PAT (06-2261)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&ht 4 XP Q"
Application Number: 06-00002261
Property Address: 78860 MERIDIAN WY
APN: 609-480-040-6 -23773 -
Application description: PATIO COVER - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 6730.
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the mess and Pr ssionals C nd my License is in full force and effect.
License Class: B Li nee N : 860958
/Date:b I j� Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 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 70001 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 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 contractorls) 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:
DOUG NELSON
78860 MERIDIAN WAY
LA QUINTA, CA 92253
(003)000-0000
Contractor:
PELLETIER PATIO
79275 DESERT STREAM DR
LA QUINTA, CA 92253
(760)275-7593
Lic. No.: 860958
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/05/06
------------7----------------------------------
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 manner so o become subject t rkers' compensation laws of California,
and agree that, if I ould beco ubject [o t e worke ' compensation provisions of Section
211
jjrr3700 of the K Code, I shat) fo h ith com ly wit hose provisions.ate:IJICi(0 pplicam:WARG: FAILURE TO SECURE KE ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES 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 cessatipofworr180 days will subject
permit to cancellation.
I certify that I have read this application and state the above rmation igree to comply with all
city and county ordinances an state laws relati to build' g constru tion, anorize representatives
oft isZ�=e
he above-mentione prop y r insp tion purp
Date: (Applicant or Agen
f..
LQPERMIT
Application Number . . . . 06-00002261
Permit . . . PATIO COVER PERMIT
Additional desc .
Permit Fee . . . . 90.00 Plan Check Fee 58.50
Issue Date . . . . Valuation . . . . 6730
Expiration Date . . 12/02/06
Qty Unit Charge Per Extension
BASE FEE 45.00
5.00 9.0000 THOU BLDG 2,001-25,000 45.00
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Special Notes and Comments
2 ALUMAWOOD LATTICE PATIO COVERS
TOTALING 506 S.F. 171X10' AT REAR &
21'X16' AT INTERIOR COURTYARD
----------------------------------------------------------------------------
Other F:es . . . . . . . . . STRONG MOTION (SMI) - RES .67
Fee summary Charged
Permit Fee Total 90.00
Plan Check Total 58.50
Other Fee Total .67
Grand Total 149.17
Paid Credited Due
.00 .00 90.00
.00 .00 58.50
00 .00 .67
.00 .00 149.17
Bin #
City of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permitfl \
Project Address:' 17 , e)(po " eArJd) CLv1
Owner's Name: ZokAC,
A. P. Number:
Address:
Legal Description:
Contractor:
City, ST, Zip: L4 2 2 S
Telephone: Qr,y
Address: -70,275 YJ t(�-S4.Y,�
Project Description:
City, ST, Zip: V"*r, Cizrz—'s
Telephone:
City Lic. #:
State Lic. # :
Arch., Engr., Designer:
l(o .�-�a� (' v�—
o
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: CGS �//k�✓(
Sq. Ft.: 50�71
# Stories:
# Units :
Telephone # of Contact Person: o' %Jcl'3
-?S-
Estimated Value of Project: PJk @tp
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING .
PERMTT 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 correctionsrssue
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 correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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RE -INSPECTION FEE' OF $30
ILL BE CHARGED IF THE PPROVED
LANS AND JOB CARD ARE NOT ON
HE SITE FOR A SCIIEDULED
I SPECTION.
NO EXCEPTIONS;
CITY OF LA QUINTA
BUILDING & SAFETY DEPT
FOR CONSTRUCTION
DA -• a ear
135/0312005 09.55 17603450755 rIELSON
STARLIGHT DUNE'S
HOMEOWNERS ASWIATIAN
Pnojxrty,gM
To: A c C
You era t��y aciv thea the above u�rk Is proposed and
Z sale (m�inoum ?/�" 1'} of thew to be lona OWMi is r+e+qusstsd. Attadred are drawings
drawings. We undsr and types of materials to be used we lndiwW on the
that Building Permh for some modi�rcattons are mqufrod by the City of i,a
Quinto and the the cods of fits peMft end the rponaibility of obtat ft permis6 and subsequent
will be borne by the applicant
We acknOwkige that ah approved d"98 In ft origind design* wig be at a,r ex
to or nfkation of existing sOnkler systems, unde pe an that awry damage
IartdsGsping to athvr damage to Astsadstion � utll�iea, building s�rcture and externor
these 11 m*W intpravOwta shNI be at our 5—P—None
the cronstruction aid/or installation of
We adrnow a Security Deposit of Jbto wicr any damage to"common area or clean.0 of the total c of the project is mQuired
Deposit amount Wit be detearMned by the ALC in relatlann xtentnt of oeg�T� he wed.
sobml# d prier to cantnrencwmerrt of wwrk. ,quer Inspection of the d 6f t must be
deposit wlil be t+ bXW. N ali aom � P by ALC, the
Ironents are reston+ed to original or pettier condition.
days of ft%elPt 0TI:: conatructfaMinafttirdlon of requested and approved modMcatlm roust begirt waln 45
written apg�vOf wrlttan appmvai and am m 4ac�l ca meet be comooed wbprtn g0 ftys of
Prior to comm ument of proposed modification, Peso Rrbmh with this a
In9<rrance, gond and copy of fit�err� if other Than iia ppflc;ation Contractors
any of t'le above °�� , Failure ro comply wiRh or
%reed. spe�firatians will result In the nullff=Wn of ft document and subm"erg appm W
41P11+tEFt SIGMA
MWiinq Address
Phone # day 0-
PAGE 02
i2A�--,CP Colo
CITY OF LA QUINTA
EUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATED 6 gy
05/03/2006 00:57 17603450755 NELSON PAGE 01
Send To:
StaHight Dunes Homeowners Association
CIO Pfflonaidred Propwty Manegement
6" 10 Adabna Road
Caifi�*a i Cly, Ca, 92234
Attn: ALC Committee
The i mWSt has bean reviamd by the ALC
Comments:R®r�is Ate.
Date reviewed:AppixovWW By:
( ) #m owed ( ) d®:"d ( ) pending