PAT (07-3006)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
07-00003006
Property Address:
53565 AVENIDA MENDOZA
APN:
774-132-014-3 -000000-
Application description:
PATIO COVER - RESIDENTIAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
3857 _
T4ht 4 4 a"
Applicant: 11 i Architect or Engineer:
�p
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRrenseNo
DECLARATION
I hereby affirm under penalty of p y that I a ensed anisi s of Chapter 9 (commencing with
Section 7000) of Division 3 of Ile Business and Pro sionalan my License is in full force and effect.
License C ass: B L . 860958
0
Date:
!=rofessions
OWNER-BUILDER DECLARATION
'ury that am exempt from the Contractor's State License Law for the
si d 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 (5500).:
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 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.).
(_ 1 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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
WISKIRCHEN JAMES D
53565 AVENIDA MENDOZA
LA QUINTA, CA 92253
(760)771-8953
Contractor:'
PELLETIER PATIO
79275 DESERT STREAM
LA QUINTA, CA 92253
(760)275-7593
Lic. No.: 860958
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/26/07
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WORKER'S COMPENSATION DECLARATION
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.
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 wh thi
's permit is issued, I shall not employ any
person in any marrCoode,
so as to ome su tto,t workers' compensation laws of California,
and agree that, if,uld become ubjec to the wo ers' compensation provisions of Section
3700 of the Lab I shall fo hwit comply w h those provisions.
WARNING: FAILURE TO SECURE RKE ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI NALTIES 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 Directoi 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 cessati _ - o for 180 days will subject
permit to cancellation. i
I certify that I have read this application and s e that the above for tion is correct. agree to comply with all
city and county ordinances and state laws rel ting to building con tru ion, and hereby thorize representatives
of this county to�enter_upon the above -menti ned .property tori pec ion purposes.
or
Application Number . . . . 07-00003006
Permit PATIO COVER PERMIT
Additional desc .
_
Permit Fee . . . . 63.00 Plan Check
Fee
40.95
Issue Date . . . . Valuation
3857
Expiration Date 5/24/08
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
ALUMA WOOD PATIO COVER 10 X 29 SQUARE
FEET PER ICBO ER-2621P TOTAL 290 SQ.FT.
---------------------------------------L
------------------------------------
Other Fees . . . . . . . . . STRONG MOTION (SMI)
- RES
.50.
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 .50 .00
.00
.50
Grand Total 104.45 00
..00
104.45
LQPERMIT
I
z
593
Bin #
W
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: `3 S�o� •-OLL
Owner's Name:Wrs
A. P. Number:
Address:—
Legal Description:
City, ST; Zip:
Contractor: 0J,-0
Telephone: -7'7 1.�'j 53
�`�+MI
Address: Z% j _= 1/
Project Description: )��' .
City, ST, Zi . - (ij/L`Z'S3
Telephone: 774
...
State Lic. #': oor,) 8 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:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
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
Grading plan
2°" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L.
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