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PMT14-01060 City of Menifee Permit No.: PMT14-01060 29714 HAUN RD. 9-k+LCM—A` MENIFEE, CA 92586 Type: Residential Mechanical MENIFEE Date Issued: 05/08/2014 PERMIT Site Address: 28120 ORANGEGROVE AVE, MENIFEE, Parcel Number: 340-063-010 _ CA 92584 Construction Cost: $13,000.00 Existing Use: Proposed Use: Description of REPLACE 3 TON (14 SEER) SPLIT HVAC SYSTEM SAME LOCATION Work: Owner Contractor NEAL PABITZKEY A R S AMERICAN RESIDENTIAL SERVICES OF 28120 ORANGEGROVE AVE CALIFORNIA INC MENIFEE,CA 92584 965 RIDGE LAKE BLVD SUITE 201 Applicant Phone: 9012719700 LAURA YENULONIS License Number: 791820 A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIi 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, CA 38120 Fee Description (City Amount 1$1 n YFcetllliro�GravitypeUraceorBuiner ,k "rry_ � 17 ' 2k m1a490" Air Handling/Condensing Units SFR 1 133.00 Bull ing P-erml�ss ace v i+. 7 -._ M i i.Q9;"" - 47 GREEN FEE 1 1.00 $310.00 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing building operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee. Except as otherwise stated,a permit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA_Bldg_Permit Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions - Professions Code an my license is in full oro and effect. Code:The Contractor's License Law does not apply to an owner of a property License Cla 'cense No. o who builds or improves thereon, and who contracts for the projects with a Expires76_),j; Sigri licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DE A TION ❑ I am exempt from licensure under the Contractors'State License Law for the ❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason: I have and will maintain a certificate of consent of self-insure for workers' gy my signature below acknowledge that, except for my personal residence in compensation,issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of work for which this which I must have resided for at least one year prior to completion of permit is issued. improvements covered by this permit, I cannot legally sell a structure that I have Policy# built as an owner-building if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Cl I have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http://www.leqin-fgxa.gov/calaw.html. permit Is issued.My workers'compensation insurance carrier and policy number are: 1 '`,__—�T Property Owner or Authorized Agent Carrier tr Date Expires ��^ �^ �� Policy �� ` Cl owner my Signature below, I certify to each of the following: I am the property Name of Agent L.Ax:JF=eC'6r (�r� Phone#�Qf�(� rj'�a^ owner or authorized to act on the property owner's behalf. I have read this (This section need not be completed if the permit is for application and the information I have provided is correct. I agree to comply one-hundred dollars($100)or less) - with all applicable city and county ordinances and slate laws relating to building construction.I authorize representatives of this city or county to enter the above- 0 1 certify that in the performance of the work for which this permit is issued,I identified property for the inspection purposes, shall not employ any persons in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Propert Ow r or Authorized Agent Date Code,I shall forthwith comply with those provisions. Date;'j.b� Appllcantl�l City Business "",a# WARNING: FAILURE TO S URE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS U FUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING ($100,000), IN ADDITION TO THE COST OF COMPENSATION, OYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES LINO EQUAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE? agency for the performance of the work which this permit is issued (Section 3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address ONO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR OWNER BUILDER DECLARATIONS GUIDE LINES I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME: License Law for the reason(s)indicated below by the checkmark(s)I have placed OYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable items) (Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct, alter, improve, demolish, ❑NO SCHOOL? or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL Section 7000)of Division 3 of the Business and Professions Code)or that he or OYES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING, compensation, will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044, Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY Y OF —°'E llFEE PLCK No: it 29714 Haun Road bate: Date: Menifee, CA 92586 --I Phone: (951)672-6777 aunt: Amount -O arm Fax:(951)679-3843 Ck# Ciiii. Building Combination Permit To Be Completed By Applicant Legal Description: b 1 Planning Case: F: L: RI R: Property Address: Assessor's Parcel Number. i ProfectRenant Name: Unit#: Floor#: Name: ��\ � Pho o. — ---�'Mn `^ POwnerty Address: t� Unit Number Zip Cod fl et L>\ Email Address: Na e c P o. .Iq p J Applicant Ad ress:aS p O�`v Unit Number Zip C Email Address: Phone No. Fax No. [1 f Contractor Add ss: �t St Zip ant r us ense o. Contractor's M of Cali omia Lice se No. Classification/{ Number of Squares: l— square Poarage Description of' j l S Cost of Work:$ Applicants Sin e l T f D Date: To Be o pleted By City Staff only l Indicate As R-Received or NIA-Not Applicable 5 Computes sets of fully dim alone drawn to sale plans which include: 1 Set of documeNs which include ❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Gen Tech/Soils Report(on cd only) ❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 V x 11) ❑El Foundation Plan ❑ Crass Section ❑ Plumbing Plan Structural Calculations ❑ Single Line diagram for elec.services over 400 AMP ❑ Floor Plan ❑ Structural Framing Plan&Decal ❑ Shoring Plan ❑ Sound Report-Residential Class Code: Indicate New Construction Alteration- Addition' Means/Methods Work Type: Repair" RetrofiC Revision to Exisfing Pernuf Required? YES NO Proposed Building Use(s): Existing Building Use(s): #Buildings. #Units: #Stories Will the Building Have a Basement? Y of N Bldg.Code Occupancy Group Indicate Indipte it YES or NO Indicate all Geo-tech.Haz.Zone At Project S dnklgretl Completion: Construction p that apply: Coastal Zone Type(s): C of O YES or NO Noise Zone Required? Listed on Historic Resources Inventory CITY PLANNING STAFF ONLY APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. Planning Comm.Zoning Administrator Fee Exempt: City Project Elec.Vehicle Charger landmark Seismic Retrofit special rase:adg Offidial Appmval Expedite Projeot(s): Child Care City Project Green Building Landmark Affordable Housing For Staff Use Only auildmglsweiy I Permil Specials( Cily Planning I Cnni Engineenng I EPWM-Admen 1,ansportation Mgmt, Rent Control THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY Simplified Preseri -ve Certificate of Com Hance:2009 Residential HVACAherations CF-IR-ALT-HVAC Climate Zones 10 to IS SheAddhsS. Enfercemenf easy: Date:' at 1 — 4 iW Conditioned Floor Gfqu4wwnt m I' List Minimum Efficiency' Duct insulation requirement Area Thermostat Packages!Unit =10 fiver 40 R of ducts addcnl or Setback re laced in tmconditiant#space Served by system ItJmxalreud}oii F_ R 6 !CZ 10-13ivresent,muv being.Unit stance 91R81CZ 14-ISI rnntniirJl nt Type'Choose the equipment being irutatled:Jy-more Bran one system.use another CF.1R-.iLT-HV,4C'Jor each,=Vremen Equipatera Efficiencies: 13 SEIA 718` ,4Ft'F.. 7.711:SPF Jor typical residential systems. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer deeides what work is being done and picks one of the appropriate Options. Each Option lists the HERS mcasures that must be conducted.A copy of the forms shall be left on site for final inspection and a copy gNon 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-611 and registered C F'4R forms(no hand filled CF-4Rs allowed)are filled out and fed, Mooing October 1,2010,a registered co of the Cr-IR and CF.6R shall also be on site for final inspection. 1.HVAC Chao eonf Required Forms: CF-6R forms: MECH-04,MECH-2I-14ERS and(for split systems)MECH-25-HERS • All HVAC Equipment replaced CF-4R.forms: MECH-21 and(fora lit systems) MECH-25 • Condenser Coil slut for CF-611 forms: MECH-21-HERS and(for split systems)MEC.11-25-HERS • Indoor Coil anVor CF.4R forms: MECH-21 and(for split s}stcros) MECH-25 • Furnace For Split Systems:Duct leakage< 15 percent; RC,CCA'_>300 CFM/ton(Minimum Air Flow Requirement),TMAH For Packaged Units: Duct leakage< I percent Exempted from duct leakage testing if., 8 1.Duct system was documented to have been previously sealed and confirmed through HERS verification-or 2.Duct systems with less than 40 linear foot in unconditioned space,or 3.Existing duct stems are constructeLt insulated or sealed with asbestos 2.New HVAC System Required Forms: is Cut in or Changeout with new CF.6R forms: MECH-04.MECH-20-HERS.and(for split systems)RIECH-22-HERS,and MECH-25-HERS ducts:(all new ducting and all I c,( R forms: MECH-20,and(tor split systems)MECH-22,and MECH-25 new equipment) For Split Systems:Duct leakage<6 percent;RC,CCA>_350 CFMtton,FWD,TMAH,STMS,and either HSPP or PSPP. For Packaged Units:Dud leakage<b percent ❑3.New Ducts with Replacement Required Forms: • Includes replacing"installing an new ducting CF-6Rforms: MECH-04,MECH-20-HERS.and(for split systems)MECIl-25-HERS and/or outdoor condensing unit and/or indoor CF4R loons:MECH-20 and(tor split systems)MECI1-25 coil and/or fumace. Not all equipment changed. For Split Systems:Duct leakage<6 percent,RC,CCA=300 CFM/ton,TMAH For Packaged Units:Duct leakagii 6Percent 4.New Donning over 40 feet Required Forms; • Includes adding or replacing more than 40 CF-61k imams: MEC14-04,MECH-2I-HERS CF-411 Forms: MECH-21 lincar feet ot'duct in unconditioned$ ace. For split stem or packaged units: Duct leakage< 15 percent F.XCEPTIOK Existing duct systems constructed.insulated or sealed with asbestos. Contractor(Documentation Author's/Responsible Designer's Declaration Statement) • 1 certify that this Cenifi�wofCompliam:e documemztion is accurate and Complete. • I an eligible under Division 3 of the Calitamia Business and Protmions(we m accept responsibility for the design idemiftsl on this Ccodicate of Compliance. i cenA Nat the energy t2atures and performance specifications for an design identified ost this C,n tj,,,of Compin we;:,,form to the nulninments of l'irtc 24. Pans I mid 6 of the C'alifomia Cc&of Regulations, • -rite design @atures identified on this Certificate of Compliance:are e0wisem with the inf tined tie alcutaNuro,plans and specifications submitted to tin enforcement encv for ,a) nth fiw 't li Name: DANIEL TRAVERSI sigma Company: ARS bete: 1?3 1 Ly Address: 1225 GRAPHITE DRIVE `i`°nse 791820 Cim'staxeZip: CORONA, CA 92881 Paton: 951-280-3101 ,1111A D.v e•:do..r:..l 1"n 1:..,.....Fan« led,. 'milt Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-SR-ALT-HVAC Climate Zones 10- 15 Site Address: Enforcement Agency: Date: Permit#: 28120 Orangegrove Ave Sun City, CA 92584 City of Menifee I Jun 5, 2014 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑Package Unit ®Furnace ®AFUE 78% ❑COP_ ❑R 6 (CZ 10-13) Served by system ®Setback ®Indoor Coil ®SEER 1�0 ❑HSPF_ If not already present, must be ®Condensing Unit ❑EER ❑Resistance ❑R 8 (CZ 14-15) 1400 sf installed) ❑Other_ 1. Equipment Type:Choose the equipment being installed;if more than one system,use another CF-IR-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-1R and CF-611 shall also be on site for final inspection. IM 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-411 forms: MECH-21 and (for split systems) MECH-25 • Furnace For Split Systems: Duct leakage..< 15 percent; RC, CCA 5 300 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 tIQ 40 linear feet In unconditioned space, or - _❑'3r-Existing duct systems are°;'onstructed, insulated or sealed with asbestos p 4.The systbrTwill not be Dusted (ie. Ductless Mini-Split System) (Also Exempt from Refrigerant Charge) ❑2.New HVAC System Required Forms: . Cut In or a""yige 7rylth CF 6R [n CH OnW� IRS, a `(f k ,$)➢st )) C 2 S, and new due (a11 ne -�„ ECHFi SkE'` 'n all new 4 ', ECH 20, a sy ,r H-22, 'MECH For Spli stems a"g' fv6 Lent; R C 50 CFM/ A` F r TMAH rand e�h PP raa sp For Pac a "d Ui,s c k c de as ❑3. New`Ducts withl,'i without Requir{ed; Replacement- � � Includes„�fepIAdp§,A%installing a knew ductLn2j`�aOd/or outQobr condensl y'unit- CF-6Rforms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or indoor coil ant)/or furnac&,=Wo or some CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. A", 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 IRequired Forms: • Includes adding or replacing more than 40 1 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: Tina Peery Signature: Tina Peery Company: A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC Date: Jun 5, 2014 Address: 965 RIDGE LAKE BLVD SUITE 201 License: 791820 City/State/Zip: MEMPHIS/TN/ 38120 Phone: (901) 271-9700 Reg: 214-A0040963A-000000000-0000 Registration Date/Time: 2014/06/05 18:25:06 HERS Provider: Cal CERTS, Inc. 2008 Residential Compliance Forms July 2010 i CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 28120 Orangegrove Ave, Sun City CA 92584 (System City of Menifee PMT14-01060 1) 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 Q,ptiogkj, 2, or 3 must be attempte4,,befplep4.q iiiizigg Opticn.A')„,' Determine gminal Fa- Flow using o e o khejollowing t caldd-latio § ethods �R' ,. ✓®Coo i zs"ystem method Size o-co enser In Tons x 400 = 1200��FM - ✓❑He"ti g system m thod 1 utput Capaci ,(n usa S to/hr - CFM ✓❑Meas edtisyste ;�a�i, lQw�uslpgRA3 3� irflpw' tes[Ipro�edures � .. FM Option'1 used then: - , 1 Allowed leakage = Fan Flow 1200 x 0.15 180 CFM ActuaL.Leakage 123 CFM.. Pass if Leakage Actual is less than Allowed M Pass 0 Fail Option 2 used then: 2 Allowed leakage = Fan Flow ?