14090082 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19721 BIXBY DR CONTRACTOR:R.C.MORENO HTNG& PERMIT NO: 14090082
A/C
OWNER'S NAME: TAMBLYN COLIN D AND VIRGINIA T 233 E RINCON AVE DATE ISSUED:09/15/2014
OWNER'S PHONE: 4082532278 CAMPBELL,CA 95008 PHONE NO:(408)379-9246
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑
REPLACE(E)DUCT WORK UNDERNEATH SFD(800 L.F.)
License Class0—Z0 Lic.# 30¢
Contractor C;40 fLe rc v Date��—
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$4000
I have and will maintain Worker's Compensation Insurance,as provided for by
( Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36909046.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter _ —
upon the above mentioned property for inspection purposes. (We)agree to save 180 D LED INSPEC ON.
indemnify and keep harmless the City of Cupertino against liabilities,judgments, --
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Secti
9 18.
a� RE-ROOFS:
Signatur Date All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio 5505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent:
permit is issued. Date:
I certify that in the performance of the work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
--
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9 18.
Signature Date
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CITY OF CUPERTINO
FEE ESTIMATOR— BUILDING DIVISION
ADDRESS: 19721 BIXBY DR DATE: 09/15/2014 REVIEWED BY: MELISSA
APN: 369 09 046 ---TB—P#: "VALUATION: 1$4,000
PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair
PRIMARY PENTAMATION
USE: SFD or Duplex - PERMIT TYPE: 1 RMAP A
WORK REPLACE E DUCT WORK UNDERNEATH SFD 800 L.F.
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Other Appliance/Equip 16APPLOT 1 # .$72
TOTALS: $72.00
Mech.Plan Check FO.0 hrs $0.00 /'latrnh I'lon t:"h"ch Lsle°. P/ana Check
Mech.Permit Fee: IMPERMIT t'honb Permit
Other Mech.Insp. 0.0 hrs $48.00 of,l er P,7wn r Irisr?
Phan t). Inas. Fee:
NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . Theseees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff 711/13) FEE QTY/FEE MISC ITEMS
st",ppl. I'('? >e
PME Plan Check: $0.00
PME Unit Fee: $72.00
PME Permit Fee: $48.00
�,,Ei3f:S"f7'LtCIt�J12 .dCI z
Administrative Fee: ]ADMIN $45.00
Work Without Permit? ® Yes 0 No $0.00
Travel Documentation Fee: ITRAVDOC $48.00
Strong Motion Fee: ]BSEISMICR $0.52 Select an Administrative Item
Bldl,Stds Commission Fee: IBCBSC $1.00
$214.52 $0.00 TEE: $214.52
Revised: 08/20/2014
STATE OF CALIFORNIA UW
ALTERATIONS - HVAC
CEC-CFIR-ALT-03-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-03-E
Alterations-HVAC CZ 1,3 to 7 and 16(formerly CF-IR-ALT-HVAC) (Page 1 of 1)
Site Address: Enforcement gency: Date repar d: Permit#:
?Z-( 6 i 0A_ Cv f G rl%.D I 1 Eq 09 0-08
Equipment Type Equipment Efficiency New:Ducting,Plenums,Lineset Conditioned Thermostat
Required R-value Floor Area(sq ft)
❑Packaged System ❑Evaporator Coil AFUE COP ❑R-6 (CZ 1,3-7)Ducts Served by system K1 Setback
9 Split System ❑Condensing Unit SEER A R-8' (CZ 16)Ducts 1720 sq ft (If not already
13 Furnace ❑Lineset EER HSPF ^R R-6(all CZ's)Plenums present must
❑R-5 or R7.5 Lineset be installed)
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered(no hand filled forms allowed)and a copy left on site.
HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
Can include new ducting
All Equipment, CFIR-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R:MECH-OS,MECH-20-HERS
Air Handler/Furnace CF3R:MECH-20-HERS
Installer Requirement:Duct leakage(:5_15%or,<10%to outside,or seal all accessible leaks)
Exempted from duct leakage testing if:
❑1.Duct system registered with HERS provider as previously sealed,or❑2.There is less than 40 linear feet of duct in unconditioned
space,or ❑3.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building .......
❑2.New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts' CFIR-ALT-02-E
CF2R-MECH-01,MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS
CF3R-MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS'
Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM),Air Flow>_350 CFM/ton(or Standards Table 150.0-C/D alternative)
111 All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
Includes replacing.or installing All New CFIR-ALT-02-E
Ducts'and one or more of the following: CF2R-MECH-01,MECH-20-HERS,MECH-(23 or 24)-HERS
Condenser Unit,Evaporator Coil,Furnace CF3R-MECH-20-HERS,MECH-(23 or 24)-HERS
Installer Requirement:Duct leakage<6%,Air Flow>_350 CFM/ton(or Standards Table 150.0-C/D alternative)
❑Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos.
4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
Adding or replacing ducts in unconditioned CF1R-ALT-02-E
space but less than All New Ducts' CF2R:MECH-20-HERS
CF3R:MECH-20-HERS
Installer Required to:Duct leakage(S.15%or,<10%to outside,or seal all accessible leaks)
❑ Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos.
'All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls,between floors etc.
'A New Duct system is when the duct system is constructed of at least 75 percent new duct material,and up to 25 percent may consist of reused
parts from the dwelling unit's existing duct system(e.g.,registers,grilles,boots,air handler,plenums,duct material.
3 R-5(1"thick insulation)for linesets 1"and less. R-7.5(1.5"thick insulation)for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%",2.5-3T-2%",3.5 to 4T-2%e",5T-4%"
Contractor(Documentation Author's/Responsible Designer's Declaration Statement)
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document.
3. 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(CCR).
4. That the energy features and performance specifications,materials,components,and manufactured devices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the CCR.
5. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents,worksheets,calculations,plans and specifications submitted to the enforcement
agency for approval with this building permit application.
ResnAnlihie Designer Name: Respo I D signer Signature: Date Signed: License:
01
Company: A dress: City/State/Zip: Phone:
Z.;3,;./�irce�r oo�3r3 odQf6�
For assistance or q estions regarding the Energy Standards,contact the Ener Hotline-at:1-800-772-3300
CUPERTINO
Owner Name
Address
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT -BUILDING DIVISION
10300 TORRE AVENUE • CUPERT*O, CA 95014-3255
(408) 777 -3228 -FAX (408)777-3? 33 • buitdina(a�cupertino.ora
i►�.inJ W/ n�.�n�/1f-,,� Permit No. V
ZC J.
EIL
qz2tLq_2.)C1
m1f
Please refer to the attached California Civil Code Sections I IGIA -1101.8 which are part of this Certification form.
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
Owner' Signature:
No Go to Question 2.
Date:
2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its
plumbing, installation of water -conserving plumbing fixtures is not technically feasible?
❑ Yes Civil Code Sections 110 1. 1 through 1101.8 do not apply.
❑ The licensed plumber's certification has. been provided to the Building Division.
Sign below and skip the rest of the form.
Owner' Signature:
No Go to Question 3.
Date:
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
Owner' Signature:
X No Go to Question 4.
Date:
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
❑ No My real property is built and available for use or occupancy after January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
Owner' Signature: Date:
Yes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached.
My property is a single-family residential real property. See Civil Code Section 1101.4.
On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing
fixtures to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1,
220.17 all non-compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless
of whether property undergoes alterations or improvements).
❑ My property is a multifamily residential real property. See Civil Code Section 1101.5.
On and after January 1, 2014, specified building alterations or improvements shall require non- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
jp,0 / 9 On or before January 1,. 2019, all non-compliant plumbing fixtures shall be replaced with water -
conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or
improvements).
❑ My property is a commercial real property. See Civil Code Section 1101.5.
On and after January 1, 2014, specified building alterations or improvements shall require non- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
SB407 2014.doc revised 03118114
o ,"j On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving
P. s .q phanbing fixtures throughout the building (regardless of whether property undergoes alterations or
,..–
ements).
" 'Me —owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixtures have been replaced
with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8, the current
California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and
that the water -conserving plumbing fixtures comply with the requirements as indicated in the table below.
Owner's (or Owner Agent's) Signature: Date:
Upon completing and signing this Certificate, please return it to the Building Division in order to final your permit.
Non -Compliant
Water -Conserving Plumbing Fixture
PlumbingFixture
(Fixture Complying with Current Code Applicable to New Construction)
Maximum Water Usage/Flow Rate
Fixture Type
Water Usage
2013 CPC Ch. 4
2013 CPC Ch. 4
2013 CPC Ch. 4
/Flow Rate
2013 CALGreen Div. 4.3
2013 CALGreen Div. 4.3
2013 CALGreen Div. 5.3
Single -Family
Multi -Family
Commercial
Residential
Residential
Water Closets
Exceed 1.6
Single flush toilets: 1.28 gallons/flush
(Toilets)
Gallons/flush
Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite,
average flush volume of two reduced flushes and one full flush
Urinals
Exceed 1.0
0.5 gallons/flush
Gallons/flush
Showerheads
Exceed 2.5
2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of
gallons per minute
U.S. EPA WaterSense Specification for Showerheads
(A hand-held shower is considered a showerhead.)
For multiple showerheads serving one shower, the combined flow rate of all
showerheads and/or other shower outlets controlled by a single valve shall not
exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to
allow only one shower outlet to be in operation at a time.
Faucets –
Exceed 2.2 gallons
Maximum 1.5 gallons per
Within units:
0.5 gallons per minute @ 60
Lavatory
per minute
minute @ 60 psi; minimum
Maximum 1.5 gallons
psi
Faucets
0.8 gallons per minute @
per minute @ 60 psi;
20 psi
minimum 0.8 gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
1.8 gallons per minute
60 psi
Faucets –
Exceed 2.2 gallons
1.8 gallons per minute @
1.8 gallons per minute
1.8 gallons per minute @ 60
Kitchen
per minute
60 psi
@ 60 psi
psi
Faucets
May temporarily increase
May temporarily
up to 2.2 gallons per
increase up to 2.2
minute @ 60 psi, and must
gallons per minute @
default to maximum
60 psi, and must -
1.8 gallons per minute @
default to maximum
60 psi
1.8 gallons per minute
Where faucets meeting
@ 60 psi
the above are unavailable,
Where faucets meeting
aerators or other means
the above are
may be used to achieve
unavailable, aerators or
reduction.
other means may be
used to achieve
reduction.
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2014.doe revised 03/18/14
W
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (P )
Project Name: S
Enforcement Agency: City of Cupertino
Permit Number: 14090082
Dwelling Address: 19721 Bixby Dr
Ci y: Cupertino
Zip Code:014
ii
A. General Information
01
Dwelling Unit Name
Tamblyn RES
02
Climate Zone
4
07
Dwelling Unit Conditioned Floor Area
09
10
Number of space conditioning (SC)
03
(ft2)
1750
04
systems being altered in this dwelling
1
Are all of the
unit.
05
Certificate of Compliance Type
Prescriptive alterations (CF1R-ALT)
06
Method used to calculate HVAC loads
ACCA Manual J
07
Calculated dwelling unit Sensible
75000
08
Calculated Dwelling Unit Heating Load
75000
Cooling Load (Btuh)
components
(Btuh)
5 t
r. T!tJ.
02
.'tT� );
MCH -01b Prescriptive Alterations Ipace Condit -)"h
S, ms Ducts`- Fans
06
07
08
09
10
Are all of the
�..:, YT, -7 7771,77 p7 RPA u- b-77 77 tsr '�.�u •m" .� _ ,. =s; wa ',fin yF �. > ;-w'M` ,..`.
B. Space Conditioning (SC) System Information
01
02
03
04"
05
06
07
08
09
10
Are all of the
system's
components
and ducts
CFA served
is the SC
Installing a
Installing
new or
SC System
SC System
by this SC
system a
refrigerant
Installing new SC
Installing more
entirely
replaced?
Identification or
Location or Area
System
ducted
containing
system
than 40 feet of
new duct
(entirely new
Name
Served
(ft2)
system?
component?
components?
ducts?
system?
system)
Alteration Type
Altered space
System 1
Location 1
1750
Yes
No
Yes
No
No
No
conditioning
• system
Registration Number: 214-A0099471A-M0100002A-0000 Registration Date/Time: 2014-09-23 08:25:47 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2014-09-23 08:19:23
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 2 of 7 )
C. Space Conditioning (SC) System Alterations Compliance Information
01
02
03
04
05
06
07
08
09
10
11
12
Heating
Cooling
New or
New
System
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
Replaced
Duct
Identification
Heating
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Duct
R -
or Name
System Type
Component
Type
Value
System Type
Component
Type
Value
Type
Length
Value
This field
This field or
This fieldThis
field
Central gas
No heating
or section
section is
No cooling
or section
or section
Less than
System 1
furnace
component
is not
not
No cooling
component
is not
is not
Setback
or equal
R6
altered
applicable
applicable
altered
applicabl
applicable
to 40 feet
a
G. Installed Duct System information
This section does not apply to this project.
Registration Number: 214-A0099471A-M0100002A-0000 Registration Date/Time: 2014-09-23 08:25:47 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2014-09-23 08:19:23
13
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 3 of 7 )
H. Installed Air Filter Device Information
This section does not apply to this project.
I. Air Filter Device Requirements
This section does not apply to this project.
y,
g v r� s 5^7x
,
�•^ � � s� '`,' ty� n �3Tex`4��r+.� � ,-AY. A. .cd�,:a✓av ,.'rte, .40 y+ v
Registration Number: 214-A0099471A-M0100002A-0000
Registration Date/Time: 2014-09-23 08:25:47
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2014-09-23 08:19:23
CERTIFICATE OF INSTALLATION CF211-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 4 of 7 )
J. HERS Verification Requirements
01
02
03
04
05
06
07
08
09
10
�y
r`P..
Rl t
,.MtYN'i.�.ak
MCH2O
A'?w
MCH21
MCH22
MCH23
MCH25
MCH28
Exemption
from
Minimum
Exemption
R -Value for
AHU Fan
AHU
SC System
SC System
From Duct
Duct
Ducts In
Ducts Located
Efficacy
Airflow
Identification or
Location or Area
Leakage
Leakage
Conditioned
In Cond Space
(W per
Rate (cfm
Refrigerant
Return Duct Design
Name
Served
Requirements
Test
Space
Verification
dm)
per ton)
Charge
Table 150.0-C or D
System 1
Location 1
No
Yes
I
Not
No
No
No
No
No
exemptions
applicable
S
Registration Number: 214-A0099471A-M0100002A-0000
U
a' },&A, F''+' Y'
i
d
R
�y
r`P..
Rl t
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"kuA" �6b4"?, enfYu,h
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s
Registration DateMme: 2014-09-23 08:25:47
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2014-09-23 08:19:23
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 5 of 7 )
K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the
system that are altered. Existing equipment may be exempt from these requirements.
Heating Equipment
01
Equipment Efficiency: All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency
Regulations.
02
Controls: All unitary heating systems, including heat pumps, must be controlled by a setback thermostat. These thermostats must be capable of allowing the occupant
to program the temperature set points for at least four different periods in 24 hours. See Sections 150.0(i), 110.2(b).
03
Sizing: Heating load calculations must be done on portions of the building served by new heating systems to prevent inadvertent undersizing or oversizing. See sections
150.0(h)1 and 2).
04
Furnace Temperature Rise: Central forced -air heating furnace installations must be configured to operate at or below the furnace manufacturer's maximum
inlet -to -outlet temperature rise spe lfkA1o°h. See Section
.,�
05
a sir t,+cnir £g "�g',"�,`%
Standby Losses and Pilot Lights n -type ce9tra r`Ic _� ay not havcottlnu sl} urning p il` t light. SM1� n 110.5 and Section 110.2(d).
,. .., ,. ...,,. ..x -.a.'" r
.A. .... k >; -. t ,din
Cooling Equipmentn7
06
Equipment Efficiency: All cooling equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency
Regulations.
07
Refrigerant Line Insulation: All refrigerant line insulation in split system air conditioners and heat pumps must meet the R -value and protection requirements of Section
150.0(j)2 and 3, and Section 150.0(m)9.
08
Condensing Unit Location: Condensing units shall not be placed within five (5) feet of a dryer vent outlet. See Section 150.0(h)3A.
09
Sizing: Cooling load calculations must be done on portions of the building served by new cooling systems to prevent inadvertent undersizing or oversizing. See Section
150.0(h)1 and 2.
Air Distribution System Ducts, Plenums and Fans
10dInsulation:
In all cases, unless ductsare enclosed entirely in directly conditioned space, the minimum duct insulation value is R-6. Note that higher values may be
required by the prescriptive or performance requirements. See Section 150.0(m)1.
Registration Number: 214-AC099471A-M0100002A-0000
Registration Date/Time
2014-09-23 08:25:47
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2014-09-23 08:19:23
I
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 6 of 7 )
K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the
system that are altered. Existing equipment may be exempt from these requirements.
Connections and Closures: All installed air -distribution system ducts and plenums must be, sealed and insulated to meet the requirements of CMC Sections 601.0,
11
602.0, 603.0, 604.0, 605.0 and ANSI/SMACNA-006-2006: Supply -air and return -air ducts and plenums must be insulated to a minimum installed level of R-6.0 or
enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing in accordance with the requirements of Reference
Residential Appendix RA3.1.4.3.8.
Heat Pump Thermostat
12
A thermostat shall be installed that meets the requirements of Section 110.2(b) and Section 110.2(c).
13
The thermostat shall be installed in accordance with the manufacturers published installation specifications
14
First stage of heating shall be assigned to heat pump heating.
1S
Second stage back up heating shall be set io come on pfily when theme Indoor set'temp�,'rata canno�t be rtiet
The responsible persons signature o his compill o.. m,�irilt affirms t 1� 1'I�applica le„r quirem t is in this t , a have been met
Registration Number: 214-A0099471A-M0100002A-0000
Registration Date/Time
2014-09-23 08:25:47
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2014-09-23 08:19:23
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 7 of 7 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Pine, David
Company:
Signature Date:
Energy Management Inc
Address:
E C rfi I I tification (if applicable):
40827 Capa Drive
CC2005762
City/State/Zip:
Phone:
Fremont CA 94539
510-270-8240
Responsible Person's Declaration statement
certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. I am eligible under Division 3 of the Business and Professions Code in the aphable classification toacceptresponsibility for the systema design, construction, or installation of features, materials,
r tea.,
components, or manufactured device5sor the scppa of work idehj afied,dn this Certificate of 1q.tallad p and 3ttes�t to t�ae;decldi atj, .` s in t�iis statement (responsible builder/installer), otherwise I am an
`a5tu s
authorized representative of the re�nsible builder/Installer r
r
"materials,
3. The constructed or installed featu comporints Qpm factured dewces'(the;(nstallaj�3n) idntifled on his Certificate of nstallatton conforms to all applicable codes and regulations, and the
installation conforms to the require `. ents given o nth, . fans 4 d s Cifications app' ed,by the e , rce �pt agen4y _ ;
4. 1 reviewed a copy of the Certificate L om app the " ` rce�n#a th e s th ` cific ' iremer fqr so��°5tr�ctjpn or installation identified on this Certificate of
�1r
Installation, and I have ensured that the tegwremeiits t at apply Cd #He construction or installation ave been met,
S. I will ensure that a registered copy of this Certificate of Installation 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. l understand that registered copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Moreno, Ruben
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Position With Company (Title):
RC MORENO HEATING & AIR CONDITIONING
Owner (/?IP/11iC�
Address:
CSLB License:
233 E RINCON AVENUE
304955
City/State/Zip:
Phone:
Date Signed:
CAMPBELL CA 95008
(408) 313-0848
2014-09-23 08:25:47
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider responsibility for the accuracy of the
information.
Registration Number: 214-A0099471A-M0100002A-0000 Registration Date/Time: 2014-09-23 08:25:47 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2014-09-23 08:19:23
k
CERTIFICATE OF INSTALLATION won ic CF2R-MCH-20-H
Duct Leakage Diagnostic Test
Project Name:
Enforcement Agency: City of
Cupertino
Permit Number: 14090082
Dwelling Address: 19721 Bixby Dr
City: Cupertino
Zip Code: 95014
A. System Information
01
Space Conditioning System Identification or Name
System 1
02
Space Conditioning System Location or Area Served
Location 1
03
Building Type from CF -111
Single family
04
Verified Low Leakage Ducts in Conditioned Space
No, credit is not taken
05
(VLLDCS) Credit from CF1R?
Total leakage
05
Verified Low Leakage Air Handling Unit (VLLAHU) Credit
No, credit is not taken
07
from CF1R?
Heating system method
06
Duct System Com, ategory
R}eplacemen
09
Calculated Target Allowable Duct Leakage (cfm)
97650
MCH -20d - Complete ReplacA ed Duct em
'4'A 4-1, -4,
B. Duct Leakage Diagnostic Test
01
Condenser Nominal Cooling Capacity (ton)
0
02
Heating Capacity (kBtu/h)
75000
03
Conditioned Floor Area served by this HVAC system (ft2)
1750
04
Duct Leakage Test Condition
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
0.06
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Heating system method
08
Measured AHUAirflow
This field or section is not applicable
09
Calculated Target Allowable Duct Leakage (cfm)
97650
10
Actual duct leakage rate from leakage test measurement
(cfm)
149
11 1
Compliance Statement: System passes leakage test
Registration Number: 214-A0099471A-M2000002A-0000 Registration Date/Time: 2014-09-23 08:25:47 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2014-09-23 08:20:47
2013 Residential Comoliance Schema Version: 0.51SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
C. Additional Requirements for Compliance
01
System was tested in its normal operation condition. No temporary taping allowed.
Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage
02
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.
03
All supply and return register boots were sealed to the drywall.
04
Building cavities were not used as plenums or platform returns in lieu of ducts.
05
If cloth backed tape was used it was covered with Mastic and draw bands.
06
All connection points between the air handier and the supply and return plenums are completely sealed.
If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the requirements
07
of Reference Residential Appendix RA3.1.4.3.6. Systems that comply using smoke test shall not be included in sample
groups for HERS v n compli e. -j-,to .
10
The responsible person's signatu t pHance doq m affil& W all applicable requirements in this table have
been met.
Registration Number: 214-A0099471A-M2000002A-0000 Registration Date/Time: 2014-09-23 08:25:47 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2014-09-23 08:20:47
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF INSTALLATION CF211-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
David Pine
Company:
Signature Date:
Energy Management Inc
Address:
EW/W e i 0I e fication (if applicable):
40827 Capa Drive
CC2005762
City/State/tip:
Phone:
Fremont CA 94539
510-270-8240
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed o iirsta features, ma 'als, crpaire s or;manmfactured devices (the.instaNation)ictentified oll this Certificate of Installation
conforms to le odes and reg u to nd the install tion conformsV- the Fequiremerits given on the plans and specifications approved by
the enforcemerd agency.
4. 1 understand that HERS rate , i e` ` h allation to v contphance,andttlat if such checking identifies defects; I am required to take
corrective action at my s n n at Energy Cq "m_ ission and k RS Provider representatives will also perform quality assurance checking
of installations; olu as {
` mpk up:bErt nottheckeckWa HElb rater, and if those installations fail to meet the
requirements of such 'qua lrty assurance'ehecking,1lie "required corrective action and additional checking/testing of other installations in that HERS
sample group will be performed at my expense.
5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on, this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met.
6. 1 will ensure that a registered copy of this Certificate of Installation 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 registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Ruben Moreno
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title): !? Cir P/yll�
Builder/Owner)
Owner
RC MORENO HEATING & AIR CONDITIONING
Address:
CSLB License:
233 E RINCON AVENUE
304955
City/State/Zip:
Phone:
Date Signed:
CAMPBELL CA 95008
(408) 313-0848
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
2014-09-23 08:25:47
Digitally signed by CaICERTS This digital signature is provided in order to secure the content of this registered document, and in noway implies
Registration Provider responsibility for the accuracy of the information.
Registration Number: 214-A0099471A-M2000002A-0000 Registration Date/Time: 2014-09-23 08:25:47 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2014-09-23 08:20:47
2013 Residential Compliance Schema Version: 0.51SDD
I
I
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (^(�j(j (Page
Project Name: RES
Enforcement Agency: City of
Cupertino
Permit Number: 14090082
Dwelling Address: 19721 Bixby Dr
City: Cupertino
Zip Code: 95014
A. System Information
01
Space Conditioning System Identification or Name
System 1
02
Space Conditioning System Location or Area Served
Location 1
03
Building Type from CF -111
Single family
04
Verified Low Leakage Ducts in Conditioned Space
(VLLDCS) Credit from CF1R?
No, credit is not taken
05
Verified Low Leakage Air Handling Unit Credit from
CF1R?
No, credit is not taken
06
Duct System Com ategory,:;,
3..0
.ftQplacement.
MCH -20d - Complete Repla A ed Duct �emf
B. Duct Leakage Diagnostic, Test
01
Condenser Nominal Cooling Capacity (ton)
0
02
Heating Capacity (kBtu/h)
75000
03
Conditioned Floor Area served by this HVAC system (ft2)
1750
04
Duct Leakage Test Condition
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
0.06
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Heating system method
08
Measured AHUAirflow
This field or section is not applicable
09
Calculated Target Allowable Duct Leakage Rate (cfm)
97650
10
Actual duct leakage rate from leakage test measurement
(cfm)
149
11
Compliance Statement: System passes leakage test
12
Notes:
Registration Number: 214-A0099471A-M2000002A-M20A Registration Date/Time: 2014-09-23 08:23:51 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2014-09-23 08:23:04
2013 Residential Compliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
C. Additional Requirements for Compliance
01
System was tested in its normal operation condition. No temporary taping allowed.
Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off during duct leakage
02
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.
03
All supply and return register boots were sealed to the drywall.
04
Building cavities were not used as plenums or platform returns in lieu of ducts.
05
If cloth backed tape was used it was covered with Mastic and draw bands.
06
All connection points between the air handler and the supply and return plenums are completely sealed.
If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the requirements
07
of Reference Residential Appendix RA3.1.4.3.6. Systems that comply using smoke test shall not be included in sample
groups for HERS uerifin compliane s
08
e
Verification Status: t
Pass=alla#�plicablerequirements are met
09
Correction Notesfomg'
The responsible person's signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status and the Corrections Notes in this table.
D. Determination of HERS Verification; Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol
requirements in order for this Certificate of Verification as a whole to be determined to be in compliance.
1 01 1 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 214-A0099471A-M2000002A-M20A Registration Date/Time; 2014-09-23 08:23:51 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2014-09-23 08:23:04
2013 Residential Comoliance Schema Version: 0.51SDD
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
David Pine
Company:
Date Signed:
Energy Management Inc
2014-09-23 08:23:51
Address:
CEA/ HERS Certification Identification (if applicable):
40827 Capa Drive
5253
City/State/Zip:
Phone:
Fremont CA 94539
510-270-8240
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Ce ifica . f Complian r t Win pr 60 the enfbr�ement agency.
4. The information=reported on applic ble i"- fthe Ce ific s) of Installation (CF2R) signed, and submitted by the person(s) responsible for the
construction or installation co to e, irements spe ' dieWthe Ce4i icat2(s) of Compliance (CF1R) approved by the enforcement agency.
5. I will ensure that a register co f C Bate of Verifi on sFa11 be postedi or made available with the building permit(s) issued for the
building, and 11 made av a age for plic tle A i ectiorfs, understand that a registered copy of this Certificate of
Verification is requite to eine ut( d, ith the ocumentatlonthe- ander provides to tfie building owner at occupancy.
Builder Or Installer Information As Shown On The Certificate Of Installation
Company Name (Installing Subcontractor, General Contractor, or Builder/Owner):
RC MORENO HEATING & AIR CONDITIONING
Responsible Builder or Installer Name:
CSLB License:
RC MORENO HEATING & AIR CONDITIONING
304955
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
Tested
HERS Rater Information
HERS Rater Company Name:
Energy Management Inc
Responsible Rater Name:
Responsible Rater Signature:
David Pine
v—Gs
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
CC2005762
2014-09-23 08:23:51
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies
Registration Provider responsibility for the accuracy of the information.
Registration Number: 214-A0099471A-M2000002A-M20A Registration Date/Time: 2014-09-23 08:23:51 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards Report Version: 2014-05-08 Report Generated: 2014-09-23 08:23:04
2013 Residential Compliance Schema Version: 0.51SDD