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12-0937 (RR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000937 Property Address: 51.270 CALLE GUATAMALA APN: 770-1637001-24 -000000- Application description: RE -ROOF Property Zoning: MEDIUM DENSITY RES Application valuation: 4000 Td4t 4 4 Q" Applicant: Architect or Engineer: 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 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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1 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 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 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.). ' (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: I herel 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 Dl. Owner: CARBAJAL DANIEL U AUG 17 51270 CALLE GUATAMALA 2012 LA QUINTA, CA 92253 ------------------------------f��7yOFLenrrr..- Contractor: Owner 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 1 should become subject to the workers' compensation provisions of Section 700 of the Labor ode, I shall forth wit omply with those provisio 6.1e: /� cant: WARNING: FAILURE TO SECU ORKERS' 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 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 re authorize represent ry s of thi co my o ente/uponuree above-mentioned property for inspection pu oses. ate: 7 (Applicant or Agent):' Application Number . . . . 12.-00000937 Permit RE -ROOF Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . 0 Expiration Date . . 2/13/13 Qty Unit Charge Per Extension BASE FEE 30.00 ------------------------------------ Special Notes and --------------------------------------- Comments RE -ROOF WITH CRRC APPROVED SHINGLE (OWENS CORNING SHASTA WHITE). 2010 CODES. 7 -------------------------------------------------------------------- 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 o 0 0 0 a.t Your Cool Roof Solution 49 ® Owens Corning" Shingles INNOVATIONS FOR LIVING* That Meet Title 24 Standards California's Building Energy Efficiency Standard—also known as Title 24, Part 6—is now in effect. The new standard calls for increased energy efficiency in homes and commercial buildings. The easiest way for many consumers and business owners to meet the new standard is to choose "cool roof" shingles when installing a new or replacement roof. Courtesy of the California Energy Conwission (CEC) Owens Coming" Roofing offers many high-performance shingles that meet Title 24, Part 6, requirements: Shingles that qualify as cool roof shingles � feature highly reflective color granules that g Y the hftof�a t—m�t.ou: AM �� dit. d d..b the and vd¢eb help lower energy bills by keeping.roofs mWD obioW hot cool' They also meet the criteria set by " the experts at the Cool Roof Rating Council 0.89 (CRRC). The California Energy Commission Sue hot 6°bmw b,• the od (CEC) has established prescriptive ¢d Omsl°°ed b Ile bUidkg bele° Cool Roof Rating Couneil(coolroofs.org) - requirements that asphalt shingles on Shasta White steep -sloped roofs in Climate Zones 10-15 must have a minimum calculated 3 -year aged reflectance of .20, a minimum emittance of .75 and a minimum Solar Reflectance Index of 16. Courtesy of the California Energy Conwission (CEC) Owens Coming" Roofing offers many high-performance shingles that meet Title 24, Part 6, requirements: Contact your Owens Corning'" Area Sales Manager to find out more about why Owens Corning' shingles are your solution to meeting new Title 24 standards. 01,w C, C aawcunrna,. MEMBER e"cetgy Sove"" - .d 1 pink is green• Asove me ?\6 'Estimated roof surface temperature reduction based on 1998 NIST study. Analytical5tudj• of Residential Euudufgs with Rellecive Roofs. A temperature reduction is representative of a change from a typical toof to a Cool Roof (solar reflectance 0.10 to 0.25) in most climates. Pub. No. 10012420. Printed in U.S.A. March 2010. THE PINK PANTHER" &© 1964-2010 Metro -Goldwyn -Mayer Studios Inc. All Rights Reserved. The color PINK is a registered trademark of Owens Corning. 02010 Owens Corning. .. • � ..- "ice. - .• Durations Premium Cool Harbor Fog 0890-0004 Lifetime 0.25 0.89 Harbor Fog Frosted Oak Sage Sunrise Shasta White Shasta White I I Shasta White Contact your Owens Corning'" Area Sales Manager to find out more about why Owens Corning' shingles are your solution to meeting new Title 24 standards. 01,w C, C aawcunrna,. MEMBER e"cetgy Sove"" - .d 1 pink is green• Asove me ?\6 'Estimated roof surface temperature reduction based on 1998 NIST study. Analytical5tudj• of Residential Euudufgs with Rellecive Roofs. A temperature reduction is representative of a change from a typical toof to a Cool Roof (solar reflectance 0.10 to 0.25) in most climates. Pub. No. 10012420. Printed in U.S.A. March 2010. THE PINK PANTHER" &© 1964-2010 Metro -Goldwyn -Mayer Studios Inc. All Rights Reserved. The color PINK is a registered trademark of Owens Corning. 02010 Owens Corning. .. • � ..- "ice. - .• Durations Premium Cool Harbor Fog 0890-0004 Lifetime 0.25 0.89 0.25 Durations Premium Cool Frosted Oak 0890-0005 Lifetime 0.25 0.89 0.25 DuratiorP Premium Cool Sage 0890-0003 Lifetime 0.25 0.90 0.25 Duratiort Premium Cool Sunrise 0890-0006 Lifetime 0.24 0.89 0.24 Durations Shasta White 0890-0007 30 -year 0.24 0.94 0.26 Oakridge° Shasta White 0890-0002 30 -year 0.25 0.89 0.25 Classic' Shasta White 0890-0001 20 -year 1 0.25 0.89 0.25 Contact your Owens Corning'" Area Sales Manager to find out more about why Owens Corning' shingles are your solution to meeting new Title 24 standards. 01,w C, C aawcunrna,. MEMBER e"cetgy Sove"" - .d 1 pink is green• Asove me ?\6 'Estimated roof surface temperature reduction based on 1998 NIST study. Analytical5tudj• of Residential Euudufgs with Rellecive Roofs. A temperature reduction is representative of a change from a typical toof to a Cool Roof (solar reflectance 0.10 to 0.25) in most climates. Pub. No. 10012420. Printed in U.S.A. March 2010. THE PINK PANTHER" &© 1964-2010 Metro -Goldwyn -Mayer Studios Inc. All Rights Reserved. The color PINK is a registered trademark of Owens Corning. 02010 Owens Corning. Certificate of Compliance: Residential Reroof >: 5/a-xd (?,*' �,%�' ( f Zone CF-IR-ALT-ReRoof ROOFING PRODUCTS (COOL ROOFS) §151(f)12 When the area of exterior roof surface to be replaced exceeds SOY. of the existing roof area, or 1,0-0—OW, ~ever is less, the new roofing area must meet the roofing product "Cool Roof" requirernents of 152(b)1H4152(b)1Hll, or 152(t>)1Hili. Check applicable attema " or exception below 9 the roof attembon is exempt from the rw&V product 'Cod -Roof requkernents:: ❑ Cool rots ta required in Cbrates Zones 1-12,14. and 16 with a low eloped roof pitch (less or 2:12 pitch). ❑ Cod roots M mgkrimd in Cfsrrates Zones 1-9, and 16 wtlh a steep -sloped roots (greater pitch than 2:12) and product weight less than 51tbld Alternatives to §152(b)IM and §162(b)Hti. Steep -slope roof (pitch > 2:12) ❑ insutabon with a themrai reslstaioe of at Wast 0.85 hr4?-*FI3bu or at least a 3/4 inch air -space is added to the rod deck over an attic; or ❑ fro duds in the attic are insulated and sealed accordng to §1$1010; or ❑ to dimate zones 10, 12 and 13, wfth 1 V of free ver dation area of attic verdedon for every 150 ft2 of attic boor area, and where at least 30 percent of the free venflWtion area is within 2 feat vertical distance of the rod ridge; or ❑ BuUdkV has at least R-30 ceiling insulation; or ❑ Bugling has radani barrier in the ettic meeting the recIukernents of §15102; or ❑ Bugling has no duds in the ettiq or ❑ In dkrdde zones 10, 11,13 and 14,.R-3 or greater roof deck insulation above vented attic. Exoep*m to §152(b)1Hill. Low -Glop& roof ( pitch S 2:12) ❑ Briding has no ducts in the attic. Other Exceptions ❑ RoofirVembwveredbyWk*VkteWdetowWvobkpandsuWsoiwVa,.tei panels are exempt fmm the Cool Roof criteria. (3 Roof constructions that have Owmai mass over the roof r wr&ene with at lased 25 tbW ere eroampt *cm the Cod Rod aileria. If any one of the &Veffn0ves or exoepdw is docked pnxkx s In § 118(0 are not applicable. Do not fie table below. Roo( Slope Product V"ght T�"m S CRRC Product Number' s 2:12 > 2:12 < 619te a 6_&W T Relied� Err rnoe SRI — OD ❑ W ❑ q-c" E3E3 13O - Note: H no CRRC-1 label Is ovalbble, this co V lance nmd)od cannot be used, use the Performnoe Approach to show oorrpltarroe, 1. The CRRC Product ID Nrunber can be obtained from the Cod Rod Raft Count's Resod Dbsdory at 2. kxfto s the type otpioduot Is being used for Via roof top, Le. single0y rod, asphalt roof.,, roof• etc, 3. N the Aped Redactor" to not ava l" In the Cod Roof Rating Colmofft< Rated Product Oiredwy then use the k*W Raftdonoe value iom the same directory and use she equation (0.2+0 7(p,,,,,, — 0.2) to obtain a calai@bd aped value. Woo p is the initial Scar Refledornoe. Aped Reflectance is a colafated value ushp trio equation above. SlitvWWbyusipshe SRI- Workdreet et andeaterthe res AtV veins in the SRI Column above and stat RI-ftdwheetbtheCF-1Rd Ihe Field Applied Coatings. the ooading must be applied across the enlim roof surface and meet the dry rM t **ness or cowby the coatings Manufactu rer and meet mi *mxn periormanoe requirements listed in §118(i}4. Selectthealpplicablecostip Pigmented Asphalt Root Coating ❑ Cement -Based Root Coating ❑ Other : Won a Cool Roof is required, the irnstarbnp contractor shall conpiete and aLftO the CF6R-ENV-W for final Inspedton. I canny under venally of Perjury, under the taws of the State of Canorrda. ttne information povided on this torn is accurate and complete. I eerey that the eneryy features and.pedormance speciestions k%ndfied on tis C MBcate of roe conform to the requkeararts of Tide 24.1 1 and 6 of the Callornin Code of Reau slims_ /) IName: 1 Sionaturo•, 1 Company: r Date: p. :ss: 5l a?o ��Iu I-ioense: ity/StatelZip: / e,17,-? rYi� Com¢ Q ss3 Phone: -� �� y, Z D yd r For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. 0 wo® v 11 P.O. BOX 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA.92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (160) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits LW09-TAN► NOTICETO >PRolTx owlv>R Dear Property Owner. An. application for a building permit been submitted ' your n lis yourself as the lder of �your improvements specified at SI S-10 �L �9 We are providing you with an Owner -Builder Acknowledgment and:Infoimation VerificationF to make you aware responsibilities and possible risk you may incur by having this permit.issued in your name as the Owner -Builder. We will nod issue a buildingpermit until yowhave read, initialed your understanding of eack'provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute ",notice unless you, the property owner, obtain the prior approval of the permitting authority. OAR'S ACfQO=ta LEAONITEM AND VERMCATIOIN OF.IWf R -HA ON Dl'REUTO1NS. Read and initial each: statement -betow to signify you understand or verify this information. 1. 1 understand a frequent practice of unlicensed persons.is to have the, property owner obtain an "Owner -Builder" wilding permit that erroneously implies that the property owner is providing his or her own labor and material personally -1, as P 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 construction and are not hiring a licensed Contractor to assume this responsibility. 3. I understand as an "Owner -Builder" I am theresponsible party of record on the permit. I understand that 1 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 pQennits and contracts. 5. 1 understand if 1 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, 1 may be considered an "employe' under state and federal law. 6. I understand if I am considered an "employee' 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 unemployment compensation for each "employee-" I also understand my failure to abide by these laws may subject me to serious financial risk. P-7.I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot .legally build them with the .intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed fourwithin any calendar year, or all of the work is performed under contract with a licensed general building Contractor. ti e_8_ I understand as an Owner -Builder if I sell the property for which this perffiit is issued, I may be held liable for any financial or personal. injuries sustained by any subsequent owner(s). that result from any latent construction defects in the workmanship or materials. , 9. I understand I may obtain more information regarding my obligations as an "employee'* from the Inte7ii111 Revenue 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 (CM13) at I- 80 -321-CSLB. (2752) or www.csib.ca.gov for more information about licensed contractors. 10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address:. 1 agree that, as the party legally and financially responsible for this proposed construction activity,.l will abide by all applicable laws and requirements that govern Owoer-Builders as well as employers. 2 12_ I agree to noti the issuer of this form immediate) of an additions; �T fY Y Y deletions, or changes to any of the infornaatiob 1 ave 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, the 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 Contractorsmay be in'civd court- It is also important for you to. understand that if an unlicensed Contractor or employee of that individual or faro is injured while :wonting on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whetter or not those Contractors are properly licensed and 'the status of their workers' compensation insurance 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.the.pormit. Note: A copy of the property owner's driver'sticensej form' not"iVition, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the.property owner's signature. } Signature of property o 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 construction permit for the Owner -Builder - AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding.the Notice to Property Owner, the execution of which 1 understand is my personal responsibility, l 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: Tel No Address of Authorized Agent: I declare under penalty of perjury that 1 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 verifrcaiion acceptable to the agency is required to bepresented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quints, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # a-' Project Address: 5/ aZ %Q we 6(, &4& wner's Name: pC.GpyypY. 4 a A. P. Number: Address: 916770 't11p Legal Description: City, ST, Zip: �¢ ilk `�/Y 7;t 2 3 Contractor: e e h ne: ,* 1 0 77 Gr Address: �J l."%v -re' !( C"'4A `•• L Project Description: A90-0.1-- 900� City, City, ST, Zip: /—,& ..r e / Tel h ne: P 0 w % G 7708 State Lic. # : City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: r Demo Lic. #: Project type one): . N w Add'n Alter Repairai Name of Contact Person: S Ft.: � # Stories: # Units: pState Telephone # of Contact Person: Estimated Value of Project: 3.549 44000 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd 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 Caics. 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 correctionsfiissue Developer Impact Fee Planning Approval Called Contact Person A. 1. P. P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees