12-1479 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
12-00001479
Property Address:
53650 AVENIDA DIAZ
APN:
774-112-028-20 -000000-
Application description:
RE -ROOF
Property Zoning:
COVE RESIDENTIAL
Application valuation:
1500
Applicant: / Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
4
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 the Business and Professionals Code, and my License is in full force and effect.
License Class: License No.:
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 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
a pplicant 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
l _) I am exempt under Sec. , B.&P2r this reason
Date: I az z& ci
' I 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: 12/27/12
Owner:
MCCLURE TIMOTHY
536.50 AVENIDA DIAZ
LA QUINTA, CA 92253
(
EF1N0APdCEc
Contractor:U11
OwnerQUINTA
DEET.
-----------------------------------------------
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 becy,me subject to the workers' compensation provisions of Section
I
3700 of the Labor C�/h�Or�hyvut comply with those provisions.
Date: % ,Applicant: f /G��
WARNI G: 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 followingissuanceof 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 country toenterupon the above-mentioned property for I p &ion purposes.
Date' G� / 17q ignature (Applicant or AgentC�/1/ r'
Application Number . . . . 12-0.0001479
Permit . . . RE -ROOF
Additional desc .
Permit Fee . . . . 30.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 6/25/13
Qty Unit Charge Per
Extension
BASE
FEE
30.00
----------------------------------------------------------------------------
Special Notes and Comments
RE -ROOF REPAIR ROOF 240 SQUARE FT
EXEMPT
FROM COOL ROOF REQUIREMENTS. 2010
CODES.APPROVED.PER G.B.
----------------------------------------------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
--------------------
Paid Credited
--------------------
Due
-----------------
Permit Fee Total 30.0.0
.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 -1 R-ALT-ReRoof
Project Address- _
J 3a51AzL
Climate Zone
Permit #
ROOFING PRODUCTS (COOL ROOFS) §151(f)12 [/ \
When the area of exterior roof surface to be replaced exceeds 50•/ of the existing roof area, or 1,000 ft`, 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 lis 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 5/lblft
Alternatives to §152(b)l Hi and §152(b)Hii, Steep -slope roof (pitch > 2.12)
❑ Insulation with a thermal resistance of at least 0.85 hr-ft2. IF/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 �A
Building has radiant barrier in the attic meeting the requirements of §151(02,, or 1�-
f^' 2�0 5 1
❑ Building has no ducts in the attic; or IK •CO
In climate zones 10, 11, 13 and 14, R-3 or greater roof deck insulation above vented attic.
Exception to §152(b)l Hiii, Low -slope roof ( pitch <_ 2:12) V l µ•� �5
❑ Building has no ducts in the attic.i?va �Nt
Other Exceptions , Z
❑ 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 SolReflectance and Thermal Emittance requirements for roofing
products in §118(i) are not applicable. Do not fill table below. Q
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
vl/l
CRRC Product ID Number'
<- 2:12 > 2:12
< 5lb/ft2 2: 51b/ft2
T e2
Reflectance3'4
Emittance
SRIS
❑
❑
❑
❑
❑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 1D Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs.ora/oMductslsearch.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(p„w„ - 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 httpYAvww.eneray.ca.aov/btte241 and enter the resulting value in the SRI Column above and attach
acopy of the SRI- Worksheet to the CF -1 R.
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.
• 1 certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24, Parts
1 and 6 of the California Code of Regulations.
Name: -
Signature:
vl/l
Company:
Address: ZLicense:
- /
City/State/Zip: 7 i Phone: �
c. /Y� 9
For assistanc or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
IID
AcenWgofsuvw4
800-303-7756 760.335.3640 FAX 760.339.9471 Website www.iid.com
SECURITY DEPOSIT
December 26, 2012
Contract Account Number:
Customer Name: MCCLURE TIMOTHY SHANE
Service Location (Domicilio Del Servicio): 53650 AVENIDA DIAZ LA QUINTA �
SECURITY DEPOSIT DUE B 01/15/2013
- $200.00
e —
k i
i i
11D.
... A—f-yofsei -
{ 800-303-7756 ' 760.335.3640 FAX 760.339.9471 Website www.iid.com
ti
i
TIMOTHY SHANE MCCLURE SECURITY DEPOSIT
i' 53650 AVENIDA DIAZ
�
LA QUINTA , CA 92253 ' r Contract Acct. No.:
z' Customer Name: MCCLURE TIMOTHY SHANE
Amount Due: $200.00
Due Date: January 15, 2013
i' -
0
VZ ,
P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY ON"ER' S PACKAGE
(760) 777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
MfP MUffr No CE TO PROPEWD(OWNIER
De" Ptaperty Owner.
An. application for a buildin has bow submitted ' your note listing yourself as the builder of the property
im¢rr+ov+ements specified at�i,
We are providing you wM an Owner -Builder AAn6wledgment and lnfmmatien Verification Form to make you swans of your
responsril4 ies and possable risk you may incur by hawing this permit-inued in your name as the
Owner -Builder. We will oot issue a .permit undl yon-huve read, i your tmderstaudi� of each provicit►n,
signed, and returned this form 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.
D&EE't7t3M. Read and initial each sratment-Mw to signify you undersumd or vez#y this KormaMon.
V1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
building permit that erroneously implies Haat the property owner is providing his or her own labor and material personalty. 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.
2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the
co traction and are not hiring a licensed Contractor to assume this responstbility.
I understand as an "Owner -Builder" I am theresponsible 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 of my
own.
`4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
5_��Tis and contracts.
.1 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 "employee"
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 umn>;sloyment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial,
risk.
jc7I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residentiz
.
lunes cannot legally build them with the intent to offer them for sale, unless all work is performed by license
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performe
under contract with a licensed general building Contractor.
I understand as an Owner -Builder if I sell the property for which this permit may be held liable for any
finhncrat or Personal. i4wies sustained by any subsequent owner(s) that result E a�»y talent construction defects in the
workmanship or materials. ` ,
j ! - 9. I understand 1 may obtain more information regarding my obligations as an "employer' from the- Iat"1021 Revenue
C� 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.
10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
PAAY legally and financially responsible for proposed construction activity at the following address:
11. 1 agree that, as the party legally and funereally responsible for this proposed constriction activity,.[ will abide by all
applicable lives and requirements that govern Owtter=Buitders as well as employers.
12.1 agree to notify the issuer of this form immediately of any additions; deletions, or ch,@nges to ariy of the information 1
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 lieease, the Contractors' State Lioease 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
itaportant for you to: understand that if an malice uW.Contor tracor employee of that individual or firm is Wured whale working
on your property, you may be held rutile for damages. If you obtain. a permit as Owner -Builder and wish to hire ConiIactm,
YOU will be FeVomil& fur vetdYing whatber or not those Contractors are pmpctiy licensed and the status of th®i% workers'
compensation insuianoe 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 Ow permit. Now A copy of die propenV owner's Mver'sfteltavi fora n0taGhMdM er
other verification acceptable to the agraney is required to be presented when the permit is issued to y the property
owner's signature.
Signature of property o� , Date: ]f�.—
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.
AUTHORUATION OF AGENT TO ACT ON 1VR0PERTY 0WNZWS ff A]L.F
Excluding the Notice to Property Owner, the execution of which I understand is my personal response-bility, I hereby authorize
the following person(s) to act as my agents) 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):
Project Location or Address:
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 venftcation
acceptable to the agency is required to -be presiwed when the permit is issued to verify the property owner's signature.
Property Owner's Signature: Date:
Bin.#
QtY Of % QWho
Buildifig 8t 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: �� - L, S U7j
Owner's Name:.'
A. P. Number.
Address: j f 11_7
Legal Description:
City, ST, Zip:
Contractor:
Telephone: �4; €.sa
Address:
Project Description:
City, ST, Zip:
Telephone:
8`. ca -�
City Lie. #;
State Lic. #:
a w d IL O
Arch., Engr., Designer.
I
Address:
City, ST, Zip:
Telephone:
Construction Type: . Occupancy.
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #:w '^ ' ;;
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project Cj c
APPLICANT: DO NOT WRITE BELOW THIS UNE
p
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sete
Plan Check submitted
item Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Pians picked up
Construction
Flood plain plan
Pians resubmitted
Mechanical
Grading plan
2iQ Review, ready for correctionsfissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'^' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval_
Called Contact Person
AXP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
Property Detail Report
Page 1 of 1
Property Detail Report for:
53650 AVENIDA DIAZ, LA QUINTA CA, 92253-3580
Owner Information:
Owner Name: WHITLOCK,ELIZABETH
Mailing Address: 53650 AVENIDA DIAZ, LA QUINTA, CA, 92253- 3580
Vesting Code:
0 DIGITAL MAR 18 aNWpPft
PRODUC r5
Phone Number:
Location Information:
Legal Description: .35 ACRES M/L IN LOTS 18,19 & 20 BILK 191 MB 0191033 SANTA CARMELITA AT VALE LA QUINTA UNIT
19
County: RIVERSIDE FIPS Code: 06065 Census Trct/Blk: 0451091 / 1
APN: 774112028 Alternative APN: 774112028 Map Ref: E2-879
Twnshp-Rnge-Sect: - - Legal Book/Page: 774-11 / Tract No:
Legal Lot: 18 Legal Block: 191
Subdivison: SANTA CARMELITA AT VALE LA QUI
Last Market Sale Information:
Sale Date:
10/02/2001
Sale Price:
$71,000
1st Mtg Amount:
Sale Doc No:
0000477539
Price Per SgFt:
$57
1st Mtg Int Type:
Transfer Doc No:
Price Per Acre:
$202,857
2"d Mtg Amount:
Multi/Split Sale:
1 It Mtg Doc No:
2"d Mtg Int Type.
Sale Type:
Deed Type:
GRANT DEED/DEED OF TRUST
Title Company:
Lender:
SHARON L
Seller Name:
TOOMEY-SZESNY,SHARON L
Property Characteristics:
Building Area:
1,248
Total Rooms:
Construction:
Living Area:
1,248
Bedrooms
2
Heat Type:
Garage Area:
400
Baths:
2.0
Air Cond:
Basement Area:
Fireplace:
Roof Type:
Parking Type:
GA1
No of Stories:
1
Roof Material:
Yr Built/Effective:
19781
Quality:
Style:
Pool Code:
YES
Tax and Value Information:
Assessed Value:
$138,358
Assessed Year:
2011
Est Market Val:
Land Value:
$34,587
Property Tax:
$2,122
Assessor Appd Val:
Improvement Value:
$103,771
Improvement %:
Total Taxable Value:
$138,358
Tax Exemption:
HOMEOWNER
Site Information:
$110,000
CENTRAL
CENTRAL
COMP SHINGLE
Assessor Acres:
0.35
Zoning: A2 Land Use: 163
Assessor Lot SgFt:
15,246
No of Buildings: Land Use Desc: SFR
Assessor Lot W/D:
I
Res/Comm Units 1 County Use Code: R1
Calculated Acres:
0.3528
Sewer Type:
Calculated Lot SgFt:
Water Type:
http://maps.digitalmapcentral.com/production/citygis/v07_O3_001 /index.p7.aspx 12/27/2012