RR (12-1124)P.O. BOX'1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 9h53
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
T4tyl 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777- 2
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/24/12
12-00001124
Owner:
57085 MERION
PGA WEST RES II
762-031-009-
- • -
39755 BERKEY STE. A
RE -ROOF
LOW DENSITY RESIDENTIAL
PALM DESERT, CA 92260
D p
1500
OCT o 5 2012
Contractor:
1:TY
Architect or Engineer:
WILLIAMS ROOFING
_
P.O. BOX 391841
OF lz1IINYA
ANZA, CA 92539
FINANCE DEPT.
1(760)399-9394
Lio. No.: 774482 '
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 Bu ess nd Pr fessionals Cod , a d my License is in full force and effect.
Lice se Class: C39 Licens N 774482
D J ntractor:
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 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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 _ ) 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
PC
LQPERMIT
-----------------------------------------------
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, 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 sho Id become subject to the workers' compensation provisions of Section
3700 of the Labor C , I hall forth comply w' those rovisions.
y t
, p - S Z -- 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 andhold 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 t mply with all
city and county ordinances and state laws relating to buil ' g co struction, and hereby authori r resentatives
�of thi coun to �n upon the above-mentioned grope for i spection pur ses.
� ignature (Applicant or Agent):
Application Number
. . . . . 12-00001124
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
Prescriptive Certificate of Compliance: Residential Reroof CF -1 R-ALT-ReRoc
Alc)
Project Address:59(
Product Weight
Climate Zone
Permit M
ROOFING PRODUCTS (COOL ROOFS) §151(1)12
When the area of exterior roof surface to be replaced exceeds 509E of the existing roof area, or 1,000 C whichever is less, the net
rooting area must meet the roofing product "Cool Roof" requirements of §152(b)1H1, 152(b)1HIl, or 152(b)MIN.
Check applicable alternative or exception below if the roof alteration Is exempt from the roofina oroduct "Coot Roof" reauirements:
❑ Cod roofs M required in Climates Zones 1.12,14, and 18 with a low sloped roof pitch (lessor 2:12 pitch).
❑ Cool roofs ng required In Climates Zones 1-9, and 18 with a steep -sloped roofs (greater pitch than 2:12) and product weightless than SAW
Alternatives to §152(b)1HI and §152(b)HIi, Steep -slope roof (pitch> 2:12)
❑ insulation with a thermal resistance of at least 1185 haft'-°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 t12 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 §15102; 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 -stops 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.
❑ Root conatructiona that have thermal masa over the root membrane with at least 26 Iblft2 are exempt from the Cod Root criteria.
• If any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Eminence requirements for rooting
products in § 118(1) are not applicable. Do not fill 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
CRRC Product ID Number'
s 2:12 > 2:12
< 5iblf51b/H2
tz z
T e2
Reflectance3'4
Emitta ce
SRI
-1 11fi
Ad dr
13
❑
E313
A,
�t3di
�,
Phone- , a
l /
❑
❑
❑
❑
❑°
Note: N 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 Coot Root Rating Council's Re todProduct Directory at
2. indicate the type of product is being used for the roof top, i.e. sMgl&piy roof, asphalt root, metal root, etc.
3. If the Aged Reflectance is not available in the Coot 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 pis the Initial Solar Reflectance.
4. Check box it the Aged Reflectance Is a calculated value using the equation above.
Calculate the SRi value by using the SRI- Worksheet at hffy!/www.eneray.ca.gnv/dtle24/ and enter the resulting value in the SRI Column above and attach
acopy 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 coven
ecommended by the coatings manufacturer and meet minimum performance requirements listed in §118(1)4. Select the applicable coating.
JDAluminum-Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ C+Iher
NOTE: When a Cod Root is required, the installing contractor shall complete and submit the CF -6R -ENV -01 for final inspection.
Declaration Statement
• I cenity 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, Part!
1 and a of the California Code of Requilations.
Name: 1AJ1
hw,<�
Signature:
Compa
p
d
Ad dr
License:
A,
Cllylt I :
�,
Phone- , a
l /
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at., 1-800-772.3300.
P.O. Box 3911841, Anza, Ca. 92539 951-763-0769
5o-855 Washington St 2c, #13o, La Quinta, Ca. 92243 760-399-9394
Contract #5o48
For: Monarch Management Trust, 39055 Berkey Suite A, Palm Desert, Ca. 9226o
Attn: JoAnne Rose Date: July 115, 2012
Job Addresses: 57-o85 Merion, La Quinta, Ca. 92253
Schedule of extras if applicable:
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 s8i.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 $ u.00 per lin. Ft. Any
CDX/OSB plywood to be replaced at an additional charge based on s a.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`10 SPF Poly Urethane foam roof system as per manufactures
specifications. Install Acrylic roof coating as per manufactures specifications
@ a rate of 112" on perimeter and to receive 4 gallons per every 11oo 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) y
Contract Price: $1,500.00
Payment to be made as follows: To be paid upon regular billing cycle. (As completed)
z
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
bin ff
Permit #
e
Project Address:
Project type (circle one): New Add'n Alter Repair Demo
A. P. Number:
Sq. Ft.: # Stories: # Units:
Legal Descri"ti n:J,
.16
Contractor:
DO NOT WRITE BELOW THIS LINE
Address:
TRACKING
(�
Cit".. ST. Zip:
0
Telephone: I 3 t :I
K
State Lic. # : t
Arch., Engr., Designer:
Address:
Cit),, ST, Zip:
Tcicphonc:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal
Plan Sets
Structural Calcs.
