BRER2015-006878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253'
Application Number: BRER2015-0068
4
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT '
Property Address:
55610 RIVIERA
APN:
775242022
Application Description:
REROOF WITH FIELD APPLIED WHITE FOAM [CRRC: 0626-00101
Property Zoning:
'Application Valuation:
$3,045.00
Applicant:
WESTERN PACIFIC ROOFING CORP
2229 EAST AVENUE Q
PALMDALE, CA 93550
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 C39 License No.: 235717
Date: 9 /9 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 or she did not build or improve for the purpose of sale.).
( 11, 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. BAP.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 Name
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of to 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 wor
�Jor 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 -arrier 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 a:; 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 37 -JO of the Labor Code, I shall forthwith
comply with those provisions.
Date: q )� Applicantgf % "/_ ,
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONCOVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,0001. IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR .N 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 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 i::suance of such permit, or cessation of
work for 180 days will subject permit to cancellbtion.
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 ordirances and state laws relating to building
construction, and hereby authorize representatives of this city to enter e%nter upon theabove-
mentionedproperty for inspection purposes.
Dare i / Signature (Applicant or Agent r //
Date:
9/8/2015
Owner:
GLAYAN MARVIN &JULIA
55610 RIVIERA
LA QUINTA, CA 92253
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Contractor:
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WESTERN PACIFIC ROOFING
ORP N
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2229 EAST AVENUE
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PALMDALE, CA 93550
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(661)273-1336
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Llc. No.: 235717
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WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of to 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 wor
�Jor 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 -arrier 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 a:; 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 37 -JO of the Labor Code, I shall forthwith
comply with those provisions.
Date: q )� Applicantgf % "/_ ,
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONCOVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,0001. IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR .N 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 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 i::suance of such permit, or cessation of
work for 180 days will subject permit to cancellbtion.
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 ordirances and state laws relating to building
construction, and hereby authorize representatives of this city to enter e%nter upon theabove-
mentionedproperty for inspection purposes.
Dare i / Signature (Applicant or Agent r //
INFORMATION'FINANCIAL
a DESCRIPTION kF�m;
=ACCOUNT sQTY '' '` AMOUNT�yj*`J� PAIDI_PAID'DATE
BSAS SB1473 FEE
101-0000-20306 0 $1.00 $0.00
�.PAID BI rs
3 F'k METHOD RECEIPT #` I€ CHECK # Yap CLTD BYa
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
Y
a Y`t w t
" .DESCRIPTION� , d
u S
�� ACCOUNT p 9fi ra.'
+QTYtAMOUNTM
-fig { �_' 4
k�£f=P. T 5 . a t r
y PAID
.� e
PAID DATE
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$49.31
$0.00
.}a •— "8Y�; .v + L tF
a, PAID:BY"v �. # .�
.A `.S r .:3 y C.
�,• METHOD<'; E
S '
f. N RECEIPT#"_:f
.t 1-£
3CHECK# `
rCLTDBY::
i
Total Paid for RE -ROOF: $49.31 $0.00
TOTALS:00
f
r
i
1
i
Description: REROOF WITH FIELD APPLIED WHITE FOAM [CRRC: 0626-0010]
Type: RE -ROOF Subtype: Status: UNDER REVIEW
Applied: 9/3/2015 AOR
Approved:
Parcel No; 775242022 Site Address: 55610 RIVIERA LA QUINTA,CA 92253
Subdivision: TR 21846-4 CM 75/164-172 Block: - Lot: 1
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled: ,
Valuation: $3,045.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: REROOF WITH LIGHT -NATIONAL COATINGS CORPORATION ACRYSHIELD-A530 WHITE [CRRC: 0626-0010] 2013 CALIFORNIA ENERGY
CODE.
Printed:. Tuesday, September 08, 2015 3:17:43 PM 1 of 2
SYSTEMS
PARENT pRO1ECT5
Printed: Tuesday, September 08, 2015 3:17:43 PM 2 of 2
SYSTEMS
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 4)
Project Name: (oAr- LJeST (Ze ► en Date Prepared:
A. GENERAL INFORMATION
01
02
01
Project Name: GA-
02
Date Prepared: ;dM.9 Is -
03
Project toc *inn! G 10 Mivt'--e—,
_.._ 04
Building Front dijenLati„on (deg or cardinal
05
CA City:
06
Number of Alt re eillgwelling Units
07
Zip Code:
08
Fuel Type. I& a %L
endix JA4
Reference
Climate Zone:
10
TofaaJConditioned Floor A C ift2)Building
L13
Type
12
Slab A}ea (ft2)-
%
Project5cope: l�a�o� c�, o�
c c..•. teo 5 S{e� _i
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)
01
02
03
04
05
06 ,476"'067 08gfi 09
10
11
Tag/ID
Assembly Type
Frame
Type
Frame
Depth
(inches)
Frame
Spacing
1 (Inches)
`P- poed 1q0 6
Required
Comments
Continuous
Cavity insulation
R -Valu R -value inF
°
+ice
`�
%-faytor
endix JA4
Reference
LI -Factor
Table Cell
P112-�r��fy�Npmber
^�{
' V.IV �� (So1 � e e-« LY '
X—"v'
%
.ep
NOTES
• Roof area covered by, building jntegrated photo o"tae-panels and solar thermal panels are exempt from the above Cool Roof requirements.
ngsmust
AUX 6.-%
.
C. ROOF REPLACEMENT (Prescriptive Alteration, Sei i'oIn .2(b)1H)
01
02
03
04 0511,
06
°670f 08 09 10 11 12 13
R -flue"
Proposed Minimum Required
Method of
Compliance
Roof
Pitch
Exception
CRC Rrod ID
`,�Ggduct Type
Deck.
I%
Insulates
Initial Solar Aged Solar Thermal SRI Aged Solar Thermal SRI
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
P112-�r��fy�Npmber
^�{
' V.IV �� (So1 � e e-« LY '
X—"v'
%
.ep
NOTES
• Roof area covered by, building jntegrated photo o"tae-panels and solar thermal panels are exempt from the above Cool Roof requirements.
ngsmust
• Liquid field applieoat comply wit�'l�nallation criteria from section 110.8(i)4.
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 MR -ALT -01-E
Prescriptive Residential Alterations (Page 4 of 4)
Proiect Name: Vt,1 - ge!%z en:la. Ort A- � i Date Prepared: 4 w T %-
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT ,.
1. I certify that this Certificate of Compliance documentation is accurate and complete. s6A _
Documentation Author Name:Documentation
Author at
Company:
P �.�
Signature Date:
W/
�cr .-c� c_ �1
Address:
CEA/ HERS Certification Ideal �catTsn"Iif applicable):
3gGZ &Jajj
9P
City/State/Zip:Phone:
RCIA M S prI e\ s C A- `2.7-6 Z
.60 -5116
RESPONSIBLE PERSON'S DECLARATION STA EMENT
I certify the following under penalty of perjury, under the laws of the State of California
1. The information this Certificate Compliance is
provided on of true and correct.
2: I am eligible under Division 3 of the Business and Professions Code to accept responsibility}for the building lesi'g'�or system design identified on this Certificate of Compliance (responsible
designer).
3. That the energy features and performance specifications, materials, componen I an manufact re 6ick flor the building design or system design identified on this Certificate of
Compliance conform to the requirements of Title 24, Part 1 and Part 6. f the California Code of Regulations.
4. The building design features or system design features identified on thi's Gerb icate of Compliance -are consistent witl .he information provided on other applicable compliance documents,
`
.n' " .i....,f i9.
worksheets, calculations, plans and specifications submitted ,tothe e�. fo7cement agentyfoapproval with is iuIlding permit application.
5. 1 will ensure that a registered copy of this Certificate Compllanc Ball be building issued for building,
of . madaviillabl� with the permit(s) the and made available to the enforcement agency
for all applicable inspections. I understand that a regist�r by ,bf this CCerti Icate`o#,Compliancy 6 qui4r'e� to be included with the documentation the builder provides to the building
owner at occupancy.
Responsible Designer. Name:
Responsible Designer Signature:
Company: J
Date Signed:
Address: v
License:
City/State/Zip:
Phone:
NSA
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-900-772-3300.
i
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014