BRER2017-0130v»r
Applicant: Contractor:
B R S ROOFING INC B R S ROOFING INC -
777 SOUTH LUGO AVE 777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408 NOV 0 9 2017 SAN BERNARDINC4 CA 92408
(909)884-8505
CITY OF LA QUINTA Lic. No.: 907600
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: C39 License No.: 907600 1
Date: Contractor:n - "U
OWNER -BU
I DEC RATION
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
1$500).:
(_J 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. . BAP.C. for this season
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 of the Labor Code, for the performance
of the work for which this permit is issued.
/ �1-}�— I have and will maintain workers' compensation insurance, as required by
S�ofior( 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity number are:
Carrier: STATE COMPENSATION INSURANCE FUND Polity Number: 9141962
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 tha1Z if I should become subject to the
workers' compensation provisions of Section 37DO ofthe Labo e, I shall forthwith
comply with hose p ovisions.
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS' COIVPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVILF.INES 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 ACKNOVaEDGEMENT
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 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 applicw ion 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 representati +es of this city to enter upon he
above-mentioned property for inspection purposes.
Date: Signature (Applicant o' Agent):
f:
O.�i
VOICE (760) 777-7125
78-495 .CALLE TAM PICO
U
. FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT -•
Date: 11/9/2017
Permit Type/Subtype:
RE -ROOF/
Owner:
Application Number:
BRER2017-0130
LQR GOLF
Property Address:
54616 INVERNESS
1 BUSH ST STE 1100
APN:
775091077
SAN FRANCISCO, CA
Application Description:
PGA WEST / REROOF
FLAT AREAS / ADDRESS 54624, 620; 616, 612
Property Zoning:
Application Valuation:
$2,310.00
v»r
Applicant: Contractor:
B R S ROOFING INC B R S ROOFING INC -
777 SOUTH LUGO AVE 777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408 NOV 0 9 2017 SAN BERNARDINC4 CA 92408
(909)884-8505
CITY OF LA QUINTA Lic. No.: 907600
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: C39 License No.: 907600 1
Date: Contractor:n - "U
OWNER -BU
I DEC RATION
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
1$500).:
(_J 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. . BAP.C. for this season
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 of the Labor Code, for the performance
of the work for which this permit is issued.
/ �1-}�— I have and will maintain workers' compensation insurance, as required by
S�ofior( 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity number are:
Carrier: STATE COMPENSATION INSURANCE FUND Polity Number: 9141962
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 tha1Z if I should become subject to the
workers' compensation provisions of Section 37DO ofthe Labo e, I shall forthwith
comply with hose p ovisions.
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS' COIVPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVILF.INES 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 ACKNOVaEDGEMENT
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 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 applicw ion 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 representati +es of this city to enter upon he
above-mentioned property for inspection purposes.
Date: Signature (Applicant o' Agent):
j
Date: 11/9/2017
Application Number:.
BRER2017-0130
Owner:
Property Address:
54616 INVERNESS
LQR GOLF
APN:
775091077
1 BUSH ST STE 1100
Application Description:
PGA WEST / REROOF FLAT AREAS / ADDRESS 54624, 620, 616, 612
SAN FRANCISCO,+=A
.Property Zoning:
Application Valuation:
$2,310.00
Applicant:
Contractor:
B R S ROOFING INC
B R S ROOFING INI`
777 SOUTH LUGO AVE
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
SAN BERNARDINO, CA 92408
(909)884-8505
Llc. No.: 907600
Detail: REROOF WITH FOAM AT FLAT AREAS ONLY [CRRC: 0770-0002] 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 - FIRST 2,000 SF
101-0000-42404
0
$53.05'
Total Paid for RE-1OOF: $53.05
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0.
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS: $59.05
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I
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CFIR-ALT-05-E Revised 04/16
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
Project Name: PGA WEST RE -ROOF
This compliance document is only a)
with a HERS Provider Data Registry.
CALIFORNIA EK
Date Prepared: 11/9/2017
i
CF1R-ALT-05-E
Page 1 of 3
not require HERS verification for compliance. When HERS verification is required, a CFIR-ALT- 01 shall first be registered
Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CFIR-ALT-05-and CF24- 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 duct system was previously tested and passed by a
HERS Rater. If space conditioning systems are altered and are not exempt from HERS verification, then a CFIR-ALT-02 must be completed.ond 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 on R -value other than 5.8 per inch, or Open Cell Spray
Polyurethane Foam (ocSPF) with a density of 0.4 to less than 1.5 pounds per cubic foot having an R -value of 3.6 per inch,.sholl complete and register a CFIR-ALT-01 with a HERS Provider Data
Registry.
If more than one person has responsibility for 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 responsibility for 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:
PGA WEST RE -ROOF
02
Date Prepared:
11/9/2017
03
Project Location:
SEE ATTACHED FOR PROJECT LOCATION
04
Building Front Orientation (deg or cardinal):
05
CA City:
LA QUINTA - PGA WEST
06 .
Number of Altered Dwelling Units:
07
Zip Code:
92253
08
Fuel Type:
09
Climate Zone:
15
10
Total Conditioned Floor Area (ft):
11
Building Type:
Single Family
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?
CA Building Energy Efficiency Standards 2016 Residential Compliance April 2016
NUMBERS / STREET./ PHASE / UNITS / BLDG TYPE
1.. 54-984, 996, 008, 020 / SHOAL CREEK / 16A / 4 / 10M
2. 54792, 804, 816, 828 / SHOAL CREEK / 16A / 4 / 10M
3. 55-540, 460, 470 / RIVIERA / 36A / 3 / 28M
4. .55-240, 250, 260 / RIVIERA./ 36A / 3 / 28M
5. 55-030, 040, 050 / RIVIERA / 37A / 3 / 28M
6. 80-435, 441, 447, 453 / OAK TREE / 9A / 4 / 11
7. 54-624, 620, 616, 612 / INVERNESS / 25B / 4 / 5M.
8. 55-498, 504, 510, 516, 522, 528, 534, 540 / FIRESTONE / 8GA / 8 /.A
9.. 54-400 / RIVIERA / 2E / 1 / G3BR
i
STATE OF CALIFORNIA
` r
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CF1 R -ALT -05-E Revised 04/16 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-ALT-05-E
Prescriptive Residential Alterations That Do Not Require HERS Field Verification Page 2 of 3
Project Name: PGA WEST RE -ROOF oatePrepared: 11/9/2017
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
'Method of
Compliance
Roof Pitch
'Exception
-
CRRC.Product
ID Number
Product
Type
R -value
Deck
I Insulation
Initial Solar
. Reflectance
Aged Solar
Reflectance ..
Thermal
Emittance
SRI
(Optional
Aged Solar
I Reflectance
Thermal
Emittance
SRI
(Optional)
SRI
5 2:12
N/A
0770-0002
FOAM
86
.71
91
88
.20
.75
16
Add9Row
b�e'i?te Ab
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.
April 2016
ST., -.,TE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
'3a
�
CEC-CFIR-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: PGA WEST RE -ROOF Date Prepared: 11/9/2017
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Narr
Documentation Author Signature:
BRS ROOFING INC
618naturn Oda
Address:
CEA/ HERS Certiflcation Id nt cation (l'ppl¢able):
777 SOUTH LUGO AVE
City/State/tip:
SAN BERNARDINO / CA / 92408
Phone:
909-997-2572
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 bivision.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:
SAME AS ABOVE.
Responslb a Designer Signature:
�Q
C)PICA C
Company :
BRS ROOFING INC
Date Signed:
Address:
License:
777 SOUTH LUGO AVE .
907600
City/State/Zip:
Phone:
SAN BERNARDINO / CAI 92408
9098848505
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