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04-7200 (RR)ON ` m'°� ?.,0. Box 1504 VOFTt�9 78495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 �`- Application Number . . . . ., 04-00007200 Date 11/15/04 Property Address . . . . . . 51860 AVENIDA HERRERA APN:' 773-173-006-19 -000000- Application description . . . RE -ROOF Property Zoning.. . . . . . . COVE RESIDENTIAL Application valuation . . . . 4900 Owner Contractor -- - - - - - - - - - - - - - - - - - - ---- BUMPUS ELLEN -----'------------------ URETHANE FOAM CONSULTING/SRVC 51860 AVENIDA HERRERA P.O. BOX 638 LA.QUINTA CA 92253 THOUSAND PALMS CA 92276 (760) 346-9840 WCC: STATE FUND WC: 0460005057 01/01/05 . CSLB: 736420 05/31/05 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 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 P.O. Box 1504�� VOICE (760) 777-7012 78-495 CALLE TAMPICO Tdf FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: O Y - > 2 00 Date: //- /k _o Applicant: /` T l , ter✓ / �l/9`l%/ �--� Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 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 Licens is in,fyll ce and effect. License Class License No. Date %/-1 5 6V Contractor OWNER43UILDER 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 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).): U 1, 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 Owner 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. _ 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 wo s' com ensation insurance carrier and policy number a Carrier S 7�i`t _ Policy Number O Y b 00 J �j _ 1 certify that, in the performance of the work for which this permit is issued, I sha} of 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 fo the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. WARNING: FAILURE TO SECURE WORKERS' 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.). Lenders 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 above-mentioned property for inspection purposes. Date/ 1 Signature (Applicant or Agent): PROPOSAL and CONTRAC RESIDENTIALII COMMERCIAL ❑ MOBILE HOME ❑ SPECIFICATIONS & UNDERSTANDINGS 1. Type of roof(s): Hip ❑ Gable ❑ Flat ❑ Metal ❑ Shingles ❑ Sloped 2. Awnings included Tile ❑ 90# Felt 3 3. Garage included Yes EN No ❑ Shed Yes ❑ No Ca 4. Carport included Yes ❑ No a Patio Yes ❑ No M 5. Existing covering is 90# 6. Vacuum Roof Yes ❑ No M Large Rock Yes ❑ No C3 7. Power Wash Yes ❑ No M Dump Truck Yes ❑ No I2 8. Desert cooler removed and replaced Yes ❑ No ® Platform ❑ 9. AC unit lifted and replaced Yes ❑ No$] Granules Yes ❑ No 10. AC duct urethaned and coated Yes a No ❑ Primer Yes ® No 11. Color of coating White lX Other ❑ 12. Application of coating 1 ❑ 2 ly 3 ❑ Sheeting 4" x 8" -- 13. Install unpainted metal edge, No. ft. ❑ Scarfing 14. Appearance 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. 15. Foam will be tapered from a minimum 1 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. ❑ Not Applicable - Repairs & Coating Only 16. 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. 17. Completion of roof application will be affected by weather conditions, including rain, wind and fog. 18. Urethane Foam Consulting & Services cannot guarantee removal of all water standing on flat roofs when completed. (Ponding Water) 19. Definition of ponding water as per industry Standards: A pool of water at least 1/2" deep that remains in an area no less than 100 square feet 24 hours or more after a rain. 20. Roof must conform to 1994 Uniform Building Code concerning adequate drainage of flat roof areas. SPECIALISTS SINCE 1971 'Urethane Joam Consulting & Services 27-555 RIO DEL SOL, P. O. BOX 638 THOUSAND PALMS, CA 92276 760-345-0622 • 760-346-9840 • FAX 760-343-1754 CAL. STATE LIC. C-39 #736420 Customer's Ellen Bumpus Name Address ,��1l 8T6:0iAV" eni 'a` H r a T.= nisi ri ra 07751 City -- s4" "" State Installation Same Address Nearest Cross Street Home Bas 568-8947 Code 45 Date 9-24-b4 Sq. Ft. 1.379 Permit # 2 5 Q— 100% 5 -YEAR GUARANTEE If a leakage, caused by defects in material and/or workmanship, occurs, within five years from date of application, we will repair it free of charge. Any other work done by other contractors will void warranty. System # SPECIAL INSTRUCTIONS: ICBO REPORT #4630 OR ER -5289 PUL REPORT #R10185 (This is a Class A over combustible deck rating) City Permit Required Yes 5a No ❑ Reroof as pe-- city r-nn2 _ Clean anri pri mer rnn f with neoprene. Apply 1" thickness ur_ethanP foam and 9 rnai-.c; of acrylic coating system. Cost $4,000.00 Addition j-" thickness urethane foam Cast $ 900-00 NOTES: IV KEEPING WITH INDUSTRY STANDARDS 1. 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 therein. This guarantee also does not cover damage to roof due to any cause beyond 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 foundations of the building on which the roof is applied, or other persons roof adjoining the structure. 2. 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 Urethane Foam Consulting & Services, nor the installer assumes any responsibility for the performance of said equipment. 3. ,Urethane Foam Consulting & Services 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, including pre-existing foam done by another contractor. Total Cost,,W.� vu...I TERMS: Paid upon completion unless `Urethane Joam Y otherwise specified in the contract. Consulting &Services The date on which work will be substantially completed is estimated to be 27-555 RIO DEL SOL, P. O. BOX 638 approximately 10 days after commencement of work unless a different estimated TH USAND PALMS, CA 92276 completion date is shown herein: If not accepted in 30 days this proposal is null and void. B y Mutually agreed beginning date: Autho e INSTALLATION: It is understood that by the acceptance of this Proposal you authorize Urethane Foam Consulting & Services 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 Urethane Foam Consulting & Services the amount specified . herein, which will cover the price of said material and'the installation charge. This estimate is based on a complete job and any surplus material remains the property of Urethane Foam Consulting & Services. 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, war, governmental regulations, or any cause beyond our control. Any changes made by you in the specifications herein, necessitating additional materials or labor shall not be included or covered by this proposal, but shall be provided for under separate and additional order from you. ACCEPTANCE Contractors are required by law to be licensed and regulated You are hereby authorized to furnish all materials and labor required to by the Contractor's State License Board. Any question complete the work mentioned in the above proposal, contract for which I/ concerning a contractor may be referred to the registrar of the We agree to pay the amount mentioned in said proposal, and according to the board whose address is: terms thereof. ACCEPTED: r - Contractor's State License Board P. O. Box 26000 x Sacramento, California 95826 Owner's Signature 'FOR YOUR PROTECTION" CUSTOMER - WHITE FILE - YELLOW WORK ORDER - PINK WE ARE COVERED BY WORKER'S COMPENSATION, AND WE HAVE GENERAL LIABILITY INSURANCE.