BRER2019-009678-495 CALLE TAMPICO D 1 Q"
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: RE -ROOF/
Application Number: BRER2019-0096
Property Address: 49499 EISENHOWER DR
APN: 658190011
Application Description: LQ RESORT / 1,800 SF POLYURETHANE RE -ROOF
Property Zoning:
Application Valuation: $7,300.00
Applicant: ZA�, 0 D
WESTERN PACIFIC ROOFING CORP D
2229 VENUE Q
PALM AS E,QCA 93550 MAY 2 4 2019 DD
CITY OF LA QUINTA
DESIGN & 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 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 A
Date: �i
OWNS"UILDVR 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).:
(_) 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/24/2019
Owner:
KSL DESERT RESORT
1 POST OFFICE SQ STE 3100
BOSTON, MA 92253
Contractor:
WESTERN PACIFIC ROOFING CORP
2229 EAST AVENUE Q
PALMDALE, CA 93550
(661)273-1336
Llc. No.: 235717
WORKER'S COMPENSATION DECLARATION
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 thew or which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Se d0 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: AjjSHLJMIJf3AlYC€COIVIPANY. Policy Number: ZAWC19401702
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.
Date: / Applicant:
WARNING: FAILURE TO SECURE W ERS' MPENSATION 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 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
construction, and hereby authorize representatives of this city to enter upon the above -
mentioned property for inspection purposes.
Dat,3 Signature (Applicant orA
Date: 5/24/2019
Application Number:
BRER2019-0096
Property Address:
49499 EISENHOWER DR
APN:
658190011
Application Description:
LQ RESORT / 1,800 SF POLYURETHANE RE -ROOF
Property Zoning:
Application Valuation:
$7,300.00
Applicant:
WESTERN PACIFIC ROOFING
CORP
2229 EAST AVENUE Q
PALMDALE, CA 93550
Owner:
KSL DESERT RESORT
1 POST OFFICE SQ STE 3100
BOSTON, MA 92253
Contractor:
WESTERN PACIFIC ROOFING CORP
2229 EAST AVENUE Q
PALMDALE, CA 93550
5661)273-1336
Ic. No.: 235717
Detail: 1,800SF REROOF FOR THE CLUBHOUSE AT KITCHEN AND HALLWAY AREAS ONLY',WITH POLYURETHANE FOAM [CRRC: 0626-0010] 2016
CALIFORNIA ENERGY CODE.
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT CITY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$54.43
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0
$108.87
Total Paid for RE -ROOF:
$163.30
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
TOTALS:
$5.00
$169.30
ta QW�Kra
PERMIT #
CALIFORNIA ----
Project Address: L¢ 99 £I 5 £(v1�0wt2 Project Description:
APN #:
rtOA
Applicant Name:/ 4 JvPA 12ISO 01 GLu
Address: q qN 9 � S J 14E0rz. L
City, ST, Zip:
Telephone:
Email: ki prJ CO Gf�
Architect/Engineer Name:
Address:
City, St, Zip
Telephone:
Email. -
State Lic
City Bus Lic:
12do t t,� ,4 cnyl,0
r L A-F- )eo )- f+/t fig
Valuation of Project $ 7 n• Od
Construction
Grading:
Bedrooms: I Stories:
Occupancy:
# Units:
Property Owner's Name: Li4 QV,,vrq Q wpT ",j New Commercial / Tenant Improvements:
Address: �! �j LI SEAI Apv) oz 0cv Total Building / D SF
City, ST, Zip LA- viNTA- CA 9 9 � Construction Type: Occupancy:
Telephone: i - 77• Z tp �' D l r PLO0
Email: Pal A.-i G0C,/1
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
# � Submittal � Required � Received
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
Purchase order: PSPLQA9070
Page 1 of 2
'�xTC H iFfJ
PURCHASE ORDER
La Quinta Resort & Club, CA
PO NUMBER : PSPLQA9070
Delivery date : 04/09f2019
Source Document:
HSM PO No.:
PO Type: Standard
Purchase type : General
Supplier: Western Pacific Roofing(On the Fly)
3462 La Campana Way
Patin Springs, CA, 92262
Attn: Linda Johnson
Title: Service Manager
Phone: 7604165877
Fax: 7603208912
Email:
DBA:
Sent From: La Quinta Resort & Club, CA
Name: Alyssa Chavez
Title: Prop Ops Exec Admin
Phone: (760)564-4111
Fax:
Email: alyssa.chavez@waldorfastoria.com
Cost
Center:
Notes and Attachments :
Header Notes
No Dotes
This Purchase Order has I Attachments
Status: Fax failed connection not made
PO Submit Date: 04/09/2019 05:11:33
Customer Account #:
Bill To: La Quinta Resort & Club, CA
49-499 Eisenhower Drive
La Quinta, CA, 92253, US
Attn: Accounts Payable
Ship To: La Quinta Resort & Club, CA
49=499 Eisenhower Drive
La Quinta, CA, 92253, US
Attn: Ordering Department
Terms:
Subject:
Partial Order
Accepted:
Payment Terms:
Department:
Payment method:
0 Item SKU Product Dese. Qty UOM
1 1 ' 161015-Construction-in -Progress 2 / 1.00 EA
NODEPT-No Department New
roof system
* - Non catalog item
Sub Total:
Freight:
Tax Amount:
Less Discount:
Total amount due:
r�
Resort Emergency CAPEX- Adobe
Elevator
No
Net 30 Days
NODEPT-No Department
Purchase order
Price Extension
$7,300.0000 $7,300,00 Lur, I.
$7,300.00
$0.00
$0.00
$0.00
$7,300.00
Tilton Worldwide is an equal opportunity employer and federal contractor or subcontractor. Consequently, the parties
gree that, if Seller has operations physically located in the territorial United States including Puerto Rico which are
avolved in Seller's performance under this agreement, and to the extent otherwise applicable, they will abide by the
equipments of 41 CFR 60-1.4(a), 41 CFR 60-300.5(a) and 41 CFR 60-741.5(a) and that these laws are incorporated
erein by reference. These regulations prohibit discrimination against qualified individuals based on their status
s protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based
n their race, color, religion, sex, or national origin. These regulations require that covered prime contractors
nd subcontractors take affirmative action to employ and advance In employment individuals without regard
s race, color, religion, sex, national origin, protected veteran status or disability. The parties also agree that, as
https://appOl.birchstreetsystems.com/j4/POReport jsp?po_number=PSPLQA9070&subscri... 4/17/2019
.lt� INS
Exhibit A
i� .4'
till `. i 1' T 1e1a_
NO
..
QUinta Kitchen Hallway Roof Area.,.
TT T—
Wi 6�'.
ekITEM
' _r
t ���
STATE OF CALIFORNIA
ENVELOPE COMPONENT APPROACH
CEC-NRCC-ENV-01-E (Revised 01116) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-ENV-01-E
Envelope Component Approach Page 1 of 4
Project Name: / _ ♦ ,'+ pate prrpau
A. GENERAL INFORMATION
01 Project Location: ^ L� q A � S�Nh�aw� 06 Compliance Method: ❑ Component
( a/t❑ Unconditioned (file Affidavit)
02 CA City and Zip Code: (,�} Q �, ,¢ 9�arf� 07 Building Front Orientation:
❑ New Construction
03 Climate Zone: 08 Phase of Construction: ❑ Additions
❑ Alteration
❑ Nonresidential
04 Total Conditioned Floor Area: 09 Building Occupancy: ❑ High Rise Residential
❑ Hotel/Motel Guest Room
05 Building Type: ❑ Schools (Public Schools) ❑ Relocatable Public School Building ✓❑ Conditioned Spaces ❑ Unconditioned Spaces
❑ Skylight Area for Large Enclosed Space > 5000 ftz (If checked, include the NRCC-ENV-04-E with submittal)
B. ENVELOPE DETAILS - FRAMED
01 02 03 04 05 06 07 08 09 10 11
Continuous Appendix JA4 Required
Reference Frame Frame Frame Cavity Insulation ReProposed U-Factor from Tables Field Inspection
Tag/ID Assembly Type Material Depth Spacing R-value R-value I Table Cell U-Factor 140.3-B, C, or D Comments
Add Row 11Remove
C. ENVELOPE DETAILS - NON -FRAMED
01 02 03 04 i 05 06 07 08 09 10
Interior or Core Continuous Appendix JA4
Assembly Thickness Insulation Insulation Reference Proposed Required U-Factor from Field Inspection
Tag/ID Assembly Type Materials (inches) R-Value R-Value Table Cell U-Factor Tables 140.3-B, C, or D Comments
Add Row lirmove Last
D. ENVELOPE DETAILS - MASS
01 1 02 1 03 04 05 06 07 08 09 10 11
CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016
STATE OF CALIFORNIA
ENVELOPE COMPONENT APPROACH
GtG-NKGG-tNV-UI-t {KeV45eO 0711bj CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-ENV-01-E
Envelope Component Approach /f is Page 2 of 4
Protect rvame: L ^ L%!�l � S0/C f f _ /U
r'{ ¢ CW Date Papered:
Appendix JA4
Mass Furring Strip Interior Exterior Reference
Mass Density Thickness Thickness Insulation Insulation
Tag/ID Type (lb/ft3) (inches) (inches) ` R-Value R-Value Table Cell
Add Row
Required LI-Factor
Proposed from Tables 140.3-B, Field Inspection
Ll-Factor C, or D Comments
E. ROOFING PRODUCTS (COOL ROOF)
01
02
03
04
05
06 07
08
09 10
11
Proposed
Minimum Required
Mass Roof
25 Ib/ftz
or Greater
Roof Pitch
CRRC Product
ID Number
Product Type
Aged Solar
Reflectance)
Thermal
Emittance
SRIZ
(Optional)
Aged Solar
Reflectance
Thermal
Emittance
SRI
(Optional)
Comments
El
L(VO-0016
c-0,4n
El
Add Row
An aged solar reflectance less than 0.63 is allowed provided the maximum roof/ceiling LI-factor in TABLE 140.3 is not exceeded
High-rise residential buildings and Hotels and Motels with low -sloped roofs in Climate Zones 1 through 8, 12, and 16 are exempted from aged Solar
Reflectance and thermal emittance requirements
- High-rise residential and Hotels/Motels with steep -sloped roofs in Climate Zones 1 and 16 are exempt from aged Solar Reflectance and thermal
emittance requirements
- The roof area covered by building integrated photovoltaic panels and building integrated solar thermal panels are exempt from aged Solar Reflectance
and thermal emittance requirements
- To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in §110.8(i)4. Select the applicable coating:
❑ Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other
Check the box if the aged Solar Reflectance was not available in the Cool Roof Council's Rated Product Directory, then use the equation in Section 110.8(i)2: paged = 0.2 + B(pinitial - 0.2) to obtain a
Iculoted aged solar reflectance value. Where Pinitial is the Initial Solar Reflectance found in the directory and 6 is either 0.65 for Field applied coatings or 0.70 for all other roofing products other
on Field -Applied Coating.
Calculate the SRI Value by using the SRI-Worksheet and enter the resulting value in the SRI column above and attach a copy of the SRI-Worksheet (NRCC-ENV-03-E) to this compliance document.
CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016
STATE OF CALIFORNIA
ENVELOPE COMPONENT APPROACH
CEC-NRCC-ENV-01-E (Revised 61116)
CERTIFICATE OF COMPLIANCE
Envelope Component Approach
Proiect Name:
F. AIR BARRIER
01
Name
02
Air Barrier
Material Type
03 04
Air Barrier Whole Building
Assembly Type Air Leakage Testing
Add Row I Remove Last
G. FENESTRATION PROPOSED AREAS AND EFFICIENCIES
01 02 03 04 05 06 07 08
Proposed
Surface # of Max Max
Tag/ID Fenestration Type Area i Orientation Panes U-Factor (R)SHGC Min VT
Add Row 1, Remove Last
09
Label I Ove
COMMISSION
NRCC-ENV-01-E
Page 3 of 4
05
Comments
10 1 11 1 12
i'
Condition
Status Comments
H. ENVELOPE MANDATORY MEASURES
Indicate location on building plans of Mandatory Envelope Measures Note Block:
INSTRUCTIONS TO APPLICANT ENVELOPE COMPLIANCE & WORKSHEETS (check box if worksheet are included)
For detailed instructions on the use of this and all Energy Efficiency Standards compliance documents, please refer to the Energy Commission website.
❑ NRCC-ENV-01-E Certificate of Compliance. Required on plans for all submittals.
❑ NRCC-ENV-04-E Use when minimum skylight requirements for large enclosed spaces are required in climate zones 2 through 15. Optional on plans.
CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016
STATE OF CALIFORNIA
ENVELOPE COMPONENT APPROACH
'+ 't i Z u u ioy CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-ENV-01-E
Envelope Component Approach Ax ot- d ZZ 17r--/}e.0� Page 4 of 4
` Project Nam-4 /NT� AirsoRr 1 `rG'1i,,,, Pet—u- 14 Y Date Pr'c Pared & 9
+--1'3;'
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documents ion Author Name:
Documentation Author Signature:
Company: �J j.
w £sT£ /t y✓
Signature Date: ..
Address:
3 6 44 1/��An
CEA/ HERS Certification Identification (if applicable):
Phone' /
�7 7
/fin
City/1 A-11� s Ic.l ^'&-� 1 l.�T .� �`�� a"
+`✓
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. 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 completed signed 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 completed signed 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:
CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016