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BRER2017-0098A gill 78-495 CALLE TAMPICO Q�i D 4v VOICE (760) 777-7125 FAX (760) 777-7011 LA QUINTA;'CAliFORNi!A"92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 10/12/2017 Permit Type/Subtype: RE -ROOF/ Owner: Application Number: BRER2017-0098 SETH HOFFMAN Property Address: 52862 EISENHOWER DR 52862 EISENHOWER DR APN: 773331006 LA QUINTA, CA 92253 Application Description: HOFFMAN / RE -ROOF WITH EXISTING TILE Property Zoning: Application Valuation: $4,600.00 Applicant: D Contractor: VISION ROOF SERVICES INC VISION ROOF SERVICES INC 49950JEFFERSON STREET 130-322 n(T 1?, 2Q17 49950 JEFFERSON STREET 130-322 INDIO, CA 92201 INDIO, CA 92201 CITY OF LAQUINTA Ct MMIN17fOVIELOPMENTDEPARTMENT (760)600-6183 Llc. No.: 651509 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a Professions Code, and my License is in full force and effect. License Class: C3 License No.: 651509 Dae %� Contr ca or: 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).: (_ 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.). ( ) 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' Stale License Law.). ( I I am exempt under Sec. B.&P.C. for this reason Date Owner: 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: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one *f the following declarations: I have and will maintain a certificate of consent to self -insure for workers' comp nsa ' n; as provided for by Section 3760 of the Labor Code, for the performance oft ork for which this permit is issued. J I have and will maintain workers' oompensation 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: AMERICAN ZURICH INSURANCE COMPANY Policy Number: _ I certify that in the performance o1 the work for which this per ..is issued, shall not employ any person in any manner so as to become subject to r ers' compensation laws of California, and agree t>iat, if I should become ct to the workers' compensation provisions of Section 3700 of the Labor C e, shall forthwith comply with those provisions. �App`licant: WARNING: FAILURE TO SECURE WORKERS'COVENSAJJON COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMt#L P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0 IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FCR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to tie Building Official for a permit subject to the conditions and restrictions set forth on tlis 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 Cityof La Quinta, its officers, agents, and employees for any act or omission related to -he 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 issmance of such permit, or cessation of work for 180 days will subject permit to cancellaticn. I certify that I have read this application and slate 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 city to enteyupor the above- mentioned propekty for inspection purposes. /J ) Signature{Appl I Date: 10/12/2017 Application Number: BRER2017-0098 Owner: PropertyMdm55 • i'r`;<•`.':�5'2862115ENHOWER DR SETH HOFFMAN APN: 773331006 52862 EISENHOWER DR Application Description: HOFFMAN / RE-ROOF WITH EXISTING.TILE LA QUINTA, U. 92253 Property Zoning: Application Valuation: $4,600.00 Applicant: Contractor: VISION ROOF SERVICES INC. VISION ROOF SERVICES INC 49950 JEFFERSON STREET 130-322 49950 JEFFERSON STREET 130-322 INDIO, CA 92201 INDIO, CA 92201 (760)600-6183 Llc. No.: 651509 Detail: REROOF WITH EXISTING TILFAT SLOPED AREAS [CRRC NOT REQUIRED] 2016 CALIFORNIA ENERGY CODE. I -DESCRIPTION FINANCIAL • ' + • ACCOUNT I QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.60 DESCRIPTION i 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 RIE -ROOF: $159.16 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEWNT FEE: JOTALS: $5.00 $165.16 V1 Bin# City of La Quinta Building & Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking. Skeet Permit# Project Address-)' p J C; s e� A 0 v e( Owner's Name:> G A.P. Number Address: _j Legal Description: City; ST; ip• Contractor:; Tele'phon Address: Project Description: City ST, Zip• � � � �� Te St to City Lic #: J / Arch, Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Proj. Type New Add'n Alter Repair Demo Name of Contact. SgFt: #Stories # Units: Telephone of Contac APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMITTEES Plan Sets Plan Check Submitted Item Amount Structural Calcs Reviewed, ready for corrections Plan Check Deposit: Truss Calcs Called Contact Person Plan Check Balance: Title 24 Calcs Plans Picked Up Construction: Flood Plain Plan . Plans Resubmitted Mechanical: Grading Plan 2nd Rev, Ready for corrections / Electrical Subcontractor List Called Contact Person Plumbing Grant Deed Plans Picked Up S.M.I. HOA Approval Plans Resubmitted Grading IN-HOUSE 3rd Rev, Ready for corrections / Developem Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Apps Date of permit issue School Fees Total Permit Fees