05-1658 (PAT)IIIIIIIIVIIIIIIVIIIIIII 36
IE
�°J.� , " " •
�.
- �l�rl�ICt/
D h� BUILDING & SAFETY D'EPARTMENT-"
R. Box 1504
O, (760)';777-7012
O F J`��p 7 495 CALLS TAM%.PICO FAX (760) "777-701'1
OF��C��P�' LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number 05-00001658 Date 4/29/"05
Property Address . . . . 80420,AVENUE-52_
AP14: 772.-170-.008= -
Application description. PATIO COVER RESIDENTIAL
Property Zoning". LOW DENSITY RESIDENTIAL
Application -valuation". 7435
Owner Contractor
---------- --------------- -------- -----------------------_--"--------
WAYNE & MARY PRICE PELLETIER CONSTRUCTION
80-420,AVENUE 52 74691 -SWEET ROAD:
LA QUINTA," CA 92253 THOUSAND PALMS, CA 9227.6
(.760)27577593
WCC: STATE' FUND
WC: 5495 01/01/06
CSLB: 260484 12/31/06
CCC:." B. -C33
P.O. BOX 1504 • /i . T
78-495 CALLS TAMPICO w VOICE (760) 777-7012
011
LA QUINTA, CALIFORNIA 92253 r FAX (760) 777-7
INSPECTIONS (760) 777-7153153
BUILDING & SAFETY DEPARTMENT
• �.Jr�I1_.i�
Application Number: C2 Date: '`� - 25' d j }
,,.Applicant; �® 9 Architect or Engineer:
Ylpplicant's Mailing Address: Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisigns of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my License i i full force and effect.
License Class License No." �"1 CJ"1
r r,
Date L4 2 Contractor r
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contraclors' State LicensiEr-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 Contractors' 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).):
U 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 or 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.).
U 1, 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner
WORKERS' 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' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for whi99%licv
sued.
I have and will maintpensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
i URd My � orke.insurance carrier and policy�rwmber are:
Carrier 2 Number
_ 1 certify that, in the performance of the or w i is permit is is ed, 1 shall nol employ any person in any manner so as to become subject to the workers'
compensation laws of California d agree that, if I s nhltecQ subject to the orkers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those p visions. )
Date Applicant \
WARNING: FAILURE TO SECURE WOR RS' COMPEN ATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOU ND DOL S ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTER ATTORNEY'S FEES.
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
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 end, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or�necomes
i on related to the work being pe mted unde , r following issuance of this permit.
2. Any permit issued as a result of this applic and void if work is no commenced 'thin 180 days from date of issuance of such permit, or
cessation of work for 180 days will sub' peto cancellati
I certify that 1 have read this application and stat hat the above information 's torroverinoned
e to comply wit all city and county ordinances and state laws relating to building
construction, and hereby authorize representativ s of this county enter up t!l a propertyFfor inspection purposes.
Date Signature
----------------------------------------------------------------------------
Application Number . . . . . 05-00001658
-----------------------------------------------------------------------------
Permit . ... . . . PATIO COVER
PERMIT,1..1.
Additional.,desc
D
Permit Fee . . . . 99.00
41
.,Plan Check
.
Fee.
A T
Issue Date . . .
Valuation.
. .
. 7435
Expiration Date 10/26/05
Qty Unit Charge Per
Extension
j.,.BAS�
FEE;
45-00
6.00 9.0000 THOUBLDG
2,601-25,000
�
54:'d0
----------------- ---------------------
Special Notes and Comments
559 SF ALURAWOOD COVERED PATIO COVER '@
REAR OF RESIDENCE.
- - - - - - - - - - - 7 - - - - - - - - - - - - 7 7 7 -- - --- - - - - - 7 ----
Other Fees r'STRONGMOTION (SMI)'-
- - - - - - -
RES
- - - - 7
.74
Fee summary Charged.".,
Paid Credited
Due
----------------- ---------- ----------
----------
----------
Permit Fee Total 99.00
.00
.00
99.00
Plan Check Total 64.35
QO
64.35
Other Fee Total 74.,
.00
.00
.74..
Grand -Total 164
-00
-00
S -09
1r 4
CITY O5 LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR Co
A RE -INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARD ARE
HE SITE FOR A SCEDUCED
INSPECTION. .
NO EXCEPTIONS!
w�Vje -+ -pr;ck
e)0420 /qve S -Z
L-& C,
3
c� 36 uJ
i� tis
colow: 4�e
5
COrrtcLc, :31
a-7 - -7 993