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13050108 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10229 SCENIC BLVD CONTRACTOR:ALLEN HSU PERMIT NO: 13050108 OWNER'S NAME: ALLEN HSU 10229 SCENIC BLVD DATE ISSUED:07/17/2013 OWNER'S PHONE: 4088938007 SAN JOSE,CA 95129-3946 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL License Class Lic.# CONSTRUCT NEW 2 STORY SFD WITH 3689 SQ FT OF LIVING SPACE WITH 462 SQ FT ATTACHED GARAGE& Contractor Date 473 1 hereby affirm that I am licensed under the provisions of Chapter 9 SQ FT OF PORCH AREA (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$610000 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:35709010.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.1 agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF ERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes, (We)agree to save 180 DAYS F T CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ] granting of this permit. Additionally,the applicant understands and will complyue y: Date: 7 11-3 with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed.if a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. OWNER-BUILDER DECLARATION thereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(x)should I store or handle hazardous 1 have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sec i ns)25505,2553 'and- 55 34. Section 3700 of the Labor Code,for the performance of the work for which this / permit is issued. Owner or authorized age ��'�: `= tz� Date: h r I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per;the Cupertino Municipal Code,Section Licensed Professional 9.18. r ) Signature �- --tate E f' . CONSTRUCTION PERMIT APPLICATIONv COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O� 10300 TORRE,AVENUE•CUPERTINO, CA 95014-3255 O (40.8).777-3228 FAX(408) 777-3333•buiidinp(a)cupertino.org �C--,U/PERTWO t` NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS IC C r 1 C V APN# — 1 n OWNER NAME PHONE o��� 7� i STREET ADDRESS/O�� �O hc,,o 5`ei,, CITY, STATE,ZIP �J �V FAX �yy CONTACT NAME {.. "n PHONE 0f 6/ ,U t_u4"C 1 Q E-MAIL y�IGti�cJQ ,/iii 1�. STREET ZZ ADDRESS 4!c. C - CITY,STATE,ZIP V 6!'-t1'J` -C``'-'l(�q�7 0 FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT k3_ARCH[TECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT -7 CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE QHITE /ENGINEER NAME LICENSE NUMBER 1 r 2-3 3 U BUS.LIC# COMPANY NAME E-MAIL 1 FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK EXISTIIdGUSEPROPOSESE CONSTR.TYPE #STZS USE TYPE OCC. SQ.FT. VALUAON($) EXISTG NEW FL00 DEMO VV T(1 TOTAL TI AREA,�1 1 _ AREA j "} AREA t` NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA D 6 oz .PORCH AREADECK AREA TOTAL/D�E�CK/11 AREA GGA/RAGE AREA: DETACH 'VI 3, 1. 4__1, ,Z TACH r 0, #DWELLINGUNITS:' ND UNIT []YES SECOND STORY ❑YES - " y =CODED? V ADDITION? ONO PRE-APPLICATION JZYES IF YES,PROVIDE COPY OF 1S THE BLDG AN ❑YES PLANNING ADPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO 3" f� By my signature below,I certify to each of the following: I am the property owner or authorized agent to a the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to build g cons ction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: Tj�U"1 r/,I SUPPLEMENTAL INFORMATION RE Do NOEI t �o>Trurc s�ne. New SFD oT Multifamily dwellings: Apply for demolition permit for existing building(s):..Demolition permit is required prior to issuance of building ♦,, permit for new building. Cl ExPxES' � Prt _ _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ,C �TtvDnRD TJsld o� r form if any Hazardous Materials are being used as part of this project. I'� D Copy of Planning Approval Letter or Meeting with Planning prior to q, su_bmittal of Building Permit application. �R MA70 _ 5 �R E visTlu ^ .,f ENVi$ONbiENTAI CLTA =,s BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10229 SCENIC BLVD DATE: 05/14/2013 REVIEWED BY: MELISSA APN: 357 09 010 BP#: % 3 G�SZ�f-) 'VALUATION: $610,000 %PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex 2nd Unit? 0 Yes •' No PENTAMATION 1R3SFDW USE: PERMIT TYPE: WORK CONSTRUCT NEW 2 STORY SFD WITH 3689 SQ FT OF LIVING SPACE WITH 462 SQ FT SCOPE ATTACHED GARAGE &473 SQ FT OF PORCH AREA OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 4,624 $3,094.33 IR3PLNCK $3,641.62 IR3INSP TOTALS: 4,624 $3,094.33 $3,641.62 P, LlNOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS(Fee Resolution 11-053 Ef 7/1/121 FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,094.33 Select a Misc Bldg/Structure Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $3,641.62 Suppl. Insp. Feer Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 #new Construction Tax: 1BCONSTAXR 1 units $641.96 Work Without Permit? 0 Yes No $0.00 E) Advanced Planning Fee: 1PLLONGR $601.12 Select a Non-Residential 0 Building or Structure 0 i Strong Motion Fee: 1BSEISAffCR $61.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $25.00 SUBTOTALS; 1 $8,065.031 $0.00 TOTAL FEE: 1 $8,065.03 Revised: 04/29/2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# 0 S$ ) OWNER'S NAME: C, / PHONE# -- �3 GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing -I--/' >2. e-11 P4` Cf1 Z Electrical S S ��" � /� ��s' C) Z- Excavation f i' �c er `� 3 �L. Fencing �Ti� u cL �� c �71 �' 4� Flooring/Carpeting Linoleum/ Wood 11 L-Jn Glass / Glazing HeatingU vov o $3 n Insulation /7� �/ a K o C-)Landscaping i "ne12Gk1 t�� t ; 34"TJ Z Lathing p ;;2 CZ)r -3 4 S' Z Masonry ' Painting/Wallpaper Paving Plastering Plumbing Roofing 77 r Septic Tank Sheet Metal �, ��� �„ U o0 U a 3 J Sheet Rock _S', N • 2,UL, S-� Tile ��DCID � SD 1 Own Contractor Signature Date Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RTI N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: 1(0 2 9 Cwt C ✓Gly• PERMIT# d OWNER'S NAME: PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile G Ow /Contractor Signature Date INSTALLATION CERTIFICATE (Page 1 of 13) CF-6R -,. ,-1 Site Address Permit 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 form 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: Ej - Healing Equipment Equip. g of Efficiency Duct Duct 0,1 ; ti Heating Type(pkg. CEC Certified Mfr Name Identical (AFUFi,etc.)' Location Piping oad Capacity heat ournal an bd el umber systems v e -r it-M) Cooling Equipment Equip. CEC Certified Compressor k of Efficiency Duct Cooling Cooling 'type(pkg. Unit Mfr Name and Identical (SEER,etc.)' location Duct Load Capacity [>CF- -v 13t r (Btu/hr) I. >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-1 R)submitted for compliance with the Energy Lucien Standards for residential buildings,and 3)equipment that meets or exceeds the appropriate requirements for m9P4#0tured devices(from the Appliance Eyficiency Regulations or Part 6),where applicable. ►°16�a�veitJc'-� Signature,Date Installing Subcontractor(Co.Name) OR General Contractor(Co.Name)OR Owner WATER HEATING SYSTEMS: Distribution If Recir- #of Rated= Tank Effi- External Flealer CEC Certified Mfr 'type(Std, culation, Identical Input(kW Volume cicncy' Standby' Insulation Ty Name&Model Number Point-of-Use) Control Type Systems or Btu/hr) (gallons) EF,RE) Loss(°/u R-value' 2 For small gas storage(rated input of less than or equal to 75,000 Btulhr),electric resistance and heat pump water beaters,list Energy Factor. For large gas storage water heaters(rated input of greater than 75,000 titAr),list Recovery Efficiency,Standby boss 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 less 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 sp 'fied in the certificate of compliance (Form CF-IR) submitted for compliance with the Energy F.�c•ency Standar for residential buildings; and 3) equipment that meets or exceeds the appropriate 7� requirem fo devices( m he Appliance I fciency Regulations or Part 6),where applicable. 1 t� r111A1kASr1C pbvlb� ldr. Signature,Date Installing Subcontractor(Co. Name)OR General Contractor(Co.Name)OR Owner COPY TO: Building Department HERS Provider(if applicable) Building Owner at Occupancy Compliance Forms August 2001 A-23 IN/STALLATION CERTIF�yIC//ATE (Page 2 of 1.3) CF-6R Site Address L Permit Number FENESTRATION/GLAZING- Total Quantity Product Product or Like Exterior Shading U•Factor'(5 SHGC'(5 #of Product Square Device or Comments/Location/ Manufacturer/Brand Name CF-IR value)2 CF-IR value)' Panes (pnrionah Feet Overhang Smcial Features (GROUF IAKI PRODUCTS) 2. 3. Sr-- -. - — -- — 6. 7. 8. 9. 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. ' Installed U-Factor must be less than or equal to values from CF-IR. Installed SHGC must be less than or equal to values from CF-IR,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-I R) submitte for compliFneith the Energy Efficiency Standards for residential buildings; and 3) the product meets or exce he ap ropriI ments foj manufactured devices(from Part 6),where applicable. GjL� �� I�C 7 Item As 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 HERS Provider(if applicable) Building Owner at Occupancy Compliance Forms August 2001 A-24 INSTALLATION CERTIFICATE (Page 3 of 13) CF-6R Site Address Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS ❑ DUCT LEAKAGE REDUCTION Pressurization Test Results(CFM @ 25 PA) Test Leakage(CFM) G��1 Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons,or as 21.7 x Heating Capacity in Thousands of Btu/hr,enter calculated value here /Poo If fan flow is measured,enter measured value here Leakage Fraction =Test Leakage/(Measured or Calculated Fan Flow)= & Pass if leakage fraction 5 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 FINISHING WALL: ❑ 1 s 1:1No ❑ Pressure pan test or House pressurization test lld Yes ❑ No ❑ Visual Inspection of Duct Connections 0/ ❑ Pass Fail ❑ THERMOSTATIC EXPANSION VALVE(TXV) _ IYes ❑ No Thermostatic Expansion Valve is installed and Access is provided for inspection d/ ❑ Yes is a pass Pass Fail ❑ DUC-> DESIGN 1• Yes ❑ No ACCA Manual D Design calculations have been completed, Duct Design is on the plans and duct installation ,� � matches plans. 2• M 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 ` 1,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 sub-contractors certifying that diagnostic testing and installation meet the requirements for compliance credit.] iro�u, 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 Compliance Forms August 2001 A-25 INSTALLATION CERTIFICATE (Page 4 of 13) CF-6R Site Address Permit Number REFRIGERANT CHARGE AND AIRFLOW MEASUREMENT Verification for Required Refrigerant Charge and Adequate Airflow for Split System Space Cooling Systems without Thermostatic Expansion Valves Outdoor Unit Serial# a 014-E Z-4Zg2i Outdoor Unit Make CA?,A EA, Outdoor Unit Model z4-^6173 3 Cooling Capacity .4�'C"q 0 Btu/hr S;'7 C �'� G'CC� b-To Date of Verification 061611z_11114 Date of Refrigerant Gauge Calibration (must be checked monthly) Date of Thermocouple Calibration (must be checked monthly) Standard Charge and Airflow Measurement(outdoor air dry-bulb 55 OF and above): Note:The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. Measured Temperatures Supply(evaporator leaving)air dry-bulb temperature(Tsupply,db) OF Return(evaporator entering)air dry-bulb temperature(Treturn,db) __7 jr OF Return(evaporator entering)air wet-bulb temperature(Treturn,wb) °F Evaporator saturation temperature(Tevaporator,sat) 3 Zi °F Suction line temperature(Tsuction,db) 4S OF Condenser(entering)air dry-bulb temperature(Tcondenser,db) Zt�)°F Superheat Charge Method Calculations for Refrigerant Charge Actual Superheat =Tsuction,db—Tevaporator,sat OF Target Superheat(from Table 1) OF Actual Superheat—Target Superheat OF (System passes if between-5 and+5°F) Temperature Split Method Calculations for Adequate Airflow Actual Temperature Split =T return,db-Tsupply,db S°F Target Temperature Split(from Table 2) l� OF Actual Temperature Split-Target Temperature Split OF (System passes if between-3°F and+3°F or,upon remeasurement, if between +3°F and-25°F) Standard Charge and Airflow Measurement Summary: System shall pass both refrigerant charge and adequate airflow calculation criteria from the same measurements. If corrective actions were taken,both criteria must be remeasured and recalculated , System Passes " yes or no Compliance Forms August 2001 A-26 INSTALLATION CERTIFICATE (Page 5 of 13) CF-6R Site Address Permit Number Alternate Charge and Airflow Measurement(outdoor air dry-bulb below 55°F): Weigh-in Charging Method for Refrigerant Charge Actual liquid line length: ft. Manufacturers Standard liquid line length: D ft• Difference(Actual—Standard): Mme, ft. Manufacturers correction(ounces per foot) _ eT x differe se in length =ounces (+ add (-=remove) Measured Airflow Method for Adequate Airflow Airflow criterion:Cooling Capacity X 0.032= CFM Measured Airflow is__ __a CFM and passes since it is greater than the criterion. Alternate Charge and Airflow Measurement Summary: System charge shall be corrected and it shall also pass measured adequate airflow criterion. System Passes U/ yes or no Compliance Forms August 2001 A-27 INSTALLATION CERTIFICATE (Page 6 of 13) CF-6R Site Address Permit Number Table K-l: Target Superheat(Suction Line Temperature- Evaporator Saturation Temperature) Return Air Wet-Bulb Temperature(°F) .4 50 51 52 53 54 1 55 56 57 58 59 60 1 61 62 63 1 64 1 65 66 67 68 69 1 70 1 71 72 1 73 1 74 75 76 55 8.8 10.1 11.5 12.8 14.2 15.6 17.1 18.5 20.0 215 23.1 24.6 26.2 27,8 29.4 31.0 32.4 33.8 35.1 36.4 1 37.7 39.0 40.2 41.5 1 42.7 43.9 45.0 56 8.6 9.9 11.2 12.6 14.0 15.4 16.8 18.2 19.7 21.2 22.7 24.2 25.7 27.3 28.9 30.5 31.8 33.2 34.6 35.9 37.2 38.5 39.7 41,0 42.2 43.4 44.6 57 8.3 9.6 11.0 12.3 13.7 15.1 16.5 17.9 19.4 20.8 22.3 23.8 25.3 26.8 28.3 29.9 31.3 32.6 34.0 35.3 36.7 38.0 39.2 40.5 41.7 43.0 44,2 58 7.9 9.3 10.6 12.0 13.4 14.8 16.2 17.6 19.0 20.4 21.9 23.3 24.8 26.3 27.8 29.3 30.7 32.1 33.5 34.8 36.1 37.5 38.7 40.0 41.3 42.5 43.7 59 7.5 8.9 10.2 11.6 13.0 14.4 15.8 17.2 18.6 20.0 21.4 22.9 24.3 25.7 27.2 28.7 30.1 31.5 32.9 34.3 35.6 36.9 38.3 39.5 40.8 42.1 43.3 60 7.0 8.4 1 9.8 1 11.2 12.6 14.0 1 15.4 16.8 18.2 1 19,61 21.0 22.4 1 23.8 1 25.2 26.6 28.1 29.6 31.0 32.4 1 33.7 35.1 36.4 37.8 39.1 40.4 41.6 42.9 61 6.5 7.9 9.3 10.7 12.1 13.5 14.9 16.3 I T7 19.1 20.5 21.9 23.3 24.7 26.1 275 29.0 30.4 31.8 33.2 34.6 35.9 37.3 38.6 39.9 41.2 42.4 62 6.0 7.4 8.8 10.2 11.7 13.1 14.5 15.9 17.3 18.7 20,1 21.4 22,8 24,2 25.5 27.0 28.4 29.9 31.3 32.7 34.1 35.4 36.8 38.1 39.4 40.7 42.0 63 5.3 6.8 8.3 9.7 11.1 12.6 14.0 15.4 16.8 18.2 19.6 20.9 22.3 23.6 25.0 264 27.8 29.3 30.7 32.2 33.6 34.9 36.3 37.7 39.0 40.3 41.6 64 - 6.1 7.6 9.1 10.6 12.0 13.5 14.9 16.3 17.7 19.0 20.4 21.7 23.1 24A 25.8 27.3 28.7 30.2 31.6 33.0 34.4 35.8 37.2 38.5 39.9 41.2 s 65 5.4 7.0 8.5 10.0 115 12.9 14.3 15.8 17.1 18.5 19.9 21_2 22.5 23.8 25.2 26.7 28.2 29.7 31.1 32.5 33.9 35.3 36.7 38.1 39.4 40.8 66 6.3 7.8 9.3 10.8 12.3 13.8 15.2 16.6 18.0 19.3 20.7 22.0 23.2 24.6 26.1 27.6 29.1 30.6 32.0 33.4 34.9 36.3 37.6 39.0 40.4 M7O 5.5 71 R.7 102 I17 13.2 14.6 16.0 17.4 I8.8 20.1 21.4 22.7 24.1 25.6 27.1 28.6 30.1 3L5 33.0 34.4 35.8 37.2 38.6 39.9 - 6.3 8.0 9.5 11.1 12-6 14.0 15.5 16.8 i8.2 19.5 20.8 22.1 23.5 25.0 26.5 28.0 29.5 31.0 32.5 33.9 35.3 36.8 38.1 39.5 a 5.5 7.2 8.8 10.4 11.9 13.4 14.8 16.3 17.6 19.0 20.3 21.5 22.9 24.4 26.0 27.5 29.0 30.5 32.0 33.4 34-9 36.3 37.7 39.1 r. - 6 4 8.1 9.7 l1.2 12.7 14.2 15.7 17A 18.4 197 20.9 22.3 23.9 25.4 27.0 28.5 30.0 31.5 33.0 34.4 35.9 37.3 383 4 5.6 7.3 8.9 10.5 12.1 13.6 15.0 16.4 17.8 19.1 20.3 21.7 23.3 24.9 26.4 28.0 29.5 31.0 32.5 34.0 35.4 36.9 38.3 6.4 8.1 9.8 11.4 12.9 14.4 15.8 17.2 18.5 19.7 21.2 22.8 24.3 25.9 27.4 29.0 30.5 32.0 33.5 35.0 36.5 37.9 € 73 5.6 7.3 9.0 10.7 12.2 13.7 15.2 16.6 17.9 19.2 20.6 22.2 23.8 25.4 26.9 285 30.0 315 33.1 34.6 36.0 37.5 F 74 - 6.5 8.2 9.9 11.5 13 1 145 15.9 17.3 186 20.0 21.6 23.2 24.8 26.4 280 29.5 31.1 32.6 34.1 35.6 37.1 h 75 5.6 7.4 9.2 10.8 12.41 13.9 1 15.3 16.7 1 18.0 19.4 21.1 22.7 24.3 1 25.9 27.5 29.1 30.61 32.2 317 35.2 1 36.7 76 - 6.6 8A 10.1 11.7 13.2 14.7 16.1 17.4 18.9 20.5 22.1 23.8 25.4 27.0 28.6 30.131.7 33.3 34.8 36.3 77 - 5.7 7.5 9-3 11.0 12.5 14.0 15.4 16.8 18.3 20.0 21.6 23.2 24.9 265 28.1 29.7 31.3 32.8 34.4 36.0 -o 78 6.7 85 10.2 11.8 13.4 14.8 16.2 173 19.4 21.1 22.7 24.4 26.0 27.6 29.2 30.8 32.4 34.0 35.6 e 79 5.9 77 9.5 11.1 12.7 14.2 15.6 17.1 18.8 20.5 22.2 23.8 25.5 27.1 28.8 30.4 32.0 33-6 35.2 U 80 - 69 8.7 10.4 12.0 13.5 15.0 16.6 18.3 20.0 21.7 23.3 25.0 26.7 28.3 29.9 1 31.6 33.2 34.8 81 - 60 7.9 9.7 11.3 12.9 14.3 160 17.7 19.4 21,1 22.8 24.5 262 27.9 29.5 31.2 32.8 34.4 82 52 7.1 8.9 10.6 12.2 13.7 15.4 17.2 18.9 20.6 22.3 24.0 25.7 27.4 29.1 30.7 32.4 X0 83 - 6.3 8.2 9.9 11.6 13.1 14.9 16.6 18.4 20.1 21.8 23.5 25.2 26.9 28.6 30.3 32.0 33.7 84 5.5 74 9.2 10.9 12.5 14.3 16.1 17.8 19.6 21.3 23.0 24.8 26.5 28.2 29.9 31.6 33.3 85 6.6 1 8.5 10.3 11.9 13.7 15.5 17.3 19.0 20.8 1 22.6 24.3 1 26.0 27.8 29.5 1 31.2 32.9 86 5.8 7.8 9.6 11.3 13.2 15.0 16.7 18.5 20.3 22.1 23.8 25.6 27.3 29.1 30.8 32.6 87 50 7.0 8.9 10.6 12.6 14.4 16.2 18.0 19.8 21.6 23.4 25.1 26.9 28.7 30.4 32.2 88 - - 6.3 8.2 10.0 12.0 13 9 15.7 17.5 19.3 21.122.9 24.7 26.5 28.3 30.1 31.8 H90 89 5.5 7.5 9.4 It 13.3 15.1 17.0 18.8 20.6 22.4 24.3 26.1 27.9 29.7 31.5 6.8 1 8.8 1 10.9 12.8 14.6 16.5 18.3 20.1 22.0 23.8 25.6 27.5 29.3 31.1 Compliance Forms August 2001 A-28 INSTALLATION CERTIFICATE (Page 7 of 13) CF-6R Site Address Permit Number Table K-1: Target Superheat(Suction Line Temperature- Evaporator Saturation Temperature) (continued) Return Air Wet-Bulb Temperature('F' 50 51 52 53 54 55 56 57 1 58 59 60 61 62 63 64 1 65 66 67 68 69 1 70 1 71 72 73 F74 75 76 91 - - - - - - 6.1 8.1 10.3 12.2 14.1 15.9 17.8 19.7 21.5 23.4 25.2 27.1 28.9 30-8 92 - 5.4 7.5 9.8 11.7 13.5 15.4 17.3 19.2 21.1 22.9 24.8 26.7 28.5 30.4 93 6.8 9.2 ILI 13.0 14.9 16.8 18.7 20.6 22.5 24.4 26.3 28.2 30.1 94 6.2 8.7 10.6 12.5 14,4 16.3 18.2 20.2 22.1 24.0 25.9 27.8 29.7 95 5.6 8.1 10.0 12.0 13.9 IS.8 ITS 19.7 21.6 23.6 2S.S 27.4 29.4 E 96 - - - 7.5 9-5 11.4 13.4 15.3 17.3 19.2 21.2 23.2 25.1 27.1 29.0 97 - - 7.0 8.9 10.9 12.9 14.9 16.8 18.8 20.8 22.7 24.7 26.7 28.7 98 - - 6.4 8.4 10.4 12.4 14.4 16.4 18.3 20.3 22.3 24.3 26.3 28.3 49 5.8 7.9 9.9 11.9 13.9 15.9 17.9 199 21.9 24.0 26.0 28.0 ° 100 5.3 7.3 9.3 11.4 13.4 15.4 17.5 19.5 21.5 23.6 25.6 27.7 101 - - - 6.8 8.8 10.9 12.9 15.0 17.0 19.1 21.1 23.2 25.3 273 102 6.2 8.3 10.4 12.4 14.5 16.6 18.6 20.7 22.8 24.9 27.0 103 T 5.7 7.8 9.9 11.9 14,0 16.1 18.2 20.3 22.4 24.5 26.7 r 104 - - - - - - - - - - - - - - - 5.2 Z2 9.3 ILS 13.6 15.7 ITS 19.9 22.1 24.2 26.3 Ct 105 I I 1 6.7 1 8.8 11,01 13.1 1 15.2 17.4 19.5 121.7 23.8 126,0 106 6.2 8.3 10.5 12.6 14.8 17.0 19.1 21.3 23.5 25,7 107 - 5.7 7,9 10.0 122 14.4 16.6 18.7 21.0 23.2 25.4 a 108 5.2 7.4 9,5 11.7 13.9 16.1 18.4 20.6 22.8 251 109 - 6.9 9.1 11.3 13.5 15.7 18.0 20.2 22.5 24-7 110 - - 6.4 1 8.6 10.8 13.1 1 15.3 17.6 19.91 22.1 24.4 III - 5.9 8.1 10.4 12.6 14.9 17.2 19,5 21.8 24.1 112 - 5.4 7.6 9.9 12.2 14.5 16.8 19.1 21.5 23.8 113 - 7.2 9.5 11.8 14.1 16.4 18.8 21.1 23.5 114 6.7 9.0 11.4 13-7 16.1 18.4 20.8 23.2 115 6.2 8.6 10.9 13.3 15.7 18.1 20-5 22.9 Compliance Forms August 2001 A-29 INSTALLATION CERTIFICATE (Page 8 of 13) CF-6R Site Address Permit Number Table K-2: Target Temperature Split(Return Dry-Bulb-Supply Dry-Bulb) Return Air Wet-Bulb(°F)(T,.um,wb) 50 51 52 53 54 55 1 56 57 58 59 60 61 1 62 163 64 65 1 66 67 1 68 1 69 70 1 71 1 72 73 74 75 76 70 20.9 20.7 20.6 20.4 20.1 19.9 19.5 19.1 18.7 18.2 17.7 17.2 16.5 15.9 15.2 14.4 13.7 12.8 11.9 11.0 10.01 9.0 1 7.9 6.8 5.7 4.5 3.2 _ 71 21.4 21.3 21.1 20.9 20.7 20.4 20.1 19.7 19.3 18.8 18.3 17.7 17.1 16.4 15.7 15.0 14.2 13.4 12.5 11.5 10.6 9.5 8.5 7.4 6.2 5.0 3.8 72 21.9 21.8 21.7 21.5 21.2 20.9 20.6 20.2 19.8 19.3 18.8 18.2 17.6 17.0 16.3 15.5 14.7 13.9 13.0 12.1 11.1 10.1 9.0 7.9 6.8 5.6 4.3 z 73 22.5 22.4 22.2 22.0 21 A 21.5 21.2 20.8 20.3 19.9 19.4 18.8 18.2 17.5 16.8 16.1 15.3 14.4 13.6 12.6 11.7 10.6 9.6 8.5 7.3 6.1 4.8 74 23.0 22.9 22.8 22.6 22.3 22.0 21.7 21.3 20.9 20.4 19.9 19.3 18.7 18.1 17.4 16.6 15.8 15.0 14.1 13.2 12.2 11.2 10.1 9.0 7.8 6.6 5.4 w 75 23.6 23.5 23.3 23.1 22.9 22.6 22.2 21.9 21.4 21.0 20.4 19.9 19.3 18.6 17.9 17.2 16.4 15.5 14.7 13.7 12.7 11.7 10.7 9.5 8.4 7.2 5.9 76 24.1 24.0 23.9 23.7 23.4 23.1 22.8 22.4 22.0 21.5 21.0 20.4 19.8 19.2 18.5 17.7 16.9 16.1 15.2 14.3 13.3 12.3 11.2 10.1 8.9 7.7 6.5 77 - 24.6 24.4 24.2 24.0 23.7 23.3 22.9 22.5 22.0 21.5 21.0 20.4 19.7 19.0 18.3 17.5 16.6 15.7 14.8 13.8 12.8 11.7 10.6 9.5 8.3 7.0 78 - 24.7 24.5 24.2 23.9 23.5 23.1 22.6 22.1 21.5 20.9 20.2 19.5 18.8 18.0 17.2 16.3 15.4 14.4 13.4 12.3 11.2 10.0 8.8 7.6 L G 79 - - - 24.8 24.4 24.0 23.6 23.1 22.6 22.1 21.4 20.8 20.1 19.3 18.5 17.7 16.8 15.9 14.9 13.9 12.8 11.7 10.6 9.4 8.1 Q 80 - - 25.0 24.6 24.2 23.7 23.2 22.6 22.0 21.3 20.6 19.9 19.1 18.3 17.4 16.4 15.5 14.4 13.4 12.3 11.1 9.9 8.7 81 - - - - 25.1 24.7 24.2 23.7 23.1 22.5 21.9 21.2 20.4 19.6 18.8 17.9 17.0 16.0 15.0 13.9 12.8 11.7 10.4 9.2 3 82 - - - - - - 25.2 24.8 24.2 23.7 23.1 22.4 21.7 21.0 20.2 19.3 18.5 17.5 16.6 15.5 14.5 13.4 12.2 11.0 9.7 a 83 - - - 25.3 24.8 24.2 23.6 23.0 22.3 21.5 20.7 19,9 19.0 18.1 17.1 16.1 15.0 13.9 12.7 11.5 10.3 84 - - - 25.9 25.3 24.8 24.2 23.5 22.8 22.1 21.3 20.4 19.5 18.6 17.6 16.6 15.6 14.4 13.3 12.1 10.8 Compliance Forms August 2001 A-30 INSTALLATION CERTIFICATE (Page 9 of 13) CF-6R Site Address Permit Number DUCT LOCATION AND AREA REDUCTION DIAGNOSTICS ❑ DU9T IN CONDITIONED SPACE Yes ❑ No Duct in conditioned space criteria matches CF-1 R 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? U3// ❑ Yes is a Pass Pass Fail lJ 1 the ned undersig 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 oftZF-bR signed by the builder employees or sub-contractors certifying that diagnostic testing and installation meet t7hr ents�for"compliance credit.] Tests ignature. Date Installing Subcontractor(Co.Name)OR Performed General Contractor(Co.Name) COPY TO: Building Department HERS Provider(if applicable) Building Owner at Occupancy Compliance Forms August 2001 A-31 INSTALLATION CERTIFICATE (Page 10 of 13) CF-6R 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 leakage less than or equal to the required level from Yes No CF-I R? 2. ❑ is Mechanical Ventilation shown as required on the CF-1 R? Yes No 2a. 0 ❑ if Mechanical Ventilation is required on the CF-I R(Yes in line 2),has it Yes No been installed? 2b. 14 ❑ 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-IR. Measured Watts= 3. ❑ Check this box yes if measured building infiltration(CFM @ 50 Pa)is es No greater than the CFM @ 50 values shown for an SLA of 1.5 on CF-I R (If this box is checked no,mechanical ventilation is required.) 4. ❑ Check this box yes if measured building infiltration(CFM @ 50 Pa)is less Yes No 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. l� ❑ Pass if: Pass Fail d. Yes in line 1 and line 3,or e. Yes in line 1 and line2,2a,and 2b,or f. Yes in line 1 and Yes in line 4. Otherwise fail. }LJ 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-I R. This is to certify 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-GR signed by the builder employees or sub-contractors certify certifying that diagnostic testing and installation meet the requirements for compliance credit.] _ 4. (r' G'�L' -6111 Gra 14L9, Test Performed Signature Date Testing Subcontractor(Co.Name)OR General Contractor(Co.Name) COPY TO: Building Department HERS Provider(if applicable) Building Owner at Occupancy Compliance Forms August 2001 A-32 INSTALLATION CERTIFICATE (Page 11 of 13) CF-6R Site Address Permit Number The following is an explanation of many of the input values required on this form: HVAC SYSTEMS Heating Equipment T e must be one of the following: __V(Furnace: as(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) 111-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 T e must be one of SplitAirCond: lit system air con ' ' ner 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= I3.0;duct location=attic;duct insulation R-value=4.2 *Refer to Energy Commission publication Appliance Efficiency Regulations, P400-92-029 Compliance Forms August 2001 A-33 INSTALLATION CERTIFICATE (Page 12 of 13) CF-6R Site Address A-11 Permit Number The following is an explanation of many of the input values required on this form: WATER HEATING SYSTEMS Distribution Systems Refer to Residential Manual for more details: 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 Information Needed Energy 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-I R OR Installed weighted average U-Factor for the total fenestration area is less than orequal to value from CF-I R SHGC: Installed SHGC must be less than or equal to value from CF-iR OR Instal led 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-I R 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 Compliance Forms August 2001 A-34 INSTALLATION CERTIFICATE (Page 13 of 13) CF-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: Access cover required to facilitate verification. 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-1 R)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-1 R)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. Compliance Forms August 2001 A-35 s CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page I of 3) CF-1R r - Project Title Date v >7­9S n ��. �3 � Project Addre4 Building Permit# Documentation Author Telephone Plan Check/Date Field Check/Date Compliance Method(Package or Computer) Climate Zone Enforcement gency se only GENERAL INFORMATION Total Conditioned Floor Area ft2 Average Ceiling Height:_ 0 ft Conditioned Slab Floor Area_ - ft Building Type: _,K_Single Family Addition (check one or more) Multi-Family Existing-Plus-Addition Front Orientation: North/South/East/West/All Orientations (input front orientation in degrees from True North and circle one) Number of Stories Number of Dwelling Units: 41 -- Floor Construction Type: Slabised Floor a one or both) RADIANT BARRIER(required in climate zones 2,_4,8-15) Required for this submittal_yes no BUILDING ENVELOPE INSULATION Component Frame Type Cavity Sheathing Total R- Assembly Location/Comments Type wd=wood Insulation Insulation Value' U-Factor' (attic,garage,typical,etc.) stl=steel R-Value R-Value Wall Wall Roof s^� Roof Floor Floor i Slab Edge For prescriptive compliance T,�tal R-Value and Assembly U-Factor are not required for a wood-frarned wall that meets cavity R-value insulation requirements for the Prescriptive Package. FENESTRATION ShadinPr Devices Fenestration Orien- Area Fenestration Fenestration Exterior Overhangs/ #!T e/Pos. tation ft2U-Factor SHGC Shading Att. Fins Front Front Left Left Rear Rear Right Right Skylight Skylight Compliance Forms August 2001 A-2 CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 2/of 3) CF-1R Project Title I Dam HVAC SYSTEMS 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 (split or package) -� P M,-,xF osj, .- 1 -?.— & SSG, Cooling Equipment Minimum Duct Heat Pump Type(air conditioner, Efficiency Location Duct Thermostat Configuration heat pump,evap.cooling) (SEER) (attic,etc.) R-Value Type (split or packs c) SEALED DUCTS and TXVs (or Alternative Measures) Sealed Ducts(all climate wries) (installer testing and certification and EIERS rater field verification required) ,(( "r TXVs,readily accessible(climate zones 2 and 8-15 only) (Installer testing and certification and ETERS Rater or field verification required) Refrigerant Charge/Air Flow(climate zones 2 and 8-15 only) (installer testing and certification and HERS Rater or field verification required) OR 1 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 Type Type in System or Btu/hr) (gallons) Efficiency Loss(%) R-Value 1. 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 Btulhr),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,Sealed Ducts,Radiant Barriers(see installation requirements for radiant barriers in Section 8.13 of the 200 1 Residential Manual). Package C: thermal mass(thermal mass type,covering,thickness,and description). Compliance Forms August 2001 A-3 i CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 3) CF-1R 10 -2-1 ( � - Project Title Date / 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. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that is varied is indicated in the Special Features/Remarks section.The undersigned recognize that compliance using duct sealing and TXVs requires installer testing and certification and field verification by an approved HERS rater. Designer or Owner(per Business and Professions Code) Documentation Author Name: Name: Title/Firm:tr-- Title/Firm: Address: �%L 'r/f Address: c) Telephone: ✓ 6Z-Z go Telephone: l.ic. f (d e) l (signature) (date) Enforcement Agency Name: Title: Agency: Telephone: (signature/stamp) (date) Compliance Forms August 2001 A-4 1 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems,Ducts and Fans Pae 1 of 2 Site Address- eat Agency: 71 -3 Permit Number: o ?� lti?fi— Gtr o 5V/o Space Conditioning Systems Heating Equipment Duct Efficiency Location Equip (AFUE, (attic, Type ARI #of etc.)I,i crawl- Heating Heating (package- CEC Certified Mfr.Name Reference Identical (zCF-IR space, Duct Load Capacity heat um and Model Number Number 2 systems value° etc.) R-value Btu/hr Btuihr SSS C&4 100�, o i- L 6:-tp> rel,aC40 (00 0o 0 G�►' t /Z-- 4t A S 7 Cooling Equipment Efficiency Duct Equip (SEER Location Type and EER) (attic, (package #of 1'3 crawl- Cooling Cooling heat CEC Certified Mfr.Name ARI Reference Identical (aCF-IR space, Duct Load Capacity um and Model Number Number 2 Systems value)° etc. R-value Btu/hr Btu/hr ' L4A69 34-0tc-3 14C 04 13 iG PE, Qe';0nc' e 000 E 1. If project is new construction, see Footnotes to Slandards Table 151-B and Table ISI-C for duct ceiling alternative compliance. 2.ARI Reference Number can be found by entering the equipment model number at hitp:,1/www.aridireclory"org/arilac.php# 3.Listed efficiency on this page must be greater than or equal(>_)to the val:ee shown on the CF-1 R form. 4. When CF-1R is reference it is also applicable to the CF-1R, CF-IR-AA or CF-IR-ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM ❑ §110-§113:HVAC equipment is certified by the California Energy Commission. ❑ §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE,SMACNA,or ACCA. ❑ §I50(i):Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of§112(c). ❑ §1500)2:Pipe insulation for cooling system refrigerant suction,chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 .Space Conditioning Systems,Ducts and Fans (Page 2 of 2 Site Address: Enforcement Agency: Permit Number: VIJ. r4'J Ducts and Fans % Ll 1 ):Duct and Fans Eff 1.All air-distribution system ducts and plenums installed,sealed and insulated to meet the requirements of CMC Sections 601,602,603,604,605 and Standard 6-5;supply-air and return-air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic,tape or other duct-closure system that meets the applicable requirements of UL 181,UL 181 A,or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch,the com ination of mastic and either mesh or tape shall be used;and I.Building cavities,support platforms for air handlers,and plenums defined or constructed with materials other than sealed sheet metal,duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to causp,reductions in the cross-sectional area of the ducts. ET'2D.Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct pes unless such tape is used in combination with mastic and draw bands. r,�,/7.Exhaust fan systems have back draft or automatic dampers. L( 8.Gravity ventilating systems serving conditioned space have either automatic or readily accessible,manually operated dampers. b"'9.Protection of Insulation. Insulation shall be protected from damage,including that due to sunlight,moisture, equipment maintenance,and wind.Cellular foam insulation shall be protected as above or painted with a coating that is w,_ate E pre ' tardant and provides shielding from solar radiation that can cause degradation of the material. 10.Flexible ducts cannot have porous inner cores. DECLARATION STATEMENT • 1 certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct. • I am eligible under Division 3 ofthe Business and Professions Code to accept responsibility for construction,or an authorized representative of the person responsible for construction(responsible person). • I certify that the installed features,materials,components,or manufactured devices identified on this certificate(thc installation) conforms to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the enforcement agency. • 1 reviewed a copy of the Certificate of Compliance(CF-1 R)form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the Cl--IR that apply to the installation have been met. • 1 will ensure that a completed,signed copy of this Installation Certificate shall be posted,or made available with the building permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) le f4E-A`,&,k5 k 147R— CQti 6l7/oA_)rrUL:, Responsible Person's Name: Responsible Person's 'g CSLB License: Date Signed: Position With Co any(Title): 7Ll 3 Z gg c)i,VtiF 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE C'F-6R-LTGOI Residential Lighting (Page 1 of 3 Site Address: - Enforcement Agency: Permit Number. - !o 229 Scenic. 61YA- oSv/v 1.Kitchen Lighting Does project include kitchen fighting? 19 Yes,complete section 1 ❑No,go on to section 2 19 Yes §150(k)3:The wattage of permanently installed luminaires Oighting fixtures has been determined as TScified by§130(d). ❑Yes ®No §150(k)3:In the kitchen,are there electrical boxes finished with a blank cover or where no electrical equipment has been installed,and where the electrical box can be used for a luminaire or a surface mounted ceiling fan?If yes,the following row must also be es: ❑Yes ®NA Wattage has been calculated as 180 watts of low efficacy lighting blank electrical box. §150(k)8 Kitchen Lighting must comply with either method(a),(b),or(c)below: (a)All high efficacy luminaires F14 Yes,complies because only high efficacy luminaires have been installed in the kitchen. ❑ No,complies with method or c). (b)_>50%watts used by high efficacy luminaires R Yes,complies because at least 50%of the installed watts are from permanently installed high efficacy luminaires as demonstrated in the table below:Total A>Total B. ❑ No,complies with method a or c). Fill out the following table if complying with either method(b)or(c). Table Efficacy Luminaire Type High Low Watts x Quantity High Efficacy Watts or Low Efficacy Watts (1L(Ris a ❑ Z�j x D = t D Or ❑ ❑ x = v or ❑ ❑ x = or ❑ ❑ x — or ° ❑ x = or Complies with method(b)if A>_B Total: A: -2-613 _> B: Mokt— (c)Additional Kitchen Low Efficacy Lighting 12 Yes,complies because the kitchen lighting qualifies for additional low efficacy lighting and as demonstrated in table in above and the table in c low that A+C >_B ❑ No,complies with method a or Additional kitchen low efficacy lighting is available only if all of the following are true: ❑ Yes. All low efficacy luminaires in the kitchen are controlled by a vacancy sensor Dimmer energy management control system(EMCs)or a multi-scene programmable control system. 10 Yes. Permanently installed luminaires in garages laundry rooms closets greater than 70 square feet and utility rooms are high efficacy luminaires AND are controlled by a vacancy sensor. Table c Use 50 W for dwelling units<_2,500 From the Table in ) Use 100 W for dwelling units>2,500 If Add YeslNo? A B C A+C Is(A+C)>B? 2.Lighting Internal to Cabinets Does project includes lighting internal to cabinets? ❑Yes, complete section 2 53 No,Fo on to section 3 ❑Yes §150(k)9:Permanently installed lighting internal to cabinets uses:5 20 watts of power per linear foot of illuminated cabinet. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE ''F-6R-LTG01 Residential Lighting (Page 2 of 3' Site Address: Enforcement Agency: Permit Number: /6 X-q .5'caxtic. r tri 3.Installed Devices and Components Have Been Certified to the Energy Commission Does the pro'ect include any of the devices or components listed blow?❑Yes,complete section 3 61 No,go on to section 4 ❑ Yes §119 and§150(k)7(F):Any of the following devices and components which have been installed have been certified to the Energy Commission according to the applicable provisions of§119:All LED lighting systems that are classified as high efficacy,ballasts used in recessed luminaires, vacancy sensors automatic off/manual on occupant sensors),dimmers,track lighting integral current limiters,and outdoor motion sensors. 4.Lighting Controls Complete section 4 14 Yes ❑ NA §150(k)7A:Permanently installed low efficacy luminaires are controlled by switches separate from those controlling high efficacy luminaires. Q Yes ❑ NA §150(k)7B:Exhaust fans with integral lighting systems are switched separately from lighting systems,OR have a lighting system that can be manually turned on and off while allowing the fan to continue to operate for an extended period of time. ® Yes ❑ NA §I50(k)7C:All permanently installed luminaires are switched with readily accessible controls that permit the luminaires to be manually switched on and off. ® Yes ❑ NA §150(k)7D:All lighting controls have been installed in accordance with the manufacturer's instructions. ® Yes ❑ NA §150(k)7E:All lighting circuits that are controlled by more than one switch,where a dimmer or vacancy sensor has been installed to comply with§150(k),no controls bypass the dimmer or vacancy sensor functions. 5.Luminaires(Lighting Fixtures) Does the project include the installation of any luminaires indoor or outdoor? Q Yes,complete section 5 ❑No,go on to section 6 ®Yes,high efficacy luminaire classification has been determined according to§150(k)1,and low efficacy htminaire classification has been determined according to§150(k)2. * Yes ❑ NA §150(k)4:Fluorescent lamps rated 13 watts or greater have an electronic ballasts having an output frequency no less than 20 kHz. ❑ Yes CKNA §150(k)5:Permanently installed night lights,and night lights integral to permanently installed luminaires or exhaust fans, contain only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and do not contain a line-voltage socket or line voltage lamp holder,OR the night light is mated to consume no more than 5 watts of power and does not contain a medium screw-base socket. ❑ Yes 01 NA §I50(k)6: Lighting integral to exhaust fans,in rooms other than kitchens,meet the applicable requirements of§150(k). ❑ Yes R NA Any electrical box finished with a blank cover or where no electrical equipment has been installed,and where the electrical box can be used for a luminaire or a surface mounted ceiling fan,has been treated as low efficacy luminaires for compliance with§150(k). Does the project include any luminaires that are recessed into insulated ceilings? Ig Yes,complete the rest of section 5 ❑No,go on to section 6 ld Yes,§150(k)l2: Luminaires that are recessed into insulated ceilings meet all of the following conditions: 53 Yes,are listed,as defined in§101,for zero clearance insulation contact(IC)by UL or other nationally recognized testing/rating laboratory,and ja Yes,have labels that certify the luminaires are airtight with air leakage less than 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283(Exhaust fan housings are not required to be certified airtight),and 14 Yes,are sealed with a gasket or caulk between hmminaire housings and the ceiling,and all air leak paths between conditioned and unconditioned spaces have been sealed with a gasket or caulk.(including all exhaust fan housings),and Yes,allows ballast maintenance and replacement to be readily accessible to building occupants from below the ceiling without requiring the cutting of holes in the ceiling. 6.Indoor Lighting(any indoor room that is not a kitchen) Does the project include permanently installed luminaires in any room that is not a kitchen? ®Yes,complete section 6 ❑No,go on to section 7 jd Yes ❑ NA §150(k)10:Permanently installed luminaires in bathrooms,garages,laundry rooms,closets>70 ft',and utility rooms are high efficacy luminaires OR are controlled by a vacancy sensor. CK Yes ❑ NA §150(k)11:Permanently installed luminaires located in rooms or areas other than in kitchens,bathrooms,garages,laundry rooms,closets,and utility rooms are high efficacy luminaires,OR are controlled by a dimmer switch OR are controlled by a vacancy sensor. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-LTG-01 Residential Lighting (Page 3 of 3 Site Address: Enforcement Agency: Permit Number. -!6++g�- B C rt�tio 7.Outdoor Lighting Does the project include any permanend installed outdoor lighting?. iQ Yes,complete section 7 ❑No,go on to section 8 B.Yes ❑ NA- §150(k)13:Luminaires providing outdoor lighting,including outdoor lighting for private patios on low-rise residential buildings with four or more dwelling units,entrances,balconies,and porches,and which are permanently mounted to a residential building or to other buildings on the same lot are high efficacy luminaires OR are controlled by a manual on/offswitch,plus a motion sensor not having an override or bypass switch that disables the motion sensor,plus one of the following three additional control methods: a. A photocontrol that does not have an override or bypass switch that disables the photocontrol;or b. An astronomical time clock not having an override or bypass switch that disables the astronomical time clock; or C. Energy management controls systems(FMCS)not having an override or bypass switch that allows the luminaire to be always on. ❑ Yes IR NA Exception 2: Low efficacy outdoor luminaires used to comply with Exception 1 to§1 50(k)l 3 are controlled by an override switch which temporarily bypasses the motion sensing function,and the motion sensor is automatically reactivated within six hours.The luminaire is controlled by a photocontrol,astronomical time clock,or EMCS as required by Exception 1 to §150(k)13. ❑ Yes ® NA Exception 3: There are permanently installed luminaires in or around swimming pools,water features,or other locations subject to Article 680 of the California Electric Code which do not need to be high efficacy luminaires_ ❑ Yes IRNA §150(k)14: Internally illuminated address signs comply with§148,OR do not contain a screw-base socket and consume no more than 5 watts of power as determined according to§130(d). ❑Yes 14 NA §I50(k)15 Lighting for parking lots and carports with a total of 8 or more vehicles per site have lighting that complies with §130,132,134, and 147.Lighting for parking garages for 8 or more vehicles comply with§130,131, 134,and 146. If yes,the Nonresidential compliance forms must be submitted 8.Common areas of low-rise residential buildings Does the project include the installation of anluminaires in common areas of low-rise residential buildings? ❑Yes,complete section 8 M No,go on to section 9 ❑ Yes,§150(k)16: Permanently installed lighting in the enclosed,non-dwelling spaces of low-rise residential buildings with four or more dwelling units shall be high efficacy luminaires OR are controlled by occupant sensor(s)certified to comply with§119(d). DECLARATION STATEMENT • I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct. I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized representative of the person responsible for construction(responsible person). • I certify that the installed features,materials,components,or manufactured devices identified on this certificate(the installation)conforms to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance(CF-1 R)form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF-1R that apply to the installation have been met. I will ensure that a completed,signed copy of this Installation Certificate shall be posted,or made available with the building permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) S W F Aa0A<AS Z'VL Responsible Person's Name: Responsi �Iture: to I CSLB License:I Date Signed: Position With Company(Title): —LV n ..M, 2008 Residential Compliance Forms August 2009 F f INSTALLATION CERTIFICATE CF-6R-MECH-01 Domestic Hot Water(DHW) (Pae 1 of 2 Site Address: !� Enforcement Agency: Permit Number. Z- ! / 114 �t /J 1. WATER LTING SYSTEMS: 7 Distribution Rated CEC Type If #of Input(kW Tank Standby Heater Certified Mfr Name&Model (Std,Point-of- Recirculation, Identical or Volume Efficiency Loss Type Number Use,etc) Control Type Systems Btuthr)) (gallons) (EF,RE) (%)] NK GCg� -7,<,- ISO Note 1:For small gas storage(rated input less than or equal to 75,000 Btu/hr),electric resistance and heat pump water heaters, list Energy Factor(EF).For large gas storage water heaters(rated input ofgreater than 75,000 Biu/hr), list Recovery Efficiency(RE), Thermal Efficiency,Standby Loss and Rated Input. For instantaneous gas water heaters, list the Thermal Efciency and Rated Input. 2. Mandatory Measures TO COMPLY-ALL BOXES MUST BE CHECKED ❑ §110-§113:Water heaters,showerhead and faucets are certified by the California Energy Commission. §1506): Water System Pipe and Tank Insulation.And Cooling Line Insulation 1. Storage tank insulation ❑ A.Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped with insulation having an installed thermal resistance of R-12 or greater;and ❑ B.Unfired storage tanks or other indirect hot water tanks have R-12 external insulation or R-16 internal insulation where the internal insulation R-value is indicated on the exterior of the tank. 2. Water piping and cooling system line insulation thickness and conductivity First 5 feet of hot and cold water pipes closest to water heater tank,non-recirculating systems,and entire length of recirculating sections of hot water pipes are insulated per Standards Table 150-13;and ❑ Pipe insulation for steam hydronic heating systems or hot water systems>15 psi,meets the requirements of Standards Table 123-A. ❑ Insulation is protected from damage, including that due to sunlight,moisture,equipment maintenance,and wind. ❑ §151(f)8D:If indicated on the CF-1R,all hot water piping that runs from the hot water source to the kitchen fixtures is insulated per Standards Table 150-13. 2008 Residential Compliance Forms August 2009 1 INSTALLATION CERTIFICATE CF-6R-MECH-01 Domestic Hot Water(DHW) (Pa e 2 of 2 Site Address: ,, �,�., Enforcement Agency: Permit Number: Z1 ,S' rte. r L/4, j0050 lob 3. Central Wat r Heating in Buildings with Multiple Dwelling Units(required for prescriptive) TO COMPLY-ALL BOXES MUST BE CHECKED All hot water piping in main circulating loop is insulated to requirements of§1500) ❑ Central hot water systems serving six or fewer dwelling units which have(1)less than 25' of distribution piping outdoors;(2)zero distribution piping underground;(3)no recirculation pump;and(4)insulation on distribution piping that meets the requirements of Section 1500) ❑ Central hot water systems serving more than 6 dwelling units- presence of either a time control or a time/temperature control DECLARATION STATEMENT • 1 certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized representative of the person responsible for construction(responsible person). • l certify that the installed features,materials,components,or manufactured devices identified on this certificate(the installation) conforms to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the enforcement agency. • l reviewed a copy of the Certificate of Compliance(CF-1 R)form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF-IR that apply to the installation have been met. • I will ensure that a completed,signed copy of this Installation Certificate shall be posted,or made available with the building permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) 14f __111( al_rFo i ac- Responsible Person's Name: Responsible Person's Signature: _IV9 rti(F C bre—W z"_W/ CSLB License: Date Signed: Position With Company(Title): 2008 Residential Compliance Forms August 2009 i INSTALLATION CERTIFICATE CF-6R-ENV-01 Envelope—Insulation• Roofing; Fenestration (Page 1 of 3) Site Address: Enforcement Agency: Permit Number: (� �-Z-c� .`AJC �vtil L I�l vL� G..?u' Ifmore than one person has responsibility for installation of the items on this certificate,eack person shall pivpare and sign a certificate applicable to the portion of construction for which they are responsible;aliematively.the person with chief responsibility for constracrion shall prepare and sign this certificate for the entire construction. All applicable Mandatory Measures with check bases require to he checked to ensure the mandato g measures have been met. Description of Insulation 1. RAISED FLOOR Material: Brand Name: Thickness(inches): `I'hennal Resistance(R-Value): q ❑ §I50(d):Minimum R-13 insulation in raised wood-frame floor or equivalent U-factor. 2. SLAB FLOORIPER METER Material: Brand Name: Thickness(inches): Thermal Resistance(R-Value): Perimeter Insulation Depth(inches): ❑ §150(1):Water absorption rate for the insulation material alone without facings is nb greater than 0.3%;water vapor permeance rate is no greater than 2.0 perm/inch and shall be protected frorn physical damage and trV light deterioration. 3. EXTERIOR WALL a.Insulation Type(e.x. Batt,Loose Fill, Spray Foam) a.Thermal Resistance(R-Value): .� b. .Insulation Type(e.x.Batt, Loose Fill,Spray Foam) b.Thermal Resistance(R-Value): Brand: Spray/Loose fill)Installed Actual Thickness Spray/Loose fill) (inches): Contractor's min installed weight/ft Ib Manufacturer's installed weight per square foot to achieve Thermal Resistance(R-Value) ❑ §150(c):Minimum R-13 insulation in wood-frame wall or equivalent 11-factor. Exterior Foam Sheathing(rigid Insolation) Material: Brand Name: Thickness(inches) : Thermal Resistance(R-Value) 4. FOUNDATION WALL Material: Brand Name: Thickness(inches): Thermal Resistance(R-Value): __ 5. CEILING Batt or Blanket Type: (r Brand Name: -3a tL is Loose Fill Type: Thermal Resistance(R-Value): -5 Spray Foam Type: Brand Name: Installed Actual Thickness(inches): Contractor's min installed weight/ft2 Ib Manufacturer's installed weight per square foot to achieve Thermal Resistance(k-Value): ❑ §I50(a):Minimum R-19 insulation in wood-frame ceiling or equivalent U-factor. 6. ATTIC ROOF INSULATION AND/OR ATTIC RADIANT BARRIER Material: Brand Name: Material: Brand Name: Thickness(inches): Thermal Resistance(R-Value): ❑ §I 18(a): insulation installed meets Standards for insulating Material. ❑ §150(8):Mandatory Vapor barrier installed in Climate Zones 14 or 16. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-ENV-01 Envelope—Insulation; Roofing; Fenestration (Page 2 of 3) Site Address: Enforcement Agency: Permit dumber: to 2 Zcj SLS tI iL �lvdf t�u,' vs�+t�t U Description of R Rug Products CRRC Product ID Manufacuver Product Roof Roof Product Initial Solar Aged Solar Thermal Type Information Area Slope Weight' Reflectance Reflectance` Bmittance �a ❑1 ❑a !. The C,RRC Product 1D Number can be obtained front the Cool RoofRating Council's Rated Product Directory of ww.Coo lrtnrfr,org/productsirearch.php 2. The weight in lbs per square feet of the roaling product being installed. 3.Check bar if the Aged Reflectance is a calculated value using the equation Below,faornore 4. 4,lfthe aged reflectance is not available in the Cool RoofRating Council's Rated Product Directory then use the initial reflectance value from the directory and use the equation 0.2+0.7 r —0.2)to obtain a calculated 9&d vahte. ✓OCHECK APPLICABLE BOX BELOW IF EXEMPT FROM THE ROOFING PRODUCT"COOL ROOF"REQUIREMENT ❑ The roof area covered by building integrated photovoltaic panels and building integrated solar thermal panels are exempt from the above Cool Roof criteria. ❑ Roof constructions that have thermal mass over the roof membrane with a weight of at least 25 lb/fl'is exempted from the above Cool Roof criteria. To apply Liquid Field Applied Coatings,the coating must be applied with a ntinintuin dn'"nil thickness of 20 mils across the entire rogf surface and neet ninirnion per arrtuunce requirements listed in§118(i)3 and Table 118-G Select the applicable coating ❑Aluminum-Pi mented Asphalt Roof Coating Cement-Based RoofCoating ❑Other V 13CRRC-1 Labcl Attached to CF-6R (Note f no CRRC-1 label is available,this compliance method cannot be used and another method is required to meet compliance). FENESTRATION/G LAZIN G Product 1F Total Quantity Add.Exterior Comments, Manufacturer/Brand Name U- Product of NFRC of Like Product Area Shading Dev. Location/Special Item GROUP LIKE RODUCTS factor" SHGC" Panes Certified"" O !Lona flr or Overhang Features 2 3 4 5 6 7. ti. T_ 1, Use values from a fenestration product's NFRC Certified Label.For finextrarion producus without as NFRC label,use the d4o ult values front Section 116.Table 116-A and 116-8 of the 2008 Energy Ejliciency Standards. 2.NFRC Label Certificates shall not be removed until the building inspector has yeti ted the a icienc a Enter Yes or No. ❑ §116(a)l:Doors anti windows between conditioned and unconditioned spaces designed to limit air leakage. ❑§I 16(x)2 and 3:Actual fenestration products installed are equivalent to or have a lower U-factor andfor a lower S14GC than that specified an the Certificate ofCornpliance(Form CF-1R). ❑§116(&)4:Fenestration products(except field-fabricated windows)have a label listing the certified U-Factor,certified Solar Heat Gain Coefficient(SHGC),and infiltration that meets the requirements of§10.11 l(a) ❑§117:Exterior doors and windows weather-stripped;all joints and penetrations caulked and sealed. 2008 Residential Compliance Forms August 2009 t INSTALLATION CERTIFICATE CF-6R-ENV-01 Envelope—Insulation; Roofin • Fenestration (Page 3 of 3) Site Address: Enforcement Agency: Permit Number: I U ZZ9 ce "L."C. 161C.1i „., DECLARATION STATEMENT • 1 certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct, • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized representative of the person responsible for construction(responsible person). • I certify that the installed features,materials,components,or manufactured devices identified on this certificate(the installation)conforms to all applicable codes and regulations,and the installation is consistent with the plans end specifications approved by the enforcement agency. • l reviewed a copy of the Certificate of Compliance(CF-IR)form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF-1R that apply to the installation have been met. • 1 will ensure that a completed,signed copy of this Installation Certificate shall be posted,or made available with the building permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. 1 understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Companame: (installing Subcontractor or General Contractor or Builder/Owner) Li!)r 1 ' RcsponPerson's me: Responsible erso 'e S' ndt sib CSLB License; Date Signed: Position Will t e : 7 . Company t_ 2008 Residential Compliance Forms August 2009 l t Me"i�wcy: Permit Nuvaber-. 17*olTcl ketiic 81v(4, If morr dhaar one ops last idstldr - or injudiation ca the bew on this_. ' t to the ierur a a:rattSttarctrtrrt,ear wdritr-h they are rr tble,.trite t�F•ate, each person steal!prepare and sign a c°ertfuate f � yf l s c�rrt- t part f �" est' rnattvwty. the person with chief responsibilikyl6r coxitrur4on shg dl prepare and sign this c eraiftcaie for the entire con ruction. All applicable MandatvrY Meamres with check 1xxtes are required to be checked to e tetar the taaaatur&ttetr measum haw been met. MUNG INSUIAMN Rigid: .� ._.� _�.�. _ Brand Name: Batt or Blanket Type: Bnmd Namc: Loose Fill Type: Thennal Resistancc (R-Valuc): Spray Edam 7pe Brand Nasik: Installed Actual Thickness(incites): Ca auc is min installed weight/W__^___ib Manufactumr's installed weight per square foot to achieve Thernietl R,esista a (R-Value): d 150(a): M' " R-19 insulation in wt►od-fratttae coling or equivalent U-fwtor. U 118(a): Inw1ation installed mesas Standards for In adating Material. 0 §lAg): Mandistory Vapor bar er instal'led m C`listtm Zotte* 14 or 16, ROOMG PROMC M(COOL ROOFS)jrsion Q Cbeck this box if the newly installod maf i:;exempted from the roofing product `Cool Moroi"require:mcnts as indicated on the CF-I R-Alt- Reroof form for this project.(dierwiw fill in the table below, Rod Supe Product Weight Aged Soler TbermW S� CRRC�sut ID Number' 0 2:12 >2:12 < S1bM2 £1 SW ProProduct,'1`ype't ltasllwietauueyc'''s Baothtausee T... i.CR 1 Wad rs avaPhOe is on the pwkW at the roaflog pr"" aasd attach the CRRC low to two rano. 2-Indkoe the type of prradua it being aced fear the roof tap, i.e. single-ptv roof, asphalt roof, metal rrwf, etc. . if the Aged Refteckosce is not av ailcabie its the Cool Roof Rating Council's Rated Nroefrtct Directory then uu the Initial Resflectance wslae from the saute dlrecomy and at ohne equation(112+0,7(t 0.2)to obtain a c akalatesd aged value_ Where :,is the Initial SSvtar Reflectance. e Check bat if the Aged fielleciance it a cakwilated w&e asing the tfatt o apply I.qWd Fhtid AppOW CewdW the coating must be applied across the entire roof surface and meet ttre dry argil thickness or coverage by the coatings manufacturer and aim minimum perfornum a reguiren"is listed in I I tg(i)t„ %cicct the upplwable a:im"sig.- Ampbadt lkttaf�ng cement-Based Roof Coating MC MT"STATEAWNT • 1 certify under penalty of perjury,under the laws of the State of C:.aliferttia,the information provided on this forma is tnte and Wit. • 1 assn eligsbuc under Division 3 of dw I3ucinaus and 3'rofessions Code to accept responsibitity for constntction,or ars authorised reprcientative of nide person responxibit for construction(rear ponable person). • t certifythat the instatlWd feature,,,materials,components,or manufactured devises identified on oris certificate(the installation)conforttat, to all applicab4c codon and regulations,and the installation is consistent with the plans,and specifications approved by dw enforcement Remy. V I reviewed a copy of the Certificate of Compliarsce(CF-IR)foam approved by the enforcement agency that identifies ft specific rssquui for the itsstallation. t certify the the requirements detailed an the(37-1 R than apply to the instaIlation have been met, • 1 Bei ll arauttat+t+flat a campkiod,Aped cry of this latstatllaation C.etrt4nidal"be posted,or as m&aarallable with dac pernigs)houell for the baalh Mn&add anside atvailatlAe to the enforcement.Verney for doll Opp"citbtiae h uttpectiom 1 tsnd"Itmd that a cM of this hoWltation Ceetificate h required to be inclutted rehh the doctam t ea the blander pirovida to the bWMWg awnasr at Occupancy. Cornpany_N arnec (lnsm1 ing Subcom or General Contractor or Ouilde:rtOwner) iOw Respoosi `s Name- Resportsibl C I.I34l DateMal- 4 Position Witt 4mpatny(Title): 2010 CALGREEN RESIDENTIAL CHECKLIST — MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 (408)777-3228-FAX(408)777-3333•building(cDcupertino.or4 PURPOSE: The 2010 CalGreen Code applies to all newly constructed hotels, motels, lodging houses, dwellings, dormitories, condominiums, shelters, congregate residences, employee housing, factory-built housing and other types of swellings with sleeping accommodations and new accessory buildings associated with such uses. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the requirements of CALGreen. Project Name: Project Address: 10 C V,Lrlj/ 17 t/r�. LA4(2,t-)`n o Project Description: a -21 t OVA Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the 2010 California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Department, the licensed professional shall complete Column 3 and sign and date Section 2 -Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Re uirements A4.1 PLANNING AND DESIGN a 777 PMeirtd �rr� rtSIteFr ervetiani r. 4.104.1 A site plan and inventory of the site is developed and used to minimize site disturbance in order preserve desirable existing natural resources and QX minimize future adverse effects on the proposed structure. , - n 1 {h I��anning aid Dsrgn:4 Srte,Development; 4.106.2 A plan is developed and implemented to manage storm water drainage during construction. 4.106.3 The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how site grading or a drainage OX system will manage all surface water flows. Page 1 of 5 CalGreen_2010.doc revised 08/27/11 A4.2 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by the California Energy Standards. A4.3 WATERAND CONSERVATION t` .fl"k �17dQQrulf�tet�tse I3� A 5tlE � 5&LN 4.303.1 Indoor water use shall be reduced by at least 20 percent using one of the follow methods. ❑ Water saving fixtures or flow restrictors shall be used per Table 4.303.2. D ❑ A 20 percent reduction in baseline water use shall be demonstrated per As of 7/01/2011 Table 4.303.1. 4.303.2 When using the calculation method specified in Section 4.303.1, multiple showerheads shall not exceed maximum flow rates. As of 7/01/2011 4.303.3 Plumbing fixtures(water closets and urinals) and fittings(faucets and showerheads)shall comply with specified performance requirements. As of 7/01/2011 ¢ firy 5 ry 4.304.1 Automatic irrigation systems installed at the time of final inspection shall be weather-based. A4.4 MATERIAL CONSERVATION AND RESOURCE EFFICIENCY im l~�ii(h C��rrhiiity anc� ed Maine�n art 4.406.1 Joints and openings.Annular spaces around pipes, electric cables, conduits, or other openings in plates at exterior walls shall be protected against the passage of rodents by closing such openings with cement mortar, concrete masonry or similar method acceptable to the enforcing agency. D�ihtctan 1A�aste Reduction, Dsd Re ► liing 4.408.2 Where a local jurisdiction does not have a construction and demolition waste management ordinance, a construction waste management plan shall X❑ be submitted for approval to the enforcing agency. �u'i ing;Maintelariice aria Operation 4.410.1 An operation and maintenance manual shall be provided to the building occupant or owner. Page 2 of 5 CalGreen 2010.doc revised 08/27/11 ENVIRONMENTAL QUALITY h we « & a psj�' 4I 4.503.1 Install only a direct-vent sealed-combustion gas or sealed wood- burning fireplace, or a sealed woodstove. SCJ lbl �>!1t r�rr trbl K r r, e to 4.504.1 Duct openings and other related air distribution component openings r-�f shall be covered during construction. NJ 4.504.2.1 Adhesives, sealants and caulks shall be compliant with VOC and ref other toxic compound limits. NJ 4.504.2.2 Paints, stains and other coatings shall be compliant with VOC limits. 0 4.504.2.3 Aerosol paints and other coatings shall be compliant with product 0 weighted MIR Limits for ROC and other toxic compounds. 4.504.2.4 Documentation shall be provided to verify that compliant VOC limit ref finish materials have been used. LTJ 4.504.3 Carpet and carpet systems shall be compliant with VOC limits. 0 4.504.4 Fifty (50) percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance Schools(CHPS) Low-emitting Materials List or be certified under the Resilient Floor Covering Institute(RCFI) FloorScore program. 4.504.5 Particleboard, medium density fiberboard (MDF), and hardwood plywood used in interior finish systems shall comply with low formaldehyde ❑X emission standards. 1>iteT car I st 4T Cohtir01 4.505.2 Vapor retarder and capillary break is installed at slab on grade foundations. ❑X 4.505.3 Moisture content of building materials used in wall and floor framing is checked before enclosure. Page 3 of 5 CalGreen 2010.doc revised 08/27/11 � >t111 $EX �ts�ta s r 4.506.1 Exhaust fans which terminate outside the building are provided in every bathroom. 1 h 4 4.507.1 Whole house exhaust fans shall have insulated louvers or covers which close when the fan is off. Covers or louvers shall have a minimum ❑X insulation value of R-4.2. 4.507.2. Duct systems are sized and designed and equipment is selected using the following methods: 1. Establish heat loss and heat gain values according to ACCA Manual J orj equivalent. uu 2. Size duct systems according to ACCA 29-D(Manual D) or equivalent. 3. Select heating and cooling equipment according to ACCA 36-S (Manual S) or equivalent. INSTALLER AND SPECIAL INSPECTOR QUALIFICATIONS ilk"'tWe"'-"C' qz'" x. -.: 2 p'"� ^a.0 t �`a :" QU���C �115i h, a u w y 702.1 HVAC system installers are trained and certified in the proper installation of HVAC systems. 702.2 The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the discipline they inspect ❑X and verify. ,�3 tim r `�Q� X 1�efaitils, .z ,; "`.xaL 703.1 Verification of compliance with CALGreen may include construction documents, plans, specifications, builder or installer certification, inspection / reports, or other methods acceptable to the enforcing agency which show substantial conformance. Implementation verification shall be submitted to the Building Department after implementation of all required measures and prior to final inspection approval. Page 4 of 5 CalGreen 2010.doc revised 08/27/11 CALGRE 1P1�EN SIGNATURE DECLARATIONS VQ Project Name: u 1 d a\ Q 1 Project Address: k O `L2 9 'S C Z>n i C AVO\ Project Description: NAW Y r 112 SECTION 1 — DESIGN VERIFICATION Complete all lines of Section 1 —"Design Verification"and submit the completed checklist(Columns 1 and 2)with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with the requirements set forth in the 2010 California Green Building Standards Code as adopted by the City of Cupertino. Owner's Signature Date Owner's Name (Please Print) _Z--)L r Design Profession�al_'s Signature Date io v�Q Design Professional's Name (Please Print) Signat re of License Professional responsible for CalGreen compliance Date . o blikp Name of License Professional responsible for CalGreen compliance(Please Print) Phone -PA1M l�-� t2{. i i I » LCTM, Email Address for License Professional responsible for CalGreen compliance SECTION 2 — IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3,together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2010 C lifornia Green Building Standards Code as adopted by the City of Cupertino. Signat a of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance(Please Print) Phone i( '' c7+\ Email Address for License Professi I responsible for CalGreen compliance Page 5 of 5 CalGreen 20i0.doc revised 08127111 May 01 2014 1:51PM 1408-774-9888 page 1 UTILITY RELEASE REQUEST FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR,P.E.,C.B.O., BUILDING OFFICIAL CUPERTINO 10300TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228•FAX(408)777-3333•buildina(&cupertino.era PURPOSE For residential single family or duplex construction,there are cases where gas and electric utilities are requested to be released prior to the issuance of the certificate of occupancy. Upon approval from the building inspector,the City of Cupertino is allowing both utilities to be released prior to the final sign-off of the building. INSTRUCTIONS 1. Download this format: htq�:/hN-xw.cupertino,org/index.aspx'?pale=297. 2. Complete the form and obtain signatures from both the owner of the property and the primary contractor. 3. Fax,E-Mail,Mail or hand deliver the original signed form to: City of Cupertino Building Division Attn: Utility Release Request Form 408-777-3228 office 10300 Torre Ave. 408-777-3333 fax Cupertino,CA 95014 bu:i_lding(d)cupertino.org 4. Schedule a Gas Meter Release inspection(#403)and/or Electric Meter Release inspection(9404). Please note,a Gas Test inspection(#506) is required prior to or at the same time of the Gas Meter Release inspection. BUILDING INFORMATION (Please complete the following information): APN BLDGERhMIT 0: DATE: S 0 O f by IV . OZZSITE SGQ ) ( , nADDRESS: 1- �4r OWNER'S NAME: /1 IIQYA FPHON AX#E# MAILING ADDRESS(if different from site address): CONTRACTOR: PHONE#: FAX#: CONTACT: �II PHONE M c l n C p S tk FAX#: I request the City to release my utilities prior to obtaining a final inspection approval for the building. I fully understand the occupants of the building cannot move into the residence until they receive all of the required final sign-offs and the City has issued a certificate of occupancyfor the building. Owner: ...........Print: ./..-T.d.Q/�. H:��u .Date: S v� 20 r.� Contractor.. .Print: .Date: UrilioAeleaseForni_2011.doc revised 08/09/11 OWNER-BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228-FAX(408)777-3333•building(c)_cupertino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESSAPN BP# o (3os�oi o� OWNER NAME �. OWNER ADDRESS DESCRIPTION OF WORK: '.(}L) l C 17,715 G We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed,and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS:Please read and initial each statement below to signify you understand or verify this information.) (A+1. I.understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. �'C,`H-2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. C-A3. 1 understand as an"Owner-Builder' I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. C;&-L,4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. CA 5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered.an "employer"under state and federal law. C.1 _6. 1 understand if I am considered an"employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. i understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 8. 1 understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s)that result from any latent construction defects in the workmanship or materials. OwnerBuilderForm 2010.doc revised 04/14/10 I understand I may obtain more information regarding my obligations as an "employer"from the Internal Revenue Service,the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB(2752) or www.cslb.ca.gov for more information about licensed contractors. G`U90. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. CA-11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. C N92. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS:Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued,this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the ' may be required to be presented when the permit is issued to verifythe property owner's si na re 1 Property Owner's Signature: Date: / -7 ( _ -- -- --- --- - - - =--------------------------------------------------------------------------------------- (NOTE: The following Autho-ri-zation-iiaForm-- is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner,the execution of which I understand is my personal responsibility, I hereby authorize the following person(s)to act as my agent(s)to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project(or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: 1 declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: OwnerBuilderForm 2010.doc revised 04/14/10 BUILDING ENERGY ANALYSIS REPORT PROJECT: Hsu Residence 10229 Scenic Blvd Cupertino, CA 95014 Project Designer: H.M.C. Associates, LLP 12280 Saratoga -Sunnyvale Rd #209 Saratoga, CA 95070 408-446-8418 Report Prepared by: H.M.C. Associates, LLP SUB` F I I TAS. 1 Job Number: 13-006 Date: 5/11/2013 The EnergyPro computer program has been used to perform the calculations summarized in this compliance report.This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards. This program developed by EnergySoft,LLC—www.energysoft.com. EnergyPro5.1 by Ener Soft User Number:6518 RunCode:2013-05-11T17:25:05 ID:13-006 TABLE OF CONTENTS I Cover Page 1 Table of Contents 2 Form CF-1 R Certificate of Compliance 3 Form MF-1 R Mandatory Measures Summary 8 HVAC System Heating and Cooling Loads Summary 11 Room Load Summary 13 Room Heating Peak Loads 15 Room Cooling Peak Loads 17 Form ECON-1 Energy Use and Cost Summary 19 Form UTIL-1 R Utility Incentive Worksheet 20 i I i I I I i EnergyPro 5.1 by EnergySoft Job Number: ID:13-006 User Number:6518 PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF-1 R Project Name Building Type m Single Family ❑Addition Alone Date Hsu Residence ❑ Multi Family ❑ Existing+Addition/Alteration 5/11/2013 Project Address California Energy Climate Zone Total Cond.Floor Area Addition #of Stories 10229 Scenic Blvd Cupertino CA Climate Zone 04 3,689 n/a 2 FIELD INSPECTION ENERGY CHECKLIST ❑ Yes ❑ No HERS Measures -- If Yes, A CF-413 must be provided per Part 2 of 5 of this form. ❑ Yes ❑ No Special Features -- If Yes, see Part 2 of 5 of this form for details. INSULATION Area Special Construction Type Cavity (ft) Features see Part 2 of 5) Status Roof Wood Framed Attic R-38 2,447 Radiant Barrier Venting New Wall Wood Framed R-21 2,963 New Door Opaque Door None 88 New Floor Wood Framed w/Crawl Space R-19 2,462 New FENESTRATION U- Exterior Orientation Area(ft) Factor SHGC Overhang Sidefins Shades Status Skylight 10.0 0.340 0.33 none none None New Front(S) 58.3 0.390 0.37 2.0 2.0/0.0 Bug Screen New Rear(NE) 93.0 0.390 0.37 2.0 2.010.0 Bug Screen New Right(E) 156.0 0.390 0.37 2.0 2.010.0 Bug Screen New Rear(N) 240.0 0.390 0.37 2.0 2.010.0 Bug Screen New Front(S) 56.8 0.390 0.37 2.0 2.010.0 Roll-down Blind or Slats New Left(W) 60.0 0.390 0.37 none none Roll-down Blind or Slats New Rear(N) 41.0 0.390 0.37 2.0 2.0/0.0 Roll-down Blind or Slats New Right(E) 96.3 0.390 0.37 2.0 2.0/0.0 Roll-down Blind or Slats New Skylight 5.3 0.390 0.37 none none None New HVAC SYSTEMS Ot . Heating Min. Eff Cooling Min. Eff Thermostat Status 1 Central Furnace 90%AFUE Split Air Conditioner 13.0 SEER Setback New 1 Central Furnace 90%AFUE Split Air Conditioner 13.0 SEER Setback New HVAC DISTRIBUTION Duct Location Heating Cooling Duct Location R-Value Status HVAC 1 Ducted Ducted Crawlspace 6.0 New HVAC 2 Ducted Ducted Attic,Ceiling Ins, vented 6.0 New WATER HEATING Ot . Type Gallons Min, Eff Distribution Status 1 Small Gas 75 0.52 Kitchen Pipe Ins New Ener Pro 5.1 by Ener Soft User Number:6518 RunCode:2013-05-11 T17:25:05 ID:13-006 Page 3 of 20 PERFORMANCE CERTIFICATE: Residential (Part 2 of 5) CF-1 R Project Name Building Type ® Single Family ❑Addition Alone Date Hsu Residence ❑ Multi Family ❑ Existing+Addition/Alteration 5/11/2013 SPECIAL FEATURES INSPECTION CHECKLIST The enforcement agency should pay special attention to the items specified in this checklist.These items require special written justification and documentation,and special verification to be used with the performance approach.The enforcement agency determines the adequacy of the justification,and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation submitted. The Roof R-38 Roof Attic includes credit for a Radiant Barrier that is Continuous meeting eligibility and installation criteria as specified in Residential Appendix RA4.2.2. The Roof R-38 Roof Attic 1/150 Vent Area requires verification. HERS REQUIRED VERIFICATION Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a completed CF-4R form for each of the measures listed below for final to be given. Ener Pro 5.1 by Ener Soft User Number:6518 RunCode:2013-05-11T17:25:05 ID: 13-006 Pae 4 of 20 PERFORMANCE CERTIFICATE: Residential (Part 3 of 5) CF-1 R Project Name Building Type m Single Family ❑Addition Alone Date Hsu Residence ❑ Multi Family ❑ Existing+Addition/Alteration 5/11/2013 ANNUAL ENERGY USE SUMMARY Standard Proposed Margin TDV kBtu/ft2 r Space Heating 17.00 16.60 0.40 Space Cooling 9.61 3.17 6.44 Fans 4.90 3.43 1.47 Domestic Hot Water 10.71 11.85 -1.14 Pumps 0.00 0.00 0.00 Totals 42.21 35.04 7.17 Percent Better Than Standard: 17.0% BUILDING COMPLIES - NO HERS VERIFICATION REQUIRED Fenestration Building Front Orientation: (S) 180 deg Ext.Walls/Roof Wall Area Area Number of Dwelling Units: 1.00 (S) 953 115 Fuel Available at Site: Natural Gas (w) 234 60 Raised Floor Area: 2,462 (N) 1,659 374 Slab on Grade Area: 0 (E) 1,007 252 Average Ceiling Height: 9.0 Roof 2,462 15 Fenestration Average U-Factor: 0.39 TOTAL: 817 Average SHGC: 0.37 Fenestration/CFA Ratio: 22,1 % REMARKS STATEMENT OF COMPLIANCE This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the Efficiency Standards of the California Code of Regulations. The documentation author hereby certifies that the documentation is accurate and complete. Documentation Author Company H.M.C.Associates,LLP f i ! �, 5/11/2013 Address Name City/State/ZipCity/State/Zip Phone Signed Date "rhe individual with overall design responsibility hereby certifies that the proposed building design represented in this set of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit application, and recognizes that compliance using duct design, duct sealing,verification of refrigerant charge, insulation installation quality, and building envelope sealing require installer testing and certification and field verification by an approved HERS rater. Designer or Owner (per Business & Professions Code) Company H.M.C.Associates,LLP I Address 12280 Saratoga-Sunnyvale Rd#209 Name Mike Chen City/StateiZip Saratoga, CA 95070 Phone 408-446-8418 Signed License# Date Ener Pro 5.1 by Ener Soft User Number:6518 RunCode:2013-05-11 T17:25:05 ID:13-006 Page 5 of 20 CERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF-1 R Project Name Building Type m Single Family ❑Addition Alone Date Hsu Residence ❑ Multi Family ❑ Existing+Addition/Alteration 5/11/2013 OPAQUE SURFACE DETAILS Surface Ll- Insulation Joint Appendix Type Area Factor Cavity Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments Roof 1,133 0.025 R-38 180 30 New 4.2.1-A21 Zone 1 Wall 295 0.069 R-21 180 90 New 4.3.1-A6 Zone 1 Door 45 0.500 None 180 90 New 4.5.1-A4 Zone 1 Wall 632 0.069 R-21 45 90 New 4.3.1-A6 Zone 1 Wall 574 0.069 R-21 90 90 New 4.3.1-A6 Zone 1 Door 43 0.500 None 901 90 1 New 4.5.1-A4 Zone 1 Floor 2,370 0.037 R-19 0 180 New 4.4.1-A4 Zone 1 Wall 141 0.069 R-21 0 90 New 4.3.1-A6 Zone 1 Wall 497 0.069 R-21 180 90 New 4.3.1-A6 Zone 2 Wall 174 0.069 R-21 270 90 New 4.3.1-A6 Zone 2 Wall 513 0.069 R-21 0 90 New 4.3.1-A6 Zone 2 Wall 138 0.069 R-21 90 90 New 4.3.1-A6 Zone 2 Floor 92 0.037 R-19 0 180 New 4.4.1-A4 Zone 2 Roof 1,314 0.025 R-38 01 30 1 New 4.2.1-A21 Zone 2 FENESTRATION SURFACE DETAILS ID Type Area LI-Factor SHGC2 Azm Status Glazing Type Location/Comments 1 Skylight 10.0 0.340 NFRC 0.33 NFRC 180 New Andersen Permashield Zone 1 2 Window 58.3 0.390 NFRC 0.37 NFRC 180 New Milgard Classic Low-E Vinyl Zone 1 3 Window 93.0 0.390 NFRC 0.37 NFRC 45 New Milgard Classic Low-E Vinyl Zone 1 4 Window 156.0 0.390 NFRC 0.37 NFRC 90 New Milgard Classic Low-E Vinyl Zone 1 5 Window 240.0 0.390 NFRC 0.37 NFRC 0 New Milgard Classic Low-E Vinyl Zone 1 6 Window 56.8 0.390 NFRC 0.37 NFRC 180 New Milgard Classic Low-E Vinyl Zone 2 7 Window 60.0 0.390 NFRC 0.37 NFRC 270 New Milgard Classic Low-E Vinyl Zone 2 8 Window 41.0 0.390 NFRC 0.37 NFRC 0 New Milgard Classic Low-E Vinyl Zone 2 9 Window 96.3 0.390 NFRC 0.37 NFRC 90 New Milgard Classic Low-E Vinyl Zone 2 10 Skylight 5.3 0.390 NFRC 0.37 NFRC 0 New Milgard Classic Low-E Vinyl Zone 2 (1) U-Factor Type: 116-A=Default Table from Standards, NFRC=Labeled Value 2 SHGC Type: 116-B=Default Table from Standards, NFRC=Labeled Value EXTERIOR SHADING DETAILS Window Ove hang Left Fin Right Fin ID Exterior Shade Type SHGC H t Wd Len H t LExt REA Dist Len H t Dist Len H t 1 None 1.00 2 Bug Screen 0.76 5.0 0.0 2.0 0.1 2.0 2.0 0.1 2.0 0 0.0 0.0 0 3 Bug Screen 0.76 5.0 0.0 2.0 0.1 2.0 2.0 0.1 2.0 0 0.0 0.0 0 4 Bu Screen 0.76 5.0 0.0 2.0 0.1 2.0 2.0 0.1 2.0 0 0.0 0.0 0 5 Bug Screen 0.76 5.0 0.0 2.0 0.1 2.0 2.0 0.1 2.0 0 0.0 0.0 0 6 Roll-down Blind or Slats 0.13 5.0 0.0 2.0 0.1 2.0 2.0 0.1 2.0 0 0.0 0.0 0 7 Roll-down Blind or Slats 0.13 8 Roll-down Blind or Slats 0.13 4.5 0.0 2.0 0.1 2.0 2.0 0.1 2.0 0 0.0 0.0 0 9 Roll-down Blind or Slats 0.13 5.0 0.0 2.0 0.1 2.0 2.0 0.1 2.0 0 0.0 0.0 0 10 None 1.00 Ener Pro 5.1 by Ener Soft User Number:6518 RunCode:2013-05-11 T17:25:05 ID: 13-006 Pae 6 of 20 CERTIFICATE OF COMPLIANCE: Residential (Part 5 of 5) CF-1 R Project Name Building Type 0 Single Family ❑Addition Alone Date Hsu Residence ❑ Multi Family ❑Existing+Addition/Alteration 5/11/2013 BUILDING ZONE INFORMATION Floor Area ft System Name Zone Name New Existing­_ Altered Removed Volume Year Built HVAC 1 Zone 1 2,370 21,330 HVAC 2 Zone 2 1,319 11,871 Totals 1 3,689 0 01 0 HVAC SYSTEMS System Name Qty. I Heating Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status HVAC 1 1 Central Furnace 90%AFUE Split Air Conditioner 13.0 SEER Setback New HVAC 2 1 Central Furnace 90%AFUE Split Air Conditioner 13.0 SEER Setback New HVAC DISTRIBUTION Duct Ducts System Name Heating Cooling Duct Location R-Value Tested? Status HVAC 1 Ducted Ducted Crawlspace 6.0 ❑ New HVAC 2 Ducted Ducted Attic, Ceiling Ins, vented 6.0 ❑ New WATER HEATING SYSTEMS Ext. Rated Tank Energy Standby Tank Input Cap. Factor Loss or Insul. R- S stem Name Qty. Type Distribution (Btu h) al or RE Pilot Value Status A.0. SMITH FPS-75-230 1 Small Gas Kitchen Pipe Ins 75,000 75 0.52 n/a n/a New MULTI-FAMILY WATER HEATING DETAILS HYDRONIC HEATING SYSTEM PIPING Hot Water Piping Length E ff o E T c Pipe Pipe Insul. Control Qt . HP w a- Plenum Outside Buried ¢ — System Name Length Diameter Thick. ❑ ❑ Ener Pro 5.1 by Ener Soft User Number:6518 RunCode:2013-05-11 T17:25:05 ID. 13-006 Pae 7 of 20 MANDATORY MEASURES SUMMARY: Residential Pae 1 of 3 MF-'I R Project Name Date Hsu Residence 5/11/2013 NOTE:Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of the compliance approach used. More stringent energy measures listed on the Certificate of Compliance(CF-1 R,CF-1 R-ADD,or CF- 1 R-ALT Form)shall supersede the items marked with an asterisk(*)below.This Mandatory Measures Summary shall be incorporated into the permit documents,and the applicable features shall be considered by all parties as minimum component performance specifications whether they are shown elsewhere in the documents or in this summary.Submit all applicable sections of the MF-1 R Form with plans. Building Envelope Measures: 116(a)l: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. §116(a)4: Fenestration products(except field-fabricated windows) have a label listing the certified U-Factor,certified Solar Heat Gain Coefficient SHGC , and infiltration that meets the requirements of 10-111(a). 117: Exterior doors and windows are weather-stripped;all joints and penetrations are caulked and sealed. 118(a): Insulationspecified or installed meets Standards for Insulating Material. Indicate type and include on CF-6R Form. §118(1):The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of§118(1)when the installation of a Cool Roof is specified on the CF-1 R Form. *§1 50 a :Minimum R-19 insulation in wood-frame ceiling orequivalent 1-1-factor. §150(b): Loose fill insulation shall conform with manufacturer's installed design labeled R-Value. *§1 50 c : Minimum R-13 insulation in wood-frame wall orequivalent 1-1-factor. *§1 50 d :Minimum R-13 insulation in raised wood-frame floor orequivalent U-factor. 150(f):Air retarding wrap is tested, labeled,and installed according to ASTM E1677-95 2000 when specified on the CF-1 R Form. 150 : Mandatory Vapor barrier installed in Climate Zones 14 or 16. §150(1):Water absorption rate for slab edge insulation material alone without facings is no greater than 0.3%;water vapor permeance rate is no greater than 2.0perm/inch and shall be protected from physical damage and UV light deterioration. Fireplaces, Decorative Gas Appliances and Gas Log Measures: 150 e 1A:Masonry or factory-built fireplaces have a closable metal or glass door covering the entire opening of the firebox. §150(e)1 B: Masonry or factory-built fireplaces have a combustion outside air intake,which is at least six square inches in area and is equipped with a with a readily accessible,operable,and tight-fitting damper and or a combustion-air control device. §150(e)2:Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket,when that indoor air is vented to the outside of the building,are prohibited. Space Conditioning,Water Heating and Plumbing System Measures: §110-§113:HVAC equipment,water heaters,showerheads,faucets and all other regulated appliances are certified by the Energy Commission. §113(c)5:Water heating recirculation loops serving multiple dwelling units and High-Rise residential occupancies meet the air release valve,backflow prevention, pump isolation valve,and recirculation loop connection requirements of§113(c)5. §115:Continuously burning pilot lights are prohibited for natural gas:fan-type central furnaces, household cooking appliances (appliances with an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt),and pool and spa heaters. §150(h):Heating and/or cooling loads are calculated in accordance with ASHRAE,SMACNA or ACCA. §150(i): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c). §150(j)1 A:Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped with insulation having an installed thermal resistance of R-12 or greater. §150(j)1 B:Unfired storage tanks,such as storage tanks or backup tanks for solar water-heating system,or other indirect hot water tanks have R-12 external insulation or R-16 internal insulation where the internal insulation R-value is indicated on the exterior of the tank. §150(j)2: First 5 feet of hot and cold water pipes closest to water heater tank, non-recirculating systems,and entire length of recirculating sections of hot water pipes are insulated per Standards Table 150-13. §150(j)2:Cooling system piping(suction,chilled water, or brine lines),and piping insulated between heating source and indirect hot water tank shall be insulated to Table 150-B and Equation 150-A. §150(j)2: Pipe insulation for steam hydronic heating systems or hot water systems>15 psi, meets the requirements of Standards Table 123-A. §150(j)3A: Insulation is protected from damage, including that due to sunlight, moisture,equipment maintenance,and wind. §150(j)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in conditioned space. 150(j)4:Solar water-heating systems and/or collectors are certified by the Solar Rating and Certification Corporation. EnergyPro 5.1 by EnergySoft User Number:6518 RunCode:2013-05-11 T17:25:05 ID:13-006 Page 8 of 20 MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF-'I R Project Name Date Hsu Residence 5/11/2013 §150(m)1:All air-distribution system ducts and plenums installed,are sealed and insulated to meet the requirements of CMC Sections 601,602,603,604,605 and Standard 6-5;supply-air and return-air ducts and plenums are insulated to a minimum installed level of R- 4.2 or enclosed entirely in conditioned space.Openings shall be sealed with mastic,tape or other duct-closure system that meets the applicable requirements of UL 181, UL 181 A,or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings reater than 1/4 inch,the combination of mastic and either mesh or tape shall be used §150(m)1: Building cavities,support platforms for air handlers,and plenums defined or constructed with materials other than sealed sheet metal,duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. §150(m)2D:Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. 150(m)7:Exhaust fans stems have back draft or automatic dampers. §150(m)8:Gravity ventilating systems serving conditioned space have either automatic or readily accessible,manually operated dampers. §150(m)9: Insulation shall be protected from damage,including that due to sunlight, moisture,equipment maintenance,and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. §150(m)10:Flexible ducts cannot have porous inner cores. §150(o):All dwelling units shall meet the requirements of ANSI/ASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air Quality in Low-Rise Residential Buildings.Window operation is not a permissible method of providing the Whole Building Ventilation required in Section 4 of that Standard. Pool and Spa Heating Systems and Equipment Measures: §114(a):Any pool or spa heating system shall be certified to have:a thermal efficiency that complies with the Appliance Efficiency Regulations;an on-off switch mounted outside of the heater;a permanent weatherproof plate or card with operating instructions;and shall not use electric resistance heating ora pilot light. §114(b)1:Any pool or spa heating equipment shall be installed with at least 36"of pipe between filter and heater,or dedicated suction and return lines,or built-up connections for future solar heating. 114(b)2:Outdoor pools ors as that have a heat pump or gas heater shall have a cover. §114(b)3: Pools shall have directional inlets that adequately mix the pool water,and a time switch that will allow all pumps to be set or programmed to run only during off-peak electric demand periods. 150 :Residential pool systems orequipment meet the pump sizing,flow rate,piping,filters,and valve requirements of§150 Residential Lighting Measures: §150(k)1:High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies contained in Table 150-C and is not a low efficacy luminaire asspecified by§150(k)2. 150(k)3:The wattage of permanently installed luminaires shall be determined asspecified by§130(d). §150(k)4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than 20 kHz. §150(k)5:Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and shall not contain a line-voltage socket or line- voltage lamp holder;OR shall be rated to consume no more than five watts of power as determined by§130(d),and shall not contain a medium screw-base socket. 150(k)6:Lighting integral to exhaust fans, in rooms other than kitchens,shall meet the applicable requirements of§150(k). 150(k)7:All switching devices and controls shall meet the requirements of§150(k)7. §150(k)8:A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. EXCEPTION:Up to 50 watts for dwelling units less than or equal to 2,500 ft2 or 100 watts for dwelling units larger than 2,500 ft2 may be exempt from the 50%high efficacy requirement when:all low efficacy luminaires in the kitchen are controlled by a manual on occupant sensor,dimmer,energy management system(EMCS),or a multi-scene programmable control system;and all permanently installed luminaries in garages,laundry rooms,closets greater than 70 square feet,and utility rooms are high efficacy and controlled by a manual-on occupant sensor. §150(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated cabinet. EnergyPro 5.1 by EnergySoft User Number 6518 RunCode:2013-05-11T17:25:05 ID:13-006 Page 9 of 20 MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF-1 R Project Name Date Hsu Residence 5/11/2013 §150(k)l0: Permanently installed luminaires in bathrooms,attached and detached garages,laundry rooms,closets and utility rooms shall be high efficacy. EXCEPTION 1:Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by a manual-on occupant sensor certified to comply with the applicable requirements of§119. EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a manual-on occupancy sensor. §150(k)l 1: Permanently installed luminaires located in rooms or areas other than in kitchens,bathrooms,garages,laundry rooms, closets,and utility rooms shall be high efficacy luimnaires. EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided they are controlled by either a dimmer switch that complies with the applicable requirements of§119,or by a manual- on occupant sensor that complies with the applicable requirements of§119. EXCEPTION 2: Lighting in detached storage building less than 1000 square feet located on a residential site is not required to comply with§150 k 11. §150(k)l2:Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact(IC) by Underwriters Laboratories or other nationally recognized testing/rating laboratory;and have a label that certifies the lumiunaire is airtight with air leakage less then 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283;and be sealed with a gasket or caulk between the luminaire housing and ceiling. §150(k)l3:Luminaires providing outdoor lighting,including lighting for private patios in low-rise residential buildings with four or more dwelling units,entrances,balconies,and porches,which are permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy. EXCEPTION 1: Permanently installed outdoor low efficacy luminaires shall be allowed provided that they are controlled by a manual on/off switch,a motion sensor not having an override or bypass switch that disables the motion sensor, and one of the following controls:a photocontrol not having an override or bypass switch that disables the photocontrol;OR an astronomical time clock not having an override or bypass switch that disables the astronomical time clock;OR an energy management control system (EMCS) not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2:Outdoor luminaires used to comply with Exceptionl to§150(k)l3 may be controlled by a temporary override switch which bypasses the motion sensing function provided that the motion sensor is automatically reactivated within six hours. EXCEPTION 3:Permanently installed luminaires in or around swimming pool,water features,or other location subject to Article 680 of the California Electric Code need not be high efficacy luminaires. §150(k)l4:Internally illuminated address signs shall comply with Section 148;OR not contain a screw-base socket,and consume no more than five watts of power as determined according to§130(d). §150(k)l5:Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable requirements in Sections 130, 132, 134,and 147.Lighting for parking garages for 8 or more vehicles shall comply with the applicable requirements of Sections 130, 131, 134,and 146. §150(k)l6:Permanently installed lighting in the enclosed,non-dwelling spaces of low-rise residential buildings with four or more dwelling units shall be high efficacy luminaires. EXCEPTION: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by an occupant sensors certified to comply with the applicable requirements of 119. EnergyPro 5.1 by EnergySoR User Number:6518 RunCode:2013-05-11T17:25:05 ID:13-006 Page 10 of 20 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name Date Hsu Residence 5/11/2013 System Name Floor Area HVAC 1 2,370 ENGINEERING CHECKS SYSTEM LOAD Number of Systems 1 COIL COOLING PEAK COIL HTG.PEAK Heating System CFM Sensible Latent CFM Sensible Output per System 73,000 Total Room Loads 995 24,231 182 787 28,991 Total Output Btuh) 73,000 Return Vented Lighting 0 Output Btuh/ ft 30.8 Return Air Ducts 579 1,211 Cooling System Return Fan 0 0 Output per System 40,500 Ventilation 0 0 0 0 0 Total Output Btuh 40,500 Supply Fan 0 0 Total Output(Tons) 3.4 Supply Air Ducts 579 1,211 Total Output Btuh/s ft) 17.1 Total Output s ft/Ton 702.2 TOTAL SYSTEM LOAD 25,388 182 31,412 Air System CFM per System 1,385 HVAC EQUIPMENT SELECTION Airflow cfm 1,385 Sears N9MP1080F16'• 33,367 5,799 73,000 Airflow cfm/s ft 0.58 Airflow cfm/Ton) 410.4 Outside Air %) 0.0% Total Adjusted System Output 33,367 5,799 73,000 Outside Air cfm/s ft 0.00 (Adjusted for Peak Design conditions) Note:values above given at ARI conditions TIME OF SYSTEM PEAK Aug 3 PM Jan 1 AM HEATING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Heating Peak 28 OF 69 OF 69 OF 105 OF j Outside AirAr — 0 cfm Supply Fan Heating Coil 104 OF 1,385 cfm - t� ROOD %,1" 69°F70 IF ..... a COOLING SYSTEM PSYCHROMETICS(Airstream Temperatures at Time of Cooling Peak) 86/67 IF 78/62 IF 78/62 OF 55/53 IF i Outside Air Ar AL Supply Fan 0 cfm p y Cooling Coil 55/54 OF 1,385 cfm 40.5% ROOM 78/62 OF 78/62 OF EnergyPro 5.1 by EnergySoft User Number:6518 RunCode:2013-05-11T17:25:05 ID:13-006 Page 11 of 20 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name Date Hsu Residence 5/11/2013 System Name Floor Area HVAC 2 1,319 ENGINEERING CHECKS SYSTEM LOAD Number of Systems 1 COIL COOLING PEAK COIL HTG. PEAK Heating System CFM Sensible Latent CFM Sensible Output per System 44,000 Total Room Loads 284 7,010 679 382 14,275 Total Output(Btuh) 44,000 Return Vented Lighting 0 Output Btuh/s ft 33.4 Return Air Ducts 230 607 Cooling System Return Fan 0 0 Output per System 46,500 Ventilation 0 0 0 0 0 Total Output Btuh 46,500 Supply Fan 0 0 Total Output(Tons) 3.9 Supply Air Ducts 230 607 Total Output(Btuh/s ft) 35.3 Total Output s ft/Ton 340.4 TOTAL SYSTEM LOAD 1 7,4691 6791 15,490 Air System CFM per System 1,720 HVAC EQUIPMENT SELECTION Airflow cfm 1,720 Sears N9MP10501312** 37,638 7,345 44,000 Airflow cfm/s ft 1.30 Airflow cfm/Ton) 443.9 Outside Air(%) 0.0% Total Adjusted System Output 37,638 7,345 44,000 Outside Air cfm/s ft 0.00 (Adjusted for Peak Design conditions) Note:values above given at ARI conditions TIME OF SYSTEM PEAK Aug 3 PM Jan 1 AM HEATING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Heating Peak) 28 OF 70 IF 105 IF 105 IF OMEN1 Outside Air 0 cfm Heating Coil Supply Fan o 105 F 1,720 cfm ROOM > 70°F70°F ..r_.. _-. E � s COOLING SYSTEM PSYCHROMETICS(Airstream Temperatures at Time of Cooling Peak) 86/67°F 78/62°F 55/54°F 55/54°F 0.Outside Air '— - 0 cfm Cooling Coil Supply Fan 55/54 OF 1,720 cfm l 40.9% _.._ROOM 3 78/62°F 78/62°F 4 ;,v . 4 —F-1--, d .4 EnergyPro 5.1 by EnergySoft User Number:6518 RunCode:2013-05-11 T17:25:05 /D:13-006 Page 12 of 20 ROOM LOAD SUMMARY Project Name Date Hsu Residence 5/11/2013 System Name Floor Area HVAC 1 2,370 ROOM LOAD SUMMARY ROOM COOLING PEAK COIL COOLING PEAK COIL HTG. PEAK Zone Name Room Name Mult. CFM Sensible Latent CFM Sensible Latent CFM Sensible Zone 1 Zone 1 1 995 24,231 182 995 24,231 182 787 28,991 PAGE TOTAL 995 24,231 182 787 28,991 TOTAL995 24,231 182 787 28,991 Total includes ventilation load for zonal systems. Ener Pro 5.1 by EnerqySoft User Number:6518 RunCode:2013-05-11 T17:25:05 ID: 13-006 Pae 13 of 20 ROOM LOAD SUMMARY Project Name Date Hsu Residence 5/11/2013 System Name Floor Area HVAC 2 1,319 ROOM LOAD SUMMARY ROOM COOLING PEAK COIL COOLING PEAK COIL HTG. PEAK Zone Name Room Name Mult. CFM Sensible Latent CFM Sensible Latent CFM Sensible Zone 2 Zone 2 1 284 7,010 679 284 7,010 679 382 14,275 PAGE TOTAL 1 284 7,010 679 382 14,275 TOTAL 1 284 7,010 679 382 14,275 'Total includes ventilation load for zonal systems. Ener Pro 5.1 by Ener Soft User Number:6518 RunCode:2013-05-11T17:25:05 ID: 13-006 Pae 14 of 20 ROOM HEATING PEAK LOADS Project Name Date Hsu Residence 5/11/2013 ROOM INFORMATION DESIGN CONDITIONS Room Name Zone 1 Time of Peak Jan 1 AM Floor Area 2,370.0 ft' Outdoor Dry Bulb Temperature 28 OF Indoor Dry Bulb Temperature 70 OF Conduction Area U-Value AT OF Btu/hr R-38 Roof Attic 1,133.0 X 0.0250 X 42 = 1,190 Andersen Permashield 10.0 X 0.3400 X 42 = 143 R-21 Wall 1,641.8 X 0.0690 X 42 = 4,758 Wood Door 88.1 X 0.5000 X 42 = 1,850 Milgard Classic Low-E Vinyl 547.3 X 0.3900 X 42 = 8,965 R-19 Floor Crawlspace 2,370.0 X 0.0370 X 42 = 3,683 X X = X X = X X = X X X X X X = X X = X X = X X X X = X X = X X = X X = X X = X X = X X = X X = X X = X X = X X = X X = X X = X X = X X = X X = Items shown with an asterisk(')denote conduction through an interior surface to another room Page Total 20.588 Infiltration:[ 1.00 X 1.077 X 2,370 X 9.00 X 0.522 /60] X 42 = 8,402 Schedule Air Sensible Area Ceiling Height ACH AT Fraction TOTAL HOURLY HEAT LOSS FOR ROOM 28,991 EnergyPro 5.1 by EnergySoft User Number:6518 Run Code:2013-05-11T17:25:05 ID:13-006 Page 15 of 20 ROOM HEATING PEAK LOADS Project Name Date Hsu Residence 5/11/2013 ROOM INFORMATION DESIGN CONDITIONS Room Name Zone 2 Time of Peak Jan 1 AM Floor Area 1,319.0 f 2 Outdoor Dry Bulb Temperature 28 OF Indoor Dry Bulb Temperature 70 OF Conduction Area U-Value AT OF Btu/hr R-21 Wall 1,320.9 X 0.0690 X 42 = 3,828 Milgard Classic Low-E Vinyl 259.4 X 0.3900 X 42 = 4,249 R-19 Floor Crawlspace 92.0 X 0.0370 X 42 = 143 R-38 Roof Attic 1,313.7 X 0.0250 X 42 = 1,379 X X = X X X X = X X = X X = X X X X = X X X X X X X X X X X X X X X X X X = X X X X = X X X X = X X X X X X X X = X X X X = X X Items shown with an asterisk(')denote conduction through an interior surface to another room Page Total 9,599 Infiltration:[ 1.00 X 1.077 X 1,319 X 9.00 X 0.522 /60] X 42 = 4,676 Schedule Air Sensible Area Ceiling Height ACH AT Fraction TOTAL HOURLY HEAT LOSS FOR ROOM 14,275 EnergyPro 5.1 by EnergySoft User Number:6518 RunCode:2013-05-11 T17:25:05 ID:13-006 Page 16 of. RESIDENTIAL ROOM COOLING LOAD SUMMARY Project Name Date Hsu Residence 5/11/2013 ROOM INFORMATION DESIGN CONDITIONS Room Name Zone 1 Outdoor Dry Bulb Temperature 86 OF Floor Area 2,370.0 ft2 Outdoor Wet Bulb Temperature 67 OF Indoor Dry Bulb Temperature 78 OF I Outdoor Daily Range: 30 OF Opaque Surfaces Orientation Area U-Factor CLTD' Btu/hr R-38 Roof Attic (S) 1,133.0 X 0.0250 X 55.0 = 1,558 R-21 Wall (S) 295.3 X 0.0690 X 18.0 = 367 Wood Door (S) 45.4 X 0.5000 X 22.0 = 499 R-21 Wall (NE) 631.5 X 0.0690 X 16.0 = 697 R-21 Wall (E) 574.0 X 0.0690 X 24.0 = 951 Wood Door (E) 42.7 X 0.5000 X 27.0 = 576 R-19 FloorCrawlspace 2,370.0 X 0.0370 X 4.0 = 351 R-21 Wall (N) 141.0 X 0.0690 X 11.0 = 107 X X = Page Total 5,106 Items shown with an asterisk(')denote conduction through an interior surface to another room. 1. Cooling Load Temperature Difference(CLTD) Shaded Unshaded Fenestration Orientation Area GLF Area GLF Btu/hr Skylight (S) 0.0 X 16.2 + 10.0 X 96.1 = 961 Front Windows (S) 58.3 X 17.5 + 0.0 X 33.7 = 1,019 Left Windows (NE) 0.0 X 17.5 + 93.0 X 36.3 = 3,379 Right Windows (E) 46.8 X 17.5 + 109.2 X 56.5 = 6,985 Window (N) 0.0 X 17.5 + 240.0 X 17.5 = 4,195 X + X - X + X - X + X - X + X - Page Total 1x,538 Internal Gain Btu/hr Occupants 2.0 Occupants X 230 Btuh/occ. = L460 Equipment 1.0 Dwelling Unit X 1,200 Btu = 1,200 Infiltration: 1.077 X 0.73 X 146.75 X = 927 Air Sensible CFM ELA 4T TOTAL HOURLY SENSIBLE HEAT GAIN FOR ROOM 24,231 Latent Gain Btu/hr 2.0 Occupants X 200 Btuh/occ. 400 Occupants = Infiltration: 4,830 X 0.73 X 146.75 X 0.00042 = -218 Air Sensible CFM ELA AW TOTAL HOURLY LATENT HEAT GAIN FOR ROOM 182 Ener Pro 5.1 by EnerqvSoft User Number. 6518 RunCode:2013-05-11T17:25:05 ID:13-006 Pae 17 of 20 RESIDENTIAL ROOM COOLING LOAD SUMMARY Project Name Date Hsu Residence 1 5/11/2013 ROOM INFORMATION DESIGN CONDITIONS Room Name Zone 2 Outdoor Dry Bulb Temperature 86 OF Floor Area 1,319.0 ft2 Outdoor Wet Bulb Temperature 67 OF Indoor Dry Bulb Temperature 78 OF I Outdoor Daily Range: 30 OF Opaque Surfaces Orientation Area U-Factor CLTD' Btu/hr R-21 Wall (S) 496.7 X 0.0690 X 6.0 = 206 R-21 Wall (M 174.0 X 0.0690 X 13.0 = 156 R-21 Wall (N) 512.5 X 0.0690 X 3.0 = 106 R-21 Wall (E) 137.7 X 0.0690 X 13.0 = 124 R-19 Floor Crawlspace 92.0 X 0.0370 X 4.0 = 14 R-38 Roof Attic (N) 1,313.7 X 0.0250 X 37.0 = 1,215 X X X X = X X Page Total 1,820 Items shown with an asterisk(`)denote conduction through an interior surface to another room. 1. Cooling Load Temperature Difference(CLTD) Shaded Unshaded Fenestration Orientation Area GLF Area GLF Btu/hr Window (S) 56.8 X 3.6 + 0.0 X 5.3 = 205 Window (M 0.0 X 3.6 + 60.0 X 10.5 = 630 Window (N) 0.0 X 3.6 + 41.0 X 3.6 = 148 Window (E) 28.9 X 3.6 + 67.4 X 10.5 = 812 Skylight (N) 0.0 X 15.6 + 5.3 X 67.6 = 358 X + X - X + X = X + X = X + X - Page Total 2,154 Internal Gain Btu/hr Occupants 4.0 Occupants X 230 Btuh/occ. = 920 Equipment 1.0 Dwelling Unit X 1,600 Btu = 1,600 Infiltration: 1.077 X 0.73 X 81.67 X = 516 Air Sensible CFM ELA AT TOTAL HOURLY SENSIBLE HEAT GAIN FOR ROOM 7,010 Latent Gain Btu/hr Occupants 4.0 Occupants X 20o Btuh/occ. = 800 Infiltration: 4,830 X 0.73 X 81.67 X 0.00042 = -121 Air Sensible CFM ELA AW TOTAL HOURLY LATENT HEAT GAIN FOR ROOM 679 EnercyvPro 5.1 by Ener Soft User Number:6518 RunCode:2013-05-11 T17:25:05 ID: 13-006 Pae 18 of 20 ENERGY USE AND COST SUMMARY ECON-1 Project Name Date Hsu Residence 5/11/2013 Rate: Electric Alameda H Fuel Type: Electricity STANDARD PROPOSED MARGIN Energy Peak Energy Peak Energy Peak Use Demand Cost Use Demand Cost Use Demand Cost (kWh) (kW) ($) (kWh) (kW) ($ (kWh) (kW) ($) Jan 1 153 1 21 168 1 22 -15 0 -2- Feb 108 5 16 107 1 16 1 4 0 Mar 83 5 14 78 1 13 4 3 0 Apr 142 6 20 92 4 14 50 2 5 May 92 9 14 35 4 9 56 5 6 Jun 298 11 36 95 6 15 203 5 21 Jul 346 9 41 120 6 17 226 3 24 Aug416 11 50 165 7 22 251 4 28 Sep 237 12 29 69 7 12 167 6 17 Oct 114 8 17 40 3 9 74 5 8 Nov 96 3 15 101 1 15 -5 1 -1 Dec 153 1 21 164 2 22 -11 0 -1 Year 2,237 12 292 1,234 7 187 1,003 5 105 CO2 1,801 lbs/yr 994 lbs/yr 807 Ibsl r Rate: Gas PG&E P Fuel T e: Natural Gas STANDARD PROPOSED MARGIN Energy Peak Energy Peak Energy Peak Use Demand Cost Use Demand Cost Use Demand Cost (therms) kBtu/hr) ($ (therms) (kBtu/hr) ($) (therms) (kBtu/hr) $ Jan 126 105 171 124 97 168 2 8 3 Feb 80 90 103 84 84 109 -4 6 -6 Mar 62 86 78 66 81 83 -3 5 -5 Apr 51 76 64 54 71 68 -3 4 -4 May 25 63 34 28 58 37 -2 4 -3 Jun 22 27 29 24 38 32 -2 -11 -4 Jul 22 6 29 24 6 32 -2 0 -4 Aua 22 6 28 24 6 32 -2 0 -3 Sep 21 6 27 23 9 31 -2 -3 -3 Oct 29 67 40 31 62 43 -2 5 -3 Nov 79 92 103 80 86 103 -1 6 -1- Dec 125 107 170 121 99 164 4 8 6 Year 664 107 875 683 99 902 -19 8 -27- 0O2 7,771 lbs/yr 7,993 lbs/yr -222 lbs/yr Annual Totals Energy Demand Cost Cost/s ft Virtual Rate Electricity 1,234 kWh 7 kW $ 187 $ 0.05/S f3 $ 0.15 /kWh Natural Gas 683 therms 99 kBtu/hr $ 902 $ 0.24/s ft $ 1.32 /therm Total $ 1,089 $ 0.30/sgft Avoided CO2 Emissions: 586 lbs/yr EnergyPro 5.1 by EnergySoft User Number:6518 RunCode:2013-05-11T17:25:0 ID: 13-006 Page 19 of 20 s { UTILITY INCENTIVE WORKSHEET UTIL-1 R Project Name Date Hsu Residence 5/11/2013 •. ANNUAL TDV ENERGY USE(kBtu/s ft- r) PERCENT BELOW TITLE 24 ENERGY COMPONENT Standard ProDosed Mar in %Better than Space Heating 17.00 16.60 0.40 Mar in Standard Title 24' Space Cooling 9.61 3.17 6.44 7.17 / 42.21 = 17.0% Heat Rejection 0.00 0.00 0.00 Cool'n Standard Indoor Fans 4.90 3.43 1.47 7.91 / 14.51 = 54.5 Domestic Hot Water 10.71 11.85 -1.14 Incentive Eligibility Yes No Pumps 0.00 0.00 0.00 Owner Incentive (>=15%) m ❑ NSHP Incentive (>=30%) ❑ m TOTALS: 42.21 35.04 7.17 Conditioned Floor Area= 3,689.0 ft2 Number of Bedrooms = 4 • 72pm ANNUAL SITE ENERGY USE Avera -5pm Standard Pro osed Mar in Single Orientation Peak d kW 7.63.s 3.7 EStandard Proposed Margin ENERGY COMPONENT Electricity Natural Gas Electricity Natural Gas Electricity Natural Gas kWh therms kWh therms kWh therms Space Heating 0.00 397.96 0.00 388.60 0.00 9.36 Space Cooling 1,200.01 0.00 355.96 0.00 844.05 0.00 Heat Rejection 0.00 0.00 0.00 0.00 0.00 0.00 Indoor Fans 1,037.05 0.00 878.39 0.00 158.66 0.00 Domestic Hot Water 0.00 266.27 0.00 294.56 0.00 -28.29 Pumps 0.00 0.00 0.00 0.00 0.00 0.00 TOTALS: 2,237.06 664.23 1,234.35 683.16 1,002.71 -18.93 POTENTIAL OWNER INCENTIVE CALCULATION Potential incentives indicated %Better than Title-24' Incentive Savings on this report are available from sten 2) Rate � from Ste 3 Subtotal �only through the California Electricity (kWh) 17.0/ o.4s X1 1,002.71 = $491 Advanced Homes Program for $/kWh kWh new construction and are Electricity (kW) 17.0% 85 x NOT GUARANTEED. Projects $/kW kW must meet all other program requirements to qualify. Natural Gas 17.0/ 1.s5 x Potential incentives are $/therm therm subject to program limitations Base Incentive = $805 Pacific Gas and Energy Star Incentive n/a x 10% 1; Electric Company Green Home Incentive n/a x 10% SOUiHMN'CALIFORNIA EI SN Compact Home Incentive n/a x 15% Photovoltaic Incentive $85 x C DC Rating kW A SernpraEnergy ututy NSHP Alf ThacaliforniaTotal = $s75 advanced humes A sempra F:nerpy mnity_ '%Better than in this equation is limited to 45 Ener Pro 5.1.3.by EnergySoft User Number:6518 RunCode:2013-05-11 T17:25:05 ID:13-006 Page 20 of 20