HomeMy WebLinkAbout11-1661 �� , CITY OF DIANIOND BAR ��. �
I I 1 UEPARTNIENT OF CONIA4UNI1'Y S DE�'ELOPI�IENT SERVICES �
� .�����ti� 21825 Cople}�Drice,Diamond Bar,CA 9176�
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 RESS
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� 1 CERTIFY TiAT I HAVE READ TMIS APPUCaTION AND STATE THAT?NE A90VE WFORMATqN IS CAAAECT. TOTAL FE ES ' �
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1/10/12
MARTHA CASTRO
20749 NORTHAMPTON ST
DIAMOND BAR CA 91789
Dear Customer,
Enclosed is your CF-4R/CF-6R form needed to clear permit with the
City of Diamond Bar. This is in regards to your HVAC install with
Sears. Please give this packet ta your city in�pe�tor on the day of
inspection.
, Sincerely,
Angela Gregory
Hers Project Manager
Questions? please contact your project coordinatar at Sears
Steve Kennedy 562 906 7782
, ,� ,
INSTALLATION CERTIFICATE* CF-6R-MECH-25-HERS
Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5)
Site Address: Enforcement Agency: Permit Number:
' , 20749 Northampton st, Walnut CA 91789 City of Diamond Bar PR20110001611 �
Note:If installation of a Charge Indicator Disp/ay(CID)is utilized as an alternative to refrigerant charge verification for
compliance,,a MECH-24 Certificate(instead of this MECH-25 Certificate)should be used to demonstrate compliance with
the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized
for compliance. :'�, .
As many,as 4 systems in the dwelling can be documented for compliance using this form. Attach an additiona/form(s)for
any additional systems in the dwe/ling as applicab/e. . •
'', Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement
' Sensors (STMS)
' Procedures for installing TMAH are specified in Reference Residentia/Appendix R.43.2. If refrigerant charge verification is
` required for compliance, TMAH are also required for compliance. STMS are only required for complete/y new or �
replacement space-conditioning systems that utilize prescriptive compliance method.
� Th9AH-Access Holes in Supply and Return Plenums of Air Handler
System Name or ldentification/Tag . System 1
System Location or Area Served Whole House
1 �/Yes No , 5/16 inch (8 mm) access hole upstream of evaporative coil in the return p�enum and
labeled according to Figure in Section RA3.2.2.2.2.
2 .i Yes No, �:;,��i 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum `�;
_`� and labeled according to Figure in Section RA3.2.2.2.2.
Yes to i;and 2 is a pass. � �.�., Enter Pass or Fail ✓ � Pass � Fail
STMS Sensor on the Eva oreto`�
� �� � � � :
,..�.�. ... P r Coil :; ��.��:. � , �: <.��:
..._
System Name oryIdentifeation/Tag'"��� ,�;.`,s ' .; y �� 1,;:; �:��� A ;, �
.cl Ste111'f .^���'� E_�'' r.�.`�i�� '�.":»,l. �
� . _ , . .. . - � ' .
�.���� : ��� �,, _ � �The�sensor�is facto,ry��i�nstalled,'�or�fteld�;in�s�alletl-::according to man�ufactur,"ers �
3 �,���Yes ��dNo �spec�fications, or is�ir�sta�letl by methotls/specificafions approved;byythe Executive ��� • . . �
��� � �� �� Director �� � , a � � � _ � ��y � `W i�3 =,,�r �� �
�'������ ..
�� „�����,i��� ?'�aThe�'sensor wire is termmated w�th�,�a'°stahdard rrain�plug�"suitabie>'for�eonnection�to a�
4 ��ryYes�,A„ �;�.�� �fJO Y� digiCal thermometer�The�sensorJm(ni plug�is ace�sss,ible.to YNeI„irisYalling,technician�r� �
� :,..P�.3 _�.ti�'� .,.,'z�, . �' � , .» .W. . .� n , �' .: • -
,. ,, and the;HERS_rater,wi,tfi`out changing th"erairFlori th.rough theFcondensercoil '
5 : ; Yes No ,;,The sensor measures the saturation temperature of the coil witfiin 1.3 degrees F
Yes to 3�4:;and;5"is a pass: Enter N�A if STMS are not ✓ .i N/A �/ Pass ✓ Fail
�.applicable,_Otherwise ente�.Pass or Faif
� ,✓ � � . � .. .1f':`` � ' . . - .
STMS-Sensor on the Conilenser.;Coil
, System Name or ldentification/Tag System 1
The sensor is factory installed, or field installed according to manufacturer's
6 Yes No specifications, or is i�stalled by methods/specifications approved by the Executive
Director.
The sensor wire is terminated with a standard mini plug suitable for connection to a
7 Yes No, digital thermometer.The sensor mini plug is accessible to the installing technician
and the HERS rater without changing the airFlow through the condenser coil
8 Yes No The sensor measures the saturation temperature of the coil within 1.3 degrees F
Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ,i � N/A' � Pass �/ Fai�
applicable: Otherwise enter Pass or Fail
Reg: 212-A0001865B-M2500001A-0000 Registration Date/Time: 2012/O1/11 16:27:09. HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms � � August 2009 ,
� ' IMSTALLATION CERTIFICATE ' CF-BR-NlECH-25-HERS
Refrigerant Charge Verification - Standard MeasurPrr«nt Procedure (Page 2 of 5)
Site Address:, Enforcemen�Agency: _ ,Permit Number:
20749 Northampton st, Walnut CA 91789 City of Diamond Bar ' . PR20110001611
Standard Charge Measurement Procedure (for use if ou�door air dry-bu7b is above 55°F)
P�ocedures for determining Refrlgerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential
Appendix RA3.2.As many as 4 systems in the dwelling can be documented for cornpliance.using thrs form. Attach an additional form(s)for •
any addltional systems in the dwelling as applicable.
� The system should be installed and charged in accordance with the manufactu�e�'s specifications befnre starting thls procedure.
� The system must meet minimum airflow�equirements as prerequislte for a valid re(rigerant charge test.
�If outdoor air dry-bulb is 55°F o�below,the installe�must use the Alternate Charge Measu�ement Procedure.
Space Conditioning Systems
System Name or ldentification/Tag System 1
,System Location or Area Served Whole House �
Gu'tdoor Unit Serial # E113�032Z4
Outdoor Unit Make KENMOftE
Outdoor Unit Model CAA336t;KD
Nominal Cooling Capacity Btu/hr 3600d
Date of Verification ' id/S/]l.t �I
L . - .;, `:' �� � •
Calibret�on o4.Diagnostic Instrumenfis .
Date of;Refcigerant Gauge Calibration ;, 12/1/11 (must be re-calibrated monthiy)
, ..
�,.�, ..
Date of The jmocouple�alibration ��, �`�'; ��� ��`� `"�a/i�'f11 n`� '�f��'�3 (must be�e ai�brated monthly)
?g'^�:�l�.t� ' �..a`'.c�r- - �"+�' K.�� ���z- :i�: "�` .a,��_" ��:�-
. .
PNeasured�temperaturesx(�°F),. ��§� � ; v,,; �r.��'''�. �. p,..��»',: �a,.. �q , ,
� ���s���..-<;�. ���;_.; >��
�.�' '"a �'�- Y,�aS'y��'a�f§�` '�"� ' �T'v�- 3 ��4 , '� � y F
, System Narne orld�e!vntffiica.�¢tion/�l'ag,�f� €� ' Syscterts�l�� �„ 4, ��3 ��; � �'� � �' ��" ��g�� ��'*��� � � ��"� � �
. ��'uk, ��nll'.,.�.l s"z'.��4k��.g � �..9���..` R��i�. ks��t� � � i�.. F,d.o'g Y�c�'r ;;£t�ti.•�t�'��!� �r F �.'d.%�.z.'Si � ��' fl� '�+.
Supply (evaporator leaving��airp�dry=bulb���`� �'���'����"�� �� e ��i� �"'>����,: �r�''�- '�x;� �.� =� �zs,� v�
r ' , �� �'� ra0 � n a �:a�.�.,} �'� . . , � , ,�.� -
-r� �-� �'`f'✓ r .
temperature(Tsupply, db�"' � �?� �-
�.
Return (evaporetor�eritering) air dry:,bulb -
lemperature(T j " � ��
,return;iib.� � ,;g������. �
, Return(evaporator entering) air wet;:bulb ' ' �
temperature (T 62 Y�
retum, wb�'��"
.o_.._� .__..
,. .. ..,;.
Evaporator saturation temperaEure" : '
�Tevaporator, sat� - . . �Q '
� �'ondensor saturation temperature 93
� I�Tcontlensor, sat� . -
Suction line tempereture (Tsuction� 5S '
Liquid Line Temperature (Tliquid� ! 8i
Condenser(entering) air dry-bulb 78 - '
temperature(Tcondenser, db�
,
Reg: 212-A0001865B-M2500001A-0000 F.egistrati.cn Date/'Pirne: 21i12/C1/.11 16�.27:G9 HERS Provider: Ca10ERTS, Inc.
2008 'Residential Compliance Forms August 2009
. . . . . . . . � y,+� ll
INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS
Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5)
Site Address: Enforcement Agency: Permit Number:
20749 Northampton st, Walnut CA 91789 City of Diamond Bar PR20110001611
Minimum Airfiow Requirement
Temperature Split Method Calculations for determining Minimum Airflow Requirement Por Refrigerant Charge
Verification.The temperature split method is specified in Reference Residential Appendix RA3.2.
System Name or ldentification/Tag System 1
Calculate: Actual Temperature Split =Treturn, 20.00
db-Tsu I db
Target Temperature Split from Table RA3.2-3 ZZ
using Treturn, wb and,Treturn, db �
Calculate difference: Actual Temperature Split- _Z '
Target Temperature Split=
Passes if difference is between -3°F and+3°F or,
upo oremeasurement, if between-3°F and PASS
-,100.F
Enter Pass or Fail
Note: Temperature Split Method Calculation is not necessary if actua!Cooling Coil Airflow is verified using one of the
airflow measurement procedures specified in Reference Residentia/Appendix R.43.3. If actual cooling coil aiiflow is ��
measured, the value must be`eqnal;;to;or greate�than the Calculated Minimum Airflow Requirement in the tab/e below.
�:i;
�:-
Calculated Minimum:Airflow Req'uirement(CFM) = Nominal Cooling Capacity(ton)X 300(cfm/ton)
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Y ���+.� ..- +e���: �����,.�'��' - ��s $�1StCf11 �.t'' ��� .,."�,n.-+3 �" . +� 3� �§s�'ff� ' f,�.�:,.
. ,t i . i �i4'���", �. �4 ��:e:.H,.,�ct.fi. " ���-'�_ . .w�,���.�`„�'
� �3 '4 ^' ✓,lA. F � a�, '�' .�-' ' T�3 ' � , ' p_ rn,v'°,�, . . �v .,,
� Calculated�Mimmum AirFlow Requir'ementY(CFM) ���`'��� � �� �, ,ra �, q � ��` �
ut � � �� �
� ' �'�`'i�'� ' � f� �'��s''��3�a�``•�5.�^ arz3 ` i.��i `��i� .�`��" ���' ��s� � F��'� # ;k�w�'�x��.i ,�,a„ .'d ^y. • • . -
� ,�`3+� R�"� r��`� �a1�'� 1 , �j{ `� XI"y &,Y^6 �. x � 4�G � ' 'rr�'
� Measured�Airtlow�using�RA3:3,proceclures,�(CFM) � ���x �,w �,,° ,,� � � ;r�,�� ;i � � r -� �
� � : r ���, � �
1
,�4�� °..i �r�x i�.,'�.��'�'.,.,ar.��.+,a&"���L.s�a.w�..��"�4�"yu�..t�''�'�..�fFa„� �r+���� �. � v I, ri�.�'��� ?.a2���':�.` .
_.«.�_ t. ��k.�Y'.t� - . , ,. ..� .
� Passes"if�-measured��airflow'is,grea[e��than o"r, >� ��� ��'-�• ��~ ""� ����`��� ��.����� � ~� �.�_���,�<_� �
equal,to the ca�culaEed minimum.air,flow; ' �
requirement `� � '`: ,
` ��:' "p Enter Pass or Fail
, � ..�
Superheat Charge Method�Caiculations for Refrigerant Charge Verification.This procedure is required to be used
for fixed orifice metering device'systems
System Name or ldentification/Tag System 1
Calculate: Actual Superheat =
Tsuction �Tevaporator, sat
Target Superheat from Table RA3.2-2 using
Treturn, wb and Tcondenser, db
Calculate difference:
Actual Superheat-Target Superheat=
. System passes if difference is between -5°F and
+S�F
Enter Pass or Fai
Reg: 212-A0001865B-M2500001A-0000 Registration Date/Time: 2012/O1/11 16:27:09 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS
Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5)
Site Address: Enforcement Agency: Permit Number:
20749 Northampton st, Walnut CA 91789 City of Diamond Bar PR20110001611
Subcooling Charge Method Calculations for Refrigerant Charge Verification.This procedure is required to be used ` ,
for thermostatic expansion valve (TXV)and eledronic expansion valve (EXV) systems.
System Name or ldentification/Tag System 1 ' ,
Calculate: Actuai Subcooling = 12.0
Tcondenser, sat'Tliquid
Target Subcooling specified by manufacturer 12
Calculate difference: �
Actual Subcooling -Target Subcooling =
System passes if difference is between
-3°F and +3°F PASS
Enter Pass or Fai
Metering Device Calculatio�s for Refrigerant Charge Verification.This procedure is required to be used for
thermostatic expansion valve(TXV) and electronic expansion valve (EXV) systems. "
System Name or ldentification/Tag System 1
Caiculate: Actual Superheat,= � �.�
Tsuction -Tevaporator, sat.'
Enter aliowable superheat,range from'�
manufacturers specifications (or use�range
betwee,n.4'F and 25°F.if manufactu�er's 4-25
specification is not ave"ilable)
System passes if acEual�superheat isv„v�nthin�the ` ' �"` ` � `s � �� �"r^•��r ,� ^�,
allowables�perheaE��range �;�, �,r,�`�'�`� ��� p��s �r�� �`�`���� '�� �� ����� � `�-a�a ����
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:.s.'�y i� t '"C, ",:,`'�.� cNA;..� fi���'����m�y-""`��,�t�'rf�� .:;x"���i;., x �y�,dd :�n� AVr.� �w,,�"�y'' ., �Q����� .
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Reg,: .212-A0001865B-M2500001A-0000 Registration Date/Time: 2012/O1/11 16:27:09 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms � August 2009
IMSTALLATIOfd CERTIFICATE CF-6R-FIECH-25�HERS
Refrigerant Charge Verification - Stanclard Measuremenr Prdcedure (Page 5 of 5)
Site Address: Enforcement dgency: Permit Number:
20749 Northampton st, Walnut CA 91789 City af.biamond Bar PR20110001611
Standard Charge Measurement Summary:
System shall pass both refrigerant charge criteria, meteri�g device criteria {if applicable), and minimum cooling coil
airflow criteria based on measurements taken concurrentl durin s stem o eration. If corrective actions were taken all
Y 9 Y P ,
applicable verification criteria must be re-measured and/or recalculated. ,
System Name or ldentification/Tag Systeny 1
System meets all refrigerant charge and airFlow
requirements. PR15S
Enter Pass or Fai
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DECLARATION'STATEMENT a"''�•
y I cerfifyunder`penalty of perjury under.the Iaws of the State of California,the informatiun provided on this form is true and correct.
.I am eligible under Division 3 of the'Business and Professlons Code to accept responsibility for construction,or an authorized
representative of the person resporisitile for construdion(responsibSe person).
o I certify that the Installed features;rriaterials,components,or manufactured devices�dentified on this certificate(the installation)
conforms to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the
enforcement agency.
.I understand that a HERS rater will check the installation to verify compliance,and that that if such checking identifies defects,I am
required to take corrective action at my expense. I understand that Energy Commission and,FiERS provider representatives will also
perform quality assurance checking of installations, including those approved as part of a sample gruup but not checked by a HERS
rater,and if those installations fail to meet the requirements of such quality assurance cfiecking,the required corrective action and
additional checking/testing of other installations in that HERS sample group will be performed at rny expense.
o I reviewed a copy of the Certificate of Compliance(CF-iR)form approved by the enforcement agency that identifies the specific
' requirements for the installatlon.I certify that the requirements detailed on the CF-iR.that apply to the installation have been met.
.I will ensure that a completed,signed copy of this Installation Certificate shall be posted,ar made available with the
building permit(s)issued for the building,and made available to the enforcement agency[or all applieable inspections.I
understand that a signed copy of this Installation Certiflcdte is required to be incl�ded w�th the dxumentation the builder
. provides to tha building owner at occupancy. I will ensure that all Installation Certificates wiil come from a HERS provider data �
registry for multiple orientation alternatives,and beginning Oc[ober 1,2010,for all lovrrise residential buildings.
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
VIGIL AIR '
Responsible Person's Name: Responsible Person's Signature:
Robert Vigil Robert Vigil
CSLB License: Date Signed: Position With Company (Titie):
864284 12/8/2011
Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable):
Control Program (TPQCP)? Yes No �
Reg: 212-A0001865B-M2500001A-0000 Registration Date/Time: .2012/O1/11 16:2�:0° HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-MECH-0
Space Conditioning Systems, Ducts and Fans (Page 1 of 2)
Site Address: Enforcement Agency: Permit Number:
20749 Northampton st, Walnut CA 91789 (System 1) Ci,ty of Diamond F3ar PR20110001611
Space Conditioning Systems
Heating Equipment
Duct
E�ciency Location
Equip (AFUE, (attic,
Type ARI #of etc.)1,3 crawl- Heating Heating
(package- CEC Certified Mfr. Name Reference Identical (>=CF-1R space, Duct Load Capacity
heat pump) and Model Number Numberz Systems value)4 etc.) R-value (kBtu/hr) (kBtu/hr) ,
Split KENMORE
Furnace G8MTL0701412 1 80 N/A Attic 70 kBtu
' Coo/ing Equlpment
' Efficiency Duct
Equip (SEER Location
Type � and EER) (attic,
(package,:� : 5„, ARI #of 1,3 crawl- Cooling Cooling
heat CEC,Cect(fied Mfr Name;. Reference Identical (>=CF-1R space, Duct Load Capacity
pump) ;; '. and�Model Numtier;;;�,; NumberZ Systems value)4 etc.) R-value (kBtu/hr) (kBtu/hr)
Split ,' , KENMORE ;;:
A/C �: :� ,���'.�*a`;�C4A336GKD , :,�«c�r Y .,�:t?.�t'���r�: ,.1,��z�+13 SCER�i� Att�c�+� „<:.ti'?�?�� .„�';'�" �s.,,,. 3 Tons
k��
gY+ ! t,�:..�.`� e,,. ���Y �' �-,'; y��,, .'� A.-s �dt'''� ��'�� ,�.tau ''£ �a ,� :"'
�� . nra �'b� �
.�.�� ��rA'R�.�'"d�` ���; - +C..�...� �+�� �a'��A v��'. i �s.�� � ��
� .
� �' ' +�� ��1�s���'�i��� ���,�'t°v � �''� °� h'� � € a�'� � �r �-� �"r"' �� �
�.��� J S l���� �`�$t� : ,A,�...2 � .
w� ^'�'^v''�^�51 tYs%�?4 xm�=�'ksd"'x � � s�€Yb �'k'u -t � _.'��. .
iY,�? �.����,��,x'•�`�xt��a��� � � �`C � .� �` *�k���,�1.-'�?��� w `'� �� r r '�.z� �Y ;p .
a:tiAa r x.txx a •c" u.+:.�i �`'*�.::�� v�`r� "h �r'��g' `�'�vc+'�4�dt ���:��`�e�r �� .1 � ��...�. �M���• � � � ' .
, .� .!� t� w,�;�a t ,:?# 1 � -;"par �� ' '
� � '������ ����.t����.,
,. �, ��r;�..�� �,,,. �, �;+� � .
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1. If p�oject is new construction, se'e'`Footnotes to Standa�ds Ta6/e 151-8 and 7able 151-C for duct ceiling a/ternative
compliance. �';;' ..
2. ARI Reference Number can be found by ente�ing Ihe equipment modei nurrl6er at
http://www,aridirectory.o�g/ari/ac:php#
3. [.isted e�ciency on this page must be greater than or equa!( ?)fo the value shown on tire CF-1R form.
4. When CF-IR is reference it is also applicab/e to the CF-1R, CF-IR-AA or CF-IR-ALT
�1LL BOXES PAUST BE C!-lECK�D Tf� B� �4 !/d�LID FORNI
� §110-§113: HVAC equipment is certified by the California Energy Commission.,
� §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SPAACNA, or ACCA.
� §150(i): Setback Thermostat on ali applicable heating end/or cboling systems meet the requirements of
§112(c).
� o150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets
minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in
conditioned space.
Reg: 212-A0001865B-M0400001A-0000 Registration Date/Ti.me: 2012/C1/11 16:24:So HEPS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms August 2009
If�lSTALLATION CERTIFICATE CF-6R-MECH-0
Space Conditioning Systems, Ducts an�i Fans (Page 2 of 2)
Site Address: Enforcement Agency: Permit Number.
20749 Northampton st, Walnut CA 91789 (System 1) City•of Diamond Bar PR20110001611
�.Ducts and Fans
§150(m): Duct and Fans
� 1. All air-distribution system ducts and plenums installed, sealed and insulated to meet the
requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply-air and return-air
ducts and plenums are insulated to a minirnum installed level of R-4.2 or enclosed entirely in
conditioned space. Openings shall be sealed with mastic, tape or other duct-closure system that meets
the applicable requirements of UL 181, UL 181A, or UL 1816 or aerosol sealant that meets the
requirements of UL 723. If mastic or tape is used to seal openings greater than �/a inch, the combination
of mastic and either mesh or tape shall be used; and
� 1. Building cavities, support platforms for air haridlers; and plenums defined or constructed with
materials other than sealed sheet metal, duct.board.or,flexible du�t shall not be used for conveying
conditioned air. Building cavities and suppart platforms may contain ducts. Ducts installed in cavities
and support platforms shall not be compressed to cause reductions in the ci-oss-sectional area of the
ducts. •
� 2D. Joints and seams of duct systems and Lheir components shall not be sealed with cloth back
rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands.
� 7. Exhaust fan systerrts have back draft or automatic dampers.
� 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible,
manually operated dampers:
� Protection of Insula[ion.:�;Insulation shall be protected from damage, including that due to sunlight,
moisture, equipment'maintenance, and wind. Cellular foam.insulation sha{I.be protected as above or
paint,ed with,a coating that is`water retardant and provides shi�lding from solar radiation that can cause
�degradation of the matenal.�: '-`,
� 10:Flexible ducts cannot,have porous inner cores.
��'�� �.�� `�"��r � '�� ���'� �'n� �`'�
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r. �.� L��������w�,�' _ _ `��r`�}��� �4 �"+'��'�j�'1 �" `� '
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"� ��� �����t °r`"Y� � ��w�a,�.y r�' ���� �� a� ,r�� ` � '� � _ .
,::' 9�r � ��� � �`!`�'��»} t ,�,x'���,s�,�'"�`�'.E�x�'",t,�y� 3� `�,�''��c.� r �. '$t'�'�� '�'�"�'S£�-�-�� ��' ��'�'.:: .
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DECLARATION STATEMENT ,�;,"� ' . . ' -
,t_�3.F t , . � � � . . '
.I certify�nder pe'naltyof pe�jury,under„the laws of the State of California,the inforrnation prcvided on tnis Form is true and correct.
.I am el�gi6le,unde�`Division 3 of the.3usiness and Frofessions Code to'zecept.responsibility forconstruction,or an authorized
representative�of the person iesponslblE.For construdlon(responsible person).
•I certify that the installed features materials,components,or manufactured devices identified on this certificate(the installation)
conforms to all applicable codes and regulations,and the fnstallation'rs cansistent wifh the pians and speciflcations approved by the I
enforcement agency.
•I revlewed:a copy of the Certificate of Complianee(CF-1R)forn approved by the enforcement agency that identifies the specific
requirements for the installation.I certify that the requirements detailed on the CF-iR that apply to the installation have been met.
.I will ensure that a completed,signed copy of this InstailetiQn Cercificate shall be posted,or made available with the
building permit(s)issued for the building,and made�vailable to the enfarcement agency for all applicable inspections.I
understand that a signed copy of this Installatioa Certificate is.required to be included with the documentation the builder
provides to the building owner at occupancy.
Company Name: (Installing Subcontractor or General Ccntractor or Builder/Owner)
VIGIL AIR
Responsible Person's Name: Responsible Person's Signature:
. Robert Vigil Robert Vigil
CSLB License: Date Signed: Position With Company (Title):
869284 12/8/2011
Reg: 212-A0001865B-M0400001A-0000 Registration Date/Time: 2012/O1/11 16:24.:16 HERS Provider: Ca10ERTS, Inc.
2008 Resident_al Compliance Forms August 2009
I Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACA/terations CF-iR-ALT-HVAC
Climate Zones 2,9 •
Site Address: Enforcement Agency: Date: Permit#:
20749 Northampton st Walnut, CA 91789 City of Diamond Bar )an 11, 2012
Duct insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat
Package Unit
� Furnace �AFUE 78% COP �Setback
Served by system
�Indoor Coil �/SEER 13.0 HSPF R 6(CZ 2 and 9) 1266 sp If not already present, must be
� Condensing Unit EER Resistance installed)
Other
1.Equlpment Type:Choose the equipment berng installed;if more than one system, use another CF-IR-ALT-HVAC for each system.
2.Minimum Equlpment Eff/clenefes: 13 SEER, 78%AFUE, 7.7HSPF fo�typical�esldentia!systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one ot the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final,the inspector verifies that the work listed on this
form was in fact Ehe work completed by the installer.The inspector also verifies that each appropriate CF-6R and registered CF-4R
forms (no hand filied CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010,a registered copy of the CF-iR
and CF-6R shall also be on site for final inspection.
� 1. HVAC Changeout Required Forms:
.All HVAC Equipment CF-6R forms: MECH-04, ����r,�,.�._�„�,s EXEMPTED and (for split systems) MECH-25-HERS
replaced CF-4R forms: ^�_,-,��EXEMPTED �1�NOand (for split systems) MECH-25
.Condenser Coil and/or CF-6R forms: MECH-04,��„�i�=�� EXEMPTED and (for split systems) MECH-25-HERS
.Indoor Coil and/or CF-4R forms: M=�,�EXEMPTED and (for split systems) MECH-25
.Furnace
For Split Systems: Duct leakage,< 15 percent; RC, CCA z 300 CFM/ton,TMAH
c..�es..��.�..ed n..:�... n..,.c i,,.,i,-..:s.: :y r..
Exempted from duct leakage;testing,<if:`
" 1'`Duct system'was documented_to have been previously sealed and confirmed through HERS verification, or
2:'Duct.systems with Iess.than 40 linear feet in unconditioned space, or
� 3:fzisting duct systems are".constructed, insulated or sealed �Nith asbestos �
4c Th,e,�system�will;not be Du,�cted (ie.�DuctlessP,Min��SpI�t45ystem),(AIso�E,xempt fno�Refrigecant�Charge)
2 New`�HVAC,System Requir.,ed Fnorrrts. � � ��� r 4'���",,��,,,x E V�, - `��l �
,4 r.1
.Cut in�or�Changeout with�ti.;�4 E e�;���-� � ,��,�� < r �� ,�.�', �� ��a� 4
new ducts''(all new , ° C� 6R forms MECH-04, ^�_� �� �=o��EXEMPTED and (for split systems) MECH 25 HERS
e.m ���� �, �+ �� � r+�,�ro�-'�-..s�� �ar� �v ,�ar�m ' a�t,� � "rR.��� �r
ductin � all�new '� ,CF 4R forms MECH 20 ancl (for spllt systems}�MECH 25,,��� � �� ; ��y � � "� , - � �� �
EGUIpfT1E� ��'�� �"'�`��'�� �� �x..._„�"ar,.. �c�" 5 �'� .»z i} � � Vi �, , � :� ��:t .
P Y � a� ��� 9 �.� _�, :,, ,'. ,���3,00 CFM/ton�TMi4H t ��� , .. ��� .� ��_�:��"��s ..Y..� i
For S I�t S'stems..Duct leaka e<,:6 ercent RC;�CCA»
�.:
For Packaged Units: Duct leakage�c,6, erc.ent '' " " ' ' ''
r �,. P
3. NewaDucts vi►ith.Replacem'e'nt`. Required Forms: �
.Include's�'replacing.or inst@Iimg ail: ',`=
new.ducting and/or ouEdoor , CF-6R forms: MECH-04, ^^_��_,.,�,�,�og EXEMPTED and (for split systems) MECH-25-HERS
condensing unit and/or indoor coil ' CF-4R forms: MECH 21 and (for split systems) MECH-25
and/or furnace. Not all equipment:s'`'
changed.
Far Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton,TMAH
For Packaged Units: Duct leakage < 6 percent .
4. New Ducting over 40 feet Requfred Forms:
.Includes adding or replacing more CF-6R fonns: MECH-04
than 40 linear feet of duct in � ML���u '��EXEMPTED
unconditioned space.
CF-4R forms: ^•_���EXEMPTED
For split system or packaged units: Duct leakage < 15 percent
EXCEPTION: Existing duct systems constructed, insulated or sealed with asoestos.
Contractor(Documentation Author's /Responsible Designer's Declaration Statement)
.I certify that this Certificate of Compliance documentation is accurate and complete.
.I am eligible under Dlvision 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
Compliance.
.I cert(fy that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24,Parts 1 and 6 of the Callfornia Code of Regulations.
.The design features identified on this Certificate of Compliance are consisterit with the information documented on other applicable compliance
forms,worksheets,calculations,plans and speciflcations submitted to the enforcement agency for approval with the permit application.
Name: Signature:
Company: VIGIL AIR Date: Jan 11, 2012
Address: 11029 CANDOR ST License: 864284
City/State/Zip: CERRITOS/CA/90703 Phone: (562) 818-5001
Reg: 212-A0001865B-00000000-OOCO Registration Date/Time: 2012/O1/11 .1b:18:40 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 201C
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5)
, Site Address: Enforcement Agency: Permit Number:
20749 Northampton st, Walnut CA 91789 City of Diamond Bar PR20110001611
Note: If installation of a Cha�ge Indicator Display(CID)is utilized as an alternative to�efrigerant charge verification for
compliance, a MECH-24 Certificate(instead of this MECH-25 Certificate)shou/d be used to demonstrate compliance with
the refrigerant charge veri�cation requirement. TMAH and STMS are not requi�ed for compliance, when a CID is utilized
for compliance. '
As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional fo�m(s)for
any additional systems in the dwelling as applicab/e.
Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement
Sensors (STMS)
Procedures for installing TMAH are specified in Refe�ence Residential Appendix RA3.2. If refrigerant charge ve�ification is
�equired for compliance, TMAH are also�equired for compliance. STMS are only�equired for completely new or
replacement space-conditioning systems that utilize prescriptive compliance method.
TIKAH-Access Holes in Supply and Return Plenums of Air Handler
System Name or ldentification/Tag System 1
System Location or Area Served Whole House ,
1 �Yes No ,` 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and
labeled according to Figure in Section RA3.2.2.2.2.
2 �Yes No, '�E'? S/16 inch (8 mm) access hole downstream of evaporetive coil in the supply plenum
� and labeled according to Figure in Section RA3.2.2.2.2.
Yes to;,l:and_2 is,,,,a pass,` ;;;�'�;� . Enter Pass or Fail ✓ � Pass � Fail
�, , .,
ti � �
��
STMS Sensor on the,Evaporator�Cml ..:+,
�.�+�,.,��;��,;��....�-:u ��-�w�c�,. y�=�n�am� .:ax:�w.�,..
, System Nar�ia,or�,Identiftcation/Tag _�� �;�� �`-�System�i� , ,t��;; �k�''��_ .���� ,��«�r^� ��� ti "��
� ��`:� .� � ,�, ��}The�sensor is factory�lnstalled,�or,�field in�stallec!�'accor,dtrig to manufacturer s �
3 � sYes \ �N�o� � speufications, or is installed by methods/specifications a'pproved�by the Executive
'� �am+��`�'�'�;DII"eCY01' � q"��a,z.�� c -�.� �z«�'" _. �'� u irs ��' �r`t++� !Ik.��,'��.�
� � an� . � � ,�S r�'�* . �so 4"#y� .. �
4 ��Yes��'���'��`� �'�The sensor wi`re'is termmated wi�fh�a stantlard,mirti�plug'suitable'for connect on�to a�
� ,��.No� digiialthermometer TheCsensor�mini plug�s�accessible,to the insiallingatechnician ,.,^�.;
= P..� . .
�� � �" • ��=�' ���`'and th"e�HERS��ratertwithouh°eHanging�the'aii�floov`th�rough the�con'denser coif� � � _ �
5 �-.Yes a No �;When attached to a digital thermometer,the sensor provides an indication of the
"`,;; ;s"saturation temperature of the coil.
Yes:to 3, 4;and 5 is a pass.:Enter N7A�if STMS are not
. � ✓ � N/A � Pass ✓ Fail
applicable.Otherwise entec,Pass or!Fail:'
_;:;;
•�.:
- ',
STMS-Sensor on the Contlenser Coil
System Name or ldentification/Tag 5ystem 1
The sensor is factory installed, or field installed according to manufacturer's
6 Yes No . specifications, or is installed by methods/specifications approved by the Executive i
Director. j
The sensor wire is terminated with a standard mini plug suitable for connection to a
7 Yes No digital thermometer.The sensor mini plug is accessible to the installing technician
and the HERS rater without changing the airflow through the condenser coil
8 Yes No When attached to a digital thermometer,the sensor provides an indication of the
saturation temperature of the coil.
Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ,i � N/A � Pass �/ Fail
applicable. Otherwise enter Pass or Fail
Reg: 212-A0001865S-M2500001A-M25A Registration Date/Time: 2012/O1/11 16:32:25 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms March 2010
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5)
Site Address: Enforcement Agency: Permit Number:
20749 Northampton st, Walnut CA 91789 City of Diamond Bar PR20110001611
Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F)
P�ocedures fo�determining Refrigerant Charge using the Standard Charge Measurement Procedure aie ava!lable in Reference Residential
Ap'pendix RA3.2.As many as 4 systems In the dwelling can be documented for compliance using thls form.Attach an additional form(s)for
any additional systems in the dwelling as applicable.
•The system should be Installed and charged in accordance with the manufacture�'s specifications before starting this p�ocedure. .
• The system must meet minlmum airflow�equlrements as pre�equisite fo�a valid�efrigerant charge test.
•If outdoor air dry-bulb!s 55°F or be%w,the installer must use the Alternate Charge Measurement Procedure.
; Space Conditioning Systems
System Name or ldentification/Tag Systein 1
System Location or Area Served Whole House �
Outdoor Unit Serial # E113403224
Outdoor Unit Make KENMORE
Outdoor Unit Model C4A336GKD
Nominal Cooling Capacity Btu/hn.` 36000
Date of Verification 12/20/li
;;i;,
Calibratiori of:Diagnostic Instcuments
DaEe of Ref�igerant Gauge Calibretion , 12/1/il (must be re-calibrated monthly)
��- �'��:� :,� �-��.. i ��ta ���-� r.� ::. r � .� '.��u 1 3 .
Date ofThecmocouple Calibration , � ��a� , �� �12/iJl�i a�� ���� a� �,;(n'�iu i���be re calibrdted rrionthiy)
���"n' ��.t �n ;x: a
�u.r� S�,�Y ,�i�.:�'�.^i�°
Measured'Temperetures(,°F)���"'�, ��.�'; � ;y,�, ��, �� � �,� -� �� .l�s
.t �s.� ' � � i` � � � � 4` � '�s � �--- v r-�e�`� .�c � w� y .
� System Narrie or ldenriflcation/Tag�,,, "�" ` System 1 '" �' �� ,�`� t�w�' * ,� ,�,��,�'�'',� �'""�" � ��'� �
�S:�w.a, aar�',��z='g� .�,��r�: ��r;: ��.Y_rt�?.+,,e.. .�� s���"��.s��r'�.., �?.,fi� :`.;t�,..- :'�..,:! hl� ��
_._
SuPP�Y �evaporator�leaving):airdry Eiulb'������"�;r'�50�.�`''`}� ;,��.��� ,-: �„--� -�ci� . s��- �;� � :�� ,�:u;'�
� temperature�(TsuPP�Y, db���� ���� „ �.: . . �, , . .- ,
Return"(evaporatorrentering) air dry�:;bulb 71
temperature(Tretum,db) ''
a,�.:'.;
Return (eJaporator entenng) air wet=6ulb 60
temperature (Treturn wb�..'�; �� .
Evaporetor saturetion temperature?`,'
�Tevaporator, sat� 25.5 .
Condensor saturetion temperature 79.2
�Tcondensor, sat�
Suction line temperature (Tsuction� 42•�
Liquid Line Temperature (Tliquid� 66.5
Condenser(entering) air dry-bulb 64
temperature (Tcondenser, db� ,
Reg: 212-A0001865B-M2500001A-M25A Registration Date/Time: 2012/O1/11 16:32:25 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms March 2010
INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5)
Site Address: Enforcement Agency: Permit Number:
20749 Northampton st, Walnut CA 91789 City of Diamond Bar PR20110001611
Minimum Airflow Requirement
Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge
Verification.The tempereture split method is specified in Reference Residential Appendix RA3.2.
System Name or ldentification/Tag System 1
Caiculate: Actual Temperature Split =Treturn, 21.00
db"Tsu I db
Target Temperature Split from Table RA3.2-3 18.3
using Treturn, wb and Treturn, db
Calculate difference: Actual Temperature Split- Z.�
Target Tempereture Split=
Passes if difference is between -4°F and +4°F or,
uponaremeasurement, if between-4°F and pASS
-100 F
� Enter Pass or Fai '
Note: Tempereture Split Method,Caiculation is not necessary if actual Cooling Coil Airflow is verified using one of the
airflow measurement p�ocedures sp?cified in Reference Residential Appendix R.43.3. If actual cooling coil airf/ow is
measured, the value must be equal�to or greater than the Calculated Minimum Airflow Requirement in the tab/e below.
�,_ .
Calculated'M�mmu.m Airflow Requi�ement(CFM) = Nominal Cooling Capacity(ton)X 300 (cfm/ton)
'�;� �
�� y �^+�s.� � ;� n'�'v -�"'' '�,{r, � s �P �9 '� r w � ,�- �t .�'**'., .��
System Name or lde�Yification/Tag � r � ;f� � ���'� g �€ , € � l'' � �� E ��� s x,:
�. '�,.> r�i ,��d�xi`� � ,� ,.# ��i '��a i ��`'�t��.' � &�aqa, i r.
r_.
Calcufated Mini'mum Airflow�Requi�reme'nt(CFM) �"���""��,, ��r ���.'-��g ' �rss , ������ ,•�' _ �;���
� � C S�rr z�� � �r�a'� � �e. �' E�� �r�a �'�o- �'.�#'""tFA� r�"� �'++":��
"4�j^^+�?�. t3"�� �d t-�,�aax Pc� ��.�+,� � -s*� d n. ..,s ri�k i .
Measured A�Gflow us�n x �`�"� �" '� �� "�' � '� �`' "� i �
� g RA3���procedures�(CFM)� x � � * �� r � � � t, �°'�
"X s�an . � r � r 'Y� ��e `��' ��R<'�A��+h � � +L �`t �
�,o-.�� �.;" _�' f`.�, ,:�����:a��k��.��. :;�. �� '��` �"�_� .,��. , �` ,.x� , ' ��.� �`�:.^�.� �` �u''�r � �
�ve.F .�� ti
,..: , . . , .: ,; . . .
Passes if,measured'airflow is.greater�;than or�- • �; ' ~
equal to the calculated minimum airfl,ow �
requirementi� :�
' -` Enter"Pass or Fai
��r -
Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used
for fixed orifice metering device`systems
System Name or ldentification/Tag^ ' I
Calculate: Actual Superheat=
Tsuction -Tevaporator,sat I
Target Superheat from Table RA3.2-2 using
Treturn, wb and Tcondenser, db
Calculate difference:
Actual Superheat-Target Superheat =
System passes if difference is between-6°F and
+6°F
Enter Pass or Fai
Reg: 212-A0001865B-M2500001A-M25A Registration Date/Time: 2012/O1/11 16:32:25 HERS Provider: Ca10ERT5, Inc.
2008 Residential Compliance Forms March 2010
INSTALLATION CERTIFICATE " CF-4R-MECH-25
Refrigerant Charge Verification - Standard PNeasuremen4 Procedure (Page 4 of 5)
Site Address: Enforcement Agency: Permit Number:
20749 Northampton st, Walnut CA 91789 , City of Diamond Bar PR20110001611
Subcooling Charge Method Calculations for Refrigerant C1aar_qe Ver6fication.This procedure is required to be used
for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems.
System Name or ldentification/Tag System 1
Calculate: Actual Subcooling = 12.� �
Tcondens'er, sat-Tliquid
Target Subcooling specified by manufacturer 10
Calculate difference: 2� �
Actual Subcooling -Target Subcooling = , ,
System passes if difference is between
-4?F and +4°F • PASS . '
Enter Pass or Fail
,
h9etering Dedice Calculations for Refrigerant Charge d°erificatian.This Procedure is required to be used for
thermostatic expansion valve (TXV) and elecfronic ex�ansian valve (EXV)systems.
�ystem Name or ldentification/Tag Syste:n 1 �
Calculate: Actual Superheat= ';;:����': L'„a _ '"—
Tsuction 'Tevaporator, sat.;' ;. . ;;i��
Enter allowable superheat range from" �
manufacturers�specifications (or use'�range
between 3°F and 26°F if manufactur'er's �-25
specification is not available) �%�� . �_ �
System pasSesuif act'ual�superheat r5�within<the '�s� �,,,�„,1 � �� ��,;,� �;� n;� t x �
allowable su erh"eat ran e � �` � t �:� � � �' � '�° �� ��r� + �� �' `� �
,a�P,�� 9 � � ,�� ' P/lS.a � � i �S �'�`�. �{�, F
�� .� � � ':
=:
� .
�'r;tdN:,•� ��E�ft01'�Pa5ti4e„O��`F01 ���, k _��'�€_.t.'_'+.��'.�`°.!&,; .� �.�R°�" „� a M , . .
a, I
� ���' �''��7,�w r�,� �r��,t�.^��',� �,��,�.�:�:1�°1 � r,�' m✓ ..s' tp ' �
�z�� � ���E`h '�'�}�i'+c� �� v�z� P�ya,�� s � 1 r s '��� ;s�1 �- r�"�a���'0 I...-
'� �� ��� �£� �i,� ����7 '�' .� .t� e�'d .'�.�'"��a'. � a.� `s;.
� ns�F� �i� �} ��d �n�r � �' ,�` �i'X "� �- f '� �l+. .
� �'.�M`r � � ,� W,�"M EW" �«Y ��� i v,y, i�n �"� ���� xi. �r
-� . ,.�`�� � 3i;�"vr'3fv �i��T�-�,�r�',��x�.,a.���"�;rY S t'ixfz� �, �'�:£A�� ��,-�� � �y'r .. �'�� 3 S .��� a+�'t ,,.Y;'�ti��.
, :����` . . . �t'".�".� �s''r;, �`3 9 �..° .. "xT k _ �I[ �.i., .
.. . . . t-� . . � . . . . ... . .. . _. . . . . - .
� � ,. , I
� ... . . . ... ... II
Rey: 212-A0001865B-M2500001A-6125A Regi,stration Date/Tiine: .2012/Ol/11 16:32:25 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Formr. . March 2010
IIdSTALLATION CERTIFICATE CF-4R-MECH'-25
Refrigerant Charge Verification - Standard h9easurement Procedure (Page 5 of 5)
Site Address: Enforcement Agency: Permit Number:
20749 Northampton st, Walnut CA 91789 City of Diamond Bar PR20110001611
Standard Charge Measurement Summary:
System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil
airtlow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, ail
applicable verification criteria must be re-measured and/or recalculated.
System Name or ldentification/Tag System 1
System meets all refrigerant charge and airflow
requirements. PASS
Enter Pass or Fai
,
��. .
�.;
z> , � :4:;
�d`
� ����� ��t��� � � ��.
�rP '�f�,ay +1�� E �_ �,� '.5 i,���� �jf �' K
. . . �.. �,'� ��"; y ��.t 3�"�� �Y ���•�',e,i.G '' C-�U,.�*i%'�< e::t K j�.�, x'� i �tf��� .
��*�.�-� � �°���� ���� � � s� � 1 `t
�7� '� 't�i' }� ' �b �` �'� . � � ._ �
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r. �`{ '�� t, �'�'�� sr�r���'� �� ' .
��.yti�' � ��, �, . '�. r , x ,*� q+ �c.�.�r-mn �c�... .�ffi�,y:�.
] . : v� A' � '� ,�}' � .-y. . �'r A i d�� "b'�°�'��� `ik�' - 'm ry,:
i d 4a:� �+i �y�F�����..� '��'�� r#sk�sdq�`���,��� �;:��c� y �� �' � � � � �� � r�������� ��a� . .
':L rn�. tl r �,�' �""ti� � ��rl� `�.� ,� r .4 2 F.�_. . .
. _ � ... ` .�� ..': .'�,. . „ . . § , .
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DECLARATION'STATEMENT ''"
. I certify under penalty of perjury,,under the laws of the State of California,the informatlon provided on this form is true and correct,
a I am the certified HERS rater who performed the verification services identified and reported on this certificate(responsibie rater).
, The installed feature,material;component,or manufactured device reqWring HERS verification that is identified on this certiFlcate(the
installation)complies wfth the applicable i-equirementr in Reference Residential Appendices RA2 and RA3 and the requirements specified
on the Certificate(s)of Compllance(CF-1R)approved by the local enforcement agency.
. The information reported on applicable sections of the Installation.Certificate(s) (CF-6R),signed and submltted by the person(s)
responsible for the installation conforms to the requirements specified on the Certificate(s)of Compliance(CF-iR)approved by the
enforcement agency.
Builder or Installer information as shown on the Installation Certificate (CF-6R)
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
VIGIL AIR
Responsible Person's Name: CSLB License:
Robert Vigil 864284
HERS Provider Data Registry Information
Sample Group # (if applicable): N/A J tested/verified dwelling not-tested/verified dwelling in
a HERS sample group
HERS Rater Information Ca10ERTS Certificate#CCi-1798621330
HERS Rater Company Name:
Coast Aire
Responsible Rater's Name: Responsible Rater's Signature:
Don DeAngelis Don UeA�gelis
Responsible Rater's CertiFlcation Number w/this HERS Provider: Date Signed: 12/20/2011
CC2004161
Reg: 212-A0001865B-M2500001A-M25A Registration Date/Time: 2012/O1/11 16:32:25 HERS Provider: Ca10ERTS, Inc.
. 2008 Residential Compliance Forms � - � . March 2010