09-0607 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant: A
09-00000607
51400 EISENHOWER DR
773-092-003-11 -000000-
RE-ROOF
COVE RESIDENTIAL
1200
T,i4t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
/V/J__(__:
rchitect or Engineer:
Alf-
--------------------------------------------------
LICENSED CONTRACTOR'S 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 Class: License No.:
Date: Contractor:
OWNER -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 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).:
1 f 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 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.).
1 _ 1 I am exempt under Sec. B.&P.C. for this reason
.ee.te: Dci O9 0 Owner:za.JS QLZCm,C;
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:
LQPER.N11T
VOICE (760) 777-7012
FAX (760) 777-7011
'TIONS (760) 777-7153
Date: 6/09/09
Owner: U
CAZAREZ JESUS
51400 EISENHOWER ✓��
LA QUINTA, CA 92253 +
(
�O4OO
Contractor:
Owner
-----------------------------------------------
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.
_ 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 workers' compensation
insurance carrier and policy number are:
Carrier - ---- ---- -------- - - - - -- 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 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 those provisions.
Pate: 06loci 01pplicant: .S esu5 Qp Cw vC: H
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 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 building construction, and hereby authorize representatives
of this countyto
nenter upon the above-mentioned property for inspection
purposes. 1
.Date: 0//`al l� (ntSignature (Applicant or Agentl: a it, S �tZgtr� t
Application Number . . . . . 09-00000607
Permit . . . RE -ROOF
Additional desc .
Permit Fee . . . . 30.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 12/06/09
Qty Unit Charge Per
Extension
BASE FEE
30.00
----------------------------------------------------------------------------
Special Notes and Comments
RE -ROOF EAGLE ROOFING LIGHT WEIGHT
CONCRETE TILE (ICC ESR 1900) WEIGHT OF
S
PSF. APPROVED PER A.J.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid
--------
Credited
----------------------
Due
---------------------------
Permit Fee Total 30.00
.00 .00
30.00
Plan Check Total .00
.00 .00
.00
Other Fee Total 1.00
.00 .00
1.00
Grand Total 31.00
.00. .00
31.00
LQPERMIT
Bin #
City of La Quinta
Building 8i: Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and. Tracking Sheet
Permit #
��
Project Address: S 00 1 S ej1 AO LUCV D r Owner's Name: S es tt
A. P. Number: Address: S.l qoo �:3ev� w e✓ {�,r
Legal Description: City, ST, Zip: Q0. G u QZL S 3
u X.. ;.a.....
Contr tat+ i� � Telephone: .4`''°::}y�,r .
Address: Project Description:
City, ST, Zip:
Telephone:.
{ ry,,•;>::...,;;:,;% c�'<:
State Lic. # :
City Lie. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:•
Telephone" ���'�x�:c� Construction Type: Occupancy*
State Lic. #_.>f<>•;::'f.`.. ., .
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact•Person: Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: I Estimated Value of Project: Z-0 0
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
# Submittal Req'd' Recd TRACMG PERMIT FEES
M
Plan Sets;
Plan Check submitted Item
Structural Calc$.
Reviewed, ready for corrections Plan Check Deposit
Truss Cales.
Called Contact Person Plan Check Balance.
Title 24 Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2°" Review, ready for corrections/issue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up, S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
'rd Review,.ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School.Fees .
L-fotal Permit Fees
CNARLES D.
Architecture, Interiors, Space and Land Planning, and Structural Design
Principle: Charles D. Garland, Architect
Associate: Efrain Cardenas, Engineer In Training
9 June 2009
The City of La Quinta
Department of Building and Safety
78.495 Calle Tampico
La Quinta, CA 92253
Project: Finish Roofing Alteration to:
The Single Family Residence for.
Jesus Cazarez
51-400 Eisenhower
La Quinta, California
Regarding: Structural Certification
To Whom It May Concern,
ARMECT
I am a licensed Architect in the State of California. The majority of my professional practice involves the structural design
of single family dwellings.
The. Owners of the noted project requested I certify a changing the roofing on their single family dwelling from asphalt
shingles to Eagle.R66fing;ligfit_.weight`concretealea(ICC_ESR=1900):' The selected concrete tile has a listed installed
weight of 5'psfwhich in my experience compares as an equal to the weight of asphalt shingles.
I hereby state therefore, that the noted residential building's structural system, in my professional opinion, will
not be overloaded and thus will not experience damage or failure due to the substitution.
if you have any further questions regarding this project please do not hesitate in contacting me.
Charles D. Garland
Architect
4 ��S u DAgyc1�
0
i013
C1199i
L�oM
L
74991 Joni Drive, Suite 9 o Palm Desert, CA 92211 o Phone: (760) 340-3528/Facsimile (760) 340-3728
v
P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(760) 777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits,
LMWA 'ANT! NOTICE TO PWRERTY OWNER
Dear Property Owner:
Ariapplication for a building permit has been submitted in your name listing yourself as the builder of the .property
:improvements specified at
We are .providing you with an Owner -Builder Acknowledgment -and Information Verification: Form to make you aware of your
responsibilities and possible risk you may incur by having this permit, issued in your narne as the
Owner -Builder. We will not issue: a buiiding.permit, until you: have read, initialed your understandm. of eachprovision,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this:notice
unless you, the property owner, obtain the prior approval of the permitting authority.
OV4WEWS ACKNQMT"GMW AND YF OF RWORMATI�N
DIhECTWNS: head and initial ear_ statementbelow Eo`signify you unzlerstand or'verlfy th-is information.
5 C 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
building permitthat erroneously implies that the property owner is providing hisor her own labor'and material personally. I, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. 'My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as -an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
'on my. property.
2. I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.. .
'SC- 3. I understand as an "Owner -Builder" I'am the responsible party of record on thepermit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his er her name instead of my
own.
mac— 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
C_ 5. I understand if I employ or otherwise engage any persons; other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars' ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
`5C 6. I understand if .1 am considered an "employer" under state and federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance, and' contribute to unemployment .
compensation for each "employee:" I also understand 'my failure to abide by these laws mayy subject me to serious financial
risk.
7. I understand under. California Contractors' State License Law, an Owner -Builder who builds single-family residential
structures cannot .legally build them with the .intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
financial or personal. 4uries sustained by any subsequent owners) that result from any latent construction defects in the
workmanship or materials.
9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
Service, the United States Small Business Administration, the California Department of. Benefit Payments, and the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CS -LB) at I-
800 -321 -CSL (2752) or www.cslb.ca.gov for more information about licensed contractors.
ZC 10. I am aware of and consent to an.Owner-Builder building permit applied for in my name, and understand that I am the
party legally and financially responsible . for proposed construction activity at the following address:
11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable 1`aws and requirements that govern Owner -Builders as well as employers.
S'C 12. I agree to notify the issuer of this, form immediately of any additions; deletions, or changes to any of the information I
have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a license,. the Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in'eivil court: It is also
ihWrUmt for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working
on your property; you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors,
you wifl be. responsible for verifying whetlter or not those Contractors are property licensed and the status of their' workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issuing; the.permiit.-Note: A copy of the,, propert�� o:wner's driver's lk!eMes form nvtar cadet or
other verification acceptable to. the agency is required to be presented when the permit is issued to verify the prop."
owner's signature.
Signature of property owner ec&JS GZcAy C Date: o6 L l
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for. a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO ACT ON.PROPERTY O NER'S BEHALF
Excluding.the Notice to Property Owner,..the execution of which I understand is my personal responsibility, I hereby authorize
the following persons) to act as. my agent(s) to apply for, sign, and file the documents necessary to obtain anOwner-Builder
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjurythat I am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification
acceptable. to the agency is required to be presented when the permit is issued to verify the property owner's signature. .
Property Owner's Signature:
Date:
Architecture, Interiors, Space and Land Planning, and Structural Design
Principle: Charles D. Garland, Architect, C11991
Associate: Efrain Cardenas, Engineer In Training
Date• 9 June 2009
To: The City of La Quinta .
Department of Building and Safety
78.495 Calle Tampico
La Quinta, CA 92253
Project:. Finish Roofing Alteration to:
The. Single Family Residence for:
Jesus Cazarez
51400 Eisenhower
La Quinta, California
AGREEMENT/INVOICE... SFR2K"28
Service: o provided: Structural Certification of roofing substitution
❑ provided: Two signed and sealed copies of the Certification Letter (herewith attached)
Be ft Noted: The Client and Architect hereby agree that the Architect's services may be abandoned by either
party upon seven day written notice. The Client is entitled to refund of unused portions of the fee paid in advance of
successfully performing the work. The Architect is entitled to unpaid portions of the fee for which work has been
performed.
Be R Noted-. The Client and Architect hereby agree that extra services may be accommodated by the'Architect,
beyond those stated herein, upon mutual agreement with the Client along with the agreement of the Client to compensate
the Architect at the rate of $225.00 per hour or any part thereof.
Be R Noted: Each party also agrees to submit disputes to mediationtarbitration prior to .seeking legal aid in
settling any such dispute.
Lump Sum Fee for providing the Architect's basic services noted above
NOW DUE AND PAYABLE ... $450.00
ACCEPTED:
(0/9,
CHARLES D. GARLAND, ARCHITECT CLIENT
74991 Joni Drive, Suite 9 ❑ Palm Desert, CA 92211 ❑ Phone: (760) 340.3528 ❑ Facsimile: (760) 340.3728