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11-0140 (RR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4bt °F 4v Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOCE (760) 777-7012 FAX (760),177-7011 INSPECTIONS (760) 777-7153 Date: 2/09/11. �--- Application Number: 11-0 00 0 014 0 Owner: Property Address: 52175 AVENIDA RUBIO HUMBERTO ALVAREZ nn APN: 773-212-019-8 -000000- 81077 AVENIDA GONZA�gZ 4 r Q Application description: RE -ROOF INDIO, CA 92201 1 Property Zoning: COVE RESIDENTIAL UUUU� ------------------ - ------- r , ---- Application valuation: 4000 t E13 O o Contractor: ( C1T7Y3F t cU 1 Applicant: Architect or Engineer: Owner ( Fgigf n,r- IN1ii4 I--------------------------------- 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 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 (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 (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 tl 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 1, 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 Lit c nse Law.l. (_ 1 I am exempt under Sec. , BA C. for this re on Date: �� wner: ,// C I hereby affirm under penalty of perjury that th work for which this permit is issued (Sec. 3097, Lender's Name: Lender's Address: LQPERMIT LENDING AGENCY n lending agency for the performance of the ----------------------------------------------- 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 Policy Number 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 ((((o become subject to the workers' compensation laws of California, and agree that, i*WORKCOMPENSATION bject to the workers' compensation provisions of Section 37,00 of the LabCowith comply with those provisions. ate: U,' Applicant• WARNING: FAILURE TO SECURCOVERAGE 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 Ouinta, 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 to comply with all city and county ordinances ands ate laws relatingog buildin ruction, and hereby authorize representatives ofof t� tq anter upon above -mention propert inspection purposes. ate: 1/ gnature (Applicant or Age Application Number . . . . . 11-0000.0140 Permit . . . RE -ROOF Additional desc . . Permit Fee. 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 8/08/11 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes' and' Comments RE -ROOF WITH OWENS-CORNING SHINGLES. 2010. CODES, SEE ENERGY FORM FOR CRRC SPECS. ---------------------------------------------------------------------------- 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 Bin # .QY Of La Quin Building 8T Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # ( J Project Address: R,-,-61'6 Owner's Name: A. P. Number: Address: 91-0-77 A-v.e—%icly� ie Z Legal Description: City, ST, Zip: Contractor•?t>:s:>`.>.<"":<s"`:>:<=; • Telephone: K-1?;�;>v :;:.:;:?:;:•<:; Address: :i:4Y• Project Description: City, ST, Zip: Sk a Telephone: ' v'•:4''tiYvGi:vu:.;:ji:3:';}�?:+. fryi:{5'F?S ..ri;.•r..::::;::?.::.::.; City Lic. #.: State Lic. # : Arch., Engr., Designer: Address: City., ST, Zip: Telephone: N>}?<K:'•.;`<":<•`:<#'':':4:;;>.: ;: :h:;;s,: •: sr :,:. .. `'$��~"'•' State Lic. #: Construction Type: Occupancy: Project type (circle one): New Add, n Alter Repair Demo Name of Contact Person: "Jrvti�2r � � v 0. Z . Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: ( Estimated Value of Project: 0-c� APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd 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 Tide 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°° Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, 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 o � r P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760) 777 -70 12 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits lMWf>>! TANT! NOT -ICE, TO p PERTY OWNER Dear Property Owner. An. application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at Vire are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OAR'S AC10OWi;14. I Glk1{ENT AND VERIFLCATLkON OF WFORNAMN DI� : Read and initial each statement below to signify you undeatand or verify this information. 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 personally. 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 injuries. I am wrllfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers onmy. I understand building permits are not required to be signed by property owners unless they are responsible for the :tion are not hiring a licensed Contractor to assume this responsibility. understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that i may protect 150m potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on tand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value :ion is at least five hundred dollars ($500), including labor and materials, I may be considered an "employee' federal law. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal g ent, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand .my failure to abide by these laws may subject me to serious financial risk. C77. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with.a licensed general building Contractor. 8�understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any cral or personal. ir{jaries sustained by any subsequent owner(s) that result from any latent construction defects in the p 4whip or materials. Npd6r_St_and I may obtain more information regarding my obligations as an "employee' from the Internal Revenue ce United States Small Business Administration; the California Department of Benefit Payments, and the California Division ustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 8 - -CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. I 0. 1 am aware of and' consent to an Owner -Builder building permit applied for in my name, and understand that I am the p legally and financially responsible for proposed construction activity at the following address: ronProperty, that, as the party legally and financially responsible for this proposed construction activity, .1 will abide by all s and requirements that govern Owner -Builders as well as employers. ee to notify the issuer of this form immediately.of any additions; deletions, or changes to any of the information I on this form. Licensed contractors are regulated by laws designed to protect the public. If you writract with does not have a license,. the Contractors' State License Board may be unable to assist you with any financial loss in as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also you to: understand that if an unlicensed Contractor or employee of that individual or firm is injured while working rty; you may be held triable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, You will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be ued, form ust be completed and signed by the property owner and returned to the agency responsible for is mit.. : A the property owner's dkiver's license, form n0tardpat1Vn; or other verification acceptable to ag ICY is ed to be resented when the permit is issued to ratify the pteperty owner's signature. Signature of property owner Date: — Note: The following Authorization Form is required 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 AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understandis my personal responsibility, I hereby authorize the following Person(s) to act as my agent(s) to apply for, sign, and file the documents necessary 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 above 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: 02/09/2011 10:52 7607777011 LA QUINTA BLDG DEPT PAGE 01/01 Prescriptive C Project Address: 5a- 1-J s Of Compliance: Residential ye. K,br'0 mate CF -1 R•ALT ROOFING PRODUCTS (COOL ROOFS) 9151012 When the area of exterior roof surface to be replaced exceeds 50% of the existing roof area, or 1,000 fe, whichever is less, me new roofing area must meet the rooRng product "Cool Roof' requirements of§152(b)1Hi, 152(b)1HU, or 152(b)1HIIl. Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Root' requirements:, O Cool roofs not required in Climates Zones 1-12, 14, and 16 with a low sloped roof pitch gess or 2:12 pitch). O Cool roofs not required in Climates Zones 1-9, and 16 with a steep -sloped roofs (greater pitch than 2:12) and product weight less than 511blf?. Alternatives to §1S2(b)1H1 and §152(b)Hii, Steep -slope roof (pitch > 2:12) ❑ Insulation with a thermal resistance of at least 0.85 hrf?-'F/Btu or at least a 3/4 inch air -space is added to the roof deck over an attic; or ❑ Existing duds in the attic are insulated and sealed according to §151(1)10: or O In climate zones 10, 12 and 13, with 1 ft2 of free ventilation area of attic ventilation for every 150 11112 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 O Building has at least R-30'esiling insulation; or O Building has radiant barrier in the attic meeting the requirements of §15102: or ❑ Building has no duds in the attic; or O In climate zones 10, 11, 13 and 14,•R-3 or greater roof deck Insulation above vented attic. Exception to §152(b)l Hiii, Low -slope roof ( pitch 5 2:12) ❑ Building has no duds in the attic. Other Exceptions E3 Roofing area is covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the Cool Roof criteria. O Roof constructions that have thermal mass over the roof membrane with at least 25 Ib/ft2 are exempt from the Cool Roof criteria. NOTE: If any one of the alternatives or exception !s checked the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in §116(1) are not applicable. Do not rill table below. Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Numbe rl s 2:12 > 2:12 < SlblW :t 516/ft' Type 2 Reflectance'• Emittance SRI' © )0 2 ❑ o SA11,u4E ❑4 13 0 0 o O4 Note: If no CRRC-1 labelis available, this compliance method cannot be used, use the Performance Approach to show compliance, 1. The CRRC Product +D Number can be obfa;nad from the Coo! Roof Reting Council's Rated Produef Directory of l olroofs onyeroducfs/searob,ahn 2. Indicate the type of product is being used for the roof fop, i.e. single -ply roof, asphalt roof, metal roof, etc, I. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Dhecfory than use the Initial Reflectance value from fhe same directory and use the equation (0.2+p,7(P.�wN _ 0.2) to obtain a calculated aged value. Where pis the Initial SolarRe6ectance. 4. Check box if the Aged Reflectance is a calcWated value using the equation above. 5. C0Icu18to the SRI valva by using the SRI- Worksheef at hMU-111M e n am Y.WA0VIWe2410 fte I enter the resulting value in tha SRI Column above and attach acOpy of the SRI- Worksheet to the CF -1R. To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or cover recommended 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 Q Other NO When a Cool Roof is required, the lnstalyng contractor shall complete and submit the CF -OR -ENV -01 for final inspection. • I certify under penalty of perjury, under the laws of the State Of C2lifomla, the Information provided on this form is accurate and Complete. • I certify that the energy features and performance specifications Identified on this Certificate f Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. Name: Abe✓` tD \U0. YpS Z ignature; Company; License: rnone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772.3300. Cool Roof Rating Council Rated Product friendly_y-iew ] (last updated 20 Dec 201( Showing Search Results Company: Owens Lorning Product Type: Shingles or Shakes, Shingles, Shakes, Tile or Slate. Brand: Oakridge®, Duration Premium®, Duration® Model: Shasta White select ' from products where company_name='Owens Corning' and (type like 'Shingles or Shakes%' or type like 'Shingles, Shakes, Tile or Slate%') and brand ='Oakridge(r), Duration Premium(r), Duration(r)' and model='Shasta White' order by company_name asc previous 1 1 1 next (showing records 1 - 1 of 1) Page 1 of 1 25 Records per Page IIEJ CRRC � Prod. ID 0890-0002 I I AAanufaoturer Information (sorted +) Brand Model Color Categ Product Solar Reflect. Therm Emit. SRI I to e Ap lication Type: init 3�r init 3y_r ini� 3�r Owens Corning Oakridge@_ Shasta Bright Shingles 0.27 0.28 0.89 0.91 28 30 Steep Darrel Higgs Duration White White or (419-248-7060) Premium®, Shakes Duration® previous I 1 I next (showing records 1 - 1 of 1) 25 ,per Page I About the CRRC. I Product Rating Program. I Rated Products Directory I CRRC Members I CRRC News Become a Member I How_Do I I Contact Us, I Cool Roof Links I Home http://www.coolroofs.orglproducts/results.php?keyphrase=&select_Vpe=select&type%5B6... 2/9/2011 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 (619) 564-2246 OF T`1 February 22, 1991 To Whom It May Concern: The structure located at 52-175 Avenida Rubio is located in a "B" flood zone per the revised F.I.R.M. (panels 060709 005 A and OO10�A) for La Quinta: The property was previously designated as zone AO (depth two (2) feet). If you have any questions, feel free to contact me. Sincerely. BUILDING AND SAFETY Tom `Hartung Director of Building an Safety TH/lc MAILING ADDRESS P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253