HomeMy WebLinkAbout15-0080DIAHOND DAR'
CITY OF DIAMOND BAR
DEPARTMENT Off' COMMUNITY & DEVELOPMENT SERVICES
21825 Copley Drive, Diamond Bar, CA 91765
(909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839-7027
BUILDING PERMIT APPLICATION
JOBSITE
ADDRESS
APN LOT TRACT
OWNER 16FIe �b
ADDRESS
CI ZIP%A-_UW6TEL.
APPLICANT TEL • 2 \ :i. Ilo�Fo
CONTRACTOR P11C
ADD SS
CITY \ — IP TEL. 21 S '1i le
ARCH/ENG/ �L 4
DESIGNER I�
ADDRESS
CITY .. ZIP TEL. �.
OWNER -BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI-
CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR
COUNTY WHICH REQUIRES A PERMITTO CONSTRUCT, ALTER, IMPROVE, DEMOLISH, OR REPAIR ANY STRUC-
TURE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED
STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI-
CENSE LAW (CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PRO.
FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP-
TION. ANY VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO
A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS ($500).)7
❑ 1, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION,
WILL Do THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSI.
NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF
PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR
OFFERED FOR SALE. IF, HOWEVER, THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLE-
TION, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR
IMPROVE FOR THE PURPOSE OF SALE).
❑ I, AS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS
To CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI-
CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND
WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRAC-
TORS LICENSE LAW.).
❑ I AM EXEMPT UNDER SEC. B. 6 P.C. FOR THIS REASON
DATE OWNER
LICENSED CONTRACTORS DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER
9 (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND
MY LICENSE IS IN FULL FORCE AND EFFECT.
LICENSE CLASS ( A 0 LIC. NO.
DATE CONTRACTOR
WORKERS' COMPENSATION DECLAR 10 }
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
_ I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS'
COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE
JXJXOF THE WORK FOR WHICH THIS PERMIT IS ISSUED.
HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY SECTION
700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
SUED'MY WOfKERS�COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE:
CARRIER
POLICY NUMBER,` \�\Y�����������
(THIS SECTION NEED NOT BE CWPLMDOF THE PERMIT IS FOR ONE HUNDREDDCUAKS($100)OR LESS}
I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I
SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE
WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME
SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR
CODE. I SHALL FORTHWITH COMPLY WI THOSE PROVISIONS.
DATE: APPLICANT.
WARNING: FAILURE TO SECURE WORKERS' COMPENARAGE IS UNLAWFUL, AND SHALL BE
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANUPTOONE HUNDRED THOUSAND
DOLLARS ($100,000), IN ADDITION TO THE COSTOFCDAMAGES AS PROVIDED FOR IN
SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY
FOR THE PERFORMANCE OF THE W1RK FOR WHICH THIS PERMIT IS ISSUED (SEC. 3097, CIV. C.).
LENDER'S NAME ,N` A
LENDER'S ADDRESS
I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT.
I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING
CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE
ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES.
LQUX a-
PE ITTEE NAME (PRINT) �
S06MTUREOF MITT DATE
WHI Department Copy, YELLOW—Finance Copy, PINK
Al
PRESS
FIRMLY
APPLICATION' PERMIT + P/C
DATE i � NUMBER L/ "WdV #
ISSUE TYPE OCC
DATE CONST. GROUP
ZONING SETBACKS
FRONT RW ❑
REAR ❑
SIDE/SIDE STREET RW ❑
SIDE 0 -
•,
PROPOSED USE S
11A
4014
NO. DWEL. N
UNITS STORIES BEDROOMS
DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION
SFR/ADD/REM
Cf)
Garaga/Carport
w
Patio/Deck
L.I
L
LL
PooVSpa
0
Z
Re -Roof
Commercial
nnfitn
-n
m
Valuation ADJ.AREA
QUANTITY DESCRIPTION FEE
J
Q
U
cc
H
U
W
w
0
Z_
m
a
J
Q
U
1
05 Inn "tckv I?
2
Q
2
U
W
CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
SMIP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE:
PRE -ALT FEE:
UIP" _T
TOTAL FEES
COMMENTS
a
RECPT NO. PAID BY VALIDATION
�upy, uvwennuu—rile L:opy, c;HEEN—Applicant's Copy V
51)
Rm CITY OF-WAMOND BAR
INSPECTION RECORD
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. BOND BEAM
FRAMING/VENTILATION
FINAL BOND BEAM
ROOF COVER
PRE -GRADING
ROUGH HEATING
BENCHING
ROUGH ELECTRIC
ROUGH GRADING
ROUGH PLUMBING
FINISH GRADING
SHOWER/TUB TEST
POOL ELECTRIC
EXT. LATH/SIDINGI,'C-J�)-, �; r,-) t{ j7
POOL FENCING
WALL INSULATIO Q-�9 I_ 'U if 'r"U d
POOL FINAL
�-, ' "i : �' ;
CEILING INSULATIO :. , i
OFF SITE IMPS.
DRYWALL NAILING U 6 8
DEDICATIONS
SEWER
FINAL ENG.
SEPTIC TANK
LANDSCAPE/IRRIG.
SEEP PIT/L.L.
ON SITE IMPS.
GAS AIR TEST
FINAL ZONING
FINAL CONST. _ _
FINAL HEATING
FINAL ELECTRIC _
FIRE DEPT. FINAL
HEALTH DEPT. FINAL
DEV. FEES PAID
_
FINAL PLUMBING
ENERGY
COMMENTS
-
SEPTIC TANK SIZE
SEEP PIT/U SIZE
1r
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT HVAC)
Project Name:
DEATON I Date Prepared:
CFiR-ALT-02-E
(Page 1 of 3 )
2014-12-29
A. General Information
CFIR-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one CF1R-ALT 02 document for each dwelling unit.
01
Project Name
DEATON
02
Date Prepared
2014-12-29
03
Project Location
522 TORITO LANE
04
Building Type
Single family
05
CA City
t
06
Dwelling Unit Name
HOME
SCS '
' SC Systietn i
CFA served
OB
Dwelling Unit Conditioned
2000
07
Zip Code
91765
Floor Area W)
ovation leap
byii�
contaioing ��
system
Number of space conditioning
entirely new
09
Climate Zone
9
10
(SC) systems In this dwelling
i
com pone ?
components? ,
feet 6f ducts?
duct system?
unit.
B. Space Conditioning (SC) System information
01
02
03
04
05
06
07
08
09
10
,4
Is the SG , r
lnstalling a;
t
SCS '
' SC Systietn i
CFA served
tz
refrige ant
installing new SC _
Installing
Installing
Installing
o
ovation leap
byii�
contaioing ��
system
amore than 40
entirely new
entirely newIdentification
SC
Alteration Type
Name
� , i Se
Systetrr ..
, system?
com pone ?
components? ,
feet 6f ducts?
duct system?
system?
r
Entirely neve or
System 1
2000
2000
Ye
U.
Yes
ergy R
Y _
ters Asso
-Yes
iation
Yes
Yes
complete replacement
space conditioning
system
.
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1D11b)
This section does not apply to this project.
Registration Number: 314-A1003517A-000300000-0000
Registration Date/rime: 2014.12-29 15:43:06
HERS Provider: USERA
CA Building Energy Efficiency Standards- 2013 Residential Compliance Report Version; 2014.03.31 Report Generated: 2014-12-29 15:43:14
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Rage 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)IE and F)
This section does not apply to this project.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)IDiia and 150.2(b)lE, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
01
02
03
04
0S
06
07
08
09
30
11
Heating
Cooling
System
Heating
Minimum
Cooling
Minimum
Required
Identification or
Heating System
Altered Heating
Efficiency
Efficiency
Cooling
Altered Cooling
Efficiency
Efficiency
Thermostat
New Dud
Name
Type
Component
Type
Value
System Type
Component
Type
Value
Type
R -Value
System 1
Central split HP
All new heating
AFUE
78
Central split
All new cooling
SEER
13
SetbackTher
mostat
R-6
components
HP
components
R �r r m r ? w
—...3 x r e1, 1'
ti'S4511
MR4MCH-01-E 5�� ditioning S ikts D k#t end Fans
-Duct insulatan requi est for new
CUR & MR-MCH.20. [ t leakage eatiof �
-leakage rate compiia 6%.
MR & MR -MCH 22 �rtacy Ver r
CF2R & COR -MCH -23 Vrz* '
-Compliance: Fan EfficacySik98 m and system 50 cfm(tQn:`
Alternative Compliance: CUR & MR -MCH -28 Return Duct Design Yeriiis a�R1,fe�yint�Ealt2ppla}�itt2 t.
CF2R & MR -MCH -25-H Refrigerant Charge Verification required when reWo t c Fehr i #ck4piy � flt'�bj� 8-15).
ExceiltionIA
Heating -only systems are exempt from the 0.58 Wfcfm and 3S0 cim/ton requirements.
hote:
An "entirely new or replacement duct system" means at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the dwelling unit's existing duct system (e.g„
registers, grilles, hoots, air handier, co;l, plenums, duct material) if the reused pans are accessible and can be sealed to prevent leakage
Registration Number- 314-A1003517A-040000000.0000 Registration Datet ime: 2014-12-29 15:43:66 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-29 15:43:14
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE UlR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature.-
ignature:!im
JimMcEligot
Signature Date:
Company:
RighTime Home Services
2014-12-29
Address:
CEA/ HERS Certification Identification (if applicable):
3030 Myers St
878533
Clty/State/Zip:
Phone:
Riverside CA 92503
951-276-9744
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2_ 1 am eligible under Drvision 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculat nns, plans and specifications submitted to the enforcement agency for approval with this building permit application.
S. 1 will ensgea registered cz�y oft OERtfltate.gf Comppliaa. shall he mad6 available with the buildingpermit(s) issued for the building, and made available to the enforcement agency for all applicable
inspecuortf demand t re i taylaxtp is fertificate of Compliance,is required to be 1"ded with the docuimeniation the builder provides to the building owner at occupancy.
Responsible Designer Responsible Designersignature:
Jim McEligot fl
Company: i Date Signed: '•
RighTime Home S- -��°
_ - - k _ 2014-12-29,
..,
Address: license:
3030 Myers St U.S. Energy Ra 3Association
City/State/Zip. Phone.
Riverside CA 92503 951-276-9744
Registration Number: 314-A1003517A-000000000.00D0
E 474
sem- TM
U.S. Energy Raters Aasoelatlon
'This dgdaf signature is provided in order to secure
the content of this registered document, and in no
way implies Registration Providarresponsihility for
the accuracy of the intormatfon.'
Registration Date/Time: 2014.12-29 15:43:06
HERS Provider: USERA
CA Build=.ng Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014.03-31 Report Generated: 2014-12-29 15:43:14
Schema Version: 0.551SDD
CERTIFICATE OF VERIFICATION
CF3R-MCH-23-H
Space Conditioning System Airflow Rate
(Page 1 of 4 )
Project Name: Deaton
Enforcement Agency: Diamond
Bar Building Department
Permit Number:
15-0080
Dwelling Address: 522 Torito Ln.
City: Diamond Bar
Zip Code:
91765
A. Ducted Cooling System Information
01
System Identification or Name
System 1
02
System Location or Area Served
2000
03
System Installation Type
Replacement
04
Nominal Cooling Capacity (tons) of Condenser
5.0
05
Condenser Speed Type
Single Speed
06
Cooling System Zonal Control Type
Not Zonal
07
Central Fan Integrated (CFI) Ventilation System Status
Not a CFI system
08
System Bypassf Duct Status ; _
No Bypj ss.'Duct ..:
09
Date of System Airflow Rate lMeasurement
10
t
Airflow Rate Protocol utili'd r '
I a 1 l
RA3 3 procedures�forairflow`rate'mea'suremt
B. Hole for the placement of a Static Pressure Prob4g;P),ESWF&Yn�0i EMIA69illgOLI iQ&be (PSPP)
in the supply plenum.
Procedures for installing HSPP or PSPP are specified in RA3.3.1.1.
01 I Method used to demonstrate compliance with theI HSPP installed and labeled consistent with Figure RA3.3-1
HSPP/PSPP requirement
C. Airflow Rate Measurement Apparatus and Procedure Information
Instrument Specifications are given in RA3.3.1.1, and system airflow rate measurement apparatus information is given
in RA3.3.2.
01
Airflow Rate Measurement Type used for this airflow rate
Flow Grid according to procedure in RA3.3.3.1.2
verification.
02
Manufacturer of Airflow Measurement Apparatus
True Flow
03
Model number of Airflow Measurement Apparatus
DG700
04
Certification Status of the Airflow Measurement Apparatus
Certified by Manufacturer and listed on CEC Website at
Accuracy
http://www.energy.ca.gov/(tbd)
Registration Number: 315-A1003517A-M2300644A-M23A Registration Date/Time: 2015-01-12 14:36:27 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-01-12 14:36:35
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 2 of 4 )
MCH -23a Forced Air System Airflow Rate Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed
Compressor
D. Forced Air System Airflow Rate Measurement
The procedures for System Airflow Rate Verification are specified in Reference Residential Appendix RA3.3.
01
Required Minimum System Airflow Rate (cfm/ton)
350.0
02
Required Minimum System Airflow Target (cfm)
1750
03
Actual System Airflow Rate Measurement (cfm)
1883
�04
Compliance Statement:
System airflow rate complies
E. Additional Requirements
01
Air filters that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in
the system during system air flow rate measurement identified on this Certificate of Installation.
The airflow rate measurement a'ppIratus usegAo perform the airflew rate measurement identified on this Certificate of
02
Installatio l wars calibrated in accordance with the apparatus -manufacturer's -specification's and conforms_ to the
instrume lation specifics ti dns gi�en,in_ft 33�1�i
A visual inspection shallspnfirm.that bypass ducts that deliver co ditioned-supply air directly to the space, conditioning
system return duct airflow are not su ed o nn ew or replacement zonlally"controlled systems unless the Performance
03
Certificate of Compliance indicates an allowance foMf,ai jq7 V111 s$ion the
Performance Certificate of Compliance, the airflow rate shall conform to the specifications listed on the Certificate of
Compliance.
04
All registers were fully open during the diagnostic test.
05
System fan was set at maximum speed during the diagnostic test.
06
If fresh air duct is part of the HVAC system it was not closed during the diagnostic test.
07
Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value.
Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan
08
efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air
handler fan speed.
09
Verification Status
Pass - all applicable requirements are met
10
Correction Notes
The responsible person's signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status and the Corrections Notes in this table.
Registration Number: 315-A3003517A-M2300644A-M23A Registration Date/Time: 2015-01-12 14:36:27 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-01-12 14:36:35
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: T
Jason Iskades'`
Company:
Date Signed:
Athens Air Inc
2015-01-12
Address:
CEA/ HERS Certification Identification (if applicable):
21151 Laguna Ct.
1408091430
City/State/Zip:
Phone:
Apple Valley CA 92308
760-486-5544
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The infomatidn reporte on a plicable,sectioris ofthe�Certlficate(s)'of Installation (CF2R) signed`and'submitted by the:pe-rso`n(s) responsible for the
construction or installation conforms to thelequirements specified'on the'Certificate(s) of Compliance'(CFI1R) approved by trie enforcement agency.
5. 1 will ensure that a registered copy of this,Certifficate bff Verification shall be posted, or -made available with the building permits) issued for the
building, and made available to the enforcement agency for all applicable spectionsa undi r'tand'that a`registered copy of tF is Certificate of
Verificati I n isl'quired to be included with-the•doumemation the builder provides tf the building owner at occupanry,--
I r �.
,
Builder Or Installer Inform tion As Sho O f,The *1frcate Of Installation t 3 ,
Company Name (Installing Subcontractor, General Contractor, orBuilder S: Energy Raters Association
RighTime Home Services
Responsible Builder or Installer Name:
CSLB License:
Jim McEligot
878533
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
315-1319
Tested
HERS Rater Information
HERS Rater Company Name:
Athens Air Inc
Responsible Rater Name:
Responsible Rater Signature:
Jason Iskades
4..111., Skal(es
asonlskades Jan 12 2015
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
1408091430
2015-01-12
TM
n "This digital signature is provided in order to secure
1 the content of this registered document.. and in no
way implies Registration Provider responsibility for
.U.S. Energy. Raters Assoclatton the accuracy of the information."
Registration Number: 315-A1003517A-M2300644A-M23A Registration Date/Time: 2015-01-12 14:36:27 HERS Provider: LISERA
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-01-12 14:36:35
2013 Residential Compliance Schema Version: 0.515DD
CERTIFICATE OF VERIFICATION CF3R-MCH-23-H
Space Conditioning System Airflow Rate (Page 3 of 4 )
F. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol
requirements in order for this Certificate of Verification as a whole to be determined to be in compliance.
01 I Complies: All specified verification protocol requirements on this document are met.
t
U.S. Energy Raters Association
Registration Number: 315-A1003517A-M2300644A-M23A Registration Date/Time: 2015-01-12 14:36:27 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-01-12 14:36:35
2013 Residential Compliance Schema Version: O.51SDD