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HomeMy WebLinkAboutB17-0970 058-820-007BUTTE COUNTY AREA DEPARTMENT OF DEVELOPMENT SERVICES 3 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:530.538.7785 www.ButteCounty.net/dds Permit No: B17-0970 Issued: 5/18/2017 APN: 058-820-007 Address: 11300 NELSON BAR RD, CONCOW Owner: LYMAN WILLIAM & DEBORAH TRUST Permit Type: FIRE SUPPRESSION -RES Description: F/S FOR B 16-2718 Flood Zone: None SRA Area: Yes Front: Centerline of Road: Rear: SRA: Street: AG: Interior Total Setback from Centerline og Road: ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING 1 Inspection Type IVR 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 Signed 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 Blockingfunderpining 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 129 417 Manometer Test Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 153 Rough Plumbing 406 A5 31 17 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 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Fire Sprinkler Test or Final 702 Swimming Pools Inspection Type ]VR INSP DATE T -Bar Ceiling 145 Stucco Lath 142 Swimming Pools Setbacks 131 Pool Plumbing Test 504 .Gas Test 404 Pre-Gunite .506 Pre -Deck 505 Pool Fencing/Alarms/Barriers .503 Pre -Plaster .507 Manufactures. Homes Setbacks 131 Blockingfunderpining 612 Tiedown/Soft Set System 611 Permanent Foundation System 613 Under round Electric 218 Sewer 407 Underground Water 417 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: Finals 4i Public Works Final1 138.7681 Fire De artment/CDF 1 138.6226 1 Env. Health Final 1 138.7281 Sewer District Final rrojecr r mai is a t-ernncare of Lcecupancy 1 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY RENEWAL 30 DAYS PRIOR TO EXPIRATION A I YEAR BUTTE COUNTY AREA. DEPARTMENT OF DEVELOPMENT SERVICES 1 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 DEVELOPMENT SERVICES - Office: 530.538.7601 Fax: 530.538.7785 www3utteCounty.net/dds- Pennit - Permit No: B17-1692';. Issued: 7/13/2017 Flood Zone: None SRA Area: No APN: 069.071-019 fSETBACKS for Zoninp- - ry Front: Centerline of Road: . Address: f 1040 PEACH ST, GRIDLEY Owner: ENRIQUEZ DAVID J Rear: SRA: Street: AG: Permit Type: • REPAIR Interior Description: REPLACE EXT CONDENSOR & INTERIOR Total Setback from Centerline of Road: ALL PLAN REVISIONS MUST BE APPROVED. BY THE COUNTY. BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 131 Foundations / Footings 111 Pier/Column Footings' 122 - Eufer Ground 216 Masonry Grout' 120 131. Pool Plumbing Test Do Not Pour Concrete Until Above are Signed 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 nderpining 612 Tiedown/Soft Set System 11•- 611-- Permanent Permanent Foundation System Do Not Install Floor Sheathing or Slab Until Above Signed ShearwalUB.W.P.-Interior 134 Shearwall/B.W.P.-Exterior • 135 ' Roof Nail/Drag Trusses 129 605 —Continuity Test 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 , Inspection Type IVR INSP DATE T -Bar Ceiling 145 Stucco Lath . .142 Plumbing Final'. 813 Fire S rinkler Test or Final. 702 Swimming Pools Setbacks 131. Pool Plumbing Test 504 Gas Test 404 Pre-Gunite 506 - - Pre -Deck 505 r Pool Fencing/Alarms/Barriers. 503 Pre -Plaster • 507 Manufactured Homes Setbacks 131 Blockin nderpining 612 Tiedown/Soft Set System 11•- 611-- Permanent Permanent Foundation System 613 Underground Electric' 218 Sewer 407 Under round Water 417 Manometer Test 605 —Continuity Test 602 Skirtin Ste s/Landin s 1 610 Coach Info Manufactures Name: Date of Manufacture:. ' Model Name/Number: . Serial Numbers: Len h x Width. . Insignia: 11777771477 +. P .. •^..i.?i+t?.t1 r Permit`Final 802. Public Works Final 538.7681 Electrical Final 803 F• ire De artment/CDF. 538.6226 Env. Health Final 538.7281 Sewer District Final ^rroject kinal is a Certificate of Occupancy f e identi f Oft - PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF. WORK HAS COMMENCED, YOU MAY PAY JOR A 3 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION . Mechanical Final 809 Plumbing Final'. 813 Fire S rinkler Test or Final. 702 ire De artment/CDF. 538.6226 Env. Health Final 538.7281 Sewer District Final ^rroject kinal is a Certificate of Occupancy f e identi f Oft - PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF. WORK HAS COMMENCED, YOU MAY PAY JOR A 3 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) Project Name: David Enriquez I Date Prepared: CF1R-ALT-02-E (Page 1 of 3) 2017-09-05 A. General Information 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 David Enriquez 02 Date Prepared 2017-09-05 03 Project Location 1040 Peach St 04 Building Type Single family 05 CA City Gridley _ 06 Dwelling Unit Name 1040 Peach St SC System SC System CFA served system a efr gerant 07 Zip Code 95948 i� 08 Dwelling Unit Conditioned 1128 Location or Area by this SC ducted containing Floor Area (ftz) more than 40 entirely new entirely new Name Number of Space System (ftz) 09 Climate Zone 11 10` Conditioning (SC) Systems in 1 Alteration Type System 1 Location 1 1128 this Dwelling Unit: Yes B. Space Conditioning (SC) System Information O3 02 03 04 !) 65 06" 07 08 09 10 Is the SC ArT Installing,a, V{ SC System SC System CFA served system a efr gerant "I tall ng newSCR Installing Installing Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System (ftz) system? component? components? feet of ducts? duct system? SC system? Alteration Type System 1 Location 1 1128 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib) This section does not apply to this project. Registration Number: 417-A020114190A-000-000-0000000-0000 Registration Date/Time: 2017-09-05 16:37:31 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-05 16:37:31 Schema Version: rev 10/16 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 2 of 3) D. Altered Space Conditioning System (Sections 150.2(b)lE and F) 01 02 03 04 05 06 07 08 09 10 it 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 Central gas No heating This field or This field or Central split All new This field or This field or System 1 furnace component section is not section is not AC cooling SEER 14 Setback section is not section is not altered applicable applicable components applicable applicable Required Documentation:] CF211-MCH-01-E - Space Conditioning Systems - Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums R6.(CZJl 10 12-and�13) and R8 (CZ 11 and 14-16) CF2R and CF3R-MCH-20-H - Duct Leakage Test 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: <=15%or <= 10% leakage to outside, or seal all accessible leaks. ` CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing compone6ts a einstalled or altered (applicable in CZ 2, 8-15). CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required. Exceptions: Dud systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements. Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MCH -25. -Existing dud systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Dud Leakage Testing requirements. IL -Ji T€___ ik_._ X )) W__ E. Entirely New or Complete Replacement Duct System, with or without Ejuipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, F) t I'Th s ectio d s no a ply to th s p�oj ct. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 417-A020114190A-000-000-0000000-0000 CA Building Energy Efficiency Standards - 2016 Residential Compliance Registration Date/Time: 2017-09-05 16:37:31 Report Version: 2016.1.006 Schema Version: rev 10/16 HERS Provider: CHEERS Report Generated: 2017-09-05 16:37:31 �1 CERTIFICATE OF COMPLIANCE 3 CF1R-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -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: Jasmina Dizdarevic Jasmc"a V4da.rr;vCo Company: Signature Date: The Energuy 2017-09-05 Address: CEA/ HERS Certification Identification (if applicable): 1215 K Street City/State/Zip: Sacramento CA 95814 Phone: y<tl',W77-600-0123 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 Division 3 of the Business and Professions Code to accept responsibilityfor 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, calculations, plans and specifications submitted to the enforcement agency for,approval;with this building permit application. iw if �Q b �'O y; ?# ').: 5. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building:permit(s) issued for the building, and made available to the enforcement agency for all applicable ' ' 04 - 'fib,-•- 01 h • y, + w..«�w inspections. I understand that a registered copy of this Certificate of Compliance is`required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Tim Gallagher Unmatched Si�rvib Responsible; Designer Signature: J`ayni'ria ti"' '' iri(a�) Company: Date Signed: Gallagher's Plumbing Heating & Air Conditioning, Inc. 2017-09-05 Address: License: PO Box 35 935316 City/State/Zip: Phone: Los Molinos CA 96055 916-452-4154 Registration Number: 417-A020114190A-000-000-0000000-0000 Registration Date/Time: 2017-09-05 16:37:31 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-05 16:37:31 Schema Version: rev 10/16 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 1 of 7) Project Name: David Enriquez Enforcement Agency: Gridley (City of) Permit Number: Pending Dwelling Address: 1040 Peach St City: Gridley Zip Code: 95948 A. General Information 01 Dwelling Unit Name 1040 Peach St 02 Climate Zone 11 07 Dwelling Unit Total Conditioned Floor 09 10 Number of Space Conditioning 1 03 z Area (ft ) 1128 04 Systems in this Dwelling Unit. Installing OS Certificate of Compliance Type Prescriptive alterations (CF1R ALTry) , ,> Method Used to Calculate HVAC Loads NotApplicableEquipmentChangeout refrigerant Installing new SC Installing more entirely Installing 07 Calculated Dwelling Unit Sensible 1,.+a i.-" This field or section is not applicable ducted Calculated Dwelling Unit Heating Load This field or section is not applicable than 40 feet of Cooling Load (Btu/h) 08 (Btu/h) Served 10-9 Dwelling Unit Number of Bedrooms 3 components? ducts? system? MCH -01b - Space Conditioning Systems Ducts and Fans - Prescriptive Alterations, ..,, t L -..l1 is ICY. B. Space Conditioning (SC) System Information V7ti f1c" ached Service v4th latecirity 01 02 03 04 05 06 07 08 09 10 CFA served Is the SC Installing a Installing SC System SC System by this SC system a refrigerant Installing new SC Installing more entirely Installing Identification or Location or Area System ducted containing system than 40 feet of new duct entirely new Name Served (ftz) system? component? components? ducts? system? SC system? Alteration Type Altered space System 1 Location 1 1128 Yes Yes Yes No No No conditioning system Registration Number: 417-AO20114190A-002-000-MO1000A-0000 Registration Date/Time: 2017-09-05 16:38:18 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-05 16:38:18 Schema Version: rev 4/7/2017 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 2 of 7) C. Space Conditioning (SC) System Alterations Compliance Information O1 02 03 04 05 06 07 08 09 10 11 12 13 08 Condenser or Package Unit SC Identification or Name Cooling Efficiency Type Cooling Efficiency Value Condenser or Package Unit Manufacturer Condenser or Package Unit Model Number Central Fan System Rated Cooling Capacity at Design Conditions (Btu/h) Condenser Rated Nominal Capacity (ton) System 1 SEER 14 GOODMAN GSX140371KC 1612119743 36000 3 Notes: Integrated Heating Cooling New or (CFI) SC Altered Heating Minimum Altered Cooling Minimum Required Replaced New Ventilation Identification Heating Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Duct Duct System or Name System Type Component Type Value System Type Component Type Value Type Length R -Value Status This This field or This field field or No heating C'.' All new I N/A - no System 1 Central gas furnace componen section is or section is Central" I 17 cooling SEER 14 Setback ducts sectio Not a CFI t altered not not split-ACo , components replaced n is system a licabl pP applicable PP �:.�� not e " applic able D. Installed Heating Equipment Information i n C ' u x K i 4 '* This section does not apply to this'project. t. rirtrrir.'r. rtr r� r�r i* wiisi Firi4cirit-5 E. Installed Cooling Equipment Information O1 02 03 04 05 06 07 08 Condenser or Package Unit SC Identification or Name Cooling Efficiency Type Cooling Efficiency Value Condenser or Package Unit Manufacturer Condenser or Package Unit Model Number Condenser or Package Unit Serial Number System Rated Cooling Capacity at Design Conditions (Btu/h) Condenser Rated Nominal Capacity (ton) System 1 SEER 14 GOODMAN GSX140371KC 1612119743 36000 3 Notes: Registration Number: 417-A020114190A-002-000-MO1000A-0000 Registration Date/Time: 2017-09-05 16:38:18 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-05 16:38:18 Schema Version: rev 4/7/2017 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 3 of 7) 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. I H. Installed Air Filter Device Information I This section;cloessnot'apply to this project. t � I. Air Filter Device Requirements i This section does,n.ofapply to this project. CP r -Jul 1 E Ems. Unmamhed Service with Integrity Registration Number: 417-A020114190A-002-000-MO1000A-0000 Registration Date/Time: 2017-09-05 16:38:18 CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Schema Version: rev 4/7/2017 HERS Provider: CHEERS Report Generated: 2017-09-05 16:38:18 ••y CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 4 of 7) J. HERS Verification Requirements 01 02 03 04 05 06 07 08 09 10 Exemption MCH -20 from MCH -23 Minimum MCH 22 MCH -25 Exemption R -Value for MCH -21 AHU MCH -28 SC System SC System From Duct Duct Ducts In AHU Fan Airflow Identification or Location or Area Leakage Leakage Conditioned Duct Location Efficacy I Rate Refrigerant Return Duct Design Name Served Requirements Test Space Verification (W/dm) (dm/ton) Charge - Table 150.0-13 or C This field3or No t t F s t 4 n '� sectTals System 1 Location 1 Yes �« No No Yes Yes No exemptions r�'appyyli{c{ayy'l({iyyle�*��: Notes: + {{ I e H! t S; Unmatched Servi with IntegIrit, Ice y Registration Number: 417-A020114190A-002-000-MO1000A-0000 Registration Date/Time: 2017-09-05 16:38:18 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-05 16:38:18 Schema Version: rev 4/7/2017 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 5 of 7) 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 Equipment Efficiency: All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency 01 Regulations. Controls: All unitary heating systems, including heat pumps, must be controlled by a setback thermostat. These thermostats must be capable of allowing the occupant 02 to program the temperature set points for at least four different periods in 24 hours. See Sections 150.0(i), 110.2(b). Sizing: Heating load calculations must be done on portions of the building _`e'rveclty-new heating systems to prevent inadvertent undersizing or oversizing. See sections 03 150.0(h)1 and 2). 1 Z ., Furnace Temperature Rise: Central forced -air heating furnace installations must�e configured to operate at or below the furnace manufacturer's maximum 04 inlet -to -outlet temperature rise specification. See Section 150.0(h)4. 05 Standby Losses and Pilot Lights: Fan -type central furnaces may not have a continuously burning pilot light. Section 110.5 and Section 110.2(d). Cooling Equipment r _ LC --r D Equipment Efficiency: All cooling equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency 06 Regulations. U3imarc ied Servicrvvvish J-nte rtty 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 07 150.0(j)2 and 3, and Section 150.0(m)9. 08 Condensing Unit Location: Condensing units shall not be placed within five (5) feet of a dryer vent outlet. See Section 150.0(h)3A. 09 Liquid Line Filter Drier: If applicable, a liquid line filter drier shall be installed according to the manufacturer's specifications. Section 150.0(h)3B 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 10 150.0(h)1 and 2. Air Distribution System Ducts, Plenums and Fans Registration Number: 417-AO20114190A-002-000-MO1000A-0000 Registration Date/Time: 2017-09-05 16:38:18 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-05 16:38:18 Schema Version: rev 4/7/2017 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 6 of 7) 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. it 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. Connections and Closures: All installed air -distribution system ducts and plenums must be, sealed and insulated to meet the requirements of CMC Sections 601.0, 12 602.0, 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. r Heat Pump Thermostat 3� 13 A thermostat shall be installed that meets the requirements of Section' 10 2(b) and Section 110.2(c). 14 The thermostat shall be installed in accordance with the manufacturers published installation specifications 15 First stage of heating shall be assigned to heat pump heating. ` 16 Second stage back up heating shall be set to come on on.l.y whenthe iri'door set temperature cannot be met. �4 ; The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. . Registration Number: 417-A020114190A-002-000-MO1000A-0000 W,9 € a sssLt,€ € 4 ate€ WA_1Z YVa ,43 aaAw € r€.Y Registration Date/Time: 2017-09-05 16:38:18 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-05 16:38:18 Schema Version: rev 4/7/2017 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 7 of 7) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Jasmina Dizdarevic ja4mLn"''D4dawevLo Company: Signature Date: The Energuy 2017-09-05 Address: CEA/ HERS Certification Identification (if applicable): 1215 K Street City/State/Zip: Phone: Sacramento CA 95814 - . ,r'' `i` :877-600-0123 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 Installation is true and correct.; '_ ! 2. 1 am either: a) a responsible person 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, or b) I am an authorized representative of the responsible person and attest to the declarations in this statement on the responsible person's behalf. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations and the installation conforms to the requirements given on the Certificate of.CAo�mpliance,r plansand spe tifficationsjapp,oved�by the enforcement agency. 4. 1 will ensure that a registered copy of this Certificate of Installationshall be posted, or m" adeiavailablefwith the building:permit(s) issued for the building, and made available to the enforcement agency for all cY• applicable inspections. I understand that a registered copy of this Certifcate of InstallaUdn is re ueed to be included with the documentation the builder provides to the building owner at occupancy. tkAmatched Service with IntegriLy Responsible Builder/Installer Name: Responsible Builder/Installer Signature: Tim Gallagher Jaa' 4u,,•Dgdtiwe1LC1(a"dwr4e&) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Position With Company (Title): Gallagher's Plumbing Heating & Air Conditioning, Inc. Contractor/Installer Address: CSLB License: PO Box 35 1935316 City/State/Zip: Phone: Date Signed: Los Molinos CA 96055 1916-452-4154 12017-09-05 Registration Number: 417-A020114190A-002-000-MO1000A-0000 Registration Date/Time: 2017-09-05 16:38:18 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-05 16:38:18 Schema Version: rev 4/7/2017 CERTIFICATE OF INSTALLATION CF2R-MCH-20-H Duct Leakage Diagnostic Test (Page 1 of 3) Project Name: David Enriquez Enforcement Agency: Gridley (City of) Permit Number: Pending Dwelling Address: 1040 Peach St City: Gridley Zip Code: 95948 A. System Information 01 Space Conditioning System Identification or Name System 1 02 Space Conditioning System Location or Area Served Location 1 03 Building Type from CF -1R Single family 04 Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Credit from CF1R? No, credit is not taken 05 Verified Low Leakage Air Handling Unit (VLLAHU) Credit from CF1R? No, credit is not taken 06 1 Duct System Compliance Category,, TAlteration MCH -20d - Complete Replacement or Altered Duct -System B. Duct Leakage Diagnostic Test 01 Condenser Nominal Cooling Capacity -(ton) a3 t M 02 Heating Capacity (kBtu/h) ' ` This field or section is not applicable 03 U iTWCM sp-I'Vice V Conditioned Floor Area served by this HVAC system (ftz) fele Intf- Pity 1128 04 Duct Leakage Test Conditions Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor 0.15 07 Air Handling Unit Airflow (AHUAirflow) Determination Method Cooling system method 08 Measured AHUAirflow This field or section is not applicable 09 Calculated Target Allowable Duct Leakage (cfm) 180 10 Actual Duct Leakage Rate from Leakage Test Measurement (cfm) 152 11 Compliance Statement: System passes leakage test Registration Number: Registration Date/Time: 2017-09-05 16:39:01 HERS Provider: CHEERS 417-A020114190A-002-000-M20000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:39:01 2016 Residential Compliance Schema Version: rev 03/16 CERTIFICATE OF INSTALLATION CF2R-MCH-20-H Duct Leakage Diagnostic Test (Page 2 of 3) C. Additional Requirements for Compliance 01 System was tested in its normal operation condition. No temporary taping allowed. Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation 02 Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required, may configure the OA damper to the closed position during duct leakage testing. 03 If a complete replacement, all supply and return register boots were sealed to the drywall. 04 Building cavities were not used as plenums or platform returns in lieu of ducts. 05 If cloth backed tape was used it was covered with Mastic and draw bands. 06 All connection points between the air handler and the supply and return plenums are completely sealed. If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the requirements 07 of Reference Residential Appendix RA3.1.4.3.6. Systemssth% comply using smoke test shall not be included in sample groups for HERS verification compliance. The responsible person's signature on this compliance`document affirms that all applicable requirements in this table have been met. Unrnatr-hod Service with Integrity Registration Number: Registration Date/Time: 2017-09-05 16:39:01 HERS Provider: CHEERS 417-A020114190A-002-000-M20000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:39:01 2016 Residential Compliance Schema Version: rev 03/16 CERTIFICATE OF INSTALLATION CF2R-MCH-20-H Duct Leakage Diagnostic Test (Page 3 of 3) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Jasmina Dizdarevic J�+�DN6r, Company: Signature Date: The Energuy 2017-09-05 Address: CEA/ HERS Certification Identification (if applicable): 1215 K Street City/State/Zip: Phone: Sacramento CA 95814 877-600-0123 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 Installation is true and correct. 2. 1 am either: a) a responsible person 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, or b) I am an authorized representative of the responsible - °1e; . person and attest to the declarations in this statement on the, rei$spgnsibleperson's behalf. ter' \ r"° "•'.;; 3. The constructed or installed features, materials, comporients or mainufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations and theirr s611Mib,n;conforms to the requirements given on the Certificate of Compliance, plans, and specifications approved by the enforcement agency.a !( ) �� ray 4. I HERS understand that a rater will check the installation to verify compiliance`ancl if such checking determines the installation fails to comply, I am required to offer any necessary corrective action at no charge to the—building owner. 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 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. c i r C:HIE } i.Jnn',,atched Service with int grit Responsible Builder/Installer Name: Responsible Builder/Installer Signature: Tim Gallagher Ja"wuma.D4da"NLr,(audtar4e&) Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): Builder/Owner) Contractor/Installer Gallagher's Plumbing Heating & Air Conditioning, Inc. Address: CSLB License: PO Box 35 935316 City/State/Zip: Phone: Date Signed: Los Molinos CA 96055 916-452-4154 12017-09-05 Third Party Quality Control Program (TPQCP) Status: Name of TPQCP (if applicable): Registration Number: Registration Date/Time: 2017-09-05 16:39:01 HERS Provider: CHEERS 417-A020114190A-002-000-M20000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:39:01 2016 Residential Compliance Schema Version: rev 03/16 CERTIFICATE OF INSTALLATION CF2R-MCH-23-H Space Conditioning System Airflow Rate (Page 1 of 3) Project Name: David Enriquez Enforcement Agency: Gridley (City of) Permit Number: Pending Dwelling Address: 1040 Peach St City: Gridley Zip Code: 95948 A. Ducted Cooling System Information Instrument Specifications are given in RA3.3.1.1, and system airflow rate measurement apparatus information is given in RA3.3.2. 01 System Identification or Name 01 verification. System 1 02 System Location or Area Served KANOMAX 03 Location 1 03 System Installation Type Certification Status of the Airflow Measurement Apparatus Certified by Manufacturer and listed on CEC Website at Alteration 04 Nominal Cooling Capacity (tons) of Condenser 3 05 Condenser Speed Type This field or section is not applicable 06 Cooling System Zonal Control Type This field or section is not applicable 07 Central Fan Integrated (CFI) Ventilation System Statuss< 4 . -Not a CFI system 08 System Bypass Duct Status '' �� No Bypass Duct 09 Date of System Airflow Rate Measurement 2017-07-28 10 Airflow Rate Protocol Utilized' RA3.3 procedures for airflow rate measurement n ?I r B. Hole for the placement of a StaticPressure-Probe-(HSPP); and;Permanently Installed Static Pressure Probe (PSPP) in the Supply Plenum. 1� U It Procedures for installing HSPP or PSP"are,;.sspecifielUv�d,;in�RA3� 1 i Integrity 01 Method Used to Demonstrate Compliance with the 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. Airflow Rate Measurement Type used for this airflow rate Traditional Flow Capture Hood according to procedure in 01 verification. RA3.3.3.1.4 02 Manufacturer of Airflow Measurement Apparatus KANOMAX 03 Model number of Airflow Measurement Apparatus 6710 Certification Status of the Airflow Measurement Apparatus Certified by Manufacturer and listed on CEC Website at 04 Accuracy http://www.energy.ca.gov/title24/equipment_cert/ama_fas /index.html Registration Number: Registration Date/Time: 2017-09-05 16:39:27 HERS Provider: CHEERS 417-A020114190A-002-000-M23000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:39:27 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF INSTALLATION CF2R-MCH-23-H Space Conditioning System Airflow Rate (Page 2 of 3) 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) 300 02 Required Minimum System Airflow Target (cfm) 900 03 Actual System Airflow Rate Measurement (cfm) 1075 04 Compliance Statement: System airflow rate complies E. Additional Requirements Air filters that meet the applicable requirements:6&nda ds Section 150.0(m)12 or 150.0(m)13 were properly installed in 01 t the system during system air flow rate measurement identified,?on this Certificate of Installation. The airflow rate measurement apparatus used top rform he airflow rate measurement identified on this Certificate of 02 Installation was calibrated in accordance with the 4 v rai .s►i �n pparatus�manufacturer's specifications and conforms to the instrumentation specifications given in•RA3.3.1. `,k 7,' A visual inspection shall confirm that bypass ducts that deliver conditioned supply air directly to the space conditioning 03 system return duct airflow are not used on newly constructed zonally controlled systems unless the Performance Certificate of Compliance indicates an allowance or`use of a bypass d'u t WFien` a byp s duct is accounted for on the Performance Certificate of Compliance, the airflow gate shall conform to the spetificati6hTlisted on the Certificate of Compliance. 04 All registers were fully open Burin Rtherdiagno",stir est:icwith Intp-grity 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. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: Registration Date/Time: 2017-09-05 16:39:27 HERS Provider: CHEERS 417-A020114190A-002-000-M23000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:39:27 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF INSTALLATION CF2R-MCH-23-H Space Conditioning System Airflow Rate (Page 3 of 3) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Jasmina Dizdarevic Ja4m4na.Vi d ,-" o Company: Signature Date: The Energuy 2017-09-05 Address: CEA/ HERS Certification Identification (if applicable): 1215 K Street City/State/Zip: Phone: Sacramento CA 95814 1877-600-0123 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 Installation is true and correct. 2. 1 am either: a) a responsible person 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, or b) I am an authorized representative of the responsible person and attest to the declarations in this statement on the: responsible person's behalf. 3. The constructed or installed features, materials, compone t or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations and the'inst6llati6h,conforms to the requirements given on the Certificate of Compliance, plans, and specifications approved by the enforcement agency. 4. 1 understand that a HERS rater will check the installation to verify compliance and if such checking determines the installation fails to comply, I am required to offer any necessary corrective action at no charge to the_building owner. 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 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. %elt!� k E R Urirl`1ZStt::hed Service with Into rity Responsible Builder/Installer Name: Responsible Builder/Installer Signature: Tim Gallagher Jaa''t'r'4"D"�da�rN'�(aud.o``",4eZ) Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): Builder/Owner) Contractor/Installer Gallagher's Plumbing Heating & Air Conditioning, Inc. Address: CSLB License: PO Box 35 1935316 City/State/Zip: Phone: Date Signed: Los Molinos CA 96055 1916-452-4154 12017-09-05 Third Party Quality Control Program (TPQCP) Status: I Name of TPQCP (if applicable): Registration Number: Registration Date/Time: 2017-09-05 16:39:27 HERS Provider: CHEERS 417-A020114190A-002-000-M23000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:39:27 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF INSTALLATION CF2R-MCH-2S-H Refrigerant Charge Verification (Page 1 of 4) Project Name: David Enriquez Enforcement Agency: Gridley (City of) Permit Number: Pending Dwelling Address: 1040 Peach St City: Gridley Zip Code: 95948 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 Location 1 03 Condenser (or package unit) Make or Brand GOODMAN 04 Condenser (or package unit) Model Number GSX140371KC 05 Nominal Cooling Capacity (tons) of Condenser 3 06 Condenser (or package unit) Serial Number 1612119743 07 Refrigerant Type R ;410A 08 D 3"r Other Refrigerant Type (if applicable) ,I� This field or section is not applicable 7 09 Liquid Line Filter Drier Installed According to Manufacturers; Yes Specifications (if applicable) 10 System Installation Type d Alteration 11 Fault Indicator Display (FID) Status (Note: Even system with� Thi's system does not have a FID device installed a FID must have refrigerant charge verified by installer). - a.Je VANWheo 581 Vice V, -Ah integrity Is the system of a type that the minimum airflow can be Yes, this is a ducted system and one of the system airflow ' 12 verified using an approved measurement procedure (RA3.3 rate measurement procedures in RA3.3 or RA3.3.3 can be or RA3.3.3)? used to verify system airflow rate requirements. Is the system of a type that approved refrigerant charge Yes, one of the Refrigerant charge verification procedures 13 verification procedures can be used to verify compliance from RA3.2.2 or RAI is applicable to this system and can be with the refrigerant charge verification requirements when used to verify compliance temperatures are >= 55°F (RA3.2.2, or RAI)? 14 Date of Refrigerant Charge Verification for this system 2017-07-28, 15 Refrigerant charge verification method used. Subcooling (outdoor temperature must be equal to or greater than 55 degF) 16 Person who performed the Refrigerant Charge Verification HERS rater reported on this Certificate of Installation 17 HERS Verification Compliance Requirement Status System does not qualify for group sampling Registration Number: Registration Date/Time: 2017-09-05 16:40:10 HERS Provider: CHEERS 417-A020114190A-002-000-M25000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:40:10 2016 Residential Compliance Schema Version: rev 4/7/2017 CERTIFICATE OF INSTALLATION CF2R-MCH-25-H Refrigerant Charge Verification (Page 2 of 4) MCH -25b - Refrigerant Charge Verification - Subcooling Method B. Metering Device Verification Subcooling Method can only be used on systems that have a variable metering device. 01 Refrigerant metering device Thermostatic Expansion Valve (TXV) 02 Subcooling Method applicability status Subcooling Method is applicable to this system. C. Instrument Calibration ' Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2 01 Date of Digital Refrigerant Gauge Calibration 2017-07-03 02 Date of Digital Thermocouple Calibration 2017-07-28 03 Digital Refrigerant Gauge Calibration Status .-Calibration is current 90 02 (Tcondenser,db) 04 Digital Thermocouple Calibration Status Calibration is current ID. Measurement Access Hole (MAH) Verification \' '/ Procedures for installing MAH are specified in Reference=Residential Appendix RA3.2.2.3 I Method Used to Demonstrate Compliance with th 01 Measurement Access Hole (MAH) Requirement installed and labeled consistent with Figure 3.2-1 E. Minimum System Airflow Rate Ver ficatO—h 1 Service with Integrity Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.3.3. 01 Minimum Required System Airflow Rate (cfm) 900 02 System Airflow Rate Verification Status System complies with minimum airflow rate requirements F. Data Collection and Calculations Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in Reference Residential Appendix RA3.2.2. Lowest Return Air Dry Bulb Temperature that Occurred 90 01 During the Refrigerant Charge Verification Procedure (°F) Measured Condenser Air Entering Dry -Bulb Temperature 90 02 (Tcondenser,db) Outdoor temperature is within range for using Subcooling 03 Outdoor Temperature Qualification Status refrigerant charge verification method Registration Number: Registration Date/Time: 2017-09-05 16:40:10 HERS Provider: CHEERS 417-A020114190A-002-000-M25000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:40:10 2016 Residential Compliance Schema Version: rev 4/7/2017 CERTIFICATE OF INSTALLATION CF2R-MCH-25-H Refrigerant Charge Verification (Page 3 of 4) F. Data Collection and Calculations Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in Reference Residential Appendix RA3.2.2. 04 Measured Liquid Line Temperature (Trquid) ('F) 78.6 05 Measured Liquid Line Pressure (Prqud) (psig) 271.6 06 Condenser Saturation Temperature (Tcondenser, sat) from 89 Digital Gauge or P -T Table using Line F05 (°F) d '-,y 07 Measured Subcooling (Line F06 - Lilne F04 ("F) 10.4 08 Target Subcooling from Manufacturer (°F) 10 09 Compliance Statement: System complies with Subcooling Method - Must also pass (inclusive) metering device verification, next section G. Metering Device Verification Y Procedures for the verification of proper metering deviceioperation are specified in RA3.2.2.6.2 .�. 01 � u«c Measured Suction Line Temperature (Tsuction) (°F), : r t. 56.4 02 Measured Suction Line Pressure (Psuction) (psi g) \ 158.2 03 Evaporator Saturation Temperature (Tevaporator, sat) from 38.7 Digital Gauge or P -T Table using Line G0Z(*F) d '-,y 0 i - n 'i Q _ V- 04 Measured Superheat (Line G01- Line -G03) ('�F) 05 Measured Superheat (Line G04) is b'efweer 4°F ari6-455'IF - V P -A' asCECrequirement (inclusive) 06 Measured Superheat (Line G04) is within Manufacturer's Yes, documentation to be provided upon request Specifications ( if known) 07 Compliance Statement Metering device verification passes MCH-2Sd - Refrigeration Charge Verification - Fault Indicator Display (FID) H. Fault Indicator Display This section does not apply to this project. I. Fault Indicator Display Additional Requirements This section does not apply to this project. Registration Number: Registration Date/Time: 2017-09-05 16:40:10 HERS Provider: CHEERS 417-A020114190A-002-000-M25000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:40:10 2016 Residential Compliance Schema Version: rev 4/7/2017 CERTIFICATE OF INSTALLATION CF2R-MCH-25-H Refrigerant Charge Verification (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: Jasmina Dizdarevic ja*mL a,1)4 v.* & Company: Signature Date: The Energuy 2017-09-05 Address: CEA/ HERS Certification Identification (if applicable): 1215 K Street City/State/Zip: Phone: Sacramento CA 95814 1877-600-0123 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 Installation is true and correct. 2. 1 am either: a) a responsible person 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, or b) I am an authorized representative of the responsible moo.. . person and attest to the declarations in this statement on the:responsible person's behalf. 3. The constructed or installed features, materials, components or,manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations and the%nstallation;conforms to the requirements given on the Certificate of Compliance, plans, and specifications approved by the enforcement agency. 4. 1 understand that a HERS rater will check the installation to verify compliance and if such checking determines the installation fails to comply, 1 am required to offer any necessary corrective action at no charge tothe_building owner. 5. 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. C IH-- -'-1 1.`;a E Unr t heed* Service With Irtteority Responsible Builder/Installer Name: Responsible Builder/Installer Signature: Tim Gallagher Jaa'"6r,wD4da#-evU, and ar"edd Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): Builder/Owner) Contractor/Installer Gallagher's Plumbing Heating & Air Conditioning, Inc. Address: CSLB License: PO Box 35 935316 City/State/Zip: Phone: Date Signed: Los Molinos CA 96055 916-452-4154 12017-09-05 Third Party Quality Control Program (TPQCP) Status: Name of TPQCP (if applicable): Registration Number: Registration Date/Time: 2017-09-05 16:40:10 HERS Provider: CHEERS 417-A020114190A-002-000-M25000A-0000 CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:40:10 2016 Residential Compliance Schema Version: rev 4/7/2017 CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 1 of 3) Project Name: David Enriquez Enforcement Agency: Gridley (City of) Permit Number: Pending Dwelling Address: 1040 Peach St City: Gridley Zip Code: 95948 A. System Information 01 Space Conditioning System Identification or Name System 1 02 Space Conditioning System Location or Area Served Location 1 03 Building Type from CF -1R Single family 04 Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Credit from CF1R? No, credit is not taken 05 Verified Low Leakage Air Handling Unit Credit from CF1R? No, credit is not taken E06 Duct System Compliance Category Alteration MCH -20d - Complete Replacement or Altered DutSy tem .�„��J.� ,a B. Duct Leakage Diagnostic Test 01 Condenser Nominal Cooling Capacity (ton) 3 02 Heating Capacity (kBtu/h) %his fiel , se on is not applicable 03 Conditioned Floor Area served b thL.Iisd ,Hi iV.irA:'s iC.'sy ,steft2IcM14 1128 h Integrity 04 Duct Leakage Test Conditions Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor 0.15 07 Air Handling Unit Airflow (AHUAirflow) Determination Method Cooling system method 08 Measured AHUAirflow This field or section is not applicable 09 Calculated Target Allowable Duct Leakage Rate (cfm) 180 10 Actual Duct Leakage Rate from Leakage Test Measurement (cfm) 152 11 Compliance Statement: System passes leakage test 12 Notes: Registration Number: Registration Date/Time: 2017-09-05 16:32:11 HERS Provider: CHEERS 417-A020114190A-002-000-M20000A-M20A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:32:12 2016 Residential Compliance Schema Version: rev 03/16 CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 2 of 3) C. Additional Requirements for Compliance 01 System was tested in its normal operation condition. No temporary taping allowed. 02 Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required, may configure the OA damper to the closed position during duct leakage testing. 03 If a complete replacement, all supply and return register boots were sealed to the drywall. 04 Building cavities were not used as plenums or platform returns in lieu of ducts. 05 If cloth backed tape was used it was covered with Mastic and draw bands. 06 All connection points between the air handler and the supply and return plenums are completely sealed. 07 If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the requirements of Reference Residential Appendix RA3.1.4.3.6. Systems that comply using smoke test shall not be included in sample groups for HERS verification compliance. E 08 Verification Status:�y. .{Passe all applicable requirements are met 09 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. D. Determination of HERS VerificationCompliance Lc;,— & M . All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order for this Certificate of Verification as a who,Le to-kdetermined;�torberin toMplianee 1 01 1 Complies: All specified verification protocol requirements on this document are met. Registration Number: Registration Date/Time: 2017-09-05 16:32:11 HERS Provider: CHEERS 417-A020114190A-002-000- M 20000A -M 20A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:32:12 2016 Residential Compliance Schema Version: rev 03/16 - CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 3 of 3) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: lasmina Dizdarevic Jas nLna,1Dgdar"Lr, Company: Date Signed: The Energuy 2017-09-05 Address: CEA/ HERS Certification Identification (if applicable): 1215 K Street City/State/Zip: Phone: Sacramento CA 95814 877-600-0123 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',th enforcement agency. 4. The information reported on applicable sections of the Certificate(s)ofInsta�llation (CF2R) signed and submitted by the person(s) responsible for the .... .�f construction or installation conforms to the requirements speeifie8.onahe Certificates) of Compliance (CF1R) approved by the enforcement agency. 5. I will ensure that a registered copy of this Certificate of Veti ication hall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency fo gall Iicablelinspections. I understand that a registered copy of this Certificate of Verification is required to be included with the documentation the builder provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General ConYractor,orBuilder'/Owner) Responsible Builder or Installer Name: '"' i 0 0 t1=10 i TCSLB;License: ' HERS Provider Data Registry Information ached ServiCA- kkrifh Integrity Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) N/A HERS Rater Information HERS Rater Company Name: The Energuy Responsible Rater Name: Responsible Rater Signature: Shaun Hogue ShauvvRogue, Responsible Rater Certification Number w/ this HERS Provider: Date Signed: RCN13149 2017-09-05 Registration Number: Registration Date/Time: 2017-09-05 16:32:11 HERS Provider: CHEERS 417-A020114190A-002-000-M20000A-M 20A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017 -09 -OS 16:32:12 2016 Residential Compliance Schema Version: rev 03/16 CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 1 of 4) Project Name: David Enriquez Enforcement Agency: Gridley (City of) Permit Number: Pending Dwelling Address: 1040 Peach St City: Gridley Zip Code: 95948 A. Ducted Cooling System Information 01 System Identification or Name System 1 02 System Location or Area Served Location 1 03 System Installation Type Alteration 04 Nominal Cooling Capacity (tons) of Condenser 3 05 Condenser Speed Type This field or section is not applicable 06 Cooling System Zonal Control Type This field or section is not applicable 07 Central Fan Integrated (CFI) Ventilation System Status, `'Not a CFI system 08 System Bypass Duct Status �_ -No Bypass Duct 09 Date of System Airflow Rate Measurement a�—=''� e 2017-07-28 1 0 Airflow Rate Protocol Utilized `' RA3.3 procedures for airflow rate measurement B. Hole for the placement of a Static ;Pressure -Probe (HSPP) nd'Permanently Installed Static Pressure Probe (PSPP) in the Supply Plenum. � II t6 4 1�1 t=:�/ Procedures for installing HSPP or PSPP�are.sspecified..ip RA3 .1.1, Integrity 01 Method Used to Demonstrate Compliance with the 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. Airflow Rate Measurement Type used for this airflow rate Traditional Flow Capture Hood according to procedure in 01 verification. RA3.3.3.1.4 02 Manufacturer of Airflow Measurement Apparatus KANOMAX 03 Model number of Airflow Measurement Apparatus 6710 Certification Status of the Airflow Measurement Apparatus Certified by Manufacturer and listed on CEC Website at 04 Accuracy http://www.energy.ca.gov/title24/equipment—cert/ama—fas /index.html Registration Number: Registration Date/Time: 2017-09-05 16:32:43 HERS Provider: CHEERS 417-A020114190A-002-000-M 23000A -M 23A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:32:43 2016 Residential Compliance Schema Version: rev 10/16 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) 300 02 Required Minimum System Airflow Target (cfm) 900 03 Actual System Airflow Rate Measurement (cfm) 1075 04 Compliance Statement: System airflow rate complies E. Additional Requirements ., Air filters that meet the applicable requirements of Standaeds Section 150.0(m)12 or 150.0(m)13 were properly installed in 01 the system during system air flow rate measurement_identified'on this Certificate of Verification. The airflow rate measurement apparatus used to;peHorm the -airflow rate measurement identified on this Certificate of 02 Verification was calibrated in accordance with theiappaeiatuis manufacturer's specifications and conforms to the instrumentation specifications given in RA3.3.1.' A visual inspection shall confirm that bypass ducts that deliver conditioned supply air directly to thespace conditioning 03 system return duct airflow are not used on newly constructed zonally controlled systems unless the' Performance Certificate of Compliance indicates an allowance for use -of a 6 p ss duct When a by duct is accounted foron the Performance Certificate of Compliance, the airflow"rate shall conform to -the spe fications'listed on the Certificate of Compliance. 04 All registers were fully open during the diagnostic to CViCa with th )t tlt gri y 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 airflow (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: Registration Date/Time: 2017-09-05 16:32:43 HERS Provider: CHEERS 417-A020114190A-002-000-M 23000A -M 23A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Genera -ed: 2017-09-05 16:32:43 2016 Residential Compliance Schema Version: rev 10/16 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 Complies: All specified verification protocol requirements on this document are met. w 3 1 vE"a. c `! {;i.S Yrs' lof u oi :ly Registration Number: Registration Date/Time: 2017 -09 -OS 16:32:43 HERS Provider: CHEERS 417-AO20114190A-002-000-M 23000A -M 23A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:32:43 2016 Residential Compliance Schema Version: rev 10/16 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: Jasmina Dizdarevic Ja �revf� Company: Date Signed: The Energuy 2017-09-05 Address: CEA/ HERS Certification Identification (if applicable): 1215 K Street City/State/Zip: Phone: Sacramento CA 95814 877-600-0123 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 buildirigapproved'by th enforcement agency. 4. The information reported on applicable sections of the Certifcate(s);of installation (CF2R) signed and submitted by the person(s) responsible for the r is construction or installation conforms to the requirement fied,,, , s specion the Certificate(s) of Compliance (CF1R) approvedby the enforcement agency. 5. 1 will ensure that a registered copy of this Certificate of Verificatwnfi6all 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 Verification is required to be included with the documentati n..the builder' provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General Contractor or Bwlder/Owner): Responsible Builder or Installer Name: % 0 9:' 1 =CSL&License:: 4,0 HERS Provider Data Registry Information tChed Sprvice, V*h Jntix ! �rity Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) N/A HERS Rater Information HERS Rater Company Name: The Energuy Responsible Rater Name: Responsible Rater Signature: Shaun Hogue ShaU*tJforgue, Responsible Rater Certification Number w/ this HERS Provider: Date Signed: RCN 13149 2017-09-05 Registration Number: Registration Date/Time: 2017-09-05 16:32:43 HERS Provider: CHEERS 417-A020114190A-002-000-M 23000A -M 23A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:32:43 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION CF3R-MCH-25-H Refrigerant Charge Verification (Page 1 of 4) Project Name: David Enriquez Enforcement Agency: Gridley (City of) Permit Number: Pending Dwelling Address: 1040 Peach St City: Gridley Zip Code: 95948 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 Location 1 03 Condenser (or package unit) make or brand GOODMAN 04 Condenser (or package unit) model number GSX140371KC 05 Nominal Cooling Capacity (tons) of Condenser 3 06 Condenser (or package unit) serial number {'"'`; 1612119743 07 Refrigerant Type `,.. " i` R -410A 08 Other Refrigerant Type (if applicable) I , `i :This field or section is not applicable .....:................ Liquid Line Filter Drier Installed According to Manufacturers' Yes 09 Specifications (if applicable) 10 System Installation TypeAlteration Fault Indicator Display (FID) Status (Note: Even systems with This system does not have a FID device installed 11 a FID must have refrigerant charge verified by installer) sJy�Yz';c::st..i' eU Vice v ith Initcgrit Is the system of a type that the minimum airflow can be Yes, this is a ducted system and one of the system airflow 12 verified using an approved measurement procedure (RA3.3 rate measurement procedures in RA3.3 or RA3.3.3 can be or RA3.3.3)? used to verify system airflow rate requirements. 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 RAI is applicable to this system and can be 13 with the refrigerant charge verification requirements when used to verify compliance temperatures are >= 55°F (RA3.2.2, or RAI)? 14 Date of Refrigerant Charge Verification for this system 2017-07-28 Refrigerant charge verification method used. Subcooling (outdoor temperature must be equal to or 15 greater than 55 degF) Person who performed the Refrigerant Charge Verification HERS rater 16 reported on this Certificate of Installation 17 HERS Verification Compliance Requirement Status System does not qualify for group sampling 18 Refrigerant charge verification method used by HERS Rater. Subcooling Registration Number: Registration Date/Time: 2017-09-05 16:33:02 HERS Provider: CHEERS 417-A020114190A-002-000- M 2 5000A -M 25A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:33:02 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION CF3R-MCH-25-H Refrigerant Charge Verification (Page 2 of 4) MCH -25b - Refrigerant Charge Verification - Subcooling Method B. Metering Device Verification HERS Rater is required to visually field verify all information from CF2R. Subcooling Method can only be used on systems that have a variable metering device. 01 Refrigerant metering device Thermostatic Expansion Valve (TXV) 02 Subcooling Method applicability status Subcooling Method is applicable to this system. C. Instrument Calibration HERS Raters are required to calibrate their diagnostic tools. Procedures for instrument calibration are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2 01 Date of Digital Refrigerant Gauge Calibration 2017-07-03 02 Date of Digital Thermocouple Calibrations i -2017-07-28 03 Digital Refrigerant Gauge Calibration Status 1. Calibration is current (Tcondenser,db) rO4 Digital Thermocouple Calibration Status �� /Calibration is current D. 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 { 01 Method Used to Demonstrate Compliance with the rVf i MAH 44 974.y and labeled consistent with Figure 3.2-1 Measurement Access Hole (MAH) Requirement E. Minimum System Airflow Rate Verification Procedures for verifying minimum system airflow are specified in Reference Residential Appendix RA3.3.3. 01 Minimum Required System Airflow Rate (cfm) 900 02 System Airflow Rate Verification Status System complies with minimum airflow rate requirements F. Data Collection and Calculations HERS Rater must independently collect all data in this section. Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2 01 Lowest Return Air Dry Bulb Temperature that Occurred 90 During the Refrigerant Charge Verification Procedure (°F) 02 Measured Condenser Air Entering Dry -Bulb Temperature 90 (Tcondenser,db) Registration Number: 417-A020114190A-002-000-M 25000A -M 25A CA Building Energy Efficiency Standards 2016 Residential Compliance Registration Date/Time: 2017-09-05 16:33:02 HERS Provider: CHEERS Report Version: 2016.1.006 Report Generated: 2017-09-05 16:33:02 Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION CF3R-MCH-25-H Refrigerant Charge Verification (Page 3 of 4) F. Data Collection and Calculations HERS Rater must independently collect all data in this section. Procedures for determining Refrigerant Charge using the Standard Charge Verification Procedure are given in Reference Residential Appendix RA3.2.2 and RA3.2.2.2 03 Outdoor Temperature Qualification Status Outdoor temperature is within range for, using Subcooling 56.4 02 refrigerant charge verification method 04 Measured Liquid Line Temperature (Thquid) ("F) 78.6 05 Measured Liquid Line Pressure (Pliquid) (psig) 271.6 06 Condenser Saturation Temperature (Tcondense, sat) from 89 Digital Gauge or P -T Table using Line F05 (°F) 07 Measured Subcooling (Line F06 - Lilne F04 (°F) 10.4 08 Target Subcooling from Manufacturer (°F) 10 09 Compliance Statement:, ,. System complies with Subcooling Method - Must also pass Measured Superheat (Line G04) is within Manufacturer's -metering device verification, next section ., ',-, "': / i G. Metering Device Verification W Ek HERS Rater must independently collect all data in this section.; Procedures for the verification of proper metering device operation are specified in RA3.2.2.6.2 01 Measured Suction Line Temperature (Tsuctlon) ("F) 56.4 02 Measured Suction Line Pressure (Psuf n)(psig)l ! � 158 2 03 Evaporator Saturation Temperature ,(Tevaporato, sat) from (ivie`' service v 38.7 ith Irrtegrrtyr Digital Gauge or P -T Table using Line`iG02 04 Measured Superheat (Line G01- Line G03) (°F) 17.7 Measured Superheat (Line G04) is between 3°F and 26°F Passes CEC requirement 05 (inclusive) Measured Superheat (Line G04) is within Manufacturer's Yes, documentation to be provided upon request 06 Specifications ( if known) 07 Compliance Statement: Metering device verification passes H. 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. 1 01 1 Complies: All specified verification protocol requirements on this document are met. Registration Number: Registration Date/Time: 2017-09-05 16:33:02 HERS Provider: CHEERS 417-A020114190A-002-000-M 25000A -M 25A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:33:02 2016 Residential Compliance Schema Version: rev 10/16 CERTIFICATE OF VERIFICATION CF3R-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: Documentation Author Signature: Jasmina Dizdarevic Company: Date Signed: The Energuy 2017-09-05 Address: CEA/ HERS Certification Identification (if applicable): 1215 K Street City/State/Zip: Phone: Sacramento CA 95814 877-600-0123 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 information reported on applicable sections of the Ceitifcate(s) of Installation (CF2R) signed and submitted by the person(s) responsible for the +-3. r. - -, r+". construction or installation conforms to the requirements specified. on: the Certificates) of Compliance (CF1R) approved by the enforcement agency. 5. 1 will ensure that a registered copy of this Certificate of Verificationlshall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency fr all applicableinspections. I understand that a registered copy of this Certificate of Verification is required to be included with the documentatio :the builder provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General Contractor,' oIo 6uilde�/Owner): { Responsible Builder or Installer Name: ' Am" i FCSLBiLicense: HERS Provider Data Registry InformationTiatCh Sj.�rvfc e Int rkty Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) N/A HERS Rater Information HERS Rater Company Name: The Energuy Responsible Rater Name: Responsible Rater Signature: Shaun Hogue Shcay.#v}foguv. Responsible Rater Certification Number w/ this HERS Provider: Date Signed: RCN 13149 2017-09-05 Registration Number: Registration Date/Time: 2017-09-05 16:33:02 HERS Provider: CHEERS 417-A020114190A-002-000-M25000A-M25A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-09-05 16:33:02 2016 Residential Compliance Schema Version: rev 10/16