_z 0.10 =_CFM Actual Leakage to outside = CFM Pass if Leakage Actual is less than Allowed 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 Reduction Pass if"/o Reduction >= 600/a Ej Pass E]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 ®Pass ®Fail Reg: 214-A0040963A-M2100001A-M21A Registration Date/Time: 2014/06/05 18:50:44 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 i CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: LEnforcement Agency: Permit Number: 28120 Orangegrove Ave, Sun City CA 92584 (System 1) of Menlfee PMT14-01060 ®Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CH CA ducts that utilize controlled motorized dampers, that open only when CA ventilation is required to meet ASHRAE Standard 62.2, and close when CA ventilation Is not required, may be configured to the closed position during duct leakage testing. -.' ®All suppl nd return register ots must bedsealed . the dry all IPsmok tit is utilized for_compliance - apphe o duct leakage c rnplWric ption 3 ilea g reductia by 4%)and option 4yfl" all`accesslble leaks) d�crlbed above „, h ® New d'' Inst�alla os c of I z building cavities a pie, s glatfor eturn lieu d�uc ® Mastic and`draw bands must tie use In cdmbioation with ck h backed rubber adhesive duct tape to seal leaks at all new duct connections. I 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) compiles with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s)of Compliance(CF-111) 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-SR) 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) A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC Responsible Person's Name: CSLB License: Tina Peery 791820 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ®tested/verified dwelling ❑not-tested/verified dwelling in a HERS sample group HERS Rater Information CaICERTS Certificate # CCi-1798866018 HERS Rater Company Name: Construction Performance Services Responsible Rater's Name: Responsible Rater's Signature: Josh Pugh Josh Pugh Responsible Rater's Certification Number w/this HERS Provider: Date Signed: 6/5/2014 CC2005640 Reg: 214-A0040963A-M2100001A-M21A Registration Date/Time: 2014/06/05 18:50:44 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 6) Site Address: Enforcement Agency: Permit Number: 28120 Orangegrove Ave, Sun City CA 92584 City of Menifee PMT14-01060 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 ❑Yes ❑Yes return plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figu e inSetion RA3.2�2 2.2. , � �,. � Retuide of the duct sys em i r la loc �d entirely v�iit i on 1 io �` Yes `❑,Y "s` ❑Yes ❑Yes spa End return air o v. p ature No� ®No ❑ No ❑ No to measurgc ak hfje urn g�le. �"�".,_`' 2 downstream of e5apo atwe!,boil m he= es ❑Yes ❑Yes ❑' es` supply plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figure in,5ection RA3.2.2.2i2. 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 http://www.enerciv.ca.goy/title24/2008standards/special case aopliance/ TMAH Compliance Option ❑ ❑ ❑ ❑ Yes to 1 and 2, or Yes to la and 2, or checking the TMAH Compliance Option, is 14 Pass ❑ Pass ❑ Pass ❑ Pass a pass, ❑Fail ❑ Fail ❑ Fail ❑ Fail Enter Pass or Fail Reg: 214-A0040963A-M2500001A-M25A Registration Date/Time: 2014/06/05 18:52:40 HERS Provider: Cal CERTS, Inc. 2008 Residential Compliance Forms February 2013 1 I ,I 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: 28120 Orangegrove Ave, Sun City CA 92584 City of Menifee PMT14-01060 STMS - Sensor on the Evaporator Coil System Name or System 1 Identification/Tag 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 [] 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 ❑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 N md`tiir ' Identificat /Tag uYskem 1_ s - � 101 - The 'for is factory�lW- Ile o eId installed according to� ndfacturer ,—ecificatio�s, or is ipstalled by rr*%ds/speciflcano s a pr ed by the Ex- Ei e` Director —Yes ❑ Nod JWOYes,CtNo'•�� ❑YeS ®No lDaYe No The Sens r'wi�e`i§ xerminated with , standard [rR�i pI0g1"sb'itable for connectian to`6Vg1tal tKdFrn °meter' 7 The sensor mini plug is accessible to the installing'technicianand the'HFPS rater without changing the airflow through the condenser coil ;0 Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No ❑Yes [] No 8 When attached to a digital thermometer, the sensor provides an indication of the saturation temperature 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-A0040963A-M2500001A-M25A Registration Date/Time: 2014/06/05 18:52;40 HERS Provider: Ca10ERTS, Inc. 2006 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6) Site Address: Enforcement Agency: Permit Number: 28120 Orangegrove Ave, Sun City CA 92584 City of Menifee PMT14-01060 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 # W051408619 Outdoor Unit Make Rheem Outdoor Unit Model 14A3M36A01 Nominal Cooling Capacity 3 Tons Date of Verification z 6/ /2 ' 4 ): CalibreR19of 0'b n�sttc I s ru nts � f Date of Rerigerant Gauge Calibration- 6/5/2014, (mist be re-calibrated monthly Date of Thermocouple Calibration 5/10/2014 (must be re-calibrated monthly) Measured Temperatures (OF) System Name or Identification/Tag System 1 Supply (evaporator leaving) air dry-bulb 50.1 temperature (Tsupply, db) Return (evaporator entering) air 72.9 dry-bulb temperature (Treturn db) Return (evaporator entering) air 57.5 wet-bulb temperature (Treturn wb) Evaporator saturation temperature 34 (Teva orator sat) Condensor saturation temperature 89.5 (Tcondensor, sat) Suction line temperature (Tsuction) 54.5 Liquid Line Temperature (Tliquid) 80 Condenser (entering) air dry-bulb 76.1 temperature (Tcondenser, db) Reg: 214-A0040963A-M2500001A-M25A Registration Date/Time: 2014/06/05 18:52:40 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6) Site Address: Enforcement Agency: Permit Number: 28120 Orangegrove Ave, Sun City CA 92584 City of Menifee PMT14-01060 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 = 22.80 Treturn db - Tsupply, db Target Temperature Split from Table RA3.2-3 using Treturn wb and Treturn db 20.2 Calculate difference: Actual Temperature 2 6 Split - Target Temperature Split = Passes if difference is between -40F and +40F or, upon remeasurement, If between -40F and -100OF 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 cog airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calcula Minim m Air low Re mremen�(CFT— Nomina C a mg C acity�(tL X 300 Rg (cfm/too, Sy stem m�e or dtif ca a ag r ' 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-A0040963A-M2500001A-M25A Registration Date/Time: 2014/06/05 18:52:40 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) 1 0— Site Address: Enforcement Agency: Permit Number: 28120 Orangegrove Ave, Sun City CA 92584 City of Menifee PMT14-01060 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 = 9.5 Tcondenser-sat- Tli uid Target Subcooling specified by g manufacturer Calculate d��Ff[�fi rice- Actual Sboolmg -Target Subc hng f � System p ses if differgncis bttyn`� ' -4°F anb +4°F n4SS a � nter Pas ,nor Fall, - ."c�x '..:s.. a 3. a h 3 .v".2k Rom. ``�<SS*"ik`� ,' � e Mi 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 = 20.5 Tsuction - Teva orator sat Enter allowable superheat range from manufacturer's specifications (or use range between 30F and 260F if manufacturer's 3-26 specification is not available) System passes if actual superheat is within the allowable superheat range PASS Enter Pass or Fail Reg: 214-A0040963A-M2500001A-M25A Registration Date/Time: 2014/06/05 18:52:40 HERS Provider: CalCERTS, 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: 28120 Orangegrove Ave, Sun City CA 92584 City of Menifee PMT14-01060 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 alrflow requirements. PASS Enter Pass or Fail ® Residential Appendix RA3.2.2 requires that if the outdoor temperature is between 55OF and 65OF 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) re=pponsj¢¢le for the insta ption nfor to-t earequ'remen �spe 'fled op the Gertificate(s)=of Compliance (CF-1R)approved by the enforce ntjg nncy. Builder 'Installerinfrmat'tnas„shown on [,1 e'Installafton C3erFificat (CF-6R) Compa "° ame: (Ins alli!WS b Itactor or Ge� C ntFact- Builder/ naY) A R S AERICANRE I,EI*TIA ERVICES Q„F CALIFORd I .fir .. Responsib'I` _Persorf' Na GSLBALicFhse, _ "_ �" = �' a Tina Peery ' _�G � " 791520 � � HERS Provider Data Registry;Information Sample Group # (if applicable) "N/A ®tested/verified dwelling not-tested/verified dwelling in a HERS sample group HERS Rater Information CaICERTS Certificate # CCI-1798866018 HERS Rater Company Name: Construction Performance Services Responsible Rater's Name: Responsible Rater's Signature: Iosh Pugh Josh Pugh Responsible Rater's Certification Number w/this HERS Provider: Date Signed: 6/5/2014 CC2005640 Reg: 214-A0040963A-M25000D1A-M25A Registration Date/Time: 2014/06/OS 18:52:40 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 28120 Orangegrove Ave, Sun City CA 92584 (System 1) City of Menifee PMT14-01060 Space Conditioning Systems Heating Equipment Duct Efficiency Location Equip (AFUE, (attic, Type ARI #of etc.)1,3 crawl- Heating Heating (package- CEC Certified Mfr. Name Reference Identical (>=CF-lR space, Duct Load Capacity heat pump) and Model Number NumberZ Systems value)4 etc.) R-value (kBtu/hr) (kBtu/hr) Split Rheem Furnace RGPQ-07NAMER 1 80 N/A 75 75 kBtu Cooling Equipment Efficiency Duct Equip _ (SEER Location Type t and EER) (attic, (package ARI #of 1,3 crawl- Cooling Cooling heat CEC Certified Mfr. Name+. Reference Identical (>=CF-SR space, Duct Load Capacity pump) and Model Number NumberZ Systems value)4 etc.) R-value (kBtu/hr) (I<Btu/hr) Split "` Rheem "` "°` A/C , . �14AIM3fiA01 �, �14.5 SF;EIi ram, _ ,36 3 Tans s A � e f 1. If project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative compliance. 2. ARI Reference Number can be'found by entering the equipment model number at http://www.aridirectory.org/ari/ac.php# 3. Listed efficiency on this page must be greater than or equal(?) to the value shown on the CF-1R form. 4. When CF-1R is reference it is also applicable to the CF-SR, CF-IR-AA or CF-IR-ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM ® §110-§113: HVAC equipment is certified by the California Energy Commission. ® §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA. ® §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). ® §150(j)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. Reg: 214-A0040963A-M0400001A-0000 Registration Date/Time: 2014/06/05 18:46:45 HERS Provider: CRICERTS, Ina. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems, Ducts and Fans (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 28120 Orangegrove Ave, Sun City CA 92584 (System City of Menifee PMT14-01060 1) Ducts and Fans §150(m): Duct and Fans ® 1. All air-distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply-air and return-air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct-closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used; and ® 1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. ® 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used In combination with mastic and draw bands. ® 7. Exhaust fan systems have back draft or automatic dampers. ® 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. ® Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material.' ® 10. Fle i led cts cannot have porous ' nep.co gs g,` t 4 i u 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 responsiblllty 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 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 detalled on the CF-SR 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. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) AIRS AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC Responsible Person's Name: Responsible Person's Signature: Tina Peery Tina Peery CSLB License: Date Signed: Position With Company (Title): 791820 S/8/2014 Reg: 214-A0040963A-M0400001A-0000 Registration Date/Time: 2014/06/05 18:46:45 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2009 i INSTALLATION CERTIFICATE CF-611-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 28120 Orangegrove Ave, Sun City CA 92584 (System City of Menifee PMT14-01060 1) 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 leaksusing smoke and HERS rater verify Note: (One of Opfol:,ns 1, 2 or 3 must be attemtec).,before,_uCilizmg,Option Determine n -mal Fa'i Flow using 8 ,e of�the"ollow g t re�calc'latio *method = " '✓®Cooli' 'system rnethjsize of condenser m To j x 400 i200CFM *- � ❑Hea g:,system m thDutputCa✓❑Measl ad ste iatpg'RA3 3`ralrflpw'kest cgdu es =:CF, „ � " 0 u 1 Allowed leakage =Fan Airflow- 1200 x 0.15 = 180 CFM Actual Leakage - 123 CFM Pass if Actual Leakage is less than Allowed leakage ®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 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_-_j x 100% _ /a Reduction Pass if"/o Reduction >= 60% ❑Pass ri 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 u Pass 0 Fall Reg: 214-A0040963A-M2100001A-0000 Registration Date/Time: 2014/06/05 18:47:20 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 I INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 28120 Orangegrove Ave, Sun City CA 92584 (System City of Menifee PMT14-01060 1) ® Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage,testing. CF1/CA ducts that utilize controlled motorized dampers, that open only when CA ventilation is required to meet ASHRAE Standard 62.2, and close when CA ventilation is not required, may be configured to the closed position during duct leakage testing. ®All sup Ind re rn register ots�lnil t be seal �o the dry WI I nuke tes,�,s ill ed fo�tcompliance - apphes�o,ducY leakage c mpl' ri e. ption 3 (lea ge reducti Eby O/n)pan tion 4�(ix alfaccessible leaks) des rlhed above, ' � ry ® New ll �Insta la n no Ltl Iz bulldl g c vlties as pie s o latfo eturn in II fdLcts. ® Mastic aril draw bands mushbe use" m mbiii Ion with clot`hacked rubber adhesive duct'tappee to sea leaks at all new duct connections DECLARATION STATEMENT .I certify under penalty of pedury,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 identifed on this certlficate(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-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) ARS AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC Responsible Person's Name: Responsible Person's Signature: Tina Peery Tina Peery CSLB License: Date Signed: Position With Company (Title): 791820 5/8/2014 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑Yes ❑No Reg: 214-A0040963A-M2100001A-0000 Registration Date/Time: 2014/06/05 18:47:20 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 6) Site Address: I Enforcement Agency: Permit Number: 28120 Orangegrove Ave, Sun City CA 92584 City of MeniFee PMT14-01060 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 c Whole House 5/16 inch (8 mm) access hole 1 upstream of evaporative coil in the ®Yes ❑Yes ❑Yes ❑Yes return plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Fig ur }nSection RA3.2.2:,2.2. a e Retu®icle of the duct system i la loc tee entirely within cond�i 'ior, r` IYes ❑vY,gs ❑Yes ❑Yes spay end return afflr to npe Ore 4��No � No ❑ No El No to b Rneasureda``t t e rekgrp grille. = , . ( 5/1,6 ch a cess hple downs�tre�m 'e�vaporaEi e`coil m hey ��Yes ❑Ye . : ❑Yes ' � 464& ` 2 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 hp(g (Jwww energy ca gov/title24/2Qgf tandardsJsoed gaffe ao lin once/ TMAH Compliance Option ❑ ❑ ❑ ❑ 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-A0040963A-M2500001A-0000 Registration Date/Time: 2014/06/05 18:49:50 HERS Provider: Cal CERTS, 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: I Enforcement Agency: Permit Number. 28120 Orangegrove Ave, Sun City CA 92584 City of Menifee PMT14-01060 STMS - Sensor on the Evaporator Coil - System Name or System 1 Identification/Tag 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 ❑ No ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No 5 IThe sensor measures the saturation temperature of the coil within 1.3 degrees F ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No ❑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 Fall STMS - Sensor on the Condenser Coil System Name or 'System 1 IdentificatipWFF64 w The se�s,cn]s factory Installe for held Installed wording to '"anufattu'rer s specifi- t"�qs, dr'is installed 6 by m�t�`:pds/specifIcatia�'p ap ro�by the Exe l Direct�r ' D, qD No q Yds ❑ " ❑Ye��7�No ❑Yes��No,� The se error w1gd ter i awed wiE star dar mi pi g su able��conn onto digit he�r otneYerir 7 The senor rriihi p>I g i acce iblehe lust II $stec nicia nd he;HEeter wi houhchanyin the airflow thro,ugh'Che'condenser coil :❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No 8 The sensor measures the saturation temperature of the coil within 1.3 degrees F ❑+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-A0040963A-M2500001A-0000 Registration Date/Time: 2014/06/05 18:49:50 HERS Provider: Cal CERTS, 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: 28120 Orangegrove Ave, Sun City CA 92584 1 City of Menifee PMT14-01060 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb temperature is 550F 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 550F, 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 # W051408619 Outdoor Unit Make Rheem Outdoor Unit Model 14AJM36A01 Nominal Cool' gm opacity 3xTo s �- Date of ;ification ,. 6/5/2 1.„4 t 5:`. _, N, Calibra io of Dagnosi�Irrstru tints Date of Re rl erarit�,au Galibr�aotr _ � 6/5/20141_- .:. (m st be monthly ''^ ... Date of Thermocouple Calibration 5/10/2014 (must be re-calibrated monthly) Measured Temperatures (00 System Name or Identification%Tag System 1 Supply (evaporator leaving) air dry-bulb 50.1 temperature (Tsupply, db) Return (evaporator entering) air 72.9 dry-bulb temperature (Treturn db) Return (evaporator entering) air 57.5 wet-bulb temperature (Treturn wb) Evaporator saturation temperature 34 (Teva orator sat) Condensor saturation temperature 89.5 (Tcondensor, sat) Suction line temperature (Tsuction) 54.5 Liquid Line Temperature (Tliquid) 80 Conde (entering) air dry-bulb 76.1 temperaturnsere (Tcondenser, db) Reg: 214-A0040963A-M2500001A-0000 Registration Date/Time: 2014/06/05 18:49:50 HERS Provider: Cal CERTS, 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: - 28120 Orangegrove Ave, Sun City CA 92584 City of Menifee PMT14-01060 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 = 22.80 Treturn db - Tsupply, db Target Temperature Split from Table RA3.2-3 20.2 using Treturn wb and Treturn db Calculate difference: Actual Temperature 2 6 Split - Target Temperature Split = Passes if difference is between -30F and +30F or, upon remeasurement, if between -30F and -1000F 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.' Calculat lmimum Airflow Re u�rement (CF ^= Norm a1 Coo ng Ca acity(t n) X'300 cf m/t System N� eI i Io�Tag Syste .1 t ,g Calculated Minimum'Airflow Requirement': " - (CFM) e 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-A0D4Q963A-M250000IA-0000 Registration Date/Time: 2014/06/05 18:49:50 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: I Enforcement Agency: Permit Number: - 28120 Orangegrove Ave, Sun City CA 92584 City of Men PMT14-01060 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 +50F 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 = 0.5 Tcondenser, sat-Tli uid Target Subcooling specified by , 9 manufacturer Calculate difference: Actual Sub�,9,01 g `Target Subcaoling , , l Wes V Jr ; System p ses if difference is betty211110111", -3°F an ;.�OF ASSI All F Entet a FaH _ a - _ ` A,It Meteringrpevice Calculatiof`i for Refrigerant htff#e„Verificat� n ,TFiis pp�deed ie isiecju7`reil`to te` ' used for thermostatic'expansion valve (TXV) and electronic expansion valve'(EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat 20.5 Tsuction - Teva orator sat Enter allowable superheat range from manufacturer's specifications (or use range between 40F and 25OF if manufacturer's 4-25 specification is not available) System passes if actual superheat is within the allowable superheat range PASS Enter Pass or Fail Reg: 214-A0040963A-M2500001A-0000 Registration Date/Time: 2014/06/05 18:49:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-6R-MECH-25-HERS III Refrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6) Site Address: I Enrcement Agency: Permit Number: 28120 Orangegrove Ave, Sun City CA 92584 Cityfo of Menifee PMT14-01060 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 65OF 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 a proved as part of a samp_IegF'$"u`p"Pt check y a (2S"f"a`ir an `1 those`inst'allatwr ail me [�the`rc),"em"pts of such quality as ranee cfieckmg, the IF orrecuve act =.anddtliti : I ch c to /tes ing�of o''tther instal ations in that HERS sa, pie group will b perfor eQ�P!Y expense t ' . I revue eb'a copy of the Ifica;Y,e of,�arhpllance (GF` )fbm app - e y the enfo ephent ag that identifies the - specif egwrements, or�nstalla i nr I certify the tut "requve nts tailed on @ CF-SR that I to Ghe , installati ri have a '�.rne �` .I will e et t i�o plet s�gne cQRY i nsta latio. a ificateie a 1 be ppsted gar env ila Je .. with thex uddmg permitO issued fo e buddm ,an fiii e: ailable to the enforcement agency for it 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 comefrom a HERS provider data registry for multiple orientation alternatives, and beginning"October 1;''2010, for all`.Igw-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) AIRS AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC Responsible Person's Name: Responsible Person's Signature: Tina Peery Tina Peery CSLB License: Date5/ Signed: 791820 position With Company (Title): 8/2014 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑Yes ❑ No Reg: 214-A0040963A-M2500001A-0000 Registration Date/Time: 2014/06/05 18:49:50 HERS Provider: Cal CERTS, Inc. 2008 Residential Compliance Forms March 2013