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08-0430 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-00000430 Property Address: 52647 VIA SAVONA APN: 772-410-999-13 -298943- Application description: DWELLING - SINGLE FAMILY Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 516815 T4'!t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: BARNARD _ 52-865 LATROBE LANE DETACHED.(2 LA QUINTA, CA 92253 Applicant: Architect or Engineer: Lic.,No.: 00 ARE FOOT // 114f- ------------------ LICENSED CONTRACTOR'S 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 Bu 'Hess and Professionals Code, and my License is in full force and effect. a Lice Class: 13 License No.: 683969 a I at Contractor: - - _ OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the . permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERIMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Contractor: 1111% CAL -TECH DEVELOPM P 78150 CALLE TAMP E ~ LA QUINTA, CA 9 253 (760)771-3738 Lic. No.: 683 9 49 Date: 8/27/08 ------------------------ ---- -------- WORKER'S COMPENSATI ON I hereby affirm under penalty of perjury one of the following declaratio I have and will maintain a certificate of consent to self -insure workers' c mpensation, as provided for by Section 3700 of the Labor Code, for the performance o e wo for which this permit is issued. 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1768839 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 37 0 of the /yLabor de, I shall fo hwith comply with those provisions. � '7 Dat 2 1 -Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned, prop ' ty for insp!cti purposes. D�Q._r'-bgSignature (Applicant orAgent). l'� I- Application Number . . . . . 08-00000430 Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 2090.50 Plan Check Fee 1358.83 Issue Date . . . . Valuation . . . . 516815 Expiration Date . . 2/23/09 Qty Unit Charge Per Extension BASE FEE 2039.50 17.00 3.0000 ---------------------------------------------------------------------------- THOU BLDG 500,001-1,000,000 51.00 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . . Permit Fee . . . . 257.80 Plan Check Fee 64.45 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/23/09 Qty Unit Charge Per Extension BASE FEE 15.00 5905.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 206.68 1056.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 21.12 1.00 15.0000 ---------------------------------------------------------------------------- EA ELEC TEMPORARY POWER POLE 15.00 Permit . . . GRADING PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/23/09 Qty Unit Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 181.50 Plan Check Fee 45.38 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/23/09 Qty Unit Charge Per Extension BASE FEE 15.00 6.00 9.0000 EA MECH FURNACE <=100K 54.00 6.00 9.0000 EA MECH B/C <=3HP/100K BTU 54.00 8.00 6.5000 EA MECH VENT FAN 52.00 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 LQPERMIT Application Number Permit . . . Additional desc . Permit Fee Issue Date . . . . Expiration Date . . . . . . 08-00000430 PLUMBING 200.25 Plan Check Fee - Valuation 2/23/09 50.06 0 Qty Unit Charge Per Extension BASE FEE 15.00 21.00 6.0000 EA PLB FIXTURE 126.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 13.00 .7500 EA PLB GAS PIPE >=5 9.75 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 5905 SQ. FT. SFD THIS PERMIT DOES NOT INCLUDE POOL & SPA BLOCK WALLS OR DRIVEWAY APPROACH. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 792.03 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 135.88 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE 22.50 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 51.68 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1930.00 Fee summary Charged Paid Credited ---------------------------------------- Due ----------------- Permit Fee Total 2745.05 .00 .00 2745.05 Plan Check Total 1518.72 750.00 .00 768.72 Other Fee Total 5477.09 .00 .00 5477.09 Grand Total 9740.86 750.00 .00• 8990.86 LQPERAUT Building l Address Z 7 Owner zi [ �� Mailing/9Gi Addres;!5?j&s L pA_dk? Cror A ress TUT 4 4 a" P.O. BOX 1504 78-495 CALLE TAMPICO �(/4J'f l�d/(/� LA QUINTA, CALIFORNIA 92253 < /"r/ ,5tf—; - D - 7 71 -- S 8 State Lic. City & Classif. Lic. # Arch., En r., Designerv1-1-7ye- (� cr r Address Tel. Q,yyp !3 6eLP°/ZiAZ 4Z✓f - Zed CT`i r? F?Z-6'r-G l,:,#C 2tfo? 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, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or im- provement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions 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.) ❑ 1 am exempt under Sec. B. & P.C. for this reason WORKER'S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT.. If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above-mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip o s ~ice ,� Slo APPLICATION ONLY BUILDING: TYPE 2 CONST R OCC. G^�R A.P. Number 7!7 '— ✓ (7y Legal Description Project Description Sq. Size No. No. Dw. Stories Units Add ❑ Alter ❑ Repair ❑ Demolition ❑ Itstimated Valuation // OOcJ, (reo lip PERMIT i 4/310 AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading 4' ,,A Driveway Enc. ° Infrastructure 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: Validated by: Validation: Date Permit WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE Coachella 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 LEVEL ONE AMOUNT: LEVEL. TWO AMOUNT: MITIGATION AMOUNT: COMNVIND. AMOUNT: DATE: RECEIPT: CHECK #: INITIALS: CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Mr. & Mrs. Jac Bernard (The Hideaway) Date: 08/29/08 Owner's Name: Mr. & Mrs. Jac Bernard Phone No. (760) 771-3738 Project Address: 52-647 Via Savona, La Quinta, CA 92253 Project Description: 1 Single Family Dwelling APN: 777-370-007 Tract #: Lot #'s: Type of Development: Residential XY! Commercial Industrial Total Square Feet of Building Area: 5,905 sq. Ft. 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: 08/29/08 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 Agreement Existing Not Subject to Fee 17620 65995 Approval Prior to 1/1/87 Requirement Number of Sq.Ft. 5,905 sq. ft. Amount per Sq.Ft. $ 3.78 Amount Collected $ 22,320.90 Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Support Services Certificate issued by: Leticia C. Torres, Facilities Analyst 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. LT:c/imdocs/devfees/certificate ofcomplimce form tablesTO 11SL'.doc 1/16/03 T Certificate of Occupanc Y OF9 Building & Safety Department q This Certificate is issued pursuant to the requirements of Appendix Chapter 1 Section 110 of the 2007 California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 52-647 VIA SAVONA Use classification: SINGLE FAMILY DWELLING Building Permit No.: 08-430 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Sprinklers Installed: NO Sprinklers Required: NO . Occupant Load: 10 Owner of Building: BARNARD I Address: 52-865 LATROBE LANE City, ST, ZIP: LA QUINTA, CA 92253 i By: STEVE TRAXEL Building Official Date: NOVEMBER 19, 2009 POST IN A CONSPICUOUS PLACE ------------ a I TITLE 24 REPORT I Title 24 Report for: Bernard Custom Home 52647 Via Savona La Quinta, CA 92253 Project Designer: South Coast Architects 13 Corporate Plaza Suite 210 Newport Beach, CA 92660 949-720-7022 Report Prep 7iGUILDINOGF LA QUINTA Chuck is & SAFETY DEPT. Energy ImVED 1015 E. ChapmatNST U TION Fullerton, CA92831 (714) 871-8;1 M2- ®� e ' Job Number: 02882 R-1 Date: IM-3AGI The EnergyPro computer program has been used to perform theisteuta<ns 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 4.4 by EnergySoft Job Number: 02882 R-1 User Number: 4749 HERS Rater PROJECT NAME DATE Bernard Custom Home 7/28/2008 Dave Highland 16821 McPherson Ave Lake Elsinore, CA 92530 909-499-6354 Reference CF -1 R 4of4 EnergyPro By EnergySoft User Number: User Job Number: 02882 R-1 Page:2 of 21 TABLE OF CONTENTS Cover Page HERS Rater Table of Contents Form CF -1 R Certificate of Compliance Form MF -1 R Mandatory Measures Summary Form WS -5R Residential Kitchen Lighting HVAC System Heating and Cooling Loads Summary Room Load Summary 1 2 3 4 11 13 14 18 EnergyPro 4.4 by EnergySoft Job Number: 02882 R-1 User Number: 4749 Certificate Of Compliance : Residential (Part 1 of 4) CF -1 R Bernard Custom Home7/28/2008 ❑ Addition Total Conditioned Floor Area: 5,905 ft2 Project Title ❑ Existing + Add/Alt Existing Floor Area: n/a Date 52647 Via_Saynna I a_Qiinta Raised Floor Area: 0 ft2 Project Address Natural Gas Slab on Grade Area: 5,309 Building Permit # FeravImpacts Average Ceiling Height: (714) 871-8197 ft Documentation Author Avg. U: 0.36 Number of Dwelling Units: Telephone Plan Check/Date _FwPm Compliance Method Number of Stories: CA Climate one 15 Climate Zone Field Check/Date TDV Standard Proposed Compliance Units Zone Type Type Ong Con ifioned SetbaCk- (kBtu/sf-yr) Design Design Margin 054 ConditionPd Sethack 0.28 Conditioned Sethack Space Heating 2.62 2.20 0.42 0.1 o Conditioned Setback Space Cooling 64.35 64.91 -0.56 Fans 9.15 9.16 -0.01 Domestic Hot Water 4.09 3.88 0.21 Pumps 0.00 0.00 0.00 Totals 80.21 80.15 0.06 Percent better than Standard: 001% Building Type: [E Single Family ❑ Addition Total Conditioned Floor Area: 5,905 ft2 ❑ Multi Family ❑ Existing + Add/Alt Existing Floor Area: n/a ft2 Building Front Orientation: (E) 90 deg Raised Floor Area: 0 ft2 Fuel Type: Natural Gas Slab on Grade Area: 5,309 ft2 Fenestration: Average Ceiling Height: 12.3 ft Area: 1,246 ft2 Avg. U: 0.36 Number of Dwelling Units: 1.00 Ratio: 21.1% Avg. SHGC: 0.32 Number of Stories: 2 BUILDING ZONE INFORMATION # of Thermostat Vent Zone Name HVA(: - 1 A/(- 2 Floor Area Volume 464 4 R41 Units Zone Type Type Ong Con ifioned SetbaCk- Hgt. 8 Area n HVAC - 2 HVAC 3 3,176 4167 1-668 19,454 054 ConditionPd Sethack 0.28 Conditioned Sethack 8 8 n/a n/a HVAC Zone 4 596 5n6 0.1 o Conditioned Setback 8 n/a OPA UE SURFACES Q Insulation Act. Type Frame Area U -Fac. Cay. Cont. Azm. Tilt Wall Wnnd 291 n_n74 R-19 R-0 n gn q WAW Wnnd 195 n.o74 R-19 R-0.0 180 _9.Q Wall Wood 158 0.074 R_19 R-0.0 270 q Wall Wnnd 123 n n74 R_19 R -n a n gn Roof Wood 483 _o_Q36_ R_30 R-0.0 n n Wall Wnnd 316 n.074 R-19 R-0.0 gn gn Wall Wnnd 295 n_074 R-19 R-00 gn gn Wall Wnnd 122 n o74 R_19 R-0 0 gn _90 Door None 24 0 500 _None_ R-0.0 go go Will Wnnd 195 0.074 R-19 R-0.0 An gn Wall Wnnd ins n n74 R_19 R-n_n 1R0 _9n Wall Wnnd 216 0074 R_19 R-QQ 180 9p Wall Wood 271 0.074 R-19 R-0.0 270 9Q Wall Wood 268 0.074 R_19 R-0.0 270 _gQ Wall Wnnd 184 0.074 R-19 R-0.0 270 9,Q Wall Wond 72 0.074 R_19 R-0.0 0 cin Wall Wnnd 722 0074 R_19 R-0.0 0 An Wall Wnnd 344 n_n74 R_19 R-0 0 Rnof Wnnd 3,176 0039 R-30 R -n_0 0 Wall Wood 146 n 07 -R_19 R-0.0 _g() gn Wall Wood 528 0.074 R-19 R-0.0 180 go, Wall Wood 115 0.074 R_19 R-0.0 180 99Q Wall Wond 100 0.074 R_19 R-0.0 270 9Il Wall Wnnd 263 n 074 R_19 R-0 n 270 qo Ronf Wnnd 1 745 n 016 R-30 R -n 0 0 Gains Condition Y / N Status JA IV Reference Location / Comments New 09-A5 Casita Znne 1 New 09-A5 Casita Zone 1 New 09-A5 Casita Zone 1 New 09-A5 Casita 7nne 1 New 02-A9 Casita Zone 1 New 09-A5 Living Zone 1 New 09-A5 Living Zone 1 New 09-A5 Living 7nne 1 New 28-A4 Living Zone 1 New 09-A5 Living Zone 1 New n9 -A5 I iving 7one 1 New 09-A5 Living 7nne 1 New 09-A5 Living Zone 1 New 09-A5 Living Zone 1 New 09-A5 Living Zone 1 New 09-A5 Living Zone 1 New 09-A5 I iving 7nne 1 New 09-A5 I ivinq 7nne 1 New 01-A17 Living 7nne 1 New 09-A5 Sleeping Zone New 09-A5 SleepinaZone New 09-A5 Sleeping Zone New 09-A5 Sleeping Zone New 09-85 SIP.eTing 7nne NPw 02-A9 Sleeninn 7nne Certificate Of Compliance : Residential (Part 1 of 4) CF -1 R Bernard Custom How 5,905 ft2 Existing Floor Area: 7/28/2008 Project Title Raised Floor Area: 0 ft2 Date 52647 Via Savona I a Quinta Average Ceiling Height: 12.3 ft Project Address 1.00 Number of Stories: Building Permit # EnP_rdV Imnacts (714) 871-8197 Documentation Author Telephone Plan Check/Date EnerayPro Compliance Method CA Climate Zone 15 Climate Zone Field Check/Date TDV Standard Proposed Compliance (kBtu/sf-yr) Design Design Margin Space Heating 2.62 2.20 0.42 Space Cooling 64.35 64.91 -0.56 Fans 9.15 9.16 -0.01 Domestic Hot Water 4.09 3.88 0.21 Pumps 0.00 0.00 0.00 Totals 80.21 80.15 0.06 Percent better than Standard: 0.1% Building Type: [j] Single Family ❑ Multi Family Building Front Orientation: Fuel Type: Fenestration: ❑ Addition ❑ Existing + Add/Alt (E) 90 deg Natural Gas Area: 1,246 ft2 Avg. U: 0.36 Ratio: 21.1% Avg. SHGC: 0.32 BUILDING ZONE INFORMATION Zone Name Floor Area Volume OPAQUE SURFACES Insulation Act. Type Frame Area U -Fac. Cay. Cont. Azm. Tilt Wall Wnnd 111 n-074 R_1A R -n n An gp Wall Wood 82 0.074 R_1A R-0.0 270 90 Wall Wood 216 0.074 R_19 R-0.0 0 gn Rnnf Wnnd 5q6 _p p32 R_30 R-0 0 _0 Q Total Conditioned Floor Area: 5,905 ft2 Existing Floor Area: n/a ft2 Raised Floor Area: 0 ft2 Slab on Grade Area: 5,309 ft2 Average Ceiling Height: 12.3 ft Number of Dwelling Units: 1.00 Number of Stories: 2 # of Thermostat Vent Units Zone Type Type Hgt. Area Gains Condition Y / N Status JA IV Reference Location / Comments EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page:5 of 21 1 Certificate Of Compliance : Residential (Part 2 of 4) CF -1 R Bernard Custom Home 7/28/2008 Project Title Date FENESTRATION SURFACES # Type Area U -Factor' SHGCZ True Cond. Azm. Tilt Stat. Glazing Type Location/ Comments _1_ Window Front (E) 45"7 0.340 NFRC X3.0 NFR _90_ -9Q New Clad - NFRC.'- 0.340 0.300 Casita Zone 1 2 Window Front (E) 3.1 0.340 NFRC 0_30 NFRC 90 90 New Clad - NFRC - 0.340 0.300 Casita Zone 1 3 Window Rear (W) 20.0 0.340 NFRC 0_30 NFRC 270 90 New Clad - NFRC - 0.340 0.300 Casita Zone 1 4 Window Right (N) 42.0 0.340 NFRC 0_30 NFRC 0 90 New Clad - NFRC - 0.340 0.300 Casita Zone 1 5 Window Front (E) 72.0 0.740 116-A 0_59 116-B 90 90 New Double Metal Tinted CEC Living Zone 1 6 Window Front (E) 24.0 0.340 NFRC 0_30 NFRC 90 90 New Clad - NFRC - 0.340 0.300 Living Zone 1 Z Window Front (E) 9.0 0.340 NFRC 0.30 NFRC 90 90 New Clad - NFRC - 0.340 0.300 Living Zone 1 8 Window Front (E) 124.0 0.340 NFRC 0.30 NFRC 90 90 New Clad - NFRC - 0.340 0.300 Living Zone 1 6 Window Left (S) 42.0 0.340 NFRC-03D NFRC 180 90 New Clad - NFRC - 0.340 0.300 Living Zone 1 -M Window Left (S) 128.0 0.340 NFRC 0.30 NFRC 180 90 New Clad - NFRC - 0.340 0.300 Living Zone 1 " Window Rear (W) 25.0 0.340 NFRC 0_30 NFRC 270 90 New Clad - NFRC - 0.340 0.300 Living Zone 1 12 Window Rear (W) 144.0 0.340 NFRC 0_30 NFRC 270 90 New Clad - NFRC - 0.340 0.300 Living Zone 1 Aa Window Rear (W) 144.0 0.340 NFRC 0.30 NFRC 270 _9.Q New Clad - NFRC - 0.340 0.300 Living Zone 1 14 Window Rear (W) 48.0 0.340 NFRC 0_30 NFRC 270 90 New Clad - NFRC - 0.340 0.300 Living Zone 1 15 Window Rear (W) 22.5 0.340 NFRC 0_30 NFRC 270 90 New Clad - NFRC - 0.340 0.300 Living Zone 1 16 Window Right (N) 36.0 0.340 NFRC 0_30 NFRC 0 90 New Clad - NFRC - 0.340 0.300 Living Zone 1 17 Window Right (N) 1205 0.340 NFRC 0_30 NFRr 0 90 New Clad - NFRC - 0.340 0.300 Living Zone 1 18 Window Front (E) 56.0 0.340 NFRC 0_30 NFRC 90 90 New Clad - NFRC - 0.340 0.300 Sleeping Zone -Q Window Left (S,) 62.0 0.340 NFRC 0.30 NFRC 180 90 New Clad - NFRC - 0.340 0.300 Slee *nng Zone 1. Indicate source either from NFRC or Table 116A. 2. Indicate source either from NFRC or Table 116B. INTERIOR AND EXTERIOR SHADING Insulation Condition Location/ Type Length R -Val. Location Window Status 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 Slab Perimeter 125 None No Insulation 26-A1 New 2 Bug Screen 0.76 2.0 2.0 11.0 0.1 3.0 3.0 3 Bug Screen 0.76 4 Bug Screen 0.76 7.0 6.0 7.0 0. 