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11-1219 (RR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: ill --_00001219` Property Address: 5'1600 AVENIDA VILLA APN: 773-144-006-19 -000000- Application description: RE -ROOF Property Zoning: COVE RESIDENTIAL Application valuation: L2UU Applicant: Architect or Engineer: Pik 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -----------------------------------------—-------- 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 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 requites 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 n 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.). ('_ 1 I, as owner of theproperty, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contra/ns to License Law does not apply to �9 owner of property who builds or improves thereon, and who for the projects with a ntract rlsl licensed pursuant to the Contractors' State License Law.I. 1 _ 1 I am exempt under Sec. , B.&P.C. for t ' e Date: caner. CONSTRUCTION LENDING AGENCKorth I hereby affirm under penalty of perjury at there is a construction lending agent performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: WHALEY'GARY S P O BOX.900837 SAN DIEGO, CA 92190 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/09/11 Contractor: j IU Owner 1 - -- -�� ''� 09 201' 1 GIiY GF c,� ��: —-————————————— — — — 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 Nu r I certify that, in the performance of the wo nr whirh this permit is issued. I shall not employ any person in any manner so as to beco ubjec o the wo ers' compensation laws of California, and agree that if I should beco bjec / e work 'compensation provisions of Section / 3700 of th abor Code, I� fort th-comply w• those provisions. [�dte: pplicant: / /WARNING: FAILURE TO SE ORKERS' COM COVERAGE IS UNLAWFUL, AND SHALL SUBJECT.AN EMPLOYER TO CRIMINAL PENALTIES AND Cl FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000)• IN ADDITION TO THE COST OF CO PENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, ANDA ORNEY'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 isnot 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 1 have read this application andstate that the above informatio is correct. I agree o comply with all city and county ordinances ands to laws relating to building constructs -, and hereby autho a representatives ofthiscounty to enter upon t above-mentioned property for ins on purpos ' Si ature l4plicant or Agen Application Number . . . . . 11-00001219 Permit . . . RE -ROOF ' Additional desc . Permit Fee 30.00 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date 5/07/12 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Opecial Notco and Commonto RE -ROOF WITH LIGHT WEIGHT TILE. VERIFY - R-30 INSULATION AT INSPECTION. 2010 CODES. -------------------------- 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' Prescri tiye Certificate of Cotta ; rlan�e. Re§iddhtlaU Reroof ;Project?Addrets'. CF=1'R�AT;ReRoof Climate Zone Pemilt # • Ga r �G�.._.. coo ��4.:, i ,�J ' � �r . . . ROOFINGPRODUCTS�(COOL ROOFS)'§151(flf2 When the area -of exterior roof surface to be replaced exceeds 50% of the existing roof area, or 1,000 fe, whichever is less, the new roofing area must meet the rooting product "Cool Roof". requirements of §152(b)1H1; 152(b)1HI1; or152(b)111111. Checlkapplicable 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 W required in Climates Zones 1-9; and 16 with a steep—sloped ped roofs Alternatives to §152(b)l Hi and §152(b)Hii, Steep -slope roof (pitch > 2:12) (greater pitch than 2:12) and product weightless than 5/Ib/ft2. ❑ Insulation with a thermal resistance of at least 0.85 hr•ftz•°F/Btu or at. least a 3/4 inch air -space is added to the roof deck over -an attic; or O Existing duds in the attic are insulated and sealed according to §151(plo; or O In dimate zones 10, 12 and 13, with 1 ft2 of free ventilation area of attic ventilation for every 150 ft2 of atic floor area, and ywhere 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 ceffing insulation; or . ❑ Building has radiant barrier in the attic meeting the'requirements of §151(1)2; or ❑ Building has no duds in the attic; or O 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 S 2.12) O Building has no duds in the attic. Other Exceptions O Roofing area is covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the Cool Roof criteria. O Roof constructions that have thermal mass over the roof membrane with at least 25 IbW are exempt from the Cool Roof criteria. .NOTE: If any one of the alternatives or exception Is checked the Aged Solar Reflectanoe and Thermal Emfttance requirements for roofing products in §118(1) are not applicable. Do not rill table below. s available, this compliance method cannot be used, use the Performance Approach to show compliance 1. The CRRC Product fD Number can be obtained from the Cod Roof Rating Councils Rated Product Directory at www- Goo/roofs onybro lucts/search aho 2. Indicate the type of product is being used for the roof top, i.e. single -ply roof, asphalt I. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rateroduct Directoryal then use the Initial Reflectance value from the same directory and use the equation (0.2+0.7(pww _ 0,2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance. t. Check box If the Aged Reflectance is a calculated value using the equation above. i. Calculate the SRI value by Worksheet to the CF -1R. using the SRI- Worksheet at hftn atopy of the SRI- Worksheetww ca enerov o)vifitle24/ and enter the resulting value in the SRI Column above and attach ro apply Liquid Field. Applied Coatings, the coating trust be applied across the entire roof surface and meet the dry mil thickness or coverag 'ecommended by the coatings manufacturer and meet minimum performance requirements listed in§113(1)4. Select the . applicable coating: 7 Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other VOTE: 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 four 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 R lulations. Name: 00, 6 Signature Company: _ Date: A. SS: License: 5�- �•'�� _�o Phone: � Si 3 y 7 oil For assistance or questions regarding the Energy Standards, contact the Energy Hot/lie at. 1-800-772-3300. CRRC Product ID Number Roof Slope s 2:12 > 2:12 ❑ ❑ Product Weight < 51bW i 51b/fe ❑ 01 Product Type2 Aged Solar Reflectance 3A Thermal Emittance SRIS Q4 133 E 13 1:31 Note: If no CRRC-1 1-s—, l s available, this compliance method cannot be used, use the Performance Approach to show compliance 1. The CRRC Product fD Number can be obtained from the Cod Roof Rating Councils Rated Product Directory at www- Goo/roofs onybro lucts/search aho 2. Indicate the type of product is being used for the roof top, i.e. single -ply roof, asphalt I. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rateroduct Directoryal then use the Initial Reflectance value from the same directory and use the equation (0.2+0.7(pww _ 0,2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance. t. Check box If the Aged Reflectance is a calculated value using the equation above. i. Calculate the SRI value by Worksheet to the CF -1R. using the SRI- Worksheet at hftn atopy of the SRI- Worksheetww ca enerov o)vifitle24/ and enter the resulting value in the SRI Column above and attach ro apply Liquid Field. Applied Coatings, the coating trust be applied across the entire roof surface and meet the dry mil thickness or coverag 'ecommended by the coatings manufacturer and meet minimum performance requirements listed in§113(1)4. Select the . applicable coating: 7 Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other VOTE: 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 four 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 R lulations. Name: 00, 6 Signature Company: _ Date: A. SS: License: 5�- �•'�� _�o Phone: � Si 3 y 7 oil For assistance or questions regarding the Energy Standards, contact the Energy Hot/lie at. 1-800-772-3300. PA). B6k-'1564 LA QUINTA,' CALIFORNIA 92247-1504 BUtLD[t-G & SAFETY DEPARTMENT .78-495 CALLS TAMPICO (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 PROPERTY OWNER'S PACKAGE Disclosure's & Forms for Owner -Builders Applying for Construction Permits NO 11CF, TO Mum 0MTWR Dear Property Owner. An. application for a building permit has been submitted in YOW name listing youEsetf as the builder of the property WWrOymmtsspecified at5-,1-6(5zc, We an pwviding you With -an �Owner-Budda A&nowledgment-and- Information Verikation.Fonn to make you avam of YOUT responsibilities and possible risk you may incur byhtving'this per=t issued myour game as.the Owner -Budder. We will Oat Issue a buil ding.permit untH yom-have read, inhialed your understanding of each:proyisiett, signed, and returned this form to us at our Official address indicated. An agent of the -owner cannot, execute ".:notice u"' You, the Property owner, obtain the prior approval of the permitting authority. Rcad and &ddal eat*swewenrb-dowto signify you an_ or very dein information. W' I. I understand a frequent practice of unlicensed persons is . to have the property owner obtain an "Owner -Builder" 'ding Permit that erroneously implies that the Property owner is providing his or her own -labor and material pemnoft- 1, 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 I Iftdif 1.11011 . am I 7AY acting as an Owner -Budder and am aware . of the limits of my insurance coverage for injuries to Workers on .; Property. 2. ,1 understand building permits are not required to be Apwd by property o unless they are responsible for the ction and am not hiring a Licensed ConuActor to assume this responsibility. owners ;3. 1 understand as an "Owner -Builder" I . I am the responsible party of record on the Permit. I understand that I may protect If from Potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name mstwd of in) Own. own' 4- J1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers o Is '6 and contracts. 5 1 f f 5. 1 understand if I employ or otherwise engage any persons, other than California Licensed Contractors, and dit total vab , /y c my nstruction is at least five hundred dollars ($500),. including tabor and material;-, I may be considered an "employe and 'tate and federal law. .�,Y6. 1 understand if I am considered an -employee, under state and Weral taw, I must register with the state and We government, withhold payroll taxes, provide workers' compensation disability insurmce, and contribute to unemploymi compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious finam understand under California Contractors' State License Law, an Owner -Builder who builds single-family resider structures cannot legally build them with the intent to Offer them for sale, unless all work is performed by ticer subcontractors and the number of structures does not exceed four within any calendEr year, or all of the work is perfon under contract with a licensed general building Contractor. Pman�understand as an Owner -Builder if I sell the property for which•this permit is issued, I may be held liable for any ciaj 1 or personal pgjaries sustained by any, subsequent owaer(s) that result from any latent construction defects in the oro anship or materials. . I • understand I may obtain more information . regarding my obligations as an "employee, from *6, Internal Revenue mce, the United States Small Business Administration, the California Department of Benefit Payments. nd the and Division of Industrial Accidents. I also understand- I may contact the California Contractois' State License Board (CSL at I- ra10- LB (2752) or www.cslb:ca.gov for more information about licensed'contractors. m aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the Party egall andfinaycially responsible for proconstruction activity at the following address: 1. I agree that, as the party legally and ftnaacially responsible for this proposed construction activity, I will abide by all able laws and requirements drat govern Ow -mer -Builders as well as employes. U. I agree to notify the issuer of this form immediately of any additions; deletions, or chi to anY of the information I 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 license, Bre Contractors' State License 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 ba iweivii court. It is also important for You to understand that if an unliconsed Contractor or employee of tbxt individual or firm is injured while wwtdng on your property, you may be he td liable for damages. If you obtain a permit as Owner -Budder and wish to bxm Comectors, you will be respond for ver&jing ver ndw or not those Contractors ace: pmpcdy licensed and the status of thm workers' erompeOsation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the prop" owner and returned to the agency responsible for issafag.tikke.permiL Note: A copy of tier prVerty awow,'s Myer.'stteatsvi f0m mar err other veriftwadan acceptable to the agancy is required to be presented wken the pmnit is issued to rerify the property owner's signature. Signature of property owner Date. 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 conduction permit for the Owner -Builder. AUT$ORIG MON OF AGENT TO ACT ON I?ROPERTY OWN 'S IBEMNLF Exck4w,g.the Notice to Property Owner, the execution of which I understand is my permni responsibility, I hereby authorize the folio n(s} to act as my agent(s) to apply for, sign, and file the documents Y to oMaiin an Owner -Builder Permit for my project. Scope of Construction Project ascription 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 lis brave information and certify its accuracy. Note: A copy of the owner's driver's license, form acceptable to the agency is required to be presented when the permit is issued to verify the Property Owner's Signature: Date: and I personally filled out the at tion, or other verification owner's signature.. Bin # 1� 1' Ci of La Uinta.: Q Building U 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: G 60 Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip:, �� Q�'�•-i7 c-� Contractor: <j w�toZ G7 Telephone: S J — 3 y ::> i q;.• 4. o . 3 Address: Project Description: lo�i City, ST, Zip:O sw �� ce Telephone: /- 3fi• 2 7— City Lie. C State Lie. # : c� Arch., Engr.; Designer: Address: City, ST, Zip: Telephone: yc4fr;,Mys°riE Construction Type: Occupancy: State Lie. #: Project type (circle one): New Addrn Alter Repair Demo Sq. Ft./.,2 yy T# Stories: / # Units: Name of Contact Person: e�� Telephone # of Contact Person: Estimated Value of Project: Vol-, APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact PersonPian Che-tk Balance Title 24 Cates. 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 correctionsAssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P_ Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees