12-1114 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
12-00001114
56876 MERION
762 -032 -012 -
RE -ROOF
LOW DENSITY RESIDENTIAL
1500
TiAt 4 4 Q"
Architect or Engineer:
Ply
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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 lass: C39 6 V Licen o.- 774482
/T
at��/� Cy 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).:
(_ 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
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 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 _ 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
Owner:
PGA WEST RES II
39755 BERKEY STE. A
PALM DESERT, CA 92260
Contractor:
WILLIAMS ROOFING
P.O. BOX 391841
ANZA, CA 92539
(760)399-9394
Lic. No.: 774482
VOICE (760) 7 - -12
FAX (760) 77 7011
INSPECTIONS (760) 777-
Date: 9/24/12
PA
FOCT �J ��12
L!�
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.
'►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, 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,s(ha11 1 rtthwith rcolnply witheose r visions.
Dat) � ):cant:
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 co truction, and hereby authorize re resentatives
oft s n to ter upo a above-mentioned propert , r i s ection urposes.
ignature (Applicant or Agent):
Application Number
. . . . . 12-00001114
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
--------------------------------------------------------7-------------------
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
Prescriptive Certificate of Com liance:
Residential Reroof CF -1 R-ALT-ReRoc
Project Address:I
edo
Aged Solar
Climate Zone
Permit 5
ROOFING PRODUCTS (COOL ROOFS) §151(012
When the area of exterior roof surface to be replaced exceeds 509E of the existing roof area, or 1,000 fe, whichever is less, the net
roofing ansa must meet the roofing product "Cool RooP'requiroments of §152(b)1H1, 152(b)1H/l, or 152(b)1H1/I.
Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof requirements::
❑ Cool roofs 0Z required in Climates Zones 1-12,14, and 16 with a low sloped roof pitch (less or 2:12 pitch).
❑ Cod roofs no required in Climates Zones 1-9, and 16 with a steep -sloped roofs (greater pitch than 2:12) and product weight less than SAW
Alternatives to §i 52(b)1 Hi and §162(b)HII, Steep -slope roof (pitch > 2:12)
❑ Insulation with a thermal resistance of at least 0.85 hr•fe.'F/tutu or at least a 34 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 tt2 of free ventilation area of attic ventilation for every 150 1112 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(02; or
❑ Building has no ducts 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)1 Hill, Low -slops roof ( pitch 5 2:12)
❑ Building has no ducts In the attic.
Other Exceptions
U Roofing area is covered by building Integrated; photovoltaic panels and solar thermal panels are exempt from the Cod Roof criteria.
❑ Root constructions that have thermal mass over the roof membrane with at toast 25 IMM are exempt from the Coot Roof criteria.
MM if any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Emittance requirements for rooting
products In § 118(1) are not applicable. Do not fill table below.
NOTE: When a Cool Roof 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
D
ws, F2ka lig-laL
CRRC Product ID Numberr
S 2:12 > 2:12
< 51biftz z 51b/ft2
TypW
Reflectance3'4
Em afice
SRIS
1601 tIQ
❑
❑
❑
13,0
❑4
ff3
❑
❑
❑
❑
❑4
Note: If no CRRC- t 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 www.coolroofs.ordoroducts/search.nhQ
2, indicate the type of product Is being used for the roof top, 1.a, single -ply roof, asphalt root, metal root, etc.
3. 11 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.,,w - 0.2) to obtain a calculated aged value. Where pis 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 hHoYA ww.engtgy.ca,00v/title24/and enter the resulting value In the SRI Column above and attach
atopy of the SRi- Worksheet to the CF- t R.
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or covers
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: 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 Califomia, the information provided on this form Is.accurate and complete.
• I certify that the energy features and performance specifications identifled on this Certificate of Compliance conform to the requirements of Title 24, Part!
1 and 6 of the California Cmole of Regulations.
Name: IA/1
hm�
Signature:
CompaKho
D
ws, F2ka lig-laL
Addr
License:
CitylS t I . Phone ty"
__C_A__
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
P.O. Box 391841, Anza, Ca. 92539 951-763-0769
So-8SS Wigton St. 2C,# 130, La Quinta, Ca. 9225' 760 -399 -
Contract #5o41
For: Monarch Management Trust, 39-755 Berkey Suite A, Palm Desert, Ca. 9226o
Attn: JoAnne Rose Date: July 15, 2012
Job Addresses: 56-876 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 $8i.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 $ iog.00 each and fascia board at s 12.00 per lin. Ft. Any
CDX/OSB plywood to be replaced at an additional charge based on $ 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
BM 1
City Of La Quinta
Building &r Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 72253 - (760) 777-7012
Building Permit Application and Tracking Sheet
,e Project Address:
tt•ner's Name:
A. P. Number: (q 5
Address: - CUA
Legal Descri'ti n: v
.6 Cit}, ST, Zip: �uf
Contractor. , t
A} elephone: �-
40 Address:
Project Description:
Cit}, ST, Zip:
Telephone:l-3�
jC State Lic. # : 1 City Li c. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Tcicphonc:
Construction Type: Occupancy
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: # Stories: # Units:
TelephonL�C ontact Person: 5
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Recd
TRACKING PERMIT FEES
Plan Sets Plan Check eubmittcd
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
Review, ready for corrections/issue Electrical
Subcontactor List Called Contact Person
Plumbing
Grant Deed Plans picked up
5.11.1.
fI.O.A. Approval Plans resubmitted
Grading
1\ HOUSE:- 3" Revie%, 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