HomeMy WebLinkAboutB16-2057 047-530-004DEVELOPMENT SERVICES
e
BUTTE COUNTY AREA
DEPARTMENT OF DEVELOPMENT SERVICES 4
INSPECTION CARD MUST BE ON JOB SITE
24 Hour Inspection Line (IVR) :530.538.4365 (Cut off time for inspections is 3pm)
Development Services cannot guarantee inspections on the date requested
Office: 530.538.7601 Fax: 530
Permit No: B16-2057 Issued: 9/19/2016
APN: 047-530-004
Address: 4251 SHORTHORN DR, CHICO
Owner: GORDON TAI & SARA T
Permit Type: AC UNIT RESIDENTIAL
Description: INSTALL NEW 15K DUCTLESS MINI SPLI
3.38.//8) www.ButteUounty.net/aas
Flood Zone: None SRA Area
Front: Centerline of Road:
Rear: SRA:
Street: AG:
Interior
Total Setback from Centerline of Road:
No
ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING
Inspection Type
JVR INSP DATE
Setbacks
131
Foundations / Footings
111
Pier/Column Footings
122
Eufer Ground
216
Masonry Grout
120
Setbacks
131
Do Not Pour Concrete Until Above are Sign d
Pre -Slab
124
Gas Test Underground/floor
404
Gas Piping Underground/floor
403
Underfloor Framing
149
Underfloor Ducts
319
Shear Transfer
136
Under Floor Plumbing
412
Under Slab Plumbing
411
Blockin nder inin
612
Tiedown/Soft Set System
611
Do Not Install Floor Sheathing
or Slab Until Above Signed
ShearwallB. W.P.-Interior
134
Shearwall/B.W.P.-Exterior
135
Roof Nail/Drag Trusses
129
Manometer Test
605
Do Not Install Siding//Stucco or Roofing Until Above Signed
Rough Framing
153
Rough Plumbing
406
Rough Mechanical
316
Rough Electrical
208
4 -Way Rough Framing
128
Gas Piping House
403
Gas Test House
404
Shower Pan/Tub Test
408
Do Not Insulate Until Above Signed
Permit Final
802 &A 9LL41
Electrical Final
803
Mechanical Final
809
Plumbing Final
813
Fire Sprinkler Test or Final
702
Swimmin2
Pools
Inspection Type
IVR INSP DATE
T -Bar Ceiling
145
Stucco Lath
142
Swimmin2
Pools
Setbacks
131
Pool Plumbing Test
504
Gas Test
404
Pre-Gunite
506
Pre -Deck
505
Pool Fencin Alarms/Barriers
1
503
Pre -Plaster
507
Manufactured Homes
Setbacks
131
Blockin nder inin
612
Tiedown/Soft Set System
611
Permanent Foundation System
613
Underground Electric
218
Sewer
407
Underground Water
417
Manometer Test
605
Continuity Test
602
Skirtin Ste s/Landin s
4—
610
Coach Info
Manufactures Name:
Date of Manufacture:
Model Name/Number:
Serial Numbers:
Len If x Width:
Insignia:
Public Works Final 538.7681
Fire De artment/CDF 538.6226
Env. Health Final 538.7281
Sewer District Final
"PROJECT FINAL �C
-rrolect Anal is a Certificate of Uccupancy for (Residential Only)
PERMITS BECOME NULL AND VOID I YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR
RENEWAL 30 DAYS PRIOR TO EXPIRATION
Butte County Department of Development Services
PERMIT CENTER
e 7 County Center Drive, Oroville, CA 95965
Main Phone (530) 538-7601 Fax (530) 538-7785
www.buttecounty.net/dds
Declaration of Installation
for Smoke Alarms and Carbon Monoxide Alarms
FORM NO
DBI -01
The newly adopted 2013 California Residential Code requires the installation of Carbon
Monoxide Detectors in dwelling units and in sleeping units within which fuel -burning appliances
are installed.and in dwelling units that have attached garages. The policy for Carbon Monoxide
Alarms in Butte County states: "Any permit obtained in which the value of work exceeds $1000
_associated with a Residential Group R Dwelling Unit or Sleeping Unit shall conform to the
following 2013 California Residential Code requirements for Smoke and Carbon Monoxide
Alarms (Section R314 & R315)."
2013 California Residential Code requirements for Carbon Monoxide Alarms:
R315.1 New construction: An approved carbon monoxide alarm shall be installed in dwelling
units and in sleeping units within which fuel -burning appliances are installed and in dwelling
units that have attached garages.
R315.1.2 Power supply: For new construction required carbon monoxide alarms shall receive
their primary power from the building wiring where such wiring is served from a commercial
source and shall be equipped with a battery back-up. Alarm wiring shall be directly connected to
the permanent building wiring without a disconnecting switch other than as required for over -
current protection.
Exceptions:
1. In dwelling units where there is no commercial power supply the carbon monoxide alarm may be solely
battery operated.
2. In existing dwelling units a carbon monoxide alarm is permitted to be solely battery operated where
repairs or alterations do not result in the removal of wall and ceiling finishes
or there is no access by means of attic, basement or crawl space. .
R315.1.3 Interconnection. Where more than one carbon monoxide alarm is required to be
installed within the dwelling unit or within a sleeping unit the alarm shall be interconnected in a
manner that activation of one alarm shall activate all of the alarms in the individual unit.
Exception:
1. Interconnection is not required in existing dwelling units where repairs do not result in the
removal of wall and ceiling.finishes, there is no access by means of attic, basement or crawl
space, and no previous method for interconnection existed.
R315.2 Where required in existing dwellings: Where a permit -is required for alterations,
repairs or additions exceeding one thousand dollars ($1,000), existing dwellings or sleeping
units that have attached garages or fuel -burning appliances shall be provided with a carbon
monoxide alarm in accordance with Section R315.1. Carbon monoxide alarms shall only be
required in the specific dwelling unit or sleeping unit for which the permit was obtained.
R315.2.6 Alarm requirements: No person shall install, market, distribute, offer for sale or sell
any carbon monoxide device in the State of California unless the device and instructions have
been approved and listed by the State Fire Marshal
Page 1 of 2
Revised .7.20.2015
Carbon monoxide alarms required by Sections R315.1 and R315.2 shall be installed in the
following locations:
1. Outside of each separate dwelling unit sleeping area in the immediate vicinity of the
bedroom(s).
