BRER2019-001278-495 CALLE TAMPICO c& 0 D stP Qu&&
LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype:
RE -ROOF/
Application Number:
BRER2019-0012
Property Address:
49480 AVE NIDA CLUB LA QUINTA
APN:
658320011
Application Description:
BURKHART/ REPLACE UNDERLAYMENT OF ENTIRE ROOF
Property Zoning:
Application Valuation:
$22,750.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
JAMES BURKHART
49480 AVE NIDA CLUB
LA QUINTA, CA 92253
Applicant: Contractor:
SOUTHWEST ROOFING P SOUTHWEST ROOFING
P 0 BOX 126 P 0 BOX 126
INDIO, CA 92202 FEB 08
2019 INDIO, CA 92202
(l C IJ (760)578-3735
CITY OF LA QUINTA Llc. No.: 787029
DESIGN & DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
9 {commencing with Section 70001 of Z870'29
son 3 of the Business and Pr ss r
and my License is in full force and effe
License Class: 9 License No.:
Date: r Contractor: `
OWNER-BUIER DECLARATION
I hereby affirm under penalty of perjury hat 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).:
() 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:
Date: 2/8/2019
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the 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 th wo k for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Secti 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 INSURAN E FUND Policy Number: RD41840
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 that, if I should becomes ject to the
workers' compensation provisions of Section 3700 a Labor C I shall forthwi
comply with t ose p ovisions.
Date: % Applicant:
WARNING: FAILURE TO SECURE WORKER�OIIMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRMIN
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 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 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 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 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
construct' n, and hereby authorize representatives of this to ente on
above. a ti ed property For inspection purposes.
.
Da t Signature (Applicant or
Date: 2/8/2019
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
SOUTHWEST ROOFING
P O BOX 126
INDIO, CA 92202
BRER2019-0012
49480 AVENIDA CLUB LA QUINTA
658320011
BURKHART/ REPLACE UNDERLAYMENTOF ENTIRE ROOF
$22,750.00
Owner:
JAMES BURKHART
49480 AVENIDA CLUB
LA QUINTA, CA 92253
Contractor:
SOUTHWEST ROOFING
P 0 BOX 126
INDIO, CA 92202
(760)578-3735
Llc. No.: 787029
Detail: TEAR OFF AND REPLACE UNDERLAYMENT ONLY, REUSE EXISTING CLAY TILE. 2016 CALIFORNIA ENERGY CODE.
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF - EA ADDITIONAL 1,000 SF
101-0000-42404
0
$25.62
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$54.43
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0
$108.87
Total Paid for RE -ROOF: $188.92
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
•, .92
za 0"iftra
Project Address: L4 6r — 46 O (V
APN #:
Applicant Name:
Address:
City, ST, Zip:
Telephone:
Email:
-I%-zozJ
Property Owner's Name:
Address: �, L� T
City, ST, Zip
Telephone:
Email:
PERMIT #
PLAN LOCATION:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
1 c 1�Lt� lJ r r "r—k I L
is
UJ �,`f/4,
Valuation of Project $ Z�
New Commercial / Tenant Improvements:
Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
STATE OF CALIFORNIA
P roa riptive Residential Alterations That Do Not Require HERS Field Verification
EC-CF1R-ALT-05-E (Revksed 04/16) CALIFORNIA ENERGY COMMISSJON11111111111111
CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E
Prescriptive Residential Alterations hat Do Not Require HERS Field Verification Pagel of 3
Project Hama- y ►
This compliance document is only applicable to simple alterations that do not require HERS verification for compliance. When HERS verification is required, a CF1R-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 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, or the existing ductsystem 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 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 an R-value other than 5.8 per inch, or Open Cell Spray
1 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 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
Ol Project Name. 14 02 (2 b Vimf �J
^ r`1 f �!
03 Project Location: C i ` J / Plr C` � L
05 CA City: ('` , �
07 zip Code:
09 Climate Zone:
11 Building Type: - Ca �'L'� `I
13 Project Scope (Select all that apply):
❑ B. Insulation ❑ D. & E. Fenestration/Glazing - ADD
02 Date Prepared:
04 Building Front Orientation (deg or cardinal):
06 1 Number of Altered Dwelling Units:
08 Fuel Type:
10 Total Conditioned Floor Area (ft):
12 Slab Area (ft)
❑ 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
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
GEC-CF1 R-ALT-05-E (Revised 04116
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
Project Name:
CALIFORNIA ENERGY COMMISSION
CF 1 R-ALT-05-E
Page 2 of 3
Date ''.• u: r c a
C. Roof Replacement (Prescriptive Alteration, Section 150.2(b)1H)
01 02 03 04 05 06 07 08 1 09 10 11 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 I ID Number Type Insulation Reflectance Reflectance Emittance (Optional) Reflectance Emittance I (Optional)
Add Row Delete 00w ._ -� I� -; J C~i U �V� E LQ '1/lit�'c tv
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.
Ci'kB�9ding Energy Efficiency Standards - 2016 Residential Compliance April 2016
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CFI R-ALT-O5-E [Revised 64116}
CERTIFICATE OF COMPLIANCE - — —
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
Prajer[ wme: C. }
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and comp
Documentation Author Name'
or
ENERGY COMMISSION
CF1R-ALT-05-E
Page 3 of 3
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I Certify the fallowing 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.
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.
Q
erxip:
bie Designer Slgnature:
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79 7 0 0-a(
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
CA Building Energy Efficiency Standards - 2 116 Residential Compliance
April 2016