B-2016-1185 l
• II
1 16®1155.,
CERTIFICATE OF VERIFICATION J CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3)
Project Name: 7627 Hollanderry PI Enforcement Agency: City of Permit Number: B-2016-1185
Cupertino
Dwelling Address: 7627 Hollanderry. PI 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 Whole House
03 Building Type from CF-1R Single family
Verified Low Leakage Ducts in Conditioned Space No,credit is not taken
04
(VLLDCS)Credit from CF1R?
05 Verified Low Leakage Air Handling Unit(VLLAHU)Credit No,credit is not taken
from CF1R?
06 Duct System Compliance Category New
MCH-20a-Completely New Duct
B.Duct Leakage Diagnostic Test ' `1
01 Condenser Nominal Cooling Capacity(ton) 0
02 Heating Capacity(kBtu/h) 80
03 Conditioned Floor Area served by this HVAC system(ft2) 2010
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 Heating system method
Method
08 Measured AHUAirflow This field or section is not applicable
09 Calculated Target Allowable Duct Leakage 4cfm) 104
10 Actual duct leakage rate from leakage test measurement 103
(cfm)
11 Compliance Statement System passes leakage test
Registration Number:217-A0000659A-M2000002A-M20A Registration Date/Time: 2017-01-03 11:28:45 HERS Provider:Ca10ERTS
CA Building Energy Efficiency Standards Report Version:2013 Rev 1.008 Report Generated:2017-01-03 11:28:23
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3)
B.Duct Leakage Diagnostic Test
12 Notes
C.Additional Requirements for Compliance
01 System was tested in its normal operation condition. No temporary taping allowed.
Outside air(OA)duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage
02 testing.OA ducts used for Central Fan Integrated(CFI)Indoor Air Quality ventilation systems,or Central Fan Ventilation
Cooling Systems,that utilize dampers that open only when OA is required and automatically close when OA is not required,
may configure the OA damper 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.
Visual Inspection at Final Construction Sta e(applicable:if s ;stem was tested atrou h-i
p g.�f pp 511 g n)
After installing the interior finishing wall and.verifying thatthe above rough-in tests,was completed.;,the following procedure must
be performed
07 For all supply and return registers,verify that thespac'esbetween the'register boof-.an''d the'interior finishing.w
ali are
properly sealed.
08 If the house rough-in duct leakage test was conducted without an air handler installed,inspect the connection points
between the air handler and the supply and return plenums to verify that the connection points are properly sealed.
09 Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used.
10 Verification Status Pass
11 Correction Notes for this table
The responsible persons 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 bedetermined to be in compliance_
01 Complies:All specified verification protocol requirements on this document are met.
Registration Number:217-A0000659A-M2000002A-M20A Registration Date/Time: 2017-01-03 11:28:45 HERS Provider:CaICERTS
CA:BuildingEnergy Efficiency:Standards Report Version:2013 Rev 1.008 Report.Generated:2017-01-03 11:28:23
Q
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3)
•
Documentation Author's Declaration Statement
1.I certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: ��pp
George Matthews &P.[? �ka[1l2Ptt6
Company: Date Signed:
Building Energy Compliance Testing 2017-01-03 11:28:45
Address: CEA/HERS Certification Identification(if applicable):
2432 Encinal Drive •
City/State/Zip: , Phone:
Walnut Creek CA 94597 510-520-4443
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. I 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 Certificate of Compliance for the building approved by the enforcement agency.
4. The information,reported on applicable sections:f the Certificate(s)of Installation(CF2R)signed:andsubm"itted by the persons)responsible for the
construction or installation conforms to the requirements specified,.`on the Certificate(s)of Compliance.(CFIR)approved by the enforcement agency.
5. I will ensure that a registered copy ofthis Certificate of Verification;shall be posted,or made available with the.building permit(s)issued for the
building,and made availableto the;enforcement agencyforall applicable inspections,I understand,'that a registered,copy of thisCertificate
Verification is required to be included with the documentation the builder'.prowdes to the building owner at occupancy.
Builder Or Installer Information As Shown On'The-Certificate Of installation`'
Company Name(Installing Subcontractor,General Contractor,or Builder/Owner):
Newhome Construction
•
Responsible Builder or Installer Name: CSLB License:
Nhat Nguyen 832709
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: ---
Building Energy Compliance Testing
Responsible Rater Name: Responsible Rater Signature: �p
George Matthews • `-' �a i'
Responsible Rater Certification Number wf this HERS Provider: Date Signed:
CC2006242 - 2017-01-03 11:28:45
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document,and in no way implies
Registration Provider responsibility for the accuracy of the information.
Registration Number:217-A0000659A-M2000002A-M20A Registration Date/Time: 2017-01-03 11:28:45 HERS Provider:CaICERTS •
CA:Building EnergyEfficiency Standards Report Version:2013 Rev 1.008 ReportGenerated:2017-01-03 11:28:23