06499 (SFD)Building 78—"0
Address
Tam Yaru
4
P.O. BOX 1504 No. 06499
78.105 CALLE ESTADO
naro LA QUINTA, CALIFORNIA 92253
Address 72»935 Amber Dr.
City Zip Tel.
Palm pert 92260
Contractor
Same
Address
State Lic. I City
& Classif. 450429 Lic. #
Arch., Engr.,
Designer
Address Tel.
City IZip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
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' �' i,,.�_.�- j �.� r { ) • , +�'f
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,131us ness and Professions Code: Any city or county which requires a
permit to construct, ager, reprove, demolish, or repair any structure, pdor to its issuance also
requires the applicant for such perms to Me a signed statement that he is licensed pursuant to
the provisions of the Contractors License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the gess and Professions Code, or that. he 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 crvit penalry of nat more than rive 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, Suisness and
Professions Code: The Contractors License law does not apply to an owner of property who
builds or Improves thereon acrd who does such work himself or through his own employees,
provided that such inproverments 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 riot build or krprove for the purpose of sale.)
❑ 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.)
❑ 1 am exempt under Sec_ B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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 ($100) valuation
or less.)
1 certify that in the performance of the work for which this permit is issued, 1 shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT: 11, after making this Certificate of Exemption you should become
subject to the Workers' Corrpensation provisions of the Labor Code, you must forthwith
comply with such prorsbns Of Orfs permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY .
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
LDING: TYPE CONST: OCC: GRP.
Number 617-382-033
Legal Description
Project Description SFD
REMARKSl.i'7lC'F�1
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INN)PEEClT$O�R
Issued by: Date Permit
Validated by:
Validation:
Sq. Ft.1r3 A
Size
No.
« Stories
No. Dw.
Units.
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
$88,109
PERMIT
AMOUNT
Plan Chk. Dep.
�a25t?.Qi
Plan Chk. Bal.
$ 249.23
Const.
585.50
Mech.
53.50
Electrical
111.40
Plumbing
157.50
S.M.I.
6.16
Grading
20.00
Driveway Enc.
20.00
Infrastructure,,77
1,944.20i?.20
Ft lu ye- oe d 1.1zand
6b.88
TOTAL
; A t f^, 7 J
REMARKSl.i'7lC'F�1
ZONE: BY:
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 INN)PEEClT$O�R
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. I ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
LOLL. AREA
SLAB GRADE 123
YARD SPKLR SYSTEM
2ND FL SO. FT. ®
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. SO. FT. ®
GROUT
DRINKING FOUNTAIN.
WALL SO. FT.
FINAL INSP.
BOND BEAM
URINAL
SO. FT. @
GRADING
cu. yd.
$ plus x$
-$
ESTIMATED CONSTRUCTION VALUATION $
FRAMING //a `! 9
WATER PIPING
NOTE: Not to be used as property tax valuation
0x/�
/!p'Dr 16!
FLOOR DRAIN
MECHANICAL FEES
REMARKS:
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
MESH
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
GRADING
SO.FT.GAR ® 3/Jc
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 !/ , D 8
ROUND PLUMBIN `
UNDERGROUND
A.C. UNIT
LOLL. AREA
SLAB GRADE 123
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
/ 9O SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
!
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP.
GRADING
cu. yd.
$ plus x$
-$
LUMBER GR.
FRAMING //a `! 9
ROOFING.4i / /J
Q
0x/�
/!p'Dr 16!
9j� , '/�(/{
b�
16'
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATH I NG 'f & VA/
MESH
/7
INSULATIONISOUNDFINISH
GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
I 4W
x P.O. Box 1504 APPLICATION ONLY
- 7&105 CALLE ESTADO
Building
Address / V %Jfn�1�+ OUINTA, CALIFORNIA 92253
i
gity Zip TeL
C.. '*177A At Lo�
Address
ct � & J
Ci {Zip
State Lic. ICA
& Classif `^)
Arch., Engr.,
Designer U V"�G
Lic. #
Proji
.DING:PE CONST. S �, OCC. GRP.
Number 7 'S
I Description iEd'23 DPCP2l 614 w-, A)o .!J
Ict Description rl P %A-
I/a'A !o 6.9,E
Sq. Ft. No. No. Dw.
Size o ` .Stories Units
New k3 Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address_ � ' �1 � t
G )
Tel.
Ci Zip,,, a � _
`�
State
Lic.
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) Division 3 of the Business and Professions Code, and my license Is in full force a
Mill= _moi
SIGNA DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the-Corhtractoes License Law for the following
reason (Sec. 7031.5.8usrress and Professions Code: Any'cify.or county *Idch requires a
pend to construct. -alley, 7nprave. demoM. or repair any structure. prior to Its issuance also
requires Me me appilmd for such permit to Ms'a sighed statement that he Is acensed-pursumd to
Me provision of me Contractor's License law. Chapter 9 (canmencirrg with Section 7000) of
e 3Professions of �3yet�apmroemfor Me� Business .An vloianan Sectionor 701s exempttherefrom, the basis
subjects me apptieant to a chf penally of not more man Ove hundred doaws ($500).
❑ 1; as owner the property, ourny. employees.with wages as-their.sole compensatioN.wUl_ _.
do the worlu, and the structure is not InterWW or offered for sale. (Sec. 7044, Bulsness and
Professions Cade. The Contractors License Law does not appy to an owner of property who
Ix its or improves thereon--aW who does.-suchwrk himself or mrougn Ns.own.mrployees,.-..
provided met such hprovements are not intended or offered for sale. N, however, me bidM
or Improvement is sold within one year of canpation, the owner -builder wM have me burden
of proving that he did not bid ork prove for the purpose o/
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con
struct the project (Sec. 7044, Busiess and Professions Code: The Contractors License Law
does not apply to an owner of property who builds or irpoves thereon. and who contracts for
such projects with a contractors) licensed pursued to me Contractor's License Law.)
❑ 1 am exempt under Sem r & P.C. for this reason
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
p. �O
plan Chit. Bal.
-
Const.
-- Mech.
Electrical
Plumbing
Grading
Driveway Enc.
Date owner
Infrastructure
)-
WORKERS' COMPENSATION DECLARATION
hereby affirm that I have a certificate of consent to self -Insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company
r Copy is filed with the city. ❑ Certified copy is hereby furnished.
/V
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
Rhtr section need not be completed 9 the perm Is for one hundred dollars ($100) valuation
orfass.)
1 certfiy that in the performance of ttV work for which this permit Is Issued, I shall not
of CaliperSon in any manner so. as to become subject to the Workers' Compensationtotals. -
Date_ ,Owner
NOTICE TO APPL)CANT. 9. after nab tats CerNhwe of Exemption you should become
apeu to the Norlrers' Compensation provisions of tie Labor Code. you mast forthwith
comply with such provisions or tis permit shelf be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work Tor which this permit Is Issued. (Sec. 3097, ChACode.)
Lender's 'Name
Lenders Address
This Is a.building permit when property filled out, signed and validated, and is subject to
expiration If work thereunder is suspended for 180 days.
1 certify that I have road this application and state that the above Information Is correct.
Zst:� CIIon, uto n with autryhorizeand representativesnntinances -of this state city to relating
to the above
mentioned property for Inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
REMARKS
S�SN i TOTAI 5 r% 00
ZONE BY:
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: _,4m,
I
SP'A'CE ABOVE THIS LINE FOR RECORDER'S USE
CORP:ORATIfON GRANT :.DEED
.Che undersigned grantor(s) declare (s) :.
Documentary transfer tax is a...:....I.�+.qQ.....
( XX computed on full value of property conveyed or,
( ) computed ,on full value less value of liens a &.encumbrances remaining at.. timeof sale: .
r 1 Unincorporated area: ( ).. City 'Of.; ...............:..:....,..:.:.::..`'.:.....::',............:.:..:.:...... sand
( ) Realty not sold. :••
.FOR A'VALUA-BLE>COI`'SIDERATION, receipt of which is hereby acknowledged,
FRIENDS OF THE CULTURAL CENTER`; INC., A CALIFORNIA NON-PROFIT
CORPORATION
a corporation organized tinder:'tlie laws'of the State of t~AL1F'OI2N1A---:--:- :--
hereby GRANTS to '
THOMAS C. YARU .and SUZANNE.'M -YARU;
husband and wife as communityproperty,.,.
the following described real_ property in the
County of Riverside State of California:
Parcel 1:
Lots 61, 72, 83; 94, 95, 105, 106, 117,. 118, ,119, 120 ,arid 124 of .DESERT CLUB MANOR
NO. 1, as shown by Map-o,n .file in; Book 2.2'. Page 53 of Maps,. Records of Riverside
County,_ California.
Parcel 2:
Lot 5 in Block 34 of SANTA CARIVIELIT'A ..A -T VALE -,LX QUINTA, .U.NIT NO. 2,'
in :the County of Riverside,. State of California,: as shown by Map on file in Book
18 Pages .55 and 56 of `Maps,: Records of Rlve;rside;County, California. `
Mail lax statements to.. ...............................
In Witness Whereof, said corporation hos cousecJ, its: co:rporote name and, seal to be offixed hereto and this
instrument to be executed by ils duly 'outhol ized officers.
Dated ... Decemb.ex-.2,.1986........ _______ FRIENDS, OF: THE. CULTURAL CENTER,
STATE OF CALINCI. A__CALIFOR:NIA NON-PROFIT
SS. CORPORATION
COUNTY OF ---• ................... ..._.......................... .............................. a Corporation
On this day of- I9
before me, the undersigned, a NotaryPublic in -and for said
.President
State, personally appeared --------------•--•---------•--••
-------------
personally known to me (or proved to me oil the basis. of Secretary
satisfactory evidence) to be the """"'"'""""'"""" ""`.............................................."
President, and
personally known to me (or proved to me on the basis`of:
satisfactory evidence) to be the
Secretary of the corporation that executed the within i istru
ment, and known tome to be. the persons who execuied.the
within. instrument on behalf of "the. corporation therein
named, and acknowledged' to mc.Ahat such -:corporation'.''
executed the same, pursuant to its by.laws;;or a.resolutton,of` :
its Board of Directors. .
WITNESS my hand and, official seal:
Signature
Notary Public In and FForSatd State (This area tor,ofticiai notoria! seal)
This form' furnishc8'by' Orange�Coast Title Company.of Riverside
i
RECEIPT NO. 15,?� - Issued By 5? Date
DISTRICT: ❑ Riverside, 1P Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records
4
COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH Assessors Parcel No.
ENVIRONMENTAL HEALTH SERVICES
PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM
Applicant: Submit this form with four copies of a scaled plot plan (1-20 scale) drawn to County speculations as indicated on the attached checklist.
A non-refundable filing fee (see below) is required when the application is submitted. Check must be made payable to the County of
Riverside. Approval of this application shall remain valid for a period not to exceed one year from date of approval.
Q
/��-•-
VERIFY ITEMS IN SECTION A FROM BUILDING & SAFETY APPLICATION BUILDING DEPARTMENT APPLICATION LOG #
Z,
O
Agent, Contra tor, Contact Person
�'
Phone
Address & Phone
14L-_!5-"
v�
4 & 2,q
Z—`I j e°.
UJ
U)
Owner ✓
(Qw� / d4�
Phone
Mailin Address
i �–� dam- kw -
city
State
Cc.
Zip
Job Property Address,(,)Legal
�
Description Prop. (PM, Tract, Lot)
�4ZdeI
v,..-,��
� o �
ai 1.3 Q sn-f CL
Lot Size
Agency eH.
Use of Permit P/P, CU etc.
Other
v ��� 6
U w�
91te etc.
7
1
Dwellings Prep,
Sign tura of Applicant
Date
CATEGORY: REV CODE FEECATEGORY:
REV CODE FEE
SUBSURFACE DISPOSAL 1238 �4'S'00 ��
17t '❑ SITE EVALUATION UPON REQUEST 7349 $42.00
❑ MULTIPLE PARCELS WITHIN SAME
(NO PLOT PLAN)
LAND DIVISION
❑ SEWER/SEPTIC VERIFICATION 7348 $11.00
Z
O
a. 1 st 4 Parcels (Each) 1238 $45.00
(Less than 1 year)
[~
b. Each Parcel after 4 7344 $16.00
❑ PRELIMINARY ELECTIVE 7352 $45.00
W
❑ Rereview (2nd review same parcel) 7344 $16.00
EVALUATION (Attach DOH SAN 53)
U)
❑ Site Evaluation in Conjunction with
❑ HOLDING TANK 7351 $45.00
Critical Area 7346 $86.00
❑ ALTERNATIVE/EXPERIMENTAL 7345 $132.00
❑ Site Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $86.00
No TS Z
Holding Tank Agreements Completed ❑ Yes A
Certification of Existing S.D. System Required ❑ Yes O No f
WQCB Clearance required. (Attach Form ❑ Yes ❑oNo
DOH SAN 007, Santa Ana Region Only)
Soils Percolation Report Required. ❑ Yes N
Special Feasibility Boring Report Required. ❑ Yes ❑,N/o,,-�
Detailed Contour Plot Plans Required (1 to 5 ft. interval) ❑ Yes Er Nom
Other ❑ Yes 10 NN:
Staff Specialist Lot Inspection Required ❑ Yes ;-No
Lot Inspection Date
Soils boring report by Project #,j Date
/f�if'�f �l `--' Date " Z r-6 L
Soils Map Page A I Soil Type Approved by
U
No. of Systems
Type of System(s)
No. Dwelling Units(
(1) Septic Tank
Soil Rate
'Ih ease/Sand
Z
❑ Holding Tank ❑ Existing
New
Bedroom9pFixtt9r Z7n tt
Grhe-ds tcp
O
8r ❑Replacement
1nM � �.
T ��
Id�
✓ln'sta1
16 Gal
Gal
LLI
(�2 % each Line Sq. Ft.
Botto
Sidewall allowance
Line(s) fL long ft wide with
Leach Bed sq. ft.
,trench area
ft rock/sq. ft.
per running ft.
�,
min. me low drainlines or
.o bottom area
Leachlines/bed special design for slope:
Applicable
(3) Pit Diameter
No. Pits
Pit13eTaw-
1Aleb(B4
Seepage Pit Total Dppth
�n
er:
Max. Allow�b� Depth
""s &'<<
N/A Overburden factor
Q
l
No. 2 System 11114A fes*
REMARK!E2Z,,�.4y r •m-. �l .�1 a,r-.
psi ,CLst�.0
�� I j�?
t1 //
This application i ROVED/D iDT6t7 for the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
on the accompanied plo plan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the
Z
above -designed system. No construction is permitted in the required reserved 100% expansio area.
(1 Septic tank and sewer lines must be 50' minimum from any wells f'�"��`�
u-
�(3
Leach lines must be 100' minimum from any wells, including expansion ora
Seepage pits must be/1/50' minimum from any wells,iricluding expansio
Signature of Health Officiali" Date
i
RECEIPT NO. 15,?� - Issued By 5? Date
DISTRICT: ❑ Riverside, 1P Indio ❑ Hemet ❑ Perris ❑ Rancho Calif. ❑ Blythe
DOH SAN 122 (Rev. 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept. GOLDENROD - Plans/Records
4
.• � •r• 'r't �:
PROJECT DATA SUMMARY
Form
1
.. .. .... owner ..
.-
*97
checked by
-_' system type i
date
-documentation-author. date
SITE INFORMATION
Heating Degr,ee'Day (from APpendiz C)R.._... ...:... ............ ..........
HOD:
1'
OF. day
<:'
Outside Design Temperature (fr6ni''Appendix C or Appendix Gl::..:................
.Td ,
2
°F
PROPOSED BUILD1NG ENVELOPE INFORMATION .
..
Gross Floor,Area if Low-Rise•(frdni Calculations) ...... ......... ................ A f
3
102
ft
Gross Wall.Area.if High -Rise: Calculations) ........:.........:.. A„„
.• ..
4 =
ft2
Designed Glazing Area (from Calculations( ................... .:. ................
A9
5`
ft2
Z
Basic Glazing Area (16%G bf Line if low-rise or 40%of:Llne 4 if high-rise)........
Ab9
6
-y ft2
' Description of Assembly
Glazing s
Ugi
7 ~
' , ' Btu/ (hr •ft2 •
F)
Ug2'.
8
Btu/ (hr.•ft2•OF)
a.
Ug3
`9,
Btu/.(hr.ft2 •°F)
, l
Wall Sr' � 1 " .%-3)WZ ` W`f�frL
`Uwl
10
(]
Sid a Btu/ (hr •ft2 -OF)
+`,
U11
w2
` Btu/(hr.ft2•OF)
;.
Uw3
12 -
Btu/ (hr .ft2 •°F)
2,
a
' Ceiling/Roof Y�\�- :Q\'
Uw4
lJc1
13 x - .. Btu/. (he ft; -
14' i-t� Z Btu/(hr•ft2•°F)
OF).
Uc2'
15
Btu/ (hr.ft2•°F)
Floor
Ufl
16.
