11-1046 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: -F1�0000:=1'046+
Property Address: 5'570'0`PINEHURST
APN: 775-241-010- -
Application description: RE -ROOF
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation:. 20000
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------=----------------------
LICENSED CONTRACTOR'S 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.
Lic seLlass: C39 L ens e 907600
Dater Contractor
OWNER -BUILDER - -
I hereby affirm under penalty of perjury that famexempt 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 of,the Contractor'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 fora permit subjects.the applicant to a civil penalty of not more than five, hundred dollars ($500).:
(_ I I, as owner, of. the property, or my employees with wages as their. sole compensation,.will do the work, and
the structurwis note intended oroiffeied for sale (Sec'. 7044, Business and Professions Code:' The
Contractors' State LicenseLaw 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 intendedoroffered 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.). '- • r .
(_ 1 1,'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. 8.&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:
LQPERMIT
5 S 4 70
VOICE (760) 777-7012
. FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/28/11
Owner:
PGA HOA
54320 -SOUTHERN HILLS
LA QUINTA, CA 92253.
. 1
Contractor: (�
BRS ROOFING INC or 03 2011
465 S. LUGO
SAN BERNARDINO., CA 92408 CITYpCi,4rVINTA.
(909.)496-3113' :,;T
_;T•....
Lic. No.: 907600
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-insurefor workers' compensation, as provided
for by Section 3700 of the Labor Code, for the, performance of the workcfor which this permit is
.issued - -
V__I have and. will mamtam 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 STATE FUND Policy Number 238403010
_ 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, it I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code; 1 shall forthwittrcom(pll�y with those provisions:
Da m-3— (( licant: ��LJ
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) IWADDITbWtO THE COST OF -COM PEN SATION y 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 building construction; and hereby authorize representatives
oft county to enter upon the above-mentioned property farms ties-pur .
r' 1 I
ate: � —� Si ature (App licant :
- -4
LQPEPMIT
Application Number . . . . . 11-00001046
Permit . . . RE -ROOF
Additional desc .
Permit Fee 30.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. .0
Expiration Date . . 3/26/12
Qty Unit Charge Per
Extension
BASE
FEE
30.00
-------------------------------------------------
Special Notes and Comments
--------------------------
REMOVE TILE, INSTALL NEW FELT
UNDERLAYMENT, REINSTALL ORIGINAL
TILE.
2010 CODES. THIS PERMIT INCLUDES
ADDRESS
55670 PINEHURST.
----------------------------------------------------------------------------
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
8/03/11
s
d Lic. #- 907000
v 6'A Bonded
4 F JCA and.
5 i Insured
379W, AVENUE, L, CALIMESA, CA 92320
PHONE: (909).496-3113.
- FAX: (909) 795-4370
ATTENTION. TO:
William Acevez
PROPOSAL FOR
PGA WEST
55700 &,55670-P.INEHURST
LA QUINTA'CA
SCOPE OF WORK :TO. BE: PERFORMED
9800 sq/ft
• Provide labor and material to remove existing two piece clay tile and store for re -use
•. Clear roof of all debris
• Remove existing felt underlayment down to plywood structure .
• Spot check deck as needed for any damaged plywood
Remove and replace any damaged or dry, rotted plywood at an additional cost of $55.00 per-
sheet(pot included in contract price) , .
• Provide and install anew duel.30# felt underlayrneni to entire roof surface mechanically fascine
with.a 1"round cap nail
• Provide and install a 24 gauge valley metal at all valley areas
• Provide and install.all new 24. gauge pipe flashings with a new aluminum pipe jack at all pipe
penetrations
• Provide and install 24.gauge 6"x4" pan.rnetal at all pan runs and around chimney area
• Provide and install as•ndede'd.new 24 gauge chimney, saddles -
• Replace all dormer vents and install new dormer venis.with a:24.gauge base flashing
• Re -install tile. back together using a 1.5" EG nail, at all span runs'arid .6" spike nail at all tops per
manufacturer specification
• Replace any damaged or broken tile, to match,as close as,.possible,to existing tile
• Provide and' install a new 7" 24 gauge T -top vents as needed
• Seal. all pipe penetrations with a urethane caulking
• Paint all pipe flashings, dormer vents,,T-top vents,to match'existing-til'e
• Provide and install a new Tera Cota.Mortar. mix at•all.ridge areas
• Clean all job related debris off of premises
19'
Bin. #
. .. .:. .
Cr of La urnta •
. tY Q, .
Stiff ng a SafetyDiylsion
Box 1.5 78-4950,111 Tampico
la.Qulnta, CA 92233 -,(760) 777 7012
Building Perrnit°Application and, Tracking Sheet
Permit #P.O..
`O
Project Address: '1C00 rLI�ltJ Owner's Name:.
A P. Number. ". Address:4.�e rA �j
.51f:3_Z.�. 500
Legal Description:City; ST, Zip: (:.q Q. (y t k L 14 9 zz 5.'
Contactor. ;�P ��"
K.7 IC,€Jvr.11�It%L Telephone:%O'=1� -�
Address: 7 Project Description: .
City, ST, Z'P' rSCI� , 6e4-�_V/ Cl d.1 V. Qrt vt_ O treF ( t
Telephone: 909— ?( -311 3 F
State Lic. # : .90 % % O 0 City'L#;ie
Arch., Fngr., Designer..L eB�
Address:
City., ST, Zip:
Telephone:
State Lie. #: .
:Constriction Type:. Occupancy:
'- Pioject type (circle one): New Add'n Alter Repair Demo
Sq. Ft.; #Stories: #Units:
Name of Contact Person:. .�(b w t-
Telephone #, of Contact Person:
Estimated Value of Project Q r. D d.Or b
APPLICANT: DO NOT WRITE.BELOW THIS LINE
#
Submittal.
'Pian Sets
Req'd
Reed
TRACMG
Plan Check submitted
PERMIT FEES
Item Amount
Structural Cales
Reviewed, ready for corrections
Plan Check Deposit, .
Truss Cake•
Called Contact Pelson
Plan Check Balance
Title 24 Calci.
Plans picked up;Ganstrucdon
Flood plain plan
Plans resubmitted .' , -
Mecharitcal
Grading plan
2'' Review, ready for corrections/issue
Electrical
Subeoutaetor List
Called Contact Person.
Plumbing
Grant Deed
Plans picked up.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE.,
''d Review; ready for correcdonaRsiue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit Issue
School Fees
16
LPermit Fees