05-3877 (AR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address: .
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
05-00003877
51955 AVENIDA RUBrO
773-161-022-11 -000000-
ADDITION - RESIDENTIAL
COVE RESIDENTIAL
7723
T-d4t
4'0"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
Owner:
EVENEL MERVILUS
51955 AVENIDA RUBIO
LA QUTNTA, CA 92253
JAN 0 4 20Eentrali o)I
GK C$NS<ING GROUP INC
CITY OF LA QJUl*+AO BOX 1101.4
NANCE L)F3?LA QUINTA, CA 92247
(760)322-2522
Lic. No.: 816725
VOICE (760) 777-7012
FAX (760) 777-701.1
INSPECTIONS (760) 771-7153
Date: 1/04/06
-'---------------------------------------=--------
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 Prof sionals 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: 13 License No.: 816725
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
e
issued.
Date:. it-` Q Contractor.
_ 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
OWNER -BUILD D LARATWN
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that m exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number .1828069-2005
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 the workers' 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 sub' to the workers' compensation pr isions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
37DO of the Labor Code, sha n it comply with those provi '
that he or she is exempt therefrom and the basis for the alleged exemption.. Any violation of Section 7031.5 by
�.� 4-40L._
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
Date- Applicant:
( 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 ORKERS' MPENSATION C AGE 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 ($100,000). 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, 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 or improves thereon, and who contracts for the projects with a contractorls) 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,
(_) 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
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 (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
of La Qumta, 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 constructio and hereby authorize representatives
of this ou ty to enter upon the above-mentioned propertr6rec rposes.
Application Number 05-00003877
Permit BUILDING PERMIT
Additional desc .
Permit Fee 99.00 Plan Check
Fee
64.35
Issue Date Valuation
. .
7723
Expiration Date 5/22/06
- Qty Unit Charge Per
Extension
BASE FEE
45.00
6.00 9.0000 THOU BLDG 2,001-25,000
54.00
Permit ." ELECT - ADD/ALT/.REM
Additional desc'.
Permit Fee . . . 19.73 Plan Check
-Fee..
4.93
Issue Date Valuation
0
Expiration Date 5/22/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
135.00 .0350 ELEC•NEW RES - 1 OR 2
FAMILY
4.•73
Permit . . . MECHANICAL
Additional desc .
Permit Fee 24.00 Plan Check
Fee,'.
6.00
Issue Date . . . Valuation
. . . .
0
Expiration Date 5/22/06
Qty Unit Charge .Per
Extension .
BASE FEE
15.00
1.00 9.0000 EA MECH APPL REP/ALT/ADD
----------------------------------------------------------------------------
9.00
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 21.00 Plan Check
Fee
5.25
Issue Date . . . . Valuation
. . . .
0
Expiration Date 5/22/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 6.0000 EA PLB ROOF DRAIN
6.00
------------------------------------------------ ---------------------------
Special Notes and Comments
135 SQ. FT. ADDITION TO HOME SITTING
ROOM .November 23, 2005 11:40:11 AM
JJOHNSON .
LQPERMIT
Application Number
. .
05-00003877
- ----------------------------------------------------------------------------
Other Fees . . .
. . . . . .
ENERGY REVIEW
FEE
6.44
STRONG MOTION
(SMI) - RES
.77
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
163.73
.00
.00
163.73
Plan Check Total
80.53
.00
.00
80.53
Other Fee Total
7.21
.00
.00
7.21
Grand Total
251.47
.00
.00
251.47
LQPERMIT
N
'
Bin #`
City of La Quinta
` Building 8L Safety Division .
Permit #e - —= P -O. Box 1504; 78-495 Calle Tampico
��. 0 La Quinta, CA 92253 - (760) 777-7012
Building Permit APPlication and Tracking Sheet
Project Address: S _ SS_ (/:!�. K* 00/6 Owner's Name: Y
E.vEc
A. P. Number: 773— //O —• 2 -� Address:
V6.
Legal
Legal Description: City. ST, Zip: X L 01vIN74 C
Contractor: X G
t� Telephone:
22t�3,
Address:
Project Description: X
City. ST, Zip: K
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v
•
TeleP hone. x
E
Xs �v G
r1/2
.
61V
State Lic. # : k
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
construction
' T Y P e:,
Oc cuPc
an y.
to
S to"
Ltc. #•
Project type (circle rc
l
e one): Ne%%• Add'n Alter Repair
Demo
Name of Contact Person:
/3, . # Stories: # Units:
Telephone # of Contact Person: y.
760- 576V— 9240 Estimated Value of Project: x AQ a O
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd
Recd TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted V6 Item
Structural Calcs.
Reviewed, read or corrections
ps Plan Check Deposit
Amount
Truss Calcs.
Title 24 Calcs.
Called Contact on
17 /z Plan Check Balance
Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading plan
2.ar
Review, ready for correctio s/issue (l Electrical
Subcontactor List
Called Contact Person i �1 Plumbing
f
Grant Deed
Plans picked up r✓
S.111,1.
H.O.A. Approval
Plans resubmitted • 7 Grading
IN HOUSE:-
'"' Review, ready for corrections/issu -� Developer Impact Fee
Planning Approval
Called Contact Person AJ.P.P.
Pub. Wks. Appr
Date.of permit issue
School Fees
f
Total Permit Fees
fi
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
Date 1/4/06 La Quinta, CA 92253
No. 28001 (760) 771-8515
Owner Evenel Mervilus
Address 51955 Avenida Rubio
City La Quinta Zip 92253
�
ocC ?moo
BERMUDA DUNES r
rr RANCHO MIRAGE
INDIAN WELLS
d PALM DESERT
t� LA QUINTA
ZfI.I.INDIO
APN # 773-161-022
Jurisdiction La Quinta
Permit #
Tract # Study Area
Type Residential Addition No. of Units 1
Lot # No. Street S.F.
Unit 1 51955 Avenida Rubio 135 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
Lot # No. Street S.F.
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiosMralkways, resideritial additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooldng, 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:
Residential Addition 500 Sq Feet or Less N
JA
EXEMPT %.
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $0.00 X 135 S.F. or $0.00 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 Exempt - Joe Gary Check No.
Name on the check Telephone 219.4830
Funding Exempt
By Dr. Doris Wilson
Superintendent ;-
Fee collected /exempte by a n McGilvr 1 Payment Recd I0.0� 0 j
aver/Under:. . ft
Signature C Ttotifyy
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will sthat 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
. 4.
TITLE 24 REPORT
Title 24 Report for:
Evenel Mervilus
51=955 Avenida Rubio
La Quinta, CA 92253
Report Prepared By:
Stephen R. Nieto
South West Concepts
78-120 Calle Estado, Ste# 206
La Quinta, CA 92253
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Date:
10/18/2005
0
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 5) ' CF -1R
Project Title
PROPOSED ADDITION & REMODEL FOR EVENIL MERVILUS
Date
10/18/2005
Building Permit #
Project Address
51-955 AVENIDA RUBIO
Joint
Appendix
IV
Reference
Plan Check / Date
Documentation Author
SOUTH WEST CONCEPTS
Telephone
(760)'564-4707
Field Check / Date
Compliance Method (Prescriptive)
PACKAGE D
Climate Zone
15
Enforcement Agency Use Only
® Alternative Component Package Method: (check one) C D y D (Alternative)
• Package C and Package D choices.require HERS rater field verification and/or diagnostic testing (see CF -1R page 3)
For Package D Alternative see Appendix B Table 151-C Footnotes 7-14
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) 1,637 ft z
Average Ceiling Height: 10'-0" ft
Maximum Allowed West Facing Fenestration Products Per Table 151-B or 1517C ---- (5% X.CFA) 81.8 ft'
Maximum Allowed Total Fenestration Products Per Table 151-B or 151-C ----(20% X CFA) 327.4"ft 2
d ❑ Building Type: (check one or more)/ Single Family Mulrifamily__y/ Addition Alteration
(If adding fenestration fill out WS -4R, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 8.3.3 for Alterations.)
Number of Stories: 1 Number of Dwelling Units: 1
Floor Construction Type:—(Sia /Raised Floor (circle one or both)
Front Orientation: 270° North / South / East Wes / All Orientations (input front orientation in degrees from True North
and circle one).
•/ ® RADIANT BARRIER (required in climate zones
OPAQUE SURFACES INCLUDING OPAQUE DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge,
Doors)
Frame
Type
(Wood or
Metal)
Cavity
Insulation
R -Value
Continuous
Insulation
R -Value
Assembly U-
factor (for wood,
metal frame and
mass
assemblies
Joint
Appendix
IV
Reference
Roof Radiant
Barrier
Installed
Yes or No
Location
Comments
(attic, garage,
typical, etc.
Wall
2X4 WOOD
N/A
LIVING ZONE
Wall
Roof
2X4 WOOD
R-38
NONE
0.025
IVA
YES
LIVING ZONE
Roof
Floor
Floor
aEdge
1) See Joint Appendix IV in Section IV.2, IV.3 and IVA, which is the basis for the U -factor criterion. U -factors can not exceed
prescriptive value to show equivalence to R -values.
Residential Compliance Forms April 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 2 of 5) CF -1R
Project Title
Date
PROPOSED ADDITION & REMODEL FOR EVENIL MERVILUS
10/18/2005
FENESTRATION PRODUCTS - U -FACTOR AND SHGC
•0' ❑ FENESTRATION MAXIMUM ALLOWED AREA WORKSHEET WS -4R - must be included for New
Construction, Additions and Alterations.
Fenestration
#/Type/Pos. Orien-
(Front, Left, tation,
Rear, Right, N, S, E,
Skylight). W'
Area
ft2
U-factor2
U -factor
Source'
SHGC°
Exterior
Shading/Overhangss''
SHGC ✓box if WS -3R is'
Sources included
Front Doors W
40 SUT.
0.55
116-A
0.67
116-B El
Transom W
12 SUT.
0.55
116-A
0.67
116-B ❑
1) Skylights are now included in West -facing fenestration area if the skylights are tilted to the west or titled in any
direction when the pitch is less than 1:12. See § 151(03C and in Section 3.2.3 of the Residential Manual
2) Enter values in this column are either. NFRC Rated value or from Standards default Table 116A.
3) Indicate source either from NFRC or Table 116A
4) Enter values in. this column from NFRC or from Standards Default Table 116B or adjusted SHGC from WS -3R
5) Indicate source either from NFRC or Table 116B.
6) Shading Devices are defined in Table 3-3 in the Residential Manual and see WS -3R to calculate Exterior Shading
devices.
7) See Section 3.2.4 in the Residential Manual.
HVAC SYSTEMS
Heating Equipment Minimum
Type and Capacity Efficiency
famace heat pump,boiler, etc. AFUE or HSPF
Distribution
Type and Location
ducts attic etc.
Duct or Piping
R -Value
Thermostat Configuration
Type lit or acka e
CARRIER 38BRC06034/35 80% AFUE
DUCTS
R-13
SETBACK SPLIT
SETBACK
SPLIT
Cooling Equipment
Type and Capacity
(A/C, heat pump, evap.
cooling)
Minimum
Efficiency Duct Location
(SEER or EER attic etc.
Duct
R -Value
Thermostat
Type
Configuration
(split or package)
CARRIER 38BRC06034/
5 12 SEER DUCTS
R-13
SETBACK
SPLIT
Residential Compliance Forms April 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 5) CF -1R
Project Title
Date
PROPOSED ADDITION & REMODEL FOR EVENIL MERVILUS
10/18/2005
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF4R Form must be provided to the building department for each home for which the following. are
re uired.
❑
Sealed Ducts all climate zones Installer testing and certification and HERS rater field verification required.)
❑
TXVs, readily accessible (climate zones 2 and 8-15 only)
Tank
Capacity
(gaeons
Installer t sting and certification and HERS Rater field verification required.)
