09-0769 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09-00000769
Property Address: 53133 AVENIDA RUBIO
APN: 774-042-019-7 -000000-
Application description: RE -ROOF
Property Zoning: COVE RESIDENTIAL
Application valuation: 3600
Applicant:*17
9
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
LARRY STUDEBAKER
53133 AVENIDA RUBIO
LA QUINTA, CA 92253
Contractor:
Architect, or Engineer: JESSE THE ROOFER' '
84503 CORTE CINDARELLA.
COACHELLA, CA 92236
(760)832-1670
Lic. No.: 927830
--------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION I WORKER'S COMPENSATION DE(
VOICE (760)777-7 12
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/15/09
I hereby affirm under penalty of perjury that I am licensed under. provisions. of Chapter 9 (commencing with
"business
I hereby affirm under penalty of perjury one of the following declarations: -
.Section7060)of Division 3 of the 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: C39 - license No.:.:'9 7830 -
_
for by Section 3700 of the Labor Code,.for.the_ perfoimance of the work for which this permit is
issued.
Date -7— 7Contractcr,. :1 _ .'•
_ I have and will maintain workers' compensation insurance- as required by Section 3700 of the Labor
1
Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION -' .'
` insurance carrier and policy number are:._ -• -
.I hereby affirm under penalty of perjury that I am exempt from the Cont -actor's State License Law for the
Carrier STATE --'FUND Policy .NUmber 238-11655-08 .
following reason`ISec: 7031.5;,Business and Professions Code: :Any, cityorcounty:thavrequires 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 structu're,” prior. to its issuance, also requires the applicant for the
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 subjectto the workers; compensation.provisions of "Section
License Law (Chapfer.9 (commencing with'Sectibn 7000) of Division 3 of the Business and Professions Code) or
3700 of tfie Labor Code, I shall forthwith comply with those provisions. ,
that fie"or. she is exempt therefrom and the basis for the,allege&exemption.- Any violation of Section 7031.5 by
�.ot
any applicant,for-a'permit subjects the applicant to a civil penalty of nmore than five hundred dollars ($5001.:
—Date: �—App
(_) 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: •Tlie -
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 CIVIL FINES 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 are not 'iritended 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.)
APPLICANT _ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively,contracting-with licensed contractors to construct the project (Sec. -
Idoes
IMPORTANT Application is hereby made to the Director. of Building and Safety for a, permit subject to the
7044;'Business and Professions Code: The Contractors' State License Law not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon,-antl who contracts for the projects with a contractor(s)-licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as -a result of this application,
1 _ I I am exempt under Sec. B.&P.C. for this reason
the owner, and the applicant, each agrees to,;and shall defend, indemnify and hold harmless the City
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
of La Qwnta, 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. 1 agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.-
OUa"te:� % o�gnature (A-pp� r Agent):�`-
Application Number . . . .
Permit . . . RE -ROOF
Additional desc . .
Permit Fee . . . . 30.00
Issue Date . . . .
Expiration Date . . 1/11/10
09-00000769
Plan Check Fee .
Valuation . . .
Qty Unit Charge Per
Extension
BASE FEE
30.00
----------------------------------------------------------------------------
Special Notes and Comments
RE -ROOF WITH CERTAINTEED APP TORCH
SYSTEM OVER EXISTING ROOF (3 PLY WITH
SNO-COAT). 2007 CODES
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS
ADMIN (SB1473)
1.00
Fee summary Charged Paid
Credited
Due
----------------- ---------- ------ -
Permit Fee Total 30.00
---
.00
---------- ----------
.00
30.00
Plan Check Total .00
.00
.00
.00
Other Fee Total 1.00
.00
.00
1.00
Grand Total 31.00
.00
.00
31.00
LQPERMIT
Product
Use
Application
Doverage
Weight `
Top
Specifications
FMAIL'
Method
`
Ibs./roll
Surfacing
ASTM a
BLACK DIAMOND' BASE SHEET ( el and
Base Sheet
Self Adhering
2 Sots.
75
Fine Black
FM
stick), a self-adhering SBS Modified ilumen
Interply Sheet
Mineral
UL G2
coated, fiber glass mat product. 60 mils.
Particles
ASTM D1970
GLASBASE` BASE SHEETBase
Sheet.
Mechanically Fastened,
3 sq.
75
Mineral
GTA-FR-C-B2
ASTM 04601,
Standard fiber 9 lass base sheet
Hot A5 hatL
Release
GTA-C-82
TypeII:
Cold Adhesive
Agent
GTA-C-B2
UL Type G2
'
-
GTA-FR-N-B2
GTA-N-132
•
STA-N-B2
FLEXIGLAS' BASE SHEET, an SBS
Base Sheet ,,,
Hot Asphalt.
3 Sqs.
90
Mineral
GTA-FR-C-B3
FM, UL G2
Modified fiber glass mat product
Interply Sheet' -
SBS Cold Adhesive'
&
' Release
GTA-FR-C-134
ASTM D4601
or Mechanically Fastened
2 Sqs.
60
Agent
GTA-FR-N-B3
Type II
GTA-FR-N-B4
GTA-C-B3
GTA-C-B4
STA-C-83
•
STA-C-84
GTA-N-B3
GTA-N-B4
STA-N-133
_
STA-N-134
FLEXIGLAS" FR BASE SHEET, an SBS,
Assemble with
Hot Asphalt,
1'/: Sq.
90
Mineral
FM
fire-resistant Bitumen product produced
FR CAP System
SBS Cold Adhesive'
Release
UL Class A
on a heavy duty glass mat and designed for hot
or
Agent
ASTM D6163
asphalt application with FR Cap Sheet
Mechanically Fastened
Grade S, Type I
FLINTLASTIC' GTA-FR', an APP, fire-resistant
Roofing Membrane
Torch Applied
1 Sq.
105
Mineral
GTA-FR-C-62
FM
Modified Bitumen product produced on a high
Granules
GTA-FR-C-B3
UL Class A
performance non-woven polyester mat, 4.2.mm.
GTA-FR-C-B4
ASTM D6222
GTA-FR-C-P3
Grade G
GTA-FR-C-P4
Type
GTA-FR-N-B2
GTA-FR-N-B3
GTA-FR-N-B4
GTA-FR-C-P3
'
-
GTA-FR-C-P6
FLIM LASTIC' GTA', an APP Modified -
Roofing Membrane
Torch Applied
1 Sq.
105
Mineral
GTA:-C-B2
FM
Bitumen with a high performance non-woven
Granules
GTA-C-134
UL Class A
polyester mat, 4.2 mm.
GTA-C-133
ASTM D6222
GTA-C-P3
Grade G
GTA-C-P4
Type I
GTA-N-B2
-
-
GTA-N-B3
GTA.N-B4
GTA-C-P3
GTA-C-P4
FUNTLASTIC'POLY SMS" BASE SHEET, an SBS
Base Sheet
Hot Asphalt,
:SBS
2 Sqs.
90
Mineral
FM, UL
Modified Bitumen coated polyester mat product
Interply Sheet
Cold Adhesive'
Release
ASTM 04601
or Mechanically Fastened
Agent
Type 11
FUNTLASTIC'ULTRA POLY SMS BASE SHEET, -
Base Sheet
Hot As halt,
1 Sq.
90
Mineral
FM/UL
a premium,heavy weight SBS Modified Bitumen,
Interply Sheet .
SBS.Co1d Adhesive'
Release
ASTM D6164
coated polyester mat product
or Mechanically Fastened
Agent
Grade S. Type I
;FUNTGL'A. S''P.LY=SHEET TYPE IV
Interply Felt
Hot Asphalt
. 5 sq.
38
GTA-FR-C-84
ASTM 02178,
Standard fiber glass ply sheet
-GTA-FR-C-P3
Type IV:
GTA-FR-C-P4
UL Type G1
GTA-FR-N-B4
GTA-C-134
GTA-C-P3
'
GTA-C-P4
STA-C-134
STA-C-P3
STA-C-P4
-
GTA-N-84
' -
-
-
STA-N-134
FLINTGLAS' PREMIUM PLY SHEET TYPE 6
Interply Felt
Hot Asphalt
5 sq.
48
GTA-FR-C-84
ASTM D2178,
Heavier, premium fiber glass ply sheet
GTA-FR-C-P3
Type VI;
'
-
GTA-FR-C-P4
UL Type GI
'
GTA-FR-N-B4
GTA-C-B4
GTA-C-P3
-
GTA-C-P4
STA-C-B4
STA-C-B4
STA-C-P3
STA-C-P4
GTA-N-B4
'
STA-N-B4
FUNTLASTIC' WHITE DIAMOND GTA',
Roofing Membrane
Torch Applied
1 Sq.
95
-Fine
FM
an APP Modified Bitumen with a
Mineral
UL Class A
high performance'non=woven polyester
Particles
ASTM D6222
mat, 4.0 mm.
Grade G. Type I
FUNTLASTIC' STA' and STA PLUS,:.
Roofing Membrane
Torch: Applied
1 Sq.
87
Talc
STA-C-B2
FM
an APP Modified Bitumen smooth surfaced
STA-C-B3
UL Class A
product constructed with a high performance
STA-C-84
ASTM D6222
non-woven polyester mat. 4 mm. & 4.5 mm.
STA-C-P3
Grade S
100
STA-C-P4
Type
•
(STA PLUS)
STA-N-132
STA-N-83
STA-N-84
STA-C-P3
STA-C-P4
FUNTCLAD' PREMIUM, an S&S ModifiedBitumenFlashing
Detail
'Torch Applied
1 Sq.
95
Foil Facing
ASTM D6798
roofing membrane surfaced with foil facing.
FLINTLASTIC' FR CAP T, an SBS: fire-resistant
Roofing Membrane
Torch Applied
1 Sq.
100
Mineral
FRBCT-C-B3
ASTM 06163
Modified Bitumen product produced on a
Granules
FRBCT-C-B4
Grade G
heavy duty glass mat.
FRBCT-C-P3
Type I
FRBCT-C-P4
FRBCT-,N-B3
'
FRBCT-N-B4
-wnsuit me ractory mutual uwoe, unaerwr¢ers Laooratones Uireclory or cenamteea for system requirements.
5/08 V111-1
Bin #
C►ty of La Quinta
Building i31 SafetyDivision
J P.O. Box 1504, 78-495,Calle Tampico
La Quinta, CA 92253--70 (760) 777'`12
Building^Permit Application and Tracking Sheet
Permit #
"1
Project Address:
Owner's Name:. �• S ��
A. P. Number:
Address: j' 3 ' JA44,L) f'
Legal Description:-.0ity,
ST, Zip: ' _ G C
Contractor: J s �- -
Te one:
le h
Address: 5-6 C_ ) r e, C Al
Project Description: .
City,. ST, Zip: G6),4CIi1 eZUf �/�T, � ��
�' p " Pf l0 • SILO .
G
Telephone: hone: 2— �
n
r
v C'J
State Lic. # : G Z % I
City Lic. #•:
A
Arch., Engr., Designer:
Address:
City., ST, Zip:
XXI
Telephone: hone:
State Lic.
Co n structioT
-type:
e:
mOccupancy:
P- roJe ct "
e (circle one): New Add'n n Alter Repair r Demo
P
Name of Contact Person:
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: tp%�
APPLICANT: DO NOT•WRITEBELOW THIS LINE
to
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check,submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
'PlawCheck Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up.
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading-,
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees