15030160Ed
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1195 YORKSHIRE CT
CONTRACTOR: DELUXE AIR
PERMIT NO: 15030160
OWNER'S NAME:
WOODLAND, CA 95776
PHONE NO: (530) 662-5008
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL
REPLACE A/C UNIT LIKE FOR LIKE
(1 ,, ^^
License Class C.' V Lic. It q01 ws 3 q
ContractoDC—LUX& r, ()Z— Date 3/C20' �s-
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self -insure for Worker's
' Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
Sq. Ft Floor Area:
Valuation: $6814
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 36211009.00
Occupancy Type:
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DAYS PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
180 DAYS F ST CALLED INSP CTION*
costs, and expenses which may accrue against said City in consequence of the
Issued by: Dat e: 2(p f
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source egulations per the Cupertino Municipal Code, Section
RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
918.
Signature Date 302 i S
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cup tmo Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 2 , 25533, a
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agents Dater A 11
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
CONSTRUCTION LENDING AGENCY
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
918.
Signature Date
CUPERTINO
GENERAL PERMIT APPLICATION - ' MEP
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION \�
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 �v
MISC(408),777-3228 • FAX (408) 777-3333 • buildingcDcupertino.org
❑ PLUMBING Il_I MECHANICAL ❑ ELECTRICAL ❑ MISCELLANEOUS
PROJECT ADDRESSI' -J n 5 �- l R �
1C
CT
APN # �' ()f . jj . 6 , ,
^
FAX
CONTACT NAME (
PHONEM _ OQ Q
E-MAIL
STREET ADDRESS/ n' / (O
CITY; STATE,VZIPj//� ` C?
yARCHITECT
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT
P CONTRACTOR ❑ CONTRACTOR AG HENT ❑ ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME \ f `
LICENSE NUMBER
J
LICENy� TYP O
`
BUS. LIC #
COMPANY'
D E l U _ T-
E-MAIL
FAX
/" qg r C f 71 {
STREET ADDRESS 10A/'/� J `•(-
/
(
CIT , ST6ArT�E; IP o9N � n n -7
7 7
Y �/'l `j (
PHONE
ARCHITECT/ENGINEER NAME('
LICENSE NUMBEWR
BUS. LIC #
COMPANY NAME
E-MAII
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or DUPLEX ❑ MULTI-FAMII.YPROJECT
IN WILDLAND ❑ YES
PROJECT IN El YES
IS THE BLDG AN ❑ YES
BUILDING: ❑ COMMERCIAL
URBAN INTERFACE AREA ❑ NO
FLOOD ZONE ❑ NO
EICHLER HOME? ❑ NO
DESCRIPTION OF WORK
nJ5'f� C A QU T D06
IZ 0aF1 &-b (F tZ t Ac- `v�
L
TOTAL VALUATION: 8 t
1E1VED
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the prqjerter's behalf. I have read this
application and the information I have provided is correct I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to build�constru�Ction, autho ' representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature ofApplicant/Agent.
Date:
SVMENTAL INFORMATION REQUIRED „ ; oFFrcE usEbN_
No
g IN
112,
MEPMiscApp_2011.doc Devised 06121/11
CITY OF CUPERTINO
��
LTi IV i C9r7M A Tl112 — RT TTI .'nINV DIVICION
LaADDRESS:
1195 yorkshire
DATE: 03/26/2015
REVIEWED BY: Mendez
Plan Check P'ee:
APN:
BP#:
EVALUATION: $6,814
*PERMIT TYPE: Mechanical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY SFD or Du lex
p
PME Plan Check:
PENTAMATION FURN/AC
PERMIT TYPE: i
USE:
Permit Fee:
suppl. Irrsr) Pee
WOR*
lace ac unit
�re
SCOPE
PME Permit Fee:
APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES
A/C Units (<=10K cfm) 1BREMAIR 1 # $72
�
TOTALS: $72 00
°� ` ��
Mech. Plan Check 0.0 1 hrs $0.00 Plumb. Pkin Check Elec, Plan Check
Mech. Permit Fee: IMPERMIT Plumh, Permit Hee: t lec PermiF Fee:
Other Mech. Insp. 0.0 hrs $48.00 Other Plumb Insp Other E-lec. Imp.
irlech. ling. Fee: Plumb, hash. Fee. Elec. /nap. Fee:
NOTE: This estimate does not includefees due to other Departments (Le. rianntng, rumic irvurx3, rtre,!ounstury ouwct �s�u as y va •svvo
•-/1H/LI/'I 1%O ))Ont JOT Qddlt'l info.
"93tssu, csa... aiswc cw -1 � r. ..............
FEE ITEMS (Tee Resolution 11-053 E . 7/1/13)
... _----------- ----------
FEE
QTY/FEE
MISC ITEMS
Plan Check P'ee:
.4uppl. P(I Pee
PME Plan Check:
$0.00
Permit Fee:
suppl. Irrsr) Pee
PME Unit Fee:
$72.00
PME Permit Fee:
$48.00
Construchon Tax: T
-T-
Administrative Fee: 1ADMIN
$45.00
Work Without Permit? ® Yes (E) No
$0.00
Ildvatneed PICFrmin4y7 Fen's:
i
Travel Documentation Fee: ITRA VDOC
$48.00
Strom Motion Fee: IBSEISMICR
$0.89
Select an Administrative Item
Bldp- Stds Commission Fee: 1BCBSC
$1.00
ag
$214.89
$0.0011- _ - 4.20TL FES
$214.89
Revised: 02/14/2015
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 1 of 7 )
Project Name: 1195 Yorkshire Court
Enforcement Agency: City of Cupertino
Permit Number: 15030160
Dwelling Address: 1195 Yorkshire Court
City: Cupertino
Zip Code: 95014
A. General Information
01
Dwelling Unit Name
1195 Yorkshire Court
02
Climate Zone
4
06
Dwelling Unit Conditioned Floor Area
09
Number of space conditioning (SC)
03
(ft2)
1400
04
systems being altered in this dwelling
1
Installing
SC System
unit.
by this SC
05
Certificate of Compliance Type `.
Prescriptive alterations (CF1R-ALT)
06
Method used to calculate HVAC loads
NotApplicableEquipmentChangeout
07
Calculated dwelling unit Sensible
This field or section is not applicable
08
Calculated Dwelling Unit Heating Load
This field or section is not applicable
system
Cooling Load (Btuh)
new duct
entirely new
(Btu h)
Name
MCH -01b Prescriptive Alterations -Space Conditioning Systems Ducts and'1=ans k
B. Space Conditioning (SC) System Information;; ' �
01
02
03
04"05`
06
07
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
(ft2)
system?
component?
components?
ducts?
system?
SC system?
Alteration Type
Altered space
System 1
Location 1
1400
Yes
Yes
Yes
No
No
No
conditioning
I
stem
Registration Number: 215-A0158274A-M0100002A-0000
Registration Date/Time
2015-06-12 17:11:25
i
V,
411 �11
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-12 17:06:34
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
01
02
03
04
05
06
07
08
09
10
11
12
13
Condenser or Package Unit
System Identification
or Name
Cooling Efficiency
Type
Cooling Efficiency
Value
�This`seg, n does�not apply to this project:
Condenser or
Package Unit
Model Number
Condenser or
Package Unit
Serial Number
System Rated Cooling
Capacity at Design
Conditions (BTUH)
Central Fan
System 1
,t
..
