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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