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BRER2015-002078-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 922 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: WILLIAMS ROOFING P O BOX 391841 ANZA, CA 92539 44 Q" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BRER2015-0020 80186 HERMITAGE 762230030 PGA WEST RES II HOA REROOF $4,500.00 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 Da ° . � CoSnnttrractor. r la' 4 POO Noayl 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).: (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-builderwill 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.). (_J I am exempt under Sec. . B.&P.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: c.: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: HSBC BANK USA 3476 STATEVIEW BLV FORT MILL, SC 92253 Contractor: WILLIAMS ROOFING P 0 BOX 391841 ANZA, CA 92539 (760)399-9394 Llc. No.: 774482 Date: 2/24/2015 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 polity 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. 1e 9. Date / Appli�L O �7'L ✓ 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 buildin construction, and hereby, authorize representatives of this city to enter on the abo e mentioned property for inspection purposes. Dat 2. Signature(Applicant.orAgent)r S,4 t �4 tr n N a O u- 1 Q ME 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 polity 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. 1e 9. Date / Appli�L O �7'L ✓ 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 buildin construction, and hereby, authorize representatives of this city to enter on the abo e mentioned property for inspection purposes. Dat 2. Signature(Applicant.orAgent)r S,4 t �4 Preacri tive Certificate of Compliance: Residential Reroof CF-IR-ALT-ReRoc Pr d e• La3 urs Climate Zone Permit�.2�5 ROOFING PRODUCTS (COOL ROOFS) §151(t)12 When the area of exterior root surface to be replaced exceeds 509b of the existing root area, or 1,000 fe, whichever is leas, the net roofing area must meet the roofing product "Cool Roof" requirements of s152(b)1H1, 152(b)1H11, or 152(b)1H111. or exception below it the roof alteration Is exempt from the roofing product "Cool Roof" requirements: ❑ Cool roofs M required In Climates Zones 1-12,14, and 16 with a low sloped roof pitch (less or 2:12 pitch). ❑ Cod roofs no required In Climates Zones 1-9, and 16 with a steep -sloped roofs (greater pitch than 2:12) and product weightless than SAb/I Alternatives to §152(b)1H1 and §152(b)HIi. Steep -slope roof (pitch > 2:12) ❑ Insulation with a thermal resistance of at least 1185 hr tez F/Btu or at least a 314 inch air -space Is added to the roof deck over an attk:; or ❑ Existing ducts in the attic are insulated and sealed according to §151(910; 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(92; or ❑ Building has no ducts 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)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 thermal mass over the roof membrane with at least 25 Ib/11:2 are exempt from the Cool Roof criteria. ya if any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Emittance requirements for rooting products in § 118(1) are not applicable. Do not fill table below. NQTE: 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 Signature: I CRRC Product ID Number' s 2:12 > 2:12 < 510/tt2 4 51bift2 Txpe2 Reflectance3,4 Emitta ce SRI i �_ 04 .D 13 13❑4 -�.3 ❑ D ❑ 11❑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 Councils Rated Product Directory at www.coolroofs.cra1DMM Wsearch.nhn 2. Indicate the type of product is being used for rhe roof top, i.e. single•pfy roof, asphalt roof, metal roof, etc. 3. If the Aged Reflectance Is not available in the Cool Roof Rating Council's Pared 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 ReRectance is a calculated value using the equation above. 5. Calculate the SRI value by using the SRI- Worksheet at htfvJM"ww:enerov.ca.and enter the resulting value in the SRI Column above and attach acopy of the SRI- Worksheet to the CF -1 R. To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coven 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 NQTE: When a Cool Root is required, the installing contractor shall complete and submit the CF -6R -ENV -01 for final inspection. Declaration Statement • 1 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, Part! 1 and 8 of the California COde of Regulations. 114 Name: i ]Ali hm`� Signature: I CompaK/1111'""b-51JO D I� Addr License: qZCity/S t ! i �_ 04 .D Phone For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800.772-3300. FINANCIAL •• 1, DESCRIPTION, ACCOUNT : ; QTY AMOUNT ." PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID.BY . :. METHOD RECEIPT #;. CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 ' DESCRIPTION ACCOUNT. ' QTY AMOUNT PAID PAID DATE RE -ROOF - FIRST 2,000 SF 101-0000-42404 0 $49.31 $0.00 PAID BY METHOD CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT' PAID PAID DATE RE -ROOF - FIRST 2,000 SF PC 101-0000-42600 0 $98.62 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for RE -ROOF: $147.93 $0.00 TOTALS: $148.93 00 Description: PGA WEST RES II HOA REROOF Type: RE -ROOF Subtype: Status: APPROVED Applied: 2/24/2015 MFA Approved: 2/24/2015 MFA Parcel No: 762230030 Site Address: 80186 HERMITAGE LA QUINTA,CA 92253 Subdivision: 28118 Block: Lot:5 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $4,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: REROOF NEW FOAM ON ALL FLAT DECKS ONLY 1050 SF 2013 CALIFORNIA ENERGY CODE. NAME Printed: Tuesday, February 24, 2015 9:49:39 AM 1 of 2 • - RS YSTEti1S ADDITIONAL CHRONOLOGY • CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT WILLIAMS ROOFING P 0 BOX 391841 ANZA CA CONTRACTOR WILLIAMS ROOFING P 0 BOX 391841 ANZA CA ]92539 92539 OWNER HSBC BANK USA 3476 STATEVIEW BLV FORT MILL SC 92253 Printed: Tuesday, February 24, 2015 9:49:39 AM 1 of 2 • - RS YSTEti1S PARENT PROJECTS BOND INFORMATION Printed: Tuesday, February 24, 2015 9:49:39 AM 2 of 2 SYSTEMS CLTD. DESCRIPTION. ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD -PAID BY BY RE -ROOF -FIRST 2,000 101-0000-42404 0 $49.31 $0.00 SF RE -ROOF - FIRST 2,000 101-0000-42600 0 $98.62 $0.00 SF PC Total Paid for RE -ROOF: $147.93 $0.00 TOTALS:60 PARENT PROJECTS BOND INFORMATION Printed: Tuesday, February 24, 2015 9:49:39 AM 2 of 2 SYSTEMS 41 bin Y 0 City of CLQ Quinta '0 V Building &r 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:wrier's Name:llq A. P. Number:Address: Legal Description: City, ST, Zip: Contractor: elephone: i Address: Project Description:TF F" PPROC41 Cit. ST, Zip: jkmZ 253 Telephone: 7i3� State Lic. # : City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person:+ Sq. Ft.: # S ories: # Units: Telephone # of Contact Person: — Estimated Value of Proje APPLICANT: DO NOT WRITE BELOW THIS LINE ri Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Cheek submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Calcs. 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. I-I.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''' Revic%, ready for corrcetions/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 A)