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13-1243 (RR)
P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00001243 Property Address: 53345 AVENIDA VALLEJO APN: 774-082-025-6 -000000- Application description: RE -ROOF Property Zoning: COVE 'RESIDENTIAL Application valuation: 3500 Applicant: Architect or Engineer: 1 ��l V _ ------------------ LICENSED CONTRACTOR'S DECLARATION 44 BUILDING & SAFETY DEPARTMENT'�•• BUILDING PERMIT I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 fcommencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: fC39 License No.: 92783 Date: / C Contractor: — `" OWNER -BUILDER DECLAR ION 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 (5500).: (_) 1, 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 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 contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 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 Owner: HARTMAN RUTH 53345 AVENIDA LA QUINTA, CA (760)564-3375 VALLEJO 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/30/13 Contractor: JESSE THE ROOFER 84503 CORTE CIND. COACHELLA, CA 92 (760)832-1670 Lic. No.: 927830 -----------------------------------=----------- WORKER'S COMPENSATION DECLARATION 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. J H 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 9020742 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 0 of the Labor Yode, I shall forthwit� with ose provisions. ' Date: (() Applicant: 5� 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 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 county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned propelty for inspection purposes. Date: !'�}_ Signature (Applicant or Agent) Application Number 13-00001243 Permit RE -ROOF Additional desc.. Permit Fee . . . . 48.62 Plan Check Fee .00 Issue Date . . . Valuation . . . . 0 • Expiration Date 3/29./14 Qty Unit Charge Per Extension 1.00 1 48.6200 LS MISC RE -ROOF, 1ST 2000 SF 48.62 ----=----------------------------------------------------------------------- Special Notes and Comments REROOF WITH SHINGLES - SHASTA WHITE COLOR [CRRC_: 0890-00021 2010 CALIFORNIA ENERGY CODE. Other Fees . . . . . . . . . PLAN CHECK, RE -ROOF 97.24 Fee summary Charged Paid Credited Due ----------------- -- -- Permit Fee Total 48.62 .00 ---------- .00 48.62 Plan Check.Total .00 .00 .00 :00 Other Fee Total 97.24 .00 .00 97.24 Grand Total 145.86 .00 .00 - 145.86 LQPERMff Bin # city of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit.# Project Address: 73__��VC ex )D z% wner's Name: gU a A. P. Number: Address: 53 32e Legal Description: City, ST, Zip: Contractor:Tele hone: P :........: Address: CO C, , e �� Project Description: �(J City, ST, Zip: t-0 %4(�* eC 614 — t?GY r►'' D � Telehone: P 26a / 2v <>.i::<.� � <«:>;.:::::;•:: ::....: •:.:�: ::::..::...::::::.:.: : ::.::::.::.:: . State Lie. # : q2 7E •j 0 City Lie. #; J D S 5 7 Q2•S ex�%� Arch., Engr., Designer: �' e Address: 94�-(a 0 'g -j L11 City., ST, Zip: Telephone: P :>; :>;>::>>.:>.::»:•;:::.;;;:.>:'; ::;; :;:<:.. Construction Type: Occupancy: i;:;G:� ��� 2i}::•::i:SLv r \.i:•} �•::::,'::{•iiiii}ii'•i:0:(•: State Lic. #: :;: :.:>::;;;;>;r:;;»;>;:<;< Project type circle one): New Add'n Alter Repair Demo Name of Contact Person: IVe d Lo Sq. Ft.:/d # Stories: # Units: Telephone #,of Contact Person: j,�a6 Z Estimated Value of Project: 3 5 0.0 APPLICANT: DO NOT WRITE BELOW THIS LINE N 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 Calcs. 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:- '"' 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 57 6-30AL i-rescnptive certificate of Compliance: Residential Reroof Project Address: `� 1 Climate Zone ROOFING PRODUCTS (COOL ROOFS) §151(1)12 When flue area of exteriorroot surface to be replaced exp rooflng area must meet the mofng product Cool Roof" Chedc applicable alternative or exceatfon below if ifip rn,f f of Lie existing roof area, or 1,000 ir, whichever s- less; the new nts of§1S2(br1H1,1S2(b)1M1, or 1521b)1MD. ❑ Cool roofs rat required in Crmlates Zones 1-12,14, and 16 with a low sloped roof pitch (less or 212 pitch).-- ❑ Cool roots not required In Climates Zones 1-9, and 16 with a steep -sloped roots (greater pteh.than 2:12) and product weight less than SWe. Alternatives to §152(b)1HI and §152(b)Ml, Steep -slope roof (pitch> 2:12) ❑ hailation with a thermal resistance of at least 0.85111'e ` il3tru or at least a 34 inch air ❑ -space is added to the roof deck over an attic; or l�hostirrg duras in the attic are insulated and sealed•aecord'mg to §151(f)10; or ❑ In climate zones 10,12 and 13, with 1 f? of free ventilation area of attic ventilation for every 150 tt of attic floor area. and where at least 30 percent of the free ventilation area is wittim 2 feet vertical distance of the roof ridge; or . ❑ Budding has at least R-30 ceiling insulation; or ❑ Budding has radiant barrier in the attic meeting the requirements of §151(f)Z or ❑ Building has no duds in the attic; or ❑ In donate zones 10,11,13 and 14. R-3 or greater roof deck insulation above vented attic. Exception to §152(b)1 Hiu, Low -slope roof ( pitch <_ 2:12) ❑ Budding has no ducts in the attic. Other Exceptions ❑ Roofing area is covered by budding irhtegrated; photovoltaic panels and solar thermal Panels are exempt from the Cool Roof criteria ❑ Roof construdiorhs that have thermal mass over fee roof membrane with at least 25 bV are exempt from the Cool Roof criteria. NOTE: If any one of the altemffiives or e=Mdon is chunked the Aged Solar Reflectance and Thermal Emittance products in §1180 are not applicable. Do not Ni table below. requirements for roo6rrg Roof Slope CRRC Product ID M mberr <- 2:12 > 2:1 .Sha- aC Whh e- ❑ a 8 --- o© a Z ❑ ❑ < bmw > — Aged Solar _ I Thernal ❑ ❑�#0 4 D 13 ❑4 Note: ff no CRRC-1 label is available, this oompllance ffwb'Wd cannot be usec( use the performance Approach to show co The CRRC Prodt,ct ID Number can be obtained horn the Cool Root ' Wcate the type d podurx is being used for the roof Raung Coruwrs Rated Product Duectoyat www.g fop, r e si vis/ ty roof, Wow Md. metal roof, etc It the Aged ReBectww is not avar7aNe in the Cool Roof Raft Councft Rated Product Dbedary then use the InOW Reflectance value from the same dfrecYory and use the equation (0-2+0,7(pawo- 0.2) to obtain a a/dAm-d aged value. Where p is the ur&d Solar Reflectance: Check box ifft Aged Reflectance is a cakutafed value using the equation above. CabuWe the SRI value by using the SRI- Worlsheet at ht0olMmrw enerov oo"6;"-"'and enterthe resulting value in Me SRI Column abkme and attach acopyof the SRI- Workslreet to the CF -1R D apply liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry and thiolmess or covers commended by the coatings manufacturer and meet mirdmum performance requirements listed in 118 r Select the § C14- applicable coating: (Alm minum-Pigmented Asphalt Roof Coaling ❑ Cement -Based Roof Coating O Other SRIs -3D a Coo] Roof is requilsA the installing contractorshall complete and 1 cwt fy under Penft of perjury, under the laws of the Slate of CaNDMia, the information provided on this form is accurate and complete. • 1 and 6 of the California ofReR�fati rrnance ons identified on this Certificate of Compliance conform to the requ�rne+>TS of Title 24. Pans J �S s e /�%�iAJ� 2— 1-ignature: Company:- Address: ompany:Address. '5'415 0 3 co r -7-e c" da Crt,,lstatel4p. C6146-lv e C,�A,_ C -/V - Date: q: 'R -,) — j g2/-?e63D: >r6a For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772 .'100.