BRER2019-001878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
ROOF TILE SPECIALTY INC
P 0 BOX 11257
PALM DESERT, CA 92255
c&ty/ 4 4 Qu&M
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
RE -ROOF/
BRER2019-0018
49823 ADELITO DR
646250002
SHAY / REROOF EXISITING TILE
b�.
I�
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
MORGAN SHAY
49823 ADELITO CIRCLE
LA QUINTA, CA 92253
MAR 0 1 r f. Contractor:
ROOF TILE SPECIALTY INC
�
P 0 BOX 11257
CI11/ 0FLAQUIWA BALM DESERT, CA 92255
(760)200-0811
Llc. No.: 810537
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect -
License la : C339�� License N OS 7
Date: �i"'t Con[ eto�rr:
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 70,00) 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' State License Law.).
() 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:
Date: 3/1/2019
WORKER'S COMPENSATION DECLARATION
I hereby affirm uncler penalty of perjury one of the fDllowing declaratlons:
I e and will maintain a certificate of consent to self -insure for workers'
compens Dn, as provided For by Section 3700 of the Labor Code, For the performance
oft ark 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 and policy number are:
Carrier: T5_ ATE COMP N TI.ON INSURANCE FUND Policy Number: W300124
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 rthwith
comply with hose provisions.
Date: < <1 Applic t:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND 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, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this 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 City of La Quinta, its officers, agents, and
employees for any act or omission related to the 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 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 county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-m ntl ned property for jnsp an poses.
Date?3f ( Signature( pplicantDr
Date: 3/1/2019
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
ROOF TILE SPECIALTY INC
P 0 BOX 11257
PALM DESERT, CA 92255
BRER2019-0018
49823 ADELITO DR
646250002
SHAY / REROOF EXISITING TILE
Owner:
MORGAN SHAY
49823 ADELITO CIRCLE
LA QUINTA, CA 92253
Contractor:
ROOF TILE SPECIALTY INC
P 0 BOX 11257
PALM DESERT, CA 92255
(760)200-0811
LIc. No.: 810537
Detail: RAISE AND RESET EXISTING TILE AND REPLACE 40# UNDERLAYMENT. PER 2016 CALIFORNIA BUILDING CODES.
DESCRIPTION
ACCOUNT I QTY I AMOUNT
TECHNOLOGY ENHANCEMENT FEE 1502-0000-43611 1 0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
ROOF TILE SPECIALTY
P.O. BOX 11257 PALM DESERT, CA 92255
CONTRACTORS LICENSE # 810537
Phone 760-200-0811 Fax 760-200-0801
A proposal submitted to: Morgan Shay
Mailing Address: 49823 Adelito Circle La Quinta CA
Job Address: 49-823 Adelito Circle La Quinta CA
Phone: 816-591-0697
Description of work to be performed:
Remove existing roof tile and stack.
Sweep clean roof surface of all debris
Remove all roof to wall sheet metal and flashings (excludes z-bar) for all hvac and plumbing
penetrations dispose of all roofing debris.
Over prepared roof surface install two layers 40# the liner nailed to all roof surfaces.
Install new roof to wall sheet metal valley metal and perimeter edge metal.
Install new primary and secondary flashing
for all hvac and plumbing penetrations including existing roof surface attic vents.
Re -install existing tile to manufactures specifications using new Boral roof file for broken and damaged tile.
Paint all roof penetrations to match color of roof.
Clean property of all roofing debris.
Ten-year warranty on maintained roofs only
Building permit additional cost to contract
IF NOT ACCEPTED WITH IN 30 DAYS THIS PROPOSAL IS NULL AND VOID
OWNERS SIGNATURE
PROPOSAL PRICE $11,540.00
(or authorized representative)
DATE
CONTRACTOR SIGNATURE 1I.1"TF
X-a aaa
— GEYI ofd„ UESFR"f —
Project Address:
APN #:
Applicant Name:
Address:
City, ST, Zip:
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Contractor Name:
Address:
City, St, Zi
Telephca n: �t
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State Lic:
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ress:
St, Zipphone:l:Lic:
Property Owner's Name:
Address: '
City, ST, Zip
Telephone:
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Email:
PERMIT #
❑ ATION:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
I tibn of Project S
f
JL_ f i SFD Construction:
Conditioned Space
Garage
J� I P• io/Porch
rollers
I y Bus Lic:
City Bus Lic:
Construction Type:
Grading:
Bedrooms: Stories:
L
SF
SF
SF
SF
Occupancy:
# Units:
New Commercial / Tenant Improvements:
' Total Building _ SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000