HomeMy WebLinkAbout2816 HIGHLAND; ; CB163639; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
09-23-2016 Permit No: CB163639
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference#:
PC#:
Project Title:
Applicant:
ASI HASTINGS
STE 200
2816 HIGHLAND DR CBAD
PME
1562002500
SHOUP:CHANGEOUT2 AC'S
4870 VIEWRIDGE AV
SAN DIEGO CA 92123
619-590-9300
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
Status:
Lot#: 0 Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
Owner:
FOWLER CRAIG&JANET
2816 HIGHLAND DR
CARLSBAD CA 92008
ISSUED
09/23/2016
SF
09/23/2016
09/23/2016
$0.00
$0.00
$163.00
$0.00
$163.00
Total Fees: $163.00 Total Payments To Date: $163.00 Balance Due:
Inspector:
FINAL APPROVtL
Date: 1/, /I-' Clearance:
$0.00
NOTICE: Please take NOTICE that approval of your project includes the 'Imposition' of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." 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.
THE FOLLOWI)IG APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0PLANNING 0 ENGINEERING 0BUILDING OFIRE 0HEALTH D HAZMATIAPCD
·~ Building Permit Application Plan Check No.<.. 'BI <o) C '39 « •,'#)' 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 cr I l-"3/ (~ ISWPPP
JOB ADDRESS SUITEif/SPACEf/UNITI IAPN 2816 HIGHLAND DR, CARLSBAD 92008 -- -
CT /PROJECT # I LOT# I PHASE# r OF UNITS r BEDROOMS #BATHROOMS I TENANT SUSINESS NAME J CONSTR. TYPE l OCC. GROUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
CHANGEOUT 2 AC'S
EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE
1
AIR CONDITIONING riRE SPRINKLERS
YESQI N<Q YEsONoO YESONoO
APPLICANT NAME JERMAINE MAEWEATHER PROPERTY OWNER NAME MATT SHOUP Prtnorv Contact
ADDRESS ADDRESS
3645 RUFFIN ROAD # 330·335 2816 HIGHLAND DR, CARLSBAD 92008
CITY STATE ZIP CITY STATE ZIP
san diee~o ca 92123 CARLSBAD CA
PHONE rAX PHONE rAX 619·590-9337 (951) 255-7351
EMAIL EMAIL JERMAINE~WEGREENINC.COM
DESIGN PROFESSIONAL CONTRACTOR BUS. NAME asi hastinas
ADDRESS ADDRESS 4870 viewridge ave
CITY STATE ZIP CITY STATE ZIP
san dieao ca 92131
PHONE 'FAX PHONE !FAX 619-590·9337
EMAIL EMAIL
'STATE LIC. # STATE UC.# I CLASS I CITY BUS. uc.1200804 513115 c20
(Sec. 7031.5 Busmess and Professions Code: Any C1ty or County which requires a perm1t to construct, alter, 1mprove, demolish or repair an~ structure, pnor to 1ts Issuance, also reqwes the applicant for such permit to file a signed statement tnat he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exem.Qt 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)).
WORI<ERS' COMPENSATION
Worke11' Compensation Declaration: I hereby affirm under penalty of petjury one of the follOwing declarations:
0 I have and will maintain a certificate of consent to self·lnsure for woiXers' compensation as provided by Section 3700 of the Labor Code, for the perfo""ance of the woiX for which this pe""it Is Issued.
[{] I have and will maintain workn' compensation, as required by Section 3700 of the Labor Code. for the performance of the woiX tor which thiS pe""n Is Issued. My woiXers' compensation Insurance carrier and policy
number are: Insurance Co. CYPRESS INSURANCE COMPANY Policy No. ASWC605204 Expiration Date 911/2016
l!!ii, section need not be completed n the pe""n Is for one hundred dollars ($1 00) or less. U Certificate of Exemption: I certify that In the of the woiX for which this permit is issued, I shall not employ any person In any manner so as to become subject to the WoiXers' Compensation Laws of
Calnomla. WARNING: Failure to secure coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dolla11 (&100,000), in
addition to the cost of compensation, damages as 3706 of the Labor code, interest and attorney's fees.
~CONTRACTOR SIGNATURE
I hereby affirm that I am exempt from Contractor's Ucense Law for the follOwing reason:
0
D
0
I, as owner of the property or my empioyees with wages as their sole compensation, will do the woiX and the structure is not intended or offered for sale (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 who does such woiX himseff 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 will have the burden of proving that he did not build or improve for the purpose of sale).
