BRER2015-006178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
COMMII_NITY DEVELOPMENT:DEPARTMENT
BUILDING'PEWIT
Application Number: BRER2015-0063
Property Address: 53080 AVENbA RUBIO
APN: 774043004
Application Description: REOOF 2800 SQUARE FEET
Property Zoning: _
Application Valuation: $5,600:00 D (�
Applicant: (r'� g IJ
T M H ROOFING INC AUG 03 2015
11227 SPRINGWAY COURT
RIVERSIDE, CA 92505
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.: 967811
Date: Contractor:
OWNER -BUILDER D C -- '
I hereby affirm under penalty of perjury that l am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code--,Any
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 toifile 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 Divisio"yA
of the Business and Professions Code) or that he or she is exempt.therefrom and th9( `
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant f • r 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 clothe 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 piiovindthat
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.).
(_ ) 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.). p
Lender's Name:
Lender's
VOICE.(760) 777-7125
FAX .(760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/3/2015
Owner:
. JUANA BLANCO
53080 AVENIDA RUBIO
LA QUINTA,.CA 92253
Contractor:
T'M H -ROOFING INC
11227 SPRINGWAY COURT
RIVERSIDE, CA 92505
(951)255-5268
LIC. No.: 967811
WORKER'S COMPENSATION DECLARATION
I hereby affirm underpenalty 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 polity 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 beco ct to the
workers' compensation provisions of Section 3700 of.the or Code, I II forthwith
Comply with those pr visions.
Gate: 5 Applicant.-
WARNING:
pplicant: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 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 forwhose-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, inilemnify.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 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 to enter upon the above-
mentioned property for inspection purposes.
Date: 8 3 ' 7� Signature (Applicant or Agen
J
®•Lei I
b''.. ` ,Y�. i� :'' d& .:.t;, S T,C7rR.:r_&kFi x -.R� ':e;,� '-: f ',.sr.�,g , k"� �"i+,,.x ,r^ ,"�'FF. 'its (Ar
DESCRIPTION��AGCO.IJNT �iQTY��AMOUIVTh
�
z::' ..wct"a•. ,,:s:;r,s,�-`�- L .._r«'.
s PAID DATEa
x� a :M� . % O .� K m .
;PAID
� .� , � i a n:.f
BSAS'SB1473:FEE
� 101 0000=20306',
0 $100
$0.00
it Wit; 'a �. r'€, 44N m;g ggp 3
',_PAIDBY' :„'�,*
s
sg «��:. i:3�' F7i .§".135,X'! 'i x �€ � �s c:
ME;THOD`'
". �.,woo
RECEIPT # _
..i -^'n
CIECK #
CLTD}BY
i'. ,:.W:W,w,ac::& x•” a .. .e.: :,,e-? ..._' .� r.._d '.. §3.$Y
Y;' ,€: si8�c.�' t'."MINTw
Total Paid forBIIILDING'STANUARDSrADMINISTRATION BS/Y $1.00'. $0.00
T' �..
. '. gf:` ..." .` "�"-r'a�gT:Y
& ¢ ^ °., frt °;a C^` `ri:." ,'' 'E< :...:
,644i'n
g:YY X4'1' ''i':f *'` x%FEa+X l+Z
'PAID
'�z i# L "",'+,"w'B€�i-.'zs3 '", dols r
�4L�1
7-g s's^�"° C: �7id iV
RAIDDATE
"AUDESCRIPTIONu ..A000UNT3AMOUNT
.xi._�454.:f#.; .. 4_ w��d".>�
sa�Rr'.3XiiXPY .3 �<4 A�'�
ai ak. $> d:.C} '.:...�r��
d%: z.:k
31e ,_.t ,.u:
RE -ROOF - EA`ADDITIONAL'1,000 SF `
101 0000 42404
3,
0
_'`,'$46.40 J,
$0.00
mg
PAIDy.BY^MEfkIOD[��
10,
fig'
<; #�
�'`Lv�`,`-"r�f..�:�,et:S>^>-�
CMECK # °r
Gl•TDBY
.:
., tryCf4..a�<k£fY.NSYRf'�MPI
..
�'Rsr..:�.<'."'�... i9'�ji�`.f
YRECEJPNT
.ifr:F»'���Ci:'S=,£
;,,.w:.
'i S�..'"�.'.rak SY�:¢`.'�`:�s�+. �`:Ad.cE-4'��°
r
'�.'Rs.�.e"Ycft:...gF:
..
-
J
'•E.d" 3 ,��e yKs m ,.dr � "4fY�,yT`.ry.�,�a V y'X
T _ � syn 'i�'_ 5�'-�°�aS-. .� af:.
r,�
Eats,- hv`i � el,"'- �i's�s" i q'�E 3' ".,A�
qTY AMOUNT e.a#`cPAID
i� "+'�j'f G�P,a'eaarc �S tea'
�
�.-,�
AIDDA
RE-ROOF-= FIRST 2,000 SF
101 0000 42404`
0 ' .. $49 31
$0.00
�i„)
xf`�r �PAID.BY_
�9'N?'.zeaS,aL:`iY'kAt?6Ci4d1
£�.4'.T°:. :_kae':''*cSS�'.k..vY. Ste. 4a3.„...'
METHOD
:6S�i�:a'`' ..<: _.'s"': F.+"Tv 2:roY ,v'"%3E,
RECEIPT#
§S:'� $ [Y
CFIECK�#�
f:e[1rfSS5.'H:F
CLTDaBY
�iv
:
. .-.,,y
..' ... '
;z�
i?µv�d:.`m?fE.>.°v?.4i'�ta..v2��e,Jm"S{ii�a:e�vf
ti M"'�.•s4
'.:,4r
:4?f ,.+ Y'�"6+ ^f; Y �i. is"F:.:rr't`W [✓,.aa"a' t: k 'a.Y'` ..,£,fl.
��ACCOUNT
e+-fi�.:-9....*�.'`�`-�t::P4
i �... <? K�.i}s a+.'{YlF..6,:�$'�
I'°-«-s�AMOUNT�
`.'::` 9pa"'k.E"`.'�!:?45 .�%i#%E4N
"`"
rtaiit�k Man e
�:
MIN `�e.v'"3 J4�ii.5-»"
e.
"--:PAID.DATE
W,Z' -
RE -ROOF= FI RST2;000, S.F.
P. C�-
-3010000-426`00:.'
0�-" ., x$9862. `
$0.00
�a.�:
'3y"'. 1 f�i`{4,.. 1 C. i.: i'k,�`,-a iC yw,-g A� ke�
:
'?$e(E gF .. ..'g,3s-.iN'.' F:. L�'k q, F4:r.C�{d`'::k
�.: METHOD
C.?Z, r" .%r."'..,..,4``''✓ ,. .-ad'°
f: s ...N-,RECItIP{T�#r�..-
`1, �'
q� :CHECKx xg
CLT,D BY:
,.<
. a''[. ,i�+. Sn k"
''. '` 'aL +m ,R ;i.it 'is.'a`x` i1-., .._'.'++ OM
."ins" "�. ;T551,£if'b1i a '- s�. ri�MA-1 Y
q
Sx+"wa.:.'iFZ�T,t.F`iT-.11s+7�ih�.'`.'3?
S I ..
_ }Total Paid,forRE`ROOF :$194 33 $0.00
F � i .o -.,a...:.... ¢ ." a,.,.. . ,. a,*.,caV.. a _..,{ 4..».1 , r „- <A. ' ... • ..... - '.,«. ' , . ' . -
• 1 11
Printed: Monday, August 03, 2015 12:47:08 PM 1 of 2'
CRWIYSTEMS
DESCRIPTION
ACCOUNT
PAID
J
�PAIDDATE:
RECEIP
ETHODQTY
CLT
BY
.:
BSAS SB1473 FEE
101-0000-20306
.0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
RE -ROOF - EA
101-0000-42404
0
$46.40.
$0.00
ADDITIONAL 1;000 SF
RE -ROOF - FIRST 2,000
101-0000-42404
0
$49.31
$0.00
SF
RE -ROOF - FIRST 2,000
101-0000-42600
0
$98.62
$0.00
SF PC
Total Paid forRE-ROOF: $194.33 $0.00
TOTALS:$0.00
REVIEW TYPE.........
,I 4 REVIEWER I SENT DATE I DI `Rb
DATE ) `REl
PARENT PROJECTS
ED I STATUS I .REMARKS Y' I NOTES';
Printed: Monday, August 03, 2015 12:47:08 PM 2 of 2
SYSTEMS
Bin #
Clty of La Quina
Building 8z Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #E
Project Address: a 3D A✓Tr ft4 2 H% i7v
Owner's Name:
A. P. Number:
Address:
Legal Description:
Ci ST, Zi
- ty, p : C a. Our ---7--4 L 0
Contractor:
µ o�
T ele h � (i
Address:
Project Description:f fc4 Dir 4,y
City, ST, Zip:22
VeO S IQ 1lv'b zle6Ft-0 t t.t �6
Telephone: S 5--- � G
v z D t✓cam o G
.3 s c D Io
State Lic. # : (� % $ l /
City Lie. #.:
Arch.; Engr., Designer:
St1L.>!-i.,,ro•CD P— Coo L Q ao
Address:
City., ST, Zip:
Li e rq
Telephone:
•-7
Con
structi n Type: Occupancy: aneY
•
State L ic. #•
ProJ t tYPa (circle one): New Add'n Alter Repair. r De mo
Name of Contact Person:
Sq. Ft.: �
#. Stories:
#Units:
Telephone # of Contact Person: I?Oq - 36-d-- d 577
Estimated Value of Project:
APPLICANT:,DO NOT WRITE BELOW THIS ONE,
if
Submittal .
Req'd
Rec',d
TRACKING
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 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2aa 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
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS �11j
CEC-CFIR-ALT-01-E Revised 06114 CALIFORNIA ENERGY COMMI§BION rti
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 4)
Project Name: �t_4AIeC) 30 D �� �i �`r �Z� Date Prepared: j
A. GENERAL INFORMATION.
Ol
.
O1:
Project Name: Lo r, L - .J
02
Date Prepared:.
03
Project Location: t7 d A t 11 �ti i�
04
Building Frcint Oh entat on°(deg or cardinal):
05
CA City: A- tir
06
Number of AlteGed�,pwelling Units:
07
Zip Code:"'
08
fuel Type.: �$. _s •. -..._" ,
09
'Climate Zone:
10
Tonal Con`di05ed Flo6r•Afe7;a
11
Building Type"
12.
SI4"'4 aft2
( )
13
Project.Scope:
• W. . . Nsb. _k�_ _ ..
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)
Ol
02
03
04
05
06 ` >;;,.�:,,� :a:,..��. 0
07 8;;?a� „A9i.
10.
11
02
03
04 .r.,, "F'`
05 °h
,:'Q 06
a; 'Q:7 fi
OS 09 .10
11 12 13
:r
Proposed �y
Required
Proposed
Minimum Required .
Method of
Roof
CRRdP'r.,oduct ID
CD 1A4
D ck
Initial Solar
Aged Solar .'
Thermal
SRI
Frame
Frame
,:Appendix
Continuous �' Reference
Exception
3 Number
-n
„Product Type
—
Frame
Depth •
Spacing
Cavity '; `Insulation
- :
Reflectance Emittance (Optional)
Tag/ID
Assembly Type '
Type . _
(inches)
(inches)
R value '< R -value :;, Ufaetor Table ;Cell
U Factor
Comments
q
:r
-
NOTES . pp .A
-
Roof area covered by bullaingJintegrated photovoltaic panels and solar thermal panels are exempt
from the above
Cool Roof requirements.
C. ROOF REPLACEMENT (Prescriptive Alteration, Seetiori50.2(b)1H�
Y.
01
02
03
04 .r.,, "F'`
05 °h
,:'Q 06
a; 'Q:7 fi
OS 09 .10
11 12 13
:r
R value
"
Proposed
Minimum Required .
Method of
Roof
CRRdP'r.,oduct ID
��„ �: iw
§
D ck
Initial Solar
Aged Solar .'
Thermal
SRI
Aged Solar Thermal SRI
Compliance
Pitch
Exception
3 Number
-n
„Product Type
M
Insulation
Reflectance
Reflectance
Emittance
(Optional)
Reflectance Emittance (Optional)
41
NOTES . pp .A
-
Roof area covered by bullaingJintegrated photovoltaic panels and solar thermal panels are exempt
from the above
Cool Roof requirements.
o Liquid field applied:tiings'must comply w the Rstallation criteria from section 110.8(i)4.
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS o
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION_
CERTIFICATE OF COMPLIANCE CFIR-ALT-01-E
Prescriptive Residential Alterations (Page 4 of 4)
Proiect Name: (4 Date Prepared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I. certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Nam
Documentation Author Signature: t w;
Company:
Signature Date:,
i > .ter jz ' •�taY
Address:
CEA/ HERS Certification IdgpiificiiiQ6"bf applicable): ti ,`c
Ciry/State/Zip: ^ • �6
Phone: +$;1 's
a
RES PONSIBLE'PERSON'S DECLARATION STATEMENT 2.
1 certify the following under penalty. of perjury; under the laws of the State of California: r
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible tinder Division 3 of the Business and Professions Code to accept responsfbiGty,for the building design or system design identified on this Certificate of Compliance (responsible
,designer).
t
3. That the energy features and performance specifications; materials, componen strand manufactured devl�ces for the bul�dmg design or system design identified on this Certificate of
Compliance' conform to the requirements of Title 24, Part 1 and Part V of the(SRrnla Code of gulations. 1: `u
.4. The building design features or system design features identified on tt�hs Certificate of Corppjjjance'-are consistent itf~ir4$H'e information provided on other applicable compliance documents,
worksheets,.calculations, plans and specifications submitted ao t(te epforcement ager>cy fol,approvai with this L�uiltling permit application.
S. I will ensure that a registered copy of this Certificate of Corr pli�ceshall be made jv�i)abl'e with the bulLdlrl& p`,ermit(s) issued for the building, and made.available to the enforcement agency
for all applicable inspections. I understand that a registerq. cq.. N..0 this Certificate o Compliance is equired fo be included with the documentation the -builder provides to the building
..
owner at occupancy. +y ,
Responsible Designer Name:
,,Re€ dasible Designer Sign e:
. UPN
Company: Cr , A is kfi �
Date Signed:. i—
Address:; <y "d,s.
License:
Cit /State/Zi Fa <u as•
Y P < x,
Phone:
For assistance o�qi uestions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Registration Number:. Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
HERS Provider:
In,n W)I A