BRER2019-0147A � '
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78-495 CALLE TAMPICO
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VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253
DESIGN
& DEVELOPMENT DEPARTMENT
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/18/2019
Permit Type/Subtype:
RE -ROOF/
Owner:
Application Number:
BRER2019-0147
LAWRENCE K. CHANGLI & ANGELA L. TAK
Property Address:
55464 LAUREL VALLEY
55464 LAUREL VALLEY
APN:
775181032
LA QUINTA, CA 92253
Application Description:
PGA WEST HOA/ REROOF
Property Zoning:
Application Valuation:
$4,545.00
Applicant: Contractor:
B R S ROOFING INC q E 1 B R S ROOFING INC
777 SOUTH LUGO AVE C: ` 777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408 I SAN BERNARDINO, CA 92408
`fix g 1 i it i
f1 ` :;
(909)884-8505
Llc. No.: 907600
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.:907600 A fl
Date: I. L—A • I `f Contractor
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' 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 Na
Lender's
WORKER'S COMPENSATION DECLARATION
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'
ompensation, as provided for by Section 3700 of the Labor Code, for the performance
f th lrwprk for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
ecti 70.0 of the labor Code, for the performance of the work for which this permit is
'sue y workers' compensation insurance carrierand policy number are:
arrier: CALIFORNIA INSURANCE COMPANY Policy Number: 828992730102
1 certify that in the performance of the work for which this permit is issued, I
hall not employ any person in any manner so as to become subject to the workers'
ompensation laws of California, and agree that, if I should become subject to the
corkers' compensation provisions of Section 3700 of t e Labor Code, I shaI l forthwith
omply with those provisions.
late: Applicant:
VARNING: FAILURE TO SECURE WORKERS' CO PENSATION COVERAGE IS UNLAWFUL,
ND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
)NE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
4TEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
APORTANT: Application is hereby made to the Building Official for a permit subject to
ie conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
=quest and for whose benefit work is performed under or pursuant to any permit issued
s a result of this application , the owner, and the applicant, each agrees to, and shall
efend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
mployees for any act or omission related to the work being performed under or
)Ilowing issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not
ommenced within 180 days from date of issuance of such permit, or cessation of work
x 180 days will subject permit to cancellation.
certify that I have read this application and state that the above information is correct.
agree to comply with all city and county ordinances and state laws relating to building
onstruction, and hereby authorize representatives of this city to enter upon the above-
ientioned propertyforinspection purposes.
,ate: � ��' ( l Signature (Applicant or Agent):
Date: • 6/18/2O19
Application Number:
BRER2019-0147
Property Address:
55464 LAUREL VALLEY
APN:
775181032
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:
LAWRENCE K. CHANGLI & ANGELA L. TAK
55464 LAUREL VALLEY
LA QU I NTA, 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
ACCOUNT CITY
li:::
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT CITY t:::AMOUNT
RE -ROOF - FIRST 2,000 SF
101-0000-42404 0
$54.43
Total Paid for RE -ROOF:
$54.43
N
DES�ENHANCEMENT
ACCOUNT CITY
AMOUNT
TECHNOLOGY FEE
502-0000-43611 0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
GEMA ajbre DESERT ..�_....
PERMiT - 12VIR 7-0 (C(
PLAN LOCATION:
55414a, 55y��, SySZ, S'SNSS
Project Address:. '
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
i,
APNn.
II it
Zr11arrrI A-I`e__ 1-CkiSf—CLkAfv1� ;
Yle-W dvol
_
Applicant Name: �"�, `] J.G!S �
Z i~4 C C.-f— a S i'1 �� P, DZ .
Address:, 5, L.V &-t']
City, ST, Zip: 5 c b W N'q' A l Y1 oL\
Telephone: -1 � p
Email: , ou& brs- Ro(9-i;:�, Ylo3 , co q1
Valuation of Project S_ �1► z 7 . (� a
rf0
Contractor Name: US R0� � �� C
New SFD Construction:
Address: i -7-7 5 C,O
Conditioned Space SF
City, St, Zip 5c\Yl �r n a O C� Z O
Garage SF
Telephone: cl 6 q $ y g SD 5
Patio/Porch SF
Email: ,be_Q r�y roo FIa r com
Fire Sprinklers SF
State Lie: 1� Cl loci 0 City Bus Lie:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Telephone.
Bedrooms: Stories: # Units:
Email:
State Lie: City Bus Lie:
Property Owner's Name: e� Ce^�'�,Qsp,�� rl�D� e
-New Commercial / Tenant Improvements:
Address: tjti 5 t-\ )A t t P 1 k cC
Total Building SF
City, ST, Zip 1�C1,Wn LA �!�� , r
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
.�� PGAIVE ST. I I
.;}
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
A 54-575 Winged Foot
e 79-993 Riviera
9 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,
1p eterson drminternet.comm
Sincerely,
' sip
Loni Peterson, CCAM-LS, CMCA, AMS, PCAM
General Manager
PGA WEST 11 Residential Association