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LICENSED CONTRACTOR DECLARATION
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 # Lic. Class Exp. Date
Date a164 Signature of Contractor, r !t "2=2A
__ .• — '__�OWA€i�-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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, & Professionals Code).
( ) 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am. exempt under Section , B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
Ihereby 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 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.
V11.IaAN0VA NO CO VJ'C'jow 4
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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 forthwith comply with 4se. provision%j
Date: 4- ;1,� r � I —_ ,+- z Applicant +� � �� �
YVaf6Tng: Failure to secure YIVoYI rs' Eomp�iis�tion, dov_erage is unlawful and
shall subject an employer to criminal penalties and civil'fines up to $100,000, in
,.ddition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is,hereby made to the Director of Building and Safety
fora permit subject to the conditions and restrictions set forth on his
application.
1: Each person,uponwhose 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 applicaton agrees to,.& shall, indemnity
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above:mentioned property for inspection pu oses.
Signature (Owner/Agent)' O T� DateJ
BUILDING PERMIT PERMIT# 21 ,.
DATE VALUATION LOT 010&1.41 TRACT
JOB SITE
APN
ADDRESS
9-4260Ai:UMM,
OWNER
CONTRACTOR / DESIGNER / ENGINEER
'I & JUDY PYLE
PK,{3::ONF! LA RC7O.F73a1G
78-32611h(UNDA
68-314 MI.Ff RD,
LA c,v+;TiA1'A',A CA 923 43
CATHEDRAL C""TfY CA 92234
060Y424• 5482 CB1,?J 5230
USE OF PERMIT
siENMA.L BUff.DINO
RY, T.tI RZIa OV IT, 4LREPI..ACL TITA TORCH. APPIAE13 YJUR TO FI.JeLT
AREAS- t::i,fM A ARE I3ATINO MATERIAL L MUST HE USED
X�'�t' ATXD CCM.' OF COXY.E'lfP11 CTION
111.2,000.00
Tf'MMC'r F:�t::'UM"RY
Iili ROOF FZZ IQ] -=1-4I a-000 $30,
�
f
JUN 12 2001
4 z W Y gi• LA i]UINTA
LF.0 PRE -PAW F03
0:0100
T OTAL PERW I PEP. 9 Di7K.HOW
RECEIPT
DATE ,'
BY
DATE FINALED
INSPECTOR
%r 'ail
it sP�cTior RE�o��
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
Cell LDWG
APPROVALS
Ali ECHAN�CAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
_
G .z�
Exhaust Fans
O.K. to Wrap
UF.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final idl > -
BLOC rKWALL AP ROVA LS
Final
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
(Dain Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric.
Underground Pibg. Test
Final
Gas Piping
PLUMBWG APPROVALS
Gas Test
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
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring'
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp, Use of Power
Final
Utility Notice (Perm)
COMMENTS:
Corporate Office:
2626 Newport. Blvd.
Costa Mesa, CA 92627
949-548-1645/Fax 949-548-2617
V0110th-0, it I it
License #460707
Desert Office:
68314 Kieley Road
Cathedral City, CA 92234
760-324-5482/Fax ?60-328-4612
PETRONELLA ROOFING hereinafter called "Contractor" and/or "Seller", agrees to provide the following listed labor, materials and construction:
NAME: Tom & Judy Pyle ADDRESS: 78126 Hacienda
CITY: La Quinta, CA 92253 PHONE:
DESCRIPTION OF LABOR, MATERIALS AND MISC.:
Petronella Ro.o.fng agrees to provide all labor, materials and' e.quipement necessary
to perform the flat roof replacement, the roof replacement, skylight replacement
and HVAC replacement in strict accordance with specifications prepared by Petronella
Roofing Company.
Includes.:
* Flat Roof. Replacement / GSFR-2-3 Roof System
* Hlgh Performance Modified Underlayment
Add 100% Mud Pack Throughout
* New Redland 'Old Sedona" 2 piece clay tile
* 3 New. Flat Glass Skylights
* 5 New Dual Dome Skylights
* 2 5 -ton HVAC Split Units with Pads
* l 4 -ton HVAC Split Unit with pads
* 1 Swamp Cooler
*Replac:ement of Deteriorated wood at Roof Level
* Plywood substrate replacement. as necessary
* Stucco Demo /Replacement As necessary to properly flash roof details.
Roofing Contract Price: $1.12,0.00.00
SPECIAL INSTRUCTIONS:
Terms: 25% Upon Award., .......... .......... .$28,000.00
25% Upon Removing tile and installing underlayment...$28,000.00
25% Upon Laoding.tile and flat roof completion ....... $28,000.00
25% Upon Final Completion ,and acceptance by Owner Rep$28.,0.00.00
Note': Any major deficiencies that are not considered stucco work or dry rot
repair will be brought to the attention of the owners representative.
TIME. FOR STARTING AND COMPLETING PROJECT:Work shall commence within' ten (10) days from the date of sale unless specified
otherwise . and be substantially completed in approximately ten, (10) working days with additional time
to be allowed as detailed in Paragraph 9. of the Terms, Conditions .and "'Notice to Owner" on the back hereof. Substantial Commencement of work
shall be defined as the installation of any materials and/or labor. Contractors failure- to substantially, commence work,' without.. lawful excuse, within
twenty. (20) days from the date specified-, above. is a, violation ,of: the Contractors License Law.
NOTICE TO BUYER: (1) Do not sign this agreement before you read it. (2) You are entitled to a completely filled in copy of this agreement. (3) Owner
acknowledges that he has read and received a legible copy of this agreement signed by Contractor, Including all Terms, Conditions and "Notice to
Owner" on the reverse side, before any work was done, and that he ,has read and received a legible copy of every document that Owner has signed
during the negotiations. (4) YOU,. THE BUYER, MAY CANCEL THIS TRANSACTION AT ANYTIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS
DAY AFTER THE DATE OF THIS TRANSACTION BY NOTIFYING THE SELLER, IN WRITINGi AT THE.ADDRESS ABOVE. IN THE EVENT YOU THE
BUYER FAILS TO EXERCISE 'THIS RIGHT AND SUBSEQUENTLY ATTEMPTS TO CANCEL THIS CONTRACT AFTER THE EFFECTIVE DATE OF
RECISION, THE CONTRACTOR SHALL BE ENTITLED TO RECOVER ALL COSTS AND LOST PROFITS ASSOCIATED WITH THIS CONTRACT.
(5) YOU, AS OWNER OR TENANT, HAVE THE RIGHT TO REQUIRE THE CONTRACTOR TO HAVE A PERFORMANCE AND PAYMENT BOND
OR FUNDING CONTROL.
OWNER (BUYER) A�_�
CTOR (SELLER)
ael Petronella
OWNFR-RI 1VFRRI�;NA711RR••
PRICE
g 112,000.00