0107-0156 (ROOF)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
ChaF"If� 9 .(cC.-tmencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force -and effect.
License # t\ Lic. Class Exp. Date
Date t t j• Signature of Contr ctor "
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section B&P.C. for this reason
Date Signature of Owner
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 & policy no. are:
Carrier Policy No.
. IAMAOIN 1101SSJRANCR Wtl'Sia21171q
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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�agreejthat if Lshould become•-•
subject to, the workers' compensation provisions of Section -3700 of the Labor
Code"hsh lI forthwith comply with those provisions.
Date' e.4 Applicant )
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 withlall City, and State laws relating to the building
construction, and hereby authorize, representatives of this City to ginter upon
the"above-mentioned property for inspection purposes.
Signature (Owner/Agent) Dae
BUILDING PERMIT PERMIT#
DATE VALUATION LOT {� j `( TRACT
JOB SITE
APN
ADDRESS
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OWNER
CONTRACTOR / DESIGNER / ENGINEER
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u, QUINTIk CA 922S3
REMUDADIMES CA 92211
(7f,q)200-0811 CMA, 1420
USE OF PERMIT
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MAY LICHT ROOF TILS
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Me MANIARY
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$30.00
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IIIIIIIIIIIIIIIIVIIIIIII 63
IE
RECEIPT
DATE >7
V,�
BY A
I
DATE FINALED
INSPECTOR
a
_
-i-
INSPECTION RECORD
am
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
V„
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
t rms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Ai!pliances
Final ...
COMMENTS:
f
+
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
__I
CONTRACTORS STATE LICENSE # 636394 P.O. BOX 11257
Palm Desert CA 92255
760-200-0811
A proposal submitted to: JOE DOLAN CONSTRUCTION
Mailing Address: 74315 BUTTONWOOD PALM DESERT, CA 92260
Job Address: 49811 ADELITO LA QUINTA, CA 92253
Phone:
Description of Work to Be Performed:
REMOVE EXISTING ROOF TILE AND DISPOSE.
INSTALL NEW 40# TILE LINER.
INSTALL NEW SHEET METAL AT ROOF TO WALL TRANSITIONS.
INSTALL NEW ROOF FLASHING AT ALL H.V.A.C. AND PLUMBING
PENETRATIONS.
INSTALL CLAY LIGHT ROOF TILE TO MANUFACTURES SPECIFICATIONS.
IF NOT ACCEPTED IN 30 DAYS THIS PROPOSAL IS NULL AND VOID
Notes: In Keeping with Industry standards: 1. This guarantee does not cover any damage to the interior or exte-
rior on which the roof is applied or damage to any contents therein. This guarantee does not cover damage to
roof due to any cause beyond our control, including, but not limited to: fire, lightning, windstorm, hailstorm, an-
tennas or other equipment, foot traffic on roof, structural fault or settlement, cracking or other failure of the roof
deck, walls or foundation of the building on which the roof is applied. 2. Should it become necessary for the roof-
ing contractor to remove and/or reinstall any antennas, cooling or heating appliances or other equipment, whether
or not an additional charge is made for such work, the customer understands that neither Roof Tile Specialty nor
the installer assumes any responsibility for the performance of said equipment. 3. Roof Tile Specialty does not
assume any responsibility for corrections of existing code violations or for the repair of any existing defects un-
less specified in estimate and proposal.
Total Cost: $ 13,250.00 Terms paid on completion unless otherwise specified in the contract. If not acceptance in
thirty days this proposal is invalid. Extra $35.00 per sheet of plywood if needed.
Acceptance: You are hereby authorized to furnish all contents written in the contract to complete work mentioned
in the proposal contract for which I/we agree to pay the amount mentioned, in said proposal, and according to
terms thereof, . (Initial). If a leakage, caused by defects in workmanship, occurs within TEN years
from date of application, we will repair it free of charge.
Installation: it is understood that by the acceptance of this proposal you authorize Roof Tile Specialty to make the
installation; to issue work order with specifications shown herein and to pay our charge for such installation.
You agree to pay the amount the specified herein, which will cover the price of said materials and labor charge.
This estimate is based on a complete job and any surplus material remains property of Roof Tile Specialty. Verbal
understanding and agreements with representatives shall not be binding unless set forth herein. There shall be no
liabilities for delays in, or failure to complete, deliver or installation of all or any of the herein mentioned mer-
chandise, if due to fire, strikes, war, government regulations, or any cause beyond our contract. Any changes
made by you in specifications herein, necessitating additional materials or labor shall not be included or covered
by this proposal, but shall be provided for under separate and additional order from you. ( Initial).
Arbitration of disputes: Any controversy or claim arising out of or relating to this contract, or the breach thereof,
shall be settled by arbitrator in accordance with the applicable Construction Industry Arbitrator Rules of the
American Arbitration Association which are in effect at the time the demand for arbitration is filed. A judgement
upon the award rendered by the arbitrator(s) maybe entered in court having jurisdiction thereof. Any arbitration
award shall be subject to correction and/or vacation for the reasons stated in the code of civil Procedure. The ar-
bitration shall award reasonable attorneys fees and expenses to the prevailing party. After being given due notice,
should any party fail to appear at or participate in the arbitrator proceedings, the arbitrator shall make an award
based upon the evidence presented by the party(ies) who do (does) appear and. participate. Notwithstanding Con-
tractor's right to arbitrate, contractor does not waive any of its lien rights. In the event of default by client in
payment of the amount due hereunder, client agrees to pay reasonable attofneys' fee's and cost incurred in con-
nection with collection of said amounts whether or not suit is filed: 1.5% per month and/or an annual percentage
of 18.0% will be charged on all past due accounts. Contractor's are required by law to be licensed and regulated
by the Contractor's State Board. Any question concerning a contractor may be referred to the register of the
board whose address is: Contractors State Licenses Board, 9835 Goathe Road, Sacramento, Ca., 95827. Mailing
Address: P. O. Box 26000, Sacramento, CA., 95826.
The above prices, specifications and conditions are satisfactory and are hereby accepted.
Owner's Signature
(or authorized representative)
Contractor's Signature
Date:
Date:
"Notice"
(Section 7019 - Contractors License Law)
"Under the Mechanics' Lien Law, any contractor, subcontractor,
laborer, material man or/other person who helps to improve your
property and is not paid for his labor, service or material, has a
right to enforce his claim against your property. Under the law
you may protect yourself against such claims by filing before com-
mencing such work of improvement, an original contract for the
work of improvements of a modification, thereof, in the office of
the county where the property is situated and requiring that a con-
tractor's payment bond be recorded in such office. Said bond
shall be in an amount not less than fifty percent (50%) of the con-
tract price and shall, in addition to any conditions for the perfor-
mance of the contract, be conditioned for the payment in full of
the claims of all persons furnishing labor, service, equipment or
materials for the work described in said contract.
"Notice"
"Under the Mechanics Lien law any conb-
tractor, subcontractor, laborer, supplier or
other persons 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 subcon-
tractor, laborer, or supplier remains un-
paid."
Buyer's Right to Cancel
You may cancel the agreement or offer referred to above anytime prior to midnight of the third day (excluding
Sunday) after the day you signed the agreement or offer. If you cancel and you have already made some payment
to the seller, the seller is entitled to retain out of the payment, as a cancellation fee. Five percent (51/o) of the cash
price of the goods or service, but in no event may the seller retain more than fifteen dollars ($15). You may give
notice of cancellation by mailing a signed and dated statement to the seller at the address indicated. In order to
have proof of the mailing. it is recommended that you mail the statement by registered or certified mail. If you
Notice to Owner
Under the California Mechanics Lien Law, any contractor, subcontractor, laborer, supplier or other persons 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.
To preserve your right to file a claim or lien against your property certain claims such as subcontractors, or mate-
rial supplies are required to provide you with a document entitled "Preliminary Notice" Original (or Prime) con-
tractors and labors for wages do not have to provide this notice. A preliminary Notice is not a lien against your
property, its purpose is to notify you of persons who may have a right to file a lien against your property if they
are not paid. (Generally, the maximum time allowed for filing a claim or lien against your property is ninety (90)
days after completion of your project.)
To Insure Extra Protection For Yourself and Your Property
You May Wish To take One Or More Of The Following Steps:
1. Require that payments be made directly to subcontractors and material suppliers through a joint control. Any
joint control agreement should include the addendum approved by the Register of Contractors.
2. Issue Joint for payments, made out to both your contractor and subcontractors or material suppliers involved in
the project. This will help to insure that all person due payment are actually paid.
3. After making payments on any completed phase of the project, and before making any further payments, re-
quire your Contractor to provide you with unconditional lien release signed by each material supplier, subcontrac-
tor and laborer involved in that portion of the work for which payment was made. On projects involving, the per-
sons signing these releases lose the right to file a claim against your property. In other types of construction this
protection may still be important, but may not be as complete.
Applicable Law:
This agreement, and all the rights and obligations of the parties under this Agreement, shall be governed by the
law of the State of California.
Consequential Damages:
Buyer shall not be entitled to recover any incident or consequential damages as that term is defined in Commer-
cial Code Section 2715.
Attorneys Fees:
In the event of litigation arising out of this agreement, or the performance or interpretation thereof, the court will
award reasonable attorney's fees to the prevailing party.
No Other Agreement:
This Agreement is full and final Agreement of the parities, and no written or oral communication between the
parties before the execution of the Agreement will modify or amend the Agreement. The Agreement may be
modified only be a written document signed by both parties.
Liquidated Damages:
( 1.5% per month service charge annual percentage of 18.0% on all past due.)
In the event of a breach of the payment terms of this agreement, it is agreed that the seller's Contractors/Subcon-
tractors/Suppliers) actual damages caused by such a breach are difficult and impractical to determine and include,
among other things, administrative costs for billing, accounting for and collecting past due payments accordingly,
buyer agrees to pay seller liquidated past damages as delinquency/service charges on all accounts past due at the
rate of 1.5% percent per month, annual percentage of 18.0% until paid in full. This agreement to be a reasonable
method for fixing seller's damage so rising.