12-0953 (RR)P.O. BOX 1504
78-495 CAL LE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: \ 12-00000953
Property Address:
56060 RIVIERA'
APN:
762 -021 -004 --
Application description:
RE -ROOF
Property Zoning:
LOW DENSITY RESIDENTIAL
Applioation valuation:
1 1500
c&ht 4 XP Q"
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Busines nd Professionals Code, and my Lice ns 's in full force and effect.
License Class: C39 Li cen No.: 774
`o -7n-1
n — ntractor:
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).:
(_ 1 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.l.
(_ 1 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.).
(_ 1 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:
LQPERMIT
Owner:
PGA WEST RES. II
C/O MONARCH GROUP
43875 WASHINGTON STREET STE C
PALM DESERT, CA 92211
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/23/12
Contractor: 1
WILLIAMS ROOFING rcc;lvo
P.O. BOX 391841ANZA, CA 92539(760)399-9394 F(l�INYA
LiC. No.: 774482 I...�r,rPT.
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 STATE FUND Policy Number 1890178-2011
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 subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' co sation provisions of Section
3700 o the Labor C , I sh 1 forthwith co ply with thos _.)n
r isions.
Dat�_/ pplicant: tY
WARNING: FAIL RE TO SECURE 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.
I certify that I have read this application and state that the above information is correct. I agree to com with all
city and county ordinances and state laws relating to buildic nstr tion, and hereby authorize repr en tiv
of Shis county to enter upon the above-mentioned property for nsp ion purposes
D/at S .ture (Applicant or Agent):
Application Number 12-00000953
Permit RE -ROOF
Additional desc .
Permit Fee 30.00
Plan Check Fee
.00 .
Issue Date
Valuation . .
. 0
Expiration Date 2/19/13
Qty Unit Charge Per
Extension
BASE FEE
30.00
----------------------------------------------------------------------------
Special Notes and Comments
RE -ROOF OVER EXISTING WITH URETHANE
FOAM. 2010 CODES.
---------------------------------------------------------------
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
BM ff
Permit #
JC Project Addre!
Number:
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777.7012
Building Permit Application and Tracking Sheet
rA PGA wner's Name: IZIA 11 l
# Submittal
Pian Sets
Structural Calcs.
Truss Calcs.
Title 24 Cales.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
d Recd TRACKING
Plan Check submitted
Reviewed, ready for corrections
--------------
Called Contact Person
Plans picked up
Plans resubmitted
2nd Review, ready for corrections/issue
Called Contact Person
Plans picked up
Plans resubmitted
Review, ready for corrections/issue
Called Contact Person
Date of permit issue
PERMIT FEES
Item
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
S.M.I.
Grading
Developer Impact Fee
A.1.P.P.
Total Permit Fees
Amount
City, ST, Zip:
116
Contractor:
elephone:
-
Address: `L4
I
Project Description:
City. ST, Zip:
Telephone:
jC
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: > P Occupancy:
State Lic. #:
.............:.
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE
BELOW THIS LINE
# Submittal
Pian Sets
Structural Calcs.
Truss Calcs.
Title 24 Cales.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
d Recd TRACKING
Plan Check submitted
Reviewed, ready for corrections
--------------
Called Contact Person
Plans picked up
Plans resubmitted
2nd Review, ready for corrections/issue
Called Contact Person
Plans picked up
Plans resubmitted
Review, ready for corrections/issue
Called Contact Person
Date of permit issue
PERMIT FEES
Item
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
S.M.I.
Grading
Developer Impact Fee
A.1.P.P.
Total Permit Fees
Amount
P.O. Box 391881, Anza, Ca. 92539 951-763-0769
So -855 Washington St. 2C,# 13o, La Quinta, Ca. 92253 760-394-939
Contract #4992
For: Monarch Management Trust, 39-755 Berkey Suite A, Palm Desert, Ca. 9226o
Attn: JoAnne Rose Date: July 15, 2012
Job Addresses: 567o6o Riviera, La Quinta, Ca. 92253
Schedule of extras if aoolicable:
During the repair process, if any asbestos is discovered, the removal and disposal cost would be borne by owner. Any dry rot
will be replaced for an additional charge based on $8i.00 per hour labor and ix6 or ix8 materials at $ 2.50 per foot. Any
damaged rafter ends will be replaced for an additional charge based on s iog.00 each and fascia board at $ iz.00 per lin. Ft. Any
CDX/OSB plywood to be replaced at an additional charge based on $ 2.00 per sq. foot, labor included.
Scope of Work as follows; Urethane foam roof system as follows on the above
rear patio flat deck only: Clean and prep roof decks to accept new materials.
Install new edge metals as needed. Wipe down and prime edge metals.
Install 1" 3.0 SPF Poly Urethane foam roof system as per manufactures
specifications. Install Acrylic roof coating as per manufactures specifications
@ a rate of 12" on perimeter and to receive 4 gallons per every loo square feet.
Remainder of roof system to receive 3 gallons per every loo square feet as per
manufactures specifications. (This roof system is Title 24 Compliant)
Contract Price: $ 1,500.00
Payment to be made as follows: To be paid upon regular billing cycle. (As completed)
Williams Roofing to leave jobsite clean and free of debris.
**Ten year workmanship warranty on all work performed by Williams Roofing only**
Owner/Agent Contractor
T
Prescriptive Certificate of Compliance: Residential Reroof CF -1 R-ALT-ReRoc
Project Address S& I -L'O-4L0-4'1a71 1
Climate Zone
Permit 5
ROOFING PRODUCTS (COOL ROOFS) §151(n12
When the area of exterior root surface to be replaced exceeds 50% of the existing roof area, or 1,000 K, whichever Is less, the net
roofing area must meet the roofing product "Cool Roof' requirements of §152(b)1H1, 152(b)114/1, or 152(b)1H111.
Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof" requirements::
❑ Cool roofs nWo required in Climates Zones 1-12,14, and 16 with a low sloped roof pitch (lessor 2:12 pitch).
❑ Cool roofs tW required in Climates Zones 1-9, and 16 with a steep -sloped roofs (greater pitch than 2:12) and product weight less than 5/Ib/l
Alternatives to §152(b)l HI and §152(b)Hii, Steep -slope roof (pitch > 2:12)
❑ Insulation with a thermal resistance of at least 0.85 heft."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(910; or
❑ In climate zones 10, 12 and 13, with 11`12 of free ventilation area of attic ventilation for every 150112 of attic floor area, and
where at least 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 §151(92; 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)1 Hlii, Low -slope roof ( pitch 5 2:12)
❑ Building has no ducts in the attic.
Other Exceptions
❑ 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 251b/tt2 are exempt from the Cool Roof criteria.
NOTE., If any one of the a/tematives or exception is checked the Aged Solar Reflectance and Thermal Emittance requirements for roofing
products In § 118(1) are not applicable. Do not fill table below.
NOTE: When a Cool Roof is required, the installing contractor shall complete and submit the CF -6R -ENV -01 for final inspection.
Declaration Statement
Roof Slope
Product Weight
Product
Aged Solar
Thermal
License: r7i
CRRC Product ID Number'
s 2:12 > 2:12
< 5ib/fe a 516/ftz
Tvpe,
Reflectance 3'4
Eminence
SRI
NO
❑
❑
❑
J ao
❑4
13
❑
❑
❑
❑
❑4
Note: if no CRRC-1 label Is available, this compliance method cannot be used, use the Performance Approach to show compliance,
1. The CRRC Product /D Number can be obtained from the Cool Roof Rating Council's Rat Product Directory at www.coolrools.oralbroducts/sean:h.nhv
2. Indicate the type of product is being used for the roof top, Ie. single -ply roof, asphalt roof, metal roof, etc.
3. If the 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(p„„,„ - 0.2) to obtain a calculated aged value. Where p is the Initial Solar Relfectance.,
4. Check box it the Aged Reflectance Is a calculated value using the equation above.
5. Calculate the SRI value by using the SRI- Worksheet at h1h2YAmm. eneravca.oov/Ntle24/ and enter the resulting value in the SRI Column above and attach
acopy of the SRI- Worksheet to the CF -1 R.
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or cover.
.commended by the coatings manufacturer and meet minimum performance requirements listed in §118(1)4. Select the applicable coating:
❑ Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other
NOTE: When a Cool Roof is required, the installing contractor shall complete and submit the CF -6R -ENV -01 for final inspection.
Declaration Statement
I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is.accurate and complete.
• 1 certify that the energy features and performancespecifications iderilified on fts.Certif tate of Compliance conform to the requirements of Title 24, Part!
1 and H of the Californla CQde.qf Regulations.
Name:
Signature:
Compan
Address: y
License: r7i
City/State/Z q -7 J3- qZ539Phone: ����� 3 1
For assistance or ouastions raeard/ne tha Ena_rav Standard*- enntaet thw Fnamv NANInn nt- 1-AnrL779_712nn