1022;APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN U
r- - P
BUILDING PROJECT I DENTI FICATION MIT NUMBER'
BUILDING APPLICATION & PERMIT. O
�. • ADDRESS
22
p I?NAve. BUILDING - ELECTRICAL- PLUMBING - MECHANICAL
OWNER'S PLAN CHECK VALIDATION
NAME �OTY.I ELECTRIC PERMIT FEE
n /
C)A_) PHONEMIS / J S
"NTRACTOR'S
(� OUTLETS -.SWITCHES -.RECEP - 5.00/1.00 �B
LIGHTING FIXTURES 5.00/1.00
Ont ' LIC.NO.,
coWrRACTOR'S �-- ,y, ^,-�_
ADDRESS A{.�A�
_ APPLIANCES -RESIDENTIAL 4.00
PANELS 5.00
,O 000p/ PHONE �QO ��,f•��
DATE OF APPLICATION
ARCHITECTSIGNS
OR
ENGINEER
LIC. NO.
.
600.
PLAN CHECK FEE
'
P.C. NO.
SIGNS TRANS. 3.00
ARCH. OR ENG.
ADOR ESS .. - -
SPECIAL CIRCUIT 5.00
PERMIT. VALIDATION
TEMP. METER'OR POLE INS: '15.00
ZIP
ACANT'S
ADDRESS
LA L'9✓Z %4_
MOTORS' SEE FEE SCH.
SERVICE CHANGE 10.00
LICENSED CONTRACTORS DECLARATION
I hereby affirm that I' am licensed under provisions of Chapter 9
(commencing with Section 7000).of Division 3 of the Business and
Professions Code nd my.license is in full force and of c
License CI ss Lic. Number
Date Contractor
Sir P•
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason. (Sec. 7031.5, Business and Professions
Code:. Any city or county which requires a permit to construct, alter,
improve, demolish, or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that
he is licensed pursuant to the provisions of the Contractor's License
Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5
by. any applicant for a permit subjects the applicant toa civil penalty
of not more than five hundred dollars ($500).):
r?G T oZ Ov
_'.00
¢ vu
u¢H a a +
F � zr+
Z O N -
O' Z - O
~ N ~ J
¢ ¢ w 4
z CrLL H
vi
FLL O.¢
- i
¢ p
i a O ¢
X m
F Z i
f = o
I- o
a 3 °
ISSUANCE DATE
BLDG.
�/
u
ELECT.
❑
PLG.
❑
MECH.
❑
BUILDING PERMIT
INFORMATION
-7.
MISC. - REFER TO ORD
_
PERMIT ISSUANCE 6.00
VALUATION
/� 'goo
$/FT. --
ELEC. CONTR. LIC. NO.
7-
ELEC.
TOTAL
PERMIT TO
QTY. PLUMBING PERMIT FEE
IES
!/
TYPES
' Ir�Jj,
ve
ALTER -DRAIN &VENT -WATER (EA.) 4.00
❑ I, as owner of the property, or my employees with wages as
their sole compensation,'will do the work, and the structure is not
BACK FLOW PROTECT. DEVICE 2.00
OCC_GROUPRES.
NITS
DRAINS' -FLOOR, ROOF, AREA,COND. 4.00
intended or offered for sale (Sec. 7044.•Busine"ss and Professions
Code: The Contractor's License Law does not apply to an owner,of
llr3,
FIXTURES- PER TRAP 4.00
SO. FT. FLOOR AREA
TOTAL ACREAGE
property who builds or improves thereon, and who does such work
himself. or through his own employees, provided that such improve-
m are not intended or offered for sale. If, however, the building
GAS - EA. SYSTEM - 1 INC.4 OUTLETS 4.00
-�yrovefor.purposeofsale.).
.
„rovement is sold within one year of completion, the owner-
adder will have the burden of proving that he did not build'or im-
O I, as owner of the property, am exclusively contracting with -
GAS EA. SYSTEM -OVER 4 (EA.) 1.00
BUILDING USE
RES IND CON PB otner.
. '❑ ❑ ❑ ❑
INDUSTRIALWASTE.INTER. 20.00
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code: The Contractor's License Law does not apply
to an owner of property who, builds or improves thereon• and who
LAWN SP LERS - 1 INC 5 V.B. 5.00
ASSESSORS PARCEL NO.
LAWN SPR,INKL OVER 5 (EA:) 1.00
-
•
contracts for such projects with a contractor(s) licensed pursuant to
the Contractor's License Law.
SEWER- - RY- EA. 200ff/8.00
TRACT NO.
PARCEL NO.
❑ 1 am exempt under Sec: B:&P.C. for thisWATER
reason
WATERHEA ER EN 4.00
Owner
WATER SWEM 4.00
ACC. DATE
ACC. FILE NO.
WATER G EQUIP, 4.00
WORK ERS'COMPENSATION DECLARATION
I hereby affirm that I have a certificate ofconsenl to self -insure,
or a certificate of Workers' Compensation Insurance, ora certified
-
ZONING
ENG. SITE NO.
0.
Z z
O
H 2
W
Z
U O
LL I-,
U
LU
} U)
copy ther��ppff ec. 3800;Lab.C.�q,�_p
Policy NdF� 02• Somp.any • A%
-A Certified copyyTTs hereby furnls ed. '"
O Cenied copy is pled jh he city'- s c I n division.
Applicant [«[y -.14- A1K �� Z
&,)/ A- - K IC r"����� CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE •.,I
(This section need not be completed if the permit is for one
hundred dollars (S 100) or,less.)
1 certify that in.the performance of the work for which this'per-
mit is issued, 1 shall not employ any person in any manner so as to
become subject to the Workers' Compensation Laws of California:
Date Applicant
FIRE SPRINK
Y ❑ N ❑
ENERGY T-24
-
Y ❑ N❑
MISC. REFER TO ORD.
PERMIT ISSUANCE 6.00
FLOOD ZONE
Y ❑ N ❑
A. L.u.c.
Y ❑ N ❑
PLG. CONTR. LIC. NO.
PLG.
TOTAL
OTY. MECHANICAL PERMIT FEE
FEE SUMMARY
BUILDING
S`t7
NOTICE TO APPLICANT: If, after making this Certificate of Ex-
APPLIANCE 4.00
PLAN CHECK
FEE
U
emption, you should become subject to the Workers' Compensation
provisions of the Labor Code, you must forthwith comply with
such provisions or this permit shall be deemed revoked.
AIR HANDLING UNIT (TO 10,000C.F.M.) 3.00
AIR HANDLING UNIT(OVER10,000C.F.M.) 5.00
SEISMIC FEE
-9e
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for
EXHAUST HOOD (WITH DUCT) 2.00
the performance of the work for which.this.permit is issued (Sec.MICROFILM
3097, Civ.C.).
HEATING UNIT (TO 100,000 B.T.U.) � 4.00
Lender'i
Address
Lender's Address
HEATING UNIE'
T (OV 100,000 B.T.U.P.5.0
ELECTRIC
�✓ '
I certify that I have read 'this application and state that the above
VENTILATION FAN (SINGLE) 3.00
ftP_,-.cntioned
information is correct. I agree to comply with all city and county
dies and state laws relating to building, construction, and
uthorize representatives of this city to enter upon the
property for inspection purposes.
PLUMBING
BOILER -COMP(3 H.P. or 100,000 B.T.U.) 4.00
BOILER -COMP (Over 100,060 BTU) SEE FEE SCH.
MECHANICAL
" (We)' agree to save, indemnify and keep harmless the City of
MISC. '. REFER TO ORD -
Cupertino against liabilities, judgments, costs and expenses which
may in any way accrue, against said City in consequence of the
CONST. TAX
• PERMIT ISSUANCE 3.00
grant in f this ermi[. I,
�• ��� `k �/
MECH. CONT. LIC. NO.
MECH.
TOTAL
TOTAL
113
'
Signaturf of Applicant/Contractor Dae
OFFICE COPY
CITY OF CUPE111TINO
I11SP1.;GTIO1! RLCORD (Office. Copy)
Ducts & Insulation
_
Fire Dampers
Fireplace _
_Z
Crease Duct & Hood
One Hour Shaft
1022
Condensate Drain
__ 10196 Adriana Ave.
PI;RPIIT NO. SANITARY DIST. NO.
LOT
NO. ADDRESS
Other
Not Approved
Addition
/
T.
Peterson
247-3735
PROJECT
OWNER
JOB SITE PHONE N0.
PERMIT ISSUED
Date
ELECTRICAL
Buildin
97-9-81
Date Insp.
Electrical
9-9-81
Power Pole
Plumbing
Underground
_
Ilcchanical
Rough Wiring
b . :5A �T
Temp. Cas/Elect.
11alls
Solar
Ceiling
Fire Sprinkler
Fixtures Int/Ext
Sign
ilotors '
Grounding
u Mise.
Temp. Power
Other
FINAL, INSPECTIONS
Not Approved
Date
Insp.
r,F.s _
Electric
Plumbing
Mechanical
Solar
Pool
Gradin
]'.lamming
' *Fire Dept
health Dept.
Pwilding
Other
BUILDING
Date Insp.
Pad Certification
Foundation
Pre-Gunite
Slab-IIeribrane
Bond Beam
Underfloor Girders . $
Floor Steel
Tiedowns
Diaphrams
Seismic Bracing
halls -Panels A7- ,,-k ,�,i,4�• 11 -1 -KI
Frame
La t
Uallboards Int/I'.xt.
Firewalls
Other
Not Approved
W'`rp�ydr",��L
i
PLUMBING
Backflow
Date Insp.
Underground
Underfloor
Partial Rough
Rough Complete
Solar Rough
Water & Insulation
Main Drain
R/of/S Drain
Gas
Other
Not Approved
MECHANICAL
Date
Underfloor S.M.
Insp.
Ducts & Insulation
_
Fire Dampers
Fireplace _
_Z
Crease Duct & Hood
One Hour Shaft
_
Condensate Drain
Equipment Anchorage
Flues & Comb. Air
Other
Not Approved
BUILDING
ELECTRICAL
MISCELLANEOUS
FLOOR AREA', ".`t
X., 1 14
TOTAL Sq Ft l�02
)OC
Window:
S quare.Fee tofW
-:ou'-w
eFeet- 6l4i�d6T
Squa7"r:
5,
`
HRMS:
CI )P- CUPERTUIO,':RESIDEITTIAL ENER
w .
"ddhEliatior4iu64ed
,V; -u.LA,, SHEET-_-,---
UB C,- GROUP";: "R-3'!.- ENERGY CONSERVATIONA;
MIN11M R - VALUE
.-
--
.;-,�.,4:-type- s4ilec;i
.0 INSULATION
JOY LA'
iii
4"A 041V
loy Address
PP :Job- is
EAST-.-
"WEST 1. 3!
ur
Data' ' 0 by`Siibdivisidni-`-
.Penetrates
fc thg"
�`Fiamizx&,"Penetrates,:,,15 litati—
u
L
'Sq-.
l. .2
allovabie
a
Rivi ate:
b.
ew,,, y
Date; '�'";,-�-
P4 rmi t rg
ofi-Ener C�2�evition.Certifi6atioi:*....�,'
-X
E, I NG 2
IL
WUMOT-7- CALCUATIONS,
M
nt. V;.
FLOOR AREA', ".`t
X., 1 14
TOTAL Sq Ft l�02
)OC
Window:
S quare.Fee tofW
-:ou'-w
eFeet- 6l4i�d6T
Squa7"r:
dctiii6d. An�
`
(GROSS,
w .
"ddhEliatior4iu64ed
kAREAy%k:,
MIN11M R - VALUE
il TT CONSTRUCT'EO14.:-,-�;.�.Indicat e-,
.;-,�.,4:-type- s4ilec;i
.0 INSULATION
JOY LA'
t r. i a r* I a, i I. Lr t+c Framing `Pere rateiXt
T1ood: Fraise th
fra-4ng:enet rat -es-- nsUiiiiori,;"��,.1Z.
P�
idin bv- itu'. cco�, ..... t 1.
gz, !-.-.,..
EAST-.-
"WEST 1. 3!
.Penetrates
fc thg"
�`Fiamizx&,"Penetrates,:,,15 litati—
...TOTALF, t'. W;na ow"",
L
'Sq-.
l. .2
allovabie
TOTAL_ r v.,
IN•D e`.j.i
MATHERS IF
#qt 11anual
TRIP
PING' t . gn.
.3,,,f.or.,,-A4ditional.-In-torma-tio
110 -TE.. See;' Sheet.,
PI.
es
Gasket ;:.s.ure:,
-J4
4
Windowa-'and.. Slidizig- Glas.4;.",: Ddorsi-WILL BE"LABET T.
dctiii6d. An�
an. : 1' Standard, 2k-134
iic I Mationa
w
EXTZRIOR:,;`BUILDI11G CONSTRUCTI
MIN11M R - VALUE
il TT CONSTRUCT'EO14.:-,-�;.�.Indicat e-,
.;-,�.,4:-type- s4ilec;i
.0 INSULATION
t r. i a r* I a, i I. Lr t+c Framing `Pere rateiXt
T1ood: Fraise th
fra-4ng:enet rat -es-- nsUiiiiori,;"��,.1Z.
P�
idin bv- itu'. cco�, ..... t 1.
gz, !-.-.,..
j
t,��t
F--frn sr;dsulztio 6.7
.Penetrates
fc thg"
�`Fiamizx&,"Penetrates,:,,15 litati—
On A
,�',1"-
r S 1ON, 'DESCRMT 101f,�A
b.
P", -W
m 'N .
-C ITTENV:
-X
E, I NG 2
IL
M
nt. V;.
'15ZIR
4
-7_
--2
T4
V
21
d- F U.- V, Ri g, i &M,
Mi", r
rtt`2
NX a
g
7
. . - r!,
'w "wn
6 fg
R
Mean' ay...j.-_po n' F
0
0. M'
nddf'-_' 30 Deg�ee., Days; Summer. D' t- be low-,* I - -
Z
..MLAT1W.TYPE
DUCT.LOCATION
,
Mechanically. Heated Only
Co
d
On.,- Roo f 6 r.om Exterior -of Building, C, Z,
'A.
n.,
cw
�G,
i..,-,, arage
'A
-A'
C611J ng - .1 pac_e�s,(
n.,
F16 L S
Wit'�id t�eii 'Condit 'oned' Soade-,. An-
ilone, required,; E.<°r ; none•.
-Cohdr or:
le in; Ground-'.
7
;VOTE'!': Wh e r e'T ducts. arek.usied for' heating and "cooling;'
'Y. . -MAX. FURITACE'CAPACITIES
ni -r'
:minimum: insulation. b e�_ as required
for the: mos 800,
71/104
.425/36 2;_500,:'
,itestr -ctivi, condi.t on
108
8 0 2;,600, 74 .
IM
:6i Y'Pis
AIpT
1000";1 -
""n 6 0,2 &in' e r,, -a al-�,, f i &4r'��blankets'arid`. felaa°� roc
`31/44. 2;700::77"%112
glas
•u, l, 3 `J048 `3 0 0 7'91116
blanket" ct zs ag,-or-�,.g ass'..
n
'm1netal f ib rb&- s- ag- 27
er
0' 82%120
'/52' 2'
equiva.'I'en't"'.-t:'o.pro-vide:'an- ins ta-lle'd-'.'6onduc tance-.-, -_O'.,:48 1,2 0'�,,' 36
0 i
-mineral*, fiber,
lb
jr
i.,5-3 lb/'c': .,mineral -blanket- (duct'' 1.,300'_ ,`-39[56 3', 0,00' 85%124
3. 10, lb d.:f mineral fiber board..,r Other equivalent-. .
to, provide:';an. installed. Conductance tr-_� -16.
-.1160
O. 1, 4 0 ,42/6,0 1,100.,-.871128-
�7v
d,.:,.weat erproc
-�60,' 'A64"
:1-; 13r
X"
ZSTING'�: BUILDING
-TION O':EX S_ l4lin
Y'6 8 3,300 �!'92/!35_
-1".:
pV
__?Rech"ici�ll 'h44ted-; 6r"."' co'bled' additions,:.mus' comp,
ng. ac -,Or J",
te"4xisti, cessib
-ittidtd?-.th41,, S!t
o 6;�,� s-f/ji '-1'39";-
-Ot4ne mu Le,' t, - , t, ��: 1: , __1 11%,
rds, if, the' gros's.':,floor'-.irea-- of. thl new,.' additi6ii,' isi,.grea er,*l,1 �'-.-TOOL"Z50,4
tj
iii 3 0 X 'a structure 's. gross;�flporj'a
'' '3'z���"Ify neTir`electric>.resistanceriiea'tiag equipment of,. the- existin
9
's, prop7o�s'edN, -'Y6� 3;500 '-.--�,9 871-431,
or.il
t 4
-pm
hia'. a!aii16 structure-,., and -_ thiz', dqla,� � ei
7- '11-',_
r i, hax-10%,.of - the ann"I -heatiik-of`the
entire
90Q� 4-
.80:.
stru. 6
cycle--.cost�
ctilk incIdding. the'addition a., life; -
i s
e uire ass
Climate.'
ion.
they.
Contra -Systeins;-.�'-S'ect
s �As
77.
out 1J.1
84'
7-
:T,7
M
&
Mik a &rZ
V AW4
"SI
"RESISTAN
a s i gn3
kW thertiios"t3t'��'"t
S
OLA
L K
"
r 6'
M
Yo
Mean' ay...j.-_po n' F
0
0. M'
nddf'-_' 30 Deg�ee., Days; Summer. D' t- be low-,* I - -
Z
..MLAT1W.TYPE
DUCT.LOCATION
,
Mechanically. Heated Only
Co
d
On.,- Roo f 6 r.om Exterior -of Building, C, Z,
'A.
n.,
cw
�G,
i..,-,, arage
'A
-A'
C611J ng - .1 pac_e�s,(
n.,
F16 L S
Wit'�id t�eii 'Condit 'oned' Soade-,. An-
ilone, required,; E.<°r ; none•.
-Cohdr or:
le in; Ground-'.
7
;VOTE'!': Wh e r e'T ducts. arek.usied for' heating and "cooling;'
'Y. . -MAX. FURITACE'CAPACITIES
ni -r'
:minimum: insulation. b e�_ as required
for the: mos 800,
71/104
.425/36 2;_500,:'
,itestr -ctivi, condi.t on
108
8 0 2;,600, 74 .
IM
:6i Y'Pis
AIpT
1000";1 -
""n 6 0,2 &in' e r,, -a al-�,, f i &4r'��blankets'arid`. felaa°� roc
`31/44. 2;700::77"%112
glas
•u, l, 3 `J048 `3 0 0 7'91116
blanket" ct zs ag,-or-�,.g ass'..
n
'm1netal f ib rb&- s- ag- 27
er
0' 82%120
'/52' 2'
equiva.'I'en't"'.-t:'o.pro-vide:'an- ins ta-lle'd-'.'6onduc tance-.-, -_O'.,:48 1,2 0'�,,' 36
0 i
-mineral*, fiber,
lb
jr
i.,5-3 lb/'c': .,mineral -blanket- (duct'' 1.,300'_ ,`-39[56 3', 0,00' 85%124
3. 10, lb d.:f mineral fiber board..,r Other equivalent-. .
to, provide:';an. installed. Conductance tr-_� -16.
-.1160
O. 1, 4 0 ,42/6,0 1,100.,-.871128-
�7v
d,.:,.weat erproc
-�60,' 'A64"
:1-; 13r
X"
ZSTING'�: BUILDING
-TION O':EX S_ l4lin
Y'6 8 3,300 �!'92/!35_
-1".:
pV
__?Rech"ici�ll 'h44ted-; 6r"."' co'bled' additions,:.mus' comp,
ng. ac -,Or J",
te"4xisti, cessib
-ittidtd?-.th41,, S!t
o 6;�,� s-f/ji '-1'39";-
-Ot4ne mu Le,' t, - , t, ��: 1: , __1 11%,
rds, if, the' gros's.':,floor'-.irea-- of. thl new,.' additi6ii,' isi,.grea er,*l,1 �'-.-TOOL"Z50,4
tj
iii 3 0 X 'a structure 's. gross;�flporj'a
'' '3'z���"Ify neTir`electric>.resistanceriiea'tiag equipment of,. the- existin
9
's, prop7o�s'edN, -'Y6� 3;500 '-.--�,9 871-431,
or.il
t 4
-pm
hia'. a!aii16 structure-,., and -_ thiz', dqla,� � ei
7- '11-',_
r i, hax-10%,.of - the ann"I -heatiik-of`the
entire
90Q� 4-
.80:.
stru. 6
cycle--.cost�
ctilk incIdding. the'addition a., life; -
i s
e uire ass
Climate.'
ion.
they.
Contra -Systeins;-.�'-S'ect
s �As
77.
out 1J.1
84'
7-
:T,7
M
&
Mik a &rZ
V AW4
"SI
"RESISTAN
a s i gn3
kW thertiios"t3t'��'"t
S
OLA
L K
"
r 6'
M
ENERGY— Vi
-CONSERVATION REQ
Ik- -4�t, ZV.
R
'A
kv,
Infiltration
Doors. andt7i
ndo%4sW i g ng doors n f doo' ' and --windows- exposed, td.,ambient.'co'ndi ions:-.,
':
fully 4eatherstrippied- Basketed
t such' as garages, shall be.
,Or. O�undonditibne&areAs
or otherwise treated. to -limit infiltration., All manufactured windows and sliding-
ass-. d6br.§.-` sh aill,. mde &.thei- sir. inf iltratiofi. standards, of';the 1972
I.Stand4rds'Institute. (A134�. 1', A134.2, A134.3, and A134'.4)�,- when tested. -Iii" acc-ordarice
t28,2 2
w i t fi� -AS 171 -!�73.-.withi a:1pr'essure. differential, of, 1. 57
in
a -f ai-�-g*ystems":exhaus t ing:a1r.;'f rom,..:'th6,--bulid" &jenye'. opd�vg the
.out— -
e
shdll:,--- bK..';'Orbgided.,', with;- b,4ckdtaft- -dampers: or automatic' -:'4 ropers installed
x�--a -r;,j1ea1cage1-i.
_2
quipmentw.•Ie 't'',
_e si�' P'reventive:ma n tenahce.'td.�maint9fn---..e
efia`nqt`q"`;-` Eii
OP
enation:' -sKaII..�.-b e.. ',,f urn' s, '---.with complete necessary maintenance: °
;_,'.Required;..foutine'.maintena'nce,'.actions shall,,beclearly stated 1'an&'-';inc,orp.orated- on: . --
` . . ;�.
anLg-,- tit -16" and/or.publication
'AccOssiblie.:labeL; which ma may"be jimited., to.; identifyJn
manualfor that.,par,ticuLar: mod'dl-`.ab ,type�.�o
dl
y.,--thel-,mlnu acitukiev'- f6r,4the :,4,
S:; ifif O-rmation-
t;;, 6f--,thi
rnished,.,�'Ib I
s fia:11 be' fu
b A4.2;
r.,';'.upon�",req.ue*sti,.-,�..-
::�4,6r.iginal owhe
k ini:` 1-a esV
I d-
n- cds��"ofi,: as. Coo P. 0 1 nc O'� 94!!r
ti�teiilit'te:n&.
gn i t'f& De'vi
...'-'-r.-co6kihg:--..appliance-;-; except:. -those designied-.-to.- burn only -liquefied A` pe. t
gases
0 r,-.', Have: .'arfz'. electrical:' line -vol -an havef
th6se*:which-.... do not.voltage supp y. -connection-'.
ights shall-:bd installed': es s-... it, a s�.
three, or.,"Ie ss --'.t, con t inubus ly,. burning: pilot�: 1
thr' ed4uh h"
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Internatio iI Conference of E ilding Officials
RESEARCH COMMITTEE REPORT
Filing Category: FIREPLACES
MODELS DF28, DF36-10, D1I40, DF42, DF42R, DF4211, DF36-
B, DF41, DF46, DF36M, DF36SD AND DE&C ZERO
CLEARANCE FIREPLACES AND M1AffCT
TYPE A8. LOW-11IEAT APPLIANCE CHIMNEY
MARCO MFG., INC.
2520 INDUSTRY WAY
LYNWOOD, CALIFORNIA 90262
I. Subject: Models DF28,. DF36-10, DF40, DF42, DF42R, DF42L.
DF36-13, DF41. DF46. DF36M. DF36SD and DFS Zero Clearance
Fireplaces and Marco Type A8 Low -heat Appliance777mney.
II. Descrjption: A. Models DF28, DF36-10, DF42, DF42R, DF42L,
DF36-B, DF41 and DF46 Fireplaces: These are solid -fuel -burning fire-
places designed for installation with zero clearance to combustibles. They
have the same basic design except for overall dimensions. Additionally,
Modcls DF42R and DF42L incorporate right and left side openings, respec-
tively. The fireplace body is a triple -walled box with intermediate and outer
walls of No. 28 gauge aluminized steel with 2 -inch -thick fiberglass insula-
tion between. The hearth pan (firebox base), fabricatcd from No. 28 gaugc
aluminized steel, is lined with 1'h -inch -thick refractory cement material.
Additional protection is *provided by two No. 28 gauge aluminized-(ypc
steel heat shields located 1'/ inches under the hearth pan. The heat shields
arc 3 inches apart to facilitate circulation of cooling air. The firebox walls
are No. 20 cold -rolled porcelainized steel. The firebox opening is protected
by a metal mesh screen. The rear wall is prolcc(cd by a 2 -inch -(hick layer of
95- to 110 -pound -per -cubic -foot -density fire bricks. The units arc designed
for use with listed triple -walled low -heat appliance chinnncys. The overall
height of the fireplace assembly including the chimney must not exceed 35
fee(.
Except for the DF36-B fireplaces the chimney is to be installed with not
less than I inch clearance to combustible material. For sections below the
first joist area a 2 -inch clearance is required for Models DF42. DF42R and
DF42L and 3'1.12. inches for Models DF28 and DF36-10. established by the
integral spacer of the starter section. Chimney clearances ti) the floor.and
cciling construction arc established by factory-furnishcd fire -slop spacer.
Chinnncy used on the DF36-B units may be installed al zero clearance to
combustiblcs. Overall size of file fireplaces, clearance to connhustibles,
chimncy size and details of the hearth extension are shown in Table No. I
and Figures A and B.
As indicated in Figures A and 13, clearance to adjacent sidcwalls may be
reduced when the manufacturer's Models 20WS and 40WS wall shields arc
used. The 20WS shield is 20 inchcs-wide and 40 inches high. The 40WS
shield is 40 inches wide and 40 inches high. Both shields consist of a No. 22
gauge cold -rolled steel sheet and a I -inch -thick Owens-Corning I -S Type II
insulation board. laminated with sodium silicate glue.
B. Model DF36M: This unit is similar to the previously described Model
DF36-B unit except for glass doors protecting the firebox openiing and an fl-
inch-diamcter hole in the firebox base to provide outside connbuslion air.
Additionally, the listed 8-inch-dianncler chimncy for this unit may be in-
stalled with zero clearance to cOtnbUslibles. LOLIVcrcd openings in the front
base of the DF36-B uni( arc onniltCd on this unit. '['he unit cannot be installed
on concrete slab Boors or any surface which docs not allow ducting of
outside connbuslion air. A template is furnished with each unit to facilitate
proper loca(ion of. the conthusuon air opening. Overall size of the unit and
details of hearth extension and chimncy arc included in Table No. I and
Figure A.
C. Model DF36SD: This is also a solid-I'LICI-burning factory-buill firc-
place designed for installation at zero cicarance•lo connbusiiblcs. It is
similar to the DF36-B unit except that it utilizes an 8-inch-diannelcr insu-
lated -type listed low -heat appliance chinnncy acid openings forcooling air in
the base are eliminated. Additional details arc noted in Table No. I and
Figure A.
D. Model DF36C• The Marco Model DF36C is also a solid -fuel -burning
•
fireplaceconsistingo(i'a0.018-inch-thick aluminized steel firebox wrap and.
'a 0.018 -inch -thick galvanized steel outer body between which is a cooling
air gap. A layer of insulation is attached to the outer body. The floor. rear
wall and the sidewalls of the firebox arc lined with 1'/ -inch -thick cast
refractory. A.damper is provided at the top of the firebox. The unit is
designed for use with (he Marco 8-inch-diannctcr listed low -kcal appliance
chinnncy. Chimney scclions arc to be inslallcd with a mininnann I. -inch
clearance to combustiblcs. Chinnncy clearances to the floor and ciling
construction arc established by factory-furnishcd firc-stop spacers. The
hearth extension must consisl of minimum I -inch -(hick asbestos millboard
Report No. 2578
Fcbrunt_v, 1980
or approved equivalent. Additional installation requirenCnts are given in
Table No. I.
E. Model DF40: This fireplace is similar to the previously described
DF41 unit except that it uses outside air for combustion, glass doors for
preventing heat loss and two blower fans to enhance the Ilocv of circulating
air within the fireplace. The firebox body is of double-wall construction
with inner and outer walls of No. 20 gauge aluminized steel and No. 26
gauge galvanized steel, respectively. with 'I -inch-thick glass fiber insulation
in between. A No. 20 gauge aluminized steel heat exchanger is fastened un
the outer surface of the firebox wall on both sides and the back. "hhe hearth
pan is fabricated from No. 20 gauge aluminized steel and is lined with 1112 -
inch -thick refractory cement material. The same refractory cenncnl nnaterial
is used to line both the sides and back walls of the firebox. Additional
protection is provided by a No. 28 gauge.galvanlzcd steel 'hcal shlcld localed
1'h inches under the hearth pan. Outside combustion air introduced into 1110
firebox by means of two 7 -inch -diameter openings on lop of the fireplace is
channeled down through the front right and left frame. A pair of bifialding
glass doors are mounted in the front frame in front of a metal nncsh screen
that covers the firebox opening.. Each bifold door assembly is provided with
a handle containing contact parts of wood. Two blower fans arc located in
I ront on either side of the fireplace in the lower cooling air intake area.
These fans are connected in parallel through a skitch into a junction box
located on the lower right side of the fireplace. A 115 volt, 60 Heriz power
source is required to operate the fans. The units arc to be installed in
conjunction with the Marco 10-inch-diamcter lislcd low -heat appliance
chianncy' The chimney is Io be inslallcd with not less than I -inch cicarancc
to combustible material. The fireplace itself may be inslallcd with zero
clearance to combustibles. The overall height of the fireplace assembly
including the chimney must not exceed 40 feet. Additional installation
de(ails arc given in Figure C.
F Marco Type A8 Chimney: The Marco Type A8 is an 8 -inch -diameter
low -heat appliance chimney for use in single- and multistoried buildings in
conjunction with solid -fuel -burning listed fireplaces and fireplace stoves.
The chimney consists of fire -stop spacers, elbows, T -assemblies, starter
caps, cleanout caps, rain caps, extension pipes and Bashing. The chinmcy is
designed for installation with a minimum I -inch cicarancc to combustibles
and is limited to a maximum height of 35 feet.
The chimncys, elbows and T-asscnnblics arc all fabricatcd as triplc-
wallcd pipes consisting of 0.012 -inch -thick -I'ypc 430 stainless steel flue
pipe, 0.018 -inch -thick aluminium -coated steel intermediate pipe and a
0.018 -inch -thick galvanized steel outer pipe: l-hc cleanout cap is fahriraled
from porcelain -coated steel, while other parts ol'Ihe rain capcxpnscd to the
products of combustion are fabricated from altnininiMl steel.
G. Identification: All fireplaces except the Model DF36M unit 61-1 N, it
permanent label containing the nnanufacturcr's name. address, nuulCI num-
ber, serial number, ICBO research report number. cicarancc to conahusti-
bles, details of chinnncy, Underwrites Laboratories Inc, loco and the
Undewriters Laboratories Inc. file number. The DF36M units carry a
similar label. with the exception that the Undcrwriters.Laboralorics Inc.
logo and file nunnber arc replaced by the name RADCO. Each connponeal of
the chimncy sysfcm is marked with the manufacturer's panne. IhC earl
number, the Underwriters Laboratory nannc or logo and, where applicahlc.
the clearance to combustiblcs.
III. Evidence Submitted: Reports ol- 1CSIS COMILICICII in accordance
with UL Standards 127 and 103, installation instruC6011S, and quality
control manual are submitted.
Findings
IV. Findings: That the fireplaces listed in this report are I'actory-
built fireplaces complying with Section 3702 of the 1979 Uniform
Building Code and the Marco Type A8 chimncy is a factor. -built
chimney designed for use vvith solid -fuel -burning fireplaces and fire-
place stoves, subject to the following conditions:
1. They are fabricated, identified and installed in accordance «ith
this report.
2. Except for the Model DF36i14 unit, the fireplaces and chinmeys
are fabricated under a recognized quality control program with
inspeclions.by the Underwriters Laboratories Inc. (AA -523).
3. The DF36M fireplaces are produced under a recognized quality
control prograrii with inspections by RADCO (AA -528).
4. Combustion air shall be provided as set forth in the 1979 Uni-
form Mechanical Code.
This report is subject to annual re-examination. Page 1 of 4
Page 2 of 4.
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0 '
r A
CHIMNEY
CLEARANCE
1"TO
COMBUSTIBLES
FIRE
STOP 7
SPACER
PIPE
SECTION
TOP
SPACER
0" TO4B.
I G
REAR
01, TO HEARTH
SIDE EXTENSION
0" TOA
FLOOR
MODELS DF28, D.F36-10, DF42, DF36-B, DF41, DF46,
DF36C, DF36M and DF36SD Fireplaces.
FIGURE A
FIRE STOP
SPACER
(MUST BE
ON BOTTOM
OF JOISTS)
STARTER
SECTION \
20 WS SHIELD
(MUST BE
USED WITH
ADJOINING
COMBUSTIBLE
WALL)
0" TO
REAR _
40
0" TO
FLOOR
44'
MODELS DF42R AND DF42L FIREPLACES
LEFT-HAND OPENING SHOWN
FIGURE B
Report No. 2578
DIMENSIONS IN INCHES
MODEL
A
B
cl
DF28
54
16
36
DF36-10
62
.16
36
DF42
76
20
36
DF36-B and DF36C
46
16
24
DF41
51
16
36
DF46
56
16
36
DF36
46
16
24
DF36SD
46.
16
24
'When 40WS wall shield is used, dimension "C" may be reduced to 12 inches.
CHIMNEY
CLEARANCE
. 1"TO
COMBUSTIBLES
0" TO
SIDE
12" FROM
OPENING
HEARTH
EXTENSION
♦ 36" FROM FIREPLACE OPENING
74" TO COMBUSTIBLE WALL (WHEN
/ COWS WALL SHIELD IS USED,
CLEARANCE MAYBE REDUCED
TO 12"
Page 4 of 4
CHIMNEY CLEARANCE
1"TO COMBUSTIBLE
PIPE SECTION -�
WARM AIR
GRILLE (DISCHARGE)
BLOWERS
(BEHIND GRILLE)
Report.No. 2578
FIRESTOPSPACER
0,,TO TO P
OUTSIDE COMBUSTION
AIR DUCT
- J•/ I 0" TO SIDE
/ I
- 0" TO REAR
E.COOLAI
0"TO FLOOR
JUNCTION BOX
R GRILLE
HEARTH EXTENSION
FIGURE C (DF40 FIREPLACE)
l
' � l
HIM" B. RREWSTFTZ
I
FA
?,)L 4 S -T
WALL
f
A
HUGH B. BREWSTER