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BRES2016-0007
78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT. BUILDING PERMIT Application Number: BRES2016-0007 Property Address: 48207 CALLE FLORISTAS APN: 646092004 Application Description: TURNER / REPLACE (6)WINDOWS Property Zoning: workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith Application Valuation: $5,801.00 .Applicant: D WICK ENTERPRISES INC DBA THREE D CONST 1515 CROWN ST REDLANDS, CA 92373 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: B License No.: 818261 Date: k_ _W— ?-0 10 Contractor: I IIIIIIIIIII11111111 57 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: BARBARA RICE 28865 SW PETES MOUNTAI WEST LINN, OR 92253 Contractor: m D WICK ENTERPRISES INC DBA 1515 CROWN ST n -REDLANDS,CA92373 9 (909)335-4846 Llc. No.: 818261 Date: 1/20/2016 r o �E f.HREEn 0 � S� DI M 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 woikers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of th rk for which this permit is issued. 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: OWNER -BUILDER DECLARATION Carrier: Policy Number: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State I certify that in the performance of the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree that, if I should become subject to the any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith signed statement that he or she is licensed pursuant to the provisions of the comply with those provisions. Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division v 1 3 of the Business and Professions Code) or that he or she is exempt therefrom and the Date: ^ M10 Applic 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO (_) I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to within one year of completion, the owner -builder will have the burden of proving that. the conditions and restrictions set forth on this application. he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose (� I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' . issued as a result of this application , the owner, and the applicant, each agrees to, and State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or the Contractors' State License Law.). following issuance of this permit. (� I am exempt under Sec. _ B.&P.C. for this reason 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. 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 Lender's Add 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: _��6. Signature (Applicant or Agent): DESCRIPTION FINANCIAL INFORMATION 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 SMI - RESIDENTIAL 101-0000-20308 0 $0.75 $0.00 PAID BY METHOD, .... RECEIPT # CHECK #.. CLTD BY Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.75 $0.00 DESCRIPTION ACCOUNT .QTY AMOUNT. - PAID PAID DATE DOOR/WINDOW, REPLACE FIRST 7 101-0000-42400 0 $60.91 $0.00 PAID BY `METHOD - RECEIPT V. CHECK # CLTD BY DESCRIPTION : ACCOUNT QTY AMOUNT PAID PAID DATE DOOR/WINDOW, REPLACE, FIRST 7 PC 101-0000-42600 0 $110.22 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $171.13 $0.00 TOTALS:00 Permit Details PERMIT NUMBER City of La Quinta BRE52016-(007 `. Description: TURNER / REPLACE (6)WINDOWS CONDITIONS Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: UNDER REVIEW Applied: 1/20/2016 SKH Approved: Parcel No: 646092004 Site Address: 48207 CALLE FLORISTAS LA QUINTA,CA 92253 Subdivision: TR 20052-2 Block: Lot: 4 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $5,801.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 PHONE - Details: CHANGE OUT (6) WINDOWS LIKE FOR LIKE. 2013 CALIFORNIA BUILDING CODES. EMAIL Printed: Wednesday, January 20, 2016 11:31:05 AM 1 of 2 C SYSTEnAS CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE - FAX EMAIL APPLICANT D WICK ENTERPRISES INC DBA THREE D CONST 1515 CROWN ST REDLANDS CA 92373 CONTRACTOR D WICK ENTERPRISES INC DBA THREE D CONST 1515 CROWN ST REDLANDS CA 92373 OWNER BARBARA RICE 28865 SW PETES MOUNTAIN WEST LINN OR 92253 Printed: Wednesday, January 20, 2016 11:31:05 AM 1 of 2 C SYSTEnAS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: SMI - RESIDENTIAL 101-0000-20308 0 $0.7S $0.00 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.7S $0.00 DOOR/WINDOW, 101-0000-42400 0 $60.91 $0.00 REPLACE FIRST 7 DOOR/WINDOW, 101-0000-42600 0 $110.22 REPLACE, FIRST 7 PC Total Paid for WINDOW/SLIDING GLASS $171.13 $0.00 DOOR/FENESTRATION: TOTALS: $172.88 00 INSPECTIf1Ni PARENT PROJECTS BOND INFORMATION ATTACHMENTS Printed: Wednesday, January 20, 2016 11:31:05 AM 2 of 2 r SYS TF. hiS Bin # City of La Quanta Building & Safety Division P.O. B"1504, 78-495 Calle Tampico La QuInta,'CA 92253 - (760) 777-7012 Building Permlt!AWlkc tldn and Tracking Sheet Permit # fD Project Address: Iff 4562-00MRZEUMS 6 Owner's Name: fx A. P. Number: kdd,,ss: Ljb2 Legal Description: City, ST, Zip: LA jokV-*4- � Contractor:Ott—, T!elephone: 0 Address: 'Project Description: City, ST, Zip: Telephone: I'M 1:110- Z-6022 State Lie. 4 City Lie. #.-0 L Arch., Engr., Designer: Address: City., ST, Zip: Telephone: State Lie.Project Construction Type: Occupancy: type (circle one): New Add'n Alter Repair Demo Name of Contact Person � Sq. Ft: # Stories: # Units: Telephone # of Contact Person:qvc) t2 I Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Reed TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2-! Review, rpily for correctionstissue Electrical Subcontactor List Called Contact act Person Plumbing Grant Deed Plans picked up H.O.A. Approval Plans resubmitted 3 Grading IN HOUSE-- Review, ready for corrtctioruqiss'e Developer Impact Fee Planning Approval Called Contact Person AJ.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees LACUNA � DE LA PAZ 1 December 10, 2015 Bob Turner 48207 Calle Floristas La Quinta, CA 92253 RE: 48207 Calle Floristas— Replace Windows Dear Mr. Turner: Your architectural request to install and replace windows listed above has been approved by the Architectural Committee since the conditions before installation have been met. Please note that this approval is valid for ninety (90) days from the date of this letter. If the modification will not be completed within that timeframe, you will need to re -apply for architectural approval. We trust that only licensed, insured contractors will be performing the work. Please be reminded that any damage to the common area due to construction should be repaired in a timely manner. Thank you for your cooperation In filing for architectural approval. If you have any questions or need further assistance, please feel free to contact me at 760.564.8864. Sincerely, Ellen Kahhan, MS, CMCA, CCAM Community Association Manager On Behalf of the Architectural Committee Laguna de la Paz Homeowners Association CC: Homeowner File Enclosure: Signed Architectural Committee Certificate Laguna de la Paz Homeowners Association 1 48300 Vista de Nopal. La Quinta. California 92253 1 Telephone: 760.564.8864 Fax: 760.564.8867 I 1 k ARCHITECTURAL COMMITTEE CERTIFICATE (Exhibit "A" to the Architectural Improvement Application and Agreement) The Architectural Improvement A pl'pDon and Agreement was reviewed by the Architectural Committee on z and has been: Approve Conditionally Approved Z Rejected Subject to the following Conditions set forth below Returned for Further Information Required ModificationsI��t� A-SSore aFr a, tm e- col a e- hrw sr V.). -c Yo4 Scvvwe a S a- ry,4 C� I a � , Comments 3 1:12a ssa x) a c.,,,, ,rt, Lnr% z-a.-nna' ki to_4�. Yes No Date - Nt C;04WO&5 "-A- 9 4 0 11011;5 c . nw,\, Recording to be sent by owner to the County Recorder's office for -N roof and/or exterior wall modifications. Deposit Required Deposit Amount$ Committee 1 Architectural Committee Architectural Committee Architectural Committee Architectural Committee NOTE: THIS APPROVAL IS VALID FOR 90 DAYS FROM APPROVAL DATE MUST NOTIFY OFFICE UPON COMPLETION OF IMPROVEMENT Rev. Nov 2012 4 RECD DEC 6:7 2015 EXHIBIT "1" ARCHITECTURAL IMPROVEMENT APPLICATION AND AGREEMENT DATE 12-S-ZolS NAME(S) bob Ty r STREET ADDRESS 4 8.207 Caiic Florist -4s _ L, CA 9-2.zS3 LOCAL PHONE 1^� Li Z- 3 o o- 2-37o REQUESTED IMPROVEMENT K e p i a c c t,► i r► of a w3 W i 1-k I'►�198 -d 1.!`1i}C jrinui re�olgccr�ICnt t.�inr�oWi OT +)Ie gftc- oycr511 Si ZS: QS eiti� i'fo�� w,lv�eiaWS� -T)R Carr- th---- sgr.c ns -+h,- 4 CV -0 S ) +h, - Ar► -os) the amen SRgc,- in back u41d. Tule .24 comphgi;" r Approval is requested for the above improvement according to the plans attached. We have attached a set of plans outlining the work to be done along with a complete description of the materials and colors to be used. If we are using a contractor(s), we enclose copies of the Contractor's License, Attachments: 1. One copy of the Architectural Improvement Application. ✓ 2. One set of plans with materials and colors to be used. ✓ 3. Contractor's name and copy of Contractor's License (not required if the improvement is under $300.00 or if "owner -builder"). V 4. Brochures and/or color samples of manufactured products to be used. ✓ We have read the Architectural Committee Rules and Guidelines and have furnished copies to all contractors to be engaged by us and we agree to comply with those Rules and Guidelines. We also understand that it is our responsibility to insure that our Contractor(s) comply with said Rules. We acknowledge that Building Permits for home improvements may be required by the City of La Quinta. The cost of permits, responsibility for retaining them, and the subsequent inspections will be our responsibility. In all cases we recognize the requirement to be in compliance with applicable building codes including, but not limited to, those adopted subsequent to the original completion and acceptance of our dwelling. The Association has no responsibility whatever in achieving compliance with newer building codes which apply as a result of Homeowner prompted modifications. Further, we understand that approval will not be granted for any modification which directly or indirectly conflicts with the Declarations of Rev. Nov 2012 Covenants, Conditions, and Restrictions. We also understand we are responsible for the accurate determination of property lines and setbacks (as applicable). We also understand that we will be responsible for all costs of this improvement and for costs associated with any repair to common area occurring as a result of implementing this improvement. Examples include, but are not limited to, sprinkler and irrigation systems, buildings, roofs, exterior walls, lawns, plants and drainage. Further we recognize that any modifications to the common area irrigation and landscaping scheme are subject to the formal acceptance by the Association. Any required remedy to achieve the required maintenance standard or irrigation standard is our responsibility. Additionally, we understand that the job site must be left reasonably clean at the end of each day, that no debris or dirt be dumped in any common area or left at a job site. Any maintenance or replacement of permitted improvements, except for certain landscaping, which are beyond "initial" improvements, shall be the homeowner's responsibility. We agree to indemnify for ourselves, as well as for our successors and assigns, and covenant and agree to hold Association harmless from all claims, demands or liability arising out of or encountered in connection with the agreement, whether such claims, demands or liability are caused by Owners, Owners' Agents or employees, or contractors or subcontractors employed on the project, their agents or employees, or caused by any products installed on the project by said contractor(s) or subcontractor(s). Such indemnification shall extend to claims, demands or liability for personal injuries and/or property damage occurring during installation, as well as after completion, including, but not limited to, all Owners' maintenance responsibilities provided herein. We further indemnify and hold the Association harmless from all liability related to any damage to existing improvements (wherever located within the subdivision) resulting from the installation/construction of the Architectural Improvement. If required by the Architectural Review Committee, we agree to record, and pay for the recording, of this improvement at the County Recorder's office. We further acknowledge that the Architectural Committee may require a deposit be submitted before work is begun. We further agree that this improvement will be completed in a reasonable and diligent manner. We further agree that 1. if we do not correct and damage caused as a result of implementation of this improvement or, 2. if we fail to complete this improvement within the allowed time frame the Homeowners Association may elect to complete the work and/or repairs, and we will be held responsible for the actual costs of such work. Payment to the Association is authorized by us in the form of an assessment or monthly penalty payments as approved in the Guidelines. Rev. Nov 2012 2 By signing this agreement below, we agree to be bound by its terms and conditions and any conditions set forth by the Architectural Committee in the Architectural Committee Certificate, which is attached hereto as Exhibit "A" and made a part hereof by this reference. Signatures of all Owners: .8 04 T.44� (Signature) (Signature) Rev. Nov 2012 3 COMPLETION INSPECTION Completed work inspected and approved Date: Deposit return authorized (if applicable, and less any reimbursement to the Association for costs incurred to bring homeowner into compliance with the governing documents). Recording Verified Comments: Signed: Architectural Committee Chairperson Rev. Nov 2012 Date: 5 CITY OF LA QUINTA DDI! DING & EAFEW DEPT. APPROVED FOR CONS -1 R'WCTllON [070 W Lf 8 207 N xa s s�xsy 32�X3� STATE OF CALIFORNIA RESIDENTIAL. ALTERATIONS CERTIFICA , F OF COMPLIANCE Pre-.rrimlve Residential Alterations udNe�- CALIFORNIA ENERGY COMMISSION CF111-ALT-01-E (Paee 1 of 41 Date Prepared: 1— Z-0 -Z O l A. GENERAL INFORMATION 01 02 01 Project Name: 05 02 Date Prepared: ! - ZO 03 Project Location: cl A 'Zp C,rsI — 1. -[,p e r i'i4 S 04 Building Front Orientation (deg or cardinal): 05 CA Gty: t l �_ 06 Number of Altered Dwelling Units: 07 Zip Code: ?_ � 3 08 Fuel Type: 09 Climate Zone: I S�' 10 Total Conditioned Floor Area (ft2): it Building Type 12Slab Area (ft2) 13 1 Project Scope: CPV --- 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. B. BUILDING INSULATION DETAILS (Section 00.2(b)1) 01 02 03 04 . 05 06 07 08 09 10 11 Tag 10 Assembly Type Frame Type Frame Depth (inches) Frame Spacing 1 (inches) Proposed Required Comments Cavity R -value Continuous Insulation R -value U -factor Appendencee Referren 1 U -Factor Table T Cell 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. C. ROOF REPLACEMENT (Prescriptive Alteration, Sectfori T5O0.2(b)1H) 01 02 03 04 05 06 07 08 09 10 11 12' 13 Method of Compliance Roof Pitch Exception CRRC Product ID Number Product Tye R -value Deck Insulation Proposed Minimum Required Initial Solar Aged Solar Thermal SRI Reflectance Reflectance Emittance (Optional) Aged Solar Thermal SRI 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: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance 1W HERS Provider: June 2014 STATE GF CALIFORNIA RESIDENTIAL ALTERATIONS CEC-CF1R•,-'.T-01•E Revised 06114 CALIFORNIA ENERGY COMMISSION CERTIFICAU OF COMPLIANCE CF1R-ALT-01-E Prescriptive Residential Alterations (Page 2 of.4) P roirct Nary -a: O_ Oate Prepared: I—Z� — Zot Co D. FENESTRATION/GLAZING AREAS ALLOWED (Section 150.2(b)l) 01 01 02 03 04 Alteration Type Orientation Maximum Allowed ft2 Comments 10 11 E) *2O 13 14 15. Tag/ ID Fenestration Type E. FENESTRATION/GLAZING PROPOSED AREAS AND EFFICIENCIES (Section 150.2(b)1) 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15. Tag/ ID Fenestration Type Frame Type Dynamic Glazing Orientation N, S, W, E, or Roof Area Removed ft2 Area Added ft2 Net Added Area ft2 Maximum Allowed U -factor U -factor Source SHGC Source Exterior Shading Device Combined SHGC from CF1R-ENV-03 W1,PDCni vlfJ`i1 �. 5 Zs� Z�' /A- 3Z .30 opos-% 220 Ff--- W �9+ I. w I W Dcnv V Ll, -`I 1 fJ l t�} (� ►0 2 ►,-J �. A Vim/ I ►4 I *j 1)c3?,(/ V I ) 1J / I l C p ►1 L �- 3 Z 3© (SLC ZZ ►.��C 1 to 04 a Net Added West -facing fenestration Area' b Existing + Added West -facing Fenestration Area c Maximum Allpwed West -facing Feriestcation Area d Is West -facing Fenestration Area < Magimum'Allowed West -facing Fenestration • Aria. . e Net Added Fenestration Area (all ori0tati-o6s) f Existing + Added Fenestration Area (all orientations) g Maximum Allov ed Fenestration Area (all orientations) h Is Existing +Added Fenestration Area < Maximum Allowed Fenestration Area (all orientations) W ,w v.J . '�ri l ,3Z ,moo rfzc w uoCA,-- .1 IL"" ^� V\j 2 2j 1►� 1IL 3a VJIrc 27-- N F '\j "I 'A - Registration Number: CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: . HERS Provider: June 2014 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CFC-CFIR-ALT-01-C (Revised 06!14) CALIFORNIA ENERGY COMMISSION CERTIFICITE OF COMPLIANCE CF111-ALT-014 Prescriptive Residential Alterations (Page 3 of 4) . Project Name: —TC j (�`L?� z. Date Prepared: F. SPACE CONDITIONING(SC) SYSTEMS – HEATING/COOLING (Prescriptive section 150.2(b)) 01 02 03 Dwelling Unit Name Dwelling Unit CFA (Ft2) Comments G. WATER HEATING SYSTEMS (Section 150.2(b)1G) 01 02 03 04 05 06 07 08 09 10 11 12 -13 14 15 # of Water Water Heating Heater Back -Up System Water Water Water 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 System Type Type system (al) Type Type. Value. Type Value Loss (Yo) R -Value Fraction Distribution Type Distribution Type H. SPACE CONDITIONING SYSTEMS AND WATER HEATING SYSTEMS IN'MULTIFAMILY DWELLING UNITS 01 02 03, 04. 05 06 Dwelling Unit Name Dwelling Unit Total CFA (U) Central Water Heating System identification or Name Dwelling Unit Water Heating System Identification or Name Dwelling Unit: Alteration to the Space Conditioning System(s)? Comments Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 R sidential Compliance HERS Provider: June 2014 STAT OF CALIFORNIA RESIDENTIAL ALTERATIONS CEC-CFIR-ALT4)1-E (Revised 06114) CALIFORNIA ENERGY COMMISSION " CERTIFICATE OF COMPLIANCE CRR -ALT -01-E ;'rescriptive Residential Alterations (Page 4 of 4) P oject Name: Date Prepared: 1-2,0 — 201Cp DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. ntation Author Name: ` Documentation Author Signature. tQoS Company: --=-- c ©f -J Signature Date: l- ZQ - Z,(!D1(4c=i Address: CEA/ HERS Certification Identification (if applicable): Cit^te(tip: i� bC.tA1� S CA Phone: Q, Q1.0 —1 2 <QS;i1 Z 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 of Title 2�, 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 Complliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency 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 building 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. Responsible Designer Name: Responsible • ' Company Date signed: --r LA4—rte -\:�> 1— Z 2�1 cP Address: 20 'E— o4,CT- license: 'a\(82� 1 City/State/Zip: .>CA.Z3? Phone: qO — For assistance 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 o HERS Provider: June 2014