05-4144 (RR)P.O. 'BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: )!
05-00004144
Property Address:
79450 TOM FAZIO+LN S
APN:
7.66-044-001- -
Application description:
RE -ROOF
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
46000
T4 ht'4
BUILDING & SAFETY DEPARTMENT
. BUILDING PERMIT
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that m7j visions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business , an ���. ttty License is in full force and effect.
License Cass: C39 t j460707
Date: ' " GS Contractor:
i
"-- 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 ($5001.: j
( _') 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.).
(_ 1 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
Owner:
BURDICK HENRYS
79450 TOM FAZIO LANE
LA QUINTA, CA 92253
(760)898-1177
Contractor:
PETRONELLA ROOFING
68314 KIELEY ROAD
CATHEDRAL CITY,' CA
(760)324-5482
Lic. NO.: 460707
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/15/05
SOUTH
------------------------------'-----------------
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 th workers' compensation provisions of Section
v
3700 of the Labor Code, shall orthw' con �y 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 hLeTeby ajAhorize representatives
of this county
%t�o,.enter
—upon the above-mentioned property r in ction ur o
Date: 9li� "\ Signature (Applicant or Agent): -
r
Application Number . . . . . 05-00004144
Permit . . . RE -ROOF
Additional desc .
Permit Fee . . . . 30.00
Plan Check
Fee
.00
Issue Date
Valuation
0
Expiration Date 3/14/06
Qty Unit Charge Per
Extension
BASE
FEE
30.00
----------------------------------------------------------
Special Notes and Comments
-----------------
REROOF WITH SPRAYED POLYURETHANE
FOAM.
CLASS "A" MP,TERIALS 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
HE REROOFING SPECIALISTS
"Since 1980"
WKTX14�1_1T ; ?
Corporate Office: Desert Office:
2626 Newport Blvd. 68-314 Kieley Road
Costa Mesa, CA 92627 Cathedral City, CA 92234
949.548.1645 / Fax: 949.548-2617 License #460707� 760.324.5482 / Fax: 760.328.4612
PETRONELLA ROOFING hereinafter called "Contractor" and/or "Seller' aerees to provide the following listed labor materials and construction:
0,
NAME / OWNER: SHERMAN ANDREWS PHONE NO: (760) 898-1177
REROOF PROJECT ADDRESS 79450 TOM FAZIO
CITY, STATE & ZIP CODE LA QUINTA, CA. 92253
BILLING ADDRESS: 75161 SEGIO LN F3
CITY, STATE & ZIP CODE: PALM DESERT CA. 92260
ADDITIONAL PHONE NUMBER: FAX NUMBER: (760) 346-8833
DESCRIPTION OF LABOR MATERIALS AND MISC.:
PetroneVa Roofing«'ill furnish all labor anti material to install:
FAXED
ROOFING COST
FAXED
OPTION 1
1" RETRO—FIT EVERCOAT POLYTHANE SPRAY APPLIED POLYURETHANE FOAM ROOFING
SYSTEM
OPTION 2
ROOF SYSTEM: COMPLETE UNDERLAYMENT REPLACEMENT AND TILE RESET:
Cost......................................................................... $ 46,000.00
SPECIAL INSTRUCTIONS:
1. Replace damaged plywood at $2.50 per S.F.. as required by city inspector.
2. Any electrical or plumbing work will be billed at $75.00 per man per hour.
CONTRACT TERMS:
10% Upon award of Contract
40% Upon Progress
50% Upon Completion
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 wwork shall be defined as the installation of an 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) Owviv.r /
Authorized Responsible parte acknowledges that lie / she has read and received a legible copy of the this agreement signed by Contractor, including all Tenus.
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 neotiations. (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 CNTRACT. (5) Yoq� AS OAER OR TENANT. HAVE THE RIGHT TO REQUIRE THE CONTRACTOR TO HAVE A PERPOMANCE AND
PAYMENT B D OR FUNDING ONTRVL.1
;OWN / PONSIIBI RTY CONTRACTOR (SELLER) CONTRACT PRICE
_ ...7
Mil< Schei $ 46.000.00
w f Res i le arh: P i t ame Petronell oofi� authoriz d R re a at ve: Print Name
$ 4,600.00
Owner / Responsible Party: Signature Pet' `ell R Eng N uthorized Repre: n tire: Signature
Au ust 02 2005
�i
INC.
Corporate Office: Desert Office:
2626 Newport Blvd. 68-314 Kieley Road
Costa Mesa, CA 92627 Cathedral City, CA 92234
949.548.1645 / Fax: 949.548-2617 License #460707� 760.324.5482 / Fax: 760.328.4612
PETRONELLA ROOFING hereinafter called "Contractor" and/or "Seller' aerees to provide the following listed labor materials and construction:
0,
NAME / OWNER: SHERMAN ANDREWS PHONE NO: (760) 898-1177
REROOF PROJECT ADDRESS 79450 TOM FAZIO
CITY, STATE & ZIP CODE LA QUINTA, CA. 92253
BILLING ADDRESS: 75161 SEGIO LN F3
CITY, STATE & ZIP CODE: PALM DESERT CA. 92260
ADDITIONAL PHONE NUMBER: FAX NUMBER: (760) 346-8833
DESCRIPTION OF LABOR MATERIALS AND MISC.:
PetroneVa Roofing«'ill furnish all labor anti material to install:
FAXED
ROOFING COST
FAXED
OPTION 1
1" RETRO—FIT EVERCOAT POLYTHANE SPRAY APPLIED POLYURETHANE FOAM ROOFING
SYSTEM
OPTION 2
ROOF SYSTEM: COMPLETE UNDERLAYMENT REPLACEMENT AND TILE RESET:
Cost......................................................................... $ 46,000.00
SPECIAL INSTRUCTIONS:
1. Replace damaged plywood at $2.50 per S.F.. as required by city inspector.
2. Any electrical or plumbing work will be billed at $75.00 per man per hour.
CONTRACT TERMS:
10% Upon award of Contract
40% Upon Progress
50% Upon Completion
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 wwork shall be defined as the installation of an 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) Owviv.r /
Authorized Responsible parte acknowledges that lie / she has read and received a legible copy of the this agreement signed by Contractor, including all Tenus.
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 neotiations. (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 CNTRACT. (5) Yoq� AS OAER OR TENANT. HAVE THE RIGHT TO REQUIRE THE CONTRACTOR TO HAVE A PERPOMANCE AND
PAYMENT B D OR FUNDING ONTRVL.1
;OWN / PONSIIBI RTY CONTRACTOR (SELLER) CONTRACT PRICE
_ ...7
Mil< Schei $ 46.000.00
w f Res i le arh: P i t ame Petronell oofi� authoriz d R re a at ve: Print Name
$ 4,600.00
Owner / Responsible Party: Signature Pet' `ell R Eng N uthorized Repre: n tire: Signature
Au ust 02 2005