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04-4320 (RR)\ U ot 17 2004 B U I L D I . Gam& SAI 1;+1�4EDIAUTM EN P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . 04-00004320{ Date 5/17/04 Property Address 78451 CALLE'SEAMA APN: 646-192-004-44 -3448 - Application description 'RE -ROOF Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . 8700 Owner Contractor SEDGWICK D ALLAN MILLER & SONS ROOFING INC, AL MECCA CA 92254 (760) 328-6616 WCC: VIRGINIA INS - WC: 1CW50109600 09/01/04 CSLB: 336547 07/31/05 CCC: C39 Permit . . . RE -ROOF --------------------------- Additional desc Permit Fee 30.00 Plan Check Fee.. .00 Issue Date' Valuation . . . . 8700 Qty Unit Charge Per Extension BASE ---------------------------------------------------------------------------- FEE 3 0.0'0 . Special Notes and Comments REROOF WITH CLASS A MATERIALS. Fee summary Charged Paid Credited Due Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total .00 .00 0.00 .00 Grand Total 30.00 .00 .00 30.00 IF LA QUINTA SAFETY DEPARTMENT 777-7012 I,TN REQUEST LINE 777-7153, Ow r'bI1)GWICK Cont actor AL MILLER & SONS Permit Number °04-4320 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 78-451 CALLE SEAMA RE-ROOF/CLASS A MATERIALS TYPE OF INSPECTION DATE INSP. TEMPORARY POWER SETBACKS U/G PLUMBING / WASTE U/G ELECTRICAL/ GROUNDING FOOTINGS / STEEL CONCRET.E.SLAB DO NOT POUR CONCRETE UNTIL ABOVE SIGNED RAIL /.PRE -ROOF Z - OKAY TO WRAP FRAMING COMBINATION ROUGH ELECTRIC ROUGH PLUMBING ROUGH MECHANICAL INSULATION COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP. BD. DRYWALL EXTERIOR LATH GAS TEST SEPTIC ABANDONMENT SEWER CONNECTION SEPTIC / GREASE INTERCEPTOR MASONRY INSPECTIONS FOOTINGS /STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE /.SETBACKS U/G PLUMBING U/G GAS U/G ELECTRICAL PRE -PLASTER (ALARMS/ BARRIERS FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER ELECTRICAL PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT COM MUNITYDEVELOPMENT DEPT. FINAL / JOB COMPLETED ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN•.ON UTILITIES OR OCCUPY BUILDING P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Nu er: ©t - Applicant: Applicant's Mailing Address: e. Architect or Engineer: // /V e' Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I aA licensed der 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 eff License Class__ Date — Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjuryt I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' 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 -1 / C,% olv�no- Ore --r Policy Number C t_, }Laj� D 0 rtify that, in the performance . f tngree for w h this permit is issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomi , t t if Ishould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr si Date y 1— Applicant WARNING: FAILURE TO SECURE WO ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T OUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR COD , INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penaky of perju 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 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. I. 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, indemnity and hold harmless the City of Le 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 cane tion. 1 certify that 1 have read this application and state that the above in G is correctle-mentioned agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county t e er n thea property for inspection purposes. Date ^1 �O gnature (Applicant or Agent): AL MILLER AND SONS ROOFING CO., INC. "BETTER ROOFS FOR BETTER LIVING" 68-760 SUMMIT DRIVE, CATHEDRAL CITY, CA 92234 PH. (760) 346-1214 FAX. (760) 321-7097 LICENSE # 336547 PROPOSAL AND CONTRACT wt 4L Owner: David S@Awi k Project: ReRoof Address: City: La Quinta WE PROPOSE TO FURNISH THE FOLLOWING MATERIALS AND PERFORM ALL LABOR TO ROOF THE ABOVE LOCATION. Flat sections: Roofer to sweep clean all loose debris, then install a four (4) ply class "A" built up roof where *Please note that tile price does not include engineers report,.or any structural changes.* Exclusions: Changes in contract, Air conditioning work,'Paint,.,.Wood nailers, Insulation. Terms: Net Cash On Completion ATTENTION Section 7018 of the Contractors License Law provides that starting July 1, 1966, everyone licensed by the Contractor's License Board shall give a copy of the following notice to the payor prior to receiving from the owner of the property or his agent any payment for work which a contractor's license is required NOTICE "Under the mechanics' Lien Law, any subcontractor, laborer, supplier or other person who helps to improve your property but is not paid for there work or supplies, has a right to enforce a claim against your property. This means that, after a court hearing, your property could be sold by a court officer for the proceeds of the sale used to satisfy the indebtedness. This can happen even if you have paid your own contractor in full, if the subcontractor, laborer, or supplier remained unpaid." Al Miller & Sons Roofing Co., Inc. Agrees to furnish its regular form GUARANTEE for 4 Years after completion of its said work. Said guarantee to cover defects in material and workmanship only and not to extend to damage to roofing caused by the elements, other unusual Acts of God and shall not cover any liability for damage to interiors fixtures, decorations, walls, contents of building or other parts of structure not to damage of faulty construction. It is also understood and agreed that the above guarantee shall be made and remain only when and if payment is made as agreed in this contract. Al Miller & Sons is not responsible for TV antennas . We are fully covered by Workmen's compensation and public liability insurance. Carriers' names and policy numbers are available on request. Any alterations or deviations from the above specifications involving extra cost of material or labor will only be executed upon written orders for same, and will become an extra charge over sum mentioned in this proposal. All agreements must be made in writing. This offer is valid for one week from the date of estimate and is based on free access to building for direct loading from our truck. Prices are based on current cost of material and labor, increases or decreases will be reflected at time of signing of contract. Al Miller & Sons is not responsible for any damage to sidewalks, curbs or driveways. If there is any conflict between this proposal, and any other contract or specification relating to the above referenced project the terms of this proposal shall prevail. Accepted By: Date: 5 -/D-O t-/ Respectfully submitted; AL MILLER & SONS ROOFING., INC. By: Matthew Miller, Estimator Date: 5-3-04