06-0514 (RR)fir►'
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
-APN:
Application description
PropertyZoning:
Application valuation:
Applicant:
06-00_000514
54550 AVENIDA RAMIREZ
774-281-003-22 -000000-
RE-ROOF
-COVE RESIDENTIAL
`11940
Architect or Engineer:
.� 1
u�ftGv
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SILLAS/HERNANDEZ
54550 AVENIDA RAMIREZ
LA QUINTA, CA 92253
Contractor:
PETRONELLA ROOFING
68314 KIELEY- ROAD
CATHEDRAL CITY, CA
(760)324-5482
Lic. No.: 460707
VOICE (760) 777-7012
FAX (760).777-7011
INSPECTIONS (760) 777-7153
e
ANY
FEB o Z. 2006
Date: 2/02/06
— — — — — — — — — - — — — — — — — — --- — — — — — — — — - — — — — —
_ LICENSED CONTRACTOR'S' DECLARATION ,
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — --- — — — — — — — — — — — —
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury that I_am licensed under provisions of Chapter9 (commencirig ;with
I hereby_ affirm under penalty of perjury'one of the following declarations:
Section 7000) of,"Division '3 of -the Business and Piofessionals"Code; nd my ` nse is in fulbforce and "effect.
I haveandwill maintain�a certificate of conserit,to self -insure -for workers' compensation, as provided -
L'icense Class C3 9 "" License 4 07 •
_
- for.by Section 3700 of the Labor Code, for the performance of the work for which this permit is
_ _.
.
litZ— Z oTractor: _ -
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 permitisissued. 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 Contractor's State License Law forthe
Carrier STATE- FUND,-'" Policy Number 18015.
following reasondSec. 7037 .S,Business and Professions Code: Any city or countythat _requires a.peTmitto . , .
_ (certify thaf;•in,the; performance of {hework for w ' 'this;p rmi .is issued Pshall not employ any:
✓construct, alter, improve demolish, or repair, any structure;: prior to its issuance, also requiies.the applicantfor the
" person in any Tannerso as to become subject 't a vers' campensati`on laws of CalifornjaJ
permit to file a`signeA.statement that:he'or she is licensed pursuant to the provisions$f-the Contract'or's;State
.and agree that, if I should become subject to t ', r s' co- pensation'provisions of Section `
License:Law (Chapter 9 (commencing with Section 7000).of Division 3'of'.thiTBusiness.and'ProfessioAs Code) or
3700 of the Labor Co
e, I shal ortliw'tir'�6tn ly' •i .those rovisions.
that he or sheis'exempt therefrom andthe basis for -the alleged exemption: Any violation of Section7031'.5 by
any applicant for a•permit subjects the applicant to a civil penalty. of not more than five hundred dollars (55,00).:
e: �z�o plicant:
( 1 1. as owner of the property, or myemployees with wages as their sole compensation, will do thewbrk, and
- -
the structure isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The �'
WARNING: -FAILURE TO SEC`RE�WORK ERS' 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 T.0 CRIMINAL PENALTIES AND CIVIL FINESUP TOONE HUNDRED THOUSAND
and who does.the work himself or herself through his or her own *employees,-provideo that the..
DOLLARSJ$100,000). IN ADDITION TO, THE COST OF COMPENSATION, DAMAGES AS PROVI6ED FOR IN
improvements are not intended or offered for sale.' If, however, the building or improvement is sold 'within
SECTION 3706 OF'THE LABOR CODE, INTEREST, AND ATTORNEWS•FEES.
one-year of'completion�the-owner-builder will°have the burden"of,proving that-he`or she`ditlnobbuildor,
•- -•" -' "- Y. - -
improve for the purpose of sale.):
APPLICANT ACKNOWLEDGEMENT
( 1 1, as owner of. the property, am exclusively contracting, with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made tothe Director of Building andSafetyfora permit subject to the
7044, Business,andLProfessions Code: The Contractors' State License Law does not apply to!an owner of
conditions and restrictions set forth on this, application. -
property who builds or improves thereon, and who contracts for the projects with a contractor(sl licensed
1 . Each person upon whose•behelf 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 am exempt under Sec. , BAP.C. for this reason
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. '
Date: Owner:
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
CORUCTI N LENDING AGENCY
permit to cancellation.
I hereby affirm under pe Ity of pe jury that there s ons tion lending agency for the performance of the
I certify that I have read this application and state that the above information is c r ec . I agr' to comply with all
work for which this per it is i su 7 Ci .) "-
city and county ordinances and state laws relating to building construction, and a author' a representatives
"
of this county to enter upon the above-mentioned property r ins ct.o a ..` '• ,
Lender's�Name: '�
"
� _
Date ignature (Applicant or Agentl:--
Lender's Ad ss:
/
LQPERMIT
LQPERMff .
Application Number . . . . . 06-00000514
Permit RE -ROOF
Additional desc -
Permit Fee . . . . 30.00
Plan Check
Fee
.00
•Issue Date . . . .
Valuation
0
- Expiration Date 8/01/06
Qty Unit. Charge Per
Extension
BASE
FEE-
3-0`:"G0
Special'Notes and . Comme_nts
�.
RE -ROOF• WITH...`EAGLELITE- TILE
- Fee summary,, Charged
Paid,, Credited
Due =
-
-- -------------
Permit;. Fee •Total 30•:00
:00
..00
30.00
Plan.- Check Total .. 00
.'00
00
.'00
Grand.Total 30.00
.:00
.00
30.00
LQPERMff .
FEB -02-2006 09:17 FROM:PETRONELLA ROOFING 17603284612 TO:97777112
P. 2/3
Corporate. Office: )Desert Office:
2626 Newport Blvd..68-314 Kieley Road
Costa Mesa, CA 92627' _ Cathedral Cit CA 92234
949.548'.1645 / Fax: 949:548-261'7 License #460707. 760.324.5482 /Fax! 70.328.4612
PE.TRONELAA 1400FING herein Li tert Illti idr lllc li,lkiwing listed lahor ntnterinis atld c(inanrcli,tn
NAME / OWN KR 'ROSARIO'SILLAS AND HENRY HirRNANDEZ PHONE "NO! .(310) 909-6436
REROOF PROJECT ADDRESS 54550' RAMTREZ:AVENUE
CITY, S'rATE & ZIP CODE LA QUIN`R'A, CA. 92253
BILLING ADDRESS:
CITY, STATE & ZIP CODE:
ADDITIONAL PHONE NUMBER: FAX NUMBER:
DLSCRIPTION OF LARnR`M'ATERULS AND MISL::'
I'Lii-nela.11,; K,wilin. trill fuunt=.I1 all Libor ;rte' Ina!rl'iitl f(1.'in�t:►It '
SCOPE.OF WORK
ROOF SYSTEM:: EAGLELITE TILE SPECIFICATION
Cost .................................... ...... • ............. $ 11,.940.00
C, �/� fit o �� •�..�
SPECIAL INSTRUCTIONS:: CONTRAC.'T-TF,RMS:
1. Replace damaged plywood at -'S2.50 per S K.' as required by crty,inspector.
2. A.ny'electrical, or" 'pluirllbang work wih,be*billed at'S75.00;per man per,ho'ur. 10%;Up9n award.of Contract
3. Replace fascia at $ 7.75 per L. F. 40% Upon Nrogresq
50% Upon Completion
TIp4F FOR tit AR DN(i AND C OMPLLTING PROJECTWui:k Shrill �uniuiencc %%ithin 'Len 00) days from the data• of s11i vides xp ailed citlua++r.'e
rand lie suklitwvolly completed in r(p�rs4x1n44' ly't6n.( Ill) +vnikipg.!jlys +11tH a8diliuitll limn to Ke ns dctndret sls Pma_aaPh0 al the
I CI'I115 Lonih Ltons and."'Not ice to t witty`: `un lltr,.nlek'hci'ec,f,•• Substlnlial (t>t nlieucalileul of%wrl., shAVhc dctin61 15 the incllllevun ol'MIN m:ncrt:ds'nnd•nI Inbol
C'uulractors 1hilurc to 5uhc:tanno lv'cnn mcncc mirk. +vilhout luwful cNcus'd. wtlhtn'awenty (30) dnt:9 ,frnill tll.� date specified. ahove Ir: n ciolnilm, of llic Contra,t-,r.;
ljcn nee I a+,
NOT K+ TO FiINFlt tI Du not sign this nereenieni beton cnn.:re'ad it,, (2) Yuu ard;:allitled.I,T,i'ILrnnplelalj filled ill Capt ol'this agrecnunt (Z) O++net
Aulhutizad Reshnncible piny :+cknimI&cfLe,, Iiu,lhey! +lie 11.11" lead' find4ecelml 11 lc ihlc^s-opy,ol',(lie '6is-1�reeillZOl sit_ir'd by (nntractor. mcludine all Tein),
Conditions Mid "Nnlice.u, Owner ,?n the rcYCrJc'cidi ' bcfiilc•Iny' wri* +v;rs done Ind thai'lle / site hi&read-drid recen•ed�n legible coley of even• doalmont that U+Vsas
Aulhorizc(l:Responslhle pxrl+ ha.: st¢ned'durillp the iieeo(ialiatis.44).YOL( TIIC'r3I1YF.FI:• k4AY CANCEL 'THIS TRANSACTION Al' ANY 'TIME PRIOR 1O
M117N1(iI IT (7P THE THIRD BUSINESS LUY AFFFR 'ME DAP OF 'I HIS 'I RANSACTION.BY NOTfFYINC. I HF .SFI LER. IN WRITING . AT I HH ABOVE
ADDRESS IN THF FVFNT Y01.1 THF BUYER FA -TO EXLRC`Ni rHIS+RIC.EIT AND S�
I.JT1-S >LIL'NI'I_1' AI FFNIPTS TO C'ANCFL. IHI\ ('ONTRAC)
.-MER THE crEci,i VE DA'rE ii- RFulNION I HE (:ON I RA(: 0R tiHAI.I HE Frrl H I. FT) TO RECOVM ALI. '0S l':ti AN[) Ll )ST 11k01 I IS AstiO( (:\TED
WI VH PHIS CONTRACT. (5) YOU. AS 6bVNE12 OR TENANT. HAVE'rliE RIGHT TO REOIIRL'. IHFI('ONTR,ACTOR TO IIAVF A PkRF(1MAN(:L ANI)
PAYMENT BOND OR' FI INDIN(i ('ON rk0l.'
NER / RES11ONSIMAE PARTY
_ r
Ill Nauit
A
p nlr!.Rechgtssi4le fart+ r signature
PRS.7,�
C'ONTRACPOR (SN:•1'I'V;lZ) CONTRACT PKICE
Prlriil ')Iir Ri `dingy :\iithnriz r Ft�pr s' nrativIiAlKhf Mime --
.� I:19�.110-
P, r191'tnoGt Allt l(4 iZtt7 I scntative: Sij imture
Vn+cmhu• 21 'QI15
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