0110-123 (SFD)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
5510498 1 A 12A 112(
Date �° '? 6 iSignature of Contractor <r f F f l
mss: •
OWNER -BUILDER DECLARATION,
I hereby 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).
() I am exempt under Section , B&P.C. for this reason
Date Signature of Owner ti
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 S_TAI"g rujN.T.y . Policy No. .4S1 tS9-01
(This section need not be completed if the permit valuation is for $100.00 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. t
Date�F� --� J , Applicant—�:y '-
Wa'rningr: 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 pursuafiFtos_-
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`
work is not commenced within 180.days from date of issuance of Nil
permit, or cessation of work for 180 days will subject permit to cancellationlL.
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 bul ng
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) !% % Date Z,011741
BUILDING PERMIT PERMTN
t
013.0-123
DATE VALUATION LOT TRACT
M.,, 87.40 23 �C.i4 5Z
JOB SITE
APN
��,y.73•�
ADDRESS Sj.•M1).A s/d'.kYJs.73c ,[.� TG L" EL
3-4. -W2
OWNER
CONTRACTOR / DESIGNER / ENGINEER
��
INDIO CA 92201
(i6 )772wme CZL. 0 1457.
USE OF P{E!R•�M�IIT
F W WL M0
SFL)4o1�AcS'e iT.R H-1..PI?•ldiy 1T DOES NOT f9CLUD?, BLOCK WALLS�
TRACT CONSTRUCTION 114112.00 Sig
1n�<p71y't�.iu3�i[f�'�•,�'n�Ip�}iy�y�g, u�pH�'
r )?;(3./0(4
o
.
5 Ft. WOOD "111C;M 20100 LIP
&'V,IT IJT,` ED CC)15'.Y.' C)F ICOINFUZIT4;MOB
92 907.10
'�{:���.���(.';j�'[{'.("aha}.i�''y�9:0�u"��r q`1 /�(,�j y{2 py�^j? $� �} yH
C-014h0'T;»:13\,'3ION 17. E. a0A-•�i•0 4�.A.el�r'S,r'00 soru,�Wb.�
FF.AH f,:"r1?✓IX FXE 101-(.470(3.439-; 163 $308.53
MW! kW1(SAL FRE 1€31.000 4.21-000 $53.50
?X,Jwr,TRIQsAfa T 101-000-420-000 00 $130.38
PLT3��.11NQ FEE 101-000-419-000 9210173
ST-rZONG MU`?'iow i ER - R&SID 101-0030-2031-000 $9.30
(I.u..Ut`iNTO PRE, 101 x000.423.00 $70,00
DTr F1VDPFX IMPACT ME $1,907.0
P.11.EC his;PLA3q 101-G00-44*1-•3441 S10140
FE M 1.)Z'M0IT 3G1.4JtKl 2 31T3 �9Q3.00
C0P x`QitX-Ji'1'(.'X AND .PL X CE WX
$:3,448.06
� — ._� Z1�`�� :T'R�-P.i,�':F�t�,�'
��23•f)QQ
TOTMI rn?AU11 PIKES DUE HOW
Mir
OCT 17 2001
:ITY OF LA QUU ,;Ta
FINANCE DEIx-,
RECEIPT
DATE
BY r
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
I INSPECTOR
OPERATION
I DATE
I INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS .
Set Backs
/_ _ _
Underground Ducts
Forms & Footings�_
Ducts
Slab Grade
l
Return Air
Steel
Combustion Air
Roof Deck
�i�Z:
S(
Exhaust Fans
O.K. to Wrap
Framing
5=p
o
�-
���
F.A.U.
Compressor
Insulation
/��/ j
Vents
Fireplace P.L.
(((
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
_ _
7i���
Final � -L`�_
Final
- POOLS -SPAS
BLOCKWALL
APY ROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
/ .. /
Z `(�
6 _]
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
_
PV R/
Appliances
`_
Final
COMMENTS:
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
i
Final
-
-
Utility Notice (Perm)
ti
7
Building f �5
Address aqACJ r
Owner ,t L '0 )'L/,\ AJ
Mailing
Address
City lZip
BOX 1504 APP (CATION ONLY
-495 78 ALLE TAMPICO
�1 —fes LA QUINTACCALIFORNIA 92253 N (Q /)
VVllll f)lil Vl
/-�. G. 'yam �'r� c s C�•.� 5 1
Address
City Zip Tel.
=' ��a yZ2o� X72--2s�
State Lic. C �R City
& Classif. �j J ! �� °J Lic. #
Arch., Engr.,
Designer �� C
Address Tel.
City Zi P State
L as G2 -S -1 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I 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,Susiness 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 live hundred dollars ($500).
I-] 1, 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, Buisness and
Professions 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. 11, however, the building
or improvement 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 1 I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: 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.)
l I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' 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
n Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg 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.
Date Owner
NOTICE TO APPLICANT: If, alter 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
Ihereby 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 slate 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 a0plicant Date
Mailing Address
City, State, Zip
.DING: TYPE'CO'-N7ST. 1� OCC. GRP.
/
Number 7 1 ; 7) C)y Z-
J Description
.ct Description
AS
Sq.Ft. qC No. 1 No. Dw.
Size -1 7 - Stories 1 Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
N(-TiZA/e. u _-) -7 - - _Z�54-�n ,
on
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc. h
Infrastructure �e
11
TOTAL
REMARKS -
AMOUNT
%1 I
�J r
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
L
Notice:
Document Cannot Be Duplicated
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 10/11/01 APN# 773-133-002
No. 22575 Jurisdiction La Quinta
Owner NameWillaim Doran Permit # 0110-123
No, 51-530 Street Avenida Herrera
City La Quinta zip 92253 `
Log #
Study Area
Tract # BLK 52 Lot # 23 Square Footage 1492
Type of Development Single Family Residence No. of Units 1
Comments
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 or replacement mobilehomes. It
has been determined 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 Government Code 53080 in the amount of
2.05 X 1,492 or $ 3,058.60 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now lie issued
Fees Paid By CC/Bank of America - Alex Torres Telephone
Name on the check
By Dr. Doris Wilson y ,
Superintendent
Fee collected /exe ted by Annette Barlow
Signature
Payment Received $3,058.60
Check No. 2010021505
40TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
rbove will begin to run from the data on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
rolled them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
. . ;P, > tea,- - : _mow, . • �_ _ . ... ' - -
,OMMONWEALTH LAND TITLC CO. a
. O
M1A
yn
go
4
N
T
T
ORDER ,# 194951
ESCROW # 2199-C
WHEN RECORDED MAIL TO:
WILLIAM E. DORAN, TRUSTEE QCC
>
VERNA H. DORAN, TRUSTEE Uj
.1224 W. 252;:Street
Harbor City, .CA 90710
APN # 773-133-002
-rg.q -a G —0162
6 SPACE ABOVE THIS LINE FOR RECORDER'S USE MAIL G
TAX STATEMENTS TO:
Same as above
G R A N T D E E D
The undersigned grantor(s) declare(s):
Documentary transfer tax is $16.50
(X) computed on full value of property conveyed, or
( ) computed on full value less value of liens and encumbrances remaining at time of sale
( ) Unincorporated area: (X) City of La Quint
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged:
CHRISTINE L. ANDELIN, A widow
hereby GRANT(S) TO
WILLIAM E. DORAN and VERNA H. DORAN, TRUSTEES OF THE DORAN FAMILY TRUST DATED SEPTEMBER
10, 1981.
that property in Riverside County, State of California, described as:
Lot 23, Block 52 of Santa Carmelita at Vale La Quinta, Unit #5, as shown on map recorded
in Book 18, Page 63 of Maps, in the Office of the County Recorder of Riverside County,
California.
Date: June 10, 1994 .7
C RISTINE L. ANDELIN
STATE OF CALIFORNIA )
COUNTY OF
OnSuj-s� before me,
T�or�np M (M j�-Z>tJ personally appeared
personally known to me (or proved to me on the basis of
satisfactory evidence) to be the person(s) whose
name(s) is/are subscribed to the within instrument and
acknowledged to me that he/she/they executed the in
his/her/their authorized capacity(ies), and that by
his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the
persons) acted; executed the instrument.
Witness my
Signature
and official seal.
Name (typed or printed)
OFFICIAL SEAL
DONNA M. NELSON
NOTARY PUBLIC -CALIFORNIA
PRINCIPAL OFFICE IN
RIVERSIDE COUNTY
My Commission Expires AUG. 29, 1995
(This ``area_ for official notarial seal)
MAIL TAX STATEMENTS AS DIRECTED ABOVE
cc
Z
Z
er-
;ica -)M
R 9
013
Z j
W N
WILLIAM E. DORAN, TRUSTEE QCC
>
VERNA H. DORAN, TRUSTEE Uj
.1224 W. 252;:Street
Harbor City, .CA 90710
APN # 773-133-002
-rg.q -a G —0162
6 SPACE ABOVE THIS LINE FOR RECORDER'S USE MAIL G
TAX STATEMENTS TO:
Same as above
G R A N T D E E D
The undersigned grantor(s) declare(s):
Documentary transfer tax is $16.50
(X) computed on full value of property conveyed, or
( ) computed on full value less value of liens and encumbrances remaining at time of sale
( ) Unincorporated area: (X) City of La Quint
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged:
CHRISTINE L. ANDELIN, A widow
hereby GRANT(S) TO
WILLIAM E. DORAN and VERNA H. DORAN, TRUSTEES OF THE DORAN FAMILY TRUST DATED SEPTEMBER
10, 1981.
that property in Riverside County, State of California, described as:
Lot 23, Block 52 of Santa Carmelita at Vale La Quinta, Unit #5, as shown on map recorded
in Book 18, Page 63 of Maps, in the Office of the County Recorder of Riverside County,
California.
Date: June 10, 1994 .7
C RISTINE L. ANDELIN
STATE OF CALIFORNIA )
COUNTY OF
OnSuj-s� before me,
T�or�np M (M j�-Z>tJ personally appeared
personally known to me (or proved to me on the basis of
satisfactory evidence) to be the person(s) whose
name(s) is/are subscribed to the within instrument and
acknowledged to me that he/she/they executed the in
his/her/their authorized capacity(ies), and that by
his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the
persons) acted; executed the instrument.
Witness my
Signature
and official seal.
Name (typed or printed)
OFFICIAL SEAL
DONNA M. NELSON
NOTARY PUBLIC -CALIFORNIA
PRINCIPAL OFFICE IN
RIVERSIDE COUNTY
My Commission Expires AUG. 29, 1995
(This ``area_ for official notarial seal)
MAIL TAX STATEMENTS AS DIRECTED ABOVE
UK -
N
ECIFNE
OCT 1 ?0P
RC DISTRICT - PLANNING REVIEW FORM C17Y Ur L 0
HuuiN7A
PLANNING_ DEPARTMENT
This form is to be used by CDD staff for review of single family dwellings in the RC (Cove
Residential) District per Section 9.50.090 of the Zoning Code. Its purpose is to determine:
1) that the proposed house design does not duplicate the same architectural style of any
house within -2-0-0-feet of the applicants and/or 2) --if there is a -need -for the applicant -to file for
Master Design Guidelines. If the applicant does need to file a Master Design Guideline, please
transmitted this information to the Building and Safety Department as part of your correction
list. Please attach additional explanations as necessary.
APPLICANT A. O. TORRES
SITE ADDRESS 51-530 Avenida Herrera
APN 773 - 133 - 002 CASE NO.: 2001-568
LEGAL: LOT 23 BLOCK 52 UNIT
S.C.@V.L.Q.
CHECK AND APPROVED BY: Wally Nesbit DATE: l6 / 2 /u
Inform the assigned Building plan checker upon your assignment to this case. The CDD
Executive Secretary maintains a log book to track applications and assign case numbers.
REQUIRED ITEM
Y.
N
COMMENT/CORRECTION
Verify legal and APN.information
Consistent with MDG on file (as
applicable
MDG filing required (5 filings since
9/3/98)
Architectural variety within 200 feet of
the surrounding area: .
Colors
Materials
Architectural design features
,
L/r
Other Requirements:
APPROVED BY COMMUNITY DEVELOPMENT DEPT
BY""`' -'DATE
EXHIBIT
CASE NO.
�7-1-rs Gs�zz 4 tavr�S
11'* TITLE 24 REPORT I
Title 24 Report for:
Doran Residence
AWL ---
Palm
vim.Palm Desert, CA
Project Designer:
Report Prepared By:
Joan D. Hacker
Insu-Form Inc.
68255 Corta Road
Cathedral City, CA 92234
. (760) 324-0216
0
Job Number:
Date:
10/9/2001
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 Gabel Dodd/EnergySoft, LLC (415) 883-5900.
EnergyPro 3.1 By EnergySoft Job Number. User Number. 2655
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
f
3
5
6
g I
10
EnergyPro 3.1 By EnergySoft Job Number. User Number. 2655
Certificate of Compliance: Residential (Part 1 of 2) CF -1 R
Doran Residence 10/9/2001
Project Title Date
Palm Desert
Project Address Building Permit #
Insu-Form Inc. (760) 324-0216 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: 1,492 f? Average Ceiling Height: 9.0 ft
Total Conditioned Slab Area: 1,492 ft2
Building Type:
(check one or more)
® Single Family Detached ❑ Addition
❑ Single -Family Attached ❑ Existing Building
❑ Multi -Family ❑ Existing Plus Addition
Front Orientation: (East) 90 deg 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.)
Slab On Grade
n/a
0.756
Covered Slab w/R-0.0 Perimeter Insulation
Slab On Grade
n/a
0.756
Exposed Slab w/R-0.0 Perimeter Insulation
R-13 Wall w/1" EPS
Wood
0.059
Exterior Wall
Solid Wood Door
None
0.387
Exterior Door
R-38 Roof (R.38.2x14.16)
Wood
0.028
Exterior Roof
FENESTRATION
Shadina Devices
Type
Orientation
Area
Fenestration
Exterior
Overhang Side Fins
SF
U -Factor
SHGC
Shading
Yes / No
Yes / No
Front
(East)
16.0
0.60
0.65
Bug
Screen
Q ❑
❑ Q
Front
(Southeast)
5.3
0.57
0.67
Bug
Screen
X❑ ❑
❑ x❑
Left
(South)
40.0
0.60
0.65
Bug
Screen
X❑ ❑
.❑ X❑
Rear
(West)
40.0
0.55
0.65
Bug
Screen
x❑ ❑
❑X❑
Rear
(West)
16.0
0.60
0.65
Bug
ScreenX❑
❑
❑ x❑
Right
(North)
20.0
0.60
0.65
Bug
Screen
x❑ ❑
❑ x❑
Right
(North)
40.0
0.55
0.65
Bug
Screen
x❑ ❑
❑ x❑
Right
(Northeast)
5.3
0.57
0.67
Bug
ScreenX❑
❑
❑ XQ
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
Run Initiation
Time: 10/09101
1 C1002662267
EnergyPro
3.1 By EnerqySoft
User Number. 2655
Job Number.
Page: 3 of 10
Certificate of Compliance: Residential (Part 2 of 2) CF -1 R
Doran Residence 10/9/2001
Project Title Date
HVAC SYSTEMS Note: Input Hydronic or Combined Hydronlc 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
r:entral Furnnre 80% AFUE Ducts in Attic 42 Sethack Living7nne
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
WATER HEATING SYSTEMS Rated 1 Tank Energy Fact! 1 External
Water Heater Water Heater Distribution # in Input Cap. or Recovery Standby Tank Insul.
System Name Type Type Syst. Btu/hr (gal) Efficiency Loss (%) R -Value
AQ SMITH WA ER Small Gas R - .ir ./Tim -+T .mp 1_ 40.000 -0 0.65 n/a n/a
PRODUCTS FG E-50-230
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 Stu/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 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. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any
shading feature that is varied is indicated in the Special Features/Remarks section.
Designer or Owner (per Business & Professions Code)
Name: A_ 6 ="ii c r -i s
Title/Firm: cffwsjt—/L-
Address: 0-2
Telephone: 71717,
— ,Y
Lic. #:
Al/
(signal re) (date)
Enforcement Agerfcy
Name:
Title/Firm:
Address:
Telephone:
Documentation Author
Name: Joan D. Hacker
Title/Firm: Insu-Form Inc.
Address: 68255 Corta Road
Cathedral City, CA 92234
Telephone:L6g) 324-o216_
(sign cl
t- (date)
3.1 By EnergySoft User Number. 2655 Job Number: PaoeA of 10
Mandatory Measures Checklist: Residential 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 (7 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 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 NIA if not applicable.
DESIGNER
ENFORCEMEN
Building Envelope Measures
'§ 150(a): Minimum R-19 ceiling insulation in wood frame assembly, or equivalent U -value.
§ 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).
150(d): Minimum R-13 raised floor insulation in framed floors.
i
§ 150(1): Slab edge insulation - water absorption rate — 0.3%, water vapor transmission rate — 2.0 permfinch.
§118: Insulation specified or installed meets insulation quality standards. Indicate type and form.
§116-17: Fenestration Products, Exterior Doors and Infiltrabon/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 SHGC, and infiltration certification.
3: Exteriordoors and windows weatherstripped; all joints and penetrations caulked and sealed.
§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.
a§150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs.
1. Masonry and factory -built fireplaces have closable doors, outside air intake with damper and control, and 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.
F] §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA or RCCA.
§150(i): Setback thermostat on all applicable heating and/or cooling systems.
§1500): Pipe and Tank Insulation
1. Storage gas water heaters with less than 0.58 energy factor shall be externally wrapped with R-12.
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.
'§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 in conditioned space. Openings shall be sealed
with mastic, tape aerosol sealant or other dud- 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 tape 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 cloth back rubber adhesive duct tapes unless such tape is used in combination with
mastic and drawbands.
2. Exhaust fans systems have back draft or automatic dampers. ,
3. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers.
§114: Pool and Spa Heating Systems and Equipment
1. Certified with 78% thermal efficiency, on-off switch, weatherproof instructions, no electric resistance heating, no pilot
'
2. System is installed with at least 3T of pipe between filter and heater for future solar, cover for outdoor pools or 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)
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.
0 150(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 altemative to this requirement allowed in Section 150(k)2.; and
recessed ceiling fixtures are IC (insulation cover) approved.
EnergyPro 3.1 By EnergySoft User Number. 2655 Job Number. Page:5 of 10
Computer Method Summary
(Part 1 of 3) C -2R
Doran Residence
Project Title
10/9/2001
Date
Palm Desert
Project Address
Building Permit #
Ins-FormInc_
(760) 324-0216
Documentation Author
Telephone
pian Check/Date
omr%l I Performance
compliance Method (Package or Computer)
15
Climate Zone
Field Check/Date
Source Energy Use Standard
Proposed
Compliance
(kBtu/sf-yr) Design
Design
Margin
Space Heating 1.18
0.80
0.38
Space Cooling 34.89
38.86
-3.97
Domestic Hot Water 15.82
12.21
3.61
Totals 51.89
51.87
0.02
GENERAL INFORMATION
Conditioned Floor Area:
Building Type:
Building Front Orientation:
Number of Dwelling Units:
Number of Stories:
1,492
Single Fam Detached
(East) 90 deg
1.00
1
Floor Construction Type: X❑ Slab Floor
❑ Raised Floor
Total Conditioned Volume: 13,428
Slab Floor Area: 1,492
BUILDING ZONE INFORMATION # of
Zone Name Floor Area Volume Units
I Mng 7nna 1 447 1147 1 M)
OPAQUE SURFACES Solar
Act. Gains
Type Area U -Val. Azm. Tilt Y / N Form 3 Reference
Thermostat Vent
Zone Type Type Hgt. Area
CnnditinnPd Sethark _Q nh;
Location / Comments
Computer Method Summary (Part 2 of 3) C -2R
Doran Residence 10/9/2001
Project Title °Date
FENESTRATION SURFACES U_ Act. Glazing Type Location/
# Type Area Factor SHGC Azm. Tilt Comments
J--
Windnw
Front
(Fast)
2
Window
Front
(Southeast)
3
Window
Left
(South)
4
Window
Left
(South)
5
Window
Left
(South)
6
Window '
Rear
(West)
Z
Window
Rear
West)
8
Window
Right
(North)
6
Window
Right
(Ngrth)
1Q
Window
Right
(North)
11,
Window
Right
(Northeast)
Living
Living
Living
Zone
Zone
16.0
0.600
_ 0
_0
90 Double NonMtl Clear Default
Zone
40.0
16 1)
5.3
n_soo
0.570
0.65
0.67
An
135
_gn Do ihl . NenMtl .I ar DPfa It
90 Double NonMtl Clear Default
Living
Living
Zone
Zone
24.0
0.600
0.65
180
90 Double NonMtl Clear Default
Living
Zone
12.0
0.600
0.65
180
90 Double NonMtl Clear Default
Living
Zone
4.0
0.600
0.65
180
90 Double NonMtl Clear Default
Living
Zone
40.0
0,550
0.65
270
90 Double NonMtl Clear Default
Living
Zone
9
Bug
Screen
16.0
4.0
0.600
0.600
0.65
0.65
270
0
90 Double NonMtl Clear Default
90 Double NonMtl Clear Default
Living
Living
Living
Zone
Zone
16.0
0.600
_ 0
_0
90 Double NonMtl Clear Default
Zone
40.0
0.550
0.65
0
0 Qouble NonMtl Clear Default
90 Double NonMtl Clear Default
Jiving
Living
Zone
5.3
0.67
0.570
-
45
Zone
INTERIOR AND EXTERIOR SHADING
#
Exterior Shade Type
SHGC
1
Bug
Screen
0.76
2
Bug
Screen
0.76
3
Buq
Screen
0.76
4
Bug
Screen
0.76
5
Bug
Screen
0.76
6
Bug
Screen
0.76
7
Bug
Screen
0.76
8
Bug
Screen
0.76
9
Bug
Screen
0.76
10
Buq
Screen
0.76
11
Bug
Screen
0.76
0.1
2.0
2.0
4.0 4.0
4.0 1.4
4.0 6.0
3.0 4.0
1.0 4.0
6.8 U
4.0 4.0
1.0 4.0
4.0 4.0
6.8 6.0
4.0 1.4
Left Fin
Dist. Len. Hgt.
EnergyPro 3.1 By EnergySoft User Number. 2655 Job Number. Page -.7 of 10 1
Overhang
Len.
Hgt.
LEA
REA.
2.0
0.1
2.0
2.0
2.0
0.1
2.0
2.0
2.0
0.1
2.0
2.0
2.0
0.1
2.0
20
2.0
0.1
2.0
2.0
2.0
_ 01
2.0
2.0
2.0
0.1
2.0
2.0
2.0
0.1
2.0
2.0
2.0
0.1
2.0
2.0
2.0
0.1
2.0
2.0
2.0
0.1
2.0
2.0
Left Fin
Dist. Len. Hgt.
EnergyPro 3.1 By EnergySoft User Number. 2655 Job Number. Page -.7 of 10 1
Computer Method Summary (Part 3 of 3) C -2R
Doran Residence 10/9/2001
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
PERIMETER LOSSES
Run Initiation Time: 10/09/01 14:17:47. Run Code: 1002662267
EnergyPro 3.1 By EnergySoft User Number. 2655 Job Number. Page:8 of 10
F2 Insulation
Type Length
Factor R -Val. Depth Location / Comments
Slab Perimeter 10
0.76 0.0 0 Living Zone
Slab Perimeter 10
0.76 n.o n Living 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
80%AFUE Ducts in Attic 4.2 Setback
Living Zone
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
jiving Zone
WATER HEATING SYSTEMS
Ratedl Tank
Energy Fact! 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.
A O SMITH WATER PRODUCTS
Small Gas RecircMme+Temp 1_ 40.000 50
0.65 n/a - n/a
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.
Run Initiation Time: 10/09/01 14:17:47. Run Code: 1002662267
EnergyPro 3.1 By EnergySoft User Number. 2655 Job Number. Page:8 of 10
HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY
PROJECT NAME DATE
Doran Residence 10/9/2001
SYSTEM NAME FLOOR AREA
Living Zone 1,492
ENGINEERING CHECKS SYSTEM LOAD
Number of Systems
1
Heating System
Output per System
92,000
Total Output (Btuh)
92,000
Output (Btuh/sgft)
61.7
Cooling System
Output per System
47,000
Total Output (Btuh)
47,000
Total Output (Tons)
3.9
Total Output (Btuhlsgft)
31.5
Total Output (sqf rron)
380.9
Air System
CFM per System
1,595
Airflow (cfm)
1,595
Airflow (cfmisgft)
1.07
Airflow (cfm/Ton)
407.2
Outside Air (%)
0.0
Outside Air (cfm/sgft)
0.00
Note: values above given at ARI conditions
Total Room Loads
Return Vented Lighting
Return Air Ducts
Return Fan
Ventilation
Supply Fan
Supply Air Ducts
TOTAL SYSTEM LOAD
COIL COOLING PEAK
11COILHTG.PEAK
CFM
I Sensiblel Latent
CFM
I Sensible
1,523
26,904
3,27
383
21,556
0
0 0
1,345
1,0781
0
r
0
0
0
0
0
0
1,345
1,078
29,5941 327 23 71
BDP CO.563AN048-A 30,865 12,002 92,000
Total Adjusted System Output30,865 12,002 92,000
(Adjusted for Peak Design Conditions)
TIME OF SYSTEM PEAK I Aug 2 pm Jan 12am
EATING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Heating Peak
26.0 of 69.4 OF 69.4 OF 123.2 OF
Supply Air Ducts
Outside Air
0 cfm Supply Fan Heating Coil 122'5 °F
1595 cfm ROOMS
69.4 of 70.0 OF
Retum Air Ducts I
11.0 / 77.4 of
Outside Air
0 cfm
78.8/66.3 of
3.1
78.8 / 66.3 OF 78.8 / 66.3 OF 60.7 / 59.6 OF
Supply Fan Cooling Coil
1595 cfm
User Number. 2655
Return Air Ducts
Job Number.
Supply Air Ducts
61.5 / 59.9 of
53.6% R.H. ROOMS
78.0 / 66.0 OF
of 10
1900M LOAD SUMMARY
PROJECT NAME
Doran Residence
DATE
10/9/2001
SYSTEM NAME
Living Zone
FLOOR AREA
1,492
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
Living Zone
Living
1
1,523
26904
,
3 271
1523
,
26 904
3271
,
383
21556
,
PAGE TOTAL I 1,523 26,904 3,271 383 21,556
TOTAL 1 1,523 26,904 3,271 383 217556
EnergyPro 3.1 By EnergySoft User Number. 2655 Job Number. Page:10 of 10
Certificate 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:
Use Classification:
Occupancy Group:
Owner of Building
SINGLE FAMILY DWELLING
51-530 AVENIDA HERRERA
R3 Type of Construction
WILLILAM DORAN
Bldg. Permit No.: 0110-123
VN Land Use Zone: RC
Address: 81-900 AVENUE 52
City: INDIO, CA 92201
By: RICHARD KIRKLAND
Date: MARCH 29, 2002
Building Official
POST IN A CONSPICUOUS PLACE