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13-1537 (RR)t; P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning:. Application. valuation: 13-00001537 55126'SHOAL CREEK 175 -142 -011 - RE -ROOF LOW DENSITY RESIDENTIAL 1925 •4 ���VIN W -BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: k �o t/ LICENSED CONTRACTOR'S DECLARATION - - I.hereby affirm under penalty ofperjury that I am licensed under'provisions of Chapter 9 (commencing with r Section 7000) of Division 3 of the Business and. Professionals Code, and my License is in full force and effect. LicenseCl s: C39 _ License No.: 907600 Date: Contractor. - OWNER -BUILDER DECLARATION 1 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-toa- civil "penalty-of-not'more than five hundred-dollats($5001.:' — ---�'� (_ 1 1, 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 uffeied for sale. It, 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.). (_) 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.). (_ 1 d 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: LQPERMIT Owner: PGA WEST HOA 54320 SOUTHERN "HILLS LA QUINTA; CA 92253 (760)771-1234 Contractor: BRS ROOFING INC' 765 S. LUGO AVENUE SAN BERNARDINO, CA 9240 (909)884-8505• VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) ,777-7153 Date: 12/02/13 Darc a � 2019 Li c. No.:' 907600 C1 VOFLAQUINdTA . 1 FINANCE DEPT' -------- - --'-- - - -- - - - - -- - - --- - - - - - — 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. y 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, nd agree that, if I shout come subject to the workers' compensation provisions of Section 700 of the Labo e, I all forthwith comply with those provisions. _Date: Apphcani '. 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 PROVIDFD 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 Ouinta, 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. 1 agree to comply with all city and un y ordinances and state laws relating to buil ' construction, and hereby authorize representatives of this c nt to enter upon the above-mentioned er[y f inspection purposes. i Date: Signature (Applicant or Agent): Application Number 13-00001537 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 - ------------------------------------------------- x 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 4.8.62 Bin # City Of La Q uih to Building 8t Safety Division P.O. Box 1504, 78-495 Calle Tampico Quinta, CA 92253 - (760) 777-7012 Building Building Permit Application and Tracking Sheet Permit # -07 P o'ecC "dd - - ,; —opw'ne NP16i me:�r s e: %A W IMT 40 :;tea A. P. Number: I ddress: .-3w Legal Description: City, ST, Zi Contractor: opt IJ G'J Js cIep�ho a Address: Cyity, ST, Zip: Nc c p 92- 4q.v� 6 V, R"" Tele h one: wMy: ivfii: �i 4Yi ` City Lic. #: 1 p� 60k,71 kv kP1 V Own. Arch.; Engr., Designer Address: ��/ two City., ST, Zip: Telephone: :...... Construction Type: Occupancy State Lic. # Project'type (circle one): New Add, n Alter Repair Demo:«:..:; ame;of . mese_ s n: RA -1, µ'e6.04L.LV. Sq. Ft: 20W O # Stories: #Units: �eTelephone; #of Cp�jrta°P�'ers�°on: - � - g,�V �.Estimat���Y"la„�ue5of�o- � •� � Q• APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRAC*dNG 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 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.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 7rd Review, ready for co �rectionsfissue 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 -1 R-ALT-ReRoof Project Address: Climate Zone Permit # ROOFING PRODUCTS (COOL ROOFS) §151(t)12 When the area of exterior roof surface to be replaced exceeds 50•/ 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)1Hiif. 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/lb/ft2. 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•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(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(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 <- 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 Refledance.and Thermal Emittance requirements for roofing products in § 118(i) are not applicable. Do not fill table below. Pv I t: When a Coot Hoof 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 lompan - �ll� CRRC Product ID Number s 2:12 > 2:12 < 5Ib/ft2 >- 5Ib/ft2 Type 2 Reflectance3.4 Emittance SRI5 0 ❑ ❑ *nt4 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.coolroofs.oralproducWsearch oh9 ?. Indicate the type of product is being used for the roof top, i.e. single -ply roof, asphalt roof, metal roof, etc. 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. '. Check box if the Aged Reflectance is a calculated value using the equation above. Calculate the SRI value by using the SRI- Worksheet at h_ ttoYAvww.energy.ca.govAitle241 and enter the resulting value in the SRI Column above and attach acopy of the SRI- Worksheet to the CF -1R. 'o apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverag commended 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 Pv I t: When a Coot Hoof 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 Calif omia, the information provided on this form is accurate and complete. • 1 certify that the energy features and performance specifications identified on this Certi ' to of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. Vame: i1 ,/� C�r � Signat re: lompan - �ll� Date: r Z/Zlis - address- � O ve License 90 (PC) Z) ;ity/State a�.o Phone: )r -assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.