BRER2015-0094t � y
78-495 CALLE TAMPICO
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LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPART
BUILDING PERMIT
I Illlll lull illi I'll—�
Application Number: BRER2015-0094 63
Property Address: 52240 AVENIDA MENDOZA _
APN: 773273026
Application Description: WARDEN RESIDENCE / REROOF
Property Zoning:
Application Valuation: $7,875.00
Applicant:
PALM DESERT CONTRACTORS
P 0 BOX 2795
PALM DESERT, CA 92261
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.: 477507
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 thef
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora
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 I I am exempt under Sec. B.&P.C. for this reason
c
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
- P.__,ll 111VOICE (760) 777-7125
OCT O 1 III III FAX (760) 777-7011
_ 20151NSPECfIONS (760) 777-7153
CI7YOFl,A QLIj�TA—A
IUNITYDEVJ{ Date: 10/1/2015
EI��g�e N T
Owner:
JAMES LEVANOFF
52240 AVENIDA MENDOZA
LA QUINTA, CA 92253
Contractor:
PALM DESERT CONTRACTORS
P 0 BOX 2795
PALM DESERT, CA 92261
(760)346-2420
Llc. No.: 477507
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 Labo e,J-skaN-fe ith
comply with those provisions.
Date: -t 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.
i. 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.
Dat ! —t' -O Signature (Ap'plicant or;
lem n Illm
. , 3. i"sc�'-.,,� r' F . 4 x .a ' iS.r:, sir r, }°e:. ,�' a �,@y. , e, ,. ^4�' .�a-•` at` -,
fir. DESCRIPTIONS ��;<rf;'x4-SACCOIINT" QTY AMOUNT PAID r>x RAID DATE°
a.; 41,
r,.es,kc x- .,a r:•. ; s - .,':: Y r< ,<,, �_ 3s �I ,,,„tee 1, <� aw: .. s r � r,
BSAS SB1473 FEE, ' . 101-0000-20306 0 $1.00 $1.00 10/1/15
.„F ' sem,
METHOD.
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PALM DESERT CONTRACTORS DEBIT R9671 BRER2015-0094 SKH
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00.
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i AMOUNTn
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PAIDDATE.
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
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$49.31
10/1/15
PAID BY
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DEBIT
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RE -ROOF - FIRST 2,000 SF PC
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10/1/15
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PALM DESERT CONTRACTORS
DEBIT
R9671
BRER2015-0094
SKH..
Total Paid for RE -ROOF: $147.93 $147.93
•9 148 93
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1
1 .
Description: WARDEN RESIDENCE / REROOF
Type: RE -ROOF Subtype: Status: ISSUED
Applied: 10/1/2015 SKH
Approved: 10/1/2015 SKH
Parcel No: 773273026 Site Address: 52240 AVENIDA MENDOZA LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: Lot: 20
Issued: 10/1/2015 SKH
UNIT 11
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $7,875.00 Occupancy Type: Construction Type:
Expired: 3/29/2016 SKH
No. Buildings: 0 No. Stories: 0 No. Unites: 0
ADDRESSI
Details: REROOF WITH COMP SHINGLES PER 2013 CALIFORNIA ENERGY CODE.
_._.J Applied to Approved
Approved to issued
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
PALM DESERT CONTRACTORS
P 0 BOX 2795
PALM DESERT
CA
92261
CONTRACTOR
PALM DESERT CONTRACTORS
P O BOX 2795
PALM DESERT
CA
92261
OWNER
JAMES LEVANOFF
52240 AVENIDA
MENDOZA
LA QUINTA
CA
92253
Printed: Thursday, October 01, 2015 11:35:21 AM 1 of 2
SYS Tf: hiS
Printed: Thursday, October 01, 2015 11:35:21 AM 2 of 2
S YS7f MS
CLTD
DESCRIPTION
ACCOUNT
CITY .
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
10/1/15
R9671
BRER2015-
DEBIT
PALM DESERT
SKH'
0094
CONTRACTORS
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
RE -ROOF - FIRST 2,000
101-0000-42404
0
$49.31
$49.31
10/1/15
R9671
BRER2015-
DEBIT
PALM DESERT
SKH
SF
0094
CONTRACTORS
RE -ROOF - FIRST 2,000
101-0000-42600
0
$98.62
$98.62
10/1/15
R9671
BRER2015-
DEBIT
PALM DESERT
SKH
SF PC
0094
CONTRACTORS
Total Paid for RE -ROOF: $147.93 $147.93
TOTALS:4:$148.93
Printed: Thursday, October 01, 2015 11:35:21 AM 2 of 2
S YS7f MS
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS Cffl
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)
Proiect Name: Date Prepared: , _ , f
A. GENERAL INFORMATION
01
02
.
01
Project Name:
06 08f 09
02
Date Prepared: '' & 14 (-*1— i —, f-
03
Project Location:
22 v 0
04
Building Front bijeritatlon`(deg or cardinal):
05
CA City:
L_.c�•.
06
Number of Altered Dwelling Units: V..�X
07
Zip Code:
z.s S 3
08
Fuel Type; t( ,."� lk,N I✓
09
Climate Zone:
Pitch
10
Total,Conditioned FloorArea (ft2):)' a pY-
11
1 Building Type
ad
Reflect geflectance Emittance tional) Reflectance Emittance (Optional)
12
1 Sla,b,Area(ft2) 'It:A
13
1 Project Scope:
e a
U 11:1711 W .
B. BUILDING INSULATION DETAILS (S ction 150.2(b)1)
01
02
03
4
05
06 08f 09
10
it
Tag/ID
Assembly Type
Frame
Type
Frame
Depth
(inches)
Frame
Spacing
(inches)
A`
P,Yoposed 01',�
Required
Comments
i \*:ov o `�. ppendixJA4
� Reference
Ca Insulation
R -value .,,,; R -value :fagtor Table7 Cell
U Factor
Roof
CRRC'P: odiact IDInitiglS`oI
Aged Solar Therm SRI Aged Solar Thermal SRI
Compliance
p
Pitch
p►,R
Exception tion
Number
,product Type
Insulation
ad
Reflect geflectance Emittance tional) Reflectance Emittance (Optional)
C. ROOF REPLACEMENT (Prescriptive Alteration, Sect 150.2(b)1H)�����'`'
Ol
02
03
04
0 '„ ._ z4
6(
X07 08 09 10 11 12 13
e
Propose Minimum Required
Method of
Roof
CRRC'P: odiact IDInitiglS`oI
Aged Solar Therm SRI Aged Solar Thermal SRI
Compliance
p
Pitch
p►,R
Exception tion
Number
,product Type
Insulation
ad
Reflect geflectance Emittance tional) Reflectance Emittance (Optional)
`
15 T
' \fie 'lk
rA
NOTESRoof
area covered by buildiinjntegrated pK6tov 1 panels and solar thermal panels are exempt from the above Cool Roof requirements.
• Liquid field applied, coatings must comply with �i,nstallation criteria from section 110.8(i)4.
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 CALIFORNIA ENERGY COMMISSION
CERTIFICATE.OF COMPLIANCE CF111-ALT-01-E
Prescriptive Residential Alterations (Page 4 of 4)
Project Name: Date Prepared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that t ' rtificate of Compliance documentation is accurate and complete. .t
Documentation At oy r Name:
Documentation Author 5' re: r
V
Company: `
Signature Date: mv
Address:
CEA/ HERS Certification Ideniificatio&(if applicable): ` s
City/State/Zip:
Phone:
RESPONSIBLE PERSON'S DECLARATION STATEMENT
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. lam eligible under Division 3 of the Business. and Professions Code to accept responsibill . for the building de gsystem design identified on this Certificate of Compliance (responsible
designer).
3. That the energy features and performance specifications, materials, components, and manufactured d`evicfor the building design or system design identified on this Certificate of
Idti Compliance conform to the requirements of Title 24, Part land Part 6 of the California Code ofrRegulati ns.
o
4. The building design features or system design features identified on th si Certificate of Compliance afe consistent With t e information provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted.to the enforcement agency'foypproval with this building -4W permit application.
va 6 -ail permlt(s)
S. I will ensure that a registered copy of this Certificate of Cop�la.Rceshall be made le with the building issued for the building, and made available to the enforcement agency
fo'r
all applicable inspections. I understand that a registered copy of this Certificate�ro�f Compliance is,required to be included with the documentation the builder provides to the building
owner at occupancy.
Responsible Designer Name: a Responsible Designer Signature:
Company :
Date Signed:
Address:
License:
City/State/Zip: + ``"
Phone:
J>,
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 lune 2014
Bin #
City of La Quinta
Building &SafM Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 7777012
Building Permit Application and Tracking Sheet
Permit #/
Project Address: 22 �(� �'�--h
Owner's Name:y� J,
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
ntra r.
Co cto e,..-
e1e h one:
Address: -8 3 33 C)ur
PiojectDescription:
City, ST, Zip:, v'
Telephone: —
C�v
3 i tom:'
State Lic. # : y'7 7 mac' %
City Lie.
Arch., Engr., Designer:
o CT--
S c�
Address:
Q ,
City, ST, Zip:
Telephone: one:
`F><
...........................................
Construction Type: v a Occupancy • S t .L�
L�
State Lic
Project (circlele ne • New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: ( 5--Z"3
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: 87r
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
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 Cates.
Plans picked up
Construction
Flood plain plan .
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready for corrections/issue
Electrical
Subcontacl'or List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Schodl Fees,
Total Permit Fees