BRER2015-000278-495 CALLE TAMPICO
D O.�i
VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/6/2015
Application Number:
BRER2015-0002
Owner:
Property Address:
52120 AVENIDA RUBIO
WILLIE JOHNSON
APN:
773213006
52120 AVENIDA RUBIO
Application Description:
REMOVE TILE INSTALL NEW UNDERLAYMENT
LA QUINTA, CA 92253
Property Zoning: .
Application Valuation:
$9,505.00
Applicant: Contractor:
FOAMBOND CORPORATION FI)EVELOPMENT
FOAMBOND CORPORATION
0 OUTSIDE CITY LIMITS 0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253 LA QUINTA, CA 92253
N ®6 209j(866)404-5440
TY OF LAWNTA Llc. No.::LIC-0107264
DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 {commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Claa License No,: :LIC -0107264
Date: r' Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempYfrom 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 Divon
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
permit subjects the applicant to a civil penalty of not more than five hundred dollar
($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.).
(_) 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 ) 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
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 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:- Policy Number: _
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.
15ate: //6/ l� Applicant:
1 11
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 Building Official 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 this city to enter upon the above-
mentioned prr perty for inspection purposes.
Date: b Signature (Applic t;�2nt)-.:
FINANCIAL INFORMATION
DESCRIPTIONk bAMOUNTrr�- 'PAID. , PAID`DATE.
BSAS SB1473 FEE 101-0000-20306 0
$1.00 $0.00
,; -- 3 ', ,,METHOD,," RECEIPT.,# -, CHECK# CLTD,BY-"
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
' DESCRIPTION ; _
C"
A CCOUNT °QTY
.>
,,. AMOUNT
.. :PAID- r""
.PAID DATE
RE -ROOF - EA ADDITIONAL 1,000 SF
101-0000-42404
0
$11.60
$0.00
METHOD r; ` ' t .
► .'RECEIPT #
- • CHECK #
-CLTD BY, `
DESCRIPTION
COUNT
'QTY
AMOUNT,
-i'PAID
PAID DATE
RE -ROOF - FIRST 2,000 SF
101-000042404
.0
$49.31
$0.00
'., PAID BY, ,..
' ^:: METHODC..`RE
_. _...
T #, f
CEIP ,.
,,. CHECK # ,",
_.
CLTD B,Y
.'_'ACCOUNTy
QT1
UNT.:O
AM_
.
PAID DATEDESCRIPTION'
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0
$98.62
$0.00
` PAID $Y :� '` '' :
' METHOD "�
'a RECEIPT # . ' °
' CHECK#
CLTD BY
Total Paid for RE -ROOF: $159.53 $0.00
TOTALS:.0 00
r
'
1
r,
Description: REMOVE TILE INSTALL NEW UNDERLAYMENT
Type: RE -ROOF Subtype:
Status: UNDER REVIEW
Applied: 1/6/2015 PJU
Approved:
Parcel No: 773213006 Site Address: 52120 AVENIDA RUBIO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 3
Lot: 17
Issued:
UNIT 1
Lot Scl Ft: 0 Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $9,505.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: REMOVE TILE INSTALL NEW 40 LB UNDERLAYMENT REINSTALL EXISTING TILE BACK 2013 CBC.TOTAL OF 2668 SQUARE FEET.
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
i QTY +- F rr r r , _ • ' METHOD PAID BY `CLT
D;
DESCRIPTION # ACCOUNT tAMOUNT Y `
i
_ PAID A ;PAID DATE RECEIPT #; CHECK #. :. V . - u ti, BY ?
BSAS SB1473 FEE 101-0000-20306 0 . $1.00 $0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
BSA: 1 $1.00 $0.00
Printed: Tuesday, January 06, 2015 9:27:09 AM 1 of 2
WHY SYSTEMS
DESCRIPTION _ .
r ACCOUNT
:QTY
AMOUNT
_,PAID.
PAID DATE
RECEIPT #
CHECK #,
METHOD
PAID BY
..
BY
RE -ROOF - EA
101-0000-42404
0
$11.60
$0.00
ADDITIONAL 1,000 SF
RE -ROOF - FIRST 2,000
101-0000-42404
0
$49.31
$0.00
SF
RE -ROOF - FIRST 2,000
101-0000-426000
$98.62
$0.00
SF PC
Total Paid for RE -ROOF: $159.53 $0.00
TOTALS:.• 00
REVIEWS
RETURNED STATUSu -REMARKS
REVIEW TYPE- -REVIEWER SENT DATE DUE.DATE ` �. ° • ` s 't` ' � "� �; NOTES n �
- s DATE _, , ;k
Printed: Tuesday, January 06, 2015 9:27:09 AM 2 of 2 CR
SYSTEMS
Iain #
01/ City of La Quint.
"Building U Safety Division
�G P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: f'2 ( 2 0 . J4ve r ���
Owner's Name: t /T e
O� w
A. P. Number:
Address: .2 Z A, A, ! D
Legal Description:
City, ST, Zip:LG Yew 44
Contractor: / P
/►d C -
0 6j-
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2--5-5- w• G
�
14Address:
ve—
City,ST, Zip: vwSolo' K
A. v
Telephone:
P ft - t-)6 Eo
»:>ss:;;:
94
iw5, a w%5�i r / C -
State Lie. # : 40 8 I
City Lie. #: s
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
'<^'' `"'' """''` ^ °° °` ^"
F :
Construction Type: Occupancy:
State Lie. #
Pro'ect a circle one): New Add'n Alter Repair Demo
J tyP ) P
Name of Contact Person: ,
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: _ �' , �
Estimated Value of Project: SO,�
APPLICANT: DO NOT WRITE BELOW THIS LINE
/1
Submittal
Req'd
Recd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H'.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'', Review, ready for correctionsgssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
C!;9O-A:M
C
0 N D
FOAM ROOFS
AND
WALL I. 4SO.LATioN
PROPOSALAND CONTRACT
Contractor: Foambond Roofing Corporation
Buyer: Willie Johnson
Address: 52.11.0 Avenida kubioJA Qui 0Aa,.QA 922.53 22.5 31
Telephone: (760) 285-5031
Email: BJess64(a-)aol.com
Date : Dedmber J 7, 2014
255.N-11 Cielo Suitd. 140-656
Palm nsorings,:CA 92262
Phone-, (866);404-5440
Fax.:.(760) 39875440
1i.cen§e,.:Nq.. 804171 C-39
FOAMBOND proposes to remove, existing .file,install
.,new underlaymentand reinstall existing the
onzpproximately 2,668 sq. f6et-of roof area.
TILER kON'EXISTING -ROOF.'
PR*E,PAR--V1A0N & JNST-A.LLAAM-N.-
Cleanplywoodsurfaceofexisting io6f,..on underlaymefit,dirt and debris
fr
2. Inspect all vents and pipe, flashings, install new ones if damaged 0r 'missing (base flashings as
,
well as aluminum flashings)
3..R6place: damaged wood-aill,85 a sq. -foot
4..Replace. 24QA dripedge, metal if.necessaryand also inspect chimney and secure saddle metal,
tile, pan apd.z=bafmeta.l
5. Removelx4from -ridge to cross new:underlayment and install. badk-overnew felt
6. Install new .40 lb. underlayment on entire surface.
T histal-1 new valleymetal oh. all: valleys (no existing metal)
8. ReinstalLexistin9roof tile back on roof-
-.
9.
Replace all damaged tiles; to mat h -as close:M:Do�si o the
c . ble t existiniz
10.. Add mastic and nails:as needed
11. Two piece filewill have cement added as needed
1 -4 -NAL WORK -
12. Paiintgsan
.all.flashin d:pippsi'to match.roof
�,
13. Remove all job related,trash from job site
14. Perf
orm:A final job walk With the Owner or Owhet?§ representative
W, �LRRANTIV-.
15. Installation w. ill -dury a 66 year labor warranty
r .
Price. and.paymentaerms ::10%upon contract acceptance. ,Balance: due on job completion.
TOTAL.PRICE FORTHIS SCOPE.OF WORK M1 $%, Q5.
Approved and:Accepted liy Owner:
Date FoamMid.Rep..
Alex ;C1ido, M$A,