10800 (SFD)t r,
P.O. BOX 1504 N0. 10800
Building � $ _ e c! El D14 do 78-105 CALLE ESTADO
AdrirPcs 9, j LA QUINTA, CALIFORNIA 92253
L)wner
Jack L. Clark
Mailing
Address P. /O. �Qx 1371
ciLa Q i nta zip92253
Contractor
Jack Clark; jr.
.Address.
P. o. Box 1371
State Lic.
& Classif. Bl 506667
Arch:, Engr.,
Designer
Address
BUILDING: TYPE CONST. OCC: GRP.
Tel.
City Zip 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.
_SIGNATURE - DATE f
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any' City. Or county which requires a.,
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that he Is exempt therefrom, and the basis
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 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,-Buisness and
Professions Code: The Contractor's License',Law does not apply to an.owner of property who
builds or Improves thereon and who does such work himself or through his own employees,
provided that' such Improvements are not intended or offered for sale.' If, however,the building.
or Improvement is sold within one year of completion, the owner -builder will.havie the burden
of proving that he did not build or improve for the purpose of sale.)
0 I, as owner of the property, am exclusively contracting with licensed contractors to con-,
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds 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
1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. ,Company
0 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE'
j (This section need not be completed if the permit is for one hundred dollars '(S100) valuation
or less.) - ,
I 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: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. -
I certify that I have read this application and state that the above information is correct:
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
] 'Peimit does not 4 nciude any block walls
or Fool
A.P. Number
Legal Description
Project Description
631-32.1-007---1
Lot 95 1.�3 037/096--098
1A t'E10YOM i�A6 sly.97,
Tel.
i
Front Setback from Center Line
S�I3
Estimated Valuation
762,227.90
Side Street.Setback from Center Line -
PERMIT 4
AMOUNT
Plan Chk. Dep. . 250.00
Tel.:
Plan Chk. Bal.
751.46
Const.
564-3511
Mech. -
102.50
Electrical,. ''
City
Plumbing
222.00
S.M.I.
Lic. # 1115
Sq. Ft.
No.
No. Dw.
20.00
Size 3273
Stories
Units
Tel.
City Zip 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.
_SIGNATURE - DATE f
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any' City. Or county which requires a.,
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that he Is exempt therefrom, and the basis
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 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,-Buisness and
Professions Code: The Contractor's License',Law does not apply to an.owner of property who
builds or Improves thereon and who does such work himself or through his own employees,
provided that' such Improvements are not intended or offered for sale.' If, however,the building.
or Improvement is sold within one year of completion, the owner -builder will.havie the burden
of proving that he did not build or improve for the purpose of sale.)
0 I, as owner of the property, am exclusively contracting with licensed contractors to con-,
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds 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
1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. ,Company
0 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE'
j (This section need not be completed if the permit is for one hundred dollars '(S100) valuation
or less.) - ,
I 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: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. -
I certify that I have read this application and state that the above information is correct:
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
] 'Peimit does not 4 nciude any block walls
or Fool
BY:
Minimum Setback
Distances:
i
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Estimated Valuation
762,227.90
Side Street.Setback from Center Line -
PERMIT 4
AMOUNT
Plan Chk. Dep. . 250.00
—FINAL DATE
Plan Chk. Bal.
751.46
Const.
1210.00
Mech. -
102.50
Electrical,. ''
,220.75
Plumbing
222.00
S.M.I.
2.63
Grading
20.00
Driveway Enc.
20.00
Infrastructure
5671.99
A.tE� i=i Publi
405.60
TOTAL Li b b. 93
t3 b d tD . 9
REMARKS
'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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. � SQ. FT.
DUCT ORK Z
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN.
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT .. WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
C LlS/ Lw �n FINAL INSP
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
r
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT: RESID ® 1% c
SEWAGE DISPOSAL -
SPARK ARRESTOR
SQ.FT.GAR 4@ 3Vac
HOUSE SEWER
GAR. FIREWALL
GAS PIPING `. r
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE I ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE �UMBING ELECTRICAL HEATING,& AIR COND. SOLAR
SETBACK
GROUND PLUMBING [ l
DERGROUND
A.C: UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
�1 4Nt-SEPTIC TANK
ROUGH WIRING.
DUCT ORK Z
CK STORAGE
FOUND. REINF.
GAS (ROUGH) *I/q3 Z
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
cz
GAS (FINAL)
TEMP. POLE
lor
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
C LlS/ Lw �n FINAL INSP
FRAMINGFINAL
INSP. �/ c1L
ROOFING2
9
VENTILATION
1240
/J
ll C
/b/'�
r
� lZaB� `tO
f
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING / a A44p
INSULATIONISOUND
..F.INISH GRADING
FINAL INSPECTION-
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
s
of
6. I
Tit� of 14a (011inta
!Nllitbin� anb -$dfet� 3liwkiiij-11
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESS 48-885 E1 Nido
Use Classification Single Family Dwelling Bldg. Permit No. 10800
Group R3 Type Construction `7N Fire Zone Use Zone SR
Owner of Building Jack Clark, Jr. Address P•0• Box 1371.
City La Quinta, CA 99253 BY: Lonnie Day
Dote: January -11, 1994
Building Official
t POST IN A CONSPICUOUS PLACE
01/06/1994 19:45 619564236i-' DES VINT RLTY COV SE
PAGE it
11-04-1993 10:37PM FROM TO 5642361 P.61
r41m U*Wt. t,altt.,t 1911,.
POST Oti10E SOX 1444 / PALM DISiRT, CALIFORNIA 12241 / TELEPHONE: 419/344-4295 410/340.4404
n-221 H14HWAT III / PALM 0111WT,.CAtIF0*HiA 92260 / TAX 411/Ul-1410
STAntfIELO SHUTTER Ca. INC.
'
Cul*ta
sto's Tet4phone No. CJXClient's Tat ephOrN No.
Sold to A1.0 1 /t - 4Z 4 ,ff 4. __ . Address
Owntr Address r S77P %tee 5,
Job Addrttaa 7 9Y7 _ �� N,(�/l4 �� /.� t% iL. (�` G)q—
We serw_to furnish N Poo fetlewins speollkationa. Ouotetlott tuhieet to Change witnottt fee 1i dw" fmq ataaee dell
" THICK FRAMES.
v
LVRS. HANGING STRIPS, STOCK HARDWARE, CARTAGE,
STATE 0WR. LIC. #32 ns
For the Net Sim of s we Q fel-41 you May Enter qty Order for Above Ettlreato
The above esti+hste when $*ad by ear will constitute a %peei/l WOW by you for the merchandise herein %e1 fertfl, aro not subject to CttrtcNtation.
A d.'esit of fttty Per cont tti0%I k ►a4lrlred with M1 dpld erdM1: bstwe of purch"t sip psyabla upon dNlvofy.
In the ~1 11181 on action %hall be inJlHutad to SAWty the terms% of shit agraernenr. Ne PVKhaser shall bo oblipted to pay reetonable a4
sp Ono Court costs.
Interest a the rate of 115116 per month will be CtWg*d on Past due eaouna.
See / %Ido. /
Dots Slpw:
By 8Y
Client
Client
Client Phone
EARTH SYSTEMS CONSULTANTS S.C.
BUENA ENGINEERS DIV.
79-811 B Country Club Drive
Bermuda Dunes, CA 92201 • (619) 345-1588
DATE
JOB NO.
LOT
NO.
5 39 � S- P3
PROJECT
Ci 2 -L� 6
LOCATION
DRY
DENSITY
Ibs./Cu. ft.
CONTRACTOR OWNER
r'Coz os --- AcK- (_CAr2_1(_
WEATHER
c Imo.= '�4 f
TEMP. o at AM
° at PM
PRESENT AT SITE
TEST
NUMBER
TEST LOCATION
LOT
NO.
ELEVATION
-` FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
%
DRY
DENSITY
Ibs./Cu. ft.
MAXIMUM
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
Ibs./cu. ft.
OPTIMUM
MOISTURE
CONTENT
%
-
� t
--,-
REMARKS: QBSf!% O VE•Q-EX O Pwkf) (o--�'�� -- —� CS cry
i\-� \ ►..)� \ V � OCL -�Z- �` � ' ---\I`) l l.lr C � SL 1v�(�-�
,��
_� ��p
k.10
t� �- +e- /"00'-
v <l�
CLIENT REPRESENTATIVE SIGNATURE
FIELD "PORT
L2W�l
TECHNICIANS SIGNATURE 0'00684
EARTH SYSTEMS CONSULTANTS S.C.
BUENA ENGINEERS DIV.
79-811 B Country Club Drive
Bermuda Dunes, CA 92201 • (619) 345-1588
Client Name
Client Address
Client Phone
7- 1 _
JOB NO. --- --
67.39 �Z
PROJECT
ELEVATION
LOCATION
-4
REFERENCE CURVE
CONTRACTOR
OWNER
WEATHER
TEMP.
o at AM
G at PM
PRESENT AT SITE
TEST
NUMBER
TEST LOCATION
LOT
NO.
ELEVATION
FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
%
DRY
DENSITY
IbsJCu.It.
MAXIMUM
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
IbsJcu. tL
OPTIMUM
MOISTURE
CONTENT
%
1
Is t,.
��.:.
lie o.
71 .
Is''
�•
I�S.g
I I+Y .
REMARKS: _$�--5 ,t��, Al2_S� -
�1 o r _._�S (T4 _
FIELD REPORT
t CLIENT REPRESENTATIVE SIGNATURE +. TECHNICIANS SIGNATURE
000460
L
* .
R UA �j
Lic. No. 496913
Cc
736 Palm Avenue • Coachella • California 92236 • (619) 398-8039
.r
LOAD CALCULATIONS FOR JACK CLARK JR. JOB 9017-A
A) GENERAL :LIGHTING 3274 feet AT,,;311ATTS PER =16•2 .250 va'
B) KITCHEN CIRCUITS 3:1000 va f
C) APPLIANCES = 5,000 va 1
D) OVEN = 5,000va !
E) LAUNDRY CIRCUITS = 5100 va
F) RANGE = 5500va
----------------------------------------------=------------
F
TOTAL = 39,850 va, 1
' L
• ,1
1st 10,000 va at 1000•=10,000va
REMAINDER AT 40%=11,940va t t
' POOL EQUIPMENT = 3250 va `
AC UNITS27,500vat r -
1 AC WINDOW UNIT =1,500 vat '
1.�
---------------
=54,190va t
54,190va =235 AMPS
USE 400 AMP SERVICE i
�t
m
TITLE 24 REPORT FOR:
CLARK RESIDENCE 9017-A
48985 El Nido
La Quinta, Ca'
PROJECT DESIGNER:
JOHN ROBERT BUND ARCHITECT
121 E. Cypress Ave'
Redlands, Ca' 92373
(7I4)798-5785 '
OWNER:
JACK and ANN [LARK
4895S El Nido
La Ouinta, Ca' 92253
REPORT PREPARED BY:
JOHN ROBERT BUND ARCHITECT
121 E. Cypress Ave'
Redlands, Ca' 92373
(714)798-5785
Job Number: 9O17-Ao
,
Date: 3/22/1993
The COMPLY 24 computer program has been used to perform the calculations
summarized in this compliance report. This program has interim approval
and is authorized by the California Energy Commission for use with the
Second Generation Nonresidential Building Energy Efficiency Standards
for Nonresidential Occupancies. Second Generation Residential Occupancies
shown to comply with this program conform to the results produced -by the
Public Domain Point System, developed by the Cali�grnia Energy Commission.
This program developed by Gabel Dodd Associates (415) 428-0803'
I
Table Of Contents for Title 24 Report
-------------------------------------
coverWage..............................................1...... ... 1
Table of Contents ................................................... 2
Form CF -1P, Certificate of Compliance: Residential 3
Form MF -1R Mandatory Measures Checklist: Residential ................ 6
Form P -2R Point System Summary ...................................... 8
Form WS -1R Points Thermal Mass Worksheet ............................ 9
Form WS -2R Interpolation Worksheet .................................. 10
Form S Shading Coefficient (SC) Worksheet ........................... 11
Form CF -3 Construction Assemblies ................................... 16
Domestic Hot Water Worksheet ......................................... 25
Form WS -5A Lighting Controls Credit Worksheet ....................... 26
_...
Project: CLARK RESIDENCE 9017--A
_ _-.. _.... ... - _.__- ....._-- -----._.------
------------------
COMPLY 24 v 3.10
Designer: JOHN ROBERT BUND ARCHITECT
R--19 stud frmg.
2578
Building Permit No
Location: Palm Desert
Date: 3/22/1992
Concrete tile roofing
Checked By
Documentation: JOHN ROBERT BUND
_-.--------------------------------------------------------------------------
ARCHITECT
Storey House
Date (User # 2258)
PROJECT ADDRESS
Job 4: 9017-A
Single
48985 El Nido
Carpeted Slab
2304
La Chu i nta , Ca.
Single
Storey House/Insul= R-0.0
GENERAL INFORMATION
Thick
Compliance Method:
Point System
Mass Material
Climate Zone:
15
Type
Total Conditioned Floor Area:
3274 sgft.
Building Occupancy:
Single Fam Det
Front Entry Orientation:
East
Number of Dwelling Units=
1
Floor Construction Type:
Slab
infiltration Control:
Standard
BUILDING SHELL INSULATION
Component
Area
U -Value
Location/Comments
R--19 stud frmg.
2578
0.0487
Single
Storey House
Concrete tile roofing
3274
0.0246
:Single
Storey House
Exposed Slab
970
0.9000
Single
Storey House/Insul= R-0.0
Carpeted Slab
2304
.0.7200
Single
Storey House/Insul= R-0.0
THERMAL MASS
Thick
Mass Material
Area
(in)
Type
Location/Description
Concrete, Heavyweight 2304 4.000 Covered Single Storey House/Ext Mass
_.. -------------------------------------------------------
6
Project:
..._.---._._..__._..._____.. ._--..._.--_-_._.._._._._.--_._----._._ _..----------_.---
Project: CLARK RESIDENCE 9017-A ; COMPLY 24 v 3.10
Designer: JOHN ROBERT BUND ARCHITECT
Location: Palm Desert
Date: 3/22/1992
Building Permit No
Checked By
Documentation: JOHN ROBERT BUND ARCHITECT ; Date (User # 2258)
---------------------------------------------------------------------------
GLAZING
Glass w/Int
Location Orient
Area
Type
U -Val SC Shade
----- -----
Description
--------- ------ -----
Single Storey House
------
-----
-----------------------
North
36.0
Single
1.10 1.00
0.62
Single/White Drapes
North
20.0
Double
0.65 0.88
0.33
Double/Light Blinds
East
44.0
Single
1.10 1.00
0.39
Single/Roller Shades
East
35.0
Double
0.65 0.88
0.37
Double/Roller Shades
South
32.0
Double
0.65 0.88
0.37
Double/Roller Shades
South
48.0
Double
0.65 0.88
0.37
Double/Roller Shades
West
64.0
Double
0.65 0.88
0.37
Double/Roller Shades
West
17.0
Single
1.10 1.00
0.39
Single/Roller Shades
East
35.0
Double
0.65 0.88
0.37
Double/Roller Shades
East
45.0
Double
0.65 0.88
0.37
Double/Roller Shades
South
8.0
Double
0.65 0.88
0.37
Double/Roller Shades
South
22.0
Double
0.65 0.88
0.37
Double/Roller Shades
South
14.0
Single
1.10 1.00
0.39
Single/Roller Shades
South
64.0
Double
0.65 0.88
0.37
Double/Roller Shades
South
40.0
Double
0.65 0.88
0.37
Double/Roller Shades
West 120.0
Double
0.65 0.88
0.37
Double/Roller Shades
West
40.0
Single
1.10 1.00
0.39
Single/Roller Shades
West
30.0
Double
0.65 0.88
0.37
Double/Roller Shades
West
10.0
Single
1.10 1.00
0.39
Single/Roller Shades
West
75.0
Double
0.65 0.88
0.37
Double/Roller Shades
West
28.0
Single
1.10 1.00
0.39
Single/Roller Shades
SHADING (for Glazing
above)
Over
Location Exterior
------------------------
Device
Sc hang
---- ----
Framing Type
---------
Single Storey House
-----------------------
None
1.00 3.0
Metal w/o Mullions
Sunscreen
w/53x16 weave 0.34 4.0
No Framing
None
1.00 4.0
Metal w/o Mullions
None
1.00 7.0
Metal w/o Mullions
None
1.00 6.0
Metal w/o Mullions
50 % Bug
Screen
0.84 6.0
Metal w/o Mullions
50 % Bug
Screen
0.84 15.0
Metal w/o Mullions
None
1.00 15.0
Metal w/o Mullions
50 % Bug
Screen
0.84 4.0
Metal w/o Mullions
None
1.00 7.0
Metal w/o Mullions
50 % Bug
Screen
0.84 3.0
Metal w/o Mullions
50 % Bug
Screen
0.84 10.0
Metal w/o Mullions
None
1.00 10.0
Metal w/o Mullions
50 % Bug
Screen
0.84 12.0
Metal w/o Mullions
None
1.00 12.0
Metal w/o Mullions
None
1.00 12.0
Metal w/o Mullions
None
1.00 12.0
Metal w/o Mullions
None
1.00 3.0
Metal w/o Mullions
None
1.00 3.0
Metal w/o Mullions
50 % Bug
Screen
0.84 5.0
Metal w/o Mullions
None
1.00 3.0
Metal w/o Mullions
i -o CL'.: SARK RESIDENCE 9017--A
jOHN ROBERT BUND ARCHITECT
io ;'.ZIm Dc 7e=rt
Date: '.31/22/1992
COMPLY 24 v 3.10
Building Permit No
Checked By
:cu.ment•. tiC:i-n: JOHN GBERT^'UND ARCHITECCT ; Date (User # 2258)
---------------------------------------------------------------------------------
;VVAC SYSTEMS Minimum Output Duct Duct Manufacturer/Model No.
