Menlo Park, CA · San Mateo County
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
This certificate of compliance is completed for qualifying residential alterations that do not require HERS verification and is provided to the enforcement agency with the building permit application.
What this form is
This certificate documents prescriptive energy-code compliance for simple residential alterations that do not require HERS verification. The form asks for project and building details, information about altered systems, and declarations signed by the documentation author and responsible designer. The document says a registered copy must be available with building permits and for applicable inspections; alterations requiring HERS verification use different compliance documents.
Who needs it
People responsible for documenting qualifying residential alterations complete this certificate and provide it to the enforcement agency with the building permit application.
How to submit it
The document says a registered copy is to be made available with the building permit and to the enforcement agency for applicable inspections. It does not give a submission address or portal.
About notarization
This document is signed without a notary; the documentation author and responsible designer sign and date their declarations, with no notarized attachment described.
How to submit this form
- 1
Download The Form
Download the certificate of compliance PDF.
- 2
Complete The Project Details
Enter the project and building information and complete the applicable alteration sections.
- 3
Sign The Declarations
Have the documentation author and responsible designer complete and sign their respective declarations.
- 4
Provide It With The Permit
Make a registered copy available with the building permit and to the enforcement agency for applicable inspections.
Frequently asked questions
- What is the Prescriptive Residential Alterations compliance form?
- It documents prescriptive energy compliance for simple residential alterations that do not require HERS field verification, including project details and signed declarations.
- Who completes this form?
- The documentation author prepares and signs the certificate, and the responsible designer completes and signs the responsible person's declaration.
- Do I need a notary for this form?
- No. The document has signature and date fields for the documentation author and responsible designer, but describes no notarized attachment.
- How do I submit this form?
- The document says a registered copy must be made available with the building permit and to the enforcement agency for applicable inspections. It gives no submission address or portal.
Need something notarized?
This Prescriptive Residential Alterations That Do Not Require HERS Field Verification doesn’t need a notary — but if you have another Menlo Park form that does, a commissioned online notary can help.