04-7481 (RR)�
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BUILDING SAFETY DEPARTMENT
.P �O:b Box 1504 (.760),777-7012 -
OFV 78=495 CALLE TAMPICO, FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-71.53
BUILDING PERMIT
Application Number\ 04-0000.7481 Dat -e. 11/29/04
Property Address 52105 AVENIDA VILLA
APN: 773-233-017-6 -000)00-
Application.description . . RE -ROOF
Property Zoning . . . . . . . COVE RESIDENTIAL
Application valuation 6985
Owner Contractor
CLARK JEFFREY A DEW.ROOFING, -NC.
P. 0-. BOX 914
�IcNA� jSvgo,5 CA 999 9 PALM SPRINGS CA 92263
�a 6jui� TA R275�
WCC: STATE FUND
WC: 15090.1903 12/01/04
CSLB: 409619 07/31/05
CCC C39
Permit RE -ROOF
Additional desc
Permit Fee 30.00 Plan Check Fee .00
Issue Date Valuation 0
Qty Unit Charge Per Extension
BASE FEE >�30.00
Special Notes and Comments
RE -ROOF WITH CLASS "A" MATERIALS -
Fee summary Charged Paid Credited` Due,
Permit Fee Total 30.00 .00 0) 30.00
Plan Check Total .00 00 00 .00
Grand Total 30.00 .00., .01) 30.00.
P.O. Box 1504 • VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (76.0) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 04- 10 Date:
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
6) 114;
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of pequry that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
C de, and my Q e m full force and effect. C�
119 �ense Class ' / cense No. � Q f !o
OWNER -BUILDER DECLARATION
I hereby affirm'under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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 exerhptiom: Any violation of Section 7031.5 by any applicant fqr a permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U 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 or 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date
WORKERS' 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.
have and will maintain workers' compensation insurance, as required by Section 37d0 of the Labor Code, for the performance of the work for which this permit is
ue My wor ers' compensation ince came and poli�.y numb rare:
Cartier policy Number (�O ,�
_ 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 the workers' compensation provisions of Section 3700 of the Labor Code, I shall
Gforthwith comply with those provisions.
ate icant
WARNING: FAILURE TO SECURE WORK COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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
Lenders Address
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 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 hereby authorize representatives of this county to enter upon the ove entioned property for inspection purposes.
o� p �
ate a/� O� / ignature (Applicant or Agent):
License-�No.409619 CONTRACT PROPOSAL
Contractors are required by law to be
AT%� licensed and regulated by the Contractors'
' ROOFIl�TG, INC. StateglceBoard. Any questions can-
DEWcernli a contractor may be referred to the
regis:rar of the board whose address Is:
640 Williams Road - P. O. Box 914 Contractors' State License Board
1020 "N" Street
PALM SPRINGS, CALIFORNIA 92263 Sacramento, California 95814
Phone (760) 327-3393
Contractor: Address:
j;
Owner: •Jeff Clark 771-1465 Job Site: 52105 Ave.. Villa La Quintj, CA.92253
WE PROPOSE AND AGREE to furnish,required. labor and material for
Remove .old roof. & re -roof
for the above named building using
SEE BELOW "•'
in accordance with submitted plans and specifications, for the sum of
S LOW ($ )Dollars
Bid O1 Roof using 1 layer.:30# fell: & 30 year. fiberglass shingies. $ 6,985.00
Bid `A2 - Roof slope roof 'using. 1 layer 4011 ifel.t & light weight hil-e.
Roof flat roof using"1 layer. glass base 1128 & 2layers glass ply. IV &
72# glass cap. $ 9,200.00
,r
3 Year C,uaranlee` -
ANY BAD SHEETING'DISCOVERED WILL BE REPLACED AT OWNERS EXPENSE. NOT INCLUDED 1N 1S BID
IF YOU WISH THE WORK TO BE DONE, SIGN THE CONTRACT PROPOSAL BELOW THE DATE AND ALSO ON THE BACK OF THE
SECOND SHEET, WHICH IS THE "NOTICE TO OWNER." WE ARE SENDING TWO (2) COPIES EACH OF rHE CONTRACT PROPOSAL
AND NOTICE TO OWNER. PLEASE RETURN ONE (1) COMPLETE SET TOPS. T
',Approximate starting date Approximate completion date:
ALL PAYMENTS TO BE 100% ON COMPLETION UNLESS OTHERWISE SPECIFIED ABOVE.
s
NOTICE.
' I "Under the Mechanics' Lien Law (California Code of Civil Procedure, Section 1181 et seq.),
r.,..
- � any contractor, subconlraclor,".laborer, supplier or other person who helps to improve ;your
property but is not'pald for his work or supplies, has a right to enforce' a claim against your
property. This means that, after a court hearing
, yourproperly could be sold by a court officer
and 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 remains unpaid."
41
.. 'This agreement shall become binding only upon .the Contractor's written acceptance hereof or upon the Contractor's commencing
.'performance and upon such acceptance or commencement of performance this shall constitute the entire contract and be binding upon the
parties hereto, there being no covenants, promises or agreements, written or oral, except as herein set forth.
% It it further understood that:,
(A) The.Conlraclor shall not be responsible for damage or delay due to strikes, fires, accidents or other causes beyond his reasonable control.
(8) The proposal is limited to days acceptance from date hereof.
...(C) The Purchaser is dealing with the Contractor as, principal and that the Contractor is not, acting hereunder as the agent or representative
of any, person, firm,'or corporation.
PRICE SUBJECT TO CHANGE'AT ANY TIME TO REFLECT INCREASED MATERIAL PWCES.
'A
Date ' 9/7R/04 {` DEW ROOFING, INC.
ac ept the above. proposal. }
F By: Salesman
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Approves!+by;