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PMT14-01108 City of Menifee Permit No.: PMT14-01108 29714 HAUN RD. Type: Residential Mechanical '"- CIC -1„J�. MENIFEE, CA 92586 MENIFEE Date Issued: 05114/2014 PERMIT Site Address: 28165 ORANGEGROVE AVE, MENIFEE, Parcel Number: 340-072-026 _ CA 92584 Construction Cost: $5,618.00 Existing Use: Proposed Use: Description of REPLACE 3 TON (13 SEER)A/C&COIL SAME LOCATION Work: Owner Contractor FRANCIS KEY VENVEST BALLARD INC 28165 ORANGEGROVE AVE 3030 MYERS STREET MENIFEE, CA 92584 RIVERSIDE, CA 92503 Applicant Phone: 9512769744 LAURA YENULONIS License Number: 878533 VENVEST BALLARD INC 3030 MYERS STREET RIVERSIDE, CA 92503 Fee Description 0yt Amount °S a'�^%rnno.c'"t'.,, ,•e .,>. ,^v�;':, ., v1- i....✓rc' r'.,andl' . ° g mt .,. t ' e x aE 133.00 Building Permit Issuance 1 27.00 x� F�N'FEE�x ' i„�t�'.4 p � z'*F�`,"�" ':. ,uas^�, "�E °.f+ X ��3%"�.xat+R• '� $161.00 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 builiding 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 f ❑ I, as owner of the roe an exclusive) contracting with licensed I hereby affirm under penalty or perjury that I am licensed under provisions of property rtY Y 9 Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions Professions Ctndmyse is in full orce and effect. Code:The Contractor's License Law does not apply to an owner of a property License Class eN . 1. �J�J� who builds or improves thereon, and who contracts for the projects with a Expire ]-�j�- r W40 licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'CON DE LA TION ❑ lam exempt from licensure under the Contractors'Stale 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' By my signature below I acknowledge that, except for my personal residence in compensation,issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of Section 3700 of the Labor Code, for the performance of work for which this improvements covered by this permit, I cannot legally sell a structure that I have permit is issued. built as an owner-building if it has not been constructed in its entirety by licensed Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the �SI have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is tion 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http,//www.leci!nLo.m.aov/calaw.html. permit is issued.My workers'compensation insurance carrier and policy number are: Carrier TM!, Co. C, - U_>eS\ie Property Owner or Aut prized Agent Date Expires 1- I- \\ \,M \Pololiicy#��J�L�aaCP Cps CA Name of Agent `70`v(� �M1��tCrro 'i��Q,'nQ Slk Y5 ❑ By my Signature below, I certify to each of the following: I am the property 9 �— 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 state 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 11�� pp workers' compensation laws of California, and agree that if I should become biz -1(1-ii subject to the workers'compensation provisions of Section 3700 of the Labor Propert O er or Authorized Agent V' Date Code,I shall forthwith comply with those provisions. p� City Busines cense# Date;��-, Applicant; WARNING: FAILURE TO SE ��11 RE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS UN4AVII�UL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN 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, AYES 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 ❑NO 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 WILL THE INTENDED USE OF THE BUILDING BY THE 3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address ❑NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR GUIDE LINES OWNER BUILDER DECLARATIONS 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 item(s)(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 AYES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from Iicensure 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($500).) CODE SECTION LOAN 25505RIAL ff E 5533,PORI AND 25534 CONCERNING El 1, as owner of the property, or my employees with wages as their sole compensation,will do( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY OF MENIFEE PLGKNe: p g 29714 Haun Road Date: Date' If O Menifee, CA 92586 5 / S Phone: (951)672-6777 Amount: Amount:) r _ Fax:(951)679-3843 Building Combination Permit y To Be Completed By Applicant Legal Descriplio .^� `�, �q `� ( Planning Case: F: L: Rf: R: fa, Pmpert ddress: " Assessor's Parcel Number: o i Projecf/7enant Name: J Unit#: Floor 9: Name: C' hon N Fax No. Property ert Atldress: U i'Numb Owner � 2ip Code (� .r7 Email Atldress: `� 84 Name •� — Pone No. p �I - Applicant Address: Unit Number Zip Code S Email Ad ress: S Name: dbP'. - hon1 No.