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BRER2015-010278-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&t�v 4 4 09"cv COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRER2015-0102 Property Address: 54725 INVERNESS APN: 775092030 Application Description: REROOF WITH FIELD APPLIED WHITE FOAM [CR Property Zoning: Application Valuation: $5,680.00 Applicant: WESTERN PACIFIC ROOFING CORP 2229 EAST AVENUE Q PALMDALE, CA 93550 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: B, C39 License No.: 235717 �_ Date: Contractor: e:2 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, 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 0 SUN —� .=300 T 2C�5 Cf 1 Y Gr' � QUIPaTA corgi r�iT_rtF'��cire�roEr, - 111111111111iiiiiiii 71 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 SERT PARTNERS DANCE CIR RT, CA 92253 Date: 10/7/2015 WESTERN PACIFIC ROOFING CORP 2229 EAST AVENUE Q PALMDALE, CA 93550 (661)273-1336 Llc. No.: 235717 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. L 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. toa-1 /f Date: `7 Applicant: —101 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 above-mentioned property for inspection purposes. Date: tv Signature (Applicant or Agent)!G FINANCIAL INFORMATION DESCRIPTION' ACCOUNT QTY r AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD:. RECEIPT # : CHECK # CLTD BY Total Paid for BUILDING 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 RECEIPT'# CHECK # CLTD BY DESCRIPTION' ACCOUNTQTY 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: TOTALS: $147.93 $148.93 $0.00 00 Permit Details PERMIT NUMBER City of La Quinta BRER2015-0102 Description: REROOF WITH FIELD APPLIED WHITE FOAM [CRRC:0626-0010] Type: RE -ROOF Subtype: Status: UNDER REVIEW Applied: 10/6/2015 SKH Approved: Parcel No: 775092030 Site Address: 54725 INVERNESS LA QUINTA,CA 92253 Subdivision: TR 22432-2 SEE ASSESSORS MB 769/43 Block: Lot: 5 Issued: FOR CMS Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $5,680.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: REROOF WITH LIGHT -NATIONAL COATINGS CORPORATION ACRYSHIELD-A510 WHITE [CRRC: 0626-0010] 2013 CALIFORNIA ENERGY CODE. Printed: Wednesday, October 07, 2015 5:25:17 PM 1 of 2 09LJ LJ SYS iEMS 00 Permit Oetrai5 PERMIT NUMBER City of La Quinta BRERs201r5-0102 Printed: Wednesday, October 07, 2015 5:25:17 PM 2 of 2 LJ L.1 LJ LJ 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 j 101-0000-42600 0 $98.62 $0.00 SF PC Total Paid for RE -ROOF: $147.93 $0.00 Printed: Wednesday, October 07, 2015 5:25:17 PM 2 of 2 LJ L.1 LJ LJ SYSTEMS 16 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CFIR-ALT-01-E Prescriptive Residential Alterations (Page 1 of 4) Project Name: PG/'- LJeST Date Prepared: q I �t A. GENERAL INFORMATION V M 01 Project Name: Gk Q £ T es icier 'ct 02 Date Prepared: o `I r 03 Project Location: 5dlS D) Vf/Y1Q55 04 Building Front 01eriiat on (deg or cardinal): 05 CA City: 06 Number of Alteied P elling Units: 07 Zip Code: S 08 Fuel Type: Qom, 09 Climate Zone: 10 Tof�I,($1?$ Toned Floo Ar7 ( 2)"� 11 Building Type 12 SI'a. ,Ahea (ft2) 13 Project Scope: o al o� ✓ cv�+ row S ��ea1 _f 4.. it '— O V B. BUILDING INSULATION DETAILS (Section 150.2(b)1)' V 01 02 03 04 05 06 08& 99 10 11 Method of Compliance Roof Pitch Exception '51 CRRC Prroduct ID C rQmber f AP11-po ed yyr Ira- Required fit` it Proposed Minimum Required ' , Initial Solar Aged Solar Thermal SRI Aged Solar Thermal SRI Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional) Frame Frame NContinuousAppenReference4 NOTES° Aw • Roof area covered by building integrated photovoltaicpanels and solar thermal panels are exempt from the above Cool Roof requirements. • Liquid field applied coatings)must comply w�thtallation criteria from section 110.8(1)4. Frame Depth Spacing Cavity 4lnsulation Tag/ID Assembly Type I Type I (inches) 1 (inches) R -value, R -value fagtor Table Cell I LI -Factor I Comments o lig" rr VIKs -t'k%,P C. ROOF REPLACEMENT (Prescriptive Alteration, �opn„�:50.2(b)iH)� V 01 02 03 04 v.4 05-,- "00 14 06 `07A 08 1 09 10 11 1 12 13 Method of Compliance Roof Pitch Exception '51 CRRC Prroduct ID C rQmber f • t? 3 6 Product Type R -value Deck , , ln3ulation fit` it Proposed Minimum Required ' , Initial Solar Aged Solar Thermal SRI Aged Solar Thermal SRI Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional) NOTES° Aw • Roof area covered by building integrated photovoltaicpanels and solar thermal panels are exempt from the above Cool Roof requirements. • Liquid field applied coatings)must comply w�thtallation criteria from section 110.8(1)4. Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CALIFORNIA CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E Prescriptive Residential Alterations (Page 4 of 4) Project Name: (�)A- Date Prepared: u �� DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. p;, K Documentation Author Name: Documentation Author at x 41,V"'I" (I* Company: Signature Date: cJ Address: r� /! � 4 � CEA/ HERS Certification Idents A119n`0f applicable): la Z � 0.n0. 4 � !(► City/State/Zip: RelM Cl4�jZz�Z Phone: _ RESPONSIBLE PERSON'S DECLARATION STA EMENT` I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 Division 3 the Business Professions Code to for building design Certificate Compliance am eligible under of and accept responsib the deg` system identified on this of (responsible designer). , ��✓ 3. That the energy features and performance specifications, materials, componer�tt.,�,, _n manufactured-,S'evice for the buil" ing design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of`R�eg, mons. 4. The building design features or system design features identified onntthis C`ertificate of Ciir t�pl nce�re consisten w,." information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to. the enforcement aged foWapproval with A is�,uil ing. permit application. its5. 1 will ensure that a registered copy of this Certificate of Comm ian shall be madealllable with the bu'II d ng permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registeere ably of this Certific'a'te f Compliance is . quired to be included with the documentation the builder provides to the building owner at occupancy.vit %OP Aft 0r.AW, Responsible Designer Name: �1 t Responsible Designer Signature: V f.. Company: �''"�,-4 Date Signed: 7W T � Address:` 'NO License: City/State/Zip: `b Phone: . szko For assistance or -questions 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