The URL can be used to link to this page

BRER2015-002678-495 CALLE'iAMPICO C 0 D LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: BRER2015-0026 78530 HIGHWAY 111 604050037 ONE ELEVEN,A-QUIh $5,000.00 Applicant: AL MILLER & SONS ROOFING CO IN 68760 SUMMIT DRIVE CATHEDRAL CITY, CA 92234 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: C39 License No.: 336547 �Vf Date: J O%< Contractor: f OWNER -BUILDER DECLARATION � I hereby affirm under penalty of perjury that I am exempt from the Contractor's 4St.t— 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).: (_) I, 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 builds or improves thereon, and who does the work himself or herself through his or her 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 I, 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 not apply 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.). ( I I am exempt under Sec.. B.&P.C. for 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 Na Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/6/2015 Owner: WASHINGTON ADAM PARTNERSHIP 42620 CAROLINE CT 102 PALM DESERT, CA 92253 Contractor: AL MILLER & SONS ROOFING CO IN 68760 SUMMIT DRIVE CATHEDRAL CITY, CA 92234 (760)328-6616 Llc. No.: 336547 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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. _ I 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 as issued. My workers' compensation insurance carrier and policy number are: �arrier: _ Polity Number 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 workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: 03ol0 l S Applicant: 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 Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application 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 hold harmless 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 such permit, or cessation of work for 180 days will subject permit to cancellation. 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. Date: O IS Signature (Applicant or Agent): FINANCIAL INFORMATION DESCRIPTION ACCOUNT' QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID.BY METHOD. RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 DESCRIPTION ACCOUNT.`-". , QTY AMOUNT PAID PAID DATE RE -ROOF - FIRST 2,000 SF 101-0000-42404 0 $49.31 $0.00 PAID BY `. METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RE -ROOF - FIRST 2,000 SF PC 101-0000-42600 0 $98.62 $0.00 PAID BY. METHOD. RECEIPT #, CHECK # CLTD BY Total Paid forRE-ROOF: TOTALS: $147.93 $148.93 $0.00 00 Description: THE SIGNTAURE TM 36537 ESTATES MODELS Type: BUILDING, RESIDENTIAL Subtype: DWELLING - SINGLE Status: ISSUED Applied: 1/23/2015 AZA FAMILY DETACHED Approved: 1/23/2015 AZA Parcel No: 775370016 Site Address: 56175 PLATINUM WAYLA QUINTA,CA 92253 Subdivision: TR 29421 Block: Lot: 2 Issued: 1/27/2015 MFA Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $165,981.50 Occupancy Type: Construction Type: Expired: 8/17/2015 crw No. Buildings: 0 No. Stories: 0 No. Unites: 0 ADDRES51, Details: 2,528 SF DWELLING -.PLAN 1A, LOT 2 [VB/RES-3/CLASS-A/13D] THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS; BBQ OR WATER FEATURE. 2013 CALIFORNIA BUILDING CODES ZIP CHRONOLOGY 4 t 0 Applied to Approved Approved to Lssued CONDITIONS CONTACTS NAME TYPE NAME ADDRES51, CITY STATE ZIP PHONE _ FAX EMAIL APPLICANT CALIFORNIA WEST CONSTRUCTION 1 5927 PRIESTLY DRIVE STE 110 CARLSBAD CA 92008 (760)918-6768 CONTRACTOR CALIFORNIA WEST CONSTRUCTION 1 5927 PRIESTLY DRIVE STE 110 CARLSBAD CA 92008 (760)918-6768 OWNER RREF II CWC LAQ LLC 5927 PRIESTLY DR STE 110 CARLSBAD CA 92008 (760)918-6768 Printed: Friday, March 06, 2015 11:23:40 AM 1 of 5 CRWYSTEMs Printed: Friday, March 06, 2015 11:23:40 AM 2 of 5 CRWYSTEM5 CLTD 'DESCRIPTION ACCOUNT - QTY AMOUNT PAID PAID DATE RECEIPT # CHECK:# METHOD PAID BY BY . BSAS SB1473 FEE 101-0000-20306 0 $7.00 $7.00 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA Total Paid forBUILDING STANDARDS ADMINISTRATION $7,00 $7.00 BSA: DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $942.00 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA DIF - COMMUNITY 254-0000-43200 0 $129.00 $129.00 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA, CENTERS DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $433.00 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA DIF - LIBRARIES 253-0000-43200 0 $344.00 $344.00 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA DIF - PARK 256-0000-43200 0 $40.00 $40.00 1/27/15 R3508 10603 CHECK RREF 11 CWC LAQ LLC MFA MAINTENANCE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 $2,048.00 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA DIF - STREET 255-0000-43200 0 $116.00 $116.00 1/27/15 R3508 10603 CHECK RREF'II CWC LAQ LLC MFA MAINTENANCE DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 $2,842.00 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA Total Paid forDIF - SINGLE FAMILY DWELLING: $6,894.00 $6,894.00 TEMP POWER SERVICE 101-0000-42403 0 $24.17 $24.17 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA TEMP POWER SERVICE 101-0000-42403 0 $16.92 $16.92 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA PC Total Paid for ELECTRICAL: $41.09 $41.09 RESIDENTIAL, EA 101-0000-42403 0 $36.99 $36.99 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA ADDITION 1,000SF RESIDENTIAL, EA 101-0000-42600 0 $15.24 $15.24 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA ADDITION 1,000SF, PC RESIDENTIAL, FIRST 101-0000-42403 0 $145.03 $145.03 1/27/15 .113508 10603 CHECK RREF II CWC LAQ LLC MFA 1,000SF Printed: Friday, March 06, 2015 11:23:40 AM 2 of 5 CRWYSTEM5 Printed: Friday, March 06, 2015 11:23:40 AM 3 of 5 CRWYSTEMS CLTD DESCRIPTION ACCOUNT QTY' AMOUNT PAID PAID DATE RECEIPT .# CHECK # METHOD PAID BY , BY RESIDENTIAL, FIRST 101-0000-42600 0 $47.86 $47.86 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA 1,OOOSF, PC Total Paid for ELECTRICAL - NEW CONSTRUCTION: $245.12 $245.12 CONDENSER/COMPRES 101-0000-42402 0 $36.26 $36.26 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA SOR CONDENSER/COMPRES 101-0000-42600 0 $24.17 $24.17 1/27/15 R3508 10603. CHECK RREF II CWC LAQ LLC MFA SOR PC EXHAUST HOOD 101-0000-42402 0 $12.09 $12.09 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA EXHAUST HOOD PC 101-0000-42600 0 $4.83 $4.83 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA FURNACE 101-0000-42402 0 $36.26 $36.26 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA FURNACE PC 101-0000-42600 0 $24.17 $24.17 1/27/15 R3508 10603 CHECK RREF 11 CWC LAQ LLC MFA VENT FAN 101-0000-42402 0 $72.54 $72.54 1/27/15 R3508 10603 CHECK RREF 11 CWC LAQ LLC MFA VENT FAN PC 101-0000-42600 0 $28.98 $28.98 1/27/15 R3508 10603 CHECK RREF 11 CWC LAQ LLC MFA Total Paid forMECHANICAL: $239.30 $239.30 MULTI -SPECIES 101-0000-20310 0 $1,292.00 $1,292.00 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA RESIDENTIAL 0-8 UNITS Total Paid forMULTI-SPECIES RESIDENTIAL- $1,292.00 $1,292.00 NEW CONSTRUCTION 101-0000-424000 $553.61 $553.61 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA PERMIT Total Paid forNEW CONSTRUCTION PERMIT: $553.61 $553.61 NEW CONSTRUCTION 101-0000-426000 $1,140.70 $1,140.70 1/27/15 R3508 10603 CHECK RREF 11 CWC LAQ LLC MFA PLAN CHECK Total Paid forNEW CONSTRUCTION PLAN CHECK: $1,140.70 $1,140.70 BACKFLOW DEVICE 101-0000-42401 0 $12.09 $12.09 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA BACKFLOW DEVICE PC 101-0000-42600 0 $4.83 $4.83 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA BUILDING SEWER 101-0000-42401 0 $12.09 $12.09 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA Printed: Friday, March 06, 2015 11:23:40 AM 3 of 5 CRWYSTEMS Printed: Friday, March 06, 2015 11:23:40 AM 4 of 5 CRWYSTEMS CCTD DESCRIPTION ACCOUNT QTY AMOUNT PAID. PAID DATE RECEIPT #. CHECK # METHOD PAID BY BY BUILDING SEWER PC 101-0000-42600 0 $12.09 $12.09 1/27/15 R3508 10603 CHECK RREF 11 CWC LAQ LLC MFA FIXTURE/TRAP 101-0000-42401 0 $193.44 $193.44 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA FIXTURE/TRAP PC 101-0000-42600 0 $193.44 $193.44 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA GAS SYSTEM, 5+ 101-0000-42401 0 $36.26 $36.26 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA OUTLETS GAS SYSTEM, 5+ 101-0000-42600 0 $24.17 $24.17 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA OUTLETS PC WATER HEATER/VENT 101-0000-42401 0 $12.09 $12.09 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA WATER HEATER/VENT 101-0000-42600 0 $7.25 $7.25 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA PC WATER SYSTEM 101-0000-42401 0 $12.09 $12.09 1/27/15 R3508 10603 CHECK RREF 11 CWC LAQ LLC MFA INST/ALT/REP WATER SYSTEM 101-0000-42600 0 $12.09 $12.09 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA INST/ALT/REP PC Total Paid forPLUMBING FEES: $531.93 $531.93 SMI - RESIDENTIAL. 101-0000-20308 0 $21.58 $21.58 1/27/15 R3508 10603 CHECK RREF II CWC LAQ LLC MFA Total Paid forSTRONG MOTION INSTRUMENTATION SMI $21.58 $21.58 SINGLE FAMILY 224-0000-203200 $1,837.44 $1,837.44 1/27/15 R3508- 10603 CHECK RREF 11 CWC LAQ LLC MFA DETACHED Total Paid forTUMF - RESIDENTIAL: $1,837.44 $1,837.44 TOTALS::•$12,803.77 Printed: Friday, March 06, 2015 11:23:40 AM 4 of 5 CRWYSTEMS INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE SEWER CONNECTION JFU 2/17/2015 2/17/2015 APPROVED DISAPPROVE LEAKING FITTING TO BE UNDERGROUND PLBG JFU 2/17/2015 2/17/2015 D REPAIRED/CHANGED. Printed: Friday, March 06, 2015 11:23:40 AM 4 of 5 CRWYSTEMS Printed: Friday, March 06, 2015 11:23:40 AM 5 of 5 CRWYSTEMS BOND •• • SUBDIR. ETRAKIT.ENABLED Attachment Type CREATED OWNER ATTACHMENTS DESCRIPTION PATHNAME DOC 1/26/2015 AMY YU PAD CERT.pdf PAD CERT.pdf 0 DOC 1/28/2015 CECILIA PATINO ISSUED PERMIT BRES201._001- 0 SFDpdf pdf SIGNATURE PGA WEST TR 36537- 1 and 2 - SCHOOL FEE AREA MODEL COMPLEX - DOC 2/5/2015 STEPHANIE KHATAMI CERTIFICATION 0 FORM.pdf SCHOOL FEE AREA CERTIFICATION FORM.pdf Printed: Friday, March 06, 2015 11:23:40 AM 5 of 5 CRWYSTEMS Pin /{ Cray of La Quin to Plan $cts. -Building 8t• Safety Division Permit /l P.O. Box 1504, 78-495 Calfe' Tampico . 7 is Quinta, CA 92253 - (760) 777-7012 ..Building Permit Application' and Tracking Sheet Project Address:'1 5_364-0 ll1 Q.i 1 f'LI,91- 64 Owner's Namc: c), K+. �uG� rJ ' -f42TN Fi,�t$ , j A. P. Nurr'W: Address: I+ —6Z� (0e.. iegal.Dcscription: City, ST, Zip: Contractor: 5 r L . > Tdc hone.: :«•-<•:� <; CoasirucGon ' Flood in plan. Address: ' �� uk,y,,rl 9� Project Description: City, ST, Zip: 112 &tt4j A �ZL3 &A -.. rIJ STfit-L R -Y Pmr. Telephone.: %Q�3 •Z) '<<....:«r._<:;r<;:>::«zw•.,;;,:..,-.:::C: ��lGD State Lic. #.: �3 �s� Called Contact Person City,Lic: C. vV1 ( /k1`l 1 f_4- Arch ,' Engr Designer: flans picked up Address: S.1vLL' H.O.A.•ApproVal City, ST. Zip: ?Plans resubmitted Grading . IN-HOUSE:- Telephone: cp ' %Developer Impact Fee Construction Type Occupancy: Called. Contact,Person "OXY : Stato Lie.: w<..<.. . Pro�cet fypc (circle one): 'New'Add'n Alter Repair Dcmb School Fees ;.:-`":: Namc ofContactPcrson: gLl.SS OA I LL S l 2 50 S .. 9: #.Stories: (Units: Telephone # of Contact Pztson: — Z Sid : -70? l Estunatcd Value:of Project r-- .., _,..... ARPLICANT: DO;NOT WfiITE BELpW-THIS LINE # Sulimittal... Rcq'd 12cc'd TRACPE12MI1 Plan $cts. ; Plaa, Chccksubmiticd item Structvrai,Calcs. 'Reviiwed, ready.for corrections Plan Check Dcposit. . Truss Calci.: CaUcd ContactPcrson - . Plan Check Balance, 'Title 24 Calci. plans picked up CoasirucGon ' Flood in plan. ;Plans resubmitted Mechanical Grading plan 2°" Rcvicw, ready for corrcclions/issue Electrical Subcontactor.i ist Called Contact Person 'Plumbing Grant Decd flans picked up S.1vLL' H.O.A.•ApproVal ?Plans resubmitted Grading . IN-HOUSE:- '`.' Rcvicw, ready for corrcctionsfissucq. ' %Developer Impact Fee Planning Approval : Called. Contact,Person "OXY : Pub. Wks. Appr Dale of permit issue School Fees Total Pcrmit Fccs Amount STATE OF CALIFORNIA ENVELOPE COMPONENT APPROACH CEC-NRCC-ENV-01-E (Revised 06/13) - CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-ENV-01-'E Envelope Component Approach (Page 1 of 3) Project Name: f4 i N-& _ ` p,.j,- < L L p Date Prepared: Q�l I k1C� I (✓ A. GENERAL INFORMATION Project Location: t 3 _ `.1 (`\ 6 Compliance Method: ❑ Component ❑ Unconditioned (file Affidavit) 1 2 CA City and Zip Code: 4-11k- qzy 573 7 Building Front Orientation (deg or cardinal): 8 3 Climate Zone: t 8 Permitted Scope of Work 1 ❑ New Construction ❑ Addition Alteration 4 Total Conditioned Floor Area: . �- t30 1 9 Building Types) ❑ Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room S ❑ Schools (Public School) ❑ Relocatable Public School Bldg. EKonditionecl Spaces ❑ Unconditioned Spaces ❑ Skylight Area for Large Enclosed Space >_ 5000 ft? (If checked include the NRCC-ENV-04-E with submittal) B. ENVELOPE DETAILS — Framed 1 2 3 4 5 6 7 8 9 10 11 Ta /ID Assembly Type Frame Material Frame Depth Frame Spacing Appendix JA4 Reference Cavity R -value Continuous Insulation R -value Proposed U -Factor Required U -Factor From Tables, B, C, D Comments C. ENVELOPE DETAILS — Non -framed 1 2 3 4 5 6 7 8 9 '10 Ta ssembly Type Assembly Materials Thickness (inches) Interior or Core Insulation R -value Continuous Insulation R -value Appendix JA4 Reference Proposed U -Factor Required U -Factor from Tables, B, C, D Comments Required U -Factor from Tables, B, C, D Comments D. ENVELOPE DETAILS — Mass 1 2 3 4 5 6 7 8 9 10 11 Tag/ID Mass Type Density (lb/ftp Mass Thickness (inches) Furring Strip Thickness (inches) Interior Insulation R -value Exterior Insulation R -value Appendix JA4 Reference Proposed Insulation U -factor Required U -Factor from Tables, B, C, D Comments CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2013 STATE OF CALIFORNIA ENVELOPE COMPONENT APPROACH ry �f CEC-NRCC-ENV-01-E (Revised 06113) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-ENV-01-E Envelope Component Approach (Page 2 of 3) Project Name: ,n1� 1 A ' 5;,? r `L a Date Prepared: Q s O� S E. ROOFING PRODUCTS (COOL ROOF) 1 2 3 4 5 6 7 8 9 10 11 Mass Roof 25 Ib ft2 or greater Roof Pitch CRRC Product ID Number , Product Type proposed Minimum Required Comments Aged Solar Reflectance Thermal Emittance SRI' (Optional) Aged Solar Reflectance Thermal Emittance SRI (optional) ❑ i 463'4 -0001 S�Nc.�z ❑1 0,16h p -, b 0 -65- e5-❑ 0 ❑1 ❑ ❑1 ❑ An aged solar reflectance less than 0.63 is allowed provided the maximum roof / ceiling LI -factor in TABLE 140.3 is not exceeded ❑ High-rise residential buildings and Hotels and Motels with low -sloped roofs in Climate Zones 1 through 8,12 and 16 are exempted from aged Solar Reflectance and emittance requirements. ❑ High-rise residential buildings and Hotels and Motels with steep -sloped roofs in Climate Zones 1 and 16 are exempt from aged Solar Reflectance and emittance requirements. ❑ The roof area covered by building integrated photovoltaic panels and building integrated solar thermal panels are exempt from aged Solar Reflectance and emittance requirements 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 §110.8(i)4. Select the applicable coating: ❑ Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other NOTES: 1. Check the box if tine agedSaiarmflectanee was not avaldWe in the Cod Roof Rating Council's Rated Product Directary, There use the equation in Section 110.8(i)2 where the Initial Reflectenoe value from dw same directory and use the equabian (0.2+8(p ft al — 0.2) to obtain a cokulated aged value. Wwre p is the Initial Solar Reflectance and B is either set to 0.65for Field-Appleed Coatings or it is set to 0. 70for all other roofing products other then Field -Applied Coating. 2. Calculate the SW Value by using the SRF Worksheet at (IBD) and enter the resdting velue in the SRI Cohnm above and attach a copyfor the SRI -Worksheet NRCC-ENV-Q3-E to the to d* form. F. Air Barrier 1' 2 3 4 5 Ta /ID Air Barrier Material Type Air Barrier Assembly Type Whole Building Air Leakage Testing Comments CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2013 CERTIF)CATE OF COMPLIANCE — DATA FIELD DEFINITIONS AND CALCULATIONS NRCC-ENV-01-E Envelope Component Approach (Page 1 of 1) DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate of Compliance documentation is accurate and com fete. Documentation Author Name: ��, . —rN 2v x Documentation Author Signatur .,ems—T Company: Af- Signature Date: Address: CEA/ HERS Certification Identification (if applicable): City/State/Zip: Phone: -160 41. r Z f RESPONSIBLE PERSON'S DECLARATION S ATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of_Compliance shall be 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 completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: 'fytrL� 1 ktL..r� Responsible Desi 'g azure: � — u. Company: L- W., r LI r_ Date Signed: 3 o(o S; Address: M License: (05—if City/State/Zi . C.. Phone: �I ,� 0 — r CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2013