BRER2017-0099yaw
78-495 CALLE TAMPICO D
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: RE -ROOF/
Application Number:
BRER2017-0099
Property Address:
53300 AVENIDA RUBIO
APN:
774073003
Application Description:
CORTEZ / REROOF WITH ASPHALT TILE
Property Zoning:
m �
Application Valuation:
$18,000.00
Applicant:
EMPIRE CONSTRUCTION & TECHNOLOGIES LLC D
1585 CREEK STREET
SAN MARCOS, CA 92078
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 Busines and Professions Code, and
my License is in full force and effect. /
License Cla s: No.: 1002801
I TLicense
Date: ` Contractor: !/v"
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 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).:
LJ 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.).
(1 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 ) I am exempt under Sec. . B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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 Na
Lender's
VOICE (760) 777-7125
rM
AXT(:760) 777-7011
�yINSPECTIO.NS�(7•.60) 777-7153
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cDate: 10/18/2017
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Owner: rn Q
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TIFFANY CORTEZ E; s
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LA QUINTA, 922532 c
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Contractor:. �11
EMPIRE CONS -RUCTION
& TECHNOLOGIES LLC D
1585 CREEK STREET
SAN MARCOS, CA 92078
(866)724-6860
Llc. No.: 1002801
WORKERS COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificcte of consent to self -insure for workers'
compensation, as provided for by Section 37DO of the Labor Code, for the performance
oft or for which this permit is issued.
I have and will maintain workers' r6mpensation insurance, as required by
Se on 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My workers' compensation insuranc.a carrier and policy number are: .
Carrier: ZURICH AMERICAN INSURANCE COMPANY Policy Number: WCO235676
_ I certify that in the performance of the wor for which this permit is issued, I
shall not employ any person in any man4ae subject to the workers'
compensation laws of California, and agbecome subject to the
workers' compensation provisions of Sebor Code, I shall forthwith
complywit thos provisions.
Date: Applicant:
WARNING: FAILURE TO SECURE WORKEN COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRINBNAL 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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to fie Building Official for permit subject to
the conditions and restrictions set forth on tHs application.
1. Each person upon whose behalf this appacation 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, anc 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 appl;cation becomes null and void if work is not
commenced within 180 days from date of issrsance of such permit, orcesbation of work
for 180 days will subject permit to cancellation. ,
I certify that 1 have read this application and state that the abov`e ination is correct.
I agree to comply with all city and county ord nances and st a la r sting to building
construction, and hereby authorize representatives of thi c y to t r upon the above-
mentioned JoperW for inspection purposes.
Date: Signature (Applicantor Agent):
�. I
t
r
Date: 10/18/2017
Application Number:
BRER2017-0099
Owner:
eG -
Propd'drets-
53300 AVENIDA RUBIO
TIFFANY CORTEZ
APN:
774073003
Application Description:
CORTEZ / REROOF WITH ASPHALT TILE
LA QUINTA, 92253
Property Zoning:
Application Valuation:
$18,000.00
Applicant:
Contractor:
EMPIRE CONSTRUCTION
& TECHNOLOGIES LLC D
EMPIRE CONSTRUCTION & TECHNOLOGIES LLC D
1585 CREEK STREET
1585 CREEK STREET
SAN MARCOS, CA 92078
SAN MARCOS,'CA 92078
(866)724-686C
--------------------------------------------------------------------------------------------
Uc. No.: 1002601
Detail: REROOF WITH ASPHALrTILE [CRRC: 0890-0010] 2016 CALIFORNIA ENERGY CODE.
t
DESCRIPTION ACCOUNTQTY
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
$12.48
DESCRIPTION .
ACCOUNT
QTY
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: $171.64
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Bin#
O
City .of La Quinta
Building & Safety Division
O��] 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit#
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Project Address:
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Owner's Name: l
C r.Fe
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A.P. Number
Address: `Z O
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Legal Description:
City, ST, Zip: / , f�
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Contractor: EmI r/
Telephone: * �
Address: Zt�
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Project•Description: J c -
City, ST, Zip: /
Telephone:
State Lic. #:cf 05
City Lic #:
Arch, Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: S
Proj. Type New Add'n
Occupancy:
Alter Repair 'Demo
Name of Contact: O J�,v7
JI /I ��) / �.
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SgFt:
#Stories
# Units:
Telephone of Contact:2
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.7
Q?
0613
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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?lan
2nd Rev, Ready for corrections /
Electrical:
Subcontractor List
Called Contact Person
Plumbirg:
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
School Fees
Total Permit Fees
�JINI GX,% c7v% t w1 X1YLA)r —1 IV r,
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
ME
CEC-CFI R -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 1 of 3
Project Name: Date Prepared: O
This compliance document is only applicable to simple alterations that do not require HERS verification for compliance. When HERS verification is required, o CFSR-ALT- 01 shall first be registered
with a HERS Provider Data Registry.
Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CFIR-ALT-OS 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 a
HERS Rater. If spoce 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 (cc5PF) 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. 1.5 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 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 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:
'T( >�� O
02
Date Prepared:
p /W/f-7
03
Project Location:r
2 �O I
J 7
u
to
04
Building Front Orientation (deg or cardinal):
05
CA City:
rl
06
Number of Altered Dwelling Units:
07
Zip Code:
08
Fuel Type:
09
Climate Zone:
I
10
Total Conditioned Floor Area (ft):
11
Building Type:
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?
d. .
CA Building Energy Efficiency Standards - 2016 Residential Compliance
April 2016
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
4
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 2 of 3
Project Name: Date Prepared:
C. Roof Replacement (Prescriptive Alteration, Section 150.2(b)1H)
O1
02
03
04
05
06
07 08 Og 10
11 12 13
Proposed
Minimum Required
R -value
Method of
CRRCfroduct
Product
Deck
Initial Solar
Aged Solar
Thermal
SRI.
Aged Solar
Thermal
-SRI
Compliance
Roof Pitch
Exception
1D Number
Type
Insulation
Reflectance
Reflectance
Emittance
(Optional)
Reflectance
Emittance
(Optional)
2
t � D -polo
r ZD
z o
Q, v
10
, 7-.0 .
ltv
�AowDel,ete
Row
t
�F
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 2.016
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
F -.
1'
-EC-CFIR-ALT-0S-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:
17 It v
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Complia9ce documentation is accurate and complete.
Documentation Author Name: N
4 A M
dfl
Documentation Author Signature:
1dIV
A4
Company: _
Sianahue nate
Address:/^
{)/
U
CEA/ HERS Certification I entific tion (if applicable):
IM -0
City/State/Zip:
vl � �. z ►
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.
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