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10-0997 (RR)c J TitltP.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/27/10 Application Number: 10-00000997 Owner: tiA. Property Address: 51400 CALLE GUATAMALA ERIC KELLER APN: 770-163-007-18 -000000- Property Zoning: MEDIUM DENSITY RES ------------------------------- - I� J Application valuation: 5850 U Contractor: E's,Il,r Applicant: Architect or Engineer: Owner --------------------------------- a�� --------------------------------------------------. 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, atter, 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).: 1) 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 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 1 am exempt under Sec. , B.&P.C. IS( this reason Dates. l CONSTRUCTION LENDRUG 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.). 0,U/0 Lender's Name: Lender's Address: A LQPERMIT -______________________________________________ WORKER'S COMPENSATION DECLARATION 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, 1 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 beco.subject to the workers' compensation provisions of Section n3700 of the Labor , I hal foAhwith comply with those provisions. A.: ��/ �r�DA )scant: a WARNING: FAILURE TO SECURE WORKERS' COMPENSATION OVERAGE 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 a? state laws relating to building consftction, and hereby authorize representatives lOf 4is �cco-unty to enter upo he above-mentioned prop t f i pe on purposes. llt7-10 gnature (Applicant or Agent): Application Number . . . . . 10-00000997 Permit . . . RE -ROOF Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/26/11 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and Comments REPLACE EXISTING COMP ROOF SHINGLES WITH OWENS CORNING DURATION PREMIUM COOL ROOF SHINGLES. 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 Project Address: s/Y66 Me � t� rN4 7zz� � Climate Zone Permit # - q { ROOFING PRODUCTS (COOL ROOFS) §151(012 1 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)1 Hl, 152(b)1HII, or 152(b)1N111. Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Root' 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 51lbiflz. Alternatives to §152(b)1HI and §152(b)HII, Steep -slope roof (pitch > 2:12) ❑ 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 ❑ Existing ducts in the attic are insulated and sealed according to §151(f)l0; 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(f)2; or ❑ Building has no duds in the attic; or ❑ In climate zones 10, 11, 13 and 14, R-3 or greater roof deck insulation above vented attic. Exception to §i 52(b)1 Hiif, Low -slope roof ( pitch 5 2:12) ❑ Building has no ducts in the attic. Other Exceptions ❑ 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 251bJfl2 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 CRRC Product ID Number 5 2:12 > 2:12 < 51b/fe z 51b/fe Type? Reflectance14 Emittance SRIS Dao -000s ❑ ❑ ❑ p ❑4 . 16 ❑ ❑ ❑ ❑ ❑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.coolmofs.oMnnxlucts/search,ahn 2. Indicate the type of product is being used for the roof top, i.e. single -ply roof, asphalt roof, metal roof, etc. . 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(pkku„ — 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:1/www.enerov.ca.novRit1e24/ and enter the resulting value in the SRI Column above and attach atopy 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 mit thickness or coverag( recommended by the coatings manufacturer and meet minimum performance requirements listed in §118(1)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 this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the Callomia Code of Regulations. Name: i C / - e� Signature: Company: Date: 24, P ss: License:/. YO 2-9 City/State/Zip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. Rated Products .Directory: Search Results [ new search ] [print friendly.�-- view ] { (last updated 24 Sep 2010 19:33 CDT) Showing Search Results for:.. , Company: Owens Coming Product Type: Shingles or Shakes, Shingles, Shakes, Tile or Slate Brand: Duration® Premium Model: Cool Shingles Frosted Oak select' from products where company_name='Owens Corning' and (type like'Shingles or Shakes%' or type like'Shingles, Shakes, Tile or Slate%') and brand ='Duration(r) Premium' and model ='Cool.Shingles,F,rosted,Oak' order by company_name'asc previous 11 next (showing records 1 1 of 1) _... -...... _.... ....... _._.. - ._._.._...__..._....----..__......_._ 25 Records per Page _ ....... _...... .-._.__...._..__.._.__.-___ .._..._...__._._._---..__...__......-... _......... -.......... ____..__._..__........._-.._._............... -._.__.__-_..-.._.-.__-__..______._._.__..__....__._.....___..._._._..-..._...._.._-...._..._.__.._._.__-_....-_.__._._- 1 i CRRC Manufacturer Information Color Product Solar Reflect. Therm. Emit Sloae Prod. ID (sorted,+)' . Brand Model Category Tvae init init • Application 0890-0005 Owens'Corning Duration® Cool Tan Shingles or 0.27 0.28 0.89 0.91 Steep ri Darrel Higgs Premium Shingles Shakes (419-248-7060) Frosted Oak previous I 1 I next (showing records 1 - 1 df 1) _._.-_........__........_..._.... _.__..................... __............. _..:...._.:.._....... 