RR (12-0492)P.O. BOX 1504
78-495 CALLE TAMPICO
_ LA QUINTA, CALIFORNIA 92253
C2PApplication Number:
12-00000492, /'
roperty'Address:------
52651 AVENIDA NAVARRO
APN:
773-304-018-5 -000000-
Application description:
RE -ROOF
Property Zoning:
COVE RESIDENTIAL
Application valuation:
1900
Applicant:
T-ihf
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
Owner:
JAMES KELLER/CHRIS J. LARSEN
52651 AVENIDA NAVARRO
LA QUINTA, CA 92253
--------------------------
Contractor:
Owner
---------------------------
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/03/12
MAY 042012
CITY OF LA QUINTA
FINANCE DEPT.
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: License No.:
Date: Contractor:
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 ISec. 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 contrac rs to construct the project (Sec.
7044, Business and Professions Code: The C tractors' State icense w do s not apply to an owner of
property who builds or improves thereon, an ho contracts f the p jects ith a contractor(s) licensed
pursuant to the Contractors' State Licdhse aw.).
1 _ I I am exempt under Sec. , B.&,P.q. oythis reason
;Date: ,Owner:
~ CONSTRUCTION/ENDING AGENCY
I hereby affirm under penalty of perjury that there is a constrrucjjon 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
WORKER'S COMPENSATION DECLARATION ,
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 olicy Number
certify that, in the performance f/the work for hice
issued, I shall not employ any
person in any manner so become subje to tmpensation laws of California,
and agree that, if I sho d me subject the wnsation provisions of Section
3700 of the Labor C e, I II forthwith omplyisions.
Dater Applicant:
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 voi if work is not commenced
within 180 days from date of issuance of such permi or cessatio f work for 1 ys will subject
permit to cancellation.
I certify that I have read this application and state that the ov information correct., I gree t comply with all
city and county ordinances and state laws relating to buil n pppstruction, d hereb thoriz epresentatives
of this county to enter upon the above-mentioned grope f iifspection rposes.
i `\
Date: I a Signature (Applicant or Agent):
Application Number . . . . . 12-00000492
Permit . . . RE -ROOF
Additional desc .
Permit Fee 30.00.
Plan Check Fee
00
Issue Date . .
Valuation
0
Expiration Date . 10/30/12
Qty Unit Charge Per
Extension
BASE FEE
30.00
----------------------------------------------------------------------------
Special Notes and Comments
REMOVE AND REPLACE ROOF. OWENS CORNING
SHASTA WHITE SHINGLES
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
(er..f. ae�OG
�tie:G
PQcroJ
:. ..'Z `to S '! i'► V C�ItJ r Dk N % U q, Ctlrroeate Zone. F
ROOFING PRODUCTS (COOL_ ROOFS) 9161(0}12
Wherr the
4—
exterior roof surface to be replaced exceeds 5040 of the exlsUn . roof area, or 1,000 ,
roofing area must meet the rooff 9 whichever is less, the new
Product t=ool Roof" ulrements of §182(b)1K.164b)MR, or 152(b)iHirl.
.Check applicable urmauve.or exceptlon-below -the-roof attenI is exempt from the rooling product -Cool Roof -requirements:: -
O Cool roofs 12M required in Climates Zones 1-12,14, and 16 with a low sloped roof pitch (less or 2:12 pitch).
❑ Cool roofs g_oj required in (linates,Zones 1-9, and 16 with a steep sioped roots (greater pitch than 2:12) and product weight less than 5Ab/ft�
AfternatNes to §162(b)1 Hi and §tti2@)Hfi, Steep.fope roof (Pito/►
O lrtsut8ttlon with a thermal resistance of at least 0.85 hr f1�•'R/Bhr or at least a 314 inch air
O Existing ducts in the attic are i�te d and seated a -sPaCe is added to the roof deck over an attic; or
' ❑ tn� climate zones 10, 12 and 13, with 11`12 of free � §151(f)10; or -
where at least 3o Ventilation area of attic ventilation, for every iso 112 of attic floor area. and
percent of the free ventilation area is within 2 -bet vertical distance of the roof ridge; or.
. ❑ Building has at least R'30'ce ft Insulation; or
O Building has radiant barrier in the attic meeting the Miul ernernts of §151 (1)2; or
O Building has no duds in the attic or
O In donate zones 10, 11, 13 and 14, - R-3 or greater roof deck instdation above vented attic.
Exception to §152(b)1 Hill, how410pe roof (Pitch S 2:12)
❑ Building has no duds to the attic.
Other Exceptions
❑ Roofing area is covered by btu in ed; OwtOvdtalc panels and solar thermic panels are exempt from the Cool Roof criteria.
t7 Roof constructions that have 5"nal mass over the roof m xnbrw* with at least 2fs � are
M0. if any care of the a/tematives or excepticxF 1s exempt from.the Cod Rod aiteda.
►roducts In§118(i) are not m4 ticable. Do not fin table below. �� r � roe and lherrrtal roe requirements for roofing
RC Producti NumberRoof Sic
s 2:12
-OC)0 ❑
❑
pe
5ibe Product a1�ni5161ft2
T
A41ed Solar
Re a
Thermal
VOL
�noe
SRi5
!13313 !133❑
❑
e.
0,
!i
Os 1 3 V
13
-
❑4
Note: If no CRRC-1 label is avanable, this compliance method rind be used, use the P01 omtanoe
. The CRRC produex ID Number ken be o0talreed from Urs aPW�Dach to show oomp/tanee,
Indicate tris type is Roof CowecN's Rated Prvdud Qhedwy at
being used lbr dee tool top, to. -0, roof, asphalt roof, meta/ root, etc
If dre Aged Rellecknoe is not av &We in die Coof Roof Reft Cot W's Rated product
dkedory and use the equat/on (0.2+0.7(%,► — 0.2) to obtatn a cakuteted aged value. tMnere p is dean !refit Solar Reft use the MW lean e. nce value tom fire same
Check box d the Aged Reflectance is a cak Ulated value using the equation above.
Calculate dee SRI value by using the SRI- worksheet at hft Lhvww enerw � oov�e2d/ SRand enter the re
atopy of the IF Wftsheet to the CF -1R suftV value in the SRI CObm above and afac,
o apply Liquid Reid Applied Coatings. the coating must be applied across the entire roof surface and meet the dry mit thickness or cove
:commended by the coatings manufacturer and meet minimum
perfomnanoe requirements listed in §118(i)4. Select the applicable eoatins
7 Aluminum -Pigmented Asphalt Roof Coating0 Cement -Based Roof Coating ❑ Other
When a Cool Roof is requlrad, the Installing contractor shall
ow►rplete and submit the CFL6R.ENV-01 for.tlnal ins dim
• i certlfy under penalty of perjury, under the laws of the State of Caftmia, the infomnatlon
• I certify that the one features and performance specif�cetbns identified on M Certirycatep of ded on thts form is accurate and oonnplete.
A and 6 of the Cada Coda of R ulattonS Compliance oo form to the
—g----,/ e9 / _ , r�requiremeMa of Title 24, P
A. :ss:
/Z.
License:
. Phone:
For assistance or questions rr3garding the Energy Standards contact the Lne
rgY Hotline at: 1-800-772-3300.
1
RECORDING REQUESTED BY:
LwMg%Tft (N"bw Dem
WHEN RECORDED MAIL TO:
CHRIS L I.ARSEN
12756 Dannan Ct
San Diego CA 92130
ORDER NO. 12-0015733
ESCROW NO. 7061426
APN. 773304-018-5
WACE AWW "M IM FOR REWRMM S USE r
Tra . #020-202 GRANT DEED
TM UNDERSIGNED GRANTOR(s) DBCL UMs):
DOCUMMWARY TRANSFER TAX is: S86.3S CM TAX
13 M marmutReaavabanPoofa:
13 cwnputed on W v" ofprWarty conveyed. or
O coarpnted on fiA vdoo Ices value of Suns or auccatUances remaining at time of eels.
13 Uataoorpoased area: ' . ® City of [a Quince, and
FOR A VALUABLE CONS.MZRATMN receipt ofahic6 la hasty w mowlodgod. Tho Beak a Wcw Yark Mellon FKA Mm
Bank afNew Yark u trnate -fur the ourtificadwUm of CWABS Ino„ assa4welood cert, sades 2007 -BCI .
hereby GRANT(S)b .James Keller, a single man and 'Chris. J. Larsen, a
married -man as his sole and separate property, as.Tenants in
Common, each to an undivided 50% interest
the ihlfawmg docrO d red prtrpaty in On Chyaf Le QWnb. CatmW of Rhwdc q State of California:
" LEGAL DBSC,RBnWN FOR BROPBRTY COMMONLY KNOWN AS 52651 Avenida Naveruv. La Quince. CA 92253 IS
ATTACHED HORSTO AND MADE A PART EMUMP AS B)(HIBIT A".
The ormtcr(4 at puretasar(s). of do Pity mw not reae0, reoo:d an adduWW ooavyaaoe doa®en% at odierwim trmsfer We m the
prepaty •wNtle 60 days following do GnwM rs tmacaian ofafs Dcai .
The Bank ofNew York Melba FKA The sank of
New Yo k as trustee for the arti&ataloldas of
CWABB Paetmams, series
2007/80
DATE April 12, 2012 By: •/a•ns
W. Beak by to
SAC LP FKA
13ome suvwng LP. mvtoer and atmrney io tint
t BAYLSY MCt MrIM. AVP.
lA
ENERGY STAR IS FOR ROOFS TO_O
r'� Simila to the energy-efficient appliances in your home,
roofing pro ucts can provide energy-saving qualities.
eri��sTnti Owens CorningT"t ENERGY STAR" rated s ingles
can help reduce your energy bil s when installed proper) .These
shingles r fleet solar energ , decreasi g the amount of heat
transferred o a home's tntenor—and t ie amount of air co ditioning
ceded to cep it eomfortab e. Actual savings will vary based on
geographic location and individual building character's ics. Call
1-8001GET-I'INK or 1 -888 -STAR YES for more iiniformation.
Product Attributes
TruDefinition� Durations Shi gle
Product Specifications
Nominal Size 13 .' 39
Exposure 5 :3"
Shingles per Square 6
Bundles per Square 3
Coverage per Square 98.4 sc}
Ap Iicabl-el Standards and Codes
ASTM E 108, (31ass Fire ST D 3462
ASTM D 3161, Gla s F W'nd ASTM D 228
ASTM D 7 .5 8, Glass H VJi d UL ?90, GI s A
AS' M D 301 Tye 1 CnSA 1 23.5§
� e c a :a I• o o p le e.n , I i bt'o u e
+� Ba ed n_ t R 04 g 8r 4 reS nay •Ove , C R b a
Qevedt5 Go I _ ,a _Oce. t e rcenr. re. nh nra0hc. s mn Que t0 an da.: • nn .
Ula C0 0 . I0 nCtO 2t t e •rt ' - � e nd C0 a ' - Ili°, td t0`- enA t ]t u a »av ( an pCit'33 1 vAl if fu 0 1 Ow tfl0 Ot l0 n
low met u f ou i s e oat qc . -to rs e o roa..a. a e r
f T st i t e s r +e Ce e+Fr ect; » i t a f L y Por cto» to ry a i s
# 7 -& o a e um we -grade a5 fln a t t !s +ded y Oovo is Co uo e L ILC.
$ J Yal�l 4Y�atyoncot c acct.
e er nd of a d • ice P on .
owe a
P e i o tr cto s n •c td Iden co ac s d e � c nit lei o tt t C t g oo ' S phat .LIC, r t> nRr ra d eo t les.
" re , r T Pa nt 72Sti 6 t e ate is d
ENE G' STJWNE G ST a a e s i t ade Vii., i U J. to Pro ect o rt a cy
ab
COLORS AVAILABLE IN�ALL SERVICE AREAS—se(
d n<
low,
WX
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low,
WX
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P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPER Y O'WNER'S PACKAGE
(7'60) 777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Sanders Applying for Construction Permits
Q.RI MOTICE
Top 'Prur^v nvrrrv�n
Dear Property Owner. ., �•� i
An - application for a build* your. name listing yourself property
uild!�tg Permit hes boen submitted inas the builder o€ the
wements specified at (' J , a �/ i.a y�T L �� 1� ok (' A �% 02 3
We We pmviding you with an Owner -Builder Acknowledgment and Inforcmatren Verifieatien Form to ,Hake you awn o€ yaw
Mpoaslbilities and possible risk you may incur by hatvir>g itispet t.iaslted. in your name as .the
Own" -Budder. We will not ime a buIldiing4.permit until you,have read, inkiaW your. understanding of each:prw4sWn,
signed, and returned this form to us at our.oMcial address indicated. An agcnt of the owner cannot execute thirnotice
unless You, the Property owner, obtain the prior approval of the permitting authority.
Read and grittud tasrh statement MOWN signify you wid miand or very this ertformadon.
Wil. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
building permit that erroneously implies that the property owner is providing his or her own labor and material personaft. I, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
[ am Y acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to worlm s
on my, property.
1 understand building permits are not required to be signed by property owners unless they are responsible for the
c ctron and are not hiring a licensed Contractor to assume this responsibility.
I understand as an "Owner -Builder" I am the responsible party of record on the pw=L I understand that I may protect
' If from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her nartte instead of M
own.
1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers o
WM—iis and contracts.
Vm_5-,Iund erstand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total vale
yonstruction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employe
under state and federal law.
6. 1 understand if I am considered an "emp{oyer" under state and federal taw, I must register with the state. and fede
vernment, withhold payroll taxes, provide workers, compensation disability insurance, and contribute to unaVloym
compensation for each "employee." I also understand my {allure to abide by these laws may subject me to serious financ
ilt�_,
understand under California Contractors' State License Law, an Owner -Builder who builds single-family resided
es cannot legally build them with the intent to offer them for sale, unless all worts is performed by liced
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is perfon
under contract with a licensed general building Contractor.
!'understand as an Owner -builder if I sell the property for which this permit is issued,.l may be held liable for any
ancial' or personal. injuries sustdaed by -any subsequent owners) that result from any latent construction defects in the
workmanslup,or materials.
understand [may obtain.>reore information regarding my obligations as an "employer' from the Internal ife nue
S ce, the United States Small Business Administration, the California Department of Benefit Paymltd%- and the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSM at I-
21-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
YC`l__C1e%4ly
. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
P— and,Ifirrancialty resppnsble for proposed constuc
rn activity at the following address:
1. [ agree that, as the party legally and finamially responsible for ibis proposed construction activity, I will abide by all
livable laws and requirements that govern owner -Builders as well as employers.
12.1 agree to notify the issuer of this form immediately of any additions; deletions, or changes tin ty Of the information I
h e provided on this form.. Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss
You may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in�vivil court. It is also
impoftant for you to understand that if ser unlicensed Contractor or eaVloyce of that individual or ffim is Wjuzed while v Mtdng
on your property, You may be hold fbr damages. If you obtain a permit as Owner -Builder and wish to hire CORUM10rs.
you will be Tendo for verifying whetha or not those Contractors are properly fieensed and the status of thm w"&c&
compensation imu anoe coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for is:efft-Wevermtt. Note;py of ttar properV owner's dWvea'sfteMei farms netaal=ne or
other vcrifieation accep"k to dre cy is nen to be presented when dee pvrmd is sawA to verify t'he
property
owner's signature. n'
Signature of property owner Date: G Z
Note: 77re following Authorization Form is riequired to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF tYLrIV`C TO ACT ON PRO
PERTY_O/N&'S ]IIA F
Excluding.the Notice to Property Owner, the sxmption of which I understand is my personal respoHsib&ty. I herby authorize
the following persons} to act as my Meat(s) to apply for, sign, and file the documents MceWMY to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the al
information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature..
Property Owner's Signature: Date:
Bln. #
City of LaQuinta
Bulldlpg &r Safety Division
P.O. Box 1504,•78-495 Calle Tampico
14-Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
'
Project Address:' 2 P ,t1Jro
Owner's Name:
A- P. Number.
Address: /
VfyldGi. c� 4d/a
Legal Descriptio
Contractor:.
City, ST, Zip: 3
Telephone: 2-
Address:
Project Description:
City, ST, Zip:
Telephone: y l
✓%?
State Lic. #: City Lie. #;
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone:
State Lie. #:. r; _
<....
Construction Type:_ Ifeca. t Occupancy.
Project type (circle one): New 1 Add'n Alter CRepair Demo
Name of Contact Person:
Sq. Ft.: .Z o # Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: dV C
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Rcq'd
'Rec'd
TRACMG
PERMITFEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calks •
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person .
Plan Check Balance
Tide 24 Calle.
Plans picked up
Construction
Flood plain plan
Pians resubmitted..
Mechanical
Grading plan
2'° Review, ready for correctionstissue
Electrical
Subcontaetor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
ML
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
1id Review; ready for correetionsfissae
Developer Impact Fee
Planning Approval.Called
Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees