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04-5353 (RR)T4&f 4 4 a" x 1504 CALLE TAMPICO VTA, CALIFORNIA 92253 er BUILDING & SAFETY DEPARTMENT (760) .777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT, APN: Application description Property Zoning . . . . . Application valuation . . 04-00'005353 Date 7/06/.04 48885 AVENIDA EL NIDO 658 -310 -013 -95 -000000 - RE -ROOF LOW DENSITY RESIDENTIAL 3100 Owner Contractor ------------------------ ------------------------ DYAL NOLA S MILLER & SONS ROOFING INC, AL 48-885 AVENIDA EL NIDO 68760 SUMMIT DRIVE' LA QUINTA CA 92253 CATHEDRAL CITY CA 92234 (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 0 Qty Unit Charge Per Extension BASE FEE 30.00 =--------------------------------------------------------------------------- Special Notes and Comments REROOF OVER ONE EXISTING ROOF USING FIBERTIGHT SINGLE PLY 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 P.O. Box 1504�� VOICE (760) 777-7012 T4,!t 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 3 S?s Date: Applicant: I Architect or Engineer: Applicant's Mailing Address:N_�aar_ Architect or Engi Lic. No.: BUILDING PERMIT DECLARATIONS 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 ' in full for a and effect. / License Class_ - �/ License No. h i -1:2 I% Date--) b- Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 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 cons ruct, 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. , B.& 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 t issued. My work compensation insurance camel ar�i policy n�uf �r �j (_11`3 .Carver - ) k C (rel (✓: �f E-L)i Policy Number 1 ( W , V fo 1 V 0� I certi that, in the performance of the work for which tPis 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 p isi s. Date l�-� -1 Applicant WARNING: FAILURE TO SECURE WOR RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREDTH USAND 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. 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 Lenders 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. 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 Ouinta, 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 cancel do I certify that 1 have read this application and state that the above info alio is co ct. 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 ter �on thbove-mentioned property for inspection purposes. Date - Signature (Applicant or Agent): U::: /'� i4 - April 21, 1992 City of La Quinta Mr. Tom Hartung Jack Clark, Jr. P.O. Box 1371 La Quinta, CA 92253 �J 40 - 885 Dear Tom, This letter is in regard to�our conversation yesterday about the home I am going ffbuild on El Nido: As I mentioned to you I am going to remove two feet and sixinches of— thlxist ng soil. Then I am going to bring in three feet of new sandy soil. I will have the import compacted in place and I will have random compaction tests which I will be happy to provide copies of to the City of La Quinta if requested. Should you require anything further please let me know. A 07 9 s- L. e 6 coc Ic E's7- ._.Z Sincerely, Jack Clark, Jr. 10 16 QUINTA - B TY DEPARTMENT 7012 JUL 0 fQ TI EOUEST LINE •^ 7 7153 CITY of QUINTA Contractor .r Permit Number_q'-qs� POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES •: s 33MWIXTA D111311. =13 10 RE -ROOF OVER ONE EXISTING ROOF USING FIBERTIGHT SINGLE PLY TYPE OF INSPECTION DATE INSP. TEMPORARY POWER SETBACKS U/G PLUMBING / WASTE U/G ELECTRICAL / GROUNDING FOOTINGS / STEEL CONCRETE SLAB DO NOT POUR CONCRETE UNTIL ABOVE SIGNED ROOF NAIL / PRE -ROOF 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 COMMUNITY DEVELOPMENT DEPT. FINAL / JOB COMPLETED ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING