PAT (13-1003)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00001003
Property Address:
56725 MERION
APN:
762 -023 -027 -
Application description:
PATIO COVER
Property Zoning:
LOW DENSITY
Application valuation:
8000
Applicant:
CCfJV(�/aCT��
Tdy
40"
BUILDING & SAFETY DEPARTMENT .
BUILDING PERMIT
- RESIDENTIAL
RESIDENTIAL
Architect or Engineer:
ENS NTRACTOR'S DECLARATION
I hereby affirm under pen4ofury t t I amcsed under provisions of Chapter 9 (commencing with
Section 7000) of Divisionusi ss and r fessionals Code, and my License is in full force and effect.
License Class: B LicenseNo.: 594043
Date:j �c —Co
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of p jury that exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Bu 'ness an rofessions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, <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.).
(_) 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.).
(_ 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 (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Owner:
Jonathane &Mara Blum
56-725 MERION
LA QUINTA, CA 92253
Contractor:
7C'S CONSTRUCTION & MAINT
48236 VISTA DE NOPAL
LA QUINTA, CA 92253
(760)564-5811
Lic. No.: 594043
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/18/13
OCT 18""
07IVQlv
ce
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 perfor&ofth ork for which this permit is issued. My workers' compensation
insurance carrier anbe� are:Carrier STATE FUND P9licyNumbar 713-2611-2011
I certify that, in the perf a work for which this permit is issued, I shall not employ any
person in any manncom ubject to the workers' compensation laws of California,
and agree that, if I se s ject to the workers' compensation provisions of Section
3700 of the Labor Cf with comply with those provisions.
Date: �u �I JApplicant:
WARNING: FAILURE TO SECURE ORKER COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI NAL P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. IN ADDITI TO E 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 perm'
2. Any permit issued as a result of this application come null and void if work is not commenced
within 180 days from date of issuance of su permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that a above form tion is correct. I agree to comply with all
city and county ordinances and state laws relating to uilding nstri ion, and hereby authorize representatives
of this county to enter upon the above-mentioned pr erty ins p ion purposes.
ll /�
Date:l-f - ` �) Signature (Applicant or Agent):
Application Number . . . . . 13-00001003
Permit . . . ELECTRICAL 2013
Additional desc . .
Permit Fee . . . . 23.83 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 4/16/14
Qty Unit Charge Pere
Extension
1.00 23.8300 LS ELEC FIXTURES, FIRST 20
----------------------------------------------------------------------------
23.83
Permit . . . PATIO COVER 2013
Additional desc . .
Permit Fee •. . . . 131.56 Plan Check Fee
00
Issue Date . . . . Valuation . . .
. 8000
Expiration Date 4/16/14
Qty Unit Charge Per
Extension
1.00 131.5600 EA MISC PATIO COVER, SPEC
131.56
----------------------------------------------------------------------------
Special Notes and Comments
REVISE PATIO COVER & REPLACE REAR
WINDOWS & DOORS ADD CEILING FAN UNDER
PATIO COVER
September 6, 2013 9:07:47 AM jjohnson.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
HOURLY PLAN CHECK
315.00.
PLAN CHECK, PATIO COVER
165.88
PLAN CHECK, ELECTRICAL
23.83
STRONG MOTION (SMI) - RES
.80
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 155.39 .00 .00
155.39
Plan Check Total .00 .00 .00
.00
Other Fee Total 507.51 .00 .00
507.51
Grand Total 662.90 .00 .00
662.90
LQPERMIT