RR (12-1127)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
TiAt 4
BUILDING & SAFETY DEPARTMENT '
BUILDING PERMIT
Application Number: !
12-00001127
I
Property Address:
+-_57058 MERION"
APN:
762 -031 -022 -
Application description:
RE -ROOF
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1500
Applicant: )
Architect or Engineer:
P/A
Owner.
PGA WEST RES II -
39755 BERKEY STE. A
PALM DESERT, CA 92260
Contractor: f
WILLIAMS ROOFING -.
'P.O. BOX 391841
ANZA, CA 92539
(7,60)_399-9394 -
Lic. No.: 774482
1 -
VOICE (760) 7712
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date
OCT 0 t5'
_,
Cmr OF ILAA QUINTA
FINANCE 7EFT
9/24/12`
LQPERMIT_
2
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: C39 License : 77;4482 � , •
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
Dat�S ntractor:
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
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 STATE FUND - Policy Number 1890178-2011
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, 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 wor ' 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 1 sho become subject to the worker c pensation 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 C e, I 'all f_orthwit comply with o pr d'sions.
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 05001.:
ate:it�ppncant:
(_ 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: FAILURE 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.).
APPLICANT ACKNOWLEDGEMENT "
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed-
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
- whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. , B.&P.C. for this reason
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.
-
Date: Owner: -
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
CONSTRUCTION LENDING AGENCY
permit to cancellation. -
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.1•
city and county ordinances and state laws relating to building construction, and hereby authorize represen des
•
of is county to enter upon the above-mentioned prope=nstiorpose .
Lender's Name:
-
eate. 1 i .tura (Applicant ar Agent):
Lender's Address:
LQPERMIT_
2
Application Number
. . . . . 12-00001127
Permit
RE -ROOF
Additional desc .
Permit Fee . . .
. 30.00 Plan Check Fee
.00
Issue Date . . .
. Valuation.
0
Expiration Date .
3/23/13 .
Qty UnitrCharge
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 4
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 y
lam
f�� P.O. Box 391841, Anza, Ca. 92539 951'763-0769
So -855 Washington St.2C,# # 1 o La uinta Ca. 2276-0'-399-9394`-
_ 5_ 3 _ � L5�
Contract #5o43
For: Monarch Management Trust, 39-755 Berkey Suite A, Palm Desert, Ca. 9226o
Attn: JoAnne Rose Date: July 15, 2012
Job Addresses: 56-058 Merion, La Quinta, Ca. 92253
Schedule of extras if aoolicable:
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 1x6 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 $ i2.00 per lin. Ft. Any'
CDX/OSB plywood to be replaced at an additional charge based on $ 2.00 per sq. foot, labor included.
r
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 Compile 9: Residential Reroof CF-iR-ALT-ReRoc
—
Project Address:Climate
Zone
5
Permita6ng
r
s
ROOFING PRODUCTS (COOL ROOFS) §151(012
When the area of exterior root surface to be replaced exceeds 50% of the existing roof ares, or 1,000 fe, whichever is less, the not
roofing ere* must meet the rooting product "Cool Roof requiroments of §152(b)1H1, 152(b)1HIl, or 152(b)MIN
Check applicable alternative or exception below it the root alteration Is exempt from the roofing product "Cool Roof' requirements:
❑ Cool roofs W required in Climates Zones 1-12.14, and 16 with a low sloped roof pitch (lessor 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 511bit
Altematives to §152(b)lHI and §152(b)HII, Steep -slope roof (pitch> 2:12)
O 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(f)10; or
❑ In climate zones 10, 12 and 13, with 1 tt2 of 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 rod 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 ducts in the attic; or
❑ In climate zones 10, 11, 13 and 14, R-3 or greater rod 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
0 Roofing area is covered by budding Integrated; photovoltaic panels and solar thermal panels are exempt from the Cod Roof criteria.
❑ Roof constnwNons that have thermal mass over the root membrane with at least 26 Ibitt2 are exempt from the Cod Roof criteria.
MM If any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Emittance requirements for roofing
products In § 118(1) are not applicable. Do not lid table below.
NOTE: When a Cod 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
J, D
CRRC Product ID Number'
S 2:12 > 2:12
< 51biftz a 516/fe
TypW
Reflectance3A
Emitta ce
SRI
D
❑
❑.10❑°
'IJ'
❑
❑
D
❑
D4
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 front Me Cod Root Rating Councils Rat Product Directory at www.coolroofs.orWDroducWseanch.nhv
2. Indicate the type of product is being used for the roof top, i.e. single -pry root; asphalt roof, metal root, etc.
. If 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(pW - 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 Me equation above.
5. Calculate the SRI value by using the SRI- Worksheet at ht1aYAYww enanw.ca.00v/title24/ and enter the resuffing value In the SRI Column above and attach
atopy of the SRI- Worksheet to the CF -1 R.
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mit thickness or covert
ecommended 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 ❑ ether
NOTE: When a Cod Root is required, the installing contractor shall complete and submit the CF -6R -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 is.accurate and complete.
• 1 certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24. Part!
1 and 8 of the California Code of Regulations.
Name:
Signature:
Compa
J, D
Add r license:
Cityl t / , Phone flbb-311?1�-j9 M C
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
JIM ff
tY
Building & Safety Division
Permit #t
P.O. Box Calle Tampico ' � '
! 504, 78-495
`
e Quinta,•CA 92253 ' #
• (760) 777.7012 �: '� � �
•
.
• Building Permit Application and Tracking Sheer " -
�C
Project Address:
wner's Name:
A. P. Number:
.
'
Address: Sib
CJ Uf
Legal Descri'tin:
Cit}• ST; Zip: q"
Contractor:'
elephone:
Address-.
`
Project Description: F
City, ST, Zip:
Telephone: �-!J� _
j�
jC
State Lic. # L4 L4 7,City
Lic. #:
Arch., Engr., Designer:
Address:
`
City, ST, Zip:
} '
Tetcphone:'
Construction Type: Occupancy:
State Lic.
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Telephone # of Contact Person:
— —
5q. Pt.:
Stories:
•# Units:
Estimated Value of Project:
APPLICANT: DO. NOT WRITE BELOW
THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING -
Plan Sets
PERMIT FEES
Plan Check subrnktcd
Item
Structural Calcs.
Reviewed, read, for corrections
-'Amount
.
Plan Check Deposit
-
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calci.
Plans picked up
Flood plain plan
Construction
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for correctionslissut
Electrical.
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.LL
ILO.A. Approval
Plans resubmitted
'
Grading
IN HOUSE:- -
Revic%, 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
. uut�c�
P.O. BOX 1504
Building.. CAL CALIFORNIA 92253
Address 57 058 i�T�ot! LA QUINTA
Owner
Mailing
Address
A : Cay
City - Ip _ _ Tel.
Palm 0eser 92268 558-2828
Contractor
National Land & Mortgage
Address
Zip I Tel
State Lic. City
& Classif. 288130. Lic. # 3M
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
f LICENSED CONTRACTOR'S DECLARATION
I herel yy firm that I am licensed under provisions of Chapter 9 (commencing with Section
l 7000) of Division 3 of the Business and Professions Code, and my license.is in full force and
effect. ir/ R3�
J
/,T ='OWNER -BUILDER DECLARATION
I hereby affirm tthat.l am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business 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 file a signed statement that he is licensed pursuant to
the 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 ($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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves 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 improvement is 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 sale.)
❑ I, 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 projects 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
O 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 tha 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. s
Date Owner
NOTICE TO APPLICANT: If, 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
I hereby affirm that there is'a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
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 slate laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant -Date-
Mailing
ateMailing Address
City, State, Zip
No. 0765T
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description TraCt 25499-1
Project Description Phase 714 plarimm
ZONE:
BY:
Minimum Setback
Distances:
Front Setback from Center Line
Sq. Ft. 28.99
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Side Setback from Property Line
FINAL DATE
INSPECTOR
4/23/90
Issued by:
Date Permit
Validated by:
Validation:
'
7
Estimated Valuation
12144,923
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
838.58
Const.
1 042.00
Mech.
73.00
Electrical
132.71
Plumbing
168.5u
S.M.I.
15.05
Grading
Driveway Enc.
Infrastructure
4,835.77
Less Credit
2,417.99
T-nfra NO
TOTAL
REMARKS
14,687.73
1fAi`1 _it1tk
4a -f n`•,'... _ 7 :�
.41+w-�3.._.°
.lt.8x'.. .. aJ t"1 ;L
4I h11« `it7{'34. F.Y
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
4/23/90
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT.
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SQ. FT. ® c
BATH TUB
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11% c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
�RAMING �
FINAL INSP.
GAS PIPING
PERMIT FEE
MIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE EPL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
ROUND PLUMOJ - ,� V
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
EWER OR SEPTI ?�J
✓✓G�
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
AS (ROUGF�—
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
(�
NAL INSP//—f
NSP / J- Q'�
U
�RAMING �
FINAL INSP.
^—
gj�ROOFING v •
v �%)
v
�/ �p
V//\// ,/�/ Z V I^
010- i v
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
04THING �' 14 0
MESH
ffiNSULATIONISOUNDg—'/
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL