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HomeMy WebLinkAboutSPYGLASS DRIVE 15300_14-00000260 CCITY OF LAKE F " LS1,110PE BUILDING & SAFETY DREAM EXTREME,- �► 130 South Main Street PERMIT JOB ADDRESS . . . . . 15300 SPYGLASS DRIVE DESCRIPTION OF WORK MECHANICAL PERMIT OWNER CONTRACTOR BARRY BRADFORD A & R HEATING AND COOLING SERV BARRY CHRISTI14E 15061 ZIEGLINDE DR 15300 SPYGLASS DRIVE LAKE ELSINORE CA 92530 LAKE ELSINORE CA 92530 951-818-9906 LIC EXP 0/00/00 389-484-010 5 - SQUARE FOOTAGE 0 OCCUPANCY GARAGE SQ FT 0 CONSTRUCTION FIRE SPRNKLR VALUATION . . . ZONE . . . . . NA ELECTRICAL PERMIT QTY UNIT CHG ITEM CHARGE BASE FEE 30 . 00 1 . 00 X 4 . 2500 RES . FIXED APPL.OR OUTLET 4 . 25 MECHANICAL PERMIT QTY UNIT CHG ITEM CHARGE BASE FEE 30 . 00 1 . 00 X 13 . 2500 FAU/FURNACE/DUCTS/VENTS 13 . 25 1 . 00 X 24 . 2500 COMPRESS/HEATPUMP 3-15 HP 24 . 25 PLUMBING PERMITS QTY UNIT CHG ITEM CHARGE BASE FEE 30 . 00 1 . 00 X 4 . 2500 INSTALL/ALTER OR REPAIR 4 . 25 FEE SUMMARY CHARGES PAID DUE PERMIT FEES ELECTRICAL PERMIT 34 . 25 . 00 34 . 25 MECHANICAL PERMIT 67 . 50 . 00 67 . 50 PLUMBING PERMITS 34 . 25 . 00 34 . 25 OTHER FEES PROF.DEV. FEE 1 TRADE 5 . 00 . 00 5 . 00 PLAN RETENTION FEE . 52 . 00 . 52 SEISMIC GROUP R . 50 . 00 . 50 TOTAL 142 . 02 . 00 142 . 02 t : OW&E Type: IF SPECIAL NOTES &, CONDITIONS 113D/lq 30 €vita€ no: 341 REPLACE FAU 20l4 EEO flp WILDING FERMIT 1.00 SIB T :rmn l Tc Vie: 1/30/l4 Time: 16:11:10 City Of Lake Elsinore � Please read and initial Building Safety Division 'Ar 1.t am Licensed under the provisions of Business and professional Code Section 7000 et seq.and my license is in full force. Post in conspicuous place __2.l,as owner of the property,or my employees w/wages as their sole compensation will do the work on the job ant thr cfrvcture is no,;--,,e.nded or off rcd for sate. __3.I,as owner of the property,arn exclusively contracting with licensed contractors to construct the You must furnish PERMIT M1NMER and the project JOB ADDRESS for each respective inspection: 4,I have a certificate of consent to selfinsure or a certificate of Workers Compensation Insurance Approved plans must be on job "- ✓� or a certified cony thereof. at all times: I _5.I shall not employ any person in any manner so as to become subject to Workers Compensation Laws in the performance of the work for which this permit is issued. Note:If you should become subject to Workers Compensation after making this certification, Code Approvals Date Inspector you must forthwith comply with such provisions or this permit shall be deemed revoked. ELOI Temporary Electric Service PLO Soil Pipe Underground EL02 Electric Conduit Underground BPOI Footings _ RP02 Steel Reinforcement BP03 Grout_ -- --- BPO4 Stab Grade PLOT. Underground Water Pipe SS01 Rough Septic System _ SWOT On Site Sewer — — BPOS Floor foists _— BP06 Floor Sheathing - — ---- F4 7 Roof Framing EPOS Roof Sheathing RP09 Shear Wall&Pre-Lath PL03 Rough Plumbing EL03 Rough Electric Conduit EL04 Rough Electric Wiring ELOS Rough Electric/ T-Bar IV1E{}1 Rough Mechanical NIE02 Ducts,Ventilating PL04 Rough Gas Pipe/Test PL02 Roof Brains _ -- BP10 Framing&Flashing BP 12 Ins ulation BPI3 BPI I !aching&Siding PL99 Final Plumbing' 2. EL99 Final Electrical N E99 Final Mechanical _ BP99 Final Building Code Pool&Spa Approvals Date Inspector OTHEFI DIVISION RELEASES _ Deputy Inspector Department Approval required prior to the I'001 Pool Steel Rein./Forms buildin bein released by the City POO I Pool Plumbing/Pressure Test P003 Pre-Gtmite Approval_ Date _ Infector 1106 Rough Poo.Electric Planning Sub List Approval _ Landscape '004 Pool Fencing/Gates/Alarms Finance "005 Pre-Piaster Approval Engineering '009 Final Pool/Spa — - ._.. ................... ...__.. ...... ._ .._. .. .._...... ___........ _ C I TY O F I..,_A..I,E , L S 11JORX DREAM EXTREME TM 130 South Main Street APPLICA'I'lON tl.a �s� APPLICATION FOR PERMIT APPLICAT AP# BY: ELECTRICAL/PLUMBING/MECHANICAL BUILDING AllD ESS j I hereby certify chat I have read this application and state that the f 3 01 c..) S I 33 f..4/--e t/S.• t. C 1 above information is correct.I agree to comply with all city and county TRACT BLUUK/MUL LOT/PARCEL ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above-mentioned 0 NAME property for inspection purposes. W ` C y N MAILING PHONE m I"s ADDRESS l 4s R CITY STATE/ZIP Signiijiere oKApffflcant or Agent Date I hereby affirih that 1 am licensed tinder the provisions of Chapter 9(connuencing C with Section 7000)of Division 3 of the Business and Professions Code,and my (circle one) O license is in full force and effect. AGENT FOR: CONTRACTOR OWNE N LICENSE# �' CITY BUSINESS 1' AND CLASS t3 j S TAX# AGENT'S NAME ` -8 i°ram N z c L� G C4" A. R NAME { A aG� AGENT'S ADDRESS_Ifa0 / e�"�,y __.