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12-0763 (RR)P.O. BOX 1504 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: -=-f1--0_900-0763-- ' Property Address: 5445"AVENIDA RUBIO APN: 774-234-030-10 -000000- Application description: RE -ROOF Property Zoning: COVE RESIDENTIAL ADDlicatlpn Valuation: 16222 Applicant: Architect or Engineer: ------------------ 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�/Clas_/. s:C39 License No.: 683894 /Date:`/6 teOntractor. / OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjur that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Busin ss and Professions Code: Ariy 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):: (_ 1 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 herown 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 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.) ( 1 I am exempt under Sec. , BAP.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: LQPERMIT Owner: PATRICIA RINGOLD 54455 AVENIDA RUBIO -LA QUINTA, CA 92253 Contractor: DEPINHO ROOFING INC 2832 NORTH OLIVE AVENUE ORANGE, CA 92865 (714y632-7663 LiC. No:: 683894 ---------------------------- WORKER'S COMPENSATION 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. YLI have and will maintain workers' compensation insurance, as required by Section 3700 ofthe Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier CA INS Policy Number 73826990103 _ 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 of the Labor C e, I shall forthwith comply with those provisions. ate:0� �2 Applicant: _ WARNING: FAILURE TO SECURE RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIM AL 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 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 buil g construction, and hereby authorize representatives of th' cou ty to enter upo the above-mentioned propert for inspection purposes. ate: gnature (Applicant or Agent): VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/10/12 LQPERMIT Application Number . . . . . 12-00000763 Permit RE -ROOF Additional desc . Permit Fee: 30.00 Plan Check Fee.. .00 Issue Date . . .Valuation 0 Expiration Date 1/06/13 Qty Unit Charge Per Extension BASE FEE 30.00 Secial Notes' and . Comments RVRO(SY WITH LANDMARK SULAKIS 1 UMI, SHINGLES WITH 15# FELT UNDERLAYMENT. 2010 CODES. ------------------------------------------------------------- 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 QO .00 1.00 Grand Total 31:00 .00 .00 3.1.00 LQPERMIT a Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations Page 3 of 5 Project Name: Climate Zone # # of Stories • 54455 Avenida Rubio, La Quinta is 1 ROOFING PRODUCTS (COOL ROOFS) §1511912 When the area of exterior roof surface to be replaced exceeds more than 50% of the existing roof area, or more than 1,000ft, whichever is less, the new roofing area must meet the roofing product "Cool Roof" requirements of§]52(b)]H4 152(b)]HU, or 152(b)]Hiii. Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof' requirements. Note: If any one of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Emittance requirements for'roofing products in §118(1) are not applicable. Do not fill table below. ❑ Cool Roofs Not Required in Climate Zones 1-12, 14, and 16 with a Low Sloped. Less or 2:12 pitch. ❑Cool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep -Sloped Roofs (pitch greater than 2:12) and product unit weight less than 5lb/ft 2. Alternatives to §152(b)1Hi and §152(b)Hii, Steep -slope roof (pitch > 2:12) ❑ Insulation with a thermal resistance of at least 0.85 hrft2.OFBtu or at least a 3/4 inch air -space is added to the roof deck over an attic; or ❑ Existing ducts in the attic are insulated and sealed according to § 151(1)10; or ❑ In climate zones 10, 12 and 13, with 1 fl? of free ventilation area of attic ventilation for every 150 ft of attic floor area, and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge; or ❑ Building has at least R-30 ceiling insulation; or ❑ Building has radiant barrier in the attic meeting the requirements of § 151(1)2; br ❑ Building has no ducts in the attic; or ❑ In climate zones 10, 11, 13 and 14, R-3 or greater roof deck insulation above vented attic. Exception to §152(b)]Hiii, Low -slope roof (pitch <2:12) ❑ Building has no ducts in the attic. Other Exceptions ❑ Roofing area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria_ ❑ Roof constructions that have thermal mass over the roof membrane with at least 25 Ib/ft is exempt from the below Cool Roof criteria. Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwise, Check the applicable box below if Exem t from the Roofin Products "Cool RoofRequirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product tD Numbers < 2:12 > 2:12 < 5lb/fie > 51b/f12 TvDe2 Reflectance 3,4 Emittance SRI 0668-0057 ❑ 0( C ❑ comp shin les ❑4 .26 .93 29 ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑. Y ❑ ❑ ❑ ❑. 04 1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs.org/productslsearch.php 2. Indicate the type ofproduct is being used for the roof top, i.e. single ply roof, asphalt roof, metal roof, etc. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same directory and use the equation (0.2+0.7(pi„iiia1— 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4. Check box if the Aged Reflectance is a calculated value using the equation above. 5. Calculate the SRI value by using the SRI- Worksheet at hltp:/Avww.enerzy.ca.gov/title24/and enter the resulting value in the SRI Column above and attach acopy of the SRI- Worksheet to the CF -IR. To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in § I18(i)4. Select the applicable coating: ❑ Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating 9 ❑ Other Registration Number: 2008 Residential Compliance Forms Registration DatelTime: HERS Provider: I August 2009 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 5 of 5 Project Name: 54455 AVENIDA RUBIO, LA OUINTA CA 92253 Climate Zone # # of Stories 10 1 HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this checklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before final inspection. Duct Sealing & Testing HERS verification is required for this measure. ❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned space, the ducts are to be sealed per §152(b)IDii and the newly installed ducts are to be insulated per §151(f)10. ❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. ❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the ducts are to be sealed per §I52(b)IDi. ❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are to be sealed per §152(b)IE. ❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RA3. ❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Refrigerant Charge -Split System HERS verification is required for this measure. ❑ YES ❑ NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat exchanger) a refrigerant charge measurement shall be verified per § I52(b)1F. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation requirements of §150 o do not apply to existing residential homes. Ducted Split Systems -Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. ❑ YES ❑ NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is replaced, the airflow and fan watt draw shall be verified per 152 b 1 Ci to meet the requirements of 151( 7B. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. Name: NELSON DEPINHO Signatu Company DROOFING INC. Date: 7/10/12EPINHO Address: If Applicable ❑ CEA or ❑ CEPE 2832 N OLIVE AVE (Certification #): City/State/Zip: ORANGE, CA. 92865 Phone: 714 632 7663 Responsible Building Designer's Declaration Statement • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • 1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts I and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Name: _T Name: Signature: Company: Date: Address: License: City/State/Zip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300. Registration Number. Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms August 2009 Lsin ff City Of La Quinta Building &r Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet J( Project Address: Se- l 1Y SJ 'I R(Ato wner's Name: P, A. P. Number: Address: AV f/V IF10, Legal Description: City, ST, Zip: !!37 A Contractor: U&NA6 Address: "2,6-3Z, p. 04jV,0 p ,4j City, ST, Zip: 0- 9ZE6�— Telephone: W 632 }66-3 State Lic. 4 : C-31 6J389Y City Lic. 4: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: ..... Iff Description: Project De Ry OV & 15-Y-15 1AJfJ-e0(LAN o *XAA.U, S014&('d Total Permit Fees I ..... Construction Type: Occupan cy: State Lic. Project type (ci rc I eo ne): New Add'n Alter Repair Demo Name of Contact Per: on: 11 , Sq. Ft, Telephone #' of Contact Person: (W # Stories:# Y) 93?- - 7) 0 I Estimated ValueProject: Units: APPLICANT: DO NOT WRITE BELOW THIS LINE # - Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Structural Calcs. Reviewed, ready for corrections Item Amount Plan Check Deposit Truss CaIcs. Called Contact Person Plan Check Balance Title 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 H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for corrections/issue !Called !Contact Developer Impact Fee Planning Approval Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees I