BLDG (9808-104)52150 Avenida Madero
9808-104
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # L•ic: Class Exp. Date
. vJl270 l..-3_, vt3O19$-
bate t'-- t I 4' , Signature of Contractor-'
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.
(V0 1 have and will maintain workers' compensation insurance, as required by
Seclion 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 STr1.r .[rLltND Policy No. 85-1704-:`1S
(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
subject to the workers' compensation provisions of Section 3700 of the Labor
ode, I shall forthwith complywitWthose.provisions. (,
Date: v in .- Applicant -- i :}-
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
thebove mentioned,property or Inspection purposes. fit,
Signature (Owner/Agent)~ •- ' Date
i
BUILDING PERMIT PERM'T " 1, 1114 CONTROL#
DATEa `' VALUATION `.D r
szi ' i LOT TRACT /
JOB SITE N.YNkhripJ't 1V1tNR)f'.,A1:t1 APN -
ADDRESS
OWNER CONTRACTOR/DESIGNER/ENGINEER
i'AT:LRY & SI-11-ARAl. EE S,RN IFP KflI D"i P4? 0'FI1h10.1,l?SS0CIATES, INC:.
52130 AV.E;: IDA MADERD 314-13 Vial LA. PA3.,:KIAS
LA QUI -WA. CA 92253 1140USAND PALMS !-,A 92276
(160)343-75f,5 CE40 M83
USE OF PERMIT
GENERAL BUILLING
1;LYt%M %Jil t' L',,NA.Z9 S iiV1:T KtJWt1 tUlL# ,4t[5t'.Srk6.t..:L' -W k 1X1 .YV7:: WY AZUV 1j%l,.V 1.
CiirRth F 1,200.00 LS
ESTXP&V3E'D COST OF CON.M=fION
PERMIT Y+ ylls SUMMARY
Y
JkER001-' FEE. 101 -000 -418 -NO IS30.00
4
3
c:`! t')tEDON AND PLAN C? Mr' K
LLSS PRE-PATU FEES
AUG I,? 199g0TALPERT IT FERS IME, NOW
..5. _r,
RECEIPT I DATE I BY I DATE FINALED I INSPECTOR
is
1,200.0)0
&K(A)
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
OX 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 v
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:
I
7
FROM BUNDE ,ROOFING PHONE NO. :x'760+343+7554 - Aug. 12 1998 01:05PM P2
. BUNDE RUOF 11 G ASSOC iA E S . I NC _
P.O. Box-205 * Thousand Palms, CA 92276 =
(760) 343-7555 * Fax (760) 343-7554
Stan sniff
52-150 Avenida Madero
La Quinta, CA 9225$
Re: Re-roof Dimensional Shingles
South Side-of-Roof
For the Sum: $ 2,070.00
f
We propose to furnish and apply the following.-
Tear
ollowing:Tear off existing roof and haul away. Inspect sheathing for dry-rot,
and replace any damaged wood on a time and material basis. Install
new metal trim around perimeter as'needed. Re-roof with one layer #15
felt nailed to hold in place. Over felt install new 25 year self
sealing dimensional shingles to manufactures specifications. Paint all
flashings with rust proof paint..Haul-away'all debris caused from above
work, and leave area clean. Any questions regarding this estimate,
please feel free to call. A five year guarantee will be in effect upon
payment in full.
TERMS: 100% UPON,COMPLETION, UNLESS OTHER ARRANGEMNTS.HAVB BEEN MADE.
THIS ESTIMATE'IS GOOD FOR 15 DAYS FROM DATE BELOW.
IT IS HEREBY AGREED BY BUNDE ROOFING &.ASSOCIATES INC. AND THE OWNER
THAT WE THE CONTRACTOR, SHALL-NOT BE LIABLE FOR.ANY OF-THE:FOLLOWING:
DIRT, ROCK, OR ANY DEBRIS THAT MAY FALL BETWEEN THE SHEATHING BOARDS
ONTO LIVING AREA. DAMAGES TO ANY CSILING.MOUNTED FIXTURES; VENT AND /
OR CONDUIT PIPES STRUCTURAL DEFECTS IN BUILDING. IT. WILL BE OWNER'S`
RESPONSIBILITY TO-REMOVE AND REPLACE ANY ROOF MOUNTED ANTENNAS AND/OR
SOLAR PANELS.
IF THE SERVICES OF AN ATTORNEY MUST BE EMPLOYED TO ENFORCE COLLECTION,
.THE OWNER AGREES TO PAY ANY ATTORNEY•AND/,OR COURT COSTS. '
CONTRACTOR'S ARE REQUIRED BY LAW TO BE LICENSED AND REGULATED BY THE,
CONTRACTOR'S STATE LICENSE BOARD.
1020 N STREET -
SACRAMENTO, CA 95814 LICENSE # 691270
RESPECTFULLY SUBMITTED BY: DATE:08/06/98
acc$aTSD sY _ DATE:
FROM BUNDE ROOFING PHONE NO: 760+343+7554 Aug. 12 1998 01:05PM PS
1Qq Bunde Roofing & Associates Inc.
P.O. Box 205
Thousand Palms, CA 92276
Office 619-3-7555 Fax 619-M' -7554
Letter I D-ansmittal
To: Date:
Job:
:;ttn:.
We are sending you: For:
Herewith
Under separate cover
As requested
Plans/specifications
Photographs
Record drawings
List of materials
Addendum
Roof .Sid
Change order
Invoice
Certificates of insurance
Copy of purchase order
Copy of letter
Other. .
Loc. r
Phone #:
Your usefinformation
Approval
Review and comment
Completion
Correction and resubmission
Estimate due
Date, initial and signature
Resubmit copies for approval
Lab analysis
Your records,
Other:
Please respond by: Transmitted-Via: ,D
Remarks: / +
21,
Y
F
tf a fax total # of pages including this one:
Contractor's State License Board - License De... Page I of 2
MW
STATE OF CALIFORNIA
CONTRACTOR'S STATE LICENSE BOARD
P. O. BOX 26000
SACRAMENTO, CA 95826
it PHONE: 1-800-321-2752
* * * DISCLAIMER * * *
The license status information shown below represents information taken from the CSLB licensing data base at the time
of your inquiry. It will not reflect pending updates which are being reviewed for subsequent data base updating. The
available information may'not reflect any civil or criminal judgments or actions that have not been reported to the CSLB.
If there are disclosable complaints (legal actions) on the contractor's license, that information will be provided. if you
intend to pursue any kind of legal action; insure you get a "Verified Certificate" which is a certified license history
covering a specific time period prior to taking any action.
Extract Date: August 1.2, 1998
TI -If. RESUL''S OF YOUR INQUIRY FOR CONTRACTOR LICENSE.NUMBER 691270 :IS:
* BUSINESS INFORMATION
BUN:DE :ROOFING AND ASSOCIATESINC
P O BOX 205
THOUSAND PALMS, CA 92276
Entity: Corporation
Issue :Date: 06/28/1994 Expire Date: 06/30/2000
* * * LICENSE STATUS * * *
This license is current and active.
* * * CLASS.IFLCATIONS * * *
C39 ROOFING
* * * CONTRACTOR BONDING INFORMATION * * *
This license has bond number SA5146540 in the amount of $7,500 with the bonding company
STAR INSURANCE COMPANY.
Effective Date: 04/05/1996
* * * WORKERS COMPENSATION INFORMATION * * *
This License has workers compensation insurance with the STATE COMPENSATION
INSURANCE FUND
Policy Number: 285-0001704 Effective Date: 04/01/1998 Expire Date: 01/01/1999
Click on Personnel List
to see the people on this license.
_ THIS IS THE END OF YOUR INQUIRY RESPONSE.
QUESTIONS ABOUT YOUR :DATA SHOULD BE DIRECTED TO 1-800-321.-2752.
http://www2.cslb.ca.gov/iXpress/CSLB Library/CSLB+Book/License+Detail.DML 8/12/98