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a
CERTIFICATE OF VERIFICATION
01
CF3R-MCH-20-H
Duct Leakage Diagnostic Test
02
(Page 1 of 3)
Project Name:
VALERIE NAGY
Enforcement Agency: City of
Newport Beach
Permit Number:
PENDING
Dwelling Address:
38 LYONS
City: Newport Beach
Zip Code:
92657
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 -1R
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 Compliance Category
Alteration
MCH-2Od - Complete Replacement or Altered Duct system"
B. Duct Leakage Diagnostic Test
01
Condenser Nominal Cooling Capacity (ton)
4
02
Heating Capacity (kBtu/h)
70
03
Conditioned Floor Area served by this HVAC system (ft)
2727
04
Duct Leakage Test Conditions
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
0.15
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Cooling system method
O8
Measured AHUAirflow
This field or section is not applicable
09
Calculated Target Allowable Duct Leakage Rate (cfm)
240
10
Actual Duct Leakage Rate from Leakage Test
Measurement (cfm)
219
11
Compliance Statement:
System passes leakage test
12
Notes:
Registration Number: Registration Date/Time: 2017-11.3013:41:04 HERS Provider: CaICERTS
217-A020112979A-000-001-M20001A-M20A
CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-11-30 13:32:46
2016 Residential Compliance Schema Version: rev 03/16
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.
02
Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage
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
If a complete replacement, 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.
07
If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the requirements
of Reference Residential Appendix RA3.1.4.3.6. Systems that comply using smoke test shall not be included in sample
groups for HERS verification compliance.
O8
Verification Status:
Pass - all applicable requirements are met
09
Correction Notes:
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.
01 1 Complies: All specified verification protocol requirements on this document are met.
Registration Number:
217-A020112979A-000-001-M20001A-M20A
CA Building Energy Efficiency Standards
2016 Residential Compliance
Registration Date/Time: 2017-11.3013:41:04 HERS Provider: CaICERTS
Report Version: 2016.1.006 Report Generated: 2017-11-30 13:32:46
Schema Version: rev 03/16
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:
Ian Jacoby
Jan daco4q
Company:
Date Signed:
i PERMIT E RATERS
2017-11-30 13:39:32
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362
818-735-7876
Responsible Person's Declaration statement
1 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 Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported on applicable sections of the Certificate(s) of: Installation (CF2R)signed 'and submittedby the person(s) responsible for the
construction or installation conforms to the requirements specified on the Certificate(s) of Compliance (CE1R) approved by the enforcement agency.
5. 1 will ensure that a registered copy of this Certificate of. Verification 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 ,
Verification is required to be included with the documentation the builder provides 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):
DEPENDABLE GRAHAM AIR CONDITIONING INC
Responsible Builder or Installer Name:
CSLB License:
Howard Phillips
472690
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:
i PERMIT E RATERS
Responsible Rater Name: -
Responsible Rater Signature:
Ryan Faris
Responsible Rater Certification Number w/this HERS Provider:
Date Signed:
CC2006345
2017-11-30 13:41:04
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies
Registration Providerresponsibility for the accuracyof the information.
Registration Number:
217-A020112979A-000-001-M20001A-M20A
CA Building Energy Efficiency Standards
2016 Residential Compliance
Registration Date/Time: 2017-11-3013:41:04 HERS Provider: CaICERTS
Report Version: 2016.1.006 Report Generated: 2017-11-30 13:32:46
Schema Version: rev 03/16