05-5563 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
0.5-00005563 j
53175 AVENIDA RAMIREZ
774-051-019-8 -000000-
RE-ROOF
COVE RESIDENTIAL
6258
Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MATLEY RICHARD W
53175 AVENIDA RAMIREZ
LA QUINTA, CA 92253
DEC 2 7 2005 LE SPECIALTY', INC.
P O. BOX 11257
�FINANCEREVY I,AQUINTA PALM DESERT, CA 92255
DE YT.
7 200-0811..
Lic'. No.: 810537
I hereby affirm under penalty of perjur that I am licensed oder provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the B sine nd Professi Is Code, and my License is in full force and effect.
License Class: C39 censeNo.: 810537
i
Date: � Contractor.— -
OWNER -BUILDER DECLARATION
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 oftheContractor's State
License Law.(Chapter 9 (commencing with Section 7000) of Division.3 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 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.). - -
1 1 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:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/27/05
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 RISK CO Policy Number WC4781792
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 agreethat, if I s Id become subject to the workers' compensation provisions of Section
3700 of the Laboi oil I shall forth-
ith c Iy with those provisions.
Date: v' Applicant1
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 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 laws relating to b i din onstruction, and by authorize representatives
of this
cun[^y�/[o enter upon the above-mentioned pro rty for nspectio p r S.
Datil' M r—Signature (Applicant or A"gent):! - � t
LQPERMIT
1
Application Number . . 05-00005563
PermitRE-ROOF
Additional desc .
Permit Fee . . . 30.00
Plan Check
Fee
.00
Issue Date .. . . .
Valuation
. . .
. 0
Expiration Date 6/25/06
Qty Unit Charge Per
Extension
BASE
FEE
30.-00
------------------------------
Speciai (Totes and Comments
------------------
------
---------- - - - - -:
REROOF-30 YR SHINGLES. CLASS "A"
MATERIALS ONLY.
Fee summary Charged
Paid Credited
Due
r.-------------------------------------
----------
----------
Permit Fee Total 30.00
.00
.00
30.00
Plan Check Total .00
.00
.00
.00
Grand Total 30.00
.00
.00
30.00
�y
LQPERMIT
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Trackin; Sheet
Permit #
Project Address: W . :
Owner's Name:
A. P. Number:
Address: ( 7Y E - 2v l K4 ( re--�
Legal Description:
Contractor:
City, ST, Zip: c
Telephone: 0 _ z
Address: 2
Project Description:
City, ST, Zip:
Telephone:
State Lic. # :a(05 Zj City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n. ete . Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Projec ''� CX)
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
.Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy 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 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.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Perrrit Fees
XxiX0�:...:. -
Contractors State.License #810537.
P.O.Box 11257 Palm Desert, CA 92255
Phone 760-200-0811 Fax 760-200-0801
A proposal submitted to: RICHARD MATLY
Mailing address: 53-175 AVENIDA RAMIREZ; LA QUINTA CA 92253
Job Address: SAME AS ABOVE
Phone: 760-485-4218
Description of work to be performed: TEAR OFF EXISTINGTAR AND GRAVEL ROOF AND DISPOSE `OF
DEBRIS.NAILI LAYER 15# SHINGLE LINER FOLLOWED BY NEW PERIMETER METAL AND ROOF JACKS
AT ALL- PENETRATIONS. INSTALL 30 YR. SHINGLE TO'MANUFACTURES SPEC'S..PAINT ALL ROOF JACKS
TO MATCH ROOF EXCLUDING PERIMETERIVIETAL.
IF NOT ACCEPTED IN 30 -DAYS THIS PROPOSAL IS NULL, AND VOID
Note: In keeping with .industry standards: 1. this guarantee does not cover any damage to the interior or exterior on which
the roof is applied or damage to any contents therein. This guarantee does hot 'cover damage to -roof due to. any cause
beyond our, control. including; but not limited to: fire, lightning; windstorm, hailstorm, antennEs or other equipment, foot
traffic on roof, structural fault or'settlement;: crack'ing� oT-other failure'ofroof deck, walls' odor- dation of the building on
which the roof is applied. 2: Should it becoine necessary fgr'the:roofing .contracto ' to.remove.and/ or reinstall any.
antennas, cooling or heating appliances or other equipment,.whether or not an additional charge is made for such work,
the customer understands that neither RTS (Roof Tile Specialty, In nor the7installer assumes any responsibility for the:
performance of said equipment. 3. RTS (Roof Tile Specialty, Inc.) does not assume any responsibil =ty for corrections of
existing code violations or for the repairs of any existing, defects unless :specified in estimate -,and proposal.
Total Cost: $6,258.00 Terms'paid on completion unless :otherwise specified in the contrect. If not accepted in thirty
days this proposal is invalid. Extra $55.00 per sheet of plywood -if needed.. .
Acceptance: You are here by authorized to furnish all contents written in the contractto complete work mentioned in the
proposal',contraci for which I/we agree to pay the amount mentioned, iri said proposal, and according to terms thereof,
.(initial). If a.leakage; caused by defects in workmanship, occurs within TEN years from date of application, we
will repair defects free of charge.
Installation: It is understood that by the acceptance of this proposal you authorize RTS (Roof Cile Specialty, Inc.) to make.
the installation; to issue work orders with specifications shown herein and to pay our charge for such installation. You
agree to pay the amount specified herein, which will. cover the..price of said material and labor charge. This estimate is
based on a complete job and any surplus material remains,property,of RTS (Roof Tile. Specialty, Inc.). Verbal understanding
and agreements with representatives shall not be binding unless set forth herein. There shall.. be no liabilities for delays in,
or failure to complete, deliver or installation of all or any of the herein mentioned merchandise, if due to fire, strikes, war,
government regulations or any cause beyond our contract. Anychanges made by you in specifications herein;
necessitating additional materials or labor shall not be included or covered by this proposal, but shall be provided for
under separate, and additional order from you. (initial)
Arbitration of Disputes: Any controversy or claim. arising out of or relating to this contract, or the bre ach_thereof, shall
settled by arbitrator in accordance with the applicable Construction Industry Arbitrator Rules of the AmericanArbitration
Association which are in effect at the time the demand for arbitration is filed. A judgment award based upon the evidence
presented by the party (ies) who do (does) appear and participate, Notwithstanding Contractor's right to arbitrate, contractor
does not waive any of its lien rights. In the event of defau'l'0y client in payment *of the amount'due hereunder, client
agrees to pay reasonable attorneys' fees and cost incurred in connection with collection of said amounts whether or not
suit is field. 1.5% per month and/or an annual percentage of 18:01/owill b6`charged on all past due accounts:'Contractors
are required bylaw to be licensed and'regulated'by the Contractor's State'Board. Any questions concernin1.g a'contractor
may be referred to the register•of the board whose address is: Contractors"State Licenses Board, 9835 Goathe road,
Sacramento, CA 95827. Mailing address: P.O. Box 26000, Sacramento, CA 95826.
The above prices, specifications and conditions are satisfactory and are hereby accepted.
Owner's Signature Date
(or authorized representative)
'*AContractor's Signature Date moi. 06
,