09-0030 (RR)P.O. BOX 1504 4,
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: f09'=0.0000030., Owner:
Property Address: 78725 CALLE TAMPICO HELGESON, KATHY
APN: 770-144-003-125.-000000- 78725 CALLE TAMPICO
Application description: RE -ROOF LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 4492 O
Contractor:
Applicant: / Architect or. Engineer: CASTRO ROOFING C
P O BOX 122
THOUSAND PALMS, A '
(760)343-0042
Lic. No. c '828478 '__
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/13/09
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- LICENS C
TRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of .perjury at 1 a icen
under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) -of Division 3 of the B.si s a Proi
nals Code, and my License is in full force and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C39
L' o.: 828478
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
- —contractor:,
---.�..
**Oy
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
- OWNER- UILDER DECLARATION
insurance carrier and policy number are:
hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND A Policy Nu ber 63914708
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
— I certify that, in the perfor ce of thew rk r which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so s to bec a su ct to the workers' compensation laws of California,
-permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I shout bec subject o the rkers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or r
3700 of the Labor Code al fort ith y wi peffose provisions.
' 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 (5500).:Date:
♦
Ei� Applicant:
IG:
1 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
WARNILURE TO SECURE WORKE S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
' 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.).
APPLICANT ACKNOWLEDGEMENT -
1—) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec._
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with'a contractor(s) licensed
1 . Each person upon whose behalf this application is made, each person at whose request and for
• - pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(— 1 I am exempt under Sec. , B.&P.C. for this reason
the owner, and, the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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:
LQPERINIT
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 issua0such cessation of work for 180 days will subject
permit to cancellation.
I certifythat Ihave read this application and statmat is correct. gee to comply with all
city and cou- ty ordinances and state laws relatin�0 a here authorize representatives
of this uqn to enter upon the above-mentioneon urpoe: 7 Signature (Applicant or Ag
1
LQPERAIIT
' Application Number . . . . . 09-00000030
Permit . . . RE -ROOF
Additional desc .
Permit Fee . . . . .30.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
0
Expiration Date 7/12/09
Qty Unit Charge Per
Extension
BASE
FEE
30.00
Special Notes and Comments
RE -ROOF 1800 SQUARE FT. REMOVE TILE
INSTALL NEW FELT AND INSTALL SAME
TILE.
Other Fees . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
Paid Credited
Due
Permit Fee Total 30.00
.00 .00
30.00
Plan Check Total .00
.00 .00
.00
Other Fee Total 1.00_
.00 .00
1.00
- Grand Total 31.00
.00 .00
31.00
LQPERAIIT
FROM : HELGESON INTERIORS
PHONE NO, : 760 564 1678 Jan. 05 2009 10:19AM P1
di/?17/2ygg 09:31 ?003432@97
GASTRO R00Fjp jG INC PAGE e2
P.O. Elft 122 Thousand P8111113, CA 9=76
('760)343-0042 * .Fax (760) 343.3097 _
Liaeftc #8ZN478]Kathy
iM00 -State Fund
78.725 CalleTampico Workmens Comp. Policy #
La Quintaa, CA 92ss3 63914 707
License ,# 82847E
Re: Estimate !Repairs Squares:
Remove roof tiles and set aside for later u%e. Check far any,, cak areas, anv found wit) be inspected
ford Any dry .rot four, will be z7l"ed on a time and material bases upm owners approval,
Sweep roof Any on valley inst�j one layer 940 felt; over felt install new valley metal, Over el va
roof install one layer4t} felt nail to hold in place. At. perimeter install Pew edge :natal as umeded
over 1kTtcr tight .00f re -install roof tiles to mant;factures wpecidzcataazi wsec
ith ondary pipe and vent
flashing,
TotnI Amount: $4,492.00
FIVE; (1) YEAR GGARANTBE AGAINST LRAKS OVER BACK SRCTION OF UOUSt ANp OARAGr ONLY WILL i9L EFFECI'IYF UPON FULLPAYMEA,7.
TB2M.S: I "1/0 (JTON COMPLF 10N. UNLESS (j'; I.IERWI5E SPECI(`)F,0 rN THE CONTRACT,
ALL DEBRIS CAUSL-'D FROM ABOVE WOMk TO 8E DISCARAFD AND AREA TO Rh I: F,FT CLCAN. J09 'IY) gE STARTED IN A TIN=y
MANNER ACCORD -No To SC.HF.DUi,F, AND W12A714ER PFRMITTINC.
WE PROPOSS TO FURN.MH 4ND APPLY [.AROR. MATERIAT S, PURMris, 'r'RANSPORTATI�I, & TY.?UC s NEC3S6ARY FOR COt�SpI„�'typ> .
OF ROOFING WORK,
TM PRO",SAL. WLLL B r NULL AND VOID AFTER 15 !TAY$ FROM DATE' SURMr:TCD.
DURiNC TiIF. ROOFING Pmiecr CASTRO ROOFLAICI WILL MAU ALL ATTEMPTS TO VnNIMIU, 5U7 WILL NC)r 13E RE•SPONSIBI-E
FOR DIRT, ROCK. OR OFBRI$ THAT MAY TALI. INTO LIVING AR>:'A$, DA.wIAGES ":O VI:NTS CONDUPr FIAL?S. OR Cti1L1A1G MpUNT�D
FIXTUP
CO&TRACPOR Do'hg NOT ASSUME AW RCSPONSI91:,r'Y FOR CORRECTION UPFX:STINC COA'£ V101.AT7gNS ()R FOR 7Nj�,41W
OF ANY F)G$TING STRUCT'MAL DEFnCTS ONLa,S5 SPECIFIED IN TI�a PROPOSAL MNTRACT.
D4 TM Vwr SUIT 18 DROUGHT TO ENFORCE THF TERMS OF THE CONTRACT, TI4E PRFVvAILTNG PARTY SHALL RECOVER ALL
COS'"3 EXF'F.ND,ED, INCLI Ir)1NO ATTORt•1EY FEES AS AN ELEMEN7 OF C05T.
CONTRACTOR$ ARE REQUIRED BY L,AW TO BE LICLNSEO AND R11GULATF.C) 9Y nir,, CONTRAt'TOR S STATE LICENSE 50ARC. ANY
QUESTIONS REFER TO, CON RACTOP,'S S TAM' LICENSED SOAR r>, 1010 " N" STRB6T, SACRAMENTO, CA 95814,
IF THIS ESTIMATE MEETS WITH YOUR APPROVAI., RL5/.S6 RJDDICATF YOUR ACCEhTANpE DY 31CININU THIS COPY ANDREI UMNINC IT -0 OUR OPPICF BY MAIL OK PA.%. urE LQQI( FORWARD TO WORKING \M.14YOU.
Subtxi,itte> bi,Accepted By:
antro Roofing.- utg. res: eat Oumer or agent
Submittal Date_ Decrm`r�er 3l, 200$ ,A=ptance Date:
Bin #
City of La Quinta
Building u Safety Division
P.O. Boz 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: I q tis
Owner's Name: M GwjOv�
A. P. Number:
Address: )pL5 I�/b
Legal Description:
Contractor:
I
City, ST, Zip:
Telephone:
Address: 0 �p� -L /
Project Descrip tion: !.� Ur
DF
City, ST, Zip: k� ►I VY", S �' '(rL�
�%
00 s r`'11/ .. ("Lwkv M/�/
Telephone: �) (ob 1 � o -L
-tt • USS J(J5Tkk Ow FvVT
State Lic. #
City Lic. #:
n lv 7 ml' -�
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: ) Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: �gU (7 # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project: -L-
APPLICANT:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd- -
TRACKING.
PERMTT 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 correctionsfissue
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 correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees