RER (09-0205)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09-00000205
Property Address: 52701 AVENIDA MENDOZA
APN: 773-302-022-9 -000000-
Application description: RE -ROOF
Property Zoning: COVE RESIDENTIAL
Application valuation: 6405
Applicant:
Tay/ 4 4, Q"
Architect or Engineer:
Pik
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury t am licensed under provisions of Chapter 9 (commencing with
Section 7Q00) of Division 3 of the Bus' an rofessionals Code, and my License is in full force and effect.
Licects9Qlass l C3 9 License No.: 810537
% 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 70001 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.).
(_) 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:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153 -
Date: 3/05/09
Owner: ; f
MARILYN GILLESPIE.-
52701 AVENIDAM�/E O G
LA QUINTA, CA g2 5
14�� O
Cj� 0� a
ROOF TILE SPECIALTY/f'0��
P.O. BOX 11257
PALM DESERT, CA 92255
(760)200-0811
Lic. No.: 810537
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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
Xissued.
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 238-0009889-08
I certify that, in the performance of the work for which this permit is issued, 1 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 a subjec a workers' compensation provisions of Section
/``/37 0 of the Labor Code, I sh I orthwith comply rose provisions.
ate v plicant:
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.
1 certify that I have read this application and s that thea formation is correct. I agree to comply with all
city and county or ances and state laws relati g to building constnJ 'q�d hereby authorize re "tm
of�7ty t0� pon he above -mention property for inspection p es
ignature (Applicant or Agen
Application Number . . . . . 09-00000205
Permit . .
. RE -ROOF'
Additional desc .
.
Permit Fee . .
. 30.00
Plan Check Fee
.00
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date
9/01/09
Qty Unit Charge Per
Extension
BASE FEE
30.00
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Special Notes and
-----------------------------------------------------
Comments
RE -ROOF WITH 30 YEAR SHINGLES, CLASS
"A"
MATERIALS
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Other Fees .
. . . . . . BLDG
STDS ADMIN (SB1473)
1.00
Fee summary.
Charged Paid
--------------------
Credited
--------------------
Due
-----------------
Permit Fee Total
30.00
.00 .00
30.00
Plan Check Total
.00
.00 .00
.00
Other Fee Total
1.00
.00 .00
1.00
Grand Total
31.00
.00 .00
31.00
LQPERMIT
1
,i Roof Tile Specialty, Inc.
RTS.
Contractors State License # 810537
P.O. Box 11257 Palm Desert, CA 92255
PHONE 760-200-0811 FAX 760-200-0801
4
A proposal submitted to: MARILYN GILLESPIE
Mailing Address: 52701 AVE. MENDOZA, LA QUINTA, CA 92253
Job Address: SAME
Phone: P-275-1525 F-341-3514
Description of work to be perform. ed:
REMOVE EXISTING TAR AND GRAVEL ROOF AND DISPOSE.
NAIL 1 LAYER 15# SHINGLE WITH NEW PERIMETER METAL AND ROOF JACKS.
INSTALL 30 YEAR SHINGLE TO MANUFACTURES SPECIFICATIONS. DISPOSE OF
ALL ROOFING DEBRIS FROM JOB SITE. BID INCLUDES BUILDING PERMIT. -
If not accepted in 7 days this proposal is null and void
Note: Roofing is not warranteed and/or guaranteed until 100% complete. Please note Roof Tile Specialty, Inc. is not responsible for delays in
roofing materials or delivery dates. All debris caused from above work to be discarded and area to be left clean.
In keeping with industrystandards: 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, Inc.) 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: $ 6A05.00 Terms paid on completion unless otherwise specified in the contract. If novaccepted in thirty days this proposal
is invalid. Extra $55.00 per sheet of plywood if needed. In the event of any increase in material price(s), said price increase shall tie passed
directly onto the client. At client's request Roof Tile Specialty shall proved written documentation of the increase in material price(s) to client
and client shall pay the actual increase in the material price in addition to any sum client agreed to pay Roof Tile Specialty for work to be
performed under this agreement. Roof Tile Specialty shall add no mark up or profit to any increase in material price(s).
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 defects free of charge. It is the
owners responsibility to properly maintain roof system. Guideline and proposed budget for annual maintenance will be provided upon
request. It is the owners responsibility to properly maintain roof system. Guideline and proposed budget for annual maintenance will be
provided upon request.
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
ytherein, 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, lnc.). 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
Cinder separate and additional order from you. (initial) 4 - -
Arbitration of Disputes: Any controversy or claim arising out of or relating to this contract, or the breach thereof, shall settled by arbitrator
yin 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
tparticipate..`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 due 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.
4 Owner's Signature Date:
(or authorized representative)
Contractor's Signature Date:
BIIt #
CI of La
City Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
PLa
6A
Project Address:
Owner's Name: Q
,
Lib
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:CJ2
Telephone:
Address: ll�
Project Description:
City, ST, Zip: U l
l
Telephone: I
State Lic. #: I 3
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING. PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Cales.
Reviewed, ready for corrections Plan Check Deposit
Truss Cales.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2i° Review, ready for corrections/'issue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:
'"' Review, ready for corrections/issuc Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees