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07-2598 (RR)P.O..BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 -Application Number: 07-00002598 Property Address: 78467 CALLE SEAMA APN: 646-192-003- - Application description: RE -ROOF Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 6750 Applicant: c&ht 4`4 Qum& Architect or Engineer: 0[k 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. License Class: C39 License No.: 336547 Date: oqkg' '`Contractor: r &_,#wt,Ll��`�—� Sc 5 B�u°c<<•.r?� / 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).: 1 _ 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 (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 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 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 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 Owner: WATT RESIDENCE 78-467 CALLE SEAMA LA QUINTA, CA 92253 Contractor: MILLER & SONS ROOFING 68760 SUMMIT DRIVE CATHEDRAL CITY, CA 922 (760)328-6616 Lic. No.: 336547 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/25/07 Ll AL SEP 5 2007 CITY OF LA e-21 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 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 0002574-2006 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 Co nshall forthwith ply with those provisions. Date:i� 7Applicant:..C1 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE S UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned y inspection purpo� Date: %� Signature (Applicant or ' r Application Number 07-00002598 Permit RE -ROOF Additional desc . Permit Fee 30.00 Plan Check Fee .00 Issue Date. Valuation . . . . 0 Expiration Date 3/23/08 Qty Unit Charge Per Extension - BASE FEE 30::00. Special Special Notes and Comments -------------------------------- ------ --- RE -ROOF CLASS "A"' MATERIAL 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 LQPERMIT Bin # City of La;Quinta , ' Building a Safety Division -P.O. Box .1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet' Permit Project Address:'$ —4 b'' C4UJZ-- Owner's'Name: A. P. Number: Address.: Legal Description: City, ST Zip:(A g,� Contractor: Az .m i(f_V r— S&9S99tf Telephone: - � Address:• g 7P0 �� j Project Description: City, ST, Zip:I'i�1/ 5L S-IVW 5:.J Z_rz Telephone: x 5 n State Lie. # : City Lie. #: /N S" 14TIbb-9 Arch., Engr., Designer:dtilt/tG/�-LE- Address: "Pt, j� fz�_ iSf 7 "AJ . 'City, ST; Zip: Telephone: Construction Type: Occupancy: State Lie. #: Project type (circle -.one):. -New Add'n , Alter , Repair Demo Name of Contact Person: TE e-✓ Sq. Ft.: #Stories "' • # Units: Telephone # of Contact Person: Estimated Value of Project: ' • `7 S-0 APPLICANT::DO NOT WRITE BELOW -THIS LINE . # Submittal Aeq'd Recd TRACKING'. ",PERMIT FEES Plan Sets Plan Check submitted :- Item Amount Structural Cales. Reviewed, ready for -corrections `: Plan Check Deposit Truss Cales. Called. Contact Person` +': L Plan Check Balance Energy. Cales. Plans pickedup t' Construction Flood plain plan Plans resubmitted x rt Mechanical Grading plan 2"d Review, ready for-corrections/issue Electrical Subcontactor List ' Called Contact Person ' .Plumbingw`-� Grant Deed Plans picked up w S.M.I. + . H.O.A. Approval Plans resubmitted Grading ,. IN HOUSE:- 3 d Review, -ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. • f Pub. Wks. Appr Date of' ermit issue School Fees Total Permit Fees ,