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11-1280 (RR), P.O. BOX 1504 78=495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: C-11,f60001t280_��� Property Address: 53400 . AVENIDA HERRERA APN: 774-084-009-16 -000000- Application description: RE -ROOF Property Zoning: COVE RESIDENTIAL Application. valuation: 3000 T4'!t 4 4 4" 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 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.l. (_ 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 _ 1 I am exempt under Sec. , B.&A.C. for this reason f - 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/29/11 Owner: SEAN O'BRIEN 53400 AVENIDA HERRERA LA QUINTA, CA 92253 -------------------- ---- W\__ p -- Contractor: a NOV.? �? Owner NOS � 2011 CITY OP F. �.i r, ill Tq --------------- ------------------ WORKER'S -----------------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 maintainworkers' 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 'G/7/`/�/,) person in any manner so s to become subject to the workers' compensation laws of California, and agree that, if I shout become subject to the workers' compensation provisions of Section 370 of th Labor Co I shall forthwith comply with those provisions. ,Allate: J dent: WARNING: FAIL RE TO S RE WORKERS' COMPENSATION COVERAGE IS U LAWFUL, 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 abov information is correct. I agree to comply with all city and co u ty ordinances and state laws relating to building nstruction, and h eby authorize representatives of thisW�Zhe above-mentioned property fo nspection purpos s. a:a (Applicant or Agent): Application Number . . . . . 11-00001280 Permit . . . RE -ROOF Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .0.0 Issue Date . . . . Valuation 0 Expiration Date 5/27/12 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and Comments REMOVE EXISTING & RE -ROOF WITH DURAOD SHINGLES. R-30 INSULATION TO BE VERIFIED AT INSPECTION. 2010 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 Pres.cri .tive Certitieate df,Corn• lidncce,Reigic9ential-'Reroof,= ; - C�'=1R-ALT-ReRoof Project Address'., Climate Zone ' Permit # 3yo v A VN&4 �Ileee6 4 ROOFING PRODUCTS (COOL ROOFS) §151(012 When the area of exterior roof surface to be replaced exceeds 50% of the existing roof area, or 1,000 , whichever is less, the new roofing area must most the'roofing product "Cool Roor requirements of §152(b)1 141, 152(b)1 1411, or 152(b)114111. Check applicable alternative, or exception below if the roof alteration -is exempt from the roofing product "Cool Roor requirements:: ❑ Cool roofs not required in Climates Zones 1-12,14. and 16 with a low sloped roof pitch (fess or 2:12 pitch). ❑ Cool roofs rot required in Climates Zones 1-9, and 16 with a steep -sloped roofs (greater pitch than 2:12) and product weight less than 5AbM?. Alternatives to §152(b)1Hi and §152(b)Hil, Steep -slope roof (pitch > 2:12) ❑ Insulation with a thermal resistance of at least 0.85 hrf?-*F/Btu or at least a 3/4 inch air -space is added to the roof deck over an attic; or ❑ Existing duds in the attic are insulated and sealed according to §151(f)10; or ❑ In climate zones 10, 12 and 13, with 1112 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 .§152(b)l Hill, Low -lope roof ( pitch S 2:12) ❑ Building has no ducts in the attic. Other Exceptions 0. 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 b are exempt from the Cool Roof criteria. OTE. If any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Emittence requirements fbr roofing products in § 118(i) 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 IO Number'. s 2:12 > 2:12 < 51b/ftz 2 516W Type? Refiectance3A Emittance SRIS Signature: ❑ o ❑ ❑ o° City/State/Zip: Phone: ❑ 0 ❑ ❑ ❑° 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 coo/roofs orrrfiroductsfsearcf►.oho 2. Indicate the type of product is being used for the roof top, le, s/ngle j* roof, asphalt roof, 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 (0.2f0.7(pj„ — 0.2) to obtain a calculated aged value. Wheys p is the Initial Solar Reflactance- 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 httoYA~.enerov.ca.aovAWe241 and enter the resulting value in the SRI Column above and attach acopy of the SRI- Worksheet to the CF -1R. To apply Uquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry m1i thickness or coverag commended 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 Certill to of Complia7 conform to the requirements of Title 24, Part! 1 and 6 of the California Code of Regulations. Name: 4 i.Jr✓ U l l.Q J t{�IJ Q')�R I E// Signature: Company: _ Date: �/d V 9, 2---, i P. :ss: License: City/State/Zip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. P.6. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78=495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits PJ;�(�P�R�Ti� t)�y[�� Ileac Property Owner An aMhcation for a budding permit has been submitted in your name listing yourself as the builder of the property imps is spocified at Vie are ptovrdmg you with an Owner -Builder AAcnowledgment-mcl Infortnatien VeriBeation Form to mekt you aware of your rosponslbilities and possible nsk you may incur by h*ving *dspermd-i=md im your name as the 0%`n" -Budder. We w0l not issue a baiidWg permit w►til yon-haveread, init€�tI your. audet�ctacome of eack provision, diener, and returnEd this form to us at our official address indicated. An agent of the owner cannot exeeute this notice unless you, the property owner, obtain the prior approval of the permitting authority. �21 1. I understand a €requent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material penmma ft. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed persot 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 inr� coverage for injuries to wodoer on my property. !�;_02. I understand building permits are not rogtrired to be signed by property owners unless they are responsible for 6 construction and are not hiring a licensed Contractor to assume this responsibility_ 3. I understand as art "Owner -Builder" I am the responsible party of record on the permit. I understand that I may prole myself from potential financial risk by hiring a licensed Contractor and baying the permit filed m his or her name- instead of o OVAL 4-I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers permits and contracts. �5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total v. Of my construction is at least five hundred dollars (5500), including labor and materials, I may be considered an "emplo under state and federal law. (�6. I understand if I am considered an "employer" under state and meral taw, I must register with the state and fe government, withhold payroll taxes, provide workers' compensation disability inswwwo, and contribute to unemploy compensation for each "empl risk oyee." I also understand my failure to abide by these laws may subject me to serious fine 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family resid structures cannot legally build them with the intent to offer them for sale, unless all work is performed by tic subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is perf, under contract with a licensed general building Contractor. 8. I understand as an Owner -Builder if I sell the property'for which this permit is issued,. I may. be held liable for any uncial or. personal. 4ories susiaifltd by any subsequent owner(s) that result from any latent construction defects in the woriananship or materials. 9A understand I • may obtain adore information regarding my obligations .as an "employee" from theernal IntRavenue . Servioo, 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 (CSIA at 1- 800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. j210. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the . ply legally and financially responsible for proposed construction activity at the following address: 11. I agree that, as the party legally and fanaucially -responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. 12. 1 agree to notify the issuer of this form immediately of any addit%ns; deletions, or eba0609 to tay of the infvrmaticm 1 have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you 000tr4et with someone who doers not have a liana, the Contreators' State Licam Board may be unable to assts you with any 6nanaial loss you may sustain as a result of a complaint- Your only remedy against unlicensed Contractors mar bo rn civil court. It is also impextaat for you to understand dM -if an unlicensed Contractor or a nVtoyee of that individual or film is i4wpd *Vdc wmiting on your property, you may be, hold h for d&atages. If you obtain a permit as Owner -Budder and with tG hFM Co ors, you will be resporslo for vcdfM v&edw or not those Contractors are pmpedy [leaned and the status of *011Y wO6=s' oompensafion insursmoe oov=W. Before a building permit can be inued, this form mast be completed and signed by the property owner and returned tt the agency responsible for b=vifttlhe4mr=k . NoW A copy of dac properq, awitar's elrU€rw'g i fWM 8009*94*+4 v other verification aeeePt4k so dw agency is ee u&wd to be prme ted when dra porndt is i to j► dw P. ++opera owner's signature. L Signature of property ovine r Dated 1/ Z Note: The following Authorization Form is required to be completed by the proper. ty owner curly when designatir an agent of the property owner to apply for a conduction permit for the Owner-Builder- AUTIEMIZ TION OF AGNT TO ACC ON e)ItOPERTY OWW&'S Excluding the Notice to Property Owner, the a xogution of which I understan& is my periacinal respom-whty, I htnby author Bra Mowing person(c) to act as my og=Ks) to apply for, sign, and file the documents necessary to obtain an OwnerBuilds 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 I am the property owner for the address listed above and I personally filled out the information and vestify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verficad, verify acceptable to the agency is req uir to be p ed when the permit is issued to verthe property l's signature. Property Owner's Signature: Date: eV ;_00 l B►ri # Cky Of La .Quii1ta ..Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico . La Quinta, 922536 Building Permit Application and Tracking Sheet Permit # . Project Address: 3 y 0D. AU9NIb sgap Il' Owner's Name: SFA- t� 01 62 lig N A. P. Number:. Address: 3 C f 04 V elvID q CT 6W(2i q Legal Description: City, ST, Zip: G /4 6U),,J 7i C4 ,. Contractor: L �(/ !i C �fi ow /4 r3� 4 R . Tele hone. M. P ' Project Description:. 06 i577,06 Address: OU�` City, ST, Zip: Telephone: State Lic. # : City Lic. #. Arch., Engr., Designer: Address: City, ST, Zip: Telephone: . State Lic. #:,.,.<}rr.. >, n �� Construction Type: Occupancy: project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft:120 D # Stories: D u6 # Units: Q Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calm Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"° Review, ready for corrett'ionsti sue 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 correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees