10-0371 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00000371
Property Address: 52608 AVENIDA DIAZ
APN: 773-282-005-19 -000000-
Application description: RE -ROOF
Property Zoning: COVE RESIDENTIAL
Application valuation: 9757
T&�144vQ"
Applicant: Architect or Engineer:
yip
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of th iness and Professionals Code, and my License is in full force and effect.
Licens�ss:99 LicenseNo.: 810537
ate:ractor:
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 �I
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 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 Law3.
(_) 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 Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/29/10
Owner:
LA QUINTA REDEVELOPMENT AGENCY
78495 CALLE TAMPICO
LA QUINTA, CA 92253
Contractor: D
ROOF TILE SPECIAL C. tt U A
P.O. BOX 11257 ! iA(U v 20110
PALM DESERT, CA 92 55
(760) 200-0811 Ct7�!!;F I AkQUINTA
Lic. No.: 810537 mo_AzICE!)ePT_.__-_-.
-----------------------------------------------
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 238-0009889-10
_ 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,
�niree that, if I s e subject to the workers' compensation provisions of Section
�^ �o Labor ode I shall fo with comply with those prov' Il pplicanr.
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 ($100,0001. 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 ounty ordinances and star relating to building construction, and hereby authorize representatives
oft 's cc�yjt�,�terupo the abv -men d property for inspection purposes.
ate: I`/ ignature (Applic t or Agent):
Application Number . . . . . 10-00000371
Permit . .
. RE -ROOF
Additional desc .
Permit Fee . . .
. 30.00
Plan Check Fee
.00
..Issue Date . . .
- Valuation . . .
. 0
Expiration Date .
.• 10/26/10
Qty Unit Charge
Per
Extension
BASE
FEE
30.00
----------------------------------------------------------------------------
Special Notes and
Comments
RE -ROOF WITH LIGHT
WEIGHT CONCRETE TILE.
2007 CODES.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged
--------------------
Paid Credited
--------------------
Due
-----------------
Permit Fee -Total
30.00
.00 .00
30.00
Plan Check Total
.00
.00 .00
.00
Other Fee Total
1.00
.00 .00
1.00
Grand Total
31.00
.00 .00
31.00
LQPERMIT
Prescriptive Certificate of Compliance: Residential Reroof CF-1R-ALT-ReRoof
Pro ect Ad ress:
-�R VC IPA Z
Climate Zone
Permit # '
ROOFING PRODUCTS (COOL ROOFS) §151(012
When the area of exterior roof surface to be replaced exceeds 50% of the existing roof area, or 1,000 ftp, whichever is less, the new
roofing area must meet the roofing product "Cool Roof' requirements of §152(b)1Hi, 152(b)1Hii, or 152(b)1Hiii.
Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof" requirements::
❑ Cool roofs not required in Climates Zones 1-12, 14, and 16 with a low sloped roof pitch (less or 2:12 pitch).
❑ Cool roofs not required in Climates Zones 1-9, and 16 with a steep -sloped roofs (greater pitch than 2:12) and product weight less than 54b/ft2.
Alternatives to §152(b)1 Hi and §152(b)HIi, Steep -slope roof (pitch > 2:12)
❑ Insulation with a thermal resistance of at least 0.85 hr-f?-°F/Btu 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(010; or
❑ In climate zones 10, 12 and 13, with 1 ft2 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(02; 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)1 Hili, Low -slope roof ( pitch 5 2:12)
❑ Building has no duds in the attic.
Other Exceptions
Cl Roofing area is covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the Cool Roof criteria.
❑ Roof constructions that have thermal mass over the roof membrane with at least 25 Ib/ft2 are exempt from the Cool Roof criteria.
NOTE: If any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Emittance requirements for roofing
products in §118(1) are not applicable. Do not fill table below.
NOTE: When a Cool Roof is required, the installing contractor shall complete and submit the CF -6R -ENV -01 for final inspection.
Declaration Statement
Roof Slope
Product Weight
Product
Aged Solar
Thermal
City/State/Zip: ' � Phone:
CRRC Product ID Number'
S 2:12 > 2:12
< 5lb/ft2 z 5lb/ft2
Type 2
Reflectance3A
Emittance
SRI 5.
❑
❑
❑
❑
❑4
❑
❑
❑
❑
❑4
Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance,
1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs.orrm/nroducts/search.nhn
2. Indicate the type of product is being used for the rooftop, 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(pn1yw — 0.2) to obtain a calculated aged value. Where p is, the Initial Solar Reflectance.
4. Check box if the Aged Reflectance is a calculated value using the equation above.
5. Calculate the SRI value by using the SRI- Worksheet at httn://www.enemy.ca.aovAitle24/and enter the resulting value in the SRI Column above and attach
acopy of the SRI- Worksheet to the CF -1R.
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 ❑ Other
NOTE: When a Cool Roof is required, the installing contractor shall complete and submit the CF -6R -ENV -01 for final inspection.
Declaration Statement
• I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is accurate and complete.
• I certify that the energy features and performance specifications identified on Certificate of Compliance conform to the requirements of Title 24, Parts
1/,and 6 of the California Code of Regulations.
Na n 1
Signa ur
Company: �— Date:
P. :ss: (1 j –\� , License: Si 1 5
City/State/Zip: ' � Phone:
For assistance or questions regarding the�nergy Standards, contact the Energy Hotline at: 1-800-772-3300.
Bin #
Permit #P.O.
A11 t
��
Project Address:_
City of La Quinta
Building & Safety Division
Box 1504, 78-49S Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
lD�Ave- l � Owner's Name:
A. P. Number: -7
a 8. _ 005
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone: ..
Address:
Project Description:
City, ST, Zip:
Telephone:'•.::s�aY
r
State Lic. # :
City Lic. #:
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
. Project type (circle one): Now Add'n Alta Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: Estimated Value of Project: C1 .9� 9 00
APPLICANT: DO NOT WRITE BELOW THIS LINE
FSu Req'd Recd TRACIUNG PERMIT FEES
Plan Check submitted ItemAmount
l Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Cates.
Caned Contact Person Plan Cheek Balance.
Tide 24 Cala.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2'' Review, ready for correetionVissue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
M HOUSE:
''' Review, ready for correctionsrmue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees