BRER2024-0124BUILDING PERMIT
DESIGN & DEVELOPMENT
DEPARTMENT
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type:
Re -Roof
Permit Number:
BRER2024-0124
Property Address:
78680 HIGHWAY 111
APN:
643220017
Legal Description
Parcel 1 PM 202/98 PM 30147
PHONE (760) 777-7125
WWW.LAQUINTACA.GOV
APPLIED DATE: 05/10/2024
ISSUED DATE: 05/17/2024
CALIFORNIA
Owner: Matt Ortiz
570 Central Ave. Suite E Suite E, Lake Elsinore, CA
92530
Applicant: Matt Ortiz
570 Central Ave. Suite E Suite E, Lake Elsinore, CA
92530
Property Zoning: CR, 1 Contractor: Matt Ortiz / 936177
Valuation: $90,000.00 570 Central Ave. Suite E Suite E, Lake Elsinore, CA
92530
PRIOR TO THE ISSUANCE OF THIS PERMIT FOR CONSTRUCTION, ALTERATION, IMPROVEMENT, DEMOLITION, OR REPAIR THE OWNER, APPLICANT AND/OR
CONTRACTOR UNDER PENALTY OF PERJURY HAVE AFFIRMED WHEN APPLICABLE, THROUGH THE SUBMITTAL OF FORMS OR BY OTHER ELECTRONIC MEANS, THE
FOLLOWING:
LICENSED CONTRACTOR OR OWNER -BUILDER DECLARATION (1 or 2)
1) They are licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professions Code, and the
referenced
License is in full force and effect, or;
2) That they are exempt from the Contractors' State License Law for the
reason(s) indicated by either (2)(a) and/or (2)(b), or (2)(c) where he or
she is exempt from licensure by a valid exemption. [Section 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
Contractors' State License Law (Chapter (commencing with Section 7000)
of Division 3 of the Business and Professions
Code] 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).)
a) As owner of the property, or my employees with wages as their sole
compensation, will do all of or portions of the work, and the structure is
not intended or offered for sale (Section 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an owner of
property who, through employees' or personal effort, builds or improves
the property, 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 it was
not built or improved for the purpose of sale.).
b) As owner of the property, will be exclusively contracting with licensed
c) Are exempt from licensure under the Contractors' State License Law.
As an Owner -Builder, they acknowledge that, except for their personal
residence in which they must have resided in for at least one year prior to
completion of the improvements covered by this permit, they cannot legally
sell a structure built as an owner -builder if it has not been constructed in
its entirety by licensed contractors. It is understood that a copy of the
applicable law, Section 7044 of the Business and Professions Code, is
available upon request when this application was submitted at the
following Web site:
http://www.Ieginfo.ca.gov/calaw.htm1.
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY (If
applicable)
A construction lender will be used for completion of the improvements
covered by this permit and the name and information of which is on file for
public inspection during the regular business hours of the public entity.
WORKERS' COMPENSATION DECLARATION (1, 2 or 3)
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.
1) Has and will maintain a certificate of consent to self -insure for workers'
compensation, issued by the Director of Industrial Relations as provided for
by Section 3700 of the Labor Code, for the performance of the work for
which this permit is issued.
2) Has 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.
3) Certifies that, in the performance of the work for which this permit is
issued, shall not employ any person in any manner so as to become subject
to the workers' compensation laws of California, and agree that, if should
become subject to the workers' compensation provisions of Section 3700 of
the Labor Code, shall forthwith comply with those provisions.
NOTICE TO APPLICANT (1, 2 and 3)
1) Each person upon whose behalf this application was made, each person
at whose request and for whose benefit work is being 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 360 days from date of issuance of such
permit, or if cessation of work for 180 days will subject permit to
cancellation. On or after January 1, 2019, every permit issued shall become
invalid unless the work on the site authorized by such permit is commenced
within 12 months after its issuance, or if the work authorized on the site by
such permit is suspended or abandoned for a period of 12 months after the
time the work is commenced.
3) Certified that they read the application and state that the information
provided is correct. 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.
IMPORTANT: An Application for Permit was made to the Building Official,
subject to the conditions and restrictions set forth at the time of application,
which is now hereby an Issued Permit. If any part of the information being
supplied on this permit is inaccurate or untrue, please contact the City of La
Printed: 5/16/25 9:07 am Page 1 of 4
BUILDING PERMIT
Permit Type: Re -Roof
Permit Number: BRER2024-0124
Property Address: 78680 HIGHWAY 111
Failure of the applicant to indicate the construction lender on the
application does not relieve that person of the requirement to give the
construction lender preliminary notice from that duty.
co
Printed: 5/16/25 9:07 am Page 2 of 4
BUILDING PERMIT
Permit Type:
Permit Number:
Property Address
Re -Roof
BRER2024-0124
78680 HIGHWAY 111
. mgm
REROOF WITH SINGLE -PLY ON LOW SLOPED AREAS [CRRC: 0628-0002] ROOF ASSEMBLY SHALL HAVE A CLASS "A" FIRE RATING
PER LQMC §8.02.040. 2022 CALIFORNIA BUILDING CODES.
7)nstruction Dot;
Re -Roof Area Square 26100 Zoning CR General Plan CG
Footage
City Limits Within La Quinta Limits Subdivision Name PM 30147 Lot Number 1
Lot Size 7322.6 Legal Description Parcel 1 PM 202/98 PM
30147
Type Group Sq Ft Value
Invoice No. Fee
Fee Amount
Amount Paid
INV-00006577 Technology Enhancement Fee
$8.00
$8.00
Digital Archiving and Records Management Fee - OTC
$12.00
$12.00
Building Standards Administration
$3.60
$3.60
Re -Roof
$428.49
$428.49
Credit Card Convenience Fee
$14.41
$14.41
Re -Roof PC
$124.49
$124.49
Total for Invoice INV-00006577
$590.99
$590.99
Grand Total for Permit
$590.99
$590.99
Workflow Step / Action Name Action Type Start Date End Date
Application Completeness Check v.1 05/10/2024 11:58 05/13/2024 15:48
----------------------------------------------------------------------------------------------------------------------------------------
Submittal Document Verification v.1 Generic Action 05/10/2024 11:58
Plan Check v.1 05/13/2024 0:00 05/13/2024 15:48
----------------------------------------------------------------------------------------------------------------------------------------
Permit Tech Review v.1 Receive Submittal 05/13/2024 0:00 05/13/2024 15:48
Permit Issuance v.1
05/13/2024 15:48
05/17/2024 11:17
----------------------------------------------------------------------------------------------------------------------------------------
Contractor / Owner -Builder Information v.1
Generic Action
05/13/2024 15:48
-------------------------------------------------
Verify & Invoice Fees v.1
Generic Action
05/13/2024 15:48
---------------------------------------------
Ready to Issue v.1
Generic Action
05/13/2024 15:48
........................................................................................................................................
Verify Fee Payment & Issue Permit v.1
Generic Action
05/17/2024 11:17
-----------------------------------------
Print, Attach, and Email Building Permit v.1
...................
Create Report
05/17/2024
.......................
11:17
05/17/2024 11:17
Re -Roof Inspections v.1
05/17/2024
0:00
05/20/2024 13:14
----------------------------------------------------------------------------------------------------------------------------------------
Pre-Roof v.1
Inspection
05/17/2024
0:00
05/20/2024 13:14
Final Inspections v.1
07/08/2024
0:00
07/10/2024 9:58
----------------------------------------------------------------------------------------------------------------------------------------
Final Re -Roof v.1
Inspection
07/08/2024
0:00
07/10/2024 9:58
Printed: 5/16/25 9:07 am Page 3 of 4
BUILDING PERMIT
Permit Type: Re -Roof
Permit Number: BRER2024-0124
Property Address: 78680 HIGHWAY 111
Construction or work for which a permit is required shall be subject to inspection by the building official and such construction or work
shall remain visible and able to be accessed for inspection purposes until approved. Approval as a result of an inspection shall not be
construed to be an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Inspections
presuming to give authority to violate or cancel the provisions of the applicable code and other ordinances of the jurisdiction shall not be
valid. It shall be the duty of the owner or the owner's authorized agent to cause the work to remain visible and able to be accessed for
inspection purposes. Neither the building official nor the jurisdiction shall be liable for expense entailed in the removal or replacement of
any material required to allow inspection.
It shall be the duty of the holder of the building permit or their duly authorized agent to notify the building official when work is ready for
inspection. It shall be the duty of the permit holder to provide access to and means for inspections of such work that are required by this
code.
A building or structure shall not be used or occupied in whole or in part, and a change of occupancy of a building or structure or portion
thereof shall not be made, until the building official has issued a certificate of occupancy therefor as provided herein. Issuance of a
certificate of occupancy shall not be construed as an approval of a violation of the provisions of the applicable code and other ordinances
of the jurisdiction. Certificates presuming to give authority to violate or cancel the provisions of this code or other ordinances of the
jurisdiction shall not be valid.
A person shall not make connections from a utility, a source of energy, fuel, or power, or a water system or sewer system to any building
or system that is regulated by the applicable code and other ordinances of the jurisdiction for which a permit is required, until approved by
the buildinq official.
Printed: 5/16/25 9:07 am Page 4 of 4
STATE OF CALIFORNIA
Envelope Component Approach
CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-ENV-E
This document is used to demonstrate compliance with mandatory requirements in 110.8(g) and 120.7(b)/160.1 for newly constructed nonresidential, hotel/motel, multifamily and
mixed -use buildings, and 141.0(b)1/ 180.2 for alterations, related to roof, wall and floor assemblies. It is also used to demonstrate compliance with prescriptive requirements in 140.31
170.2 for newly constructed buildings, and 141.0/ 180.1/ 180.2 for additions and alterations, related to roof, wall, floor, door, fenestration and daylighting requirements.
Project Name: La Quinta Staples
Report Page: (Page 1 of 5)
Project Address:
Date Prepared: 2024-05-13T11:54:04-04:00
A. GENERAL INFORMATION
01
Project Location (city)
La Quinta
05
# of Stories (Habitable Above Grade)
1
02
Zipcode
92253
06
Total Conditioned Floor Area (ft2)
26100
03
Climate Zone
15
07
Total Unconditioned Floor Area (ft2)
0
Occupancy Types Within Project: (select all that apply): If one occupancy
04
constitutes >= 80% of the conditioned floor area, the entire building
08
❑
Project includes unconditioned enclosed space(s) > 5,000 ft2 under a roof with a ceiling
envelope may be designed to comply with the provisions of that occupancy
height of at least 15 ft.'
per 100.0(f).
• Retail
' FOOTNOTE: Enclosed spaces > 5,000ft' directly under roof with ceiling height > 15ft in climate zones 2 through 15 are required to meet the minimum daylighting requirements
defined in 140.3(c)/170.2(b). Compliance with 140.3(c)/170.2(b) is documented in Table L. This is the only prescriptive requirement which applies to unconditioned spaces.
B. PROJECT SCOPE
This table specifies project envelope components within the permit application demonstrating compliance using the prescriptive paths outlined in 140.31170.2 and 141.0(a)1/180.1
and 141.0(b)1 and 21180.2 for additions and alterations.
My project consists of (check all that apply)
Component Types
01
02
❑
New Construction or Newly Conditioned Space
❑
Roof
El
El
Exterior Opaque Doors
❑
One or more enclosed spaces > 5,000 ft' directly under roof with ceiling height > 15ft
❑
Floors
❑
Fenestration/ Glazed Doors'
❑
Addition of conditioned space
El
Roof
❑
Walls
❑
Exterior Opaque Doors
❑
One or more enclosed spaces > 5,000 ft2 directly under roof with ceiling height > 15ft
El
Addition is <=700 ft2
❑
Floors
❑
Fenestration/ Glazed Doors'
❑
Addition is >700 ft2
®
Alteration of conditioned space
❑
Roof Assembly
❑
Walls
❑
One or more enclosed spaces > 5,000 ft2 directly under roof with ceiling height > 15ft
and lighting system installed for the first time
®
Roofing
Materia12
❑
Floors
❑
Fenestration
Generated Date/Time:
Documentation Software: Energy Code Ace
CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 198422-0524-0002
Schema Version: rev 20220101 Report Generated: 2024-05-13 08:54:05
STATE OF CALIFORNIA
Envelope Component Approach CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-ENV-E
Project Name: La Quinta Staples
Report Page: (Page 2 of 5)
Date Prepared: 2024-05-13T11:54:04-04:00
B. PROJECT SCOPE
'FOOTNOTE: Doors that are more than 25% glass in area are considered Glazed Doors and should be documented on table K with fenestration.
2Roof recovers and replacements must also check "Roof Assembly" box and document compliance with insulation requirements in Table F. Roof recoats may document compliance with
roof material only in Table G.
C. COMPLIANCE RESULTS
Results in this table are automatically calculated from data input and calculations in Tables F through L. Note: If any cell on this table says "COMPLIES with Exceptional Conditions" refer
to Table D. Exceptional Conditions for guidance or see the applicable table referenced below.
