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Home My WebLink About11-871� _ - - y V �� . �`_ CITY OF DIAMOND BAR �� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � e 21825 Copley Drive,Diamond Bar,CA 91765 _�'��; S (909)839-7020 Fax(909)861-3117 Building Inspection Sotline(909)839-7 �� BUILDING PERMIT APPLICAI'ION Y � JOBSITE n �,�� /Z'�� C �t�� DATE CATION NU B R '1 8"71 #� ¢ ADDRESS /�"� �� ISSUE J TYPE OCC � APN LOT TRACT DATE O �� I/ CONST.� ROUP p OWNER �� " ADDRESS � ��.n ZONING SETBACK o FRONT RW O Z C�Ty�� a ZIP TEL. REAR ❑ o APPLICANT TEL. SIDE/SIDE STREET RW � CONTRACTOR SIDE ❑ o ADDRESS �'ti-'�P y TE PRpPOSED USE C e- � � cirv w ARCWENG/ z DESIGNER NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDROOMS � ��7y ZIP TEL. N DESCAIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION co ¢ OWNER-BUILDER DECLARATION SFR/ADD/REM O � I MEREBV AFFIRM UNDER 7ENPLTV OF PERJURV THAT I AM E7(EMPT FROM THE CONTRACTORS LI- GflfBgB/C8f�10fI W CENSEUWFORTHEFOIIOWINOREASON(SEC.7091.6BUSINESSANDPHOFESSIONSCWE:ANYCITVOR (n ZCOUMYWHICHREQUIRESAPERMITTOCONSTRUCT.ALT£R,IMPROVE.DEMOLISH,ORREPAIAANVSTqUG W P8�10/DBCK W TURE.PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SI6NED W � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LL � CENSE UW(CHAPTER e(COMAdENCWG WITH SECTION)000)OF DIVISION 3 OF TNE BUSINESSAND PRO� � QOOVSPB FESSIONS CODE)OR 7HAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEOED EXEAIP- TION,ANV VIOlAT10N OF SECTION 7031 5 BV ANV APPLICANT FOR A PEFiM1T SUAlECTS THE APPUCPNT TO Z Re-Roof � A CML VENALTV OF NOT MOFE iHAN FIVE HUNDRED DOLIARS(t500).)' � ❑I,ASOWNEROFhIEPROPER7Y.ORMVEMPLOYEESWITHWAGESASTMEIR50LECOMPENSATION, Q COR1TBfC181 Z WILL DO TNE WORK��THE STPUCTU0.E IS NOT IMENDED Ofi OFFERED FOR SAIE(SEC.70�I.BUSI- J � NE55 AND PqOFE5510NS CODE:TNE CONTRACTORS LICENSE LAW DOES NDT APPLY TO AN OWNER OF = PROPEH'fY WFIO BUILOS OR IMPROVES THEREON,NJD WHO DOES SUCH WONK HIMSELF OR HEHSELF OR Q TF7ROUGHNISORHEROWNEAIPLOYEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTWTENDEDOR m ' QOFFEREDFORSALEIF,HOWEVER,THEBUILDINGOfiIMPqOVEMENTI550LDWRHINONEVEAROFCOMPLE- Z TqN,THE OWNER�BUILOEF W�LL MAVE THE BURDEN OF PROVWO THAT HE OR SHE DIO NOT BUILD OR � IMPROVE fORTHE PURPOSE OF SALE). , w OI,ASOWNEROF7HEPROPEHT`/,AME%CLUSIVELYCOMRACTWOWfTMLICENSEDCONTMCTORS Q 70 CANS1pUCT THE PHOJEC7(SEC.7oal,BUS1NE591Jtl0 PROFESSIONS COOE:7HE CONTRACTQRS LI- V81U8i1Of1 ADJ.AREA � CENSELAWDOESNOTAPPLVTOANOVMEROFAPROPERTVWNOBUILOSORIMPROVESTHEREON.AND WFqCONTRACTSFORSUCHPR0.1EC75WITHACONTRACTOR(5)LICENSEDPURSUAN770THECONTRAG QUANTITY DESCRIPTION FEE � TORS UCENSE UW.). O ❑1 AM E%EMPT UNDEH SEC. 6.8 P.C.FOH THIS REASON U � Q LL D�TE OwNER V Z W � LICENSED CONTRACTORS DEClARATION � OC W I HEREBY AFFIHM UNDER PENALTV OF PERIURY THAT I AM LICENSED UNDEFl PROVISIONS OF CHAPTER Vr d 9(COMMENGN(3 WITH SECTqN]000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE.AND Z MY LICENSE IS IN FULL FORCE AND EFFECT. m � ��/�f� LIG.NO. �� LICENSE C/LJASS J V DATE i��O "��— CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION � � 1 HERfHY AFFIRM UNDER VENALTI'OF PERJURV IXJE OF 1HE FOLLOWMG DECLARATIONS: � � Z Q � 1 HAVE AND WILL MAINTAW A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORNERS' _ /� � COMPENSATION,AS FROVIOED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE w V OF THE WORK FOR WHICH THIS 7ERMIT IS ISSUED. � � W _I HAVE AND WILL MAIMAW WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SEC710N Q 3700 OF hl£LABOP CODE,FOR THE PERFOFMPNCE OF THE WORN FOR WN1CH THIS PERA/1T IS ISSUED.MV WORKERS'COM7ENSATION INSURANCE CARRIER AND POLICY NUMBER AAE: CONSTRUCTION j cnaRiER PLAN REVIEW � POLICV NUM6ER ELECTRIC Z Q � (ROSSECiK7NNE�NO7BECOMFLEfEDOF7HEPEFAQTISFORONEFiIY�DRE�Da1/�1s100)017LESSF PLUMBING w MECHANICAL Z 1 CERTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WH�CH THIS PERMIT IS ISSUED,I ('J SHALL NOT EMPLOV ANv PERSON IN ANV A/ANNER SOAS TO BECAME SUBJECT TOTHE INSPECTION FEE � WORNERS'COMPENSATION LAWS OF CALIFORNI0.AND�OREE 7HAT IF I SHOULD BECOME S SU6IECTTOTHEVJORKERS'COMPENSATIONPROVISIONSOFSECTION37000FTHELABOR ISSUANCE �� CODE,I SHAIl FORTHWITN COMPLY WITH THOSE PRDVISIONS. O SMIP p DATE; APPLICANT. , � w ENERGY P/C � WARNINO:FAILURE TO SECURE WOHKEAS'COMPENSATION COVERAOE IS UNUWFUL,AND SHALL BE LL SU&IECTANEMPLOYERTOCRIMINALPENALTIESANOGVIIFINE5l1PTO�NEHUNDREDTNWSAND ENERGYPERMIT pp��qpg(=7pp,000),IN ADDI710N TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 3108 OF THE LABOR COOE.INTEREST,ANO ATTORNEVS FEES. RETENTION FEE: �� w CONSTFUCTION�ENDING AGENCY PRE-ALT FEE: � O � I HEREB�AFFIRM UNpER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDING AGENCY �Z FOR THE PERFORMANCE OF THE WORK FOR WHICN THIS PERMIT IS ISSUED(SEC.J087,CIV.C.). � . W �Z' LENDER'S NAME i F= LENDEflSADDRESS � I CERTIFV THAT I HAVE FEAD THIS APPUCATION AND STATE THAT THE ABOVE INFORMATqN IS CORRECT. TOTAL FE ES I ��/� w 1 AGREE TO COMP�v WITH ALL CfTV AND CAUNTV OFDINANCES AND STATE lAWS RELAT�NG TO BUIIDINa � CANSTRUCTION,ANDHEREBVAUTNORIZEREPRESENTATIVESOFTHISCOUNTVTOENTEFU70NTHE ZABOVE�MENTIONED PflOPEfiTV FOR INSPECTION PURPOSES. CQMMENTS � ��'� a—Z m PERMITT NAME(PRINTJ ' . Q � � .�.� � N3NA F PERMITf ATE RECPT.NO. PAID BY VALIDATION 2 � WHITE—Department Copy,YELLOW—Finance Copy.PINK—Assessar Copy,GOLDENFOD—File Copy.GFEEN—ApplicanYs Copy r.�, ,a lr��CT��f ll ,,�''�-�� fi ��' ��'cci�; CI�'V OF D.iA6Vi0(�D �AR r � ��'�,,_,.1�� s� 16�S��CTBO� �iIECORD � ��, �)•1 �i.�� :�. ��:.�—>�a� .1 �. 'o ��400a � �: .�; �� oa��a � .:: qa�p�c�o� �-'�'na�� =� `�a�i�r�r�c��c��`: SET BACK FLOOR JOIST ' FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT � GROUND PLUMBING UNDER FLOOR CONDUIT � � SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MiD HT: BOND BEAM ROOF SHEATHING . 8 FT: BOM11D BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERlTUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING � WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAIUNG DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANQSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING ��_u HEALTH DEPT. FINAL FINAL ELECTRIC �- DEV. FEES PAID FINAL PLUMBING ENERGY . �p . COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE , a - e� � .�9y . .'� F.: • . - �t , � �:�'�',,- - 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: 20836 QUAIL RUN DR., City of Industry CA 91789 City of Diamond Bar 11-871 Note:If installation of a Cha�ge Indicator Display(CID)is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate(instead of this MECH-25 EertiFcate)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 additional form(s)for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedu�es for installing TMAH are specified in Reference Residential Appendix R.43.2. If refrigerant charge veriFication is �equired for compliance, TMAH are also required for compliance. STMS are only required for completely new or �eplacement space-conditioning systems that utilize presc�iptive compliance method. TMAH-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 0 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 0 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 1 and 2 is a pass. Enter Pass or Fail ✓ 0 Pass ✓ p Fail �:: . � STMS-Senso�[�on+th„e Evaporator Coil - .�;��, ��.�4N,� &' �,.,,�„y„ System Name or,Idenfification/Tag',��'��% `:; �; System,-1� � M h, V � � � " �, � ti' � �� 3 p Yes k � Tihe sensor is factoI�Emstalled, or�field insta`Iled'acCordm to manufacturer s �J'�L ""�'Sv. �UUF Knt' .sAw�"' � � �� Nzo��, sp�ec�fications, or is installed.by methods/specificat�ons�approvecl by the Executive � �� _"� ' birector � Sc ��a� � �- .�." .� �� `"„��,� �The�sensor wire,.is terminated with�a standard rr%n y lu�`:suitable for connection,�toaS- �?.. 9 4 pp Yes ' � �[�.No ,,, dig�tai�the mr ornete"r�The senso�r�rriini plu,g�iis accessible to�th�e inst'"alling�techr�ician .. � '�°�� "„'arid'the HERS'�rater without`changing'the'aiifilow'tFi'r'ough the contlenser coil 5 ❑Yes,��,»�; . ❑No �'When attached to a digital thermometer,the sensor provides an indication of the --- ;� saturation temperature of the coil. Yes to 3,4, and 5 is a pass. Enter N/A if STMS are not ./ 0 N/A ✓ ❑Pass �/ ❑Fail appiicable. Otherwise ente�Pass or„Fail STMS-Sensor on the Condenser Coil System Name or ldentification/Tag System 1 The sensor is factory installed, or Feld installed according to manufacturer's 6 �Yes ❑No specifications, or is installed 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 When attached to a digital thermometer, the sensor provides an indication of the saturetion temperature of the coil. Yes to 6, 7,and 8 is a pass. Enter N/A if STMS are not ,/ Q N/A ✓ ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail _ Reg: 211-A0056244A-M2500001A-M25A Registration Date/Time: 2011/10/28 14:33:46 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 1 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: 20836 QUAIL RUN DR., City of Industry CA 91789 City of Diamond Bar 11-871 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Ref�igerent Charge using the Standard Charge Measu�ement Procedure are available in Reference Residential Appendix RA3.2.As many as 4 systems in the dwelling can be documented for compliance using this fo�m.Attach an additional form(s)for any additlonal systems!n the dwelling as applicable. •The system should be installed and charged in accordance wlth the manufactu�er's specifications before starting this procedu�e. •The system must meet minimum airflow requiremen(s as prerequisite for a valid ref�igerant charge test. •If outdoor air dry-bulb is 55°F o�below, the installer must use the Alte�nate Charge Measurement Procedure. Space Conditioning Systems System Name pr ldentification/Tag System 1 System Location or Area Served Whoie House Outdoor Unit Serial # 0809X9403 Outdoor Unit Make BRYANT Outdoor Unit Model 538ANR060-B Nominal Cooling Capacity Btu/hr 300000 Date of Verification „b 10/28/11 Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibretion 10/1/11 (must be re-calibrated monthly) ,... �.M«�.,� --. .. „ s«...z m�.�.._._v -._ ,,,�� . _._.,��_ �....».»�- — ��n.�. � Date of Thet;�nocouple Calibration �'�' � i ��' ��`30/1�%1�1 � ; ('�'m�u'st'be re'��i�brated monthly) k� .��'�� . �' �".-' ,t-+ �a�."' . ^ ,,n'��.�. r.: '�t'h'�Sds° Measureii�T'emperatures�'(`O�F)�. �k�.�a'�,�� _�,:. "��; �' rr•, "�� • - , �r ; � � System Na�m pr ldenG�cation/Tag �` Syst��l ,�� E s� „��" �� '�� -�,��''�' '�'%� �� PPY � P �"_�rr��`�� "�r�' � ,� � , � .. Su I eva orator::leaving,)�aird'°ry`=bulb ,°�; �,s�!. .'�'.�,_�- � ��'�.��;: '�;., x:,;�� °�" ..,. > +�. .�_- �� temperature (Tsupply, db� �" � ��f � Return (evapocatoc entering) air dry;:bulb temperature(Treturn, db� Return (evaporator entering) air wet=bulb temperature (Treturn, wb� ' Evaporator saturation temperature. � 35 �Tevaporetor, sat� Condensor saturation temperature 85 �Tcondensor, sat� Suction line temperature (Tsuction� 50.8 Liquid Line Tempereture (T�iquid� �Z•1 Condenser(entering) air dry-bulb 59.1 temperature(Tcondenser, db� � Reg: 211-A0056244A-M2500001A-M25A Registration Date/Time: 2011/10/28 14:33:46 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: 20836 QUAIL RUN DR., City of Industry CA 91789 City of Diamond Bar 11-871 ' Minimum Airf�pw Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification.The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or ldentification/Tag Calculate: Actual Temperature Split =Treturn, db -Tsu 1 db Target Temperature Split from Table RA3.2-3 using Treturn, wb and Treturn, db Calcutate difference: Actual Temperature Split- Target Temperature Split = Passes if difference is between -4°F and +4°F or, upon remeasurement, if between -4°F and -100°F Enter Pass or Fail Note: Tempe�ature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures s'pecified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum AirPlow Reqluirement(CFM) = Nominal Coolin Ca aci g p ty(ton)X 300 (cfm/ton) �u.�._ - �._ _ System Nam"�e�Or lden�fication/Tag �n � ' �'? ��f� � �w � F � �a'� ��" �K�� F: System 1� ,�� r � ��:� r�.�.::..� � r� ��-� .�� r Calculated Minimum A��ui�re'��ent(CFM) 16 0 �'�" £ � -'' �� '�� r * �� }� r" s x .'��. m �°��n�r A :� � 9 l L4��c �`�'�ip ri s� � :,t��::�; s � MEBSUfEd�A71;fIOW.�U�SIf1�R/�'�� "�� e�+r� � � , v° e^T :- �y,�� '�• �� . �� e ;a� t , ��g� ^3 8 procedures (CFM� 3333� r �a � , r � � ��-. .�.. �� '�'...� �a '� ax4_ a � `. �� . � � >d� � :. r �,�� ,, M., � � . P Passes if ineasured airflow is greate"r,:than o� equal to the calculated minimum airflow PASS requirement.'" ,.. � ` Enter Pass or Fai � d�;;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 Caiculate: Actual Superheat= Tsuction -Tevaporator, sat Target Superh�t from Table RA3.2-2 using Treturn,wb an Tcondenser, db Calculate difference: Actual Superheat-Target Superheat = System passes if difference is between -6°F and +6°F Enter Pass or Fail Reg: 211-A0056244A-M2500001A-M25A Registration Date/Time: 2011/10/28 14:33:46 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 4 4 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5) Site Address: Enforcement Agency: Permit Number: 20836 QUAIL RUN DR., City of Industry CA 91789 City of Diamond Bar 11-871 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 = 1Z.9 Tcondenser, sat"Tliquid Target Subcooling specified by manufacturer 12 Calculate difference: �.9 Actual Subcooling -Target Subcooling = System passes if difference is between -4°F and +4°F PASS Enter Pass or Fail Metering Device 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 Superheat = 15.8 €� Tsuction 'Tevaporator, sat +`^�� Enter allowable superheat range from manufacturer's specifications (or use range 15.8 between 3°F and 26°F if manufacture�'s specification is not_available) System pas5�if att�5at=superheat is��5vithtr�CFte� '�� _: �. "�� allowable 5upertieat range ,� E "` „�:?�` i^:' p S ,.=' � � �� r� �.., � ; , - HS'. ,. �;�,�, �:�Enter Pas��or"Fail � �� " ��"� � - -� �- � ! � � � � � � ' � �.� �` �� s _ae 3 �,� � . � � � r^ f'�'g�� r t"S= �,` ,-�_._- � d __ E R .y. E � Ag' � � . £ - �`�� t,�y wP ., � kP r��17 �f.9 �, � H� kw��• ��,,,� '��-�� 5v,��.� �x..9 � �,�- . .. , • ' . . n::✓ ...,. . .":i�� . .�.++ _ . .. . ... ' . .. . . , . � . . .R;. . . . .�� ,�*' � . .. . � . .. .. � �s� . � s";2. . .�:;_�... b • - Reg: 211-A0056244A-M2500001A-M25A Registration Date/Time: 2011/10/28 14:33:46 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-4R-MECH-25 i Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 20836 QUAIL RUN DR., City of Industry CA 91789 City of Diamond Bar 11-871 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,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. �j PASS Enter Pass or Fai � �:;� � ��5�:. �� :.�c.,�: i ;,`l�.�. I �t,�a:;. '� ��-�. , a 3 r«: �.-~_�� '''� � .. _ � .a 'r �� . �t s: �'`�� "�'' � ; � �� £' d %z z . � � �' � � � � ,��&4y �' �� ' m �r �� , ... , , F'�� I1 � +v 3' ... ''�3 ' 4K5 � �� ' �� r - �w� � � , r. z .» ma 'P�'3. �� +�� '�"�" r � d � � � .�� .:�� '� �a�9 ,�� f '; „� . N ��Y� EE �+ M�� :� k : ��.�, �� " �a'� 1 ��"�� 4 � '��-��-�` � . . �t�`.'�,`��i .,r�t; . . . ` : ... » � . �'�.-� .. i �,; � . � . •. �� a�``-� �' .a;i w� ; DECLARATION STATEMENT� , . I certify under penalty of peejury, under the laws of the State of California,the information provided on this form.is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate(responsible rater). . The installed feature,material, component,or manufactured device requiring HERS verification that is identifled on this certiFlcate(the installation)complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s)of Compliance(CF-1R)approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s) (CF-6R),signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certlficate(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 Generel Contractor or Builder/Owner) TORO HEATING AND AIR CONDITION Responsible Person's Name: CSLB License: jose gonsalez 921672 � HERS Provider Data Registry Information Sample Group# (if applicable): N/p Q tested/verified dwelling ❑not-tested/verified dwelling in �� a HERS sample group HERS Rater Information Ca10ERTS Certifcate#CCi-1798603462 HERS Rater Company Name: Plus Air Duct Testing Responsible Rater's Name: Responsible Rater's Signature: 7ason Samaniego Jason Samaniego Responsible Rater's Certification Number w/this HERS Provider: Date Signed: 10/28/2011 CC2005629 Reg: 211-A0056244A-M2500001A-M25A Registration Date/Time: 2011/10/28 14:33:46 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 - — CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test— Existing Duct System (Page 1 of 2) Site Address• 20836 QUAI� RUN DR., City of Industry CA 91789 Enforcement Agency: _ Permit Number: (System 1) City of Diamond Bar 11-871 Enter the Duct 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 that must demonstrate comp/iance in the dwelling. This installation certi�cate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or�eplacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessib/e and they can be sealed. For a comp/ete/y new or rep/acement duct system installed in an existing dwelling, use the Installation CertiFcate tit/ed "Duct Leakage Test- Completely New or Replacement Duct System." Duct Leakage Dfagnostic Test-existing duct system Select one compliance method from the following four choices. �1. Measured leakage less than 15%of fan Flow �2. Measuredneakage to outside less than 10%of Fan Flow �3. Reduce leakage by 60%and conduct smoke and fix all leaks �4. Fix all accessible leaks using smoke and HERS rater verify }. Note: (One of Options,�l, 2, or 3 must'be attempted,�b„efo,e�utilizing Option,;4..)x,a; �,�,��,,,p,� Determine nominal'Fan�Flow using one of tfi"e`followtn'g three�caiculation methotls ��, �,�.., �a r� ��,�s = �, � � � � �-� �� _ � �"�� ✓0 Coolin system method: Size of condenser in Tons��x 400�=f 2000 CFM�� """ � � ,>�. � � � 9°� � ,,�.�s � p�, � � � � , - ✓❑Heatmgesystem met od: 21�7 x� Output Capac��in�Thousands of Btu/hr CFM � 'q� � �'�' i`��. ;� .� :' � �" a5�' �..z..�.�� r, d i�,r� ��'4'�^"�"��! �'� � "` W�' w r.d�t�` rl't`�e'+� � � � ' � d � .'� a, t � ... ❑Measure�d systern°'�a�rtlo„�,w,�,u5�ng�RA3,�a�rflpw�test�proCedur,es "_GFM � '�,�� , Option�`1"used�then"i ��.-� ;u�:, �.. �.,.�.;" _ � .��sr. .. � 1 Allowed leakage = Fan Flow 2000 x 0.15 = 300 CFM Actu_al,Leakag"e'°=. 301 CFM . ' � ;��. Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then:>. t;'i �� z Aliowed leakage = Fan Flow ='`"2000 x 0.10 = 200 CFM � Actual Leakage to outside = '��_�� CFM • Pass it Leakage Actual is less than Allowed Pass Fail Option 3 used then: Initial leakage prior to start of work = CFM Final leak�ge after sealing all accessible leaks using smoke test = CFM 3 Initial lea age_- Final leakage_= Leakage reduction CFM ((Leakage reduction_/Initial leakage� x 100% _ % Reduction Pass if% Reduction > 60% Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No smoke allowed to leak from system. Including ducts, plenums, air handler and door panel. Pass if all accessible leaks have been repaired using smoke 0 Pass Fail Reg: 211-A00 244A-M2100001A-M21A Registration Date/Time: 2011/10/28 14:28:33 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forma March 2010 , . • � . CERTIFICATE OF FIELD VERIFICATION 8� DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test— Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 20836 QUAIL RUN DR., City of Industry CA 91789 City of Diamond Bar 11-871 (System 1) b � Outside air (OA) ducts for Centrat Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage 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 cfosed position dunng duct leakage testing �.., � � �b. �:� � � .�' �' "w`'-� �,"�� a�� All supply�and return register boots must be`�seafed'to the drywall�if�,smqke test�is utilrzed forteompliance — applies to duct leakage compliance option 3 (leakage reduction�by 60%)�and option 4'�(f��all a�ccessible, - leaks) descri�bed above:�'�+ rs� ��=� E ��-� ��"`�� r� � � �� " ��'� �.� � ,� � �� Cw �'�` ! ,� � �� - �� -�� ,M��',�"��', �' �New duct inst�al,la�t�ons��cannot util�e�building cav�t�ies as�°ple�nums�or platform returnS in lieu of Gucts M .....w,�+. �..� �� `�; ��'.��'�'' - -��a;�;-�.t .�_ ��_ ��.�'`w ,�,.,�'. � _: �;!.��''.��,r� � Mastic e�nd'draw bancls must�be.used�m'corribination�with�cloth'backeii`rubber�adhesive duct tape to seal leaks at all new duct connections� ` ��:�, �, DECLARATION STATEMENTyF`';'' . 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 the certified HERS rater wFio performed the verification services identified and reported on this certificate(responsible rater). . The installed feature,material,component,or manufactured device requiring HERS verification that is identified on this certificate(the installation)complies with the applfcable requirements in Reference Residentlal Appendices RA2 and RA3 and the requirements specified on the Certificate(s)of Compliance(CF-1R)approved by the local enforcement agency. . The information reported on applicable sections of the Installation CertlFlcate(s)(CF-6R),signed and submitted by the person(s) responsibte for the installation conforms to the requirements specified on the Certificate(s)of Compliance(CF-1R)app.roved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF-6R) Company Name: (Installing Subcontractor or General Contractor or BuilderJOwner) TORO HEATING AND AIR CONDITTON Responsible Person'S Name: CSLB License: jose gonsalez 921672 HERS Provide�Data Registry Information Sample Group # (if appiicable): N/A �tested/verified dwelling ❑not-tested/verified dwelling in a HERS sample group FIERS Rater Information CaICERTS Certificate#CCi-1798603462 HERS Rater Company Name: Ptus Air Duct Testing Responsible R er's Name: Responsible Rater's Signature: Jason Samaniego Jaso� Samaniego Responsible Rater's Certification Number w/this HERS Provider: Date Signed: 10/28/2011 CC2005629 Reg: 211-A0056244A-M2100001A-M21A Registration Date/Time: 2011/10/28 14:28:33 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010