0110-156 (RR)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License #' Lic. Class Exp. Date
'1113 0#0 19
Date Z� A I Signature of Contracto±P�'s ' ✓�°�� �I; '' r�
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed,
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section , B&P.C. for this reason
Date . Signature of Owner
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 & policy no. are:
Cartier ,! c.A.yg F1:�jq) Policy No. 16424-0-01
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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
subject to the workers' compensation -,provisions of Section 3700 of the Labor
Code, I shall forthwith comply with;tho a provisionsr'
Date: 4 d d Applicant /�✓`�' :,.�;.0 + , r
f V—
,
•
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the, above- mentioned prope9for ipspectio ,purpgses.
Signature (Owner/Agent), �7-�%t� Date �y
-'BU'ILOING PERMIT PERMIT#
01 QED
DATE VALUATION LOT TRACT
JOB SITE
ADDRESS so. f) c.Yigux 0,.0 o
APN
OWNER
CONTRACTOR / DESIGNER ENGINEER
dyMMyy SSAyyMN --' '�
CKpRO100TwO�
,
50.6351 f'Al2Z QX =0
K.-.597 NUMIS AVE, 0302 X110 Ch 92201
4.+A 42253
W .10 Cry 9 201
(161)902.8602 f ',.6525
USE PERMIT
ttOFFg{p�y(
C,:T:G,6Y,Ce(FtL'S+i/ W.1L.1ll.S'Y45
iAt t (LESS THAN4 WSAME,t3). Cf, .13- M7 0 L'
i�0� �,aSFt,t101f
IU)€'f(t1Ea' MID w 01SIr OF CONS" TFMON
PERMIT FEE 6UMM"lly
RMOO.+ FEE 101-000418-000 54�U.1)0
Azao�
OCT 12
CITY OF LA 0111IMTA
e
i
WS -707W, G°CDMk':ia;@;TCIION AND 1-Y!—W ("MECYC
$30.00
..ESS 1"'RE-FMIDFTM
{D.pfj
TOTAL Pirl&t1'rw ; ES DU3,.", HOW
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RECEIPT
DATEBY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts .
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap'
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
W,.
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
License No. -787029
CASTRO ROOF
P.O. Box 126
Indio,Ca 92202
(760)902-8602 (760)775-96
CONTRACT PROPOS
LA QUINTA REAL ESTATE`S
RUPERT E. YESSAYIAN
Broker
78-023 CALLE ESTADO (760) 564-4218
(across from Post Office) fax 564-4328
LA QUINTA, CA 92253 t7 7s-
Contractor: - PEDRO CASTRO Address: 50-630 Calle Quito.
Owner: RUPERT YESSAYIAN Job Site: La Quinta Ca 92253
WE PROPOSE AND AGREE to furnish required labor and material for Remove old r o D f &-reroof .
ANY BAD SHEETING..NOT.INCLUDED IN THIS BID.
(Eaglelite Malibu/color #449 -Santa Paula
for the above named building using Light weight tile, 1 layer #40 base.drig edge,
APP torch on,.tile-pan,. aluminum flashings.
accordance with submitted plans and specifications, for the sum of
FIVE THOUSAND TWO HUNDRED FIFTY DOLLARS. (85;'250. ) Dollars
charge.•n• s . .- - •t. jacks — jarimary f -n he • . -•
Its site - • • • F-MMUM walm• - 11 •as I u ZAR WXVEo-im;?Emswom- • 11111F.Were • • u. • -
• •• • • • •• •fit! - •� • �- •� • •- • - ►• • ••
Contractorto haul off all.debris.
IF YOU WISH THE WORK TO BE DONE, SIGN THE CONTRACT PROPOSAL BELOW THE DATE AND ALSO ON THE BACK OF THE
SECOND SHEET, WHICH IS THE "NOTICE TO OWNER." WE ARE SENDING TWO (2) COPIES EACH OF THE CONTRACT PROPOSAL
AND NOTICE TO OWNER. PLEASE RETURN ONE (1)'COMPLETE SET TO US.
Approximate starting date:
Approximate completion date:
ALL PAYMENTS TO BE 100% ON COMPLETION UNLESS OTHERWISE SPECIFIED ABOVE.
NOTICE
"Under the Mechanics' Lien Law (California Code of Civil Procedure, Section 1181 at sect.),
any contractor, subcontractor, laborer, supplier or other person who helps to Improve your
property but is not paid for his work or supplies, has a right to enforce a claim against your
property. This means that, after a court hearing, your property could be sold by a court off bar
and the proceeds of the sale used to satisfy the Indebtedness. This can happen even If you have
paid your own contractor In full, If the subcontractor, laborer, or supplier remains unpaid."
.This agreement shall become binding only upon the Contractor's written acceptance hereof or upon the Contractor's commencing
performance and upon such acceptance or commencement of performance this shall constitute the entire contract and be binding upon the
parties hereto, there being no covenants, promises or agreements, written or oral, except as herein set forth.
It if further understood that:
(A) The Contractor shall not be responsible for damage or delay due to strikes, fires, accidents or other causes beyond his reasonable control.
(B) The proposal is limited to days acceptance from date hereof.
(C) The Purchaser is dealing with the Contractor as principal and that the Contractor Is not acting hereunder as the agent or representative
of any person, firm, or corporation.
PRICE SUBJECT TO CHANGE AT ANY TO REFLECT INCREASED MATERIAL PRICES.
Date y _ U
accept the above proposal.
`` - CASTRO ROOFING
By: Salesman
Approve
i
78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
January 3, 1991
To Whom It.May Concern:
The structure located at 50-630 Calle Quinto in La Quinta is in. a .
"AO" Flood Zone, depth 1 foot, according to F.E.M.A. flood,map,
parcel numbers 060709 0005 A.
Sincerely,
BUILDING AND SAFETY DEPARTMENT
Tom Hartung
Building and Safety Director
TH:es
LTRTH001
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253