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BRES2016-02291, w. IT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BRES2016-0229 Property Address: 52541 MERIWETHER WY APN: 767690026 Application Description: JERRY RISE / ADDITION Property Zoning: Application Valuation: $111,263.30 c&ht 4 4a Q91KZ DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Applicant: VASSOS DEMETRIOU 43100 COOK ST SUITE 203 PALM DESERT, CA 92211 MAY 0 2 2017 CITY OF LA QUINTA DESIGN AND DEVELOPMENT DEPARTMENT 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: License No.: Date: Contractor: 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 Vub:s the applicant to a civil penalty of not more than five hundred dollars ($500).: as owner of the property, or my employees with wages as their sole nsation, 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 r she did not build or improve for the purpose of sale.). Mss owner of the property, am exclusively contracting with licensed contractors to r t 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 ontractors' State License Law.). exempt under Sec. B.&P.C. for this reason r 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: JERRY RISE P 0 BOX 2896 KIRKLAND, WA 92253 Contractor: OWNER BUILDER Llc. No.: Date: 5/2/2017 ,4A&Ut to /1040 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: C r Policy Number: _ I certify that in the performance of the work for which this permit is issued, l sha 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. 9P� 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 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 th' ity to enter up the above- mentioned property for inspection purposes. 6-2,1 Date: Signature (Applicant or Agent): f A ' Date: 5/2/2017 Application Number: BRES2016-0229 Owner: Property Address: 52541 MERIWETHER WY JERRY RISE APN: 767690026 P 0 BOX 2896 .Application Description: JERRY RISE/ ADDITION KIRKLAND, WA 92253 Property Zoning: Application Valuation: $111,263.30 Applicant: Contractor: VASSOS DEMETRIOU OWNER BUILDER 43100 COOK ST SUITE 203 PALM DESERT, CA 92211 -------------------------------------------------------------------------------------------- Llc. No.: Detail: 1189 SQ. FT. ADDITION WITH ATTACHED 636 SQ. FT. GARAGE PER 2013 CRC CODES ' r F, 1 .t. FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, EA ADDITIONAL 500 SF 101-0000-42400 0 $187.08 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $52.20 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, FIRST 100 SF 101-0000-42400 0 $120.83 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, FIRST 100 SF PC 101-0000-42600 0 $171.14 Total Paid for ADDITION: $531.25 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - CITY BUILDING STAFF 101-0000-42600 0.5 $76.00 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - YES ADMINISTRATIVE STAFF 101-0000-42600 0.25 $10.00 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - YES ADMINISTRATIVE STAFF 101-0000-42600 0.25 $10.00 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - YES STRUCTURAL PLAN REVIEW ENGINEER 101-0000-42600 4 $380.00 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - YES STRUCTURAL PLAN REVIEW ENGINEER 101-0000-42600 1.25 $118.75 Total Paid for BLDG CITY STAFF - PER HOUR: $594.75 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $5.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $5.00 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $12.33 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $5.08 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $145.03 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $47.86 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $210.30 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 0 '$72.52 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 0 $48.34 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE 101-0000-42402 0 $72.52 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE PC 101-0000-42600 0 $48.34 78-495 CALLE TAMPI1 I LA QUINTA, CALIFOR .IA 92 . 3 Application Number: t . Bg� 2016-0229 Property Address: 0 541 MERIWETHER WY APN: 767690026 Application Description: JERRY RISE /ADDITION Property Zoning: Application Valuation: $111,263.30 Applicant: VASSOS DEMETRIOU 43100 COOK ST SUITE 203 PALM DESERT, CA 92211 T4t�t 4 64� Qa4tM DESIGN & DEVELOPMENT DEPARTMENT, 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 7000} of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: _ License No.: _ Date: Contractor: 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. 70315, 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 70315 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: () I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law:). (_J I am exempt under Sec. P.C. for this r n 01 . Date: n , CONSTRU N 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: COPY VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: .10/10/2016 Owner: JERRY RISE P O BOX 2896 - KIRKLAND, WA 92253 Contractor: /�------�__ OWNER BULC0,11ELIC ____,' Q16 Llc. No.:Lr�OuN.TA 'MEWDEP;tRTf,IEf,T WORKER'S COMPENSATION DECLARATION I hereby affirm under.penalty of perjury one of the following declarations: 1 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: 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 ci to' nter upon above-mentioned property for inspection purposes. Date'7of0�1 Signature (Applicant or Agen t , + 4 Date: 10/11/2016 Application Number: BRES2016-0229 Owner: Property Address: 52541 MERIWETHER WY JERRY RISE APN: 767690026 P 0 BOX 2896 Application Description: JERRY RISE / ADDITION - ` KIRKLAND, WA 92253 Property Zoning: ' Application Valuation: $111,263.30 r; . Applicant: Contractor: r VASSOS DEMETRIOU OWNER BUILDER 43100 COOK ST SUITE 203 PALM DESERT, CA 92211 Llc. No.: Detail: 1189 SQ. F.T. ADDITION WITH ATTACHED 636 SQ. FT. GARAGE PER 2013 CRC CODESJ. 1 1 lirn # City of La: Quinta • Building a Safety _Division Permlt.# P.O. Box:1504, 78-495 Cale Tarnplco - La Qulnpa CA 92253 • (760):777-7012 20 tb' 3..Q Building Permit Application, and Tracking Sheet Project Address: 52-541 Menwether Way, La Quinta, CA ..'Owner's -Name:::.. Jerry Rise A: P. Number: 767-690-026 Address: 52-541 Menwether Way Lot orac , ass own in map o0 Legal Description: maus.recQversdey. City;.ST, Zip: La Quinta, CA 92252 nanqContractor; Owner as contractor: Jerry Rise Telephone: _.. Address: 52-541 Merlwether Way. Project Description:: City; ST, zip: to Quinta, CA 92252 2 -story, 1,186 SF addition to.a.single-family residence, with Telephoner (206)9 . 48 1508 State Lic. # i .... City Lie # Arch. Engr. Designer: Brian Gotlieb, B.G. Structural' Address: 43-100 Cook Street, Suite 203 city., sT, zip: Palm Desert, CA 92211 Telephone: (760) 5683553 .•,q "� Construction Type: V -B Occupancy: Group R Group U >• State Lic # C33047 Project. a circle.one New Add'n Alter Repair.. Demo Vassos DemetriouF man aavassa Name of Contact Person.pemetrArcoSq. Ft 1,186 SF # Stories:„ 2 #Units: 1 (existing) Telephone # of Contact Person::. (425)-827..1700 Estimated Value of Project; $113,521.80 APPLICANT: DO NOT WRITE BELOW THIS LINE Submittal Req'd:. i2ec'd... TRACMG' PERMIT FEES Plan Sets Plan Check submitted.. Item Amount: Structural Calcs. Reviewed; ready. for corrections Plan Check Deposit Truss Cales . Caned Contact Person Plan Check Balance;. ; Title 24 Cates. Plans picked.up Construction' Flood plain lad Plans:iesubmitted Mechanical: .... ... Grading plan; tad Review, ready for corrections/issue. Electrical Subcontactor List :Called Contact Person , Plumbing. Grant Deed Plans picked up S.M.L. H.O.A. Approval Plans resubmitted-: Grading IN HOUSE:- '"' Reytew, ready for corrections/issue Developer Impact Fee �ld: 9 .gAE S4Y1 1ledontaciPerson:.P... P n In p Pub. Wks. Appr Date of permlt issue Schodl Fees _....... Total Permit Fees..... Coachella Valley Unified School District • This Box For District Use only 83-733 Avenue 55, Thermal, CA 92274 DEVELOPER FEES PAID (760) 398-5909 — Fax (760) 398-1224 AREA: - AMOUNT LEVEL ONE AMOUNT: LEVELTWOAMOUNT: MITIGATION AMOUNT: COMM/IND. AMOUNT: DATE: RECEIPT: ' CHECK q:INITIALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Rise (Madison Club) Date: October 10, 2016 Owner's Name: Rise Phone No. Project Address: 52-541 Meriwether Way, La Quinta, CA 92253 Project Description: Room Addition APN: 767-690-026 Tract #: Lot #'s: Type of Development: Residential Commercial Industrial XX Total Square Feet of Building Area: 1,189 SQ. FT. Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is autho ' sign on beha of the owner/developer. Dated: 0 AJ �� Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project Agreement Existing Not Subject to Fee 17620 65995 Approval Prior to 1/1/87 . Requirement Number of Sq.Ft. 1,189 Amount per Sq.Ft. $3.48 Amount Collected $4,137.72 Building Permit Application Completed: Yes/No By: Elsa F. Esqueda, Director of Facilities and Maintenance Certificate issued by: Leticia Torres, Facilities Analyst Signatur NOTICE OF 90 DAY PERIOD FOR PROTEST OF FE SD TATE E OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this D strict provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to, issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. M V:c/mydocs/devfees/certificafe of compliance .fomrupdated 3-2007 11/2010 0 THE MADISON CILUB OWNERS' .ASSOCIAPION August 29, 20.16 r K I D Mr. Jerry Rise. SEP 2 6 20.16. 52541 Meriwether Way.' • CITY OF LA QUINTA La Quinta, CA 92253 COFAMUNITY DEVELOPMENT RE: Lot 34B at 52541 Meriwether Way Remodel — Room, Addition at Front of dome , Dear Mr. Rise: ti This. correspondence shall serve as notification from The Madison. Club Design Review Committee ("DRC") that your request to remodel the.home .was approved subject to the following conditions: , 1. No landscape changes were received. The 'committee understands that landscape will be removed to accommodate the addition: If, any landscape changes are proposed, other than the 'removal of :trees and plant material in the impacted area, the -changes must be submitted .for:review prior to installation in the field. 2. All color and material selections are to match the existing materials. 3. Per the field meeting with Bruce Maize .and Brook Marshall, the existing property line wall on the southeast side of the home will be finished (where it faces Lot 35B) as part of the remodel construction. Please contact Brook Marshall at. 760-219-8057 or by.email at DRCFacilitator@gmail.com with any questions or to. schedule your Pre -Construction Meeting once a Building Permit has been obtained by the City'of La Quinta:, Constriction and/or demolition cannot begin until a Building Permit is received. Sincerely,. MADISON CLUB DESIGN REPTEW COMMITTEE ' By: Ito - L Title: Dater Pursuant to CaL Civil Code, any, rejection. by *ARC may be appealed to,the Board of Directors for the Association. Ifyou Irish to. pursue an appeal• please contact.the Association's. property manager so :thatyou may be put on the wxt meeting agenda.. cc DRC Filr t • ,µ Plan Submittal Job Site Owners N Number, Street, or PO city, State, Postal C Owner's Phone Nun Owners E -Mail Add Project Managers Project Manager's Phone N Project Managers E -mall Ai Building Permit Number. Project Description: SFR Exempt ❑ (Materials may contain hazardous wastes and are not subject recycling provisions) Construction Debris Management Plan. 9/9/2016 52-541 Meriwether Way, La Quinta 92252 Jerry Rise P.O. Box 2896 Kirkland We 98034 . Amanda Cavassa / Demetriou Architects 425.827.1700 ANCOdemetriou.net 74 4 ? � V.. SEP 2 6 2016 Builder/contractor JerryRise Number, Street or PO Box P.O. Box 2896 CIT( OF LA QUiNTA City, State, Postal code Kirkland We 98034 CO�jgMUNITY DEVELOPMENT Project Square Footage 1,822 SF City Approval By ! J --� d7U2ahte- W8g;6-, Date of City Approval Materials To Be Discarded: Product Tons Trash 8.00 Not recyclable Product Tons Asphalt 0.00 Recyclable Masonry (broken) 0.00 Recyclable Brick/Block 0.00 Recyclable Piaster 2.00 Recyclable Cardboard 0.00 Recyclable Scrap Metal 0.00 Recyclable Commingled 0.00 Recyclable Tile (floor) 0.12 Recyclable Concrete 7.25 Recyclable Tile (roof) 0.13 Recyclable Drywall 0.75 Recyclable Wood I 2.75 Recyclable Donated / Reuse' 0.00 Recyclable. Landscape Debris 1 0.00 Recyclable 'Describe Items Totals: Recycle Trash Projected Diversion: 13.0 F61.909/0 I understand it is the property owner's responsibility to submit copies of weight tickets or receipts to the District Environmental Coordinator as these hauls occur. I hereby certify that completion, Implementation and adherence of the Debris Management Pian (DMP) for the above named project shall guarantee that at least 50% of the Jobsite waste Is diverted from landfilling. The remaining material will be recycled or reused. I will divert, for recycling or reuse, remaining materials generated from the first day of the project through the completion of the project In accordance with this plan. This DMP is Issued in the name of the property owner(s) and shall remain their property throughout the construction and/or demolition project A contractor serving as agent of the owner may obtain a DMP for the owner. However, the DMP is stili issued In the name of the property owner(s) and V owner retains legal responsibility for ensuring that the provisions of the DMP are adhered property owners d general contractor shall be kept informed of the diversion progress through bi-monthly reports. auling, all refus erial from this project site must be taken to an approved recycier or transfer station. owner / or / Project Minifer /`Sygpdntendant Date I understand as an Owner-Bailder if. I sell rty the propefor.: which flus:perrivt is issue may be held liable for any financial..or personal:in'uries sustained •b an y;. ysubsequent owners) that result from any latent constructton defects in;the workmanship or,materials.: b I understand 1 may. obtain. more: information regarding my:"obligaiions ;as an "employer` -* from: the Internal Revenue eru ce,ahe::United.States:Small Busmess;Administration,:the Califomia::Department of Benefitand.1he California .Payments Divisnon:of Industrial Accidents I also understand Imay coatact:the California Contractors:' State. License` Board.(CSLB)::at OU= CSLB (2732) or www cslb. ca gov for more <mformation:about lrcensed contractors_: J. am aware of And 'consent`to an Owner -Builder building pernvt:apphed for to my.name; and understand that :amahe gaily ;and:: financially responsible for proposed construction ` activity at : the :< following address: D1AL a La umta CA 92252...... _. ether W y. Q tsomeon I agree that,as the; partyaegally and financially responsible for this proposed:construction activity, L will: abidelelaws and: requirement$ tilat govern Owner -Builders as well: as employers:; Iagreeto notify the issuer.of this form immediately of any additionsdeletions, or changesto:anyofthe information I vided:on.this. foniit Licensed contractorsare. regulated'by.:laws designed to protect: the: public:: If you'contract with who does not have a license, the Contractors', State Zicense Board may be unable to.assistyou -with any financial loss you: may sustain.a&a result, of a.co lanni :.Your remedy: a au>st`unlicen§ed Contractors:ma be in.civil 'court. -It is'also Y Y Y X g y important for you to understand that: if an unlicensed Contractor `or employee of that individual or:firm: i'smi juredwhile working on your property;:you:may, be held liabl$ for damages If you obtain a:peibit a§ Owner -Builder and':wish to. -hire Contractors; you will be.responsible for verifying whether or: not those Contractors are:properly.licensedland.the status: of theirworkers' compensation insurance:coverage Before a building permit can:be issued, this form must lie completed':and.signed by the property:owner;and retunned to the agency responsible for issuin :the'permit.,Naie A:copy. of the property owner.'s driver's liceirse,.form notar4ation, or other yerifrcai{on: acceptable to e . ency is_r i. ::to he presente4.wheivVie permit::is issued lo; verify the property owner's signature. nature: of. roe owner:: yyKQO $ . P P rh' . - 1 _... ..:........... Si ._ .. Date .l Note: 77ie follotivingAuthorizatzon Form is required to be completed by lhe:property owner-only.when dd ating do a ent.a .the ro ert owner lo..a l or a construction 1.ermtt or the t2x!ner Builder ,: Property.Owner s Signature :.. Date%.. t_ _... _ r ' ,. r REXCO. ELECTRIC, INC. ' RISE RESIDENCE' _ 52-541 Meriwether Way LaQuinta, CA ' '. ... Madison Club Electrical Load Calculations General load @ 3 Watts per square foot (6277 X 3) 16830.0 ' Small appliance circuits (1500_ X 2) 3000.0 Laundry Circuit ` ' 1500.0 Ovens/Range ,! 7500.0 Dishwasher x 1800.0 Disposal X 2 1800.0 Washer . 1200.0 ' Dryer 5500.0 Refrigerator. 1800.0 ' Microwave 1500.0 Compactor 1800.0 Spa tub`- f 1800.0 Landscape lighting F f 4000.0 _ Partial Load } - 50030.0 First .10 KVA @ 100% 10000.0 Remainder @ 40% 16012.0 , Air conditioning 66500.0 Pool/Spa/Water feature equipment ,@ 100% ,> ` •12500.0 TOTAL LOAD , ♦ 105012.0 . - .. .Muir. i- �` ' • ' 240,. VOLTS /.105012:0+ WATTS= 438 AMPS USE 600 AMP MAIN, SERVICE CITY OF LA QUINTA RuE' C E. BUILDING & SAFETY DEPT. uc. #611016 APPROVED S E P 2016 77-700 Enfield Land, Ste. D-1,.Palm Desert, CA 9 Phone M1 FOR CONN #760-345-8051 Fax #760-345-688 OF ., ., DATE :BL C0,0MUWITY 13Ev1 ,10ENT , mEXCO •. f ` ` _ EDTRNEW ICAL G�NTRACTOR 1NC. SUB PANEL "D, 4 SINGLE LINE DIAGRAM Main rated @ 22K AIC/ series rated system #imiting branch circuits to 10K AfC 10K AIC 100 AMP LOAD CENTER 12{24 CIRCUIT F70] 413 NM CABLE SUB PANEL B" P"V " 22K AIG Main breaker 600 AMP MAIN SERVICE 2"`PVC 3#310 CU THHN SEP 2 6.2016I 10KAIC I` 200 AMP CITY OF LA QUINTA & #6 LOAD CENTER C0%, 4MUNITY DEVELOPMEITO2C)n M.L.O. 30/40 CIRCUIT SUB PANEL `A" #4 CU BOND TO GAS PIPING i 2': PVC 'w{3#3/0 CU THH 10KAIC i 200 AMP &LOAQ CENTER 30i40 CIRCUIT • _ �, • 2" PVC w{3# /O CU THHN & 1#6 "C-SUB PANEL ,CONDUIT(S) PER S,C:'E./I.I,'D. 10K AIC TO POWER CO. P.O.C: 200 AMP OAD CENTER _ 210 CU TO COLD H2O PIPE & (N(QF" QUINTAt - BUILDING & SAFETY DEPF. APPROVED Li c., #Ep d .CgNSTRUCTION 7, -760 Enfield LanLDATE alm esert, CA 92211- (760) 345-3x,(760) 345-6884 0{40 CIRCUIT j BY CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1 R -PRF -01 Project Name: Rise Residence Addition Calculation Date/Time: 15:30, -Mon, Sep 12, 2016 - Page 1 of 8 f Calculation Description: Title 24 Analysis w Input File Name: Rise Residence Addition.ribdx t` GENERAL INFORMATION 01 Project Name Rise Residence Addition �i ¢ tf r4 - s. i. �M! 02 -` This building Incorporates features�that require 'field testino and/or verificationpby a certifed:HERS raterunder the supervision of a CEC-approved HERS provider. - 02 Calculation Description Title 24 Analysis ; "• f . _ ENERGY USE'SUMMARY' •. ' 03 Project Location 52541 Meriwether Way - 04 . City is Quinta 05 Standards Version Compliance 2015. - 06 Zip Code 92253 07 Compliance Manager Version BEMCmpMgr 2013-4b (433) 08 - Climate Zone CZ15. ' 09 Software Version EnergyPro 6.8 10 • "f Building Type Single Family' 11 Front Orientation (deg/Cardinal) 90 . 12 Project Scope Newly Constructed - 13 Numberof Dwelling Units 1 14 Total Cond. Floor Area (W) 1189 ' ' 15 Number of Zones 2 16 Slab Area (ft2) 529 v ,, 17' Number of Stones 2 > 18 Additioo Cond. Floor Area N/A ': 18 "Natural Gas Available Yes, '. 20 • _ „Addition Slab Area (ft2) N/A r" 21 '_ Glazing Percentage (%) 26.8% - COMPLIANCE RESULTS 01 . Building Complies vrith`Computer'Performance `i ` �')j� !) "" i •.� At �i ¢ tf r4 - s. i. �M! 02 -` This building Incorporates features�that require 'field testino and/or verificationpby a certifed:HERS raterunder the supervision of a CEC-approved HERS provider. - 03 This building Incorporates one .or more SpecfaLfFeaturesFshown below "- '* "• f . _ ENERGY USE'SUMMARY' •. ' coo F f . _ ENERGY USE'SUMMARY' •. ' t �705 O6 '07 , -08 E s� Ik -yr) ". • Standard Design '`Proposed Design Compliance Margin Percent Improvement '• Z ci91 tin 9.267.54 1.72 18.6% r p c o 170.50: - 171.92. -1.42 -0.8% t r C t• ;1.01 9 :01 0.00.., 0.0%- 17:03 16.20 0.83 4.9% ®o VfiRa�' et — 0.00 ,; 0.00 — Complianc me>bTotal ". 197.80 + -. 196.67 1.13 0.6% p - Registration Number: 216-N6336609A-000000000-0000 ; Registration Date/Time: j " 201609-12 15:50:39, a. HERS Provider:, CaICERTS inc. 't •` CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-03112016-433 Report Generated at: 2016-09-12 15:30:50 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1 R -PRF -01 •. Project Name: Rise Residence Addition { Calculation Date/Time: 15:30, Mon, Sep 12, 2016 r . Page 2 of 8h.`," Calculation Description: Title 24 Analysis R Input File Name: Rise Residence Addition.ribdx C• + ir ". ENERGY DESIGN RATING"�- 4 This is the sum of the annual TDV energy,bonsumption for energy`.usee components$ included in the performance compliance approach'for the Standard Design Building (Energy Budget) and the annual TDV energy consumption for lighting and components not regulated by'Titie 24; Part 6"(such`as domestic appliances and consumer electronics)_ and accounting for.the annual TDV energy offset by an on-site renewable energy system. Reference Energy Use ; ( E. , Design Rating Margin Percent Improvement, ce 1 Energy -y , , s i_ 0.4%r." mclud s Iculat lia�egs a iscellaneous Energy Use (AME ,rV x- *,, r � r BUILD -FEAT E ON 02. 03 ' 05• 07O C0 C0. ='` = -$rojec m Conditioned floor Area (ft2) Number of DWelling Units Number of Bedrooms F: Number of Zones .1 Number of Ventilation Cooling Systems Number of Water ' Heating Systems. i Resid yt n1189 1,` 1 2 0 1 ZON I FORM/ - i Y 0 V102 03 04 05• 06 07 "one -blame{ Zone Type HVAC System Name Zone Floor Area (ftp) Avg. Ceiling Height Water Heating System 1 Water. Heating System 2 Zone,1 Conditioned • HVAC System 11 660 - 9 DHW Sys 1 Zone 2. Conditioned HVAC System 22 529 9 DHW Sys 1 Registration Number:' 216-No3366o9A-000000000-0000 Registration Date/ Time: 2016-09-12 15:50:39 ' ' HERS Provider: ., CaiCERTS inc.- C4 nc.CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-03112016-433 _ Report Generated at: 2016-09-12 15:30:50 a CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Rise Residence Addition Calculation Date/Time: 15:30, Mon, Sep 12, 2016 Calculation Description: Title 24 Analysis Input File Name: Rise Residence Addition.ribdx CFI R -PRF -01 Page 3 of 8 OPAQUE SURFACES 01 04 051 , e.,: ti.. rµ. 06 07, 08 Name Constr'uctiori" Type { -""Roof Rise :1 -'ADof Reflectancei f.: Roof Emittance Radiant Barrier Cool Roof Attic Zone 1 Attic RootZone 1wi,'`� +d r .� s. Veiihlated ' 2 0.1a %4 is 0.85 Yes No 01 02 03 04 05 06 07 08 Name Zone Construction Azimuth Orientation Gross Area (ft2) Window & Door Area (111:2) Tilt (deg) North Exterior Wall Zone 1 R-21 Wall 0 Right 690 32 90 South Exterior Wall Zone 1 R-21 Wall 180 Left 870 90 East Exterior Wall Zone 1 R-21 Wall 90 Front 610 101 90 West Exterior Wall Zone 1 R-21 Wall 270 Back 690 54.5 90 Roof Zone 1 R-38 Roof Attic 660 North Exterior Wall 2 Zone 2 R-21 Wall 0 Right 400 24 90 South Exterior Wall 2 Zone 2 R-21 Wall 180 Left 590 48 90 East Exterior Wall 2 ;' ;Zone 2 R-21 Wall 90 Front 780 50 90 West Exterior Wall 2 1 % ,Zone 2 1 R-21 Wall 270 Back -790 33.5 90 ATTIC 01 04 051 , e.,: ti.. rµ. 06 07, 08 Name Constr'uctiori" Type { -""Roof Rise :1 -'ADof Reflectancei f.: Roof Emittance Radiant Barrier Cool Roof Attic Zone 1 Attic RootZone 1wi,'`� +d r .� s. Veiihlated ' 2 0.1a %4 is 0.85 Yes No c vo +. oG'® ' coo ��� - _. . . � < m,� Y —i M C:_ zC�Z Registration Number: 216-N0336609A-000000000-0000 Registration Date/Time: •2016-09-12 15:50:39 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R 03112016 433 Report Generated at: 2016-09-12 15:30:50 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CFIR-PRF-01 Project Name:.Rise Residence Addition Calculation Date/Time: 15:30, Mon, Sep 12, 2016 Page 4 of 8 Calculation Description: Title 24 Analysis Input File Name: Rise Residence Addition.ribdx ` .WINDOWS a e ' de of Building ,�. b3 Si Area (ft2) -factor U -•n '. ;North Exterior Wall 2 ritL ,1) r 130a ,: 24.0 01 02 03 04 05 06 07 08 09 10 Name Type { - Surface (Orientation -Azimuth) Width (ft) Height (ft) Multipli er Area (ftp) U -factor SHGC Exterior Shading Window 204 Window North Exterior Wall (Right -0) 3.0 4.0 1 12.0 0.28 0.18 Insect Screen (default) Window 206 Window North Exterior Wall (Right -0) 5.0 4.0 1 20.0 0.28 0.18 Insect Screen (default) Window 205 Window East Exterior Wall (Front -90) 3.0 4.0 1 12.0 0.28 0.18 Insect Screen (default) Window 207 Window East Exterior Wall (Front -90) 5.0 4.0 1 20.0 .0.28 0.18 Insect Screen (default) Window 208 Window East Exterior Wall (Front -90) 5.0 4.0 " 1 20.0 0.28 0.18 Insect Screen (default) Window 211 a Window East Exterior Wall (Front -90) : - 1 49.0 0.32 0.23 _ Insect Screen (default) Window 201 Window 7- West Exterior Wall (Back -270) 5.0 ' ', 4.0 .1 20.0 0.34, 0.23` Insect Screen (default) Window 202 Window West Exterior Wall (Back -270) .6.0', • = , 4.5 _ 1 • 27.0 a 0.49 0.19 Insect Screen (default) Window 203 Window West Exterior Wall (Back -270) 2.5 , 3.0 1 ; 7.5 0.28 ' 0.18 Insect Screen (default) ,Window 131a + Window" South Exterior Wall 2 (Left -180) • ` - -.1 " 48.0 0.32 0.23.. Insect Screen (default) -Window 107 `. Window., - .1-90) - - 1 25.0 0.28' 0.18 Insect Screen (default) Window 108 Window \ East Exterior Wall 2 (Front -90);- f 1 25.0 0.28 0.18' insect Screen (default) Window 101 Window ,,O,`0 < ., ltll� 77.5 0.28 0.18' Insect Screen (default) Window 102 WindowWest Extenor,Wall 2 Back -270 +� = " t�� 1 t x•.•.6:0 0.28 ' . 0.18. Insect Screen default DOORS r , ,� �► «y,+ n - a e ' de of Building ,�. b3 Si Area (ft2) -factor U -•n '. ;North Exterior Wall 2 ritL ,1) r 130a ,: 24.0 py .' `' .SIMS . • { ,.X�- ww��. �. •'. C.r. _ a ` { •_ ., • , ":a.. ��_-' _ ' _ .. .1 -.,Tri .. , ..,. Registration Number: 216-NO336609A-000000000-0000 Registration Date/Tirrie:' 2016-09-1215:50.39 HERS Provider: •CaICERTS inc. '1 4 CA Building Energy Efficiency Standards,- 2013 Residential Compliance Report Version - CFIR-03112016-433 ReportGenerated 'at: 2016-09-12 15:30:50 CERTIFICATE OF COMPLIANCE = RESIDENTIAL PERFORMANCE COMPLIANCE METHOD' CF1 R -PRF -01 y Project Name: Rise Residence Addition ; Calculation Date/Time: 15:30, Mon, Sep 12, 2016 Page 5 of 8 Calculation Description: Title 24 Analysis Input File Name: Rise Residence Addition.ribdx OVERHANGS AND FINS 0102: -G TI �,;r"03 ra-` ..,...:•_» 04=. 05,E 06 07 l ` ,. �" "' • , - ,•� c �I Total Cavity,,. 01 02 03 04 05 06 —0777-F 08 09 10 • 11 12 13 14 x I Cavity /Frame: no insul. / 2x4 Top Chrd Overhang - . 2x4)Top;Chord of�Roof Truss @,24 Left Fin • , Roof Deck: Wood Siding/sheathing/decking Attic RoofZone 1 ' Right Fin Wood:Framed Ceiling- Window Depth Dist Up • Left Extent Right Extent Flap Ht.,: Depth Top Up DistL Bot Up Depth Top Up Dist R Bot Up Window 204 2 0.1. 2 2 0 0 0 0 0 0 0 0 0 Window 206 2 0.1 ' 2 2 0 0 0 0 0 0 0 0 0 Window 205 2 0.1 2 2 0 0 0 0 0' 0 0 0 0 Window 207 2= 0.1- 2 2 0 0 z: .. 0 0 0 0 0 0 0 Window 208 2 0.1 2 2 0 0 0 0 0 0 0 0 ,. p Window 201 2 0.1 2 2• 0 01 0 '0 . • 0 0 0 0 0 Window 202 2 A: 0.1 2 2 0 0 0 0 0 0 0 0 0, Window 203 . ; 2 i , 0.1 t 2 2 :. ' 0 : 0. • . 0 p.. 0 _ ' 0 y 01 - 0.. OPAQUE SURFACE CONSTRUCTIONS•-�, _ " �. -.z:. .. r s 0102: -G TI �,;r"03 ra-` ..,...:•_» 04=. 05,E 06 07 l ` ,. �" "' • , - ,•� c �I Total Cavity,,. iWinter;Design ` k "Assembly 'Construction Name ' Surface Type Constru ion Type ; , Framing �� � R -value .t ii f 11 -value;;,- . Layers U IA • V r 4a: x I Cavity /Frame: no insul. / 2x4 Top Chrd - . 2x4)Top;Chord of�Roof Truss @,24 , r • , Roof Deck: Wood Siding/sheathing/decking Attic RoofZone 1 ' Attic Roofs Wood:Framed Ceiling- in. O.C. none �•+ 0:644 •. Roofing: Light Roof (Asphalt Shingle) p :� _ ` w . K Inside Finish: Gypsum Board ; ` wdo -•4 R-21 Wall' C' .. Exterior Walls , Wood Framed Wall 2x6 @ 16 in: O C. , ' ', • R 21 , 0.Oi39 _ • Cavity / Frame: R-21 /2x6 Exterior Finish: 3 Coat Stucco Inside Finish: Gypsum Board :.� Z Ceilings (below ± = '0.025, Cavity/:Frame: R-9.1 /2x4 , 1 F2-38 R attic) Wood Framed Ceiling 2x4 @ 24 in. a.C. R38 - over Ceiling Joists: R-28.9 insul. SLA LOORS� -G TI 02 03 - = -04 t-- 05 06 Ir>e Zone Area (ftZ)' Perimeter (ft) Edge insul. R -value 8 Depth Carpeted Fraction Heated Slab a Z= Zone 2 : 529 120 None 1 No f rn ' Registration'Number: 216-NO336609A-OOOOO0000-0000 '.Registration Date/Time: 2016-09-12 15:50:39 HERS Provider: ; CaICERTS inc. CA Building Energy Efficiency Standards -'2013 Residential Compliance' Report Version - CF1R-03112016-433 Report Generated at: 2016-09-12 15:30:50 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CFIR-PRF-01 Project Name: Rise Residence Addition .Calculation Date/Time: 15:30, Mon, Sep 12, 2016 Page 6 of 8• Calculation Description: Title 24 Analysis - Input File Name: Rise Residerice Addition.ribdx - BUILDING ENVELOPE - HERS VERIFICATION 01 02 03 04 Quality Insulation Installation (QII) Quality Installation of Spray Foam Insulation Building Envelope Air Leakage CFM50 Required Not Required Not Required WATER HEATING SYSTEMS _ '01 '02 03 04 05 06 Name - System Type Distribution Type Water Heater Number of Heaters Solar Fraction (%) DHW Sys 1 - 1/1, DHW Standard DHW Heater 1: t .0% i' F WATER HEATERS ' 01 02,h T 03 1;. 04 05 06 07' 08 - me I��me C . ` Pipe Insulation. .' _ Polnt-of Use Recirculation Control t ' Tank Exterior Dfi . Sys 1 - 4q , r- ., �� Tank Volume -Energy Factor or Heat Pump Heating and Cooling System ' Insulation, ' Standby toss Name Heater Eleme T a Yp Tank T• Yf� al (9 ) Efficient Y In ut Ratlnrv' p g R -value Fraction (Fraction) - No 4 , DHW Heater;l ^Natural Gas _ "7 � .z. Small Storage 50 0.62 37000-Btu/hr . 0_ + 0' WATER HEATING -HERS VERIFICATION/"AF.' FA A x--01 �.��- = 02"A �t ,. � ...., .w, 03�' - -... •., .: ��04 ,�% ;� 05 �. 66 07 '04 me I��me C . ` Pipe Insulation. ,.,.Parallel Piping I'Awso Compact Distribution Polnt-of Use Recirculation Control t ' Central DHW- Distribution Dfi . Sys 1 - 4q , r- ., Distribution Name' -feat Pumyse:: _ I . + - Heat Pump Heating and Cooling System ' _. 3 :s N . r • •y�yx e SPACE COND TIONIN Yf S .. k �- AI12o 02 03 '04 05 06 SCS 3e�Tl System Type Heating Unit Name Cooling Unit Name fan Name Distribution Name' -feat Pumyse:: _ I . + - Heat Pump Heating and Cooling System ' Heat Pump System 1 ' Heat Pump System 1- ' _ None- 7 - None- at Pump�y f2i:: -p Heat Pump Heating and Cooling System. Heat Pump System 2 ,Heat Pump System 2 - No None � { _ � • `e •G� _ tt _. • - ! - •, a a• . f'.. l YT • , i,.. _ _ � , , r Registration Number: 2 1 6-N0336609A-000000000-0000 ` Registration Date/Time: 2016-09-12 15:50:39 HERS Provider: T! CaICERTS inc. CA Building Energy Efficiency Standards _'2013 Residential Compliance Report Version - CF1R-03112016-433 - Report Generated at: 2016-09-12 15:30:50 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Rise Residence Addition Calculation Date/Time: 15:30, Mon, Sep 12, 2016 Calculation Description: Title 24 Analysis Input File Name: Rise Residence Addition.ribdx CF1 R -PRF -01 Page 7 of 8 HVAC - HEAT PUMPS 01 02,' 03 04 05, O6 07 08 09 10 Name . Type Heating HSPF/COP Cap 47 Cap 17 Cooling SEER EER Zonally Controlled Multispeed Compressor HERS Verification Heat Pump System 1 DuctlessHeatPump 8.3 ' 38000 34000 17 8.3 No No Heat Pump System 1 -hers -cool Heat Pump System 2 € DuctlessHeatPump 8.3 30000 26000 19 10.7 No No Heat Pump System 2 -hers -cool HVAC COOLING - HERS VERIFICATION a 01 02 03 04 05 06 Name Verified Airflow Airflow Target Verified EER Verified SEER Verified Refrigerant Charge Heat Pump System 1 -hers -cool [,,,Not Required — Not Required Not Required 'Not Required` Heat Pump System 2 -hers -cool • Not Required _ — 'Not Required Not Required Not Required - - r a — — -CP IAQ (Indoor Air Quality) FANS . • ""� * - 01� Dwelling Unit. x'02 ,[�.',� �f IAQ, M 00M )L03j.,i� IAQ Watts/CFM .. 1104 rw� IAQ Fan Typ US IAQ Recovery Effectiveness(%) Ofi, ., HERS Verification ` SFam � CIL en p '� 26.89`� r _ �' ' 0.25'1; )�Defaul4', ' > - 0 Required 00M T o r _ Z7 i• , , M�� Registration Number: 216-No336609A-000000000-0000 Registration Date/Time: 2016-09-12 15:50:39 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-03112016-433 - Report Generated at: 2016-09-12 15:30:50 . _ - CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1 R -PRF -01' . Project Name: Rise Residence Addition Calculation Date/Time: 15:30, Mon, Sep 12, 2016 • _ Page_ 8 of 8 ` Calculation Description: Title 24 Analysis - Input File Name: Rise Residence Addition.ribdx , DOCUMENTATION AUTHOR'S DECLARATION STATEMENT ' 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: - Butch White Company: Signature Date: BREEZE AIR CONDITIONING INC 2016-09-12 15:50:39 Address: CEA/HERS Certification Identification (If applicable): : i • �., -75-145 ST CHARLES PLACE .`-' `• City/State/Zip: s - Phone: PALM DESERT, CA 92211 T. ° 760-346-0855 RESPONSIBLE PERSON'S DECLARATION STATEMENT • 4 �" .. +. o I certify -the following -under penalty of perjury, under the laws of the State of California: 1. 1 am eligible under Division 3 of the Business`"and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. i~ 2. -1 certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations.'-rik4,.� „ 3. '0 The building design features or system design1eatures 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 agency for approval_with-this. building permit application, . Responsible Designer Name: - Responsible Designer Signature: Butch White <,, 07 .: Company: e 4 • Date, Signed: �f. BREEZE Ai ITIONING INC •v ' F f.M r '2016.09-12 15.50:39 ' .`"7 �. .•a •e...- ~ h.4:: t. Tett' Address: A r • License: '' `+ 75-145 HA ES r�'� ''^' 406394 '' ,, City/State ..J> Phone: *1•N T G . �- PALM SER C11 "" ` ,' n r 760-346-0855t� r -•-•�+ ,.-fi-. .:.sem... � ._ �, : vJ - _. .. ,. .:. f • .. .yl... w � -_ • - - . � � t--.- t ,,. �.- . - .. _ � �• r � S,. - l � k • yr ^. Digita 1 signed by CaICERT ital signature is provided in order to secure the content of this registered document and in no way implies Registration Prove er for the ac�cur cy of the information. " t Registration Number: 216-N0336609A-000000000-0000 = Registration Date g g• Mme: 2016-09 12 15:50:39 + HERS Provider: ;CaICERTS inc. s ` CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version'- CF1R-03112016-433 Report Generated at: 2016-09-12 15:30:50 f