The URL can be used to link to this page

04-7924 (AR)4 i►a�wvruq�,� U BUILDING & SAFETY DEPARTMENT Bo 4. �. ;.. (760),777-7012 7 eo C TAMPICO FAX (760) 777-7011 . u A C LIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 c+�rNp�cEOE BUILDING PERMIT Application Number . . . . 04-0.0007924 Date 3/15/05 Property Address. . . . . . . 55900 PEBBLE BEACH , APN: 775-130-019- - - Application description . . ADDITION - RESIDENTIAL Property Zoning . .. LOW DENSITY RESIDENTIAL . Application valuation . . . . 25000 Owner Contractor. GRIFFIN CBR ENG CONTRACTOR .55-900 PEBBLE BEACH 54015 SOUTHERN HILLS LA QUINTA CA 92253 LA QUINTA CA 92253 (.760-)-- 771-2278._.._ WCC: STATE FUND WC: 1542568 08/.01/05 CSLB: 504183 01/31/07 CCC:, A=B =----- Structure. Information 28 SQ. FT. REM/'ADD ----- Construction Type TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . CODE EDITION 2001 CBC FLOOD ZONE NO .1ST FLOOR SQUARE FOOTAGE 28.00 ------------------------------------------ --------------------------- Permit . . ... . BUILDING PERMIT - t Additional desc Permit Fee 252.00 Plan Check Fee 163.80 Issue Date Valuation . . . . 25000 Qty. Unit Charge 'Per ' Extension BASE FEE 45.00 23.00 9.0000 THOU BLDG 2,001-25,000 207.00 ----------------------------------------------=----------------------------- Permit . . . . ELECT -,ADD/ALT/REM Additional desc Permit Fee 15.98 Plan Check Fee 4.00 Issue Date Valuation .�? 0 Qty Unit Charge Per Extension BASE FEE 15.00 28.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY .98 -------------------------------------------------------------------=-------- Permit . . . . . MECHANICAL Additional desc Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . Valuation 0 Qty Unit Charge Per Extension P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: �� - 7 a� Applicant: �-- Applicant's Mailing Address: Date: .� ' / S� • D Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 Business and Professionals Code, and ss Licen3e is in ful orce and effect. /License Class ,[�� %�� I --License No. J Date ^ 5�_0�ntractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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 ($500).): U I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , B.& P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is su$d. M workers compensation insur carrier and policynumber are: �r r -C �u k i- p icy Number / 4 t' _ I certify that, in the performance of the work for which this permt 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 subje the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prov 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. CONSTRUCTION LENDING AGENCY 1 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 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. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to upon the ve-=ionpor inspection purposes. ate (J d S_ ignature (Applicant or Agent): Page 2 Application Number 04-00007924 Date 3/15/05 Qty Unit Charge Per, Extension BASE FEE 15.00 1.00 9.0000 EA MECH APPL REP/ALT/ADD 9.00 Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 18.00 Plan Check Fee 4.50 Issue Date Valuation .0 Qty .Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 --------------------------------------------------- Special Notes and Comments 28 SQ. FT. KITCHEN ADD/REMODEL.3/14/05 1 1:54:.44 AM jjohnson ----------------------------------------------------------- Other Fees ENERGY REVIEW FEE ----------------- 16.38 STRONG MOTION (SMI) - RES 2.50 Fee summary Charged Paid ----------------- Credited Due -------------------- Permit Fee Total 309.98 ---------- .00 ---------- .00 309.98 Plan Check Total 178.3,0 .00 .00 178.30 Other Fee Total. 18.88 .00 .00 18.88 Grand Total 507.16 .00 .00 507.16 ,...- A _CERTIFICATE OF COMPLIANCE: RESIDENTIAL -(i ANY ,Yroject,Titl do _ - r ex Pro ect Address Doctunentation Author Telephone ge.l of 3). CF -1R gate Building Permit # Plan Check/ Date Field Check / Date - Compliance Method (Package or Computer) Climate Zone ' Enfoi•cetnent Agency Use Only tr GENERAL INFORMATION Total Conditioned Floor Area = ft v e ht* tip,• Conditioned Slab Floor Area -�Z ft2 �v"Frr I A ' a BUILDING &SAFETY DEPT, Building Type: Single Family fry Additio `, (check one or more) Multi -Family �`"'� Existing Plus-AdAcp P R V E D Front Orientation: _ North /777/ East / West / A I Orienta�R CON T UCTION - (input front orientation in degrees fro True No i ne), Number of Storie� DA Y Number of Dwelling Units S `4 Floor Construction Type: :Slab/Raised Floor (circle one or both) ' '160IANT6BARRIER (required in climate zones 2.4.8-15) Required for this submittaL—.—A.yes *no BUILDING ENVELOPE INSULATION Component Type - Frame Type wd = wood stl =steel Cavity Sheathing Insulation Insulation R -Value R -Value Total R- Assembly _ Location/Comments Value' U -Factor (attic, garage, typical, etc.) Wall41 Front Wall Left Roof i Rear" Roof Rear Floor,_, Right L 10 Floor Skylight Slab Ede - - xsv w� tiw,a \harhnn IlavirAe Fenestration #/T e/Pos. Orien- tation Area Fenestration , Fenestration Exterior Overhangs/ (ft) U -Factor SHGC Shading Att. Fins Front Front Left Left i Rear" Rear Right L 10 Right Skylight - Skylight �. January 5,'2001 CERTIFICATE OF COMPLIANCE: RESIDENTIAL HVAC SYSTEMS ,J F4k • . Note: Input hydronic or combined hydronic data under Water Heating Systems, except Design Heating Load. Distribution Heating Equipment Minimum Type and Duct or Heat Pump Type (furnace, heat Efficiency Location Piping Thermostat Configuration pump. etc.) AFUE or HSPF) ducts, attic, etc.) R -Value Type lit orpackage) Cooling Equipment " `Minimum Duct Type fair conditioner; r`_�(Efiic! , y�� Location eat pump, evap: cooling) - . AO '(SEER) , 1 y f � rh (attic, etc.) ❑ Sealed Ducts (all climate zones) (Installer testing and certification and HERS rater field verification required) Heat Pump Duct Thermostat Configuration R -Value Type (split or package) ❑ TXVs or Commission approved equivalent, readily accessible (climate zones z and 8-15 only) (Installer testing and certification and HERS Rater or field verification required) OR ❑ Alternative to Sealed Ducts and TXVs (see Package C or D Alternative Package Features for Project Climate Zone) Climate Zone Window SHGC Window U -Factor SEER Heating WATER HEATING SYSTEMS = Energy' External Rated' Tank,,- Factor or Tank Water Heater Distribution Number Input (kw Capacity Recovery Standby' Insulation TYPS Tyre in System or Btu/hr(gallons) Efficiency Loss % R -Value r --AIA o l: For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss. For instantaneous gas water heaters, list rated input and recovery efficiencies. SPECIAL FEATURES (add extra sheets if necessary). Package C and D: TXVs or Commission approved equivalent, Sealed Ducts, Radiant Barriers (see installation requirements for radiant barriers in Section 8.13 of the 1999 Residential Manual). Package C: thermal mass (thermal mass type, covering, thickness, and description). January 5, 2001 • ; -ERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 3) CF -1R COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement' them. This certificate has been signed by the individual with overall design responsibility. The undersigned recognize that compliance using duct sealing and TXVs (or Commission approved equivalent) requires installer testing and certification and field verification by an approved HERS rater. Designer or Ow`ner.(peF Business land Professions Code) Documentation}—Author, Name: tp II tJ �T ci I �O t7 ✓ S Name: 7 JAi Ike( X,41 b e i,,`J—pS Title/Firm: �r? /2 Title/Firm: Address: Address: G 2B Telephone: 7 7 t< :-,,7 27 f& Telephone: _ -7607'71 Z Z % Lic. M o q1 gi-3 �-- Zp_oeI ( gnature)ea" (date) (signature) (date) Enforcement Agency Name: Title: Agency: Telephone: (signature / stamp) (date) January 5, 2001 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Part 1) CF4R 'Project Title Date Project Address Builder Name Builder Contact Telephone Plan Number HERS Rater Telephone Sample Group Number Certifying Signature Date Sample House Number Firm: HERS Provider: Street Address: City/State/Zip: Copies to: Builder, HERS Provider HERS RATER COMPLIANCE STATEMENT The house was: ❑ Tested ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form comply with the diagnostic tested compliance requirements as checked on this form. ❑ Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts) ❑ Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. ❑ MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM . If fan flow is calculated as 400cfm/ton k number of tons enter calculated value here If fan flow is measured enter measured value here Leakage Percentage (100 x Test Leakage/Fan Flow) _ Check Box for Pass or Fail (Pass=6% or less) ❑ THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent ❑ ❑ Pass Fail ❑ Yes ❑ No Thermostatic Expansion Valve (or Commission approved equivalent) is installed and Access is provided for inspection ❑ ❑ Yes is a pass. Pass fail ❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT 1. ❑ Yes ❑ No ACCA Manual D Design requirements have been met (rater has verified that actual installation matches values in CF -1R and.design on plan. 2. ❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV, verified fan flow matches design from CF -1 R. Measured Fan Flow = ❑ ❑ Yes for both 1 and 2 is a Pass Pass Fail January $, 2001 CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Part 2) 1 CF4R Project Title Plan Number Sample Group Number Date Sample House Number ❑ MINIMUM REQUIREMENTS FOR DUCT IN CONDITIONED SPACE COMPLIANCE CREDIT, Field Verification Results ❑ Yes ❑ No Duct in conditioned space criteria matches CF -1 R ❑ ❑ Yes is a Pass Pass Fail ❑ MINIMUM REQUIREMENTS FOR REDUCED DUCT SURFACE AREA COMPLIANCE CREDIT Measured duct exterior surface. area in the following unconditioned duct locations (square feet): Attics Crawispaces Basements Other (e.g., garages, etc.) ❑ Yes ❑ No Duct surface area matches CF -1 R? ❑ ❑ Yes is a Pass Pass Fail January4, 2001 January 4, 2001 A a " CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING (Part 3) CF4R Project Title Plan Number Date Sample Group Number Sample House Number ❑ MINIMUM REQUIREMENTS FOR INFILTRATION REDUCTION COMPLIANCE CREDIT Diagnostic Testing Results Building Envelope Leakage (CFM @ 50 Pa) as measured by Rater 1. ❑ ❑ Is measured envelope leakage less than or equal to the required . Yes No level from CF -1 R? 2-.- ❑ ❑ Is Mechanical Ventilation shown as required on the CF -1 R? Yes No f 2a. ❑ ❑ If Mechanical Ventilation is required on the CF -1 R (Yes in line 2); Yes No has.it been installed? 2b. ❑ ❑ Check this box yes if mechanical ventilation is required (Yes in line Yes No 2) and ventilation fan watts are no greater than shown on CF - 1R. 3: ❑ ❑ Check this box yes if measured building infiltration (CFM @ 50 Pa) Yes No is greater than the CFM @ 50 values shown for an SLA of 1.5 on CF -1R (If this box is checked no, mechanical ventilation is required.) 4. ❑ ❑ Check this box yes if measured building infiltration (CFM @ 50 Pa) Yes No is less than the CFM @ 50 values shown for an SLA of 1.5 on CF -1R, mechanical ventilation is installed and house pressure is greater than minus 5 Pascal with all exhaust fans operating. ❑ ❑ Pass if: Pass Fail a: Yes in lined and line 3, or b. Yes in line 1 and line2, 2a, and 2b, or c. Yes in line 1 and Yes in line 4. Otherwise fail. January 4, 2001 IN, STALLATION CERTIFICATE (Page 1 of 8) CF -6R Site AddressPermit 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 forth is required; however, use of this form to provide the information is optional.) 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(b). HVAC SYSTEMS: Heating Equipment Equip. # of Efficiency Duct Duct of Heating Heating Type (pkg. CEC Certified Mfr Name Identical (AFUE, etc.)' location Piping Load Capacity heat numn) and Model Number Svst c f F -I R vA -1 (atti t 1 R-val ue (B Jhr) (B m/hrl Cooling Equipment Equip. CEC Certified Compressor # of Efficiency Duct Cooling Cooling Type (pkg. Unit Mfr Name and Identical '(SEER, etc.)' Location Duct load Capacity heat numn) Model Number Cvctems F>F-1R valuer Patti etc.) R-val ie (Btu/hr) (B ./hr) 1. > reads greater than or equal to. I, 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. Signature, Date WATER HEAUNG-SYSTEMS: Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR.Owner Distribution . If Recir- # of . Rated2 Tank Effi- External Heatcr CEC Certified Mfr Type (Std, culation, Identical Input (kW Volume cicncy Standby' Insulation Type Name & Model Number Point -of -Use) Control Type Svstcros or Btu/hr) (gallons) (EF RE) Loss (%) R -value 2 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. For large gas storage water heaters (rated input of greater than. 75,000 Btu/hr), list Recovery Efficiency, Standby Loss and Rated Input. For instantaneous gas water heaters, list Recovery Efficiency and Rated Input. 3. R-12 external insulation is mandatory for storage -water heaters with an energy factor of Icss than 0.58. Faucets & Shower Heads: All faucets and showerheads installed are certified to the Commission, pursuant to Title 24, Part 6, Section 111. 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. Signature, Date _1 COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner January 4, 2001 INSTALLATION CERTIFICATE (Page 2 of 8) .-CF-6R• Site Address Permit Number FENESTRATION/GLAZING: Total Quantity Product Product of Like Exterior Shading U -Factor' (5 SHGC' (<_ # of Product Square Device or Comments/Location/ Manufacturer/Brand Name CF -IR value)' CF -IR value)t Panes (Ontionah Feet Ov rhan Cnecial Features (GROUP LIKE PRODUCTS) 1. — 2. _ 3. _ 4. _ 5. _ 6. 7. _ 8. _ 9. _ 10. _ 11. _ 12. _ 13. 14. _ 15. ' Manufactured fenestration products use the values from the product label. Field fabricated fenestration products 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 CFA R. 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 -IR. Alternatively, installed weighted average U -Factors for the total fenestration area are less than or equal to values from CF -1 R. 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 COPY TO: Building Department r. HERS Provider (if applicable) �. Building Owner -at Occupancy .� January 4, 2001 I;NSTALLATION.CERTIFICATE (Page 3 of 8) CF -6R Site Address'Permit'Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS' ❑ DUCT LEAKAGE REDUCTION, Pressurization Test Results (CFM @.25 PA) Test Leakage (CFM) Fan Flow If Fan Flow is Calculated as 400 cfnVton x number of tons, or as 21.7 z Heating Capacity in Thousands of Btu/hr, enter calculated value here If fan flow is measured, enter measured value here Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) _ Pass if leakage fraction <_ 0.06 ❑ ❑ Pass Fail ❑ For. AEROSOL TYPE SEALANTS ONLY - The following diagnostic testing was completed: Duct Fan Pressurization at rough -in measured leakage (CFM) CHECK AFTER FIMSAING WALL: ❑ Yes ❑ No ❑ Pressure pan test or House pressurization test ❑ Yes ❑ No ❑ Visual Inspection of Duct Connections ❑ ❑ Pass Fail ❑ THERMOSTATIC EXPANSION VALVE (TXV) - ❑ Yes ❑ No Thermostatic Expansion Valve (or Commission approved equivalent) is installed and Access is provided for inspection. ❑ . " ❑ Yes is a pass pass Fail ❑ DUCT DESIGN 1 ❑ Yes ❑ No ACCA Manual D Design calculations have been completed, Duct Design is on the plans and duct installation matches plans. 2• ❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV, verified fan flow matches design from CF -1R. Measured Fan Flow = Yes for both 1 and 2 is a Pass Pass Fail ❑ I, the undersigned, verify 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 sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit.] I Tests Signature, Date Performed COPY TO: Building Department HERS Provider (if applicable) Building. Owner at Occupancy January 4; 2001 Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) ' INSTALLATION CERTIFICATE (Page 4 of 8) '` CF -W Site Address Permit Number DUCT LOCATION AND AREA REDUCTION DIAGNOSTICS ❑ DUCT IN CONDITIONED SPACE ❑ Yes ❑ No Duct in conditioned space criteria matches CF -1R ❑ ❑ Yes is a Pass Pass Fail ❑ REDUCED DUCT SURFACE AREA Measured duct exterior surface area in the following unconditioned duct locations (square feet): Attics Crawlspaces Basements Other (e.g., garages, etc.) ❑ Yes ❑ No Duct surface area matches CF -1R? ❑ ❑ Yes is a Pass Pass Fail ❑ I, the undersigned, verify that the duct surface area and duct locations claimed for duct surface area reductions and duct location improvements beyond those covered by default assumptions match those on the plans. [The builder shall provide the HERS provider a copy of the CF -6R signed by the builder employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit.) Tests Signature, Date Installing Subcontractor (Co. Name) OR Performed General Contractor (Co. Name) COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy January 4, 2001 INSTALLATION CERTIFICATE (Page '5 of 8) CF -6R ;r Site Address Permit Number BUILDING ENVELOPE -LEAKAGE DIAGNOSTICS' " ❑ 'ENVELOPE SEALING INFILTRATION REDUCTION Diagnostic Testing Results Building Envelope Leakage (CFM @.50 Pa) as measured by Rater 1. ❑ Is measured envelope leaka9e less than or equal to the required level Yes No from CF -1 R? '2. ❑ ❑ Is Mechanical Ventilation shown as required on the CF -1 R? Yes No 2a. ❑ ❑ If Mechanical Ventilation is required on the CF -1 R (Yes in line 2), has Yes No it been installed? - 2b. ❑ ❑ Check this box yes if mechanical ventilation is required (Yes in line, 2) Yes No and ventilation fan watts are no greater than shown on CF -1 R. Measured Watts = 3. ❑ ❑ Check this.box yes if measured building infiltration (CFM @ 50 Pa) is Yes No rgreater than the CFM @ 50 values shown for an SLA of 1.5 on CF -1R (If this box is checked no, mechanical ventilation is required.) 4. ❑ ❑ Check this box yes if measured building infiltration (CFM @ 50 Pa) is Yes No less than the CFM @ 50 values shown for an SLA of 1.5 on CF -1R, mechanical ventilation is installed and house pressure is greater than minus 5 Pascal with all exhaust fans operating. - Pass if: —'Pass Fail a. Yes in line 1 and line 3, or - b. Yes in line 1 and line2, 2a, and 2b; or c. Yes in line 1 and Yes in line 4. < Otherwise fail. ❑ -I, 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 abovediagnostic 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 sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit.] Test Perfoimed Signature Date Testing Subcontractor (Co. Name) OR . General Contractor (Co. Name) COPY TO: Building Department . HERS Provider (if applicable) Building Owner at Occupancy January 4, 2001 INSTALLATION CERTIFICATE (Page 6 of 8) CF -6R' m Site Address Permit Number The following is an explanation of many of the input values required on this form: HVAC SYSTEMS Heatine Equipment T e must be one of the followin Furnace: Gas (including Liquefied Petroleum Gases) or oil -fired central furnace & space heater Boiler: Gas or oil -fired boiler PckgHeatPump: Packaged central heat pump SplitHeatPump: Split central heat pump RoomHeatPump: Room heat pump LgPkgHeatPump: Large packaged heat pump (> 65,000 Btu/hr output) Electric: Electric resistance heating (fixed HSPF = 3.413); radiant electric resistance (fixed HSPF = 3.55) CombinedHydro: Reference water heater under water heating systems below CEC Certified Manufacturer Name & Model Number from applicable Commission approved appliance directory. # of Identical Systems is for those systems with the same efficiency, duct location, duct R -value and capacity. Efficiency from applicable Commission certified appliance directory: Duct (or Piping) Location is attic, crawl space, CVC crawl space, conditioned space, unconditioned space or none. Duct (or Piping) R -Value from Directory of Certified Insulation Materials and/or manufacturer's data. Heating/Cooling Load refer to Commission approved load calculation procedure. Heating/Cooling Capacity from the applicable Commission certified appliance directory. Note: location elevations over 2,000 ft above sea level require a derating of output capacity (refer to manufacturer's literature). Cooling Equipment Tyne must be one of the fnllnuiinv SplitAirCond: Split system air conditioner PckgAirCond: Packaged air conditioner Split Heat Pump: Split system heat pump PckgHeatPump: Packaged heat pump RoomHeatPump: Room heat pump LgPkgHeatPump: Large packaged heat pump (> 65,000 Btu/hr output). Substitute EER for SEER when SEER is not available RoomAirCond: Room air conditioner. Minimum SEER varies* LgPkgAirCond: Large packaged air conditioner (2!.65,000 Btu/hr output). Substitute EER for SEER when SEER is not available EvapDirect: Direct evaporative cooling system. For compliance calculation purposes, fixed values: SEER = 11.0; duct location = attic; duct insulation R -value = 4.2 EvapIndirect: Indirect evaporative cooling system. For compliance calculation purposes, fixed values: SEER = 13.0; duct location = attic; duct insulation R -value = 4.2 6J yuU„%:auun appliance cprciency Reguiattons, Y40U-92-029 January 4, 2001 INSTALLATION CERTIFICATE 6 of 8) CF -6R Site Address . .. Permit Number The following is an explanation of many of the input values required on this form: a . MVAC SYSTEMS Heating Equipment Type must be one of the following: Furnace: Gas (including Liquefied Petroleum Gases) or oil -fired central furnace & space heater Boiler. Gas or oil -fired boiler PckgHeatPump: Packaged central heat pump SplitHeatPump: Split central heat pump RoomHeatPump: Room heat pump LgPkgHeatPump: Large packaged heat pump (>_ 65,000 Btu/hr output) Electric: Electric resistance heating (fixed HSPF = 3.413); radiant electric'resistance (fixed HSPF = 3.55) CombinedHydro: Reference water heater under water heating systems below CEC Certified Manufacturer Name & Model Number from applicable Commission approved appliance directory. # of Identical Systems is for those systems with the same efficiency, duct location, duct R -value and capacity. Efficiency from applicable Commission certified appliance directory: Duct (or Piping) Location is attic, crawl space, CVC crawl space, conditioned space, unconditioned space or none. Duct (or Piping) R -Value from Directory of Certified Insulation Materials and/or manufacturer's data. Heating/Cooling Load refer to Commission approved load calculation procedure. Heating/Cooling Capacity from the applicable Commission certified appliance directory. Note: location elevations over 2,000 ft above sea level require a derating of output capacity (refer to manufacturer's literature). Cooling Equipment Type must be one of the following: SplitAirCond: • Split system air conditioner PckgAirCond: Packaged air conditioner Split Heat Pump: Split system heat pump PckgHeatPump: Packaged heat pump RoomHeatPump: Room heat pump LgPkgHeatPump: Large packaged heat pump (> 65,000 Btu/hr output). Substitute EER for SEER when SEER is not available RoomAirCond: Room air conditioner. Minimum SEER varies* LgPkgAirCond: Large packaged air conditioner (>-65,000 Btu/hr output). Substitute EER for SEER when SEER is not available EvapDirect: Direct evaporative cooling system. For compliance calculation purposes, fixed values: SEER = 11.0; duct location = attic; duct insulation R -value = 4.2 EvapIndirect: Indirect evaporative cooling system. For compliance calculation purposes, fixed values: SEER = 13.0; duct location = attic; duct insulation R -value = 4.2 *Refer to Energy Commission publication Appliance Efficiency Regulations, P400-92-029 January 4, 2001 - INSTALLATION CERTIFICATE (Page 7 of 8) CF -6R I Site Address Permit Number The following is an explanation of many of the input values required on this form: WATER AEATING SYSTEMS• nistrihntinn CvctPmc RrfPr to Roeidontinl Alnntinl fnr tnnro Aat�ac- Standard: Standard — Supply pressure based system, no pumps Pipe Insulation: Pipe Insulation on all 3/4 -inch pipes POU/HWR: Point of Use/Hot Water Recovery System Recirc/NoControl: Recirculation loop with no controls Recirc/Timer: Recirculation loop with a timer Recirc/Temp: Recirculation loop with temperature control Recirc/Time+Temp: Recirculation loop with a timer and temperature control Recirc/Demand: Recirculation loop with demand control Water Heater Type Windows, sliding glass doors, French doors, skylights, garden windows, and Information Needed any door with more than one square foot of glass Operator Type: Enerev Factor Recovery Efficiency Standby Loss Rated Input Storage Gas, Oil or Electric Yes No No No - Heat Pump Yes No No No Instantaneous Gas No Yes No No Instantaneous Electric Yes No No No Large Storage Gas No Yes Yes Yes Indirect Gas (Boiler) No Yes (AFUE) No Yes FENESTRATION/GLAZING Fenestration: Windows, sliding glass doors, French doors, skylights, garden windows, and any door with more than one square foot of glass Operator Type: Slider, hinged, fixed U -Factor: Installed U -Factor must be less than or equal to value from CF -1R OR -Installed weighted average U -Factor for the total fenestration area is less than orequal to value from CF -1R SHGC: Installed SHGC must be less than or equal to value from CF -1 R OR Installed weighted SHGC for the total fenestration area is less than or equal to value from CF -1R OR An interior shading device, overhang, or exterior shading device is installed consistent with the CF -1R Shading Device: Include when the building complied using an exterior shading device: woven sunscreen, louvered sunscreen, low sun angle sunscreen, roll -down awning, roll -down blinds or slats (do not list bug screen), or an overhang (include depth in feet January 4, 2001 INSTALLATION CERTIFICATE (Page 8 of 8) "�- CF-6R.- Site F_6R. Site Address Permit Number The following is an explanation of many of the input values required on .the Diagnostic portion of this form (page 3 of 6): TYPE OF CREDIT Refer to Residential Manual Chapters 4 and 5 for more details: Reduced Duct Surface Area: Calculated as the outside area of the duct. Areas must be measured and verified by a HERS rater. Improved Duct Location: Supply duct located in other than attic, as verified by location of registers (does not require HERS rater verification). Catastrophic Leakage: Pressure pan test readings must be less than 1.5 Pascal at a house pressure of . 25 Pascal. TXV (or Commission Access cover required to facilitate verification. Eligibility criteria for approved equivalent): Commission approved equivalent, if applicable, is required to be met. Infiltration Reduction: Infiltration is measured without mechanical ventilation operating. Mechanical ventilation is required for very tight house construction when credits for infiltration reduction using diagnostic testing are being used for achieving compliance. These very tight houses are defined as those with SLA of less than 1.5. The compliance documentation (CF -1R) will contain the measured CFM target value from a blower door test at 50 Pascal pressure difference that represents this SLA of 1.5. Mechanical ventilation is also required if the builder chooses to design the building to use mechanical ventilation and claims a credit for infiltration below an SLA of 3.0. The compliance documentation (CF -1R) will contain the measured CFM target value that represents this 3.0 SLA. If the builder claims credit in a design for infiltration reduction that is at an SLA of 3.0 or higher, and the actual measured SLA is 1.5 or greater, then mechanical ventilation is not required. If the SLA in this case were below 1.5, then mitigation (such as mechanical ventilation) would be required. January 4, 2001 ",.. MANDATORY MEASURES CHECKLIST: RESIDENTIAL (Page.l of 2) MF -1R 7Note: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (•) may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. r Instructions: Check or initial applicable boxes `when completed or enter N/A if not applicable. ' DESCRIPTION DESIGNER ENFORCEMENT Building Envelope Measures: • §150(a): Minimum R-19 ceiling insulation. § 150(b): Loose fill insulation manufacturer's labeled R-Valuc. • §150(c): Minimum R-13 wall insulation in wood framed walls or equivalent U-Fauor in metal frame walls does not apply to exterior mass waits). • §I50(d): Minimum R-13 raised floor insulation in flamed floors. § 1500): Slab edge insulation - water absorption rate no greater titan 0.3%, water vapor transmission rate no greater than 2.0 perridinch. § 118: Insulation specified or installed meets insulation quality standards. Indicate type and form. § 116-17: Fenestration Products, Exterior Doors; and Infiltration/Exfiltration Controls 1. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. 2. Fenestration products (except field -fabricated) have label with certified U -Factor, certified Solar Heat / Gain Coefficient (SHGC), and infiltration certification. ✓ 3. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. § 150(g): Vapor barriers mandatory in Climate Zone 14 and 16 only. §150(f): Special infiltration barrier installed to comply with § 151 mecca Commission quality standards. §150(c): Installation of Fireplaces. Decorative Gas Appliances and Gas Logs. 1. Masonry and factory -built fireplaces have: a. Closeable metal or glass door b.Outside air intake with damper and control C.Flue damper and control 2. No continuous burning gas pilot lights allowed. - - Space Conditioning, Water Heating and Plumbing System Measures: §110-§113: HVAC equipment, water heaters, shorwerheads and faucets certified by the Commission. § 150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA or ACCA. § 150(i): Setback thermostat on all applicable heating and/or cooling systems. , §150(1): Pipe and tank insulation 1. Storage gas water heaters ratesd with an Energy Factor l ss than 0.58 must be externally wrapped with insulation having an installed thermal resistance of R-12 or greater. 2. First 5 feet of pipes closest to water heater tank, non -recirculating systems, insulated (R4 or greater) 3. Back-up tanks for solar system, unfired storage tanks. or other indirect hot water taroks have R-12 external insulation or R-16 combined intemal/extemal insulation. 4. All buriesd or exposed piping insulatesd in recirculating sections of hot water systems. 5. Cooling system piping below 55• F insulated. 6. Piping insulated between heating source and indirect hot water tank. January 4, 2001 MANDATORY MEASURES CHECKLIST: 2 of 2) MF -1R - Note: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (•) may be superseded by more -stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. Instructions: Check or initial applicable boxes when completed or enter N/A if not applicable. DESCRIPTION DESIGNER ENFORCEMENT Space Conditioning, Water Heating and Plumbing System Measures: (continued) • § 150(m): Ducts and Fans 1. All ducts and plenums installed, sealed and insulated to moa the requirement of the 1998 CMC Sections 601, 603, 604, and Standard 6-3: ducts insulated to a minimum installed level of R41 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape. aerosol sealant, or other duct•clostut system that mats the applicable requirements of UL 181, UL 181 A. or UL 181 B. If mastic or tape is used to seal openings greats than 1/4 inch, the combination of mastic and either mesh or tape shall be used. Building cavities shall not be used for conveying conditioned air. Joints and seams of duct systrnts and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and drawbands. 2. Exhaust fan systems have back draft or automatic dampers. 3. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampen. § 114: Pool and Spa Heating Systems and Equipment. 1. System is certified with 78% thermal efficiency, on -of switch, 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 beater 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 central furnaces, pool heaters, spa heaters or household cooking appliances have no continuously burning pilot light. (Exception: Non -electrical cooking appliances with pilot < 150 Btu/hr) Lighting Measures: §150(k)l.: Luminaires for general lighting in kitchens shall have lamps with an efficacy of 40 lumcnslwan or Beater for general lighting in kitchens. This general lighting shall be controlled by a switch on a readily accessible lighting control panel at an entrance to the kitchen. § I50(k)2.: Rooms with a shower or bathtub must have either at least one luminaire with lamps with an efficacy of 40 lumenstwatt or greater switched at the entrance to the room or one of the alternatives to this requirement allowed in § 150(k)2.. and recessed ceiling fixtures are IC (insulation cover) approved. u January 4, 2001 x A X i rtri # � ! Ciof La City Qulnta Building al: Safety Division Permit #J�— P.O. Box 1504, 78-495 Calle Tampico —M a La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking. Sheet Project Address:. _ Ov 6� J� Owner's Name: O � A. P. Number: Address: �®4a Leal Description: City. ST, Zip: Contractor: FTelephoneG (. Address: XProject Description: City, ST, Zip: _� 2g �� Telephone: _::. =; :; ; • In State Lic. # : DL City Lic. #: Arch., Engr., Designer. Address: City, ST, Zip: Telephone: :rti .. .�.: Construction ction Type: Occupancy: State Lic. #: Project type (circle one • New Add'n Alter Repair Demo Name of Contact Person: &I�' . (per - I SX Sq. Ft: Stories: # Units: Telephone # of Contact Person: _ stimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE q Submittal Req'd Rec'd TRACKING PERMIT FEES Ian Sets Plan Check submitted It Amount Structural Cala. Reviewed, ready fo corrections NO Plan Check Deposit Truss Calcs. Called Contact Person 4,41 S Plan Check Balance 2 Energy Cala. Plans picked up QS Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for o ect'on &sue A Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S nI I 2 Plans resubmitted Grading J OBJ H.O.A. Approval IN HOUSE: Review, ready focorrections/ u �05Developer I pact Fee Called Contact Person j A.I.P.P. Bats of -per is.issoz u CS O Planning Approval Pub. Wks. Appr School Fees 1I bft- AW 15 I Permit F... TOtaHEI I G//6 _5'/-A-cT - �rcr✓a Dvc 2 27 . sofli✓�it- ,^� r�'; 0 '1 -3146v� 311 q G,-t,t�� c 94