Opaque Envelope Components
Fenestration
Daylighting Spaces >
5,000ftz
Compliance Results
Roof Assembly
Roofing Materials
Walls
Floors
Doors
01
02
03
04
05
06
07
08
(See Table F)
(See Table G)
(See Table H)
(See Table 1)
(See Table J)
(See Table K)
(See Table L)
COMPLIES
Yes
D. EXCEPTIONAL CONDITIONS
This table is auto filled with uneditable comments because of selections made or data entered in tables throughout the form.
E. ADDITIONAL REMARKS
This table includes remarks made by the permit applicant to the Authority Having Jurisdiction.
F. ROOF ASSEMBLY SCHEDULE
This section does not apply to this project.
Generated Date/Time:
Documentation Software: Energy Code Ace
CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 198422-0524-0002
Schema Version: rev 20220101 Report Generated: 2024-05-13 08:54:05
STATE OF CALIFORNIA
Envelope Component Approach CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-ENV-E
Project Name: La Quinta Staples
Report Page: (Page 3 of 5)
Date Prepared: 2024-05-13T11:54:04-04:00
G. RATED ROOFING MATERIAL (COOL ROOF)
This table demonstrates compliance with prescriptive roof material requirements in 140.3(a)1A/ 170.2(a)1A for new construction, 141.0(a)/ 180.1 for additions, and 141.0(b)28/ 180.2
or alterations. Roof recovers and replacements must also document compliance with insulation requirements in Table F. Roof recoats may document compliance with roof material only
in Table G.
01
02
03
04
05
06
07
08
09
10
Name/
LI-factor /
Tag/Plan
Roof
Required Minimum
Designed Material
Description/
Status
Occupancy Type
Roof Material
Compliance Method
R-value of
Detail ID
Slope
Material Performance
Performance
Location
Assembly
Relocable Public
Reflectance
0.63
Reflectancel
69.36
Initial solar
0628-
Carlisle 60 mil TPO
Altered
School Building for
Low
Single ply
reflectance and
Emittance
0.75
Emittance
0.9
0002
use in all climate
slope
thermoplastic
SRI
SRI
zones Occupancy: E
thermal emittance
H. WALL ASSEMBLY SCHEDULE
This section does not apply to this project.
I. FLOOR ASSEMBLY SCHEDULE
This section does not apply to this project.
J. EXTERIOR DOOR SCHEDULE
This section does not apply to this project.
K. FENESTRATION AND GLAZED DOOR SCHEDULE
This section does not apply to this project.
L. DAYLIGHT IN LARGE ENCLOSED SPACES
This section does not apply to this project.
Generated Date/Time: Documentation Software: Energy Code Ace
CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 198422-0524-0002
Schema Version: rev 20220101 Report Generated: 2024-05-13 08:54:05
STATE OF CALIFORNIA
Envelope Component Approach
CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-ENV-E
Project Name: La Quinta Staples
Report Page: (Page 4 of 5)
Date Prepared: 2024-05-13T11:54:04-04:00
M. DECLARATION OF REQUIRED CERTIFICATES OF INSTALLATION
Selections have been made based on information provided in this document. If any selection have been changed by the permit applicant, an explanation should be included in Table E
Additional Remarks. These documents must be provided to the building inspector during construction and can be found online
Form/Title
NRCI-ENV-01-E - Must be submitted for all buildings
N. DECLARATION OF REQUIRED CERTIFICATES OF ACCEPTANCE
There are no NRCA forms required for this project.
O. DECLARATION OF REQUIRED CERTIFICATES OF VERIFICATION
There are no forms required for this project.
Generated Date/Time:
Documentation Software: Energy Code Ace
CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 198422-0524-0002
Schema Version: rev 20220101 Report Generated: 2024-05-13 08:54:05
STATE OF CALIFORNIA
Envelope Component Approach
CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-ENV-E
Project Name: La Quinta Staples
Report Page: (Page 5 of 5)
Project Address:
Date Prepared: 2024-05-13T11:54:04-04:00
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Francene Jensen
Company:
Signature Date:
Commercial Roofing Concepts, Inc,
Address:
CEA/ HERS Certification Identification (if applicable):
City/State/Zip:
Phone:
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, a 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 ovide to the building owner at occupancy.
Responsible Designer Name: Francene JensneResponsible
Designer Signature:
Company: Commercial Roofing Concepts, Inc.
Date signed: 05/13/2024
Address:
License:
city/state/zip: Lake Elsinore CA 92530
Phone:
Generated Date/Time:
Documentation Software: Energy Code Ace
CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 198422-0524-0002
Schema Version: rev 20220101 Report Generated: 2024-05-13 08:54:05