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12-0501 (PAT) I IIIIIII VIII III VIII IIII 47 Y4 P.O. BOX 1504 _IE 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: 5/07/12 Application Number: 12��0000501�� Owner: Property Address: 60920 ZUL ROGER GOODWIN APN: 7627240-003-31 -300961- 80920 CALLE AZUL Application description: PATIO COVER - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: MEDIUM, DENSITY RES Application valuation: 878 DWA . Contractor: Applicant: Architect or Engin rGOLD STAR CSTM PTG LQ PATIO CO 42335 WASHINGTON ST #F363 PALM DESERT, CA 92211 (760)574-1043 Lic. No. : 855623 ------------------------------- ------------------------------------------------------------------ LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000)of Division 3 of the Buts and Professionals Code,and my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided Lice Class: C33 C51 i ense 855623 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is �7 issued. Date: / ontractor: 1 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 DEC ATION 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 PAN AMER INS Policy Number WKN1438261 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 become subject to the workers'comp sation provisions of Section License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 3700 of the Labor C I shall forth h c ply with those pr isions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by v any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).: Date:✓ 7 Z plicant: (_) I,as owner of the property,or my employees with wages as their sole compensation,will do the work,and t the structure is not intended or offered for sale(Sec.7044,Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAC IS UNLAWFUL,AND SHALL Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT 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 I,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, (_1 I am exempt under Sec. ,B.&P.C.for this reason the owner,and the applicant,each agrees to,and shall defend,indemnity 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 the above information is correct. I agree to comply with all work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating to building construction,and ereby authorize representatives of this ounty to a ter upon the above-mentioned property for i pection pur es. Lender's Name: �✓ ate: 7 i ure(Applicant or Agent): _ Lender's Address: ' LQPERMIT Application Number . . . . . 12-00000501 Permit . . . PATIO COVER PERMIT Additional desc . Permit Fee . . . 23.00 Plan Check Fee .. 14.95 Issue Date . . . . Valuation 878 Expiration Date 11/03/12 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 2.0000 HND BLDG 501-2,000 8.00 ---------------------------------------------------------------------------- Special Notes and Comments 66. S.F. WEATHERWOOD LATTICE SHADE STRUCTURE ATTACHED TO REAR OF SFD. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 STRONG MOTION (SMI) - RES .50 Fee summary Charged Paid Credited Due Permit Fee Total 23.00 .00 .00' 23.070 Plan Check Total 14.95 .00 .00 14.95 Other Fee Total 1.50 .00 .00 .1.50 Grand Total 39.45 .0.0 .00. 39.45 LQPERMIT ADJACENT RESIDENCE ------------ _ { PROPERTY LINE 1` 12'--i 1 l CITY OF LA QVINTA PROPOSED ALUMINUMWEATHERWOOD BUILDING SAFETY DEPT CI / LATTICE SHADE STRUCTURE APPROVED FOR CONSTRUCTION @R,TE-f-f L?i BY' .3� GOODWIN RESIDENCE 80920 CALLE AZUL GARAGE ENTRY GUEST PARKING Bin# City of La Quinta Building 8T Safety DivLsion P.O. Box 1504, 78-495 Calle Tampico Permit # La Quinta, CA 92253 . (760) 777.7012 1V Building Permit Application and Tracking Sheet Project Address: j U� Owner's Name: Address: �p � A.P.Number: CfZ��3 City,ST,Zip: (, /v10* ............. : ,'�,.�,.^^:�e>:;ra; :. off•: Legal Description: P Convactor: ILD►'� C . � 1 A•I�l u Telephone: z tt 3(0 3 Project Description: Address: 2-33 W {flNbiDN �� --y ;e:F� _ 2, C_, q zz- 1 l (� �•� City,sT,Z p: (tom �5 y.:•><v ;; (,Gj Telephone: 6o ' .. . � e � ! O �� • State Lic.# : City Lic.4:3 ! �Arch.,Engr.,Designer: Address: City,ST,Zip: : >::i.•.•,;:s.:s<f;>,...::$r:ar::.:;:.:>:3 Occupancy: Construction Type: <;...: r « �: ,�• »;f Y Y Alter p Demo Telephone: ��Y aS'% Project type(circle one): New Add'n Repair State Lic.#: Sq Ft: _ #Stories: y1=2kon/ M o Name of Contact Person: D 3 Estimated Value of Project: 7 Telephone#of Contact Person: T�" 5 � Li— I APPLICANT: DO NOT.WRITE BELOW THIS LINE PERMIT FEES Rec'd TRACKING # Submittal Req'd Item Amount Plan Check submitted Plan Sets Plan Check Deposit Reviewed,ready for corrections Structural Calcs. plan Check Balance. Called Contact Person Truss Calcs. Construction Plans picked up Title 24 Cates. Mechanical Plans resubmitted Flood plain plan Electrical 2•'Review,ready for corrections/issue Grading plan Plumbing Called Contact Person Subcontactor List S.M.I. Plans picked up Grant Deed Grading Plans resubmitted act Fee H.O.A.Approval Developer Imp I"Review,ready for correctionsAssue IN HOUSE:- A.I.P.P• Called Contact Person Planning Approval Date of permit issue Pub.Wks.APPr School Fees Total Permit Fees