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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
235717 C-39 B,WIC 0 rd A*(
Date y'. / Signature of Contractor -•r' �/� •�
i
OWNER -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).
( ) I, 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
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 & policy no. are:
Carrier 3YATE FUND Policy No. 045'924-03
(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 those -provisions!
Date: ? f Applicant 4,;.1 - -/ Z/ . , '-,,
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& 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 purposes.
Signature (Owner/Agent) C Date
BUIDING -PERMIT PERMIT#
DATE 03n_Vx(K VALUATION $611(nm LOT TRACT
JOB SITE
ADDRESS) �:lsssease f .AaO,�''6iS(
APN
OWNER
CONTRACTOR / DESIGNER / ENGINEER
LAGUNA D1✓ L.APAZ 1:IOA
WR:T1J PACIFIC 8002-AJG
4P-1(10 VISTA I-AGUINA'
3462 LA. CAMPhNA WAY
LA QUI TA CA 42253
PA1 M SPRINGS CA 92262
(760)416-5877 CBW 425'3
USE OF PERMIT
G1'".A:MW:Y�7idCi
FtF-P,001?'Wi f H P0L'Y11£i.l?'PHAME FOAM
VAIXATIOg1 15,30 ,li0 1,
ESIMM ATE.`D C057 CYP COMT UC1101K
PUMM IME SUMMARY
IREROOF FRE 101-000.418-000 $30,00
STM -TOTAL CON TX110K AND PL" CO'rUX
$30.00
PRE -PAW M. 3
$0,00
I,L PRRAllfMS DUE���
00100
"LALMS
RE EIPT
BY I�
DATE FINALED
INSPECTOR
�-
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck 3 '2 —
Exhaust Fans
O.K. to Wrap
F.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
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING 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
Law Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
Gr�sS�
MAR -22-2004 05:19 PM
Gent 8y: MSTERN PACIFIC ROOFING CORP.;(7�780 320 8912;
\ WESTERN PACIFIC
Roafing Corporation
Sincc I949 Liu. 8235717
March G. 2004
Judy Williams
DF.SVRT RFSOAT MANAC RIVIRNT
48-300 Vista Dat Noprl
La Quints. CA 93253
P.01
War -22.04 to:1@!_:::::: Page 2!5
RE: xc-rooug Project: LAGUNA UE LA FAz 110MEOWNEM ASSOCIATION
Appltcatioo of a polyurethane loam and acrylic coating roolittl; system
r}txtr Ms. Williams:
'Ibunk nk you for the opportunity to inspect the roofing systems an the above referenced property. Having
dune so we an: pleased to submit our m-commenda Wns and ptuposA for the ins taftatiun of a polyur thane
roof system. The recommended scope of work and :associated carets arc as follows:
Unless expressly stated to the contrary, the contractor shall be responsible for peribrming the liriluwing
acts.
1)FSC'RIPT10N
A. 'I he general conditions of this standard construction contract shall Porto a part of these
stxt;ifr%aticuts with the same force and effm as though repeated hc=in.
Is
(he eontraL-utr shall furnish all labor, materials, equipment. permits, contractor'',, licenses,
insurance certifications to perform ull operations required and specified. The contmctor .small
provide labor and material customarily included in work of the sumo nature to tgivc at quality,
complote,job.
C. ! 1' unexpected conditions are encountered during the warn, Goer the conditions adversely affect the
cost or progress of the work the contractor will notify the owner immediately, and Oic owner will
twbotiaw a change -order to resotvc the unexpected condition.
V. The Contrnotor shall occupy, use, and permit others to us,.- the premises only for the purpose of
completffig the worts to he lx-rtarmed under this contract with the Owner. True Contras dor xhal l
not authorize or permit any other person to use said premises for any purpose wlusturcva.-r.
Western Pacific is to be )riven all reaaonahle set-up and staging areas.
E. Cuwrat;tor's scope of work shall not include the identificarion, derectinn, abatement,
ancupsulation or removal of ashe_stos or similar hazardous substances including mull and or
mildew. if Contractor encounters any such products u r matcriars in the courxe of performing its
work, or If such hazardous nuaerials are encountered by any othtr firm performing work at the
jubsite and contractor determines that such materials present a hazard to its ctuployam, contractor
shall have the right to diwontinue Its work and remove Its employees from the jobsite until such
products to
3462 La Campataa Way • Palm Springs, CA 92262 • (760) 416-5877 • Fax (760) 320-8912
www.westpncroof com • P -maul: wpreps@westp=oof corn
MAR -22-2e04 05:20 PM
tent By: WESTERN PACIFIC ROOFING CORP.; 790 320 8012;
Lxguaw De La Paz HOA
March 6, IIH)4
Vote 2
P.02
Mar -22-04 t4:tt?: ? Page 3!5
m:ucrial,, and any hazards connected therewith. are located and abated encapsnlated or removed,
or it is determined thuno hazard exists (we the k:m may require), and contractor shell receive nn
t:xu msioo of time to complete Its work hereunder and compensation for relays encrwntered as a
result of such situation and correction. With the pusytble �="Lmcc of mold ftn preexisting
t:oudltlons. Westem Piffle Roofing Corp. will not he told responsible for mold related claims
resulting livar tuuld detected at any rime in the future.
.l'tlKh'A(.F. PREPARATION
.t. Reprove any contaminants that will interibm with the adhesion ul'sprayed urethauc t'isu) ro
the subMralc. Surface shell be free of Ioo*e particles.
d. 1(e nove all roofing matuial aruund die scuppers to expose the flance of the scupper.
C. l(eplace damaged plywuud at an additional cost of $43.00 per xhcct or any purtiun thereol.
D. Rauf duck shall be pruned with Neuprime primer at the rate of .33 m.50 gallons per I no square
feet.
F. Install new foam -stop metal an)und the perimeter of The building, including all Lalwalks.
%aychni rs. '11te new meml will nor be painful.
APPLICA'nt7N OF POLYUKETHA14F: PIOAM AND COATING
A. Urethane fvam insulation shall be sprayed -applied to a nominal thickness of I' (plus or miniu
114 inch). Additional foam will be added to the low areas to help minimize pondlag. Some
ponding will remain. Only 3 lbs density foam will he used In this application.
It. Coating %hall be ippliecl in a minimum ui three (3) sepi ue conn.
n. The baac and Intermediate cuals shall be uppiied at a rue of 1.25 %nilluns per Inn cgn,re
fact.
b. 1 he top carat shall be applied at a rare of 1.30 gulluim prr 100 square tcct, y i6kiint; it tutal
system thickness for all three coats of 30-32 Total Ery Mlls.
C. During the final topcoat application, %iu N 11 granules will be embedded into the wet
topcoat material at a rate of 50 pounds per 100 eyuare feet 'rop coat color and granules
to be Upt gray.
d. All foam is to be coated Coutint4 shnll extend up and over all foamed vent pipes rurd
Term inn" a rnialmunt 02 inches above the foam, creating a scat appearance, scll'-
wrminnting flashing
This »ificatiun meets rnallufaeturer reyuircuocnta, Ujiderwriter Laboratory
speciticativns and ICAO compliance.
MAR -22-2004 05:21 PM
Sent By: WESTERN PACIFIC ROOFING CORP.i`=' 760 320 8812;
t-sguna lk tat P*A HOA
March 6, 2004
Page 3
P.03
Mar -22.04 14:1� Page 4!5
The total uxt for all lahor, malcriul. supervision, ia3uratice. taxes, etc., is:
('(.)N1*RAC:TAM0tJN"r -J
U-238 Calie florin= S6,%&00InkW
48-202 Calle Flurlwaa 56,303.00 1 Initial
o, Note: knit /t4X-202 011e Floristas has two self -flashing skylights that should be removed and replaced
with curb -mounted skylights m raise the height and provide for proper Waterpmuting. Building the curbs
t and supplying the skyllots will Cost 5600,00 leltlaL No interior work is included with the raising
,f the akyliahrt as may he ruquircd by others.
PAYMENT TF,RIN,S
10% deposit upon approval ur Lhe contract. Balance date upon completion and paid within 10 days of
receipt of the invoice.
WARRANTY
A Tee (10) tient' warrunty on the polyurethane foam system will be Issued upon cumplctiun of the roof
and Itrral pttynicsit Is received.
I'he price quoted has been structurud to retlecr standilyds we ussurnc arc muluutly desired: quality
installation, servos reliability and long -tarn performance. The price may be subject to change 15 clays
from the date of this pntposal.
I f you ure in accordance with the conditions herein, ple-asexecute the agreement below and return both
copies u, this uMce. We will, in turn,, sign them and rctum one ropy to you. Thank you fur your
cuupera:ion in expediting this contract for your roofing needs.
NUTICIt TO OWNER
Cuntreclurs are required by taw to be licensed and rugulawd by the Contractor's State License Board.
Any questions cunccrning it contract ntay be referred to the Registrar, Contractor's State License how -El.
11.0. Box 26000, Sacramento, California 95S26.
ACKNOWIXT)Gi41ENT: Owner acknowledges that he has rwd and received a leoihle copy of this
agreement including all terns and standardpruvisbn8 before any work is performed and that he has road
and received u legible copy of every otter docuosc u that owner has sigaod during thi.e negotiation. I/we
hereby acknowle4v under the penalty of perjury &W I/we ara/um the legal uwaors and am/arc auLlwrized
io sign this contract as an agont orthe Legal owner.
MAR -22-2004 05:21 PM
Sent 8Y: WESTERtJ PACIFIC ROOFING CORP.; 780 320 8912; Gar -22.04
Laguna Ve Iv P*Z 11OA
March 6, 2004
fake 4
ACCEI'TA NCE: The above priem apsciftsdons and oondtdons are satisfactory and are herehy
aecrpledi. You are authorized to do the geek as specified. Payment wilt be as outlined above You,
the buyer may eancei this transaction at say dose prior to midnight of the third businem dry after
the date of this irarrsactioo. Set the attached Nlotks or Caucenatiun fur as explanactoor of this right.
Owner hus lite right to require contractor to have a perfur natrce and payment bond at u.v,icj"- cxpcnew.
LAG 1.14A DE LA PAZ HOA W BSTFRN PACIFIC ROOFING, CORP,
Contractors Lketrse # 235717
ulhor At;cnt Robin 1r Winkle
Operations Manager
Title
34 March Narcb 6, ZOtii
Date
WESTFRN PACIFIC ROOFING HAS THE XtGHTTORESCIND THIS CONTRACT WITHIN
FI N TEEN DA YS OF ACCEPTANIC& 'M3 AGREEWNJT IS NOT BINDING UNTIL
ACCEPTED BY THE OFFICE MANAGEMENT AT 3462 LA CArdPANA WAY. PALM SPRINGS,
CA 9226.2. NiO CHANCES OR ADDITiON3 TO THIS AGRFRMENT SHALL BE FFFECTIV.P.
UNTIL APPHOVF.D BY WESTERN PACirt NA(;EMENrT.
MnNAGE146 ACCf;PTANCEt."c--�-1-• 1)AT6
3�z3 of
r
P.04
Page 5!5