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09-1268 (AR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 09-00001268 80215 VIA TESORO 772-250-018-14 -31349 - ADDITION - RESIDENTIAL LOW DENSITY RESIDENTIAL 65000 T4'!t 4 4 Q" Architect or Engineer: C / T1171 ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that I am licensed un provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busines a essiona ode, and my License is in full force and effect. License Class: B1 cense No.: 550864 /Date:/ !z Jo Contractor: 0 R -BUILDER DECLARATION I hereby affirm under penalty o per ry that I am empt 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 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, 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 bullds or improves lhereuii, olid who contracts for the projects with o controctorls) 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: LQPERIIIIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/21/10 Owner: JOHNSON GLENN 802.15 VIA TESORO LA QUINTA, CA 92253 (760)619-3054 //C/ Contractor:BLS if U 777-770NROBINTRO IN PALM DESERT, C 9221L'/j�, u/O (760) 275-9116 Lic. No.: 550864 trn.._�VYe ------------------ WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1932584 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 s ould o subject to the workers' compensation provisions of Section �t/l,,Iican he Labor de s I orthwith comply with those provisions. /Date: t ZZ WARNING: FAILURE TO SEC RE WO S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 applinatinn 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 abov ' formation is correct. I agree to comply with all city and county ordinances and state laws relating to ildin o truction, and hereby authorize representatives oLfi/s�unt toenter uyon the above-mentioned o rty r i pection purposes. Datl� Signature (Applicant or A Application Number . . . . . 09-00001268 ------ Structure Information DETACHED GUESTHOUSE ----- Other struct info . . . . . CODE EDITION 2007 # BEDROOMS .1.00 FLOOD ZONE no GARAGE SQ FTG 123.00 PATIO SQ FTG .00 1ST FLOOR SQUARE FOOTAGE 568.00 ---------------------------------------------------------------------------- 2ND FLOOR SQUARE FOOTAGE .00 Permit . . . BUILDING PERMIT Additional desc . . 568 SF DET. GUESTHOUSE Permit Fee . . . . 482.00 Plan Check Fee 313.30 Issue Date . . . . Valuation . . . . 65000 Expiration Date . . 7/20/10 Qty Unit Charge Per Extension BASE FEE 414.50 15.00 4.5000 ---------------------------------------------------------------------------- THOU BLDG 50,001-100,000 67.50 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 37.34 Plan Check Fee 9.34 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 17/20/10 Qty Unit Charge Per Extension BASE FEE 15.00 568.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 19.88 123.00 .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 2.46 Permit GRADING PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/20/10 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Permit MECHANICAL Additional desc . . Permit Fee . . . . 39.50 Plan Check Fee 9.88 Issue Date . . . . Valuation . . . . .0 LQPERMIT Application Number 09-00001268 Permit . . . . . . MECHANICAL BASE FEE 15.00 Expiration Date . . 7/20/10 24.00 1.00 Qty Unit Charge Per 1.00 Extension PLB WATER HEATER/VENT 7.50 BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 1.00 ---------------------------------------------------------------------------- 6.5000 EA MECH VENT FAN 6.50 Permit . . . Additional desc . . Permit Fee . . . . Issue Date . . . . Expiration Date . . PLUMBING 64.50 Plan Check Fee . . 16.13 Valuation . . . . 0 7/20/10 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 6.0000 EA PLB FIXTURE 24.00 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 ---------------------------------------------------------------------------- Special Notes and Comments DETACHED GUESTHOUSE ADDITION - 568 SF LIVING, 123 SF CART GARAGE. 2007 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 3.00 ENERGY REVIEW FEE 31.33 STRONG MOTION (SMI) - RES 6.50 Fee summary Charged Permit Fee Total 638.34 Plan Check Total 348.65 Other Fee Total 40.83 Grand Total 1027.82 LQPERMIT Paid Credited Due .00 .00 638.34 .00 .00 348.65 .00 .00 40.83 .00 .00 1027.82 Bin # 3a City of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # q/`Zla Project Address: 4�4 V/,t I—kso/zo Owner's Name: 614WA( A. P. Number: 777. 3/0 - oly, Address: & -ogls- 1/,-.* rasaRo Legal Description: City, ST, Zip: /— -d?. Cf . Contractor: Al— e CO IV S-rIfV :-7—/ 0-1/ Telephone: AW&/9-3y5JA- Address: '77-770 IFPS14 Project Descr . iption: City, ST, Zip: P -WN nt Telephone:70 State Lic. # : 3-50 93 6 � City Lic. Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Oocupancy: State Lic. #: Project type (circle one): New tt-A Alter Repair Demo Name of Contact Person: Sq. FL: Stories: #Units: Telephone # of Contact Person: 16&W 0-7551/�' Estimated Value of Project: APPLICANT- DO NOT WRITE BELOW THIS LINE N Submittal Reqld Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted 1261 Item Amount' Structural Cafes. Reviewed, ready for corrections2/- 1 2-rx Plan Check Deposit Truss Cafes. Called Contact Person -XV Z,q Plan Check -Balance. Tide 24 Cafes. e;� Plans picked up Constructim Flood plain plan Plans resubmittedil (pl oq Mechanical Grading plan --------------- 2". Review, ready for correction issue Electrical Subcontactor List Called Contact Person i2 Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading I X IN HOUSE:- . 3" Review, ready for correctionsifissw Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. wt -I Pub. Wks. Appr Date of permit issue • School Fees IV L V Total Permit Fees rz /Z-/ !L- ZSR 04 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: COMMAND. AMOUNT: DATE: RECEIPT: CHECK #: INITIALS: CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Glenn Johnson Date: 01/04/10 Owner's Name: Glenn Johnson Phone No. (760) 275-9116 Project Address: 80-215 Tesoro, La Quinta, CA Project Description: Detached Guesthouse APN: 777-310-014 Tract #: Lot #'s: Type of Development: Residential XXi Commercial Industrial Total Square Feet of Building Area: 568 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 9f the owner/developer. Dated: 01/04/10 Signature: �[_�?� I u *****************sss********************************************sss** SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PR CT 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 Total Square Footage 568 Sq. Ft. Amount per Sq.Ft. $ 2.97 Amount Collected $ 1,686.96 Building Permit Application Completed: Yes/No By: Jamie T. Brown, Asst. Supt., Business Services 7 Certificate issued by: Leticia C. Torres, Facilities Analyst Signature; - NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEE9—ANI% STATEN*DWOF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. t,T:c/nI}docs/dc%fees/certificate of compliance lbrnl tables'1'0 USE.doc 9/11/08 MOUNTAIN VIEW COUNTRY CLUB at La Quinta November 17, 2009 Glenn & Candice Johnson 2559 138' St. Surrey, BC V41P 2M1 Re: Architectural Request 80-215 Via Tesoro Dear Mr. & Mrs. Johnson: The Architectural/Landscape Committee of the Mountain View Country Club Homeowners' Association have reviewed the plans for your improvements per the enclosed application. The committee has approved the addition of your casita pending the following: 1. Submittal of neighbor comments form (attached). 2. The gate is not approved as submitted. It must have some architectural character, similar to others in the neighborhood, so please resubmit. Thank you for your patience and understanding during this approval process. If there are any questions please contact me at 760-776-5100 ext. 351. Sincerely, FOR THE BOARD OF DIRECTORS MOUNTAIN VIEW COUNTRY CLUB Bill Clifford, CCAM Association Manager cc: Board of Directors Unit File 13 i TITLE 24 REPORT Title 24 Report for: Johnson Casita La Quinta, CA Project Designer: CITY OF LA QUINT BUILDING & SAFETY DEPT. APPROVED FQR CONSTRUCTION DArELL- Report Prepared By: Joan D. Hacker Insu-form, Inc. 77-810 Las Montanas Road, Suite 201 Palm Desert, CA 92211 t (760) 345-1352 - [ZWe Job Number: li� j DEC 14 2009 I� Date: I 11/24/2009 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 2005 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC - www.energysoft.com. EnergyPro 4.4 by EnergySoft Job Number: User Number: 2655 TABLE OF CONTENTS I Cover Page 1 Table of Contents 2 Form CF -1 R Certificate of Compliance 3 Form MF -1 R Mandatory Measures Summary 7 HVAC System Heating and Cooling Loads Summary 9 Room Load Summary 10 EnergyPro 4.4 by EnergySoft Job Number: User Number: 2655 Certificate Of Compliance : Residential (Part 1 of 4) CF -1R n 568 ft2 ❑ Multi Family ❑ Existing + Add/Alt Existing Floor Area: n/a ft2 11/24/2009 Date .)nhnc .,asita Project Title a Qli*nta 568 ft2 Fenestration: Average Ceiling Height: 8.0 ft Project Address 1.00 Ratio: 19.0% Avg. SHGC: 0.45 Number of Stories: 1 Building Permit # Insu-firm, Inr Zone Name Floor Area Volume Units Zone Type Type Lz11est S8 A 1 00_ — rorif itioned Setback Hgt. Area —n[a (760) 345-1352 Documentation Author Wall Wnnd 1An nim R_13 R -n o 1Rf1 qp ® ❑New n9 -A.1 f;LEst Telephone Plan Check/Date FneravPrn Com�plian'ce Method CA Climate 7one_15 Climate Zone Field Check/Date TDV Standard Proposed Compliance (kBtu/sf-yr) Design Design Margin Space Heating 2.16 2.65 -0.48 Space Cooling 113.65 76.58 37.07 Fans 12.39 10.69 1.70 Domestic Hot Water 28.24 27.29 0.95 Pumps 0.00 0.00 0.00 Totals 156.45 117.21 39.24 Percent better than Standard: Building Type: [Z Single Family ❑ Addition Total Conditioned Floor Area: 568 ft2 ❑ Multi Family ❑ Existing + Add/Alt Existing Floor Area: n/a ft2 Building Front Orientation: (S) 180 deg Raised Floor Area: 0 ft2 Fuel Type: Natural Gas Slab on Grade Area: 568 ft2 Fenestration: Average Ceiling Height: 8.0 ft Area: 108 ft2 Avg. U: 0.57 Number of Dwelling Units: 1.00 Ratio: 19.0% Avg. SHGC: 0.45 Number of Stories: 1 BUILDING ZONE INFORMATION # of . Thermostat Vent Zone Name Floor Area Volume Units Zone Type Type Lz11est S8 A 1 00_ — rorif itioned Setback Hgt. Area —n[a OPAQUE SURFACES Insulation Act. Gains Condition Type Frame Area U -Fac. Cay. Cont. Azm. Tilt Y / N Status JA IV Reference Location / Comments Wall Wnnd 1An nim R_13 R -n o 1Rf1 qp ® ❑New n9 -A.1 f;LEst Wall Wood 205 n 107 R_13 R_n n 27n gQ ® El New n9 -A3 (west Wall Wond 216 0 102 R_13 R -n_0 _Q 90 ® ❑New n4 -A3 (;iiPct Wall Wnnd 171 n 102 R_13 R -n n P gn ® ❑New n9 -A3 C"uPst Roof Wood 56A n 075 R_39 R-0 n 1R0 _n ® ❑New n1 -AIA (�uPct M ❑❑ ❑❑❑ ❑❑ F1 EnergyPro 4.4 by EnergySoft User Number: 2655 Job Number: Page:3 of 10 1 Certificate Of Compliance : Residential (Part 2 of 4) CF -1 R Johnson Casita 11/24/2009 Project Title Date FENESTRATION SURFACES True Cond. Location/ # Type Area LI -Factor' SHGC2 Azm. Tilt Stat. Glazing Type Comments J- Winnow Front (R) 40 nn 0,57 NERC: Q4 NERC: 180 _91L New IW(: F;?nn Alum/[ ow -F C;uPct 2 Window Left (W) 3.8 0.570 NFRC 0.45 NFRC 270 90 New IWC 6200 Alum/Low-E Guest 5 Window Left (W) 3.8 0.570 NFRC 0_45 NFRC 270 90 New IWC 6200 Alum/Low-E Guest 4 Window Left (W) 3.8 0.570 NFRC 0.45 NFRC 270 90 New IWC 6200 Alum/Low-E Guest 5 Window Left (W) 3.8 0.570 NFRC 0_45 NFRC 270 90 New IWC 6200 Alum/Low-E Guest 5 Window Rear (N) 3.8 0_570 NFRC 0_45 NFRC 0 90 New IWC 6200 Alum/Low-E Guest L Window Right (E) 24.0 0_570 NFRC 0_45 NFRC 90 qQ New IWC 6200 Alum/Low-E Guest 8 Window Right (E) 25.0 0.570 NFRC 0.45 NFRC 90 90 New IWC 6200 Alum/Low-E Guest 0.76 8.0 3.0 2.0 0.1 2.0 2.0 8 Buq Screen 0.76 5.0 5.0 2.0 0.1 2.0 2.0 1. Indicate source either from NFRC or Table 116A. 2. Indicate source either from NFRC or Table 116B. INTERIOR AND EXTERIOR SHADING Window Overhang Left Fin Right Fin # Exterior Shade Type SHGC Hgt. Wd. Len. Hgt. LExt. REA Dist. Len. Hgt. Dist. Len. Hgt. 1 Bug Screen 0.76 8.0 2.5 2.0 0.1 2.0 2.0 2 Bug Screen 0.76 1.5 2.5 2.0 0.1 2.0 2.0 3 Bug Screen 0.76 1.5 2.5 2.0 0.1 2.0 2.0 4 Bug Screen 0.76 1.5 2.5 2.0 0.1 2.0 2.0 5 Bug Screen 0.76 1.5 2.5 2.0 0.1 2.0 2.0 6 Bug Screen 0.76 1.5 2.5 2.0 0.1 2.0 2.0 7 Bug Screen 0.76 8.0 3.0 2.0 0.1 2.0 2.0 8 Buq Screen 0.76 5.0 5.0 2.0 0.1 2.0 2.0 THERMAL MASS FOR HIGH MASS DESIGN Run Initiation Time: 11/24/09 13:29:54 Run Code: 1259098194 EnergyPro 4.4 by EnergySoft User Number: 2655 Job Number: Page:4 of 10 Area Thick. Heat Inside Condition Location/ Type (sf) (in.) Cap. Cond. R -Val. JA IV Reference Status Comments Insulation Location/ PERIMETER LOSSES Condition Type Length R -Val. Location JA IV Reference Status Comments Slab Perimeter 34 None No Insulation 26-A1 New Guest Run Initiation Time: 11/24/09 13:29:54 Run Code: 1259098194 EnergyPro 4.4 by EnergySoft User Number: 2655 Job Number: Page:4 of 10 Certificate Of Compliance : Residential (Part 3 of 4) CF -1 R Johnson Casita 11/24/2009 Project Title Date HVAC SYSTEMS Heating Minimum Cooling Minimum Condition Thermostat Location Type Eff Type Eff Status Type Guest Room Heat Pump 6.59 HSPF Room PTAC without Side 10.3 EER New Setback Louvers HVAC DISTRIBUTION Duct Duct Condition Ducts Location Heating Cooling Location R -Value StEtus Tested? Guest Ductless / with Ductless n/a n/a Nev Yes an 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. A O SMITH WATER PRODUCTS Small Gas No Pipe Insulation 1 37,000 50 New 0.59 n/a n/a Multi -Family Central Water Heating Details Hot Water Pump Hot Water Piping Length (ft) Add 1/2" Control # HP Tvge In Plenum Outside Buried Insulation COMPLIANCE STATEMENT This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 o9 the California Code of Regulations, and the administrative regulations to implement them.This certificate has been signed by the individual with cverall design responsibility. The undersigned recognizes that compliance using duct design, duct sealing, verification of refrigerant charge and TXVs, 'nsulation 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: Joan D. Hacker Title/Firm: Address: Telephone: Lic. #: (signature) (date) Enforcement Agency Name: Title/Firm: Address: Telephone: (signature) (date) User Number: 2655 Title/Firm: Address: 77-810 Las Montanas Road, Suite 201 Palm Desert, CA 92211 Telephone: (760) 345-1352 (sig atur (date) Certificate Of Compliance : Residential (Part 4 of 4) CF -1 R Johnson Casita 11/24/2009 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 aaencv determines the adeauacv of the iustification. and may refect a building or design that otherwise complies 3ased on the adequacy of the special justification and documentation submitted. Plan I Field 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 "Guest' incorporates a HERS verified Refrigerant Charge test or a HERS verified Thermostatic Expansion Valve. The Cooling System "Mitsubishi Electronics MSHI7NW" includes credit for a 10.3 EER Condenser. A certified HERS rater must field verify the installation of the correct Condenser. Run Initiation Time: 11/24/09 13:29:54 Run Code: 1259098194 EnergvPro 4.4 by EneravSoft User Number: 2655 Job Number: Page:6 of 10 Mandatory Measures Summary: Residential (Page 1 of 2) MF -1 R NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. More stringent compliance requirements from the Certificate of Compliance supercede the items marked with an asterisk (') below. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION Check or initial applicable boxes or check NA if not applicable and included with the permit application documentation. N/A DESIGNER ENFORCE - MENT Building Envelope Measures ❑ ER ❑ .§ 150(a): Minimum R-19 in wood ceiling insulation or equivalent U -factor in metal frame ceiling. ❑ 0 ❑ § 150(b): Loose fill insulation manufacturer's labeled R -Value: ❑ ❑ ❑ �§ 150(c): Minimum R-13 wall insulation in wood framed walls or equivalent U -factor in metal frame walls (does not ❑ a ❑ apply to exterior mass walls). ❑ N ❑ § 150(d): Minimum R-13 raised Floor insulation in framed floors or equivalent U -factor. ❑ E�] ❑ § 150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs. ❑ ER ❑ 1. Masonry and factory -built fireplaces have: ❑ ❑ a. closable metal or glass door covering the entire opening of the firebox ❑ ❑X ❑ b. outside air intake with damper and control, flue damper and control ❑ ❑X ❑ having an installed thermal resistance of R-12 or greater. ❑ N ❑ 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. ❑ ❑X ❑ § 118: Insulation specified or installed meets insulation installation quality standards. Indicate type and include ❑ FX1 ❑ CF -6R 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. ❑ 51 ❑ 2. Fenestration products (except field fabricated) have label with certified U -Factor, certified Solar Heat Gain El 51 ❑ Coefficient (SHGC), and infiltration certification. ❑ ❑ ❑ 3. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. ❑ ❑X ❑ Space Conditioning,.Water Heating and. Plumbing System Measures § 110-13: HVAC equipment, water heaters, showerheads and faucets certified by the Energy Commission. ❑ FX1 ❑ § 150(h): Heating and/or cooling loads calculated in accordance with ASH RAE, SMACNA or ACCA. ❑ ER ❑ § 150(i): Setback thermostat on all applicable heating and/or cooling systems. ❑ ❑ § 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 ❑ ❑X ❑ 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 ❑ ❑X ❑ insulation or R-16 internal insulation and indicated on the exterior of the tank showing the R -value. 3. The following piping is insulated according to Table 150-A/B or Equation 150-A Insulation Thickness: 1. First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire ❑ Q ❑ length of recirculating sections of hot water pipes shall be insulated to Table 1508. ❑ ❑X ❑ 2. Cooling system piping (suction, chilled water, or brine lines), piping insulated between heating source and indirect hot water tank shall be insulated to Table 150-B and Equation 150-A. 4. Steam hydronic heating systems or hot water systems > 15 psi, meet requirements of Table 123-A. ❑ ❑ ❑ 5. Insulation must be protected from damage, including that due to sunlight, moisture, equipment maintenance, ❑ ❑X ❑ 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. ❑ ❑ ❑ EnergyPro4.4 by EnergySoft User Number: 2655 Job Number: Page:7 0f 10 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. NIA DESIGNER MENT Space Conditioning, Water Heating and Plumbing System Measures: (continued) § 150(m): Ducts and Fans 1. All ducts and plenums installed, sealed and insulated to meet the requirements of the CMC Sections 601, 602, 603, 604, ❑ ❑X ❑ 605, and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minumum installed level of 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 1818 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 dud 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 duds cannot have porous inner cores § 114: Pool and Spa Heating Systems and Equipment 1. A thermal efficiency that complies with the Appliance Efficiency Regulations, on-off switch mounted outside of the heater, weatherproof operating instructions, no electric resistance heating and no pilot light. 2. System is installed with: a. At least 36" of pipe between filter and heater for future solar heating. b. Cover for outdoor pools or outdoor spas. 3. Pool system has directional inlets and a circulation pump time switch. § 115: Gas fired fan -type central furnaces, pool heaters, spa heaters or household cooking appliances have no continuously burning pilot light. (Exception: Non -electrical cooking appliances with pilot < 150 Btu/hr) § 118 (i): Cool Roof material meets specified criteria Lighting Measures § 150(k)l: 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)l: 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 in Section 130(c), of permanently installed luminaires in kitchens may be in luminaires that are not high efficacy luminaires, provided that these luminaires are controlled by switches separate from those controlling the high efficacy luminaires. § 150(k)3: Permanently installed luminaires in bathrooms, garages, laundry rooms, utility rooms shall be high efficacy luminaires. OR are controlled by an occupant sensor(s) certfied to comply with Section 119(d). § 150(k)4: Permanently installed luminaires located other than in 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 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 certified to ASTM E283 and labeled as air tight (AT) to less than 2.0 CFM at 75 Pascals. § 150(k)6: Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy luminaires (not including lighting around swimming 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. ❑ ® ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ® ❑ ❑ ❑ ❑ E a ❑X a FE -1 ❑ ❑ ❑ § 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: 2655 Job Number: Page:8 of 10 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY PROJECT NAME DATE Johnson Casita 11/24/2009 SYSTEM NAME FLOOR AREA Guest 568 26.0 of 70.0 of Outside Air 0 cfm Supply Fan 300 cfm 70.0 of ;DOLING SYSTEM PSYCH 11.0 / 77.6 of Outside Air 0 cfm 78.0/56.6 of 70.0 of Total Room Loads Return Vented Lighting Return Air Ducts Return Fan Ventilation Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COIL COOLING PEAK I COIL HTG. PEAK CFM Sensible Latent CFM Sensible 250 10,562 1,138 236 9,275 0 0 0 0 0 0 0 0 0 0 0 0 01 1 0 10.562F7:;:;38 1 9 275 Mitsubishi Electronics MSH17NW 12,691 0 11,804 Total Adjusted System Output12 691 0 11,804 (Adjusted for Peak Design Conditions) TIME OF SYSTEM PEAK Aug 2 pm Jan 12 am Heating Coil �% Return Air Ducts `S 78.0 / 56.6 of 78.0 / 56.6 of M 38.3 / 36.6 of Supply Fan 300 cfm Cooling Coil h Return Air Ducts 'I Supply Air Ducts 107.0 of ROOMS 70.0 of Supply Air Ducts 38.3 / 36.6 of 24.4% R.H. ROOMS 78.0/56.6OF EnergyPro 4.4 by EnergySoft User Number: 2655 Job Number: Page:9 of 10 1 ROOM LOAD SUMMARY PROJECT NAME Johnson Casita DATE 11/24/2009 SYSTEM NAME Guest FLOOR AREA 568 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 Guest Guest 1 250 10,562 1,138 250 10,562 1,138 236 9,275 PAGE TOTAL 1 2501 10,562 1 138 236 9,275 TOTAL 1 250 10,562 1,138 236 9,275 EnergyPro 4.4 by EnergySoft User Number: 2655 Job Number: Page: 10 of 1-071 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 1) CF -4R Project Address [ Johnson Casita ] Yes is a pass f pass Li Fail Builder / Installer 80-215 Tesoro / La Quinta / CA / 92253 BLS Construction, Inc. Builder / Installer Contact Telephone Plan Number / Permit Number Bennett Sperber 7603454116 91268 TIERS Rater Telephone Sample Group Number Dave Bricker - CIHIEIEIRISO ID #CCN99380828 7605419025 0 Compliance Method (Prescriptive) Climate Zone 15 Certifying Signature _ j' 1� 2010.04.22 Date Sample House Number 13:45:44 -07'00' 91268 HERS Provider Firm Energy Driven Solutions Inc. CIHIEIEIRISO Address City/State/Zip P.O. Box 6705 La Quinta /CA /92248 Copies to: BUILDER, HERS PROVIDER AND BUILDING DEPARTMENT HERS RATER COMPLIANCE STATEMENT This house was: V Tested As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution system is fully ducted and correct tape is used before a CF -4R may be released on every tested building. The HERS rater must not release the CF -4R until a properly completed and signed CF -6R has been received for the sample and tested buildings. ,/ The installer has provided a copy of CF -6R (Installation Certificate). ❑ New Ducts are fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). ❑ New ducts with cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. v/ THERMOSTATIC EXPANSION VALVE (TXV) Procedures for field verification of thermostatic expansion valves are available in RACM, Appendix RI. System # 1 Yes ❑ No Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed on the system and installation of the specific equipment shall be verified. Yes is a pass f pass Li Fail f HIGH EER AIR CONDITIONER Procedures for verification are available in RA CM, Appendix RI. System # 1 I v/ Yes ❑ No EER Values of installed systems match the CF -1R 2 Y/ 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 Required) is a pass f pass ❑ Fail Residential Compliance Forms Generated by CIHIEIEIRISS http://www.CHEERS.org December 2005