13-1533 (RR)P.O. BOX 1504 ^ VOICE (760) 777-7012
78-495 CALLE TAMPICO ` FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 12/02/13
Application Number: :�L_ ,,_13=00001533] Owner:
Property Address: 54396 SHOAL CREEK PGA WEST HOA -
APN: 775-071-087- - - 54320 SOUTHERN HILLS
Application description: RE -ROOF LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (760) 771-1234
Application valuation: 1925
Contractor: O� 2Q IJ.
Applicant: Architect or Engineer: BRS ROOFING C ��
765 S. LUGOE
SAN'BERNARDNARDI LA QVI%yA
(909)884-8505 FNANCER.
Lic. No.: 907
---------------------------------.------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals 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
License C ss: C3 9 License No.: 907600 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
„�;--OF I issued. '
'r Date:- �` Co� 1 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
_ OWNER -BUILDER DECLARATION 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 639-0509596
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 work 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 manner so as to become 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 should become subject to the workers' compensation provisions of Section
License Law (Chapter 9'(c6mmencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the lab , I shall forthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 01 „�.,1; _ '
any applicant for a permit subjects the aoulicant to a civil penalty of not more than five hundred dollars ($5001.: ...Date:. .: rApplicant::
1 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 1Z'�
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER 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 ($100,0001• 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. improvementis sold'within .. SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. _ - -
1 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.). - • APPLICANT ACKNOWLEDGEMENT ^
(_ 1 I, 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. '
property who builds or improves thereon, and who contracts for the 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, indemnity and hold harmless the City '
of La-Quinta, its officers, agents and employees forany act or omission related to the work being
performed under or following issuance of this permit.
�. Date: Owner: ' 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
CONSTRUCTION LENDING AGENCY permit to cancellation. ar
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city aWcouy ordinances andstate laws relating to g construction, and hereby authorize representatives
of thito enter upon the above -mention ropert for inspection purposes.
Lender's Name:Date:-Signature (Arpricant or Agent):
Lender's Address:
LQPERMIT
Application Number. 13-00001533
Permit RE -ROOF
Additional desc .
Permit Fee . . . 48.62
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 5/31/14
Qty Unit Charge Per
Extension.
1.00 48.6200 LS MISC
RE -ROOF, 1ST 2000
SF
-------------------
48.62
Special Notes and Comments
REROOF WITH FOAM - [CRRC: 0770-00021
2010 CALIFORNIA ENERGY CODE.,
Fee summary Charged
---------- ----
Paid Credited.
Due.
-----------------
Permit Fee Total 48.62
.00
.00:-
48.62
Plan Check Total .00
.00 ..00
.00
Grand Total 48.62
-.00
.00
48.62
LQPERMIT
Bin #
city of La Q um LQ
Building 8L Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Fro;ecttAa cess a i3S`I' $ ?0 ,
gbYnseAM= P6 A W MT
A. P. Number:
jddress:
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Legal Description:
City,ST ---aVAA I2 2
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Telephone 9� /– H 9 i` C�
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City Lie.` #;
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Arch., Engr., Designer:
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Address:
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City., ST, Zip:
Telephone:
"ProJecttyPa
Constriction Type. Occupancy.
State Lic.#::..:...<:.::<..r.::::<.>...
circle one): New Add'nv.Alter Repair Demo
Sq. Ft.: "OF # Stories: # Units:
Name. of=Coiac Peason: µ CGo 04C. LV.
�tyelephone#ofCConta" c"�t-'Pe on: -
VFsttalue fir Jo ect Q� .
APPLICANT: DO NOT WRITE BELOW THIS LINE
t/
Submittal
Req'd
Rec'd
TRACKING
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
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.OA. 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
Prescriptive Certificate of Compliance: Residential Reroof CF-1R-ALT-ReRoof
roie t Adc)reg:
LPVI
Climate Zone
Permit #
Aged Solar
Reflectance3'4
Thermal
Emittance
SRI
ROOFING PRODUCTS (COOL ROOFS) §151(1)12
When the area of exterior roof surface to be replaced exceeds 50.16 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 (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 product weight less than 5/Ib/fe.
Alternatives to §152(b)1Hi and §152(b)Hii, Steep -slope roof (pitch> 2:12)
❑ Insulation with a thermal resistance of at least 0.851102•OF/Btu 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 ft2 of free ventilation area of attic ventilation for every 150 ftz 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(02; 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 thermal 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 roofino
proaucis ,n 9 r rata are not applicable. Vo not fill table below.
CRRC Product ID Number
Roof Slope
<- 2:12 > 2:12
Product Weight
< 5lb/ft2 >_ 51be
Product
Type 2
Aged Solar
Reflectance3'4
Thermal
Emittance
SRI
Date:
Z
'EY
11
City/State
a+#
❑
�'fiN
E]4
1
g'
❑
❑
❑.
❑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.coolrools.ora/nroducts/search.phn
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;,;,;,, — 0.2) 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 httpYAvww.energy.ca.00vltitle241 and enter the resulting value in the SRI Column above and attach
acopy of the SRI- Worksheet to the CF -1 R.
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 c: when a Goa wool 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 Ce rti ' to of Compliance conform to the requirements of Tittle 24, Parts
I and 6 of the California Code of Regulations.
Signat e:
Compan S I�vflF�>
Date:
Z
Address -`71 Ltk� ie
1p
License* 0 (60Z
7
City/State
a+#
Phone:
$149 P-.
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.