12-0608 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
112=`00000608._.
48537 VIA AMISTAD
646-122-016-. - -
REMODEL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
5000
'T419 4.4 Q"
Architect or Engineer:
alp
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Professionals Code, and my License is in full force and effect. `
Li n ss: B C35 _ LicenseNo.: 904954
late.
�'•ontractor:
OWNER -BUILDER '
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 ($5001.:
1—) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or _
improve for the purpose of sale.).
(_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions_Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: -
Lender's Address: 13
LQPERMIT
Owner:,
MR & MRS MCKAY
48537 VIA AMISTAD
LA QUINTA, CA 92253
VOICE (760) 777-.7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/18/12
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 and policy number are: -
Carrier XEMPT Policy Number EXEMPT
1 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
//� 37 0 of the 'Labor tC e, I shall forthwith comply with those provisions.
�+ plicant:
WARNING: FAIL RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT'
IMPORTANT Application is hereby made to the Director of Building and Safety 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 unty ordinances and state laws relating to building construction, and hereby authorize representatives
of thi ou y to enter u n the above-mentioned property for insp tion purposes.
te: `� gnature (Applicant or Agent):
[D1 A-�
Contractor:
PINSCORP CONSTRUCTION
P.O. BOX 1852
IRVINE, CA 92623
=J {� J41N ; 2012 )
i ( .��
! L---c+'(''�c�sc;�;��1?+�"i�
(760) 275-5748
•Lic. No. 904954
TY
_ t •'_=—r ?, "„y--'
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 and policy number are: -
Carrier XEMPT Policy Number EXEMPT
1 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
//� 37 0 of the 'Labor tC e, I shall forthwith comply with those provisions.
�+ plicant:
WARNING: FAIL RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT'
IMPORTANT Application is hereby made to the Director of Building and Safety 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 unty ordinances and state laws relating to building construction, and hereby authorize representatives
of thi ou y to enter u n the above-mentioned property for insp tion purposes.
te: `� gnature (Applicant or Agent):
Application Number. 12,-000.0.0608
-
------ Structure Information KITCHEN REMODEL,[CONVENTIONAL]
-----
Other struct info .. CODE -EDITION
--------=------------------ -:- - -----=-=--------------=--=------==---------.-•
2010'
Permit. . BUILDING PERMIT
'
Additional desc
Permit Fee 72.00 Plan 'Check -Fee
46.80•
Issue Date Valuation
5,000
Expiration Date;12/11/12'
Qty.- Unit Charge Per
Extension
BASE FEE
45.00 r .
3.00 9.0000 THOU BLDG 2,001-25,000
-------------------------- ---------------------------------------
27.00-
------------
Permit ELECT.- ADD/ALT/REM .
Additional desc
Permit' Fee ; 32.25 L Plan Check Fee
r
8.06
Issue Date Valuation
0
• Expiration Date 12/11/12
Qty Unit Charge Per
Extension
BASE' FEE
15.00
•- 20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
15.00
5.00 .:4500 EA ELEC DEVICE/FIXTURE >20
2.25
Permit . . . PLUMBING
Additional desc ...
Permit Fee.. . . . . 30.00 Plan Check Fee
7.50
Issue Date . . Valuation . .
. 0
Expiration Date 12/11/12
Qty Unit Charge Per
r
Extension.
BASE FEE
15:00
2.00 6.0000 EA PLB'FIXTURE -
12..00
• 1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
- ------------------------------------------------
Special Notes and Comments
REMODEL KITCHEN TO OPEN INTO LIVING AREA:
BY REMOVING NON-BEARING WALL AND
CREATING ISLAND ["CONVENTIONAL] THIS
PERMIT DOES NOT -INCLUDE ALTERATION TO '
THE EXISTING LOAD-BEARING OR LATERAL'
RESISTING STRUCTURE. 2010 CALIFORNIA
BUILDING CODES.
'June 14, 2012 11:09:49 AM AORTEGA
LQPERMIT ..
-
r
Application Number
. . . . .
