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10-0706 (RR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T-4bt °F aCwQ" Application Number: 10-00000706 Property Address: 46615 CAMEO PALMS DR APN: 643-181-006-43 -2117 - Application description: RE -ROOF Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 7000 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 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).: 11, 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 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: / 1�'0 Q Owner: CONSTRUCTION LENDING AGENC 1 hereby affirm under penalty of perjury that there is a construction lending agency for th performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: VOSSLER ERNIE 46615 CAMEO PALMS LA QUINTA, CA 92253 ( L Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/30/10 2010 >mr Off. A (QUINTA 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 f California, and agree that, if I should become subject to the workers' comp nsation provisis/o/fSection 3700 of the Labor Code, I shall forthwith m ly with t s ovisions. �� Date: - Applicant: WAR G:/IILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLA FUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,0001. 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 t ' i onstru on, and hereb r thorize repres� ves of this co -ty to nter upon the above-mentioned proper f insDe purpos ��`� Date:. Signature (Applicant or Agent): v Application Number . . . . . 10-00000706 Permit . . . RE -ROOF INV FEE Additional desc . Permit Fee . . . . 60.00 Plan Check Fee .00 Issue Date . . . Valuation . . . . 0 Expiration Date . . 1/26/11 Qty Unit Charge Per Extension BASE FEE 60.00 ---------------------------------------------------------------------------- Special Notes and Comments RE -ROOF 2007 CODES INVESTIGATION FEE ASSESSED PER 1997 UNIFORM ADMINISTRATIVE CODE §304.5 FOR WORK BEGUN WITHOUT BUILDING PERMIT. PERMIT APPROVED PER S.T. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due ----------------- Permit Fee Total ---------- --- - ------ ---------- ---------- 60.00 .00 .00 60.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 61.00 .00 .00 61.00 LQPERMIT i # R Qty of La Quinta Building 8T Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet " Project Address-' WMom�q Owner's Name: A. P. Number: � � - � �3 Address: 2 2-/6 &_ L Legal Description: City, ST, Zip: G} a a Jr� r _ Contractor: _ Tele phone ; �.� © Address: 22- Project Description: City, ST, Zip: TelephoneM. State Lic. # : City Lic. #: Arch., Engr., Designer: Address: — — -City: �i,—ZiP• Telephone: `\ ::y,' Construction Type: Occupancy: SIA) 64E, Project type circle one): New Add'n Alt a air Demo State Lic. #: Name of Contact Person: ; Sq. Ft.: # Stories: # Units: Telephone R of Contact Person: Estimated 'value of Project . APPLICANT: DO NOTWRITE BELOW THIS LINE fJ Submittal Req'd Recd TRACKING PERMIT FEES Pian 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 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: ''' 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 ! i ' I ! Total Permit Fees I P.O. Box 1504 LA QUINTA; CALIFORNIA -92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY O VNER5 S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits MWaRT'ANT! NOTICE TO PROPE) W QWNER Dear Property Owner. Ari. application for a building permit has been submitted in your name listing yourself as the builder of the .property improvements specified at We are.providing you with an Owner -Builder Acknowledgment -and- Information 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_notissue_a_building-permit-=&-yowhovve--read; initialed--your-undmtandi Wat-each-pro ision, 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. OFD'S ACR! WLEDGIC!IENP ANDYERIEICATIOFt 41 I1 O�iTII.OPI DIRECTIONS. Read and initial each statement beloiv to signify you understand or'veri this information. 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder' building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious. financial risk for any injuries sustained by an unlicensed person and his or her employees while 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 coverage for injuries to workers 'on my property. 1jl ✓ 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.. 1/_3. I understand as. an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect ' " myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own: 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. -Ai-5. I 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 "employer" under state and federal law. Z6. I .understand. if I am considered an "employee' under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. /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. .,'S'o � �8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal. igj.uries sustained by any subsequent owner(s) that result from any latent construction defects in the wo anship or materials. 9. I understand I may obtain more information regarding my obligations as an "employer" from the Interact Re*enue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CS -LB) at 1- 800-321-CSLB (2752) or www.csib.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 Zarty legally and financially responsible for proposed construction activity at the following address: 11. I agree that, as the party legally and fmaucially responsible for this proposed construction activity, .1 will abide by all able laws and requirements that govern Owner -Builders as well as employers. 4/ 12.1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information 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 Contractors' State License Board may be unable to assist you with any finaaeial. 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 CorttraCtors, ou will be .whether nutotAose_Contractor&,ve_pmpertyAicensecLand-the-staltic 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 dte..ptermit. Note: A copy of the propertyowner's dirivea Is!'iccertset form nota Zatiun; or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Signature of property owner Date: 7 e 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. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction ProjecE_(or Description of Work).:_ _. Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjurythat t am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required'to fie presented when the permit is issued to verify the property owner's signature.. Property Owner's Signature: Date: INSULATION CERTIFICATE Thiglis to certify that insulation has been installed in conformance with the current energy regi#atlon, California Administrative Code, Title 24, State of Califorriia, in the building located at: 46-615 Cameo Palms CEILINGS: TYPE BLOW MANUFACTURER: OWENS CORNING Thickness: R-22 t WALLS: TYPE) N/A MANUFACTURER: GENIdRAL CONTRACTOR: Marlene Vossler s BY: TITLE: MASgO CONTRACTOR SERVICES OF CALIFORNIA, INC, c CO3 Ed Thickness: LICENSE # LICENSE # 221517 8 TITLE: ACCOUNT REPRESENTATIVE DATE: 07/15/2010 6 f L l f i i f f 4 1 Z0/Z0 39Vd QIWHOS N09VdVd 5TOU-P609L Bb:TT 0TOZ/bT/L0 ,Pres ri tive Certificate of Compliance: Residential Reroof 117 CFA R-ALT-ReRoof Project Address: P Climate Zone Permit # ROOFING PRODUCTS (COOL ROOFS) §151(1)12 When the area of exterior roof surface to be replaced exceeds 50% of the existing roof area, or 1,000 ff, , 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)1Hiff. Check applicable alternative or exception below if the roof alteration is exempt 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 (lessor 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 511b/ft2. Alternatives to §152(b)l Hi and §152(b)Hii, Steep -slope roof (pitch > 2:12) ❑ Insulation with a thermal resistance of at least 0.85 hrrfe.*FBtu 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 §15i(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 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(f)2; 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)l Hili, Low -slope roof ( pitch 5 2:12) ❑ Building has no ducts in the attic. Other Exceptions ❑ Roofing area is covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the Cool Roof criteria. ❑ Roof constructions that have thermal mass over the roof membrane with at least 25 INV are exempt from the Cool Roof criteria. NOTE: If anv one of the alternatives or exception is checked the Aaed Solar Reflertanre and Thermal Fmittance reauirements for roofina products in §118(1) are not applicable. Do not fill table below. NOTE: When a Cool Roof is required, the installing contractor shall complete and submit the CF -6R -ENV -01 for final inspection. Declaration Statement Roof Slope Product Weight Product Aged Solar Thermal City/State/Zip: Phone: CRRC Product ID Number s 2:12 > 2:12 < 51bM2 a 51btft2 Type 2 Reflectance3.4 Emittance SRI �3< ❑ ❑ ❑° ❑ ❑ ❑ ❑ ❑4 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 from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs.omlproducts/search.pho 2. Indicate the type of product is being used for the roof top, i.e. single -ply roof, asphalt roof, metal roof, etc. 3. 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(pj jw — 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 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 http:!/www.enemy.ca.aov,4#le241 and enter the resulting value in the SRI Column above and attach acopy 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 coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in §118(1)4. Select the applicable coating: 51"Aluminum-Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other NOTE: 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 California, the information provided on this form is accurate and complete. • 1 certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Reg ulations. Name: Signature: Company: Date: F :ss: License: City/State/Zip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 9-800-772-3300.