12-1133 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 91253
Application Number:
.Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
12-00001133'
53935 AVENIDA VILLA
774-173-022-10 -000000-
RE-ROOF
COVE RESIDENTIAL
6000
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
PAUL VAN VLYMEN
r - 53935 AVENIDAVILLA
LA QUINTA, CA 92253
I
Contractor: U
4.STAR ROOFING INC
30775 AVENIDA DEL YERMO
CATHEDRAL CITY, CA 92234
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.
LicenseClass: C39 License No.: n579840 -
ate:
tr.clor..AA""�--"• """lli
OW;�JIUILDER 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
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 sole.).
(_ 1 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.).
I—) 1 am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
Ihereby 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: 9/25/12
I
w U
L"P 25 2011
CITY OF LA Of IINTA
` (760)770-4535
Lia. No.. 579840
WORKER'S COMPENSATION DECLARATION'
It 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 0000890-2011
_ I certify that, in the performance of the work for which thispermitis 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 ?
371010 of the Labor Cod , I's ha 11 forthwith comply with those provisions.
plicant:
WARNING: FAIL RE TO SECURE WORKERS OMPENSATION 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 Quints, 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 t ' 'county to enter u on the above-mentioned property r inspec on purp es.
ate: Ods `� ignature (Applicant or Agent): �� Q
Application Number. . . . . . 12-00001133
r
Permit RE -ROOF
Additional desc .
Permit Fee . . . . 30.00 Plan Check Fee
.00
' Issue Date . . . . Valuation
0
Expiration Date .. 3/24/13
'
Qty Unit Charge Per
Extension
BASE FEE
30.00
-------- - - - - - -
Special Notes and Comments
RE -ROOF WITH 1 LAYER OF OWENS CORNING
DURATION FIBERGLASS SHINGLE SYSTEM -
WHITE. APPROVED COOL ROOF RATED PRODUCT.
2010 CODES.
Other Fees .. . . . . BLDG STDS ADMIN (SB1473)
1.00- ,
Fee summary jCharged Paid Credited
Due '
- ------------------ - - - ------ ----------- ----------
-------
Permit
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 -1 R-ALT-ReRoof
-
Climate Zone Permit #
ROOFING PRODUCTS (COOL ROOFS) §151(1)12 -
When the area o1 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 roofing product "Cool Root" requirements of §152(b)1HI, 152(b)1Hii, or 152(b)1HIli.
Check applicable alterative or exception below if the roof alteration is exempt from the roofing product 'Cool Roof requirements::
O Cool roofs not required in Climates Zones 1-12, 14, and 16 with a low sloped roof pitch gess or 2:12 pitch).
O 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 5AbW.
Alternatives to §152(b)1 Hi and §152(b)HII, Steep -slope roof (pitch > 2:12)
O Insulation with a thermal resistance of at least 0.85 heft-*F/Btu or at least a 314 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(f)10; or
❑ In climate zones 10, 12 and 13, with 1 f12 of free ventilation area of attic ventilation for every 1561:2 of attic floor area, and
where at least 30 percent of the free ventilation area is within 2 feet vertical dsice of the roof ridge; or
❑ Building has at least R-30 ceding insulation; or
❑ Building has radiant barrier in the attic meeting the requirements of §151(f)2; or
❑ Building has no duds in the attic; or
O In dimate zones 10, 11, 13 and 14,.R-3 or greater roof deck insulation above vented attic.
Exception to §152(b)1Hill, Low -slope roof (pitch:5 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 IbM are
VOTE: If anyone of the altematives or exception is checked tris A exempt from the Cool Roof criteria.
)roducfs in § 1180) are not applicable. Do not fill table below. Solar ReiJed�enoe and Thermal Emittance requirements for roofing
CRRC
Roof Slope
5 2:12 > 2:12 1 <
Note: If no CRRC-I label is available, this compliance method cannot be used, use the Pedbrmance Approach to show compliance,
The CRRC Product /0 Number can be obtakW /rpm the Cool Roof
Indicate the type of product is being used the roof Counslrs Rated Produd Directory at www. coakwfs,
top, i.e.Jesir►gle-ply rpof asp" roof metal rool, etc.
If the Aged Reflectance is not available in the Cool Roof Rating CourrcB's Rated Product
directory and use the equation (0.2+0.7(p, — 0.2) to o0tain a calculated Directory then use the Initial Reflectance value bpm the same
Check box i/ the Aged Reflectance is a cabAded value value. Where p is the initial Solar Reflectance.
Cakxdate the SRI value b using using � equaborr above.
Y sto t the SRI- Worksheet at hitt /Avww enerpv.ca �v/ti`le ai and enter the resulting value in the SRI Column above and attach
eoopy of the SRI- Worksheet tothe CF -IR.
Product Weight
51b/fiz i 5lb/ft'
Product
TypeF
Aged Solar
Refiedanoel"
Thermal
Emittance
SRIS
°
EO
E34°
o 14
0
Ste.
❑4
o apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
3oommended by the coatings manufacturer and meet minimum performance requirements listed in §118%4. Select the applicable coating:
Aluminum -Pigmented Asphalt Roof Coating
LE: When a Cool Roof is rranttirmwi h% -
Declaration Statement
❑ Cement -Based Roof Coating . ❑ Other
contractor shall complete and submit the CF -M -ENV -01 for final
• 1 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
I and 6 of the California Code of Regulations.
Name:
At AA J,r 0— Signature:
Company:
A :ss:
For assistance or questions
Date:
-1
License:
Phone:
gar the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
wri ff
City of La Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
-nnBuilding Permit APPlication and Tracking Sheer
L &00171 wner's Name-`
Cit},, ST, Zip-
)'T'elephone: '266-7-7-1-1-7,Q4
c
Project Description:
_� Li. k
City Lic. #:
�E
13
q
Permit #
Req'd
Recd
TRACKING
JC
Project Address:
A. P. Number:
Legal Description:
Contractor: - c
PERMIT
Address:
-
City. ST, Zip:
Telephone:
jC
State Lic. #
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Item
State Lic. #:
Name of Contact Person.
Telephone # of Contact Person:
City of La Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
-nnBuilding Permit APPlication and Tracking Sheer
L &00171 wner's Name-`
Cit},, ST, Zip-
)'T'elephone: '266-7-7-1-1-7,Q4
c
Project Description:
_� Li. k
City Lic. #:
�E
13
q
Submittal
Req'd
Recd
TRACKING
Plan Sets
PERMIT
FEES
Plan Check submitted
Structural Cates.
Item
Amount
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
Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" 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
IFS