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 wnh contractor(s) licensed pursuant to the Contracto(s License Law).
1 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 Do
2. I (have I have not) signed an application for a building pe""n for the proposed woiX.
3. 1 have contracted with the following person (firm) to provide the proposed construction (include name address I phone I contractors' license number):
4. I plan to provide portions of the woiX, but I h hired the following person to coordinate, supervise and provide the major woiX (Include name I address I phone I contractors' license numbe~:
5. I will provide some of the woiX, but I have tracted (hired) the following persons to provide the woiX Indicated (Include name I address I phone I type of woiX):
~PROPERTY OWNER SIGNATURE 0AGENT DATE
Is ttfe applicant or future building occupant required to submit a business plan, a:utely hazan!ous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the
Presley-Tanner Hazan!ous Substance Account Act? CJ Yes CJ No
Is the applicant or future building occupant required to obtain a permn from the alr pollution control district or air quality management district? CJ Yes CJ No
Is the fa:ility to be constructed within 1,000 feet of the outer boundary of a school sne? CJ Yes CJ No
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF
EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
Lender's Name
I certify that I halie read the application and state that the above Information Is con8CI and that the information on the plans is accurate. I agree to cornply\Wth all City ordnances and State laws relating to building construcllon.
I herei:Y)' authorize representative of the City of Carlsbad i> enter upon lhe abow mentbned property fi:lr inspectbn purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST ALL UABIUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY. N ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA An OSHA perm~ is required tor excavations over 5'0' deep and demolition struction of structures over 3 stories in height
EXPIRATION: Every perm~ issue:! by the Buikling Official t.nder the proviskms of Code II expire by Imitation and become nuU and ..00 K the building or work autllorized by such permit is not corrmenced within
180 days from the date of such ~or Wlhe buikling or work authorized by rm~ · at any line alter the work isoom!\'le~Y.:)9j tor a period of 180days (Section 106.4.4 Unifi:lrm Buikfng Code).
A$ APPLICANT'S SIGNATURE DATE
PERMIT INSPECTION HISTORY REPORT (CB163639)
BLDG-Residential 09/23/2016Application Date:Permit Type:Owner:PINHEIRO FAMILY LP
Subdivision:P/M/E 09/23/2016Work Class:Issue Date:
2816 Highland Dr
Carlsbad, CA 92008
Address:Issued - Active 03/22/2017Expiration Date:Status:
IVR Number: 717314
Scheduled
Date Inspection Type Inspection No.Inspection Status Primary Inspector Reinspection CompleteActual
Start Date
11/17/2016 11/17/2016 BLDG-43 Air
Cond./Furnace Set
001660-2016 Passed Jonathan West Complete
COMMENTS PassedChecklist Item
BLDG-Building Deficiency Yes
BLDG-Final
Inspection
001661-2016 Passed Jonathan West Complete
COMMENTS PassedChecklist Item
BLDG-Mechanical Final Yes
November 21, 2016 Page 1 of 1
'f
CERTIFICATE OF INSTALLATION I CF2R-MCH-01-E I I
Space Conditioning Systems, Ducts, and Fans I (Page 1 of 8 ) ,
I
Project Name: 2816 Highland Dr Enforcement Agency: Carlsbad Building Permit Number: CB163639 I
Department i
Dwelling Address: 2816 Highland Dr City: Carlsbad Zip Code: 92oo8 I
- -----·--· -·----· ----------
I A. General Information
01 Dwelling Unit Name 2816 Highland Dr 02 Climate Zone 7
03 Dwelling Unit Total Conditioned Floor 3500 04 Number of Space Conditioning 2 Area (ft2) Systems in this Dwelling Unit.
OS Certificate of Compliance Type Prescriptive alterations (CF1R-ALT) 06 Method used to Calculate HVAC Loads NotApplicableEquipmentChangeout
07 Calculated Dwelling Unit Sensible 0 Cooling Load (Btuh)
09 Dwelling Unit Number of Bedrooms 5
01
SC System SCSystem CFAserved
Identification or Location or Area by this SC ducted Name Served System (ft2) system?
System 1 I Main I 1750 I Yes I
Registration Number: 316-A1034142A-M0126142A-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
08 Calculated Dwelling Unit Heating load
(Btuh)
- - - -- --· -·--------
05 07 '"
tef191f\8EK> iatiOJtnore
containing system than 40 feet of
components? ducts? component?
