h:=.�:a'�'�" ,� �.
� � `:�E �� '� � � � � ��� � �: # � fi k�� Y �
G. Installed Duct System information����� - �'��,� , u��� � �.� � � 5 � „ . ���� ' ,
.����
;3', This section does not apply to this project.
H.Installed Air Filter Device Information
This section does not apply to this project. �
I.Air Filter Device Requirements
This section does not apply to this project.
Registration Number:214-A0067567A-M0100002A-0000 Registration Date/Time: 2015-01-20 08:04:37 HERS Provider:CaICERTS
' CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-05-13 Report Generated:2015-01-20 08:01:51
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CERTIFICATE OF INSTALLATION CF2R-MCH-01-E �
Space Conditioning Systems,Ducts,and Fans (Page 4 of 7)
J. HERS Verification Requirements
OS 02 03 04 OS 06 07 08 09 10
MCH2O MCH21 MCH22 MCH23 MCH25 MCH28
Exemption
from
Minimum
Exemption R-Value for AHU Fan AHU
SC System SC System From Duct Duct Ducts In Ducts Located Efficacy Airflow
Identification or location or Area Leakage Leakage Conditioned In Cond Space (W per Rate(cfm Refrigerant Return Duct Design
Name Served Requirements Test Space Verification cfm) per ton) Charge Table 150.0-C or D
No ` Not
System 1 Location 1 exemptions ,' Yes applicable No No Yes Yes No
y ,���" �` � ��"w� _�re w � �� - 'z""� �'as`
`� � � '.�-�`� � & -� T 'az. -�`'� 3a4� �,� f 1.,
Yfi�� � �' �C >�.L � �'` � � �,: �. � � �
��"i ��� � ��. . -� }�� �.,:
�n� � � Y g�� ^�' ,. .t h` .:Y'`�'. � ,F�- �'"' t¢�.
E`
� F s � � y �
'�'� '� � �r?�fi' � :� �-:�s u ��� �.,� '��«�r,� -i���ah� "��'�93"�`"We
, ��°: :-v,.'_3 ., .. � ..
>F_
>.q�, "
Registration Number:214-A0067567A-M0100002A-0000 Registration Date/Time: 2015-01-20 08:04:37 HERS Provider:CaICERTS
' CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-05-13 Report Generated:2015-01-20 08:01:51
Schema Version:0.551SDD
CERTIFICATE OF INSTALLATION Cf2R-MCH-01-E �
Space Conditioning Systems,Ducts,and Fans (Page 5 of 7) �
K.Space Conditioning Systems,Ducts and Fans Mandatory Requirements and Additional Measures
Note:Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems.These requirements may be applicable to only newly installed equipment or portions of the
system that are altered.Existing equipment may be exempt from these requirements. ,
Heating Equipment �
01 Equipment Efficiency:All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a)and the Appliance Efficiency
Regulations.
02 Controls:All unitary heating systems,including heat pumps,must be controlled by a setback thermostat.These thermostats must be capable of allowing the occupant
to program the temperature set points for at least four different periods in 24 hours.See Sections 150.0(i),110.2(b).
03 Sizing: Heating load calculations must be done on portions of the building served by new heating systems to prevent inadvertent undersizing or oversizing.See sections
150.0(h�l and 2). �
3;;�
Furnace Temperature Rise:Central forced-air heating f"u,�nace installations must be configured to operate at or below the furnace manufacturer's maximum
04 inlet-to-outlet temperature rise speci�ication.See Section 150 0(h)4 � �' ��` ' �`:� ���y� �"" ` �`���'�
, .. u � � �;: 4' _ k}�
r �
� �Z_ ��^�ru'1Fs�"� c 'F`c' �I , p �' � . - �.�t4
�,,.` ' ` .d'a;�'� �#t '� t.' : � � -= `��.�'� �'�
05 Standby Losses and Pilot Lights Fan-type central�furndces may not have a;continuously burnmg pilot light.Sectton 110.5 and Section 110.2(d).
�� .�.�:�� � ,�..�d 3 " ::�A '� �� ,.�. -*,� w,�'���. �� (�
�: ��°�s�����¢��� �� � � e � ��� �° - � ;�
Cooling EquipmeM � �E ������ ��� � ?�-r �-����`�"� �� �� � ��'' ��,�� ��,�
�, ���.
06 Equipment Efficiency:All cooling equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a)and the Appliance Efficiency
Regulations.
�� Refrigerant Line Insulation:All refrigerant line insulation in split system air conditioners and heat pumps must meet the R-value and protection requirements of Section
150.0(j)2 and 3,and Section 150.0(m)9.
08 Condensing Unit Location:Condensing units shall not be placed within five(5)feet of a dryer vent outlet.See Section 150.0(h)3A.
09 Sizing:Cooling load calculations must be done on portions of the building served by new cooling systems to prevent inadvertent undersizing or oversizing.See Section
150.0(h)1 and 2.
Air Distribution System Ducts,Plenums and fans
10 Insulation:In all cases, unless ducts are enclosed entirely in directly conditioned space,the minimum duct insulation value is R-6. Note that higher values may be
required by the prescriptive or performance requirements.See Section 150.0(m)1.
Registration Number:214-A0067567A-M0100002A-0000 Registration Date/Time: 2015-01-20 08:04:37 HERS Provider:CaICERTS
� CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-05-13 Report Generated:2015-01-20 08:01:51
Schema Version:0.5515DD
, CERTIFICATE OF INSTALLATION CF2R-MCH-01-E i
Space Conditioning Systems,Ducts,and Fans (Page 6 of 7) i
�
K.Space Conditioning Systems,Ducts and Fans Mandatory Requirements and Additional Measures �
Note:Additional mandatory requirements from Section I50.0 that are not listed here may be applicable to some systems.These requirements may be applicable to only newly installed equipment or portions of the :'
system that are altered.Existing equipment may be exempt from these requirements.
Connections and Closures:All installed air-distribution system ducts and plenums must be,sealed and insulated to meet the requirements of CMC Sections 601.0, �
11 602.0,603.0,604.0,605.0 and ANSI/SMACNA-006-2006:Supply-air and return-air ducts and plenums must be insulated to a minimum installed level of R-6.0 or �
enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing in accordance with the requirements of Reference
Residential Appendix RA3.1.4.3.8.
Heat Pump Thermostat '
12 A thermostat shall be installed that meets the requirements of Section 110.2(b)and Section 110.2(c).
13 The thermostat shall be installed in accordance with the manufacturers published installation specifications
14 First stage of heating shall be assigned to heat pump heating.
� �,� ��..<� � � � - � .- �-�� �;
15 Second stage back up heating shali�be sei to��come on only when.the indoor set,-�temperature cannot be met ';�
�.�..- �:=o � ;.��- ��- �� > �_: ,�:� ''���x
' �"`�' � .t,,..�,:� -� �., a� s� �,,.r- ' = �' �� � � �.
7he responsible person signature on��complia,/,3n'ce tJ,ocuCm, ei�tPaffirms that�Il;applica,b�3�le requirements'm this table�have been met ��,,
�� � .A3Y', _�f. -k.�k' "� �s'}X-�: ��:: ,.x"--� ":. 4.„c 5r�:� �,f"+�t :.z,..
""�",� '�'.� � '���+'e. . '''� �� � 3 ��y 3�"�`"� '� .�f�_� �-.,i- � � , �� ,��" �,
"`�5y��� �. � ; � ;� � � � �","�"�'�.
�,��: .. �r � _
�;,
�. -�.
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Registration Number:214-A0067567A-M0100002A-0000 Registration Date/Time: 2015-01-20 08:04:37 HERS Provider:CaICERTS
� CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-05-13 Report Generated:2015-01-20 08:01:51
Schema Version:0.5515DD
. CERTIFICATE OF INSTALLATION CF2R-MCH-Ol-E j
Space Conditioning Systems,Ducts,and Fans (Page 7 of 7) �
�
Documentation Author's Declaration Statement '
i
1. I certify that this Certificate of Instaliation documentation is accurate and complete. �
Documentation Author Name: Documentation Author Signature: /� !
Jacoby,lan �an acob i
Company: Signature Date: �
Stratz Permit Service 2015-01-20 08:04:18 �
Address: CEA/HERS Certification Identification(if applicable):
5858 Dovetail Drive �
City/State/Zip: Phone:
Agoura Hills CA 91301 818-735-7876
Responsible Person's Declaration statement
I certify the following under penalty of pery'ury,undec the laws of the State of Califomia:
1. The information provided on this Certificate of Installation is true and corred.
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,
.�^ � �. �= ��t ��� � � � t6° �. ,
components,or manufactured devices�for the scope of work identrfied on this Ce�rtifm�a�of Installatio��and�attest to the decla�atinns in this statement(responsible builder/installer),otherwise I am an
authorized representative of the resPons,ible build`e''r/installer� . , ��� " �,�, �_ , 'c �
3. The construded or installed feature�aterials,components or mdnufactured devices�the�installati0n)�deritified onxthis Certificate�of;lnstallation conforms to all applicable codes and regulations,and the
installation conforms to the require�me ts given on the p al ns and specifications approveif by"the enforcement agency'�� y � '3 � ��` �'�
;� ,i� �' �", �'a ,• ' - �i f"w . ^`� .�'� �-h:� �d^9. :4-� `,� �, '`�.r:: � `�:
4. I reviewed a copy of the Certificate of�C�ompl�anpe,,�appr�a�v,e€d�b,y.the"eo�or�cem�ent agen�cy that iden rfies the��pecific reguirements for=the swpe o�co�nst�ction or installation identified on this Certificate of
Installation,and I have ensured that the regwrements that appiyto�the construcU"on'or;installatiori-haGe been met ,���� ��`� �
5. 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 regisfered copy of tliis'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: C�d4:l�(�J1'R�/
Cochran, Rusty � `
Company Name:(Installing Subcontractor or General Contractor or Builde�/Owner) Position With Company(Title�:
W C HEATING&AIR CONDITIONING INC Owner
Address: CSLB License:
25976 MADISON AVE 779604
Ciry/State/2ip: Phone: Date Signed:
MURRIETA CA 92562 (951)600-0700
2015-01-20 08:04:37
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:214-A0067567A-M0100002A-0000 Registration Date/Time: 2015-01-20 08:04:37 HERS Provider:CaICERTS
. CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-05-13 Report Generated:2015-01-20 08:01:51
Schema Version:0.5515DD
. ' . .
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Dud Leakage Diagnostic Test (Page 1 of 3)
Project Name: JIM NAKATA Enforcement Agency: City of Permit Number:
Diamond Bar PR2014-0004287
Dwelling Address: 1341 HONEYHILL DRIVE City: Walnut Zip Code: 91789
A.System Information
Ol Space Conditioning System Identification or Name System 1
02 Space Conditioning System Location or Area Served Location 1
03 Building Type from CF-1R Single family
04 Verified Low Leakage Ducts in Conditioned Space No,credit is not taken
(VLLDCS)Credit from CF1R?
, 05 Verified Low Leakage Air Handling Unit(VLLAHU)Credit No,credit is not taken
from CF1R?
06 Duct System Comp�lia�e��Category: ' - . „�„� ���, � � Alteration.using srnoke test � �
...'n.�;:�° t�n. �.�5� .�nFsric ��.`�. ��,.-� ,.,�-: �..�...�'x,a�' -��.'�.,��:�.�.
+ � �"�-X: � .
«.i�::.� ,.�``�`.� �'g�`�� '�fi'�',:*
d " � �g ��';> F�� F �,� r�- �� : xt.� �
MCH-20e-Seal�ng Al1-Accessible�i.ealc�u�ng Smoke�Test : � � � �, . , � �
�
� = � � � `�,:
x.A�.,'�_ �-»r-�;� �_ ���,�. -��:-. .�- �..�:_� A��.�-�^���.
. . � "ra�'.a� �. � �_� ���.�k h &c.a�¢. �.;,�„�r:. ����., '��:,�.�5� , ,� �`�=-'`<t�.
�'-��"�"-�r �- _,h;� ....,� > . ...
I B. Duct Leakage D�agnost�c Test F t �
� �n,.��. �,..
01 Condenser Nominal Cooling Capacity(ton) 5
02 Heating Capacity(kBtu/h) 0
03 Conditioned Floor Area served by this HVAC system(ft2) 2645
04 Duct Leakage Test Condition Test final
OS Duct Leakage Test Method Total leakage
06 Leakage factor 0.15
�� Air Handling Unit Airflow(AHUAirflow)Determination Cooling system method
Method
08 Measured AHUAirflow This field or section is not applicable
09 Calculated Target Allowable Duct Leakage Rate(cfm) 300
10 Actual duct leakage rate from leakage test measurement 500
(cfm)
Compliance Statement:System passes using smoke test of an altered HVAC system in an existing building.No visible smoke
11 exits the accessible portions of the duct system.Smoke is only emanating from air-handling unit(AHU)cabinet and non
accessible portions of the duct system.Note-Accessible is defined as having access thereto,but which first may require
Registration Number:214-A0067567A-M2000002A-M20A Registration Date/Time: 2015-01-20 13:45:00 HERS Provider:CaICERTS
CA Buiiding Energy Efficiency Standards Report Version:2014-OS-O8 Report Generated:2015-01-20 08:05:04
2013 Residential Compliance Schema Version:0.551SDD
I � �
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H '�
Dud Leakage Diagnostic Test (Page 2 of 3)
B. Duct Leakage Diagnostic Test
removal or opening of access panels,doors,or moving similar obstructions.If access to the ducts requires an object to be
demolished or deconstructed then sealing of those ducts is not required
12 Notes:
C.Additional Requirements for Compliance
01 System was tested in its normal operation condition.No temporary taping allowed.
Outside air(OA)ducts for Central Fan Integrated(CFI)ventilation systems,shall not be sealed/taped off during duct leakage
02 testing.CFI OA ducts that utilize controlled motorized dampers,that open only when OA ventilation is required to meet
ASHRAE Standard 62.2,and close when OA ventilation is not required,may be configured to the closed position during duct
leakage testing.
03 All supply and return registerboots'",were sealed to the drywall.
04 Building cavities werenot used as.plenums or platform returns in lieu of ducts.
.�, �� �-;� �~�� °�� �'� � �
05 If cloth backed ta{�e was�used it was coverecl with�Mast�c and tlra�u bands.�� � � �� �,.:���
,_.., �.��. ��- � ,��:� �-
� ��,
06 All connection�points betwee�he�ir t�andler and the�su.pply and'retum pienurris are completely�sealed..: re
� �, ,�� � ��F �� � �� � � a��._ � :- :� �� . ��
' S�� '"'� �a"c�'°_-� *� �-� �^" ��:��� � � ' ���� �":�'�
If the system complies;using ihe-5moke�Test�inethod;thQ smoke test was conducted in accordance�with the requirements
, _
I 07 of Reference Residential Appendix RA3.1.4.3.6.Systems that comply using smoke test shall not be included in sample
groups for HERSR e ification compliance. i
08 Verification Status: �� Pass-all applicable requirements are met
,.,. _.
09 Correction Notes for this table:
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status and the Corrections Notes in this table.
D. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol
requirements in order for this Certificate of Verification as a whole to be determined to be in compliance.
Ol Complies:All specified verification protocol requirements on this document are met.
Registration Number:214-A0067567A-M2000002A-M20A Registration Date/Time: 2015-01-20 13:45:00 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-OS-08 Report Genereted:2015-01-20 08:05:04
2013 Residential Compliance Schema Version:0.5515DD
.:•
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3)
Documentation Author's Declaration Statement
1.I certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: /�
lan Jacoby c9an�acob,r
Company: Date Signed:
Stratz Permit Service 2015-01-20 08:11:41
• Address: CEA/HERS Certification Identification(if applicable):
5858 Dovetail Drive 10059
City/State/Zip: Phone:
Agoura Hills CA 91301 818-735-7876
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. I am the certified-HERS Rater who performed the verification identified and reported on this Certificate of Verification(responsible rater).
3. The installed features,mateFials,components,manufadured devices,or system performance diagnostic results that require HERS verification I
identified on this Certificate of Verification comply with the applicable reqwrements in Reference Appendices RA2 RA3,and the requirements
specified on the Cei�tificaYe of�Compliance for the�b lu�din apprrnretl6y Yhe enforcerrient<agency � � �,`� -�
r� �'�a� �r - �. , �»�..., �,� �. *Y:•.:. I
4. The information reported ori�applicable sectro�s�of the Certificate(s)of Installation(C�2R)'signed�and submttted by the person(s)responsible for the
*a�.,,: � -� �s�� r * � �,-�:
construction or installation corrform3ito�khe seqairements spectfietl,Qri the Certiflcate(s)of Complia�_ce(CF1Rj approved�by the enforcement�agency.
� ��� � �� � ; �,�-°,., �r ��" n
5. I will ensure thdt a��registered�copy of�ttus Certif{cate of VerifiGationshall be posted,or made avadable with the'buFlciing permit(s)issued for the
�^ �¢ .r�'^����-� �' : -a � �' z, � ?�-_. €� � ' r
building,and made availak�e•to the'enforcemenUagency for all applicable mspgctioas 1 understand that a registered copy of this.Certificate of
.e,� � � : +�.,-� � '�:;�;
,
Verification is required to b cf d d With the d umentation the builder.provides to tKe'buil'ding'owner at•occupancy.
: � �'...a... - _ �.. . . . �� --
Builder Or Installer;lnfocmation As Shown On The Certificate Of Installation
��_�
Company Name(Installing Subcontrector,Ge�eraf Contrector,or Builder/Owner):
W C HEATING&AIR CONDITIONING INC �
Responsible Builder or Installer Name: CSLB License:
Rusty Cochran 779604
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: ,���
Stratz Permit Service af��'�%!'i��i'f7/GE��d�
Responsible Rater Name: Responsible Rater Signature:
Garrett Williams 2015-01-20 13:45:00
Responsible Rater Certification Number w/this HERS Provider: Date Signed:
CC2006208
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this reqistered document and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number:214A0067567A-M2000002A-M20A Registration Date/Time: 2015-01-20 13:45:00 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-20 08:05:04
2013 Residential Compliance Schema Version:0.551SDD