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Prescriptive Certificate of Compliance: <br />Residential Additions <br />Site Address· , e1% 11 r-Ak, rkL, pr <br />CF-1R ADD <br />(Page 5 of 5) <br />Enforcement Agency:Da- <br />l /8 !8 <br />HERS VERIFICATION SUMMARY - The enforcement agency should pay special attention to the HERS Measures specified in this <br />checklist below. A completed and signed CF-4R Form for all the measures specified shall be submitted to the building inspector before final <br />inspection. <br />Duet Scaling & testing HERS verijication is required for this measure. <br />¤ YES J) In all Climate Zones, if a new space-conditioning system (HVAC equipment and ducting) is installed to serve the additionalone, the ducts are to be sealed and tested per §151(010. <br />In Climate Zones 2 and 9-16, i f more than 40 linear feet of new or replacement ducts are installed in unconditioned <br />O YES [0 space to serve the addition, the ducts are to be sealed and tested per §152(b)1 D. D EXCEPTION: Existing duet systems <br />that are extended, which are constructed, insulated or sealed with asbestos. <br />In Climate Zones 2 and 9-16, ifthe existing HVAC equipment is replaced (including replacement of the air handler, outdoor <br />condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) and will serve the addition, the ducts <br />are to be sealed and tested per § 1 52(b) 1 E. <br />O YES *NO O EXCEPTION: Duet systems that are documented to have been previously sealed confirmed through HERSverification in accordance with procedures in the Reference Residential Appendix RA3. <br />O EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. <br />O EXCEPTION: Existing duet systems constructed, insulated or sealed with asbestos. <br />Refrigerant Charge - Split System HERS verification is requiredfor this measure. <br />O YES a NO In Climate Zones 2 and 8-15, if a newly ducted split A/C or heat pump is installed to serve the addition alone, a refrigerantcharge measurement shall be verified per §151(07A. <br />In Climate Zones 2 and 8-15, i f the existing HVAC equipment is replaced (including replacement of the air handler, outdoor <br />¤ YES BNO condensing unit of a split system, cooling or heating coil, or the furnace heal exchanger) and will serve the addition, a <br />refrigerant charge measurement shall be verified per §1 52(b) 1 F. <br />Central Fan Integrated Ventilation System - Airflow and Fan Watt Draw - do not apply for additions 1,000 ft or less. <br />Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow and Fan Watt Draw HERS verification is required. <br />In Climate Zones 10 through 15, if a new space-conditioning system (HVAC equipment and ducting) is installed to serve theO YES [)10 addition alone, the airflow and fan watt draw shall be verified per §151(f)7B. <br />0,TO In Climate Zones 10 through 15, if the existing space-conditioning system (HVAC equipment and ducting) is replaced and¤ YES wIll serve the addition, the airflow and fan watt draw shall be verified per §152(b)1F. <br />Documentation Author's Declaration Statement <br />• I certify that this Certificate of Compliance documentation i Lte and complete. <br />Name: ,60.00 6-6046A L-- <br />Signatur <br />Company : .OC+VSK DES (64 5 <br />Ad*rf l /4 4450 fl-22 On.(Certification #): <br />lCEA or ¤ CEPE <br />Cit14341(44'Ar·l te,c*, cA 91(¥* 09 904-4#zi <br />Responsible Building Designer's Declaration Statement <br />• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on <br />this Certificate of Compliance. <br />• I certi fy that the energy features and performance specifications for the building design identified on this Certificate of Compliance con form <br />to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. <br />• The building design features identified on this Certificate of Compliance are consistent with the information provided to document this <br />building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement <br />agency for approval with this building permit application. <br />Name:Signature: <br />.tal <br />-ail <br />Date· / <br />If Appliable [ <br />Company:Date: <br />Address:License: <br />City/State/Zip:Phone: <br />For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. <br />Registration Number: <br />2008 Residential Compliance Forms <br />Registration Date/Time:HERS Provider: <br />March 20]0