BRER2016-010278-495 CALLE TAMPICO V ] Qum&
VOICE FAX (760) 777-7011
' (760) 777-7125
4
LA QUINTA, CALIFORNIA 92253 DESIGN &DEVELOPMENT DEPARTMENT FAX
(760) 777-7153
BUILDING PERMIT
Date: 11/9/2016
Application Number: BRER2016-0102 Owner:
Property Address: 55718 RIVIERA PGA RESIDENTIAL ASSOCIATION
APN: 775242013 54320 SOUTHERN HILLS
Application Description: PGA WEST HOA / POLYURETHANE FOAM ROOF LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $2,140.00
Applicant: o tractor:
B R S ROOFING INC S ROOFING INC
777 SOUTH LUGO AVE 7 SOUTH LUGO A./E
SAN BERNARDINO, CA 92408 NOV 10 2016 BERNARDINO; CA 92408
CITY OF LA QUINTA (909)884-8505
DESIGN AND DEVELOPMENT DEPARTMAT'Np.: 907600
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 C39 license No.: 90766000
d.,(AOContractor:'
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 l
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(_) 1, 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.).
(_) I, 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. . B.&P.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:
WORKER'S COMPENSATICH DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate cf consent to self -insure for workers'
compensation, as provided for by Section 3700 o' the Labor Code, for the performance
oft wok for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
SVti/ 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: STATE COMPENSATION INSURANCE FUN:) Polity Number: 9141962
I certify that in the performance of thte work for which this permit is issued, I
shall not employ any person in any manner so asto become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
workers' compensation provisions of Section 37CO of the Labor Code, I shall forthwith
comply with thos provisions.
Date: A Applicapr-J,
WARNING: FAILURE TO SECURE WORKM' COM s-ENSATION 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 IW SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the 3uilding 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 is!uance of such permit, or cessation of
work for 180 days will subject permit to cancella=ion.
I certify that I have read this application and stat` that the above information.is correct.
I agree to comply with all city and county ordinances and state laws relatipg4&4uilding
construction, and hereby authorize representati+es of this city to enter e
above menti ned roperty for inspection purposes.
ri n
Date: U/ signature (Applicant o Agent);-"
Date: 11/9/2016
Application Number:
BRER2016-0102
Owner:
Property Address:
55718 RIVIERA
PGA RESIDENTIAL ASSOCIATION
APN:
775242013
54320 SOUTHERN HILLS
Application Description:
PGA WEST HOA / POLYURETHANE FOAM ROOF
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$2,140.00
Applicant:
Contractor:
B R S ROOFING INC
B R'S ROOFING INC
777 SOUTH LUGO AVE
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
SAN BERNARDINO, CA 92408
(909)884-8505
Llc. No.: 907600
Detail: REROOF WITH POLYURETAHNE
FOAM - LA POLLA COATINGS[CRRC: 0770-0002] 2013 CALIFORNIA ENERGY CODE.
FINANCIAL INFORMATION
DESCRIPTION;,
ACCOUNT CITY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION ESA:
$1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF - FIRST 2;000 SF
101-0000-42404
$51.68
Total Paid for RE -ROOF: $51.68
TOTALS:
Bin ##
Permit ##
Project Address: ,^
City of La Q uin ta
Building sr Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2.
Bdilding Permit Application and Tracking Sheol
.
/t�'��'Me O�vneT'sName: � e
A. P. Number:
t Ora
Address: /% o
i -
Legal Description:
City, ST, Zip: . [.
Contractor:
;-
Telephone: -
Address: v �t
Project Description: n
,��//
City- ST, Zip: ('�� !C!M
_
Telephone: _AreK
State Lic. # : 0 69K
City Lie. #.:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
an eY:
on iruction Type: Occupancy:
C s YP VA!
a
S t to Lic. #
ProJ ecttYPe (circle one • New' Add'n AIter Repair- Demo
0
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Caics.
Reviewed, ready for corrections
Plan Check Deposi[
Truss Calcs.•
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Floodplain plan
Plans resubmitted
Mechanical
Grading plan
tad Review, ready for correctionsfissue
Electrical
SubcQntactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I. .
II.O.A. Approval
Plans resubmitted
Grading
IN If OUSE:-
Review, ready for corrections/issue
Developer Impact ree
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. APpr
Date of permit issue
School Fees,
Total Permit Fees
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS ! i
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSIONi`3
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 4)
Project Name: 74 / /?�,( r,C/ /'-0 'W Date Preoared: // Y7' e*)n / (
A. GENERAL INFORMATION
�'0'Pk150.2(b)1H)
�
01
01
03
05
Project Name:
Project Location: r t �i
CA City: ` ???
02
At 04
06
Date Prepared: t>
Building Front Ci igntatl'on (deg or cardinal):
Number of Altered�Dwelling Units:
07
Zip Code:
08
Fuel i , ``'•
ype. `�
09
Climate Zone: 0
10
Tot'bl Cht1 ed Floor Ares (ft2) I
11
Building Type rA n ar,
12
S(ab,%1fe?(ft2) V,V-
13
Project Scope:
'Compliance .
°
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)~�t�
�'0'Pk150.2(b)1H)
�
01
02
03
04
05
067% -iX07 08y 09
10
11
Roof
T
CRRCT�roc('04ct ID
^
R -value "T.
Deck.
Proposed Minimum Required
Initial Solar Aged Solar
Thermal
'Compliance .
Pitch
i;"'P;r4Xed
Required
,oductT
g ` AppendixJA4
~.�
Reflectance Reflectance
Emittance
SRI Aged Solar
(Optional) Reflectance
Thermal
Emittance
Frame
Frame
31
Frame
Depth
Spacing
C�ontinuous
Cavity 6lnsulation .�, ' Reference
Y, e
•�
Tag/ID
Assembly Type
Type
(inches)
(inches)
R -valuer R-value`9 factor Table Cell
1 U -Factor
I Comments
NOTES ,
s
• Roof area covered by build!gintegrated phbtp,v61taiclpanels and solar thermal panels are exempt from the above Cool Roof requirements.
• Liquid field applie&�patings'must comply wiffi installation criteria from section 110.8(i)4.
C. ROOF REPLACEMENT (Prescriptive Alteration, SecA"
�'0'Pk150.2(b)1H)
�
01
02
03
04
0%,, -14h
06
Ot `67-0 08 09 10 11 12 13
Method of
Roof
T
CRRCT�roc('04ct ID
^
R -value "T.
Deck.
Proposed Minimum Required
Initial Solar Aged Solar
Thermal
'Compliance .
Pitch
Exception
.1 number
,oductT
_Insulatidn
Reflectance Reflectance
Emittance
SRI Aged Solar
(Optional) Reflectance
Thermal
Emittance
SRI
(Optional)
31
.190
'.
Y
Y, e
•�
NOTES ,
s
• Roof area covered by build!gintegrated phbtp,v61taiclpanels and solar thermal panels are exempt from the above Cool Roof requirements.
• Liquid field applie&�patings'must comply wiffi installation criteria from section 110.8(i)4.
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance lune 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations
(Pne 4 of 4)
I Project Name: `VC-7fl li/t-�,' �-f I Date Prepared: ////) -7 /
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:
7, 20n 1
Signature Date: ! '° 3AW
.' :11
/9 ANa
Address
CEA/ HERS Certification Ide 4ificklori°(if pplicable): %
City/State/Zip: n �f
/4)
Phone:, x'
RESPONSIBL PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California: 4A �y'
1. The information provided on this Certificate of Compliance is true and correct.'"
2. 1 am eligible under Division 3 of the Business Professions Code to
and accept responsibillytifor the building lesl 11!or system design identified on this Certificate of Compliance (responsible
designer). �� N "
3. That the energy features and performance specifications, materials, componefiUts� manufact "c1 de�v1! 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 o,. the Callfornia Code of°geNla{ions.
4. The building design features or system design features identified on t s Certificate of Compliance are consisten it lae information provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted to the enforcement agenq� for.approval with Ais bui�ldln ermit application.
g P P P
4 �, �. �,,•
5. 1 will ensure that a registered copy of this Certificate of Compl ancetshall be made,availa t with the building permit(s) issued for the building, and made available to the enforcement agency
for all applicable inspections, I understand that a registered copy of this Certifcgt�e� Compliance is,requ�l�red to be included with the documentation the builder provides to the building
owner at occupancy.
Responsible Designer
ame:--!!
v*x`f
jRespbIhsible Designer Signature:
n !` G�GQV(Q
C
4 1 h
Company: q � w ? 5 r
Date Signed:
Address:Licen
p'
r '1
� � 7
se:
1�
O / •
City/State/Zip: /1) ytkt�
Phone:
W
-zx0SO
?Y, �}
For assistance or 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