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BRES2015-0267Applicant: Contractor: D WICK ENTERPRISES INC DBA THR D WICK ENTERPRSES INC DBA THR 1515 CROWN ST 1515 CROWN ST REDLANDS, CA 92373 REDLANDS, CA 92373 (909)335-4846 Llc. No.: 818261 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSAa ION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one ol- the following declarations: 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, _ I have and will maintain a certificat? of consent to self -insure for workers' and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance License Class: B License No.: 818261 of the work for which this permit is issued. ]� - I have and will maintain workers' compensation insurance, as required by y, Date: —T Contractor: Section 3700 of the Labor Code, for the performance of the work for which this permit II �' is issued. My workers' compensation insuranC2 carrier and policy number are: 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 Divisio 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 f a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (� I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of,property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. . B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that 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: Carrier:— Policy Number: _ I certify that in the performance of :he work for which this permit is issued, I shall not employ any person in any manner so 3s to become subject to the workers' compensation laws of California, and agree thzt, if I should become subject to the workers' compensation provisions of Section 37,00 of the Labor Code, I shall forthwith . comply with those provisions. Date: —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 FOF IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to they 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 owne , and the applicant, each agrees to, and shall defend, indemnify and hold harmless the :ity 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 cancelhtion. 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 representaifves of this city to enter upon the above- mentioned property for inspection purposes. ' Date: Zd« Signature (Applicant m Agen . C� Q�i ai4�IlA�/ VOICE (760) 777-7125 78-495 CALLE TAMPICO 0 D FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/14/2015 Application Number: BRES2015-0267 Owner: Property Address: 47965 VIA FIRENZE DAVID MCCANN APN: 643130007 47965 VIA FIRENH Application Description: REPLACE (3) RETRO FIT WINDOWS SAME 4 SAME LA QUINTA, CA 92253 Property Zoning: Application Valuation: $2,035.00 Applicant: Contractor: D WICK ENTERPRISES INC DBA THR D WICK ENTERPRSES INC DBA THR 1515 CROWN ST 1515 CROWN ST REDLANDS, CA 92373 REDLANDS, CA 92373 (909)335-4846 Llc. No.: 818261 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSAa ION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one ol- the following declarations: 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, _ I have and will maintain a certificat? of consent to self -insure for workers' and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance License Class: B License No.: 818261 of the work for which this permit is issued. ]� - I have and will maintain workers' compensation insurance, as required by y, Date: —T Contractor: Section 3700 of the Labor Code, for the performance of the work for which this permit II �' is issued. My workers' compensation insuranC2 carrier and policy number are: 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 Divisio 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 f a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (� I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of,property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. . B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that 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: Carrier:— Policy Number: _ I certify that in the performance of :he work for which this permit is issued, I shall not employ any person in any manner so 3s to become subject to the workers' compensation laws of California, and agree thzt, if I should become subject to the workers' compensation provisions of Section 37,00 of the Labor Code, I shall forthwith . comply with those provisions. Date: —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 FOF IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to they 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 owne , and the applicant, each agrees to, and shall defend, indemnify and hold harmless the :ity 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 cancelhtion. 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 representaifves of this city to enter upon the above- mentioned property for inspection purposes. ' Date: Zd« Signature (Applicant m Agen . INFORMATION `DESCRIPTION€ "'� '�PcACCO,UNT . t"9aAMOUNT `;'PAID.PAID DATE n BSAS 561473 FEE 101-0000-20306 0 $1.00 $0.00 " a` SPAID:BY.<e'�xx�, RECEIPT.#� s CHECK# 'CLTD BY wMETHOD��": r ri e Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 4�} { A000UNT A PAID'DATEDESCRIPxTION i SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.00 PAdZY t a wn ; xi t " METHOD z {, ,:RECEIPT_# s. Y CHECK # r: ` CLTD BY.' s�; . 7 Total Paid forSTRONG MOTION INSTRUMENTATION SMI $0.50 $0.00 1 y y a;rDESCRIPTION t <'d :s; ''° ACCOUNT 'QTY '`"�AIVIOUNTw,k PAID DATE' �. �. - t t ..PAID. t DOOR/WINDOW, REPLACE FIRST 7 101-0000-42400 0 $60.91 $0.00 y'r�ry, By,t -METHOD `'' ,' RECEIPT# '" CHECK# `�CLTD BY': tµr,PAID t t' y DESCRIPTION a `� ; " ACCOUNT s"' t. '..QTY! ' 't AMOUNT '� '' PAID PAID DATE, ,` k DOOR/WINDOW, REPLACE, FIRST 7 PC 101-0000-42600 0 $110.22 $0.00 *PAID.BY ? `CHECK.# CLTD BY :"_ Total Paid forWINDOW/SLIDING GLASS DOOR/FENESTRATION: $171.13 $0.00 TOTALS:00 ^T a - i i 7 s� ^T a - i i Description: REPLACE (3) RETRO FIT WINDOWS SAME 4 SAME Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: APPROVED _ Applied: 7/14/2015 PJU .. t Approved: Parcel No: 643130007 Site Address: 47965 VIA FIRENZE LA QUINTA,CA 92253 Subdivision: TR 26152 Block: Lot: 7 Issued:. Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Fina led: Valuation: $2,035.00 Occupancy Type: , Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 D WICK ENTERPRISES INC DBA THR Details: REPLACE THREE RETRO FIT WINDOWS SAME FOR SAME PER 2013 CALIFORNIA BUILDING CODES. _ CHRONOLOGY CONDITIONS Printed: Tuesday, July 14, 2015 1:18:43 PM 1 of 2 - full,+,< CONTACTS �a•'-*'•n..':,.... '. _ •c• -=:f �Y'.. �%c.'�. •��'-tea - ._. :-.'�-.vi' �'� 'l�rc . �'+r _ _ _ .. .��•`_..` .f:.. ,� .'�'R i s �',.iu:g. .'Ca W!'•. Slf:! �t4. �'F P- F ^�NXi,1 'FJ+w� �"T�'l' 'i4i.' NAME;TYPE ,NAME' �, ADDRE5S1 x� ''"" `CITY . .STATES ,ZIP` t}. A '`PHONE '. ' : • , , -. ^ ... . to -; +�" �. .4.- ,r. � - ..�s,..' _f .{ _. ,••..'�' FAX. s EMAIL,, ::sra;Y APPLICANT D WICK ENTERPRISES INC DBA THR 1515 CROWN ST REDLANDS CA 92373 (909)335-4846 CONTRACTOR D WICK ENTERPRISES INC DBA THR 1515 CROWN ST T REDLANDS CA 92373 (909)335-4846. OWNER DAVID MCCANN 47965 VIA FIRENZE LA QUINTA CA 92253 (909)335-4846 Printed: Tuesday, July 14, 2015 1:18:43 PM 1 of 2 - full,+,< DESCRIPTION' -,,(--�ACC� 1,NO—TES - v- "!AMOUNT. e,i. 7777 71 '��RECEIPT4. �Z . �A `CL A N 3- 4 �'PAi D - PAID DATE,. NOTES �METH METHOD •'PAID B PA IL 44 RV 4m 77,' SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.00 Total Paid forSTRONG MOTION INSTRUMENTATION SMI $0.50 $0.00 DOOR/WINDOW, f . 101-0000-424 00 0 $60.91 $0.00' REPLACE FIRST 7 DOOR/WINDOW, 101-0000-426.00 0 $110.22 $0.00 REPLACE, FIRST 7 PC Total Paid forWINDOW/SLIDING GLASS $171.13 $0.00 DOOR/FENESTRATION:' TOTALS: $172.63 $0.00 P'FrTIr .-Sfcii6,.'I�-'''-INSPECTION,-TYP'E--'-'-`�•7, INSPECTOk)-,i,�,t.4 COMPLETEDREMARKS 1,NO—TES - v- qr IZ - RETURNED REVIEWS STATUS . �A I ,REVIEW TYPE 4 -REVIEWER:-,. 1sfNTjDATE ,- 3- FINAL" BLD NOTES -F - RETURNED REVIEWS STATUS REMARKS �A ,REVIEW TYPE 4 -REVIEWER:-,. 1sfNTjDATE ,- TIE NOTES PA Bin # CQ�y Of La Qluinta ,1 Building Br Safety Division a'�-� P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 -Building Permit Application and Tracking Sheet Permit # ' = Project Address: i S v t l� lQrch t r Owner's Name:�DAq-,r_--,. (Y\cC 4.*4W . A. P. Number: Address: t -{r19 4-S Legal Description: City, ST, Zip: 1,fA Jit rtA CA ZZ7-6 Contracto r -T: ej D Ct,n , uC?,r Telephone: )ice -Co r7 1— 311 Address:,p >�-�- Project Description: ' t City, ST, Zip:OCN`O� L' A Telephone: at_ _ l2 .. .. fiii: ":':`mac z> :c<,>;: r' f. `:::s: ;•• State Lic. # : 2�P j City Lic. #:O10<o9�9 Arch., Engr., Designer: Lic Address: Cl City., ST, Zip: Telephone: State Lic. #: :; ;.,;;•��?,:<n;>:,.:�•y,w::: ?4;:::}A.'#-n,??�`yj:;?r n;<..;;;:N•;�;. Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Ad1, n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: CPU Estimated Value of Project: Z © APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, 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 Mechani®i Grading plan 2°4 Review, ready for correctionOssueElectrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Develope_ Impact Fee Planning Approval Called Contact Person A•I.P•P• Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Xc#� �� 7:2 a f _7 Desart Resort Wianagem.enL P - izi Letel! r r+ f La Quint -a, CA'0 7-A eariC..� ` archltecU.:,r�irw . r e mays threw e)d5v be r ^n win&rvs and replace therr. nth - �pat nLoA tantW-In-dows ,I^ the same size has been approked bj, dig Am itevtnjral �Q�rn.� a$ '. bmltted, 'lie txust that c N* 11=e sed, �rnsursd cortracrcrrs will be the �AMrk. Please ae t �minde.tl►�a a:rt a- tQ the ccrn°rricn a,,ea due W ccpistru �cn shco d e repa 1 rmely manner. Nesse m-anage•rnent in -wtnb upon c04-ri)Iv�,Jcrr o� the p =of t If you 'have sav ques tns or need further assistance, pjea.se- feej free to cc,- �� 1764.345.116,% r t f �ffic erely, J esle'6W! Farris,`PCAM, AMS, -"Ci i Community Association Manager. 7n Behalf of the Architectural Review Committee .ake to Quinta Homeowner#,Assodatw.�'- c: Architectural Cor¢ mfttee Unit File k ' CIC Ur4.'; _ A rch&e=-raw Al P - izi Letel! r r+ f La Quint -a, CA'0 7-A eariC..� ` archltecU.:,r�irw . r e mays threw e)d5v be r ^n win&rvs and replace therr. nth - �pat nLoA tantW-In-dows ,I^ the same size has been approked bj, dig Am itevtnjral �Q�rn.� a$ '. bmltted, 'lie txust that c N* 11=e sed, �rnsursd cortracrcrrs will be the �AMrk. Please ae t �minde.tl►�a a:rt a- tQ the ccrn°rricn a,,ea due W ccpistru �cn shco d e repa 1 rmely manner. Nesse m-anage•rnent in -wtnb upon c04-ri)Iv�,Jcrr o� the p =of t If you 'have sav ques tns or need further assistance, pjea.se- feej free to cc,- �� 1764.345.116,% r t f �ffic erely, J esle'6W! Farris,`PCAM, AMS, -"Ci i Community Association Manager. 7n Behalf of the Architectural Review Committee .ake to Quinta Homeowner#,Assodatw.�'- c: Architectural Cor¢ mfttee Unit File k ' CIC Ur4.'; _ A rch&e=-raw STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CEC-CFfR-ALT-01-E (Revised 06114) CERTIFICATF OF COMPLIANCE Prescriptive Residential Alterations Project Name:`���j A. GENERAL INFORMATION 01 Project Name: J \ C Q 03 Project Location: n S v,& - o5, ra dry: --- 07 Zip Code: 09 Climate Zone: it Building Type 13 Project Scope:I B. BUILDING INSULATION DETAILS (Section iS0.2(b)1) 01 02 03 04 05 06 Props Frame frame Continuous Frame Depth Spacing Cavity Insulation Tag/ID Assembly Type f Type I (inches) (inches) R -value R -value OZ I Date Prepared 04 Buildin Front 06 1 Number of Alt CF1R-ALT-01-E (Page 1 of 4) Date Prepared: -- I L{LS� I (der nr rardinall- 08 1 09 10 it Required Appendix JA4 Reference Table Cell LI -tactor Comments C. ROOF REPLACEMENT (Prescriptive. Alteration, Sediori 1 1(b)1H) 01 02 03 04 05 06 07 08 09 10 .11 12 13 R -value Proposed Minimum Required Method of Roof CRRC Product ID Oeck Initial Solar Aged Solar Thermal SRI Aged Solar Thermal SRI Compliance Pitch Exception . Narnber ,Product Type In3ulat)pn Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional) NOTES •. Roof area covered by building integrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements. • Liquid field applied coatings must comply with installation criteria, from section 110.8(1)4. Registration Number: CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: HERS Provider: June 2014 STATE CF CALIFORNIA - RESIDENTIAL ALTERATIONS .CEC-CFIR-ALT-01-E Revised 06114 - CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE MR -ALT -01-E Prescriptive Residential Alterations '(Page 2 of 4) Project Name: ,I1Vj Q -Date Prepared: D. FENESTRATION/GLAZING AREAS ALLOWED (Section 150.2(b)1) nt 02 - 03 - 04 . Alteration Type Orientation Maximum Allowed ft2 Comments 02 ► 1 04 05- 06 07 08 09. E. FENESTRATION%t;LAZING PROPOSED AREAS AND EFFICIENCIES (Section iS0.2(b)1) 01 02 03 04 05- 06 07 08 09. 10. 11 12 13 14 15 Tag/ ID Fenestration' .: Type 'Frame Tye Dynamic Glazing Orientation N, S, W, E, or Roof Area Removed ft2 Area Added ft2 Net Added Area ft2 Maximum Allowed I U -factor U -factor Source SHGC-ENSource Exterior Shading Device Combined SHGC from CFIRV-03 wtni0" qw-11 I. C) t0 — .3z ,30 ,21 t=qC /✓ l� K/ 14 iS.Z "Fenestration Zz �- ,32 ,� o A1C ,? ► A1C-. iv) r4- ,v a Net Added. West -facing Area': .. .. - In Existing. Addeq,West-facing Fenestration Area c Maximum 4.11pinied West -facing Fenesfiation Area d Is West -facing Fenestration Area < Maximum Allowed West -facing Fenestration ! Aroii .. e Net Added Fenestration Area (all orientation`"s) f Existing + Added Fenestration Area (all orientations) 9 Maximum Allowed Fenestration Area (all orientations) h Is Existing + Ad'ded Fenestration Area < Maximum Allowed Feneitration Area (all orientations) 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 06/14 CERTIFICATE OF COMPLIANCE CALIFORNIA ENERGY COMMISSION Prescriptive Residential Alterations _.. CF1R-ALT-01-E Project Narne: -f-->&V lD fheC,4t�r,.J (Page 3 of 4)' Date Prepared:-�l.t_?p1S " F. SPACE CONDITIONING(SC) SYSTEMS - HEATING/COOLING (Prescriptive section 1S0.2(b)) 01 02 r 03 Dwelling Unit Name Dwelling Unit CFA (Ft2) Comments G. WATER HEATING SYSTEMS (Section 150.2(b)iG) 9 10 01. 02 .03 04 05 06 07 08rEfficiency 11 12 13 14 Water Heating +► of water 15 Water Heater System Water Water Rated Ratedtin Heatin Heaters Storage g g Exterior Back -Up Solar Identification or Heating Heater in Volume Fuel • Input Input Efficiency Name Standby Insul. Savings Dwelling UnitDHW Central DHW System System Type, Type system al T e T ( ) vo Pe.. Valueypg Value Loss (.%) R -Value Fraction System y Distribution Type Distribution Type H. SPACE CONDITIONING SYSTEMS AND WATER HE- tIN"d SYSTEMS IN MtTIFAMILY DWELLING UNITS 01 02 _ 03. 04 05 Central Water Heating Dwelling Unit Dwelling Unit: 06 Dwelling Unit Total CFA System Identification or Water Heating System Dwelling Unit Name Alteration to the Space (ft2) Name Identification or Name ConditioningSystem(s)? Comments. Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance HERS Provider: June 2014 STAFF OF CALIFORNIA RESIDENTIAL ALTERATIONS GF1R-ALT-01-E Revised06/14 CAUFORNIAENERGY COMMISSION 2TIFICATE OF COMPLIANCE MR -ALT -01-E !scriptive Residential Alterations (Page 4 of 4) )ject Name: �,,v �� C>J� Date Prepared: t)— l9_2_01S DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. 0 mentation Author Name: - 0 � CC.) 4y) YYl Document ut re: ' � ' Company: ` Signature Date: I L4 - zo 1<5;�- Addre�ss:,, 1 CEA/ HERS Certification Identification (if applicable): Ci tate/Rip: . . -t�O � �r� S C.�4 °t23 � phone: °►� � - ? �c 2 - acp t 2 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance, is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of • Compliance conform to the requirements Title 24, Part of 1 and Part 6 of the California Code of Regulations. A. , The building design features or system design -features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agengy for approval with this building permit application. S. I will ensure that a registered copy of this Certificate of Compliance shall be made.available with the_buildirig permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Re sr Designer Name: /\^'//c/C 't �V\ Responsible Designernature: :27- Company - r�Q\ Date Signed: r� V _2(0) 1 Addr ss: 1 License: c. 1:�571 257 n 1 — 6 l Z_ For assistance or questions regarding the Energy Standards, contact the Energy Hotline. at: -i-800-772-3300. Registration Number:. a rion ate/Time. HERS Provider: CA Building Energy Efficiency. Standards - 2013 Residential Compliance r, June 2014