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12079 (SFD)�����II N1 41 `..✓ ceity� P.O. BOX 1504 N o . 12079 ' 78-105 CALLE ESTADO Bulldmg Address 54¢190 •C3bZ'egon LA QUINTA, CALIFORNIA 92253 Owner Hank CZeranski Mailing Address 67-220 RaT3go Road • City Zip Tel. Cathedral: eii� 92234 11.322-8'08'5 Contractor z ' .. i _ czeraxiski Ce>.ristruction Address _ Same City„�..,:. Zip Tela State Lic. X102905'', City 2© 81 & Classif.Lic. # Arch., Engr.,- Designer Address : f,' : Tel. F1 •4 City Zip State } Lic. # n LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I.am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3o the Business and Professions Code, and my license is in full force and effect. > �. • �- .�f..P”! - OWNER -BUILDER DECLARATION, 1 I hereby affirm that l am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city orlcounty which requires a permit to construct, alter, improve, demolish, or repair any structure, I prior to its issuance also requires the applicant for, such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License. Law, Chapter 9, (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis , for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit .. subjects the applicant to a civil penalty of not more than five hundred dollars ($500). O I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for sale. (Sec. 7044,'Buisness and 'Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon - and who does such work himself or through his own employees, provided that'.such Improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) . ❑ I, as owner of the property, am exclusively contracting with licensed contractors,to con struct the project. .,(Sec. 7044, Business and Professions Code: The Contractor's, License ' Law�_ does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) D 1 am exempt under Sec. B. & P.C. for this reason Date Owner v WORKERS' COMPENSATION DECLARATION ' I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. > � Company O Copy is filed with the city. ' ❑ Certified copy is hereby furnished. • CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not.be completed if the permit is for one hundred dollars .($100) valuation or less.) ._, - a I certify that in,.the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip l ' BUILDING: TYPE CONST. OCC:.GRP. - A.P. Number 774-204--009 ` Legal Description r * Lot 10 Block 252 Project Description Sr.0 Sq. Ft. 16+8,. No. No. Dw. Size Stories Units Newel Add ❑ Alter ❑ Repair O Demolition ❑ - Permit does not include block walls or pool. tstlmateo.valuatlon 07, 264.80 PERMIT ` AMOUNT F Plan Clik. Dep.' l50. 00 ' •+'' Plan Chk. Bal. 2'f 3, 5 . XXXXXX Const 630.-go— oMech. Mech. s Electrical + - 131.26 , Plumbing ,. '141. 00 Grading t, , 20.00 Driveway Enc. s ; -0- Infrastructure T- p P}.2 TOTAL, S4 0 / , 1. I REMARKS -3. 4VQ? f 7-7 e�A >a Fi'eli# 31Ji?tt 3 a-44:,:§ (.i ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line ` FINAL DATE INSPECTOR Issued by: Date_ Permit - Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE I tf, or ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. S0. FT. FORMS Z�SEWER 9�1� 3ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE Ct3- DRAINAGE PIPING CAR P. SO. FT. ® GROUT WATER HEATER WALL SD. FT. FINAL INSP. DRINKING FOUNTAIN SO. FT. ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ _$ WATER PIPING NOTE: Not to be used as property tax valuation FRAMING 1�L� ✓S FLOOR DRAIN MECHANICAL FEES 22 /{�� �� 5XJ TL WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT. ®c I WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/a c SEWAGE DISPOSAL INSULATION/SOUND SO.FT.GAR ® 3/ac HOUSE SEWER FINISH GRADING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK ll l LO GROUND PLUMBING l %, UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE I tf, or ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS Z�SEWER 9�1� 3ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. Z GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REIN F. STEEL GAS (FINAL) TEMP. POLE Ct3- GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING 1�L� ✓S FINAL INSP. X31 ROOFING i 22 /{�� �� 5XJ TL REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL HING if -C13 Lh MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION 1-31-qq C CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES11NITIALS GARDEN WALL FINAL Building Address Owner Mailing Address C 7 / - City ,>4eW1z:-e Contractor, IL, 1cv- , Ti4 P.O. BOX 1504 / 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 C2e- Zipr1�� J � Tel. Address City lZip Tel. State Lic._ I City M� &Classif. Z`O � � O S Lic. # r Arch., Engr✓, Designer Address I Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Profession's Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencfng with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). I-! I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) I 1 I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 1) 1 am exempt under Sec. B. & P.C. for this reason %�� Date Z ` Own7er WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company n Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i1 the permit is for one hundred dollars (5100) valuation or less.) I certify that in the performance of thg work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compe sation Laws of Cal Date 1 owner�,�!'�' NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and stale that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING DIVISION APPLICATION ONLY BUILDING: TYPE CONST. S O C. GRP. A.P. Number Legal Description 2,,l Project Description G// / 2 el - Sq. / i Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Inf structure TOTAL REMARKS 0 — Y..rHJP'i Y J U I HL 1 t liIOU - ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: f f .AWTp . CONSTRUCTION ESTIMATE NO. ;rA. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. @ $ 2ND FL. SO. FT: @ POR. SO. FT. @ GAR. SQ. FT. @ CAR P. SO. FT. @ WALL SO. FT. @ SO. FT. @ ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT, @ c BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 1 Y. c SEWAGE DISPOSAL SQ.FT.GAR @ ?/ac HOUSE SEWER REMARKS: VENTILATION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP, FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL mare � vn a munra i oncarm� � ww GARDEN WALL FINAL r' DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 4/15/93 Type of Permit JLa Quinta No. 112147 Permit # Owner Name Hank Czeranski Log No. 54190 Street Avenida Obregon City La Quinta Zip 92253 Study Area 110 APN # 774-204-009 Tract # Lot # 10 Square Footage 1648 Type of Development Single Family Residence No. of units 0 Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/ carports, covered patios/ walkways, residential additions under 500 square feet, detached accessory structures. or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE . This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.58 x 1648 or $ 2,603.84 have been paid to D.S.U.S.D. for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By Hank Czeranski Telephone 322-8085 Name on the check By jams F. Lively Assistant Superintendent, Business Services Fee collected /exempted by Vickie J. Durrett Payment Rec_eivPci�'' �-7 Signature �= Q{ ., Check IVo.212,,.,. Collector. Attach a copy of county or city plan check application form to district -copy fopall' H"vers.``` Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Cop,}/Accounting Received Fro -my. ���. ( ^. I Address: Q� (- t l� COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL17 +` ` 7 �J ' . l �- il_ 1 I o 1t'\ (_fir' l 1 .'.. C L -L: �CC � ll. CL�t C ¢ r �' Date: Account No. L, � Lots)' Tract Cash Service Address C % La I . - 1.�..l I 1 C. Pil i. I.G.A. Code Water Service f ' L2' Service(s) (n �( p ❑ Backflow(s) �, `�) Cashier Money ❑ House Laterals) Order J ❑ DetectorCheck(s) ❑ Meter Surcharge 1�Sanitation Capacity Charge - ' . 1 -' ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name ❑ Inspection Fee - Tract - Fee - ` ❑ Plan Check Fees Water I Sewer - Tract - ❑ Bond Payment - A.D. - Bond Assmt. t ❑ Customer Deposit ❑ Other TOTAL, $ ) Remarks: ❑Copy to: r Cash Water Service f ' Check ✓ �( �, `�) Cashier Money Order CVWD-438 (11189) TITLE 24 REPORT FOR:' CZERANSKI 54-190 OH RECON LA OUINTA, CALIFORNIA PROJECT DESIGNER° REPORT PREPARED by: JOAN HAC K.ER JOHN H. HACk,:ER &. ASSOCIATES ' 4501 E. Sunny Dune Rd. Suite C PALM SPRINGS, CALIFORNIA 92264 ( 619) 327-4565 Job Number. E Date: 4/7/1993 The COMPLY 24 computer program hays been used ,to' perf_91M .the calculations summarized in this compliance report. This program ham ypproval and is authorized by the California �rnia Energy ,Commiss.ibn �f� �r use_ with bath the Residential and Nonresidential Building Energy Efficiency. Standards. This program developed by Gabel Dodd 'Associates (5100 428-OB03. Table Of Contents for Title 24 Report Cover Page ...... ........ ............. 1 Table of Contents.......................e....................'....... Form CF -1R Certificate of Compliance: Residential Form MF -IR Mandatary Measures Checklist: Residential Form C -2R Computer Method Summary .............................. i Form P -2R Point System Summary .... .............................. 10 rA ^ .CERTIFICATE OF COMPLIANCE: Residential (part 1 of 21 .CF -1R page 3 of 10 -------------------------------------------r------------------------------ Project Name: CZERANSKI :Date: 4/7/1993 ' Address: 54-190 OBREGON ________________ iA QUINTA, CALIFORNIA :Building Permit No |_______-___-�_______ Designer: ' :Checked by / Date | Documentation: JOHN H� HACKER & ASSOCIATES |COMPLY 24 User 2655 ------------------ 7-- ----------------- 7 ------- _---------------------------- GENERAL INFORMATION Cbmpliance Method: Climate Zone: Conditioned Floor Area: Building Type: Building Front Orientation: Number of Dwelling Units: Floor Construction Type: BUILDING SHELL INSULATION Component ----------------- R-11 Wall Wall (W.11.2x4.16) R-38 Roof(R.38.2x14.16) Slab Perimeter w/R-0.0. ' Slab Perimeter w/R-0.0 ^ FENESTRATION Orient. --------- Area ------ U -Val ----- Type --_--- Left (N) 60.0 0.65 Double Back (E) 23.0 0.65 Double Right (S) 40.0 0.65 Double Front (W) 40.0 0.65 Double COMPLY 2' version 4.10 15 1688 sqft ` Single Fam Det 270 deg (W) 1 Slab on Grade U -Value Location/Comments . ------- ---------- ------------------------- 0.098 1ST_FLOOR ' 0.028 AST FLOOR ' 0.900 ISE FLOOR 0.720 AST FLOOR ` Shading Devices Frame Interior ,' Exterior _ OH SF Type --------------- --------------- -- -- ----- Light Blind Standard Bug Scr Y N Metal Light Blind Standard Bug Scr Y N Metal Light Blind ' Standard Bug Scr Y N Metal Light Blind Standard Bug Scr Y N Metal ` THERMAL MASS Area Thick Type Covering (sf) (in) Location/Description --------------------- ----- n-- ----- ----- ------------- - ---------------- Concrete, Heavyweight Exposed 880 3.50 Slab on Grade Concrete, Heavyweight Covered 808 3.50 Slab on Grade Tile in Mortar Exposed1.50 AST FLOOR/Int Mass ` ~ . . . CERTIF=ICATE OF COMPLIANCE: Residential (part 2 of .2) CF= -1R pane 4 of 10 ----- Project Nameo CZERANSKIDate: 4/7/1'�C '=� Documentation: JOHN H. HACKER & ASSOCIATES :COMPLY 24 User 2655 -------------------------------------------------------- ------------------ HVAC SYSTEMS Minimum D.istrib Type Duct TStat + System Type Efficiency and Location Val Type Location/Comments ----------- Furnace 0.800 AFUE Ducts in Attic. 4.2 SetBck: WHOLE HOUSE Sp1tA.irCondic..000 SEER Ducts in Attic 4.2 SetBck: Water No. Tank: Ext. WATER HEATING SYSTEMS Heater in Energy Size Ins+_i1 System Name Distribution Type Type Sys Factor Agal) R -Val Meets CEC Standard AFUE WATER HEATER EQUIPMENT DETAIL. /Rec Rated Stdby Tank: Pilot System Name System Type Eff Input Loss R -Val Light ---------- - ------------ ----------- ---- ----- --- -- ----- ----- SPECIAL FEATURES/REMARKS COMPLIANCE STATEMENT This Certificate of Compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 & S of the Califor- nia Code of Regulations, and the administrative regulations to implement' them. This certificate has been signed by the .individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that is varied is indicated in the Special-Features/Remarks section DESIGNER or OWNER (Per Business & Professions Code) ' 1 Lic V -------------.---------------------- (signature) (date) ENFORCEMENT AGENCY Name° Title: Agency: ----------- --------------- Telephoneo ------------------------ DOCUMENTATION AUTHOR JOAN HACKER JOHN H. HACKER & ASSOCIATES+ 4501 E. Sunny Dune Rd. Suite C PALM SPRINGS, CALIFORNIA 92264 ( 619) 327-4565 (sig -t+_tre? :date? ---------------- ------------------- (signat+_ire/stamp)(date) . ^ MANDATORY MEASURES CHECKLIST (part 1 of 2) MF -1R page 5 of 10 ---------------------------------------- = ------------ 7 --------------------- Project Name: CZERANSKI ;Date: 4/7/1993 | Documentation: -JOHN H. HACKER & ASSOCIATES :COMPLY 24 User 2655 � --------------------------------------------------------------------------- NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (*) may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in,the documents or on this checklist only. BUILDING ENVELOPE MEASURES Enforcement o Sec. 150(a): Minimum R-19 ceiling insulation. * o Sec. 150(b): Loose fill insulation manufacturers ' labeled R -Value. o Sec. 150(c): Minimum R-13 wall insulation in framed walls (does not apply to exterior mass walls). * ' o Sec. 150(d): Minimum R-13 raised floor insulation in framed floors; Minimum R-8 in concrete raised floors. * o Sec. 150(l): Slab edge insulation - water absorption rate no greater than 0.3%, water vapor transmission rate no greater than 2.0 perm/inch. ___________ o Sec. 118: Insulation specified or installed meets California EnergyCommission quality standards. Indicate Type & form. ----------- o Sec. 116-117: Fenestration Productsf Ext Doors & Infil/Exfil Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Manufactured fenestration products have label w/certified U -Value c. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. o Sec. 150(g): Vapor barriers mandatory in Climate'Zones 14 ' and 16 only. ' . ___________ o Sec. 150(f): Special infiltration barrier installed to comply with Sec. 151 meets Commission quality standards. o Sec. 150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs 1. Masonry and 'factory -built fireplaces have: ' a. Closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. ' . ` . - MANDATORY MEASURES CHECKLIST (part 2 of 2) MF -1R page 6 of 10 -----------------------------------------�_----------_--------------------- Project Name:'CZERANSKI |Date: 4/7/1993 ' .| Documentation: JOHN H. HACKER & ASSOCIATES |COMpLY 24 User 2655 --------------------------------------------------------------------------- SPACE CONDITIONING, WATER HEATING AND PLUMBING SYSTEM MEASURES Enforcement ^ o Sec. 110-13: HVAC equipment, water heaters,,showerheads and faucets certified by the Commission., o Sec. 150(i): Setback thermostat on all .applicable ` heating systems. ' ___________ o Sec. 150(j): Pipe and Tank Insulation ' 1. Indirect hot water tanks (eg unfired storage tanks or backup solar hot water tanks) have insulation blanket (R-12 or greater) or combined interior/exterior insulation (R-16 or greater). . 2. First 5 feet of pipes closest to water heater tahk, non -recirculation systems, insulated (R-4 or greater. 3. All buried or.exposed piping insulated in recirculation. sections of hot water system. . 4. Cooling system piping below 55 F insulated. 5. Piping insulated between heating source and indirect hot ' water tank. o Sec. 150(m) Ducts and Fans * 1. Ducts constructed, installed and sealed to comply with UMC Sections 1002 and 1004; ducts insulated to a minimum R-4.2 or ducts enclosed entirely within conditioned space.� 2. Exhaust systems have backdraft or automatic dampers. 3. Gravity ventilating systems serving conditioned space have either automatic or readily accessible manually operated dampers. ----------- o Sec. 114:Pool and Spa Heating Systems and Equipment 1. System is certified with 78% thermal efficiency, on-off switch, weatherproof operating instructions, no electric resistance heating and no pilot light. 2. System is installed with: . a. At least 36" pipe between filter and heater for future solar heating. b. Cover for outdoor pools or outdoor spas.' . 3. Pool system has directional inlets and a circ 'lation pump time switch. � o Sec. 115: Gas-fired central furnace, pool heater, spa heater or household cooking appliance have no tontinuously burning pilot light. (Exception: Non -electrical cooking appliance with -pilot < 150 Btuh) LIGHTING MEASURES o Sec. 150(k): Lighting - 40 lumens/watt or greater for general lighting in kitchens and rooms with water closets;' and recessed ceiling fixtures IC (insulation cover) appioved. _`_______ ` - COMPUTER METHOD . . SUMMARY (part 1 of 3) , � C_ 2R page 7 of 10 .. . ------------------------- ---------- ----------- ------------- ------��--...... Project Name: CZERANSKI � ' � !Date: 4/7/199P ' Documentation: JOHN H. HACKER & ASSOCIATES |COMPLY 24 Us 'r 2655 - �------------------------------------------------------------------------- ` POINT SYSTEM COMPLIANCE SUMMARY ` ' Proposed Design' point Score � � 4 Points *Building Complies* Budget Compliance Point Goal Points GENERAL INFORMATION Compliance Method: Climate Zone: Conditioned Floor Area: Building Type: . Building Front Orientation: Number of Dwelling Units: ` Number of Stories: Floor Construction Type: ` Total.Conditioned Volume: Conditioned Footprint Area: Ground Floor Area: BUILDING ZONE INFORMATION Floor Zone Name ' Area --------------------- --i-- WHOLE HOUSE 1688 ` OPAQUE SURFACES Act 1. Solar I COMPLY 24 version'4.10 15 1688 sqft ' Single Fam Det 270 deg (W) 1 1 . Siab on Grade ' ^ 13504 cuft' 1688 sqft 1688 sqft ` # of Vent Volume UnitsZoneType TStat Type Hgt Area ------ --�-- ----------- ---------- --- ---- 13504 1.00Conditioned Setback 2. n/a Type Area U -Val Azm Tilt Gains Form 3 Reference Location/Comments ZONE NAME = WHOLE HOUSE Wall 296 0.098 270 90 Yes R-11 Wall (W.11.244.16) 1ST FLOOR Wall 324 0.098 0 90 Yes R-11 Wall (W.11.2x4.16) IST FLOOR Wall 313 0.098 90 90 Yes R-11 Wall (W,11.2x4.16) 1ST FLOOR ' Wall 344 0^098 180 90 Yes R-11 Wall (W.11.2x4.16) 1ST FLOOR Roof 1688 0.02a,270 22 Yes R-38 Roof(R.38.2x14.16) 1ST FLOOR -COMPUTER METHOD SUMMARY (part �� of 3)' � 2R page � ^ . - � �- u of 10 ----------------------------_---------------------------------------------- Project Name: CZERANSKI |Date: 4/7/1993 | ' Documentation: JOHN H. HACKER & ASSOCIATES ;COMPLY 24 User 2655 ----------------------- ---------------------------------- ------------------ PERIMETER LOSSES F2 Insulation Type Length Factor R -Val Depth'. Location/Comments --------- ------ ------ ----- ----- -------- ZONE NAME NAME = WHOLE HOUSE ` Exposed 180.0 0.90 0.0 0 in IST FLOOR Covered 160.0 0.72 0.0 0 in IST FLOOR ` ` ' . . FENESTRATION SURFACES SC ' Act Glass # Type Area Frame Div &Val Azm Tilt Only Location/Comments -- ------------- ----- ----- --- ----- ----- -7 - ----- ---------7----------- ZONE NAME = WHOLE HOUSE 1 Wdw Front (W) 40.0 Metal No `0.65 270 .00 0.88 IST FLOOR 2 Wdw.Left (N) 60.0 Metal No 0.65 , 0 90 0,88 IST FLOOR 3 Wdw Back (E) 23.0 Metal No 0.65 90 90 0.88 1ST FLOOR 4 Wdw Right (S) 40.0 Metal No 0.65 180 90 0.88 1ST FLOOR ` INTERIOR & EXTERIOR SHADING # Type -- ---- Interior Shade Typel ----------------------- SC ---- Exterior ----------------------- Shade Type SC' 1 Wdw Light Blind 0.58 Standard Bug Screen ---- 0.87 2 Wdw Light Blind 0.58 Standard Bug Screen 0.87 3 Wdw Light Blind 0.58 Standard Bug Screen 0.87' 4 Wdw Light Blind 0.58 Standard ^' Bug Screen . 0.87 ' �, ^ COMPUTER METHOD SUMMARY (part3 of 3) C�-2R page 9 of 10 ------------------------------------------------------------_-------------- Project Name: CZERANSKI !Date: 4/7/1993 | � Documentation: JOHN H. HACKER & ASSOCIATES |COMPLY 24 User 2655 --------------------------------------------------------------------------- OVERHANGS/SIDE FINS -----Overhang------ Len Ht LExtRExt 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.D 2.0 0.1 2.0 2.0 ---Left Fin--- ---Right Fin -- Dist Len Ht Dist Len Ht ---- ---- ---- ---- ---- ---- THERMAL MASS Area Thick Heat Inside Location Type (sf) (in) Cap Cond Form 3 Reference R -Val. Comments. ------------- ---- ----- ----- ---- ----------------------- ------ -------- ZONE NAME = WHOLE HOUSE Exposed Slab 880 3.50 28 0.98 n/a 0 Covered Slab 808 3.50 28 0.98 n/a 2 Interior Mass 880 1.50 24 0.67 n/a 0 ` HVAC SYSTEMS Minimum Distrib Type Duct TStat System Type Efficiency and Location Ryal Type Location/Comments ----------- ---------- ---------------- ---- ------ ----------- ----------- Furnace 0.800 AFUE Ducts in Attic 4.2 SetBck WHOLE HOUSE SpltAirCond10.000 SEER Ducts in Attic 4.2 SetBck Water No. ' Tank Ext. WATER HEATING SYSTEMS Heater in Energy Size Insul System Name Distribution Type Type Sys Factor (gal) !-Val ----------------------- ------------------ ------- --- ------ ----- Meets CEC Standard ____________________ -------------------------- ___ ______ _____ _____ AFUE WATER HEATER EQUIPMENT DETAIL /Rec Rated Stdby Tank Pilot System Name System Type Eff Input Loss R -Val Light ----------------------- ----------- ---- ----- `----- ----- ----- SPECIAL FEATURES/REMARKS --Window-- # Type Ht Wd 1 Wdw 4.0 4.0 2 Wdw 4.0 4.0 3 Wdw 4.0 4.0 4 Wdw 4.0 4.0 -----Overhang------ Len Ht LExtRExt 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.0 2.0 0.1 2.0 2.D 2.0 0.1 2.0 2.0 ---Left Fin--- ---Right Fin -- Dist Len Ht Dist Len Ht ---- ---- ---- ---- ---- ---- THERMAL MASS Area Thick Heat Inside Location Type (sf) (in) Cap Cond Form 3 Reference R -Val. Comments. ------------- ---- ----- ----- ---- ----------------------- ------ -------- ZONE NAME = WHOLE HOUSE Exposed Slab 880 3.50 28 0.98 n/a 0 Covered Slab 808 3.50 28 0.98 n/a 2 Interior Mass 880 1.50 24 0.67 n/a 0 ` HVAC SYSTEMS Minimum Distrib Type Duct TStat System Type Efficiency and Location Ryal Type Location/Comments ----------- ---------- ---------------- ---- ------ ----------- ----------- Furnace 0.800 AFUE Ducts in Attic 4.2 SetBck WHOLE HOUSE SpltAirCond10.000 SEER Ducts in Attic 4.2 SetBck Water No. ' Tank Ext. WATER HEATING SYSTEMS Heater in Energy Size Insul System Name Distribution Type Type Sys Factor (gal) !-Val ----------------------- ------------------ ------- --- ------ ----- Meets CEC Standard ____________________ -------------------------- ___ ______ _____ _____ AFUE WATER HEATER EQUIPMENT DETAIL /Rec Rated Stdby Tank Pilot System Name System Type Eff Input Loss R -Val Light ----------------------- ----------- ---- ----- `----- ----- ----- SPECIAL FEATURES/REMARKS r P61NT SYSTEM SUMMARY P -2R pape 10 of 10 Project Name! CZERANSKI !Date: -4/7/1993 Documentati� Win! . JOHN H. HACKER & ASSOCIATES !COMPLY 24 User 2655 BUILDING DATA -------------- Conditioned Fly or Area_ 1688 sgft Number of Stories 1 Occupancy Type Single Fam Det SCORE CARD Measure Paints 1. Roof Insulation 0.0283 (U -Value) 0 2. Wall Insulation 0.0978 (U -Value) -9 3. Raised Floor Insulation 0,0i�00 -(U-Value) _ . lJ -Va 1 �_i� ; ^a. Controlled Vent Crawlspace 0;0 (R -Valu& ; -;: -1 4. Slab Edge Insulation 0.8153 (f'.Z factor) O. Infiltration Standard 0 6. Glass Heat Less 0.65 9.7% 1-1 SUM 176 -S 7. Fenestration Heat Gain SC Orientation Area % Glass Open Eff X SFR North 60.0 3.6 x 0.77 = 2.7 0.64 1 East 23.0 1.4 0.68 = 6.9 0.57 .,_ South 40. 2.4 x 0. 64 = 0. 48 1 West 40. O••. ` 2. 4 x 0.65 _. 1.6, 0.59 2 Skylight 0-0 0.0 x 0100 = O O 0.00 0 8. Interior Thermal Mass -4.51 J. Exterior Wall Mass 0.00 i_) Sum 7-9 9 lige Heating System 1 Zonal Control! No 11. Cooling System 12. Water Heating _ ci Point 'Total! 4 Installation Certificate: Residential CF -6R Use of this form to satisfy the requirements of the Administrative Code is optional, but the Information must be provided end posted. (..:. 54-190 Obregon 12079 Site Address Permit Number An installation certificate is required to be posted at the building site prior to the issuance of the occupancy permit. 1 his form maybe used to meet these requirements. All appliance categories listed below are the actual equipment installed. Note that the efficiency and type of the appliance installed must be equivalent or better than the appliance .specified on the Carlificate of Compliance (CF -1R). This certificate (or its equivalent) shall be prepared and signed by the person(s) assuming overall responsibility for the appliance installation. I, the undersigned, verify that the equipment listed in the category above my signature is the actual equipment installed and that the equipment meets or exceeds the requirements of the Appliance Efficiency Standards. In addition, 1 have verified that the equipment is equivalent to or more efficient than the equipment specified on the Certificate of Compliance submitted to demonstrate compliance with the Energy Efficiency Standards for residential buildings. HVAC SYSTEMS Note: Hydronic boiler information is entered here. Other hydronic or combined hydronic equipment is listed under Water Heating Systems. Heating Equip. CEC Certified Actual Distribution Duct or Healing Load Heating Type (furnace, Manuf. Make b Efficlency Type and Piping Before Over- Equipment heat pump, etc.) Model Number (AFUE etc.) Lmtlgn R -Value Slzlno (Stuh) Caaaclty(Btuh �� 11 ' . s• /.or CEC Certified Cooling Equip. Compressor Unit Actual plsttibutlon Duct w Type (air cond., Manuf. Make i Efficiency Type and ��q heat pump, etc.) Model Number (SEER) Location 14V -duo LL �� 4 ' epmebuil6n a loss and design heat gain rate hawee ban "arrnined using a n+ethod apecillod n Section 150(h) of the E flit t arts, and are two of the rnteria tne0 for�agQy/'n "71,d Von- Signawre Dula HVAC Subontracta (Co. Name) or General Contractor or owner WATER HEATING SYSTEMS Water Heating CEC Certified Rated' Tank Factor or External System Type Manuf. Make & Input (kW Capacity Recovery Standby' Insulation (storage gas, etc.) Model Number or Btuh) (gallons) Efflciency Loss (°h) R -Value (Z- 1. For small gas storage (rated inputs 75,000 Btu/hr), electric resistance and heat pump water heaters, list Energy Factor. For large gas storage water heaters (rated input >75,000 BtWhr), list Rated Input, Recovery Efficiency and Stanooy Loss. For instantaneous gas water heaters, list Rated Input and Recovery Efficioncy. For Instantaneous electric water heaters, list Rated Input. FAUCETS b SHOWER HEADS All faucets and showerheads installed are listed in the Commission's Directory of Certified Faucets and Showerheads, pursuant to Title 24, Part 6, Subchapter 2, Section 111. Se ,Pl", . Signature Date Plumbing Subcontractor (Co. Name) or General Contractor or Owner Revised January 1992