05-4774 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
0.5-0.0.0047-74= --_—.
79815 WESTWARD HO DR
649-061-005-5 -2190
RE -ROOF
LOW DENSITY RESIDENTIAL
10280
Architect or
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
------------------
LICENSED CONTRACTOR'S DECLARATION
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 B iess ar�1 Professionals Code, and my License is in full force and effect.
License Class:`C39 J License No.: 336547
rDate:_ _ ZJ 6ntractorr'rrthat
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of.peam exempt from the Contractor's State License Lawforthe
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 orshe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031 .5 by
anyapplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$5001.:
(_ 1 1, 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 I
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 _ 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 (Seca 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
MCCLELLAND DON D
79815 WESTWARD HO DR
LA QUINTA, CA 92253
Contractor:
MILLER & SONS ROOFING INC, AL
68760 SUMMIT DRIVE
CATHEDRAL CITY, CA 92234
(760)328-6616 .
LiC. No.: 336547
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10%25/05
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.
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 VIRGINIA SURETY Policy Number ICW50109602
_ 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 sho d ecom subject to the workers' compensation provisions of Section
3,7�0r/0 of the Labor C , I hall f rthwith comply with those provisions
WARNING: FAILURE TO SECURE W RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALT
SUBJECT AN EMPLOYER TO CRIM AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000). IN ADDITI N 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 su permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that e a ve infrmation is correct. I agree to comply with all
city and county ordinances and state laws relating to ildin onst ction, and hereby authorize representatives
of thiscounty to enter uratur,
he above-mentioned pro erty insp ion purposes.
Date-. 0`L ` 70 Si (Applicant or Agent):
Application Number -. 05-00004774
Permit . . ... RE -ROOF
Additional desc-
Permit Fee 30.00,Plan Check
Fee
.00
Issue Date Valuation
0.
Expiration Date 4/23/06
Qty Unit Charge Per
Extension
BASE FEE
30.00
--..- -
Special Notes and Comments_
'
REROOF-TEAR OFF WOOD SHAKE/REPLACE WITH
FIBREGLASS 30 YR SHINGLES/CLASS "A"
MATERIALS ONLY
Fee summary Charged Paid Credited
Due
t'a
Permit Fee Total 30.00 .00
.00.1
30.00
Plan Check Total .00 .00
.00
.00
Grand Total 30.00 .00
00
30.00
LQPERMIT
.
Bin #
City of La Q uinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: )Ci W C z / tUW2Q 140
Owner's Name: ocoo GG e Acv /
A. P. Number:
Address: �—, g .� LS f A F
Legal Description:
City, ST, Zip:
I
Contractor: �C {-� 9 1 1 t `t1e:y�_ Su ^1 S (� �t n.
(_ ^
Telephone: i a
g-
�, o
rr
Address: (o O S CU M wt 11— Q2
Project Description:
City, ST, Zip: CLT
Telephone:
WOO 0 (—�Off S
State Lic. #:
CityLic. #:
r'rj C t✓ k%/ G
Arch., Engr., Designer:
Q = el Z (� 2214S
Address:
S t ✓tr. � o v L. 2 � U
City, ST, Zip:
is O NU A le /L—
Telephone: t�
� yit
State Lic. #:
Name of Contact Person:
It
Construction Type: Occupancy:
Project j ct type (circle one): New Add'n Alter Repair Demo .
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 3L L — ('Z I �-!.
Estimated Value of Project: 1 (�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
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 Cates.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
iew, ready for corrections/issue
Electrical
Subcontactor List
FCallc-,dContact Per
Plumbing
Grant Deed
picked up s
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.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
i l
AL MILLER AND SONS ROOFING CO., INC.
BETTER ROOFS FOR BETTER LIVING"
68-760 SUMMIT DRIVE, CATHEDRAL CITY, CA 92234 I /�
PH. (760) 346-1214 FAX. (760) 321-7097
LICENSE # 336547
PROPOSAL AND CONTRACT
Owner: Don A4eKedua— Project: Nk-Keffan-Res.
Address: 79-815 Westward Ho Address: 79-815 Westward Ho
City: La Quinta, CA 92240 i QR �3 City: La Quinta, CA 9229 a 3
Phone: 33q-2215 3 417 - a a 17
WE PROPOSE TO FURNISH THE FOLLOWING MATERIALS AND P RFORM ALL LABOR TO ROOF THE ABOVE LOCATION.
Pitch Roofs Complete Re -Roof Scope of Work:
Roofing contractor will remove all of existing roof to wood deck and haul away. Any water damaged
plywood needed to be replaced per uniform building code will be installed at an extra charge of $42.00
per sheet. Roofmg contractor will install a class `A' 30 year Dimensional Shingle roof ( owner to choose
color ) over One ( 1 ) layer #'30 felt over existing main roof. Roofer will install new 2 inch edge metal
around perimeter of home. edge metal is unpainted and of Lalvanized finish_ Price includes roof nermits
Roofer to install a class `A' 40 year Shingle in lieu of 30 year Roof Price: $11,250.00
Note: Trees, Landscaping, must be trim back away and or off the existing roof by others.
*Work to start in approximately eight to ten weeks of receiving signed proposal*
• Terms: Net Cash on Completion
ATTENTION
Section 7018 of the Contractors License Law provides that starting July 1, 1966, everyone licensed by the Contractor's License Board shall
give a copy of the following notice to the payor prior to receiving from the owner of the property or his agent any payment for work which a
contractor's license is required
NOTICE
"Under the mechanics' Lien Law, any subcontractor, laborer, supplier or other person who helps to improve your property but is not paid'for there
work or supplies, has a right to enforce a claim against your property. This means that, after a court hearing, your .property could be sold by a court
officer for the proceeds of the sale used to satisfy the indebtedness. This can happen even if you have paid your own contractor in full, if the
subcontractor, laborer, or supplier remained unpaid."
Al Miller & Sons Roofing Co., Inc. Agrees to furnish its regular form GUARANTEE for 2 Years after completion of its said work. Said guarantee
to cover defects in material, and workmanship only and not to extend to damage to roofing caused by the elements, other unusual Acts of God and
shall not cover any liability for damage to interiors fixtures, decorations, walls, contents of building or other pars of structure not to damage of
faulty construction. It is also understood and agreed that the above guarantee shall be made and remain only when and if payment is made as agreed
in this contract. A] Miller & Sons is not responsible for TV antennas ,
We are fully covered by Workmen's compensation and public liability insurance. Carriers' names and policy number are available on request.
Any alterations or deviations from "the above specifications involving extra cost of material or labor will only be executed upon written orders for
same, and will become an extra charge over sum mentioned in this proposal. All agreements must be made in writing. This offer is valid for one
' week from the date of estimate and is based on free access to building for direct loading from our truck.
Prices are based on current cost of material and labor, increases or decreases will be reflected at time of signing of contract. Al Miller & Sons is not
responsible for any damage to sidewalks, curbs or driveways. If there is any conflict between this proposal, and any other contract or specification
relating to the above referenced project the terms of this proposal shall prevail.
- RECD JUN 2 0 2005
Respectfully submitted,
c AL MILLER & SONS ROOFING., INC.
Accepted:
By: John Lamons, Estimator
Date: �//3 �d�' Date: 06-05-05