s.tam T; r=e E ff iciency3tLlh , Location R`�a.1 t, of approved equal)
Gas Fired, 0.x70 .SE 81000 Vent. Attic Space 4.2 BDP 398A048080/594AN042
,air (-ond 10.500 NEER 41500 Vent. Attic Space
Hax . Furnace Output: 77023 Btuh + F( 87'.. 71`0) x 70001 189023 Btuh
>li.ng !.xcepti.on: CFM Cooling (see Load Calcs) rCrquiies Btuh
;-;OT WATER SYSTEMS Tank Ma M of Energy R-12
:system Type volume (or approved equal) Sys Credits Blanket
Gas -fired 47 .S tc) .O .S�llrith PGC -50 (a 3 ) 2 0
`:,PECIs`,L `r7EATt.J;:ES/REr-lARK5 ( Add extra, sheet�; if necessary)
COMPLIANCE STATEMENT
Thia,; Certificate of Compliance lists the building features and performance
:�pecificalionti needed to comply with Title 24, Chapter 2-53 a.nd Title 20,
Chapter 2, Subchapter 4, Article 1 of the California Administrative Code.
This certificate has been signed by the individual with overall design
responsibility and the building owner, who shall retain a copy of it and
transmit the certificate to any subsequent purchaser of the building. When
this Certificate of Compliance is submitted for (a single building plan to
be built in multiple orientations, all building conservation -features which
vary are indicated in the Special Features/Remarks section.
LGNER
JOHN ROBERT BUND ARCHITECT
121 1.. Cypress AVC
Redlands, Ca. 92373
'714)79.8-578'
License No:
(Date)
BUILDING OWNER
JACK and ANN CLARK
48955 E1 Nido
La Quinta, Ca. ?21253
:signed: L! 43-2-6;- 7--
( Date )
DOCUMENTATION AUTHOR ENFORCEMENT AGENCY
:, iN ROBERT BUND ARCHITECT Name:
1^1 Cy p ss Ave . Agency
Redlands.. Ca . 92373' Telephone: _
/ l ')7
5 :l .
1;;118 d : •~��Cti�d�/ `�,..J � .�� . ! � C 1 g 11 � d :
( Date )
( Date )
----------------
Project: CLARK RESIDENCE 9017-A ; COMPLY 24 v 3.10
Designer: JOHN ROBERT BUND ARCHITECT
Location: Palm Desert
Date: 3/22/1992
Building Permit No
Checked By
Documentation: JOHN ROBERT BUND ARCHITECT ; Date (User # 2258)
---------------------------------------------------------------------------
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 riore stringent compliance
requirements listed on the Certificate of Compliance. When this checklist
is incorporated into the permit documents, the features noted shall be
considered by all parties as binding minimum component performance
specifications for the mandatory measures whether they are shown elsewhere
in the documents or on this checklist only.
BUILDING ENVELOPE MEASURES
o Sec. 2-5352(a): Minimum ceiling insulation R-19
weighted average. *
o Sec. 2-5352(b): Loose fill insulation manufacturers
labeled R -Value.
<� Sec. 2--5352(c:): Minimum wall insulation in framed walls R-11
weighted average (does not apply to exterior mass walls). *
0 Sec. 2-S352(k): Slab edge insulation - water absorption rate
no greater than 0.3e, water vapor transmission rate no
greater than 2.0 perm/inch.
o Sec. 2-5311: Insulation specified or installed meets
California Energy Commission (CEC) quality standards.
Indicate type and form.
o Sec. 2-5352(f): Vapor barriers mandatory in Climate Zones 14
and 16 only.
o Sec. 2-5317: Infiltration/Exfiltration Controls
a. Doors and windows between conditioned and unconditioned
spaces designed to limit air leakage.
b. Doors and windows certified.
c. Doors and windows weatherstripped; all joints and
penetrations caulked and sealed.
ci Sec. 2-5352(e): Special infiltration barrier installed to
comply with Sec. 2-5351 meets CEC quality standards.
c::) Sec. 2-5352(d ): Installation of Fireplaces
1. Masonry and factory -built fireplaces have:
a. Tight fitting, closeable metal or glass door
b. Outside air intake with damper and control
c. Flue damper and control
2. No continuous burning gas pilots allowed.
Enforcement
--
Project. CLARK RESIDE NCE 9017-A COMPLY 24 v 3.10
Oesigner : .JOHN ROBERT BUND ARCHITECT
Location: Palm Desert
Date : '31/221/11;:192
13uilding Permit No
Checked By
Documentation: .JOHN ROBERT BUND ARCHITECT ; Date ( User #k 2258 )
_---------------------------------------------------------------------------
HVAC AND PLUMBING SYSTEM MEASURES
o Sec. 2-5352(g) and 2-5303: Space conditioning equipment
sizing: attach calculations.
Sec. -5352`h) and 2-5315: Setback thermostat on all
applicable heating systems.
Sec. 2•-.5316(a): Ducts constructed, installed and insulated
per Chapter- 10, 1976 Uh1C .
c _:�.ec. 2-5316(b): Exhaust systems have damper controls.
:>eC 2 "5314 c i l,�as--'fired space heating equipment has
intermittent ignition devices.
o
Sic. 2-5314: HVAC equipment, water heaters, :showerheads and.
faucets certified by the CEC.
o Sec. 2--5352(i): Water heater insulation blanket (R-12 or
greater) for storage & backup tanks for solar water heating
systems; 'first 5 feet of pipes closest to tank insulated
( R-3 or greater).
o Sec. 2-5312(Exception I): Pipe insulation on steam and steam
condensate return & recirculating piping.
c�
S e c . 2-5318(d). Swimming Pool Heating
1. system has:
a.. On/off switch on heater .
b. Weatherproof instruction plate on heater.
c. Plumbed to allow for solar.
75 percent thermal efficiency.
3. Pool cover.
4. Time clock.
S. Directional water inlet.
LIGHTING AND APPLIANCE MEASURES
o Sec. 5352(j): Lighting - 25 lumens/watt or greater -for
general .lighting in kitchens and bathrooms.
c =•ec. 2- 5314(c): Gas fired appliances equipped wil'.h
intermittent ignition devices.
c's Sec. 2-5314(a.): Refrigerators, refrigerator -freezers,
freezers and fluorescent lamp ballasts certified by the CEC.,
I
ndicate make and model number.
Enforcement
Project: CLARK RESIDENCE 9017-A
Designer: JOHN ROBERT BUND ARCHITECT
Location: Palm Desert Date: 3/22/1992
COMPLY 24 v 3.10
Building Permit No
Checked By
Documentation: JOHN ROBERT BUND ARCHITECT ; Date (User # 2258)
---------------------------------------------------------------------------
BUILDING DATA
Conditioned Floor Area
3274 sqft
Number of
Stories 1
Occupancy Type
Single
Fam
Det
SCORE CARD
Measure
Points
-------------------------
1.
Roof Insulation
-------
0.0246
(U -Value)
------
2
2.
Wall Insulation
0.0487
(U -Value)
4
3.
Raised Floor Insulation
0.0000
(U -Value)
3a.
Controlled Vent Crawlspace
0.0
(R -Value)
4.
Slab Edge Insulation
0.7886
42 factor-)_,
S.
Infiltration
Standard
0
6.
Glass Heat Loss
0.75
25.30
-17
Sum 1-6
-12
7.
Shade Open Area %
------------
Glass
SC
----
OH Eff %
a.
North 56.0
1.7
x
0.68
---- -----
-
1.2
0
b.
East 159.0
4.9
x
0.80
x 0.79 =
3.0
-1
c.
South 228.0
7.0
x
0.76
x 0.46 =
2.4
0
d.
West 384.0
11.7
x
0.79
x 0.65 =
6.0
1
e.
Skylight 0.0
0.0
x
0.00
=
0.0
0
8.
Shade Closed Area %
Glass
SC
----
OH Eff %
a.
------------
North 56.0
1.7
x
0.45
---- -----
=
0.8
0
b.
Fast 159.0
4.9
x
0.33
x 0.67 =
1.1
1
c.
South 228.0
7.0
x
0.32
x 0.45 =
1.0
2
d.
West 384.0
11.7
x
0.33
x 0.56 =
2.1
-3
e.
Skylight 0.0
0.0
x
0.00
=
0.0
0
9.
Interior Thermal Mass
0.35
-6
10.
Exterior Wall Mass
0.27
4
Sum 7-10
-2
11.
Heating System 0.870 SE
x 0.82
Duct Eff =
0.71
Eff SE
4
Zonal Control: No
12.
Cooling System 10.500 SEER
x 0.81
Duct Eff =
8.51
Eff SEER
16
13. Water Heating (see DHW Worksheet) _ -4
Point Total: 2
---------------------------------------------------
Project: CLARK RESIDENCE 9017-A
; COMPLY 24 v 3.10
Designer: JOHN ROBERT BUND ARCHITECT
Building
Permit No
Location: Palm Desert
Date:: 3/22/1992
/ 1a9:_ , Checked
By
Documentation: JOHN ROBERT BUND
._--------------------------------------------------------------------------
ARCHITECT
Date (User # 2258)
INTERIOR THERMAL MASS
Interior
Interior
Sides
Wall
Mass Mass
Mass
Mass Material Thick
Exposed
U -Value
Area f=actor
Capacity
None 4.00
1
0.0487
970 .0 x 0.0 =
0.0
Concrete, Heavyweight 4.00
0
0.0487
2304.0 x 0.5 =
1152.0
TOTAL
1152.0
INTERIOR MASS FACTOR
1152.0
IMC /
3274 sgft = 0.35
Mass listed above with a Wall
U -Value
denotes
the Interior Mass
credit
for Exterior Mass Walls, and
are repeated
below
for Exterior Mass
credit.
0 Sides Exposed indicates mass
covered
with surface
material >=
R-2.
EXTERIOR MASS WALLS
Exterior
Exterior
Sides
Wall
Mass Mass
Mass
Mass Material Thick
---------------------- -----
Exposed
-------
U -Value
-------
Area Factor
------ --------
Capacity
--------
None 4.00
1
0.0487
970.0 x 0.0 =
0.0
Concrete, Heavyweight 4.00
0
0.0487
.2304.0 x 1.0 =
2304.0
Other Opaque Wall Area
0.0 x 0.0 =
0.0
TOTAL
2304.0
EXTERIOR MASS FACTOR
2304.0
EMC /
3274 sgft = 0.70
-----------------------------
Project: CLARK RESIDENCE 9017--A ; COMPLY 24 u 3.10
Designer: JOHN ROBERT BUND ARCHITECT
Location: Palm Desert
Date: 3/22/1992
Building Permit No
Checked By
Documentation; JOHN ROBERT BUND ARCHITECT ; Date (User # 2258)
---------------------------------------------------------------------------
INTERPOLATION
Point
Point
Point
Score
Actual
Value
Score
Score
Value
Value
Point
I: tern
1
Value
1
2
1
2
1
Score
-------
Roof
-----
4
+(
------
0.0246
-----
- 0.02)
x
-----
(
-4
-----
- 4)
/(
-----
0.04
-----
- 0.02)
-----
= 2
Wall
6
+(
0.0487
- 0.04)
x
(
1
- 6)
/(
0.06
- 0.04)
= 4
Slab Edge
2
-F(
0.7886
- 0.70)
x
(
-1
- 2)
/(
0.80
- 0.70)
= -1
Glass Type 1
-36
+(2S.2596
-25.00)
x
(
•-38
- -36)
/(26.00
-2S.00)
= -37
Glass Type 2
-11
+(25.2596
-25.00)
x
(
-12
- -11)
/(26.00
-2S.00)
= -11
N Shade Open
0
+(
1.1691
- 1.00)
x
(
0
- 0)
/(
2.00
-- 1.00)
= 0
E Shade Open
-1
+(
3.0388
- 3.00)
x
(
-1
- -1)
/(
4.00
- 3.00)
= -1
S Shade Open
0
+(
2.4327
- 2.00)
x
(
0
- 0)
/(
3 .00
- 2.00)
= 0
W Shade Open
1
+(
5.99S4
- 5.00)
x
(
1
- 1)
/(
6.00
- 5.00)
= 1
N Shade Clsd
1+(
0.768:3
- 0.00)
x
(
0
- 1)
/(
1.00
- 0.00)
= 0
E Shade Clsd
1
+(
1-0640
- 1.00)
x.
(
-2
- 1)
/(
2.00
- 1.00)
= 1
S Shade Clsd
2
+(
1.0087
- 1.00)
x
(
-2
- 2)
/(
2.00
- 1.00)
= 2
W Shade Clsd
-3
+(
2.1198
- 2.00)
x
(
-7
- -3)
/(
3.00
- 2.00)
= -3
Int Mass
-6
+(
0.3519
- 0.30)
x
(
-5
- -6)
/(
0.50
- 0.30)
= -6
Ext Mass
3
+(
0.2681
- 0.20)
x
(
5
- 3)
/(
0.40
- 0.20)
= 4
Heating
4
+(
0.7134
- 0.70)
x
(
7
- 4)
/(
0.80
-- 0.70)
= 4
Cooling
11
+(
8 .5050
- 8.00)
x
(
20
- 11)
/(
9.00
- 8.00)
= 16
WEIGHTED AVERAGE
POINTS
Type 1
Type
2
Type
3
Total
Average
Item
Points Area
Points
Area
Points
Area
Area
Points
---------
Glass Type 1,2&3(-36.5
------ ----
x 189
------
+-11.3
x
----
638
------
+ 0.0
x
----
0)
-----
/ 827
-------
= -17
t_F=,rk RtSID�t'd�.E '� `A
-ier : JCHN >•;OEiERT 3'v'N^v i; Cf SIT`CT
;c.at:ion :ilir'i Deser"+
Date : i`?,� I - -? 2
COMPLY 24 v 3.10
�3u1Lldinq permit No
:hicn,d 8y
MldN R1^8ER T Rt ND R,CHITEGT Date (User ',k 2258 )
t (NERAL :INFORMATION
:_,lazing Type:
r a„min:-s Type
rarningihlullion Factor
�. Inter for hadn Type:
SC Shade Open:
3. SC Shade Closed:
Cin^le
Metal Mull:ion�;
0” 8 (from Table G-10)
::;insole/White Drapes
1 .G0 (,from Table G -moi or show calculation)
( from Table (:;-9 or show ca.1culation )
ALING ,
INTERIOR
SHADE
& F=RAMING
ya 1 . 00
(SC #�) x
0 . "3
( -Mr l � J � i) .88 =.0 Shade i'Jja_: TI
lOa .0."2
( SC kk8) x
0 .88
( FMF 0.55 SC Shade Closed
EXTERIOR SHADE
Exterior ::ha.de Type: NO EXTERIOR SHADE
OVERHANG FACTOR
Glass Ovrhng Dist Glass prof 01H Factor OH Factor
Orientation Area Depth Above Height Ratio Shade Open Shade Clsd
NO OVERHANGS
e
Project: CLARK RESIDENCE 9017-A ; COMPLY 24 v 3.10
Designer: JOHN ROBERT BUND ARCHITECT
Location: Palm Desert Date: 3/22/1992
Building Permit No
Checked By
Documentation: JOHN ROBERT BUND ARCHITECT ; Date (User # 2258)
---------------------------------------------------------------------------
GENERAL INFORMATION
1.
Glazing
Type:
Double
:3.
Framing
Type:
No Framing
S.
Framing/Mullion
Factor:
1.00 (from
Table G-10)
6.
Interior
Shade Type:
Double/Light
Blinds
7.
SC Shade
Open:
0.88 (from
Table G-9 or show calculation)
S.
SC Shade
Closed:
0.33 (from
TabNe G-9 or show calculation)
GLAZING, INTERIOR SHADE & FRAMING
9a. 0.8S ( SC #7) x 1.00 (FMF #S) = 0.88 7C Shade open
10a.0.33 (SC #8) x 1.00 (FMF #5) = 0.33 SC Shade Closed
EXTERIOR SHADE Exterior Shade Type: Sunscreen w/53x16 weav
11. SC Exterior Shade: 0.34 (from Table G-11 or manufacturer's data)
12. E(0 .88 (SC 49a) x 0.25) +- 0.7S] x 0.34 ( SC #11) = 0.33 SC Shade Open
13. E( 0 .34 (SC #11) x 0.25) + 0.751 x 0.33 (SC #10a) = 0.28 SC Shade Close
---------------------------------------------------------------------------
OVERHANG FACTOR
Glass Ovrhng Dist Glass Pro.j OH Factor OH Factor
Orientation Area Depth Above Height Ratio Shade Open Shade Clsd
----------- ----- ------ ----- ------ ----- ---------- ----------
NO OVERHANGS
<<�:) =:t: .:`ARK RESIDENCE
�.<:`ner • IHN R(.)BERT uUND ARCHITECT
t C, ate
c umantation: .JOHN ROBERT BUND ARCHITECT
--------------------------------------------------------
ENERAL INFORMATION
"lazing Type: Single
ramin:� Iypc7: Metal w/o Mulliot 3
5 . Framing/Mullion Factor : 0.83 (from Table G-10)
COMPLY 24 v 3.10
Building Permit No
Checked By
Dai.e ( User # 2258 )
--------------------
Interior Shade Type: Single/Roller Shades
7. SC Shade Open: 1.00 (from Table G-9 or show calculation)
:3C Shade Closed: 0.39 From Table G-9 or s1how calculation)
�il_AiT, IG , INTERIOR SHADE a FRAMING
`.,1 . r .00 (` :;C 4,t7) x 0 .88 ( FMF 1145) - 0 .83 z>C Shade Open
0a .0 .39 SC ,t8) x 0.88 (FMF 4,S) == 0.34 SC Shade Closed
XTERIOR SHADE
OVERHANG FACTOR
Exterior Shade Type: 1'•40 IvXTERIOR SHADE
Glass
Ovrhrrg
Dist
Glass
Proi
OH Factor
OH Factor
Orientation
Area
Depth
Above
Height
Ratio
Shade Open
Shade Clsd
-------------
t ast
-----
44.0
------
4.0
-----
/ ( 0 . ].
------
+ s .0)
-----
= 0.49
----------
0.88
----------
0.78
West.
17.0
15.0
/ ( 0.1
+ 5.5)
= 1.70
0 . S5
0.46
South
1 "I .0
10 .0
( 0 . 1
+ F5 .5)
= 1..70
0.27
0.42
West
40.0
12.0
/ ( 0.1
+ 8.0)
= 1.49
0.59
0.49
Wast
10 .0
:3 .0
/ ( 0.2
+ 2.0)
= •1 .36
0.62
O.51
West
23 .0
3.0
i ( 0.2
+ 6.0)
= 0.48
0.8s
0.79
Protect: CLARK RESIDENCE 9017-A ; COMPLY 24 v 3.10
Designer: JOHN ROBERT BUND ARCHITECT
Location: Palm Desert
Date: 3/22/1992
Building Permit No
Checked By
Documentation: JOHN ROBERT BUND ARCHITECT ; Date (User # 2258)
---------------------------------------------------------------------------
GENERAL INFORMATION
1.
Glazing
Type:
Double
3.
Framing
Type=_:
Metal
w/o Mullions
S.
Framing/Mullion
Factor:
0.88
(from Table G-10)
6.
Interior
Shade Type:
Double/Roller
Shades
7.
SC Shade
Open:
0.88
(from Table G-9 or show calculation)
8.
SC Shade
Closed:
0.37
(from Table G-9 or show calculation)
GLAZING, INTERIOR SHADE & FRAMING
9a. 0.8S (SC .#7) x 0.88 (FMF #S) = 0.77 SC Shade open
10a.0.37 (SC #8) x 0.88 (FMF #5) = 0.33 SC Shade Closed
EXTERIOR SHADE
OVERHANG FACTOR
Exterior- Shade Type: NO EXTERIOR SHADE
Glass
Ovrhng
Dist
Glass
Proj
OR Factor
OR Factor
Orientation
Area
-----
Depth
------
Above
-----
Height
------
Ratio
Shade Open
----------
Shade Clsd
----------
-----------
East
35.0
7.0
/ ( 0.1
+
8.0)
-----
= 0.87
0.77
0.63
South
32.0
6.0
/ ( 0.1
+
8.0)
= 0.74
0.70
0.52
East
45.0
7.0
/ ( 0.1
+
5.0)
= 1.38
0.64
0.52
South
40.0
12.0
/ ( 0.1
+
8.0)
= 1.49
0.35
0.42
West
120.0
12.0
/ ( 0.1
+
8.0)
= 1:49
0.59
0.49
West
30.0
3.0
/ ( 0.2
+
2.0)
= 1.36
0.62
0.51.
rrjject
,'esigner
CL Ai�K RESIDENCE `;017--A ; COMPLY 24 v 3.10
JOHN ROBERT SUND ARCHITECT
Loc -a1-1 ion Palm Desert:
Date: 3/22/1992
,3uilding Permit No
Checked By
Documentation: JOHN ROBERT SUND ARCHITECT ; Dale (User # 2258)
--------------------------------------------------------------------
GENERAL IINFORMATION
Glazing Type: Double
3. Framing
Type:
Metal
wio MUIIi.or�s
S. Framing/Mullion
Factor:
0.88
(-From Table G-10)
>. Interior
':,hade Type:
Double/Roller :shades
SC Shade
Open:
0.88
(from Table G--9 or show calculation)
3. SC Shade
Closed:
0.37
(from Table G-9 or show calculation)
GLA I1,4G , INTERIOR SHADE &< FRAMING
9a .
0.88 ( SC 97 ) x 0 .88 ( FMF #5) = 0.77 SC Shade Open
10a .0.37 (SC 48) x 0.0-6 (FMF IS) - 0 .33 SC Shade Closed
`IXTERIOR :SHADE Extortor Shade Type: SO Bug Screen
11. SC Exterior Shade: 0.84 (from Table G-11 or manufacturer's data)
12. [(0 .84 (SC #11) x 0.25) -i• 0.75] x 0.77 (SC 49a) = 0.74 SC Shade Open
13. [(0.84 (SC #11) x 0.2S) + 0.751 x 0.3.3 (SC #10a) = 0.31 SC Shade Close
OVERHANG FACTOR
Dist
;lass
Orientation
Area
South
-----
48.0
West.
64.0
East
35.0
South
8.0
:youth
?2.0
-.ou t.h
64.0
West
/ 5 .0
Ovrhng
Dist
Glass
Proj
Depth
Above
Height
Ratio
6.0
/
( 0.1
+ 3.0)
= 0.74
15.0
/
( 0.1
+ 8.0)
= 1.70
4.0
/
( 0.1
+ 7,O)
= 0.56
3.0
/
( 0.'?
+ 2.0)
= 1.36
10.0
/
( 0.1
-+- S . S)
= 1 .7 0
12.0
/
( 0.1
1- 8.0)
= 1.49
5.0
/
( 0.1
+ 8.0)
= 0.62
OH Factor
Shade Open
----------
0.70
0.55
0.36
0.39
0 .27
0.35
0.81
OH Factor
Shade Clsd
----------
0.52
0.46
0.75
0.43
0.42
0.42
0.73
-------------------------------------------------------------------
Project: CLARK RESIDENCE 9017-A ; COMPLY 24 v 3.10
Designer: JOHN ROBERT BUND ARCHITECT
Location: Palm Desert
Date: 3/22/1992
Building Permit No
Checked By
Documentation: JOHN ROBERT BUND ARCHITECT ; Date (User 4 2258)
----------------------------------------------------------------------------
Assembly Name: R-19 stud frmg.
Assembly Type: (.fall
Assembly Tilt: 90 deg (Vertical)
Framing Percentage: 0.0 %
Framing Material: NONE
--------------------------------
Sketch of Construction Assembly
OVERALL VALUES ADJUSTED FOR FRAMING
Absorptivity: 0.70
Roughness: Concrete, Asph. Shingles
Weight: 10.9 lb/saft
Heat Capacity: 2.30
R -Value
U -Value
20.62 20.53
0.0485 0.0487
Th
R -Value
Construction Components
Fr (in)
Summer
Winter
---------------------------------------------------------------------------
Outside Air Film
0.25
0.17
1. Plaster, Cement w/Sand Aggregate
0.875
0.17
0.17
2. Membrane, Vapor -Seal, Plastic Film
0.010
0.06
0.06
3. Insulation, Mineral Wool, R-19
* 6.000
19.00
19.00
4. Gypsum or Plaster Board
0.500
0.45
0.45
S.
6.
7.
a.
9
Inside Air Film
---------------------------------------------------------------------------
0.68
0.68
Total
20.62
20.53
Framing Percentage: 0.0 %
Framing Material: NONE
--------------------------------
Sketch of Construction Assembly
OVERALL VALUES ADJUSTED FOR FRAMING
Absorptivity: 0.70
Roughness: Concrete, Asph. Shingles
Weight: 10.9 lb/saft
Heat Capacity: 2.30
R -Value
U -Value
20.62 20.53
0.0485 0.0487
--------------
-,roject: '-:LARK RESIDENCE 9017-A ; COMPLY 24 v 3.10
Designer: JOHN ROBERT BUND ARCHITECT
Location: Palm Desert
Date 3/22; 1992
Building Permit No
CI-,ecked By
Documentation: JOHN ROBERT BUND ARCHITECT ; Date (User # 2258)
._--------------------------------------------------------------------------
Assembly Name: Concrete tile roofing
Assembly Type: Roof
Assembly Tilt: 0 deg (Horizontal Roof- )
Framing Percentage: 0.0
Framing Material: NONE
--------------------------------
Sketch of Construction Assembly
Absorptivity: 0:70
Roughness: Concrete, Asph. Shingles
OVERALL VALUES ADJUSTED FOR FRAMING
'Vleight: / .6 ib/sgtt
Heat Capacity: 1.80
R -Value:
40.96 40.57
U -Value 0.0244 0.0246
Th
R -Value
Construction Components
Fr (in)
summer
Winter
._--------------------------------------------------------------------------
Outside Air Film
0.25
0.17
1. Concrete Roof Tile
1.250
0.50
0.50
2. Membrane, Vapor -Permeable f=elt
0.010
0.06
0.06
Plywood
0.625
0.78
0.78
=:. Insulation, Mineral Wool, R-38
11.500
33.00
38.00
S. Gypsum or Plaster Board
0.500
0.45
0.45
f3 .
Inside Air Film
---------------------------------------------------------------------------
0.92
0.61
Total
40.96
40.57
Framing Percentage: 0.0
Framing Material: NONE
--------------------------------
Sketch of Construction Assembly
Absorptivity: 0:70
Roughness: Concrete, Asph. Shingles
OVERALL VALUES ADJUSTED FOR FRAMING
'Vleight: / .6 ib/sgtt
Heat Capacity: 1.80
R -Value:
40.96 40.57
U -Value 0.0244 0.0246
----------------------------------------------------------------------
Project: CLARK RESIDENCE 9017-A ; COMPLY 24 v 3.10
Designer= JOHN ROBERT BUND ARCHITECT
Location: Palm Desert
Date: 3/22/1992
Building Permit No
Checked By
Documentation: JOHN ROBERT BUND ARCHITECT ; Date (User # 2258)
-----------------------------------------------------------------------------
Assembly Name: Carpeted Slab
Assembly Type: Floor
Assembly Tilt: 180 deg (Horizontal Floor)
Framing Percentage: 0.0 %
Framing Material: NONE
_------------------------------
Sketch of Construction Assembly
OVERALL VALUES ADJUSTED FOR FRAMING
R -Value 3.22 3.45
U --Value 0.3106 0.2899
Absorptivity: 0.70
Roughness: Concrete, Asph. Shingles
Weight: 40.9 lb/sqft
Heat Capacity: 9.01
Th
R -Value
Construction Components
Fr (in)
summer
Winter
----------------------------------------------------------------------------
Outside Air Film
0.25
0.17
1. Concrete, 140 lb, Not Dried
3.500
0.28
0.28
2. Flooring, Carpet and Fibrous Pad
0.250
2.08
2.08
3.
4.
S.
6.
7.
S.
9.
Inside Air Film
0.61
0.92
Total
3.22
3.45
Framing Percentage: 0.0 %
Framing Material: NONE
_------------------------------
Sketch of Construction Assembly
OVERALL VALUES ADJUSTED FOR FRAMING
R -Value 3.22 3.45
U --Value 0.3106 0.2899
Absorptivity: 0.70
Roughness: Concrete, Asph. Shingles
Weight: 40.9 lb/sqft
Heat Capacity: 9.01
--------------
'roject: CLARK RESIDENCE 9017-A ; COMPLY 24 v 3.10
Ci:'�ignc r' JOHN ROBERT BUND ARCHITECT ; Building Permit No
Location: Palm Desert Date: 3,122/1992 Checked By
DocuimenLatlon : .JOHN ROBERT BUND ARCHITECT ; Date ( User # 2258 )
-•--------------------------------------------------------------------------
Assembly Name: Exposed Slab
Assembly Type: Floor
;'assembly Tilt: 130 deg (Horizontal Floor)
Framing Percentage: 0.0 %
Framing Material: NONE
--------------------------------
Sketch of Construction Assembly
Total
1.19 1.42
OVERALL VALUES ADJUSTED FOR FRAMING
R -Value 1.19 1.42
U -Value 0.8403 0.7042
;,bsorptivity: 0.70
Roughness: Concrete, Asph. Shingles
Weight: 40 .9 lb/.sgft
Heat Capacity: 9.00
Th
R -Value
Construction Components
Fr (in)
Summer
Winter
-------------------------------------------------------------------------------
Outside Air Film
0.25
0.17
1. Concrete, 140 lb, Not Dried
3.500
0.28
0.28
2. Floorins3, Asphalt, Lino, Vinyl or Rubber
0.010
0.05
0.05
4.
C.
6 ,
.
3.
9.
Inside Air Film
----------------------------------------------------------------------------
0.61
0.92
Framing Percentage: 0.0 %
Framing Material: NONE
--------------------------------
Sketch of Construction Assembly
Total
1.19 1.42
OVERALL VALUES ADJUSTED FOR FRAMING
R -Value 1.19 1.42
U -Value 0.8403 0.7042
;,bsorptivity: 0.70
Roughness: Concrete, Asph. Shingles
Weight: 40 .9 lb/.sgft
Heat Capacity: 9.00
-------------------------------------------
Project: CLARK RESIDENCE 9017-A
Designer='JOHN ROBERT BUND ARCHITECT
Location: Balm Desert Date: 3/22/1992
-------------------
COMPLY 24 v 3.10
Building Permit No
Checked By
Documentation: JOHN ROBERT BUND ARCHITECT ; Date (User # 2258)
----------------------------------------------------------------------------
Assembly Name: Solid Wood Door
Assembly Type: Door
Assembly Tilt: 90 deg (Vertical)
Th R -Value
Construction Components Fr (in) Summer Winter
---------------------------------------------------------------------------
Outside Air Film 0.25 0.17
1. Hardwood, Maple 1.750 1.54 1.54
2.
J
4.
C
6
7.
3.
9.
Inside Air Film 0.68 0.68
-----------------------------------------------------------------------------
Framing Percentage: 0.0 %
Framing Material: NONE
Total 2.47 2.39
OVERALL VALUES ADJUSTED FOR FRAMING
R -Value 2.47 2.39
-------------------------------- U -Value 0.4049 0.4184
Sketch of Construction Assembly
Absorptivity: 0.70
Roughness: Clear Pine
Weight: 6.1 lb/sgft
Heat Capacity: 2.39
Project: CLARK RESIDENCE 9017-A
Designer : JOHN ROBERT BUND ARCHITI—
t_ocation: Palm Dessert Date: 3/22/1992
I)ocumentation: JOHN ROBERT BUND ARCHITECT'
---------------------------------------------------------
Assembly Name: Single/White Drapes
Assembly Type: Glazing
------------
COMPLY 24 v 3.10
Building Permit No
Checked By
Date: ( User # 2258 )
--------------------
Th R -Value
Construction Components Fr in :rummer Winter
------------------------------------------ --------------------------------
Ou.tside Air Film 0.25 0.17
1. CEC Single Glazing 0.125 0.06 0.06
4.
c
r:
7.
11-1side Air Film 0.68 0.68
-----------------------------------------------------------------------------
Framing Percentage: 0.0
Framing Material: NONE
-------------------------------
Sket.ch of Construction Assembly
!•linter Shading Coefficient: 1.00
Summer Shading Coefficient: 0.62
Total 0.99 0.91
OVERALL VALUES ADJUSTED FOR FRAMING
R -Value 0.99 0.91
U -Value 1.0110 1.1000
-----------------------------------------------
Project: CLARK RESIDENCE 9017-A ; COMPLY 24 v 3.10
Designer: .JOHN ROBERT BUND ARCHITECT Building Permit No
Location: Palm Desert Date: 3/22/1992 Checked By
Documentation: JOHN ROBERT BUND ARCHITECT Date (User # 2258)
---------------------------------------------------------------------------
Assembly Name: Single/Roller Shades
Assembly Type: Glazing
Th R -Value
Construction Components Fr (in) Summer Winter
---------------------------------------------------------------------------
Outside Air Film 0.25 0.17
1. CEC Single Glazing 0.125 0.06 0.06
2.
3.
4.
S.
6.
7.
8.
9.
Inside Air Film 0.68 0.68
---------------------------------------------------------------------------
Framing Percentage: 0.0 %
Framing Material: NONE
-------------------------------
Sketch of Construction Assembly
Winter Shading Coefficient: 1.00
Summer Shading Coefficient: 0.39
Total 0.99 0.91
OVERALL `,VALUES ADJUSTED FOR FRAMING
R -Value 0.99 0.91
U -Value 1.0110 1.1000
Project: CLARK RESIDENCE 9017-A
d=esigner: JOHN ROBERT BUND ARCHITECT
Wocation: Palm Desert Date: :3/22/1992
Documentation: JOHN ROBERT BUND ARCHITECT
---------------------------------------- ---------------
ossembly Name: Double/Light Blinds
Assembly Type: Glazing
COMPLY 24 v 3.10
Building Permit No
Checked By
Date ( User # 2258 )
--------------------
Th R -Value
Construction Components Fr (in) Summer Winter
----------------------------------------------------------------------------
Outside Air Film 0.25 0.17
1. CEC Double Glazing 0.500 0.69 0.69
2.
3.
4.
S.
r
0.
7.
8.
9.
Inside Air Film 0.68 0.68
Framing Percentage: 0.0 %
Framing Material: NONE
---------------------------------
Sketch of Construction Assembly
Winter Shading Coefficient: 0.88
Summer Shading Coefficient: 0.33
Total 1.62 1.54
OVERALL VALUES ADJUSTED FOR FRAMING
R -Value 1.62 1.54
U -Value 0.6179 0.6500
-----------------------------------------------------
Project: CLARK RESIDENCE 9017-A
Designer: JOHN ROBERT BUND ARCHITECT
Location: Palm Desert Date: 3/22/1992
Documentation: JOHN ROBERT BUND ARCHITECT
--------------------------------------------------------
Assembly Name: Dquble/Roller _Shades
Assembly Type: Glazing
-------------------
COMPLY 24 v 3.10
Building Permit No
Checked By
Date ( User 4 2258 )
--------------------
Th R -Value
Construction Components Fr (in) summer Winter
---------------------------------------------------------------------------
Outside Air Film 0.25 0.17
1. CEC Double Glazing 0.500 0.69 0.69
2
3.
4.
S.
6.
7.
a.
9.
Inside Air Film 0.68 0.68
---------------------------------------------------------------------------
Framing Percentage: 0.0 %
Framing Material: NONE
---------------------------------
--------------------------------
Sketch of Construction Assembly
Winter Shading Coefficient._: 0.88
Summer Shading Coefficient: 0.37
Total 1.62 1.54
OVERALL VALUES ADJUSTED FOR FRAMING
R -Value 1.62 1.54
U -Value 0.6179 0.6500
Project: CLARK RESIDENCE 9017--A
Designer: JOHN ROBERT BUND ARCHITECT
Location: Palm Desert
Date: 3/22/1992
COMPLY 24 v 3.10
Building Permit No
Checked By
Documentation: JOHN ROBERT BUND ARCHITECT ; Date (User # 2258)
---------------------------------------------------------------------------
A EQUIPMENT DATA
1
Water heater type
SG
Enter SG or SE
2
Manufacturer &
18700
KBtu/yr/unit, see Table 1
3
model number
140
A .0 .Smit.h PGC -50 (SG)
4
Ignition device
GP
GP, gas pilot or IID, int. ignition device
5
Tank volume
47.5
Total gallons, from CEC Appliance Directory
6
Recovery efficiency
76.0
Percent from CEC Appliance Directory
7
Standby loss
3.7
Percent/hour, from CEC Appliance Directory
8
Rated input
44000
Btu./hr, from CEC Appliance Directory
9
Number of pumps
0
( 1 kWh = 3413 Btu)
9
Number of Heaters
2
From building plans (total)
10
Insulation Jacket
Y
(Y/N) R-12 insulating jacket on the plans
3 OPERATING DATA
1
Climate Zone
1S
See Appendix D
2
Water heating budget
18700
KBtu/yr/unit, see Table 1
3
Tank set temp.
140
F, fixed input
4
Water main temp.
70.0
F, see Table 1
5
Daily hot water load
50
50 or 35 gallons/unit, see Table 1
6
Ambient air temp.
72.6
F, see Table 1
7
Adj Standby Losses
0.0240
See Table 2 or Appendix B
8
No. dwelling units
1
From building plans (total)
9
Number of pumps
0
From building plans
10
Pumping energy
0.0
Watt-hr/yr per Pump, see Table 3
C
WATER HEATING ENERGY
CREDITS
----------------------------------------------------------------------------
1
Credit name
See Table 5
2
Annual savings
0.0
KBtu/yr/dwelling unit, see Table 5
D CALCULATE ANNUAL WATER HEATING ENERGY (KBtu/yr)
---------------------------------------------------------------------------
1 Recovery load 10539.4 (CBS x 8.25 x( 140-B4 )x 365 x 0.0011-C20 B8
2 Recovery energy 13867.6 D1 / A6
3 Standby loss energy 10888.S ( 24 - [(D2 x 1000)/(A8 x A9 x 36S)I) x 8.25
x A5 x B7 x 365 x( 140-66) x 0.001 x A9
4 Pumping energy 0.0 89 x B10 x 3.413 x 3 x 0.001
5 Total energy 24756.1 GAS SYSTEMS: (D2 + D3 + D4) / B8
ELECTRIC: ( [( D2 + D3) x 33 + D4) / B8
6 Water heating budget
comparison -6056.1 KBtu/yr/unit B2 - D5
7 Water heating budget -3.7 Points (D6 / Floor Area) x 2 x B8
='r Ujr'Ct: C:L�;RK RESIDENCE `.-'017 -A
OHN ROBER T BUND ARCHITECT
_c)cation I DeseT't Datt: 3/22/1992
Documentation: .70HN ROBERT BUND ARCHIT`CT
HVAC ZONE DESCRIPTION
HVAC Zone flame:
Heating System Name".
Cooling System Name:
System Mulltiplier :
Heating. Schedule:
Cooling Schedule:
Fan Schedule:
Peak Load Method:
Relative Humidity:
ESPACES
PACES
Iia FHIS ZONE
PEAK
Single
Storey House
----
(Jan 12am)
TOTAL
SPACE LOAD
Bypass
Ventilation Air
( 0 cfm)
Supply
Duct Conduction
Supply
Duct Leakage
Supply
Fan Heat Gain
EFFECTIVE SPACE LOAD
Ventilation ( 0 cfm )
Return Air Lighting Gain
Return Duct Conduction
Return Duct Leakage
Return Fan Heat Gain
TOTAL SYSTEM LOAD
SYSTEM PERFORMANCE
AT DESIGN CONDITIONS
HEATING
73287
73287
0
3664
1466
-3637
74780
0
748
1496
-0
77023
162000
COMPLY 24 v 3.10
Building Permit No
Checked By
Datta ( User # 2258 )
--------------------
Single Storey House
BDP 398AO48080/594AN042
2
Residential Heating
Residential Cooling
Residential HVAC & Fans
COINCIDENT
50 %
COOLING
PEAK SENSIBLE LATENT
------
(Aug 2pm ) 65639 1473
65639 1473
0 cfm ) 0 -0
3282
1313 29
3637
73871 1502
0 c:fm ) 0 -0
0
739
1477 30
0
76087 1533
6.3 tons 0.1 tons
61985 12771
5.2 tons 1.1 tons
Project: CLARK RESIDENCE 9017-A ; COMPLY 24 v 3.10
i
Cosigner: JOHN ROBERT BUND ARCHITECT ; Bui.lding Permit lido
Location: Palm Desert Date: 3/22/1992 Checked By
Documentation: JOHN ROBERT 83UND ARCHITECT ; Date (User # 2258)
_--------------------------------------------------------------------------
Space; Name:
Design Indoor Dry Bulb Temperature:
Design Outdoor Winter Dry Bulb Te=mperature.
Design Temperature Difference:
Conduction
R--19 stud fang.
Solid Wood Door
Single/White Drapes
Double/Light Blinds
Single/Roller Shades
Double/Roller Shades
Concrete the roofing
Exposed Slab
Carpeted Slab
Infiltration: 1.00 x 0.018 x
`jingle Storey House
70 F
32 F
38 F
Area
------
U -Value
-------
TD
----
Btu/hr
2578.0
x
0.0487
x
33.0
------
= 4771
116.0
x
0.4184
x
38.0
= 1844
36.0
x
1.1000
X
38.0
= 1505
20.0
x
0.6500
x
38.0
= 494
153.0
x
1.1000
x
33.0
= 6395
618.0
x
0.6500
x
38.0
= 15264
3274.0
x
0.0246
x
38.0
= 3067
Perim = 151.0
x
42
= 6267
Perin = 245.0
x
42
= 10168
3274 sqf t x 10 .5 fit x 1.00 AC x 38.0 = 23514
TOTAL HOURLY HEAT LOSS FOR SPACE 73287
SUPPLY AIR QUANTIT`(
-------------------
Heat. i ng: 73287 Btu/hr / [ 1.10 * (10S F Supply - 65 F TSta t )] = 1666 cf m
Pro jec:t : "_ARK ,.ESIDE NCE 9017-A
Designer : . 0HN ROBERT BUND ARCHITECT
1 -ovation: Piini Desert
Date: 3/22/1992
COMPLY 24 v 3.10
Building Permit No
Checked By
F):)cun-ieni:,ation: JOHN ROBERT BUND
ARCHITECT
Area
;
Date
( User
# 2258 )
>; a(:, -e Na.m
3274.0 x
Single
Storey
= 0
'rouse
1.00 x
Design Indoor Dry Bulb Temperature:
225 /
SGF
- 1473
Area
78 F
Design Outcioor rummer Dry Bulb
Temperature.-
Single/White
Drapes
North
112 F
0.0
Design Temperature Difference:
15
+
36.0
x 15]
34 F
0.55
Conduction
Area
Blinds
U -Value
[
DETD
Btu/hr
R-19 stud frmg.
2578.0
x
0.0485
x
27.6 -
3452
Solid Wood Door
116.0
x
0.4049
x
27.6 -
1296
Sinyle/Whit` Drape=s
36.0
x
1.0110
x
34.0 =
1237
Double/Light. Blinds
20.0
x
0.6179
x
34.0 =
420
Single/Roller Shades
.153.0
x
1.0110
x
34.0 =
5259
Double/Roller Shades
618.0
x
0.6179
x
34.0 =
12982
Concrete tilo roofing
327" .0
x
- 0.0244
:;
43.0 =
3837
Infiltration: 1.00 x 0.018 x 3274 sqft x10.5 ft x 1.00 AC x 34.0 = 21039
TOTAL HOURLY SENSIBLE HEAT GAIN FOR SPACE 65639
Latent Gain
Op Frac.
Area
Heat Gain
Shaded
Btu/hr
Unshaded
1.00 x
3274.0 x
0.000 x
Solar Gain
= 0
Orient.
1.00 x
Area
225 /
SGF
- 1473
Area
SGF
SC
Btu/hr
Single/White
Drapes
North
[
0.0
x
15
+
36.0
x 15]
x
0.55
= 295
Double/Light
Blinds
North
[
0.0
x
15
•+-
20.0
x 15]
x
0.28
= 83
Single/Roller
Shades
East
[
17.1
x
15
+
26.9
x 731
x
0.34
= 763
Double/Roller
Shades
East
[
24.1
x
15
•+-
10.9
x 73]
x
0.33
= 376
Double/Roller
Shades
South
[
32.0
x
15
+
0.0
x 32]
x
0.33
= 156
Double/Roller
Shades
South
[
48.0
x
15
+
0.0
x 32]
x
0.31
= 225
Double/Roller
Shades
West
[
64.0
x
15
+
0.0
x 73]
x
0.31
= 300
Single/Roller
Shades
West
[
17.0
x
15
+
0.0
x 731
x
0.34
= 88
Double/Roller
Shades
East
[
15.5
x
15
+
19.5
x 731
x
0.31
= 518
Double/Roller
Shades
East
[
45.0
x
15
+
0.0
x 73]
x
0.33
= 220
Double/Roller
Shades
South
[
8.0
x
15
+
0.0
x 32]
x
0.31
= 38
Double/Ro11al-
Shades
South
[
22.0
x
15
•+-
0.0
x 32]
x
0.31
= 10:3
Single/Roller
Shades
South
[
14.0
x
15
-+-
0.0
x 32]
x
0.34
= 72
Double/Roller
Shades
South
[
64.0
x
15
+
0.0
x 32]
x
0.31
= 300
Double/Roller
Shades
South
[
40.0
x
15
+
0.0
x 32]
x
0.33
= 195
Double/Roller
::shades
West
[
120.0
x
15
-+-
0.0
x 73]
x
0.33
= 586
Single/Roller
Shades
West
[
40.0
x
15
+
0.0
x 73]
x
0.34
= 206
Double/Roller-
Shades
West
(.
30.0
x
15
+
0.0
x 73]
x
0.33
= 147
Single/Roller
Shades
West
[
10.0
x
15
+
0.0
x 73]
x
0.34
= 51
Double/Roller
Shades
West
[
36.8
x
15
+
38.3
x 73]
x
0.31
= 1045
Single/Roller
Shades
West
[
10.3
x
15
+
17.7
x 731
x
0.34
= 497
Internal �:ain
Op Frac.
Area
Heat
Gain
r:,onv.
Btu/hr
Lighting
1.00
x 3274.0
x
0.500
x
3.413 =
5587
Equipment
1.00
x 3274.0
x
0.250
x
3.413 =
2794
Occupants
1.00
x 3274.0
x
225
/
500 =
1473
TOTAL HOURLY SENSIBLE HEAT GAIN FOR SPACE 65639
Latent Gain
Op Frac.
Area
Heat Gain
Conv.
Btu/hr
Equipment
1.00 x
3274.0 x
0.000 x
3.413
= 0
Occupants
1.00 x
3274.0 x
225 /
500
- 1473
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 7/9/92 1 Type of Permit I La Quinta
No, 11556 Permit #
Owner Name Jack L. Clark Log #
No. 48985 Street El Nido
city La Quinta zip 92253
Study Area
APN # 631-321-007-1 Tract # I DLot # Square Footage 13Z74
Type of Development Single Family Residence No. of units
Comments
At the present time, the Desert Sands Unified School District does not collect fees on
garages/carports, covered patios/walkways, residential additions under 500 square feet,
detached accessory structures or replacement mobilehomes. It has been determined
the above-named owner is exempt from paying school fees at this time due to the
following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.58 X 74 or$ 5,172.92 have been paid to D.S.0 S.D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now be issued.
Fees Paid By Clark, Jack or Anne or Jack Jr.
Name on the check
By James E. Lively
Assistant Superintendent, Business Services
Telephone
Fee collected /exempted by Shelley D. Bennett
Payment Received
Signature ` �' Check No. 423 3-
Collector: Attach a copy of county or city plan check application form to district copy fvr all,wa vers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting