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BMCH2015-0024a w, .r 78-495 CALLE TAMP CO LA QUINTA, CALIFORNIA 92253 ' COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT -LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed der provisions of Chapter 9 (commencing with Section 7000) of Division 3 of th Bu sin s nd Professions Code, and my License is in full force and effect. License Class: C20 License No.: 954337 Da� t Contractor:. V f OWNER -BUILDER DECLARATION 1 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: VOICE (760) 777-7125 FAX (760).777-7011 INSPECTIONS (760)777-7153 Date: 1/26/2015 Owner: DAVID ANAYA 47005 VIA ANTIBES LA QUINTA, CA 92253 Contractor: ALL DAY HEATING & COOLING 83-947 MOONLIT DRIVE COACHELLA, CA 92236 (760)834-1064 Llc. No.: 954337 WORKER'S COMPENSATION DECLARATION 1. I hereby affirm under penalty of perjury one of the following declarations: 9, 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' comperisation 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 whit I this permit is issued, I shall not employ any person in any manner so as to bet a subct he workers' . compensation laws of California, and agree that, if 1 o Id beco subject to the workers' compensation provisions of Section 3700 o th Labor de, I shall forthwith comply with those provisions. Da ( Z (- Applicar WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CCkYERAGE 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 abo a inf 1•mat' correct. I agree to comply with all city and county ordinances and s t laws el ing to building construction, and hereby authorize representatives of this o en it pon the above, mentio ed property for inspection purposes. i Dater tib (� Signature (ApplicantIrrAgent): D Q Application Number: BMCH2O15-0024` Property Address: 47005 VIA ANTIBES APN: 643160014 Application Description: 2 SPLIT SYSTEMS HVAC CHANGEOU Property Zoning: CITY OF LA QUINTA Application Valuation: $18,000.00 COMMUNITYDEVELOPA9ENTDEPARTMENT Applicant: ALL DAY HEATING & COOLING 83-947 MOONLIT DRIVE COACHELLA, CA 92236 -LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed der provisions of Chapter 9 (commencing with Section 7000) of Division 3 of th Bu sin s nd Professions Code, and my License is in full force and effect. License Class: C20 License No.: 954337 Da� t Contractor:. V f OWNER -BUILDER DECLARATION 1 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: VOICE (760) 777-7125 FAX (760).777-7011 INSPECTIONS (760)777-7153 Date: 1/26/2015 Owner: DAVID ANAYA 47005 VIA ANTIBES LA QUINTA, CA 92253 Contractor: ALL DAY HEATING & COOLING 83-947 MOONLIT DRIVE COACHELLA, CA 92236 (760)834-1064 Llc. No.: 954337 WORKER'S COMPENSATION DECLARATION 1. I hereby affirm under penalty of perjury one of the following declarations: 9, 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' comperisation 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 whit I this permit is issued, I shall not employ any person in any manner so as to bet a subct he workers' . compensation laws of California, and agree that, if 1 o Id beco subject to the workers' compensation provisions of Section 3700 o th Labor de, I shall forthwith comply with those provisions. Da ( Z (- Applicar WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CCkYERAGE 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 abo a inf 1•mat' correct. I agree to comply with all city and county ordinances and s t laws el ing to building construction, and hereby authorize representatives of this o en it pon the above, mentio ed property for inspection purposes. i Dater tib (� Signature (ApplicantIrrAgent): DESCRIPTIONOUNT FINANCIAL INFORMATION .r {4 ` f'QTYyr AMOUNT'` iE PAID PAIDDATE` BSAS SB1473 FEE 101-0000-20306' 0 $1.00 $1.00 1/26/15 W sPAID.BYE.. , 'METHOD :. t , a RECEIPT # CHECK # A _.F CLTD BY ALL DAY HEATING & COOLING CHECK R3502 2181 MFA Total Paid forBUILD'ING STANDARDS ADMINISTRATION BSA: $1.00 $1.00 DESCRIPTION `" �_ 1 : ; ACCOUNT.;'r , a ., ' QTY AMOUNT -' r PAID iPAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $145.04 $145.04 1/26/15 r. IPAID BY METHOD. tRECEIP,T # ';� CHECK # g �CLTD BY ALL DAY HEATING & COOLING CHECK R3502 2181 MFA ` "DESCRIPTION "" .� . - , ,`_ , a -H _ .ACCOUNT ` , - k QTY = *m AMOUNT PAID PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $72.52 $72.52 1/26/15 g .PAID BY _ Se �* . # METHOD ;RECEIPT # X, - EC `CHK # CLTD BY ALL DAY HEATING & COOLING CHECK R3502 2181 MFA Total Paid forCHANGEOUT: $217.56. $217.56 3r . .� DESCRIPTION^ a _ f j ACCOUNT „ '`QTY ., ° ., AMOUNT'- , - PAID L PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 1/26/15 z, rt-fi PAID BY 42 METHOD f + RECEIPT # F s ;,� CHECK # , .; ' .&D.By ALL DAY HEATING & COOLING CHECK R3502 2181 MFA Total Paid forPERMIT ISSUANCE: $91.85 $91.85 TOTALS:0.4 Description: 2 SPLIT SYSTEMS HVAC CHANGEOUT Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 1/26/2015 MFA Approved: Parcel No: 643160014 Site Address: 47065 VIA ANTIBES LA QUINTA CA 92253 Subdivision: TR 26152 Block: Lot: 140 Issued: Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $18,000.00 Occupancy Type: Construction Type: Expired: " No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 2 HVAC CHANGE OUT - 16 SEER/80AFUE SPLIT SYSTEM 12008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. CONDITIONS CONTACTS t- NAME eNANIETYPE ADDRESSlCITY` STATEf. ZIP- PHONE" FAX, j -. EMAIIa A f., APPLICANT ALL DAY HEATING & COOLING 83-947 MOONLIT DRIVE COACHELLA CA 92236 CONTRACTOR ALL DAY HEATING & COOLING 83-947 MOONLIT DRIVE COACHELLA CA . 92236 ' OWNER DAVID ANAYA 47005 VIA ANTIBES LA QUINTA CA • 92253. FINANCIAL INFORMATION DESCRIPTION r S ' ACCOUNT QTY AMOUNT t PAID .-.7' bb RECEIPT # CHECK tt METHOD PAID BY k � � � a Fra • z' .. .r +a s` : '�.. ku� • Permit DetallS BSAS SB1473 FEE 101-0000-20306 0 $1.00'• PERMIT NUMBER BMCH2O15=0.0,24 1/26/15 R3502 • . Cityaof La Quinta: COOLING Total Paid forBUILDING STANDARDS ADMINISTRATION • ` Description: 2 SPLIT SYSTEMS HVAC CHANGEOUT Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 1/26/2015 MFA Approved: Parcel No: 643160014 Site Address: 47065 VIA ANTIBES LA QUINTA CA 92253 Subdivision: TR 26152 Block: Lot: 140 Issued: Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $18,000.00 Occupancy Type: Construction Type: Expired: " No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 2 HVAC CHANGE OUT - 16 SEER/80AFUE SPLIT SYSTEM 12008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. �s - j fc A 6 A�� a �� t . • ADDIT16NAL CONDITIONS CONTACTS t- NAME eNANIETYPE ADDRESSlCITY` STATEf. ZIP- PHONE" FAX, j -. EMAIIa A f., APPLICANT ALL DAY HEATING & COOLING 83-947 MOONLIT DRIVE COACHELLA CA 92236 CONTRACTOR ALL DAY HEATING & COOLING 83-947 MOONLIT DRIVE COACHELLA CA . 92236 ' OWNER DAVID ANAYA 47005 VIA ANTIBES LA QUINTA CA • 92253. FINANCIAL INFORMATION DESCRIPTION r S ' ACCOUNT QTY AMOUNT t PAID PAID DATE- bb RECEIPT # CHECK tt METHOD PAID BY k � � � a Fra • z' .. .r +a s` : '�.. ku� • -_� � � `r�'a. a � .CS�.w , t g f� :'�>, i� : <ra<: � u BY Si � BSAS SB1473 FEE 101-0000-20306 0 $1.00'• $1.00 1/26/15 R3502 • . 2181 ALL DAY HEATING& CHECK MFA COOLING Total Paid forBUILDING STANDARDS ADMINISTRATION • ` $1.00 $1.00 BSA: rx. °� � }. D TE ECRM COMPLETED RESULT`„ " REMARKS, _' DATE' �_' =DATE $ .. -NOTES +I * �• DESCRIPTION'ACCOUNT QTY.' AMOUNT a P jPAID RECEIPTp CHS E' *+ PAID BYCLTD" " 'SENT DATE DUE DATE t r +RETURNED .y...DATE " STATUS r , : REMARKS .. r}. o ,.t tR.i BYY f HVAC CHANGEOUT - 101-0000-42402 0 $145.04 $145.04 1/26/15 R3502 2181 CHECK ALL DAY HEATING & ' 'MFA SPLIT -SYSTEM . COOLING HVAC C - 101-0000-42600 0 $72.52 $72.52 1/26/15 R3502 2181 CHECK ALL DAY HEATING & MFA SPLIT -SYSTEM PC SYSTEM PC COOLING Total Paid forCHANGEOUT:. $217.56 $217.56 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 1/26/15 R3502 2181' CHECK ALLDHEATING& MFA COOLING COOLIN' Total Paid forPERM1T ISSUANCE: $91.85. $91.85 TOTALS: SEQID.} ,''INSPECTIO.N TYPE r, •.4 MECHANICALFINAL REVIEW.TYPE R,<. 3; REVIEWER INSPECTIONS j INSPECTOR'- SCHEDULED: F krt. COMPLETED RESULT`„ " REMARKS, _' DATE' �_' =DATE $ .. -NOTES +I * �• PARENT PROJECTS " 'SENT DATE DUE DATE t r +RETURNED .y...DATE " STATUS r , : REMARKS .. "tifF `NOTES BOND INFPRIVIATION Bin # City of LA Qui ta. Building st: Safety Division : Permit # P.O. Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: C� '� :p�5 U t 40, A+�-i ; � e'S Owncr's Name: k- A. P. Number: Address: —1 ---t — ©o Legal Description: City, ST, Zip: ) Contractor:sG Telephone: %'>s<::•,..>: >.::»;;;Fz: s;•<.:>:s;;;>s Address: S3—r�1Z. Project.Description: City, ST, Zip:. Telephon 53'--1—lobi{' ;»"<r'3ti>'•.::>:;a :»....;';....::r>:<' LoG.A—� State Lic. #:, -3 3- City Lic. #t Arch., Engr., Designer: Address: City., ST, Zip: hone: Telepp State Lic. #: £i�:>$ii:4�.:iii�.ii%lynv}•ii: is iii:::}•..!... :::..:.,.;:::;::;:.;:.;:>.;::::.>:;:» ;>:;-s:::<s;>s• •�::�=<;:i>:,.:;::i:.><><>:�.::;::::;:::::•>::'.;;�:<:;:>;:»: '"'' %' ' `>;i»>'>`>'^ '%' >' '>` :'' ........:.............................................. ' Construction Type: Occupancy. Pro cet c circle one): New Add'n Alter. Repair Demo j TyP ) Name of Contact Person: , �' Sq. Ft.: #Stories: Units: Telephone *,of Contact Perso .—� g�--t— 11 6 Estimated Value of Project: I g p o O , o� APPLICANT: DO NOT WRITE BELOW THIS LINE if Submittal Req'd Rec'd TRACMIG PERMIT FEES. Plan Sets Plan Check submitted Item Amount Structural Calcs. RevicNved, ready for corrections Plan Check Deposit Truss Cala. 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 corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'r° 12evinv, ready for corrcctionsfissuc Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Datc of permlt issue School Fees Total Permit Fees t CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 ) Project Name: 47005 Via Antibes Date Prepared: 2015-01-26 A. General Information CF1R-ALT 02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one CF1R-ALT-02 document for each dwelling unit. 01 Project Name 47005 Via Antibes 02 Date Prepared 2015-01-26 03 Project Location 47005 Via Antibes 04 Building Type Single family OS CA City La Quinta 06 Dwelling Unit Name 47005 Via Antibes 07 Zip Code 92253 08 Dwelling Unit Conditioned 2500 Installing new SC Installing Installing Installing Floor Area (ft2) Identification or Location or Area 'by this SC ' ducted containing Number of space conditioning more than 40 09 Climate Zone 15 10 (SC) systems in this dwelling 2 system? component? components? feet of ducts? unit. , B. Space Conditioning (SC) System Information 01 02 '� < 03'e, a 04 05-.; t 06 07 a 08 " ` 09 10 ` Is ihe.SC ' •` Installmg'a " SC System SC System CFA served system a refrigerant Installing new SC Installing Installing Installing Identification or Location or Area 'by this SC ' ducted containing system • more than 40 entirely new entirely new Name Served System (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type System 1 living, kitchen 1300 Yes Yes Yes No No No Altered space conditioning system System 2 bedrooms 1200 Yes Yes Yes No No No . Altered -space cyst conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section1S0.2(b)1Diib) This section does not apply to this project. Registration Number: 21S-A0027269A-000000000-0000 Registration Date/Time: 2015-01-26 12:51:01 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-01-26 12:48:58 Schema Version: 0.551SDD i CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 ) D. Altered Space Conditioning System (Sections 150.2(b)lE and F) . 01 ' 02 03 04 05 06 07 08 09 10 11 12 Heating Cooling System Heating Altered Heating Minimum Altered Cooling Minimum Required New or Identification System Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency' Thermostat Replaced New Duct or Name Type Components Type Value System Type Components Type Value Type Duct Length R- Value Central gas All new Central split All new This field or This field or System 1 furnace heating AFUE 0.78 AC cooling SEER 16 Setback . section is not section is not components components applicable applicable Central gas All new Central split All new This field or' This field or System 2 furnace heating AFUE 0.78 AC cooling SEER 16 Setback section is not section is not components components applicable applicable Required Documentation: ' CF2R-MCH-01-E - Space' Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums: R6 - �«m.y,,. �,: y„+•+.x,� .y �....v.•f ay y«,v.-� ,a+u +�.:.;w=«.y�:r ,;«+t.q... CF2R-MCH-20-H & CF3R-MCH-20-H - Duct Leakage testing required when heating or cooling components a 1. re installed in ducted systems, or when mgre.than 40 ft of duct length is replaced. -Leakage rate compliance: 5 15%, ors 10% leakagedo'qutside or seal all accessible leaks. ' • ' CF2R-MCH-25-H & CF3R-MCH-2541 Refrigerant. Charge Verification required when refrigerant contammg'components armee installed o :altered (applicable in CZ 2, 8-15). CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow z 300 CFM/ton reguiretl when MCH 25 is required 4' F • �_ �.. • Excel tlons: kMii2.��'¢�.Xrti� '4A:� ,.4h-•r,.4.i•,sa,e.s h 1,•h''.f` it `.'ate M= -Duct systems registered with HERS provider as previously sealed are exempt fromMCH-20 Duct Leakage Testing requirerrments. -Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-25. -Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements. E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)IDiia and 150.2(b)1E, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 1S0.2(b)IC) This section does not apply to this project. Registration Number: 215-'A0027269A-000000000-0000 Registration Date/Time: '2015-01-26 12:51:01 CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Schema Version: 0.551SDD HERS Provider: CaICERTS Report Generated: 2015-01-26 12:48:58 0 t N CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3 ) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: SANCHEZ, MIGUEL G Company: signature Date: MIGUELSANCHEZ 2015-01-26 12:51:01 Address: CEA/ HERS Certification Identification (if applicable): • ' 83947 Moonlit Drive City/State/Zip: Phone: Coachella CA 92236 (760) 834-1064 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 acceptreiponsibdity for the budding design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials components; and manufactured devn:es'for the building designor system design identified on this Certificate of Compliance conform to the requirements of Tide 24, Part 1 and Part.6'of the California Code of Regulations. A 4. The building design features or systemldesign features identified on this'Certificate of Compliance are consistent with the informabod:provided on other applicable compliance documents, worksheets, calculations, plans and specifications -submitted to the enforcement agency for approval. with this bmldirg permit application: S. I will ensure that a registered copy of this Certifcate of Compliance shall be made available w th.the building_permids)iisued for the .buildmg 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 Signature: SANCHEZ, MIGUEL Company: Date Signed: MIGUEL SANCHEZ 2015-01-26 12:51:01 Address: License: 83947 Moonlit Drive 954337 City/State/Zip Phone: ' Coachella CA 92236 (760) 834-1064 l Digitally signed by CBICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-A0027269A-000000000-0000 Registration Date/Time: 2015-01-26 12:51:01 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-01-26 12:48:58 Schema Version: 0.5515DD t