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BRES2015-020378-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 E k Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: RISEN CONSTRUCTION 82-775 CHARLESTON AVE INDIO, CA 92201 Tjht 4 4 Q" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BRES2015-0203 79957 RANCHO LA QUINTA DR 602370002 RANCHO LA QUINTA/ANTONE/ENCL $9,895.60 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: B License No.: 792381 Date: 'Contractor, OWNER-BUILDERCLAR ION 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 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.). (_) 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 am exempt under Sec. . B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that thereis 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 VOICE (760) 777-7125 FAX (760) 777-7011. INSPECTIONS (760) 777-7153 Date: 7/8/2015 Owner: DOUGLAS ANTONE 27076 HIDDENTRAIL LAGUNA BEACH, CA 92253 Contractor: RISEN CONSTRUCTION 82-775 CHARLESTON AVE INDIO, CA 92201 (760)347-6399 Llc. No.: 792381 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 is issued. My workers' compensation insurance carrier and polity number are: Carrier: _ Policy 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 Sec43700bor PWFUL, comply with those provisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERCOVERA71SUN 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 eVuponabove mentioned///prrope/Irtyy for inspection purposes. Date: -7/,q [_E_Signature (Applicant or Agent). s "DESCRIPTION ' 4 FINANCIAL INFORMATION `ACCOUNT. QTY. 6. ; ..AMOUNT._ - `; PAID iPAID DATE,. ADDITION, EA ADDITIONAL 500 SF 101-0000-42400 0 $62.36 $0.00 $ -PAID BY . ``� -METHOD' a RECEIPT4. p CHECK# CLTD BY DESCRIPTION . ' (ACCOUNT QTY ` AIVI6' NTS " ,„PAID � `.� `- PAID DATE' ADDITION, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $17.40 $0.00 i PAID. BY ' METHOD -"IRECEIPT # CHECK # , CLTD BY DESCRIPTION ACCOUNTAMOUNT PAID PAID DATE ADDITION, FIRST 100 SF 101-0000-42400 0 $120.83 $0.00 PAID: BY METHOD•'RECEIPT# t.'CHECK#, ,' CLTD BY DESCRIPTION ` ACCOUNT QTY - AMOUNT a PAID PAID DATE' ADDITION, FIRST 100 SF PC 101-0000-42600 0 $171.14 $0.00 PAID BY ,' a ,. ` , METHOD . . < ��. RECEIPT # ' CHECK# CLTD BY Total Paid forADDITION: $371.73 $0.00 . =DESCRIPTION '= I "ACCOUNT QTY._ AMOUNT:' ' PAID PAID. DATE HOURLY PLAN CHECK - YES 101-0000-42600 1 $70.00 $0.00, :PAID BY ' ; t METHOD ' :, , "h.> RECEIPT # CHECK # CLTD BY:-. ss - DESCRIPTION ACCOUNT CITY AMOUNT - °PAID, PAID DATE HOURLY PLAN CHECK - YES 101-0000-42600 0.75 $52.50 $0.00 PAID BY METHOD `, RECEIPT # ,i CHECK # C a.' LTD BY Total Paid for BLDG CITY STAFF - PER HOUR: $122.50 $0.00 DESCRIPTION '' .•' ACCOUNT. : r. '- � � - ;,, QTY e `�. ;+AMOUNT .`:Y PAID'' s: PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY, N' METHOD RECEIPT,# CHECK # CLTD BY, k - Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 :., DESCRIPTION' ° `: ACCOUNT QTY , ` AMOUNT PAID,,, PAID DATE RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $145.03 $0.00, H 't PAID BY METHOD,'`° RECEIPT.#' ' `CHECK # :CLTD BY �. DESCRIPTION '* `ACCOUNT � QTY } ' AMOUNT.` PAID PAID DATE RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $47.86 $0.00 PAID BY METHOD ,..'a. -. RECEIPT -#,- CHECK # ;CLTD BY Total Paid forELECTRICAL - NEW CONSTRUCTION: $192.89 $0.00 r{ " 'DESCRIPTION �- , , :` .'.ACCOUNT , ;QTY AMOUNT -. x PAID PAID DATE'. APPLIANCE REPAIR/ALTERATION 101-0000-42402 0 $12.09 $0.00 -PAID BY , ` - ''%METHOD = RECEIPT CHECK # `" CLTD BY DESCRIPTION "' _•, W ACCOUNT QTY.' .'; AIVIOUNTP• .. X PAID PAID DATE; APPLIANCE REPAIR/ALTERATION PC 101-0000-42600 0 $4.83 $0.00 PAID BY ° =Y`> METHOD h RECEIPT#' ` 'z` r -CHECK.# p CLTDIBY ..: DESCRIPTION ° F `. '' ACCOUNT QTY ,.. 'AMOUNT ;.:' a. PAID PAID DATE, VENT FAN 101-0000-42402 0 $24.18 $0.00 'PAID BY.z" . METHOD RECEIPT # "CHECK # M CLTD BY , DESCRIPTION 'k' ' A000UNT _ ' . QTY `' 'AMOUNT ,.;, °' PAID PAID DATE' VENT FAN PC 101-0000-42600 0 $9.66 $0.00 METHOD s . r, F. F, .e. RECEIPT # CHECK # r ' CLTD BY F; Total Paid forMECHANICAL: $50.76 $0.00 ° - 'DESCRIPTION • .. s - .ACCOUNT w. .QTY _ AMOUNT t: PAID PAID DATE FIXTURE/TRAP 101-0000-42401 0 $36.27 $0.00 'PAID BY"METHOD 7. L ... t RECEIPT'#` kw t CHECK?# xCLTD BY _ DESCRIPTION - . ' ACCOUNT ". ` * ..QTY° AMOUNT '` •PAID` PAID DATE' FIXTURE/TRAP PC 101-0000-42600 0 $36.27 $0.00 ';PAID BY ,. METHOD �;. RECEIPT-;# 4 CHECK ,# ., 4y T , .CLTD BY . DESCRIPTION:ACC.OUNT 3 ,; QTY .x °AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 $0.00 4 PAID BY METHOD . '"'RECEIPT# ' 'CHECK # ° s -' ` `CLTD BY; r DESCRIPTION __ACCOUNT1 CITY, �r AMOUNT .: PAID PAID DATE WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 $0.00 `PAID BY -.-; �:. ,: ,,. 'METHOD `' •,,' RECEIPT # i; : CHECK.# , CLTD BY Total Paid forPLUMBING FEES: $96.72 $0.00 DESCRIPTION ACCOUNT , QTY, AMOUNTS • PAID PAID DATE SMI - RESIDENTIAL 101.0000-20308 0 $1.29 $0.00 jPAID BY •.. r ' 4 METHOD ; $ RECEIPT # CHECK # CLTD BY ,' Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $1.29 $0.00 TOTALS:00 i Description: RANCHO LA QU I NTA/ANTON E/EN CLOSE PATIO Type: BUILDING, RESIDENTIAL Subtype: ADDITION Status: APPROVED Applied: 5/22/2015 SKH Approved: 7/7/2015 JJO Parcel No: 602370002 Site Address: 79957 RANCHO LA QUINTA DR LA QUINTA,CA 92253 Subdivision: TR 29457-3 Block: Lot: 4 — Issued: Lot Sq Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $9,895.60 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 'No. Unites: 0 6/1/2015 Details: ENCLOSE EXISTING PATIO TO LIVING SPACE PER 2013 CRC CODES. 173 SQ. FT. PENDING STRUC CORRECTIONS 46 9 Printed: Wednesday, July 08; 2015'10:38:60 AM Iof4 AbDIVONAL'SITES CHRONOLOGY CHRONOLOGY TYPE-...,,: .,.STAFF NAME # ACTION DATE . 'COMPLETION DATE; NOTES T a;` NOTE JIM JOHNSON 6/1/2015 6/9/2015 PENDING STRUC CORRECTIONS PLAN CHECK COMMENTS FROM CONSULTANT KAY HENSEL 7/2/2015 7/2/2015 STRUC APPROVABLE 7/1/2015 RECEIVED PLAN CHECK COMMENTS FROM CONSULTANT MARY FASANO 6/8/2015 6/8/2015 RECEIVED PLAN CHECK PICKED UP MARY FASANO 6/15/2015 6/15/2015 SIA PICKED UP PLANS -FOR CORRECTIONS PLAN CHECK SENT TO STEPHANIE KHATAMI 5/22/2015 5/22/2015 . OUTSIDE PC PLAN CHECK SUBMITTAL STEPHANIE KHATAMI 5/22/2015 5/22/2015 RECEIVED RESUBMITTAL ED VASQUEZ 6/24/2015 6/24/2015 2ND PLAN CHECK SUBMITTAL Printed: Wednesday, July 08; 2015'10:38:60 AM Iof4 Printed: Wednesday, July 08, 2015 10:38:00 AM 2 of 4 C2 SYSTEMS 2nd Plan check submittal received, Red Lines,Calcs, HOA RESUBMITTAL ED VASQUEZ 6/24/2015 6/24/2015 Approval, title 24, CALLED SIGIFREDO TO INFORM HIM PLANS ARE READY FOR TELEPHONE CALL JIM JOHNSON 6/9/2015 6/9/2015 CORRECTIONS CONDITIONS CONTACTS NAME TYPE NAME ADDRESSi CITY STATE ZIP; PHONE FAX EMAIL APPLICANT RISEN CONSTRUCTION 82-775 CHARLESTON INDIO CA 92201 AVE CONTRACTOR RISEN CONSTRUCTION 82-775 CHARLESTON INDIO CA 92201 AVE OWNER DOUGLAS ANTONE 27076 HIDDENTRAIL LAGUNA BEACH CA 92253 `CLTD DESCRIPTION ACCOUNT . QTY :AMOUNT PAID PAID DATE : RECEIPT #: CHECK # METHOD PAID BY By ADDITION, EA 101-0000-42400 0 $62.36 $0.00 ADDITIONAL 500 SF ADDITION, EA 101-0000-42600 0 $17.40 $0.00 ADDITIONAL 500 SF PC ADDITION, FIRST 100 SF 101-0000-42400 0 $120.83 $0.00 ADDITION, FIRST 100 SF 101-0000-42600 0 $171.14 $0.00 PC " . Total Paid forADDITION: $371.73 $0.00 HOURLY PLAN CHECK - 101-0000-42600 1 $70.00 $0.00 YES HOURLY PLAN CHECK - 101-0000-42600 ' 0.75 $52.50 $0.00 YES Total Paid forBLDG CITY STAFF - PER HOUR: $122.50 $0.00 Printed: Wednesday, July 08, 2015 10:38:00 AM 2 of 4 C2 SYSTEMS �''::+..'e .. - `�` •n ;Y vOATE rRECEIPT #DESCRIPT.ION ACCOUNT`• `"= "QTYgg "µAMOUNTih _ PAID y PAID # "CHECK #, 'METHODS PAID BY ; s' �CLTD };s.'. BYj4 BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: RESIDENTIAL, FIRST 101-0000-42403 0 • $145.03 $0.00 1,000SF RESIDENTIAL, FIRST 101-0000-42600 0 $47.86 $0.00 1,000SF, PC Total Paid for ELECTRICAL - NEW CONSTRUCTION: $192.89 $0.00 APPLIANCE 101-0000-42402 0 $12.09 $0.00 REPAIR/ALTERATION APPLIANCE 101-0000-42600 0 $4.83 $0.00 REPAIR/ALTERATION PC VENT FAN 101-0000-42402 0 $24.18 $0.00 VENT FAN PC 101-0000-42600 0 $9.66 $0.00 Total Paid forMECHANICAL: $50.76 $0.00 FIXTURE/TRAP 101-0000-42401 0 $36.27 $0.00 FIXTURE/TRAP PC 101-0000-42600 0 $36.27 $0.00 WATER SYSTEM 101-0000-42401 0 $12.09 $0.00 INST/ALT/REP WATER SYSTEM 101-0000-42600 0 $12.09 $0.00 INST/ALT/REP PC Total Paid for PLUMBING FEES: $96.72 $0.00 SMI - RESIDENTIA7 101-0000-20308 0 $1.29 $0.00 Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $1.29- $0.00 TOTALS:00 Printed: Wednesday, July 08, 2015 10:38:00 AM' 3 of 4 SYSTEMS FINAL" BLD Printed: Wednesday, July 08, 2015 10:38:00 AM '4 of 4 SYS TEtiiS ATTACHMENTS RETURNED REVIEWS STATUS.. REMARKS SUBDIR r =ETRAKIT� ENABLED. REVIEW TYPE'{', REVIEWER SENT DATE ;DUE:DATE 0 �� _ �.:, NOTES a COMMENTS.pdf DOC 6/24/2015. v .DATE HOA APPROVAL.pdf 0 DOC 6/1/2015 NON-STRUCTURAL - BUILDING 5/22/2015 6/5/2015 6/1/2015 REVISIONS REQUIRED QUINTA DR..docx QUINTA DR..docx PENDING STRUC CORRECTIONS 2 WK BUCKET YOUNG 5/22/2015 6/5/2015 6/8/2015 REVISIONS REQUIRED STRUCTURAL - 2 WK ENGINEERING NON-STRUCTURAL- JIM JOHNSON 6/24/2015 7/1/2015 7/7/2015 APPROVED 1 WK c. YOUNG 6/24/2015 7/1/2015 7/1/2015 READY FOR APPROVAL STRUCTURAL - 1 WK ENGINEERING Printed: Wednesday, July 08, 2015 10:38:00 AM '4 of 4 SYS TEtiiS ATTACHMENTS Attachment Type CREATED OWNER = f -. . ;DESCRIPTION ' PATHNAIVIE' SUBDIR r =ETRAKIT� ENABLED. DOC 6/24/2015 ED VASQUEZ 2ND SUBMITTAL 2ND SUBMITTAL 0 COMMENTS.pdf COMMENTS.pdf DOC 6/24/2015. ED VASQUEZ . HOA APPROVAL.pdf HOA APPROVAL.pdf 0 DOC 6/1/2015 JIM JOHNSON 79-957 RANCHO LA 79-957 RANCHO LA 0 QUINTA DR..docx QUINTA DR..docx Printed: Wednesday, July 08, 2015 10:38:00 AM '4 of 4 SYS TEtiiS Qin # . t o 0 3 City of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012. Building Permit Application and Tracking Sheet Permit # Project Address: 57 iZp"q o to OU (NTE}- Owner's Name:: �+ A. P. Number: � Q 2-- '3 7 Q - O o �— Address: / - ANC Q C A U(tJ 1 A - Legal Description: City, ST, Zip: I A O U NSA c i. C{ Z 2S 3 Contractor: co uQ 0C Jo,� Tele P hn o e. Address: Z-)� 52foLOU 40 L Project Description: City, ST, Zip: IA) j(, C Telephone: G 5 State Lie. # : City Lie. Arch., Engr., Designer:!! (} 0(: S (3 N 5 Address: City., ST, Zip: Q UQ [��T Cf�- `I.2-30 ) h ne:9G65-3�466 ` ..; CoTele n stru ti n e • Occu ancY: Type: P State Lie. #• Project ha (circle one): New Add'n Alter Re air Demo P Name of Contact Person: C�rk51 R,D Ct(D N, Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Lr -7 (p 372 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE k Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2a. Review, ready for correctio s/issue Electrical Subcontactor List Called Contact Person I Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person, A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees CERTIFICATE OF COMPLIANCE 4�J�tFt�s��o Desert Sands Unified School District 47950 Dune Palms Road 4" BERMUDADUNESO V) RANCHO MIRAGE Date 7/8/15 La Quinta, CA 92253 INDIAN WELLS P No. 31859 va PALM y (760) 771-8515 Z�QINDIO s�0. 0 Owner Antone APN # 602-370-002 Address 79957 Rancho La Quinta Jurisdiction La Quinta City La Quinta Zip Permit # BIZFS 2-0 05- 020 3 Tract # No. of Units. 1 Type Residential Addition Lot # No. Street S.F. Unit 1 79957 Rancho La Quinta 173 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments Lot # No. Street S.F. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.00 X 173 S.F. or $0.00 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By Exempt - Siji Fernandez Check No. Bank Name/Recipient of Certificate Telephone 760-347-6399 Funding Exempt BY Dr. Gary Rutherford Superintendent, +4 Fee collected lexem Shar rey . Payment Recd i ', ;Calver/Under Signature P �� '� " t .J NOTICE: Pursuant to Government Code Sectl • n 6602 (d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to ru the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID without embossed seal Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting Master Association for Rancho La Quinta 79-285 Rancho La Quinta Drive La Quinta CA 92253 Phone: 760-777-8807 Fax: 760-777-8961 www.rlgma.com April 28, 2015 Doug & Catherine Antone 641 Loretta Dr Laguna Beach CA 92651 Re: 79957 Rancho La Quinta Driv - Approval of Submission Dear Mr. & Mrs. Antone, The Architectural Committee reviewed your request to enclose the side courtyard at your residence located at the above address. Your submission as presented, is approved contingent on the following: • Any damage to the common area caused during this construction shall be repaired by the Owner to the satisfaction of the Association. • All work is to be done in accordance with all applicable requirements of governmental entities, including the City of La Quinta and in accordance with all Homeowners Association Architectural/Landscape Guidelines and governing documents. • New roof tiles must match existing roof tiles in both style and color. • If required, a City of La Quinta building permit will be obtained and copy furnished to the Association prior to commencement of work. • No other structural changes are approved with this submission. Once completed, please submit a "Notice of Completion" and the Association's Architect will schedule an inspection so we can process your deposit for return. If you have any questions, please contact the onsite office at 760-777-8807. Sincerely, Jamie Circle Architectural & Communications Manager Master Association for Rancho La Quinta JUN 2 4 2015 CITY OF LA QUINTA COMMUNITY DEVELOPMENT 4 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CF1 R -ADD -02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CFIR-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 1 of 9) Pmled Name: Antone Addition - 173 sq. ft. - Date Prepared: 5/15/15 This compliance document is only applicable to additions 300 or less, or additions that do not require HERS field verification for compliance. When HERS verification is required, a CFIR-ADD-01 shall first be registered with a HERS Provider Data Registry. Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CFIR-ADD-02 and CF2R- ADD -01 Compliance Documents. Possible exemptions from duct leakage testing include: less than 40 ft of ducts were added or replaced; or the existing duct system was Insulated with asbestos; or the existing duct system was previously tested and passed by a HERS Rater. If space conditioning systems are altered and are not exempt from HERS verification, then a CFIR-ADD-01 must be completed and registered with a HERS Provider Data Registry. Additions or alterations that utilize Closed Cell Spray Polyurethane Foam (ccSPF) with a density of 1.S to less than 2.5 pounds per cubic foot having an R -value other than 5.8 per inch, or Open Cell Spray Polyurethane Foam (ocSPF) with a density of 0.4 to less than 1.5 pounds per cubic foot having an R -value of 3.6 per inch, shall complete and register a CFSR ADD -01 with a HERS Provider Data Registry. If more than one person has responsibilityfor installation of the items on this certificate, each person shall prepare and sign a certificate applicable to the portion of construction for which they are responsible. Alternatively, the person with chief responsibilityfor construction shall prepare and sign this certificate for the entire construction. All applicable Mandatory Measures shall be met. Temporary labels shall not be removed before verification by the building Inspector. A. GENERAL INFORMATION 01 Project Name: Antone t7 02 Date Prepared: 5/15/15 03 Project Location: 79-957 rn C o 04 Building Front Orientation (deg): East 05 CA City: La Quint —T' ' 06 Number of Dwelling Units with Additions: 1 07 Zip Code: 92253, G 08 Fuel Type: Gas 09 Climate Zone: 15 '-4 ®D 30 Total Conditioned Floor Area (ft) (Addition): 173 11 Building Type Additi 0 M.0 12 Slab Area (ft): 173 13 Protect Scope: 300 feet o less 0 CA Building Energy Efficiency Standards - 2013 Residential Compliance MAY 2 2 2015 CITY COMMON TY OEVEULOPA45 NT January 2015 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CFIR-ADD-02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 2 of 9) Pmjec[Name: Antone Addition - 173 sq. ft. - Date Prepared: 5/15/15 B. OPAQUE SURFACE DETAILS — Framed (Section 1S0.2(a)) 01 02 03 04 05 06 07 08 09 10 11 Tag/ID Assembly Type Frame Type Frame Depth (inches) Frame Spacing (inches) Proposed Required Comments Cavity R -value Continuous Insulation R -value . LI -Factor Appendix JA4 Reference U -Factor Table Cell Roof Wood 2X 24" 38 0 .025 4.2.1 21. .025 Complies Walls Wood 2x4 16" 15 0 .065 N/A N/A .065 Complies M 00 O�� OO OO C/) C � ill C Z CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA Prescriptive Residential Additions 300 0 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CFIR-ADD-02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 3 of 9) Project !Jame: Antone Addition - 173 sq. ft. Date Prepared: 5/15/15 C. OPAQUE SURFACE DETAILS — Non -framed (Section 150.1(c)1) 01 02 03 04 05 06 07 08 09 10 it Tag/ID I Assembly Type Assembly Materials Thickness (inches) Proposed Required . Comments Core Insulation R -value Continuous Insulation R -value U -Factor Appendix JA4 Reference U -Factor from I Package A Table Cell R -value N/A R -value U -factor Table Cell R -value LI -factor R -value U -factor N14 n�Z Z S'>0 ®D n Z ® 0 Z D. OPAQUE SURFACE DETAILS — Mass Walls (Section 150.1(c)1) 01 02 03 04 05 06 07 08 1 09 10 li p G@CThickness irde 1type Mass (Inches) Furring Strip ThicknessTag/ID (inches) Proposed Required Interior Insulation Exterior Insulation Appendix JA4 Reference Interior Insulation Exterior Insulation R -value U -factor R -value U -factor Table Cell R -value LI -factor R -value U -factor N14 n�Z Z S'>0 ®D n Z ® 0 Z CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA ` Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CFIR-ADD-02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 4 of 9) Project Name: Antone Addition -173 sq. ft. Date Pre°are°: 5/15/15 E. SLAB INSULATION (Table 150.1-A) 01 02 03 04 05 06 Floor Type Proposed Required Comments Insulation R -value Insulation U -factor Insulation R -value Insulation U -factor Slab on Grade N/A • Radia e6daII eet specific eligibility and installation criteria to receive energy credit for compliance with the Building Energy Efficiency Standards -Na N/A • &e.e �f0% adiant barrier shall be less than or equal to 0.05 as tested in accordance with ASTM C1371 or ASTM E408. For , "Eriptiv o ate a attic shall be ventilated to provide a minimum free ventilation area of not less than one square foot of vent area for each 300 ft2 of attic r areacu"uit�fiq h n 30 percent upper vents. Ridge vents or gable end vents are recommended to achieve the best performance. The material should be cu o alto II l o the venting. • Heated slab floors require mandatory slab Insulation (see Table 110.8-A). F. RADIANT BARRIER (Section 150.1(c)2 01 02 Radiant Barrier installed below the roof deck and on all gable end walls Comments Required o M C _. r A radl barrier+ i Vu d r Climate Zones 2-15) • Radia e6daII eet specific eligibility and installation criteria to receive energy credit for compliance with the Building Energy Efficiency Standards -Na for low We buildings. Refer to RA4.2.1 • &e.e �f0% adiant barrier shall be less than or equal to 0.05 as tested in accordance with ASTM C1371 or ASTM E408. For , "Eriptiv o ate a attic shall be ventilated to provide a minimum free ventilation area of not less than one square foot of vent area for each 300 ft2 of attic r areacu"uit�fiq h n 30 percent upper vents. Ridge vents or gable end vents are recommended to achieve the best performance. The material should be cu o alto II l o the venting. CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification 'EC-CF1 R -ADD -02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 5 of 9) Project Name: Antone Addition - 173 sq. ft. Date Prepared: 5/15/15 ' G. ROOFING PRODUCTS (COOL ROOF) (Section 150.1(c)11) s 01 02 03 04 05 - 06 " .07 08 09 10 11 12 Mass Roof 25lb/ft2 or Greater Roof Pitch Method of Compliance Product Type CRRC Product ID Number Proposed Required Initial Solar Reflectance Aged Solar Reflectance Thermal Emittance SRI (Optional). Aged Solar Reflectance Thermal Emittance SRI (Optional) N/A The Greater The Greater Z !p Maximum Maximum Addi 1o07fype im Allowed Allowed Comments m Maximum D C cul ed Maximum Calculated Maximum U -factor SHGC C fr1 bOd on � Calculated based on Calculated n �ge % 2 Allowed ft Allowed %U 2 Allowed ft _—F 173 Z CRtri z __J 75 60 60 0.32 0.25 NOTES: • Any roof area covered by building integrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements. • Liquid field applied coatings must comply with installation criteria from section 110.8(i)4. I n I H. FIE 4r�Slfi RATION/G REAS ALLOWED (Section 150.2(a)1) 01 Qr— 103 04 65 06 07 08 0o Maximum Allowed Maximum Allowed OZ Area For All Orientations ftZ West -Facing Fenestration Area Only ft2 The Greater The Greater Z !p Maximum Maximum Addi 1o07fype im Allowed Allowed Comments m Maximum D C cul ed Maximum Calculated Maximum U -factor SHGC C fr1 bOd on � Calculated based on Calculated n �ge % 2 Allowed ft Allowed %U 2 Allowed ft _—F 173 Z CRtri z __J 75 60 60 0.32 0.25 LL--f-!�J CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CF1 R -ADD -02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 6 of 9) Project Name: Antone Addition - 173 sq. ft. Date Prepared: 5/15/15 I. FENESTRATION PROPOSED AREAS AND EFFICIENCIES 01 02 03 04 05 06 07 08 09 30 11 12 13 Tag/ID Fenestration Type Frame Type Dynamic Glazing Orientation N, S, W, E or Roof Number of Panes Proposed Fenestration 2 Area ft Proposed West Facing Fenestration Area ftZ Proposed U -factor Proposed SHGC Source Exterior Shading Device Combined SHGC from CF1R-ENV- 03 Window Vinyl N/A North 2 30 0 10.32 0.25 150.1-A N/A N/A French Door Metal N/A North . 2 14 0 0.32 0.25 150.1-A N/A N/A 14 lotal Proposed n t on Area 44 15 Maxim vied s ration Area 16 Compli;Pc a ent ITotal Proposed Fenestration Area 5 Maximum Allowed Fenestration Area ® Yes O No 17 Total P o be c ng Fenestration Area 0 18 Maxim �J t Facing Fenestration Area 19 %OmplqWna Total Proposed West -Facing Fenestration Area15 Maximum Allowed West -Facing Fenestration Area ® Yes ❑ No 20 Proposes r<Kelit1nu factor 0.32 21 Requir on U facior 0.32 22 Compl Proposed Fenestration U -factor 5 Required Fenestration U -factor ® Yes ❑ No 23 Proposed Fenes a 5 iGC 0.25 24 1 Required Fenestra on S1 IGC 0.25 25 Compliance Statement Proposed Fenestration SHGC:5 Required Fenestration SHGC ® Yes O No CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 _ STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification ii' N%i 4�f CEC-CF1 R -ADD -02-E Revised 01/15 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 7 of 9) Project Name: Antone Addition - 173 sq. ft. I DatePmpamd: 5/15/15 J. SPACE CONDITIONING(SC) SYSTEMS - HEATING/COOLING (Prescriptive section 150.2(b). Alterations to Space Conditioning Systems shall be exempt from HERS verification requirements as prerequisite for use of the CFI11-ADD-02 and CF2R-ADD-02 Compliance Documents. If new space conditioning systems are installed or existing systems are altered and are not exempt from HERS verification, then a CFSR-ADD-01 shall be completed and registered with a HERS Provider Data Registry. In each row below for each dwelling unit in the building, check the box that indicates the exemption from HERS verification compliance: ❑ a: space conditioning system was not altered; ❑ b: less than 40 ft of ducts were added or replaced; ❑ c: (exempt from duct leakage testing) If: the existing duct system was insulated with asbestos; ❑ d: (exempt from duct leakage testing) if: the existing duct system was previously tested and passed by a HERS Rater. 01 02 03 04 Dwelling Unit Name SC System Identification or Name SC System Location or Area Served Exemption from HERS Verification Addition Existing Entire Residence ® a ® b ® c ® d n M C O o CD W W CCm0 o®CM, -o CA Buildin I nergy Efficiency at nd - 2013 Residential Compliance January 2015 0 0 13 0 0 0 0 0 0 0 0 0 0 C3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 El 0 0 0 0 0 0 ❑a 13 0 0 ❑a 0 13 0 b 0 0 0 0 0 0 0 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CF1 R -ADD -02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF111-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 8 of 9) Project Name: Antone Addition -173 sq. ft. I Date Prepared: 5/15/15 K. WATER HEATING SYSTEMS (Section 150.1(c)8) List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 Water Heating System Dwelling Unit Identification or Name Name Water Heating System Location or Area Served Water Heating System Type Water Heater Type q of Water Heaters Ins stem Water Heater Storage Volume (gal) Fuel Type Rated Input Type Rated Input Value Heating Efficiency Type Heating Efficiency Value Standby Loss (%) Exterior Insulation R -Value Back -Up Solar Savings Fraction N/A 0 D (p m �z0 ®mZ -i CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CF1 R -ADD -02-E (Revised 01/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 9 of 9) Project Name: Antone Addition - 173 sq. ft. Date Prepared: 5/15/15 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author 5 ature: Paul Nelson Company: Signature Date: Nelson Designs 5/15/15 Address: CEA/ HERS Certification Identification (if applicable): 16169 Siskivou Ct. Apple Valley, CA 92307 760 508-3400 RESPONSIBLE PERSON'S DECLARATION STATEMENT 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. That 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. S. I will ensure that a registered 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 registered 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: Responsible Designer Sig lure: Paul Nelson Company: Nelson C Address: 16169 Si Apple Vs For assn si s OU Ct'Tt C Ie y,.CA z Q Z —n go a ce oCIP rjfpr�e �<M0 -� M C z° ®� z Date Signed: 5/15/15 license: Phone: (760) 508-3400 arding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. CA Building Energy Efficiency Standards - 2013 Residential Compliance January 2015