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Home My WebLink About13-759 ^T. " _��_ CITY OF DIAMOND BAR DEPARTMENT OF CONIMUNITY&DEVELOPMENT SERVICES �—• 21810 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 � PRESS II ��^^'�f BUILDING PERMIT APPLICATION FIRM LY JOBSITE ¢ ADDRESS �ZO N P� �n y� APPUCATION��2-? i3 PERMIT Zj�' P/C 0 1't�e A DATE NUMBER �� ` ti � APN LOT TRACT ISSUE Z� c3 TYPE pCC DATE Z- CONST. GROUP p OWNEfI na v i c� � Rnq Q�Y p ADDRESS 3 2� 'M �1�z-1-r<cJ� �Y ZONING SETBACKS oCITY i�t.,�z„o,,,elf3cw ZaP�I/765 TEL�Iv`l-��-f�/�/�t3d REART RW p o APPLICANT Sh.+,.✓vr re�,�i�r -rc.�s TEL.qoq-NNS-Cufs�r SIDE/SIDE STREET RW O �� CONTRACTOR(�{j��3,f�fr�-,1 garv Ycs SIDE ❑ ADDRESSU'75/ /�-r��.-J I�-},� r.�1-c�y � CfTY Pqovr�-aCc+-t/ 21P q l 7b 3 TEL�/D 9-�f'�S-axt� PROPOSED USE w ARCWENG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p 1 HEAEBY AFFlRM W�IDER PENALTY OF FEiLRlRY THAT I AII IXEIdPT FROM THE CONTMCTORS U- G8f3g0/CBIPOfI ' W CENSEUWFORTIEFOLLOWWOREISON(SEC.7mt.5BU5WE55M1DPROFE5S10N5CO0EANYp7YOR (n � C-� ODUNTYNTi1C7iRE0UIRESAPEHMITTOWrlS7RUGi.ALTEA,WPROVE.DFAlOLISH.ORfiEPAIAPNY9iAUG w . w NRE,PRIOR TO RS ISSUANCE,ALSO REWIRES iHE MttIGWT FOR SUCH PERMIT TO FlLE A SK3NED w P8�i0/DBLI( STATENEHT THAT HE OR SHE IS LICENSED PURSUANT TO TNE PROVISlONS OF THE CONTMCT00.4 LL � CENSE UW(pUPTER D(COMMENCW�WITH SECTION 7000)OF DMS10N 3 OF THE BUSW ESS ANO PRO U- PooUSpa . � 0 FESSqN5CO0�ORhUTHEOR5HE15E%EMP7TNEREFfiOMANDiHEBASISFORTHEALLEOEDEXEMP- (� . U T10N.ANYVIOLA710NOFSECT10N7Wt.6BYANVM7LICANTFORAPERAUTSU&lECT37HEAVPLICANTTO Z RB-ROOI � A C1VIL PENALTY OF NOT MORE 7NAN FIVE HUNURED OOlURS(SbOD).): � ❑I,ASOWNEROFTHEVFOCEHTY,ORA1vEMPLOVEESN/IiHWAGESASTHEIR50LECOMPENSA710N, 0 �mercial - � Z VALL DO THE WORK,M1D THE STRIKTURE IS NOT IMENDED OR OFFERED FOR SALE(sEC.70N,BUSF� J � NESS AND PROFESSIONS CODE 7T1E CONTRACTORS LICENSE UW DOES NOT A7VLV TO AN OWNER OF � PROPER�Y WHO BUILDS OR IMPROVES 7HERE011 M1D WHO DOES SUq7 WOqK H WSELF OR HERSQF OR � Q THROU(3H HI9 0R HER OWN EAIPLOVEES,PRONDED THAT SUCH IIIPROVEMQ7TSARE NOT PfTENDED OR m Q OFFERmFORSALEIF,HOwEVERTMEBUILDW�ORIMPqOVEMENTI550LpWfiHWpNEYEAROFCOW7LE- Z T10N,7HE OWNER�BUILDER 1NLL HAVE THE BUROEN OF PROVIN6 THAT HE OR S1iE DID NOT BUILD OR � PIPROVE FOR THE PURPOSE OF SALE} w ' �I,tiS ONNER OF TNE PROPERTV,AM E%CLUSNE�V CAHTRACT7NO WfTH IICENSED CONiFiACTOqS Q TO CONSTRUGt THE PROJECT(SEC.7aH,BUSINE55 AND PROFESSIONS CODE:7YiE COHTMCTORS LI- VOIUflilOfl AQI.AREA W CENSEUWDOE3NOTAPPLYTOANON7JEAOFAVROPEATYWFIOBURDSOqIMPROVE57HEREON,AND � VAiOCO�lTAACTSFOfiSUCHPR0.IECTSWrt1fACOMMCTOfi(5)l10EN5EDVUfiSUANTTOTHECONTHAG QUANTITY DESCRIPTION �E . � 70R5110EN5E LAW.). � ❑I AN D(EMPT UNpER BE4 B.6 P.G FOR TMIS R£ASON � ?� U tL ¢ . OATE OWNER F- � w F, . LJCENSED CONTi7ACTORS DECLARATION w � . � � � 1 HEREBYAFFlRM UNDER PENALTY OF PERIUFY THAT I AId LICENSED IJNDER VROVISIONS OF CMAGTER � . � Y(COMMFNC7i(i WfT?7 SECTION 7000)OF OMSION]OF THE BUSINESS M1D PROFESSIONS ODDE,NJD Z �� IAY LICENSE IS IN FULL FORCE AND EFFECT. m 'll � uceNSEcuss C_7�')1C3� uc.No. 7� 7�7 f � J v o�rE '7_27— !3 corrrw,croa �� _/' a w . � WORKERS'COMPENSATION DECLARATION '� � � I HEREBY AFFIHII UNDEA PENALTY OF GERNqV ONE OF THE FOLLOW W(i DECLARAT10N5: z � � � _IHAVEANDWtLLMIJNTNNACERTIFlCATEOFCONSENTTOSELHNSUREFORW'OPo(ERS gy � � COMPENSA710N.AS CROVIOm BY SECTION�10o OF 7HE UBOH CODE,FOR TNE PERFORMANCE W OF THE WORK FOR WH1Gi THIS PERMIT r3 ISSUED. � � � � � . QW _IHAVEMIDWILLMAPRAWWORI(EAS'COMPENSATIONINSURANCE,AsqEWIRED9Y5ECTION �700 OF THE LABOA CADE,FOR THE PERFORMANCE OF THE WOPo(FOR W/4CJ/THIS PERMIT IS �ssuEo.►n woauEas•couv�s�rar�wsuwwce c waEa um roucr muMeEA�aE: CONS'fRUCTION jc�atu�l �.� .� �r�� PLAN.REVIEW . . � POIICVNUMBER `FO�'7C94f U ql R� ELECTRIC o (nassEcrorar�mrareFaor,s�.F'r�oF'nfaaxrrawaa+E�x�n�ooalus�oo�ca�ss� PLUMBING w Z 1 CERTfFY'fHAT W 7HE PEAFOFiMnNCE oF THE wOPo(FOR WHICM iH�S GERAUT IS ISSUEO.I �MECHANICAL �. J C7 SHNl NO7 EMPLOY M1Y 7ERSON W ANV MqNNER 50AS TO BECOAIE SU&IECT TO THE � (/� WORI(ER5 COAIPENSATION UWS OF CALIFORNIA AND AGREE 7NAT IF I SHOUlO BECOME INSPECTION FEE S SUBJECT TO THE WiDRKERS COMPENSATIDN PRpV�S10NS OF SECTION 3700 OF THE U60R coa�,i sw�u wrnrnvrtH couv�r vnn�niosE vRov�sroas. ISSUANCE .T p DATE: ��7'� 3 APPL�ICANT: ,��y—�—C� �� .SMIP w ENERGY P/C � WARNINO:FAILURETOSECUREWORKERS'CAMPENSATqNCOVERAGEISIINLAWFUL,ANOSHAL�BE , � � SUBJECT AN EMPLOVER TO CRIMINAL CENALTIES ANU GVIL FlNES UP TO ONE HUNDRFD TMOUSAN� �ryERGY PERMIT DOLLAR9(f100,000�W ADDITION TO THE COST OF COMPENSAiION,DAMAGES AS PROVIDED FaH IN J 6ECTION 370!OF T1E LA80R(.'OOE,INTEREST,AND ATTORNEY'S FEES. � [L RETENTION FEE: Za GY O � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBYAFFlRM UNDER PENALTY OF PERJURY THA7 7HERE IS ACONSTRUCTION LENDWO A(iENc.'Y Z FOR THE PERFORMANCE OFTHE WOPo(FOq WHIp17M15 PERMIT IS ISSUED(SEC.3097.CIV.G�, , W � LENDERS NAME F- LENDERSADDRE55 � � ICERTIFYTHATIHAVEREADTHI3APPUGATqNANUSTATETHAT7HEABOVEWFORAlAT10NISCOMECT, TOTAL FEES q��$g � 1 AGREE TO COMPLY WITH ALL CITV AN�CAUN7Y OHOWANCES AND STA7E UWS RELA71N6 TO BURDINO � CONSTPUCfVON,ANDHERFBYAUTHOi112EREPRESENTATIVE50F7HI5COUNTYTOENTERUPONTHE Z �BOVE-NEMIONEDPROPER7YFOFiINSPECTIONVURP0.5E5. , COMMENTS � � S�'I.a.w-n Cc�.'�-4�e��S [O p EN�,MElpRllfn � ¢ � �— �_�y7 r�� uJ SK3NANREOFP RMfTTEE DATE pECPT.NO. PAIDBY VAUDATION � . � ' WHITE—DepaAmen[Copy.YELLOW--Finance Copy.PINK—Assessor Copy.GOLpENRO�File Copy,CiREEN—ApplicanCs Copy . . , . � , ,: ,. �6�'�/°` �� C�EA91fl�3f�1� �Af3 . �', �V' 6i��6��G�'IC��! ��RL� � a` � '� G- �� ' � -;' �~ � � � � � �. � A, i " :�.'S�k' _ ' SET BACK FLOOR JOIST r----- -- ---- - ------ FTGS/FORMS/STEFL . --- --------- -- ----- — FHP,REQMT; _ -- ELECTRIC GROUND �JNDER fLOC?R DUCT - �------------ -- GROURD PLUN161�G UND� ER OR CONDUIT _ SLAB GRADE __�_ —� i FIREPLACE FOUNDATION _ TENiP PO4VER _� FIREPLACE BOND AEAM WATER SERVICE AAID HT.BOP�lD BEAM ROOF SHEATHING �8 FT.BOND BEAM FRAMIPJG/VENTILATION ______ _ FINAL BOND BEAM ____ ______ _ ROOF COVER _ _ __ _____ PRE-GRADING _____ _ ____ __ ROUGH HEATING I I BEPJCHIPJG ___ _ _ ROUGH ELECTRIC f � ROUGI-I GRADING ROUGH PLUME31P1G (FiNISH GRA�ING SHOWER/TUBTEST POOL ELECTRIC EXT.LATH/SIDING � I POOL FENCING WALL INSULATIQN POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYbVALLNAILING DEDICATIONS _____ _ _______� SE4VER ---- -—�-- ------- FINAL ENG. - — SEPTICTANK ___ _ _ ___ LANDSCAPE/IRRIG_ _ _ __ SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING fiNAL CONST. FIRE DEPT.FINAL fINAL HEATING � HEALTH DEPT.FINAL FINAL ELECTRIC DEV.FEES PAID FINAL PLUMBING ENERGY ' FINAL PLANING � FINAL ENGINEERING ' 9 � COMMENTS -- -------- ---- -- --- -- SEPTICTANKSIZE _ __ _` SEEP PIT/U SIZE � - � Simplified Prescriptive Certificate of Campliance: 2008 Residential HVAC Alterations CF-iR-AI.T-NVAG Ciimate Zones 2,9 Sfite Address; EMorcemecrt Agency: Date: Permit#: � 320 N PINTARO DR Diamond Bar, CA 91765 City of Diamond Bar Feb 27, 2013 Dud insulation Conditioned Floor Equipment Typel List Mintmum Efficiency2 requirement Area Thermostat ❑Package Unit �Fumace (,�AFUE 7$% ❑CQP Served by system �$etback ❑Indaor Coil ❑SEER p HSPF ❑R 6(CZ 2 and 9) 1449 sf If not already present, must be ❑Condensing Unit �EER (�Reslstance insta!/ed) ❑Other 1.Equtpmenf Typer Chaose the equtpment heing lnstatled;ff more than ane system,use another CF-IR-AtT-HVAC for each system. 2.Ml�lmum Equlpment EMclencles: 13 SEER, 78°r6 AFUE, 7JHSPF for typlcal resldantlal systems. HERS VERIFICATIOIV SUMMARY l.isted below are FOUR HVAC alteration Qptions.The installer decides what wark is being done and picks ane of the apprapriate Optio�s. Each Optio�lists the HERS measures that must be canducted.A copy af the farms sha11 tae left on site for final inspection and a copy given to the homeowner. At flnal,the inspectar verifies that the work listed on this . form was in fact the work completed by the instaRer.The inspectar also verifies that each appropriate CF-6R and registered CF-4R forms(no hand filled CF-4Rs allowed)are filled out and signed,Begirtning October 1,2010,a registered copy oP the CF-iR and CF-6R shall alsa be on site for flna)inspectlon. I�1.HVAC Changeaut Required Farms: ' .AIt HVAC Equ�pment CF-6R forms: MECH-04,MECH-2I-HERS and {for spiit systems)MECH-25-HERS replated CF-4R forms: MECH-21 and (for split systems) MECH-25 . .Condenser Coil and/or �F-6R forms: MECH-04, MECH-2I-HERS and {for split systems) MEGH-25-HERS .Indoor Cail and 1ar CF-4R forms: MECH-21 and (for split systems} MECH-25 . . Furnace For Split Systems: duct leakege��15 percent; RC, CCA z 300 CFM/ton,TMAH ExempYed from duct leakage teskin°g i�f}'; . p 1:Duct-system'was documentedsEo have been previously seated and confirmed through HERS verification, or ❑2. Duct systems with less•than�40.1lnear feet in unconditioned space,or p 3. ExisCing duct systems are Gonstructed, insulated or sealed with ash'estos ❑`4:The�s,y,sEem�waii not be Duc``d`:(ie�,�e�#es,�t`'lic��p1�C�,�ter�j�E��xempt�fr,o et�,igerat�t Charge} . . .:�,,... .n��. .a-.w, ....�: . ..��.t�r.w..s, ��r�:.. ❑2.Niew�HYAG Systei» Requi t!=�ot`!�!s�`�-:, �� '�"�� `�"�"_. �',_„„;::" ��v��'��: .Cut in�nr�Ghangeout rei � ; °� � �_ „ �� ,� ��' � '� � ,.: �� new ducks�(all new � C,��,;,6�,2 o ' MECH-04, �HERS ( 4�split sy s) MECM Z H RS,.o. �""'E' ' ductErig�,�p�,a!!n�ew �, �C�=��R fo�"�9: MECHc O�a �� r�5pi :sy ty;�s} ECN-25 �� "�'� '�` � '� �� - e ui m�ht r � �� _� �� ,, 4 I? .. )� .�s�"a �.w ��r�K n,. �' '° " � �'�� x"''"��i�w��.a4 � ��,�� For Split System9;'�u�teakage�"a�5�'perc�n�,�R��CCA�300�C�Mjto ,��TMA�#��a�'� ��,�r v�r��"�'"" ""�` �"'" " . n:.,i ..Is�4 K' ��:�sa�+3ss..r� '�.��'��` §rx.�s .,��•�* ,�c'�s� :.i .,$q... A . , ., � ., For Packaged.t7nFtst Duct leaka:ge�<�6�percent�: . ,i:' O 3.:New;Ducts"�with Repfacement,;, Requlre�Porms: .Znclu,tles�repiecang or'installing_ail'�new'ducting � � and/oroutdaor condensin unit al1�i%or indoor CF-6R forms: MECH-04,MECH-2I-HERS and (for split systems) MECH-25-HERS coii and(or furnace. Not al�loequipment CF-4R forms: MECH 21 a�d {for spiit systems}MECH-25 '�:.' �,�,�;. changed. �;�„�, : For Split Systems: Duct leakage;<':6�percent; RC,CCA � 3p0 CFM/ton,TMAH Fvr Packagetl Units: Duct leakage z 6 percent O 4.'New Ducting over 40 feet Required Farms: .Includes adding or replacing more than 4Q CF-6R forrns: MECH-04, MECH-2I-HERS � , linear feet of duct in unconditioned space. CF-4R forms: MECH-21 For sptit system or packaged units: Duct leakage < 15 percent • [J EXCEPTION: Existing duct systems constructed,insulated or seafed with asbestos: Contractar(Documentation Author's/Responsible Designer's Declaratian 5tatement) .I certify that this Certificate of Compilance documentation is accuraCe and complete. , .I am eligibie under Division 3 of the California Business and Protessions Code to accept responsibiifty for the design identified.on ihis Certiflcate aE Compliance. .I certify that the energy features and performance specifications for the design identified an this Certificate of Campiiance conform to the requlrements of Title 24;Parts 1 and 6 of the California Code of Regulakfons. •The deslgn features Identifled on this Gerkificate of Compiiance are cansistent wtfh the information documented on other applicab{e'compliance forms,'warksheets,caiculations,plans and speclFlcations submltted to the enforcement agency for approval with the permit applicatfon. : Name: Scatt De Vore Slgnature;,�� pe Vors Company: QUA�TY CdNSERVATION SERVICES INC Date: Feb 27, 2013 . Address: 4751 ARROW NIGNWAY License: 757471 Cityf State/Zip: MQNTCLAIR/CA 1 91763 Phdne: (909)445-4454 Reg: 213-A0012546A-000000004-0000 Regietration Date/Time: 2013/02/27 11:23:51 HERS Pravider: Ca10ERTS, Inc. 2408 Reszdential Comp2iance Fozms . � July 201Q IPtSTA�LATION CERTxFICATE CF-6R-MECH-0 Spaee Conditioning Systems, Ducts and Fans (Page 1 af 2) Site Address: Ertforcement Agency: Permit Number: i 32Q N PINTADO DR, Diamond Bar CA 91765 (System �ity of Diamond Bar 13-759 1} ! i Space Conditioning Systems Neating Equipment Duct Efficiency Location Equip {AFUE, (attic, Type ARI #of etc.)1�� crawl- Heating Heating (package- CEC Certified Mfr.Name Reference identical (>=CF-SR space, Duct �oad Capacity heat pump) and Model Number Numberz Systems value)4 etc.) R-value (kBtu/hr) (kBtu/hr) Splik Goodman Furn�ce Grns80603ax 1 84 AFUE 80 77 k8tu Caoting Equipment , Efficiency DucC Equip (SEER location , , < ' 7ype . `;; and EER) (attic, (package ` ARI #of 1,3 crawt- Coofinq Cooiing heat CEC Certified Mfr,Narrie Reference Identical {>=CF-iR space, Duct Load Capacity pump) and Model Numtrer` . Number2 Syskems value)4 etc.) R-vatue (kBtujhr} (kBtu/hr) .r��.�, � ��'. �z. �, �� ' M:; ��.:.. �;'��, ,,yS4Y�`�;c.., �"�N': .r�,.. l`a&y". , _;. ,.� .. . ��. ,:.,,,. , ...- St�x s x,�'c� . .,..: �, ��.:� � . % '.�',�'? �,+ st x�� tz n s,�, ., �-� t � � � � . Y� Z a. . _. - " .� a. � w"}1�1�. ,�uv�,��:' � .�' ..;� .r"ti`.�. , .. . _ ,�,,,� �,.. � ��r �4k ... �y al .r �s�"°�` c- ._ Sdf+� �.� ��``�.E,�.:��,. �( �tw� 5,n1..�. :i,' a '...�',,,'9r'wr�' '� F�?,!4 ,�W.r 3�`# - � '^�Fk.+ � '` � g �'�fi r ��'Y" "µ �L`� � 3 � � � ` ^*Y ". ��r y` �.�1.��'S��i!3K ,.,§��t#� rr�",, �`�,*S� .�'4�� t,,,A� i��`�z ,� e : ras+��. xr�,:. �;.�� 2. If project is new constructron, see`Footnates to Standards Tatr1e I51-B and Tabte I51-C far duct ceiting aiternative compliance. � 2. ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.org/ari/ac:php# 3. tisted e�ciency on this page must be g�eater than or equal(?)to the value shown an the CF-IR form. 4. When CF-1R is reference it is a/so applicable to the CF-IR, CF-IR-AA or CF-IR-AL7 ALL BOXE� MUST BE CIiECKED TO BE � VALiD FORhri � §110-§113; HVAC equipment is certified by the California Energy Commissian. � §150(h}: Heating andJor cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. � §250(i): Setback Thermostat on ail applicable heating andJor cooling systems meet the requirements of §112(c). � §150(j}2: Pipe insu(ation for caoling system refrigerant suction, chilled water and brine �ines meets minimum requirements of Table ].50-8 and includes a vapar refiardant ar is enclosed entirely in canditioned space. Reg: 213-A4012546A-M0400001A-0000 RegisCration DatejTime: 2013/05/08 17:42:55 HERS Provider: Ca10ERTS, Inc. 2008 Resiclential Camp2iance Porms August 2009 _ ._ _ INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systemsr Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 32Q N PINTADO DR, Diamond Bar CA 91765 (System Gity of Diamond Bar 13-759 1) Ducts and Fans §150(m): Duct and Fans � l. Ali air-distribution system ducts and plenums instailed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 6Q3, 604, 605 and Standard 6-5; supply-air and return-air ducts and ple�ums are insulated to a minimum installed level of R-4.2 or enclosed entirely in canditioned space. Openings shail be sealed with mastic, tape or other duct-ciosure system that meets the applicable requirements of UL 181, UL 1$1A, or UL 1818 or aerasol sealant that meets the requirements of UL 723. If mastic or tape is used to seal apenings greater than �/a inch, the combination of mastic and either mesh ar tape shail be used; a�d � 1. 8uilding cavities, support platforms for air handlers, and plenums de�ned or constructed with materials other than sealed sheet metal, duct baard or flexible duct shall not be used far conveying conditianed air. Building cavities and suppart platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductians in the cross-sectional area of the ducts. �2D. 7oints and seams of duct systems and their companents shall not be sealed with elath back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. � �7. Exhaust fan systems have back draft or autamatic dampers. I �8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, I manuaily operated dampers. i � Protection af Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulatian shall be protected as above or pain[ed with a coating that'is water retardant and provides shielding fram solar radiation that can cause degradation of the material. �•10. Flexible�ducts cannot have por�ous�inner�cores�� ;�� ,�, � . »��' - �� .�;. � � �� ` � � � �� '�� '� n � � �i F M ,S `�� +�%' ;� �3; , - . ', �; �. `� � ° .: # # � �` � �� y �;�' �r. .� �� .�,.„�,, '�.� : � �� .� � y „ �` " �'.. �a"�� , � N��"�� '.�;, �� ti r�„;._ � ,�� ' �,�;' � . °�� .�:` '` �"�f� ., � : ._ , DECL%iRATION STATEMENT •I certify under penaity of perjury,under the laws of khe State of California,the informdtio�provided on this form is true and correct. •I am eligible under Division 3 oP the 8usiness and Professions Code to accept responsibility for construction,or an euthprized representative of the person responsible for construction{responsible person}. .I certify that the installed features;materials,componenCs,or manufactured devices identified on this certificate(the installation) conforms to aIl appiicabie cpdes and requlations,and the instat(atior�is consistent with the pians and specifications approved by the enforcement agency. •I reviewed a copy af the Certificate of Compliar�ce(CF-iR}Form approved by the enforcement agency thaC identiftes the specific requirements for the installation.I certiFy that the requirements detailed on the CF-1R that apply to the installation have been met. •I will ensure that a tompieted,signed topy of this Instaltation CerFif:�ate s�:a!I�e post��,or m:.�e avaiiable rnr9ih the building permit(s)issued for the building,and made available to the enforcement agency for al!appliceble inspections.I understand that a signed copy of this Installation Certificate is reqaired to be included witb the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractar or General Cantractor or Builder/Owner) QUALITY CONSERYATION SERYICES INC Responsible Rerson's Name: Respansible Person's Signature: Steve Gonzalez 5teve 6onzalez CSLB License: Date Signed: position With Company (Title): ��74�1 s11512013 Reg: 213-A0012546A-M0400001A-0000 RegisCration Date/Time: 2013/05/OB 17:42:55 HERS Provider: Ca10ERTS, Inc. 2408 Residential Compliance Porms August 2609 INSTA�LATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test- Existing Duct Sys#em �Pa9e 1 °f 2� Site Address: Enforcement Agency: Permit Number: 320 N PINTADO DR, Diamand Bar CA 91765 (System �i�, af Diamond Bar 13-759 1) Enter the puct System Name or ldentification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certi�cate for each duct system ttrat must demonstrate compliance in zhe dwetling. This installation certiFcate is required far compliance for alterations and additians in existing dwellings to space conditioning systems and duct systems. Note: For existing dwe!lrngs, a completely new or replacement duct system can alsa incJude existing part's af the original duet system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessib/e and they can be sea/ed. For a completely new.or rep/acement duct system installed in an existing dwelling, use the Znstattation Certificate titled "Duct Leakage Test- CompteteJy New ar Reptacement Duct System." Duct Leakage Diagnastic Test-existing duct system Select one compliance method from the following four choices. �1. Measured leakage less than 15°!0 of fan flow �2. Measured feakage to autside less than 10°to af Fan�low �3. Reduce Ieakage by 60°fo and conduct smoke and fix all teaks �4,-Fix alI accessibie leaks using smoke and HERS rater verify Note:(dne of Options 1, 2 or 3 must"be attempted befa,wre,utilizing,Option,�4.), � j� ,m�,_r,,,„„�„„,� „�,,._...,,,, Determine nominal Fan,�Flow using one of the�follow�ng th,ree caiculation methods.�` � ; �' ,u� ✓�Coo�ng system method Size of�conde ser��in Tons�x 400' �GFM�` � ,r ,,, �� ' � ��' '" �a �. .�� r�� Heat�mg��;system mettiod 21 �7-x,,��OuCput Capacf,ty m�Thousands'��of�Btul�r 1670 9 CFM ^� - �� , . ❑Measured sy,stem`�,�a rflowsu i g�RA�airFlowYtest�procedures,�� CFM� ,� , ,��r Ag��,_ � �3,�; �� . ' � � F... �� . .. � �, Option 1 used then: c ��{ F, .:�k��y.;�� :.r ,�,., �. ;,. ..,;,�,. , . .�,. ; : . 1 Ailowed leakage- Fan Airfilow 1670.'3 x 0 15 — 25Q.64 CFM Actual Leakage"= 110 CFMz; Pass if Actual�eakage is less than Allawed leakage �Pass�Fail Option 2�sed then; z Allowed leakage = Fan Airflow ��x 0.10 =_CFM Actual �eakage to outside=_,:,,CFM Pass if Adual leakage to outside is less than Allowed leakage Pass Fail Option 3 used then: Initiat leakage prior to start of work =.,,,_,CFM Final leakage after sealing all accessible leaks using smoke test=_CFM I 3 Initial leakage�- Final leakage_= Leakage reduction_CFM ((Leakage reduction_/Initial leakage�) x 200% = ofo Reduction Pass if°lo Reductian>= SO�Jo Pass FaiE Qption 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if a11 accessibie leaks have been repaired t�sing smake Pass Faii Reg: 213-Ap012546A-M2100001A-0000 Registration Date/Time: 2013/05/08 17:43:27 HEftS Provider: CalCERTS, Inc. 2608 Residential Compliance Forms March 2010 INSTALLATIQN CERTIFICATE CF-6R-MECH-2I-HERS � Duct Leakage Test— Existing Duct System (Page 2 of 2) Site Address: Enfarcement Agency: Permit Number: �� 320 N PINTADO DR, Diamand Ba�CA 91765 (System Ci�, of Diamond Bar 13-759 2) �Outside air(OA} ducts far Centra! Fan Integrated (CFI) ventilatian systems, shali not be sealedJtaped off during duct leakage testing. CFI nOA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meetASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the clased position during duct leakage testing. >`�i'� � � � � ��Y�.`��4�, .. � �4-4„4T'S4r�`k.4 �� ..�5 �i'a �Atl supp!y and refiurn register boots�must`be�sea�ed to,tlie dry�,w�all if�smoke test�is utilized for��compliance —appHes�to duct leakage compl�ance opk�an 3 {leakage reduct�on�t�y 60°,�l0} and�`o`pt�on�4(§fix all accessible leaks) des�ribed above.��' � � ' .� �ti,�� -�`� �� . � � � ��.�` �,� ��<_ �� ,��, k " ; ��w �� y,� �r �New cluct instafiat�ons�cannot util�zetbuildEng cavities as�plenums'o�r platfor�m returns �n heu�af ducts�,�`� �` �� ,r �n� � �.'Y *� � ��,� � � � ..,r'�"� �" �e� : :"�a.'"��7.�e�a m��',,„ �:. � � �y„ '��. � �5;�'.�.�„_ � :+ �Mastic arid°clraw�bantis rriust�b``�°u'secl�inicombmation with�doth"backed'rubtie�"adhesive duct�tape to seai leaks at ali new duct connections . DEC�ARATION STATEMENT •I certify under penalty of perjury, under.the laws of the State of California,the Information provided on this form is true and correct. .I am eligible under Division 3 of the Business and Prafessions Code to accept responsibiiity for construction,or an authorized represe�tative of the person responsibie for construcCion{responsible person). .I certify that the instailed features,materia�s,components,or manufactured devices idenkified on this certificate(the instai�ation) conforms to all applicable codes a�d regulatio�s,and the installation is consistenk with the plans and specifications approved by the enforcement agency. � .1 u�derstand that a HERS rater w411 check the installation to verify compliance,and that that if s�ch checking idenkifies defecks,I am required to take corrective action at my expense.I understand that Enery-'y Commission and MERS provider representatives will also perform quaiity assurance checking of instailations,inctuding those approved as part of a sampie group but not checked by a NERS rater,and if those inst811ations fail to meet the requirements of such quality assurance checking,the required corrective action and additional checkingjtesting of other installatio�s in that NERS sample graup wiii be peeformed at my expense. •I reviewed a copy of the Certificate of Compliance(CF-1R)form approved by the enforcement agency that identifies the specific requirements for the installetion.I certify that the requirements detailed an the CF-iR that apply to the installation have been met. .I will ensure that a campleted,signed capy of this Installation Certificate shall be posted,or made available with the building permit{s)issued for the building,and made availeble to the enforcement agency for alI applicabte inspections.I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I wili ensure that aII Instaliation Certificates wi1l come from a HERS provider data registry for multiple orientation alternatives,and beginning October 1,2010,for all low-rise residential buildings. Company Name: (Installing Subcantractor or General Contractar or Builder/Owner) QUAIITY CONSEFtVATIOtM SERVICES INC Responsible Person's Name: Responsible Persan's Signature: Steve Gonzalez 5teve 6onzalez CSLB License: Date Signed: position With Company (Title): 757471 3J15j2Q13 Is this installation monitored by a Third Party Quality Name of TPQCP(if applicable): Controi Program (TPQCP}? 0 Yes ❑No Reg: 213-A0012546A-M2100001A-OOpO Registration Date/Time: 2013/05/OB 17:43:27 HERS Provider: Ca10ERT5, Inc. 2008 Residential Compliance Forms March 2010 INSTAI.LATItIh CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification -Standard Measurement Procedure {Page 1 of 6) Site Address• Enforcement Agency: Permit Number: 320 N PINTADO DR, Diamond Bar CA 91765 City of Diamond Bar 13-759 Note: If installation af a Charge Indicator Display (CID) is utilized as an alternative to refrige�ant charge veri�cation far comptiance, a MECN-24 Certifrcate (instead of this MECN-25 Certifrcate) shoutd be used to demonstrate compliance with the refrigerant charge verification reQuirement. TMAH and 5TMS are not �equi�ed for compliance when a CID is utilized For compliance. As many as 4 systems in the dwelling can be documented for carrrpliance usie�g this farm. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Noles {TMAN) and Sakuration Temperature Measurement Sensors (STMS) Procedures for installing TMAH a�e specified in Reference Residential Appendix RA3.2. If refrigerant charge veri�cation is required for compliance, TMAH are also requrred for comptiance, untess the TMAH Compliance Option is chosen. STMS are oniy requrred for comptetety new or reptacement space-conditioning systems that utilize prescriptive campliance method. TMAH -Access Noles in Suppiy and Return Ptenums of Air Handler System Name or ldentification%Tag System 1 System Location or Rrea Served, Whole House 5/16 inch (8 mm) access iiqle 1 upstream of eVaporative coil in the �Yes ❑Yes ❑Yes ❑Yes r,etu�n pienum and labeled accordirrg ❑No ❑ No O No ❑No to Figure�n;,Section RA3.2.2.2:2.- � . .��; �_��;�. ��x<::��; ,.�a,,,�, Return"�side'af the duct systemvis � ' � * . �'� `;�� `� �� ' �tt1 �"� �S�' s acetl�entirel� within condiCion¢d', CI�Y � �, � � �� ` y '� � es ❑Yes�"` �Yes¢ - ❑Yes la p �n�nd return.airf"'1�`ow temp�e atu're O�No� " ��!`�No , ,O No �.,�� 0 No � � to by,�e measured,�,at the return g�lle: � ��.�� ,��,�a� , ��;' <�>�� - };�� SJI`6��nch (8�mm}access�Fiole��""`rf �: �li �� ,rfi � ,.,��,� � �,�� `��A�,�s fk�,� :�'�'�} Z downstrearia of eva'porative co�l in�the�� I��Yes,, '� � � �Yes�'''' � ❑Yes �� ❑�Yes supply plenum arid labeled"according �O No � ❑No ❑ No ❑No to �igure in.;Sectian RA3.2.2:2:2. The TMAH Compliance Option sh,outd be checked onty if it is physically impossible to dril)the TMAH as required by Section F2A3.2,2.2.2: Using this Compliance Option requires the HVAC installer Co annotate on the HERS Provider's data registry an explanation as to why the TMAH cannot be installed on the system, and photographs af the equipment on which the TMAH cannat be installed. Use af this Compliance Optian also requires minimum airflow verification through the direct rneasurement of airflow per RA3.3 For more information see htto //www enerav ca aov/title24/2008standards/special case ap�liance/ TMAH Compliance Optian ❑ ❑ O O Yes to 1 and 2, or Yes ta 1a and 2, or checking the TMAH Comptiance Optiq�, is �Pass ❑Pass ❑Pass ❑Pass a pass. ❑ Fail ❑Fail 0 Fail ❑Fail Enter Pass or Faii Reg: 213-A0012546A-M25p0001A-p000 Registration DaCe/Time: 2013/05/OQ 17:45:09 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forma March 2013 ^-�,- � INSTA�LATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Yerification - Standard Measurement Procedure (Page 2 of 6) Site Address• Enforcement Agency: Permit Number: 320 N PINTADO DR, Diamand Bar CA 92765 City of Diamand Bar 13-759 STMS - Sensor an the Evaparator Coil System Name or �ystem 1 IdentificationJTag The sensor is factory insta!led, or field installed according to manufacturer's specifications, or is installed � by methods/specifications approved by the Execukive Directar. ❑Yes ❑No ❑Yes ❑No ❑Yes ❑No ❑Yes ❑No The sensar wire is terminated with a standard mini plug suitable for connection to a digitat thermorneter. � 4 7he sensor mini plug is accessible to the installing technician and the HERS rater without changing the � airflow through the condenser coil I ❑Yes ❑No ❑Yes ❑No ❑Yes ❑No ❑Yes �No 5 The sensor measures the saturation temperature of the cail within 1.3 degrees F ❑Ys:s �No ❑Yes ❑Na O Yes O No O Yes O No Yes ta 3, 4, and 5 is a pass. g��1q ❑NJA ❑ NJA ❑NJA Enter NjA if STMS are not ❑ pass ❑Pass ❑ Pass ❑ Pass appiicable. ❑Fail ❑Fail ❑Faii ❑ Fail Qtherwise enter Pass or Fail STMS - Sensor arn�the Condenser Coil System Narne or `gystem�i .. � �,-..� r�.�, �;�� ` �� Fdenti�cation/7ag��.. ��, � . .,,�_. �� `��, ,. ` �� b� method'sJspecificati ons'a�a�roved!b �the Execut ordin � � �� °' � ' " " �`�to manufacturer s s ecifications, ar�ls installed � $ 4, Y �� .� � ' iv� Director � Y ��. PP ..�_ Y �,..� ` �•� _ � ,�, - W _ �;�:,` „�" ,,:.�CI�Yes�-`p No � °:CI Yes`�N.o ��: O Yes�'D No '��,��Yes�C7�No,, ',�� ;G, The sensor w'rre4s�ter",m�ma�ted wEth�a stanclard�,mim plug�,su�tab{eifor eonnecfiron to a,�dig�tal fhe�rrriorrtie�te�' 7 The sensor�rriini°�plug�is�access+ble�to�the�instatling�»technician�,ancf�the.�HERS�rater wiEhout ch'anging`the � .��. airFlow Chrough�the"conaenser�coil�'�'=�� " � � ` � � - �`Yes �No ❑Yes ❑No ❑Yes ❑No ❑Yes ❑ No 8 The sensar measures the saturation Cemperature of the coil within 1.3 degrees F c:''Ci Yes ❑No ❑Yes ❑ Na ❑Yes ❑Na �Yes ❑Na Yes to 6, 7, and 8 is a ,' " pass, p NJA ❑NJA ❑NJA ❑NJA Enter N/A if STMS are not ❑ pass �Pass Cl Pass ❑ Pass appiicabie. ❑Fail ❑Fail ❑Fail ❑ Fai) Otherwise enter Pass or ( Fait Reg: 213-Aq012546A-M2500001A-0000 }2egistration Date/Time: 2013/05/08 17:45:09 HERS Frovider: Ca10ERTS, Inc. 2Q48 Residential Compliance Forms March 2013 � INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS I Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6) I Site Address: Enforcement Agency: Permit Number: 320 N PINTADO DR, Diamond Bar CA 91765 City of Diamond Bar 13-759 Standard Charge Measurement Procedure (far use if outdoor air dry-butb temperature is 55°F or abave) Procedures for determining Ref�igeranC Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwe!ling can be documented for compiiance using this farm. Attach an additionat farm(s)for any additionai systems in the dwetling as appticable. • The system should be installed and charged in accordance with the manufacturer's speciFications before starting this procedure. • The system must meet minimum airf�ow requirements as prereQuisite for a valid refrigerant charge test. •If outdoor air dry-bu16 tempe�atu�e is less than 55°F, the installer must use the RA3.2.3 A/ternate Charge Measurement Procedure{Weigh-In Charging Method)= Ff the Weigh-In Method is used, the dwet/ing cannot be inctuded in a sample � group for HERS ve�ification compliance.) Space Canditioning Systems System Name or ldentificatian/Tag System 1 System Locatian or Area Served Whole House 4utdoor Unit Seriai # N ja Outdoor Unit Make N/a i Outdoor�Unit Modelf Nja Nominal Caoling�Capacity .__, �,��„ 3 Tons � -;;.� � � �� ,�,tr � - . '�._ � ,,�>�. �w=� _.. J Q w ,,,. na,,. �,�. � „ ;. � ,:' � .. � :� �� d, �� °_ A � � , Date of U�eification� �� '� 3 f 15�j;��3 - �� :�� . _, .. . _ � r_„ . � w ,� . ,�� ."�� ,.�,� �..,�_:� �.,.7 4��,�v»-..�' s„*� ... « � u_. � �, �_ - , - _ Calibratlon of Diag"�st��IriStr�umerits .� �k`� �,�"k`' � � "� ' � �� "' e�'Y a?..§£; T.,3y, „u,ex�u,. �, �, . � ��'� � ��_ ' � .. i. = "�`��+�`'' �:_ h�•`�^`� :�fi�m�� Date of R'efr�gerant Gauge CaEibrak�on„ � �f,µ3/1/13 � (musC be re-catibrated monthiy)� , � �._ ��.. �� :> Date of Thermoco"uple Calibration ,� 3/1/13 (must be re-calibrated monthly) m� � � Measured Temperatures (°F;}: System Name or ldentificaCion)Tag System 1 Supply (evaparator leaving) air dry-bulb 52.5 temperature (Tsu I db) Return (evaporatar entering) air �2.8 dry-bulb temperature (Treturn db) Return (evaporatar entering) air 62.4 wet-bulb temperature (Treturn wb) Evaparator saturation ternperature �5,� (Teva orator sat) Condensor saturation temperature ��.1 �Tcondensor sat} Suctian line temperature (Tsuction} 60.3 Liquid Line Temperature (Tl�qu�d) 67.9 Condenser (entering) air dry-buib �a temperature (Tcondenser db) Reg: 213-A0012546A-M25000p1A-q000 Registration Date/Time: 2013/05/08 1'7:45:09 HERB Provider: Ca10ERTS, Inc. 24Q8 Resiclentia3 Compliance Forms March 2013 IINSTALLA7ION CERTIFICATE CF-6R-MECH-25-HERS � Refrigerant Charge Yerificatian - Standard Measurement Procedure (Page 4 of 6) Site Address� Enforcement Agency: Permit Number: 320 N PINTADO DR, Diamond Bar CA 91765 City of Diamond Bar 13-759 Minimum Airflaw Requirement Temperature Sptit Methad Calculations for determining Minimum Airflow Requirement for Refrigeran#Charge Verification.The temperature split method is specified in Reference Resie#entiai Appendix RA3.2. System Name or ldenti�cation/Tag System 1 Calculate: Actual Temperature Split = �p,3a Treturn db -Tsu I db Target Ternperature Split from Table RA3.�-3 18.2 using Treturn wb and Tretum db Calculate difference: Actual Temperature 2.� Split-Target Temperature Split = Passes if difference is between -3°F and � +3°F or, upan remeas�rement, if between pASS I -3°F and -100°F I Enter Pass ar 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 Refe�ence Residentia/Appendix RA3.3. If actua! coolirag�coit arrfiow;is measured�'t'he value must be equa!to or greater than the Catculated Minimum Airflow Requirement in the table below .. �, m �� , �� j s�:, a��r'�`; � ,,� � � �` x a'"- i �'s;' �9� ,�� 3 �*� s v.:� �� Calculatec!„�M�nimum A�rflow Requerement(CFMi) Nam�nal Coolirig Capac�ty�(#o�) X�300 �, (cfm/ton) � ��„' �`» ,� � ` � �� ' � ��r, � �� ;� � � ,�� r � � � System Name or�Identificati�on�ag �� Syste�i�� y � � ' � �� . �,� �'�_ �,,� �. 3.,��» �„�.� �� ar.i �. rn ., � � � - .�€- b - xt � �„ .. . ,�_» s . � ,a M _ .� ,..v a�_,-� _., .. : ._.� �p��.� . .. CalculaCed Minimum�A�irflow`'Require"rnent�`� �'�� (CFM} "�' �� w„�, � Measured Airflow using RA3.3,procedures (CFM) ' �. ';�.� Measurement MeChod Passes if ineasured airflow is greater than or equal to the calculated minimum airflow requirement. � Enter Pass or Fail Reg: 213-Aq012546A-M2500001A-0000 Registration Date/Time: 2013/05/OB 17:45:09 HERS Provider: Ca10ERTS, Inc. 2008 Residential Campliance B'orms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) Site Address: Enforcement Agency: Permit Number: 320 N PINTADO DR, Diamond Bar CA 91765 City of Diamond Bar 13-759 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 System 1 Calculate: Actual Superheat = Tsuction -Teva orator 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 +5°F Enter Pass or Fail Subcooling Charge Method Calculations for Refrigerant Charge Verification.This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or ldentification/Tag System 1 Calculate: Actual Subcooling =':, 9.2 Tcondenser sat'Tli u"id Target��Subcooling specified by ��•*:�� 10 manufacturer �' . Calculate difference: ` --- Actual`�Subcoc�fing'`��'�Target Subcooling = � -Q 8 s �� "� �� ?T, System pa`sses if diffe`rence is between,�'� ..� � "' �. �� K -, �� + -3°F and +�3°F � PASS � - � Y � r; ;Enter�.Pa,�of Fai) a �' �` "'�' � *� � � - _. � �`� .,`� �� I � ��' ��: � .�� 2��.�'� � z. �a ,_ � � �. , „L �� ,:,�� , ��,. �'�� __ ,�: Metecing'�Dev�ce°Calculations:��for�Refrigerant��`�"`a�ge�1/e��ficafio�This"'��'procedure�is�'r`equired to be � used for thermo'static��expansionry�valve�(TXV)`�and�:eleet�ronic�expansion�valve��(EXV) systems:�� ^f f':.. . System-Name or"'=�Identification/Tag System 1 Calculate: Actual Superh2at ' 14.5 Tsuction -Teva orator sat ��``��'� Enter allowable superheat range from manufacturer's specifications (or use range 4-25 between 4°F and 25°F if manufacturer's � specification is not available) System passes if actual superheat is within the allowable superheat range PASS Enter Pass or Fail Reg: 213-A0012546A-M2500001A-0000 Registration Date/Time: 2013/OS/08 17:95:09 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6) Site Address: Enforcement Agency: Permit Number: 320 N PINTADO DR, Diamond Bar CA 91765 City of Diamond Bar 13-759 Standard Charge Measurement Summary: System shall pass both reFrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re-measured and/or recalculated. System Name or ldentification/Tag System 1 System meets all refrigerant charge and airflow requirements. PASS Enter Pass or Fail � Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55°F and 65°F the return air dry bulb temperature shall be maintained above 70°F during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate. DECLARATION STATEMENT .I certify under penalty of perjury, under the laws of the State of California,the information provided on this form is true I and correct. .I am eligible under Division 3:of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the,person responsible for construction (responsible person). .I certify that the installed features;materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and speeifications approved by the enforcement agency. .I understand that a'HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS ' provieder representatives wili also perform quality assurance checking of installations including those approved as part of a sampl�e�group�but not checked�by a HERS rat�antl if�thos�e.insYallaYio',n�s�fail�to""mee�t`the�reguirerrients of such quality.as'Surance�checking, the required�o�rective'action'a�d additianal�check�n`g/.testing,of othe�nstaltations in that � .,.., »� HERS sample�°�group w�ill be perfo�ecl�at��my`expense ��"� " � � '� � �� -..� •� �`" �•' �� .I reviewed"�a��co � �'"'� � ��'�:�� specifie ceq�uirements for�the m�sCa�liat�n��I�e�rtify that he��equ remen�ts�+cte ailed on the CF�1R that a ply t�the ifies the ��w�-� instaliation�have been m��,�� ', �� °� ,� � � ; r �� . : � "� :�. �:. �- �� ;� �� .�� ., �� , I .i w�ll erisure�that a completed,s�gned copy of th�s�I,n�s�t_allatio�CerEifi�c�,ate�shall�be posted,ao�made,availablee� ��sr�:-� c, with the�bwldin;g permit(s) �ssuetl�fo�Che b�ilding;and�made availableato'th`e".enforceinen#,egency fior all �� applicable inspections.I understand=that�a�signed copy�of this Installation C'ertificate is required to be included w�th the;documentation�the builder provides to the building owner at occupanty.I will ensure that all Installation'Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning';`October 1,'`2010 for alla;low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) QUALITY CONSERVATION SERVICES INC Responsible Person's Name:. Responsible Person's Signature: Steve Gonzalez Steve 6onzalez I CSLB License: Date Signed: position With Company (Title): 757471 3/15/2013 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑Yes ❑ No Reg: 213-A0012546A-M2500001A-0000 Registration Date/Time: 2013/OS/08 17:45:09 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2013 a;:1C�..+-�w'.``'�,r,=ra.;1��•',r�+�.::xc^-��.., �F3i:..,.;�n;�,.u'.::r'2s;,�'i��;;;.:�r-n:�.v.:,•s'C:.�.r=---:--��:.�`—.'_'--�.,.""1., �� . . . � ' " .��I �� CITY OF DIAMOND BAR , -�::;� Community and Development Services.Department ��£ - 21810 E.Copley Drive•Diamond Bar,CA.91765 ,.g� Building Inspection Request Hotline ��`-�a � (909)839-7027 � `*5 ��'i,tiLn M�S, �ga9 Building . Planning � Engineering :.r� (909)839-7020 (909)839-7030 (909)839-7040 :;..<� . CORRECTION NOTICE � ::�� j ,k:� PERMIT NO. �� /�� DATE: �� a.m.,' :: - TIME: .' 3� �� + p.m: � �:i!� CONTRACTOR/ ` .,,� OWNER BUILDER ... I 1 ��.c7 �.1 r r�r� `��c� �'? `:`,`s� ' ADDRESS(Project Site) � _ ':.� ,;m� � -z:,; n t o ' -,� � .f..�fc d Vi �i �'�"t"/ U �1 . ";`� � � . . , r,i t ..,;� r�. i-. -,;�s :. t / ( - I - ::�:::�� , ! a � -t�V �1�� ,('D(J6��v�� ;. �� _ � , :�� ,.- � ,� .�:,.� , � r� -` 1_/ ,. .I 1, . - S , , . 1! :-„ , i/ ,:�� . . . . 0 1 �� V�+\ y ..ti: Z : �;`� t . �' ; 1� � � �? �� ' �� _ .:;....,.� , �;::{� �, � 4 � � � 1 � ,s�� [��n��I r, -�--� -� � v0 ca \r, l�� _� . v . �:.► � ;:� : � � �r-{ , : _,y-�� _:,, -:;�.� ❑PLEASE CONTACT THE UNDERSIGNED � � ��-'..;y ❑PLEASE MAKE CORRECTIONS AND CALL FOR REINSPECTION = ,,� ❑REINSPECTION FEE REQUIRED „,F ❑PLEASE MAKE CORRECTIONS AND PROCEED;WITH WORK . �:,� INSPECTOR: � +�� ' `:: � ' �� (pri„t nan,e) � . . . -='. _ ' �. .4 �. , �SIGNATURE OF INSPECTOR: ` �� . �f� :,-�� ,(+.. - . � � . . � , ' .. .. ~`yS� 7�. . " . ' . . . . � . .� ��