� Contractor Address: Ij Z - 5q8 Stre Zip de ontractor s UnY 13USunells License o. Contractor' City State Calliomie License No. Classificalion: Number of Squares: Square Footage } Description of Work: 3 E Cost of Work:$ 6 Applicant's Signature CQ, Dale: To Be Gorapl By City Staff Only Indicate As R-Received or N,A-Not Applicable 5 Completes sets of fully dimens�oneq drawn to sale plans which include. 1 set of documents which Inciude ❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Soils Report(on cd only) ❑ Plot I Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8'G x 11) Foundation Plan ❑ Structural Calculations ❑ ❑ Crass Section ❑ Plumbing Plan ❑ Single Line diagram for also,services over 400 AMP ❑ Floor Plan ❑ Structural Framing Plan 8 Details ❑ Shoring Plan ❑ Sound Report-Residential Class Code: Indicate New Construction Alteration` Addition' MeanslMethods Work Type: Repair` El Retrofit* Revision to Existing Permit' Required? YES NO Proposed Building Use(s): Existing Building Use(s): Buildings: 8 Units, rt Stories' Will the Building Have a Basement? Y of N Bldg.Code Occupancy Group Indicate Indicate it YES or NO Indicate all Geo-tech.Haz.Zone RI Project Constuction SPrinklereC that apply: Coastal Zone Completion: Type(s): C DIP YES or NO Noise Zone Required? Listed on Historic Resources Irventory CITY PLANNING STAFF ONLY APPROVALS: Costal Commiss Arch.Review 8oartl Landmark Comm. Planning Comm.Zoning Administrator Fee Exempt: City Project Elea Vehicle Charger landmark Seismic Retrofit speoet case:alap offici royal Expedite ProjeM(s): Child Care Gity Project Green Building Landmark Affordable Housing For Staff Use Only Builrimgl5afely Permit Specialist City Panning CmA Fn ins?nng LPWM-Adman Iansponalior fv7gml. Rani ConVoi THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY a � T Simplified Prescriptive Certifi 08 Residential HVAC Alterations CF-IR-ALT-HVAC Climate Zones 10 to 15 MAY 14 2014 Site Address: En orcementAg y: Date: -� P nut•#„ 0' �� C t�• Conditioned Floor E ui ment Type' List Minimum Efficiency' Duct insulation requirement Area Thermostat Packaged []Furnace ❑AFUE COP Unit Over 40 It of ducts added or JR[] Setback Indoor Coil MEER� HSPF_ r laced in unconditioned space Served by system p already IqCondensing Unit []EER_ Resistance R 6 (CZ 10-13) sf present,must 6e Other R 8 (CZ 14-15) installed) 1.Equipment Type:Choose the equipment being installed;if more than one system,use another CF-1 R-ALT-HVAC for each system. 2.Minimum Equipment Efficiencies:13 SEER, 78%AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted.A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final,the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF4R 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-6R shall also be on site for final inspection. 1.HVAC Changeout Required Forms: P r t k CSYN t • All HVAC Equipment replaced CF-6R forms: MECH-04,MECH-21-HERS and(for sp' ystems)MECH-25-HERS CF-4R forms: MECH-21 and(fors lit systems) MECH-25 • Condenser Coil and/or • Indoor Coil and/or CF-6R forms: MECH-2I-HERS and(for split systems)MECH-25-HERS CF-4R forms: MECH-21 and(for split systems) MECH-25 • Furnace For Split Systems:Duct leakage<15 percent; RC,CCA>300 CFM/ton(Minimum Air Flow Requirement),TMAH For Packaged Units: Duct leakage<15 percent Exempted from duct leakage testing if: 1.Duct system was documented to have been previously sealed and confirmed through HERS verification,or 2.Duct systems with less than 40 linear feet in unconditioned space,or 3.Existing ducts stems are constructed,insulated or sealed with asbestos HVAC System Required Forms: • Cut in or Changeout with new CF-6R fors: MECH-04,MECH-20-HERS,and ducts:(all new ducting and all (for split systems)MECH-22-HERS,and MECH-25-HERS new equipment) CF-4R fors: MECH 20-,and(for split systems)MECH-22,and MECH 25 For Split Systems:Duct leakage<6 percent;RC,CCA>350 CFM/ton,FWD,TMAH,STMS,.and either HSPP or PSPP. For Packaged Units:Duct leakage<6 percent [33.New Ducts with/or without Replacement Required Forms: • Includes replacing or installing all new ducting CF-6R fors: MECH-04,MECH-20-HERS,and(for split systems)MECH-25-HERS and/or outdoor condensing unit and/or indoor coil CF-4R fors:MECH-20 and(for split systems)MECH-25 and/or furnace. No or some equipment changed. For Split Systems:Duct leakage<6 percent,RC,CCA>300 CFM/ton,TMAH For Packaged Units:Duct leakage<6 percent 4.New Ducting over 40 feet I Required Forms: • Includes adding or replacing more than 40 CF-6R fors: MECH-04,MECH-2I-14ERS CF-4R fors: MECH-21 linear feet of duct in unconditioned space. For splits