11-1366 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: ,�11-OOOD136'6
Property Address: 52410 AVENIDA OBREGON
APN: 773-255-007-7 -000000-
Application description: RE -ROOF '
Property Zoning: COVE RESIDENTIAL
Application valuation: 7700"
Applicant:. Architect or Engineer:
BUILDING & SAFETY DEPARTMENT .
BUILDING PERMIT
Owner:
ZAMORA TINA M
52410 AVENIDA OBREGON
LA QUINTA, CA 92253
Contractor:
MILLER .& SONS ROOFING.- C
68760 SUMMIT DRIVE
CATHEDRAL CITY, CA 922 4"
(760)328-6616 "
Lic. No.: 336547 "
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/29/11
A�AEc so tu„ D,
-------------------------- -----------------------------
LICENSED CONTRACTOR'S DECLARATION
---------------------- — — — — — --- — — — — — — — — — —
WORKER'S COMPENSATION DECLARATION' "
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
_ I have.and will maintain a certificate ofconsent"to self -insure for workers' compensation, as provided
License Class: C39 LicenseNo.: 336547
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
.r
*
issued.
�_tqed M��/ S 'nU%��
11 N/�'✓�DERA
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.
OWNER-BUILDEON
insurance carrier and policy number are:
I hereby'affirm under penalty ofperjury that I am exempt -from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 238002574
following reason (Sec. 7031.5, Business: and Professions.Code: •Any city or county that requires permit to
_ I certify that, in the perform anceof the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance; also requirestheapplicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a"signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workers' compensation provisions of Section
License l_aw (Chapter-9-Icommencing with Section 7000)`of Division 3 of the Business and Professions Code) or
3700 of 'the Labor Co hall forthwith comply with those provisions.
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).:
Date:• .gApplicant:-.�� ''
I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
'
the structure isnot intended or offered foi sale (Sec. 7044, Business and Professions Code: The
wARNIN FA LURE.TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, --,AND SHALL
Contractors' State License Law doesnot apply to an owner of property who builds.or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL'PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself''or herself through his or her own employees, provided that the
DOLLARS ($100,000).' IN ADDITION TO THE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN
improvements are not. intended or offered for sale.. It, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one year of completion, the owner -builder will have the burden ofproving that he or she did not build or
improve for the purpose of sale.).
APPLICANT ACKNOWLEDGEMENT
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions. Code: The Contractors' State License Law does"not apply to an owner of
conditions an -d restrictions set forth on this application.
property who builds or improves thereon, end who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. . , BAP.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
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 county to enter upon the above-mentioned prope r inspection p�ylises.
Da�'te: +Q= ' Signatrire•(AppliCanrorAgentl: u'��
Application Number . . . . . 11-00001366
Permit . .
. RE -ROOF
Additional desc .
Permit Fee . . .
. 30.00
Plan Check Fee
.00
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date
6/26/12
Qty Unit Charge
Per
Extension
BASE
FEE
30.00
----------------------------------------------------------------------------
Other Fees . . .
. . . . . - BLDG STDS ADMIN (SB1473)
1.00
Fee summary
-----------------
Charged
--------------------
Paid Credited
--------------------
Due.
Permit Fee Total
30.00
.00 .00
30.00
Plan Check Total
.00
.00 .00
.00
Other Fee Total
1.00
.00 .00
1.00 -
Grand Total
31.00
.00 .00
31.00
LQPERMIT
Prescriptive Certificate of Com '1ianee: Residential - CF -IR -ALT
Residential Alterations Page 3 of 5
Project Name- Climate 'Lone # # of Stories
U /I'LL- iZ 1 � - Sz. : �: 1' 1 . ' 8B IT _
A -N. . .:'_n A
ROOFING PRODUCTS (COOL. ROOFS)'41510912
When the area of exterior roofsurface.to be replaced exceeds more than 50% of the existing. roof area, or more Chun 1,000f?, whichever is
less, the new roofing area must meet the roofing product `Cool Roof" requirements of §l52(b)/Hi, 152(b)1Hii, or 152(6) IHiii'. .
Check applicable alternative or exception below if the roof alteration is exempt from the roofingprodiict- "Cool Roof,' -requirements. Note: if any
one of the alternatives or exception below is checked,. the. Aged Solar Reflectance and Thermal Gmittance requirements for roofing products in .
§118(1) are not applicable. Do not ftlhtable below. -
❑ Coop Roofs Not Required in Climate Zones 1-.12, 14, and 16 with a Low Sloped: Lessor 2:12 pitch.
❑Cool Roofs Not Required in Climate Zones.I through 9 and 16 with.a Steep -Sloped Roofs (pitch greater than 2:12) and.product unit weight less
than 5lb/ft2.
Alternatives to §152(b)lIli and §152(b)llii, Steep -slope roof (pitch` >.2:12) .
Insulation with a thermal resistance of at least 0.85 hrft2•°F/Btu or at least a 3/4 inch air -space is added to the roof deck
over an attic; or
❑ Existing ducts in the attic are insulated and sealed according to §151(f)10; or
❑ to climate zones 10, 12 and 13, with 1 112 of free ventilation area of 6uic,ventilation for every 150 112 of attic floor area, and
/Vhere at least 30 percent of the free .ventilation area is within 2 feet vertical distance of the roof ridge; or
56 Building has at least R-30 ceiling insulation; or
❑ Building has radiant barrier in the"attic m6eting the requirements of §151(f)2; or
❑ Building has no ducts in the attic; or
❑ In climate zones 10, 11, 13 and 14; R-3 or greater roof deck insulation above vented attic.
Exception to §152(b)1Hiii, Low-slope•roof(pitch 52:12)
❑ Building has no ducts in the attic.
Other Exceptions
❑ Roofing area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria.
❑ Roof constructions that have thermal mass over the roof mernbrane•with at least 25 lb/ftZ°is exempt from the below Cool Roof criteria-
riteriaNote:
Note:1 Trio CRRC-1 label is available, this compliance`method cannot,be used, use thePerformance Approach to show compliance, otherwise,
Check thea ' licable box below if Exem t from the Roofing Products "Cool RoofRequirement:
Roof Slope
Product Weight
Product
Aged -Solar
°
Thermal
CRRC Product ID Number..
< 2:12. > 2:12
< 5lb/fi2 > 51b/112
Type2
Reflectance3
Emittance
SRIS
❑
❑
❑ -
. ❑
❑4
o
❑
a' ..
01.
4
'
❑
❑
❑..
.. ❑
..
❑4
'
❑'
❑
❑ .
❑
❑4:'
❑
o
0
0
❑4
I. The CRRC Product ID Number can be obtained from the'Cool Roof Rating Council's Rated Product Directory at www.coolrnofs:orgproducWsearch.ahn
2. Indicate the type of produce is being used for the roof top, i.e. single ply roof asphalt roof, metal roof, etc.
3. ffthe Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same
directory and use the equation (0.2+0.7(pi„ it,at— 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance.
Check box if the Aged Reflectance is a calctdated•value using the equation above:
5. Calculate rhe .S'RI value by using the SRI- Worksheet at hop;llwww.enerey.CaAov/tide24/ and enter the resulting value in the .SRI Column above and attach atopy of
the SRI- Worksheet to the CF -I R.
fo apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in §118(i)4. Select the applicable coating:
❑ Aluminum -Pigmented Asphalt Roof Coating❑
I
Cement -Based Roof Coating
❑ Other '
w I s 2-
Registration
Registration dumber: ...... Registration Date%Time: HERS Pruvider:
2008 Residential Compliance 1,orms . f igus•t 2009
a
Bin `#
-Ity Qurnta
Building d. Safety Ditiision
P.O.'Box: fSQ4, :78-495: Calle Tampico "
La:Qulnta, CA 92253 -' (760) 777-7012: '
Building Permit. AP and Tracking Sheet
Permit #
�l
Project Address: SZ- O
f' , - j
i fi i / lit Q Qy�/
Owtlec's Name:
A. P. Number:'
Adtites§:
Legal Description:
t..Ctty; ST, Zip17. LEaJ;s c4 /s -z (7
Contractor. id/f I LL,i2�'SdL'd
Tele ones
...P� 0 s 7714 1/ .L11ny 6
Address:(j O (A*11% _I T DL
City, ST, Zip: l/ � nt -qt -Z
Telephone: 7b6 ! 3 Y
State Lic. # : Sy City Lic. #c'
Arch., Engr., Designer '
ftject Description: ► I T%✓V it
LL. 30 'Dim 7� lei
�0
Address:
I
City, ST. Zip:
State Lic-#: ,�:v�.s.,,. :x.';
"
Telephone: !—v5-t)
of Contact Person: R ti't-�2
onstruction T �p�,,�,�.� ype: f-rsy ril4 Occupancy:
P'ect circleone : New Add'n Alter R Demo
�"�". �. �Name
Sq. Ft: Oo.
#Stories: #Units:,
Telephone # of Contact Person: io0-- :.
Estimated Value of Prbjectc 00 .0Q
APPLICANT:
DO NOTWRITE. BELOW THIS`UNE.
#
Submittal
Req'd
Recd •�
TRACKING
PERMIT FEES
Plan Sets
,
Plao Check, submitted ..
Item Amount
Structural Cates.
Reviewed; readydor. corrections
plan Cheek it
Depos
Truss Cala.
Called ContactTersou
Plan Check Balance
Tide 24 Calm
picked up,
Construction
Flood plain plan
Plans resubmitted
Mechanical.
Grading plan
2e° Review, ready, for correetions/issue
Electrical
Subcontactor List
- Called Contact Person
Plumbing
Grant Deed
Plans picked up
S LL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrcctiousrm. ue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
c-
JAL