PAT (06-2462)79854 Memorial Pl
06-2462
P.O. BOX 1504.
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number's
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
,r T4ht 4 4Qumrw
06-00002462
79854 MEMORIAL,PL
604-501-003-28 -24197 -
PATIO COVER - RESIDENTIAL
LOW DENSITY RESIDENTIAL
4855
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under ions of Chapter 9 (commencing with
Section 7000) of Division 3 of the 8u ' ss an fessionals ode, a d my License is in full force and effect.
License lass: B Li ense N .: 860958
Dat 21yLlContractor: .
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury t I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business andProfessionsCode: 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).: ( _
(_ 1 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 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.).
(_) 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:
KEVIN SHEK
79854 MEMORIAL PL
LA QUINTA, CA 92253
Contractor:
PELLETIER PATIO
79275 DESERT STREAM
LA QUINTA, CA 92253
(760)275-7593
Lic. No.: 860958
DR
VOICE (760) 777-7012
FAX (760) 777-7011,
INSPECTIONS (760) 777-7153,
Date: 6/21/06
JUN t-20
1006
CITY OF 6 QIJINTAFIWAWCE 00t.
------------------
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 for 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 EXEMPT Policy Number EXEMPT
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any man become subj to a workers' compensation laws of California,
and agree that, i should beco a subject the rkers' compensation provisions of Section
rr rr// 3770xr0 of the La or Code, I shall orthwith c mpl with those provisions.
Date:t.PIU1't/ bApplicant I /
WARNING: FAILURE TO SECUWOR RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS J$ 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 is not commenced
within 1.80 days from date of issuance uch permit, or cejd
r 180 days will subject
permit to cancellation.
I certify that I have read this application and ate that the ab a informatree to comply with all
city and county ordinances and state laws r ating to building onstructionorize representatives
of this clunty to enter upon the above -men ioned pro erty 'nspection
. IZ1I cs
Date. ignature_IApplicant o Age
Application Number
. . . . 06-00002462
Permit
PATIO COVER
PERMIT
Additional desc .
Permit Fee
72.00
Plan Check
Fee
46.80
Issue •Date
Valuation
: .
. 4855
Expiration Date
12/18/06
Qty Unit Charge
Per
-
Extension: .
BASE
FEE
45.00
- 3.00 9.0000
THOU. BLDG
2,001-25,000
27.00
Special Notes.and Comments
365 ALUMAWOOD LATTICE
PATIO COVER
IN
REAR YARD.
---------------------------------------------
Other Fees . . . .
7 -------------------------------
STRONG MOTION (SMI)
- RES
x.50 -
Fee summary Charged
Paid Credited
Due
Permit Fee Total
72.00..
.00
.00
72.00 -.
Plan Check Total
46.80
.00
.00
46.80
Other Fee Total
.50
.00
.00
.50
Grand Total
119.30
.00
.00
119.30
CITY OF LA QUINTA + '•r f • '
. • BUILDING & SAFETY DEPT.-
APPROVED
EPT:APPROVED
FOR CONSTRUCTION
A F E -INSPECTION FEE OF $30 +
WIL BE CHARGED, IF.THE APPROVED-
PL
PPROVED PL S AND JOB CARD ARE NOT ON.0
TH SITE FOR SCHEDULED 5Ne"'"'`
INS ECTION. Lc' c4 12253
NO EXCEPTIONS!
33 '
w►l&z.,r-6 el"— P4rt>
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit.#
211
Project Address: --1q_ OS" M e'v„%v.r vq. )p
Owner's Name:
A. P. Number:
Address: 5 E✓VYl COY 1 a 1 Q L
Legal Description:
City, ST, Zip: L_e'
Contractor: C J
Telephone: C Q) 9 - Cx (,P3
Address: _)92`) -!
Project Description:
City, ST, Zip: L QA4V' _1 CA
C o
Telephone: Qr 5 - I? _S 9
State Lie. #:
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:;
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:.
Project type (circle one): New Add 'n Alter Repair Demo
Sq. Ft.:
# Stories..
# Units:
Telephone # of Contact Person: a?'5-15 3
Estimated Value of Proje —f CSU
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 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading, plan
2" Review, ready for correctionsfissue
Electrical
Subcontactor. List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval:
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees