15050111-cert of complianceCERTIFICATE OF COMPLIANCE
CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) / 570-5-0/// (Page 1 of 3 ) I
Project Name:
10500
Prepared:
2015-05-19
A. General Information
CF111-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
10500 OAKVILLE/WILSON
02
Date Prepared
2015-05-19
03
Project Location
10500 OAKVILLE AVE
04
Building Type
Single family
05
CA City
Cupertino
06
Dwelling Unit Name
10500 OAKVILLE/WILSON
07
Zip Code
9501408
Dwelling Unit Conditioned
1700
.. �c
L
r
r'
Y•
Floor Area (ft2)
SC System
SC System ,.
` CFA served
'
yL r
refrigerant
Number of space conditioning
gym.
wL
09
Climate Zone
,j .:},
4
10
(SC) systems in this dwelling
1
°ducted ¢
containing
.-
Nlnstalhrig
more than 40
unit.
entirely new
B. Space Conditioning (SC) System'lnformation
01
02
03
04 il.
05 i.
06
07
, ;,
08
09
10
k s the SC-'--"�liistalling
a
.. �c
L
r
Y•
SC System
SC System ,.
` CFA served
•..,system a
yL r
refrigerant
..: f �`
g•�n
Installinew SC
gym.
wL
i`^>`... ,a.
Instalhng
f^'xvjn
InstaNing
Identification or
Location or Area
by this SC
°ducted ¢
containing
system
Nlnstalhrig
more than 40
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
1700
Yes
Yes
Yes
Yes
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A0133074A-000000000-0000
Registration Date/Time: 2015-05-19 09:17:09
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-05-19 09:17:10
Schema Version: 0S55SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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
Type
Value
Type
Duct Length
R -Value
System 1
Central gas
Gas furnace
AFUE
0.8
Central split
All new
cooling
SEER
14
Setback
Greater than
R-6
furnace
AHU
AC
40 feet
components
Required Documentation:
CF211-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20-H & CF313-MCH-20-11— 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.
CF211-MCH-25-11 & 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 a 300 CFM/ton required when MCH-25.is-required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements
-Heating-only systems and Air Handler/Furnace changes do, not require verification of Air Flow MCH-23,';or Refrigerant -Charge MECH 25
-Existing dud systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct,Le'akage Testing requirements.
E. Entirely New or Complete Replacement Duct System, wlth or % ithout`Equipment Changeout'(Sections 150 2(4)1Dn6'and%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-A0133074A-000000000-0000
Registration Date/Time
2015-05-19 09:17:09
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-05-19 09:17:10
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF111-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: ���
Phelps, Dale
Company:
Signature Date:
A & H HEATING & AIR CONDITIONING SERVICE INC
2015-05-19 09:17:09
Address:
CEA/ HERS Certification Identification (if applicable):
770 CHESTNUT STREET
City/State/Zip:
Phone:
SAN JOSE CA 95110
(408) 279-0722
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. lam eligible under Division 3 iif'#tie'eusiness'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 ori this Certificate'of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
to withthls building permit application.
calculations, plans and specifications submitted the enforcement agency for;approval`
:.
5. 1 will ensure that a registered copy of this'Certificate of Compliance shall 6e'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 Compliance is required to be included with the; documentation the .builder provides to the building owner at occupancy.
Responsible Designer Name: _-'
ible Designer Signature.
Responsible ��
Phelps, Dale
Company:
Date Signed:
A & H HEATING & AIR CONDITIONING SERVICE INC
2015-05-19 09:17:09
Address:
License:
770 CHESTNUT STREET
304472
City/State/Zip:
Phone:
SAN JOSE CA 95110
(408) 279-0722
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-A0133074A-000000000-0000 Registration Date/Time: 2015-05-19 09:17:09 HERS Provider: CaICERTS
_CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-05-19 09:17:10
Schema Version: 0.555SDD
CERTIFICATE OF INSTALLATION
CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans
(Page 1 of 7 )
Project Name: 10500 OAKVILLE/WILSON
Enforcement Agency: City of Cupertino
Permit Number:
15050111
Dwelling Address: 10500 OAKVILLE AVE
City: Cupertino
Zip Code:
95014
A. General Information
01
Dwelling Unit Name
10500 OAKVILLE/WILSON
02
Climate Zone
4
06
Dwelling Unit Conditioned Floor Area
08�
MCH-01b Prescriptive Alterations -Space Conditioning Systems Ducts and Fans01
Number of space conditioning (SC)
03
(ft2)
1700
04
systems being altered in this dwelling
1
Installing
SC System
unit.
by this SC
05
Certificate of Compliance Type y�
Prescriptive alterations (CF1R-ALT)
06
Method used to calculate HVAC loads
NotApplicableliquipmentChangeout
07
Calculated dwelling unit Sensible
Th is field or section is not applicable
08
Calculated Dwelling Unit Heating Load
This field or section is not applicable
system
Cooling Load (Btuh) ��- --- �- - -e
entirely new
( Btuh)
Name
Served
(ft2)
system?
component?
components?
ducts?
B. Space Conditioning (SC) System information �•
n �,� { ��� r �• .�,.. �'`� * ;, ,- .M
01
02
03
04
#05 "
06
07
08�
MCH-01b Prescriptive Alterations -Space Conditioning Systems Ducts and Fans01
10
CFA served
Is the SC
Installing a
Installing
SC System
SC System
by this SC
B. Space Conditioning (SC) System information �•
n �,� { ��� r �• .�,.. �'`� * ;, ,- .M
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
System 1
Location 1
1700
Yes
Yes
Yes
Yes
No
No
conditioning
system
Registration Number: 215-A0133074A-M0100002B-0000 Registration Date/Time: 2015-05-2108:05:57 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-05-21 07:34:07
Schema Version: 0.555SDD
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
13
Rated Heating Capacity,
Name
HeatingEfficiency Type.
Value
Manufacturer
Model Number
number
Output (BTUH)
i
Central,Fan
TUD2B080A9V3V
System 1
AFUE
Q.8 °
Integrated
F i
14 46
64000
Heating
k x
ro.P
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
Central gas
as
Central
new
Not a CFI
System 1
furnace
fur ace
,': AFUE
0.8
split AC
Colol' g
SEER
14
Setback
GT40Ft
R6
system
AHU
components
D. Installed Heating Equipmentinformation _
01
02
J - -.v.03
04
05
06
07
System Identification or
_
Heating Efficiency;
:-:A - :..,
Heating _Un�t
i .......mac •: S ..
Heating Unit
;
"Heating -Unit -serial
Rated Heating Capacity,
Name
HeatingEfficiency Type.
Value
Manufacturer
Model Number
number
Output (BTUH)
i
TUD2B080A9V3V
System 1
AFUE
Q.8 °
z TRANS •
F i
14 46
64000
i
k x
ro.P
Notes:
Registration Number: 215-A0133074A-M0100602B-0000
Registration Date/Time:
2015-05-21 08:05:57
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-05-21 07:34:07
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:
01
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
Cooling Efficiency
Package Unit
Package Unit
Package Unit
Capacity at Design
Nominal Capacity
or Name
Type
Value
Manufacturer
Model Number
Serial Number
Conditions (BTUH)
(ton)
System 1
SEER
14
TRANE
4TTR40443L000
150723EKAF
43000
3.5
Notes:
H. Installed Air Filter Device Information
This section does not apply to this project.
1. Air Filter Device Requirements
This section does not apply to this project.
Registration Number: 215-A0133074A-M0100002B-0000 Registration Date/Time: 2015-05-21 08:05:57 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-05-21 07:34:07
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
MCH2O
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 (dm
Refrigerant
Return Duct Design
Name
Served
Requirements
Test
Space
Verification
cfm)
pertain)
Charge
Table 150.0 -Cor D
b(,'isting duct
system is
System 1
Location 1
J insulated or
No , -:
,r Not
No
No
No
No
No
sealed with
applicable
asbestos
{rv} =
Registration Number: 215-A0133074A-M0100002B-0000
�S
Registration Date/Time: 2015-05-2108:05:57
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-05-21 07:34:07
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 cL,-ntraf furnaces may no%have a continuously burning pilot light`: Section 110.5;and Section `1fi0.2(d).
Cooling Equipment -. .=,
Equipment Efficiency: All cooling equipment must`meet the minimum efficiency'require ments;of5ectior 110.1 and Section 110;2(a) and the Appliance Efficiency
06
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
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.
S Registration Number: 215-A0133074A-M0100002B-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time
Report Version: 2014-05-13
Schema Version: 0.555SDD
2015-05-21 08:05:57
HERS Provider: CaICERTS
Report Generated: 2015-05-21 07:34:07
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 beat pump heating.
1s
Second stage back up heating shall be set to come on'oiily when the indoor set. temperature cannot be met
The responsible person signature on this compliance.documidnt affirm`" at all applicable reguiiremments #his table have been
r`•
' Registration Number: 215-A0133074A-M0100002B-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-05-21 08:05:57
Report Version: 2014-05-13
Schema Version: 0.555SDD
HERS Provider: CaICERTS
Report Generated: 2015-05-21 07:34:07
6
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:
Kirksey, Diana
-Nana cJCirL
Company:
Signature Date:
DuctTesters, Inc.
2015-05-19 13:48:33
Address:
CEA/ HERS Certification Identification (if applicable):
118SElm Ave
City/State/Zip:
Phone:
Ripon CA 95366
1209-579-5000
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 Professibns^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: instaliation).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 ;ty the enforcement agency.
4. 1 reviewed a copy of the Certificate of.Compliance approved by the`enforcement agency that ldentifies the specific regwrementsfor-the stype of construction or installation identified on this Certificate of
_. -
Installation, and I have ensured that the requirements thatapply to the construction or installation have been met.
-- -
_. ; r
S. I will ensure that a registered copy of this Certificate of Installation shall be posted or made available with` the building permif(sj issued forthe building and made;a'vailable 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 b6iIderp ovides 1'o the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Phelps, Dale
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Position With Company (Title):
A & H HEATING & AIR CONDITIONING SERVICE INC
RMO
Address:
CSLB license:
770 CHESTNUT STREET
304472
City/State/Zip:
Phone:
Date Signed:
SAN JOSE CA 95110
(408) 279-0722
12015-05-21 08:05:57
Digitally signed by Ca10ERTS. 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-A0133074A-M0100002B-0000 Registration Date/Time: 2015-05-21 08:05:57 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-05-21 07:34:07
Schema Version: 0.555SDD