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BMCH2016-0154a t 78-495 CALLE TAMPICO LA QUINTA,'CALIFORNIA 92253 4 haw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2O16-0154 Property Address- 54135 SOUTHERN HILLS APN: 775101043 Application Description: HIETBROWN / HVAC CHANGE OUT (2) SPLIT SYSTEMS Property Zoning: Application Valuation: Applicant: PALOMA AIR CONDITIONING 83019 AVENUE 45 •INDIO, CA 92201 - -----.----------------------•---------------- --- 1 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 my License is in full force and effect. License Class: C20 License No.: 619b91 ' Date:'" f "L� f 6 -Co ntractor: 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 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, arid.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.). (� I, 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.). .( ) lam exempt under Sec. B.&P.C. for this reason Date: Owner: f CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Na Lender's Add VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 ------------------- 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' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. have and will, maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation -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. Date: _ 6 Applicant:. 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 PROVIDEDTOR 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 property f inspection purposes. - Date: Signature (Applicant or Agent): Date: 5/12/2016 Owner: C'3 JIM HIETBR 54135 SOUTHERN HILLS c' LA QUINTA, CA 92253 �C.-I D Contractor: t� ' PALOMA AIR CONDITIONINf C 83019 AVENUE 45m n cS INDIO, CA 92201 a (760)347-1212 Llc. No.: m 619091 ------------------- 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' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. have and will, maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation -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. Date: _ 6 Applicant:. 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 PROVIDEDTOR 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 property f inspection purposes. - Date: Signature (Applicant or Agent): INFORMATION z+DESCRIPTION,A000UNT µQTY 3AMOUNT�hkl PAID �',PAID DATE; HVAC CHANGEOUT - SPLIT -SYSTEM f 101-0000-42402. .0 $145.04 $0.00 PAID! '.° METH D, Mie s ; > �, 0 � ^ `' Q RECEIPT #M N Q r "CHECK # 4 f CLTD'BYy , • �$> . §DESCRIPTION'gf4ACCOUNTV+f*AMOUNT j�"` PA # PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $72.52 $0.00 p ,< ��a m � ..M >,: » vEr� t€e,-xt•n'. 1 <.c. g. M ,•, s - a>. C LTU - B PAIU$Y METHODa ..RECEIPT# K.41 Total Paid for CHANGEOUT: : $217.56 $0.00 c .i•.. �z .,.. € �w z; aESCRIPTION , ;QTY DAMOUNT PAID ,i PAID DATE: . _ _ PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 VI PAIDxBYRECEIPT3#'4 ''` CHECK #M k CCTD BY. H� Total Paid for PERMIT ISSUANCE: $91.85 $0.00 _ TOTALS:0• 00 Description: HIETBROWN / HVAC CHANGE OUT (2) SPLIT SYSTEMS Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 5/12/2016 SKH Approved: Parcel No: 775101043 Site Address: 54135 SOUTHERN HILLS LA QUINTA,CA 92253 Subdivision: TR 22432-2 SEE ASSESSORS MB, 769/43 • Block: Lot: 1,2-P Issued: . FOR CMS Lot Scl Ft: 0 - Building Scl Ft: 0. Zoning: Finaled: Valuation: $0.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: HVAC CHANGE OUT - (2)16SEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO . .FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. a r ADDITIONAL SITES Printed: Thursday, May 12, 2016 10:04:50 AM 1 of 2 CRw'1yS.*rfmS J C Printed: Thursday, May 12, 2016 10:04:50 AM 2 of .2 Cff?WsYSTEMS ::.DESCRIPTION`° `:ACCOUNT ":QTY AMOUNTS $4PAID PAID DATE RECEIPT,#.';CHECK#{ ,.METHOD; `` PAIDBY, Y '"+7 T 3� .�1'.' ,1+."' ..?«- tY krk'' "''p`i" C i. ( "'R.. f . ! { ttt..- 'S k.p" •K t ,. BY HVAC CHANGEOUT - 101-0000-42600 0 $72.52 $0.00 SPLIT -SYSTEM PC Total Paid for CHANGEOUT: $217.56. $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85: $0.00 - TOTALS:0• 00 Printed: Thursday, May 12, 2016 10:04:50 AM 2 of .2 Cff?WsYSTEMS ]jin # Permit #{ Project Address:' 3 City of La Quinta Building 8t Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet CJ o u71 6 Owner's Name: RA A. P- Number: Address: G d U-f or v LJ 141 I Legal Description: City, ST, Zip: Contractor: VN Telephone: hone: 7 z 1-7 Address: Project Description: r Z_ City, ST, Zip:. , ( D . C K Telephone: hone: State Lic. # :Q City Lie. #.- Arch., Engr., Designer: I e Address: City., ST, Zip: . Telephone: one: Cotructi ns on Ty Occupancy: P ane Y: State Lie. #• Project type (circle one): New Add'n Alter Repair r De mo Name of Contact Person:,Sq. Ft.: #Stories: # Units: Telephone # of Contact Person:. P Q Estimated Value of Project: O t APPLICANT:, DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance, Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2pd Review, ready for—correction's/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 tis CERTIFICATE OF COMPLIANCE CFiR-ALT-02-E , Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 4). Project Name:, Jeam Hietbrown Date Prepared: 2016-05-12' .B. Space -Conditioning (SC) System Informat on s Y A. General Information .. - CFIR-ALT-02 is applicable. to multiple'space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, , use'one MR -ALT, -02 document for each dwelling unit. - - t_ r. .01 Project Name `' Jeam Hietbrown _ 02 - Date Prepared 2016-05-12 03� Project Locations - _- 54135 southern hill 04. Building Type _- Single family i• ` 05 CA City La Quinta ; ti : 06 Dwelling Unit Name Jeam Hietbrown. * Is the SC I. stalling a 07 Zip Code 92253 08 Dwelling Unit Conditioned- • 3200 SC System �` CFA'served ystem aY-4- efriger nt t x Floor Area (ft2) . . ILalli g Installing = Identification or Number of space conditioning , 09 Climate Zone 15 `„ - 10 (SC) systems in this dwelling 2 y Name System (ft2) unit. component? .B. Space -Conditioning (SC) System Informat on s Y 01 : 02 •'r`- 03 - .. 04 05 6 0 08 U9 10 * Is the SC I. stalling a SC System SC System �` CFA'served ystem aY-4- efriger nt t x Installing a SC W � u lnstalli g w ILalli g Installing Identification or Location or Area.. by this SC W, , ducted . • � *. It containing � system more than 40 entirely new entirely new - -- Name Served System (ft2) system? component? components? feet of ducts? duct system?. SC system? Alteration Type . - Entirely new or complete System 1 Livingf Room ; 1600 Yes Yes t. Yes . - Yes _ Yes Yes - replacement space conditioning system ^d. - Entirely new or System Z Bedrooms . 1600 _ - a . Yes Yes` Yes Yes Yes Yes complete replacement space conditioning system Registration Number: 216-A0177342A-000000000-0000 -'Registration Date/Time: 2016-05-12 10:06:53 HERS Provider: CaICERTS CA Building Energy Efficiency Standards =2013 Residential Compliance z M Report Version: 2013 Rev 1.007 Report Generated: 2016-05-12 10:07:04 ,r.hPma Vo-rrinn• n.SSStnn - FICATE OF COMPLIANCE - CF1R-AL1 itions to Space Conditioning Systems (formerly CF-lR-ALT-HVAC) ? ' (Page 2 ension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib) _ This section does not apply to this project. - :eyed Space Conditioning System (Sections 150.2(b)1E and F) , - This section does not apply to this project. _ • , - :irely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)1E, F) - This section does not apply to this project. . F.Intirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) y r - 01 02 r „• 03 04, " - ' " '05 06 07; .' 08 09 10 11 System _ - '�` - Heating Heafing M ni um _ " to . Cooling Minimum . Required ; Identification or Heating System Altered Heatirig� Efficiency Efficiency Cooling Altered .Cooling III Effiaency Efficiency Thermostat New Duct Name � Type . `Components ` Type Value System Type Component Type Value Type R -Value f .. }. Jt fM'�'' M^"w. — a1`•i. F '•'ww1"^'M. ! -R" �R .R'•""ti- 1""` !M"'N. Central gas- All new heating `A M Central -split (.%AI11new cooling SetbackTher ' System 1. .. - furnace - components AFUE 0:78 r AC components SEER 13 mostat R-8 . System 2 Central gas.' All new heating .AFUE:- 0.78 f . Central split �- All new cooling SEER 13 SetbackTher R-8 . furnace �. �component•s . AC :components". , mostat Required Documentation: CF2R-MCH-01:E= Space Conditioning Systems Ducts and Fans. -Duct insulation requirement for new plenums: R6. • , - "' - CF2R & CF3R-MCH-20-H Duct Leakage Verification required. -Leakage rate compliance: 5 6%. v _ CF2R & CF3R-MCH-22 Fan Efficacy Verification CF2R & CF3R-MCH-23 System Air Flow Rate Verification -Compliance: Fan Efficacy 5 0.58 W/cfm and System Airflow >_ 350 cfm/ton. i • , _ - Alternative Compliance: CF2R & CF3R-MCH-28 Return Duct Design Verification is an -alternative to MCH -22 and MCH -23 verification. CF2R & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). _ - - "` r ' • Exceptions: . ; Heating -only systems are exempt from the 0.58 W/cfm and 350 cfm/ton requirements. Registration Number: 216-A0177342A-000000000-0000 '. Registration Date/Time: 2016-05-12 10:06:53- -HERS Provider: CaICERTS CA Building Energy Efficiency Standards'- 2013 Residential Compliance- Report Version: 2013 Rev 1.007 Report Generated: 2016-05-12 10:07:04 ' Cchpma Vprcinn• 0 SSSCnn CERTIFICATE OF COMPLIANCE , " t CFIR-ALT-02-E' ' Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 4 )^ ' Note: ` � _ � ..� y a ~: •:- 4 .. •� An "entirely new or replacement duct system",means at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil; plenums, duct material) if the reused parts are accessible and can be sealed to prevent leakage ff Al R.,- -, T-: ,. Registration Number: 216-A0177342A-000000000-0000 Registration Date/Time: 2016-05-12 10:06:53 w •HERS Provider. CaICERTS CA Building Energy Efficiency Standards- 2013 Residential Compliance ..F Report Versio6: 2013 Rev 1.007 Report Generated: 2016-05-12 10:07:04 ' , Crhpma Vprkinn O.SSSSnfI a CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 4 of 4 Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Paredes, Herman Company: - Signature Date: PALOMA AIR CONDITIONING 2016-05-12 10:06:53 Address: CEA/ HERS Certification Identification (if applicable): P 0 BOX 3501 Herman Paredes City/State/Zip: Phone: PALM DESERT CA 92261 760-347=1212 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate -of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer)_ 3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the on""' requirements of Title 24, Part 1 and Part 6 of the California Code Regulitions. ate of Compliance are�consistent.withtthe informatibn.provided on"oth'er appticable-compliance documents, worksheets, 4. The building design features or system design features identified on this Ceriific01, calculations, plans and specifications submitted to the enforcement agency foe _approval with this building permit application. S. I will ensure that a registered copy of this Certificate�of,C?mpliance shalt<b"e:made'available withtttie buitding;permit(s).issued forthe-building,and made available to the�enforcement agency for all applicable inspections. I understand that a registered copy of this -Certificate of Compliance isjequired to be,included with the documentation the builder provides to,the building owner at occupancy. Responsible Desig er Signature: V t Responsible Designer Name: Paredes, Herman Company': Date Signed: ' PALOMA AIR CONDITIONING 2016-05-12 10:06:53 Address: — License: P 0 BOX 3501 _ 619091 City/State/Zip: Phone: ' PALM DESERT CA 92261 760-347-1212 Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 216-A0177342A-000000000-0000 Registration Date/Time: 2016-05-12 10:06:53 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-12 10:07:04 Schpma V. n.SSSCf)n 'in + ' ,007 Qty of La Quinta Building u Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012. Building Permit Application and Tracking Sheet Permit # Project Address: j Owner's Name: �( A. P. Number: �� j�d 1 O Address: 0•, S- Legal Description: City, ST, Zip: kb C Contractor:p Tele hon t:� 2 :.:'.. Address: ProjectDescription: Q(,'� City, ST, Zip: O f,)+% Af—k5 Aj ' Ab Telhon /,, � e P �1�% hh v State Lic. # : City Lic. #, Arch., Engr., Designer: Address: AA)C6 City, ST, Zip: 1,1A -JC AJ -L ZY6 4-1 T. one: eleP h Construction Type: Occupancy: P P Y• State Lic. #• Project tYPa (circle cle one : New Add'n Alter r RePa' r Demo Name of Cohtact Person:�iW/ %� Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: ( Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Reed 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°d Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted Grading IN IIOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue f t School Fees Total Permit Fees ' i ' 1. y' ,y, _ _. � f`' ` - . • •` '-• '°`✓ - •J � • ' ; ; , !I + � - '. ILI Coachella Valle Unif ed School District Y. , This Box For District Use Only" .. t 83-733 Avenue'55,',Thermal, CA 92274 DEVELOPER FEES PAID., (760) 398-5909—fax,(760) 398-1224- • - •4t r• J . r '' � `�' �i AREA: .'- �. " - AMOUNT • LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: ,.COMM/IND. AMOUNT: - DATE: - ;r ' _ RECEIPT: _ \'•, CHECK N 5 ., \ - INITIALS ••'� t. � a { l • , • _' - +wi; . i., � �� y •^ y• a ' ` ,r -• i � •,� � .ter c"y ��• • - ~CERTIFICATE OF COMPLIANCE. (CaliforniaaEducation Code 17620) Project Name: ' Jim and Jane Heitbrink ; Date:' ? October 12 2015 Owner's'Name: Tim and Jane Heitbrink - - ' 'Phone No: « _ . Project Address: 54.135.Southern Hills, La Quinta, CA 92253. -Project Description: Room Addition r. APN: 775-101-043 . a , s Tract #:• • ti y' Lot #'s:. r Type of Development:. • Residential • '.XXI Commercial " Industria) r r • " �- •TotalyS� , Square :Feet of BuildingArea:.. 394 S FT' �• • - A t - .� 1. _ • � Certification of Applicant/Owners: -The person signing certifies that he above information is correct and'makes this statement under. - penalty of,perjury and further represents that he/she is authorized to sig on behal of the-owner/developer:. 4 '; + ,.. - ) .. ,' ., yr -y - y I -. . y a' ,�' ., -1,Y •,: F •,.- �,• \ ,Y iF . Dated:` — Signature: 4 " SCHOOL DISTRICT'S -REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN, ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) - . Education Code .'Gov. Code • " 'Project -• ' Agreement Existing Not Subject toTee „ i - 17620, ^` 65995 - Approval' . Pr 611 1/1/87 -Requirement -" Note:.. ,. '' -' 1. • `:j' Number of Sq.Ft. 136. ursuant to AB 181 any room additions or enclosures of 500 •» s.f. or_less _are exempt _from -developer _ fees. Any mobile homes Amount per Stj.Ft. `EXEMPT being relocated or replaced. within the same'school district's Amount Collected _ 0.00 ,' ` r . jurisdiction are exempt from developer fees. Building Permit Application Completed: Yes/No �► `'' `., r By: Elsa F. Esqueda, Director of Facilities and -Maintenance • _ . ' x, " Certificate issued by:. Leticia Ti Facilities Analyst :, Sign -at re: ' r •.: •- NOTICE OF.90 DAY PERIOD FOR PROTEST OF ANDS AT ENT OF FEES Section 66020 of the Government Code asserted.by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other- exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other, applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this , time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter,. the, 90:days atarts on the date hereof. .This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District; and up to three (3) such extensions may be granted. MV:chnydocs/dcvfecs/cerlilicate ol"compliance form updated 3-2007 "• 11/2010 Coachella Valley Unified School District 83-733 'Avenue 55,.Thermal, CA 92274, (760) 398-5909— %1224 - . E R AUG 2 5 2015 This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT L EVEL ONEAAIOL?iT: LEVEL TWO AMOUNT* 1,11TI ATION ANIOUINT: COMMIND. A\IOUNT: DAVE: RECEIPT: CHECK b: CITY OF LA QUINTA COMMUNITY DEVELOPMENT CERTIFICATE OF COMPLIANCE _ (California Education Code 17620) Project Name: Tim -Niel: rink Date: August 24, 2015 Owner's Name: Phone No. 714-417-9277 Project Address: 54-135 Southern Hills, La Quinta, CA 92253 Project Description: Room Addition APN: 775-101043 Tract #: ' Type of Development: I Residential ' XX Commercial Total Square Feet of Building Area: 136 SQ. FT Lot #'s: Industrial Certification of Applicant/Owners: The person'signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sign on behalf of the ownerldeveloper. Dated: 8/24/15 Signature: John F. McNeely (Sent Via Email: ifm7Cmac.com) SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project 17620 65995 Approval. Number of Sq.Ft. 136 Amount per Sq.Ft. EXEMPT Amount Collected 0.00 Building Permit Application Completed: Yes/No By: Elsa F. Esqueda, Director of Facilities and Maintenance Agreement Existing Not Subject to Fee Prior to 1/1/87 Requirement Note: Pursuant to AB 181 any room additions or enclosures of 500 s.f, or less are exempt from developer fees. Certificate issued by: Leticia Torres, Facilities Analyst Signa re: NOTICE OF 90 DAY PERIOD FOR PROTEST OF E ND ST TEh I T OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires thiarTlris District provide (1) a written notice to the project appellant, at,the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period inkregard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. i1i1?: ri:C...v.;'ti•F;_: ,; a '.i'?st ..,.>. 'i.iQa. rit' 1112010 ,I - - I It, ., __ W-1 Building Permit Number: AUG 2 5 2015 Project Description: ISFIR t 1 Exempt: ❑ CITY OF LA `'tUINTA (Materials may contain hazardous wastes and MUNITY DEVELOPMENT are not subject to recycling provisions). 'Construction Debris Management Plan City Approval By Date of,City Approval Materials To Be Discarded: Product Trash. Asphalt Brick/Block Cardboard Commingled Concrete Drywall Donated / Reuse* 54135 SOUTHERN HILLS JAMES HIETBRINK 54135 SOUTHERN HILLS LA QUINTA, CA 92253-5628 (949) 640-1754 'hl .etbrink�aol.com EXIST.=3,537 NEW = 136 Tons 0.10 Not recyclable 0.00 Recyclable 0.00 Recyclable 0.00 Recyclable 0.00 Recyclable 0.00 Recyclable 0:10 Recyclable 0.20 Recyclable *Describe Items JAII cabinets, plumbing fixtures Product Masonry (broken) Plaster Scrap Metal Tile (floor) Tile (roof) Wood Landscape Debris Tons 0.00 Recyclable 0.20 Recyclable 0.00 Recyclable 0.25 Recyclable 0.00 Recyclable 0.00 Recyclable 0.00 Recyclable Totals: Recycle Trash Projected Diversion: 0.8 F88.24% I understand it is the property owner's responsibility to submit copies of weight tickets or receipts to the District Environmental Coordinator as these hauls occur. I hereby certify that completion, implementation and adherence of the Debris Management,Plan (DMP) for the above named project shall guarantee that at least 50% of the jobsite waste is diverted from landfilling. The remaining material will be recycled or reused. I will divert, for recycling or re -use, remaining materials generated from the first day of the project through the completion of the project in accordance with this plan. This DMP is issued in the name of the property owner(s) and shall remain their property throughout the construction and/or demolition project. A contractor serving as agent of the owner may obtain a DMP for the owner. However, the DMP is still issued in the name of the property owner(s) and the owner retains leg3Vesponsibility for ensuring that the provisions of the DMP are adhered to. The property owner(s) and general contractor shall b pt informed of the diversion prog5s4s through bi-monthly reports. If self -hauling, all refuse material from this project site s aken to an roved rev r ansfe talion. O&DoK Developer/ Projec a Superinten nt Date ENGINEERING s dA r A F a o s Letter of Transmittal To: City of.La Quints �.a Tod'ay's Date 8-1'7,15 } X78-4051Calle Tampico, ,. < City Due�Date 8,:10-15 La Quint6,,.CA;92253: s <. Project.Address: 54135 Southern.Hills> i Attn Kay'` rs Plan Check*.- BRES 2015-0284 ^ - Y;Submittal , ® 1sc ❑ = 0' R { ❑ • . YJ 2nd �❑ r 5thl ,n •� E]. �3'd ❑ r'Other �A We are forwarding ® 13y:Messenger F,'❑ ByMail (Fed Ex orUPYour•Pickup Includes:' # Of' Description -s-, , ' Includes # Of • ` Y Descriptions: 3 Copies w Copies:. � Structural Plans `L " ❑ ' , f Revised •Structural. Plans ®{1 Structural :Calculations ❑ �': Revised Struct. Calcs Truss Calculations Floor Y`' ' ❑-:«and-Ro'of ` ❑ Revised Truss, i ❑ 1 ° : Soils Report :'K ❑ y RevisedSoils Report', „ ` '• Structural Comment'Litt/ Y ❑❑: Approved Structural'Plans• ' .; Responses. ❑., ,Redlined'Siructural Plans❑ Approved Structurai Calcs ' . Y , •� ❑ Redlined Structural�CaI s . - ❑ > : ', . Approved Truss Calcs }, Redlined •Truss,Calcs ❑ t Approved Soils. Report ❑' Redlined Soils Reports s ❑ + _ ' Other.' _ Comments s .'Structural content is approvable pending the following:Provide soil testing report for;soluble sulfate,levels in_the'soil fog verification of adequacyof concrete strength:and.type. If report isnot available, M Sp ecif on 'structural;` Ian to test`soil forsoluble sulfate rior.fo our.;Provide`a tables ecif i' - p y P ' p� P. P Y ng -the w concrete str' gth:arid ;type•for the differ"ent.levels'of,soiubte sulfate.; Referto ACI 318-11,.4 2'and 4.3.. Or specify Type'V 4500 PSl concrete. ' N -if •you "have any. questions; please call.,' Time =135 HR' This ,Material "S_'ent 'for Y ' ❑ Your Files. "' ` 'Y ® Per Your Request ^ .� ❑° Y Your,Review, Y :❑ APProval s ❑ bChecking r a ❑ ; .At the request of: ' Other El", " v BY .Kathryn Samuels Palm Desert Office'. ® ,• (760) 772-5107 ' Other. E .r p PGA WEST RESIDENTIAL ASSOCIATION, INC. . June 16, 2015 „ Mr. James Hietbrink C/O Hietbrink Resident, LLC ` P.O. Box 4372 Roche Harbor, WA -98250 Re: 54-1.35 Southern Hills -Proposed Remodel Protect Dear Mr. Hietbririk; .. ' The Architectural Committee received your Preliminary Architectural Variance Request for proposed interior modifications, an office room addition, patio shade structures. and new windows all shown ori sheets A-2, A 3 and S 1, dated March 30, 2015, all prepared by John.,F. Neely Residential Design. On May 18, 2'015, the Committee reviewed the information provided. The scope of work is conceptually acceptable; in accordance with the Architectural Guidelines. , Homeowner's Association CC&R's and Maintenance and Indemnity Agreement. , 1. The proposed two shade structures require additional review, relative 'to the adjacent_ neighbors' properties and the completion of the "Adjacent Neighbor Notice Form". , 2. The new replacement window and glass doors are to have a brochure with specifications and color samples for review. ' 3. The garage door is to have a manufacturer sample and brochure for review. This letter does not include any pool, spa, pool decking, landscape, irrigation and exterior lighting review. The" Committee's -review does not provide an opinion on the acceptance and compliance with the City of La Quinta building codes and planning requirements. It is understood that the existing theme: and details are to be maintained in `design, finish and color including the roofing materials to match. i The project approval is subject to submission of final drawings ready for plan check, to include specifications and material samples as applicable. If I may be of further assistance, please contact me at the HOA office, (760),771 -4 234, Extension 15. Cordially, C Kell alliard :Operations Manager For the Architectural Committee Cc: Architectural Committee 54-320. Southern _Hi--%...La_Quinta.,..California.92253-5665,..Tei.e.phone 760-7._71-_1.234 FAX.760-.7.71-5125.... CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Hietbrink Residence Addition Calculation DateJrime-. 20:36, Tue, Jun 30, 2015 Calculation Description: Title 24 Analysis Input File Name: Hietbrink.xml CF1 R -PRF -01 Page 1 of 9 GENERAL INFORMATION ENERGY USE SUMMARY 01 Project Name Hietbrink Residence Addition Building Complies with Computer PerformaiGe 06 02 Calculation Description Title 24 Analysis 02 This building incorporates feature'Aksstr hat require field testmg.and/or,verlficatio,by a -certified HERS ratecun ierthe supervision of a CEC-approved HERS'provider. Tm Y1 t, Cp�k... � 03 Project Location 54135 Southern Hills �`.-' a -"Y, .i-^ �.....-:.IR"T.•.. �''.r •cc S .:.6 d!•K 04 City La Quinta 05 Standards Version Compliance 2015 06 Zip Code 92253 07 Compliance Manager Version BEMCmpMgr 2013-4 (744) 08 Climate Zone CZ15 09 Software Version. EnergyPro 6.6 10 Building Type Single Family 11 Front Orientation (deg/Cardinal) 90 12 Project Scope Addition and/or Alteration 13 Number of Dwelling Units 1 14 Total Cond. Floor Area (ft2) 3537 15 Number of Zones 3 16 Slab Area (ft) 3537 17 Number of Stories 1 18 Addition Cond. Floor Area 136 19 Natural Gas Available Yes 20 Addition Slab Area(ft) 136 21 Glazing Percentage (%) 19.6% COMPLIANCE RESULTS ENERGY USE SUMMARY 01 Building Complies with Computer PerformaiGe 06 07 08 02 This building incorporates feature'Aksstr hat require field testmg.and/or,verlficatio,by a -certified HERS ratecun ierthe supervision of a CEC-approved HERS'provider. Tm Y1 t, Cp�k... � Compliance Margin �� k N{ �`.-' a -"Y, .i-^ �.....-:.IR"T.•.. �''.r •cc S .:.6 d!•K ,3""`?- ... . r�... +..- -0.66 -32.5% Space Cooling 180.12 APPROVED FOR CONSTRtiq0tv Registration Number: 215-A0178653A-0 09ci00 � i n'.Date/Time: 2015-07-01 14:26:45 CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-06232015-744 AUG 2 5 2015 CITY OF LA QUINT• COMMUNITY DEVELOF1`_ jT HERS Provider: CaICERTS inc. Report Generated at: 2015-06-30 20:37:11 ENERGY USE SUMMARY 04 05 06 07 08 Energy Use (kTDV/ft2-yr) Standard Design Proposed Design Compliance Margin Percent Improvement Space Heating 2.03 2.69 -0.66 -32.5% Space Cooling 180.12 168.49 11.63 6.5% IAO Ventilation 0.00 0.00 0.00 0.0% Water Heating 0.00 0.00 0.00 ° Photovoltaic Offset 0.00 0.00 Compliance Energy To I 1%8 1 171.1 10.97 6.0% APPROVED FOR CONSTRtiq0tv Registration Number: 215-A0178653A-0 09ci00 � i n'.Date/Time: 2015-07-01 14:26:45 CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-06232015-744 AUG 2 5 2015 CITY OF LA QUINT• COMMUNITY DEVELOF1`_ jT HERS Provider: CaICERTS inc. Report Generated at: 2015-06-30 20:37:11 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Hietbrink Residence Addition Calculation Date/Time: 20:36, Tue, Jun 30, 2015 Calculation Description: Title 24 Analysis Input File Name: Hietbrink.xml REQUIRED SPECIAL FEATURES The following are features that must be installed as condition for meeting the modeled energy performance for this computer analysis. NO SPECIAL FEATURES REQUIRED CF1 R -PRF -01 Page 2 of 9 HERS FEATURE SUMMARY The following is a summary of the features that must be field -verified by a certified HERS Rater as a condition for meeting.the.modeled energy performance for this computer analysis. Additional detail is provided in. the. building components tables below.. Building -level Verifications: -- None -- Cooling System Verifications: Minimum Airflow Verified -SEER Fan Efficacy Watts/CFM HVAC Distribution System Verifications: --None -- Domestic Hot Water System Verifications: –None -- ENERGY DESIGN RATING This is the sum of the annual TDV energy cohs.umption, for energy use components included in;the performance compliance approach for the Standard Design Building (Energy Budget) and the annual TDV energy consumption for lighting and components not regulatedFby Title 24 Part,6f(such s domestic appl ances and consumer elec onies and accounting for the annual TDV energy offset by an on-site renewable energy system. Reference�Enecgy Use a IJ Energy Design Rating Margin Percent Improvement Total Energy (kTDV/f2-yr)' 1222.06- t 10.97 4.9% ` includes calculated Appliances and Miscellaneous Energy Use (AMEU) BUILDING - FEATURES INFORMATION 01 02 03 04 OS 06 07 Project Name Conditioned .Flooc Area (ft2) Number of Dwelling Units Number of Bedrooms Number of Zones Number of Ventilation. Cooling Systems Number of Water Heating Systems Hietbrink Residence Addition 3537 1 3 3 0 0 Registration Number: 215.A0178653A-000000000-0000 Registration Date/Time: 2015-07-01 14:26:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version -- CF1R-06232015-744 Report Generated at: 2015-06-30 20:37:11 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Hietbrink Residence Addition Calculation Date rime! 20:36, Tue, Jun 30, 2015 Calculation Description: Title 24 Analysis Input File Name: Hietbrink.xml CF1 R -PRF -01 Page 3 of 9 ZONE INFORMATION 01 02 03 �04' 05 .06 07 Zone Name Zone Type HVAC System Name Zone Floor Area (ft) Avg. Ceiling Height Water Heating System 1 'Water Heating System 2 Sleeping Zone Conditioned Sleeping Zone1 1700 9 DHW Sys 1 Addition Conditioned Sleeping Zone1 136 9 DHW Sys 1 Living Zone Conditioned Existing FAU2 1701 9 DHW Sys 1 OPAQUE SURFACES 01 02 03 04 05 06 07 08 09 10 Name Zone Construction Azimuth Orientation Gross Area (ft2) Window & Door Area (ft) Tilt (deg) Status Verified Existing Condition North Wall Sleeping Zone R-11 Wall 0 Right 210 40 90 Existing No East Wall Sleeping Zone R-11 Wall 90 Front 225 90 Existing No South Wall Sleeping Zone R-11 Wall 180 Left 547 111 90 Existing No West Wall 'Sleeping Zone R-11 Wall 270 Back 195 80 90 Existing No Wall to Garage Sleeping Zone»_Garage_ RR --0 Wall`'"` 19 5 s+1s Existing No Existing Roof Sleeping'ZoneRoo R;19�f Attic t 17}00 iz Existing No North Wall 2 Addition ++.aanr x -r a R-13 Wall w as �, k _ 0spa r ' Right u � ��y 186 �+ 35 90 New N/A West Wall 2 Addition fiw13 1Nail " 270% Back I ti—? 27 tl 90 New N/A Addition Roof Addition R-30 Roof Attic 136 New N/A North Wall 3 laving Zone R-11 Wall 0 Right 480 12 90 Existing No East Wall 2 Living Zone R-11 Wall 90 Front 214 91 90 Existing No South Wall 2 Living Zone R-11 Wall 180 Left 230 107 90 Existing No West Wall 3 Living Zone W11 Wall 270 Back 392 266 90 Existing No Existing Roof 2 Living Zone R-19 Roof Attic 1701 Existing No North Wall 4 _Garage_. R 11 Wall 0 Right 225 90 Existing No East Wall 3 _Garage_ R-11 Wall 90 Front 201 90 Existing No South Wall -3 _Garage_ R-11 Wall 180. Left 248 168 90 Existing No West Wall 4 _Garage_ R-11 Wall 270 Back 34 90 Existing No Existing Roof 3 _Garage_ R-19 Roof Attic 619 Existing No Registration Number: 215-A0178653A-000000000-0000 Registration Date/Time: 2015.07-01 14:26:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-06232015-744. Report Generated at: 2015-06-30 20:37:11 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Hietbrink Residence Addition Calculation Date/Time: 20:36, Tue, Jun 30, 2015 Calculation Description: Title 24 Analysis Input File Name: Hietbrink.xml . CF1 R -PRF -01 Page 4 of 9 ATTIC 01 02 03 04 05 06 07 08 09 16 11 Name Surface (Orientation --Azimuth) Width(ft) Height (ft) Multiplie r Radiant U -factor Statu Verified Existing Name Construction Type Roof Rise Roof Reflectance Roof Emittance Barrier Cool Roof s Condition Attic Garage Attic Garage Roof Cons Ventilated 4 0.1 0.85 No No En9ti No 0 21* Insect Screen (default) Altered N/A Altered Glass Doors South Wali -(Left -180) ) } 1 ,OJ 0.38 0 22 (� Insect Screen (default) Altered N/A Altered Glass Doors 2 West Wall (Ba6k=270)-^ Exi ti 1 , r x Attic Sleeping Zone Attic RoofSleeping Zone Ventilated 4 0.1 '0.85 No No No 1 35.0 0.31 0.21 Insect Screen (default) New N/A Altered Window 3 ng ---- Attic Addition Attic RoofAddition Ventilated 4 0.1 0.85 No No New No 1 38.0. 1.04 0.76 Insect Screen (default) Existing ExixistiNo Altered Window 4 Attic Living Zone Attic RoofLiving Zone Ventilated 4 0.1 0.85 No . No Altered N/A Altered Window 5 South Wall 2 (Left -180) . ---- ---- 1 43.0 0.31 0.21 Insect Screen (default) • Altered WINDOWS 01 02 03 04 05 06 07 08 09 10 11 Name Surface (Orientation --Azimuth) Width(ft) Height (ft) Multiplie r Area (ft) U -factor SHGC Exterior Shading Status Verified Existing Condition ' Altered Window North Wall (Right 0) �4g40..0 ;0.31 0.21 Insect Screen (default) Altered N/A Altered Window 2 South Wall (Left -180) 6 3. 0 0.313 0 21* Insect Screen (default) Altered N/A Altered Glass Doors South Wali -(Left -180) ) } 1 ,OJ 0.38 0 22 (� Insect Screen (default) Altered N/A Altered Glass Doors 2 West Wall (Ba6k=270)-^ k 1 , r x , 80EOw 1 v8 0:38 x 0.22 Insect Screen (default) Altered N/A New Window North Wall 2 (Righ't-0) 1 35.0 0.31 0.21 Insect Screen (default) New N/A Altered Window 3 North Wall 3 (Right -0) ---- 1 12.0 0.31 0.21 Insect Screen (default.) Altered N/A Existing Window East Wall 2 (Front -90) 1 38.0. 1.04 0.76 Insect Screen (default) Existing No Altered Window 4 East Wall 2 (Front -90) ---- ---- 1 5.0 0.31 0.21 Insect Screen (default) Altered N/A Altered Window 5 South Wall 2 (Left -180) . ---- ---- 1 43.0 0.31 0.21 Insect Screen (default) • Altered N/A Altered Glass Doors 3 South Wall 2 (Left -180) ---- ---- 1 64.0 0.38 0.22 Insect Screen (default) Altered N/A Altered Window 6 West Wall 3 (Back -270). - 1 28.0 0.31 0.21 - Insect Screen (default) Altered N/A Altered Glass Doors 4 West Wall 3 (Back -270) ---- 1 238.0 0.38 0.22 Insect Screen (default) Altered N/A DOORS 01 02 03 04 05 06 Name Side of Building Area (ft) U -factor Status Verified Existing Condition Door East Wall 2 48.0 0.50 Existing No Registration Number: 215-A0178653A-000000000-0000 Registration Date/Time: 2015-07-01 14:26:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF111-06232015-744 ReportGenerated at: 2015-06-30 20:37:11 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD . Project Name: Hietbrink Residence Addition :. Calculation DatelTime: 20:36, Tue, ,lun.30, 2015 Calculation Description: Title 24.Analysis Input File Name: Hietbrink.xml CF1 R -PRF -01 Page 5 of 9 OPAQUE SURFACE CONSTRUCTIONS 01 02 03 04 05 06 07 Total Cavity Winter Design Construction Name Surface Type Construction Type Framing R -value U -value Assembly Layers • Inside Finish: Gypsum Board Cavity/Frame: R-11 /2x4 • Exterior Finish: Wood R-11 Wall Exterior Walls Wood Framed Wall 2x4 @ 16 in. O.C. 'R 11 0.103 Siding/sheathing/decking • Inside Finish: Gypsum Board Ceilings (below Cavity/Frame: R-9.1 /2x4 R-19 Roof Attic attic) Wood Framed Ceiling 2x4'9 24 in. O.C. R 19. 0.049 Over Floor Joists: R-9.9 insul. • Cavity/Frame: no insul. /2x4 Top Chrd 2x4 Top Chord of Roof Truss @ 24 Roof Deck., Wood Siding/sheathing/decking Attic Garage Roof Cons Attic Roofs Wood Framed Ceiling in. O.C. none 0.644 Roofing: Light Roof (Asphalt Shingle) • Cavity/ Frame: no insul. / 2x4 Top Chrd 2x4 Top Chord of Roof Truss @ 24 Roof Deck: Wood Siding/sheathing/decking Attic RoofSleeping Zone Attic Roofs i Wood Framed Ceiling in. O.C. none 0.644 Roofing: Light Roof (Asphalt Shingle) • 'Inside Finish: Gypsum Board • Cavity/ Frame: no insul. /2x4 R-0 Wall Interior Walls Wood Frametl>Wall 2x4 @«1.6 inO;C. s none; : 0.277 Other Side Finish: Gypsum Board . 2x4�Top Chord of Roof Truss .@ 24 _ ' t Cavity / Frame: no insul. /2x4 Top Chrd Roof Deck. Wood Siding/sheathing/decking Attic RoofAddition Attic Roofs Wood Framed•Ceiling of �' n O.CY none 0:644 Roofing: Light Roof (Asphalt Shingle) `#~� #'U V 1 4 Inside Finish: Gypsum Board • Cavity/Frame: R -13/2x4 Exterior Finish: Wood R-13 Wall Exterior Walls Wood Framed Wall 2x4 @ 16 in. O.C. R 13 0.095 Siding/sheathing/decking Inside Finish: Gypsum Board Ceilings (below Cavity/Frame: R-9.1 /2x4 R-30 Roof Attic attic) Wood Framed Ceiling 2x4 @ 24 in. O.C. R 30 0.032 Over Floor Joists: R-20.9 insul. Cavity/Frame: no insuL /2x4 Top Chrd 2x4 Top Chord of Roof Truss @ 24 Roof Deck: Wood Siding/sheathing/decking Attic RoofLiving Zone Attic Roofs Wood Framed Ceiling in. O.C. none 0.644 Roofing: Light Roof (Asphalt Shingle) Registration Number: 215-A0178653A-000000000-0000 Registration Date/Time: 2015-07-01 14:26:45 - CA Building Energy Efficiency Standards - 2013.Residential Compliance Report Version - CFIR-06232015-744 . HERS Provider: CaICERTS inc. Report Generated at: 2015-06-30 20:37:11 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Hietbrink Residence Addition Calculation Daterrime: 20:36; Tue, Jun 30, 2015 Calculation Description: Title 24 Analysis Input File Name: Hietbrink.xmi CF1 R -PRF -01 Page 6 of 9 SLAB FLOORS 01 02 03 04 05 06 07 08 09 _ Name Zone Area (ft2) Perimeter (ft) Edge Insui. R -value Carpeted Fraction Heated Status Verified. Existing Condition Slab -on -Grade Sleeping Zone 1700 131 None 0.8 No Existing No Slab -on -Grade 2 Addition 136 13 None 0.8 No New No Slab -on -Grade 3 Living Zone 1701 146 None 0.8 No Existing No BUILDING ENVELOPE - HERS VERIFICATION 01 02 03 04 Quality Insulation Installation (QII) Quality Installation of Spray Foam Insulation Building Envelope Air Leakage ACH @ 50 Pa Not Required Not Required Not Required SPACE CONDITIONING SYSTEMS 01 02 03 04 05 06 07 08. 09 CntrlFurnace - Fuel -fired central furnace 92 AFUE Heating System'0 Cooling',System itp D' ist�ribution Fant Floor Area Verified Existing Name System Type System System Served . NameDucted Name aDucted Status Condition Sleeping Zone1 p g Other Heating and, Cooling System Heating Component`1 Yes CoolingAir,Distribution rs € Component 1 3` p Yes 4V r x N System 1 j HVAC Fan 1 1836 Altered No c Existing FAU2 Other Heating and- Cooling System Heating Component 2 Yes Cooling Component 2 Yes Air Distribution System 2 HVAC Fan 2 1701 Existing No HVAC - HEATING SYSTEMS 01 02 03 Name Type Efficiency Heating Component 1 CntrlFurnace - Fuel -fired central furnace 92 AFUE Heating Component 2 CntrlFurnace - Fuel -fired central furnace 78 AFUE Registration Number: 215-A0178653A-000000000-0000. Registration Date/Time: 2015-07-01 14:26:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance . Report Version - CF1R-06232015-744Report Generated at: 2015-06-30 20:37:11 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE. METHOD Project Name: Hietbrink Residence Addition Calculation Date/Time: 20:36, Tue, Jun 30, 2015 Calculation Description: Title 24 Analysis Input File Name: Hietbrink.xml CF1 R -PRF -01 Page 7 of 9 HVAC - COOLING SYSTEMS 01 02 03 04 05 06 07 Name Verified Airflow Efficiency Verified EER Multi -speed Verified Refrigerant Charge Name System Type EER ' SEER Zonally Controlled Compressor HERS Verification Cooling Component 1 SplitAirCond - Split air conditioning 11.7 15 No No Cooling Component Locatyon system Status. Condition Verification 1 -hers -cool Cooling Component 2 SplitAirCond - Split air conditioning 10 13 No No N/A system (not `K to x tA tom. 'a t4 i4 WWW PF, HVAC COOLING - HERS VERIFICATION 01 02 03 04 05 06 Name Verified Airflow Airflow Target Verified EER Verified SEER Verified Refrigerant Charge Cooling Component 1 -hers -cool Required 350 Not Required Required Not Required HVAC - DISTRIBUTION SYSTEMS. 01 02 03 04�" ..r 05 � .A.�u�%u, .>�rn,... r 06 •=a+.. .,r�-w, 07 ,� 08 09 10 Duct Leakage Target (%) Verified Duct Location Verified Duct Design Return Supply Insulationf` Supply Duct Return Duct Verified Existing HERS Name Type DuctrLeakage�R-valueLocatin Locatyon Bypass Duct Status. Condition Verification Air DistributionExisting (not `K to x tA tom. 'a t4 i4 WWW PF, si X= A 10 System 1 Ducts located in attic �:rr. •:-. specEif ed) i 2.1 a Attic Attic None Existing No N/A � _5 2 Air Distribution System 2 Ducts located in attic Existing (not, specified) 2.1 Attic Attic None Existing No N/A HVAC DISTRIBUTION - HERS VERIFICATION 01 01 02 03 04 05 06 Name Duct Leakage Verification Duct Leakage Target (%) Verified Duct Location Verified Duct Design Return Supply . . EAir DistributionSystem 1 -hers -dist N/A Air Distribution System 2 -hers -dist N/A --- --- HVAC - FAN SYSTEMS & HERS VERIFICATION 01 02 03 04 Name Type Fan Power (Watts/CFM) HERS Verification HVAC Fan 1 Single Speed PSC Furnace Fan 0.58 Required HVAC Fan 2 Single Speed PSC Furnace Fan 0.58 Registration Number: 215-A0178653A-000000000-0000 .Registration Date/Time: . 2015-07-01 14:26:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-06232015-744 Report Generated at: 2015-06-30 20:37:11 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Hietbrink Residence Addition Calculation. Datefrime: 20:36, Tue, Jun 30, 2015 Calculation Description: Title 24 Analysis Input File Name: Hietbrink.xml CF1 R -PRF -01 Page 8 of 9 IAQ (Indoor Air Quality) FANS 01 02 03 04 05 Name IAQ CFM IAQ Fan Type IAQ Recovery Effectiveness(%) HERS Verification SFam IAQVentRpt 0 Default 0 Not Required PROJECT NOTES Providing accurate Title 24 Energy Calculations since 1988 Registration Number: 215 A0178653A-000000000 0000 Registration Date/Time:. 2015-07-01 14:26:45 CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-06232015-744 HERS Provider: CaICERTS inc. Report Generated at: 2015-06-30 20:37:11 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD i Project Name: Hietbrink Residence Addition Calculation Datefrime: 20:36, Tue, Jun 30, 2015 Calculation Description: Title 24 Analysis Input File Name: Hietbrink.xml CF1 R -PRF -01 Page 9 of 9 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: _ Stephen Lilly Company: Southland Energy. Consultants of FV Signature Date: 2015-06-30 20:40:590 r Arr Address: CEA/HERS Certification Identification (If applicable): 8592 La'Casita Avenue R13-93-10045 AS cp``'0re°,b I e4gyc,i,rtF,Jr. City/State/Zip: Phone: Fountain Valley, CA 92708 714-848-3756 _ RESPONSIBLE.PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am eligible under Division 3 of the Business'and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. ' 2. 1 certify that the energy features and performance specifications identified on this Certificate of Compliance conform to.the requirements of Title 24, Part land Part 6 of the California Code of Regulations. 3. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submittedtoXhe enforcemen qen .yyfor app oval w th,his, ilding permit application. Responsible Designer Name: it A �� u:� wr ,Responsible Designer Signature:, � L John McNeely I o Company: ^ 'v i AlF Date,Signed: Iw.. John F McNeely Inc 2015-07-01 1L�4:26:45 Address: License: 1792 Skyline Drive NA City/State/Zip: Phone: Santa Ana, CA 92705 - , 714-417-9277 Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider responsibility for the accuracy of the information. I Registration Number: - 215-A0178653A-000000000-0000 Registration Date/Time: 2015-07-01 14:26:45 HERS Rrovider: CaICERTS inc. CA Building Energy Efficiency Standards. 2013 Residential Compliance . Report Version - CF1R-06232015-744 Report Generated at: 2015-06-30 20:37:11