13-1539 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c &, y �'.. 4 Zfv a"
Application Number: 13-00001539
Property Address: 55174 SHOAL CREEK
APN:. 775-142-008- - -
Application description: . RE -ROOF
Property Zoning:' LOW DENSITY RESIDENTIAL
Application valuation: 2337
Applica L' Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapters (commencing with --
Section 7 00) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Cl ss: C39 License No.: 907600
Dat!" `Contracto
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 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 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
IL
�Jz
Owner:
PGA WEST HOA
54320 SOUTHERN HILLS
LA QUINTA, CA 92253
(760)771-1234_"
Contractor:
BRS ROOFING INC
765 S. LUGO AVENUE D
SAN BERNARDINO, CA 92408
(909)884-8505
Lic. No.: 907600
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/02/13 '
DEC o2 2013 UI.
-----------------------------------------------
WORKER'S
--------------------------`---------------
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.
�r 1l3700 of the Lab ofls , 1 shall forthwith comply with those provisions.
Dat(i] = Applicam:—
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 AODIT10N 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 purouont to ony 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 4untinances and state laws relating to building construction, and hereby authorize representatives
of thter upon the above-mentioned proper r inspection purposes.
DateSignature (Applicant or AgenU:
Application Number 13-00001539
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 Quinta
Building 8T SafetyDivision
P.O. Box 1504, 78-495 Calle Tampico.
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
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Construction Type:
Occupancy:
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State Lic. #: " :":";.,,.:• i '<^=-' ~ ?<":•`"r: <i `, "• °: '>,,ProJec
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# Stories:
# Units:
Telephone #=vf, o"°Rac Pe son: SV
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APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Rcq'd
Rec'd
TRACKrNG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
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:-
'rd 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 Com liance: Residential Reroof CF-1f3-ALT-ReRoof
Project Address:
s I'
Climate Zone
Permit #
ROOFING PRODUCTS (COOL ROOFS) §151(6)12
When the area of exterior roof surface to be replaced exceeds 50'1. of the existing roof area, or 1,000 ff, whichever is less, thInew
roofing area must meet the roofing product "Cool Roof " requirements of§152(b)1Hi, 152(b)1Hii, or 152(b)1Hifi'.
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/f?.
Alternatives to §152(b)1Hi and §152(b)Hii, Steep -slope roof (pitch> 2:12)
❑ Insulation with a thermal resistance of at least 0.65 hr-ft2•0F1Btu 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 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 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 Aced Solar Reflectance and Thermal Emittance recuirements for rnnfinn
products in § 118(i) are not applicable. Do not fill table below.
NOTE. When a Cool 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
Compan
CRRC Product ID Number'
<- 2:12 > 2:12
< 5lb/ft2 >_ 51b/ft2
Type 2
Reflectance3'4
Emittance
SRI
�
�
❑
❑
�fiN
❑4
I
Q'
❑
❑
❑
❑
❑4
Note: H 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.ora/nroducts/search.nh
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(piw„ — 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.
5. Calculate the SRI value by using the SRI- Worksheet at httpYlwww.eneroy.ca.aovltitle24/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(i)4. Select the applicable coating:
❑ Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other
NOTE. When a Cool 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 California, 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.
Name: '/t ct
�`
Signat re:
Compan
Date:
Address,
p 1
License?0 60
77
City/State
`
Phone:
?40 P-. -�
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.