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04-7605 (RR)r . 0. 1504 ELLE TAMPICO A, CALIFORNIA 92253 r BUILDING PERMIT Property Address . . . . APN: ( Application description Property Zoning . . . . Application valuation . . BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 0=400007605 _ Date 12/06/04 53175 AVENIDA JUAREZ 774 -032 -015 -7 -000000 - RE -ROOF COVE RESIDENTIAL 6500 Owner Contractor ------------------------- -----=------------------ LAKES WILLIAM P ROOF TILE SPECIALTY, INC. 53175 AVENIDA JUAREZ P..O. BOX 11257 LA QUINTA CA 92253 PALM DESERT CA 92255 (760) 200-0811 WCC: EXEMPT ' WC: EXEMPT 11/30/05 CSLB: 810537 07/31/06 CCC: C39 =------------------------------------------------------------------------- Permit . . . . RE -ROOF Additional desc Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . 0 Expiration Date . . 5/06/05 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------7------------------------------------------ Special Notes and Comments RE -ROOF WITH.LIGHT WEIGHT TILE 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 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 044 - '1160015 Applicant: Applicant's Mailing Address. Date: /� � (o • O y Architect or Erigineer: Architect or Engineer's Address: Lic. No.: /A 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 is in full force and effect. License Class License No. Date Contractor. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that 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 (commenc'.ng 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 1, 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 Ksold 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.). 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 c ate /Z.:j—Oy er Own(ci�r a e_- IS1192 Q .tL_ 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 Policy Number _ 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 f pplicant Co .!20 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. 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 A 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 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 JZ vd O ignature (Applicant or Agent): �iJ __ ::a t LEGACY REPORT ER -3984 Reissued August 1, 2003 ICC Evaluation Service, Inc. Business/Regional Office ■ 5360 Waivnan Mill Road, Whittier, Califomia 90601 ■ (562) 6994D543 Regional Office ■ 900 Montclair Road, Suite A, Birmingham, Alabama 35213 ■ (205) 599-9800 www.icc-es.org Regional Office ■ 4051 West Flossmoor Road, Country Club Hills, Illinois 60478 ■ (708) 799-2305 Legacy report on the 1997 Uniform Building CodeTm the 2000 International Building Code® and the 2000 International Residential Code® DIVISION: 07—THERMAL AND MOISTURE PROTECTION Section: 07320—Roof Tiles WESTILE CONCRETE ROOF TILES WESTILE DIVISION OF OLDCASTLE ARCHITECTURAL WEST, INC. 1742 SOUTH ROOFTILE ROAD CASA GRANDE, ARIZONA 85222 1.0 SUBJECT Westile Concrete Roof Tiles. 2.0 DESCRIPTION 2.1 General: Westile roof tiles are interlocking, extruded concrete roof tiles. Various accessory tiles are provided for roof ridges, hips and rakes. The regular -weight tiles are composed of portland cement and selected sand aggregates. Lightweight tiles are composed of portland cement and lightweight aggregate. Anchor lugs are provided on the underside of all tiles, to overlap wood battens. Holes are provided in each tile for fastening where the installation requires fasteners. Interlocking ribs.are provided on the longitudinal edges of the tiles, to restrict lateral movement and provide a water stop. Transverse bars are provided on the undersides, to serve as weather checks. The tiles are cured to reach required strength before shipment. The tiles have dimensions and installed dry weights as noted in Table 1. See Figure 1 for tile profiles. 2.2 Installation: Installation shall be in accordance with the Roof Tile Institute's Installation Manual for Moderate Climate Regions, recognized in evaluation report ER -6034P. 2.3 Roofing Classification: When installed as described in this report, the Westile concrete roof tiles are Class A roof coverings in accordance with Section 1504.1 of the 1997 Uniform Building CodeTM (UBC), Section 1505 of the 2000 International Building Code® and Section R902.1 of the 2000' International Residential Code®; and are noncombustible roof coverings in accordance with Section 1504.2 of the UBC. 2.4 Identification: Labels on pallets of tiles bear the installed tile weight specified in this report; the Westile name; the tile profile; and the evaluation report number (ER -3984). In addition, the company name (Westile) is imprinted on the underside of each tile. 3.0 EVIDENCE SUBMITTED Data in accordance with the ICC -ES Interim Criteria for Clay and Concrete Roof Tiles (AC180), dated January 2002, and a quality control manual. 4.0 FINDINGS ' That the Westile concrete roof tiles described in this report comply with the 1997 Uniform Building Code TM, the 2000 International Building Code®, and the 2000 International Residential Code®, subject to the following conditions: 4.1 The tiles are manufactured, identified and installed in accordance with this report and the manufacturer's instructions. 4.2 The tiles are manufactured at plants located in Littleton, Colorado; Casa Grande, Arizona; and Corona, California. This report is subject to re-examination in one year. ICC -ES legacy reports are not to be construed as representing aesthetics or any other attributes not specifically addressed, nor are they to be construed as an endorsement of the subject of die report or a recommend ition for its use. There is no warranty by ICC Evaluation Service, Inc., express or implied, as toM.W, any finding or other matter in this report, or as to any product covered by the report. . Copyright © 2003 1 Page I of 2 Page 2 of 2 ER -3984 TABLE 1—TILE DIMENSIONS AND INSTALLED WEIGHTS TILE PROFILE PRODUCT NAME INSTALLED WEIGHT' (psf) TILE DIMENSIONS (length x width x height) (inches) MANUFACTURING LOCATION S -Tile Sierra Mission 9.0 17 x 12% x 3 Casa Grande Mission 9.5 16'/2 x 13 x 21/2 Corona FeatherStone Mission 5.9 16'/2 x 13 x 21/2 Corona Low Profile Coronado 9.3 17 x 123/8 x 21/e Casa Grande Verona 9.5 16'/2 x 13 x 2'/e Corona FeatherStone Verona 5.9 16'/2 x 13 x 2'/e Corona Double Roman 9.0 16'/2 x 13 x 2'/e Littleton Flat Profile Dublin Shake and Dublin Slate 10.3 17 x 12'/8 x 1'/, Casa Grande Shake and Slate 10.3 16'/2 x 13 x 1 Corona Double Notched Shake and Slate 10.75 16'/, x 13 x 1 Littleton Shake and Slate 10.3 16'/2 x 13 x 1'/, Littleton FeatherStone Slate and Shake 6.95 16'/2 x 13 x 11/4 Littleton Featherstone Slate and Shake 5.95 16'/, x 13 x 1 Corona rur at; I Inun = LD.4 mm, 1 PST = U.1.141`J Kra. 'Installed weight was determined with a 3 -inch headlop. UTTLETON SHAKE or TOP VIEW OF TILE Field TOP VIEW OF TILE ries w Y� Configuration of surface and interlocking joint , UNDERSIDE VIEW OF TILE�- Headlugs r x "�`•`irt uwacam nest on solid sheathing or N hang over battens. Noselugs and weather checks normally rest on ''�; a•_ 'F_r �.,;,i_ lower course of tiles. CORONA SHAKE or ' TOP VIEW OF TILE SLATE Reid Tile Configuration of surface and interlocking joint <�,> UNDERSIDE VIEW OF TILE Headlugs rest on solid sheathing or 9.9•',� hang over battens. Noselugs and weather checks normally rest on lower course of tiles. r®u CASA GRANDE DUBLIN SHAKE or SLATE Field Ille � TOP VIEW OF TILE Configuration of surface and <�,> interlocking jointRM�.9 UNDERSIDE VIEW OF TILE 9.9•',� Headlugs rest on solid sheathing or hang over battens. Noselugs and weather checks normally rest on lower course of tiles.. r®u DOUBLE ROWAN Field Tile VERONA I Field Tile _ 77 _ \" 9a,ua CORONADO Field The •"` 1„ -- lanae 9m99x ... m9A[9IEF I'm wlaoa9a ,mus FIGURE 1—TILE PROFILES FEATHERSTONE Field Tile MISSION Field Tile l mn9m m. 9rnaoma .' ' SIERRA MISSION Field Tile \' 9