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LICENSED CONTRACTOR DECLARATION
I nereby affirm under penalty of perjury that I am licensed under provisions of
,hapter 9 ,(commencing with Section 7000) of Division 3 of the Business and
�rvfessionals Code, and my License is in full force and effect.
License # Lic. Class 'L'xp. Date
0250M C k) / W_W9 S
Date ^ ` Signature of Contractor A.. ,-":/Aj";„—I/Z,*”
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 37,00 of. the Labor Code, for the performance of the work for which this
p. 71bR Vx SIT4 1.tI�Y?t
permit is Issued. My workers' compensation insurance career & policy no. are:
Carrier Policy No.
(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, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
r Code, I shall forthwith comply with those provisions. f
Date: r- -er6 Applicant J -- '?✓ �`
Warning: Failure to secure Workers' G mpensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes. �• j
Signature (Owner/Agent)' i���. /� 'Date
BUILDING PERMIT
PERMIT#
t)6"01-°'93902
CONTROL#
DATE S/26/96 VALUATION 52-"(1-00 LOT
TRACT
JOB SITE SZ -160 UkRREfVZA
APN
ADDRESS
OWNER
CONTRACTOR/DESIGNER/ENGINEER
P1 11L RLIPUNT. 11'
UJI' M ROOFING
52-ioO CARRENZA
38W RikNI CHO LOS CO GMS
T,A QIANTA CA 42253
INDIO
CA 42201
t� 131,N 1:
USE OF PERMIT
0i~Nks;RA1, tit 1{{A)INt;
22(00 SF ills i{00F
iT•;,4'!'!i�'!�1"!'!:!) Cts.*ii'
;�'il!.itl(113 � f'l�,tti �IIt41A'f/�rt�f
(:1X� (.t�NS�-litit:'1'lt3i�
Z.'liHa.itil
il�flf•�(:rir f�C�.is ill! tftjf).iixtitx)
'$:98 tNi
4
;;4Jf3= •. 'c"►l+fS"TRLtL'i�E)N
ANIi i'1.�1N �'i11iC_'E:
$ 0 00o
41i'.1f, Nl;iiR'!!'!'
LESS IT -PAID VEEN
",N4 011M Ni3lY
$0.00
;S30,00
P ,
gy
RECEIPT
DATE
BY /`
DATE FINALED
INSPECTOR
Fre -PIT o ..�
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
Final'
POOLS - SPAS
BLOCKWALL APPROVALS
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
COMMENT'S:
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)
78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 - (760) 777-7000
FAX (760) 777-7101
TDD (760) 777-1227
December 10, 1997
Phil Burnett
52-160 Avenida Carranza
La Quinta, CA., 92253
RE: Re -roof Permit #9608-079 @ 52-160 Avenida Carranza
Dear Mr. Burnett.
The purpose of this letter is to inform you that your Re -roof Permit #9608-079, for the project at
52-160 Avenida Carranza, has expired. In accordance with 1994 UBC section 106.4.4, no
further work may be performed until a new permit has been issued.
Please contact Daniel P. Crawford Jr., Building Inspector I, at (760) 777-7012 to obtain any
information you need regarding a new permit and/or any required inspections. Should you
choose not to complete the project, we would then have to pursue any or all of the following
actions:
1) Abatement of the project through the City Attorney's Office and Code Compliance Division.
2) Notice of non -conforming structure placed upon property profile.
3) Action filed with Contractor State License Board. Optional if Owner/Builder.
Please contact us at your earliest convenience prior to 10 working days to resolve this issue, and
for any questions you may have.
Sincerely,
Mark Xold
Build.
�g & Safety Mana r
D niel P. Crawfor Jr.
Building Lispector I
cc: file
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MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253
CUSTOM ROOFING COMPANY CA LIC NO. 625038 PROPOSAL NO.: 1
38-980 RANCHO LOS COYOTES SHEET: 1
INDIO CA 92203
PHONE: (619) 345-3751
P R O P O S A L AND C O N T R A C T
Date: AUGUST 23, 1996
To: PHIL BURNETT Phone NO: (619) 771-1195
Mailing Address: City:
Job Address: -52-160 CORANZA City: LA QUINTA CA
SPECIFICATION AND UNDERSTANDING
Tear off roof and re -roof using new metal on edges, valley metal where needed,
1 layer base sheet, and 25 year limited warranty fiberglass architectrual
shingles. Custom Roofing Company is responsible for clean up and removal of
roofing debris from property.
SPECIAL INSTRUCTIONS AND NOTES: (1.) Any sheeting needed will be an extra
charge of $30.00 per sheet above contract price. (2.) A down payment may be
required. (3.) Any air conditioners, duct work, electrical, etc. that needs
moved or removed from roof will be the owner's responsibility above contract
prace.
FIVE (5) year guarantee against leaks on Custom Roofing Company's work.
NOTES: IN KEEPING WITH INDUSTRY STANDARDS:
(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, installation of
antennas or other equipment, foot traffic on roof, structural fault or
settlement, cracking or other failure of 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, customer understands that neither Custom Roofing Company, nor
installer assumes any responsibility for the performance of said equipment.
(3.) Custom Roofing Company does not assume any responsibility for existing
code violations or for the repair of any existing defects unless specified in
estimate and proposal.
TOTAL COST $2.900.00 PLUS COST OF SHEETING IF NEEDED.
TERMS: PAID IN FULL ON COMPLETION OF WORK DONE BY CUSTOM ROOFING COMPANY
UNLESS OTHERWISE SPECIFIED IN THE CONTRACT.
If not accepted within thirty (30) days this proposal is null and void.
JOB TO BE STARTED IN A TIMELY MANNER ACCORDING TO SCHEDULE AND WEATHER
CONDITIONS.
ACCEPTANCE: You are hereby authorized to furnish all contents written in
contract to complete work mentioned in the proposal and contract for which
I/We agree to pay the amount mentioned, in said proposal, and according to the
terms thereof.
INSTALLATION: It is understood that by the acceptance of this proposal you
authorize Custom Roofing Company to make the installation, to issue work order
with specifications shown herein and to pay our charge for such installation.
You agree to pay Custom Roofing Company the amount specified herein, which
will cover the price of said materials and labor charges. This estimate is
based on complete job and any surplus material remains the property of Custom
Roofing Company. 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,
governmental regulations, or any cause beyond our control. 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
under separate and additional order from you.
OWNER'S SIGNATURE
ATE:
CONTRACTOR'S SIGNATURE DATE:
(Please see notice on back)
"I', 11 IIA'
(S..elion 1010•-C-1,t,nut U,0n,t (ate)
Un'l,1 list Mfflun,e1, Ciro 1tv, any rlittle A(1nr, $Iekmim of fees, I,bour,
.i,lrnsn ,u often prrrnn -hit I., 1p, 111 isnpnsvr ymn lin Alae uY aml is
laid Ina hi, labor, ,rrvict0 oe laecaial. as a right fo enforce his
claim np� tines rates ptnPttty.
Ihsdtr 11+0 r„ay panel, )nur,rIf ag,inu fuel, claims by liling.
hrinrr sonun,n,ing tush �nrk �f impr..amtnr, at, nriRirul to #I see (.n
..ori nl inyn n•r mint al a mosldrufinn, rhe'rnf, in lire officr of tilt
C Oecmd.t M else (luny --,ere else" ptaperty it silsrt eff and
requiting slur a tnmr.cor't I ay...env bond be trcorded in tuck office.
S,id bond ,lull be in an ,,Amor not Ices than fifty pe,tenl (507-I of the
calefrate Itiice and 01911, in addition so anY coldiriont lar tilt
pet(menanct of tlw tonstaet, be cm lifioncd (at lite payment in full of flit
'I.;see, .>/ all pp.s,nno furnishing lab-, services, equipment or naterlalt
(or she +oil d ectibed in Iaid tonrract.
nuT Ice
"lludef lite I.Ifthsleiu' Litre 1 aw, any ta1l103fsa1, tobtnnsrutot, lah.,rrr,
supplier or Allier Perron w110 helps Ia bnpeove rout propculy bill It leaf paid
(ns Ilia work or supplies, has a right fa rnlmtt a claim 0g.6,11 yam.
Properly. This Israeli lost, slier a miler Mating, your ProhttlY tnultl hr
told by a cattle allicer and else proctr.dt of tilt lilt ustd w satisfy lisp
indrbudnrn, 1'Isia tan hal.peo evto i( you hart I•aid yon. nen tnntra.tns
in (Oil. if sitz tubcantractur, labour, ler Supplier remain ulepuid."
BUYER'S RIGHT TO CANCEL.
