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BRER2015-0046Applicant: Contractor: MARCOS PERALES ' OWNER/BUILDER 52115 AVENIDA BERMUDAS 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.). (_ 11, 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.). U I am exempt under Sec. . B.&P.C. for thi relson i Date: Ali � Owner: CONSTRUCTI/LENDNG NCYI hereby affirm under penalty of perjurye is a cons ion lending agency for the performance of the work for which is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: 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 ($100,000).IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this. application and state that the above inform 'on is correct. I agree to comply with all city and county ordinances and state laws rel i g to building construction, and hereby authorize representatives of this city to enterYon on the above• mentionedrfor inspection purposes. - tlDate: ['$y r.? Signature (Applicant or Agent): � 4 VOICE (760) 777-7125 78-495 CALLE TAMPICO 78-495 CALLE TAMPICO D FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEP TMENT INSPECTIONS (760) 777-7153 MIT DDate: 6/3/2015 Application Number: BRER2015-0046Owner: JUN 201 Property Address: 521.15 AVENIDA BERMUDAS MARCOS PERALES APN: 773235016 QUINTA .52115 AVENIDA BERMUDAS Application Description: PERALES RESIDENCE REROOF SHINGL S 101110E DryA MEM LA QUINTA, CA 92253 Property Zoning: OOMMUNMDEVELOP Application Valuation: $3,000.00 Applicant: Contractor: MARCOS PERALES ' OWNER/BUILDER 52115 AVENIDA BERMUDAS 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.). (_ 11, 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.). U I am exempt under Sec. . B.&P.C. for thi relson i Date: Ali � Owner: CONSTRUCTI/LENDNG NCYI hereby affirm under penalty of perjurye is a cons ion lending agency for the performance of the work for which is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: 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 ($100,000).IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this. application and state that the above inform 'on is correct. I agree to comply with all city and county ordinances and state laws rel i g to building construction, and hereby authorize representatives of this city to enterYon on the above• mentionedrfor inspection purposes. - tlDate: ['$y r.? Signature (Applicant or Agent): DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY AMOUNT PAID PAID DATE' BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 6/3/15 PAID BY METHOD.:RECEIPT .#. CHECK # CLTD BY MARCOS PERALES DEBIT R6720 MFA Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00 DESCRIPTION. ACCOUNT:;' QTY AMOUNT PAID PAID DATE RE -ROOF - FIRST 2,000 SF 101-0000-42404 0 $49.31 $49.31 6/3/15 'PAID BY METHOD ' RECEIPT #, CHECK # CLTD BY MARCOS PERALES DEBIT R6720 MFA DESCRIPTION ACCOUNT. _ . QTY AMOLINrT PAID . PAID DATE RE -ROOF - FIRST 2,000 SF PC 101-0000-42600 0 $98.62 $98.62 6/3/15 PAID BY METHOD RECEI PIT # CHECK # CLTD BY MARCOS PERALES DEBIT R6720 MFA Total Paid forRE-ROOF: TOTALS: $147.93 $147.93 Description: PERALES RESIDENCE REROOF SHINGLES CONDITIONS NAME TYPE Type: RE -ROOF Subtype: Status: ISSUED Applied: 6/3/2015 MFA Approved: 6/3/2015 MFA Parcel No: 773235016 Site Address: 52115 AVENIDA BERMUDAS LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 92 Lot: 5 Issued: 6/3/2015 MFA UNIT it APPLICANT MARCOS PERALES Lot Scl Ft: 0 Building 5q Ft: 0 Zoning: Finaled: Valuation: $3,000.00 Occupancy Type: Construction Type: Expired: 11/30/2015 MFA No. Buildings: 0 No. Stories: 0 No. Unites: 0 OWNER/BUILDER Details: TEAR OFF AND REROOF WITH SHINGLES 2013 CALIFORNIA ENERGY CODE. p Applied to Approved Approved to Issued CHRONOLOGY CONDITIONS NAME TYPE NAME ADDRESSI CONTACTS CITY STATE ZIP PHONE FAX EMAIL APPLICANT MARCOS PERALES 52115 AVENIDA BERMUDAS LA QUINTA CA 92253 (760)574-3530 CONTRACTOR OWNER/BUILDER (760)574-3530 OWNER MARCOS PERALES 52115 AVENIDA BERMUDAS LA QUINTA CA 92253 (760)574-3530 FINANCIAL INFORMATION Printed: Wednesday, June 03, 2015 4:42:59 PM 1 of 2 r SYS7EMS PARENT PROJECTS BOND INFORMATION ATTACHMENTS Printed: Wednesday, June 03, 2015 4:42:59 PM 2 of 2 CR SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS'SB1473 FEE 101-0000-20306 0 $1.00 $1.00 6/3/15 R6720 DEBIT MARCOS PERALES MFA Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: RE -ROOF - FIRST 2,000 101-0000-42404 0 $49.31 $49.31 6/3/15 R6720 DEBIT MARCOS PERALES MFA SF RE -ROOF - FIRST 2,000 101-0000-42600 0 $98.62 $98.62 6/3/15 R6720 DEBIT MARCOS PERALES MFA SF PC Total Paid for RE -ROOF: $147.93 $147.93 TOTALS:4:$148.93 INSPECTIONS SEQID. INSPECTION TYPE. INSPECTOR 'SCHEDULED COMPLETED RESULT REMARKS' NOTES DATE DATE PRE -ROOF BLD FINAL*" BLD PARENT PROJECTS BOND INFORMATION ATTACHMENTS Printed: Wednesday, June 03, 2015 4:42:59 PM 2 of 2 CR SYSTEMS T CiF �p 4 . . a Wy�l 4 4V a4a P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT (760) 777-7012 FAX (760) 777-7011 Considering Becoming an Owner -Builder? Important information you need to know BEFORE pulling your permit! The term "Owner -Builder" can mean three different things: "Owner as Worker", "Owner as Contractor" or "Owner as Employer" Understand each has Benefits or Risk, and it is possible to combine them! Hiring a California Licensed Contractor means you do not personally perform any of the construction work, the permit is not taken out in your name, you are not personally responsible for the construction and you are not an Owner -Builder. Instead, you become a "Customer" and California law provides you the benefit of protection from poor workmanship, failure to finish the job and financial risk due to worker injury. Benefit/Risk: Highest Benefits and the Least amount of Risk Owner -as -Worker is a type of Owner -Builder where you personally perform the construction. work, the permit is taken out in your name and you are personally responsible for the construction management, knowledge, workmanship, and completion of the job. You benefit by not paying others to perform this work for you and your risk depends on your own ability to complete the job successfully. Benefit/Risk: Possible Benefit with Low Financial Risk Owner -as -Contractor is a type'of Owner -Builder where you personally act as your own General Contractor, the permit is taken out in your name and you hire California lioensed sub -contractors to perform portions of the construction work. WARNING: The benefit of protection provided by law when you hire only California licensed sub -contractors can turn to serious financial risk if you hire unlicensed contractors to perform any of the work. Benefit/Risk: Possible Benefit and Significant Financial Risk Owner -as -Employer is a type of.Owner-Builder where you pay any unlicensed individual to perform any construction work valued at more than $500.00, the permit. is taken out in your name and you are personally responsible for their employment requirements, supervision, performance, safety and welfare while on your property. WARNING: Cost savings benefit can turn'to serious financial risk if you fail to deduct payroll taxes or provide workers compensation insurance for each worker. Benefit/Risk: Possible. Benefit with Significant Financial Risk (Health and Safety. Code Section 19827) The California Legislature declares an "urgent and statewide public . interest in assuring" that contractors comply with Contractors' License Law, Business and Professions Code and Workers' Compensation Insurance requirements to ensure property owners are informed about, and protected from the following when improving their property as Owner -Builders: Fraudulent representations - Liability for worker's injuries - Liability for material and labor costs unpaid by contractors • Licensing requirements - Employers tax liabilities Over 20,000 consumer. complaints are filed each year. Many complaints relate to owner/builder projects and include workmanship and workers' compensation issues Homeowners suffer financial harm due to defective workmanship and injured employees. Following are alarming examples of what has occurred with Owner -Builder permits: Example 1: Homeowner received insurance money to rebuild burned -down home. • Owner/Builder permit pulled to rebuild structure. ■ Unlicensed contractor built substandard structure — must be torn down and replaced. • Estimated financial injury is $225,000. ■ Additional financial injury - IRS threatened to tax insurance payout if house not completed by the end of the year. Example. 2: Brother-in-law had active license but filed an exemption from Workers Comp. ■ Owner -Builder hires brother-in-law to install a new roof. • Employee falls and sustains multiple spinal and extremity fractures as well as a head injury and remains in a coma to this day. ■ The Owner -Builder, who has sold the home, is now a defendant in a lawsuit for reimbursement for benefits paid to the injured worker. Example 3: Employee of contractor without Workers Comp is hired by Owner -Builder to install septic system and suffers injury that results in permanent disability. ■ The Owner -Builder did not have a homeowner's insurance policy on the house against which to submit a claim. ■ The Owner -Builder is now a defendant in a lawsuit for reimbursement for benefits paid to the injured worker. Did you know — unlicensed persons frequently have the property. owner obtain an "Owner -Builder" building permit which -erroneously implies that the property owner is providing his or her own labor and material personally? Did you know — your homeowner's insurance may not provide coverage for injuries sustained on your property by an unlicensed contractor and his/her employees? Did you know — if you are considered an "employer" under state and federal law, you must register with the state and federal government; withhold payroll taxes, provide workers compensation and disability insurance and contribute to unemployment compensation for each "employee"? Did you know — that if you fail to abide by these laws you may be subjected to serious financial risk? OWNERS BEWARE AND CONSIDER THE RISK BEFORE ACCEPTING FULL RESPONSIBILITY FOR YOUR CONSTRUCTION PERMIT Tw�p 4 4aUMrw P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-15.04 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760)777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in�� you�r� name listing yourself as the builder of the property improvements specified at �� i�5 AV �R�'�s I L45C (5A We are providing you with an Owner -Builder Acknowledgment and Informatiod 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. Read and initial each statement below to signify you understand or verify this information. 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" 4g permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as mer -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person his or her employees while working on my property. My homeowner's insurance may not provide coverage for those ies. 1 am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers I understand building permits are not required to be signed by property owners unless they are responsible for the ;tai pn and are not hiring a licensed Contractor to assume this responsibility. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect from 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 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value y construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" r state and federal law. 6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal rnment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment )enation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential gores cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed )ntractors and the number of structures does not exceed four within any calendar year, or all of the work is performed r contract with a licensed general building Contractor. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any X or�ersonal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the uLs v or materials. J understand I may obtain more information regarding my obligations as an "employer" from the. Internal Revenue the United States Small.Business Administration, the California Department of Benefit Payments, and the California n of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 1-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the legally and financially responsible for proposed construction activity at the following address: ��l15 �V� • '��2M1U1'� Lf� G� X12253 igrde that, as the party legally and financially responsible for this proposed construction activity, I will abide by all laws and requirements that govern Owner -Builders as well as employers. e12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I ave ovided 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 Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable 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 issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the per 't. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the age cy is required to be presented when the permit is issued to verify the property owner's signature. Signature of property owner Date: '' ! Note: The following Authorization Form is required to be completed by theproperty 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 and nd is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign as a 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 perjury that I am the property owner for the address listed above and I personally filled out the above information and ce its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the gency is required to be presented when the permit is issued to verify the property owner's signature. Property OAer's Signature: Date: STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS RRACO CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E Prescriptive Residential Alterations (Page 1 of 4) Proiect Name: Date Prepared: A. GENERAL INFORMATION Ol 02 01 Project Name: 02 Date Prepared: 03 Project Location: IGr2 lt aj SVA. $0 V— W.Vrvs 04 Building Front O ientation (deg or cardinal): 05 CA City: LA 64 ( WE^ 06 Number of Altefeil;Dwelling Units: 07 Zip Code: q 08 Fuel Type; 09 Climate Zone: 10 TotahCon``ditidned Floor;Area `(ft2):) ii 1 Building Type 1 1 SIab;Area`(ft2) 13 1 Project Scope: f I r.,NN v " B. BUILDING INSULATION DETAILS. (Section 150.2(b)1) Ol 02 03 04 05 06 , �� 07 I 08 X09 10 11 Tag/ID Assembly Type Frame' Type Frame Depth (inches) Apro kld 1,;1s # " Appendix JA4 Frame( Continuous Reference Spacing Cavity i Insulation � (inches) R -value R -value,{ j"U,factor Table, Cell Required Comments LI -Factor value Deck Insulation i N,4. Proposed Minimum Required \i Initial Solar Aged Solar Thermal SRI Reflectance Reflectance Emittance (Optional) Aged Solar Thermal SRI Reflectance Emittance (Optional) * !f` -\N 'O 17 Nk v C. ROOF REPLACEMENT (Prescriptive Alteration, Secti50.2(b)1H)l` 01 02 03 04 05h,, 06 tt).7j 08 09' 10 11 12 13 Method of Compliance Roof Pitch Exception VV CRRC Product ID tNxer tN\R #01gduct Type value Deck Insulation i N,4. Proposed Minimum Required \i Initial Solar Aged Solar Thermal SRI Reflectance Reflectance Emittance (Optional) Aged Solar Thermal SRI Reflectance Emittance (Optional) NOTES µ r • Roof area covered bey, buil"di g,integrated pnoto;ol aWpanels and solar thermal panels are exempt from the above Cool Roof requirements. • Liquid field applied.c�o�atings)must comply with�installation criteria from section 410.8(i)4. ` Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E Prescriptive Residential Alterations (Page 4 of 4) Proiect Name: • I Date Prepared: I DOCUMENTATION AUTHOR'S DECLARATION STATEMENT ,,.A& V. 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. " Documentation Author Name: Documentation Author Signat Company: Signature Date: Address: � � � �G epi \r 'n^ CEA/HERS Certification Idehtffic tttabfe�. City/State/Zip: Phone: 414.* RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: " 10 Compliance is >' 1. The information provided on this Certificate of true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsiblyfor the building'desl n or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, components, and manufactlredde5l.ee s,for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part1 and Part 6 of the C fornia Code of Reg cions. � , 4. The building design features or system design features identified on this teertificate of Compliance are consisten%tp rth tl a information provided.on other applicable compliance documents, worksheets, calculations, plans and specifications submitted ;to the en+fotcement agency,, pproval with tthiisrbuilding 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 th uilding, and made available to the enforcement agency for all applicable inspections. I understand that a registered c6pyhf this Certificates o Compliance is.r'e ul ecl'to be included wit the ocumentation the builder provides to the building owner at occupancy. '� Responsible Des' n Name`: r rL� Responsible Designer Company: Date Signed: Address: � � r � �� ^ A � � - License: � City/State/Zip: •• g7j7f 3 "'� (, j�' )G��—•�� C./ Y / Ph ppr`� � G_7 HCl �C/ w� 1 V w :x"k* For assistance or -questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300. Registration Number: . Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 Bin # City of La Quinta. Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Applicationsand Tracking Sheet Permit # ,Project Address: — Owner's Name: A. P. Number: Address: ',0�1f AVE Vw*U 1PhC Legal Description: • Contractor: 'City, ST, Zip: CA 12Z�J l .T ele h0 ne: 1 Address: - ProjectDescription:a f 0.9 00fr City, ST, Zip: h Telephone: one: State Lie. # : City Lie. #; Arch., Engr., Designer: Address: City, ST, Zip: Telephone: one: .......................................'.. ............... structo YP Occupancy: Con i n Type: Occu ane : State Lie. Demo Project (circle one): New Add'nAlter RepairairDem Name of Contact Person:N1pS �Sq. Ft.�(2, - # Stories: l #Units: Telephone # of Contact Persona —AVO . 4�f7, c 'Estimated Value of Project: _ 2 — APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. 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 S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" 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 • NOTICE: THIS IS NOT A BUILDING PERMIT — APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE DISTRICT —_ 711 r Permit No 284 199 9.74 CANARY --FILE, PINK—APPLICANT Owner Architect. __... _ .. .. Contractor_. 671 f��, *e -rte .. _. Address_:. _4!. rZo41- jM e 0e' Address. _..__ ..._ .. _ . _ ._ _ _.. _.._ Address 10i p r (�d,,fr /-77-73...._ .. _ City_ -3W .N/yL- -..._ ... City ._. _ ._ . - ....... _ City- /j�/{�/Q� �AG /F• - Phone--,,- .. .._._ ._._._. ... Phone.. _. _. _... Phone......3�� 1 (we) the undersigned, hereby certav and acknuwh:dge mar I Ise) have read the application and aprec that if Carl) and Gurler, and C9 W Z Paving, and/or Dedication of right of way .s required by the County of Rnerside, the Riverside County Department of Building and Safety 3 shall not make a Final Insl:nh.•n until said requirements have been met I •tin also aware that no work is to be done within the County R/W O wdhoul an CnCroachnicrif permit NOW, therefore. it .s .Meed that I (we) will not occupy said property and will not cause said property to be occupied until I (we) have c-mplied with all law% of the Couniv of Rnersrde and the Slate of California goveuung said property. DATE _,.rZ.-.�� -7.7' _ SIGNATURE OF OWNER AND/OR AGENT ._ . _.._ .. Approval by Signature from the Following Departments Listed Below Must Bo Obtained Prior to the Issuing of a Construction Permit. p� I SPACE NO. USE OF STRUCTURE JOB ADDRESS _S.•:-::Pq_ 7_/7/677/ 4_'0V1 12"f -. 40AINZE FAMILY DUPLEX (J LEGAL DESCRIPTION PROPERTY/ Z Fes- OF �ft J GL�i�' APARTMENTS I_ AGRIC. �'"6 7 73-- -V6! '' COMMERCIAL INDUSTRIAL rJ Q C W Q NO. COMMUNITY _ ALTERATIONS a OF SUBMIT ED PLANS .. USE OF PERMIT _:_ ,�_ � ��___•....__ — CASE NO.�`"? Cry t1 2 aZONE NO. OF PARKING SPACES REQUIRED NO. OF BUILDINGS NOW XISTING .SETBACKS: FRONT __...__.;Z_/...... SIDE_ REAR m GRADING PERMIT REQUIRED? YES '- NO v` LOT SIZE _ _. _.---Ei--- -7 SETBACK ORDINANCE ___.. __.. OF _ _... .. _.. FEET REQUIRED ON TREET DATE��__ . _ SIGNATURE. OF LAND USE OFFICIAL r t w DEDICATION REQUIRED: YES ,_, NO C NO. OF FEET CURB AND GUTTER REQUIRED: YES [; NOG i�" tg/ REET � jr'rf /``t -( ' .,! = I CAN CURB AND GUTTER FEA 9LY BE INSTALLED? YES [ NO C / I HAS AN ACCEPTABLE APP CA'�ION BEEN MADE FOR ENCROACHMENT PERMIT FOIL DRIVEWAY AND -STREET IMPROVEMENT? YES NO `; I �/PT DAT£ � ' SIGNATURE OF ROAD DE. OF ' = a W SWIMMING POOLS P _044 SEWAGE DISPOSA _ FOOD ESTABLISHMENT WATER POLLUTION __._ _—_ REMARKS �n FLOOD CONTROL—_____.__.—.r.__._—... _.---_ 1X AIR POLLUTION w Di',( OF HWY h I- 0 a ___. _ —.�� —r YOUR PROPERTY MAY BE SUBJECT TO 0 o ----•- --- FLOOD. RIVERSIDE COUNTY ASSUMES ---- ------ - --- - NO RESPONSIBILITY 1N EVENT OF FLOOD. 284 199 9.74 CANARY --FILE, PINK—APPLICANT