10-0449 (RR)11#111 6 5
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
10-00000449
54265 AVENIDA ALVARADO
774-235-025-2 -000000-
RE-ROOF
COVE RESIDENTIAL
9500
cetty/4 SCA"
Architect or Engineer:
air
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MATT LEHLMAN
54265 AVENIDA DIAZ
LA QUINTA, CA 92253
Contractor:
DIAZ ROOFING CO, INC.
66301 ESTRELLA AVENUE
DESERT HOT SPRINGS, CA
(760)329-4833
Lic. No..: 794658
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/25/10
iIiA� 2 3 2010 .�
CITY OF LA QUINTA
9224 FINANCE DEPT.
UCENSED 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 Cass: C39 i License No.: 794658
Date: S
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 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.).
( 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
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 1795873
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' compensation provisions of Section
3700 of the Labor Code, I shall fortJ3taith comply with those provisions.
WARNING: FAILURE 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 comply with all
city and county ordinances and state laws relating to building constructio , and hereby authorize representatives
of this c•unty to nterQupon the above-mentioned property for inspectiy'purposes.
e (Applicant or Agent):
Application Number 10-00000449
Permit RE -ROOF
Additional desc
Permit Fee . . 30.00 Plan Check Fee .00
Issue Date . . Valuation 0
Expiration Date 11/21/10
Qty Unit Charge Per
BASE FEE
Extension
30.00
Special Notes and Comments
RE -ROOF WITH OWENS CORNING SHASTA WHITE
30 YEAR SHINGLES. 2007 CODES
Other Fees BLDG STDS ADMIN (SB1473) 1.00
Fee summary Charged Paid Credited Due
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
LQPERMIT
30.00
.00
1.00
31.00
.00
.00
.00
.00
.00
.00
.00
.00
30.00
.00
1.00
31.00
Bin # .
City of La Quinta
Building 8T Safety Division
Permk # v)
!,� La
10 -
.
P.O. Box 1504, 78-495 Calle Tampko
Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: 5�2 / f c i dO
Owner's Name: ilqa t e A t,,i m k
A P. Number.
Adams: 5-1(2 6 S 4(v G Yef 1,
Legal Description: /2p_ •
_yin f
City, ST, Zip:
,,
Contractor: t h
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Telephone: 9 r a,; c :
PROPOSAL
FROM:
DIAZ ROOFING CO INC. CA LIC #794658
66301 ESTRELLA AVE
DESERT HOT SPRINGS, CA 92240
PROPOSAL SUBMITTED TO:
0
ze S Alvarado
•
l
PHONE
PAGE NO.
1
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PAGES
DATE
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:JOB NAME
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ADDRESS
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CITY/STATE/ZIP
LC( (.�nn
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We hereby submit specifications and estimates for:
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,t/},y0uhcl I( edt r 15'0 0 'volih 1h pr,'r.e
We herebyproposeto furnish laborr7 and materials - complete in accordance with the above specifications, for the sum of
Al; he / 4 0 (/S or AN 7' r 1/e it uH JYc d dollars ($ ,9' cg a ) with payment to be made as follows:
/0 4 s , h,7/9 OrO posy ( s'o). S %a r, tie J o
and I3(4(atii,e o(ve up /A Jdb cow,,/eros
All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration
or deviation from above specifications involving extra costs will be executed only upon written orders and will become an extra charge
and above the estimate. All agreements contingent upon strikes, accident or delays beyond our control. This proposal subject to acceptance
within days and it is void thereafter at the option of the undersigned.
Authorized Signature
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are hereby accepted. You are authorized to do the work as specified. Payments will be made
as outlined above.
ACCEPTED:
Gz
Signature
Date 03/03/10 Signature
0E -Z Contractors Forms Form No. EZ 120 g
k
Prescriptive Certificate of Compliance: Residential Reroof
Project Address:
sy 2‘S 7 lvarac(
Climate` Zone
/✓
CF -1 R-ALT-ReRoof
Permit #
/0 -44q
1..
ROOFING PRODUCTS (COOL ROOFS) §151012
When the area of exterior roof surface to be replaced exceeds 50% of the existing roof area, or 1,000 ftz, whichever is less, the new
roofing area must meet the roofing product "Cool Roof" requirements of §152(b)1Hi, 152(b)1Hii, or 152(b)1Hiii.
Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof requirements::
❑ Cool roofs not required in Climates Zones 1-12, 14, and 16 with a low sloped roof pitch (less or 2:12 pitch).
Ci Cool roofs not 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/ft2.
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•ft2•°FBtu 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(f)10; or
❑ In dimate zones 10, 12 and 13, with 1 ft2 of free ventilation area of attic ventilation for every 150 ft2 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(f)2; or
❑ Building has no ducts in the attic; or
❑ In dimate zones 10, 11, 13 and 14, R-3 or greater roof deck insulation above vented attic.
Exception to §152(b)1 Hiii, 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 25 Ib/ft2 are exempt from the Cool Roof criteria.
NOTE: If any one of the alternatives 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.
CRRC Product ID Number
0 3TO^DOG)
Roof Slope
<- 2:12 > 2:12
Product Weight
< 5Ib/ft2 2 5Ib/ft2
0
0
Product
Type2
Aged Solar
Reflectance3'4
Thermal
Emittance
SRI5
❑4
0
0
0
0
❑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 ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs.oro/products/search.php
2. Indicate the type of product is being used for the roof top, i.e. 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 Reflectance.
4. Check box if the Aged Reflectance is a calculated value using the equation above.
5. Calculate the SRI value by using the SRI- Worksheet at htto://www.enerov.ca.gov/title24/ and enter the resulting value in the SRI Column above and attach
acopy of the SRI- Worksheet to the CF -1R.
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in §118(i)4. Select the applicable coating:
0 Aluminum -Pigmented Asphalt Roof Coating 0 Cement -Based Roof Coating
0 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.
• I certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24, Parts
1 and 6 of the California Code of Regulations.
Name:
S6Le fro ) 4
Company:
P. ;Ss:
i) R.o-e3
oer • It i f -
Signature:
f � �
Date:
City/State/Zip:
License:
DP.S.rr1Fof i'3
(h
Phone:
S_/2 5L 0
-�9ift;rgr
7, 2 n n 6711
For assistance or questions regarding th Energy Standards, contact the Energy Hotline at: 1-800-772-3300.