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RR (12-0471)51525 Avenida Martinez 12-0471 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000471 Property Address: 51525 AVENIDA MARTINEZ APN: 773-141-002-2 -000000- Application description: RE -ROOF Property Zoning: COVE RESIDENTIAL Application valuation: 4800 Applicant: Architect or Engineer: 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 an 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.). (_ 1 1, 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 te: S U Owner: fGci C t > 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: LQPER.MIT Owner: FELIX JESSE 51525 AVENIDA MARTINEZ LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/01/12 Contractor: D961T_Y0F1LAA0U1NWTA Owner -----------------=-----= ---- 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 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 37''00 of the Labor,C,od e Jsfp all forthw/it/h CoZplyh those provisions. ate:7 1 licant: C ITGe cs /-/ 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 Quints, 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 construction, and hereby authorize representatives of t s county to enter upon !Pe 'above-mentioned property /fy//) sectiom ate: ..S / b/ZSi ature (Applicant or Agent):¢—c' Application Number . . . . . 12-00000471 Permit . . . RE -ROOF Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . .0 Expiration Date 10/28/.12 Qty Unit Charge 'Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and Comments RE -ROOF WITH SHASTA WHITE SHINGLES. 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 P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 s BUILDING & SAFETY DEPARTMENT PROPER'L`Y OWNER'S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner-B.allders Applying for Construction Permits 149MANT, 1 1Q'TI _F Tn tZrtn> ury OWI TIeI Dear Property Owner: Mt. application €or a building permit has been submitted in your namelisting yourself as the builder of the property .i WPrV =Wts specified at We are providing you with an Owner -Builder Acknowledgment and: Infotmation Veri&eation Form to male you awam of your r nsibilities and possible risk you may incur by having this permit isstted in your name as :the Owner -Budder. We will not Issue a building. permit until you have read, initialed your understanding of each:provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. Read a &Wtal each: statenrentbehO d6 signify you undw3tand or ver* dhis irrfornration. I. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing hisor her own labor and material petsonalhy.1, as an Owner -Builder, may be held liable and subject to serious financial. risk for. any injuries sustained by an unlicensed person and his or her employees white working on my property. My homeowner's insurance may not provide coverage for those— inJunes- I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property - 2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. 6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, 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 7. 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 a licensed general building Contractor. 8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal. 4.aries sus lined by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 9. I understand I may obtain more information regarding my obligations as an "employee" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Paymeeits, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CS. LB) at 1- 800-321-CSLB (2752) or www.cslb.ca gov for more information about licensed contractors. 10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the ply legally and financially responsible for proposed construction activity at the following address: agree that, as the party legally and financially responsible for this proposed constriction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. 12. 1 agree to notify the issuer of this. form immediately of any additions; deletions, or chsngs to any of the infumlahoit 1 have provided on this form. Licensed contractors are regulated by laws designed to protect the public. U you contract with someone who does not have a lienee. the Contactors' State License Board may be unable to ass;Wt you with any f3na aW loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be tnicivil court. It is also importaf t for you to understand that if an unlicensed or employee of that individual or firm is injured while worldng on your property; hel You may be d t WAW for damages. if you obtain a permit as Owner -Budder and wish to hire ConU00tors, You Witt be respoWfOle for verf ging v4tether or not those Coutructors areI IeY ro licensed and the status of ftlx wc&cre P commotion insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency res for issttip reit. N co Nre propel owner's dven'ffi.less, fdrvre tiotar;bvnt or other venfica n accep to. the agency is be when the pqm t , is sestte 6 to ut,rify the paoperty owner's signature. Signature of proper Date: r - Note: The following Authorization Forst is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNUM BEE ALF Excluding. the Notice to Property Owner, the exw4ttion of which I understand is my personal responsibility, I hereby authorize the following person(s). to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Buildet Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: S I _S L 3-4`4 ' (tel A P_ k e 3 Name of Authorized Agent: Tel No -'/O 11 Address of Authorized Agent:. I S 2 r4 12 41 Al e I declare under penalty of peij that I am the property owner for the address listed above and I personally filled out the above information and is acc cy. Note: A copy of the owner's driver's license, form notarization, or other venfrcation acceptable to the gency is (ed to be presented why the pegow is issued to verify the property owner's signature.. Property Owner's Signature: Date: S / 20 /z yl4l` P,rect: Aeffikes VIVO rtif3c te ofuira "l n cEa. } , :, E`alil tt2t: eroo; 'Climate Zone Pe ROOFING PRODUCTS,(COOL ROOFS) 6161(012 INhan the area ofexterror roof surface to be replaced exceeds 6046 of the existing roof area,, or 1,iM 1, whichever Is less, the new rooting area must meet the roofing product "Cool Roof"urrements of §162(b)1Hi,162(b)1Hfl; or 162(b)1H111.. . Check applicable alternativwo.r exception below :if the roof alteration is exempt from the roofing product 'Cool Roof requirements:: ❑ Cool roofs not required to Climates Zones 1-12,14, and 16 with a low.sb D Cool roofs W required in Climates Zones 1-9, and 16 with a t roof pitch (tens or 2:12 pitch). Alternatives to §152(b)iHi and § dOPed roofs (greater pitch than 2:12) and product weight less than 511bltt2. 162(b)Hii, Stee"Ibpe roof (pitch >.2:12) ❑ Insulation with a thermal resistance of at least 0.85 heft ••FBtu or at least a 3/4 inch air ❑ Existing ducts in the attic are spa oe is added to.the roof deck over an attic; or insulated and sealed according to §151(f)10; or ❑ In dimate zones 10, 12 and 13, with 1 f12 of free veMitation 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: celiing insulation; or ' ❑ Building has radiant barter in the attic meeting the requlrernents of §151(Q2; or ❑ Building has no duds in the attic; or. ❑ In climate zones 10, 11,13 and 14, R-3 or greater roofdeck insulation above vented attic. Exception to §152(b)1Hiil, Low 'lope roof (Pitch:g 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 Coot Roof arteria. ❑ Roof constructions that have themial'mass over the roof membrane with at least 25 are exempt from the Cool Roof caterta. ..NOTE. If any one of the altemativves or exception Is checked q ged *Sokproducts in §1180 are not applicable. Do not rill table below. r Rellectanoe and rural C-mittance requirements for roofing CRRC Product ID Number' Roof Slop 5 2:12 > i —o0/ ❑ e :12 Product Weight i 5[blft2 Product T. T 2 Aged Solar Reftedance''4 Thal SKIS ?W ❑ 4 ❑ ❑ ❑. Note: If no CRRG 1 label is evaJlable, this compliance method cannot used use Performance 1. The CRRC Product ID Number can be Approach to show compliance; 2. Indicate the type of product is being used for the roof C Roof Rating Council's Rated Product Directory at ter. 000froofs orv/vroducrslsea. ten., I- If the Aged Reflectance is not available in the Cool Roof RatingProduct01rMetal roof, etc. dlrecxovy and use the equation (0.2+0.7(fpa41 _ 0.2) to obta/n a calculated d value'then use the Initial Reflectance value tiom the same {. Check box f1 the Aged Reflectance Is a calculated value . Where p the Initial Solar Reflectance. i. Cakwfate the SRI value by u using eQuatk rr above. sing the SRI- Worksheet at hitn /ibvww.errerr v ca oovAltle241 and enter the resufUng value in the SRI Column above and attach acopy of the SRI- Worksheet to the CF -1R. fo apply Liquid Field Applled Coatings, the coating must be ecommended by the coatings manufacturer and meet minimum plied across the entire roof surface and meet the dry m8 thickness or covenperfortnanoe requirements listed in §1180)4. Select the applik:able coating: 7 Aluminum -Pigmented Asphalt Roof Coating 13 Cement -Based Roof Coating 13 Other IQTE When a Cool Roof is required, the installing contractor shall complete and submit the CF`6R-ENV-01 for final insoedln- • 1 certify under penalty of perjury, under the laws of the State of Califomia, the in provided on this form is accurate and complete. • I certify that the energy features and 1 and 6 of the California Code of R Porto nsance sperdfications Identified on this Certificate of Compliance conform to the requinMenh of Idle 24, Part Name: Gx Signature: :ss: Ca eivo 11 \ Date: License: For assistance or questions regarding the Energy Standards, contact the Ene rgy Hotline at: 1-800-772-3300. 05-01-12 06:53:49 AM Page 1/1 I ' Q880700 RWC BUILDING PRODL.kCTz 1250 VALDIVIA WAY PALM SPRINGS CA 92262 760-322-9390 QUOTE PRINT Bill-to:34008 ELR BUILDING CONTRACTOR t Ship-to:TEMP ELR BUILDING CONTRACTOR 938 VELLA ROAD 51-525 AVE. MARTINEZ PALM SPRINGS CA 92264 a ELIAS LA QUINTA CA 92253 760-406-1500 EXPIRES SLSP yTERMS ?NIT WH CUSTOMER PO FRT. REF. SHIPVIA 06-01-12 HSE PP PSP CD R QUOTED BY : RICARDO FORERO HERNANDEZ QUOTBD TO : ELIAS Item Description Quantfy UM11Price UM Extension 2599 SHASTA WHITE: OAKRIDGE:OWENS COFOING:3 BU/SQ:MTC 24.000 SQ 75.95' SQ 1822.80 LIMITED LIFETIME WARRANTY 1518 FONTANA:15#:ASTM:4869:SATURATED FELT = = 6' RL 22.99 RL 137.94 - 4 SQ/RL:36 RL/PAL L 3222 CROWN: 30.:H&R: DOVER WHITE 3 BX 49.95 BX 149.85 30 LF/BX:CROWN ENHANCED HIP&R:DCE DELIVERY RWC Roof Load Conveyer 1 EA 65.00 EA 65.00 BILL TO CUSTOMER FSURCHGE FUEL SURCHARGE - FSURCHGE i 1' EA 35.00 EA 35.00 C _ Ir ,MERCHANDI£E TAX'.f TEND RED CASH BACK TOTAL 2210_9 r 190. 36, 0.00 0.00'2400.95 mat•. •ra [. .mw.awrbn. e4}nm.•wl wrwoan.w•.tiW...piv.un rrLLa+rm.Mvn.m.dm.w.neaax...ne•prt+tm nmm•Yp<, •nksr¢tl•rn,IM.•rWpWpl mawhaawour wm.E•wdwmled. rncr..ammmu..a manvu •.imrpm dacutM etl nv4l.+ wn•bm•wua.mx.c.ot. ..rywm +dwe.a.cr..m ••wl. mm..ebn. waw •oW m.=ct .Orw..o.>ww. uuvrl t•nV•r tmMTUO bpant•.iVNur•wnw WtlYv mr w[ v u.lmV/M1FtHM1p•nv.nMtOmd w•nuMm wawr•wdbv..WMOct3bt.0•v mrt•rWmMlm'sM1•OMtM PM•w.•ni••tvwwsuv 6.Wbt•muW W%N••Mmu.ltl mmbluR•04 peYY ml.el[a•Itlnt VOAGon.fotltbn rctW oM tL[tl Mh NY WO• •aT'•¢•OWtivMacvn. Trrro Fcoti¢ t wim Ju•mctl !rb w1iN m•Y •{q•a m wtm•I• IomW vW W rcl a .a•q a a.• iltr. Bin. # City of La Quinta Buifdfng 8r Safety Division P.O. Box 1504,78-495 Calfe Tampico La.Qulnta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Perinit #^ 1 Project Address: 5 / g 2.3 A r ,¢p F// / j Owner's Name:. e Sse e f A P. Number. Address: Legal Description: a Lcc • 5 L4 t h( Q "' City, ST, Zip: 14 G ` , C4 9 2 2 S' j Contractor. Tel hone: eP bD 2 Ff S - ( Address: Project Description: R, a t . Ut I/.( (1C. City, ST, Zip: Telephone: State Lic. 4: City Lie. #: Arch., Engr., Designer. Address: City., ST, Zip'. ` Telephone: Y' `' State Lic. #:. '_ w.:.."` `% ,r Construction Type VVW Occupancy: CWtAte • Project type (circle one): New Add'n Alter Repair Demo Name of Contarx Person: Sq. Ft: Stories: # Unity: Telephone # of Contact Person: Estimated Value of Project" I p 7 APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACEING PERMIT FEES Plan Sets Pian Check submitted Item Amount Structufal Calcs. Reviewed, ready for corrections Plan Check Deposit. Truss Cafes. Called Contact Person Plan Check Balance Title 24 Calcs Plans picked up Construction Flood plain plan Plans resubmitted.'. Mechanical Grading plan 2'' Review, ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up &IVLL H.O.A. Approval Plans resubmitted Grading 11Y HOUSE:- '^' Review; ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees