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05-3532 (SFD)0 rl P.O. BOX 1504 Ti'y/ 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 05-00003532 Owner: Property Address: 54975. AVENIDA OBREGON MARK GRIMES APN: 774-294-025-12 7000000- 22021 NEWPORT CIR. Application description: DWELLING - SINGLE FAMILY DETACHED HUNTINGTON BEACH, CA 92646 Property Zoning: COVE RESIDENTIAL Other struct info . . . . Application valuation: 201155 to� Contractor: Applicant: Architect or Engineer: .DOwner 2DITION 2001 CBC crrY �, Qu.TA LICENSED CONTRACTOR'S DECLARATION . I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License -Class: License No.: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by Vplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$500).: 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, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the 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 or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. B.&&P.C. for this reason r— /late: J ' ! ry(O Owner. 4' ' CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency. for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/17/06 C WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a'cenificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work_ for which this permit is issued. My workers' compensation insurance carrier andpolicy number are: Carrier 3 . 00 Policy Number NO .'r I certify that, in the performance of the work for which this permit is issued, I shall not employ any J person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Co e, I shall forthw * h comply with those provisions. "Date : Applicant. '. .WARNING: FAILURE TO SECURE WORKERS' COM14NSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and.for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced . within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. 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 county to enter upon the above-mentioned prop rty or inspection purposes. Date: �� / "1� Signature (Applicant or Agentl: ti Application Number . . . . . 05-00003532. Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 996.50 Plan Check Fee 647.73 Issue Date . . Valuation . . . . 201155 Expiration Date 11/13/06 Qty Unit Charge Per Extension BASE FEE 639.50 102.00 3.5000 ------------------------------------------------------- THOU BLDG 100,001-500,000. --------------------- 357.00 Permit ELEC-NEW RESIDENTIAL Additional.desc . Permit Fee 154.75 Plan Check Fee 38.69 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/13/06 Qty Unit Charge Per Extension BASE FEE 15.00 2702.00 .0350 `ELEC NEW RES - 1 OR 2 FAMILY 94.57 1509.00 0200 ELEC GARAGE OR NON-RESIDENTIAL 30.18 1.00 15.0000 ---------------------------------------------------------------------------- EA ELEC TEMPORARY POWER POLE 15.00 Permit GRADING PERMIT Additional desc . Permit Fee 15.00 Plan Check Fee ..00 Issue Date . . . . Valuation . . 0 Expiration Date 11/13/06 Qty Unit Charge Per Extension' BASE FEE 15..00 Permit MECHANICAL Additional desc . Permit Fee 77.00 Plan Check Fee 19.25 Issue Date . . . . Valuation 0 Expiration Date 11/13/06 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9..0000 EA MECH FURNACE.<=100K 18.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 3.00 6.5000 EA MECH VENT FAN 19.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 LQPERMIT LQPERMIT J Application Number 05-00003532 Permit .PLUMBING Additional desc . Permit Fee 138.00 Plan Check Fee .. 34.50 Issue Date . . . Valuation . . . . 0 Expiration Date 11/13/06 Qty Unit Charge Per _ Extension BASE FEE 15.00 11.00 6.0000 EA PLB FIXTURE 66.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 10.00 .7500 EA PLB GAS PIPE >=5. 7.50 1.00 15.0000 EA `PLB GAS METER 15.00 ------------------------------------------------------------------------------ Special Notes and Comments 2702 SQ. FT. SFD WITH R.V. GARAGE.THIS PERMIT DOES NOT INCLUDE POOL & SPA BLOCK WALLS OR DRIVEWAY APPROACH.January 18, 2006 3:11:44 PM jjohnson ---------------------------------------------------------------------------- Other Fees ". . ". . .. . . . ART IN PUBLIC PLACES -RES 20.00 DIF COMMUNITY CENTERS -RES 74.00* DIF CIVIC CENTER = RES 480.00 ENERGY REVIEW FEE 64.77 DIF FIRE PROTECTION -RES 140.00 DIF LIBRARIES - RES 355.00. DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 COVE PRECISE PLAN FEE 100.00. STRONG MOTION (SMI) - RES. 20.11 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1666.00 Fee summary Charged Paid Credited Due Permit Fee Total 1381.25 .00 .00 1381.25• - Plan Check Total 740.17 250.00 .00 490:17 Other Fee Total 3900.88 .00 .00 3900.88 Grand Total •6022.30 250.00 .00 5772.30 Building Z A Q01 t4 *"A Address D Uu C P.O. BOX 1504 �O � Q �oOJ O 78-495 CALLE TAMPICO A (:1-R Mp AUINTA LA QUINTA, CALIFORNIA 92253 FINANCE DEPT. 'Mailing' Address WCip Tel. UNT/Al GTaN FAcg. 92d r7iyiRo�-.S� ress State Lic. City & Classif. Lic. #. Arch., Engr., Designer TE�CN NK- re Address Tel. 7F-/20 CA 46f eSADo 15V/TF 206 City Zlp st ae t#52,83% LA G?v/IJTA 92253 CK 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 Professions 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 (commencing with Section 70 Division 3 of the Business and Professions Code, or that he is exempt therefrom, and the= 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). ❑ 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, Business and Profes- sions 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 im• provement 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 construct 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.) 0 1 am exempt under Sec. B. & P.C. for this reason WORKER'S 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 ❑ 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). 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 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 WHITE = BUILDING DEPARTMENT BUILDING: TYPE CONST OCC. GRP. A.P. Number 7� —29y� 02S Legal Description I Project Description Z.? 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_ Issued by: Validated by:— Validation: YELLOW = APPLICANT INSPECTO Date Permit PINK = FINANCE Sq. Ft. ,��V1o. v 2� 702 SQ+;`/Stories OiV No. DIN.Size Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Ccwr,4cT' sT—EP/�F�+ Ni< -1'11 <<Z9i 3r -d -'1-V707 Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. 0a Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure ILA W TW TOTAL REMARKS 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_ Issued by: Validated by:— Validation: YELLOW = APPLICANT INSPECTO Date Permit PINK = FINANCE Owner Mark Grimes APN # 774-294-025 *'4 Address Jurisdiction La Quinta City) Zip Permit # Tract # Study Area Type Single Family Residence No. of Units 1 e. J Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 54975 Avenida Obregon 2702 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, c:ooldng, eating or sanitation) or replacement mobile ho mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: co EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.63 X 2,702 S.F. or $7,106.26 have been paid 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 CC/Union Bank of California - Mark Grimes Check No. 0035005018 Name on the check By Dr. Doris Wilson Superintendent Telephone 714.801.5134 Funding Residential Fee collected /exempted by aron McGilvrey Payment Recd 0.00 . $7,106.26 "Giver/Under Signature t `�}ffi,����` �^ r` *':��•, NOTICE: Pursuant to Government Code Section 66020(d)(1), this will rve to notify you that the 90 -day approval period in which you may protest the fees o r other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting CERTIFICATE OF COMPLIANCE n Desert Sands Unified School District off- n''?ti0 47950 Dune Palms Road < BERMUDA DUNE pDate 5/17/06La Quinta, CA 92253 GC RANCHO MIRAGE 0 � INDIAN WELLS 6'No. 28475 (760) 771-8515 LMOESERT dPQ lLA QU INDIO y7� 0 Owner Mark Grimes APN # 774-294-025 *'4 Address Jurisdiction La Quinta City) Zip Permit # Tract # Study Area Type Single Family Residence No. of Units 1 e. J Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 54975 Avenida Obregon 2702 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, c:ooldng, eating or sanitation) or replacement mobile ho mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: co EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.63 X 2,702 S.F. or $7,106.26 have been paid 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 CC/Union Bank of California - Mark Grimes Check No. 0035005018 Name on the check By Dr. Doris Wilson Superintendent Telephone 714.801.5134 Funding Residential Fee collected /exempted by aron McGilvrey Payment Recd 0.00 . $7,106.26 "Giver/Under Signature t `�}ffi,����` �^ r` *':��•, NOTICE: Pursuant to Government Code Section 66020(d)(1), this will rve to notify you that the 90 -day approval period in which you may protest the fees o r other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting a0"�Q j_44P CIO P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 BUILDING & SAFETY DEPARTMENT 78-495 CALLE TAMPICO (760) 777-7012 OF I LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 October 26, 2006 Ms. Esther Sanchez Riverside County Assessor's Office 3255 E Tahquitz Canyon.Way, Ste 114 Palm Springs, CA 92262-6962 Dear Ms Sanchez: Due to a clerical error, please be advised of an address change for the.following structure. The structure formerly addressed as 54-975 Avenida Obregon,, permit # 05-3532, is now addressed as. -54-916 Avenida Obregon. - Please note this change and contact me directly at (760) 777-7084 if I may be of further assistance. Sincerely, Kay Hensel ' Counter Technician ` RECORDING REQUESTED BY: ]] New Century Title Company - Riverside Title ORDER NO.: 2346193 ESCROW NO.: 39040507 -SG AND LIMEN RECORDED MAIL TO: Marc H. Grimes Jean C. Watson 22021 Newport Circle Huntington Beady CA 92646 --CCR 0)'V -a/ GOC_ A 2004-0579248 87/27/2804 08:00A Fee:30.00 Page 1 of 2 Doe T Tax Paid Recorded in Official Records County of Riverside Gary L. Oran so Assesr, County Clerk A Recorder I IilOi f11018UI 0101011 Ofi I�lUI 0111011 fill GRANT bEE1 THE UNDERSIGNED GRANTOR(S) DECLARES) that documentary.transfer tax is $275.00 ( X) computed on full value of property conveyed, or ( ) computed on full value fess liens or encumbrances remaining at time of sale ( X) City of La Quinta FOR A VALUABLE CONSIDERATION, receipt of whkh is hereby acknowledged, Walter E. Ahlefeld and Donna Ahlefeld, husband and wife as joint tenants who acquired title as Walter E. Ahlefeld, a married man hereby GRANT(S)to Mark H. Grimes, an unmarried man and Jean C. Watson, ar unmarried woman, as joint tenants the f lowing described real property in the City of La Quints, County of Riverside, State of California: LOTS 11 AND 12 1N BLACK 2.80 OF UNIT NO. 25, SANTA CARMELITA AT VALE LA QUINTA, AS SHOWN BY MAP ON FILE IN BOOK 19, PAGES SO AND 51 OF MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY. DATED: June 29, 2004 SME OF CAUFORMA MMM PIP.211 Personalty known to me (or proved to me on the bass of satisfactory evidence) to be the person(s) whose name(s) are subscribed to the Within Instrument and acknowledged to me that they executed the same in hMw/thelr authorized capaoty(ies),-and that by he/her/their signature(s) on the instrument the person(s) or the entity upon behalf of whk h the pento(s) acted, executed the instrument Wl'TTfESS rnY hand andgfficial seal. a 8AR8ARA COULTER Commission tt 1997130 Notary Public -- Colifomio:y RiversiJa County W Comm E4*esNov 25, 2006 Oe mMIMERIMMMMMM 00000� seel��e�ee� GRANT bEE1 THE UNDERSIGNED GRANTOR(S) DECLARES) that documentary.transfer tax is $275.00 ( X) computed on full value of property conveyed, or ( ) computed on full value fess liens or encumbrances remaining at time of sale ( X) City of La Quinta FOR A VALUABLE CONSIDERATION, receipt of whkh is hereby acknowledged, Walter E. Ahlefeld and Donna Ahlefeld, husband and wife as joint tenants who acquired title as Walter E. Ahlefeld, a married man hereby GRANT(S)to Mark H. Grimes, an unmarried man and Jean C. Watson, ar unmarried woman, as joint tenants the f lowing described real property in the City of La Quints, County of Riverside, State of California: LOTS 11 AND 12 1N BLACK 2.80 OF UNIT NO. 25, SANTA CARMELITA AT VALE LA QUINTA, AS SHOWN BY MAP ON FILE IN BOOK 19, PAGES SO AND 51 OF MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY. DATED: June 29, 2004 SME OF CAUFORMA MMM PIP.211 Personalty known to me (or proved to me on the bass of satisfactory evidence) to be the person(s) whose name(s) are subscribed to the Within Instrument and acknowledged to me that they executed the same in hMw/thelr authorized capaoty(ies),-and that by he/her/their signature(s) on the instrument the person(s) or the entity upon behalf of whk h the pento(s) acted, executed the instrument Wl'TTfESS rnY hand andgfficial seal. a 8AR8ARA COULTER Commission tt 1997130 Notary Public -- Colifomio:y RiversiJa County W Comm E4*esNov 25, 2006 I M RC DISTRICT .- PLANNING REVIEW FORM This form is to be used by CDD.staff for review of single family dwellings -in the RC (Cove Residential) District per Section 9.50.090 of the Zoning Code. Its purpose is to determine; 1) . that the proposed housing design does not duplicate the same architectural style of any house within 200 feet of the applicant; .and/or' 2) if there is a need for the applicant to file for Master Design Guidelines. If the applicant does need to file a Master Design Guideline, please transmit this information to the Building and Safety Department as. part of your correction list.. Please attach additional explanations as necessary. APPLICANT: WayV YYI GS � �P�Y1 SITE ADDRESS: 54- g75 Out. @breawj APN - o�g. - '0A 5— CASE NO.: ) 071 LEGAL: LOT BLOCK UNIT Z<'. - S.C:@V.L.Q. CHECK AND APPROVED.BY: �'�� DATE: Sf vs� Inform the assigned Building plan. checker upon your assignment to this case. The CDD Executive Secretary maintains a log book to track applications. and assign case numbers. REQUIRED ITEM Y N COMMENT/CORRECTION Verify legal and APN information ✓ Consistent with MDG on file (as applicable). .MDG filing required (5 filings since 9/3/98) Architectural variety within 200 . feet of the surrounding area: �kPPROVED BY COMMUNITY DEVELOPMENT DEPART Y DATE XHIBIT ASE NO. ?� `- Architectural design features EN -1 Other Requirements: PUBLIC WORKS/ENGINEERING DEPARTMENT CLEARANCE SHEET FOR BUILDING PERMITS Date: ��„� I on. Developer: S Tract No: Se,-_ _ 6c:. tai= Lot No. (s):e Address(s): A S'Lil - .9--15 nb rep Oy) L c os The following are the requirements for Green Sheet clearance to issue a building permit. i for the'subject building lot(s): USTOM HOMES: ,PROVIDE ITEMS #2, AND #3 BELOW. TRACT HOMES: PROVIDE ITEMS #1, #2, AND #3 BELOW.- COMMERCIAL ELOW •COMMERCIAL BUILDINGS: PROVIDE ALL ITEMS BELOW (#144), 1. =Attach or previously submitted (current within 6 months) Pad Elevation Certificates in compliance with the approved design elevation for building pad (deviations of ±,0..1. foot). 2. Proposed building locations are legal lofts; -final map recorded.` ".;N-OY, -.3. Attach a complete Fugitive Dust Control (PM-10).Plan and packet. '., 4. Precise grading plan approved.' W. I have reviewed and confirmed the requirements. listed above and find the improvements to be sufficiently complete; except as specially provided below, for construction of:the proposed structure(s) on the subject lot(s). Pursuant to my findings; I find that the above may be released for build' a it is uanc WQ CP Oe Recommended by r Dated: 3 ! 6 SPECIAL PROVISIONS: Building & Safety has been advised that it is appropriate to issue the Building Permit; however, the Certificate of Occupancy should not be authorized until the following issues have been addressed: Contractor Name: Instructions: • Please complete this form for each phase ofthe construction project.. Identify the phase by number (e.g.; Phase 2 of 5) in the spaces provided below. • Phase of. 0 AnstructionstoA 'lilt: Masi enter informMion bebiv cis pplici ❑ Clearing/Grubbing [] Mass Grading Project Phase (check): [] ii<nish Grading Construction Phase : [].Other (specify:_ Anticipated Start Date: Anticipated Completion Date:. Number of Acres under Active Construction: Detailed description of. dust control actions implemented during this phase (should 'i match infofnnation provided on site plan; use additionalpages as necessary): r .Attpach a Plot Pah for reference 10pFwJw.¢,�r.. SAvv A Ck�-^� ce_� .N,.' c-Ak S1fo� Fo�,�,nt��1 90�-396- Z183. l0cQcH bSI CQ�-s� �eS, j \'�.lu��2e. IJ �.P�v�'✓ecQ Remember... DUST CONTROL IS REQUIRED 24 HOURS A DAY, 7 DAYS A WEEK, aFr.Aans Fcc nr rnucroitrrtnu C -V eA"IC • 0 .4 t�G�LIGV Site Specific Construction Phase PM 10 Plan. The signature of the property owner (or authorized representative): ■ Shall act as his/her. acknowledgement of dust control requirements and their enforceability, pursuant to AQMD Rules 403 and 403.1; ■ 'Shall constitute an agreement to comply with all project 'conditions as identified in the approved dust control plan; The property owner (or authorized representative): Acknowledges that dust control is required 24 hours a day, 7 days..a week,. throughout the period of project performance, regardless of project .size or status; ■ Shall ensure that. each and every contractor/subcontractor. and all other persons associated with the project shall be in. continuous compliance with . all requirements of the approved•dust control plan; ■ Shall take all necessary precautions to minimize: dust, even if additional measures beyond those listed in the dust control plan are necessary; . ■ Shall authorize representative of.. the City/County to enter upon the above mentioned property for inspection and/or abatement purposes; and Shall hold harmless the City/County and it's representatives*from liability for any actions .related to this dust control- plan or any City/County-initiated abatement activities. Please fill out this section: ...[Property Owner or Authorized Representative Title: Company': Signature: X Printed Nam �/+99 6Alf7795 - Date: IV41" loI — 05' Project Contact Information for (check one) o Owner o Owner's Authorized Representative o Environmental Observer o General Contractor o Sub-Contractor(s) involved in earth movement and/or soil stabilization Instructions: Please enter information below., Name: Title: (If Applicable) Q Company Name:.(If Applicable) (,{ rl Mailing Address: City: State: Zi Code: aLt Primar _Phone:. 19IfR.A1 w,2/M65 Fax: e(©q rZ/7.-!;- acvne 24 Hour Access/Emergency Phone: p — a DC7 Cell Phone: 7 U 0 — Email Address: Responsible for dust control dqu'ngconstruction activities? (circle one) Yes No Responsible for dust. controlunn ff hours? (circle one) es No *Where property owner is NOT the .lead .contact forthe .project, his/her authorized representative is responsible for ALL dust control actions. Remember... DUST CONTROL IS REQUIRED 24 HOURS A DAY, 7 DAYS .A WEEK, REGARDLESS'OF CONSTRUCTION STATUS. Rug 30 07 11:35a Benjamin Herbst (208) 630-5079 P.I. r qtr ` -- L Summit Structural Engineering 106 E. Park Street, Ste. 206 McCall, ID 83638 (866) 862-8148 (208) 634-8148 July 30, 2007 Fax (208) 630-5079 Southwest Concepts 78-120 Calle Estado, Ste. 206 La Quinta, CA 92253 Attn: Stephen Nieto Subject: Structural Observation Grimes Residence r 54-975 Avenida Obregon La Quinta, CA Dear Stephen, Per your request, we visited the subject job site on July 20, 2007 to perform a structural observation. While we were at the job site, we found several omissions and deviations from the plans. All missing items were installed and verified while we were at the jobsite, and at that time we found the structure to be in general compliance with .the, structural design concept. { If you have any questions, please give me a call Yours truly, SUMMIT STRUCTURAL ENGINEERING,,' 401 Nc:. ";O54 `91 r . Benjamin Herbst, P.E. BH oFcau g:Wy Documents120054obfiles\Sd-2521252 field3(cert).doc ~ ~- Residential. Commercial. Industrial. Land Develoornent ti • Y B'City Per. Q of La Quinta Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 uilding Permit Application and Tracking Sheet Project Address:' SIA q'lb �.�� �- Owner's Name: A. P. Number: Address: b , OK1 Legal Description: City, ST, Zip: Contractor: O VS`t� Telephone: Address: Project Description: City, ST, Zip: --� \ �� �L• �7 DN+rc Telephone: State Lic. # : City Lic. #: Arch., Engr., Designer:�� Address: 133 City, ST, Zip: O)C—Ctt� \,6 '$ o - '05 -35,97 Construction.Typ Occupancy: - 53ZTelephone: Telephone:$ Lb �1o'L $� Q State Lic. #: GY\ VQaA Name of Contact Person: p �,� Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: -J)D6 --)02' 1'�lj coo Estimated Value of Project: 1060 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd. Recd TRACIMG . PERMIT FEES Plan Sets Q Plan Check submitted *W/T/ tem Amount Structural Cn1cs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person (` Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan. Plans resubmitted Mechanical Grading, plan 2°' Review, ready for correctio0--S—u- - su11311a. Electrical Subcontactor List . Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for corrections/issue 001 Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 107 015A'10 1? 9_ ��(a�Mora •Ii P.O. BOX, 1504 BUILDING & SAFETY DEPARTMENT •78-495 CALLE TAMPICO (760) 777-7012 LA QUINTA, CALIFORNIA :92253 FAX "(76O) Z77-701 1 . Finance Department, Please Collect The Following Fees For The Services Rendered HTE APPLICATION No. 05-3532 PROJECT: S.F. DWELLING ADDRESS: 54-976 AVENIDA OBREGON CUSTOMER: DOUG BOGREN SERVICES RENDERED: REVISION UNDERCONSTRUCTION, HOURLY PR. Fees: PLAN REVIEW @ $35.00 PER HOUR PR (4 -HR) - 7/31/2007: ............. ... .. .............. ......$ 140.00 Date: 7/31/2007 Initials: AJ TOTAL FEES NOW DUE: ...... *....................... $ 140.00 CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE.*L[Ol . TITLE .24 REPORT .l Title 24 Report for: Grimes/Watson Residence 54-975 Avenida Obregon La Quinta, CA Project Designer: Report Prepared By: Joan D. Hacker.. Insu-form, Inc. 41-921 Beacon Hill, Suite A Palm Desert, CA 92211 (760) 779-0657 Z®O® OWWcc o Job Number: !OOF LL 06CL 0 v ®ZCLCC (.) o � <0 Date: a 10/19/2005 The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2005 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC - www.energysoft.com. EnergyPro 4.0 by EnergySoft Job Number: User Number: 2655 s TABLE 'OF CONTENTS Cover Page 1 Table of Contents 2 Form CF -1 R Certificate of Compliance 3 Form MF -1 R Mandatory Measures Summary 7 . Form WS -5R Residential Kitchen Lighting 9 HVAC System Heating and Cooling Loads Summary ,10 Room Load Summary 11 Room Heating Peak Loads 12 Room Cooling Peak Loads 13 Certificate Of Compliance: Residential ❑ Addition (Part 1 of 3) CF -1 R Czim?s/Natson Residence Project Title ❑ Multi Family ❑ Existing + Add/Alt 10/19/2005 Date 54-A75 Avenida aQuinta (West) 270 deg Raised Floor Area: 0 ft2 _Obrenon—I Project Address Natural Gas Slab on Grade Area: Building Permit # Insu-formYInc_ (760) 779-0657 9.0 ft Documentation Author 488 ft 2. Avg. U: 0.39 Telephone Plan Check/Date FneravPro Compll ce Method 18.1% Avg. SHGC: 0.37 Number of Stories: 15 Climate Zone Field Check/Date Source Energy Use Standard Proposed Compliance Vent (kBtu/sf-yr) Design Design Margin Hgt. Area -2 n/a Space Heating 1..42 0.49 0.94 Space Cooling 56.79 57.71 -0.92 Fans 8.54 8.44 0.10 Domestic Hot Water 9.50 9.03 0.47 Pumps 0.00 0,00 0.00 Totals 76.26. 75.67 0.58 Percent better than Standard: Building Type: [X—) Single Family ❑ Addition Total Conditioned Floor Area: 2,702 ft2 ❑ Multi Family ❑ Existing + Add/Alt Existing Floor Area: n/a ft2, Building Front Orientation: (West) 270 deg Raised Floor Area: 0 ft2 Fuel Type: Natural Gas Slab on Grade Area: 2,702 ft2 Fenestration: Average Ceiling Height: 9.0 ft Area: 488 ft 2. Avg. U: 0.39 Number of Dwelling Units: 1.00 Ratio: 18.1% Avg. SHGC: 0.37 Number of Stories: 1 BUILDING ZONE INFORMATION # of Thermostat Vent Zone Name I Mng 7pne Floor Area Volume 2 702 2411R�1a Units Zone Type Type 1 on rondltioned setback Hgt. Area -2 n/a OPAQUE SURFACES Insulation Act. Type Frame Area U -Fac. Cay. Cont. Azm. Tilt Wall Wnnd 415 n 074 R_1 Q R -n n 270 Ap nnnr NnnP 20 1 450 None R-0 0 270 Ap Wall Wnnd 45 n n74 R-19 R-0 0 X15 _gQ Wall Wnnd 49A n n74 R_1 Q R-0 0 _jLAIl Wall Wnnd 650 0110 R_1I R-0.0 90 A0 Wall Wnnd 312 0 074 R-19 R-0 0 1 R0 A Rnnf Wnnd 2 6R9 0 051 R-19 R-0 0 180 Gains Condition Y / N Status JA IV Reference Location / Comments Run Initiation Time: 10/19/05 17:31:36 Run Code: 1129768296 EnergyPro 4.0 by EnergySoft User Number: 2655 Job Number: Page:3 of 14 Certificate Of Compliance : Residential (Part 2 of 3) CF -1 R Grimes/Watson Residence 10/19/2005 Project Title- Date FENESTRATION SURFACES True Cond. Location/ # Type Area U -Factor' SHGCZ Azm. Tilt Stat. Glazing Type Comments L Windnw 2 Window Front Front (West) 100 n sgo NFRC; Q 37 NFRC 270qQ New Si -rra Pacific Windnws R Dnnrsl iving (West) 15.0 0.390 NFRC 0637 NFRC 270 90 New Sierra Pacific Windows & Doors Living 7nne Zone 3 Window Front (West) 40.0 0.390 NFRC 0_37 NFRC 270 90 New Sierra Pacific Windows & Doors Living Zone 4 Window Front (Northwest) 15.0 0.390 NFRC 0_37 NFRC 315 90 New Sierra Pacific Windows & Doors Living Zone 5 Window Left (North) 7.1 0.390 NFRC 0_37 NFRC • 0 90 New Sierra Pacific Windows & Doors Living Zone 6 f Window Rear (East 7.10 .390 NFRC 0.37 NFRC 90 y90 New Sierra Pacific Windows & Doors Living Zone L r Window Rear • (East) 20.0 0.390 NFRC 0.37 NFRC 90 New Sierra Pacific Windows & Doors Living Zone 8 Window Rear -,U (East) 48.0 0.390 NFRC 0.37 NFRC 90 90 New Sierra Pacific Windows & Doors Living Zone 61 Window 10. tWindow 1.1 ( Window Rear Rear Rear (East) 48.0 0.39D11F$Q-O-U NFRQ 90 --Q New Sierra Pacific Windows & Doors Living (East), 0.3991VF$Q-QaZ NFRC 90'--K New Sierra Pacific Windows & Doors Living (East) 6.7 0.390 NFRC 0.37 NFRC _90 90 New Sierra Pacific Windows & Doors Living Zone Zone Zone � Window Rear (East)4.5 0.390 NFRC 0_37 NFRC 90 90 New Sierra Pacific Windows & Doors Living Zone 13. Window 14 Window 15 Window Right Right Right -- ( outh)` 15-0 -!,a�Nc -LU NFRC 1$.0_ -,q0- New Sierra Pacific Windows & Doors Living (South) 48.0 - 0.390 NFIkC 0_37 NFRC 180 90 New Sierra Pacific Windows & Doors Living (South) 144.0 0.390, NF C 0_37 NFRC 180 90 New Sierra Pacific Windows & Doors Living Zone Zone Zone 116 Window Right (South) 31.5 0.390 NFRC 0_37 NFRC 180 - 90 New Sierra Pacific Windows & Doors Living Zone 17 Skylight Right (South) 13.0 0.390 NFRC 0_37 NFRC: 180 0 New Sierra Pacific Windows & Doors Living Zone 0.76 1. Indicate source either from NFRC or Table 116A. 2. Indicate source either from NFRC or Table 1168. INTERIOR AND EXTERIOR SHADING Window Overhang Left Fin Right Fin # Exterior Shade Type SHGC Hgt. Wd. Len. Hgt.. LExt. REA Dist. Len. Hgt. Dist.. Len. Hgt. 1 Bug Screen 0.76 5.0 2.0 20.0 0.1 20.0 20.0 2 Bug Screen 0.76 3 Bug Screen 0.76 4 Bug Screen 0.76 5 Bun Screen 0.76 2.8 2.8 2.0 0120 2.0 6 Bug Screen 0.76 7 Bug Screen 0.76 8 Bug Screen 0.76 8.0 6.0 12.0 0.1 12.0 12.0 9 Bug Screen 0.76 8.0 6.0 12.0 0.1 12.0 12.0 - 10 Bug Screen 0.76 11 Bug Screen 0.76 _ 12 Bug Screen 0.76 13 Bug Screen 0.76 5.0 3.0 3.0 0.1 3.0 3.0 _ 14 Bug Screen 0.76 8.0 6.0 3.0 0.1 3.0 3.0 _ 15 Bug Screen 0.76 9.0 12.0 12.0 0.1 12.0 12.0 16 Bug Screen 0.76 4.5 7.0 . 6.0 0.1 6.0 6.0 17 None 1.00 THERMAL MASS FOR HIGH MASS DESIGN Area Thick.Heat ' Inside Condition Location/ Type (sf) (in.) Cap. Cond. R -Val. JA IV Reference Status Comments Frame Wall, Stucco 415 1.00 21 0.47 0 09-A5 New Living Zone / Exterior Mass Frame Wall, Stucco 45 1.00 21 0_47 0 09-A5 New Living Zone / Exterior Mass Frame Wall, Stucco 493 1.00 21 0_47 0 09-A5 New Living Zone / Exterior Mass Frame Wall, Stucco 650 1.00 21 0_47 0 09-A2 New Living Zone / Exterior Mass Frame Wall, Stucco 1.00 21 0_47 0 09-A5 New Living Zone / Exterior Mass PERIMETER LOSSES Insulation Condition Location/ Type Length R -Val. Location JA IV Reference Status Comments Slab Perimeter 18. None No Insulation 26-A1.. New Livinq Zone Run Initiation Time: 10/19/05 17:31:36 Run Code: 1129768296 EnergyPro 4.0 by EnergySoft User Number: 2655 ' Job Number: Page:4 of 14 Certificate Of Compliance: Residential (Part 3 of 3) CF -1 R GrimesMatson Residence 10/19/2005, Project Title Date HVAC SYSTEMS Heating Minimum Cooling Minimum Condition Thermostat Location Type Eff Type Eff Status Type Living Zone Central Furnace 80% AFUE Split Air Conditioner 12.0 SEER New Setback HVAC DISTRIBUTION Duct Duct Condition Ducts Location Heating Cooling Location R -Value Status Tested? Living Zone Ducted Ducted Attic 4.2 New - Yes Hydronic Piping Pipe Pipe Insul. System Name Length Diameter Thick. WATER HEATING SYSTEMS Rated' Tank ' Energy Standbyl Tank Insul. Water Heater # in Input Cap. Condition Factor Loss R -Value System Name Type Distribution Syst. (Btu/hr) (gal) Status or RE 1 (%) Ext. A O SMITH PGCG-50-246 Small Gas' No Pipe Insulation 1 40,000 • 50 New 0.62 Multi -Family Central Water Heating Details Hot Water Pump Hot Water Piping Length (ft) Add 1/2" Control # HP Type In Plenum Outside Buried Insulation 1 For small gas storage (rated input — 75000 Btu/hr), electric resistance and heat pump water heaters, list energy factor. For large gas storage water heaters (rated input > 75000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input, and Recovery Efficiency. REMARKS n/a n/a COMPLIANCE STATEMENT This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall design responsibility. The undersigned recognizes that compliance using duct design, duct sealing, verification of refrigerant charge and TXVs, insulation installation quality, and building envelope sealing require installer testing and certification and field verification by an approved HERS rater. Namess & Professions Code) e- erorowneSbTJ I HnWEST CONCEPTS Name' U Enforcement Agency Name: Title/Firm: Address: T.1 -h - - Documentation Author Name: Joan D. Hacker Title/Firm: I nsu-form. Inc. .Address: 41-921 Beacon Hill, Suite A Palm Desert, CA 92211 Telephone: (760) 779-0657 (dign%ture) L -W V - V - (date) Certificate'Of Compliance: Residential (Addendum) CF -1R GrimesMatson Residence 10/19/2005 Project Title Date Special Features and Modeling Assumptions The local enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification to be. used with the performance approach. The local enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy or the special lusuncation ano aocumentatnon suomirrea. Plan Field i HERS Required Verification Items in this section require field testing and/or verification by a certified home energy rater under the supervision of a CEC- approved HERS provider using CEC approved testing and/or verification methods and must be reported on the CF -4R.. Plan Field installation certificate. The HVAC System "Living Zone" incorporates HERS verified Duct Leakage. Target leakage is calculated and documented on the CF - 4R. EnergyPro 4.0 by EnergySoft User Number: 2655 Job Number: . Page:6 of 14 1 r Mandatory Measures Summary: Residential (Page 1 of -2) MF -1 R NOTE: Low-rise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. More stringent compliance requirements from the Certificate of Compliance supercedes the items marked with and asterisk (') below. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION Instructions: Check or initial applicable boxes when completed or check N/A if not applicable. NIA 'DESIGNER ENFORCE - MENT Building Envelope Measures ❑X ❑ ❑ �§ 150(a): Minimum R-19 in wood ceiling insulation or equivalent U -factor in metal frame ceiling. ❑X ❑ ❑ § 150(b), Loose fill insulation manufacturers labeled R -Value: ❑X ❑ ❑ •§ 150(c): Minimum R-13 wall insulation in wood framed walls or equivalent U -factor In metal frame walls (does not ❑x ❑ ❑ apply to exterior mass walls). �§ 150(d): Minimum R-13 raised floor insulation in framed floors or equivalent U -factor. ❑X ❑ ❑ § 150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs. f 1. Masonry and factory -built fireplaces have: a. closable metal or glass door covering the entire opening of the firebox ❑X ❑ ❑ b. outside air intake with damper and control; flue damper and control Q ❑ ❑ 2. No continuous burning gas pilot'lights allowed. ❑X ❑ ❑ § 150(0: Air retarding wrap installed to comply with §151 meets requirements specified in the ACM Residential Manual. ❑x ' ❑ ❑ § 150(g): Vapor barriers mandatory in Climate Zones 14 and 16 only. ❑X ❑ ❑ § 150(1): Slab edge insulation - water absorption rate for the insulation alone without facings no greater than 0.3%, water vapor ❑X ❑ ❑ permeance rate no greater than 2.0 permfinch. § 118: Insulation specified or installed meets insulation installation quality standards. Indicate type and include ❑x ❑ El Form: § 116-17: Fenestration Products, Exterior Doors, and Infiltration/Exfiltration Controls. 0 ❑ ❑ 1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. ❑X ❑ ❑ 2. Fenestration products (except field fabricated) have label with certified U -Factor, certified Solar Heal Gain ❑X ❑ ❑ Coefficient (SHGC), and infiltration certification. 3. Exterior doors and windows weatherstripped; all joints and penetration's caulked and sealed. ❑X ❑ ❑ Space Conditioning, Water Heating and Plumbing System Measures § 110-13: HVAC equipment, water heaters, showerheads and faucets certified by the Energy Commission. ❑X ❑ ❑ § 150(h): Heating and/or cooling loads calculated in accordance with ASH RAE, SMACNA or ACCA. ❑X ❑ ❑ § 150(i): Setback thermostat on all applicable heating and/or cooling systems. ❑X ❑ ❑ § 1500): Water system pipe and tank insulation and cooling systems line insulation. 1. Storage gas water heaters rated with an Energy Factor less than 0.58 must be externally wrapped with insulation ❑X ❑ ❑ having an installed.thermal resistance of R-12 or greater. 2. Back-up tanks for solar systems, unfired storage tanks, or other indirect hot water tanks have R-12 external ❑X ❑ ❑ insulation or R-16 internal insulation and indicated on the exterior of the tank showing the R -value. 3. The following piping is insulated according to Table 150 -AIB or Equation 150-A Insulation Thickness: 1. First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire ❑X ❑ ❑ length of recirculating sections of hot water pipes shall be insulated to Table 150B. 2. Cooling system piping (suction, chilled water, or brine lines), piping insulated between heating source and ❑X ❑ ❑ indirect hot water tank shall be insulated to Table 150-8 and Equation 150-A. 4. Steam hydronic heating systems or hot water systems > 15 psi, meet requirements of Table 123-A. ❑X ❑ ❑ 5. Insulation must be protected from damage, including that due to sunlight, moisture, equipment maintenance, Q ❑ ❑ and wind. 6. Insulation for chilled water piping and refrigerant suction piping includes a vapor retardant or is enclosed Q ❑ ❑ entirely in conditioned space. 7. Solar water -heating systems/collectors are certified by the Solar Rating and Certification Corporation. 0 ❑ ❑ EnergyPro 4.0 by EnergySoft User Number: 2655 'Job Number: Page:7 of 14 Mandatory Measures Summary: Residential (Page 2 of 2) WAR NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. More stringent compliance requirements from the Certificate of Compliance supercede the items marked with an asterisk (') below, When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. Instructions: Check or Initial applicable boxes when completed or check N/A if not DESCRIPTION ENFORCE - applicable. N/A DESIGNER MENT Space Conditioning, Water Heating and Plumbing System Measures: (continued) § 150(m): Ducts and Fans 1. All ducts and plenums installed, sealed and insulated to meet the requirements of the CMC Sections 601, 602, 603, 604, X❑ 11 El605, and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minumum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used. 2. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than ® ❑ ❑ sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Duds installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the duds. 3. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive ® ❑ ❑ duct tapes unless such tape is used in combination with mastic and draw bands. , ® ❑ ❑ 4. Exhaust fan systems have back draft or automatic dampers. 5. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operating ® ❑ ❑ dampers. 6. Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment ® ❑ ❑ maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. ® ❑ ❑ 7. Flexible duds cannot have porous inner cores. § 114: Pool and Spa Heating Systems and Equipment 1. A thermal efficiency that complies with the Appliance Efficiency Regulations, on-off switch mounted outside of the ® ❑ ❑ heater, weatherproof operating instructions, no electric resistance heating and no pilot light. 2. System is installed with: ® ❑ ❑ a. At least 36" of pipe between fiker and heater for future solar heating. b. Cover for outdoor pools or outdoor spas. ® ❑ ❑ 3. Pool system has directional inlets and a circulation pump time switch. ® ❑ ❑ § 115: Gas fired fan -type central furnaces, pool heaters, spa heaters or household cooking appliances have no continuously ® ❑ ❑ burning pilot light. (Exception: Non -electrical cooking appliances with pilot < 150 Btu/hr) § 118 (i): Cool Roof material meets specified criteria ® ❑ ❑ Lighting Measures § 150(k)1: HIGH EFFICACY LUMINAIRES OTHER THAN OUTDOOR HID: contain only high efficacy lamps as outlined in Table ® ❑ ❑ 150-C, and do not contain a medium screw base socket (E24/E26). Ballasts for lamps 13 Watts or greater are electric and have an output frequency no less than 20 kHz. § 150(k)l: HIGH EFFICACY LUMINAIRES - OUTDOOR HID: contain only high efficacy lamps as outlined in Table 150-C, ® ❑ ❑ luminaire has factory installed HID ballast. § 150(k)2: Permanently installed luminaires in kitchens shall be high efficacy luminaires. Up to 50% of the Wattage, as determined X❑ ❑ ❑ in Section 130(c), of permanently installed luminaires in kitchens may be in luminaires that are not high efficacy luminaires, provided that these luminaires are controlled by switches separate from those controlling the high efficacy luminaires. § 150(k)3: Permanently installed luminaires in bathrooms, garages, laundry rooms, utility rooms shall be high efficacy luminaires. X❑ ❑ ❑ OR are controlled by an occupant sensor(s) ceritfied to comply with Section 119(d). § 150(k)4: Permanently installed luminaires located'other than in kichens, bathrooms, garages, laundry rooms, and utility rooms shall be high efficacy luminaires (except closets less than 70 ft) OR are, controlled by a dimmer switch OR are ® ❑ ❑ controlled by an occupant sensor that complies with Section 119(d) that does not turn on automatically or have an always on option. § 150(k)5: Luminaires that are recessed into insulated ceilings are approved for zero clearance insulation cover (IC) and are ❑ ❑ certified to ASTM E283 and labeled as air tight (AT) to less than 2.0 CFM at 75 Pascals. § 150(k)6: Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on the ® ❑ ❑ same lot shall be high efficacy luminaires (not including lighting around swimming pools/water features or other Article 680 locations) OR are controlled by occupant sensors with integral photo control certified to comply with Section 119(d). § 150(k)7: Lighting for parking lots for 8 or more vehicles shall have lighting that complies with Sections 130, 132, and 147. ® ❑ ❑ Lighting for parking garages for 8 or more vehicles shall have lighting that complies with Section 130, 131, and 146. § 150(k)8: Permanently installed lighting in the enclosed, non -dwelling spaces of low-rise residential buildings with four or more ® ❑ ❑ dwelling units shall be high efficacy luminaires OR are controlled by occupant sensor(s) certified to comply with Section 119(d). ' EnergyPro 4.0 by EnergySoft User Number: 2655 Job Number: Page:8 of 14 Residential Kitchen Lighting Worksheet WS -5R GrimesMatson Residence 10/19/2005 Project_Title Date At least 50% of the total rated wattage of permanently installed luminaires in kitchens must be in luminaires that are high efficacy luminaires as defined in Table 150-C. Luminaires that are not high efficacy must be switched separately. Kitchen Lighting Schedule. Provide the following information for all luminaires to be installed in kitchens. - High Efficacy Luminaire Type High Efficacy? Watts Quantity Watts Other Watts (2) 4 ft Fluorescent T8 Elec Yes X No 62.0 x 1 = 62 or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No , x = or Yes No x = or Yes No x = or Yes No x = or :Yes. I No 11 x = or `fes I No 11 x = or Yes I No x = or Yes No x = or Yes No x = or Yes No x — or Yes No x = or Total A: 62 B: 0 COMPLIES IF A;-,, B YES ® NO ❑ EnergyPro 4.0 by EnergySoft' User Number: 2655 Job Number: Page:9 of 14 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY PROJECT NAME - DATE GrimesMatson Residence 10/19/2005 SYSTEM NAME FLOOR AREA Living Zone 2,702 ENGINEERING CHECKS 11SYSTEM LOAD Number of Systems 2 Heating System Output per System 74,000 Total Output (Btuh) 148,000 Output (Btuh/sqft) 54.8 Cooling System Output per System 40,000 Total Output (Btuh) 80,000 Total Output (Tons) 6.7 Total Output (Btuh/sqft) 29.6 Total Output (sgft/Ton) 405.3 Air System CFM per System 1,395 Airflow (cfm) 2;790 Airflow (cfm/sgft) 1.03 Airflow (cfmrron) 418.5 Outside Air (%) 0.0 Outside Air (cfm/sgft) 0.00 Note: values above given at ARI conditions EATING SYSTEM PSYCHROMETRICS 26.0 OF 69.0 OF 69.0 OF Outside Air 0 cfm 69.0 OF 11.9 / 77.6 OF Outside Air 0 cfm 79.5/67.0 O F Total Room Loads Return Vented Lighting Return Air Ducts Return Fan Ventilation Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COIL COOLING PEAK I COIL HTG. PEAK CFM I Sensible Latent I CFM I Sensible 2,415 37,492 3,109 648 32,956 0 4,505 3,042 0 0 0 0 0 0 0 0 0 4,505 3,042 46,5021 3 109 39 040 BDP CO. 563AN042-A 52,325 21,216 148,000 Total Adjusted System Output 52,325 21,216 148,000 (Adjusted for Peak Design Conditions) TIME OF SYSTEM PEAK Aug 2 pm Jan 12 am earn Temperatures at Time of Heatina Peak) 118.8 OF Supply Fan Heating Coil 2790 cfm Return Air Ducts ROMETRICS (Airstream Temperatures at Time of Cc 79.5/67.0 OF 79.5/67.1OF 61.9/60.9 OF Supply Air Ducts 117.8 OF ROOMS 70.0 OF Supply Air Ducts Supply Fan Cooling Coil 63.4 / 61.4 OF 2790 cfm 55.3% R.H. ROOMS 78.0 / 66.5 OF Return Air Ducts 4.0 by EneravSoft User Number: 2655 Job Number: 10 of 14 • • 11 • _ s Al7,—,VZ PROJECT NAME Grimes/Watson, Residence DATE 10/19/2005 SYSTEM NAME Living Zone FLOOR AREA 2,702 ROOM LOAD SUMMARY ROOM COOLING PEAK COIL COOLING PEAK COIL HTG. PEAK ZONE NAME ROOM NAME Mult. CFM SENSIBLE LATENT CFM SENSIBLE LATENT CFM SENSIBLE Living Zone Living 1 2,415 37,492 3,109 2,415 37,492 3,109 648 32,956 PAGE TOTAL 1 2,415 37,492 3,109 648 32,956 TOTAL 1 2,415 37,492 3,109 648 32,956 EnergyPro By EnergySoft User Number: User Job Number: Page: 11 of 14 ROOM HEATING PEAK LOADS Project Title Date GrimesMatson Residence 110/19/2005 Room Information Desion Conditions Room Name Living Time of Peak Jan 12 am Floor Area 2,702 Outdoor Dry Bulb Temperature 26°F Indoor Dry Bulb Temperature 70OF Conduction Area • U -Value AT of Btu/hr perimeter =18.0 415.0 10.0 15.0 40.0 20.0 45.0 15.0 492-9 7.1 650.1 7.1 20.0 48.0 48.0 15.6 4.5 311 5 15.0 144.0 31.5 2,689.0 0 X X X X X X X X X X X X X X X X X X X X X X . X X X X X X X X X X X X X X X X X 44 = = = = = = = = = = = = =[a22648 = = = = =6,034 = = = = = = = = 578 44 1,351 44 172 44 257 44 686 44 1,276 44 147 44 257 44 1,605 122 44 44 44 44 115 44 77 44 1,014 44 257 44=824 44 2.471 44= 541 44_223 Items shown with an astensK (-) aenote conaucuon mrougn an mtenor surrace to anomer rovnt. Page Total: I 23,5341 Infiltration: r 1.00 X 1.064 X 2 702 X 9.00 X 0.497 / 6] X 44 = 9 422 schedule Air Sensible Area Ceiling Height ACH OT Fraction TOTAL HOURLY HEAT LOSS FOR ROOM 42,505 EnergyPro 4.0 by EnergySoft User Number: 2655 Job Number: Page: 12 of 14 RESIDENTIAL ROOM COOLING LOAD SUMMARY Project Title Date GrimesMatson Residence 110/19/2005 Room Information Design Conditions Room Name: Living Outdoor Dry Bulb Temperature: 78OF Floor Area: 2,702 sf Outdoor Web Bulb Temperature: 113OF Indoor Dry Bulb Temperature: 78 of Outdoor Daily Range: 3PF Items shown with an asterisk (') denote conduction through an interior surface to another room. Page Total 1. Cooling Load Temperature Difference (CLTD) Fenestration Window Window Window Window Window Window Window Window Window Window Btu/hr 1,013 957 101 839 2,360 599 7,680 13549 Orientation Orientation Area X X X X X X X X X X X X U -Factor X X X X X X X X X X X X CLTD 1 = = = = = = = = = = = West 415.0 0.0740 33.0 West 20.0 1.4500 33.0 Northwest 45.0 0.0740 30.2 North 492.9 0.0740 23.0 East 650.1 0.1100 33.0 South 311.5 0.0740 26.0 (South) 2,689.0 0.0510 56.0 0.0 21.5 7.1 21.5 152 East 0.0 21.5 7.1 43.4 308 East 0.0 21.5 20.0 43.4 869 East Items shown with an asterisk (') denote conduction through an interior surface to another room. Page Total 1. Cooling Load Temperature Difference (CLTD) Fenestration Window Window Window Window Window Window Window Window Window Window Btu/hr 1,013 957 101 839 2,360 599 7,680 13549 Orientation Shaded Area X X X X X x X X X x X. GLF + + + +S + + + + + + Unshaded Area X X X x X X X X X X X Page GLF = = = = = = = = = = Btu/hr est 10.0 21.5 0.0 . 43.4 215 West 0.0 21.5 15.0 43.4 652 West 0.0 21.5 40.0 43.4 1,738 Northwest 0.0 21.5 15.0 33.4 501 North 0.0 21.5 7.1 21.5 152 East 0.0 21.5 7.1 43.4 308 East 0.0 21.5 20.0 43.4 869 East 48.0 21.5 0.0 43.4 1,031 East 48.0 21.5 0.0 43.4 1,031 East 0.0 21.5'+ 15.6 43.4 678 I Total 7173 Internal Gain Btu/hr Occu ants 4 x Occupants X 230 Btuh/OCc. = 920 E ui ment B1 X Dwelling Units X 1.60 Watts/sgft = 1 1,6001 Infiltration: 1 osa x 1 1 x 171 2 x = 7 as Air Sensible CFM ELA DT TOTAL HOURLY SENSIBLE HEAT GAIN FOR ROOM 37,492 Latent Gain Btu/hr Occu ants x Occupants x 200 Btuh/OCC. = 800 Infiltration: a 769 X 1.18 X 171.20 X 0.00240 = 2 309 Air Latent CFM ELA &W TOTAL HOURLY LATENT HEAT GAIN FOR ROOM 3,109 Ener Pro 4.0 by Ener Soft User Number: 2655 Job Number. Page: 13 of 14 RESIDENTIAL ROOM COOLING LOAD SUMMARY Project TitleDate GrimesMa'tson Residence 110/19/2005 Room Information Desi - n Conditions Room Name: Living Outdoor Dry Bulb Temperature:' 78°F Floor Area: . 2,702 sf Outdoor Web Bulb Temperature: 113°F Indoor Dry Bulb Temperature: 78 OF Outdoor Daily Range: 350F burraces Orientation Area U -Factor CLTD 1 x X = x x = x x = x X = x x = x x = x x = x x = x x = x x = x x = x X = Pa a Total Items shown with an asterisk (') denote conduction through an interior surface to another room. g 1. Cooling Load Temperature Difference (CLTD) Fenestration Orientation Shaded Area X X X X X X x x x X X GLF + + + + + + + + + + + Unshaded Area X X X x X X X x x X X Page GLF = = = = = = = = = = Btu/hr East 0.0 21.5 6:7 43.4 291 East 0.0 > 21.5 4.5 43.4 195 South 15.0 21.5 0.0 21.6 322 South 48.0 21.5 0.0 21.6 1,031 South 144.0 21.5 0.0 21.6 3,092 South 31.5 21.5 0.0 21.6 676 (Skylight)0.0 21.9 13.0 72.0 936 Total s 5aa Internal Gain Btu/hr Occu ants X . Occupants X 230 Btuh/occ. = 920 E ui ment EJX Dwelling Units X. 1 600 Watts/sgft = 1 1,6001 Infiltration: 1.osa X 1 18 X 171.20 X = 7 4 Air Sensible CFM ELA DT TOTAL HOURLY SENSIBLE HEAT GAIN FOR ROOM 37 a92 Latent GainBtu/hr OCCU ants IF X Occupants X 200 Btuh/occ. = 800 Infiltration: 4 769 x 1.18 X 171.20 X Air Latent CFM ELA AW 2 309 TOTAL HOURLY LATENT HEAT GAIN FOR ROOM 3,109 Energ Pro 4.0 by Ener Soft User Number: 2655 Job Number: Page: 14 of 14 Ca10ERTS Page 1 of 1 CF -4R CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING May, 20 2008 This CF -411 Issued by Ca10ERTS® is for the home located at: 54975 Avenida Obregon La Quinta CA, 92253 Certificate Number: CC3-1798436920 Passed Date Inspected: May, 20 2008 1 aw Ca10ERTS Rater: Paul Van Vlymen Duct Sealing Passed CC2004367 1 C HERS Analyst: N/A l E Builder/ Developer: Project: Home Owner -Builder 54975 Avenida Obregon 5'q -47t. ' Phase: Phase 1 Plan Name: SingleSFR Lot Number: Lot Specifics about this General Information Conditioned Floor Area: Conditioned Volume: Front Orientation: Number of Stories: Heating and Cooling Systems Heating Equipment: Cooling Equipment: Heating Equipment: Cooling Equipment: .t HVAC Air Distribution Duct Location: Duct Insulation R -Value: home: 2702 Square Feet 0 Cubic Feet N/A 1 Heat Pump: 100 Heat Pump: 14 Heat Pump: 100 Heat Pump: 14 Attic 4.2 Water Heating S stem Pro osed TY I Size I Fuel I EF I Distribution Water Heating System Actual 1QTY1 ize Fuel 1EF1 Distribution Testing & Verification Results Main System HVAC System Duct Sealing Passed Installation of Thermostatic I Expansion Valve TXV Passed New System HVAC System Duct Sealing Passed Installation of Thermostatic I Expansion Valve Passed The energy efficiency rating of this home Is determined using California Home Energy Rating System (C -HERS) rules. The rating considers heating, cooling and water heating and assumes average weather, thermostat settings, and quantities of hot water for a typical household. Actual energy use will vary according to occupant behavior. This Rating Completion Summary is provided only after the features listed have been verified and approved by the CaICERTS Certified Rater shown above. If you have a concern or complaint regarding this report of the services used in obtaining it, you may contact: Ca10ERTS - Customer Service 31 Natoma St Suite 120, Folsom, CA 95630. Ca10ERTS Page 1 of 4 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF 4R Project Address Builder Name 54975 Avenida Obregon - La Quinta, CA 92253 Home Owner -Builder Builder Contact Telephone Plan Number Grimes 714 801 5134 SingleSFR HERS Rater Telephone Sample Group Number/ Lot # (if applicable) Paul V VI men 760-777-1724 96338 / Lot Co fiance IYeLW (prescriptive)Climate Zone 15 Cetl Sign re Date Certificate Number May 20, 2008 CC3-1798436920 Firm: Air Experts Air Conditioning HERS Provider:CalCERTS, Inc. Strefft Address: PO Box 94 City/State/Zip: La Quinta / CA /92247 Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was 0 Tested ❑ Approved as part of sample testing, but was Associated. As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form compiles with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution system Is fully ducted and correct tape is used before a CF -411 may be released on every tested building. The HERS rater must not release the CF -411 until a properly completed and signed CF -611 has been received for the sample and tested buildings. Q The Installer has provided a copy of the CF -611 (Installation Certificate). © New Distribution system Is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). Q New systems where cloth backed, rubber adhesive dud tape is Installed, mastic and drawbands are used In combination with cloth backed, rubber adhesive duct tape to seal leake ar .1—+ —.,.,o,+i--- MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT: Main System NEW CONSTRUCTION Dud Pressurization Test Results (CFM @ 25 Pa) Measured Values 1 Enter Tested Leakage Flow In CFM: 112 2 Fan Flow: Calculated (Nominal 'tib Coolin` Enter Total Fan Flow In CFM: g '= Heating) or __ Measured 2000 3 Pass if Leakage Percentage < 6% [ 100 x ( Line 1 / Line 2 )]: 5.60% Q Pass ❑ Fail ALTERATIONS: Duct System and/or HVAC Equipment Change -Out 4 Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Dud System Prior to Dud System Alteration and/or Equipment Change -Out. 5 Enter Tested Leakage Flow In CFM: Final Test of New Dud System or Altered Dud System for Dud System Alteration and/or Equipment Change -Out. 6 Enter Reduction in Leakage for Altered Dud System [Une 4 - Line 5] - (Only if Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) 8 Entire New Dud System - Pass if Leakage Percentage < 6% [ 100 x ( Line 5 / Line 2 )J: ❑ Pass ❑ Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pass if Leakage Percentage <= 15% [ 100 x ( Line 5 / Line 2 )J: ❑ Pass ❑ Fall 10 Pass if Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: Pass ❑❑ Fail 11 Pass if Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )] and Verification by Smoke Test and Visual Inspection ❑Pass Fall 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fall Pass if One of Lines #9 through #12 pass ElPass El Fail Ca10ERTS Page 2 of 4 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF 4R Project Address Builder Name 54975 Avenida Obregon - La Quinta, CA 92253 Home Owner -Builder Builder Contact Telephone Plan Number Grimes 714 801 5134 SingIeSFR HERS Rat;96i;k Telephone sample Group Number/ Lot # (if applicable) Paul Va 760-777-1724 96338 / Lot Com lig ce Met (Prescriptive) Climate Zone 15 Certifying Signa Date Certificate Number May 20, 2008 CC3-1798436920 Firm: I Air Experts Air Conditioning HERS Provider:Ca10ERTS, Inc. Street Address: PO Box 94 City/State/Zip:La Quinta / CA / 92247 Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was 0 Tested ❑ Approved as part of sample testing, but was Associated. As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution system Is fully ducted and correct tape is used before a CF -411 may be released on every tested building. The HERS rater must not release the CF -4R until a properly completed and signed CF -6R has been received for the sample and tested buildings. Q The Installer has provided a copy of the CF -611 (Installation Certificate). New Distribution system Is fully ducted (i.e., does not use building cavities as plenums or platform returns In lieu of ducts). 0 New systems where cloth backed, rubber adhesive duct tape Is installed, mastic and drawbands are used In combination with cloth backed. tubber adhesive Burt Pane t•n cenl i..i a r 4..,+ ____ ...... MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT: New System NEW CONSTRUCTION Duct Pressurization Test Results (CFM @ 25 Pa) Measured Values 1 Enter Tested Leakage Flow In CFM: 116 r . .D 2 Fan Flow: Calculated (Nominal', Cooling ' :. Heating) or 'C _ ' Measured Enter Total Fan Flow in CFM: 2000 3 Pass if Leakage Percentage < 6% [ 100 x ( tine 1 / Line 2 )]: 5.80% © pass ❑ Fail ALTERATIONS: Duct System and/or HVAC Equipment Change -Out 4 Enter Tested Leakage Flow In CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. 5 Enter Tested Leakage Flow In CFM: Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change -Out. 6 Enter Reduction in Leakage for Altered Duct System [Line 4 - Line 5] - (Only if Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) 8 Entire New Duct System -Pass if Leakage Percentage < 6% [ 100 x ( Line 5/ Line 2 )J: ❑ Pass ❑ Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pass If Leakage Percentage <= 15% [ 100 x ( Line 5 / Line 2 )): El Pass El Fall 10 Pass if Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: ❑Pass E3 Fall 11 Pass if Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )] and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fall 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fall Pass if One of Lines #9 through #12 pass ❑ Pass 11 Fail CalCERTS Page 3 of 4 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 8) CF -4111 Project Address Builder Name 54975 Avenida Obregon - La Quinta, CA 92253 Home Owner -Builder Builder Contact Telephone Plan Number Grimes 714 801 5134 S1n91eSFR HERS Rater . Telephone Sample Group Number/ Lot # (if applicable) Paul Van VI en 760-777-1724 96338 / Lot Com /ianc Metho rescritive Climate Zone 15 Certifying teq Date Certificate Number May 20, 2008 CC3-1798436920 Firm: Air Experts Air Conditioning HERS Provider:CaICERTS, Inc. Street Address: PO Box 94 City/State/Zip:La Quinta / CA / 92247 Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was R Tested ❑ Approved as part of sample testing, but was Associated. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the di a nostic tested compliance requirements as checked on this form. The Installer has provided a copy of the CF -611 (Installation Certificate). HERMOSTATIC EXPANSION VALVE (TXV): Main System Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed on the system and installation of the specific equipment shall be verified. Main System HVAC System TXV I R Pass ❑ Fail CaiCERTS Page 4 of 4 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 8) CF -4R Project Address Builder Name 54975 Avenida Obregon - La Quinta, CA 92253 Home Owner -Builder Builder Contact Telephone Plan Number Grimes 714 801 5134 SingleSFR HERS Rater Telephone Sample Group Number/ Lot # (if applicable) Paul Van m 760-777-1724 96338 / Lot Complia4fice Meth ,,(Prescriptive) Climate Zone 15 Certlfying';?lgnatu Date Certificate Number .% May 20, 2008 CC3-1798436920 Firm: it Experts Air Conditionin HERS Provider:CaICERTS, Inc. Street Address: PO Box 94 City/State/ZIp:La Quinta / CA / 92247 Coolies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT The house was © Tested ❑ Approved as part of sample testing, but was Associated. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the di a nostic tested compliance requirements as checked on this form. [� The Installer has provided a copy of the CF -611 (Installation Certificate). Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed on the system and installation of the specific equipment shall be verified. New System HVAC System TXVJ irJ Pass LJ Fail V age 3 of 13) � perrmif.��T Address ]DOWN DIAGNOSTICS DUCT L 4KAG1 �•1 �o ❑ DUCT LEAKAGE RFAUCT@IOPI 1Z- PrTestR�m 25 PA) TesYI.ealcaSe (CFN)-- on oftons, oras21.7%Heatmg ee zwU Fan Flow „a�M,tated as 400 c6mRon x num T>looeai++�Zf J°atue ere IfFan�l i m If fan flaw S In , Rr c d Fan FlOw _ age Fraction = "`� pass if leakage hwgion s0-06 / Fail g wa comply LTYPE�S ONLY- Thefonowft�(� ® For AER' onatroug-nmeas leaker CIFSCK AFSFMSUN G WALL: ❑ ❑ test o; House �yation test ❑ Yes . 13No Q visnal Im'g�on of Duct Comiections Pass Fail ❑ Yes ❑ No ON VALE v j ❑ �09rATIC EIfPA ❑ Is Th�c bion Valve is ir�alled and A ccess Pass Fail tes ❑ NO provided for uhspoh' Yes is a pass ❑ DUCT DESIGN ACCO Mares DilF' cat cnlatiom have" 1. ❑ Yes 13 NO �pletedy DoctDeshe}h is cm fibs P and duct instanation matches PlMr f ed If no TXV. TxNr is Moved or Fan flow las been voerlie 2. ❑ Yes ❑ No verified fan flow maw d Meoured Fan Flow - ❑ ❑ ' pass Fail Yes for botch 1 and 2 is a Pass ciated with $1e test(s) is in f the CF -6R verify fiat the above dhsgn� test [The builder sl�llprovidr �Setequirem Aco ��re ements forcredit. c te�usS mon m eats ying signed by the builder emP1oY'w or sub-con� for compl'� creditl In�S ��. Name) OR : GactM (Co. Name) Tests Ste' Date, ���tz. performed DePo mens COPY TO: Building 1ms Provider (if applicable) Buildingat Occupaac7' Building ovmer A-25 AWUSt 200' Comp arm Forms