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0112-136 (BLDG)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 7 1.5 9W x'39 VITC I Z.8 :12( ✓Date, ,3 1!"= 4 Signature of Contracto r - 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.M workers' compensation insurance carrier & olicy o. are:. Carrier'�'i)yN11 Policy No. 1.:3�$' EJiif' Otfl!3G (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 issuedt 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.:thosprovision t ,.Date: /-3 ? Z, Applicant— Warning: pplicant � Warning: Failure to secure Wo kers' 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 the above-mentioned property for inspection purposes. ..� Si nature 'Owner/Anent)^ <-�.� -f” �' .•� .-• -�•-� .date �--• �� �%�'%+° PERMIT # BUILDING PERMIT 0112 136 DATE J2A? f2(; VALUATION $4,1.26= LOT TRACT JOB ADDRESS .a�+.7�ntAi�iiii.lV4CJ t l�iddk APN OWNER CONTRACTOR/DESIGNER/EN INEER ROA3ts,T-S) 114A ISTAR ROUF C.IC3, 53665 AVEXIDAIVEWCX) 79130 CLTV ST TJA,Quumrm CA 92253 BE,R1q !%A XA,'`NX1§ CA 92201 USE OF PERMIT Q-011 A,' ,W.f.J.%i.kt�.. D1Q riL`•J�.�.IVl �.,.trrx.aw .t►..ax ear ka... b1.&a!!00F 4,326.00 LS r '� 'I ti ;'C;tc°Z' C7 'Comma'ls`�CC)k�1' 4,,.00 R E, �• OOF ME �. 1 d13-�}Oi)�• 1 i�<aCia �Jg.dif f1Fr i 7 ��01 CITY OF LA41UNRA a' "Am 102103 PRE-41AID RESS $10.00 RECEIPT DATE BY` DATE FINALED INSPECTOR K 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. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final ZROVALS BLOCKWAL A Final POOLS-SPAS Steel 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: E ABLISHED 1923 'Mate License No. 715997 q -t -, I �L L.A. STAR ROOF CO. 79-130 CLIFF ST. BERMUDA DUNES, CA. 92201 760-345-3525 FAX: 760-345-4439 DATE: 11/9/2001 JOB ADDRESS: 51-855 AVENIDA MORALES CITY: LA QUINTA, CA. CROSS STREET: 1 W. OF EISENHOWER RONALD MILLSPAUGH 40-725 MEADOW LANE PALM DESERT, CA. 92260 FAMILY OWNED SINCE 1932 Los Angeles: 323-292-8145 TOTAL PRICE OF JOB: $4,526.00 DEPOSIT: /9t &'n15— ' $1,526.00 M�09// COMPLETION OF JOB: $3,000.00 COLOR: DARK BROWN HOME PHONE: 760-341-6568 BUS. PHONE 760-862-4608 FAX PHONE: 760-341-5827 CELLPHONE: 760-333-2515 EST #:10007.01 CONT.# WE AGREE TO FURNISH LABOR AND MATERIAL ON THE JOB ADDRESS LISTED ABOVE AND PERFORM THE SAME ON THE ITEMS LISTED BELOW: ALL PITCHED SECTIONS OF THE HOUSE AND GAR -,',,.GE. 1. Tear off roofing to the sheeting & and haul away. Install canvas around the perimeter if necessary to keep debris out of the lawn. Note: The charge for tear off is based on the estimated number of layers to be removed. If there are any additional layers over the estimated amount, it will cost $25.00 per layer, per 100 sq. Ft. to remove and haul away. The maximum number of layers per the building code is 1 on commercial, 2 or 3 layers on residential depending on the building dept. The maximum number of layers to be torn off on your roof is 1. Wood replacement: We include 20' of 1'x6" sheeting board or 1/2 piece of %" 0. S. board free of charge. If any wood over and above that has to be replaced it will cost $2.00 per foot for the 1"x6" or $40.00 per sheet or $25.00 per piece. Any specialty wood will have to be quoted 2. Remove any bad vents and replace with new vents as needed. Also replace all of the roof.jacks where possible. 3. Install 1%'x 3" White metal edging to all edges. 4. Install one layer of 30# plain GS base felt nailed on. 5. Install Owen Corning Supreme, 25 year warranty, Class A fire rating, 3 tab shingles Install 30# felt to any valleys for added protection. Install shingles through the valley of lower section. Install shingles through the valley from the other section, chalk line cut valley. Leave '/4" to 3/8" overhang on all eves and rakes to provide a proper drip edge per manufacturers specifications. 6. Install Modified Asphalt roll roofing behind all chinmeys, large A/C ducts and the dead valley between the house and garage to provide a longer life to the roofing in this area. 7. Lift 1 air conditioner(s). Clean roofing from under AC. Install roofing under unit the salve as the balance of the roof. Reset unit in place on existing framework. Install Modified Asphalt behind AC duct to provide a proper waterway to divert the water around the AC duct. Seal off any open AC ducts with a layer of White Coating, Polyester cloth and additional Coating. 8. Install individual hip & ridge shingles to all hips and ridges. NOTE: WE USE THE BEST MATERIALS AVAILABLE AND INSTALL THEM AT OR ABOVE MANUFACTURERS SPECIFICATIONS. WE US GS ROOFING MATERIALS BY CERTAINTEED, TRUMBELL ASPHALT MANUFACTURED BY OWENS CORNING, AND HENRY'S SEALANT PRODUCTS. MOST OF THE TIME THESE BRANDS ARE MORE EXPENSIVE THEN THE COMPETITION. WE FEEL THEY DO A BETTER JOB. THE MINIMUM AMOUNT OF HOT ASPHALT REQUIRED BY MANUFACTURERS IS 25#'S PER 100 SQ. FT. AS SPECIFIED ABOVE, WE ARE INSTALLING IT AT 30 TO 35#'S PER 100 SQ. FT. WE ARE INSTALLING 20-40% MORE THAN REQUIRED BY THE MANUFACTURERS. QUALITY IS IMPORTANT. NOTE: THE ABOVE PRICE INCLUDES A 5% DISCOUNT GOOD FOR 2 WEEKS ONLY. THE NORMAL PRICE IS $4,765.00 We agree to maintain vour new roof free of charee for 5 nears for causes due to lab.or and materials on the areas & items we worked on only.