05-4132 (RR)P.O. BOX 1504 .
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
,05-l;04713:2�
Property Address:
49105 CALLE FLORA
APN:
658-210-001- -
Application description:
FRE-ROOF3
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
19000
T-iht -4 4 Q"
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Business and Professionals Code, and my License is in full force and effect.
License Class: CC3399 .11 License No.: 67595
Daf to-�"C� Contractor. ' 0.
O R -BUILDER DECLARATION
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 tequires 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):
(_ 1 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.).
(_ 1 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 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:
LQPERMIT
Owner:
KNOX GABRIELLA
49105 CALLE FLORA
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-701.1
INSPECTIONS (760) 777-7153
Date: 9/15/05
FCITy
Contractor:SPRAY FOAM OF SOUTHERN CA 5 1005
43890 WARNER TRAIL
PALM DESERT, CA 92211 OV: LA (760)345-5599 E0A
LiC. No.: 675959
-----------------------------------------------
- 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.
41 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 STATE FUND Policy Number 0440022264
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 Cohall fo hwith comply w' ese-pre isions.
Applicant07•
WARNING: FAILURE TO SECURE WORKERS OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 15100,0001. 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 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 1 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 buildm ction,�td hereby orize representatives
of this county to enter upon the above-mentioned prope or ms ction
nature (Applicant or Agi
Application Number . . . . . 05-00004132
x
Permit RE -ROOF
Additional desc .
Permit Fee 30.00
Plan Check
Fee
.00
Issue .Date
Valuation
. . .
. 0
Expiration Date 3/14/06
Qty Unit Charge Per
Extension
BASE
FEE
30.00
----------------------------------------------------------------------------
'Special Notes and Comments
REROOF WITH URETHANE FOAM/CLASS
"A"
MATERIALS ONLY
Fee summary Charged
----------------- ----------
Paid Credited
----------
Due
-----------
Permit Fee Total 30.00
.00
----------
.00
30.00
Plan Check Total .00
.00
.00
.00
Grand Total 30.00
.00
.00
30.00
LQPERMIT
Sprayfoam of Southern California
43-890 Warner Trail
Palm Desert, CA 92211
(760)345-5599 (760)345-5159 fax
675959
Residential
Customer Information
Permit No.
Bit1 To: InstaUadon Address:
Gabriella Knox Re000f
49-105 Calle Flora 49-105 Calle Flora
La Quinta Ca 92253 LA Quinta CA 92253
SPECIFICATIONS:
Icbo Report # 4630 UI Report # R10185
Proposal and Contract
# DC871
Monday, August 29, 2005
100% 5 -Year Guarantee
If a Leakage, caused by defects in material and/or
workmanship occurs, within the above duration
from date of application, we will repair it free of
charge.
(Class A Over Combustible deck rating)
Broom Vac Broom to remove all Dirt and Rock. (OWNER TO REMOVE ALL UNUSED EQUIPMENT AND ELECTRICAL,= PLANTER BOXES.
�ut around all drains on roof to remove repair where they are necessary.
Primer entire roof with neo prime primer (black Color).
Install 11/2 inches of Urethane Foam roofing to entire flat roof.Build-Up low areas where necessary:
Apply two coats of permax 108 elastromeric coating system at a rate of 3 gallons total per 100sgf total
Finnish color White.
r.Ac work is to be done by Owner
SPECIAL INSTRUCTIONS:
JOB SQ. FT 5700
Appearence of the finished roof surface will be pebbly and somewhat uneven. Final roof surface will be affected by the texture of the existing roof
surface.
Foam will be tapered a minimum one inch thickness to a thickness of approximately three quarter inch plus or minus at all roof edges. Existing
gravel guard will not be removed unless customer wishes to pay the cost and replacement of new gravel guard.
Only loose gravel, dust, and dirt will be swept off. Secure gravel will remain on the roof. Gravel will be removed from premises unless customer
wants it.
Completion of roof application will be affected by weather conditions, including rain, wind, and fog.
Sprayfoam of Southern California cannot guaran tee removal of all water standing on flat roofs when completed. (Ponding Water)
Definition of ponding water as per industry standards: A pool of water at least 1/2 inch deep that remains in an area no less than 100 square feet
24 hours or more after rain.
Industry Standards:
This guarantee does not cover any damage to the interior or exterior of the premises on which the roof is applied or damage to any
contents therin. This guarantee also does not cover damage to roof due to any cause behond our control including, but not limited to,
fire, lightning, windstorm, hailstorm, installation of antennas or other equipment, traffic on roof, structural fault or settlement,
cracking or other failure of the roof deck, walls or foundation of the building on which the roof is applied.
Should it become necessary for the roofing contractor to remove and/or reinstall any antennas, cooling or heating appliances or
other equipment, whether or not an additional charge is made for such work, customer understands that neither Sprayfoam of
Souther California, not the installer assumes any responsibility for the performance of said equipment
Sprayfoam of Southern California does not assume any responsibility for corrections of existing code violations or for the repair of
any existing defects unless specified in the estimate and proposal
Terms and Conditions:
Installation: It is understood that by the acceptance of this Proposal you authorim Spmyfoam of Southern California to make the installation; (1) to issue work order with specifications shown
herein and (2) to pay our charge for such installation. You agree to pay to Sprayfoam of Southam California, the amount sperafied herein; which will cover the price of said materiel and the
installation charge.
This estimate is based on a complete job and any surplus material remains the property of Spmyfoam of Southem California
Verbal understandings and agreements with representatives shall not be binding unless set forth herein.
There shall be no liability for delays in, or failure to complete, delivery or installation of all or any of the herein mentioned merchandise, if due to fire, strikes, at, governmental regulations, or
any muse beyond our control. '
Any changes made by you in the specifications herein, necessitating additional materials or labor shall not be covered by this proposal, but shall be provided for under separate and additional
Completion of above job will be estimated Total
at 10 days from the commencement of
Signature: work unless otherwise specified.here:
$19,000.00
Date: Agreed upon begining date:
.................................................
.................................................
TOTAL -PAID UPON COMPLETION
Authorized lie UNLESS OTHERWISE SPECIFIED IN THE
CONTRACT
Contractors are required by law to be licensed and regulated by the Contractors' State
License Board. Questions concerning a contractor may be referred to the registrar of the
board whose address is:
Contractors' State License Board
1020 North Street
Sacramento, CA 95814
Valid for 30 daysfrom the proposal dare indicated above
Ell
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
78-194 Elenbrook Ct.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE Of
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ Q/GA
❑POST TENSIONED CONCRETE ❑ASPHALT ❑OTHER ��`� V....�
❑ REINFORCED MASONRY ❑ FIRE PROOFING
JOB LOCATION .. �� CA / 0�A 1, hr1 REPORT SEQUENCE NO.
` ^L
TYPE 0 S _ 6TURE ^
j8�
YF�SIw./t"'/17—
PERMIT N0. DAT I II /
DAY OF WEEK
MATERIAL DESCRIPTION
ARCHITECT INSPECTOR
HRS. CHARGED
ENGINEER ASSISTANTS
HRS. CHARGED
SUB
INSPECTION GENERALCONTRACTOR& �{ ®Q W \fit I �S CONTRACTOR
DATE
v"a le PAS -S- L -::i0.L C.C;' wwe
IIS''
�IQ Pte- fI f4 60t
COPY SENT TO CLIENT ❑
CONTINU NEXT PAGE 0
PAGE OF
CERTIFICATION OF COMPLIANCE
'HEREBY CERTIFY THAT 1 HAVE INSPECTED TO THE BEST OF MV
KNOWLEDGE ALL OF TME ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED, I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
/,(Gt/qTURE OF REGISTERED INSPECT
3o7,�
DA E F REPOR REGISTER NUMBER