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07-1557 (AR)k. P.O. BOX 1504 78-495 CALLE TAMPICO. LA QUINTA, CALIFORNIA 92253 AppGcation'Nurnber: CProperty.Address:- 07 - 0 0 0 01x5 5 7� —,., 56235-JACK—NICKLAUS APN: 762-070-025- - - Application description: ADDITION - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 10180 Applicant: Architect or Eng' eer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: B Lice a o.: 541716 Date: 6�; Contractor: O ER -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.). (_) 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 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: HASLAM GARY L 56235 JACK NICKLAUS LA QUINTA, CA 92253 Contractor: PC CONSTRUCTION 49950 JEFFERSON 413 INDIO, CA 92202 (760)771-6332 Lic. No.: 541716 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 1 Date: 8/14/07 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 0036806-2006 certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith com ly ith those provisions. ;`ate:. V Applicant: WARNING: FAILURE TO SECURE WORKERS' COM(W51C flON COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS 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 county ordinances and state laws relating to building construction, and hereby authorize representatives of this cou y to nter upon the above-mentioned proper or inspection purposes. Dated ®Signature (Applicant or Agentl: LQPERA4[T •Application Number . . . . . 07-00001557 --.-..--- Structure Iriforariation 126SF ADDITION/V-NR/RES-3 [ENGINEERED] ----- .Other,struct info CODE EDITION 2001/2005 # BEDROOMS 1.00 FLOOD ZONE' NO 1ST FLOOR SQUARE FOOTAGE 126.00 Permit . . BUILDING PERMIT Additional desc . Permit Fee 126.00 Plan Check Fee 81.90 Issue Date Valuation . . . . 10180 Expiration Date 2/10/08 Qty Unit Charge Per Extension BASE FEE 45.00 9.00. 9.0000 THOU BLDG 2,001-25,000• ---------------------------------------------------------------------------- 81.00 Permit . . . ELECT - ADD/ALT/REM Additional desc ` Permit Fee . . . . 23.25 Plan Check Fee 5.81 Issue Date Valuation 0 Expiration Date 2/10/08 Qty Unit Charge Per Extension BASE FEE 15.00 11.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 ---------------------------------------------------------------------------- 8.25 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 19.50 Plan Check Fee 4.88 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/10/08 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 EA' MECH VENT INST/ DUCT ALT 4.50 ---------------------------------------------------------------------------- Special Notes and Comments 126SF ADDITION TO MASTER/V-NR/RES-3 [ENGINEERED] 2001 CBC, CMC, 2004 CEC 2005 ENERGY. August 14, 2007 11:20:31 AM AORTEGA ------------------------------------------------- --------------------------- Other Fees . . . . . . . ENERGY REVIEW FEE 8.19 STRONG MOTION (SMI) - RES 1.01 LQPERA4[T LQPERMIT Application Number . . . . 07-00001557 , Fee summary, Charged Paid Credited Due ----------------- Permit Fee Total ------- 168.75 .00 .00 168.75 Plan Check Total 92.59 .00 .00 92.59 Other Fee Total 9.20 .00 .00 9.20 Grand Total 270.54 .00 .00 270.54 LQPERMIT City Of La Quinta'. Building U Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - 760 777- . i ) 7012 Building Permit Application and Tracking Sheet Project Address:, +- 5 Owner's Ne A. P. Number. C :A:dd:rm�s- Contractor: Legal Description: A City, ST, Zip. �R � � A L L- Telephone: _ - Address: ��a �� •�} Project Description: City, ST, Zip: l �- C( Telephone: State Lie. # ip Ci Lie. #: Arch., Lnn ., Design Address: City; ST, Zip: Telephone) L 3 Z(_—J'�j S Coastzuctioa Type: Occupancy: State Lie. #: j type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. FL& # Stories: # Units: Telephone # of Contact Person: '1 Z Estimated Value ojProjed APPUCAUT: DO NOT WRITE BELOW THIS UNE N Submittal Req'd Recd TRACIMG PERMIT FEES Plan Sets p? Plan Check submitted 't Structural Cala. /°tT� em Amount . Reviewed; raidy for corrections l L� Play Check Deposit Truss Cala. Called Contact Person Plan Check Balance Energy Glp. Plans Olcked,ap Construction Flood plain plan Plans resubmitted Mechanical Grading, plan' 2'' Review, ready fo correc o Issue Electrical Q Subeontactor List . Called Contactperson Grant Deed L4 Plumbing Plans picked up ( S.K ILO.A Approval Plans resubmitted IN HOUSE, Gradin � g '"' Review, ready for, correctionelisue Developer Impact Fee Planning Approval Called .Contaet person AXP.P. Pub. Wks. Appr Date, of permit issue School Fees & ® •�rCLTotal Permit Fees 30-�vu� �t3 07 Coachella Valley Unified School District 81-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMMIND. AMOUNT: DATE: RECEIPT: CHECK pi INITIALS: CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: iResidencelis,at P,GA West Date: July 30, 2007 Owner's Name: Gary & Valerie Haslam Phone No. Project Address: 56-235 Jack Nicklaus Project Description: Aaddition to Master bedroom APN: 762-070-025 Tract #: Lot #'s: Type of Development: Residential XX Commercial Industrial Total Square Feet of Building Area: 126 sq. ft. Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement.under penalty of perjury and further represents that he/she is authorized to sign on beha of the owner/developer. Dated: 7-30-07 Signature: *********************************************************************** SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project Agreement Existing Not Subject to Fee 17620 65995 Approval Prior to 1/1/87 Requirement . No'te'• Number of Sq.Ft. 126 Ny addition under 500 sq. ft. is exempt from paying developer Amount per Sq.Ft. $0 fees. Amount Collected $ 0 Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Support Services Certificate issued by: Elvira Mattson, Office Technician Signature: NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. ivlV:c/mydocs/devfees/certificate of compliance form updated 3-2007 3/9/07 May 23, 2007 Mr. Gary Haslam PGA WEST II RESIDENTIAL ASSOCIATION, INC. 42-600 CAROLINE COURT, SUITE 101 PALM DESERT, CALIFORNIA 92211 PHONE (760) 7705100 • FAX (760) 776-5111 Reference: 56-235 Jack Nicklaus Blvd. — Architectural Change Request Room addition, add walkway Dear Mr. & Mrs. Haslam: The Architectural Committee reviewed and approved your application as referenced above. Per the Architectural Rules and Application for Change, page 3 states....."and 5 feet from side property line (corner lots setback is 20 feetfrom the side yard street). " A portion of your extended concrete encroaches into this setback. Therefore, if an emergency arises which would necessitate the Association having to dig in this area, the homeowner will be responsible to replace any damaged concrete. All concrete used in PGA WEST II Residential Association shall be in accordance with that shown in "Concrete. Mix", Appendix 3, enclosed for your convenience. Review by the Committee is only for general conformance with the Architectural Rules It is the responsibility of the owner to fully understand and conform to the Architectural Rules criteria whether or not all dericiencies are noted during review It is also the owner's full responsibility to field verify all existing conditions. The Committee's decision with regard to nroiect design will be rnaL Please refer to the Architectural Rules for all reauired submittals This application is approved with the understanding that there will be no additional landscaping. Approvals given by the Architectural Committee are good for only six months from the date on the approval letter. If construction has not commenced within six months after the project approval date, a new application must be submitted. Upon completion of your project, please complete and return The Notice of Completion of Architectural Change. For additional information or questions, the Board has directed that you contact Carol Fuller, Association Manager, at 760/776-5100, Ext.320, or Cathy Clark, Assistant Manager, Ext. 318. Sincerely, PGA WEST II Residential Association n ;iq Architectural Committee �—� f ► J JUN 28 2007 Enclosure CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 4) CF -1R Project Title MA STEfZ E2Df7_00M Date HUDI-TION 29 AYTL D! Assembly U - factor (for wood, metal frame and I mass assemblies) BltncJn—��t Roof Radiant Barrier Installed Yes or No Location Comments (attic, garage, typical, etc. WAtL �0` Project Address J J IaLK NICK AU 5 (IUD LK QU 1 NTP CA 92153 a 4IN Documentation Author Telephone ROOF Wool) PERR`I RICE C7�O1 -2Z1-7 8 5 7 r 1. °a, rr 3 Compliance Method (Prescriptive) Climate Zone P (� C1�C la G 15- o ✓ Pf Alternative Component Package Method: (check one) C D D (Alternative) Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF -1 R page 3) For Package D Alternative see Appendix B Table 151-C Footnotes 7-14 - GENERAL INFORMATION Total Conditioned Floor Area (CFA) 2 5 7 6 ft2 1 Z G AD D I T I OSN �� ,!� 2 1 3 Average Ceiling Height: I D ft ji JUN 2 8 2007 Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-C ---- (5% X CFA) ftZ Maximum Allowed Total Fenestration Products Per Table 151-B or 151-C ----(20% X CFA)--- g2 ✓ ❑ Building Type: (check one or more) / Single Family Multifamily �L Addition Alteration (If adding fenestration fill out WS -4R, Fenestration Maximum Allowed Area W or s ee an see ec ion for Additions and 8.3.3 for Alterations.) CITY OF LA QUINTA BUILDING & SAFETY DEPT. Number of Stories: DN E Number of Dwelling Units: APPROVED Floor Construction Type: 51A 3 Slab/Raised Floor (circle one or both) FOR CONSTRUCTION Front Orientation: 1 y 5 'North / South / East / West / All Orientations (input fir � T nt orie tib rees fr rue Not and circle one). DA Y UL ❑ RADIANT BARRIER (required in climate zones 2,4,8-_151 OPAQUE SURFACES INCLUDING OPAOUE DOORS ff� Component Type (Wall, Roof, Floor, Slab Edge, Doors) Frame Type (Wood or Metal) Cavity Insulation R -Value Continuous Insulation R -Value Assembly U - factor (for wood, metal frame and I mass assemblies) Joint Appendix IV Reference Roof Radiant Barrier Installed Yes or No Location Comments (attic, garage, typical, etc. WAtL VTM R ROOF Wool) R -39 N11 k Y E5 I) see Joint Appendix 1V to Section 1V.2, 1V.3 and 1VA, which is the basis for the U -factor criterion. U -factors can not exceed presch `ve value to show equivalence to R -values. Residential Compliance Forms DRAFTSM R.N W/ April 2005 =I�-O7 CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 2 of 4) C&IR Project Title N ASTER, B ETD EDON ADD 1T I O N Date 2 4 APR 0 7 FENEST "T10 I PRODUCTS — U -FACTOR AND SHGC Minimum OfFENESTRATION MAXIMUM ALLOWED AREA WORKSHEET Additions and Alterations. WS -4R —must be included for New Construction, Fenestration Efficiency AFUE or HSPF #/Type/Pos. Duct or Piping Thermostat (Front, Left, Orien- Exterior Rear, Right, ;..'talion, Area U -factor Shading/Overhangs6" t Z S ti ht N,: S, E, W ft U-factor2 Source SHGC V box if WS -3R is SHG Sources REAR : N 1 u..5� included �. ❑ 13 13 ,. i E3r Skylights are now included in West -facing fenestration area if the skylights are tilted to the west or tilted in any direction when the pitch is less than 1:12. See § 151(f)3C and in Section 3.2.3 of the Residential Manual 2) Enter values in this column are either NFRC Rated value or from Standards default Table l 16A. 3) Indicate source either'from NFRC or Table 116A, 4) Enter values in this column from NFRC or from Standards Default Table 116B or adjusted SHGC from WS -3R. 5) Indicate source either. from NFRC or Table I I6B. 6) Shading Devices are defined in Table 3-3 in the Residential Manual and see WS -3R to calculate Exterior Shading devices. 7) See Section 3.2.4 in the Residential Manual. HVAC SYSTEMS Heating Equipment','-.. ,'': Minimum Distribution Type and Capacity , .. furnace, heat um , boiler, etc. Efficiency AFUE or HSPF Type and Location Duct or Piping Thermostat Configuration EXIST, GA5 ducts, attic, etc.) RTT.I L R -Value Type slit or package) R - 8 F . EX15T. C' NEW Cooling Equipment Type and Capacity Minimum - (A/C, heat pump, evap. cool Efficiency SEER or EER n Ductjetc. Duct Thermostat Configuration EMT, IST, 2 9 0 V att AT R-Value T e slit or acka e fL B A/C EX 15T. a kip w Residential Compliance Forms April 2005 W CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -1R project Title NRBTEFL OD) ZOOM PDDITIOM Date Z9 RPR 07 SEALED DUCTS and TXVs (or Alternative Measures) A signed CF -4R Form must be provided to the building department for each home for which the following. are required. OR ❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14. 111.4 For additions and alterations, duct systems that are not documented to have been previously sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the ; Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D. " WATER HEATING SYSTEMS Sealed Ducts all'climate zones Installer testingand certification and HERS rater field verification required.) ❑ TXVs, readily accessible (climate zones 2 and 8-15 only) M❑❑ Installer testing and certification'and HERS Rater field verification required.) ❑ Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field EXIST. !A/.H, verification required.) OR ❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14. 111.4 For additions and alterations, duct systems that are not documented to have been previously sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the ; Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D. " WATER HEATING SYSTEMS Systems serving single dwelling units Water Heater Type/Fuel Type Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per lY dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is Tank Capacity (gallons) not allowed. ❑ Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in. the Residential EXIST. !A/.H, Manual. No water heating calculations are required, and the system complies automatically. U 1 Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved ❑ Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the submittal. ❑ Check box to verify that a time control is required for a recirculating system pump for a system serving multiple units Systems serving single dwelling units Water Heater Type/Fuel Type Distribution Type . Number in System Rated Input (kw or Btu/hr) Tank Capacity (gallons) Energy Factor' orExternal Thermal Efficiency Standby' Loss % Tank Insulation R -Value EXIST. !A/.H, C)lr(ELT U 1 rn System serving multi le dwelling units Water Heater Type Distribution Type Number in System Rated Input (kw or Btu/hr(gallons) Tank Capacity Energy Factor[ orExternal Thermal Efficiency Standby' Loss (%) Tank Insulation R -Value 1) 1~or small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000 Btu/hr),' list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input and Thermal Efficiencies. Pipe Insulation (kitchen lines > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are '/4 :..--hes or greater in diameter shall be thermally insulated as specified by Section 150 0).2 A or 150 0)'2 B. Residential Compliance Forms April 2005 SPECIAL FEATURES NOT REQUIRING HERS VERIFICATION (add extra sheets if necessary) Indicate which special features are part of this project. The list below only represents special features relevant to the prescri tive method. ,/ I Feature Required Forms if applicable) Description ❑ Metal Framed Walls CF -1R CF -6R art 6 of 12 Ca' Radiant Barriers CF -IR ❑ Exterior Shades WS -4R N/A; Attach CRRC Label to ❑ Cool Roof Forms. Dedicated Hydronic Heating Performance Calculation ' ❑ System Required; Attach Run to Forms. ❑' Combined Hydronic System Performance Calculation Required; Attach Run to Forms. ❑ Gas Cooling Performance Calculation Required. ❑ Buried Ducts N/A; Indicate on building plans. ❑ Kitchen Pipe Insulation See Section 5.6.2 Distribution Systems in Residential Manual. Multiple Water Heaters Per See Table 5-13 or use ❑ Performance Calculation and Dwelling Unit attach Run to Forms. ❑ Central Water Heating System Performance Calculation and Serving Multi le Dwellings attach Run to Forms. ❑ Non-NAECA Large Water CF -1R Heater See Table 5-13 or use ❑ Indirect Water Heater Performance Calculation and attach Run to Forms See Table 5-13 or use ❑ Instantaneous Gas Water Heater Performance Calculation and attach Run to Forms See Table 5-13 or use ❑ Solar Water Heating System Performance Calculation and attach Run to Forms ❑ Wood Stove Boiler Performance Calculation and attach Run to Forms SPECIAL FEATURES REQUIRING HERS RATER VERIFICATION (add extra sheets if necessary) Indicate to the HERS Rater which credits are part of this proiect and need verification I/ Feature Required Forms if applicable) Description '. ❑ Duct Seating CF -6R part 4 of 12 ❑ Refrigerant Charge CF -6R part 5 of 12 ❑ Thermostatic Expansion Valve CF -6R art 6 of 12 Residential Compliance Forms . April 2005 FENESTRATION - MAXIMUM ALLOWED AREA WORKSHEET WS -4R Project Title Date MMIEFL IIEDR.00NA P,DD1-TION I Z,4 APTL 07 FENESTRATION PRODUCTS — NEW CONSTRUCTION- NEW BUILDINGS Use this table for new building construction to account for total building % of fenestration. A B C D E F G #/Type/Pos. (Front, Left, Rear, Right, Skylight) Orientation Total Fenestration, West Facing Area(ft) Total Fenestration for N, S, E Orientations Area(ft) CFA(ft) Total Percent of West Facing Fenestration' (C/E) x 100% Total % of FenestrationZ Including West (D/E) x 100%+ F Existing CFA (ft) North Existing Area Removed Orientation Removed Area ft2 Proposed Installed Orientation Proposed 'Installed New Area ft2 Total Net Fenestration (ft2) C-E+G South North East North West South West Totals Li South 1) If west facing area exceeds 5% of CFA in climate zones 2, 4, and 7-15, the performance approach must be used. 2) If total percent of fenestration exceeds 20% including West facing orientations then performance approach must be used. West facing area includes skylights tilted to the west or tilted in any direction when the pitch is less than 1:12 for Package D only. FENESTRATION PRODUCTS — NEW CONSTRUCTION- ADDITIONS ✓ [Less than 100 ft2, LY Less than or Equal to 1000 ft2, ❑ Greater 1000 ft2 A B C D E F G.. H #/Type/Pos. (Front, Left, Rear, Right, Skylight) Proposed Orienta- Addition's tion CFA 1.2.3 Proposed Addition's Fenestration Area (ft2)4 Fenestration Area Removed to make way for Addition ftZ' Total Area Added Fenestration Total % of West Facing Fenestration (G/C) x 100% Total % of Fenestra - tion 2.1. 4 F/C x 100% Existing CFA (ft) North Existing Area Removed Orientation Removed Area ft2 Proposed Installed Orientation Proposed 'Installed New Area ft2 Total Net Fenestration (ft2) C-E+G South North North East South West 9 Li South East Total East 1) Additions <100 sf are allowed to install up to 50ft' of fenestration and are exempt from the 5% west facing and 20% maximum total area limits and shall meet the U -factor and SHGC requirements of Package D. See Table 8-2 in the Residential Manual. Note: Leave columns E, F, G, H, and l blank. 2) Additions :_1,000 ft2, the maximum net allowed fenestration is 20% and may be increased additionally to by the amount of glazing removed in the wall that separates the addition from the existing house. However, the total West facing fenestration can not exceed 5% of the proposed addition's CFA including skylights orientated in any direction and tilted with a pitch of < 1:12. Column G can not exceed 5% and Column H can not exceed 20%. 3) Additions > 1,000 112, must meet Package D requirements. See Table 8-2 and Table 151-C in Appendix B of the RM or use Performance Approach. 4) The 5%west orientation restrictions are only for Climate zones 2, 4, and 7-15; for Climate Zones 2, 4 and 7-15 enter zero (0) in column E. FENESTRATION PRODUCTS: ALTERATIONS Use this table for alterations to an existing building where fenestrations products twindows are being removed and/or added. A B C D E F G H 1 Existing CFA (ft) Existing Orientation(ft) Existing Area Removed Orientation Removed Area ft2 Proposed Installed Orientation Proposed 'Installed New Area ft2 Total Net Fenestration (ft2) C-E+G Total % of Fenestra -tion"' (WA) x 100% Max of 20% North North North South South South East East East West West West Total Total Total I) When 50 tt' or more of fenestration area is added to an existing building, then the fenestration must meet the requirements of Package D. 2) The area requirement for the total fenestration area for the whole building, including the added fenestration, must not exceed 20%. Otherwise, the Performance Approach must be used. See Section 8.3.3 in the RM for further details. .'. Resiclential Compliance Forms December 2005 MANDATORY MEASURES SUMMARY: RESIDENTIAL (Page I of 2) MF -IR Project TitleDate M NSTEFL TEOV .0OM AD D i-fOU Z1. AFFL 0-7 Note: Low-rise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. More stringent compliance requirements from the Certificate of Compliance supersede the items marked with an asterisk (*) below. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. Instructions: Check or initial applicable boxes when completed or check NA if not applicable. ` DESCRIPTION F a NA Designer ' Building Envelope Measures: v/ r ' § 150(a): Minimum R-19 in wood frame ceiling insulation or equivalent U -factor in metal frame ceiling. ❑ ❑ j., -. § I50(b): Loose fill insulation manufacturer's. labeled R -Value: ❑ ❑ M` • § I50(c): Minimum R-13 wall insulation in wood framed walls or equivalent U -factor in metal frame walls (does not apply K v to exterior mass waits). ❑ ❑ ' • § 150(d): Minimum R-13 raised floor insulation in framed floors or equivalent U -factor. ❑ ❑ § I50(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs. PP g 1. Masonry and factory -built fireplaces have: I Yom; a. closeable metal or glass door covering the entire opening of the firebox ❑ ❑ �,�;, �; � , b. outside air intake with damper and control, flue damper and control ❑ ❑ s - 2. No continuous burning gas pilot lights allowed. a ❑ § L 50(f): Air retarding wrap installed to comply with § 151 meets requirements specified in the ACM Residential Manual. El § I50(g): Vapor barriers mandatory in Climate Zones 14 and 16 only. ❑ ❑ §150(1) :Slab edge insulation -water absorption rate for the insulation material alone without facings no greater than El 11 4S' }' 0.3%, water vapor ermeance rate no eater than 2.0 perm/inch. § 118: Insulation specified or installed meets insulation installation quality standards. Indicate q ry type and include CF -6R ❑ ❑ Form: § 116-17: Fenestration Products, Exterior Doors, and Inftltration/Exftltration Controls. I. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. '''' 2. Fenestration products (except field -fabricated) have label with certified U -factor, certified Solar Heat Gain ❑ ❑ Nra; Coefficient SHGC , and infiltration certification. 3. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. ❑ ❑ r= -' Space Conditioning, Water Heating and Plumbing System Measures: =tip - §110-§113: HVAC equipment, water heaters, showerheads and faucets certified fied by the Energy Commission- ❑ ❑ ta::a- *' %> qs _ § 150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA or RCCA. ❑ ❑ c`�: 1. §150(i): Setback thermostat on all applicable heating and/or cooling systems. § 150(j): Water system pipe and tank insulation and cooling systems line insulation. ❑ ❑ L Storage gas water heaters rated with an Energy Factor less than 0.58 must be externally wrapped with insulation having ❑ ❑ an installed thermal resistance of R- 12 or greater. ;sy'•'dtc 2. Back-up tanks for solar system, un""" fired storage tanks, or other indirect hot water tanks have R- 12 external insulation or ❑ " R- 16 internal insulation and indicated on the exterior of the tank showing❑ the R -value. 4,: 3. The following piping is insulated according to Table I50-A/B or Equation 150-A Insulation Thickness: ' nter1; A I. First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire lengthIT ❑ ❑ e A. of recirculatingsections of hot water pipes shall be insulated to Table 150B. ' = is 2. Cooling system piping (suction, chilled water, or brine lines), piping insulated between heatingand source indirect hot tank ❑ ❑-=fr water shall be insulated to Table 150-B and Equation 150-A: 4. Steam hydropic heating systems or hot water systems > 15 psi, meet requirements of Table 123-A. El Residential Compliance Forms April 2005 , Q —A _ DATORY MEASURES SUMMARY: RESIDENTIAL (Page 2 of 2) MF -1R Space Conditioning, Water Heating and Plumbing System Measures: (continued) NA✓ Desi ner " • fnent�". 5. Insulation must be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. ❑ ❑ 6. Insulation for chilled water piping and refrigerant suction piping includes a vapor retardant or is enclosed entirely in ❑ ❑ : "_ ' i F> conditioned space. 7. Solar water -heating systems/collectors are certified by the Solar Rating and Certification Corporation ❑ ❑ " " .r41i ` • § 150(m): Ducts and Fans 1. All ducts and plenums installed sealed and insulated to meet the requirement of the CMC Sections 601, 602, 603, 604, 605-.:, and Standard 6-5; supply -air and retum-air ducts and plenums are insulated to a minimum installed level of R-0.2 or enclosed 4'> entirely in conditioned space_ Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable ❑ od requirements of UL 181, UL 181A, or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is >"t" used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used 2. 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 platform shall not be compressed to cause reductions in the cross-sectional area of the ducts. ' " 3. Joints and seams of duct systems and their components shall. not be sealed with cloth back rubber adhesive duct tapes ❑ ❑ t " ' unless such tae is used in combination with mastic and draw bands. 4. Exhaust fan systems have back draft or automatic dampers. ❑ ❑ Q' ur," 5. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated- ❑ ❑ Pad. 6. Protection of Insulation. 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 ❑ ❑ :'c:' :: retardant and provides shielding from solar radiation that can cause degradation of the material. 7. Flexible ducts cannot have porous inner cores. ❑ ❑'--`r0:'''ai; § 114: Pool and Spa Heating Systems and Equipment. 1. A thermal efficiency that complies with the Appl iance 'Efficiency Regulations, on-off switch mounted outside of the ❑ ❑ :�'.' heater, weatherproof operating instructions, no electric resistance heatingand no pilot light. 2. System is installed with: a. at least 36" of pipe between filter and heater for future solar heating ❑ ❑ `-.'�:.'".' b. cover for outdoor pools or outdoor spas ❑ ❑ ` : Q?r•.:' 3. Pool system has directional inlets and a circulation pump time switch. ❑ ❑ .:: § 115: Gas fired fan -type central furnaces, pool heaters, spa heaters or household cooking appliances have no continuously ❑ ❑ 0 ':., burning pilot light. (Exception: Non -electrical cooking appliances with pilot < 150 Btu/hr) .'. § 118(i): Coot Roof material meets specified criteria ❑ ❑ Residential Lighting Measures: § 150(k)1: HIGH EFFICACY LUMINAIRES OTHER THAN OUTDOOR HID: contain only high efficacy lamps as outlined in Table 150-C, and do not contain a medium screw base socket (E24/E26). Ballast for lamps 13 watts or greater ❑ ❑ , ❑ .;' „. are electronic and have an output frequency no less than 20 kHz. § 150(k) I: HIGH EFFICACY LUMINAIRES - OUTDOOR HID: contain only high efficacy lamps as outlined in Table ❑ 'r' 150-C, luminaire has factory installed HID ballast -a § l50(k)2: Permanently installed luminaires in kitchens shall be high efficacy luminaires. Up to 50 percent of the wattage, as determined in § 130 (c), of permanently installed luminaires in kitchens may be in luminaires that are not high efficacy ❑ ❑2. " luminaires, provided that these luminaires are controlled by switches separate From those controlling the high efficacy luminaires. § I50(k)3: Permanently installed luminaires in bathrooms, garages, laundry rooms utility rooms shall be high efficacy luminaires. OR are controlled by an occupant sensor(s) certified to comply with Section 119(d) that does not turn on ❑ ❑":.: automatically or have an always ono tion. § 150(k)4: Permanently installed luminaires located other than in kitchens, bathrooms, garages, laundry rooms, and utility rooms shall be high efficacy luminaires (except closets less than 70W): OR are controlled by a dimmer switch OR are ❑ ❑ a' controlled by an occupant sensor that complies with Section l I9(d) that does not turn on automatically or have an always ." " ono tion. § 150(k)5: Luminaires that are recessed into insulated ceilings are approved for zero clearance insulation cover (IC) and are ❑ '"_ `_ " certified airtight to ASTM E233 and labeled as air tight(Al)to less than 2.0 CFM at 75 Pascals. § 150(k)6: Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy luminaires (not including lighting around swimming pools/water features or other ❑ r�1 u ^` Article 680 locations) OR are controlled by occupant sensors with integral photo control certified to comply with Section I 19(d). § 150(k)7:: 'ghting for parking lots for 8 or more vehicles shall have lighting that complies with Sec. 130, 132, and 147. 11 C1 Lighting for parking garages for 8 or more vehicles shall have lighting that complies with Sec. 130, 131, and 146. 3150(k)8: 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 OR are controlled by occupant sensor(s) certified to comply with ❑ ❑ ❑. Section 119(d). Residential Compliance Forms' April 2065