HomeMy WebLinkAbout369 WALNUT ST - Building Permits, CITY OF COSTA MESA
BUILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (774) 754-5626
PERMIT NUMBER: B10-00064
PERMIT TYPE B_ROOF2
APN: 42630204
JOB ADDRESS: 369 WALNUT ST CM
Vicinity: HOUSE AND GARAGE
Squares: 0 � � �
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
ISSUED
0311012010
RMD
Valuation: $4,000.00
SCOPE OF WORK: TEAR OFF (E) ROOF MATERIALS, INSTALL A MINIMUM 1 LAYER OF 15# FELT AND REROOF WITH 30 YEAR
COMP SHINGIES ON HOUSE AND GARAGE, APPROX 18 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED.
OWNER: FLEMING RONALD W AND
PHONE:
APPLICANT: WHITE, HENRY � �
PHONE: 760-808-9192 .
CONTRACTOR: OWNER-BUILDER
Address: Unit:
City/State/Zip:
ARCHITECT: �
ENGINEER:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $97.25
Reinspection Fee: $0.00 -
Bldg Std Admin Fund $1.00
Address: 580 SEVILLE LN
City/State/Zip: BLYTHE, CA
Address:
Ciry/State/Zip:
License No.
License No.
PHONE:
TOTAL FEES $98.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3N7
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm.
New Years Dav. Memorial Dav. Indeoendence Dav. Labor Dav, -
License No. 000000
CELL:
PHONE:
PHONE:
UniF
Unit: :
irs - Sundays and the (ollowing Federal
and Chris[mas Day
NOTICE: The work authorized by this permit shall comply with all appliwble handiwp access requiremenls under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must wmply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obWin inspections and fnal approval vrill result in the expiretion of this permit.
CO�Et INSPEC710NTYPE D�TE INTITIALS �� MSPECTIONTYPE giF� INTITIRL
7fi78 Fixed System Final Fire Prevention 206 Final Mechanical
1286 Pool Spa Final /�. _ 208 Final Plumbing
200 Final Re-Roof �Y �a �� 210 Final Electncal
201 Final 81aWRetaining Wall 212 Final Fire Prevention
202 Final Faclory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final BuildinyOccupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aff rm under penalry of perjury one of Ihe following declarations:
❑ I have and will maintain a certificate of consent to sel/-Insure for workers'
compensation, as provitletl for, by section 3700 of the Labor Code, !or the
peAormance of the work for which this permit is issuetl.
❑ I have and will main�ain workers' compensation insurance, as required by
seclpn 3700 0( the Labor Code, (or the peAormance of the wvrk for which this
permit is issued. My vrorkers' compensation Insurance carrier and policy
number are:
Carrier:
(rnis secfrr� neM rp10e rompletetl Atne pam� is valuetl at one huneretlWllars (St00) orless)
P�oli�c-y� .Number:
[—I certify that in the peAormance of [he work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the vrorkers' compensation laws of Califomia, and agree that it I shoultl
become subject to the vrorkers' o 7ensation provisions of Section 3700 ot
ihe Labor Cod , hall (orthwit o bly with these prov ons
��b�6
ppy ' ' ignature rOate�
V�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000�. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that 1 am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Cotle, antl
my license is in (ull force and effect.
Lic. # Class #
GONractor's SgnaWre Dale
CONSTRUCTION LENDING AGENCY:
❑ I hereby aNirm that there is a constmction lending agency (or ihe
pedortnance of Ihe work for wfiich this permit is issuetl. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
OW NER-BUILDER DECLARATIONS:
1 here�y affirm �hat under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Pmfessions Cotle: Any city or counry which requires a permit to
construcl, alter, improve, demolish, or repair any structure, prior lo its
issuance, also requires the applicant tor such permit to fle a signetl statement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapler 9(commencing with Section 7000) o( Division 3 0( the
Business and Protessions Cotle) or that he or she is exempt therefrom and
the basis !or the alleged ezemption. Any violation of Section 7031.5 by any
applicaN for a permit subjects the applicant [o a civil penalry of not more than
(ve hundred dollars (3500).):
as ovmer of the property, or my employees with vrdges as their sole
ompensation, WILL DO 7HE WORK, and the strucWre is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an ovmer of property who builds or improves
thereon, and who does such work himself or herself or Nrough his or her ovm
employees. provided that such improvements are not intended or offered for
sale. It, however, the building or improvemeN is sold within one year o(
completion, the ovmer-builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of Ihe property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the projecl (Sec. 7044, Business antl
Professions Cotle: The contractors License Law dces not appty to an ovmer of
property who builds or improves Ihereon, antl who contracts for such project with
a contractor(s) license pursuant to the CoN2ctors License Laws.).
Ovme,r ID verified by tlriver s iicense. ❑ Yes �.Mo ' / -
D�'[Icense No�� �����/ pirb's."�j�3
Verifiwtion o! Ownership by (type of documenl, i.e. - propeny tax 6ill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N:
❑ I hereby ceRify that no excavation frve (5) or more feet in depth into wfiich a
person is required to descend, will be made in wnnection with work authonzetl
by this pertnit, and that no builaing sWcture, scaHddinq, (alse�+ork, a demolition
or dismantling thereol, will be more Ihan thirty-six (36) (eet high. (Chap. 32. Grp
2. M 2, Sec. 341, TOe 8, Califpmia Administ2tive Code).
❑ As ownervbuilder, I will not employ anyone to do work which vroultl
require a permit from the Division of Intlustrial Safery, as noted above, unless
such person has a permit to do such work from the division.
Applicanfs $ignaWre oate
Division ot Industrial Safety Permi� Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or preseN or fuNre building occupant neetl lo file and
certify a Business Plan for emergency response ro release or threatenetl
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 0( lhe Califomia Health antl Safery Code requires, wilh some
exceptions, that a Business Plan be filed vrith the Costa Mesa Fire
Department by every business vmich �as at any one time during a reportetl
year a quantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standartl temperature and pressure).
2. Does or will the applicant or present or fuNre building occupant neetl to file
a registration form (or acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 0( Ihe Califomia Health and Salety Code, with some
exceptions, requires regislration with the Costa Mesa Fire Department by
each business which al any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weight of WO pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
temperaWre and pressure).
3. Does or will �he applicant or present or fuWre building occupant neetl to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? � Yes ❑ No
(Section 25534 of the California Health and Satety Code pmvides Ihat Ihe
Costa Mesa Fire Department may require the preparation, certifcation antl
filing with the Fire Department ot an RMPP by 6usinesses which are required
to register acutely hazardous materials wim me Fire DepanmeN.
4. Ii an RMPP is presently required, has Sec[ion 25534 0( the California
Health and Safely Code been (ully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or fuWre building occupant require for
the work which is ihe subject of lhis application a permit for such construction
or modification from the South Coast Air Quali�y Management District or from
any other air pollution control tlistricl or agency? ❑ Ves ❑ No
(Sectbn 658502 of ihe Calitomia Govemment Code requires Ihat Ihe requesletl
intortnation be fumishetl on applications for non-residential building pertnits).
6. Will any part of the faciliry to be constructed under this permit be vrithin
1000 feet !rom Ihe outer bountlaries of a school7 ❑ Ves ❑ No
(If "yes", the lacility must meet the requirement of Sections 25534 antl 42303
of the Califomia Health and Safety Code).
7. It a permit fmm the South Coast Air Qualiry Management District or other
air pollution control district or agency is required for the work which is Ihe
subject of this application, have all of the disclosures prescribed by Califomia
Health and Safety Code Seciion 42303 been made? ❑ Yes ❑ No
8. Qf yes", attach certificate of compliance Irom the appropriate air pollution
control officer).
CERTIFICATE OF COMPIIANCE: I certify that untler penalry of perjury the
in(ormation given above is correcL I agree ro comply with all state laws antl
city ordinances regarding Hazardous Materials and Emissions.
SignaWre
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certi(y under penally of perjury that I have read this application and sta[e that
❑ I am exempt under sec. lhe informalion given is correcl. I agree to comply with all state laws and city
ordinances relating to Duiltling construction, antl authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-0escnbed property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until fnal inspection.
, 7-]�" // � namre o.Bal r Oaie
Gnla[—P'r�— —� '�j3 d` � / / _
3051-a6 (3I0]� �— / / /
M I�I�onaetlAPP��nt �{�."p ate r�–�
�^rescriptivc CcrCiTict�tc u1'Cumpliancu:
ltt,�•ideniitd Altvratimsa'
1'ru,jecl Namc:
�.
Genernl lulnrmaliou
SiteAddress: ���} {,1I�i/_ T�
i
Building"I)�pu�inglcPumily ❑ Idulti Pnmily
Conditioned i�loor Ara.� (CFA):
Clinuitc
linlorcemenl Age��cY:
Circla the Proni Orienteiion; 1�', E, S, V��, nr degrees
PfOI�CI � Y�]C: ❑ AILCf8110115 CJ�nvelope � Fene:
�j d '����(
e 7 ui'
HVAC
NOTL•: 7'hi.c,/nrni is' nn� �o br ua�er! fa� Ne�nli� Gma�trueted ItuildinA.c nr' �lAditinrrs'
]nsuln(imi Vnlue.e For Opaquc Swjnces (fm� Finring v.re Ihc A�lusu' nnc! Furring SYrip.e Cavsu�tmlinn m61tr below)
Assem6ly Alteratiuu
❑ Openinh o1' lrametl c:n4h' nlone- dherniinns (hm im,ohr. tlic opening n/�he franrecl cnvii,p ofo wall. ceiling. or':/loor musi ina��ull ihr.
iuunilnlnrp mininnmr insvlolian vnlwc pr✓�.yC/50 fiir thc n6ered assemb/r. Fi(I in Colimm.s A-C mid eiver mandalor�� insulatinn value in Cohmw H.
❑ Replucement oT entire �issemblp-IfeylucemeM o/-ma enlirc wull, ceiling, m' floor ussembh' rcguirca' Ihe ins�ulluiion o(Comp�nen!
Puckuee- D ina'idntion vnlues in Tuhle ]5/-C. Fill in Column.r A-J. .
IpaqUe SurlecL
A i �y
7ag/ Assembly
ID� OrTVt
.Nole: Fm_/urredassembliea,
Por 16e lun�ed uortiuned of' M.iss VJalls sec Tu
Sm��da+'d
Tl�iclmess,
U- � ]A4 Teble
cmr° Numbers
rec
Cunsiructiun Tabir. beloe�.
.1
Values Fran JA4 Table
Framed Continuous JA4
Cavip� ]nsulation Assem
R-value�' R-Value' Cell Va
use !he Mas.t pud
1. For Tag/ID indicaie die iden�ificniion nane thai mmches Uie bui(ding plans�.
?. Indicnle IhelissemGlt�Nume or q+pe: Roo(/Ceiling, W'alls, Floors, S(u6at Crow/ Space, Loora� and e�t,..Lidicote (he Frame rype andSize: For
Wood, Meia?, Metal Buildirrgs, Mass, emer ?z4, ?sG, or eic... see JA4 (or o�her passible f'ame p��e assemGlies.
3. Emer ihe �hicicneas for masr in inches a� Spacing benveeio jraming members emer; 1 G'or 29 "OC; m' Olher ja� all oNier assembl�� dra•criptlon
suc6 as Cnncreie Sandwich Panel, Symtdrel Panel, Logs, Sn�aN� Bale Panel and eic....
4. Bna�ed on Ihe Clima�e Zone; emer' Ihe Siandm�d U fac�o�.�•om Table 151-B, C or D fm� each d�ereni assernblp Narne or q�e.
5. Enier tbr T4ble numGer �hai dw�elv rea�em6le.x 1he yroposed assemblr.
G. Lmer ihe R-nalue iha� is 6eing insmlled in �he wall canim or Geiween rhe f'aminS: orherwise, en�er "0 ".
Z L•nter �he CoivLeunu.r Ina�rdntiar R-��nlue far Ihe pro/wsed ursembl��; alheiwisc, eiofer "0 ".
d. Lnier �he rom ond colunm q/�hc U-(acmr vuluc Loa�ed on Colwnn F Tublc Num6er mid enier Ihe dssem6lp U facior in Colunar J
J. Thr Nropna�ed d.rnenrbl i� U-facroi�, Cnk�mrr J, iuua�l Ge equal 10 a� le.r.r 11rmr Ure SYwulard U-Tactor iu Cnlunur E �o coniPlt�.
Furriu� 3trips Corictruction 7'abiefor Masti Walls Uniy
A li C D L�' P C il I .I K L M
I'rupused Pruperties of Musnnr�' anci Cuncrete Added Inleriur ur lixlerim' Luulutiun
V1'alls frum Reference iu l� m'ring S�» �ce Irum Relerencc
,luinf h> mndix 7��bic 4.35, 4.3.G. 4.3.7 dniul A� �eudix 7'nbir 4.3.73
U V� j � ! U
J, � o v � r^ c ^ "v:
i\F\(;IIII]I�' G+ J L.G G ~ ~ L 0��? L n V >_ Final
Mas� Nmnror .IAd'InbL: d� �.`, = E F p � n �_ �`m llssclnh�y
i ^ \ ` '_ _ .' z � L� o E . C ' L.'1
Thickncs� 'I' u' 1Jumbcr _ c u; c ` LL � L c _ �� � U-[uctor Comment
� J
I
i��� I � I�
lfe�; is�qwrinx /vuneLer: Ile�; i.rtrution Uu+c/7'inxc 1/BIlS' I'rovider:
Z(1081iesiden[iuf Cnm/�liunce Forms Augua7 2(l0y
� 1'rescri �five Certific:il
Residentinl AlteraYinn.e
lq�ojccl Na e:
r,�. _
Climtite 7Dnc q
of
3 01'
T
ItOORING PRODUCTS (COOL ROOFS) §l57(/�12
N'de» U�e nren nJ'esterior rr�q/�swfnee to be repluced ceceeda' iuore lGnn SOin of tlie existing roof uren, w' uiore tLu�i I,000 f�, �nliic/iever is
��.,•.,, u�� ,����� rooj,r�; r�.�« „�«.�� „�ee� u�� ..,��,�b �.�,d���i "Cnn! Rno/" re7uiremenet of §I52(G)Ilii, 752(b)lHii, nr 152(GJIHiii.
ChecG upplicnG/e n[tenm/ivc or exception Gelow i(�he rno%ahcrurion i.s esemp�fi�an U�e ranJing produc� "Coo/ Roof., re9uirements. Nnie: /f unp
one qf Ihe ulrernu�ives or ezceplimi 6eloe� is checked, �he Aged Solm� ReJlectance and Therma! Lmitiance reyz�iremeiv�s fm� rnqfing prnduct.c in
.�7/8(iJ rn'e noi npplicuble. Dn nol �ll �able belnw.
❑ �ool Roofs Not Requi�d in Chmnfe Zones 7-12, 14, and 1( with a Lou� Sloped. Less or 2:12 pitch.
J�Ce�ol Roofs No� Required in Climete Zones 1 thmugh 9 and 16 with a Steep-Sloped Roofs (pitch greater [han 2:12) and product unit weight less
Alternatives tu §152(b)1Hi nnd §152(b)Hii, Steep-slupc ronf (pitcli > 2:12J
❑ L�sulalion with u[hermal resistnnce of at leasl 0.85 hr112�°F/f3tu or aLleast a 3/4 ineli air-spaee is added to [he roof decic
over an attic; or
❑ Existing ducts in the attic are insulated and sealed according to §I51(�10; or
❑ In climate zones �10, 12 and 13, wi�h, I�fl'�of-free-ventilatio�raren of attic ventilation for evep� 150 ft� of attic floor area, and .
where ai least 30 percent of die free ventilatiou area is within 2 feet vertical distance of the roof ridge; or .
❑ Building has at least R-30 ceiling insulation; or
❑ Building has radiant barrier in tfie atlic meeting the requirements of § I51(fJ2; or
❑ Building has no ducts in the attic; or
❑ In climate zones 10, 1 l, 13 and 14, R-3 or greater roof deck insulation above vented atlic.
Exeeption ta §152(b)1Hiii, Low-slope raof (pitclr �2:12)
❑ Building has no ducts in ihe attic.
Other L�xceptions
❑ Roofing area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria.
❑ Roof constructions thal have thermal mass over the roof inem6rane with at least 25 Ib/ft' is exempt from the below Cool Roof criteria.
Notc If no CRILC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwi
Check the a licable box below if Exem t from the RooSn Products "Cool Roof' Re uirement:
Roof Slope Produc� Weight Product Aged Solar Thermal
CRRC Vroduct ID Number� 5 2:12 > 2:12 a 516/ft' ? 516/ft' Type� Reflectance3'4 Emittance
❑ � ❑ � ❑ � ❑
0
0
0
❑�
0
Q
Q
❑�
0
0
0
❑�
�
0
0
r
��
OQ
�4
SRIS
T6c C2RC1'r'oAucl !U Nun�Ger cmi Ge obinined (nm 16e Cool 2oa/Raling Cwmcil'e' HaledYroducl Uirecl�r�� nt n�m�r.cnoUan(r orn/m�nd� cn7search nhn
Indimie �lie q/�e oJproduc� ia Leing usedlor �hc rnol�op, i.e .tingle-pl�� ronf, usphafi roof, �ue�al roof, elc.
/(Ihe dyed IieQecmnee is nol m�nilnGle in.Ihe Cnol ltoo(Rqling Cnuneil',s Raied Producl Direcmrp Ihen usr Ilie lnitia! IteQeciance vuluc,fi�om !he anme
!/i�'c'clm:P �»�r/ bd'e Ihe e�/unlinn (U.7+(1.7(flini/rrd — �.ZJ IO nl�laiu n cnle!//ale•(� ab et/ vu/uc. 11%ie�'c /� 4s lhe bliGal Solm' Ifef�eGm)cB.
Checl; Iro.r il !he dged Rellne�nuce is n cnlcidaied vulue usi�g die e�piaiion nLnve.
Cnladnie �he S/fl vuluc In� ua'ing �he S'Ifl- VVnrka�heei nl Ivntd/u,n.m.enerrr.ca.¢nn/litle24/m�d emer lhc rea�u6ing va6�e in Ihc Sli/ Cnhimn nbnne nnAutlach ucolm nf
Ihe SRI- H'nrhshee� lu Ihc CF-Ilt.
��ipplr Liquicl I�ield Applied Cm�tings, the coaling musl 6c applied across lhe entirc roof surface and meet the dq� mil lhiclaiess or cover�ge
cnmmended by the cotitings manufacturer and meet minimum perlbrmancc requirements listed in ¢118(i)4. Selcc� [hc �pplicable coating:
Alwninum-PigmentedAsphal� RoofCoating
Cemen(-Bnned Itciof Caating
Other
/iegi.xn'uiion Number: Ifegi.vrnlion Duic/Time: F/EILSYrovider:
200d' 2e,sidentiul Compliunce Forma� .
�lugur� 200Y
.._
e Ce:rCificatx ui�Cumpli.u�ce: 72esidei�ti��l
Alternti�n�s
L•cl
Cliw:ue
cr-i r._AL•r
'Pa��e � oi� �)
L' uf Styries
�I�7:S 1��12II�1 CAT1U(� SOAIPIAILY Tl�e errJorcemem ngerver e�hmdd pqr a�iecicJ iine�ulon io ihc HE7;S'ldeaseu�esey�eciJied in d�is
deeclrlia�t Lelmr A comple�cd cinc/si�nad L'F-4J! Form fr�r ul/ llr- meusure.r speci/ied ahnU be svLmiued �a li�v Luilding iu��pecmr Lef�re� Jinnl
�u cl senliu�p b�1�CSCitle� HEXS oertficn�inn is reqeiiracll��� Ihis mcasm�e.
❑ i'�S ❑ NO 1'liS. ]n Climate Zoues ° tmd )-1 G, il' more thaii 4U linenr 1'eei o1 new nr replacement ducu: art insuilletl in unenndltioued
space, the duc�n are to be seuled per g] 52fbpDii und the uewly installed-ducis are tu 6e insulated pei 1151(1:110.
� EXC�PTJO�': Lsisting duct sl'stem5 t1inl s�re esIended; �vJ�icL m'e cunstrncted; insul.ucd ur sealeA ivitl� asbestus.
❑�'�S ❑ NO 1'L+S 1n Climatc Lones 2 and )J G, if [he e�:islinE spuce-eonditioui�g system (}7�iAC eyuipmenl und tlueting) i� replaced; the
ducts are to be sealed per §7 52(bp Di.
❑ YES ❑ NO ]'�5: ln Climate "Lones 2 und 9-] 6, if�the eaisiin� HVAC equipment is repluced (inciuding thH ieplucemem of'the air handler;
ouldoor condensing unii of a splii systeni, coolinb or heating cvil, urthe furnuce hetu excha��ger� the duets m'e to be
seoled per y"+] S2(b)1 E.
� ❑�XC�RT]On: Duct sysiems thnt arc ducumented tu h�rve Ueen previuusly senled coniirmed through HCPS
. .... . .. .. . . .. . . . ....
- veritieation in mecorclance �vith prucedures in��tl�e Reference Residenti;il Appendis�ItA3. �
� -- ❑�XC�PTTO�': Uuct s��stems with iess thau 40iinet�r teet iu unc�nditioned spnec. �.
��XC�PT10i�: P�xistinp duct sYstems construcied, insuleted or .eenled with asl�estus.
$�f1'1gCt'.7nf (,'hH1'oC - Spjlf S}Btem HERS veriJicntio�� is reguirecl.ior this measw�c.
❑ Y�S ❑ NO YGS: ln Climate Zones 2 and 5-15, when the existing HVAC equipment is replaced (including the replacement of the air
� handler, outdoor condensina unit of a spli� system A/C or heat pump, cooling or heatin� coil; or the fumace hea�
meas�rmnent shall 6e
Central Fan Inte�rated (CFI) l�entilafion S)'stem and Fan R'att Draw
The vencilation reauiremenis of F150(o) do not anolr m existine residential homes.
Ducted Split Systems - Air Conditioners and Heai Yumps: Air17oH� HERS veri��cation is require� jor rhia measurc.
❑ Y�S ❑ NO P�S: ln Climate Zones 70 t4rough 15, when the existiu� spaee-conditionino syst�m (HVAC equipment ancl ductingj is
� replaced. ths airf]ow and ian watt draw sha➢ 6e veriLed oer § 152(bl l Ci to meet the renuireinev[s of $151(f17H.
Author's Deelaratlon Statement �
tliis Certificate of Comnliance ducumentniion is aecurat=
Name:
s.
Company:
Aduresc:
Respunsi6lcBuikline7)exie�ner'slleclar:rfiun St,itement
]i
� ■
� 1 mn eligiblc under Livision i of lhc California Business nncl ProJessions Codc lo uccep� responsibility for thc buildiug design identifiecl on
thi:; CeniLcate of Complianee.
• ] curtily Ihai thc energg fextures iind perCorm�ncc specificriiion;. inr the buildin� design idemlLed on thls Certificate o� Cumpliaucc confonn
to lhu requirmnenis ol'Tille _��, ]'nris 7 tmA G ui llie Caliibrni�i Codr of"Regulntiunc.
• The buildin�: deni�u ic��uves Idemiliud ou �6i:. CeniGc[iw ofCom��lfuuce ara cunsis�cm � �u iniornmtinn pravided tu ducwn�m ihi::
buildln� dcsigu on the olher xpplic�ibic compliance �(onn;, worl:shcet�, ealcula �,,, plam: aud speci(ictuiu»:�, suhmlLlcd tu tht en1'urccmem
ucenc�� ioi tipprnvul witb lhis buildinp P-rmii 7�pPlicuiion.
Nuntc� / 7 i � / Si�nalurX. ,s /
La�c.
Licens�.
Ci
Fm'rar.ri.r ccnrquc�e•�ion.rregm�rli�agUzeE�em�ei'Sun:dtu'd,s,cmtt�ecl>l�c�»aro:l�Ua!ll�ac�rt:1-r�'00-;i2-:;3/Ill.
ke�,ie�iru�im�hhunber . _J(egi.��u�aiinnLaie/Timc� 1/iRSPrn�ad¢r: