BRER2019-020278-495 CALLE TAMPICO T 0 D illlilI Q9&&
VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Permit Type/Subtype: RE -ROOF/ Owner:
Application Number: BRER2019-0202 ELENE POLLARD
Property Address: 52255 AVENIDA RUBIO 52255 AVENIDA RUBIO
APN: 773252013 LA QUINTA, CA 92253
Application Description: POLLARD / REROOF ENTIRE DWELLING WITH ASPHALT SHINGLES
Property Zoning:
Application Valuation: $6,700.00
Applicant: Contractor:
ROBERTO NAVA - SUPREME ROOFING P
SUPREME ROOFING
84323 ROYAL CT 84323 ROYAL CT
COACHELLA, CA 92236 OCT 21 2019D COACHELLA, CA 92236
CITY OF LAQUINTA 0 (760)485-8218
DESIGN& DEVELOPMENT DEPARTMENT Llc. No.: 1057964
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: C39 License No.: 1057964
Date: Z- 1 Contractor
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).:
(_) 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
Lender's Address:
Date: 10/21/2019
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 t�rk for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 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: FUND, Policy Number: 9258857
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. 1
Date: DIZ Applicant:
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.
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-
mentloned property for inspection purposes.
Date:[t Signature (Applicant or Agent):
Date: ?,0/21/2019
Application Number:
BRER2019-0202
Property Address:
52255 AVENIDA RUBIO
APN:
773252013
Application Description:
POLLARD / REROOF ENTIRE DWELLING WITH ASPHALT SHINGLES
Property Zoning:
Application Valuation:
$6,700.00
Applicant:
ROBERTO NAVA - SUPREME
ROOFING
84323 ROYAL CT
COACHELLA, CA 92236
Owner:
ELENE POLLARD
52255 AVENIDA RUBIO
LA QUINTA, CA 92253
Contractor:
SUPREME ROOFING
84323 ROYAL CT
COACHELLA, CA 92236
(760)485-8218
Llc. No.: 1057964
Detail: REROOF ENTIRE DWELLING WITH OWENS CORNING 'OAKRIDGE' ASPHALT SHINGLES IN SHASTA WHITE AT SLOPED AREAS [CRRC: 0890-0002] PER
2016 CALIFORNIA ENERGY CODE.
DESCRIPTION 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
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - EA ADDITIONAL 1,000SF
101-0000-42404
0
$12.88
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - FIRST 2,000SF
101-0000-42404
0
$54.74
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - FIRST 2,000SF PC
101-0000-42600
0
$109.48
Total Paid for RE -ROOF 2019: $177.10
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
tev Qwkra
CALIFORNIA
PERMIT # , Q t —0202-
PLAN LOCATION:
Project Address: r _ _ S ZZ Sr A\)D. "to
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
e U
Applicant Name: �/ p OaVA
Address: (Fq 3 z 3 o L
City, ST, Zip: et(
I ZZ 31
Telephone:
Email: I�h 12C0
Valuation of Project $ 7d o
Contractor Name: ��
New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip
Garage SF
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: to 579 09 City Bus Lic:
Arch/Eng Name:
Construction Type: pu- "h - Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms: Stories:
# Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name: lQ
New Commercial / Tenant Improvements:
Address: 5 2Z 5 S V Ub p
Total Building 2— qDo SF
City, ST, Zip L
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO LA QUINTA, CA 92253 (760)777-7125
W W W. LAQU I N TACA. GOV
OFFICE USE ONLY
#
Submittal
Req' d
Ree' d
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtcc Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CF1 R-ALT-05-E (Revised 07/17)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
-
This compliance document is cofy applicable to simple
with a HERS Provider Data Registry.
that do not require HERS verification for
A
MMISSION
IM
CF1R-ALT-05-E
paop 1 of :Z
When HERS verification is required, a CF1R-ALT- 01 shall first be
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 duct system 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 CF1 R-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 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:
03
Project Location:
05
CA City:
07
Zip Code:
09
Climate Zone:
11
Building Type:
QVJ
5 Z-2-5
L
a a-15
S
13 Project Scope (Select all that apply):
02 Date Prepared:
()� 04 Building Front Orientation (deg or cardinal):
C06 Number of Altered Dwelling Units.
08 -FZ2tT7p2--
10 1--Tvta-I-C Maned Floor Area (ft):
12 Sla�)
❑ 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 July 2017
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CFIR-ALT-05-E (Revised 071171 — —
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
Project Name.
Roof Replacement (Prescriptive Alteration, Section 150.2(b)1H)
01 02 03 04 05
Method of I CRRC Product Product
:ompliance Roof Pitch Exception ID Number Type
�jTEEF� �wsms aw
084v — CwZ Ak-;WAr-T
CALI
MMISSION
CF1R-ALT-05-E
Page 2 of 3
06 07
08 09
10
11
12 1 13
Proposed
Minimum Required
R-value
Deck Initial Solar
Insulation Reflectance
Aged Solar
Reflectance
Thermal
Epmitttaance
SR'. Aged Solar Thermal
(Optional) Reflectance Emittaance
SR
(Optic
Ca
tl Gi �J
o YS
V 1�
I ` F�. LV
O • (�
Add Row Delete Row
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.
July 2017
CA Building Energy Efficiency Standards - 2016 Residential Compliance
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CFIR-ALT-05-E (Revised 07/17
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
I. I certify that this Certificate of Compliance documentation is accurate a
Documentation Author Nam
Company:
HERS
ZL
ENERGY C.QMAMISSION
CF1R-ALT-05-E
Page 3 of 3
0'3--C4Z 5 to 2- Lr
RESPONSIBLE PERSON'S DECLARATION §TATEIIAENT
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.
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.
Responsible Designer Name: Responsible Des' ner sign ore:
�� V�
Company : Date Signed:
JbJ7 I 1(-q
Address:
License:
C' a[ I nc� -7 6A�
GIylState/Iip;
PhonB
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 July 2017