BRER2015-005078-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
WILLIAMS ROOFING
P 0 BOX 391841
ANZA, CA 92539
T4'it 4 4wQu;.rw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BRER2015-0050
80000 HERMITAGE
762231017
MATT RESIDENCE RE -ROOF
$18,000.00
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 Professions Code,
and my License is in full force and effect.
License Class: C39 License No.: 774482 n
Date:/ % Contractor / r—v C vv
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 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 sale.).
I ) 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 am exempt under Sec. . BAP.C. for this reason
Date:
Owner:
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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/9/2015
_Owner:
MATT, COLLEEN A
Contractor:
WILLIAMS ROOFING
P 0 BOX 391841
ANZA, CA 92539
(760)399-9394
Llc. No.: 774482
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 become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date �3 �S Applicant:
WARNING: 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 Building Official 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 hereby authorize representatives of this city to enter upon the 3&0ve•
mentioned property for inspection purposes.
Date:2'_ - Signature (Applicant or Agent)
La
"..FINANCIALINFORMATI•
r a DESCRIPTION s ,° `' �&ACCOUNT�
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BSAS SB1473 FEE - - 101=0000-20306
0
$1.00 $0.00
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Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION ��
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101-0000-42404
0
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Total Paid forRE-ROOF:. $182.73 $0.00
• 06
Description: MATT RESIDENCE RE -ROOF
Type: RE -ROOF Subtype: Status: APPROVED
Applied: 7/9/2015 EVA
Approved: 7/9/2015 EVA
Parcel No: 762231017 Site Address: 80000 HERMITAGE LA QUINTA,CA 92253
Subdivision: TR 27332 SEE ASSESSOR MAP 761 PG 47 Block: Lot: 5
Issued:
&48
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $18,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
CITY
Details: REROOF - [CRRC: 0942-0008] 2013 CALIFORNIA ENERGY CODE.
ADDITIONAL
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE NAMEADDRESS1-
CITY
STATE.
ZIP_- _
' PHONE : - '
;-.:.,FAX , :
EMAIL >.
APPLICANT WILLIAMS ROOFING
P 0 BOX 391841
ANZA
CA
92539
CONTRACTOR WILLIAMS ROOFING
P 0 BOX 391841
ANZA
CA
92539
OWNER MATT, COLLEEN A
1801 PORT ASHLEY PL
NEWPORT
CA
92660
BEACH
Printed: Thursday, July 09, 2015 4:28:29 PM 1 of 2 Cm
SYSTE/v1S
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
RE -ROOF -EA
101-0000-42404
0
$34.80
$0.00
ADDITIONAL 1,000 SF
RE -ROOF - FIRST 2,000
101-0000-42404
0
$49.31
$0.00
SF
RE -ROOF - FIRST 2,000
101-0000-426000
$98.62
$0.00
SF PC
Total Paid for RE -ROOF: $182.73 $0.00
TOTALS:00
PARENT PROJECTS
F_ BOND INFORMATION
Printed: Thursday, July 09, 2015 4:28:29 PM 2 of 2
sys�rnns
116
41
Off! #
City of La Quinta
Building ar Safety Division
P.O. Box I SO4, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777.7012
5 0 Building Permit Application and Tracking Sheet
Permit At
kZ 2 0 t 100
'Project Address:
wner's Name:P6
A. P. Number:
Address:
Legal Desch ion:.
C
City, ST, Zip: LA7 00 q22,S3
Contractor.7Wrelephone.-7
P06-
Address: Pr
MY -':�q I Sq I
Project Description:
City. ST, Zip:
Telephone: qSj—-�Oqkq
."01'L
Pr
State Lic. #
Citv Lic. #i
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: 7
N Stories: .1
#Units:
Telephone# of Contact Person:
C/o Estimated Value of Project: $ 9
f I /M
r
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Rcq'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calts.
Rtviewtd, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for corrctflonsfissut
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
ISAII.I.
11.6A. Approval
Plans resubmitted
Grading
[N'HOUSE:-
1*4 Rtvic%, "adv for corrections/issut
btvttoptr Impact Fee
Planning Approval
Called Contact Person
AJ.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
II
Total Permit Fees
lb/Ar.
Prescri Uve Certificate of Compliance: Residential Reroof CF-iR-ALT-ReRoc
RrolAddre s•
81ArJ6=,i L477DJLL, L qZ253
Climate Zone
I
Permit 0
I
U
ROOFING PRODUCTS (COOL ROOFS) 9151(012
When the area of exterior root surface to be replaced exceeds 50% of the existing root area, or 1,000 fe, whichever Is less, the net
roofing are* must meet the roofing product "Cool Root" requirements of §152(b)MI, 152(b)11111, or 152(b)1HIII,
Check applicable altemative or exception below it the roof alteration is exempt from the rcpjing product "Cool Roor requirements:
❑ Cool roofs not required in Climates Zones 1-12,14, and 18 with a low sloped roof pitch (less or 2:12 pitch),
❑ Cool: roofs V& required in Climates Zones 1-9, and 18 with a steep -sloped roofs (greater pitch than 2:12) and product weightless than 5/lbil
Alternatives to §152(b)1H1 and §182(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 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(11)10; or
❑ In climate zones 10, 12 and 13, with 1111:2 of free ventilation area of attic ventilation for every ISO 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(92; or
❑ Building has no ducts in the attic; or
❑ In climate 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 S 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 thermat mase over the roof membrane with at least 25 Ib/ft2 are exempt from the Cool Roof criteria.
NOTE: it any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Emiltance requirements for roofing
products in §118(1) are not applicable. Do not fill table below.
nIOTE: When a Cool Root 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
Name:
CRRC Product ID Number'
S 2:12 > 2:12
< 51b111112 a 5lb/ft2
Type2
Reflectance3'4
Em1tta ce
SRI
i
❑
❑
❑
� ' �, Phone _.
❑4
1T3
❑
❑
❑
❑
❑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 10 Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroo1s.oa1Wm ctsisearch.nhQ
2, Indicate the type of product Is being used for the rooftop, I, e. single -ply roof, asphalt root, 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 htta;/www.eneray.ca.ggWptle24Jand enter the resulting value in the SRi Column above and attach
atopy of the SRI- Worksheet to the CF. I R.
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or cover
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
nIOTE: When a Cool Root 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.
• [certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24, Part,
1 and 6 of the California
COO of Re ulations.
Name:
Signature:
CompaW1
I 11'AM'S
RWDMQ Obtfr
Addr
ffn
License:
City/S t J
� ' �, Phone _.
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.