BRER2020-000678-495 CALL TAMPICO D�iEJ
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype:
RE -ROOF/
Application Number:
BRER2020-0006
Property Address:
78800 LIMA ST ST
APN:
776080015
Application Description:
ZUZACK REROOF ROCK TO MEMBRANE
Property Zoning:
Application Valuation:
$32,000.00
Applicant:
DIVERSIFIED ROOFING SERVICES INC D
42933 MADIO STREET
INDIO, CA 92201 17 2020 , 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: C39 License No.: 947919
Date: &17- Z Contractor:
OWNER-8 DER O RATION
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).:
(_) 1, 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, 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 Add
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/17/2020
Owner:
RONALD ZUZACK
Contractor:
DIVERSIFIED ROOFING SERVICES INC
42933 MADIO STREET
INDIO, CA 92201
(760)895-4465
Llc. No.: 947919
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 the ork 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: NY Policy Number:
_ 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: - 2-4 Applicant:
WARNING: FAILURE TO SECURE WOR ' C MP NSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TOCRI I 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.
Date: 1-17 2J Signature (Applicant or Agent):
Date: 1/17/2020
Application Number:
BRER2020-0006
Property Address:
78800 LIMA ST ST
APN:
776080015
Application Description:
ZUZACK REROOF ROCK TO MEMBRANE
Property Zoning:
Appllcatlon Valuation:
$32,000.00
Applicant:
DIVERSIFIED ROOFING SERVICES
INC
42933 MADIO STREET
I N DIO, CA 92201
Owner:
RONALD ZUZACK
Contractor:
DIVERSIFIED ROOFING SERVICES INC
42933 MADIO STREET
INDIO, CA 92201
(760)895-4465
Llc. No.: 947919
Detail: REROOF REMOVE EXISITING ROCK INSTALL 1/2' FOAM AND REROOF WITH MULE HIDE PVC [CRRC# 0670-0015). PER 2019 CALIFORNIA BUILDING
CODES
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00
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
$51.52
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: $215.74
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
8495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verificationin
CEC-CFIR-ALT-05-E (Revised 01r20) _ _ CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-05-E
Prescriptive Residential Alterations That Do Not Require HERS Field Verification Page 1 of 3
pro" N me�z � J � Date Pre rr¢d-
This compliance document is ony 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 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 CFIR-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 greater 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 on 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
1 Project Name:
`
{7 u 7-4 r
]
02
Date Prepared:
I I_ ►L U
03
Project Location:
7 6_ �1�� /! �
, �
Q (92
04
Building Front Orientation (deg or cardinal):
05
CA City:
7 5-
06
Number of Altered Dwelling Units:
07
Zip Code:
2 7
08
Fuel Type:
09
Climate Zone:
10
Total Conditioned Floor Area (ft):
11
Building Type:
S wt
12
Slab Area (ftz)
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?
'CA Building Energy Efficiency Standards - 2019 Residential Compliance January 20',20
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
C-EC-CF1R-ALT-05-E(Rev*s 01120)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
zo�OJlfC NPM'
CF1R-ALT-05-E
Page 2 of 3
C. Roof Replacement (Prescriptive Alteration, Section 150.2(b)1H)
01
02
03
04
05
06
07 08 09 10 11
12
13
Initial Solar
1 Reflectance
Proposed
Aged Solar Thermal
Reflectance Emittance
Minimum
SRI Aged Solar
(Optional) Reflectance
Required
Thermal
Emittance
Method of
Compliance
Roof Pitch
CRRC Product Product
Exception ID Number Type
R-value
Deck
Insulation
SRI
(Optional)
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.
CA Building Energy Efficiency Standards - 2019 Residential Compliance January 2020
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CF1 R-ALT-05-E (Revised 01J20)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
P
Signature
`/ Z -9 T3 &"i
CALIFORNIA ENERGY C
Date PmParW-
�—/ 7—�2— a
MMISSION r
CF1R-ALT-05-F
Page 3 of 3
Phone:
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the fo€lowing under penalty of perjury, under the laws of the State ❑f 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 Oesi$ner Sigrra ure:
b j, Aj
Company: • �''-'��'+
Date sfgned:
Address; License:
iz `� �3 �r�s� �`a Srr P�
City/statejzip: _
Phone: _
�2 za lb a - 7 S—
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
CA Building Energy Efficiency Standards - 2019 Residential Compliance
January 2020