BRER2020-001378-'95 CAL LE TAMPICO
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LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: RE -ROOF/
Application Number: BRER2020-0013
Property Address: 48115 VIA HERMOSA
APN: 646100014
Application Description: LAGUNA DE LA PAZ HOA / 3000SF TILE RAISE AND RESET
Property Zoning:
Application Valuation: $8,565.44
Applicant:
JOSPEH JUAREZ - B R S ROOFING INC
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
rrir Iy L A 1�� �A �--
DE51GN & DIEliEIt. 0P i' i`iE T 0Ef-)ART', [7%i T
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 fcommencing with Section 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C(3]9 License No.: W7600
Date: 2 —1 Contractor:
OWNER-BUILDADECRAAT
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
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/3/2020
Owner:
Dubose Robert Elwood / Dubose Denise Souza
48115 VIA HERMOSA
LA QUINTA, CA 92253
Contractor:
B R S ROOFING INC
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
(909)884-8505
Llc. No.: 907600
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'
com a 'ion, as provided for by Section 3700 of the Lobar Code, for the performance
oft rk for which this permit is issued.
I have and will maintain workers' compensation fn5urance, as required by
Sect rn 700 of the Labor Cade, for the performance of the work for which this permit
s issued My workers'tampensation insurance [arrier and panty number
are:
Carrier: CALIFORNIA INSURANCE 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 became subject to the
workers compensation provisions of Section 3 7W Of the Labor Code, I shall forthwith
camplywll-t7h those provisions.
Date: `�' 1 ZQ Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMP SATION COVERA tS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL NALTIES AND CIVIL FINES UP TO
ONE HUNDRED TH0USAN D DOLLARS 1$100,000), IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR I 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 an this application.
I. 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 O.uInta, 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 thiscity to tter upon the
above -mentioned property for inspection purposes. n
Date: T,41 10 Signature (Applicant or Agent)
Date: 2/3/2020
Application Number:
BRER2020-0013
Property Address:
48115 VIA HERMOSA
APN:
646100014
Application Description:
LAGUNA DE LA PAZ HOA / 3000SF TILE RAISE AND RESET
Property Zoning:
Application Valuation:
$8,565.44
Applicant:
JOSPEH JUAREZ - B R S ROOFING INC
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
Owner:
Dubose Robert Elwood / Dubose Denise Souza
48115 VIA HERMOSA
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: 3000SF TILE RAISE AND RESET AT SLOPED AREAS WITH DUAL 40LB UNDERLAYMENT. PER 2019 CALIFORNIA ENERGY CODE.
FINANCIAL
DESCRIPTION
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
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - EA ADDITIONAL 1,000SF
101-0000-42404
0
$12.88
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - FIRST 2,000SF
101-0000-42404
0
$54.74
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RE -ROOF - FIRST 2,000SF PC
101-0000-42600
0
$109.48
Total Paid for RE -ROOF 2019: $177.10
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
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Project Address: `[
APN #: I
Applicant Name: J't,
Address-- 5 L O
City, ST, Zip:
Telephone: (� p
Email: O PLO bra r00-1;-,z71 n g� , CO "A
Contractor Name: ko0Ci
Address: , -7 -j 3. LO C Q 1�
city, St, zip 5 ci n l ec n cx(-A „n o CA , 9 )-y o s
Telephone: Q O q $ c, j$ SD 5
Email: � b 6 fu repo Com
State Lic: CA DI b 0 0 City Bus Lic:
Arch/Eng Name:
Address:
City, St, Zip
Telephone:
Email:
State Lic: City Bus Lic:
PEIZWT # -UC- ,Zo M — COO 13
PLAN LOCATION:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
-e-f -Po r,Y, -I-I1e__ ('C� ►sue and rP-) Wi14
I L a e-r- e A s n e.t:d e, A. 3o q
Valuation of Project $
New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Construction Type:
Grading:
, qLl
SF
SF
SF
SF
Occupancy:
Bedrooms: I Stories: I # Units:
Property Owner's Name: AA r' - M�"14 -m "+ New Commercial / Tenant Improvements:
Address: y��bs ��a�,� W4, �Q Total Building
SF
City, ST, Zip �'
Construction Type: Occupancy:
Telephone: 3 0
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000