BRER2015-005878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BRER2015-0058
53640 AVENIDA OBREGON
774115006
RUST RESIDENCE RE -R(
$12,000.00
Applicant:
HERNANDEZ ROOFING INC
P 0 BOX 344 '
OCEANSIDE, CA 92048
COMMUNITY DEVELOPMENT'DEPARTMENT,
BUILDING PERMIT
Owner: ,
KATHLEEN RUST,
'80613 APPLE CT
INDIO, CA 92253
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:.
HERNANDEZ ROOFING INC
P 0 BOX 344
OCEANSIDE, CA 92048
(760)721-7417
Llc. No.: 939728.
Date: 7/21/2015
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter ,
Phereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7 0) of Division 3 of the Business and Professions Code,
I have and will maintain a certificate of consent to self -insure for workers'
and my License is in f orc nd effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance
License CI : C39 L" ense No.: 939728
of the work for which this permit is issued.
Dat ebontractor.
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
`r "
is issued. My.workers' corrmpensation insurance carrier and policy are:
OWNER -BUILDER DECLARATION
Carrier: _ 'Policy Number.
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify thatin.the performance of the work for which.this permit is issued, I
License Law for the following reason (Sec. 7031.5,.Business and Professions Code: Any ;
shall not employ any, person in.any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair •'compensation_laws
of California, and agree that, if I should become subject to the,
any structure, prior to its issuance, also requires the applicant for the permit to file a
ions of Section 3700 of the Labor Code, I shall forthwith
workers' com4pris
signed statement that he or she is licensed pursuant to the provisions of the
comply withContractor's
State License'Law (Chapter 9 (commencing with Section 7000) of Division 3
that
of the Business and Professions Code) or he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora
Da.Applicr ant:
permit subjects the applicant to a civil penalty of not more than five hundred dollars
WARNI : FE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL iSUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(_) I, as owner of the property, or my employees with wages as'their'sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). 1N ADDITION TO THE COST OF
compensation, will do the work, and the structure is not, intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law:does not
INTEREST, AND'ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT'
are not intended or offered for sale. If, however, the building or improvement is sold .
IMPORTANT:Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of -proving that :
the, conditions and restrictions' set forth on this application.
he or she did not build or improve for the purpose of sale:).
1."Each person upomwhose behalf this application is made, each person at whose
(� 1, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the.owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall5defend indemnify and hold harmless the Cityof La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any actor omission related to'the work being performed under or
the Contractors' State License Law.)..
following issuance of this permit.
(� I am exempt under Sec. B.&P.G. for this reason
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.
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:). I.
Lender's Name:
Lender's Add
I certify that I have read this application and state that the above information is correct.
I agree.to comply with sill cit and nty ordinances and state laws relating to building
cou
construct,, and he;fbyXthorize representatives of this city to'enter upon the above"
ment' ed propespection purposes.
i
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�,� DESCRIPTION ': r'ACCOUNTQT,YANIOUNI` �Pi41D �PAID:DATE
: , „ Y
BSAS'561473 FEE .101 0000.20306` 0 $1 00 $0.00
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�METFiOD BY
� �, �RECEIPT #pJCHECK�#
,.PAID..BY� �CLTD
Om sit -40 +.:.a ��'< �."✓_.,'";FC i'.:+"ac'''iro-�,'%'
Total Paid forBllILDINGSTANDARDS;ADMINISTRATION,
BSioc $1 00 $0:00
�gf3>o..h<�y=✓'tib='^,•:.�'te
'+'DESCRIPTIONAMOUNTS,P..AID�
PAIUDi4TE
.$.:SS..'xi� .-* .$Y <a�.w��."°+m�'f.
..�X��i
RE -ROOF- EA ADDITIONAL:I,000.SF
101 0000`42404;
0
$TEi 60# ` ..
$0.00
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yPAID BAY
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t<'kr.r r
x.
.:AMOUNT
_ �is��
.
RE -ROOF - FIRST 2,000 SF
101 0000 42404
q•
0
$0.00
P�ic,iry o `F:=gds ';:, PAY«,: ID4`xBk� YO rf .'ly {•: <��3%” _k °4 .Ry�e'-'C
10
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EMETIOD0
�E RECEIPT#
F° :
TDBYE
'`x`'
DESCRIPTION
firYiYi ':2 _- '� s... �y.,`��;�.Zs1.c.:
F 011"MCCOUNTy� �
QTYAMOUNT
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.�ii+"if',
saM; ;PAID Y�
PAID DATES:
x'+�5<..`x'a2''sek�x.?':2 i,.�3'CiRYs*w;S.'"cv `.." '..:1�('.
�
;.
-.:, t :i:"5
��.a.az<,m,-+F�n':...dR�
..s.1%
AMR:#,'�;as
RE -ROOF - FIRST 2,000 SF PC ":
101-0000-42600
f.
..;.,."3'F''^
<`
PAID BY.
METHOD
.Kr
RECEIPTr #
» a_. l.E•.i�i'
is
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P—dffor�RE 6159-,53--
.ROOF^:.:,.
Description:'RUSTRESIDENCERE=ROOF .
Type:.RE=ROOF Subtype: Status: UNDER REVIEW Applied`. 7/21/2015 EVA
Parcel No: 274115006' . Site Address: 53640 AVENIDA OBREGON LA QUINTA;CA:92253 ` Approved:
Subdivision: SANTA;.CARMEUTA AT VALE LA QUINTA `Block: 188 , Lot: .6 Issued:
UNIT -19
Lo,t Sq Ft: 0 Building 5g Ft: 0 Zoning; Finaled:
Valuation: $12,000.00... Occupancy Type:• Const�uction.Type: Expired:
No Buildings: 0 No Stones 0 No.. Unites: 0
Details REROOF.,PER. CRRC 0942 0008 .2013•CALIFORNI'' ENERGY CODE
;APPLICANT HERNANDE
CONTRACTOR HERNANDE
OWNER' KATHL
ONC ":Fou
j
INC P:O.E
• , ` 80613"
I
OCEANSIDE
QC kA
TIN610677#
SCA
I
BSAS-sB1473 FEE 101-0000-20306 0 $1.60 $0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION .
BSA: $1.00. $0.00
Printed: Tuesday, July 21, 2015 4:02:56 PM 1 of 2
SYSTEMS
i
I
F..
BSAS-sB1473 FEE 101-0000-20306 0 $1.60 $0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION .
BSA: $1.00. $0.00
Printed: Tuesday, July 21, 2015 4:02:56 PM 1 of 2
SYSTEMS
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID .
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
.
BY
RE -ROOF -EA
101-0000-42404
0
$11.60
$0.00
ADDITIONAL 1,000 SF
RE -ROOF -FIRST 2,000
101-0000-42404
0
$49.31
$0.00
SF
RE -ROOF - FIRST 2,000
101-0000-42600
0
$98.62
$0.00
SF PC
Total Paid for RE -ROOF: $159.53 $0.00
TOTALS:.0
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
_.
PRE -ROOF BLD
FINAL" BLD
BONDIINFORMATI.ON.
ATTACHMENTS
Printed: Tuesday, July 21, 2015 4:02:56 PM 2 of 2 1 . ;
SYSTEMS
Bin #
City .of, La Quinta
Building & Safety Division
P.O. Box 1504, 78-495.Calle Tampico
La-Quinta, CA•92253.' (760) 777-7012. .
Building PerrnitA01kation. and Tracking Sheet
Permit #
Project Address: I'5 S(o 1-t 0 4 - t Dn call&
A. P. Number:
Address:
Legal Description:
amity, ST, Zip: L-& C2.%J I C-6, al2�eg�
Contra� Zo F \ h
Tel
honeo:
eP
Address ��rJ �5. �,p' �QCtC
-Project —De script oon:
k
Tele h ne
P o .
State Lic
Arch., Engr., Designer:
Address:
City, ST, Zip:,
ne•
TeleP ho .
�>
<:
'Cons utr cti n Type: o e: ane
Occu P Y:
State to Lic. #
Pro'e '
et e circlene w
o New Add'n ,t
Al er ReA ai r Demo
Name of Contact Person: ,4,4v66L
Sq. Pt.: 700
# Stories:
#Units:
Telephone # of Contact Person: �(OO' (� .r%,y l r%
Estimated Value of Project:\2 t 00 C�
APPLICANT: DO NOT WRITE BELOW, THIS LINE .
#
Submittal
Req'd
Recd :
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
'Reviewed, ready for -corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan.Check Balance.
Title 24 Cates.
Plaps'picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
26' Review, ready for corrections/issue,
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for corrections/issue'
Developer Impact Fee
PlanningApproval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
STATE.OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION .
CERTIFICATE. OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 4 of 4)
Project Name: tr2e-- t 12i:.Date Prepared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
(Documentation Author Name>
Documentation Author Signature: ' '•
Company:
Signature Date:
Address:CEA/
X2:•'7 tS rC �t2C t_
HERS Certification Iden' catlon� ap 1cable)r '
.
City/State/Zip: j
ti �Gc`d,►-�s�� g'i 20 5 `7
Phone:
�Ko-,� - `7 `11 %
RESPONSIBLE PERSON'S DECLARATION STATEMENT'
I certify the following under penalty'of perjury, under the laws of the State of California:
Wr
1. The information provided on this Certificate of Compliance is true and correct: �.
2. I am eligible under Division 3 of the Business and Professions Code to accept responslb tt for the building�design or system design identified on this Certificated Compliance (responsible
designer):
3. That tlie energy features and performance specification s,,materiaIS, components, and manufactured devic 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 42iiornla Code of"Rega it ons.
4. The building design features.or system design features identified on this t-ertlficate of Compll�iance reconsistent`wtmable.compliance documents,
and th%
ent:egencyfopprovai with.-.thisbuildlhg permit application._
worksheefs,'ealculations plans specifications submitted to enforcemra
made available for the made.available
5. 1 will ensure that a: registered copy:of this Certificate o€Compllancetshall be with the building.peemit(s) issued building, and to the enforcement agency
:. ek _:
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 -occupancy. WX
Responsible Designer Name: - t
Respowsible•Designer Signature:
Company : v
Date Signed:
Address:. V _
License:
City/State/Zipi
Phone:
For assistance or1"questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 4)
'Prosect Name: (L T- QCS t1).t__X_C Date Prepared:
A. GENERAL INFORMATION
i 02
03
01
Project Name:
02
Date Prepared:
03
Project Location: (,1t t7
04
Building Front:Orien at(on (deg or cardinal):
05
CA City: L, Q
06
Number of;Alte&a(P elling,Units:. e;
07
Zip Code: 2 . (p
08
Fuel'Type.
09
Climate Zone:
30
Total Conditio ed:FloorA�ea (ft2)�
11
' Building Type.. — ": �C. �t g"t-
12
SIab;Area (ft2)- `M '
13.
'ProjeciScope:
, 09duct=Type
,Insulation
B. BUILDING INSULATION DETAILS (Section 1S0.2(b)1)___
i 02
03
04
05
06 ' 07 1 08 E09
10
11
Ta'g/ID Assembly Type
Frame
Type.
Frame
Depth
I (inches)'
Frame-.
Spacing
(inches).
Proposed mss. _
Required
Comments
CavityInsulation
R -value y
Continuous
R -value
Vt'AppendixJA4
Reference
a U,J ctorr Ta61e: Cell
LI -Factor
Roof
CRRC.Prr6duct'ID
De k
Initial Solar Aged Solar . Thermal SRI Aged Solar Thermal SRI '
._ . .. . .
Compliance _
Pitch
Exception
Number �,
, 09duct=Type
,Insulation
Reflectance Reflectance Emit'ance (Optional) , Reflectance Emi4tance `. (Optional).'.
ER -60F REPLACEMENT (Prescriptive Alteration, Section&5_6.2(b)l
)Z -4D_
01
02.
03
04
05'
06
07 O8 09 10 11-_ -,.12 _ 13
R -value
Proposed - Minimum Required
Method of
-
Roof
CRRC.Prr6duct'ID
De k
Initial Solar Aged Solar . Thermal SRI Aged Solar Thermal SRI '
._ . .. . .
Compliance _
Pitch
Exception
Number �,
, 09duct=Type
,Insulation
Reflectance Reflectance Emit'ance (Optional) , Reflectance Emi4tance `. (Optional).'.
NOTES
• Roof area covered y buiIding�integrated ph6ttovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements.
• Liquid field applied coating must comply with nstallation criferia'-from section 110.8(i)4.
,.
IN
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014