15003 (RR)i
tk 4
P.O. BOX 1504 No. 15003
78-495 CALLE TAMPICO
Address 78-14,05 Calle Estado LA QUINTA, CALIFORNIA 92253
Owner George Penady
Mailing BUILDING: TYPE CONST: OCC. GRP.
Address .
A.P. Number
City Zip Tel.
( Legal Description
Contractor,Reroof
PYO -Tech Roofing Company Project Description
€
Indio, CA CA Zip 92201 rel.:977-5477
State Lic. C -3_S 615515 City 1925
& Classif. Lic. #
Designer
Address
Tel.
City Zip State
1. Lic. # '
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
1,M) of Division 3 oUthe•Business and Professions Code, and my license is in full force and
-SIGNATURE— ^`DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License' Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct,- after, improve, demolish, or repair -any structure, prior to Its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) or
Division 3 of the Business and Professions Code, or that. he 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 rive 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner or property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such 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 did not build or improve for the purpose or sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to torr
struct the project. (Sec. 7044, Business and -Professions Code: The Contractor's License Law
does not apply to an. owner of property who builds or Improves thereon, and who contracts for
such projects with a contractor(s)1lcensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION '
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy Noir Company
p�vpy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM '
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of tha 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
Date Owner
NOTICE TO APPLICANT: d, after making this Certificate of Exemption you should become
`to
Sq. Ft.
Size.
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Rear Setback from
WARNING: FAILURE TO SECURE WORKERS'. COMPENSATION COVERAGE IS UNLAWFUL, AND.
Side Street Setbae
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,
Side Setback fr •�
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
FINAL DATE INS
This is abuilding permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder Is suspended for 180 days.
fj
Estimated Valuation
$31200.00
I agree to comply with all -city and county ordinances and state laws relating to building
PERMIT
construction, and hereby authorize representatives -of this -city to enter the above-.
AMOUNT
Plan Chk. Dep.
Validated by:
Signature of applicant —Date—
ateMailing
Plan Chk. Bal.
MailingAddress
Validation:
Const.
30.00
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
30.00
REMARKS
Date Owner
NOTICE TO APPLICANT: d, after making this Certificate of Exemption you should become
`to
ZONE: BY:
subject the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
Front Setback from
Rear Setback from
WARNING: FAILURE TO SECURE WORKERS'. COMPENSATION COVERAGE IS UNLAWFUL, AND.
Side Street Setbae
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,
Side Setback fr •�
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
FINAL DATE INS
This is abuilding permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder Is suspended for 180 days.
fj
I certify that I have read this application'and state that.the above information is correct:
Issued by: Date
I agree to comply with all -city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this -city to enter the above-.
mentioned property for inspection purposes.
Validated by:
Signature of applicant —Date—
ateMailing
MailingAddress
Validation:
City, State, Zip
Ce
Lin
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
SEWER OR SEPTIC TANK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
CAR P. SO. FT. ®
METER LOOP
HEATING (FINAL)
WALL SO. FT. ®
REINF. STEEL
DRINKING FOUNTAIN.
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LUMBER GR.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FRAMING
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/sc
HOUSE SEWER
SPARK ARRESTOR
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
Cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
,l� /Vv�
y"
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION ;�
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
P TECH ROOFING COMPANY NUMBER=F3 :LO
83-900 AVENUE%45 SUITE F SHEET NO:01•
INDIO , CA 92201 OATE : 1
.(619) 775-5477
( 619) 775--5479 FAX PfiaPdiz:.F1L_
Proposal.Submitted To:
G:cORGE F E_NADY
0"2 i IU{ f H Ci-iEROKEE AVE
LOS ANGLES CA 90004
01114 213 466--5001
LICENSE #-615515
Work To BB Performed At;
/8-10-S ES fADO
LAQUINTA CA 92253
We hereby propose to furnish the materials and perform the labor, necessary for
IREROOF 3PLY 3.U.R W/ROCK
the completion of:
1. REMOVE EXCISTING :GOOF FO SHEET ING , HAUL OFF DEERIS . DI'-z�CONNECT A/C.
2. INSTALL IP'LY #28 GLASBASE NAILED TO S-HEE f ING .
. RESET ALL DUCTS AND ROOF= FLASHINGS.
4 . IMS l`ALL 2PLY #11 GLASI='LY MOPPED BETWEEN EACH LAYER.
'3 . INSTALL IP LY GLASCAP MOPPED UP WALL AREAS AND A/C STANDS.
'1 NS
TALL 3;"8 ROCK OVER HOT FLOOD i -OAT .
7. CLEAN UP ;i OB , HAUL OFF TRASH.
4 YEAR WARRANTY
r `material is guaranteed to be as specified, and the above work to be
P,..,frmed in accordance with the drawings and specifications submitted for the
above described work and complete' in a substantial workmanlike manner for the
sum
sum of
$-"200.00 UPON COMPLETION
:
Any alteration or deviation from the above specifications involving extra
costs, will be executed only upon written orders, and will become an extra
charge over and above the estimate.. All agreements are contingent upon strikes
accidents or other delays beyond our control. Owner to carry fire, tornado
and all other necessary insurance upon the above work. Workman's Compensation
and Public Liability Insurance on above work is to be provided by:
PRO—TECH ROOFING•COMPANY Respectfully Submitted
David Krastel, Operator
ACCEPTANCE OF PROPOSAL
THE ABOVE PRICES. SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND ARE
HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO' THE WORK AS SPECIFIED. PAYMENT WILL
IBE MADE AS OUTLINED ABOVE.
I Date
Signature -7
Signature
Any controversy or claim arising out of or relating to this contract, or the
b* -each theereof, shall be settled by arbitration in accordance with the Uniform
ds for Better Business Oureau Arbitration, and the judgement upon the award
r-.andesred by the ArbitratoT(s) may be. eentered in any Court having jurisdiction
thereof.