RR (11-0298)51920 Avenida Martinez
11-0298
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00000298
Property Address:
51920 AVENIDA MARTINEZ
APN:
773-181-008-17 -000000-
Application description:
RE -ROOF
Property Zoning:
COVE RESIDENTIAL
Application valuation:
7500
c&'4t. 4 XP:Q"
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm underpenalty 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
any, applicant for a 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 workhimself 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 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. ., BAP.C. for this rolson
te: 3nec
011
10NRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that t 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: ril
LQPERMIT
Owner:
BRIAN JOHNSON
51920 AVENIDA
LA QUINTA, CA
Contractor:
Owner
MARTINEZ
92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/23/11
------------------------------------- - - - - --
WORKER'S COMPENSATION DECLARATION
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
St—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 becom bjact to the workers' compensation laws -of California,
and agree that, if I should becom s ect to the the compensation provisions of Section
3700 of the Labor Code, I all ith comply with those provisions.
i te• C pp"cant:
WARNI G:tILURE TO SECURE W EELTIES
OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI L P 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 inmotion is correct. I agree to comply with all
city and county ordinances and state laws relating to building con uction, and hereby authorize representatives
of this co my t enter upon a above-mentioned property r IhsPection purposes.
77
Dpa e ignature (Applicant or Agentl:
Application Number . . . . . 11-00000298
Permit . .
. RE -ROOF
Additional desc .
.
Permit Fee . . .
. 30.00
Plan Check Fee
.00
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date
9/19/11
Qty Unit Charge
Per
Extension
BASE
FEE
30.00
-----------------------------7----------------------------------------------
Special Notes and
Comments
RE -ROOF WITH LIGHT
WEIGHT CRCC APPROVED
TILE. 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
Prescriptive Certificate of Com linnce: Residential Reroof
Project Address: CF -1 R-ALT-ReRoof
I 92-0 rAV ?,v ,s Climate Zone Permit #
15
ROOFING PRODUCTS (COOL ROOFS) §151(012
Wham tao pro, _ -=-
_.. -A ctrrrur MOT surface to be replaced exceeds 50`Y of the existing roof area, or 1,000 ff, whichever is less, the new
roofing area must meet the roofing product ,Cool Roof' requirements of §152(b)lHi, 152(b)l Hii, orf 52(b)lHiii.
Check applicable alternative or exception below it 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 w 2:12 pitch).
❑ Cool roofs not required in Climates Zones 1-g, and 16 with a
Alternatives to §152(b)l Hi and §152(b)HII, Steep -slope roof steep -sloped roofs (greater pitch than 2:12) and product weight less than 5/Ib/ftz.
❑ Insulation with a thermal (Pitch > 2:12)
resistance of at least 0.85 hr-ftp•"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(f)10, or
❑ In climate zones 10, 12 and 13, with 1 Vof 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 duds 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)l Hill, Low -slope roof ( pitch S 2:12)
❑ Building has no duds in the attic.
Other Exceptions
❑ Roofing area is covered by building integrated; photovoltaic panelsand solar tt►emmal panels are exempt from Cool Roof criteria.
the
❑ Roof constructions that have thermal mass over the roof membrane with at least 25 IbW are exempt from the Cool Roof criteria
NOTE: If any one of the aliemauves or exception is checked
products in §118(1) are not applicable. Do not fill table below.
CRRC Product ID Number5Roof
2:12 2:12
>9 c - Qc sw ❑
LEI
Aged Solar Reflectance and Thermal Emittance requirements for roofing
Slope
> 2:12
Product Weight
< 51bf 2 Nb/ft2
Product
Type 2
Aged Solar
Reflectance3,4
❑49
'
❑4'❑EHEO
Thermal
Emittance
SRI
Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance,
I. The CRRC Product ID Number can be obtained from the Cool Roof Rating Coon/'s Rated Product Directory at www.cooJmofs oro/vrodI&Wsearah nho
2. Indicate the type of product is being used for the roof top, i.e. sl
3. ng/e-ply roof, asphalt roof, metal roof, etc.
If the Aged Reflectance is not available in the Cool Roof Rating Councils Rated Product Directory then use the Initial Reflectance value from the same
directory and use the equation (0.2+0.7(pi~ - 0.2) to obtain a4. calculaaged l
Check box if the Aged Reflectance is a calculated value using the equationted above.vaue. Where p is the Initial Solar Reflectance.
5. Calculate the SRI value by using the SRI_ Worksheet at:/Mrwry,enerw rA
scopy of the SRI- Worksheet to the CF -1 R. ^^v'4dlA9d/ and enter the resulting value in the SRI Column above and attach
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or cover
recommended by the coatings manufacturer and meet minimum performance requirements listed in118 14. Select the
§ C) applicable coating:
❑ Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other
E3 Aluminum
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 taws 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 r
1 and 6 of the California Code of R ufations. P requirements of Title 24, par
Name:
ZIY i., S61J Gti Sign
Company:
Date:
P. ss: fssb/
License:
City/State/Zip:
o dti s•! C { Z Z Phone:, 13 7 I 33 `/C)
300.
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772- to
P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(7 60) 777-7012
FA -X (760) 777-7011
Disclosures & Forms for"Owner-Builders Applying for Construction Permits
lMPORT.IlYT! NOTICE TO pROPERTY OWNER
Dear Property Owner.
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified at 1r 1
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. 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.
OWNIER'S ACICNOWI,EDGM W -r AND VERIFICATION OF N
DfRECTTONS. Read and initial each statement below to signify you understand or verify this information.
1. 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 his or her own labor and material personally. 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 while working on my property. My homeowner's insurance may not provide coverage for those
injuries. 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. ( 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-
Ti
esponsibility_Ti 3. 1 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.
r'
4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers or
permits and contracts.
Q ( 5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total vale
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employee
under state and federal law.
6. 1 understand if I am considered an "employee' under state and federal law, I must register with the state and fedei
government, withhold payroll • taxes, provide workers' compensation disability insurance, and contribute to unemploymt
compensation for each "employee." I also understand. my failure to abide by these laws may subject me to serious financ
risk.
i1 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family resides
structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licen
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is perfon
under contract with a licensed general building Contractor.
8. I understand as an Owner -Builder if l sell the property for which this permit is issued, I may De held liable for any
financial or personal ogituies sustained 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 "employer" from the Internal Revenue-
Service,
evenueService, the United States Small Business Administration, the California Department of Benefit Payments, and the California
Division.of Industrial Accidents. I also understand l may contact the California Contractors' State License Board (CSLB) at 1-
800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
n
h'r10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that t am the
party legally and financially responsible for proposed construction activity at the following address:
agree that, as the party legally and financially responsible for this proposed construction activity, l 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 changes to any of the information I
have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court It is also
important for you to understand that if an unlicensed Contractor or employee of that individual or firth is injured while wotiong
on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors,
You will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation 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 responsible for issuing the permit. Mate: A copy of the property owner's driver's liccense, fOrm notaricaea rt, err
other veriftcadon acceptable to the agen is required to be presented when the permit is iastted to verify the ProPertY
owner's signature. ZZ
Signature of property owner Date: J 2
Note. The following Authorization Form 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 OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understated is my personal responsibility, 1 hereby authorize
the following person(s) to act asmy agent(s) to apply for, sign, and file the documents necessary to obtain an Owuet-Builder
Permit for my project.
Scope of Construction Project (or Description of Work): _
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the ab
information and certify its accuracy. Note.- A copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature.
Property Owner's Signature: Date: _
Bin #
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
Permit #
Project Address: 3- 1 Z0 M
Owner's Name:A.
P. Number:
Legal Description:
Address: .Sk 5-1 9W AVC -0I -11A a vl'IA1 Ne
City, ST, Zip: Q(4t -T A, C 4Z6 7 7
Contractor:
Telephone: one: 94 9 71 Y0
Address:
Project Description: 7C — ,O o.F
City, ST, Zip: L Qk til a A ZZ
Tel e hone:
P —
r'l y v
q
f 3
State Lie. # :
City Lie. #c
Arch., Engr., Designer:
Address:
City, ST, Zip: .
Telephone:
Construction T e: O anc
YP ccu P Y•
State to Lia #-
Project ect le one . Neww
hPe (circle rcAdd' n Alter Repair air Dem
p o
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: Z(j
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
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 corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'`' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P_P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees