BRER2019-013178-495 CALLE TAMPICO Tit(t D 4,u 0"tz VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Permit Type/Subtype: RE -ROOF/ Owner:
Application Number: BRER2019-0131 SUSAN GAIL ORMAN
Property Address: 55581 WINGED FOOT 55581 WINGED FOOT
APN: 775182006 LA QUINTA, CA 92253
Application Description: PGA WEST HOA / REROOF
Property Zoning:
Application Valuation: $4,545.00
Applicant: SP 4��`• Contractor:
B R S ROOFING INC B R S ROOFING INC
777 SOUTH LUGO AVE 777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408 ++ }] ) SAN BERNARDINO, CA 92408
} (909)884-8505
CITE i7 1. r',i J.!`-; i; LIc. No.: 907600
[.)_L. 1Z:I) pe DIE JLJI'..li:f4 i
LICENSED CONTRACTOR'S 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 Professions Code, and
my License is in full force and effect.
License Class:: C39 License No.: 7
Date: L Contractor:
OWNER -BUILDER ❑ CtARMION
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' 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 Addres
Date: 6/18/2019
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'
compen ation, as provided for by Section 3700 of the tabor Code, for the performance
oft rk fvr which this permit is issued.
I have and wilt maintain workers' compensation insurance, as required by
Sect n 700 of the Labor Code, for the performance of the work for which this permit is
issued. y workers' compensation insurance carrier and policy number are:
Carrier: CALIFOOR JIA In5URANCE COMPANY_ Policy Number: 828992730102
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 37 f the Labor Code, I shall forthwith
comply with those provisions.
Date: 2 1 ' Applicant:
WARNING: FAILURE TO SECURE WORKERS' CO PE SATION 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 ofthis 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 ci to enter upon the above -
mentioned property far inspection purposes. i
f�,
Date: ignature (Applicant or Agent):
4 4,-
Date: 6/18/2019
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BRER2019-0131
55581 WINGED FOOT
775182006
PGA WEST HOA / REROOF
$4,545.00
Applicant:
B R S ROOFING INC
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
Owner:
SUSAN GAILORMAN
55581 WINGED FOOT
LA QUINTA, CA 92253
Contractor:
B R S ROOFING INC
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
(909)884-8505
Llc. No.: 907600
Detail: REROOF 1500SF - RAISE TILE AND RESET WITH NEW DUAL SB5 UNDERLAYMENT. REROOF WITH EXISTING CLAY TILE AT SLOPED AREAS ONLY. ANY
FLAT ROOFED PORTIONS ARE NOT INCLUDED WITH THIS PERMIT. PER 2016 CALIFORNIA ENERGY CODE.
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT CITY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - FIRST 2,000 SF
101-0000-42404
0
$54.43
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - FIRST 2,000 SF PC
101-0000-42600
0
$108.87
Total Paid for RE -ROOF:
$163.30
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
TOTALS:
$5.00
taQaiara
GEM aI.A? DESERT
Project Address: 1515 ! ' sSS�'1 . Sc,� 3 , S`5S9 r1
APN #:
Applicant Name:
Address: • L_ V �r-t7
City, ST, Zip:
Telephoner [ L2A
Email: 0 ( bC� f0(?-fit V�03 , CO
Contractor Name: a�s kC301 Y)
Address: ! L �Q
City, St, Zip Scn ❑ -- 11
Telephone: q 6 q %$ `i S SD S
Email: �6,e-8
State Lie: b Ij O City Bus Lie:
Arch/Eng Name:
Address:
City, St, Zip
Telephone:
Email:
State Lie:
City Bus Lie:
Property Owner's Name:
Address: J LA 5 K,n� t c-p , vkce
City, ST, Zip 4-
Telephone:
Email:
PER.vIIT ® ( �
PLAN LOCATION: '
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
q t52 cttt-p—SP.T WtTYI
�!1eW OctUn�e.-1at(me-ql+
Rz ot0-f as nee-ded -
Valuation of Project S Z� (� p C,
c0 (�
New SFD Construction:
Conditioned Space SF
Garage SF
Patio/Porch SF
Fire Sprinklers SF
Construction Type: Occupancy:
P cy:
Grading:
Bedrooms: Stories: j Units:
dew Commercial / Tenant Improvements:
Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA; CA 92253
760-777-7000
PGA WEST II
Residential Association
June 10, 2019
Dear City of La Quinta Permit Department,
The Board of Directors voted to contract with BRS Roofing to reroof the following
homes:
+ 54-595 Winged Foot
54-575 Winged Foot
79-993 Riviera
• 56-105 Riviera
• 56-565 Riviera
• 56-745 Merion
• 56-665 Merion
• Also, four Medalist Buildings 55-301 to 55-331 Winged Foot, 55-581 to 55-611
Winged Foot, 55-290 to 55-320 Laurel Valley and 55-440 to 55-470 Laurel
Valley.
I have included a copy of the CC & R's with the Maintenance Matrix for your
refrence.
There are only 6 homes within our Association that the HOA does not Maintain or
Re -roof. Should you need a copy of that list please let me know and I'll send it to
you.
Should you have any questions or concerns, please feel free to contact me,
1peterson_�7a drminternet com.
Sincerely,
Loni Peterson, CCAM-LS, CMCA, AMS, PCAM
General Manager
PGA WEST II Residential Association