0100-066 (RR)N
04
W
O v �
' W
�Z�^
ccoo0�
I� l O,
co
J
r`
W
U)
Z
LICENSED CONTRACTOR DECLARATION n
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
.2.31717 C-39 B
Date 4. ? r Signature of Contractor
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 Policy No.
(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 provis ons.
Date: �' ' - Applicant—
Warning:
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an Temloyer to criminal Fena`l666 and -civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton Agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Pe" rr �w
Signature (Owner/Agent) r='1 • Z✓��� • Date
BUILDING PERMIT PERMIT#
DATE VALUATION LOT TRACT
JOB SITE
APN
ADDRESS
41-246
OWNER
CONTRACTOR/DESIGNER/ENGINEER
3W A.-0-S'L C,0W, ROA
W-. ` SRN PA CD -1c R0��.�`t1te�O
POBOX.799
3462 LA C&M—PANA, WAY
RANCHO NMAC E CA 92270
PAIN SMINGS CA, 92262
(760)41 r✓-5TI7 CMN 4293
USE OF PERMIT
Ccf��f�47S3RP v .&:'i f . ICRC llf?R�t B3Q n POLY'k.$T:Ivi"F."9 7e APA & dsCRYIJG'
VALUATIOW 4786.00 L3
R ' `ff%4�Y i7•V5M
��yyvY��yy yy,,,,pp ae 7�;�3. p�R.�9/�bgJvL.�,t',vin,5pt•�\.,0735��A��'��tiBJ"i�(]YI.J'F�J5w1i.d,Yl,4�
P.Rw•LSd,P.C1' (�`k.i"'�,t..I�AAR
bey
P11=114Y0!° FLA Z S 04'18-000 t Wn w`. tlfr
W
SEP 0 i 2001
CITY OF LA QUINTA
FINANCE DEPT.
�r
S'CiB-`ii'.D°k"JVi C ihfMUC:t"IVC>N f441) PLAN'clu;g1c
T
4 $30.00
�v. d
RECEIPT
DATEr
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel r
Roof Deck �ZI 0 ��
Combustion Air
Exhaust Fans
O.K. to Wrap 111
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
Finall2_ . 6
BLOCKWALL A 'PROVALS
Final
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
Low—Voltage Wiring
Fbctures
Main Service
SLO Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
AUG -17-2001 10:16 AM P.01
Sent 8y: WESTERN PACIFIC ROOFING CORP.; 790 320 8912; Aug -fl -01 7o48AM; Page 2l5
ArWESTERN PACIFIC
ft\)?0j 'lg CnrporAtfoK
Singe 1949 Lie. #235717
AUCM 7, 2001
Kati*" Jordaa
LAGURA DR L.A PAZ ROA
C/O DZBRJtT MANAG61![M
P.O. Ho= 79l.
Janet* Mirage. CA 92770
RR: ]11Dert+Oooss g Pra j=4 Lquaa ne I.q Pim Hameowaern Amodadss
46•2011 cmic roaristaa a dtb?Ati Caib Fiwiltaa
Aprikatioa of a prytn odme (am and acryk cost* roaAat 0811101
Dear hb. Jordan:
i%aah you for tae opporranity to inspect the roofing 9YNCMW ase abM meed lXVM1Y K"ia6
done so we are pleaned to aftnt our nxon+mudodom ad Dropmal Sec the ivataUmlon of a polytuethane
mursyatem. Tae mm mttended scope of work aad nNoWated cam an as fbilows
f Ely #RAL
Unim a gmmly stated to the conuwy, rho oontraww shall be reapoaai6ic lbr perfbrming dw AW10winr
acts.
URSCR11MON
A. Tito geao:al coedidws of thia shmdard conwwdon canttact shall fo m a part of these
q=ificablosta wl& ft tame ft= and eSott " dw h rgmted I wvm
B. The ma:rrar. .ball farsda6-all Lsbm aaatedals, c*dl tneot, casuactor's liceimm, iaumanct:
o__ _fi mow, err:., to pciftm all operatlorrs mgdted and sptxldod The oaorracW tOspll provide
labor and motorial c agamrlly Irscludod in work of the agate Hague to give a quaihy, oa nplete
}ob.
C. if un=poaod canditima we awotmteted clueing the work and the cmdltlone advertldy aff—I the
ones or progmw of the -a& ft ommsctor will nodf y the owner immadlatcty, and the ow= will
ra•Rodate a chaap•+*der to resolve the wsexpeceod ooedhim
A The CaeuwW.ban =Upq, We, And pamlt Gd= to tree the pmzr dm tatty far ft PUPSe of
oomph the work to be pwf rmed tt Ww this cwm ct with the Ownw. 77o Canty imm ahrtll
mt rtuthoarti-c or permit am oftr Dessert w an am Fe n ow fbr say pwpoae whataoem.
waters Pk ift is to be given au resaonehie get-up mea 10019ing arta..
3462 La.Camputa Way -.Palm Springs, CA 92262 • (760) 416-5877 • Fax (760),120-8912
wwnv.we9tpacraof.com • E-mail: wprcps )westpacrocf.cnm
AUG -17-2001 10:17 AM
P.02
sent By: 1VE8TERN PACIFIC ROOFING CORP.; 780 320 8812;
Aug -a-01 7;48AM; Page 3!6
Lou" Do La Pas HGA
AmCW 7, 3001
Prue 2
R. C'artt ntor's nonpo of work •stn not indiude the idatAftifoa4 delealm abawnt,
ettcapat* Y Comracwr Woouatera
Gay owk prodrw or esaadsb in the cottttts at pedunm8 td wc*, or it hwh hfuscdotu
reatoWl am mum =cd by aM atbot arm PU*MMiAg wort at Ole Jabl= Gad ooauaaor
dc'aratino that sxh moterisis prmxma hamrd to its nmptoyms. amts 'i sbrcll hard the rngm
to Oxo wir= its wort and remove lm etnptoyera nnm the jobdre m dl sodr pmchim or
t mutuals. and day hww* connocted awferwitlL are located aced abateiL awpihad or
rernov4 or it is maesmined that no hXemd =I" (aa the cane may regaim), atd convenor Chap
receive an ermaa orame io compl®e Us work ba miler mid eompen atbn fix delalys
esoormtfflod as a =oil of Gash afteadon and cow. an
sOBFACB P'WAR TWff
A. Pzxw w ortht rooting aggreguc shall be by brvoming or paver •A^uuntio:. Tht cxistiiig Vurcl
s Ucc will be vscuma ed, swc% toed vacuumed for proper NOW prOPMEb a
S Ra:w ve the w6s0ng low Topa and replace with taller onm as nesse, .
C. Crrind ell Z4mf metal to propm tar tbo Mplic nju of the libatn. (Gee suacbed detslq
A. RcrnQK -:dSd a roo8nir MUM eQtirppM to expose the melid &-mp. (Gee artwaded dwW)
E. Install new lbatnf.top tncW UQWW the perimeter ddw bulldhW where eocessarY.
(ow attwJwd &-tag
F Remove two couraoa of fik st the built-lp roaring mwoltkm and sot asides Cat s water4 tock lo
wpmte the taro waMg sytmmos and en ms a watertight mai. (Gee rnebW deWl)
APPLICATION OF POLYURETRANE FOAM AND COA71WG
A, Renoft any eoatamitst m that wW inwiftm with the adhesion of spnryed urctham Loom to the
sttbetrate. Surthoe dell be Lioe of low pariidw.
B. Roof dock shall be pdmod wfth Neomwc pnro a ai tae two at _33 in .SO galloon per 100 squat
fiat.
G Uretbmne loaee insolation &sell bo sprayed •appiled to a nonmfui ftcknm of 1" (plus or rtdrmc
meat)_ Additional Loam will be aW ied in the ponding ereaa m help disperse itis ditattg %Mr.
'Me addltloftai law will be s maximum of 1.3" tbiadr. The addltiofosl loam is not i.tty i m
clog" palkive dopic+ but will batp W x tae ovend depth of tide powdif .raw and allow
fw fa w evapsratba. Ono 3 ML dmft baw wtil be aced In tbb APPU940 L
D_ Coadog shall be applied ins minimus» of three (3) sepaeaee eosm. Acrylic aoaina w be 6096
solidi ( plus or adnne 2%).
a. The baps and intetmedla coat shall be sppllod st a rant of 1.2-4 gallons par 100 squaw
AUG -17-2001 10:18 AM
P.03
sant By: WESTERN PACIFIC ROOFING COAP,; 780 320 9012;
Aug -9.01 7:49AM; Page 4/5
Laputa De La Pat HOA
AUPS 7, 2001
PW 3
b. no tap aced dt u be tlPOW as a no of 1.50 0p1lons per 100 agnsee plot yielo"s a
local yrsmn dddmeaa fm bats coats of 30.31 Total Dry M111t.
d Date# ibr tlmi top acct appiicsmoo, rite @111 grammes will be embedded into the wet
top Coat tnSMI&l m a nut Cf 90 pamda per 100 arm tbat. Top tint COW to 04
LIGHT GRAY.
d. All abase is to be ceased. Coating dull squad up ted over all famed van piper and,
ter sinond a minimatn o[2 inches ahm the fbatn,.crcatleg A neat appeiuraoee, Ulf-
ocrmioaUW d—biag ices sdwlMd detWO
Thie specification meets w==ftctonor rogaircmems, und"Witer l&bosacary
bona sed 1CB0 oanwUaoae_ Thls sysotn . when apptiod over an Odstin"' fire -
mW Claes A at B built-up root syaoom lois a UL 790, A claesilloatioa When appimd
over as tutlattng C rwcd roof systt:ra+, dte exlating ntnag m®ias. RTC ICBG d Eli 4630
The total Cost for all labor, mrW%] sgmrvuwk% irbttralto0. MGM cm, Is:
CONTRACT AMOUNT SMSMW
4&10 Calle lzariataa. No" a 3&' 7fi6.0
*146 salk noridaa Medea 8 56.E
WARRANTY
A '%n (10) year Mandedwres FW19ystrm wxmuity w0l be lasted by Reals T=hndaRy
C'crporatioa cad West" pacific Roa t Corporadca uprm compietion of the and and fi nal payment
it rsaiv+d
PAYMZNT TERMS
1095 deposal up n approval or the contact. PtoV= psymcatr to be tendo twice a month untll oomMetlon.
8alan= due upon coq%ctlon and paid wtthia 10 dor. of reedp of the uwatee.
The price quotod has beet► atrocxxured to rcdwt stsodenW we aamm we mutually dWmd: quality
installation, sermi a reliability and bong ts®t Perf0f"8"= The prise =' be stun to change 13 days
item tate date of this proposal
if you as in aooanW= with the condmom h=cin. punas eaa a the agmmm below and ramrn both,
capica to this ofioc We will, is turn, ap there oW return one oopy to pow. Thank lou for your
cooperntion in ezpc&Uvg tyle co®uaa 1'3r y mr reefing mW&
NOME TO OWNU
Contcactota are requimd by Isw to be liccnmd mid regulated by the C'aWracoor's State Leone Board.
AM gpeations oaoroerniag, a motraaor lacy to raft I d to the Rcgistnr. Cotdrac='b Stade Licmw Board
P.O. Hex 26000.5a=umnlo, Calit6aeis 9=6-
rA i =m= I �'"' I -
IC -17-2001 10:18 AM
Sant 8y: WESTERN PACIFIC ROOFING CORP.; 760 320 8912; Aug -8-01 7:50AM; Page 5!5
Lagma De La Pao HOA
As" 7, 2001
PWA
ACl00WLRMMElrTr Owasr aduvwlec*s dict be has red Sod raoeivod a laflbic copy of thi's
allsa u mbj*r,& all wma and mmdSd p wAmlow bWboa mW wok it pod amM 04 chow bo has lead
and nmtyW a lei copf of soap Ww dm0mad tbu Owwr hes d688d d"tQ5 tail nogdadon- Une
h=t9 acknowkd : under tho pemaky ofpcdM do LAm am*c the kgtl Ovum and rldare sutbormW
to siva this c VbW ac an a mi Of the 100 Owes'
ACCE TANC& The sl a prism spodllcmdM =4 emdMOM are s tb%dM Ad arc hm Y
accepted- Yam are amtaorhted to do the wads as Med. Prpoemt will be sa vrtt MM AWM Ym
dlre bmM eaq caned lbb traeaactlam at my dee prior to ddsldM at the ddrd bwWw t day ager
dee dam of tbb tr aseetloe. Sae the Atisand NWee ed Caw-4080es fbr ar asptanatlem Of tale rig"
( wu& has me rio to rergdee aonncwr m have a petibrnranae and pgercnt boed of Garners ea ppm.
LAGUM DE LA PAZ HOA
WZSTZRN YACOW ROOMG, CORP.
Coalradom Lmmm M 23M17
Rubls L WivALM
Opersdoms Mnomw
7-7-01
Drate
wvrsatr rAR,MC sur MWP II" =X MORT TO s:M"'rtos Corr'rsACf vvrrrn„ nrrrwe nArs ur
AC$'MApM Turn AritnYM&" (d 140T gn%UM UNMACCXrraar gy IRK Offta MArrAGWaNT AT 3"1
LA CAMTANA WAY. PALM MMS, CA 922CL NO C RAMU OR A=ff"a TO THiI AGM=hWff SHALL as
EIm-nvt UNTIL APPROVED BYN M3URrAt.'l W. MAPtM:I Mff-
AdA1tA WC®a aCLaPJAJK.LG: OaTR
c
P.04