HomeMy WebLinkAbout13-758 `�- 1 CITY OF DIAMOND BAR �
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� 21810 Copley Drive,Diamood Bar,CA 91765
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INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5)
Site Address: Enforcement Agency: Permit Number:
23806 Twin Pines Ln, Diamond Bar CA 91765 City of Diamond Bar 13-758
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 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 identified on this
certificate (the installation) compiies with the applicable requirements in Reference Residential Appendices RA2 and
RA3 arid the requirerrients 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) resUomsit�le for the installation conforms,to the,r,equi,cements;specified:on.the.Cer,tificate(s)>of.Compliance
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(CF-1R).yapp�oved by the enforce`ment,agency. ' a� ���
Builder,or=Installer information,as.shownFon the Installation Certificate,,.(CF-6R);;;xa,; N
Company;Name: (Installing Subcontractor or General Contractor or�Builder/Owner) `'. ;, �
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� LA SERNI�CES INCr • , , �.t�. :s. �
Responsible P_,erson'srName r=' , -- CSLB�License" �. .. „
Leslie Diamond � 614102
HERS Provider Data Registry =nformation
Sample Group.# (if applicable): N/A �tested/verified dwelling � not-tested/verified dwelling
in a HERS sample group
HERS Rater Information Ca10ERTS Certificate # CC1-1798735718
HERS Rater Company Name:
2nd to None HERS Ratings
Responsible Rater's Name: Responsible Rater's Signature:
Raymond Moreno Raymond Moreno
Responsible Rater's Certification Number w/this HERS Date Signed: 2/28/2013
Provider:
CC2006075
Reg: 213-A0013135A-M2500001A-M25A Registration Date/Time: 2013/03/O1 09:41:07 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms February 2013
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