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09281 (SFD)Building Address 54-905 Rubio Owner Address P.0. Box City lZip Contractor t3 Chomp Address 4 P.O. BOX 1504 M o . 092-8.1 78-105 CALLE ESTADO i LA QUINTA, CALIFORNIA 92253 ttt.••rrr BUILDING: TYPE CONST. -OCC.-GRP.- A.P. Number 774-291-020 Tel. State LiaI City & Classif. Lic. # Designer Address I Tel. City( Zip ( State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70 00) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION (,hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a •,permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also '', requires . the applicant for such permit to rile a signed statement that he is licensed pursuant to r;[the>'provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis •Ls for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). O 1, 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 I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a,contractor(s) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. - B. & P.C. for this reason Date "+% Owner ` >• e WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a-certificateof Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company O 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.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of.the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it 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-. i mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip Legal Description Project Description SFS Sq. Ft. �2� F, No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk.�Dep. 250.00 Plan Chk. Bal. •t7 Const. 612.50', Mech. 55.50 Electrical 133.30 Plumbing 153.10 S.M.I. _ 5� Grading 20.00 Driveway Enc. 20.00 Infrastructure 2075.40 TOTAL 3599.67 3349.67 REMARKS ylti 11 �t +JJ tJ io d CIi7r i 4 2 dL0 . Jk1f ZONE: BY:w Minimum Setback Distances: Front Setback from Center. Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR. Issued by: Date ' Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SO. FT. ® POR. SQ, FT. ® GAR. SQ, FT. ® CAR P. SO. FT. ® WALL SQ. FT. ® SQ, FT, ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS j DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation ROUGH PLUMB. FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FINAL) KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB BOND BEAM SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® 3/ac HOUSE SEWER FRAMING I FINAL INSP. 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 ��+ LGGROUND PLUMBING 71f) UNDERGROUND A.C. UNIT COLL. AREA SLABGRADE _�� / ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SE R OR PT�IC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL / �-7/ GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. Q / FRAMING I FINAL INSP. ROOFING VENTILATION REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING Y041167//Al MESH ,�,1'�I INSULATION/SOUND70j 9 A / FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Building Address 77'' /7 Owner D., U! r�1 � � j�� Cle Mailing �Oa �� Address r City Zip FT�el Contractor V GGvr1�0"—��i/c�eH _,_ Address.., ' City Zip Tel.. State Lic. & Classif. City Lic. # -Arch.; Engr--T• _- Designer_ - Address Tel. P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 9,225 City Zip State . _.� ... _ rd Lia. # •!. t LICENSED CONTRACTOR'S DECL'Aft%1TION ' I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. — 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) or Division 3, of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exempflon. Any violation or Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, 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.) 0 I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds of Improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 amm/ exempt under Sec. B. & P.C. for this reason Date6�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 ` - ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be -completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of 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 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's 'Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives .of this city to enter the above-. mentioned property for inspection purposes. t Signature of applicant Date .Mailing Address City, State, Zip BUILDING DIVISION I, I APPLICATION ONLY may•+ BUILDING: _TYPE -CONST./- - OCC. GRP. / A.P.,N_umber 2-7 �i — Legal Description Project Description Sq. Ft. No. No. Dw. Size - AZ2 G Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition 0 Estimated Valuation 00 -PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL (j REMARKS _ Al) ZONE: _ L.. BY: Minimum Setback Distances: _ - Front Setback :rom Center Line Rear Setback f`om Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permitµ Validated by: , Validation: 2ND FL. SQ. FT. ® POR. SO. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SQ. FT. SQ. FT. ® ESTIMATED CONSTRUCTION VALUATION Is MOBILEHOME SVC. POWER OUTLET PLUMBING FEES YARD SPKLR SYSTEM ' BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation COLL. AREA FLOOR DRAIN MECHANICAL FEES BONDING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRY TRAY AIR HANDLING UNIT CFM OTHER APPJEQUIP. KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB GRADING cu. yd. $ -plus-x$_=$ SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL FINAL INSP. SQ.FT.GAR ® 3Ac 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 APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ -plus-x$_=$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL ::1 DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated.(619) 347-8631 Date 5/7/91 1Type of Permit JLa Quinta No. 110579 Permit # Log # Owner Name David C. Rice No. 54-905 street Avenida Rubio City La Quinta Zip 92253 Study Area 110 APN # Tract # Lot # . , Square Footage 11720 Type of Development Single Family Residence No..ofunits 0 Comments At the present time, the Desert Sands'Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions .under 500 square feet, detached accessory structures or replacement mobiiehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facili p ty fees `im posed pursuant to Governm(mt Code 53080 in the amount of 1.58 X 11.720 or $ 2,717.60 have been paid to W&U S:D. for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By. David C. Rice - Telephone . Name on the check By Richard M. Beck Director, Facilities Planning & Development Fee collected /egem d b p y Ka , en Emme lin, a , r Payment Receveo3�. L` Signa y Cffsck z38 Collector: A ach a cop county or city plan check application form to district copy for all waivers. Embossed Original- Building. Dept./Applicant Copy - Applicant/Receipt Copy - Accounting RECORDING REQUESTED BY FIDELITY NATIONAL TITLE INS. CO. AND WHEN RECORDED MAIL THIS DEED AND. UNLESS OTHERWISE SHOWN BELOW, MAIL TAX STATEMENTS TO: F DAVID C. RICE SANDRA J.. RICE P.O. BOX 1162 RANCHO MIRAGE, CALIFORNIA 92270 L_ 0 ESCROW NO. 1024-24-14260-1—BJ TITLE ORDER NO. 108082 The undersigned .grantor(s) declare(s) J cc a a cc be0 W CC 8 m H , od lI— irL -o��, o� °0 rr `I8✓I� Q U. 0 rn _ Cq V W C SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED Documentary transfer taxis $25.30 A.P.N.774 291 020 ( X ) computed on full Value of property, conveyed, or ( ) computed on full value less value. of liens and encumbrances remaining at time of sale. ( ) Unincorporated area: ( X ) City of LA QUINTA , and By this instrument dated FOURTEENTH DAY OF NOVEMBER, 1990 for a valuable consideration LYNDON WAYNE FRANZ AND KRISTI FRANZ, HUSBAND AND WIFE hereby GRANTS to DAVID C. RICE AND SANDRA J. RICE; HUSBAND AND WIFE, AS JOINT TENANTS the following described real property in the CITY .OF LA QUINTA County of RIVERSIDE , State of CALIFORNIA LOT 8 IN BLOCK 277 OF UNIT NO. 25, SANTA CARMELITA AT VALE LA QUINTA, AS PER MAP RECORDED IN BOOK 19, PAGES 50 AND 51 OF MAPS, IN THE OFFICE.OF THE COUNTY RECORDER OF RIVERSIDE COUNTY, CALIFORNIA. STATE OF CALIFORNIA, ✓' �j COUNTY OF Riverside, % On November 16, 1990 before me 1._Jzy HO WAYNE FRANZ the undersigned, a Notary Public in and for said County and State, 1 personally appeared Lyndon Wayne Franz and 111 Kristi Franz----=-- ---- _ _;�__ _.-0.�11;Sr1; �:►i�:I,..�. KRISTI FRANZ proved to me•on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument, and acknowledged to me tTiat he/she they executed the.same. WITNESAr y hand and official.scal. i Judy X/ Hansidn (OFFICIAL SEAL) JUDY M. HANSEN NOTARY PUBLIC - CALIFORNIA n RIVERSIDE COUNTY My Commission' Expires August 25, 1991 I MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY IS SHOWN, MAIL AS DIRECTED ABOVE. APD730 Name Street Address City & State 4P. O. Box IN4' 76105 CALLE ESTADO LA OUINTA. CALIFORNIA 92253 Contractor Owner r Address Job Address La Quinta City License No.: Expires: Bldg. Permit No.: This form shall be posted on the job with the Building Inspection Card and it shall -be the duty of the General Contractor or if Owner -Builder Pe: --mit, the owner to see that all sub -contractors sign this card, giving his City of La Quints Business License Number, Contractors License Number and a current certificate of Workman's Compensation Insurance Certificate when he starts the job. Failure to comply may cause Building Inspectors to stop work, or complaints to be filed against such contractors or owners. CITY CONT. SUB -CONTRACTORS NAME LIC. NO. EXPIRES LIC. NO. EXPIRES ✓1 • Grade i Excavate, 0 �h� �< <J 155/6 t/ % 2• Pipelines V/3- Cement -Foundations 4. Cement Walks i Drives �r �' 4' S. Asphalt Paving V16- Framing 7. Steel Structural 8. Masonry ✓ 9- Plumbing S /, 12-1W17-1 374W-SPS/D L0.1 ' Lathing, Ll. Drywall L2. Plastering' �- C3. HVAC ✓ L4 - Electricalr,l n I' - L5. Roofing 16. Sheet Metal F 17: Floors -All Types 18. Glass - Glazing ' 19- Insulation/Weatherstrip 20• Sewage Disposal 21. Painting/Decorating 22• ,Tile 23. Cabinets -Installations 24• Ornamenta CMetal 25- Fences/Blockwalls 26. Landscaping 27.. Others 28. DO NOT REMOVB THIS CARD Before Final Building Inspection Will Be'Made This Form Must Be Completed and Filed With .Title 24 Calcs and Plans a - OFFICE OF AGRICULTURAL COMMISSIONER )� AND .Y :r•.,,�;, WEIGHTS & MEASURES CAf_VIN C. KAMINSKAS JAMES O. WALLACE 4080 LEMON STREET, ROOM 19 /"SCornmIS3i v RIVERSIDE, CALIFORNIA 925011 CLLMENENI BENVENISISIE Agricultural Commbiloner' Urecloi of Weights & Meofum . (714) 787-2561 Soo�or 83-612 Ave..45, Suite 7 'Indio, CA 92201 Z q / (619) 342-8291 DATE - d ( l ( CASE NO. ✓� d K • DEVEIAPER' S N11NE: Q�2v ADDRESS: TELEP11ONE: Dear Developers After reviewing your landscaping plans, all plant material listed is not in violation of quarantine laws governing the Coachella Valley. If subs =itutions do. occur. and they differ frau plant material listed, this office mus t.be notified immediately. ' Thank you for protecting and preserving the Coachella Valley's pest=free enviromr-lit. Ag—riculturaf Commissioner's Office cc: Indio and Riverside Office e,�OC qa . C VZ 2 C es.,s A v\ Mandatgry Measures Checklist: Residential MF -1R _ NOA.Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used: Items marked with an asterisk (*) may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION DESIGNER ENFORCEMEN'r Building Envelope Measures * §2-5352(a): Minimum ceiling, insulation R-19 weighted average. §2-5352(b): Loose frill insulation manufacturer's labeled It -Value. * §2-5352(c): Minimum wall insulation in framed walls R-11 weighted average (does not apply to exterior mass walls). ,^ §2-5352(k): Slab edge insulation - water absorption rate no greater than 0.3%, water vapor transmission rate no greater than 2.0 perm/inch. §2-5311: Insulation specified or installed meets California Energy Commission (CEC) quality standards. Indicate type and form. §2-5352(f): Vapor barriers mandatory in Climate Zones 14 and 16 only. §2-5317: Infiltration/Exfiltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Doors and windows certified. c. Doors and windows weatherstripped; all joints and penetrations caulked and sealed. §2-5352(e): Special infiltration barrier installed to comply with §2-5351 meets CEC quality standards. §2-5352(d): Installation of Fireplaces 1. Masonry and factory -built fireplaces have: a. Tight fitting, closeable metal or glass door b. Outside air intake with damper and control �J c. Flue damper and control 2. No continuous burning gas pilots allowed. HVAC and Plumbing System Measures §2-5352(g) and 2-5303: Space conditioning equipment sizing: attach calculations. §2-5352(h) and 2-5315: Setback thermostat on all applicable heating systems. * §2-5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC: §2-5316(b): Exhaust systems have damper controls. §2-5314(c): Gas-fired space heating equipment has intermittent ignition devices. §2-5314: HVAC equipment, water heaters, showerheads and faucets certified by the CEC. §2-5352(1): Water heater insulation blanket (R-12 or greater) or combined interior/exterior insulation (R-16 or greater); first 5 feet of pipes closest to tank insulated (R-3 or greater). §2-5312(Exception I): Pipe insulation on steam and steam condensate return & recirculating piping. §2-5318(d): Swimming Pool Heating 1. System has: a. On/off switch on heater. b. Weatherproof instruction plate on heater. c. Plumbed to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet.. Lighting and Appliance Measures §2-J'3520): Lighting 25 lumens/wall or greater for general lighting in kitchens and bathrooms. §2-5314(c): Gas fired appliances equipped with intermittent ignition devices. §2-5314(a): Refrigerators, refrigerator -freezers, freezers and fluorescent lamp ballasts certified ^ , by the CEC. Indicate make and model number. (�Vv Form Revised December 1987 a Point System Summary: Climate Zone f7- Pao id /T'ct L..OT,B �_t.lb /O rroJeccTlue ,��. ..�?A1�. PC�N� uate - BUILDING DATA Conditioned Floor Area ZOO Number of Stories Slab/Raised Floor Check all applicable Unit Type condition(s): �Q Single Family Detached (SFD) [ J Addition Alone [ ] Single Family Atutched (SFA) [ ] Existing Building [ J Multi-Fatnily (MF) I ) Existing -Plus -Addition' 13 -21t SCORECARD Measures Point Scores 1. Ceiling Insulation K- 3�& ;or 07-`10 0 R -value U -value 2. Wall Insulation or It -value U -value 3: Raised Floor Insulation Qf or � O ' ' 4. Slab Edge. Insulation value or value R -value F2 factor 5. Infiltration Standard 0 G. Glass Heat Loss Iyllc U-vallle % lolal Glass Stim 1.6 7. Shading (Shade Open) % Glass SC Eff. % Glass a. North x 71 = 3.9 % b. East x 7 H = 0 - C. South , x 7`i _ 3.5 7 d. West _< x , ? `( = 2_87- -8? - c. c. Skylight x = Q 8. Shading (Shade Closed) % G lass SC Eff. % G lass a. North 5..3 x 7-o = J y� p b. East Qi ' x C. South y,� x = I -> d. West - x v = (• �h _� e. Skylight x _ p 9. Interior Thermal Mass Interior Mass/CFA 10. Exterior Wal[ Mass - 2 Gxtcrior Wall Mass Sum 7-10 11. Heating System ,-7f0 x 9S- ZZonal ZonalControl? ( Y / N) SI: or IISIT Duct Efficiency Effective SEor INN: 12. Cooling system 10,0 x Zonal Control? ( Y / N) SEER Duct tifficiency Effective Slant 13. Water heating S IG NoNc� 7 1'ype Credit Point Total: Form Revised March 1988 Certificate of Compliance: Residential (rage I of 2) Cr -1 R -7ZO4 PZAIJi Project Title Date J.p f" 8: Jai lo A .27% 6f 5�r m4 /D©l `.� Project Address Building Pennit N Documentation Author Telephone Checked By / Date 1 `moi --�------ Catutpll:uice hlelh(Kl (Package, Point Syslem or Computer) . Climale Zone Eii1mccmcnt Agency Use only GENERAL INFORMATION Total Conditioned Floor Arca: 172-4�7 ft2 Building Type: _X Single Family Hotel/Motel (check one or more) Multi -Family (less than 4 stories) Addition Multi -Family (4 or more stories) Existing -Plus -Addition Front Entry Orientation: North / East / South / West All rientations (circle oroc or mare) WgPiCST CA T Az` Number of Dwelling Units: Floor Construction Type: Slab / Raised Floor (circle one or both) Infiltration Control: Standard/Tight (circle one) BUILDING SMELL INSULATION Component Insulation Location/Comments Type R -Value (attic, to garage, typical, etc.) Wall .............. &U,000d Wall .............. Roof ............. �Z - �l C=AL �c7F NS7T:Zj QQ Roof ............. Floor ............. Floor :............_—. --- Slab Edge..... GLAZING Shading Devices Glazing Arca Glass Type Interior Exterior Overhang Framing Type Orientation (sf) (single, double) (roller blind, etc.) (shadescreen, etc.) (yes/no) (metal/wood) Front.... (M SO DUAL lac-:: ` buwM IV a No C7-4 L_ Front.... ( )— Left......— Lcft...... ( ) Rear..... (�) Rear..... ( ) Right.... (5) f O rZ Right.... ( ) Skylight....... Skylight....... TIIERMAL MASS Typc/Covering Arca (slab/exposed, tile, etc.) (so MuE7 38'7 Thickness Inches Location/Description (kitchen, bath, etc '4�Z— Certificate of Compliance: Residential V Project'1'tuc 1-7 zO� HVAC SYSTEMS (Page 2 of 2) U -11Z Ualc Minimum Duct Type (furnace, air Efficiency Location Duct Output Manufacturer/ Modcl dl conditioner, heat pump) (SE, SEER,llSPF) (attic, etc.) R -Value (13tull) (or al)proved equal) A Till �� 3 Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS Tank Manufacturer/Model # System Type (storage gas, etc.) Capacity (or approved equal) Special Featurc(s) �F GasS7Z�►2Pyc O. S/�qw �AC_ — .SO SPECIAL FEATURES/REMARKS (Add extra sheets i f necessary) COMPLIANCE STATEMENT' This certilialte of compliance lists the building Icatures anti Ix rlbrruancc specifications Heeded to Comply Willi Tills 24, Chapter 2-53 and Title 20, Chapter 2, Subchapter 4, Article 1 of the California Administrative code. 'Phis certificate has been signed by the individual Willi overall design responsibility and die building owner, who shall retain a copy of it and transmit the certificate to any subse(lucnt purchaser of the building. Whcn this certificate of compliance is submitted for a single building plan to be built in multiple orientations, all building C011SellValioll features which vary arc indicated in the Special Features/Remarks section. Designer Title/Firm: Address: Telephone: Lie. #: 7 si nature) (!iI Documentation Author Name: QAm45)� 1 %01:—:,Vj A.6 Titic/Finn• A G;7L/i wS C „V, _, Address: Tclephonc: a 0 6 G ( ate) ;c. it56�0�6 Fonn Rcviscd March 1988 Iltdiding Owner N:uno a3.V I • I l Tills/Firm: O n �Y` l.� �:. ► d < ✓' Address: '> Ve A' Telephone: a g o (tiignat� /�datc) Enforcement Agency Name: Agency: Tclephonc: (signature or stamp) (date) S{"„ Qo. 1•^"+y7' -. 7 j;K' _01 IV V OP 0 Kw _4 U111 Jaf Tit� aW W 1-1 :�- k- �.a�itltn .2, A lift. all This Certificate issued pursuant to the requirements'of Section.*..,30,6,,. :af, the Uniform Building Code certifying that at the time of issuance this structure Wavjn,,cbmpliapce with the various ordinances of the ,City. regulating -building construction. or useFor,-the' following: BUILDING ADDRESS 54-905*AVENIDA,RUBI,O Use SINGLE FAMILY DWELLING- 9281 ,P!assification _;Bldg. Permit No.. - R3 GroupVN Type Construction Fire Zone Use Zone SR -10 . wner of. Building DAVID C RICEP 0 BOX' -1162 Address city• -RANCHO 'QA '22270 MARK HAROLD' By•• OCTOBER -12, 1991 rltl� Date;' Building Official POST IN A CONSPICUOUS PLACE