3.0 3.0 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 Bug Screen 0.76 11 Bug Screen 0.76 5.0 5.0 13.5 0.1 15.5 3.0 12 Bug Screen 0.76 9.0 16.0 13.5 0.1 15.5 3.0 13 Bug Screen 0.76 14 Bug Screen 0.76 8.0 6.0 17.8 0.1 10.0 10.0 15 Bug Screen 0.76 16 Bug Screen 0.76 9.0 4.0 13.5 0.1 15.5 3.0 17 Bug Screen 0.76 18 Bug Screen 0.76 19 Bug Screen 0.76 THERMAL MASS FOR HIGH MASS DESIGN Area Thick.Heat Inside Condition Location/ Type (sf) (in.) Cap. Cond. R -Val. JA IV Reference Status Comments PERIMETER LOSSES Insulation Condition Location/ Type Length R -Val. Location JA IV Reference Status Comments Slab Perimeter 88 None No Insulation 26-A1 New Casita Zone 1 Slab Perimeter 301 None No Insulation 26-A1 New Living Zone 1 Slab Perimeter 125 None No Insulation 26-A1 New Sleeping Zone Run Initiation Time: 07/28/08 14:03:34 Run Code: 1217279014 EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page:6 of 21 Certificate Of Compliance : Residential (Part2 of 4) CFA R Bernard Custom Home 7/28/2008 Project Title Date FENESTRATION SURFACES True Cond. Location/ # Type Area U -Factor' SHGCZ Azm. Tilt Stat. Glazinq Type Comments M Window Left (S) 20.0 0.340 NERC 03 NERC 180 q.Q New Clad - NFRC- 0 340 0.3n0 S__ Aping Zone 21 Window Rear (W) 40.0 0.340 NFRC 0_30 NFRC 270 90 New Clad - NFRC - 0.340 0.300 Sleeping Zone 22 Window Rear (W) 48.0 0.340 NFRC 0_30 NFRC 270 90 New Clad - NFRC - 0.340 0.300 Sleeping Zone 23 Window Front (E) 8.0 0.340 NFRC 0_30 NFRC 90 90 New Clad - NFRC - 0.340 0.300 2nd Floor Zone 24 Window Rear (W) 42.0 0.340 NFRC 0_30 NFRC 270 90 New Clad - NFRC - 0.340 0.300 2nd Floor Zone 25 Window Rear (W) 8.0 0.340 NFRC 0_30 NFRC 270 90 New Clad - NFRC - 0.340 0.300 2nd Floor Zone 2M Window Right (N) 20.0 0.340 NFRC 0.30 NFRC _0 90 New Clad - NFRC - 0.340 0.300 2nd Floor Zone 1. Indicate source either from NFRC or Table 116A. 2. Indicate source either from NFRC or Table 11613. INTERIOR AND EXTERIOR SHADING Window Overhang Left Fin Right Fin # Exterior Shade Type SHGC Hgt. Wd. Len. Hgt. LEA REA Dist. Len. Hgt. Dist. Len. Hgt. 20 Bug Screen 0.76 21 Bug Screen 0.76 6.0 6.0 7.0 0.1 5.0 5.0 22 Bug Screen 0.76 23 Bug Screen 0.76 24 Bug Screen 0.76 7.0 6.0 17.8 0.1 8.0 8.0 25 Bug Screen 0.76 26 Bug Screen 0.76 THERMAL MASS FOR HIGH MASS DESIGN Area Thick.Heat Inside Condition Location/ Type (sf) (in.) Cap. Cond. R -Val. JA IV Reference Status Comments PERIMETER LOSSES Type L Insulation R -Val. Location JA IV Reference Condition Location/ Status Comments Run Initiation Time: 07/28/08 14:03:34 Run Code: 1217279014 EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page:7 of 21 Certificate Of Compliance : Residential (Part 3 of 4) CF -1 R Bernard Custom Home Condition Ducts R -Value Status Tested? 7/28/2008 Project Title Yes 8.0 New Date 8.0 New HVAC SYSTEMS New 0.78 1.91% 0.0 Heating Minimum Cooling Minimum Condition Thermostat Location Type Eff Type Eff Status Type HVAC - 1 A/C 2 Central Furnace 80% AFUE Split Air Conditioner 13.0 SEER New Setback HVAC - 2 Central Furnace 80% AFUE Split Air Conditioner 13.0 SEER New Setback HVAC 3 Central Furnace 80% AFUE Split Air Conditioner 13.0 SEER New Setback HVAC DISTRIBUTION Location Duct Coolinq Location HVAC - 1 A/C 2 Ducted Ducted Attic HVAC - 2 Ducted Ducted Attic HVAC 3 Ducted Ducted Attic Hydronic Piping Pipe Pipe Insul. System Name Length Diameter Thick. Duct Condition Ducts R -Value Status Tested? 8.0 New Yes 8.0 New Yes 8.0 New Yes WATER HEATING SYSTEMS Rated Tank Energy Tank Insul. Water Heater # in Input Cap. Condition Factor Standby R -Value System Name Type Distribution Syst. (Btu/hr) (gal) Status or RE Loss (%) Ext. A O Smith Water Products FPSH-75 Large Gas All Pipes Ins 1 80,000 74 New 0.78 1.91% 0.0 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 REMARKS Title 24 Parts 1-4 Sec10-103 Section CBC 310.11 by installing discipline. Special Features R-19 wall R-30 Roof HERS Test HVAC all R-8 Ducts Energy Specification "approved equal' is performance and certification similar. Rev -2 7/28/08A 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: South Coast Architects Address: 13 Corporate Plaza Suite 210 Newport Beach, CA 92660 Telephone: 949-720-7022 Lic. #: (signature) (date) Enforcement Agency Name: Title/Firm: Address: Telephone: (signature) (date) Documentation Author Name: Chuck Visnic Title/Firm: Energy Impacts Address: 1015 E. Chapman Ave., #205 Fullerton, CA 92831 Telephone: (714)/W1 -01W t % _ A (signature) (date) CABEC C2001nia Assodadon of Buildi.� ngy Coats (IF RTI F 1 E D EMER 07 Y AiN'ALYST ti 1 CH `v;'r +� I"Q..Itli: R 05-02-688 NR 05-03-733 I EnergvPro 4.4 by EnergvSoft User Number: 4749 Job Number: 02882 R-1 Pane -8 of 21 1 Certificate Of Compliance : Residential (Part 3 of 4) CF -1 R Bernard Custom Home 7/28/2008 Project Title Date HVAC SYSTEMS Heating Minimum Cooling Minimum Condition Thermostat Location Type Eff Type Eff Status Type HVAC Zone 4 Central Furnace 80% AFUE Split Air Conditioner 13.0 SEER New Setback HVAC DISTRIBUTION Location Heatir HVAC Zone 4 Ducted Duct Duct Condition Ducts Cooling Location R -Value Status Tested? Ducted Attic 8.0 New Yes Hydronic Piping Pipe Pipe Insul. System Name Length Diameter Thick. WATER HEATING SYSTEMS Rated Tank Energy Tank Insul. Water Heater # in Input Cap. Condition Factor Standby R -Value System Name Type Distribution Syst. (Btu/hr) (gal) Status or RE Loss (%) 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 REMARKS Title 24 Parts 1-4 Sec10-103 Section CBC 310.11 by installing discipline. Special Features R-19 wall R-30 Roof HERS Test HVAC all R-8 Ducts Energy Specification "approved equal' is performance and certification similar. Rev -2 7/28/08Q 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) Documentation Author Name: Name: Chuck Visnic Title/Firm: South Coast Architects Address: 13 Corporate Plaza Suite 210 Newport Beach, CA 92660 Telephone: 949-720-7022 Lic. #: (signature) (date) Enforcement Agency Name: Title/Firm: Address: Telephone: (signature) Title/Firm: Energy Impacts Address: 1015 E. Chapman Ave., #205 Fullerton, CA 92831 Telephone: 7 871-8 97 ki (signature) r r (date) CrQ _ ABEL R 05-02-688 NR 05-03-733 I EnergvPro 4.4 by EnergvSoft User Number: 4749 Job Number: 02882 R-1 Paoe:9 of 21 I Certificate Of Compliance: Residential (Part 4 of 4) CF -1 R Bernard Custom Home 7/28/2008 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 )asea on the adequacy of the special justitication ana documentation submitted. Plan I Field The DHW System "A O Smith Water Products FPSH-75" is a Large Gas water heater with Pilot Loss = 0 btuh. An Air Retarding Wrap must be installed per the manufacturer's specifications that must comply with ASTM E1677-95. An Air Retarding Wrap must be installed per the manufacturer's specifications that must comply with ASTM E1677-95. An Air Retarding Wrap must be installed per the manufacturer's specifications that must comply with ASTM E1677-95. HERS Required Verification Items in this section require field testing and/or verification by a certified home energy rater under the supervision of a HERS provider using approved testing and/or verification methods. Plan Field The HVAC System "HVAC - 1 A/C 2" incorporates HERS verified Duct Leakage. Target leakage is calculated and documented on the CF -4R. The HVAC System "HVAC - 2" incorporates HERS verified Duct Leakage. Target leakage is calculated and documented on the CF - 4R. The HVAC System "HVAC 3 " incorporates HERS verified Duct Leakage. Target leakage is calculated and documented on the CF -4R. The HVAC System "HVAC 3 " incorporates a HERS verified Refrigerant Charge test or a HERS verified Thermostatic Expansion Valve. The HVAC System "HVAC Zone 4" incorporates HERS verified Duct Leakage. Target leakage is calculated and documented on the CF -4R. The HVAC System "HVAC Zone 4" incorporates a HERS verified Refrigerant Charge test or a HERS verified Thermostatic Expansion Valve. EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page:10 of 21 1 Mandatory Measures Summary: Residential (Page 1 of 2) MF -1 R NOTE: Lowdse 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. ENFORCE - 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 LI -factor in metal frame ceiling. COMPLIANCE FEATURE ❑ 9-30 a ❑ § 150(b): Loose fill insulation manufacturer's labeled R -Value: ❑ ❑ ❑ Cg9Y❑PLIANCE FEATURE El apply 150(c): Minimum R-13 wall insulation in wood framed walls or equivalent U -factor in metal frame wa s oes not l- 14 X apply to exterior mass walls). § 150(d): Minimum R-13 raised Floor insulation in framed floors or equivalent Ll -factor. ❑ ❑ ❑ § 150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs 1. Masonry and factory -built fireplaces have: ❑ Q ❑ a. closable metal or glass door covering the entire opening of the firebox ❑ 0 ❑ b. outside air intake with damper and control, Flue damper and control ❑ Q ❑ 2. No continuous burning gas pilot lights allowed. ❑ ❑X ❑ § 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. § 118: Insulation specified or installed meets insulation installation quality standards. Indicate type and include El ❑ El Form: ❑ Q ❑ § 116-17: Fenestration Products, Exterior Doors, and Infiltration/Exfiltration Controls. COMPLIANCE FEATURE WM& 290: Cf. 1R.. 1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. ❑ Q ❑ 2. Fenestration products (except field fabricated) have label with certified LI -Factor, certified Solar Heat Gain ❑ ❑X ❑ Coefficient (SHGC), and infiltration certification. 3. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. ❑ Q ❑ Space Conditioning, Water Heating and Plumbing System Measures § 110-13: HVAC equipment, water heaters, showerheads and faucets certified by the Energy Commission. ❑ Q ❑ § 150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA or ACCA. ❑ Q ❑ § 150(i): Setback thermostat on all applicable heating and/or cooling systems. ❑ Q ❑ § 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 -AIB 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 ❑ Q ❑ 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 ❑ Q ❑ 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 4.4 by EnergySoft User Number. 4749 Job Number: 02882 R-1 Page: 11 of 21 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 ENFORCE - applicable. N/A DESIGNER MENT Space Conditioning, Water Heating and Plumbing System Measures: (continued) § 150(m): Ducts and Fans COMPLIANCE FEATURE R'S 1. All ducts and plenums installed, sealed and insulated to meet the requirements of the CMC Sections 601, 602, 603, 604, ❑ O11 ❑ 605, and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minumum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements 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. 2. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed ❑ ❑X ❑ sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. 3. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive ❑ © ❑ duct tapes unless such tape is used in combination with mastic and draw bands. ❑ ❑ ❑ 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. 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: 07 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 (E24/E26). 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, ❑ © ❑ 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 ❑ ❑X ❑ 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. ❑ 0 ❑ 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 kitchens, 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 ❑ 0 ❑ by an occupant sensor that complies with Section 119(d) that does not tum 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 ❑ 0 ❑ 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 ❑ R ❑ same lot shall be high efficacy luminaires (not including lighting around swimming poolstwater 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 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page: 12 of 21 Residential Kitchen Lighting Worksheet WS -5R Bernard Custom Home 7/28/2008 Project Title Date At least 50% of the total rated wattage of permanently installed luminaires in kitchens must be in luminaires that are high efficacy luminaires as defined in Table 150-C. Luminaires that are not high efficacy must be switched separately. Kitchen Lighting Schedule. Provide the following information for all luminaires to be installed in kitchens. High Efficacy Luminaire Type High Efficacy? Watts Quantity Watts Other Watts (1) 26w Com Flur Triple 4 Pin Elec Circuit 1 Yes X No F 28.0 x 8 = 224 or d (1) 14w Lin FlurT5 Elec Under Cab Circuit 2 Yes X1 No 1 18.0 x 6 = 108 or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes No x = or Yes N0 x = or Yes No x = or Yes No x = or Yes No x = or Total A: 332 B: 0 COMPLIES IF A >_ B YES ® No ❑ EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page: 13 of 21 1 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY PROJECT NAME DATE Bernard Custom Home 7/28/2008 SYSTEM NAME FLOOR AREA HVAC - 1 A/C 2 464 Number of Systems 1 Heating System Output per System 72,000 Total Output (Btuh) 72,000 Output (Btuh/sgft) 155.1 Cooling System Output per System 36,000 Total Output (Btuh) 36,000 Total Output (Tons) 3.0 Total Output (Btuh/sgft) 77.6 Total Output (sgftrron) 154.7 Air System CFM per System 700 Airflow (cfm) 700 Airflow (cfm/sgft) 1.51 Airflow (cfm/Ton) 233.3 Outside Air (%) 0.0 Outside Air (cfm/sgft) 0.00 Note: values above _given at ARI conditions 26.0 of 69.2 of Outside Air 0 cfm Supply Fan 700 cfm 69.2 of Total Room Loads Return Vented Lighting Return Air Ducts Return Fan Ventilation Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COIL COOLING PEAK COIL HTG. PEAK CFM I Sensible Latent I CFM I Sensible 246 9,429 1,180 92 9,317 0 800 569 0 0 0 0 0 0 0 0 0 800 1 569 11,0291 1,180 10,456 Maytag PGF1 RK072'12A PSA036 28,383 0 72,000 Total Adjusted System Output 28,383 0 72,000 (Adjusted for Peak Design Conditions) TIME OF SYSTEM PEAK Aug 2 pm Jan 12 am 69.2 of ® 165.9 of Heating Coil of Heatina Peak �% Return Air Ducts 4 Supply Air Ducts 165.10F ROOMS 70.0 of DOLING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Cooling Peak 111.0 / 77.6 of 79.1 / 57.0 of 79.1 / 57.10F 41.0 / 39.2 of O4 Supply Air Ducts Outside Air 0 cfm Supply Fan Cooling Coil 42.0 / 39.8 of 700 cfm 24.5% R.H. ROOMS 79.1 157.0 of 78.0 / 56.6 of h Return Air Ducts 1� EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page:14 of 21 1HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY PROJECT NAME DATE Bernard Custom Home 7/28/2008 SYSTEM NAME FLOOR AREA HVAC - 2 3,176 ENGINEERING CHECKS SYSTEM LOAD Number of Systems 2 Heating System Output per System 116,000 Total Output (Btuh) 232,000 Output (Btuh/sgft) 73.0 Cooling System Output per System 56,000 Total Output (Btuh) 112,000 Total Output (Tons) 9.3 Total Output (Btuh/sgft) 35.3 Total Output (sgft/Ton) 340.3 Air System CFM per System 1,395 Airflow (cfm) 2,790 Airflow (cfm/sgft) 0.88 Airflow (cfm/Ton) 298.9 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 COIL HTG. PEAK CFM Sensible Latent CFM I Sensible 1,567 47,252 3,404 608 49,268 0 4,008 3,010 0 0 0 0 0 0 0 0 1 0 4,0081 3,010 55,267 3,404 55,288 Maytag PGF1RA144"20C PSA060 92,152 0 232,000 Total Adjusted System Output g2 152 232,000 (Adjusted for Peak Design Conditions) TIME OF SYSTEM PEAK I Aug 2 pm Jan 12 am EATING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Heating Peak 26.0 OF 69.0 OF 69.0 OF 147.10F OSupply Air Ducts Outside Air 0 cfm Supply Fan Heating Coil 146.1°F 2790 cfm ROOMS 69.0 OF 70.0 °F )% Return Air Ducts `i ICOOLING SYSTEM PSYCHROMETRICS (Airstream Temperatures at Time of Coolina Peak) I 11.0/77.6°F 79.3/59.8°F 79.3/59.8°F. 48.3/46.7°F ✓ -1— �� Outside Air 0 cfm 79.3/59.8 °F Supply Fan Cooling Coil 2790 cfm Return Air Ducts Supply Air Ducts 49.7 / 47.4 OF 32.3% R.H. ROOMS 78.0 / 59.3 of EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page: 15 of 21 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY PROJECT NAME DATE Bernard Custom Home 7/28/2008 SYSTEM NAME FLOOR AREA HVAC 3 1,668 EATI N 26.0 of 69.2 of 69.2 of Outside Air 0 cfm 69.2 of Total Room Loads Return Vented Lighting Return Air Ducts Return Fan Ventilation Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COIL COOLING PEAK COIL HTG. PEAK CFM I Sensible Latent CFM I Sensible 599 18,410 2,168 240 19,553 0 1,562 1,195 0 0 0 0 0 0 0 0 0 1,562 1,195 21,533 2,168 Maytag PGF1RA144'20C PSA060 46,019 0 Total Adjusted System Outputa6,o19 0 (Adjusted for Peak Design Conditions) TIME OF SYSTEM PEAK I Aug 2 pm yam Temperatures at Time of Heati 147.3 of Supply Fan Heating Coil 1395 cfm �% Return Air Ducts '4 21,943 116,000 116,000 Jan 12 ann Supply Air Ducts 146.5 of ROOMS 70.0 of (COOLING SYSTEM PSYCHROMETRICS (Airstream Tem[)eratures at Time of Coolina Peak) I 11.0 / 77.6 of 79.1 / 59.7 of 79.1 / 59.8 of . 48.1 / 46.5 of Outside Air 0 cfm 79.1/59.7 of Supply Fan Cooling Coil 1395 cfm Return Air Ducts Supply Air Ducts 49.1 / 47.0 of 32.4% R.H. ROOMS 78.0 / 59.4 of EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page: 16 of 21 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY PROJECT NAME DATE Bernard Custom Home 7/28/2008 SYSTEM NAME FLOOR AREA HVAC Zone 4 596 Total Room Loads Return Vented Lighting Return Air Ducts Return Fan Ventilation Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COIL COOLING PEAK COIL HTG. PEAK CFM Sensible Latent CFM Sensible 375 7,699 1,35 95 5,619 0 653 343 0 0 0 0 0 0 0 0 0 653 343 9 005 1,35 6,306 Maytag PGF1RK060"12A PSA024 17,747 4,466 48,000 Total Adjusted System Output 17 747 4,466 a8,000 (Adjusted for Peak Design Conditions) — TIME OF SYSTEM PEAK Aug 2 pm Jan 12 am EATING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Heating Peak 26.0 OF 69.6 OF 126.0 OF 126.0 OF O Supply Air Ducts Outside Air 0 cfm Heating Coil Supply Fan 125.6 °F 800 cfm ROOMS 69.6 OF 70.0 OF h Return Air Ducts "I ICOOLING SYSTEM PSYCHROMETRICS (Airstream Temaeratures at Time of Coolina Peak) I 11.0 / 77.6 OF Outside Air 0 cfm 78.8/64.6 °F 78.8 / 64.7 OF . 57.9 / 56.8 OF Cooling Coil Supply Fa 800 cfm 57.9 / 56.8 of -� Supply Air Ducts Fan 58.7 / 57.1 of 48.1% R.H. ROOMS 78.0/64.4 OF h Return Air Ducts `i EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page:17 of 21 ROOM LOAD SUMMARY PROJECT NAME Bernard Custom Home DATE 7/28/2008 SYSTEM NAME HVAC - 1 A/C 2 FLOOR AREA 464 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 Casita Zone 1 Casita 1 246 9,429 1,180 246 9,429 1,180 92 9,317 PAGE TOTAL 1 246 9,429 1,180 92 9,317 TOTAL 1 246 9,429 1,180 92 9,317 EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page: 18 of 21 ROOM LOAD SUMMARY PROJECT NAME Bernard Custom Home DATE 7/28/2008 SYSTEM NAME HVAC - 2 FLOOR AREA 3,176 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 1 Living Zone 1 1,567 47,252 3,404 1,567 47,252 3,404 608 49,268 PAGE TOTAL 1 1,567 47,252 3,404 608 49,268 TOTAL 1 1,567 47,252 3,404 608 49,268 EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page: 19 of 21 ROOM LOAD SUMMARY PROJECT NAME Bernard Custom Home DATE 7/28/2008 SYSTEM NAME HVAC 3 FLOOR AREA 1,668 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 Sleeping Zone Sleeping Zone 1 1 599 18,410 2,168 599 18,410 2,168 240 19,553 PAGE TOTAL 1 599 18,410 2,168 240 19,553 TOTAL 1 599 18,410 2,168 240 19,553 EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page: 20 of 21 ROOM LOAD SUMMARY PROJECT NAME Bernard Custom Home DATE 7/28/2008 SYSTEM NAME HVAC Zone 4 FLOOR AREA 596 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 2nd Floor Zone 2nd Floor 1 375 7,699 1,351 375 7,699 1,351 95 5,619 PAGE TOTAL 1375 7,699 1,351 95 5,619 TOTAL 375 7,699 1,351 95 5,619 EnergyPro 4.4 by EnergySoft User Number: 4749 Job Number: 02882 R-1 Page: 21 WT7771 r. , INSTALLATION CERTIFICATE '(Page 1 of 12) CF -6R Site Address Permit Number An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided on this form is required) After completion of final inspection, a copy must be provided to the building department (upon request) and the building owner at occupancy, per Section 10-103(a). WATER HEATING SYSTEMS: Distribution CEC Certified Type If # of Rated Input Heater Mfr Name & (Std, Point- Recirculation, Identical (kW or Tank Volume Type Model Number of -Use, etc) Control Type Systems Btuthr)(gallons) External Efficiency Standby Insulation (EF, RE)z Loss (%)Z R-value2 Signature: Date: AHPROVED 1 For small gas storage (rated input of less than or equal to 75,000 Btu/hr), electric resistance and heat pump water heaters, list Energy Factor (EF). For large gas storage water heaters (rated input of greater than 75,000 Btu/hr), list Recovery (RE), Thermal Efficiency, Standby Loss and Rated Input. For instantaneous gas water heaters, list Thermal Efficiency and Rated Input. 2. R-12 external insulation is mandatory for storage water heaters with an energy factor of less than 0.58. Kitchen Piping: If indicated on the CF -1R, all hot water piping >_ 3/4 inches in diameter that runs from the hot water source to the kitchen fixtures is insulated. Faucets & Shower Heads: All faucets and showerheads installed are certified to the Energy Commission, pursuant to Title 24, Part 6, Section 111. Central Water Heating in Buildings with Multiple Dwelling Units (required for prescriptive) ❑All hot water piping in main circulating loop is insulated to requirements of §1500) ❑Central hot water systems serving six or fewer dwelling units which have (1) less than 25' of distribution piping outdoors; (2) zero distribution piping underground; (3) no recirculation pump; and (4) insulation on distribution piping that meets the requirements of Section 1500) ❑Central hot water systems serving more than 6 dwelling units - presence of either a time control or a time/temperature control ✓ ❑ I, the undersigned, verify that equipment listed above my signature is: 1) the actual equipment installed; 2) equivalent to or more efficient than that specified in the certificate of compliance (Form CF -1R) submitted for compliance with the Energy Efficiency Standards for residential buildings; and 3) equipment that meets or exceeds the appropriate requirements for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner , r I I OF EA UUINTA .31JILDING & SAFETY DEPT, Signature: Date: AHPROVED r-(JH UUNSTRUCTION Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNERr�1IYX__ (( MAR 10 2008 Residential Compliance Forms jBy April 2005 INSTALLATION CERTIFICATE (Page 2 of 12) CF -6R Site Address Permit Number An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided on this form is required) After completion of final inspection, a copy must be provided to the building department (upon request) and the building owner at occupancy, per Section 10-103(a). FENESTRATION/GLAZING: Item Manufacturer/Brand Name (GROUP LIKE RODUCTS) Total Quantity of Area Exterior Product U -factor Product SHGC # of Like Product Square Shading Device Comments/Location/ (5 CF- IRvalue z (<_CF-IRvalueZ Panes (Optionao Feet or Overhang Special Features 1. General Contractor (Co. Name) OR Owner 2. OR Window Distributor 3. Signature Date Installing Subcontractor (Co. Name) OR 4. General Contractor (Co. Name) OR Owner 5. OR Window Distributor 6. Signature Date Installing Subcontractor (Co. Name) OR 7. General Contractor (Co. Name) OR Owner 8. OR Window Distributor 9. 10. 11. 12. 13. 14. 15. Use values from a fenestration product's NFRC label. For fenestration products without an NFRC label, use the default values from Section 116 of the Energy Efficiency Standards. z> Installed U -factor must be less than or equal to values from CF -1R. Installed SHGC must be less than or equal to values from CF -1R, or a shading device (exterior or overhang) is installed as specified on the CF -1R. Alternatively, installed weighted average U -factors for the total fenestration area are less than or equal to values from CF -1R. If using default table SHGC values from § 116 identify whether tinted or not. ✓ ❑ I, the undersigned, verify that the fenestration/glazing listed above my signature: 1) is the actual fenestration product installed; 2) is equivalent to or has a lower U -factor and lower SHGC than that specified in the certificate of compliance (Form CF -1R) submitted for compliance with the Energy Efficiency Standards for residential buildings; and 3) the product meets or exceeds the appropriate requirements for manufactured devices (from Part 6), where applicable. Item #s Signature Date Installing Subcontractor (Co. Name) OR (if applicable) General Contractor (Co. Name) OR Owner OR Window Distributor Item #s Signature Date Installing Subcontractor (Co. Name) OR (if applicable) General Contractor (Co. Name) OR Owner OR Window Distributor Item #s Signature Date Installing Subcontractor (Co. Name) OR (if applicable) General Contractor (Co. Name) OR Owner OR Window Distributor Copies to: Building Department, HERS Rater (if applicable) Building Owner at Occupancy Residential Compliance Forms April 2005 J INSTALLATION CERTIFICATE (Page 3 of 12) CF -6R Site Address Permit Number An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided on this form is required) After completion of final inspection, a copy must be provided to the building department (upon request) and the building owner at occupancy, per Section 10-103(a). HVAC SYSTEMS: Heating Equipment Equip Type (pkg. heat um CEC Certified Mfr. Name and Model Number # of Identical S stems>_CF-IRvalue) Efficiency (AFUE, etc.) Duct Location attic, etc. Duct or Piping R -value Heating Load Btu/hr Heating . Capacity Btu/hr Cooling Equipment Equip Type (pkg. heat um CEC Certified Mfr. Name and Model Number # of Identical Systems Efficiencyi (SEER or EER) >_CF-IRvalue) Duct Location attic etc. Duct R -value Cooling Load Btu/hr Cooling Capacity Btu/hr 1. > symbol reads greater than or equal to what is indicated on the CF -IR value. Include both SEER and EER if compliance credit for high EER air conditioner is claimed. ✓ 1:111, the undersigned, verify that equipment listed above is: 1) is the actual equipment installed, 2) equivalent to or more efficient than that specified in the certificate of compliance (Form CF -1R) submitted for compliance with the Energy Efficiency Standards for residential buildings, and 3) equipment that meets or exceeds the appropriate requirements for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Signature: Date: Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 J INSTALLATION CERTIFICATE (Page 4 of 12) CF -6R Site Address Permit Number INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE INSTALLER COMPLIANCE STATEMENT The building was: ✓ ❑Tested at Final ✓ ❑ Tested at Rough -in INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE: ❑ Remove at least one supply and one return register, and verify that the spaces between the register boot and the interior finishing wall are properly sealed. ❑ If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points between the air handler and the supply and return plenums to verify that the connection points are properly sealed. ❑ Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used ✓ ❑ DUCT LEAKAGE REDUCTION Procedures for field verification and diagnostic testing of air distribution systems are available in RA CM, Appendix RC4.3 NEW CONSTRUCTION: Duct Pressurization Test Results (CFM @ 25 Pa) MeasuredValues 1 Enter Tested Leakage Flow in CFM: Fan Flow: Calculated (Nominal: ✓ ❑ Cooling ✓ ❑ Heating) or ✓ ❑ Measured 2 If Fan Flow is Calculated as 400 cfm/ton x number of tons or as 21.7 cfm/(kBtu/hr) x Heating Capacity in Thousands of Btu/hr, enter total calculated or measured fan flow in CFM here: ✓ ✓ 3 Pass if Leakage Percentage!— 6% for Final or :5 4% at Rough -in: ❑Pass ❑Fail 100 x Line # 1 / Line # 2 ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow in CFM from Pre -Test of Existing Duct System Prior to Duct 4 System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct 5 System for Duct System Alteration and/or Equipment Chan a -Out. Enter Reduction in Leakage for Altered Duct System 6 Line # 4 Minus Line # 5 —(Only if Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) ✓ ✓ Entire New Duct System - Pass if Leakage Percentage:5 6% for Final or:5 4% at Rough -in ❑pass ❑Fail 8 100 x Line # 5 / Line # 2 TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change- ✓ ✓ Out Use one of the following four Test or Verification Standards for compliance: 9 Pass if Leakage Percentage:5 15% [100 x [ (Line # 5) / (Line # 2)]] ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage :5 10% [100 x [(Line # 7) / (Line # 2)]] ❑ Pass ❑ Fail Pass if Leakage Reduction Percentage >_ 60% [100 x [(Line # 6) / (Line # 4)]] ❑ Pass ❑ Fail 11 and Verification by Smoke Test and Visual Inspection r2 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail Pass if One of Lines # 9 through # 12 pass ❑ Pass ❑ Fail ✓ ❑I, the undersigned, verify that the above diagnostic test results were performed in conformance with the requirements for compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 150 (m) of the 2005 Building Energy Efficiency standards. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Signature: Date: Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE (Page 5 of 12) CF -6R I Site Address Permit Number ✓ ❑ THERMOSTATIC EXPANSION VALVE (TXV) Procedures for field verification of thermostatic expansion valves are available in RACM, Appendix R1. ✓ U REFRIGERANT CHARGE MEASUREMENT Verification for Required Refrigerant Charge and Adequate Airflow for Split System Space Cooling Systems without Thermostatic Expansion Valves Outdoor Unit Serial # Access is provided for inspection. The procedure shall Location consist of visual verification that the TXV is installed on ✓ ❑ Yes ❑ No the system and installation of the specific equipment ❑ ❑ Outdoor Unit Model shall be verified. Cooling Capacity Yes is a eass I Pass Fail ✓ U REFRIGERANT CHARGE MEASUREMENT Verification for Required Refrigerant Charge and Adequate Airflow for Split System Space Cooling Systems without Thermostatic Expansion Valves Outdoor Unit Serial # Location Return (evaporator entering) air dry-bulb temperature (Tretum, db) Outdoor Unit Make OF Outdoor Unit Model Cooling Capacity Btu/hr Date of Verification OF Date of Refrigerant Gauge Calibration (must be checked monthly) Date of Thermocouple Calibration (must be checked monthly) Standard Charge Measurement Procedure (outdoor air dry-bulb 55°F and above): Procedures for Determining Refrigerant Charge using the Standard Method are available in RACM, Appendix RD2. Note: The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. Measured Temneratures Supply (evaporator leaving) air dry-bulb temperature (Tsupply, db) OF Return (evaporator entering) air dry-bulb temperature (Tretum, db) OF Return (evaporator entering) air wet -bulb temperature (Tretum, wb) OF Evaporator saturation temperature (Tevaporator, sat) OF Suction line temperature (Tsuction, db) OF Condenser (entering) air dry-bulb temperature (Tcondenser, db) OF Superheat Charge Method Calculations for Refrigerant Charge Actual Superheat = Tsuction, db — Tevaporator, sat OF Target Superheat (from Table RD -2) OF Actual Superheat — Target Superheat (System passes if between -5 and +5°F) OF Temperature Split Method Calculations for Adequate Airflow S lit Method Calculation is not necessarv, i Ade uate Air ow credit is taken Actual Temperature Split = T return, db Tsupply, db OF Target Temperature Split (from Table RD3) OF Actual Temperature Split Target Temperature Split (System passes if between - 3°F and +3°F or, upon remeasurement, if between -3°F and -100°F of Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE (Page 6 of 12) CF -6R Site Address Permit Number Standard Charge Measurement Summary: System shall pass both refrigerant charge and adequate airflow calculation criteria from the same measurements. If corrective actions were taken, both criteria must be remeasured and recalculated. ✓ ❑Yes ❑ No I System Passes Alternate Charge Measurement Procedure (outdoor air dry-bulb below 55 °F) Note: The system should be installed and charged in accordance with the manufacturer's specifications and installer verification shall be documented on CF -6R before starting this procedure. If outdoor air dry-bulb is 55 OF or above, installer shall use the Standard Charge Measure Procedure: Procedures for Determining Refrigerant Charge using the Alternate Method are available in RACM, Appendix RD3. Weigh -In Charging Method for Refrigerant Charge Actual liquid line length: ft Manufacturer's Standard liquid line length: ft Difference (Actual — Standard): ft Manufacturer's correction (ounces per foot) x difference in length = ounces (+ = add) (- = remove) Zeasured Airflow Method for Adequate Airflow Verification available in RACM, Appendix RD2.6 Calculated Airflow: Cooling Capacity (Btu/hr) X 0.033 (cfm/Btu-hr) = CFM Measured Airflow is CFM (Measured airflow must be greater than the calculated airflow). Alternate Charge Measurement Summary: System shall pass both refrigerant charge and adequate airflow calculation criteria from the same measurements. If corrective actions were taken, both criteria must be remeasured and recalculated. ✓ 10 Yes 111 No I System Passes 7771 Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Signature: Date: Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE (Page 7 of 12) CF -6R Site Address Permit Number MISCELLANEOUS CREDITS ✓ ❑ DIAGNOSTIC SUPPLY DUCT LOCATION, SURFACE AREA AND R -VALUE Procedures for field verification and diagnostic testing for this group compliance credits are available in RA CM, Appendix RC, RE & RH. ✓ ❑ LESS THAN 12 LINEAL FEET OF SUPPLY DUCT OUTSIDE OF CONDITIONED SPACE COMPLIANCE CREDIT ✓ ❑Yes I ❑No I Less than 12 lineal feet of supply duct outside of conditioned space. Yes to this compliance credit is a pass ✓ ❑ Pass ✓ ❑ Fail ✓ ❑ SUPPLY DUCTS LOCATED IN CONDITIONED SPACE COMPLIANCE CREDIT ✓ ❑Yes 1 ❑ No I Ducts are located within the conditioned volume of building. Yes to this compliance credit is a pass ✓ ❑ Pass ✓ ❑ Fail ....... vJ u...... ...,u.6.. .... ...cua.v.. w. n wu.f.uauw c.cw. w• wc.vuvw ws. 1. Supply duct surface area reduction 2. Buried supply ducts on the ceiling 3. Deeply buried supply ducts ✓ ❑ DUCT SYSTEM DESIGN VERIFICATION ✓ ❑ Yes ❑ No Adequate airflow verified ✓ ❑ Yes ❑ No The duct system design plan meets the requirements specified in RACM, Appendix RE, Section RE.4.2 ✓ ❑ Yes ❑ No The duct system design plan exists on building plans ✓ ❑ Yes ❑ No Duct sizes, duct system layout and locations of supply & return registers match the duct system design plan Yes to all is a pass I ✓ ❑Pass ✓ ❑Fail ✓ ❑ SUPPLY DUCTS SURFACE AREA REDUCTION COMPLIANCE CREDIT Attic Crawl Space Basement Deeply Covered Covered Other R-4.2 Duct Surface Diameter Area R-6.0 Surface Area R-8.0 Surface Area ❑ ❑ ❑ Yes to ducts stem design, supply duct surface area reduction and this compliance credit is a pass ❑ ❑ ❑ ❑ Fail ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Total Surface Area for Each R -Value = ✓ ❑ Yes I ❑ No ktches Performance's CF -1R? ✓ ✓ Yes to all is a pass ❑ Pass ❑ Fail ✓ ❑ BURIED DUCTS ON THE CEILING COMPLIANCE. CREDIT ✓ ❑ DEEPLY BURIED DUCTS COMPLIANCE CREDIT ❑ Yes ❑ No Buried Ducts on the Ceiling ❑ Yes ❑ No I Verified High Insulation Installation Quality ✓ ✓ Yes to ducts stem design, supply duct surface area reduction and this compliance credit is a pass ❑ Pass ❑ Fail ✓ ❑ DEEPLY BURIED DUCTS COMPLIANCE CREDIT Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 ❑ Yes ❑ No Deeply Buried Ducts ❑ Yes ❑ No Verified High Insulation Installation Quality ✓ ✓ Yes to ducts stem design, supply duct surface area reduction and this compliance credit is a pass ❑Pass ❑ Fail Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE (Page 8 of 12) CF -6R Site Address Permit Number ✓ ❑ FAN WATT DRAW Procedures or measuring the air handler watt draw are available in RACM, Append'x RE3.2. ✓ Method For Fan Watt Draw Measurement ❑ RE3.2.1 Portable Watt Meter Measurement ❑ RE3.2.2 Utilitv Revenue Meter Measurement Measured Fan Watt Draw Measured Fan Flow enter total cfm from airflow verification Enter results of Watts/cfm ❑ RE4.1.1 ✓ ✓ ✓ ❑ Yes ❑ No Measured fan watt/cfm draw is equal to or lower than the fan watt/cfm draw documented in CF -1R ❑ ❑ Dia nostic Fan Flow Using Plenum Pressure Matching Yes is a pass Pass Fail ✓ ❑ ADEQUATE AIRFLOW VERIFICATION Procedures for measurine the airflow are available in RACM. Annendix RE3.1. ✓ Method For Airflow Measurement ✓ ❑ Yes ❑ RE4.1.1 Dia nostic Fan Flow Using Flow Capture Hood ❑ Yes ❑ RE4.1.2 Dia nostic Fan Flow Using Plenum Pressure Matching ❑ No ❑ RE4.1.3 Diagnostic Fan Flow Using Flow Grid Measurement ❑ Yes 0 No Duct design exists on plans ❑ Yes ❑ No Cooling capacities of installed systems are <_ to maximum cooling capacity indicated on the Performance's CF -1R and RF -3. 5 Measured Airflow: ❑ Yes ❑ No If the cooling capacities of installed systems are > than maximum ✓ ✓ cooling capacity in the CF -1R, then the electrical input for the installed systems must be <_ to electrical input in the CF -IR. ❑ ❑ Rated Tons cfrn/ton Yes to 1, 2, and 3; and Yes to either 4 or 5 is a pass Pass Fail ✓ ❑ Yes ❑ No Measured airflow is greater than the criteria in Table RE -2 ✓ ✓ Yes is a ass ❑ Pass El Fail ✓ ❑ MAXIMUM COOLING CAPACITY Prneedures fnr determining maximum rnnling Innd rnnnrity nre nunilnhlo in RArAf Annvndir RF? Watts cfm Watts/cfm Total cfm cfm/ton 1 ✓ ❑ Yes ❑ No Adequate airflow verified (see adequate airflow credit) Refrigerant charge or TXV 2 ✓ ❑ Yes ❑ No 3 ✓ ❑ Yes ❑ No Duct leakage reduction credit verified 4 ✓ ❑ Yes ❑ No Cooling capacities of installed systems are <_ to maximum cooling capacity indicated on the Performance's CF -1R and RF -3. 5 ✓ ❑ Yes ❑ No If the cooling capacities of installed systems are > than maximum ✓ ✓ cooling capacity in the CF -1R, then the electrical input for the installed systems must be <_ to electrical input in the CF -IR. ❑ ❑ Yes to 1, 2, and 3; and Yes to either 4 or 5 is a pass Pass Fail ✓❑ HIGH EER AIR CONDITIONER Procedures or ver' tcation are available in RACM, Appendix R1. 1 ✓ ❑ Yes ❑ No I EER values of installed systems match the CF -1R 2 ✓ ❑ Yes ❑ No For split system, indoor coil is matched to outdoor coil ✓ ✓ 3 ❑ Yes ❑ No Time Delay Relay Verified (If Required) ❑ ❑ Yes to 1 and 2: and 3 (If Reouired) is a Dass Pass Fail Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Signature: Date: Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE (Page 9 of 12) CF -6R Site Address Permit Number An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided on this form is required) After completion of final inspection, a copy must be provided to the building department (upon request) and the building owner at occupancy, per Section 10-103(a). BUILDING ENVELOPE LEAKAGE DIAGNOSTICS ✓ ❑ ENVELOPE SEALING INFILTRATION REDUCTION Procedures for field verification and diagnostic testing of envelope leakage are available in RACM, Appendix RC. Diagnostic Testing Results ✓ ✓ Building Envelope Leakage (CFM @ 50 Pa) as measured by Rater: 1 ❑ ❑ Measured envelope leakage less than or equal to the required level from Yes No CFAR? ❑ ❑ 2. Is Mechanical Ventilation shown as required on the CF -1R? Yes No 2a ❑ [1 If Mechanical Ventilation is required on the CFAR (`Yes' in line 2), has it Yes No I been installed? ❑ E] Check this box `yes' if mechanical ventilation is required (`Yes' in line 2) 2b. and ventilation fan watts are no greater than shown on CF -1R. Yes No Measured Watts = ❑ ❑ Check this box "yes" if measured building infiltration (CFM @ 50 Pa) is 3. greater than the CFM @ 50 values shown for an SLA of 1.5 on CF -IR Yes No If this box is checked no, mechanical ventilation is required.) Check this box "yes" if measured building infiltration (CFM @ 50 Pa) is 4 ❑ ❑ less than the CFM @ 50 values shown for an SLA of 1.5 on CFAR, Yes No mechanical ventilation is installed and house pressure is greater than minus 5 Pascal with all exhaust fans operating. Pass if: a. Yes in line I and line 3, or ✓ ✓ b. Yes in line I and line2, 2a, and 2b, or c. Yes in line I and Yes in line 4. ❑ ❑ Otherwise fail. Pass Fail ✓ 1:11, the undersigned, verify that the building envelope leakage meets the requirements claimed for building leakage reduction below default assumptions as used for compliance on the CF -IR. This is to certify that the above diagnostic test results and the work I performed associated with the test(s) is in conformance with the requirements for compliance credit. (The builder shall provide the HERS provider a copy of the CF -6R signed by the builder employees or subcontractors certifying that diagnostic testing and installation meet the requirements for compliance credit.) Test Performed Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Signature: Date: Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE (Page 10 of 12) CF -6R Site Address ___fPermit Number Insulation Installation Quality Certificate ✓ ❑ Description of Insulation, (CF -6R, formerly IC -1) signed by the installer stating: insulation manufacturer's name, material identification, installed R -values, and for loose -fill insulation: minimum weight per square foot and minimum inches ✓ ❑ Installation meets all applicable requirements as specified in the High Quality Insulation Installation Procedures (ACM, Appendix RH) ✓ FLOOR ❑ Yes ❑ No ❑ NA All floor joist cavity insulation installed to uniformly fit the cavity side-to-side and end-to-end ❑ Yes ❑ No ❑ NA Insulation in contact with the subfloor or rim joists insulated ❑ Yes ❑ I No ❑ NA Insulation properly supported to avoid gaps, voids, and compression ✓ WALLS ❑ ❑ ❑ Wall stud cavities caulked or foamed to provide an air tight envelope Yes No NA ❑ Yes ❑ No ❑ NA Wall stud cavity insulation uniformly fills the cavity side-to-side, top -to -bottom, and front -to -back ❑ ❑ ❑ Yes No NA No gaps ❑ Yes ❑ No ❑ NA No voids over 3/4" deep or more than 10% of the batt surface area. ❑ ❑ ❑ Hard to access wall stud cavities such as; corner channels, wall intersections, and behind Yes No NA tub/shower enclosures insulated to proper R -Value ❑ ❑ ❑ Small spaces filled Yes No NA ❑ ❑ ❑ Rim -joists insulated Yes No NA ❑ ❑ ❑ Loose fill wall insulation meets or exceeds manufacturer's minimum weight -per -square -foot Yes No NA requirement ✓ ROOF/CEILING PREPARATION ❑ Yes ❑ No ❑ NA All draft stops in place to form a continuous ceiling and wall air barrier ❑ ❑ ❑ All drops covered with hard covers Yes No NA ❑ Yes ❑ I No ❑ NA All draft stops and hard covers caulked or foamed to provide an air tight envelope ❑ ❑ ❑ All recessed light fixtures IC and air tight (AT) rated and sealed with a gasket or caulk between the Yes No NA housing and the ceiling ❑ Yes ❑ No ❑ NA Floor cavities on multiple -story buildings have air tight draft stops to all adjoining attics ❑ Yes ❑ No ❑ NA Eave vents prepared for blown insulation - maintain net free -ventilation area ❑ Yes ❑ No ❑ NA Knee walls insulated or prepared for blown insulation ❑ ❑ ❑ Area under equipment platforms and cat -walks insulated or accessible for blown insulation Yes No NA ❑ ❑ ❑ Attic rulers installed Yes No NA Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE (Page 11 of 12) CF -6R Site Address Permit Number ✓ ROOF/CEILING BATTS DECLARATION ✓ ❑ I hereby certify that the installation meets all applicable requirements as specified in the Insulation Installation Procedures. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Signature: Date: Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 Yes No NA No gaps Yes No NA No voids over % in. deep or more than 10% of the batt surface area. ❑ ❑ ❑ Yes No NA Insulation in contact with the air -barrier ❑ ❑ ❑ Yes No NA Recessed light fixtures covered ❑ ❑ ❑ Net free -ventilation area maintained at eave vents Yes No NA ✓ ROOF/CEILING LOOSE -FILL ❑ ❑ ❑ Yes No NA Insulation uniformly covers the entire ceiling (or roof) area from the outside of all exterior walls. ❑ ❑ ❑ Yes No NA Baffles installed at eaves vents or soffit vents - maintain net free -ventilation area of eave vent ❑ ❑ ❑ Yes No NA Attic access insulated ❑ ❑ ❑ Yes No NA Recessed light fixtures covered ❑ ❑ ❑ Yes No NA Insulation at proper depth — insulation rulers visible and indicating proper depth and R -value ❑ ❑ ❑ Loose -fill insulation meets or exceeds manufacturer's minimum weight and thickness requirements Yes No NA for the target R -value. Target R -value . Manufacturer's minimum required weight for the target R -value (pounds -per -square -fool). Manufacturer's minimum required thickness at time of installation 'Manufacturer's minimum required settled thickness . Note: To receive compliance credit the HERS rater shall verb that the manufacturer's minimum weight and thickness has been achieved for the target R -value. CF -6R only) DECLARATION ✓ ❑ I hereby certify that the installation meets all applicable requirements as specified in the Insulation Installation Procedures. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Signature: Date: Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE (Page 12 of 12) CF -6R Site Address Permit Number County Subdivision Lot Number Description of Insulation (Formerly IC -1 Form) I. RAISED FLOOR Material Brand Name Thickness (inches) Thermal Resistance (R -Value) 2. SLAB FLOOR/PERIMETER Material Brand Name Thickness (inches) Thermal Resistance (R -Value) Perimeter Insulation Depth (inches) 3. EXTERIOR WALL Frame Type A. Cavity Insulation Material Thickness (inches) B . Exterior Foam Sheathing Material Thickness (inches) 4. FOUNDATION WALL Brand Name Thermal Resistance (R -Value) Brand Name Thermal Resistance (R -Value) Material Brand Name Thickness (inches) Thermal Resistance (R -Value) 5. CEILING . Installing Subcontractor (Co. Name) OR Batt or Blanket Type Brand Name Thickness (inches) Thermal Resistance (R -Value) Loose Fill Type Brand Contractor's min installed weight/ftz lb Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R -Value) 6. ROOF General Contractor (Co. Name) OR Owner Material Brand Name Thickness (inches) Thermal Resistance (R -Value) Declaration ✓ ❑ I hereby certify that the above insulation was installed'in the building at the above location in conformance with the current Energy Efficiency Standards for residential buildings (Title 24, Part 6, California Code of Regulations) as indicated on the Certificate of Compliance, where applicable. Item #s (if applicable) Signature Date Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner OR Window Distributor Item #s Signature Date Installing Subcontractor (Co. Name) OR (if applicable) General Contractor (Co. Name) OR Owner OR Window Distributor Item #s Signature Date Installing Subcontractor (Co. Name) OR (if applicable) General Contractor (Co. Name) OR Owner OR Window Distributor Residential Compliance Forms April 2005