06-4391 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Application Number:
X0'6; O'0'Or0 9`l
Property Address:
52680 AVENIDA RUBIO
APN:
773-283-010-14 -000000-
Application description:
RE -ROOF ,
Property Zoning:
COVE RESIDENTIAL
Application valuation:
7500
Applicant:
T-iht
4'Q,"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
tP
Owner:
DAVID KRASTEL
52680 AVENIDA RUBIO
LA QUINTA, CA 92253
Contractor:
PRO TECH ROOFING INC
2947 W. LINCOLN ST, S
BANNING, CA 92220
(951)922-3446
Lic. No.: 741152
.VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Civ OF
Date: 12/27/06
272006
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' LICENSED CONTRACTOR'S DECLARATION
-------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions"of Chapter9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. -
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: 'C3 9 _ - License No.: 741152
. forby 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
Z
Code; for the performarice of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number are: -
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier EXEMPT- Policy Number EXEMPT
following reason .(Sec. 7031.5. Business and Professions Code: Any city or county that requires a permit to
✓ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure; prior to its issuance, also requires the applicant for the
yam' person in any manner so as to become subject to the workers' compensation laws of California,
,permit to file a signed. statement that he or. she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9,(commencing with Section 7000) of Division -116 the Business and Professions Code) or
3700 of the Labor Code, I.shall forthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption: Anyrviolation of Section 7031:5 by
any applicant for a permit subjects the applicant to a civil, penalty of not more.than five hundred dollars (55,001.:
ate:IZ�Z-7- i plicaril.
1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structuie is not intended or offered for sale (Sec.3044,.Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION'COVERAGE IS UNLAWFUL, AND SHALL -
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVILFINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or'herself.through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
:improvements ate:not intended or offered for sale. If, however, the building -or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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, asownerof 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 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.I.
Lender's Name:
Lender's Address:
LQPERMIT
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 aws relating to building construction, and hereby authorize representatives
of this county to enter upon the ove-mentioned property for inspection purposes.
- P(tDat A i ure (Applicant or Agent):
.LQPERMIT ..
Application Number . . . . . 06-00004391
Permit . . . RE -ROOF
Additional desc .
Permit Fee . . 30.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 6/25/07
Qty Unit Charge Pet
Extension
BASE
FEE
30.00
Special Notes and Comments
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---------------------
s,•. RE.=ROOF,WITH LIGHT WEIGHT TILE,
30 LBS.
FELT
Fee: summary Charged,
Paid Credited
Due
' Permit Fee Total 30.00..
.00._
.00
30:00'
Plan --Check Total 00
0:0 '
.00
0.0
Grand..Tota1: 30..00
00.:
.00
30..00
.LQPERMIT ..
Bin #
Ptybf La Q uinta
Building U Safety Division
P.O. Box 1504; 78-495 Calle Tampico
La.Quinta, Ck92253 - (760) 777-7012
Building Permit. Application and Tracking. Sheet
Permit #
Project Address:s Q
Owner's Name:
A. P. Number:
-
Address:c_75
Legal Description:
'
City, ST, Zip:: r --
Contractor: Q
— Cco
Telephone: —
Address: 7,& 7o
r*-- (6.
Project Description:
c
City, ST, Zip: c,lk)�'1•.
L ,
Telephone: b Q
State Lic. # :, 1
City Lic. #:
Arch., Engr., Designer:
Address:
.City, ST, Zip:
Telephone:Construction
State Lic. #:
Name of Contact Person:
Type: ccupancy:
:`Project type (circle one): New. Add'n t j`" 'Repair
Sq. Ft.:g2*6 O " # Stories: 0A- #Units:
Demo
Telephone # of Contact Person:
Estimated Value -of �%S0�-
Project:
J 0 -
APPLICANT: DO NOT WRITE. BELOW THIS LINE
#
Submittal
Req'd _.
Rec'd'
TRACKING.-
PERMIT FEES
Plan Sets
Plan Check submitted :
_ Item ..
Amount
Structural Calcs.
foo'Reviewed,
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked upConstruction
Flood plain plan
Plans resubmitted
Mechanical
Grading.plan
2' Review, ready for correetions/'issue
Electrical
Subcoi tactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I: '
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
3" Review, ready for. correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees