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11-0751 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00000751 Property Address: 79095 KAYE CT APN: 604-371-008-100 -27899 - Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 15000 Tit!t 4.4 Q" Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of per' y that I am licensed and rovisio hapter 9 (commencing with Section 7000) of Division 3 of the us ess and rofession s Co e, all.. my icense is in full force and effect. License Class: B License N 7199 Dater --10 -Lk Contractor: 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).: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 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.). 1 _ 1 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: LQPERMIT Owner: LUIS CERROS / SONIA CURBELO 79095 KAYE CT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 C% I—[) Date: 9/07/11 Contractor:�r A CORONEL ENTERPRISES f 42760 MADIO STREET j INDIO, CA 92201 I (760)775-1234 Lic. No.: 727199 GITYQFj,/� 02011 ----------------------------------------------- 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 STATE FUND Policy Number 1948821-2011 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any m ner so as become ct to th or rs' compensation laws of California, and agree that, f I ould be me sub ect to the rkers' ompensation provisions of Section 3700 of the Lab r C e, I s II forth ith comply ith t ose provisions. CDate: - a0- L) 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 ($100,0001. 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 t e aboLtion is correct. I agree to comply with all city and county ordinances and state laws relating t bui ing cd ere auth presentatives of this county to enter upon the above-mentioned pr a for o es. Date: t a0 Signature (Applicant or Agent) Application Number . . . . . 11-00000751 LQPERMIT Structure Information Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type . . . . . DWELLG/LODGING/LONG <=10 Other struct info . . . . . CODE EDITION 2010 ------------------------------------------------------- # BEDROOMS 1 -------------------- 1.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation . . . . 15000 Expiration Date 2/11/12 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 117.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 24.17 Plan Check Fee 6.04 Issue Date Valuation . . . . 0 Expiration Date 2/11/12 Qty Unit Charge Per Extension BASE FEE 15.00 219.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 7.67 2.00 .7500,PER ------------------------------------------------------=--------------------- ELEC DEVICE/FIXTURE 1ST 20. 1.50 Permit MECHANICAL Additional desc . Permit Fee . . . . 30.50 Plan Check Fee 7.63 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/11/12 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 4.5000 EA MECH VENT INST/ DUCT ALT 9.00 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH VENT FAN 6.50 PermitPLUMBING Additional desc . Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/11/12 LQPERMIT EWA LQPERMIT Application Number . . . . . 11-00000751 Permit . . . . . . PLUMBING Qty Unit Charge Per Extension BASE FEE 15.00 3.00 6.0000 EA PLB FIXTURE 18.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 ---------------------------------------------------------------------------- Special Notes and Comments 219 SF GARAGE CONVERSION INTO BEDROOM AND BATHROOM. 2010 CODES.R-3 OCCUPANCY TYPE V -B CONSTRUCTION. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 10.53 STRONG MOTION (SMI) - RES 1.50 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 257.17 .00 .00 257.17 Plan Check Total 129.10 .00 .00 129.10 Other Fee Total 13.03 .00 .00 13.03 Grand Total 399.30 .00 .00 399.30 Bin_# A • -City of La Quetta 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 �A S G'f• Owner's Name: A. P. Number: &04 • 3 QD Address: Legal Description: Contractor: City, ST, Zip: Telephone: Address: Project Description: City, ST, Zip: 742 s N �l3�2 rd.l /ZS✓yoesc. Telephone: ...;'v��:� �•' frVff'i:!):j{fj\{n: ref::riif<�:{h (Jifi:::j 'A, {"r'%`:'<:''>:>::'>.`•:>sa;, State Lie. # : City Lie. #; Arch., Engr., esi 1 &-7 • Address: Qja• ape( HwY Al (�iTaC PM City., ST,.Zip: 1'V910614 f >0 ( Telephone: (o'I P '760 �i%5� ';? `< '<'< ;fin; s......... < :< ::v::;:v...:-;;:.{....:...: { f. 'i.:�%: SI.