BRES2015-0006t
A MPI D Qum&
78 495 C LLE TA CO
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BRES2015-0006
Property Address:
46645 WASHINGTON ST
APN:
643182014
Application Description:
WINDOW CHANGE OUT 3 OLD TO 1 NEW
Property Zoning:
Application Valuation:
$800.&
Applicant: IF
EJA
"
MARTIN NORIEGA
46645 WASHINGTON ST 0 9 2014
LA QUINTA, CA 92253
YOFUQ—U—EAMCOMMUNITYDEVELOPMENT AENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: _ License No.:
Date:
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 x
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fo a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
t2!!Nl, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for•sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that
he or she did not build or improve for the purpose of sale.).
(1 I, as owner of the property;�am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
(_) I am exempt under Sec. . BAP.C. for this reason
Contractor:
Date: (2 Is 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: 1/12/2015
Owner:
MARTIN NORIEGA
46645 WASHINGTON STREET
LA QUINTA, CA 92253
Contractor:
Llc. No.:
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 insura-hce•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: Z Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above•
mentioned property for inspection purposes.
.Date: Signature (Applicant or Agent): %y'1 '✓%�
1
7
FINANCIAL OR
'. . fi DESCRIPTIONA� 't:`�' _ ACCOUNT ,.
'QTY AMOUNT' Fy PAID "
PAID?DATE
;`
�,3 vr' F F' .. •- t. r .�i i�,... .. t .0
BSAS SB1473 FEE 101-0000-20306
0 $1.00
$0.00
�!
PAIDMETHOD' r
it k�j:i
y ', CHECK #
BY
rS;W
.xRECEIP.T
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA , $1.00 $0.00
DESCRIPTIONAMOUNT
< PAID'
MAID DATE.
Ft
SMI - RESIDENTIAL
101-0000-20308
0
$O.SO
$0.00
'- -r PAID BY _`
:, :METHOD s " �
,
t �RECEIP,T#` '� _
` CHECK # x..
CL TD•BY
•
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00
`§xc
,DESCRIPTION ' '
:i' c ACCOUNT"'*'tQTY'
`AMOUNT F
F- `" PAID _
',PAIDDATE
<
ft
DOOR/WINDOW, REPLACE FIRST 7
101-0000-42400
0
$60.91
$0.00 1
". •'PAID BY i
;` `'s-•, M OD
ETH
r r� i 1#RECEIPT ``
! CHEGK #
CLTD. BY
r
DESCRIPTIONti�, `" d
'-
'QTY
AMOUNT
PAID';
'PAID DATE'
,f"r^ s:^
;:ACCOUNT
DOOR/WINDOW, REPLACE, FIRST 7 PC
101-0000-42600
0
$110.22
$0.00
PAID BY
RECEIPT # '
=CHECK#
CLTD BY,_.
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $171.13 $0.00
TOTALS:• •0
1
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,'
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'ted
•
I
1
7
Description: WINDOW CHANGE OUT 3 OLD. TO 1 NEW
Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: UNDER REVIEW
Applied: 1/12/2015 PJU
Approved:
Parcel No: 643182014 Site Address: 46645 WASHINGTON STLA QUIII 92253
Subdivision: TR 2117 Block: Lot: 71
Issued:
Lot Scl Ft: 0 Building Sci Ft: 0 Zoning:
Finaled:
Valuation: $860.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: REMODEL& REPLACE THREE OLD WINDOWS CONVERTING INTO ONE LARGE WINDOW PER 2013 CBC &APPROVED. PER
CLTD
.ACCOUNT QTY'. �;ZAMOUN ;*PAIDDATE•qR PAID BY'c 7
DESCRIPTION PAID D::__'�;' ECEIPT'.# CHECK # MEfk'0'D B
Y
13SAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
Printed: Monday, January 12, 2015 12:29:09 PM J 1of2 . . I CRWIYSTEMS
W_
CONDITIONS
CONTACTS
CLTD
.ACCOUNT QTY'. �;ZAMOUN ;*PAIDDATE•qR PAID BY'c 7
DESCRIPTION PAID D::__'�;' ECEIPT'.# CHECK # MEfk'0'D B
Y
13SAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
Printed: Monday, January 12, 2015 12:29:09 PM J 1of2 . . I CRWIYSTEMS
_
'
PARENT PROJECTS.�
m
RONnINFnRMATION
L
j
ATTACHMENTS
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.00
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00
101-0000-42400
0
$60.91
$0.00
REPLACE FIRST
DOOR/WINDOW,
101-0000-42600
0
$110.22
$0.00
REPLACE, FIRST 7 PC
Total Paid forWINDOW/SLIDING GLASS
r
$171.13 $0.00
DOOR/FENESTRATION:
TOTALS: $172.63 $0.00
_
'
PARENT PROJECTS.�
m
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,
. - .
'
Printed: Monday, January 12, 2015 12:29:09 PM 2 of 2 SAff
CRUff SYSTEMS
RONnINFnRMATION
L
j
ATTACHMENTS
`
,
. - .
'
Printed: Monday, January 12, 2015 12:29:09 PM 2 of 2 SAff
CRUff SYSTEMS
Bin # City of La Quinta.
Building &r 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: t'1'(o (o 4S wAShCt\)lot,,' S -t-. Owner's Name: Mo,r'ri Nflt`1 2 0.
A. P. Number:
Address: tA 6 (c 14 5 Uj 1"' n, � ,o n ��•
Legal Description:
4
Ci ty.ST Zip: L_a, Q..,�kC� 22S 3
Contractor: O.,a r. a..c-gv i
Tcicphone: 014 � 9
:;:,.•:;:>^;<•;>::;::<>:;:»::><ss�':;:<<;:;
Address:
Project.Description:
City, ST, Zip:.
P- 'L to, c- e- o
Telephone:
State Lic. #:
City Lie. #;
j�� d . o ?� t w o \ 1 5 e }
Arch., Engr., Designer:
Vj ci
Address:
b ov Q--
_City,
City.,ST, Zip:
Telephone:
State Lic. #
1.<••s • ;•;:: •
'Construction Type: Occupancy:
Add'n Alter Repairair DemooJectnPacircle one): New:
Name of Contact Person:
M o f- �� ,� {�1os.; Q 0.
Sq. Ft.:
# Stories:
# Units:
Tcicphone # of Contact Person: 5 4 9 2°1 t -1 `t to }
Estimated Value of Project: gOO , o0
# Submittal
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rcq'd Rcc'd TRACK MG PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance •
Titic'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 Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN IiOUSE:
'`d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit.issuc
SchoolFccs
t
Tofa1 Permit Fees
r
r w
4 f
P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504 BUILDING, & SAFETY DEPARTMENT
78-495 CALLE TAMPICO - (760) 777-7012
` LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011'
PROPERTY(
'S PACKAGE , a
k ; ,
Disclosures & Forms for Owner -:Builders Applying for Construction Permits fi t"Q
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitted in our name listing yourself as the builder of the property
improvements specified at y(14s _)AS��YW}�ew S �.al (10 -,
We are providing you with an Owner -Builder Ackn ledgment and Information Verification Form to make you aware of your
responsibilities and possible risk you may incur by having this permit'issued in your name as the
Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice
unless you, the property owner, obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
1. I understand a frequent practiceofunlicensed persons is to have the property owner obtain an "Owner -Builder"
building permit that erroneousiy:impli}es: that the property owner is providing his or her own lab and material personally. I, as
an Owner -Builder, may be held`hable and subject to serious financial- risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
on my property.
'jr'f'1'i 2. I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
7"'0 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit: I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his'of her name instead of my
own.
4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
'LN"5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
under state and federal law. `
I! 6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
risk.
,44'x'„7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
structures cannot legally build them with the, intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
M*O 8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
"I tj 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and the Califomia
Division of Industrial Accidents. I also understand I may contact the Califomia Contractors' State License Board (CSLB) at 1-
800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
N 10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party legally and financially respponsible for proposed construction activity at the following address:
444S I.w Ove +,L GA g22Sa
VN -A 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owner -Builders as well as employers.
ftJ 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a license, the Contractors' State License Board may be unable to -assist you with any financial loss
you may sustain as a result of a complaint. Your'oinly`remedy against •unlicensed' Contractors may=be'in civil court. It is also
important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working
on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors,
you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or
other verification acceptable to the agency is required to be'presented when the permit is issued to verify the property
owner's signature. .
Signature of property owner W2 _71Date: 1Z 30 1't
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize '
the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above '}
information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the properly owner's signature.
Property Owner's Signature: Date:
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS r�
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: r4oR%E4A Rtc%vcc^jc.E Date Prepared: %-z
A. GENERAL INFORMATION
01
y
03
01
03
05
07
Project Name:
Project Location:
CA City:
Zip Code:
Noit%E A $t%OEr►C.E
N 66 4 S N+ &L w IevetTo w ST -
t_4 J a N T &
2 2
02
04
06
08
Date Prepared:
Building Front Orientatipn'(deg or cardinal):
Number of Alie,i Dwelling Units: .v ,
Fuel Type: "—
FYPe' � "`�'� '�` ��
%2 / t5
eSST
09
Climate Zone:
10
To6l Coriditioned Floor Area (ft2)
11
11
Building Type
S tNC,LE
CRRC Product ID
12
Slab ArA'(h2) ; "z�;'�*
I [.Sail
13
Project scope:
1Nk%-%-N
S -s s%-
w .66—b6
owe Gw1
Frame
-,
F Lontinuous �,+. f
Reference
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)�
01
02
03
04
05
06 07 08, tv_e�• 09
10
11
t 'O7 08 09 10 11 12 1 13
v � ° Proposed Minimum Required
-4. ` s '
x Proposed.
Required
Initial Solar Aged Solar Thermal SRI Aged Solar Thermal. SRI
Method of
Roof
CRRC Product ID
tv A endix JA4
'qua ry_ .Y� _ � PP
Compliance
Pitch
Exception
ftyumber ,
Frame
Frame
F Lontinuous �,+. f
Reference
y�
Y ?y���. C3... 'E�,
Frame
Depth
Spacing
Cavity a, ;,:Insulation k.
Tag/ID
Assembly Type
Type
(inches)
(inches)
.' ..
R -value f R -value', -,A',, . U.fa 'r Table Cell
LI -Factor
Comments
G:
C?i h;
C. ROOF REPLACEMENT (Prescriptive Alteration,ron4§d.2(b)1H)
01
02
03
04 ,A,
A-'
055
06
R -value t
al
t 'O7 08 09 10 11 12 1 13
v � ° Proposed Minimum Required
-'
Deck..
Initial Solar Aged Solar Thermal SRI Aged Solar Thermal. SRI
Method of
Roof
CRRC Product ID
Compliance
Pitch
Exception
ftyumber ,
3 ProductType
;Jnsulation
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
y�
Y ?y���. C3... 'E�,
.i �i%• Gy'
�'<
[
NOTES t,, �s,.
�-
• Roof area covered by building_integrated photovcG'-ic•panels and solar thermal panels are exempt from the above Cool Roof requirements.
• Liquid field applied coatingsymust comply with. stallation criteria from section 110.8(i)4.
G:
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance. lune 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION 'C.`
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 2 of 4)
Project Name: Noa.IE40 I Date Prepared: 1 tZ / 1S
D. FENESTRATION/GLAZING AREAS ALLOWED (Section 150.2(b)1) Al",
04
01 02 03 _
Alteration Type Orientation Maximum Allowed ft2 Comments <r
E. FENESTRATION/GLAZING PROPOSED AREAS AND EFFICIENCIES (Section 150.2(b)1) lkko
01
02
03
04
05
06
07
08 u
k � 9
ld`
111
12
13
14
15
`
Net
Exterior
Combined
SHGC
Tag/
fenestration
Frame
Dynamic
Orientation
N, S, W, E, or
Area
Removed
Area
Added �
��Added
Maximums
Al�lov�ed�
shading
g
from
ID
Type
Type
Glazing
Roof
ft2
ft2,
Area ft2
U:factdr
U -factor
Source
SHGC
Source
I Device
CF1R-ENV-03
w,r.v.•w
v►wy�
�rs.�ere
E
20.3
285
8.4 f,
a
:.>•
Net Added Wes faou" enestration A a
O
b
Existing + Added 0l",t,facing Fengstration Brea
c
Maximum All wed West-facinggFen station Area
s+, �. � a •l&..W�t
d
Is West facing fenestration Are�,< IyJa imam Allowed WestCfac ng Fenestration:
`es
e
` z. Net Added Fenestration Area (all oen4atioiis)
8,t{y
+tng+Addeef tArieatios)
o�t
Zp2.gd
'�.
g
Maximum A�Ilowed�t=enestration Area (all orientations)
�,,y ;�
h
•Is
Existing + Ad ed Fenestration' Area <Maximum Allowed Fenestration Area (all
F
i" orientations)
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 3 of 4)
Proiect Name: r4oittE4ft GLE5.ivew-6 Date Prepared: /is
F. SPACE CONDITIONING(SC) SYSTEMS — HEATING/COOLING (Prescriptive section 150.2(b))
Ol 02 03
�ate.
Dwelling Unit Name Dwelling Unit CFA (Ft2) CommentsO
G. WATER HEATING SYSTEMS (Section 150.2(b)1G)
01
02
03
04
05
06
07
08
Central Water:Heatin
Dwelling Unit
Dwelling Unit:
12
13
14
15
Wates Heating System
Alteration to the Space
Dwelling Unit Name
Water
,.."s
18entification or Name
Conditioning System(s)?
Y
3q� Al
Water Heating
# °f
Heater
Via.
t:y
"
Back -Up
System
Water
Water
Water
Rated
Rated
Heating
Y Heatjng
>
Exterior
Solar
Dwelling Unit DHW
Identification or
Heating
Heater
Heaters
in
Storage
Volume
Fuel
Input
y?
putt
Efficiency
�fficiiency
Standby
Insul.
Savings
Central DHW System
System
Name
System Type
Type
system
(gal)
Type
Type.
Value
?
Type'%;
�: Value
Loss (%)
R -Value
Fraction
Distribution Type
Distribution Type
H. SPACE CONDITIONING SYSTEMS AND WATER H T 3 SYSTEMS IN MULTIFAMILY�D.WELLING UNITS
Ol
02 �a"
. 03
r+w' 04 `
05
06
Central Water:Heatin
Dwelling Unit
Dwelling Unit:
Dwelling UnitFTotWaICFA
System Ide tification oar,
Wates Heating System
Alteration to the Space
Dwelling Unit Name
(fti2),„Y`Name
,.."s
18entification or Name
Conditioning System(s)?
Comments
3q� Al
E'y.. �crfn
N �.
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY- COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 4 of 4)
Project Name: mo0.►EGs Res%oe.+cic Date Prepared: iZ %S
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
MARTIN 140avec.,
Company:
Signature Date: a ✓ y �"'
a
�'c^-'Jit � .
12L y,•.! Sir s. �6
Address:
CEA/ HERS Certification Identi Ica4{on'(if applicablel:
y1Jo6 LJ C, WASOiNATzM Sr.
a` ' l ,5.
City/State/Zip:
Phone:?a
f19 9
L-& Qu104T& C- q 2.2co
I- . 29 11611.
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California:s'a',*'
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 responsi0ii ity,,for the building e`sig Jor system design identified on this Certificate of Compliance (responsible
designer). :;.
3. That the energy features and performance specifications, materials, components°Mand manufactured'.devices fnrthe 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 wlth.the information provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted totI4 enforcement agency foVpproval with this buiillding permit application.
5. I will ensure that a registered copy of this Certificate of Compliance shall be made v'a able with the bui q g 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 Certi�lce,te taf Compliance is.requuiired to be included with the documentation the builder provides to the building
VL
owner at occupancy. yx 4f :114V
Responsible Designer Name: y� u
:Re§po(:,sible Designer Signature:
Company: µ �? 1; � 4p '
Date Signed:
Address: '' '`5. `'' y
'44, 3 nom. aura
License:
City/State/Zip: f' Rid
Phone:
�.th
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 lune 2014
,n.DDRG:SS:
46645 WASHINGTON ST
LA QUINTA, C,o, 92253
OWNERS;
MARTIN E'ic C -a. RACE
NoRI��A
PREPARED GY:
MARTIN NORIEC�A
949-2917464
CITY OF LA QUINTA
BUILDING & SAFETY D PT.
APPR VE
FOR CONS UCTION
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