�'�� _CA 'it r3rr C: MAILIN �r street city state zip T ADDRESS ( �0 + G t v- 6)c' R'x O Cl Y STAT'E/Z1P PHONE Lam. r CONTRACTOR'S SIGNATURE YL ELECTRICAL Qualt PLUMBING Qualt MECHANICAL Quan New Res. Multi Family/SQ.FT. Fixture or Trap F.A.U./Furnace/Ducts/Vents New Res, Single Family/SQ. Fr. Building Sewer F.A.U./Furnace/Misc./> 100000 Pool Electric System, Private Rain Water System per Drain Floor Furnace/Vent Switches/ 1st 20 Private Septic System Unit Healer/Wall Heater Switches/Over 20 Water Heater/Vent Install/Relocate/Replace Vent Receptacle Outlet/ ist 20 Gas Piping System I -4 Outlets Ventilating Fan Receptacle Outlet/Over 20 Gas Piping 5 or More Outlets Evaporative Cooler Lighting Fixtures!Ist 20 Dishwasher Ventilating System Lighting Fixtures/Over 20 Solar Tank Exattst Hood Residential Fixed Appliance/OtltiCt Solar Collector per Panel Fireplace Non-Residential Appliance/Outlet Grease'Trap/(Interceptor) Commercial Incinerator 100-200 Amp Service<600V Install,Alter or Repair System Air Handler> 10000 CFM 200- 1000 Amp Service<600V Lawn Sprinkler System Air Handler< 10000 CFM Misc.Apparatus,Conduits,Etc. Backflow Device Smaller than 2" Fire Dampers Signs Backtlow Device Larger than 2" Registers Sign Branch Circuit Floor Drain Compressor/I-Iealpump-3 H.P. Busways/EA 100 FI' Floor Sink Compressor/Heatpump 3- 15 I-I.P. Temporary Power Service Water Service Compressor/Heatpump 15-30 H.P. Temporary Power Distribution System Alter or Repair Drain or Vent Compressor/Heatpump 30-50 H.P. Motors/Transformers lFire Sprinklers per Building Repair/Alter Misc.IIVAC Motors up to 1 H.P. Swinuning Pool Compressor/featpump Over 50 1.1.P. Motors/'Transformers 1 - 10 H.P. Swimming Pool/Public Motors/Transformers 10-50 H.P. Swimming Pool/Private Motors/Transformers 50- 100 H.P. Water Heater/Vent Motors/Transformers> 100 H.P. Replace Piping Replace Filter Misc. Replace Gas Piping Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-iR-ALT-HVAC Climate Zones 10- 15 Site Address: Enforcement Agency: Date: Permit#: 15300 Spyglass Lake Elsinore, CA 92530 City of Lake Elsinore Jan 28, 2014 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑Package Unit ®Furnace ®AFUE 78°/a ❑COP ❑R 6(CZ 10-13) Served by system ®Setback ®Indoor Coil ®SEER 13.0 ❑HSPF If not already present, must be ®Condensing Unit ❑EER ❑Resistance [3 R 8(CZ 14-15) 2000 sf installed) ❑Other 1.Equipment Type:Choose the equipment being installed; if more than one system, use another CF-1 R-ALT-HVAC for each system. 2.Minimum Equipment Efficiencies:13 SEER, 78%AFUE, Z7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options.The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer.The inspector also verifies that each appropriate CF-6R and registered CF-4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-iR and CF-6R shall also be on site for final inspection. ®1. HVAC Changeout Required Forms: •All HVAC Equipment CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF-4R forms: MECH-21 and (for split systems) MECH-25 •Condenser Coil and/or CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS •Indoor Coil and /or CF-4R forms: MECH-21 and (for split systems) MECH-25 •Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement),TMAH Exempted from duct leakage testing if: ❑1. Duct'system was documented to have been previously sealed and confirmed through HERS verification, or ❑2. Duct systems with less than 40 linear feet in unconditioned space, or ❑3. Existing duct systems are constructed, insulated or sealed with asbestos ❑4. The system will not be Ducted (ie. Ductless Mini-Split System) (Also Exempt from Refrigerant Charge) ❑2. New HVAC System Required Forms: .Cut in or'Changeout with CF-6R'forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and new ducts: (all new MECH-25-HERS ducting and all new CF-4R forms; MECH-20, and (for split systems) MECH-22, and MECH-25 equipment) For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD,TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent 113. New Ducts with/or without Required Forms: Replacement .Includes replacing or installing all new ducting and/or outdoor condensing unit CF-6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton,TMAH For Packaged Units: Duct leakage < 6 percent ❑4. New Ducting over 40 feet Required Forms: .Includes adding or replacing more than 40 CF-6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF-4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor(Documentation Author's /Responsible Designer's Declaration Statement) •I certify that this Certificate of Compliance documentation is accurate and complete. •I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. •I certify 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. •The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms,worksheets,calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: ROBERT GRZEGORCZYK Signature: ROBERT GRZE60RCZYK Company: A&R HEATING AND COOLING SERVICE Date: ]an 28, 2014 Address: 15061 ZIEGLINDE DRIVE License: 905577 City/State/Zip: LAKE ELSINORE/CA/92530 Phone: (951) 818-9906 Reg: 214-A000672OA-000000000-0000 Registration Date/Time: 2014/01/28 21:30:34 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page i of 6) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 1 City of Lake Elsinore 14-00000260 Note: If installation of a Charge Indicator Display(CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance, unless the TMAH Compliance Option is chosen. STMS are only required for completely new or replacement space-conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 5/16 inch (8 mm) access hole 1 upstream of evaporative coil in the H Yes ❑Yes ❑Yes ❑Yes return plenum and labeled according ❑ No ❑ No ❑ No ❑ No Ito Figure,in Section RA3.2.2.2.2. Return side of the duct system is la located entirely within conditioned. P'Yes ©Yes ❑Yes ❑Yes space and return airfivw temperature 0 No No El No fl No to 1 measured.at the return gri(e. 15/161nch (8,im) actess-hole 2 downstream of evaporative.coil M he k Yes ❑Yes El Yes ❑Yes supply plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figure in Section RA3.2.2.2.2. The TMAH Compliance Option should be checked only if it is physically impossible to drill the TMAH as required by Section RA3.2.2.2.2. Using this Compliance Option requires the HVAC installer to annotate on the HERS Provider's data registry an explanation as to why the TMAH cannot be installed on the system, and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance Option also requires minimum airflow verification through the direct measurement of airflow per RA3.3 For more information see http' www enerav ca aov/title24/2008standards/special case appliance/ TMAH Compliance Option t ❑ ❑ ❑ 13 Yes to 1 and 2, or Yes to la and 2, or checking the TMAH Compliance Option, is ® Pass ❑ Pass ❑ Pass ❑ Pass a pass. ❑Fail ❑ Fail © Fail ❑ Fail Enter Pass or Fail Reg: 214-A0006720A-M2500001A-0000 Registration Date/Time: 2014/02/25 14:31:36 HERS Provider: CalCERTS, Inc. 2008 Residential compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6) Site Address: Enforcement Agency: F14-00000260 ermit Number: 15300 Spyglass , Lake Elsinore CA 92530 City of Lake Elsinore STMS - Sensor on the Evaporator Coil System Name or System i Identification/Tag The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed 3 by methods/specifications approved by the Executive Director. CJ Yes 0 No I ❑Yes 0 No ©Yes 0 No 0 Yes © No The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 4 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil ❑Yes ❑ No ❑Yes ❑ No ❑Yes El No El es [] No 5 IThe sensor measures the saturation temperature of the coil within 1.3 degrees F ❑Yes 0 No 0 Yes 0 No 0 Yes ❑ No U Yes L1 No Yes to 3, 4, and 5 is a pass. ® N/A ❑N/A © N/A 0 N/A Enter N/A if STMS are not ❑ Pass ❑ Pass ❑ Pass ❑ Pass applicable. ❑Fail ©Fail 0 Fail 0 Fail Otherwise enter Pass or Fail STMS - Sensor on the Condenser Coil System Name or System 1 Identification/Tag The sensor is factory installed,'or.field installed according to frianufacturer's specifications, or is installed 6 by methods/specifications approved_by the Executive Director. l�Yes`'0 No D Yes 0 No 0 Yes l No 0Yes ©,No The sensor wire is terminated with a standard mini plug suitable for connection to a, digital thermometer: 7 The sensor mini plug is accessible to the instaliing technician and the HERS rater without changing the airflow through the condenser coil ❑Yes [] No ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No 8 IThe sensor measures the saturation temperature of the coil within 1.3 degrees F 0 Yes 0 No 0 Yes 0 No 0 Yes 0 No 0 Yes 0 No Yes to 6, 7, and 8 is a pass. 13 N/A ❑N/A 0 N/A ❑ N/A Enter N/A if STMS are not ❑ Pass ❑ Pass ❑ Pass ❑ Pass applicable. 0 Fail ❑ Fail ❑ Fail 0 Fail Otherwise enter Pass or Fail Reg: 214-A0006720A-M2500001A-0000 Registration Date/Time: 2014/02/25 14:31:36 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 1 City of Lake Elsinore 14-00000260 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb temperature is 55°F or above) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s)for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. •If outdoor air dry-bulb temperature is less than 55°F, the installer must use the RA3.2.3 Alternate Charge Measurement Procedure (Weigh-In Charging Method). If the Weigh-In Method is used, the dwelling cannot be included in a sample group for HERS verification compliance.) Space Conditioning Systems System Name or Identification/Tag System 1 System Location or Area Served Whole House Outdoor Unit Serial # 0114x64598 Outdoor Unit Make payn Outdoor Unit Model pa13n60-e Nominal Cooling Capacity 5 Tons Date of Verification F220/2014 Calibration of Di,agnostjc pstrurnents Date of Refrigerant Gauge Calibration 2/15/2014 (must be re-calibrated monthly) Date of Thermocouple Calibration 2/15/2014 (must be re-calibrated monthly) Measured Temperatures (OF) System Name or Identification/Tag System 1 Supply (evaporator leaving) air dry-bulb 51.1 temperature (Tsu I db) Return (evaporator entering) air 70.4 dry-bulb temperature (Treturn db) Return (evaporator entering) air 56 wet-bulb temperature (Treturn wb) Evaporator saturation temperature 28.4 (Teva orator sat) Condensor saturation temperature 83.5 (Tcondensor, sat) Suction