}Yj7irii.Lr..'Fi::i!::4ir:•. i::{:i;f::ii�.;:yvgy?:, : ` `yam?""m `'° �:>V::>:::->:: >: >>" Construction Type: Occupancy: State Lie. #: Project type (circle one): New Add'n Alter epair Demo Name of Contact Person: Sq. Ft.: a _ G #Stories: / #Units: Telephone # of Contact Person: <e. S'1 r Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE ff Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submi ? Item Amount. Structural Calcs. Reviewed, readyr corrections I Plan Check Deposit Truss Cates. Called Contact Pe % Plan Check Balance Title 24 Calcs. a Plans picked up Construction Flood plain plan Plans resubmitted i 7 Mechanical Grading plan 21" Review, ready for correction issu (Z 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 correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Vol' Total Permit Fees • 3D 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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: Residential Addition 500 Sq Feet or Less CERTIFICATE OF COMPLIANCE This certifies that school facility fees imposed pursuant to , Desert Sands Unified School District o��i�scyo in the amount of $0.00 X 219 S.F. or $0.00 have been paid for 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. 47950 Dune Palms Road ¢ BERMUDA DUNES O Date 9/2/11 La Quinta, CA 92253 CZ) RANCHO MIRAGE N INDIAN WELLS No. 31093 (760) 771-8515 PALM DESERT �� LA A �y Fee collected /exem •teed b Payment Recd p y Sh on M�Gil�7rey yo.00 INDIO "AQINDIO a Owner Luis & Sonia Cerros APN # 604-371-008 Address 79095 Kaye Ct Jurisdiction La Quinta City La Quinta Zip Permit # Tract # No. of Units 1 Type Residential Addition Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 79095 Kaye St 219 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant to , Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.00 X 219 S.F. or $0.00 have been paid for 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 Exempt - Luis Cerros Check No. Name on the check Telephone Funding Exempt By Dr. Sharon P. McGehee Superintendent ` •, � Fee collected /exem •teed b Payment Recd p y Sh on M�Gil�7rey yo.00 �!/ I Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this Jillfserve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date onich the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public � tity authorized to collect them on the Districtfs) behalf, whichever is earlier. NOTICE: This Document NOT VALID without embossed seal Embossed original- Building Department Applicant Copy - Applicant/Receipt Copy -Accounting Pre0cri tive Certificate of Compliance: CF -1R ADD Residential Additions (Page 1 of Site Address: l0 qcS ✓14-i ' —. Enforcement Agency:. LA- vtNr4- Date: General Information Project Name C ��O S Reg. Gl�24GE ca -iv Climate n5 # of SI ries Building Type 0 Single Family ❑ Multi Family I Circle the Front Orientation: N,E, S, W or Degrees Conditioned Floor Area of Addition (CFA): 2001 New Addition Size: ❑ Less than or equal to 100 Less than or equal to 1000 fl . (Do not use this orm or additions eater than 1000 - NOTE: For Alterations to an existing home, submit a coIR-ALT Form. Exception: Existing HVAC stems that are replaced or altered to serve the addition may be included on the CF -IR ADD Form. PRESCRIPTIVE ENVELOPE REQUIREMENTS FOR ADDITIONS For standard wood and assemblies meeting the Cavity R -value only. • For 100 ftz additions; the Proposed values must be equal or greater than the Standard column or when indicated when using Package D, ' Pkg D ". Enter values in the shaded Proposed Columns. • For less than 1,000 ft2additions must comply with "Pkg D" requirements unless indicated in the Standard Column. To meet 'Pkg D" minimum energy compliance reo ruirements, see RCM.Appendix B, Table 151-C or 152 in the RCM. Enter values in the shaded Proposed Columns. Size of Addition 100 ftp or less Less than 1,000 ftp Component Standard Proposed Comment Standard Proposed Comment Ceiling Insulation R-19 Minimum Pkg D 2- 3-i6 Table 151-C Wall Insulation R-13 Minimum R-13 l2— 13 Minimum Floor Insulation R-13 Minimum Pkg D N / A Table 151-C Fenestration U- U- factor SHGC factor SHGC 0.40 Pkg D Enter Values From "FenestrationAddition 50 f fl Proposed — Areas" Page 2 of 5 U- factor U- SHGC factor SHGC Enter Values From "Fenestration Proposed Areas" Page 2 of 5 0.40 Pkg D , 40 .3s Maximum Glazing Area Alone' 2 C�C7 Enter Values From "Addition Allowed Fenestration Areas" Page 3 of 5 For West -Facing Orientation. Radiant Barrier N/A Pkg D Table 151-C I Roofing N/A See Roofing Products Below Pkg D See Roofing Products Below SURFACE DETAILS For the furred portioned of Mass Walls see Furring Strips Construction Table below. -OPAQUE A B I C D E F I G I H II J Proposed sm Note Standard Values From JA4 Table Tag/ IDI Assembly Name or Type' Framing Material and Size Thickness, Spacing, or OthW U- factor° JA4 Table Numbers Framed Cavity R-value6 Continuous Insulation R -Value' JA4 Assembly Cell Value' Proposed Assembly U -facto? t VAL4-s Oju�0 2 � 0/cr 0.0.5& q, 3 1 010156 8 3 0- os; �l it t, Rm NG Note: Forfurred assemblies, accountin for Conti Futrin Construction table below. uAnloh AvWe, fee age A4 3 and E ation 4-1. For ' th J 441'75 JUL 11 2011 LDATES � �----- s „y si Registration Number: Registration DateMme: HERS Provider: 2008 Residential Compliance Forms March 2010 PreScri tive Certificate of Compliance: CF -1R ADD Residential Additions (Page 2 of Site Address: -7 o 9 s KAY, Enforcement Agency: L4 62 vt.A/ r-.4- Date: %- 1.For Tag/ID indicate the identification name that matches the building plans. 2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc ... Indicate in column G the Frame material and Size: For Wood, Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing.between framing members enter; 16"or 24 "OC; or Other for all other assembly description such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel, and etc.... 4. Based on the Climate Zone; enter the equivalent Ufactor found in JA4 Table based on the R -Value from Table 151-C 5. Enter the Table number that closely resembles the proposed assembly. 6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0 ". 7. Enter the Continuous Insulation R -value for the proposed assembly; otherwise, enter 110".. 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 ONLY A I B I C I D I E F I G I H I I I J I 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 43.5 43.6 4.3.7 Joint Appendix Table 43.13 Final Assembly U-factorb7 Comment Mass Thiclmess` Assembly Name or T : ;, JA4 Table Number' < > a F. N oa c o G g ' 6 B c ".5 c 00 ' y a > d > WW ink 1. Indicate the Mass Thickness from Reference Joint Appendix JA. 2. Indicate the Assembly Name or type: Roof/Ceiling Walls, Floors, Slabs, Crawl Space, Doors and etc ... Indicate the Frame type and Size: For Wood, Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies. 3. Enter the Table number that closely resembles the proposed assembly. 4. Enter the row and column of the U factor value. 5. Enter the Effective R -value listed in the JA4 Table Number. 6. The Final Assembly is calculated by using Equation 4-1 or Equation 4-4 of the Reference Joint Appendix JA4. Enter the value in Column L. 7. Insert the Final Assembly U- actor value back on to the Opaque Su ace Details table in Column J. FENESTRATION PROPOSED AREAS Orientation Fenestration Type and Frame (North, East, ProposedArea' Maximum Maximum NFRC or Window, Glass Door or Skylight) South West ft U -factors' 3 SHGC2, 3' ° Default Values' N00,J E,a-sr Ib 5X .440 3S NF2L Total s 1. Fenestration area is the area of total glazed product (i.e. glass plus frame). Exception: When a door is less than 50•� 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 specked on the Fenestration Proposed Area table above. 4. Submit a completed WS -3R Form if a reduced SHGC is calculated with exterior shading. 5. I applicable at this stage enter "NFRC"for NFRC Certified windows or CEC "Default " values found in Table II6-A or B. Registration Number: 2008 Residential Compliance Forms Registration Datefine: HERS Provider: March 2010 Prescriptive Certificate of Compliance: CF -1R ADD Residential Additions (Page 3 of 5 Site Address: Enforcement Agency:' Date: i�,c1s V Y� c� C�'itA.11/4 7- -,/ ADDITION ALLOWED FENESTRATION AREAS Check applicable box below f the roof addition is exempt from the roofing product "Cool Roof' requirements. Note: If any one of the boxes are A B C D E O Roofing area covered by building integrated, photovoltaic panels and solar thermal panels are exempt from the above Cool Roof criteria F Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwise, check CFA of Addition Allowed % Allowed Area Area Removed2 Maximum Allowed Area Po S Solar ft of CFA (A x B) ft C+D < 51b/112 51b/112 TZ (Table Above) Total Fenestration Area3 Emittance 0.20 4o ❑ >_ 4 (.c• West Fenestration Area 1,4 ❑4 q 3 2S (Required In CZ's 2,4 & 7-15) 0.05 .25 a > (&X1Srin�C) 1. West Fenestration Area includes west -sloping skylights and any skylights with a pitch less than 1:12. 2. Glass removed to make way for the addition. 3. For additions less than 1,000 flz the standards allows glazing removed during the remodel to be added to the glazing area allowance. The maximum allowed glazing area for the addition is the CFA x 20.0 + glass removed to make way for the addition. 4. In climate zones 2, 4,.7-15, no more than 5% of the CFA is allowed for west facing glazing plus west facing glass area removed to make way for the addition. The maximum allowed west facing glazing area is the CFA x 5% + west facing glass removed to make way for the addition. 5. To meet compliance, the ProposedArea must be less than or equal to the Total Allowed Area or BOTH the Total and West Fenestration Areas. ROOFING PRODUCTS (COOL ROOFS) §151(#12 Check applicable box below f the roof addition is exempt from the roofing product "Cool Roof' requirements. Note: If any one of the boxes are checked below, the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in §118(i) are not applicable. Do not fill table below. E3 Roofing compliance Not Required in Climate Zones 1-12, 14, and 16 with a Low -Sloped. Less or 2:12 pitch. E3 Roofing compliance Not Required in Climate Zones 1 through 9 and 16 with a Steep -Sloped Roofs pitch greater than 2:12 and product weight less than Slb/ft . O Roofing area covered by building integrated, photovoltaic panels and solar thermal panels are exempt from the above Cool Roof criteria 0 Roof constructions that have thermal mass over the roof membrane with at least 25 Iblf? is exempt from the above 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 e applicable box below if Exempt from the Roofing Products "Cool Roof' Requirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product m Number] < 2:12 > 2:12 < 51b/112 51b/112 TZ Reflectance3'4 Emittance SRIS 000 ❑ ❑ Tize ❑4 q 3 2S .25 a (&X1Srin�C) ❑ ❑ ❑ ❑ ❑4 ❑' ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4. ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4 1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www. coolroofs. org/products/searchghp. 2. Indicate the type of product is being used for the roof top, i.e. single ply roof, asphalt roof, metal roof, etc. 3. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same directory and use the equation (0.2+0.7(pj ;j d — 0.2) to obtain a calculated aged value. Where pis the Initial Solar Reflectance. 4. Check box if the Aged Reflectance is a calculated value using the equation above. 5. Calculate the SRI value by using the SRI- Worksheet at hMz://www.ener.pv.ca.zovltitle241and enter the resulting value in the SRI Column above and attach acopy of the SRI- Worksheet to the CF -JR. To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage ecommended by the coatings manufacturer and meet minimum performance requirements listed in § 118(i)4. Select the applicable coating: ❑ Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating Q Other Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms March 2010 Prescriptive Certificate of Compliance: CF -1R ADD Residential Additions (Page 4 of Site Address: Enforcement Agency: Date: 7 9 o q s v A -YE oT-- Lf4 GZ /v r_4 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 storage gas or propane fired. non -recirculating, and may not exceed 50 gallons. If no natural gas is connected to the building, an electric storage DHW heater less than 50 gallons with an energy factor greater than 0.90 maybe used. Hot water pipe insulation from the DHW heater to the Duct or Configuration Cooling Equipment Minimum Distribution Piping (Central, Split, Heating Equipment Efficiency Type and Insulation Thermostat Space, Package or Type and Ca aci ', 2, 3 ' AFUE or HSP LoCation4 R -Value Type H dronic 0,ENT&4(_ (-v4w46,1c Y. (oc-fS - Se S c (_ e -,(tSn"VC Standard, Recirculatin Z System 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 < 1 KW or 7,000 Btulhr 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 Pages 3 and 4 of the CF -IR -ADD Form for additional requirements and check applicable boxes. 4. Indicate Type or Location(Ducts, H dronic in Floor, Radiators, etc. HVAt SYSTEMS - COOLING List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be storage gas or propane fired. non -recirculating, and may not exceed 50 gallons. If no natural gas is connected to the building, an electric storage DHW heater less than 50 gallons with an energy factor greater than 0.90 maybe used. Hot water pipe insulation from the DHW heater to the Configuration Cooling Equipment Minimum Distribution Duct or Piping (Central, Split, Type and Capacity' 2 Efficiency Type and Insulation Thermostat Space, Package or Water Heater Type/Fuel SEER/EER or COP Location R -Value Type H dronic lc- Energy Factor or Insulation Type' Standard, Recirculatin Z System 1. Indicate Cooling Type (A/C, Heat pump, Rvap. Cooling, etc). . 2. Refer to the HERS Verification section on Pages 3 and 4 of the CF -IR -ADD 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 storage gas or propane fired. non -recirculating, and may not exceed 50 gallons. If no natural gas is connected to the building, an electric storage DHW heater less than 50 gallons with an energy factor greater than 0.90 maybe used. Hot water pipe insulation from the DHW heater to the kitchens and on all underground hot water pipes is required in all component packa es in all climate zones. Heated Slab Insulation DYES NO I Slab edge insulation required foi heated slabs in all Climate Zones. See details in Table 118-A of the standards. Raised SlabInsulation D YES I 'M(NO External Tank Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation Type' Standard, Recirculatin Z System Capacity Thermal Efficiency R-Value3 C+S STRr I .S-0 lz-�Z 1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc) 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling units. 3. The water heating tank and i es shall be insulated to meet the Muirements o 150 ' . SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below. These items may require written justification and documentation and special verification. Applicable special features shall be marked with a YES and be specified within the plans. Radiant Barrier (Roof) YES 10 NO Required in Climate Zones 2, 4, and 8-15 for additions larger than 100 ft . Slab Edge (Perimeter) Insulation O YES O I In Climate Zone 16 under Component Package D, R-7 insulation is required. Heated Slab Insulation DYES NO I Slab edge insulation required foi heated slabs in all Climate Zones. See details in Table 118-A of the standards. Raised SlabInsulation D YES I 'M(NO In Climate Zones 1, 2, 11, 13, 14 & 16 R-8 insulation is required, and in Climate Zones 12 & 15 R-4 insulation is required under Component Package D. Thermal Mass - To obtain Compliance Credit for the installation of thermal mass, use the Performance Approach. Registration Number: Registration Date.Mme: HERS Provider: 2008 Residential Compliance Forms March 2010 Prescriptive Certificate of Compliance: CF -1R ADD Residential Additions (Page 5 of Site Address:Enforcement Agency: Date: 79U 95 K,4yE S 7- LSF QV(A l"A 7- HERS VERIFICATION SUMMARY - The enforcement agency should pay special attention to the HERS Measures specified in this checklist below. A completed and signed CF4R Form for all the measures specified shall be submitted to the building inspector before final inspection. Duct Se Ung & Testing HERS verification is re uired or this measure. In all Climate Zones, if a new space -conditioning system (HVAC equipment and ducting) is installed to serve the addition 0 YES *0 alone, the ducts are to be sealed and tested per § 151(f)10. In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned 0 YES XNO space to serve the addition, the ducts are to be sealed and tested per §152(b)1D. ❑ EXCEPTION: Existing duct systems that are extended which are constructed, insulated or sealed with asbestos. In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including replacement of the air handler, outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) and will serve the addition, the ducts are to be sealed and tested per § I52(b)IE. 0 YES XNO ❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RA3. ❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Refrierant Char e - Split System HERS verification is requiredfor this measure. In Climate Zones 2 and 8-15, if a newly ducted split A/C or heat pump is installed to serve the addition alone, a refrigerant 0 YES NO charge measurement shall be verified per 151 7A. In Climate Zones 2 and 8-15, if the existing HVAC equipment.is replaced (including replacement of the air handler, outdoor 0 YES _XNO condensing unit of a split system, cooling or heating coil, or the furnace beat exchanger) and will serve the addition, a refrigerant charge measurement shall be verified per 15 1F. Central Fan Integrated Ventilation System — Airflow and Fan Watt Draw - do not apply for additions 1,000 ftz or less. Ducted Split S stems - Air Conditioners and Heat Pumps: Airflow and Fan Watt Draw HERS veri cation is required. 0 YES )�NO In Climate Zones 10 through 15, if a new space -conditioning system (HVAC equipment and ducting) is installed to serve the addition alone, the airflow and fan watt draw shall be verified per § 151 7B. In Climate Zones 10 through 15, if the existing space -conditioning system (HVAC equipment and ducting). is replaced and 0 YES )NO will serve the addition the airflow and fan watt draw shall be verified per § 152 1F: Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. Name: �, 14- Signature: Company: LT Date: Address: -7 U Q S f C� - If Applicable 0 CEA or ❑ CEPE ! (Certification #): City/State/Zip: !_1 62 L/ 9 Z 2 2 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 I and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Name: Signature: Company: Date: Address: License: City/State/Zip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300. Registration Number: Registration DatelTime: HERS Provider: 2008 Residential Compliance Forms March 2010 Mandatory Measures Summar MF -1R Residential (Pae 1 of 3) Site Address: ^ _ Enforcement Agency: Date:—�7 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 -1R, 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) 1: 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(i): 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(0: Air retarding wrap is tested, labeled, and installed according to ASTM E1677-95(2000) when'specified on the CF -IR 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 greater 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)1 A: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox. § 150(e)IB: 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)5. § 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) I 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. § 150(j)1 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-B. § 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 Summar MF -1R Residential (Page 2 of 3) Site Address: Enforcement Agency: Date: § 1506)4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation. Ducts and Fans Measures: § 150(m)l: 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 reater than 1/4 inch the combination of mastic and either mesh or tape shall be used § l 50(m)1: 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. § I50(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: § 1 14(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 heat 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 programmed to run only during off-peak electric demand periods. §I50(p): Residential pool systems or equipment meet the pump sizing, flow rate, piping, filters, and valve requirements of §I50(p). Residential Lighting Measures: §I50(k)1: 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 asspecified by § 150(k)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-C 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 § I50(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 ft2 or 100 watts for dwelling units larger than 2,500 ftZ 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 (FMCS), 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 Summar MF -1R Residential (Page 3 of 3 Site Address: Enforcement Agency: Date: 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. §I50(k)11: 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 k 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/fating laboratory; and have a label that certifies the lumitinaire 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 (EMCS) not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2: Outdoor luminaires used to comply with Exceptionl to §I50(k)13 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)l4: 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 § I50(k)l6: 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. August 2009 2008 Residential Compliance Forms