HomeMy WebLinkAboutFENNEL LANE 35134_13-00002257 CITY OF
�, 1KE L,SI1�ORX BUILDING & SAFETY
+` DREAM FXTREMETM
130 South Main Street
PERMIT
PERMIT NO: 13-00002257
JOB ADDRESS . . . . . : 35134 FENNEL LANE LT101
TENANT NBR, NAME . . TRACT 30495 HILLSIDE
DESCRIPTION OF WORK SINGLE FAMILY RESIDENCE
OWNER _ CONTRACTOR _
PARDEE PARDEE CONSTRUCTION COMPANY
10880 WILSHIRE #1400 35050 CANYON HILLS RD
LOS ANGELES, CA LAKE ELSINORE CA 92532
LOS ANGELES, CA 90024 951-246-2010
LIC EXP 0/00/00
A. P.# . . . . . 358-390-024 SQUARE FOOTAGE 1965
OCCUPANCY . . . DWELLINGS, LODGING HOUSES GARAGE SQ FT 472
CONSTRUCTION . . TYPE V- NON RATED FIRE SPRNKLR
VALUATION . . . 155 , 078 ZONE . . . . . . R-1
BUILDING PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 895 . 00
54 . 00 X 5 . 0000 VALUATION 270 . 00
ELECTRICAL PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 30 . 00
1965 . 00 X . 0500 NEW RES . SINGLE FAM /SQFT 98 . 25
1 . 00 X 1 . 0000 SWITCHES / 1ST 20 1 . 00
1 . 00 X 1 . 0000 RECPT, OUTLET / 1ST 20 1 . 00
1 . 00 X 1 . 0000 LIGHTING FIXTURES/1ST 20 1 . 00
5 . 00 X 4 . 2500 RES . FIXED APPL.OR OUTLET 21 . 25
1 . 00 X 27 . 2500 100-200AMP .SERVICE<600VLT 27 . 25
MECHANICAL PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 30 . 00
1 . 00 X 13 . 2500 FAU/FURNACE/DUCTS/VENTS 13 . 25
6 . 00 X 6 . 5000 VENTILATING FAN 39 . 00
1 . 00 X 9 . 5000 EXHAUST HOOD 9 . 50
1 . 00 X 24 . 2500 COMPRESS/HEATPUMP 3-15 HP 24 . 25
PLUMBING PERMITS
QTY UNIT CHG ITEM CHARGE
BASE FEE 30 . 00
16 . 00 X 8 . 7500 FIXTURE OR TRAP 140 . 00
1 . 00 X 22 . 0000 BUILDING SEWER 22 . 00
tp~: MKrM Typ2: DF
*** CONTINUED ON NEXT PAGE ** : 7/23/13 23 F;Lmmipt no:
2013 351
B' HADN " 1 10R
Trans n : 1
rm/1.12
Tres date: 7/23/13 Time: 13:01:02
City of Lake Elsinore Please read and initial
Building Safety Division 1.1 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.I,as owner of the property,or my employees w/wages as their sole compensation will do the
on the job and the structure is not intended or offered for sale.
t t a of the
1 , s gamer of the property,an-t exclusively contracting with iicensed contractors to construct the 1
V_=oust fbrnis-h PER1v1I1 iv UMBER and the
project.
lu
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 copy thereof.
at all times: 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.
EL01 Temporary_Electric Service
PT.(Ii .-Snit Pipe Underground
EL02 Electric Conduit Underground
BPOI Footings
BP02 Steel Reinforcement
BP03 Grout
BP04 Slab Grade
PLO1 Underground Water Pipe
SS01 Rough Septic System
SWOT On Site Sewer
BPOS JR.Joists
BP06 Floor Sheathing
BP07 Roof Framing
BPO8 Roof Sheathing
BP09 Shear Wall&Pre-Lath
PL03 Rough Plumbing
EL03 Rough Electric Conduit
F.1,04 Rough Electric Wiring
EL05 Rough Electric/ T-Bar
ME01 Rough Mechanical
NIE02 Ducts,Ventilating
PLO4 Rough Gas Pipe/Test
PL02 Roof Drains
BP10 Framing&Flashing
BP 12 Insulation
BP13 Drywall Nailing
BP11 Lathing&Siding
PL99 Final Plumbing
EL99 Final Electrical
ME99 Final Mechanical
BP99 IFinal Building
Code Pool&Spa Approvals Date Inspector OTHER DIVISION RELEASES
Deputy Inspector Department Approval required prior to the
P001 Pool Steel Rein./Forms build
in being released b the City
P001 Pool Plumbing/Pressure Test
P003 Pre-Gunite Approval Date Inspector
EL06 Rough Pool Electric rPlanninSub List Approval e
P004 Pool Fencing/Gates/Alarms Finance
P005 Pre-Plaster Approval Engineering
P009 Final Pool/Spa
CITY OF
; -1K_E ? L,SI_l�C� E BUILDING & SAFETY
DREAM EXTREME,.
130 South Main Street
PERMIT
PERMIT NO: 13- 00002257
** PAGE 2
JOB ADDRESS . . . . . 35134 FENNEL LANE LT101
TENANT NBR, NAME . . TRACT 30495 HILLSIDE
DESCRIPTION OF WORK SINGLE FAMILY RESIDENCE
1 . 00 X 11 . 0000 WATER HEATER OR VENT 11 . 00
1 . 00 X 11 . 0000 GAS PIPING SYS 1-4 OUTLET 11 . 00
1 . 00 X 4 . 2500 .DISHWASHER 4 . 25
1 . 00 X 13 . 2500 LAWN SPRINKLER SYSTEM 13 . 25
1 . 00 X 22 . 0000 BACKFLOW DEVICE >2" 22 . 00
1 . 00 X 8 . 7500 WATER SERVICE 8 . 75
1_. 00 X 15 . 0000 FIRE SPRINKLERS 15 . 00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
BUILDING PERMIT 1165 . 00 . 00 1165 . 00
ELECTRICAL PERMIT 179 . 75 . 00 179 . 75
MECHANICAL PERMIT 116 . 00 . 00 116 . 00
PLUMBING PERMITS 277 . 25 . 00 277 . 25
OTHER FEES
DAG FEE, COTTONWOOD 1000 . 00 . 00 1000 . 00
PROF.DEV. FEE 4 TRADES 20 . 00 . 00 20 . 00,
LIBRARY MITIGATION 150 . 00 . 00 150 . 00
PLANNING REVIEW FEE 233 . 00 . 00 233 . 00
PLAN RETENTION FEE . 78 . 00 . 78
SEISMIC GROUP R 15 . 31 . 00 15 . 31
GREEN BUILDING FEE 4 4 . 00 . 00 4 . 00
GREEN BUILDING FEE 5 3 . 00 . 00 3 . 00
PLAN CHECK FEES 436 . 88 . 00 436 . 88
TOTAL 3600 . 97 . 00 3600 . 97
SPECIAL NOTES & CONDITIONS
NSFR PLAN 3
TUMF EXEMPT - Development Agreement
City of Lake Elsinore Please read and initial
Building Safety Division 1.I 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.t,as owner of the property,or my employees w/wages as their sole compensation will do the x
on the job and the structure is not intended or offered for sale. i l 1 o f the
i s o:: er propc.�y,a.,�exclusively contracting with licensed contractors to construct the 1
iou must furnish PERivfil MCA11BER and the
project.
JOB ADDRESS for each respective inspection: 4.1 have a certificate of consent to selfinsure or a certificate of Workers Compensation Insurance
Approved plans must be on job or a certified copy thereof.
at all times: 5.1 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 Pate lInspectorl you must forthwith comply with such provisions or this permit shall be deemed revoked.
ELO 1 Temporary Electric Service
P101 c,.a v:.,v r r..a.,_,.,.,,.._A
EL02 Electric Conduit Underground
BPOI Footings
BP02 Steel Reinforcement
BP03 Grout
BP04 Slab Graded,
PLO1 Underground Water Pipe
SSO1 Rough Septic System
SW01 10n Site Sewer P9 2;0
BP05 I Floor Joists
BP06 Floor Sheathing
BP07 Roof Framing
BPO8 Roof Sheathing ,)�
BP09 Shear Wall&Pre-Lath .
PL03 Rough Plumbing p•( t fnEi�
EL03 Rough Electric Conduit
EL04 Rough Electric Wiring Ht •Tv�5
EL05 Rough Electric/ T-Bar
MEOI Rough Mechanical D r•1 r--•r
1v1E02 Ducts,Ventilating
PL04 Rough Gas Pipe/Test
PL02 Roof Drains
BPIO Framing&Flashing �-
BP 12 Insulation -7.0 1 N•5�, .
BP13 Drywall Nailing ®• ems,
BPI I Lathing&Siding .�
PL99 Final Plumbing
EL99 Final Electrical (•12 •1 t
ME99 Final Mechanical
BP99 IFinal Building
Code Pool&Spa Approvals Date Inspector OTHER DIVISION RELEASES
Deputy Inspector Department Approval required prior to the
P001 Pool Steel Rein./Forms building be in released by the City
P001 Pool Plumbing/Pressure Test
P003 Pre-Gunite Approval Date Inspector
EL06 Rough Pool Electric Planning
Sub List Approval 1 Landscape
P004 Pool Fencing/Gates/Alarms t , Finance
P005 Pre-Plaster Approval Engineering
P009 Final Pool/Spa
L A KE
1"1-LXC-/LSINORE
I)R F A NA [_XI F2 F N,,A Err, 130 South Main Street
APPLICATION FOR APPI,ICATI(
BUILDING PERMIT C IZWIC'�EIVED
DAI I-
VALUATIONCALCULATIONS
1st FLOOR �SF
2nd FLOOR L
3rd FLOOR 0
ry
GARAGE W A
N ADDRE
STORAGE E :AT-E IP
R
DECK&BALCONIES I sere y a trill that am It licensed tit) er Provisions o c iaptor, Commerical
------------------- SF -
with section 7000)of division 3 Of the business and professions code,ind
OTHER: SF '"Y license- is In full force and effect.
0 LICr NSE#
N CI I-Y BUSINESS
F AND CLASS lAX#
R
A
FEES C, ADDRESS
I- cl,T
BUILDING PERMIT' $ 0
R
PLAN CHECK A
PLAN REVIEW A
R MKI --
SEISMIC C ADDRESS
----------- H
PLAN RETENTION
1-1 NEW OCC GRP I CONS
�
n ADDITION DIVISION, TYPE
DALTERATION NUMBER OF
NUMBER OF
OTHER STORIES, -------BEDROOM$
SINGLE FAMILY ZONE:
5�DAPARTMENTS
0 1 certify that I have lead this application and state that the DCONDOMINIUM HAZARD YES
above information is correct.I agree to comply with all city 7FOWN HOMES AREA? NO
and county ordinances and state laws relating to building I COMMERCIAL SPRINKLERS YES
construction,and hereby authorize representatives of this E]INDUSTRIAL, REQUIRED NO
(j REPAIR
city to enter upon the above,Mentioned property for insp. PROPOSED USE OF BLD
G
0.0EMOLISH PRESENT USE OF BLOG:
JOB DESCRIPTiON
Signature of Applicant or Agent Date
Agent for 0 contractor, )�k�wner
Agents Name
Agents
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-ENV-20
Building Envelope Sealing (Page I of 1
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
BUILDING ENVELOPE SEALING
Diagnostic Testing Results
CFM50H—the measured airflow in cubic feet per minute(cftn)at 50 pascals for the dwelling with air distribution registers unsealed.
SLA =3.819 x(CFM50H/Conditioned Floor Area in ft')per Residential ACM Manual Equation R3-16
Building Envelope Leakage CFM50H as measured using a blower door diagnostic device ✓ ✓
I Enter the blower door leakage target CFM50H value for compliance
from the CF-1R(cfm).
2 Enter the blower door leakage minimum CFM50H value corresponding to 1.5 SLA
from the CF-1R(cfm).
3. Enter the measured CFMSOHvalue from the blower door test(cfm)
The leakage test passes if the measured envelope leakage CFM501.1 value from row is 3 less ❑ ❑
4. than or equal to the value required for compliance from row 1,otherwise the test fails.
check/enter Pass or Fail Pass Fail
If measured CFM50H from row 3 is less than the minimum CFM50H value corresponding to El El
5. 1.5 SLA from row 2: check/enter < 1.5 SLA,otherwise check/enter>1.5 SLA < 1.5 >1.5
SLA* SLA
*Advisory note to builder and enforcement agency: If row 5 indicates "< 1.5 SLA",it is critical to ensure that combustion
and solid-fuel burning appliances in the dwelling are provided with adequate combustion and ventilation air and vented in
accordance with manufacturers'installation instructions and all applicable codes as specified by ASHRAE Standard 62.2
Section 6.4. Additional information about compliance with this requirement is given in Section 4.6.5 of the Residential
Compliance Manual under the topic of Combustion and Solid-Fuel Burning Appliances.
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-I R)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 on the Certificate(s)of Compliance(CF-I R)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)
Pardee Homes
Responsible Person's Name: CSLB License:
Ron Nugroho B-General Contractor(251810)
HERS Provider Data Registry Information
Sample Group#(if applicable): ❑ tested/verified dwelling ® not-tested/verified dwelling
RNCO2515 in a HERS sample group
HERS Rater Information
HERS Rater Company Name:
DuctTesters, Inc.
Responsible Rater's Name Responsible Rater's Signature
Jason Samaniego Jason Samaniego
Responsible Rater's Certification Number w/this HERS Provider: Date Signed:
RCN10105 11/22/2013 1:42 PM
Registration Number: 413-N0003832A-E2000089a-E20A Registration Date/Time: 11/22/2013 1:42 PM HERS Provider: CHEERS
2008 Residential Compliance Forms August 2009
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-ENV-21
Quality Insulation Installation QII - Framing Stage Checklist (Page 1 of 2
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore -7 13-00002257
Quality Insulation Installation QII) Framing Stage Checklist
Air barrier installation and preparation for insulation must be done at framing stage before insulation is installed. If there
are any"No"answers,rows not filled out,or a signature missing then this is not a valid form and cannot be accepted by the
building department or HERS rater.
SPF insulation can be considered an air barrier when the bottom and top plates of vertical framing and both ends of
horizontal framing,including band and rim joists,are sprayed to completely fill the cavity adjacent to and in contact with
the framing to a distance of 5.5 inches away from the framing for open cell SPF(ocSPF)or 2.0 inches away from the
framing for closed cell SPF(ccSPF). SPF can be considered as an air barrier with less than the above thickness when a
product data or specification sheet is provided that shows the product meets an air permeance no greater than 0.02 L/s-m2
at 75 Pa pressure differential when tested in accordance to ASTM E2178 or ASTM E283.
All structural framing areas shall be insulated in a manner that resists thermal bridging of the assembly separating
conditioned from unconditioned space. Structural bracing,tie-downs,and framing of steel,or specific framing used to meet
structural requirements of the CBC are allowed and must be insulated. These areas shall be called out on the building plans
with diagrams and/orspecific design drawings indicating the R-value of insulation and fastening method to be used.
✓ FLOOR AIR BARRIER
❑ ❑ ❑ All gaps in the raised floor to unconditioned space or to outside larger than 1/8"filled with foam or
Yes No NA caulk.(NA if SPF meets conditions above)
❑ ❑ ❑ All openings in the raised floor including second floors,such as under a tub where the drain
Yes No NA penetrates the floor are sealed.(NA if slab ongrade)
✓WALLS AIR BARRIER
❑ ❑ ❑ All gaps to outside larger than 1/8"filled with foam or caulk.(NA if SPF meets conditions above)
Yes No NA
❑ ❑ ❑ All openings in top and bottom plate to the outside in interior and exterior walls, including holes
Yes No NA drilled for electrical and plumbing larger than 1/8"filled with foam or caulk.(NA if SPF meets
conditions above)
❑ ❑Ye Rope caulk,foam gasket,or caulking bead under exterior sole plate of the home.
s No
❑ ❑ All gaps around windows and doors caulked or foamed. Low expanding foam recommended if
Yes No allowed by window manufacturer.(Stuffing with fiberglass not acceptable)
✓ ATTIC INSPECTION
❑ ❑ ❑ Attic rulers appropriate to the material installed are evenly distributed throughout attic to verify
Yes No NA depth.(NA if SPF or batt)
❑ ❑ ❑ Number of rulers installed
Yes No NA Attic area(sqft) -250= minimum number of rulers installed. Must round up.
(NA if SPF or batt)
❑ ❑ ❑ Ventilation baffles installed at all Cave vents to prevent air movement under or into insulation.
Yes No NA (NA if SPF meets conditions above)(NA if unvented attic)
❑ ❑ ❑ Net free-ventilation area of the eave vent maintained from eave vent,past insulation,to attic space.
