08-0293 (RR)t r Q
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 08-00000293
Property Address: 53615 AVENIDA DIAZ
APN: 774-111-018-6 -000000-
Application description: RE -ROOF
Property Zoning: COVE RESIDENTIAL
Application valuation: 3300
Applicant: Architect or Engineer
-----------------
LICENSED CONTRACTOR'S DECLARATION
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: C39 Lic a No.: 774482
22 _i
Date: %-'/J -C 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 (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 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. , 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:
JOHNSON DAVID B
53-615 AVENIDA DIAZ
LA QUINTA, CA 92253
(
Contractor:
WILLIAMS ROOFING
P.O. BOX 391841
ANZA, CA 92539
(760)399-4394
Lic. No.: 774482
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/13/08 .
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WORKER'S COMPENSATION DECLARATION
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 1890178
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 t workers' compensation provisions of Section
3700 of the Labor Coodee�shall forthwith co y with those provisions.
f 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 ($100,0001. 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 J 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 reby authorize representatives
of this county to enter upon the above-mentioned property or inspection purp s s.
Date -'a Signature (Applicant or Agent):��A
Application Number
. . . . .. 08-00000293
Permit . .
. RE -ROOF
Additional.desc .
Permit Fee• :.
30.00
Plan Check
Fee
.00
Issue Date. . . .
. .
Valuation
. . .
0
Expiration Date
8/11/08
Qty Unit Charge
Per
Extension
BASE
FEE.
30.00
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Special Notes and
Comments
RE -ROOF WITH CLASS
"A" MATERIALS'
February 13, 2008
10':09:55 AM pjuarez.
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
Williams Roofing
P.O. Box 391841, Anza, Ca. 92539 '
951-763-0769 760-399-9394 License # 774482
Residential Re -Roof
Attn: Dave Johnson
53-615 Avenida Diaz
Lo Quinta, Co. 92253
Building Type: One story residential
Job site: 53-615 Avenida Diaz, la Quints, Co. 92253
Contract # 1024
Date : February 8, 2008
Salesperson: Steve Williams
Phone: 760-799-0728
Page 1 of 2
WILLIAMS ROOFING SHALL FURNISH LABOR, MATERIALS AND WILL PERFORM IN A WORKMANSHIP LIKE MANNER IN STRICT
ACCORDANCE WITH THE PLAN AND SPECIFICATIONS AS FOLLOWS:
Note: During the Re -roofing process if any asbestos is discovered, the removal and disposal cost will be borne by owner.
Dry rot will be replaced for an additional charge based on $81.00 per hour labor and 1x6 or 1x8 material @ $2.50 per foot.
Damaged rafter ends will be replaced for an additional charge based on $109.00 each and fascia board @ $12.00 per foot.
Damaged CDX plywood will be replaced for an additional charge based on $2.00 per square foot, labor included.
* Tear off one layer of existing roof system, to a clean surface, and haul away.
* Install one layer 151b. Felt.
* Install new brown painted baked on enamel metal edge and new painted flashings.
* Install GAF 30 (or equal) self sealing composition shingles. The shingle has a CLASS A FIRE RATING PRO
RATED 30 YEAR LIMITED WARRANTY.
* Install High profile ridge caps.
For a complete Re roof.
Williams Roofing will leave the job site neat and clean of
Owner to pick color: Color:
CONTRACT PRICE : $ 3,300.00 ( Three thousand three hundred and 00/100)
Payment to be made as follows: $ 2,100.00 due upon commencement of work./ Material draw.
$ 1,200.00 due upon completion.
*Five year guarantee on workmanship*
II Williams Roof i ne Ph 760-399-9394 ucense # 774482 III
CONTRACT # 1024
Pago 2 of 2
PRICES QUOTED DO NOT INCLUDE CORRECTING ANY ORIGINAL OR CURRENT CONSTRUCTION DEFECTS OR THE COST
OF RELOCATING ANY PLUMBING LINES, HEATING OR AIR CONDITIONING EQUIPMENT, SOLAR EQUIPMENT, TV
ANTENNA, OR ELECTRICAL LINES UNLESS EXPRESSLY STATED ABOVE.
Notice: Do not sign this agreement before you read it in its entirety. You are entitled to a completely filed copy of the Agreement.
You acknowledge that you have read and received a legible copy of this Agreement signed by
Williams Roofing (Hereafter "Contractor"), Including all terms and conditions, before any work was done and that you have read
and received a legible copy of every document that you have signed during negotiation..If you cancel the Agreement after any rights
of rescission have expired and before commencement of construction, you shall pay contractor the amount of expenses incurred to
that date Rllus loss of profits.
Late charges: 9 any payment is not received within five (5) days after such amount is due, you shall pay to the contractor a late
charge equal to ten percent (10%) of such overdue amount. The parties hereby agree that such late charge represents
A full and reasonable estimate of the costs the contractor will incur by reason of such late payment, and are therefore deemed to
be liquidated damages. Interest on past due obligations: Any amount due contractor not paid when due shall bear interest at the
maximum nate then allowable by law from the date due, but in no event shall such interest be less than ten percent (10%). Such
interest shall not be payable on late charges.
CONTRACTORS ARE REQUIRED TO BE LICENSED AND REGULATED BY THE CONTRACTORS STATE LICENSE BOARD, ANY
QUESTIONS CONCERNING A CONTRACTOR MAY BE REFERRED TO THE REGISTRAR OF THE BOARD WHOSE ADDRESS IS:
CONTRACTORS STATE LICENSE BOARD, 1020 N STREET, SACRAMENTO, CA. 95814.
****NOTICE TO OWNER****
Under the mechanics' lien law, any Contractor, Subcontractor, laborer, material man or other person who helps to improve your
property and is not paid for his labor, services or material, has a right to enforce his claim against your property. Under the
law, you may protect yourself against such claims by filing, before
Commencing such work or improvement, of a modification thereof, in the office of the county recorder of the county where the
properly is situated and requiring that a Contractor's payment bond be recorded in such office.
Said bond shall be in an amount not less than fifty (50%) of the contract price and shall,in addition to any conditions for the
performance of the contract, be conditioned for the payment in full of the claims of all persons furnishing labor, services,
equipment or materials for the work described in said contract.
IF THIS WORK IS PERFORMED ON RESIDENTIAL PROPERTY, THE OWNER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO
MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.
have, the complete contract and agree to th specifications p
Accepted by: Date: --- e) ,00
(Owner or A4orized Agee
Accepted Contract # 1024 - Effective as of : Date: By:
Bin #
City of La Quints
Building U Safety Division ,
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #P.O.
�j
b$
ProjectAddress: s -�% Qt)r �o(�
Owner's Name: paie dko dAj
A. P. Number:
Address:
Legal Description:
City, ST, Zip: t IdRv
Contractor: U 1 i1,4 c—
Telephone: - ] ` -
Address:
Project Description: t%106r
City, ST, Zip: 40 2 /i
Telephone: -3 - 35
State Lic. # : 77VY�,2 City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: 2 C Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Cejaig3Demo
Name of Contact Person:
Sq. Ft.: 0
# Stories:
# Units: /
Telephone # of Contact Person: 7 jJ -,3 ci3
c�
Estimated Value of Project: 66
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIQNG .
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°d Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans. picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
M Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees