9902-066 (SFD)LICENSED CONTRACTOR DECLARATION
_I hereby affirm under penalty of perjury that I am licensed under provisions of
�thapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
ate * , Signature of Contractor
OWNER -BUILDER DECLARATION
I he affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 &, Professionals Code).
( )•• I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() f am exempt under Section , B&P.C. for this reason
Date Signature of Owner
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.
Se( ) I'have and will maintain workers' compensation insurance, as required by
ction 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance. carrier & policy no. are:
Carrier Policy No.
7 t\11TH(; as. Ca. zt 12 �? 50i
(This section need not be completed if the permit valuation Is for 10.00 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 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 c
Applicant—
Warning:
pplicant Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for, a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
.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
y 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 State laws relating to the building
construction; and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes. rt
V. ignature (Owner/Agent) � 1 - Date
BUILDING PERMIT PERMIT#
r
DATE / VALUATION LOT 9SIO2- 66 TRACT
uu�L� LLLL(p� �i(� �}
$386,669.70
A fd'a1ff\),14f3%. 3iJ +�I• J .r./7°�NJM
JOB SITE
ADDRESS
L90415W�rSKOIPP
rtr y t yt� t3a�
i lll-'i�+►V�[70�
OWNER CONTRACTOR/DESIGNER/ENGINEER
C:AP i' NES C•OLF UT ST U,C SHANNON CO&LMUNIM1 S OF CAL11F., RISC
200 E. WAS14I.NG'iY:iiVAV ENUE V- 01E. WAS.11INGION AVE., 4100
ESCONDRYD CA 92025 ESCONDIDO CA 92025
(760)839.8239 CELS;. 8413
USE OF PERMIT
LOT 4, PLAID 3-1138,-SM1?E1M41.T DOES NOT 1NC1.C, DE BLOCK WALLS
0 .'POOLS PLAN, CRE:C%K FEE IS RFD'LJCEJ? 7.5° o FOR h1tJ'LTIPLE
TARS r. 0V9AVFZ PLAN TVY) .
COMM CONSTRUCTION 4,621.00 SF
P0RCT£/C'KTJ0 4390.00 SF
C7E+,:t2a GIMARPOR 15$.00 5F
ESTIMATED COST OF CONSTRUCTION
386,669.7111
PERMIT FEE SUMMARY
CONSTREXTION FER. 101-000-41."00 1,614.
PL PN CHECK FEli 101.000-439-318 3332.53
NT-1CHN.N1C'At, fiE_ 101-000-421-000 $124,00
ELFC"1 RIC',A1- :h K 1.0.1.600420-000
PLUMBING TiVE 101400119-000
STRONG MM 1014 FEE - RESID 101-000-241.000
GRADINGFEE 1 U.1.-000-423-000 MOO
1NFP_A31?_UC1UTJ1 FEE 223-000-441-342 $6,000.00
AR'i INVML IC PLACES • RI .51D. 701-000-255-0100 $716.67
SULK-1't3"1AL CONSIRUC'1'lON AND PLAN CI-I.1:CK
$9,,37052
[.ESS PRE -:PAID FEES
$10.U0
TOTAL i�'EIbNUT I+'.a . � �' .11 UE, NOW
$9.370.52
�RECEIPTe.}
DALE\
BY��'w ,.
DATE FINALED
INSPECTOR
4 '
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
--------------
BUILDING APPROVALS
MECHANICAL APPROVALS. :.
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing 41,W24
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall Ot
Exterior Lath
Drywall - Int. Lath e
O'70 WA
Final
Final
BLOCKWALL APPROVA S
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
_
Gas Test
Appliances
Final
Final
Utility Notice ( Gas )
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
//�y4lyl 71�s/
ocommunities
i
January 31, 2000
City of La. Quinta
Building and Safety Department
78495 Calle Tampico y`
La Quinta. CA
To whom it may concern,
�s
We have supervised the installation of thirty-seven (37) of the O'hagan cloaked
roof vents in Lot 4 at 80415 Weiskopf. We find them to be installed properly and
as per manufactures recommendations.
Thank You
1
Rick Snyder
Project Superintendent
200 E. Washington Ave., Suite 100 Escondido, CA 92025 Ph:(760) 839-8238 Fax: (760)839-8246
uertificate of Occupancy
City of La Quinta �
building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building .construction or use. For the following:
BUILDING ADDRESS: 80-415 WEISKOPF
Use Ciassifieation: SINGLE FAMILY DWELLING Bldg. Permit No.:
Occupancy Group: R-3 Type of Construction: VN Land Use Zone;
Owner of Building: CAPSTONES GOLF WEST LLC
Building Official
9902-066
RL
Address:
200 E. WASHINGTON AVENUNE
City:
ESCONDIDO, CA., 92025
By:
DANIEL P. CRAWFORD JR.
Date: 2/1/2000
.POST IN A CONSPICUOUS PLACE
3.
LICENSED CONTRACTOR DECLARATION
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 # Lic. Class Exp. Date
686690 B 4/30/00
Date Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
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 & policy no. are:
Carrier Policy No.
ZENITH INS. CO. x(14239450
(This section need not be completed if the permit valuation Is for $100. 0 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 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: Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Ouinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 9902-066 TRACT
$386,669.70 4 28444
JOB SITE
APN
ADDRESS 88-415 WEISKOPF
761-080-089
OWNER CONTRACTOR/DESIGNER/ENGINEER
CAPSTONES GOLF WEST LLC SHANNON COMMUNITIES OF CALIF., INC
200 E. WASHINGTON AVENUE 200 E. WASHINGTON AVE., #100
ESCONDIDO CA 92025 ESCONDIDO CA 92025
(760)839-8238 CBL# 5413
USE OF PERMIT
LOT 4, PLAN 3-1BR, -SFD- PERMIT DOES NOT INCLUDE BLOCK WALLS
OR POOLS. FLAN CHECK FEE IS REDUCED 75% FOR MULTIPLE
ISSUANCEF SAME PLAN TYPE -
CUSTOM CONSTRUCTION 4,621.00 SF
PORCH/PATIO 890.00 SF
GARAGEICARPORT 758.00 SF
ESTIMATED COST OF CONSTRUCTION
386,669.70
PERMIT FEE SUMMARY .
CONSTRUCTION FEE 1014000-418-000 51,644.00
PLAN CHECK FEE 101-000439-318 $332.53
MECHANICAL FEE 101-000-421-000 $124.00
ELECTRICAL FEE 1014000-420-000 " ` $253.40
PLUMBING FEE 101-000-419-000 $241.25
STRONG MOTION FEE - RESID 101-000-241-000 $38.67
GRADING FEE 101-000-423-000 520.00
INFRASTRUCTURE FEE 225-000-443-342 56,000.00
ART IN PUBLIC PLACES - RESIT; 701-000-255-000 5716.67
SUB -TOTAL CONSTRUCTION AND PLAN CHECK
$9,370.52
LESS PRE -PAID FEES
$0.00
TOTAL PERMIT FEES DUE NOW
$9,37052
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
?, B
. '
City of. La. Quinta PoF, Avi t,7,
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico (00 Z- S'C, 79
Quinti, CA 92253 - (760) 777-7012 f
Building Permit Application and Tracking Sheet
Permit #
0La
L
Project Address: (4 ` W-Gis IP,
Owner's Name: L��A4
A. P. Number: , (o �� d d to �',
Address: IQ'A S
Legal Description: �� 'qts W �,1$kOQ'� `A
(�'b�
City, ST, Zip: Lob,,. � U I � � C'i�IUZZ5' 3
Contractor: AN 1 i20Wt16�
Telephone-"] Q.- -Vl-\
Address:
Project Description:
City, ST, Zip:
Telephone:
�r a
p 11
State Lic. # :
City Lic: #:
Arch., Engr., Designer:AW
A
z .
Address:
rs
City, ST, Zip:
Telephone:
.'
Construction Type: Occupancy:
State Lic. #:?
Project type (circle one): New Add'n Alter Repair Demo
Name of Conti erson:
Sq. Ft.: zoo#Stories:
T#Units:
Telephone # of Contact Person: $ l — Ql -
Estimated Value of Project: Zp (-
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING _
PERMIT FEES
21.
Plan Sets '
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections 0S9fr—
8
Plan Check Deposit
Truss Calcs.
Called Contact Person
® 2
Plan Check Balance
Energy Calcs.
Plans picked up
�,3
Construction
Flood plain plan
Plans resubmitted
"{
Mechanical
Grading. plan
2" Review, ready. for cofrection-ssu
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
B2Oivz POE : 8/7/00
9,p` Sim, NIS RfC--
J2:Z_J74)(0— CjeA C,w+t4t-f '
1q �won ULe -i I Z&IDko
0 ANOW (01)
q
. .
.Machella Valley Unified School District
83-733 Avenue 55, Thermal, CA 92274
(760) 398-5909 — Fax (760) 398-1224
This Box For District Use Only
DEVELOPER FEES PAID
AREA:
AMOUNT
LEVELONEAMOUNT:
LEVEL TWO AMOUNT:
MITIGATION AMOUNT:
COMMAND. AMOUNT:
DATE:
RECEIPT:
CHECK #:
INITIALS:
CERTIFICATE OF COMPLIANCE
(California Education Code 17620)
Project Name: Lew & L - Blackwell Date: October 4, 2006
Owner's Name: Lew & Lynn Blackwell Phone No. (760) 965-6096
Project Address: 80-415 Weiskopf, La Quinta, CA 92253
Project Description: Room Addition
APN: 762-090-010 Tract #: Lot #'s:
Type of Development: Residential XX Commercial Industrial
Total Square Feet of Building Area: 204 sq. feet
Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under
penalty of perjury and further represents that he/she is authorized to sign on behalf of the owner/developer.
Dated: 10/04/06 Signature:
***********************************************************************
SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN
ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE)
Education Code Gov. Code Project
17620 65995 Approval
Number of Sq.Ft. 204 sq. ft.
Amount per Sq.Ft. $ 0.00
Amount Collected $ 0.00
Building Permit Application Completed: Yes/No
By: Carey M. Carlson, Asst. Supt., Business Services
Certificate issued by: Leticia C. Torres, Facilities Analyst
Agreement Existing Not Subject to Fee
Prior to 1/1/87 Requirement
Note: Pursuant to AB -181, any mobilehomes being replaced
or relocated within the same school district are exempt from
developer fees. Any additions of 500 sq. ft. or less is also
exempt from developer fees. (Unless additions are on a
structure that is under construction.)
NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMFAT OF FEES
Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the
project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these
Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to
advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other
requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this
time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of
Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up
to three (3) such extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject
of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance.
MV:c/mydocs/devfees/certificate of compliance form tablesTO USE.doc 1/16/03 T
TITLE 24 REPORT
Title 24 Report for:
MR. BLACKEWELL CECIL L.
80-415 WEISKPOF
LA QUINTA, CA 92253
Project Designer:
Santamaria Design Associates
75-153 Merle Drive. Suite B
Palm Desert, CA 92211
760.568.3838
Report Prepared By:
SLO
Santiago Lopez-Ocampo
P.O. Box 1018
La Quinta, CA 92247
(760) 485-8927
Job Number:
Ig071906
Date:
SEP 14: Z406
� 9/6/2006
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED.
FOR CONSTRUCTION
DAT BYLS
The EnergyPro cdm0uterprog�amhas tieen 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 2005 Building Energy Efficiency Standards.
This program developed by EnergySoft, LLC - www.energysoft.com.
EnergyPro 4.2 by EnergySoft Job Number: Ig071906 User Number: 5732
TABLE OF CONTENTS
Cover Page 1
Table of Contents 2
Form CF -1 R Certificate of Compliance 3
Form MF -1 R Mandatory Measures Summary 7
HVAC System Heating and Cooling Loads Summary 9
EnergyPro 4.2 by EnergySoft Job Number: Ig071906 i User Number: 5732
Certificate Of Compliance: Residential (Part 1 of 4) CF -1 R
MR_BLA.CKFWEI CEC_II I
204
ft2
916/2006
Project Title
ft2
Raised Floor Area:
Date
_8.0 -415 -WP ISKPO_ELA_Q UI NTA
Slab on Grade Area:
204
ft2
Project Address
10.0
ft
Building Permit #
Santia;go�opezO�.aC11po
(760) 485-8927
Plan Check/Date
Documen ation Author
Telephone
Ener vPro
Compi rice Method
15
Climate Zone
Field Check/Date
TDV Standard
Proposed
Compliance
kBtu/sf-yj Design
Design
Margin
Space Heating 4.49
5.20
-0.71
Space Cooling 95.74
81.51
14.22
Fans 14.34
11.71
2.63
Domestic Hot Water 0.00
0.00
0.00
Pumps 0.00
0.00
0.00
Totals 114.57
98.43
16.14
Percent better than Standard:
Building Type: [Z Single Family
❑ Multi Family
Building Front Orientation:
Fuel Type:
Fenestration:
FXI Addition
❑ Existing + Add/Alt
(NE) 45 deg
Natural Gas
Area: 48 ft2 Avg. U: 0.34
Total Conditioned Floor Area:
204
ft2
Existing Floor Area:
n/a
ft2
Raised Floor Area:
0
ft2
Slab on Grade Area:
204
ft2
Average Ceiling Height:
10.0
ft
Number of Dwelling Units:
0.04
Ratio: 23.5% Avg. SHGC: 0.26 Number of Stories: 1
BUILDING ZONE INFORMATION # of Thermostat Vent
Zone Name Floor Area Volume Units Zone Type Type Hgt. Area
HVAC System 204 2 n4nn4n _0-04_ Conditioned- -Setback- 2 -n/a
OPAQUE SURFACES Insulation Act.
Type Frame Area U -Fac. Cay. Cont. Azm. Tilt
Rnof- Wood- 204 X025_ -R_3.8_ -0 0 0_ 18
Wall 119 _0_06.9 R_21 R-0-0 X5__9.0
-Wall_ Wood- 53_ X069 _R21 R-0_0_ 135_ 9.0
-Call_ W..00d- x.3.8_ _0-.69_ R-91-R--0-0--3J-5------R0
Gains Condition
Y / N Status JA IV Reference Location / Comments
-01--18
Addition
-09_A6
Addition
_0.9=A6
_0.9=A6
Addition
Addition
I EnergyPro 4.2 by EnergySoft User Number: 5732 Job Number: Ig071906 Page:3 of 9 1
Certificate Of Compliance : Residential (Part 2 of 4) CF -1 R
MR. BLACKEWELL CECIL L. 9/6/2006
Project Title Date
FENESTRATION SURFACES
True Cond. Location/
# Type Area U-Factorl SHGCZ Azm. Tilt Stat. Glazing Type Comments
J_ Window Front (NE) 94.0 _0-3,5ONER-Cil.29 _NFRC 45_ —9.0_ dew Pozzi Windows A_ddit%n
2 Window Right (NW) 24.0 0.320 NFRC 0_24 NFRC 315 90 New _ Pozzi Doors Addition
1. Indicate source either from NFRC or Table 116A.
2. Indicate source either from NFRC or Table 116B.
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
2 Eug Screen 0.76
THERMAL MASS FOR HIGH MASS DESIGN
Type
Area Thick. Heat
(so (in.) Cap.
Inside
Cond. R -Val.
JA IV Reference
Condition
Status
Location/
Comments
Concrete, Heavyweight
204
3.50 28
0_98 0
26-A1
New
Addition / Slab on Grade
PERIMETER LOSSES
Insulation
Condition
Location/
Type
Length
R -Val.
Location
JA IV Reference
Status
Comments
Slab Perimeter
36
None No Insulation
26-A1
New
Addition .
Run Initiation Time: 09/06/06 20:34:55 Run Code: 1157600095
EnergyPro 4.2 by EnergySoft User Number: 5732 Job Number: Ig071906 Page:4 of 9
Certificate Of Compliance : Residential (Part 3 of 4) CF -1 R
MR. BLACKEWELL CECIL L.
Project Title
9/6/2006
Date
HVAC SYSTEMS
Location
Heating
Type
Minimum
Eff
Cooling
Type
Minimum Condition
Eff Status
Thermostat
Type
HVAC System
Central Furnace
78% AFLIE
Split Air Conditioner
9.7 SEER Existing
Setback
HVAC DISTRIBUTION
Location
Heating
Cooling
Duct
Location
Duct Condition
R -Value Status
Ducts
Tested?
HVAC System
Ducted
Ducted
Attic
4.2 Existing
No
Hydronic Piping Pipe Pipe . Insul.
System Name Length Diameter Thick.
WATER HEATING SYSTEMS Rated' Tank Energy Standby' Tank Insul.
Water Heater # in Input Cap. Condition Factor Loss R -Value
System Name Type Distribution Syst. (Btu/hr) (gal) Status or RE' (%) Ext
Multi -Family Central Water Heating Details
Hot Water Pump Hot Water Piping Length (ft) Add 1/2"
Control # HP Type In Plenum Outside Buried Insulation
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.
COMPLIANCE STATEMENT
This certificate of compliance lists the building features and 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 recognizes that compliance using duct design, duct sealing, verification of refrigerant charge and TXVs, 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)
Name:
Title/Firm: Santamaria Design Associates
Address: 75-153 Merle Drive. Suite B
Palm Desert. CA 92211
Telephone:;:&,ii-
Lic. #:
00
(signature) (date)
Enforcement Agency
Name:
Title/Firm:
Address:
Telephone:
Documentation Author
Name: SLO
Title/Firm: Santiago Lopez-Ocampo
Address: P.O. Box 1018
La Quinta, CA 92247
Telephone: (760) 485-8927
7-o6
(signature) (date)
(signature/stamp) (date)
I EnerpyPro 4.2 by Ener. ySoft User Number: 5732 ,lob Number 1a071906 Pana S of Q I
Certificate Of Compliance: Residential (Part 4 of 4) CF -1 R
MR. BLACKEWELL CECIL L. 9/6/2006
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 based on the
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HERS Required Verification
Items in this section require field testing and/or verification by a certified home energy rater under the supervision of a CEC-
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EnergyPro 4.2 by EnergySoft User Number: 5732 Job Number: Ig071906 Paae:6 of 9 1
Mandatory Measures Summary: 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. More stringent compliance
requirements from the Certificate of Compliance supercede the items marked with an asterisk (') below. When this checklist is incorporated into the permit
documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether
they are shown elsewhere in the documents or on this checklist only.
DESCRIPTION Check or initial applicable boxes or check NA if not applicable and included with the ENFORCE -
permit application documentation. N/A DESIGNER MENT
Building Envelope Measures
§ 150(a):
Minimum R-19 in wood ceiling insulation or equivalent U -factor in metal frame ceiling.
❑
0
❑
§ 150(b):
Loose fill insulation manufacturer's labeled R -Value:
❑
❑
❑
§ 150(c):
Minimum R-13 wall insulation in wood framed walls or equivalent U -factor in metal frame walls (does not
❑
❑X
❑
apply to exterior mass walls).
❑
❑
❑
§ 150(d):
Minimum R-13 raised floor insulation in framed floors or equivalent U -factor.
❑
❑
❑
§ 150(e):
Installation of Fireplaces, Decorative Gas Appliances and Gas Logs.
❑
insulation or R-16 internal insulation and indicated on the exterior of the tank showing the R -value.
1. Masonry and factory -built fireplaces have:
3. The following piping is insulated according to Table 150-A/B or Equation 150-A Insulation Thickness:
a. closable metal or glass door covering the entire opening of the firebox
❑
❑
❑
length of recirculating sections of hot water pipes shall be insulated to Table 150B.
b. outside air intake with damper and control, flue damper and control
❑
❑
❑
❑
2. No continuous burning gas pilot lights allowed.
❑
❑
❑
§ 150(f):
Air retarding wrap installed to comply with §151 meets requirements specified in the ACM Residential Manual.
❑
❑
❑
§ 150(g):
Vapor barriers mandatory in Climate Zones 14 and 16 only.
❑
❑ .
❑
§ 150(1):
Slab edge insulation - water absorption rate for the insulation alone without facings no greater than 0.3%, water vapor
❑
❑
❑
❑
permeance rate no greater than 2.0 perm/inch.
❑
entirely in conditioned space.
§ 118: Insulation specified or installed meets insulation installation quality standards. Indicate type and include
❑
❑X
❑
❑
CF -6R Form:
EnergyPro 4.2 by EnergySoft User Number: 5732 Job Number: Ig071906
§ 116-17:
Fenestration Products, Exterior Doors, and Infiltration/Exfiltration Controls.
1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage.
❑
❑X
❑
2. Fenestration products (except field fabricated) have label with certified U -Factor, certified Solar Heat Gain
❑
Q
❑
Coefficient (SHGC), and infiltration certification.
3. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed.
❑
❑X
❑
Space Conditioning, Water Heating and Plumbing System Measures
§ 110-13: HVAC equipment, water heaters, showerheads and faucets certified by the Energy Commission.
❑
❑
❑
§ 150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA or RCCA.
❑
❑X
❑
§ 150(i): Setback thermostat on all applicable heating and/or cooling systems.
❑
❑X
❑
§ 1500): Water system pipe and tank insulation and cooling systems line insulation.
1. Storage gas water heaters rated with an Energy Factor less than 0.58 must be externally wrapped with insulation
❑
❑
❑
having an installed thermal resistance of R-12 or greater.
2. Back-up tanks for solar systems, unfired storage tanks, or other indirect hot water tanks have R-12 external
❑
❑
❑
insulation or R-16 internal insulation and indicated on the exterior of the tank showing the R -value.
3. The following piping is insulated according to Table 150-A/B or Equation 150-A Insulation Thickness:
1. First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire
❑
❑
❑
length of recirculating sections of hot water pipes shall be insulated to Table 150B.
2. Cooling system piping (suction, chilled water, or brine lines), piping insulated between heating source and
❑
❑
❑
indirect hot water tank shall be insulated to Table 150-B and Equation 150-A.
4. Steam hydronic heating systems or hot water systems > 15 psi, meet requirements of Table 123-A.
❑
❑
❑
5. Insulation must be protected from damage, including that due to sunlight, moisture, equipment maintenance,
❑
❑
❑
and wind.
6. Insulation for chilled water piping and refrigerant suction piping includes a vapor retardant or is enclosed
❑
❑
❑
entirely in conditioned space.
7. Solar water -heating systems/collectors are certified by the Solar Rating and Certification Corporation.
❑
❑
❑
EnergyPro 4.2 by EnergySoft User Number: 5732 Job Number: Ig071906
Page:7 of 9
Mandatory Measures Summary: 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. More stringent
compliance requirements from the Certificate of Compliance supercede the items marked with an asterisk (') below. When this checklist is incorporated
into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory
measures whether they are shown elsewhere in the documents or on this checklist only.
DESCRIPTION Instructions: Check or initial applicable boxes when completed or check N/A if not
applicable.
ENFORCE -
N/A DESIGNER MENT
Space Conditioning, Water Heating and Plumbing System Measures: (continued)
§ 150(m): Ducts and Fans
same lot shall be high efficacy luminaires (not including lighting around swimming pools/water features or other Article
1. All ducts and plenums installed, sealed and insulated to meet the requirements of the CMC Sections 601, 602, 603, 604,
❑ X❑ ❑
605, and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minumum installed level of
680 locations) OR are controlled by occupant sensors with integral photo control certified to comply with Section 119(d).
R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system
that meets the applicable requirements of UL 181, UL 181A, or UL 181 B or aerosol sealant that meets the requirements
§ 150(k)7: Lighting for parking lots for 8 or more vehicles shall have lighting that complies with Sections 130, 132, and 147.
of UL 723. 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.
Lighting for parking garages for 8 or more vehicles shall have lighting that complies with Section 130, 131, and 146.
2. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than
❑X❑ ❑
sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and
§ 150(k)8: Permanently installed lighting in the enclosed, non -dwelling spaces of low-rise residential buildings with four or more
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.
dwelling units shall be high efficacy luminaires OR are controlled by occupant sensor(s) certified to comply with Section
3. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive
❑ ® ❑
duct tapes unless such tape is used in combination with mastic and draw bands.
119(d).
4. Exhaust fan systems have back draft or automatic dampers.
❑ ® ❑
5. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operating
❑ ® ❑
dampers.
Page:8 of 9
6. Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment
❑ ® ❑
maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water
retardant and provides shielding from solar radiation that can cause degradation of the material.
7. Flexible ducts cannot have porous inner cores.
❑ ® ❑
§ 114: Pool and Spa Heating Systems and Equipment
1. A thermal efficiency that complies with the Appliance Efficiency Regulations, on-off switch mounted outside of the
❑ ❑ ❑
heater, weatherproof operating instructions, no electric resistance heating and no pilot light.
2. System is installed with:
a. At least 36" of pipe between filter and heater for future solar heating.
❑ ❑ ❑
b. Cover for outdoor pools or outdoor spas.
❑ ❑ ❑
3. Pool system has directional inlets and a circulation pump time switch.
❑ ❑ ❑
§ 115: Gas fired fan -type central furnaces, pool heaters, spa heaters or household cooking appliances have no continuously
❑ ® ❑
burning pilot light. (Exception: Non -electrical cooking appliances with pilot < 150 Btu/hr)
§ 118 (i): Cool Roof material meets specified criteria
❑ ❑ ❑
Lighting Measures
§ 150(k)1: HIGH EFFICACY LUMINAIRES OTHER THAN OUTDOOR HID: contain only high efficacy lamps as outlined in Table
❑ ® ❑
150-C, and do not contain a medium screw base socket (E241E26). Ballasts for lamps 13 Watts or greater are
electric and have an output frequency no less than 20 kHz.
§ 150(k)1: HIGH EFFICACY LUMINAIRES - OUTDOOR HID: contain only high efficacy lamps as outlined in Table 150-C,
❑ Q ❑
luminaire has factory installed HID ballast.
§ 150(k)2: Permanently installed luminaires in kitchens shall be high efficacy luminaires. Up to 50% of the Wattage, as determined
❑ ❑ ❑
in Section 130(c), of permanently installed luminaires in kitchens may be in luminaires that are not high efficacy luminaires,
provided that these luminaires are controlled by switches separate from those controlling the high efficacy luminaires.
§ 150(k)3: Permanently installed luminaires in bathrooms, garages, laundry rooms, utility rooms shall be high efficacy luminaires.
❑ ❑ ❑
OR are controlled by an occupant sensor(s) certfied to comply with Section 119(d).
§ 150(k)4: Permanently installed luminaires located other than in kichens, bathrooms, garages, laundry rooms, and utility rooms
shall be high efficacy luminaires (except closets less than 70 ft) OR are controlled by a dimmer switch OR are
❑ ❑ ❑
controlled by an occupant sensor that complies with Section fl 9(d) that does not turn on automatically or have an
always on option.
§ 150(k)5: Luminaires that are recessed into insulated ceilings are approved for zero clearance insulation cover (IC) and are
❑ X❑ ❑
certified to ASTM E283 and labeled as air tight (AT) to less than 2.0 CFM at 75 Pascals.
§ 150(k)6: Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on the
❑
❑
❑
same lot shall be high efficacy luminaires (not including lighting around swimming pools/water features or other Article
680 locations) OR are controlled by occupant sensors with integral photo control certified to comply with Section 119(d).
§ 150(k)7: Lighting for parking lots for 8 or more vehicles shall have lighting that complies with Sections 130, 132, and 147.
❑
❑
❑
Lighting for parking garages for 8 or more vehicles shall have lighting that complies with Section 130, 131, and 146.
§ 150(k)8: Permanently installed lighting in the enclosed, non -dwelling spaces of low-rise residential buildings with four or more
❑
❑
❑
dwelling units shall be high efficacy luminaires OR are controlled by occupant sensor(s) certified to comply with Section
119(d).
EnergyPro 4.2 by EnergySoft User Number: 5732 Job Number: Ig071906
Page:8 of 9
HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY
PROJECT NAME DATE
MR. BLACKEWELL CECIL L. 9/6/2006
SYSTEM NAME FLOOR AREA
HVAC System 204
Number of Systems
1
Heating System
Output per System
0
Total Output (Btuh)
0
Output (Btuhlsgft)
0.0
Cooling System
Output per System
1
Total Output (Btuh)
1
Total Output (Tons)
0.0
Total Output (Btuhlsgft)
0.0
Total Output (sgft/Ton)
,448,000.0
Air System
CFM per System
0
Airflow (cfm)
0
Airflow (cfmisgft)
0.00
Airflow (cfm/Ton)
0.0
Outside Air (%)
0.0
Outside Air (cfm/sgft)
0.00
Note: values above given at ARI conditions
:ATING SYSTEM
26.0 of
Outside All
0 cfm
70.0 of
111.0 / 77.6 of
)0 ;;l
Outside Air
0 cfm
78.0/62.2 of
Total Room Loads
Return Vented Lighting
Return Air Ducts
Return Fan
Ventilation
Supply Fan
Supply Air Ducts
TOTAL SYSTEM LOAD
COIL COOLING PEAK
1COILHTG.PEAK
CFM
I Sensible
Latent
CFM
I Sensible
192
4,705
610
89
3,797
0
830
544
0
0
0
0
0
0
0
0
0
830
544
6,3651 610 4,885
Default FAU/AC 1992 - 2005 1 0 0
Total Adjusted System Output 1 0
(Adjusted for Peak Design Conditions)
TIME OF SYSTEM PEAK Aug 2 pm Jan 12 am
HROMETRICS (Airstream Te
70.0 of 1110.00F
Heating Coil
at Time of H
�% Return Air Ducts 4
drstream Temperatures at Time of
78.0 / 62.3 of. 55.0 / 53.7 of
Cooling Coil
h Return Air Ducts 'I
n
Supply Air Ducts
110.0 of
ROOMS
70.0 of
Supply Air Ducts
55.0 / 53.7 of
41.2% R.H. ROOMS
78.0 / 62.2 of
EnergyPro 4.2 by EnergySoft User Number: 5732 Job Number: Ig071906 Page:9 of 9