stem or packaged units: Duct leakage< 15 percent EXCEPTION:Existing ducts stems 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. • 1 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, Pam I 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,pins and specifications submitted to the enforcement agency fora royal with the permit a lication. m Nae:Laura Yenulonis - Agent Signature: company:Venvest Ballard Inc., dba: RighTirre Air Conditioning & Hea Address:3030 Myers Street License:878533 city/Statercip:Riverside, Ca 92503 Pnone:951-276-9744 2008 Residential Compliance Forms March 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC Climate Zones 10- 15 Site Address: Enforcement Agency: Date: Permit#: 28165 OrangeGrove Ave Menifee, CA 92584 City of Menifee May 20, 2014 Duct insulation Conditioned Floor Equipment Typei List Minimum Efficiency2 requirement Area Thermostat ®Package Unit ❑Furnace ❑AFUE_ ❑COP ck Q R g(CZ 10-13) Served by system I®of already present, must be M Indoor Coil IM SEER 13.0 ❑ HSPF ®R g (CZ 14-15) 1300 sf installed ®Condensing Unit ❑EER ❑Resistance ) ❑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-SR and CF-6R shall also be on site for final Inspection. M 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) MECFI-25-HERS .Indoor Coil and/or CF-4R forms: MECH-21 and (for split systems) MECH-25 .Furnace For Split Systems: Duct leakage< 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement),TMAH Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or 2. Duct systems with less than 40 linear feet in unconditioned space, or 0 3. Existing duct systems are:constructed, insulated or sealed with asbestos []4.The system will not be Ducted (le. Ductless Mini-Split System) (Also Exempt from Refrigerant Charge) ❑2.New HVAC System Required.Forms: .Cut In or.Changeout with CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and new ducts: (all new M£CH-25-HERS- ducting And all new CF-411.forms:MECH-20, and (for split systems) MECH-22, and.MECH-25 equipment) For Split Systems: Duct leakage <6 percent; RC, CCA i 350 CFM/ton, FWD,TMAH, STMS,and either HSPP or PSPP. For Packaged Units: Duct leakage< 6 percent 3. New Ducts with/or without Required:Forms: Replacement .Includes replacing or installing all:new ducting and/or outdoor condensing unit CF-611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace; No or some CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton,TMAH For Packaged Units: Duct leakage < 6 percent ❑4. New Ducting over 40 feet Required Forms: .Includes adding or replacing more than 40 CF-6R forms: MECH-04, MECH-2I-HERS linear feet of duct In unconditioned space. CF-4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor(Documentation Author's/Responsible Designer's Declaration Statement) •I certify that this Certificate of Compliance documentation Is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design Identified on this Certificate of Compliance. •I certify that the energy features and performance specifications for the design Identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. •The design features identified on this Certifcate 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: Jim McEligot Signature: Jim McEligot Company: VENVEST BALLARD INC Date: May 20, 2014 Address: 3030 MYERS STREET License: 878533 City/State/Zip: RIVERSIDE/CA/92503 Phone: (951) 276-9744 Reg: 214-A0036618A-000000000-0000 Registration Date/Time: 2014/05/20 23:17:40 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010 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: 28165 OrangeGrove Ave, Menifee CA 92584 (System City of Menifee PMT14-011,08 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 Options 1, 2,or 3 must be attempted before utilizing Option 4.).. Determine nominal Fan:Flow using one of the following three calculation methods. - ✓®Cooling system method: Size of condenser in Tons 3.: x 400 = 1200 '-.CFM Heating system method; 21.7 z_Output Capacity In Thousands of Btu/hr =_CFM ✓O Measured system airflow using J RA3.3 airflow test procedures: CFM Option 1 used then: - 1 Allowed leakage = Fan Flaw 1200 x 0.15 = 1110 CFM Actual:Leakage = 13 CFM Pass if Leakage Actual Is less than Allowed ®Pass 0 Fail Option 2 used then`: 2 Allowed leakage =Fan Flow_x 0.10 =_CFM Actual Leakage to outside =—CFM Pass if Leakage Actual is less than Allowed p 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% _ /o Reduction Pass if% Reduction >= 60% Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No sampling). Pass If all accessible leaks have been repaired using smoke Pass Fail Reg: 214-A0036618A-M2100001A-M21A Registration Date/Time: 2014/05/20 23:35:15 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms March 2010 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-411-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 28165 OrangeGrove Ave, Menifee CA 92584 (System City of Menifee PMT14-01108 1) ®Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. ® All supply and return register boots must be sealed to the drywall if smoke test is utilized for compliance - applies to duct leakage compliance option 3 (leakage reduction by 60%) and option 4 (fix all accessible leaks) described above. ® New duct installations cannot utilize building cavities as plenums or platform returns in lieu of ducts. ` ® Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to seal ! leaks at all new duct connections. DECLARATION STATEMENT I certify under penalty of perjury, under the laws of the State of California,the information provided on this form is true and correct. I am 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 Certifcate(s)of Compliance-(CF-SR)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 Certlficate(s)of Compliance(CF-1R)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) VENVEST BALLARD INC Responsible Person's Name: CSLB License: Jim McEligot 87SS33 HERS Provider Data Registry Information Sample Group # Cif aPPlicable : N/A tested/verified dwelling ❑not-tested/verified dwelling in a HERS sample group HERS Rater Information CalCERTS Certificate# CCI-1798861505 HERS Rater Company Name: Precision HERS Testing Responsible Rater's Name: Responsible Rater's Signature: Ezequiel Moreno Ezequiel Moreno Responsible Rater's Certification Number w/this HERS Provider: Date Signed: 5/19/2014 CC2005795 Reg: 214-A003661BA-M2100001A-M21A Registration Date/Time: 2014/05/20 23:35:15 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: 28165 OrangeGrove Ave, Menifee CA 92584 City of Menifee I PMT14-01108 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 Figure in Section RA3.2.2.2.2. Return side of the duct system is la located entirely within conditioned ❑Yes ❑Yes ❑Yes ❑Yes space and return airflow temperature ❑ No ❑ No ❑ No ❑ No to be measured at the return grille. 5/16 inch (8 mm) access hole 2 downstream of evaporative coil in the ®Yes ❑Yes ❑Yes ❑Yes supply plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figure in Section RA3.2.2.2.2. The TMAH Compliance Option should be checked only if the HERS Rater is able to confirm that it was physically impossible for the HVAC Installer to drill the TMAH as required by Section RA3.2.2.2.2. Using this Compliance Option requires the HVAC installer to annotate on the HERS Provider's data registry an explanation as to why the TMAH cannot be installed on the system, and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance Option also requires minimum airflow verification through the direct measurement of airflow per RA3.3. For more information see httr)://www.enerciv.ca.ciov/title24/2008standards/``special case appliance/ TMAH Compliance Option ❑ ❑ ❑ ❑ Yes to 1 and 2, or Yes to la and 2, or checking the TMAH Compliance Option, is IN Pass ❑ Pass ❑ Pass ❑Pass a pass. ❑ Fail ❑ Fail ❑ Fail ❑ Fail Enter Pass or Fail Reg: 214-A0036618A-M2500001A-M25A Registration Date/Time: 2014/05/20 23:38:17 HERS Provider: CaICERTS, Inc. 2008 Residential Compliance Forms February 2013 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 6) Site Address: Enforcement Agency: Permit Number: 28165 OrangeGrove Ave, Menifee CA 92584 City of Menifee PMT14-01108 STMS - Sensor on the Evaporator Coil System Name or System 1 Identification/Tag The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed 3 by methods/specifications approved by the Executive Director. ❑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 Name or System 1 Identification/Tag The sensor is factory installed, or field installed according to manufacturer's specifications, or is installed 6 by methods/specifications approved by the Executive Director. ❑Yes ❑ No 1 ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 7 The sensor mini plug is accessible to the Installing technician and the HERS rater without changing the airflow through the condenser coil ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No 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 Yesto6, 7, and 8isa 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-A0036618A-M2500001A-M25A Registration Date/Time: 2014/05/20 23:3B:17 HERS Provider: Cal CERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 6) Site Address: Enforcement Agency: Permit Number: 28165 OrangeGrove Ave, Menifee CA 92584 City of Menifee PMT14-01108 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 550F) 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 # 1402016130 Outdoor Unit Make GOODMAN Outdoor Unit Model GSX13O361EB Nominal Cooling Capacity 3 Tons Date of Verification 5/19/2014 Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 5/1/2014 (must be re-calibrated monthly) Date of Thermocouple Calibration 5/1/2014 (must be re-calibrated monthly) Measured Temperatures (OF) System Name or Identification/Tag System 1 Supply (evaporator leaving) air dry-bulb 48 temperature (Tsu I db) Return (evaporator entering) air 70 dry-bulb temperature (Treturn db) Return (evaporator entering) air 56 wet-bulb temperature (Treturn wb) Evaporator saturation temperature 32 (Teva orator sat) Condensor saturation temperature 78 (Tcondensor, sat) Suction line temperature (Tsuction) 50 Liquid Line Temperature (Tliquid) 69 Condenser (entering) air dry-bulb 66 temperature (Tcondenser db) Reg: 214-A0036618A-M2500001A-M25A Registration Date/Time: 2014/05/20 23:38:17 HERS Provider: CalCERTS, 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: 28165 OrangeGrove Ave, Menifee CA 92584 City of Menifee PMT14-01108 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 = 22.00 Treturn db - Tsupply, db Target Temperature Split from Table RA3.2-3 19.5 using Treturn wb and Treturn db Calculate difference: Actual Temperature 2 5 Split - Target Temperature Split = Passes if difference is between -40F and +40F or, upon remeasurement, if between PASS -40F and -1000F Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name or Identification/Tag Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 procedures (CFM) Measurement Method Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement, Enter Pass or Fail Reg: 214-A0036618A-M2500001A-M25A Registration Date/Time: 2014/05/20 23:38:19 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms February 2013 INSTALLATION CERTIFICATE CF-411-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 6) Site Address: Enforcement Agency: Permit Number: 28165 OrangeGrove Ave, Menifee CA 92584 City of Menifee I PMT14-01108 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 +60F 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 = 9.0 Tcondenser, sat- Tli uid Target Subcooling specified by 10 manufacturer Calculate difference: _1 Actual Subcooling - Target Subcooling = System passes if difference is between -40F and +40F PASS Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat = 18.0 Tsuction - Teva orator sat Enter allowable superheat range from manufacturer's specifications (or use range 4-25 between 30F and 260F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range PASS Enter Pass or Fail Reg: 214-A0036618A-M2500001A-M25A Registration Date/Time: 2014/05/20 23:38:17 HERS Provider: CaICERTS, Inc. 2008 Residential Compliance Forms February 2013 ii INSTALLATION CERTIFICATE CF-4R-MECH-25 Refrigerant Charge Verification - Standard Measurement Procedure (Page 6 of 6) Site Address: Enforcement Agency: Permit Number: 28165 OrangeGrove Ave, Menifee CA 92584 City of Menifee PMT14-01108 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 550F and 650F the return air dry bulb temperature shall be maintained above 70OF during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate. DECLARATION STATEMENT . I certify under penalty of perjury, under the laws of the State of California, the Information provided on this form is true and correct. . I am 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-SR)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: (Installing Subcontractor or General Contractor or Builder/Owner) VENVEST BALLARD INC Responsible Person's Name: CSLB License: Jim McEligot 878533 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ®tested/verified dwelling ❑ not-tsted/verifed dwelling in a HERS sample group HERS Rater Information Ca10ERTS Certificate * CCI-1798861505 HERS Rater Company Name: Precision HERS Testing Responsible Rater's Name: Responsible Rater's Signature: Ezequiel Moreno Ezequiel Moreno Responsible Rater's Certification Number w/this HERS Provider: Date Signed: 5/19/2014 CC2005795 Reg: 214-A0036618A-M2500001A-M25A Registration Date/Time: 2014/05/20 23:38:17 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: 28165 OrangeGrove Ave, Menifee CA 92584 (System City of Menifee PMT14-01108 1) 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-SR space, Duct Load Capacity heat pump) and Model Number Number2 Systems value)4 etc.) R-value (ketu/hr) (ketu/hr) Split TRANE Furnace TUD080R936H4 1 80 AFUE Attic R-4.2 64 80 ketu Cooling Equipment Efficiency Duct Equip. (SEER Location Type. and EER) (attic, (package ARI #of 1,3 crawl- Cooling Cooling heat CEC Certified Mfr. Name Reference Identical (>=CF-IR space, Duct Load Capacity pump) and Model Number Number2 Systems value)4 etc.) R-value (kBtu/hr) (kBtu/hr) Split iGOODMAN A/C GSX130361ES 1 13 SEER Attic R 4.2 36 3 Tons 1. If project is new construction, see Footnotes to Standards Table 151-8 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( 7) to the value shown on the CF-IR form. 4. When CF-IR is reference it is also applicable to the CF-IR, CF-SR-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(1): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of §112(c). IN §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-A0036618A-M0400001A-0000 Registration Date/Time: 2014/05/20 23:31:08 HERS Provider: CalCERTS, Inc. 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: 28165 OrangeGrove Ave., Menifee CA 92584 (System City of Menifee PMT14-01108 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. Flexible ducts cannot have porous inner cores. DECLARATION STATEMENT Ili .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 certlflcate(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-IR)form approved by the enforcement agency that identifies the specific requirements for the installation..I certify that the requirements detailed on the CF-1R that apply to the installation have been met. .I will ensure that a completed,signed copy of this Installation Certificate shall be posted,or made available with the building permit(s) issued for the building,and made available to the enforcement agency for all applicable inspections.I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) VENVEST BALLARD INC dba RIGHTIME AIR CONDITIONING AND HEATING Responsible Person's Name: Responsible Person's Signature: Jim McEligot Jim McEligot CSLB License: Date Signed: position With Company (Title): 878533 5/19/2014 Reg: 214-AO03661BA-MO4000OIA-0000 Registration Date/Time: 2014/05/20 23:31:08 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms August 2DD9 INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test - Existing Duct System (Page 1 of 2) Site Address: Enforcement Agency: Permit Number: 28165 OrangeGrove Ave, Menifee CA 92584 (System City of Menifee PMT14-01108 1) Enter the Duct System Name or Identification/Tag: System I Enter the Duct System Location or Area Served: Whole House Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System.' Duct Leakage Diagnostic Test-existing duct system Select one compliance method from the following four choices. ® 1. Measured leakage less than 15% of fan flow 2. Measured leakage to outside less than 10%.of Fan Flow ®3. Reduce leakage by 60%and conduct smoke and fix all leaks 4. Fix all accessible leaks using smoke and HERS rater verify � Note: (one of options 1, 2 or 3 must be attempted before utilizing Option 4.) Determine nominal Fan Flow using one of the following three calculation methods,.,. ✓®Cooling system method: Size of condenser in Tons 3 x 400 = 1200 CFM ✓❑Heating system method: 21.7 x_Output Capacity in Thousands of Btu/hr =_CFM ✓❑Measured system airflow using RA3.3 airflow test procedures: _CFM Option 1 used then: 1 Allowed leakage= Fan Airflow 1200 x 0.15 - 1so CFM Actual.Leakage= 137 CFM Pass if Actual Leakage is less than Allowed leakage Pass 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_1 Initial leakage--)x 1000% =%Reduction Pass if% Reduction >= 60% Pass Fail Option 4 used then: 4 All accessible leaks repaired using smoke test. HERS rater must verify (No Sampling). Pass if all accessible leaks have been repaired using smoke rl Pass Fall Reg: 214-A003661BA-M2100001A-0u0 Registration Date/Time: 2014/05/20 23:31:40 HERS Provider: Ca10ER March nc. 2008 Residential Compliance Forms INSTALLATION CERTIFICATE CF-6R-MECH-2I-HERS Duct Leakage Test — Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 28165 OrangeGrove Ave, Menifee CA 92584 (System City of Menifee PMT14-01108 1) ®Outside air (CIA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage testing. CFI 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 supply and return register boots must be sealed to the drywall if smoke test is utilized for compliance — applies to duct leakage compliance option 3 (leakage reduction by 60%) and option 4 (fix all accessible leaks) described above. ® New duct installations cannot utilize building cavities as plenums or platform returns in lieu of ducts. ® Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to seal leaks at all new dud connections DECLARATION STATEMENT •I certify under penalty of perjury,under the laws of the State of California,the information provided an 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-1R)form approved by the enforcement agency that identifies the specific requirements for the installation.I certify that the requirements detailed on the CF-lR 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) VENVEST BALLARD INC dba RIGHTIME AIR CONDITIONING AND HEATING Responsible Person's Name: Responsible Person's Signature: Jim McEligot Jim McEligot CSLB tkense: 5/Date Signed: Position With Company (Title): 878533 Is this installation monitored by a Third Party Quality Name of TPQCP(if applicable): Control Program (TPQCP)? ❑Yes [3 No Reg: 214-A0036618A-M2100001A-0000 Registration Date/Time: 2014/05/20 23:31:40 HERS Provider: CalCERTS, 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: 28165 OrangeGrove Ave, Menifee CA 92584 City 0f Menifee PMT14-01108 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 Handier 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 Figure in Section RA3.2.2.2.2. Return side of the duct system Is la located entirely within conditioned ❑Yes [I Yes ❑Yes ❑Yes space and return airflow temperature ❑ No ❑ No ❑ No ❑ No to be measured at the return grille. 5/16 inch (8 mm) access hole 2 downstream of evaporative coil in the ®Yes ❑Yes ❑Yes ❑Yes supply plenum and labeled according ❑ No ❑ No ❑ No ❑ No to Figure in Section RA3.2.2.2.2. The TMAH Compliance Option should be checked only if it is physically impossible to drill the TMAH as required by Section RA3.2.2.2.2. Using this Compliance Option requires the HVAC installer to annotate on the HERS Provider's data registry an explanation as to why the TMAH cannot be installed on the system, and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance Option also requires minimum airflow verification through the direct measurement of airflow per RA3.3 For more information see http //www eng ray,ca oov/title24/2008standards/special case appliance/ 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-A003661BA-M2500001A-0000 Registration Date/Time: 2014/05/20 23:34:39 HERS Provider: Cal CERT8, 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: 28165 OrangeGrove Ave, Menifee CA 92584 City of Menifea PMT14-01108 STMS - Sensor on the Evaporator Coil S Identification/Tag ystem Name or System 1 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. [3 Yes ❑No ❑Yes [3 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 0 Yes ❑No ❑Yes O 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 Name or System I Identification/Tag The sensor is factory Installed, or field installed according to manufacturer's specifications, or is installed 6 by methods/specifications approved by the Executive Director. O Yes ❑ No ❑Yes ❑ No 11 ❑Yes ❑No ❑Yes ❑ No The sensor wire is terminated with a standard mini plug suitable for connection to a digital thermometer. 7 The sensor mini plug is accessible to the Installing technician and the-HERS'rater without changing the airflow through the condenser coil ❑Yes n No ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No fOthterwiseenter or measures the saturation temperature of the coil within 1.3 degrees F ❑Yes ❑ No 0Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No and 8 is a ❑ N/A ❑ N/A ❑ N/A ❑N/A f STMS are not ❑ Pass ❑ Pass ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Fail 0 Fail nter Pass or Reg:. 214-A0036618A-M2500001A-0000 Registration Date/Time: 2014/05/20 23:34:39 HERS Provider: Ca10ERTS, 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: 28165 OrangeGrove Ave, Menifee CA 92584 1 City of I PMT14-01108 Standard Charge Measurement Procedure (for use if outdoor air dry-bulb temperature is 55OF or above) Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential Appendix RA3.2, As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for any additional systems in the dwelling as applicable. • The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. •If outdoor air dry-bulb temperature is less than 55°F, the installer must use the RA3.2.3 Alternate Charge Measurement Procedure(Weigh-In Charging Method). If the Weigh-In Method is used, the dwelling cannot be included in a sample group for HERS verification compliance.) Space Conditioning Systems System Name or Identification/Tag System 1 System Location or Area Served Whole House Outdoor Unit Serial # 1402016130 Outdoor Unit Make GOODMAN Outdoor Unit Model GSX130361EB Nominal Cooling Capacity 3 Tons Date of Verification 5/19/2014 Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration 5/1/2014 (must be re-calibrated monthly) Date of Thermocouple Calibration 5/1/2014 (must be re-calibrated monthly) Measured Temperatures (OF) System Name or Identification/Tag System 1 Supply (evaporator leaving) air dry-bulb 48 temperature (Tsu I db) Return (evaporator entering) air 70 dry-bulb temperature (Treturn db) Return (evaporator entering) air 56 wet-bulb temperature (Treturn wb) Evaporator saturation temperature 32 (Teva orator sat) Condenser saturation temperature 78 (Tcondensor, sat) Suction line temperature (Tsuction) so Liquid Line Temperature (Tliquid) 69 Condenser (entering) air dry-bulb 66 temperature (Tcondenser, db) Reg: 214-A003661BA-M2500001A-0000 Registration Date/Time. 2014/0S/20 23.34.39 HERS Provider: Cal CERTS, Inc. 2008 Residential Compliance Forms March 2013 INSTALLATION CERTIFICATE CF-611-MECH-25-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 6) Site Address: Enforcement Agency: Permit Number: 28165 OrangeGrove Ave, Menifee CA 92584 City of Menifee PMT14-01108 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 = 22.00 Treturn db Tsu I db Target Temperature Split from Table RA3.2-3 19.5 using Treturn wb and Treturn db Calculate difference: Actual Temperature 2.5 Split - Target Temperature Split = Passes if difference is between -30F and +30F or, upon remeasurement, if between PASS -30F and -100OF Enter Pass or Fail Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name or Identification/Tag System 1 Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 procedures (CFM) Measurement Method Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Reg: 214-A0036618A-M2500001A-0000 Registration Date/Time: 2014/05/20 23:34:39 HERS Provider: Ca10ERTS, 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: 28165 OrangeGrove Ave, Menifee CA 92584 City of Menifee PMT14-01108 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 = 9.O Tcondenser, sat-Tli uid Target Subcooling specified by 10 manufacturer Calculate difference: -1 Actual Subcooling - Target Subcooling = System passes if difference is between -30F and +30F PASS Enter Pass or Fail Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag System 1 Calculate: Actual Superheat = 18.0 Tsuction -Teva orator sat Enter allowable superheat range from manufacturer's specifications (or use range 4-25 between 40F and 250F if manufacturer's specification is not available) System passes if actual superheat is within the allowable superheat range PASS Enter Pass or Fail Reg: 214-AO03661BA-M2500001A-0000 Registration Date/Time: 2014/OS/20 23:34:39 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 6 of 6) Site Address: Enforcement Agency: Permit Number: 28165 orangeGrove Ave, Menifee CA 92584 City of Menifee PMT14-01108 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 19 Residential Appendix RA3.2.2 requires that if the outdoor temperature Is between 55OF and 650F the return air dry bulb temperature shall be maintained above 70OF during the Standard Charge Measurement Procedure. The signature of the Responsible Person in the declaration statement below certifies this requirement has been met for all applicable system verifications reported on this certificate. DECLARATION STATEMENT .I certify under penalty of perjury, under the laws of the State of California,the information provided on this form is true and correct. .I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized representative of the person responsible for construction (responsible person). .I certify that the Installed features,materials,components, or manufactured devices identified on this certificate(the Installation) conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. .I understand that a HERS rater will check the installation to verify compliance,and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of Installations, Including those approved as part of a sample group but not checked by a HERS rater,and If those installations fail to meet the requirements of such quality assurance checking, the 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) VENVEST BALLARD INC dba RIGHTIME AIR CONDITIONING AND HEATING Responsible Person's Name: Responsible Person's Signature: Tim McEligat Jim McEligot CSLB License: Date Signed: Position With Company (Title): 878533 5/19/2014 Is this installation monitored by a Third Party Quality Name of TPQCP (if applicable): Control Program (TPQCP)? ❑Yes ❑ No Reg: 214-A0036618A-M2500001A-0000 Registration Date/Time: 2014/05./20 23:34:39 HERS Provider: EalCERTS, Inc. 2008 Residential Compliance Forms March 2013