14-0291 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
14-00000291
Property Address:
52569 AVENIDA VALLEJO
APN: '
773-292-015-3 -000000-
Application description:
RE -ROOF
Property Zoning:
COVE RESIDENTIAL
Application valuation:
3760
cei444Q"
Applicant: Architect or Engineer
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Cha o+w+ewsiag with
Section 7000)_of Division 3 of the Ikusiness and Professionals Code, and cense is in full force and effect.
Date:
42 21 9014
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.).
(_) 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 contractors) licensed
pursuant to the Contractors' State License Law.).
( .) I am.exempt under Sec. , BAP.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
OF LA 01UNTA
Owner:
BRYL
52569 AVENIDA VALLEJO
LA QUINTA, CA 92253
(701)430-6947
Qontractor:
I
OOF TILE SPECIALTY INC.
O. BOX 11257
�AIALM DESERT, CA 92255
760)200-0811
ic. No.: 810537.
-VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/21/14
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 1969351-2012
certify that, in the performance of the work for which this permit is issued, I shall not employ any
p rson in. any manner so as to become subject to the workers' compensation laws of California,
n ree that, if I should b es a sub' the workers' compensation provisions of Section
p0 'of the La ode, Ih or with comp those provisions.
D\ App scant:
WAR ING: 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 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 performedunderor 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 ave read this application and state t he above information is correct. I agree to comply ith all
city and cou�t ordinances and state laws relating t b 'Idin constru cd„hEL�by authorize represe tives
of i count t (ethter upon the above-mentioned pr ate
purposes.
Dat �1 Sign ure (Applicant or Agern
Application Number . . . . . 14-00000291
Permit--RE-ROOF
Additional desc-.
Permit Fee 48.62 Plan Check Fee
.00
Issue Date . . . . Valuation
0"
Expiration Date 9/17/14
-'Qt"y Unit -Charge Per
Extension
1.00 48.6200 LS MISC RE -ROOF, 1ST 2000 SF
---------------------
48.62
------------------------------------------------
Special Notes and Comments
RE -ROOF - REMOVE EXISTING ALPHALT
SHINGLES, INSTALL NEW 30 YR. SHINGLE
OVER PREPARED ROOF SURFACE (CRRC:
0850-00141 2013 ,CALIFORNIA BUILDING
CODES.
-------------=------------------------------------------------
Other Fees . . . . . . BLDG STDS ADMIN ,(SB1473)
--------------
1.00
PLAN CHECK, RE -ROOF
97.24
Fee summary Charged Paid Credited
- --- ---------- ---------- ---------- ----------
Due
-------------
Permit Fee Total 48.62 .00 .00
48.62
P1an,Check Total .00 00 .00
.00
Other Fee Total 9.8:24 .00 .'00
98.24
Grand Total 146.86 .00 .00
146.86
LQPERMIT
Bin #
City of La Quinta
Building U Safety'Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
ftildin Permit Application and TrackingSheet
Permit #
I
1
,l
Project Address: 5 510 o
Owner's'Name:
A. P. Number:
Address: \ ON lt"-*�t �Lo h
Legal Description:
Contractor:
� c�
City, ST, Zip:
Telephone:
Address:Vo p( I `L S %
Project Description:
City, ST, Zip: ��. p�
Telephone: 00
State Lic. # : ` . D 1
City Lic. #.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
p
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:.,....:;•:.::::.::.>:.:::..••:.:;::::;
:.
Construction Type: Occupancy:
i
State Lc. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:166V
# Stories:
1
# Units:
Telephone # of Contact Person: 2co M U I
Estimated Value of Project: D
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21" 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:-
'"' Review, ready for correctionsrssue
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 CF -IR -ALT
Residential Alterations Page 3 of 5
Project Name: �l/� � ' /� Climat Zoite # # of Storie.1s
ROOFING PRODUCTS (COOL ROOFS) §151(f)12
When the area of exterior roof surface to be replaced exceeds more than 50% of the existing roof area, or more than 1,000f12, whichever is
less, the new roofing area must meet the roofing product "Cool Roof'requirements of§152(b)IHi, 152(b)IHii, or 152(b)IHiii.
Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof' requirements. Note: #Jany
one of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in
§/ 18(i) are not applicable. Do not fill table below.
❑ Cool Roofs Not Required in Climate Zones 1-12, 14, and 16 with a Low Sloped. Less or 2:12 pitch.
❑Cool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep -Sloped Roofs (pitch greater than 2:12) and product unit weight less
than 51b/ft2.
Alternatives to §152(b)IHi and §152(b)Hii, Steep -slope roof (pitch >2:12)
❑ Insulation with a thermal resistance of at least 0.85 heft •°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)10; or
❑ In climate zones 10, 12 and 13, with 1 ftZ 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(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)1Hiii, Low -slope roof (pitch 52:12)
❑ Building has no ducts in the attic.
Other Exceptions
❑ Roofing area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria.
❑ Roof constructions that have thermal mass over the roof membrane with at least 25 lb/ftZ is exempt from the below Cool Roof criteria.
Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwise,
Check the applicable box below:if Exem t from the Roofing Products "Cool RoofRequirement:
Roof Slope
Product Weight
Product
Aged Solar
Thermal
CRRC Product 1D Numbcri
<_ 2:12 > 2:12
< 5lb/ft2 >_ 5lb/ft2
Type Z
ReflectanCeM
Emittance
SRIS
5� _ o
❑
�-
13❑
ss;n�
❑4
❑
Cl
❑
❑
❑4
❑
❑
❑
❑
❑4
❑
❑
❑
❑
❑4
1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council s Rated Product Directory at winv. coolroafs.org/produclslsearch.php
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(pi„i,iQt— 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance.
4. Check bar if the Aged Reflectance is a calculated value using the equation above.
5. Calculate the SRI value by using the SRI- Worksheet at hilpWinviv.ener .ca.gov/ritle241 and enter the resulting value in the SRI Column above and anach acopy of
the SRI- Worksheet to the CF -IR.
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
TE30ther
Registration Number:
2008 Residential Compliance Forms
Registration Date/Time: HERS Provider:
August 2009