Truss Calcs.
Title 24 Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Dccd
Ill-O.A. Approval
IN HOUSE:.
Planning Approval
Pub, Wks. Appr
Schuol Fees
City of La QuInta
Building 8T Safety Division
P.O. Box 1504, 78.495 Calle Tampico
La Quinta, CA 72253 • (760) 777.7012
Building Permit Application and Tracking Sheet
®_ tuner's Name: r,1 I i
Cite. ST, Zip:nl +'
i
Telephone:�
Project Description:
City 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: ' as
APPLICANT:
DO NOT WRITE BELOW THIS LINE
Recd
TRACKING
PERMIT FEES
Plan Check eubrnhtcd (tem
Amount
Reviewed, ready for corrections
Plan (.'heck Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2"' Review, ready for correctionslissue Electrical
Called Contact Person Plumbing
Pians picked up
SALI.
Plans resubmitted
Grading
Review, ready for corrections/issue
Dcveloper�ImpactFee
Culled Contact Perron
A.I.P.P.
Date of permit issue
Total Permit Fees
r P.O. BOX 1504 ' . No. 07,227.
* ":
Building 78-105 CALLE ESTADO
Address 57-085tion. LA QUINTA, CALIFORNIA 92253.' :, J
Owner J
SuiRt'iSl? Company
BUILDING:. TYPE CONST. OCC.GRP. '
'Mailing
S
Address 42404 Cook Street • SU i to 200A.P. Number POA
-
City Zip Tel.
YdCiG �� - .
Palle Desert 9�'Z6fl 568.2828 Legal Description
ContractoSa me Project Description Ph3.st • Ski Plan HIV
Address F
• City Zip Tel.:
State Lic. City
& Class428$ 30 Lic. #398 Sq. Ft., 2353 ' ',,.,No. No. Dw..
Size
Arch., Engr., Stories - + Units
Designer New ❑ Add:❑'-'• - Alter ❑ ' ` Repair ❑ Demolition.❑
Address r Tel. .
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION+'
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section ;
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect..
SIGNATURE DATE
- r
r - OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for -the following . Estimated Valuation $170.470 3 � �
,reason:.(Sec. 7031.5,Business and Professions rode:. .Any city or county which requires a. I
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 PERMIT,', AMOUNT
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 Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). _Plan Chk. BSI. ' ` .'
❑ 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 COf1St:•�
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon'and who does such workhimself or through his own employees, Mech. C�f
provided. that such improvements are not intended or offered for sale. If, however, the building 0 a 5_0
or improvementis sold within one year of completion, the owner -builder will have the burden - r Electrical •'-"' ' � -
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- .- Plumbing 156. ,50
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 S.M.I.-
• • • 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 Grading
Driveway Enc.
Date owner Infrastructure
eSS "r f 1, 1 du `
4A^ - : -
WORKERS' COMPENSATION DECLARATION 1 Infra Dui
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.. f
r� TOTAL a
CERTIFICATE OF EXEMPTION FROM REMARKS }
WORKERS' COMPENSATION INSURANCE t - _
(This section need not be completed it the permit is for -one hundred dollars ($100) valuation - r�•�""_`'�•0r;E+T`� Z�-`�T {...W ' '.;'r)- '--�•° it
., 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.
l " Date Owner
NOTICE -TO APPLICANT: If, alter making this Cerfirrcate of Exemption you should become • ZONE:–
subject to the Workers' Compensation provisions • of the Labor Code, you must 'forthwith
comply with such provisions or this permit shall be deemed revoked. • - - .Minimum Setback Distances: - • ,� '
Front, Setback from Center Line r
Rear Setback from Rear Prop. Line `
CONSTRUCTION LENDING AGENCY " —Side Street Setback from Centel -Lin@
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.)°Side Setback from Property:Line. -
+ Lender's Name - • - ,:� `t�- . '
Lender's, Address FINAL DATE INSPECTOR
This is a building permit when property filled out, signed and validated, and is subject to • : .
expiration if work thereunder is suspended for 480 days: 2j2v/�i9
I certify that,l have read this application and state that the above information is correct. Issued by: Date L V Permit. + F
"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-.• w '
mentioned property for inspection purposes. - Validated by: u
Signature of applicant Date `
-Mailing Address dValidatlon.
r
City,. State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. Fr. ® $
UNITS
SLAB GRADE L (
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
SEWER OR SEWA
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH02
vv
METER LOOP
GAR. SO. Fr. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT. ®
GROUT
WATER HEATER
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SQ Fr. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
LOINAL INSP. o2J
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
THING -�
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
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
GROUND PLUMBIN�
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE L (
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEWA
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
�tFOUND. REINF 46
GAS (ROUGH02
vv
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.
LOINAL INSP. o2J
�IARAMING . T
FINAL INSP.
60OFING L 6-
/j �. n _
q /1d n6
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING -�
MESH
INSULATIONISOUND -l3
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL