10-0144 (MECH)"'
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
1.0-0:0.0.0.0:144
Property Address:
54913 OAK HILL
APN:
775 -141 -035 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
5000
Applicant: Architect or ngineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
----------------------- I ---- ----------------------
SE ONT ACTOR'S DECLARATION
hereby affirm under penalty of perjury at I -amlic s rider provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bus, ass and Pr �sionals Code; andmy License is in full force and effect:
License Clas : C 0 Licens6 No.: .725283
Date: + 'Lfo K) Convacto" .
L
OWNER -BUILDER DECLARATION
-I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or.county that requires•a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she.is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she 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 to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 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 and Professions Code: The
Contractors' State License Law does not apply to an,owner of property who buil ds'or improves thereon,
and.who does the work. himself or herself through his or own,employees, provided that the
improvements are not intended or offered for sale. If; however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not.build or
improve for the purpose of sale.). -
(_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does notapply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.). -
1 1 I am exempt under Sec. , B.&P.C:* foi'this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Owner:
STINE RESIDENCE
54913 OAK HILL
LA QUINTA, CA 92
(760)777-1201
Contractor:
AIR EXPERTS AIR
PO BOX 94
LA QUINTA, CA 92
(760)777-1724
Lic_ No.: 725283
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
21.
FEB 2 r' 2040
C ND
E -
CITY nF LA WANTA
Date: 2/26/10
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: I -
I have and will maintain a certificate,of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code for the performance of the work for which this permit is
issued.
have and will maintain workers' compensation insurance,'as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier EXEMPT ollcy Number EXEMPT
I certify that, in the per of she work for which this permit is issued, I shall not employ any
person in any marine so asto `omesubject to the workers' compensation laws of California,
and agree that, if I s uld beco e. ubject to the workers' compensation provisions of Section
3700d0 of the Labor Co a,. I shall hwith-comply with those provisions.
Date:19 • _ /V Applicant:
114
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, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application._1. Eachpersonupon whose behalf this appG6ation is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and holdharmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of suc permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state at the ov information is correct. I agree to comply with all
city and county ordinances and state laws relating to buildi nstruction, and hereby authorize representatives
of this coty enter upon the above-mentioned r pe r inspection purposes.
Dat ,� Signature(Ap entl:
f I
Application Number . . . . . 10-00000144
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 33.00
Plan Check Fee
8.25
Issue Date
Valuation . . .
. 0
Expiration Date 8/25/10
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000 EA MECH
FURNACE <=100K
9.00
1.00 9.0000 EA MECH
B/C <=3HP/100K BTU
9.00
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE PACKAGE (1)AIR CONDITIONING UNIT
15 SEER.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
-------------------------------------
Paid Credited
Due
Permit Fee Total 33.00
--------------------
.00 .00
33.00
Plan Check Total 8.25
.00 .00
8.25
Other Fee Total 1.00
.00 .00
1.00
Grand Total 42.25
.00 .00
42.25
LQPERMIT
Prescriptive Certificate of Compliance: Residential CF -1R ALT
Residential Alterations age 1 of
Project Name: Climate Zone # # of Stories
'%►N E I /K' ,
General Information
Site Address: S I3 Q �t f
Enforcement Agency:
Date: -ZZ(D 1 ()
Building Type B'Stmgle Family ❑ Multi Family
Circle the Front Orientation: N, E, S, W, or degrees 1�
Conditioned Floor Area (CFA): /(A
Project Type: -0Alterations ❑ Envelope ❑ Fenestration ❑ Roof TrVXC
Replacement or Chan e'Out ❑ Duct Replacement: ❑ Water Heater
NOTE: This form is not to be used for Newly Constructed Buildutgs or, Additions
Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Straps Construction table below)
Assembly Alteration
❑ Opening of framed cavity alone—Alterations that involve the opening of theframed cavity ofa wall, ceiling: or floor must install the
mandatory minimum insulation value per §150 for the altered assembly. Fill in Columns A —C and enter mandatory insulation value in Column H.
❑ Replacement of entire assembly— Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component
Packs e- D insulation values in Table 151-C Fill in Columns A—J.
Opaque Surface Details For the furred4rtioned of Mass:R'alis; see Furring StriConstruction Table below.
A B C D 'E.. F I G H I J
Proposed See Noft Standard. Values'From JA4 Table
TJ
ID
Assembly Name
or Type'
Framing
Material
and Size2
Thickness, Framed
Spacing, U- JA4 Table Cavity
or Other' factor4 .Numbers R-value6
Continuous JA4 Proposed
Insulation Assembly Assembly
R -Value' Cell ValueU-factory
Walls From Reference
in FurringSpace from Reference
Joint Appendix Table 43.5 43.6 43.7
Joint A ndix Table 43.13
U
$
`�
w o
U
n
v,
Assembly � < g
w
]
g a
`o g 1 9
m "
y U
H o ,p o � o ' �
"
Final
Note: For furred assemblies, accormung for Continuous Insulation R -value, see Page JA4-3 and Equation 4-I. For calculating furred walls use the Mass and
Fumng Construction table below.
1. For Tag/ID indicate the identification name that matches the building plans.
2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, CraQ Space, Doors and etc ... Indicate the Frame type and Size: For
Woott Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing Between framing. members enter; 16 "or 24 "OC; or Other for all other assembly description
such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc....
4. Based on the Climate Zone; enter the Standard U factor from Table 151-B, C or D for each different assembly Name or type.
5. Enter the Table number that closely resembles the proposed assembly.
6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0".
7. Enter the Continuous Insulation R -value for the proposed assembly, otherwise, enter " 0 ".
8. Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U factor in Column J
9. The Proposed Assembly U factor, Column J, must be equal to or less than the Standard U factor inColumn E'to comply.
Furring Strips Construction Table for Mass Walls Onl
A I B I C D I E
F G H I J I K
L
M
Proposed Properties of Masonry and Concrete
Added Interior or Exterior Insulation
Walls From Reference
in FurringSpace from Reference
Joint Appendix Table 43.5 43.6 43.7
Joint A ndix Table 43.13
U
$
`�
w o
U
n
v,
Assembly � < g
w
]
g a
`o g 1 9
m "
y U
H o ,p o � o ' �
"
Final
Mass
Name or JA4 Table
>
"'
�
0 5 o -a
'fi� ' '
�Assembhl,
Thickness'.
T e2 Number' Q
c
a >
U -factor" r
Comment
Registration Number: Registration Date/Time:
2008 Residential Compliance Forms
HERS Provider:
August 2009
Prescriptive Certificate of Com fiance: Residential CF -1R -ALT
Residential Alterations age 2 of
Project Name: Climate Zon # of Stories
�i 1N IS
ass and Furring Strips Construction ooaWotes
. Indicate the type ofassembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Etc. Additional assemblies can
found Reference Joint Appendix JA4.
2. This is the U -Factor based on the thickness of the assembly in inches.
3. The R -value of the insulation. to be added on the interior or exterior of the assembly.
The Calculated R- Value is the R -value of theArred, out section of thiassembly.
.-6 The Final Assembly is calculated using Equation`4-2 or Equation 4-4of the Reference. Joint Appendix JA4. The equation is the inverse of Colum
added to Column I. Column K is the inverse from column J.
7 Insert the calculated U- actor value on to the OpaqueSurface Details in Column J
FENESTRATION PROPOSED AREAS
❑ Replacing window alone — Replacement windows shall meet the U -Factor and SHGC Value requirements of Component Package D in
Table 151-C. The Total Fenestration and West facing Area requirements are not applicable.
❑ Adding 50ft2 or less ofwindow area —Newly installed windows shall meet the U Factor•and SHGC Value requirements of Component
Package D in Table 151-C.
❑ Adding more than 50ftz ofwindow area — Newly installed windows shall meet the U -Factor and SHGC Value and the Fenestration
Area requirements of Component Package D in Table 151 -C. Complete the Altered Fenestrationllowed Area Table on Page 2 of the CF -1 R -ALT
Orientation..
E
F
Fenestration Type and Frame (North, East,
indow, Glass Door or S li South, West)
PropsedArea'
(8
Maximum Maximum
U-factorz' 3 SHW 3 °
NFRC or Default
values
Existing
Fenestration
Total Area
CFA of Entire
% of
. Fenestration
Area
Fenestration
Allowed
Proposed Areal
Dwelling
CFA
Area
Removed
1. Fenestration area is the area of total glazed product (i.e. glass plusframe). Exception: When a door is less than 50106 glass, the fenestration
area may be the glass area plus a 'T inti frame" around the, glass.
2. Enter value from Component Package D Requirements in Table 151-C.
3. Actual fenestration products installed and as, indicated in CF -6R -ENV Form shall be equivalent to or have a lower U factor and/or a lower
SHGC value than that.spec*fred on the CF -IR ALT Form.
4. Submit a completed WS -3R Form if a reduced SHGC is calculated with exterior shading. .
5.YiWlicable at this stage enter `NFRC" or NFRC Cert* d windows or are CEC "Default" valuesfound in Table,116-A or B.
ALTERED FENESTRATION ALLOWED- AREAS
O 4* if more throe"5OJt3
of enestration is added)
A
B
C
D
E
F
G
Allowed
Existing
Fenestration
Total Area
CFA of Entire
% of
. Fenestration
Area
Fenestration
Allowed
Proposed Areal
Dwelling
CFA
Area
Removed
Area Added
A x B
D + C
Total Fenestration Area
20
-
>
West Fenestration Area
(Required In
.05
>_
CZ's 2, 4&7-15
1. West Fenestration Area includes west -sloping skylights and any. skylights with a pitch less than 1:12.
2. West facing glazing area removed cannot be "counted" twice. " In order to distribuie the west glazing area removed to the other orientations,
input the west glazing area removed in the Total Fenestration Area raw, column D.
3. Include the Proposed Area of the West facing fenestration in both Area .columns below.
4. To meet compliance, the Proposed Area must be less than ore l to the Total Allowed Area or BOTH the Total and West Fenestration Areas.
Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms
August 2009
Prescriptive Certificate of Com fiance: Residential CF -1R ALT
Residential Alterations age 3 of
Project Name: Climate Zone # # of Stories
ROOFING PRODUCTS (COOL ROOFS).§15](1)12
When the area of exterior roof surface to be replaced ext Beds more than 50•/ of the existing roof area, or nwre than 1, 000 ,whichever is
less, the new roofing area must meet the roofing product "Cool Roof'requiiements of§I52(b)IHi, I52(b)IHii, or 152(b)IRUL
Check applicable altemadve or exception below if the roof alteration is exempt from the roofing product "Cool Roof' requirements. Note: If any
one of the alternatives or exception below is checked the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in
§118(1) are not applicable. Do not fill table below.
❑ Cool Roofs Not Required in Climate Zones 1=12, 14, and 16 with a Low -Sloped. Lessor 2:12 pitch.
❑Cool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep -Sloped Roofs (pitch greater than 2:12) and product unit weight less
than 5lb/ft2.
Alternatives to §152(b)1Hi and §152(b)Hi4 Steep -slope roof (pitch > 2:12)
❑ Insulation with a thermal resistance of at least 0.85 hrtV•°F/Btu or at least a 3/4 inch air -space is added to the roof deck
over an attic; or
❑ Existing ducts in the attic are insulated and sealed according to § 151(f)10; or
❑ In climate zones 10, 12 and 13, with 1 fl of flee ventmon area of attic ventilation for every. 150 f of attic floor area, and
where at least 30 percent of the fire ventilation area is within 2 feet vertical distance of the roof ridge; or
❑ Building has at least R-30 ceiling insulation; or
❑ Building has radiant barrier in the attic meeting the requirements of §151(f)2; or
❑ Building has no ducts in the attic; or
❑ In climate zones 10,11,13 and 14, R-3 or greater roof deck insulation above vented attic.
Exception to §152(b)lHii4 Low -slope roof (pitch <2:12)
❑ Building has no ducts in the attic:
Other Exceptions
❑ Roofing area covered by building integrated; photovoltaic panels and solar thermal. panels are exempt from the below Cool Roof criteria
❑ Roof constructions that have thermal mass over the roof membrane.withatleast 25 lb/ftis exempt from "the below Cool Roof criteria.
Note: If no CRRC-I label is available, this compliance method,cannot: be used; use the Performance Approach to show compliance, otherwise,
Check the applicable box below if Exempi-from the Roo " Products "Cool Roof'
Roof Slope
Pfodiict Weight
Product
Aged
Solar
Thermal
CRRC Product ID Number'
< 2:12 > 2:12
< 5Ili%fid, ..> 5lb1fe
TYM2
Reflectance'
.4
Emittance
SRI'
❑
a
a
❑
❑4
❑
❑
' ❑
❑
❑4.
❑
❑
❑
❑
❑4
❑
❑
❑
❑
❑4
o
❑
o
o
❑4
1. The CRRC Product ID Number can be obtained from the Cool Roof Ratrag Council's Rated Product Directory at www.coolroo&org(producis/search PhD
2. Indicate the type ofproduct is being used for the roof top, i.e. single: ply roof,. asphalt roof, inetal roof, etc.
3. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same
directory and use the equation (0.2+0.7(p1it &d — 0.2) to obtain a calculated aged value. Where pis the Irdtial Solar Reflectance.
4. Check box if the Aged Reflectance is a calculated value using the equation above.
5. Calculate the SRI value by using the SRI- Worksheet at httn://www. energy.ca.gov/tide24/and enter the resulting value in the SRI Column above and attach acopy of
the SRI- Worksheet to the CF -IR
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in §118(1)4. Select the applicable coating:
❑ Aluminum -Pigmented Asphalt. Roof Coating
Cement -Based Roof Coating
Other
Registration Number:
2008 Residential Compliance Forms
Registration DatelTimec HERS Provider:
August 2009
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations age 4 of
Project Name: Climate. Zone # # of Stories
`s'rN 1�
HVAC SYSTEMS - HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be
gas or propane fired and may not exceed SO gallons. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground
hot water pipes is required in all com nentpa&kw in all climate zones.
Minimum
Duct or Piping Configuration
Heating Equipment
and
Efficiency Distribution
(AFUE or HSP Type and Location°
Insulation Thermostat (Central, Split,
R -Value Type Space, Package or H dronic
1Type
04mle izo,tto
C-
- 2 q
Tank
Energy Factor or
Insulation
1. Indicate Heating Type (Central Furnace, Wall Furnace, Heat pump, Boden. Electric Resistance, etc.)
2. Electric resistance heating is allowed only. in Component Package C, or except where electric heating is supplemental (i.e., if total capacity
< 2 KW or 7,000 Btu/hr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §151(b)3 exception.
3. Refer to the HERS Verification section on Page 4 of the CF -IR -ALT Form for additional requirements and check applicable boxes.
4. Indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc.)
HVAC SYSTEMS - COOLING
Minimum r
Cooling Equipment
Type and Capacity -2
Efficiency Dud or Piping Configuration
(SEER/EER or Distribution Insulation Thermostat (Central, Split,
COP) Type and Location': R -Value Type Space. Pac a or H dronic
y
,v G : L
1. Indicate Cooling Type (A/C, Heat pump, Evap. Cooling, etc)
2. Refer to the HERS Verification section on Page 4 of the CF -JR -ALT Form for additional requirements and check applicable boxes.
3. Indicate Type or Location(Ducts, H dronic in Floor, Radiators, etc.
WATER HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be
gas or propane fired and may not exceed SO gallons. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground
hot water pipes is required in all com nentpa&kw in all climate zones.
External Tank
Water Heater Type/Fuel
Distribution Type
Number In
Tank
Energy Factor or
Insulation
Type'
(Standard,.Recircul )'
System
C )
Thermal Efficiency
R -Value'
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.)
2. Recirculating systems serving multiple. dwelling units shall meet the recirculation, requirements of §150(n). ,Tire Prescriptive requirements do
not allow the installation of a recirculating water heating system for single dwelling units.
3. The external water heating tank and i shall. be insulated io meet the requirements o 1 SO ' .
SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below.
These items may require written Justdication and documentation and special verfication.
NEW ROOF ASSEMBLY - Riiidiant Barrier
The radiant barrier requirement of § 151 2 does not apply to roof alterations.
Slab Edge (Perimeter) Insulation D YES .D NO
YES: In Climate Zone 16 in Component Packages D, R-7 insulation is required.
Heated Slab Insulation D YES O NO
YES: Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation, 13 YES D NO
YES: In Climate Zones 1, 2, 11, 13 14 & 16, R-8 insulation is • in Climate Zones 12 & 15, R-4 is required under component Package D.
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass, use the Performance Approach.
Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms
August 2009
Prescriptive Certificate of Com fiance: Residential CF -IR -ALT
Residential Alterations age 5 of
Project Name: Climate# # of Stories
S%INF— 1 .1
HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERSMeasures specified in. this
checklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector beforefinal
final
inspectiom
Duct Sealing esting HERS verification is required for, this measure.
❑ YES O YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned
space, the ducts are to be sealed per § 152(b)1 Dii and the newly installed ducts are to be insulated per § 151(f)10.
❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
❑ YES NO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the
ducts are to be sealed per §I52(b)IDi.
ES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler,
outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are to be
sealed per §152(b)1E.
❑ EXCEPTTON: Duct.systems that are documented to have, been previously sealed confirmed through HERS
verification in accordance with procedures in the Reference Residential Appendix RA3.
❑ EXCEPTION: °Duct systems with less than 40 linear feet in unconditioned space.
❑ EXCEPTION: Existin duct stems constructed insulated or sealed with asbestos.
Refrigerant arge - Split System HERS verification is required for this measure.
❑ YES O YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (inchiding the replacement of the air
handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat
exc er areffigerant charge measurementshall be verified pet §152(b)IF.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The ventilation requirements of § 150(o) do not apply to existing.residential homes.
Ducted Split Sy i ms - Air Conditioners and Heat Pumps: Airflow HERS • verification is required for this measure.
❑ YES 0 YEs: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is
replaced, the airflow and fan watt draw shall be verified per § 15 1Ci to meet the requirements of § 151 7B.
Documentation Author's Declaration Statement
• I ce . t this Certificate of Compliance documentation is accurate and co ete.
Name: � I N , !, I Lc, J
Signature:
Comlrany • AIR gX PE-2•ZS Are- IGnIQI i q� rt w - N
Date ;Z& / U
Address: n /
`� "(
If App cable ❑ CEA or ❑ CEPE
(Certification
City/Stip:
/-f+ Qu•N-rX a4 922 Y -7
Phone
% ?? J 7 2 L
Responsible Building Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance.
• 1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24, Parts 1 and 6 of the Catifornia.Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building application.
Name:
Signature:
Company:
Date:
Address:
License:
City/State/Zip:
Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300.
Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms August 2009
Bin #
Cray of [ a � Qurnta
Bial ni, 8z Safety Diirfrlofl
Permit # P.O. Box'1504, 7&495 Calle-Tainpko
La Quinta, CA 12253 = (760) 777-7012
Q ��� Building Permit Application and Tracking Sheet
Project Address: S 91S dKe-A l/ Owner's Name: /N
A. P. Number:
Address: If'3 OA�
Legal Description:
City.-ST, Zip: L4 A �A �Z _
Contractor: A je n i
'Telephone: -77 120/
Project Description:
Address: zOK 9y
City, ST, Zap: 1Q QU%A)7-A. a+ 92 7 4/. 7.�
Cr Al,— nN
Telephone: 7(po 7_7717Z-4
•.City. Lie. C
State Lie. # : Zs—ZY.3
Arch., Engr., Designer
Address:
City, ST, Zip:
Telephone: :Construction Type: Occupancy:
State Lie. #: ` ' Project type (eircle.,onc): New Add'n Ai Repair Demo
Name of Contact Person: �vl VA V V yJ cam/ T Sq. Ft.: `, # Stories: ( # Units:
Tel hone # of Contact Person:
� �?'Y!�
..F.stitnated:Value of Project: Q(� —
APPLICANT: DO NOT _WRITE BMQ THIS LINE
M
Submittal
Plan Sets
Req'd
Recd'
TItACKIIVG PERMIT FEES
Plan Check nbinitted item Amount
Structural Cafes.
Reviewed,°ready for corrections Plan Cheek Deposit
Truss Cala.
Called Contact Person Pian Check Balance.
Title 24 Calea.
'Plans picked up Construction
Flood plain plan
Plans resubknitted Mecbinkal
Grading plan
2`' Review, ready for correcdouslinue 'Electrical
Subeoatactor Llst
•:Ca1led,Coutact Person -Plumbing
Grant Deed
. Plans picked ap S.M.L
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
''' Review, ready, for correctioniaisue Developer Impact Fee
Planning Approval
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees