04793 (SFD)44a
93
.v �• 7
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address $2-940 Velasco LA,QUINTA, CALIFORNIA 92253
Owner
Joe Stemmer. " '" BUILDING: TYPE CONST. OCC. GRP.
Mailing
'Address 79-940 Horseshoe
City Zip' Tel.
A:P. Number,
La
iAinta 92253 342 3'17 Legal Description y
'Contractor Project Description
Address
City Zip Tel.
State Lic. City
& Classif. Lic. # Sq. Ft. 120E No. No. Dw.
Arch., Engr.;
Size '� Stories Units
-Designer , New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address 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 Dlvision 3 of the,Business and Professions Code, and my license is in full force and
`tiaikli b%r L
effect.` sr., t` ''"�..•t�y'>ir✓f..a �C,•r. �id'�,.:.o'"r. s ,
SIGNATURE DATE '
OWNER -BUILDER DECLARATION
.'I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuatio$64r830 is
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a N -
permil to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT AMOUNT,
theprovisionsof 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 plan Chk. Dep.
,for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permitY
subjects the applicant to a civil penalty of not more than five hundred dollars (8500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. +eC fr.�i
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, Mech.
provided thahsucti 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 Electrical wad
of proving that he did not build or improve for the purpose of sale.)
O 1,•as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing rt ,'Q•
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 S.M.I,
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) '
O 1 am exempt under Sec. ' B. & P.C. for this reason Driveway Enc.
Date owner Infrastructure # +
WORKERS' COMPENSATION DECLARATION
I 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:T(Sec. 3800, Labor Code.) -
Policy No. company &-W_ MU .-&_ 1
❑ Copy is filed with the city. ❑ Certified:copy is hereby furnished. _
TOTAL j705 j 45
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (8100) valuation
or less.)
I certify that in the performance of thg 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.
Date Owner
NOTICE TO APPLICANT. If,. after making this Certificate of Exemption you should become ZONE: BY: -
subject to the Workers'„ Compensation . provisions. of. the Labor Code, you must' forthwith - , -
•comply with such provisions ofthis permit shall bedeemed revoked.- MIr11R1UmSetback Distances
. *� h
Front Setback fr�omente e - � �� { �
Rea Setback from Rear�Prop. ,Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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.) - - Side Setback from Property Line
Lender's Name 7
Lender's Address
This Is a building permit when properly filled out, signed and validated, and is subject tom.,` FINAL DATE - INSPECTOR
' expiration if work thereunder is suspended for 180 days.
r I certify that I have read this application and state that the above information Is correct. Issued by: Date ! Permit
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. Validated by:
Signature of applicant • - Date "
f. Mailing Address ` Validation:
City,•State,'Z!p
WHITE `FINANCE PINK APPLICANT, GREEN BUILDING, GOLDENROD;, ASSESSOR'S OFFICE, HARD COPY -FILE r
S
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT rp S
UNITS '
COLL. AREA
SLAB GRADE
ROUGH PLUMB
YARD SPKLR SYSTEM
2ND FL SO FT. 6
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR SO FT. a
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR SO. FT. la
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P. SO FT. 6
GROUT
WATER HEATER
DRINKING FOUNTAIN
WALL SO. FT. @
FINAL INSP.
BOND BEAM
WATER SYSTEM
URINAL
SO. FT. a
GRADING
cu. yd.
$ plus XE
=$
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to he used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
J� ,��
U r
WATER SOFTENER
VENT SYSTEM . FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOHDISH)
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
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ IA c
SEWAGE DISPOSAL
S I>SNISOUND Z
c�
SO.FT.GAR r Vic
HOUSE SEWER
FINISH GRADING
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 8 AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
' 4FMP. POLE 1`•'14
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus XE
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
J� ,��
U r
_ 6—•
/�/�
C
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR -
GAR. FIREWALL
LATHING /
MESH
S I>SNISOUND Z
c�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURE511NITIALS
,
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF
SCHOOL FACILITY FEES
RAI
DOCUIWENTp�
TO: City of LgaEQ�n:'a-LiCAT �+/4NNO' DATE: ZI— 4--�� E1U
Department of Community Dewelopment
78-105 Calle Estado
La Quinta, CA 92253
This is to certify that Joz - ,
developer of ,ttWC) I which is
located at — / within
this District, has paid school facility fees imposed pursuant to the
authority gener(t d by Gpvernment Code Section 308^`Q i the amo nt of
r "li 8 q �lJo
covering a total of square feet of ( ) residential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
),r(()O
4 Ho -d, for DESERT SANDU.URIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
��"- /O / 0 (10137
rv.
' COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH - Assessors Parcel No.
ENVIRONMENTAL HEALTH SERVICES 77.E — .324
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 check list.
- 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' # x e
Z
Q
Agent, Contractor, Contact Person
Phone
Address & Phone
F-
D�
Phone
Mail'ng AddMSS
- 9 l0,4eSF
City
State
A
Zip
F�.z
Job Property Address
��
Legal Desc 'pt'an Prop. (PM, Tract 4
3
N ATS l�
Lot Size
1
Water Agency a
Use of Permit P/P, CU, c. m WL4A_ ?"_
�e �a:�cc.�.c
Other
/zLr
Site rep.etc.
v
icy
�-a - 7. 1
Sigriatureof Applicant
r -+# : e Date
CATEGORY: , �, REV CODE FE
CATEGORY:. REV CODE FEE " -
&, SUBSURFACE DISPOSAL r 1238 $45.00
❑ SITE EVALUATION UPON REQUEST 7349 $42.00
❑ MULTIPLE PARCELS WfTHIN; SAME.', `k 5
(NO PLOT PLAN)
ZLAND
DIVISION . Y ' fi
r
❑ SEWER/SEPTIC VERIFICATION it. 7348 ' $11.00
Q
a 1st 4 Paroels (Each),},5: x", i ' 1238 $45.00
(Less than 1 year)
U.
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)
CO)
❑ Site Evaluation in Conjunction with
❑ HOLDING TANK 7351 $45,00
Critical Area 7346 $86.00
❑ ALTERNATIVE/EXPERIMENTAL 7345 $13200
❑ Site Evaluation Lot Less than
SYSTEM
10,000 Sq. Ft. 7347 $86.00
ITIAL DA G
Holding Tank Agreements Completed ❑Yes - No�p
Certification of Existing S.D. System Required ❑ Yes ❑allo
WOCB Clearance required. (Attach Form ❑ Yes
DOH SAN 007, Santa Ana Region Only) /
Soils Pemolation Report Required. ❑ Yes
Special Feasibility Boring Report Required. ❑ Yes
Detailed Contour Plot Plans Required (1 to 5 It. interval) ❑ Yes
Other ❑- Yes
Staff Specialist Lot Inspection Required ❑ Yes 6 NO
Lot Inspection Date
Soils boring report by' project Date
/ p
Soils Map Page l Soil Type `^� Approved by Date �r -3 —too
U
No. of Systema
TA of System(s)
�� ng Tank Existing
No. Dwelling Units
Bedrooms, Fbftrevidnits
(1) Septic Tank
Soil Rate
Grease/Sand
0
iReplacement
❑❑
low-/
/Df-
[f D
1-3,
U
Gal
U.1
LineSq.FFt
Sidewali allowance
n rock/ sq. R
per running it.
Install '_S n s) n long a wide with
min. inches ro c d nlirres or
Bed sq. n
of area
/
Leachlines/bed special design for slope: (3) Pit Diameter No. Pita Pit Below S68722,7Pal
Seepage Depth Other.
Applicebl Inlet (BI)
N/A Overburden factor Max. AlJoyyabl� Depth
No. 2 System 4114
REMARKS: IdZI, d lsv�aoi tea.
VED _ .Edfor the category checked in SECTION B above, regarding the design of a subsurface disposal system as indicated
This application is AP;Do
on the accompanied pan, using the requirements set forth in SECTION C above. A building permit is necessary for the installation of the
0
above -designed system. No construction is permitted in the required reserved 10096 ex nsion area.
IPA
Septic tank and sewer lines must be 50' minimum from any wells
Leach lines must be 100' minimum from any wells, including expansion ar
(3) Seepage pits must be '50' minimum from ny wells, including expansion area
Signature of Health Official '. w. z-,, � 'u,
RECEIPT NO. Issued By _ ate
DISTRICT: ❑ Riverside, ❑-el dfi' io ❑ Hemet ❑ Perris ❑ Rancho Calif.: ❑. Blythe
DOH SAN 122 (Rev: 5/88) DISTRIBUTION: WHITE - Office file YELLOW - Applicant PINK - Bldg. Dept GOLDENROD ' Plans/Records
I
:a•. set tl.tttal u. �.utt•trtutaa.a-• ■.a..}.v%-@itt,.tt %..b., • –.–, — ...
Compliance Method (Peckele, post system or Compaiev) Ciltnete zone Fsforcenent Agency Ute Only
GENERAL INFORMATION���
Total Conditioned Floor Area: 2
Duilding Type: Single Family I lotet/Mote!
(check ase or move) Multi -Family (less than 4 stories) Addition
Multi-ramay (4 a more stories) Existing -Plus -Addition
Front Entry Orientation:
North / East / South / West / All Orientations (circle one or more)
Number of Dwelling Units:
/
floor Construction Type:
lab Raised Floor (circle one or both)
Infillralion Control:
larxla ighl (circle one)
N
�oQRpFESS/
FIUILDING SHELL INSULATION '
�i
".IOII alE'VR
Component insulation
Location/Contmcnis
R
i Type R-.V.due
(otdc, to Aatale, typical, etc.)
f
Wttll,,, R f f
Wall.............
DRAW WALLS
kcxtf.............
EOF
Itoor.............
CAAl1F
I9oor.............
floor .............
Slab Edge..... 0
TYPICAL
GLAZING
Shading Devices
Gluzing Area
Glass Tyre Interior Exterior
Overhang Framing Type
Ulienlalioll (SI)
(sinxle, double) (roller blind, etc.) (thadereroen, etc.)
(yet/no)
(metal/wood)
front.,.. (E)
SINGLE- WHE_
YES
tlETAL
Front....
l_cll...... (�j)
IIC>rIC
YES
ICTAL
Itear...... (W)
SINGLE
11ETAL
-YES
SINGLE. GLE. - 1401E
YES
BETAL
Skylight........
_
_ND
I Skylight.......
TIIERMAL MASS
Tyltc/Covering Arca 'Iltickness
(slab/ettpored, tile, etc.) (St) (inches) LOcatioil%I)CScription (kitchen, bath. etc.)
SLAt3/EXPOSED 3 11211 K 1 TCVIEN/OATI t/ENTRY
.i
T rtunt ll I Inh!r.-. .. _. —..•_ ..- ._—_ ..
t• ;y
i` I -` ; - a
•,_
'
NAME — --=-- JOE STEMMER
„
ADDRESS
DATE -------- 10 AUG 1313
REF. CI1L .'ENERGY. CUNSFRVAT I ON DES I GN MANUAL , . FORM 2 ,
MEAT I NG - LOSSE5
MANUAL J FOT2' COUL I NCS+ LUSSE5
AREA PLDG SC?. FT.
,
PERIMETER 130.E o.7 5[Z. F -r:
�
INSULATION R VALUES '.FLOOR 0 ,,CEIL_ING Q ,.WALL
11
AREA NORTH WINDOWS 49 SG?. F'T: PPRCF_,NT OF' AREA .>. R4
AREA EAST WINDOWS 25 SGI. FT . 1?'FFICENT OF AREA 2
1
•
AREA SOUTH W I NDOWT3 95 SQ. FT. ' rE:RCENT OF ATEA 7.6'
w
i
AREA WEST' WINDOWS. U SO. FT. ftRCENT OF AREA Q
AREA S1:YLIGHTS 0' SO. FT. PERCENT OF AREA, Q
�
k
TOTAL WINDOW AREA 169 SG?. FT. PERCENT OF AREA 1". 44-
t
THE U VALUE OF THE WINDOWS IS .65 SINGLE
S
i
y4 } �. � _. - • 1 4
THE TOTAL .9..C.. -OF' THE WINDOW'S IS
i
SOUTH OVERHANG LENGTH 2
INTERIORTHEi'�MAL MASS AREA = 125 SC) FT.
INFILTRATION (STD 0.018, MED 0.('11.4, TIGHT 0.Q12) -
.Q19
1IEATING LOSSES
F130T I NO LOSSES... 40^2.222
CEILING LOSSES... 7SI.0127 PTU
WINDOW LOSSES.. ":385`.2 PTU
i
WALL LOSSES.... 23=(3.915 PTU
INFILTRATION LOSSES... 5nao P'rU
,
TOTAL HEAT LOSSES PTU/11P.-:. ' 1711)7.
GAS FURNANCE SIZE 34737.56 BTU UR 4 5, i ii iQ BTU
t
COOLING LOSSES
FOOTING -LOSSES... 1555.Sp 56 PTU
CEILING LOSSES... 947.~671 PTU
WINDOW LOSSES:.. 11640 PTU 3
WALL_ LOSSES.... 226._.467 BTLI
I NF ILTRAT ION LOSSES. c . I acin '.BTIJ ('
NO. OF PEOPLE... 5- ICOULING LOSSES... A2000KITCHEN...
• 1500 t STU
DUCT LOSSES INCLUDED' IN TOTAL_
•
TOTAL COOLING LUSSE9 257.09..39 PTU
r
POINT SYSTEM SUMMARY! CL_ I MATE 'TONE
10 F -2R
PROJECT TITLE=JOE
STEMMER
DATE=10 AUG De
A. NORTH
i►
PUILDING.DATA,
P. EAST
-1
CONDITIONED FLOOR
AREA-
NUMBER OF STORIES= 1
SLAP/RAISED FLOOR
SLAP
-1
TOTAL GLASS AREA
160 SQ.. FT
- %GLASS 13.44
CF.(ECk; ALL APPL_ I CAPLF_
UNI -T' TYPE COND I T I ON (S)
(X)'SINGLE FAMILY
DETACHED (F)F=D)
( ) ADDITION ALONE
I ( ) SINGLE FAMILY
'ATTACHED '(SFA)
( ) EXISTING PUIL_DING
( ) MULTI -FAMILY
(MF)
( > EXISTING -FLUS -ADDITION
ISCOPE CARD
7.6.
D. WEST
MEASURES
0
POINT SCORES
0
1.CF_ILING INSU.
20
1
2.WALL INSU.
11
10
SUM 7-10 -( 0
3 -RAISED FLOOR INSU 0
i►
. 4. SLAP EDGE INSU
i►
S.INFILTRATION
STANDARD
r►
13 WATER HEATING S.G.
6. GLASS. HEAT LOSS
SINGLE. - PANE
U=.65 J
SUM 1-6- -(,_6
j 7.SHADIN13 (SHADE OPEN)
GLASS AREA
SC= .6.776
A. NORTH
i►
49
P. EAST
-1
S
D. 'SOUTH
E. , WEST
-1
U
H. SKYLIGHT'-
i ►
O
S. SHADING
% GLASS
A. NORTH
_
3.84
P. EAST
2
C. SOUTH
-1
7.6.
D. WEST
6
0
E. SKYLIGHT SC= 0.77
0
0
9. I NTER I.OR THERMAL_ MASS 1
10.EXTERIOR WALL MASS ►-►
C►
SUM 7-10 -( 0
)
1 1. HEATING SYSTEM 72 S.E.
i►
12. COOLING SYSTEM 9. 1 ('1000 1
SEER
0
13 WATER HEATING S.G.
�►
TOTAL POINTS 11
IIOT WATER SYSTEMS. Tank Manufacturer/Model 0
System Type (storage gee, etc.) Capacity (or approved equal) Special Features)
STORAGE TANK GAL WATERKING nR-50 NONE
SPECIAL FEATURES/REMARKS (Add extra sheets if necessary)
COMPLIANCE. STATEMENT
This certificate of compliance lists the building features and performance specifications needed to comply with
Title 24, Chapter 2-53 and 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 singlc building plan to be built in multiple orientations. all building conservation
features which vary ane indicated in the Special Featums/Remarks section.
Designer
Nttme:
Title/Pirrrt:
Addreu:
Telephone.
Lie. N:
(signature) (dote)
Docttmentation Author
None: JOHN H. HACKER 6 ASSOCIATES
Tltle/Pi"n-
Address: 4501 E. SUNNY DUNES, SUITE C
PALM SPRINGS, CA 92264
Telephone: ) 327-4565
signatu (date)
Porn Revised Mach 1988
Building Owner
Name:
Title/Pirm:
Address:
Telephone:
(signature)
Enforcement Agency
None:
Agency:
Telephone:
(dote)
(signature or stamp) (date)
., Certificate of Compliance:
Residential
(Page 2 of 2) Cie -lit
i I Project Title
i
Date
HVAC SYSTEMS
Minimum
Duct
' Type (hrrrtace,.ir Efficiency
Location
Duct Output
Manufacturer /Model 0
conditioner, hat pump) (SP„ SEER,HSPF)
(ottic, etc.)
R -Value (Bluh)
(oi approved equal)
i FURNACE 72% SE
ATTIC
R-2.1
DAY & NIGHT — 394 J
' AIR COND. 9./ SEER
ATTIC
R-2.1
DAY G NIG14T — 568 EJ
Maximum Furnace heating Output:
Btuh
IIOT WATER SYSTEMS. Tank Manufacturer/Model 0
System Type (storage gee, etc.) Capacity (or approved equal) Special Features)
STORAGE TANK GAL WATERKING nR-50 NONE
SPECIAL FEATURES/REMARKS (Add extra sheets if necessary)
COMPLIANCE. STATEMENT
This certificate of compliance lists the building features and performance specifications needed to comply with
Title 24, Chapter 2-53 and 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 singlc building plan to be built in multiple orientations. all building conservation
features which vary ane indicated in the Special Featums/Remarks section.
Designer
Nttme:
Title/Pirrrt:
Addreu:
Telephone.
Lie. N:
(signature) (dote)
Docttmentation Author
None: JOHN H. HACKER 6 ASSOCIATES
Tltle/Pi"n-
Address: 4501 E. SUNNY DUNES, SUITE C
PALM SPRINGS, CA 92264
Telephone: ) 327-4565
signatu (date)
Porn Revised Mach 1988
Building Owner
Name:
Title/Pirm:
Address:
Telephone:
(signature)
Enforcement Agency
None:
Agency:
Telephone:
(dote)
(signature or stamp) (date)
Mandatory Measures Checklist: Residential MF -111
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 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 spec ficadons for the mandatory measures
whether they are shown elsewhere in the documents or on this checklist only.
DESCRIMON
Building Envelope Measures
• 12.5352(a): Minimum ceiling insulation R-19 weighted average.
42-5352(b)..Loose fill insulation manufacturer's labeled R -Value.
• 42-5352(c): Minimum wall Insulation In framed walls R-11 weighted average (does not apply to
exterior mass walls).
§2-5352(k): Slab edge insulation - water absorption rate no greater than 03%, water vapor
transmission rate no greater than 2.0 pernyinch.
12-5311: insulation specified or Installed meets California Energy Commission (CECT quality
standards. Indicate type and form.
42-5352(f): Vapor barriers mandatory in Climate Zona 14 and 16 only.
42-5317: Infiltmdon/Exfiltration controls
L Doors and windows between conditioned and unconditioned gptices designed to limit air .
leakage.
b, Doors and windows certified.
c. Doors and windows weatherstripped; all joints and penetradons caulked and sealed
12-5352(e): Special infiltration barrier installed to comply with 62-5351 meets CEC gyality
standards.
42-5352(d): Installation of Fireplace
fir
1. Masonry and factory -built eplaces 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.
MVAC and Plumbing System Measures
42-5352(8) and 2-5303: Space conditioning equipment sizing: attach calculations.
12-5352(h) and 2-5315: Setback thermostat on all applicable heating systems.
02-5316(x): Ducts constnacted, instalM and insulated per Chapter 10, 1976 UMC.
42-5316(b): Exhaust rysunr s have damper controls.
12-5314(c): Gas -Cued space heating equipment has intermittent ignition devices.
42-5314: HVAC equipment water heaters. showerheads and fauces certified by the CEC.
42-5352(1): Water heater insulation blanket (R-12 or greater) or combined Interior/exterior
insulation (R-16 or greater); Cyst 5 feet of pipes closest to tank insulated (R-3 or greater).
42-5312(Exeeption n; Pipe insulation on steam and steam condensate return tit recirculating
piping.
12.5318(d): Swimming Pool Heating
1. System has:
L On/ofr switch on heater.
b. Weatherproof instruction plate on heater.
c. Plumbed to allow for solar.
2. 75 percent thermal efficiency.
3. Pool cover.
4. Time clock.
5. Directional water inlet.
Lighting and Appliance Measures
42-53520): Lighting - 25 lumerWwau or greater for general lighting in kitchens and bathrooms.
42-5314(c): Gas rued appliances equipped with intermittent ignition devices.
42-5314(a): Refrigerators, refrigerator-freemrs, freezers and fluorescent lamp ballasts certified
by the CEC. Indicate make and model number.
Pam Reviled Demnbw 1997
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