BRES2015-02174 78-495 CALLE TAMPICO VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/8/2015
Application Number: BRES2015-0217
Owner:
Property Address: 77550 CALLE CHIHUAHUA
CATHERINE POTTER
g
r
APN: 773323013
77550 CALLE CHIHUAHUA.
Application Description: POTTER/ REPLACE PATIO DOOR
LA QUINTA, CA 92253
z
Property Zoning:
z
Application Valuation: $2,100.00
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0
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-D D
Applicant:
Contractor:
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N
ALLIANCE CONSTRUCTION ENTERPRI
ALLIANCE CONSTRUCTION ENTE
Lzt
C
46267 MONTE VISTA DRIVE
46267 MONTE VISTA DRIVE
n„D
INDIO, CA 92201
INDIO, CA 92201
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r
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and myLse is in full force and effect.
License Class: B License No.: 928697 /e
Contracto,_,-.�6_flwa�
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
( )'I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that
he or she did not build or improve for the purpose of sale.).
(� 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
( I I am exempt under Sec.. B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permitis issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
(760)222-8895
Llc. No.: 928697
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensatiion,-as provided for by Section 3700 of the Labor Code, for the performance
of the rkfior which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 3 00 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier:- Policy Number: _
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions. 1
�S= I APPlican"t/Ay
(0 L _ 6,k \
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or.
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work -is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
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 upon the above.-
mentioned
bove.mentioned property for inspection purposes.
Dat
e: I Signature (Applicant or Agent)
'�... Permit Details PERMIT NUMBER
City of La Qu inta BRES2015=0217
L �
Description: POTTER / REPLACE PATIO DOOR
CHRONOLOGY
Type: BUILDING RESIDENTIAL Subtype: REMODEL
Status: UNDER REVIEW
Applied: 6/8/2015 SKH
WEB
COMPLETION DATE NOTES
Approved:
Parcel No: 773323013 Site Address: 77550 CALLE CHIHUAHUA LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 158
Lot: 14
Issued:
UNIT 16
STEPHANIE KHATAMI
6/8/2015
Lot Sq Ft: 0 Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $2,100.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: CHANGE OUT PATIO DOOR LIKE FOR LIKE NO STRUCTURAL REQUIRED. [2013 ENERGY] 2013 CALIFORNIA BUILDING CODES.
Printed: Monday, June 08, 2015 5:37:48 PM 1 of 2
U 1..f !JL SYS TEti1S
CHRONOLOGY
CHRONOLOGY TYPE STAFF NAME
ACTION DATE
COMPLETION DATE NOTES
PLAN CHECK. SUBMITTAL
STEPHANIE KHATAMI
6/8/2015
6/8/2015
RECEIVED
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP PHONE
FAX
EMAIL
APPLICANT
ALLIANCE CONSTRUCTION ENTERPRI
46267 MONTE VISTA
INDIO
CA
92201
DRIVE
CONTRACTOR
ALLIANCE CONSTRUCTION ENTERPRI
46267 MONTE VISTA
INDIO
CA
92201
DRIVE
OWNER
CATHERINE POTTER
77550 CALLE
LA QUINTA
CA
92253
CHIHUAHUA
Printed: Monday, June 08, 2015 5:37:48 PM 1 of 2
U 1..f !JL SYS TEti1S
Printed: Monday, June 08, 2015 5:37:48 PM 2 of 2 CN?
SYSTEMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
RESULT REMARKS NOTES
DATE DATE
FINAL" BLD
Printed: Monday, June 08, 2015 5:37:48 PM 2 of 2 CN?
SYSTEMS
Avnn11da Qarr,re2_..
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
_DA*J-yBY �
Bin #
:City of La Quinta
Building 8l: Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
3S�cS�
Project Address: �J( CJ1lhLx3L �
Owner's Name:
/�
A. P. Number: L�j `3—
Address: -775. O CoOr—
l•G CK kuaU Cj
u3 +3
Legal Description: LC 4 1y M t3 Ol O '099
City, ST, Zip: 1-0 Q of n fn CA g2Z53
'' _
Contractor: l�a he n GTel
Telephone:
Address: Mai,- mbb O •
Project Description:
City, ST, Zip: I �a (C) (�A q Z20 (
9A o dw r Qe yo -(1 4i Yl
P �r�
Tel hon
e n
ll(.l✓ 2 22� `1 5
'
State Lic. # : 91201
City Lie. #:
Arch., Engr., Designer: —` X
Address:
City, ST, Zip:
•TelePhone. nstru in TYPe•
COccupancy:
- an cY
State L ic. #
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Ayiamc Cx)cYYo
Sq. Ft.: ' q391
# Stories: (
#Units:
c.,
Telephone # of Contact Person: -T 222 8 q J
�
Estimated Value of Project: a
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Title 24 Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2". Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
r
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEG CF -IR -ALT Revised 03/10 CALIFORNIA ENERGY COMMISSION
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations age 1 of 7
Project Name: Climate Zone # # of S ones
nar. 4
General Information
Site Address:
Enforcement Agency:
Date: CbC6 I
Building Type Single Family ❑ Multi Family
Circle the Front Orientation: N W, or de ees
Conditioned Floor Area (CFA): 4,59
Project Type: ❑ Alterations 079nvelopFenestration 13Roof ❑ HVAC
Replacement or Change Out ❑Duct Re lacement ❑ Water Heater
NOTE: This form is not to be used for Newly Constructed Buildings or Additions
Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below)
Assembly Alteration
❑ Opening of framed cavity alone—Alterations that involve the opening ofthe framed cavity ofa wall, ceiling, or floor must install the
mandatory minimum insulation value per §1 50for the altered assembly. Fill in Columns A --C and enter mandatory insulation value in Column H.
❑ Replacement of entire assembly— Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component
Package- D insulation values in Table 151-C. Fill in Columns A — J.
Opaque Surface Details For the furred portioned of Mass
Walls see Furring Strips Construction Table below.
A B C D
E
F G H I J
Proposed see Note
Standard
Values From JA4 Table
Walls From Reference
Framing
Thickness,
Framed Continuous JA4
Proposed
Tag/
Assembly Name
Material
Spacing,
U-
JA4 Table Cavity Insulation Assembly
Assembly
IDI
or Type 2
and Size
or Other3
factor"
Numbers R-valuO R -Value? Row/Col'
U-factor9
Final.
Mass
Name or JA4 Table
.o
y d N
c k >
Assembl
Thickness`
Type' Number' ¢ >`
a
'
¢ >
U -factor
Comment
Note: For furred assemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-1. For calculating furred walls use the Mass and
Furring Construction table below.
1. For Tag/ID indicate the identification name that matches the building plans.
2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc... Indicate in column G the Frame
material and Size: For Wood Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24 "OC; or Other for all other assembly description
such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc....
4. Based on the Climate Zone; enter the equivalent U factor found in JA4 Table based on the R -Value from Table 151-B, C, or D
5. Enter the Table number that closely resembles the proposed assembly.
6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0".
7. Enter the Continuous Insulation R -value for the proposed assembly; otherwise, enter "0".
8. Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U factor in Column J
9. The Proposed Assembly U factor, Column J, must be equal to or less than the Standard U factor in Column E to comply.
Furring Strips Construction Table for Mass Walls Onl
A I B I C I D I E
F G I H I J K
L
M
Proposed Properties of Masonry and Concrete
Added Interior or Exterior Insulation
Walls From Reference
in Furring Space from Reference
Joint Appendix Table 4.3.5, 4.3.6 4.3.7
Joint Appendix Table 4.3.13
-a2
N
Assembly ;�
a
o '
o c?
°'
? 7
Final.
Mass
Name or JA4 Table
.o
y d N
c k >
Assembl
Thickness`
Type' Number' ¢ >`
a
'
¢ >
U -factor
Comment
Registration.Number: _ ______ _ ReAistration.Date/Time:._ HERSProvider: _
2008 Residential Compliance Forms March 2010
c
r
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC- CF -1 R -ALT Revised 03/10 CALIFORNIA ENERGY COMMISSION
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations age 2 of 7
Project Name: �6kv
11 �Q , _ '1�• ^�� C� CCUate Zone # "of tories
Mass and Furring Strips Construction(footnotes)
1. Indicate the type of assembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Etc. Additional assemblies can
e found Reference Joint Appendix JA4.
2. This is the U -Factor based on the thickness of the assembly in inches.
3. The R -value of the insulation to be added on the interior or exterior of the assembly.
4. The Calculated R- Value is the R -value of the furred out section of the assembly.
-6. The Final Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix JA4. The equation is the inverse of Column
added to Column L Column K is the inverse from column J.
7. Insert the calculated U -factor value on to the Opaque Surface Details in Column J
FENS RATION PROPOSED AREAS
eplacing window alone — Replacement windows shall meet the U -Factor and SHGC Value requirements of Component Package D in
able 151-C. The Total Fenestration and West facing Area requirements are not applicable.
❑ Adding 50ft' or less Of window area —Newly installed windows shall meet the U -Factor and SHGC Value requirements of Component
Package D in Table 151-C.
❑ Adding more than 50ft2 of window area — Newly installed windows shall meet the U -Factor and SHGC Value and the Fenestration
Area requirements of Component Package D in Table 151-C. Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF -IR -ALT
D
Orientation
F
Fenestration Type and Frame
(Window, Glass Door or S li t
(North, East, PropsedArea'
South, West) (ft'
Maximum Maximum
U -facto?-' SHGC''s, 4
NFRC or Default
Values
- ►1� 1 Cor
W
0,20 02-25
NFQC
Entire
% of
Fenestration
Area
Fenestration
Area
Proposed Area' 4
Dwelling
CFA'''
Area4
Removed
Area Added
1. Fenestration area is the area of total glazed product (i. e. glass plus fame). Exception: When a door is less than 50% glass, the fenestration
area may be the glass area plus a "2 inch fame" around the glass.
2. Enter value four Component Package D Requirements in Table 151-C.
3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower U factor and/or a lower
SHGC value than that specified on the CF -IR ALT Form.
4. Submit a completed WS -3R Form if a reduced SHGC is calculated with exterior shading.
51fapplicable at this stage enter 'NFRC" or NFRC Certified windows or are CEC "Default " valuesound in Table 116-A or B.
ALTERED FENESTRATION
ALLOWED AREAS
(Co lete if more than SOfta of fenestration is added)
A
B
C
D
E
F
G
CFA of
Allowed
Existing
Allowed
Entire
% of
Fenestration
Area
Fenestration
Area
Proposed Area' 4
Dwelling
CFA'''
Area4
Removed
Area Added
A x B
-D + C
Total Fenestration
Area' ft'
>
West Fenestration Area`
(Required In
>
CZ's 2,4&7-15
2008 Residential Compliance Forms March 2010
STATEIOF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEG CF -1 R -ALT Revised 03/10 CALIFORNIA ENERGY COMMISSION
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations age 3 of 7
Project Name: ' !� �n ' r Climate Zone # ' � l# of Stories
1. The Proposed West Fenestration Area includes West -sloping skylight area and any other skylight area with a pitch less than 1:12.
2. Enter 20% when no West orientation restriction or 15% when West fenestration is being installed in Climate Zones 2, 4, & 7-15. Note that the
maximum allowed fenestration can only be 5% of the CFA as indicated in Column F. Column G must be equal to or less than Column F.
3. In climate zones 2, 4, 7-15, no more than 5% of the CFA is allowed for west facing glazing.
4. Existing Fenestration area must be counted toward the maximum allowed 15% or 20% of the whole building and calculated in Column G. The
Proposed Area must be less than or equal to Column F.
