15060095IS1
Address
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building cDcupertino.org
9c)(010 MF
arms
Carbon M
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERAL INFORMATION
Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon
Monoxide Alarms be installed in the following locations:
AREA
SMOKE ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling unit including basements
X
X
Within each sleeping room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply: h -t dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl
space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms have been tested and are operational, as of the date signed
below.
I have read and aciree to comply with the terms and conditions of this statement
Owner (or fOwner Ag t's) Name:
l M(s GrL
,
Si nature...... ..........................`.. .............. Date: ... .. ..
Contractor Name:
Sin .... ............. ..... .......Lic.# .....501H..'? ........... Date:
�/ V
Smoke and CO form.doc revised 03/18/14
CUPERTINO
Owner Name
Address aVF
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISIONILE
r
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 �/ 1
_(408()777-3228 • FAX (408) 777-3333 • build ing(alcupertino.org
M1 Pen -nit No.
9 S8
PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE
HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION
Please refer to the attached California Civil Code Sections 1101.1 — 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: Date:_ -7/045-
_
�No Go to Question 2. r -� (/' J
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 1101.1 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:
No Go to Question 4. �ALI
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.
'Q
Owner' Signature: �,� Date:
Q/
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-coinpliant plumbing
fixtures to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1,
2017, 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.
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 iunprovernents shall require non- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
SB4072015.doc revised 02/04/15
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).
I/We, the owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced
prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 110 1. 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 pl fixtures comply with the requirements as indicated in the table below.
Owner's (or Owner Agent's) Signature: - Date: -4 ziAt-
Upon
completing and signing this Certificate, please return it to the Building Division in order to final your permit.
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 2015.doc revised 02/04/15
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 2015.doc revised 02/04/15
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 1 of 7 )
Project Name: Kim, Mishael
Enforcement Agency: City of Cupertino
Permit Number: 15060095
Dwelling Address: 20614 Mapletree Place
City: Cupertino
Zip Code: 95014
A. General Information
01
Dwelling Unit Name
Kim, Mishael
02
Climate Zone
4
07
Dwelling Unit Conditioned Floor Area
09
10
Number of space conditioning (SC)
03
(ft2)
1385
04
systems being altered in this dwelling
1
SC System
SC System
unit.
system a
05
Certificate of Compliance Type
Prescriptive alterations (CF1R-ALT)
06
Method used to calculate HVAC loads
NotApplicableEquipmentChan
07
Calculated dwelling unit Sensible
This field or section is not applicable
08
Calculated Dwelling Unit Heating Load
This field or section is not applicable
than 40 feet of
Cooling Load (Btuh)
entirely new
(Btuh)
Served
MCH -01b Prescriptive Alterations - Space Conditioning Systems Ducts and Fans
B. Space Conditioning (SC) System Information
01
02
03
04
05
06
07
08
09
10
CFA served
Is the SC
Installing a
Installing
SC System
SC System
by this SC
system a
refrigerant
Installing new SC
Installing more
entirely
Installing
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?
SC system?
Alteration Type
Altered space
Kim, Mishael
Whole house
1385
Yes
Yes
Yes
No
No
No
conditioning
system
Registration Number: 215-A0151803A-M0100002A-0000
Registration Date/Time
2015-06-15 15:59:21
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -OS -13 Report Generated: 2015-06-15 15:58:00
Schema Version: 0.555SDD
LjL
1-1
CERTIFICATE OF INSTALLATION CF2R-MCH-0I-E
Space Conditioning Systems, Ducts, and Fans (Page 2 of 7 )
C. Space Conditioning (SC) System Alterations Compliance Information
O1
02
03
04
05
06
07
08
09
10
11
12
13
Heating Efficiency Type
Heating Efficiency
Value
Heating Unit
Manufacturer
Heating Unit
Model Number
Heating Unit serial
number
Rated Heating Capacity,
Output (BTUH)
Kim, Mishael
AFUE
0.8
Bryant
310JAV024045
0815A14878
Central Fan
Notes:
Integrated
Heating
Cooling
New or
(CFI)
System
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
Replaced
New
Ventilation
Identification
Heating
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Duct
Duct
System
or Name
System Type
Component
Type
Value
System Type
Component
Type
Value
Type
Length
R -Value
Status
This
field
All new
All new
N/A - no
or
Kim, Mishael
Central gas
heating
AFUE
0.8
Central
cooling
SEER
13
Setback
ducts
sectio
Not a CFI
furnace
componen
split AC
components
replaced
n is
system
is
not
applic
able
D. Installed Heating Equipment information
01
02
03
04
05
06
07
System Identification or
Name
Heating Efficiency Type
Heating Efficiency
Value
Heating Unit
Manufacturer
Heating Unit
Model Number
Heating Unit serial
number
Rated Heating Capacity,
Output (BTUH)
Kim, Mishael
AFUE
0.8
Bryant
310JAV024045
0815A14878
45000
Notes:
Registration Number: 215-A0151803A-M0100002A-0000
Registration Date/Time
2015-06-15 15:59:21
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -OS -13 Report Generated: 2015-06-15 15:58:00
Schema Version: 0.555SDD
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 3 of 7 )
E. Installed Cooling Equipment information:
O1
02
03
04
05
06
07
08
Condenser or Package Unit
Condenser or
Condenser or
Condenser or
System Rated Cooling
Condenser Rated
System Identification
Cooling Efficiency
Coaling Efficiency
Package Unit
Package Unit
Package Unit
Capacity at Design
Nominal Capacity
or Name
Type
Value
Manufacturer
Model Number
Serial Number
Conditions (BTUH)
(ton)
Kim, Mishael
SEER
13
Bryant
113ANOA02400
4114E15509
24000
2
Notes:
F. Extension of Existing Duct System, Greater Than 40 Feet
This section does not apply to this project.
G. Installed Duct System information
This section does not apply to this project.
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.
Registration Number: 215-A0151803A-M0100002A-0000
Registration Date/Time
2015-06-15 15:59:21
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-15 15:58:00
Schema Version: 0.555SDD
CERTIFICATE OF INSTALLATION CF2R-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
MCH20
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
cfm)
per ton)
Charge
Table 150.0-C or D
Existing duct
system is
Not
Kim, Mishael
Whole house
insulated or
No
No
No
No
No
No
applicable
sealed with
asbestos
Registration Number: 215-A0151803A-M0100002A-0000 Registration Date/Time: 2015-06-15 15:59:21 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-15 15:58:00
Schema Version: 0.555SDD
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(1), 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 specification. See Section 150.0(h)4.
05
Standby Losses and Pilot Lights: Fan -type central furnaces may not have a continuously burning pilot light. Section 110.5 and Section 110.2(d).
Cooling Equipment
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 1S0.0(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
10
Insulation: In all cases, unless ducts are 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: 215-A0151803A-M0100002A-0000
Registration Date/Time: 2015-06-15 15:59:21
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards- 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-15 15:58:00
Schema Version: 0.555SDD
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.
15
Second stage back up heating shall be set to come on only when the indoor set temperature cannot be met.
The responsible person signature on this compliance document affirms that all applicable requirements in this table have been met.
Registration Number: 215-AO151803A-MO100002A-0000
Registration Date/Time
2015-06-15 15:59:21
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-15 15:58:00
Schema Version: O.SSSSDD
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:
Sanchez, Rafaelsl11orlc
l
Company:
Signature Date:
PELLE HEATING & AIR INC
2015-06-15 15:59:21
Address:
CEA/ HERS Certification Identification (if applicable):
179 SAN RAMON DRIVE
City/State/Zip:
Phone:
SAN JOSE CA 95111
1(408) 978-7060
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 or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the
installation conforms to the requirements given on the plans and specifications approved by the enforcement agency.
4. 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.
5. 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:
Sanchez, Rafael
_ j4l�
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Position With Company (Title):
PELLE HEATING & AIR INC
Manager
Address:
CSLB License:
179 SAN RAMON DRIVE
809887
City/State/Zip:
1(408)
Phone:
Date Signed:
SAN JOSE CA 95111
978-7060
12015-06-15 15:59:21
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: 215-A0151803A-M0100002A-0000 Registration Date/Time: 2015-06-15 15:59:21 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-06-15 15:58:00
Schema Version: 0.555SDD
M
L
A. General Information
CFiR-ALT 02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one CF1R-ALT 02 document for each dwelling unit.
01
Project Name
Kim, Mishael
02
Date Prepared
2015-06-08
03
Project Location
20614 Mapletree Place
04
Building Type
Multi -family
05
CA City
Cupertino
06
Dwelling Unit Name
Kim, Mishael
07
Zip Code
95014
08
Dwelling Unit Conditioned
1385
Installing
Insxalling
Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system
Number of space conditioning
entirely new
09
Climate Zone
4
10
(SC) systems in this dwelling
1
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information
x. ..x
01
02
03
�
09
10
Is the SC
Installing a
SC System
SC System
CFA served
system a
refnge�ant
�Instalhrig>new SG
Installing
Insxalling
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
Altered space
Kim, Mishael
Whole house
1385
Yes
Yes
Yes
No
No
No
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A0151803A-000000000-0000
Registration Date/Time:
2015-06-08 14:45:16
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-08 14:38:06
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CUR -ALT -024
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
05
06
07
08
09
10
11
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New or
Identification
System
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
New Duct
or Name
Type
Components
- Type
Value
-System Type-
-Components
Tgpe
-Value
-Type
Duct Length
R -Value
Central gas
All new
Central split
All new
This field or
This field or
Kim, Mishael
furnace
heating
AFUE
0.8
AC
cooling
SEER
13
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: 515%, or 510% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow -e 300 CFM/ton required when MCH -25 is required.
Exceotions:
-Duct systems registered with HERS provider as previously sealed are exempt frof MCH -20 Duct Leakage Testing requirements Y '
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH=23;;or Refrigerant Char'ge MECH-25,.
Existing duct systems constructed, insulated or sealed with asbestos are exempt -from MCH -20 Duc4,Leakage Testing regwremerits.
E. Entirely New or Complete Replacement Duct System, with br wAthout1quipment Changeouts(Secttons 150 2(b)1Duaaand,150.2(b)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 215-A0151803A-000000000-0000
Registration Date/Time:
2015-06-08 14:45:16
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-08 14:38:06
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: i�C��aPi(/��LC%JI�FJZ
Sanchez, Rafael
Company:
Signature Date:
PELLE HEATING & AIR INC
-2015-06-08-1.4:45:16
Address:
CEA/ HERS Certification Identification (if applicable):
179 SAN RAMON DRIVE
City/State/Zip:
Phone:
SAN JOSE CA 95111
(408) 978-7060
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 Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. 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 California Code of Regulations.
4. The building design features or system design features identified on this Certificate bf Compliance are'consistent.with'the information provided on. otherapplicatile compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval,with this building permit application.
5. 1 will ensure that a registered copy of this Certificate W. Compliance skall be`made available with the building permit(s) issued forthe=building, and made available to the"einforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is,reauired to be included with the,documentation,the.builder provides to,the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature: '"
Sanchez, Rafael
i�V�6Y(/�lL3LC�lLPJL
Company:
Date Signed:
PELLE HEATING & AIR INC
2015-06-08 14:45:16
Address:
License:
179 SAN RAMON DRIVE
809887
City/State/Zip:
Phone:
SAN JOSE CA 95111
(408) 978-7060
Digitally signed by Ca/CERTS. 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: 215-A0151803A-000000000-0000 Registration Date/Time: 2015-06-08 14:45:16 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-08 14:38:06
Schema Version: 0.555SDD