line temperature (Tsuction) 42.3 Liquid Line Temperature (Tliquid) 69.1 Condenser (entering) air dry-bulb 68 temperature (Tcondenser, db) ---------- -- --- -- -- --- -- - -- -- Reg: 214-A0006720A-M2500001A-0000 Registration Date/Time: 2014/02/25 14:31:36 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 City of Lake Elsinore 14-00000260 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification.The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification/Tag System 1 Calculate: Actual Temperature Split = 19.30 Treturn db -Tsupply, db Target Temperature Split from Table RA3.2-3 19.5 using Treturn wb and Treturn db Calculate difference: Actual Temperature -0.2 Split -Target Temperature Split = Passes if difference is between -30F and +3°F or, upon remeasurement, if between PASS -30F and -100°F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement'; (CFM 11) = Nominal;Coaling Capacity (ton) X 300 (cfm/t4n), System Name or Id ntific�tioii/Tag System 1 Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 procedures (CFM) Measurement Method Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Reg: 214-A0006720A-M2500001A-0000 Registration Date/Time: 2014/02/25 14:31.:36 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 1 City of Lake Elsinore 14-00000260 Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag System 1 Calculate: Actual Superheat = Tsuction - Teva orator sat Target Superheat from Table RA3.2-2 using Treturn wb and Tcondenser, db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -50F and +5°F Enter Pass or Fail Subcooling Charge Method Calculations for Refrigerant Charge Verification.This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Subcooling = 14.4 Tcondenser, sat-Tli uid Target Subcooling specified by 15 manufacturer Calculate difference: _0.6 Actual Subcooling-,Target Subcooling =, " System passes if difference is between -30F and 3°F PASS Enter,Pass or Fail Metering'Devi'ce Calculations for'Re€rigerant'Charge Verification. This procedure is required to be used for thermostatic expansion"valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat = 13.9 Tsuction - Teva orator sat Enter allowable superheat range from manufacturer's specifications (or use range 4-25 between 40F and 250F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range PASS Enter Pass or Fail Reg: 214-A0006720A-M2500001A-0000 Registration Date/Time: 2014/02/25 14:31:36 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 City of Lake Elsinore 14-00000260 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re-measured and/or recalculated. System Name or Identification/Tag System 1 System meets all refrigerant charge and airflow requirements. PASS Enter Pass or Fail ® Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55OF and 650F the return air dry bulb temperature shall be maintained above 70OF during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate. DECLARATION STATEMENT .I certify under penalty of perjury, under the laws of the State of California,the information provided on this form is true and correct. .I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). .I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. .I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample,group but not checked by a HERS rater, and if those installations fail to meet the,requirements of such quality assurance checking, the regdired.corrective action and additional_checking/testing of other installations in that HERS sample group will be performed'at my expense. " .I reviewed copy of the Certificate of�Compliance (CF71R)form apprvved;by the enforcement agency,that identifies the specific,.requirements.,for the installation. I certify that'therequirements dgtdiled on the CF-1R that apply to the .. installation have been mete .I will ensure that a completed,'signed.copy of this Insitiallation.Certificate shalt be posted,or made available with the Building permits)issued fbe the building,and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy.I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010,for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) A & R HEATING AND COOLING SERVICE Responsible Person's Name: Responsible Person's Signature: ROBERT GRZEGORCZYK ROBERT GRZEGORCZYK CSLB License: Date Signed: Position With Company (Title): 905577 12/20/2014 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ©Yes 0 No Reg: 214-A0006720A-M2500001A-0000 Registration Date/Time: 2014/02/25 14:31:36 HERS Provider: CaICERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test— Existing Duct System (Page 1 of 2) Site Address: I Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 (System 1) City of Lake Elsinore 14-00000260 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test- Completely New or Replacement Duct System." Duct Leakage Diagnostic Test-existing duct system Select one compliance method from the following four choices. ® 1. Measured leakage less than 15% of fan flow 0 2. Measured leakage to outside less than 10%of Fan Flow 0 3. Reduce leakage by 60% and conduct smoke and fix all leaks p 4. Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options 1, 2 or 3 must be attempted before utilizing Option 4.) Determine nominal Fan Flow using one of the following three calculation methods. ✓®Cooling system method: Size of condenser in Tons .5 x 4.00 = ` 200it CFM J ©Heating system method:;21.7 x Output Capacit",in Thousands of Btu/hr =_CFM V❑Measured system airflow using RA3.3"airflow test.procedures:�CFM optio-mi used t4en: . 1 Allowed leakage - Fan Airflow 2000 x 0.15= 300 CFM Actual Leakage = 106 CFM Pass if Actual Leakage is less than Allowed leakage N Pass 0 Fail Option 2 used then: 2 Allowed leakage = Fan Airflow_x 0.10 =_CFM Actual Leakage to outside = CFM Pass if Actual leakage to outside is less than Allowed leakage Lj Pass©Fail Option 3 used then: Initial leakage prior to start of work = CFM Final leakage after sealing all accessible leaks using smoke test = CFM 3 Initial leakage_- Final leakage_= Leakage reduction_CFM ((Leakage reduction_/Initial leakage_� x 100% = a/o Reduction Pass if a/o Reduction >= 60% 0 Pass 0 Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify(No Sampling). Pass if all accessible leaks have been repaired using smoke 0 Pass 0 Fail Reg: 214-A0006V20A-M2100001A-0000 Registration Date/Time: 2014/02/25 13:49:54 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test— Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 (System 1) City of Lake Elsinore 14-00000260 ®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 ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. ®All supply and return register boots must be sealed to the drywall if smoke test,is utilized for compliance — applies to duct leakage compliance,option 3 (leakage reductiort.by 60%)'and.option 4 (fix all.accessible leaks) described above. 129 New duct installations cannot utilize building cavities as plenums or platform'returns in lieu.of ducts. ® Mastic,and draw bands must be used in combination with cloth backed rubber adhesive duct tape to seal leaks at all new duct connections' DECLARATION STATEMENT •I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct. •I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized representative of the person responsible for construction (responsible person). •I certify that the installed features,materials,components,or manufactured devices identified on this certificate(the installation) conforms to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the enforcement agency. .I understand that a HERS rater will check the installation to verify compliance,and that that if such checking identifies defects,I am required to take corrective action at my expense.I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations,including those approved as part of a sample group but not checked by a HERS rater,and if those installations 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 group will be performed at my expense. •I reviewed a copy of the Certificate of Compliance(CF-iR)form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF-1R that apply to the installation have been met. •I will ensure that a completed,signed copy of this Installation Certificate 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 signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives,and beginning October 1, 2010,for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) A&R HEATING AND COOLING SERVICE Responsible Person's Name: Responsible Person's Signature: ROBERT GRZEGORCZYK ROBERT GRZEGORCZYK CSLB License: Date Signed: position With Company (Title): 905577 2/20/2014 Is this installation monitored by a Third Party Quality Name of TPQCP(if applicable): Control Program (TPQCP)? p Yes p No Reg: 214-A0006720A-M2100001A-0000 Registration Date/Time: 2014/02/25 13:49:54 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 6) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 City of Lake Elsinore 14-00000260 Note: If installation of a Charge Indicator Display(CID) is utilized as an alternative to refrigerant charge verification for compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is required for compliance, TMAH are also required for compliance, unless the TMAH Compliance Option is chosen. STMS are only required for completely new or replacement space-conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Identification/Tag System 1 System Location or Area Served Whole House 5/16 inch (8 mm) access hole 1 upstream of evaporative coil in the ®Yes ❑Yes 0 Yes ❑Yes return plenum and labeled according ❑ No © No ❑ No ❑ No to Figure,in Section RA3.2.2.2.2. Return side of the duct system j' is located entirely within,conditioned Q1 Yes, C,1.Yes ❑Yes- ❑Yes space and return airflow temperature 0 l�io'' C] No ❑ No ❑ No to be measured at the return girilie. 5/16"i9ch (8rrirn) access h61e 2 downstream of evaporative coil in the 181 Yes ❑Yes ❑Yes' ❑Yes supply plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figure in Section RA3.2.2.2.2. The TMAH Compliance Option should be checked only if the HERS Rater is able to confirm that it was physically impossible for the HVAC Installer to drill the TMAH as required by Section RA3.2.2.2.2. Using this Compliance Option requires the HVAC installer to annotate on the HERS Provider's data registry an explanation as to why the TMAH cannot be installed on the system, and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance Option also requires minimum airflow verification through the direct measurement of airflow per RA3.3. For more information see httD://www.energy.ca.aov/title24/2008standards/special case appliance/ TMAH Compliance Option p ❑ p ❑ Yes to 1 and 2, or Yes to I and 2, or checking the TMAH Compliance Option, is 0 Pass ❑ Pass © Pass © Pass a pass. 0 Fail 0 Fail 0 Fail 0 Fail Enter Pass or Fail Reg: 214-A0006720A-M2500001A-M25A Registration Date/Time: 2014/02/2.5 14:42:51 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms February 2013 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 City of Lake Elsinore 14-00000260 STMS - Sensor on the Evaporator Coil System Name or System 1 Identification/Tag T 3 The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed by methods/specifications approved by the Executive Director. ❑Yes ❑ No I ©Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 4 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil ❑Yes I❑No ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No 5 When attached to a digital thermometer, the sensor provides an indication of the saturation temperature of the coil. ❑Yes [] No ❑Yes ❑ No ❑Yes ❑No Cl Yes ❑ No Yes to 3, 4, and 5 is a pass. ® N/A ❑N/A ❑ N/A ❑ N/A Enter N/A if STMS are not ❑ pass ❑ Pass ❑ Pass ❑Pass applicable. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Otherwise enter Pass or Fail STMS - Sensor on the Condenser Coil System Name or System 1 Identificaticin/Tag 6 The sensor is factory installed, orfield installed;accorc ing to manufacturer's"specification , or is installed by methods/specifications a 7prove'd by the Executive Directcr. 0 Yes ❑ No. Ij Yes L7'"i�o. ❑Y .es ❑No Cl Yes Cl'No The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 7 The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑No When attached to a digital thermometer, the sensor provides an indication of the saturation temperature 8 of the coil. ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑No ©Yes ❑ No Yes to 6, 7, and 8 is a pass. ❑ N/A ❑ N/A ❑ N/A ❑ N/A Enter N/A if STMS are not ❑ pass ❑ Pass ❑ Pass ❑ Pass applicable. ❑Fail ❑Fail ❑ Fail ❑ Fail Otherwise enter Pass or Fail Reg: 214-A0006720A-M250000lA-M25A Registration Date/Time: 2014/02/25 14:42:51 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 City of Lake Elsinore 14-00000260 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. •If outdoor air dry-bulb temperature is less than 55°F, the installer must use the RA3.2.3 Alternate Charge Measurement Procedure(Weigh-In Charging Method). If the Weigh-In Method is used, the dwelling cannot be included in a sample group for HERS verification compliance.) Space Conditioning Systems System Name or Identification/Tag System 1 System Location or Area Served Whole House Outdoor Unit Serial # 0114x64598 Outdoor Unit Make payn Outdoor Unit Model pa13n60-e Nominal Cooling Capacity 5 Tons Date of Verification, 2/25/2014 Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 2/15/2014 (must be re-calibrated monthly) Date of Thermocouple Calibration 2/15/2014 (must be re-calibrated monthly) Measured Temperatures (OF) System Name or Identification/Tag System 1 Supply (evaporator leaving) air dry-bulb 51.1 temperature (Tsu I db) Return (evaporator entering) air 70.4 dry-bulb temperature (Treturn db) Return (evaporator entering) air 56 wet-bulb temperature (Treturn wb) Evaporator saturation temperature 28.4 (Teva orator sat) Condensor saturation temperature 83.5 (Tcondensor, sat) Suction line temperature (Tsuction) 42.3 Liquid Line Temperature (Tliquid) 69.1 Condenser (entering) air dry-bulb 68 temperature (Tcondenser, db) Reg: 214-A0006720A-M2500001A-M25A Registration Date/Time: 2014/02/25 14:42:51 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 City of Lake Elsinore 14-00000260 Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification.The temperature split method is specified in Reference Residential Appendix RA3.2, System Name or Identification/Tag System 1 Calculate: Actual Temperature Split = 19.30 Treturn db -Tsupply, db Target Temperature Split from Table RA3.2-3 19.5 using Treturn wb and Treturn db Calculate difference: Actual Temperature -0.2 Split - Target Temperature Split = Passes if difference is between -40F and +4°F or, upon remeasurement if between -40F and -100°F PASS Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement(CFM)= Nominal Cooling Capacity (ton) X 300 (cfm/torn) System Narne prldentification/Tag Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 procedures (CFM) Measurement Method Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Reg: 214-A0006720A-M2500001A-M25A Registration Date/Time: 2014/02/25 14:42:51 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4111-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 1 City of Lake Elsinore 14-00000260 Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag Calculate: Actual Superheat = Tsuction - Teva orator sat Target Superheat from Table RA3.2-2 using Treturn wb and Tcondenser db Calculate difference: Actual Superheat - Target Superheat = System passes if difference is between -60F and +6°F Enter Pass or Fail Subcooling Charge Method Calculations for Refrigerant Charge Verification.This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Subcooling = 14.4 Tcondenser, sat- Tli uid Target Subcooling specified by 15 manufacturer Calculate difdeence;` -0.6 Actual Subcooling -Target Subcooling System passes if difference is between' -40F and.+4°F `PASS Enter Pass or Fail, Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat = 13.9 Tsuction - Teva orator sat Enter allowable superheat range from manufacturer's specifications (or use range 3-26 between 30F and 26°F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range PASS Enter Pass or Fail Reg: 214-A0006'720A-M2500001A-M25A Registration Date/Time: 2014/02/25 14:42:51 HERS Provider: CaICERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 City of Lake Elsinore 14-00000260 Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all applicable verification criteria must be re-measured and/or recalculated. System Name or Identification/Tag System 1 System meets all refrigerant charge and airflow requirements. PASS Enter Pass or Fail ® Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55°F and 65°F the return air dry bulb temperature shall be maintained above 70OF during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate. DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF-1R) approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s) (CF-6R), signed and submitted by the person(s) responsible for the installation conforms to the,requirements specified().,n the ertificate(s)of Compliance (CF-1R),ap Proved`by the enforcement agency. Builder or Installer informaton. s shown on the Installation Certificate (CF-6111) Company.Name: (Installing Subcontractor or Genehal'Contractor 9r'Builder/0W-ner) A & R HEATING AND,CO04NG*RVICE, Responsible.Person's Name:,, ICSLB License: ROBERT GRZEGORCZYK 905577 HERS Provider Data Registry Information Sample Group # (if applicable): N/A tested/verified dwelling o not-tested/verified dwelling in a HERS sample group HERS Rater Information Ca10ERTS Certificate # CC1-1798832973 HERS Rater Company Name: The Cool Guys Responsible Rater's Name: Responsible Rater's Signature: Steven Gonzales Steven Gonzales Responsible Rater's Certification Number w/this HERS Date Signed: 2 25 2014 Provider: 9 / / CC2004596 Reg: 214-A0006720A-M2500001A-M25A Registration Date/Time: 2014/02/25 14:42:51 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 (System 1) City of Lake Elsinore 14-00000260 Enter the Duct System Name or Identification/Tag: System 1 Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test- Completely New or Replacement Duct System." Duct Leakage Diagnostic Test-existing duct system Select one compliance method from the following four choices. ® 1. Measured leakage less than 15%of fan flow 2. Measured leakage to outside less than 10% of Fan Flow 3. Reduce leakage by 60% and conduct smoke and fix all leaks 4. Fix all accessible leaks using smoke and HERS rater verify Note: (One of Options 1, 2, or 3 must be attempted before utilizing Option 4.) Determine nominal Fan-Flow using one of the following three calculation methods. ✓®Cooling`system method: Size of condenser in Tons 5 x 400 = 2000. CFM ✓©Heating system method:f 21.7 x=Output Capacity in Thousands,of Btu/hr = CFM +�0 Me6sUred system`airflow using RA3.,3 airflow test.procedures: CFM Option JL,used then: . 1 Allowed leakage ='Fan Flow 2000 x 0.15 300 CFM s Actual Leakage = 106 CFM Pass if Leakage Actual is less than Allowed ®Pass❑Fail Option 2 used then: 2 Allowed leakage = Fan Flow_x 0.10 =_CFM Actual Leakage to outside =_CFM Pass if Leakage Actual is less than Allowed ©Pass D Fail Option 3 used then: Initial leakage prior to start of work = CFM Final leakage after sealing all accessible leaks using smoke test = CFM 3 Initial leakage_- Final leakage_= Leakage reduction CFM ((Leakage reduction_/Initial leakage_) x 100% _ % Reduction Pass if% Reduction >= 600/6 ©Pass©Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No sampling). Pass if all accessible leaks have been repaired using smoke Ll Pass❑Fail Reg: 214-A0006720A-M2100001A-M21A Registration Date/Time: 2014/02/25 13:54:44 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 15300 Spyglass , Lake Elsinore CA 92530 (System 1) City of Lake Elsinore 114-00000260 ®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 ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. 19 All supply and return register boots must be_sealed,�to the drywall if smoke testis utilized for compliance - applies to duct leakage compliance option 3 fleakade reduction by 60 0)`and eobtion 4 (fix all`accessible leaks) described above. ® New ducf installations c nnot utlliie;building cavities as plenums r platform;returns in lieu of ducts. ® Mastic arid draw bands must be used in combirlation with cloth backed rubber>adhesive duct tape to seal leaks at all new duct connections: DECLARATION STATEMENT I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate(responsible rater). The installed feature, material,component,or manufactured device requiring HERS verification that is identified on this certificate(the installation)complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s)of Compliance(CF-1R)approved by the local enforcement agency. The information reported on applicable sections of the Installation Certificate(s)(CF-611),signed and submitted by the person(s) responsible for the installation conforms to the requirements specified on the Certificate(s)of Compliance(CF-1R)approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF-6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) A&R HEATING AND COOLING SERVICE Responsible Person's Name: CSLB License: ROBERT GRZEGORCZYK 1905577 HERS Provider Data Registry Information Sample Group # (if applicable): N/A IN tested/verified dwelling a not-tested)verified dwelling in a HERS sample group HERS Rater Information Ca10ERTS Certificate # CC1-1798832973 HERS Rater Company Name: The Cool Guys Responsible Rater's Name: Responsible Rater's Signature: Steven Gonzales Steven Gonzales Responsible Rater's Certification Number w/this HERS Provider: Date Signed: 2/25/2013 CC2004596 Reg: 214-A0006720A-M2100001A-M21A Registration Date/Time: 2014/02/25 13:54:44 HERS Provider: Ca10ERTS, Inc 2008 Residential Compliance Forms March 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-iR-ALT-HVAC Climate Zones 10- 15 Site Address: Enforcement Agency: Date: Permit#: 15300 Spyglass Lake Elsinore, CA 92530 City of Lake Elsinore Jan 28, 2014 7 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat LJ Package Unit IM Furnace ®AFUE 78% ❑COP Setback ❑R 6 (CZ 10-13) Served system ®Indoor Coil N SEER 13.0 ❑ sf HSPF If not already present, must be N Condensing Unit ❑EER ❑Resistance Ll R 8 (CZ 14-15) 2000 installed) ❑Other 1.Equipment Type:Choose the equipment being installed;if more than one system,use another CF-1 R-ALT-HVAC for each system. 2.Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options.The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final,the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010,a registered copy of the CF-1111 and CF-611 shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: .All HVAC Equipment CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF-4R forms: MECH-21 and (for split systems) MECH-25 •Condenser Coil and/or CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS .Indoor Coil and/or CF-4R forms: MECH-21 and (for split systems) MECH-25 . Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement),TMAH ter d...kaged Units- P-1-14 leakage 4 i.S_.r,e.r_rnL=i# Exempted from duct leakage testing if: ® 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑2. Duct systems with less than 40 linear feet in unconditioned space, or ❑3. Existing duct systems are constructed, insulated or sealed with asbestos ❑4. The-system will not be Ducted (ie. ,Ductless Mini-Split System) (Also Exempt frorq Refrigerant Charge) ❑ 2. New HVAC System Required Forms .Cut in'or.Changeout with CF 6R forms` MECH-04, MECH-20-HERS;and.(for split systems) MECH-22-HERS,and new ducts: (all new (WECH-25-HERS ducting and all new &-41k forms: MECH-20, and(for split systems)�MECH-22,and MECH-25 equipment) For Split Systems: Duct leakage <;6 percent; RC,°CCA -e 350 CFM/ton,FWD,TMAH, STMS, and either H5PP or PSPP. ' For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement .Includes replacing or installing all new ducting and/or outdoor condensing unit CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton,TMAH For Packaged Units: Duct leakage < 6 percent ❑4. New Ducting over 40 feet Required Forms: .Includes adding or replacing more than 40 CF-6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF-4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's/Responsible Designer's Declaration Statement) •I certify that this Certificate of Compliance documentation is accurate and complete. •I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. •I certify 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. •The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms,worksheets,calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: ROBERT GRZEGORCZYK Signature: ROBERT GRZEGORCZYK Company: A&R HEATING AND COOLING SERVICE Date: Jan 28, 2014 Address: 15061 ZIEGLINDE DRIVE License: 905577 City/State/Zip: LAKE ELSINORE/CA/92530 Phone: (951) 818-9906 Reg: 214-A0006720A-000000000-0000 Registration Date/Time: 2014/01/28 21:30:34 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010