HomeMy WebLinkAbout114 WINDVANE LN; ; CBR2016-0065; PermitPrint Date: 12/21/2016
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
#Dwelling Units:
Bedrooms:
Project Title:
Description:
Applicant:
114 Windvane Ln
BLDG-Residential
2145901308
$0.00
BURT: REPLACE 1 AC LIKE FOR LIKE
Owner:
' City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Residential Permit Permit No: CBR2016-0065
www.carlsbadca.gov
Work Class: P/M/E Status: Issued -Active
Lot#: Applied: 11/10/2016
Reference#: Issued: 12/02/2016
Construction Type: Finaled:
Bathrooms: Inspector: JWest
Orig. Plan Check #:
Plan Check#:
Contractor:
OAK ISLAND HEATING & A/C INC
TOM WOOD
COOWNER HAWKES PATRICK&DIANE
114 Windvane St
OAK ISLAND HEATING & A/C INC
1250 Pacific Oaks PI, #103
ESCONDIDO, CA 92029
760-839-8383
PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT
Total Fees: $166.00
CARLBAD, CA 92011
Total Payments To Date: $166.00
1250 Pacific Oaks PI, 103
Escondido, CA 92029-2908
760-839-8383
Balance Due:
Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter
collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these
fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the
protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section
3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their
imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection
fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this
project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the
statute of limitation has previously otherwise expired.
FINAL APPROVAL
DATE I zer)! /_.CLEARANCE ___ _
SIGNATURE ___ ~5:1 ____ _
$166.00
$0.00
,,,,,,, ____ ~---·----·-·-·---·--·----------------·
THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0PLANNING 0 ENGINEERING 0BUILDING OFIRE 0HEALTH 0 HAZMATIAPCD
«~~' Building Permit Application Plan Check No. G'\L~~t6-oa~
1635 Faraday Ave., Carlsbad, CA 92008 Est. Value ~ CITY OF Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit CARLSBAD email: building@carlsbadca.gov
www.carlsbadca.gov Date ({l('c l I~ lswPPP
JOB ADDRESS SUITEf/SPACEf/UNIT, rPN 114 WINDVANE LANE ---
CT/PROJECT # I LOT# I PHASE# I # OF UNITS I # BEDROOMS #BATHROOMS I TENANT BUSINESS NAME I CONSTR. lYPE I occ. GROUP
DESCRIPT10N OF WORK: Include Square Feet of Affected Area(s)
REMOVE AND REPLACE 1 AIC UNIT, LIKE FOR LIKE
EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE I AIR CONDITIONING I FIRE SPRINKLERS
YESQ No(:] YESE:)Noc:J YESE:)Noc:J
APPLICANT NAME TOM WOOD PROPERTY OWNER NAME GWEN BURT Prtnarv Contact
ADDRESS ADDRESS 1250 PACIFIC OAKS PL. #103 114 WINDVANE LANE
CITY STATE ZIP CITY STATE ZIP ESCONDIDO CA 92029 CARLSBAD CA 92011
PHONE (AX PHONE JFAX 760 839-8383 760 839-8380 559-280-0720
EMAIL EMAIL
INFO@OAKISLANDAC.COM
D~GNPRO~ONAL CONTRACTOR BUS. NAME OAK ISLAND HEATING AND AIR
ADDRESS ADDRESS 1250 PACIFIC OAKS PL #103
CITY STATE ZJP CITY STATE ZIP ESCONDIDO CA 92029
PHONE PHONE I FAX 760 839-8383 I FAX 760 839-8380
EMAIL EMAIL
INFO@OAKISLANDAC.COM
'STATE LIC. # STATE LIC.# rLASSC-20 I CITY BUS. uc.121271 0 745400
' . (Sec, 7031.5 Bus1ness and Prof~1ons Code: Any C1ty or County wh1ch requ1res a penmt to c~nstruct, alter, Improve, <!emol1sh or repa1r any structure, prtor t~ 1ts 1ssuance, also re<l~1res the applicant for such permit to file a s1eJled statement that he 1s licensed pursuant to the [)roviSIOns of the Contractor's L1cense Law !Chapter 9, commendmg w1th Section 7000 of DIVISIOn 3 of the Business and Professions Code} or that he is exemP.t therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than fiVe hundred dollars {$500)).
WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the wotk for which this permit is issued. 0 I have and will maintain workers' compensation, as reQuired by Section 3700 of the Labor Code, for the performance of the work for which this perm~ is issued. My wotkers' compensation insurance carrier and policy
number are: Insurance eo. EVEREST NATIONAL INSURANCE Policy No. 7600000635141 Expiration Date 01/0112017
~section need not be completed W the perm~ is for one hundred dolars ($1 00) or less. U Certificate of Exemption: I certify that in the performance of the work for which this perm~ is issued, I shaH not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
Calffomia. WARNING: Failure to secure workers' compensation coverage is and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in
addition to the cost of compensation, damages as for in 3706 of the interest and attorney's fees.
g CONTRACTOR SIGNATURE
I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: 0 I, as owner of the property or my employees with wages as their sole compensation, will do the wotk and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's
License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of completion, the owner-builder wil have the burden of proving that he did not build or improve for the purpose of sale).
D
0
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contracto~s license Law does not apply to an owner of
property who builds or improves thereon, and contracts for such projects with contractor(s)licensed pursuant to the Contractor's license Law).
I am exempt under Section Business and Professions Code for this reason:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement DYes 0No
2. I (have I have not) signed an application for a building permK for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction Onclude name address I phone I contractors' license number):
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name 1 address 1 phone 1 contractors' license number):
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the wotk indicated Onclude name I address I phone I type of work):
g PROPERTY OWNER SIGNATURE 0AGENT DATE
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY
Is lhe applicant or future building occupent required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of lhe
Presley-Tanner Hazardous Substance Account Act? Cl Yes Cl No
Is lhe applicant or future building occupent required to obtain a permit from lhe air poUution control district or air quality management district? Cl Yes Cl No
Is lhe facility to be constructed within 1,000 feet of the outer boundary of a school site? Cl Yes Cl No
IF ANY OF THE ANSWERS ARE YES, A ANAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPUCANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF
EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
I cerlllythatl have read the application and slate that the above information is COIIIlCtand that the information on the plans is acx:urate.l agree to complyMth an C11J Oldlnancesand S1a1e laws R!lallngto building construction.
I hereby authorize representative of the City of carlsbad to enter upon the above mentioned IJOper\y tJr inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST All UABIUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA penn~ is required i:>r excavations over 5'0' deep and demolition or construction of structures over 3 stories in height
EXPIRATION: Every penn~ issued by lhe Ek!ilding Oflicial under the provisions of lhis Code shal expi'e by lin italian and become nul and voKI if the buildilg or 1\011< aulhorized by such ~ is not CXlfllmenoed Wlhi1
180 days from the date of such permit or if the building or 'NJrk authorized by
1
such perm~ rspended or abandoned at any time after the 1\011< is commenced tJr a period of 180 days (Section 106.4.4 Unm Eklildi1g Code) .
.8$ APPUCANT'S SIGNATURE ~ (J..ruucJ\ DATE f/ .(} b
PERMIT INSPECTION HISTORY REPORT (CBR2016-0065)
BLDG-Residential 11/10/2016Application Date:Permit Type:Owner:COOWNER HAWKES
PATRICK&DIANE
Subdivision:P/M/E 12/02/2016Work Class:Issue Date:
114 Windvane Ln
Carlsbad, CA 92011
Address:Issued - Active 05/31/2017Expiration Date:Status:
IVR Number: 183
Scheduled
Date Inspection Type Inspection No.Inspection Status Primary Inspector Reinspection CompleteActual
Start Date
12/05/2016 12/05/2016 BLDG-43 Air
Cond./Furnace Set
004145-2016 Passed Jonathan West Complete
BLDG-Final
Inspection
004144-2016 Passed Jonathan West Complete
COMMENTS PassedChecklist Item
BLDG-Mechanical Final Yes
BLDG-Electrical Final Yes
December 22, 2016 Page 1 of 1
~
CERTIFICATE OF COMPLIANCE CFlR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-1R-ALT-HVAC) (Page 1 of3)
Project Name: BURT RESIDENCE Date Prepared: 2016-11-10
A. General Information
CFlR-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one CFlR-ALT-02 document for each dwelling unit.
01 Project Name BURT RESIDENCE 02 Date Prepared 2016-11-10
03 Project Location 114 WINDVANE LANE 04 Building Type Single family
OS CAClty Carlsbad 06 Dwelling Unit Name BURT RESIDENCE
07 Zip Code 92011 08 Dwelling Unit Conditioned 2142 Floor Area (ft2)
Number of space conditioning
09 Climate Zone 7 10 (SC) systems in this dwelling 1
unit.
B. Space Conditioning (SC) System Information
01 02 03 04 OS 06 07 08 09 10
Is these Installing a
SCSystem SCSystem CFAserved $\'Stem a refrigetartt lnstalli.,.g new sc Installing Installing Installing
Identification or Location or Area bythisSC ducted containing system more than 40 entirely new entirely new
Name Served System (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type
System 1 Location 1 2142 Yes Yes Yes No No No Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
Registration Number: 216-A0419126A-000000000-0000
CA Building Energy Efficiency Standards -2013 Residential Compliance
This section does not apply to this project.
Registration Date/Time: 2016-11-10 09:38:39
Report Version: 2013 Rev 1.008
Schema Version: 0.555SDD
HERS Provider: CaiCERTS
Report Generated: 2016-11-10 09:39:05
CERTIFICATE OF COMPLIANCE CFlR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-lR-ALT-HVAC} (Page 2 of 3)
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01 02 03 04 OS 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 Centra I split Outdoor Less than or
System 1 component section is not section is not condensing SEER 14 Setback equal to40 R-6 furnace altered applicable applicable AC unit feet
Regyi!J:~ QO!;Ym!l!lt~tiQn:
CF2R-MCH-01-E-Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-2Q-H & CF3R-MCH-20-H-Duct Leakage testing required when heating or cooling components are installed inducted systems, or when more than 40ft of duct length is replaced.
-Leakage rate compliance: s 15%, or s 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow~ 300 CFM/ton required when MCH-25 is required.
E!l&lll!liQn~:
-Duct systems registered with HERS provider as previously sealed are exempt from I\4CH-20 Duct Le!lkage Testing requirements.
-Heating-only systems and Air Handler/Furnace changes do not require verificatiQI'I of Air Flow MCH•23,or ~efrigetant ChaiJe MECH-2S.
-Existing duct systems constructed, insulated or sealed with asbestos ,are exempt from MCH~20 Duct L~kage Testi11Jrequi~rmlf)ts.
E. Entirely New or Complete Replacement Dudt5¥Jtem, with or withoutfquipment Changeout (Sections 1S0.2(b)1Diia and 150.2(b)lE, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
Registration Number: 216-A0419126A-000000000-0000
CA Building Energy Efficiency Standards -2013 Residential Compliance
This section does not apply to this project.
Registration Date/Time: 2016-11-10 09:38:39
Report Version: 2013 Rev 1.008
Schema Version: 0.555SDD
HERS Provider: CaiCERTS
Report Generated: 2016-11-10 09:39:05
#
CERTIFICATE OF COMPLIANCE CFlR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-lR-ALT-HVAC) (Page 3 of 3)
Documentation Author's Declaration Statement
1. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: ~r~ Young, Les
Company: Signature Date:
OAK ISLAND HEATING AND AIR CONDITIONING INC 2016-11-10 09:38:39
Address: CEN HERS Certification Identification (if applicable):
1250 PACIFIC OAKS PL # 103
City/State/Zip: Phone:
ESCONDIDO CA 92029 760-839-8383
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. I am eligible under Division 3 of the Business and Professions 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 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.
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
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: Responsible Designer Signature: ~r~ Young, les
Company: Date Signed:
OAK ISLAND HEATING AND AIR CONDITIONING INC 2016-11-10 09:38:39
Address: License:
1250 PACIFIC OAKS PL # 103 745400
City/State/Zip: Phone:
ESCONDIDO CA 92029 760-839-8383
Digitally signed by CaiCERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-A0419126A-OOOOOOOOO-OOOO
CA Building Energy Efficiency Standards -2013 Residential Compliance
Registration Date/Time: 2016-11-10 09:38:39
Report Version: 2013 Rev 1.008
Schema Version: O.SSSSDD
HERS Provider: CaiCERTS
Report Generated: 2016-11-10 09:39:05
CERTIFICATE OF COMPLIANCE CflR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-1R-ALT-HVAC) (Page 1 of3)
Project Name: BURT RESIDENCE I Date Prepared: 2016-11-10
A. General Information
CFlR-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one CFlR-ALT-02 document for each dwelling unit.
01 Project Name BURT RESIDENCE 02 Date Prepared 2016-11-10
03 Project Location 114 WINDVANE LANE 04 Building Type Single family
OS CACity Carlsbad 06 Dwelling Unit Name BURT RESIDENCE
07 Zip Code 92011 08 Dwelling Unit Conditioned 2142 Floor Area (ft2)
Number of space conditioning
09 Climate Zone 7 10 (SC) systems in this dwelling 1
unit.
B. Space Conditioning (SC} System Information
·' .:·· '' '
01 02 03 1': 04' .. ' · ·os 06 ' 07 08 09 10
,· Is the SC lnstallii-1g a : ···<
SCSystem SCSystem CFAserved system a refrigerant Installing new SC lnstaHing Installing Installing
Identification or Location or Area by this SC ducted containing system morethan40 entirely new entirely new
Name Served System (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type
System 1 Location 1 2142 Yes Yes Yes No No No Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
Registration Number: 216-A0419126A-OOOOOOOOO-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
This section does not apply to this project.
Registration Date/Time: 2016-11-10 09:38:39
Report Version: 2013 Rev 1.008
Schema Version: 0.555SDD
HERS Provider: CaiCERTS
Report Generated: 2016-11-10 09:39:05
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-1R-ALT-HVAC) (Page 2 of3)
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01 02 03 04 OS 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 14 Setback equal to 40 R-6
altered applicable applicable unit feet
R~:gyir!:d Do~;ymenta!ign:
CF2R-MCH-01-E -Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20-H & CF3R-MCH-20-H-Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40ft of duct length is replaced.
-Leakage rate compliance: s 15%, or s 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow~ 300 CFM/ton required when MCH-25 is required.
Ex~;~:gtjoc~·
-Duct systems registered with HERS provider as previously sealed are exempt from MCI:I-20 Duct L~age T~~g rj.1QlJJJ;(!me.Q~· . . . ·· .. · .
-Heating-only systems and Air Handler/Furnace changes do not require verificatiOh of Air Flow. MC~23.:M'Ref~igerani: Chaie 'M~H~25!
_'''::_ 2 -Existing duct systems constructed, insulated or sealed with asbesto.s are exempt from MCH~20Duct Leakage Testlfts.lequirt!metrts. ·
7: · .. ' . '.
E. Entirely New or Complete Replacement Ducts;.tem, with or without Equipment Changeout (Sections 150.2(b)1Diia and 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)
Registration Number: 216-A0419126A-OOOOOOOOO-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
This section does not apply to this project.
Registration Date/Time: 2016-11-10 09:38:39
Report Version: 2013 Rev 1.008
Schema Version: 0.555SOO
HERS Provider: CaiCERTS
Report Generated: 2016-11-10 09:39:05
CERTIFICATE OF COMPLIANCE CFlR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-lR-ALT-HVAC) (Page 3 of 3)
Documentation Author's Declaration Statement
1. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: ~r~ Young I Les
Company: Signature Date:
OAK ISLAND HEATING AND AIR CONDITIONING INC 2016-11-10 09:38:39
Address: CEA/ HERS Certification Identification (if applicable):
1250 PACIFIC OAKS PL # 103
City/State/Zip: Phone:
ESCONDIDO CA 92029 760-839-8383
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. I am eligible under Division 3 of the Business and Professions 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 ~esign 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 ~illations. , ' , ' , ,·· ·· . . f . ,.· . ..
4. The building design features or system design features identified onihis Certificate•of Comp!iance areCcmsiste'".wiutthe information provided ori:othtra'Pf!icabfecompliance documents, worksheets,
calculations, plans and specifications submitted to the etJtorcement jlgency for approval with this buildlng perf1'1lt applicatioi't. . • : '';
5. I will ensure that a registered copy of this Certificat6,qf Compliance shall be made available With the bUilding permit(s} issutid for the bliildirig, and made avaJlabii! to the enforcement agency for all applicable
inspections. I understand that a registered copy of thiseeitlficate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy .
Responsible Designer Name: . Responsible Designer Signature: ~r~ Young I Les
Company: Date Signed:
OAK ISLAND HEATING AND AIR CONDITIONING INC 2016-11-10 09:38:39
Address: license:
1250 PACIFIC OAKS PL # 103 745400
City/State/Zip: Phone:
ESCONDIDO CA 92029 760-839-8383
Digitally signed by Ca/CERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-A0419126A-OOOOOOOOO-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
Registration Date/Time: 2016-11-10 09:38:39
Report Version: 2013 Rev 1.008
Schema Version: 0.555SDD
HERS Provider: CaiCERTS
Report Generated: 2016-11-10 09:39:05
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 1 of7)
Project Name: BURT RESIDENCE Enforcement Agency: City of Carlsbad Permit Number: on site
Dwelling Address: 114 WINDVANE LANE City: Carlsbad Zip Code: 92011
--------------------------
A. General Information
01 Dwelling Unit Name BURT RESIDENCE 02 Climate Zone 7
03 Dwelling Unit Total Conditioned Floor 2142 04 Number of Space Conditioning 1
Area (ft2) Systems in this Dwelling Unit.
05 Certificate of Compliance Type Prescriptive alterations (CFlR-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 Cooling Load (Btuh) (Btu h)
09 Dwelling Unit Number of Bedrooms 3
.::'---( .-.. · •: ; "l} { -~
MCH-Olb Space Conditioning Systems Ducts ancflans -PrescriptiveiAtteritions ~-'s _, i '''" J! ···-t · .. _ <~ -~_--.. , ·_-L -.,,,., ·. ,; -..
--,i~L_
-:: B. Space Conditioning {SC) System Information .
01 02 03 04
SCSystem SCSystem CFA served Is the SC
Identification or Location or Area bythisSC system a
Name Served System (ft2)
ducted
system?
System 1 Location 1 2142 Yes
Registration Number: 216-A0419126A-M0100002A-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
(
:
OS 06 07
Installing a Installing new SC Installing more refrigerant system than 40 feet of containing components? ducts? component?
Yes Yes No
------------------
Registration Date/Time: 2016-11-2810:11:51
Report Version: 2013 Rev 1.008
Schema Version: 2013.1.008
.
08 09 10
Installing Installing
entirely new entirely new SC Alteration Type
duct system? system?
Altered space
No No conditioning
system
HERS Provider: CaiCERTS
Report Generated: 2016-11-28 10:11:14
I J
I
!
!
I
CERTIFICATE OF INSTALLATION
Space Conditioning Systems, Ducts, and Fans
C. Space Conditioning (SC) System Alterations Compliance Information
01 02 03 04 OS 06 07 08 09
Heating Cooling
System Altered Heating Minimum Altered Cooling Minimum
Identification Heating Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency
or Name System Type Component Type Value System Type Components Type Value
This field
No heating or This field All new Central gas section is or section Central System 1 furnace componen not is not split AC cooling SEER 14
t altered applicabl applicable components
e
--------------·-----
D. Installed Heating Equipment Information
This section doe~ not apPly to tf\is ~rojed.
,'
E. Installed Cooling Equipment information
01 02 03
System Identification Cooling Efficiency Cooling Efficiency
or Name Type Value
System 1 SEER 14
Notes:
Registration Number: 216-A0419126A-M0100002A-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
' ' '
04 OS 06
Condenser or Package Unit
Condenser or Condenser or Condenser or
Package Unit Package Unit Package Unit
Manufacturer Model Number Serial Number
Heil nh4a448aka10 x163186652 0
----
Registration Date/Time: 2016-11-2810:11:51
Report Version: 2013 Rev 1.008
Schema Version: 2013.1.008
CF2R-MCH-01-E
(Page 2 of 7)
10 11 12 13
Central Fan
Integrated
New or (CFI)
Required Replaced New Ventilation
Thermostat Duct Duct System
Type Length R-Value Status
Not a CFI Setback LTE40Ft R6 system
-
07 08
System Rated Cooling Condenser Rated
capacity at Design Nominal Capacity
Conditions (BTUH) (ton)
48000 4
HERS Provider: CaiCERTS
Report Generated: 2016-11-28 10:11:14
CERTIFICATE OF INSTALLATION
Space Conditioning Systems, Ducts, and Fans
F. Extension of Existing Duct System, Greater Than 40 Feet
G. Installed Duct System information
H. Installed Air Filter Device Information
I. Air Filter Device Requirements
Registration Number: 216-A0419126A-M0100002A-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
This section does not apply to this project.
This section does not apply to this project.
This section does not apply to this project.
This section does not apply to this project.
Registration Date/Time: 2016-11-2810:11:51
Report Version: 2013 Rev 1.008
Schema Version: 2013.1.008
CF2R-MCH-01-E
(Page 3 of7)
HERS Provider: CaiCERTS
Report Generated: 2016-11-28 10:11:14
CERTIFICATE OF INSTALLATION
Space Conditioning Systems, Ducts, and Fans
J. HERS Verification Requirements
01 02 03 04
MCH20
Exemption
System SCSystem From Duct Duct
Identification or Location or Area Leakage Leakage
Name Served Requirements Test
System 1 Location 1 No Yes exemptions
Notes:
-
Registration Number: 216-A0419126A-M0100002A-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
OS 06 07
MCH21 MCH22
Exemption
from
Minimum
R-Valuefor
Ducts In Ducts Located AHU Fan
Conditioned In Cond Space Efficacy
Space Verification (W/dm)
No No No Exemption
------
Registration Date/Time: 2016-11-28 10:11:51
Report Version: 2013 Rev 1.008
Schema Version: 2013.1.008
CF2R-MCH-01-E
(Page 4 of 7)
08 09 10
MCH23 MCH25 MCH28
AHU
Airflow
Rate Refrigerant Return Duct Design
(dm/ton) Charge Table 150.0-C or D
No No No
-------------
HERS Provider: CaiCERTS
Report Generated: 2016-11-28 10:11:14
CERTIFICATE OF INSTALLATION CFZR-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 5 of7)
K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section lSO.O that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the
system that are altered. Existing equipment may be exempt from these requirements.
Heating Equipment
01 Equipment Efficiency: All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency
Regulations.
02 Controls: All unitary heating systems, including heat pumps, must be controlled by a setback thermostat. These thermostats must be capable of allowing the occupant
to program the temperature set points for at least four different periods in 24 hours. See Sections 1SO.O(i), 110.2(b).
03 Sizing: Heating load calculations must be done on portions of the building served by new heating systems to prevent inadvertent undersizing or oversizing. See sections
150.0(h)1 and 2).
04 Furnace Temperature Rise: Central forced-air heating furnace installations must be configured to operate at or below the furnace manufacturer's maximum
inlet-to-outlet temperature rise specification. See Section 1SO.O(h)4.
OS Standby Losses and Pilot Lights: Fan-type central furnaces may not have a continuously burning pilot Oght. Section 110.5 and Section 110.2(d). ' :· :· ·: ,' .;: : ' .:··=· ', ,.
Cooling Equipment ': ; ·:·,
\'-·~
'' :=
06 Equipment Efficiency: All cooling equipment mllstmeet the minimum effidency requirements of Section 110.1 and Section ll0.2(a) and the Appliance Efficiency
Regulations.
07 Refrigerant Line Insulation: All refrigerant line insulation in split system air conditioners and heat pumps must meet the R-value and protection requirements of Section
1SO.O(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 1SO.O(h)3A.
09 Sizing: Cooling load calculations must be done on portions of the building served by new cooling systems to prevent inadvertent undersizing or oversizing. See Section
150.0(h)l and 2.
Air Distribution System Ducts, Plenums and Fans
10 Insulation: In all cases, unless ducts are enclosed entirely in directly conditioned space, the minimum duct insulation value is R-6. Note that higher values may be
required by the prescriptive or performance requirements. See Section 150.0(m)1.
L__. ___
Registration Number: 216-A0419126A-M0100002A-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
Registration Date/Time: 2016-11-2810:11:51
Report Version: 2013 Rev 1.008
Schema Version: 2013.1.008
HERS Provider: CaiCERTS
Report Generated: 2016-11-28 10:11:14
!
I
CERTIFICATE OF INSTALLATION CFZR-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page6 of7)
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,
11 602.0, 603.0, 604.0, 605.0 and ANSI/SMACNA-006-2006: Supply-air and return-air ducts and plenums must be insulated to a minimum installed level of R-6.0 or
enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing in accordance with the requirements of Reference
Residential Appendix RA3.1.4.3.8.
Heat Pump Thermostat
12 A thermostat shall be installed that meets the requirements of Section 110.2(b) and Section 110.2{c).
13 The thermostat shall be installed in accordance with the manufacturers published installation specifications
14 First stage of heating shall be assigned to heat pump heating.
15 Second stage back up heating shall be set to come on only when the indoor set temperature cannot be met.
.. ·'>'' ,.:·,•, < ,. ·· ·,.·rc>, ,,,,·.,,;.>•·• .·'
The responsible person signature on this compliance document affirms that a11 applicabl~uequlrements iJ this table have bfaen met. :: ,', ' ' ' . :,, '
Registration Number: 216-A0419126A-M0100002A-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
Registration Date/Time: 2016-11-2810:11:51
Report Version: 2013 Rev 1.008
Schema Version: 2013.1.008
HERS Provider: CaiCERTS
Report Generated: 2016-11-28 10:11:14
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 7 of 7)
Documentation Author's Declaration Statement
1. I certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: ~~L Les Young
Company: Signature Date:
OAK ISLAND HEATING AND AIR CONDITIONING INC 2016-11-28 10:11:51
Address: CEA/ HERS Certification Identification (if applicable):
1250 PACIFIC OAKS PL # 103
City/State/Zip: Phone:
ESCONDIDO CA 92029 760-839-8383
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. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials,
components, or manufactured devices for the scope of work identified on this Certificate of Installation, and attest to the declarations in this statement (responsible builder/installer), otherwise I am an
authorized representative of the responsible builder/installer. < ~!"·;'
3. The constructed or installed features, materials, components or rnaflufactured'·devices{t~ installatiCJh) identified.~ this ~rtifi-of lnstallatiolt conf~ to ~·89J!Iicable codes and regulations, and the
installation conforms to the requirements given on thel!ans and ~cificationsliJ)I)roved ~the enf0JY;ernent.geh¢y. ) · : •·· .· · :: ,
4. I reviewed a copy of the Certificate of Complianciappr*d by the I!Morce~t qenc:y thM iqe{ltifi" the spd'tific rtlquiretilents4'or die scope ofconstruct!Cm dt.tnstaiiJtion identified on this Certificate of
Installation, and I have ensured that the requirements-apply to the construction or installation have been met.
5. I will ensure that a registered copy of this Certificate of iiistallation shall be posted, or made aliailable 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: ~ -:?~.
Les Young
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Position With Company (Title):
OAK ISLAND HEATING AND AIR CONDITIONING INC MGR
Address: CSLB License:
1250 PACIFIC OAKS PL # 103 745400
City/State/Zip: Phone: I Date Signed:
ESCONDIDO CA 92029 760-839-8383 2016-11-28 10:11:51
Digitally signed by Ca/CERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-A0419126A-M0100002A-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
Registration Date/Time: 2016-11-2810:11:51
Report Version: 2013 Rev 1.008
Schema Version: 2013.1.008
HERS Provider: CaiCERTS
Report Generated: 2016-11-28 10:11:14
.
I
I
CERTIFICATE OF INSTALLATION CFZR-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3)
Project Name: BURT RESIDENCE Enforcement Agency: City of Permit Number: on site
Carlsbad
Dwelling Address: 114 WINDVANE LANE City: Carlsbad Zip Code: 92011
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 No, credit is not taken
(VLLDCS) Credit from CF1R?
OS Verified Low Leakage Air Handling Unit (VLLAHU) Credit No, credit is not taken
from CFlR?
06 Duct System Compliance Category Alteration using smoke test
0!/' ,,, ' ';, C ,,,,,,, :!' "' ,, 'l'''o;~'"" ,:!'_"lit'''''''' E~C''' Jc
MCH-20e-Sealing All Accesslbl .. aks iing s-e.r4t\'. f·' ' < ;i \,' ' "
J' ', :,' ;:
' ::;::,, ,~::~, ' ; ' ':; . ' :,; !,,,. ,', ,· '>'' ~ ,-'.' ; " .
B. Duct Leakage Diagnostic Test"'''!i(~
01 Condenser Nominal Cooling Capacity (ton) 4
02 Heating Capacity (kBtu/h) 0
03 Conditioned Floor Area served by this HVAC system (ft2) 2142
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 Cooling system method
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 338
(cfm)
Registration Number: 216-A0419126A-M2000002A-OOOO
CA Building Energy Efficiency Standards
2013 Residential Compliance
Registration Date/Time: 2016-11-2810:11:51 HERS Provider: CaiCERTS
Report Version: 2013 Rev 1.008 Report Generated: 2016-11-28 10:11:55
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of3)
B. Duct Leakage Diagnostic Test
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
11 accessible portions of the duct system. Note-Accessible is defined as having access thereto, but which first may require
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 ofthose ducts is not required
C. Additional Requirements for Compliance
01
02
03
04
OS
06
07
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
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.
All supply and return register boots were sealed to the drywall.
Building cavities were not used as plenums or platform returns in lieu of ducts.
,,,cJi>'ili,• ;; ,,·,, ,,,,, ~,· ,,.. ,, " . ,.
If cloth backed tape was used it was co~red wifl!!la~c 'nd draw,'~gds~ >~' ~ " \~
If the system complies using the Smoke T~st fnethod, 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.
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met.
Registration Number: 216-A0419126A-M2000002A-OOOO
CA Building Energy Efficiency Standards
2013 Residential Compliance
Registration Date/Time: 2016-11-28 10:11 :51 HERS Provider: CaiCERTS
Report Version: 2013 Rev 1.008 Report Generated: 2016-11-28 10:11:55
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R·MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3)
Documentation Author's Declaration Statement
1. I certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature~ ~.L
Les Young iT 7
Company: Signature Date: 2016-11-2810:11:51 OAK ISLAND HEATING AND AIR CONDITIONING INC
Address: CEA/ HERS Certification Identification (if applicable):
1250 PACIFIC OAKS PL # 103
City/State/Zip: Phone:
ESCONDIDO CA 92029 760-839-8383
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. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
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, aJtd the install~ion c9.r~9rms~.9J~t re.!J.Mlr~.!"EI!:I~~~EI." o~~~ plans and specifications approved by
the enforcement agency. , · , < 1 { ; •:, 'l •} <. . .....
4. I understand that a HERS rater wiM check the1nstallation tii'if!rifi cc$lpliance, -that · ecfg ide-s defects; I'm reiiulft!l t9<take co~rective ~ctio~ at my expense. · nderstarlifhat Ene¢/'~rfss~ and HEf Provi sen1@tive~ will. at' ~erfor~u-+v asfr11Jce checking
of mstallat1ons, mcludmg oved as part.of a sa.-grOUp b~.chiao1by te~land if,tftore nlftallat!Ons fidl to meet the
requirements of such quality a .. ·. ce checking, the required C(lrrective action and additior:tal checking/testing of':Other installations in that HERS
sample group will be performed at''riiv expense. . . . . . .
5. 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. 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.
Responsible Builder/Installer Name: Responsible Builder/Installer Sign~ ~~,
Les Young
Company Name: (Installing Subcontractor or General Contractor or Position With Company (Title): , v
Builder/Owner) MGR
OAK ISLAND HEATING AND AIR CONDITIONING INC
Address: CSLB license:
1250 PACIFIC OAKS PL # 103 745400
City/State/Zip: Phone: I Date Signed:
ESCONDIDO CA 92029 760-839-8383 2016-11-28 10:11:51
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 no way implies
Registration Provider responsibility for the accuracy of the information.
Registration Number: 216-A0419126A-M2000002A-OOOO
CA Building Energy Efficiency Standards
2013 Residential Compliance
Registration Date/Time: 2016-11-28 10:11:51 HERS Provider: caiCERTS
Report Version: 2013 Rev 1.008 Report Generated: 2016-11-28 10:11:55
Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3)
Project Name: BURT RESIDENCE Enforcement Agency: City of Permit Number: on site
Carlsbad
Dwelling Address: 114 WINDVANE LANE City: Carlsbad Zip Code: 92011
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 No, credit is not taken
(VLLDCS) Credit from CF1R?
OS Verified Low Leakage Air Handling Unit (VLLAHU) Credit No, credit is not taken
from CFlR?
06 Duct System Compliance Category Alteration using smoke test
'"·'. i£ ~LV '""'. ,f' ,II , 'i : 't $ 'f s .····
MCH-20e -Sealing All Acces#~~bl~f.eaks ~~g S"f'tfmtt
,{'; ::. : ': ··:· .. : '.
•,,, V, ·,:, ... ,,.,., 'ry:,, ,.:::·:· ·~· ::, ··:.
····~'t'}~L
' ·' :
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) 2142
04 Duct Leakage Test Condition Test final
OS Duct Leakage Test Method Total leakage
06 Leakage Factor 0.1S
07 Air Handling Unit Airflow (AHUAirflow) Determination Cooling system method
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 338
(cfm)
Registration Number: 216-A0419126A-M2000002A-M20A
CA Building Energy Efficiency Standards
2013 Residential Compliance
Registration Date/Time: 2016-11-2816:00:20 HERS Provider: CaiCERTS
Report Version: 2013 Rev 1.008 Report Generated: 2016-11-28 15:59:54
Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3)
B. Duct Leakage Diagnostic Test
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
11 accessible portions of the duct system. Note -Accessible is defined as having access thereto, but which first may require
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) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage
02 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 All supply and return register boots were sealed to the drywall.
'! ,~.:,· •. : ·;, :·::.•;;:.: ..
04 Building cavities were not used as plenUms or pf~ffjprr&r~~rns in ~~.of~~: ; ' ~-3\ c: ~,$J;r.tJ:J!f ~t .~~:~ { ~k' '"·~;:\
If cloth backed tape was A'~i~,was coveredw~h'~aJ1c i~draJt>ands. ·.' OS
{:';'~{~::.:\
06 All connection points between tHe air handler a~d 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. Systems that comply using smoke test shall not be included in sample
groups for HERS verification compliance.
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.
01 I Complies: All specified verification protocol requirements on this document are met.
Registration Number: 216-A0419126A-M2000002A-M20A
CA Building Energy Efficiency Standards
2013 Residential Compliance
Registration Date/Time: 2016-11-28 16:00:20 HERS Provider: CaiCERTS
Report Version: 2013 Rev 1.008 Report Generated: 2016-11-28 15:59:54
Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION
Duct Leakage Diagnostic Test
Documentation Author's Declaration Statement
1. I certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Jason Solarez
Company:
Air-Tite Duct Testing
Address:
2386 Warmlands Ave
City/State/Zip:
Vista CA 92084
Responsible Person's Declaration statement
Documentation Author Signature:
Date Signed:
2016-11-2816:00:20
CEA/ HERS Certification Identification (if applicable):
Phone:
760-231-9444
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.
CF3R-MCH-20-H
(Page 3 of 3)
2.
3.
I am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
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.
The information reported on applicable sectiqes. ·.·'. ·t!f···· the Certific~·· (s~. ,. '~ .... · .. · I ·. . ·.C··· F . . ·. ~.·. ·.· •. ··.by t. he pertO···· n(s .. ) resp· .. o·· ns·i·.·b.·le. ~ .. o. r the construction or installation conforms to the fquireme ·. d, the Ce .~(s (C.tapproved byfle ~me~agency.
I will ensure that a registered co of this Ctificate of n .. "all be po ,, , or ith tffil~'lfWilding peljlit(f issu\Wd tpr the
building, and made availa force .U$n . pi ... ,,l.~~q:;p~~R~· I • _.at a~,&.~re;copy ~thjJCertlficale,of .
Verification is required to be with the docume 1on t e builder proviaes tot e ui !ling owner at occupBhcy. ·
4.
5.
·, r ·• i i ·•.
Builder Or Installer Information As ~hown On The Certificate Of Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
OAK ISLAND HEATING AND AIR CONDITIONING INC
Responsible Builder or Installer Name:
Les Young
HERS Provider Data Registry Information
Sample Group Number (if applicable):
HERS Rater Information
HERS Rater Company Name:
Air-Tite Duct Testing
Responsible Rater Name:
Jason Solarez
Responsible Rater Certification Number w/ this HERS Provider:
CC2006013
CSLB license:
745400
Dwelling Test Status in Sample Group (if applicable)
Tested
Responsible Rater Signature:
Date Signed:
2016-11-28 16:00:20
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 Date/Time: 2016-11-2816:00:20 HERS Provider: CaiCERTS Registration Number: 216-A0419126A-M2000002A-M20A
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008
Schema Version: 2013.1.007
Report Generated: 2016-11-28 15:59:54
2013 Residential Compliance