BRER2014-1036LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I a licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 the Business and Professions Code,
and my License is in full force and effect.
License Class: C39 License No.: 828478
Date: "k Contractor:
OWNER -BUILDER D LARATION
I hereby affirm under penalty of perjury that I a 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
($500).:
(_) 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.).
(_) 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 Addre!
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 th rk or which this permit is issued.
i %1 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 to become subject to the workers'
compensation laws of California, and agree tha if I should become subject to the
workers' co pensation provisions of Section 3 0 of the Labor Code, 1 shall forthwith
comply wi h se provisions.
Date:` �� Applicant:
WARNING. FAILURE TO SECURE WORKERS' COM NSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). N 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 Building Official 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 ihe above information is correct.
I agree to comply with all city and county ordinances i nd state laws relating to building
construction, and hereby authorize representatives of Lhis city to enter upon the above -
menti property for inspection purposes.
rf of
DR ; � Signature (Applicant or Ag )�J
T -a � 44Qumcu
VOICE (760) 777-7125
78-495 CALLE TAMPICO
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 11/7/2014
Application Number: BRER2014-1036
Owner:
Property Address: 44155 DALEA CIR
PAMELA ELDRIDGE
APN: 604091024
44155 DALEA CIR
Application Description: REROOF - INSTALL NEW UNDERLAYMENT
LA QUINTA, CA 92253
Property Zoning:
cc
Application Valuation: $7,727.00
0 O r¢ w
Applicant:
Contractor:
g a
CASTRO ROOFING INC
CASTRO ROOFING INC
> o
P O BOX 122
P O BOX 122
Z
THOUSAND PALMS, CA 92276
THOUSAND PALMS, CA 92
6 g
�
(760)343-0042
U
Llc. No.: 828478
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I a licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 the Business and Professions Code,
and my License is in full force and effect.
License Class: C39 License No.: 828478
Date: "k Contractor:
OWNER -BUILDER D LARATION
I hereby affirm under penalty of perjury that I a 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
($500).:
(_) 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.).
(_) 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 Addre!
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 th rk or which this permit is issued.
i %1 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 to become subject to the workers'
compensation laws of California, and agree tha if I should become subject to the
workers' co pensation provisions of Section 3 0 of the Labor Code, 1 shall forthwith
comply wi h se provisions.
Date:` �� Applicant:
WARNING. FAILURE TO SECURE WORKERS' COM NSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). N 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 Building Official 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 ihe above information is correct.
I agree to comply with all city and county ordinances i nd state laws relating to building
construction, and hereby authorize representatives of Lhis city to enter upon the above -
menti property for inspection purposes.
rf of
DR ; � Signature (Applicant or Ag )�J
FINANCIAL INFORMATION
DESCRIPTION
- ACCOUNT
QTY
AMOUNT
PAID PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK # CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
_ .' PAID
PAID DATE
RE -ROOF - EA ADDITIONAL 1,000 SF
101-0000-42404
0
$11.60
$0.00
PAID BY
METHOD
-RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$49.31
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0
$98.62
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forRE-ROOF: $159.53 $0.00
TOTALS:.• •0
Description: REROOF - INSTALL NEW UNDERLAYMENT
CONDITIONS
Type: RE -ROOF
Subtype: Status: SUBMITTED
Applied: 11/7/2014 SKH
Approved:
Parcel No: 604091024 Site Address: 44155 DALEA CIR LA QUINTA,CA 92253
Subdivision: TR 22982
Block: Lot: 24
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $7,727.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: REROOF -REPLACE LIN DERLAYM ENT AND RESET CERAMIC TILE. 2013 CALIFORNIA ENERGY CODE.
NAME,
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME,
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
CASTRO ROOFING INC
P 0 BOX 122
THOUSAND
PALMS
CA
92276
CONTRACTOR
CASTRO ROOFING INC
P 0 BOX 122
THOUSAND
PALMS
CA
92276
OWNER
PAMELA ELDRIDGE
44155 DALEA CIR
LA QUINTA
CA
92253
FINANCIAL INFORMATION
Printed: Friday, November 07, 2014 1:56:51 PM 1 of 2 CRsrsrEMS
DESCRIPTION
ACCOUNT d
QTY
AMOUNT
y PAID
PAID DATE
RECEIPT #^
CHECK #
METHOD
i PAID BY v `
IZL�13_
BY
BSAS S81473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00
$0.00
BSA:
RE -ROOF - EA
101-0000-42404
0
$11.60
$0.00
ADDITIONAL 1,000 SF
RE -ROOF - FIRST 2,000
101-0000-42404
0
$49.31
$0.00
SF
RE -ROOF - FIRST 2,000
101-0000-42600
0
$98.62
$0.00
SF PC
Total Paid for RE -ROOF:
$159.53
$0.00
TOTALS:.0
00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR
SCHEDULED COMPLETED RESULT REMARKS NOTES
DATE
DATE '
FINAL"
PRE -ROOF
Printed: Friday, November 07, 2014 1:56:51 PM 2 of 2 CRWYSTEMS
ism
P.O. Box 122, Thousand Palms, CA 92276
Office: 760-343-0042 1 Fax: 760-343-2097
www.CastroRoofinglnc.com
License #828478
November 4, 2014
'S
Doug Horenstein
44-155 Dalea Court '� DMP 'I'0
La Quinta, CA 92253 % ^�� j )7V, pN�"–
V4
Re: hoof Estimate 2 n� �
- Remove existing roof tiles and set aside for later use.
- Check for weak areas any found will be inspected for dry rot and replaced at a rate of $1.75 per
square feet (4x8x'/2) sheet upon approval of owner of agent. .
- Clean roof surface and remove all debris or any other foreign matter that may deplete the new
roof system.
- Substrate to be inspected for loose or non -flush nails, any found will be complete pulled out
and re -nailed using a new nail.
- Install new 2x2 drip edge at perimeter, and eve riser as needed.
- At valley install one (1) layer of underlayment with new valley metal fastened to secure.
- Over entire slope roof install two (2) layer of #40lbs. underlayment with new saddle, eve riser,
tile an, roof to wall, and primary pipe and vent flashing.
- Over water proof roof re -install roof tiles with secondary pipe and vent flashing (all broken
tiles to be replaced with new).
- Paint all pipe and vent flashings to match tile.
Total Amount: $7,727.00 initials
Price includes removing broken skylight and haul away, install new weather strip and new
double dome skylight.
11/07/2014 12:21 FAX
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-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
PerrWt #
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Project Address: t
L41
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Owner's Name:. D o
A. P. Number.
Address:qq mt ir) Vv -T
Legal Description:
City, ST, Zip: tit Q
Contractor.
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Telephone
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Address: Q ga X { Zv •
Project Description: 1� T-1, lLf✓tf _
City, ST, Zip:
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Telephone:.
State Lic. 4:
City Lia #;
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Arch, Engr., Designer
Address:
City, ST, Zip:
Telephone:
State Lic. #:
NEW
Construction Type: --0E Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft : O
# Stories:#
Units:
Telephone # of Contact
Person:
Estimated Value of Project: Z .
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES -
Plan Seb
Pian Check submitted
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss C21cs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2f4 Rtview, ready for corrections/issue
Electrical
Snbcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resabmitted
Grading
BY 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