5. Enter the fenestration removed as part of the alteration if arty in column D.
6. Enter the Fenestration area that is being added as part o the alteration.
Registration Number: _ _ °Registration Date/Time: __ _ _ _ ________ __ HERS Provider:
2008 Residential Compliance Forms March 2010
STATE OF CAt.IFORNIA
RESIDENTIAL ALTERATIONS
CEC- CF -1 R -ALT Revised 03/10 CALIFORNIA ENERGY COMMISSION ` 4 .'aW
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alter tions age 4 of 7
Project Name: . r . A . _. 1-1^ _ 6 _ _ _ „ Clit fate Zone # �j1 I # of stories
R FING PRODUCTS (COOL ROOFS) §1510912
en the area of exterior roof surface to be replaced exceeds more than 50% of the existing roof area, or more than 1,000ft2, whichever is
-kys, the new roofing area must meet fit roofing product "Cool Roof requirements of §152(b)1Hi,152(b)1Hii, or 152(b)1H&
Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof' requirements. Note: If any
one of the alternatives or exception below is checked the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in
§118(1) are not applicable. Do not fill table below.
❑ Cool Roofs Not Required in Climate Zones 1-12, 14, and 16 with a Low Sloped. Less or 2:12 pitch.
❑Cool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep -Sloped Roofs (pitch greater than 2:12) and product unit weight less
than 51b/ft.
Alternatives to §152(b)IHi and §152(b)Hii, Steep -slope roof (pitch > 2:12)
❑ Insulation with a thermal resistance of at least 0.85 heft •°FBtu or at least a 3/4 inch air -space is added to the roof deck
over an attic; or
❑ Existing ducts in the attic are insulated and sealed according to §15l(f)l0; or
❑ In climate zones 10, 12 and 13, with 1 1'C of free ventilation area of attic ventilation for every 150 ft of attic floor area, and
where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge; or
❑ Building has at least R-30 ceiling insulation; or
❑ Building has radiant barrier in the attic meeting the requirements of §15l(f)2; or
❑ Building has no ducts in the attic; or
❑ In climate zones 10, 11, 13 and 14, R-3 or greater roof deck insulation above vented attic.
Exception to §152(b)IHiii, Low -slope roof (pitch <2:12)
❑ Building has no ducts in the attic.
Other Exceptions
❑ Roofing area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria.
❑ Roof constructions that have thermal mass over the roof membrane with at least 25 lb/ft is exempt from the below Cool Roof criteria.
Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwise,
Check the applicable box below if Exem t from the Roofing Products "Cool RoofRequirement:
Roof Slope
Product Weight
Product
Aged Solar
Thermal
CRRC Product ID Number
_< 2:12 > 2:12
< 5lb/ft2 >_ 51b/ft 2
TyneZ
Reflectance 3,4
Emittance
SRI
❑
❑
❑
❑
❑4
❑
❑
❑
❑
❑4
❑
❑
❑
❑
❑4
❑
❑
❑
❑
❑4
❑
❑
❑
❑
❑4
1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www. coolroofs.om1products/search.phg
2. Indicate the type ofproduct is being used for the roof top, i.e. single ply roof, asphalt roof, metal roof, etc.
3. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same
directory and use the equation (0.2+0.7(pinirioi — 0.2) to obtain a calculated aged value. Where pis the Initial Solar Reflectance.
4. Check box if the Aged Reflectance is a calculated value using the equation above.
5. Calculate the SRI value by using the SRI- Worksheet at hgp:/hvww.energy.ca.gov/tide24/and enter the resulting value in the SRI Column above and attach acopy of
the SRI- Worksheet to the CF -IR
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in § 118(i)4. Select the applicable coating:
❑ Aluminum -Pigmented Asphalt Roof Coating
TO Cement -Based Roof Coating
❑ Other
ate/Time 7,7� �7f,a :: 7 ,a_ a,_: HERSP.rov:der:"t:
2008 Residential Compliance Forms March 2010
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CALIFORNIA ENERGY COMMISSION
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations age 5 of 7
Project Name: Z , , , _ Climate Zone #
I # of Stories
!AVAC SYSTEMS - HEATING
Lisl water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be
gas or propane f red. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground hot water pipes is required in all
Minimum Duct or Piping Configuration
Heating Equipment
T pe and Ca act 1,2,3
Efficiency Distribution Insulation Thermostat (Central, Split,
AFUE or HSPF Type and Location" R -Value Type Space, Package or H dronic
1
1. Indicate Heating Type (Central Furnace, Wall Furnace, Heat pump, Boiler, Electric Resistance, etc)
2. Electric resistance heating is allowed only in Component Package C, or except where electric heating is supplemental (i.e., if total capacity
< 2 KW or 7,000 Btu/hr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §151(b)3 exception.
3. Refer to the HERS Verification section on Page 4 of the CF -IR -ALT Form for additional requirements and check applicable boxes.
4. Indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc)
HVAC SYSTEMS - COOLING
Type,
Minimum
System
Capacity (gal)
Thermal Efficiency
Efficiency Duct or Piping
Configuration
Cooling Equipment
Type and Ca act 1'2
(SEER/EER or Distribution Insulation
COP) Type and Location R -Value
Thermostat
Type
(Central, Split,
Space, Package or H dronic
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Prescriptive requirements do
1. Indicate Cooling Type (A/C, Heat pump, Evap. Cooling, etc)
2. Refer to the HERS Verification section on Page 4 of the CF -IR -ALT Form for additional requirements and check applicable boxes.
3. Indicate Type or Location (Ducts, H dronic in Floor, Radiators, etc)
OWN
ATER HEATING
Lisl water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be
gas or propane f red. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground hot water pipes is required in all
component packages in all climate zones.
External Tank
Water Heater Type/Fuel
Distribution Type
Number In
Tank
Energy Factor or
Insulation
Type,
(Standard, Recirculating)2
System
Capacity (gal)
Thermal Efficiency
R-Value3
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Prescriptive requirements do
not allow the installation of a recirculating water heating system for single dwelling units.
3. The Vxternal water heating tank and i es shall be insulated to meet the requirements of§l506).
CUL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below.
hes 'tems may require written 'usti tcation and documentation and special veri cation.
NEW ROOF ASSEMBLY - Radiant Barrier
The radiant barrier requirement of § 151 2 does not apply to roof alterations.
Slab Edge (Perimeter) Insulation ❑ YES ❑ NO
YES: In Climate Zone 16 in Component Packages D, R-7 insulation is required.
Heated Slab Insulation ❑ YES ❑ NO
YES: Slab ed a insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation ❑ YES ❑ NO
YES: In Climate Zones 1 2, 11, 13, 14 & 16, R-8 insulation is required; in Climate Zones 12 & 15, R-4 is required under component Package D.
Registration Nu tuber: _ _ _Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms March 2010
C
STATP OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC- CF -1 R -ALT Revised 03/10 CALIFORNIA ENERGY COMMISSION
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations (Page 6 of 7
Project Name: f-*-,. I I _, `„_ , —, , A,1. /-N _ nn _ _ _ ., n Climate Zone # r_I # of §tories
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass, use the Performance Approach.
RIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this
e ist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before final
inspe 'on.
Duct Sealing & Testing HERS verification is required for this measure.
❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned
space, the ducts are to be sealed per §152(b)1Dii and the newly installed ducts are to be insulated per §151(f)10.
❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the
ducts are to be sealed per §152(b)IDi.
❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler,
outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are to be
sealed per §152(b)IE.
❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS
verification in accordance with procedures in the Reference Residential Appendix RA3.
❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space.
❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos.
Refrigerant Charge- Split System HERS verification is required for this measure.
❑ YES ❑ NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air
handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat
exchanger) a refrigerant charge measurement shall be verified per § 152(b)1F.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The ventilation requirements of § 150(o) do not apply to existing residential homes.
Ducted Split Systems -Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure.
❑ YES ❑ NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is
replaced, the airflow and fan watt draw shall be verified per § 152 1 C to meet the requirements of § 151(07B.
Doeugientation Author's Declaration Statement
-.14certify that this Certificate of Compliance documentation is accurate and corn tete
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Responsible Building Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance.
• I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit application.
2008 Residential Compliance Forms March 2010
STATS OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC- CF -IR -ALT Revised 03/10 CALIFORNIA ENERGY COMMISSION
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations age 7 of 7
Project Name:VN�, V j') YrOK k()CQ r 'n r� Climate Zone # # of Stogies
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Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
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RegistrutionNumber: ___ __ __ __. ___Registration Date/Time: HLRSP,rovider:
2008 Residential Compliance Forms March 2010
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