RR (07-1488)t
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:.
Application description:
Property Zoning:
Application valuation:
Applicant:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Q7-00001488
1-3-97—AVENIDA-NAVARRO
773-103-009-3 -000000-
RE-ROOF
COVE RESIDENTIAL
8000
Architect or Engineer:
Nj
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisionsof Cha 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and m I Lic se s in full force and effect.
License Class: C39 License No.: 60 07
a
late 6' `�v rG��ntrao'riury
N. IL EC
I hereby affirm under penalty 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.).
(_) 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 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: '
LQPERAIIT
Owner:
JUAN GARCIA
51397 AVENIDA NAVARRO
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/21/07
Contractor: C.
P.ETRONELLA ROOF CO REROOF
68314 KEILEY ROAD
CATHEDRAL CITY, .CA 92234 F1 MAY 2 12097
(760)324-5482
Lic. No.: 460707 CITY
OF LA
QUINTA
FINeu,-e ---
-
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 whichthis 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 1801579
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.
Date: Appli
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 thisapplication 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 I have read this application and state that the above information is correct. I agree to com with all
city and county ordinances and state laws relating to building cons tion, and hereby a thorize repr en rives
of this county to enter upon the above-mentioned prop y for ins tion p
%� r1
Signature -(Applicant or.Agent)%
LQPERMIT
Application Number 07-00001488-
7-00001488Permit
PermitRE -ROOF
Additional desc .
Permit Fee 30.00
Plan Check
Fee
00
Issue -Date
Valuation
. . .
. 0
Expiration Date 11/17/07
Qty Unit Charge Per
Extension
BASE FEE
30.00
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Special Notes and Comments
REROOF WITH 1-1/2" SPRAY APPLIED
POLYURETHANE FOAM ROOFING SYSTEM.May
21, 2007 8:50:50 AM AORTEGA
Fee 'summary 'Charged Paid
Credited
Due
Permit Fee Total 30.00
.00
.00
30.00
Plan Check Total .001*
.00
.00
.00
Grand Total 30.00
.00
.00
30.00
Fax sent by : 9898864184 ATI SB 85-16-87 88:44
THE R ER00FING SPECIAl,_ISTS. INS
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1!®oflate
26 rate onBlOffice.. Desert Otftx:
Costa Men, C Blvd. 68-314 Kieley Road
Costa Mesa, CA 92627 Cathedral CRY CA 92234
949.548.1645 / Fax: 949.548-2617 4icoosr #46mo7 760.3245482 / Fa[: 760.328.4612
PLIROMLLLAk0011NGhercnxitmtullcd'(m(rdant'and'or'L kr Apra: ILL JulmiltIhr Iv)hmrljLh.,t:d1a111uauu,llantJun;uu,tum
INAME I OWNER JUAN CARCIA
REROOF MOACT ADDRESS 51397 AV39NIDA NAVAkltO
ICITY, STATE 6f: ZIP CODE LA QUINTA. CA. 92253
BILLING ADDRESS: 2g7 W. ORANGE SHOW LANE
PHONE NO: (909) Sw4joe
CITY, STATE & ZIP CODE: SAN URNARDINOa CA. 924M
ADDITIONAL PHONE NUMBER. FAXNUM89R: eA9)SM4104
DESCRivnON OFI.ABOR UTAPFIUAI.S Ann M1141 -
SCOPE OF WORK:
I %" SPRAY APPLIED POLYURETRANE FOAM RoorlimG SYRT'?RM
Uoat........................................................................... $8.000.00
Note: S 0.891 Per sq. £t for tear of Anyenlore then the OWN* evisting
WARRAM
t. t'etronella Roofing will issue a 10 Year ` Wcathershickr wanwty.
2. Il is the owner's [esponsibility to properly maintain mof system. GUideUM and proposed budget for annual
maintanatice will be provided upon request.
SPECIAL INSTRUC'TI()N,S: CONTRACT TrRMS:
1. Repiurc damaged pl3wuod 2t32-5111 per S.F_ as required by City Inspector.
2_ Any electrical or plu[ubteg work will be billed at 575.00 per man per hour, 10% Upon award or Contract
3. Disconnect and reconnect A/C at S 650.00 each 40% Upon Progress
A- DSaeannect pnd recoaneet swap cooler at S 450.00 cath 50°% Upon Comp4liou
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Bin # f
City of La Quinta
Building W Safety Division
Permit-#
--P.O. -Box '1504; -78=495 -Calle Tampico ---- -- --`� — - _
La Quinta, CA 92253 - (760) 777-7012
Building Permit APPlication and Tracking Sheet
Project Address: �3 7
Owner's Name: X
A. P. Number:
Address:
Legal Description:
City, ST, Zip: ><
Contractor: X Die&4
K GOf>�/�.�fj Telephone:
Address:,\\
-���!/
Project Description:
aty..sT. zip: 9Z��c
Telephone:. Z e
It
State Lic. # : X, ��G �—
City Lic. #:
Arch., Engr.. Designer:
Address:
City: ST, Zip:
Telephone: 4
1 !
'
C ons frac to
e: i
n Type: P Occupancy,
P ancy.
Sate Lic.
i
Name of Contact Person:
>>;„:: Project le
type (circle rcone • Ne%%• Add' n Alter Repair c
Demo
1-
�:>::. Sq. Ft.110':00Q
���/ `>
Telephone # of Contact Person:JC
/IG� #Stories: #Units:
.
t Estimated Value of Project: X �-
APPLICANT: DO NOT WRITE BELOW .THIS LINE
# Submittal Req'd
Rec'd TRACKING
Plan Sets
PERMIT FEES
Plan Check submitted
Structural Calcs.
Item Amount
Reviewed, ready for corrections
Truss Calcs.
Plan Check Deposit .
Called Contact Person Plan Check Balance,
Title 24 Calcs.
Plans picked up
Flood plain plan
Construction
Plans resubmitted
Grading plan
Mechanical
2"d Review, ready for corrections/issue.
Subcontactor List
Electrical �
Called Contact Person
Grant Deed
Plumbing
Plans picked up
H.O.A. Approval
S.1 U.
Plans resubmitted
IN HOUSE:-
Grading
'ed Review, readv for corrections/issue 2l eloper Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
A.I.P.P.
Datc.of permit issue
School Fees
Total Permit Fees