0201-219 (SFD)U)
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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
42$318�.1 B f` 07 311/9C
Daiee y h,,t_ Signature of Contractor
7—/
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). - A.
() 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.
`Q;) 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.
11, ATS M24D J280990-01
(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.
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. e'
IMPORTANT Application is hereby made to the Director of Building and Safety p
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 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
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 enterrupon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) Dater}%�+%�.
BUILDING PERMIT PERMIT /i
DATE _, t VALUATION LOT TRACT
JOB SITE
APN k
ADDRESS q p� p 9� yt�y q p A
r� 7 7 gSiG
OWNER
CONTRACTOR/ DESIGNER/ EN (NEER
1719
ri 19 3 rpt�!'0: .
(X—S&MCDE CA 92054
S OCERANSITA. VA. W2054.
(766)967.0069 C13110 1955
USE OF PERMIT
SPO- PhXMIT 1:rVE.3 N0, MtC:i.UDE PLO= WAIAZ. POOL, OR. DR1V.xWA'V
TRACT C-ONSTRUCTION 1,352100 O
61,A,fsA:0WC:,lARPORT 460.00 SIS
; ,mi ; 'WOOD TgVINC4 200.00 1.1
1tUMATAltAi"6:•OdDT 0.7.1 C'01YFYXA:L4'.PCA..E'V:r'H
97,1%5,0q,
FEE DEP031T 1014400-439-318 a�?0:tt4
CONSTRUCTION VEX 1IR"000 s�itS.Sit
KA114 MIMIC, (RE i406,71
FERIi?'D�00Q-tz). 000
RUX I RIM, ME 1.01':.000.42Q3 MO MUM
PLUIVISttacrPc;>'• 1014,100-419-000
S°T1i.OW0 MOTlOWPU - 3I1J.'. ID' 101.000.241.000
aL-MA DY140 ITIS 101-000.423-O W
PIMA.R89Is'1..1!N 101-U0"41-3-45 $1.00,011
Ji
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7
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RECEIPT
DATE f, J o ,z:
3
1
BY
I PEC OR
.1J f .,
J
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
— —Q
Underground Ducts
Forms & Footings
J
Ducts If
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
_ 6/ Z_
Exhaust Fans
O.K. to Wrap
in�
F.A.U.
Framing
o
Compressor
Insulation
— 2 y
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
-�
Drywall - Int. Lath
Z
Final
Final
POOLS - SPAS
BLOCKWALL
APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Y
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. 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
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
Final — — —
Utility Notice (Perm) 7 �
r y.
1N -
I
a1
J)
Building
Address
Owner
Mailing
Address /7
fit. f- f
��utrCt/
P.O. BOX 1504 APPLICATION ONLY
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 02- o
]BUILDING: TYPE'CONST. OCC. GRP.
7tr'/(1'+r/ A.P. Number
Contractor
Address/
City lZip Tel.
State sic.�'l Z S 3 �I I i
& Classif. L
'7 ica#
Arch., Engr.,
Designer
Address Tel.
City IZip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION L
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he Is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for thealleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
I] 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, 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. If, 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.)
1 II'
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.)
17 1 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 turnished.-
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of 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, after making this Certificate or Exemption you should become
subject to the Workers' Compensation provisions or the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Signature of a0plicant Date
Mailing Address
City, State, Zip
Project Description
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
pt�z�
No.
Stories
No. Dw.
Units
New dV" Add ❑
Alter ❑
Repair ❑ Demolition ❑
Date Permit
Validated by:
Validation:
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
�5 0
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure `
1 i A
T I
TOTAL
REMARKS
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:
L3 Id (�
WHITE = FINANCE YELLOW = AP A PINK = BU ION
Notice:
Document Cannot Be Duplicated
Date 2/4/02
No. 22900
owner NameDavid R. Miller
No. 52705
city La Quinta
Desert Sands Unified School District
.47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Street Avenida Herrera
APN# 773-293-023
Jurisdiction La Ouinta
Zip 92253
Permit # 0201-219
Log #
Study Area
Tract # BLK 152 Lot # 10 Square Footage 1382
Type of Development Single Family Residence No. of Units 1
Comments
Tract Construction 1382 s.f. ,
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 1,382 or $ 2,833.10 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
Fees Paid By CC/Capital Bank of North County - David Miller Telephone
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Nicola Wong
' Signature
Payment Received $2;833.10
'Check No. 086014.
NOTICE: Pursuant to Assembly Bill 3081 (CHAP 549,VATS. 1996) 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 sssued or on which they are paid to the District(s) or to another public entity authorized to
collect 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
tie
RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL THIS DEED AND,
UNLESS OTHERWISE SHOWN BELOW,
MAIL TAX STATEMENTS TO:
David Ross Miller
1719 S. Tremont
S. Oceanside, CA 90254
SPACE ABOVE THIS LINE FOR RECORDER'S USE
The undersigned grantor(s) declare(s): Grant Deed . A.P.N. 773-293-023
Documentary transfer tax is $
( XX ) 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, ( ) City of
,and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
FRED & ULA V.C. OLDS
herebyGRANT(S)to DAVID ROSS MILLER, a married man as his sole. and separate property
the real property in the City of La Quinca
State of California, described as
County of Riverside
Lot . 10 of Block 152 Unit No, Santa Carmelita at Vale La
Quinta,
as per map recorded in Book Pages • g mf Maps, Records of Riverside County,
California
Dated January 8, 2002 Signature of Grantor
Slate of California )
County of )
FRED & ULA V.C: OLDS
On before me,
,personally appeared - -
FRED & ULA V C OLDS
personally known to me (or proved to me on the basis of satisfactory
evidence) to be the person(s) whose nane(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they executed _
the same in his/her/their authorized capacity(ies), and that by
histher/their signature(s) on the Instrument the person(s), or the entity
upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signature
MAIL TAX STATEMENTS TO,
I -
RECEIVED \
o JAN 15 2002 z
RC DISTRICT - PLANNING REVIEW FORM
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 200 feet of the applicant, 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
SITE ADDRESS
DAVID MILLER
52-705 Avenida Herrera
APN i 3 - Z23 - OZ3 CASE NO.:
LEGAL: LOT /O
CHECK AND APPROVED BY:
BLOCK / �Z
2002-609
Wally Nesbit
UNIT l6 S.C.@V.L.Q.
DATE:
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
r
epproved h4
Other Requirements: p Planning Comm
O City Council
�ommunity Dev.
Initials
Case No, �C—°Z�--
Exhibit
slo
Dept
Beso #
�..—._.—
= �_.—.
Certificate of Occupancy
City of La Quintal
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:
SINGLE FAMILY DWELLING.
52-705 AVENIDA HERRERA
R-3 Type of Construction: VN
Owner'of Building: DAVID R. MILLER
Building Official
Bldg. Permit No.: 0201-219
Land Use Zone: RC
Address: 2551 STATE STREET, STE. 111
City: CARLSBAD, CA 92008
By: DANIEL P. CRAWFORD, JR.
Date: MAY 28, 2002
POST IN A CONSPICUOUS PLACE
r- - TITLE 24 REPORT
Title 24 Report for:
San Felipe Model -East
Pacific Trades Model Houses
, CA
Project Designer:
Pacific Trades
1719 S. Tremont
Oceanside, CA 92054
760-967-0069
Report Prepared By:
J. Lyon/ L. Joven Aun
J.B.L. ASSOCIATES
242 NORTH 8TH ST.
EL CENTRO, CA 92243
(760) 352-2105
Job Number:
J0113 -S. Fel.
Date:
2/1/02
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: J0113-S.Fel. User Number: 4305
a
I -- TABLE OF CONTENTS
Cover Page 1
Table of Contents. 2
Form CF -1 R Certificate of Compliance 3
Form MF -1 R Mandatory Measures Checklist 6
Form C -2R Computer Method Summary 7
HVAC System Heating and Cooling Loads Summary 11
EnergyPro 3.1 By EnergySoft Job Number. J0113-S.Fel. User Number. 4305
Certificate of Compliance: Residential (Part 1 of 2) CF -1 R
San Felipe Model -East 2/1/02
Project Title Date
Pacific Trades Model Houses
Project Address Building Permit #
J.B.L. ASSOCIATES (760) 352-2105 Plan Check I Date
Documentation Author Telephone
Computer Performance 15Field Check / Date
Compliance Method (Package or Computer) Climate Zone Enforcement Agency Use Only
GENERAL INFORMATION
Total Conditioned Floor Area: 1,431 ft2 Average Ceiling Height: 10.0 ft
Total Conditioned Slab Area: 1-431f?
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,
Number of Dwelling Units: 1.00
Number of Stories: 1
Component
Floor Construction Type: ® Slab Floor
❑ Raised Floor
Const.
Frame Assembly Location/Comments
Tvoe I I -Vali 1P (attic. aaraae. tvoical. etc.
Slab On Grade
n/a
0.756
Exposed Slab w/R-0.0 Perimeter Insulation
Slab On Grade
n/a
0.756
Covered Slab w/R-0.0 Perimeter Insulation
R-13 Wall (1.13.2x4.16)
Wood
0.088
Exterior Wall
Metal insulated
None
0.098
Exterior Door
Garage Wall
Wood
0.085
Exterior Wall
Solid Wood Door
Wood
0.387
Exterior Door
R-38 Roof
Wood
0.024
Exterior Roof
FENESTRATION
Shading Devices
Type
Orientation
Area
Fenestration Exterior
Overhang Side Fins
SF
Shading
Yes / No
Yes / No
Front
(East)
25.0
0.72
0.70
Bug Screen
❑X ❑
❑ ❑X
Right
(Northeast)
4.0
0.72
0.70
Bug Screen
❑x ❑
❑ X❑
Front
(Southeast)
4.0
0.72
0.70
Bug Screen
X❑ ❑
❑ X❑
Left
(South)
60.0
0.59
0.38
Buq Screen
x❑ ❑
❑ X❑
Rear
(West)
89.0
0.59
0.38
Bug Screen❑
x❑
❑ x❑
Right
(North)
33.0
0.72
0.70
Bug Screen
❑R ❑
❑ X❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
Run Initiation Time: 02/01(02 09:13:41
Run Code; 1012672821
En Pro 3.1 By Ener Soft
User Number: 4305
Job Number: J0113-S.Fel.
P e:3 of 11
Certificate of Compliance: Residential (Part 2 of 2) CF -1 R
San Felipe Model -East 2/1/02
Project Title Date
HVAC SYSTEMS Note: Input Hydronic or Combined Hydronlc data under Water Heating Systems, except Design Heating Load.
Equipment Minimum Distribution
HeatingType and Duct or
Type (furnace, heat Efficiency Location Piping Thermostat Location /
pump, etc.) (AFUE/HSPF)(ducts, attic, etc.) R -Value Type Comments
Central Fumace 80% AFUE Ducts in Attic 4.2 Setback Res HVAC
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 10.0 SEER Ducts in Attic 42 Setback Re-, HVAC
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
A.O. SMITH FPS -4a224 Small Gas Standard 1_ 42.000 40 0.62 n/a n/a
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. 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:
Documentation Author
Name: J. Lyon/ L. Joven Aun
Title/FirTn: Pacific Trades Title/Firm: J.B.L. ASSOCIATES
Address: 1719 S. Tremont Address: 242 NORTH 8TH ST.
Oceanside CA 9205 EL CENTRO, CA 92243
phone: 760-967-0069 Telephone: (760) 352-2105
Lic.
IN
(signature)( ate)
Enforcem It Agency
Name:
Title/Firm: _
Address:
Telephone:
L
('nature) n ;yi — �� L (da e)
Z`l lU�
lEnergyPro 3.1 By EnergySoft User Number: 4305 Job Number: J0113S.Fel. Page:4 of 11 1
Certificate of Compliance: Residential (Addendum) CF -1 R
San Felipe Model -East 2/1/02
Project Title Date
Special Features and Modeling Assumptions
The local enforcement agency should pay special attention to the items specked 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
oases on me aaequacy oT me specrai lustmcatron ana aocumentation sunmMW.
Plan I Field
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.p(� Field
The HVAC System "Res HVAC" includes Refrigerant Charge and Airflow Credit (or a TXV). A certified HERS rater must provide
verifification 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.
EnerayPro 3.1 By EnergySoft User Number: 4305 Job Number: J0113 S. Fel. Page:5 of 11 1
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 (') 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 N/A if not applicable.
DESIGNER
ENFORCEMENT
Building Envelope Measures
FV7'§ 150(a): Minimum R-19 ceiling insulation in wood frame assembly, or equivalent U -value.
§ 150(b): Loose fill insulation manufacturers labeled R -Value.
a.§ 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.
❑ §150(l): Slab edge insulation -water absorption rate <= 0.3%, water vapor transmission rate <= 2.0 pematinch.
FX§118: 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 SHGC, and infiltration certification.
3. Exterior doors 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.
❑ §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
X 9110-13: HVAC equipment water heaters, showerheads and faucets certified by the Commission.
X §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA or ACCA.
a§150(1): Setback thermostat on all applicable heating and/or cooling systems.
§150(j): 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 internaUexternal 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.
'§15%m): Ducts and Fans
1. I 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 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 114 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 doth 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: Pod 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 36' 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.
X] §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/ r)
Lighting Measures
❑ §150(k)1: Luminaires for general lighting in kitchens shall have lamps with an efficacy 40 lumensfwatt 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.
❑ 150(k)2: Rooms with a shower or bathtub must have either at least one luminaire with lamps with an efficacy of 40 lumenstwatt
or greater switched at the entrance to the room or one of the attemative 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: 4305 Job Number: J0113 -S. Fel. Page:6 of 11
Computer Method Summary (Part 1 of 3) C -2R
P o Tele Model -East Date 211102
Pacific Trades Model Houses
Project Address Building Permit #
.1 B_ -L_ ASSOCIATES (60) 352-2105 plan Check/Daft
Author Telephone
-m-uter Performance 15 Field Check/Date
Co p1lance Method (Package or Computer) Climate Zone
Source Energy Use Standard Proposed Compliance
(kBtu/sf-yr) Design Design Margin
Space Heating
3.36
3.78
-0.42
Space Cooling
39.96
41.60
-1.64
Domestic Hot Water
16.29
13.59
2.70
Totals
59.60
58.97
0.63
GENERAL INFORMATION
Conditioned Floor Area: 1,431 Floor Construction Type: X❑ Slab Floor
Building Type: Single Fam Detached ❑ Raised Floor
Building Front Orientation: (East) 90 deg
Number of Dwelling Units: 1.00 Total Conditioned Volume: 14,310
Number of Stories: 1 Slab Floor Area: 1,431
BUILDING ZONE INFORMATION # of Thermostat Vent
Zone Name Floor Area Volume Units Zone Type Type Hgt. Area
Res HVA - 1 431 14 310 1 00 _rnnd"nned Stthar-k
OPAQUE SURFACES Act.
Type Area U -Val. Azm. Tilt
Wall 128 0.088 90 90
nonr 21 0.098 9 _ gn
Wall 12 0.088 _ 45 _fid
Wall _ 12 0-088 135 9a
Wall 201 0.085 _a 90
Door 21 0.387 _0 _go
Wall 258 0.088 180 90
Roof 1,431 0.024 _ 0 _22
Wall 318 0.088 270 Aa
yy;111 _ 247 0.088 _a ga
Solar
Gains
Y / N Form 3 Reference
Location / Comments
►'�
■
� ._ a .. -
■
■
:13:41
I EneravPro 3.1 By EnergvSoft User Number: 4305 Job Number: J0113-S.Fel. Page:7 of 11 1
Computer Method Summary (Part 2 of 3) C -2R
San Felipe Model -East 2/1/02
Project Title Date
FENESTRATION SURFACES
# Type
-1-
2
Window
Window
Front
Right
(East)_
(Northeast)
3
Window
Front
(Southeast)
4
Window
Left
(South)
5
Window
Left
(South)
8
Window
Rear
Meg)
L
8
Window
Window
Rear
Right
(West)
(North)
Floor Zone
4.0
0.720
0.70
135
90 Double Metal Clear
Floor Zone
40.0
0.590
0.38
180
90 Double Metal Clear Low E
INTERIOR AND EXTERIOR SHADING
# Fviarinr Chnria Tuna QwrZf,
Overhang Left Fin Right Fin
Len. Hgt. LEA RExt. Dist. Len. Hgt. Dist. Len. Hgt.
1 Bug
U-
0.76
Act.
Glazing Type
Location/
Area
Factor
SHGC
Azm.
Tilt
Comments
3 Bu q
screen
0.76
4.0
1.0
6.0 0.1 6.0 6.0
25.0
4.0
0.720
0.720
0.70
0.70
90
45
90 Double Metal Clear
90 Double Metal Clear
Floor Zone
Floor Zone
4.0
0.720
0.70
135
90 Double Metal Clear
Floor Zone
40.0
0.590
0.38
180
90 Double Metal Clear Low E
Floor Zone
20.0
0.590
0.38
180
90 Double Metal Clear Low E
Floor Zone
40.0
0.590
0.38
270
90 Double Metal Clear Low E
Floor Zone
49.0
33.0
0.590
0.720
0.38
0.70
270
0
90 Double Metal Clear Low E
90 Double Metal Clear
Floor Zone
Floor Zone
INTERIOR AND EXTERIOR SHADING
# Fviarinr Chnria Tuna QwrZf,
Overhang Left Fin Right Fin
Len. Hgt. LEA RExt. Dist. Len. Hgt. Dist. Len. Hgt.
1 Bug
Screen
0.76
4.0
4.0
6.0 0.1 6.0 6.0
2 13u�
Screen
0.76
4.0
1.0
6.0 0.1 6.0 6.0
3 Bu q
screen
0.76
4.0
1.0
6.0 0.1 6.0 6.0
4 Bug
Screen
0.76
7.0
6.0
2.0 _0. 2.0 2.0
5 Bug
Screen
0.76
4.0
4.0
2.0 _0. _ 2.0 2.0
6 Bug
Screen
0.76
7 Bug
Screen
0.76
8 Bu
Screen
0.76
5.0
3.5
2.0 0.1 2.0 2.0
EneravPro 3.1 By EneraySoft User Number: 4305 Job Number: J0113-S.Fel. Page:8 of 11 1
Computer Method Summary (Part 3 of 3) C -2R
San Felipe Model -East 2/1/02
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: 02/01102 09:13:41 Run Code: 1012572821
EnergyPro 3.1 By EnerqySoft User Number: 4305 Job Number: J0113S.Fel. Pa e:9 of 11
F2 Insulation
Type Length
Factor R -Val. Depth Location / Comments
Slab Perimeter _ 7
0.76 0.0 0 Floor Zone
Slab Perimeter 123
0.76 0.0 _0 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
80%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
10.0 SEER Dui in Attic 4.2 Setback
Res HVAC
WATER HEATING SYSTEMS
Rated' 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 FPS -40-224
Small Gas Standard 1 _ 42.000 40
0.62 n/a n/a
For small gas storage (rated input — 75000 Btulhr), 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: 02/01102 09:13:41 Run Code: 1012572821
EnergyPro 3.1 By EnerqySoft User Number: 4305 Job Number: J0113S.Fel. Pa e:9 of 11
Computer Method Summary (Addendum) C -2R
San Felipe Model -East 2/1/02
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
Dasea on me adequacy or me Special justdlcatlon and documentation submitted.
Plan I Field
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 I Field
The HVAC System "Res HVAC" includes Refrigerant Charge and Airflow Credit (or a TXV). A certified HERS rater must provide
verifification 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.
EneravPro 3.1 By EneravSoft User Number: 4305 Job Number: J0113•S.Fel. Page: 10 of 11 1
HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY
PROJECT NAME DATE
San Felipe Model -East 2/1/02
SYSTEM NAME FLOOR AREA
Res HVAC 1,431
NGINEERING CHECKS SYSTEM LOAD
Number of S stems
1
Heating System
Output per System
55,000
Total Output (Btuh)
55,000
Output (Btuh/sgft)
38.4
Cooling System
Output per System
47,000
Total Output (Btuh)
47,000
Total Output (Tons)
3.9
Total Output (Btuh/sgft)
32.8
Total Output (sgft/Ton)
365.4
Air System
CFM per System
1,595
Airflow (cfm)
1,595
Airflow (cfm/sgft)
1.11
Airflow (cfm/Ton)
4072
Outside Air (%)
0.0
Outside Air (cfm/sgft)
0.00
NOW 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 PEAKCOIL
HTG. PEAK
CFM
Sensible Latent
CFM
Sensible
1,022
25,408
-543L
668
25,267
0
1,270
1,263
0
0
0
0
01
0
0
0
0
1,270
1,263
27,949 -543 27 794
IER 58BMA075-12 37,459 1,739 55,000
Total Adjusted System Output 37,459 1,739 55,000
(Adjusted for Peak Design Conditions) TIME OF SYSTEM PEAK Aug 2 pm Jan 12 am
Temoeratures at Time of Heatina Peak)
26.0°F
69.3°F
69.3 OF 105.00F
Supply Air Ducts
Outside Air
0 cfm
104.3 OF
Supply Fan
Heating Coil
1595 cfm
ROOMS
70.0 OF
69.3 OF
411
Retum Air Ducts
I
DOLING SYSTEM PSYCHROMETRICS Airstream Temperatures
at Time of Coolin
.Peak
114.0/73.1°F
78.7/61.7°F 78.7/61.7°F
"F
55.0/52.9°F
Supply Air Ducts
`
Outside Air
0 cfm
Supply Fan Cooling Coil
55.7153.2 °F
1595 cfm
ROOMS
38.4% R.H.
78.7/61.7 ° F
78.0 I / 61.4 °F
I .t_
I� r ' u
EnerovPro 3.1 By EnerovSoft User Number: 4305 Job Number: J0113-S.Fel. Page: 11 of 11