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08-0201 (RR)Applicant: T4ht 4 4 Q" 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 4wei^�and Professionals Code, and my License is in full force and effect. License Classl C39 /`\ \ License No.: 810537 ^` I Date Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the following reason ISec. 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 pursuantto 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 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 ISec. 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.). (_ l 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. , BAP.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: LQPER119IT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/29/08 Owner: PIPER MICHAEL 46770 CAMEO PALMS LA QUINTA,.CA 92253 ( D Contractor: ROOF TILE SPECIAL C.�qN 2 s zoos P.O. BOX 11257 PALM DESERT, CA 9 25 (760)200-0811 CITY OF LAQUINTA Lic. No.: 810537 FINANCEDF0, 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 STATE FUND Policy Number 285073183 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 t ecome subject to the workers' compensation laws of California, and agree that, if I shout ecom ubject to [he workers' compensation provisions of Section 3700 of the Labor Code I s all fort with comply with thos Date: Applicant: WARNIN : 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 appli n a to that the above information is c y with all city and county ordinances and t s relatin to building cons[ru nd hereby authorize representatives of this ounty o e ter pon the a ve- entioned p perty fo ection purposes. Date:\ ignature (Applicant or Agent): Application Number . . . . . 08-00000201 Permit . . . . . . RE -ROOF Additional desc . Permit Fee 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/27/08 k Qty Unit Charge Per Extension BASE FEE 30.00 ----------------------------------------------------------------------------- Special Notes and Comments RE -ROOF CLASS "A" MATERIALS HOT TAR TO SHINGLES. 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 i I I LQPERMIT _. . - Bin # B'"" City of La nuinta City of La Quinta Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Bulldft Permit Application and Tracking Sheet Permit #P � Project Address:' r Q Owner's Name: MY+ mos 01 oz I A. P. Number: Address: I -r Q_ Legal Descri n: City, ST, Zip: Contractor: Telephone: Address: X Project Description: City, ST, Zip: Telephone: I State Lie. # 6513City Arch., Engr., Designer: Lic. #: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: Project type (circle one): New. Add'n Alter Repair Demo State Lie. #: Name of Contact Person: �l� Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: O V. ' Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd 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:- 3" 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 Permit Fees RTS Roof Tile Specialty, Inc. Contractors State License # 810537 P.O. Box 11257 Palm Desert, CA 92255 PHONE 760-200-0811 FAX 760-200-0801 A proposal submitted to: MICHAEL PIPER Mailing Address: 46770 CAMEO PALMS DR., LA QUINTA, CA 92253 Job Address: SAME Phone: 564-1254 Description of work to be performed: TEAR OFF EXISTING 2 LAYERS ROOF AND DISPOSE. NAIL 1 LAYER 15# SHINGLE LINER OVER PREPARED SURFACE. INSTALL NEW ROOF JACKS AND ALL ROOF TO WALL SHEET METAL. INSTALL NEW 30YR. SHINGLES TO MANUFACTURES SPECIFICATIONS. PAINT ALL ROOF JACKS TO MATCH ROOF. 70% Upon dry in and loading 130% upon completion If not accepted in 30 days this proposal is null and void Note: Roofing is not warranteed and/or guaranteed until 100% complete. Please note Roof Tile Specialty, Inc. is not responsible for delays in'roofing materials or delivery dates. All debris caused from above work to be discarded and area to be left clean. 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 not cover damage to roof due to any cause beyond our control, including, but not limited to: fire, lightning, windstorm, hailstorm, antennas or other equipment, foot traffic on roof, structural fault or settlement, cracking or other failure of the roof deck, walls or foundation of the building on which the roof is applied. 2. Should it become necessary for the roofing contractor 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, Inc.) nor the installer assumes any responsibility for the performance of said equipment. 3. RTS (Roof Tile specialty, Inc.) does not assume any responsibility for corrections of existing code violations or for the repair of any existing defects unless specified in estimate and proposal. Total Cost: $ 5,270.00 Terms paid on completion unless otherwise specified in the contract. If not accepted in thirty days this proposal is invalid. Extra $55.00 per sheet of plywood if needed. Acceptance: You are hereby authorized to furnish all contents written in the contract to complete work mentioned in the proposal contract for which I/we agree to pay the amount mentioned, in 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 Tile 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 materials 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. Any changes 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 breach thereof, shall settled by arbitrator in accordance with the applicable Construction Industry Arbitrator Rules of the American Arbitration 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 default by client in payment of the amount due hereunder, client agrees to pay reasonable attorneys' fee's and cost incurred in connection with collection of said amounts whether or not suit is filed. 1.5% per month. and/or an annual percentage of 18.0% will be charged on all past due accounts. Contractor's are required bylaw to be licensed and regulated by the Contractor's State Board. Any questions concerning 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 (or authorized representative) Contractor's Signature Date: ,...... � - .. .Date:.