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RR (10-0462)52681 Avenida Martinez 10-0462 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000462 Property Address: 52681 AVENIDA MARTINEZ APN: 773-301-020-7 _000000 - Application description: RE -ROOF Property Zoning: COVE RESIDENTIAL Application valuation: 5000 Tdy 40" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: Owner: WILLIAMS HERMAN 52-681 AVENIDA MARTINEZ LA QUINTA, CA 92253 Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/05/10 ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and, my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: - Contractor: _ 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier Policy Number following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to - I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish o repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code I shall forthwith comply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by /U 1 an pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars IS500).: /7i„ Date: l/ plicant: r/i. '^ ( 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 WARNING: FAI URE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. one year of completion, the owner -builder will have the burden of proving that he or she did not build or improvefor 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. , B.&P.C. for this reason Date:.1Q "J — /0Q..er: UV 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: ii r LQPERMIT 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 construction, and hereby authorize representatives of this county to enter upon the above-mentioned property or inspection tipurposes. Date: /G S" G 9nature (Applicant or Agent): t i' /!/v` Application Number . . . . . 10-00000462 Permit . . . RE -ROOF Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . .. Valuation . . . . 0 Expiration Date 4/03/11 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and Comments RE -ROOF WITH CLASS A CRCC APPROVED SHINGLES, TIMBERLINE PRESTIGE- WHITE. 2007 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 2008 Building Energy Efficiency Standards Table 151-C Component Package D Data extracted from Standards for use in La Quinta, CA Climate Zone 15 Insulation Minimums Ceilings R-38 Walls Wood -frame walls R-21 Heavy mass walls . R-4.76 Li ht mass walls NA Below -grade walls RO Floors Slab floor perim. NR. Raised floors R-19 Concrete raised floors R-4 Radiant -Barrier ----- - - REQ Roofing --Products Low -sloped -(2:12 or less) - Aged Solar Reflectance 0.55 min Thermal Emittance 0.75 min or a minimum SRI of' Steep-sloped (> 2:12) (w/ roofing material density less than 5 psf [shingles, metal Aged Solar Reflectance 0.2"min," Thermal Emittance 0.75 min or a minimum SRI of Steep -sloped (> 2:12) (w/ roofing material density of 5 sf-or-more` cla concrete Aged Solar Reflectance 0.15 min Thermal Emittance 10.75 min or a minimum SRI of 10 Fenestration Maximum-U=factor r. 0.40 Maximum Solar Heat Gain Coefficient SHGC 0.35 Maximum Total Area 20% Maximum West Facing Area 5% Thermal Mass NR Space Heating Electric -resistance allowed No If gas, AFUE =. 78 If heat pump, HSPF = 7.7 Setback Thermostat REQ Space Cooling SEER = 13.0 If split system, refrigerant charge measurement or charge indicator displav REQ Central Forced Air Handlers Cooling Airflow and Watt Draw REQ Central Fan Integrated Ventilation S sten Watt Draw REQ Ducts Duct sealing REQ Duct Insulation R-8 Water Heating System shall meet Section 151(f)8 or Section 151(b)1 For alterations [replacement], meet Section 152 b 1 G or 1 52 b 2 Extract date: 01/08/2010 --Cool Roof Rating Council Page l . of 2 •Zv. " - Rated Products Directory: _Search ReSUIts-j new search j [ print friendly view (last,updated 28 May 2010 19:45 CDT) Showing Search Results for: CROW. Company: GAF Materials Corp' Product Type: Shingles or Shakes, Shingles, Shakes, Tile or Slate select' from products where company_name='GAF Materials Corp' and (type. like'Shingles or Shakes%' or type like'Shingles, Shakes, Tile or Slate%') order by.company_name asc previous l 1 l next (showing records 1-- 8 of,8) ....... _.._..... _.... ___:......._._........._.._......____................. ......_..... 25 Records per Page01 CRRC Prod. ID Manufacturer Information Brand Model Color Catepory Product Tvpe Solar Reflect. init Therm Emit. init - Slone Application 1 (sorted +) j 0676-0033 GAF Materials Corp Roval Sovereign White Shingles or 0.27 pending 0.91 pending Steep Beth McSorley Shakes'. (973-872-4421) 0676-0035 GAF Materials Corp Sentinel .. White Shingles or 0.27 pending 0.91 pending Steep Beth McSorley ." Shakes I (973-872-4421) i 0676-0030 GAF Materials Corp Timberline. Prestique 30 : White Shingles or 0.26. pending 0.85 pending Steep Beth .McSorley Shakes (973-872-4421) 0676 0031 GAF Materials Corp Timberline Prestique 40 or Cool White Shingles or. 0.26 pending 0.85 pending Steep Beth McSorley Timberline Cool Series Shakes (973-872-4421) 0676-0042 GAF Materials Corp Timberline Prestique 40 or. Cool Weathered Shingles or pending 0n92 pending Steep Beth McSorley. Timberline Cool Series Wood Shakes n26 I http://www.coolroofs.org/products/results.php?keyplirase=&select.type=select&type%o5B6%5D=Shingles+or+Shakes&market_t 6/1/2010 Cool Roof Rating Council Page 2 of 2 previous 1 1 1 next (showing records 1 - 8 of 8). 25 Records per Page l About the CRRC I Product Rating Program I Rated Products Directory I CRRC Members I CRRC News. Become a Member I How Do I I Contact Us I Cool Roof Links I Home http:Hw.ww.coolroofs.org/products/results.php?keyphrase=&select type=select&type%5B6%5D=Shingles+or+Shakes&market t... 6/1/2010 l (973-872-4421) 0676 0043 GAF Materials Corp Timberline Prestique 40 or Cool Antique Slate Shingles or 0.27 0.26 0.92 0.81 Steep Beth McSorley Timberline Cool Series Shakes j (973-8724421) I 0676-0041 GAF Materials Corp Timberline Prestique 40 or Cool Barkwood Shingles or 0.27 0.26. 0.92 0.81 Steep Beth McSorley Timberline Cool Series Shakes (973-872-4421) 0676-0032 GAF Materials Corp. Timberline Prestique Lifetime White Shingles or 0.26 pending 0.85 pending Steep i Beth McSorley Shakes I (973-872-4421) previous 1 1 1 next (showing records 1 - 8 of 8). 25 Records per Page l About the CRRC I Product Rating Program I Rated Products Directory I CRRC Members I CRRC News. Become a Member I How Do I I Contact Us I Cool Roof Links I Home http:Hw.ww.coolroofs.org/products/results.php?keyphrase=&select type=select&type%5B6%5D=Shingles+or+Shakes&market t... 6/1/2010 P.O. BOX 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits IWf1RIANT! NOME TO PROREM O)MR Dew Property Owner. An. application for a building t has beeii submitted in your name listing yourself as the builder of the property improvements specified at 3 % q y/- MCI / i (IV Z 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 hawing this permit issued in your name as the Owner -Builder. We will not issue a building permit until you, have read, initiated 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. OM'S ACKNOWL ErDGM ENT AND VERWWATMN OF II OI flN I;JiR'EC7TONS. Read and initial each statement below to signify you understand or verify this information. yY 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain- an "Owner-Buildee' building permit that erroneously implies that the owner is providing his or her own labor and material Mwnally- I, as ProP Y P 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 P rty- e2. I understand building permits are not required to be signed by property owners unless they are responsible for the corn's/truction and are not hiring a licensed Contractor to assume this responsibility.. l'1/ 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. #94. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. k5-. I understand if I employ or otherwise engage any persons other than California licensed Contractors, and the total valuf 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. A0ver 6. I understand if I am considered an "employer" under state and federal law, I must 'register with the state and 11 nment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemploymel compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financi risk. L7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family resident 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 perfom under contract with a licensed general building Contractor. 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 izyucies 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 "employee' from the Inter -nal Revenue er ce, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors. li`i0_ I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party, ,7allyandfinancially responsible for proposed construction activity at the following address: / (o f Gi/j P zi el Z0 1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. agree to notify the issuer of this form immediately of any additions, deletions, or chWc to any_ of the information I ave 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 unbconsetl Contractor or employee of that individual or firm is injured while working on your property; you may be hetd liable for damages. If you obtain a permit as Owner -Bud& -r and wish to hire Contractors, You wdl be reRmske for verifying whether or not those Contractors are property licensed and the status of their workers' compensation instuanoe ooverage. Before a building permit can be issued, this form must be completed and signed by the property owner aad returned to the agency responsible for issuing: the.per=& Note. A copy of the -property owner's ddver'sAbonsei forst ttatarMtv04 or Other veriftcation acceptable to the agency ii required to be presented when the pemat is inued to va* the pmperty owner's signature. Signature of property owner Date: —5- _ Q 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 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 -Builder Permit for my project. Scope of Construction Project (or Description of Work): p/ A --a Project Location or Address: Name of Authorized Agent: /f%A%% `f/// q /r r Tel No ;7t1,,46 271 y`3 Address of Authorized Agent: e Z I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the abov 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: /,/4%/ , /y Date: S — . I ' 0