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0204-039 (SFD)LICENSED CONTRACTOR DECLARATION y I hereby affirm under penalty of perjury that I am licensed under provisions of .� jChapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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"& Professionals Code). ( ) I, as owner of the` property, am exclusively contracting; with licensed contractors to construct the project (Sec. 7044, Business &!Professionals Code). ( ) I am exempt under Section B&P.C. for this reason' Date Signature of Owner 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. ( ) I 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 & policy no. are:. Carrier Policy No. (This section need not be completed if the permit valuation is for $100.00 or less). () 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: Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) Date cefp-i BUILDING. PERMIT PERMIT02.39 DATE yry$ VALUATION $15015 *519.80 LOT TRACT F LK 92 JOB SITE (�.I ADDRESST� APN OWNER CONTRACTOR/DESIGNER/ENGINEER 'L)MaM, 0e:)Or)WO f7vraLl"R. Bid LR 7€-967;�:i:�iEC"3Q';iM'I GF, LA QUINTA CA 92253 CBLO USE OF PERMIT Y'aJJ I.��a if.Yf RrM Si ,i�Y S), , LM'5. I YMIT LlORS NOT INCLUDE 8.f..gC.K 'KAL1, POOL, OR DRIVI?:WAYAPPRC3ACH, 93 Ct9D�E— TRC"[ CONSTRUCTION I,000O SF t,O.iLf'HiP.A.'riO 126.00 SF , GARS 0RICATtF°ORT 702.00 SIS 2t5�:ti41.Lr's+," ,�.:f) C09T OF CiONV1N1i3MON 159411,592's F't0ffF F9FSUMMARY FEE '103.000.418oOOO II3 �'t1 PLAN CR K: FEE 101,rO0 D-4:39-318 FEE DEPOSIT 101-000-439.318 MEC'KKNICAL FEE $109.00 E1.1,�t IT LCAT, FEE 101-000-420.000 11"130 PL,UMBIN t FEZ 101-000-419-000 $450.50 STRONG IWYA034 PER - REWD 101-000-241-000 $15.06 OaLd40ING FLOP, 101-000-423-00-0 -0 $30.00 T}LVU,0P .RI.MPACZ FKle gt,�8lY.ttk1 11161-lyy3TAL CONVYRUCTION AND ,PUN CITBOX 1' rMs Pn%:PA XMM' 3 4,250.00 TOTAL 111amiff FXW� DUE NOW RECEIPT DATE BY DATE FINALED INSPECTOR �d ' INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck -a':. - O Exhaust Fans O.K. to Wrap -p F.A.U. Framing - Compressor _ Insulation o,� ! Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final Q POOLS - SPAS BLOCKWALL AF4ROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final _ Water Piping Plumbing Final Plumbing Top Out r'p Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection G==p - o' Encapsulation Gas Piping Gas Test — G Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) .: ­ i � � ­11r?49"141r11" 1 1 - Y 0 7 g, P.O. BOX 1504 APPLICATION ONLY Building—� A 1,Z-1 78-495 CALLE TAMPICO Aririrpqq LAQUINTA, CALIFORNIA 92253 Owner a Z? V7 / ; t— r. In � -1 ->,,I "51 -V, , I Add ress 91,7 13t h,,. City Zip Tel 9,2 2, rJ (� -h -, 1 0 Contractor O'd .., e . y // Y_ Address ity Izip State Lic. City & Classif. Lic. # Arch., Engr.' Designer 4 C, ActOress— Tel. /,�� J_ 71 lff -3 4/!-; .. City lZip State Lic. # LICENSED CONTRACTOR'S DECLARATION I herelogif irm that I am licensed under provisions of Chapter 9 (commencingfwith Section 7000) of v ision 3 of the B usi ness and Professions Code. and my license is in ull force and effect. DATE OWNER -BUILDER DECLARATION I h oreby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec . 7031 .5.Business and Professions Code: Any city or county which requires a permit to construct, after. 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 th6'provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Divisiol 3 of the Business and Professions Code. of that -he is exempt therefrom, and the basis lot 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). C., I as owner I the pr perty, or my employees with wages as their sole compensation, will do ihe work, aond the storucture is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If,. however. the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) I 1 1, as owner of the property, am exclusively contracting with licensed contractors to con. struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 1-1 1 am exempt under Sec.—B. & P�C. fo.r this reas'on Date —Owner 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. (Sec. 3800, Labor Code.) Policy No. Company 171 Copy is filed with the city. 0 Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COM P ENSATION INSURANCE (This section need not be completed it the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thp work for which this permit is issued, I shall not empl by any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date_Owner NOTICE TO APPLICANT., ff. after making this Certificate of Exemption you should become subject to 111. Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permil shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name— Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above - .mentioned property for inspection purposes. Signature of a0plicant —Date— Mailing Address City, State, Zip L*;�A*,/ 6A 6VW BUILDING: TYPE'CONST.—OCC. GRP. �6z. A.P. Number =53 7 749- 042- 00 Legal Description 4,,-7" No, �e X.2 Project Description J, 71�- Sq. Ft No. No. Dw. Size �2 05,!� Stories Units New,ED— Add 0 Alter 0 Repair 0 Demolition 0 Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical K Plumbing S.M.I. ly I AFIR U 4t luu I I Grading C�_� — k .. Driveway Enc. LAIYUK.AQUINTA '5!51 NrL TOTAL REMARKS ZONE: BY: Minimum Setback Distandes: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date_Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Notice: Document Cannot Be Duplicated Date 5/24/02 No. 23240 Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE I VIED BERMUDA DUNES r I) RANCHO MIRAGE Y INDIAN WELLS b PALM DESERT Q,y LA UINTA INDIO . APN # 770-092-003' Jurisdiction La Ouinta owner NameDenise Goodman N0.78655 Street Avenida Ultimo city La Quinta zip 92253 Permit #0204-039 Log # Study Area Tract # BLK92 Lot # 5 Square Footage 2456 Type of Development Single Family Residence No. of Units' 1 Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 2.14 X 2,456 or $ 5,255.84 , the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued Fees Paid By CC PDNB - Brian Devlin Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Crystal Scott Payment Received Check No. Signature Telephone 760/535-0907 $5,255.84 1 083887; IOTICE: Pursuant to Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified bove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to ollect them on the Dishict(s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting •:rsai� �Aa!STAT °=�> s y �'.",��,nY� s���-szcc�a 4'a:+.f x�s�..w,�+rs..t y�rscaiF+s� 3 •.7r*C.hL,F' � �5� �,�� • -t ..,r' icc � *,_ �� r� ai'g ^ i i' - i : r�.ti.,+� r....y �e[:: 0_" ' . -a'-T. : �. .t'. • -. fs�-.� aY�i_�r.•��k :,� �� 1y,:.."'; •y, r,• -r '..Y .�� .�-. �"�- �h• �� • ...'.:.. DENISE (;66 SAN •r - C/O 'CHL/74399..$Wy III'' - PALM DESERT,•CA..92260 t^^ = ESCROW NO _• 310 0 0 615 I TITLE NO_ 05008882 SPACE ABOVE THIS LINE FOR RECORDER, II9E APN: 770-092-003 TER UNDERSIGN GRANTpa(S1 DECLARR(S) DOCUMENTARY TRANSFER TAx IS S 82.50 X Computed on full value of property conveyed, or GRANT DEED _ Computed on full value less liana i[ eactmbraneee regaining thereon at time of sale. _ IIaincorporated area City of LA QUINTA and FOR A VALUABLE CONSIDERATION, receipt of which is hereb DAVID BRIAN BOGGS AND KIMBERLY ANN BOGGS, $pgH�. AND WIFE owledged, hereby GRANT(s) to DENISE GOODMAN TRUSTEE:OF THE DENISE GOODMAN 1994 TRUST the following described real property is the CouUty of RIVERSIDE ' y N State of -California; LOT 5 OF DESERT CLDB TRACT UNIT NO. 5, AS SHOWN By o IN BOOK' 21-; --PAGE& 61• AND 62 OF It"S `'btBCORDS OB RIVHBSIDN FILE COUNTY, CALIFORNIA. Dated December ii ,•;2001' iI State of California } D BRIAN BOGGS County of g i Smr SS- On Ito before me. A Notary Public in and for said County and State, perso.Uy appeared [ v Personally known to me (or uved to me on the base of satisfactory evidence) to be tba personovbose namr®i�,u to the within iastrumcn d ac"aw1c4ed to at c ' NE(L utcd t �,sris a'ame io Or utburucd capaci[y t and that q hi, ,� ccc — sfgnature ) is rum eut the pers s ' r the entity upon behalf r�' "` PIMI ICC/�1 iFOFiNtA y of which t c perso s) ted, caccuted ibve' mcni- t �' NVF1iSiDE MINTY M WITNESS my hand and tial al - \ LV Coif nt EgNs Atli 8.200 i S[snat,rrr FOR VOTARY SEAL OR .'TAMP OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City or County. They are also required by law' to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the State and Federal Government as an employer -and you are subject to several obligations including State and Federal income tax withholding, federal social security taxes, worker's compensation insurance4�disability insurance costs and unemployment compensation contributions. > .� There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta,CA 92253 (760) 777-7012 FA�777-7011 n ER'S SIGNATURE/ DATE 7,i�c5- �­ A��v�� PROPERTY ADDRESS b? -OV- 0!9 PERMIT NUMBER(s) /Tom �s^5� ✓� p CITY OF LA •QUINTA SUB -CONTRACTOR LIST 1,,tcef;kn JOB ADDRESS h , PERMIT NUMBER OWNER flr<ti, r c 5-= BUILDER D94./' This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employee are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. Trade / Classification Contractor State Contractor's License Workers Compensation Insurance City Business License Company Name Classification . (e.g. A, B, C-8) License Number (xxxxxx) Exp: Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) �. C / 0 "' 0 Q CONCRETE (C-8) ��C � � O J .'/� i1 OOD 2^D D� v� l FRAMING (C-5)1-7- 4 t� -2-7-7� STRUCT. STEEL (C-51) , MASONRY (C-29) ® S �j �j �� l0 '04- - $ dQ Q a-35-5- 616 3 PLUMBING (C-36) p S i ! �0 C� © --6 5�+ LATH, PLASTER (C-35) `C C 6 Q DRYWALL (C-9) © _�_ at HVAC (C-20) S W `i.�% - O �O a O ELECTRICAL (C-10) �, () °� l eq (. © C 2 ROOFING (C-39) 7 D�01 f o[ fl c_-') G SHEET METAL (C-43) FLOORING (C-15) 0 GLAZING (C-17) Q � � / 1 `t a INSULATION (C-2)44 C-2)�l &ed-� 0 �� v-1 6 SEWAGE DISP. (C-42) PAINTING (C-33) -%b 0 oa8k CERAMIC TILE (C-54) j CABINETS (C -6)L ti.e 7 G %7 G U �.. 3 6o�7a��od / p •l � G FENCING (C-13) co , LANDSCAPING (C-27) POOL (C-53) C � 6 Certificate of Occupancy City of La Quinta Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS: Use Classification: SINGLE FAMILY DWELLING 78-655 AVENIDA ULTIMO Occupancy Group: R-3 Type of Construction: VN Bldg. Permit No.: 0204-039 Land Use Zone: RL Owner of Building: DENISE GOODMAN Address: 78-967 BRECKENRIDGE �dz"l Building Official City: LA QUINTA, CA 92253 By: STEVE TRAXEL Date: 12-24-2002 POST IN A CONSPICUOUS PLACE - - � r J6 CITY OF LA QUINTA BUILDING & SAFETY DEPT. Title- 24 ft APPROVED Avenida. Ultimo LOATE Z, 13 Le Quinta, Wort PrIepared: -Joan D. Hicksr C-Otthedral'..City, CA 91* r J6 I TABLE OF CONTENTS I Cover Page Table of Contents Form CF -1 R Certificate of Compliance Form MF -1 R Mandatory Measures Checklist Form C -2R Computer Method Summary HVAC System Heating and Cooling Loads Summary Room Load Summary 1 2 3 6 7 11 13 EnergyPro 3.1 By EnergySoft Job Number: User Number: 2655 I' Certificate of Compliance: Residential (Part 1 of 2) CF -1 R David Boggs 10/17/2001 Project Title Date Avenida Ultimo La Quinta Project Address Building Permit # Insu-Form Inc. (760) 324-0216 Plan Check l Date Documentation Author - Telephone Computer Performance 15 1 Field Check / Date Compliance Method (Package or Computer) Climate Zone Enforcement Agency Use Only GENERAL INFORMATION Total Conditioned Floor Area: 2,456 fit Average Ceiling Height: 9.6 ft Total Conditioned Slab Area: 2,456 f? Building Type: (check one or more) X❑ Single Family Detached ❑ Addition ❑ Single Family Attached ❑ Existing Building ❑ Multi -Family ❑ Existing Plus Addition Front Orientation: (North) 0 deg Number of Dwelling Units: 1.00 Number of Stories: 1 Floor Construction Type: ® Slab Floor ❑ Raised Floor FENESTRATION Shading Devices Type Orientation Const. Component Frame Assembly Location/Comments Type Type U -Value (attic, garage, typical, etc.) Slab On Grade n/a 0.756 Exposed Slab w/R-0.0 Perimeter Insulation R-13 Wall (W.13.2x4.16) Wood 0.081 Exterior Wall Solid Wood Door None 0.387 Exterior Door R-38 Roof (R.38.204.16) Wood 0.028 Exterior Roof Slab On Grade n/a 0.756 Covered Slab w/R-0.0 Perimeter Insulation FENESTRATION Shading Devices Type Orientation Area Fenestration Exterior Overhang Side Fins SF U -Factor SHGC Shading Yes / No Yes / No Front (North) 40.0 0.55 0.65 Bug Screen 0 ❑ ❑ Q Front •(Northeast) 20.0 0.57 0.67 Bug Screen Q ❑ ❑ Q Rear (South) 64.0 0.55 0.65 Bug Screen 0 ❑ ❑ 0 Rear (South) 84.0 0.57 0.67 Bug Screen 0 ❑ ❑ Q Right (West) 104.0 0.55 0.65 Bug Screen Q ❑ ❑ Q Right (Northwest) 20.0 0.57 0.67 Bug ScreenQ ❑ ❑ X❑ Left (East) 25.0 0.60 0.65 Bug Screen 0 ❑ ❑ 0 Left (East) 18.0 0.57 0.67 Bug Screen x❑ ❑ ❑ X❑ Rear (Southwest) 40.0 0.55 0.65 Bug Screen x❑ ❑ ❑ x❑ Right (West) 6.0 0.57 0.67 Bug Screen X❑ ❑ ❑ X❑ El El El 11 El El E] Run Initiation Time: 10117/01 23:08:17 Run Code: 1003385297 Ener Pro 3.1 By Ener Soft User Number: 2655 Job Number: Pa e:3 of 14 Certificate of Compliance: Residential (Part 2 of 2) CF -1 R David Boggs 10/17/2001 Project Title - Date HVAC SYSTEMS Note: Input Hydronic or Combined Hydronic data under Water Heating Systems, except Design Heating Load. Distribution Heating Equipment Minimum Type and Duct or Type (furnace, heat Efficiency Location Piping Thermostat Location / pump, etc.) (AFUE/HSPF)(ducts, attic, etc.) R -Value Type Comments r Antral Furnas centrnl Eumace 80% AFUE Ducts in Attic 80% AFUE Ducts in Attic 42 42 Setback LivingJone Setback Fledrooms Cooling Equipment Minimum Duct Type (air conditioner, Efficiency Location Duct Thermostat Location / heat pump, evap. cooling) (SEER) (attic, etc.) R -Value Type Comments Split Air Conditioner Split Air Conditioner 12.0 SEER Ducts in Attic 12.0 SEER Ducts in Attic 42 42 Sethark Living Zona Sethark Bedrnoms WATER HEATING SYSTEMS Rated 1 Tank Energy Fact! 1 External Water Heater Water Heater Distribution # in Input Cap. or Recovery Standbyy Tank lnsul. System Name Type Type Syst. Btu/hr (gal) Efficiency Loss (%) R -Value A O SMITH WATER Small Gas Recirc/Time+Temp 1 40-000 _ 50 0.65 n/a n/a PRODUCTS FGSE-50-230E For small gas storage (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance and heat pump water heaters, list energy factor. For large gas storage water heaters (rated input of greater than 75,000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input and Recovery Efficiency. REMARKS COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that is varied is indicated in the Special Features/Remarks section. Designer or Owner ,(per rBBusiness && Professions Code) Documentation Author Name: t"1:�;b ���i I moi' Name: Joan D. Hacker Title/Firm: Title/Firm: Insu-Form Inc. Address: -654 4t lk 57 Address: 68255 Corta Road Cathedral City, CA 92234 Telephone: -1(20 2 z+0 - `52e;, Telephone: (760) 324-0216 Lic. #: (signature) Enforcement Agency Name: Title/Firm: Address: Telephone (date) IEnergvPro 3.1 By EnergvSoft User Number: 2655 Job Number: Page:4 of 14 1 Certificate of Compliance: Residential (Addendum) CF -1 R David Boggs 10/17/2001 Project Title Date Special Features and Modeling Assumptions The local enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification to be used with the performance approach. The local enforcement agencv determines the adequacy of the justification, and may reject a building or design that otherwise complies )ased on the adequacy of the special justification and documentation submitted. Plan I Field The HVAC System "Living Zone" must meet all CEC Criteria for a Zonally Controlled system serving only Living Areas. HIGH MASS Design(see C -2R) - Verify Thermal Mass: 1071 sqft Exposed Slab Floor, 3.50" thick at Living The HVAC System 'Bedrooms" must meet all CEC Criteria for a Zonally Controlled system serving only Sleeping Areas. HIGH MASS Design(see C -2R) - Verify Thermal Mass: 1385 sqft Covered Slab Floor, 3.50" thick at Bedrooms HERS Required Verification These features must be confirmed and/or tested by a certified HERS rater under the supervision of a CEC approved HERS provider. The HERS rater must document the field verification and diagnostic testing of these measures on a form CF -6R. Plan Field Run Initiation Time: 10/17/01 23:08:17 Run Code: 1003385297 EnergyPro 3.1 By Energysoft User Number: 2655 Job Number: Page:5 of 14 Mandatory Measures Checklist: Residential MF -1 R 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 minimum component specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION Instructions: Check or initial applicable boxes or enter NIA if not applicable. DESIGNER ENFORCEMEN Building Envelope Measures VNJ '§ 150(a): Minimum R-19 ceiling insulation in wood frame assembly, or equivalent U -value. § 150(b): Loose fill insulation manufacturer's labeled R -Value. §150(c): Minimum R-13 wall insulation in wood framed walls or equivalent U -value in metal frame walls (does not apply to e exterior mass walls). F'§ 150(d): Minimum R-13 raised floor insulation in framed floors. § 150(1): Slab edge insulation - water absorption rate — 0.3%, water vapor transmission rate — 2.0 perm/inch. §118: Insulation specified or installed meets insulation quality standards. Indicate type and form. §116-17: Fenestration Products, Exterior Doors and Infiltration/Exfiltration Controls 1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. 2. Fenestration products (except field fabricated) have label with certified U -Factor, certified SHGC, and infiltration certification. 3. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. F] §150(g): Vapor barriers mandatory in Climate Zones 14 and 16 only. §150(f): Special infiltration barrier installed to comply with Section 151 meets Commission quality standards. §150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs. 1. Masonry and factory -built fireplaces have closable doors, outside air intake with damper and control, and flue damper and control; 2. No continuous burning gas pilots allowed. Space Conditioning, Water Heating and Plumbing System Measures §110-13: HVAC equipment, water heaters, showerheads and faucets certified by the Commission. §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA or ACCA. §150(i): Setback thermostat on all applicable heating and/or cooling systems. X§1500): Pipe and Tank Insulation 1. Storage gas water heaters with less than 0.58 energy factor shall be externally wrapped with R-12. 2. First 5 feet of pipes closest to water heater tank, non -recirculating systems, insulated (R-4 or greater) 3. Back-up tanks for solar system, unfired storage tanks, or other indirect hot water tanks have R-12 external insulation or R-16 combined internal/external insulation. 4. All buried or exposed piping insulated in recirculating sections of hot water systems. 5. Cooling system piping below 55 degrees F. insulated. 6. Piping insulating between heating source and indirect hot water tank. K_7'§150(m): Ducts and Fans 1. All ducts and plenums installed, sealed and insulated to meet the requirements of the 1998 CMC Sections 601, 603, 604 and Standard 6-3; ducts insulated to a minimum installed level of R-4.2 or enclosed in conditioned space. Openings shall be sealed with mastic, tape aerosol sealant or other duct- closure system that meets the applicable requirements of UL181, UL181A, or UL181 B. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh tape or tape shall be used. Building cavities shall not be used for conveying conditioned air. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and drawbands. 2. Exhaust fans systems have back draft or automatic dampers. 3. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. ry LnL §114: Pool and Spa Heating Systems and Equipment 1. Certified with 78% thermal efficiency, on-off switch, weatherproof instructions, no electric resistance heating, no pilot. 2. System is installed with at least 36" of pipe between filter and heater for future solar, cover for outdoor pools or spas. 3. Pool system has directional inlets and a circulation pump time switch. X§115: Gas fired central furnaces, pool heaters, spa heaters or household cooking appliances have no continuously burning pilot light. (Exception: Non -electrical cooking appliances with pilot < 150 Btu/hr) Measures rLiighting M I x I §150(k)1: Luminaires for general lighting in kitchens shall have lamps with an efficacy 40 Iumenstwatt or greater for general 'Lv lighting in kitchens. This general lighting shall be controlled by a switch on a readily accessible lighting control panel at an entrance to the kitchen. �t I X I 150(k)2: Rooms with a shower or bathtub must have either at least one luminaire with lamps with an efficacy of 40 lumens/watt �l or greater switched at the entrance to the room or one of the alternative to this requirement allowed in Section 150(k)2.; and recessed ceiling fixtures are IC (insulation cover) approved. EnergyPro 3.1 By EnergySoft User Number: 2655 Job Number: Page:6 of 14 Computer Method Summary (Part 1 of 3) C -2R nnvid Roaac Project Title Avenida Ultimo La Quinta Project Address Building Permit # Insu-Form Inc 324-0216 -(760) Documentation Author Telephone plan Check/Date CornputPr PPrforman 15 Field Check/Date Compliance Method (Package or Computer) Climate Zone Source Energy Use Standard Proposed Compliance (kBtu/sf-yr) Design Design Margin Space Heating 12.63 12.85 -0.22 Space Cooling 52.70 54.87 -2.17 Domestic Hot Water 11.52 9.11 2.41 Totals 76.84 76.82 0.02 GENERAL INFORMATION Conditioned Floor Area: 2,456 Floor Construction Type: X❑ Slab Floor Building Type: Single Fam Detached ❑ Raised Floor Building Front Orientation: (North) 0 deg Number of Dwelling Units: 1.00 Total Conditioned Volume: 23,489 Number of Stories: 1 Slab Floor Area: 2,456 BUILDING ZONE INFORMATION # of Zone Name Floor Area Volume Units I iving 7nnP 107 96,14 0 44 Bedroom__ 1„385 13,850 0.56 OPAQUE SURFACES Act. Type Area U -Val. Azm. Tilt Wall 380 0.081 0 g0_ Door 40 0 387 0 90 Wall 20 0.081 45 _gn W211 188 0.081 180 _9Q Wall 201 0.081 270 90_ Wall 20 0 081 315 g0_ Rnnf 1,071 0.028 270 0 Wall 229 0.081 90 gQ Wall 164 0 081 180 90_ Wall 50 0.081 225 _90 Wall 184 0.081 270 90 Roof 1,385 0.028 270 _0 Solar Gains Y/N Me Zone Type 1 iving Sleeping Thermostat Type I ivingStat SlPPpin9Stat Vent Hat. Area Location / Comments Run Initiation Time: 10/17/01 23:08:17 Run Code: 1003385297 EnergyPro 3.1 By Energysoft User Number: 2655 Job Number: Page:7 of 14 Computer Method Summary (Part 2 of 3) C -2R David Boggs 10/17/2001 Project Title Date FENESTRATION SURFACES # Type Area U- Factor SHGC Act. Azm. Glazing Type Tilt Location/ Comments J- Window_Fso.ot (N.odh) -t0_0_ . 0.5b0_ -0-65- 0_ _9D. Double NonMtLCJear-Qefault_ livinn _Zone 2 Window Front (Northeast) 20.0 s 0.570 0.67 45 90 Double NonMtl Clear Default Living Zone 3 Window Rear South 64.0 • 0.550 0.65 180 90 Double NonMtl Clear Default Living Zone 4 Window Rear South 48.0 • 0.570 0.67 180 90 Double NonMtl Clear Default Living Zone 5 Window Right (West)_ 64.0 • 0.550 0.65 270 90 Double NonMtl Clear Default Living Zone 6 Window Right (Northwest) 20.00 0.570 0.67 315 90 Double NonMtl Clear Default Living Zone 3 Window Left (East) 25.0 • 0.600 0.65 90 90 Double NonMtl Clear Default 3edrooms 8 Window Left (East) 8.0 • 0.570 0.67 90 90 Double NonMtl Clear Default Bedrooms 6 Window Left (East) 10.0 • 0.570 0.67 90 90 Double NonMtl Clear Default Bedrooms _1.0 Window Rear (South) 36.0 ' 0.570 0.67 180 90 Double NonMtl Clear Default Bedrooms 11 Window Rear (Southwest) 40.0 0.550 0.65 225 90 Double NonMtl Clear Default Bedrooms 12 Window Right (West) 6.0 • 0.570 0.67 270 90 Double NonMtl Clear Default Bedrooms 13 Window Riaht Mei4 X49.0 0-550 QS5 X7.0_ 90 Qauble_d nMtl_Clear_Default_ _BgWrooms INTERIOR AND EXTERIOR SHADING # Exterior Shade Type SHGC 1 Bug Screen 0.76 2 Bug Screen 0.76 3 Bug Screen 0.76 4 Bug Screen 0.76 5 Bug Screen 0.76 6 Bug Screen 0.76 7 Bug Screen 0.76 8 Bug Screen 0.76 9 Bug Screen 0.76 10 Bug Screen 0.76 11 Bug Screen 0.76 12 Bug Screen 0.76 13 Bug Screen 0.76 Window Hgt. Wd. LEA RExt. 8.0 2.5 2.0 0.1 2.0 2.0 8.0 2.5 2.0 0.1 2.0 2.0 8.0 8.0 8.0 0.1 8.0 8.0 8.0 3.0 8.0 0.1 8.0 8.0 8.0 8.0 2.0 0.1 2.0 2.0 8.0 2.5 2.0 01 2.0 2.0 5.0 5.0 2.0 0.1 2.0 2.0 2.0 2.0 2.0 0.1 2.0 2.0 4.0 2.5 2.0 0.1 2.0 2.0 6.0 6.0 2.0 0.1 2.0 2.0 8.0 2.5 2.0 0.1 2.0 2.0 2.0 3.0 2.0 0.1 2.0 2.0 8.0 2.5 2.0 0.1 2.0 2.0 Left Fin Dist. Len. Hgt. EnergyPro 3.1 By EnergySoft User Number: 2655 Job Number: Paae:8 of 14 1 Computer Method Summary (Part 3 of 3) C -2R David Boggs 10/17/2001 Project Title Date THERMAL MASS FOR HIGH MASS DESIGN Area Thick. Heat Inside Location Type (sf) (in.) Cap. Cond. Form 3 Reference R -Val. Comments Concrete Heavyweight 1071 -3-5.0 _28_ 0 98 n/a 0- livin�ZoneLS1ab-on-Giade Concrete. Heavyweight 1.385 3_50 28 0_98 n/a 2 Bedrooms / Slab on Grade PERIMETER LOSSES F2 Insulation - Type Length Factor R -Val. Depth Location / Comments Slab Perimeter 10 0.76 0.0 0 Living Zone Slab_eerimeter J..Q6.0 0.76 0.0 0 Bedrooms HVAC SYSTEMS Heating Equipment Minimum Distribution Type Type (furnace, heat Efficiency and Location Duct Thermostat Location / pump,.etc.) (AFUE/HSPF)(ducts/attic, etc.) R -Value Type Comments Central Furnace 80%AFUE Ducts in Attic 4.2 Setback Living Zone Central Furnace 80%AFUE Ducts in Attic 4.2 Setback Bedrooms Pipe Hydronic Piping Pipe Insul. System Name Length Diameter Thick. Cooling Equipment Minimum Duct Type (air conditioner, Efficiency Location Duct Thermostat Location / heat pump, evap. cooling) (SEER) (attic, etc) R -Value Type Comments Split Air Conditioner 12.0 SEE Ducts in Attic_ 4.2 Setback Living Zone Split Air Conditioner 12.0 SEER Ducts in Attic 4.2 . Setback Bedrooms WATER HEATING SYSTEMS Ratedl Tank Energy Fact! 1 Tank Insul. Water Heater Water Heater Distribution # in Input Cap. or Recovery Standby R -Value System Name Type Type Syst. (Btu/hr) (gal) Efficiency Loss (%) Ext. A O SMITH WATER PRODUCTS -FGSE=50=23 Small Gas Recirc/Time+Tema 1 40,000 50 0.65 n/a n/a 1 For small gas storage (rated input — 75000 Btu/hr), electric resistance and heat pump water heaters, list energy factor. For large gas storage water heaters (rated input > 75000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input, and Recovery Efficiency. REMARKS Run Initiation Time: 10/17/01 23:08:17 Run Code: 1003385297 EnergyPro 3.1 By EnergySoft User Number: 2655 Job Number: Page:9 of 14 Computer Method Summary (Addendum) 2-2R David Boggs 10/17/2001 Project Title Date Special Features and Modeling Assumptions The local enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification to be used with the performance approach. The local enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies )ased on the adequacy of the special justification and documentation submitted. 'Plan I Field The HVAC System "Living Zone" must meet all CEC Criteria for a Zonally Controlled system serving only Living Areas. HIGH MASS Design(see C -2R) - Verify Thermal Mass: 1071 sqft Exposed Slab Floor, 3.50" thick at Living The HVAC System 'Bedrooms" must meet all CEC Criteria for a Zonally Controlled system serving only Sleeping Areas. HIGH MASS Design(see C -2R) - Verify Thermal Mass: 1385 sqft Covered Slab Floor, 3.50" thick at Bedrooms HERS Required Verification These features must be confirmed and/or tested by a certified HERS rater under the suaervision of a CEC aaaroved HERS provider. i ne HhKs rater must document the field verification and diagnostic testing of these measures on a form GF -61K. plan Field Kun Initiation l ime: tun t U9 Z3:U m t Kun GOCie: 1UU33t35Zy/ EnergyPro 3.1 By EnergySoft User Number: 2655 Job Number: Page: 10 of 14 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY PROJECT NAME DATE David Bogs 10/17/2001 SYSTEM NAME FLOOR AREA Living Zone 1,071 Outside Air (cfm/sgft) I 000 Note: values above given at ARI conditions 26.0 OF 69.4 OF Outside Air 0 cfm Supply Fan 1595 cfm 69.4 OF Total Room Loads Return Vented Lighting Return Air Ducts Return Fan Ventilation Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COIL COOLING PEAK COIL HTG. PEAK CFM Sensible Latent CFM I Sensible 1,387 25,150 2,348 450 19,198 0 1,257 960 0 0 0 0 0 0 0 0 0 1,257 960 27 665 2 348 21 118 BDP CO. 563AN048-A 31,430 11,138 70,000 Total Adjusted System Output 31,430 11,138 70,000 (Adjusted for Peak Design Conditions) TIME OF SYSTEM PEAK Aug 2 pm Jan 12 am ream Temperatures at Time of Heatina Peak) 69.4 OF . 110.40F Heating Coil �% Return Air Ducts `{ Supply Air Ducts 109.8 OF ROOMS 70.0 OF DOLING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Cooling Peak 111.0/77.4°F 78.7/65.9°F 78.7/65.9°F 60.4/59.2°F O Supply Air Ducts Outside Air 0 cfm Supply Fan Cooling Coil 61.1 / 59.5 OF 1595 cfm 52.2% R.H. ROOMS 78.7 / 65.9 °F 78.0 / 65.6 OF h Return Air Ducts `S I EnergyPro 3.1 By EnergySoft User Number: 2655 Job Number: Page:11 of 14 1 VAC SYSTEM HEATING AND COOLING LOADS SUMMARY PROJECT NAME DATE David Boggs 10/17/2001 SYSTEM NAME FLOOR AREA Bedrooms 1,385 (Number of Systems 1 Heating System Output per System 70,000 Total Output (Btuh) 70,000 Output (Btuh/sgft) 50.5 Cooling System Output per System 47,000 Total Output (Btuh) 47,000 Total Output (Tons) 3.9 Total Output (Btuh/sgft) 33.9 Total Output (sgft/Ton) 353.6 Air System CFM per System 1,595 Airflow (cfm) 1,595 Airflow (cfm/sgft) 1.15 Airflow (cfm/Ton) 407.2 Outside Air (%) 0.0 Outside Air (cfm/sgft) 0.00 Note: values above 26.0 of Outside Air 0 cfm 68.1 of given at ARI conditions M PSYCHROMETRICS 68.1 OF 68.10F Supply Fan 1595 cfm Total Room Loads Return Vented Lighting Return Air Ducts Return Fan Ventilation Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COIL COOLING PEAK 26,051 CFM I Sensiblel Latent �JCOILHTG.PEAK I CFM I Sensible 1,472 26,051 3,302 1,664 66,123 0 1,303 3,306 0 0 0 0 011 0 0 0 0 1,303 3,306 28,656 3,3021 72 735 BDP CO. 563AN048-A 30,832 12,034 70,000 Total Adjusted System Output 30,832 12,034 70,000 (Adjusted for Peak Design Conditions) TIME OF SYSTEM PEAK Aug 2 pm I I Jan 12 am 109.0 of Heating Coil f% Return Air Ducts `i Supply Air Ducts 107.1 of ROOMS 70.0 of (COOLING SYSTEM PSYCHROMETRICS (Airstream Temperatures at Time of Coolina Peak) I 11.0 / 77.4 of Outside Air 0 cfm 78.8/66.3 of 78.8 / 66.3 of 78.8 / 66.3 of = 60.7 / 59.6 of --(P Supply Fan 1595 cfm Cooling Coil h Return Air Ducts `S Supply Air Ducts 61.5 / 59.9 of 53.6% R.H. ROOMS 78.0/66.0 OF EnergyPro 3.1 By EnergySoft User Number: 2655 Job Number: Pane: 12 of 14 1 ROOM LOAD SUMMARY PROJECT NAME David Boggs DATE TOM 7120.0,1 SYSTEM NAME Living Zone FLOOR AREA 1,071 ROOM LOAD SUMMARY ROOM COOLING PEAK COIL COOLING PEAK COIL HTG. PEAK ZONE NAME ROOM NAME Mult. CFM SENSIBLE LATENT CFM SENSIBLE LATENT CFM SENSIBLE Living Zone Living 1 1,387 25,150 2,348 1,387 25,150 2,348 450 19,198 PAGE TOTAL 1 1,387 25,150 2,348 450 19,198 TOTAL 1 1,387 25,150 2,348 450 19,198 EnergyPro 3.1 By EnergySoft User Number: 2655 Job Number: Page: 13 of 14 .N ROOM LOAD SUMMARY 1 ::1 PROJECT NAME David Boggs DATE 10/17/2001 SYSTEM NAME Bedrooms FLOOR AREA 1,385 ROOM LOAD SUMMARY ROOM COOLING PEAK COIL COOLING PEAK COIL HTG. PEAK ZONE NAME ROOM NAME Mult. CFM SENSIBLE LATENT CFM SENSIBLE LATENT CFM SENSIBLE Bedrooms Bedrooms 1 1,472 26,051 3,302 1,472 26,051 3,302 1,664 66,123 PAGE TOTAL 1 1,472 26,051 3,302 1,664 66,123 TOTAL 1 1,472 26,051 3,302 1,664 66,123 EnergyPro 3.1 By EnergySoft User Number: 2655 Job Number: Page: 14 of 14