BRER2019-005978-495 CALLE TAMPICO T jht D 4 Qu&*1
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: RE -ROOF/
Application Number: BRER2019-0059
Property Address: 78016 CALLE NORTE
APN: 770012001
Application Description: Bollmeyer / REROOF
Property Zoning:
Application Valuation:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
Bollmeyer Monica
78016 CALLE NORTE
LA QUINTA, CA 92253
Date: 4/23/2019
Applicant: Contractor:
WESTERN PACIFIC ROOFING CORP DL WESTERN PACIFIC ROOFING CORP
2229 EAST AVENUE Q f 2229 EAST AVENUE Q
PALMDALE, CA 93550 A,�)i`, 2 3 20 19 PALMDALE, CA 93550
aTY OF [_.AO;i. NIA (661)273-1336
DEWN & (_IEVEL',JRMENT DER'l),TKIENT Llc. No.: 235717
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
{commencing with Section 70001 of Division 3 of the Business and Professions Code, and
my License is in full force and effect.
License Class: B. C39 License No.: 235717
Date;; I Contractor.
OIAINER4KLDER 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 anyapplicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_11, asowner 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, as owner ofthe 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
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'
corn pens@ tl a n, as provided for by Section 3700 of the La bar Code, for the performance
of th %W11rbrwhich this permit is Issued.
ave and will maintain workers' compensation Insurance, as required by
Section 3700 of the Labor Code, for the performance of the work far which this permit is
issued. My workers' compensation insurance carrier and policy number are:
Carrier: AKH JNSUR6NCE COMeANY Policy Number:ZAWC1940170Z
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 become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Dater Applicant
WARNING: FAILURE TO SECURE W RKERS' 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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subjectto
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, Indem nlfy and hold harmless the City of to Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
fallowing issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not
:ommenced within 180 days from date of issuance of such permit, or cessation of work
:or 180 days will subject permit to cancellation.
certify that I have read this application and state that the above information is correct.
agree to comply with all city and county ordinances and state laws relating to building
:onstruction, and hereby authorize representatives of this city to enter upon the above-
nentioned property for inspection purposes.
nn q �
)ate: 4'? �/ Signature (Applicant orAgentJ:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BRER2019-0059
78016 CALLE NORTE
770012001
Bollmeyer / REROOF
Applicant:
WESTERN PACIFIC ROOFING CORP
2229 EAST AVENUE Q
PALMDALE, CA 93550
Date: 4/23/2019
Owner:
Bollmeyer Monica
78016 CALLE NORTE
LA QUINTA, CA 92253
Contractor:
WESTERN PACIFIC ROOFING CORP
2229 EAST AVENUE Q
PALMDALE, CA 93550
(661)273-1336
Llc. No.: 235717
--------------------------------------------------------------------------------------------
Detail: TEAROFF OF ROLLED ROOF AN REPLACE WITH POLYURATHANE FOAM AND ACRYLIC ON FLAT PORTIONS OF DWELLING [CRRC:0626-0010] PER
2016 CALIFORNIA ENERGY CODE.
DESCRIPTION
RE -ROOF - FIRST 2,000 SF
DESCRIPTION
RE -ROOF - FIRST 2,000 SF PC
DESCRIPTION
TECHNOLOGY ENHANCEMENT FEE
ACCOUNT QTY
AMOUNT
101-0000-42404 0
$54.43
ACCOUNT QTY
AMOUNT
101-0000-42600 0
$108.87
Total Paid for RE -ROOF:
$163.30
ACCOUNT QTY
AMOUNT
502-0000-43611 0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
Bin # City of L2 Quin is
Building a Safety Division
Permit # - 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
al��,ol 5-G�S�j Budding Permit Application and Tracking Sheet
Project Address: go J(0 CA Z L f, ''u O R r f Owner's Name: M 0 N 1614 13 0 t L �1
A. P. Number:
Address: �Q 6 6A [ C f- N 0 R j f -
Legal Description:
City, ST, Zip: L.4 Q u I v r 4- CA 91_9 a S ,3
Contractor:w E S r'£R,✓ P/¢G/% / G
Teicphone: Q – 7 7� ' 7
Address: 3 Oe LA
Project Description: E (I' j 0 v L F k1 J li N 4
City, ST, Zip: PAL /"l 7,24a
90c)
Telephone: )&Q _ _716 �.7 g 7•%
'��"`�-w�,;:;.:.,.,.;;,;;,;;;;,;,•.::-:o:
/ d L (%/2F/ir/i� � /�It Gni
StateLic.#: ,357%
City Lic-#;OODy�i/tib
Arch., Engr., Designer:
2 (� — 00/0
Address:
City, ST, Zip:
Telephone:
>£ N;
e<-- rr: ,
-----------r>< - "•
Occupancy:
Construction T P Y�
Type:
Project ty e (circle one): New Add'n Alter Repair Demo
J P^
State Lic- #:
Name of Contact Person: � / %
,� ^4 /y J-2
Sq. Ft.: J, (00 # Stories: # Units:
Telephone # of Contact Person:) 6 0
L j
Estimated Value of Project: oo
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
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 Cluck Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°' Review, ready for correctionsCssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Pcrmit Fees
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
CEC-CFiR-ALT-01-E (Revised 06114)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations TC £ - fro 0,
Project Name: 0 C C
A. GENERAL INFORMATION
01 Project Name: It f 0^J) G L EY f
03 Project Location: 7 3'0 J C4 G L
05 CA City: a V Jn%rr`+�}
07 Zip Code:
09 Climate Zone:
11 Building Type
13 Project Scope: J.r.r t� / ItC E pr., d �[
B. BUILDING INSULATION DETAILS (Section 150.2(b)1)
01 02 03 04 05
Frame Frame
Frame Depth Spacing
Tag/ID Assembly Type Type (inches) (inches)
�S JfJfNG£ Date Prepare(
S �+ E�+G G 02 Date Prepared:
04 Building Front Orientation (deg or cardinal
06 Number of Altered. %welling Units: ,• ;
08 Fuel Type: c_ "' r
10 Total Conditioned Floor•Area (U):t*
12 5.16b-4rea (ft 2)
06 .�.'' "All 07Q8 09 10
'Proposed Ifte ° A Required
s FT
encllx JA4
a, $,Continuous pp
Cavity Reference
y ;�1lnsuiation
R value '<< R -value j� 7 U-factarl?I_e Cell LI -Factor
C. ROOF REPLACEMENT (Prescriptive Alteration, Sec' l:oiit150.2(b)1H)�'
1
Ol 02 03 04 ft05, #` 06� 08 09 10 1
a R -value t s Proposed
Method of Roof CRRC'Pxodiect I❑ Dec •, Vnitial Solar Aged Solar Thermal SRI Aged
Coirii.3:;ance Pitch Exception ,-:• NumberPraductTypeulatjvn Reflectance Reflectance Emittance {Optional} Reflec
NOTES
,t •
• Roof area covered by builrJing•;integrated phbtovbl[aic panels and solar thermal panels are exempt from the above Cool Roof requirements.
� � rx
• , Liquid field applied. coatings must comply WAIri tallation criteria from section 110.8(i)4.
Registration Number: Registration Date/Time:
CA Buildine Enerev Efficiencv Standards - 7011 RPciriPntial Cmmnlinnrn
Y COMMISSION
CF1R-ALT-01-E
(Page 1 of 4)
11
Comments
12 1 13
nimum Required
Thermal SRI
Emittance (
Opt
iona
H R5rovider:
STATE OF CALIFORNIA
RESIDENTIAL ALTERATIONS
C1-C-CFIF1-ALT-01-E Revised Dfd14
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations
Project Name: M 0 ^/1 CA
C�-XVO
OL[n1FYF/L X5,10
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documenta ut
Cornp i�; Si atur ate:
U)EST1R/J PAC, r�l L %ZOv`NG'
Address:
— w A CEAI HERS Certification
3Y6-)- Gia C R ,4
f-a-Ista 12ip: Y Phone:
W L" l s C�9 _ 91,6 0�
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 responsio6illit'�for the build
designer). '
3 That the ener featu d f
4
applicab
Date Pre
9Y COMMISSION`
CF1 R -ALT -01-E
{Page 4 of 41
4 l
9 system design identified on this Certificat of lompliance (responsible
by res an per ormance specifications, materials, compor>e�,, n mann#ac#uge;;�rvffor the building design or system design identifie on his Certificate of
Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the 4li6riia Cote ofV lgtions.
4. The building design features or system design features identified on t . Is C rti€icate of C
��: ,� ��iance re cons'E�ster�lt';iv�it�the information provided on other appli abl compliance documents,
worksheets, calculations, plans and specifications submitted to tt e e floi cement ager�o a60roval with budding permit application.
5. 1 will ensure that a registered copy of this Certificate of liR� e- shall be mad A le with the bun g Pei. .Mit(s) issued for the building, and made available t the enforcement agency
for all applicable inspections. I understand that a regist Co�j+'of this Certi ica� bmpliance is to be included with the documentation the build 'r pr vides to the building
owner at occupancy.
Responsible Designer Name: Resible Designer signature: i
. P� �d � �_ �, _ •!� til
Company:
ress:
Date Signed:
License:
Phone:
4�
For assistance or questions regarding.the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Comoliance
rovider: