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BLDG (0303-207)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 # ` # Lic. Class Exp. Date 630394 �1}} x34 1 ' 1r41104 Date - 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. 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 & policy no. are: Carrier STATE FUND Policy No. x$.133416•©2 (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,land agree that if I should become subject to the ,workers' compensation provisions of Section 3700 of the Labor Code,^ lyas all forthwith comply with those provisions. ,Daie: � 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 ielating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspectio n purposes. (� Signature (Owner/Agent) e Date PERMIT BUILDING 03W-207 Y .PERMIT DATE�vVALUATION LOT TRACT JOB SITE ADDRESS 9k -87i ,VENO b,101' INH0 APN - OWNER CONTRACTOR/DESIGNER/EN INEER .fAL.1. RAY 1tC1C1F Z'UX SPEC WIT"Y. 69-05 VB.'1-/C W S ANE 74-980 RUNAWAY BAY DR, =3MYRALCfrY CA. 133q MMADUNES CA 92211 (760)200-0811. C1 101 1420 USE OF PERMIT GEN.M. L}3LMANG 1'iltC10.1y WITH U.S. ULaY IVL&A K.61UJ ' 1L. z' 1Z:�4bkaR 4 5:1 VALUATION LS 1X:91.WA:= COST OF COINIS' 1fJC''7[ OPT 17ot1�lti.43�i 1'F ii�9..0 YKE RA4.N1'ARY 1aMOO>z 1+-1? x c1180004 ] 8-CIIU S O.�a MAR 2 CITY OF L�. t'stliR IFY C014MIZT-TCIAIOK AND PLAR CIC LESS PRE -PAD, Fni 0 $0,00 'f0TAJ 'P1U1 V T Ik'MtS i7UF. JN0>'W WAX00 RECEIPT DATE " TE' BY DAT INAL � g - INSPECTOR IFA 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 O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. zj Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final — BLOCKWALL APPROVALS Steel POOLS - SPAS Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. 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: L ROOF TILE SPECIALTY P.O. BOX 11257 PALM DESERT, CA 92255 PH: 760-200-0911 FAX 760-200-0801 LICENSE # 810537 PROPOSAL AND ESTIMATE CLIENT.- JALE RAY DATE: 3-17-03 ADDRESS: 69675 WILLOW LANE ADDRESS MONTERO ESTATES CITY :CATHEDRAL CITY, CA. CITY: LA QUINTA, CA 92253 PHONE: 760-831-0243 WE PROPOSE TO FURNISH THE FOLLOWING MATERIALS AND PERFOnI ALL LABOR TO ROOF THE ABOVE SITE: REMOVE EXISTING WOOD SHAKES AND DISPOSE, CLEAN ALL GROUND AREAS. INSTALL NE W PERIMETER METAL AND SHEET METAL AT ALL ROOF TRANSITIONS. INSTALL NEW ROOF JACKS ( PRIMARY & SECONDARY). INSTALL SHEET METAL AT SKYLIGHT CURBS. REPLACE 2 X 2 SKYLIGHTS WITH NEW. NAIL ONE LAYER 40# TILE LINER INCORPORATING ALL SHEET METAL. NAIL NEW RIDGE BOARD AND GABLE END, NAIL BOARD FOR TRIM. INSTALL NEW U. S , CLAY MAX ROOF -TILE TO MANUFACTURES SPECIFICATIONS. PAINT ALL ROOF JACKS TO MATCH ROOF TILE. PATIO COVER INSTALL PLYWOOD AND TAR AND CAP. REMOVE BATONS AND INSTALL 5/8 T -1I1 COST' $1,850.00 TERMS: 70% ON MATERIAL DRAW 30% FINAL DRAW ROOF PRICE: $17,800.00 ATTENTION SECTION 7018 OF THE CONTRACTORS LICENSE LAW PROVIDES THAT STARTING JULY 1, 1966, EVERYONE LICENSED BY THE CONTRACTOR'S LICENSE BOARD SHALL GIVE A COPY OF THE FOLLOWING NOTICE TO THE PAYER PRIOR TO RECEIVING FROM THE OWNER OF THE PROPERTY OR HIS AGENT ANY PAYMENT FOR WORK WHICH A CONTRACTOR'S LICENSE IS REQUIRED.. NOTICE UNDER THE MECHANICS' LIEN LAW, ANY SUBCOMIRACTOR, LABORER, SUPPLIER OR OTHER PERSON WHO HELPS TO IMPROVE YOUR PROPERTY BUT IS NOT PAID FOR THERE 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 FOR 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 REMAINED UNPAID ROOF TILE SPECIALTY AGREES TO FURNISH ITS REGULAR FORM GUARANTEE FOR TEN YEARS AFTER COMPLETION OF ITS SAID WORK. SAID GUARANTEE TO COVER DEFECTS IN MATERIAL AND WORKMANSHIP ONLY AND NOT EXTEND TO DAMAGE TO DAMAGE CAUSED BY THE ELEMENTS, OTHER UNUSUAL ACTS OF GOD AND SHALL NOT COVER ANY LI ABILTI'Y FOR DAMAGE TO INTERIORS FIXTURES, DECORATIONS, WALLS, CONTENTS OD BUILDING OR OTHER PARTS OF STRUCTURE NOTTO DAMAGE OF FAULTY CONSTRUCTION IT IS ALSO UNDERSTOOD AND AGREED THAT THE ABOVE GUARANTEE SHALL BE MADE AND REMAIN ONLY WHEN AND F PAYMENT IS MADE AS AGREED IN THIS CONTRACT. WE ARE FULLY COVERED BY WORKAPEN'S COMPENSATION AND LIABILITY INSURANCE. CARRIERS NAME S AND POLICY NUMBERS ARE AVAILABLE ON REQUEST. ANT ALTERATIONS OR DEVIATIONS FROM THE ABOVE SPECIFICATIONS INVOLVING EXTRA COST OF MATERIAL OR LABOR WILL ONLY BE EXECUTED UPON WRITTEN ORDERS FOR SAME, AND WILL BECOME AN EXTRA CHARGE OVER SUM MENTIONED IN THIS PROPOSAL. ALL AGREEMENTS MUST BE MADE IN WRITING. THIS OFFER IS VALID FOR ONE WEEK FROM DATE OF ESTIMATE AND IS BASED ON FREE ACCESS TO BUILDING FOR DIRECT LOADING FROM OUR TRUCK. ACCEPTED: RESPECTFULLY SUBMITTED BY DATE ROOF TILE SPECIALTY