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Home My WebLink About12-642 _ �- CITY OF DIAMOND BAR � -"--�'�`—�'' DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �� 21810 Copley Drive,Diamond Bar,CA 91765 ' . (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS ��''"'. BUILDING PERMIT APPLICATION FIRMLY Q DDRESS � L �`� ��j� � APPLICATIO PERMIT /�J n p/C I o DATE � NUMBERI�� r � APN � � OT TRACT ISSUE / 7yPE �C DATE ��/ CONST. GROUP ' p OWNER 2 o ADDRESS � ��C� ��C�Iu�� ZONING SETBACKS z CITY�v� ��. ZIP `1'/7l�fTEL.G 3�LJ�� FRONT pyy � . � APPLICANT TEL. � REAR � ¢ SIDE/SIDE STREET pyy p � CONTRACTOR _ E�� SIDE � ADDRESS_�9l 3-E' fi�L�-✓l.L,w.�_ G�t�C�. • o CITY � ZIP�TEL_��7 j^ZL PROPOSED USE , � ^ �- o ARCH/ENG/ �z DESIGNER NO.DWEL NO. NO. a ADDRESS cn UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION OWNER-BUILDER DECLARATION p � SFR/ADD/REM p I HER�V AfFIRM UNDER 7ENIW7Y OF PEiL1URV THAT I AN E7tEMPT FROM 7HE CONTMCTORS LL GefB B/C9 I W CENSEUWFORTHEf-0LLOWINOREASON(SEC.7o31.60U51NE5SMIDPROFE5S10N5CO0E:ANYCIIYOR (n 8 �� WU COUNTYWHIq1RE0UIRE3APERMITTOCONSTRUCT,ALTEFLfMPROVE.DEMOLISH,ORREVAIRANVSTRUG ' P8I10/DBCk � I TURE.PRpR TO RS�ISSUANCE,ALSO qEWIRES THE MPL1CANf FOR SUGi PERMIT TO F7LE A SqNED �W � STATEMENi THAT HE OR SHE IS LICENSED.PURSUANT 70 hIE PROVLSIONS OF THE COMMCTORS L4 . , . � CENSE UW(CHAPTER Y�COMMENCWU WITH SECTION 7000)pF DINSION 3 OF T1E BUSWESS AND PRP � POOVSPB � �. FESSIDNSCOO�ORTHATHEORSHEISEXEAIPTTHEREFROMAND7HEBASISFOR7HEALLE6EDF�cEMP- � (� TIDN.ANYVIOIATIONOFSECT10N703t.6BVANYAPP�ICMlTFORAPERMI7SU81ECTSTHEAPPLICANTTO Z� RaRoot � ACIVR VENN_TY OF NpT A10RE�THAN.FNE HUNDRED DOLLARS(1500).): � Z ❑4�4�WNEROFTHEPROPERTV,ORMYEMPLOVEE9WfTH14AOE5ASTHEIRSOLECOMPENSATION, � COR1R1BfCi81� � WILL DO THE WORI(AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SLLE(SEC.7a+,BUSF _J � NESS ANO PROFESSIONS CODE:THE COMMCTORS UCENSE lAW DOES NOT MVLY TO AN OWNER OF ? � .. PROVEqry NR{p BU�L0.4 OR IMVROVES THEREON.AND WHO DOES SUp1 WpRI(HW SE�F OR HERSELF OR � THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ME NOT INTENDED OR m � . � OFFEREDPDRSALEIF,HOWEVER7MEBUILDWOORIMPROVEMENTISSOLDWfTHINONEVEAROFCONPLE- Z TION,.THE OWNER�BUILDER WILL HAVE 7HE BURDEH OF VROW�(3 T}�AT HE OR SHE DID NOT BUfLD OR _ = IMPROVE FOR 7HE PURPOSE OF SALE� � . . W ❑I,ASONNER OF 7HE PROPERTY;AM E%CLUSNELV CANTRACTINO WfTH LICENSED COHiRACTORS [[ TO CONSTRUCT THE PROJECT(SEC.70N,BUSINESS ANO PROFESSIOHS CODE THE CONTMCTORS U- Valuatlon� qp,�.pqE,q � � -� • L11 CENSE UW DOES NOTAP7LY TOAN OWNER OFA VROPERTV WHD BURDS OR W PROVES hiEREON,AND � � F N41000NTRACTSFORSUCHPROJECfSWfTHACANTRACTOR�S)UCENSEDPURSUANTTOTHECONiRAP p�qN�7Y DESCRIPTION FEE . TORS UCEMSE UW.). � ❑I AM E%EMPT UNDER 6EC. �B.6 P.C.FOR TUS REASON � S � U � OATE ONTJER �f- � � LICENSED CONTRACTOFS DECLl+RATION � W �- � � �� - � � 1 HEREBY AFFlRAI UNDER PENALTV OF PE0.RIRV THAT IAM LICENSFD UNDER PROVISION$pF G7AFTER � � � Y(COADAENCMO LNTM SECTION 7000)OF DMSION]OF iHE BUSMESS M�/PROFESSIONS CODE,AND Z , � �� AIY LICEN9E IS fN FULL FORCE AND EFFECT. m � LICENSE CLASS LIC.NO.. � � - , � V DATE CONTRACTOR d �� . W � WORKERS'COMPENSATION DECLARATION � � � - �- � � 1 HEREBY AFFIRM UNDER vENµT/pF pERNiiY ONE OF THE FOLLOW WG DECLAfUiqNS: U N Z � _I HAVE�AND WILL MAINTNN A CERTIFICATE OF CONSENTTO SELF-INSURE FOR WORKERS' � � / - � COMPQlSATION,15 PROVIDED BV SECTION 3700 OF 7HE UBOR COOE,Fpq 7HE pEqFpqMM1�F W� (�(�- OF THE WORK FOR WHICH THIS PERMIT B ISSUED. � � � � _I IiNVE AND WILL AWNTAW�WOR)(ERS'COMPENSATION IN9UR/NlCE;A9 REOUINED BV SECTION - � � . � 37ooOFTHE IABOR CODE,FORTHE PERFORAIANCEDFTHE WORK FOR WHI IS PERMI719. ISSUED.MV ERS COMPENSATION INSUHAIJC CARqIE 'AND VOLICY qAqE � �CONSTRUCTION� � POLICV NUMBER� � Z // ' . . . ELEC�REC� .. . . . . . . �� _ ¢ r �� (n+ssEcnonN�r+oreeaotir�'rmoFn�a�rrswaa�Huo�noowwsls�ro)ora� PLUMBING Z 1 CERTIFV THAT W THE PERFO{UTANCE OF THE WORK FOR WH1C7/TNIS PERMR IS ISSUED,I MECHANICAL� � �Q , (� C� SHALLNOTEMPLOYM7YVERSONWANYMANNER50/�STOBECOME�SU&IECTTOTHE � � (/� WORKERS COAIPENSATION LAWS OF CALIFORNIA,AND A6REE THAT IF I S/IOULD BECOME INSPECTION FEE SV91EC7 TO 7HE WORKERS'�(XIMPENSATqN PRpyt510N5 OF SECTION 77 F THE UBOf�� - ' O cooE,i sruu FoarM+nn�coua�r vnni nwsE Pqo�sior�s. ISSUANCE � 0 DATE:`� _W�I/ APPI:ICMli: .SMIP , . W � WARNINO:�FMLURETOSECUREWOfiKERS'COMPENSATIONCA GEISUNUWFUL,ANDS 8E ENERGY�P/C � " � SUBJECTANEMPLOYERTOCRIMWALPENALTIESANDCIVILFWESUPTOONEHUNDREDTFqU,aANp ENEROYPERMIT D�lUA3(S10o,o00),�W ADDI710N TO THE COST OF COMPENSATION,DAMAl3E5 AS PROV�Ep�Fpq IN J 6ECTION 37oe OF THE LABOR CODE,BdTEREST,AND ATfORNEY'S FEES. � - ' - w RETENTION FEE: �Zi,D�� O . CONSTRUCTION LENDING AGENCY - PRE-ALT FEE � 1 HER�Y AFFIRM UNDER PEN�LTV OF PERIURY THAT THERE IS ACONSTRUCTION LENDINO A(iENCY Zd' FOR THE PERFORMANCE OF THE WORK FOR WHlq1 THIS PERMIT IS ISSUED�SEC.70W,qV.C.�. W ��. LENDERSNMIE . . . � . � LENDEfYSADDRES3 ' �' - - �� . . _ . - . . . ��./�� 1 I CERTIFY THAT I HAVE READ TH19 APPLICATION AtJD STATE THATTiEABOVE MFORMATqN IS CORAECL TOTAL FE ES 1 ARREE TO COAIPLv WITH ALL CT'AND COUNTv ORDINMICES AND STATE UWS R9ATN(i Tp BUI�DINO .� CONSTRUCTION,ANDHEREBYAU7HORIZE�REPRESEN7ATIVESOFTHISCOU!l7Y70EHiERUPONiHE ' Z ABOVE-MEMIONEO PROPERi7 FOR INSPECTION PURPOSES. COMMENTS " � � �^' � �� . . . . "'� {f'pi(..�v � m FE fTTEE E(VRI � � `('.. y�)/ Uj SIONATURE OF P ITTEE DA7E " � RECPT.NO. PAID BY' VALIDATFON WHITE—Deperlment Copy,YELLOW—Finer�ce Copy,PINK=Assessor Copy,GOLDENROD—Ffle Copy,GREEN—ApplfcaM's Copy CITY 4F D1AtVI�NQ BAR � �- - ' '' - ' I�SPECTit?�i REGORD � + ' . F;-� �r � �.P � , . � -;�"'.� � {}� t y.: �:� 8 + � �'��'�y e .. � a ... e+�3. . .:. . .,y . ..�� . +. -?a +5::: . ,u� ��.:a �-��'„F;�:�. �- SET BACK FL(30R)OIST .t , , , c _. _ FTGS/FORMS/STEEL � }�HA REC}MTS ELECTRIC GftOUND ..—�_ — — —� �UNDER F(.00?R DUCT � _ GRQUND PtUMBiNG UNQER Ff.40R CC?NDUlT SLAB GRADE FIREPLACE Ft�UNQATIQN TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT.BOND BEAM ROOF SHEATHING 8 FT.BOND B[AM FRAMING/VENTILATIOId FI(dAl BOND BEAM ROOF CQVER � FRE-GRADING � � ---.._...—...�. ROUGH HEATING i— —�—_� _._ BENCN(NG ROUGH ELECTRIC RC7UGH GRADING ^ R{}t1GH P�UMBiNG FIN{SN GftADING SNOWER1TilB TEST FOC3L ELECTRIC EXT.�ATN151DING PC?OL FEhlCING WAI�IN5ULATIQN PC70L FINAL CEILING INSULATION OFF 51TE IMPS. DRYWALL NAILItdG DEDICATIONS ��R � � FINAL ENG. - - SEPTICTANK ^ lAND5CAPE/IRRIG. � SEEP PIT/L.L. ON S�TE IMPS. GAS.AIRT.ES�- FlNAt�ZONING �""' F1NAE Ct3N5T. FIRE DEF'T,FINAL FINA�HEATING NEALTH DEPT.FINAL FINA�ELECTRIC ! :�' QEV.FEES PAID FiNAL PlUM64NG � }'f`a ENERGY FINAL PLANING FINAL ENGlNEERING � u • � � � CQMMENTS _ _ ; . ��. — �_�(( �r`e.C ��"'�- i(,l !�.��{L ��"1'�.�� __.`�. ,__ 13,i�t ��'y'b i q+i,�r �ic vt^ ��`1�.�'_ : t C� �.,f,' ,+�-��' �-�-�� . SEPTIC TANK 5lZE ` � 5EEP FIT/U$!ZE �� 1� ,,, � 4 • _ F+rescri tive Certificate of Com liance: Residential CF-IR-ALT 'Residerz£ia!AI[erations (Pa e 5 of 5� Project Nam�: Climate Zone# #of Stories �.�� iv�,�- � �. HERS VERIFICATION SUMMARY The enforcement agency should pa�+special altentio�r to the HERS Measures.specified in zhis checklist 6eloH�. A completed and signed CF-4R Form for al!the measures specified shall be submt�ted lo the building ii�speclor before ftnal irrs ection. Duct Sealing&Testing HERS verrf:catia�is required.for this measure. ❑YES ❑NO YES:In Climate Zones 2 and 9-16,if more than 40 lineaz feet of new or replacement ducu aze installed in unconditioned space,the ducts are to be sealed per§152(b)1Dii and the newly installed ducts aze to be insulated per§151(�10. � EXCEPTION:Existing duct systems that are�eatended,which are constructed,insulated or sealed with asbestos. ❑YES ❑NO YES:In Climate Zones 2 and 9-16,if the existing space-conditioning system(HVAC equipment and ductiog)is replaced,the ducts are to be sealed per§152(b)1Di. ❑YES ❑NO YES:In Climate Zones 2 and 9-]6,if the existing HVAC.equipment is replaced(including the replacement of the au handler, outdoor condensing unit of a split system,cooling or heating coil,or the furnace heat exchanger)the ducts are to be sealed per§152(b)lE_ ❑ EXCEPTION:Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix I2A3. ❑ EXCEPTION:Duct systems with]ess than 40 linear Feet in unconditioned space. ❑ EXCEPT'ION:Eaistin duct s stems constructed,insulated or sealed with asbestos. Refrigerant Charge-Split System HERS ver�cation is required for this meosure. ❑YES ❑NO YES:In Climate Zones 2 and 8-15,when the existing HVAC equipment is replaced(including the replacement of the air handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the fumace heat exchanger)a refri erant char e measurcment shall be verified er 152(b)IF. � Central Fan Integrated (CFn Ventilation System and Fan Watt Draw . The ventilation r uiremcnts of§150 o do not a ly to existin residential homes. Ducted Split Systems-Air Conditioners and Iieat Pumps: Airflow HERS veriftcation is r•equired for�his measure. ❑YES ❑NO YES:In Climace Zones 10 through 15,when the existing space-conditioning system(HVAC equipment aiid ducting)is re ]aced,the airflow and fan watt draw shall be vcrified per§152(b)1Ci to meet the rec�uirements of§151(�7B. Docamentation Author's Declaration StaYement • I certif that this Certificate of Com liance documentation Ls accurate and com lete. Name: ��j Signature: ��_ "�z. Compan : Date: �,�,�o � J'-_ �- i 2r Address: /�, � ��_ If Applicable O CEA or 0 CEPE �� (Certification#): City/StatefZip: , ' Phonc: • �'�'�� Responsible Building Designer's Declaration Statement v I am eligible under Division 3 of the Califomia Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • I certify that the anergy features and performance speciFicauons for the building design identified on this Certificate of Compliance conform to the requiremenu of Title 24,Parts 1 and 6 of the California Code of Regulations. e The building design features identified on this Cerbficate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms,worksheets,calculations,plans and specifications submittcd to the enforcement a ency for a roval with this buildin ermit a lication. Name: �, � Signature: Compan� Date: r "' � 7�� / Z_ Address: � �� ^ �� License: y.l"'ui� City/Sta ip: Phone: - ' � Jv ,-�bG � For assisialr.ce or questions regarding t/ze E�:er�Standarrts,contact the Energy Hotline ar:1-800-772-3300. Registration Number: Regisrration DatelTime.• HERS Provider: 2008 Residential Cnmpliance Forms August Z009 � . - �.�..;_, �'' IN5TALLATIUN CERTIFICATE CF-6R-MECN-2I-HERS II Duct l.eakage Test— Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Perrnit Nurnber: 1906 WHITE STAR DRIVE, Diamand Bar CA 91765 (System City of Diamand Bar 12-642 1) Enter the Duct System Name or ldentification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Instatla[ion Certi�cate for each duct system that must demonstrate complrance in the d welling. This installation certiFcate is required for compliance for alteratians and additions in existing dwellings to space conditioning systems and duct systems. lVote; For existing dwellings, a campletely new or replacement duct system can also include ex�sting parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system +nstalled in an existing dwe!ling, use the Installation Certifieate titled "Duct�eakage Test- Completely New ar Replacement Duct System." Duct Leakage Diagnastic Test-existing duct system Select one complia�ce methad from the following faur choices. 0 1. Measured leakage less than 15% of fan flow �2. Measured leakage to autside(ess than 1Q%of Fan Flow I � �3. Reduce leakage by 60°lo and conduct smake and fix aif leaks �4. Fix aiI accessibie ieaks using smoke and HERS rater verify Note; (One af Options 1, 2 or 3 must be attempC,ed�before.uti�izingrOption„_4.)_ Determine norr`�ina) Fan-F1ow using one af.tfie"�foNbw�ng th,r,"ee'calctilation rn"ethods.��" ^�Y �rt *�' �' ✓0 Cooling�s,ystem rnethod Size of�conclenser in Tons r�5 x 400 �2�00�CFM ��: � r� f�3'_"'� �'�'i �' �'�`. 7�� . .,r� . � �` . `� �' . i � ��" � �k J O Heat�ng�system me�hod 2� 7� ��OutpuC CapacEty in Tt�ousands of�BtuJhr= � e�M � � � �, � , ��.a� � �"�� T �� '°� � ��`� �� ' � ✓O Measured sys�em airfiow�using�RA3 3�airflow-test�procedures�,,�"'�C�M�� ,�'�� '` ,�� _"� ��,;�� _,,� � ,� _, ,..� �_ � .�,. �, . ._ . .. ...,_�_ .,_ , . „_., Actua)Leakage =�,2,�1 CFM � .� . Opt�an 2 iised then: ` � �� 1 Allowed leakage �Fan AirFlow 20Q0 x 0:15 = '.300 ' CFM '� Pass if Actua! �eakage is less than Allowed(eakage Pass Fail Option'2 used then;,, z Ailawed Ieakage = �an.Airflow�x d.10 =_CFM Actua!Leakage to outside =_.CFM Pass if Actual leakage to outside is fess than AOowed leakage Pass Fail Option 3 used tfien: Initial leakage priar to start of work =_CFM Final leakage after seaiing ail accessible ieaks using smoke test =_CFM 3 Initial leakage_- Finai feakage_ = Leakage reduction_CFM ((Leakage reduction_„/Initial leakage� x 100°/a = % Reduckion Pass if�!o Reduction > 60% �Pass p Fail Option 4 used then: 4 AII accessible ieaks repaired using smake test. HERS rater must verify(No Samp(ing}. Pass if all accessible leaks have been repaired using smoke p Pass�Fail Reg: 212-AOQ29225A-M2I00001A-0000 Registration DatefTime: 2012f06�0? 42:1?:21 HERS Provider: CalGERTS, Inc. 2008 Residential Compliance Forms March 2010 C +� INSTALLATION CERTIFICATE* CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5) Site Address: Enforcement Agency: Permit Number: 1906 WHITE STAR DRIVE, Diamond Bar CA 91765 City of Diamond Bar 12-642 , Note:If installation of a Charge Indicator Display(CID)is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate(instead of this MECH-25 Certificate)should be used to demonstrate compliance with the ref�igerant charge verification requirement. TMAH and STMS a�e not requi�ed for compliance, when a CID is utilized for compliance. : As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are speciFed in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required fo�compliance. STMS are only required for completely new or replacement space-conditioning systems that utilize prescriptive 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 m 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 ! 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 qass. ' Enter Pass or Fail ✓ m Pass .i ❑ Fail STMS-Sensor o�the Evaporator-Coil _�,�_ �_., _,-�._ -�..�.�...�.,.-. ...._,..�,.. ___ ...� _ System`Name or ldentification/Tag"�1 ��',-�' System„1 'v,,' - rr,�r,,,' `.s N� ,,��_ , �< � �.� i' '�� ,:The�sensor is factory"installed;�or field installed°according to'm'a'nufacturer's ..»� _. ' ❑�Yes p�No� �spe cifications, or is�in�stelle'd by rnethods/specification`s'approved?by th`e Executive �" ,�` � Director. �� "� r�� _ � ' �� ` � 'The�sensor wire is terminated wrth a standard��rrSlni plug,-suitable�for conhection to a � � �' ��,.�� -' � � � ��. . �.� � � �� 4 � p�Y�es,�, p'No v� dig�tal�thermometer Ttie�senso��mirn plug is accessible to.fFie installing,,,techrncian • ��, � �"�'and the'HERS rate��v�iithout�changing�the.airflovv tliro.ugh the condens'er coil�' � �' 5 ❑Ye. ,. _.. , , s ❑No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yesto 3,4; and S is,a>,pass. Enter N/A"if STMS are not � 0 N/A ✓ ❑Pass ✓ ❑Fail � applicable;;Qtherwise enter Pass orvFail STMS-Sensor on the Condenser;Coil System Name or ldentification/Tag" System 1 The sensor is factory installed, or field installed according to manufacturer's 6 p 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 The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not ,� p N/A ✓ ❑Pass ✓ ❑Fail applicable. Otherwise enter Pass or Fail Reg: 212-A0029225A-M2500001A-0000 Registration Date/Time: 2012/06/07 02:19:47 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms � . August 2009 - - . ' , I .. , CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test— Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 1906 WHITE STAR DRIVE, Diamond Bar CA 91765 (System City of Diamond Bar 12-642 1) Enter the Duct System Name or ldentification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the . dwelling. This installation certificate 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 replacement duct system can also include existing parts of the original duct system (e.g., register boots, ai�handler, coil, plenums, etc.) if those parts are accessible " and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test- Completely New or Replacement Duct System." Duct Leakage Diagnostic Test-existing'duct system Select one compliance method from the following four choices. 0 1. Measured leakage less than 15%of fan Flow �2. Measured leakage to outside'less than 10%of Fan Flow p 3. Reduce leakage by.60%and conduct smoke and fix all leaks �4. Fix all accessibie leaks using smoke and HERS rater verify Note: (�One of Options�l, 2, or 3 must-be�ettempted before_utiliziag Option�4,.),, �,�,, ;,.� Determine,momina6�Fan"�Flow using one�of the'follo�rii'ng three calculaEion�rneEhods ,-'�� j' � ��'�� ✓�Coolin��"g�system method Srze of�conde ser�in Tons a�� x 400= ��2000�^�CFM � �`�� r�� # � � ��'"�+� a x �`' i , �r,�r�' A�'� � i�` / %w ✓❑Heating,system method�21 7 x b Output Capacity irnThousantls of Btu/fir= J CFM ' ' � ,� � ✓❑Measur�ed system�a rtlo�w�usng'`RA3 3"�airflow test�p ocedures .�-� CFM.; � � � � � r • r — L ��1 �,�t� '� �� ,.� :Ls � . ,.. �,� W �,.� � _� , Option 1 used,then:. �,. __. �._ .. . ,. 1 Allowed leakage = Fan Flow 2000 z 0.15-= 300 CFM Actual Leakage,= 281 CFM �:: , �',;,, ' Pass if Leakage Actual is less than Allowed Pass Fail .� _. _. Option 2 used then<; 2 Allowed leakage = Fan�Flow x 0.10 =_CFM Actual Leakage to outside = CFM Pass if Leakage Actual is less than Allowed Pass Fail Option 3 used then: Initial leakage prior to start of work = CFM Final leakage after sealing all accessible leaks using smoke test = CFM 3 Initial leakage_- 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 �Pass p Fail Reg: 212-A0029225A-M2100001A-M21A Registration Date/Time: 2012/06/07 02:22:32 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms . March 2010 .).i �. � INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure • (Page 5 of 5) Site Address: Enforcement Agency: Permit Number: 1906 WHITE STAR DRIVE, Diamond Bar CA 91765 City of Diamond Bar 12-642 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 � �,,,. �..,��,, _ �� ,�Ta�" ��'.,,'� �,� +�� t-�` �:�� r� �t� � j k j 1 � V�' x � � n'?t !'.' T 1'. . E S � ; � ��',r� �i°� Y ��1 � �. � � . �£ €... � �� ,.. + ,r- �� , � �`�� ,3_ . �� II Wk � F t,�� `4�_ i � /r Ex�' � .� a 3 . � �,� �'"'x«''�z , '' . � ��y�' n7 "y' ,,`� ��. J ji "� ��' �� "��', � �',x �w f�i3 j ` .. ��:s.�-i�`�°� �+,�,, _ o. .ns ��'-;,,-y�.�`,�-�i"� ,. ,- '" 8� a . 4 �#>.�n .;-q� 1: . _ � '�,.� :�i^, .:.,eru-`� �. �,n.i � . � .. , �.'�'x,.._.. . . . .: �'`� .�v� . ' , ',�::. .. . DECLARAl`ION STATEMENT . I certlfy 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 certlfied HERS rater'who pertormed the verification services identified and reported on thls certificate(responsible rater). . The installed feature, material,component,or manufactured devlce requirinq HERS verification that is identified on this certificate(the installation)complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s)of Compllance(CF-1R)approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s)(CF-6R),si9ned and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s)of Compllance(CF-iR)approved by the enforcement agency. Builder or Installer i�formation as shown on the Installation Certificate (CF-6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) MDDR INC Responsible Person's Name: CSLB License: Monica Salgado 445220 HERS Provider Data Registry Information Sample Group # (if applicable): N/A Q tested/verified dwelling ❑not-tested/verified dwelling in a HERS sample group HERS Rater Information CaICERTS Certificate# CCi-1798662189 • HERS Rater Company Name: Mrs. Hers Duct Testing Responsible Rater's Name: Responsible Rater's Signature: Amber Bernard Amber Bernard Responslble Rater's Certification Number w/this HERS Provider: Date Signed: 6/6/2012 CC2006020 Reg: 212-A0029225A-M2500001A-M25A Registration Date/Time: 2012/06/07 02:21:26 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 .