BRER2014-101778-495 CALLE TAMPICO
LA'CIUINTA, CALIFORNIA 92253
Application Number: BRER2014-1017
COMMUNITY DEVELOPMENT DEPARTMENT
4
BUILDING`PERMIT
Property Address: 52334 AVENIDA RUBIO
APN,: 773253024
Application Description: REROOF WITH URETHANE FOAM COATING [CRRC: 0620-0029]
Property Zoning:
Application Valuation: $19,000.00
Applicant:
URETHANE FOAM SPECIALIST,INC Q. �•
OUTSIDE.CITY LIMITS D q A
LA QUINTA, CA 92253 SEP 2 201Y
— CITY OF LA uuu• I^
COMMUNITY DEVELOPMENT DEPARTMENT
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.
Lic rise Class: cense No.::LIC-0109658
Date: Contractor,
OWNER -BUILDER 9 CLARATION
I hereby affirm under penalty of.perjurythat I ' m exempt from th ontractor's State
License Law for the following reason -(Sec. 7031.5, Business and Pr fessions 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 sheds exempttherefrom and the • 7
basis for the alleged exemption. Any violation ofSection 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.).
(__j 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/29/2014
Owner:
TQRINO, TAMARA
52334AVENIDA RUBIO
LA QUINTA, CA 92253
Contractor:
URETHANE FOAM SPECIALIST INC
OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
(760)346-0670
Llc. No.: :LIC -0109658
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penaltyoUperjury one,of the following declarations:
I have and will maintain a certificate of consent to -self -insure for workers'
compensation, as proJided'for by Section 3700 of the Labor Code, for the performance
of the w,Pfffor which this permit is issued.
I have and will maintain workers'.compensation insurance, as required by
Section 3700.0the Labor Code, for the performance of the work for which this permit
is issued. My wokers 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 to become subject to the workers'
compensation laws of California, and.agree that, if I should become subject to the
workers' compensation provisions of Section 3700 the Labor Code, I shall hwith
comply with Ase p ovisions.
Date: Applica
WARNING: FAILURE TO SECURE WORKERS' OMPENSATION CO AGE 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 it 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 oromission 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 and state laws relating to building
construction, and hereby authorize representatives of this city toe er upon the above"
mentionodppe for inspection purposes.
71
Date:lv�%4 411Signature (Applicant or Age
FINANCIAL INFORMATION
DESCRIPTION
ACCOUNT
QTY
AMOUNT PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00 $1.00
9/29/14
PAID BY
METHOD
RECEIPT # CHECK #
CLTD BY
URETHANE FOAM SPECIALIST INC
CHECK
R1566 4799
AOR
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RE -ROOF - EA ADDITIONAL 1,000 SF
101-0000-42404
0
$34.80
$34.80
9/29/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
URETHANE FOAM SPECIALIST INC
CHECK
R1566
4799
AOR
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$49.31
$49.31
9/29/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
URETHANE FOAM SPECIALIST INC
CHECK
R1566
4799
AOR
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0
$98.62
$98.62
9/29/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
URETHANE FOAM SPECIALIST INC
CHECK
R1566
4799
AOR
TotalfPaid for RE -ROOF: $182.73 $182.73
TOTALS:
Description: REROOF WITH URETHANE FOAM COATING [CRRC: 0620-0029]
Type: RE -ROOF Subtype: Status: ISSUED
Applied: 9/29/2014 AOR
Approved: 9/29/2014 AOR
Parcel No: 773253024 Site Address: 52334 AVENIDA RUBIO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 10 Lot: 20
Issued: 9/29/2014 AOR
UNIT 1
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $19,000.00 Occupancy Type: Construction Type:
Expired: 3/28/2015 AOR
No. Buildings:.0 No. Stories: 0 No.. Unites: 0
Details: REROOF WITH URETHANE FOAM COATING -WHITE COLOR, AT EXISTING ROOF AREAS AND NEW AREAS SEPARATELY PERMITTED
[CRRC: 0620-0029] 2013 CALIFORNIA ENERGY CODE.
'DESCRIPTION _: ACCOUNT` '.;' ' QTY AMOUNT PAID .z PAID DATE ;`RECEIPT# :CHECK#.' , .METHOD' PAID.BY
x rBY
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 9/29/14 R1566 4799 CHECK URETHANE FOAM AOR
SPECIALIST INC
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
"Printed: Monday, September 29, 2014 4:32:10 PM 1 of 2
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT '#
CHECK #
METHOD
PAID BY
CLTD
BY
RE -ROOF - EA
101-0000-42404
0
$34.80
$34.80
9/29/14
R1566
4799
CHECK
URETHANE FOAM
AOR
ADDITIONAL 1,000 SF
SPECIALIST INC
RE -ROOF - FIRST 2,000
101-0000-42404
0
$49.31
$49.31
9/29/14
R1566
4799
CHECK
URETHANE FOAM
AOR
SF
SPECIALIST INC
RE -ROOF - FIRST 2,000
101-0000-42600
0
$98.62
$98.62
9/29/14
R1566
4799
CHECK-
URETHANE FOAM
AOR
SF PC
SPECIALIST INC
Total Paid for RE -ROOF: $182.73 $182.73
TOTALS: $183.73 $183.73
PARENT PROJECTS
Printed: Monday, September 29, 2014 4:32:10 PM 2 of 2 Cr'"W-
Bin # :Gey. f La Qulnta
Building &Safety Division
Permit # P.O. Box 1504, 78-495.91le Tampico .
La Quinta, CA 92253 = •(760) 777-7012
B ilding Permit Application and Tracking Sheet
Project Address: Owncf's Namc: v
A. P. Number:
Address: �� ee,,
Legal Description:
City, ST, Zip:�i�
Contractor:r-
Telc hone:
Item
Address:
Project.Deseription:
City, ST, Zip:'
Telephone: nc
Reviewed, ready for corrections
State Lie. # :
City Lie. #c
Arch., Engr., Designer:
Address:
Called Contact Person
City., ST, Zip:
Plan Check Balance
telephone:
R:::a>s:_:: <; s:<::i::z< s :z l.
.Construction Type: Occupancy:
3tatc Lic. #:
PoJ'ecttyPa circle one)� New a n Alter Repairair Demo
vamc of Contact Person:
-.4 Ft.: v :.
# Stories:
#Units:
Flood plain plan
�
Ccicphone #,of Contact Person:Estirrixted
Value of Project: (/w
APPLICANT: DO NOT. WRITE.BELOW THIS.LINE
#
Submittal
Req'd
Rcc'd
TRACXCING
PERMIT FEES,
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 _Gales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'' Reviewi ready for corrcctions/issue
Electrical
Subcontacior List
Called Contact Person
Plumbing
Grant Dccd
Plans picked up _
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
M HOUSE:-
a`' Reyiew, ready"for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.T.I.P.
Pub. Wks. Appr .
Date of permit issue
School Fees
Total Permit Fccs
W ZF-t<LnE 9oam. 4EciaL t AM.
Reroofing • Recoating • Repairs
72-875 Sonora Dr.
Palm Desert, CA 92260
Telephone (760) 346-0667 Fax (760) 568-0191
La Quinta Building Dept:
I robert Froetschel owner of Urethane Foam Specialists Inc. Authorize the following people to
pull permits in my behalf:
Mario Mugni
Andrew Flores
Effective immediately.
Robert Froetschel - Owner
1
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1 R -ALT -01-E Revised 06114 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 4)
Project Name: Date Prepared:
A. GENERAL INFORMATION
01
02
01 Project Name:
02
Date Prepared: —Z .•
03 Project Location:
04
Building Front Orientation (deg or cardinal):
05 CA City: Nut, AQ CA
06
Number of Altered Dwelling Units:
07 Zip Code:
08
Fuel Type:
09 ` Climate Zone:
10
Total Conditioned Floor Area (112):
11 1 Building Ty a
12
Slab Area (112)
13. 1 Project Scope:
B. BUILDING INSULATION DETAILS (Section 150;2(b)1)
01
02
03
04
05
06 07 08 09
10
11
Tag/ID
Assembly Type
Frame
Type
Frame
Depth
1 (inches)
Frame
Spacing
(inches)
Proposed
Required
Comments
Continuous AppendixJA4
Reference
Cavity Insulation
I R -value R -value LI -factor Table I Celli
U -Factor
Initial Solar Aged Solar Thermal SRI
Reflectance Refl ct nce Emi ante (Optional)
Aged Solar. Thermal SRI
Reflectance Emittance (Optional)
a
C. ROOF REPLACEMENT (Prescriptive Alteration, Section 150.2(b)1H)
01
02
03
04
0S
06
07 08 09 10
11 12 13
Method of
Compliance
Roof
itch
Exception
CRRC Product ID
Number
Product Tye
R -value
Deck
Insulation
Proposed
Minimum Required
Initial Solar Aged Solar Thermal SRI
Reflectance Refl ct nce Emi ante (Optional)
Aged Solar. Thermal SRI
Reflectance Emittance (Optional)
a
NOTES
• Roof area covered by building integrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements.
• Liquid field applied coatings must comply with installation criteria from section 110.8(1)4.
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
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 4 of 4)
Project Name: Date Prepared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete. 1.1
Documentatl uthor Name:
1&10&
Doc t tion or S n ure:
Comp ny: �^
Signat re Date -
Address:
7z- 0 T Sol•.�r- �e.
CEA/ HERS Certification identifica on (if applicable):
tate/Zip:
Phone:
7 - 3 5(o - tika
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California:
1. The Information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible
designer),
3. That the energy features and performance specifications, materials; components, and manufactured devices 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 California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents,
worksheets,, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency
for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is quired to be in uded with the documentation the builder provides to the building
owner at occupancy.
Responsible 0 erName:
Respo b ur
G.i
Date Signed:
Company:
Q,1
Address:
7 �,�/ brA i
License:�� 7Q
CI to/Zlp:
Ilipst--r-1
Phone:
+
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
negisrrenon ivumoer: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014