BRER2015-009278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
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COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BRER2015-0092
Property Address:
54848 INVERNESS WY
APN:
775091023
Application Description:
REROOF WITH FIELD APPLIED WHITE FOAM [CRRC: 0626-00101
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 1
Date: /6 - 4e'/JO 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.).
(_) 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 contractors) 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:
6,
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
LAWSON FAMILY TRUST
54848 INVERNESS WY
LA QUINTA, CA 92253
Contractor:
WESTERN PACIFIC ROOFIN
2229 EAST AVENUE Q
PALMDALE, CA 93550
(661)273-1336
Llc. No.: 235717
Date: 9/30/2015
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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.
X 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 s all forthwith
comply with those provisions.
Date: p -6-/I 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 represehtatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: -110 `/JroSignature (Applicant or Agent <��z 4�k
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 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
Total Paid for RE -ROOF:
TOTALS:00
$49.31
$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: 54848 INVERNESS WY LA QUINTA,CA 92253
Subdivision: TR 22432-1 CM 063/112 SEE ASSR MAP Block: Lot: 2
Issued:
BK 769/43
Lot Sq 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 5:14:22 PM 1 of 2 cel"
SYSTEMS
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
LAWSON FAMILY TRUST
54848 INVERNESS WY
LA QUINTA
CA
92253
Printed: Wednesday, September 30, 2015 5:14:22 PM 1 of 2 cel"
SYSTEMS
DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD
BY
RE -ROOF - FIRST 2,000 101-0000-42404 0 $49.31 $0.00
SF
Total Paid for RE -ROOF: $49.31 $0.00
PARENT PROJECTS
Printed: Wednesday, September 30, 2015 5:14:22 PM 2 of 2
RWYSTEMS
is -
,y
r
s
0
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
rFr_r F�R_AI T_n -P nRHd\
rcr rcnaurn cucanv rnMneiccinti
CERTIFICATE OF COMPLIANCE CHR -ALT -01-E
Prescriptive Residential Alterations (Page 1 of 4)
Project Name: (,=A- L:L,4='T Date Prepared:
j,
A. GENERAL INFORMATION
,
01
Project Name: GA- UJ T (LeS i en '.
Aro 02 Date Prepared: ' 914 1 Is -
03
Project Location: 13 erye 5 5
04 Building Front OnenLati`gn (deg or cardinal):
05
CA City: •�cl
06 Number of Alt ret ga(pwelling Units:
07
Zip.Code: - 73
08 Fuel Type: 0,
09
Climate Zone:
10.: s.T.ofal,Condi;ioned Floo <AFea (ft2
11
Building Type
42 7 ',SIab,Xrea(ft2) *i%
13
Project Scope: �ryk.�l�w�a� o a �\ ✓
nc n.•. %c, S �w�r ':_.�.j.:
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)
01
02
03
04
05 06 _ a� X67 08�' X09
10
11
Tag/ID
Assembly Type
Frame
Type
Frame
Depth
(inches)
ropo ed p
6Appendix JA4
Frame ( Continuous Reference
Spacing Cavity kOInsulation
(inches) R value, R -value + fagtor Ta;tel Cell
Required
Comments
I LI -Factor
C,R1�RC Rrod"uct ID Deck
Compliance
Pitch
Exception
IL p rvumber c a%d1`uctType
Reflectance Refle�c7tance Emittance (Optional) Reftec+tance ttance to
%
Ylnsula_io
!Thermal
7,4
& ff�'* Xr N... 10 :ti %-p
C. ROOF REPLACEMENT (Prescriptive Alteration, Se i�n�"V50 .2(b)1H),
01
02
03
04 6W= 05j 06
a ' 'U.7,a O8 09 10 11 12 13
e R -value
v4 Proposed Minimum Required
Initial Solar Aged Solar Thermal SRI Aged Solar SRI
Method of
Roof
C,R1�RC Rrod"uct ID Deck
Compliance
Pitch
Exception
IL p rvumber c a%d1`uctType
Reflectance Refle�c7tance Emittance (Optional) Reftec+tance ttance to
%
Ylnsula_io
!Thermal
7,4
NOTES _ w
• Roof area covered by, buil'dingJntegrated photovoltal' panels and solar thermal panels are exempt
• Liquid field applieiit"cia mgs•rmust comply Witli�i�nstallation criteria from section 110.8(i)4.
from the above Cool Roof requirements.
kegistration Number: Registration Date/Time:
'CA Building Energy Efficiency Standards - 2013 Residential Compliance
HERS Provider:
June 2014
D-0
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 4 of 4)
I Protect Name: l�lhlA- lt�e-%T EkcA'* 1 I Date Prepared: 9/4 /io I
AM
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT r m
1. 1 certify that this Certificate of Compliance documentation is accurate and complete. _
Documentation Author Name:
Documentation Author nat
Company:
(20.�-h �r
Signature Date: ItW
`�%�l �� �
rte ���P c
Address: J
CEA/ HERS Certification Ideh ALgr (if applicable):
City/State/Zip:
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. b.
2. I Division 3 the Business Professions Code building d, design identified this Certificate Compliance
am eligible under of and to accept responsib�ilrty3for the ss, or system on of (responsible
designer).
3. That the energy features and performance specifications, materials, compon4ntss amend manufacturr d�'� revice 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 11ifornia Code ofYtegulatlons.�,,�
4. The building design features or system design features identified on this Certificate of Co�nplliaanceare consistent rth�tie information'provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted .to the enforcement agenfb .approval with tis uIl ing permit application.
an& permit(s)
5. 1 will ensure that a registered copy of this Certificate of Compl -shall be made:ava ablwith the building issued for the building, and made available to the enforcement agency
building
for all applicable inpections. I understand that a regist coQy of this CCertif�Idatte f Cbmpliancei rt;equlrea to be included with the documentation the builder provides to the
owner at occupancy. Alp lih, *,A -
Responsible Designer Name: 14 AfReso6hsible Designer Signature:
Company: ! r' �
p
Date Signed:
Address: b '
License:
%.
City/State/Zip:Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300.
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
HERS Provider:
June 2014
10