09-0179 (RR)�F,
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,. CALIFORNIA 92253
Application Number: 09-0,0000179
Property Address: L50875 CALLE RONDO
APN: 770'693 -005 -28` -000000 -
Application description: RE -ROOF
Property Zoning: LOW DENSITY RESIDENTIAL
Appliaation Valuation: lOG13
Tl&f 4.4 Q�m&
Applicant: / Architect or. Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
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 Projossuanals Code, and my License is in full force and effect.
Lice se lass: C39 Lle nseNo.: 810537
Date: • �� Contractor:--
OWNER -BUILDER DECLARATION
I 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 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).:
(_) 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 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.). -
• (_) 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 aconstruction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERAIIT
N
Owner:
SMITH MICHAEL
50875 CALLE RONDO
LA QUINTA, CA 92253
(
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/02/09
Contractor:
ROOF TILE SPECIALTY. INC. D /a� Q
P.O. BOX 11257 "7j
PALM DESERT, CA 92255
(760)200-0811 FEB 272009
. Lic. No. 81053.7
�- CIF OFLA Otn..� _
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: -
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 238-0009889-08
_ 1 certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manne�oa become subject to the workers' compensation laws of California,
and agree that, if I stout eco a subject to the workers' compensation provisions of Section
3700 of the Labor C de, I s all f hwith comply with those r -
'-Date:'" Applicant:
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 law relating to building construction, and hereby authorize representatives
of this c unty t enter upon the above- a ti ed property for inspection purposes
Date: " \Signature (Applicant o Agent . y
r
(r
Application Number . . . . 09-00000179
Permit . . . . RE -ROOF
Additional desc
Permit Fee . . . 30.00 Plan Check Fee
.00
Issue Date . . Valuation . . .
. 0
Expiration Date 8/29/09
Qty Unit Charge Per
Extension
BASE FEE
30.00
------------------------------------------------ ---------------------------
qpqcj;Lj ynt-a_c nnri rnmmPnt-S
RE -ROOF REMOVE EXISTING -TAR & GRAVEL.
INSTALL NEW DRIP EDGE WITH 1 LAVER 40#
TILE NAILED TO ROOF.112007-CODE"
----------------------------------------------------------------------------
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
RTS
Roof_Tile Specialty, Inc.
Contractors State License # 810537
P.O. Box 11257 Palm Desert, CA 92255
PHON$ 760-200-0811 FAX 760-200-0801
A proposal submitted to: MIKE SMITH
Mailing Address: 50875 CALLE RONDO, LA QUINTA, CA 92253
Job Address: (SAME)
Phone: P-899-4165
REVISED BID: 12/15/08
Description of work to be performed:
TILE REROOF- `
REMOVE EXISTING TAR AND GRAVEL ROOF AND DISPOSE. INSTALL NEW'DRIP EDGE
WITH 1 LAYER 40# TILE LINER NAILED TO -ROOF SURFACE: INSTALL NEW VALLEY
METAL AND PRIMARY AND` SECONDARY FLASHINGS' FOR H:V.A.C'AND PLUMBING
PENETRATIONS. PAINT ROOF JACKS TO MATCH ROOF. INSTALL EAGLE LITE
CAPISTRANO LHC 8710 LADERA BLEND PER MANUFACTURES SPECIFICATIONS. CLEAN
PROPERTY OF ALL ROOFING DEBRIS AND DISPOSE. ENGINEERING AND PERMIT
INCLUDED.
70% Upon dry in and loading /30% upon completion
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 lefi clean.
In keeping with industry standards: 1. This guarantee does not cover any damage to the interior or-exter=or on which the roof is
applied or damage to any contents therein. This guarantee does not cover damage to roof due to any cau,-e beyond our control,'
including, -tint not limited to: fire, lightning, windstorm, hailstorm, antennas or other equipment, foot:traftlic 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 (Rz.of 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: $ 10,613.00 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 ' the proposal
contract for which Uwe agree to pay the amount mentioned, in said proposal, and according to terms thereof, P1. C (initial). If a
leakage, caused by defects in workmanship, occurs within TEN years from date of application, we will repair fects 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 anycause beyond our contract.
Any changes made by you'in specifications herein, necessitating additional materials bor 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 by.law to be licensed and regulated by the Contractor's State Board. Any
questions concerning a contractor may be re erred to the register of the board whose address is: Contractors State Licenses Board, .
9835 Goathe Road, Sacramento, CA 958 M 'ling address: P.O. Box 26000, Sacramento, CA, 95826.
The above prices, specifications and on P �a jS tory and are hereby accepted.
Owner's Signature
(or authorized representative)
Contractor's Signature
Date: / J40*8
Date:
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-4.95 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Q
Project Address: SCW1 i .)Mrdo
Owner's Name: rl'1 C rn —h
` J r /
A. P. Number:
Address:
Legal Description:
City, ST; Zip: `/( C .0 lG'
Contractor: 1
C1c,
Telephone:
Address: s, x `\2
Project Description:
City, ST, Zip: VekCpl�
Telephone!\
1
State Lic. # : `
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Name of Contact Person:
Q
Telephone # of Contact Person: -�45-.q ?
Estimated Value of Project: �b
APPLICANT: DO NOT WRITE BELOW THIS LINE
11
Submittal
Plan Sets
Req'd.
• Rec'd
TRACKING PERMIT FEES .
Plan Check submitted Item Amount
Structural Cates.
Reviewed, ready for corrections Plan Check Deposit
Truss Cates.
Called Contact Person Plan Check Balance
Energy Cales.
Plans picked up Consaruction
Flood plain plan
Plans resubmitted Mectanical
Grading plan
2'" Review, ready for corrections/issue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
3" Review, ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A.IP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees