08-1926 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: -08-00001926 - -
Property Address: `50025--CALLE� ROSARITA
APN: 658-250-039- - -
Application description: REMODEL RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 10000
Applicant:
Architect or Engineer:
MIN
•.4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
�J
09
-------------------------=------------------------------------------------------7----------------
• LICENSED CONTRACTOR'S DECLARATION
Date*
Owner:
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
SCOTT BOHANNON
r
50025 CALLE ROSARITA
LA QUINTA, CA 92253
a C•�
`„n _ !�
- for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
_
issued.
r Date:/ yw �' Contractor:
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Contractor:
STARK CONSTRUCTION COMPANY INC
I�'=
39725 GARAND LANE, SUITE E
insurance carrier and policy number are: _
PALM DESERT, CA 92211
(760)345-9711
r
Lic. No.: 577776
�.
�J
09
-------------------------=------------------------------------------------------7----------------
• LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License C ss:'tens o.: 577776
- for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
_
issued.
r Date:/ yw �' 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 -BUILDER DECLARATION
insurance carrier and policy number are: _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier. STATE FUND Policy Number 1834492-2008
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 requiresthe 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
an agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3 00 of the Labor Co shall forthwith ly with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7631.5 by
27U
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
_Date: -'I Applicant:
(_) 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
WAR ING FAILURE TO SECURE WORKER COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
• Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the '
DOLLARS ($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
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
-
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of •
conditions and restrictions set forth on this application.
- _ property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) 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 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. I agree to comply with all
city and county ordinances and state laws relating to building struction, and hereby authorize representatives
of this cou�fy to Ater upon the above-mentioned property i pection r es.
-Date: I Y DO Signature (Applicant or Agent).
LQPERMIT
Application Number .
. . . . 08-00001926
------ Structure Information
80SF ATRIUM ENCLOSURE/VB/RES-3/CLASS
A ------
Other struct info . .
----------------------------------------------------------------------------
. . . CODE EDITION
2007CODES
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee
117.00 Plan Check Fee
76.05
Issue Date . . . .
Valuation
10000
Expiration Date
7/25/09
Qty Unit Charge
Per
Extension
BASE FEE
45.00
8.00 9.0000
THOU BLDG 2,001-25,000
72.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
17.80 Plan Check Fee
4.45
Issue Date
Valuation . . .
. 0
Expiration Date
7/25/09
Qty Unit Charge
Per,
Extension
BASE FEE
15.00
80.00 .0350
----------- -----------------------------------------------------------------
ELEC NEW RES - 1 OR 2 FAMILY
2.80
Permit . . .
MECHANICAL
Additional desc .
Permit Fee'
26.00 Plan -Check Fee'.
6.50
Issue Date
Valuation
0
Expiration Date
7/25/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 4.5000
EA MECH VENT INST/ DUCT ALT
4.50
1.00 6.5000
EA MECH EXHAUST HOOD
6.50
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
24.00 Plan Check Fee
6.00
Issue Date . . .
Valuation . . .
. 0
Expiration Date
7/25/09
Qty Unit Charge
Per.
Extension
BASE FEE
15.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
Application Number . . . . . 08-00001926
Permit .. . . . . . PLUMBING
Qty Unit Charge. Per
Extension
2.00 3.0000 EA PLB GAS PIPE 1-4
OUTLETS 6.00
Special Notes and Comments
80SF ATRIUM ENCLOSURE WITH KITCHEN
REMODEL/VB/RES-3/CLASS A [ENGINEERED)
THIS PERMIT DOES NOT ALLOW THE PROPOSED
FNf T,nRTTRF NOR THE EXISTING ADJACENT ROOM
TO BE USED FOR SLEEPING PURPOSES. THESE
ROOMS DO NOT MEET THE REQUIREMENTS FOR A
LEGAL SLEEPING ROOM UNLESS AN ESCAPE
OPENING PER CBC 1026.2. & 1026.3 IS
PROVIDED AT A LATER DATE. 2007
CALIFORNIA BUILDING CODES.
January 26, 2009 9:12:16 AM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . ENERGY REVIEW
FEE 7.61
STRONG MOTION
(SMI) - RES• 1.00
Fee summary Charged Paid
-----------------------------------------------
Credited Due
----------
Permit Fee Total 184.80 .00
.00 184.80
Plan Check Total 93.00 .00
.00 93.00
Other Fee Total 8.61 .00
.00 8.61
Grand Total 286.41 .00
.00 286.41
LQPERMIT
Bin #
City of La Quinta00*. q
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico '
La Quinta, CA 92253 - (760) 777-7012 �✓
Building Permit Application and Tracking Sheet
Permit #
�V
i
Project Address: —fj29
Owner's Name�'�/"1i�/v�%Onf✓
A. P. Number:
Address��1:2
Legal Description:
Contractors' ,.� ,�>�
1G0
City, ST, Zip: %4,i 4f"71, �Ioy,�j
��-
Telephone: 5 . sem. i
Address�97 �fQJ�' ,446 g
Project Description:
City, ST, Zip:p�
`
—m -MM
State Lic. #- City City Lic. #:
Arch., Engr., Designer:
Address: //��/9p/s��s>/
City, ST, Zip y//-/ !� (/��Gi, 5
JO/[.tel
9 7
Telepho 0
6th 3�
Construction Type: Occupancy:
Project type (circle one): New Add'n Alte Repair Demo
State Lic. #:
r
Name of Contact Person:7 ��
/�� S/19i!�-
Sq. Ft.:
#Stories:
# Un, its:
Telephone # of Contact Person: 9 %11
Estimated Value of Project: �O pOd
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
TRACKING PERMITFEES
Plan Sets
/Rce'd
Plan Plan Check submittedI
�t¢m
Amount
Structural Cales.
Reviewed, ready for corg92tionsn
—%06-1 Alan Check Deposit
Truss Calcs.
Called Contact Person UU gI Pllan Check Balance
Energy Calcs.
Plans picked up
I
� � /�% Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2"' Review, ready for correction ssu i
Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
'`" Review, ready for correctionssu Developer Impact Fee
Planning Approval
Called. Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
rm• LIS "fG
d� ra - i9 -off
• ��I -��ex►z �`�Zt�a .
CERTIFICATE OF COMPLIANCE 42�
��FIEOScyo
Desert Sands Unified School District
47950 Dune Palms Road Q BERMUDA DUNES O
RANCHO MIRAGE (�
Date 1/27/09 La Quinta, CA 92253 J INDIAN WELLS
Vi PALM DESERT ,y
No. 30290 (760) 771-8515 dJ, LA QU
�QIN®OTA
y7
Owner - GaryStark
APN # 658-250-039
Address 50025 Calle Rosarita
Jurisdiction La Quirta
City La Quinta Zip
Permit #
Tract #
No. of Units 1
Type Residential Addition
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 50025 Calle Rosarita 80 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilites for living, sleeping, cooking, 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 folloMng 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 80 S.F. or $0.00 � have been paid for the property listen 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 - Gary Stark Check No.
Name on the check Telephone 345-9711
Funding Exempt
BY Dr. Sharon P. McGehee
Superintendent ' 4 ..
Fee collected /exempt d by Shar Mc II rey w Payment Recd 50-00-71-71
^z,lver/Underti
Signature
o d
Fr
Lr �t
NOTICE: Pursuant to Government Code Section 66020(d)(1),this will rve o not il
notify you that 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 whic 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 Districts) behalf, whichever is earlier.
NOTICE: This Document NOT VALID without embossed seal
Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting
_
1
Dec¢mber 1. 2065 ,
Scott Bohannon
Re:
Aichitectural Variance / 5.()-025 Ca -He Rosatita
' Dear'Nir• Bohannon; '
Your architectural request dated November 13, 2008 tor'th.'atriuni enclosure, and the skylight installation has •'
been approved with the following stipuiatioris' 1
•
A $500 refundable deposit trust be submitted with the Application.
•
In order to guarantee imiformity and'continuance of "' e`ristin9'w9rranties held by the Association the work
must be performed. by the Asiociation'. i Rooting Contractor; Western Pacific Rooflng (760) 416-5877.
•
If the Owner chooses not to use:thz Associatiozi's,R.00fing Cdntiucior, the Owner is responsible for the service
inspection fee, atter the roof modification is corapl'eted_., ` ' r
•
Additional roof area .rill be assessed a one-tiinc4fet of $5 per,SQuace foot or fractiolt thereof, l -or the new
roofarea, due and (aysble upon approval, Please se 6.d 'o vour;clieck`in the amount of $360, payable to ,
Seats Kusa Cove HOA;a
'
Owner must provide a rr:•inen 5 -year guivantee covering tIlt n, -'W roof aita`and drat portion of die old roof
+
within 6 feet of theluriLmon with the new.
.. , •
All roof leaks within that -area of the roof within the 5 year period wi-il be the sole Financia, respolisibility of the
Owner granted approval;' His/her assign or successor O%w.er(s). Said written guarantee must t:e delivered upon
approval of the application, After the original guarantee has expired the maintenance of this additional roof will
become the responsibility of,the,Associarion.
a
Skylight installationsit6d. maintenance will be at the sole financial responsibility, of the Owner.
•
Actual modification inuat conforntto the plons and specpications submitted and approved.
-!F
•
It r
Ccinpatent and hcens�ed,protes torials .:hall iso alk.work iwa w�rkrnanlike manner,
'All
work is to be it, compliticc with local buliding codes std ord»lances. 1
•
All exterior stuccowc+rk must be p'ainteo1oimatch existing,szti o (Vista Paint Vista #33 Off Waite, Weather ,
Masterj, � .,
•
All- electrical wiring, if _applicable, miisY be contained within approved conduit painted to :Hatch the surface it
contacts. ^ i, ,
•
Any damage tp the common area resulting from this modification. and its construction shall be repa,--d'�E'the
Owner's expense. !
' e _
'if a construction bin is rented tllroiigii Bturtec It must be beige in. color and stored, if posvible., in the garage. The
t
construction bin trust be kept locked. All construction debris is tole removed from the site by the close of egCh "
day to maintain order"and retain the aesthetics Of the Santa Rosa Cove.
•
Prior to the commencement of any wort: the contractor and their subcontractor(s) must the Association
provide
proof of worker's comp, liability and auto insurance; naming rhe Association as additionally imured r
•
Prior to the commencementlof any work you or your contractor .must .provide the names of -the scheduled
workmen to the security guai-cis at the Mazatlan gate. (564-5414). w
•• - .
moi'!.. ,` • J '.1 � ..
•
.. r ]' 1 • • .. •
Architecuiral Variance -• Bohannon
Page 2
• Prior to the commencement of any work your contractor. must read anal. sign the .Association's Contractor Rules,
which has been supplied to them,
Please contact the Association office once your modifications are complete for a final inspection. A copy of the
approved variance will be mailed to you after the inspection. if you have any questions, please call.
Vary truly yo 1
Christina Enriquez
Association Manager
On Behalf of the Architectural Cotnmiftr
THE SANTA ROSA COVE ASSOCIATION
49^991 Eisenhpwer Ari,e
rs quanta. i:allbMia 922.,3
760) 777-ib2L
RIX' i'•60) 777+1622
4
'
Architecuiral Variance -• Bohannon
Page 2
• Prior to the commencement of any work your contractor. must read anal. sign the .Association's Contractor Rules,
which has been supplied to them,
Please contact the Association office once your modifications are complete for a final inspection. A copy of the
approved variance will be mailed to you after the inspection. if you have any questions, please call.
Vary truly yo 1
Christina Enriquez
Association Manager
On Behalf of the Architectural Cotnmiftr
THE SANTA ROSA COVE ASSOCIATION
49^991 Eisenhpwer Ari,e
rs quanta. i:allbMia 922.,3
760) 777-ib2L
RIX' i'•60) 777+1622
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 5 CF -IR
Proj Titl� Q, 1 r ,
Date t-7-01
r7.O1
Building Permit N
Project Address150CZ50 CML5C�iz ! A
CA�
Plan Check .' Date
tP506W011-c'-Niat SaV�
T
2;3 ""S863
Field Check /Date
Complia d re pti
Climate Zone '
Enforcemed Agency Use Only
Alternative Component Package Method: (check one) C %L D D (Alterative)
• Package C and Package D choices require HERS rater field verification and/or diagnostic testing (;ee CF -1R page 3)
• For Package D Alternative see Appendix B Table 151-C Footnotes 8-14 in the Residential Compliance Manual (RCM)
GENERAL INFORMATI N
Total Conditioned Floor Area (CFA) ft'
Average Ceiling Height: ft
CITY OF LA QUINTA
0� BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
Cheek Applicable Boxes
Building Type: (check one or more) Single Family Mullifamily_x
(If adding fenestration fill -out WS4R, Fenestration Maximum Allowed Area N
for Additions and 8.3.3 for Alterations in the RCM.)
• Maximum Allowed Total Fenestration Area 5-0 ft' (from WSAR)
• Maximum Allowed West Facing Fenestration Area K ft' (from WS -4R)
• Number of Stories: Number of Dwelling Units:
• Floor Construction T au loor (circle one or both)
• Front Orientation: North / So tl East West : All Orientations (input front orientittion in degrees
from True North and circle one).
t RADIABARRIER (check box if reouiredin climate zones 2, 4,8-15)
OPAQUE SURFACES INCLUDING OPAQUE DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge,
Doors)
Frame
Type
(Wood or
Metal)
Cavity
Insulation
R -Value
Assembly U -
factor (for wood,
Continuous metal frame and
Insulation mass
R -Value assemblies)'__Reference
Joint
Appcndix
IV
Roof Radiant
Barrier
Installed'
Yes or No
Location
Comments
(attic, garage,
typical,cte.
VVLKJU
.-
_.
1) See Joint Appendix IV in Section TV.2, TV.3, and IVA, which is the basis for the U -factor crrtenon. L -tactors can not excee(l
prescriptive value to show equivalence to R -values.
2) This column is for the Inspector to verify installation of roof radiant barrier.
Residential Compliance P'onns December 2005
FE='FSrRATION PRODUCTS - U -FACTOR AND SHGC
✓ [3 FENESTRATION MAXIMUM ALLOWED AREA WORKSHEET WS -4R - must be included for New
rnnctnintinn Additions_ and Alterations.
Fenestration
#/fype/Pos. (Front,
Left, Rear, Right,
Skylight)N,
Orien-.
talion, Area U -factor
S, E, W' W U -factor' Source'
Exterior
Shading/Overhangs" 7
SHGC ✓ box if WS -3R is
SHGC° Sources included
13❑
s '
13'T
LA t7wi
❑
13
13
1) Skylights are now included in West -facing fenestration area if the skylights are tilted to the west or tilted in any direction when
the pitch is less than 1:12. See §151(f)3C and in Section 3.2.3 of the Residential Manual.
2) Enter values in this column from either NFRC Certified Label or from Standards Default Table 116-A.
-3) Indicate source either from NERC or Table 116-A,
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 NERC, Table 116B or WS -3R
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 Distribution Duct or Pi Thermostat Configuration
fuType and Capacity Efficiency Type and Location p' e
macc, heat m boiler, etc. AFUE or HSPF) duals. attic, etc. R -Value T s „t �
Cooling Equipment
Type and Capacity
(A/C, heat pump, evap.
coo .
Minimum
Efficiency Distribution
(SEER or Type and Location
EER) (ducts aai eta
Duct or Piping Thermostat Configuration
R -Valu Type ftlit or package)
s '
Residential Compliance Forms December 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 3 of.5) CF -1R
Prnippi-N dlv I Dale
- r .
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -4R Form must be provided to the building department for each home for which the following are required.
❑ 1 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)
Installer testing 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
verification required.) _
❑ IAlternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Packag: Features for
Project Climate Zone in the RM Appendix B Table 151-0, Footnotes 7-14.
No ducts installed.
❑ New ducts from existing space conditioning equipment, not exceeding 40ft. in len
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.
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
F_7-1
❑
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per dwelling
Rated
Input'
(kW or
BtlAr(gallons)
unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recireulatioa system is not allowed.
Tank
External
Standby Insulation
Loss % R -Value
Check box when using Preapproved Alternative Water Heating table, 'fable 5-4 in Chapter 5 is the Residential
❑
Manual. No water heating calculations are required, and the .system complies automatically.
Check box if system does not meet criteria of "Standard" .system, and does not comply with the Preapproved
0
Alternative Water Heating table. In this case, the Performance Method must be used and mus:. be included in the
:Stndby'
submittal.
❑
Check box to verify that a time control is required for a recirculating stem pump fora system serving multiple units
CvetPma sprvina cinolr• dwellino unite tGp RM Tohlr 4;-A AItPTAfiVP. WAtP.f NPA}Ie0 CVQiP.mC fnr nrIMJl+Afinn re(IIIlrementcl
Water Heater
Type/Fuel Type
Distribution Number
Type
Rated
Input'
(kW or
BtlAr(gallons)
Energy
Tank Factor or
Capacity Thermal
Efficiency
Tank
External
Standby Insulation
Loss % R -Value
Tank
Input'
Tank
FactorT os
:Stndby'
External
Water Heater Distribution
Number
(kW or
Capacity
Thermal
Insulation
T T
in S stem
%vctem cervinp multinle dwellino unite (Cee Reaidantial Manual Secticm 5111
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 % inches or greater in diameter shall be thermally insulated as specified by Section 150-0) 2 A or 150 6) 2 B,
Residential Compliance Forms December 2005
Rated
Enerty
Tank
Input'
Tank
FactorT os
:Stndby'
External
Water Heater Distribution
Number
(kW or
Capacity
Thermal
Insulation
T T
in S stem
Btu/trc
attens
Efficienci
ss
R -Value
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 % inches or greater in diameter shall be thermally insulated as specified by Section 150-0) 2 A or 150 6) 2 B,
Residential Compliance Forms December 2005
I CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 4 of 5) CF -IR I
Date
Indicate which special features are parts of this project. The list below only represents special features relevant to the prescriptive method.
(Check Annlicahle boxesl
Category
Building Official
Verification of
Special Features
HERS Rater
Verification
HERS Rater
Diagnostic
Testing
Measure
Duets
❑
Y
100% of ducts in crawispace/basement
❑
Y
Buried ducts
❑
Y
Diagnostic supply duct location, surface area, anc R -value
❑
Y
Duct increased R -value
❑
Y
Duct leakage
❑
Y
Ducts in attic with radiant barriers
❑
Y
Less than 12 ft. of duct outside conditioned space,
❑
Y
Non-standard duct location
❑
Y
Supply registers within two ft of floor
Envelope
❑
Y
Air retarding wrap
❑
Y
Cod roof
❑
Y
Exterior shades
❑
Y
High thermal mass
❑
Y
Inter -zone ventilation
❑
Y
Metal framed walls
❑
Y
Nan-defauh vent freights
❑
Y
Quality insulation installation
Y
Radiant barrier
❑
Y
Reduced infiltration (blower door). May also require mechanical ventilation.
❑
Y
Solar gain targeting (for surspaoes)
❑
Y
Subspace with interzone surfaces
❑
Y
Vent area greater than 10%
HVAC Equipment
❑
Y
Adequate air flow
❑
Y
Air conditioner size
❑
Y
Air handler fan power
❑
Y
High EER
❑
Y
Hydronic heating systems
❑
Y
Mechanical ventilation
❑
Y
Refrigerant charge
❑
Y
Thermostatic expansion valve JXV)
❑
Y
Zonal control
Water Heater
❑
Y
Combined hydronic
❑
Y
High EF for existing water heaters
❑
Y
Non-NAECA water heater
❑
Y
Non-standard water heaters (whlunit)
❑
Y
Water heater distribution, credits
Residential Compliance Forms December 100.5
CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 5 of 5) CF -IR
Project Titl 4o� Date (-7-0c7
Special Remarks
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.
DesiLyner or Owner (ver Business and Professions Code) Documentation Author
Name 1-A U IV E. L
Name. VIP C -U [ O
1 IN
Title/Firm: E
Titla/Firm: I&RZOC —
Address: I
CE
Address 90t3 SvL gi�
YcMOO Lc9 c
fele e: ?60 — 2 -.
Telephone:
Incense
License k: (if a9ele) �—
( Z
(signature)
(date)
(signature)
(date)
infnrsppm.-nt AnPnev %.-
Name:
Title
Agency:
Telephone:
(signature / stamp) —
Residential Compliance Forms
December 2005
FENESTRATION - MAXIMUM ALLOWED AREA WORKSHEET WS -4R
Project TitleeeA S44 00l � I Date Q
t_-7-0 I
FENESTRATION PRODUCTS - NEW CONSTRUCTION- NEW BUILDINGS
"on this tahi. fnr .— h,,ilrline nnnetnmtinn to acrnnnt fnr Ental hnildina a/, of fenestratinn.
A B
C
D
E
F
G
#/Type/Pos.
(Front, Left,
Rear, Right,
Skylight) Orientation
'Total
Fenestration,
West Facing
Area(ft')
Total Fenestration for
N, S, E Orientations
Area ft2
CFA ftZ)
Total Percen_ of
West Facing
Fenestratioal
(C/E) x LOC%
Total % of
FenestrationZ
Including West
/E x 100% + F
North
Total Area
I
Total a/a of
(Front, Left,
Existing
Area
South
Addition's
East
Added
West
Fenestra -
Rear, Right,
Orienta-
Addition's
Totals
make way for
Fenestrations
Feneslation2
tion 3� ],
Skylight)
1) If west facing area exceeds 5% of CFA in climate zones 2, 4, and 7-15, the performance approach must be used.
2) If total percent of fenestration exceeds 20% including West facing orientations then performance approach must be used. West facing area includes
skylights tilted to the west or tilted in any direction when the pitch is less than 1:12 for Package D only.
FENESTRATION PRODUCTS — NEW CONSTRUCTION- ADDITIONS
✓ ❑Less than 100 f?. ❑ Less than or Eaual to 1000 f . ❑ Greater 1000 fe
A
B
C
D
E
F
C
H
#rTvpe/Pos.
D
E
Proposed
Fenestration
Total Area
I
Total a/a of
(Front, Left,
Existing
Area
Proposed
Addition's
Area Removed to
Added
Total a/o of West Facing
Fenestra -
Rear, Right,
Orienta-
Addition's
Fenestration
make way for
Fenestrations
Feneslation2
tion 3� ],
Skylight)
tion
CFA -2,'
Area (ftp)°
Addition (ft'
D - E)
(G/C) x.100%
FIC x 100%
North
East
East
East
South
West
East
West
West
West
Total
Total
--�� I) Additions 5100 sf are allowed to install_ wn rn S J of fenestretion end are exempt from the 5% west facing and 200/'o maximum total area
limits and shall meet the U -factor and SHGC requirements of Package D. See Table 8-2 in the Residential Man-aal. Note: Leave columns E, F,
G, H, and I blank.
2) Additions =1,000 ft', the maximum net allowed fenestration is 20% and may be increased additionally to by the mnount of glazing removed in
the wall that separates the addition from the existing house. However, the total West facing fenestration can not:exceed 5% of the proposed
addition's CFA including skylights orientated in any direction and tilted with a pitch of < 1:12. Column G can not exceed 5% and Column 11 can
not exceed 20%.
3) Additions >1,000 W, must mcet Package D requirements. See Table 8-2 and Table 151-C in Appendix B of the 2M or use Performance Approach.
4) The 5%west orientation restrictions are only for Climate zones 2, 4, and 7-15; fir Climate 7cnes 2, 4 and 7-15 anter zero (0) in column E.
FENESTRATION
PRODUCTS:
for alterations to an existin
ALTERATIONS
build' where fenestrations
roducts windows are beinA
removed and/or added.
Use this table
A
B
C
D
E
F
G
H
I
Existing
CFA
(ft?)
Existing
Orientation(ft)
Existing
Area
Removed
Orientation
Removed
Area
ft2
Proposed
Installed
Orientation
Proposed
Installed
New Area
(ft2)
Total Net
Fenestration
(ft2)
(C-E+G
Total ono of
Fenestra-tionn,2
(H/A) x 100%
Max of 20%
North
North
North
South
South
South
East
East
East
West
West
West
Total
Total
Total
1) When 50 fe or more of fenestration area is added to an existing building, then the fenestration must meet the requirements of Package D.
2) The area requirement for the total fenestration area for the whole building, including the added fenestration, must not exceed 20%.
Otherwise, the Performance Approach must be used. See Section 8.3.3 in the RM for further details.
Residential Compliance Forms December 2005
,MANDATORY MEASURES SUMMARY: RESIDENTIAL (Page 1 of 2) MF -IR
Project Title' ' w N , , + , t Date L ^ 7 ,..�
C'j7�t P}{J'ty ^CJ
Note: Low-rise residential buildings subject to the Standards must contain these measures regardless of the eomplian-w approach used. More
stringent compliance requirements from the Certificate of Compliance supersede the items marked with an asterisk (0) below. When this
checklist is incorporated into the permit documents, the features 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: Cheek or initial applicable boxes or check NA if not applicable and included with the pernLt application
documentation.
DESCRIPTION
NA
Des ner
Enforce
-meet
Building Envelope Measures:
:
✓
V,
§150(a): Minimum 9 in wood frame ceiling insulation or equivalent U -factor in metal frame ceiling.
❑
W
❑
§150(b): Loose fill insulation manufacturer's labeled R-Valuc: Il&❑
,Q
❑
s §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).
An
❑
[3to
§150(d): Minimum R-13 raised floor insulation in framed floors or equivalent U-factur.
JV
❑
❑
§150(c): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs.
1. Masonry and fautury-built fireplaces have:
a. closeable metal or glass door covering the entire opening of the firebox
yy
❑
❑
b. outside air intake with damper and control, flue damper and control
❑
❑
2. No continuous burning gas pilot lights allowed.
❑
❑
§150(f): Air retarding wrap installed to comply with §151 meets requirements specified in the ACM Residential Manual.
❑
❑
§150(g): Vapor harriers mandatory in Climate Zones 14 and 16 only.
❑
❑
§150(1): Slab edge insulation - water absorption rate for the insulation material alone without facings no greater than 0.3%,
water vapor permzanre rate no Rmtcr than 2.0 Pcriniinoh.
Y
❑
❑
§118: Insulation specified or installed meets insulation installation quality standards. Indicate type and include CFVR'
Form:
❑
❑
§116-§117: Fenestration Products, Exterior Doors, and Infiltration/Exfiltration Controls.
1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage.
t�
,�
❑
2. Fenestration products (except field-fabrieatod) have label with certified U-faotor, ocrtified Solar Heat Clain❑
Coefficient SHC and infiltration certification.
3. Exterior doors and windows weather-stripped; all joints and penetrations caulked and scaled.
❑
❑
Space Conditioning, Water Heating and Plumbing System Measures:
§110-§113: HVAC equipment, water heaters, showerheads and faucets certified by the Energy Commission. ❑ ❑
§150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA or RCCA. ❑ ❑
§150(i): Setback thermostat on all applicable heating and/or cooling systems. ❑ ❑
§1506): Water system pipe and tank insulation and cooling systems line insulation.
1. Storage gas water heaters rated with an Energy Factor less than 0.58 must be externally wrapped with insulation
havinR an installed thermal resistance of R-12 or greater.
❑
❑
2. Beak -up tanks for solar system, unfired storage tacks, or other indirect hot water tanks have R-12 external insulation or jx
internal insulation and indicated on the exterior of the tank showingthe R -value. T
E3
13R-16
3. The following piping is insulated according to Table 150 -AB or Equation 150-A Insulation Thickness:
1. First 5 feet of hot and cold water pipes closest to water heater tails, non-reciruulating systems, and entire length
of recirculating sections of hot water pipes shall be insulated to Table 150B.
❑
❑
2. Cooling system piping (auction, chilled water, or brine lines piping insulated between heating source and
indirect hot water tank shall be insulated to Table 150-8 and Equation 150-A.
❑
❑
4. Steam hydromic heating systems or hot water systems >15 psi, meet requirements of Tabtc 123-A.
IT
❑
❑
Residential Compliance Forms December 2005
MANDATORY MEASURES SUMMARY: RESIDENTIAL Page 2 of 2 MF -IR
DESCRIPTION
Enforce -
INA
Deskner went
Space Conditioning, Water Heating and Plumbing System Measures: continued
✓
✓ ✓
5. Insulation must be protected Som damage, inchtding that due to sunlight, moisture, equipment maintenance, and wind.
❑ ❑
6. Insulation for chilled water piping and refrigerant auction piping includes a vapor retardant or is enclosed entirely in
�r
1�
El 1:3conditioned
e.
7. Solar water -heating systems/collectors are certified by the Solar Rating and Certification Corporation.
❑ ❑
§150(m): Ducts and Fans
1. All ducts and plenums installed, sealed and insulated to meet the requaemem of the CMC Sermons 601, 602, 603, 604, 605
and Standard 6-5; supply -aur and rchuo-air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed
entirely in conditioned space. Openings shag be sealed with mastic, tape or other ductolosure system that meets the
❑
❑
applicable requirements of UL 181, UL 181 A, or UL 181 B or aerosol sealant that meets the requirements of UL 723. If
'T
mastic or tam is used to seal openings greater 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 dcfmcd or constructed with materials other than
sealed shoot metal, duel board or flexible duct shall not be used for conveying conditioned air. Building cavities and
[3
13support
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 dual tapes
®
13
13unless
such to is used in combination with mastic and draw bands.
4. Exhaust fan systems have back draft or automatic dampers.
Iff
❑
�❑
5. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated
pl
13
dampers.[3
�-+
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 coaling that is water
❑
❑
retardant and provides shielding from solar radiation that can cause degradation of the material.
7. Flexible ducts uarmot have porous inner cares.
❑
❑
§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
13
13heater
weatherproof instruetione no electric resistance heatingand no pilot li t.
2. System is installed with:
a. at least 36" of pipe between filter and heater for future solar heating ❑
b. cover for outdoor pools or outdoor spas ❑ ❑
3. Pool system has directional inlets and a circulation pump time switch. Ea ❑ --❑
§ 115: Gas fired fan -type central furnaces, pool heaters, spa heaters or household cooking appliances have no continuously ❑ 13burnin
'on:
ilot light. Non -electrical 000kin is noes with pilot < 150 Btu/hr
§118(i): Cool Roof material meets specified criteria ❑ ❑
Resldentiai Lighting Measures:
§150(k)l : HIGH EFFICACY LUMINAIRES OTHER THAN OUTDOOR HID: contain only high efficacy lamps as
outlined in Table 150-0, and do not contain a medium screw base socket (E24/E26). Ballast for lamps 13 watts or greater
❑,
are electronic and have an output frequency no less than 20 kHz
§150(k)l: HIGH EFFICACY LUMINAIRES - OUTDOOR HID: contain only high efficacy lamps as outlined in Table
❑
13150-C,
luminaire has foot installed HID ballast
§150(k)2: Permanently installed luminaires in kitchens shall be high efficacy h►mmaees. Up to 50 percent of the wattage, as
determined in § 130 (e Js of permanently installed luminaires in kitchens may be in lumineircs that ars not high efficacy
b
Al13
❑
luminaires, provided that these luminaires are controlled by switches separate from those controlling the high efficacy
luminaires.
§150(k).3: Permanently installed luminaires in ba8nrooms, garages, laundry rooms and utility rooms &hall be high efficacy i
luminaires. OR arc controlled by an occupant sensor(s) wed to Section 119(d)
ki
comply with that does not tum on
❑
❑
automatic -ally or have an always on option.
§150(k)4: Permanently installed luminaires located other than in kitchen, bathrooms, garages, laundry rooms, and utility
rooms shall be high efficacy luminaires (except closets less than 70fti): OR are controlled by a dimmer switch OR are
13
13controlled
by an occupant sensor that complies with Section 119(d) that does not turn on automatically or have an always
on option.
§150(k)5: Luminaires that are recessed into insulated ceilings are approved for zero ctcaranoc insulation cover (IC) and azo
'
91
13
13octtified
t to ASTM E293 and labeled as air li t A to less than 2.0 CFM at 75 Pascals.
§I50(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 fighting around swimming pools/water features or other..rf
ICJ
❑
❑
Article 680 locations) OR are controlled by occupant sensors with integral photo control certified to comply with Section
119(d).
§150(k)7: Lighting for parking lots for 8 or more vehicles shall have lighting that complies with Sec. 130, 132, and 147.
❑
❑
Lilthtinst for oarldnit ftarages for 8 or mare vehicles shall have hAting that empties with Sec. 130 131 and 146.
§ I50(k)l: 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
❑
❑
Section 11 d
Residential Compliance Forms December 2005