0105-239 (RR)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
_CFlapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
17' License # Lic. Class Exp. Date
770.940 039 IIS' .� _..,._ ... 1113012C
Date T:" � '� . Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
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 & policy no. are:
r`.arripr Policv NO.
+A47o7'�!""'YMV S YS' ii
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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 ibo a p"rovisjons. ...,
Date:.rt "'„ Applicant.=n.�,wM...
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 010&.239 TRACT
1'Sl2IrA Of $7 n3ft.
JOB SITE APN
ADDRESS
OWNER CONTRACTOR / DESIGNER / EN (NEER
a`.8D3di65i$L 1JL`-59
MEWYMN OAKS C'A 911413 INDIO CA 92201
(760)347-9869 (MIN 5 M
USE OF PERMIT
}7Z# ,ROOF id01.YL!RA'T'f'R.AW9
CLAOSA MATEIaCEii.» C3NLY
11E111CW
7,600,00 tat'
�y �y�,, /,, y+p ,y 7�'y g��q y{y��8a�+Ey���q�.11MIeA7110)'O,n(�Aa 0F: i+OJ.7��.K,yF.U4rdM�eR
RITIf )F FTZ 1.01.000-41.8.000 $50100
IMPORTANT Application is hereby made to the Director of Building and Safety'""-"
for a permit subject to the conditions and restrictions set forth on his
1
application.
1. Each person upon wr `:=llf 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 applicaton agrees to, & shall, indemnify
—
;5U)%T1Y1'.1.0C1
_
& hold harmless the City of La Quinta, its officers, agents and employees..
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.
M AY 2 1 201
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
CITY OF LA OUINTA
construction, and hereby authorize representatives of this City to enter upon
FINANCE DEPT
-
the above-mentioned property for inspection purposes.
"'h..^^°
Signature (Owner/Agent) S `` `"*'"�' "-^ Date'
RECEIPT. , .
A ;E / �. ..
BY
lura PLANT (. TEC K
INSPECTOR
_7e61 too
MOO
x+0.00
00.90
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
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
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
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
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)
COMMENTS:
EMERALD ROOFING INC.
PHONE: 760-347-9869
FAX: 760-347-9879
83-600 PEACH
INDIO, CA. 9220.1
LIC# 770940
SCOPE OF WORK
Furnish all labor, materials, equipment and services necessary for completion of all roofing and related work as specified in
this document.
STORAGE AND PROTECTION OF MATERIALS
Precautions shall be taken to keep roofing product clean, dry and free of damage.
PUBLIC SAFETY
Materials and equipment must be installed in such a manner as to preclude any danger, disturbance or interference with
normal business operations or to constitute a fire hazard.
State, Local and Federal Fire and Safety Regulations shall be complied with fully in the performance of the required work.
SPECIAL INSTRUCTIONS
1. Grounds to be kept neat, clean washed down daily.
2. All debris hauled away from jobsite daily.
3. All areas under construction to be marked off with safety cones and construction tape.
4. Hours of Operation: 7:00 a.m. to 4:00 p.m., five (5) days a week.
5. Job staffed with a diligent crew of journeymen roofers.
6. All debris to be handled in trash chutes to dumpsters below.
7. Obtain all necessary permits and inspections to be in accordance with the City.
8. Emerald Roofing to provide liability and Workmen's Compensation Insurance.
APPLICATION OF POLYURETHANE FOAM AND COATING
1. (REMOVE ALL EXISTING ROOFING TO PLYWOOD SUBSTRATE)
2. All surfaces shall be primed with FECoat primer at the rate of not less than %i gallon per 100 square feet prior to foam
application.
3. Urethane foam shall be sprayed -applied to a nominal thickness of 1" (plus or minus t/4 inch). Additional foam will be
applied in ponding areas to help disperse the standing water. The additional foam will not exceed 1" thick.
4. Coating shall be applied in two (2) separate coats. Acrylic coating to be 60% solids (plus or minus 2%)
a. The base coat shall be applied at a rate of 1.50 gallons per 100 square feet.
b.. The top coat shall be applied at a rate of 1.50 gallons per 100 square feet with a combined thickness of 25-27 total dry
mils.
POLYURETHANE FOAM APPLICATION (FOAM ENTERPRISES INC.)
(Note) Apply black neoprene primer at the rate of V2 gallon per 100 square feet.
1. Application shall be by a contractor approved by the PSI and ECI and in accordance with the PSI and ECI application
instructions.
2. Substrate shall have sufficient. slope to eliminate excessive ponding water. Ponding water is defused as an area of 100
square feet or more, which hold in excess of 2 inches of water as measured 72 hours after a rainfall. If the substrate
does not have sufficient slope, then ponding water must be eliminated by building in slope by the application of
polyurethane foam, channeling, and /or by the proper placement of drains.
3. Weather Conditions: The foam application shall not proceed during periods of inclement weather. The applicator shall
apply foam within the temperature and humidity and wind limitations specified by Foam Systems Inc. Wind barriers
should be used if wind conditions could affect the quality of installation.
PHONE:760-347-9869
FAX: .760-347-9879
83-600 PEACH
INDIO, CA. 92201
LIC# 770940
4. Spray polyurethane foam thickness shall be a minimum of (] .inch). The polyurethane foam shall be applied uniformly
over the entire surface and the edges shall be feathered to'produce smooth transitions.
5. The spray polyurethane foam must be applied in a minimal pass thickness of V2 inch.
6. The spray polyurethane foam shall be terminated neatly a minimum of four (4) inches above the roofline at all
penetrations (except drains, parapet wall, or building junction). Foamed in place cants shall be smooth and uniform to
allow positive. drainage.
7. The final sprayed polyurethane foam surface shall be smooth, orange peel, coarse orange peel, or verge of popcorn.
Polyurethane foam surfaces termed popcorn or treebark are not acceptable. These areas shall be re -foamed to an
acceptable surface.
MAINTENACE PROCEDURES , , ,
1. It is recommended that maintenance procedures, including annual inspections, be established with your contractor for
any roofing system to yield maximum value.
PRODUCTS
POLYURETHANE FOAM
1. The foam shall be Foam Enterprises Inc. PSI SH2O0-30RD.
2. Physical properties of cured foam:
A. Minimum in-place density is 3.0 lbs/cubic feet.
B. Closed cell content is minimum 95%.
C. Compressive strength, parallel rise is minimum 47 psi.
D. The foam shall have a flame spread rating of less than 41 when tested according to the procedures outlined in
ASTM E-84.
SPRAY APPLIED ELASTOMERIC ACRYLIC COATING SYSTEM (FECoat 1000 100% Acrylic Coating)
1. The coating shall be the spray applied FE 1000 elastom6ric acrylic coating system, manufactured by Foam Enterprises
Incorporated.
2. Physical properties of cured coating system.
A. The coating shall have good resistance to ponding water.
B. The coating system shall contain no plasticizers.
C. The coating system shall contain no migrating fire retardants.
D. The coating system shall have a class `B" fire rating over foam on a combustible deck when tested according to
the products procedures outlined in ASTM E-108.
E. The coating shall remain flexible in temperatures down to below 30 degrees F.
F. Elongation, ASTM D-412 is minimum 380% +/- 50.
G. Tensile strength, ASTM D-412 is minimum 150% +/-30.
H. Shore a hardness, ASTM C-661 is minimum 62.
I. Reflectivity, ASTM E-97 is minimum 90%
N