09-0406 (PAT)4 P.O. BOX 1504 ,
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
Property.Address:'
1'09-00000406 _,
51861 AVENIDA MONTEZUMA
APN:
773-151-006-6 -000000-
Application description:
PATIO COVER - RESIDENTIAL
Property Zoning:
COVE RESIDENTIAL
Application valuatioA:
5692
Applicant: ,Jl/ Architect or Engineer:
AIK
V .
-------_--------------------------------- - -'--------
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 Professionals Code, and my License is in full farce and effect.
License Class: C51 Li enseN 49379
T
ate: J tractor:
OWNER -BUILDER ECLARATION
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 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—) 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
LQPERMIT
Owner:
BETANCOURT JOHN
P O BOX 1280
LA QUINTA, CA 92253
Contractor:
LA QUINTA PATIO
40133 CALLE LOMA
BERMUDA,DUNES, C
(760)863-4335
Lic- No.: 449379
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/01/09
- — — — — — — — — — — — — — — — — — — — — — - — — — ----�:_^�Ci°= — — — —
WORKER'S COMPENSATION DECLARATIO
I hereby affirm under penalty of perjury one of the following declarations:
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 which this,permit is
issued.
17< I have and will maintain workers' compensation insurance, as required by Section 3.700 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 IST COMP INS Policy Number WEN0003727-03
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 b come subject to the orkers' compens provisions of Section
3300 of the Labor Code, atl forthwi o ith h se ro
pill can
WARNING: FAIL RETO URE WORKERS' COMPENSATION COVERAG LNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,000). 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 above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, a!!�Aresentati
hves
of��this c�orlu y toenter upon the above-mentioned pro inspeSS^«•'/�y pu 11Date:v � iggnar(u/re (Applicant or Agent):,M�/
Application Number . . . . .. 09-00000406
Permit . . . PATIO COVER PERMIT
Additional desc .
Permit Fee . ._ 81.00 Plan Check Fee
52.65
Issue Date Valuation
5692
Expiration Date 10/28/09
Qty Unit Charge Per
Extension
BASE FEE
45.00
4.00 9.0000 THOU BLDG 2,001-25,000
36.00
--------------------------------------------------
Special Notes and Comments
INSTALL 2-ALUMAWOOD LATTICE SHADE
STRUCTURES - 1 AT FRONT OF SFD & 1 AT
-
REAR OF.SFD, TOTAL OF 428 S.F.
----------- - ---------------------------------
Other Fees . . . . . BLDG STDS ADMIN (SB1473)
1.00
STRONG MOTION (SMI) - RES
.57
Fee summary Charged Paid Credited.
Due
----------------------------------------
�. Permit Fee Total 81.00 .00 .00
81.00
Plan Check To 52.65 .00 .00
52.65
Other Fee Total 1.57 .00 .00
1.57
Grand Total 135.22 .00 .00
135.22
AVENIDA MORALES
49'-10"
BACK YARD
3111 -8 -
PROPOSED ALUMAWOOD LATTICE
SHADE STRUCTURE
j -1,5(Q / 112'
751IM3rAVENIDA MONTEZUMA
CITY OF LA C UINTA s
BUILDING & SAFETY DEPT. 7.
APPROVED
FOR CONSTRUCTION
y
DATE;=,.- 0 8Y 12� A 0� S
ILI
PROPOSED ALUMAWOOD LATTICE ® V
s
SHADE STRUCTURE 0
15'-4" `
cl
9s
m
14'-10' V
5'-6z'
SPA
30'-2" POOL
BOND
WIRE
O POOL
DRIVEWAY ` FRONT
AVENIDA MONTEZUMA
Bin #City
of La Quinta
Building U- Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Permit #
La Quinta, CA 92253 - (760) 777-7012
AD
OR,
Building Permit Application and Tracking Sheet
I ! N ZvtE�lf� Owner's Name: —SE>k v1%AicDU �T
Project Address:
J
A. P. Number: CJ
City, ST, Zip: L,,P I 4 �- !'/� S3
Legal Description:
Telephone: ??-q
Contractor: L f} ()TAJ r;
�A-rl� (✓D
L vA-
Address: SIO - (3 3 C1+ LL (^ O /vl A iE-: N Tp -A -DA Project Description: 02
2:6' STZ V e 2 �S
City, ST, Zip: /U t7 I OS1-F�D
Telephone: 7 6f- 5-7 '-('
�%�j
State Lic. # : 13 7 !
City Lic. #: lips0
Arch., Engr., Designer:
Address:
City, ST, Zip:
Construction Type: occupancy:
Telephone:
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #:OSq. Ft.: 2 # Stories: # Units:
Name of Contact Person: `�1 /t}-oZ
WLF
.
-7 At Estimated Value of Project:
Telephone # of Contact Person:
4 -5
WRITE BELOW THIS LINE
APPLICANT: DO NOT
PERMIT FEES
'd TRACKING .
# Submittal Req'd RecAmount
Item
Plan Check submitted
Plan Sets
Plan Check Deposit
Reviewed, ready for corrections
Structural Cates.
Plan Check Balance
Called Contact Person
Truss Cates.
Construction
Plans picked up
Energy Calcs.
Mechanical
Plans resubmitted
Flood plain plan
Electrical
21' Review, ready for corrections/issue
Grading plan
Plumbing
Called Contact Person
Subcoatactor List
S.M.I.
Plans picked up
Grant Deed
Grading
H.O.A. Approval
Plans resubmitted
Developer Impact Fee
''l Review, ready for corrections/issue
IN HOUSE:-
A.I.P.P.
Called Contact Person
Planning Approval
Date of permit issue
Pub. Wks• Appr
School Fees
'total Pcrnlit Fees
APPROVED
FOR CONSTRUCTION
pA 5-/•e BY---'