Yes No NA (NA if no eave vents or SPF)
✓ CEILING AIR BARRIER
❑ ❑ ❑ All draft stops in place to form a continuous ceiling air barrier no gaps larger than 1/8". (NA if SPF
Yes No NA meets conditions above)
❑ ❑ ❑ All dropped ceilings/soffits covered with hard covers. Gaps around or in the hard cover larger than
Yes No NA 1/8"filled with foam or caulk. (NA if no drops)
❑ ❑ ❑ Openings around flue shafts fully sealed with flashing and caulked.(NA if no flue shafts)
Registration Number: 413-N0003832A-E2100083A-E21A Registration DatelTime: 11/22/2013 1:42 PM _HERS Provider: CHEERS
2008 Residential Compliance Forms May 2012
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-ENV-21
Quality Insulation Installation (QII) -Framing Stage Checklist (Page 2 of 2)
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
Yes No NA
❑ ❑ ❑ Piping shaft openings fully sealed and caulked. (NA if no pipe shafts)
Yes No NA
❑ ❑ ❑ Penetrations through the ceiling air barrier from electrical boxes in the ceiling,fire alarm boxes,etc.sealed with
Yes No NA caulk or foam. (NA if no penetrations)
❑ ❑ ❑ All duct chases,fireplace chases,and double walls sealed air tight at the ceiling level. All gaps into shafts larger
Yes No NA than 1/8"filled with foam or caulk(NA if none of the above or SPF meets conditions above)
✓ GARAGE/CEILING AIR BARRIER FOR TWO STORIES (no conditioned space over garage)
❑ ❑ ❑ Air barrier installed at joists in garage to house transition (between floors). No gaps larger than 1/8"
Yes No NA allowed. (NA if SPF meets conditions above)
✓ GARAGE/CEILING AIR BARRIER FOR TWO STORIES(conditioned space over garage)
❑ ❑ ❑ If insulation is to be installed at subfloor then subfloor has no gaps over 1/8". Air barrier installed at
Yes No NA joists in garage to house transition (between floors). Use of SPF meeting conditions above as the air
barrier satisfies the requirement to seal the gaps.
❑ ❑ ❑ If insulation is to be installed at ceiling of garage then ceiling and joists to the outside have no gaps
Yes No NA over 1/8". (NA if SPF meets conditions above or no conditioned space over garage.)
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 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 and Phone Number: (Installing Subcontractor or General Contractor or Builder/Owner)
Quality Interiors
Responsible Person's Name: CSLB License:
Jennifer Dinsmore C-2 Insulation(802519)
HERS Provider Data Registry Information
Sample Group#(if applicable): ❑ tested/verified dwelling ® not-tested/verified dwelling
RNCO2515 in a HERS sample group
HERS Rater Information
HERS Rater Company Name and Phone Number:
DuctTesters, Inc.
Responsible Rater's Name Responsible Rater's Signature
Jason Samaniego Jason Samaniego
Registration Number: 413-N0003832A-E2100083A-E21A Registration DatelInne: 11/22/2013 1:42 PM HERS Provider: CHEERS
2008 Residential Compliance Forms May 2012
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-ENV-22
Quality Insulation Installation QII - Insulation Sta a Checklist (Pagel of 3
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
All structural framing areas shall be insulated in a manner that resists thermal bridging of the assembly separating conditioned from
unconditioned space. Structural bracing,tie-downs,and framing of steel,or specialized framing used to meet structural requirements of
the CBC are allowed and must be insulated. These areas shall be called out on the building plans with diagrams and/or specific design
drawings indicating the R-value of insulation and fastening method to be used.
SPF insulation can be considered an air barrier when the bottom and top plates of vertical framing and both ends of horizontal framing,
including band and rim joists,are sprayed to completely fill the cavity adjacent to and in contact with the framing to a distance of 5.5
inches away from the framing for open cell SPF(ocSPF)or 2.0 inches away from the framing for closed cell SPF(ccSPF). SPF can be
considered as an air barrier with less than the above thickness when a product data or specification sheet is provided that shows the
product meets an air permeance no greater than 0.02 L/s-m2 at 75 Pa pressure differential when tested in accordance to ASTM E2178 or
ASTM E283.
Closed cell and open cell manufacturers claim various R-values per inch. In California the maximum R-value that can be claimed for
ceSPF is an R-value of 5.8 per inch and for ocSPF is an R-value of 3.6 per inch. Higher R-values per inch cannot be claimed even with
manufacturer data.
Insulation Stage Checklist
✓FL,OOR INSULATION
❑ ❑ ❑ All floor joist cavity insulation installed to uniformly fill the cavity side-to-side and end-to-end,NO gaps. (NA if
Yes No NA slab on grade)
❑ ❑ ❑ Insulation in full contact with the subfloor,NO gaps. (NA if slab on grade)
Yes No NA
❑ ❑ ❑ Batts:cut to fit around wiring and plumbing,or split(delaminated). (NA if loose fill,SPF,or slab on grade)
Yes No NA
❑ ❑ ❑ Batts: shall be properly supported to avoid gaps,voids,and compression. (NA for other forms of insulation)
Yes No NA
❑ ❑ ❑ Insulation R-value same or greater than listed on CF-1R.(NA for slab on grade)
Yes No NA
❑ ❑ ❑ Gaps between studs larger than 1/8"the cavity must be filled with insulation or foam. (NA for slab on grade)
Yes No NA
❑ SPF: list the required floor cavity R-value from CF-1R,R- Determine required thickness for ccSPF
NA (required R-value_/5.8R)=_inches),or required thickness for ocSPF(required R-value_/3.6=
inches).(NA for other forms of insulation)
❑ ❑ ❑ SPF: measure thickness of floor insulation in 6 random areas. Minimum thickness for ccSPF shall be no more
Yes No NA than%2 inch less than the required thickness listed above. Minimum thickness for ocSPF shall be no more than 1
inch less than the required thickness listed above. (NA for other forms of insulation)
✓WALL INSULATION
Batts,loose fill mineral fiber,mineral wool,and cellulose: tills cavity and is in contact with air barrier.
❑ ❑ ❑ ocSPF: shall completely fill cavities of 2x4 inch framing or less. Cavities greater than 2x4 inch framing
Yes No NA dimensions must be filled to the thickness calculated above.
ccSPF: insulation is not required to fill the cavities of framed assemblies provided the installed thickness of
insulation conforms to the thickness calculated above.
❑ ❑ ❑ Double walls and bump-outs-insulation fills the cavity or additional air barrier installed in the cavity so that the
Yes No NA insulation fills the cavity and in contact with the air barrier.(NA if SPF meets conditions above and meets the
required R-value)
❑ ❑ ❑ Insulation installed in exterior walls adjacent to tub/shower,walls under stairs,and fireplace. Insulation required
Yes No NA to fill wall cavity. Cavity required to be air tight.(NA if none of the above)
❑ ❑ 11
All gaps around windows and doors filled with insulation or filled with low expanding foam.
Yes No
❑ ❑ ❑ Batts:no voids/depressions greater than 3/4"in ANY stud bay.(NA for other forms of insulation)
Yes No NA
❑ ❑ ❑ Batts: voids/depressions less than 3/4"allowed as long as the area is not greater than 10%of the surface area for
Yes No NA each stud bay. NA for other forms of insulation)
❑ ❑ ❑ Loose Fill: no gaps or voids. Insulation completely tills the cavity.(NA for other forms of insulation)
Yes No NA
❑ ❑ 1 1 Gaps between studs larger than 1/8"the cavity must be filled with insulation or foam.
Yes No
Registration Number: 413-N0003832A-E2200084A-E22A Registration Uatel'me: 11/22/2013 1:42 PM HERS Provider: CHEERS
2008 Residential Compliance Forms May 2012
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-ENV-22
Quafity Insulation Installation ( II) -Insulation Sta a Checklist (Page 2 of 3)
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
❑ ❑ ❑
Yes No NA All Rim joists to the outside insulated. (NA if no Rim joists)
❑ ❑ ❑ Insulation installed at corner channels,wall intersections,and adjacent to tub/shower enclosures insulated to
Yes No NA proper R-Value.
❑ ❑ ❑ All skylight shafts and attic kneewalls insulated with minimum R-19. (NA if no skylights,kneewalls or in
Yes No NA conditioned attic)
❑ ❑ ❑ Insulation in full contact with air barrier or wall finish for skylight shafts and attic kneewalls. (NA if no skylight or
Yes No NA kneewalls)
❑ ❑Yes No Installed wall insulation R-value equal to or greater than what is listed on the CF-1R.
❑ ❑ ❑ SPF: insulation installed without gaps and to provide an air seal when specified as an air barrier. (NA for other
Yes No NA forms of insulation)
❑ SPF: list the required wall cavity R-value from CF-1R,R- Determine required thickness for ccSPF
NA (required R-value_/5.8R)=_inches),or required thickness for ocSPF(required R-value_/3.6=
inches). (NA for other forms of insulation)
❑ ❑ ❑ SPF: measure thickness of wall insulation in 6 random areas. Minimum thickness for ccSPF shall be no more
Yes No NA than'/2 inch less than the required thickness listed above. Minimum thickness for ocSPF shall be no more than 1
inch less than the required thickness listed above. (NA for other forms of insulation)
✓ CEILING/ROOF INSULATION
❑ ❑ Gaps between studs larger than 1/8"the cavity must be filled with insulation or foam.
Yes No
❑ ❑ ❑ Batts: no gaps/voids/depressions greater than 3/4". (NA for other forms of insulation)
Yes No NA
❑ ❑ ❑ Batts: voids/depressions less than 3/4"allowed as long as the area is not greater than 10%of the surface area for
Yes No NA each stud bay. (NA for other forms of insulation)
❑ ❑ ❑ Loose Fill: NO gaps or voids allowed.,(NA for other forms of insulation)
Yes No NA
❑ ❑ All ceiling/roof insulation installed to uniformly fit the cavity side-to-side and end-to-end.
Yes No
❑ ❑ Insulation in full contact with the ceiling/roof,NO gaps.
Yes No
❑ ❑ Insulation in contact with air barrier.
Yes No
❑ ❑ ❑ Batts: cut to fit around wiring and plumbing,or split(delaminated). (NA for other forms of insulation)
Yes No NA
❑ ❑ ❑ Batts taller than bottom chord must expand over the bottom chord or additional insulation installed so bottom
Yes No NA chord not visible. (NA for other forms of insulation)
❑ ❑ ❑ Batts cut to fit around ALL webbing. No gaps allowed between webbing and batts. (NA for other forms of
Yes No NA insulation)
❑ SPF: list the required ceiling R-value from CF-1R,R . Required depth of insulation for ccSPF(required
NA R-value_/5.8R= inches),or required depth of ocSPF(required R-value_/3.6=_inches). (NA
for other forms of insulation)
❑ ❑ ❑ SPF: measure thickness of ceiling insulation in 6 random areas. Minimum thickness for ccSPF shall be no
Yes No NA more than'/2 inch less than the required thickness listed above. Minimum thickness for ocSPF shall be no more
than 1 inch less than the required thickness listed above. (NA for other forms of insulation)
❑ ❑ ❑ HVAC Platform and Catwalks-insulated to R-value equal to ceiling R-value listed on CF-1R. If less
Yes No NA insulation installed then called out on CF-1R. (NA if no platform or catwalks)
❑ ❑ ❑
Yes No NA Attic access gasketed. (NA of no attic access)
❑ ❑ ❑ Attic access insulated with rigid foam or batt insulation using adhesive or mechanical fastener. Attic access door
Yes No NA R-value equal to ceiling R-value listed on CF-1R. If less insulation installed then called out on CF-1R. (NA if
no attic access)
❑ ❑ ❑ Recessed light fixtures covered full depth with insulation. If SPF used then other forms of insulation used to
Yes No NA cover or enclose fixture in a box fabricated from'/z-inch plywood, 18 ga.sheet metal, 1/4-inch hard board or
drywall. SPF or other insulation then covers light fixture to full depth. (NA is no recessed light fixtures)
❑ ❑ ❑ All recessed light fixtures in non conditioned space are IC rated and air tight(AT). (NA if no recessed light
Yes I No I NA I fixtures)
Registration Number.- 413-N0003832A-E2200084A-E22A Registration DatelTijne: 11/22/2013 1:42 PM HERS Provider. CHEERS
2008 Residential Compliance Forms May 2012
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-ENV-22
Quality Insulation Installation ( II) - Insulation Stage Checklist (Page 3 of 3)
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
❑ ❑ ❑ All recessed light fixtures are sealed with a gasket or caulk between the housing and the ceiling. (NA if no
Yes No NA recessed light fixtures)
❑ ❑ Ceiling insulation equal to or greater than what is listed on the CF-IR.
Yes No
❑ ❑ ❑ Loose Fill: Minimum thickness required to meet the stated R-value listed on CF-1R.Insulation rulers visible for
Yes No NA verifying the installed R-value for blown in insulation. (NA for other forms of insulation)
❑ ❑ ❑ Loose Fill: insulation uniformly covers the entire ceiling(or roof)area from outside of all exterior walls. (NA
Yes No NA for other forms of insulation)
Weight of Mineral-Fiber Loose-fill(Fiberglass,Rock wool)-Target R-value (from CF-1R) Minimum
❑ ❑ ❑ weight from insulation bag label to meet target R-value (lb./ft2) . Weight of insulation from coring tool
Yes No NA _(lb).Area of coring tool (ftz). Sample weight= (lb./ftz).Is sample weight(lb./ftz) the same as or
.greater than required weight(lb./ftz) (NA for other forms of insulation)
Thickness-ALL Loose-Fill Insulation-Target R-value(from CF-1R)_.Required thickness from
❑ ❑ ❑ insulation bag label to meet Target R-value for(Installed Thickness (in)),and(Settled Thickness
Yes No NA (in)). Average Installed thickness min). Is Installed Thickness the same as or greater than Required
Thickness? (NA for other forms of insulation)
✓ GARAGE ROOF/CEILING INSULATION FOR TWO STORIES(no conditioned space over garage)
❑ ❑No ❑ Insulation installed at rim joists against the air barrier in the garage to house transition(between floors). (NA if
Yes I NA I conditioned space over garage or single story).
✓ GARAGE ROOF/CEILING INSULATION FOR TWO STORIES(conditioned space over garage)
❑ ❑ ❑ If insulation is installed at subfloor above garage-then insulation must also be installed at joists against the air
Yes No NA barrier in the garage to house transition(between floors) and to R-value as specified on CF-IR. (NA if no
conditioned space over garage or single story)
❑ ❑ ❑ If insulation is installed on ceiling of garage-then the joists to the outside(front,and both sides) must be
Yes No NA insulated to the R-valuespecified on CF-1R. (NA if no conditioned space over garage or single story)
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 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 and Phone Number: (Installing Subcontractor or General Contractor or Builder/Owner)
Quality Interiors
Responsible Person's Name: CSLB License:
Jennifer Dinsmore C-2 Insulation(802519)
HERS Provider Data Registry Information
Sample Group#(if applicable): ❑ tested/verified dwelling ® not-tested/verified dwelling
RNCO2515 in a HERS sample group
HERS Rater Information
HERS Rater Company Name and Phone Number:
DuctTesters, Inc.
Responsible Rater's Name Responsible Rater's Signature
Jason Samaniego Jason Samaniego
Responsible Rater's Certification Number w/this HERS Provider: Date Signed:
RCN10105 11/22/2013 1:42 PM
Registration Number: 413-N0003832A-E2200084A-E22A Registration Date/Time: 11/22/2013 1:42 PM HERS Provider.' CHEERS
2008 Residential Compliance Forms May 2012
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-20
Duct Leakage Test—Completely New or Replacement Duct System (Page 1 of 2
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
Enter the Duct System Name or Identification/Tag:
Enter the Duct System Location or Area Served:
Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling.
This certificate is required for compliance for completely new duct systems installed in new dwelling construction, and also
for completely new or replacement duct systems in existing dwellings. 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.
Duct Leakage Diagnostic Test—completely new or replacement ducts stem
Enter a value for the Allowed Leakage(CFM)for the duct system leakage verification. The value entered must be the
Verified Low Leakage Ducts in Conditioned Space criteria or one of the three calculated leakage rates described below.
Verified Low Leakage Ducts in Conditioned Space(VLLDCS)Compliance Credit. If compliance credit Allowed
for verified low leakage ducts in conditioned space is shown in the special features section of the CF-I R,the Leakage
leakage to outside test method must be used to verify duct leakage(refer to RA3.1.4.3.4),and 25 CFM must be (CFM)
entered for Allowed Leakage.
Allowed leakage calculation—(select one calculation method from this section). Use 6%(leakage factor=
0.06)for calculations. When utilizing Low Leakage Air Handler(LLAH)credit,the allowed duct leakage may
be specified by the CF-1R to be less than 6%, in which case the user-specified leakage rate must be used in the
calculations below. For example,if the user-specified leakage(specified as a percentage of fan airflow)is
reported on the CF-I R as 3%,then use a leakage factor of 0.03 in the calculations below.
