BRER2020-002678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
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DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: RE -ROOF/
Application Number: BRER2020-0026
Property Address: 48141 VIA HERMOSA
APN: 646100001
Application Description: LAGUNA DE LA PAZ HOA / 3000SF TILE RAISE AND RESET
Property Zoning:
Application Valuation: $8,565.44
Applicant: D) Z
JOSPEH JUAREZ - B R S ROOFING INC
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
JUDY WOHL
48141 VIA HERMOSA
LA QUINTA, CA 92253
—
Contractor:
B R S ROOFING INC
777 SOUTH LUGO AVE
SAN BERNARDINO, CA 92408
CITY CAI` [A QU, i VA
DESIGN & DE�JEL(�i�'MEDIT J�:PA aTa"�i(�.N�j LIc. N .: 90765
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 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class:
C3` License No.: 07
Date: �S'-1 Contractor: [MTnAr,_.
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).:
() 1, 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 Nam:
Lender's
Date: 2/3/2020
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'
camp nsation, as provided for by Section 3700of the Labor Code, For the performance
of th k for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Sectio 700 of the Labor Code, for the performance of the work for which this permit
Is issued. My workers' compensation insurance carrier and polity 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 become subject to the
workers' compensation provisions of Section 37 of the Labor Code, I shall forthwith
comply wi h th tse provisions.
Date: Z(9 Applicant'
WARNING: FAILURE TO SECURE WORKERS' CO PENSATION 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 a ent r upon the
above:-Z"
prpy for inspection purposes.Date:�� Signature (Applicant or Agent):
Date: Z/J/2g20
Application Number:
BRER2020-0026
Property Address:
48141 VIA HERMOSA
APN:
646100001
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:
JUDY WOHL
48141 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 RESETAT SLOPED AREAS WITH DUAL 40LB UNDERLAYMENT. PER 2019 CALIFORNIA ENERGY CODE.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
QTY
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
QTY
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 I 502-0000-43611 0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
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Project Address: ` vq1 q 1 A { p
APN #:
Applicant Name: L'b —s-p—p h �
Address: LO C —
City, ST, Zip: 5 cl n ( e-iiLoLrA i n o i" , q 2LibZ
Telephone: 1 6 p
Email: -, op—D �jr� 'ro0-�1 Yto� , CO vy1
Contractor Name: ko0C
Address: L C,0 1�
city, st, zip S c, n 6-0) CK'A inO CA , 9 2y c� s5
Telephone: Q 6 q %$ y$ SO S
Email: �bv—, Q 6 Its repo .FI n Covh
State Lic: q 0] to 0 0 City Bus Lic:
Arch/Eng Name:
Address:
City, St, Zip
Telephone:
Email:
State Lic: City Bus Lic:
Property Owner's Name:
Address: y` S(,S 160C N4 )A)
City, ST, Zip 111 Telephone: -2 G(3 346 CIO()
Email:
PERMIT #
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PLAN LOCATION:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
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view 4 U a I '-[,C)# Ur,der-laI(qere-} ,
e� ael '�Dis)
Valuation of Project $ S S�p�. q q
New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Construction Type:
Grading:
Bedrooms: I Stories:
SF
SF
SF
SF
Occupancy:
# Units:
k-- _ . MR tlrjk Lm "+ New Commercial / Tenant Improvements:
_ 41 Q 1 Total Building SF
(Lw � 71�111 Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000