BRER2018-0011w
� w
VOICE (760) 777-7125
78-495 CALLE TAM PJCO Q�i 0 D
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 2/22/2018
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
RELIABLE ROOFING BY T G Y
P 0 BOX 1961
PALM SPRINGS, CA 92263
RE -ROOF/
BRER2018-0011
52571 EISENHOWER DR
773295018
SCOTT / RE -ROOF / FOAM OVERLAY
$9,650.00
FEB 2 2'2018
CITYOFLAQUINTA
Owner:
WILLIAM SCOTT
77517 EDINBOROUGH ST
PALM DESERT, CA 92253
Contractor:
RELIABLE ROOFING BY T G Y
P0BOX 1961
PALM SPRINGS, CA 92263
(760)323-2705
Llc. No.: 764608
--------------------------.------s---------------------------------------
--------------------
LICENSED CONTRACTOR'S DE TION WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty of perjury that I am Ii.— sed u ovisions of Chapter I hereby affirm under penalty of perjury one of the following declarations:
(commencing with Section 7000) of Division 3 f e ness and Professions Code, and _ I have and will maintain a certificate of consent to self -insure for workers'
my License is in full force and effect. 'compe ion, as provided for by Section 3700 of the Labor Code, for the performance
License Class: C39 License No.: 764 • o or which this permit is issued. .
b, ave and will maintain workers' compensation msuran , as required by
Date: V Contra or: ( e 700 of the Labor Code, for the performance c the wo or which this permit is
issued. My workers' compensation insurance carrier and icy number are:
OWNER -BUILDER DECLARATION Carrier: STATE COMPENSATION INSURANCE FUND Polity Number: 1795377
1 hereby affirm und), penalty of perjury that I am exempt from the Contractor's State _ I certify that in the performance of th ork for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any mann s to . a subject to orkers'
city or county that requires a permit to construct, alter, improve, demolish, or repair any compensation laws of California, and a to the
structure, prior to its issuance, also requires the applicant for the permit to file a signed workers' compensation provisions ction 3700 a Labor Code, I shall fo ith
statement that he or she is licensed pursuant to the provisions of the Contractor's State comply with hose P56visions. A
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business j
and Professions Code) or that he or she is exempt therefrom and the basis for the Date: v plicant: Ii
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 ($500).: WARNING: FAILURE TO SECURE WORKER COMPENSATION COVERAGE IS UN FUL,
(1 I, as owner of the property, or my employees with wages as their sole AND SHALL SUBJECT AN EMPLOYER TO IMINAL PENALTIES AND CIVIL FI UP TO
compensation, will do the work, and the structure is not intended or offered for sale. ONE HUNDRED THOUSAND DOLLARS ($ 0,000). IN ADDITION TO T OST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not COMPENSATION, DAMAGES AS PROVIDE FOR IN SECTION 3 F THE LABOR CODE,
apply to an owner of property who builds or improves thereon, and who does the work INTEREST, AND ATTORNEY'S FEES.
himself or herself through hi's or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that he IMPORTANT: Application is hereby made to the Building Official for a permit subject to
or she did not build or improve for the purpose of sale.)., the conditions and restrictions set forth on this application.
(1 I, as owner of the property, am exclusively contracting with licensed contractors to 1. Each person upon whose behalf this application is made, each person at whose
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State request and for whose benefit work is performed under or pursuant to any permit issued
License Law does not apply to an owner of property who builds or improves thereon, as a result of this application, the owner, and the applicant, each agrees to, and shall
and who contracts for the projects with a contractor(s) licensed pursuant to the defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
Contractors' State License Law.). employees for any act or omission related to the work being performed under or
(� I am exempt under Sec. B.&P.C. for this reason following issuance of this permit.
2. Any permit issued as a result of this application becomes null and id if work is not
commenced within 180 days from date of issuance of such permi r cessation of work
Date: Owner: for 180 days will subject permit to cancellation.
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
I certify that I have read this application andslaKIpffie above information is correct.
I agree to comply with all city and county ordi S aw lating uilding
construction, and hereby authorize represen ryes of this ci enter upon the ove-
mentioned p /o�perry f inspection purpo.t
Date: �/ gnature ( or A t): Oft
A
Date: 2/22/2018
Application Number:
BRER2018-0011
Owner:.
Property Address:
52571 EISENHOWER DR
WILLIAM SCOTT
APN:
773295018
77517-EDINBOROUGH ST
Application Description:
SCOTT / RE -ROOF / FOAM OVERLAY
PALM DESERT, CA 92253
Property Zoning:
Application Valuation:
$9,650.00
Applicant:
Contractor:
RELIABLE ROOFING BY T G Y
RELIABLE ROOFING BY T G Y
P0BOX 1961
P0BOX 1961
PALM SPRINGS, CA 92263
PALM SPRINGS, CA 92263
(760)323-2705
----------------------------------------------------------------
Llc. No.: 764608
Detail: REROOF / FOAM FLAT ROOF [CRRC: 0770-0007] 2016 CALIFORNIA ENERGY CODE.
A
FINANCIAL INFORMATION
�...: DESCRIPTION, _- ,-. _ ACCOUNTQTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total.Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
Credit Card Fee
101-0000-43505
0
$3.20
Total Paid for Credit Card Fee: $3.20
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF - EA ADDITIONAL 1,000 SF
101-0000-42404
0
$12.48
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF -FIRST 2,000 SF
101-0000-42404
0
'$53.05
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RE -ROOF.- FIRST 2,000 SF PC
101-0000-42600
0
$106.11
Total Paid for RE -ROOF: $171.64
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: ' $5.00
............. GEM gfsb DE3.tiTuK:.T' _...._.
PERMIT # .
PLAN LOCATION:
Project Address:�� /0�4
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
14
APN
Telephone:
Garage SF
Telephone:
Applicant Name:scdij_
Email• "
Address a$KA
0#770 nnoc)7
City, ST, Zip:
Fire Sprinklers SF
,j
Telephone: Z1
Email:
Valuation of Project$ bbv
Contractor Name:4"MWNNew
Address:
I q
Address:
SFD Construction:
Conditioned Space SF
City, St, ZipN
64 Da(03
Telephone:
Garage SF
Telephone:
b .as0-01,0 (7
Email• "
Patio/Porch SF
Email: /, `
' v @ R urf-�n"
!
l7
Fire Sprinklers SF
State Lic:2(L
CityBus Lic:
-
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Construction Type: Occupancy:
Telephone:
Bedrooms:
Stories:
#U
Email• "
State Lic: City Bus Lic:
Property Owner's Name:
New Commercial /Tenant Improvements:
Address:
Total Building SF.
City, ST, Zip
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
#
Submittal 4
' Req'd
-Rec'd
Plan Sets
Structural Calcs
Truss Calcs . '• '`""
Title 24 Calcs
• '
Soils Report
Grading Plan (PM 10)
Landscape Plan
'
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval ,
Fire approval
City Business License