2. On every level of a dwelling unit including basements.
R315.1.5 Multiple -purpose alarms: Carbon monoxide alarms combined with smoke alarms
shall comply with Section R315, all applicable standards, and requirements for listing and
approval by the Office of the State Fire Marshal, for smoke alarms.
Butte County's Interpretation of 2013 CRC, Sections 314 & 315 for
Smoke Alarms & Carbon Monoxide Alarms:
Where alterations, repairs or additions exceeding $1,000 in valuation, existing dwellings shall be
retrofitted with smoke alarms and those that have attached waraizes or fuel -burning appliances shall have
carbon monoxide alarms installed. Existing smoke alarms can be replaced with dual function alarms for
Smoke and Carbon Monoxide and in most cases will comply with the aforementioned code requirements
for Carbon Monoxide Alarms.
DECLARATION OF INSTALLATION UNDER THE PENALTY OF PERJURY
As Owner/Contractor, I/we affirm and declare under the penalty of perjury, under the laws
of the State of California, by our signatures below as Owner/Contractor, that I/we will
comply prior to final inspection with Items A & B as specified herein:
A. Both Owner/Contractor have read and clearly understand the aforementioned 2010
California Residential Code (CRC) Carbon Monoxide Alarm requirements.
B. Both Owner/Contractor are responsible for installing Carbon Monoxide Alarms prior to
final inspection as per the aforementioned building code and maintaining such
installation. Smoke Alarms will also be installed prior to final inspection as per the 2010
CRC.
Smoke and Carbon Monoxide alarms are now installed in the following locations:
Owner's name (print): I old 61o -"off
Owner's signature:
5- I:�-1,7
Contractor's name (print):Yzgp.,� Air2� e_ CSLB License: 5\CrWAU
Contractor's signature: Date:
Project Address:� , r��6ira'1i�YV1 � C.Int (_0 Permit#:'�J� S�
Page 2 of 2
Revised 7.20.2015
3
a
Account
0104402400422000
i Description
DB CA SB 1473 100 DBCP.
Applied 9/15/2016
:Paid Date
09/15/2016
0104402300422000
DBMET ETRAKIT AC UNIT RES 09 DB CPPC
BUTTE COUNTY
', Date: +
'
DBA PERMIT ISSUANCE RES 09 DB CPPC
30.00 '
09/15/2016
DEPARTMENT OF DEVELOPMENT SERVICESpermit No.: B 1'6-2057
DBA TRAVEL DOCUMENTATION RES 09 DB CPINSP '
30.00
E
OFFICE #: (530) 538-7601 • w, .
- . -
'
24-HOUR.PHONE INSPECTION SCHEDULING
" Type: ETRAKIT
IVR #: (530) 538-0365 _. ; ..
ONLINE INSPECTION
Sub -Type: AC UNIT
v m
.24-HOUR SCHEDULING
PERMIT PAYMENTS / RENEWALS:-
/ RESIDENTIAL
• C A t t F O R.N 1 A
www.buttecounty.net/dds' -•
r
Site Address:
4251 SHORTHORN DR �. j
Site APN:• 047-530-004
CHICO, CA 95926
Subdivision:
Site Block:
Site Lot:
Valuation: $4,385.00. .
Site Tract:
t
Permit Status: ISSUED '
Description of Work:
INSTALL NEW 15K DUCTLESS
MINI SPLIT SYSTEM Contracto:
ROYAL AIRE INC,
Address:
2530 ZANELLA WAY SUITE A '
Chico CA 95928
Phone:
(530) 899-9999
Owner: -
. GORDON-TAI & SARA -T-
_ Address: _
4251 SHORTHORN DR '
CHICO'CA 95973 -
Phone:
(530) 864-5277 `,•
Applicant:
ROYAL AIRE INC
-
Address:
2530 ZANELLA WAY SUITE A
CHICO CA 95928 ,. r
Phone:
° (530) 899-9999 °+
Account
0104402400422000
i Description
DB CA SB 1473 100 DBCP.
:Amount ',
1.00
:Paid Date
09/15/2016
0104402300422000
DBMET ETRAKIT AC UNIT RES 09 DB CPPC
63.00
09/15/2016
0104402300422000
DBA PERMIT ISSUANCE RES 09 DB CPPC
30.00 '
09/15/2016
00104402400-422000
DBA TRAVEL DOCUMENTATION RES 09 DB CPINSP '
30.00
09/15/2016
TOTAL FEES $124.00
TOTAL FEES PAID $124.00
TOTAL FEES DUE $0.00
CERTIFICATE OF VERIFICATION
CF3R-MCH-25-H
Refrigerant Charge Verification
(Page i of 4 )
Project Name:
TAI GORDON
Enforcement Agency: County of
Butte
Permit Number: B16-2057
Dwelling Address:
4251
City: Chico
Zip Code: 95973
A. System Information
HERS Rater to field -verify all system information, discrepancies to be noted by overwriting entry.
01
System Identification or Name
System 1
02
System Location or Area Served
GARAGE
03
Condenser (or package unit) make or brand
FUJITSU
04
Condenser (or package unit) model number
AOU15RLFF
05
Nominal Cooling Capacity (tons) of Condenser
1.5
06
Condenser (or package unit) serial number
MQN000S66
07
Refrigerant Type ,. ,.
�11-i41r0Ak
08
Other Refrigerant Type (if applicable)
09
System Installation Type
New
f IIC' i aC
' M 0--& V f I rsi Or
10
Charge Indicator Display (CID) Status (Note: Even systems
This system does not have a CID device installed
with a CID must have refrigerant charge verified by installer).
Is the system of a type that the minimum airflow can be
No, the airflow rate measurement procedures in RAM or
11
verified using an approved measurement procedure (RAM
RA3.2.2.7 are not applicable to this system, therefore
or RA3.2.2.7)?
compliance shall use HERS Rater observation of the
installer's weigh-in charging procedure.
Is the system of a type that approved refrigerant charge
Yes, one of the Refrigerant charge verification procedures
verification procedures can be used to verify compliance
from RA3.2.2 or RA1 is applicable to this system and can be
12
with the refrigerant charge verification requirements when
used to verify compliance
temperatures are greater than or equal to 55F (RA3.2.2, or
RA1)?
13
Date of Refrigerant Charge Verification for this system
2016-09-28
14
Refrigerant charge verification method used.
Weigh-in with HERS Rater Observation
15
Person who performed the Refrigerant Charge Verification
HVAC system installer
reported on this Certificate of Installation
16
HERS Verification Compliance Requirement Status
System does not qualify for group sampling
17
Refrigerant charge verification method used by HERS Rater.
Weigh -In observation
Registration Number: 216-A0358423A-M2500002A-M25A Registration Date/Time: 2016-09-28 18:30:34 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 18:28:54
2013 Residential Compliance Schema Version: 2013.1.008
IV
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 2 of 4 )
MCH -25c - Refrigerant Charge Verification - Weigh In Observation Procedure
B. Measurement Access Hole (MAH) Verification - HERS Raters are required to visually field verify MAH
Procedures for installing MAH are specified in Reference Residential Appendix RA3.2.2.3
Minimum Required System Airflow Rate (cfm)
Method used to demonstrate compliance with the
The airflow rate measurement procedures in RA3.3 or
System Airflow Rate Verification Status
Measurement Access Hole (MAH) requirement
RA3.2.2.7 are not applicable to this system, therefore
01
RA3.2.2.7 are not applicable to this system, therefore
Comp anc' shall'use°HERS' ater (RA3.2.3.2)
compliance shall use HERS Rater observation (RA3.2.3.2) of
r�
rr
observation of
#a ,K !f 4{. *t }r. '#�o"� �
the installers� -weigh-in charging procedure (RA3.2.3.1);
the installer's weigh-in charging procedure (RA3.2.3.1); and
t
# i F—I% It, y � 1 I(i i f
compliance with MAH installation shall not be required
C. Minimum System Airflow Rate Verification
Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.2.2.7.
01
Minimum Required System Airflow Rate (cfm)
525
02
System Airflow Rate Verification Status
The airflow rate measurement procedures in RA3.3 or
02
-
RA3.2.2.7 are not applicable to this system, therefore
Comp anc' shall'use°HERS' ater (RA3.2.3.2)
04
r�
rr
observation of
#a ,K !f 4{. *t }r. '#�o"� �
the installers� -weigh-in charging procedure (RA3.2.3.1);
05
t
# i F—I% It, y � 1 I(i i f
D. Weigh In Charge Procedure - `HERS RaterJMust+'Obse ve and'ConfirmsAllf ata Collected' ��
Procedures for Refrigerant Charge using the Weigh in Cha gigProcedure are give Reference "Residential Appendix
RA3.2.2.2 and RA3.2.3
01
Measured Condenser air entering dry-bulb temperature (T
condenser, db) (degreeF)
70
02
Specify the method of weigh-in
TotalCharge
03
Manufacturer standard charge for condenser (lbs, oz.)
2,12
04
Manufacturer Standard liquid line length (ft)
30
05
Manufacturer's Standard liquid line diameter (in)
0.25
06
Manufacturer's Standard indoor coil size (tons)
1.5
07
Installed liquid line length (ft)
25
08
Installed liquid line diameter (in)
0.25
09
Installed indoor coil size (tons)
1.5
10
Charge adjustment to standard charge from manufacturer's
specifications (ounces, positive add, negative remove)
0
Registration Number: 216-A0358423A-M2500002A-M25A Registration Date/Time: 2016-09-28 18:30:34 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 18:28:54
2013 Residential Compliance Schema Version: 2013.1.008
CERTIFICATE OF VERIFICATION CF3R-MCH-25-H
Refrigerant Charge Verification (Page 3 of 4 )
D. Weigh In Charge Procedure - HERS Rater Must Observe and Confirm All Data Collected
Procedures for Refrigerant Charge using the Weigh-in Charging Procedure are given in Reference Residential Appendix
RA3.2.2.2 and RA3.2.3
11
Refrigerant required to be weighed in by the installer (lbs,
2,12
oz)
02
12
Refrigerant weighed in by Installer (lbs, oz)
2,12
Pass - all applicable requirements are met
Verification Status
System complies with the Weigh-in charge requirement
13
Note: If Verification Status for this table indicates system
reason shall be described in the correction notes for this
does not comply, the reason shall be described in the
table. .
correction notes for this table.
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
Correction Notes for this table:
The responsible persons signature on this compliance document affirms that.all applicable requirements in this table have
been met.
E. Weigh In Charge Procedure - Additional Requirements
01
The indoor coil correction to refrigerant weight is.used if itis supplied-by;the•manufacturer.�
`� nn ((-4
�i 4 �+;- t >Ii i i6 dt it 4
`� �• i �4+ s€ l ��, i< -e (
Prior to introducing recY
efrigerant, system is evacuatto'500 microns or -less and, when isolated,Lhas risen no more than 300
02
microns after 5 minutes. H E E
Verification Status
Pass - all applicable requirements are met
03
Note: If Verification Status for this table indicates Fail, the
reason shall be described in the correction notes for this
table. .
Correction Notes for this table:
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.
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 1 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-A0358423A-M2500002A-M25A Registration Date/Time: 2016-09-28 18:30:34 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 18:28:54
2013 Residential Compliance Schema Version: 2013.1.008
CERTIFICATE OF VERIFICATION MR -MCH -25-H
Refrigerant Charge Verification (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:
Jeff Guess
Documentation Author Signature:
kpdd�
Company:
Date Signed:
Energy Intent
2016-09-28 18:30:34
Address:
CEA/ HERS Certification Identification (if applicable):
1576 BUTTE VISTA LANE
City/State/Zip:
Phone:
Yuba City CA 95993
530-209-5625
Responsible Person's Declaration statement
1
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 information reported on applicable sectioCertificate(s) f-1 stallation(GF2R) sigYned:a pai—U6mltted;by the pe 5 on(s) responsible for the
�n�s.of.the
41
construction or installation conforms to the requirements'specified,on the Certificate(s) of Compliance (CF1R) approved bythe enforcement agency.
t } 1 t }'
5. 1 will ensure that a registered coCertificate
g I y f this C *rtificate of Verification s {all be posted, or made�a�ailatifle with the,b#ilding permit(s)�issued 1 4 the
I.understand
building, and made available to the,enforcement,agency foe all apphc`ble_inspectons, that a,registeredxopy of this Certificate of
documentatio the provides owner at'o upancy. "
Verification is required to be included with the builder to the building
rr%> ,w.. 0"010. arm 10-%, * 0 " 0
Builder Or Installer Information As Shown OnThCertificate Of Instatio
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
ROYAL D HAWKLEY
Responsible Builder or Installer Name:
CSLB License:
Royal Hawkley
510286
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information —
HERS Rater Company Name:
Energy Intent
Responsible Rater Name:
Jeff Guess
Responsible Rater Signature:
lGP,dJ%
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2006554
2016-09-28 18:30:34
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-A0358423A-M2500002A-M25A Registration Date/Time: 2016-09-28 18:30:34 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 18:28:54
2013 Residential Compliance Schema Version: 2013.1.008
CERTIFICATE OF INSTALLATION
CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans
(Page 1 of 8 )
Project Name: TAI GORDON
Enforcement Agency: County of Butte
Permit Number:
B16-2057
Dwelling Address: 4251
City: Chico
Zip Code:
95973
A. General Information
01
Dwelling Unit Name
TAI GORDON
02
Climate Zone
11
07
Dwelling Unit Total Conditioned Floor.
09
10
Number of Space Conditioning
SC System
03
Area (ft)
3043
3043
04
in this Dwelling Unit.
3
05
Certificate of Compliance Type
Prescriptive alterations (CF1R-ALT)
06
Method used to Calculate HVAC Loads
ACCA_Manual.l
07
Calculated Dwelling Unit Sensible
18000
08
Calculated Dwelling Unit Heating Load
18000
Name
Cooling Load (Btuh)
System (W)system?
(Btuh)
components?
09
Dwelling Unit Number of Bedrooms
4
ra
'
i. Imo- ;� g..�.._.. at; -.�\. ; I' SC- `T 1111
FMCH-01b Space Conditioning Systems Ducts and�Fans - Prescripti a Alterations: .
'�5.._
01
02
03
P` 1 .a. it ( 4 l it Vii, . .
05
06
07
i V l ---- .-.. _ __ -- _ _. .— It -- .._ _..
B. Space Conditioning (SC) System Information E R V I L > E its,
01
02
03
04
05
06
07
08
09
10
SC System
SC System
CFA served
Is the SC
systema
Installing a
refrigerant
In new SC
Installing more
Installing
Installing
Identification or
cation
Location or Area
by this SC
ducted
system �
than 40 feet of
entirely new
entirely new SC
Alteration Type
Name
Served
System (W)system?
component?
components?
ducts?
duct system?
system?
Altered space
System 1
GARAGE
500
No
Yes
Yes
No
No
No
conditioning
system
System 2
WHOLE HOME
3043
Yes
No
No
No
No
No
No alteration
i
performed
Registration Number: 216-A0358423A-M0100002A-0000
Registration Date/Time: 2016-09-28 18:14:10
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 18:11:31
rrhamz Varcinn• 7012 1 MR
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Duds, and Fans (Page 2 of 8 )
B. Space Conditioning (SC) System Information
01
02
03
04
05
.06
07
08
09
10
SC System
SC System
CFA served
Is the SC
Installing a
. Installing new SC
Installing more
Installing
Installing
Identification or
Location or Area
by this SC
systema
ducted
refrigerant
containing
system
than 40 feet of
entirely new
entirely new SC
Alteration Type
Name
Served
System (ft2)
system.
component?
components?
duds?
dud system?
system?
System 3
WHOLE HOME
3043
Yes
No
No
No
No
No.
No alteration
(CFI)
S stem
Y
Altered
,Heatin
Minimum
d
1 $
performed
C. Space Conditioning (SC) System Alterations Compliance Information
01
02
03
04
05
06
07
08
09
10
11
12
13
Central Fan
Integrated
Heating)
�
Ctr,
(
CoolingNew
'Re
or
(CFI)
S stem
Y
Altered
,Heatin
Minimum
d
1 $
.Conlin
� g�..
sMinimum
wired'"'
�r,4�
�Re laced
p
New
Ventilation
Identification
Heating
Heating
.fig
Efficiency
Efficiency
Cooling•
Cooling
Efficiency
EfficiencyI
! Thermostat
Duct
Duct
System
or Name
. System Type.
Component
Type;
Value .
-System Type;
Components
- Type
UType
Length
R -Value
Status
'*r
�/�Vlue r
i�► L
This
field
All new
All new
N/A - no
or
System 1
Ductless
heating
HSPF
80
Ductless
cooling
SEER
14
Setback
ducts
sectio
Not a CFI
split HP
componen
split HP
components
replaced
n is
systema
is
not
applic
'
able
This field
This field
This field
No heating
or
This field
No Cooling
or
or
System 2
Central gas
componen
ser�tion is
or section
Central
component
section
section is
Setback
LTE40Ft
R8
Not a CFI
furnace
t altered
not
is not
split AC.
altered
is not
not
system
applicabl
applicable
applicabl
applicabl
e
e
e
Registration Number: 216-A0358423A-M0100002A-0000
Registration Date/Time: 2016-09-28 18:14:10
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 18:.11:31
i Crhamz \/arcinn• ')n12 1 nnn
_t
CERTIFICATE OF INSTALLATION { CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans ' . (Page 3 of 8 )
C. Space: Conditioning (SC) System Alterations Compliance Information
01
02
03
04'
05
06 '
07.
08
09
10
11
12
13
Identification o
Heatmg
„
1
HeatingUSystem rnt :
.
Heating Unitserial
_.
"Name
Heating Efficiency Type.
Valuep,
Manufacturer
Central Fan
Model Number;
er : '
numbM.
Output (BT UH)
System .1
HSPF
,-80 +. _
JUJITSU
AOU15RLFF
MQN000566
18000
Notes:
Integrated
Heating
Cooling
New or
(CFI),
System '
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
.Replaced
New
Ventilation
Identification
Heating
Heating
Efficiency
Efficiency
Cooling
Cooling- -
Efficiency
Efficiency
Thermostat
Dud
Dud
I 'System
or Name,
System Type
Component
. Type
Value
System Type
`-Components.
Type
Value
Type
. Length
R -Value
Status
t.
This field
This field
-This field
Central gas
No heating
or
section is
;This field
or section.
Central
No cooling
or
section
or.
section is
Nota CFI
System 3
furnace "
componen
=,
not
is not
split AC '
component.
,
I is not
not
Setback.
LTE40Ft
. • R8
system
t altered
applicabl
applicable
altered
applicabl
applicabl
1 Ie
e
e
D. Installed Heating Equipment Information.
ee
01
1 •02
03�.dt, t(; I
�jqj04W :j (.
11, 05
A�1 `�� �ay�06q�4� ..
07 •
Identification o
Heatmg
„
1
HeatingUSystem rnt :
.
Heating Unitserial
' Rated'Heating Capacity,
"Name
Heating Efficiency Type.
Valuep,
Manufacturer
Model Number;
er : '
numbM.
Output (BT UH)
System .1
HSPF
,-80 +. _
JUJITSU
AOU15RLFF
MQN000566
18000
Notes:
i
Registration Number: 216-A0358423A* M0100002A-0000 Registration Date/Time:. 2016-09-28°18:14:10 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential. Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 .18:11:31
rrhemn %/crcinn• .n11 1 nnA ' -
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts,, and Fans (Page 4 of 8 )
E. Installed Cooling Equipment information
�, This section -does not apply to this project.
/� 1k (� ?Ca.r' �: .?�'o%' MSR.. 1M�rl�. //�1t1+ r6 .A" Ar '}f14.11C'w' �. •
,01
02.
03
04 05. - ;
06
07
08
Condenser or Package Unit
r
System Identification
or Name
Cooling Efficiency
Type
Cooling Efficiency
Value
Condenser or
Package Unit
Manufacturer
Condenser or;
Package Unit i
-Model Number
Condenser or
Package Unit
Serial Number
System Rated Cooling
Capacity at Design
Conditions (BTUH) .
Condenser Rated
Nominal Capacity
(ton) .
System 1
SEER
14•
i
FUJITSU
AOU15RLFF
MQN000566
18000
1.5
Notes:
F. Extension of Existing Duct System, Greater Than 40 Feet
This.section does not apply to this project.
G. Installed Duct System information .
�, This section -does not apply to this project.
/� 1k (� ?Ca.r' �: .?�'o%' MSR.. 1M�rl�. //�1t1+ r6 .A" Ar '}f14.11C'w' �. •
�' - '® ✓ !.. .V'' I U R"A a 'SII F 9V0 'mow. W F.
H. Installed Air Filter Device Information
- This section does not apply to this project.
I. Air Filter'Device Requirements
This section does not apply to this project.
Registration Number: 216-A0358423A-M0100002A-0000 Registration Date/Time: 2016-09-28 18:14:10
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008
rncama\/crcinn• )n921'nns2
HERS Provider: CaICERTS
Report Generated: 2016-09-28 18:11:31
CERTIFICATE OF INSTALLATION �. CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans ,. '(Page 5.of 8 )
J. HERS Verification Requirements
01
02
03
04
05,
067
.07
08
09
110
a
MCH2O'
.,MCH21 • +.
- MCH22
' MCH23
MCH25
MCH28
'
Exemption
from
-
-
Minimum
Exemption
R -Value for
AHU
System
SC System
.From Duct
Duct
Ducts In
Ducts Located,
AHU Fan
Airflow
Identification or
Location or Area
' Leakage .
Leakage
Conditioned
In Cond Space
Efficacy
Rate
Refrigerant
Return Duct Design
Name
Served
Requirements
Test
Space
Verification.
(W/dm)
(cfm/ton)
Charge
Table 150.0-C or D
System 1
..GARAGE
. N/A I
�f r,
I
No
No
Exemption
- No-
No
No
Yes
No
System 2
WHOLE HOME lµ
N/A
..No .
tion
No;
No
No
No
No
Exem
System 3
WHOLE HOME_
N/A:
No
o
,
ISN'c
No
No
No
}
m ionNoE
.'
�p
Notes:
• , , r ,
f.1 '9i 6,.
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Duds, and Fans (Page 6 of 8 )
K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the
system that are altered. Existing equipment may be exempt from these requirements.
Heating Equipment
01
Equipment Efficiency: All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency
Regulations.
02
Controls: All unitary heating systems, including heat pumps, must be controlled by a setback thermostat. These,thermostats-must be capable of allowing the occupant
to program the temperature set points for at least four different periods in 24 hours. See Sections 150.0(1), 110.2(b).
03
Sizing: Heating load calculations must be done on portions of the building served by new heating systems to prevent inadvertent undersizing or oversizing. See sections
150.0(h)1 and 2).
04
Furnace Temperature Rise: Central forced -air heating furnace installations must be configured to operate at or below the furnace manufacturer's maximum
inlet -to -outlet temperature rise specification. See Section 150.0(h)4.-.
05
Standby Losses and Pilot Lights: Fan -type central furnacest utnng3 _pd ilotj If., Rht!"ion 1105 and Section 110.2(d).
�mno�t�~htiavII a(
tinu.,ou� sit l
cfo'
/ , �n_yti
Cooling Equipment ;
I C
07
I'll
06
Equipment Efficiency: All cooling equipment must meet the'roinimum efficienP equirements of�Section,110.1fa d Section 110b2(a,)''and the Appliance Efficiency
Sr° � '�°�V 0
Regulations.
07
Refrigerant Line Insulation: All refrigerant line insulation in split system air conditioners and heat pumps must meet the R -value and protection requirements of Section
150.0(j)2 and 3, and Section 150.0(m)9.
08
Condensing Unit Location: Con densing'units shall not be placed within five (5) feet of a dryer vent outlet. See Section 150.0(h)3A.
09
Sizing: Cooling load calculations must be done on portions of the building served by new cooling systems to prevent inadvertent undersizing or oversizing. See Section
150.0(h)1 and 2.
Air Distribution System Duds, Plenums and Fans
10
Insulation: In all cases, unless ducts are enclosed entirely in directly conditioned space, the minimum duct insulation value is R-6. Note that higher values may be
required by the prescriptive or performance requirements. See Section 150.0(m)1.
Registration Number: 216-A0358423A-M0100002A-0000
Registration Date/Time: 2016-09-28 18:14:10
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 18:11:31
rrhamn Varcinn• Mil 1 nnu
•
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning.Systems, Ducts, and Faris (Page 7 of 8 )
K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to,some systems. These requirements may be applicable to only newly installed equipment or portions of the
system that are altered. Existing equipment may be exempt from these requirements.
Connections and Closures: All installed air -distribution system ducts and plenums must be, sealedpand insulated to meet the requirements of CMC Sections 601.0,
11
602.0, 603.0, 604.0, 605.0 'and ANSI/SMACNA-006-2006: Supply -air and return -air ducts and plenums must be insulated to a minimum installed level of R-6.0 or
enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing in accordance with the requirements of Reference
-Residential Appendix RA3.1.4.3.8.
Heat Pump Thermostat
12
A thermostat shall be installed that meets the'requirements of Section 110.2(b) and Section 110.2(c).
t
13
+The thermostat shall be installed in accordance with the manufacturers published installation specifications
14
First stage of heating shall be assigned to heat pump heating.
15
Second stage back up heating shall be set to come.on'only a he indoor set temperature cannot be met.
11. ..rpt OWN
I& �t
The responsible person signature on this compliance,document affirms that all applicable requirements in.thistable have been meta.
� .. r' t l >t' c "e� e o f 14 .
- -
IN
-Registration Number: 216-A0358423A-M0300002A-0000 Registration Date/Time:.; 2016-09-28 18:14:10. HERS Provider: CaICERTS
CA Building Energy Efficiency Standards = 2013 Residential Compliance - Report Version: 2013 Rev 1.008 _ Report Generated: 2016-09-28 18:11:31
ZrKam2A/arcinn• ,)n11 1 nnf2
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 8 of 8 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete..
Documentation Author Name:
Documentation Author Signature:
Jeff Guess
Company:
Signature Date:
Energy Intent
2016-09-28 18:11:48
Address:
CEA/ HERS Certification Identification (if applicable):
1576 BUTTE VISTA LANE
`
City/State/Zip:
Phone:
Yuba City CA 95993
1530-209-5625
Responsible Person's Declaration statement
t
I certify the following under. penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. I am eligible under Division 3 of the Business and Professions Code in -the applicable classification to accept responsibility for the system design, construction, or installation of features, materials,
components, or manufactured devices for the scope of work identified on this Certificate of Installation, and attest to the declarations in this statement (responsible builder/installer), otherwise I am an
authorized representative of the responsible builder/instal,lec Al, s ..
3. The constructed or installed features, materials, components or factured devices (thetinstallatlon).identified on this Certificate of Installation conforms•to all -applicable codes and regulations, and the
.► a ar: 4 t e- 1 .. 0
installation conforms to the requirements given on the plans and specifications:approvefty the enforcement agency.
fFi1�. ➢f.. 3y
4.. . 1 reviewed a copy of the Certificate of Compliance'app;o§ end by the enf,�orcemenvagen,�y that I�den�tifies the -specific reequirA1ents°for the of4onsst(uctionffinstallition identified on this Certificate of
�seppe
Installation, and I have ensured that the requirements that+Tpply to the construction or installation have been met.' gr
�ti!
f �.. Y e ' ima 'l7
c
S. I will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with -the building permit(s) issued for the building, and madvailable to the enforcement agency for all
Ne K 0 14* oa
* �. 11 +�� W. -AV > a.
applicable inspections. I understand that a registered copy of this Certificate of'Installation is 'required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Royal Hawkley
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Position With Company (Title):
ROYAL D HAWKLEY _
OWNER'
Address:
CSLB License:
10 FAIRWAY DRIVE
510286
City/State/Zip:
Phone:
Date Signed:
CHICO CA 95928.
530-519-9944
12016-09-28 18:14:10
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 216-A0358423A-M0100002A-0000 Registration Date/Time: 2016-09-28 18:14:10 HERS Provider: CaICERTS ,
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version`. 2013 Rev 1.008 Report Generated: 2016-09-28 18:11:31
rrhomz \rurcinn• Inn 2 1 nnQ
CERTIFICATE OF INSTALLATION
CF2R-MCH-25-H
Refrigerant Charge Verification
(Page 1 of 4 )
Project Name:
TAI GORDON
Enforcement Agency: County of
Butte
Permit Number: B16-2057
Dwelling Address:
4251
City: Chico
Zip Code: 95973
A. System Information
Each system requiring refrigerant charge verification will be documented on a separate certificate.
01
System Identification or Name
System 1
02
System Location or Area Served
GARAGE
03
Condenser (or package unit) Make or Brand
FUJITSU
04
Condenser (or package unit) Model Number
AOU15RLFF
05
Nominal Cooling Capacity (tons) of Condenser
1.5
06
Condenser (or package unit) Serial Number
MQN000566
07
Refrigerant Type
*R- 1
08
Other Refrigerant Type. (if
09
4applicable)
System Installation Type
NewP
.'�"
�. YL -4 Imo' Mltr
e'°w. V ,r li iiC`''r+: ;t'� ik""'J►
10
3t 0 � # 1* a.
Charge Indicator Display (CID) Status (Note: Even systems
"�..f IV #, a .�- 1� it 1e
This system does not have a CID device installed
with a CID must have refrigerant charge verified by installer).
Is the system of a type that the minimum airflow can be
No, the airflow rate measurement procedures in RA3.3 or
11
verified using an approved measurement procedure (RA3.3
RA3.2.2.7 are not applicable to this system, therefore
or RA3.2.2.7)?
compliance shall use HERS Rater observation of the
installer's weigh-in charging procedure.
Is the system of a type that approved refrigerant charge
Yes, one of the Refrigerant charge verification procedures
verification procedures can be used to verify compliance
from RA3.2.2 or RA1 is applicable to this system and can be
12
with the refrigerant charge verification requirements when
used to verify compliance
temperatures are greater than or equal to 55F (RA3.2.2, or
RA1)?
13
Date of Refrigerant Charge Verification for this system
2016-09-28
14
Refrigerant charge verification method used.
Weigh-in with HERS Rater Observation
15
Person who performed the Refrigerant Charge Verification
HVAC system installer
reported on this Certificate of Installation
16
HERS Verification Compliance Requirement Status
System does not qualify for group sampling
MCH -25c - Refrigerant Charge Verification - Weigh In
Registration Number: 216-A0358423A-M2500002A-0000 Registration Date/Time: 2016-09-28 18:27:09 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 18:25:31
2013 Residential Compliance Schema Version: 2013.1.008
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H.
Refrigerant Charge Verification (Page 2 of 4 )
B. Instrument Calibration
Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.3.1.4
01
Date of expiration of Digital Refrigerant Scale Calibration
2016-09-28
02
Date of Digital Thermometer and Temperature Sensor
Calibration
2016-09-28
03
Digital Refrigerant Scale Calibration Status
Calibration is current
04
Digital Thermocouple Calibration Status
Calibration is current
C. Measurement Access Hole (MAH) Verification
This section does not apply to this project.
D. Minimum System Airflow Rate Verification
Procedures for verifying minimum-system'airflow are specified in Reference Residential Appendix RA3.2.2.7.
01
Minimum Required System Airflow Rate'(cfm
525
02
Specify the method of weigh-in
TotalCharge
03
�t ��I
System Airflow Rate Verification Status
y
f�
The�airflow rate measurement rocedures in RA3.3 or
a i; +� t t t t p r.. 4
02
i
�+ t� k ! t,
not
RA3:2.2.7"are not applicable'to this system, therefore
05
Manufacturer's Standard liquid line diameter (in)
shall use ERSI�ater observation'I(RA3.r2'3.2) of
06
Manufacturer's Standard indoor coil size (tons)
the installer's eigh incharging procedu e (R -A3.2.3.1);
E. Weigh In Charge Procedure
Procedures for Refrigerant Charge using the Weigh-in Charging Procedure are given in Reference Residential Appendix
RA3.2.2.2 and RA3.2.3 —
0,
Measured Condenser air entering dry-bulb temperature (T
condenser, db) (degreeF)
70
02
Specify the method of weigh-in
TotalCharge
03
Manufacturer standard charge for condenser (lbs, oz.)
2,12
04
Manufacturer Standard liquid line length (ft)
30
05
Manufacturer's Standard liquid line diameter (in)
0.25
06
Manufacturer's Standard indoor coil size (tons)
1.5
07
Installed liquid line length (ft).
25
08
Installed liquid line diameter (in)
0.25
09
Installed indoor coil size (tons)
1.5
Registration Number: 216-A0358423A-M2500002A-0000 Registration Date/Time: 2016-09-28 18:27:09 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 18:25:31
2013 Residential Compliance Schema Version: 2013.1.008
r
CERTIFICATE OF INSTALLATION " ' ' CF2R-MCH-25-H
Refrigerant Charge Verification (page 3 of 4 )
E. Weigh In Charge Procedure
Procedures for'Refrigerant Charge using the Weigh-in Charging Procedure are given in Reference Residential Appendix
RA3.2.2.2 and RA3.2.3
10
Charge adjustment to standard charge from manufacturer's.
0
02`
specifications (ounces, positive add, negative remove)
_
11
Refrigerant required to be weighed in by the installer (lbs,
2,12
oz) • .
12
Refrigerant weighed in by Installer (lbs, oz)
2,'12
'13
Compliance Statement: System complies with,the Weigh-in charge requirement ^
F. Procedure --Additional Requirements
01
All brazing of refrigerant lines done with dry nitrogen in lines and evaporator coil .
02`
'The indoor coil correction to refrigerant`weight is used if.it is supplied by the manufacturer."
03
Prior to introducing refrigerant ,,system is -evacuated to 500 micronsFor-lessrand,, when^isolated, has risen no more than 300
%
microns after 5iminupes r'0411111"T P -H.
'�
!f .��tit 3t ofat isF
When applicable and if necessary to avoid-delayof'approvalaof dwelling•units completed,when•outsidetemperatures'are
L -ebelow 55�degrees F, the enforcement agency may'approve co—mpliance with the refrig0ranticharge verification requirements'
based on registration of this CF2R�MCH-25, d cmenting Use of the RA3 2.3 1�HVAC�l staller We gh In Charging Procedure
04,
when the optional Section RA3.2.3.2 HERS Rater Observation of Weigh -In Charging Procedure is.not used. As condition for
such enforcement agency,approval; the responsible person,'s signature on this compliance'document affirms the installer
agrees to return to correct refrigerant charge if a HER Rater determines at a later time, when the outside temperature is 55
degrees F,or,greater, that refrigerant charge correction is necessary.
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.' `
F
erification of Charge Indicator Display - CF2R; MCH -25d - CID
I: This section does not apply to this project. t
.. . h'
Registration Number: 216-A0358423A-M2500002A-0000 , , Registration Date/Time: 2016-09-2818:27:09 HERS Provider: CalCERTS '
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 18:25:31
2013 Residential Compliance 7 Schema Version: 2013.1.008 _
CERTIFICATE OF INSTALLATION CF2R-MCH-25-H
Refrigerant Charge Verification r (Page 4 of 4) .
Documentation Author's Declaration Statement
1. 1 certify that•this Certificate of Installation documentation is accurate and complete. _.
Documentation Author Name:
Documentation Author Signature: /J
lrle~
Jeff Guess
(
Company:
Signature Date: 2016-09-28 18:25:39
Energylntent —
Address:
CEA/ HERS Certification Identification (if applicable):
1576 BUTTE VISTA LANE '
City/State/Zip: +
Phone:
Yuba City CA 95993
1530-209-5625
Responsible Person's Declaration statement-'
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information providedron this Certificate of Installation is true and correct.
2.. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of _
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
- ____responsiblebuild er/installer.'"" "-- - __ _ �__. _ _ �� _ -- - -
•
3. , The co structed or installed features, materials; components or manufactured devices (the installation) identified on this Certificate of Installation
conforms Lo all applicable codes and regulations,and the installation conforms.to the requirements.given omthe plans andspecifications approved by
• .� the enforcement agency.-r.!'�. � � iFf �A
���'°"��[•����4. I understand that a HERS rater iwII check the installationto.vencompliance;
thasuch-checking identifies defects;
and I am required to take
i4• d o
corrective, action at my expense understandkhat Energy Commission and HERS Provider representatives will also perform quality assurance checking
• �� -4i..
i- Ya -,t 0,* �*v... Ai �� i, bi• cif p* *c #1; 0*
of installations, including thosee•appr�oved as part of aisample;group but not;checked'by4a HERS rateri,and if those installations faihto meet th
requirements of such quality assurance checking, the required corrective action and additional checking/testinggdo'ther installations.in that.HERS
will be
timy£expense (IV
sample group performed
I D
S. . " I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met. 4
6. 1 will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the
building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer. Name:
Responsible Builder/Installer Signature:
Royal Hawkley
R�
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)'
Owner
ROYAL D HAWKLEY
Address: •
CSLB License:
10 FAIRWAY DRIVE
510286
City/State/Zip:
Phone: —
Date Signed: -
CHICO CA'95928•
530-519-9944
2016-09-28 18:27:09
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP.(if applicable):
Digitally signed by Ca10ERTS. This digital signature is provided in order to. secure the content of this registered document, and in noway implies Registration Provider,
'responsibility for the accuracy of the information.
Registration Number: 216-A0358423A-M2500002A-0000 • Registration Date/Time: 2016-09-28 18:27:09 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards ~ Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 18:25:31
2013 Residential Compliance Schema Version:.2013.1.008
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name: i . TAI CORDON Date Prepared: 2016-09-28
A. General Information i
CF1R-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
TAI GORDON
02
Date Prepared
2016-09-28
03
Project Location
4251
04
Building Type
Single family
05
CA City
Chico
06
Dwelling Unit Name
TAI GORDON
07
Zip Code
95973
08 .
Dwelling Unit Conditioned
i
3043
if
,
Floor Area (ft2)
SC System
SC System
CFA served
'
refrigera t ;
Number of space conditioning
,Installing
09
Climate Zone
11
10
(SC) systems in this dwelling
3
ducted
cntaining a
�i system .
more than 40
unit.
entirely new
B. Space Conditioning (SC) System Information
Ol
02
03
04.
' ;' k�
-�
06
I U8 ':
( 09
10
f
0.07 ,
Is the SC
Installing a
if
SC System
SC System
CFA served
system a
refrigera t ;
ilnstalling ew SC
,Installing
InstallingInstalling
Identification or
Location or Area
by this SC
ducted
cntaining a
�i system .
more than 40
entirely w
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
GARAGE
500
No
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
WHOLE HOME
3043
Yes
No
No
No
No
No
No alteration
performed
System 3
WHOLE HOME
3043
Yes
No
No
No
No
No
No alteration
performed
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)iDiib) .
1 This section does not apply to this project.
Registration Number: 216-A0358423A-000000000-0000 Registration Date/Time: 2016-09-28 17:54:26 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 17:48:54
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CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) t (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)1E and.F)
01
02
03
04
05
06
07
08
09
10
11
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New or
Identification
System
Heating
Efficiency
Efficiency'
Cooling
Cooling
'Efficiency
Efficiency
Thermostat
Replaced
New Duct
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Duct Length
R -Value
Ductless split
All new
Ductless split
All new
This field or
This field or
System 1
HP
heating
HSPF
80
HP
cooling
SEER
14
Setback
section is not
section is not
components
components
j
applicable
applicable
Required Documentation:
MR -MCH -014 - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
MR -MCH -20-1-1 & CF3R-MCH-20-H — Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: 515%, or 510% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 300 CFM/ton required when MCH -25 is required. '
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
t�x,r df C , � y .,
Air Handler/Furnace do 25.
Heating -only systems and changes not require verification of Air F�oSw�MCH -23, or Refngerent Charge ME4 H
Existing duct systems constructed, insulated or sealed with asbestos,are exemptfrom MCH', 20 DAILeakage Testreq re Brits
?
1 1 %%_ ...f ( IV, I I Xk .. It'' # i t f# ., a i. 31 J ti f F W .�
E.•Entirely New or Complete Replacement Duct,System, with or without Equipment Changeout (Sections 150.2(b)1Diia=and 1,50.2(b)1E, F)
�t 111 11 �r l
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) .
7
This section does not apply to this project.
Registration Number: 216-A0358423A-000000000-0000 Registration Date/Time: 2016-09-28 17:54:26 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 17:48:54
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CERTIFICATE OF COMPLIANCE CF111-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:
Guess, Jeff
Documentation Author Signature:
Company:
Signature Date: _
Energy Intent
2016-09-28 17:52:56
Address:
CEA/ HERS Certification Identification (if applicable):
1576 BUTTE VISTA LANE '
City/State/Zip:.
Phone:
Yuba City CA 95993
530-209-5625 i
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. I am eligible under Division 3 of the Business and Professions Eode 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 oegulation�r*
4., The building design features or system�design features identified on this Certificate of Compliance are consistenf�wiit�h the information.provided on otherrapplicable'compliance documents, worksheets,
i" -Fi6ef S.=m R.. 4S ,
calculations, plans and specifications sutimitted_to the enforcement agency forppapprovaal with this bwlding permit appbcatiO
lif ` .�
5. I will ensure that a registered copy of this Certificate�ofCompliance shall b;e.made av„ailable witRA a building permits);issued for<the'buildmg, anc, ade available•to the enforcement agency for all applicable
inspections. I understand that a registered copy of this C�ertiaicate of Compliance is,requiireed to bbe..included witth the�docum�entation theW.�,builder proyi�des to the building owner at occupancy.
Responsible Designer Name: F`
Hawkley, Royal
Respons Dess g er Signature: V, 11i`
��
Company:
Date Signed:
ROYAL D HAWKLEY
2016-09-28 17::54:26
Address:
License:
10 FAIRWAY DRIVE
510286
t
City/State/Zip: ,'
Phone:
CHICO CA 95928
530-519-9944
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 216-A0358423A-00000000070000 Registration Date/Time: •2016-09-28 17:54:26 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 17:48:54
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