12-1056 (RR)F � V
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: �--T12-00001056
Property Address: 48801 SAN PEDRO ST
APN: 646-140-017- -
Application description: RE -ROOF
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation' 15000
c&ht 4 4 Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bus' ss and Prof onals Code, and my License is in full force and effect.
License Class: C39 enseNo.: 922766
/ate:_—1T/ontractor:
WNER-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).:
1 _ 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 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.).
I _ 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: PIP
LQPERMIT
Owner:
BRUCE AKINS
48801 SAN PEDRO STREET
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/17/12
Contractor:
D Q
URETHANE FOAM SPECIALIST I
72875 SONOMA DRIVE I� 101
PALM DESERT, CA 92260
(760)346-0667
Lic. No.: 922766 CFINA)ULAQUINTA
CE DE4T.
------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 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 STATE FUND Policy Number 0002012-2011
_ I certify that, in the performance of the ork for which this permit is issued, I shall not employ any
person in any manner o as to beco a subject to the workers' compensation laws of California,
and agree that, if I s o d become ub ct to the workers' compensation provisions of Section
//%} 3700 of the Lab shall forth it comply .those provisions.
/ate:'1 A pplicant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIOW150VERAGE 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 tha a 4informis correct. I agree to comply with all
city and county ordinances and state laws relatin u dind hereb uEkeciz�representatives
ofthist/.coo�,unttyyto /enter upon the above -mention pose � [ l / v Signature (Applicant or Age
Application Number
. . . . . 12-00001056
Permit . .
. RE -ROOF
Additional desc .
Permit Fee . . .
. 30.00 Plan Check
Fee
.00
Issue Date . . .
. Valuation
. . .
. 0
Expiration Date .
., 3/16/13
Qty Unit Charge
Per
Extension
BASE FEE
30.00
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Special Notes and
Comments
RE -ROOF WITH FOAM
& COATING SYSTEM. 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 .00
.00
1.00
Grand Total
31.00 .00
.00
31.00
LQPERMIT
Permit # , n 49
Jt' Project Address:
A. P. Number:
Legal Description:
Contractor: V 4,G-Im'
&
Address: `76 �/7�- S v,.
Ciq•, ST, Zip: ��
Telephone:
�( State Lic. #: �.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:? C
Telephone # of Contact Person - 7
# Submittal Req'd
Plan Sets
Structural Calcs.
Truss Calcs.
Title 24 Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
ILO.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City Of La Quinta
Building 8i Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit APPlication and Tracking Sheet
N Aearig wner's Name: (
Address:
, ST, Zip:
-Z--7 S-3
-(�-> t eiephone: -
Project Description:
City Lic. #:
Total Permit Fees
Construction Type:
Occupancy:
Project ro�ect type (circle one): Ne%v Add'n Alter Repair Demo
Sq. Ft.:
H#S
ories:
# Units:
`1 CXO Estimated Value of Project:
r
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd
TRACKING
PERMIT FEES
Plan Check submitted
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mech2niCal
Review, ready for correctionstissue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.I.
Plans resubmitted
Grading
'N Review, ready for corrections/issue
Developer Impact Fee
Called Contact Person
A.I.P. P.
Date of permit issue
Total Permit Fees
Prescrf tive Certlflaate of Compliance. Residential Reroof
Project Address: ee,. tt
CF -1 R -ALT ReRoof .
Comate Zone Permit d
ROOFING PRODUCTS (COOL ROOFS) §151(1)12
wren me area o1 extmfor root surface to be replaced exceeds 5095 of the exlstlng roof ares, or 1,000. If. whichever Is less, the new
roofing arae must meet the rooting product "Coal Root" requi ements of §152(b)1HI, 152(b)1Hp. or 152(b)1HIU.
or exception below if the roof
❑ Cool roofs no required in Climates Zones 1-12,14, and 18 with a low sloped roof pitch (lessor 2:12 pitch).
❑ Cod roofs DA required In Climates Zones 1-9, and 16 with a steep -sloped rocs (greater pitch than 2:12) and product weight less than 5/11W.
Alternatives to §1520b)1H1 and §152(b)HiI, Steep -slope root (pitch>2.12)
❑ Insulation with a thermal resistance of at least 0.85 hr•ftz °FBtu or at feast 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 ft2 of free ventilation area of attic ventilation for every -150 f12 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 !ranter 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, R3 or greater roof deck Insulation above vented attic.
Exception to 9752(b)l Hill, Low -slope root ( pitch 5 2.12)
❑ Building has no ducts in the. aft.
Other Exceptions
13. Roofing area is covered by building Integrated; photovoltaic panels and solar thermal panels are exempt from the Cool Roof criteria
❑ Root constructions that have thermalmass over the roof membrane with at least 25 IhM are exempt from the Cool Roof criteria
IDTF,s If any one of the alfemabves or exception rs checked the Aged Solar Refiectarrce and Themral Em/ttartce requImments for roofing
roducts in 9118(1) are not applicable. Do not fill We below.
Roof Slope
oduct ID Number' S 2.12 > 2:12
D
❑ D
Weigh I Product 1. Aged Solar . I Thermal
SRI 6 -
Note,-
Note, If no CRRC-1 label is available, this compliance method cannot be used, use the Perfomrance Approach to show compliance,
The CRRC Product ID Number can be obtained from the Cool Roof Rating Cormdrs Rated Product Directory at www.000lroofsorrz�rodcArys^�a�-!
Indicate the type of prodiict is being used for the roof top, Le. singlepty root, asphalt roof, metal roof, eta
if the Aged Reflectance Is not avaflable in die Cool Roof Rating C&MG1115 Rated Product Dleciory then use &a Initial Reflectance value hom the same
directory and use the equation (0.2+0.7(p;,. - 0.2) to obtain a calculated aged value. Where p is the initial Solar Reflectancaa
Check box if the Aged Reflectance Is a caWated value using tfre equation above.
Calculate the SRI valurksheet to die CF1 R e by using the SRI- Waftheet at h
acopy of the SRI- Wotto //4vww enerov ra.riov wand crier Me resulting value in the SRl Column above and attach
apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or covers
commended by the coatings manufacturer and meet minimum performance requirements listed in §1180)4. Select the applicable coating:
I Aluminum -Pigmented Asphalt Roof Coating D Cement -Based Roof'Coating D Other
2M When a Cool Roof is required, the Installing contractor shall complete and submit the CF6R-ENV-0i for final Inspection.
)eclaration Statement
• I certify under penalty of perjury, under the laws of the State of CaUtomia, the information provided on this form is accurate and complete.
• I certfiy that the energy features and performance specifications Identified on this rti icate of pllance conform to the requirements of Tide 24, Parts
1 and 8 of the Callomia Code of Reculations. i Cor�
I ' - lI ZVNUe, atie-'1�. C.� -- v Date: -
Address- --*AL AL - - . --
City/State/Zip:
For assistance or
/A
mgardinrg the Energy Standards, contact the Energy Hotline at: 1-600-772 MOO