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11-0110 (PAT)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T '44 4tyl 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 11-00000110 Property Address: 54290 AVENIDA MONTEZUMA APN: 774-231-003-14. -000000- Application description: PATIO COVER - RESIDENTIAL Property Zoning: COVE RESIDENTIAL Application valuation: 3139 Applic Architect or ginee 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 force and effect. License Class: B License No.: 770843 Date: 777��7 OW -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).: (_) 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.). (_ 1 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.l. (_) 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: JOHNS RESIDENCE 54290 AVENIDA MONTEZUMA LA QUINTA, CA 92253 (760)779-9980 Contractor: LIFETIME PATIOS PO BOX 5806 LA QUINTA, CA 92248 (760)777-2650 Lic. No.: 770843" VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/31/11 WORKER'S 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 f6r 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 SOUTHERN INS Policy Number WSIO04013401 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 become subject to the workers' compensation provisions of Section 3 0of the Labor Code, I shall forthwith comply with those provisions. Date: ( Applicant• WARN JIG : AILURE TO SICU PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE 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. 1 certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordi antes and state laws relating to building construction, and hereby authorize representatives of this court2to en r upon the above-mentioned property for inspection purposes. Date: V `.signature (Applicant or A n . Application Number . . . . . 11-00000110 Permit . . . PATIO COVER PERMIT Additional desc . . Permit Fee . . . . 63.00 Plan Check Fee 40.95 Issue Date . . . . Valuation . . . . 3139 Expiration Date . . 7/30/11 Qty Unit Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG 2,001-25,000 18.00. ---------------------------------------------------------------------------- Special Notes and Comments WEATHERWOOD SHADE STRUCTURE OPEN LATTICE FREE STANDING TOTAL OF 236 SQUARE FEE PER APPROVED PLANS, 2009 IBC;2009 IRC;2010 CBC & A.J. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited ---------- Due ------------------------------------- Permit Fee Total 63.00 ---------- .00 .00 63.00 Plan Check Total 40.95 .00 .00 40.95 Other Fee Total 1.00 .00 .00 1.00 Grand Total. 104.95 .00 .00 104.95 LQPERMIT Bin # City of La Quints Building a Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 . Building Permit Application and Tracking Sheet Project Address: Owner's Name: A' P. Number: Address: L29c d3 Legal Description: n" -city. ST, Zip:' j Contractor: ��l 1,1i1,�. L s 2Z S Telephone: ?(�G Twp+ 4- Address: ��ov G(e Project Description: City, ST, Zip: Telephone: GG - —M e?G : �. i" ` . State Lie. # : 13.17G Ec[3. cityi.e. #: 325 Arch., Engr., Designer: Address: .City, ST, Zip: Telephone: 3'�� Conshuction Type: -Occupancy: State Lic. #: Project type (circle. one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft. i.2 SG#Stories Units: Telephone # of Contact Person: Estimated Value of Project: et APPLICANT: DO NOT WRITE. BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person' Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Gradingplan J.V Review, ready for correctionsfimue Electrics! Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A Approval Plans resubmitted Grading INHOUSE:- `-Review, ready for correctionsrssue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. .Pub. Wks. Appr Date of permit issue School Fees ` Total Permit Fees