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06-0899 (RR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06-00000899 Property Address: 52920—AVENIDA RUBIO APN: 773-313-009-18 -000000- Application description: RE -ROOF Property Zoning: COVE RESIDENTIAL Application valuation: 5800 Applicant: Architect or En T4ht 4 stP Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: LORENZ 52920 AVENIDA RUBIO LA QUINTA, CA 92253' e� v MAp Q 6 6®06 Contractor: 1� LEHMAN ROOFING, INC. �� 12 WATER LILY WAY COTO DE LAZA, CA 92679 (949)888-1665 Lic. No.: 499608 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under .penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class C39 LicenseNo.: 499608 ate'ractor: 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 heor 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 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 Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/06/06 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 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 0000154-2006- 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 subjec o the workers' compensation provisions of Section /U 4700 of the Labor C . e/I s�ha�ll(forthw' co ply with those rovisions. to icant. 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 1$100,0001. 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 11 ti nd state that the above information is «act. I agree to comply with all city and co y ordinances ands laws relating to bu' ing construction, a hereby authorize representatives of thi ,V ter upon above-mentioned prop y for inspe tion p oses. te: nature (Applicant or Agent): A_ < < Application Number . . .. 06-00000899 Permit . . . RE -ROOF Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/02/06 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and Comments RE -ROOF WITH 30 YEAR SHINGLES Fee summary Charged ----------------- Paid Credited Due -------------------- Permit Fee Total 30.00 ---------- .00 ---------- .00 30.00 P1an.Check Total .00 .00 .00 .00 Grand Total 30.00 .00 .00 30.00 LQPERMIT FROM : LEHMAN LEHMAN ROOFING INC. 12 WATER LILY WAY COTO DE CAZA, CA 92679 TEL/FAX 949/888-1665 NAME/ADDRESS G{LLIAN 10NFS -- KELLER-WILLIAMS R. E. ITEM REROOF FAX NO. : 949 8Ie-1665 DESCRIPTION JOB SITE: 52-920 AVENIDA RUBIO, LA QUINTA TEAR OFF EXISTING ROCK ROOF TO PLYWOOD NAIL 1 LAYER 30# FELT OVER PLYWOOD INSTALL ALL GENERAL ROOF SHEET METAL WHERE NEEDED INSTALL 30 'YEAR COMPOSITION SHINGLES WITH TRIM PIECES SEAL. AND -PAINT ALL PIPE AND VENT FLASH INGS CLEAN AND HAUL AWAY ALL ROOFING DEBRIS S YEAR LABOR GUARANME CONTRACTOR WILL PROVIDE PERMITS EXTRA: ALL DRYOT AND DAMAGED WOOD WORK SHOULD NOT EXCEED AN ADDITIONAL $1,000.00 RESPECTIV PROPOSAL DATE VALID FOR 30 DAYS PLEASE SIGN AND RETURN BY MAIL OR FAX. THANK YOU Mar. 01 2006 10:03AM P1 PROPOSAL DATErESTIPBATE NO. i 02/10/'06 i 1879 TOTAL 5,800.00 CALIFORNIA STATE FUND - WORKERS COMPENSATION INSURANCE l GEMINI - LIABILITY INSURANCE I Total $5,800.00 Bin #; T City of: La Quints Building 8Z .Safety Division P -O: Box,t50'4, 78`495 Calle"Tampico U Quints,'CA�92253.- (760):777-70i Building Permit App(icationand Tracking Sheet Permit # Project Address: j�' ;.�` ` �Z �1� Cit/t, `'-" �-(v Owner's Name: �U �. ' . l i2LN z A. P. Number. Address: S Z ' I Z� /.� VLT 12,, 4,'0 Legal Description: ,( /J Contractor: L t%/l. f�'t�t it K7 /,V) .-In ' ��- City ; C� , ST Zip: �« Telephone: % Project Description: T Q Address: 1 (/1/ ✓� ¢-� .r' L-1 L-11 W City, ST, Zip:(fV7i Telephone.'NI -I&(, f 'vt-,3 0 T State Lic. # : `t. 0 CL 0 � !� City Lic: #: . Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #:Project Name of Contact Person: Ci v 3 Construction Type: Occupancy: 1' type (circle one): -New' ,Add'n Alter Repair ee7m Sq. Ft.: ries: ! # Units: Telephone # of Contact. Person:(�{ - 7 t (% - 2-Z Z� Estimaied Value of Pro1ect y ,r� ce- ©0 APPLICANT DO NOTMRITE BELOW THIS LINE # Submittal Req'd ". Rec'd TRACKING . PERMIT FEES Pian Sets Plan.C_ heck.submitfed-'`. •Item Amount Structural Calcs. r Reviewed; ready for corrections Plan Check Deposit Truss Calcs. 'Called Contact Person Plan Check Balance Energy Calcs. Plans picked up -:Construction Flood plain plan. i •Plans resubmitted Mechanical Grading. plan' •2°" Review;`ready for corrections�ssue .Electrical Subcontactor 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 corrections/issue Developer Impact Fee Planning ApprovalCalled Contact Person "A,I,p p Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees X ,: .