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12-0430 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: CE 12-00000430 Property Address: 79420 BROOKVILLE APN: 772-040-021- - - Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 23000 T41it 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: FINSILVER,IRIS JOAN Contractor: Applicant: Architect or Engineer: PILLEY, ROGER G. 74892 SOUTH COVE DRIVE INDIAN WELLS, CA 92210 (760)674-3316 Lia. No.: 839969 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. Licens Class: B Li s No: 839969 ates!r' C rector: OWNER -BUILD C RATION I hereby affirm under penalty of perjury that I am exempt from the Con Factor'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 ownerof 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 (Sec. 3097, Civ. C.). - Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/10/12 o a a MAY 112012 CITY OF LA QUINTA FINANCE DEPT. 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 EXEMPT Policy Number EXEMPT 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, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I_shall forthwi8ftfomply with those provisions. WARNING: FAILURE TO SECURE WdRKERS' COMPENSATION E AGE 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 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. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby ut representatives of this county to enter upon the above-mentioned property for inspection purgss� (Applicant or ., Application Number . . . . . 12-00000430 ------ Structure Information 198SF PATIO ENCLOSURE/ADDITION ----- Other struct info . . . . . CODE EDITION 2010 ----------------- ---------------------------------------------------------- Permit . . . Additional desc . . Permit Fee . . . . Issue Date . . . Expiration Date . . BUILDING PERMIT 234.00 Plan Check Fee . . 152.10 Valuation . . . . 23000 11/06/12 Qty Unit Charge Per Extension BASE FEE 45.00 21.00 9.0000 THOU BLDG 2,001-25,000 189.00 ---------------------------------------------------------------------------- Permit . . ELECT - ADD/ALT/REM Additional desc . . Permit Fee . . . . 21.93 Plan Check Fee 5.48 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/06/12 Qty Unit. Charge. Per Extension BASE FEE 15.00 198.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 6.93 ---------------------------------------------------------------------------- Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 19.50 Issue Date . . . . Expiration Date . . 11/06/12 Plan Check Fee . . 4.88 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT •4.50 ---------------------------------------------------------------------------- Special Notes and Comments 198SF PATIO ENCLOSURE/VB/RES-3/CLASS A -FR (ENGINEERED] THIS PERMIT DOES NOT INCLUDE ALTERATIONS TO THE EXISTING DWELLING. 2010 CALIFORNIA BUILDING CODES. May 8, 2012 1:07:52 PM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . BLDG ST•DS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 15.21 STRONG MOTION (SMI) - RES 2.30 LQPERMIT Application Number . . . . . 12-00000430 Fee summary Charged Paid Credited Due ----------------- Permit Fee Total ---------- 275.43 ---------- .00 -------------------- .00 275.43 Plan Check Total 162.46 .00 .00 162.46 Other Fee Total 18.51 .00 .00 18.51 Grand Total 456.40 .00 .00 456.40 LQPERMIT 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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. 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 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 198 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 - Roger Pilley Check No. Name on the check Telephone Funding Exempt BY Dr. Sharon P. McGehee Superintendent Fee collected Signature Payment Recd Over/Under F F i NOTICE: Pursuant to Government Code Section 66020(d)(1), this wilgerve to notify you that the 90 -day approval period in which you may protest the fees or 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 without embossed seal Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting To: rsi FOUNG ENGINEERING SERVICES www.valuengr:com 71=780 San Jacinto Dr: Ste.. E2; Rancho Mirage;, Ca; 922.7,0 ph. (:760) 834-8860 fax (760) Letter of Transmittal City of La Quinta Today's Date: 5-1-12 78-495 Calle Tampico City Due Date: By Mail (Fed Ex or UPS) 5-2-12 La Quinta, CA 92253 Project Address: Descriptions: 79-420 Brookville Descriptions: Copies: Plan Check #: Copies: 12-430 Kay Structural Plans ❑ Submittal: ® 1sl ❑ 4 t ❑ ❑ 2nd ❑ 5th Truss Calculations ❑ 3rd ❑ Other: We are forwarding: ® By Messenger ❑ By Mail (Fed Ex or UPS) ❑ Your Pickup Includes: # Of Descriptions: Includes: # Of Descriptions: Copies: Copies: ® 1 Structural Plans ❑ Revised Plans ® 1 Structural Calculations ❑ Revised Struct. Calcs ❑ Truss Calculations ❑ Revised Truss w/Ltr. ❑ Soils Report ❑ Revised Soils Report ❑ Structural Comment List ❑ Approved Structural Plans ❑ Redlined Structural Plans ❑ Approved Structural Calcs ❑ Redlined Structural Calcs ❑ Approved Truss Calcs ❑ Redlined Truss Calcs ❑ Approved Soils Report ❑ Redlined Soils Reports ❑ Other: Comments: Structural content is approvable; see attached structural plan check comment list. Engineer of Record to sign the structural plans. Structural Plan Review Time = 1.5 Hrs. This Material Sent for: ❑ Your Files ® Per Your Request MAY 0 2 0012 ❑ Your Review ❑ Approval ❑ Checking ❑ At the request of: Other: ❑ By: John W. Thompson Rancho Mirage Office: ® (760) 834-8860 Other: ❑ The Management Tryst MONARCH GROUP DIVISION THE ESTANCIAS AT RANCH LA QUINTA April 16, 2012 Ms. Iris Joan Finsilver Re: Architectural Application 79-420 Brookville Dear Ms. Finsilver: The Architectural Committee/Board of Directors of The Estancias Homeowners Association has reviewed your application to enclose the patio at the rear of your home. The committee/Board of Directors is pleased to inform you that it has approved the application as submitted. Also enclosed, you will find an Appendix VI — Architectural Notice of Completion. Please complete and submit the Notice of Completion to The Management Trust, Monarch Group Division upon completion of these improvements. Thank you for your patience and understanding during this approval process. If you have any questions please contact The Management Trust, Monarch Group Division, at 760-776-5100 ext. 311. Sincerely, Architectural Committee/Board of Directors, The Enstancias at Rancho La Quinta enclosure cc: Board of Directors Unit File 11ECEIVRID, APR 18 2012 39755 Berkey Drive, Suite A, Palm Desert, CA 92211 CONNECTING PEOPLE TO THE PROMISE I PH: 760.776.5100 FAX: 760.776.5111 www.managementtrust.com B,riAl� #Citiy of'. Quilled. . But 8t Safe Division' P.O. Box. 1504, '78-495 Calle Tampico l.a.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Perm,t # : O a' Project Address: owner's Name/?S!f G A P. Number. Address: escription: or. Gt , / r City, ST, Zip: z�.- Y�;14 Telephoner ' �� Project Description: D G City, sT; Telephone: O State Lia # : cs City Lie, C. Ate-, EW.. mer. Address: City, ST. Zip: Telephone State Lia #: Name of Contact Person:�f Construction Type:. f� Project type (circle one): New dd' Aber• d cr / Ft.: # Stories~ Repair Demo # Uuim Telephone # of Contact Person: Bsdmaw Value of Projecup�� j �o��yY�i PPLICaNT: DO NOT WRITE BELOW THIS UNE AN Submittal ReVd Ree'd TRACMG PERMPP FEES plan Sets o�? Pias Cheek submitted / item Amount Strgdnral (;alts a Reviewed, rady for conecdous Pian Check Deposit. . Trust Caics. Called Contact Person Plan Check Balance. Mgt 24 CRW6 Plans picked up Construction Flood plain plan Plans resnbmltted.-. Mechanical G:mding plan 2'! Review, ready for corcationetaue Electrical Subeoatactor List Called Contact Person Plumbing Grant Deed. Plans picked up S.Ti91.I. H.O.A. Approval Pians resubmitted Grading IN HOUSE:- 24 Review; ready for correcd c r 1/ Developer Impact Fie Planning Approval Called contact Person AJ.P.P. Pub. Wks. Appr Date of permit issue School Ftes Total Permit Fees CITY OF LA QUINTA'SUB-CONTRACTOR LIST Q JOB ADDRESS `�`y�� r��C� 4�/ll PERMIT NUMBER OWNER-=,-7�XS JOW11 BUILDER This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their a oyees are auk orized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. :.; . <.<> so :.:.::::<.....:.::. >:: ; . ...:. Cit . Biisne Li en— ion Trade / Clas �ficatContract r State..Contractor .s L�cens8 . Workers Com ensation lrisurance:°'.: ` ` :::::. y ss cse::<> :. Ars eF 5110 l ?812 :. Company Name Classification (e.g. A, B, C-8) License Number (xxxxxxx) Exp. Date (xrx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date LU License Number (xxxx) Exp. Date (xx/xx/xx) (- EARTHWORK (C-12) G� G - ��b// ✓ `" !`GI C� ��1� (i�� , �1xx �D� J� 3� 7 ✓�!-/ CONCRETE (C-8) FRAMING ;lC-5) :`.;;` (1v` �/��i �� `� l' f S� D✓� �� r STRUCT'.STEEL (C-51) MASONRY (C-29) ". PLUMBING IC -36j LATH; PLASTER (C35) 0 DRYWALL (C-9) ..:..: /lo: ELECTRICAL (C4d) : .: 4-- O - D Jr .3l R00FINGIC=39).`.:;: ; :::'>'�n / �/✓ / C/ '' %/� G� G�� - b /�� SHEET METAL (0=43)` FLOgRING 10:15):. GLAZING (C-17)_ '. ::> ..:::. �f/ U/i% g `" r C�'yC v �it�%�/Y 1141 v 01<- INSI LATIO'l (C72) .* �'C- �� 1)►+�awC� ! SEWAGE DIS' (0-421 Q PAINTING (C=33) "�/✓' .a �C✓ � 9 Q CERAMIC TILE (C -54)/e d CABINETS (C-6) "VX FENCING (CAM LANDSCAPING (C=27).: POOL (C-53) Ars eF 5110 l ?812 Prescriptive Certificate of Compliance: CF -1R ADD Residential Additions(Page 1 of Site Address: Enement Agency: Date: '7q -+0k0 SrzmvV_u l LLQ �� . forc**I/ t General Information Name t, -Ttzt #bm'i liate Zone #Project C # of Stories I Building Type Dingle Family ❑ Multi Family Circle the Front Orientation: N4t>, W or Degrees Conditioned Floor Aiea of Addition New Addition Size: 13 Less than or equal to 100f?ess than or equal to 1000 (CFA):Q (Do not use this orm or additions greater than 1000 NOTE: For Alterations to an existing home, submit a completed CF -IR -ALT Form. Exception: Existing MVAC systems that are replaced or altered to serve the addition may be included on the CF -IR ADD Form Prescriptive Envelope Requirements for Additions Option 1: U Option 1 for standard wood and assemblies meeting the Cavity R -value only. For all other use Option 2. • For 100f? c dditions, the Proposed values must be equal or greater than the Standard column or when indicated when using Package D, "Pkg D ". E 7ter all values in the Proposed Columns. • For less than 1, 000ft2 additions must comply with `Pkg D" requirements unless indicated in the Standard Column. To meet `Pkg D" minimum -energy comr, fiance requirements, see RCMAppendix A Table 151-C. Or 151 in the RCM. Enter all values in the Proposed Columns. Size of A dition 100 ftp or less Less than 1,000 ftz Com on nt Standard Pro -posed Comment Standard Proposed"--:. Comment Ceiling Insu atiion R-19 Minimum Pkg D _g :: _ Table 151-C Wall Insula ion R-13 Minimum R-13� 5. Enter the Tabl II number that closely resembles the proposed assembly. 6. Enter the R-vd ue that is being installed in the wall cavity or between theframing; otherwise, enter 110 ". Minimum Floor Insuh tion R-13 Minimum Pkg D °-- Table 151-C U- U- U- U-.. Fill out Fenestrate n factor o S o ed factor SHGC 'factor SHGG Fenestration Pkg D �,^ Y::`�l/?��PropBelowreas tnU 0. 0 Y1� e0.40 eBU�L.D1 nFill Package D (20% oat Additional Maximum GI ing Area y 50 ft /� f i R ( A of CFA) +Glass `l. a � fl? Allmved .. Removed Fenestration TRU Areas Bel ow Radiant B Her N/A Pkg D Table 151-C RoofingI kg D oofin P oduc Below Pkg D See Roofing Products Below O a ue Su ace Details rre portioned of Mass Walls see Furring Strips Construction Table below. A B C D E F G H I J Proposed See Note Standard Values From JA4 Table Framing Thickness, Framed Continuous JA4 Proposed Tag/ Ass mbly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly ID' r Type' and Size2 or Othe? factor' Numbers R-value6 R -Value? Cell Value8 U-factor9 W w kv ttaoofl aTb 4" , OR ,3,1.4 -a 1 O .3.1 -Rb , alb{ NMI +tiJ o -+t._. va D a / '' XN ,1, t - o �, O 3 . t -1310 , i7bdi ?1007- wwo �x I'2. IQ DAK.A. i - AR -3$ -a- ,a , I • , 001 40 1 Note: For furred alsemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-1. For calculating furred walls use the Mass and Furrin Constructi n table below. 1. For Tag/ID in ficate the identification name that matches the building plans. 2. Indicate the Aj sembly Name or type: Roof/Ceiling Walls, Floors, Slabs, Crawl Space, Doors and etc ... Indicate the Frame type and Size: For Wood, Metal, i detal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies. 3. Enter the thin vessfor mass in inches or Spacing between framing members enter; 16 "or 24 "OC; or Other for all other assem i�n such as Concr to Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc.... 4. Based on the timate Zone; enter the Standard U factor from Table 151- C for each different assembly Name or type. 5. Enter the Tabl II number that closely resembles the proposed assembly. 6. Enter the R-vd ue that is being installed in the wall cavity or between theframing; otherwise, enter 110 ". APR j g 7. Enter the Conj inuous Insulation R -value for the proposed assembly, otherwise, enter "0". 8. Enter the row c nd column of the U factor value based on Column F Table Number and enter the Assembly U factor in Column J. 9. The Proposed 4ssembly Ufactor, Column J, must be equal to or less than the Standard Ufactor in Column E to comply. BY; Registration Numer: 2008 Residentiai Compliance Forms Registration Date/Time: HERS Provider: August lUU'l 2012 Prescriptive Certificate of Compliance. CF -1R ADD Residential Additions (Page 2 of Site Address: Enforcement Agency: Date: -7q-4a-0 T-_; 2-aotZu t LLQ &44 iz_ f Furring Strips Construction Table for Mass Walls Onl tJ A B C D E H1 I J I K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation r ` `V, l Crri lv.d � `:�R eA ��!' 2 YM /6 p0 ` 1'� Walls From Reference in Furring Space from Reference 40 Joint A pendix Table 4.3.5, 4.3.6 4.3.7 Joint Appendix Table 4.3.13 y A Assembly Total 9,,; tv ] o` .o — �T o ,o ° > ; Final Mass Thickness' Name or JA4 Table ' ¢ > y a 0 8 0 c X c ° m ' a ¢ > 12 ' Assembl .7 Type, Number; U -factor Comment 1 1. Indicate the Mass Thickness frot Reference Joint Appendix JA. 2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc ... Indicate 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 Table number that cloAly resembles the proposed assembly. 4. Enter the row and column of the U factor value. 5. Enter the Effective R -value listed in the JA4 Table Number. 6. 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. 7. Insert the Final Assembly U factor value back on to the Opaque Sur ace Details table in Column J FENESTRATION PROPOSED AREAS Orientation Fenestration Type and Frame (North, East, PropsedAreal (Window, Glass Door oris li t South, West) ft U Maximum -factor' Maximum NFRC or SHGC- ° Default Values' GL"t, izov-n. 1i �1) ..��yp�, . 4,y - SS' ,�ynu. r ` `V, l Crri lv.d � `:�R eA ��!' 2 YM /6 p0 ` 1'� SIDE- L)10i,*t 40 Total 9,,; tv 1. Fenestration area is the area of total area may be the glass area plus a 2. Enter value from Component Package 3. Actual fenestration products installed SHGC value than that specified on 4. Submit a completed WS -3R Form S. If a licable at this stage enter "NFRC" glazed product (i. e. glass plus frame). Exception: When a door is less than 50% glass, the fenestration "2 inch frame" around the glass. D Requirements in Table ISI -C. and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower U factor and/or a lower the CF -1 R ADD Form. if a reduced SHGC is calculated with exterior shading. or NFRC Certified windows or CEC "Default" values ound in Table 116-A or B. Registration Number: I Registration Date/Time: HERSProvider: 2008 Residential Compliance Fo+is Prescriptive Certificate of Compliance: CF -1R ADD Residential Additions (Page 3 of Site Address r Enforcement Agency: Date: ADDITION ALLOWED FENESTRATION AREAS r Check applicable box below if the roof addition is exempt from the oo ing product "Cool Roof'requirements. 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. O Roofing compliance Not Required in Climate Zones 1-12,14, and 16 with a Low Slope. Less or 2:12 pitch. A B C D E e applicable box below if Exempt from the Roofing Products "Cool Roof' Requirement: F Roof Slope CFA of Addition Allowed % Allowed Area Area RemovedZ Total Area Allowed p 3 4 Proposed Area < 2:12 > 2:12 ft of CFA (A x B) ft2 C + D (Table Above) Total Fenestration Area qlb e90% '2j R, & 4 A, 36AX, g > West Fenestration Area ❑ ❑ ❑ ❑ ❑4 (Required In CZ's 2 4 & 7 -15) .05- ❑ ❑ 13 1. 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. ❑ ❑ 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 Allowed Area for BOTH the Total and West Fenestration Areas. ROOFING PRODUCTS (COOL ROOFS) §751091 Check applicable box below if the roof addition is exempt from the oo ing product "Cool Roof'requirements. 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. O 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/fe. • 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/ft 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: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number[ < 2:12 > 2:12 < 5lb/ft2 > 5lb/ftO Type2 Reflectance 3,4 Emittance SRIS ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4 ❑ ❑ 13 ❑4 11 !0j ❑ ❑ ❑4 1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coalroo1s orelproducts/search.pho 2. Indicate the type ofproduct is being used for the roof top, i.e. single ply roof, asphalt roof, metal roof, etc. If the Aged Reflectance is not available in the Cool RooJRating Council's Rated Product Directory then use the Initial Reflectance value from the same . directory and use the equation (0.2+0,7(p1,,t,t0t— 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance. . Check box if the Aged Reflectance is a calculated value using the equation above. 5. Calculate the SRI value by using the SRI- Worksheet at htto:/Avww.enerev.ca.gov/title24/arid enter the resulting value in the SRI Column above and attach acopy of the SRI- Worksheet to the CF -1R To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in §118(i)4. Select the applicable coating: ❑ Aluminum -Pigmented Asphalt Roof Coating FE3 Cement -Based Roof Coating ❑ Other Registration Number: Registration Date/time: $ HERSProvider. 2008 Residential Compliance Forms R NS NJ• LVV/ LR escri tive Certificate of Com liance: CF -1R ADD sidential Additions a e 4 ofe Address: Enforcement Agency: Dat HVAC SYSTEMS - HEATING List water heaters and boilers for both domestic hot water (DHI9 heaters and hydronic space heating. Individual dwelling DHW heaters must be gas or propane fired 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 tom onent acka es in all climate zones. Duct or Configuration Minimum Distribution Piping Distribution Type Standard, Recirculatin Z (Central, Split, Heating Equipment Efficiency Type and Insulation Thermostat Space, Package or Type and Ca aci '• z, 3 AFUE or HSPF Location' R -Value Type H dronic 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 i es shall be insulated to meet the requirements o 150 ' . 1. Indicate Heating Type (Central Furnace, Wall Furnace, Heat pump, Boiler, Electric Resistance, etc.) 2. Electric resistance heating is allowed only in Component Package C, or except where electric heating is supplemental (i.e., if total capacity < 2 KW or 7,060 Btulhr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §151(6)3 exception. 3. Refer to the HERS Verification section on Pages 3 and 4 of the CF -IR -ADD Form for additional requirements and check applicable boxes. 4. Indicate Type or Location(Ducts, H dronic in Floor, Radiators, etc. HVAC SYSTEMS - COOLING Configuration Cooling Equipment Minimum Distribution Duct or Piping (Central, Split, Type and Capacity' -2 Efficiency Type and Insulation Thermostat Space, Package or SEER/EER or COP Location3 R -Value Type H dronic) 1. Indicate Cooling Type (A/C, Heat pump, Evap. Cooling, etc). 2. Refer to the HERS Verification section on Pages 3 and 4 of the CF -IR -ADD Form for additional requirements and check applicable boxes. 3. Indicate Tye or Location(Ducts, Hydronic in Floor, Radiators, etc.) WATER HEATING List water heaters and boilers for both domestic hot water (DHI9 heaters and hydronic space heating. Individual dwelling DHW heaters must be gas or propane fired 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 tom onent acka es in all climate zones. External Tank . Water Heater Type/Fuel Type' Distribution Type Standard, Recirculatin Z Number In System Tank Capacity (gal) Energy Factor or Thermal Efficient Insulation 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 i es shall be insulated to meet the requirements o 150 ' . SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below. These items may require written justification and documentation and special verification. Radiant Barrier (Root) 5rES ❑ NO YES: Required in Climate Zones 2, 4, and 8-15 for additions !_4ger than 100 fl Slab Edge (Perimeter) Insulation 0 YES RNO YES: In Climate Zone 16 under Component Pac , R-7 insulation is required. Heated Slab Insulation O YES 121090 - YES: Slab edge insulation required for heated slabs in all Climate Zones. See details in Table 118-A of the standards. Raised Slab Insulation 0 YES O YES: In Climate Zones 1, 2, 11, 13, 14 & 16 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 Date/time: 2008 Residential Compliance Forms HERSProvider. August 2009 -11 Prescriptive Certificate of Compliance: CF -1R ADD Residential Additions (Page 5 of 5 Site Address: Enforcement Agency: Date: - 42�p lZ¢1p 6�tll Lt C -P� • . A Z HERS VERIFICATION SUMMARY - The enforcement agency should pay special attention to the HERS Measures specified in this checklist below. A completed and signed CF4R Form for all the measures specified shall be submitted to the building inspector before final inspection. Duct Sealing 4ioTesting HERS verification is required for this measure. ❑ YES IrNO 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 tested per §151(f)10. 13 YES & O 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. 13 EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. –s ❑ YES [3'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 §I52(b)IE. ❑ 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 Marge - Split System HERS verification is required for this measure. ❑ YES CrNO 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. [3 YES 13"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 refrigerant charge measurement shall be verified per § 152 b IF. Central Fan Integrated Ventilation System – Airflow and Fan Watt Draw - do nota ply for additions 1,000 fi? or less. Ducted SphIPSystems - Air Conditioners and Heat Pumps: Airflow and Fan Watt Draw HERS verification is required. ❑ YES fNO YES: In Climate Zones 10 through 15, if a new 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. �� C3 YES Lel 0 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 IF. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is acc rate and m Tete. Name: Signature: i>r Company : T1'L + Date: ��~ I� Address:T % 0 lb � yii 1 LI�f Lal pave) Df!\ J IB If Applicable ❑ CEA or CEPE (Certification #): City)fState/Zi : Phone: -4 %8o Responsible Building Designer'sDeclaration 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 on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consistent with the informatio vided to document this building design on the other applicable compliance forms, worksheets, calculations, plans an su to the enf ent agency for approval with this buil6ing permit application. Name: u 1� Signature: Company: dA30I4, Date. Address: 4 S l C�� V f 1 i J7 ` ®`� License: J City/State 14t�,r✓� l .z I �� $ -r Phone:oaca1% For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. Registration Number: I Registration DaWRine: HERSProvider: 2008 Residential Compliance Forms August 2009 Mandatory Measures Summa MF -1R Residential (Page 1 of 3 Site Address: Enforcement Agency: Date: 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 -1 R, CF -JR -ADD, or CF -1 R ALT Form) shall supersede the items marked with an asterisk (*) 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 -1R Form with plans. DESCRIPTION Building Envelope Measures: §I 16(a)l: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. § 116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain Coefficient SHGC , and infiltration that meets therequirements of 10-11l(a). §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(i) 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 -frame wall or equivalent U -factor. 1150(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 -IR 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 0.3%; water vapor permeance rate is no greater than 2.0perm/inch 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)1B: 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 tight -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 vented to the outside of the building, are prohibited. Space Conditioning, Water Heating and Plumbing System Measures: §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 § 113(c)5. § 115: Continuously burning pilot lights are prohibited for natural gas: fan -type central furnaces, household cooking appliances (appliances with an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool ands a 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 wrapped with insulation having an installed thermal resistance of R-12 or greater. § 1506) IB: 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 internal insulation where the internal insulation R -value is indicated on the exterior of the tank. § 1500)2: 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. are insulated per Standards Table 150-B. § 1500)2: Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot water tank shall be insulated to Table 150-B and Equation 150-A. § 1500)2: Pipe insulation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards Table 123-A. § 1500)3A: Insulation is protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. §1500)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 Mandatory Measures Summa MF -1R Residential (Page 2 of 3 Site Address: Enforcement Agency: Date: §1500)4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation. Ducts and Fans Measures: §150(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 tae shall be used § 150(m)1: 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. § I50(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. § 150(m)7: Exhaust fan systems have back draft or automatic dampers. §I50(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. § 150(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(o): All dwelling units shall meet the requirements of ANSUASHRAE 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 Systems 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. §114(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 built-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 2. §150(k)3: The wattage of permanently installed luminaires shall be determined as specified by §130(d). § 150(k)4: 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 lights 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-C 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 not contain 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 the requirements 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 fig or 100 watts for dwelling units larger than 2,500 flz 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 Mandatory Measures Summa MF-1R Residential a e 3 of3) Site Address: Enforcement Agency: Date: EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided that they are 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)11: 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 Exceptionl to §150(k)13 may be controlled by a temporary override switch which bypasses the motion sensing function 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 high efficacy luminaires. § I50(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 §I50(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. 1 2008 Residential Compliance Forms i August 2009