BRER2015-0060Z
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BRER2015-0060
Td,v, 4 4 QuiKro
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property Address: 52595 AVENIDA DIAZ
APN: 773281017
Application Description: MOSEBROOK / REROOF SHASTA WHITE SHINGLES [CRRC: 0890-6002]
Property Zoning:
Application Valuation: $6,100.00
Applicant:
JESSE THE ROOFER
84503 CORTE CINDARELLA
COACHELLA, CA 92236
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.: 927830
Date: 25-1��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).:
(_) 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 impr6ements
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 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 N
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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.
1L9__ I have and will maintain workers' compensation insurance, as required by
Sec'Yio'n(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:— PolicyNumber:_
— 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 tabor Code, I shall forthwith
comply with those provisions.
Date Applicant:
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, 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 fro ' m 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
construetion, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
1-19
Date: nature (Applicant or Agent -
Date: 7/23/2015
Owner:
MICHAEL MOSEBROOK
52595 AVENIDA DIAZ
LA QUINTA, CA 92253
Ctj
Contractor*
CrD
c -
JESSE THE ROOFER
W3
84503 CORTE CINDARELLA
COACHELLA, CA 92236
(760)832-1670
Lic. No.: 927830
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.
1L9__ I have and will maintain workers' compensation insurance, as required by
Sec'Yio'n(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:— PolicyNumber:_
— 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 tabor Code, I shall forthwith
comply with those provisions.
Date Applicant:
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, 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 fro ' m 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
construetion, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
1-19
Date: nature (Applicant or Agent -
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
BSAS S81473 FEE
101-0000-20306
0
$1.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA
$1.00
$0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RE -ROOF - EA ADDITIONAL 1,000 SF
101-0000-42404
0
$11.60
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$49.31
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0
$98.62
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for RE -ROOF:
TOTALS:.0
$159.53
$0.00
0•
F'b OF
Description: MOSEBROOK / REROOF SHASTA WHITE SHINGLES [CRRC: 0890-0002]
Type: RE -ROOF Subtype: Status: UNDER REVIEW
Applied: 7/23/2015 SKH
Approved:
Parcel No: 773281017 Site Address: 52595 AVENIDA DIAZ LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 166 Lot: 4
Issued:
UNIT 17
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $6,100.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: REROOF WITH SHASTA WHITE SHINGLES [CRRC: 0890-0002] 2013 CALIFORNIA ENERGY CODE.
Printed: Thursday, July 23, 2015 1:42:57 PM 1 of 2
7Lz� 6J SYSTEMS
077
GO: ' 0 1 1 . 1
CF'y OF TNF' QEftmD
Printed: Thursday, July 23, 2015 1:42:57 PM 2 of 2
0M�� e...! SYSTEMS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS S81473 FEE
1 101-0000-20306
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
101-0000-42404
0
$49.31
$0.00
SF
RE -ROOF - FIRST 2,000
101-0000-42600
0
$98.62
$0.00
SF PC
Total Paid forRE-ROOF: $159.53 $0.00
TOTALS..0 00
Printed: Thursday, July 23, 2015 1:42:57 PM 2 of 2
0M�� e...! SYSTEMS
- -ar N
: entid Retrool CF -1
PrescriptWe Ow ticale of Resid R-ALT-ReRaof
",i
Product weight
< 5ttMtf? Z 51b182
�Ie Zone
Permit ft:
ROOiFNG PRODUCTS (COOL ROOFS) §151Mf2
When the ares ofexbrior rotsurAwe to be, rpftosd exceeds 50% of the exis*W roof are% or 1,000 if, utdchner b lose, Bre new
rt>od arse axmd , ear the raofiV raauct'Cod liooFmqukwnents oi§152(b)1#41i2lbrAlk or Mffirwa
Check applicable aftru tive or eoaception below if the root alteration is exempt from the roMkg prodtuct -coal Roor mquiremwb:,
❑ Cool root not tequip d to Climates pones 1-12.14, and 16 wAh a low sloped roof pitch(less or 212 pilch).
❑ Cool roofs mM regti ed it Curates Zones 1-3, and 16 widr asleep -sloped roots (greater pitch than 212] and product weight less than 510f.
Ab n dWn to §152(b)1Hi and §15@)x, ShXWwSlope trod 6 ffch a 2.14
❑ - Irerde0on wRr aOmmmal resislonce of at least 0.85 hW-I F/Blu or at least a 314 inch air-spme is added tea the roof deck over an attic; or
❑ Egos ft duds in the alit are irerided and seefeda000rd'ng to §151(1)10; or
❑ In drnele zones 1% 12 and 13. wkh 1 ff d tree venfildon area d attic verdation far every 150 fF d af6cfloor area. and
whereat least 30 percent d Ate tree venthfion area is vrihin 2 but d veftd dida nce d the roof ridge; or.
❑ Buidrtg has at best R30 c eifing itsubdon; or
❑ Buil ft has radiant bai far in the attic meebg the re*mffwft d f 15l MZ: or
❑ Buidrtg has redu cls in the alic; or
❑ In r' le zones 1% 11.13 and 14, R3 or greahm rod deck biwisdon above verged attic.
Exception to §154dr14k Lo+r4hW roof (,pAch S 2.12)
❑ Buildrtg has no ducts in the attic.
Omer 6coep6 , 4
❑ Rooting area is covered by bu l ft integrated; phalovollab panels and solar ihemtal panels are enoerr 11 from the Caol Boat alienia
❑ Rod eonsUucflons that have thermal mess over the root membrane vrth at least 25 bW are am roan the Cool Root orients
NOTE fi°any ane of ere aftinafts or a cieipdw is dmedE+ed Me Aged solar Rewe and Thermal Emftw a r6qu"vernents for mo ft
products in §118(1) are not aAdfcabla. Co not fll W* below.
-
CRRC Product 1D Nunberr
Ralf Slope
5 212 > 2:12
Product weight
< 5ttMtf? Z 51b182
Product , Aged Solar-
TyW Reieclarwe
Thermal
Ens lance
w
t)8 o, coo 2-
0
For asslsr ww-- or auesLians roaardhm the Emw Standards. en ad the Enernv Hodlne ad: IW0-772-3=
❑
0
45P14 Ir
0
2
:5 a Sf 6( w h
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a
1 0
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Note: a no CRRF1 I" is araffaW ant's eonyofia we method carrot be =4 use Me-ft*wmaroe AWwch to show oagatfaw%
t. The CMC Rod& V Namberaw be rbirted liar the Coat awaswu Ccunclik R819d Pt M*& Qi Cftyst II We
lirdk able the f�{JB dpradaeta be6p rued fiarthe rad taR pfY and aspfiatroaf rttebl IM9 eft
Mthe Aged RaMectanoe is riot atraifebb In Me God Aod ROW Ccuncft sebd Product Dkec W VM use the tnAiel aeMeciance wake fFam the same
drect qo w d um f o squabon (Q2hg_76%mo— Q.M b o6tein a cabAged a gad vafas ftw&p is M e kAW Sdw PIedectartoeL
_ Chedt bin f Vw Aged Aeffi1,rnGe is a ralr ubled vacua ratrg Mie eguaflot abom
(�lra/eb Mme Sfff vatoby using Me MN- lVadmhed at and e#ww Me resr#tg vane fn Mme Sat Cok m above and altafi
aogpyddwSfli- VAx* heetbMret2~1R
o apply Liquid Raid AppBed Coatings, the coating must be applied across the entire rod surtamce and meet the dry eel tticknnen or CWOUW
by the eaat'ings mannuiaMwer and meet ainhum performance requrernents fisted in §118()4. Select the appicabie coaling:
Asphalt Roof Coating O Cemreti-Based Rod Coating O Otter -
/NST€- When a Cod Rod is required the erwa ft oonnac or stuaf con pAM and submit ere CF 6R EW -01 far first lnspediai.
Deciafation Shienwit
• 1 cerWy oder pene9ty d pe*", under the Imes of On Stove of Cama. the it ww9la n provided on this form Is acerata and,
• t oet67y oral Are energryr teadxes atd peAomtanoe apecisca6orts lderd" an this Cerdkab d Canpiartoe cadam loft mluiements d 70924. Pada
1 and 6 of to Cdkffntia Code of PAgublonL
Nance:
� � 2i
Sigrrdlwe:
Se le A -z� °ate
Address: SC Co e- I.cermse� Z7�5a
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For asslsr ww-- or auesLians roaardhm the Emw Standards. en ad the Enernv Hodlne ad: IW0-772-3=
Find rated products - Cool Roof Rating Council Page 1 of 2
13 SEARCH RESULTS
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Manufacturer. Owens Coming Roofing and Asphalt, LLC
Primary product type: Steep Slope: Asphalt Shingles
PRINT EXPORT ALL PRODUCTS
CRRC PROD. ID
MANUFACTURER: BRAMD
PRWUCTTYPE
COLOR
SOLAR REIPLECTAMCE
THERMAL
EMITTANCE
AU
MORE '
MODEL
060
Initial
37ear
INtIaR
37=
hdtw
3Y-
0890.0001
Owens Commig Roofing and Asphalt,
Steep Slope, Asphalt
Bright White
oa7
0.29
i 0.89
j o.g2
z8
31
+
U.C. Classic(, Supreme®
Shingles
Shasta White
.'
r
i
#
1
0890-0005
Owens Coming Roofing and Asphalt,
Steep Slope: Asphalt
Tan
0.28
0.28
0.89
10.91
# 29
; 30
+
ILC: Duration( Premium
Shingles
1 -
Cool Shingles Frosted Oak
i
0890-04
Owens Coming Roofing and Asphalt,
Steep Slope: Asphalt
Grey
0-27
0.3D0.89
0.90
z8
32
+
I.I.C. Duration® Premium
Shingles
-
Cool Shingles Harbor Fog
;
08900003
Owens Coming Roofing and Asphalt,
Steep Slope: Asphalt
Green
o.28
0.29
0.90
o.88
j 29
;o
±
ILC: DuraborM Premium
Shingles
;
i
;
Cool Shingles Sage
08900006
Owens Corn and
Corning Roofing Asphalt,
Steep Slope: Asphalt.
Red, Orange
026
0.28
i 0.89
F 0.91
26
#
; 30
+
LLC Duration( Premium'
Shingles
Yellow,
-
Cool Shingles Sunrise
Multicolor
3
0890,OW2
Owers Coming Roofing and Asphalt,
Steep Slope: Asphalt
Bright White
o.26
0.28
0.90
0.91
27
30
+
LLL: midge®
Shasta Whirp
Shhnhgles
0890-0013
Owers Coming Roofing and Asphalt,
Steep Slope: Asphalt
Grey
0.20
pending
� o.9z
; perhding
= zo
pending
+
Oakridge(, TruDefinitiorO
Shingles
DuratiorO
Sierra Gray
I
I
G890-0014
Owens Coming Roofing and Asphalt,
Steep Slope: Asphalt
.Orange
0.23
pending
: 0.92
i Pig
; 24
pedl,
LLL: Supreme®
Shingles
S
Amber
08900mo
Owens Coming Roofing and Asphalt,
Steep Slope: Asphalt
Grey
0.20
pending
; 0..9z
; pending
zo
pending
+
LLC: Supreme(
Shingles,
I
Aspen Cray
a
08900008
Owers Coming Roofing and Asphalt,
Steep Slope Asphalt
Bright white
0.25
o.28
0.94
o.9h
; 27
30
+L1C
TruDefirrition( DuratimA
Shasta white
Shingles
o89o0oo9
Owens Coming Roofing and Asphalt,
Steep SIOpe: Asphalt
Orange
o.zz
pending
0.92
pending
i
u
i peeling
t
1
±
LLC TruDefmitionO Duratiorh(,
Shingles
Oakridge(
Amber
08900011 Owers Caning Roofing and Asphalt, Steep Slope: Asphalt Grey ozz Pendi,g 0.92 ped' z2 Pending {
LLC TruDefirdtion( Duration(, Shingles -
Oakridge(
Antique Saver
http://coolroofs.org/products/results 4/7/2015
Bin #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
COLO La Quinta, CA 92253 - (760) 777-7012.
�5--Building Permit Application and Tracking Sheet'
Permit #
2��
Project Address:SZs v i
Owner'sName:
A. P. Number:
Legal Description:
City, ST, Zip:
Contractor: 2_
�
T IePh0
Address: .e_ e- te �O
Project Description:
City, ST, Zip -.e OkCJ4 e C(A C—,O—
�� 0
T ne:
ele h a2 6�
�a d a � O0
State Lic. # / C63D City Lic. #:
Any p p� —. l� °j
Arch., Engr., Designer:
Address:
City., ST, Zip:
9C -A 0 (d
Telephone:
.Con
struction Type: Occupancy-.
Y
State Lic.
Demo .
Project New Add'nAlter Repair.airD
nP (circle one)N
Name of Contact Person:
Sq. Ft.: DO
1 # Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
tl I
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 Cafes.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2pd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
I-I.O.A. Approval
Plans resubmitted
Grading
IN I{OUSE:-
7id 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
J