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13-0043 (PAT) IIIIIII VIII III VIII(III 52 P.O. BOX 1504 - 1-E- �4 � VOICE(760)777-7012 78-495 CALLE TAMPICO FAX(760)777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS(760)777-7153 BUILDING PERMIT Date: 1/11/13 Application Number: 13-00000043 Owner: Property Address: 80921 CALLE AZUL COLLINS JIM APN: 762-240-003-41 -300961- 80921 CALLE AZUL Application description: PATIO COVER - RESIDENTIAL LA QUINTA, CA 92253 p Property Zoning: MEDIUM DENSITY RES Application valuation: 1064 D Contractor: 9A� .�4 2013 Applicant: /1 Arch*ect o Engineer: GOLD STAR CSTM PTG LQ PA Ok / 42335 WASHINGTON ST #F363 G1NOp�DEQ PALM DESERT, CA 92211 PCNA (760)574-1043 Lic. No. : 855623 ------------------- --- - ------------------------------------------------------------------------- UCENSE%CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisio s of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000)of Division 3 of the Busin ss an Professionals Code License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided License CI-s: C33 C51 Lice 855623 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is 2 issued. Data: / > Contractor: _ 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 OWNER BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier PREFERRED EMPLR Policy Number WKN1438262 following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ I certify that,in the performance of the work for which this permit is issued,I shall not employ any construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the person in any manner so as to become subject to the workers'compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that,if I should beco subject to the workers'compensation provisions of Section License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 3700 of the or Cod ,1 II forthw' with those provisions. 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).: '-Bat Applicant: (_) 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 WAR G: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUB,( CT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees,provided that the DOLLARS($100,000). IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If,however,the building or improvement is sold within SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. 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.). APPLICANT ACKNOWLEDGEMENT (_1 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon,and who contracts for the projects with a contractor(s)licensed 1. Each person upon whose behalf this application is made,each person at whose request and for pursuant to the Contractors'State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_) I am exempt under Sec. ,B.&P.C.for this reason 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. Date: Owner: 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 CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that t/aboveformation is correct. I agree to comply with all work for which this permit is issued ISec.3097,Civ.C.1• city and county ordinances and state laws relating to bruction,and hereby authorize repres ives of this cou y to ter upon the above-mentioned propeection purposes. Lender's Name: - ate: Signature(Applicant or Agent): —w Lender's Address: LQPERMIT Application Number . . . . . 13-00000043 Permit PATIO COVER PERMIT Additional desc . Permit Fee . . . . 27.00 Plan Check Fee 17.55 Issue Date . . . . Valuation 1064 Expiration Date . . 7/10/13 Qty Unit Charge Per Extension BASE FEE 15.00 6.00 2.0000 HND BLDG 501-2,000 12.00 ---------------------------------------------------------------------------- Special Notes and Comments ALUMAWOOD PATIO COVER 716" X 1014' TOTAL OF 80 SQUARE FT. PER APPROVED PLANS & 2009IBCODE,2009IRCODE, 2010 CBRC. -------------------------------------------------------------=-------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 27.00 .00 .00 27.00 Plan Check Total . 17.55 .00 .00 17.55 Other Fee Total 1.00 .00 .00 1.00 Grand Total 45.55 .00 .00 45.55 LQPERMIT Bin.# . . CTL}/ of Q[ ino Bta7ding sr Safety DAwon Permit# P.O.Box 1504,"78-495 Cage?ampkfl 4 QUhX4 CA 92253-:(760)777-7012 " Bui(d' rngiPermitApplication"and Trackrng Sheet Projax Address Boz ( owner's Name:. j A.P.Number. Address. I Legal Description: f City.ST.Tap: Contractor. A A01Tdep6one: Address: `J_ AJa eDesexiption: City,ST,Zip: '�TPk' Telephone'2G6 �7�1Dif ne State Lia S City Lic,9,Jb ArcdL.Bug-,Designer Address City.ST,Zip: Telephone: Construction Type.. Occupancy: Static Lie #: Project type(circle otic. N • Add'a Alter Repair Demo Name of Convict Person: Sq.FL: furies ff Unita Telephone#of Contact Person: Estimatod Value of Proj APPLICANT:DO NOT WRITE BELow TMS LINE # Submittal Req'd Beed TRACI@IG Pt3ItMITFEES- Plan Cheek submitted Item Amonat Structural Coles. Reviewed,ready for corrections Plan Cheek Deposit. . Truss Calor. Called Contact Penn Plan Check Balance Tithe 24 talcs. Pians picked up Construction Flood plain plan Plans resubmitted.'. Mechanical Grading plan Z'!Review.ready for correctionsrkssue Electrical Subeostacoor List Called Contaet Person Plumbing Grant Decd Plans pldced up S.NU E-O.A.Approval Plans resobmitted Gradluj IN]ROUSE:- ''Review;ready for eorrectionslissee Developer Impact Fee Planntn8 Aptt Called Coataet Person A.I.P.P. Pab.Wha Appr Date of permit issue School Fees Total Permit Fees PUERTA AZUL , RCHITECI JRAL APPLICA.Tl01► Name(Please Print) +I*CA nc5 r It•M {'..tJ f {_ S. Phone Q Xj M`1 i3 Puerta Azul Address d t__r cx i It, (N-2 zr 1 Maiiing Address(if different), 1 "1 ttil Z.(,_�h S +)JSL ir, f gg ADA U 7N G. `, Proposed Starting Date_a<-P Pcojected completion tine I - 5 Plans/Forms.indgded%ith the Application:Please cheek nem to applicable boxes ndsca iCo7cirador Corriptiante F rri ati rzina� �ons of A 27,oval A Disc La i tin o t Regulations F pool/Spa water Featarq ?notice of Completion to (tiled at End of Project] \41f C4--k"i f a LfC, Y � De�scriptiion of lmpro-.1m�ents desired(give full details of type and e.�nt ofImprovements): �SL'.�t141`,t;�'.. nr•r+� Pr.4 � c'? f',C)I C! '� �-* . `�` X l'� `{' i L�_h,C._ 1 .. f t C; !���r'. *�<t _$' +S.Sa .rye .t P f <a _ .ti..)s tJ 65 c,en , Compr=ce Statement: As legal owns s ofrite abmre-ref ed property,I(we)hereby state t'hatthis application and the plans submitted ase in compliance with thu Association's"Landscape,Design Guidelines." 1(We)have i reviewed the Guidelines.checked off the appropriate items on the attached''Landscape Installation Contratux Compliance Statcmc:►t and Documents Submittal",and a tach hcrcw sepmte cheeks(payable to-Puerta A7Al')for the $SU Application Fee,and corcrspandi ndalik deposit, E3p: ,/y ,� ?�.,.-� Date Owner(s)Signature(s) A.pplicatiow?lans Roe'd By:'j Date a /Z int Signature) Application[Plans are: G COMPLETE 0 NOT COMPL 15TE(Exptain below): Application,Plaas(Matcrialssubmitted to Association on Cs1 '3 Approved on 6'1.1/��)Denied on Application Reviewc4 on __ By: r' Committee Rep_ "socialion Manager i 80921 CALLE AZUL LA QUINTA CA T-6"7-F -I 10'-41" T-6" 8'-8" i 19'-104"