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11-0154 (RER)P.O.' BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application. Number: !11-00000154 i Property Address: 58505 JEREZ " APN: 764 -650 -001 - Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 10000 Tavl 4 4 Q" Architect or Engineer: N�r BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LIC M91R DECLARATION I hereby affirm under penalty of perjury th . I amisions of Chapter 9 (commencing with Section 7000) of ivision 3 of the Busin s and and my License is in full force and effect. License CI s: ano.: 879734 ate: mractor: E ATION 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 (55001•: / 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.). (_) 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.). (_) 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: GEHL LARRY F Contractor: CHEROKEE HOMES 73180 HIGHWAY 1'11 PALM DESERT, CA 922 (760)341-0920 Lic. No.: 879734 / VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 . Date: 2/17/11 ---------------- - ------------.:c '��------- WORKER'S COMPENSATION DECLA FU I hereby affirm under penalty of perjury one of the following declarations: _ 1 have and will maintain a certificate of consent to self -insure for workers' co s ion, 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 EXEMPT Polic Number EXEMPT I certify that, in the performan e f the w rk for which thi mit is issued, I shall not employ any person in any manner so'as t become u ect to the or ers' compensation laws of California, a agree that, if I �uld b -ome su a to the which cer compensation provisions of Section 2 00 of the Lab Code, I all fort comply h ose provisions. /r I : ` ' pplican WARNING: FAILURE TO SECURE W RKERS' COMPEN N C VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWI FnrF-MFNT 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 applicati ecome and vo' if wor is n t commenced wit)80s from date of issuance o uch er ' , or c ssatio f w for 80 days will subject perlation. I certify that I he application and state at the e i for do i c ect. I a ree to comply with all city and countynd state laws relatin to buil co truc io a d ereby au orize representatives of 's coynty(tthe above -mention prope or' spec o pu es. Date: re (Applicant or Agent . Application Number . . . . . 11-00000154 ------ Structure Information EXTERIOR SURFACE REMODEL/WINDOW ADDITION ----- Other struct info . . . CODE EDITION 2010 ---------------------------------------------------------------------------- Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 117.00 Plan Check Fee 76.05 Issue Date . . . . Valuation . . . . 10000 Expiration Date 8/16/11 Qty . Unit Charge Per Extension BASE FEE 45.00 8.00 9.0000 THOU BLDG 2,001-25,000 72.00 ----------------------------------------------------------------------------' Special Notes and Comments EXTERIOR SURFACE REMODEL AROUND ENTIRE DWELLING AND WINDOW ADDITION AT MASTER CLOSET. **MASTER CLOSET NOT PERMITTED FOR SLEEPING PURPOSES** 2010 CALIFORNIA BUILDING CODES. February 16, 2011 8:42:27 AM AORTEGA --------7------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 7.61 STRONG MOTION (SMI) - RES 1.00 Fee summary Charged Paid Credited ------------------------------ Due --------------------------- Permit Fee Total 117.00 .00 .00 117.00 Plan Check Total 76.05 .00 .00 76.05 Other Fee Total 9.61 .00 .00 9.61 Grand Total 202.66 .00 .00 202.66 LQPERMIT DRAFT REVISION OF IMPROVEMENT..APPLICATION (WITHOUT A NEIGHBOR COMMENT -SECTION) APPENDIX II: ARCHITECTURAL / LANDSCAPING IMPROVEMENT REQUEST AND AGREEMENT Date.of Request: 3L �� Lotract No. • Owner/Applicant:: bV62`t ('%4L Andalusia at Coral MountainAddress; , • Architect(s), 'tf_applicable: Architect(s)'s Adtlress: _ Architect(s)'s Telephone Number: Contractor(s), if applicable: t 1 �/ l 1 f�(J� (� Q� Contractor(s)'s-Address: ` C� 6 l� tj C � -s l Contractor'(s)`s Telephone:. 76 0 to c_,t : O'A z0 6q (Attach additional sheets with oame(s) of Contractors/Subcontractors, if necessary) • Description of Improvement: (Provide a complete narrative description of the proposed modification and, include drawings.as appropriate): t^ #AoAUt & / �C-evs�—I[x l.S it�✓� 19-0 Y) S1 f7z: • Attachments (3' sets): - ❑ Full construction drawings ❑ Site Plan ❑ Landscape Plans ❑ Specifications/Dimensions ❑ Drainage Plan ❑ Elevations. ❑ Other (describe/list-or attach additional pages as. required): Starting Dater '2 17. ,Z D �� l Estimated Completion Date: ling This Architectural / Landscape Improvement Request,shall be -accompanied by ❑ A hon -refundable fee of $400 as a processing and review'fee to check the plans for conformance with the Design. Review Guidelines. The check for this fee shall be paid to the order. of Andalusia -at Coral Mountain Association. ❑ A security deposit to be drawn against by Master Association for any.and all direct costs to. the Master Association including; but not limited to, the following: (1) legal expenses; (2) consulting fees; ,(3) filing fees; (4) recordation costs; (5) nonrefundable administrative costs (application fee); (6)zosts to repair any damage to the common area and/or streets maintained by the Master Association caused by the construction of the Architectural Improvement; (7) any other costs directly related to and/or necessary. for the supervision of the Architectural Improvement, as well as to bring the costs necessary for the. Master Association to bring the Architectural Improvement into compliance with the Master :Declaration and/or 'these Guidelines; and (8) 'payment: for any Enforcement Assessment levied in accordance with the Master Association's Enforcement Procedure. The check forthis fee shall be -paid to the order of Andalusia At Coral Mountain Association. This security deposit, minus Master Association's direct costs, shall be returned upon receipt of the Notice of 'Completion from .Owner and final sign -off by Design Review Committee. ❑ All copies of plans and specifications, as enumerated in the. Application Procedure, Section 4, (page 30) FEB 11 2011 THE OWNER(S) UNDERSTANDS AND AGREES TO THE FOLLOWING: 1. By submission of this .application, Itwe have followed the Architectural / Landscape Request Procedure as specified in the Master Association's Architectural 7 Landscape Guidelines, beginning on page 29, including the attachment of three sets of any applicable plans, specifications, drawings; manufacturer's brochures, city building permits, signed constructiom regulations, and/or other descriptions as maybe required, by the Checklists, beginning on page 32. 2. The architectural modifications will be made in strict compliance with the approved plans and specifications submittedwith this application. Should any changes be required at any during the project; those changes must be approved by the Design Review Committee Architectural & Landscaping: Approval Request;Forn and Agreement and notedon this application. 3. Owner shall hold the Master Association .harmless from all liability related :to any damage to existing residences, improvements thereon, any common area property and/or golf course, wherever located within the. Andalusia at 'Coral Mountain subdivision, resulting from the installation/construction of this.improvementor modification. Applicant shall advise Master.Association office promptly upon completion of the work. 4. Any application shall*be deemed incomplete, and the Design Review Committee shall disapprove, any and all,plans and/or specifications submitted toit for approval if the Owner failsto deliver the required fees and security deposit referenced herein. 5. Owner shall comply with the Design Guidelines of the: Andalusia at Coral Mountain.Master Association, and furnish copies of these provisions to the contractors) engaged• by Owner for the improvement. Applicant further understands that it is Owner's responsibility to ensure=that his/her contractors) also complies with these provisions. 6. Owner shall secure proper building permits, if required by the local governmental entity. Applicant understands that the City of La Quinta.may not approve any plans which have, not yet been approved by the Master Association's Design Review Committee. 7. Owner shall pay the fees and deposits, as set forth: in Section 5,3 of .the Design Guidelines to process this Architectural Request Forth, the terms of which are incorporated; herein by this reference; 8.. Applicant agrees. to complete the Properties within ninety (90) days of the Properties Approval date, unless otherwise stated. "Properties Approval Date" is.dr efned as the date of the lettegranting Applicant approval to. proceed with .the Properties. "Completion" is defined at the date when the City of La Quinta has. conducted itsfinal inspection and approved the improvement(s), or,. if no building permit is required, the date the Design Review Committee gives final.approval. 9. ' Owner(s)agrees that he/she/they will be solely responsible for the maintenance of the improvement Signature(s): Owner: !/ Date: % Z %^ ZZ Owner: Date: (For Master Association use only) The attached request has been reviewed by the Design Review Committee add its action is: ;K'Approved as Submitted ❑ Approved as Amended ❑ Rejected ❑ Re acted, Pending Further Information 0 Refer to attached: comments Date: �1 �1 1 Signature: For the Assoc' ion ign Review Committee Final Inspection: ❑ .Approved Date: Signature: D Disapproved (refer to the attached comments) the. Association Design Review Committee ,t i FEB 2011 t APPENDIX IV: CONTRACTOR/SUBCONTRACTOR AGREEMENT Date of Notice: t / �/ . / Lot / Tiac No. Owner/Applicant:: Andalusia Address: S �.-� :::V 64L Local Phone Number , � Other Phone Number. Brief: Description of Improvement: CGef/��116nj G ✓�%�+ .S prij%J J/A*6W, I, the: undersigned, as contractor or subcontractor on the above described:project e n nd agree that I have reviewed the Construction Requirements, as enumerated on page 5 ih of the Design Guidelines and egree:to: compy.with sold Guldelines: I further understand the u 'o comply With the: Guidelines could subject the above -referenced Owner to disciplinary actio .; er.Assodation, including but not limftedto;an Enforcement Assessment I, the undersigned, as contractor or subcontractor /on the. ab C ' � [act Understand and agree that CONTRACTOR NAME:` i SignatureDate: �t U Signature: �i Date: 0 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 1 of 5 Project Name: Gehl Residence ClimatI1>ju# 1#of Stories J General Information Site Address: IY13-6s� Enforcement Agency: Date: Building Type[H] Single Family 0 Multi Family Circle the Front Orientation: N, E, S, W, or degrees Conditioned Floor Area (CFA): 5089 Project Type: E. Alterations Envelope __ Fenestration _' Roof HVAC Re lacement or Change Out Duct Replacement Q 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 Q Opening of framed cavity alone— Alterations that involve the opening of the framed cavity ofa wall, ceiling, or floor 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. El Replacement of entire assembly— Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component Package- 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 I C D E F G I H I I J Proposed See Note Standard Values From JA4 Table Tag/ ID' Framing Thickness, Framed Continuous Assembly Name Material Spacing, U- JA4 Table Cavity Insulation or Type' and Suez or Other' factor° Numbers R-value6 R -Value? JA4 Proposed Assembly Assembly Row/Col' U-factor9 Joint Appendix Table 4.3.5 4.3.6 43.7 Joint Appendix Table 4.3.13 0` U ' k, p o a n� ; - \1 \ c L A U Note: For flared 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 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 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 the framing; 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. s Furring StriConstruction Table for Mass Walls CMI A B I C D I E F I G I H I J I K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation ; FEB Walls From Reference in Furring Space from Reference i A Joint Appendix Table 4.3.5 4.3.6 43.7 Joint Appendix Table 4.3.13 0` U ' k, p o a n� ; - \1 \ c L A U Assembly ., `g .4 .� [- E- o i�jl^� IN Mass Name or JA4 Table C:a o t > Thickness T eZ Numbe? Q > c x c ¢�ti " nt Vrl-8 W 2008 Residential Compliance Forms March 2010 1 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations Page 2 of 5 Project Name: Gehl ResidenceClimate Zone # # of Stories LAI,- 1 ass 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 befound Reference Joint Appendix J44. 2. 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. 4. The Calculated R- Value is the R -value of the furred out section of the assembly. -6. The Final Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix JA4. The equation is the inverse of Column 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 [I Replacing window alone — Replacement windows shall meet the U -Factor and SHGC Value requirements of Component Package D in Table 151-C. The Total Fenestration and WestfacingArea requirements are not applicable. Adding 50ftz 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 50ft2 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 on Page 2 of the CF -JR -ALT Orientation Fenestration Type and Frame (North, East, PropsedArea' Maximum Maximum NFRC or Default (Window, Glass Door or Skylight) South, West) ft2 U-factorz 3 SHGC' 1,4 Value Window J 1. Fenestration area is the area of total glazed product (i. e. glass plus frame). Exception: When a door is less than 50106 glass, the fenestration area may be the glass area plus a 'T 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 WSw3R Form if a reduced SHGC is calculated with exterior shading. 5.Ifapplicable at this stage enter "NFRC" or NFRC Certified windows or are CEC "Default" valuesfound in Table 116-A or B. ALTERED FENESTRATION ALLOWED AREAS (Complete if more than 50ft2 of fenestration is added) A B C D E F G CFA of Allowed Existing Allowed Entire % of Fenestration Area Fenestration Area Proposed Area' ° Dwelling CFA z 3 Area° Removed5 Area Added A x B (E -D) + C Total Fenestration Area.2 ft West Fenestration Area (Required In 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, & 7-15. Note that the maximum allowed fenestration can 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. 6. Enter the'Fenestration area that is being added as part of the alteration. Registration Number: Registration Date/Time: HERSProvider: 2008 Residential Compliance Forms March 2010 r Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 3 of 5 Project Name: Gehl Residence Climate Zone # 1# of Stories ROOFING PRODUCTS (COOL ROOFS) §1511912 When the area of exterior roof surface to be replaced exceeds more than 50% of the existing roof area, or more than 1,000j?, whichever is less, the new roofing area must meet the roofing product "Cool Roof' requirements of§152(b)1Hi,152(b)IHii, or 152(b)IHiii. 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. 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 I through 9 and 16 with a Steep -Sloped Roofs (pitch greater than 2:12) and product unit weight less than 5lb/fl Alternatives to §152(b)lAi and §152(b)Hii, Steep -slope roof (pitch >2:12) ® Insulation with a thermal resistance of at least 0.85 hrft2.OFBtu or at least a 3/4 inch air -space is added to the roof deck over an attic; or U Existing ducts in the attic are insulated and sealed according to §151(f)10; or In climate zones 10, 12 and 13, with 1 if of free ventilation area of attic ventilation for every 150 fig of attic floor area, and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the proof ridge; or Building has at least R-30 ceiling insulation; or ® Building has radiant barrier in the attic meeting the requirements of §151(1)2; 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)1Hiii, Low -slope roof (pitch <_2:12) E] 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. Roof constructions that have thermal mass over the roof membrane with at least 25 lb/ft, 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 Exem t from the Roofin Products "Cool Roof' Re uirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number' < 2:12 > 2:12 < 5lb/ft2 > 5lb/ft' TyrO62 Reflectance 3,4 Emittance SRI Ell D 0 0 D 0 1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroo s. org/products/searchoho 2. Indicate the type ofproduct 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("p;,,;j;ot — 0.1) 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 http:/hvww.enerev cagov/title24/and enter the resulting value in the SRI Column above and attach acopy 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 §I 18(1)4. Select the applicable coating: Aluminum -Pigmented Asphalt Roof Coating [71Cement-Based Roof Coating h Other Registration Number:_ Registration Date/Tim_ e:_ HERS.Provider:_ 2008 Residential Compliance Forms March 2010 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 4 of 5 Project Name: Gehl ResidenceClimate Zone # # of Stories 1 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 Type and Capacity 1.2.3 Efficiency AFUE or HSPF Distribution Insulation Thermostat (Central, Split, Type and Location R -Value Type Space, Package or H dronic External Tank Water Heater Type/Fuel Distribution Type Number In Tank 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(6)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 Thermal Efficiency R-Value3 Minimum Efficiency Duct or Piping Configuration Cooling Equipment T andCapacity'z (SEER/EER or Distribution Insulation COP) Type and Location' R -Value Thermostat Type (Central, Split, Space, Package or H dronic 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 external water heating tank and i es shall be insulated to meet the requirements of §1506). 1. Indicate Cooling Type (A/C, Heat pump, Evap. Cooling, etc) 2. Refer to the HERS Verification section on Page 4 of the CF -1 R -ALT 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 component packa es in all climate zones. External Tank Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation Type' (Standard, Recirculatin )2 System Capacity (al) Thermal Efficiency R-Value3 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 external water heating tank and i es shall be insulated to meet the requirements of §1506). SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below. These items may require written 'usti tcation and documentation and special verification. NEW ROOF ASSEMBLY - Radiant Barrier The radiant barrier requirement of §15 1 2 does not apply to roof alterations. Slab Edge (Perimeter) Insulation Lj YES UNO YES: In Climate Zone 16 in Component Packages D, R-7 insulation is required. Heated Slab Insulation Q YES 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 LJYES _i NO YES: In Climate Zones 1, 2, 11, 13, 14 & 16, R-8 insulation is required, in Climate Zones 12 & 15, R4 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/Time: HERS Provider: _ 2008 Residential Compliance Forms March 2010 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations p �•J p age 5 of 5 Project Name: Gehl ReS I l./ �i I7 Ce Climate Zone # # of Stories 1 HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERSMeasures specified in this checklist below. A completed and signed CF -41? Form for all the measures specified shall be submitted to the building inspector before final inspection Duct Sealing & Testing HERS verification is required for this measure. YES Q 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)1 Dii and the newly installed ducts are to be insulated per § 151(f)10. Q EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. YES ONO 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 §I52(b)IDi. QYES ONO YES: In Climate Zones 2 and 9-16, 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 §l52(b)IE. 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. Refrigerant Charge - Split System HERS verification is required for this measure. Q YES Q 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 re&i erant charge measurement shall be verified per 152(b)1 F. Central Fan Integrated (CF1) Ventilation System and Fan Watt Draw The ventilation requirements 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. YES NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is replaced, the airflow and fan watt draw shall be verified per 152(b)]Ci to meet therequirements of 151(07B. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. Name: Signature: i Company: Date: Address: If Applicable - CEA or _ : CEPE (Certification #): City/State/Zip: 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. • 1 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 to document this provided 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 Date/Time: HERS Provider. _ 2008 Residential Compliance Forms March 2010 Bin # _ City of La Quinta Building 8r Safety Division Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application -and Tracking Sheet Permit #P.O. 0A - ��' Project Address: f j W IZYLk� Owner's Name: &0j4� A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: eI� "v` AF 1-(7A� Telephone: Address: 3 - - Jv0 � � 1.1 1 Project Description: City, ST, Zip: WrV�'1 OL"\ -A r_ a 4,j1 /,-00 1dJ Telephone: ��,`3i! �,��::'t:; ;:zh:z .: >:?>::::<#":«:c:> �: ; ? > :: < GLI G% AA-cwx 6A) State Lic. # : City Lic. #: Arch., Engr., Designer: (�� t♦% �((1 i� Address: City., ST, Zip: Telephone: State Lic. #: v i:M �Y•.;�M•?•:•,:•.;� N : ;:>s''}::c::<:A ::x:>Y »:;r<:?;..: >,4;�.:.:.,.:i':;•?;: ••::.:.:: �r.<:>:;.:..:r..:y 1<."":"":i•:......:. ,;•>iiri>. X. ii�v4C:f?ti ii±inl:_:i%l:: i{ '%r.%n?:iW !�}: \ C Construction Type: Occupancy: Project type (circle one): New Add'n ter Repair Demo Name of Contact Person: i.1' l v.JerVlr>� Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: IN � LQ C3Q 1 Estimated Value of Project: �[I APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Amount Structural Calcs. FEBItem Reviewed, ready for corrections D 1 1 2 16,6 Check Deposit Truss Calcs. Called Contact Person Plan Check Balance.^C Tide 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical �► Grading plan 2"! Review, ready for correctionstissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. �a H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for correctio IS 0 Developer Impact Fee coo Planning Approval Called Contact Person A..I..P..PP..,-` Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 1.�� 'liop • I�SIg'[Q o os touC ("It- W ,b mi<4 O�o�► �a-wr