HomeMy WebLinkAbout073-340-00473-34--04 4058-90B,P;E,M
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SITE PIAN REVIEW APPLICATION
0 913 _.4'�10 - 0 0 �/
Date: `/— v;- / — o 5
Permit Number (if applicable)
1PPLIC�4NT LVFORh
11
Owners Name:
Owners Address: _ //,:�? S -3
AP#
Parcel Size: / • �_&. aC/u.
l d
Telephone No.: -3 71 /
Situs Address: ,51®,(
Proposed Use:
Residential
❑ New Single Family Residential
❑ Single Family Addition ❑ Single Family Remodel
❑ Mobile Home
❑ Residential Accessory
❑ Permanent Second Dwelling.
❑ Temporary Mobile Home (Aunt ATinnie)
❑ Temporary Travel Trailer
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition ❑ Commercial Remodel
❑ New Industrial
❑ Industrial Addition ❑ Industrial Remodel
Other ,
N Septic ❑ Well
❑ Agricultural Exempt Building
❑ Other.
Brief Explanation (if necessary):
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SERVICES EIVFORMA.TION (For Sufi Use)
'l /0"ed ��—F0i
Approved ❑ Conditionally��Approved. ❑ Resolve Problems Prior to Approval
/J �
ALL TEEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
19 Snow Load Area._•��
❑ Land Conservation Act Minimum Acreage: ElVerify residence can be built per contract
❑ Nitrate Action Plan (See Environmental Health for standards)
❑ Watershed Protection Overlay Zone (See attached standards and requirements)
Expansive Soils (Test for expansive soils and if verified proper foundation design required) Mod
SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain: (See attac�)
Flood Zone:
Flood Panel No.: odd Index Date,
❑ Sacramento River Reclamation District (Approval must be obtained from the C ' o' 'a Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements)
❑ Chapman/Mulberry (See attached standards and requirements)
❑ Cohasset Area (See attached standards and requirements)
❑ Grading Zone (See attached handout)
Use Requires:
❑ Use Permit ❑ minor Use Permit
❑ Mmor Variance El Variance
El Administrative Permit
❑ Detached Building Use Form ❑ Encroachment -Permit ❑
❑ Agricultural Worker Affidavit Agricultural Aclmowledgem-nt Statement
Zoning:
G -�
Applicable Building Setbacks:
Zoe Code Streets & Ifighways Fire Prevention Subdivision Map
Frani � ,
Side 5 r
8'
Side Street l� r
Real
Height
Waterway N/A N/A N/A
❑ Setbacks drawn on site Plan, ❑ CDF approval needed for encroachments into SRA setbacks.
Applicable Development Fees:
Standard Fees Amount Formula
❑ Fire
❑ School*
❑ Parks/Recreation
❑ Roads .
❑ Sheriff
❑ Drainage
❑ NCSP/CSA 87
❑ Chico Urban Area — Road
❑ Thermalito Impact
❑ Other
Subdivision Map Special Fees
❑ Water Tender
❑ Road Improvement
❑ North Oroville Area
❑ Other (per map)
* Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of
the building pemait.
Parcel Created By
❑ Deeds:
Date of Creation: Legal Access Provided: ❑ No ❑Yes
Deed of Reference:. Legal Access Required El No Yes
Parcel Frontage on Publicly Maintained Road; ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation:❑ No ❑ Yes
Comments:
❑ Parcel Deemed to be legal
❑ Verify Legal Parcel ❑ Verify Legal Access ❑Provide Deed of Creation
❑ Obtain a Certificate of Compliance
❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment
❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23).
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
J1 Subdivision Map2gcel MM:
Map Date of Recording: �L% 7 7
isV73
Lot: Book: Page:
❑ Use Permif/Minor Use Permit
Permit Number:
Date of Approval:
Parcel Map/Subdivision Map/Use Permit Conditions
❑ Comply with the following Conditions of Approval:
❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290
❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the
National Fire Protection Association Standard *for installation of sprinkler systems in one
and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized
community wafer system, with hydrants that meet the Fire Department specifications, serves
the parcel.
❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission
requirements of the California Clean Air Act of 1988, as amended.
❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan
must be prepared by a registered civil engineer or other qualified professional and be
submitted to and approved by the Department of Public Works.
❑ Tn lieu of a pressurized water system or, water storage tank payment into the appropriate
Battalion Waxer Tender Fund may be required.
❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil
construction associated with residential development . Approved dust control measures are
found in the fugitive dust control plan for the site approved by the Butte County Air Quality
Management District, a copy of which can be obtained from the Butte County Department
of Development Services, Building Division. -
Engineered foundations are required,
❑ Class A roofs are required.
❑ Property owners responsible for ma
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0R 0_V1_L.LE.,_.CALIEQRNIA
GENERAL CLAIM
CLAIMANTS Barry Scott
ADDRESS: P.O. Box 118
CITY & STATE: Oregon House. CA 95962 IMPORTANT:
DATE OF CLAIMS December 13, 1990 SEE INSTRUCTIONS
ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING neinnc nv tcovfrce
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO. AVOID DELAY)
AMOUNT
Owner has decided not to do work. Permit #4058-90B,P,E,M,
AP#73-34-04, Receipt #84528, dated 11/27/90.
`
Total Permit Fees Paid ----------__——_----$714.45
e $16g gn
____
.Retain Energy Plan Checking Fee--------- 15.00
Retain Building Permit -Filing Fee----- 10.00
Retain::Electrical Permit Filing Fee— - 10.00
Retain Plumbing Permit Filing Fee--------- 10 .00
Retain Mechanical Permit Filing Fee----- 10.00
Total Permit Fees Retained —--- -----__—__�_--__ 223.50
TOTAL REFUND DUE----------, ---_-$490.95
TOTAL
$490
95 "
I. the undersigned. declare under penalty of perjury that the services or articles claimed hav4been erformed or del erred
true and c/orrreectt an atsted.qvDated this ..........L...4,........« daYof......� 19fo........«... v1�_,,,,,,,,,,,,,,, et Calit.u t Claimant
that thisciaim,is
I, the undersigned, hereby certify that. to the best of my knowledge, the services or articles specified above have been performed or do -
livered and that there is a Budget Appropriation C] or Specific Board Approval (Check one) fa;L—
13th day of December , 19 90 at Oroville , Calif. Dated this ...... ......./+nt ead or Autho ze utycode
, 440-002 ................. Code ....421 OSOO........... PAYA 1tP�9
.......».. BLE FROb! t...«i.�rX ma,rrr�.............« .. ».
FUND
DO NOT WRITE BELOW. THIS LINE _ AUDITOR'S USE ONLY
DEPT. & SUB. PROJ. SUB. OBJ: CLAIM NO. INV. NO. INV. DATE ENCUMB.'
GROSS AMT.
7� 73
l�' tDs8�9CJ
93-34-oy-
U(�;��pfeS,l;
�eeS �!�.
` .
FLT ENGINEERING
PROJECT : R.E.HALL — GEN. CONTRACTOR 5790 CLARK ROAD
JOB NO. : 0719 — 2 PARADISE, CA
DATE : 8/1990 (916) 872-0254
CALCIS BY : FLT SHEET 3 OF x�
`
FOOTING DESIGN:
----------------
DENSITY OF SOIL (PCF):
100
DENSITY OF CONCERTE (PCF):
150
ALLOW. SOIL BEARING PRESSURE (PSF):
1500
ALLOW. LATERAL BEARING PRESSURE (PSF):
200
FRICTION COEFFICIENT — Fc:
0.35
BEARING PRESSURE REDUCTION (PSF): '
0
NET, ALLOW. BEARING PRESSURE (PSF):
1500
'
PRELIM. FOOTING — WIDTH (INCHES):
12.57
— DEPTH (INCHES):
6.00
DESIGN FOOTING WIDTH
— DEPTH (INCHES)
6.00
TOTAL GRAVITY LOAD — Pv (KIP):
1.57
� .
`
INCREASE OF ALLOW. SOIL PR'SSURE (%):
0.0
ACTUAL SOIL PRESSURE — Q (PSF):
1572 < 1500
SLIDING RESISTANCE — Fr (KIP):
0.31 > 0.20
SLAB REINFORCEMENT:
___________________
REINF @ TOP OF WALL (BAR #): 4
MAX. HORIZONTAL SPAN OF WALL (FEET): 8.65
DESIGN HORIZONTAL SPAN (FEET): 4
SLAB THICKNESS (INCHES): 4
SLAB WIDTH REQUIRED (FEET): 7.27
DESIGN AREA OF SLAB REINF (M2/LM: 0.029
ALLOW. TENSILE STRESS OF R IWF (KSI): 24
LENGTH OF DOWELS (I 9.78
• COUNTY OF BUTTE:- DEPART•M-NOF PUBLIC WORKSERMIT
NO.
7 County Center Drive - Otoville, California 95965 - Telephone: 916/538-7541 _
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
73-34-04
ZONING
U
BUILDING PERMIT
OWNER
DON TIMONEY
TELEPHONE
S0. FT. OCC. BUILDING VALUATION
1931 R
240
OWNER'S MAILING ADDRESS
11426 SUTTON WAY SUITE 102 GRASS VALLEY 95945
367 M
5138
CONTRACTOR'S NAME
BARRY SCOTT
TELEPHONE
692-1405
150
CONTRACTOR'S MAILING ADDRESS
P.O. BOX 118, OREGON HOUSE 95962
Fireplace A
1000
CONSTRUCTION LENDER
NNE
UNKNOWN
Total Valuation Is
67528
Filing Fee
$
10_00
LENDER'S MAILING ADDRESS
Permit Fee
$
33p7.00
ARCHITECT OR ENGINEER
NONE
LICENSE NO.
Plan Checking Fee
$
168.50
Ener Plan Checking F
Energy g ee
$
15.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING FORBESTOWN ROAD FORBESTOWN DRESS
Permit tee
$
530.50
PLUMBING PERMIT
Filing Fee
10.00
Each Trap
8 1 2.00
16-00
Solar or heat pump water heater
20.00
LOT NO.
3
SUBDIVISION NAME
WALDEN POND EST
PARCEL MAP
Ll' 7 3
Water piping
5.00
5.00
Each qas water heater or vent Ppr, 1 5.00
5.00
USE OF STRUCTURE
SF[M Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
4ALP 5.00
5.00
Building sewer 5.00
5.00
Mobile Home S I G W 10-00ea
TYPE OF WORK
NewFX] Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: 3 BR _
Permit Fee $
46.00
Contractor
ELECTRICAL PERMIT Filing Fee
10.00
Main service BOOV OR LESS
100 AMP OR LESS
10.00
10,00
Main Service EA, ADD'L 100 AMP
2.50
2.50
CONTRACTORS LICENSE LAW
1 declare nder penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Profess io s Code and my license is in ful force and effect.
C( �(�
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. ( DWELLING OCCUP.&V
OR ADDNS. ACC. BLDGS.
982'=¢sgft 47.45
NEW CONSTR.ULTI.OUTLET
NON.RESID BRANCH CIRC ITS 2.50 ea
POWER APPARATUS &)
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES SAL@3C
GALA 30
FIXED APPLNS.
Ex. OCCUp. R
OUTLETS ((RESID )EA.) 2.00
Temporary service 10.00
10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $ 79.95
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
f Consent to Self -Insure.
1 shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT Filing Fee 10.00
Heating 6.00
HEAT PUMP
Cooling 6.06-
Hood 3.00 3.00
Ventilation 1 3.001 3.00
permit Fee $ 28.00
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in an way accrue
again aid County in onse nce of the granting of this permi
l��lr'�
cy'asions
S gnature of pplicant - Owner ❑ Contractor Z Agent ❑
An OSHA p rmit is 'required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $ 30.00
00,C
'3
CONS PE
V
TOTAL FEE $ ,714.45
HAZ
CUA
PARK
I SCHL
I FL
PAR
PD
HD ISSUE
This permit is nereby issued under
of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable
resolutions
have
WORKS
Date
provi-
to do
been paid.
Receipt No. 84528
WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
'.! Y. . .R 1 " '7 a^R 'a+' -2^ - ae/r{@M/... �--., yM.iT,T+ nuN iS�NT'� `�f- J �; •GY
• .ir {,1 J irM .
`�. � t ��0.'.� .1 S.% vYi C' • lel' ,
_ COUNTY OF BUTTE - DEPARTMENT,OF PUBLIC WORKS - BUILDING DIVISION
9 COUNTY CENTER ®RIVE _ ® ®V166 CALIFORNIA 08003 - TELEPHONE: 910/538•9341
PERMIT APPLICATION DATA SHEET -�-
Permlt No,
OWNER ho 01 T,4? nn A. P. No. _Q
Proposed Building Use JBullding Inspector Date AC
At time of permit application, I was advised the following data must be submitted prior`to permit processing and/or issuance:
DATE RECEIVED APPROVED
1. All items have been submitted . .....................................
2. Plot plans in duplicate/triplicate, signed by preparer of plans........ -
3. Complete plans in duplicate/triplicate, signed by preparer. of plans . .
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ......................................... .
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings
8. Engineered truss details and layout in duplicate (required prior to plan check)
9; Mobilehome installation data including manufacturer's installation
instructions........................................................
10. Fees of $ ...............
11. Chico Urban Area fees paid .......................................
12. Park es paid ..,.............................................
13. r, ySy 1 I` eool D istr' t fees paid ..............
4. Sanitation approval from i0 V i F - Health Department – 1
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning' approval for (A) Use: (B) Parking: `
524 8. Improvements may be required. Contact Land Development Section DPW
Driveway permit (construction approval required prior to occupancy) %Z 2_- y
20. Pre -Inspection for required Pre-Inspec. request to -
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
-23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
Letter of si'gnatur uthorization................................... '
26: � Z -�
27.
Whe ou issue the t,pro ssasfollows: Mai o owner. Mai -Ito contractor.
Telephone �Mnd hold for pickup at office. Deliver, w./ inspector.
Other
Applicant:Date ll �� Yid
Copy of Haz-Mat form sent Health Dept: Fire DeVt. -----Air Pollution Date `'
Copy of plans sent Health Dept. Fire Dept. OtherDate By„
The following data must be submitted prior to permit issua
1. Index permit for above items No. 3 oz�
2. Additional items required:
(Circle,newfit
Contractor, designer, owner, was advised of above required data by—phone---mai [—counter by ..date
Contractor, designer, owner, was advised of above required data by —phone _maII—counter by date
Plans checked by Date Plans approved by 61_1_�_ — Date �J
Sets of plans on hold in File cabinet AP folder
Copy—DPW
TO: Building Department
F
FROM: Encroachmen'C''Permit Section
RE: Driveway Clearance
owner location
AP #
-Driveway permit �10 / Sa 9, E has been issued for the above property.
si ature date
TO Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
me,r(-j Mk GJa-f-Pr Co
Plan Approved for: Sewage Disposal _ Water Supply
Hold final for: Water Supply
Final clearance O.R. for: Water Supply
Clearance for bedroom mobile ome. Other
NOTE ***
Fri
Sanitarian
Date
ADJACENT
PARCEL INFO: %
SIZE (AC):
ZONING:
GEN PLAN: /
i
USES: /
Y./ I
OC --
Zzi
zzt-
812
Zoe
GEI
i
i
ire
- BUILDIN PLAN APPROVAL j
Use: pate:
L�
` Parking:_- Lands ping:
bs� g
04iter. j
- "-- %natur+e.
" - 1
-PIPE
00
2y,� G
Lertiticate of Compliance: Residential • VC- tens e Zone 16
ProJtxtTltle
Budding Pt3mit 0
t�eciced ay /Data
Fnforeerneru ARetcy Use Only
Project Address
Documentation Author Telephone
BUILDING DATA
\ Conditi- ea 14,37
Sla fSGd
Sin a Family Detached (SFD)
[ ] Single Family Attached (SFA)
[ ] Multi -Family QAT)
B UILDING SHELL INSULATION
Component Insulation Location/Comments
Type R -Value (attic, to garage, typical, etc.)
wau..............
R G
Glass Area % Guts
Title 24. Chapter 2-53 and Title 20, Chapter 2- Subchapter 4. Article 1 of the Califomia Administrative code. This
Roof .............
retain a copy of it and transmit the
North
tsigner
Floor ........:....
Number of Stories
Floor .............
East
Slab Edge.....
"
Number of Units �
[ J Addition Alone
.._ . _'.. Shading Devices
South
West
--y? • �
.
[ ] ping Building
Enforcement Agency
Skylight
_.
Co
Tttk/Fmn:
[ l Existing -Pitts -Addition
Address:
Total
,a -v
B UILDING SHELL INSULATION
Component Insulation Location/Comments
Type R -Value (attic, to garage, typical, etc.)
wau..............
R G
wall ..............
Title 24. Chapter 2-53 and Title 20, Chapter 2- Subchapter 4. Article 1 of the Califomia Administrative code. This
Roof .............
retain a copy of it and transmit the
'Roof .............
tsigner
Floor ........:....
Name
Floor .............
Tuk/Frms:
Address:
Slab Edge.....
"
GLAZING -
.._ . _'.. Shading Devices
Glazing
Area Glass Type Interior • Exterior
Orientation
(sf) (single double)_ (JoUcr blind, etc.) (shadmcreem etc.)
Overhang-. Framing Type
North C
East ( )_
East
Souuh ( ) Z_ ,,
Sou th ( )
West 04
rf I
West ( )
Skylight.......
I
- THERMAL MASS - - i
Type/Covering Area — Thickness
(slab/exposed, tile, etc.) (SO (inches) Location/Description (kitchen, bath etc.)
Mandatory Measures Checklist: Residential MF -1R
NOTA Lowr%= residencal buildings subiou to the Scantuds must contain these mcastan rtgardJc s of the camplia,¢
approach coca Items marttcd w,tn an asmrut (*)MAY tc superseded by more strttntc nt complian¢ requtremcats kaW
On the Caul cafe of Compsland Whcr, ttus checklist u incorporated Into the permit doeumcriM one (twures nerd shalt
be conudced by all panus as budrng mtrumum component perforrnarnce spcafraucns for the mandatory measures
-- rheiher they are slnowm elsewrbea to the documents or on this c.4ackLst earthy.
DESC7JFn0N DESICN R ENFORCEMENT
avildint En•elope Measures
• j2.5352(a): Minimum ceiling insuluion R•19 weithted a.enge.
§2.5352(b): Loose fill insulation man facuucr's labeled R -Value
• 12.5352(c): Minimum wall insulation in famed w%ILs R•I1 weighted a,"c (does not apply to
cstrnormuss .alts).
12.5352(1): Stab edge irtstdation _ water absorption ram no peter than 0.3%..uor vapor
transmission nue no pflter than 2.0 perm/irch.
12-5311* Insulation specified or installed mats California Energy Conmisoat (CEC) quality
standards. )ndream type and form.
§2.53574): Vapor barriers mandatory in Climate Zones 14 and 16 only.
J2-5317: I n filtruiwuEa filtration Controls
L Doors and windows between conditioned and unconditionad spx- designed to limit air
leakage.
b. Doors and windows crnifncd.
e Doors and wirdows weaLherstripped: all joints sect pe nctr2tiom caulked and sealed
12.5352(1): Special infiltration barrier installed to comply with §2.5351 menu CEC quality
I ualdwdL
12.5352(d): Installation of Fireplaces
I. Masonry and factory -built rucplacts have
L Tight fitting• closeable metal or glass door
b. Outside air intake with damper and control
c. Flue damper and control
t 2. No continuous bunting ger pilots allowed.
HVAC and Plumbing Sysaem Measures '
12.5352(8) and 2-5303: Space conditioning equipment sizing: attach cakulations.
§2-5352(h) and 2.5315: Setback thermostat on all applicable heating systems.
• §2.5316(a)- Ducts constructed. installed and insulated per Chapter ser 1976 UMC.
12-5316(b). Exhaust systems have damper controls.
§2-5314(c)r Cas-fvt:d space heating equipment has intermimcnt ignition devices. "
§2-5314: HVAC o"quipmcrawatt heuets. showesbeads and faucets certified by the CEC_
§2.5352(7 Water heater insulation blames (R-12 or greater) or combined imerior/uterior
insulation (R-16 or pe=er): fust 5 fest of pipes closest to Lank insulated (R-3 or greater). '-
§2.5312(Exception 1): Pipe insulation os steam and steam condensate return & recirculating
piping
J2-53 18(d)- Swimming Pool Heating t-
1. System has:
L On/off switch on heater.
b. Weatherproof instruction plate on heater.
e Plumbed to allow for solar.
2. 75 percent thermal efrciency. -
3. Pool cover.
4. Time clock.
5. Directional water inlet
Lighting and Appliance Measures
r
52-5352(1): Lighting - 25 lumcns/watt or greater for general lighting in kitchens and bathrooms.
§2.5314(e): Gas Rued appliances equipped with intermittent ignition devices.
!
12.5314(a): Refrigerators, refrigerator -freezers, fm=c s and fluorescent lamp ballasts certified
by the CEC. Indicate make and model number.
HVAC SYSTEMS • Minimum Duct
Type. (furnace, air Efficiency , Location Duct Output _ Manufacturer /Model #
conditioner, hest pump) (SE, SEER,HSPF) (attic, etc.) R -Value (Btuh) (or approved ecrual)
Maximum Fumace Heating Output: Btuh f
HOT WATER SYSTEMS Tank Manufacturer/Model #
System Type (storage gas etc.) Capacity, (or approved equal) Special Fearure(s)
.. r
SPECIAL FEAT URES/REMARKS (Add extra sheets if necessary)
COMPLIANCE STATEMENT
This crstificatt of mtnpliw= lists
the building features and performance sp fications needed to comply with
Title 24. Chapter 2-53 and Title 20, Chapter 2- Subchapter 4. Article 1 of the Califomia Administrative code. This
met ficst.e has bean rigned by the individual with overaU design responsibility and the building owner. who shall
retain a copy of it and transmit the
certificate to zny subsequent purchaser of the building.
tsigner
Building Owner
Name
Nt
Tuk/Frms:
Address:
TiLk/Fian:
Add==:
Tcicphone
Telephone
t;c. 8:
(stgrn'otre) -
(date) (signattrre) (date)
Documentation Author .
Enforcement Agency
Narrre
Name_
Tttk/Fmn:
,s nay.
Address:
- Ttkasonc
1. Ceiling Insulation
-46
-45
na
Number of stories
Single -
R -value,.
One
Two
Three
•
R-0
-120
-59
-40
R-19
-10
-5
3
R-30
.2
-1
-1
R-38
0
0
0
U -value
R-19
.0
0
0.50
-200
-99
-66
0.30
-118
-59
-39
0.10
-32
-16
-11
0.08
-23
-11
-8
O.C6
-14
-7
-5
0.04
-5
-2
42
0.02
5
2
2
0.00
14
7
4
2. Nall Insulation
-46
-45
na
Single-
Single -
-38
12. Cooling $; ,tem
Family
Family
Multi -
R -value
Detached
Attached
Family
R -J
-102
-77
-51
R-11
-11
-8
-5
R-13
-8
-6
-4
R-19
.0
0
0
U -value
InteriorMasslCFA
35
Interior Thermal plass
0.80
-212
-160
-107
0.50
-132
-100
-67
0.30
-74
-56
37
0.10
-11
-8
-6
0.08
-5
-3
-2
0.06
2
1
1
0.04
9
6
4
0.02
15
11
8
0.00 -
22
16
11
3. Raised
Floor Insulation
Poor
Stories
18
Insulation
in Floor
-22
..+• r�
-1
Number of stories
19
R -value
One
Two
Three
R-0
-24
-12
-8
R-11
-5
-2
-1
R-19
0
0
0
R-30
4
2
1
C U -value
Three
One
Two
.-• 0.60
-218
-103
-67
i 0.50
1
-180
-85
-55 '
i 0.40
-142
-67
-44
0.30
-103
-49
32
0.20
-64
-31
-20
- 0.10
-24
-12
-8
0.08
-17
-8
-5-
0.06
-9
-4
3.
0.04
-1
-1
0
0.02
6
3
2
0.00 •
14
7
5
Controlled Ventilation Crawlspace
Sx
tOX
Number of stories
20%
R -value
One
Two
Three
R-0
-15
-10
-7
R-5
-4
-5
-4
R-11
-1
3
•2
R-19
0
-2
-2
4. Slab Edge Insulation
0
SEER
less -15 -5 +5
Number of Stories
more
R -value
One
Two
Three
R-0
-13
-8
-4
R-5
-1
-1
0
R-7
0
0
0
F2 factor
14
3.6
3.6
0.90
-19
-13
-6
0.80
-14
-9
-5
0.70
-9
3
-3
0.60
-4
-3
-1
0.50
0
0
0
0.40
5
3
2
S. Infiltration (Air Leakage)
Specification Points
Standard 0
6. Glass Heat Loss
Total
-46
-45
na
Effective Percent Glass
U -value
-38
12. Cooling $; ,tem
.23
Effective
.51 to
.41 to
.31 to 0.30 0
Glass
Single Double
.60
.50
.40
less
50
-190
-85
-63
-41
-20
1
40
-141
-59
-42
-25
-8
InteriorMasslCFA
35
Interior Thermal plass
-46
-31
-17
-2
12
30
•93
34
-21
-9
3
15
29
-88
-31
-19
-7
5
16
28
-84
-29
-17
-6
6
17
27
-79
-26
-15
-4
7
17
terior
Mass
. -75
Slab Floor
Stories
-13
Raised
Poor
Stories
18
SEER
(assumes ducts in attic)
-70
-22
..+• r�
-1
9
19
24
-65
-19
-9
1
4 nr1 1 h> s -tuns
- 4.2-
t•..=oo.cd
-61
=t,e1
-7
2
,
20
22
-56
-14
-5
:CFA
One
Two
Three
One
Two
Three
5
13
22
20
"�'�•�`-��
-9
-1
7
15
22
19
-43
-7
1
8
16
23
18
-39
-5
3
10
17
24
17
-34
-2
4
11
18
24
0.0
-10
-6
-4
-2
-1
-1
15
Sum of 7-10
-25 or -24 to • 14 to -4 to
+6 to
16 or
14
0%
Sx
tOX
15%
20%
25X
W%
JS%
4o% 45%
SOX
55%
t97%
65k
70%
7S%
6C%
65X
W%
95%
100X 105% 110% 115% 120% 125•.
0.1
.9
-5
-3
-1
0
0
SEER
less -15 -5 +5
+15
more
-4
0
0.2
0.4
06
0.6
1.1
1.3
1.5
1.7
1.9
it
23
2S
27
29
32
14
3.6
3.6
4
4.2
44
4.5
4.6
5
53
0.3
•8
-4
-2
0
1
1
8.0
-6 .5 -3 -2
-1
0
10%
0.2
0.4
06
0.1
1
1.2
1.4
1.6
1.9
It
23
25
27
29
11
33
3.5
.3.7
4
4.2
4.4
AS
48
5
52
5 4
0.5
-7
.3
•1
1
2
2
_� X
SEER (8.91
Duct Efficiency [0.741 Effective SEER 16.591
2o%
0.3
0.6
0.6
1
12
1.4
1.6
1.5
2
22
24
Z7
29
3.1
13
15
17
3.9
4.1
43
4.5
48
5
52
5.4
5 6
0.7
-6
-2
-1
2
2
3
8.5
•2 -2 -1 .1
0
0
30%
0.5
0.7
09
1.1
1.4
1.6
1.6
2
22
24
26
26
3
32
3.5
17
3j
4.1
41
4.5
4.7
4.9
S.1
5.3
S6
56
0.9
-5
-1
0
2
3
4
8.9
0 0 0 0
0
0
40%
0.7
0.9
1.1
1.3
1.5
1.7
1.9
22
24
26
26
3
32
3.4
16
11
4
4.3
4 5
4.7
4.9
5.1
53
53
5 7
59
1.1
-5
-1
1
3
4
4
O
0.9
1.1
1.3
131.7
1.9
21
23
ZS
27
3
32
14
3.6
34
4
42
4.4
4.6
4.1
S.1
5.3
5.5
5.7
5.9
6.1
1.3
4
0
2
4
5
5
9.0
10.0
3 3 2 10
6 4 3 2
0
1
0
SM
0.9
1.1
1.4
1.6
1.6
2
22
24
2.6
26
3
32
35
3.7
19
4.1
4.3
4.S
4.7
4.9
11
53
56
51
6
62
1.5
-3
1
3
5
6
6
10.5
8 6 5 3
2
0
60'x.
1
12
1.4
1.7
1.9
21
23
25
2.7
29
11
3.3
35
3.1
4
4.2
4.4
4.6
4 6
S
5.2
5.4
5.6
5.9
6.1
6 3
2.0
•1
3
4
6
7
8
65%
1.1
1.3
1.5
1.7
1.9
22
24
25
26
3
12
14
36
3.1
4
4.3
4.5
4.7
4.9
5.1
53
55
5.7
5.9
6.1
64
2.5
0
4
6
8
9
9
11.0
10 8 6 4
2,
0
70'x•
1.2
1.4
1.6
1.1
2
22
25
21
2.9
11
13
15
3.7
3.9
4.1
43
4.5
4.6
5
52
5.4
56
56
6
62
64
3.0
1
5
7
9
10
10
120
13 10 8 5
5
3
0
75%
1.3
15
1.7
tj
21
23
25
27
3
12
14
16
31
4
4.2
4.4
4.6
4.6
5.1
5.3
JS
5.7
5.9
6.1
6.3
65
3.5
2
6
8
10
• 11
12
13.0
16 13 9
3
0
4.0
3
7
9
11
12
13
60%
1.4
1.6
1.6
2
22
24
26
2.1
3
3.3
1.S
ZI
].9
1.1
1.]
1.5
4.7
!.0
S.1
S 1
5.6
S 6
6
6 2
61
6 6
as%
1.4
1.7
1.9
2.1
23
25
2.7
29
3.1
33
3.5
18
4
42
4.4
46
4.6
5
52
54
56
59
6.1
63
65
67
4.5
4
8
10
12
13
14
Effective SEER
90%
1.5
1.7
2
22
24
26
26
3
32
3.4
3.6
33
4.1
4.3
4.5
4.7
4.9
5.1
53
5 5
5.1
59
62
64
66
6 6
5.0
5
9
11
13
14
14
(SEER x duct efficiency
95Y.
1.6
1.6
2
22
25
27
29
11
33
3.S
17
3.9
4.1
-4.3
4.6
4.1
5
5.2
5.4
5.6
5.1
6
0.2
6.4
6.7
69
5.5
6
10
12
14
15
15
100%
1.7
1j
21
23
2S
26
3
32
3A
16
16
4
4.2
4.4
4.6
4.9
5.1
5.3
55
5.7
5.9
0.1
0.3
6.5
6.7
1
6.0
7
11
12
15
16
16
Sum of 7-10
1.9
2
22
2.4
26
26
1
3.3
3.5
3.7
3.9
4.1
45
4.7
1.9
5.1
5.4
55
5.6
6
6.2
64
66
93
7
6.5
7
1 t
13
15
16
16
Effective -25 or -24 to -14 to -4 to
+6 to
16 or
105%
25
27
29
11
13
3.6
38
4
4.2
.]
4.4
4.6
4.6
S
52
5.4
5.7
5.9
0.1
6.3
65
6.7
69
1.1
7.0
8
12
13
16
17
17
SEER
less -15 -5 +5
+15
more
110:
1.9
2
21
22
2.3
2.4
26
26
3
3.2
14
3.6
3.6
4.1
4.3
4.5
4.7
4.9
5.1
5.3
5.5
5.7
59
6.2
6.4
6.6
6.6
7
7.2
7.5
8
12
14
16
17
17120%
5.0
-6
-3
0
115%
2
23
25
2.7
29
3.1
13
3.5
3.7
3.9
4.1
4.4
4.6
4.6
S
5.2
5.4
5.6
58
6
6.2
6.5
6.7
6.9
7.1
7.3
8.0
8
12
14
16
17
18
125%
21
23
25
26
3
32
3A
16
3.6
4
4.2
4A
4.5
4.9
M
5.3
55
5.7
5.9
6.1
6.3
65
6.7
7
7.2
7.4
85
9
1314
17
18
18
6.0
- 5
5 44 33 2
1
0
Total
-46
-45
na
Effective Percent Glass
U -value
-38
Percent
.23
Effective
.51 to
.41 to
.31 to 0.30 0
Glass
Single Double
.60
.50
.40
less
50
-190
-85
-63
-41
-20
1
40
-141
-59
-42
-25
-8
8
35
-117
-46
-31
-17
-2
12
30
•93
34
-21
-9
3
15
29
-88
-31
-19
-7
5
16
28
-84
-29
-17
-6
6
17
27
-79
-26
-15
-4
7
17
26
. -75
-24
-13
-3
8
18
25
-70
-22
-11
-1
9
19
24
-65
-19
-9
1
10
19
23
-61
-17
-7
2
11
20
22
-56
-14
-5
4
12
21
21
-52
-12
-3
5
13
22
20
-47
-9
-1
7
15
22
19
-43
-7
1
8
16
23
18
-39
-5
3
10
17
24
17
-34
-2
4
11
18
24
16
30
0
6
13
19
25
15
-25
2
8
14
20
26
14
-21
5
10
16
21
26
-13
-17
7
12
17
22
27
12
-12
9
14
19
23
28
11
-8
12
16
20
24
28
10
-4
14
18
21
25
29
9
0
16
19
23
26
30
8
4
18
21
24
27
30
7. Shading (Shade Open)
-46
-45
na
Effective Percent Glass
-39
-38
(percent glass x SC)
.23
Effective
-31
na
-18
%Glass
North East South
West
Skylight
18
10 6 12
4
na
16
9 6 11
4
na
14
7 6 10
4
na
12
6 6 9
4
na
11
5 5 8
4
na
10
4 5 8
4
4
9
4 4 7
4
5
8
3 4 6
4
5
7
2 3 5
3
5
6
2 3 4
3
6
5
1 2 3
2
6
4
1 1 2
1
6
3
0 0 0
0
5
2
-1 -2 -3
-2
4
1
-1 -4 -6
-3
3
0
-2 3 -11
-6
0
na = not allowed
X
71=
8. Shading (Shade Closed)
ERective Percent Glass
(percent glass x SC)
Effective
%Glass North
18 -9
16 -8
14 3
12 -5
11 -5
10 -4
9 -4
8 -3
7 -3
6 -2
5 -1
4 -1
3 0
2 0
1 1
0 1
na = not allowed
East South West Skylight
-32
-46
-45
na
-27
-39
-38
na
.23
-32
-31
na
-18
-25
-24
na
-16
-22
-21
na
-14
-19
-18
-63
-13
-16
-15
-54
-10
-14
-13
-46
-8
-11
-11
-38
3
-8
-8
•30
-4
-5
•6
-23
-2
-3
-3
-17
-1
-1
-1
-11
1
1
2
-7
2
" 3
4
-3
4
4
6
0
• 6.6 0 0 0 0 0 0
8.0 s 7 s 4 z 0 Point System Summary: Climate Zone 16
9.0 13 11 8 5. 3 0
10. Exterior Wall Thermal Mass 10.0 17 14 10 7 3 . 0 SCORE CARD
A
Exterior
Single-
Single-
f 13. Water
_
Single -Family
..-- ._._ _ .
Water
Heater Credit
Type Type
Heating
Detached
1199
or
less
11.0
12.0
20 16 12 8
23 18 14 9 5
0
0
:._.
2700
or
more
Measures -
Wall
Mass
Family
Detached
Family
Attached
Mule
Fami ly
-
_..._
13.0
2 20 10 5
0
1. Ceiling Insulation
3b or
0.00
0
0
0
units)
.
Zonal Control Adjustment
Q • X
�
U -value (0.651
R -value (381 1.1 -value (0.0301
0.20
2
2
1_
12
8
10 8 6 4 2
0
2. Wall Insulation
or _.. _..... .
0.40
0.60
5
7
4
6
2
4
.3. % X
-_
To Cooling System Installed
-.-_ .. ---_.
0.50
HP HWR
R -value ( 91 U -value [0.066]
0.80
1.00
10
13
8
10
5
6
II-
Stories
One
0 0 0 0 0
0
3. Raised Floor Insulation
_
. or
1.20
16
12
8
17
9
Two +
5 4 3 2 1
0
6
3
R-value[191 U -value [0.0371
1.40
1.60
1.80
2.00
19 14
22 16
22 19
22 21
9
11
12
14
f 13. Water
_
Single -Family
..-- ._._ _ .
Water
Heater Credit
Type Type
Heating
Detached
1199
or
less
Unit
1200
to
1699
-
and Attached
Size (sQ
1700
to
2199
2200
to
2699
:._.
2700
or
more
4.
S.
6.
Slab Edge Insulation
_.
• Infiltration
Glass Heat Loss
R -value [71
Standard
or
_._..._.._..
F2 factor [0-511 -
--
_
-
_..._
less
11. Heating System
Heating y
-5
I SG None
0
0
0
0
0
units)
.
Type [double]
Q • X
�
U -value (0.651
To Total Glass [ 161
0.30
na
0.40
2.75
3.41
3.67
-94
-57
-43
j or Solar
12
8
6
5
4
_
: Y
Unit Size (sl)
Ito 1(to 1700
22r
South
.3. % X
-_
SE or HSPF
0.50
HP HWR
9
6
4
3
3
7.
Shading (Shade Open)
(assumes ducts in attic)
d. Wen
WS8
- POU
17
9
12
6
9
4
7
3
6
3
0
__
% Glass
0
_. Sc. _
Eff. % Glass
Credit
Type
Sum of 1-6
to
1199
(to
1699
to
2199
or
more
e. Skylight
X
71=
--s`---
a. North
3
X
i -
oZ-ifj
SE HSPF
-25 or -24 to -14 to -4 to
less -15 -5 +5
+b to 16 or
+15 more
SE None
Solar
39
-2
-26
-1
-19
-1
1
-15
-1
-13
-1
- • b. East -
3•
X
0.72 6.60
0 0 0 0
0 0
W B
2
22
1
13
20
11
17
1
None
Solar
c. South
%7
X
=
El_
�,
0.75. 6.88
4 4 3 3
3 2
POU
-18
-12
-9
-7
-6
33
d. West
�f oC
X'
HP
HWR
0.80 7.33
11 10 9 8
7 6
3
2
Intortor Vass/CFA
CONO. FLOOR
AREA
1.00
9.17
47
43
38
0.85 7.79
16 15 13 12
10 9
IG None
-2
-1
-1
-1
-1
6
2
e. Skylight
X
AREA _ $
0.90 8.25
21 19 17 15
13 11
Solar
10
7
5
4
3
3
3
Exterior Wall Mass
ND. r L OR
0.95 8.71
26 24 21 19
16 14
POU
7
5
3
3
2
g_
Shading (Shade Closed)
�6
2
-23
1
-15
1
-12
0
-9
0
Effective SE or HSPF
_-�X
_
Res
Resistance
10
9
J
6
5
3
HWR
(SE or HSPF x duct efriciency)
-11
11
IE None
-28
-19
-14
-11
-9
Effective SE or
Other
'
% Glass
6
SC
Eff. % Glass
d
3
2
Sol
10
7
5
4
3
4
-5
12. Cooling System
(o. 6.61
- �.Y
HSPF (0-56/5.151
= 7
Point Scores
_._ 0
Sum 1-6
Eff e
-le or --1 to -1- to 4 to +6
16
ar
POU
-1
-5
-3
-3
•2
a. North
�� % X
�'
SE
HS
HSPF
less
-15
-5
+5
+15
5
more
re
Multi -Family
(individual
units)
b- East
Q • X
�
T
0.30
na
0.40
2.75
3.41
3.67
-94
-57
-43
-85
-52
-39
•76
-46
-35
-68
-41
-59
-36
-8
-50
31C.
i
Water
6or
Unit Size (sl)
Ito 1(to 1700
22r
South
.3. % X
-_
0.50
4.58
-13
-12
-11
-1
-10
-8
-7
-7
d. Wen
X
0.56
5.13
0
0
0
0
0
0
Heater
Type
Credit
Type
or
less
to
1199
(to
1699
to
2199
or
more
e. Skylight
X
71=
--s`---
0.60
5.50
7
6
6
5
4
4
0.70
0.80
6.=2
7.33
21
32
19
29
17
26
15
23
13
20
11
17
SG
or
None
Solar
0
14
0
7
0
5
0
3
0
3
9. Interior Thermal Mass
TYPE 1 MASS
AREA fi
0.90
8.25
40
37
33
29
25
22
HP
HWR
10
5
3
3
2
Intortor Vass/CFA
CONO. FLOOR
AREA
1.00
9.17
47
43
38
34
30
25
WSB
29
14
5
10
7
6
2
lU. Exterior Nall Blass
TYPE 2 MASS
E
AREA _ $
Zonal Control
Adjustment
POU
10
3
3
Exterior Wall Mass
ND. r L OR
AREA
System Type
-
SE
None
Solar
�6
2
-23
1
-15
1
-12
0
-9
0
11. Heating System
_-�X
_
Res
Resistance
10
9
J
6
5
3
HWR
_23
-11
11
-8
7
-6
-5
Zonal Control? Y / N
( )
S a SPF
Duct ETu:i=cy (0.781
Effective SE or
Other
'
6
5
4
d
3
2
WSB
POU
22
•23
-11
-8
5
-6
4
-5
12. Cooling System
(o. 6.61
- �.Y
HSPF (0-56/5.151
= 7
n
None
Solar
-2
11
1
6
_1
4
0
3
0
2
Zonal Control? ( Y / N )
_� X
SEER (8.91
Duct Efficiency [0.741 Effective SEER 16.591
POU
8
4
3
2
2
13. Water Heating
IE
None
-28
-14
-9
-7
-6
T (SG1
Credit (nonel
Solar .22 11 7 6 4 YPe
POU -4 -2 -1 -1 -1 v t«. •r •..x.
67
6