RR (12-1116)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4tvl 4 4 Qum&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777- 12
FAX (760) 777-701
INSPECTIONS (760) 777-7153
Date: 9/24/12
Application Number: 12-00001116 Owner:
Property Address: 56941 MERION PGA WEST RES II
APN: 762-031-003- - - 39755 BERKEY STE. A
Application description: RE -ROOF PALM DESERT, CA 92260
Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1500 EEO Contractor:Applicant: Architect or Engineer: WILLIAMS ROOFING P.O. BOX 391841
ANZA, CA 92539 �(760)399-9394
Lic. No.: 774482
--------------------------------------------------------------=-----------------------------
-----
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 Cod , 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
Lice "Class: C39 Licen e N 774482 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
�� ntractor: �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 1 am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 18 90178-2 011
following reason (Sec. 7031.5, Business and Professions Code: Any city or county,that requires a permit to _ 1 certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or 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 wo cers' 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 Mlhall rth (ith comply i t se provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 1
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.: atJ�"p cant:
1 ) 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 WARNING: FAILUR 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
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.).
(_ ) 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:1 1A
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.
1 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 cons ruction, and hereby author' a epresentatives
of/�+s ount t/oj ente up n the above-mentioned property in ection p(u/rpos/es.
DOtel ignature (Applicant or Agent):
Application Number
. . . . .
12-00001116
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
Prescriptive Certificate of Com liance: Residential Reroof CF -1 R-ALT-ReRoc
Project Addre r
Climate Zone
Permit N
ROOFING PRODUCTS (COOL ROOFS) 9151(012
When the area of exterior root surface to be replaced exceeds 50% of the existing root ants, or 1,000 fr, whichever is less, the net
roofing eros must meet the roofing product "Cool Roof 'requirements of §152(b)1Hi, 152(b)1H11, or 152(b)1H111.
Check applicable alternative or exception below if the roof alteration Is exempt from the roofing product "Cool Roof" requirements::
❑ Cod roofs ao required in Climates Zones 1-12,14, and 16 with a low sloped roof pitch (lessor 2:12 pitch),
❑ Cool roofs VA required in Climates Zones 1-9, and 16 with a steep -sloped roofs (greater pitch than 2:12) and product weightless than SAW
Alternatives to §152(b)l HI and 1162(b)Hii, Steep -slope roof (pitch > 2:12)
❑ insulation with a thermal resistance of at least 0.85 heft'-°F/Btu or at least a 314 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(010; or
❑ In climate zones 10, 12 and 13, with 1 ft2 of free ventilation area of attic ventilation for every 150 tt2 of attic floor area, and
where at least 30 percent of the free ventilation area Is within 2 feet vertical distance of the root 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, 8-3 or greater roof deck insulation above vented attic,
Exception to §152(b)1Hill, Low -slope roof ( pitch S 2:12)
❑ Building has no ducts in the attic.
Other Exceptions
O Roofing area is covered by building Integrated; photovoltaic panels and solar thermal panels are exempt from the Cod Root criteria.
❑ Roof constructions that have thermal mass over the roof membrane with at toast 26 Ib/ft2 are exempt from the Cool Roof criteria.
�1(Q If any one of the alternatives or exception Is checked the Aged Solar Reflectance and Thermal Etnr'ttance requirements for rooting
products In § 118(1) are not applicable. Do not 1111 table below.
NOTB: When a Cool Root is required, the installing contractor shall complete and submit the CF -BR -ENV -01 for final inspection.
Declaration Statement
Roof Slope
Product Weight
Product
Aged Solar
Thermal
Addr
CRRC Product ID Number'
S 2:12 > 2:12
< 51b/fe a 516/fig
Typa2
Refiectance14
Emitta ce
SRI'
()(0t_1UA)-Mq
W
❑
❑
❑
04
13
0
o
❑
❑
❑4 1
IF
Note: N 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 Roof Rating Council's Rat Product Directory at fnv.coolroofs.ordaroducts/search,nha
2. indicate the type of product Is being used for the roof top, I.e. single -ply roof, asphalt roof, metal roof, 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 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 .ene=ca.00v/drle24/ and enter the resulting value in the SRI Column above and attach
atopy of the SRI- Worksheet to the CF- 1R.
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coven
recommended by the coatings manufacturer and meet minimum performance requirements listed in §118(1)4. Select the applicable coating:
D Aluminum -Pigmented Asphalt Roof Coating o Cement -Based Roof Coating D Other
NOTB: When a Cool Root is required, the installing contractor shall complete and submit the CF -BR -ENV -01 for final inspection.
Declaration Statement
• 1 certify under penalty of perjury, under the laws of the State of California, the information provided on this form IsAccurate and complete.
• I certify that the energy features and performance specifications identif led on this Certificate of Compliance conform to the requirements of Title 24, Part!
1 and 8 of the California bole of Regulations.
Name:
Rh
Signature: Of
CompsWmom
ftJr D
Addr
License:
City/St / . PhZ5 ��Cfone` n
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800.772-3300.
V P.O. Box 39184.1, Anza, Ca. 92539 951-763-0769
5o-855 Washington St. 2c, # 13o, La Quinta, Ca. g2253 76o-399-- 4a
Contract #50045
For: Monarch Management Trust, 39-755 Berkey Suite A, Palm Desert, Ca. 9226o
Attn: JoAnne Rose Date: July 15, 2012
Job Addresses: 56-941 Merion, La Quinta, Ca. 92253
Schedule of extras if a0olicable:
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 ix8 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 $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
am ff
Permit #
�C Project Address:
A. P. Number:
# Submittal Req'd
Plan Sets
Structural Calcs.
Truss Calcs.
Title 24 Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
II -0-A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City Of La Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777.7012
Building Permit Application and Tracking Sheet
aner's Name: PT.i 1 ,-,� r
ity. ST, Zip: I q2z
.lephone: 6-5
oject Description:
Citv Lic. #:
Contractor:
'0
Address:
Cit}. ST, Zip:
New Add'n Alter Repair Demo
Telephone:1-!J� ^I
�C
State Lic. # (414
# Units:
Arch., Engr., Designer:
Estimated Value of Project:'
Address:
APPLICANT: DO NOT WRITE BELOW THIS LINE
City, ST, Zip:
Recd
Telephone:
State Lic. #:
Name of Contact Person:
Telephone M of Contact Person:
# Submittal Req'd
Plan Sets
Structural Calcs.
Truss Calcs.
Title 24 Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
II -0-A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City Of La Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777.7012
Building Permit Application and Tracking Sheet
aner's Name: PT.i 1 ,-,� r
ity. ST, Zip: I q2z
.lephone: 6-5
oject Description:
Citv Lic. #:
Total Permit Fees
Construction Type:
Occupancy:
Project type (circle one):
New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Estimated Value of Project:'
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd
TRACKING
PERMIT FEES
Plan Check submitted
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2" Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
5.11.1.
Plans resubmitted
Grading
Revieu, ready for correctionshi ue
Developer Impact Fee
Called Contact Person
A.I.P.P.
Date of permit issue
Total Permit Fees
T 0 4hf 4 4 a
" 5"(
P.O. BOX 1504 No, 07232
Building � � �.jnn 7&105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253 �^
Owner11
Sunrise CoMany
Mailing
Address 42-600 Cook St. Suite 20
City Zip Tel.
Palm Desert 92260 568--2828
Contractor
National tortgage 8 land
Address
Same
State Lic. I City
& Classif. M8130 Lic. # 398
Arch., Engr.,
Designer
Address Tel.
City IZip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70110) of Division 3 of the Business and Professions Code, and my license is in full force and
effect
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,13usness and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
Me provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he 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 (5500).
❑ 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, Suisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or igpmves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
or Improvements sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of safe.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such proiects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
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.
Date Owner
NOTICE TO APPLICANT: ft, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this peril is issued. (Sec. 3097, Civil Code.)
Lenders Name
Lenders Address
This is abuilding permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 100 days.
I certity that 1 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 city to enter the above.
mentioned property for inspection purposes.
Signature of
Mailing Addi
City, State,
BUILDING: TYPE CONST.
A.P. Number PGA
OCC: GRP.
Legal Description Tract 24801
Project Description Phase 5H — Plan H2A
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
2/28/90
Issued by: Date Permit
Validated by:
Validation:
Sq. Ft. 2645
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
$191,443
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
.40
Const.
So . Su
Mech.
76.00
Electrical
123. 19
Plumbing
kbZ.tu
S.M.I.
13.44
Grading
Driveway Enc.
Infrastructure
$4.3 /.6
. ed l illi
n. n
a r u 9
,+°
TOTAL
H
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
2/28/90
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL SO. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR SEPTIC TANK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
V,FOUND. REINF.
DRAINAGE PIPING
CAR P. I SO. FT. ®
METER LOOP
HEATING (FINAL)
WALL SO. FT.
REINF. STEEL
DRINKING FOUNTAIN.
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LUMBER GR.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
1�RAMING ��
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® 3Yac
HOUSE SEWER
SPARK ARRESTOR
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
OUND PLUMBS
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
V,FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cU. yd.
$ plus x$
=$
LUMBER GR.
INAL INSP/Q-/1)
1�RAMING ��
FINAL INSP.
ROOFING/
_
`
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
I-ATHING
MESH
INSULATION/SOUND 20
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL