06-1632 (RR)i
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00001632
Property Address: 78169 LAGO DR
APN: 646 -200 -021 -
Application description: RE -ROOF
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 14000
Applicant:
Tiht 4 4 Q"
Architect or Engineer:
r`.
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
Q
LICENSED CONTRACTOR'S 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 Class: C39 License No.: 33654
Date: °" -t tractor: A -L AX i
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).:
(_) 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 (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 contractorls) licensed
pursuant to the Contractors' State License Law.). '
1 ) 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: PC
LQPERMIT
MELVIN L
FILE
CA 99999
r SONS ROOFING
JMMIT DRIVE
INC, AL
CATHEDRAL CITY, CA 92234
(760)328-6616
Lic. No.: 336547
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/25/06
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 -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 VIRGINIA SURETY Policy Number 1CW50109602
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
-,� �(,,.� %�377000�of the Labor Code, I shall forthwith comply with those provisions.
S fe: �� cant: ' Mc LC L SC}-AJS iZ f y
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 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 comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of i ountty too enter upon the above-mentioned pr for
inspection purposes.
0'0
Date azure (APPticant or Agentl: _ �`�"�
:S
Application Number . . . . . 06-00001632
Permit ... . RE -ROOF
Additional desc .
Permit Fee . . . . 30.00.
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
ExpirationDate 10/22/06
Qty Unit Charge Per
Extension
BASE FEE
30.00-
----------------------------------------------------------------------------
Special Notes and Comments
INSTALL FIBERTITE SINGLE PLY -OVER
EXISTING ROOFS, LIFT A/C UNITS &
REINSTALL BY CRANK
Fee summary Charged Paid
--- ------ ----------
Credited
---------- ----------
Due
-----------------
Permit Fee Total 30.00
.00
.00
30.00
Plan Check Total .00
.00
.00
.00
Grand Total 30.00
.00
.00
'30.00
LQPERMIT
B'° #
City of La Quinta
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: LA -6D I Z
Owner's Name: MCL 13F
A. P. Number: a00 Q Z(
Address:
Legal Description: /1 -Ir- —IS ( (m -c( 1i 60 bg
Contractor: 1 �I. f j f�
City, ST, Zip: � �� I tl,� C# -q2 24 -7
Telephone: �
Address: `1 0 r
Project Description:
City, ST, Zip: ' 2AL4 %l
i't��1E�j11 4,-,U A'S -t -m T5ws
Telephone: 3'�'Ib (�1
' .
t , --n��
State Lie. # : City Lie. #:
Arch., Engr., Designer:
N �t tn-L �i A) &L
5�
Address:
ll m rr i.
City, ST, Zip:
Telephone:
State Lie. #:JIM
Name of Contact Person:
Construction Type:
YP �,�- /ZO�� Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 7i � O l �l. e`( 1
Estimated Value of Project:
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
2" Review, ready for correctionsrssue
Electrical
Subcontactor. List
Called Contact Person
Plumbing
Grant Deed
Plans 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
1.
MAR -27-2006 MON 05:51 PM AL MILLER & SONS ROOFING FAX N0. 322556666 P. 03
AL ,LEIS AND SON'S ROOFING CO., INC.
`t.l3N"I'TER ROOFS FOR BETTER L1VIN(IF
68-760 SUMMITDIUVE, CATHEDRAL CITY, CA 92234
(760).146-121,1 FAX. (760) 321-7097
LICENSi!; )'1336547
PROPOS., AND CONTRACT
OvAl ;r: Met Benjamin Project: Benjamin Res
Address: 7A-169 J. ago Ar Address: 78-169 Lago Dr
City: La Quinta, CA 92247 City; La Quinta, CA 92247
Phonc:
Wi; PROPOSE, TO VURN1S11 THE hOU,OWING MATERIALS AND PI:RI'ORM AI,L LABOR TO ROOF TI Ili A4OVr. LOCATION .
Oil l.,Itonf,S'c��pe,nf_1Ynrk Erbertile.cinle�/yrun_c_}�s/en>:Roofin�c�n_tractorwillswc�lon5c_r�►rk
_._
eC�.(t> >nn[ end haul awRy_ Rootint; cuntrltctttr will tl>Icn insts►ll a Fihcrtitc �infulo my roof sem,wcr
ecix1n1l; r(>nf Usble tl►e Fgllc�win nl;>ttcrials. Qi>,c { U l?ycr 4. Mil Beiee Fihertite roafin 1n4Lc]ppLe.alIy
fastened over One 1 1 R -Tech insulation rnechanically fR.. encd over existing roof to wood roof
__.. _.L�_...--
der.k. Pric_r. i��cludes removing and reinst�tillitwp courses of the ax needed to instill flat roof system_,
illIS1a11 11eW cast irondrains,.removing and rcinsQall n�A/C anc� duclworl:, new A/C curl, new white
lydl c nitasil, rnaf j►ermiks taxes, and a manufacturer IQycnr was ranly on malcriHls_ _
-� --- - Flat Roof. Price: S 7,500
�'itchPtnlif.S'rn�rc of N!nrk: filellkgles removiil� an�I reinstallin g !0 3000 srl 1t of,cxistin ltic ropy over
=l evo (1.� I yer Ati1'IW hase,shect nailed_to roof deckper malitp1 tures recommrndztinns_
Totgkl_Ronf Price: S 14 000.00
1Vnt( V!'n�kwar4ld rtgt start for aPProximsitcly 2 to 4 weeks from date of received sic ietl, contract._
Tcrm!e: Net Cash, on Com letipn late t.uck,,,�.., C4a,r,,L, �.�, C" h�,,il-A
_ .. R�a,,� tats, --k us1an. ,,,w,.t:J. c,Fos•- �^-� �essl�der
ATTENT10N AN +fe-samt c� _. V..,� �
Section 701 R orulc Contractors License Law pruvides that starlinl, July 1, 1966, everyone licetthe C.ontrutor's I-icentio luard shall
give a copy of the following notice to the paynr prior to receiving from the owner of the property or his agent any payment for work which it
coiiinlctor's license is rexluired NOTIC ria
"Under The nwcicuuics' Licn Law ,any subconlractor, laburer, suppli.a- or other per.on who helps to improve your property but is 1101 paid for
there work or supplies, h.is a right to enfurce it claim against your prnP4rty. This mcans that, utter z court hettring, your properly could ho sold
by it court oflicar ih1 the proceeds of dlu sale used 10 SatiSry 111e n1dL'btcdnc5S. 'I'llis can huNpcn MCI if you have paid your own coninictor in
full, if talc +ubtamir:letor, laborer, or Supplit•r remained unpaid "
AI Millet & Som IRoortnf Co., Inc. Agrees to (111-1111 its regular form GUARANI'F;1; for _2 Ycar, after contplcliort of its said work. Stud
gnruanlce 10 wver de.11:cis in material and Workmanship 0111y and not to extend to damage to roofing caused by [he elements, other nnusunl
Acts of Uud and shall not cover ally liability for damage to int.riurs fixture%, decorations, .walls. contents of building or other parts of %iniclurc
nil In dinllage of Iinllty c:onsmrlctiou. it is 31so uriderslwld and iter::d that the above guarantee shall be n1alle thea remain only when and if
11--WIM1,111 is Mado as a2,reed in this contract. Al Miller Rc Sons is not rcr ponsiblc for TV antennas ,
We 4r<: fully covered by Workmen's compensation and public liability insurance. Can-iers' names and policy nu,nbers arc available on request.
Any 111enitions or devinlions firont 1114 tlbuve spec ifical ions inv0lvinr extra cost ol'male.rial or lahor will only bo execuled upon wrillcn orders
liar sarric, and will become an cxtri churge over sutn mentioned in this proposal. All ngrcemcnis must be made in writing. This offer is valid for
one wNli- front [lie date of estimate mad is based On free access to building for direct loading frons nur truck, i'rices ore bused on ci.trreut cost (it'
Inalw•ial and Inbar, incr:atcs or decreases will be reflected at tittle of signing of contract. Al Miller & Sons is not responsible lbr tiny rlimilrc
W sidewalks, cnibs or drivuways. If there is any con(lict between this proposal, Land any olher contract or specification relating to the ahove
refircoced prnjcct the terms ofthis proposal shall prevail
A reeptcd:
11alc: A#4*, 'tejz ft
,4 mlccen 0 W 2oAf016 �, ►tvG
I#A Lt, 1001* eRVbY 19 AaWao
Aalwo *% ✓krt IN VAPAI
7f� t6'-A4W "'bbl. waw
fi , w� ra7ryW -to t
�rx �f�° •%WA110
Respectfully submitted,
At. MILLER & SONS ROOFING., INC.
By: Peter Turvey, Estimator
nn ti•: 03/27/2006