BRER2014-102078-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
BRER2014-1020
Property Address:
49778 ENTRADA CIR
APN:
646240002
Application Description:
RE -ROOF HALF AT 1250 FT
Property Zoning:
P O BOX 122
Application Valuation:
$5,391.00
Applicant:
CASTRO ROOFING INC
P 0 BOX 122
THOUSAND PALMS, CA 92276
c&tit D VOICE (760) 777-7125
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/9/2014
Owner:
ANN WIDENER
1110 E MOUNTAIN ST
GLENDALE, CA 92253
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lic sed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 oft Business and Professions Code,
and my License is in full force and effect.
License Class: C39 License No.: 828478
i
io q wt o
Date: " Contractor:
OWNER -BUILDER DECLAR74TION
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.).
(_) 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 Addre:
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.i1 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:
Ca'rrier: Y Policy Number:
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manneo as to become subject to the workers'
compensation laws of California, and agre that, if I should become subject to the
workers' compensation provisions of Sectio 3700 of the Labor Code, I shall forthwith
comply with tthho provisions.
Date:! , i Applicant: `
WARNING: FAILURE TO SECURE WORKERS' CIAPENSATION 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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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 an,
I agree to comply with all city and county o
construction, and hereby authorize represe
mentionnee ro erty for inspection purpose
Date:' V- Signature (App
state that the above information is correct.
dCmances and state laws relating to building
Eatives ty to enter up the above
t or Agent):
D e
�o
Contractor:
N
M
CASTRO ROOFING INC
3 s
P O BOX 122
LLo
THOUSAND PALMS, CA 92276
o
(760)343-0042
z
Llc. No.: 828478
C
Q
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.i1 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:
Ca'rrier: Y Policy Number:
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manneo as to become subject to the workers'
compensation laws of California, and agre that, if I should become subject to the
workers' compensation provisions of Sectio 3700 of the Labor Code, I shall forthwith
comply with tthho provisions.
Date:! , i Applicant: `
WARNING: FAILURE TO SECURE WORKERS' CIAPENSATION 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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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 an,
I agree to comply with all city and county o
construction, and hereby authorize represe
mentionnee ro erty for inspection purpose
Date:' V- Signature (App
state that the above information is correct.
dCmances and state laws relating to building
Eatives ty to enter up the above
t or Agent):
FINANCIAL •R
•
DESCRIPTION
ACCOUNT,
QTY
AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forBU1LDING STANDARDS ADMINISTRATION BSA
$1.00
$0.00
DESCRIPTION
ACCOUNT,
QTY
AMOUNT
PAID
PAID DATE
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$49.31
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0
$98.62
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forRE-ROOF:
TOTALS:00
$147.93
$0.00
Description: RE -ROOF HALF AT 1250 FT
CONDITIONS
Type: RE -ROOF
Subtype: Status: SUBMITTED
Applied: 10/9/2014 SKH
Approved:
Parcel No: 646240002 Site Address: 49778 ENTRADA CIR LA QUINTA,CA 92253
Subdivision: TR 4293
Block: Lot: 17
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $5,391.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
ZIP
Details: REROOF -REMOVE EXISTING CLAY TILE, REPLACE UNDERLAYMENT AND RESET TILE. 2013 CALIFORNIA ENERGY CODE.
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESS1
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
CASTRO ROOFING INC
P O BOX 122
THOUSAND
PALMS
CA
92276
(
Printed: Thursday, October 09, 2014 9:52:36 AM 1 of 2
EYOF SYSTEMS
INSPECTIONS
RESULT REMARKS NOTES
FINAL"
PRE -ROOF
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS S131473 FEE
1 101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
RE -ROOF - FIRST 2,000
101-0000-42404
0
$49.31
$0.00
SF
RE -ROOF - FIRST 2,000
101-000042600
0
$98.62.
$0.00
SF PC
Total Paid for RE -ROOF: $147.93 $0.00
TOTALS:0•
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
FINAL"
PRE -ROOF
Printed: Thursday, October 09, 2014 9:52:36 AM 2 of 2
=SYSTEMS