BPLB2015-0026^.ham
/�' .-6-495" ALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPLB2015-0026
Property Address: 54438 SOUTHERN HILLS
APN: 775110037
Application Description: KAHLER RESIDENCE WATER HEATER CHANGE OU
Property Zoning:
Application Valuation: $2,250.00.
Applicant:
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
jjjj Date: 2/18/2015
II ale
FR , S•& RICK KAHLER
54 OUTHERN HILLS
i .B 1 8 2015 LA TA, CA 92253
:ITS
Contractor:
HARRISON
HARRISON ENTERPRISES INC DBAG
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
(760)343-7488
Llc. No.: 686310
---------------------------------------------------------------------------------------------
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: C20 License No.: 686310
Otte: 115 Contractor: �Z ~
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. 309'7, Civ. C.).
Lender's Name:
a
Lender's
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 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.
Dae: I6 1S APPIie nt:
Ii
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 Fiereby.authorize representatives of this city to.enter upon the above-
mentioned property for inspection purposes.
Date:) ` ) J Signature (Applicant or Agent):
I
C
FINANCIAL •• •
TMOUNTAlm�t DEDKDATFxE
P+ PAID, AC OLIN
BSAS SB1473 FEE
101-0000-20306
0 $1.00
$0.00 '
h f Vit' PAID�BY ».
° METHOD
'` sRECEIPT # ? + CHECK # sx, �* CLTD BY
;
'
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA .$1.00
$0.,00,
* t om DESCRIPTION` _ t
ACCOUNTS
QTY
t °AMOUNT';
PAID ��
PAID=DATES
¢
=y
¢'t
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY x®
:. r
METHOD
CLTD BYE'
i�,
LLRECEIPT
4
Total Paid for PERMIT ISSUANCE: $91:85
$0.00
a4 x+ "`DESCRIP.TION'' ?s {;"
,"
QTY
_- AMOUNT K``PAID
�'
PAID DATE
,AACCOUNT
z
r.
rs
WATER HEATER/VENT
101-0000-42401
0
' $12.09,-
$0.00
_BY
e M
ETHOD
CLTD BYE
_-
ta�RECEIPTV
fix -' DESCRIPTION`. s `:, N
:ACCOUNT`
QTYqAMOUNTf
`PAID U7,
PAID¢DATE:
E�x'�t.:'..Y-
WATER HEATER/VENT PC.
101-0000-42600
0
$7.25
$0.00
F" PAID,BY{f"
+p a a, METHOD
�rRECEIPT`uCHECK
#
CLTD BY
s
�¢r
`
Total Paid for PLUMBING FEES: $19.34
$0.00
TOTALS:00
,,
.n
Description: KAHLER RESIDENCE WATER HEATER CHANGE OUT
Type: PLUMBING Subtype: Status: APPROVED •
Applied: 2/18/2015 MFA
Approved: 2/18/2015 MFA
Parcel No: 775110037 Site Address: 54438 SOUTHERN HILLS LA QUINTA,CA 92253
Subdivision: TR 28776 Block: Lot: 3'
Issued: --
Lot-Scl Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $2,250.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: WATER HEATER CHANGE OUT - 75GALLON [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
A
C �T1T.�
R �f0�,/
,f'Flit(lhlfll,�-1�1 T n
CONDITIONS ~
7
4 1.
'�;7.,-PAID
-c"LT
"T
�DESCRIPTION.
'ACCOUNT
QTY
-AMODATE.
,AMOUNT
PAID q
PAID.K
;RECEIPT * T
CHECK
MET HOD
BY.��',
F
By'!�
BSAS-SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00
$0.00
BSA:
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-
L
$0.00
PC.
Total Paid forPLUMBING FEES:
$19.34
$0.00
TOTALS:
$112.19
$0.00
....................................... ...... ......... ...
INSPECTIONS
......... ..
SEQID.kESULt
NSRECTION TYPE � INSPECTOR .
COMPLETED, REMARKS�,. '�—NOTES
DATE
PATlir�
PLUMBING FINAL"
PARENT PROJECTS
Printed: Wednesday, February 18, 2015 1:14:00 PM 2 of 2
C§FWIYSTE'MS
Bin N
City of U Quin to .
Building 8L Safety Division
' P.O. Box 1504, 78-495 Calle Tampico .
,/
La Quinti, CA 92253 - (760) 777.7012
Building Permit Application and Tracking Sheet .
Permit #
L (��
Project Address: Sy438..Sou1r\e�cv.
Owner'sNamc:
A.P.Number:
Address: SL443a
Legal Description:
City, ST, Zip: L CA C 2-Z 3
ntract
Telephone: Z — C�544(�O�
Address:: 31
Project Description:
City, ST,.Zip: 1 C7JSG 0.� 5 CA g2271s,
1� l G -7� 6 AtecAcr
Telephone:. x(00-343-1428''
..............................................
State Lic. # : (0$ 310
City Lie. #:
Arch.,.Engr., Designer:
Address:
City., ST, Zip:
Telephone:
..................................
Construction Type: Occupancy:
State Lie. #:Project
type (circle one): New . Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
#Stories:
Units:
Telephone#,of Contact Person:
Estimated Value of Project: Zt ZZ!50^
APPLICANT: DO NOT WRITE BELOW THIS LINE .
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Revic)ved, ready for corrections
Plan Check 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"d Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Dccd
Plans picked up
IiA.A. Approval
Plans resubmitted
Grading
IN IiOUSE:-
'`� Reyierv, ready for corrections�ssue
Developer Impact Fee
Planning Approval
Called Contact Person
A:LP.P.
Pub. Wks. Appr
Date of permit issue
School Fecs
Total Pcrmit Fees
1. STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS _
CEC-CFIR-ALT-01-E Revised 06/14
CERTIFICATE OF COMPLIANCE • `
Prescriptive Residential Alterations
Project Name: SL44434 So,>"erv;n :115
i
CALIFORNI
Date Prepared:
e COMMISSION
CF1R-ALT-01-E
(Page 1 of 6)
r )S
A. GENERAL INFORMATION '
01 •
02
01
Project Name:
05
02
Date Prepared: I 15
03
Project Location:
E44 3 .MNer
04
Building Front_orieniation`(deg or cardinal):
05
CA City:i
aha
06
Number of Ali- ed,Dwelling Units:
•07
Zip Code:
Ct?aS� "
08
Fuel TypK. , + ct}vYct Ca g
09
Climate Zone:
Ac
10Total,Conditioned
FloorSA e'a (ft2):,
11
Building Type
a , Cavity Ins4lat�i�on. �,
'R;yaIue A Lf_ R;waIue) U -factor.*, T;abie Cell
12
Slab,Area (ft2) p` /
13
Project Scope:
-
(Exc ptions to Minimum"kAged Solar . i.
14 Reflectance and Mimm.' Thermal or SRI
„per 150.2(b)1Hi'(
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)
01 •
02
03,
04
05
06e, 411.1#— 1 07 ,; ', (Q8 1 09
• 10
11 =
~
Proposed,
Required
'
01
02
03
Frame
Frame
Appendix JA4
� Continuous 5
Reference
�
,
Tag/ID
r
Assembly Type
Frame
Type
Depth
(inches),
Spacing
(inches)
a , Cavity Ins4lat�i�on. �,
'R;yaIue A Lf_ R;waIue) U -factor.*, T;abie Cell
U Factor
Comments
�
!)
•
.-
3
as rd'
.� • � � � � � � ._
Method of
.
Product
ID
Product
R=value
Deck
Aged Solar Aged Solar
Initial Solar Aged Solar Thermal SRI Reflectance Reflectance Thermal SRI
C. ROOF REPLACEMENT
(Prescriptive Alteration;i5ection
150.2(ub)1H)'*`'r
,
i
~
'
01
02
03
04
, , 05 y
06 _
�
_. 8,+,, 09
10
11' ..
12'
13
14
�
!)
CRRC
-
;' `fid
3
"
Proposed Minimum Required'
,
Tag/
Method of
'Roof
Product
ID
Product
R=value
Deck
Aged Solar Aged Solar
Initial Solar Aged Solar Thermal SRI Reflectance Reflectance Thermal SRI
`Number
_ ,
'Reflectance
ID
Compliance
,�Pitell
p Exception
,
.,Type
Insula ion
i Reflectance Emittance (Optional) (Max) (Min) Emittance (Optional)'
Vol
r
..
NOTES-
• Roof area covere' ing integrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements. ,
• Liquid field applie coatings'must comply with installation criteria from section 110.8(i)4. -
Registration Number: - Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
r
HERS Provider:
June 2014
STATE OF CALIFORNIA ,
' RESIDENTIAL ALTERATIONS n
A R CEC-CF1 R -ALT -01-E Revised 06/14 c CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE « '• ` CF1R-ALT-01-E
Prescri tive,Residential Alterations __4
- P - _ _ z Y. ._ (Page 2 of 6) —
Project•Name: �: •_ Date Prepared: -
a+
DJENESTRATION/GLAZING _AREAS ALLOWED'(Section 150.2(b)1)
01
02
03
04
05 .
_.06
07 a
14
Makimum Maximum
• .
_
-Allowed ' Allowed
•Fenestration Fenestration
Maximum
Allowed
•
Existing' Existing •
Fenestration. West -Facing
•
Maximum Maximum
4
Maximum
r�r "'
Maximum
',Allowed"
_
-'
Alteration'
Type
Area For All Area For All
West Facing
Fenestration_
y Area for All Fenestration
Allowed Allowed
U -factor; U -factor
Allowed
SFIGC
A
SFi A0
l . Comments
x
- ,
Orientations Orientations
(ftz) (ft ;
,
Area Only,
Orientations Area
(ftz) (ftz)
(Windows) (Skylights)
;
(Windows)
(SKyghts)
-
s
(Windows) _ '(Skylights)'
Al
-
T
..
r
L
1W
`
_
•, I
i � ,
• .rte
Y
_
• + µ
,
i
a. M �•
e 411� "lift
k4
jr
AML
.lig Na
t� e l . i i r• `
Registration Number: • ` �• , Registration Date/Time: �. t HERS Provider:, fi
CA Building Energy Efficiency Standards - 2013 Residential Compliance " ' June 2014
'STATE OF CALIFORNIA ,.
RESIDENTIAL ALTERATIONS y o
CEC-CF1 R -ALT -01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E i
Prescriptive. Residential Alterations _ - _ - -(Page 3 of 6) -
Project Name: Date Prepared: '
E. FENESTRATION PROPOSED AREAS AND EFFICIENCIES — Add (Section 150.2(b)1A). - {
01
02
03
. , 04
05
06
X07
08
09, '''
10 (
N
11
12
13
14
Tag/ID
Fenestration Type
Frame
Type
Dynamic
Glazing
Orientation
N, S, W, E
Number
of ' W
panes -,
Proposed
Fenestration
Area
(ft2).
Proposed
West Facing
Fenestration
Area (ftz) 1
U -factor,
�
n
Source
� �-'
d.
SHGC
0.a +
Y
• Source
Exterior
Shading
Device'•
Combined
SHGC from
CF1R-ENV-
03• ,
1S_'
Existing + Proposed Fenestration Area ti
16
Maximum Allowed Fenestration Area '° i
17
Compliance Statement
18
Existing+ Proposed West -Facing Fenestration -Area'"
19
Maximum Allowed West Fenestration Area '
�. � ..�. ,ate •
20'
Compliance Statement •' OF
.21
Proposed Fenestration U -factor (Windows) . s v
22
Required Fenestration.U-factor (Windows)
23
Compliance Statement
24
Proposed Fenestration SHGC (Windows) `
25
Required Fenestration SHGC (Windows).,11 1% ,� *A> t V
26'
Compliance Statement^
27-
Proposed Fenestration U -facto (Skylights) '%61
-
28
Required Fenestration U -Q orl(Skylights)
i
29
Compliance Statement '�
�.
30
Proposed Fenestrpt on SHGC (Skylights.)
31
Required Fenestration SHGC (Skylights)
32 .
v
Compliance Statement
Registration Number: - ` _ Registration Date/Time:
CA Building Energy Efficiency Standards .2013 Residential Compliance
HERS Provider
June 2014
r
STATE OF CALIFORNIA
..RESIDENTIAL ALTERATIONS �+a
CEC-CEI R- -0 Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 4 of 6)'
- .Project Name: _S44438 Date Prepared: 2- 1; IS
F.,FENESTRATION/GLAZING PROPOSED AREAS AND EFFICIENCIES — Replace (Section 150.2(b)1B)
17 F Maximum Allowed West -facing Fenestration Area
y
ds West -facing Fenestration Area < Maximum Allowed West -facing Fenestration18 .1,
19 r Net Added Fenestration Area (all orientations)
tt 20 Existing + Added Fenestration Area (all orie#nto�s)�` li
21 Maximum Allowed Fenestration Area (a ll-oorrien a,tions) :
22 r Is Existing + Added Fenestration Area < Maximum Alllowed,Fe nhe�stration Area,
,,_,(all orientations).L w
ti G. SPACE CONDITIONING(SC) SYSTEMS — HE IN,NG/COOLING (�'P,rescriptlive sectioffU50.2(b))
01 NU 03
Dwelling Unit NameDwelling�U itt ZFA(Ft2) `- Comments , a
.�.' 4-r
H. WATER HEATING SYSTEMS (Section 150:2(b
1G)
' 014..
<62
'
Q` 4
05
06
07
08 ,,
09 +;
01
02
03,
04
05 -
06
07 08
+ •9,•
10
= 11
12
13•
14
Area
Area Net
--Water Heating
"Exterior
Water
Combined SHGC
Tag/'
'Fenestration
Frame
Dynamic
Orientation
Removed'
Added Added
' .System
Shading
from
ID
Type
Type
. Glazing
N, S, W, E
(ftz)
(it) Area (ft)-
U -factor
Source
S.
„ So'urce
Device
CF1R-ENV-03
Heating�
Heater
; , in -
Volume ..
''
Input
Input
Efficiency ;
Efficiency
”
Insul.
,.
Savings
Central DHW System
System "
Name .
SystemTType}
Type.,
system
(gal)
Type
Type
Value
Type
Value
Loss (%)
R -Value
17 F Maximum Allowed West -facing Fenestration Area
y
ds West -facing Fenestration Area < Maximum Allowed West -facing Fenestration18 .1,
19 r Net Added Fenestration Area (all orientations)
tt 20 Existing + Added Fenestration Area (all orie#nto�s)�` li
21 Maximum Allowed Fenestration Area (a ll-oorrien a,tions) :
22 r Is Existing + Added Fenestration Area < Maximum Alllowed,Fe nhe�stration Area,
,,_,(all orientations).L w
ti G. SPACE CONDITIONING(SC) SYSTEMS — HE IN,NG/COOLING (�'P,rescriptlive sectioffU50.2(b))
01 NU 03
Dwelling Unit NameDwelling�U itt ZFA(Ft2) `- Comments , a
.�.' 4-r
H. WATER HEATING SYSTEMS (Section 150:2(b
1G)
' 014..
<62
-03 _
Q` 4
05
06
07
08 ,,
09 +;
10
11
f 12
13'
14
15
f
f ofBack-Up
Water
;
--Water Heating
{4y
'�4
Water
Heater
' .System
Water
Water
,t
Heaters
Storage
Rated.
Rated
Heating
Heating.
Exterior
Solar
.'Dwelling Unit DHW
Identification or
Heating�
Heater
; , in -
Volume ..
Fuel
Input
Input
Efficiency ;
Efficiency
„Standby
Insul.
,.
Savings
Central DHW System
System "
Name .
SystemTType}
Type.,
system
(gal)
Type
Type
Value
Type
Value
Loss (%)
R -Value
Fraction
Distribution Type
Distribution Type -
L
�q
1
%
+
I14,44 -As
" Registration Number: = Registration Date/Time: o 'HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance : June 2014
' STATE OF CALIFORNIA, r1
1• } , �' 4..ot
} ' RESIDENTIAL ALTERATIONS ;r `a• . , -
' a , CEC-CF1 R -ALT -01-E Revised 06114 " �' CALIFORNIA ENERGY COMMISSION
`
-CERTIFICATE OF COMPLIANCE' t_ J ;. ,.'_ CF113-ALT-01-E
' Prescriptive Residential Alterations ,._ *�'- *�--• --� - - _ - - ;'• z`(Page 5 of 6)
' Project Name. Mr` _ i =' Date Prepared:
s„
I. SPACE CONDITIONING SYSTEMS AND WATER HEATING SYSTEMS IN MULTIFAMILY DWELLING UNITS Y.
01 �'
02 w'7
03 i
04 a. r 05,
06.-
r:
Central Water Heating
Dwellin Unit
g r = Dwelling Unif:
Dwelling Unit,Total CFA
System Identification or
Water Heating System Altera ion o the Space
Y
• ' r
Dwelling Unit Name
�` (ft2) "
Name �, =. '
Identification or Name' _ 4CondiUoning System(s)?
- Comments
t
tPn•
-
. , ,.) ^ , .. ti . • '"s1l-• 1 a eft' ,Ja ^ -
.5' '. �, r f . `. ` .� .� ` � � '� ), •.2-. � . �' ••fir ti e •. `� .• . ,. '• •.
VIP
i INP*
,. Ate` • '" „ . :.� .. �. .� ;:, � ; , � �.
.{.v. '�M_. z♦��- .1 +, �: ',.,.+^�. r-. `-_- -•; ry' ... .s __ [,• _;ate _ •• +f,! _�r. ''.� ,
I& ic
• - •. k` ' � I � _ r t � e •• • tom' • f s: � F.. _ t � i 4 � _
t-.
- ♦ yK••� . f �s'21 . .5�. •• f. 'i '•-= µ ` . �,n`' ' ,=r 1J _,i t•..>ti• �` ' * c� j_ 'Q.4 fr" +4 -..Y,' Y•
f 7-
r �?' 1 'Registration Number:'. ' j, - Registration Date/Time:., r �x 't HERS Provider.! . M ,
r .1CA,Building EnergyrEfficiency Standards - 2013 Residential Compliance f'+ .`•+ .0 .June 2014'
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE .. r ' ' CF1R-ALT-01-E
" Prescriptive Residential Alterations -�'; >� ' v : ` - ;.r - '(Page 6 of 6) '
Project Name: Syy3g S va- eri ' ��lS Date Prepared: allalls
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. '1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: • 1 -
Documentation Author Signature:
Q
Company: '•
Signat re Date: '
e-\-, ex C. i' !' i i
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Address: ^
CEA/ HERS Certification IIdentifica[ion�(if applicable):
City/State/Zip: r
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Phone: ,�'`� • ��++ -
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RESPONSIBLE PERSON'S DECLARATION STATEMENT ` +11 ' t
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.- ,
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2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibilityfor the building"desor•system identified on this Certificate of Compliance (responsible
designer).
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3. That the energy features and performance specifications, materials; componenttss,'and manufacturred de, Ic §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 of4egulatlons. t
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4. The building design features or system design features identified on this Certificate of Compliance are consistenttwlth.theM Information provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted to the enforcement agency,.foh pproval with this building permit application. ;.
5. 1 will ensure that a registered copy of this Certificate of Compliance= hall be made:availa le with the building p m t(s) issued for the building, and made available to the enforcement agency .
for all applicable inspections. I understand that a registered copy of this Certificat of ompliance is regtalred•to be included with the documentation the builder provides to the building
z owner at occupancy. ,+
Responsible Designer Name:
Responsible Designer Signature:
Company: �' _ '
Date Signed: _
Address:
License: , s'
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: y
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014