HomeMy WebLinkAboutE2021-0719 - MiscPRESCRIPTIVE RESIDENTIAL ADDITIONS THAT DO NOT REQUIRE HERS FIELD VERIFICATION
CALIFORNIA ENERGY COMMISSION CEC- CF2R-ADD-02-E
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate c plete.
Documentation Author Name:
Documentation or ature,
Company: a^
Signature Date:
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Address:
CEA/ HERS Certification Identification (if applicable):
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City/State/Zip:
�3v^GK halls , a
Phone:
9y� 326 -�3 yZ
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. I am either: a) a responsible person 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, or b) I
am an authorized representative of the responsible person and attest to the declarations in this
statement on the responsible person's behalf.
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 Certificate of
Compliance, plans, and specifications approved by the enforcement agency.
4. 1 understand 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, and I will take the necessary steps to ensure this requirement is
accomplished.
5. 1 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, and I will take the
necessary steps to ensure this requirement is accomplished.
Responsible Designer Name:
Responsible Designer Signature:
Company:
Date Signed:
Address:
License:
City/State/Zip:
Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300
CA Building Energy Efficiency Standards - 2022 Residential Compliance
January 2022