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)