05-5096 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
05-00005096
49995 PARK AVE
649 -210 -021 -
RE -ROOF
PARKS & RECREATION
9930
T,aT
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT .
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/18/05
Owner:
BOYS/GIRLS CLUB COACHELLA VALL
- 42600 COOK ST STE 120
PALM DESERT, CA 92211
Architect or Engineer:
----------------------------------------------------
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.
,LicenseClass: C39 LicenseNo.: 460707
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).:
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, 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 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
Contractor:
PETRONELLA ROOFING COMPANY
68314, KIELEY ROAD
CATHEDRAL CITY, CA 92234
(760)324-5482
Lic. No.: 460707
------------------
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 1801579
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 Code, I shall forthwith comply with those provisions. . _
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 laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
LQPERMIT
Application Number 05-00005096
Permit . . . RE -ROOF
Additional desc "•
Permit Fee .00 Plan Check Fee .00
Issue Date 11/18/05 Valuation . . . . 0
Expiration Date 5/18/06
----------------------------------------- ------------ --
Special Notes and Comments
REROOF WITH POLYURETHANE FOAM. CLASS
"A" MATERIALS ONLY
Fee summary Charged Paid Credited Due
---------------------- ---- ---
Permit Fee Total .00 .00 .00 .00
P1an.Check Total .00 .00 .00 .00
Grand Total 00 .00 .00 .00
f
T H' R
ER.O0FING
0
C
SPECIALISTS, IN.
ROO-PING
Corporate Office: Desert Office:
2626 Newport Blvd. 68-314 Kieley Road
Costa Mesa, CA 92627 Cath.-dral Ci CA 92234
.949.548.1645 /Fax: 949.548-2611 License. #46070'7 760.324.5482 /Fax: 60.328.4612
PETRONELLA ROOFING hereinafter called "Contractor" and/or "Seller" agrees to provide the following listed labor materials and construction: .
NAME / OWNER: CITY OF LA QUINTA
PHONE NO:
REROOF PROJECT ADDRESS: 49925 PARK AVENUE
CITY, STATE & ZIP CODE LA QUINTA, CA. 92253
BILLING ADDRESS: P.O. BOX 1504 78-495 CALLE TAMPICO
CITY, STATE & ZIP CODE: . LA QUINTA, CA. 92247-1504
ADDITIONAL PHONE NUMBER:' FAX NUMBER:
DESCRIPTION OF LABOR MATERIALS AND MISC.:
Petronella Roofin ' will furnish all labor and materials for roofing as per specifications dated March 31, 2005.
1. 1" RETRO -FIT EVERCOAT POLYTHANE SPRAY APPLIED POLYURETHANE FOAM
ROOFING SYSTEM..
2. SPRAY APPLIED ELASTOMERIC ACRYLIC COATING SYSTEM.
Cost...................:.......................................................................... $ 9,930.00
SPECIAL INSTRUCTIONS:
SCHEDULE OF EXTRAS CONTFACT TERMS:
10% Upon Award of Contract
1. Replace damaged plywood at $2.50 per S.F. as required by City 40% Upon Tear Off-
Inspector.
ffInspector. 50% Upon Completion.
2. Any electrical or plumbing work will be billed at $75.00 per man per
hour.
TIME FOR STARTING AND COMPLETING PROJECT: Work Shall commence within. 'ten (10) days from the date of sale unless specified otherwise
and be. substantially completed in approximately ten (10) working days with additional. time to be as detailed in Paragraph 9. of the
Terms, conditions and "Notice to Owner" on the back hereof. Substantial Commencement of work shall be defined as the installation -of any materials and/or labor.
Contractors failure to substantially commence work, without lawful excuse, within twenty (20) days from the date specified, above is •a violation of the Contractors
License Law.
NOTICE TO BUYER: (1) Do not sign this agreement before you read it. (2) You are entitled to a completely filled in copy of this agreement. (3) Owner /
Authorized Responsible party acknowledges that lie / she has read and received,a legible copy.of the this agreement signed by Caitractor, including all Terns,
Conditions and "Notice to Owner" on the reverse side, before any work was done and that he / she has read and received a legible copy of every document that Owner/
Authorized Responsible party has signed during the negotiations. (4) YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO
MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION BY NOTIFYING THE SELLER, IN WRITING, AT THE ABOVE
ADDRESS. IN THE EVENT YOU THE BUYER FAILS TO EXERCISE THIS RIGHT AND SUBSEQUENTLY ATTEMPTS TO CANCEL THIS CONTRACT
AFTER THE EFECTIVE DATE IF RECISION, THE CONTRACTOR SHALL BE ENTITLED TO RECOVER ALL COSTS AND LOST PROFITS ASSOCIATED
WITH THIS CONTRACT. (5) YOU, AS OWNER OR TENANT, HAVE THE RIGHT TO REQUIRE THE CONTRACTOR TO H&VE A PERFOMANCE AND
PAYMENT BOND OR FUNDING CONTROL.
OWNE RESPONSIBLIE PARTY
L-7JD✓�"
Owner./ Responsible Party: Print.Name
Owner /Responsible Party: Signature a
Date of Sale
CONTRACTOR (SELLER) CONTRACT PRICE
Orren Burns S 9,930.00
Petronella Roofing Authorized Representative: Print Name
S, .993.00.,
Petronella Roofing Authorized Representative: Signature
July 20, 2005
Date of Sale
Craig E. Anthony
Fire Chief
Proudly serving the
unincorporated
areas of Riverside
County and the
Cities of:
Banning
Beaumont
Cahmesa
Canyon Lake
Coachella
Desert Hot Springs
Indian Wells
Indio
Lake Elsinore
4 -
La Quinta
Moreno Valley
Pahn Desert
Perris
Rancho Mirage
San Jacinto
•:
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jeff Stone,
District,3
Roy Wilson,
District 4
Marion Ashley,
District 5
RIVERSIDE COUNTY
FIRE DEPARTMENT
82-6575 Highway ii , Fax (760) 863-7072
May 2, 2005
TMAD Taylor & Gaines
3050Chicago Ave., Ste 100
Riverside, CA 92507
Re: Non -Structural Building TA Plan Review
LAQ=05-TI-041 / La Quinta Boys & Girls Club
Fire Department personnel have reviewed and approved the plans you submitted f6r the above
referenced project. Please be advised the following conditions apply as a part of the conditions for the
issuance of a building permit.
1) New HVAC ductwork shall be reviewed for possible obstruction(s) of existing fire sprinkler system
coverage. Any potential modification of the fire sprinkler system will require plans submitted by the
C-16 contractor for review and approval prior to commencing work.
Please contact the Fire Department Planning & Engineering staff for final inspectio.i prior to,occupancy.
Applicantrinstaller shall be responsible to contact the.Fire Department to schedule inspections.
Requests for inspections are to be made at least 72 hours in advance and may be arranged by calling
(760) 863-8886.
All questions regarding the meaning of these conditions should be referred to the Fire Department
Planning & Engineering staff at (760) 863-8886.
Sincerely,
FRANK KAWASAKI`
Chief Fire Department Planner
By
Walter Brandes
Fire Safety Specialist
Cc:. City of La Quinta — Building Dept
H:VPMWP DataLLa Umrta%PROJECTSTUA04)5-T1-Ul.doe
EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE
82-675 Highway 111,"2^d A., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072