BRER2017-0081P.-
78 -495a "� Cl/ VOICE (760) 777-7125
CALLE TAMPICO 4
LA QUINTA, CALIFORNIA 92253 ;a ` �- FAX (760) 777-7011
DESIGN & DEVELOPMENJ DEEPARTMENT-•�: '� 4 INSPECTIONS (760) 777-7153
BUILDING PERMIT
AUG. 14k % Date: 8/14/2017
Application Number: BRER2017-0081 Owner:
Property Address: 52260 AVENIDA VILLA CTM OFLJdAMES HILL
Application Description: ..HILL 2RESIDENCE / REROOF 74004 DESIGN'
DEVELQi 4h,�fNuyg�nA 92n, id1?A
Vr
Property Zoning:
Application Valuation: $7,686.00 ,
Applicant: Contractor:
FOAMBOND CORPORATION FOAMBOND CORPORATION'
255 N EL CIELO RD STE 140-656. 255 N EL CIELO 4D STE 140-656
PALM SPRINGS, CA 92262 PALM SPRINGS,CA 92262
(866)404-5440
Llc. No.: 868171
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
9 (commencing with Section 7000) of Division 3 of the Business i
and my License is in full force and effect.
License ass:.C39 License No.: 868171
Irk' wrnntraetor:
y6sions of Chapter
Professions Code,
OWNER-BUILDP Lam
LARATION
I hereby affirm under penalty of perjury th exempt from the ctor's StateLicense Law for the following reason (Sec. 70 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.).
(_) 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.).
(_) 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:
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
iOssued`My workers' compensation insurarce carrier and policy number are:
Carrier: CALIFORNIA INSURANCE COMPANY Policy Number: 4684631401
_ I certify that in the performance d the work fob 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 the
workers' compensation provisions of Section3700 of a Labor Code, I shall forthwith
comply with those provisions.
Date /Y1V7;;;2- '(A—nn lica`nty
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL,SUBJECT AN EMPLOYER TO CRIM`NAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,00). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FCR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to tie Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person'upon whose behalf this appication 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 :he work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this appli:ation becomes null and void if work is
not commenced within 180 days from date o- 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 abov ' motion is correct.
I agree to comply with all city and county ordFnences and sta a law elating to building
construction; and hereby authorize representatives of t ' city t nter upon the
above -men 0 ned roperty for inspection purposes.
Da�teD �4/ I Signature (A� ppli r A nt):
FINANCIAL INFORMATION
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00.
DESCRIPTION
ACCOUNT
ACCOUNT
QTY
AMOUNT
.101'000d(-42404
1.
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00.
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF - EA ADDITIONAL 1,000 SF
.101'000d(-42404
0
$12:16
DESCRIPTION
ACCOUNT
I QTY
AMOUNT
RE -ROOF- FIRST 2,000 SF
101-0000-42404
0
$51.68
DESCRIPTION
ACCOUNT '
QTY
AMOUNT
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0 •
$103.36
Total Paid for RE -ROOF: $167.20
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
.0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
f>
i
Bin#
City o. f La Quinta
Building & Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building.Per`nitApplication and Tracking.Sheet
Permit#
Project Address: S -'Z Z 6�
Owner's Name:
A.P. Number
Address:
Legal Description:
City, ST, Zip:
Contractor-Telephone:�AAD�
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Address: 7?l? / A�
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Project Description:
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City, ST, Zip: �... S r,. C
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Telephone:
S/
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N.. rov ; a
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State Lic. #: /
City Lic #:
_.11
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Arch, Engr., Designer:
Address:
City, ST, Zip:
Telephone:
-Construction
Type
Occupancy:
State Lic. #:
Proj. Type
New
Add'n
Alter
Repair
Demo
Name of Contact:
SgFt: V -2
#Stories
# Units:
Telephone of Cont act:O vG d
F ell- L�
Estimated Value of Project:
G as
FI
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check Submitted
Item
Amount
Structural Cates
Reviewed, ready for corrections
Plan.Check Deposit:
Truss Calcs
Called Contact Person
Plan Check Balance:
Title 24 Calcs
Plans Picked Up
Construction:
Flood Plain Plan
Plans Resubmitted
Mechanical:
Grading Plan
2nd Rev, Ready for corrections /
Electrical:
Subcontractor List
Called Contact Person
Plumbing:
Grant Deed
Plans Picked Up.
S.M.I.
HOA Approval
Plans Resubmitted
Gradirg
IN-HOUSE
3rd Rev, Ready for corrections /
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Apps
Date of permit issue
School Fees
Total Fermit Fees
wet coating. EC=100",:at 11%:=gal/100 ft. 1611owed immediatelywith 'Wo -Tech Gran6Ies" (not UL:Classified) at E0 Ib/sgambedded'irV
Ti pVCoat—:"EC-.W",;atJVi-"gal/100-ft:Z.
4. Deck: NC inclines;1%2., .
Existing Roof System: _bass A; 15 o(.0 roof covering: system; to retarn.the:existing Class A : B or C classification Nhen covered.;with:
- . .
Foam: — 'Pro=Tech Urethane Foam :or Polythene Systems SH -.200=25 insulation, min l• In tlifck,.,
Base,toat. "EC 100 ;at 1r/1-gal/100 ft;2..
TO Coat:.=.,'+EC=1k"`,,at;1i'h<ga1j16-ft-
5 Deck: d',k5%32. ,,Incline::1j7.
Existing, Roof system Class A, B`or C roof coverinq.system to.retaIri the exlsting CIassA, B'or'Ccla'ssificatron:-Nheh'c&ered: WIff:
Foami —"Pro -Tech Urethane Foam" or Polythahe•Systems "SHr200 25>"°insulation; min;.2.ln`.:fhkk.:
Base;Coet — "EC :300 6t17h gal%10040'foll6wed immediately wI h, "Pro-Tech,GFanules ,(not ULCIa'ssifiedj at!50`Iti/sq.'Imbedded in
wet coating
Top'Coat 11. "EC=100",.at 1'h gal/:f00-fti1::
Class A
1. Deck: C=15/32' Incilne:.1'/ :;
Existing Roof System Class;A;. B:or C roof covering _system covered with
Foam: _ Pro Tech Products Urethane Foam 'or Polythane Systems SH 200 25 insulation min 2;in thick.
Coating Two:or three coats EC 100 at 3=174 gal/sg%coat with "Pro Tech Granules. not:. L,Classified)at, 64 1a/sq Imbedded into one
of the�wet coats:
Surfacing Mixture:of "Pro Tech Prod.ucts,Dry Mix' (:40,`Ibs), :Rohm &Haas MC -76 (1[2;galj,, Rhone Poulenc E61lcAd,622- (3/,4: oz): and:
yreter.(4 1/2 gal;) spray';a.pplled.pec 100,`sq.,ft.
2. Deck: C-15/32; Incline: 172 Ympactca,
ExistingAoof System:,; -;'.Class A: Bor C,roof-covering system covered`with'i
Foam: Pro `Tech Urethane Foam insulation;only,;min 1 In thick.
.
Coating Two or three coats EC 100 at;1 1/4 gal/sq/coat with "Pro Tech Granules (noC.UL Classified) at 64 lie/sq Imbedded into one,
ofthe wet coats'.
Surfacing ':Mizture.of"Pro Tech,'Dry.Mix-1I" (40.Ibs);. Rohm &Haas MC -76 (1/2 gal), Rhone,Poulenc.Colloid 622 (3%4.oi)'ar d'viaterat
(3 i/2..to 4 1/2 gal) spray applied, per 100 sp f:
3; Deck: NC- ;.Incline: Urilimited Impacts 1.
`Ezisting� Rdof System:.—:Class A;: @ or C coof;covenng�system covered wrthi� •'
Foam: _ ProjTech urethane Foam";insulation>only min 1 In 'th'ick:
Goatin® — Tvuo;'or,three:coats.°EC'100',,at;i=1/4,dbl/sq/eoat,with "Pro -Tech Granules" (not',UL:CIas'sined) at 6496/sq Imbedded into one.
of the wet coats..
Surfacing Mixture oP'.P,ro Tech Dcy Mix 1. (40 lbs) Rohm.& Haas MC'76:(.1/2 gal); Rhone Poulenc Collold:`G22 (J'4',oz)•and water a[
(371;' to 4-:1/2 gaL} spray+appliedpe"r 100 sq, ft.
Class`:B
1: Deck: C-'15%37 Incline::;1/2'.
l
Existing Roof System. —Class :A or.,B gravel (loose gravel;may be removed),or'smooth`surfaced. BUR co4ered'wifi;.
Foam: —Pro Tech Products Inc 10-011 1V1 -in minimum thickness:
Coating NCFhPolyurethanes 'EnduraTech Q" or "EnduraTech.fi' applied at'a:maxi.mum of 3iZ gal/100.f 2'
Surfacing.,='No: 11•roofng:granules'at"45= lbsf1OOA1..
LastUodated on�201;602-10
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