RR (07-0152)50231 Calle Maria
07-0152
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA. 92253
Application Number:
i
07-00000152
Property Address:
50231 CALLE MARIA
APN:
773-340-010-10 -14496
Application description:
RE -ROOF
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
3727
Applicant: Architect or Engineer:
N
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT .
--------------------------------------------------
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 Professionals Code, and my License is in full force and effect.
License lass: B C39 License No.: 235717
ate: -2f"d 1 ontractor: r
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).:
(_ 1 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.).
(_ 1 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.). _
I—) 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: 1
Lender's Address:
LQPER,%IIT
Owner:
BARNES ROBERT
P O BOX 1340
LA QUINTA, CA
A
92.253
Contractor:
WESTERN PACIFIC ROOFING CORP
3462 LA CAMPANA WAY
PALM SPRINGS, CA 92262
(760)416-5877
Lic. No.: 235717
VOICE (760),777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/18/07
PF JN 2 9 2007
CITY OF LA QUINTA'
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury.one of the following declarations:
Lhave 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 and policy number are:
Carrier STATE FUND Policy Number 046001635506
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 houId become subject to the workers' compensation provisions of Section
3700 of the or Code, 1 shall forthwith complywiththose rovisions.
te: 'cs09plicant:
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 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 1 have read this application and state that the above information is correct. I agree to comply with all
city andptiuhty ordinances and state aws relating to building construction, and hereby authorize representatives
of t ' Ignatutre
ove-mentioned prop ertyy ffor inspection purposeDate:plicant or Agent):— / t-
r-
Application Number . . 07-00000152
Permit . . RE -ROOF
Additional desc
Permit Fee30.00
Plan Check
Fee
"
..00
Issue Date . . . .
Valuation"
0 �{
Expiration Date 7/17/07
Qty .Unit Charge Per
Extension
BASE FEE
30.00
----------------------------------------------------------------------------
Special Notes and Comments
REMOVE.EXISTING TILES & INSTALL NEW
UNDERLAYMENT. REPLACE ORIGINAL TILES -
Fee summary Charged Paid
Credited
Due
Permit Fee Total 30.00
.00
.00•
30.00
Plan Check Total .00
.00
.00
00 `
Grand Total 30.00
.00 _
.00
30.00
x
LQPERAlff -
,
4.4
P.O. BOX 1504 N o .
Building50" 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Zip
State
Mailing
Address
Sam
City
Zip
Tel.
la 40ainft
. 92253
1 '
Contractor
70 00) of Division 3 of the Btusiness,and Professions Code, and my license is in full force and
Address
73-125
City
Zip
Tel.
Palm Wit.
922-0
340-3447
State Lic.
I hereby affirm that I am exempt from the Contractor's License Law for'the'following
City
& Classif.
404640
Lic. #
Arch., Engr.,
permit to construct, alter, improve, demolish, of repair any structure, prior to its issuance. also
Designer
,_r•
Address Tel.
BUILDING: TYPE CONST. - OCC: GRP.
A.P. Number 773--340-010 -
Legal Description 10L 10
Project Description Fma
Sq. Ft. No. No. Dw.
Size Stories Units
New ®i Add ❑ Alter ❑ Repair ❑
Demolition ❑
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commenting with Section -
1 '
70 00) of Division 3 of the Btusiness,and Professions Code, and my license is in full force and
effect.
S GNATTB - DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for'the'following
4, .
4 7d} •
reason: (Sec. 7031.5,Business and Professions Code: Any city or, county which requires a
-.
permit to construct, alter, improve, demolish, of repair any structure, prior to its issuance. also
,_r•
requires the_ applicant for such permit to file a signed statement that he is licensed pursuant to
PERMIT. -
r- " ' -. AMOUNT
the provisions of the Contractor's License Law, - Chapter 9 (commencing with Section 7000) of
Division 3'of the Business and Professions Code, or. thatheis exempt therefrom, and .the basis
for the Any Section 7031.5 'any., for
..
Plan Chk. Dep.
-
alleged exemption. violation of ,by applicant. a permit
subjects the applicant to a -civil penalty of not more than five hundred dollars ($500): • ' -
Plan Chk• Bal-
J
❑ 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, Buisness and.
Const.
Professions Code: The Contractor's License Law does not apply to an owner of property who
• 50
builds or improves thereon and who does such work himself. or through his own employees,'
Mech.
provided that' such 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
Electrical
Y
'. Y{ ,•'
. of proving that he did not build or improve for the, purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
y
struct the project. (Sec. - 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or. improves thereon, and, who contracts for
S.M.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
0 I am.exempl under Sec. B. & P.C. for this reason .
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I'have a certificate of consent to self -insure, or'a certificate of.
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy' No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL..
_
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS'. COMPENSATION INSURANCE
(This. section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.).. .... .. ..
I certify that in the performance of thg 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.
' Date ' ' Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
ZONE:
BY: '
subject to the Workers' Compensation provisions of the -Labor Code, you. must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affiim that there is 'a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097,. Civil - Code.)
Side Setback from Property. Line
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
This isa building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days. r J
I certify that 1 have read this application and state that the above information is correct.
Issued by:
Date Permit -
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representativew-of this city to' enter the above-
mentioned property for inspection purposes:
I t }r
Validated by:
Signature of applicant t 1 Y k i' (. 1.4 tt Date
Mailing Address.L` 4!
Validation:
City, State, Zip
` t
AG299
9 813355 Cf,
_ .
_ HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SQ. FT. ®
GAR. SQ, FT. ®
CAR P. SQ. FT.
WALL SQ. FT. @
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
ONDING —/ S! ��
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. (off c
BATH TUB
FINAL INSP.
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
VENTILATION
GAS PIPING
PERMIT FEE
FIRE ZONE ROOFING
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUNNDr
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
ONDING —/ S! ��
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
NF. STEEL 9
GAS (FINAL)
TEMP. POLE
AIV
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ —Plus—X$—=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL