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BRES2019-032278-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: JOSEPH ELKINS 54485 AVENIDA MARTINEZ LA QUINTA, CA 92253 T4'!t 4 �P Q" DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT BUILDING RESIDENTIAL/ADDITION BRES2019-0322 54485 AVENIDA MARTINEZ 774253028 ELKINS / 440SF POOL HOUSE ADDITION $40,000.00 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/3/2019 Owner: RAMONA L. & JOSEPH A. ELKINS 54485 AVENIDA MARTINEZ LA QUINTA, CA 92253 D!� � 0D Contractor: OWNER BUILDER 54485 AVENIDA MARTINEZ LA QUINTA, CA 92253 DEC 0 3 2019 Llc. No.: CITY OF IA QUINTA --------------------------------- BESIGN&QEVELOP-MEWDEPARTMENT ---___-______-_______---_____-__--- 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, 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 [A he 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 ontractors' State License Law.). I am exempt under Sec. , B.&P.C. for this reason Date: lZ /-3 h Owner - CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Lender's 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. 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:_ Q& 1 certify that in the performance of the work for which this permit is issued, 1 shaffnaCemploy 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 SHALLSUBJECTAN 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 ofthis 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 orAgen . Date: 12/3/2019 Application Number: BRES2019-0322 Property Address: 54485 AVENIDA MARTINEZ APN: 774253028 Application Description: ELKINS / 440SF POOL HOUSE ADDITION Property Zoning: Application Valuation: $40,000.00 Applicant: JOSEPH ELKINS 54485 AVENIDA MARTINEZ LA QUINTA, CA 92253 Owner: RAMONA L. & JOSEPH A. ELKINS 54485 AVENIDA MARTINEZ LA QUINTA, CA 92253 Contractor: OWNER BUILDER 54485 AVENIDA MARTINEZ LA QUINTA, CA 92253 Llc. No.. Detail: 440 SF DETACHED POOL HOUSE [COLEMAN ENGINEERING]. THIS PERMIT DOES NOT INCLUDE POOL/SPA, PV SYSTEM, SITE WALLS, OR FIRE/WATER FEATURES. 2016 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, EA ADDITIONAL 500 SF 101-0000-42400 0 $68.84 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $19.21 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, FIRST 100 SF 101-0000-42400 0 $134.48 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, FIRST 100 SF PC 101-0000-42600 0 $188.92 Total Paid for ADDITION 2018: $411.45 DESCRIPTION ACCOUNT CITY AMOUNT 101-0000-42600 ($112.60) DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - ESGIL STRUCTURAL ENGINEER 101-0000-42600 0 $67.40 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - ESGIL STRUCTURAL ENGINEER 101-0000-42600 1.5 $112.60 Total Paid for BLDG CITY STAFF - PER HOUR: $67.40 DESCRIPTION ACCOUNT QTY AMOUNT 101-0000-42600 ($2.00) DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $2.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $0.00 DESCRIPTION ACCOUNT QTY AMOUNT Credit Card Fee 101-0000-43505 0 $2.25 Total Paid for Credit Card Fee: $2.25 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $26.68 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $26.68 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES/FIXTURES, ADDITIONAL 101-0000-42403 0 $77.43 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES/FIXTURES, ADDITIONAL PC 101-0000-42600 0 $19.43 DESCRIPTION ACCOUNT QTY AMOUNT OTHER ELECTRICAL EQUIPMENT 101-0000-42403 0 $26.68 DESCRIPTION ACCOUNT QTY AMOUNT OTHER ELECTRICAL EQUIPMENT PC 101-0000-42600 0 $26.68 Total Paid for ELECTRICAL 2018: $203.58 DESCRIPTION ACCOUNT QTY AMOUNT AIR HANDLER 101-0000-42402 0 $40.02 DESCRIPTION ACCOUNT QTY AMOUNT AIR HANDLER PC 101-0000-42600 0 $13.34 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 VENT FAN 101-0000-42402 0 $13.34 DESCRIPTION ACCOUNT CITY AMOUNT VENT FAN PC 101-0000-42600 0 $5.34 Total Paid for MECHANICAL 2018: $138.74 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 CITY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $53.36 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $53.36 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 Total Paid for PLUMBING 2018: $168.08 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 ($5.20) DESCRIPTION ACCOUNT CITY AMOUNT 101-0000-42600 ($5.20) DESCRIPTION ACCOUNT CITY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $5.20 DESCRIPTION ACCOUNT CITY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $5.20 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.00 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 DESCRIPTION I ACCOUNT I CITY AMOUNT AL T ERATIONS/ADDITIONS - RESIDENTIAL 101-0000-42400 Total Paid for ZONING CLEARANCE - PLANNING PLAN CHECK: $81.00 $81.00 ta Qa' tra CALIFORNIA PERMIT # �R�SZ0tq - 0322 PLAN LOCATION: 4 (J Project Address: Project Description: APN #: / Applicant Name: -[ Address: r 1�L �c� P City, ST, Zip: i� �� 411 Telephone: f Email: J� Uri f� C� Project Valuation $_ 066 Contractor Name: ne,� �� New 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: ,�c Construction Occupancy: Address: K U a �C9zvL Grading: city, st, Zi 0 Telephone: `� " _—" Bedrooms: Stories: # Units: Email: S✓�� c r✓ �'S ` �✓,�•c State Lic: City Bus Lic: Property Owner's Name��ceL� New Commercial / Tenant Improvements: Add ress:�9r-]Kc,- Total Building SF City, ST, Zip] �} `Z 2 "�7j Construction Type: Occupancy: Telephone: `� ! ' Email: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 OFFICE USE ONLY # Submittal Required Received Plan Sets Structural Caics Truss Caics Title 24 Calcs CVWD Fire Flow Letter 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 Date: 11/13/2019 No.: 19-01535-1 Owner: Joseph/Ramona Elkins Address: 54485 Avenida Martinez City: La Quinta Type: Residential Addition < 500 Sq ft Lot # Street No. 54485 Comments: CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760)771-8515 Street Name Avenida Martinez y� r 2 �6 H EVE R1.[UUh tlIINE:� EI Ak N Uj ti u�n LA WrA D. w ?'3 Email: Jurisdiction: La Quinta Tract #: Sq. Feet APN 440 774-253-028 Permit No. 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: Residential Addition 500 Sq Feet or Less Exempt This certifies that school facility fess imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.00 X 440 S.F. or $0.00 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: EXrMpt /Joe Elkins Check No.: Bank Name/Recipient of Certificate Telephone: 760-250-8701 Funding: Exempt By Scott L. Bailey Superintendent Fee Collected/ Exempted by: Rodney Slagle Certificate Fees Due: $0.00 Original Payment(s) Rec'd: $0.00 { New Payment Rec'd: $0.00 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. Building Permit Number: Project Description: 1 p EFR / Exempt:❑ _ (Materials may contain hazardous wastes and y 0, are not subject to recycling provisions) Construction Debris Management Plan Plan Submittal Date UQ66f#!� l0/�6 /� I Job Site Address 54485 Avendia MFetiftex L.Q ChA ,crr ; -& e- -Z_ Owner's Name Number, Street, or PO Box City, State, Postal Code Owner's Phone Number Owner's E-Mail Address Project Manager's Project Manager's Phone N Project Manager's E-mail A Joseph &Ramona Elkins 77810 Calle Temeculs La Quinta CA 92253 Joseph Elkins Same Builder / Contractor Ownwe Builder Number, Street or PO City, State, Postal C Project Square Footagel 430 Approval By Burrtec k_,4` Date of City Approval Materials To Be Discarded Product Trash Asphalt Brick/Block Cardboard Commingled Concrete Drywall Donated / Reuse* *Describe Items Tons 1.50 Not recyclable 0.00 Recyclable 0.0E Recyclable 0.10 Recyclable 0.00 Recyclable 2.00 Recyclable 0.25 Recyclable 0.00 Recyclable Totals: Recycle Trash 3.8 1.5 RECEIVED NOV 12 2019 CITY OF LA QUINTA DESIGN AND DEVELOPMENT DEPARTMENT Product Masonry (broken) Plaster Scrap Metal Tile (floor) Tile (roof? Wood Landscape Debris Tons EO.'50 0 Recyclable Recyclable 0.00 Recyclable 0.05 Recyclable 0.06 Recyclable 0.80 Recyclable 0.00 Recvctahle Projected Diversion: 71.48 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 orooerty owner(s) and general contractor shall be kept informed of the diversion progress through bi-monthly Owner I Developer I Project Manager / Superintendant Date T4ht 4 4 Q" 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 qame listing yourself as the builder of the property improvements specified at _ 5 t S— JQ v c n t a c_ 4� 1 _y'� ►, h [� C Z 2 5--3 We are providing you with an Owner -Builder Acknowledgment and lnformah�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 statement below to signify you understand or verify this information. �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. 1A 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. 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. ,;�Z!t4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 4te_5. 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, ,::5� 6. 1 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. . 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. 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. 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. 10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: 5;rl 11. 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 employers. —'—, 2. I 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 wish to 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 form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Signature of property owner t� _ _ 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 person(s) 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): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: Aj'ev��a" CITY OF LA QUINTA SUB -CONTRACTOR LIST JOB ADDRESS N V� PERMIT NUMBER AkrSaQl O �t,��, -. ,�.OWNER��0.S� � �(BUILDER � r►.�,� This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous {ac . Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. Trade 1 classification Contractor State Contractor's I it-s-ncz . EARTHWORK .(C:=12.) CONCRETE (C=8) FRAMING .(C=5) STRUCT. STEEL (C-51) MASONRY (C-29.) PLUMB.IN.G (C-36) LATH, PLASTER (C-3.5) DRYWALL (C-9). HVAC (:C-20). ELECTRICAL (C-10) ROOFING (C739) SHEET :METAL (C. 43) FLO.OR.ING i.C-15). GLAZING (0-17) INSULATION (C-2) SEWAGE DISP. {C-42) PAINTING (C-3:3) CERAMIC TILE: (C>54)1 CABINETS (C-6) KNCING (C-13) OLDS. CAP.I NG_.(C-27:). OL (C-53) Company Name Classification License Number Exp. (e.g. A, B, C-8) (X) I (xx/).j kt.e W ex_ K-e Y► O V c can g 0. I ( sC� QlCtFlo, A t t ()fk,((.P,-o' 0eLJr.,u,(( 14)t5.114- P�.(�-.s r61� L-�(_� L C�(,, 100 R M 9�a�� Workers Co.m ensati.on.Insurance Ply Business License )ate Carrier Name Policy Number Exp. Date License Number Exp. Date ./xx) (e.g. State Fund, CalComp) (Format Varies) (xx/xx/xx) (xxxx) (xx/xx/xx) -74 iUc 1 �� 7 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD AWIN 0 CF1R-PRF-01 Project Name: Elkins 440 s.f. Pool House Calculation Date/Time: 10:42, Sat, Aug 24, 2019 1N'Wd"1� ONY 1 of 6 Calculation Description: Title 24 Analysis Input File Name: 19-08-075.ribdl6x vwo r j4 �w IZ10 / 7 J710 GENERAL INFORMATION 01 Project Name Elkins 440 s.f. Pool House 02 Calculation Description Title 24 Analysis 03 Project Location 54-485 Avineda Martinez 04 City La Quinta CA 92253 05 Standards Version Compliance 2017 06 Zip Code 07 Compliance Manager Version BEMCmpMgr 2016.3.1 (1149) 08 Climate Zone CZ15 09 Software Version EnergyPro 7.2 10 12 Building Type Project Scope Single Family Newly Construct NITA F tit Orientation (deg/Cardinal) Number of Dwelling Units 90 1 14 Total Cond. Floor Area (ft2) 440 BUILPMUNumber of Zones 1 16 Slab Area (ft2) 440 Htvlrvv- Number of Stories 1 18 Addition Cond. Floor Area(ft2) n/a MEW AN 'PE Natural Gas Available Yes 170-1 Addition Slab Area (ft2) n/a 21 Glazing Percentage (%) 31.2% COMPLIANCE RESULTS gA 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-approved HERS provider. 03 This building incorporates one or more Special Features shown below ENERGY USE SUMMARY 04 05 06 07 08 Energy Use (kTDV/ft2-yr) Standard Design Proposed Design Compliance Margin Percent Improvement Space Heating 1.98 2.58 -0.60 -30.3% Space Cooling 149.14 165.09 -15.95 -10.7% IAQ Ventilation 2.03 2.03 0.00 0.0% Water Heating 19.79 17.84 1.95 9.9% Photovoltaic Offset — -28.19 28.19 ---- Compliance Energy Total 172.94 159.35 13.59 7.9% C'J 19 - 0 � 5 q q 6 �7 /9 V4�Al Registration Number: 219-P010186316A-000-000-0000000.0000 Registration Date/Time: 2019-08-24 10:58:02 HERS Provider: CaICERTS inc. 0*>.ICA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version - CF1 R-01162019-1149 Report Generated at: 2019-08-24 10:43:12 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1 R-PRF-01 Project Name: Elkins 440 s.f. Pool House Calculation Description: Title 24 Analysis Calculation Date/Time: 10:42, Sat, Aug 24, 2019 Input File Name: 19-08-075.ribd16x Page 2 of 6 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 53.5 56.5 34.9 21.6 ❑ Design meets Tier 1 requirement of 15% 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 ENERGY DESIGN RATING PV SYSTEM INPUTS - DETAILED DC System Size (kWdc) Module Type CFI Azimuth (deg) Tilt Input Array Angle (deg) Tilt: (x in 12) Inverter Eff. (%) 2 Standard ❑ 180 deg 22.0 4.8 96 • PV System offsets 62% of the total proposed design kTDV/ft-yr REQUIRED SPECIAL FEATURES The following are features that must be installed as condition for meeting the modeled energy performance for this computer analysis. • PV System: 2 kWdc • Cool roof • Window overhangs and/or fins 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: • High quality insulation installation (QII) • IAQ mechanical ventilation Cooling System Verifications: • — None -- HVAC Distribution System Verifications: • -- None -- Domestic Hot Water System Verifications: • --None -- Registration Number: 219-P010186316A-000-000-0000000-0000 Registration Date/Time: 2019-08-24 10:58:02 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2016 Residential Compliance ReportVersion - CF1 R-01162019-1149 Report Generated at: 2019-08-24 10:43:12 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Elkins 440 s.f. Pool House Calculation Date/Time: 10:42, Sat, Aug 24, 2019 CF1R-PRF-01 Page 3 of 6 Calculation Description: Title 24 Analysis Input File Name: 19-08-075.ribdl6x 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 Elkins 440 s.f. Pool House 440 1 0 1 0 1 ZONE INFORMATION 01 02 03 04 05 06 07 Zone Name Zone Type HVAC System Name Zone Floor Area (ft2) Avg. Ceiling Height Water Heating System 1 Water Heating System 2 1st Floor Zone Conditioned Res HVAC1 440 12 DHW Sys 1 n/a 7-71 OPAQUE SURFACES 01 02 03 04 05 06 07 08 Name Zone Construction Azimuth Orientation Gross Area (ft2) Window & Door Area (ft2) Tilt (deg) Front Wall 1 st Floor Zone R-21 Wall 90 Front 240 124.793 90 Left Wall 1 st Floor Zone R-21 Wall 180 Left 264 21.2 90 Back Wall 1st Floor Zone R-21 Wall 270 Back 240 8 90 Right Wall 1st Floor Zone R-21 Wall 0 Right 264 0 90 OPAQUE SURFACES — Cathedral Ceilings 01 02 03 04 05 06 07 08 09 10 Name Zone Type Orientation Area (ft2) Skylight Area (ft2) Roof Rise (x in 12) Roof Reflectance Roof Emittance Cool Roof R-38 Attic 1st Floor Zone R-38 Roof Cathedral Right 440 0 4 0.2 0.75 Yes FENESTRATION / 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 Windows Window Front Wall (Front-90) 5.8 2.5 2.003 28.8 0.32 0.25 Insect Screen (default) Windows 0' Overhang Window Front Wall (Front-90) 12.0 8.0 1 96.0 0.32 0.25 Insect Screen (default) Windows 0' Overhang 2 Window Left Wall (Left-180) 1.5 3.0 1 4.5 0.32 0.25 Insect Screen (default) Windows 0' Overhang 3 Window Back Wall (Back-270) 4.0 2.0 1 8.0 0.32 0.25 1 Insect Screen (default) Registration Number: 219-Po10186316A-000-000-0000000-0000 Registration Date/Time: 2019-08-24 10:58:02 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version - CF1 R-01162019-1149 Report Generated at: 2019-08-24 10:43:12 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Elkins 440 s.f. Pool House Calculation Date/Time: 10:42, Sat, Aug 24, 2019 CF1 R-PRF-01 Page 4 of 6 Calculation Description: Title 24 Analysis Input File Name: 19-08-075.ribd16x OPAQUE DOORS 01 02 03 04 Name Side of Building Area (ft2) U-factor Door Left Wall 16.7 0.50 OVERHANGS AND FINS 01 03 04 05 06 07 08 09 10 11 12 13 14 Overhang Left Fin Right Fin Window ist Up Left Extent Right Extent Flap Ht. Depth Top Up Dist L Bot Up Depth Top Up Dist R Bot Up Windows lDepth 0.33 2 2 0 0 0 0 0 0 0 0 0 Windows 0'Overhang 0 0 0 0 0 0 0 0 0 0 0 0 Windows 0'Overhang 2 0 0 0 0 0 0 0 0 0 0 0 0 Windows 0'Overhang 3 0 0 0 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 • Inside Finish: Gypsum Board • Cavity / Frame: R-38 / 2x 12 • Roof Deck: Wood Siding/sheathing/decking • Tile Gap: present R-38 Roof Cathedral Cathedral Ceilings Wood Framed Ceiling 2x12 @ 16 in. O.C. R 38 0.029 Roofing: 10 PSF (Rooffile) • 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 SLAB FLOORS 01 02 03 04 05 06 07 Name Zone Area (ft2) Perimeter (ft) Edge Insul. R-value & Depth Carpeted Fraction Heated Covered Slab 1st Floor Zone 440 84 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 Required Not Required Not Required nla Registration Number: 219-Po10186316A-000-000-0000000-0000 Registration Datefrime: 2019-08-24 10:58:02 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version - CF1 R-01162019-1149 Report Generated at: 2019-08-24 10:43:12 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Elkins 440 s.f. Pool House Calculation Date/Time: 10:42, Sat, Aug 24, 2019 CFI R-PRF-01 Page 5 of 6 Calculation Description: Title 24 Analysis Input File Name: 19-08-075.ribd16x 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 Input Rating / Tank Standby Heater Tank Uniform Energy Pilot / Insulation Loss / First Hour NEEA Heat Pump Tank Location Element Number Volume Factor / Energy Thermal R-value Recovery Rating / Brand / Model / or Ambient Name Type Tank Type of Units (gal) Factor / Efficiency Efficiency (Int/Ext) Eff Flow Rate Other Condition DHW Heater 1 Gas Small 1 0 0.91 EF <= 200 kBtu/hr R-0/R-0 0 n/a n/a n/a Instantaneous SPACE CONDITIONING SYSTEMS 01 02 03 04 05 �06 SC Sys Name System Type Heating Unit Name Cooling Unit Name Fan Name Distribution Name Res HVAC1 Heat Pump Heating and Cooling System Heat Pump System 1 Heat Pump System 1 None - none - HVAC - HEAT PUMPS 01 02 03 04 05 06 07 08 09 10 11 Name System Type Number of Units Heating Cooling Zonally Controlled Compressor Type HERS Verification HSPF/COP Cap 47 Cap 17 SEER EER Heat Pump System 1 DuctlessMiniSplitHeatPump 1 7.7 16800 15840 14 11.7 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 Not 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 19 0.25 Default 0 Required Registration Number: 219-P010186316A-000-000-0000000-0000 Registration Date/Time: 2019-08-24 10:58:02 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version - CF1 R-01162019-1149 Report Generated at: 2019-08-24 10:43:12 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Elkins 440 s.f. Pool House Calculation Date/Time: 10:42, Sat, Aug 24, 2019 CF1 R-PRF-01 Page 6 of 6 Calculation Description: Title 24 Analysis Input File Name: 19-08-075.ribd16x DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature, ✓�.� C l l �.-�I- David Elliott Company: Signature Date: David Elliott Energy Services 2019-08-24 10:54:53 Address: CEA/HERS Certification Identification (If applicable): 9013 SVL BX City/State/Zip: Phone: Victorville, CA 92395 760-243-3883 RESPONSIBLE PERSON'S DECLARATION STATEMENT 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. 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. �r Paul K Nelson�•`'�` Company: Date Signed: Nelson Design 2019-08-24 10:58:02 Address: License: 16169 Siskiyou Ct. N/A City/State/Zip: Phone: Apple Valley, CA 92307 760-508-3400 Digitally signed by CaICERTS. 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. l L ❑ Registration Number: 219-Po10186316A-000-000-0000000-0000 Registration Date/Time: 2019-08-24 10:58:02 CA Building Energy Efficiency Standards - 2016 Residential Compliance ReportVersion - CF1 R-01162019-1149 HERS Provider: CaiCERTS inc. Report Generated at: 2019-08-24 10:43:12