Y„(r nuy canctl flit &Settl.(tit at o((es trftnrd to abavt 111 any vilest pfim'Ia midnight of %lee duel day (eaclledit.g Sunday) slier rhe day Yen tigleed
rhe n11raernent or olfer. It You cancel street ym lure slteady nude some payment to flit teller, the teller It ctittdtJ to retain out of flet p3yrtfcnt, u a
cerutllaticen (oc, S percent of the cath price of site 1"I1 or scrti(es, but In no event may the teller retain more than fifteen Jollies 015).
Ym. may lite nosiu of reW.rllston 1 Waiting • tiF Alli nal dared nnrwent Is tilt teller at the addrrtt 6nliratpd. In police to lour 111-4 elf rhe
rnailirsl, it it rremnrnuukd that you rleail jilt sratestsrn, Iry regi•ctted at eerrilied nail. If you Jo so, you alotdd keep 'lit Blip fire Pott 01" c gist you
Notice To Owner
Undcr flit California hltchanics Licit Law any contractor, sulaconlfaclol, laboltr, supe•
lits or olhtt Ptlsnit 14110 hcIPI to jnlpf0vt your PI0(t(rly: bul is not paid (or his/lie, Murk ler
111P1,14l..list a Iighl to cnlorcc a claim against your propctty. "Phit mcartr that stiff a court
heating. Youl prnprrly could be Intel by a court officers and the procuds of the tale uenl to
satisfy she inJthledn(ee. llsit can Implicit even if you haver Paid your contractor ire lull if tilt
ntbronU atlou, labortr,, or sopplices remain unpaid.
'10 present Iherit tirhv to lilt s claim of litre a9ainsl you,property, eettainelaimmlle elect,
le
at fahcnaua,:lrert t nuptial %upp6col ate eequittd to prm(dt vote with m doeunfcnf tousled
-Viclintinsty 1406(e -.06F.6121 (lit pritexlfonlr3clots 0,111laboifrt lot %k3g(s(10nol have In
pnrvidr Otis nnrirr. A Ver6mitesty Malice it still a lien 119116111 vnor prsg1t11y. Ill Parpnic is to
nu,ify Yale lel prnuns who may blur a si9hi it, lilt a lirn araintl ymrt pinptrsy it IhcY art nor
paid(ticnttail),Ihcrosaistnnnlimrallnwtillotlilin9aclaimoflicnagainstyou'pfopcel)it
nirtctv (90) days alter eompleliun of your praitel.)
10 INSUIIF.'CX'IItA ritoIt:CTI(1N r011 VOMISF.I.F ANI) YOUll
1'IIOI'rI1TY, VOU hIAV WIMP 10 TAKt: ON.I: Oil MORE OF 1Ill:
FOLL(Iss'IhG Slrrsi
1. Ilrgoirc 11.31 your cuotraclor supply yoo with a payment and pctfnrnuncer hoad011*1 a
licrreec bund), which pinvidcs trial the bonding company will citllcr confpltle tilt
pnrjf(f or pay d3110aPet lilt to file smounl cellist bond. "Phis payment and petlornsmnce
lensed at acll a, a costly a( lite ennsituclion contract should be Writ with flit (aunty
cuotdrr pill your Intil+ty Pnrtectinn.
7 1t,qu,tt tut payments he madt di,,ety to n,beonfreetors and mattrinl nspplitu
trrtn,gb a joins clinical. Ales, joint conlreel agrtemfnl should inelvdc Plot atldcndure,
apl,rosed I -i, flit Relisuar of Cmrtnenap.
J. letter joint checks lar payofenl, mads our to built your estnlraelar and nthimsfuclast
Of Asteria) fteplsineinvolved its lite plaitelAhiswill htlpininlultlhalallprrsmednt
ptyostnl alt acpiall) paid. r
4• Alice making payment an a:,y eonsphOtd P1,31e of flit project, and hefutt ntmkiter seer
further Payments, require your cuntraelor Io pru%h)e lou with unconditional here
rel(111(I liFnrd by facts aflal(riml supphrs, fubennlraelor and Ialeorct involved in 11111
111104111 of lilt 14'utt Ina Which Payment lest made. On ploiccle int'nlving inp'ruvr-
nrfnst In a %inylt fancily rtvidenct or a duplea owned by individuals, lilt perunit
sigrsir.r lbric rrleap, Inter file ri9hl lie lilt a chine a911inel your psap:rly. In n0oe1 types
of c-emMicliore 110i prtfttetion mal• still be impnrunt, but may tint be at complctt. 10
11It01L(:I -1'Oltit%i:I.r UN01:lt THIS upIION YOki MI►Sr II@ CUR IAlN
I IIAI At.(. MAIURIAI. SUPPLIERS. SURCONIRAC"IORS UK LAIIUREIIS
PIAVE SIGNC,O.
AFITICABLE LAW:
Tlfis agrecnlenl, and all Isle tighls and obligations of tee Parties under this
Agreement, shall be govemed by the laws of the Slate of California.
CONSLQUCNTIAL DAMAGES:
Iluycr shall nal be entitled to recover any incidental or cunserluential damages
as Ilial Icons is defined to Commercial Code Seccllotr 2715.
ATTORNEY'S FEES:
In the event of liligali6l, arising out of this Agreement, or lite petfomlance or
Intetprclation lherto(, the court will award rtasonablt attorney's fees to the
prevailing patty.
NO OTIIUR AGREEMENT1
This Ag,ctnttnt is the full and final Agreement of lilt parliis, and no written or
oral conutiunicalion belweeu (Ile iemtits before the citeculion of this Agrtemenl
will modify or amend lite Agrctmenl. The Agreement may be neodifed only by a
wiMen document signed by boll, patties.
LIQUIDATED DAMAGES:
(1.1/211, 1'M MONTH SERVICE CIIARCE)
IN T III EVENT OF A fillrAC11 OF TIIF PAYMENT TERMS OF 1'1115
AGIII;EiefENT, ITIS ACIIEEI) TIIAT TIIF, SEI.I.61'S (CU ll -I IC7Y US1
ACTUAL DAMAGES CAUSED H SUC;II
A MICACI1 ARE DIFFICULT AND IMPRAL-TICAL TO DlilERMINE AND
INCI.IIUE, AMONG 01111:11 THINGS. ADMINISTRATIVE COSI:S FOIL
IIILLINC. ACCOUNTING FUII'AND C01.1.1 -A -11 W: PAST' DUE VAYPIENTS
AS WFIJ. AS 111 f•, COST TO SELLEII OF TIIE AMOUNTS PAST 1)(116.
AC'C()III)INGLY, HUYL'II A(:IIF.FS TO PAY SEI.I,F•,1( 1,101II11AT1:1)
DAMAGES AS OELINOLIENCY/SERVICE CIIAIIGF_S ON ALI, ACCOUNTS
('AST DUE. AT TIIF, RATE 01' 1.112 PEIIHN'T PI?li MONI.11 UNTIL )WO.
11115 IS ACIIF:F.O TU (IE A REASONABLE PtETI10U FOR FIXING
SELLUM'S DAMAULS SO AItISING,
'Arvy Cele"Ir rvsY a clolni.o,hlnp tad of or roUhp to lltls 0lxtlrr d.
r I110 brooch Ihrvnot, %lion bis soflhsd by 0,t)Ihosbt1 4s OODMitx,co
welly Ilio lln1100n Rubs f0t 1)n11ty DUS11xsu tlumcni Nlyltoflon. ted
Il rr lv(k onfonl uoun 11xs err w�Yd t Jfwd by Ra AdAlratfy (s) fy.tylr be
enttrn) ks any (: oust Aovinp wrtarklb(t II ttXtRy,'
4
t- C ! ti 4�,rd
US Postal Service
Receipt for Certified Mail
No Insurance Coverage Provided.
Do not use for International Mail See reverse
Sent to Phil Burnett
Street & Number
52-160 Ave. Carran a
Post Office State. Q & LP Code
La uanta, CA 9225
Postage $ .32
Certified Fee 1.35
Special Delivery Fee
Restricted Delivery Fee
Ln
Return Receipt Showing to
_ Whom & Date Delivered 1:10
Return Ree* S vAV to Whom,
Date, & Addressee's Address
0 TOTAL Postage & Fees $ 2.77
CV) Postmark or Date
ti
a
the right of the retL
it 4 04�
1504 - LA QUINTA, CALIFORNIA 92253
P 277 543 737
MAIL
7�-
Phil Burnett
52-160 Avenida Carranza
La Quinta, CA., 92253
irn AvPni(1a Carr"