PAT (0303-100)LICENSED CONTRACTOR 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 # Lic. Class Exp. Date
Date Signature of Contractor•'
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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'& Professionals Code).
( ) I, as owner of the, property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section _ B&P.C. for this reason
Date Signature of Owner
i
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty.of perjury one of the following declaratio•,ns:
() 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 & policy no. are:
Carrier i'�I i C;3'g ' I,R,Ei 1113 Policy No. 10.MkIMS09
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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 3700 of the Labor
Code, I shall forthwith comply with those provisions r
Date: Applicant��'�°'u'"'�"
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application. i
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property -for inspection purposes.
Signature (Owner/Agent)i• / Date
BUILDING PERMIT PERMIT#
DATE f f ,�YALUATION LOT_ ., �-' �"TRACT
as
JOB SITE
APN
g� ���y g����}e� �qry
ADDRESS n7v�YSY LA.)i;i.L�.3 dPA&�5til.�lJbr«�e
OWNER
CONTRACTOR/DESIGNER/EN (NEER
Sty,. -C AT BU:[L.. D S -3
3,44 0 A'IMN.UA M M� OZA,
37300 D.=WE :F?,41LKUP,
LA Q'f.J `A CA, 922:3
THOLTZVO .PAT:,' IS C"A 922,16
t;'J60)343u1134 CmVi 5737
USE OF PERMIT
Pmrio
'250 V BUILTMVP VP PX1710 COV 111P PER CITY 'STAKOARD.
F
PLAN CHEZCK FOE7 Vt n000-4394118. �,,'•!tl. lib
C.' 2dSIFYiJC°I°s�; FER, 101-000-418-000
ST;RONOMOT ION MW -RESIN'► 101,-000-241-000
•4,
.y
SITS -TOTAL Ct3NS'!RC:TM109 Al3'D 11 ARI' C'f~ ,,K
U.381 .17'.$2F -.,PAW 1 K63
$0.00
'1'MAL MRINiU MES IYU. NOW
RECEIPT
DATE � /� ti
'�1%�.f
BY
DATE FINALED
INSPECTO ,/
4��
Q�
�`''
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
_3
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Z p
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Ba- s
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
' ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
RAFTER SIZE AND SPACING SPECIFY'ROOFING AND SHEATHING OR OPEN LATTICE
nN /--pd (SEE ROOFING NOTE ON REVERSE)
I
1 • ROOF PITCH .
CONTINUOUS LEDGER '
(SAME SIZE AS RAFTERS) I- -
4 uo
HEADER SIZE - I T• AND 'L' STRAPS
6"x670"x1/8" WITH .
— — r Z- Ll
I (4) 160 NAILSt 0 0� I z
RAFTER SPAN: r POST SPACING:______
---- -
O.H. a O.H. ix
_v
OVERALL LENGTH: �- a OVERALL LENGTH:
POST SIZE: -79--r� .
REAR SETBACK SIDE SETBACK - \, , •.r (4'x4' MIN.) S
2000_P.S.I CONCRETE —�1 I FINISH GRADE FINISH GRADE
L _ J I '– �— MIN. - 12" x 12' FOOTING' I 1
12* BELOW GRADE L _ J
" PROVIDE 1" CLEARANCE
' BETWEEN POST AND
NOTE: CONCRETE
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4" x'5' LAG SCREW THROUGH -FASCIA INTO EACH RAFTER TAIL. '!
s U—STRAP OR ANGLE
c
r — x•3/8" x 5" LAG SCREWS INTO STUDS AT 16" D.C. •NON —CORROSIVE. PLATE PpE
CONTINUOUS LEDGER - c - "' ��• - _ �15� GR N
11.7
(4)- • 1 6d NAILS
OR BOLT '
r
r. U -STRAP OR ANGLE
r •
(4)- 16d NAILS
OR BOLT
JOIST HANGER OR SOLID BLOCKING ,
NAIL RAFTER TO BLOCKING r
PROVIDE 1" CLEARANCE
+ _ BETWEETEPOST ANDCONCR
II
BUILDING DEPARTMENT APPROVAL BELOW �� II II 111 II
CI 1 i OF LA Q�� �A ANCHOR BOLT (EMBED
BUILDING & SAFETY DEPT.
� MIN. INTO CONCRETE)
APPROVED..Y, . , ,_ : ,, - , ,' JYP�ICAL,A.P,AT103\ COV&RO
'FOR C NSTRUC ON '
... �-v'•i� �`. , !' ,DATE OF APPL'ICATIO.N " :s3 —.0 4• �, ":!. '1% aj
r�q� I� �� r• a �' ,.` �•:. �A aJy, ,,OWNER'S NAME .� t. , *yY
r
�.
. ♦• . i. ;. '.r ......,. +, ,y •, :,; >.� - 1j, t, •'' 7a ` 4z"�-' ,,.STREET aADDRESS.'N
3'3- � T • 0, e.4 lO ZAq•
,� j,,3� w -I RC'Ta ST ZIP ,% � �� � �1('''
TELEPHONE 64 Z
H.O.A.' APPROVAL �/� f
+i
Q. Q. Q
Iz- v' Q- v Q v 00
RAFTER SPAN TABLE ��� � � _* ALL CONSTRUCTION SHALL CONFORM
GRADING RULES � O
Ps 20-70 ��� �s� �v� �`5 TO THE PROVISIONS OF THE:
(FEET & INCHES)
1998 CALIFORNIA BUILDING CODE.
61 ry
• ��� ��� ��� COQ SUPPLEMENTAL NOTES:
NATES:
1.' 32" RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY.
1
2. FOR SOLID PATIO COVERS (NOT LATTICE)
RAFTER SPAN IS LIMITED TO 10'-0" USING
THIS STANDARD.
LATTICE
ROOF
BUILT—UP ROOF
HEADERS
HEADERS
DOUGLAS
FIR NO. 1
DOUGLAS
FIR NO. 1
SIZE
SPAN
O.C.
��
4x.4
1 •
4x4
4'-0"
4x6
8'-0"
4x6
6'-0"
4x8
4x10
11'-0"
14'-0"
•
1
®1
10'-0"
1
1 7'-0"
4x 1 2
12'-0"
6x8
14'-0"
6x8
NATES:
1.' 32" RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY.
1
2. FOR SOLID PATIO COVERS (NOT LATTICE)
RAFTER SPAN IS LIMITED TO 10'-0" USING
THIS STANDARD.
LATTICE
ROOF
BUILT—UP ROOF
HEADERS
HEADERS
DOUGLAS
FIR NO. 1
DOUGLAS
FIR NO. 1
SIZE
SPAN
SIZE
SPAN
4x.4
5'-0"
4x4
4'-0"
4x6
8'-0"
4x6
6'-0"
4x8
4x10
11'-0"
14'-0"
4 8
8'—O"
4x1
10'-0"
• 4x 1 2
1 7'-0"
4x 1 2
12'-0"
6x8
14'-0"
6x8
12'-0"
6x 10
17'-0"
6x 10
14'-0"
ROOFING NOTES:
A. BUILT—UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.
AMUo
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