BRER2017-012878-495 CALLE TAMPICO D VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760.) 777-7153
BUILDING PERMIT
Date: 11/9%2017
Permit Type/Subtype: RE -ROOF/ Owner:
Application Number: BRER2017-0128 LQR GOLF
Property Address: 54624 INVERNESS 1 BUSH ST STE 1130
APN: 775091075 SAN FRANCISCO, •--A
Application Description: PGA WEST / REROOF FLAT AREAS / ADDRESS 54624, 620, 616, 612
Property Zoning:
Application Valuation: $2,310.00
Applicant: Contractor:
B R S ROOFING INCNO V O g B R S ROOFING INC
777 SOUTH LUGO AVE, 2017 777 SOUTH LUGOAVE
SAN BERNARDINO, CA 92408 U0 SAN BERNARDINC, CA 92408
. CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT (909) Llc. Noo8.: 9076'00' 600
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
r
Date: Contracto . r
OWNER -B R DEI 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
($500).:
L_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.).
(__J 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.).
(_J 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. Q.
Lender's
Lender's
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificateof consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
Df the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
S n 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: STATE COMPENSATION INSURANCE FUND Policy Number: 9141962
I certify that in the performance of tine 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 l should become subject to the
workers' compensation provisions of Section 3770 of th Labor Co , I shall forthwith
comply with Pose provisions.
Date: Applicant:
WARNI G: F (LURE TO SECURE WORKERS' COWPENSATION 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 3d 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.
1. Each person upon whose behalf this applicaion 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 application becomes null and void if work is
not commenced within 180 days from date of is_ uance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and staff 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 upo e
above-ment'oned roperty for inspection purposes.
Date: Signature (Applicant of Agent):
{
Date: 11/9/2017
Application Number:
BRER2017-0128"
Owner:
Property Address:
54624 INVERNESS
LQR GOLF
APN:
775091075
1 BUSH ST STE 1100
" Application Description:
PGA WEST/ REROOF FLAT AREAS / ADDRESS 54624, 620, 616, 612
SAN FRANCISCO, CA
Property Zoning:
Application Valuation:
$2,310.00
Applicant;
Contractor- •"
B R S ROOFING INC
B R S ROOFING INC
777 SOUTH LUGO AVE
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
SAN BERNARDI NC, CA 92408
(909)884-8505
---------------------------------------------------------------------------------------------
Llc: No.: 907600
Detail: REROOF WITH FOAM AT FLAT AREAS ONLY [CRRC: 0770-0002] 2016 CALIFORNIA ENERGY CODE.
+FINANCIAL
DESCRIPTION
INFORMATION
ACCOUNT ARTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION! BSA:
$1.00
DESCRIPTION
ACCOUNT
6:1TY
AMOUNT
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$53.05
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0
$106.11
Total Paid for RE -ROOF:
$159.16
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
01
$5.00
-
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
TOTALS:
$5.00
STATE OF CALIFORNIA
(® Prescriptive Residential Alterations That Do Not Require HERS Field Verification
AM -1
CEC-CFIR-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 1 of 3
Project Name: PGA WEST RE -ROOF Date Prepared: 11/9/2017
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 existing duct system was previously tested and passed by 6
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 I.S.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 o density of 0.4 to less than 1.5 pounds per cubic foot having an R -value 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 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?
12 CA Building Energy Efficiency Standards - 2016 Residential Compliance April 2016
NUMBERS] STREET / PHASE / UNITS / BLOG TYPE
1.. - 54-984, 996, 008, 020 / SHOAL CREEK / 16A / 4 / IOM
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, 44-11447, 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
r.
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification>
CEC-CFIR-ALT-05-E Revised 04/16 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-0S-E
Prescriptive Residential Alterations That Do Not Require HERS Field Verification Page 2 of 3
Project Name: PGA WEST RE -ROOF Date Prepared: 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
Propo3cd
rvtlninium Required
R -value
Method of
CRRC Product
Product
Deck
Initial Solar
Aged Solar
Thermal
SRI
Aged Solar
Thermal
SRI
Compliance.
p
Roof Pitch
Exception
p
ID Number
Type
yp
Insulation
Reflectance
Reflectance
Emittance`
(Optional)
Reflectance
Emittance(Optynal)
SRI
5 2:12
N/A
0770-0002
FOAM
.86-
.71
.91
88
.20
.75
Ad'd Row
elite Rb.W'
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(1)4.
CA Building Energy Efficiency Standards - 2016 Residential Compliance
April 2016
STW,TE OF CALIFORNIA
:Y Prescriptive Residential Alterations That Do Not Require WSRS Field Verification
CEC-CFIR-ALT-05-ERevised 04/16
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not.Require HERS Field Verification=
Project Name: PGA WEST RE -ROOF
CALIFORNIA ENERGY COMMISSION
CF1R-ALT-05-E
Page 3 of 3.
11/9/2017
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author NarT
Documenta8oh Author Signature:
Jqr e ��I�wc�rJr�Q4',
Fn(q�_
companv:BRS ROOFING INC
signature Date:
&&
Address:�Ab
777 SOUTH LUGO AVE
CE HERS Certification Id nt catlon (f pp icable):
City/State/Zip:Phone:
SAN BERNARDINO / CA / 92408
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 Divisi6n.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. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permits) 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.(
Responsible Designer Signature:
f
)
`
orcA ca
Company:
BRS ROOFING INC
Date Signed:
0/
Address:
License:
777 SOUTH LUGO AVE .
907600
city/State/zip:
Phone:
SAN BERNARDINO / CA / 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
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