BPLB2015-012178-495 CALLE TAMPICO
31
*�4aw
VOICE (760) 777-7125 LA QUINI`A, CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
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: C20. C36 License No.: 686310
Date: IOIZlo1L5 Contractor: 1.:..« -t�
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.).
(_) 1, 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
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.
Date: 1c Zb 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: 4L -,Signature (Applicant or Agent)-_<;_ /L �� r
Date: 10/26/2015
Application Number:
BPLB2015-0121
16J N�4!_?' __
j, ti
Owner:
Property Address:
55114 FIRESTONE
�) -- '
— "
PLUMMER OKHUI
APN:
775153039
J C CT a
i
55114 FIRESTONE
Application Description:
PLUMMER RESIDENCE / WATER
HEATER CHAN_ GE OUT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$2,000.00���
Applicant:
Contractor:
IE INC
HARRISON ENTERPRISES INC DBA GENERAL AIR
31225 LA BAYA
31170 RESERVE DRIVE
WESTLAKE VILLAGE, CA 91362
THOUSAND PALMS, CA 92276
SCANNED
SCANNED
(760)601-3500
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 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C20. C36 License No.: 686310
Date: IOIZlo1L5 Contractor: 1.:..« -t�
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.).
(_) 1, 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
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.
Date: 1c Zb 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: 4L -,Signature (Applicant or Agent)-_<;_ /L �� r
FINANCIAL •• •
DESCRIPTION ACCOUNT QTY AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00
$0.00
PAID.BY METHOD RECEIPT #
CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD.
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
'PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0
$7.25
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS: $112.19 00
Description: PLUMMER RESIDENCE / WATER HEATER CHANGE OUT
Type: PLUMBING Subtype: Status: APPROVED
Applied: 10/26/2015 MFA.
Approved: 10/26/2015 MFA
Parcel No: 775153039 Site Address: 55114 FIRESTONE LA QUINTA,CA 92253
Subdivision: TR 21846-2 Block: Lot: 2
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $2,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
IE INC
Details: WATER HEATER CHANGE OUT— 40 GALLON/GAS [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. PER 2013 CALIFORNIA BUILDING CODES.
CONDITIONS
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY -
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
IE INC
31225 LA BAYA
WESTLAKE
VILLAGE
CA
91362
(951)255-4020
CONTRACTOR
HARRISON ENTERPRISES INC DBA
GENERAL AIR
31170 RESERVE DRIVE
THOUSAND
PALMS
CA
92276
(951)255-4020
OWNER
PLUMMER OKHUI
55114 FIRESTONE
LA QUINTA
CA
92253
(951)255-4020
Printed: Monday, October 26, 2015 8:26:24 AM 1 of 2
SYSTEMS
ATTACHMENTS.
Printed: Monday, October 26, 2015 8:26:24 AM 2 of 2 C
SYSTFMS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT # .
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING 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
$0.00
PC
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:•0
ATTACHMENTS.
Printed: Monday, October 26, 2015 8:26:24 AM 2 of 2 C
SYSTFMS
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
of
EC-CF1 R -ALT -01-E (Revised 09/15) CALIFORNIA ENERGY COMMISSION 40W
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 6)
Project Name: 114 r-es�dn� Date Prepared: ro z..J IS
A. General Information -
01
02
01 Project Name:
02
Date Prepared:
03 Project Location:04
10
Building Front O'rgn. tion 'deg or cardinal):
05 CA City:
06
Number of Alter d . le, hing Units: 4f.
07 Zip Code: Ci
08
Fuel Type:
09 Climate Zone:
10
TQtal C n.,d i ned Floor r :( 2)
11 BuildingType
12
Slablgreatj` 2) e%
13 Project Scope:
Frame
E.ceptionsto MinlIdgged Solar
lectance-Sd Min'iQ).um Thermal or SRI
150.2(b)1Hi!'
B. Building Insulation Details (Section 150.2(b)1)�
01
02
03
04
05
06_• 07 QS 09
10
11
11
12
13
14
Proposed
Required
Continuous; AppendixJA4
Proposed
Minimum Required
Tag/
Method of
Frame
Frame
roro
yProduct R-valu
ID Rroduct Deck�
10flal'Solar Aged Solar Thermal SRI
Aged Solar
Reflectance
Aged Solar
Reflectance Thermal SRI
ID
Com liance
R Terence .
fi+xce 'tion
Numbe,"LT' e Insula itgh3Reflectance
Reflectance Emittance (0 tional)
(Max)
Frame
Depth
Spacing
Cavi Insula'n _
OY
Ta ID
Assembly Type
Type
(inches)
(inches)
dr7,(t:-vai t;val U-factofAl Cell
U -Factor
Comments
NOTES�A
• Roof area covered by bil'�'Ipglptegrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements. _
• Liquid field Bust installation from 110.8(i)4.
applied cd"' .tings` comply with criteria section
C. Roof Replacement (Section 150.2(b)1H) x
01
02
03
04
r 06
08P
09
10
11
12
13
14
. a
Proposed
Minimum Required
Tag/
Method of
Roof
roro
yProduct R-valu
ID Rroduct Deck�
10flal'Solar Aged Solar Thermal SRI
Aged Solar
Reflectance
Aged Solar
Reflectance Thermal SRI
ID
Com liance
Pitch
fi+xce 'tion
Numbe,"LT' e Insula itgh3Reflectance
Reflectance Emittance (0 tional)
(Max)
(Min) Emittance (Optional)
fa r
OY
x�
w
NOTES�A
• Roof area covered by bil'�'Ipglptegrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements. _
• Liquid field Bust installation from 110.8(i)4.
applied cd"' .tings` comply with criteria section
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
HERS Provider:
September 2015
F�t
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
►OWN;
CEC-CHR-ALT-01-E Revised 09/15 CALIFORNIA ENERGY COMMISSION '1-1
CERTIFICATE OF COMPLIANCE CFIR-ALT-01-E
Prescriptive Residential Alterations (Page 2 of 6)
Project Name: Date Prepared:
D. Fenestration/Glazing Allowed Areas and Efficiencies (Section 150.2(b)1)
01
02
03
04
05
r 06a
07
Maximum
Maximum
q .
Allowed
Allowed West-
Existing
Existing West -
Fenestration
Facing
Fenestration
Facing
Maximum Maximum
MaximuplM ximum
Area For All
Fenestration
Area for All
Fenestration
Allowed Allowed
q (rwe,, Allowed5
Alteration
Orientations
Area Only
Orientations
Area
1.1 -factor U -factor
t'S SHGC.
Type
(ftZ1
(ft2)
(ft')
(ft')
(Skylights)
ipd�ws) (Sl�yligN
Comments
1-
I rra(V'
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
9
HERS Provider:
September 2015
_7
i
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF•1R-ALT-01-E Revised 09/15 CALIFORNIA ENERGY COMMISSION �
CERTIFICATE OF COMPLIANCE CHR -ALT -01-E
Prescriptive Residential Alterations (Page 3 of 6)
Project Name: Date Prepared:
E. Fenestration/Glazing Proposed Areas and Efficiencies — Add (Sectiori 150.2(b)1A)
01
02
03
04
05
06
07
08
09
1001
?
12
13
14
Tag/ID
Fenestration Type
Frame
Type
Dynamic
Glazing
Orientation
N, S, W, E
Number
of
Panes
Proposed
Fenestration
Area (ft
Proposed`"''
West Facing
Fenestration
Area (ft2)
Propos d
U-fac o'ri
Source
��
Prpposedr
F1
Source
Exterior
Shading
Device
Combined,
SHGC from
CF1R-ENV-03
1
4�
15
Existing + Proposed. Fenestration Area
^ I
16
Maximum Allowed Fenestration Area
q?,
17
Compliance Statement'""
Ce
18
Existing+ Proposed West -Facing Fenestration Area
19
Maximum Allowed West Fenestration Area
q>
20
Compliance Statement
&OP q
21
Proposed Fenestration U -factor (Windows)
4 ire
22
Required Fenestration 1.1 -factor (Windows)
23
Compliance Statement {
N AR'
24
Proposed Fenestration SHGC (Windows)
25
Required Fenestration SHGC (Windows), rA..
26
Compliance Statement
h:
27
Proposed Fenestration U -factory VAk. )
28
1 Required Fenestration U!w%'o A(S'ylights) _
29
Compliance Statemeaa."
30
Proposed Feestti " SHGC (Skylight''
31
Required Fen $ration SHGC (aylights) '
32-
Compliance Statement
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
HERS Provider:
September 2015
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
FOR
CERTIFICATE OF COMPLIANCE CF1R-ALT=01-E
Prescriptive Residential Alterations (Page 4 of 6)
Project Name: Date Prepared:
F. Fenestration/Glazing Proposed Areas and Efficiencies — Replace (Section 150.2(b)1B) mAK
Ol
02
03
04
OS
06
07
08
9
10
X1!1 {
' 12
13
14
Tag/
ID
Fenestration
Type
Frame
Type
Dynamic
Glazing
Orientation
N, S, W, E
Area
Removed
Wft
Area
Added
(ft)
Net�
Added
Area (ft)U-factor
Proposed
SoO,Ece
Prfioposed
SHGC
c
Exterior
Shading
Device
Combined SHGC
from
CF1R-ENV-03
A
i.
y
15
Net Added West -facing Fenestration Area
4
4
16 Is Net Added Fenestration Area S 0 for west -facing fenestration?yE
17 Net Added Fenestration Area (all orientations)'
18 Is Net Added Fenestration Area <_ 0 for all orientations?
19 Proposed Fenestration U -factor (Windows) y�
20 Required Fenestration U -factor (Windows)
21 Compliance Statement
22 Proposed Fenestration SHGC (Windows)_A' •.
23 Required Fenestration SHGC (Windows)
24 Compliance Statement's
25 Proposed Fenestration U -factor (Skylights)
26 Required Fenestration U -factor (Skylights) qv i1 4i
27 Compliance Statement
28 Proposed Fenestration SHGC (Skyligt5 ;.
f ea 9
29 Required Fenestration U -fa( o S lights) RP�
30 Compliance Statement �4`3 V14
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
HERS Provider:
September 2015
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
�,T
CEC-CFIR-ALT-01-E Revised 99/15 CALIFORNIA ENERGY COMMISSION 'wry
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 5 of 6)
Project Name: SS114 ire done- Date Prepared: Ip 2,ro
G. Space Conditioning (SC) Systems - Heating/Cooling (Section 150.2(b)).
01 02 03 ,. ��,,,0
Dwelling Unit Name Dwelling Unit Total CFA (ft') Commei4t ti
as
41l ff5p �1 ". _ **NL 'fir
H. Water Heating Systems (Section 1S0.2(b)1G) w
Systems K.Mitltlfamfly�D Ijng nit
01
02
03
04
05
06
07
08
09
ro ' °;
11 +Gy
12.;
13 14
15
Water
#of
Water
Heating
Water
Water
Heater
Back -Up Central DHW
Dwelling Unit
System
Heating
Water
Heaters
Storage
Rated
RatedHet)r��
Heating!kf�
Exterior
Solar System
DHW System
Identification
System
Heater
}n
Volume
Fuel
Input
Input
fificie`ncy
Efficiep y'
artandby
Insul.
Savings Distribution
Distribution
or Name
Tye
Type
system
(gal)
T e
Type
Vale
pe
C) VSTU
Loss (%)
R -Value
Fraction Tye
Type
�411,J
I
b'tu
, E )
-`
..
N I A.
R8 N A
1 r4l A
St-c—naa
I. Space Conditioning Systems and Water Heating.
Systems K.Mitltlfamfly�D Ijng nit
01
02,
3
. ,, 04 QA's , 05
06
Dwelling Unit Name
Dwelling Unit Total CFAysvtm
(ftZ)
Gent l Water Heatir
Ident' icati
Na t
Dwell! ''i_`t'. Dwelling Unit:
Water In -System Alteration to the Space
Ide�ti,fcatioTn or Name Conditioning System(s)?
Comments
ei
1 01 A,
NNOW
O
P"o
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance September 2015
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 0911 CALIFORNIA ENERGY COMMISSION -'%W-
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 6 of 6)
Project Name: _cSJ1L1s Date Prepared: to 2to IS
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete. , x
Documentation Author Name:
SyGI.
Documentation Author Signature:
o rtr h1\ �t �i<Zf
,
' Company:' .
'Gerece.l Arc Co\,,A,�o�n�h
Signature Date:
/d2b
%
LS � NN .
Address:
-3ll? O�Sesti 1�c-iv
CEA/ HERS Certi ication Identi i.uo ff'Sppllcable): -
"
Clty� /Zip:
i4.ovS0.ha 17A�wnS CSA C(Z2'1
Phone:
'2-L13 498 n°r
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, lam eligible:under Division 3 of the Business and Professions Code to accept responsib'lity ford a building design • r m design Identified on this Certificate of Compliance (responsible
designer).
the
pmanufacturecidn'a'3, That the energy features and performance specifications, materials, component ar`fbrr building design or system design identified on.this Certificate of
Compliance conform to. the requirements of Title 24, Part 1and Part 6 of thg�alifotniaCodeofRe,{�
4, The building design features or system design features identified on this,Certifj�aYe of Com�p�lian aFe ons eqt wl h �pformation provided on other applicable compliance documents,
>- .
worksheets, calculations, plans and specifications submitted to the erffo' r�ement agency>f. r' proval with this b ildingermit application.
5; 1 will ensure that a registered copy of this Certificate of CompiiancAhafill e made ava iith the buildi g' e (s) issued for the building, and made available to the enforcement agency
for inspections. I Wis Certificat is included the documentation the builder to the building
all applicable understand that a registere o Co1ance Is req e with provides
l'C41 m
�, '
owner at occu ancy. tL�. i
Responsible Designer Name:
Res posit le esigner Signature:
Alf
Company: Zt3
bate Signed:
Address:
License:
City/State/Zip: -
Phone:
If'hA.r
o iassistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1 800-772-3300
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
HERS Provider:
September 2015
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h
City. Of La Quinta
Building 8t Safety Divlsion
,l)D; f .�v P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Pemtit #
Project Address: 55114 Firestone
Owner's Name:. Okhui Plummer
A. P. Number.
Address: 55114 Firestone
Legal Description:
Contractor: General Air Conditioning.951-255-4020
City, ST, Zip: La Quinta, CA 92253
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Telephone: ,. '�.::a :.;...
Address: 31170 Reserve Drive
Project Description: Replace 40 Gallon Gas Water Heater.
City, ST, Zip: Thousand Palms, CA 92276
Telephone: 760-343-7488
�1
State Lic. # : 686310
City Lie. #
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone: ;'. "
State Lia #:� a j 7 ` .
Name of Contact Person: Steven Schnierer
Construction Type: Occupancy:
Project type (circle one): Nlew Add'n Alter Repair Demo
Sq. Ft.: #Stories: # Units:
Telephone # of Contact Person: 818-735=7876 X 1
Estimated Value of Project: $2,000.00
APPLICANT: DO NOT WRITE BELOW THIS UNE
ff
Submittal
Plan Sets
Req'd
Reed
TRACKNG
Plan Check submitted
PERMIT FEES
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Calas.
Plans picked up
Construction
Flood plain plan
Plans resubmitted.'.
Mecharileal
Grading plan
2" Review, ready for correctiouMmue
Electrical
Subcostattor 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 correctionsfissue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees