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12-0249 (RR)P.O. BOX 15.04 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 4 u�ftrGv. BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number. 12 m_0 _00_0,24. Property Address: 53310 AVENIDA NAVARRO APN:- 774 -095 -003 -22 -000000 - Application description: RE -ROOF Property Zoning: COVE RESIDENTIAL Applirnfinn trnhistinn 65nt1 Owner: DON KARASEVICZ 53310 AVAENIDA NAVARRO, LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/19/12 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 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. - - certify that I have read this application and state that th bove information i correct. I agree to comply with all city and county ordinances and state laws relating to bu' di g construction, a hereby authorize representatives 4%;��Ze above-mentioned pr y or ins ion pur s (Applicant or Agent): 5 Contractor: 01 Applicant: Architect or Engineer: URETHANE FOAM SPECIALIST IN11 72875 SONOMA DRIVE G(f4a2 1' Q 2� lJ i E ELJ PALM DESERT, CA 92260 (760) 346-0667 LiC. No.: 922766 cill LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licens under provisions of Chapter 9 (commencing with 1 hereby affirm under penalty of perjury one of the following declarations: ' Section 70001 of Division 3 of the Busi sand Prof. naIs Code, and my License is in full force and effect... _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided Licen e'Class: C39 - License'No.: 922766 Jissued. ate: ! Co actor: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is 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 • NER-BUILD�ECN insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 0002012-2011 ' - following reason (Sec. 7031 5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the ork for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any mann .so as to beco a subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the'provisions of the Contractor's State and agree that, if, I h uld become s ject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or - 3700 of the Labff *a, I rt it com with those provisions. " that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 7jQ any applicant for a permit, subjects the applicant to a civil penalty of not more than five hundred dollars 1$5001.: �- ate: J l •plicant: - (_ 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 WARNING: FAI RE TO SECU E WORKERS' CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL ' Contractors' State License Law does not apply' to an owner of property who builds or improves thereon, SUBJECT AN E PLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND . and who does the work himself or herself through his or her own employees, provided that the ' DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve forthe purpose of sale.). - APPLICANT ACKNOWLEDGEMENT 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and�Safety for a -permit subject to the • 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. • - propertywho builds or improves thereon, and who contracts forthe projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for - pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, ' I am exempt under Sec. , B.&P.C. for this reason 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 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 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. - - certify that I have read this application and state that th bove information i correct. I agree to comply with all city and county ordinances and state laws relating to bu' di g construction, a hereby authorize representatives 4%;��Ze above-mentioned pr y or ins ion pur s (Applicant or Agent): Application Number •. . . . . 12-00000249 Permit RE -ROOF Additional desc . Permit 'Fee 30.00 Plan Check Fee '.00 Issue Date . . . . Valuation 0 Expiration- Date 9/15/12 Qty Unit Charge Per Extension BASE FEE 30.00 Special Notes and Comments RE -ROOF WITH COOL ROOF APPROVED URETHANE FOAM 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 . scrip ttV V. Cate of .C3om ih�nace ` �e iul : er�tit 9`Rbedof ProJeaf .Address,- R ALT Climate le.."P9rmit tf ,ROOFING'PRODUCTS (COOL ROOFS) §151(012' When the area of oxferior roof surface to be replaced exceeds 50% of the existing roof area, or 1,.000 fe, whichever Is less, the new roofing area must meet the roofing product "Cool Root" requirements of §152(b)1H1, 152(b)1H11, or 152(b)Mill. Check applicable alternative or ex ceptlon below if the roof alteration is. exempt from the roofing product `Cool Roof requirements:, O Cool roofs not required in Clunates Zones 1-12. 14, and 16 with a low sloped roof pitch (less or 2:12 pi=th). 0 Cool roofs W required in Climates Zones 1-9, and 16 with a steep`sloped roofs (greater pitch than 2:12) and product weight less than 5llbff Alternatives to §152(b)i Hi and §152(b)HII. Steep-61ope roof (pitch > 2:12) O Insulation with a thermal resistance of at least 0.85 hr•fe-TBtu or at least a 314 inch air ❑ Existing ducts in the aft are Insulated and sealed according to §151(1)10 or sPaoe is � to the roof deck over attic; or 0. In climate zones 10, 12 and 13; with 1 if2 of free ventilation area of attic Ventilation for Every 150 ft2 of attic floor area, and where at least 30. percent of the free ventt7atiOn area is within 2 feet vertical distance of the roof ridge; or O Building has at least R-30 oeiling insulation; or ❑ Building has radiant barrier in the attic meeting the requirements of §151(f)2; or ❑ Building has no duds in the aftic; or O In climate zones 10, 11,13 and 14,.R-3 or greater roof deck insulation above vented attic Exception to §152(b)l Hili, Lowslope roof ( pitch 5 2:12) O Building has no duds in the attic. Other Exceptions ❑ Roofing area is ❑ Roof constructiocovered by building integrated; photovoltaic panels and solar thermal panels are exempt from the Cool Roof arteria. ns that have thermal mass over the roof membrane with at least 25 IbM are NOSE: if any one of the altemafives or exception• is checked the exempt trori tine Cool Roof Criteria. products in § 118(1) are not applicable. Do not rill table below. �� $aJar Reflectance and 7ihei r t Erlhittance requirements for roofing Roof Slope s 2:12 > 2:12 ❑ ❑ ❑ Product Weight < 51111111? i 5ib/ft Product Type? Aged Solar Reftecta//neea.a Thermal EGmtttanoe SRI5 E0. !o (�O f'Y ❑4 'r tG q f ❑4 Note: Nno CRRC-1 label is available, this compliance method cannot be used use the performance Approach to show compliance; The CRRC Prvduet rD Number can be obta/ned /rpm the Cool Roof RatbhgRated Product Dftdwy at Indicate the type Ofpioduc is being used for the roof top, i.e. Singh"* nW. asphalt roof, metal roof, etc. If the Aged d use q not avaflable In the Coo/ Roof Rating directory and use Cods Rated product Diary then use the InNAW Retiedanoe value from the same the equatiovh (0.2*0. 7(Al-w — 0.2) to obtain a calculated aged value. Where p is Check box IF the Aged Reflectance is a calculated value using the equation above. the lniNal Solar Reflectance. Calculate the SRI value by using the SRI- Worksheet at lift /hvww enerav ca >1ov/t>i>e241 and enter the rasa atopy of the SRl- Worksheet to fire CF -1R. IM9 velUG in the SRI Column above and attach o apply Liquid Field -Applied Coatings, the ooatin must be 9 applied akxoss the entire roof surface and meet the dry mil thickness or covers roommended by the coatings manufacturer and meet minimum performance requirements listed in §118%4. Select the applicable coating: Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating !—E.-. When a Coo/ Roof is required, the installing contractor'shall complete and submit the • ice" under penalty of perjury, under the laws of the State of California, the information provi • (certify that the energy features and Perforrance specifications identified on this kertificate of 1 and 6 of the Catifomia Code of R utations Name 67 i Company: UG P. ;ss*� r•a, rc� a n � . Ogler EtiV-01 for final inspection this form is accurate and complete. ance conform to the requirements of Title 24, Pan i r f nil / � Phone T to �% For assistance or questions regarcfing the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. PROPOSAL and CONTRACT RESIDENTIAL 9 COMMERCIAL ❑ MOBILE HOME ❑ 1. Type of roof(s): Tar/Gravel I Foam ❑ 90# Felt ❑ Metal ❑ 2. Garage included Yes ❑ No J0 Addition Yes ❑ No Qi 3. Carport included Yes It No ❑ Patio Yes ❑ Noe 4. Vacuum Roof Yes ❑ No (t'j, S. Tear Off Roof Yes No ❑ Power Wash Roof Yes ❑ No,& Dump truck Yesi. No C1 Primer Roof Yese No ❑ 6. Desert cooler removed and replaced Yes ❑ No W_ 7. AC unit lifted and replaced Yes ❑ No4& Platform ❑ S. AC duct urethaned and coated Yes ❑ No 19 9. Color of coating White Tan ❑ Grey ❑ 10. Application of coating 1 ❑ 219 3 ❑ Granules Yes ❑ NoX] 11. Install unpainted metal edge, No. ft. 12. Appearance of the finished roof surface will be pebbly and somewhat uneven. Final roof surface will be affected by the texture of the existing roof surface. EFobe tapered from a minimum inch thickness to a thickness of approx- ree quarter inch plus or minus at all roof edges. Existing gravel guard removed unless customer wishes to pay the cost and replacement avel guard. ❑ Recoat only 14. Roof mounted equipment, including TV antennas, will will not be removed from roof. 15. Only loose gravel, dust, and dirt will be swept off. Secure gravel will remain on the roof. Gravel will be removed from premises unless customer wants it. 16. Completion of roof application will be affected by weather conditions, including rain, wind and fog. 17. Urethane Foam Specialists, Inc. cannot guarantee removal of all water standing on flat roofs when completed. (Ponding Water) 18. Definition of ponding water as per Industry Standards: A pool of water at least 1/2" deep that remains In an area no less than 100 square feet 24 hours or more after a rain. 19. Roof must conform to 1994 Uniform Building Code concerning adequate drainage of flat roof areas. Urethane - Foam Specialists, Inc. 72-875 Sonora Dr. Palm Desert, CA 92260 Bus 760/346-0667 Fax 760/568-0191 CAL. STATE LIC. C-39 #922766 Customer's Name �V)0 N 24 1 to Address, N.:• 'Ant city S I a I el,: Ary y Billing Address Home 31 37V 7 Fax Code Date Sq. Ft. COO, 100% 5 -YEAR GUARANTEE If a leakage, caused by defects in material and/or workmanship, occurs within five years from date of application, we will repair it free of charge. SPECIAL INSTRUCTIONS: ICBO REPORT +x4630 City`Permit Required YES ❑ . NO 9 V x.044~ 1 r.. \ 'T'Nh% I1 1 4-.. w NOTES: IN KEEPING WITH INDUSTRY STANDARDS 1. This guarantee does not cover any damage to the Interior or exterlor of the premises on which the roof Is applied or damage to any -contents therein: This guarantee also does not cover damage to roof due to any cause beyond our control including, but not limited to, fire, lightning, windstorm, hailstorm, installation of antennas or other equipment, traffic on roof, structural fault or settlement, cracking or other failure of the roof deck, walls or foundation of the building on which the roof Is applied. 2. Should it become necessary for the roofing contractor to remove and/or reinstall any antennas, cooling or heating appliances or other equipment, whether or not an additional charge is made for such work, customer understands that neither Urethane Foam Specialists, Inc. nor the installer assumes any responsibility for the performance of said equipment. 3. Urethane Foam Specialists, Inc. does not assume any responsibility for corrections of existing code violations or for the repair of any existing defects unless specified in the estimate and proposal. T t Cost: TERMS: Paid upon completion unless Urethane Foam � S00 - 0otherwise specified in the contract. Specialists, Inc. The date on which work will be substantially completed Is estimated to be 72-875 Sonora Dr. approximately 10 days after commencement of work unless a different Palm Desert, CA 92260 estimated completion date Is shown herein: If not accepted In 30 days this proposal is null and void. Mutually agreed beginning date: X Authorized Representative INSTALLATION: It is understood that by the acceptance of this Proposal you authorize Urethane Foam Specialists, Inc. to make the installation; (1) to issue work order with specifications shown herein and (2) to pay our charge for such installation. You agree to pay to Urethane Foam Specialists, Inc. the amount specified herein, which will cover the price of said material and the installation charge. This estimate is based on a complete job and any surplus material remains the property of Urethane Foam Specialists, Inc. Verbal understandings and agreements with representatives shall not be binding unless set forth herein. There shall be no liability for delays In, or failure to complete, delivery or installation of all or any of the herein mentioned merchandise if due to fire, strikes, war; governmental regulations, or any cause beyond our control. Any changes made by you In the specifications herein, necessitating additional materials or labor shall not be included or covered by this proposal, but shall be provided for under separate and additional order from you. Contractors are required by law to be licensed and regulated by the Contractors' State License Board. Any question concerning'a contractor may be referred to the registrar of the board whose address is: Contractors' State License Board 1020 N Street Sacramento, California 95814 ACCEPTANCE , You are hereby authored to furnish all materials and labor required to complete the work mentioned in the above proposal, contract for which I / We agree to pay the amount mentioned in said proposal, and according to the terms thereof. ACCEPTED: X Owner's Signature (OVER) CUSTOMER - WHITE FILE - YELLOW JOB - PINK # : C(/ 0 QLI([I `Building BL Safety Mbion . P.O. Box 1504,78-495 Calle Tampico 14.Quinta, CA 92253 - {760) 777-7012 Building Permit Application and Tracking Sheet Permit # ' Owner's Name:.1ProjectAddress: @ O . 164 v �Z A. P. Number Address: —7io 14k 1 J A VAtft) Legal Description:. Contractor." l City, ST, ZIP: C `2 Y 0 A�` Telephone: �� 7 ..> ::'fs=�' Address: — ' S 000 tn 6n Project Description: 12e P00 f -R—( . City, ST, Zip: rTt-y pe�- /Or -H Fo"e)ril,Aepo Telephone: State Lic. # : Lie*- #; 4City Arch., Engr., Designer.' Address: City., ST, Zip: Telephone: State Lia #: ,�,w,y; Name of Contact Person: Construction Type- . Occupancy: Project type (circle one): New Add'n Alter Repair Demo . Sq. Ft : # Stories: #Units: . Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACMG 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. Titre 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2fd Review, ready for correctionsfissue Electrical Subeoutactor List Called Contact Person Plumbing .Grant Deed Plans picked up SALL 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 Fees