Yes I Yes I No
Registration Date/Time: 2016-10-13 15:21:04
Report Version: 2013 Rev 1.007
Schema Version: 2013.1.007
I 08
Installing
entirely new
duct system?
I No
0
-
I 09 I 10
Installing
entirely new SCI Alteration Type
system?
Altered space
I No I conditioning
system
HERS Provider: USERA
Report Generated: 2016-10-13 15:21:34
..
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 2 of8)
B. Space Conditioning (SC) System Information I
I
01 02 03 04 OS 06 07 08 09 10
!
SCSystem SCSystem CFAserved Is the SC Installing a Installing new SC Installing more Installing Installing '
Identification or location or Area bythisSC system a refrigerant system than 40 feet of entirely new entirely new SC Alteration Type
Name Served System (ft2)
ducted containing components? ducts? duct system? system? system? component?
Altered space
System 2 Main 1750 Yes Yes Yes No No No conditioning
system
-
C. Space Conditioning (SC) System Alterations Compliance Information
Central Fan
Integrated
Heating Cooling New or (CFI)
sy .. em f ' A .. , •• ~ Heating I Minimum Altered Cooling Minimum Required Replaced New Ventilation
Identification kl!eating •1 ;: ~'1iea!~!l~-i; JV4t¥cy ·.Efficiency Cooling· . Cooling EfftciEmcy Efficiency Thermostat Duct Duct System
or Name · . em Tvoe ~ ~Comolnrnt · . e · Value svstemTvoe ·Components Type Value Type length R-Value Status
All new I I I I System 1 I~ I ' comfli3 --~· ·-.1 -· ,:-_-:~:-·· I ;;~~RJt~;;itsb~;:ti 1 +4.000 Setback LTE40Ft RG Not a CFI
system
e --
This field
h I 0
'
This field All new I Central gas
1
No eatmg . . Central I I I I I System 2 sect1on IS or section cooling I SEER 14.000 Setback LTE40Ft RG Not a CFI
furnace componen not is not split AC system t altered r bl applicable components app 1ca
e
Registration Number: 316-A1034142A-M0126142A-OOOO Registration Date/Time: 2016-10-13 15:21:04 HERS Provider: USERA
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-10-13 1S:21:34
Schema Version: 2013.1.007
~
CERTIFICATE OF INSTALLATION
Space Conditioning Systems, Ducts, and Fans
D. Installed Heating Equipment Information
This section does not apply to this project.
E. Installed Cooling Equipment information
01 02 03 04 OS 06
Condenser or Package Unit
Condenser or Condenser or Condenser or
System Identification Cooling Efficiency Cooling Efficiency Package Unit Package Unit Package Unit
or Name Type Value Manufacturer Model Number Serial Number
System 1 SEER 16.000 DAIKIN DX16SA0481AB 1608360799
System 2 SEER 16.000 DAIKIN DX16SA0481AB 1608360786
Notes:
F. Extension
Thi'S section do.es notapplyto this project.
G. Installed
U.S. iiifler§)loRatetS tA&sooiatio n
H. Installed Air Filter Device Information
Registration Number: 316-A1034142A-M0126142A-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
This section does not apply to this project.
Registration Date/Time: 2016-10-13 15:21:04
Report Version: 2013 Rev 1.007
Schema Version: 2013.1.007
CF2R-MCH-Ol-E
(Page 3 of8)
07 08
System Rated Cooling Condenser Rated
Capacity at Design Nominal Capacity
Conditions (BTUH) (ton)
48 4.0
48 4.0
HERS Provider: USERA
Report Generated: 2016-10-13 15:21:34
CERTIFICATE OF INSTALLATION
Space Conditioning Systems, Ducts, and Fans
I. Air Filter Device Requirements
This section does not apply to this project.
U.S. Energy Raters Association
Registration Number: 316-A1034142A-M0126142A-0000 Registration Date/Time: 2016-10-13 15:21:04
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version: 2013 Rev 1.007
Schema Version: 2013.1.007
CF2R-MCH-Ol-E
(Page 4 of 8)
HERS Provider: USERA
Report Generated: 2016·10-13 15:21:34
CERTIFICATE OF INSTALLATION
Space Conditioning Systems, Ducts, and Fans
J. HERS Verification Requirements
MCH20 I I MCH21 I MCH22
Exemption
from
Minimum
Exemption R-Value for
System
I
SC System I From Duct Duct Ducts In Ducts Located AHU Fan
Identification or Location or Area Leakage Leakage Conditioned In Cond Space Efficacy
Name Served Requirements Test Space Verification (W/dm)
Altered duct
system has
System 1 I Main I less than 40 ft I No I No I No I No of duct in Exemption
unconditioned
spaces
System 2 No Yes ' No I No··· ·.·I No '•/fiiVt. ' · <i<~roptioris. Exemption >..mi,...,,,,, (c7i ,,
' Notes:
U.S. Energy Raters Association
Registration Number: 316-A1034142A-M0126142A-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
Registration Date/Time: 2016-10-13 15:21:04
Report Version: 2013 Rev 1.007
Schema Version: 2013.1.007
CF2R-MCH-01-E
(Page 5 of8)
I MCH23 I MCH25 I MCH28
AHU
Airflow
Rate I Refrigerant I Return Duct Design
(dm/ton) Charge Table 150.0-C or D
I No I No I No
I No I No I No
HERS Provider: USERA
Report Generated: 2016-10-13 15:21:34
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 6 of8)
K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the
system that are altered. Existing equipment may be exempt from these requirements.
Heating Equipment
01
02
03
04
OS
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.
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 lSO.O(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
lSO.O(h)l and 2).
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.
Standby Losses and Pilot Lights: Fan-type central furnaces may not have a continuously burning pilot light. Section 110.5 and Section 110.2(d).
Cooling Equipment
06 meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency
·~~ '
07 in split system air conditioners and heat pumps rQ.U~t meet the R-value and protection requirements of Section
08 I Condensing Unit Location: Condensing units shall ni2JI~S>Jai.cfler'(!lftleAatelfgdAseO~~ction 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
lSO.O(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 lSO.O(m)l.
Registration Number: 316-A1034142A-M0126142A-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
Registration Date/Time: 2016-10-13 15:21:04
Report Version: 2013 Rev 1.007
Schema Version: 2013.1.007
HERS Provider: USERA
Report Generated: 2016-10-13 15:21:34
CERTIFICATE OF INSTALLATION CFZR-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 7 of8)
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.
The responsible person signature on this compliance document affirms that all applicable requirements in this table have been met.
U.S. Energy Raters Association
Registration Number: 316-Al034142A-M0126142A-OOOO
CA Building Energy Efficiency Standards-2013 Residential Compliance
Registration Date/Time: 2016-10-13 15:21:04
Report Version: 2013 Rev 1.007
Schema Version: 2013.1.007
HERS Provider: USERA
Report Generated: 2016-10-13 15:21:34
I I
i
'
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 8 of 8)
Documentation Author's Declaration Statement
1. I certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
Maria Baldwin
Signature Date:
2016-10-13
Identification (if
ViPwrirlPP Av. #200
Phone:
619-590-9300
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, and the
installation conforms to the requirements given on the plans and specifications approved by the enforcement agency.
4. I reviewed,a.coov of the Certificate of C~ aooroved.by .th!l.~llforcemeot agtmCY thiit.identifie~ the specific requjre!Jlents for the scope of construction or installation identified on this Certificate of
apptYtd'ttie construction orinstall1i"tion\fli1Ve:been met. · . ; .
5. I will ensdte,that a registeiil:lt:Coov df!his Certificate~f InstallatiOn shall be posted, or rniide availabl~ )inih the building' permit(s) issued for the building, and made available to the enforcement agency for all
of this C~rtificafe of InstallatiOn is required'tt,~.be included with the documentation the builder provides to the building owner at occupancy.
re:
619-590-9300
us
U.S. Energy Rsters Association
"This digital signature is provided in order to secure
the content of this registered document. and rn no
way implies Registration Provider responsibility for
tire accuracy of the information.·
Registration Number: 316-A1034142A-M0126142A-0000
CA Building Energy Efficiency Standards-2013 Residential Compliance
Registration Date/Time: 2016-10-13 15:21:04
Report Version: 2013 Rev 1.007
Schema Version: 2013.1.007
HERS Provider: USERA
Report Generated: 2016-10-13 15:21:34
CERTIFICATE OF VERIFICATION
Duct Leakage Diagnostic Test
Project Name: 2816 Highland Dr Enforcement Agency: Carlsbad
Building
Dwelling Address: 2816 Highland Dr City:
A. System Information
01
02
03
04
05
06
Space Conditioning System Identification or Name
Space Conditioning System Location or Area Served
Building Type from CF-1R
Verified Low Leakage Ducts in Conditioned Space
(VLLDCS) Credit from CF1R?
Verified Low Leakage Air Handling Unit Credit from
CF1R?
Duct System Compliance Category
Department
Carlsbad
System 2
Main
Single family
No, credit is not taken
No, credit is not taken
Alteration
'" ~
CF3R-MCH-20-H
(Page 1 of 3)
Permit Number: CB163639
Zip Code: 92008 i
01 U.S.I Energy Raters Association
02 I Heating Capacity (kBtu/h) 1
03 I Conditioned Floor Area served by this HVAC system (ft2) I 1750
04 I Duct Leakage Test Condition I Test final
05 I Duct Leakage Test Method Total leakage
06 I Leakage Factor .15
07 1 Air Handling Unit Airflow (AHUAirflow) Determination I Cooling system method
Method
08 Measured AHUAirflow 0
09 Calculated Target Allowable Duct Leakage Rate (cfm) 240
10 1 Actual duct leakage rate from leakage test measurement I 227
(cfm)
11 I Compliance Statement: System passes leakage test
Registration Number: 316-A1034142A-M2015614A-M20A Registration Date/Time: 2016-10-13 15:23:54 HERS Provider: USERA
CA Building Energy Efficiency Standards
2013 Residential Compliance
Report Version: 2013 Rev 1.007
Schema Version: 2013.1.007
Report Generated: 2016-10-13 15:24:23
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3)
B. Duct Leakage Diagnostic Test
12l Notes:
C. Additional Requirements for Compliance
01 System was tested in its normal operation condition. No temporary taping allowed.
02
Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage
testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation
Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required,
may configure the OA damper to the closed position during duct leakage testing.
03 If a complete replacement, all supply and return register boots were sealed to the drywall.
04 Building cavities were not used as plenums or platform returns in lieu of ducts.
OS If cloth backed tape was used it was covered with Mastic and draw bands.
06 All connection points between the air handler and the supply and return plenums are completely sealed.
07
r.l'i!tt;mhthod~ the smoke test was conduct~d\IO'accordance With the requirements
Systems that comply using sm()ke test shall not be jndtided in sample
08 I VeriTir::mnr Pass-all applicable requirements are met
09 I Correction Notes for this table u.s Raters Association
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: 316-A1034142A-M2015614A-M20A Registration Date/Time: 2016-10-13 15:23:54 HERS Provider: USERA
CA Building Energy Efficiency Standards
2013 Residential Compliance
Report Version: 2013 Rev 1.007
Schema Version: 2013.1.007
Report Generated: 2016-10-13 15:24:23
• ..
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3 I
Documentation Author's Declaration Statement
1. I certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Nathan Gray
Company:
We Green Inc.
Address:
4077 32nd Street #8
City/State/Zip:
San Diego CA 92194
Responsible Person's Declaration statement
Documentation Author Signature:
Date Signed :
2016-10-13
CEA/ HERS Certification Identification (if applicable):
10361563
Phone:
6195497372
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The reported"gn afl'plicable sections of the Certificate(s) of Installation (CF2R) signed and submitted by the person(s) responsible for the
installatiorf conforms to thel"~qolrem~nts specified on the Certificate(s) of Compliance (CFlR) approved by the enforcement agency.
5. a register'ed copy f this Certificate of Verification shall be posted, or made available with the building permit(s) issued for the
made availaole to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of
included with the the builder provides to the building owner at occupancy.
e Certificate Of lnstallati.on
Company Name (Installing Subcontractor, General Contractor, or Builder~@; Energy Raters Association
ASI
Responsible Builder or Installer Name:
Maria Baldwin
HERS Provider Data Registry Information
Sample Group Number (if applicable):
316-27290
HERS Rater Information
HERS Rater Company Name:
We Green Inc.
Responsible Rater Name:
Nathan Gray
Responsible Rater Certification Number w/ this HERS Provider:
10361563
CSLB License:
513115
Dwelling Test Status in Sample Group (if applicable)
Tested
Responsible Rater Signature:
Date Signed:
2016-10-13
u.s. Ener.gy Raters As:oociatton
"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: 316-A1034142A-M2015614A-M20A
CA Building Energy Efficiency Standards
Registration Date/Time: 2016-10-13 15:23 :54 HERS Provider: USERA
2013 Residential Compliance
Report Version: 2013 Rev 1.007
Schema Version: 2013.1.007
Report Generated: 2016-10-13 15:24:23
. .