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14-0073 (RR)1 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 14-00000073 Property Address: 53563 AVENIDA .NAVARRO APN: 774-134-013-3 -000000- Application description: RE -ROOF Property Zoning: COVE RESIDENTIAL Application valtratiQfl: '4000 Applicant: 06� a, 1 672 Architect or Engineer: 4 BUILDING & SAFETY DEPARTMENT . BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm undei•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. Li;rclass: License No.: vet 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 @�y�$gplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 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 1Xt,I� improve for the purpose of sale.). 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.). V)/I�am7 exempt under Sec. �/, B.&P.C. for this reason Date: U I ( `f • Ownt?r: - 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: LQPER,MIT Owner: MEZA M JESUS *NOT ON FILE. UNKNOWN, CA 99999 ---------------------------- Architect --------'------ ------- Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 TIONS (760) 777-7153 1/27/14 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 Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person up6n 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. Iagree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of tpiyEounty to enter upo he above-mentioned pro erty for inspection purposes. Dateal, /_/� Signature (Applicant or Agentt„�/><� Application Number . . 14-00000073 'Permit RE -ROOF Additional desc . Permit Fee . . . . 60.06 Plan Check Fee , _ .00 Issue Date . . . . Valuation . . 0 Expiration Date 7/26/14, Qty Unit Charge Per Extension 1.00 48.6200 LS MISC RE -ROOF, 1ST 2000 SF 48.62 1.00 11.4400 EA MISC RE -ROOF, ADDL 1000 SF 11.44 ---------....-------------------------- ----------------.Special Notes and Comments Special RE -ROOF - RE -ROOF WITH POLYURETHANE FOAM PRODUCT COVERED WITH 1 PLY FIBERGLASS. 2010 CALIFORNIA ENERGY CODES. Other Fees . . . .. . . . BLDG STDS ADMIN (SB1473) 1.00 PLAN CHECK, RE -ROOF '97.24 Fee summary Charged Paid Credited Due Permit Fee Total 60.06 .00 00' 60.06 Plan Check Total .00 .00 .00 .00 Other Fee Total .98.24 .00 .00 98.24 Grand Total 158.30 .00 .00 158.30 Bin # City of La Quinta Building 8T Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # �j l Project Address: ; _ •v Owner's Name: V S Z A. P. Number: lAddress: "` orA N 6 Legal Description: City, ST, Zip: Contractor: it elephone - Address: i ,Project Description _ D �` City, ST, Zip: _ , s Telephone: � State Lic. # : City Lic. #c Arch., Engr., Designer: S — w�i Address: City., ST, Zip: Telephone: P :z•;:•>:>:;:;;:.:<:.., .::::;.;.:;:.::<:.;:.<.;;:.;:;; ' •i:;�r�'f Slate Lic. #•:»i:?:•viF'ii;.:'(:ji :::::• .>i:i.'.,:?: Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo 'S F`�aStories: # , 9 _Units: Telephone #,of Contact Person: Estimated Value of Project: coo L 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 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 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 F --es Prescriptive Certificate of Compliance: Residential Reroof CF -1 R-ALT-ReRoof ePro ect Address: Product Weight Pe t #r ROOFING PRODUCTS (COOL ROOFS) §151(t)12 When the area of exterior roof surface to be replaced exceeds 50.56 of the existing roofarea, or 1,000 , 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)1Hiii. Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Foof" requirements:: ❑ Cool roofs not required in Climates Zones 1-12_14, and 16 with a low sloped roof pitch (less or 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 p--oduct weightless than 5/IW. Altey1�atives to §152(b)1Hi and §152(b)Hii, Steep -slope roof (pitch> 2:12) V insulation with a thermal resistance of at least 0.85 hr•ft2_'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 §151(f)10; or ❑ In climate zones 10, 12 and 13, with 1 ftZ of free ventilation area of attic ventilation for every 150 fe 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 Hiii, 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 thennat mass over the roof membrane with at least 25 Ib✓ft2 are exempt from the Cool Roof criteria. NOTE: If any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Emittance requirements for roofinq pruuucrs in 9 r r ay) are nor appucaoie. uo not til 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 CRRC Product ID Number' S 2:12 > 2:12 < 51b/f? >- 51bfft2 T ez Reflectance3'4 Emittance._.; ,_..SRI_ City/State/Zip: Phone: ---a ❑ ❑ ❑ 04 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.coolroafs.ora/nroducts/search.p 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(p; vg — a2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4. Check box if the Aged Reflectance is a calculated value using the equation above. . Calculate the SRI value by using the SRI- Worksheet at httpl/www.eneroy.ca.aovltitle241 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: ❑ 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 • 1 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 Regulations. Name: , U 5 c Signatur : /i/ 2' Company: Date: Address- - }�I to c� [Allo Cro LA i- License: �. C' `;-) d v City/State/Zip: Phone: 6F5rrassis1ance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-8670-772-3300. .P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING &'SAFETY DEPARTMENT (7,60, .777-7012 FAX (760) 777-70.11 PROPERTY OWNER'S PACKAGE Disclosures & Forris for Ovlaer Bgtlders.Appl�ikng"for Coastrtciion P.ernits: I.11fP�1���IYT/ NO'�>�CE•TQ•kR(?�EI,ZTX•QWNER . • . Deari'mpulyOwner.. .. ".... . • , . • .. Aa-. applicatiousfor =a .building permit .has. been- submitted..ia ur, name 'listing,' yourself as the builder of the .�ptrmperty vemcnts ifiod at = 3 s --JWAX : � - � = «� a i r We are providing you,with an Owner-B"der:A&mowiedgment-amidInforinatzFmn'-Veiifiea6DnTotmYW-make -you .4wa of your responsmbilitics-and-.possiible nsk:you may, incur by..havingihispemut•isswd-1 'y�oitrriamc as'die •; �' c Owner: Builder. We`wri*lfmoassue,31 buildiiag:permit until <you -have lead; imiitialed-your. awderstumidutg of each'provision, signed, and returned this form to us at our official address indicated. An agent of the owner caniiot.execute'this notice unless you, the property owner, obtain the prior approval of the permitting authority. AtYZA7I1!L7il.Ca-',A:/•!?l.'ttTl:1x34Y:•.tir ��:....•-..ti..,...�,..-..�.�.............�.��.. ..��..�......�s�i..:.i�vsi�i:. ,.. ;d •:.l.e .. ' ; �" verify thks irifb 'rrirciilivir. . you uracTeistattcl or ' fuildinglpermit 1.understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" that erroneously -implies, that the property owner is providing his or her own labor ani material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustain of 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 actiing as an Owner -Builder and am aware of the limits of my insurance -coverage for injuries to workers on my -property. hs_^ - I understand Building permits are not required to be signed by property owners unless they are responsible for the construction and are not ":,a.,,, 4ccnsed Contractor to assume, this responsibility.. VAM,3_ I understand .as ari ."Owner Buildee' I am t ie responsible party of record: on the permit I understand that I ray protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her;name uu_tead of my own. 4. I understand Contractors are required by law to be licensed and bonded in California and :to_ .list their license numbers on J perinits and contracts. . 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. b: considered:an,`,`employer" under state and federal law. 6_ I. understand if I am, -and an "employer" under state and federal law, I must register with the , state and federal government, withhold payroll .taxes, provide workers' compensation disability. , insurance, and c-ontribute: to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. PK -7. I understand under California Contractors' StateLicense 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. I understand as an Owner -Builder if I sell the property for which this permit is issued, 1 may be held liable.. for any financial or personal. injuries #ustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials: JI understand I may obtain more information regarding my obligations as an "employee' from the. iuvicenat Revenue 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 -L11) at 1- 800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. W10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party le all and financially responsible for proposed construction. activity, :at .:-the following address: 11. I agree that, as .the party legally and fumacially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner=Builders as` well as employers. 12. I 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 hcense,.lthe Contractors' State License.Board may be unable to 1 loss you may sustain as a result of a complaint_ Your only remedy against unlicensed Contractors may be in civil COWL it is also important for you to: understand that if an ualicensbd Contractor or eniployce of that individual or firm is injured while worlang on your property; you may be Ladd. liable :for damages. if you obtain a permit•as Owner -Builder and wish to hire.Contraetors, you .will be responsible fouverifying wiKthe€ or,not :those Contractomare prop, dy 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 ' txsaigg t .pt:mit. Note- A. copy of the property owners driver.! lr'cpur farm no(Adva0 r: or other verification aecCptablc to the agency is required to be "presented .when - the, permit is, ustud to, edify the property owner's signature. Signature ofproperty owner %Date: 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 f6llowia9 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 Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjurythat 1 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'verifrcation acceptable to the agency is required'to bepresented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: