BRER2017-000378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT. DEPARTMENT
BUILDING PERMIT
Application Number: BRER2017-0003
Property Address: 44090 CAMINO AZUL
APN: 604180010 .
Application Description: PALERMO / REROOF REPAIR 350 SQ FT
Property Zoning:
Application Valuation: $3,900.00
Applicant:
MIGZ GENERAL CONTRACTING
31-330 AVENIDA MARAVILLA
CATHEDRAL CITY, CA 92234
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 License No.: 983810 n
Date Contraete�W.� j gl��l
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 i
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 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 one of !.he following declarations:
- I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 if 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: VEMPT Policy Number: _
y 1 certify that in the performance of tF a work for which this permit is issued, I
shall not employ any person in any manner so a: 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 3770 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 T.0 CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000. IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR N SECTION 3,706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWSEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for.a permit subject to
the conditions and restrictions set forth on this s pplication.
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 Cty 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 applicaaion 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 stat=_ 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 representati-es of this city to ent r upon the
above-mentioned property for inspection purposes. .
Date: Signature (Applicant o -Agent):
VOICE (760) 777-7125
FAX (760) 777-7011
IN QN, (760)
7 -7153
LU
Date.
1/%3/2017
Owner:
STEVEN PALERMO
y
CD
92253
M
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Z�
a
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Contractor:
MIGZ GENERAL CC
z¢
31-330 AVENIDAh,
VIL
CATHEDRAL CITY,
(760)668-0003
Llc. No.: 983810
WORKER'S COMPENSATION DECLARATION
I hereby affirm -under penalty of perjury one of !.he following declarations:
- I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 if 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: VEMPT Policy Number: _
y 1 certify that in the performance of tF a work for which this permit is issued, I
shall not employ any person in any manner so a: 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 3770 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 T.0 CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000. IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR N SECTION 3,706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWSEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for.a permit subject to
the conditions and restrictions set forth on this s pplication.
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 Cty 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 applicaaion 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 stat=_ 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 representati-es of this city to ent r upon the
above-mentioned property for inspection purposes. .
Date: Signature (Applicant o -Agent):
0
Date: 1/13/2017
Application Ncymber: BRER2017-0003
Owner:
Property Address: 44090 CAMINO AZUL
STEVEN PALERMC .
APN: 604180010
Application Description: PALERMO / REROOF REPAIR 350 SQ FT
92253
Property Zoning:.
Application Valuation: $3,900.00
Applicant:
Contractor:
MIGZ GENERAL CONTRACTING
MIGZ GENERAL CC NTRACTING
31-330 AVENIDA MARAVILLA
31-330 AVENIDA MARAVILLA
CATHEDRAL CITY, CA 92234
CATHEDRAL CITY, CA 92234
(760)668-0003
---------------------------------------------------------------------------------------------
Llc. No.: 983810
Detail: REROOF WITH MULE-HIDE KOOK CAP BRIGHT WHITE COLOR CRRC[0670-0023]
.2013 CALIFORNIA ENERGY CODE.
r
DESCRIPTION.
FINANCIAL INFORMATION
ACCOUNT QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT
CaTY
AMOUNT
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$51.68
DESCRIPTION
ACCOUNT
ZtTY
AMOUNT
RE -ROOF -FIRST 2,000 SF PC
101-0000-42600
0
$103.36.
Total Paid for RE ROOF:
$155.04
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CF1R-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 1 of 4)
Proiect Name: Yo A&, c . /L Z, o.0 rn Date Prepared: I i 'Z Z/ 7
A. GENERAL INFORMATION
01
02
01 Project Name:
cZ 02
Date Prepared:,.
03 Project Location:
05 LH Clty'
04
06
Budding Front,OnPr tati,nn (rleg nr rardpnai);
Number of Alt re edDwelling Units:
07 _ Zip Code:
08
Fuel Type;
09 Climate Zone:
10
Total,Con'difioned FloorA�re7a'(�t2):�
11 Building Type I Rasr
12
Slab,' eV(ft2) IB%
13 Project Scope:
AL -44 _
duct Insulation
t[ IV
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)
01
02
03
04
05
06,;'� >, 67 08.y; ' _0-
10
11
Tag/ID
Assembly Type
Frame
Type
Frame
Depth
(inches)
Frame
Spacing
(inches)
kroposed te!►
Required
Comments
Continuous pendix JA4
ii ou
�Reference
Cavity ^1 )Insulation is N
R -value, R -value w ) lJ fifactor Table. Cell
I U -Factor
+Number
duct Insulation
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
...s4
4' d ,'o
20 Co
-ii►w
• Roof area covered y, builaing�integrated p oho l aie panels and solar thermal panels are exempt from the above Cool Roof requirements.
field from
• Liquid applied`coatings must comply, wik nstallation criteria section'110.8(i)4.
V 2r .IP
C. ROOF REPLACEMENT (Prescriptive Alteration, Sect
�150.2(b)1H)t "w
01
02 03
04
05�,, 06
tt '67 08 1 09 1 10 11 1 12 1 13
V
Pu
R-va,lue
Proposed Minimum Required
Method of
Roof
-1 D
Decd
Initial Solar Aged Solar Thermal SRI Aged Solar Thermal SRI
Compliance
Pitch Exception
+Number
duct Insulation
Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional)
4' d ,'o
20 Co
NOTES '1'
• Roof area covered y, builaing�integrated p oho l aie panels and solar thermal panels are exempt from the above Cool Roof requirements.
field from
• Liquid applied`coatings must comply, wik nstallation criteria section'110.8(i)4.
is r -
r
46.1 .
Registration Number: .
CA Building Energy Efficiericy Standards - 2013 Residential Compliance
Registration Date/Time:
HERS Provider:
June 2014
4 ti
w
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
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFIR-ALT-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE U CF1R-ALT-01-E
Prescriptive Residential Alterations (Page 4 of 4)
Project Name: 1—E C Date Prepared: t
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
UOLUlhellt'dtluh AuthUt Ni lne: //_ 7
L)UuMOCIU66 Au r 5i tures -
Company: I
Signat Date: '
Address:
CEA/ HERS Certificati Ide6tlfic` ori V a licable): 0
City/State/Zip:
Phone:
9� r�DO
RESPONSIBLE PERSON'S DECLARATION STATEMENT +a>
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information Certificate Compliance is
provided on this of true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility,forthe builrd
dinge�ig ?or system design identified on this Certificate of Compliance (responsible
designer).
3. That the energy features and performance specifications, materials, componentts,, and manufactured��devics, o"r 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 wlth3ttie information provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted,to theenforcement agencyfo :,approval with this building permit application.
lk
5. I will ensure that a registered copy of this Certificate of Compliance:shall be made availlable with the building permit(s) issued for the building, and made available to the enforcement agency
for all applicabe inpections. I understand that a registered cc-opy�bf this�CertificatVof Compliance is �( esd'to be included with the docu ntation the builder to the building
qu provides
owner at occupancy. p[[ per
Responsible Designer Name:, a
Responsible De ' ner S' atur�
..«....
Company: °
Date Signed:
r
1-7
Address:
License:
City/State/Zip: i V
Phone:
HERS Provider:
June 2014
Bin Qty of La Quinta
Building 81; Safety Division
Permit # 78-495 Calle Tampico
.�� Zcil Ood La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
Project Address: /Vo C) ',VC ' L Owner's Name
A. P. Number:
Address: Yja
Legal Description:
City, ST, Zip: 9Z2-53
Contractor: 1
�
r
Telephone:
Project Description:
Address: 3 _
City, ST, Zip:
Q
ne•
TeleP ho .
60 -
9-0003 o
::.
-350S o� S F T' .
State Lit.. #
CityLie. #.: (�
J
Arch.,'Engr., Designer:
o
Address:
City,. ST, Zip:
Telephone:
imam•
.....................
.......................
Occupancy:
Co n tructi n Type: cY-
s o
t ic. #•
State a L
Demo
0Pro•ect type circle one • New Add'n Alter Repair
Name of Contact Person:
e--Z_
iA e4"Telephone
Sq. Ft.:
# Stories:
# Units:
# of Contact Person:6 D
6 000 3
Estimated Value of Project: -7, 0O
APPLICANT: DO NOT WRITE BELOW THIS LINE /v'1 tt t )Ov
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Cales.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°d Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
Jrd Review, ready for corrections/issue
Developer Impa•_t Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Dale of permit issue
sC11061 Fees.
-
I
Total Permit Fe-s
rsE=
• 1
4400l C is ��,� CITY OF. LA QUINTA SU�B--CONTRACTOR, LIST
JOB ADDRESS _ PERMIT NUMBER BW4- 7_ �1 �' 0WQGVNER �' - 2-� - _ BUILDER KCLC;2C_ 'tL
This'fdriwshall'b6 posted on=the jo-b with the•,B`itilcliiict'•lnspecfion Card at ail imes in.a consp ctious-place. Only persons appearing•on this list or their employees are authorized to work
on this iob. Anv changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. Fob each applicable trade, all information requested below must be completed by:opplicant. "On File" is not an acceptable response
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Company Name
Classification
License Number
Exp. Date
;Carrier Name
Policy Number
Exp. Date
License Number
Exp. Date'`
(e.g. A, B, C-8) '
(xxxxxx)
(xxlxx/xx)
(e.g. State Fund, CalComp)
(Format Varies)
(xx/xx/xx)
(xxxx)
(xx/xx/xx)
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