BRER2016-010653345 Avenida Madero
BRER2016-0106
Applicant:
Contractor:
Ta^""^
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VOICE (760) 777-7125
78-495 CALLE TAMPICO
P 0 BOX 1387
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INDIO, CA 92201
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LA QUINTA, CALIFORNIA 92253
DESIGN & DEV OPMnDE ENT
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FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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Date: 11/28/2016
Application Number:
BRER2016-0106
UOwner:
NOV 2 8 2016
Property Address:
53345 AVENIDA MADERO
,REGO NIETO
APN:
774033015
53345 AVENIDA MADERO
Application Description:
NIETO RESIDENCE / RER00LA
CITY OF LA QUINTA
QUINTA, CA 92253
Property zoning:
DEVELOPMENT DEPARTMENT
Application Valuation:
$5,800.00
DESIGN AND
Applicant:
Contractor:
AJ I ROOFING
AJ I ROOFING
P 0 BOX 1387
P 0 BOX 1387
INDIO, CA 92201
INDIO, CA 92201
LICENSED CONTRACTOR'S 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 Professions Code,
and my License is in full force and effect.
License Class: C39 License No.: 951335
QDA—
ontractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 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 to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor'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 civil penalty of not more than five hundred dollars
($500).:
( 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 Contractors' State License Law does not
apply to an owner 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.).
(_) 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.).
(__j 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. Q.
Lender's Name:
Lender's Address:
(760)609-1758
Llc. No.: 951335
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.
1 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 COMPENSATION INSURANCE FUND Policy Number: 9138587
_ 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 Code, I shall forthwith
comply with those provisions.
Dat—Z' 'lib _gjApplicant: _
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP 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 Building Official 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 subjei
F Date: 11/28/2016
Application Number:
BRER2016-0106
Owner:
Property Address:
53345 AVENIDA MADERO
REGO NIETO
APN:
774033015
53345 AVENIDA MADERO
Application Description:
NIETO RESIDENCE / REROOF
LA QUINTA, CA 92253 '
Property Zoning:
Application Valuation:
$5,800.00
Applicant:
Contractor:
AJ I ROOFING
Al I ROOFING
P 0 BOX 1387
P 0 BOX 1387
INDIO, CA 92201
INDIO, CA 92201
(760)609-1758
Llc. No.: 951335
Detail: REMOVE EXISTING TILE AND UNDERLAYMENT. INSTALL NEW UNDERLAYMENT
AND USE EXISTING TILE.'PER 2013 CALIFORNIA BUILDING CODE
r
r
DESCRIPTION I ACCOUNT I QTY I AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF - EA ADDITIONAL 1,000 SF
101-0000-42404
0
$12.16
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$51.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0
$103.36
Total Paid for RE -ROOF: $167.20
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La�Quinta,'CA 92253 -.(760) 777-701,2
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APPLICANT: DO NOT WRITE BELOWTHIS LINE"
Submittal
Req'd
Rec'd
TI2ACiCTI1G
r PERMIT FE
Plan Sets
Plan Check submitted'
Item
'Amount
Structural Calcs.
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Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance.
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Title24 Calcs.
Plans picked up
Construction
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Flood plain plan
Plans resnbmilted
Mechanical
Grading plan2°"
Revieiv, ready for corrections/issue
Electrical
Subcontact'or List
Called Contact Person
Plumbing
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Grant Deed
Plans picked up
MOA. Approval
Plans resubmitted a
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'rd Rcyiew, ready for correctionsfissuc
Developer Impact Fee
Planning Approval
Called Contact Person
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Pub. 1Yks. Appr
Date of permit issue.
School Fees,
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Total Permit Fees