BRER2015-009378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T-it�p 4 4 Qf1m&
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BRER2015-0093
Property Address:
54844 INVERNESS
APN:
775091023
Application Description:
REROOF WITH FIELD APPLIED WHITE FOAM [CRRC: 0626-0010)
Property Zoning:
Application Valuation:
$2,765.00
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: 16--6-�f 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).:
(_) 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.).
(_J 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/30/2015
Owner:
BIAS[ LORRI
54844 1NVERNESS WY
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LA QUINTA, CA 92253
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Contractor:
WESTERN PACIFIC ROOFING
T1
CORP
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2229 EAST AVENUE Q
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PALMDALE, CA 93550
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(661)273-1336
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Llc. No.: 235717
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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 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.
Date: f'6 -O—/e 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 enter upon the
above-mentioned property for inspection purposes.
Date: 10 ` 1 /r Signature (Applicant or Agen
FINANCIAL INFORMATION
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
PAID BY
;,METHOD
p .,-.;RECEIPT#
CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
$0.00
DESCRIPTION
ACCOUNT
CITY
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
ACCOUNT
CITY
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
$0.00
••
Description: REROOF WITH FIELD APPLIED WHITE FOAM [CRRC: 0626-0010]
Type: RE -ROOF Subtype: Status: UNDER REVIEW
Applied: 9/30/2015 SKH
Approved:
Parcel No: 775091023 Site Address: 54844 INVERNESS LA QUINTA,CA 92253
Subdivision: TR 22432-1 CM 063/112 SEE ASSR MAP Block: Lot: 2
Issued:
BK 769/43
Lot Scl Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $2,765.00 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, September 30, 2015 4:50:04 PM 1 of 2
RWSYS iEMS
ADDITIONAL
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP PHONE FAX EMAIL
APPLICANT
WESTERN PACIFIC ROOFING CORP
2229 EAST AVENUE Q
PALMDALE
CA
93550
CONTRACTOR
WESTERN PACIFIC ROOFING CORP
2229 EAST AVENUE Q
PALMDALE
CA
93550
OWNER
BIASI LORRI
54844 INVERNESS WY
LA QUINTA
CA
92253
Printed: Wednesday, September 30, 2015 4:50:04 PM 1 of 2
RWSYS iEMS
Printed: Wednesday, September 30, 2015 4:50:04 PM 2 of 2
N?WYSTEMS
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 $0.00
TOTALS:• ••
Printed: Wednesday, September 30, 2015 4:50:04 PM 2 of 2
N?WYSTEMS
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF111-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 4)
Project Name: 1,_)C' -v- - Date Prepared:
A. GENERAL INFORMATION
01
02
01 Project Name: Gk U..) is T(2es' den '
02
Date Prepared: � 9 y
03 Project Location:
04
Building Front Oiienati$n (deg or cardinal):
.05 CA City:
06
Number of Alfered yelling Units:
07' "Zip Code:
08
Fuel Type: y 4.
09 Climate Zone:
10...
,'&To l 'C3' r iti ned Floo A lft2)"
11 Building Type
12 ;
S31 A%e (h2) V
13 Project Scope:' 1�a:�c� a 0. 0\
nc cv.+ (o0 5 5k..'%
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)
01
02
03
04
05 06 x'07 08e .09
10
11
Tag/ID
Assembly Type
Frame
Type
Frame
Depth
(inches)
/Pr, po ed cls,,%
h, 01ppenx
Frame Conti uous AReference4
Spacing Cavity alnsulation
(inches) R -value R -value n,,1�,.-,factor Table Cell
Required
Comments
I LI -Factor
R -valuer
Propos d Minimum Required
SRI Aged Solar Thermal SRI
Method of
Roof
CRRC�L�Sict ID
De .kms
initial Solar Aged Solar Thermal
Compliance
Pitch
Exception
1 Amber a
tlbctType _
q uIat$n
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
C. ROOF REPLACEMENT (Prescriptive Alteration, SSeect
ri 50.2(b)1H)_ Q `�
01
.02
03
04 , a1 .V "
0%, v
' 06 .
b7 0$ 09 10 11 12 13
o�
R -valuer
Propos d Minimum Required
SRI Aged Solar Thermal SRI
Method of
Roof
CRRC�L�Sict ID
De .kms
initial Solar Aged Solar Thermal
Compliance
Pitch
Exception
1 Amber a
tlbctType _
q uIat$n
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
d �-
VP�"-td :
"6:
SAT
NOTES' ` "'
• Roof area covered, by, building integrated ph`atovolta epaneIs and solar thermal panels are exempt from the above Cool Roof requirements.
• Liquid field appliecloaings must comply JA nstallation criteria from section 110.8(i)4.
z
�s
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations
Project Name:�,.,IA- ltJe T R
Date Prepared:
t COMMISSION ®r,
MR -ALT -01-E
(Page 4 of 4)
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT ,
1. 1 certify that this Certificate of Compliance documentation is accurate and complete. "
Documentation Author Name:
DocumentatlomAuthor at1 `tl
!� Wlf1
4q
Company:
PA -
Signature Date: "
t % *
1q
r� -C- C- �9_V
Address:
CEA/ HERS Certification Ideritlficitipri(If applicable): '*4
City/State/Zip: /t
3 �- 22-6Z
rI' A
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 l
am'eligible under Division 3 of the Business and Professions Code to accept responsilViRy,for the building de or system design identified on this Certificate of Compliance (responsible
designer).s
3. That the energy features and performance specifications, material s,.components`�and manufactu�re``de�3i�ce for the building 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 li�e,gulatlons.
4. The building design features or system design features Identified on thi ertificate of Cd pliance�are consister�t�v,�sIf ,ttfae information provided on other applicable compliance documents, .
worksheets, calculations, plans and specifications submitted to the a fo cement agerSuc4faapproval with this wl�t(ing permit application.
5. 1 will ensure that a registered copy of this Certificate of Compllan�shall be made-ai'v ilable with the buildi g permit(s) issued for the building, and made available to the enforcement agency
for all applicable inspections. I understand that a registered co05bf this Certificate oflompliance is,Cequij�red to be included with the documentation the builder provides to the building
owner at occupancy.
.Responsible Designer.Name:
Responsible Designer Signature:
a
`� ti f .tea.
Company:. 'Y_ y1j
Date Signed:
<.er
Address: `� "'
License:
City/State/Zip: ^� E
Phone:
For assistance o"rrquestions 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
io