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BRER2015-003178-495 CALLE TAMPICO LA QUINTA, CALIFORNIA Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: . DANIEL DUENAS . 78635 AVENIDA TUJUNGA LA QUINTA, CA 92253 78630 AVENIDA TUJUNGA 770092009 DANIEL DUENAS REROOF $4,597.00 APP, 0 7 2015 CITY OF LA QUINTA 4wVOICE (760) 777-7125 FAX (760) 777-7011 DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 WILDING PERMIT Date: 4/7/2015 Owner: DANIEL DUENAS _ 78635 AVENIDA TUJUNGA LA QUINTA, CA 92253 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: License No.::CONV:140528101254137249 J( I 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 Divisio of the Business and Professions Code) or that he or she is exempt therefrom and th basis for the alleged exemption. Any violation of Section 7031.5 by any applicant r permit s bjects 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.). ( ) 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 Contractor: DANIEL DUENAS /OWNER BUILDER 78635 AVENIDA TUJUNGA LA QUINTA, CA 92253 (760)564-9745 Llc. No.::CONV:140528101254137249 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: _ 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 provisions. Pate: 4 r Appll �- c' 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 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, indemnity 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. Z. 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 represe?.thtes of this ciW-Yo enter upon the above- rtlentioned property.for inspection purpos I/ r Pte: �^L Signature (Applicant or Agent): STATE OF CALIFORNIA . RESIDENTIAL ALTERATIONS CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E Prescriptive Residential Alterations (Page 4 of 4) Proiect Name: Date Prepared: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 'r 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signat e Company: Signature Date:j ° `l\"^8�5 Address: CEA/ HERS Certification (dent ficatiioir(if applicable): City/State/Zip: hone: 4411..1'� J RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 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 respons)b for the building desi nor system design identified on this Certificate of Compliance (responsible designer). for building design design identified this Certificate 3. That the energy features and performance specifications, materials, components and' manufacture9d'e5ices the or system on of y .A 0 A W - Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code ofiRegulations. ,� 4. The building design features or system design features identified on this Certificate of Com ,Dance are consistent withhe information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to t ti enforcement agen��cy�fohapproval with th Wb�ull`ding permit application. 5. 1 will ensure that a registered copy of this Certificate of Co ppliannce,,0aII be made available with the buildding permlt(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registeredcop,,yy of this Certificate oaf *Compliance is require to be included with the documentation the builder provides to the building owner at occupancy.,, Responsible Designer Name:. lip Responsible er Signature: Company: "r Date Signed: Addres—s:� 0License: w y "�. City/State/Zip: V Ph ne: ' For assistance or -questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. Registration Number: Registration Date/Time:HERS Provide: CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E Prescriptive Residential Alterations (Page 1 of 4) Proiect Name: Date Prepared: U --I A. GENERAL INFORMATION 01 02 01. Project Name: 02 Date Prepared: --I 03 Project Location: Z - -� , G �v �ti �G 04 Building Front_Ortientation"(deg or cardinal): 05 CA City: L 06 Number of AI`te ed;Dwelling Units: 0, 07 Zip Coder Z 08 Fuel Type: t( A %*� IX -,p4,,, 09 Climate Zone: 10 Total,Con'dj1R ned FlooraA?ea (ft.2)-:� 067 :11 1 Building Type 6_ 12 S1ab;'Ar0(h2) � v 13 1 Project Scope: I (j"'4 B. BUILDING INSULATION DETAILS (Section 150.2(b)1) '0'. *%, 01 02 03 04 05 06 1. 07 1 08, 'x, 09 10 11 Tag/ID Assembly Type Frame Type. Frame Depth (inches) Frame Spacing (inches) ,Pr9po ed aty Required Comments v p ` dCtontinuous �' Cavity Insulation R-value,q R -value! r Ufactor Appendix 1A4 Reference U -Factor Table Cell Number w product Type , ,; Insulatoh Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional) cc ob 101'Slli' G-i.L' �a d n t d�1� NOTES - ' • Liquid field applied"coatings must comply with installation criteria from section 110.8(1)4. v C. ROOF REPLACEMENT (Prescriptive Alteration, SSeec-t 'n'AY6.2(b)1H).�1-0-Is "o `'t' 01 02 03 04 05'S, 06 'O7 08 09 10 11 12 13 R -value Pro osed Minimum Required Initial Solar Aged Solar Thermal SRI Aged Solar Thermal SRI Method of Roof CRRCl rod D u e k `' Compliance p Pitch Exception p Number w product Type , ,; Insulatoh Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional) cc ob 101'Slli' G-i.L' �a d n t d�1� NOTES • Roof area covered�by, bu ilaig-integrated ph'Otovo� ic-panels and -solar thermal panels are exempt from the above Cool Roof requirements. • Liquid field applied"coatings must comply with installation criteria from section 110.8(1)4. v Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 • r, ri, - '`• �� t, t Vin•' } rr- r '" S, - „^ . ' � � y ;C r`• t r P t ; r Al •- 4'. v • � Fos (, �.., :,°° ,r' •n.�. �,r 1 -. '� - a o }�. � a �� . f � ? -” A , `J j' •1.r. 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BOX 1504 LA QUINTA,; CALIFORNIA 92247-1504 BUILDING'& SAFETY DEPARTMENT 78.-495 CALLS TAMPICO e (760) 777-7012 LAjQUINTA, CALIFORNIA 92253 FAX (760) 777-7011 PROPERTY OWNER'S PACKAGE Disclosures & Forms for Owner -Builders Applyi,ngfor. Construction Permits IMPORTANT! .NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submittgdyou; name listing, yourself the builder of the property improvements specified at .Z — C3 .,�.;L R • ",7 c� t We are providing you with an Owner -Builder Acknowledgment. and Info on V�ficati n orm to make you aware of your responsibilities and possible risk you may incur by:having this permit issued in your name as the ` , Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this'forrri to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. t OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner;Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as, an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as'an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 9 4 2. 1 understand building permits' are not required to be' signed by property owners • unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. �)�3. I understand.as an "Owner -Builder" I am the responsible party of record on the permit.. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor.and having the permit filed in his or her name instead ofmy own. , fi 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer,' under state and•federal law. 6. I understand if I am considered an."employer" under state and federal law, I.must register with the -state and- federal government, withhold payroll taxes,* provide workers' compensation disability insurance, and 'contribute to •unemployment '' compensation for each"employee." I• also -understand my fai risk. lure to abide by,these laws may subject me to serious financial _7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential. structures cannot legally build them with the intent to offer them for sale, unless all work is performed by .licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor: 8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. bl�) 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. D�) 10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially - esponsible for proposed construct io activity the following address: _L C 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all .applicable laws and requirements that govern Owner -Builders as well as employers. q12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors. are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Signature of property owner _ ��p� Date: L-1 Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project: Scope of Construction Project (or Description of Work): M `J Project Location or Address: _ �( (cif' Q L�w��� �� 1 Ll Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy: Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency 4 required to be presented when.the permit is issued to verb the.property owner's signature. Property Owner's Signature:a '—.T Date: Bin�f Permit # _ Address: l rrf f City of La Qui ta. La Building 8t: Safety Division P.O. Box 1504, 78-495 Calle ,Tampico . ° La Quinta, CA 92253 - (760) 777-7012 Building Permit, Applica tion and Tracking-Sheet- owner's Owner's Name: -' A. P. Number: Address: (,So Legal Description: City, ST, Zip: ntract r Co o . cic h �•�E S T o 1• P .p l Address: "Z l ,(d (D Project Description: City, ST, Zip: C.` L! `�� ���� C C4 _ .C- Telephone: n• b , State Lic. #.: City Lie. #; Arch.,.Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: :#ri<::<:;<; •v:.'::_<;>><::;: '` .: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: 2 y # Stories: # Units: Telephone # of Contact Person_t O>: : C•1 q Estimated value of Projcc . ,APPLICANT: DO NOT WRITE BELOW THIS LINE _ # -Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sets PIan Checksubmitted Itcm Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance • Title 24 Calcs. Plans picked.up Construction Floodplain plan Plansresubmitted M,cchanical' Grading plan 2pd Review, reidy for corrections/issue . Electrical Subcontactor List ,Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. Ii.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'rd Rcyiew, ready for eorrcctionsfissue Developer Impact Fee Planning Approval Called, Contact.Person A.I.P.P. Pub. Wks. Appr Datc of.permit issue } School Fees Total rcrmit Fccs FINANCIAL INFORMATION 6UN "!c`lf,�PAIW �'"0'-. PAID, DATE� .141 BSAS SB1473 FEE 101-0000-20306 0 '$1..00 $0.00 B Y' 5 METHOD? .CHECK LTD s , Ap Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00. $0.00 ESCRWTIO I N' 'Tt�"t"tACC OLINTAK f OUNT PAID rd t, OA D: DATE= 4, RE -ROOF - FIRST 2,000 SF 101-0000-42404. 0 $49.3i' $0.00 P-4 I e6 RECEIPT V. " `CHECK CLTD RY.;, M�TFtqp� 7. ';i6 u DE CRIPTION 41 AC C AMOUNT- �q, DATE :PAID -DATE' .0 RE -ROOF FIRST 2,000 SF PC 101-0000-42600. 0 $98.62 "$0.00 J ► 1, !0 ]tomr .; - '7 CLTD' 4t Total Paid forRE-ROOF: $147.93 '$0.00 TOTALS: $148.93 $0.00 Description:i DANIEL DUENAS REROOF CONDITIONS Type: RE -ROOF' Subtype: Status: UNDER REVIEW Applied: 4/7/2015 PJU Approved: Parcel No: 770092009 Site Address: 78630 AVENIDA TUJUNGA LA QUINTACA 92253 Subdivision: DESERT CLUB TR UNIT 5 Block: Lot: 21 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $4,597.00 Occupancy Type: Construction Type: - Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 j k6S,fi� Details: RE -ROOF 1200 SUARE FEET PER 2013 CALIFORNIA BUILDING CODES. APPROVED PER JF. TE to 1 '1501, F_Imt ADDITIONAL SITES CHRONOLOGY CONDITIONS CONTACTS � N-AAh- i.� 6 j k6S,fi� Cl TE I APPLICANT DANIEL DUENAS 78635 AVENIDA TUJUNGA LA QUINTA CA 92253 (760)564-9745 CONTRACTOR DANIEL' DUENAS / OWNER BUILDER 78635 AVENIDA TUJUNGA LA QUINTA �CA 92253 (760)564-9745 OWNER DANIEL DUENAS 78635AVENIDA LA QUINTA CA 92253- (760)564-9745 7. TUJUNGA, FINANCIAL INFORMATION Printed: Tuesday, April 07,'2015 12:28:53 PM 1 of 2 SYSTEMS r-`77-77-7777- P e'mit Details, PERMIT NUMBER _bQ, 151 �i 4 6 �oi I: - B La Quifita'_ FINAL" BLDI 1, PARENT PROJECTS itEVIE , �=k iREVIEWER 7 kS5MI I K I BOND INFORMATION ATTACHMENTS Printed: Tuesday, April 07, 2015 12:28:53 PM 2 of 2 Cffw.1YSTEm*S 7 INSPECTIONS SE 1P I SPE I N, P T. SCR I COUNT;-. '1-4 PRE -ROOF' P I D PAID -DATE� ECEIPT E. ETHOD1 D. BSAS SB1473 FEE 101-0000-20306 0 $1.60 1 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0..00 BSA: RE -ROOF -FIRST 2,00.0 101-0000-42404 SF' .0 .$49.31' .$0.00 `RE -ROOF - FIRST 2 000 101-0006-42600 0 $98iU $0.00 SVPC- Total Paid for RE -ROOF: $147.93 $6.00 TOTALS: $148.93 $0.00 FINAL" BLDI 1, PARENT PROJECTS itEVIE , �=k iREVIEWER 7 kS5MI I K I BOND INFORMATION ATTACHMENTS Printed: Tuesday, April 07, 2015 12:28:53 PM 2 of 2 Cffw.1YSTEm*S INSPECTIONS SE 1P I SPE I N, P T. PRE -ROOF' BLD FINAL" BLDI 1, PARENT PROJECTS itEVIE , �=k iREVIEWER 7 kS5MI I K I BOND INFORMATION ATTACHMENTS Printed: Tuesday, April 07, 2015 12:28:53 PM 2 of 2 Cffw.1YSTEm*S