0402-187 (BLCK)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
779799 C39 06/306�i1
mato-
Date 612 ��'r��Signature of Contractor ,.
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
S tion 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 STATE r"fJND . Policy No. 170469-P
J (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
3 subject to the workers' compensation provisions of�Section 3700 of the Labor
Code, I shall forthwith comply-with-th se prov&s&on .
S Date: _?Tri Applicant
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 property for inspection purposes.
Signature (Owner/Agent) _ _ Date
BUILDING PERMIT PERMI�j�48I;
DATE , VALUATION � LOT TRACT
JOB SITE ADDRESS C {P S9,4AJJ r ?A: I APN r ^
OWNER CONTRACTOR / DESIGNER / EN &NEER
COOK CP.SrR0 :RCt0FM1TG., STC,
48.690 SAN I'LUI 20 MREEVf F,O. BOXX 172
LA QII�1+ A CA 92233 THOT3SAND :d'AI:.:M-3 CA
(-760) .43.004" ER -A 2130
USE OF PERMIT
C1':r'rNL RAL1SG1if DINTO
R&ROOP WITH GLASS "AF "dl.F!`t E REA1.1S
VALUATION 16,394M LS..
EMt4!NXrED COSTOF C0MMIUC:gION 16,394.00
T'MtYUUT, ss RE su..f�t�'�URY
R&ROOP 1+VItt 101-000418-000
D Q
F=3 1 R 2004
CITY OF LA QUINTA
FINANCE DEPT.
rJU3- (YrA:L C':1)Mi:13.€ CI—ION AND P LAit 02-1:9)C51C f $.30.00
UPS FRE -PAID FEE3 $0.00
A 011-1- L F k`1%@i•9ul X FFAS D1 JE .PV'0W P50-00,
V
RECEIPT DATE ! BY DATE FIN LED INSPECT
&
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 ,'Z . — y
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
_
Fireplace T.O.
Fans & Controls
_
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
BLOCKWALL AP ROVALS
Final
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
r 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
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:
NF=:wv►cIF= 6Ww%W IMM
P.O. Bog 122, Thousand Palms, CA 92276
(760) 343-0042 - fax (760) 343-2097
License 779799
Mr. Cook
2012 Windward
New Port Beach, CA 92660
Re: Estimate Re -roof
Lake La Quinta
48-690 San Isidro
La Quinta, CA 92253
Tear off both flat and sloped roof systems and haul away. Substrate to be inspected for dry rot or
defective plywood panels and any found to be in need of replacement will be replaced at a rate of
$45.00 per sheet (4 X 8 X'/2), upon approval of owner or agents. Substrate to be inspected for loosened
or. non -flush to deck sheathing nails, any found will be driven flush, or completely pulled out, and re -
nailed using a new nail at a new location. Substrate to be cleaned and free of all debris, prior to new
roof installation.
On sloped roof Over sheathing install new, metal trim on perimeter as needed. At roof valleys install
one layer #40 felt, Over . felt install new valley metal. Over sheathing on sloped roof install one layer
#40 felt with primary pipe flashings nailed to secure. Over watertight membrane install new Eagle Tile
standard weight and colors, with secondary pipe flashing to manufactures specificsttions. Mortar all hip,
and ridges as needed and install the trim. Paint all pipe and vent flashings to match roof tile.
On low slop over tile (south side & back patio)
Install a built-up GAF four ply specification (or equal), consisting of installing dant strip on all roof to
wall transitions and tapered edge cant strip on all crickets as needed and one layer of #28 base sheet
nailed to hold in place. Over base install 3 -layers #11 ply sheet individually mopped with hot asphalt.
On top of new membrane, install new metal trim as needed and set in plastic ce 'ent staggered nailed
at 3" centers. Seal top of metal with two layers of #11 ply sheet, and hot asphA. All corners to be
sealed with Irish flax felt saturated with hot asphalt. In all angles install one layer:6f #72 fiberglass cap
sheets, back mopped and set in hot asphalt. Over entire watertight membrane flood coat with hot
asphalt and apply roofing granite at a rate of approximately 350 — 400 pounds per 100 square feet of
roof area.
Total Amount: $16,394.00
TERMS: 100% UPON COMPLE'T'ION, UNLESS OTHERWISE SPECIFIED IN THE CONTRACT.
FIVE (5) YEAR GUARANTEE AGAINST LEAKS WILL BE EFFECTIVE UPON FULL PAYMENT.
THIS PROPOSAL WILL BE NULL AND VOID AFTER 15 DAYS FROM DATE SUBMITTED.
Page 1 of 2 n
O U•
ALL DEBRIS CAUSED FROM ABOVE WORK TO BE DISCARDED AND AREA TO BE LEFT CLEAN.
JOB TO BE STARTED IN A TIMELY MANNER ACCORDING TO SCHEDULE AND WEATHER PERMITTING.
CONTRACTOR TO SUPPLY OWNER OR AGENT WITH CERTIFICATES OF LIABILITY, AND WORKERS COMPENSATION INSURANCE
UPON REQUEST.
WE PROPOSE TO FURNISH AND APPLY LABOR, MATERIALS, PERMITS, TRANSPORTATION, & TOOLS NECESSARY FOR COMPLETION
OF ROOFING WORK.
DURING THE ROOFING PROJECT CASTRO ROOFING WILL MAKE ALL ATTEMPTS TO MINIMIZE, BUT WILL NOT BE RESPONSIBLE
FOR DIRT, ROCK, OR DEBRIS THAT MAY FALL INTO LIVING AREAS. DAMAGES TO VENTS CONDUIT PIPES, OR CEILING MOUNTED
FDCrURES.
CONTRACTOR DOES NOT ASSUME ANY RESPONSIBILITY FOR CORRECTION OF EXISTING CODE VIOLATIONS OR FOR THE REPAIR
OF ANY EXISTING STRUCTURAL, DEFECTS UNLESS SPECIFIED IN THE PROPOSAL CONTRACT. DOES NOT INCLUDE
ARCHITECTURAL., ENGINEERING OR EXTRA WORK IF REQUIRED BY CITY.
IN THE EVENT SUIT IS BROUGHT TO ENFORCE THE TERMS OF THE CONTRACT, THE PREVAILING PARTY SHALL RECOVER ALL
COSTS EXPENDED, INCLUDING ATTORNEY FEES AS AN ELEMENT OF COST.
CONTRACTORS ARE REQUIRED BY LAW TO BE LICENSED AND REGULATED BY THE CONTRACTOR'S STATE LICENSE BOARD. ANY
QUESTIONS REFER TO: CONTRACTOR'S STATE LICENSED BOARD, 1020 "N" STREET, SACRAMENTO, CA 95814.
IF THIS ESTIMATE MEETS WITH YOUR APPROVAL, PLEASE INDICATE YOUR ACCEPTANCE BY SIGNING THIS COPY AND
RETURNING IT TO OUR OFFICE BY MAIL OR FAX. WE LOOK FORWARD TO WORKING WITH YOU.
Qu f t � c� /2-.,� •C- -(-s.. 1� e c'. {;� � (,,► , F'ti � Icy E -r S /,.... � f �' c�--. / rw,.1 u ., �-,9 ti. �.:r 1� � r., ,�.
.wr j l(M 'sca 'iL f..✓�,� �..i�...'l.;i. a...e •+a• . bt. faro "�7•�LI .JAI fqsl (v o p. �
4* C_CYu'cd� 'W.J�h ��. d!
�' � • r1 • � j• f y� � � ,�/_•bT •i'it % � .�, 'i/"4+'^ T U io'r"" C1wMG:� t r(i (", 'lc a.
Submitted by: Accepted By: 3tzba
J�
Richard Nastrol Presidnet Owner or agent
Submittal Date: December 3, 2003 'Acceptance Date: 12-,/
Page 2 of 2
48.690 San Isidro