14-0394 (RR)T4tvl 4
P.O. BOX 1504 �^' VOICE 760 777-7012
7.8-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Application Number: 14-00000394 Owner: Date: 4/08/14
Property Address: 54552 AVENIDA OBREGON SHERRATT JOSHUA
APN: 774-274-028-3 -000000- 1035 CA1ZMELO ST.
Application description: RE -ROOF MONTEREY, CA 93940 r('�
Property Zoning: „gig. COVE RESIDENTIAL (831) 601-9003
Application valuatjon: 3370
Contractor: APR :g
Applicant: Architect or Engineer: Owner. APR
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 Professionals 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
Wapplicant 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 or she did not build or
improve for the purpose of sale.).
as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
C./ 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.0.for Ais reason
Date:') ioi Owner: H^—�
CONSTRUCTION LE DING 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
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
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 subje tot workers' compensation laws of California,
and agree that, if I should ome subject the kers' compensation provisions of Section
700 of the Labor Co shall for ith those provisions.
Date: Applicant: ��.
WARNING. FAILURE TO SE E 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 Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.' 1
I certify that I have read this application and state that the abov formation is orrect. /I agree to comply with all
city and county ordinances and state laws relating to buildi structio 'I
a hereby/authorize representatives
of this co y trent r upon the above-mentioned property inspection r ses.
Date: /Signature (Applicant or Agent):
0
LQPERM[T
Application Number . . . . . 14-00000394
Permit . . . RE -ROOF
Additional desc .
Permit Fee 48.62
Plan Check
Fee
.00
Issue Date
Valuation
. . .
. 0
Expiration Date 10/05/14
Qty Unit Charge Per
Extension
1.00 48.6200 LS MISC
RE -ROOF, 1ST 2000
SF
48.62
----------------------------------------------------------------------------
Special Notes and Comments
REROOF HALF OF ROOF WITH LIGHT -WEIGHT
SHINGLE - CALIFORNIA SHASTA WHITE
[CRRC:
0890-00021 2013 CALIFORNIA ENERGY
CODE.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . PLAN CHECK, RE -ROOF
97.24
Fee summary - Charged Charged
-----------------
Paid Credited
Due
--------------------
Permit Fee Total 48.62
----------
.00
----------
.00
48.62
Plan Check Total .00
.00
.00
.00
Other Fee Total 97.24
.00
.00
97.24
Grand Total 145.86
.00
.00
1.45.86
4/3/14
CCF00432014 00004.jpg
04/01/2014 20:11 FAX
0002
Prescriptive Certificate of Compliance: Residential Reroof CF -1 R-ALT-ReRoof
Project Address; vQ
14 cniV ` ®t
Ciima a Zone
Permit !l
ROOFING PRODUCTS (COOL ROOFS) §151(012
When the area of exterior roof surface iro be replaced exceeds 50% of the existing roof area, or 1,000 ft", whichever is less, the new
roofing area must meet the roofing product "Cool Roof" requirements of§152(b)1H1, 152(b)1Hli, or 152(b)1Ht11.
Check applicable alternative or eXceptlon below it the roof alteration Is exempt from the roofing product. -Cool Roof" requirements::
0 Cool roofs 4 required In Climates Zones 1-12.14, and 16 with a low sloped roof pitch (lessor 2:12 pitch).
❑ Cool roofs W required in Climates Zones 1.9, and 16 with a steep -sloped roofs (greater pitch than 2:12) and product weight less than WWI?.
Alternatives to §152(b)1 HI and §152(b)HII, Steep -slope roof (pitch > 2:12)
❑ Insulation with a thermal resistance of at least 0.85 hr-i?-'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(010; or
❑ In climate zones 10, 12 and 13, with 1 112 of free ventilation area of attic ventilation for every 150 Ito of attic floor area, and
where at toast 30 percent of the free ventilation area Is within 2 feet vertical distance of the roof ridge; or
❑ Building has at least R-30 ceiling insulation; or
❑ Building has radiant barrier in the attic meeting the requirements of §15102; or
❑ Building has no ducts in the attic; or
❑ In climate zones 10, 11, 13 and 14, R-3 or greater root deck insulation above vented attic.
Exception to §152(b)1HIII, Low -slope roof ( pitch_ S 2:12)
0 Building has no ducts In the attic.
Other Exceptions
C) Roofing area is covered by building Integrated; photovoltaic panels and solar thermal panels are exempt from the Cool Roof criteria.
❑ Roof constructions that have thermal mass over the roof membrane with at least 25 Ib/ft2 are exempt from the Cool Roof criteria.
NO if any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Emittanee requirements for tooling
products in § I 18()) are not aoolicable. Do not fill table below
CRRC Product 10 Numbers
Roof Slope
S 2:12 > 2:12
Product Weight
c 5lb/ft2 a 51b/t6
Product
TypG2
Aged'Solar
Reflectance 3.4
Thermal
Emittance
SRI,
Date: { /
Address: /0:35
D I, C C� n,� U S
7
License
D r
Clly/State/zip0
� �
Phone:
❑ 13
❑ [1
❑°
Note: if no CRRC-I label Is available, this compilano method cannot be used, use the Performance Approach to show compliance,
1. The CRRC Product iD Number can be obtained from the Cool Roof Re (Ing Councils Rated Product Directory at www. coafwof& ofulproducts1seamb.pho
2. Indicate the type of product is being used for the roof top, I.a singleply roof, asphalt roof, metal root, etc.
3. R the Aged Reflectance /s not available in the Cool Roof Rating CounclAp Rated Product 0irectory then use the initial Reflectance value from the same
directory and use the equation (0.2+a 7(pnw — 0.2) to obtain a calculated aged value. Where p Is the initial Solar Reflectance.
. Check box if the Aged Reflectance is a calculated value using the equation above.
5. Calculate the SRI value by using the SRI- Wodrsheet at hnol and enter the resuffing value in the SRI Column above and attach
atopy of the SRi• Worksheet to the CF iR.
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
ocommended by the coatings manufacturer and meet minimum performance requirements listed In §118(1)4. Select the applicable coating:
13 Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other
�v1 t: when a coot moor is required, the installing contractor shall complete and submit the CF -BR -ENV -01 for final inspection.
Declaration Statement
• 1 certify under penalty of perjury, under the laws of the State of California. the Information provided on this form Is accurate and complete.
• I certify that the energy features and performance specifications Identified on this Certificate of Complianca conform to the requirements of Title 24. Parts
1 and a of the California Code of Regulations,
✓
Signature:
Company: O
Date: { /
Address: /0:35
D I, C C� n,� U S
7
License
D r
Clly/State/zip0
� �
Phone:
For assistance or questions regfarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
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.Jof Rating Council
Rated Products [
(last updated 29 Mar 2013
Showing Search Results
Match any of:
Company Name:
Brand:
Mndal• ^�
Page 1 of 2
Type: ""oakridge—
Company: Owens Coming Roofing and Asphalt, LLC
Color Category: Bright White
Product Type: Shingles or Shakes, Shingles, Shakes, Tile or Slate
Brand: Oakridge®, Duration Premium®, Duration®
Model: Shasta White
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(showing records 1 - 1 of 1)
25 Records per Page
.........._........._.........__........
`14 PsD��ro�
CRRC
Prod. ID
.........-......_..... _...._.... _............... .... ...... ........_.
Manufacturer Information
(sorted +) '
.........__ .
__. ...._................. ._......... .._.._..._._......... -
I.Brand
.._...................._...........
..
Model
.....
_............_......---._._............__......._......---..._._._.................._.._._...
Color
Category
.
Produc t
Type
-----._..__......_..__.._..:........__.._.._._...----..___
Solar Reflect
snit ILr
Therm Emit.
init ;Y -r
... __.... -__..... ---........_--
SRI
init
................ ......................... ..............----............
Slope
Application
.............. -...
Note about
Ratings
0890-0002
Owens Coming Roofing
and Asphalt, LLCfemiUM0,
Gerry Greaves
O`$li'i3 Duration
Duration® �,
Sha"ta
.�;
Bright White
Shingles or
Shakes
0.26 0.28
0.90
0.91
27
30
Steep
(740-321-7780)
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(showing records 1 - 1 of 1)
h4://www.coolroofs.org/products/results.php?keyphrase=oakridge&select type=select&type%5B6%5D=Shingles+or+Shakes&... 4/4/2013
4/3/14
CCF 00432014_00002.j pg
04/01/2014 20:13 FAX 0002
WWI i
P -O. BOX 1504 -
LA QUINTA; CALIFORNIA 92247=1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & S 'FETY DEPARTMENT
(760) 777-701.2
AX (760) 777-7011
PROPERTY OWNER'S PACKAGE
Disclosures & Forius for Owner -Builders Applying fOr Coastruegon Permits,
lur.mufff N011C$ Q RQPfiI&TY OWN _R
DearTspinrty Owner
An. ai►fication • for •a building pmt has�Ve
ped in r tttuhze as :tbo builder of the property
impt6bents specified at �bIL Ow u 1
We are prnvidW you wt& an Owner -Builder Acknowledgeat-oAd l • Vcriftcation Foam to aaakie you. awam.of your
rasponstbitities and possible risk:you may incur by having Otiapetmit issued'in your came as the
Owner Builder. •We'ttM not issue a builfte•pee p it until you -h the reals, iditiaM•yowr. understanding of eack'provision,
signed, slid returned this form to us at our official address Indicated. An agent of the owner cannot execute -"-notice
unless you, the property owner, obtain the prior approval of the permitting authority.
Di`RECI VJC- Awd and f►rielal earn statement below to se"griffyYOU. uadarst6nd or verb tl►is i>rfomWdon.
d1. I understand a lr quent practice of unlicensed prions is to have the property owner obtain an "Owner-Buildee,
building permit that erroneously implies that the property owner is providing his or her own labor and material personally.1, as
an Owner -Builder, may be held liable and subject to serious financial risk for any iWurics sustained by.an unlicensed person
and his or her employees whilew0elting on my property. My homeowner's instuance may not provide coverage for those
injuries. I am willfully acting as an Owner -Builder and atm aware of the limits of my insurance -co verage for injuries to workers
:on
ding
MY Property.
construction and aro b td Pests am not required to be signed by property owners re unless they aresponsible for the
no hiring a 4censed Contractor to assume this responsibility..
3.1 understand as an "Owner -Builder" I am the nsibk
m if from ° ply "of record on the.perou .I understand that I may protect
Potential financial rusk by piling a licensed Contractor and having the pumit filed in his or her name instead of my
own.
Q�414.1 understand Contractors are required by law to be licensed and bonded is California and to list their license numbers on
and contracts.
`1 understand if i employ or otherwise engage any persons, other than California licensed Contractors, and the total 'value
of y construction is at least five
hundred dollars ($500), including labor and materials, I may be considered an employee
understate and federal law.
6: I understand if I am considered an "employee' under state and federal law, I must register with the state and federal
So
crnment, withhold payroll taxes, provide w.o&crs' compensation disability insuraatse, 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 it licensed general building Contractor.
N
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4/3/14
C C F00432014_00003.j Pg
04/01/2014 20:23 FAX 0 004
t K7_ ,
- ilda if I sell the property for which this permit is issued, t4tDay be lie A liabia for any
�8. understand =.an owner 1u latent constru�n defects in the
financial or personal b#uri% sustaine,d by soy subsequent owget(s) that result from any
wo anship or matenals.
nut
9 I understand I tray obtain more information regarding my obligations as m "employe' train !tel alifo rni
Z9
Ice,
the United States Small Business Administration, the California Depullnent of Benefit Payments; and'the California
Division of Industrial Accidents. i also understand I may contact the Californiaieicontractors. arc License Board (CSW at 1-
800-321-CSiZ (2752) or www.csib.ca.gov for more information about Gccrised contractors '
10.1 am aware of and consent to an owner -Builder building permit applied for in my name, and understandttg t 1 am the
foll"inaddress:
b!e .for prop
p9Ycousttuctioa activity at!tbc
P Y legally and fipanciauy .n °s+ L Lpo ca.r Z: - 7eOL 1-;L
1. I agree that, as the party legally and fwaa Wly respousible for this proposed construction activity, t will abide by all
4iicl
able laws.and requice'ntents that govern (i vidtO" ' tdldets w '�'ellas ettiQloyccs.
Of chMae$ to any of rhe infgraoatioh I
12.1 agree to notify the issuer of this. form immediately of any. additions; deletions, If you.corttrttct with
4h,provided on this form. Licensed contractors are regulated by laws designed to protect the publoss
.someone who does. not leave a Ikeenso, tote CAuaaetocs' State License Boar d may be ttnable to
you may sustain as a result of a complaint Your only remedy against unlicensed Contractors tray be in'civil coact- It is •alae.
r or.employee of that individual or fm is injures while wortdng
impoitaat for you to.ttaderstand that if as pnliepau9ed Contr'acto and wtah to hire Compt+aetvrs,
on our pm may be held liablo for damages. If You Wain a permit., as Owner -Builder
Y P�5': Y'� ►d.aad.the au►tiis of chair wortae:s'
you. will bo .responsble for verifying � or: not those CQiltinet4tE are .prWrdy
oompaasatioc itt9ttraaoe ooveta�e. .
Before a building permit cann be issued, this form must be compkted and signed by the property owner and returned to
for ixs
the agency resporesponsibled g t te.pel;�sit.. Note: A copy of, 6W. prolxrh' o!vntr's deirar do , fa^' Kot or
other awAptabfa to, the agirtcy err
oer ver¢e pre d;when tiro permit is iastuii to vsWfy.the py""
owner's signature.
... Sigtiature of psnpestp owner
to be completed by the property owner only when designating
Note: The following.luthorization Form is required
an agent of the property owner to apply for a construction permit for the Owner-Builder-
UTHORIZ,ATION PV'Atjb1X L iv At- l vr. rte%%YAL —.•- - -- - - - ibility, I hereby authorize
Excluding the Notko to Property Owner, the exeWtion of which I understand is my ytain an Owner -Builder
-the fto
ollowitis.petsvn(s) to act as my agettt(s) to apply for, sign, and fila •thea eats tteccssary
Permit for MY project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
�lnea14 Tel No 7G� �67 -73/4�
Name of Authorized Agent: J /1
Address of Authorized Agent:
I declare under penalty of
information and certify its
aeeeptable'to the agency i
Property Owner's
a ,rm i l C
4 I am the property owner for the address listed above and I Personally filled out the above
Note.'A copy of the owner's drivers license, form notarization, .. other verificatton
pr7w the permit is issued to verify the property owner's signature.
7�_ � ~Date:
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4/3/14 CCF00432014 00000.jpg
04/01/2014 20:17 FAX
@1003.
Rin ll
City of La Quints
Buflding & Safety DWslon
Permit # r
P.O. Box 1504, 78-495 Calle Tampico
La Qulnta, CA 92253.(760) 777.7012
Building, permit Application and Tracking Sheet
Project Address:
� �. YGN t�t U Owner's Name:
S�—�R—
A. P. Number.
VT.Address:
Legal Description:
City, ST, Zip; 01� -e
Contractor:
Telephone: V 60 / 9f 3
Address:
Project Description:
• City, ST, Zip:
l��l� ✓'�iX 1S 1
Telephone;
State Lie. # :
City Lie. N, p 41
Arch., Engr., Designer:
Addtrss:
- '
1
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
p er
State Lie. #:
project type (circle ono): New Add'n Alter air Demo
Name of Contact Person:
# Stories: #1 Units:
�7��'
Tclephonq #,of Contact Person: V % /� �Estimatod Value of Project:—�n 3 O a
APPLICANT: 00 NOT WRITE BELOW THIS LINE
b Submittal
Req'd Reed I TRACKING PERMIT FEES
Plan Seta
Plan Chtek submitted Item Amount
Structural Casts.
Revlewtd, ready for corrections Plan Check Deposit
Trust- CRlcr,
Called Contact Person Plan Check Balance •
•Title 24 Cates.
Plana picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2•! Review, ready for corrections/Issue Electrical
Subconlaclor List
Called Contact Person Plumbing
Grant Deed
Plans pleked up
H -OA. Approval
Plaits resubmitted Grading
M riOUSF:•
' Revlew, ready for correctlopsnssue Developer Impact Fee
Planning Approval
Callcd Contact Person A.I.P.P.
Pub. Wks. Appr
Date or permit Issue
Schodl Feet-
Total Permit Fees
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