BRER2020-0046u7, VOICE (760) 777-7125
78-495 CALLE TAMPICO DFAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/10/2020
Permit Type/Subtype: RE -ROOF/ Owner:
Application Number: BRER2020-0046 HAYNOSCH DANIEL S & CAROL J
Property Address: 49839 COACHELLA DR 49839 COACHELLA DR
APN: 646250005 LA QUINTA, CA 92253
Application Description: HAYNOSCH / 8000SF TILE RAISE & RESET
Property Zoning:
Application Valuation: $14,760.00
Applicant: �. Contractor:
TERESA TOHOMAS - ROOF TILE SPECIALTY INC D ROOF TILE SPECIALTY INC
P 0 BOX 11257 P 0 BOX 11257
PALM DESERT, CA 92255 MAR 10 2020 PALM DESERT, CA 92255
CITY OF LA QUINTA (760)200-0811
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 810537
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: Q39 License No.: 8105.3
Date: 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 Name:_
Lender's Address:
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'
comp tion, as provided for by Section 3700 of 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
Section 700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: STATE COMPENSATION INSURANCE FUND Policy Number: 9230004
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' compensatlon provisions of Secr37
he Labor Code, I shall forthwith
comply, )th b$8 p grtisienS. - - —
Data: ✓ Appllcant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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
slued 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
iot 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 r esentativas of this city to enter upon the
above mentioned ropertyfor inspec urpose�s
Dater po Signature (A plicant or gA ent);
e, Date: 3/10/2020
Application Number:
BRER2020-0046
Property Address:
49839 COACHELLA DR
APN:
646250005
Application Description
HAYNOSCH / 8000SF TILE RAISE & RESET
Property Zoning:
Application Valuation:
$14,760.00
Applicant:
TERESA TOHOMAS - ROOF TILE SPECIALTY INC
P 0 BOX 11257
PALM DESERT, CA 92255
Owner:
HAYNOSCH DANIEL S & CAROL J
49839 COACHELLA DR
LA QUINTA, CA 92253
Contractor:
ROOF TILE SPECIALTY INC
P 0 BOX 11257
PALM DESERT, CA 92255
(760)200-0811
Llc. No.: 810537
Detail: 8000SF TILE RAISE AND RESET AT SLOPED AREAS WITH DUAL 40LB UNDERLAYMENT. PER 2019 CALIFORNIA ENERGY CODE.
FINANCIAL INFORMATION
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
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
$77.28
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: $241.50
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
a& Qaiorry
- - GEM ofrhe DESERT --
PERMIT #--t� ve r- zow — OC ` 0
PLAN LOCATION:
Project Address:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
�DEL A
t 'k
fbahv
)
Applicant Name:
r C�
SQQOs
Address:
City, ST, Zip:
l / m---e
Telephone:
Email:
Valuation of Project S
f 1 New
Contractor Name.uf ut6 1,
SFD Construction:
Address:
`L
Conditioned Space SF
City, St, Zip
Garage S1=
Telephone: Q
Patio/Porch SF
EN.
i e Sp i klers SF
State Lic:=�.i
City Bus Lic:
)
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Telephone
Bedrooms: Stories:
# Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name:
New Commercial / Tenant Improvements:
Address: I
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
ROOF TILE SPECILATY
P.O. BOX 11257 PALM DESERT, CA 92255
CONTRACTORS LICENSE # 810537
Phone 760-200-0811 Fax 760-200-0801
2/3/2020 _
A proposal submitted to: Dan Haynosh
Qo
�_ �
_
Mailing Address: 49839 Coachella Dr. La Quinta, CA
w
o
r-
3 0J
Job Address: 49839 Coachella Dr. La Quinta, CA
cc
a
1.1..
C) }
111
o
Phone:
w
�
Z
Description of work to be performed:
TILE ROOF
Remove existing roof file and stack. Sweep clean roof surface of all roofing debris. Remove all
roof to wall sheet metal and flashings (excludes z-bar) for all hvac and plumbing penetrations. Dispose
of all roofing debris. Over prepared roof surface install 2 layers 40# file liner nailed to all roof surfaces. Install
new roof to wall sheet metal valley metal and perimeter edge metal. Install new primary and secondary
flashing for all hvac and plumbing penetrations including existing roof surface attic vents.
Reinstall existing tile to manufactures specifications using new Boral roof tile for broken and damaged tile.
Paint all roof penetrations to match color of roof. Clean property of all roofing debris.
10 Year warranty
Building permit additional cost to contract
$14,760.00 X. " P'
IF NOT ACCEPTED WITH IN 30 DAYS THIS PROPOSAL IS NULL AND VOID
OWNERS SIGNATURE - DATE
(or auto rized representative)
CONTRACTOR SIGNATURE � DATE 2/3/2020