BRER2019-014378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T- dw 4 9(wQa4rw
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: RE -ROOF/
Application Number: BRER2019-0143
Property Address: 55440 LAUREL VALLEY
APN: 775181036
Application Description: PGA WEST HOA / REROOF
Property Zoning:
Application Valuation: $4,545.00
Applicant: v
B R S ROOFING INC ,
777 SOUTH LUGO AVE L%
SAN BERNARDINO, CA 92408
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 Class: C39 r License No.: 0160 IN
Date: 0 411 Contractor,
' +
OWNER -BUILDER ECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (See. 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 provislons 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 bui{dirigor improvement is sold APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder wfli 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.
(—) 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 orpursuant to any permit issued
License Law does not apply toan 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 Le auinta, 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 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.
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
ROGER A. & JAN LANG
55440 LAUREL VALLEY
LA QUINTA, CA 92253
Contractor:
B R S ROOFING INC
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
(909)884-8505
Llc. No.: 907600
Date: 6/18/2019
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 Addre:
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 tion, as provided for by Section 3700 of the Labor Code, for the performance
of t rk for which this permit is issued.
JI have and will maintain workers' compensation insurance, as required by
Sect3700 of the Labor Code, for the performance of the work for which this permit is
y workers' compensation insurance carrier and policy number are:
Carrier: EALEQRN 6 i 0RANCE CQbdPANY _ Policy Number: 8289927 0102
_ 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 provisions.
Date: U _ 11
\ 1' I Applicant:
WARNING: FAILURE TO SECURE WORKERS' C MPEN TION 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,
NTEREST, AND ATTORNEY'S FEES.
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 tate laws relating to building
construction, and hereby authorize representatives of thi ty tgenter upon the above -
mentioned property for inspection purposes. `1 i1
Date: ` L � ' I Signature (AppliFant or Agent)
Dat€: -6/S8y 2O19
Application Number:
BRER2019-0143
Property Address:
55440 LAUREL VALLEY
APN:
775181036
Application Description=
PGA WEST HOA / REROOF
Property Zoning:
Application Valuation:
$4,545.00
Applicant:
B R S ROOFING INC
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
Owner:
ROGER A. & JAN LANG
55440 LAUREL VALLEY
LA QUINTA, CA 92253
Contractor:
B R S ROOFING INC
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
(909)884-8505
Uc. No.: 907600
------------------------------------------------------------------
Detail: REROOF 1500SF - RAISE TILE AND RESET WITH NEW DUAL 5135 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
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: $5.00
to ia rev
i
PERMIT T 1� 12R. 2 O
- -- GEM VJi6, D S-raT ......
55�4a; 55y41., -5yS2, ,-5--(57,
Project Address: '
PLAN LOCATION:
"3'1 4 SS�)v Ufa , Ilc
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
n
Applicant Name: Tc, h t]
Address: � .
City, ST, Zip:�11403
Telephone: l4 p
12
Email: pp ( bra i'DO4:�t n4, , CO q\
Valuation of Project 5�21�� % (9 . ('� O
Cf
Contractor Name: 8R5 kooC ►1
New SFD Construction:
Address: 7 55 A
Conditioned Space SF
City, St, Zip 5 C it TOE4 C1 R CYq 10 LA. 9 2. L{ p %
Garage SF
Telephone:
Patio/Porch SF
Email: p nS coo I , CO YKFire
Sprinklers SF
State Lie: 0J 10 f7 O City Bus Lic:
Arch/Eng Name:
Construction Type: Occupancy:
P cY:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms: Stories: # Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name: -DeS CAAAA 0 r1 nA
New Commercial / Tenant Improvements:
Address: tj1tj3S Ht� W\►.e 1 kc-e'
P
Total Building SF
City, ST, Zip TC, NW t ��� �a �1� ,
Construction Type: Occupancy:
Telephone: 111,
Email:
78495 CALLE TAM.PICO
LA QUINTA' CA 92253
760-777-7000
rl PGA NEST H
,iJResidential 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:
7 54-595 Winged Foot
0 54-575 Winged Foot
d 79-993 Riviera
■ 56-105 Riviera
• 56-565 Riviera
0 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,
112eterson@drminternet.com.
Sincerely,
Loni Peterson, CCAM-LS, CMCA, AMS, PCAM
General Manager
PGA WEST II Residential Association