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08-1558 (RR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T-iht 4 XP Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 08--0_6001558 I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Owner: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.- Property Address: 518.8'4 AVENIDA OBREGON STEVE SAFT issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor APN: 773-164-025-8 -000000- 51884 AVENIDA OBREGON I hereby affirm under penalty of perjury that 1" am.exempt from the Contractor's State License Law for the Application description: RE -ROOF _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any - LA QUINTA, CA 92253 person in any manner so as to become subject to the workers' compensation laws of California, Property Zoning: COVE RESIDENTIAL (213) 448-3825 3700 of the Labor Code, I shall forthwith comply with.those provisions. Application valuation: 8550 (_) 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 Applicant: Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Architect or Engineer: Contractor: DESERT ROOFING SERVICES INC DOLLARS ($100,000).. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. " 41910 BOARDWALK, STE B-3 PALM DESERT, CA 92211 (760)568-1751 Lic. No.: 903296 VOICE (760) 777-7012 FAX (760) 777-7011 TSS (760) 777-7153 X11 m �v �V 6011_64�44�- 0 ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION " I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with 1 hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.- I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided license ss: C39 License No.: 903296 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is h (� ate: 1� 'l ntracto,: `0 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 " OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that 1" am.exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 7130023049 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any - construct,alter; improve, demolish, or repair any structure, prior, to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section" License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with.those provisions. 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).: �� f� �d at scant: (_) 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL . Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND • - and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000).. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. " 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 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.). 1 1 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: LQPERMIT APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety 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 rmation is correct. I �ree,4complyh all city and county ordinances and state laws relating to building ns ction, and hereb Koes oft ' countty to enter upon the ove-mentioned prop y r in action purpo Date: J�� S ature (Applicant or Agent): Application Number . . Permit . . . RE -ROOF Additional desc . . Permit Fee . . . . 30.00 Issue Date . . . . Expiration Date . . 3/11/09 08-00001558 Plan Check Fee . . .00 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and Comments RE -ROOF / 2008 CODES Fee summary Charged. Paid Credited Due --------------------------------------------------------- Permit,Fee Total 30.00 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 .00 .00 30.00 LQPERMIT Licensed Bonded Insured 40 Years Experience ON V,pOFING S IN_ C '/C Voted # 1 Urethane Foam Applicator in the Coachella Valley! Simply the BEST Boardwalk, Suite B-3 -Palm Desert, .CA 92211 (7601568-175 1 - Fax (760) 779-5881 California Contractors License #903296 Cu Job Site �oss � Name %g 51-41r 77 11Address 201a Address `/ U n �4majphone H CityAA d% State IPA 1.47 Zip? Fax Roof type: Capsheet ❑ T&G ❑ Tile Shingle ❑ foam ❑ New ❑ Sno-Coat ❑ Garage included: 0 Yes ❑ Carport included: Slide foamed board under A/C unit: —� 0 Install metal: size: -� /v Vii; © Cut back edges 6 inches: Q Sweep and blow.clean roof surface: --jol. ® Prime roof with urethane primer: —► (As Needed) Yes 0 Yes ❑ Metal ❑ 1t Grind perimeter edges to 450 angle: -♦ Yes ❑ NOX 12 Apply white acrylic elastomeric at a rate of 2 gallons per No square (100 sq. ft.) alt color Yes ❑ N6.k� NoN t3 Embed Granules in Coating: —► Yes❑ NoX 'No C to Install Ib. felt and year) Yes ❑ No ❑ 'Composition shingle (customer choice of color) Yes ❑ No is e+, Damaged plywood replaced at $ 65 per sheet Yes No ❑ is Final roof surface may be affected by texture of existing roof. Yes ❑ No �� Desert Roofing will attempt but cannot guarantee removal of all water standirig on flat roof. 0 Shoot one inch urethane foam: —0 Yes❑ • Noo Other: plus or minus 118 inch tolerance t8 All coatings.to contain 70%(+/- 5%) solids. f9 Foam ICBG # ER5513. to Foam ducting on roof: 10 Yes ❑ NOX .(20 Urethane foam shot over an existing built up roof is a class A Special Instructions: T114 11V4 elle-?41) 'Ak/ AG017- Oz:i.4__ilJC.L0Z) M Should it become. necessaryfor the roofing contractor to remove.and/or reinstall antennas, cooling or heating applianceK-or oth6r equipment, the contractor does not assume any responsibility for the performance of.said equipment. The contract does not cover any damage to the interior or exterior of the premises on which the roof is applied. Contractor does not assume any responsibility for correction of existing code violations or for the repair of any existing defects unless specified in the proposal contract: Any work done by'other contractors voids warranty. Any alteration or deviation from the above specifications involving extra cost of material or labor will only be executed upon written orders from same and will become an extra charge over sum mentioned in this contract. All agreements made must be in writing. Contractor does not assume any responsibil' .for damage from water, leaks.or damage to the interior or contents thereof caused by inclement weather during the installation or before completion% f said roof, nor after• completion of roof under terms of the guarantee. Mutually agreed upon price of.project Deposit upon signing Balance due upon completion This proposal valid only 30 days after date shown. Subm Bin # City of La Quinta Building:& Safety Division Permit # � P.O. Box 1504; 78-495 Calle Tampico La Quinta,. CA 92253 - (760) 777-7012 V -Bulldmg..Permit Application- and.Tracking Sheet --Projeci dress: V L jl Owner's Name: S A. P. Number: Address: ✓ v 5 fl 0 vh Legal Description: City, ST, Zip: LP's f �i. Contractor: e,SQ, 'Telephone: Address: (� t fa Iptl .. 7FPLject Description: �J amityi p:alr� S .�Telephon� � •�� ,. �� S� City Lic. #: *A'l -State Lic: #': Arch., Engr., Designer: . Address: City, ST, Zip: -s Telephone: Construction Type: Occupancy: P Y= State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: CEstima ed„Value.of.Project: S v APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING. PERMIT FEES Plan SetsPlan Check.submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3” Review, ready for correctionsrssue. Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees