BRES2019-008578-495 CALLE TAMPICO T4t�t U "i - QuIam VOICE (760) 777-7125
LA QUINTA, CALIFORNFAX (760) 777-7011IA 92253 DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Permit Type/Subtype: BUILDING RESIDENTIAL/REMODEL Owner:
Application Number: BRES2019-0085 KEVIN GENE DERRYBERRY
Property Address: 53531 AVENIDA CARRANZA 53531 AVENIDA CARRANZA
APN: 774115013 LA QUINTA, CA 92253
Application Description: DERRYBERRY / 980SF INTERIOR REMODEL
Property Zoning:
Application Valuation: $3,800.00
Applicant: U Contractor:
HORACIO, VERA OWNER BUILDER
17300 CORNELL ROAD
LA QUINTA, CA 92253 MAY 2 4 2019 ]D
CITY OF LA QUINTA LI c. No.:
DESIGN & 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 subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
,,,. i 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.).
(7dkl 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.).
(kO I am exempt under Sec. B.&P.C. for this reason
Date: ��` Owner* J
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:
Date: 5/24/2019
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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
COMPEN&ATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST. AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above -mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):. AF_7�_
Date: 5/24/2019
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
HORACIO, VERA
17300 CORNELL ROAD
LA QUINTA, CA 92253
BRES2019-0085
53531 AVENIDA CARRANZA
774115013
DERRYBERRY / 980SF INTERIOR REMODEL
$3,800.00
Owner:
KEVIN GENE DERRYBERRY
53531 AVENIDA CARRANZA
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
1 a S
! f Llc. No..
---------------- --- - -----�--* ------f--`-------------------_.----•-----•--•--•-
Detail: DERRYBERRY / 980SF REMODEL. REPLACE DOORS & WINDOWS, AJ)D NEW DOOR � KITCHEN;, NEW ELECTRICAL FIXTURES AND NEW PLUMBING
THROUGHOUT HOME. NEW FAU, WATER HEATER, AND 200A SERVICE PRNEL. ADD NEW CLOSET AT MASTER. [CONVENTIONAL LIGHT -FRAME DESIGNS].
THIS PERMIT DOES NOT INCLUDE THE ALTERATION OF ANY LA'rERAL RESISTING CONSTRUCTION OR ADDITIONAL BUILDING AREA. 2016 CALIFORNIA
BUILDING CODES.
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, FIRST 1,000SF
101-0000-42403
0
$160.10
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, FIRST 1,000SF, PC
101-0000-42600
0
$52.83
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $212.93
DESCRIPTION
ACCOUNT
CITY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
0
$40.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$26.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FURNACE
101-0000-42402
0
$40.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FURNACE PC
101-0000-42600
0
$26.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
VENT FAN
101-0000-42402
0
$26.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
VENT FAN PC
101-0000-42600
0
$10.68
Total Paid for MECHANICAL: $170.76
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PLAN CHECK DEPOSIT - ADDITION/REMODEL
101-0000-42600
1
$125.00
Total Paid for PLAN CHECK DEPOSIT - ADDITION/REMODEL: $125.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$133.40
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$133.40
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$13.34
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0
$13.34
Total Paid for PLUMBING FEES: $293.48
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE - MAJOR
101-0000-42416
0
$21.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $21.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
101-0000-42600
($124.50)
DESCRIPTION
ACCOUNT
CITY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$48.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$38.42
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 100 SF
101-0000-42400
0
$54.43
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$124.50
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$24.39
Total Paid for REMODEL: $165.26
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-•0000-42600
($0.50)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL 101-0000-20308 10 $0.50
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.00
DESCRIPTION ACCOUNT QTY AMOUNT
TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
ta Qwkra
PERMIT # al 9
- CALIFORNIA
PLAN LOCATION:
Project Address: <s S _ C
Project Description:
APN #:
✓1 fi.� L./ 1 vl U i.✓ yl r/
Applicant Name:
u,�e
Address:
City, ST, Zip: -JL2
Telephone: O - Z& ge
Email:
CM /3 Ve► to rz-0 I , CC/1
o
valuation of Project $ ,T0Q-,
Contractor Name:
New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip
Garage SF
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: City Bus Lic:
Architect/Engineer Name:
Construction Occupancy:
Address:
Grading:
City, St, Zip
Telephone: �'� Q t�3
Bedrooms:
Stories:
# Units:
Email: J LA�IZA 1 1.
State Lic: City Bus Lic:
Property Owner's Name:
New Commercial / Tenant Improvements:
Address:
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Plan Sets
Required
Received
I
III
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
l
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(760)777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitted in your name list'ng yours as the builder of the property
improvements specified at t' -- 5 [�7,<R� t�-7'79 r; .y ,w
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice
unless you, the property owner, obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statemenf below to signify you understand or verify this information.
AU 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
on my property.
A, �, 2. I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
_4, V, 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
R,4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
P_VS. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
k6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
risk.
%( V.7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
AIL�8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
)LV 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California
Division of Industrial Accidents, I also understand I may contact the California Contractors' State License Board (CSLB) at 1-
800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
A1/, 10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name and iinrle.rctnnd that T am the
party legally and financially responsible for proposed construction activity at the following address:
)-1JL11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owner -Builders as well as emp lovers.
f.12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also
important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working
on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wishto hire Contractors,
you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this orm-must be completed and signed by the property owner and returned to
the agency responsible for issuing the it. Note: opy oft roperty owner's driver's license, form notarization, or
of/ter verification acceptable to the ug cy is requires be r anted when the permit is issued to verify the property
owner's signature. 11
Signature of property owner
Date: -
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize
the following persons) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project. _
Scope of Construction Project (or Description of Work): -1- 'i0A 3 f Q ,.J ,
Project Location or Address: SA -- 5� l C6 le kaAJ Z A- t! n-- 7-4 ,
Name of Authorized Agent:
Ve 2 a
Tel No -7 �� •- Yn `{ Y� d '
Address of Authorized Agent:
/�-
I declare under penalty of perjury that I am a prope owner for address listed above and I personally filled out the above
information and certify its accuracy. N copy oft owner' driver's license, form notarization, or other verification to the agency is req ' ed p .sented w en th emdt is issued 9_verify the property owner's signature,
Property Owner's Signature: K Date: - 2 6 <9
-bcCES-Lcl g -00ds
STATE OF r'ALIFORNIA
RESIDENTIAL ALTERATIONS
Cle
EC-CFIR-ALT-01-E (Revised 09/16) _ _ CAUFORN.IA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 6)
Project Name:-� y ,: a-d Date Prepared:
A. General Information
01
Project Name:
/ v ! rzOro
02
Date Prepared:
L
03
Project Location:
'S ?
04
Building Front Orientation (deg or car final):
i
05
CA City:
06
Number of Altered Dwelling Units:
ytL
07
Zip Code:
08
Fuel Type:
tr9
Climate Zone:
10
Total Conditioned Floor Area (ft`)- •-_
F13
Building Type:
12
Slab Area (ft`):
L
Project Scope:
14
Exceptions to Minimum Aged Solar Reflectance
and Minimum Thermal Emittance or SRI-
B. Building
Insulation Details — Framed (Section 150.2(b)1)
01
02
03
04
05
06 07 08 09
10
11
Tag/ID
Assembly Type
Frame
Type
Frame
Depth
(inches)
Frame
Spacing
(inches)
Proposed
Required
�7�
l�1� — co 8
i s
Cavity
R-value
Continuous
Insulation
R-value
��
U-factor
Appendix JA4
Reference
��£
Table
Cell
Fro
4;r
{�Lil
-_"�."EE�V �1ll IiJIV1Y
Note:
• Where insulation is installed above the roofing membrane, or above the layer used to seal the roof from water penetration, the in
percent by volume when tested according to ASTM Standard C272.
'_.. . _.
ulation shall have a'rr I &ater absorption of
.3
,*. t r A, i - - • • - --- -- - - —
C. Building Insulation Details - Non -framed Y
'�91
-
01
02
03
04
05 — 06 07 08 1 09WWI
Tag/ID
Assembly Type
_<01Package
Assembly
Materials
.�'
Thickness
(inches)
inches
Proposed
Required
C
Comments
Core
Insulation
R-value
Continuous
Insulation
R-value
U-factor
Appendix JA4
Reference
Required
Table
Cell
U-factor
from
A
Ok\'%
Registration Number: Registration Date/Time, HERS Provider_
CA Building Energy Efficiency Standards - 2016 Residential Compliance September 2016
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1 R-ALT-01-E (Revised 09/16) _ CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 2 of 6)
Project Name: Date Prepared:
D. Building Insulation Details — Mass Walls
01
02
03
04
05
06
07 08 09
10 11
Tag/ID
Wall Above
Grade
Mass Tye
Mass
Thickness
(inches)
Interior
Furring
Strip
Thickness
(inches)
Exterior
Furring
Strip
Thickness
(inches)
Proposed
Required
Interior Insulation
Exterior Insulation
AppendixJA4
Reference
Interior Insulation
Exterior Insulation
R-value
U-factor
R-value
1-1-factor
Table
Cell
R-value
U-factor
R-value
U-factor
E. Roof Replacement (Section 150.2(b)1H)
01
02
03
04
05
06
07
08
09
10
11
12
13
14
CRRC
Proposed
Minimum Required
Product
R-value
-
Aged Solar
Aged Solar
Tag/
Method of
Roof
ID
Product
Deck
Initial Solar
Aged Solar
Thermal
SRI
Reflectance
Reflectance
Thermal
SRI
ID
Compliance
Pitch
Exception
Number
Type
Insulation
Reflectance
Reflectance
Emittance
(Optional)
(Max)
(Min)
Emittance
(Optional)
Notes:
•
Roof area covered by building integrated photovoltaic panels and solar thermal panels are exe pt from the above Cool Roof requirements.
'C>'
•
Liquid field applied coatings must comply with installation criteria from section 110.8(i)4.
F. Fenestration/Glazing Allowed Areas and Efficiencies (Section 150.2(b)1)
01
02
03 04
Existing West -
Facing
Fenestration
Area
(ftz)
05
Maximum
Allowed
U-factor
(Windows)
Maximum
Allowed
U-factor
(Skylights)
06
Maximum
Allowed
SHGC
I (Windows)
Maximum
Allowed
SHGC
(Skylights)
07
Comments
Alteration
Type
Maximum
Allowed
Fenestration
Area Nr All
Orientartigns
(ft)
_
Maximum
Allowed West- Existing
Facing Fenestration
Fenestration ,. Area for All
Area Only Orientations
(ftz (ftz)
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2016 Residential Compliance September 2016
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E (Revised 09/16) CALIFORNIA ENERGY COMMISSION —44W'
CERTIFICATE OF COMPLIANCE CFIR-ALT-01-E
Prescriptive Residential Alterations (Page 3 of 6)
Project Name: rw Date Prepared:
G. Fenestration/Glazing Proposed Areas and Efficiencies —Add (Section 150.2(b)1A)
01 02 03 04 05 06 07
08 09 10
11 12
13 14
Tag/ID
Fenestration Type
Frame
Type
Dynamic
Glazing
Orientation
N, S, W, E
Number
of
Panes
Proposed
Fenestration
Area (ftz)
Proposed
West Facing
Fenestration
Area (ftZ)
Proposed
U-factor
Source
Proposed
SHGC
-
Source
Exterior
Shading
Device
Combined
SHGC from
CF1R-ENV-03
)
i
15
Existing + Proposed Fenestration Area
16
Maximum Allowed Fenestration Area
17
Compliance Statement:
18
Existing + Proposed West -Facing Fenestration Area.•
19
Maximum Allowed West Fenestration Area
ti t
20
Compliance Statement:
21
Proposed Fenestration U-factor (Windows)
22
Required Fenestration U-factor (Windows)
23
Compliance Statement:
24
Proposed Fenestration SHGC (Windows)
i
-
25
Required Fenestration SHGC (Windows)
26
Compliance Statement:
27
Proposed Fenestration U-factor (Skylights)
28
Required Fenestration U-factor (Skylights)
29
Compliance Statement:
30
Proposed Fenestration SHGC (Skylights)
31
Required Fenestration SHGC (Skylights)
32
Compliance Statement:
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2016 Residential Compliance September 2016
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1 R-ALT-01•E (Revised Q8116) CALIFORNIA ENERGY COMMISSION _'MV_
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 3 of 6)
Project Name:iL d&LA�. Date Prepared: V_2CV (' --_
G. Fenestration/Glazing Proposed Areas and Efficiencies —Add (Section 150.2(b)1A)
01
02
03
04
05
06
07
08
09
10
11
12
13
14
Tag/ID
Fenestration Type
Frame
Type
I Dynamic
Glazing
Orientation
N, S, W, E
Number
of
Panes
Proposed
Fenestration
Area (ft)
Proposed
West Facings
Fenestration
Area (ft)
Proposed
U-factor
Source
Proposed
SHGC
Source
Exterior
Shading
Device
Combined
SHGC from
CF1R-ENV-03
,.
f"�
. ZZ
15
Existing+ Proposed Fenestration Area
16
Maximum Allowed Fenestration Area
17
Compliance Statement:
18
Existing+ Proposed West -Facing Fenestration Area
19
Maximum Allowed West Fenestration Area
20
Compliance Statement:
21
Proposed Fenestration U-factor (Windows)
22
Required Fenestration U-factor (Windows)
23
Compliance Statement:
24
Proposed Fenestration SHGC (Windows) rF
25
Required Fenestration SHGC (Windows)
26
Compliance Statement:
27
Proposed Fenestration U-factor (Skylights)
28
Required Fenestration U-factor (Skylights)
29
Compliance Statement:
Proposed Fenestration SHGC (Skylights)
30
31
Required Fenestration SHGC (Skylights)
32
Compliance Statement:
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2016 Residential Compliance September 2016
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
"
SEC-CFIR-ALT-01-E (Revised 09/16) CALIFORNIA ENERGY COMMISSION "CX'
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations
(Page 4 of 6)
Project Name: n ��,�r.ts�e�s�-1��•�+ —��- -� jay: �-5 Date Prepared: G�
-1 _., _ _
H. Fenestration/Glazing Proposed Areas and Efficiencies- Replace (Section 150.2(b)1B)
01
02
03
04
05
06
07
08
9
10
11 _
12
13
14
Tag/
ID
Fenestration
Type
Frame
Type
Dynamic
Glazing
Orientation
N, S, W, E
Area
Removed
(ftz)
Area
Added
(ftz)
Net
Added
Area (ft2)
Proposed
U-factor
Source
Proposed
SHGC
56urce .
Exterior
Shading
Device
Combined SHGC
from
CF1R-ENV-03
c J
I 4J
2
2
•27
i-C
wfxc.
15
Net Added West -facing Fenestration Area
i
i
`
16
Is Net Added Fenestration Area <_ 0 for West -Facing Fenestration?
17
Net Added Fenestration Area (all orientations)
18
Is Net Added Fenestration Area 5 0 for All Orientations?
19
Proposed Fenestration U-factor (Windows)
r
20
Required Fenestration U-factor (Windows)
21
Compliance Statement:
22
Proposed Fenestration SHGC (Windows)
23
Required Fenestration SHGC (Windows) A
24
Compliance Statement:
25
Proposed Fenestration U-factor (Skylights)
26
Required Fenestration U-factor (Skylights)
27
Compliance Statement:. _.
28
Proposed Fenestration SHGC (Skylights)
29
Required Fenestration U-factor (Skylights)
30
Compliance Statement:
0
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2016 Residential Compliance September 2016
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1R-ALT-91-E (Revised 09/16)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations
Project Name: lam, J_—,—
9
�✓�I Date Prepared:
RGY CDMMISSInN le
CF 1 R-ALT-01-E
(Page 4 of 61
H. Fenestration/Glazing Proposed Areas and Efficiencies— Replace (Section 150.2(b)1B)
01 02 03 04 05 06 07 08 9 10 11 12 13 14
Area Area Net7. Exterior Combined SHGC
Tag/ Fenestration Frame Dynamic Orientation Removed Added Added Proposed Proposed Shading from
ID Tye Type Glazing N, S, W, E z
(ft ] (ft ) Area (ft j U-factor Source SHGC Source Device CF1R-ENV-03
15 Net Added We#acing,enestration Area
16 Is Net Added Fenestration Area <_ 0 for West -Facing Fenestration?
17 Net Added Fenestration Area (all orientations)
18 Is Net Added Fenestration Area <_ 0 for All Orientations?
19 Proposed Fenestration U-factor (Windows) :_•'
s
20 Required Fenestration U-factor (Windows)
21 Compliance statement:
22 Proposed Fenestration SHGC (Windows)
23 Required Fenestration SHGC (Windows) or
24 Compliance Statement:
25 Proposed Fenestration U-factor (Skylights)
26 Required Fenestration U-factor (Skylights)
J
27 Compliance Statement:
28 Proposed Fenestration SHGC (Skylights)
29 Required Fenestration U-factor (Skylights)
30 Compliance Statement:
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2016 Residential Compliance September 2016
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1R•ALT-07-E Revised 69116 CAUFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations
CF 1 R-ALT-01-E
(Page 4 of 6j
Project Name: . ,� s, v G r.�. G Date Prepared:
H. Fenestration/Glazing Proposed Areas and Efficiencies — Replace (Section 150.2(b)1B)
01 02 03 04 05 06 07 08 9 10 11 12 13 14
Area Area Net Exterior Combined SHGC
Tag/ Fenestration Frame Dynamic Orientation Removed Added Added Proposed Proposed 'Shading from
ID Type Type. Glazing N, S, W, E {ft1) {ftx) Area (ft.,) U-factor Source SHGC S Device CF1R ENV 03
AI
15 Net Added West -facing Fenestration Area
16 Is Net Added Fenestration Area <_ 0 for West -Facing Fenestration?
17 Net Added Fenestration Area (all orientations)
18 Is Net Added Fenestration Area <_ 0 for All Orientations?
19 Proposed Fenestration U-factor (Windows)
20 Required Fenestration U-factor (Windows)
21 Compliance Statement:
22 Proposed Fenestration SHGC (Windows)
23 Required Fenestration SHGC (Windows)
24 Compliance Statement:
25 Proposed Fenestration U-factor (Skylights)
26 Required Fenestration U-factor (Skylights)
27 Compliance Statement:
28 Proposed Fenestration SHGC (Skylights)
29 Required Fenestration U-factor (Skylights)
30 Compl)ance Statement:
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2016 Residential Compliance
HERS Provider:
September 2016
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 09/16
CERTIFICATE OF COMPLIANCE
CALIFORNIA ENERGY COMMISSION
Prescriptive Residential Alterations
CF111-ALT-01-E
Project Name:�.yt
�y.r,��
G.FG�wI Date Prepared: S
Page 4 of 67
��
H. Fenestration/Glazing Proposed Areas and Efficiencies—
Replace (Section 150.2(b)1B)
04 05
01"FenestrationFrame
06 07
08
9 10 11
12 13 14
Tag/ Dynamic Orientation
Area Area
Removed Added
Net
Added
Proposed Proposedshading
Exterior Combined SHGC
from
IDGlazing N, S, W, E
(ft) (ftz)
Area W)
U-factor Source SHGC
Sourc6 Device CF1R-ENV-03
C
Z� Z—
15 gnestration Area
16 Is Net Added Fenestration Area <_ 0 for West -Facing Fenestration?
17 Net Added Fenestration Area (all orientations)
~
18 Is Net Added Fenestration Area 5 0 for All Orientations?
19 Proposed Fenestration U-factor (Windows)
+
20 Required Fenestration U-factor (Windows)
21 Compliance Statement:
22 Proposed Fenestration SHGC (Windows)
23 Required Fenestration SHGC (Windows)
n
24 Compliance Statement:
25 Proposed Fenestration U-factor (Skylights)
26 Required Fenestration U-factor (Skylights)
27 Compliance Statement:
28 Proposed Fenestration SHGC (Skylight$)
29 Required Fenestration LI-factor. (Skylights)
30 Compliance Statement:
k.J
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2016 Residential Compliance
HERS Provider:
September 2016
STATE OF �IALIFORNIA
RESIDENTIAL ALTERATIONS
;EC CPZR•ALT-01-E (Revised 09116) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 5 of 6)
Project Name: 1`f{"P✓7cn/,✓liL1Ga•, —j✓�} (ij � Date Prepared:
I. Space Conditioning (SC) Systems - Heating/Cooling (Section 150.2(b))
01 02 03
Dwelling Unit Name Dwelling Unit Total CFA (ft) Comments
J. Water Heating Systems (Section 150.2(b)1G)
01
02
03
04
05
06
07
08
09
10
11
2`
13
14
15
Water
Heating
System
Identification
or Name
Water
Heating
System
Type
Water
Heater
Type
# of
Water
Heaters
in
System
Water
Heater
Storage
Volume
(gal)
Fuel
Type
Rated
Input
Type
Rated
Input
Value
Heating
Efficiency
Type
Heating
Efficiency
Valise
Standby
Loss
N
Exterior
Insul.
R-Value
Back -Up
Solar
Savings
Fraction
Central DHW
System
Distribution
Tye
Dwelling Unit
DHW System
Distribution
Type
K. Space Conditioning Systems and Water Heating Systems in Multifamily Dwelling Unit L
01
02
03 04
05
06
Dwelling Unit Name
Dwelling Unit Total CFA
(ft)
Central Water Heating Dwelling Unit
System Identification or Water eating System
Name Identification or Name
Dwelling Unit:
Alteration to Existing or
Installtion of Space
Conditioning System(s)?
Comments
I
��Y may,,. fir_
�O
Registration Number: Registration Date/Time; HERS Provider:
CA Building Energy Efficiency Standards - 2016 Residential Compliance September 2016
STATE OF 1 4,LIFORNIA
RESIDENTIAL ALTERATIONS
Wc
C E C-C F I R-A LT-0 I -E (Revised 09116) CALIFORNIA ENERGY COMMISSION r
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 6 of 6)
Project Name: r%,fv�e>y i� P-, Ale-, Date Prepared: C/ f Y j 7
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
DocurnenLatiOn Author Name:
CeW
OOCumen[a ian Author Signature:
Campan
Sign. [ure Date:
Address:
CEA/ AERSCertiFica nidentification fJapplicabW �-
&() r .
City/State/Zip::
Phone;
RESPONSIBLE PERSON'S DECLARATICrN 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. A
2. I 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 24, Part 1 and Part 6 of the California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent 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. 1 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 occupariCy. v.
Responsible Designer Name:
Rewrislb}B Designer Signature:
Company: � � �
atieSig ed%A
Address:
Lic se:
C�[ylSsatel2ip"
Phone:
X
rF' assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300
0
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2016 Residential Compliance September 2016