Kenmore
TCA748GK200
N/A
iii:
4
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
Duct
Duct
System
or Name
System Type
Component
Type
Value
System Type
Component
Type
Value
Type
Length
R -Value
Status
This field
No heating
; .. or
This field
Outdoor
System 1
Central gas
componen
section is
or section
Central
condensing
SEER
17
Setback
LTE40Ft
R6
Not a CFI
furnace
t altered
not
'
is not
split AC
unit
system
applicabl
applicable
e
E. Installed Cooling Equipment information:
D. Installed Heating Equipment information •, s
02
03
04 05
06
07
08
Condenser or Package Unit
System Identification
or Name
Cooling Efficiency
Type
Cooling Efficiency
Value
�This`seg, n does�not apply to this project:
Condenser or
Package Unit
Model Number
Condenser or
Package Unit
Serial Number
System Rated Cooling
Capacity at Design
Conditions (BTUH)
Condenser Rated
Nominal Capacity
(ton)
System 1
,t
..
Kenmore
TCA748GK200
N/A
iii:
4
Notes:
E. Installed Cooling Equipment information:
01
02
03
04 05
06
07
08
Condenser or Package Unit
System 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 (BTUH)
Condenser Rated
Nominal Capacity
(ton)
System 1
SEER
17
Kenmore
TCA748GK200
N/A
48000
4
Notes:
Registration Number: 215-A0158274A-M0100002A-0000
Registration Date/Time
2015-06-12 17:11:25
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-12 17:06:34
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.
H. Installed Air Filter Device Information
This section does not apply to this project.
I. Air Filter Device Requirements
Registration Number: 215-A0158274A-M0100002A-0000
This section does not apply to this project
:
4 E
Registration Date/Time
2015-06-12 17:11:25
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-12 17:06:34
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: ea&61&
Caitlin Moore
G ' 1. oot&
Company:
Signature Date: 2015-06-12 17:08:40
DuctTesters, Inc.
Address:
CEA/ HERS Certification Identification (if applicable):
118SElm Ave
City/State/Zip:
Phone:
Ripon CA 95366
209-579-5000
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 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/installer ;:.
3. The constructed or installed features, materials, comporents`or manufactured devices (the installation) identified on this Certificate of Installation
conforms to a'll..applicable codes and,,regulations, and, the installation conforms to -the requirements given on the plans andspecifications approved by
the enforcement agency. .�:
.
4. 5 a
4. 1 understand that`s HERS rater will check the`installation to verify compliance, and that ifrsuchycheckmg identifies defects, I a{m required to take
corrective actidn'at my,expense. I',& understand4that Energy Commsson`and HERS Provider representatives willalsoperformguality assurance checking
of installations, including thosey,approved as part of a.sarpple:grbbp but not[checked by a�HERS!.rater; and if those m`stallatio_ns fail.to meet the
requirements of such quality assurance checking, the required corrective action and additional. checking/testing of other installations in that HERS
sample groupwillbe performed at mjr expense.,N.
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.
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:
Roy Bradshaw
fi. 4wgav
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
Installer
SEARS HOME IMPROVEMENT PRODUCTS INC
Address:
CSLB License:
1024 Florida Central Parkway
721379
City/State/Zip:
Phone:
Date Signed:
LONGWOOD FL 32752
407- 551-6000
2015-06-12 17:11:25
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
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: 215-A0158274A-M2000002A-0000 Registration Date/Time: 2015-06-12 17:11:25 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-06-12 17:07:56
2013 Residential Compliance Schema Version: 0.51SDD
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
MCH2O
MCH21
MCH22
MCH23
MCH25
MCH28
Exemption
from
Minimum
Exemption
R -Value for
AHU Fan
AHU
SC System
SC System
From Duct
Duct
Ducts In
Ducts Located
Efficacy
Airflow
Identification or
Location or Area
Leakage
Leakage
Conditioned
In Cond Space
(W per
Rate (cfm
Refrigerant
Return Duct Design
Name
Served
Requirements
Test
Space
Verification
cfm)
per ton)
Charge
Table 150.0-C or D
System 1
Location 1
No
exemptions
Yes
Not
applicable
No
No
No
No
No
Registration Number: 215-A0158274A-M0100002A-0000
Registration Date/Time
2015-06-12 17:11:25
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-12 17:06:34
t
Registration Date/Time
2015-06-12 17:11:25
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-12 17:06:34
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 served by new heating systems to prevent inadvertent undersizing or oversizing. See sections
03
150.0(h)1 and 2).
Furnace Temperature Rise .Central::forced-air`heating-furnace installations must be configured to operate at or below the furnace manufacturer's maximum
04
inlet -to -outlet temperature 'rise specification. See Se.ction.150:-0(h)4.
05
Standby Losses and Pilot Lights: Farr=type central furnaces may not have�a continuously burning pilotMlight' ,Section 110 , and Section 110.2(d).
"� iw,.x
,,.� � t Y '� N• } r , r�- w`a ( .. �. y d X5;1 q % k .F i ,�
k
Cooling Equipment �r.�.._r..
�...F? 4 ,�,. LJ� }Sir . 1s+:C`✓'^4a�`�
Equipment Efficiency: All cooling equipment must�meet the= mi'nimurn efficiency�"�equirements=of,"Section 110.x1 and Section 1f0.2(a'i)and the Appliance Efficiency
06
Regulations.
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.
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
09
150.0(h)1 and 2.
Air Distribution System Ducts, Plenums and Fans
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
10
required by the prescriptive or performance requirements. See Section 150.0(m)1.
Registration Number: 215-A0158274A-M0100002A-0000
Registration Date/Time:
2015-06-12 17:11:25
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-12 17:06:34
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.
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,
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
11
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).
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 -;on y when the indoor set temperature cannot be met
F. K 4p'� A� �t ` % �ZY� YM nfi. 3ti` r� fft ,yYk [!fi,)
The responsible person signature on this compliance documeynM affirms that all applicable'requirements in�thi§Aable have been met, ei"
Registration Number: 215-A0158274A-M0100002A-0000
> t .>N•u., '' ;R a dw Z< `q + ",%k c { a inx �' *,; ,t 8s '"'�,,(
'_.;
Registration Date/Time: 2015-06-12 17:11:25
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-12 17:06:34
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:
GZd&l
Moore, Caitlin
CROOW
Company:
Signature Date:
DuctTesters, Inc.
2015-06-12 17:08:40
Address:
CEA/ HERS Certification Identification (if applicable):
118SElm Ave
City/State/Zip:
Phone:
Ripon CA 95366
209-579-5000
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 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/installer' , ,.
3. The constructed or installed features, materials, components or manufactured de'vices'(the°installation) identified on'thist ertifi-atewof Installatioril-conforrns to alltapplicable codes and regulations, and the
installation conforms to the requirements iven on the ' ans and s `ecifications a roved,b the enforcements enc . " U
q g p p pp ya Y
r r ,g �.
4. I reviewed a co of the Certificate ofCom. liance, a raved b the enforcement;agency that'identifies thespecific reguirements,forthe scope of$constiuction or mstaliation identified on this Certificate of
copy p Y
SPP k s 4
Installation, and I have ensured thatthe requirements that apply to the construction or installation have been met F '
tl,��� �.-.tri �ii.. +� ��i`Vxivl..�
5. 1 will ensure that a registered copy of this Certificate of Installation shall,be posted, or made available with the building permits) is"sued for,the building, and made available to the enforcement agency for all
yidr' ub a,r,.,aC".:': tl .w' �'x:�MPu h 3� 'M`yn ,ri' �r. �.. �?
applicable inspections. I understand that a registered copy"' this Certificate of installation is required to lie inclu6cl with the documentation the"builder'provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Bradshaw, Roy
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Position With Company (Title):
SEARS HOME IMPROVEMENT PRODUCTS INC
Installer
Address:
CSLB License:
1024 Florida Central Parkway
721379
City/State/Zip:
Phone:
Date Signed:
LONGWOOD FL 32752
407- 551-6000
12015-06-12 17:11:25
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: 215-A0158274A-M0100002A-0000 Registration Date/Time: 2015-06-12 17:11:25 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-12 17:06:34
CERTIFICATE OF INSTALLATION
CI`211-MCH-20-1-1
Duct Leakage Diagnostic Test
(Page 1 of 3 )
Project Name: 1195 Yorkshire Court
Enforcement Agency:
Cupertino
City of
Permit Number: 15030160
Dwelling Address: 1195 Yorkshire Court
city:
Cupertino
Zip Code: 95014
A. System Information
01
Space Conditioning System Identification or Name
System I
02
Space Conditioning System Location or Area Served
Location 1
03
Building Type from CF -113
Single family
134
Verified Low Leakage Ducts in Conditioned Space
(VLLDCS) Credit from CF1.R?
No, credit is not taken
05
Verified Low Leakagp.Air'Handling Unit (VLLAHU) Credit
from CF1R?
No, credit is not taken
06
Duct System'CoMpliance Category
Alteration using smoke test
P7
MCH-20eSealing All Accessible bW-Leaks using STi
3
B. Duct Leakage Diagnostic Test
01
Condenser Nominal Cooling Capacity (ton)
4
02
Heating Capacity (kBtu/h)
0
03
Conditioned Floor Area served by this HVAC system (ft2)
1400
04
Duct Leakage Test Condition
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)
240
10
Actual duct leakage rate from leakage test measurement
(cfm)
540
11
Compliance Statement: System passes using smoke test of an altered HVAC system in an existing building. No visible smoke
exits the accessible portions of the duct system. Smoke is only emanating from air -handling unit (AHU) cabinet and non
accessible portions of the duct system. Note - Accessible is defined as having access thereto, but which first may require
Registration Number: 215-A0158274A-M2000002A-0000 Registration Date/Time: 2015-06-12 17:11:25 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-06-12 17:07:56
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
B. Duct Leakage Diagnostic Test
removal or opening of access panels, doors, or moving similar obstructions. If access to the ducts requires an object to be
demolished or deconstructed then sealing of those ducts is not required
C. Additional Requirements for Compliance
01
System was tested in its normal operation condition. No temporary taping allowed.
Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage
testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet
02
ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct
leakage testing.
03
All supply and return register boots were sealed to the drywall.
04
Building cavities were;`notlused as plenums or platform returns in lieu of ducts.
05
If cloth backedJaDe.*as 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.
:...
? sy—
If the system complies. using the Smoke Test method, th°esmoke test�was conducted in accordance with the req'uirements of
07
Reference Residential Appendix RA3 14,:3 6 Systems that"'comply using smoke test hall.-not,be included m sample.groups
for HERS verification compliance Y
rc
r
The responsible persons signature on this compliance document affirms that all app4licable requirements in this table have
been met.
Registration Number: 215-A0158274A-M2000002A-0000 Registration Date/Time: 2015-06-12 17:11:25 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-06-12 17:07:56
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: e;C&(M
Moore, Caitlin
0400W 1.
Company:
Signature Date:
DuctTesters, Inc.
2015-06-12 16:00:21
Address:
CEA/ HERS Certification Identification (if applicable):
118SElm Ave
City/State/Zip:
Phone:
Ripon CA 95366
209-579-5000
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.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 CaliforniaCode of Regulations t;
4. The building design features or system design features identified onrthis Certificat66f Compliance arefconsistentwitWihe information provided on other applicable'compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for4ap'pprov6IWtl this building permit application:`12 4 '°
5. 1 will ensure that a registered copy ofahis Certificate of Compliance shall be made available with the building pe'rmit(s),,issued for therbdilding, and ►rade available tq=;thesenforcement agency for all applicable
inspections. I understand that a registered copy of this°Cert ficate of Compli�ance�,is required to b,e,_included with thsgcumentation. they builder provides to:Athe building owner at occupancy.
Responsible Designer Name: " r�
Responsible Designer Signature.. r
Bradshaw, Roy
Company:
Date Signed:
SEARS HOME IMPROVEMENT PRODUCTS INC
2015-06-12 16:04:50
Address:
License:
1024 Florida Central Parkway
721379
City/State/Zip:
Phone:
LONGWOOD FL 32752
407- 551-6000
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: 215-A0158274A-000000000-0000 Registration Date/Time: 2015-06-12 16:04:50 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-12 16:00:27
Schema Version: 0.555SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3 )
Project Name: 1195 Yorkshire Court Enforcement Agency: City of Permit Number: 15030160
Cupertino
Dwelling Address: 1195 Yorkshire Court City: Cupertino Zip Code: 95014
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
05
Verified Low Leakage Ducts in Conditioned Space
No; credit is not taken
04
(VLLDCS) Credit from CF1R?
0.15
07
Verified Low Leakage Air Handling Unit (VLLAHU) Credit
No, credit is not taken
05
from CF1R?
This field or section is not applicable
06
Duct System Compliance Category
Alteration using smoke test
MCH -20e -Sealing All Accessible=Leaks using Smoke}Test's
q UY a'�1
.. 'cT..'S'"� F i�3. � ":k _.. # �4.. ih. � `m'.. �_� ♦^_, .,,. _ s �. .�. %k.s 1 . i..,�'�*� �>f� .. �. - .... F
�.v � r rvr;
�) ( S 'mak 's' Y ^k �e ' t: f*= 5.. Y
frr ;L
- n
B. Duct Leakage Diagnostic Test "�
01 Condenser Nominal Cooling Capacity (ton) 4
02
Heating Capacity (kBtu/h)
0
03
Conditioned Floor Area served by this HVAC system (ft2)
1400
04
Duct Leakage Test Condition
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)
240
10
Actual duct leakage rate from leakage test measurement
(cfm)
540
11
Compliance Statement: System passes using smoke test of an altered HVAC system in an existing building. No visible smoke
exits the accessible portions of the duct system. Smoke is only emanating from air -handling unit (AHU) cabinet and non
accessible portions of the duct system. Note - Accessible is defined as having access thereto, but which first may require
Registration Number: 215-A0158274A-M2000002A-M20A Registration Date/Time: 2015-06-15 14:22:47 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-06-12 17:09:45
2013 Residential Compliance Schema Version: 0.551SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
B. Duct Leakage Diagnostic Test
01
removal or opening of access panels, doors, or moving similar obstructions. If access to the ducts requires an object to be
demolished or deconstructed then sealing of those ducts is not required
12
Notes:
C. Additional Requirements for Compliance
01
System was tested in its normal operation condition. No temporary taping allowed.
Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage
testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet
02
ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct
leakage testing.
03
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
� ,� r o � � .
All connection points between the air Handler and the supply andreturn plenums are completely sealed -{ j°
If the system complies usingthe Smoke Test'method, the smoke test was "conducted in accordance with the requirements
07
of Reference -Residential Appendix RA3 14 3Q 6 S, temps thaVcom ply using smoke test shall,d'ot be included in sample
groups for HERS verification compliance. x
08
Verification Status:
Pass - all applicable requirements are met
09
Correction Notes for this table:
The responsible persons 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 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: 215-A0158274A-M2000002A-M20A Registration Date/Time: 2015-06-15 14:22:47 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-06-12 17:09:45
2013 Residential Compliance Schema Version: 0.551SDD
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:
Caitlin Moore
O&ffobC4rsow-/
Company:
Date Signed:
DuctTesters, Inc.
2015-06-12 17:10:01
Address:
CEA/ HERS Certification Identification (if applicable):
118SElm Ave
City/State/Zip:
Phone:
Ripon CA 95366
209-579-5000
Responsible Person's Declaration statement
I certify the following under penalty. perjury, under the laws of the State of California:
1. The information provide -don 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 onthe Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections ofthe Certificate(s) .Of InstaIiation (CF2R)*signed'and'submitted'by the person(s) responsible for the
construction or installation conforms to the requirements specifiedjo,n the Certificate(s)�of Compliance (CF1R) approved by fhe�enforcement''agency.
5. I will ensure that.a registered copy�rof this Certificate of Verification�shall be posted, or made available with the building permits) issued for the
building, and made,available°.to the.;enforcement agency for all applicablerinspections I understand that a registered,.copy o' s,Certificate of.; i
Verification is:i equired to i included with the documentation the buwltler`provides to the building owner at'occupancy.
Verification
.. S.�.a. S t� z� ;r.'
Builder Or Installer Information As Shown On"Th4tertificateiOf Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
SEARS HOME IMPROVEMENT PRODUCTS INC
Responsible Builder or Installer Name:
CSLB License:
Roy Bradshaw
721379
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:
DuctTesters, Inc.
Responsible Rater Name:
Responsible Rater Signature:
Tony Souza
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2006052
2015-06-15 14:22:47
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: 215-A0158274A-M2000002A-M20A Registration Date/Time: 2015-06-15 14:22:47 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2015-06-12 17:09:45
2013 Residential Compliance Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE
CF1R-ALT 02-E
I Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 1 of 3 ) I
Project Name:
1195 Yorkshire Court I Date Prepared:
2015-06-12
A. General Information
CF111-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
1195 Yorkshire Court
02
Date Prepared
2015-06-12
03
Project Location
1195 Yorkshire Court
04
Building Type
Single family
05
CA City
Cupertino
06
Dwelling Unit Name
1195 Yorkshire Court
07
Zip Code
95014
08
Dwelling Unit Conditioned
1400
. 4.-.t*: r� _ k:a: i+.t�
"
:.; ��:='' �
3 n ,0'd;
�x-., `��„
Floor Area (ft2)
SC System
SC System
CFA served
.
4syystem a?
refrige'rarit
Number of space conditioning
T )...
09
Climate Zone
4
10
(SC) systems in this dwelling
1
ducted
c
containing
system
more than 46
unit.
entirely new
.�tk
�
B. Space Conditioning (SC) System Information $
01
02
03
04E�
06
07 `
08
09
10
...'�;
the SC
aY•n�m `"✓:a
Installing a
. 4.-.t*: r� _ k:a: i+.t�
"
:.; ��:='' �
3 n ,0'd;
�x-., `��„
SC System
SC System
CFA served
.
4syystem a?
refrige'rarit
3hlnstalling"new�SCInstalling
T )...
',Installing,,
:`1,
Identification or
Location or Area
by this SC
ducted
c
containing
system
more than 46
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
Altered space
System 1
Location 1
1400
Yes
Yes
Yes
No
No
No
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: 215-A0158274A-000000000-0000
Registration Date/Time:
2015-06-12 16:04:50
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-12 16:00:27
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF111-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)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
Central gas
No heating
This field or
This field or
Central split
Outdoor
Less than or
System 1
furnace
component
section is not
section is not
AC
condensing
SEER
17
Setback
equal to 40
R-6
altered
applicable
applicable
unit
feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans_:
-Duct insulation requirement for new plenums: R6.
CF211-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testingxeq fired 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 510% leakage to outside, dr seal all accessible leaks.
C172R-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 >t..300 CFM/ton required when MCW25 is required.
Exceptions: < ,f
1i f
-Duct systems registered with HERS provider as previously sealed are -,exempt from,MCH 20 Duct Leakage=Testing repquirements
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCHC 23; nor Refrigerant Charge MECH 25
-Existing duct systems constructed insulated or sealed with asbestos are exempt from M(iH'�20 Dui*dakage Testing requirements. r
k i
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diilond�150.2(b)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 215-A0158274A-000000000-0000
Registration Date/Time
2015-06-12 16:04:50
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-12 16:00:27
Schema Version: 0.5S5SDD
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC -CFIR- ALT -03 -E (Revised 06114) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R- ALT -03 -E
Alterations - HVAC CZ 1, 3 to 7 and 16 (formerly CF-1R-ALT-HVAC) (Page 1 of 1)
Site Address:
Enforcement Agency:
Date Prepared:
Permit #:
161 5 fiml e I q. (I T
Equipment Type
Equipment Efficiency
New: Ducting, Plenums, Lineset
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
13 Packaged System
❑ Coil
AFUE
COP
R 6 (Q 1,3 -7) Ducts
Served by system
Setback
QSplit System
�Evaporator
C3Condensing Unit
SEER
❑ R -S' (CZ 16) Ducts
J 00 sq ft
(if not already
HSPF
❑ R -6 (all CZ's) Plenums
present must
❑ Furnace
❑ Lineset
EER
❑ R -5 or R7.5 Lineset'
be installed)
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
❑ 1. HVAC Changeout /Repair
Required Compliance Documents to be left on site for Final:
Can include new ducting
All Equipment,
CFI11- ALT -02 -E
Condenser Unit, Evaporator Coil,
CF2R: MECH -01, MECH -20 -HERS
Air Handler /Furnace
CF3R: MECH -20 -HERS
Installer Requirement: Duct leakage (<.15% or, < 10% to outside, or seal all accessible leaks)
Exempted from dud leakage testing if:
❑ 1. Dud system registered with HERS provider as previously sealed, or 112. There is less than 40 linear feet of dud in unconditioned
space, or ❑ 3. Existing dud systems are constructed, insulated or sealed with asbestos (list manufacture date of building
❑ 2. New HVAC System
Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts'
CFIR- ALT -02 -E
CF2R- MECH -01, MECH -20 -HERS, MECH -22 -HERS, MECH -(23 or 24) -HERS
CF3R- MECH -20 -HERS, MECH -22 -HERS, MECH -(23 or 24) -HERS2
Installer Requirement: Duct leakage < 6 %, Fan Efficacy (.58W /CFM), Air Flow >_ 350 CFM /ton (or Standards Table 150.0 -C / D alternative)
❑ 3. All New Duds with Replacement
Required Compliance Documents to be left on site for Final:
Includes replacing or installing All New
CFIR- ALT -02 -E
Ductsz and one or more of the following:
CF2R- MECH -01, MECH -20 -HERS, MECH -(23 or 24) -HERS
Condenser Unit, Evaporator Coil, Furnace
CF3R- MECH -20 -HERS, MECH -(23 or 24) -HERS
Installer Requirement: Duct leakage < 6 %, Air Flow_ 350 CFM /ton (or Standards Table 150.0 -C / D alternative)
❑ Exempted from duct leakage testing I existing duct systems are constructed, insulated or sealed with asbestos.
❑ 4. New Ducting over 40 feet
Required Compliance Documents to be left on site for Final:
Adding or replacing ducts in unconditioned
CFIR- ALT -02 -E
space but less than All New Ducts2
CF2R: MECH -20 -HERS
CF3R: MECH -20 -HERS
Installer Required to: Duct leakage (: 15% or, < 10% to outside, or seal all accessible leaks)
❑ Exempted from duct leakage testing I existing duct systems are constructed, insulated or sealed with asbestos.
' All new ducting R -8 required when more than 40 ft installed and R -6 when less than 40 ft installed. This includes in walls, between floors etc.
: A New Duct system is when the duct system is constructed of at least 75 percent new duct material, and up to 25 percent may consist of reused
parts from the dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, plenums, duct material.
a R -5 (1" thick insulation) for linesets 1" and less. R -7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5- 2T -2 % ", 2.5-3T-2%", 3.5 to 4T -2% ", 5T -4%"
Contractor (Documentation Author's /Responsible Designer'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 California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR).
4. 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 CCR.
S. The building design features or system design features identified onthis 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 applicatio
Responsible Designer Name:
Responsible Des! ature:
Date Signed:
License:
€ c- P 1 1z
'-
3 S
4q -Is-3
Company:
Address:
City /State/Zip:
Phone:
°
ERs ST /0
GlJod. LaNS UT
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