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13-1540 (RR)M P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00001540 Property Address: 55150 SHOAL CREEK APN: 775-142-009- - Application description: RE -ROOF. Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1925 Applicant: / Architec or f ngineer: ------------------ LICENSED CONTRACTOR'S DECLARATION 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that I am licensedunderprovisions 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. License CI s: JC39 License No.: 907600 Da te:1 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 any applicant for a permit subjerts the applicant to a civil penalty of iiut more than five hundred dollars ($500).: 1 _ 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 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.). (_) 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.). I—) 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/02/13' Owner: PGA WEST HOA 54320 SOUTHERN HI LA QUINTA, CA 922 (760)771-1234 i Contractor: I BRS ROOFING INC 765 S..LUGO AVENUE SAN BERNARDINO, CA (909)884"-8505 - Lic. No.: 907600 92408 0R 2®J3 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, and agree that, if I should become subject to the workers' compensation provisions of Section �i/ 3700 of the Labor I shall forthwith comply with those provisions. Date:`- 1� Applicant: v'I �1 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 DOI-I•ARS 1$100,0001. IN ADDITION TO THE COST OF CUMPENSATION, 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 c un ordinances and state laws relatingto b ' - g construction, and hereby authorize representatives of this co ty o enter upon the above-mentioned ert f r inspection purposes. Date: Signature (Applicant or Agent): �� Application Number . . . . . 13-00001540 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 Bin # City of La Quinta Building &r SafetyDivision P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # ?j' 7 r._Pioiect fid" _114 19G� Owner same: A WMT A. P. Number: fIddress: Legal Description: Gty, STS:: contractor: S�GF�1.1i7 �✓) . cicphone: %V - l ! I' iJiA i. •�r>>:w�:::v:,>;�r•,`•z�:::;�:;> �6Address: 5.. 1A / � /t' J� —. M -"p io e`ct�Descn""'''p�f o lity, ST, zip: A t-0 L M q7 4c k6VOi 6 =, Tele hone:9 p :�3i 6te� e Li_ c. f!_ J r , % fla City Lic. #: Arch., Engr., Designer: 114 19 tro 9A.A1 S 'Cro Address: 7 City., ST, Zip: Telephone: -zxt::;>:x;>T <:, >:<.: <:>< �F;..:.•>:..:>..�:..:;.>.::.;;,,,.�;;::<.:::;<.: Construction Type: Occupancy: State Lic. #: ProJecttYPa circle one): New Add'n Alter Repair Demo " amexfjConti cO! on: 94kU a R CGp 04(, LV. Sq, Ft.: 2$2,01D # Stories: # Units: �rTelephone # of £or �ct�P "e Mon: I -frog- fro APPLICANT: APPLICANT: DO NOT WRITE BELOW THIS LINE tl 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 Calcs. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for correclionstissue 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 Schodl 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(1)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)1HIf, 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 weightless than 5/1b/ft2. Alternatives to §152(b)l Hi 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(f)l0; or . ❑ In climate zones 10,12 and 13, with 1 ft2 of 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 Aged Solar Reflectance.and Thermal Emittance requirements for roofinq u—m—a it, y, iuriii a1G !7ut ctuptiGdole. uo not un taote velow. CRRC Product ID Number' Roof Slope s 2:12 > 2:12 Product Weight < 5lb/ft2 ? 51b/ft2 Product Type2 Aged Solar Reflectance 3A Thermal Emittance SRI Date: 'Z' Z IS 0 � :ity/StateLZip: ❑ �'fiN ❑4 • 1 ' Q' El ❑ ❑ ❑4 Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, I. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs.orolDroducfs/watch rho Z. 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(pi" — 0.2) 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 httoJ1www.enerov.ca.00v/tif1e24/ 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 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 1� r c: vvnern a wor now is required, the instautng 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. • I 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. Name: 'I Signat re: mom an P S �l�t Date: 'Z' Z IS address-ll s- ic��� License* (00 V :ity/StateLZip: Phone:c :r -assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.