RR (05-1896)77173 Calle Mazatlan
05-1896
04866
P.O. BOX 1504- VOICE (760) 77777012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING &-SAFETY DEPARTMENT INSPECTIONS (760) 777-7153.
BUILDING PERMIT
Date: 5/19/05
Application Number: 0_5 -00001896` Owner:
Property Address: 77173 CALLE MAZATLAN MEYER PAUL KEVIN
APN: 658-230-006- - - 3020'BUCHANAN ST
Application description: RE -ROOF SAN FRANCISCO, CA 94123
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 10189
nW Contractor:
Applicant: Architect or Engine iJ WESTERN -PACIFIC ROOFING CORP
MAYO 2005 3462 LA CAMPANA WAY
1 PALM SPRINGS, CA 92262
(760)00
CIN Lic. No.: 235®F LAQUiNTA .: 235
717
FIPIAWCE DEPT.
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION -
I. hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:.: -
section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers'' compensation, as provided
License Class: B C39 LicenseNo 235717 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. _
rt e: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
• OWNER -BUILDER DECLARATION - insurance carrier and policy number are:
hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - - Carrier STATE .FUND - Policy Number 0457624-2005
following reason (Sec. 7031.5; Business and. Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit.is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to theworkers' compensation laws of California, .
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section '
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the La ode, I shall forthwith comply with se provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by -Z °"B % ! -
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: .Date: ppIicant: ../
(_ 1 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. -
property who builds br improves thereon, and who contracts for the projects with a contractor(s) licensed 1.- Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). - whose benefit work is performed under or pursuant to.any permit issued as a result of this application,
( 1 I am exempt under Sec. , B.&P.C. for this reason - 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. -
_ Date: Owner: 2. Any permit issued as a result of this application becomes null and void if work isnotcommenced
- - within 180 days from date of issuance of such permit; or cessation of work for 180 days will subject
CONSTRUCTION LENDING AGENCY permit to cancellation. - -
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the 1 certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). 'city and county ordinances ;and state laws relating to building construction„and hereby authorize re rese'tat' es
ofthis county to enter upon thee -mentioned property for inspection purposes. ,
Lender's Name: c _-
Date:J Z ignature (Applicant or Agent):
-Lender's Address: • /-df
LQPERMIT
Application Number .05-00001896
Permit . . .• . . . RE -ROOF
Additional desc
Permit Fee . . . . 30.00
Plain Check
Fee
.00
Issue Date
'Valuation
Expiration Date 11/15/05
t
Qty Unit Charge Per
Extension
BASE
FEE
30.00
------------------------------------------
Special Notes and Comments
----------------------------------
RE -ROOF WITH POLYURETHANE FOAM COATING
SYSTEM
Fee summary Charged
- - - - - - - - - - - - - - - - - - - - - - - - - - - -
•Paid Credited
- - - - - - - - - - - -
- - - ---
Due
- - - - - - - -
Permit Fee Total 30.00
.00, ..00
30.00
Plan Check Total .00
00
.00
.00.
Grand Total 30.00
.00
.00
30.00
LQPERMIT
Building 77-173 Mazatlan
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address
City Zip Tel.
La Q1;Rinta 92253
Contractor
F. 0. Box 1540
City Zip Tel. . .<
,, Quinta 9226 _56 62,44
State Lic. City
& Classif. 378318 Lic. #
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATIONi
I hereby affirm that I am licensed under provisions of Chapter 9:(66mmencing witt(Seclion
7000) of Divisionr3 of the Business and Professions Code, and my license isfiinnffull''force and
effect. 7Z;
SIGNATURE `Y 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, atter, 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 7000) of
Division 3 of the Business and Professions Code, or thathe 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 dollais ($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.)
O 1, 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.)
0 1 am exempt under Sec. B. ti P.C. for this reason
Date Owner
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 t/•""
p0°Copy is filed with the city. O 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.)
1 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' 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
1 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
JILDING: TYPE CONST. OCC. GRP.
P. Number Santa Rosa ctyL,
Legal Description
Project Description SPA
04866
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
aimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
$36.72
Plan Chk. Bal.
Const.
56.50
Mech.
20.00
Electrical
16 . 00
Plumbing
14.00
S.M.I.
•
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
fh)tiia2,, . 0 309 I7,^-7ah^,.41, __10
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 i Permit
Validated by:
Validation:
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT rp $
UNITS t
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. C
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING •
MOBILEHOME SVC.
BAR SINK
POR SO FT a
GAS (ROUGH)
METER LOOP
GAR SO. FT. of
POWER OUTLET,
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO FT. (a
GROUT
WATER HEATER
WALL SO. FT. al
FINAL INSP.
DRINKING FOUNTAIN
SO. FT. fd
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as ProPeNy tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTONDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
ISHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
LATHING
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID a IV, C
SEWAGE DISPOSAL
SO.FT.GAR @ 3.c
HOUSE SEWER
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 APP./EOUIP-
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
INSPECTOR'S SIGNATURESIINITIAlS
GARDEN WALL FINAL
P.O. BOX 1504 No: aJ
Building ??-173 Mazatlan78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA:92253
Owner . ...: I .... • .." _ __
.•_ , . .. ,. .:1 . --
La
.. La [,3aini4a Joint Venture ' I. BUILDING:'TYPE'CONST.'"` -OCC,---GRP.,
Mailing _
Address P. O. Sax 780 " A.P. Number Santa Rosa " Cove
-
City . Zip . Tel.
'aL to 92253 ..564-116315 .. Legal Descnption
Contractor. Project Description G-3 a 0 !-nta
=r a Construction '' '
.-
City Zip Tel. r
T> iintA 9 351 56 -6244
State Lia City
& Classi f.,.378318 Lic. # Sq.. Ft. No. No. Dw.
<.. .».. Size. - Stories.- Units ?
::.. Arch.,^Ehgr., ... _
•Designer_ New ❑ Add ❑ • Alter ❑ ' Repair ❑.. • Demolition ❑
..: ,.•
Address Tel.
..City ]Zip State
.: Lic.#..
It LICENSED CONTRACTOR'S DECLARATION ,✓ ;
herofI affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of bivision.3 of the Business and Professions Code, and my licens/e is:in full foicee-+and .
effect
.dg 'f',', ' - ' -„✓.f :s,Y' rl''r; . .. ..-:E ,'/,tfs'{r3 ..
SIGNATURE' l' :J' -.. .€0 DATE - ... .. .. ..
`
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following ,S1 1.994
y ”
reason: (Sec. 7031.S,Business and Professions Code:.Ang.'city. or• county -which requires' a I . - '
permit to construct, alter, improve; demolish, or repair any structure; prior to its. issuance -also - f AMOUNT
requires. the applicant for such permit to file a signed statement that he is licensed pursuant to _ .:PERMIT - • -
the provisions of the Contractor's License' Law; Chapter 9 (commencing with Section 7000f• of - - - .
Division'3:'ol the Business and Professioris Code, or that. h'e is exempt therelrom, and the basis'
for The alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit 'Plan,.Chk. Dep. - ..
"subjects the applicant to'a civil penalty of not more than live hundred dollars($500). ' ' - ' ` Plan Chk. BBI. rrp,C
❑ I; as owner of the property, or my employees with wages astheir sole compensation, will.
do the work, and the structure is not intended or offered for sale: (Seca 7044, Buisness'and COr1St.'
.. Professions Code: The Contractor's License Law does not; apply to an owner ofproperty - who •
03
builds or. improves Thereon and who does such work himself or through his own employees, Mech.' ST
t4
provided. that' such improvements .are not intended or. offered for sale.. If,._ however, the' building - . .i1 3 s 'O . .
,or improvement is sold within one year -of completion; the owner -builder will have the burden • 5 -
o/ proving that.he did not build or improve /or the purpose of sale.) Electrical 98
❑ I; as owner of the property, am exclusively contracting with.licensed contractors to con- •Plumbingm (,
- 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 S,M,I, 11.73
- - such projects with a contractors) licensed pursuant to the Contractor's License Law.) - -
D. I am exempt under Sec.. B.•& P.C. for this reason Grading _
Driveway Enc.
Date Owner Infrastructure 779
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
❑ Copy is filed with the city.. ❑ Certified copy is hereby furnished..
'aTOTA0 f, t]r
CERTIFICATE of EXEMPTION FROM REMARKS , <
" WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is /or one hundred dollars'($100) valuation - - -
.. or less.)... ._ .. .><i - .. .• -...: , ,_-, '? . .
I certify that in the performance of the work for which this permit is issued, I shall not -' '3•& X "I' .y 3 8 ' '
employ anyperson in any manner sous to -become subject to the Workers' Compensation - - ,, Yt+ i': . >ti ti•
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this, Certificate o/ Exemption' you should become , ZONE; ' 'BY: -
'subject to" the Workers' Compensation provisions .of the Labor code; you' must 'iorthwitn' .Minimum Setback Distances: '
comply with such provisions or this permit shall be deemed revoked. -- _ -
Front Setback from Center -Line
Rear. Setback •from.Rear Prop. Line
CONSTRUCTION, LENDING AGENCY - Side Street Setback from Center Line '
hereby affirm that there is a construction lending a
agency for the performance of the '
work for which this permit is issued. (Sec: 3097, Civil.Code.)
-Side Setback from Property: Line
Lender's Name
Lender's Address
This is a buildingpermit when properly filled out, signed and validated,. and is subject to - FINAL DATE INSPECTOR'
,. 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. -Issued b Date Permit
agree to' comply with all city' and county ordinances and state laws relating to building - y
construction, and hereby authorize representatives -of, this city toenter the -.above-.
mentioned property for inspection purposes. "Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, ZiP -
HARD COPY • - }, u
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. @ $
2ND FL. SQ. FT.
POR. SO. FT. @
GAR. SO. FT. @
CAR P. SQ. FT.
WALL SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
I 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.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
/
(ROUGH) _ 3
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
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
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/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.
/
(ROUGH) _ 3
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
AS (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
FINI GRADING
NAL INSPECTION72-3 -gj
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
+KJ ti !ygG5cP4 Cavq^'gat{ S,!.'>• d' .
"Attach documentation ft -r. efficien
PREPARED BY: cies and FIS;,
Joseph N. Cicchini, Civil Engineer, Inc.'
44267 Monterey Avenue, Suite B.
Palm Desert, California 92260 (619)-341-2273
AtLechment D
PREPARED FOR:
Glenn Bradley Enger,, A.I.A.
Form 2
(P.ev;sc:a
3/34?
73-960 E1 Paseo, Suite 5
'CI i-51 d t e Zones 2, 4, G', and
9-15
Palm Desert, California 92260
COMPLIANCE CHECKLIST TYPICAL GUESTHOUSE by LaQuinta Joint Venture
•
Fc.r Low-Rise Residential Buildings -
(except hotels and motels)
Step 1: Enter on the form the values for each treasure'from your building plan
and specifications sheet.
Step 2: Enter points on this page"while working through-the
point system
Bu.i•ldind Shell
Meesire
Points
Total-Floor Area34
3 ft2
1. Slab-on-Ground; Perimeterh ft., Deo i.n.
2.' Raised Floor R-Vaiue,
. , . R-
R_ N .
- Q
3: Ceiling Insulation or Construction Assembly
.
o
Attic, Percent of Roof Over Conditioned Space IUD A
343 ft-
_g_
4, Wall Insulation or Construction Assembly,
R- Iq
D
Glazing; Total % Floor Area Single Double
Triple
5. .forth-Facing., Z (P s . ft2f t 2
2
c: East -Facing 3.3 A ft2_ft2.
7. South
ftz
0
-Facing. 1,R.." ft5y, ft
8. 'West-Facing 2 2
ft2.
;.!_i ft2' ft.2
9. Skylight.
_. ft2.
p—p ft O" ft
ft
p
10. .Shading,Coefficient
(ex I'd' rhang)
\\".
a. East YEI2T14A l_lN?SJ 0.30 SC
...
-2
" . b_ South. V&PkT0 -" 64fNQ¢). 0,30 SC
=O
C. West (VB TC a. ,. QL.N05i . '0.3DSC.
-
S
d. North... D;bS SC
e. Skylight . . . . / H SC
O
11. Horizontal South Overhang Length.',. 2 ft"
. . ` .
•
D
O
- 12. Movable Insulation, q Floor urea. To
O
13. Infiltration (indicate Standard, Mee dium urlig;it)
NYlEprwm
-1
14, Thermal Mass
Exterior Wall Thermal Mass .
'Area; Heat Capacity; R-Value . . . , ,
ft2, HC, R-
Interior Thermal ilass
Area, Heat Capacity, R-Value IS/ ft ij,g hC, R-0,_3
'h 20
HVAC Svstema'
$ >C'!,3
34
15. Gas Furnace without' Refrigeration•Cool.ing3
(Seasonal Efficiency) . 1. . . . .
II& Sf.
O
16, Neat Pump (Energy Efficiency Ratio)
N A E ER'
0
11. Gas Furnace with Refrigeration Cooling,
Seasunal Efficiency and Seasonal
Energy Efficiency Ratio
SE 2$
t1 2
13. Active Solar (Net Solar" Fraction, ;)
_Sr"R
_F
19. Zonally Controlled Electric
— —
Resistance Space Heating , . ,
(Yes/No.
DomeStic Water Heatinq**
20. Shcar`With Gas Backup (,let Solar Fraction, '1 , , •
'Water
• 'NSF
0
21. Other Heating (Describe'type)
_
A 5
Point System Ccmoliance Total. . . .
. .
- 2
`Check.l tst lte;-.:;; not a. point syste^; measure.... ., .
"Attach documentation ft -r. efficien
PREPARED BY: cies and FIS;,
Joseph N. Cicchini, Civil Engineer, Inc.'
44267 Monterey Avenue, Suite B.
Palm Desert, California 92260 (619)-341-2273