BRER2016-002878-495 CALLE TAMPICO
4
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BRER2016-0028 Owner:
Property Address: 77318 CALLE TEMECULA JOHN KLIMKIEWICZ
APN: .774234012 P 0 BOX 264
Application Description: JOHN KLIMKIEWICS / REROOF LA QUINTA,
Property Zoning: ID
Application Valuation: $9,400.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/25/2016.
Applicant: Contractor: U II OR 2 6 2016
G M GORDON ROOFING G M GORDO R F1ttY�FC�QUINTA
79-041 DELTA STREET. 79-041 DEL §T I OEVFL AQUI TA
DEPA
BERMUDA DUNES, CA 92203 BERMUDA DUNES—,C-A-92,20-
(760)565-7006
UNES; C -A-92203----
(760)565-7006
LIC. No.: 969798
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 {commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C39 license No.: 969798
Date: 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 subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(� 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.).
(_) 1, 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 contractors) 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. Q.
Lender's Name:
Lender's Address:
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
Sect n 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity number are:
Carrier: _ Policy Number:
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 Labor Code, I shall forthwith
comply with those rovisions.
Date: Applicant: A, /
WARNING: FAILURE TO SECURE WORKE S' 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 Building Official 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 county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to ntDon
above-mentioned property for inspection purposes.
Date: :+ Signature (Applicant or Agent
;..4 !_. ���f __v.
r:..': �. d:w� �6; �._ � �.,�y �.,., .�_4„ ....fir..., x ,.rr r�w�>w'e �i+�.n�'e
Description: JOHN KLIMKIEWICS / REROOF
Type: RE -ROOF Subtype:
Status: UNDER REVIEW
Applied: 4/25/2016 RSE
Approved:
Parcel No: 774234012 Site Address: 77318 CALLE TEMECULA LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 263
Lot: 13
Issued:
UNIT 24
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $9,400.00 Occupancy Type:
Construction Type:
~
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: REROOF WITH LIGHT -WEIGHT MONIER ESPANA 600 TILE -CALIFORNIA MISSION BLEND COLOR [CRRC: 0890-0008] 2013 CALIFORNIA
ENERGY CODE.
CONDITIONS
FINANCIAL INFORMATION
Printed: Monday., April 25, 2016 7:59:13 AM 1 of 2
SYSTEMS
.. . ... . ...... ..
INSPECTIONS
PARENT PROJECTS
. . . . ..... .. .... ... ..
C
REMARKS RETURNED z
6REVIEWTYP REVIE' SEDATEDUE,DA r . n•I k: — _ ;D E
un. iniFraiK,nnc
NTTACHIVIEN
Printed: Monday, April 25, 2016 7:59:13 AM 2 of 2 CgewsYSTEMS
CHECK. #
PAID, BYJ',
DESCRIPTION
-ACCOUNT,
QTY
AMOUNT,r.
RE'
By
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00-
BSA:
RE -ROOF - EA
101-0000-42404
0
$11.60
$0.00
ADDITIONAL 1,000 SF
RE -ROOF - FIRST 2,000
101-0000-4240,4
0
$49.31
$0.00
SF
RE -ROOF -FIRST 2,000
101-0000-42600
0
$98.62
$0.00
Total Paid for RE -ROOT: $159.53 $0.00
.. . ... . ...... ..
INSPECTIONS
PARENT PROJECTS
. . . . ..... .. .... ... ..
C
REMARKS RETURNED z
6REVIEWTYP REVIE' SEDATEDUE,DA r . n•I k: — _ ;D E
un. iniFraiK,nnc
NTTACHIVIEN
Printed: Monday, April 25, 2016 7:59:13 AM 2 of 2 CgewsYSTEMS
Bin #
City of La Quinta
Building 8i Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit -Application and Tracking Sheet
Permit #
Project Address: -77—'-31 ` 01 i
Owner's Name:
A, P. Number:
Address: 7 1 7---511-G
Legal Description:
City, ST, Zip: 3
Contractor:
r
Telehone:
P
Address:
Project Description:
City, ST, Zip: '
14
Telephone:
q,.
State Lic. # :.
City Lie. #.:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
�>
C o tructi
.on TY e• Occupancy:
P P Y: 1 IC E
a #•
St to Lrc.
Project tYPa(circle ne) New Add'n Alter Repair Demo
Name of Contact Person:
C�MA. 6�
Sq. Ft.:
#Stories:
=#units:
Tele hone # of Contact Person: —
P
O
Estimated Value of Project: �
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets -
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans Tesubmitted
Mechanical
Grading plan
2"a Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Pcrson
Plumbing
Grant Deed
Plans picked up
S.M.I.
Ii.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
School Fees,
Ll
Total Permit Fees
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS_
-CEC-CFIR-ALT-01-E Revised 06/14
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations
Project Name:
CALIFORNIA ENERGY COMMISSION
CF1R-ALT-01-E
(Page 1 of 4) .
Date Prepared:
A. GENERAL INFORMATION
01
02
01
Project Name: 1,
02
Date Prepared: Z
03
Project Location:
04
Building Front,Orrlentatlon (deg or cardinal):
05
CA City:
• 06
Number of Alte.redD_welling Units:
07
Zip Code:
08
Fuel Type, & "*
09
Climate Zone:
10
Total,Con�ditioned FloorjAfea'(ft2) '
11
Building Type -
12
Si'A'Aea(ft2) dkI'40''
13
1 Project Scope:
I'VW
L'.::,:
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)11 - .
01
02
03
04
05
06- ,fin 0-�67 I 08 ` ° 09
10
11
Tag/ID
Assembly Type
Frame
Type
Frame
'Depth
(inches)
Frame
Spacing
(inches)
P;r- osedcp
Required
Comments
' v� Appendix JA4
[ (Iontinuous » Reference
Cavity 44 Insulation
R -value, R -value ^ s U,fagtor Table. Cell
U -Factor
C�RRC', oduct ID
Deck
nitial Solar Aged Solar Thermal. SRI Aged Solar Thermal SRI
Compliance
+ 4wo
Exception
h�. ryumber
du
oct Type
fig
Reflectance Reflectance Emittance- (Optional) Reflectance Ernittance - (Optional)
C. ROOF REPLACEMENT (Prescriptive Alteration, See"t, 150.2(b)1H) '
01 _
02
03
04 _
051{
06
0.7 _ 08 09. 10 11 12 13
R value
Proposed Minimum Required
Method of
Roof
C�RRC', oduct ID
Deck
nitial Solar Aged Solar Thermal. SRI Aged Solar Thermal SRI
Compliance
Pitc
Exception
h�. ryumber
du
oct Type
fig
Reflectance Reflectance Emittance- (Optional) Reflectance Ernittance - (Optional)
M ..
NOTESRoof
area covered by bb ilding integrated photovoltaic panels and solar the al panels are exempt
h
from the above Cool Roof requirements.
• Liquid field applied coatings must comply wi Ins10 tallatiori criteria from section 110.8(1)4.
v
Registration Number:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: -
HERS Provider:
June 2014
STATE OF CALIFORNIA '
•RESIDE,NTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 `
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations
Project Name: 2 Was
Date Prepared:
ENERGY COMMISSION
CF1R-ALT-01-E'
(Page 4'of 4)
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT ,,–A '
1. 1 certify that this Certificate of Compliance documentation is accurate and complete. All
Documentation AutMk
Documentation Au 5' to
f'
Company:
G. C�
signature Date: —
, Y►
a 5.1
Address:
5�`
CEA/ HERS Certification Idef ificatlo0f applicable): -
.
7r�. L1
e e
Cit /State/Zi
y
Phone:
f6 ,
U Q5
b .
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California:reuilidingNIIGAYNro�
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am'eligible under Division 3 of the Business and Professions Code to accept responsibili for ystemdesign identified on this Certificate of Compliance (responsible
designer).
3. That the energy features and performance specifications, materials,. componen—ts,, and manufactured d`eviee ,fog the building design or system design identified on this Certificate of
Compliance conform to the requirements of Title.24, Part 1 and Part tithe California Code of`Regulations.
4. The building design features or system design features identified on this Certificate of C641iance are consistent:.wlthttie information provided on other applicable compliance documents,
�s
worksheets, calculations, plans and specifications submitted ,to the enforcement agencyfor:approval with this building permit application.
13blb
5. 1 will ensure that a registered copy of this Certificate of Compllance,shfall be made;ava with the building permit(s) issued for the building, and made available to the enforcement agency
a registeredcopy of this
for all applicable inspections. I understand that—-ompliance is r ired'to be included with the documentation the builder provides to the building
owner at occupancy.�C �C,ertificateMof
_
Responsible Designer Name: �, . - t Responsible Designer Signature:
Company: '+fit -
Date Signed: • -
Address:
License:
City/State/Zip: ""
Phone:
04 x
For assistance or -questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
i
HERS Provider:
June 2014
Uc/. 9 6 9 7 9 8
79041 -Delta- Street Phone: 760)565-7006'
Bermuda Dunes, CA 92203 Fax: 760)200-1951
gmgordonroofing@gmaii.com
Name/Address,'
,
-John Klimkiewicz
77-318 Calle Temecula
La Quinta, CA 92253
Proposal
-,at
0'" oi
r a""'!bA
03/01/16
472
Project Name/Adres-s
-77-31-8 Calle Temecula
La Quinta; CA 92253
7.,
'T
.7lDescription
ax
ROOF REMOVAL: Tear -off one existing Built Up Roof from substrate. Inspect for any damaged
plywood. Remove and replace @ $45.00 per sheet as needed. Remove all roofing debris from
property.
ASPHALT SHINGLE ROOF: Install drip'edge metal around perimeter of roof using electro
9,450.00
galvanized nails. Install 2 -ply UDL fiberglass SBS modified base sheet. Install asphalt shingle starter
course around perimeter of roof using electro galvanized nails. Install 30 year Owens Coming
Duration asphalt shingles (Title 24 Compliant, Cool Roof Rated) mechanically fastened to substrate
using electro galvanized nails. Install high-profile decorative trim shingles at hip and ridge details. All
-electrical; plumbing., HVAC flashings, and attic vents to be installedwith shingles toinsure. proper
sealing of roof penetrations. Paint all electrical, plumbing, HVAC flashings, and attic vents with paint
color matched to shingles. i
Price includes: Drip edge metal, roof to wall metal, chimney saddle metal, and tin shingles.
BUILT UP ROOF: Install 4 ply built up roof system. Nail in place 2" cant strip in all angle details.
'Install-1--Oly of*Z61b. fiberglass base she'e't mechanically fastened to substrate with simp'le'x type
fasteners. Install gravel stop over 1 -ply of fiberglass ply sheet mopped with hot asphalt to base
sheet. Install all flashings. in a bed of plastic roof cement, nail, and primer using asphalt primer. Apply
2 -plies of fiberglass ply sheet to be solid mopped with hot asphalt at the rate of 25lbs. per 100 sq. ft.
per ply. Seal all roof penetrations 'including electrical, plumbing, and HVAC flashings. Mop in place
with hot asphalt 721b. mineral surface cap sheet in all angle and parapet wall details. Apply 1 -ply of
721b. mineral surface cap sheet to be solid mopped with hot asphalt at the rate of 25lbs. per 100 sq.
ft. as finished surface. Price includes standard galvanized gravel stop metal, removal of skylight and
plywood sheeting @ skylight detail.
WARRANTY: Roof to'receive 5 *Year warranty upon date of completion.
Acceptance 'Date
The Proposal described herein is yfor 60 days from the above date. 77-1
T A9.4 "
,450.00
Signature