HomeMy WebLinkAbout9711-021 (RR)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
235717 1,11i99
° Date j 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
pert rmance of the work for which this permit is issued.
SectI have and will maintain workers' compensation insurance, as required by
ion 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 Policy No.
-Ir I'A11I'VND
(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
S ubject to the workers' compensation provisions or Section 3700 of the Labor
Code, I shall forthwith comply with'those �provisi.orts./
\/Date: ',!'' ?.G"► Applicant ,0,-'4-
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 relating to the building ¢
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection ',purposes.
*ISignature (Owner/Agent) t `- Date
BUILDINGPERMIT PERMIT# CONTROL#
9711-021
DATE 11/7197 VALUATION ztiif.11o LOT TRACT
6309
JOB SITE
APN
ADDRESS 77-935 LAGO DIM,�l�i-^4�I�•1��11
OWNER
CONTRACTOR / DESIGNER / ENGINEER
JOIRI C PEPPI.111:
W1,SCI RN PACT[ IC P,001`11`10
110 F.W.).X 1654
3,162 LA.Ct1MMNA WAY
1.A QUI WA CA 92751
PALM SPK1Nt:iS CA !)12160
It+1�)1:t2ti•C�f}2u C IIIN1293
USE OF PERMIT
BUR I'DING
REAK VE, RMSTING WOOD Sim ROOFING. [Ni TALL WIX r -Ek
HNOtNE~IsF(HO GALL'S A'l' laI'1"t ?ilii) A}t1s i, INITYALL POLY VOMf OVER
GARi1OF AkEA i. iNCIAtf)FA lF WNTICAI, WR +Rig: AT 77-429 LA00 I -At
Ef—STINIXIND COST OF MN3THMMON,
PE32f<1MiT I -ET,, S fMMrl RY
Itl fst F"fi 1f)t-t)tiil-dlti-f30(1 SY1.0+)
J,'
Slilk-T(Yr'AF,C'ONSFROCTIC,)N Ail 1PLAN ICIIt:CK.
��,rK►
' r1 y • LESS ' PRE PAID FE I'S*
$0.00
�ul, rI a r
'1'Oi'AL 11'r'.I~tMI'1' >I EM441)iiE NMY
S34.IN)
N O V 1 b 1997
DATE
DTE FINALEDRECE
INSPECTOR
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
Final
POOLS - SPAS
BLOCKWALL P ROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
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
COMMENTS:
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)
15
October ?. 1997 '
WESTERIN M
Mr ,John Peppier
77-Lago Dr.
La Quinta, CA. 92253
Roofing
RE: Re -roofing Project;
Application of U.S. Clay Tile Roofing
Dear Mr. Peppier,
ECCITY OF LA QUINTA
IVIG & SAF=ETY DEPARTMENT
CONDITIONALLY
ACCEPTED FOR CONSTRUCTION
SUBJECT TO INSTALLATION AS PER
AND ALL APPLICABLE ODES
I BYL 2N
Thank you for the opportunity to inspect the roofing system on the above referenced property. Having
done so we are pleased to submit our recommendations. and the installation of a U.S. clay tile roofing
system. The recommended scope of work and associated costs are as follows:
GENERAL
Unless expressly stated to the contrary, the contractor shall be responsible for performing the following
acts.
DESCRIPTION
A. The general conditions of this standard construction contract shall form a part of these
specifications with the same force and effort as though repeated herein.
B. The contractor shall furnish all labor, materials, equipment, permits, contractor's licenses,
insurance certifications, etc., to perform all operations required and specified. The contractor
shall provide labor and material customarily included in work of the same nature to give a quality,
complete job.
C. If unexpected conditions are encountered during the work, and the conditions adversely affect the
cost or progress of the work, the contractor will notify the owner immediately, and the owner will
negotiate a change -order to resolve the unexpected condition.
D. The Contractor shall occupy, use, and permit others to use the premises only for the purpose of
completing the work to be performed under this contract with the Owner. The Contractor shall
not authorize or permit any other person to use said premises for any purpose whatsoever.
Western Pacific is to be given all reasonable set-up and staging areas.
E. Contractor's scope of work shall not include the identification, detection, abatement,
encapsulation or removal of asbestos or similar hazardous substances. If Contractor encounters
any such products or materials in the course of performing its work, or if such hazardous materials
are encountered by any other firm performing work at the jobsite and contractor determines that
such materials present a hazard to its employees, contractor shall have the right to discontinue its
work and remove its employees from the jobsite until such products or materials, and any hazards
connected therewith, are located and abated, encapsulated or removed, or it is determined that no
hazard exists ( as the case may require), and contractor shall receive an extension of time to
complete its work hereunder and compensation for delays encountered as a result of such situation
and correction.
3462 La Campana Way • Palm Springs, CA 92262 • (619) 416-5877 • Fax (619) 320-8912
'Mr. Peppier
Page 2
INSTALLATION OF A U.S. CLAY TILE ROOFING SYSTEM
PREPARATION -TEAR OFF
A. Remove all existing wood shake roofing, and composition base flashing.
B. In the event that roof removal or "tear -off is a part of this specification, all old roofing will be
removed down to the sheathing, with the exception of that material so firmly fixed to the
sheathing that continued attempts to remove it. could damage that sheathing. Under this condition,
the material will be left in place.
C. The exposed roof deck sheathing will be examined. Where sheathing is defective and when
authorized by the client's representative, remove and replace defective sheathing at a cost of
$45.00 per sheet or any portion thereof.
D. Clean roof of all debris.
APPLICATION OF U.S. CLAY TILE
A. Install two (2) layers of 940 organic base felt underlayment mechanically fastened.
B. Install new edge metal around the perimeter of the building (unpainted).
C. Install new galvanized roof flashings as necessary.
D. Install U.S. clay tiles to manufacturers' specifications.
E. Install U.S. clay bird stop.
F. Install new aluminum mailable secondary flashings in conjunction with the tile installation.
G. Install mortar at hip and ridge detail areas.
H. Install matching hip and ridge tiles to manufacturers' specifications.
CONTRACT AMOUNT
TOTAL CONTRACT AMOUNT: $9,825.00
WARRANTY
A five (5) year labor and materials warranty will be issued upon completion of the roof and fmal payment
is received.
PAYMENT TERMS
10% deposit upon approval of the contract Balance upon completion and paid within 10 days of receipt of
the invoice.
WESTERN PACIFIC
�Jra\ Roofing G-P---
Mr. Peppier
Page 3
The price quoted has been structured to reflect standards we assume are mutually desired: quality
installation, service reliability and long term performance. The price may be subject to chane 15 days
from the date of this proposal.
If you are in accordance with the conditions herein and the General Conditions enclosed, please execute the
agreement below and return both copies to this office. We will, in turn, sign them and return one copy to
you. Thank you for your cooperation in expediting this contract for your roofing needs.
NOTICE TO OWNER
Contractors are required by law to be licensed and regulated by the Contractor's State License Board.
Any questions concerning a contract may be referred to the Registrar, Contractor's State License Board,
P.O. Box 26000, Sacramento, California 95326.
ACKNOWLEDGMENT: Owner acknowledges that he has read and received a legible copy of this
agreement including all terms and standard provisions before any work is performed and that he has read
and received a legible copy of every other document that owner has signed during this negotiation. Uwe
hereby acknowledge under the penalty of perjury that Uwe am/are the legal owners and am/are authorized
to sign this contract as an agent of the legal owner.
ACCEPTANCE: The above prices, specifications and conditions are satisfactory and are hereby
If accepted. You are authorized to do the work as specified. Payment will be as outlined above. You,
the buyer may cancel this transaction at any time prior to midnight of the third business day after
the date of this transaction. See the attached Notice of Cancellation for an explanation of this right.
Owner has the right to require contractor to have a performance and payment bond.
HOMEOWNER �1
thorized Agent
/,�,Zf
Date
WESTERN PACIFIC ROOFING, CORP.
Authorized Agent
D/ 4-16 Cav►x,.c., J'L /o
Project Manager Date
WESTERN PACIFIC ROOFING HAS THE RIGHT TO RESCIND THIS CONTRACT WITHIN FIFTEEN DAYS OF'
ACCEPTANCE. THIS AGREEMENT IS NOT BINDING UNTIL ACCEPTED BY THE OFFICE MANAGEMENT AT
3462 LA CANIPANA WAY, PALM SPRINGS. CA 92262. NO CHANGES OR ADDITIONS TO THIS AGREEMENT
SHALL BE EFFECTIVE UNTIL APPROVED BY WESTERN PACIFIC :MANAGEMENT.
MANAGERS ACCEPTANCE: DATE
WESTERN PACIFIC
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