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12-1388 (SFD)y 'z P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4'it 4u'fti�v VOICE (760) 777-7012 J FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 Application Number: 12-00001388 Property Address: 54277 AVENIDA DIAZ ' APN: 774 -233 -014 -2 -00 000 - Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: COVE RESIDENTIAL Application valuation: 126516 Applicant: Architect or Engineer: , 0 ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: License No.: Date: 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 rnntrarting 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 4 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: KNALL, CHRISTIAN Contractor: Owner Date: 2/12/13 a ° 'FEB 115 2011 i . iL CITY OF LA QUINTA FINA"ICE DEPT ------------------- 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 Policy Number I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall orthwi co�o////Im�ply with those provisions. /Date: dZ �S t�Applicant: �tY/�' 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 ($100,000). 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 county to enter upon the above-mentioned property for i pection u oses. / Date: 02M 1 ( ignature (Applicant or Agent): Application Number . . . . . 12-00001388 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 59.00 Plan Check Fee 14.75 LQPERMIT Structure Information Construction Type . . . . . TYPE V, UNPROTECTED Other struct info . . . . . CODE EDITION 2010 cbc # BEDROOMS. 3.00 FIRE SPRINKLERS YES GARAGE SQ FTG 466..00 NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- IST FLOOR SQUARE FOOTAGE 1860.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 734.00 Plan Check Fee 477.10 Issue Date . . . . Valuation 126516 Expiration Date 8/11/13 Qty Unit Charge Per Extension. BASE FEE 639.50 27.00 3.5000 --------------------------------------------------------------------'-------- THOU BLDG 100,001-500,000 94.50 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 104.42 Plan Check Fee 26.11 Issue Date . . . . Valuation . . . . 0 Expiration Date 8/11/13 Qty Unit Charge Per Extension BASE FEE 15.00 1860.00 .0350 ELEC NEW RES.- 1 OR 2 FAMILY 65.10 466.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.32 1.00 15.0000 ------------------------=------------------------------------------------- EA ELEC TEMPORARY POWER POLE 15.00 -- Permit . . . GRADING PERMIT Additional desc . Permit Fee .. . . 15.00 Plan Check Fee ., .00 . Issue Date Valuation . . . . 0 Expiration Date 8/11/13 Qty Unit Charge Per Extension._ ---------------------------------------------------------------------------- BASE FEE 15.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 59.00 Plan Check Fee 14.75 LQPERMIT Application Number . . . . . 12-00001388 Extension Permit . . . . . . MECHANICAL 11.00 6.00002A PLB FIXTURE Issue Date . . . . PLB BUILDING SEWER Valuation . . . . 0 Expiration Date . . 8/11/13 PLB WATER HEATER/VENT 7.50 Qty Unit Charge Per ----------=----------------------------------------------------------------- Special Notes and Comments Extension 1860 SF SFD. R-3 OCC. TYPE BASE FEE 15.00 . 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 3.00 6.5000 EA MECH VENT FAN 19.50 1.00 ---------------------------------------------------------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Permit PLUMBING Additional desc . . Permit Fee . . . . 130.50 Issue Date . . . . Expiration Date . . 8/11/13 Plan Check Fee . . 32.63 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 11.00 6.00002A PLB FIXTURE 66.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 4.00 6:0000 EA PLB ROOF DRAIN 24.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ----------=----------------------------------------------------------------- Special Notes and Comments 1860 SF SFD. R-3 OCC. TYPE V -B CONSTRUCTION W/ FIRE SPRINKLERS. 2010 CODES. CONVENTIONAL CONSTRUCTION. **PERMIT DOES NOT INCLUDE BLOCK WALLS, FENCES,.SWIMMING POOLS, SPA, BBQ'S and DRIVEWAY APPROACH** ---------------------------------------------------------------------------- Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473) 6:00 DIF COMMUNITY CENTERS -RES 104.00 .DIF CIVIC CENTER - RES 1089.00 ENERGY REVIEW FEE 47.71 DIF FIRE PROTECTION -RES 612.00 DIF LIBRARIES - RES 334.00 MULTI -SPECIES (MSHCP) FEE 521.00 DIF PARK MAINT FAC - RES 51.00 DIF PARKS/REC - RES 1773.00 STRONG MOTION (SMI) - RES 12.65 DIF STREET MAINT FAC -RES 158.00 DIF TRANSPORTATION - RES 3592.00 Fee summary Charged Paid Credited Due LQPERMIT ' Application Number . . . . . 12-00001388 ----------------- ------- Permit Fee Total - -- 1042.92 ------- --- ---------- .00 .00 ---------- 1042.92- 042.92Plan PlanCheck Total 550.59 250.00 .00 300.59 Other Fee Total 8300.36 .00 .00 8300.36 Grand Total 9893.87 250.00 .00 9643.87 LQPERMIT Building Address Owner IA) Mailing Contractor Address T_11�4 4 4 a" P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 y State Lic. Glty & Classif. I Lic. # Arch., Engr., Designer dress el. 01 6 h1Ae�4 • Cil�flti Lic. # LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that he 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). ❑ 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 Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or im- provement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Cede: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT.. If, after making this Certificate of Exemption you should become subject to the Workers' Compensation Provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above-mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT 1,2-1386 APPLICATION ONLY BUILDING: TYPE CONST. r OCC. GRP. A.P. Number 3724'~3 b 14: Legal Description I Project Description Sq. Ft. No. No. Dw. Size Stories Units Nev6o Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. a 50 "00 Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure I!/ i TOTAL yQF t REMARKS MCE rA AMIV ZONE: BY: Viniibacl (stances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL�T INSPECTOR Issued by: Date Permit Validated by: Validation: YELLOW = APPLICANT PINK = FINANCE Date 2/15/13 No. 31550 Owner Christian Knall Address 4224 La Salle Avenue City Culver City Zip Tract # Type Single Family Residence CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 APN # Jurisdiction Permit # No. of Units 4�'33�FtEDs+��O C1�312r'r�j, o. Q BERMUDA DUNES Cn RANCHO MIRAGE t7 INDIAN WELLS �i PALM DESERT tja LA QUINTA �Q0 INy� 774-233-014 La Quinta 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 54277 Avenida Diaz 1806 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 patiostwalkways, 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: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $3.20 X 1,806 S.F. or $5,779.20 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 CC -Bank of America - Christian Knall Check No. 001973471 Bank Name/Recipient of Certificate Telephone Funding Residential By Dr. Gary Rutherford Superintendent Fee collected /exem ed b S ron ilvrey Payment RecdQ;00 $5,779.20 Cl i-dUnder Signature 1 NOTICE: Pursuant to Government Code Section 66020(d)(lkjhi^ill serve 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 on which 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 entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID without embossed seal Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting RECORDING REQUESTED BY: EQUITY TITLE -ORANGE COUNTY/INLAND EMPIRE AND WHEN RECORDED MAIL TO: Christian Knall 4224 La Salle Avenue Culver City, CA 90232 Order No.: OR1050671 Escrow No.: PD -04191 -LH A.P.N.: 774-233-014—q DOC # 2010-0146399 03/31/2010 08:00A Fee:15.00 page 1 of 1 Doe T Tax Paid Recorded in Official Records County of Riverside Larry U. !lard un Assessor, Coty Clerk 6 Recorder Ilf till 111111II1!l1111 . _IIIlllll111Irl1Nl� SR U PAGE SIZE DA I MISC I LONG1 RFD I COPY M I A I L 1 465 1 426 CO COR SMF NCHG T: I CTY I UNI GRANT DEED THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX IS $49.50 [X] computed on full value of property conveyed, or ( ] computed on full value less value of liens or encumbrances remaining at time of sale. [ ] unincorporated area JX] City of La Quinta AND FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Betty Bissell, Executrix of The Estate of Florence R. Slinkard, deceased hereby GRANT(S).to Christian Iosif Rnall, a single man the following described real property in the County of Riverside, _.State.of California: >..,; Lot 2, Block 262 of Santa Carmelita at Vale La Quinta, in the'Cityof La Quinta; as shown by map on file In Book 19, Page(s)44-05, Inclusive of Maps, Records of Riverside County, California. AKA: Vacant Lot 2 Avenida Diaz, La Quinta, CA 92253 Dated: March 24, 2010 STATE OF CALIFO iA COUNTY OFSS. On P�h 2-(0 , e20 10 _ before me �1o5E 7 - t�KluhnJi�F_� Nota Public, personally appeared aa-wl 13155E j_1--• who proved to me on the basis of satisfactory evidence to be the personK whose name(p'f istwb subscribed to the within instrument and acknowledged to me that V/she/thyy executed the same in "IhedtherC authorized capacity(iod) and that by W/her/thed signatureo on the instrument the person(s). or the entity upon behalf of which the person(s), acted, executed the instrument. I certify under PENALTY OF PERJURY underthe laws of the State of California that the foregoing paragraph is true'and.correcl... WITNESS reel ' 'Signature ' Signature of Notary Commission Expiration Date:Ap /(e a/T Z 0/1 MAIL TAX STATEMENTS TO: same as above The Estate of Florence R. Slinkard, deceased By: Betty Igissell, Executrix JOSE J..FERNANDEZ COMM. (/1773806 NOTARY PUBLIC - CALIFORNIA ORANGE COUNTY MN Comm. E*h% Clacber I6, 2011 (This area for official notarial seal) 6 MM 025 T-11af 4 4 a" P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 To: Burt Hanada, Plans Examiner, Inspection Supervisor From: Les Johnson, Planning Director BUILDING & SAFETY DEPARTMENT (760) 777-7012 FAX (760) 777-7011 Building Plans Approval To CDD: /11,241/1 - Due ,{ a4 /ZDue Date: z Status: The Community Development Department has reviewed the Building Plans for the following project: Description: o", al akL44 t l � �) 6 Address or general location: 94-,W77 Applicant Contact: )� The Community Development Department finds that: ❑ ...these Building Plans do not require Community Development Department approval. ...these Building Plans are approved by the Community Development e Department. ❑ ...these Building Plans require corrections. Please forward a copy of the attached corrections to the applicant. When the corrections are made please return them to the Community Development Department for review. Les Johnson, anning Director Date received NOV 292012 City of Lo 9uinta Planning Department PROUDLY SERVING THE UNINCORPORATED AREAS OF RIVERSIDE COUNTY AND THE CITIES OF: BANNING BEAUMONT CALIMESA CANYON LAKE COACHELLA DESERT HOT SPRINGS EASTVALE INDIAN WELLS INDIO LAKE ELSINORE LA QUINTA MENIFEE MORENO VALLEY PALM DESERT PERRIS RANCHO MIRAGE RUBIDOUx CSD SAN JACINTO TEMECULA WILDOMAR BOARD OF SUPERVISORS: BOB BUSTER DISTRICT 1 JOHN TAVAGLIONE DISTRICT 2 JEFF STONE DISTRICT 3 JOHN BENOIT DISTRICT 4 MARION ASHLEY DISTRICT 5 RIVERSIDE COUNTY FIRE DEPARTMENT IN COOPERATION' WITH THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION -1 77-933 Las Montanas Rd., Ste. #201, Palm Desert, CA 92211-4131 • Phone (760) 863-8886 • Fax (760) 863-7072 www.rvcfire.org January 28, 2013 Shasta Re: Residential Fire Sprinkler Plan Review LAQ-13-RS-002 Knall Residence 54-277 Avenida Diaz La Quinta, CA The sprinkler plans you submitted for the above referenced project have been reviewed by Riverside County Fire Department Planning & Engineering personnel and are approved with the following conditions: A minimum of three spare fire sprinklers of each type and temperature rating along with a sprinkler wrench should be located in a spare head cabinet at the system riser or other approved location. Permanently marked identification signs shall be attached to all control valves. A warning sign, with minimum '/ inch letters, shall be affixed adjacent to the main shutoff valve and shall state the following: WARNING: The water system for this home supplies fire sprinklers that require certain flows and pressures to fight a fire. Devices that restrict the flow or decrease the pressure or automatically shut off the water to the fire sprinkler system, such as water softeners, filtration systems, and automatic shut-off valves, shall not be added to this system without a review of the fire sprinkler system by a fire protections specialist. DO NOT remove this sign. The following inspections/tests are required to be witnessed by the Fire Department Planning Division staff: (a) Overhead Rough and Hydro static test: All piping shall be visible and pumped at normal operating pressure. (b) Final inspection. The Fire Department job card, approved plans and conditions letter must be at the job site or NO inspection will be performed. Applicant/installer shall be responsible to contact the Fire Department to schedule inspection(s) a minimum of 72 hours prior to the requested inspection date. All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering staff at (760) 863-8886. Applicant/installer shall be responsible to contact the Fire Department to schedule inspection. Sincerely, Jason Stubble Fire Safety Specialist T4ht 4 44 Q" P.O. Box. 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760)777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building. permit has been submitted in your name listing yourself as the builder of the property improvements specified at We are providing .you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS. Read and initial each statement below to signify you understand or verify this information. GIC 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. C= 2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial'risk by hiring a -licensed Contractor and having the permit filed in his or her name instead of my own. �JL 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. C K 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer' under state and federal law. GK 6. I understand if I am considered an "employer" under state and federal law, I must register with, the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. Cr— 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. CK 8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. Cr -9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. Ct—' 10.1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party. legally and financially responsible for proposed construction activity at the following address: 11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. C.. Ic- 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or fain is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, You will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the -permit is issued to verify the property owner's signature. Signature of property owner Date: Z I I Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign; and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: i Electronically Filed by Joan D. Hacker and Authenticated at Ca10ERTS.com - 1/17/2013 Electronically Signed at Ca10ERTS.com by Gabriel Rios (Rios Designs) 1/18/2013 PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF -1 R Project Name Knall Residence Building Type ® Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Afteration Date 1/17/2013 Project Address Lot 2 - Avenida Diaz La Quinta California Energy Climate Zone CA Climate Zone 15 Total Cond. Floor Area 1,860 I Addition 1 n/a # of Stories 1 FIELD INSPECTION ENERGY CHECKLIST ❑ Yes ❑ No HERS Measures -- If Yes, A CF -413 must be provided per Part 2 of 5 of this form. a Yes ❑ No Special 'Features --If Yes, see Part 2 of 5 of this form for details. INSULATION Area Special Construction Type Cavi ( Features see Part 2 of 5 Status Wall Wood Framed R-19 1,033 New Door Opaque Door None 20 New Roof Wood Framed Attic R-8 1,860 Radiant Barrier New Slab Unheated Slab -on -Grade None 1,860 Perim = 153' New FENESTRATION U- Exterior Orientation Area Factor SHGC Overhang Sidefins Shades Status Front (E) 40.0 0.400 0.32 10.0 none Bug Screen New Left (S) r-,• . , 36.5 0.400,7---- .,,0.32._ - 2.0 . _ - none r . -. Bug Screen - �- _ New Rear 51.4 ] 0.400 l 0.32 2.0 j none Bug Screen New Right (N) ,rC69.4 % 0.400 0.(32 2.0 none 1 New 1 FOR CO IPA AT B , HVAC SYSTEMS Ot . Heating Min. Eff Cooling Min. Eff Thermostat Status 1 Split Heat Pump 8.00 HSPF Split Heat Pump 13.0 SEER Setback New HVAC DISTRIBUTION Duct Location Heating Cooling Duct Location R -Value Status Whole House DLrW Ducted Attic, Ceiling Ins, vented 8.0 New WATER HEATING Ot . Type Gallons Min. Eff Distribution Status 1 Small Elec. 50 0.99 All Pipes Ins New EnergyPm 5. f by Ener oft User Number. 2655 RunCode: 2013-01-17T18:35:21 /D: Page 1 of 5 Reg: 213-N0003613A-000000030-0000 Registration Date/Time: 2013/01/17 21:38:39 HERS Provider: Ca10ERTS, Inc Electronically Filed by Joan D. Hacker and Authenticated at Ca10ERTS.com - 1/17/2013 Electronically Signed at Ca10ERTS.com by Gabriel Rios (Rios Designs) 1/18/2013 PERFORMANCE CERTIFICATE: Residential Part 2 of 5) CF -1 R Project Name Knall Residence Building Type ® Single Family ❑ Addition Alone 1 ❑ Multi Family ❑ Existing+ Addition/Alteration Date 1111712013 SPECIAL FEATURES INSPECTION CHECKLIST The enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification to be used with the performance approach. The enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation submitted. HIGH MASS Design - Verily Thermal Mass: 800.0 & Exposed Slab Floor, 3.500" thick at Whole House HIGH MASS Design - Verify Thermal Mass: 1,060.0 ft2 Covered Slab Floor, 3.500" thick at Whole House The Roof R-38 Roof Attic includes credit for a Radiant Barrier that is Continuous meeting eligibility and installation criteria as specified in Residential Appendix RA4.2.2. I r HERS REQUIRED VERIFICATION Items in this section require field testing and/or verification by a certified HERS Rater The inspecttirmust receive a completed CF -411 form for each of the measures listed below for final to be given. The Cooling System BDP CO. 661 CJ060 includes credit fora 11.5 EER Condenser. A certified HERS rater must field verify the installation of the correct Condenser. The HVAC System Whole House includes credit for Verified Fan Energy. Measured Fan Energy may not exceed 0.58 wlcf n. The HVAC System Whole House incorporates HERS Verified Refrigerant Charge or a Charge Indicator Display. The HVAC System Whole House includes credit for verified adequate airflow. A certified HERS rater must diagnostically measure airflow of the HVAC System. The HVAC System Whole House incorporates HERS verified Duct Leakage. HERS field verification and diagnostic testing is required to verify that dud leakage meets the specified criteria. EnerqyPro 5. 1 by Ene oft User Number. 2655 RunCode: 2013-01-17T18:35:21 ID: Pace 2 of 5 Reg: 213-N0003613A-000000000-0000 Registration Date/Time: 2013/01/17 21:38:39 HERS Provider: Ca10ERTS, Inc ,,,'Electronically Filed by Joan D. Hacker and Authenticated at Ca10ERTS.com - 1/17/2013 Electronically Signed at CalCERTS.com by Gabriel Rios (Rios Designs) 1/18/2013 PERFORMANCE CERTIFICATE: Residential Part 3 of 5 CF -1 R Project Name Building Type m Single Family ❑ Addition Alone Date Knall Residence ❑ Multi Family ❑ Existing+ Addition/Alteration 1111712013 ANNUAL ENERGY USE SUMMARY Standar/ Proposed Margin TDV kBtu/ft2 Space Heating 2.37 2.61 -0.24 Space Cooling 42.49 35.23 7.26 Fans 8.57 8.32 0.25 Domestic Hot Water 17.03 24.26 -7.23 Pumps 0.00 0.00 0.00 Totals 70.46 70.42 0.04 Percent Better Than Standard: 0.1% BUILDING COMPLIES - HERS VERIFICATION REQUIRED Fenestration Building Front Orientation: (E) 90 deg Ext. Walls/Roof Wall Area Area Number of Dwelling Units: 1.00 (E) 320 40 Fuel Available at Site: Natural Gas (S) 290 37 Raised Floor Area: 0 (w) 320 51 Slab on Grade Area: 1,860 (N) 320 69 Average Ceiling Height: 8.0 Roof 1,860 0 Fenestration Average U -Factor: 0.40 TOTAL: 197 Average SHGC: 0.32 Fenestration/CFA Ratio: 10.6% REMARKS t , t STATEMENT OF COMPLIANCE This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the Efficiency Standards of the California Code of Regulations. The documentation author hereby certifies that the documentation is accurate and complete. Documentation Author Company Insu-form, Inc. 1/172013 Address 77810 Las Montanas Road, Suite 201 Name Joan D. Hacker City/State/7jCity/State/7jp Palm Desert Ca 92211 Phone 760-345-1352 Signed Date The individual with overall design responsibility hereby certifies that the proposed building design represented in this set of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit application, and recognizes that compliance using duct design, duct sealing, verification of refrigerant charge, insulation installation quality, and building envelope sealing require installer testing and certification and field verification by an approved HERS rater. Designer or Owner (per Business & Professions Code) Company Address Name City/State/Tp . Phone Signed License # Date EnemyPro 5.1 by EnemySoft User Number. 2655 RunC de: 2013-01-17T18:35:21 ID: Pa - e 3 of 5 Reg: 213-N0003613A-000000000-0000 Registration Date/Time: 2013/01/17 21:38:39 HERS Provider: Ca10ERTS, Inc Electronically Filed by Joan D. Hacker and Authenticated at Ca10ERTS.com - 1/17/2013 Electronically Signed at Ca10ERTS.com by Gabriel Rios (Rios Designs) 1/18/2013 CERTIFICATE OF COMPLIANCE: Residential Part 4 of 5 CF -1 R Project Name Knall Residence Building Type ® Single Family 13 Addition Alone 13 Multi Family ❑ Existing+ Addition/Alteration Date 1111712013 OPAQUE SURFACE DETAILS Surface U- Insulation Joint Appendix Type Area Factor Ca ' Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments Wall 260 0.074 R-19 90 90 New 4.3.1-A5 Whole House Door 20 0.500 None 90 90 New 4.51-A4 Whole House Wall 254 0.074 R-19 180 90 New 4.3.1-A5 Whole House Wall 269 0.074.R-19 270 90 New 4.3.1-A5 Whole House Wall 251 0.074 R-19 0 90 New 4.3.1-A5 Whole House Roof 1,860 0.025 R-38 90 0 New 4.2.1-A21 Whole House Slab 800 0.730 None 0 180 New 4.4.7 -Al Whole House Slab 1,060 0.730 None 0 180 New 4.4.7-A1 Whole House FENESTRATION SURFACE DETAILS ID Type Area LI -Factor' S Cz Azm Status Glazing Type Location/Comments 1 Window 40.0 0.400 NFRC 0.32 NFRC 90 New IWC 6200 Alum/Low-E Whole House 2 Window 16.0 0.400 NFRC 0.32 NFRC 180 New IWC 6200 Alum/Low-E Whole House 3 Window 4.5 0.400 NFRC 0.32 NFRC 180 New IWC 6200 Alum/Low-E Whole House 4 Window 16.0 0.400 NFRC 0.32 NFRC 180 New IWC 6200 Alurnkow-E Whole House 5 Window _ _ 6.0 0.400 NFRC 0.32 NFRC 270 New IWC 6200 Alum/Low-E Whole House 6 Window , 12.0 0.400 NFRC,-, ; ' 0.32 NFRC 270 New IWC 6200 AlumA ow-E Whole House 7 Window 133.4 0.400 NFRC 0.32 NFRC 270 New IWC 6200 Alurnkow-E Whole House 8 Window 33.4 '-'0.400 NFRC 0.32 NFRC -1 0 New IWC 6200 Alumkow-E Whole House 9 Window 16.0 10.400 NFRC 0.32 NFRC 0 New IWC 6200 Alum/Low-E Whole House 10 Window A 120.0 , 0.400 NFRC 0.32 NFRC 0 New IWC 6200A1um/Lou-E Whole House' (1) U -Factor Type: 116-A = Default Table from Standards, NFRC = labeled Value 2 SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value EXTERIOR SHADING DETAILS ID Exterior Shade Type SHGC Window H t T Wit Ove hang Left Fin Len Hat LExt RExt Dist Len I Right Fin Hat Dist Len Hqt 1 Bug Screen 0.76 6.8 6.0 10.0 0.1 10.0 10.0 2 Bug Screen 0.76 4.0 4.0 2.0 0.1 2.0 2.0 3 Bug Screen 0.76 1.5 3.0 2.0 0.1 2.0 2.0 4 Bug Screen 0.76 4.0 4.0 2.0 0.1 2.0 2.0 5 Bug Screen 0.76 3.0 2.0 2.0 0.1 2.0 2.0 6 Bug Screen 0.76 2.0 6.0 2.0 0.1 2.0 2.0 7 Bug Screen 0.76 6.8 5.0 2.0 0.1 2.0 2.0 8 Bug Screen 0.76 6.8 5.0 2.0 0.1 2.0 2.0 9 Bug Screen 0.76 4.0 4.0 2.0 0.1 2.0 2.0 10 Bug Screen 0.76 4.0 5.0 2.0 0.1 2.0 2.0 EnergyPro 5.1 by EnergySoft User Number. 2655 RunCode: 2013-01-17T78:35:21 /D: Page 4 of 5 Reg: 213-N0003613A-000000000-0000 Registration Date/Time: 2013/01/17 21:38:39 HERS Provider: Ca10ERTS, Inc Electronically Filed by Joan D. Hacker and Authenticated at CalCERTS.com - 1/17/2013 Electronically Signed at Ca10ERTS.com by Gabriel Rios (Rios Designs) 1/18/2013 CERTIFICATE OF COMPLIANCE: Residential Part 5 of 5 CF -1 R Project Name Knall Residence Building Type ® Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date 1111712013 BUILDING ZONE INFORMATION System Name Zone Name Floor Area New Existing Altered Removed Volume Year Built Whole House Whole House 1,860 14,880 Totals 1,860 0 0 0 HVAC SYSTEMS System Name Qty. Heating Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status Whole House 1 Split Heat Pump 8.00 HSPF Split Heat Pump 13.0 SEER Setback New ; HVAC DISTRIBUTION I k d i ' `,=— I r , System Name Heating - +I 'Duct Coolin Duct Location R -Value Ducts-' Tested? Status Whole House Ducted Ducted Attic, Ceiling Ins, vented 8.0 ® New 13 WATER HEATING SYSTEMS S stem Name Qty. Type Distribution Rated Input Btuh Tank Cap. al Energy Standby Factor Loss or or RE Pilot Ext. Tank Insul. R- Value Status AO SMITH PEC -050 1 Small Elea All Pipes Ins 15,359 50 0.99 n/a n/a New MULTI -FAMILY WATER HEATING DETAILS HYDRONIC HEATING SYSTEM PIPING Control Hot Water Piping Length a = — System Name Pipe Length_Diameter Pipe Insul. Thick. HP Plenum Outside Buried EnemlyPro 5.1 by Ere User Number. 2655 Runt ode: 2013-01-17718:35:21 ID: Page 5 of 5 Reg: 213-N0003613A-000000000-0000 Registration Date/Time: 2013/01/17 21:38:39 HERS Provider: CalCERTS, Inc o BUILDUP G1 EMERMt MALYSIS REPORT � i PROJECT: i Knall Res pence Lot 2 -Avenida Diaz La Quinta, CA ny-_r_s_ 4n _, NOV, 2 9 2012 BY: Report Prepared by: ',-an D. Hacker Insu-form, Inc. 77810 Las Montanas Road, Suite 201 Palm Desert, Ca 92211 760-345-1352 C>iFf [C -C-1 CITY OF LA QUINT BUILDING & SAFETY DEF APPROVED FOR CONSTRUCTION DAT�"?2BY71E� \2 !333b '@Wq-'"er• A 11/27/2012 i The EnergyPro computer program has been used to perform the calculations summa«ed in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC — www.energysoft.com. EnergyPro 5:1 by EnergySoft User Number. 2655 RunCode: 2012-11-27709:37.53 ID: TABLE OF CONTENTS I Covey Pale 1 Table of Co€ tel ts 2 Form CF -11:2 Cerf flcate of Com, -..l ance 3 Form MF -1 R Mandatory Measurl.,Bs Surr;rnary 8. H\/AC )�sE _ F ! <ea..: E a t Coolling:::.;; LoaU S :.: E .�__ S 11 EnergyPro 5.1 by EnergySoft Job Number: ID: User Number. 2655 PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF-1 R Project Name Knall Residence Building Type 0 Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration 11112712012 Date Project Address Lot 2 - Avenida Diaz La Quinta California Energy Climate Zone CA Climate Zone 15 Total Cond. Floor Area 1,860 Addition n/a # of Stories 1 FIELD INSPECTION ENERGY CHECKLIST El Yes ❑ No HERS Measures -- If Yes, A CF-413 must be provided per Part 2 of 5 of this form. El Yes ❑ No Special Features -- If Yes, see Part 2 of 5 of this form for details. INSULATION Area Special Construction Type Cavity Features see Part 2 of 5 Status Wall Wood Framed R-19 1,033 New Door Opaque Door None 20 New Roof Wood Framed Attic R-38 1,860 Radiant Barrier New Slab Unheated Slab-on-Grade None 1,860 Perim = 153' New FENESTRATION U- Exterior Orientation Area Factor SHGC Overhang Sidefins Shades Status Front (E) 40.0 0.400 0.32 10.0 none Bug Screen New Left (S) 36.5 0.400 0.32 2.0 none Bug Sween New Rear (IM 51.4 0.400 0.32 2.0 none Bug Screen New Right (N) 69.4 0.400 0.32 2.0 none Bug Screen. New HVAC SYSTEMS Q . Heating Min. Eff Cooling Min, Eff Thermostat Status 1 Split Heat Pump 8.00 HSPF Split Heat Pump 13.0 SEER Setback New HVAC DISTRIBUTION Duct Location Beating Cooling Duct Location R-Value Status Whole House Ducted Ducted Attic, Ceiling Ins, vented 8.0 New WATER HEATING Ot . Type Gallons Min. Eff Distribution Status 1 Small Elec. 50 0.99 All Pipes Ins New Ener Pt-o 5. 1 by Ener Soft User Number. 2655 RunCode: 2012-11-27709:37.53 ID: Page 3 of 11 PERF0RahWv";'-9.'f'E CERTWICATE: Residential (Pail 2 of 5 CF-1 R Project Name Knall Residence Building Type 0 Single Family ❑ Addiiion Alone ❑ Multi Family . ❑ Existing+ Addition/Alteration Date 11/27/2012 SPECIAL FEATURES INSPECTION CHECKLIST The enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification tp he Used with the performance approach. The enforcement agency determines the adequacy of the justification, and may reject a building or design that othery ise complies based on the adequacy of the s ecial justification and documentation submitted. HIGH MASS Design - Verify Thermal Mass: 800.0 ftp Exposed Slab Floor, 3.500" thick at Whole House HIGH MASS Design - Verify T,';ermal Mass: 1,060.0 fie Covered Slab Floor, 3.500" thick at Whole House The Roof R-38 Roof Attic includes credit for a Radiant Barrier that is Continuous meeting eligibility and installation criteria as specified in Residential AppendYx 844.2.2. HERS REQUIRED VERIFICATION Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a completed CF-4R forrir, for each of L ie measures lister belovi for final to be given. The Cooling System BDP CO. 661CJ060 includes credit for a 11.5 EER Condenser. A certified HERS rater must field verify the installation of the correct Condeeenser. The HVAC S;ste,^; I ole He ..,, ,..eludes creat for Verified Fan E,^ergy. ,",",e. �d Fan E^e, y� may not cxcced 0.58 :v/cf n. The HVAC System Whole House incorporates HERS Verified Re,Wgerant Charge or a Charge Indicator Display. <C ._._:: 1�ti�!_ ous::-•:-_•'tJ_' Fwd:.. i__..__'':r.;''__..._a_ •,..._,.. rvfl-aj �:� ____.: _:c ___ r'-_J u•_a �'+�.;ii! vcii'v _- vv__r fi fs:!_:f:_u �. _"(: fU! Vdri:i:v C''v '- `�. .,—'1:�t�� ar:::_:. CS :: 1 rcr..� rate.-must - � _ : —_ ...::t .rr:u.. u`! w r v The Htli'v $ ... --_ r:c.c..... System. The HVAC System Whole House incorporates HERS verffe-d Dent Leak---.--. HERS field veri1 ca> on and diagn_st = testis: j is required to verify that duct leakage meets the specified criteria. Ener Pro 5.1 P1 Ener - Soft User Number 2655 RunCode: 2012-11-27T x8:37:53 ID: Page 4 of 11 PERFOR : At4�E CER -T F!C t- E: Residential Pali 3 of 5) CF -1 Project Name Building Type M Single Family ❑ Addition Alone . Date Knall Residence ❑ Multi Family O Existing+ Addition/Alteration 11112712012 ANNUAL ENERGY USE SUMAINIARY _ Standard Proposed ?Margin TDV kBtu/ftz r Space Heating 2.37 2.61 -0.24 Space Cooling 42.49 35.23 7.26 Fans 8.57 8.32 0.25 Dor-nestic Fluff Aater 17.03 24.26 -7.23 Pumps 0.00 0.00 0.00 Totals 70.46 70.42 0.04 PGEGrsvc z -- = Ec='eE 0.1% BUt��?=CQ� � L 9— E�RIaCo� _—LMD Fenestration n(E) -00 deg rlomi %0r:i.aton: Ext. I'Valls/Roof 'Jail Area Area Number of Dwelling Units: 1.00 (E) 320 40 Fuel Available at Site: Natural Gas (S) 290 37 Raised Floor Area: 0 (W) 320 51 Slab on Grade Area: 1,860 (N) 320 69 Average Ceiling Height: 8.0 Roof 1,860 0 Fenestration Average U -Factor: 0.40 TOTAL: 197 Average SHGC: 0.32 Fenestration/CFA Ratio: 10.6% �� /c REMAI iBCS STATEMENT EMENT KF COMI-PLIANCE This c_..ffica:C o -~pflrnce „sts e h_..rJi,:,, ,_.ures and-..e-4fir.-,: ,ng :,ceded to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the Efficiency Standards of the California Code of Regulations. The documentation author hereby certifies that the documentation is accurate and complete. Documentation Author Jr�Ro/nl, Inc. ``i"„pany � 11l27P1012 Address 77810 Las IMontanas Road, Suite 201 Name Joan D. Hacker City/State/ZipCity/State/Zip Palm Desert, Ca 92211 Phone 760-345-1352 Signed Date The individual with overall design responsibility hereby certifies that the proposed building design represented in this set of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit application, and recognizes that compliance using duct design, r.. a ..� 1' It IO a: l s • 1.. L.a:,, a u_a:.. 14 r !_..ar: 1„ r nuc: sealing, verilicauon o: refrigerant charge, insulation insta. 1" on qua+ity, anus uuilu ng envelope Seating require installer testing and certification and field verification by an approved HERS rater. Designer or Owner (per Business & Professions Code) Company Address Name Ci /C,at22ip . Phone 'Signed I°canse # Date Ene. ,.Rc 5.1 by Ena mfoft User Nw rter 2655 Ru^Cock: 2212=11.27T09:37:&? ID: Paw 5 of 11 CEV t WICATE OF COQ PLIANK-WE: Residential fart 4 of 5 CF -1 R Project Name Knall Residence Building Type 10 Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date 1OT 2012 OPAQUE SURFACE DETAILS Surface U- Insulation Joint Appendix Type Area Factor Cavity Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments Wali 260 0.074 R-19 90 90 New 4.3.1-A5 Whole house Door 20 0.500 None 90 90 New 4.5.1-A4 Whole House Wall 254 0.074 R-19 180 90 New 4.3.1-A5 Whole House Wall 269 0.074 R-19 270 90 New 4.3.1-A5 Whole House Wall 251 0.074 R-19 0 90 New 4.3.1-A5 Whole House Roof 1,860 0.025 R-38 90 0 New 4.2.1-A21 Whole House Slab 800 0.730 None 0 180 New 4.4.7-A1 Whole House Slat 1,060 0.730 Non-- 0 180 T!e r 4.4.7-A1 W101a f;0us F€iecSTRATION SURFACE DETAILS ID Type Area Ll -Factor' SHGC Azm Status Glazing Type Location/Comments 1 e? edew 40.0 �Win-CR O.s•�n: "1R n -Vew ,'/C e^..^.n n20w -E 2 Window 16.0 0.400 NFRC 0.32 NFRC 180 New IWC 6200 Alum2ow-E Whole House 3 Window 4.5 0.400 NFRC 0.32 NFRC 180 New 101C 6200 Alum/Low-E VMola ; souse 4 Window 16.0 0.400 NFRC 0.32 NFRC 180 New IWC 6200 Alum/Low-E Whole House 5 VVI'ndc r 6.0 0.400 NFRC 0.32 NFRC 270 New IVVC 6200 AlurilLow-E Who?e House 6 Window 12.0 0.400 NFRC 0.32 NFRC 270 New IWC 6200 Alum/Low-E Whole House 7 window 33.4 0.400 NFRC 0.32 NFRC 270 New IWC 6200 Alum✓Low-E Whole House 8 W%n-dow 33.4 0.400 NFRC a.92 NFRC 0 New IWC 6200Rtirr2ow-E Whole House 9 Window 16.0 0.400 NFRC 0.32 NFRC 0 New IWC 6200 Alum/Low-E '01hole House 10 Window 20.0 0.400 NFRC 0.32 NFRC 0 New IWC 6200 Alum/Low-E Whole House (1) U -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value 2 SHGC Type: 116-6 = Default Table from Standards, NFRC = Labeled Value EXTERIOR SHADING DETAILS ID Exterior Shade TyRe SHGC Window H t Wd Ove hang Left Fin Ri ht Fin Len H t I LExt RExt Dist Len H t Dist Len H t 1 Bug Screen 0.76 6.8 6.0 10.0 0.1 10.0 10.0 2 _vy 'C-reen 0.76 4.0 4.0 2.0 0.1 2.0 2.0 3 Bug Screen 0.76 1.5. 3.0-- 2.0 0.1 2.0 2.0 4 Bug Screen 0.76 4.0 4.0 2.0 0.1 2.0 2.0 5 Bug Screen 0.76 3.0 2.0 2.0 0.1 2.0 2.0 6 Bu` Sci-ee;, 0.76 2.0 6.0 2.0 0.1 2.0 2.0 7 Bug Screen 0.76 6.8 5.0 2.0 0.1 2.0 2.0 8 Bug Screen 0.76 6.8 5.0 2.0 0.1 2.0 2.0 9 Bug Screen 0.76 4.0 4.0 2.0 0.1 2.0 2.0 10 Bug Screen 0.76 4.0 5.0 2.0 0.1 2.0 2.0 EnergyPfq 5.1 by EnergySoft User Number.- 2655 RunCode: 2012-11-27T09:37:53 ID: Page 6 of, CERTIRC-RATE L OF COQ c'LIA'WICRE: "Residential- - (Part 5 of 5) CF -1 R Project Name Kna// Residence Building Type ® Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date 111 71209 BUILDING ZONE INFORMATION System Name I Zone Name Floor Area New Existing Altered Removed Volume Year Built Whole House Whole House 1,860 14,880 Totals 1,860 01 01 0 •I�Tr�VC System Name Qty. Heating Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status Whole House 1 Split Heal Pump 8.00 HSPF Split Heat Pump 13.0 SEER Setback New HVAC DISTR;BUTION S yste- 'a:ne Heatiino Duct Coo:i Duct Loc R-Vai;:e Ducts Tes.ed? Status Whole -House Ducted Ducted Attic, Ceiling Ins, vented 8.0 New ❑ WATER HEATING SYSTEMS Systcm Name Q-ty. Type Dirttrib-ution Rated Input 'St,"h Tank Cap. r^al Energy Factor or RE Standby Loss or Piot Ext. Tank Insul. R- `rnlue gtntus AO SMITH PEC -050 1 Small Elec. All Pipes Ins 15,3591 50 0.99 n/a n/a New ` LTF-FA€LY W€€ ER fEATINIG DETAILS HY3=ON 1 HEATWG SYSFEf'i! PIRIMG Control Hot Water Piping Length ft 0 ro a <— System Name Pipe Len th Pipe Diameter Insul. Thick. Qt HP Plenum Outside Buried i ❑ ❑ EnergyPrp 5. 1 by EnergySoft User Number. 2655 RunCode: 2012-11-27709:37:53 ID: Pae 7 of 11 MANDATORY MEASURES iMAc : Residential Pao 1 of 3 LFIP-1 R Project Name Date Knall Residence 11112712012 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 -1 R, CF -1 R -ADD, or CF - 1 R -ALT Form) shall supersede the items marked with an asterisk (`) below. This Mandatory Measures Summary shall be incorporated into tlhc- p---_: . J_ _..-_ ! flh,- - - I-- f - --- - - - - - - - - - -- - -- - - - - - specifications whether they are shown elsewhere in the documents or in this summary. Submit all applicable sections of the MF -1 R Form with plans. Building Envelope Measures: 116(a)l: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. §116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain Coefficient SHGC , and infiltration that meets the requirements of 10-111 (a). 117: Extectar doors and winldaE S are waa-Mer-stripp-ad; all joints and peneirations are cauRed and sealed. 118(a): Insulationspecified 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 r ^c!:.31 �. f is fapo-- fio�i= �the CF -1 R Form. 150 a): Minimum R-19 insulation in wood -frame ceiling orequivalent U -factor. 150(b): Loose fill insulation shall conform with manufacturer's installed design labeled R -Value. *§ 150(d: Mi imam n 1-e: er _n -_ a1ent 1. c__aO- !nf:l,�::. n-131n$:i!a Irl=i ir! `:uO�G-ua"r:L• Y�,.;!! yr � .!r v-:aL! '§150(d): Minimum R-13 insulation in raised wood -frame floor orequivalent U -factor. 150(f): Air retarding wrap is tested, labeled, and installed according to ASTM E1677-95 2000 when specified on the CF -1 R Form. 150 : i'Alandatory Vapor barrier irlstaHed 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. 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)l B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is eel!inned u.i+h a uli+h o '.wCki on —iWa nnp kln Jnr! +ink+_f;";mn An—ar onri nr nnmhuictinn_�irnnn+rnI !�eVlce §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 buildin , are 2rohibited. Space Conditioning, Water Heating and Plumbing System Measures: §110-§113: HVAC equi pill fGnf, water hewiefs, sho:.w:l,3cos, fauces., a.d i;l other rey4:..tad i♦p;,:;..:1>res are certifie-d bly t1he 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 i.solation valve and recirr_.olation long connection rt? uirements 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 and spa heaters. 1 50(h,): huu:!.! and'!--.: �: wo;i! !v ;oa:iG ar r; ::u;•..la! �u In u , SMV 150(i): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c). §1500)1 A: Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped l.d+h incl.lo+inn 1+o..ing on inc+ollerl +kerm�l retic+ohne of D_17 nr groat §1500)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. pr'•ui;z: Firs; 5 1r •'! r.! e, ,.1. nrn ..!.:e: recirculatinq sections of hot water pipes are insulated per Standards Table 150-B. §1500)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. V I50uf2. ! !l,iLin su 1, u':IUn for sto4m !!ydrJl!!li h-oal ong Sy$telil$ or !iUl :IQI>rl :aysit;m$ 7 iv psl, 17;L'tit$ the rCq_lrl;!!ltr!lJ QI Stan Ltlyd$ Table 123-A. 1500)3A: Insulation is protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. FnM'!A. 1_-..1-.:.... [-_�i�.�_. -_J -_[..:__-..... -..-.: _.._ 1; -!Jit !J clLi it -i :..-I..J-� - - �- �_J�_. - _ .__I-�-J _. .._l.. :- conditioned space. 150(j)4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation. EnergyPro 5.1 by EnergySoR User,'Jumber. 2655 RunCode: 2012-11-27T09:37:53 ID: Page 8 of 11 MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF -1 R Project Name Date Kna►1 Residence 111/27/2012 §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 181 A, or UL 181 B 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 §150(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 sea! -?s of duct systema and their corn„nems shall not be sealed' with cloth back. rubber adhesive duct tapas unless such tape is used in combination with mastic and draw bands. 150(m)7: Exhaust fans stems have back draft or automatic dampers. §150(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. §150(m)9: Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. 150 m 10: Flexible ducts cannot have porous inner cores. §150(0): All dwe!ling units shall meet the requirements of ANSVASHRAE 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 re-uired in Section 4 of that Standard. Pool and Spa He ifing Systems and Equipment Measures: §114(a): Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency Regola-€ ff sv_:r E mn . �_.� o�lts d= ^` the beef= ; a erm ,- ' _atr _ -,f ni_Sc d ,;,itr: ^. e¢�;,: ' c<rI1 1 ons• : .'^nr , an. on -o.. ... n!!n!n. a _. p a: ent . ... : .r plate „r car .. opa: a!'nn. net .i , and shall not use electric resistance heating ora pilot light. §114(b)1: Any pool or spa heat!ny equip.-nent 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 ors as 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. 150` `: Residential pool s yjterl'is or equipment meat the; pulllp sizing, flfivi late, pi in ,filters, and Valve iCiiir6,ilcili5 of §1500`p). Residential Lighting Measures: §150(k)1: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies -nn nined in Table 150-C andis not a low _fficac Erin.-aire as =-adified by 1550(k)2. §150(k)3: The wattage of permanently installed luminaires shall be determined asspecified 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 installer night ilghis and night ligihis intelgrai to a permanently installer lurfl!inairp or exhaus-1 farri, sha!i centain 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 re uirements of §150(k)7. §150(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. i C 1. 11• L I s til I a .. a1 s n 0 is F.. I' in It .• , EXCtt�T1Ui�: Up to .,� �6a[:= Gr ��vel?Iny uni � lec1v if FCc?? �i equ^: lSi G,500 ff<or 10u vrat:� ,Vr a«�ellilg win !aFgGt a len 2,50u fi2 ma;• by exempt from the 50% high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant sensor, dimmer, energy management system (EMCS), or a multi -scene programmable control system; and all permanently installed Inminariaa in narogac lallnrini rnnmc He%catc nraatar than 7n cmiara feat nnri Utility rnnmc era high Pffinn v and cont "ad by g .........-...-r ... �M.-,--, ........-.I _.. .....�,-.....�... �.__. ...-... . - .. ,, -. _.� .e-_, -..._ ........��..... .-.- ...�..-...�-.��.._ --. ... �. ,Manua! -on Accu ant sensor. §150(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. EnergyPro 5.1 by EnergySoft User Number: 2655 RunCode: 2012-11-27T09:37:53 ID: Page 9 of 11 MANDATORY MEASURES SUMMARY: Residential Page 3 of 3 MF-1 R Project Name Date Knall Residence 11112712012 §150(k)10: Permanently installed luminaires in bathrooms, attached and detached garages, laundry rooms, closets and utility rooms shall be high efficacy. 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 occupancy sensor. §150(k)l 1: 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 complieswith 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)l2: Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or other nationally recognized testing/rating laboratory; and have a label that certifies the lumiunaire is airtight with air ,;: dkaye less then 2.0 CFM at 75'ar-rik when tested in ac^ nclancewith 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 Cff'o y. EXCEP T I^vr� 1: Permianently installed outdoor iutir 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 dock; OR an energy management control system (EMCS) not having an override or bypass switch that allows the lurninaire to be always on EXCEP i iON 2: Outdoor luminaires used to comply with Exceptionl to §150(k)l3 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 swimr,,ing nnnl water features, Or Other location guhiart to Article 680 of the Califnrnia FIaM►in Godo need not ._...___ -. _ J-__ ___.._. 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). - :.::::: 3:J. _;::•:::::::_ ": �:::" ::::-. -.... ;:,- .. -:.;:i :. ---_. :. , .,.�,c-_..._._ .. , :.._ ... v. -..::i :.._ „gable requirements in Sections 130, 132, 134, and 147. Lighting for parking garages for 8 or more vehicles shall comply with the applicable requirements of Sections 130, 131, 134 and 146. §150(k)16: Permanently installed lighting in the enclosed, non-dwelling spaces of low-rise residential buildings with four or more . w_.... ...:di ;:.a budii --- -:; e-- :__ 'd � - - _ .,.,...� y .. �..�:.� .. ..... l=E i : i'irifii `-...: iii i. -. ..:.:: .. ....... .:y:.,. .... ... ,...,........ ...... N. .. that the are controlled by an occupant sensors certified to comply with the applicable requirements of 119. EnergyPro 5.1 by EnergySoft User Number. 2655 RunCode: 2012-11-27T09:37:53 ID: Page 10 of 11 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name Knall Residence Date 11/27/2012 System Name Whole House Floor Area 1,860 ENGINEERING CHECKS SYSTEM LOAD Number of Systems 1 COIL COOLING PEAK CFM Sensible Total Room Loads 640 15,378 Return Vented Lighting o Return Air Ducts 888 Return Fan o Ventilation 0 0 Supply Fan 0 Supply Air Ducts 888 TOTAL SYSTEM LOAD 1 17,153 COIL HTG. Latent CFM 1,961 509 0 0 1,961 PEAK Heating System Sensible Output per System 56.000 18,771 Total Output Btuh 58,000 Output BWh/ 31.2 718 Cooling System 0 Output per S em 56,000 0 Total Output Btuh 56,000 0 Total output ons 4.7 718 Total Output Btuh/ 30.1 Total Output s ft/Ton 398.6 20,206 Air System CFM per System 2.000 HVAC EQUIPMENT SELECTION Aldlow cfm 2,000 BDP CO.661CJ060 42,249 5,721 36,225 Alrllow (cfm/ft 1.08 10.0 kW Supplemental Electric Total Adjusted System Output 1 42,249 (Adjusted for Peak Design conditions) TIME OF SYSTEM PEAK 34,130 5,721 1 70,355 Aug 3 PM I F Jan 1 AM Airflow cfm/Ton 428.6 Outside Air (%) 0.0% Outside Air cfm/ 0.00 Note: values above given at ARI conditions .HEATING SYSTEM PSYCHROMETRICS Airstream Tem ratures at Time of Heatin Peak 26 OF 70 OF o Outside Air 0 cfm Supply Fan 2,000 cfm 70 OF 70 OF 105 OF 105 OF -, I _H I I 13 Heating Coil Aux. Heat Coil 105 OF ROOM 70 OF COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak 112/78°F 78/63°F 78/63°F 55/54°F — - Outside Air c 0 cfm Supply Fan Cooling Coil 2,000 cfm 42.2% 78/63°F riA 55 / 54 OF � ROOM 0 78/63°F &wr%*'w 5.1 by EmWSoft User Number. 2655 RunCode: 2012-11-27T09:37:53 /D: Page 11 of 11 i t . rt una®rwriiern333 MngsbM Road llf »!nok Division Lboralories Ince NortbmoK ,LL-20%USA j wwwAicorn 1 t& 1 647 272 880(1 twr 1847 272 8129 Customer wNlca 1677 854 3677 I Pile MH30042 Vol 1 Issued 2005-03-10 Revised FOLLOW-UP SERVICE PROCEDURE 1 (ZIPS .L) SOLID FUJ?L-BURN CAU' LIANCS ACCESSORI CI QTY O F' A Q U i fVTA Manufacturer- AMERICAN t�IIMNEY sFmouD INC BUILDING & SAFETY DEPT. (127145-001) 26401 VIA DBL AM APPROVED sAN sw►N CAPrsTRallo CA 9267s FOR CONSTRUCTION Applicant: SAME AS MANUFACTURER (127145-001) 11 l BY Classified Company: SAME AS MANUFACTURER l �cr � (127145-001) L 0 This Procedure authorizes the above Manufacturer to use the marking specified by Underwriters Laboratories Inc. only on products covered by this Procedure, in accordance with the applicable Follow-Up Service Agreement. j The prescribed Marklor Marking sball•be used only at; the above manufacturing location on such products which comply with this Procedure and any other applicable requirements. ' The Procedure contains information for the use of the above named Manufacturer and representatives of Uaderwriters•Laboratories Inc. and is not to be used for any other purpose. It is lent to the Manufacturer with the understanding that it is not to be copied, either wholly or in part, and that it will be returned to Underwriters Laboratories Inc..4on request. This PROCEDURE, and any subsequent revisions, is the property of UNDERWRITERS LABORATORIES INC. and is not transferable. UMDERWRITSRS LABORATORIES INC. t A.W. Schaefer fSr. Vice President Global services and Administration I i i An independent organization working for a safer world with Integrity, preclsion and knowledge. i AUTHORIZATION TO MARK This authorizes the application of the Certification Mark(s) shown below to the Product covered describe below herein when made in accordance with the authorized Listing Report, including Manufacturing/Machining Specifications, and under conditions set forth In the Certification Agreement and Listing Report, including Manufacturing/Machining specifications. This authorization also applies to the Multiple Listee model(s) identified on the correlation page of the Listing Report. Applicant Industrial Chimney Company (ICC) 400, J.F. Kdnnedy St -Jerome; QC J7Y 4137 Contact: Name: Andre Bibaud Phone: (450) 565-6336 Manufacturer: American Chimney Shroud 26401 Via de Anza San Juan Capistrano, CA 92675 Party Authorized Same as. Manufacturer To Apply Mark: Report Issuing Office: Intertek ETL Semko, 1829, 32"d Avenue, Lachine, Quebec Canada H8T3J1 Report No.: 3091753 Product Covered: Custom Shroud, Model RIS -COMPONENT Description: Decorative shroud surrounding the standard termination cap. Standard(s): UL 103 - 08/23/2001 Factory -Built Chimneys for Residential Type and Building Heating Appliances -Tenth Edition; Reprinted with Revisions Through and Including December 9,2005 This document is the property of Intertek Testing Services and is not transferable. Only the Applicant may reproduce this document. The certification mark(s) may be applied only at the above noted location of the Party Authorized to Apply Mark(s). This document supe edes all previous Authorizations to Marie for the noted Report number. Authorized by. �\R�s Date: ")S�N Bob Davison, Certification Manager, Toronto Center Intertek Testing Services NA Inc. 3210 American Drive, Mississauga, ON L4V 1 B3 Canada Phone 905-678-7820 Fax 905-678-7131 W 16.3.106(9/10/62) CI'T'Y C-'"' = '�, 1i !�` FOS )WCTT QN DA M 5 IS--1, EnduraRock. EnduraRock' Roofing System Premier Roofing System An EnduraRock- Roofing System can solve your leaking, flat roof problems and save you thousands of dollars a year in maintenance and energy costs. This proven roofing system incorporates high compressive strength, seamless spray -in-place rigid polyurethane foam with a thick layer of protective gravel. Your investment in a low cost, trouble-free EnduraRock'" roof will return your dividends in savings and comfort for years to come. Seamless And Self -Adhering Because our advanced polyurethane spray foam is self -flashing and sprayed in place, there are no seams, channels, complex flashings or overlapping edges for water to seep through. Rugged Compressive Strength Rigid polyurethane exhibits superior high compressive strength and, when combined with the protective gravel layer, provides excellent resistance to inclement weather and mechanical damage. Weather Resistant The unique combination of foam and gravel provides the best possible protection from the elements. EnduraRock" Roofing System evenly disperses precipitation and ice in the winter and enhances evaporation in the summer. Energy Efficient Spray polyurethane foam is specially formulated with closed cells, which makes it one of the best insulating materials on the market today. This translates into drastically reduced energy costs for you. Our spray polyurethane foam is so efficient, it has been used by NASA to insulate the external fuel tanks on the space shuttles. Improved Drainage Because the spray polyurethane foam is sprayed in place, it can be tapered to improve water drainage on an existing roof. This eliminates the detrimental effects of standing water. UL Approved EnduraRock' passes the class A fire test in accordance with Underwriters Laboratories test standard UL 790. Breathable EnduraRock is part of the EnduraTech Premier Roofing Systems While the closed cell structure of spray polyurethane foam is impervious to liquid water, water vapor can diffuse Endura�tchn through the foam. Premier Roofing Systems .. •!� ..p .._:t e.. y •....40. M 5 IS--1, EnduraRock. EnduraRock' Roofing System Premier Roofing System An EnduraRock- Roofing System can solve your leaking, flat roof problems and save you thousands of dollars a year in maintenance and energy costs. This proven roofing system incorporates high compressive strength, seamless spray -in-place rigid polyurethane foam with a thick layer of protective gravel. Your investment in a low cost, trouble-free EnduraRock'" roof will return your dividends in savings and comfort for years to come. Seamless And Self -Adhering Because our advanced polyurethane spray foam is self -flashing and sprayed in place, there are no seams, channels, complex flashings or overlapping edges for water to seep through. Rugged Compressive Strength Rigid polyurethane exhibits superior high compressive strength and, when combined with the protective gravel layer, provides excellent resistance to inclement weather and mechanical damage. Weather Resistant The unique combination of foam and gravel provides the best possible protection from the elements. EnduraRock" Roofing System evenly disperses precipitation and ice in the winter and enhances evaporation in the summer. Energy Efficient Spray polyurethane foam is specially formulated with closed cells, which makes it one of the best insulating materials on the market today. This translates into drastically reduced energy costs for you. Our spray polyurethane foam is so efficient, it has been used by NASA to insulate the external fuel tanks on the space shuttles. Improved Drainage Because the spray polyurethane foam is sprayed in place, it can be tapered to improve water drainage on an existing roof. This eliminates the detrimental effects of standing water. UL Approved EnduraRock' passes the class A fire test in accordance with Underwriters Laboratories test standard UL 790. Breathable EnduraRock is part of the EnduraTech Premier Roofing Systems While the closed cell structure of spray polyurethane foam is impervious to liquid water, water vapor can diffuse Endura�tchn through the foam. Premier Roofing Systems I i� The Unmatched EnduraRock' Process The EnduraRock' System offers premium, top quality components that have demonstrated exceptional, extended performance. EnduraRock_ Premier Roofing System Sidewall Coat Foam Termination Line Gravel Layer Polyurethane h Foam { IExisting or New Roof Every roofing project is different, so we customize our roofing systems to meet and exceed your specifications and expectations. With on-site specially trained, qualified Tier One Applicators, you can be assured every step in the process will be performed with excellent proficiency delivering an unmatched, premier roofing system. EnduraRock" provides flexible, long lasting protection even in the most adverse conditions for flat roofs. This comprehensive roofing system provides a superior roof for new construction as well as existing structures, as the application process addresses each weakness in the existing roof and is ideal for any application over prefabricated metal roof panels. The EnduraRock' process involves four distinct steps: Prepare Surface—All surfaces are cleaned and debris is removed including loose dirt, chalking and rust Primers may be required depending on the condition of the roof. Apply Foam— With a seamless, water -tight application, advanced closed cell spray polyurethane foam is applied. This layer keeps the elements from your roof while providing a flexible fit able to expand and contract with variable temperatures and weather conditions. Apply Acrylic Coating —An extremely flexible elastomeric coating is applied around detail areas, vertical surfaces and penetrations. Apply Gravel — Finally, gravel is applied to completely cover the flat areas of the roof to achieve a thickness of 3/ to 1 inch protects the roofing system from adverse weather and evenly disperses precipitation. Once installed, the EnduraRock7 Premier Roofing System is a seamless, energy efficient, economical and weather resistant solution for years to come. '=R.uY S;dR PnmNER NCFI Polyurethanes Div. of Barnhardt Mfg. Co. P.O. Box 1528 Mount Airy, NC 27030 Spray Equipment and Parts ordering hotline: 866.812.7320 Fax: 336.789.9586 Email: moreinfo@ncfi.net A I. EnduraRock is partof the EnduraTech Premier Roofing Systems EnduraTech. Premier Roofing Systems P O L Y U R E T H A N E S A whole new comfort level, for you and for the world. 800.346.8229 • NCFl.com .o L ENNOXry HEARTH PRODUCTS INSTALLATION AND OPERATION INSTRUCTIONS qL- aTM EPA Wood -Burning Fireplace GAVE LENNOX P%N 506023-03 REV: C'05/2010 COLLECTION MODELS [Lade a BKS Ladera-BN This installation manual will enable you to obtain a safe, efficient and dependable installation of your fireplace system. Please read and understand these instructions before beginning your installation. Do not alter or modifythe fireplace or its components under any circum- stances. Any modification or a Iteration of the f irep lace system, including but not limited to the fireplace, chimney components and accessories, may void the warranty, listings and approvals of this system and could result in an unsafe and potentially dangerous installation. Lennox Hearth Products wood -burning fireplaces are designed for use as a supplemental heater. They are not intended for continuous use as a primary heat source. DA ; \e7" FOR THESE INSTRUCTIONS FOR FUTURE REFERENCE `Nt ER rF/r )us' �flC U e"1ock NO'gm� I Listed to standards: ULC -S610 and UL -127 Report # 3151759 NATIONAL We recommend that our woodburning INSTIITT'UTE* hearth products be installed and serviced hiby professionals who are certified in the U.S. by the National Fireplace Institute® (NFI) as NFI Woodburning Specialists or who are certified in Canada by D CERTIFIED Wood Energy Technical Wood Energy „Mnficer1ieedore Training (WETT). recnnscnrruinrng I PILADERA REV.3 05/2010 CONGRATULATIONS! When you purchased your new fireplace, you joined the ranks of thousands of individuals whose answerto their home heating needs reflects their concern for aesthetics, efficiency and our environment. We extend our continued supportto help you achieve the maximum benefit and enjoyment available from your new fireplace. Thank you for selecting a Lennox Hearth Products fireplace as the answer to your home supplemental heating needs. TABLE OF CONTENTS Safety Rules......................................Page 2 Locating the Name Plate ...................Page 2 Introduction......................................Page 3 Parts Required .................................Page 3 Optional Equipment ...........................Page 3 Operating The Ladera Fireplace ......... Page 3 Fuel...................................................Page 3 Starting And Maintaining A Fire ........Page 4 Combustion Control .........................Page 4 Refueling For Best Performance ... _..Page 4 Smoking — Causes And Troubleshooting..............................Page 4 Important Cautions ...........................Page 5 Maintaining Your Ladera Fireplace .........................Page 5 Creosote............................................Page 5 Chimney Maintenance .......................Page 5 Dealing With A Chimney Fire.............Page 5 Top Baffle Removal ...........................Page 5 Finish Door Casing Care....................Page 5 Disposing of Ashes ...........................Page 6 Refractory Installation .......................Page 6 Door Removal...................................Page 6 Door Adjustment...............................Page 6 Glass Care - Replacement .................Page 7 Glass Care - Cleaning ........................Page 7 Gasket Replacement ........................Page 7 Fireplace Installation ........................Page 7 Locating The Ladera Fireplace ........... Page 7 Optional Cast Facade Installation ...... Page 8 Hearth Extension Requirements .......Page 8 Framing, Facing And Mantel..............Page 9 Fireplace Blower................................Page 11 Hot Air Ducting Installation ..............Page 11 Gravity Kit ......................................... Page 11 Central Forced Air Kit............................Page 12 Outside Air Kit ..................................Page 13 Chimney System...............................Page 14 Chimney Installation Notes...............Page 14 Chimney Installation Instructions ...... Page 15 Offset Chimney Installation...............Page 16 Angled Wall Radiation Shield ............ Page 19 Chimney Support Installation ............ Page 19 Chimney Chase And Multiple Terminations ......................Page 19 Masonry Application Instructions ..... Page 20 Installation Accessories ....................Page 21 Chimney Components Lists..............Page 21 Replacement Parts............................Page 23 Product Reference Information ......... Page 24 THE FIREPLACE INTRODUCTION The Ladera wood -burning fireplace isan energy efficient, heat circulating, closed combustion fireplace. You will receive a lifetime of comfort and enjoyment from your fireplace provided itis installed, maintained and operated properly. • Please read these instructions and retain this manual for future reference. • Before beginning the fireplace installation, consult the local authorities to obtain your building permit and check your local building codes. Install the fireplace only as described in these instructions and using only Lennox Hearth -Products components.- __ i--- • This fireplace has been tested for CAN/ULC S610 -M87 and ANSI/UL 127 under report( number 3151759. It has also been tested for EPA 40 C.F.R Part 60, section 60.532(b),_ L Certificate number 706. • The Ladera fireplace is NOT intended for use with aaas log set. Do not useafireplace insert orany other product with this fireplace unless it is specified by Lennox Hearth Products for use with this appliance. Failure to follow these instructions will void the certification and the warranty of the fireplace and may result in an unsafe installation. • These appliances are designed to provide supplemental heat to the immediate area only. Therefore, it is advisable to have an alternate heat source when installed in a dwelling. • These appliances are NOT approved for Manufactured Home installations. PARTS REQUIRED Fireplace Model Ladera • 6" diameter chimney - Model ASHT+, S-2100+, HT6000+, HT6103+ or AC manu- factured by Security Chimneys International only. OR • 7" diameter chimney - Model ASHT and HT6103 manufactured by Security Chimneys International only. 6" and 7" Chimneys Includes: - Chimney lengths - Elbows (where necessary) - Associated components as per these installation instructions • Decorative Door (included in the fireplace) • UZY6 blower (Included w/Fireplace) OPTIONAL EQUIPMENT Order Separately - See Pages 21 and 22 Additional Equipment (optional) - AC Chimney Starter Section and AC Chimney - Outside Air Kit (required if using AC Chimney) - Chimney Adaptor 7 inch (6AW7) (If you choose to use 7 inch ASHT or HT6103 chimney) - Gravity Venting System - Rigid Firescreen - Forced Air Kit O - Cast Facade Kit - Blower Speed Control (VRUW) - Blower Thermodisc Heat Switch Control (VTU) - Outside air kit O Not tested under EPA certification. If in- stalled, this appliance no longer qualifies for EPA certification. OPERATING THE LADERA FIREPLACE Fuel USE SOLID NATURAL WOOD FUEL ONLY. The Ladera fireplace is designed to work best when fueled with dry seasoned natural wood only. Hardwoods are preferred to softwoods since the energy content of wood is relative to its density. Hardwoods will result in a longer burning fire and less frequent refueling. A moisture content of 15% to 20% (seasoned) is recommended. Wood that has been cut and split and let to dry under a cover for a period of one year will usually meet that criteria. The required drying time will vary depending on the climate. Wood that is packed tight together will take longer to dry. Seasoned wood is darker in colorthan wetwood and will have visible cracks in the grain on the ends. Excessively wet wood will be difficult to burn and will result in lower efficiency, increased creosoting and deposits on the glass and in the chimney. Excessively dry wood will burn well but will also have higher emissions and shorter burning time. Do not burn scrap or garbage, treated wood or wood such as driftwood from the ocean which has been exposed to salt or other chemicals. Salt or chemicals can corrode the firebox and chimney. Do not burn large amounts of paper, cardboard, Christmastree branches or building construction materials. Intense firing with these materials may overheat the fireplace, causing damage to the unit, afire or even possibly ignit- ing a chimney fire if the chimney is creosoted. Burning unapproved fuel, resulting in excessive pollutants being emitted, maybe prohibited and subjectto a fine or other penalty by the authority having jurisdiction in your area. Processed firelogs can be used. Use only fire- logsthat have been evaluated forthe application of fireplace and refer to firelog warnings and caution markings on packaging prior to use. ,EPA Wood Burning Fireplaces-, Specifications Cat.# Model Description H7162 'Laden -BK laderaEPA Wood Burning Fireplace H7230 Ladera-BN Ladera EPA Wood- Buming F/P Br Nickel PRODUCT REFERENCE INFORMATION Weight 215 lbs Height 37-5/8 Width 32-3/4" Depth 22-12" Firebox W x H x D 19-12" x 13 - measured In front 1/4" x 12" Chimney Weight ASHT 0 6" 6.251bM. Chimney Weight AC 0 6" 3.25lb/ft. Chimney Weight S-2100+0 6" 10.81bM FRAMING DIMENSIONS A 35-7/8 911 mm B 37-5/8" 956 mm C 29-1/8" 740 mm D 12-12" 318 mm E 70" 1778 mm F 35" 889 mm G •22" 559 mm J 49-12" 1257 mm K 8" 203 mm LaderaTM Back Wall of Chase/Enclosure OUTSIDE CHASE Including Finishing Materials, It any i'I C IN • zero Clear, From Back to Spacerto l i — ,O H � Q Total depth I 12 Inches(57 Including the spacer minu Inch (13mm drywall to be with the tacin 10.15n6" (278 mm) Rough Face (Unfinished Shown) P/N 505035.09 REV. NC 072008 37.518" (956 mm) 22414" (565 mm) 31-11/16" (805 mm) 6-m6• (154 mm) 20-1/2"(521 mm) —I 22.7/16" (570 mm) 25-1/16" (637 mm) LENNOX ry HEARTH PRODUCTS OAVE LENNOX COLLECTION Corner Installation /\ Combustible materials can NOT be used In the space directly above the fireplace. Donal fill the space above the fireplace with airy material (Except the \ wood training) 6'8" (2M) Min. 8 2" If 3" Min. Rough Framing Face (dimension Include finish material Inside framing, If any) Optional Combustion Air Kit K Notes Due to Lennox Hearth Products ongoing commitment to quality, all specifications, ratings and dimensions are subject to change without notice. All framing dimensions calcula led for W dry wall at the fireplaceface. Ifsheathingthechaseorfinlshing wlthother thlcNness materials, calculations will need to be made. • The fireplace must not be In contact with any Insulation or loose filling material. Co ver the Insulation with Drywall panels around the fireplace. `*IFJtTAzt �. Listed to standards: ULC -S610 & UL -127 C(! r .+ US o dock 146' Page 1 of 2 LaderaTM EPA Wood Burning Fireplaces DAVE LENNOX Specifications COLLECTION Rain Cap Roof Support Storm Collar HE Flashing Collar Attic Radiation! Flashing Flashing Shield Floor, Roof Support Ceiling& `^ Attic Radiation Shield wan 6-1/2" Min. Q (165mm) to ceiling Q Must have the same H firestopping resistance Flrestop as adjacent wall. Must have the same insu- Q 68" Min. lation as adjacent ceiling. •� ® } (1727mm) Flrestop Follow local rules regard - >Z I ing framing construction. 39" MIn. 6' 8" (990mm) (2 m) on -Combustible 7 Min. Facing (2.1 m) Min. a QDrywall or Any Rigid Material OCombuslibles are not allowed be low top spacers above the fireplace. o ® Facing In front of fireplace must be 1/2" Plywood 2" x 4" non-combustible below this area. CLEARANCE TO COMBUSTIBLES The following clearances meet the minimum requirements for a safe installation; Q Area where wood mantel Q Side wall: 17" (324 mm) measured from the fireplace Zi can be Installed side Ceiling: 6' 8" (2,032 mm) measured from the base of the fireplace Fireplace enclosure: Bottom: 0" Side: 0" to spacer ac 39" Back: 0" to spacer ( 990mm ) V Top: Do not fill the space above the fireplace +'. Min. 45 Deg. 17" Mtn. with any material (Except the wood Q Hearth 4" \ r(432mm) framing - See Page 9, Figure 8 in the QJ Extension (102mm 7� Installation and Operation Manual) _ 18 32-3/4" (457mm) �/ \� (832mm) Chimney: 2" (50mm) Min. Min. Mantel: 39" (990mm) measured from the base of Non -Combustible Material the fireplace. Printed in U.S.A. © 2008 by Lennox Hearth Products LENNOX P/N 505035.09 REV. NC 072008 Page 2of2 HEARTH PRODUCTS `54-2,7-7 AvcN ► �A ��Z CITY OF LA QUINTA'SUB-CONTRACTOR LIST JOB ADDRESS PERMIT NUMBER OWNER (:,H?Abl) 4N I,,AL-L- BUILDER. OW»E-P— This form shall be posted'on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. Trade Classification'Contractor,,::; Tra /:.::.....::. :;< ....:.....:.. . .::.<::::::::`;.::<;:: State..Contractor s Lncense . >:`. .:.:aura ...:: ::. ` Workers Com erisatiorian nce:°`:<^: .' >:: ,:'::::.. p. Cit . Business L'r�ense';<..:. y Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12). ;;. CA L-1. -2)u I L-6 is S 1 t1VS 201 1 job 1't�-t0 f I 3 C.ONCRETE(C.8)': C/�U -'QUI L(� j� -C,� ��51LJ Sf / 1%C_' Ir1S 01 3 ICS�j�tO 1 31 I FRAMING ;IC -51 ;.;' /-Ail N ,'TD til i K(c-�j fQgL�fl I �T� �l1 Nle `10 3.7%-12- - I� 1% (3 37Z -Lt �( STRUCT::STEEL (G-51) — MASONRY (C-29) /l/ N A � �I�SoN ^ l r l�"Z°I p DO� �(o1�J. Z;Z$ MAi�K- 1 INS, I" WC10071��801 �0 6�g5 $ I PLUMBING IC -361 C7�r1-V i� 1�i ✓ C-' �O 151 5 g _f S 1�-� w N %, 10 9 O 0� -2-0(2- 0 O) l 3 i. % I I 1 LATH; PLASTER (C735) 0 W N DRYWALL (C-9) ..:..: U W N le HVAC. IC -20)'":::.:' e_S Ckto kC' L C- 24 `16S 1 I o ELECTRICAL. (C=10) :..... ow IN eZ UVJ SHEET METAL (d43') -:`-.- F IC=:15):. ' :.; ;. 0 W N G-(.!- -(ZGLAZING GLAZING(C-:.17):':: INSULATIOR:W72) �1 ASS CA C.ONTRAC�T(b 2 C 2 (, �3 l� 2,2-1571-7 q 30 13 1 N� E �1 1 T`1 1"S g 2,p 13 I O �I 2J. �1 13 SEWAGE DISP (.-42) 33)'-: PAINTING (C'7. ©vV N 5_ CERAMIC TILE IC -54) OW N EPL. CABINETS IC -6) VU ►1 FENCING (C-13) — LANDSCAPING (C=27)..::• OvU N L POOL (C-53)