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13-1544 (RR), u�l'ItrGv yJ P.O. BOX 1504 itY4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA. 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: l 13-0-0001544 Owner: Property Address: 54564 SHOAL CREEK PGA WEST HOA APN: 775-071-075- - - 54320 SOUTHERN HILLS Application description:. RE -ROOF LA QUINTA, CA 92253 Property Zoning:, LOW DENSITY RESIDENTIAL (760) 771-1234 Application valuation: 1500 D ~ Contractor: Applicant: Architect or Engineer: BRS ROOFING.,INC 765'S. LUGO AVENUE SAN BERNARDINO, CA 9 40 (909)884-8505' %f Lic. No..::.907600 ----------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0) of Divisiori 3 of the Business and Professionals Code, and my License is in full force and effect. - Li seClz s: JC319 09nLicense No.: 907600 i^1�Date: j Contractors 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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1 _ 1 I, is owner of the property, or my employees with wages as their sole compensation, will do the work, and lire 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(sl licensed pursuant to the Contractors' State License Law.). (_) 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: t_ LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/02/13 0® 1 01 OF LA QUINTA FIIy=EDEPS 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 STATE FUND Policy Number 639-0509596 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 Laborr hall forthwith comply with those provisions. i t Daomin 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 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 that the above information is correct. I agree to comply with all ' city and count ordinances and state laws relating to building construction, and hereby authorize representatives of t ..lco ty o an u the above-mentioned pp for inspection purposes. Date: • I �! Si;!(Applicant"oma Ag-e_...i f� '-. Application Number . . . . . 13-00001544 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: 0770-0002]. 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 Quinta Building sz Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Permit Application and Tracking Sheet Permit # 3 Of -Building i�ojectFA�d _ b Owners ame: 124, A W MT 40 A. P. Number: �k V (� i ,ddress: Legal Description: Contractor: F VoettJ & City, STpZi :�-'tAA I2 rx f./: ,.N,f..ti ;SN'•y.`.v n -y a cphone: �� - l ! 1I s -,''Address: k P lectiDescn�" fit on Mity, ST, Zip: AOI t-0 ctrl 17 4 -elephone.4 "Lic. State Lic_#J , % PI) amu---- City #; Arch., Engr., Designer. L rf e W11 WOW4 6 Address: .' A 3 . City., ST, Zip: Telephone: <s�<:;::;::>ri".:::;::::::::.�:;1:::.>::�;:•:�:.11 •�:.<::::;s: '•:.�G:i:::Fii 'i.ylii .CC -h:::: �:vii�-:�:?':•$:vii)S � iiii :r:::..::::..:.:.:::::::.:..;::::<::<•1:.:::::::::.::-ProJect . Construction Type: Occupancy: State Lic. #: type (circleone): New Add'n Alter Repair Demo ' 2Name�.ofConta 3' on: µ LGp At LV Sq. Ft.: # Stories: # Units: WTelep4q!Le #2bf o ersP on: gS?i stitn`ate�i>!�it of�I.ojed'-`. O � � ' 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 Cales. Called Contact Person Plan Check Balance Title 24 Cala. 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.L 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 Schodl Fees Total Permit Fees Prescriptive Certificate of Compliance: Residential Reroof CF -1 R-ALT-ReRoof Pro' ct Address: � ,. & 0.1at SDA, Climate Zone Permit # ROOFING PRODUCTS (COOL ROOFS) §151(1)12 When the area of exterior roof surface to be replaced exceeds 5056 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)1Hiii. 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 5Ab/fe. Alternatives to §152(b)1Hi and §152(b)Hii, Steep -slope roof (pitch> 2:12) ❑ Insulation with a thermal resistance of at least 0.85 hr•it2-°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(010; or ❑ In climate zones 10,12 and 13, with 1 ft2of free ventilation area of attic ventilation for every 150 ft2 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 <_ 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. NO If any one of the alternatives or exception is checked the Aaed Solar Reflectance.and Thermal Emittance reouirements for ronfinn vrovucis in 9 r r up) are not applicable. Do not fill table below. CRRC Product ID Number 1 Roof Slope 5 2:12 > 2:12 Product Weight < 51b/fl? >_ 51bM2 Product Type 2 Aged Solar Reflectance3,4 Thermal Emittance SKIS VV OZ address�I ��O � f� ❑ :ity/State ❑ �'fiN ❑4 1 ❑ ❑ ❑ ❑ ❑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.coolroois.orp/nroducts/search.jo 2. Indicate the type of product is being used for the roof top, i.e. single -ply roof, asphalt roof, metal roof, etc. 1. 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 j" — 02) to obtain a calculated aged value. Where p is the Initial Solar Reflectance. f. Check box if the Aged Reflectance is a calculated value using the equation above. i. Calculate the SRI value by using the SRI- Worksheet at hnol/www.energy.ca.aovlitfe24/and enter the resulting value in the SRI Column above and attach acopy of the SRI- Worksheet to the CFIR. o apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage ecommended by the coatings manufacturer and meet minimum performance requirements listed in §118(i)4. Select the applicable coating: 7 Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other COTE: When a Cool Roof is required, the installing contractor shall complete and submit the CF -6R -ENV -01 for final inspection. Ueclaration 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. • [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 Requiations. Name: �j i1� Signat re: mom an P Sri address�I ��O � f� License 40 � b ? :ity/State Phone: :)r assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.