0309-013 (BLDG)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
1— Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
C14 W Professionals Code, and my License is in full force and effect.
O =) M License # Lic. Class Exp. Date
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Z r. -Date ` Signature of Contractor -
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c0 � OWNER -BUILDER DECLARATION
W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~ U) License Law for the following reason:
Z_ ( ) 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).
t'`) () I am exempt under Section , B&P.C. for this reason
LO
N Date Signature of Owner
O0)
Q WORKER'S COMPENSATION DECLARATION
C) Z I hereby affirm under penalty of perjury one of the following declarations:
U-) � O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W �= compensation, as provided for by Section 3700 of the Labor Code, for the
m� Q performance of the work for which this permit is issued.
Q () (,�) I have and will maintain workers' compensation insurance, as required by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
rn H permit is issued. My workers' compensation insurance carrier & policy no. are:
`* Z Cartier Policy No.
ob O F10'r WRTMAN ST TV! �h2iAZ2#.E
J (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 agree that if I should become
3 subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.,
Date: " . '' '-,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 with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
1
Signature (Owner/Agent) t Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT. TRACT
TRACT
JOB SITEI APN
ADDRESS
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USE OF PERMIT
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RECEIPT DACE� I BY ' DF�IE�IN9�F�gr� I INSP
INSPECTION RECORD
OPERATION
DATE
INSPECTOR OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
0.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS -SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
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
Appliances
' Final
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)
COMMENTS:
RTS
Roof Tile Specialty, Inc.
Contractors State License # 810537
P.O. Box 11257 Palm Desert, CA 92255
PHONE 760-200-0811 FAX 760-200-0801
A proposal submitted to: MR. & MRS. MEYERS
Mailing Address: 52-900 MONTEZUMA LA QUINTA, CA 92253
Job Address: SAME AS ABOVE
Phone:
Description of work to be performed:
OBTAIN ALL REQUIRED CITY PERMITS.
REMOVE EXISTING ROOF AND DISPOSE.
LOW SLOPE- ROOF NAIL ONE LAYER GLASS BASE WITH NEW PERIMETER METAL.
INSTALL ONE LAYER POLY GLASS INTER PLY FOLLOWED BY ONE LAYER POLY GLASS GRANULATED.
PITCHED AREA- ROOF NAIL ONE LAYER 40# TILE LINER .
FOLLOWED BY NEW SHEET METAL AT ALL ROOF TO WALL TRANSITIONS.
INSTALL NEW GALVANIZED & ALUMINUM ROOF JACKS. INSTALL NEW DORMER VENTS.
INSTALL ONE PIECE CLAY LIGHT ROOF TILE TO MANUFAC'T'URES SPECIFICATIONS.
INSTALL MUDDED TOPS AND RANDOM BOOSTERS.
PAINT ROOF JACKS TO MATCH ROOF.
CLEAN JOB SITE TO OWNERS STANDARDS.
IF NOT ACCEPTED IN 30 DAYS THIS PROPOSAL IS NULL AND VOID
Note: In keeping with industry standards: 1. This guarantee does not cover any damage to the interior or exterior 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, antennas 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 roofing 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 RTS (Roof Tile specialty,
incl nor the installer assumes any responsibility for the performance of said equipment. 3. RTS (Roof Tile specialty, Inc.) does not assume
any responsibility for corrections of existing code violations or for the repair of any existing defects unless specified in estimate and
proposal.
Total Cost: $ 8,042.00 Terms paid on completion unless otherwise specified in the contract. If not accepted in thirty days this
proposal is invalid. An additional cost of $35.00 per sheet of plywood will be charged if plywood needs to be replaced.
Acceptance: You are hereby authorized to furnish all contents written in the contract to complete work mentioned in the proposal
contract for which Uwe 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 defects free of
charge.
Installation: It is understood that by the acceptance of this proposal you authorize RTS (Roof Tile Specialty, Inc.) to make the installation;
to issue work orders with specifications shown herein and to pay our charge for such installation. You agree to pay the amount
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 RTS (Roof Tile specialty, Inc.). 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 merchandise, 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 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 judgment award based upon the evidence presented by the party(ies)
who do (does) appear and participate. Notwithstanding Contractor'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 &ue hereunder, client agrees to pay reasonable attorneys' fee's and
cost incurred in connection 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 questions 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 Date.
(or authorized representative)
Contractor's Signature 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 this 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 commencing 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 contractor's payment bond
be recorded in such office. Said bond shall be in an amount not less than fifty
percent (50%) of the contract price and shall, in addition to any conditions for
the performance 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 Libn law any contractors,
subcontractor, laborer, supplier & other persons
who helps to improve your proper[. 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 you own
contractor in full, if the subcontractor, laborer,
or supplier remains unpaid." .
Buyer's Right to Cancel
You my 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 (50/6) 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.
Notice to Owner
Under the California Mechanics Lien Law, any contractor, subcontractor, laborer, supplier or other persons who help 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 material supplies are required to provide
you with a document entitled "Preliminary Notice." Original (or Prime) contractors and laborers for wages do not have to provide
this notice. A Preliminary Notice is not alien against your property, its purpose is to notify you of persons who may have a right to
file alien against your property if they are not paid. (Generally, the maximum time allowed for filing a claim or lien against your
property i§ 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 payments, made out to both your contractor and subcontractors or material suppliers involved in the project. This
will help to insure that all persons due payment are actually paid.
3. After making payments on any completed phase of the project, and before making any further payments, require your Contractor
to provide you with unconditional lien release signed by each material supplier, subcontractor and laborer involved in that
portion of the work for which payment was made. On projects involving unconditional lien releases the persons 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 Commercial Code Section
2715.
Attorney's 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 parties 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 by a written document
signed by both parties.
Liquated Damages
In the event of a breach of the payment terms of this agreement, it is agreed that the seller's (Contractors/Subcontractors/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% 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.