9603-028 (COMB)LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with
W Section 7000) of Division 3 of the Business and Professionals Code, and my
o _cn
r,lfj *b6ense c, in full force and effect.
nW / License # Lic. Class Exp. Date
ZDate Signatureof Contractor
c -0P 0) OWNER -BUILDER DECLARATION
U I hereby affirm that I am exempt from the Contractor's License Law for the
H a following reason:
Z ( ) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals Code).
( ) I am exempt under Section B&P.C. for this reason
C0 Date Signature of Owner
LON
rn WORKER'S COMPENSATION DECLARATION
dQ I hereby affirm under penalty of perjury one of the following declarations:
2 Z () I have and will maintain a certificate of consent to self -insure for workers'
LO <Cc compensation, as provided for by Section 3700 of the Labor Code, for the
X w LL. pgrformance of the work for which this permit is issued.
p J J 1. ( ) I have and will maintain workers' compensation insurance, as required by
m Q U Section 3700 of the Labor Code, for the performance of the work for which this
p CJ permit is issued. My workers' compensation insurance carrier & policy no. are:
dLOCarrier Policy No. -,nv. -AIik
Z (This section need not be completed if the permit valuation is for $100.00 or less).
Cy00
(') I certify that in the performance of the work for which this permit is issued,
C7 I shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
'Code, I shall forthwith comply with those provisions.
Date: Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and shall
subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3708
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his application.
1. Each person upon whose behalf this application is made & each person at
f4
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this application agrees to, & shall, indemnify
& hold harmless the City of Indian Wells, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
Work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is I
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon the h
• above-mentioned property for inspection purposes.
Signature (Owner/Agent) Daae
A"'
BUILDING PERMIT
PERMIT•
DATE �� �>/�� ��
VALUATION q!"3 m,0114M 7
TRACT
JOB SITE ADDRESS
APN
OWNER CONTRACTOR
1 ii`.1�`skA c'9 if Ji�lu i4 ryFf�1 !�? 3. i, oyy"q�.�j}} kA ie.
e'>lif�Q1: V�•13�7. �: 't'�-SV•PJ;fu, !�/.1 °�b'i�9
LJ,AQ14NN1'A ar,(t))4-111I,t321
DESIGNER/ENGINEER
USE OFPERMIT;LI"(T,A)1'1_I1,PI,4-PM 9K -'i AlHINA*11(
faNtL(nt &iyil.4.h,X1111},ARf4,$?I44.K}`YV.RIFNTil(;40?to9.°}'t#61
FEE DESCRIPTION
FEES
k.°t"I,tt)�Nlf.>ON,i'l (14-,I,1 Air 4000Isi.
124="XIC JVWL % 4.7680i I.S
UMNIATIED WST OV CON+NS1`IZltj4IM
PEf3(V31.I' VEX N lMAIARV
PT,AN K li CK FFF X357 I
1,FFjs 101000111119-090 g } so
CV1°:01AN1C'Ah F&fi 59
H, EX "I`R1('Al, FF !U j-I)UQ�l()-t?1JU 821?. H
11��t1+.<6 �`}1s xl)i�CJt)Or�31���1� sa�►�
.1 � .'f I M TIONS Fklk tdEVID 101 -M -241-M
SUB -TOTAL CONvS"MUCTION ANIS PLAM ('11KK
LESS PR .-1'AIt) FEEN
�
J ,Ilii
�1
PD� TOTM, PWIMIT ITEN 1 AW, NOW
MAR 1 9 1996
By
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
- 'OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap 3
F.A.U.,
Framing
Compressor
Insulation b/L -/Z
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
Desert Sands Unified School District
N6tice• 82-879 Highway 111
• Indio, CA 92201
pocument Cannot Be Duplicated 619-775-3500
CERTIFICATE OF COMPLIANCE
Date 3/19/96 APN # 631-387-730-2 x
. ._ _
No. 14272 Jurisdiction La Quints . -
fi
Owner Name Herb Chaffe y Pe -,mit # -
No. 49615 Street Vista Bonita log #
City La Quinta zip 92253 Study Area 110'
Tract # 14496-2 Lot # Square Footage 80
Type of Development Residential Addition' No. of Units 1
Comments I -Enclose atrium, remodel tc en and, guest room.
At the present time, the Desert Sands Unified School District does not collect fees on"garages/carports,; '
covered patios/walkways, residential additions under 500 square feet, detached accessory structures or
replacement mobilehomes. It has been determined the above-named owner i-,;: exempt from paying
school fees at this time due to the -following reason:
Residential Addition 500 Sq .Feet or Less
EXEMPT T
This certifies that school facility fees imposed pursuant to Government Code 53080 r
in the amount of 0.00 X 80 or $9.00
the property listed above and that building permits and/or Certificates of Occupancy_for
this square footage in this proposed project may now'be issued. : ,=��i`� ✓t�
Fees Paid B �.
Y N/A Telephone{ `771-07x80:
Name on the check
By Dolores A. Ballesteros``<' ,
Superintendent.F
Fee collected /exempted by Pauline Pearson -Exempt $0.00
Check No. N/A-------
Signature
/ASignature
Collector: Attach a copy of county or city plan check application form to district copy for all waivers. 4
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
r
a SANTA ROSA COVE ASSOCIATION _ 11
a�ir•.n - %, r�- - ,- ..+ ''' �a. .. ,*tb ' , FEB t 6-•1996
` = EXTERIOR ARCHITECTURALt/LANDSCAPE-VARIANCE-REQUEST
Recuest Number
Chaff e,,. February 15', 1996
Owner's -Name Date ;
.! .li •` •+ .•'fit, a-�}i~_ s# - .-.. .. ��;p ate.• - y
V 1 s lie •Boni a
Property, Address_ Mailirig ;Address '
La Quinta., CA`, 22.53 -
City, State; Zipj ; x Mailing City, State. 'Zip
.771-0780
` F,
Telephone Number - local - Telephone Number,-'pernanenr:
The followind' modification is proposed. and ,approval.
pproval is requested .for, an Architectural/Landscape
Variance.rn accordance; v4ith the CC&Rs. '
We have attached the necessary documents as outlined in the'procedures-sheet: Wwunderitand that, ` if approval,is-grantea, we will be responsible for ifte costs of:siid'modification.and arvy and all damage
which may occur to anycommon-area property including but not limited :to', sprinkler systems; utilities, "
buildings. lawns, andplants:' We -understand that the Architectural Committee -may impose additional
restrictions or obligations of -the homeowner which shall.pass, to successive owners oll the property and
as a condition of approval; applicant for ,.the variance will'be required to<execute a:v�ritten agreement -
and a notice. of that; agieement using the attached forms for recordation.-- We un, derstand.that• the %'
'
'recordation will beat our,expense We,furtherunderstand that:all building-: modifications -require the
' approval of the City of La Qulnta .and that,modifications,shall• beperformed by a licensed contractor.
The cost of ahe=approvals and permits will be borne by applicant. 'We `further agree -that, if approved;
the modifications'Will, be: made:in-strict!compliance with the plans submitted with. this•appiicatiori.
'•s r -
TYPE OF`REOUEST:. °Please provide a 'complete' narrative description of the- proporsed modification,
.including specific materials, <color., and dimensions..
EE ATTACHED VARI:AN•CE :RE .UES
Conractor. G. L SCRTVENS 'CONST' Teleph'ane'Number {619) 349=3327;
contractor. License Number 521353
Owner's. Signature
- ` -. b. a.r �' v .fir � t. } - R •` -, -a- . ' . .. . .a r � 7 ! • -
G. L. SCRIVENS CONSTRUCTION
260 Pinyon Crest, Mountat;r Center, CA 92561 .
Mi : Rer6 Chqffey, 49-613 Vista Bonita, by Quinla, • CA 92253
-J. ROOFING FORAM9it1UM:
2. 1,,'NYRY COUR77AIt DOM USING 1.X1.SYN(; I.,N77tY Doul S.
3. M R PA7JO 320 SC), PT CC)N(`RETE PA 110 07711' MMI S.'1'UN.is.
4, REAR WINLOWS (3) 5-0 X 8-013PONZL' SLJI)INC;, C:"HA1V(�L' !U
S-0 X 6.0 M?0)VW, FRMF, DUAL GI,AZ ,p I'IX1,.v,
5. CHANGE AUR 5-0 X 8-0 PAIR 12 W I{R15MCH DOORS" 7011.17F.
FRT-NCH DUAL GLAZED PAIN?' M MA 71 H UISTING.
6. MURAWTI;R. BAM WINDOW CHAN{i1 70 8" GI..ASS BLOCK
32" Wl!)1: X 64" TALL.
7, RRQUES T REMOVING (2) 0MA.NDIJ, ? BUSHES ON (IOI.PCO 1.IILS'L',
JUST EAST Ol, .11NIT, HINDEU VIEW
---------------------
8. CIA UE EXIMING GARAGE DOORS TO MEM S7.X WONAL USING
(APPROVED CLOPAYDOON) , PAINTED 7O kfA7C:'11 lXS"TlNG, WOOD
/"OAS Q) $-Q X. 7-0
A INS7ALL NsW A.C:. PACICAGE UNIT ON ROOE' (Ctl1?B MOUNT)
ALSO... ALL .S`Ti/CCO PA7ICI NGY 70 MATY, d�t1S`?'lN4i TL;X1'Cllif: Atvf). `
PAINM-70 MAWH COLOR
FROM SCRIDENS CONSTRUCTION PHONE NO. 615 3450956 Mar. 12 1996 06:24AM P02
Ire
Ao
UtArl
Moi at',.t ,► . tN - --
'PPO" 0� foz- ' pR• tS pp�t`i vp.� -,
2`t' 17090-5 - � p. all
w.
E�tll, (. fi Ott• -'Mf .'
X4.. Dp .
fMltJ�'fL: tVG 'SID
WALL IN
( �R �t�2T • �f�t� :ice �/->' - � c Vv�i,i..
rt --yr, WALet,
ova
> <-,W u NGS �f"�":�Ilt'•1C.t. • c� , . cit: ti11f
WALL.
I
�i�lfii...�P,67_..(.4.�.....nIIG `�a 1Ii__sI .�iili tfs 11 I:r
FROM : SCRIVENS CONSTRUCTION PHONE NO. 619 7-450956 Mdr..12 1996 O5:a0PM PO4,
rhodur oval firep�;,acd
D*Acf: 3/1 96 l�®ernChek ?.0
Min Bearing Area Ri= 1.1 in? R/Q .1.1 in'
L�Atit Qriem Span ` 6:0 R. Reactlen 1 464 At
abaft Wt per ft 4,68 is Rbaction 2 464 # �
Bbam W4101 24 # - Maximum V 464 # .
Max Moment 6904 Max V (Roducad) $93#
TL Wx DO L / 240 TL Actual 00 L. h, 1000
4ttrtht��� 8ectwo (In') Shear fin°) TL Dalt; (Ire)
Actual
CrNira{ 7.4E '':6f D.3U
Statue OK OK OK
rlatlo 439/a 41 V0 249/c _
_._.._,......._...__. �_.... ---- �_ --
Fb (PSI) Fv (psi) c: (pet x rrdi)
1 ease CtaTuai 3..._.
Rae* Adjusted 1100 _ 78 --- 1.3 OG —
lUstmrrrrltsF
TIT
Cd
...��
I Cd Ouretlon
Cr Rooeptlnva
' en shoal, stress
cm Wet Use -
BeamOhWhoe uWtonGtically added th(A Lerim soli-weigN Inlo thA ca Sulaklona,
Lti�1 Uolorm Tt.: 150 m A
1
- Uniform L'aac ,X—:.
Rf--41'vi A 464 1
m
SPAN -0, 0 F°f
Un{rorni and part ril'O"I s rare lbe per lineal Ii.
Notes unliorm loud (torn Interior chlmnrry w*11 i
palm spring's condo header left & right fireplace ;
ti Prepared by: terri • Date: 2/29/1-6 BeamChek 2.0
Choice 4x 6 DF -L #2 ' BASE Fb = 875 ADJ Fb = 1138
Conditions . In Grade Values
Min Bearing Area ' R1= 0.6 int R2= 0.6 int DL DO, 0.01 in
MUMUres Oecavn kin- near kin- i L ven kin) LL uen
Actual 17.65 19.25 0.01 <0.01
Critical 4.11 4.74 0.20 0.13
Status OK OK. OK OK
t. Ratio 23% 25% 7% 1% i
Fb (psi) Fv (psi) E (psi x mil) Fc I (psi)
Values
Adjustments
r
palm springs condo header @ laundry
Prepared by: terri Date: 2/29/96 BeamChek 2.0
Choice 4x 8 DF -L #2 BASE Fb = 875 ADJ Fb = 1138
Conditions In Grade Values
Min Bearing Area R1= 1.9 int R2= 1.9 int DL Defl 0.09 in
Data Beam Span 9.0 ft Reaction 1, 1202 # Reaction 1 LL : 698#
Beam Wt per ft 6.17 # Reaction 2 1202 # Reaction 2 LL 698 #
Beam Weight 55 # Maximum V 1202 #
1 L IVIax UeTI L/ '18U I L HcTual UeTI L / 488
LL Max Defl L/240 LL Actual Defl L / 841
Attribute Section (in 3) Shear (in Z) TL Defl (in). LL Defl
Actual 30.66, 25.38 0.22' 0.13
Critical 28.54 16.43 0.60 0.45
Status OK OK OK OK '
Ratio 93% 65% 37% 29%
Fb (psi) Fv (psi) E (psi x mil) FL (psi)
Values Base Values 875 95 1.6 625
Base Adjusted 1138 95 1.6 625 -
Adjustments CF Size Factor 1.30
Cd Duration
Cr Repetitive
Ch Shear Stress.
Cm Wet Use
BeamChek has automatically. added the beam self -weight into the calcLlations.
palm springs condo bm under chimney
Prepared by: terri Date: 2/29/96 BeamChek 2.0
Choice 4x 6 DF -L #2 BASE Fb = 875' ADJ Fb = 1138
Conditions In Grade Values
- Min Bearing Area R1= 1.1 in' R2= 1.1 in DL,Defl X0.05 in
Data
Attribute
Actual
Critical
Status
Ratio
Values
Adjustments
Beam Span
6.0 ft
Reaction 1
674 # Reaction 1 LL 306 #
Beam Wt per ft
4.68 #
Reaction 2
- 674 # Reaction 2 LL : 306 #
Beam Weight
28 #
Maximum V
674 #
Max Moment
1011 '#
Max V (Reduced)
571 #
TL Max. Defl
L/180
TL Actual Defl
L / 855
LL Max Defl
L/240
LL Actual DO,.
L / >1000
Section (in') Shear (in2) . TL Defl (in) LL Defl
17.65
19.25
0.08
0.04
10.67
.9.02
0.40
0.30
OK
-OK
OK
OK
60%
47%
21% ,
13%
Fb (DSO
Fv (DSO
E (Dsi x mill Fc—I (Dsi)
palm springs.condo pt load from chimney a
Prepared by: terri Date: 2/29/96 BeamChek 2.0
Choice 4x 6 DF -L #2 BASE Fb = 875 ADJ Fb = 1138
Conditions In Grade Values
Min Bearing Area R1= 0.8 int R2= 0.4 inz
Actual
Critical
Status
Ratio
Values
Adjustments
palm springs condo header overpocket doors
Prepared by: terri Date: 2/29/96 BeamChek 2.0
Choice U 10 DF -L #2 BASE Fb = 875 ADJ Fb = 1050
Conditions In Grade Values
Min Bearing Area .R1= 2.1 int R2= 2.0 inz DL Defl 0.12 in
Attnbutes Section (in-) ; Shear (ins), I L DO (In) I LL DO
Actual
Critical
Status
Ratio
Values
Adjustments
s
•palm springs condo ridge beam `
Prepared by: terri Date: 2/29/96 BeamChek 2.0
Choice 6-3/4x 13-1/2 GLB 16F -V3 DF/DF BASE Fb = 1600 AN Fb = 1778
Conditions
Min Bearing Area R1= 10.4 int R2= 10.4 in DL Defl 0.32 in Suggested Camber 0.47 in
Data Beam Span 20.0 ft Reaction 1 5821 # Reaction 1 LL 4000 #
' Beam Wt per ft 22.14 # . Reaction 2 5821.# Reaction 2 LL 4000 #
Beam Weight 443 # Maximum V 5821 #
Max Moment 29107'# Max. V (Reduced) 5167 #
TL Max Defl L/180 TL Actual Defl L/238 -
LL
/238LL Max Defl L/240 LL Actual Defl L / 347
Attributes Section (in 3) Shear (inz) 'TL Defl (in) LL Defl
Actual
Critical
Status
Ratio
Values
Adjustments
Y
}
e
MAR - 1 3- 9 6 WED 13:40 BREEZE PIR C ONDI T I O N I N G
21000 ft2
Package
Package
Package
Package
Package
-Package
Package
Package
(fro electric)
Na
Standard
Allowed
w/Calculation f
1. Meet the component prescriptive requirement for Package D for slab -on -grad€ Construction or
Package E for raised floor construction (see Chapter 3) and all mandatory requirements,
2. "Heavy" and "Light Mass" mass walls may meet the Package D or H requirements for mass wall.
insulation instead ofR-13 (see Chapter 3).
3. For compliance of additions and alterations only, dual glazed "greenhouse" windows and skylights
may bt assumed to meet this requirement,
4, The Package D or E fenestration area plus the area of any glazing removed because of the addition.
S. All applicable mandatory measures for insulation or HVAC systems must be met (see Chapter 2).
•6. No ele::tric resistance space heating may be installed.
7. A standard water heating system is explained in Section 6.6.
S, If the wtal number of wator heaters increases in the residence, then the entire existing plus addition
system mus: meet the water heating energy budget (sot Chapuer 6). Table 3.4 lists water heating'
system combinations which have been pre -calculated to comply with the water heating budget.
P 04
Table 7-1: Prescriptive Compliance of'Additions -
Summary of Section 152(a)11 Requirements of the Standards
COMP .ONEN T .
7.2 COMPLIANCE ANALYSIS OF . ,
the existing structare,.except when calculating the
AN ADDITION ALONE
Walter heating energy use for any addition in which
the total nurnber of water heaters in the building
Any addition -- that is, the sum of all now
increases. The analysis may be performed using
conditioned spaces and associated new exterior
either a special prescriptive package according to
walls. ceilings, and floors within the building -
the size of the addition or with the point system or
may be shown to meet the energy budget as a
any approved computer performance method.
separate entity. This procedure does not involve
,
21000 ft2
Package
Package
Package
Package
Package
-Package
Package
Package
(fro electric)
Na
Standard
Allowed
w/Calculation f
1. Meet the component prescriptive requirement for Package D for slab -on -grad€ Construction or
Package E for raised floor construction (see Chapter 3) and all mandatory requirements,
2. "Heavy" and "Light Mass" mass walls may meet the Package D or H requirements for mass wall.
insulation instead ofR-13 (see Chapter 3).
3. For compliance of additions and alterations only, dual glazed "greenhouse" windows and skylights
may bt assumed to meet this requirement,
4, The Package D or E fenestration area plus the area of any glazing removed because of the addition.
S. All applicable mandatory measures for insulation or HVAC systems must be met (see Chapter 2).
•6. No ele::tric resistance space heating may be installed.
7. A standard water heating system is explained in Section 6.6.
S, If the wtal number of wator heaters increases in the residence, then the entire existing plus addition
system mus: meet the water heating energy budget (sot Chapuer 6). Table 3.4 lists water heating'
system combinations which have been pre -calculated to comply with the water heating budget.
P 04
Table 7-1: Prescriptive Compliance of'Additions -
Summary of Section 152(a)11 Requirements of the Standards
COMP .ONEN T .
S A`ft2
100-499 ft2
500-999 ft2
InsulatiR;n
Ceilip .
R-19
Packagget
Package
Wall
Floor
P.13
Mandatory s
R-13
Package
R-13
Package.
k`enescr:ttio
U -value
0.75
0.75
Package
% of CFA
5 50 Pct
Pk$ + Removee
Pkg + Removed
Shading
n/a .
Package
Package
'Therm' al Mass
n/a
Package
Package
Space Heating
'Mandatorys
Package
Package '
& Cooling ;
Quo electric)
(No elsctrie)
(No electric)
Water Heating -
No Increase &
No Change
n/a
n/a
ells "
Replacement:
No Increase
Standard
Standard
Standard .
Increase
Allowed
w/Calculation$
Allowed
Allowed
w/Calculation
w/Calculatio n
21000 ft2
Package
Package
Package
Package
Package
-Package
Package
Package
(fro electric)
Na
Standard
Allowed
w/Calculation f
1. Meet the component prescriptive requirement for Package D for slab -on -grad€ Construction or
Package E for raised floor construction (see Chapter 3) and all mandatory requirements,
2. "Heavy" and "Light Mass" mass walls may meet the Package D or H requirements for mass wall.
insulation instead ofR-13 (see Chapter 3).
3. For compliance of additions and alterations only, dual glazed "greenhouse" windows and skylights
may bt assumed to meet this requirement,
4, The Package D or E fenestration area plus the area of any glazing removed because of the addition.
S. All applicable mandatory measures for insulation or HVAC systems must be met (see Chapter 2).
•6. No ele::tric resistance space heating may be installed.
7. A standard water heating system is explained in Section 6.6.
S, If the wtal number of wator heaters increases in the residence, then the entire existing plus addition
system mus: meet the water heating energy budget (sot Chapuer 6). Table 3.4 lists water heating'
system combinations which have been pre -calculated to comply with the water heating budget.
P 04
MAR- 1 3-11=4E. WED 1 3: 255 BREEZE A I R - COND I T I ON I NG P. 03
Mandatory Measures Checklist: Residential SIF -1R
MOTE: Lowrr'se residential buildings subject to the Sta,dards must contain these measures regardless of the compliance
approach used. Items marked with an asterisk (') may be superseded by more stringent compliance requirements
listed on the Certificate of Compliance. Whdn this checklist is incorporaled into the permit documents, the features
noted shall be considered by all parties as binding minimum component performance specificatlons for the
Mandatory measures"whether they are shown elsewhere In the documents or on this checklist only,
DESCRIPTION DESIGNER ENFORCEMENT
Bullding Envelope Measures
§150(a): -Minimum R-19 ceiling insulation.
§150(b): -oose fill insulation manufacturer's labeled R -Value.
+ §150(c); rdlnimum A-13 wall insulation in framed walls (does not apply to exterior mass walls),
* §150(d): Minimum R- 1, 3 raised floor insulation in framed floors; mAnimum P.-8 In concrete raised floors.
§150(p: Slab edge insulation - water absorption rate no greaterthan 0.3%, water vapor transmission rate no
greater thi m 2.0 per.Tinch.
§118:- fro4ation specified or installed meets California Energy Commission quality standards.
lndicate type and form,
§11&17; Fenestration Products, Exterior Doors and InfiltrationrUiiltration Controls
a. Door.; and windows between conditioned and unconditioned spaces designed to limit air leakage.
b. Manufactured fenestration products have label with certified U -value, and infitration certification.
e. Exterior doors and windows weathersuipoed; all joints and penetrations caulked and sealed.
§150(g): Vapor barriers mandatory in Climate Zones 14 and 16 only.
§150(f): Scotia( infiltration bwrier installed to comply with §151 meets Commission quality standards.
§150(el: kysWlEtion of Fireplaces, Decorative Gas Appliances and Gas logs
1. Masonry and factory -built firepiaoes have;
a. Closeable metal or glass door
b Outside air Intake with damper and control
c Flue damper and control
2, No Xnti;luous burning gas pilots allowed.
Space Conditioning, Water Heating and Plumbing System Measures
§110.13: "100 equicment, water heaters showerheads and faucets certified by the Commissior..
§t 50(I): Sotbaclk thermostat on all applicable healing systems.
§150): Pine and Tank Insulation
1. Indire.,t hot nater tanks (e,g., unfired storage tanks or backup solar hot water tanks) have insulation
blaniult (R-12 or greater) or combined interiorlexterior Insulation (R-16 or greater),
2. First i, feet of pipes closest to water heater tank. non-redroulating systems, insulated (R-4 or greater).
3. All buried or exposed piping insulated in recirculating sections of hot wafer system.
4. Cooling System piping below 56°F insulated.
5. Piping insulated between heating source and indirect ho! water tank.
* g150(m): Ducts and Fans
1, Ducts constructed, installed and sealed to comply with UMC Sections 1002 and 1004; ducts insulated
to a nilnlmum Installed value of R-4.2 or ducts enclosed entirely within conditioned space.
2. Exhayst tan systems have backdraft or automatic dampers
3. Gravity ventilating systems serving conditioned space have either automatic or readily accessible,
ma,uruly operaled dampers..
§114: Pool and Spa Heating.ystems end Equipment
1, System is certified with 78% thermal efficiency, on-off switch, weatherproof operating Instructions,
no els=lc resistance heating and no pliot light.
2. System is installed with;
a. Al least 36' pipe between filter and heater for future solar heating.
b. Ower for out9oor pools or outdoor spa,
3. Pool system has directional inlets and a circulation, pump time switch.
§11 S: Gas, fired central furnace, pool heater, spa heater er household cookirg appliance have no
continuously buring pilot light. (Exception Non -electrical cooping appliance with pilot vz 150 BUN,)
bighting Measures
§150(k): 40lumena+watt or greater for general lighting in kitchens and rooms with water closets; and
recessed roiling fixtures IC (insulation cover) approved.
Revlsed Jonuery 1992
MAR -13-1.51G WED 1:5:25S SREE2E AIR CONDITIONING
Certificate of Compliance: Residential
(Page 2 of 2)
P . 0:2
CF -1 R
o�-yy L*�`
rofeot as
Minimum Duct
Date
(date)
HVAC SYSTEMS
'type (ail conditioner,
Efficiency Location
Duct
Note; Input hydronic or combined hydronlc data under Water Heating Systems, except Design Heating Load.
Configuration
purnii,. wolin
SEER
Distribution
Heating Equipment
Minimum
Type and Duct or
Heat Pump
Type (fuinace,heat
Efficiency
Location Piping Thermostat
Configuration
pump, etc
AFLIEMSP10
ducts/,attic, etc, R -Value Type,
_(split o* apka e
Energy'
fl L
Cooling Equipment
Minimum Duct
(signature)
(date)
'type (ail conditioner,
Efficiency Location
Duct
Thermostat
Configuration
purnii,. wolin
SEER
FI -Value
slt or package)
�heat
.eveQ7C�- _
(�, t4Y� � c�.
T�4,'z.
5�� �3r9•.2.�
'Pt�t� E
WATER HEATING SYSTi:MS
Energy'
External
Rated'
Tank
Factor or
Tank
water hieater Distow, tion Number Input (kW Capacity Recovery Standby' Insulation
Type Type in System or Btu/hr) (gallons) Efficiency Loss (%) R -Value
: 72zp ,r„arr,, 10,000 SO Sc43 -1,;
W4141 1om(-t14
t. For small gait atorage (rated Input S 75,000 Slu/hr), electric resistance and heat pump water haters, list Energy Factor.
For iargu gait storage water heaters (rated Input a ?5,000 Stulhr), list Rated input. Fiecovety Effidency and Standby Loss,
For Insutntansous gas water heaters, Ilst Rated Input and Roconry Efficiency.
SPECIAL. FEATURES/REMARKS (Add extra sheers If necessary)
COMPLIANCE STATEMENT
This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts t and 6, of
I
he California Code of Regulations, and the administrative regulations to Implement them. This certificate has been signed by the
individual with overall design responsibility. when this certificate of compliance is submitted for a single building plan to be built in mu!tple
orientation;,, any shading feature that is varied is indicated in the Special FeatureslRemarks section.
Designer or Owner (per Business is Professions Code)
Name: - — —
'title/F�rm: -
Addrp�s:
telephone:
tic. at;
(signature) (data)
Enforcement Agency
Name:
Title:
Agency:
Telephone;
(Signature uamp (date)
F vvlsod Dsc ember 1902
Documetttatto Aultlhorj.Name:
Tide/Finn; T-iL s�P.
Address:
044, Q
TolophO
®
MJ 1115t
(signature)
(date)
MAR— 1 3-96 WED 1:3 37 E,REEZ _A I R
CONDITIONING P. 0 1
Certificate of Cnmplianee: Residential (Page i of 2) CF -1 R
���.� 1����Qt lr�►ta-r-�
b
Date la
'080
An--r,cicc
Q
ComAllanCr
GENERAL INFORMATION
Total Conditioned Floor Area: 1 tt2
Building Type: Single Family --Z'Additiort
(check one as more) qort,9
i-Famil Existing -Plus -Addition
Front orientation, O East I South / West / All Orientations
orientation in mgrees and circle orae.)
Number of Dwelling Units:
Floor Construction Type: Slab FtBised Floor (circle one or both)
BUILDING SMELL INSULATION
Construction
Component insulation Assembly
Location/Comments
t3ujfd nq Permit 0
Plan Chock / Date
void Chock 10810
-0,5— liA n-=•Qsa NM aiLs��
C1 c� NoZ
FENESTRATION Shading Devices
Fenestration Area Fenestration interior Exterior Overhang Framing Type
Orientation s( U -Value roller blind, etc, shadescreen, etc. es/no metai/woodNin t)
Front..... i
Front...., iLett, ...... I
Lett .......
Rear--
Rear.....
ear--Rear.... r }
Right--
Skylight
ight., Skylight ......--�--
Skylight ...... _,.,,.�...,. .��...
THERMAL MASS
Type/Covering Area Thickness
slsblexoosed *ile etc) (inches) LocationiDescriplion (kitchen, bath, etc.)
it.vj"4 09a4mbur 1002
r
t
.. � .�
' .t
xl-a �y�r Q,�
w , �� �� 8 �,P��,�� s
- b �Te�o �� r � I e� e,
�.
,.
., _
��
0'3,,2 1. 196
THC; 1ii:1Z FAX 206 822 1508-HAFFEY C(IRP - -- -- - -
- -
Palm springs condo AC SUPPORT
Prepared by: TERRi Date: 3
1iE6
BeamChck 2,0
2x i 0 HF #2 BASE Fb =
50 - ADJ- Fb = 93{ -'—
Condition
Min Bearing Area R1= 1.2 ins R2= 1,2 in' DL Def. in
.0.09 .
Beam Span 10.0 ft Reaction 1 472 # Rea
tion 1 LL280
Beam Vit per ft 3.37 # Reaction 2 472 # Reaction
2 LL
250 #
' Beam Weight 34 # Maximum V 472'#
Max Moment 1285,'#, Max V (Reducad) 415 #
TL Max Defl L / 1.80 TL Actual Defi L ! 681
i LL Max Defl L / 240 LL Actual Defl L /=1000
Arir Section (in') Shear (in4) TL Defl (inj LL Defl —
----
Actual 21.39 13.88 0,18 0.09 -
--
—
Critical! 16.49 8.31 0.67 0,50
Status IOK OK OK OK
Ratio ! 77% 60% 26% 17%
'
Fb (psi) Fv (psi) E (psi x mil)
Fr, -L. (psi)
— —
Value i Base Values 85075 _ --
1.
40� ----
- --
Base Adjusted 935 75 1.3
405
A&stments Cp Size
i Cd Duration
Cr Repetitive
Ch Shear Stress
' Cm Wet Use
BeamChek has automatically added the beam self -weight into the ca
culations.
—
Uniform TL: 70 =A Uniform LL; 50
-----. _
_
Start
2:0
:..8.0
. i
R1 = 472
R2 P 472
SPAN = 10 FT
m3nd_padial ur_ iinrn, loads are lbs per lineal ft
n a UNiFORM ROOF LOAD: 35PLF x 2 = 70 PL'
AC LOAD: 558 LES; SUPPORTED BY 3 RAFTERS = 186 LES PER RAF
TER
`�.
186 LBS /5.33'= 35 LBS PLF CENTER RAFTER
`t