06-1564 (RR)r"
Py
�9
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
06-00001564
53601 AVENIDA VELASCO
774-124-019-7 -000000-
RE-ROOF
COVE RESIDENTI,
9680
BUILDING-& SAFETY DEPARTMENT
BUILDING PERMIT
-----------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under p visions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Co ,and y License is in full force and effect.
License C%l/ay/S���Cj3ee9 0.: 60707
Date:4�b 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 ISec. 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 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. , BAP.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:
RUMMONDS STEVEN R
P 0 BOX 1021
LA QUINTA, CA 92253'
Contractor:
PETRONELLA ROOFING COMPANY
68314 KIELEY ROAD
CATHEDRAL CITY, CA 92234
(760)324-5482
Lic. No.: 460707
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/18./06
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 compensation laws of California,
and agree that, if I should become subject to a wo�,orkers'
censationprovisions of Section
3700 of the Labor Code, hall rthithose provisions.
Dat 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 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. to comply with all
city and county ordinances and state laws relating to building&,o
n, and here auth ize representatives
of this coU Yto enter upon the above-mentioned property fo
Date. = / e4ionature (Applicant or Agent):
Application Number . . . . . 06-00001564
Permit . . RE -ROOF
Additional desc .
Permit Fee 30.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 10/15/06
Qty Unit Charge Per
Extension
BASE
FEE
30.00
----------------------------------------------------------------------------
Special Notes and Comments
r REMOVE TAR & GRAVEL ROOF -REPLACE
WITH
SAME -CLASS A MATERIALS ONLY
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 #a
City of La Quinn
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 # - ' r�
1 "1
Project Address"—60/ /i �4,fCa
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor: ,W;RaW/lwrf e
City, ST, Zip:
.. di,�/ �ZZS3
Telephone: NA -"
Address: `
Project Description: �-
City, ST,Zip: G
i�
Telephone: �• J Z
Az �.
State Lic. # : G City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: a .
State Lic. #: Y
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: �G
# Stories: .
# Units:,
Telephone # of Contact Person: ' _ _ _ _ __ _
_Estimated_Value_of Project:.__ __ 4A,.._..:._
~ APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check• submitted
Item
:.Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit '
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I. .
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer. Impact -Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue ,
School Fees
Total Permit Fees
a a a F I x 0
Corporate Office: Desert -Office:
COT 68-314 Kieley Road
262 Newport Blvd. Cathedral City, CA 92234
Costa Mesa, CA. 92627
949.548.1645 / Fax: 949.548-2617 License #460707 760.324.5482 / Fax: 760.328.4612
PETRONEI,L.� ROOFING li . ereimlftel- C"Ille(I "CoIltv.,ictol", 911Cl/01. "Selltit" agrees tit 1"),*()vide the followhip listed )stege III',IteI-iZIlS -111(i COIISIRICtioil:
NAME / OWNER
STEVE RUMMONDS-
REROOF PROJECT ADDRESS
CITY, STATE & ZIP CODE
BILLING ADDRESS:
CITY, STATE & ZIP CODE:
I
ADDITIONAL PHONE NUMBER:
53601 AVENIDA VELASCO
LA QUINTA, CA. 92253
DESCRIPTION OF LABOR INIA I LKI.A.LN AMP
PHONE NO: (760) 564-2672 '
FAX NUMBER:
OPTION 2
ROOF SYSTEM: GNB -3 SPECIFICATION
Cost.................... .................... .................................... $9,680.00
JL
WARRANTY
1. Petronella Roofing will issue a 10 Year "weathershield" warranty.
2. It is the owner's responsibility to properly maintain roof system. Guidelines and proposed budget for annual
maintenance will be provided upon request.
SPECIAL INSTRUCTIONS: CONTRACT TERMS:
1. Replace damaged plywood at $2.50 per S.F.. as required by city
inspector. 10% Upon award of Contract
401/6 Upon Progress
2. Any electrical or plumbing 'Work will be billed at.$75.00 per man 50% Upon Completion
per hour.
3. Replace fascia at $.7.75 per L. F.
flAND Work Shall conlillelicc With'in tell I Itli da\s iron Ihe da(c of cele Ilolc,s s ,11ccilic(I oilw. r%
in approxilliatelY tell (Illi \\oikiw! days \\ illi additional limew be as dct;liled in tilt:
"ll tile lmcl*: hercol'. '�tlhslalllizll ill, work shall hi defined as tile ill'ZIAI;Ilioll ol'am
I"erms. conditions :inti -'Notice it, 0mler"
Collo-noors Gliltire ro substilillijiliv coijulicnce ki-ork. williom lilwilkll C.\Cllse. wilhill (welliv 0(1) cklvs froll) the dale sliecified. ahove is a \i0I;IIWn. ol"llie I ontricl-l-<
License Um.
NOTICE' TO 13l 1YER: ()o not si.,Il this :,Lrecniem helbre >rnt -read it. (2) Yon are entitled to o C(11111)ldek: Idled in 1:01W 0l: this ;.',I I lmlcl
,\F the illis aurcellielli �i,_,Iled h\' (.'onlroclor. illcllltlijl,_� all, Term,.
Aulliorized Ropollihle party 11CI,IIo\0CJ,.!es ilmi -lie 1; she has read and received 0 Ic.-011e COP
Conditions :Inst 11
to OwnQr" ".111C leversc side. browam work \\;is done and thall he she. hate emitd (I le"cr\ docillnew that Q',vI;,:r M'
-L THIS 'I'RANSACTI(M A,r ANN' TIMI" - PRIOR K)
pol-It. hos siLmcd durillu, tile 11CLotiatiolls. (41 YOU. 1'111:' BUYER. Mi Y CANCE -1' -1
I"I IE DATE (.')F 'ITII.S TRANSAC'I'ION 13Y NOTIFYING THE SELIJ.--'R- IN WRITIN6 . A 1 -11' AB,()VF
NjjI.)NI( il-F! )I.- D.; Y Al"FIR
ADDRESS. IN 1-11-. I-'Vl-.-N'I* Y(A.1 -1-1-1117 BUYER FAIIJS TO EXERCISE- THIS Rl(*il-l-r AND St,111SE(IUENI-LY 'IT CANcia. fH11 (,(,)N-
_I-'FI'-C'TIVI_-' DATE' IF THE ('0N.'I-RACT()R SHALL B.F. FNTITLED l'o RECOVER ALL COSTS AND LOST PROFITS AS.�;(_)CIATFD
Wl"I'l-I TI-IIs(""t')N1"RA(,l'. OWNER OR 1'1-'.NAN-I*. HAVE THE 8101-I'T 'K) RE( I iIRE THE C0N1'R,--\CTOR TO IAVF A PE:RFOrtIANCE AND
(')I'\ FI INDIN(i
�\V`Nf_:R RIESPO�NSIBIJE PARTY
tuner i Responsible P. ' P.
nt N:unC
Owner Responsible Party: Signature
)atc of
CONTRACTOR (SELLER) CONTRA(']- PRICE
Nlik, Scheid 9,680.00
Petrollel lotifill Ilth Se t: ive. Print Name
Print
968-00
Pe onella (Vol -Ill", thorized RePITse Si-n»
.11:11111an. 3.21100
Date of Sale