BRER2016-001178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tit!t 4 4 QuIRM:
COMMUNITY DEVELOPMENT DEPARTMENT .
1111111101>`LCI»iv, IIIc
Application Number:
BRER2016-0011
Property Address:
49380 AVENIDA FERNANDO
APN:
658320002
Application Description:
BOTSFORD RESIDENCE / REROOF FOAM
Property Zoning:
Application Valuation:
$3,798.00
Applicant:
FOAMBOND CORPORATION
255 N EL CIELO RD STE 140-656
PALM SPRINGS, CA 92262
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.: 868171
Date:2 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.).
(� 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. . 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:
62
77-7125
77-7011
:::;=R/ 77-7153
FEB U 9oa9/2016'
Owner: • I
BOTSFOR FAMILY
49380 AVE
LA QUINTS, CA 92253
Contractor:
FOAMBOND CORPORATION
255 N EL CIELO RD STE 140-656
PALM SPRINGS, CA 92262
(866)404-5440
LIC. No.: 868171
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 workfor 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 th a prov' ions.
Date: Z 5 <G 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 a on the
above-menti/on/e�Oroo y for inspection purposes.
Date: G/ "r Signature (Applicant or Agent):
FINANCIALINFORMATION
DESCRIPTION,�'�'� � � t "ACCOUNT �� 4��'� � -. PAID;�'�'�; PAID DATE
,,�� N . �•
AMOUNT
BSAS SB1473 FEE 101-0000-20306
0 $1.00 $0.00
ri' "S 'SYS 4� . �".0 �^ *r�- � � r 5' •kms �Yn„�,�;. t r �✓��' �,� wn�')4�'.'�1* � � 05 �.iYlf:`'ai"�u�C a i4'sb*S,hr r -
t PAID BYa x5:`ME ,r REGEIP,J��#� ' #,CLTD, BY
<M i
,I CHECK
.Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
°a DESCRIPTION
!3i ('"
'GC.rOUN'
`4'Crr
ba `
71
PAID
,7
PI110 DATE
� _•
.a,
`AMOUNT ,
s
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$49.31
$0.00
h PAID BY
RECEIPT#
CHECK#CLTDBX
a°`�
;METHOD$.
DESCRIPTIONMR,f
;WIN rr�a
ACC ��
-
AMOUNTr
�
�s�PAID
U.",
PAID DATE4
r
�qTY'
„Cr�;'Sa r''�'h` "'z%
'-�. •4T :n«Fw., 6+E ,e -e',.*
x' �u.T.5Y.55..a.>2,.^3r
RE -ROOF - FIRST 2,000 SF PC
101=0000-42600
0
$98.62
$0.00
METHH
I#
#i
e
_ .�RE :`CHECK
CLTD BY
Total Paid for RE -ROOF:. $147.93 $0.00
o�: 00
Description: BOTSFORD RESIDENCE / REROOF FOAM
Type: RE -ROOF
Subtype: Status: APPROVED
Applied: 2/9/2016 MFA
Approved: 2/9/2016 MFA
Parcel No: 658320002 Site Address: 49380 AVENIDA FERNANDO LA QUINTA,CA 92253.
Subdivision: TR 16786 CM 040/168
Block: Lot: 1
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $3,798.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
PHONE
Details: GRAVEL SWEEP AND INSTALL POLYURETHANE FOAM ROOF SYSTEM PER2013 CALIFORNIA ENERGY CODE.
ADDITIONAL SITES
CHRONOLOGY
CONTACTS
NAME TYPE
NAME
ADDRESS1
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
FOAMBOND CORPORATION
255 N EL CIELO RD STE
140-656
PALM SPRINGS
CA
92262
(626)945-8913
CONTRACTOR
FOAMBOND CORPORATION
255 N EL CIELO RD STE
140-656
PALM SPRINGS
CA
92262
(626)945-8913
OWNER
BOTSFORD FAMILY 2005 TRUST
49380 AVENIDA
FERNANDO
LA QUINTS
CA
92253
(626)945-8913
FINANCIAL INFORMATION
Printed: Tuesday, February 09, 201611:14:52 AM 1 of 2 0?
SYSTEMS
Printed: Tuesday, February 09, 2016 11:14:52 AM 2 of 2
SYSTEMS
"C
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
By
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
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:00
Printed: Tuesday, February 09, 2016 11:14:52 AM 2 of 2
SYSTEMS
I A I t OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1 R -ALT -01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION { �'
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 2 of 4)
Project Name: Date Prepared:
D, FENESTRATION/GLAZING AREAS ALLOWED.(Section 150.2(b)1) „
01
02
04
03.
Alteration Type
Orientation
Maximum Allowed ft2 Comments °
.
�09
V;
E. FENESTRATION/GLAZING PROPOSED AREAS AND EFFICIENCIES (Section 150.2(b)1) .
.
�09
V;
01
02
03
04
05
06
07
OSAM
1-0
11
12
13
14
15
"
Combined
Orientation
Area
Area
.. Net �
Maximum
Exterior
SHGC
Tag/
Fenestration
Frame
Dynamic
N, S, W, E, or
Removed
Added
4 Added
All�d ed
Shading
from
ID
Type
Type
Glazing
Roof
ft2
ft2'��s
Area ft2
tor
U -factor
Source
SHGC
Source
Device
CF1R-ENV-03
e
w�
tar
a
Net Added WeS'TrgaclFenestratio n.Aea
.
;
- -
b
Existing + Add . Wstfacing Fene�straEipnA�r,.ea
m
c •
MaximumAll wed Vilest-facir�g,�F�er st�r�.a�tion Area
VK 'FV
d
Is West -facing Fenestration Area < Maximum Allowed West -facing Fenestrae
'
Area;,
e
,Net Added Fen�est anon Area (all or•ent,�ti ns)
f
'%Existing + Added�F%'46' ration Area (all�oriV��tatlons)
9
Fenestration Area (all o(ientations)
h
Is Existing + gilded Fenestration Area rMaximum Allowed Fenestration Area (all
orientations
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
F CALIFORNIA
RESIDENTIAL ALTERATIONS
GEC-CFIR-ALT-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION `
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 3 of 4)
Project Name: Date Prepared:
F. SPACE CONDITIONING(SC) SYSTEMS—HEATING/COOLING (Prescriptive section 150.2(b))
01 02 03
Dwelling Unit Name Dwelling Unit CFA (Ft2) Comments~ to
G. WATER HEATING SYSTEMS (Section 150.2(b)1G) .�.
01
02
03
04
05
06
07
08
Centra,,Wate4r Beating
. it {'
Sys Ic)entl.f.ication or.WaterHeating
�, ! ' Name 4
~10
¢11 .
3 12
13
14
15
Water
��" '�
Water Heating
s�,
'�
Back -Up
System
Water
Water
Water
Heater
Rated
sa
Rated
Heating
�Heat,,ng
%
Exterior
Solar
Dwelling Unit DHW
Identification or
Heating
Heater
Heaters
in
Storage
Volume
Fuel
Input
U �t
r
Efficiency
111, f
�Effieiency
Standby
Insul.
Savings
Central DHW System
System
.:'�^.Inpuj
Name
System Type
Type
system
(gal)
Type
Type,
Value
Type-
.�4-_va(ue
loss.(%)
R -Value
Fraction
Distribution Type
Distribution Type
H. SPACE.CONDITIONING SYSTEMS AND WATER H�EATIN*G SYSTEM IN4PAULTIFAMILY�DWE'LLING UNITS
01
02
,. 03`?., K
04`x°
05
06
Dwelling Unit Name
DwellingUnit4Totfal CFA
Centra,,Wate4r Beating
. it {'
Sys Ic)entl.f.ication or.WaterHeating
�, ! ' Name 4
\
DWelling Unit
System
'!(Identification or Name
Dwelling Unit:
Alteration to the Space
Conditioning System(s)?
Comments
y.,(ff2)s
Registration Number:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time:
HERS Provider:
lune 2014 f
STArs E GF CALIFORNIA
RESIDENTIAL ALTERATIONS
CERTIFICATE OF COMPLIANCE CF111-ALT-01-E
Prescriptive Residential Alterations (Page 4 of 4)
Proiect Name: Date Prepared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT",
1. 1 certify that this Certificate of Compliance documentation is accurate and complete. ewe t�
Documentation Author Na e:
Documentation Author Signature:
Company:
Signature Date:
Address:
CEA/ HERS Certification Ide i Icatlon`(If applicable):.
City/State/Zip:
Phone:
U11X.
RESPONSIBLE PERSON'S DECLARATION STA EMENT t? "
I certify the following under penalty of perjury, under the laws of the State of California: g
1. The information provided on this Certificate of Compliance is true and correct.
2.. 1 am eligible under Division 3 of the Business and Professions Code to accept responsgUity,for the buildinng,d; sig or system design identified on this Certificate of Compliance (responsible
designer). q
+
3. features the building design design identified on this Certificate of
That the energy and performance specifications, materials, component, a,ltd"manufacturedd'evi.cesfor or system
Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Co4e of, eg laflons.
4. The building design features or system design features identified own this Certificate of Commpliiaance,are cons•I�ster V ithU,tt a Information provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted to�the e;gforcement ager�ey''f%approval with t�h'.is I! Ing permit application.
5. 1 will ensure that a registered copy of this Certificate of Corp lian 0all be made .44 )fable with the building pgrmit(s) issued for the building, and made available to the enforcement agency
a.
for all applicable inspections. I understand that a registe e , 'top of this Certificates - Compliance is,rd"Wre,:d to be included a documentation the builder provides to the building
owner at occupancy. 3
Responsible Desig er Name:
Qe��alible Designer Signalur .
company:
Date Signed: /
Address: �*
2ss ell % .
License:
rY6rf/
City/State/ZIp: 6 �`�
Phone:
`ram s
For assistance orYquestions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
zi i A i t OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 4)
Project Name: Date Prepared:
A. GENERAL INFORMATION
01
T4,,
01
Project Name: J&#
02
Date Prepared:
03
Project Location: 3 0
04
Building Front Orieniation`(deg or cardinal):
05
CA City: Q,
06
Number of Altered Dwelling Units:,`.
07
Zip Code-.*
08
Fuel -Type: 1�, o-,
09
Climate Zone:
10
T,otal,Conydiiioned Floor=Area,(ft2)c'I
11
Building Type
12
Slab A.rea`(ft2)
13
Project Scope:;w
i';PrgdUctType ,
}
4t .'. W �& 110
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)
01
02
03
04
05
06 `• 07 08 Q9
10
11
Tag/ID
Assembly Type
Frame
Type
Frame
Depth
(inches)
FrameConGnuous
Spacing
(inches)
`Proposed
Required
Comments
Cavity
R -value,
q>,
Insulation
R -value,!' ''U=factor
1Appendix JA4
Reference
LI -Factor
Table FCell
l
CRRC Prodd' ID
,. " ?
� ,
Deck
`
Compliance
p
Pitch
Exception
p
t=; Number
i';PrgdUctType ,
. Insulation
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
e!t"i�s
X\",
. 40 v
C. ROOF REPLACEMENT (Prescriptive Alteration, Secti;onj}S6.2(b)11-1)..
01
02
03
04 rT,` *
05?x •
P 06
ei `07�4' 08 09 10 11 12 13
` \
R-vplue
�`+ Propos d Minimum Required
initial Solar Aged Solar Thermal SRI Aged Solar Thermal SRI
Method of
Roof
l
CRRC Prodd' ID
,. " ?
� ,
Deck
`
Compliance
p
Pitch
Exception
p
t=; Number
i';PrgdUctType ,
. Insulation
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
NOTES . �_�
• Roof area covered by.bu ilding`integrated photovoltaic, panels and solar thermal panels are exempt from the above Cool Roof requirements.
• Liquid field applied coatings must comply with. stallation criteria from section 110.8(i)4.
• �L
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
Bin #
City of La Quinta
Building ST Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit .# /„
lfJ
Project Address:
�l
Owner's Name: S Oma
A. P. Number:
Address: L /
,� ' v 2n � •dc �P.rtr c ��
Legal Description:
City, ST, Zip:
Contract r•
a�-
C L O �
Z /S
Address: Z_ 5-S ,V.
F Ci Pi a
-Telephone:
Project Description:
City, ST, Zip: K
�. e -h
p e- .3 4,r o -AA r00
ele h
Telephone:
Po . O
6
State Lic. # :96 8
City Lie. #;
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
aneY
n TY Pa Occupancy:
Construction
State Lic. #:
Project type (circle ne • New A dd'n Alter Repair Demo
Namd,of Contact Person:
Sq. Ft.: 77/2
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: 7j
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan'Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance,
Title 24 Calcs.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'q Review, ready for corrections/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