11-0119 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
011-0000011.9—..:a
Property Address:
" 78480. CALLE REMO
APN:
646-182-004-. - -
Application description:
RE -ROOF
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2667
Applicant: Architect or Engineer:
A&
---------- 7 -------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Class: C39 i if
L�iyceenseQpp1/e�: 4471
CD ate;/// i Contractor: ►J
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 jChapter 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.).
(_ 1 1, 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. , 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:
LQPERMIT
Owner:
HOWARD BILL
78480 CALLE REMO
LA QUINTA, CA 92253
(760)275-6698
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/02/11
Contractor:
DESERT VALLEY CONSTR & R G PiEJ
594 W. 7TH. STREET
SAN JACINTO, CA 92583
(951)654-1980
Lic.. No.: 447139 FtPiPyfF
p.. -
-----------------------------------------------
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 PREF CONTR INS Policy Number 414261
_ 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
3%7�00 of the Lab9Co , I shall forthw' h om ly with C provisions.
Date:
yG=F`.APPlicanr.
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 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 th t the bove information is correct. 1 agree to comply with all
city and county ordinances and state laws relating . buil g construction, and hereby uthorize representatives
of this county to enter upon the above-mentioned ope for inspe osesL%`^~a
r
Date. l/. Signature (Applicant or Agen .
Application Number
11-00000119
Permit
RE -ROOF.
Additional desc .
Permit Fee . . .
. 30.00
Plan Check Fee
.00
Issue Date
Valuation . . .".
0
Expiration Date
8/01/11
Qty Unit Charge
Per
Extension
BASE FEE
30.00
Special Notes and
Comments
REMOVE AND REPLACE'ROOF
2007.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
.00 .00
1.00
Grand Total
.31.00
00 .00
31.00
LQPERMIT
Prescriptive Certificate,of Com Ilance: Residential Reroof
Project Address: CF -1 R=ALT-ReRoof
Climate Zone Penna alt
ROOFING PRODUCTS (COOL ROOFS) §151012 l
Ittt'hen the area of exterior roof surface to be replaced exceeds 50% of the exWng roof area, or 1,000 fe, whichever is less, the new
roofing area must meet the roofing product "Cool Roof" requirements of §152(b)1H1, 152(b)1Hli, or 152(b)1Hp1.
Check applicable altemative or exception below If the roof alteration is exempt from the roofing product 'Cod Roof•
requirements:,
❑ Cool roofs not required in Climates Zones 1-12, 14, and 16 with a low stoped roof pitch (less or 2:12 pitch).
❑ Coot roofs Qg required in CCmates Zones 1-9, and 16 with a steep -sloped roofs (greater pitch than 2:12) and product weight less than SAW.
Alternatives to §152(b)iHi and §152(b)Mi. Steep•clope roof (pitch > 2:12)
❑ Insulation with a thermal resistonoe of at least 0.85 hr•fe..F/Btu or at least a 3/4 inch air -space is added to the roof deck over an attic; or
❑ Existing ducts m the attic are 'W"ed and sealed according to §151m1a, or
O In climate zones 10, 12 and 13, with 1 ft2 of free ventilation area of attic ventilation for every 150 >t2 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
O Building has at least R-30 ceiling insulation; or
❑ Building has radiant barrier in the attic meeting the roqkofnents of § 151(1)2; or
RP"'Building has no duds in the attic; or
O In climate zones 10, 11, 13 and 14,.R-3 or greeter roof deck insulation above vented attic.
Exception to §1'S2(b)1Hill, Low -elope roof (pith S 2:12)
O Building has no duds in the attic
Ottwr Exceptions
❑ Roofing area is covered by building integrated; phobvokoic Par and soli thermal panels are exempt from the Cool Roof criteria.
O Roof oor>strtction>s the have thermal mass over the roof membrane with at least 25 b/R2 are
Han one oI the exempt horn the Cod Roof criteria.
NOTE: Y aframadves or exception iss checked the Aged Solar ReSoctanoe and Thermal Emittance
products in § 118(1) are not applicable. Do not AM table below. reglNrements for roofing
I
Ct2RC Product ID NumRoof Slope
Number'' s 2:12 > 2:
=KM;
MER
Note: H no CRRC-1 label is available
Product Weight
< We 2 51130f
Product
TyW
Aged Solar
RetlectanoWA
Thermal
Emittanoe SRI
ME3
13
❑4
this oomplianoe method car>.lot be used, -use the Performance Approach to show cmr pliance,
r. The CRRC Product ro rvu nber can be obtakted iron the Cool Rod Ratiinpc«.0 rs Rated Pirodtad Directory at
"M WQftQ&QM&MQ1&h11N�.1W1Q
t rndieate the type of p odW is bo*V used for are rod tap. 1le-ply .9. singtoo+ asphalt root, Metal roof, etc.
H the Aped Relfedwm is not availaW in the Cod Rod �1g Cotxols Rated Prouct dDirectory then use the Musial ReAedartoe value tom the same
dCtpec* box if Ow irectory and the
squaoon (0. 2+0 - 0.2) to obtain a calctidad ped valueWere is the ktttia! Scar Reflectance.
Reflectance is a cebt�tsted value . p uaitp the ern above.
C Catdate the SRI vaftue by using ate SRI- KtdMbeet at
soapy of ate SRI- Worksheet to the CF -!R and enter the resting value in the SRI Column above and attach
o apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or covers
eoommendedbythe
coatings manufacturer and meet minimum p re4ukerneft listed in 118 l Select the
§ CN• applicable coating:
Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other
EM When a Cod Roof is required, the fn ?g contractor shall
complete and submit the CF -6R -ENV -01 for sinal inspection.
Declaration Statement
• I certify under Penalty of PerlwY, under the taws of the State of CaNtomia, tAe inforrnatbn
• I certify that the energy features and performance provided on this form is accurate and oompiete.
I and S of A; Catlomia Coded tions identified on this CertWsmta o Compliance conform to the requirements of TRb 24, Part
--�-� Reotdations. � /
Name / / /A _-e
6e 71 License: Y V71 3
City/StatelZip:
Phone: ?V_ - K5 YSS`
For assistance or stlons �regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Birt #
City of LQ Quinta
Building & Safety Division LQ
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet.
Permir#
0�
Project Address:Owner's
Name:
A. P. Number:
Address: 7YWO
Legal Description:
City, ST, Zip:
Contractor:
;• fi<:z` ::<:r rt>?% <;?'moi^<;<t e
telephone:
4y Y:4i ji:41.^'•5}ii�:4:i}.i.'!J%:':'li
Address:
Project Description:
City, ST, Zip: CtM
Telephone:
State Lic. # :
City Lic. #•:
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
vi:.;K:{•:I+ian;:i(ri`v:.;
:w;:4c;; ;: > ` 4 :;:•,•:< ,_; ?::
v K.,
-
Construction Type. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #:?
Name of Contact Person:
Sq. Ft.: GQQ
• # Stories:
J # Units:
-
Telephone # of Contact Person: I 3 - Lf %
Estimated Value of Project: '-0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
'Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain pian
Plans resubmitted
Mechanical
Grading plan
21" 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:
''d 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
4::