09-0071 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
e0'9 -. 0 0�0 0`0'0�T1
5-3'S3'5'AVENIDA OBREGON
774-114-017-7' -000000-
RE-ROOF.
COVE RESIDENTIAL
9900'
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm undecpenalty of perjury that I•am licensed under provisions of Chapter 9 (commencing with
Section 70001 of 61Viiion 3 of the Business s and Professionals Code, and my License is in full force and effect.
License Class: ,C39 ense No.: 409619
Date /-: � 0-'9�� Com- o� tor. -
OWNER -BUILDER DECLARATION
hereby affirm under penalty of,perjurythat l am exempt from the Contractor's State License Law for the,
following reason ISec. 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 to7file a signed statement that he or sheds licensed pursuant to the provisions of thdContractor'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 civilpenalty of not more than five hundred dollars ($
500).:
(_ 1 I, as owner of the property, or my employeeswith 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 amowner: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 _ 1 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.).
(_ 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
Owner:
RILEY, DAWN
53635 AVENIDA OBREGON
LA QUINTA, CA 92253
Contractor:
DEW ROOFING, INC.
P.,.O. BOX 914
PALM SPRINGS,,CA 92263
(760)327-3393
Lic. No.: 409619
VOICE (760) 777-7012
FAX (760) 7.77-7011
INSPECTIONS (760) 777-7153
Date: 1/29/09
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.
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 STATE FUND Policy Number 0003766-2008
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 1 should become subject to the workers' compensation provisions of.Sectiori
3700 of -the Labor Code, I -shall forthwithtbtn
. _ A— i / ' . ff �� �� 11ply with those provisions.
"
WARNING:FAILURE TO SECURE WORKERS' COMPENSATION. COVERAGE IS UNLAWFUL, AND SHALL .
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES "AND '61VIL' FINESIUP 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 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 information is correct. 1. agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of thi�tynto enter upon the above-mentioned property for '✓ns/pecti(onn purr
Date:" � �T '� Signature a-IApp i antY o��t�; [�% �G�
Application Number . . .
Permit . . . . . RE -ROOF
Additional desc . .
Permit Fee . . . . 30.00
Issue Date . . . .
Expiration Date . . 7/28/09
09-00000071
Plan Check Fee . . .00
Valuation . . . . 0
Qty Unit Charge Per
Extension
BASE
FEE
30.00
----------------------------------------------------------------------------
Special Notes and Comments
RE -ROOF WITH CLASS "A" MATERIALS
2008
CODES" 30 YEAR SHINGLES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS
ADMIN (SB1473)
1.00
Fee summary Charged
-------------------------------------
Paid.
Credited
--------------------
Due
Permit Fee Total 30.00
.00
.00
30.00
Plan Check Total .00
.00
.00
.00
Other Fee Total 1.00
.00
.00
1.00.
Grand Total 31.00
.00
.00
31.00
LQPERI%IIT
License No. 409619 CONTRACT PROPOSAL
DEW ROOFING, INC.
640 Williams Road - P. O. Box 914
PALM SPRINGS, CALIFORNIA 92263
Phone (769) 327-3393
Contractors are required by law to be'
licensed and regulated by the Contractors'
State License Board. Any questions con-
cerning a contractor may be referred to the
registrar of the board whose address Is:
Contractors' State License Board
1020 "N" Street
Sacramento, California 05814
Contractor: D & R Select Construction Address: 741 Eugene Rd., Palm Springs, CA.92264
Owner: Job Site: 53635 Ave Obregon, La Quint a, CA.
WE PROPOSE AND AGREE to furnish ..required labor and material for
SEE BELOW NEEDS A NEW ROOF
for the above named building using
n accordance with submitted plans and specifications, for the sum of
SEE BELOW
($ ) Dollars
Bid #1 - Remove old roof & re -roof using'l layer 30# felt & 30•.year fiberglass
_shingles.. 3 Year Guarantee $ 91900.000
Bid #2 - Repair wind damage to garage. Roof area approx. 250 sq. ft. $ 850.00
Replace 2 sheets plywood
X00
ALL PAYMENTS TO BE 100% ON COMPLETION UNLESS OTHERWISE SPECIFIED ABOVE.
NOTICE
"Under the Mechanics' Lien Law (California Code of Civil Procedure, Section 1181 et seq.),
any contractor, subcontractor, laborer, supplier or other person who helps to improve your
property but is not paid for his work or supplies, has a right to enforce a claim against your
property. This means that, after a court hearing, your property could be sold by a court officer
and the proceeds of the sale used to satisfy the indebtedness. This can happen even if you have
paid your own contractor in full, if the subcontractor, laborer, or supplier remains unpaid."
$ 80.00
This agreement shall become binding only upon. the Contractor's written acceptance hereof or upon the Contractor's commencing
performance and upon such acceptance or commencement of performance this shall constitute the entire contract and be binding upon the
parties hereto, there being no covenants, promises or agreements, written or oral, except as herein set forth.
It if further understood that:
(A) The Contractor shall not be responsible for damage or delay due to strikes, fires, accidents or other causes beyond his reasonable control.
m
(B) The proposal is limited to days acceptance frnm nava hornnf
(C) The Purchaser is dealing with the Contractor as principal and that the Contractor is not acting hereunder as the agent or representative
of any person, firm, or corporation.
PRICE SUBJECT TO CHANGE AT ANY TIME TO REFLECT INCREASED MATERIAL PRICES.
Date_ 1/21/09.
accept the above proposal.
DEW ROOFING, INC.
By: Salesman
��.o . ASM
Bin #
City. of La Quinta;
Building eI Safety Division.
P.O. Box 1504; 78-4.95 Calle Tampico
La Quinta,- CA 92253 - (760) 777-7012
Building Permit.Applicatic4 and Tracking Sheet
Permit #
Project Address: • 6
o
O'wrier's Name: '
e')e
A. P. Number:
Address: —
Legal Description:
f City, ST, Zip
ontractor:&
J` .
Telephone: 0, o?
Address:
Project'Description:
dd
City, ST, Zip: I•
.+
Telephone: T 3 L�'3`
:. .
'S 0
State Lic. # : l
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip: "
Telephone: : ;
State Lic.
Name of Contact Person:
Construction Type: Occupancy:
;
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:
P
Estimated Value of Project:•
APPLICANT: DO',NOT`WRITEtBELOW THIS INE. .
#
Submittal
Req'd
RecdKI
TRACNG..:•
PERMIT FEES
Plan Sets
Plan Check submitted
Item.;
Amount
Structural Calcs.
Reviewed, ready'foe corrections
Plan Check Deposit
Truss Calcs.
Called Contact Pers"on
Plan Check Balance
Energy Calcs.
Plans picked up
CConstruction
Flood plain plan
Plans resubmitted
Mecfianical
Grading plan
2nd Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
i..Plans.resubinitted,Grading
IN HOUSE:-
''d Review, ready for corrections issue
Developer Impact Fee
Planning Approval
Called Contact Person.
A.LP.P..
Pub. Wks. Appr
Date of permit issue
School Fees
.Total Permit Fees