25 Records per Page About the CRRC I Product Rating Program I Rated Products Directory I CRRC Members I CRRC News Become a Member How Do I I Contact Us I Cool Roof Links I Home i http://www.c,00lroofs.org/products/results.php?keyphrase=&select. type=select&type%SB... ` 9/27/2010 P.O. Box 1504 LA QUINTA; CALIFORNIA -92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING &c SAFETY DEPARTMENT PROPERTY OWNER' S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms- for Owner -Builders Applying for Construction Permits, iMMTANT1 NQTICF Dear Property Owner: Ari. Wlication for a buil"g, en has beyo name' listing yourself as the builder of the .psopecty improvements specified at '> UU (� L7 We are psaoviding you with an Owner -Builder Aclarowiedgment an Infoimatiofl Veri€reation Fortis to make you awa> a.o€ your eesPQ=ib1ht= and Possible risk you may incur by having thispermit issued m your name as the Owner -Builder. We will not issue a baildintg.peFmlt until you -have read, lniitialod your understanding of each:providen, signed, and returned this form to us at our efQeial address indicated. An agent of the owner cannot execute thisometice unless You, the Property owner, obtain the prior approval of the permitting authority. ©.. E09MM A N Dl'R"EETFOIVS. Read anddtial-em*stmte�nerrtb¢fs v signify you andwstand orver#y dols infibm a oon. dd�understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" i�Perrnit that erroneously implies that the property owner is providing his or her own labor and material personatky-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 ain aware of the limits of my insurance coverage for injuries to workers an my Party �. I 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.. K3. I understand as an "Owner-i3uilder" I am.the responsible 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 ow,%n.. �244. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. c 6 I 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 "employer" 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 unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk- 7. isk7. 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 four within any calendar year, or all of the work is performer under contract with a licensed general building Contractor. 2a�ncialI understand as an Owner -Builder if I sell the property for which this permit is issued, [may be held liable €or any or personal. i' .odes sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. PI understand I may obtain more information regarding my obligations as an "employee" from the Intemil Revenue ervice, 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 ((3L,B) at 1- 800-321-CSLB (2752) or www.osib.ca.gov for more information about licensed contractors. �To- I 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 fin3mcially resPOTib for proposed const r�-�rioe activity at the following address: I agree that, as the party legally and financially responsible for this proposed construction activity,.[ will abide by all e laws and iegiiire[ttehts that govern Oweier-Builders as well as employers. c 12.1 agree to notify the issuer of this form immediately of any additions, deletions, or .choges to any of the in Oblation I ve rovided on this form. Licensed contractors are protect the Public. If contract with P regulated by laws designed top p You someone who does not have a lic ensaAhe Contractors' State License Board maybe unable to assi3t 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 important for you to: understand that if art urttieensed Contractor of esplayee of that individual or fain is ir►fnred while w dditg 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 respowible- for ver*ing whether or not those Contractors are propetty licensed and the status of their workers' compensation insurance boverage. 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 issubg; ft permtt. Now A copy, of lira properW ownwIs Mvea'sl e, force nota dM or other verification aeceptt4le to fire agency is regrElsed to be preseawed when the pe.mat is' to �,�Y the property owner's signature. ' r, G � Signature of property owner)( Date: Z,� Z 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 BI�HaF Excluding the Notice to Property Owner, the exewtion of which I understand is my personal responsibility, I hete'by authorize the following person(s) to act as my agent(s) 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:. AU ( � 1- iUr w lk4 Tel No Address of Authorized Agent , z� A)A* ZLA� I declare under penalty of perjury that I am the property owner for the address listed above and I personally felled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form )notarization, or other verification acceptable -to the agency is required to be presented when the permit is issued to verify the rop rty owner's signature.. Property Owner's Signature! �'L\� Date: 61 Bin # City Of La Quinta Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico -La Quints, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 5 y b D u Q Owner's Name: A. P. Number: Address: ( Legal Description: City, ST, Zip: Contractor: • Telephone: �%` ..'•,..�,,''.>'�' z� , Address: Project Description: J P City, ST, Zip: Telephone: j f�•. �'V M if bn� V�'yL e ./ .i (P�� State Lie. # : City Lie. #, Arch., Engr., Designer P/ Address: City., ST, Zip: Telephone: Construction Type: Occupancy: State Lie. #: _ Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: d — APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2id 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:- 7n4 Review, ready for correctionOssue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees