0107-123 (RR)CONTRACTOWDECLARATION
.,�-,khere - by aff- er penalty of perjury th I am licensed under provisions of
A 'Section 7000) of Division 3 of the Business'and'.
pter.-9 commencing with
Pr6feisibnals Code', and my License is in full force and effect.
License # Lic. Class Exp. bate'
Date Signature of'Contracto
I hereby affirm under penalty of perjury that I am exempt from th6*,Oontractor's..�
License Law for the following reason: o-,.,
1, as owner of the property, or my employeeswith wages,as their sole'- L*,�
compensation, will do the work, and the structuie is'not intend*e.d;or offered for.
sale (Sec. 7044, Business & Professionals Code).
contractors to construct the project (Sec. 7044, Business & Pi6f6'ssional-s
)'I am exempt un�ler Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under,penalty of perjury one of the following cleclaratio.ns:.
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 & policy no. are:
Carrier Policy No.
ISTATE FUND
(This section na6dhot becompleted nthe permit valuation isfor $10O.0Om s
( ) |oortify that inthe performance o,the work for which this permit isissued,
| shall not employ any person in any manner oo as to u000mo subject mthe
workers'; compensation laws ofCalifornia, and agree that if| oxou|U become
subject -to the workers' compensation provisions nfSection 37OOofthe Labor
Code, | shallforthwith comply with those -provisions,
L�_ Applicant
W61;Y1�aoure to secure Workers' Compensation coverage is unlawiziland
'shall subject an employer to criminal penalties and civil firies up to $100, 000, in
addition to the cost of compensation, damages as provide , d for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Appomumn.ohereby made mthe Director mBuilding and Safety
�o, a permit subject td the onnmUone and restrictions set forth on his
application.
, -
person1. Each up
wxno ��dfu application6n whose behalf this � person
any permit iss . bed as a result of I
this applicaton agrees to, & shall, indemnify
& hold harmles� the City of La Quinta, its officers, agents and . employees'.
��Any permit issued as aresult of this '
work is not commenced within 180 'days from .date of issuAn�c'e *of such
permit, nrcessation cVwork for 18Odays will subject permit �� .
I certify that I have read this application and state that the above information is"
Correct. |ageom comply with all City, and State laws ed�
ngv�obuilding
construction, and hereby authorize iep^eeentatives ofthiu Citym enuorupvn
the above-mentioned p,vptqy.Lar-inapomionpvq�seo.
Signatur.
PERMIT
JILDING.
TO LOT
Art �7150.00
JOB SITE
N
LA
OWNER
CONTRACTORY
F -71 1 ROOFING C0.
(760131150-8099 milk 1925
BmXdATrD Con or cojiwmvaj�qx
191750R.0
REROOP'Feg -000-4184000
JUL
13 20ol
L
30.0
EIPT
DATE'
BY
FINALED
INSPECTOR
----' — -- —' --
' F
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
;
Underground Ducts
Forms & Footings
Ducts
Slab Grade
' !
Return Air
Steel
Roof DeckIG-`!
_ _ j �"
/
Combustion Air
Exhaust Fans
O.K. to Wrap
l
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
%
Fans & Controls
Party Wall Insulation
'
Condensate Lines
Party Wali Firewall
Exterior Lath
H
Drywall - Int. Lath
1
1
+
Final
Final
tPOOLS
- SPAS
BLOCKWALL APPROVALS ?steel
. '
Set Backs
+ a
Electric Bond
Footings
�_
Main brain
Bond Beam • . -
Approval to Cover
'I
Equipment Location
Underground Electric
Underground Plbg. Test
Final
r"' i
Gas Piping
` { PLUMBING APPROVALS
Gas Test
r
I
Electric Final
Waste Lines
Heater Final
Water Piping
?
Plumbing Final
Plumbing Top Out
-
Equipment Enclosure ,
Shower Pans
;
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
* :
Encapsulation s
Gas Piping
Gas Test
,
Appliances
o
Final
'COMMENTS:
i
Final .a
Utility Notice (Gas)
!
4
ELECTRICAL APPROVALS
.:.;
Temp. Power Pole
;
Underground Conduit
t
- Rough Wiring
Low Voltage Wiring.
1
Fixtures
J
Main Service
Sub Panels •,
Exterior Receptacles
,
G.F.I.
I
Smoke Detectors
`
Temp.: Use of Power.
. Final
Utility Notice (Perm)
'
r
PRO -TECH ROOFING, INC.:PROPOSAL
78-670 HIGHWAY iil SUITE 185
LA QUINTA, CA 92253
(760)360-8099 _
LIC.# 741152
DATE
PROPOSAL#
3/28/2001
455
DESCRIPTION
TOTAL
REROOF W/ U.S. RED 2PC MISSION
-
1.9,750.00
r
f
1. REMOVE EXCISTING ROOF TO SHEETING, ALL DAMAGED PLYWOOD OR FACIA
BOARDS TO BE EXTRA.
2. INSTALL ONE PLY BASE NAILED TO SHEETING OVER FLAT ROOF AREAS,JNSTALL
ONE PLY SMOOTH MODIEFIED OVER BASE, THEN SET DRAINS SCUPPERS OR SHEET
.
'
„
3. ALL TILE ROOF AREAS 3 IN 12 PITCH AND BELOW TO HAVE ONE LAYER BASE ,
NAILED AND ONE LAYER MODIEFIED TORCH INSTALLED BEFORE TILE.
4. ALL TILE AREAS ABOVE •3 IN 12 TO HAVE TWO LAYERS 40 LBS FELT NAILED TO
SHEETING. '
5. INSTALL TILE TO LOOK HISTORIC LAQUINTA WITH FULL MUD.
DESCRIPTION
TOTAL
REROOF W/ U.S. RED 2PC MISSION
-
1.9,750.00
r
f
1. REMOVE EXCISTING ROOF TO SHEETING, ALL DAMAGED PLYWOOD OR FACIA
BOARDS TO BE EXTRA.
2. INSTALL ONE PLY BASE NAILED TO SHEETING OVER FLAT ROOF AREAS,JNSTALL
ONE PLY SMOOTH MODIEFIED OVER BASE, THEN SET DRAINS SCUPPERS OR SHEET
METAL. INSTALL ANOTHER LAYER MODIEFIED GRANULATED TAN OVER SMOOTH
'
TO FINISH:
3. ALL TILE ROOF AREAS 3 IN 12 PITCH AND BELOW TO HAVE ONE LAYER BASE ,
NAILED AND ONE LAYER MODIEFIED TORCH INSTALLED BEFORE TILE.
4. ALL TILE AREAS ABOVE •3 IN 12 TO HAVE TWO LAYERS 40 LBS FELT NAILED TO
SHEETING. '
5. INSTALL TILE TO LOOK HISTORIC LAQUINTA WITH FULL MUD.
.
6. CLEAN UP JOB.
-7. NOTE: ALL A/C CONNECTION AND RECONNECTIONS -IF REQUIRED TO BE DONE BY
"
OTHER AT OWNERS EXPENCE.
ti
Thank'you for your business. ,
David Krastel, President '
$19,750.00
_ �' _ _.._._.__. _. -. -•
THE ABOVE PRICES, SPECIFICATIONS AND CONDITIONS
ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU
ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.
' PAYMENT•W LL BE MADE AS OUTLINED ABOVE.
SIGNATURE'