RR (12-1100)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
12-00001100
56690 MERION
762 -032 -003 -
RE -ROOF
LOW DENSITY RESIDENTIAL
1500
c&tv1440"
Architect or Engineer:
PIP
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: C39 Li se No.: 777,"82
Date( ractor:
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)•:
(_) 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.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Cade: 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. , BAP.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: n
Lender's Address:
LQPERMIT
Owner:
PGA WEST RES
39755 BERKEY
PALM DESERT,
Imm
VOICE (760) 777- 2
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
ate: /24/12
II V____ h
SAE. A
CA 92260 �v L
�tIV
0P LAQUOTA
Contractor:
WILLIAMS ROOFING
P.O. BOX 391841
ANZA, CA 92539
(760)399-9394
Lic. No.: 774482
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, 1 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 sho become subject to the workers' compensation provisions of Section
3700 of the Labor Co e I shalliforthwith comply with those provisions.
Bate plicant:
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 6&6ers, 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 ca collation.
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 buil ni g construction, �hereb�authonzeepresentatives
of this county
county tto+en er upon the above-mentioned propert f ins ction
tej ` nature (Applicant or Agent):
Application Number . . . . . 12-00001100
Permit . .
. RE -ROOF
Additional desc .
.
Permit Fee . . .
. 30.00
Plan Check Fee
.00
Issue Date . . .
-
Valuation . . .
. 0
Expiration Date .
. 3/23/13
Qty Unit Charge
Per
Extension
BASE FEE
30.00
----------------------------------------------------------------------------
Special Notes and
Comments
RE -ROOF REAR PATIO
FLAT DECK WITH
URETHANE FOAM ROOF
SYSTEM. 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
i
NIMP.O. Box 391841, Anza, Ca. 92539 951-763-0769
50-855 Washington St. 2c, #iso, La Quinta, Ca. cLzzS-3 760-399-9394
Contract #5031
For: Monarch Management Trust, 39-755 Berkey Suite A, Palm Desert, Ca. 9226o
Attn: JoAnne Rose Date: July 15, 2012
Job Addresses: 56-690 Merion, La Quinta, Ca. 92253
Schedule of extras if annlicable:
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 s81.00 per hour labor and ix6 or 1x8 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 $12.00 per lin. Ft. Any
CDX/OSB plywood to be replaced at an additional charge based on s 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
Prescriptive Certificate of Compliance: Residential Reroof CF -1 R-ALT-ReRoc
Project Address:
(56 au Al
Product Weight
Climate Zone
Permit 0
ROOFING PRODUCTS (COOL ROOFS) §151(012
When the area of exterior root surface to be replaced exceeds 50% of the existing root area, or 1,000 M`, whichever is less, the net
[20eckSapplicable
nares must meet the roofing product "Cool Roof" requirements of §152(b)1H1, 152(b)1Hll, or 152(b)1H/l►.
alternative or exception below it the roof alteration Is exempt from the roofing product "Cool Roof requirements::
❑ Cool roofs no required in Climates Zones 1-12,14, and 16 with a low sloped roof pitch (less or 2:12 pitch).
❑ Cod roofs nQj required in Climates Zones 1-9, and 18 with a steep -sloped roofs (greater pitch than 2:12) and product weight less than SAW
Alternatives to §152(b)1Hl and §152(b)HII, Steep -slope roof (pitch> 2:12)
❑ Insulation with a thermal resistance of at least 0.85 hr-fe-OF/Btu or at least a 34 inch air -space is added to the roof deck over an aft; or
❑ Existing ducts In the attic are insulated and sealed according to §151(010; or
❑ In climate zones 10, 12 and 13, with 1 ft2 of free ventilation area of attic ventilation for every ISO 112 of aft 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 root deck Insulation above vented attic.
Exception to §152(b)1 Hill, Low -slope roof ( pitch 5 2:12)
❑ Building has no ducts In the attic.
Other Exceptions
❑ Rooting area Is covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the Cod Roof criteria.
❑ Roof constructions that have thermal mass over the root membrane with at least 26 Ib/ft2 are exemat from the Cool Roof criteria.
MQU., If any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Eln►ttance requirements for roofing
products in § 118(1) are not applicable. Do not fill table below.
NOTE�r When a Cool Root 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
CRRC Product ID Number'
s 2:12 > 2:12
< 51b/fe a 516/fe
TYPW
Reflectance3'4
Emitta ce
SRI
CitylS t I .14, Cpr�
Phone��r
❑
❑
o
❑°
'13
❑
❑
13
(3
W
IF
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 Root Rating Council's Rat Product Directory at MMcoolrools. ora/oroducts/search.nho
2. Indicate the type of product Is being used for the roof top, i.e. single -ply roof, asphalt roof, metal roof, etc.
3. It 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. More 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 htbJ/www.enM.ca.oavig le24/and enter the resulting value In the SRI Column above and attach
atopy of the SRI- Worksheet to the CF- i R.
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and most the dry mil thickness or cover
recommended 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�r When a Cool Root 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, Park
1 and 8 of the California Code of Regulations.
Name:
IAII
Signature:
Compa
p
Ig -1 -a
Addr
License:
CitylS t I .14, Cpr�
Phone��r
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
drn ff
Permit #
Je Project Address:
A. P. Number:
Legal Descriitis
-16 Contractor:
Address:
City. ST, Zip:
Telephone:
jC State Lic. # : —7
Arch., Engr., Designer:
Address:
City. ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal Req'd
Plan Sets
Structural Calcs.
Truss Calcs.
Title 24 Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
1\ HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777.7012
Building Permit Application and Tracking Sheet
mg
w
City Lic. #:
APPLICANT: DO NOT
Recd TR
Plan Check submitted
Reviewed, ready for coi
Called Contact Person
Plans picked up
Plans resubmitted
2'' Review, ready for co
Called Contact Person
Plans picked up
Plans resubmitted
Review, ready for cot
Called Contact Person
Date of permit issue
ner's Name:
Address:31q 5 Cu(
City. ST, Zip: v/'„
elephone: 1 Z� �+
Project Description:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Estimated Value of Project:
/RITE BELOW THIS LINE
►CICING PERMIT FEES
Item Amount
rections Plan Check Deposit
Plan Check Balance
Construction
Mechanical
rections/issue Electrical
Plumbing
SAM.
Grading
rections/issue Developer Impact Fee
A.I.P.P.
Total Permit Fees