BRER2020-004778-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
MARIO LOAYZA
52425 AVENIDA DIAZ
LA QUINTA, CA 92253
Tit�p 4 4 Qu,!K&
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
RE -ROOF/
BRER2020-0047
52425 AVENIDA DIAZ
773251019
LOAYZA / REROOF ENTIRE DWELLING WITH ASPHALT SHINGLES
$4,000.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/12/2020
Owner:
MARIO LOAYZA
52425 AVENIDA DIAZ
LA QUINTA, CA 92253
Contractor:
PD OWNER BUILDER - MARIO LOAYZA
52425 AVENIDA DIAZ
MAR 12 2020 LA QUINTA, CA 92253
D
CITY OF LA QUINTA 0
DESIGN&DEVELOPMENT DEPARTMENT LIc. No.::CONV:140528101254098628
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
{commencing with Section 7000) of Division 3 of the Business and Professions Code, and
my License is in full force and effect.
License Class: _ License No.::CONV:14DS28101254098628
Date
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
U.
applicant to a civil penalty of not more than five hundred dollars ($500).:
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 did not build or improve for the purpose of sale.).
( s owner of the property, am excluslvely 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
�7 �q
Date: 2 !/�'Zt� Owner:
CONSTRUCTION LE DING A NCY
I hereby affirm under penalty of perjury that t emLis a nstruct n 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'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work 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:
CarW,-te�lrp-loy
Policy Number:rtify that in the performance ofthe work for which this ermit is issued, I
shaany person in any manner so as to become subject the workers'
compensation laws of California, and agree that, if 1 shoal becam subject to the
workers' cam ensatio provisions of Sect or e, I shall.fprthwith
comply with t ase Pr visions. 1 _,
Date: a f ` ` Applicant: i�T1TT`""'rrr�
WARNING: F•AILU E TO SECURE WORKERS' CO PELON 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 buildi
construction, and hereby authorize representatives of this city to enter upo a ab e-
mentioned pr perty rr inspection purposes. -
Date: ]�re(Applicant orAgent):
s
Date: 3/,12/2020
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
MARIO LOAYZA
52425 AVENIDA DIAZ
LA QUINTA, CA 92253
BRER2020-0047
52425 AVENIDA DIAZ
773251019
LOAYZA / REROOF ENTIRE DWELLING WITH ASPHALT SHINGLES
$4,000.00
Owner:
MARIO LOAYZA
52425 AVENIDA DIAZ
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER - MARIO LOAYZA
52425 AVENIDA DIAZ
LA QUINTA, CA 92253
Llc. No.: :CON V: 140528101254098628
Detail: REROOF WITH ASPHALT SHINGLES TILE AT SLOPED AREAS OAKRIDGE 'AMBER' [CRRC: 0890-0009] WITH TYPE 'A' FIRE RATING 2019 CALIFORNIA
ENERGY CODE.
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
1
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
w
- GEnt nf,h, r)E.SEWr -
PERMIT # l✓���20 ��
PLAN LOCATION:
Project Address:
S 2 q Z5
- 142
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
.r— ; N- i i
Applicant Name:
G �'! 6�' f: t �2
? ,�:4
G d
Address: vZ
/�'
%�
2 550 S F
City, ST, Zip: L4
P v CA
zJ 3
Telephone
Email:
Valuation of Project $ 1 19
Contractor Name:
New SFD Construction:
Address: _
Conditioned Space SF
City, St, Zip
Garage SF
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: City Bus Lic:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms:
Stories:
# Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name:
New Commercial / Tenant Improvements:
Address: Z� /�1"7� &y
Total Building SF
City, ST, Zip zz r3
Construction Type: Occupancy:
hone:
EEma
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
t(lv Qa i4 ( r(V
CALIFORNIA
Disclosures & Forms for Owner -Builders Applying for Construction Permits
Dear Property Owner:
An application for a building.pe it as bee ubmittgd in y ur name listing you �lf as the builder of the property
improvements specified at
We are providing you with anOwner-Builder Acknowledgment and Information Verification Form to make you
aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each
provision, signed, and returned this form to us at our official address indicated. An agent of the owner
cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEDGMENT ANUF.R1FiCATION OF INF.Q RMAT10N
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
tl 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -
Builder" building permit that erroneously implies that the property owner is providing his or her own labor and
material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries
sustained by an unlicensed person and his or her employees while working on my property. My homeowner's
insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of
the limits of my insurance coverage for injuries to workers on my property.
2" 1 understand building permits are not required to be signed by property owners unless they are responsible
for the construction and are not hiring a licensed Contractor to assume this responsibility.
}111, 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I
may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or
her name instead of my own.
" 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contracts.
f + 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and
the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be
considered an "employer' under state and federal law.
. �'� = 5. 1 understand if I am considered an "employer" under state and federal law, I must register with the state and
federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to
unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject
me to serious financial risk.
i `I 7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family
residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by
licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the
work is performed under contract with a licensed general building Contractor.
-8 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for
any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction
defects in the workmanship or materials.
Page 3 of 4
I
. 1..9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal
Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments,
and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State
License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed
contractors.
10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand
that I am the party legally and financially responsible for proposed construction activity at the following address:
-1 1. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide by all applicable laws and requirements that govern Owner -Builders as well as employers.
12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the
information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public.
If you contract -with someone who does not have a license, the Contractors' State License Board may be unable to
assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed
Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or
employee of that individual or firm is injured while working on your property, you may be held liable for damages. If
you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or
not those Contractors are properly licensed and the status of their workers' compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and
returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's
license, form notarization, or other verification acceptable to the agency is required to be presented when
the permit is issued to verify the property owner's sign ture.
ff�I , I _
Signature of Property Owner: r` Date:
Note: The following Authorization Form is required to be completed by the property owner only when
designating an agent of the property owner to apply for a construction permit for the Owner -Builder.
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby
authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to
obtain an Owner -Builder Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
hone:
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled
out the above information and certify its accuracy. Note: A copy of the owners driver's license, form notarization, or
other verification acceptable to the agency is required to be presented when the permit is issued to verify the
property owners signature.
Signature of Property Owner:
Date:
Page 4 of 4
S i A i c� ;ALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CFIR-ALT-05-E(Rerised01120)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
ftlea Ndrrtl:
1 his compliance document is oMy applicable to simple alterations that do not require HERS
with a HERS Provider Data Registry.
3Y COMMISSION ,
CF111-ALT-05-E
Page 1 of 3
Z0
for compliance. When HERS verification is required, a CFIR-ALT- 01 shall first be registered
Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CFIR-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 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 responsibilityfor 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:
02
Date Prepared:
Z
!
03
Project Location.
5 `Z (r�� p p�� ._ /� ,�+�
—
04
Building Front Orientation (deg or cardinal):
JI
05
CA City:
UrI
�NI 'r
06
Number of Altered Dwelling Units:
07
Zip Code:
08
Fuel Type:
09
Climate Zone:
/ 1
10 Total Conditioned Floor Area
11
Building Type:
12 1 Slab Area (ft)
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 2020
STATE OF CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CFIR-ALT-05-E Revised 0 1 M)
CERTIFICATE OF COMPLIANCE
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
F114j"t Ni me:
w
COMMISSION
CF111-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
Proposed
Minimum Required
i
Method of
CRRC Product
ID Number
Product
Type
R-value
Deck
Insulation
Initial Solar Aged Solar
Reflectance Reflectance
Thermal
Emittance
SRI
(Optional)
Aged Solar
Reflectance
Thermal SRI
Emittance (Optional)
Compliance
Roof Pitch
Exception
f-
S
Go CIO -C-'Co
Add Row
Delete Row
� `�� ,f-�� � '-�� ; y'
- �0-0�% �' 7
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 Bui(Wzng Energy Efficiency Standards - 2019 Residential Compliance January 2020
Stir CALIFORNIA
Prescriptive Residential Alterations That Do Not Require HERS Field Verification
CEC-CFIR-ALT-05-E (Revised 01/20)
CERTIFICATE OF COMPLIANCE
Prescriptive Residentia
s That Do Not Require HERS Field Verification
ENERGY COMMISSION .
CF 1 R-ALT-05-E
Page 3 of 3
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Doenmentatie uthor nta e'
Documentation Author Signature:
Company:
Signature Date: 1 �,
Addr CW HERS CertMcati n IdentiFicatiaa (iFapplirahle):
CitylStatelLi J �] Phon
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. 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 documentati n the builder provides to the building
owner at occupancy.
Responsible Designer Name: Responsible Designer Signature:
company: Date Signed:
-3 rz
Address License:
JkL
/�
[7state ip4 Phone:
d k/*7*
7
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
1:•1 111•
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A CRRC product rating describes the radiative performance of a roofing material; it does not indicate a ranking or approval. A product's placement on the Rated
Products Directory (Directory) does not mean that the product is "cool" as defined by any particular code or program. Only products with active ratings can be
found on the Directory.
An asterisk (*) next to a product rating indicates a CRRC Rapid Rating.
Read More
CRRC PROD. ID MANUFACTURER BRAND AND MODEL
o89o-0009 Owens Corning TruDefinition® Duration® Cool
Roofing and Amber I Oakridge® Amber
Asphalt, LLC TruDefinition® Duration® Amber
PRINT EXPORT ALL PRODUCTS
Showing t-t of t result
PRODUCTTYPE COLOR SOLAR REFLECTANCE THERMAL EMITTANCE SRI MORE INFO
INITIAL 3 YEAR INITIAL 3 YEAR INITIAL 3 YEAR
Asphalt Shin Orange 0.22 0.23 0.92 0.92 22 24
gle
COOL ROOF RATING COUNCIL 2435 N. Lombard St. TEL (866) 465-2523 EMAIL: Info@coolro6h.olg
Portland, OR 97217
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Certificate 3146.oi