0303-002 (RR)LICENSED CONTRACTOR 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 6.3siness and
Professionals Code, and my License is in full force and effect. 1 0
License # Lic. Class Exp. Date
Q 47' � C39 "M 01/31n(
• ate — Signature of Contractor-
OWNER-BUILDER
ontractor OWNER -BUILDER DECLARAT
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) I, as owner of the property, or my employees with wages as tli'eir sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec: 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
Contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
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
pertormance of the work for which this permit is issued.
(. I have and will maintain workers' compensation insurance, as required by
Secfion 3700 of the Labor Code, for the, performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier .STATE FUM) Policy No. 094028-.01
(This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become
subject to the workers' compensation provisions OlSection 3700 of the Labor
Code, I sh II fo�?h ith comply with t � e provisio:I
Date: �'�++ Applicant
} I, r
Warning: Failure to secure Workers' Comp nsation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby autqJDrize representatives of this City to enter upon
� S
the above-mentioned property or insspectio p poses .
`Signature (Owner/Agent) �'N Date OR
BUILDING PERMIT PERMIT#
DATE VALUATION LOT '> ., . TRACT
JOB SITE
APN .
ADDRESS ,* •147 1,A130 D rRI
OWNER
CONTRACTOR/DESIGNER/ENGINEER
i3 ]R.HOM
,1'MOlwf;'. LA. R001440
7 8-147 LAGO:1 1ZM J
U-314 :t DIXY RD.
J.AQT. VfA. CA 92253°C�':'
M' RA1,•C"�'(.`"4{,, —CA 92,234
C/60)324-3482
=41V 5230'
USE OF PERMIT
s lwr(wL -
MROOF FOAMIA'aND WUH'I'W"MONT T H.,F PIM IC80 RS0513
CLAM A MATERIALS ONLY
M, 00F 17,0 ts:QQ LS
:A UI.'7:MAIM) CC3Ur OF CONFIRUCTIO, DT
RI;I 001? IN't 101400.418.000
MAR 0 3 2003
CITY OF LA QUINTA
FINANCE DEPT.
M38-1 G1I. C01J=TJf~"FdQA .11i�".J PLAN T f I3 ?c:
$30,00
p,F= PRz4WD nm
3:0.00
,I'MAL VX:I`',?V1 IX:fi RNS' ICU:,, NOW
RECEIPT
DATE
' % '
BY �' �`, , -IDAtE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKINALL APPROVALS
POOLS -SPAS
steel
Set,Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
` ELECTRICAL APPROVALS
Temp. Power Pole
Wderground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final `
Utility Notice (Perm)
COMMENTS:
Speci icatbons
A11 areas under construction to be marked off with safety cones and construction tape.
'gours of Operation: 7:00 a.m. to 4:00 p.m., five (5) days a week.
P
S Job staffed with a diligent crew of journeymen roofers.
6. All debris to be handled in trash chutes to durnpsters below.
7. Obtain all necessary permits and inspections to be in accordance with the City.
ROOF SYSTEM: U.S. CLAY "S" TILE SPECIFICATION
1. Resheet with ``/z" cdx plywood, nailed as per U.B.C. nailing schedule.
2. Underlayment: Provide and install vapor barrier 440 organic felt underlayment A.S.T.M. #D2626-86 applied
in a double application method consisting of two layers of 940 base sheet underlayment applied in a shingle
type fashion.
�ive tile proper rise
2" furring strep �0n mai ll of sufficeaves to e
3. Battens and tile fastening: Install 1" x
nt length to penetrate 3/4"taper.into
tiles to be fastened with 11 d gauge corrosion resistant box
solid sheeting. All tiles to have (2) fasteners per tile and be in strict accordance with factory mutual 1-60
requirements for wind uplift.
4. Roof penetrations and flashing: All roof projections, vents, dormers, chimneys and roof to wall transitions to
be properly flashed in a double flash method consisting of one (1) primary 26 Ga. flashing integrated into
base sheet underlayment and set in bed of mastic cement. Secondary 26 Ga. flashing to be integrated into .
tiles and sealed with plastic cement. All flashings treated with zinc chromate paint to match roof color.
5. Eave Tiles: All eaves to have a starter the installed prior to field tile installation.
6. Ridge and Barge Boards: After underlayment is completed a 2" x 4" ridgeboard will be installed along all
hips and ridges. All rakes to have one (1) 2" x 4" installed face down with one (1) 2" x 2" installed on top
of 2" x 4 to properly anchor and secure all rake trim tiles and meet all requirements for factory mutuals I-
60 requirements for rake tile wind uplift.
7. Field Tile application: Provide and install U.S. Tile. U.S. Tiles to be installed in strict accordance with U.S.
Tile roof tile specifications meeting all governmental and federal codes. All tiles to be double fastened and
exposures to be 14" as per manufacturer's specifications. Tile to be manufactured by U.S. Tile roof
tiles I.C.B.O. report 3523. Installation to conform to U.B.C. 32-12 and U.S. Tile roof tiles. Style of tile
and color to be chosen by customer.driven
8. Ridge and rake tiles: All ridge and rake tiles to be doublenailed with lid vth a bullnose of corrosion emenresl to finish ant nails rd e end.to
ridge or hip framing members. All ridge ends to be detailed
All hip and ridge tiles to be made watertight by bedding in Portland cement mortar.
9. Install complete cement weather block at all hip & ridges and detail all ridge ends with bullnose of cement.
10. Paint all flashings with one coat of high quality exterior paint.
FOAM ROOF SYSTEM:
$. Tear off existing roof system ower swee er, air
C. All loose gravel, dust and residue shall be -remove
d using power vacuum equipment, p P
blowing, or other suitable means.
D. The roof shall be inspected or tested to determine if moisture is resent within the roof assembly. If damp
insulation is found, the insulation might be able to be vented through the polyurethane foam or with
insulation relief vents. Saturated insulation must be removed and replaced with compatible materials.
E. The existing roof shall be inspected for adhesion between felts, insulation, and deck. Areas of poor adhesion
should be fastened. Blisters, buckles, wrinkles, and fishmouths shall be cut and /or fastened.
F. All soft mastic or asphaltic materials that could impede polyurethane adhesion must be removed
or refasten all loose base flashing, counter -flashing, and gravel the rate of requot ss less than gallon per 100 square
G. All surfaces shall be primed with Evercoat Acrylic prim
feet prior to foam application.
F -S' REPORT
Reissued ER -3523
Reissued January 1, 2003
ICBO Evaluation Service, Inc. - 5360 Workman Mill Road, Whittier, California 90601 • www.icboes.org
Filing Category: ROOF COVERING AND ROOF DECK CONSTRUCTION -Roof Covering
ONE-PIECE "S," TAPERED TWO-PIECE MISSION, FLAT
SHINGLE, ROMANO- PANS, CLAYLITE® AND
CLAYMAX® CLAY ROOFING TILES
UNITED STATES TILE COMPANY
909 WEST RAILROAD STREET
CORONA, CALIFORNIA 92882-1906
1.0 SUBJECT
One-piece "S," Tapered Two-piece Mission, Flat Shingle,
RomanoTm Pans, Claylite® and ClayMa)& Clay Roofing
Tiles.
2.0 DESCRIPTION
2.1 General:
The roofing tiles are a vitrified clay product, manufactured
by United States Tile Company for use as a roof covering
under the 1997 Uniform Building CodeTN7 (UBC). The tiles
are machine -formed, fired to various degrees and have a
selection of burned -on colors. The various colors are
obtained by controlled firing of the kilns. Tile profiles are
illustrated in Figure 1.
The tiles may be installed on roof surfaces having slopes
up to a maximum of 21:12 (175%). A solid sheathing
conforming to the requirements of the UBC is required for
all slopes.
2.2 Materials:
2.2.1 One-piece "S" -shaped Tile:
The finished tiles are 18 inches (457 mm) long, 13 inches
(330 mm) wide and 7/2 inch (12.7 mm) thick, with two nail
holes in the pan side and one nail hole in the cover side.
The installed weight of the tiles is approximately 8 pounds
per square foot (39.1 kg/m2), and the tiles are designed for
installation with an 11 -inch (279 mm) center -to -center
spacing and a minimum 3 -inch (76 mm) head lap.
2.2.2 Tapered Two-piece Mission Tile: The finished tiles
are 18 inches (457 mm) long, curved to approximately one
third of a circle, and have a chord width of 87/2 inches (216
mm) at the butt end and 7 inches (178 mm) at.the smaller
end. The tiles have an average thickness of 7/2 inch (12.7
mm) and an installed weight of approximately 9.6 pounds
per square foot (46.9 kg/m2). They are designed for
installation with 11 -inch (279 mm) center -to -center spacing
and a minimum 3 -inch (76 mm) head lap.
2.2.3 Flat Shingle Tile: The finished tiles are 18 inches
(457 mm) long, 93/, inches (248 mm) wide and 9/16 inch
(14.3 mm) thick. There are three ribs on the underside of
the tiles that are 7/2 inch (12.7 mm) wide, and one rib at the
lock that is 1 inch (25.4 mm) wide. Ribs are approximately
3 inches (76 mm) apart and run the full 18 -inch (457 mm)
length of the tile. Each tile has two nail holes in the top.
Installed weight of the tiles is approximately 97/2 pounds per
square foot (46.4 kg/m2). They are designed for installation
with 9-incfi (229 mm) center -to -center spacing and a
minimum 3 -inch (76 mm) head lap.
2.2.4 Romano Pans: The finished tiles are 18 inches
(457 mm) long, 11 inches (279 mm) wide and 9/16 inch (14
mm) thick, with two nail holes near the top of the pan. The
completed installed weight of the tiles is approximately 9.9
pounds per square foot (48.3 kg/m2). They are designed for
installation with two-piece Mission cover tiles with a 13 -
inch (330 mm) center -to -center spacing and a minimum 3 -
inch (76 mm) headlap.
2.2.5 Claylite Tile: The tiles are the same shape and size
as one-piece "S" -shaped tiles. The finished tiles are 18
inches (457 mm) long, 13 inches (330 mm) wide and 3/6
inch (9.5 mm) thick, with two nail holes in the pan side and
one nail hole in the cover side. The installed weight of the
tiles is approximately 5.9 pounds per square foot (28.8
kg/m2). They are designed for installation with an 11 -inch
(279 mm) center -to -center spacing and a minimum 3 -inch
(76 mm) headlap.
2.2.6 ClayMax Tile: The finished tiles are 18 inches (457
mm) long, 13 inches (330 mm) wide and 73/32 inch (10.3
mm) thick, with two nail holes in the top. The installed
weight of the tiles is approximately 5.8 pounds per square
foot (28.3 kg/m2). They are designed for installation with an
11 -inch (279 mm) center -to -center spacing and a minimum
3 -inch (76 mm) head lap,
2.3 Installation:
2.3.1 General: Tiles shall be installed in accordance with
the Concrete and Clay Roof Tile Installation Manual for
Moderate Climate Regions (ER -6034P), except as noted in
this report.
2.3.2 Flat Shingle Tile: Rake the or a full bed of mortar is
provided under the exposed portion of each tile as a rake
closure at the gable end. At hips and ridges, a Mission -type
or a "V" type hip -and -ridge tile is set and nailed in cement
mortar or roofers' cement.
2.3.3 Claylite Tiles: Claylite tiles shall be fastened to the
sheathing with two nails per tile. As an alternative, a single
nail, using the fastener hole located in the pan side 1%
inch (44.3 mm) from the head end of the tile, may be used
when the following conditions are met:
1. The roof slopes do not exceed 7:12 (58.3% slope).
2. Solid sheathing shall be not less than '/,,-inch (11.1
mm) oriented strand board or "/32 -inch (11.9 mm) wood
structural panels.
i,REPURlS" are not to be construed as representing aesthetics or any other attributes not speer ,tally addressed, nor are they to be construed as
an endorsement of the subject of the report or a recommendation fir its use. There t no warranty by JCBO Evaluation Service, Inc., express or implied,
as to any finding or other matter in this report, or as to any product covered by the report.
Copyright (9 2003
Page 1 of 3
0-
Page 2 of 3 ER -3523
3. The structure is located in an area designated by the
building official as being subject to a maximum basic
wind speed of 80 miles per hour (129 km/h), Exposure
C, with the roof height up to 40 feet (12 192 mm) above
grade.
2.3.4 ClayMax Tiles: ClayMax tiles shall be fastened to
the sheathing with two nails per tile. As an alternative, a
single nail,using the fastener hole located in the center,.
1'/, inch (44.3 mm) from the head end of the tile, may be
used when the following conditions are met:
1.. The roof slope does not exceed 7:12 horizontal (58.3%
slope).
2. Solid sheathing is not less than '/,s inch (11.1 mm)
oriented strand board or "/32 -inch (11.9 mm), four -ply,
three -layer wood structural panels.
3. The structure is located in an area designated by the
building official as being subject to a maximum basic
wind speed of 80 miles per hour (129 km/h), Exposure
C, with the roof height up to 40 feet (12 192 mm) above
grade.
Installation details pertinent to the ClayMax tiles are as
follows:
1. Hips and ridges are provided with continuous nominal
2 -by -3 nailers to support ClayMax trim tiles.
2. Continuous nailers along the gable rakes are not
required.
2.3.5 Tile Repair:. The damaged tile is removed by
breaking it completely out of the field and cleaning away all
debris. Existing fasteners must. be removed and the nail
hole sealed with an approved sealant. Any damage to
existing underlayment must be repaired priorto installation
of the replacement tile. The replacement tile is inserted into
the open space, maintaining head and side laps. The tile is
secured with approved plastic cement or adhesive, a No.
11 gage corrosion -resistant nail or an existing wire tie
fastener.
2.4 Roofing Classification:
When installed over new construction as described in this
report, the clay roof tiles are Class A roof coverings in
accordance with Section 1504.1 of the UBC, and are
noncombustible roof coverings in accordance with Section
1504.2 of the UBC.
2.5 Identification:
The letters "U.S.T." are embossed on the bottom of each
tile near the nail hole on the cover side. Additionally, the
tiles are identified by means of a tag attached to each
shipping pallet bearing the evaluation report number (ICBO
ES ER -3523) and the installed weight.
3.0 EVIDENCE SUBMITTED
Reports of tests conducted in accordance 'with the ICBO
ES Acceptance Criteria for Clay and Concrete Roof Tiles
(AC180), dated January 2002, installation instructions, and
a quality control manual.
4.0 FINDINGS
That the One-piece "S," Tapered Two-piece Mission,
Flat Shingle, Romano Pans, Claylite and ClayMax clay
roofing tiles described in this report comply with the
1997 Uniform Building Code'"', subjectto the following
conditions:
4.1 The tiles are manufactured and installed in
accordance with this report and the
manufacturer's instructions.
4.2 The tiles are manufactured at the United States
Tile Company plant in Corona, California.
This report is subject to re-examination in two years.
r
Page 3 of 3
HEAD
END
TOP \
/ °� PAN
81/2"
3..
BUTT 18"�'
.81/2" END :. 7„
MISSION TWO-PIECE ROOF TILE
HEAD
END134 ,
Q
y � .
18 13"
\ / BUTT
/ END
ONE-PIECE "S" AND. CLAYLITE@
ROOF TILE
HEAD
END
\,\ INTERLOCKING
CHANNEL
18t
9
/ .. 93/4
\ BUTT
END
FLAT SHINGLE ROOF TILE
FIGURE 1—TILE PROFILES
•\ 13/4"
'a
18 ". 13"
CLAYMAX® ROOF TILE
ROMANO@ PAN
ER -3523
3/4" Iy