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BRES2019-018678-495 CALLE TAMPICO C& 0 D 66P Qaiftm VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 11/4/2019 Permit Type/Subtype: BUILDING RESIDENTIAL/DWELLING - SINGLE FAMILY DETACHED Owner: Application Number: BRES2019-0186 SMITH DAVID E / SMITH ANNETTE Property Address: 54080 AVENIDA OBREGON 54080 AVENIDA OBREGON APN: 774204028 LA QUINTA, CA 92253 Application Description: SMITH / 2,452SF DWELLING/VB/RES-3/CLASS A-FR/13D/CONY-FRAME Property Zoning: Application Valuation: $160,030.60 Applicant: r1 Contractor: SIPOVAC CONSTRUCTION INC P SIPOVAC CONSTRUCTION INC 72651 THEODORA LANE !� 72651 THEODORA LANE Nov o a 20�9 PALM DESERT, CA 92260 PALM DESERT, CA 92260 (760)567-2347 CITY OF LA QUINTA Llc. No.: 581636 - - - - - - - - - - - - - - - - - - - - - - - - -0ESIGNLgiVEppyM NT 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: B. C33 C53 C-9 C10 C20 C 6 21 License No.: 581636 Date �1Z7 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 clVll penalty of not more than five hundred dollars ($500).: �} I, as ownerof 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 oneyear of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Na Lender's Address: 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. 1�wl 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: 5ILTE COMPENSATIONPolicy Number: 9087965 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:—"/Zp Applicant: S 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 Jefend, indemnify and hold harmless the City of La Quinta, its officers, agents, and =mployees for any act or omission related to the work being performed under or `ollowing issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not :ommenced within 180 days from date of issuance of such permit, or cessation of work or 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 propert for Inspection purposes. Nate: Signature (Applicant or Agen�� FINANCIAL DESCRIPTION INFORMATION ACCOUNT CITY AMOUNT HOURLY CHARGE - CITY BUILDING STAFF 101-0000-42600 1 $161.00 DESCRIPTION ACCOUNT CITY AMOUNT HOURLY CHARGE - CITY BUILDING STAFF 101-0000-42600 1 $161.00 DESCRIPTION ACCOUNT CITY AMOUNT HOURLY CHARGE - CITY BUILDING STAFF 101-0000-42600 0.5 $80.50 Total Paid for BLDG CITY STAFF - PER HOUR: $402.50 DESCRIPTION ACCOUNT CITY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $7.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $7.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - CIVIC CENTER 252-0000-43200 0 $796.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - COMMUNITY CENTER 254-0000-43200 0 $129.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - FIRE PROTECTION 257-0000-43200 0 $366.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - LIBRARIES 253-0000-43200 0 $344.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - PARKS/REC 251-0000-43200 0 $2,048.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 Total Paid for DIF - SINGLE FAMILY ATTACHED: $6,681.00 DESCRIPTION ACCOUNT CITY AMOUNT SERVICES 101-0000-42403 0 $26.68 DESCRIPTION ACCOUNT CITY AMOUNT SERVICES PC 101-0000-42600 0 $13.34 Total Paid for ELECTRICAL: $40.02 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $27.22 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $11.20 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $160.10 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, FIRST 1,000SF, PC 1101-0000-42600 1 0 $52.83 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $251.35 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT>7KSF 101-0000-42408 0 $40.02 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT>7KSF PC 101-0000-42600 0 $200.12 Total Paid for GRADING: $240.14 DESCRIPTION ACCOUNT CITY AMOUNT AIR HANDLER 101-0000-42402 0 $280.14 DESCRIPTION ACCOUNT CITY AMOUNT AIR HANDLER PC 101-0000-42600 0 $93.38 DESCRIPTION ACCOUNT CITY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 0 $120.06 DESCRIPTION ACCOUNT CITY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 0 $80.04 DESCRIPTION ACCOUNT CITY AMOUNT EXHAUST HOOD 101-0000-42402 0 $13.34 DESCRIPTION ACCOUNT CITY AMOUNT EXHAUST HOOD PC 101-0000-42600 0 $5.34 DESCRIPTION ACCOUNT CITY AMOUNT VENT FAN 101-0000-42402 0 $80.04 DESCRIPTION ACCOUNT CITY AMOUNT VENT FAN PC 101-0000-42600 0 $32.04 Total Paid for MECHANICAL: $704.38 DESCRIPTION ACCOUNT CITY AMOUNT MULTI -SPECIES RESIDENTIAL 0-8 UNITS - 2019 UPDATE 101-0000-20310 0 $1,331.00 Total Paid for MULTI -SPECIES RESIDENTIAL: $1,331.00 DESCRIPTION ACCOUNT CITY AMOUNT NEW CONSTRUCTION PERMIT 101-0000-42400 0 $607.26 Total Paid for NEW CONSTRUCTION PERMIT: $607.26 DESCRIPTION ACCOUNT CITY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,244.43 Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,244.43 DESCRIPTION ACCOUNT CITY AMOUNT PLAN CHECK DEPOSIT- RESIDENTIAL 101-0000-42600 1 $750.00 Total Paid for PLAN CHECK DEPOSIT - RESIDENTIAL: $750.00 DESCRIPTION ACCOUNT CITY AMOUNT BUILDING SEWER 101-0000-42401 0 $26.68 DESCRIPTION ACCOUNT CITY AMOUNT BUILDING SEWER PC 101-0000-42600 0 $18.68 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $240.12 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $240.12 DESCRIPTION ACCOUNT CITY AMOUNT GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $13.34 DESCRIPTION ACCOUNT CITY AMOUNT GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $26.68 DESCRIPTION ACCOUNT CITY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $13.34 DESCRIPTION ACCOUNT CITY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $8.00 DESCRIPTION ACCOUNT CITY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $13.34 DESCRIPTION ACCOUNT CITY AMOUNT WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $13.34 Total Paid for PLUMBING FEES: $613.64 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 SMI - RESIDENTIAL 101-0000-20308 0 $20.80 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $20.80 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 DESCRIPTION ACCOUNT CITY AMOUNT 101-0000-42600 ($750.00) DESCRIPTION ACCOUNT CITY AMOUNT SINGLE FAMILY DETACHED 2018 UPDATE 224-0000-20320 0 $1,560.00 DESCRIPTION ACCOUNT CITY AMOUNT SINGLE FAMILY DETACHED 2018 UPDATE 224-0000-20320 0 $750.00 Total Paid for TUMF - RESIDENTIAL: $1,560.00 ta (Qa � ( hl iFORNI_t---- Project Address:+/ APN #: Applicant Name: D®,� S Address:? _6 s �►a��,. f�,. G City, ST, Zip: I /�cSGA LZc Telephone: Email: �L,� `i �-J�o vim, �.�•, Property Owner's Name: , Address: C. )c,a it City, ST, Zip � �� _ Telephone: Email: Project Description: M1 , � a Valuation of Project $ 3 G)E�,, cL� New Commercial / Tenant Improvements: Total Building SF c Construction Type: Occupancy: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 OFFICE USE ONLY --F# Submittal Required 1 Received Plan Sets Structural Calcs Truss Calcs Title 24 Calcs Soils Report Grading Plan (PM10) Landscape Plan Subcontractor List Grant Deed HOA Approval School Fees Burrtec Debris Plan Planning approval Public Works approval Fire approval City Business License CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road wer:Ni,,Q�n MA'r` Y1y_]iAl1 NELii� Date: 9/18/2019 La Quinta, CA 92253 a ^C ld OK FRT� 3 L' RLJH+k'ILtA Y 1. A�' No.: 19-01472-1 (760)771-8515 % 41'iti y�V Owner: David and Annette Smith Email: Address: 54-080 Avenida Obregon Jurisdiction: La Quinta City: La Quinta Tract #: Type: Single Family Residential Lot # Street No. Street Name Sq. Feet APN Permit No. 54-080 Avenida Obregon 2452 774-204-028 Comments: RECEIVED OCT 2 4 2019 CITY OF LA QUINTA DESIGN AND DEVELOPMENT DEPARTMENT At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking eating, or sanitation) or replacement mobile homes. It has been determined that the above -named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility Tess imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $3.79 X 2452 S.F. or $9,293.08 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in the proposed project may now be issued. Fees Paid By: CC ar o n Basilio Check No.: 7234705174 Bank Name/Recipient of Certificate Telephone: Funding: Residential By Scott L. Bailey Superintendent Fee Collected/ Exempted by: Arianne Catano Certificate Fees Due: $9,293.08 Original Payment(s) Rec'd: $0.00 New Payment Rec'd: $9,293.08 Over/Under: $0.00 NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90-day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. Notice to Building Department: THIS DOCUMENT VALID ONLY IF IMPRINTED WITH EMBOSSED SEAL. Water Quality Management Plan (WQMP) Exemption Form - Whitewater River Region Documentation of Project Not Requiring a WQMP but Requiring Site Desi n BMPs and Source Control BMPs by Entitlement Conditions of Approval or Permit Conditions — WQMP Required for the Listed Change of Land Uses or for Changes of Pollutant Stream (All Questions Below Must be Answered "No" To Exempt Project) y Yes No Entitlement or construction of new single-family hillside residence(s) that create 10,000 square feet, or more, of impervious area where the pre -development natural slope is 25% orgreater? Entitlement or construction of new single-family hillside residence(s) that create 10,000 square feet, or more, of impervious area where the pre -development natural slope is 10% or greater Y where erosive soil conditions are known? Entitlement or construction of new commercial and industrial development(s) of 100,000 square y� feet or _more? Entitlement or construction of new automotive repair shop(s) including body, upholstery, paint, exhaust, tire, transmission, engine or other automotive specialty repair. [Standard Industrial Classification (SIC) codes 5013, 7532, 7533, 7534, 7537, 7538. and 75391? Entitlement or construction of new retail gasoline outlet(s) disturbing greater than 5,000 square feet? _ Entitlement or construction of new restaurant(s) (or potential restaurant shell space) disturbing greater than 5,000 square feet? }( Entitlement or construction of new home subdivision(s) with 10 or more housing units? Entitlement or construction of new parking lot(s) of 5,000 square feet or more, or with 25 or more parking spaces, and potentially exposed to Urban Runoff? Applicant Information Name and Title ! s • �(` Company C m Phone47 Email d . ✓a( L' �° O"T'l� Project Information Project Name p Type (SFH, Multi -Family, Commercial, Etc.) Location or Street Address — p g(> Nearest Cross Streets c Municipality/County/Zip Code La Quinta Tract Number(s) and/or Assessor Parcel Number(s) Other Location Information Watershed Whitewater River Source Control BMP Information Size of Project Area (nearest 0.1 acre) �t y?j GC Project Area managed with Site Design or Low Impact Development (LID) BMPs (nearest 0.1 acre) Is the project subject to onsite retention by City A I� ' ordinance or policy? Name of the Entity that will implement, operate, and maintain the Source Control BMPs Contact Name Street or Mailing Address City Zip Code Phone Check Item To be Performed Source Control BMP Requirements - All Projects Require Non -Structural BMP Source Control Non -Structural BMP (See Appendix H, Section 4.5.2.1) LOngoing Irrigation System and Landscape Maintenance Ongoing Litter Control Ongoing Drainage System Inspection & Maintenance �J Education/Training for Property Owner, Operators, Occupants, or Employees / Activity Restrictions — Prohibition of Debris Blowing/Sweeping/Washing into Street/Storm Drain, V Closed Trash Lids, Restriction of Vehicle Washing Ongoing Street Sweeping at Private Streets and Private Parking Lots Check Item Source Control BMP Requirements — Small Sloped Lots, Small Commercial, < 10 Unit To be Subdivisions, <5,000 Square Ft. Parking Lots, Etc. Provided Structural BMP (See Appendix H, Section 4.5.2.2) Storm Drain Inlet Stenciling and Signage Landscape and Irrigation System Design to Minimize Erosion & Nuisance Runoff Protection of Slopes and Channels to Minimize Erosion Multi -Family Project Use of Community Car Wash Racks Wash Water Controls for Food Preparation Areas to Use Sanitary Sewer Fueling Area (Design & Maintenance) Including PCC Surface, Canopy & Spill Prevention Air/Water Supply Area Drainage (Design & Maintenance) Including Spill Area Containment Trash Storage Areas (Design & Maintenance) Including Attached Lids, Storm Water Controls Loading Docks (Design & Maintenance) Including Storm Water Controls, Dry & Frequent Cleaning Procedures Maintenance Bays (Design & Maintenance) Including Indoor Location & Storm Water Containment Vehicle and Equipment Wash Areas (Design & Maintenance) Including Canopy & Containment Outdoor Material Storage Areas (Design & Maintenance) Including Canopy & Containment Outdoor Work Areas or Processing Areas (Design & Maintenance) Including Canopy & Containment CC&R's: Maintenance Agreements or Other mechanisms will be used to ensure the ongoing operation, maintenance, funding, transfer and implementation of the project -specific WQMP requirements. Legal description and plat stamped by Registered Surveyor to be attached to the applicable CC&R or Maintenance Agreement for recordation at Riverside County. (Optional Requirement to be reviewed on a Project by Project basis) BMP Acknowledgement The applicant shall comply with listed BMPs and applicable provisions of the City's NPDES stormwater discharge permit, LQMC Sections 8.70.010 et seq. (Stormwater Management and Discharge Controls), and 13.24.170 (Clean Air/Clean Water); Riverside County Ordinance No. 457; the California Regional Water Quality Control Board — Colorado River Basin Region Board Order No. R7-2008-0001 and the State Water Resources Control Board's Order No. 99-08-DWQ. Signature: Print Name: C9 Sj J Title. Date: Phone: (7G0) Applicant Certification I certify that I have read this form in its entirety and understand the City's submittal and review process and the { Signature: -- k;PC requirements for this form. I understand and agree that if during the processing of the form, it is determined the I Print Name:f information contains errors or omissions, clarification and/or i supplemental information may be required and the i Title: preparation of such information may be considered, in the Community Development Director's judgment, an S Date: unreasonable delay and will result in a suspension of processing time limits in accordance with the California Code Phone: ( '766) of Regulations, Title 14, Section 15109. ---- i _ Owner Certification certify under the penalty of the laws of the State of California that I am the property owner of the property that Signature: is the subject matter of this application and I am authorizing and hereby do consent to the filling of this application and Print Name: acknowledge that the final approval by the City of La Quinta, if any, may result in restriction, limitations and construction Title: obligations being imposed on this real property. Date: / Phone: ( road Tr," fovr an OoTsfary j,-Wj tse C'tv'% uApe"TA: *rmj tfav,.*VV n,4r,C44% tqmeqxv* W'd Ar�i $01 go "Im %,t. w 'v(" I w .'r, t i %I Ic M I r the ttve TW A U 0 4n Dow kmal #n w J."%-* wtih Of 4, soctkofA I S 10 Owroc C40mc-atiov IN, t__, 1 Pro t7ll "t, I s % r 14 ;1ja;A I t. tS L k 1, 1 V'-e 303 Plan Submittal Building Permit Number, jZES2pl -U Ig(Q Project Description: SFR Exempt: (Materials may contain hazardous wastes and are not subject to recycling provisions) Construction Debris Management Plan July 29. 2019 Job Site Address 54080 Avenida Obregon La Quinta ,CA 92253 Owner's Name David Smith Number, Street, or PO Box 54080 Avenida Obregon City, State, Postal Code La Quinta, CA 92253 Owner's Phone Number Owner's E-Mail Add Project Manager's N Project Manager's Phone Nur Project Manager's E-mail Add Builder I Contu Number, Street or PO City, State, Postal C Project Square Foo Bob Sipovac 760-567-2347 bob si ovac.rom Bob Sipovac 72-651 Theodora Ln. Palm Desert, CA 92260 5,672 Approval By Burrtec __ d Date of City Approval Materials To Be Discarded: Product Tons Trash 21.00 Not recyclable Product Tons Asphalt 0.00 Recyclable Masonry (broken) 0.00 Recyclable Brick/Block 0.00 Recyclable Plaster 7.00 Recyclable Cardboard 1.50 Recyclable Scrap Metal 0.00 Recyclable Commingled 0.00 Recyclable Tile (floor) 0.75 Recyclable Concrete 28.00 Recyclable Tile (roof) 0.75 Recyclable Drywall 3.00 Recyclable Wood 11.00 Recyclable Donated / Reuse" 0.00 Recyclable Landscape Debris L0.00 Recyclable "Describe Items Totals: Recycle Trash Projected Diversion: 52.0 21.0 71.23% 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 Plan (DMP) for the above named project shall guarantee that at least 65% of the jobsite waste is diverted from landfilling. The remaining material will be recycled or reused. I will divert, for recycling or re -use, 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 still issued in the name of the property owner(s) and the owner retains legal responsibility for ensuring that the provisions of the DMP are adhered to. The property owner(s) and general contractor shall be kept informed of the diversion progress through bi-monthly reports. If self -hauling, all refuse material from this project site must be taken to an approved recycler or transfer station, Owner / Developer) Project Manager I Superintendant Date COACHELLA VALLEY WATER DISTRICT OIS7�1G� P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date:10122/2019 SUBJECT: SANTA CARMELITA, 54080 AVENIDA OBREGON, LA QUINTA, LOT 2, LID 518158 DAVID SMITH Project: 19-10412 2169 WESTWOOD LN Project Date: 10/4/2019 Amount Due: $14,968.14 EUGENE, OR 97401 GEO: 06-06-13-2 Planner: SANDRA VILLALOBOS TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK SUBJECT: SANTA CARMELITA, 54080 AVENIDA OBREGON, LA QUINTA, LOT 2, LID 518158 COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Page CETIfICAi?7E OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CFI R-PRF-01 Project Name: Residential Building Calculation Description: Title 24 Analysis Calculation Date/Time: 11:11, Fri, Aug 09, 2019 Input File Name: David Smith.dbdl6x Page 1 of 8 GENERAL INFORMATION 01 Project Name Residential Building 02 Calculation Description Title 24 Analysis 03 Project Location 54080 Avenida Obregon 04 City La Quinta Ca 05 Standards Version Compliance 2017 06 Zip Code 92253 07 Compliance Manager Version BEMCmpMgr2016.3.1 (1149) 08 Climate Zone CZ15 09 Software Version EnergyPro 7.2 10 Building Type Single Family 11 Front Orientation (deg/Cardinal) 90 12 Project Scope Newly Constructed 13 Number of Dwelling Units 1n 14 Total Cond. Floor Area (ft2) 2452 is Number of Zones 2- 16 Slab Area (ft2) 2452 17 Number of Stories 1 18 Addition Cond. Floor Area(ft2) n/a 19 Natural Gas Available Yes 20 Addition Slab Area (ft2) n/a 21 Glazing Percentage (%) 23.8% COMPLIANCE RESULTS II 01 Building Complies with Computer Performance 02 This building Incorporates features that require field testing and/or verification by a certified HERS rater under the supervision of a CEC-ap HERS provider. c 03 This building Incorporates one or more Special Features shown below I ENERGY USE SUMMARY 04 05 06 07 08 Energy Use (kTDV/ft2-yr) Standard Design Proposed Design Compliance Margin Percent Improvement Space Heating 1.49 1.69 -0.20 -13.4% Space Cooling 101.20 92.99 8.21 8.1 % IAQ Ventilation 1.59 1.59 0.00 0.0% Water Heating 6.68 5.90 0.78 11.7% Photovoltaic Offset --- 0.00 0.00 Compliance Energy Total 110.96 102.17 79 7. ° Registration Number: 219-Po10177326A-000-000-0000000-0000 CA Building Energy Efficiency Standards - 2016 Residential Compliance •`.tJLI V L.LI ir-, n o nn4n/5L iN T ERVV OONSUI Registration Datefrime: 2019-08-09 11:26:45 Report Version - CF1 R-01162019-1149 AUG 21 2019 CM OF LA QUINTA DESIGN AND DE"JELQPMENT DEPARTMENT K HERS Provider: CaICERYS 40t Report Generated at: 2019-08-09 11:13:08 i)p CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Residential Building Calculation Date/Time: 11:11, Fri, Aug 09, 2019 CFI R-PRF-01 Page 2 of 8 Calculation Description: Title 24 Analysis Input File Name: David Smith.ribd16x ENERGY DESIGN RATING Energy Design Rating (EDR) is an alternate way to express the energy performance of a building using a scoring system where 100 represents the energy performance of the Residential Energy Services (RESNET) reference home characterization of the 2006 International Energy Conservation Code (IECC) with California modeling assumptions. A score of zero represents the energy performance of a building that combines high levels of energy efficiency with renewable generation to"zero out' its TDV energy. Because EDR includes consideration of components not regulated by Title 24, Part 6 (such as domestic appliances and consumer electronics), it is not used to show compliance with Part 6 but may instead be used by local jurisdictions pursuing local ordinances under Title 24, Part 11 (CALGreen). As a Standard Design building under the 2016 Building Energy Efficiency Standards is significantly more efficient than the baseline EDR building, the EDR of the Standard Design building Is provided for Information. Similarly, the EDR score of the Proposed Design is provided separately from the EDR value of installed PV so that the effects of efficiency and renewable energy can both be seen EDR of Standard Efficiency EDR of Proposed Efficiency EDR Value of Proposed PV + Battery Final Proposed EDR 57.2 54.0 0.0 54.0 ❑ Design meets Tier 1 requirement of I S% or greater code compliance margin (CALGreen A4.203.1.2.1) and QII verification prerequisite. ❑ Design meets Tier 2 requirement of 30% or greater code compliance margin (CALGreen A4.203.1.2.2) and QII verification prerequisite. ❑ Design meets Zero Net Energy (ZNE) Design Designation requirement for Single Family in climate zone CZ15 (CALGreen A4.203.1.2.3) including on -site photovoltaic (PV) renewable energy generation sufficient to achieve a Final Energy Design Rating (EDR) of zero or less. The PV System and QII must be verified. Notes: • Excess PV Generation EDR Credit: Bypassing PV size limit may violate Net Energy Metering (NEM) rules REQUIRED SPECIAL FEATURES The following are features that must be installed as condition for meeting the modeled energy performance forthis computer analysis. • Ceiling has high level of insulation • Window overhangs and/or fins • Northwest Energy Efficiency Alliance (NEEA) rated heat pump water heater; specific brandimodel, or equivalent, must be installed HERS FEATURE SUMMARY The following is a summary of the features that must be field -verified by a certified HERS Rater as a condition for meeting the modeled energy performance for this computer analysis. Additional detail is provided in the building components tables below. Building -level Verifications: • IAQ mechanical ventilation • High R-value Spray Foam Insulation Cooling System Verifications: • Verified Refrigerant Charge HVAC Distribution System Verifications: • ..None -- Domestic Hot Water System Verifications: • ..None -- BUILDING - FEATURES INFORMATION 01 02 03 04 05 06 07 Project Name Conditioned Floor Area (ft2) Number of Dwelling Units Number of Bedrooms Number of Zones Number of Ventilation Cooling Systems Number of Water Heating Systems Residential Building 2452 1 7 2 0 1 Registration Number: 219-P010177326A-000-000-0000000-0000 Registration Date/Time: 2019-06-09 11:26:45 HERS Provider: CaICERTS ino CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version - CF1 R-01162019-1149 Report Generated at: 2019-08-09 11:13:08 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Residential Building Calculation Date/Time: 11:11, Fri, Aug 09, 2019 CFI R-PRF-01 Page 3 of 8 Calculation Description: Title 24 Analysis Input File Name: David Smith.ribd16x ZONE INFORMATION 01 02 03 04 05 06 07 Zone Name Zone Type HVAC System Name Zone Floor Area (ftz) Avg. Ceiling Height Water Heating System 1 Water Heating System 2 Zone 1 Conditioned HVAC Systeml 1851 10 DHW Sys 1 n/a Zone 2 Conditioned HVAC Systeml 601 10 DHW Sys 1 n/a OPAQUE SURFACES 01 02 03 04 05 06 07 08 Name Zone Construction Azimuth Orientation Gross Area (ft2) Window & Door Area (ftz) Tilt (deg) Front Wall Zone 1 R-21 Wall 270 Back 470 205 90 Left Wall Zone 1 R-21 Wall 0 Right 270 24 90 Rear Wall Zone 1 R-21 Wall 90 Front 466 31.004 90 Right Wall Zone 1 R-21 Wall 180 Left 526 170.5 90 Roof Zone 1 R-38 Roof Attic n/a n/a 1851 n/a n/a Rear Wall 2 Zone 2 R-21 Wall 90 Front 346 95.024 90 Right Wall 2 Zone 2 R-21 Wall 180 Left 240 78 90 Left Wall 2 Zone 2 R-21 Wall 0 Right 240 0 90 Front Wall 2 Zone 2 R-21 Wall 270 Back 350 25 90 Roof 2 Zone 2 R-38 Roof Attic n/a n/a 601 n/a n/a ATTIC 01 02 03 04 05 06 07 08 Name Construction Type Roof Rise Roof Reflectance Roof Emittance Radiant Barrier Cool Roof Attic Zone 1 Attic RoofZone 1 Unventilated 4 0.1 0.85 Yes No Attic Zone 2 Attic RoofZone 2 Unventilated 0 0.1 0.85 Yes No Registration Number: 219-P010177326A-000-000-0000000-0000 Registration Date/Time: 2019-08-09 11:26:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version - CF1 R-01162019-1149 Report Generated at: 2019-08-09 11:13:08 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Residential Building Calculation Date/Time: 11:11, Fri, Aug 09, 2019 CFI R-PRF-01 Page 4 of 8 Calculation Description: Title 24 Analysis Input File Name: David Smith.ribd16x FENESTRATION I GLAZING 01 02 03 04 05 06 07 08 09 10 Name Type Surface (Orientation -Azimuth) Width (ft) Height (ft) Multiplier Area (ft2) U-factor SHGC Exterior Shading Window 1 Window Front Wall (Back-270) 16.0 6.5 1 104.0 0.32 0.25 Insect Screen (default) Window 1 a Window Front Wall (Back-270) 16.0 2.0 1 32.0 0.32 0.25 Insect Screen (default) Slider L Window Front Wall (Back-270) 6.0 8.0 1 48.0 0.32 0.25 Insect Screen (default) Window 6 Window Rear Wall (Front-90) 4.0 6.0 0.521 12.5 0.32 0.25 Insect Screen (default) Window 7 Window Rear Wall (Front-90) --- ---- 1 12.5 0.32 0.25 Insect Screen (default) Window 8 Window Rear Wall (Front-90) ---- ---- 1 6.0 0.32 0.25 Insect Screen (default) Window 2 Window Right Wall (Left-180) ---- ---- 1 45.5 0.32 0.25 Insect Screen (default) Window 2a Window Right Wall (Left-180) ---- --- 1 14.0 0.32 0.25 Insect Screen (default) Window 3 Window Right Wall (Left-180) --- ---- 1 12.5 0.32 0.25 Insect Screen (default) Window 4 Window Right Wall (Left-180) ---- ---- 1 12.5 0.32 0.25 Insect Screen (default) Window 5 Window Right Wall (Left-180) ---- ---- 1 6.0 0.32 0.25 Insect Screen (default) Slider E Window Right Wall (Left-1 W) 10.0 8.0 1 80.0 0.32 0.25 Insect Screen (default) Window 12 Window Rear Wall 2 (Front-90) ---- ---- 1 15.0 0.32 0.25 Insect Screen (default) Slider O Window Rear Wall 2 (Front-90) 8.0 8.0 1.016 65.0 0.32 0.25 Insect Screen (default) Window 9 Window Rear Wall 2 (Front-90) 3.0 5.0 1 15.0 0.32 0.25 Insect Screen (default) Window 10 Window Right Wall 2 (Left-180) ---- ---- 1 15.0 0.32 0.25 Insect Screen (default) Window 11 Window Right Wall 2 (Left-180) --- ---- 1 15.0 0.32 0.25 Insect Screen (default) Slider S Window Right Wall 2 (Left-180) 6.0 8.0 1 48.0 0.32 0.25 Insect Screen (default) Window 13 Window Front Wall 2 (Back-270) 5.0 5.0 1 25.0 0.32 0.25 Insect Screen (default) OPAQUE DOORS 01 02 03 04 Name Side of Building Area W) U-factor Door Front Wall 21.0 0.50 Door 2 Left Wall 24.0 0.50 Registration Number: 219-P010177326A-000-000-0000000-0000 Registration Datefrime: 2019-08-09 11:26:45 HERS Provider: CaICERTS inc CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version - CF1 R-01162019-1149 Report Generated at: 2019-08-09 11:13:08 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Residential Building Calculation Daterrime: 11:11, Fri, Aug 09, 2019 CF1 R-PRF-01 Page 5 of 8 Calculation Description: Title 24 Analysis Input File Name: David Smith.ribdl6x OVERHANGS AND FINS 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Overhang Left Fin Right Fin Window Depth Dist Up Left Extent Right Extent Flap Ht. Depth Top Up Dist L Bat Up Depth Top Up Dist R Bat Up Window 1 2 0.1 2 2 0 0 0 0 0 0 0 0 0 Window 1 a 2 0.1 2 2 0 0 0 0 0 0 0 0 0 Slider L 10 0.1 10 10 0 0 0 0 0 0 0 0 0 Window 6 8 0.1 8 8 0 0 0 0 0 0 0 0 0 Slider E 10 0.1 10 10 0 0 0 0 0 0 0 0 0 Slider 0 6 0.1 6 6 0 0 0 0 0 0 0 0 0 Window 9 6 0.1 6 6 0 0 0 0 0 0 0 0 0 Slider S 10 0.1 10 10 0 0 0 0 0 0 0 0 0 Window 13 4 0.1 4 4 0 0 0 0 0 0 0 0 0 OPAQUE SURFACE CONSTRUCTIONS 01 02 03 04 05 06 07 Total Cavity Winter Design Construction Name Surface Type Construction Type Framing R-value U-factor Assembly Layers • Under Roof Joists: R-37.0 insul. • Cavity/Frame: R-13.0/2x4 Top Chrd • Roof Deck: Wood Siding/sheathing/decking 2x4 Top Chord of Roof Truss @ 24 • Above Deck Insulation: R2.5 Sheathing Attic RoofZone 1 Attic Roofs Wood Framed Ceiling in. O.C. R 50 0.019 • Roofing: 15 PSF (Heavy Ballast or Pavers) • Inside Finish: Gypsum Board • Cavity/Frame: R-21 /2x6 R-21 Wall Exterior Walls Wood Framed Wall 2x6 @ 16 in. O.C. R 21 0.069 • Exterior Finish: 3 Coat Stucco • Inside Finish: Gypsum Board Ceilings (below • Cavity/Frame: R-9.1 /2x4 R-38 Roof Attic attic) Wood Framed Ceiling 2x4 @ 24 in. O.C. R 52 0.019 - Over Ceiling Joists: R-42.9 insul. • Under Roof Joists: R-37.0 insul. • Cavity/Frame: R-13.0/2x4 Top Chrd • Roof Deck., Wood Siding/sheathing/decking 2x4 Top Chord of Roof Truss @ 24 • Above Deck Insulation: R2.5 Sheathing Attic RoofZone 2 Attic Roofs Wood Framed Ceiling in. O.C. R 50 0.019 • Roofing: 15 PSF (Heavy Ballast or Pavers) Registration Number: 219-PO10177326A-000-000-0000000-0000 Registration Datelrime: 2019-08-09 11:26:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version - CF1 R-01162019-1149 Report Generated at: 2019-08-09 11:13:08 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Residential Building Calculation Date/Time: 11:11, Fri, Aug 09, 2019 Calculation Description: Title 24 Analysis Input File Name: David Smith.ribdl6x CF1 R-PRF-01 Page 6 of 8 SLAB FLOORS 01 02 03 04 05 06 07 Name Zone Area (ftZ) Perimeter (ft) Edge Insul. R-value & Depth Carpeted Fraction Heated Slab Zone 1851 196 None 1 No Slab -on -Grade Zone 2 601 0.1 None 0.8 No BUILDING ENVELOPE - HERS VERIFICATION 01 02 03 04 Quality Insulation Installation (QII) Quality Installation of Spray Foam Insulation Building Envelope Air Leakage CFM50 Not Required Required Not Required n/a WATER HEATING SYSTEMS 01 02 03 04 05 06 Name System Type Distribution Type Water Heater Number of Heaters Solar Fraction (°�) DHW Sys 1 DHW Standard DHW Heater 1 (1) 1 .0% WATER HEATERS 01 02 03 04 05 06 07 08 09 10 11 12 Name Heater Element Type Tank Type Number of Units Tank Volume (gal) Uniform Energy Factor / Energy Factor / Efficiency Input Rating I Pilot I Thermal Efficiency Tank Insulation R-value (Int/Ext) Standby Loss / Recovery Eff First Hour Rating / Flow Rate NEEA Heat Pump Brand / Model I Other Tank Location or Ambient Condition DHW Heater 1 Heat Pump n/a 1 83 NEEA Rated n/a R-0/11-0 n/a Sanden / GS3-45HPA-US & SAN-83SSAQA (83 gal) Outside or Exterior closet SPACE CONDITIONING SYSTEMS 01 02 03 04 05 06 SC Sys Name System Type Heating Unit Name Cooling Unit Name Fan Name Distribution Name HVAC Systeml Heat Pump Heating and Cooling System Heat Pump System 1 Heat Pump System 1 None - none - Registration Number: 219-Po10177326A-000-000-0000000-0000 Registration Date/Time: 2019-08-09 11:26:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version - CF1 R-01162019-1149 Report Generated at: 2019-08-09 11:13:08 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Residential Building Calculation Description: Title 24 Analysis Calculation Date/Time: 11:11, Fri, Aug 09, 2019 Input File Name: David Smith.ribd16x CF1 R-PRF-01 Page 7 of 8 HVAC - HEAT PUMPS 01 02 03 04 05 06 07 06 09 10 11 Name System Type Number of Units Heating Cooling Zonally Controlled Compressor Type HERS Verification HSPF/COP Cap 47 Cap 17 SEER I EER Heat Pump System 1 DuctlessMiniSplitHeatPump 4 9.5 47500 43000 18 13 Not Zonal Single Speed Heat Pump System 1-hers-cool HVAC COOLING - HERS VERIFICATION 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 n/a Not Required Not Required Required IAQ (Indoor Air Quality) FANS 01 02 03 04 05 06 Dwelling Unit IAQ CFM IAQ Watts/CFM IAQ Fan Type IAQ Recovery Effectiveness(%) HERS Verification SFam IAQVentRpt 85 0.25 1 0 Required F R S R R 0 V I E R Registration Number: 219-P010177326A-000-000-0000000-0000 Registration Date/Time: 2019-08-09 11:26:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version - CF1 R-01162019-1149 Report Generated at: 2019-08-09 11:13:08 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Residential Building Calculation Date/Time: 11:11, Fri, Aug 09, 2019 CF1 R-PRF-01 Page 8 of 8 Calculation Description: Title 24 Analysis Input File Name: David Smith.ribdl6x DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Bob Sipovac Company: Signature Date: SIPOVAC CONSTRUCTION INC 2019-08-09 11:26:45 Address: CEA/HERS Certification Identification (If applicable): 72651 THEODORA LANE 080919 City/State/Zip: Phone: PALM DESERT, CA 92260 760-567-2347 X123 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. I am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. 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. 3. 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. Responsible Designer Name: Responsible Designer Signature: Bob Sipovac Company: Date Signed: SIPOVAC CONSTRUCTION INC ` r 2019-08-09 11:26:45 Address: License: 72651 THEODORA LANE 581636 City/State/Zip: Phone: PALM DESERT, CA 92260 760-567-2347 X123 Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider responsibility for the accuracy of the information. Easy to Verify at CaICERTS.com Registration Number: 219-P010177326A-000-000-0000000-0000 Registration Date/Time: 2019-08-09 11:26:45 CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version - CF1 R-01162019-1149 HERS Provider: CaICERTS inc. Report Generated at: 2019-08-09 11:13:08