BPLB2014-1037LICENSED 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: _ License No.: :LIC -0111366
Contractor: '
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).:
( ) 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 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:
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.
e0 1 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:_ 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 Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date o �y 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 en �on th bove-
mentioned property for inspection purposes.
Date: "! �`4 Signature (Applicant or A
Ce
4 Q�
VOICE (760) 777-7125
78-495 CALLE TAMPICO
a D
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS
(760) 777-7153
BUILDING PERMIT
Date: 11/18/2014
Application Number:
BPLB2014-1037
Owner:
Property Address:
79520 CITRUS
EDWARD RILEY
APN:
776140018
Property Zoning:
¢ o
Application Valuation:
$2,497.00
N o w
t�
�. C a
Applicant:
Contractor:
rt ow
RESCUE ROOTER
RESCUE ROOTER
7 �: o
0 OUTSIDE CITY LIMITS0
OUTSIDE CITY LIMITS
Q O
Z
LA QUINTA, CA 92253
LA QUINTA, CA 92253
U
(951)341-9370
��
Llc. No.::LIC-0111366
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: _ License No.: :LIC -0111366
Contractor: '
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).:
( ) 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 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:
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.
e0 1 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:_ 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 Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date o �y 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 en �on th bove-
mentioned property for inspection purposes.
Date: "! �`4 Signature (Applicant or A
PAID
PAID DATE
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
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
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD-
RECEIPT #
CHECK #
CLTD BY
Total Paid forPERM1T ISSUANCE: $91.85 $0.00
DESCRIPTION '
ACCOUNT
t QTY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0
$7.25
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
i
i --I
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:00
Permit Details PERMIT NUMBER
.r
City of La Quinta BPL8201y :1037 .
Description: HOT WATER HEATER CHANGE OUT- (1) 75 GALLON GAS WATER HEATER
Type: PLUMBING Subtype: Status: SUBMITTED
Applied: 11/18/2014 SKH
Approved:
Parcel No: 776140018 Site Address: 79520 CITRUS LA QUINTA,CA 92253
Subdivision: TR 24890-7 Block: Lot: 28
Issued:
Lot Sq Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $2,497.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
ADDRESSI
Details: WATER HEATER CHANGE OUT - 75GALLON/GAS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed: Tuesday, November 18, 2014 1:29:25 PM 1 of 2 Cff-SYSTEMS
CONTACTS
NAME TYPE NAME
ADDRESSI
CITY STATE
ZIP
PHONE
FAX EMAIL
APPLICANT RESCUE ROOTER
0 OUTSIDE CITY LIMITS
LA QUINTA CA
92253
(
Printed: Tuesday, November 18, 2014 1:29:25 PM 1 of 2 Cff-SYSTEMS
Printed: Tuesday, November 18, 2014 1:29:25 PM 2 of 2
g?WYSTEMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
PLUMBING FINAL"
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00
WATER HEATER/VENT
101-0000-42600
0
$7.25
$0.00
PC
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:00
Printed: Tuesday, November 18, 2014 1:29:25 PM 2 of 2
g?WYSTEMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
PLUMBING FINAL"
Printed: Tuesday, November 18, 2014 1:29:25 PM 2 of 2
g?WYSTEMS
Bin #
City of La Quinta
Building sr Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
�U(h'tibl�
Project Address: 6%q '?.• C ( TILOS
Owner's Name: tD 2 i LC
A. P. Number:
Address: —1q,05-10 t✓ v
Legal Description:
City, ST, Zip: t '� c LL
Contractor: SSC._ 12 0 b 1�
Telephone:
Address: s
L�IProject
Description: w K L N
n�
City, ST, Zip: 21 (" MOO 6 Z
—7�
Telephone:
3
Statc Lic. # : (
City Lic. k JIM&
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
:`•'`>'`>>
Construction Type: Occupancy:
Statei.#
L c
Repair Project type (circle one): New A dd'n Alter p Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person:
Estimated Value of Project: DO
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES
Plan Sets
PIan Check submitted
��
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Cluck Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for corrcctionsrssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Dccd
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1 R -ALT -01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 4)
Project Name: It-ev r,.. I" I Date Prepared: / /—/Q -/y
A. GENERAL INFORMATION
01
,
01
Project Name: (Le- (
02
Date Prepared:
03
Project Location: LO L u
04
Building Front Orieriiation`(deg or cardinal):
05
CA City: - L-A C2iIA1P1,6
06
Number of AlLered'Dwelling Units: 41A\
07
Zip Code: t
08
Fuel Type; (( *& A-" '*�
09
Climate Zone:
10
Tofal,Conditioned FloorArea (ft2):)
11
Building Type
12
SIab,A�e`a'(ft2) 'A'�"bt Y
13
Project Scope:"1i
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
v ,; ti.
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)r../'x — A# %I% �
01
02
03
04
05
06 `t',,p�`07 08r. \M09
10
11
Tag/ID
Assembly Type
Frame
Type
Frame
Depth
(inches)
Frame
Spacing
(inches)
ffP,roppossed ,�,y A
Required
Comments
p ��
Continuous `3+j
Cavity Insulation �?
R -value R -value Of a V- ctor
�AppendixJA4
Reference
LI -Factor
Table I Cell
S
DeckInitial
Compliance
Pitch
Exception
(,� tNu er
uct Type
lInsulation
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
*-JR
*
of &'\\'b M�� :&Ll -p
C. ROOF REPLACEMENT (Prescriptive Alteration, Se& ib!�A50.2(b)iH)�
01
02
03
04
051, *-4
06
(1( "671g 08 09 10 it 12 13
R -value
r+
�1 Proposed Minimum Required
Solar Aged Solar Thermal SRI Aged Solar Thermal SRI
Method of
Roof
RC ProdD,
CRuct II
S
DeckInitial
Compliance
Pitch
Exception
(,� tNu er
uct Type
lInsulation
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
*-JR
*
—16AN11
1;tT,
NOTES�l V► V
• Roof area covered by bu`ldin�g`integrated phcit of`taic panels and solar thermal panels are exempt from the above Cool Roof requirements.
Liquid field installation from 110.8(1)4.
• applied coatings must comply wit criteria section
% y►
- t .
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1 R -ALT -01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 2 of 4)
Project Name: Date Prepared: I — / Q -/ -t/
D. FENESTRATION/GLAZING AREAS ALLOWED (Section 150.2(b)1)
04 V.
01 02 03 h D �.
Alteration Type Orientation Maximum Allowed ft2 Comments av-
ISti�
E. FENESTRATION/GLAZING PROPOSED AREAS AND EFFICIENCIES (Section 150.2(b)1),i
01
02
03
04
05
06
07
0,8 Al
�','�
; � o 09
101�
f�
10 11
12
13
14
15
Orientation
Area
AreaNe`tf"
Maximum\`G'
Exterior
Combined
SHGC
Tag/
Fenestration
Frame
Dynamic
N, S, W, E, or
Removed
Added
Added
Allowed
Shading
from
ID
Type
Type
Glazing
Roof
ft2
ft2N
Area ft2
U of ctor
U -factor
Source
SHGC
Source
Device
CF1R-ENV-03
#4
�
a
Net Added Wes -fyac ngfenestrationneat
b
Existing + AddedWe t;facmg Fenesttrationn Xrea
c
Maximum Allowed West-faciMg: 4 stwation Area
d
Is West -facing Fenestration Area,a•`< um"'Allowed West�rfacing Fenestrations
rMaxiin
7Pz'l►�JI tkeA* ,,,. lAra,
ewh
Net Added Fenestration Area (all ori�n�tations)
f
44�Ez sting + Acdecl-Fenestration Area (all'or en`tations)
�A Maximum Allowed Fenestration Area (all orientations)
rh
Is Existing + Ad8e'W enestration Area <'�Maximum Allowed Fenestration Area (all
A _ orientations)
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1 R -ALT -01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 3 of 4)
Project Name: Date Prepared: // - /)? -/y
F. SPACE CONDITIONING(SC) SYSTEMS - HEATING/COOLING (Prescriptive section 150.2(b))�
01 02 03'��`�—`
Dwelling Unit Name Dwelling Unit CFA (Ft2) Comments
ommm ne ts�V
'A\ 4Y .nr� ♦ '
G. WATER HEATING SYSTEMS (Section 150.2(b)1G)�
01
02
03
04
05
06
07
08
_ ,Q9y L
10
r 1%
j W 12
13
14
15
Water Heating -
of.
Water
(
NN
�
Back -Up
_
Water
Heater
�'�
.
i
_
System
Water
Water
Heaters
Storage
Rated
Rated
1
Heating
Heating
Exterior
Solar
Dwelling Unit DHW
Identification or
Heating
Heater
in
Volume
Fuel
Input
: Inpu
Efficiency
'Efficienc
Standby
Insul.
Savings
Central DHW System
System
Name
System Type
Type
system
(gal)
Types
Value
Typed
Value
Loss,(%)
R -Value
Fraction
Distribution Type
Distribution Type
I� J Id
W
O li
ppTy��pe
GA
�'TIVV
26KI=�
F
�% 7
Nt
_ lIzv
�
6w
k, `4
r �
+�*�I
I
Li
x(L))" _ikv" ri
H. SPACE CONDITIONING SYSTEMS AND WATER HEATING SYSTEMS IN MULTIFAMILY DWIELUNG UNITS
r �. 4% �� V _ P( �t
01
02 ,,4';
, 03'�
05
06
Dwelling Unit Name
DwellingUnitTotal CFA
(ft2
f tiN
Central later -Heating
Sys,my,4�ldentification or- ('"�WaterHeating
111, ,Name .r,rldentification
Dwelling Unit
System
or Name
Dwelling Unit:
Alteration to the Space
Conditioning System(s)?
Comments
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1R-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 4 of 4)
Proiect Name: Date Prepared: 1/ —/ 9-1V
a
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete. l� `
Documentation Author Name:
Documentation Auth '�"^ '11. r`•r
p+
Company: q,
Signature Date: J� r Il Y ==r
/ a
� �v
f ( ,W
Address:
CEA/ HERS Certification Ideritificetiori'(if applicable): V
City/State/Zip:
�= 06OLS., foe c.A 2 `?
Phone:
4 ;tel JY! 7c� ?,.l
RESPONSIBLE PERSON'S DECLARATION STATEMENT yl
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.Nnor
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibUOY for the building deesystem design identified on this Certificate of Compliance (responsible
designer).9
3. That the energy features and performance specifications, materials, componen�manufact d eviefor 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. �p�
4. The building design features or system design features identified on th`s'"Certificate of Co"mplian a are consistentwitt:Rt a information provided on other applicable compliance documents,
t� �� a M V� t, rjrti�•I--
worksheets, calculations, plans and specifications submitted to the enforcement agencyfortapproval with this building permit application.
�� .r�-, 'V fi'N.i'+✓
5. 1 will ensure that a registered copy of this Certificate of Compliance -shall be made.abailable with the building permit(s) issued for the building, and made available to the enforcement agency
011 V,IsZ, 41
,
for all applicable inspections. I understand that a registered copy -of this Certificate -of Compliance to be included with the documentation the builder provides to the building
►�j
i'ISequ,Ired
owner at occupancy. R_#1 1,♦tib"
l
Responsible Designer Name:
Responsible Designer Signature:
{�
Company:
y
'Date Signed:
Address:
License:
p J
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:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014