HomeMy WebLinkAbout14-4841 � i� DEPARTMENT OF COMMUNTTY&DEVELOPMENT SERVIC���� �����
. - G 21810 Copley Drive,Diamond Bar,CA 91765 P
�R,o�,,,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909�������
''e"'� BUILDINGPERMITAPPLICATION 11 �' �w FIRMLY
g 3�' L 0 �--( APPLICATION DATE: �G ��Y� / P/C# �y� �O yI �
x JOB SITE ADDRESS ���� v (' f`
? APN OT���TRACT ISSUE DATE: �V �� y ��/ PERMIT#�7 ��v / I
� OWNER C.-IC VS TYPE CONST. OCC GROUP:
� ADD SS Q r
J CITY ZI TEL. ZONING SETBACKS
� ` �a FRONT RW ❑
� APPLICANT - REAR
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Q CONTRACTOR -� � � �� SIDE/SIDE STREET RW ❑
� SIDE ❑
� ADDRESS 3 - r+- PROPOSED U9E '�'�` �'`L b v G+�✓V '«-
� CITY�n,r�_ZIP o!b TEL. 3 VC�� �Q.S�/� �S s�l•nti�s.
� ARCH/ENG/DESIGNER
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� ADDRESS
� #DWEL.UNITS #STORIES #BEDROOMS
zd CITY ZIP TEL.
� owNEa-BuaDFA DECu�aanoN DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION �
= I hereby afflrm under penalty of per�ury that I am ezempt from the Contrador's State License Law tor the reason(s) SFR/ADD/REM I
L indicated below by the checkmark(s),I have placed nezt fi the applicable item(s)[Sectlon 7031.5,Business and Garage/Carport I
� Professloos Code:Any city ar caurrty that requires a permtt tn consVuct,alter,Improve,demollsh,or repalr,any
y structure,prior to Its Issuance,also requires the applicant for the parmtt to flle a slgrred shatement that he w she � Patio/Deck I
� Is Ilcensed pursuant to the proWsions of the Contractor's State License Law(Chaptar 9)Cammencing wMh Sectlon w
� 7000 of Olvlslon 3 of the Busl�ress and Prolessio�Code]or that he or she is exempt from Ilcensure and the basis for � PooUSpa I
n the alleged exemptlon.Any violation of Sectlon 7031.5 by any applicant for a permlt subjects the applicant to a civil penalty C7
of not more than five hundred dollars($500�. Z Re-Roof i
I
� U I,as owner of the property,or my employees with wages as their sole compensation,wlll do(,all of or(�portlons � Commerclal
y of the work,and the structure is not intended or o(fered for sale(Section 7044,Business and Professions Code:The � I
� Contractors'State License Law dces not apply to an owner of property who,�hrough empbyees'a personal effort,builds m
i or Improves the property,pmvided that the Improvements are not intended or ottered for sale.tt however,the building or I
� improvement Is sold within one year of comple6on,Ne Owner-Builder will have the buNen ot prwing Nat it was not bullt
� or imprmed for Me purpose of sale.). I
:�
(,I,as owner of the property,am exclusively contractlng with licensed Contractors to consWct the project(Section �
� 7044,Buslness and Protessions Code:The Coritractors'State Llcense Law does not appty to an owner of property who Valuation: Adj.Area: �
nbuildsorimprovesthereon,andwhocontractsfortheproJectswithalicensedContractorpursuaMtotheContractors'State QUANTITY DESCRIPTION FEE �
Y License Law.�. � I
_ (�I am ezempt hnm Ilcensure under Me Contractor's State License law for the following reason(sj: � I
�
'L By my signature below I acknovAedge that,ezcept for my personal residence In which I must have resided for at least one � I
� year prior to completlon of the imprmemants covered by this permlt,l cannot legally sell a structure ihat I have buitt as an �
w
2 owner-bullder if it has not been constructed in its entirety by licensed contracturs.I undershand that a copy of the applicable
Y law,Sectlon 7044 of the Buslness and Professions Code is available upon request when this applicatlon Is submitted or at. I
i the following Web slte:M�/www.leginfo.ca.gov/calaw.html. �
� I
= DATE: SIGN: �
— - LICENSED CONTHACTOfl'S DECLARATION � I
a I
y I hereby afFlrm under penatty of perjury thffi I am Iicensed under provisions of Chapter 9(wmmendng wIm Section 7000)
� of Oh�islon 3 of the Business and Professlons Code,and my license Is In full force and efted. � (� S A �u G� I
� LICENSE,7CLAS � ^ Z LIC.NO.: � !
� DATE: L��I carmucroa� �lp��°-�"6t � / S /'� ef Y� Q C �
WOPI�A'S COMPENSATION DECUIHATION � �
y I HEREBYAFFIRM UNDER PENALTY OF PFAJURY ONE OF 7HE FOLLOWING DECLARATIONS: I
� I have and will malntain a Certlflcate of Consent to Self-Insure fir Worker's Compansa6on,as provlded by CONSTRUCTION: I
Sectlon 3700 of the labor Code,for the pertormance of ihe work for which this permit is issued. PLAN REVIEW:
� _�I have and wlll maintaln Worker's Compensation Insurance,as reqWred by Sectlon 3700 of ihe Labor Code,for
� the performance of the work for which this permit is Issued.My Worker's Compensatlon Insumnce Carrler and ELECTRIC:
zd PolicyNumber e: / � � PLUMBING:
y cnaR�� �e0u��i c ��L✓r,UY,�c i�S MecH,ariica,�:_ �u. `�7
� POLICY NUMBER_��I����s'—6Q
INSPECTION FEE:
n (fHIS SECIION NEED NOT BE COh�LEfED IF1HE PHiMR IS FOR ONE HUNDR�DOLLARS(5100)OR LESS). ISSUANCE: 3 S^ S J
= I certFy that in the pertomiarxe of the wak for vfikh this permtt Is Lssued,I shall not employ any persan In any manner so as to
� becane sub�ect to the Worker's Canpensation laws of Califania Md agree tlrat if I should become subJect to ttieWakers SMIP:
JCanpensation pruvisbns ot Section 3700 ot the Labor Code,I shall fortlnvim compy wim Urose prwisions. ENERGY P/C:
1 �A�' ���T' ENERGY PERMIT:
= WARNING:Failure to secure Worker's Compensatlon coverage is unlawful,and shall subject an employer to criminal RETENTION FEE: , W
i penalUes and civil fines up to one hundred thousand dollars($700,000),in addltbn to the cost of the compensation,
= damages as provlded for in sectlon 3708 of the labor code,Interest,and attomey's fees. PRE-ALT FEE:
i CONSTFIUCTION LENDING AGENCY BSAF:
= I hereby afflrm under penalty of pehury that there is a Construction Lending Agency fa the pertormance of the work for
� which this permit is Issued(Sec.3097,Civ.C.).
LENDEA'S NAME:
= LENDEA'SADDHESS:
i I certify that I have read this applicatlon and state that the above Information Is crorred.I agree to compty with all clty and TOTAL FEES
Z counry ordinances and s[ate laws relating to bullding consWctlon,and hereby authorize representatives of this county to COMMENTS:
� enter the a e-mentioned properry for Inspection pur s.�
o �1'�,� ��1 P r�`-"s�✓��
¢ P ITTEE N,Mf�(PRI
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= SI TUREOFPERMfTTEE DATE '0� `� RECEIPTN��S�/3 PAID BY: �3�I/�Y VALIDATION:
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy
iRn,' ...Y��:..4: .. r..,'2 i-��4 yM�l .r�y i'� �
� • ; ;;;�, .;. .: •�� � �; CITY Ot= QIA�IAOND BAR
� '``� � �� "'' � �`� �` ���"�'�� " �s INSPECTIUN RECORD
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gSETBAClU�LETT€R �. � ����```� a",�r�_�-' ,.,��`��� TRACT AND LEDGER
FOQTI(JGS�FORMS �`� ��� ;�`� _.Q��� .' ��.��a,� SWITCH GEAR
��� -� '"'"` �����'� " `���� COMMERCIAL HOOD
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UG�ELECTRIGAL, '�';`�,: + �`�k� „ ,;�„;,,. '> INTEACEPTER
UFER�G�iOUND�� �,��' `��',�„a., �� ._,� ����',.�'r�����' HOT MOP/SHOWERPAN
SEWEFI LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE " HERS REPORT RECEIVED
SEWER Ct�ANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONQUIT
��NEAR�WALLS EXTERIOR,, = �' =���'�� � �°����� POOUSPA �'�� � ��_§ , �� '° � � ��
-- :-�--�.� ����,� �" � ROUGH�PLUMBING �. � ��` � ���� � ��•u�a� ,� ,��-�`' ",,�*
SHF1�R WkILS ItdTERIOR� ��° �
�F�RAMlJ�G/iIEM1fT'iNC�� � �� �� � � � ��� �� RdUGHELECTRICAI�� �� �� �,�� ��" �u� r� ''� � �
ROtJGFIiMECHANICAL}"�� ��� � ,, � � ,.� ����� � 'RQUGH�MECHANICAL ✓,.. . ,
ROUG ELEGTRiCAL�W(��3)C(�}`;,,� .�:� �� � ��` ,�'��-��� � GAS TEST ��`�� ��a�'"�� Y
ROUGti,F�UMBING�: � ,�� �',�r����� .:�� .�. y�;�� �� RREGl1N{TE�� � ,�„�e� , � �� e
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INSULATION WALL POOL PRE_pEGK BONDING -v��r a��_��, � ,aa� , � � ��
INSULATION CE►L1NG P-TRAP''=-�� � ���� �� �� ' �`�� ^ �
DRYWALL FENCE/GATE(ALARM "`�a�' d � ' ,x
A� �<x,� a. . .- ��, ,_, .
WTH(PRE) FINAL P,OOL ��, �°�- °, � ,
LATH EXTERIOR WALLS:
IATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�( )2N°( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
_.F.
SPECIAL INSPECTION fl0 R3AM(NG PLANNINGAPPROVAL` � `� ��`; ' "°
..W ,w. �. � — � � .- ar, —„ � � . .- � ��; _, � _. � � `_,�
: —�'_.�., ��� � _ . w�. x�� aa�. `rg°f � �-- �.,A. � �� ..- �� �y_ a' ,`- .
FINAL�BUILDING ° �. �-. �� ..�` , �� ° .�;� ..� �°�_-����� o� ROUGH FIRE APPROUAL � ,f. � ' ,
EINAL MEC}I�NiCAL�����,� /J ! ��� � .� , FiN;4C�FIRE DEPARTMENT�t_� " ° ,�� . �
t" �` � � ��``� �� �. �t�� `��� �=� " �= ,EINA�PLANNIN�°- ` �d���. "�` � �� �
FINRiL ELECTRIC/SL= �� ' � A,._ � -- - _� �
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F,INAI PL'UMBING� � ;�� _a g. ��� � � ' �� ���� �` � � ���
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§7.C.of OCCUFANCY "�� ��� �� �� W � �������°` ��
_:�" � ��� �-�� �� � � .,�. � , �
_a�_ ..�. ��_ �, � � ,� �'��� � � �� � � �'� FINAL NEALTH DEPT, � � .,
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;�ERT�of OC�UPANCY�-.._� : � _����_�n �m ��_����� __�v,•�. ., :ea . �
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FfNAiL;INdUSTRIAL,WASTE x�e � �� ' ''� „;��'��a>�
COMMENTS:
._ _ ,.. i
'I CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3)
Project Name: CROSS,ERWIN Enforcement Agency: City of Permit Number: 144841
Diamond Bar
Dwelling Address: 935 N LOOKING GLASS City: Diamond Bar Zip Code: 91765
DRNE
A.System Information
01 Space Conditioning System Identification or Name System 1
02 Space Conditioning System Location or Area Served Location 1
03 Building Type from CF-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 Credit from No,credit is not taken
CF1R?
�� ���r � ��<� . � ,-`. -- r �� . �, �. - - .; �,
06 Duct System Compliance�Category I � �` ' , Repl�cement ' ,
> _�•, f '
,r-, , ' F
J'��`� ,s' � ; �
MCH-20d-Complete,Repla errient or Altered Duct_System�'��� � � � ' �� ,� � ����� �
�-� _ . .. .�_... �- f., . �'',:
B. Duct Leakage Diagnostic Test
O1 Condenser Nominal Cooling Capacity{ton) 0
02 Heating Capacity(kBtu/h) p
03 Conditioned Floor Area served by this HVAC system(ft2) 2000
04 Duct Leakage Test Condition Test final
05 Duct Leakage Test Method Total leakage
06 Leakage Factor 0.06
�� Air Handling Unit AirFlow(AHUAirflow)Determination Default air flow method
Method
08 Measured AHUAirflow This field or section is not applicable
09 Calculated Target Allowable Duct Leakage Rate(cfm) 60
10 Actual duct leakage rate from leakage test measurement 51
(cfm)
11 Compliance Statement:System passes leakage test
Registration Number:214-A0128331B-M2000002B-M208 Registration Date�me: 2014-10-29 11:22:14 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2014-10-29 11:23:07
2013 Residential Compliance Schema Version:0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3)
B. Duct Leakage Diagnostic Test
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 register boots were sealed to the drywall.
04 Building cavities were not used as plenums or platform returns in lieu of ducts.
05 If cloth backed tape was used it was covered with Mastic and draw bands.
06 All connection points between the air handler"end:the supply2nd-retuirrplenums a�e�completely sealed.
r� � i: I � � 1� � • � �e�
�' � � �^ / � � � �� l.�:�� /? `��_ i�� � �� � �� _
If the system�complies using the Smoke Test method;'the smoke,test was conducted in accordance with the requirements
07 of Reference"Residential Appendix RA3:1.4.3.6.Systems that_co,mply using smoke test shall not be included'in�sample
groups for HERS:vecification 2ompliance. : �`: .`' � �� _. : �- ,,,� � " �� ",�-^,-
08 Verification Status:., Pass-all applicable requirements are met
09 Correction Notes for this table:
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.
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.
01 Complies:All specified verification protocol requirements on this document are met.
Registration Number:214-A0128331B-M20000028-M208 Registration Date�me: 2014-10-29 11:22:14 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2014-10-29 11:23:07
2013 Residential Compliance Schema Version:0.51SDD
. , - , . �
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Dud 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: ��� �
Don DeAngelis
Company: Date Signed:
Coast Aire 2014-10-29 11:22:14
Address: CEA/HERS Certification Identification(if applicable):
14 Santa Catrina 639
City/State/Zip: Phane:
Rancho Santa Margarita CA 92688 949300-3494
Responsible Person's Declaration statement
I certify the following under penalty of perjury,undecthe laws of the State of Califomia:
1. The information provided on this Certificate of Verification is true and corred.
2. I am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verifiqtion(responsibie rater).
3. The installed features,materials,components,manufactured devices,or system performance diagnostic results that require HERS verification
identified on this Certificate of Verifiption comply with_the appliqble requirements in Reference Appendices RA2�RA3,and the requirements �
specified on the:Ceitrficate:of Compliance for the 6uilding approved by fhe enforce e t agency; �,� ^�',-' �I
4. The i�formaUon'reported�on applicable sections of the Ceitifi cete(s)�Installation(CF2R)signed and submitted by'the person(s)responsible for the
construction o��in'stallation conforms to the requirements specified on the Certificafe('s)of Compliance(CF1R)approved;by the enforcement agency.
5. I will ensure�Tthat e registered copy'of this Certificate of Verification sFiall be posted;or made available with the building permit(s)issued f,o�the
building,and made a�railab�le to'the enforcement agency''fonall appliolile inspections:.l unde�stand that�a registered copy:of this Certificate of
Verification is requlredrto be incluiJed with the documentation tHe builder provides to�ttie liuilding owner at occupancy. ` { ` `'`�'
Buifder Or Installer Information As Shown On The Certificate Of Installation
Company Name(Installing Subcontrac[or,General Contrector,or Builder/Owner):
TRACER HEATING AND AIR CONDITIONING`
Responsible Builder or Installer Name: CSLB License:
TRACER HEATING AND AIR CONDITIONING 968565
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:
Coast Aire
Responsi6le Rater Name: Responsible Rater Signature: ��� �
Don DeAngelis �
ftesponsible Rater Certification Number w/this HERS Provider: Date Signed:
CC2004161 2014-10-29 11:22:14
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
responsibility for the accuracy o(the information.
Registration Number:214-A01283316-M20000028-M208 Registration Date/Time: 2014-10-29 11:22:14 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-OS Report Generated:2014-10-29 11:23:07
2013 Residential Compliance Schema Version:0.51SDD
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CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3)
Projed Name: CROSS,ERWIN Enforcement Agency: City of Permit Number: 144841
Diamond Bar
Dwelling Address: 935 N LOOKING GLASS City: Diamond Bar Zip Code: 91765
DRIVE
A.System Information
O1 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 CFiR?
%,r �, .� � � r ,.--.- , �� -�.
,�, c-- f_,�`'�y��; ,�,;�',�..� . d;�,t�`��� :� �F..
06 Duct 5 stem Com' liance`Cate o t 'T";:�
Y p g ry ��'` Replacement'
/ ,-� � , 1 r I / : i �
{ �i-. � i , < '. z,
e
� f ,
MCH-20d-Complete Replacement;or Altered Duct,System- '� ^ * , : � t �„',�,
_ �� . (, ,� �.
B. Duct Leakage Diagnostic Test " :
01 Condenser Nominal Cooling Capacity,(ton) 0
02 Heating Capacity(kBtu/h) p
03 Conditioned Floor Area served by this HVAC system(ft2) 2000
04 Duct Leakage Test Condition Test final
05 Duct Leakage Test Method Total leakage
06 Leakage Factor 0.06
�� Air Handling Unit Airflow(AHUAirflow) Determination Default air flow method
Method
08 Measured AHUAirflow This field or section is not applicable
09 Calculated Target Allowable Duct Leakage(cfm) 60
10 Actual duct leakage rate from leakage test measurement 51
(cfm)
il Compliance Statement:System passes leakage test
Registration Number:214-A0128331B-M20000026-0000 Registration Date�me: 2014-10-29 11:20:10 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2014-10-29 11:20:11
2013 Residential Compliance Schema Version:0.51SDD
, _ . , .- i
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H I
Duct Leakage Diagnostic Test (Page 2 of 3)
C.Additional Requirements for Compliance
Ol 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 register boots were sealed to the drywall.
04 Building cavities were not used as plenums or platform returns in lieu of ducts..
05 If cloth backed tape was used it was covered with Mastic and draw bands.
06 All connection points between the air handler and the supply and return plenums are completely sealed.
If the system complies using the Smoke Test method,the smoke test was conducted in accordance with the requirements
07 of Reference Residential Appendix RA3.1.43.6.Systems that comply using smoke test shall not be included in sample
groups for HERS,verification compliance.�,,,�� -^�� �•���� .�-n-�+ �-w--t��, j^r-y--�-� ,,�,�--,-��,
;.. � �
The responsible person's signature on'this compliance document affirms thet all applicable requirements m this table have
been met. a> �y .� , ;. 1 �.
�` ?/;r y;, t, f,/ , °,; ; '.
,.�� � . - �;.-� . c.,. . i
Registration Number:214-A0128331B-M20000026-0000 Registration Date�me: 2014-10-29 1120:10 HERS Provider:CaICERTS
CA Building Energy E�ciency Standards Report Version:2014-05-OS Report Generated:2014-10-29 11:20:11
2013 Residential Compliance Schema Version:0.515DD
_ . , . i
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3)
Documentation Author's Declaration Statement
1. I certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
ramin fakhri '�l�.NGGYi
Company: signature Date: 2014-10-29 11:20:10
TRACER HEATING AND AIR CONDITIONING
Address: CEA/HERS Certification Identification(if applicable):
20829 ANZA AVENUE#329
City/State/Zi p: P hone:
TORRANCE CA 90503 (310)951-9720
Responsible Person's Declaration statement �
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction,or installation of features,materials,components,or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to tfie declarations in this statement(responsible builder/installer),otherwise I am an authorized representative of the
responsible builder/installec
3. The constructed or-installed.features,materials,components ormanufactured;devices-(the installation)identified�on this Certificate of Ins[allation
conforms to all applicable codes and regulations,.and the installation conforms to the requirements given on the plans and specifications approved by
the enforcement agency. ��, � , . � ' � � ,- . ' ` ,
� ,,.. ����.
4. I understand that a HERS rater�check.the installation to ve�ify compliance,and tfiat if such.checking identifies defects;I am required to.take
corredive 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 partof,arsample g�oup:but not'checked by a HERS,rater,'and if,those installations"fail#o meet the
requirements of such quality assurance checking,the requi�ed corrective actlon and additional checking/testing of other installations in that HERS '
sample group will be performed at my expense.
5. I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of I
construction or installation identified on this Certificate of Installation,and I have ensured that the requirements that apply to the construction or
installation have been met.
6. I will ensure that a registered copy of this Gertificate 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 inspedions.I understand that a registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name: Responsible Builder/Installer Signature:
ramin fakhri
Company Name:(Installing Subcontractor or General Contrdctor or Position With Company(Title):
Builder/Owner) OWflef
TRACER HEATING AND AIR CONDITIONING
Address: CSLB License:
20829 ANZA AVENUE#329 968565
Ciry/State/Zip: Phone: Date Signed:
TORRANCE CA 90503 (310)951-9720 2014-10-29 11:20:10
Third Party Quality Control Program(TPQCP)Status: Name of TPQCP(if applicable):
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document,and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number:214-A01283316-M20000028-0000 Registration Date/Time: 2014-10-29 11:20:10 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-OS Report Generated:2014-10-29 11:20:11
2013 Residential Compliance Schema Version:0.515DD
__ _.
_
-------_
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