BRER2017-0096Twyl 4 aumal,
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
. BUILDING PERMIT
Permit Type/Subtype: . RE -ROOF/
Application Number: BRER2017-0096
Property Address: 52211 AVENIDA BERM[ DAS.
APN: 773235022ZY
Apey1
Application Description: GUZMAN RESIDENCE/ F�OF
Property Zoning:
Application Valuation: $6,087.00 SEP 2 8 2011
, nDi
Applicant: CITY OF D, Q INTA
URETHANE FOAM CONSULTING AND SERVICES.
P O Box 638 DESIGN AND DEVELOPMENT DEPARTMENT
THOUSAND.PALMS, CA 92276
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: C399 . License No.: 736420 I -
Date: —ao �fl Contractor: �`�917_
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
the 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/28/2017
Owner:
LAURA GUZMAN
52211 AVENIDA BERMUDAS
;LA QUINTA, CA 92253
Contractor:
URETHANE FOAM CONSULTING AND SERVICES
,P O BOX 638
THOUSAND PALMS, CA 92276
(760)345-0622
Llc. No.: 736420
WORKER'S COMPENSA-ION DECLARATION
I hereby affirm under penalty of perjury one cf 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: CALIFORNIA -INSURANCE COMPANY Policy Number: 4684855701
I certify that in the performance ofrthework 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 _70 of the Labor Code, I shall forthwith
comply with those provisions.
Date: — 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 FOF. 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 thi! 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 Me work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this appliotion 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 cancel ation.
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 ordir ances and state laws relating to building
construction, and hereby authorize representa-ives of this city ko enfer upon the
above-mentioned property for inspection purposes. �� /
Signature (Applicant :)r Agen .
'
Date: 9/28/2017
Application Number: BRER2017-0096
Owner:
Property Address: 52211 AVENIDA BERMUDAS
LAURA GUZMAN
APN: 773235022
52211 AVENIDA BERMUDAS
Application Description: GUZMAN RESIDENCE / REROOF
;LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $6,087.00
-Applicant:
Contractor:
URETHANE FOAM CONSULTING AND SERVICES
URETHANE FOA14 CONSULTING AND SERVICES
' P 0 BOX 638
P. 0 BOX 638
THOUSAND PALMS, CA 92276
THOUSAND PALMS, CA 92276
(760)345-0622
r.
---------------------------------------------------------------------------------------------
LIc. No.: 736420
Detail: REROOF WITH URETHANE FOAM CLASS A. PER 2016.CALIFORNIA BUILDING CODE
=' DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT CITY
AMOUNT
BSAS 561473 FEE
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$51.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0
$103.36
Total Paid for RE -ROOF:
$155.04
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502=0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00 ,
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not. Require HERS Field Verification
CEC-CFIR-ALT-05-E Revised 04/16)CALIFO
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
Project Name: _ Date Prepared:
CF111-ALT-05-E .
Page 1 of 3
This compliance document is only applicable to simple alterations that do not require HERS verification for compliance. When HERS verification is required, a CFIR-ALT 01 shall first be
with a HERS Provider Data Registry.
Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CFIR-ALT-05 and CF2R- ALT -05 Compliance Documents. Possible exemptions from duct
leakage testing include: less than 40 ft of ducts. were added or replaced; or the existing duct system was insulated with asbestos; or the exi5tina-ductsystem was oreviously tested and nnstPd by n
HEHS Rater. If space conditioning systems are altered and are not exempt from'HERS verification, then a CFIR-ALT-02 must be completed and registered with a HERS Provider Data Registry.
Alterations that utilize close Cell Spray Polyurethane Foam (ccSPF) with a density of 1.5 to less than 2.5. pounds per cubic foot having an R -value other than 5.8 per inch, or Open Cell Spray
Polyurethane Foam (ocSPF) with a density of 0.4 to less than 1.S pounds per cubic foot having an R-volue of 3.6 per inch, shall complete and register a CFIR-ALT-01 with a HERS Provider Data
Registry.
If more than one person has responsibilityfor installation of the items on this certif/cate, each person shall prepare and sign a certificate applicable to the portion of construction for which they ore
responsible. Alternatively, the person with chief responsibilityfor construction shall prepare and sign•this certificatefor the entire construction. All applicable Mandatory Measures shall be met.
Temporary labels shall not be removed.before verification by the building inspector.
A. General Information.
01
Project Name:
446.,,,r g �� Z M,4 A)
02
Date Prepared:
_ $ -
03
Project Location:
s�� ! / 3E/?kew2>A-
04
Building Front Orientation (deg or cardinal):
-05
CA City:
/ „
`��e u�uTi4�-
06
Number of Altered Dwelling Units:
07
Zip Code:
08
Fuel Type:
09
Climate Zone:
`S
10
Total Conditioned Floor Area ytz):
11
Building Type:
r-
1 AJ G' CLC. t— A I—t
12
Slab Area (ft)
.13
Project scope (Select all that apply):
❑ B. Insulation ❑ D. & E. Fenestration/Glazing - ADD ❑ G. Space Conditioning System. (Heating, Cooling, Duct system) . ❑ Lighting
❑✓ C. Roof Replacement ❑ D. & F. Fenestration/Glazirig - REPLACE ❑ H. Water Heating System ❑ Include Mandatory Measures? -
CA Building Energy Efficiency Standards - 2016 Residential Compliance April 2016
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require. HERS Field Verification
CEC-C 1 R -AL -05 Revised 04/16, CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E.
Prescriptive. Residential' Alterations That Do Not Require HERS Field Verification Page"2 of.3
Project Name: ' Hla- late P are�i8-
z1"7
C hoof Replacement (Prescriptive Alteration, Section 150.2(b)1H)
.0i
02
03
04
05
06
'07 08 09 10
11
12 13
Proposed
Minimum Required
R -value
Method of
CRRC Product
Product
Deck
Initial Solar
Aged Solar
Thermal
SRI
Aged Solar
Thermal
SRI
Compliance
Roof Pitch.
Exception
ID Number
Type
Insulation
Reflectance'
Reflectarice
Emittance
(Optional)
Reflectance
Emittance
(Optional)
)CZA7-
06 ao6qZIA
a11Q7RALJ6
A
eeewyu,
i
NOTES:
• Roof area covered by building integrated photovoltaic, panels and solar thermal panels are exempt from the above Cool Roof requirements.
• Liquid field applied coatings must comply with installation criteria from Section 110.8(i)4.
• I
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Reauire HERS Field Verification
s
-CF]R-ALT-05-E Revised 04/16) CALIFORNIA ENERGY COMMISSION�; .
CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E
Prescriptive Residential Alterations That Do Not Require HERS Field Verification Page 3 of.3
Project Name:
Date PreOared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author ignature:
Company:
signature Dahl
�� Lv x► s r -7,c+ Se -N C' -- 1 � - 1-lj I
Address: CEA/ HERS Certification Identification (it applicable):
City/State/Zip: Phone:
r sa 7 74o- 3
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. 1 am eligible under Division 3 of the Business and*Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible
designer).
3. That the energy features and performance specifications, materials,.components, and manufactured devices 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 Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building; and made.available to the enforcement agency
for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building
owner at occupancy:
Responsible Designer Name:
Responsible Designer Si ature:Or
a_�
Company:
e c— AIT- Vous
Date Signe
Address:
SdL
License:'
3 p
City/State/Zip:
Phone:
�s 74
7 d-21,
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
CA Building Energy Efficiency Standards - 2016 Residential Compliance April 2016
t
e. . 9
Bin#
'
City of La Quinta
Building & Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit#
Project Address: _ r _ ve v,:D
d
Owner's Name:LA tA_(z_A
L&Z
A.P. Number
Address: so_ 141
(-
Ue i�4 U r)AS
Legal Description:
City, ST, Zip: �AQI,kMTP;
Contractor: C
51�T1A1 �+ J
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Telephone&
Addressa ��sS /
Project Description:
City, ST, Zi '
70.) W,
(f-
Telephone: _ 3(/,<-!-
6% a
State Lie. #: DO
City. Lic #:
Arch, Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Cons ecttiion Type:
Occupancy:
State Lie. #:
Prej. Type New
Add'n
Alte
Repair
Demo
Name of Contact:
SgFt: / a q 1)
#Stories
# Units:
Telephone of Contact:
Estimated Value of Project:
O 4 d
O
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'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 Calcs
Plans Picked Up
Construction:
Flood Plain Plan
Plans Resubmitted
Mechanical:
Grading Plan
2nd Rev, Ready for corrections /
Electrical: .
Subcontractor List
Called Contact Person
Plumbing:
i
Grant Deed
Plans Picked Up
S.M.I.
HOA Approval
Plans Resubmitted
Grading
IN-HOUSE
3rd Rev, Ready for corrections /
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Apps
Date of permit issue
School Fees
Total Permit Fees