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Home My WebLink About10-1008 CITY OF DIAMOND BAR �n ' � -"��'— DEPARTMENT OF COMMUNITY&��}� ES � " I 21825 Co ple y Drive,Diamond Bar,CA�'1789�� p �f�� (909)839-7020 Fax(909)861-3117 Buildi�g Inspection Hotline(909)83�Q �E$$ "�^' BUILDING PERMIT APPLICATION FI�tMLY � JOBSITE '�' APPLICATION PERMIT p/C I � o ADDRESS � � h"� DATE ��r��O NUMBER �OO g °-° APN L T TRACT DA EE �v��/ O ONST./�IC_Gi/� GROUP p OWNER " " ADDRESS ZONING SETBACKS 0 Z CITY ZIP TEL. FRONT qyy � � APPLICANT TEL. REAR p � SIDE/SIDE STREET RW ❑ z � CONTRACTOR i : SIDE ❑ � ADDRESS ' PROPOSED USE CSZ VI C� � CI7Y � ZIP TEL. w ARCH/EN z DESIGNER w NO.DWEL. NO. NO. n. ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � �n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p I HEREBV AFFIRM UNDER PENALTY OF PE0.IURV THAT I AM E%EMPT FROM THE CONTRACTORS LI� G8fd9B/CBfPOfI W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.SBUSINESSANDPROfESSIONSCADE:ANYC17YOq (n U COUN7VWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUG - w TURE,PRIOR TO ITS ISSUANCE,AL50 RE�UIRES 7HE APPLICAN7 FOR SUCH PERMIT 70 FILE A SIGNED w Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PUFSUAN7 TO THE PROVISIONS OF THE CONTRACTORS LI- � � CENSE UW(CHAPTER e(CAMMENCING WI7H SECTION 7ooa)OF DIVISION 3 OF THE BUSINE55 AND PRO- POOVSP3 0 FESSIONSCADE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEC,EDEI(EMP- (� V TION.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IEC7S THE APPLICANT TO Z Re-Roof � A CIVIL PENAL7V OF NOT MORE THAN FIVE HUNDRED DOLURS(5500).): Z ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � COrtIrtIBlC181 WILL DO 7HE WORK,AND THE STRUCTURE IS NOT INTEN�ED OR OFFEHED FOR SALE(SEC.7ou,BUSI- J N NESS AND PROFESSIONS CODE:THE CONTRAC70R5 LICENSE UW DOES NO7 APPLV TO AN OWNER OF � PROPERTY WHO BUILDS OR IMPROVES 7HEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR CC THROUGH HIS OR HER ONRJ EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m w OFFEREDFORSALEIF,HOWEVERTNEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE� 0 TION,iHE OWNER�BUILDEH WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). = OI,ASOWNEROFTHEPROPEHTV,AME%ClUSNELYCONTRACTINGWITHLICENSEDCONTRACTORS W � 70 CANSTRUCT THE PRQIECT(SEC.7aa,BUSINESS AND PROFESSIONS CADE:THE CONTRACTORS LI- V81ll8flOf1 ADJ.AREA W CENSE lAW DOES NOTAPPLV 70AN ONRJER OF A PROPEHTV WHO BUILDS OR IMPROVES 7HEREON,AND � WHOCAMRACTSFORSUCHVRQIECTSWITHACONTRACTOR�S�LICENSEDPURSUANTTOTHECANTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE UW.�. �� ❑I AM EXEMPT UNDEF SEC, B.8 P.C.FOR THIS REASON Q U ti � DATE OWNER � � Z W � LICENSED CONTRACTORS DECLARATION W � I HEREBY AFFIRM UNDER PENALTV OF PERJUf7V 7HA7 I AM LICENSED UNDER PROVISIONS OF CHAPTER � � i(COMMENCING WITH SECTION 7000)OF DIVISION 3 0F THE BUSINESS AND PROFESSIONS CAOE,AND Z X MY UCENSE IS IN PULI FORCE AND EFFECT. � g�o�- � LICENSE CLASS LIC.NO. � J V DATE CONTRACTOR d W � WORKERS'COMPENSATION DECLARATION Q NI HEREBY AfFIflM UNDER PENALTV OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: Z Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSEN770 SELF-INSURE FOR WORNERS' 2 Q COMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR fADE,FOR THE PER WRMANCE �U Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � w �I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS RE�UIRED BY SECTION Q3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBERARE: CONSTRUCTION J �-r �tANI� . j CARRIER�_rC' /� PLAN REVIEW ZPOLICY NUMBEF '��'��'T4-- ELECTFIIC ¢ •--�� (IHISSECTqNNE�NOTBEOJA1RFfEDOFh1EPEPMfTISFOPONEHUWREDDOLLl�AS(f10D)ORLESS). PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I CA �Q C.'} SHALL NOT EMPLOY ANV PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE Uj WORKERS'COMPENSATION LAWS OF CAUFORNIA,AND AGREE THAT IF I SHOULD BECOME TION FEE � SUBJECTTOTHEWORKERS'CAMPENSATIONPROVISIONSOFSECTION37o00FTHELABOR � /1 `. � � � CODE,I SHA FORTHWITHCOMPLV WI OSE PROVISIOIS. L� � SMIP p DATE: APPLICANT: �� J WARNING:FAILURETOSECUREWORKERS'COMPENSATIONCOVERAGEISUNLAWFUL. SHALLBE ENERGYP/C � � SU&IECTANEMPLOYERTOCRIMINALPENALTIESAN�CIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN '] � SECTION 3708 OF THE LABOR CODE,IN7ERE57,AND A7TORNEV'S FEES. RE FEE: r "" d CONSTAUCTION LENDING AGENCY pR - EE: O � I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY � FOR THE PERFORMANCE OF THE WOFK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDER'S NAME F-� LENDER'SADDRESS � TOTAL FEES "S�� I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CAHRECT. w I AGREE TO COMPIV WITH ALL G7V AND COUNTY ORDINANCES ANO S7A7E UWS REUTING 70 BUILDING � � CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE Z ABOVE-MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS o r Nr , � m PERMI7T N E(PR T . � � . Q � � � SIGNA RE OF P MI DAT � � i I = RECPT.N0. O PAID BY VALIDATION l I ~ WHITE—De a t Co YELLOW�inence Co PINK—Assessor Co GOLDENRO�File Co GREEN— P PY, PY. PY� PY. ApPlicant's Copy — -- � — � 'F ,��.� . � �`� Y�7:iw.." �� B�a�� $ � ,��j�-,x c:�� c �<.�'tr¢ � .�,->�,C�!��-��'�� P�l��(Fd� � � • �"��.�� a�-� � r �• ��. � '�rt� r� �� .�i - ��`�?��;��.'.��:.�l�,y ._� oa�p�c�ooa aca4��, aa�p��4oa a��p�c�400a : aa4� ��c��i� .�:;. SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATI�N TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION, POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS __ SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. F FIRE DEPT. FINAL FINAL HEA7ING HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FI NAL PLU M B I NG ------- ------- EN ERGY-- -------- --------------_ C��o � COMMENTS —I�a � � �CZcW� - �- _ ! ,L �/� -c� �. � `� �0� �OrA�� Q�'"�, � ' J � SEPTIC TANK SIZE SEEP PIT/U SIZE a - -- - � � � t � Prescri tive Certificate of Com liance: Residential CF-IR-ALT Residential Alterations a e 1 of 5 P'°'e``Na'"e:(E) F U R N AC E R E P LAC E M E N T Climate Zone#9 2 of Stories General Inforroatlon Site Address:21325 COTTONWOOD LANE Enforcement Agency:DIAMOND BAR Date:10/12/2010 Building Type�Single Family Q Multi Family Circle the Front Orientation:N,E, ,W,or degrees 3�p Conditioned Floor Area(CFA): ��368 S.F. Project Type: Alterations Envelope Fenestration Roof X HVAC Re lacement or Change Out Duct R lacement Q Water Heater NOTE:This form is not to be used for Newly Consducted Buildings or Additions Insulation Values For Opaque Surfaces(�'or Furring use the Mass and Furring Strips Construction table below) Assembly Alteration ❑Opening of framed cavity alone—Alterations that involve the opening of the framed cavity of a wall, ceiling,orJloor must install the mandatory minimum insulation value per§I SO for the altered assembly.Fill in Colum�:s A—C and enter mandatory insulation value in Column H. [�Replacement of entire assetnbly—Replacement of an entire wall,ceiling,or floor assembly requires the installation of Component Packa e-D insulation values in Table 1 SI-C. Fill in Columns A—J. � a ue Sul'faCe Detalls For the furred ortioned of Mass Walls see Furrin Stri s Construction Table below. A B C D E F G H I J Pro osed e` °�e Standard Values From JA4 Table Framing Thickness, Framed Continuous JA4 Proposed Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly ID� or T e2 and SizeZ or Other� factor4 Number� R-value6 R-Value� Row/Col� U-factor9 N/A Note:For furred rusemblies,accounting for Cantinttaus Insulation R-valtte,see Page JA4-3 and Equation 4-1. For calculating funed wa!!s use the Mass und Furrin Construction ta61e 6elow. ___.__ .._ ..__ 1.For Tag/ID indicate the identification name that matches the building plans. 2.Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors,Slabs, Crawl Space,Doors and etc...Indicate in column G the Frame material and Size:For Wood,Metal,Metal Buildings,Mass,enter 2x4,2x6,or etc...see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inche.r or Spacing between framing members enter;16"or 24"OC;or Other for all other assembly descriprion such as Concrete Sandwich Panel,Spandrel Panel,Logs,Straw Bale Panel and etc.... 4.Based on the Climate Zone;enter the equivalent U factor found in JA4 Table based on the R-Value from Table 1 Sl-B, C,or D 5.Enter the Table number that closely resemb/es the proposed assembly. 6. Enter the R-value that is being installed in the wall caviry or between the framing;otherwise,enter "0". 7. Enter the Continuous Insulation R-value for the proposed assembly;otherwise, enter "0". 8.Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U factor in Column J 9.The Proposed Assembly U factor, Column J,must be equal to or less than the Standard U factor in Column E to comply. Furrin Stri s Construction Table for Mass Walls Onl A B C D E F G H I J K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation ' Walls From Reference in Furring Space from Reference Joint A endiz Table 4.3.5 4.3.6 4.3.7 Joint A endix Table 4.3.13 � � � d o � °' � �, � a� U y � ,, c "'a .�. o.� A y �� ° � � � H o �;, � >;, Final Assembl �, o.o •.. en ❑ �� .� a Mass Name or JA4 Table d. � � �,G, �y � �o 'E � �. � $ � Assemb� Thiclrness' T ez Number' Q > d '� � � � d > � U-factor�� Comment N/A -- —- - -- - - - --- - — - -__ __-- - - - --- - _ -- - - - --_ _ - - ---- �Registration Number_ Regtstration Date/Time: HERSProvider: _ i 2008 Residential Compliance Forms March 2010 Prescri Nve Certificate of Com liance: Residential CF-IR-ALT I Residentia[Alterations Pa e 2 of 5 Project Name:�E) F U R N AC E R E P LAC E M E N T Climate Zone#n 2 of Stories �� ass and Furrin Stri s Construction ootnotes 1.Indicate the type of assembly to include;Hoflow Unit Masonry Walls,Solid Unit Masonry,Solid Concrete Walls,Etc. Additional assemblies can e found Reference Joint Appendiz JA4. . This is the U-Factor based on the thickness of the assembly in inches. . The R-value of the insulation ta be added on the interior or exterior of the assembly. . The Calculated R-Value is the R-value of the furred out section of the assembly. .-6.The Final Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix JA4. The equation is the inverse of Column added to Column I. Column K is the inverse from column J. 7.Insert the calculated U-actor va[ue on to the O a ue Sur ace Details in Column J FENESTRATION PROPOSED AREAS Q ReplaCing window alone-Replacement windows shall meet the U-Factor and SHGC Value requirements of Component Package D in Table ISI-C. The Total Fenestration and West facingArea reguirements are not applicable. ❑Adding SOft�or less of window ares-Newly installed windows shall meet the U-Factor and SHGC Value requirements of Component Package D in Table I51-C. �Adding more than 50ftZ of window area- Newly installed windows shall meet the U-Factor and SHGC Yalue and the Fenestration Area requirements of Component Package D in Table 1 SI-C. Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF-IR-ALT Orientation Fenestration Type and Frame (North,East, PropsedArea' Maximum Maximum NFRC or Default Window,Glass Door or S li ht South,West ft U-factor2'3 SHGCZ'3'4 Values N/A 1.Fenestration area is the area ojtotal glazed product(i.e.glass plus frame). Exception: When a door is less than SO%glass, the fenestration i area may be the glass area p[us a "2 inch frame"around the glass. , 2.Enter value from Component Package D Requirements in Table 1 SI-C. 3.Actual fenestration products installed and as indicated in CF-6R-ENV Form shall be equivalent to or have a lower U factor and/or a lower SHGC value than that specified on the CF-IR ALT Form. 4.Submit a completed WS-3R Form if a reduced SHGC is calculated with exterior shading. S.I a licable at this sta e enter "NFRC' or NFRC Certi ted windows or are CEC "De ault"values ound in Table 116-A or B. � ALTERED FENESTRATION ALLOWED AREAS(Complete if more than SOft'ojfenestration is added) ' A B C D E F G ' CFA of Allowed Existing Allowed Entire %of Fenestration Area Fenestration Area Proposed Area�°4 �i Dwellin CFAZ•3 Area° Removed5 Area Added6 A x B E-D +C i Total Fenestration � ! Area2'ftZ - West Fenestration Area• (Required In > CZ's2,4&7-15 1. The Proposed West Fenestration Area includes West-sloping skylight area and any other skylight area with a pitch less than 1:12. 2.Enter 20%when na West orientation restriction or I S%when West fenestration is being installed in Climate Zones 2, 4, &7-1 S.Note that the maximum allowed fenestration can only be 5%of the CFA as indicated in Column F. Column G must be equa!to or less than Column F. 3. In climate zones 2,4, 7-I5,no more than 5%of the CFA is allowed for west facing glazing. 4.Existing Fenestration area must be counted toward Ihe mazimum allowed 1 S%or 20%of the whole building and calculated ln Column G. The Proposed Area must be less than or egual to Column F. , 5.Enter the fenestration removed as part of the alteration if any in column D. 6.Enter the Fenestration area that is bein added as art o the alteration. ' L --- - - -- -- - -- -- - - - - -- - — - — - --- - - ---- —- --- - --- - Registration Number: Registration Date/Time:_ HERS Provider: 2008 Residential Compliance Forms March 2010 Prescri tive Certificate of Com liance: Residential CF-IR-ALT Residential Alterations a e 3 of 5 Project Name: Climate Zone# #of Stories (E) FURNACE REPLACEMENT 9 2 ROOFING PRODUCTS(COOL ROOFS)§151(�12 When the area of eacterior roojsurface to be replaced exceeds neore than SO%of the existing roojarea,or more than I,000 f ,whichever is less,the new roofing area must►neet the roofing product"Coo!RooJ"requirements of§I52(b)IHi,I52(b)1Hii,or 152(b)IHiii. Check applicable a[ternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof'requirements.Note:If any one of the alternatives or exception below is checked, the Aged Solar Re�lectance and Thermal Emittance requirements for roofing products in �118(i)are not applicable.Do not fill table below. Cool Roofs Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or 2:12 pitch. QCool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less than Slb/ftZ. Alternatives to§152(b)1Hi and§152(b)Hii,Steep-slope roof(pitch>2:12) � Insulation with a thermal resistance of at least 0.85 hr•ftZ•°FBtu or at least a 3/4 inch air-space is added to the roof deck over an attic;or Q Existing ducts in the attic aze insulated and sealed according to§151(fl 10;or � In climate zones 10,12 and 13,with 1 ft�of free ventilation area of attic venrilation for every 150 ft of attic floor area,and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or ❑ Building has at least R-30 ceiling insulation;or � Building has radiant barrier in the attic meeting the requirements of§151(�2;or ❑ Building has no ducts in the attic;or ❑ In climate zones 1Q 1 l,13 and 14,R-3 or greater roof deck insulation above vented attic. ExcepNon to§152(b)1Hiri,Low-slope roof(pitch<_2:12) � Building has no ducts in the attic. Other Egceptions � ❑Roofing area covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria. Roof constructions that have thermal mass over the roof inembrane with at least 251b/ft is exem t from the below Cool Roof criteria. Note:If no CRRC-1 label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise, Check the a licable box below if Exem t from the Roofin Products"Cool Roof'Re uirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number� < 2:12 >2:12 < Slb/ft2 > Slb/ftZ T eZ Reflectance3'4 Emittance SRIS 0 ❑ ❑ � � ❑ ,� � � FJ � � ❑ � F� � � ❑ ❑ � � ❑ 0 ❑ � 1. The CRRC Product ID Number can be obtained from the Cool RoofRating Council's Rated Product Directory at www.coolroo s.org/�roducts/search.ph� 2.Indicate the type of product is being used for the roof top,i.e.single ply roof,asphalt roof,metal rooJ,etc. . If the Aged RefJectance is not available in the Cool Roof Rating Council's Rated Product Direclory then use the Initial ReJlectance value from the same directory and use the equation(0.2+0.�(pin;ria!—0.1)to obtain a calculated aged va/ue. Where p is the Inrtial Solar Reflectance. 4.Check box iJ�the Aged Reflectance is a calculated value using the equation above. S.Calculate the SRI value by using the SRI-Worksheet at http://www.ener�.ca.gov/titlel4/and enter the resulfirsg value in the SRI Column above and attach acopy of the SRI-Worksheet to the CF-IR. � o apply Liquid Field Applied Coatings,the coating must be applied across the enrire roof surface and meet the dry mil thiclmess or coverage ' ecommended by the coatings manufacturer and meet minimum performance requirements listed in§118(i)4. Select the applicable coating: I Aluminum-Pigmented Asphalt Roof Coating ❑Cement-Based Roof Coating Other - - --- __ -- - — - -- -- -- - -- -- - - - - - -- - - �Registration Number: Registration Date/Time: HERS Provider: ---- - � ---- --- _ _. -- 2008 Residential Compliance Forms March 2010 , , Prescri tive Certifcate of Com liance: Residential CF-IR-ALT Residential Alterations Pa e 4 of 5 Project Name:�E) F U R N AC E R E P LAC E M E N T Climate Zone#9 2 of Stories HVAC SYSTEMS-HEATING Minimum Duct or Piping Configurarion Heating Equipment Ef�iciency Distribution Insulation Thermostat (Central,Split, T e and Ca aci 1,2•3 AFUE or HSPF T e and Location° R-Value T e S ace,Packa e or H dronic CENTRAL FURNACE 80%AFUE DUCTS 4.2 SETBACK CENTRAL 1.Indicate Heating Type(Central Furnace, Wal!Furnace,Heat pump,Boiler,Electric Resistance,etc.) 2.Electric resistance heating is allowed only in Component Package C, or ezcept whe"re elecfnc heating is.rupplemental(i.e., if total capacity <2 KW or 7,000 Btu/hr e/ectric heating is control/ed by a rime-limiting device not exceeding 30 minutes). See�1SI(b)3 exception. 3.Refer to the HERS Yerification section on Page 4 of the CF-IR-ALT Form for additional requirements and check applicable boxes. 4. Indicate Type or Location(Ducts,Hydronic in Floor,Radiators,etc.) HVAC SYSTEMS-COOLING Minimum Efficiency Duct or Piping Configuration Cooling Equipment (SEER/EER or Distribution Insulation Thermostat (Central,Split, T e and Ca aci �°Z COP T e and Location3 R-Value T e S ace,Packa e or H dronic (E)A/C 10.0 SEER DUCTS 4.2 SETBACK CENTRAL 1.Indicate Cooling Type(A/C,Heat pump,Evap. Cooling, etc) 2.Refer to the HERS Verif:cation section on Page 4 of the CF-IR ALT Form for additional requirements and check applicable boxes. 3.Indicate T e or Location cts,H dronic in Floor,Radiators,etc. WATER HEATING � List woter heaters and boilers for both domestic hot water(DHW)heaters and hydronic space heating. Individual dwelling DHW heaters must be gas or propane fired. Hot water pipe insulation from the DHW heater to the kitchen(s)and on all underground hot water pipes is reguired in all com onent ncka es in all climate zones. Extemal Tank Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation T e� (Standard,Recirculatin )Z S stem Ca aci ( al Thermal Efficienc R-Value3 (E)STORAGE GAS STANDARD 1 50 0.53 N/A ��I 1.Indicate Type(Storage Gas,Heat Pump,Instantaneous, etc.) 2.Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of§I50(n). The Prescriptive requirements do ' not allow the installation of a recirculating water heating system for single dwelling units. 3. The external water heatin tank and i es shall be insulated to meet the re uirements o 1 SO '. SPECIAL F�'AT�ES The enforcement agency shou[d pay special attenrion to the Special Features specified in this checklist below. These items ma re uire written 'usti ication and documentation and s ecial veri ication. NEW ROOF ASSEMBLY-Radiant Barrier The radiant barrier re uirement of 151 2 does not a I to roof alterations. Slab Edge(Perimeter)Insulation YES X NO YES:In Climate Zone 16 in Component Packages D,R-7 insulation is required. Heated Slab Insulation �YES X O YES:Slab ed e insulation re uired for all heated slabs in all Climate Zones. See details in Table 118-A of the standards. Raised Slab Insulation YES x NO YES:In Climate Zones 1,2, 11, 13, 14& 16,R-8 insulation is re uired;in Climate Zones 12& 15,R-4 is re uired under com onent Packa e D. Thermal Mass To obtain Com liance Credit for the installation of thermal mass,use the Performance A roach. - - -_-- ----- - --------- _- - ---— -- ------ -__ . _- --- --- ---- _ ' �Registration Number: Registration Date/Time: HERS Provider: � -- - --- _ -- - - 2008 Residential Compliance Forms March 2010 f � � Prescri tive Certificate of Com liance: Residential CF-IR-ALT Residential Alterations Pa e 5 of 5 Pr°'e``Na`"e:(E) F U R N AC E R E P LAC E M E N T Climate Zone#9 2 of Stories HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERSMeasures specified in this checklist below. A completed and signed CF-4R Form for all the measures specified shall be submitted to the buildirzg inspector before final ins ection. Duct Sealing& TesNng HERS verification is reguired for this measure. �YES Q NO YES:In Climate Zones 2 and 9-16,if more than 401inear feet of new or replacement ducts are installed in unconditioned space,the ducts are to be sealed per§152(b)1 Dii and the newly installed ducts are to be insulated per§151(fl 10. 0 EXCEPTION:ExisHng duct systems that are estended,which are constructed,insulated or sealed with asbestos. �YES ONO YES:In Climate Zones 2 and 9-16,if the existing space-conditioning system(HVAC equipment and ducting)is replaced,the ducts are to be sealed per§152(b)1 Di. DYES �NO YES:In Climate Zones 2 and 9-16,if the existing HVAC equipment is replaced(including the replacement of the air handler, outdoor condensing unit of a split system,cooling or heating coil,or the fumace heat exchanger)the ducts are to be sealed per§152(b)lE. � EXCEPTION:Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance wlth procedures in the Reference Residential Appendix RA3. � EXCEPTION:Duct systems with less than 40 linear feet in unconditioned space. EXCEPTION:Ezistin duct s stems constructed insulated or sealed with asbestos. Refrigerant Charge-Split System HERS verification is required for this measure. ❑YES �X NO YES:In Climate Zones 2 and 8-15,when the existing HVAC equipment is replaced(including the replacement of the air handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the furnace heat exchan er a refri erant char e measurement shall be verified er 152(b)1F. Central Fan Integrated (CFI)Ventilation System and Fan Watt Draw ' The ventilation re uirements of 150 o do not a I to existin residential homes. Ducted Split Systems-Air Conditioners and Heat Pumps:Airflow HERS verifzcation is required for this measure. ❑YES �NO YES:In Climate Zones 10 through 15,when the existing space-conditioning system(HVAC equipment and ducting)is �i re laced,the airflow and fan watt draw shall be verified er 152(b 1Ci to meet the re uirements of 151( 7B. Documentation Author's Declararion Statement ' • I certl that this Certiflcate of Com liance documentarion is accurate and com lete. � Name:PEN .�. �� Signature: c°mpan'':P J DESIGN SQUARE Da �10/12/2010 a,aa�ess:2321 FALLEN DRIVE IfApplicable CEAor cEPE (Certification#): c�ty�state�z�p:ROWLAND HEIGHTS, CA 91748 Phone:626-839-9385 Responsibie Building Designer's Declaration Statement • I am eligible under Division 3 of the Califomia Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts 1 and 6 of the Califomia Code of Regulations. � The building design features identified on this Certificate of Complianc ��is4t� 'th the informarion provided to document this building design on the other applicable compliance forms,workshee io� Y�� specifications submitted to the enforcement a enc for a roval with this buildin ermit a lication. � , ,, , Name: igna e: �""` �° PEN J. KAO c°mpan'':P J DESIGN SQUARE � ' ��2p�� ate:10/12/2010 Aad`ess:2321 FALLEN DRIVE - s-3�- � � '°e°Se:C22022 Ciry�scace�z�p:ROWLAND HEIGHTS, CA 91748 ��l'F DATE ,�� Phone:626-839-9385 For assistance or questions regarding the Energy Standards,contact the nergy Hotline at:1-800-772-3300. -- — --- - -- -- --- ----- - - --- --- ---- LRegistrahon Number: Registration Date/Time: HERSProvider: � - -- — - — -- — - -- --- -- 2008 Residential Compliance Forms March 2010