AR (14-0637)P.O. BOX 1504
rr 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
14-00000637
Property Address:
8T700—NATIONAL DR
APN:.
767-600-002- - -
Application description:
ADDITION - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
35000
Tdy 4 4v Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING. PERMIT
--------------------------------------------------
UCENSED CONTRACTOR'S DECLARATION
I hereby affirm oder penalty of p rjur t a a licensed under provisions of Chapter 9 (commencing with
Section0001 f Division 3 of th B in ss n fessicnals Code, and my License is in full force and effect.
License lass• B C27 Li ansa No.: 684857
RL '000r
✓ Dater #_J 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 7000) 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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 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
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.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
Owner:
GARY POLLACK
461 ELEANOR DR.
WOODSIDE, CA 94062
(760)777-8202
Contractor:
EDWARDS CONSTRUCTION INC,
51455 DESERT CLUB DRIVE.
LA QUINTA, CA 92253
(760)77778202
Lic. No.: 684857
✓V�
BOB �vt
VOICE (760) 777-7012
FAX (766) 777-7011
,TIONS (760) 777-7153
Date: 6/24/14
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate 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 and policy number are:
Carrier BENCHMARK INS Policy Number CSTS003510
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any m, er s s t come subject to the workers' compensation laws of California,
LI
agree that, if sho come subject to the worker ' compensation provisions of Section
/ he La Cod , I hall fo with comply with h se provisions.
Date://Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($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 ermit, orce ation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that t e ove ' form ion i correct. I agree to c�yyJJ��ply with all
city and oun ordinances and state laws relating to b ild' g c structi , a hereby authorize relfresentatives
o this to nter pon the above-mentioned prop for spe on u es.
Date: I Signature (Applicant or Agent): ��
Application Number .
. . . . 14-000006.37
r.
Structure Information
Construction Type . .
. . . TYPE V, UNPROTECTED
Occupancy Type . .
. . DWELLG/LODGING/CONG <=10 "
Flood Zone .
. . . NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION
2013 / 2010 ENE
# BEDROOMS
.00
FLOOD ZONE
NO
--------------------------
1ST FLOOR SQUARE FOOTAGE
--------------------------------------------------
33.8.00
Permit . . .
ROOM ADDITION 2013
Additional desc .
Permit Fee . . . .
181.61 Plan Check Fee..
.00
Issue Date . . . .
Valuation
0
Expiration Date+.
12/21/14
Qty Unit Charge
Per
Extension
1.00 120.1200
LS MISC ROOM ADDN, 1ST 100 SF
120.12
1.00 61.4900
----------------------------------------------------------------------------
EA MISC ROOM ADDN, ADDL 500 SF
61.49
Permit . . .
ELECTRICAL 2013
Additional desc
Permit Fee . . . .
143.00 Plan Check Fee
.00
Issue Date . . . .
Valuation
0
Expiration Date
12/21/14
Qty Unit Charge
Per
Extension
1.00 143.0000
LS ELEC NEW RES, FIRST 1 KSF
143.00
t ----------------------------------------------------------------------------
Permit . . .
MECHANICAL 2013
Additional desc . .
Permit Fee . . . .
71.50 Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
12/21/14
Qty Unit Charge
Per
Extension
1.00 35.7500
EA MECH FURNACE
35.75
1.00 35.7500
----------------------------------------------------------------------------
EA MECH CONDENSER/COMP
35.75
Permit . . .
PLUMBING 2013
Additional desc . .
Permit Fee . . . .
23.84 Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . .
. 12/21/14
LQPERMIT
LQPERMIT
Application Number . . . . .
14-00000637
Permit . . . . . . PLUMBING
2013
Qty Unit Charge Per
Extension
1.00 11.9200 EA PLBG FIXTURE/TRAP
11.92
1.00 11.9200 EA PLBG WATER'INST/ALT/REP
11.92
Special Notes and Comments
338 SF SITTING ROOM ADDITION.'
TYPE, V -B
CONSTR. R-3 OCCUPANCY. 2013 /
2010
ENERGY CODES.
-------------------------------------------------------------------
Other Fees . . . . .
BLDG STDS ADMIN (SB1473)
-
2.00
HOURLY PLAN CHECK
70.00
PLAN CHECK, ELECTRICAL
47.19
PLAN CHECK, ROOM ADDITION
185.90
PLAN CHECK, MECHANICAL
47.66
PLAN CHECK, PLUMBING
23.84
STRONG MOTION (SMI) - RES
3.50
Fee summary Charged
Paid. Credited
Due
Permit Fee Total 419.95
.00 .00
419.95
Plan Check Total .00
.00 .00
1.00
Other Fee Total 380.09
.00 .00
380.09 -
Grand Total 800.04
.00 .00
800.04
01
n#
Permit #
Project Address:
A. P. Number: .76 7
Legal Description: ' Arlir
City of. La Quinta
Building Sr Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253- (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name:
0`�'�"�e�C) Z Address: 1—/00 QA77,vX &
` • Z�7gOo City ST Zi t 4 %e •(-r-A,.,
Contractor:�
Address:
City, ST, Zip:
Telephone: -77 % eJ 20 2
State Lie. # :
Designer:]
Address: --6 ZZ GCO
City, ST, Zip:(
Telephone•• -760 ZAY -742
P :.,:.:.::........:....
lt.
Telephone: 7 'zflZ I
El
Project Description:
Moc.._I
tti i:LF i•+f•'':'i �': i"ri:i «:y1y4 .v\#N:.Cn:::y
MIN
City Lie. #,
QQA.A
CA1 71 I
:<<y, :•rr> »:: K' ; :; Construction TYP Occupancy:
State Lie. #:..�.<>••�i:?�cr;.>;�t.::>;;ss..:.r:;:#::h::::.
:.>y s�:<:s,. y..:;:<:<srwsr:.>•ss Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq. Ft.:
3�8 # Stories: # Units:
Telephone # of Contact Person: —71 Q 2
Estimated value of Project: —
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Plan Sets
Req'd
Recd TRACKING
Plan Check submitted
PERMIT FEES
Item
Amount
Structural Caics.Reviewed,
ready for corrections
l
Plan Check Deposit
Truss Calcs.
alled Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up Je
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
Subeontactor List
Grant Deed
2°d Review, ready for correctio s/issue
Called Contact Person
Plans picked up
L 31
Electrical
6
Plumbing
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionsrissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.Y.P. ,
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
5/30
Coachella Valle Unified School District
Valley This Box For District Use Only '
83-733 Avenue 55, Thermal, :CA 92274 DEVELOPER FEES PAID
(760) 398-5909 — Fax. (760) 398-1224
AREA: ...
AMOUNT ... .
' LEVEL ONE AMOUNT:
LEVEL TWO AMOUNT:'
M ITIGATION AMOUNT:
COMMflND. AMOUNT:
DATE: '
. RECEIPT:
CHECK #:
IMTIALS
CERTIFICATE OF COMPLIANCE
:.:.: (California Education Code:1.7620) - .
Project Name: PGA West-Greg.Norman, Date: June 24,.2014
Owner's Name:: Gary. Pollack Phone No. 760-777-8202
Project'Address: 81-100 National Dr.; LaQuinta
Project Description: Sitting room addition to existing single family dwelling
APN:. . 767-600-002 Tract #: Lot #'s:
Type of Development:, Residential XX! Commercial Industrial:
Total Square Feet of Buildi ea:.. 338
Certification of Applicant/Owners: _The person signin certif s th' he a ormatiort is correc and makes this statement under
penalty of perjury and further represents that he/she.is. a thoriz d o sig o e f of the owner/deve er.:
Dated: June 24, 2014 -Signature:.
SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN:OR WILL BE SATISFIED IN
ACCORDANCE WITWONE OF THE FOLLOWING: (CIRCLE ONE)
Education Code : Gov. Code: •.- Project.- Agreement Existing Not Subject to Fee
17620 65995 Approval Prior*to 1/1/87 Requirement
. Note:
Number of Sq.Ft., 338 Pursuant to AB:181:any.room additions or enclosures of 500
sq. ft. or less are exempt from developer fees. Any mobile
Amount per Sq.Ft. $0.00 homes being.relocated within:the same school district's .
Amount Collected $0.00
jurisdiction are. exempt from developer fees..
Building PermitApplication Completed: Yes/No
By: Elsa F. Esqueda, Director. of Facilities and Maintenance
Certificate issued by: Laurie Howard, Secretary Signature:G_�f�t/hc
NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES
Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the
project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these
Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to
advise you that the 90 -day protest period in regard to such.Fees.oc the:validity thereof; commences with the payment of the fees or performance of any other
requirementsas described in section 66020'of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this
time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days.starts on the date hereof This Certificate of
Compliance is valid for thirty (30) days from the -date of;issuance. Extension will be granted only for good cause, as determined by the School District, and up
to three (3) such extensions may be granted.
MV:c/mydocs!devfees/certificate ofcompliance fonn updated 3-2007 .. 11/2010
PGA WEST®
FAIRWAYS ASSOCIATION
April l7, 2014
Gary Pollack
P.O. Box 620413
Woodside; CA 94062-0413
Re: Architectural Application — 81100 National Drive
Dear Gary Pollack:
At the Architectural Committee meeting held at 3:00pm, Monday, April 7, 2014, the Committee voted to
approve your Preliminary Plans (concept only) for the modification of your residence at 81100 National
Drive. Because of the scope of your project and the impact it will have on the surrounding areas, the
Committee also approved an independent architect, Robyn Ritchey of Stoney Creek Design Studio, to
review your Final ]Plans and provide the Board of Directors with a written opinion as to your desired
construction project.
As also voted by the Committee, you are responsible directly for the cost of the review of those Final
Plans by Ms. Ritchey. The proposal submitted by Ms. Ritchey indicates her rate is $195/hour and
estimates it should take 1'/z to 2 hours for review and additional time for a site visit. Plan on
approximately $500-600 in total costs.
Before you commence any construction Ms. Ritchey must review your Final Plans and provide the Board
with an opinion letter which the Board will review for recommendations, if any, by Ms. Ritchey. Final
Plans must also be delivered to the Architectural Committee for the file. Please be assured the Board will
act expeditiously to review the findings of Ms. Ritchey in the approval process.
If you have any questions, please contact Cassie Gertz at 760-776-5100 Ext. 6345 or email:
Cassie.Gertz(lManas ementtrust.com.
Sincerely,
For the Architectural Committee
PGA WEST Fairways Association
JeJ�McDald, CCAM, PCAM
Geager
cc: Lot File
Architectural Committee
Post Office Box 1690 • La Quinta, California 92247 • Phone (760) 776-5100 • Fax (760) 776-5111 • www.pgawestfairways.com
W.tsc
f.
[-Residential
rescri five Certificate of Compliance: CF -1R ADD
Additionste Address: a e 1 Of
Enforcement Agency: Date:
151-100 /v1R f iotJ4v n VC s - l2 - 2-0141
Opaque Surface Details For the furred portioned of Mass Walls see Furrin StriConstruction Table below.
A B C D E F G H I J
Proposed See ole Standard
Values From JA4 Table
Framing Thickness, Framed Continuous JA4 Proposed
Tap! Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly
ID or T and SizeZ or Other3 factor° Numbers R-value6 R -Value Cell Value' U-factor9
• at -0 ./o..•H. -10
9-COF Ptoo 6 womd 6" •OZ 812.1 8 S 3>;. - Ah OZ6
Note: For fivrrd assemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-1. For cdculatingfrored walls use the Mass and
F—or Construction table below. .
J. For Tag/JD indicate the identification name that matches the building plans
2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs Crawl Space, Doors and etc ..lndicate the Frame type and Size: For
Wood Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter, • 16 "or 24 "OC; or Other for al oem
)EIVE
such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc.... % C
4. Based on the Climate Zone; enter the Standard U factor from Table 151- C for each different assembly Name or type.
5. Enter the Table number that closely resembles the proposed assembly.
6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0' : JUN 0 9 2 014
1 7. Enter the Continuous Insulation R -value for the proposed assembly, otherwise, enter "0':
8. Enter the row and column of the U factor value based on Column FTable Number and enter the Assembly Ufactor in
9. The Proposed Assembly Ufactor, Column J, must be equal to or less than the Standard Ufactor in Column E to==
Registration Number.
2008 Residential Compliance Forms
Registration Datef lme: HERSProvider.
F LA QUINT
August 2009
J
Project Name
Climate Zone # # of Stories
PO LILA cid- 1?v 5+ 0eNC€ da,DD, i iavJ
t5
Building Type 1] Single Family [3 Multi Family . Circle the Front Orientation: N, E,W orDegrees
Conditioned Floor Area of Addition New Addition Size: 13 Less than or equal to 100 fe � Less than or equal to 1000
(CFA): 338 fe
(Do not use this formfor additions greater than 1000
NOTE: ForAlterations to an existing home, submit a completed CF -1R ALT Form
Exc tion: Ejastaw HVAC stems that are replacedor altered to serve the addition maybe included on the CF -IR ADD Farm
Prescriptive Envelope Re quirements for Additions
Option 1: Use Option lfor standard wood and assemblies meeting the Cavity R value only. For all other use Option 2.
• For 100}i2 additions, the Proposed values must be equal or greater than the Standard
column or when indicated when using package D,
'Pkg D ". Enter all values in the proposed Columns.
• For less than 1, 000 f? additions must comply with "Pkg D" requirements unless indicated in the Standard Column. To meet `Pkg D" minimum
liance
energy com re4 wirementy& see RCMA ndix B, Table I Sl -C. Or §151 in the RCM. Enter all values in the Pro osed Columns
Size of Addition 100 W or less Less than 1,000 fe
Component Standard Pro osed`: - Comment Standard"Pro Comment
............ .
Ceiling Insulation R 19 um Pkg D ::':.: 't Table 151-0
Wall Insulation— 3 :::: ;; : Minimum R -l3
- Minimum
Floor Insulatio 3 Minimum PkgD Table 151-0
BU1 & S U -Fill Fill out
Fen on a SHGC:_ Enter Proposed factor SHG :factor:::SHGC Fenesaation
40 ::.-.. values then 0.40 Pkg D ..:H p ':.. , :35.: _ Proposed Arras
:..: Skip Over .....:.... .... .. Below
Maximum Gl " g.To Roofing Package D (20% Fill out
7/ Product Additional
5
Area pq B Below of CFA) +Glass Allomved
:. Removed_.....
- Fenestration
Areas Below
L:Rjd:i�antBarrier N/A Pkg D -Table 151-0
Roofing Pkg D See Roofing Products Below
Pkg D
See Roofing Products Below
Opaque Surface Details For the furred portioned of Mass Walls see Furrin StriConstruction Table below.
A B C D E F G H I J
Proposed See ole Standard
Values From JA4 Table
Framing Thickness, Framed Continuous JA4 Proposed
Tap! Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly
ID or T and SizeZ or Other3 factor° Numbers R-value6 R -Value Cell Value' U-factor9
• at -0 ./o..•H. -10
9-COF Ptoo 6 womd 6" •OZ 812.1 8 S 3>;. - Ah OZ6
Note: For fivrrd assemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-1. For cdculatingfrored walls use the Mass and
F—or Construction table below. .
J. For Tag/JD indicate the identification name that matches the building plans
2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs Crawl Space, Doors and etc ..lndicate the Frame type and Size: For
Wood Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter, • 16 "or 24 "OC; or Other for al oem
)EIVE
such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc.... % C
4. Based on the Climate Zone; enter the Standard U factor from Table 151- C for each different assembly Name or type.
5. Enter the Table number that closely resembles the proposed assembly.
6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0' : JUN 0 9 2 014
1 7. Enter the Continuous Insulation R -value for the proposed assembly, otherwise, enter "0':
8. Enter the row and column of the U factor value based on Column FTable Number and enter the Assembly Ufactor in
9. The Proposed Assembly Ufactor, Column J, must be equal to or less than the Standard Ufactor in Column E to==
Registration Number.
2008 Residential Compliance Forms
Registration Datef lme: HERSProvider.
F LA QUINT
August 2009
J
01-10 0 1-%4 ompr l 1J r t.J r
unn ')InDs Construction Table for Mass Walls
A I B 1 r 1 n E
Proposed Properties of Masonry and Concrete
Walls From Reference
I G LH I I I i I
g
� s
r
ccri five Certificate of
Mass Name or JA4 Table
Residential Additions
ickness' __!Loe Number'
Site Address:
01-10 0 1-%4 ompr l 1J r t.J r
unn ')InDs Construction Table for Mass Walls
A I B 1 r 1 n E
Proposed Properties of Masonry and Concrete
Walls From Reference
CF -1R ADD
Paae 2 of 5)
EntorcementAgenW. Date:
.7- 2001
F
I G LH I I I i I
g
� s
Assembly
°4
Mass Name or JA4 Table
q
ickness' __!Loe Number'
¢ > 5
CF -1R ADD
Paae 2 of 5)
EntorcementAgenW. Date:
.7- 2001
F
I G LH I I I i I
g
Added Interior or Exterior Insolation
in Furring Space from Reference
Joint A endix Table 43.13
'
b
N
V
o c
Lo. o.� m
Z
�.caD� 0 •p ColXQ8 7m.
Final
Indicate the Mass 73riclmess from Reference Joint Appendix JA.
Indicate the Assembly Name or type: Roof/Ceilfng, Walls, Floors, Slabs, Crawl Space, Doors and etc -.Indicate the Frame type and Size: For
Wooed; Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies
Enter the Table number that closely resembles the proposed assembly.
Enter the row and column of the U factor value.
Enter the Effective R -value listed in the JA4 Table Number,
The Final Assembly is calculated by using Equation 4-1 or Equation 4-4 of the Reference Joint Appendix JA4. Enter the value in Column L
Insert the Final Assembly Ufactor value back on to the Opaque Surface Details table in Column J.
FENESTRATION PROPOSED AREAS
Orientation
Fenestration Type and Frame (North, East, PropsedAreal Maximum Maximum
(Window. Glass Door or S t NFRC or
Sou West (ft U -factor;; SHGC;1.4 Default Valu
r- tcN Doox Z'1 Yn .35
NPR.0
F f e rJ CH D00>` . v.t .yt. `I kv
35
NFRG
F` eJ i Z w 12- . qio .55 1.+FR.0
az J CH
1T-slu p.
Total 100. .'1
I. Fenestration area is the area of toW-.glazed product Cl. e. glass plus frame). Exception: When a door is less than SO% glass, -the-
area fenestration
may be the glass area plus.a "2 inch' around around the glass
2. Enter value from Component. Package D Requirements in Table I51 -C
3. Actual fenestration products installed and as indicated. in CF -6R E?W Form shall be equivalent to or have a lower U factor and/or a lower
SHGC value than that specified on the"CF-IR ADD' Far m.
4. Submit a completed WS -3R Form f a reduced SHGC is ;calculated with exterior shading.
S. I licable at this stage -enter `NFRC" for NFRC Ce . ' ed windows or CEC "Default " values found in Table 116-A or B.
Registration Number: Registration Date/Pume: HERSProvider.
2008 Residential Compliance Forms
August 2009
pf1 4Df"
Enforcement Agency:
CF_ D
PaLre 3 of 5)
Date:
T- 12 -2e1Y
ADDITION ALLOWED FENESTRATION AREAS
Checkapplicable box below if the roof addition is exempt from the roofing product "Cool Roof" requirements. Note: If any one of the boxes are
checked below, the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in §118(1) are not applicable. Do not fill
A
B
C
-
Prescri tive Certificate of
Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwise, check
F
:x.
Residential Additions
Allowed %
Site Address:
'te a
Remove&
Total Area
Allowed
pf1 4Df"
Enforcement Agency:
CF_ D
PaLre 3 of 5)
Date:
T- 12 -2e1Y
ADDITION ALLOWED FENESTRATION AREAS
Checkapplicable box below if the roof addition is exempt from the roofing product "Cool Roof" requirements. Note: If any one of the boxes are
checked below, the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in §118(1) are not applicable. Do not fill
A
B
C
D
E
Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwise, check
F
CRRC Product ID Number'
CFA of
Addition
Allowed %
o
Allowed Area
A
'te a
Remove&
Total Area
Allowed
Proposed Areas 4
SRI
ft
of CFA
x
O
C + D
T i
(Table Above)
Total Fenestration Area 3 $ .2t) l'67. & 113
iff > 1 /oU• 14
West Fenes6ation Area
—(Required In CZ's 2,4 & 7 -15 133OS 6 43
51.5 1> h 3
L West Fenestration Area includes west -sloping skylights and any skylights with a pitch less than 1:12.
❑
2. West facing glazing area removed cannot be "counted" twice. " In order to distribute the west glazing area
removed to the other orientations,
input the west glazing area removed in the Total Fenestration Area row, column D.
o4
3. Include the Proposed Area of the West facing fenestration in both Area columns below.
4. To meet compliance, the Proposed Area must be less than or equal to'the Total Allawed Area for BOTH the Total and West Fenestration Areas.
ROOFING PRODUCTS (COOL ROOFS) §]51(1)12
Checkapplicable box below if the roof addition is exempt from the roofing product "Cool Roof" requirements. Note: If any one of the boxes are
checked below, the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in §118(1) are not applicable. Do not fill
table below.
13 Roofing compliance Not Required in Climate Zones 1-12,14, and 16 with a Low Slope. Less or 2:12 pitch.
❑ Roofing compliance Not Required in Climate Zones 1 through 9 and 16 with a Low -Sloped. Roofs pitch greater than 2:12 and product weight
less than 5lb/ft
❑ Roofing area covered by building integrated, photovoltaic panels and solar thermal panels are exempt from the above Cool Roof criteria
❑ Roof constructions that have thermal mass over the roof membrane with at least, 25 lb/f is exempt from the above Cool Roof criteria.
Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwise, check
e applicable box below if Exempt from the Roofing Products "Cool Roof' Requirement-.
CRRC Product ID Number'
Roof Slope
< 2:12 > 2:12
Product Weight
< 51b/8> 51b/ftF
Product
TYve2
Aged
Reflectance
Solar
3.4
Thermal
Emittance
SRI
'
❑
O
T i
❑
❑
❑
❑
o4
❑
❑
❑
13
o4
❑
❑
❑
❑
❑4
1. The CRRC Product ID Number can be oblained from the Cool RooflRatmg Council's Rated Product Directory at mviv.coolrootsorr/productr/search oho
2. Indicate the type is being
ofproduct used for the roof top, i.e. single ply roof, asphalt roof, metal roof, etc,
1. Ifthe Aged Reflectance is not available in the Cool Roof Rating Council 's Rated Product Directory then use the Initial Reflectance value from the same
directory and use the equation (0.2+0.7(pjdfid– 0.1) to obtain a calculated aged value. Where p is the Initial Solar Reflectance.
Check box lithe Aged Reflectance Is a calculated value using the equation above.
Calculate the SRI value by using the SRI- Worksheet at htto:/Av,vsv-enerry ca. govltitle24/cad enter the resulting valve in the SR! Column above and attach acopy of
the SRI- Worksheet to the CF -IR.
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
commended by the coatings manufacturer and meet minimum performance requirements listed in § 118(1)4. Select the applicable coating-
oating❑
13Aluminum -Pigmented Asphalt Roof Coating 113
Cement -Based Roof Coating
113 Other
Registration Number Registration Date/time:
2008 Residential Compliance Forms
HERSProvider.
August 2009
U
L\
Prescriptive Certificate of Compliance:
Residential Additions
Site Address: Enforcement Agency:
HVAC SYSTEMS -
Duct or
Minimum Distri=bution Piping
Heating Equipmentveeand['anar;t„t•z7 Efficienc _ Insstlatiat
Nvgc heft MP 'I 0 +•1sQF7 oyc+ -e-D
1. Indicate Heating Type (Central Furnace, Wall Furnace, Heat pump, Boiler,
ectric resistance heating is allowed only in Co onent Package G. or exc
2 e e is heating is c oiled time- limiting dev"
3. Refer to the HERS Vericatlon section on Pages 3 and 4 of e - ADL
4. Indicate Tune or Location (Ducts, Hydronic in Floor. Radiators etc)
HVAC SYSTEMS - COOLING
Cooling Equipment Minimum istribution
Type and Capac;*- � T:fr;,.:o., , ®'m om,
r\\jAc K{ eo-tp o rnq' I. 1 � s c e D u c_.A- e,b
1. Indicate Cooling ype. (A/C, Heat pump, Evap. Cooling, etc).
? r tofS WNCtion section o.the CF -IR
__ hEaf
CF -1R ADD
(Page 4 of 5)
Date:
5- rX -2ory
Configuration
(Central, Split
'O'R-Value I `ype I �Hvdroi�iic)
spl,+ 7s+er
Electric Resistance, etc.)
ZZ-4.! electric heating is,suppl n.e., if total capacity
-4.! exceedm res 1 Sl (b)3
Form for additional requirements and check applicable boxes.
Form for additigjx� requirements and check
Configuration
(Central, Split
Pa�apkaee or
I
boxes.
WATER HEATING
List water heaters and boilers for both domestic hot water (DH*9 heaters and hydronic space heating. Individual dwelling D�I)Vheaters must be
gas or propane fnret4 and may not -exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground
hot water pipes is required in all com onent packages in all climate zones.
Water Heater Type/Fuel Distribution Type Number In Tank External Tank .
Energy Factor or Insulation
T e Standard, RecirculatiZ system Ca ac' (al) Thermal Efficien R Value3
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Prescriptive requirements do
not allow the installation of a recirculating water heating system for single dwelling units
3. The water heating tank and pipes shall be insulated to meet the reauiremente nt s t snr,
SPECIAL, FEATURES The enforcement agency should pay special attention to the Special Features
items may j special
1 specified in this checklist below. These
Y mquue writtenjustification and documentation and verification.
Radiant Barrier (Roof) 9 YES O NO
YES: Required in Climate Zones 2, 4, and 8-15 for additions larger than 100 ft .
Slab Edge (Perimeter) Insulation ❑YES 51 NO
YES: In Climate Zone 16 under Component Package D, R-7 insulation is required.
Heated Slab Insulation 13 YES 10 NO
YES: Slab edge insulation required for heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation 13 YES 1NO
YES: In Climate Zones 1, 2, 11, 13, 14 & 6 R-8 insulation is required, and in Climate Zones 12 & 15 R-4 insulation is required under
Component Package D.
Thermal Mass - To obtain Compliance Credit for the installation of thermal mass, use the Performance Approach.
Registration Number: Registration Dal&Time: HERSProvider.
2008 Residential Compliance Forms August 2009
Prescriptive CertlScate of
Residential Additions`.
CF --11R ADD
Site Address::;..- . °.::: Pa e 5 of
Enforcement Agencyt Date:
�1 �oG. N'tdNrftl �f;J
5_1Z-Z011f
Ir
ERS 'VERIFICATION SUMMARY - The enforcement agency should pay special attention to the HERS Measures specified in this
hecklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before final
it it
ction
uct Sealing & Testing HERS verification is required for this measure.
YES NO YES: In all Climate Zones, if a new space -conditioning system (HVAC equipment and ducting) is installed to serve
the addition. alone, the ducts are to be sealed and bested per §151(f)10.
❑ YES ANO YES: In Climate. Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned
space to serve the. addition, the ducts are to be sealed and tested per §152(b)1D.
,3 EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
❑ YES 19 NO YES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including replacement of the air handler, .
outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) and will serve the
addition, the ducts are to be sealed and tested per §152@)IE.
17 EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS
verification in accordance with procedures in the Reference Residential Appendix RA3.
❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space.
❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos.
Refrigerant Charge - Split System HERS verification is required for this measure.
❑ YES PINO YES: In Climate Zones 2 and 8-15, if a newly ducted split A/C or heat pump is installed to serve the addition alone, a
refrigerant charge measurement shall be verified per §151(f)7A.
❑ YES P NO YES: In Climate Zones 2 and 8-15, if the existing HVAC equipment is replaced (including replacement of the air handler,
outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) and will serve the
addition, a refri erant charge measurement shall be verified r 152 1F.
Central Fan Int ted Ventilation System — Airflow and Fan Watt Draw - do not apply for additions 1,000 for less.
Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow and Fan Watt Draw HERS verifications required
❑ YES UtNO YES: In Climate Zones 10 through 15, if anew space -conditioning system (HVAC equipment and ducting) is installed to
serve the addition alone, the airflow and fan watt draw shall be verified per § 151(f)7B.
` ❑ YES P1 NO YES: In Climate Zones 10 through 15, if the existing space -conditioning system (HVAC equipment and ducting) is replaced
and will serve the addition, the airflow and fan watt draw shall be verified per 152(b)1F.
Documentation Author's Declaration Statement
• I ceirtify that this Certificate of Compliance documentation inaccurate and complete.
Name:
-V Signature:
Company:-
o -fl b eezf -t t'4 1'e . Z'1 -X N C . Date: 5 - 17, - 240/y .
Address:
-7-7 - G o If Applicable 13 CEA or ® CEPE
a Wl t C'ht C: e. • (Ce1tification#)'-jZa6- 10 -193a
r t7Qtatn/7;,.-
ik1(M C Phone:
`Fall 7ro0 200 `l7?X)
Responsible Building Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance. '
• I certify that the energy features and performance specifications for the building design identified on4his Certificate of Compliance conform
to the requirements of Title 24, Parts.I and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the informatior ro ' ed to document this
building design on the other applicable compliance forms, worksheets,. calculations, pl ecifica ' met to the enforcement
agency for approval with this buildino nermit nnnliro#;n..
Name: p Sign
R-0 o g c t- •� ►� c-rtfocD
Company:
(2-0 Fi CC k A , i���o 1 C5i 1.1 l { , •�•� N 'Date:5
Address: :
77 " raW2 CO c' -Jr. License:
City/State/Zip: Phone:
A1t"n �� G� 01-2,- 7-11 7�0 - 3Nro - �bS(o
For assistance or questions regarding the Energy Stmidards,;contact the Energy FRodine at. 1-800-772-3300.
Registration Number. Registration Dame:
2008 Residential Compliance Forms
HERS Provider.
August 2009
Mandatory Measures Summa MF 1R
Residential
(Page 3 of 3
Site Address: Enforcement Agency: Date:
pt
EXCEPTION 1: Permanently installed low effieppy:luminaires shall be allowed provided that they ate controlled by a manual -on
occupant sensor certified to comply with the applicable requirements of § 119.
EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a
manual -on occupant sensor.
§150(k)ll: Permanently installed luminaires located in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms, closets, and utility
rooms shall be high efficacy luimnaires.
EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided they are controlled by either a dimmer switch
that complies with the applicable requirements of § 119, or by a manual -on occupant sensor that complies with the
applicable requirements of §119.
EXCEPTION 2: Lighting in detached storage building less than 1000 square feet located on a residential site is not required to comply
with § 150 k 11.
§150(k)12: Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or
other nationally recognized testing/rating laboratory; and have a label that certifies the lumiunaire is airtight with air leakage less then
2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; and be sealed with a gasket or caulk between the luminaire housing
and ceiling.
§ 150(k)13: Luminaires providing outdoor lighting, including lighting for private patios in low-rise residential buildings with four or more dwelling
units, entrances, balconies, and porches, which are permanently mounted to a residential building or to other buildings on the same lot
shall be high efficacy.
EXCEPTION 1: Permanently installed outdoor low efficacy luminaires shall be allowed provided that they are controlled by a manual
on/off switch, a motion sensor not having an override or bypass switch that disables the motion sensor, and one of the
following controls: a photocontrol not having an override or bypass switch that disables the photocontrol; OR an
astronomical time clock not having an override or bypass switch that disables the astronomical time clock; OR an
energy management control system (FMCS) not having an override or bypass switch that allows the luminaire to be
always on
EXCEPTION 2: Outdoor luminaires used to comply with Exception) to §150(k)13 may be controlled by a temporary override switch
which bypasses the motion sensing fimction provided that the motion sensor is automatically reactivated within six
hours.
EXCEPTION 3: Permanently installed luminaires in or around swimming pool, water features, or other location subject to Article 680 of
the California Electric Code need not be hi effica luminaires.
§150(k)14: Internally illuminated address signs shall comply with Section 148; OR not contain a screw -base socket, and consume no more than five
watts of Power as determined according to §130(d).
§ 150(k)15: Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable requirements in
Sections 130, 132, 134, and 147. Lighting for parking garages for 8 or more vehicles shall comply with the applicable requirements of
Sections 130 131, 134, and 146
FI 5-0(k) 16: 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.
EXCEPTION: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by an occupant sensor(s)
certified to comply with the applicable requirements of $119.
1008 Residential Compliance Forms
August 2009
Mandatory Measures Summa MF -1R
Residential (Page 2 of 3
Site Address: Ji Enforcement Agency: Date:
6(- (c -o N�-k00j Pr' f.V� ... s �rz —7.001
§ 1506)4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation.
Ducts and Fans Measures:
§I50(m)1: All air -distribution system ducts and plenums installed, are sealed and insulated to meet the requirements of CMC Sections 601, 602,
603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum 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 ater than 1/4 inch, the combination of mastic and either mesh or tape shall be used
§ 150(m)l: 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.
Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts.
§ 150(m)2D: 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.
§ I50(m)7: Exhaust fan systems have back draft or automatic dampers.
§150(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers.
§ I50(m)9: 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
§ 150(m)10: Flexible ducts cannot have porous inner cores.
§150(0): All dwelling units shall meet the requirements of ANSVASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air Quality in
Low -Rise Residential Buildings. Window operation is not a permissible method of providing the Whole Building Ventilation required in
Section 4 of that Standard.
Pool and Spa Heating stems and Equipment Measures:
§ 114(a): Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency Regulations;
an on-off switch mounted outside of the heater, a permanent weatherproof plate or card with operating instructions; and shall not use
electric resistance heating ora pilot light.
§1 14(b)l: Any pool or spa heating equipment shall be installed with at least 36" of pipe between filter and heater, or dedicated suction and return
lines, or buift-up connections for future solar heating
§ 114(b)2: Outdoor pools or spas that have a heat pump or gas heater shall have a cover.
§ 114(b)3: Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or
programmed to run only during off-peak electric demand periods.
§150(p): Residential pool systems or equipment meet the pump sizing, flow rate, piping, filters, and valve requirements of §150(p).
Residential Lighting Measures:
§150(k)l: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies contained in
Table 150-C and is not a low efficacy luminaire as specified by §150(k)2.
§ 150(k)3: The wattage of permanently installed luminaires shall be determined as specified by §130(d).
§150M4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than 20 kHz
§150(k)5: Permanently installed night tights and night lights integral to a permanently installed luminaire or exhaust fan shall contain only high
efficacy lamps meeting the minimum efficacies contained in Table 150-0 and shall not contain a line -voltage socket or line -voltage
lamp holder, OR shall be rated to consume no more than five watts of power as determined by § 130(d), and shall notcontain a medium
screw -base socket.
§150(k)6: Lighting integral to exhaust fans, in rooms other than kitchens, shall meet the applicable requirements of §150(k).
§150(k)7: All switching devices and controls shall meet therequirements of §150(k)7.
§150(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy.
EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 ftZ or 100 watts for dwelling units larger than 2,500 ft may be exempt
from the 50% high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant
sensor, dimmer, energy management system (FMCS), or a multi -scene programmable control system; and all permanently installed
luminaries in garages, laundry rooms, closets greater than 70 square feet, and utility rooms are high efficacy and controlled by a
manual -on occupant sensor.
§150(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated
cabinet
§150(k)10: Permanently installed luminaires in bathrooms, attached and detached garages, laundry rooms, closets and utility rooms shall be high
efficacy.
2008 Residential Compliance Forms August 2009
4
a�
Measures Summary
Site Address: Enforcement Agency:
61- (oo rJ �A+��r,�� c i J
d e
MF -1R
_ (Page 1 of 3'
Date:
S' ( -a I *X-eldl
NOTE. Low-rise residential buildings subject to the. Standards must comply with all applicable mandatory measures listed
regardless of the compliance approach used More stringent energy measures listed on the Certificate of Compliance (CF -Illy
CF -IR -ADD, or CF -I R ALT Form) shall supersede the items mw*gd with an asterisk M below. This Mandatory Measures
Summary shall be incorporated into the permit documents and the. applicable features shall be considered by all parties as minimum
component performance specifications whether they are shown elsewhere in the documents or in this summary. Submit all
applicable sections of the MF -IR Form with plans.
DESCRIPTION
§ 116(a)1: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage
§ 116(a)4Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat
(SHGC) and infiltration that meets the reauiremenk nf R r n_1 r r r -N
§ 117: Exterior doors and windows are weather-stripped; all joints and penetrations are caulked and sealed
§118(a): Insulation specified or installed meets Standards for Insulating Material. Indicate type and include on CF -6R Form.
§ 118(i): The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of § 118(1) when the installation of
a Cool Roof is specified on the CF -1R Form.
*§150(a): Minimum R-19 insulation in wood -frame ceiling or equivalent U -factor.
§ 150(b): Loose fill insulation shall conform with manufacturer's installed design labeled R -Value.
*§150(c): Minimum R-13 insulation in wood-fiame wall or equivalent U -factor.
*§150(d): Minimum R-13 insulation in raised wood -frame floor or equivalent U -factor.
§150(f): Air retarding wrap is tested, labeled, and installed according to ASTM E1677-95(2000) when specified on the CF -1R Form.
§150(g): Mandatory Vapor barrier installed in Climate Zones 14 or 16.
§ 150(1): Water absorption rate for slab edge insulation material alone without facings is no greater than 0.35/6; water vapor permeance rate is no
greater than 2.0 permlinch and shall be -protected from physical damage and UV light deterioration.
Fireplaces, Decorative Gas Appliances and Gas Log Measures:
§ 150(e)IA: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox.
§150(e)IB: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is equipped
with a with a readily accessible, operable, and tiRlit-fitting damper and or a combustion -air control device.
§150(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is
huildino arc nmh;hito.i vented to the outside of the
Water Heating and
§110-§113: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified by the Energy Commission.
§ 113(c)5: Water heating recirculation loops serving multiple dwelling units and High -Rise residential occupancies meet the air release valve,
backflow prevention, pump isolation valve, and recirculation loop connection requirements of §I 13(c)5
§ 115 Continuously burning pilot lights are prohibited for natural gas. fan -type central furnaces, household cooking appliances (appliances with an
electrical suppl voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool and spa heaters
§ 150(h). Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA.
§150(i): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c).
§1500)IA- Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally
insulation having an installed thermal resistance of R-12 or greater Wrapped with
-j-1500) 1 B Unfired storage tanks, such as storage tanks or backup tanks for solar water -heating system, or other indirect hot water tanks have R-12
external insulation or R-16 irate insulation where the internal insulation R -value is indicated on the exterior of the tank.
T§ 1500A First 5 feet of hot and cold water pes closest to water heater tank, non -recirculating systems, and entire len
of hot water pipes are insulated a Standards Table • 150-B. length of recirculating sections
§ 150G)2: Cooling system piping (suction, c ed water, or brine lines),and piping insulated between heating source and indirect hot water tank
shall be insulated to Table 150-B d Equation 150-A.
§ 1506)2: Pipe insulation for steam hydropic I eating systems or hot water systems >15 psi, meets the requirements of Standards Table 123-A.
§1500)3A: Insulation is protected from dam e, including that due to sunlight, moisture, equipment maintenance, and wind
§ 150G)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in conditioned space.
2008 Residential Compliance Forms August 2009