BRER2016-0111LICENSED 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 Business and Professions Code,
and my License is in full force and effect.
License Class: C39 License No.: 969798
Date 6n Contract ro : ic-
v
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).:
(� 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.).
( ) I, 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.).
U 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 Na
Lender's Add
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'
comp nsation, as provided for by Section 3700 of the Labor Code, for the performance
Work for which this permit is issued.
`I have and will maintain workers' compensation insurance, as required by
S n 3 00 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity number are: .
Carrier: STATE COMPENSATION INSURANCE FUND Policy Number: 9003560
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 beco a subject to the
workers' compensation. provisions of Section 37 o the Labor de, I shall forthwith
comply with those provisions.
Date: t i Applicant:
WARNING: FAILURE TO SECURE WORK S' COMPENSATION OVERAGE 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 Building Official 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.
I certify that I have read this application and state that the above information is co rest.
I agree to comply with all city and county ordinances and state laws relating to b i ding
construction, and hereby authorize representatives of tAcitytr upoabove-mentione property for inspection purposes.
�Date: ' Signature (Applicant or Agent
.
78-495 CALLE TAMPICO
o 4��
VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253
FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
-
BUILDING PERMIT
v
Dat 5
Application Number: BRER2016 0111Owner:
Z
Property Address:. 52450 EISENHOWER DR
GEORGE GABLE
APN: 773271011
M
Property Zoning:
m C)
D
Application Valuation: $9,575.00
OCOQ
1
mC
Applicant:
Contractor:
c
�j ZL�
I C"
G M GORDON ROOFING
G M GORDON ROOFING
EC2 n
79-041 DELTA STREET
79-041 DELTA STREET
BERMUDA DUNES, CA 92203
BERMUDA DUNES, CA 92203
_
`
mm ��
(760)565-7006
—i
Llc. No.: 969798
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 Business and Professions Code,
and my License is in full force and effect.
License Class: C39 License No.: 969798
Date 6n Contract ro : ic-
v
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).:
(� 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.).
( ) I, 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.).
U 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 Na
Lender's Add
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'
comp nsation, as provided for by Section 3700 of the Labor Code, for the performance
Work for which this permit is issued.
`I have and will maintain workers' compensation insurance, as required by
S n 3 00 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity number are: .
Carrier: STATE COMPENSATION INSURANCE FUND Policy Number: 9003560
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 beco a subject to the
workers' compensation. provisions of Section 37 o the Labor de, I shall forthwith
comply with those provisions.
Date: t i Applicant:
WARNING: FAILURE TO SECURE WORK S' COMPENSATION OVERAGE 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 Building Official 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.
I certify that I have read this application and state that the above information is co rest.
I agree to comply with all city and county ordinances and state laws relating to b i ding
construction, and hereby authorize representatives of tAcitytr upoabove-mentione property for inspection purposes.
�Date: ' Signature (Applicant or Agent
s
Date: 12/5/2016
Application Number: BRER2016-0111
Owner:
. Property Address: 52450 EISENHOWER DR
GEORGE GABLE
APN: 773271011
Property Zoning:
Application Valuation: $9,575.00
Applicant:
Contractor:
G M GORDON ROOFING
G M GORDON ROOFING
79-041 DELTA STREET
79-041 DELTA STREET
BERMUDA DUNES, CA 92203
BERMUDA DUNES, CA 92203
(760)565-7006
----------------=------------------------------------------------------,----------------------
LIc. No.; 969798
Detail: REROOF WITH MALARKEY ROOFING PRODUCTS: PANOCAP MEMBRANE: BUILT-UP AND MODIFIED BUITUMENT SHEET ROOFING OFF-WHITE COLOR
[CRRC: 0850-0002) 2013 CALIFORNIA ENERGY CODE.
s
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF - EA ADDITIONAL 1,000 SF
101-0000-42404
0
$12.16
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$51.68
• DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0
$103.36
Total Paid for RE -ROOF: $167.20
t
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U
Qin #
City of La Quin to
Building 8F Safety Division
Permit #E
. - 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
_ N
_ _Project -Address: _
� i � � -
,Owner's Name: Gp
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
C no tractor:
Tel r h
e P 0 ne:
_
F Address:z- cut �m4jpo
Project Description:
' City)ST, Zip:
40i
E • Tele p hone
State'Lic. # :CIG 9
City Lie. #.-
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
n t' ecu ant
Co strut ton Type: Occupancy:
P P Y•
State Li
c. te Ltc. # •
0roJect tTPa (circle one • New Add'n Alter Repair
Demo
Nam of Contact Person:
Sq. Ft.:+ � ba
# Stories: I
# Units: 1
Telephone It of Contact Person:
71 57
6
Estimated Value of Project:91
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd
Rcc'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance.
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2.4 Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
I-I.O.A. Approval
Plans resubmitted
Grading
IN IiOUSE:-
'rd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Aper
Date of permit issue
School Fees,
I
Total Permit Fees
Lui969798
79041 Delta Street
Phone: 760)565-7006
Bermuda Dunes, CA 92203 Fax: 760)200-1951
gmgordonroofing@gmaii.com
I Name/Address
George Goble
Proposal
DatePro
osal No.
11/15/16
561
Project Name/Adress
52-450 Eisenhower Drive
La Quinta, CA 92253
I Description I Total
ROOF REMOVAL: Tear -off one existing Built Up Roof from substrate. Inspect for any damaged
plywood. Remove and replace @ $45.00 per sheet as needed. Remove and replace 5 roof
scuppers with 4 inch x 4 inch roof scuppers. Remove all roofing debris from property.
BUILT UP ROOF: Install 4 ply built up roof system. Nail in place 2" cant strip in all angle details.
Install 1 -ply of 281b. fiberglass base sheet mechanically fastened to substrate with simplex type
fasteners. Install gravel stop over 1 -ply of fiberglass ply sheet mopped with hot asphalt to base
sheet. Install all flashings in a bed of plastic roof cement, nail, and primer using asphalt primer. Apply
2 -plies of fiberglass ply sheet to be solid mopped with hot asphalt at the rate of 25lbs. per 100 sq. ft.
per ply. Seal all roof penetrations including electrical, plumbing, and HVAC flashings. Mop in place
with hot asphalt 721b. mineral surface cap sheet in all angle and parapet wall details. Apply 1 -ply of
721b. mineral surface cap sheet to be solid mopped with hot asphalt at the rate of 25lbs. per 100 sq.
ft. as finished surface. Price includes installation of seven 12 inch x 12 inch gravity vents, standard
galvanized gravel stop metal, and 30 feet of metal cap @ front parapet wall detail.
WARRANTY: Roof to receive 5 year warranty upon date of completion.
OPTION; ELASTOMERIC ROOF COATING: Remove all debris from roof areas and pressure wash
roof surface. Coverall skylights and any necessary areas to protect against overspray for duration of
project. Apply two coats of white elastomeric roof coating.(TILTE 24 COMPLIANT and COOL ROOF
RATED) 1 st coat- applied at the rate of 1.25 gallons per 100 sq. ft. and 2nd coat -applied at the rate
of 1 gallon per 100 sq. ft. to all flat roof areas. ADD: $2,200.00
Acceptance
Date
The Proposal described herein is for 60 days from the above date.
Signature
9,575.00
Total $9,575.00
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1 R -ALT -01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 4)
Project Name: r n1/, �o V n—, Date Prepared:
A. GENERAL INFORMATION
01
02
01
Project Name:
02
Date Prepared:
03
Project Location: —
04
Building Front dijekation'(deg or cardinal):
05
CA City: '
06
Number of Aliered,Dwelling Units: .
07
Zip Code:
08
Fuel Type.
09
Climate Zone:
30
Total,Conditioned Floor,-AriOa (ft?).)'
11
Building Type
12
Slab,' �rea'(ft2)`
13
1 Project Scope: I
_.
4714 V "
Lb "�"-t
B. BUILDING INSULATION DETAILS (Section 150.2(b)1) 'J
01
02
03
04
05
06 g* L,,b7 I 08 , X 09
10
11
Tag/ID
Assembly Type
Frame
Type
Frame
Depth
(inches)
Frame
Spacing
(inches)
Pr osed vso
Required
Comments
ntinuousAReferependlnce
Cavity&insulation
R -value. R -value
s U;fabtor
4
LI -Factor
Table. Cell
'ZInitial Solar Aged Solar Thermal SRI Aged Solar Thermal SRI
Compliance
Pitch
Exception
Number ,
u
� Insulation
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
t
\'o"*
NOTES`
• Roof area covered by, building integrated photovoltaic panels and solar thermal panels are exempt
• Liquid field }must n tallation from 110.8(1)4.
e fF"1N V T? \\.V 't. i\_�p
C. ROOF REPLACEMENT (Prescriptive Alteration, 3n�hb.2(b)11HI)l
01
02
03
04 A:N:
05\,,,
�* 06
'67,PO' 08 09 1 10 11 12 13
4,o �
R -value �'
�� Proposed Minimum Required
Method of
Roof.*
CRRC'P odD
1
roduct
Deck-,y�
'ZInitial Solar Aged Solar Thermal SRI Aged Solar Thermal SRI
Compliance
Pitch
Exception
Number ,
+ - Type
� Insulation
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
t
\'o"*
NOTES`
• Roof area covered by, building integrated photovoltaic panels and solar thermal panels are exempt
• Liquid field }must n tallation from 110.8(1)4.
from the above Cool Roof requirements.
applied' coatings comply with` criteria section
M
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Pave 4 of 4) 1
Project Name: C f�I� blot. I Date Prepared: 1
r.
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documett1,a� C author ame:
Documentatio r e:
Company:
6J, CA€
Signature D" tei'
,
Address:
5
CEA/ HERS Certification Iden flca on'(if applicable): 4.16-1
WI c
City/State/Zip: I C{/7
Phone:
RESPONSIBLE PERSON'S DECLARATION STATEMENT►►
I certify the following under penalty of perjury, under the laws of the State bf California:" "M
1. The information provided on this Certificate of Compliance is true and correct.
2. I am eligible under Division 3 of the Business and Professions Code to accept responsibllfor the building�d nor system design identified on this Certificate of Compliance (responsible
designer).
3. That the energy features and performance specifications, materials, componentsaSmanufacture'd cYe�7lces for the building design or system design identified on this Certificate of
Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the Cajifornia Code of1kegu aAonss 4
4. The building design features or system design features identified on thifs�Certificate of C6 pliance are consisten1`t wiih Fie information provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted to the enforcement ageriyfo approval with this bui ding permit application.
with
5. 1 will ensure that a registered copy of this Certificate of Compl a ce: hall be made -mail ble the building permlt(s) issued for the building, and made available to the enforcement agency
for all applicable inspections. I understand that a register; py of this�Certific� a�of Compliance isir�eguii're ' to be included with the documentation the builder provides to the building
owner at occupancy. X.P %JW
Responsi a Desig er : \ `� '
Re•3potlsibl Sig ture:
Ne. CJ .* "W%r or"Y
775
/7,� L
;
Company :\ 44,
Date Sig ed.
1-1)41r.
Address:
License: I
Ci / tate/Zip: ` V
9i '
Phone:
1� C 0
For assistance or -questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014