❑
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
AO SMITH PGCG-50-226
verification required.)
OR
Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
❑ sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WATER HEATING SYSTEMS
Systems serving single dwelling units
Water Heater
Type/Fuel Type
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
®
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Tank
Capacity
(gaeons
not allowed.
❑
Check box when using Preapproved Alternative Water Heating table, Table 54 in Chapter 5 in the Residential
AO SMITH PGCG-50-226
Manual. No water heating calculations are required, and the system complies automatically.
ONE
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
❑
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
❑
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
Systems serving single dwelling units
Water Heater
Type/Fuel Type
Distribution
Type
Number
in System
Rated
Input'
(kW or
BW/hr)
Tank
Capacity
(gaeons
Energy
Factor' or
Thermal
Efficiency
Standby'
Loss %
Tank
External
Insulation
R -Value
AO SMITH PGCG-50-226
ONE
50 GAL.
0.62 AFUE
System serving multi le dwelling units
Water Heater
Type
Distribution
Type
Number
in System
Rated
Input'
(kw or
Btu/hr)
Tank
Capacity
(gallons)
Energy
Factor' or
Thermal
Efficiency
Standby'
Loss %
Tank
External
Insulation
R -Value
N/A`
1) For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and
heat pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
Pipe Insulation (kitchen lines > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures
that are 1/4 inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2
B.
Residential Compliance Forms April 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL
(Page 4 of 5) CF -1R
Project Title
Date
10/18/2005
PROPOSED ADDITION & REMODEL FOR EVENIL MERVILLIS
SPECIAL FEATURES NOT REQUIRING HERS VERIFICATION (add extra sheets if necessary)
Indicate which special features are part of this project. The list below only represents special features relevant to the
prescriptive method.
,or
Feature
Required Forms if applicable)
Description
❑
Metal Framed Walls
CF -1R
CF -6R part 6 of 12
®
Radiant Barriers
CF -1R
❑
Exterior Shades
WS -4R
❑
Cool Roof
N/A; Attach CRRC Label to
Forms
❑
Dedicated Hydronic Heating
Performance Calculation
System
Required; Attach Run to Forms.
❑
Combined Hydronic System
Performance Calculation
Required; Attach Run to Forms.
❑
Gas Cooling
Performance Calculation
Required.
❑
Buried Ducts
N/A; Indicate on building plans.
❑
Kitchen Pipe Insulation
See Section 5.6.2 Distribution
Systems in Residential Manual.
Multiple Water Heaters Per
See Table 5-13 or use
❑
Performance Calculation and
Dwelling Unit
attach Run to Forms.
❑
Central Water Heating System
Performance Calculation and
Serving Multiple Dwellings
attach Run to Forms.
❑
Non-NAECA Large Water
CF -1R
Heater
See Table 5-13 or use
❑
Indirect Water Heater
Performance Calculation and
attach Run to Forms.
See Table 5-13 or use
❑
Instantaneous Gas Water Heater
Performance Calculation and
attach Run to Forms.
See Table 5-13 or use
❑
Solar Water Heating System
Performance Calculation and
attach Run to Forms.
❑
Wood Stove Boiler
Performance Calculation and
attach Run to Forms.
SPECIAL FEATURES REQUIRING HERS RATER VERIFICATION
(add extra sheets if necessarv) Indicate to the HERS Rater which credits are part of this vroiect and need verification.
./ . Feature
Required Forms if applicable) Description
❑ Duct Sealing
CF -6R art 4 of 12
❑ Refrigerant Charge,
CF -6R part 5 of 12
❑ Thermostatic Expansion Valve
CF -6R part 6 of 12
Residential Compliance Forms April 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 5 of 5). CF -1R
Project Title
PROPOSED ADDITION & REMODEL FOR EVENIL MERVILUS
Date
10/18/2005
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.
Designer or Owner (per Business and Professions Code) Documentation Author
Name:
STEPHEN R. NIETO
Name:
STEPHEN R. NIETO
Title/Firm:
SOUTH WEST CONCEPTS
Title/Firm:
SOUTH WEST CONCEPTS
Address:
78-120 CALLE ESTADO SUITE 206
Address:
78-120 CALLE ESTADO SUITE 206
LA QUINTA CA, 92253
LA QUINTA CA, 92253
Telephone:
(760)564-4707
Telephone:
(760)564-4707
License #: 4GC#
523837
1042
(signa
(date)
(signa re)
(at )
Enforcement Agency
Name:
Title
Agency:
Telephone:
Comments:
Residential Compliance Forms April 2005
MANDATORY MEASURES SUMMARY: RESIDENTIAL (Page 1 of,2) MF -1R
Project Title
PROPOSED ADDITION & REMODEL FOR EVENIL MERVILUS
Date
1 10/18/2005
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 supersede the items marked with an asterisk (*) below.
When this checklist is incorporated into the permit documents, the fratures 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 NA if not applicable.
DESCRIPTION
NA
Designer
Enforce -
ment
Building Envelope Measures:
* §150(a): Minimum R-19 in wood frame ceiling insulation or equivalent U -factor in metal frame ceiling.
❑
[r
❑
§ 150(b): Loose fill insulation manufacturer's labeled R -Value:
[r
❑
❑
* § 150(c): Minimum R-13 wall insulation in wood framed walls or equivalent U -factor in metal frame walls (does not apply
exterior mass walls)L70
❑
r�
Elto
* § 150(d): Minimum R-13 raised floor insulation in framed floors or equivalent U -factor.
(]�
❑
❑
§ 150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs.
1. Masonry and factory -built fireplaces have:
a. closeable metal or glass door covering the entire opening of the firebox
gr
❑
❑
b. outside air intake with damper and control, flue damper and control
Gir
❑
❑
2. No continuous burning gas pilot lights allowed.
Rr
❑
❑
§ 150(0: Air retarding wrap installed to comply with § 151 meets requirements specified in the ACM Residential Manual.
❑
Eir
❑
§ 150(g): Vapor barriers mandatory in Climate Zones 14 and 16 only.
Gir
❑
❑
§ 150(1) : Slab edge insulation - water absorption rate for the insulation material alone without facings no greater than
0.3% water vapor performance rate no greater than 2.0perm/inch.
&r
❑
❑
§ 118: Insulation specified or installed meets insulation installation quality standards. Indicate type and include CF -6R
Form:
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§ 116-17: Fenestration Products, Exterior Doors, and Infiltration/Exfiltration Controls.
1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage.
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2. Fenestration products (except field -fabricated) have label with certified U -factor, certifies Solar Heat Gain
Coefficient SHGC and infiltration certification.
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3. Exterior doors and windows weather-stripped; all joints and penetrations caulked and sealed.
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Space Conditioning, Water Heating and Plumbing System Measures:
§ 110-§ 113: HVAC equipment, water heaters, showerheads and faucets certified by the Energy Commission.
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§ 150(h): Heating and/or cooling loads calculated in accordance with ASHRAE. SMACNA or ACCA.
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§ 150(i): Setback thermostat on all applicable heating and/or cooling systems.
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§ 1500): Water system pipe and tank insulation and cooling systems like insulation.
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1. Storage gas water heaters rated with an Energy Factor less than 0.58 must be externally wrapped with insulation
having an installed thermal resistance of R-12 or greater.
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2. Back-up tanks for solar system, unfired storage tanks, or other indirect hot water tanks have R-12 external insulation or
R-16 internal insulation and indicated on the exterior of the tank showing the R -value.
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3. The following piping is insulated according to Table 150-A/B 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 length
of recirculating sections of hot water pipes shall be insulated to Table 150B.
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2. Cooling System piping (suction, chilled water, or brine lines), piping insulated between heating source and
indirect hot water tank shall be insulated to Table 150-B and Equation 150-A.
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4. Steam hydronic heating systems or hot water systems > 15 psi, meet requirements of Table 123-A.
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7071
Residential Compliance Forms April 2005
C
MANDATORY MEASURES SUMMARY: RESIDENTIAL (Page 2 of 2) MF -1R
Space Conditioning, Water Heating and Plumbing System Measures: (continued)Enforce-
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5. Insulation must be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind.
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6. Insulation for chilled water piping and refrigerant suction piping includes a vapor retardant or is enclosed entirely in
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conditioned space.
7. Solar water -heating systems/collectors are certified by the Solar Rating and Certification Corporation.
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' § 150(m): Ducts and Fans
1. All ducts and plenums installed, sealed and insulated to meet the requirement of the CMC Sections 601, 602, 603, 604, 605
and Standard 6-5; supply -air and retum-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
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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 eater 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
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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.
3. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes
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such tape is used in combination with mastic and draw bands.
4. Exhaust fan systems have back draft of automatic dampers.
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5. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated
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Eldampers.
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
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retardant and provides shielding from solar radiation that can cause degradation of the material.
7. Flexible ducts cannot have porous inner cores.
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§ 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
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heater, weatherproof operating instuctions, no electric resistance heating&r
no pilot light.
2. System is installed with:
a. at least 36" of pipe between filter and heater for future solar heating.
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b. cover for outdoor pools or outdoor spas.
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3. Pool system has directional inlets and a circulation pump time switch.
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§ 115: Gas fired fan -type central furnaces, pool heaters, spa heaters, or household cooking appliances have no continuously
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pilot light. (Exception: Non -electrical cooking appliances with pilot < 150 Btu/hr
§ I I8(i): Cool Roof material meets specified criteria
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Residential 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). Ballast for lamps 13 watts or greater
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are electronic and have an output frequency no less than 20 kHz
§I50(k)1: HIGH EFFICACY LUMINAIRES - OUTDOOR HID: contain only high efficacy lamps as outlined in Table
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150-C, luminaire has facto installed HID ballast
§ I50(k)2: Permanently installed luminaires in kitchens shall be high efficacy luminaires. Up to 50 percent of the wattage, as
determined in § 130 (c), of permanently installed luminaires in kitchens may be in luminaires that are not high efficacy
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luminaires, provided that these luminaires are controlled by switches separate from those controlling the high efficacy
luminaires.
§ I50(k)3: Permanently installed luminaires in bathrooms, garages, laundry rooms & utility rooms shall be high efficacy
luminaires. OR are controlled by an occupant sensor(s) certified to comply with Section I I9(d) that does not tum on
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automatically or have an always ono tion.
§150(k)4: Permanently installed luminaires located other than in kitchens, bathrooms, garages, laundry rooms, and utility
rooms shall be high efficacy luminaires (except closets less than 70ft'): OR are controlled by a dimmer switch OR are
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controlled by an occupant sensor that complies with Section 119(d) that does not turn on automatically or have an always
ono tion.
§ 150(k)5: Luminaires that are recessed into insulated ceilings are approved for zero clearance insulation cover (IC) and are
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certified airtight 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
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Article 680 locations) OR are controlled by occupant sensors with integral photo control certified to comply with Section
119d:
§ I50(k)7: Lighting for parking lots for 8 or more vehicles shall have lighting that complies with Sec. 130, 132, and 147.
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Lighting for parking garages for 8 or more vehicles shall have lighting that complies with Sec. 130 131 and 146.
§ I50(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
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Section 119(d).
Residential Compliance Forms April 2005
Residential Kitchen Lighting Worksheet WS -5R
PROPOSED ADDITION & REMODEL FOR EVENIL MERVILUS 10/18/2005
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
No kitchen lighting Yes No x = or
Yes No x _ or
Yes o x = or
Yes No x = or
Yes No x = or
Yes No x = or
Yes No x. = or
Yes No x = or
Yes o x = or
Yes No x = or
Yes No x = or
Yes No x = or
Yes No x = or
Yes No x = or
Yes x or
Yes No x = or
Yes No x = or
Yes No x = or
Yes No x = or
Yes No x = or
Total A: 0 B: 0
COMPLIES IF A> B YES® NO❑
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