12-00000608
-------------------------------------------------------------
Other Fees
BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
4.68
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
134.25
-- - - - - - - ------- - - - - - ----------
.00 .00
134.25
Plan Check Total
62.36
.00 .00
62.36
Other Fee Total
5.68
.00 .00
5.68
Grand Total -
202.29
.00 .00
202.29-
Bin. #
P�
City. Of La Quinta
Building 8T SaMy Division
P.O. Box 1504,78-495 Calle Tamplco
La.Qulnta, CA 92253 • (760) 777-7012
Building Permit -Application and Tracking Sheet :
Permit #
Project Address:
Owner's Name:.
A P. Number.
Address:
Legal Description:
City, ST, Zip:ft
Telephone: O
Contractor. covpq p
Address: d3 - a
��uf Dr
Project Description: Q
City, ST, Zip:
c
Telephone: 6
~ s#>
State'Lia. #:
City.Lic. #,
Arch., Engr., Designer
Address: b
City., ST. Zip:
Telephone: b
State Lic. #: —^ k
. :
Construction Type:- V Occupancy:
project type (circle one): New Add'n Repair Demo
Ft.: # Stories: # Units: _
Name of Contact Person:Sq.
Telephone #.of Contact Person: -^
Estimated Value of Project r%�'• .
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
'd
Rec'd
TRACKING
PERMi .FEES-
PIAn Sets
Plan Check submitted
Item Amount
Structuial Cales.
Reviewed, ready for corrections
Plan Check Deposit_ . .
Truss Cates.
Called Contact Person
Plaa Check Balanct_
Tole 24 Cates.
Plans picked up
Construe don
Flood pin plan
Plans resubmitted..
Mechanical
Giadlog plan
2i° Review, ready for correctionslissue
Electrical
Subeontaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
H.O.A. Approval
Plans resubmitted
Grading
IN $OUSE:-
1n° Review; ready for eorrectio u `
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees V ��
Prescriptive Certificate of Compliance: Residential CF -1R -ALT
Residential Alterations age 1 of 5
Project Name: Climate Zone # _ # of Stories
_ McKay. Residence , 1& - • 1 .
General Information
Site Address: 48 -537 -Via Ami stad
r
i
Prescriptive Certificate of Compliance: Residential CF -1R -ALT
Residential Alterations age 1 of 5
Project Name: Climate Zone # _ # of Stories
_ McKay. Residence , 1& - • 1 .
General Information
Site Address: 48 -537 -Via Ami stad
Enforcement Agency: Date: 05/31 /2012
Building Type Single Family [] Multi Family
Circle the Front Orientation: N, E, S(Dr degrees
Conditioned Floor Area (CFA): 132
Project Type: Iffl Alterations n Envelope Fenestration[] Roof OHVAC
Replacement or Change Out rl Duct Replacement Water Heater
NOTE: This form is not to be used for Newly Constructed Buildings or Additions
Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below) '
Assembly Alteration
Opening of framed cavity alone— Alterations that involve the opening of the framed cavity of a wall, ceiling, orfloor must install the
mandatory minimum insulation value per §150 for the altered assembly. Fill in Columns A —C and enter mandatory insulation value in Column H-
E3Replacement of entire assembly— Replacement of an entire wall, ceiling; or floor assembly requires the installation of Component
Packs e- D insulation values in Table 151-C. Fill in Columns A —J -
Opaque Surface Details For the furred portioned of Mass
Walls see Furring Strips Construction Table below.
A .. B C D
-" E
F G I H I J
Proposed 5" Not`
Standard
Values From JA4
Table
Walls From Reference
Framing Thickness,
Framed Continuous
JA4 Proposed
-Tag/ - Assembly Name
ID' or Type'
Material Spacing,
and Suez or Otherl
U-
factor4 '
JA4 Table Cavity Insulation
Numbers R-value6 ' R -Value?
Assembly Assembly
Row/Cols U -facto?
WALL
W • 16, O.C. 'H
151-C R-13 • R-13
Assembly
ca
Do
Final
Mass
Name or JA4 Table
r
,
Assembl
ZU-actor
TypeZ Nbe
>
Note: For furred assemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-1. For calculating furred walls use the Mass and
Furring Construction table below.
1. For Tag/ID indicate the identification name that matches the building plans.
2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc. -..Indicate in columnG the Frame
material and Size: For Wood, Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter, 16 "or 24 "OC; or Other for_ all other assembly description
such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc....
4. Based on the Climate Zone; enter the equivalent U factor found in JA4 Table based on the R -Value from Table 151-B, C, or D
5. Enter the Table number that closely resembles the proposed assembly.
6. Enter the R -value that is being installed in the wall cavity or between theframing, otherwise, enter "0 ".
7. Enter the Continuous Insulation R -value for the proposed assembly; otherwise, enter " 0".
8. Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U factor in Column J
9. The Proposed Assembly U factor, Column J, must be equal to or less than the Standard U factor in Column E to comply.
Furring Strips Construction,Table for Mass Walls Onl
A B C D E
F G H I J K
L
M
Proposed Properties of Masonry and Concrete
Added Interior or Exterior Insulation
Walls From Reference
in Furring Space from Reference
Joint Appendix Table 4.35 43.6 43.7
Joint Appendix Table.43.13
it,
Assembly
ca
Do
Final
Mass
Name or JA4 Table
°
g -5 -a
Assembl
ZU-actor
TypeZ Nbe
>
=
,Thickness'
I Comment.
N/A
Registration Number: _ Regrstration.DatelTtme:. , .. HERS Provider:
r,
2008 Residential Compliance Forms March 2010
4
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations age 2 of 5
Project Name: McKay ResidenceClimate Zone # t 15
1 of Stories
Mass and Furring Strips Construction(footnotes)
1. Indicate the type of assembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Etc. Additional assemblies can
found Reference Joint Appendix JA4.
. This is the U -Factor based on the thickness of the assembly in inches.
3. The R -value of the insulation to be added on the interior or exterior of the assembly. -
The Calculated R- Value is the R -value of thefiirred out section of the assembly. -
5. -6. The Final Assembly is calculated using Equation 4-2 or Equation 44of the Reference Joint Appendix JA 4. The equation is the inverse of Column
,D'added to Column I. Column K is the inverse from column J.
7. Insert the calculated U- actor value on to the Opaque Surface Details in Column J
FENESTRATION PROPOSED AREAS
Replacing window alone - Replacement windows shall meet the U -Factor. and SHGC Value requirements of Component Package D in
Table ISI -C. The Total Fenestration and West facing Area requirements are not applicable.
El Adding 50ft2 or less of window area — Newly installed windows shall meet the U -Factor and SHGC Value requirements of Component
Package D in Table 151-C ,
Adding more than 50fe of window area — Newly installed windows shall meet the U -Factor and SHGC Value and the Fenestration
Area requirements of Component Package D in Table 151-C Complete the Altered Fenestration Allowed Area Table oie Page 2 of the CF -IR -ALT.
RALT-
'C
Orientation
Orientation
e.
Fenestration Type and Frame
Window, Glass Door or S G t
(North, East,
South, West(ft)
PropsedArea' Maximum Maximum NFRC or Default
U-factor2. 3 SHMZ 3,4 Value
N/A
CFA of
,
Existing
,.Allowed
Entire
% of
Fenestration
s, Area
Fenestration
Area
1. Fenestration area is the area of total glazed product (i.e. glass plus frame)` Exception: When a door is less than 50'0 glass, the fenestration
area may be the glass area plus a "2 inch frame" around the glass.
2. Enter value from Component Package D Requirements in Table 151-C.
3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower U factor and/or a lower
SHGC value than that specified on the CF -IR ALT Form. .
4. Submit a completed W3 -3R Form if a reduced SHGC is calculated with exterior shading.
5.1 applicable at this stage enter "NFRC" or NFRC Certified windows or are CEC "Default" values ound in Table 116-A or B.
ALTERED FENESTRATION
ALLOWED AREAS
(Complete if more than 5
of fenestration is added)
A
B
'C
'D ;
E
F r
G
CFA of
Allowed
Existing
,.Allowed
Entire
% of
Fenestration
s, Area
Fenestration
Area
Proposed Area• °
Dwelling
CFA2` 3
Area°
Removed'
Area Added
A x B)'.
-D + C .
Total Fenestration
'p
Areaz(ft )
West Fenestration Area
(Required Ir
'
>
CZ's 2,4&7-15 '
—
1. The Proposed West Fenestration Area includes West -sloping skylight area and any' other skylight area with a pitch less than 1:12.
2. Enter 20% when no West orientation restriction or 15% when West fenestration is being installed in Climate Zones 2, 4, & 7-I5. Note that the
maximum allowed fenestration cavi only be 5% of the CFA as indicated in Column F. Column G must be equal to or less than Column F.
3. In climate zones 2, 4, 7-15, no more than 5% of the CFA is allowed for west facing glazing.
, 4. Existing Fenestration area must be counted toward the maximum allowed 15% or 20% of the whole building and calculated in Column G. The
Proposed Area must be less than or equal to Column F.
5.`Enter the fenestration removed as part of the alteration if any in column D. - y
6. Enter the Fenestration area that is being added as part of the alteration.
Registration Number: wr. y. r .. Registration. Date/Time: HERS Provider:.
2008 Residential Compliance Forms -March2010
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations age 3 of 5
Project Name: e . Climate Zone # . # of Stories
McKay Residence 115 1 .
ROOFING PRODUCTS (COOL ROOFS) §151(1)12
When the area of exterior roof surface to be replaced exceeds more than 50% of the existing roof area, or more than j000ffl, whichever is
less, the new roofing area must meet the roofing product "Cool Roof" requirements of §152(b)1H4152(b)1Hii, or 152(b)1Hiii.
Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof' requirements. Note: If any
one of the alternatives or exception below is checked the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in
§118(1) are not applicable. Do not fill table below.
0 Cool Roofs Not Required in Climate Zones 1-12, 14, and 16 with a Low Sloped Less or 2:12 pitch.
Cool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep -Sloped Roofs (pitch greater than 2:12) and product unit weight less
than 5lb/f
Alternatives to §152(b)1Hi and §152(b)Hii, Steep -slope roof (pitch > 2:12)
Insulation with a thermal resistance of at least 0.85 hrfl2-°F/Btu br at least a 3/4 inch air -space is added to the roof deck
over an attic, or
Existing ducts in the attic are insulated and sealed according to § 151(1) 10; or
In climate zones 10, 12 and 13, with 1 fl of free ventilation area of attic ventilation for every 150 fl of attic floor area, and ,
where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge; or
Building has at least R-30 ceiling insulation; or
E) Building has radiant barrier in the attic meeting the requirements of § 151(02; or
® Building has no ducts in the attic; or
E In climate zones 10, 11, 13 and 14, R-3 or greater roof deck insulation above vented attic.
Exception to §152(b)lHii4 Low -slope roof (pitch <_ 2:12)
El Building has no ducts in the attic.
Other Exceptions
Roofing area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria. .
El Roof constructions that have thermal mass over the roof membrane with at least 25 Ib/f is exempt from the below Cool Roof criteria.
Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwise,
Check the applicable box below if Ex em t from the Roofing Products "Cool Roof' R uirement:
- Roof Slope
Product Weight
Product
Aged
Solar
Y Theimal
CRRC Product ID Number
< 2:12 > 2:12
< 51bW > 51b1f
T e2
Reflectance""
Emittance
SRIS
N/A
1-0-
0
C3
®
®
®
®
®t
E
a
13
13
Er
13
El
®
®
0
0
®
I. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs.oMIRroductslsearcknhn
2. Indicate the type ofproduci is being used for the roof top, i.e. single ply roof, asphalt roof, metal roof, etc.'
If the.AgedReflectance is not available in the Cool.Roof Rating Council's. Rated Product Directory then use the.Initial.ReJlectance value from the same
directoryand use the equation 0.2+0.7
qua ( (p;,,;,;at — 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance.
4. Check box if the Aged Reflectance is a calculated value using the equation above.
5. Calculate the SRI value by using the SRI- Worksheet at http://wmv-enerrzv.cagmlhtle24/and enter the resulting value in the SRI Column above and attach atopy of
the SRI- Worksheet to the CF -IR
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in § 118(i)4. Select the applicable coating: -
Aluminum -Pigmented Asphalt Roof CoatingCement-Based
Roof Coating , Other
Registration Number: _ Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms , t March 2010
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations - age 4 of 5
Project Name: McKay Residence Climate Zone # 15 F 1 of Stories
HVAC SYSTEMS - HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be
gas or propane fired Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground hot water pipes is required in all
Minimum
Duct or Piping
; Configuration
Heating Equipment
Efficiency
Distribution Insulation
Thermostat
(Central, Split,
Type and Capacity' 2,3
AFUE or HSPF
T and Location° R -Value
Type
Space, Package or H dronic
EXISTING
System
`
Thermal Efficiency
R -Value'
EXISTING
1. Indicate Heating Type (Central Furnace, Wall Furnace, Heat pump, Boiler, Electric Resistance, etc.)
2. Electric resistance heating is allowed only in Component Package C, or except where electric heating is supplemental (i.e.' if total capacity
< 2 KW or 7,000 Btu/hr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §151(b)3 exception.
3. Refer to the HERS Verification section on Page 4 of the CF -IR ALT Form for additional requirements and check applicable boxes.
4. Indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc.) ` `
HVAC SYSTEMS - COOLING
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.)
Minimum
I not allow the installation of a recirculating water heating system for single dwelling units.
3. The external water heating tank andpoes shall be insulated to meet the re uirements o 15061 . `
Efficiency
Duct or Piping,
Configuration
Cooling Equipment
(SEER/EER or
Distribution
Insulation
Thermostat (Central, Split, '
Type and ity is
COP)•
Type and Location' '`
R -Value
Type Space, Package or H dronic
EXISTING
1. Indicate Cooling Type (A/C, Heat pump, Evap. Cooling, etc)
2. Refer to the HERS Verification section on Page 4 of the CF-IRALT Form for additional requirements and check applicable boxes..
3. Indicate Type or Location(Ducts, H dronic in Floor, Radiators, etc.
WATER HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be
gas or propane fired Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground hot water pipes is required in all
com nent packages in all climate zones.
External Tank
Water Heater Type/Fuel
Distribution Type
Number In
Tank
Energy Factor or
Insulation
T t
(Standard, Recirculatin )2
System
Capacity (gal)
Thermal Efficiency
R -Value'
EXISTING
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Prescriptive requirements do
I not allow the installation of a recirculating water heating system for single dwelling units.
3. The external water heating tank andpoes shall be insulated to meet the re uirements o 15061 . `
SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below -
These items may require written 'usti cation and documentation and spicial verification.
NEW ROOF ASSEMBLY - Radiant Barrier
The radiant barrier requirement of § 151 2 does not apply to roof alterations. `
Slab Edge (Perimeter) Insulation LJYES x NO
• YES: In Climate Zone 16 in Component Packages D, R-7 insulation is required.
Heated Slab Insulation []YES x O
YES: Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation UYES • ®x NO
YES: In Climate Zones 1, 2, 11, 13, 14 & 16, R-8 insulation isrequired; in Climate Zones 12 & 15, RA is required under component Packs a D.
Thermal Mass ' . - I.
To obtain Compliance Credit for the installation of thermal mass, use the Performance Approach.
Registration Number:. Registration,Date/Time: _ HERS Provider: _
- 2008 Residential Compliance Forms March 2010
riptive Certificate of Compliance: Residential CF-1R-
ential Alterations age 5
t Name:McKay Residence' comate zone # 15 1 of stn
HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this
checklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector, before,inal '
ins ection.
Duct Sealing & Testing HERS verification is required for this measure. ;
® YES NO YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement, ducts are installed in unconditioned
space, the ducts are to be sealed per § 152(b)1Dii and the newly installed ducts are to be insulated per §151(010.
El EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
OYES EINO-YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the
ducts are to be sealed per §152(b)IDi.
®YES ATO YES: In Climate Zones 2 and 9716, if the existing HVAC equipment is replaced (including the replacement of the air handler,
outdoor condensing unit of a split system, cooling or heating coil; or the furnace heat exchanger) the ducts are to be
sealed per § 152(b) lE.' "
f EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS
verification in accordance with procedures in the Reference Residential Appendix RA3.
EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space..
EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. `'•
Refrigerant Charge - Split System HERS verfication is required for this measure.
YES El NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air
handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat
exchanger) a refrigerant charge measurement shall be verified per § I52(b)IF.
Central Fan Integrated (CF1) Ventilation System and Fan Watt Draw
The ventilation re uirements of § 150 o do not apply to existing residential homes.
Ducted Split Systems Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure.
Q YES E) NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is
re laced, the airflow and fan watt draw shall be verified per 152(b)ICi to meet the requirementsof 151(f)7B.
Documentation Author's Declaration Statement '
• I certify that this Certificate of Compliance documentation is accurate and cogNete. I-
+
Signature:-
r'
riptive Certificate of Compliance: Residential CF-1R-
ential Alterations age 5
t Name:McKay Residence' comate zone # 15 1 of stn
HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this
checklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector, before,inal '
ins ection.
Duct Sealing & Testing HERS verification is required for this measure. ;
® YES NO YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement, ducts are installed in unconditioned
space, the ducts are to be sealed per § 152(b)1Dii and the newly installed ducts are to be insulated per §151(010.
El EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
OYES EINO-YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the
ducts are to be sealed per §152(b)IDi.
®YES ATO YES: In Climate Zones 2 and 9716, if the existing HVAC equipment is replaced (including the replacement of the air handler,
outdoor condensing unit of a split system, cooling or heating coil; or the furnace heat exchanger) the ducts are to be
sealed per § 152(b) lE.' "
f EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS
verification in accordance with procedures in the Reference Residential Appendix RA3.
EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space..
EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. `'•
Refrigerant Charge - Split System HERS verfication is required for this measure.
YES El NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air
handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat
exchanger) a refrigerant charge measurement shall be verified per § I52(b)IF.
Central Fan Integrated (CF1) Ventilation System and Fan Watt Draw
The ventilation re uirements of § 150 o do not apply to existing residential homes.
Ducted Split Systems Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure.
Q YES E) NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is
re laced, the airflow and fan watt draw shall be verified per 152(b)ICi to meet the requirementsof 151(f)7B.
Documentation Author's Declaration Statement '
• I certify that this Certificate of Compliance documentation is accurate and cogNete. I-
Name: Gabriel RIOS
Signature:-
r'
compaay. Rios Designs
Date' 05/31/2012
Address:
Cinnabar Lane
If
If Applicable -CEA or _ CEPE
(Certification #):
C ity/state/zip: Coachella, CA 92236
Coachella,
Phone -
Responsible Building Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance. ,
• I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the information provided to document this .
building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building t application.
Name" Gabriel Rios
signature:
Company: Rios Designs
Date: 05/31/2012
Address: 49-901 Cinnabar Lane
License:
City/State/Zip:
Coachella, CA 92236
Phone:
760-485-7431
For assistance -or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Registration Number: ,' r.- RegudationDatelTinte. 7 77 ffERSProvuter:...
2008 Residential Compliance Forms March2011
0
Mandatory Measures Summa MF -1R
Residential (Page 1 of 3
Site Address: Enforcement Agency: Date:
48-537 VIA AMISTAD 05/31/2012
NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed,
regardless of the compliance approach used. More stringent energy measures listed on the Certificate of Compliance (CF -IR,
CF -IR -ADD, or CF -IR -ALT Form) shall supersede the items marked with an asterisk(*) below. This Mandatory Measures
Summary shall be incorporated into the permit documents and the applicable features shall be considered by all parties as minimum
component performance specifications whether they are shown elsewhere in the documents or in this summary. Submit all
applicable sections of the MF -IR Form with plans.
DESCRIPTION
Building Envelope Measures:
§116(a)l: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage.
§116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain Coefficient
SHGC , and infiltration that meets the requirements of § 10-111 (a).
§117: Exterior doors and windows are weather-stripped; all joints and penetrations are caulked and sealed.
§118(a): Insulation specified or installed meets Standards for Insulating Material. Indicate type and include on CF -6R Form.
§118(1): The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of §118(i) when the installation of
a Cool Roof is specified on the CF -1R Form.
*§150(a): Minimum R-19 insulation in wood -frame ceiling or equivalent U -factor.
§150(b): Loose fill insulation shall conform with manufacturer's installed design labeled R -Value.
*§150(c): Minimum R-13 insulation in wood -frame wall or equivalent U -factor.
*§150(d): Minimum R-13 insulation in raised wood -frame floor or equivalent U -factor.
§150(f): Air retarding wrap is tested, labeled, and installed according to ASTM E1677-95(2000) when specified on the CF -1R Form.
§ 150(g): Mandatory Vapor barrier installed in Climate Zones 14 or 16.
§ 150(1): Water absorption rate for slab edge insulation material alone without facings is no greater than 0.3%; water vapor permeance rate is no
eater than 2.0perm/inch and shall be protected from physical damage and UV light deterioration.
Fireplaces, Decorative Gas Appliances and Gas Log Measures:
§150(e)IA: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox.
§150(e)1B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is equipped
with a with a readily accessible, operable, and tight -fitting damper and or a combustion -air control device.
§ 150(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the outside of the
building, are prohibited.
Space Conditioning,Water Heating and Plumbing System Measures:
§ 110-§ 113: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified by the Energy Commission.
§ 113(c)5: Water heating recirculation loops serving multiple dwelling units and High -Rise residential occupancies meet the air release valve,
backflow prevention, pump isolation valve, and recirculation loop connection requirements of § 113(c)S.
§ 115: Continuously burning pilot lights are prohibited for natural gas: fan -type central furnaces, household cooking appliances (appliances with an
electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool ands a heaters.
§ 150(h): Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA.
§ 150(i): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c).
§ 1500)1 A: Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped with
insulation having an installed thermal resistance of R-12 or greater.
§ 1506) I B: Unfired storage tanks, such as storage tanks or backup tanks for solar water -heating system, or other indirect hot water tanks have R-12
external insulation or R-16 internal insulation where the internal insulation R -value is indicated on the exterior of the tank
§ 1500)2: First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire length of recirculating sections
of hot water pipes are insulated per Standards Table 150-13.
§1506)2: Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot water tank
shall be insulated to Table 150-B and Equation 150-A.
§1500)2: Pipe insulation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards Table 123-A.
§1500)3A: Insulation is protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind.
§ 1500)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in conditioned space.
2008 Residential Compliance Forms August 2009
Mandatory Measures Summa MF -1R
Residential (Page 2 of 3
Site Address: Enforcement Agency: Date:
48-537 VIA AMISTAD 05/31/2012
§ 1500)4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation.
Ducts and Fans Measures:
§ 150(m)1: All air -distribution system ducts and plenums installed, are sealed and insulated to meet the requirements of CMC Sections 601, 602,
603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-4.2 or
enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable
requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to
seal openings ater than 1/4 inch, the combination of mastic and either mesh or tape shall be used
§ 150(m)l: Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal,
duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts.
Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts.
§ 150(m)2D: 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 draw bands.
§ 150(m)7: Exhaust fan systems have back draft or automatic dampers.
§ 150(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers.
§ 150(m)9: Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam
insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that
can cause degradation of the material.
§ 150(m)10: Flexible ducts cannot have porous inner cores.
§ 150(0): All dwelling units shall meet the requirements of ANSI/ASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air Quality in
Low -Rise Residential Buildings. Window operation is not a permissible method of providing the Whole Building Ventilation required in
Section 4 of that Standard.
Pool and Spa Heating Systems and Equipment Measures:
§ 114(a): Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency Regulations;
an on-off switch mounted outside of the heater; a permanent weatherproof plate or card with operating instructions; and shall not use
electric resistance heating ora pilot light.
§ 114(b)l : Any pool or spa heating equipment shall be installed with at least 36" of pipe between filter and heater, or dedicated suction and return
lines, or built-up connections for future solar heating
§ 114(b)2: Outdoor pools or spas that have a beat pump or gas heater shall have a cover.
§ 114(b)3: Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or
progarnmed to run only during off-peak electric demand periods.
§ 150(p): Residential pool systems or equipment meet the pump sizing, flow rate, piping, filters, and valve requirements of § 150(p).
Residential Lighting Measures:
§150(k)l: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies contained in
Table 150-C and is not a low efficacy luminaire as specified by § 150 2.
§150(k)3: The wattage of permanently installed luminaires shall be determined as specified by § 130(d).
§ 150(k)4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than 20 kHz.
§ 150(k)5: Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain only high
efficacy lamps meeting the minimum efficacies contained in Table 150-0 and shall not contain a line -voltage socket or line -voltage
lamp holder, OR shall be rated to consume no more than five watts of power as determined by § 130(d), and shall not contain a medium
screw -base socket.
§ 150(k)6: Lighting integral to exhaust fans, in rooms other than kitchens, shall meet the applicable requirements of § 150(k).
§ 150(k)7: All switching devices and controls shall meet the requirements of § 150(k)7.
§ I50(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy.
EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 f? or 100 watts for dwelling units larger than 2,500 fl may be exempt
from the 50% high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant
sensor, dimmer, energy management system (EMCS), or a multi -scene programmable control system; and all permanently installed
luminaries in garages, laundry rooms, closets greater than 70 square feet, and utility rooms are high efficacy and controlled by a
manual -on occupant sensor.
§ I50(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated
cabinet.
§150(k)10: Permanently installed luminaires in bathrooms, attached and detached garages, laundry rooms, closets and utility rooms shall be high
efficacy.
2008 Residential Compliance Forms August 2009
.Mandatory Measures Summa MF -1R
Residential (Page 3 of 3 .
Site Address: Enforcement Agency: Date:
48-537 VIA AMISTAD 05/31/2012
EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by a manual -on
occupant sensor certified to comply with the applicable requirements of § 119.
EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a
manual -on occupant sensor.
§150(k)ll: Permanently installed luminaires located in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms, closets, and utility
rooms shall be high efficacy luimnaires.
EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided they are controlled by either a dimmer switch
that complies with the applicable requirements of § 119, or by a manual -on occupant sensor that complies with the
applicable requirements of § 119.
EXCEPTION 2: Lighting in detached storage building less than 1000 square feet located on a residential site is not required to comply
with 150 11.
§150(k)12: Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or
other nationally recognized testing/rating laboratory; and have a label that certifies the lumiunaire is airtight with air leakage less then
2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; and be sealed with a gasket or caulk between the luminaire housing
and ceiling.
§150(k)13: Luminaires providing outdoor lighting, including lighting for private patios in low-rise residential buildings with four or more dwelling
units, entrances, balconies, and porches, which are permanently mounted'to a residential building or to other buildings on the same lot
shall be high efficacy.
EXCEPTION 1: Permanently installed outdoor low efficacy luminaires shall be allowed provided that they are controlled by a manual
on/off switch, a motion sensor not having an override or bypass switch that disables the motion sensor, and one of the
following controls: a photocontrol not having an override or bypass switch that disables the photocontrol; OR an
astronomical time clock not having an override or bypass switch that disables the astronomical time clock; OR an
energy management control system (FMCS) not having an override or bypass switch that allows the luminaire to be
always on
EXCEPTION 2: Outdoor.luminaires used to comply with.ExceptionI to §.150(k)I3 may be controlled by a temporary override switch
which bypasses the motion sensing function provided that the motion sensor is automatically reactivated within six
hours.
EXCEPTION 3: Permanently installed luminaires in or around swimming pool, water features, or other location subject to Article 680 of
the California Electric Code need not be high efficacy luminaires.
§ 150(k)14: Internally illuminated address signs shall comply with Section 148; OR not contain a screw -base socket, and consume no more than five
watts of power as determined according to § 130(d).
§ 150(k)l5: Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable requirements in
Sections 130, 132, 134, and 147. Lighting for parking garages for 8 or more vehicles shall comply with the applicable requirements of
Sections 130, 131, 134, and 146
§ 150(k)16: Permanently installed. lighting in the enclosed, non -dwelling spaces of low-rise residential buildings with four or more dwelling units
shall be high efficacy luminaires.
EXCEPTION: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by an occupant sensor(s)
certified to comply with the applicable requirements of §119.
2008 Residential Compliance Forms August 2009