Btu/ (hr • ft2 •
°F)
Uf2
'17
Btu/ (hr•ft2 •OF)
PROPOSED SPACE.HEATING SYSTEM (Chapter 7)
Gas Furnace
L9
Building Oesign.Houily Heat.Loss (from Form 2) .............. .............
qh
18
Btu/hr
Maximum Allowed.Bonnet Capacity, 1 .5 x Line 18
79
Btu/hr
Proposed furnace
-
Make
Modei'Descr ptlon
Rated Bonnet Capacity
Electric Resistance'Alone '
Elearic Resistance Life Cycie Cost (from Form 5), .....................:.............
sLCC'e
20
$
Lowest Life Cycle Cost of -the Other,Systernslfrom-Form 5) ..::.::............. sLCC$O„ 21
$
Non-Depletable Energy w/Eleetric`Resistance Balt -Up
Percentage of Annual Heat Loss Met by Non-Oepletabi'e Energy
Source (from Calculations) ................ .... `
..
22
%
Heat Pump
Percentage of. Annual Heat Loss Met -by Eleciic Resistance
(from Calculations)...,:..;..................................................:................................
23
%
.PROPOSED WATER HEATING SYSTEM INFORMATION (Chapter 8)
Electric Resistance Aloha ` .
Electric R"esisiance Life Cycle Cost (from Form 61l' ............ ::.'........ :.......... wLCCe.
24
$
Lowest Life Cycle Cost of the,Other Systems (from Form:6)................::
wLCCp; 25
$
PROPOSED SWIMMING POOL HEATING SYSTEM INFORMATION (Chapter 9)
Solar Life Cycle Cost (from::F.orm 7) 0.
pLCCs
'26
Natural Gat Life Cycle Costi(from Form 7) ............... ...:.. PLCCn 9
27
$
EUILDING D,ESI,GN AND EQUIPWENTSUMM-A,RY`"
M-3
irCjeC.-altte - cttmate zone
,protect acoreas ;
project owner
on autnor Cate -
N:C\
n..n Yn..c�n nrww'nr ^..r'tr manLi AESLrinek
Fol m 2
page 1 of 2
plamcneck/permat numem
. ,CneCkeC 0Y
Cate
Enforcement Agency -Use Only
BUILDINGB`I`DE! ir' DeSiGI-4 Description of Item, Dimension
Points
fts
Total Floor Area
1v a `' F,,
n
1. Floor Siao Perimeter, Type 1
Ty 2
Type 1 ' .�'IZt� C'►7T O� AT_�C
- Fj
. Dino
1 S
ft
4
Type'2C �.1 �> C'� ��y�1K._
fts
-� l cam' J
f
O
2.' Ceiling: Typo 1 _
I
Type 2 nn ,
1
fts
Wall: 1 "l. .SV`
3Type
fts '
:0
Type 2
fts
4. Glazing: We Type T S �C,(L1-T ,
\ %
Sit.
TYPe 2
North'. Type l 7A -
`'%
Type 2fe
s
East, Type J _
2'.Z -fir e
Type 2
South, Type -_� �-lr P i. �.
%
• 1" '�%_
h:
ft.
I '
Ty Re
9:
`
fts
.2
Skylight; Type 1
_SC `
hs
N .
Type 2
SC
ft,
�-C?
SC
Sc
" 2
S. _ Shading Coefficient. West
Sc
6
North
SC
South
_'TrZ
Sc
O
ft
6. Horizontal. South Overhang'
.7. Movable Insulation
g; fts
STA kJDAvuo-
�y
-- T
8, Infiltration Control
''9. Thermal 'Mass:. . Type 1 `f t ilk _ atL.Ql
5 , '3 I Q�
ft=
I
_R
TYPe
.q
NG.—�dG
t� `SG
fts
fts
3
Typs 3; .,
l NC, v TY pe 4. —R
—)4G _ MC
fts_
TYPe 5
_•�n�• .y \ .3
Point Total,This Page
1183 : 420 — CEC
284-66 (2/83-)
- - - oralm:z.aaurvar -
HEATING, VENT] LAT1NG; AIR GCNGITIO'NING SYST_M
10. Heating (fill in information on proposed system)
Central Gas Fumaca
orana:ana
moeet'numoer .
• SE
Btu/hr
:
nearing caoauti''
L.2-" z)
65�'�
Z
Heat Pump
brana ana:mccevnunoer
ACOP
LA., Ij; .
Btu /hr
mating opacity -at 47-;-
Active Solar
.ty0e (Ifauia or air) 7
cO11GCOr wand ano model number Solar fraction
fta .
o
collector area collector orientation- -' collector
tilt rated,' - ratea slope
'•
y -Intercept
Other
' describe
11. Cooing (fill in information on proposed. system),
Electric Air-Canditione r'
craiio-ano maael number seasonal EER
a /hr.
Stu
cabling caoltY acat 9 . F '
Electric Heat Pump $ �� �• S'
�i't� Btu
/hr
cooling. cibautY°at 95- F
Other
describe - .
12. Mechanical VentilationACH
DOMESTIC WATER SYSTEM
13. Heating (fill in information an proposed system) :
Gas Only 75 Gallons
brana ana`moaet number. tank size
Heat Pump w/Electric Backup 1-- T«"'i' Gallons
branwano moaet number. tantt`slze-
Active Solar,
cauector brand ana model numoer'�nterceateo rates stone• solar fraction
y ot •.
fta•
"oacxup neateraype. orana anG'maaeli`number•r:cdo eac" area collector
orientation
Other
Point Total .from Page 1.
Total -Point Score
1/83 - 420 - CEC
Points
x
HOURLY AND -ANNUAL Q ret
BUILDING HEATIOSS RATE (8/81)
Check One: Proposed Design'''
StanAdaid;'tD�esign//
_Enfore.rnent Agency Use Only
Owner project -Dui oing Permit numoer
. .:
LA
project location Sy Slam type vlecKeo By
oocumen:auon: autnor - ' nate- Gate
SITE INFORMATION
Heating.Degree Day (from Appendix) . .... . FI00 I Z�S Z:F•day
Outside Oesigh Temperature.(from Appendix)- ......... .. ... To OF:
oF:
Outside January Mean Temperature (from Appendix)-. ....: :....... Tian
,.,
PROPOSED BUILDING ENVELOPE -INFORMATION'
. I ft2 .
Gross Floor -Area (from plans). ..... ... ... .. Af:
1 4 Z ft2
Greta Wall Ar.ajfrom plans) Aw
Designed Glazing Area (from, plans) ` A9i. f,2'
Basic Glazif9Ares (1$% of Atif low-rise or'40% of a.n'if hi hise)Zy ft2
HOURLY HEAT
'LOSS
DESIGN TEMPERATURE DIFFERENCE' r
0
For All Assemblies Other Than The Three Below ..7e- F. of AT6 . 1;' F
To, from an6we ...:
For Insulated Floor Over.-VentedUnheated Space .:.. Lina l'-:- .Z .��Thi 2 (� F
V o
For Uninsulated Floor Over Vented Unheated Space.:. Line 2 - 5'F ��The 3 F
For Slab -on Ground Floors ... . iOoF �y oo
F OThs 4 I f
. - TJan:"from.aoove: - - -
CONDUCTIVE HEATIOSS Average. .
of Ana mMy.: CT " hourly neat
Area. ft2 or or F2 from.
C Oescriatlon of Assembly Length ft ,: ' Graon 4-1 from above loss..�Q _
Glazing 1 1, 1 `^ `" X 1 ' ` x Btu/hr
Wall i
X as
Ceiling/Roof. 1 \ ♦ 1.L �'��7 l X �0: �ri..Xn o�
ZZ
Floor x x ' .1
O.O. Q2 _I x =
Other 1 Tl<C F1�-L X
Subtotal 5 1� 1 Rtu/hr
volume S
• r-� umo w the aooo
�-jI.g �Q' O� DF
INFILTRATION ....... t�'.fr2 x . ft x x 3, 6 ZO
Af frorrm;above weignted •, afrom Th from'
Average Taole• 3-7 Line 1 Z� S
CallingHeight -
Subtotal;; 7to/hr
Una • une oq
DUCT HEAT LOSS (Enter 0 if there are no duds).... 0715 x Line 7 8 J `
f
TOTAL HOURIY:HEAT LOSS, QL 9 Z tulhr
ANNUAL HEAT LOSS, aL
\ Z, L of •day/Yr X Z-�Btu/hr x Q x 24 hr/day t of ." 10 ZZA ZI Btu/yr
MOO Hourly HeatLoss C from Ti from-=
from above from Line 9 Taoie'3-a Lin• 1,
1 HEAT TRANSFjEk COEF.FICI ENT; "
PROPOSED CONSTRUCTION ASSEMBLY
Form 3
Inside Surface Air Film
(�
V
cooling
heating
Sketch of Construction Assembly
Outside'Surface Air Film
WEIGHT: Ib/ft?';
;
:cooling
heating
Check
one:
-Total: Resistance Rt
-cooling
hea.ting
Wall
_. .
Roof
-Value`
C I
d�
pi
U t �2t
}
;cooling 'ng
eati
h ^9
Floor ..—
b
form
3
tR
heating
�1
heating
heating
heating
HEAT TRANSFER COEFFICIENT ° .
PROPOSED•CONSTR UCTION.ASSEMBLY
L.ist of Coristruction;Components
--
y
4.
7.
8:
to ,�- � - �;
•,� v
Inside• Surfac, e;Air Film
�
cooling
Sketch of Construction, Assembly.
Outside Surface Air Film
WEIGHT: Ib/ft2
cooling
Check one:
Total Resistance R•f
'
cooling
Wall
Roof
U -Value W_F#Tk CA
cooling
Floor
form
3
tR
heating
�1
heating
heating
heating
^
ZONEl5
TITLE 24 COMPLIANCE PACKA8E
Dave's Air Conditionin�
52-l0l Industrial Way
Coachella'Cali92235
Tele�hone� 6l9-398-��89
License264767 (C-20)
C O N T
E N T S
Form NoSheets
Point System Summary
P-2R l
Thermal
Mass Worksheet
WS-lR l
Certificate
Of Compliance
CR-lR 2
Heatin�
& Coolin��
Load Calculation
N/A 2
Mandatory
Measures
Checklist
MF-lR l
Insulation
Certifica'�e
l
Appli�nce
Certificate
�
Project InformaT�ion� '
'Type �Single Family Detached l Story Enforcement Agency
Owner �Tom Yaru Name�______________________
Address
Permit
Data Loc�Palm
~ ..
POINT
SYSTEM SUMMARY: CLIMATE
ZONE-15
P - 2 R
ProjeAr
Tom Yaru"Residence
Date: 10-16-89
Address;
La Quinta CA.
BUILDING
--------------
DATA:
____--____________________________-_
Stories = l
Glass Area
%6lass
Conditioned
Floor Area =1540
North 72
4.7
Floor
Type- Slab Slab Area-
1540
East 40
2.6
Unit
Type: Single Family Detached
(SFD)
South is
l 0
[ ] Addition Alone
West 40
2.6
[ ] Existing Building
Skylight 0
0.0
[ ] Existing Plus
Addition
Total 167
10.8
-~_____-__.-_________________-_____~'______________________________--______-_---_�
S C O
R E C A R D
Measures
Point Scores
R-Value U-Value
l`
Ceiling Insulation
38 0
0
2'
Wall Insulation
19 0
0
3.
Raised Floor Insulation
0 0
O
4.
Slab Edge Insulation
�
0 0
0
5�
Infiltration
Standard
�
�.
Glass Heat Loss
Double 0
6 Sum(!-6)=
6
7.
SHADING % Glass
Sc Eff
% Glass
'
(Shade Open) -------
---- -----------
a. North 4.7
X 0.77 =
3.60
' -1
b. East 2.6
X 0.77 =
2.00
0
c' South 1.0
X 0.77 =
0.75
0
d. West 2.6
X 0.71 ="
2.00
0
e. Skylight 0.0
X 0.77 =`
0.00
O
��.
SHADING % Glass
Sc Eff
% Glass
(Shade Closed)
---- -----------
a' North 4.7
X 0.66 =
3.03
-1
b. East 2.5
X 0.66 =
1,7111.
-2
c. South 1.0
X 0.56 =
0.64
4
d. West 2.6
X 0.66 =
7.7l
~-2
e. Skylight 0.0
X 0.ES
04
9.
Interior Thermal Mass
5.70 (Int
Mass/CFA)
�
10.
Exterior Wall Mass
0.00 TE:«t
Wall Mass)
Sum(7-10)=
3
lJ,
Heating System
Duct Eff.
'
Duct Ins=R- 6.3 HSFF
0.00
Eff
HSPF
Loc. in NONE -----
------~--
-------
7.50
X 0 =
0.00
-2
12.
Cooling System SEER
Duct Eff.
Effective
Duct Ins=R- 6.3 9.-5
0.81
See,,-
Loc. in NONE -----
---------
-��-�---
9.O0
X '81
=
7.3
13.
Water Heating TYPE
Credit
SG
NONE
Point
Goal....... .....
=
Point
Total this package
= l0
Point
System Summary
Revised
March 1988
L_. ?'v; r_t ! ,y1;_I I.;: _ .y �:_ f::_ ..I I' I.11�,1.., �_ : {J 1 !'� 7 !_
I_:i~Jij,.;::;_I: I1ari'l y-,.iE,I R1"t:sid"L';il:_.'
!
l NTER 1 tin ..,..I_iER1 iA` r;l
J4.1=':.SE—=�1.:::+.1= 1 ` V I h C 1�'1i'!._' 1 .--arc,
LL . ..,. r—rirlll�l�I ri»:: !L. rl•�. , _L» k_ _ +. C- .:�... ! i� i .i •r_ I.—.: c i•: ' -::':','il �. r
v:..� 1_.: L_ _.. � ! � _ .� 1_l n za'i l 1...1 •,.--- z'
r_ ...:
fw. •I : __ : •_a , .- _ i _� t_' ?~ `a � •-_ 1 _I E i I �:: i 11_:I •_ l :' _. _; k•.: d Ma r i h 1._ _. _ _ . __ = 1 -_ ' ! t' 1_ 1 _ : I �= •i ' :1 _i _: t C
FI1._Ilii••'t•1} - 4.1.I.1 �. 1~���Iv:�. L_ ril -.:J.I L1.::1rl1h;IAT.:{...:L7Dt-i a in d ..v .rl`•i _... "f. 11 t. _.i l.irllF:'-_ .
; •I;::,•;:N {=� ..i 1 1 i.F 1 -'!t' ! !'il-1 r-'-• - ..1=:� r. •i l_' ._r ~ 3 -}T. i—O i
• i - J. i' I _ 1. -a E _ jl i :i: _ J. '-1 "t c. ! : _ :1 � -I '�'' C.. _ `::1-_ 1 I _ '1 _
L=tj1:1ir Fl:i =•_! :i'i �.?! i"I_+.�_ it- ��5: i~�C:�_it tl
._ '_.1 i..! : �. �I ~' •-- I -._ _ 1 r 11._ ^} '-J 7 _ f- 1 i ! r-I '='-••. F� s- - = `� �_ ^ 1 .� C,:4 �:11 1
lvi
1-
... .... . . . . . .
ill l'Y L••. '_ I' .L �: is �. _ . .
_..
�I• t • rt L=
r'?' 11 i' arii U _L:`.v . . . . .
. .
. .
. ' .
ZONE l5 CERTIFICATE OF COMPLIANCE� Resi�ential CF-lR
Project� Tom Yaru Residence Date� l0-l5-89
Address CA
___-_____-_-_�_�_____��______
GENERAL INFORMATION
Total Conditioned Floor Area� l�40 sqft
BUILDIN3TYPE�
l Story
[��]
Single Family Detached)
[ ]
SingIe Family Attached
[ ]
MuIti-Family(less than 4 stories)
[ ]
Addition Alone
[ ]
Existing Bui�ding
'
[ ]
Existin�J Plus Ad�jition
Front Entry'
Orientation �
north
Number of
Dwelling Units|
l
.
Floor Construction
Type |
Slab
Infiltrati
on Control I
Standard
BUILDING SHELL
INSULATION
Component
InsuIation
Type
R-Value
Location or Comments
Wall
l!9
Frame WaIls
Roof
38
Typical
Floor
0
Raised Floor(Typical)
- -_~_______-____________
_- -____--- ____
______________________
GLAZIN8
Glazing Area Glass Type Interior Exterior Uver�an�
Orien� (sf) Single/Double Type Blind Type Screen Y/N
Nble __________ ________
South
East 40 O Double
THERMAL MASS
Type Covering Type Area
SIab/Ex�osed Mass (sf)
Exposed/tiled Interior 300
Slab(Carpeted) Interior l240
............
Fr�ming typE
Metal/Wood
Thickness Location/Descript�on
(inches) � (kitchen,batetc�)
Certificate of Compliance Pa�Je l of 2 Revised March l988
ZONE l5 CERTIFICAT� OF COMPLIANCE'
ResidentiaI
ject Title� Tom Yaru
Residence
Date� l0-i6-89
Project Address� La �uinta
CA
_____________________�______��_-~.-__�____________�
HVAC SYSTEM�
Type Minimum
Duct
Furnace Efficiency
Location
Duct Output
MaF:ufacturer/Model#
Heat Pmp (Se'Seer,Hspf)
(attic etc)
R-VaI (Btuh)
(or approved equal)
Air Cond Seer 9�00%
NONE
Radiant Hspf 7 ��0%
NONE
P-A.axin�'um Furnace Heatin�
OutputNil btuh ----
------------'-------'~-------
HOT WATER SYSTEMS
System Type T��nk
Manufacturer/Model#
(storage,gas) Capacity
______-___-_- _________
(or approved equaI)
_______________________
.
Special Feature(s).
Stora-7e "as N/A 8aI�
--
N/A/N/A
________---- _________�-____
_______________--
SP�CIAL FEATURES AN� REMARKS
(Add extra s�eets if necessary)
' -
COMPLIANCE STATEMENT
This certificate of compliance li�ts the �uilding �eatures and ��erfo�mance
specifications needed to comply with Ti�Ie 24, Chapter 2-53 and Title 20'
Chapter 2, Subchapter 4' Article l of the California Administration code
`This certificate has been signed by the individuaI with overall desi1�n r`s-
ponsibility and the building owner' who �hall retain a copy of it and trans-
mit the certificate �o any subsequent purchaser of the buildingWhen this
certi�icate o� com�liance is submitted for a single bui�ding plan to be built
in multipIe orient�tions' all buiIdin� conservation features which vary are
indicaterk� Section
DESI8NER N� O
�ame
Ti�Ie/Firn�'�
Address ' 64�� --------------------�-�--
Licence # � ---------^�-�--`------�---
DOCUMENTATION AUT ENFORCEMENT AGENCY
^
� _��w*��1�U����0���
Ti�le/Firm�_______��_��__U4�U5fRk�L_9A9`�
Address ... ..... ____�_�Q��H�A-A'r_G-A g2-236'_ TelePhone ��_^.�-------�----------~--_
Telephone ---------
Si�nature
_____- -___��______-_____-__��~___��--^����_�_���_______________
Dave's
Air
Conditioning
Heating Equipment 52-101
Industrial
Way
Sizing Compliance Coachella'Calif.
92236
Point System
______________
264757
(C-20)
-------
619-398-5589
Job No. Tom Yaru
Project :Single Family Detached
l
Story Structure
Owner :Tom Yaru
Address Ka Quinta CA.
Orientation inorth
� METHOD� ASHRAE Load Calculation
-----
Manual
------
Date: 10-16-89
HOURLY HEAT LOSS:
------------�����������������������
Total Conditioned
Floor Area= 1540
Site information:
inside Design Temperature.....,—,—.;—,
. . ' . . . . . .
. . . . . . .= 70.0 F
| Outside Design Temperature. ..
. ' .. . .
' . . . . ' .. . ' . ' -. . . ' ..
.-- . . ^w 31.0 F
Design Temperature Difference (TD):
.
For Standard Assemblies...........
..'....'.................=
20.0 F
For Floor Over Vented Unheated Space. . . . .
. . .
. . . ., ' . '-
19.5 F
CONDUCTIVE HEAT LOSS:
Description of Assembly
Area
------
U-Value TD
-------- _____
Btu/hr.
-------
Slab: R- 0 0 Inches 156 (ft)
X 42
= 6552
Ceiling: R- 38
1540
X
0.030 X 39
= 1802
Wall : R- 19
1271
X
0.065 X 39
= 3164
N Glazing; Double
72
X
0.650 X 39
= 1825
S Glazing; Double
is
X
0.650 X 39
= 380
E Glazing; Double
40
X
0.650 X 39
= 1014
W Glazing; Double
40
X
0,550 X 39
= 1014
Skylight ; Double
0
X
0,650 X 39
= 0
Subtotal
`
= l575i
Infiltration: 1540 X 8 X 0.50
X
0.018
' '
X 39
p° 4324
'
Duct Heat Loss:
. '
O. is X 20075 3011
Total Hourly Heat Loss = 23087
Maximum Btu/hr: 1.3 X ( 23087 + (10 X 1540)) = 5000
MINIMUM HEATING EQUIPMENT OUTPUT: 23087 (Btu/hr)
MAXIMUM HEATING EQUIPMENT OUTPUT: 50033 (Btu/hr)
Heating Equipment Sizing
. Dave's Ai� Conditioning
C��lin�'EquipIT: ent' 52-l0� Industrial Way
Sizing Compliance Coachella'Calif92235
Point System 264767
____-______�_____________
Job No� |Tom Yaru
Project �Single Family Detached l Story Structure
5l9-398-558�
Owner �Tom Yaru
Address �La �uinta CA
Orientation �north
METHOD� ASHRAE Load Calculation Manual 0-16-89
-----____-_-________________________________-_______~--_-------
HOURLY HEAT 8AIN� Total Conditioned Floor Area= l54/�
Site Information��
Inside Design Temperature.- . ' . ' . . . .'. . .= 7F
Outside Design Temperature......''............'.......'....1l2.0 F
Daily Temperature Swing. .''-~-.'....'-..'....'.'....'....=` 34 0 F
Design EquivaIent Temperature Differences� (TDeq)
Standard Temperature Difference. . . . . '. ' . . . . .... . . . . . . . . . . .= 34.0 F
For WaIls and Doors. . . . . .' . . ' .'. . ' . . . . . . ' . 0 F
For Masonry Walls. . . . . . . . . . . . . ...'.'-.'.............. ....= 2l�0 F
For Floor. . . . . . . . . . . . . . . . . . . . ......'.....-..........`...�= 20�0 F
For Cend Rcof . . . . . . . . . . . . . . . . . ' . . . . . . ' . . . . . . . . . . . .= 43 0 F
CONDUCTIVE HEAT GAIN�
Description
_____~_-____________-_________�_
of Assembly
Area
U-Value
TD
Btu/hr'
Ceiling| R-
38
=,___�_
l540
_________
X 0O302264
Wall � R-
l9
l2�6
X 00G5
X 28.0
= 2285
N 8lazing
Double
72
X 0550
)< 34.0
= l59l
S 8lazing
Double`
l5
X 0 550
X 34.0
= �32
E Glazi
Double
40
X 0G50
W Glazing
Doub1e
4��
X 0650
X 34.0
= 884
Skylight
�ouble
O
X 0550
X
'
Subtots,l
= 8240
SOLAR HEAT 8AIN�
Description of Assembly
N 8lazing Double
S 8lazing Double
E Glazin� Double
W Glaz�ng Double
��ylight Double
Area W'F.
720 X 30 �"
l50 X 44 =
Net Solar Heat Gain =*
Infiltration� l540 X 8 X 050 X 00l8 X 34 p=
Internal Heat Gain...........'......'.''.';....'.�''
TotaI Heat
Duct Heat 8ai0 =�
Total Sensible Hourly Heat 8ain =^
Latent Load�
O20 X 26565
------ ___________-_-________________________
SENSIBLE COOLIND� 26565 (Btu/hr)
TOTAL SENSIBLE COOLING LOAD + LATENT LOAD� 3l878 (Btu/hr)=
Btu/hr.
2l60
660
3l50
3l60
0
9l40
3770
3000
24l50
24l5
26��5
27 Tons
'oling Equipment Sizing
ZONE l& MANDATORY MEnSURES CHECKLIST: Residential MF-15
---___-___^_
Project: Tom Yaru Residence Date: 10-1�-8'5:
Address: La Quinta CA.
_________- ____~_____--_-___
NOTE:
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 listec
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.
~-__________________________________________________________-�___��_�
D E S C R I P T I O N
Desiqner
Enforcement
_______________________________________________________________________________
*Minimum Ceiling insulation .............. =
38
[
] [
]
Loose Fill Insulation.. . .. .. .. ...... . . .=
[
] [
]
*Minimum Wall Insulation............. ...=
l9
[
] [
]
Slab Edge Insulation.......
NR
[
] [
]
............=
Type Insulation used. .. . ...... .. .. . . .=
Batt
Vapor Barrier... . . ... .. .. .. .... . .. .. .=
NR
' [
] [
]
Infiltration.
Standard
. .. .. . . . . . ., . . . . . . .. . . . .=
Doors/Windows desi�ned to limit leakage =
Yes
[
] [
]
Doors/Windows certified..�
Yes
[
] [
I
�
Doors/Windows weatherproo���,���������=
Yes
infiltration Barrier........... .. .... =
NR
Fireplace metal or Glass closable doors.-
NA
[
] [
]
Fireplace air intake with damp & control=
NA
[
] [
]
Fireplace flue damper and control... ...=
NA
Space conditioning equipment sizing. ....v=
See Calcs
[
] [
J
Setback Thermostat on heating systems--
Vm:;
[
] [
]
*Ducts installed per Chapter 10' 1976 UMC=
Ye5
]
Space heating has ignition devices .....=
Yes
[
] [
]
Water Heaters' HVAC etc. CEC certified..=
Yes
[
] [
]
Water Heater Insulation Blanket. ...=
Yy�
Water Heater Insulation R-Value......... =
Yes
Water Heater insulated. =
Yes
[
] [
]
pipes .... .
Swim Pool heater has on/off switch ...... =
NA
[
] [
]
him 2oc� we in=+� ohtr =
solar
All PooI pl[�mned to ��l^bw ror �vlar.=
N-A
L
Swim Pool equip 75% thermal efficiency..-
NA
[
] [
�
Swim Pool Cover and time clock. . . .. .. .=
] [
]
Lighting in Kitchen/baths >=25 lumens..'=
Yes
[
] [
]
Gas appliances equipped with igniters
Yes
[
]
�
'.=
Appliances/lamp ballasts CEC certified'.=
Yes
[
] [
]
=--~-------
--------------------------
APPLIANCES:
r---------------
Refrigerator Manufacturer: N/f�
Model# N/A
Freezer Manufacturer ..... I N/A
Model# N/A
------------------------- ____________________
Model#
Model#
Model� ___...... ......
______________
Mandatory Measures Checklist
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
Ainr§ SCHOOL FACILITY FEES
7 -fits 00CUIV
TO: City of La Q9 ARLICA CANiqo-rDATE:
Department of CommunitTlEftelopment
78-105 Calle Estado
La Quinta, CA 92253
This is to certif th t
7
'Ll–A—IC
Jg=:L_
developer of _A I I—Y( 9) A whico is
1 o c a t e d a t 17 9 - (,o R 0 Daat 0 1 IW7-�'-V, /7 AL,,::�- OOiPffe n
�L14
LA
an
FND
this District, has paid Vchool falcility fees -imposed pursuant to the
au�ority ge�erat*,by Government Code Sqclion 5�080, in the t Of
-tUt �d
,,Vmoun
$ 1CWJJn5 gy/;��o
covering a total or square feet of residential o'r
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
AroL,
(IV -9- 3 f7,�-
!�hf e e t_4_y 0 - Lg� lbt
for DESERT SANDS -UNIFIED SCHOOL DISTRICT
White - Building Department 46 Yellow - Facilities Planning 0 Pink - Accounting 0 Gold - Developer
640 LP e-�' (10)-37