08-0351 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING &. SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: C--08-00000351 `--�
Property Address: 78021 LAGO DR-
APN: 658-270-011-11 -3941 -
Application description: RE -ROOF
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 13125
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under pen "y
of perj at I am licensed under provisions of Chapter 9 (commencing with
Section. 000 f D'y�'isi 3 of the Busine ionals Code and my License is in full force and effect.
license
CIM
I sf�/Ci3if� Lrcens—e0537
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury 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.).
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project fSec.
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.).
1 _ 1 I am exempt under Sec. , BAP.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:
LQPERA11T
Owner:
LONG PETRY BARBARA M
78021 LAGO DRIVE
LA QUINTA, CA 92253
(
Contractor:
ROOF TILE SPECIALTY
P.O. BOX 11257
PALM DESERT, CA 9225
(760)200-0811
Lic. No.: 810537
-VOICE (760) 777-7012
- FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/26/08
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.
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 285073183
I certify that, in the perfor nce of or which this permit is issued, I shall not employ any
person in any manner so a ecome subje to the workers' compensation laws of California,
and agree that, if I should ome subject to th workers' compensation provisions of Section
Dater3700 of/Ahe Labor Code, 1 h II forthwith comply ith those provisions.
A qn1:
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 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'applicafion,
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 a and state that the above information is correct. I agree to comply with all
city and county ordinances and state relating to building construction, and hereby authorize representatives
of this ounty enter upon the bov me 'oned property for inspection purposes.
Dat 1��' Signature (Ap cant or Agent):
LQPERMIT
Application Number
. . . 08-00000351
Permit . .
. RE -ROOF
Additional desc .
Permit Fee
30.00
Plan Check
Fee
.00
Issue Date
Valuation
0
Expiration Date
8/24/08
Qty Unit Charge •Per
Extension
BASE
FEE
30.00
------------------------ ----
Special Notes and Comments
--------------------------------------
RE -ROOF WITH CLASS
"A" MATERIALS
Fee summary
-----------------
Charged
--------------------
Paid Credited•
--------------------
Due
Permit Fee Total
30.00
:00
.00
30.00
Plan Check.Total
.00
.00
d0
.00
Grand Total
30.00
.00
.00
30.00
4 �1( k Aad:
RT- S Roof Tile Specialty, Inc.
Contractors State License # 810537
P.O. Box 11257 Palm Desert, CA 92255
PHONE 760-200-08f 1 FAX 760-200-0801
A proposal submitted to: BARBARA LONG
Mailing Address: 78021 LAGO DR., LA QUINTA, CA 92253
Job Address: 78021 LAGO DR., LA QUINTA, CA 92253
Phone:
Description of work to be performed:
REROOF LOW SLOPE TILE AREAS. BELOW 3/12 REQUIRES ADDITIONAL HEAVY
UNDERLAYMENT.
REMOVE EXISTING ROOF TILE AND STACK. CLEAN TOP SURFACE OF EXISTING
UNDERLAYMENT AND INSTALL 2 LAYERS MULE HIDE MODIFIED PEEL AND STICK
TO PREPARED SURFACE. INSTALL NEW SHEET METAL AT ALL ROOF TO WALL
TRANSITIONS AS WELL AS SECONDARY FLASHING FOR H.V.A.C. AND PLUMBING
PENETRATIONS. REINSTALL EXISTING TILE TO MANUFACTURES SPECIFICATIONS.
ALL BROKEN TILE. WILL BE REPLACED WITH STACCO TILE TO MATCH.
70% Upon dry in and loading /30% upon completion
Ijnot accepted in 30 days this proposal is null and void
Note: Roofing is not warranteed and/or guaranteed until 100% complete. Please note Roof Tile Specialty, Inc. is not responsible for
delays in roofing materials or delivery dates. All debris caused from above work to be discarded and area to be left clean. 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, antennas or other equipment, foot traffic on roof, structural fault or settlement, cracking or
other failure of the 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, the customer understands that neither RTS (hoof Tile Specialty, Inc.) nor the installer assumes any
responsibility for the performance of said equipment. 3. RTS (hoof Tile specialty, Inc.) does not assume any responsibility for corrections
of existing code violations or for the repair of any existing defects unless specified in estimate and proposal.
Total Cost: $ 13,125.00 Terms paid on completion unless otherwise specified in the contract. If not accepted in thirty days this
proposal is invalid. Extra $55.00 per sheet of plywood if needed.
Acceptance: You are hereby authorized to furnish all contents written in the contract to complete work mentioned in the proposal
contract for which I/we agree to pay the amount mentioned, in said proposal, and according. to terms thereof, (initial). If a
leakage, caused by defects in workmanship, occurs within TEN YEARS (ON MAINTAINED ROOFS) years from date of
application, we will repair defects free of charge.
Installation: It is understood that by the acceptance of.this proposal you authorize RTS (Roof Tile specialty, Inc.) to make the installation;
to issue work orders with specifications shown herein and to pay our charge for such installation. You agree to pay the amount
specified herein, which will cover the price of said materials and labor charge. This estimate is based on a complete job and any
surplus material remains property of RTS (hoof Tile specialty, Inc.). 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, government regulations or any cause beyond our contract. 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. (initial)
Arbitration of Disputes: Any controversy or claim arising out of or relating to this contract, or the breach thereof, shall settled by
arbitrator in accordance withthe applicable Construction Industry Arbitrator Rules of the American Arbitration Association which are.
in effect at the time the demand for arbitration is filed. A judgment award based upon the evidence presented by the party(ies) who do
(does) appear and participate. Notwithstanding Contractor's right to arbitrate, contractor does not waive any of its lien rights. In the
event of default by client in payment of the amount due hereunder, client agrees to pay reasonable attorneys' fee's and cost incurred in
connection with collection of said amounts whether or not suit is filed. 1.5% per month and/or an annual percentage of 18.0% will be
charged on all past due accounts. Contractor's are required bylaw to be licensed and regulated by the Contractor's State Board. Any
questions concerning a contractor may be referred to the register of the board whose address is: Contractors State Licenses Board,
9835 Goathe Road, Sacramento, CA 95827. Mailing address: P.O. Box 26000, Sacramento, CA, 95826.
The above prices, specifications and conditions are satisfactory and are hereby accepted.
Owner's Signature Date:
(or authorized representative)
Contractor's Signature Date: 1 �lY
Bin #
City of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
U Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # i
Project Address:'
Owner's Name:
hcnQ
A. P. Number:
Address: V 2-1
O&C UV
Legal Description:
Contractor: - t 1, lVl
City, ST, Zip:
Telephone: - -
Project Description:
Address:
City, ST, Zip:
0qq
7
Telephone: 1
City Lic. #:
State Lic. #: l
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Construction Type: Occu anc
p y:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact -Person : 0 (
Estimated Value of Project: l
APPLICANT:
DO NOT WRITE BELOW THIS LINE .
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan,
Plans resubmitted
Mechanical
Grading, plan
god Review, ready for corrections/issue
Electrical
Subcontactor List
Called 'Contact Person
Plumbing
Grant'Deed
Pians.picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees