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BRER2017-007578-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 �*Y 4 4aQuuKro DESIGN & DEVELOPMENT DEPARTMENT BUILDING.PERMIT Application Number: BRER2017-0075 Property Address: 78620 BOTTLEBRUSH DR APN: 646311039 Application Description: RINZA / RE -ROOF ENTIRE DWELLING Property Zoning: Application Valuation: $8,000.00 ' Applicant: EDGAR RINZA 78620 BOTTLEBRUSH DR LA QUINTA, CA 92253 AUG 1.1 2017 . ID. r VOICE (760) 777-7125 . FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: EDGAR RINZA 78620 BOTTLEBRUSH DR LA QUINTA, CA 92253 Contractor: OWNER BUIQDER Date: 8/11/2017 CITY OF LA QUINTA Llc. No.: DESIGN AND DEVELOPMENT DEPARTMENT -----=-------------------------------=------------------------------------------------------ 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: License No.: Date: IContractor: . 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 therefPom 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.). ( 11, 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:. WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury oce 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 LaborCode, for the performance of the work for which this permit is issued I have and will maintain worker' 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 insura.-ice carrier and policy number are: Carrier: _ Polity 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: Applicant: WARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CFUMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDEC FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT AC<NOWLEDGEMENT IMPORTANT: Application is hereby made ro the Building Official for a permit subject to the conditions and restrictions set forth or this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is periormed 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 alpplication 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 crdinances and state laws relating to building construction, and hereby authorize repres ?ntatives of this city to enter upon the above- mentioned property for inspection purpos?s. Date: Signature (Applic.ent or Agent): Date: 8/11/2017 1 1 Application Number: BRER2017-0075 Owner: Property Address: 78620 BOTTLEBRUSH DR EDGAR RINZA APN: 646311039 78620 BOTTLEBRUSH DR Application Description: RINZA / RE -ROOF ENTIRE DWELLING LA QUINTA, CA 92253 Property Zoning: Application Valuation: $8,000.00 Applicant: Contractor: EDGAR RINZA OWNER BUILDER 78620 BOTTLEBRUSH DR LA QUINTA, CA 92253 Llc. No.: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - r - Detail: REROOF ENTIRE ROOF WITH COOL ROOF SHINGLES[CRRC: 09-18-0043] 2016 CALIFORNIA ENERGY CODE FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT ' BSAS SB1473, FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT RE -ROOF - EA ADDITIONAL 1,000 SF 101-0000-42404 0 $12.16 DESCRIPTION ACCOUNT QTY AMOUNT RE -ROOF - FIRST 2,000 SF 101-0000-42404 0 $51.68 DESCRIPTION ACCOUNT QTY AMOUNT RE -ROOF - FIRST 2,000 SF PC 101-0000-42600 0 $103.36 Total Paid for RE -ROOF: $167:20 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 Y Bi°# Ci o La Uinta '. f Q. Building & Safety Division 78-495 Calle Tampico ` La Quinta, CA 92253 - (760) 777-7012 —pp7,5' Building Permit Application and Tracking Sheet Permit# I' leepao Project_Address:.11• � '0 • Ownerrs Name' �� r �� .. C �LAj A.P. Number Address: 7 - C' 6iry;'ST,�Zi51:0 cJ Y Bi°# Ci o La Uinta '. f Q. Building & Safety Division 78-495 Calle Tampico ` La Quinta, CA 92253 - (760) 777-7012 —pp7,5' Building Permit Application and Tracking Sheet Permit# I' leepao Project_Address:.11• � '0 • Ownerrs Name' �� r �� .. C �LAj A.P. Number Address: 7 - Legal Description: 6iry;'ST,�Zi51:0 cJ Contractor:' Telephoner Address: Project Descriptio n:19 City, ST, Zip: Telephone: _ 1 State Lic. #: City Lic #: Arch, Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Proj. Type New Add'n Alter Repair Demo Name -of Contact ' SgFt•,300 #Stories # Units: Telephone of Contact: —...�..: z e 1' -7 Estimated_,Value of Project? 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: 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 r School Fees, Total Permit Fees Titf 4.4 a" P:'O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT • PROPERTY OWNER'S PACKAGE (760)777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER { Dear Property Owner: An application for. a building permit has been submitted in your name .listing yourself as the° builder of the property improvements specified at P , (o_?ss�to �� �C tip, 0 We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior.approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this informaiion. OCj41!I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. &Z'=-2 I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. k I understand as an"Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his o = own. her name instead of my ti4PI understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five -hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. �6�)I understand if'I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance; and contmbute to unemployment compensation for each "employee." I also understand my failure to abide by these laws m riskay subject me to .serious financial }�-,�I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. A&) I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. I understand I may obtain more information regarding my obligations as an ."employer" from the Internal Revenue Service, the United States Small -Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 800-32 1 -CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally, and financially responsible for proposed construction activity at tie following address: f�1E1=1? I agree that, as,the-party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as.well as employers. agree to notify the issuer of this form immediately of any additions, deletions, or changes b any of the information I have provided on this form Licensed contractors are regulated by laws designed to protect the pt6lic.,If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractois may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed- and the status of their workers' compensation insurance coverage. Before a building permit can be.issued, this form must be completed and signed by the property owner and returned to -the agency responsible for issuing the permit. Note: A copy of the property owner's driver's licer•se, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. d gnature-of_property owner Drat � Q (( 2� •-Z. Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S EEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsil5ility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign; and file. the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I perso_ially filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, o: other verification acceptable to the agency is required to be presented when thepermit is issued to verify the property owners signature. Property Owner's Signature: Date: STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification j :EC-CFIR-ALT-05-E (Revised 04116) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E Prescriptive -Residential Alterations That Do Not Require HERS Field Verification Page 1 of 3 Project Name: Date Prepared: *T © (o +� 7Z ('�Q �— r'f- r l 1265 This compliance document is only applicable to simple alterations that do not require HERS verification for compliance. When HERS verification is required, a CF1R-ALT- 01 shall first be registered with a HERS Provider Do to 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 existing dud system was previously tested and passed by o HERS Rater. If space conditioning systems are altered and are not exempt from HERS verification, then a CF1R-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 S.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 -value of 3.6 per inch, shall complete and register a CF1R-ALT-01 with a HERS Provider Data Registry. If more than one person has responsibilityfor installation of the items on this certificate, each person shall prepare and sign a certificate applicable to the portion of construction for which they are responsible. Alternatively, the person with chief responsibilityfor construction shall prepare and sign this certificate for 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: d 02 Date Prepared: �J 03 Project Location: ^ d ( 04 Building Front Orientation (deg or cardinal): 05 CA City: Q L't 06 Number of Altered Dwelling Units: 07 Zip Code: o 08 Fuel Type: 09 Climate Zone: 0 10 Total Conditioned Floor Area (ft): 7e o 11 Building Type: C 2 z �c �� / \� C�..� _ 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/Glazing - REPLACE ❑ H. Water Heating System ❑ Include Mandatory Measures? K CA Building Energy Efficiency Standards - 2016 Residential Compliance April 2016 STATE OF CALIFORNIA Prescriptive Residential Alterations That Do_ Not Require HERS Field Verification.. CEC-CF1 R -ALT -05-E Revised 04/16 CALIFORNIA ENERGY COMMISSION 11110101011 CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E Prescriptive Residential Alterations That Do Not Require HERS Field Verification Page 2 of 3 Project Name: Date Prepared: C. Roof Replacement (Prescriptive Alteration, Section 150.2(b)1H) 01 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 Reflectance Emittance (Optional) Reflectance Emittance (Optional) b d i ST E E p �` rr +�-.1e Z< IPty 1 •"i`� l7 Odd Row Y Delete Row< Ct-a c� NOTES: C • 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. CA Building Energy Efficiency Standards - 2016 Residential Compliance STATE OF CALIFORNIA Prescriptive Residential Alterations That Do Not Require HERS Field Verification CEC-CF1 R -ALT -05-E (Revised 04116) 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 Prepared: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate of Compliance documentation is accurate and complete. Docume�ntation Author Name: Documentation A or S ature: Company: Signature Date: / Q7 %, lel7. Address: CEA/ HERS Certification Identification (if applicable)- pplicable):7S 7SQ? Z o 75077 (-& clkt H -. 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. 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. S. I 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. ResponsibleDesignerName: Responsible Designer Signature: L Company: Date Signed: 8 2c5 l` -T Address: 7CEICo'-6 t'�0 Cac &A 0k- - License: City/State/Zip: G tet- Q v "�-? - �. c �' 9 2 i r Phone: -1(aO �' --� e� 7 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 2,016