BRER2017-014178495 CALLS TAMPICO
LA QUINTAL CALIFORNIA 92253
44 QRAIA&
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: RE -ROOF/
Application Number: BRER2017-0141
Property Address: 53655 AVENIDA MADERO•
APN: 774102019
Application Description: MARVAN / REROOF
Property Zoning:
Application Valuation:
Applicant:
FERNANDO MARVAN
6640 VARNEY DR NOV 1`7 2017
SAN DIEGO, CA 92253 .. P 0
CITY OF LA QUINTA
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.::CONV,140528101254114199 .
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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
icense Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
d Professions Code) or that he or she is exempt therefrom and the basis for the
a ged exemption. Any violation of Section 7031.5 by any applicant for a permit
s ects 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
m ensation, 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
imself or herself through his or her own employees, provided that the improvements
e not or
or offered for sale. If, however, the building or improvement is sold
thin one yeof completion, the owner -builder will have the burden of proving that he
he did narot build or improve for the purpose of sale.):
Jawho
as owner of the property, am exclusively contracting with licensed contractors to
uct the project. (Sec. 7044, Business and Pr Code: The Contractors' State
e Law does not apply to an owner of pr arty who bui s or improves thereon,
contracts for the projectswithacractors) licens d pursuant to the
actors'State License Law.am exempt under Sec. B.&C. for th' son
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:
VOICE (760) 777-7125
FAX (760)777-7011
INSPECTIONS (760) 777-7153
Date:. 11/17/2017
Owner:
FERNANDO MARVAN
6640 VARNEY DR
SAN DIEGO, CR 92253
Contractor:
FERNANDO MARVAN / OWNER BUILDER
6640 VARNEY DR
SAN DIEGO, CA -92253
Llc. No.::CONV4140528101254114199
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have'and will maintain a certifica:,e of consent to self -insure for workers'
compensation, as.provided for by Section 37CO 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.
Se n \__ 700 of the Labor Code, for the perfo•-mance of the work for which this permit is
issue My workers' compensation insuraftheworkfor
policy number are:
Ca rri Policy Number: _
t 1 certify that in the performanr hi s permit is issued, 1
shall employ any person in any mannubject to the workers'
compensation laws of California, and agld come subject to the
workers' compensation provisions of SeLa or Code, l shall forthwith
comply with those provisions.
S
Date? Appliiicca�nt:
r
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 FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES:
I
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to t! a 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 he 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 tie 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 issuance of such permit, or cessation of work
for 180 days will subject permit to cancellationi. �1
I certify that I have read this application and sta that the ab formation is correct.
I agree to comply with all city and county ordin nces a ate la relating to building
construction, and hereby authorize represent of this city to; ter upon the above-
mentioned property for inspection purp
t
Date: Signature (Applicant or Ag
T
Date: ' 11/17/2017
Application Number: BRER2017-0141
Owner:
PropeRy` Cddre5s1' "-': ':?'53555 AVENIDA MADERO
FERNANDO MARVAN
APN: 774102019
6640 VARNEY DR
Application Description: MARVAN / REROOF
SAN DIEGO; CA_ 92253
Property Zoning:
Application Valuation:,
Applicant:
Contractor:.
FERNANDO MARVAN
FERNANDO MARVAN / OWNER BUILDER
6640 VARNEY DR
6640 VARNEY =DR
SAN DIEGO, CA 92253
SAN DIEGO, CA 92253
-Llc. No.::CONV:140528101254114199
Detail: REROOF WITH SHINGLES AT SLOPED AREAS [CRRC: 0890-0013] 2016
CALIFORNIA ENERGY CODE.
. 4
FINANCIAL
_ .DESCRIPTION
•• •
ACCOUNTQTY
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
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS: $164.1
i
1
J
STATE OF CALIFORNIA
r ;Prbsi KVtive Residential Alterations That Do Not Require HERS Field Verification
6
w
CEC-CF1 R -ALT -05-E (Revised 04h6) r 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:
This compliance document is only applicoble to
with a HERS Provider Data Registry.
at do not require HERS verification for compliance. When HERS verification is required, a CF1R-ALT- 01 shall first
Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CF1R-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: nr thr Pxicting dart tyctrm wnc invdWith �th nchpctns; am was the existing duct system previou3ly tcstcd god NusseJ by u
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 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, shall complete and register a CF1R-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 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.InforFnation
01
Project Name:
/�% �
0 �.
02
Date Prepared:
03
Project Location:
` A e
04
Building Front Orientation (deg or cardinal):r��'
0S
CA City:
06
Number of Altered Dwelling Units:
07
Zip Code:
08
Fuel Type: '
09
Climate Zone:
10
Total Conditioned Floor Area (ft):
11
Building Type:
12
Slab Area (ft2)
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
-A
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
-05- (Revised 04/16) 'CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF111-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
it 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)
00/
6,00
`
y�
�AddRowelete
Rows
g "
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. S
CA Building Energy Efficiency Standards - 2016 Residential Compliance
1
,• t
April 2016
STATE OF CALIFORNIA +,
T Pres-criptive Residential Alterations That Do Not Require HERS Field Verification
SEC-CFIR-ALT-OS-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 Prepared: '
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
'Documentation Author Name:
Documentation Author Signature:
Company:
Signature Date:
Address:
CEA/ HERS Certification Identification (if applicable):
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., 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 Signature:
Company:
Date Signed:
Address:
License:
City/State/Zip:
Phone:
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
PERMIT 14
PLAN LOCATION '
Project Address: Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:®S
City, St, Zip
Garage _ SF
Telephone:
Applicant Name:
Email:
Address: M
State Lic: City Bus Lic:
City, ST, Zip: 2
avail:
Telephone:
tate Lic: City Bus Lic:
Email:
Valuation of Project $
Contractor Name:^
Address:
New SFD Construction:
Conditioned Space SF
City, St, Zip
Garage _ SF
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: City Bus Lic:
# Units:
krch/l✓ng Name:
Construction Type: Occupancy:
address:
Grading:
-ity, St, Zip
Construction Type: Occupancy:
Telephone:
Bedrooms:Stories:
elephone:
# Units:
avail:
tate Lic: City Bus Lic:
Toperty Owner's Name: �,
New Commercial /Tenant Improy.ements:
,ddress: "'
Total Building SF
:ity; ST, Zip '
Construction Type: Occupancy:
elephone:
mail: O Ma rlla4 Q O maiz ea
78495 CAL LIE TAMPICO
LA QUINTA, CA 92253
760-777-.7000
BUILDING •4C SAFETY DEPARTMENT
78-495 CALLE TAMPICO (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
Considering Becoming an -Owner -Builder?
Important information you need.to know BEFORE pulling your permit! . .
The term "Owner -Builder" can mean three different things:
"Owner as Worker", "Owner as Contractor" or "Owner as Employer"
Understand each has Benefits or Risk, and itis possible to combine them!
Hiring a California Licensed Contractor means you do not personally perform any of the construction work, the permit is not taken
out in your name, you are not personally responsible for the construction and you are not an Owner-BuLder. Instead, you become a
"Customer" and California law provides you the benefit of protection from poor workmanship, failure tc finish the job and financial
risk due to worker injury.
Benefit/Risk: HL -hest Benefits and the Least amount of Risk
Owner -as -Worker is a type of.Owner-Builder where you personally perform the construction. work, the: permit is taken out in your
name and you are personally responsible for the construction management, knowledge; workmanship, and completion of the job. You
benefit by not paying others to perform this work for you and your risk depends on your own ability to complete the job successfully.
Benefit/Risk: Possible Benefit with Low Financial Risk
Owner=as-Contractor is a type of Owner -Builder where you personally act as your own General Contractor, the permit is taken out in
your name and'you hire California licensed sub -contractors to perform portions of the construction work. 'WARNING: The benefit of
protection provided. -by law when you hire only California licensed sub -contractors canturn .to serious financial risk if you hire
unlicensed. contractors to perform any of the work
Benefit/Risk: Possible Benefit and Significant Financial Risk
Owner -as -Employer is a type of.Owner-Builder where you pay any unlicensed individual to perform any construction work valued at
more than $500.00, the permit is taken .out in your name and • you are- personally responsible for their employment requirements,
supervision, performance, safety and welfare •while on your property. WARNING: Cost savings benefit can tunm'to serious financial
risk if you fail to deduct payroll taxes or provide workers compensation insurance for each worker..
Benefit/Risk: Possible. Benefit with Silznificant Financial Risk
(Health and Safety Code Section 19827) The California Legislature declares an "urgent and statewide
public interest in assuring" that contractors comply with Contractors' License. Law, Business and
Professions Code and Workers' Compensation Insurance requirements to ensure property owners are
informed about, and protected from the following when improving their property as Owner -Builders:
Fraudulent representations - Liability for worker's injuries - Liability for material and labor costs unpaid -by
contractors - Licensing requirements - Employers tax liabilities
OVer 20,000. consumer complaints are filed each year. Many complaints relate to owner/builder projects
and include workmanship and workers' compensation issues Homeowners suffer financial harm due to
defective workmanship and injured employees.
Following are alarming. examples of what has occurred with Owner -Builder permits:
Example 1: Homeowner received insurance money to rebuild burned -down home.
.Owner/Builder permit pulled to rebuild structure.
Unlicensed contractor built substandard structure — must be torn down and replaced.
■ Estimated financial injury is $225,000.
Additional financial injury - IRS threatened to tax insurance payout if house not completed by the end of
the year.
Example 2: Brother-in-law had active license but fled an exemption from Workers Comp.
■ Owner -Builder hires brother-in-law to install a new roof.
■ Employee falls and sustains multiple spinal and extremity fractures as. well as a head injury and
remains in a coma to this day.
The Owner -Builder, who has sold the home, is now a defendant.in a lawsuit for reimbursement for
benefits paid to the injured worker.
Example 3: Employee of contractor without Workers Comp is hired by Owner -Builder to install septic
system and suffers injury that results in permanent disability.
■ The Owner -Builder did not have a homeowner's insurance policy on the house against whi
a claim. ch to submit
■
The -Owner -Builder is now a defendant in a lawsuit for reimbursement for benefits paid to the injured
worker.
Did you know— unlicensed persons frequently have the property -owner obtain an "Owner -Builder" building
permit which erroneously implies that the'property owner is providing his or her own labor and material
personally?
Did you know — your homeowner's insurance may not provide coverage for injuries sustained on your
property by an unlicensed contractor and his/her employees?
Did you know — if you are considered an "employer" under state and federal law, you must register with
the state and federal government, withhold payroll taxes, provide workers compensation and disability
insurance and contribute to unemployment compensation for each "employee"?
Did you know — that if you fail to abide by these laws you may be subjected .to serious financial risk? .
OWNERS BEWARE AND CONSIDER THE RISK BEFORE ACCEPTING FULL RESPONSIBILITYFOR
YOUR CONSTRUCTION PERMIT
J
F.U.WC4
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 TOTROPERTY OWNER
Dear Property Owner: .
An application ' for a building peimit has been submitted in your. name listing yourself as the .builder of thero
improvements: specified at p gym'
We are rovid' �� 2453.
p mg you with an Owner -Builder Acknowledgment and Informarion Verification orm 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
RECTIONS. Read and initial each statement below to signer you understand or verify this information.
1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an `owner -Builder"
have ding 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 coverag,- for injuries to workers
oli my property.
2. I understand building permits are not required to be signed by property owners unless. they, are responsible for the
ruction and are not hiring a licensed Contractor to assume this responsibility.
11 understand as an "Owner -Builder" I am the responsible party of record on the permit I understand that I may protect
if from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
I understand Contractors are required by law to be licensed and bonded in California and to list taeir license numbers on
and contracts.
5.1 understand if l employ or otherwise engage any persons, other than California licensed Contrac.ors, and the total value
y construction is at least five hundred dollars ($500), including labor and materials, I may be considered an ".employer"
r 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
mment, withhold payroll taxes, provide workers' compensation disability insurance; and contribute to unemployment
)enation for each "employee." I also understand my failure to abide by these laws may subject me to.serious financial
13 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
clunes 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 fie work is performed
under contract with -a licensed general building Contractor.
8. I understand as an Owner -Builder if I sell the property.for which this permit is issued, I may be held liable for any
fin cial or personal injuries sustained by any subsequent owner(s) that result from any latent ccnstruction defects in the
anship or materials.
9. I understand I may.obtain more information regarding my obligations as an "employer" from the Internal Revenue
S ice, the United States Small -Business Administration, the California Department of Benefit Pay`nents, and -the Californiaivision of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-
8%0-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
.legally, and financially .responsible for proposed constructi9n activity at tl a following . address:
Jas �er�n.t A Marl'oen �,.. %,�.. �..� . yrs J=la-
11. I agree that, as the party legally and financially responsible for this proposed construction activity, I wills abide by all
cable laws and requirements that govern Owner -Builders as.well as employers.
12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes tc• any of the information'l
ave provided on this form Licensed contractors are regulated by laws designed to protect the pudic. If you contract with
someone who does not have a license, the Contractors' State License Board may be unable to assist yeu with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may br 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 bei ed, this m must be completed and signed by the property owner and returned to
.the.agency responsible for issuin the permit. copy of the propeny.owner's driver's license, form notarization, or
other verification acceptable to t e age x quired to be presented when. the permit is issuer to verify the property
owner's signature.
Signature of property owner
Date:
Note: The following Authorization Form is required lobe 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 BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personalresponsibility, I hereby authorize
the following person(s) to act as my agents) 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 personally filled out the above
information and certify its accuracy. Note: A copy of the.owner's driver's license, form notarization, or ether verification
acceptable to the agency is required to be presented when thepermit is issued to verify theproperty owrer s signature.
Property Owner's Signature: Date: