BRER2014-1001•78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&t�p 4 4 0"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BRER2014-1001
Property Address: 52580 AVENIDA RAMIREZ
APN: 773292004
Application Description: APPROX. 2500 SQ. FT. /
Property Zoning: I
Application Valuation: $5,950.00
Applicant: \�
RUBENFAUSTO v
52580 AVENIDA RAMIREZ
LA QUINTA, CA 92253
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: _ 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 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,kicense Law.).
( I am exempt under Sec. B.&P.C. for this reason
Dat" e:
—7111 I L Qw" 00n
1 �Q
2v►� fiv5y'b
CONSTRUCTION LENDING AGEN
I hereby affirm under penalty of perjury that there is a constr tion lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/1/2014
Owner:
RUBEN FAUSTO
52580 AVENIDA. RAMIREZ
LA QUINTA, CA 9;•kcZ
Llc. No.:
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 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 Code, I shall forthwith
comply with those provisions.
Date:
Applicant:
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 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 w I ork
for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is corcl
I agree to comply with all city and county ordinances and state laws relating to buildi
construction, and hereby authorize representatives of this city to enter upon the a
mentioned property for inspection purposes.
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Da,":'`' � 4 Signratu�re'(Applicant or Agent) �,/
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Permit Number: BRER2O14-1001
Applied: 7/1/2014
Issued:
Status: SUBMITTED
Parent Permit:
Parent Project:
Details
Approved:
Finaled:
Description: APPROX. 2500 SQ. FT.
Site Address: 52580 AVENIDA RAMIREZ
City, State Zip Code: LA QUINTA, CA 92253
Applicant: RUBEN FAUSTO
Owner: RUBEN FAUSTO
Contractor: <NONE>
RE -ROOF - REPLACING APPROXIMATELY 2500 SQ. FT. SHINGLES. 2013 CALIFORNIA BUILDING CODES.
Printed: Tuesday, 01 July, 2014 1 of 1 CRW'STEMS
Bin #
Qty of La . Qurnta
"Building &r Safety. Division
P.0 -Box 504, 78-495 Caile Tampico .
La Quinta, CA 92253 -.(760) 777.-7012
Bu►Idmg..Perm►t,Applicat►on and Tracking Sheet
Peri
Project Address:
`Owner's Name:+
A. P. Number:
Address: S gC) 4�VF • R R M If?, Z
Legal Description:
City, ST, Zip: LA (Do m NTfl CA - Cl a a.53
Contractor: Q, 2 J
Telephone: _I Q a ; 2
�� 2
Address:
Project.Description:ED(jl L
City, ST, Zip:
E E"ORE' E '
Telephone:
=:><";:.;;;:.,,:..:::,,,.:,: ,+r:,.��•::::+-:•
State Lic. # :
City Lic..#;
Arch., Engr., Designer:
Address:
City, ST, Zip.
J
Telephone:
:, r,.:;:;o-:::::.:�_. ter:-:>:o:::cr;:-:xa•:4'.:::`::
'
.,'Construction Type: Occupancy:
- Project type (circle one): New Add'n Alter Repair Demo
State Lic. #: ;: ,;.t,:::::.;::::• • .- .:.,...
Name of Contact Person:
Sq. Ft.: a, 500
# Stories: /
# Units:
Telephone # of Contact Person:
Estimated. Value of Project: 6� q6D . 00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Redd
TRACTMG
PERMIT FEES.
Plan Sets
Pian Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Prescriptive Certificate of Compliance: Residential Reroof CF -1 R-ALT-ReRoof
Project Addres Climate 7,gne . Perm'
�b metre .2�tifilz� . Cq- avitir>9 �� � qaa `S y`
HOOFING PRODUCTS (COOL ROOFS).§751(t)12
When the area of exterior roof surface to be replaced exceeds 50% of the existing roof area,. or 1,000 fe, whichever is less, the new
roofing area must meet the roofing product "Cool Roof" requirements of§152(b)1Hi,.152(b)1Hii, or 152(b)1Hiii.
Check applicable alternative or exception below if the roof alteration is enitipt from the roofing product "Cool Roof" requirements::
❑ Cool roofs not required in Climates Zones 1-12, 14, and 16 with'a low sloped roof pitch (less or 2:12 pitch).
❑ 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 5/Ib/ft2.
Alternatives to §152(b)1Hi and §152(b)Hii, Steep -slope roof (pitch•> 2:12)
❑ Insulation with a thermal resistance of at Ieast0.85 hr rft2• `F/Btu or at least a 3/4 inch air -space is added to the: roof deck over an attic; or
Existing ducts in the atticare insulated and sealed;accordirig: to §1;51;(f)10;'or
---- -
----------
❑ In climate zones 10, 12 and 13, with 1 ft2 of free ventilation area of attic ventilation for every 150 ft2 of attic floof 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(02; or
❑ 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)1Hiii, Low -slope roof (pitch <_ 2:12)
❑ Building has no ducts in the attic.
Other Exceptions
❑ Roofing area is covered by building integrated; photovoltaic panels and solar the panels are exempt from the Cool Roof criteria.
❑ Roof constructions that Have thermal mass over the roof membrane with atleas1'25 Ib/ft2 .'a're exempt from the Cool Roof criteria.
NOTE: If any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Emittance requirements for roofinn
pruuucis rn y i i afr/ are not appiicaole. Vo not fill table below.
Roof Slope Product Weight Product Aged Solar Thermal
CRRC Product ID Number s. 2:12 > 2:1.2 - < 5lb/ft2 >_ 51be Type2 Reflect ance3*4 Emittance SKIS
. fZ❑ ❑ ❑4
D. ❑ ❑ ❑ 1 C1
Note: if no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance,
1. The CRRC Product ID Number can be obtained fromthe Cool Roof Rating Councils Raled Product Directory at www.coolroofs.oro%roductsrsearch.nho
2. Indicate the type of product is being used for the roof top, i.e. single7ply 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-vse-ttre-egoationY0.2�p.7(p:,;,�, — 0 . o MUM a calculated value. ere p is the Initial Solar Reflectance.
4. Check box if the Aged Reflectance is a caAc6lated value using the equation above.
5. Calculate the SRI value by using the SRI- Worksheet at httoJ/www.enerov.ca.aov/title24/and enter the resulting value in the SRI Column above and attach
atopy 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
-ecommended by the coatings manufacturer and meet minimum performance requirements listed in §118(i)4. Select the applicable coating:
El Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other I
VOTE. When a Cool Roof is required, the installing contractor shall complete and submit the CF -6R -ENV -01 for final inspection.
Declaration Statement
• I certify under penalty of perjury, under the laws of the State of Califomia, the information provided on this form is accurate and complete.
• I certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24, Paris
1 and 5.of,the California Code.otleoulations- ;-,/l
Signature: .::._.
Company
Address: License:
y/State/Zip: Phone:
or assistance or questions regarding. the Energy Standards, contact the Energy Hotline at:. 1-600-772-3300.
..............
BUILDING & S.AFETY DEPARTMENT
q �78-495 CALLS TAMPlco (T60) 777-701,2 .
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-70T'I
RTY-0" 'S PACKAGE.
=Disclosures &-Folrms for Omer=Builders A :1—` for` Construction Perufs- - --
VLIW01M- 4-N- V'NOTICE 19-B, MERTY OWNER
Dear Property Owner
An application . for a ;bbuddw '.t has ltod is .}ro ting •yoluxelf:as the builder of-:,ihc :pleperty
improvementsspecified: at
We are,providing=you with-an.Owner-Builder A— wadgmnt ainonYeria.' rm omkyu;awaa off your
responsibilities;and possible risk,you ruay;ineur tb • bm this tissued in,yqur name ss. V
y l
Owner-Builder. We w<il not Issue,a btWding amitauntil�Yoti l�ave.res , iriit'ta d your.•understalndin&of each provision;
signed, and returned this form to us at our oftieial. address indicated. An. agent of the: owner. cannot exeeute. this :notice
unless you, the property owner, obtain the prior approval of the permitting authority.
OMMRx s ACM Af VER C x ort of n o tc�rl
DfREG77DNS Reait''ai,cl
40 6,al,ecich statcnietit Getijw to sigrsrfyyou understand.m ti'errfy`: rs urfozmaiion.
:I I uAdcrgtarrd :a 'G •
equent practice of unlicensed persons is to Have tits. property owner obtain an "owner-4tulde�'
building perriut tliat:cmonoousky_implies that'the property owaer is_pCo�nding Us .or. her owtt laUof attd. tnaterral personally
an O vncr Builder, may `bcltcld:liable and subject to serious fininciif' isk for auy itijirries:sustaincd:uy an unitccnsod ped'
and his or her employees m4 lc working on my property. My-.homeowner's insurance may not provide coverage. for those
injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance•coveragc forinjuries to workers
on my prey.
�2. I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this .responsibility.
3. I understand as an "Owner=Butldet" I aintkie responsible party of record on tle.permiL I tinderstand that I may protect
myself Gom potential financial risk by hiring a licensed Contiactor and having the pemut filed in his of her`name instead, of my
own.
t 4. 1 understand Contractors are required by law to be licensed and bonded in California and to List their license numbers on
permits and contracts.
'16 5. 1 understand if I employ or otherwise engage any persons;-other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employee'
under state and federal law.
----- - — — --- ----= .. ----.
�6. I understand if I am_considered_an"emaleral'_law _I_ ust_re ter_wiih the stale_and_fedeial _
government, withhold payroll taxes provide workers'; compensation disability insurance, -and "coatn"bute, to unemployinent
compensation for each "employee-" I also understaind my failure ,to abide by these laws may.subjecf me to scrious financial
risk.
i
7. I understand under California Contractors' State License Law, an Owner-Builder who builds -single-family residential
structures 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.
i. understand as :an O.%vnet=Builder if I sell the property for which this permit is issued, I may be held liable, for any
financial br pcisonal .itiur`ics stystaiixcd: by any subsequent ownerhat s) tresult from any latent construction defects in the
girl,�riaiiship'cir"tnatcrials.
9. I understand I may obtain more information iegarding- my .obl'iptions as iiia "emj5loyc�" tr9cu'tl�C lintcrual Rc rcnuc
Service, the United States Small Business Admiai. t"don, thc:Califoniia Dcp4r n dnl of Bcneftt Paymcnts,.and tlic Caltforoaa
Division of Industrial Accidents. 1 also understand 1.may:contact:tlie Califorriia:Conttactois, State: tccnsc'I3oarii (CSLt j at l-
800-321-CSLB (2752) or www.esib.ca.gov for more information about licensed contractors.
10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party legally and financially responsible ,for proposed _ construction activity at the following address:
11. I agree -that; as the -party legally and futaucially responsible for-this-proposcd coastruction.activity,_I will abide.by all
applicable laws_and.requirements.that.govern OwnerBuilderi as well.as cmployera..__.________
12.1 agree to notify the issuer of this form immediately of any additions; deletions, or ch91W to any of the wfvematioil I
have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a license; the Gonttaetors' State Lioense Board may be unable to assistyou ou with any finaineial loss
You may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in•civil coria. It is also
important for you tounderstand that.if an udliceused Contractor or employr e'of that individual or firm is injured while woddng
on your pro
Ply; you a:pc:nit.;w1Ownpr-DWldar *stt`:ta: hum Contractors,
you will be .rt sppnsrble for vet fyiiis whctTnar ar not: tltosa Contiaclors arc groperlX .(accused tend the; Sus' of their wotkes'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issues: ti!►c.: trm#. Nota: A copy of tkepropaty owner's dsiver'r. " • f + or
other verification acceptable to the agency is riqu.# to be presented when the permit is isswd to verif!' the Pr'P7'
owner's signature.
Signature of property own C 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.
Excluding the Notice to Property Owner, the execution of which I understand.is my personal responsibility, I hereby authorize
the following persons) to act as my agents) 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
- [-declare-under-penalty-of perjury Qsat-1-am the property owncr-for-thc address -listed -above -and -I -personally -filled -out -the -above----
'intorma on and ce ify rts accuracy. ore: copy o [ e owners rivers icense. ora no arz r 1'erifttuitron
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:
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
per-
F.A.U.
Framing
%
Compressor
Insulation
g. • O.0
57
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
_517
Final
Z�
S7
Final
POOLS - SPAS
BLOC AL A PROVALS
Steel
Set Backs
—m0
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping-
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
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Appliances
Final
COMMENTS:
Final
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Utility Notice (Gas)
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ELECTRICAL
APPROVALS
Temp. Power Pole
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Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)