13-1085 (PAT)79830 Amora Dr
13-1085
( IIIIIIIIVIIIIIIVIIIIIII 20
P.O. BOX 1504 ' IE _ - _ --, 4am&rW
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT 41,
BUILDING PERMIT
Application Number:
13-00001085
Property Address:
79830 AMORA DR
APN:
609-620-003- - -
Application description:
PATIO COVER - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
8600
Applicant: Architect r Engineer:
------------------
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 nd Profess' nals Code, and my License is in full force and effect.
License Class: D03 /) LicenseNo.: 835140
Contra r/
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 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 witti 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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address: V
LQPERMIT
Owner:
GERTZ
79830 AMORA DRIVE
LA QUINTA, CA 92253
(760)578-7770
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/29/13
Contractor:
ATLAS AWNING & SCREEN, A
754 S. WILLIAMS ROAD D --
PALM SPRINGS, CA 92264
(760)327-8466 20
Lic. No.: 835140 fel
CITY OF LA
-----------------------------------------------
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' compensation, as provided
or by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I -have and will maintain workers' compensation insurance, as required by Section 3700 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 EVEREST NATL Policy Number 7600004167121
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 t become subject to the workers' compensation laws of California,
and agree that, if I should b o e subject to the workers' compensation r v' ' n
3700 of the Labor Code, I h rthwith co ovisions.
Date: p Z7/A Applici t r
i
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 Director of Building and Safety 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 bove information is correct. I agree to comply with all
city and county ordinances and state laws relating to buil n cons rK!*e u torize representatives
of tth iis county to enter upon the above-mentioned pro inspection purposes.
Date: J?/ -'b A Signature (Applicant or Agent):
Application Number . . 13-00001085
Permit . . . PATIO COVER 2013
Additional desc
Permit Fee . . . . 95.81 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 8600
Expiration Date 2/25/14
Qty Unit Charge Per
Extension
1.00 95.8100 EA' MISC PATIO COVER, STD
95.81
----------------------------------------------------------------------------
Special Notes and Comments
PATIO COVER - 614SQ FT AMERIMAX PATIO
COVER 1 PORTION SOLID/2 PORTIONS LATTICE
{MANUFACTURER SPECIFICATIONS] DOES NOT
INLCUDE ELECTRICAL . 2010 CALIFORNIA
BUILDING,CODE.
--------------------------'--------------------------------------------------
Other Fees . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, PATIO COVER
94.38
STRONG MOTION (SMI) - RES
.86
Fee summary Charged Paid Credited
Due
Permit Fee Total 95.81 .00 .00
95.81
Plan Check Total .00 .00 .00
.00
Other Fee Total 96.24 .00 ..00
96.24
Grand Total 192.05 .00 .00
192.05
C
LQPERA11T
Bing
City of La Quinta
Building & Safety Division
P.O. Box 1504
..
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78-495 Calle Tampico
La Quinta, CA 92253
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Building Permit Application and Tracking Sheet
Project Address: 79 D
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Estimated Value of Project: $ eo CBQ
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