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04-5924 (SFD),T P.O. Box 1504 78-495 CALLE-TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760) .777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number . . . J04-00005924 Date 9/08/04 Property Address 54800 AVENIDA-DIAZ APN: 774-291-003-22 -000000- Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . COVE RESIDENTIAL Application valuation . . 103945 Owner Contractor ------------------------ ------------------------ DELIO PAUL G PGD DEVELOPMENT 81715 HIGHWAY 111 STE 302 81715 HIGHWAY 111 INDIO CA 92201 INDIO CA 92201 (760) 218-4160 WCC: STATE FUND WC: 1090912 03/01/05 CSLB: 520268 11/30/05 CCC: B 4 -------------------------- Structure Information --------- --°------------- Construction Type . . . . . TYPE V - NON RATED ��� Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10`y Flood Zone NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION v/ �;�' 200,1 CBC # BEDROOMS v®G�3.00 FIRE SPRINKLERS) GARAGE SQ FTG°���' 484.00 PATIO SQ FTG o�F�� 36.00 NUMBER OF UNITS 1.00 FIRST FLOOR SQ FTG 1643.00 --'-------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 653.50 Plan Check Fee 424.78 Issue Date . . . . Valuation . . . . 103945 Expiration Date 9/08/05 Qty Unit Charge Per Extension BASE FEE 639.50 4.00 3.5000 THOU BLDG 100,001-500,000 14.00 ---------------------------------------------------------------------------- Permit . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 97.19 Plan Check Fee 24.30 Issue Date Valuation . . . . 0 Expiration Date 9/08/05 r� P.O. Box 1504�� VOICE (760) 777-7012 T-Vf 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Oq — Applicant: Applicant's Ma g ����/ Date: c7- /O- D Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commenci with Section 7000) of Division 3 of the Business and Professionals Code, and my License is inorce and effect. r License Class !_G License No. fill!! Date _ / V 1 Contractor DOL;— OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' 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 s da My rkers' ompensation insurance carrier and policy numbej � 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 forthwith comply with those provisions. • Date v Applicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 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 Ouinta, 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 t enter upon thg ab ve-mentioned property for inspection purposes. Date +1H Signature (Applicant or Agent): i� Application Number . . . . . 04-00005924 Page 2 Date 9/08/04 Qty Unit Charge Per Extension BASE FEE 15.00 1643.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 57.51 484.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.68 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 9/08/05 Qty Unit Charge Per Extension BASE FEE 15.00 ---------=------------------------------------------------------------------ Permit . . . . MECHANICAL Additional desc Permit Fee . . . . .52.50 Plan Check Fee 13.13 Issue Date Valuation 0 Expiration Date 9/08/05 Qty Unit Charge Per Extension 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 2.00 6.5000 EA MECH VENT FAN 13.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ----------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 123.00 Plan Check Fee 30.75 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/08/05 Qty Unit Charge Per - Extension BASE FEE 15.00 .9.00 6.0000 EA PLB FIXTURE 54.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 Application Number . 04-00005924 Page 3 Date 9/08/04 Qty Unit Charge Per Extension 6.00 .7500'EA PLB GAS PIPE >=5 4.50 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 1643 S.F. SFD PERMIT DOES NOT INCLUDE BLOCK WALL, POOL/SPA OR DRIVEWAY APPROACH ---------------------------------------------------------------------------- Other Fees . . . ... . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 42.48 DIF FIRE PROTECTION -RES 97.00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 10.39 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Permit Fee Total 941.19 Plan Check Total 492.96 Other Fee Total 2457.87 Grand Total 3892.02 Fj Paid Credited Due ---------- ---------- ---------- ..00 .00 941.19 250.00 .00 242.96 .00 .00 2457.87 250.00 .00 3642.02 Date 9/9/04 No. 26417 Owner Paul Delio Address City La Quinta Zip 92253 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 # Study Area No. of Units i>� sP11%. Q BERMUDA DUNES co) r0 RANCHO MIRAGE d ,,.A WELLS PALM DESERT y LA QUINTA otlz 0O O 774-291-003 La Quinta 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 54800 Avenida Diaz 1643 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments Cert #26416 and 26417 are both on check 319637. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: 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 $2.24 X 1,643 S.F. or $3,680.32 have been paid for the property listed above and that buitding permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By CCNIB-Paul Delio Check No. 319637 Name on the check Telephone Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Vanessa Robles Payment Recd $3,680.32 Over/Under Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will 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 if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting ,,,..,,.....,_ — ...,,,., .._.... I erACE lEOVEThtIe UME FOR RECORDING OIL I� GRANT DEED C ,wi Y ti 1 THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX is $ri2..Q5 4q computed on full value of property conveyed, or L] computed on full value loss value of lions or encumbrances remaining at time of safe. p unincorporated area Xcttyof— La Quinta ,AND FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, JAY G. TRUBBE and JUNE N. TMEE Husband and Wife as Joint Tenants hereby GRANT(s) to PAUL G. DELICL A Single Man as to an undivided b interest and DAHIEN A. DSWO, A Single Han as to an undivided 11 .interest the following descrfbad real property In the city of La Quinta County of Riverside , State of California: 777 Lots 22, 23, and 24 in Block W of Santa C.armelita at vale La Quinta, Unit N25 as per map recorded in Book 14 Page 51 of naps in the office of the County Recorder of said County TRIS IS BEING RE-RECORDED TO CORRECT THE BLOCK NUMBER IN THE LEGAL DESCRIPTION. Dated April 11, tQ,Q_D Je ubee STATc OF CALIFORNIA SS. COUNTYOF Riv rsidr+ 6' e N. Trubee On this 15th day of Aori t in [holeeF._1U& _ !blare me, the undersigned, a Nota Publle In end tot eat State, fictionally appean+d_ Jay G. MI= and June M. Trubee d petioneuy known to me *Ftavod to me on the b"s or satisfactory Guidance to be Un person who" name Is sLtstribad to MI Instrument, end ecknowl- edged to me that he (she of they) executed IL sI�M I � weuo a A* ren 8MM MATI mt% wn at omd.l eoraAu "ao .. � � �. ,. .. .. �. „_ .- .. AMrIY •II.I rI�Gq I+M YMrsv rar Mv: �, k r �_HLTH LAND TITLE Cd. RICOWNtl RVQUU lD BY as "!e 11tn M ellin aw T"Is l"I WWI$ Iteirmll Palms loos Mut IA[ 41MO to n: Paul Dehio ®i jh-9 ou.,1 Add,..& cin s 61715 NNy 111 (p L' auT. Lndio, CA 92201 ' W ,I TAX 77ATENLNTe TO r'� I .� rtswd data" SANE AS ABOVE i Cit/ • L J ,,,..,,.....,_ — ...,,,., .._.... I erACE lEOVEThtIe UME FOR RECORDING OIL I� GRANT DEED C ,wi Y ti 1 THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX is $ri2..Q5 4q computed on full value of property conveyed, or L] computed on full value loss value of lions or encumbrances remaining at time of safe. p unincorporated area Xcttyof— La Quinta ,AND FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, JAY G. TRUBBE and JUNE N. TMEE Husband and Wife as Joint Tenants hereby GRANT(s) to PAUL G. DELICL A Single Man as to an undivided b interest and DAHIEN A. DSWO, A Single Han as to an undivided 11 .interest the following descrfbad real property In the city of La Quinta County of Riverside , State of California: 777 Lots 22, 23, and 24 in Block W of Santa C.armelita at vale La Quinta, Unit N25 as per map recorded in Book 14 Page 51 of naps in the office of the County Recorder of said County TRIS IS BEING RE-RECORDED TO CORRECT THE BLOCK NUMBER IN THE LEGAL DESCRIPTION. Dated April 11, tQ,Q_D Je ubee STATc OF CALIFORNIA SS. COUNTYOF Riv rsidr+ 6' e N. Trubee On this 15th day of Aori t in [holeeF._1U& _ !blare me, the undersigned, a Nota Publle In end tot eat State, fictionally appean+d_ Jay G. MI= and June M. Trubee d petioneuy known to me *Ftavod to me on the b"s or satisfactory Guidance to be Un person who" name Is sLtstribad to MI Instrument, end ecknowl- edged to me that he (she of they) executed IL sI�M I � weuo a A* ren 8MM MATI mt% wn at omd.l eoraAu "ao .. � � �. ,. .. .. �. „_ .- .. AMrIY •II.I rI�Gq I+M YMrsv rar Mv: �, k r M l � Certificate of Occupancy' '�' � IcesrwTm 4 G� OFT�w Building & Safety Department This Certificate is issued pursuant to the requirements of Section. 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS- 54-800 AVENIDA DIAZ Use classification: SFD Building Permit No.- 04-6368 Occupancy. Group: R3 Type of Construction: VN Land Use Zone- RC Owner of Building: PGD Address: 81715 HWY 111 City, ST, ZIP: INDIO CA 92201 By: KIRKLAND ` _ b Date- 10-6-05 Building Official POST IN A CONSPICUOUS PLACE i TITLE 24 REPORT - Title 24 Report for: PGD Development Single Family Residence -All Orientations La Quinta, CA 92253 6�42 a� AAt Project Designer: Stephen R. Nieto 78-120 Calle Estado Ste. 206 La Quinta, CA 92253 760-564-4707 Report Prepared By: Stephen R. Nieto South West Concepts 78120 Calle Estado, Suite 206 La Quinta, CA 92253 (760) 564-4707 Job Number: 00153 CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED Date: FOR CONS UCTION 8/10/2004 DATE48/67 The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2001 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC (415) 883-5900. EnergyPro 3.1 By EnergySoft Job Number: 00153 User Number: 5970 f TABLE OF CONTENTS Cover Page Table of Contents Form CF -1 R Certificate of Compliance Form MF -1 R Mandatory Measures Checklist Form C -2R Computer Method Summary HVAC System Heating and Cooling Loads Summary Room Load Summary 1 2 3 6 8 12 13 EnergyPro 3.1 By Energysoft Job Number: 00153 User Number: 5970 Certificate of Compliance: Residential (Part 1 of 2) CF -1 R PGD Development 8/10/2004 Project Title Date Single Family Residence -All Orientations La Quinta Project Address Building Permit # South West Concepts (760) 564-4707 Plan Check / Date Documentation Author Telephone Computer Performance 15 Field Check / Date Compliance Method (Package or Computer) Climate Zone Enforcement Agency Use Only GENERAL INFORMATION Total Conditioned Floor Area: 1,643 ft2 Average Ceiling Height: 9.5 ft Total Conditioned Slab Area: 1,643 ft2 Building Type: Wood (check one or more) Exterior Roof X❑ Single Family Detached ❑ Addition ❑ Single Family Attached ❑ Existing Building ❑ Multi -Family ❑ Existing Plus Addition Front Orientation: All Four Orientations Floor Construction Type: ® Slab Floor Number of Dwelling Units: 1.00 Number of Stories: 1 ❑ Raised Floor Component Tvpe Const. Frame Assembly Location/Comments Type U -Value (attic, garage, typical, etc.) R-38 Roof (R.38.2x14.16) Wood 0.028 Exterior Roof R-13 Wall w/1" EPS Wood 0.059 Exterior Wall Solid Wood Door Wood 0.387 Exterior Door Slab On Grade n/a 0.756 Covered Slab w/R-0.0 Perimeter Insulation FENESTRATION Shading Devices Type Orientation Area Fenestration Exterior Overhang Side Fins SF U -Factor SHGC Shading Yes / No Yes / No Front 18.0 0.72 0.73 Bug Screen Q ❑ ❑ Q Front 16.5 0.87 0.70 Bug Screen Q ❑ ❑ Q Left 39.0 0.87 0.70 Bug Screen 191 ❑ ❑ a Rear 19.0 0.87 0.70 Bug Screen Q ❑ ❑ Q Rear 40.0 0.85 0.70 Bug Screen Q ❑ ❑ 0 Right 15.0 0.87 0.70 Bug Screen Q ❑ ❑ Q Right 16.6 0.85 0.70 Bug Screen Q ❑ ❑ Q ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ EJ 1:1 ❑❑ El 1-1 El El El ❑❑ Run Initiation Time: 08/10/04 11:30:39 Run Code: 1092162639 Ener Pro 3.1 By Ener Soft User Number: 5970 Job Number: 00153 Pa e:3 of 13 Certificate of Comaliance: Residential (Part 2 of 2) CF -1 R PGD Development 8/10/2004 Project Title Date HVAC SYSTEMS Note: Input Hydronic or Combined Hydronic data under Water Heating Systems, except Design Heating Load. Distribution Heating Equipment Minimum Type and Duct or Type (furnace, heat Efficiency Location Piping Thermostat Location / pump, etc.) (AFUE/HSPF)(ducts, attic, etc.) R -Value Type Comments Central Furnare 92% AFUE Ducts in Attic 4.2 Setback Res HVAC Cooling Equipment Minimum Duct This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with Type (air conditioner, Efficiency heat pump, evap. cooling) (SEER) Location (attic, etc.) Duct R -Value Thermostat Location / Type Comments Split Air Conditioner 12.0 SEER Ducts in Attic 42 Setbark Res HVAr WATER HEATING SYSTEMS Water Heater Water Heater System Name Type Distribution Type Rated 1 # in Input Syst. Btu/hr Tank Cap. (gal) Energy Fact! 1 External or Recovery Standby Tank Insul. Efficiency Loss (%) R -Value Standard Gas 50 gal or Less Small Gas Standard 1 40MO 50 0.53 n/a 12 1 For small gas storage (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance and heat pump water heaters, list energy factor. For large gas storage water heaters (rated input of greater than 75,000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input and Recovery Efficiency. REMARKS COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall design responsibility. The undersigned recognize that compliance using duct sealing and TXV's requires installer testing and certification and field verification by an approved HERS rater. Designer or Owner (per Business & Professions Code) Documentation Author Name: Name: Stephen R. Nieto Title/Firm: Stephen R. Niet Title/Firm: South West Concepts Address: 78-120 Calle EsIddo Ste. 206 Address: 78120 Calle Estado, Suite 206 La Quinta CA 253 La Quinta CA 53 Telephone: 760-564-470 Telephone: 760 564-47 Lic. #: den (signature) (date) (signature) (date) Enforcement Agency Name: Title/Firm: Address: Telephone: (siqnature/stamp) (date) IEnergvPro 3.1 By EnergvSoft User Number: 5970 Job Number: 00153 Page:4 of 13 1 Certificate of Compliance: Residential (Addendum) CF -1 R PGD Development 8/10/2004 Project Title Date Special Features and Modeling Assumptions The local 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 local enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies )ased on the adequacy of the special justification and documentation submitted. Plan I Field The DHW System "Standard Gas 50 gal or Less" Energy Factor = 0.530. An EF below 0.58 requires an R-12 External Blanket. The HVAC Svstem "Res HVAC' includes credit for a Radiant Barrier installed per Section 8.13 of the Residential Manual. HERS Required Verification These features must be confirmed and/or tested by a certified HERS rater under the supervision of a CEC approved HERS provider. The HERS rater must document the fiel verification and diagnostic testing of these measures on a form CF -6R. Plan Field The HVAC System 'Res HVAC' includes Refrigerant Charge and Airflow Credit (or a TXV). A certified HERS rater must provide verification of the TXV, or measure the Refrigerant Charge and Airflow. The HVAC System "Res HVAC' is using reduced duct leakage to comply and must have diagnostic site testing of duct leakage performed by a certified HERS Rater. The results of the diagnostic testing must be reported on a CF -6R Form. t I EnergvPro 3.1 By EnergySoft User Number: 5970 Job Number: 00153 Page:5 of 13 1 Mandatory Measures Checklist: Residential (Page 1 of 2) MF -1 R NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (') may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION Instructions: Check or initial applicable boxes or enter N/A if not applicable. DESIGNER ENFORCEMENT Building Envelope Measures ❑ •§150(a): Minimum R-19 ceiling insulation. ❑ §150(b): Loose fill insulation manufacturer's labeled R -Value. , 150(c): Minimum R-13 wall insulation in wood framed walls or equivalent U -value in metal frame walls (does ❑§ not apply to exterior mass walls). X ❑ ' § 150(d): Minimum R-13 raised floor insulation in framed floors or equivalent. §150(1): Slab edge insulation -water absorption rate no greater than 0.3%, water vapor transmission rate no ❑ greater than 2.0 perm/inch. § 116: Insulation specified or installed meets insulation quality standards. Indicate type and form. ®§116-17: Fenestration Products, Exterior Doors and Infiltration/Exfiltration Controls 1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. 2. Fenestration products (except field fabricated) have label with certified U -Factor, certified Solar Heat Gain Coefficient (SHGC), and infiltration certification. 3. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. a§ 150(g): Vapor barriers mandatory in Climate Zones 14 and 16 only. ❑ §150(f): Special infiltration barrier installed to comply with Section 151 meets Commission quality standards. ❑ § 150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs. 1. Masonry and factory -built fireplaces have: a. Closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. Space Conditioning, Water Heating and Plumbing System Measures ❑ § 110-13: HVAC equipment, water heaters, showerheads and faucets certified by the Commission. a§150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA or ACCA. §150(i): Setback thermostat on all applicable heating and/or cooling systems. FXJ §1500): Pipe and Tank Insulation 1. Storage gas water heaters rated with an Energy Factor less than 0.56 must be externally wrapped with insulation having an installed thermal resistance of R-12 or greater. 2. First 5 feet of pipes closest to water heater tank, non -recirculating systems, insulated (R-4 or greater) 3. Back-up tanks for solar system, unfired storage tanks, or other indirect hot water tanks have R-12 external insulation or R-16 combined internal/external insulation. 4. All buried or exposed piping insulated in recirculating sections of hot water systems. 5. Cooling system piping below 55 degrees F. insulated. 6. Piping insulating between heating source and indirect hot water tank. EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00153 Page:6 of 13 Mandatory Measures Checklist: Residential (Page 2 of 2) MF -1 R NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (•) may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION Instructions: Check or initial applicable boxes or enter N/A if not applicable. DESIGNER ENFORCEMENT Space Conditioning, Water Heating and Plumbing System Measures: (continued) a'§ 150(m): Ducts and Fans 1. All ducts and plenums installed, sealed and insulated to meet the requirements of the 1998 CMC Sections 601, 603, 604 and Standard 6-3; ducts insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape, aerosol sealant, or other duct -closure system that meets the applicable requirements of UL181, UL181A, or UL181 B. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used. Building cavities shall not be used for conveying conditioned air. Joints and seams of duct systems and their components shall not be sealed with Goth back rubber adhesive duct tapes unless such tape is used in combination with mastic and drawbands. 2. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or Flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. 3. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such a tape is used in combination with mastic and drawbands. 4. Exhaust fan systems have back draft or automatic dampers. 5. Gravity ventilation systems serving conditioned space have eitherautomatic or readily accessible, manually operated dampers. 6. Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind but not limited to the following: Insulation exposed to weather shall be suitable for outdoor service e.g., protected by aluminum, sheet metal, painted canvas, or plastic cover. 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. ❑ § 114: Pool and Spa Heating Systems and Equipment 1. Certified with 78% thermal efficiency, on-off switch, weatherproof operating instructions, no electric resistance heating, and no pilot. 2. System is installed with at least 36" of pipe between filter and heater for future solar, cover for outdoor pools or spas. a. At least 36" of pipe between filter and heater for future solar heating. b. Cover for outdoor pools or outdoor spas. 3. Pool system has directional inlets and a circulation pump time switch. ❑ §115: Gas fired central furnaces, pool heaters, spa heaters or household cooking appliances have no continuously burning pilot light. (Exception: Non -electrical cooking appliances with pilot < 150 Btu/hr) ❑ §118 (f): Cool Roof material meet specified criteria Lighting Measures ® §150(k)1: Luminaires for general lighting in kitchens shall have lamps with an efficacy 40 lumens/watt or greater for general lighting in kitchens. This general lighting shall be controlled by a switch on a readily accessible lighting control panel at an entrance to the kitchen. a§150(k)2: Rooms with a shower or bathtub must have either at least one luminaire with lamps with an efficacy of 40 lumens/watt or greater switched at the entrance to the room or one of the alternative to this requirement allowed in Section 150(k)2.; and recessed ceiling fixtures are IC (insulation cover) approved. 3.1 By EnergySoft User Number: 5970 Job Number: 00153 Page:7 of 13 Computer Method Summary (Part 1 of 3) C -2R PGD Development 8/10/2004 Project Title Date Single Family Residence -All Orientations La Quinta Project Address Building Permit # South West Concepts (760) 564-4707 Documentation Author Telephone Plan Check/Date Computer Performance 15 Field Check/Date Compliance Method (Package or Computer) Cimate Zone Source Energy Standard Use (kBtulsf-yr) Design Space Heating 1.99 Facing North Margin Ll ❑ ❑ ❑ Facing East Margin _0 Door 20 0 387 _0 -g0- Wall 361 0.059 90 90 Facing South Margin wall 260 0 059 270 90 Facing W est Margin 0.88 1.11 1.09 0.90 1.25 0.74 1.06 0.92 Space Cooling 35.29 28.35 6.94 28.29 7.00 ❑ 27.42 7.87 28.71 6.57 Domestic Hot Water 14.81 1 14.67 0.15 14.67 0.15 14.67 0.15 14.67 0.15 43.89 8.20 44.05 8.04 43.33 8.76 44.45 7.64 Totals 52.09 I BUILDING COMPLIES This C -2R describes the front facing North occurrence of a four cardinal orientation analysis. Features are identical in all orientations. Total Conditioned Floor Area: 1,643 ft 2 Building Type: Single Fam Detached Floor Construction Type: ❑ Raised Floor ❑X Slab Floor Building Front Orientation: All Four Orientations Total Fenestration Area: 10.0% Number of Dwelling Units: 1.00 Total Conditioned Volume: 15,608 ft' Number of Stories: 1 Total Conditioned Slab Area: 1,643 ft 2 BUILDING ZONE INFORMATION # of Thermostat Vent Zone Name Floor Area Volume Units Zone Type Type Hat. Area OPAQUE SURFACES Solar Act. Gains Type Area U -Val. Azm. Tilt YIN Form 3 Reference Location I Comments Rnnf 1,643 0.028 0 29 Wall 296 0 059 90 ®❑ Ll ❑ ❑ ❑ R -3R Roof (R 1R 9,14 tri) 1st Flnnr 7nnP R-13 Wall w/1" EPS1St Flnnr Zone snim i wn0,i p.0or 1st Flnnr lone R-13 Wall w/1" FPS 1st Flnnr 7nnP R-13 Wall w/1" FPS 1st Flnnr 7nnP _0 Door 20 0 387 _0 -g0- Wall 361 0.059 90 90 wall 292 0.059 180 90 wall 260 0 059 270 90 1:1❑ R-13JN la w/1" FPS 1st Floor 7one ❑ ❑ ❑ ❑ ❑ ❑ ❑❑ ❑❑ Run Initiation Time* 08/10/0411oX39 Run Code: 1092162639 3.1 By EnergySoft User Number: 5970 00153 Page:8 of 13 Computer Method Summary (Part 2 of 3) C -2R PGD Development 8/10/2004 Project Title Date FENESTRATION SURFACES # Type Area U- Factor SHGC Act. Azm. Glazing Type Tilt Location/ Comments 1 Window Front (North) _ 9.0 0 79f) 073 _ 1L _ 90 Double Metal Menr Default 1st Floor Zone 2 Window Front (North) 16.5 0.870 0.70 0 90 Double Metal Clear Default 1st Floor Zone 3 Window Front (North) 9.0 0.720 0.73 0 90 Double Metal Clear Default 1st Floor Zone 4 Window Left (East) 20.0 0.870 0.70 90 90 Double Metal Clear Default 1st Floor Zone 5 Window Left (East) 16.0 0.870 0.70 90 90 Double Metal Clear Default 1 st Floor Zone 6 Window Left (East) 3.0 0.870 0.70 90 90 Double Metal Clear Default 1st Floor Zone L Window Rear (South) 16.0 0.870 0.70 180 90 Double Metal Clear Default 1st Floor Zone 8 Window Rear (South) 40.0 0.850 0.70 180 90 Double Metal Clear Default 1st Floor Zone 6 Window Rear (South) 3.0 0.870 0.70 180 90 Double Metal Clear Default 1st Floor Zone 1Q Window Right (West) 6.0 0.870 0.70 270 _ 90 Double Metal Clear Default 1st Floor Zone " Window Right (West) 9.0 0.870 0.70 270 90 Double Metal Clear Default 1st Floor Zone 12 Window Right (West) 16.6 0.850 0.70 270 90 Double Metal Clear Default 1st Floor Zone INTERIOR AND EXTERIOR SHADING Window Overhang Left Fin Right Fin # Exterior Shade Type SHGC Hgt. Wd. Len. Hgt. LExt. REA Dist. Len. Hgt. Dist. Len. Hgt. 1 Bug Screen 0.76 5.6 2.0 1.0 0.1 2.0 2.0 2 Bug Screen 0.76 5.5 3.0 1.0 0.1 2.0 2.0 3 Bug Screen 0.76 4.5 2.0 1.0 0.1 2.0 2.0 4 Bug Screen 0.76 4.0 5.0 1.5 0.1 2.0 2.0 5 Bug Screen 0.76 4.0 4.0 1.5 0.1 2.0 2.0 6 Bug Screen 0.76 1.0 3.0 1.5 _ - 2.0 2.0 7 Bug Screen 0.76 4.0 4.0 1.5 0.1 2.0 2.0 8 Bug Screen 0.76 6.6 6.0 1.5 0.1 2.0 2.0 9 Bug Screen 0.76 1.0 3.0 1.5 0.1 2.0 2.0 10 Bug Screen 0.76 3.0 2.0 1.5 0.1 2.0 2.0 11 Bug Screen 0.76 3.0 3.0 1.5 0.1 2.0 2.0 12 Bug Screen 0.76 6.6 2.6 1.5 0.1 2.0 2.0 Run Initiation Time: 08110104 11:14:48 Run Code: 1092161688 EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00153 Page:9 of 13 Computer Method Summary (Part 3 of 3) C -2R PGD Development 8/10/2004 Project Title Date THERMAL MASS FOR HIGH MASS DESIGN Area Thick. Heat Inside Location Type (sf) (in.) Cap. Cond. Form 3 Reference R -Val. Comments Frame Wall. Stucco 291i X35 91 0.47 R-13 Wall w/1"EPS 2 1st Floor 7one / xt prior Mn,,-; PERIMETER LOSSES F2 Insulation Type Length Factor R -Val. Depth Location / Comments Slab Perimeter 90 0.76 0.0 0 1st Floor Zone HVAC SYSTEMS Heating Equipment Minimum Distribution Type Type (furnace, heat Efficiency and Location Duct Thermostat Location / pump, etc.) (AFUE/HSPF)(ducts/attic, etc.) R -Value Type Comments Central Furnace 92% AFUE Ducts in Attic 4.2 Setback Res HVAC Hydronic Piping Pipe Pipe Insul. System Name Length Diameter Thick. Cooling Equipment Minimum Duct Type (air conditioner, Efficiency Location Duct Thermostat Location / heat pump, evap. cooling) (SEER) (attic, etc,) R -Value Type Comments Split Air Conditioner 12.0 SEER Ducts in Attic 4.2 Setback Res HVAC WATER HEATING SYSTEMS Ratedl Tank Energy Factl 1 Tank Insul. Water Heater Water Heater Distribution # in Input Cap. or Recovery Standby R -Value System Name Type Type Syst. (Btu/hr) (gal) Efficiency Loss (%) Ext. Standard Gas 50 gal or Less Small Gas Standard _ 1 40.000 50 0.53 n/a 12 1 For small gas storage (rated input <= 75000 Btu/hr), electric resistance and heat pump water heaters, list energy factor. For large gas storage water heaters (rated input > 75000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input, and Recovery Efficiency. REMARKS Run Initiation Time: 08/10/04 11:14:48 Run Code: 1092161688 EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00153 Page: 10 of 13 Computer Method Summary (Addendum) C -2R PGD Development 8/10/2004 Project Title Date Special Features and Modeling Assumptions The local 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 local enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies 3ased on the adequacy of the special justification and documentation submitted. Plan I Field The DHW System "Standard Gas 50 gal or Less" Energy Factor = 0.530. An EF below 0.58 requires an R-12 External Blanket. The HVAC Svstem 'Res HVAC' includes credit for a Radiant Barrier installed per Section 8.13 of the Residential Manual. HERS Required Verification These features must be confirmed and/or tested by a certified HERS rater under the supervision of a CEC approved HERS provider. The HERS rater must document the field verification and diagnostic testing of these measures on a form CF -6R. Plan Field The HVAC System 'Res HVAC' includes Refrigerant Charge and Airflow Credit (or a TXV). A certified HERS rater must provide verification of the TXV, or measure the Refrigerant Charge and Airflow. The HVAC System 'Res HVAC' is using reduced duct leakage to comply and must have diagnostic site testing of duct leakage performed by a certified HERS Rater. The results of the diagnostic testing must be reported on a CF -6R Form. 7777 Run Initiation Time: 08/10/04 11:14:48 Run Code: 1092161688 EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00153 Page: 11 of 13 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY PROJECT NAME DATE PGD Development 8/10/2004 SYSTEM NAME FLOOR AREA Res HVAC 1,643 Number of Systems 1 Heating System Output per System 92,000 Total Output (Btuh) 92,000 Output(Btuh/sgft) 56.0 Cooling System Output per System 47,000 Total Output (Btuh) 47,000 Total Output (Tons) 3.9 Total Output (Btuh/sgft) 28.6 Total Output (sgftlTon) 419.5 Air System CFM per System 1,595 Airflow (cfm) 1,595 Airflow (cfm/sgft) 0.97 Airflow (cfm/Ton) 407.2 Outside Air (%) 0.0 Outside Air (cfmisgft) 0.00 Note: values above aiven at ARI conditions 24.0 of Outside Air 0 cfm 69.3 of 69.3 of 69.3 of Total Room Loads Return Vented Lighting Return Air Ducts Return Fan Ventilation Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COIL COOLING PEAK COIL HTG. PEAK CFM I Sensible Latent CFM I Sensible 1,097 26,208 -383 618 22,456 0 1,310 1,123 0 0 0 0 0 0 0 0 0 1,310 1,123 28 829 -383 24 702 BDP CO. 563AN048-A 36,118 3,710 92,000 Total Adjusted System Output36,118 3,710 92,000 (Adjusted for Peak Design Conditions) TIME OF SYSTEM PEAK Aug 2 pm Jan 12 am 105.0 of Supply Fan Heating Coil 1595 cfm k Return Air Ducts `s of Supply Air Ducts 104.3 of ROOMS 70.00 F 113.9 / 73.0 of 78.8 ! 62.7 of 78.8 / 62.7 of 55.0 / 54.0 of 0 Supply Air Ducts Outside Air 0 cfm Supply Fan Cooling Coil 55.8 / 54.3 of 1595 cfm 42.2% R.H. ROOMS 78.8/62.7 of 78.0 162.4 of Return Air Ducts I EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00153 Page: 12 of 13 ROOM LOAD SUMMARY PROJECT NAME PGD Development DATE 8/10/2004 SYSTEM NAME Res HVAC FLOOR AREA 1,643 ROOM LOAD SUMMARY ROOM COOLING PEAK COIL COOLING PEAK COIL HTG. PEAK ZONE NAME ROOM NAME Mult. CFM SENSIBLE LATENT CFM SENSIBLE LATENT CFM SENSIBLE 1stFloor Zone 1st Floor 1 1,097 26,208 -383 1,097 26,208 -383 618 22,456 PAGE TOTAL 1 1,097 26,208 -383 618 22,456 TOTAL 1 1,097 26,208 -383 618 22,456 EnergyPro 3.1 By EnergySoft User Number: 5970 Job Number: 00153 Page: 13 of 13 MetroScan /Riverside (CA) 020-096 020-/09 1 ' 774-29 r. R. A. oto_ o/1 02o-069 POR. N• //2 SEC. /3 T. 6S. R. 6E. 71- 020-/02 020 -/JO 6/ 9 -2 020-//6020./4/ 020-069 020-/2/ 020-076 2j L - Y i _ 1C O.rJ4.r aiJ4. • au4 ara4 (D02 1J ® 2 2!O 2 P P 0.104 11G) ®! , 22© J. Ag 21(D ©! (D a_lAs_ae l @1 20® ®1"� ©1 N ©1 • J /9 © 8 6 mr'/9� 6 Na 1Q6 ®6 O 9/ N 92 93 9 /7�.. ®7 W /6 O ®9 i /6 © ® 9 Q /6 O 9 9 ©9 W /J ® ,® /0 /1 0/0 or. 150 @/0 /40 @" 0 .f]4 0.TJA° t Df /!Q{ /2 /! Q /2 s• CALLE rrt .I.rs,.rm SANTA CARMEL?A AT VALE LA OWNTA' Wn'Na 25 MB/9/50-5/ e • • • ° �r awr Na 29 MB /9/59-6o "'t' -• A//7 /967 lMR N<P /J Rl4 ISJ6.f./G'I PNAP099 a49' PO Tp ENO r• I r. 24 aJs.e , 2! ® P � Fe •iy V e4 -0 © 1 /_9 ® 6 O { 0 /BO 9®7�i{ O ., e `d8c a /6 ® 09 alJ4. i /1 ro /4 © ®// Q{ @ L UWE _ I J_Ltl DEC 0 0 2002 ASSESSAPS 'MAP 9K 774 P6.29 NN£RS/0£ COUNTY CALIF R Information compiled from various sources. Real Estate Solutions makes no representations or warranties as to the accuracy or completeness of information contained in this report. 774 291 003 Pos Int Ref APN : 000 000 000 er : Delio Paul G Land :$14,540 oOwner Struct Site : *no Site Address* Other Mail : 81715 Us Highway 111 #302 Indio Ca 92201 Total : $14,540 Xfered : 07/01/1998 Doc # : 317444 Multi -parcel Exempt Price Deed : Misc Type LoanAmt Loan % Imprvd Lender IntTyp % Owned VestTyp Tax Area : 20-015 Use : R07Vacant,Residential 03-04 Tax : $184.34 Plat : 19 Map Grid Census : Tract Block : OwnerPh S : T : R Q Tenant Ph Bedrms Stories Acres :.11 Year Built BthFull Fireplace : No LotSgFt :4,791 Street Type : Paved Bth3Qt Pool : No Bldg SF Waterfront BthHalf : RmAddtns : No AddOnSF Gas Service : None CntlHt : No AddPkgTyp' GarSgFt . Water Source : Developed Cnt1AIC : No Roof Type Gar Type Sewer Type : None Agri Preserve 020-096 020-/09 1 ' 774-29 r. R. A. oto_ o/1 02o-069 POR. N• //2 SEC. /3 T. 6S. R. 6E. 71- 020-/02 020 -/JO 6/ 9 -2 020-//6020./4/ 020-069 020-/2/ 020-076 2j L - Y i _ 1C O.rJ4.r aiJ4. • au4 ara4 (D02 1J ® 2 2!O 2 P P 0.104 11G) ®! , 22© J. Ag 21(D ©! (D a_lAs_ae l @1 20® ®1"� ©1 N ©1 • J /9 © 8 6 mr'/9� 6 Na 1Q6 ®6 O 9/ N 92 93 9 /7�.. ®7 W /6 O ®9 i /6 © ® 9 Q /6 O 9 9 ©9 W /J ® ,® /0 /1 0/0 or. 150 @/0 /40 @" 0 .f]4 0.TJA° t Df /!Q{ /2 /! Q /2 s• CALLE rrt .I.rs,.rm SANTA CARMEL?A AT VALE LA OWNTA' Wn'Na 25 MB/9/50-5/ e • • • ° �r awr Na 29 MB /9/59-6o "'t' -• A//7 /967 lMR N<P /J Rl4 ISJ6.f./G'I PNAP099 a49' PO Tp ENO r• I r. 24 aJs.e , 2! ® P � Fe •iy V e4 -0 © 1 /_9 ® 6 O { 0 /BO 9®7�i{ O ., e `d8c a /6 ® 09 alJ4. i /1 ro /4 © ®// Q{ @ L UWE _ I J_Ltl DEC 0 0 2002 ASSESSAPS 'MAP 9K 774 P6.29 NN£RS/0£ COUNTY CALIF R Information compiled from various sources. Real Estate Solutions makes no representations or warranties as to the accuracy or completeness of information contained in this report. CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING Title — 4. BLfiIder ContactTelephone i ri, Ga'M'1114 117.,1,0)1'1?- <.7a 3 Date/ Bwlder Name, Plan Number Sample Group Number CF -4R C ifyingg Signature Dae Sample House Number Firm: HERS Provider: C i/��E� /Q s Street Address: �79&1b/ b ffrael Ld -,W C/YL lf- City/State/Zip: u 4,267, /k 1 Cl� Copies to: Builder, HERS Provider z a x HERS RATER COMPLIANCE STATEMENT The house was: Rested ❑ Approved as part of sample testing, but was not tested .As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form com ith the diagnostic tested compliance requirements as checked on this form. Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu ducts) Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination ith cloth backed, rubber adhesive duct tape to seal leaks at duct connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM If fan flow is calculated as 400cfm/ton x number of tons enter calculated value here If fan flow is measured enter measured value here Q i Leakage Percentage (100 x Test Leakage/Fan Flow) _ / . D J Check Box for Pass or Fail (Pass=6% or less) ❑ Pass Fail THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent Yes ❑ No Thermostatic Expansion Valve (or Commission approved equivalent) is installed and Access is provided for inspection Yes is a pass ❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT 1. ❑ Yes ❑ No ACCA Manual D Design requirements have been met (rater has verified that actual installation matches values in CF -1 R and design on plan. 2. ❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV, verified fan flow matches design from CF -1 R. Measured Fan Flow = Yes for both 1 and 2 is a Pass ass Fail Pass Fail r- �s . 53 2 /a A VE + �� TWT o�, 5 �7 PO. BOX 1504 APPLICATION ON4 Building P J,6 x/78-495 CALLE TAMPICO Address ©Q r[L' Y`�f1! Y LA QUINTA, CALIFORNIA 92253 Owner BUILDING: TYPE CONST. OCC. GRP. MailingW L^ a9 1 r ®Q 3 Address (,� � A.P. Num ber I City vv�'�1 Zip Tel.— Legal Description Contractor Project Description C 1 /vim z'ft e5no-eyy6� Addre s City %I, Ip 221 % -;%0 '-SJ I 6'0 State Lic. �City Sq. Ft. No. No. Dw. & Classif. �a Lic. # Size Stories Units Arch., Engr., New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Designer Address Tel. City �U 1ZiP9,zr) � Lic.t#5��L- LICENSED CONTRACTOR'S DECLARATION +n 20D4 �U I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section �, 7000) of Division 3.a;,�ie Business and Professions Code, and my Ilces in full force and effect. 7S SIGNATUREV UA—T—E CITY OFL.AQUINTA OW ER -BUILDER DECLARATION Estimated Valuation FINANCE L)L:ht. 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 PERMIT AMOUNT 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 Plan Chk. Dep. 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). Plan Chk. Bal. ❑ 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- Const. sions Code: The Contractor's License Law does not apply to an owner of property who builds ori mproves thereon and who does such work himself or through his own employees, provided Mech. 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 Electrical 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 Plumbing the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does S.M.I. 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) Grading ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. ❑ora n o,narV4461Infrastructure WORKER'S COMPENSATION DECLARATION I hereby Company_G�11 • 1 1 C.� ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM TOTAL WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation REMARKS 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. ZONE: BY: Minimum Setback Distances: CONSTRUCTION LENDING AGENCY Front Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the work Rear Setback from Rear Prop. Line for which this permit is Ned. IS 309 Civi ode.) Lender's Name Side Street Setback from Center Line Lender's Address � ,yL—l� This is a building per�periy III o, si ed and validated, and is subject to Side Setback from Property Line 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. FINAL DATE INSPECTOR 1 agree a to comply with all city a county ordinances and state laws relating to building - construction, and hereby author' pre nt ' as f this city to enter the above-mentioned property for inspection purpose L Issued by: Date Permit Signature of applican wvl�at 4 Mailing Address Validated by: City, State, Zip Validation: WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE