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Home My WebLink About15-0028 ,..__,�''.�____......_ CITY OF DIAMOND BAR , — ' . �k i ,; DEPARTMENT OF COMMUNII�'&D4.='ELOPMENT SERVICES . �: ''� '� 21810 Copley Drive,Diamond Bar,CA 91765 � PRESS �,,\�8��,� (909)839-7020 Fax:(909)861-3117 Buildiog Inspection Hotline(909)839-7027 FIRMLY BUILDING PERMTT APPLICATION = JOB SITE ADDRESS APPLICATION DATE: ' Z� P/C# I z APN LOT TRACT ISSUE DATE: ��d�l dD�,� PERMIT# lJ ' DO �� OWNER � " K TYPE CONST. OCC GROUP: I � ADDRESS O ^ — ZONING SETBACKS I QCITY P TEL�� FRONT RW ❑ = APPLICANT TEL Y//— REAR ❑ ¢ CONTRACTOR ` SIDE/SIDE STREEf RW ❑ � SIDE ❑ � ADDRESS PROPOSED USE � CITY ��,�_��ZIP��TEL7��—�/'�3 I� = ARCH/ENG/DESIGNER � � = ADDRESS #DWEL.UNITS #STORIES #BEDROOMS z CITY ZIP TEL. ¢ OWNEB-BUILDEH DEClAM710N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � = I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) SFR/ADD/REM I I � indicated below by the checkmark(s),I have placed next to the applicable item(s)[Section 7031.5,Business and Garage/Carport � PraTessions Code:Any city or caunty Mat requlres a permit ta construct,alter,improve,demolish,or repair,any z structure,prior to its issuance,also requires the applicant for the permit to file a signed statement that he or she w Patio/Deck � i is licensed pursuant to the provisions of the Contractor's State License Law(Chaptzr 9)Commencing with Section � 7000 of Divisian 3 of the Business and Professions Code]or that he or she is exempt from licensure and the basis for � Pool/Spa I � the alleged exemption.Any violation of Sedion 7031.5 by any applicant for a permit subjecis the applicant to a civil penalty C7 I = of not more than five hundred dollars($500). ZQ Re-Roof � (�I,as owner of the property,ar my employees with wages as their sole compensation,will do(J all of or(,portions � Commercial I y of the work,and the stFucture is not intended or offered for sale(Section 7044,Business and Professions Code:The � I ' Contractors'State License Law does not apply to an owner of property who,through employees'or personal effort,builds m y or improves the property,provided that the improvements are not intended or offered for sale.If however,the building or I � improvement is sold within one year of completion,the Owner-Builder will have the burden of proving that it was not built � or improved for the purpose of sale.�. I � L)I,as owner of the property,am exclusively cont2cting with licensed Contrac6ors to construct the project(Section Z 7044,Business and Professions Code:The Contracfors'State Ucense Law does not apply to an owner of property who Valuation: Adj.Area: i � buildsorimprovesthereon,andwhocontractsformeprojectswithalicensedConhactorpursuantrotheContractors'State QUANTITY DESCRIPTION FEE I Y License Law.). I � ()t am exempt from licensure under the Contractor's State License law for the following 2ason(s): � I � � l By my signature below I acknowledge that,except for my personal residence in which I must have resided for at least one � I = year prior to compleGon of the improvements covered by this permit,l cannot legally sell a struc[ure that I have huilt as an w owner-builder if it has not been constructed in its entirety by licensed contradors.I understand that a copy of the applicable I � law,Section 7044 of the Business and Professions Code is availa6le upon request when this application is submitted or at I X the following Web site:httphwiw.leginfo.ca.gov/calaw.htmL � ��. � Z_ I = DATE: SIGN: � — LICENSED CONTNACTON'S DECLAHATION � I a I � I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with Section 7000) � of Division 3 of the Business and Professions Code,and my license is in full force and effect. J I � � / U n LICENSE CLASS: �Ca � IC.NO.: O � � DATE:r' 2— �j CONTRACTOR: � � i Z w ¢ WOHI�H'S COMPENSATION DECLAMTION � I y I HEREBY AFFIRM UNDER PENAL7Y OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS: I � I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION: � � Sedion 3700 of the Labor Code,for the pertormance ot the work for which this permit is issued. p�.qN REVIEW: > I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for z the performance ot the work for which this permit is issued.My Worker's Compensation Insurance Carrier and ELECTRIC: ¢ PoIi�yNumberare: �� PLUMBING: � CARRIER ,./� � � POUCYNUMBER MECHANICAL: �� INSPECTION FEE: 'n (THIS SECiION NEED N T BE COMPLETED IFTHE PFRMR IS F9R ONE HUNDRFD DOLLPAS($100)OR LESS). ISSUANCE: _ ��•,f'7 = I certAy that in the perfortnance of the work for which tl�is pertnft is issued,I shall not employ any person in any manner so as to � become su6ject to me Worker's Compensation Laws of Califomia.Md agree that if I should become subject m the Worker's SMIP: � Compensatlon provisions of Section 3700 of the labor Code,I shall forthwim comply with those pmvisions. ENERGY P/C: J DATE: APPLICANT: 1 ENERGY PERMIT: � WARNING:Failure to secure Worker's Compensation coverage is unlawful,and shall subject an employer to criminal �n ipenalties and civil fines up to one hundred thousand dollars($100,000),in addition Tn the cost of the compensation, RETENTION FEE: �_ = damages as provided for in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE: ' i CONSTRUCTION LENDING AGENCY BSAF: I y I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the pertormance of the work for � which this permit is issued(Sec.3097,Civ.C.�. LENDER'S NAME: I x LENDER'SADDRESS: � i I certfy that I have read this application and state that the above information is correct.I agree to comply with all city and TOTAL FEES I Z county ordinances and sfate laws relating to building construction,and hereby authorize 2presentatives of this county to COMMENTS: � � enter upon the above-mentioned property for inspection purposes. J r _ /� b ¢ PE EE ME(PRI - � n `�f = SIGN R E DATE RECEIPT# ��, pqlD BY: CM,r� VALIDATION: V,J V � WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy CITY OF DIAMOND BAR IiVSPECTIC�s� R`CORQ � ' � � . . . � • � � • • - • • � � . � . ��..m, _ - , SETBAGKi LETTER � �` �� ` �� TRACTAND LEDGER i �FQi�T(NGS;F013MS :+�;��_ �� ;, d� �� SWITCH GEAR I �:�: , . � - — s�A$ � �_� COMMERCIAL HOOD i Uf;�PLUMBING .�` �.�' "�` �" '��`' � T-BAR UG>ELECTHICAL INTERCEPTER x-. UF�R GROUN� -�� r��s. � � _, k p � HOT MOP/SHOWERPAN ( SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLddR SHEATNING ROUGH CONDUIT ��FIEARWWALLS EXTERIOR ,� � �,, POOUSPA � r;�� .,�.�b _ �, � , _--� — �,� �- 4�. ' _x , _ ,�F�EAR WALL��NTE(�IOR � � ,�-- ;`�'� �� ,�, . - � �ROUGH�'LUf��ING ' � ��'" ' �t�M1NGNE�IT€N��` s ,� '�w �� . _ ��R�U��i ELECTRICAL 5 ., �tiF m �� ,. _, � �_ �ROIJGH�ECNANICAL�� ROUGH MECHANICAL �.. �e v��. _ ROUGFI ELECTRI6AL W( }C�( ) � �° GAS TEST ;� Q� „ _ ROUGH PLUMBING u �� : �PRE GUNITE, INSULATION INALL 'POOL'PRE DECK BONDING " ' °" INSULAi ION CEILING P-T�P QRYWALL xFENCE/GATE/AIARM 9 LATH(PRE} ��FINAL_,POOL_ � LATH EXTERIQR WALLS: IATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1sT( )2Ne( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION R0.fRAMING;_PLANNINGAPPROVAL, � n ,.. 3:. _ ..., �� _ __ ROUGHFIREAPPROUAL _ �, -�- FINAL.BIIILDING '� �� FIN�4i.�MECHANICAL',; ,r „ � �/J �S" �� '-�� ,� FINAL FIREDEPARTMENT �, _ '�INAL ELECTRICAL -_ �_ �'. _ ,�� _ , _ FINAt.PLANNING ;FINAL�PLUMBING � `�`� �� ° ` ~� "' �� fINAt ENGINEERING/PW ° ' � �TC�,,of QCCUpANCY�,; _; �, � � , �. FINAL COMNiUNITY SERVICES --�,,, ,� ,�� :,. _, . . ,.� � , � � _ ,e , � GfRT.M OCCUPICNCY� �� FINAL HEALTH DEPT. �' ` xFINAL INOU$TRIAL WASTE � z�, ,��`,` � ��- COMMENTS: I STATE OF�CA�(�ORNIA , ' ALT�RR�CJONS - HVRG ' � �"�`�� ' CEGCFIR-ALT-04-E Revised 06%14 CAUEORNIA ENERGY COMMISSfQN CERTIFICATE OF COMPLIANCE � CF1R-ALT-Q4-E _ -Alterations-HVAC CZ 2,and 8-15(formerly CF-1R-ALT-HVAC) {Page 1 of 1) s Site Acld�essi ' ' - ��- Enforcemenf Ageciryi Date Prepared: Permit#: ��A ��R�' �` � , New Ducti�rg,Ptenums,Lineser: Conditioned Equipment Type Equipment Efficiency Thermostat Required R-value Floor Area(sq ft} Packaged.Systern ❑Evaporator Coil �� AFUE �4P ❑R'6 (CZ 2,8-13)Ducting Served by system ❑Setback ❑Spiit System ❑Condensing Unit � O R-8' (CZ 11,14,ISJ Ducting sqft (If not already ❑Mini Split � ❑Compressor � SEfR NSPF p R-6(allCZ's)Plenums p�esent,must , �Furnace �lineset EER ❑R-S or R7.5}LinesetA be instoiJedJ O 7XV HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this for is allowed to 6e filied out by hand. For final inspection aU forms are to be registered(no hand filled forms allowed)and a copy left on site. 1.HVAC Changeout/Repair Required Comptiance documents ta be left on site for Final: All Equipment, CF1R-AlT-02-E Condenser Unit,Evaparator Coil, CF2R: MECH-Ql,MECH-20-HERS,MECH-(23 ar 24)2-HERS,MECH-25-HER5= Compressor,TXV,Lineset, CF3R: MECH-20-HERS,MECH-(23 or 24)-HERS�,MECH-25-HERS� Air HandierJFurnace={Can include new ductittg) lnstaller Requirement:Duct leakage(<159'4,or<2Q%to outside,or seal all acceuible leaks},Air�law>_3QQ CFM/ton,Refrigerant Charge, Exempted from duct leakage testing if: ❑1.Duct system registered with HERS provider as previously sea�ed,or O 2.There is iess than 40 linear feet of duct in unconditioned space,or O 3.Existing duct systeins are tonstructed,insulated ar sealed with asbestos{Iist manufacture dete of building�_,,,}, ❑2.New NVAC System Required Comp}iance Qocumen#s to be left on site for Finat: All new equipment and AU New Oucts} CF1R-ALT-02-E including Mini Split CF2R: MECH-01,MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HER5x,MECH-25-HERSZ CF3R: MECH-2d-HERS,MECH-22-HERS,MECH-f 23 or 24)-HERSz,MECH-2S-HER52 , � Mini Spiits require CF1R-AL7-d2-E,CF2R-MECN-Ol,and (CF2R-CF3R}1vVECN-25-NERS Installer Requirement:Duct leakage<6%,Fan Efficacy(.58WiCFM},Air Flaw>_354`CFM/ton(or alternative},Refrigerant Charge ❑3.All New Ducts with Replacement Required Compliance Documents to be left on site for Final: • All New.Ducts�and one o"r mare of the following CF1R-ALT-02-E �replaced:Condenser Unit,Evaporator Coii, CF2R: MECH-pl,MECH-2p-NERS,MECH-(23 or 24)-HERS,MECH-25-HER5 Compressar,TXV,Lineset,Furnace2 C�3R: MECH-20-NERS,MECH-(23 ar 2A}-NER5,MECH-25-HERS Installer Requirement:Duct leakage<5%,ARr flow>_354 C�Miton(ar afternative),Refrigerant Charge Exempted from duct leakage testing if:�I. Existing duct systems are constructed,insulated or sealed with asbestos ❑4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final: New ducting but iess than Al�New Ducts' CF1R-ALT-02-E,CF2R: MECH-20-HERS,CF3R: MECH-20-HERS . instatler Required to:Duct leakage{K 15°la or,<ld%to outside or,or seal all accessible leaks) ❑ EXCEPTION:Existing duct systerns constructed,insulated ar seafed with asbestos. 'Ail new"ducting ft-8 required when rttare than 40 ft instalfed and R-6 when less than AO ft insta{led. This includes in wails,between flaars etc. Z Heating only systems and Air Haniilerf Furnace changes do not require Air Flow MECH-(23 or 24�,or Refrigerant Charge verification MECH-25 3 All New Ducts is when at least 75 percent of the duct system is new duct material,and up ta 25 percent may consist of reused parts from the �weliing unit's existing duck system(e.g.,registers,gril(es,boots,air handfer,coil,plenums,duct material} "R-5{3"thick+nsulation)for linesets 1"and less. R-7.5{1.5"thick insu3ation}far linesets over 1 inch. Most mfg wil!require Suction line Diameter with insulation as the fallowing 1.5-2T-25/8',2.5-3T-2'l,",3:5 to 4T-2Y.",5T-4%." Cantractor{Docamentation Author's/Responsible Designer's Declaration Statexnent) I certify.the following under penalty of perjury,under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. , I am e(igible under Ltivisian 3 of the California Business and Professions Code fo actept respansibility for the information on this document. 3. That the energy features and performance specifitatians for the design identified on this Certificate of Compliance conform to the requirements of 7itle 24,Parts 1 and 6 of the California Code of Regulations(CCR�. � 4. That the energy features and performance specifications,materials,components,and manufactured devices for the building design or system design iden#ified on this Certificate af Campliance conform to the requirements of Tit(e 24,Part 1 and Part 6 of the CCR. 5. The buiiding design features ar system design features identifiec!an this Certificate of Complianee are consistent with the infarmation provided on other applica6le cornpliance dacuments,worksheets,calculations,plans and specifications submitted to the enfarcement agency for apprnval with this building permit application. Res esig r Nam • Responsibte Designer Signature: Date Signed: � License: Compa : ( Address: CityJState(Zip: /-`C.�-�� P��L } �G ,�,�(� l Y i w' 1 � For assist ce or qu ions regardmg the Energy Standards,contact the Energy Hotiine at:1-800-772-3300,. i. ' _ CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Dud Leakage Diagnostic Test (Page i of 3) Project Name: 1102 Enforcement Agency: City of Permit Number: 15-0028 Diamond Bar Dwelling Address: 1102 Cleghorn Unit 3 City: Diamond Bar Zip Code: 91765 A.System Information 01 Space Conditioning System Identification or Name System 1 02 Space Conditioning System Location or Area Served Location 1 03 Building Type from CF-iR Single family 04 Verified Low Leakage Ducts in Conditioned Space No,credit is not taken (VLLDCS)Credit from CFiR? 05 Verified Low Leakage Air Handling Unit(VLLAHU)Credit No,credit is not taken from CFiR? 06 Duct System Compliance.Category _,, ..y .,;., . . ., ;.Alteration using.smoke test. . �_;.w .,.- , � . ;_ , . , ; ; . , � , . , ,. _ . , ; _., , : , ; ; MCH-20e-Sealing;All Accessibl_e Leaks using Smoke Test .;__ ; ,. _ ._ . � � :. _, a ,�. - . ,. , B. Duct Leakage Diagnostic,Test , Ol Condenser Nominal Cooling Capacity{ton) 2.5 02 Heating Capacity(kBtu/h) 0 03 Conditioned Floor Area served by this HVAC system(ft2) 1510 04 Duct Leakage Test Condition Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor 0.15 07 Air Handling Unit Airflow(AHUAirflow)Determination Cooling system method Method 08 Measured AHUAirflow This field or section is not applicable 09 Calculated Target Allowable Duct Leakage Rate(cfm) 150 10 Actual duct leakage rate from leakage test measurement 115 (cfm) 11 Compliance Statement:System passes-system complies with allowable duct leakage rate criterion 12 Notes: Registration Number:215-A0020577A-M2000002A-M20A Registration Date/Time: 2015-01-17 1025:03 HERS Provider:CaICERTS CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-17 09:49:34 ' 2013 Residential Compliance Schema Version:0.5515DD � � „ CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 2 of 3) C.Additional Requirements for Compliance 01 System was tested in its normal operation condition. No temporary taping allowed. Outside air(OA)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 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 HERS vecification compliance. . -- - � :�. , , ;. , . 08 Verification Status: ., . 'Pass-all applicable requirements are met ��:- � _ 09 Correction Notes°for this�fable._ � �" = ' ` '�� ' � ` " 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 Verificatiort Compliance All applicable sections of this document shall indicate compliance with the specified veri�cation 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:215-A0026832B-M20000026-M20B Registration Date/Time: 2015-01-27 08:58:47 HERS Provider:CaICERTS CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-27 08:58:29 2013 Residential Compliance Schema Version:0.5515DD 4 ` 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: Denis R Higginson �� Company: Date Signed: ATB Images 2015-01-27 08:58:47 Address: CEA/HERS Certification Identification(if applicable): 4790 Irvine Blvd.Suite 105-142 2488 City/State/ZiP: Phone: Irvine CA 92620 714 309 9241 Responsible Person's Declaration statement I certify the following under penalty of perjury,under the laws of the State of California: 1. Trie 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 reter). 3. The installed features,materials,components,manufactured devices,or system perFormance diagnostic results that require HERS verification identified on this Certificate of Verification comply with,the applicable requirements in Reference Appendices RA2,_RA3,and the requirements specified on the Certificate.of Compliance for the building;approved b,y the enforcement agency._:: ,, .., :,. , : . , , 4. The information reported on apphcable sections of the Certificate(s)of Installation(CF2R)signed and submitted by'the person(s)responsible for the construction-or installation conforms to the requirements specified on�the Certificate(s)ofCompliance(CF1R)approved by the enforcement agency. 5. 1 will ensure;that a registered`copy of this Cerhificate of Verification shall be posted;or made available with the°building permit(s)issued fo�the building,and made ayailable to'the enforcement agency for:all applicable inspections.J undersfand that a registered copy;of this Certificate of Verification is required to be included with the documentation the builder providesto the building owner at occupancy. ' � ' Builder Or Installer Information As Shown On The Certificate Of Installation Company Name(Installing Subcontractor,General Contractor,or Builder/Owner): NIX PLUMBING HEATING AND AIR CONDITIONING Responsible Builder or Installer Name: CSLB License: Dale Nix 542033 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: ATB Images Responsible Rater Name: Responsible Rater Signature: � Denis R Higginson Responsible Rater Certification Number w/this HERS Provider: Date Signed: CC2005579 2015-01-27 08:58:47 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:215-A0026832B-M20000026-M206 Registration Date/Time: 2015-01-27 08:58:47 HERS Provider:CaICERTS CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-27 08:58:29 2013 Residential Compliance Schema Version:0.551SDD r. CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 1 of 4) Project Name: 1102 Enforcement Agency: City of Permit Number: 15-0028 Diamond Bar Dwelling Address: 1102 Cleghorn Unit 3 City: Diamond Bar Zip Code: 91765 A. Ducted Cooling System Information 01 System Identification or Name System 1 02 System Location or Area Served Location 1 03 System Installation Type New 04 Nominal Cooling Capacity(tons)of Condenser 2.5 05 Condenser Speed Type � Single Speed 06 Cooling System Zonal Control Type Not Zonal 07 Central Fan Integrated�(CFI)Ventilation System Status___._. , Not a CFI system___ _ .. ,:_,... 08 System Bypass Duct Status , No Bypass Duct� 09 Date of System Airflow Rate.Measurement r` ' . 2015-01-07 , .,° �• � 10 Airflow Rate Protocol utilized RA3.3 procedures for airflow rate measurement B. Hole for the placement of a Static Pcessure Probe(HSPP),and Permanently installed Static Pressure Probe(PSPP) in the supply plenum. Procedures for installing HSPP or PSPP are specified in RA3.3.1.1. 01 Method used to demonstrate compliance with the HSPP installed and labeled consistent with Figure RA3.3-1 HSPP/PSPP requirement C.Airflow Rate Measurement Apparatus and Procedure Information Instrument Specifications are given in RA3.3.1.1,and system airflow rate measurement apparatus information is given in RA3.3Z. 01 Airflow Rate Measurement Type used for this airflow rate Fan Flowmeter according to procedure in RA3.3.3.1.1 verification. 02 Manufacturer of Airflow Measurement Apparatus TSI 03 Model number of Airflow Measurement Apparatus 8371 04 Certification Status of the Airflow Measurement Apparatus Certified by Manufacturer and listed on CEC Website at Accuracy htt p://www.energy.ca.gov/(tbd) Registration Number:215-A0020577A-M2300002A-M23A Registration Date/Time: 2015-01-17 1025:03 HERS Provider:CaICERTS CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-ll 09:50:37 � 2013 Residential Compliance Schema Version:0.515DD - - , .� CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 2 of 4) MCH-23a Forced Air System Airflow Rate Measurement-Newly Installed Non-Zoned Systems or Zoned Multi-Speed Compressor D. Forced Air System AirFlow Rate Measurement The procedures for System Airflow Rate Verification are specified in Reference Residential Appendix RA3.3. 01 Required Minimum System Airflow Rate(cfm/ton) 350 02 Required Minimum System Airflow Target(cfm) 875 03 Actual System Airflow Rate Measurement(cfm) 881 04 Compliance Statement: System airflow rate complies E.Additional Requirements 01 Air filters that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in �,:�•; _,: . , - .__ . _ the system dunng sy"stem air flow rate:•:measu�ement identified on this Certif cate of Installation.'- The airflow rate measurementapparatus�used to perform the airflow rate measurement identified on this Certificate of 02 Installation was;calibrated in,:accordance with the apparatus manufacturer's specifications and confo�ms to:the `` .-. . ..� ., .: .. . , .,,:- instrumentation specifications given in RA3:3.1.` ° . . . A visual inspection shall confirm that 6ypass 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. 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:215-A0020577A-M2300002A-M23A Registration Date/Time: 2015-01-17 1025:03 HERS Provider:CaICERTS CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-17 09:50:37 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. ., _ . ,. _ � � , . � �.. � � . < , - � � � - - F . • i , . Registration Number:215-A0020577A-M2300002A-M23A Registration Oate/Time: 2015-01-17 10:25:03 HERS Provider:Ca10ERTS CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-17 09:50:37 2013 Residential Compliance Schema Version:O.SISDD i 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 Certi�cate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Denis R Higginson �� Company: Date Signed: ATB Images 2015-01-17 10:25:03 Address: CEA/HERS Certification Identification(if applicable): 4790 Irvine Blvd.Suite 105-142 City/State/Zip: Phone: Irvine CA 92620 714 309 9241 Responsible Person's Declaration statement I certify the following under penalty of perjury,underthe laws of the State of California: 1. Trie intormation 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,materials,components,manufactured devices,or system performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2,RA3,and the requirements ,_•. _ ... . _ -- specified on the Certificate;of Compliance for the buildiog approved by the enforcement agency.,; 4. The information reported on'applicable sections of the Ceitificate(s)of Installation(CF2R)signed and submitted by the person(s)responsible for the construction o�installation conforms to;the requirements specified ortthe Certificate(s)of Comptiance(CF1R)�approved by the enforcement agency. 5. I will ensure�tFiat a registered"copy of this Certificate of Verificationshall be posted,or made available-with the building permit(s)issued for the building,andimade availatile to tfie eriforcement agency forall applicable inspections:I understarid that"a registered.copy of this Certifcate of , , . ,,. ; ; , - • ,. Verification is requir'ed'to be i�cluded with the docurtientation thebuild'er"provides to the building owner at occupancy. ' Builder Or Installerinformation As Shown On The Certificate Of Installation Company Name(Instalfing Subcontractor,General Contractor,or Builder/Owner): NIX PLUMBING HEATING AND AIR CONDITIONING Responsible Builder or Installer Name: CSLB License: Dale Nix 542033 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: ATB Images �— Responsible Rater Name: Responsible Rater Signature: Denis R Higginson 2015-01-17 10:25:03 Responsible Rater Certification Number w/this HERS Provider: Date Signed: CC2005579 Digitally signed by CalCERTS. This digital signature is provided in order to secure the conteni of this registered document and in no way implies Registration Provider responsibility for the accuracy of the information. Registretion Number:215-A0020577A-M2300002A-M23A Registration Date/Time: 2015-01-17 10:25:03 HERS Provider:CaICERTS CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-17 09:50:37 2013 Residential Compliance Schema Version:0.51SDD