❑ Cooling system method:
Nominal capacity of condenser in Tons x 400 x leakage factor = (CFM)
❑ Heating system method:
21.7 x Output Capacity in Thousands of Btu/hr x leakage factor= (CFM)
❑ Measured airflow method(RA3.3):
Enter measured fan flow in CFM here x leakage factor = (CFM)
Enter value for Actual leakage(CFM)in the right column,from measurement using applicable duct leakage ActualLeakage
pressurization test procedure from Reference Residential Appendix RA3.1(CFM @ 25 Pa). (CFM)
List Actual Leakage from duct leakage test(CFM)
Pass if Actual Leakage is less than Allowed Leakage ❑Pass❑Fail
For complete replacement of duct systems only,if the 6 percent leakage rate criteria cannot be met,a smoke
test should be performed to verify that the excess leakage is coming only from a pre-existing furnace cabinet
(air handler cabinet),and not from other accessible portions of the duct system. A HERS rater must verify the
installation(No sampling allowed). List Actual Leakage from smoke test(CFM)
Pass if all accessible leaks(except for existing air handler)are sealed using smoke ❑Pass❑Fail
Registration Number: 413-N0003832A-M2000094A-M20A Registration DatelTime: 11/22/2013 1:42 PM HERS Provider: CHEERS
2008 Residential Compliance Forms August 2009
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-20
Duct Leakage Test-Completely New or Replacement Duct System (Page 2 of 2)
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
❑ 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
❑ 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 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-6R),signed and submitted by the person(s)
responsible for the installation conforms to the requirements specified on the Certificate(s)of Compliance(CFAR)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)
Total Comfort,Inc.
Responsible Person's Name: CSLB License:
Steven C000per C20 HVAC(935238)
HERS Provider Data Registry Information
Sample Group#(if applicable): ❑ tested/verified dwelling ® not-tested/verified dwelling
RNCO2515 in a HERS sample group
HERS Rater Information
HERS Rater Company Name:
DuctTesters, Inc.
Responsible Rater's Name Responsible Rater's Signature
Jason Samaniego Jason Samaniego
Responsible Rater's Certification Number w/this HERS Provider: Date Signed:
RCN10105 11/22/2013 1:42 PM
Registration Number: 413-N0003832A-M2000094A-M20A Registration DatelTtme: 11/22/2013 1:42 PM HERS Provider: CHEERS
2008 Residential Compliance Forms August 2009
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-4R-MECH-23
Verification of High EER Equipment (Page I of 1
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
Verification of High EER Equipment
Procedures for verification of High EER Equipment are described in Reference Residential Appendix RA3.4. For dwelling units with
multiple systems, the procedures must be applied to each system separately. As many as 4 systems in the dwelling can be documented for
compliance using this fibrin. Attach an additional orm(s) or any additional s stems in the dwelling as applicable.
1 System Name or Identification/Tag
2 System Location or Area Served
3 Certified EER Rating of the installed
equipment(Btu/Watt-hr)
4 Make and Model Number of the installed
Outdoor Unit
5 Make and Model Number of the installed
Inside Coil
6 Make and Model Number of the installed
Furnace or Air Handler.
7 Minimum Equipment EER required for
compliance as reported on the CF-I R
❑ When a high EER system specification includes a time delay relay,the installation of the time delay relay must be verified for
compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Time Delay Relay Verification Procedure.
❑ When installation of specific matched equipment is necessary to achieve a high EER,installation of the specific equipment must be
verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Matched Equipment Verification Procedure.
If the Certified EER Rating in row 3 is
equal or greater than the required
8 minimum EER in row 7,the unit
complies.
If the unit complies enter Pass
DECLARATION STATEMENT
• I certify under penalty of perjury,raider 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-IR)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 on the Certificate(s)of Compliance(CF-I R)approved by the
enforcement agency.
Builder or Installer information as shown on the Installation Certificate CF-611
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Total Comfort,Inc.
Responsible Person's Name: CSLB License:
Steven C000per C20 HVAC(935238)
HERS Provider Data Registry Information
Sample Group If(if applicable): ❑ tested/verified dwelling ® not-tested/verified dwelling
RNCO2515 in a HERS sample group
HERS Rater Information
HERS Rater Company Name:
DuctTesters, Inc.
Responsible Rater's Name Responsible Rater's Signature
Jason Samaniego Jason Samaniego
Responsible Rater's Certification Number w/this HERS Provider: Date Signed:
RCN10105 11/22/2013 1:42 PM
Registration Number: 413-N0003832A-M2300093A-M23A Registration DatelTime: 11/22/2013 1:42 PM _ HERS Provider: CHEERS
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-ENV-20-HERS
Building Envelope Sealing (Page I of 3)
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
BUILDING ENVELOPE SEALING
Two methods are available to the installer for demonstrating compliance with the building envelope sealing requirement:
1) Rough Frame Inspection Checklist and Final Inspection Checklist, or 2)Building Envelope Leakage Diagnostic Test
utilizing a blower door diagnostic test instrument. Note: HERS verification of the actual envelope leakage is required to
be performed using the Building Envelope Leakage Test. In order to receive credit for the Building Envelope Sealing
measure, the dwelling must comply with the HERS verification requirements. Completion of the Rough Frame Inspection
Checklist and Final Inspection Checklist does not insure that the envelope will meet the requirements of the HERS
verification procedure.
la. Rough Frame Inspection Checklist
Sole Plate
El Entire sole plate of the home is either Rope caulk,foam gasket,or with caulking bead scaled.
Top Plate
• All electrical penetrations between conditioned and unconditioned spaces sealed with foam
• All piping penetrations between conditioned and unconditioned spaces sealed with foam
Ceiling
EI Ceiling forms a continues air barrier and any gaps or openings are filled with foam
El All recessed light fixtures in unconditioned space are IC(Insulation Contact)and AT(Air tight)rated and a gasket
or sealing material is installed.
El All duct chases,fireplace chases,and double walls sealed air tight at the ceiling level. All gaps into
shafts must be filled with foam or caulk.
0 Openings around flue shafts fully sealed with solid blocking or flashing and any remaining gaps sealed with fire-
rated caulk or sealant.
IZI Penetrations from wiring sealed with caulk or sealant
Floor Air Barrier
0 All gaps in the raised floor between conditioned and unconditioned space(or to outside)filled with foam or caulk.
EI All openings under a tub where the drain penetrates the floor sealed
0 Garage band joist must be air tight at bays adjoining conditioned space
Walls
0 All gaps around the windows caulked
El All gaps in exterior wall sheathing between conditioned and unconditioned space(or to outside)filled with foam
or caulk
El All gaps in sheathing between conditioned space and the garage,attic,or covered patio filled with foam or caulk
El All other penetrations or cracks between conditioned and unconditioned space(the exterior of the home)sealed
with foam or caulk
HVAC
Ensure that the following are sealed with an approved UL 181 mastic or tape:
Duct Work
❑� All register boot seams
0 Return seams
EI Return and supply collars
El Duct collars
El Duct board,T and Y seams
Furnace
EI FAU seams
EI FAU door
EI Coil box is air tight including seams,condensate line,knockouts,and lineset.
EI Supply and return plenums
HERS Provider: CHEERS Registration Number: 413-N0003831A-E2000126A_0000 Registration Date: 11/22/2013 11:15 AM
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-ENV-20-HERS
Building Envelope Sealing (Page 2 of 3)
Site Address: Enforcement Agency: Tlp3-00002257
ermit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore
lb. Final inspection Checklist
All gaps and penetrations in the drywall must be caulked or gasketed. All gaps and penetrations in the exterior sheathing
must be caulked or gasketed Some examples are:
Ceiling Penetrations
El All HVAC register boots are sealed to the drywall with caulking or tape
0 All returns are sealed to the drywall
❑� All lighting fixtures are sealed to the drywall with a gasket,caulking or tape
El Any other penetrations to the drywall(for example fire sprinklers,whole house fans,surround sound speakers,
ceiling outlet box etc.)are sealed with caulk or tape
El Attic access door is installed with weather stripping
Wall Penetrations
EI All electrical outlets and switches are installed and sealed
El Any other penetrations to the drywall or exterior walls are sealed
General Inspections
El Flooring is installed
El Weather stripping is installed on doors and windows
El Exhaust fan dampers for kitchen and bath fans installed and working
PIERS provider: CHEERS Registration Number: 413-N0003831A-E2000126A-0000 Registration Date: 11/22/2013 11:15 AM
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-ENV-20-HERS
Building Envelope Sealing (Page 3 of 3)
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
2. Building Envelope Leakage Test
Diagnostic Testing Results
CFM5011=the measured airflow in cubic feet per minute(cfrn)at 50 pascals for the dwelling with air distribution registers unsealed.
SLA =3.819 x(CFM50H/Conditioned Floor Area in f 2)per Residential ACM Manual Equation R3-16
Building Envelope Leakage CFM50H as measured using a blower door diagnostic device ✓ ✓
I Enter the blower door leakage target CFM50H value for compliance
from the CF-1R(cfm).
2 Enter the blower door leakage minimum CFM50H value corresponding to 1.5 SLA
from the CF-1R(cfm).
3. Enter the measured CFM50H value from the blower door test(cfm)
The leakage test passes if the measured envelope leakage CFM50H value from row is 3 less ❑ ❑
4. than or equal to the value required for compliance from row 1,otherwise the test fails.
check/enter Pass or Fail Pass Fail
If measured CFM50H from row 3 is less than the minimum CFM50H value corresponding to ❑
5. 1.5 SLA from row 2: check/enter < 1.5 SLA,otherwise check/enter>1.5 SLA < 1.5 >1.5
SLA* SLA
*Advisory note to builder and enforcement agency: if row 5 indicates"< 1.5 SLA", it is critical to ensure that combustion
and solid-fuel burning appliances in the dwelling are provided with adequate combustion and ventilation air and vented in
accordance with manufacturers'installation instructions and all applicable codes as specified by ASHRAE Standard 62.2
Section 6.4. Additional information about compliance with this requirement is given in Section 4.6.5 of the Residential
Compliance Manual under the topic of Combustion and Solid-Fuel Burning Appliances.
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.
• 1 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-IR 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)
Pardee Homes
Responsible Person's Name: Responsible Person's Signature:
Ron Nugroho Ron Nugroho
CSLB License: Date Signed: Position With Company(Title):
B-General Contractor(251810) 11/22/2013 11:15 AM Builder
FIERSProvider: CHEERS__ Registration Number: 413-N0003831A-E2000126A-0000 Registration Date: 11/22/201311:15AN
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-611-ENV-2I-HERS
Quality Insulation Installation QII - Framing Stage Checklist (Page 1 of 2
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
Quality Insulation Installation(QII) Framing Stage Checklist
Air barrier installation and preparation for insulation must be done at framing stage before insulation is installed. If there
are any"No"answers,rows not filled out,or a signature missing then this is not a valid form and cannot be accepted by the
building department or HERS rater.
SPF insulation can be considered an air barrier when the bottom and top plates of vertical framing and both ends of
horizontal framing, including band and rim joists,are sprayed to completely fill the cavity adjacent to and in contact with
the framing to a distance of 5.5 inches away from the framing for open cell SPF(ocSPF)or 2.0 inches away from the
framing for closed cell SPF(ccSPF). SPF can be considered as an air barrier with less than the above thickness when a
product data or specification sheet is provided that shows the product meets an air permeance no greater than 0.02 L/s-m2
at 75 Pa pressure differential when tested in accordance to ASTM E2178 or ASTM E283
All structural framing areas shall be insulated in a manner that resists thermal bridging of the assembly separating
conditioned from unconditioned space. Structural bracing,tie-downs,and framing of steel,or specific framing used to meet
structural requirements of the CBC are allowed and must be insulated. These areas shall be called out on the building plans
with diagrams and/orspecific design drawings indicating the R-value of insulation and fastening method to be used.
✓ FLOOR AIR BARRIER
El ❑ ❑ All gaps in the raised floor to unconditioned space or to outside larger than 1/8"filled with foam or
Yes No NA caulk.(NA if SPF meets conditions above)
El ❑ ❑ All openings in the raised floor including second floors,such as under a tub where the drain
Yes No NA penetrates the floor are sealed. NA if slab ongrade)
✓WALLS AIR BARRIER
❑ ❑ ❑ All gaps to outside larger than 1/8"filled with foam or caulk.(NA if SPF meets conditions above)
Yes No NA
0 ❑ ❑ All openings in top and bottom plate to the outside in interior and exterior walls,including holes
Yes No NA drilled for electrical and plumbing larger than 1/8"filled with foam or caulk.(NA if SPF meets
conditions above)
El ❑ Rope caulk,foam gasket,or caulking bead under exterior sole plate of the home.
Yes No
El ❑ All gaps around windows and doors caulked or foamed. Low expanding foam recommended if
Yes No allowed by window manufacturer.(Stuffing with fiberglass not acceptable)
✓ ATTIC INSPECTION
0 ❑ ❑ Attic rulers appropriate to the material installed are evenly distributed throughout attic to verify
Yes No NA depth.(NA if SPF or batt)
❑� ❑ ❑ Number of rulers installed 4
Yes No NA Attic area(sqft) 800.00 -250= 4 minimum number of rulers installed. Must round up.
(NA if SPF or batt)
El ❑ ❑ Ventilation baffles installed at all eave vents to prevent air movement under or into insulation.
Yes No NA (NA if SPF meets conditions above)(NA if unvented attic)
El ❑ ❑ Net free-ventilation area of the eave vent maintained from eave vent,past insulation,to attic space.
Yes No NA (NA if no eave vents or SPF)
✓ CEILING AIR BARRIER
❑ ❑ El All draft stops in place to form a continuous ceiling air barrier no gaps larger than 1/8". (NA if SPF
Yes No NA meets conditions above)
❑ ❑ El All dropped ceilings/soffits covered with hard covers. Gaps around or in the hard cover larger than
Yes No NA 1/8"filled with foam or caulk. (NA if no drops)
IZI ❑ ❑ Openings around flue shafts fully sealed with flashing and caulked.(NA if no flue shafts)
Yes No NA
ID ❑ ❑ Piping shaft openings fully sealed and caulked.(NA if no pipe shafts)
Yes No NA
Registration Number: 413-N0003831A-E2100113A-0000 Registration DatelTime: 11/18/2013 11:48 AM HERS Provider: CHEERS
2008 Residential Compliance Forms May 2012
INSTALLATION CERTIFICATE CF-6R-ENV-2I-HERS
Quality Insulation Installation (QII) -Framing Stage Checklist (Page 2 of 2)
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
r❑ ❑ ❑ Penetrations through the ceiling air barrier from electrical boxes in the ceiling,fire alarm boxes,etc.
Yes No NA sealed with caulk or foam. (NA if nopenetrations)
0 ❑ ❑ All duct chases,fireplace chases,and double walls sealed air tight at the ceiling level. All gaps into
Yes No NA shafts larger than 1/8" filled with foam or caulk (NA if none of the above or SPF meets conditions
above)
✓ GARAGE/CEILING AIR BARRIER FOR TWO STORIES (no conditioned space over garage)
❑ ❑ I El Air barrier installed at joists in garage to house transition (between floors). No gaps larger than 1/8"
Yes No NA allowed. (NA if SPF meets conditions above)
✓ GARAGE/CEILING AIR BARRIER FOR TWO STORIES(conditioned space over garage)
El ❑ ❑ If insulation is to be installed at subfloor then subfloor has no gaps over 1/8". Air barrier installed at
Yes No NA joists in garage to house transition (between floors). Use of SPF meeting conditions above as the air
barrier satisfies the requirement to seal the gaps.
1] ❑ ❑ If insulation is to be installed at ceiling of garage then ceiling and joists to the outside have no gaps
Yes No NA over 1/8". (NA if SPF meets conditions above or no conditioned space over garage.)
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.
• All rows in this document have been checked and all answers are yes or NA
• 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-1R)form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF-IR 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)
Quality Interiors
Responsible Person's Name and Phone#: Responsible Person's Signature:
Jennifer Dinsmore Jennifer Dinsmore
CSLB License: Date Signed: Position With Company (Title):
C-2 Insulation(802519) 11/18/2013 11:48 AM Contractor/Installer
Registration Number: 413-N0003831A-E2100113A-0000 Registration Datel7nne: 11/18/2013 11:48 AM HERS Provider: CHEERS
2008 Residential Compliance Forms May 2012
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-6R-ENV-22
Quality Insulation Installation QII - Insulation Sta a Checklist (Paget of 3
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
All structural framing areas shall be insulated in a manner that resists thennal bridging of the assembly separating conditioned from
unconditioned space. Structural bracing,tie-downs,and framing of steel,or specialized framing used to meet structural requirements of
the CBC are allowed and must be insulated. These areas shall be called out on the building plans with diagrams and/or specific design
drawings indicating the R-value of insulation and fastening method to be used.
SPF insulation can be considered an air barrier when the bottom and top plates of vertical framing and both ends of horizontal framing,
including band and rim joists,are sprayed to completely fill the cavity adjacent to and in contact with the framing to a distance of 5.5
inches away from the framing for open cell SPF(ocSPF)or 2.0 inches away from the framing for closed cell SPF(ccSPF). SPF can be
considered as an air barrier with less than the above thickness when a product data or specification sheet is provided that shows the
product meets an air penneance no greater than 0.02 L/s-m2 at 75 Pa pressure differential when tested in accordance to ASTM E2178 or
ASTM E283.
Closed cell and open cell manufacturers claim various R-values per inch. In California the maximum R-value that can be claimed for
ccSPF is an R-value of 5.8 per inch and for ocSPF is an R-value of 3.6 per inch. Higher R-values per inch cannot be claimed even with
manufacturer data.
Insulation Stage Checklist
✓FLOOR INSULATION
❑ ❑ ❑� All floor joist cavity insulation installed to uniformly fill the cavity side-to-side and end-to-end,NO gaps. (NA if
Yes No NA slab on grade)
❑ ❑ ❑� Insulation in full contact with the subfloor,NO gaps. (NA if slab on grade)
Yes No NA
❑ ❑ ❑ Batts:cut to fit around wiring and plumbing,or split(delaminated). (NA if loose fill,SPF,or slab on grade)
Yes No NA
❑ ❑ ❑✓ Batts: shall be properly supported to avoid gaps,voids,and compression. (NA for other forms of insulation)
Yes No NA
❑ ❑ 1] Insulation R-value same or greater than listed on CF-1R.(NA for slab on grade)
Yes No NA
❑ ❑ ❑� Gaps between studs larger than 1/8"the cavity must be filled with insulation or foam.
Yes No NA (NA for slab on grade)
❑� SPF: list the required floor cavity R-value from CF-I R,R- Determine required thickness for ccSPF
NA (required R-value_/5.8R)= inches),or required thickness for ocSPF(required R-value_/3.6=
inches).(NA for other forms of insulation)
❑ ❑ El SPF: measure thickness of floor insulation in 6 random areas. Minimum thickness for ccSPF shall be no more
Yes No NA than'/inch less than the required thickness listed above. Minimum thickness for ocSPF shall be no more than 1
inch less than the required thickness listed above. (NA for other forms of insulation)
✓WALL INSULATION
Batts,loose fill mineral fiber,mineral wool,and cellulose: fills cavity and is in contact with air barrier.
O ❑ ❑ ocSPF: shall completely fill cavities of 2x4 inch framing or less. Cavities greater than 2x4 inch framing
Yes No NA dimensions must be filled to the thickness calculated above.
ocSPF: insulation is not required to fill the cavities of framed assemblies provided the installed thickness of
insulation conforms to the thickness calculated above.
❑✓ ❑ ❑ Double walls and bump-outs-insulation fills the cavity or additional air barrier installed in the cavity so that the
Yes No NA insulation fills the cavity and in contact with the air barrier.(NA if SPF meets conditions above and meets the
required R-value)
El ❑ ❑ Insulation installed in exterior walls adjacent to tub/shower,walls under stairs,and fireplace. Insulation required
Yes No NA to fill wall cavity. Cavity required to be air tight.(NA if none of the above)
El ❑ All gaps around windows and doors filled with insulation,or filled with low expanding foam.
Yes No
❑ ❑ ❑ Batts:no voids/depressions greater than'14"in ANY stud bay.(NA for other forms of insulation)
Yes No NA
❑p ❑ ❑ Batts: voids/depressions less than 3/4"allowed as long as the area is not greater than 10%of the surface area for
Yes No NA each stud bay.(NA for other forms of insulation)
❑ ❑ ❑� Loose Fill: no gaps or voids. Insulation completely fills the cavity.(NA for other forms of insulation)
Yes No NA
El ❑ Gaps between studs larger than 1/8"the cavity must be filled with insulation or foam.
Registration Number: 413-N0003831A-E2200114A-0000 Registration DatelTime: 11/18/2013 11:50 AM HERS Provider: CHEERS
2008 Residential Compliance Forms May 2012
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-6R-ENV-22
Quality Insulation Installation (QII) - Insulation Stage Checklist (Pa e 2 of 3)
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
Yes No
❑ ❑ ❑ All Rim joists to the outside insulated. . (NA if no Rim joists)
Yes No NA
❑� ❑ ❑ Insulation installed at corner channels,wall intersections,and adjacent to tub/shower enclosures insulated to
Yes No NA proper R-Value.
El ❑ ❑ All skylight shafts and attic kneewalls insulated with minimum R-19. (NA if no skylights,kneewalls,or in
Yes No NA conditioned attic)
❑� ❑ ❑ Insulation in full contact with air barrier or wall finish for skylight shafts and attic kneewalls. (NA if no skylight
Yes No NA or kneewalls)
El ❑ Installed wall insulation R-value equal to or greater than what is listed on the CF-1R.
Yes No
❑ ❑ ❑ SPF: insulation installed without gaps and to provide an air seal when specified as an air barrier. (NA for other
Yes No NA forms of insulation)
❑� SPF: list the required wall cavity R-value from CFAR,R-_. Determine required thickness for ccSPF
NA (required R-value_/5.8R) = inches),or required thickness for ocSPF(required R-value_/3.6=
inches). (NA for other forms of insulation)
❑ ❑ ❑� SPF: measure thickness of wall insulation in 6 random areas. Minimum thickness for ccSPF shall be no more
Yes No NA than inch less than the required thickness listed above. Minimum thickness for ocSPF shall be no more than 1
inch less than the required thickness listed above. (NA for other forms of insulation)
✓ CEILING/ROOF INSULATION
❑� ❑ Gaps between studs larger than 1/8 the cavity must be filled with insulation or foam.
Yes No
❑ ❑ ❑ Batts: no gaps/voids/depressions greater than 3/4". (NA for other forms of insulation)
Yes No NA
❑ ❑ l7 Batts: voids/depressions less than 3/4"allowed as long as the area is not greater than 10%of the surface area
Yes No NA for each stud bay. (NA for other forms of insulation)
❑� ❑ ❑ Loose Fill: NO gaps or voids allowed. (NA for other forms of insulation)
Yes No NA
❑ All ceiling insulation installed to uniformly fit the cavity side-to-side and end-to-end.
Yes No
YesNo❑ Insulation in full contact with the ceiling,NO gaps.
e
❑� ❑ _ Insulation in contact with air barrier.
Yes No
❑ ❑ ❑ Batts: cut to fit around wiring and plumbing,or split(delaminated). (NA for other forms of insulation)
Yes No NA
0 ❑ ❑ Batts taller than bottom chord must expand over the bottom chord or additional insulation installed so bottom
Yes No NA chord not visible. (NA for other forms of insulation)
❑ ❑ El Batts cut to fit around ALL webbing. No gaps allowed between webbing and batts. (NA for other forms of
Yes No NA insulation)
El SPF: list the required ceiling R-value from CF-1R,R- . Required depth of insulation for ccSPF
NA (required R-value_/5.8R= inches),or required depth of ocSPF(required R-value_/3.6=
inches). (NA for other forms of insulation)
❑ ❑ 0 SPF: measure thickness of ceiling insulation in 6 random areas. Minimum thickness for ccSPF shall be no
Yes No NA more than inch less than the required thickness listed above. Minimum thickness for ocSPF shall be no more
than 1 inch less than the required thickness listed above. (NA for other forms of insulation)
p ❑ ❑ HVAC Platform and Catwalks-insulated to R-value equal to ceiling R-value listed on CF-1R. If less
Yes No NA insulation installed then called out on CF-1R. (NA if no platform or catwalks)
❑ ❑ ❑Yes No NA Attic access gasketed. (NA of no attic access)
❑ ❑ ❑ Attic access-insulated with rigid foam or batt insulation using adhesive or mechanical fastener. Attic access
Yes No NA door R-value equal to ceiling R-value listed on CFAR. If less insulation installed then called out on CF-1R.
(NA if no attic access)
❑ ❑ ❑ Recessed light fixtures covered full depth with insulation. If SPF used then other forms of insulation used to
Yes No NA cover or enclose fixture in a box fabricated from '/2-inch plywood, 18 ga.sheet metal, 1/4-inch hard board or
drywall. SPF or other insulation then covers light fixture to full depth. (NA is no recessed light fixtures)
El ❑ 1 ❑ 1 All recessed light fixtures in non conditioned space are IC rated and air tight(AT). (NA if no recessed light
Registration Number: 413-N0003831A-E2200114A-0000 Registration Date/Time: 11/18/2013 11:50 AM HERS Provider: CHEERS
2008 Residential Compliance Forms May 2012
CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF-6R-ENV-22
Quality Insulation Installation ( II) - Insulation Stage Checklist (Page 3 of 3)
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
Yes No NA fixtures)
O ❑ ❑ All recessed light fixtures are sealed with a gasket or caulk between the housing and the ceiling. (NA if no
Yes No NA recessed light fixtures)
❑ Ceiling insulation equal to or greater than what is listed on the CF-1R.
Yes No
❑� ❑ ❑ Loose Fill: Minimum thickness required to meet the stated R-value listed on CF-1R.Insulation rulers visible
Yes No NA for verifying the installed R-value for blown in insulation. (NA for other forms of insulation)
❑ ❑ ❑ Loose Fill: insulation uniformly covers the entire ceiling(or roof)area from outside of all exterior walls. (NA
Yes No NA for other forms of insulation)
Loose Fill: meets or exceeds manufacturer's minimum weight and thickness requirements for the target R-
❑� ❑ ❑ value.List target R-value 30 .List minimum required weight for target R-value 0.97 (lbs/ftz).List minimum
Yes No NA required thickness at time of installation 13.20 .List minimum required settled thickness 13.10. (NA for other
forms of insulation)
✓ GARAGE ROOF/CEILING INSULATION FOR TWO STORIES(no conditioned space over garage)
❑ ❑No El Insulation installed at rim joists against the air barrier in the garage to house transition (between floors). (NA
Yes NA if conditioned space over garage or single story)-
✓ GARAGE ROOF/CEILING INSULATION FOR TWO STORIES(conditioned space over garage)
0 ❑ ❑ If insulation is installed at subfloor above garage-then insulation must also be installed at joists against the air
Yes No NA barrier in the garage to house transition(between floors) and to R-value as specified on CF-1R. (NA if no
conditioned space over garage or single story)
❑� ❑ ❑ If insulation is installed on ceiling of garage-then the joists to the outside(front,and both sides) must be
Yes No NA insulated to the R-valuespecified on CF-1R. (NA if no conditioned space over garage or single story)
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.
• All rows in this document have been checked and all answers are yes or NA
• 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-1R)form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF-iR 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)
Quality Interiors
Responsible Person's Name and Phone#: Responsible Person's Signature:
Jennifer Dinsmore Jennifer Dinsmore
CSLB License: Date Signed: Position With Company(Title):
C-2 Insulation(802519) 11/18/2013 11:50 AM Contractor/Installer
Registration NUMber: 413-N0003831A-E2200114A-0000 Registration DatelTbne: 11/18/2013 11:50 AM HERSPro Vider: CHEERS
2008 Residential Compliance Forms May 2012
INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS
Duct Leakage Test—Completely New or Re lacement Duct System (Pagel of 2
Pe
Site Address: Enforcement Agency: rmit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
Enter the Duct System Name or Identification/Tag: HOUSE: 1
Enter the Duct System Location or Area Served: ATTIC
Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling.
This certificate is required for compliance for completely new duct systems installed in new dwelling construction, and also
for completely new or replacement duct systems in existing dwellings. 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
Duct Leakage Diagnostic Test—completely new or replacement ducts stem
Enter a value for the Allowed Leakage(CFM)for the duct system leakage verification. The value entered must be the
Verified Low Leakage Ducts in Conditioned Space criteria or one of the three calculated leakage rates described below.
Verified Low Leakage Ducts in Conditioned Space(VLLDCS)Compliance Credit. If compliance credit Allowed
for verified low leakage ducts in conditioned space is shown in the special features section of the CF-1R,the Leakage
leakage to outside test method must be used to verify duct leakage(refer to RA3.1.4.3.4),and 25 CFM must be (CFM)
entered for Allowed Leakage.
Allowed leakage calculation—(select one calculation method from this section). Use 6%(leakage factor=
0.06)for calculations if tested at"final"or 4%(leakage factor=0.04)if tested at"rough." When utilizing
Low Leakage Air Handler(LLAH)credit,the allowed duct leakage may be specified by the CF-1R to be less
than 6%, in which case the user-specified leakage rate must be used in the calculations below. For example, if
the user-specified leakage(specified as a percentage of fan airflow)is reported on the CF-I R as 3%,then use a
leakage factor of 0.03 in the calculations below.
O Cooling system method: 96
Nominal capacity of condenser in Tons 4.0 x 400 x leakage factor = 96 (CFM)
❑ Heating system method:
21.7 x Output Capacity in Thousands of Btu/hr x leakage factor= (CFM)
❑ Measured airflow method(RA3.3):
Enter measured fan flow in CFM here x leakage factor = (CFM)
Actual
Enter value for Actual leakage(CFM)in the right column,from measurement using applicable duct leakage Leakage
pressurization test procedure from Reference Residential Appendix RA3.I(CFM @ 25 Pa). (CFM)
List Actual Leakage from duct leakage test(CFM) 70
Pass if Actual Leakage is less than Allowed Leakage El Pass❑Fail
For complete replacement of duct systems only, if the 6 percent leakage rate criteria cannot be met,a smoke
test should be performed to verify that the excess leakage is coming only from a pre-existing furnace cabinet
(air handler cabinet),and not from other accessible portions of the duct system. A HERS rater must verify the
installation(No sampling allowed). List Actual Leakage from smoke test(CFM)
Pass if all accessible leaks(except for existing air handler)are sealed using smoke ❑Pass❑Fail
Registration Number: 413-N0003831A_M2000119A-0000 Registration DatelT ime: 11/20/2013 1:47 PM HERS Provider: CHEERS _
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS
Duct Leakage Test—Completely New or Re lacement Duct System (Page 2 of 2
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
Compliance Method
This dwelling was:(select one of the following two choices):
❑✓ Tested at Final
❑ Tested at Rough-in(requires installer to complete the visual inspection at final construction stage described below)
Visual Inspection at Final Construction Stage if applicable)
After installing the interior finishing wall and verifying that the above rough-in tests was completed,the
following procedure must beperformed:
❑ For all supply and return registers,verify that the spaces between the register boot and the interior finishing wall are
properly sealed.
❑ If the house rough-in duct leakage test was conducted without an air handler installed,inspect the connection points
between the air handler and the supply and return plenums to verify that the connection points are properly sealed.
❑ Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used.
El 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.
El All supply and return register boots must be sealed to the drywall
0 New duct installations cannot utilize building cavities as plenums or platform returns in lieu of ducts.
0 Mastic and draw bands must be used in combination with Cloth backed,rubber adhesive duct tape to seal leaks at 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 perfonned at my expense.
• I reviewed a copy of the Certificate of Compliance(CF-I R)form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF-I R 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)
Total Comfort,Inc.
Responsible Person's Name: Responsible Person's Signature:
Steven C000per Steven C000per
CSLB License: Date Signed: Position With Company(Title):
C20 HVAC(935238) 11/20/2013 1:47 PM Contractor/Installer
Is this installation monitored by a Third Party Quality Control Name of TPQCP(if applicable):
Program(TPQCP)? ❑Yes ❑No
Registration Number: 413-N0003831A-M2000119A-0000 Registration DatelThne: 11/20/2013 1:47 PM HERS Provider: CHEERS
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-611-MECH-23-HERS
Verification of High EER Equipment (Page 1 of 1
Site Address: Enforcement Agency: Permit Number:
Lot 101 -Plan 3-35134 Fennel Lane City of Lake Elsinore 13-00002257
Verification of High EER Equipment
Procedures for verification of High EER Equipment are described in Reference Residential Appendix RA3.4. For dwelling units with
multiple systems, the procedures must be applied to each system separately. As many as 4 systems in the dwelling can be documented for
compliance using this form. Attach an additional forms)for any additional systems in the dwelling as applicable.
I System Name or Identification/Tag HOUSE:1
2 System Location or Area Served ATTIC
3 Certified EER Rating of the installed 11.00
equipment(Btu/Watt-hr)
4 Make and Model Number of the installed CARRIER
Outdoor Unit CA13NA048
5 Make and Model Number of the installed CARRIER
Inside Coll CNPHP4821ALA
6 Make and Model Number of the installed CARRIER
Furnace or Air Handler. 58STXO-0116
Minimum Equipment EER required for
7 compliance as reported on the CF-1R 11.00
El When a high EER system specification includes a time delay relay,the installation of the time delay relay must be verified for
compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Time Delay Relay Verification Procedure.
El When installation of specific matched equipment is necessary to achieve a high EER,installation of the specific equipment must be
verified for compliance credit. Refer to Reference Residential Appendix RA3.4.3 for the Matched Equipment Verification Procedure.
If the Certified EER Rating in row 3 is
equal to or greater than the required
8 minimum EER in row 7,the unit
complies.
If the unit complies enter Pass Pass
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-I R)form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF-IR that apply to the installation have been met.
• 1 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)
Total Comfort,Inc.
Responsible Person's Name: Responsible Person's Signature:
Steven C000per Steven C000per
CSLB License: Date Signed: Position With Company(Title):
C20 HVAC(935238) 11/20/2013 1:47 PM Contractor/Installer
Registration Number: 413-N0003831A-M2300120A-0000 Registration DatelTirne: 11/20/2013 1:47 PM HERS Provider: CHEERS
2008 Residential Compliance Forms August 2009