06-0466 (PAT)P.O. BOX 1504
- ' 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
06-00000466
57037 MERION
762-031-607- - -
PATIO COVER RESIDENTIAL
LOW-DENSITY RESIDENTIAL
3352
Architect or Engineer
4
f�G1�GV
BUILDING & SAFETY DEPARTMENT
_B116h.DING PERMIT
Owner:
JOHN PFAFFI_
57-037 MERION.
LA QUINTA, CA 92253
Contractor:
FLORES BLDRS CONSTR, FRANK
61125 PIERSON
WHITE -WATER, CA 92282
(760)251-7957
Lic. No.: 516625
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
5/02/06
----------------------------------------- --.-------------------.----------------------,-------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
- Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B License No.: 516625
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: Contractor:
_ 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 workerscompensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
' I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 1640796-2006
' following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a'signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workers' compensation provisions of Section
' License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I shall forthwith comply with those provisions.
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).:
_
4ate: -1 Applicant: - i
(_ I.af, 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
WARNING: FAILURE TO SECURE'WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
- Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT '
1 A 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
1 _ I I am exempt under Sec. , B.&P.C. for this reason e7
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
Date_: le 'Owner.
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 cessation of work for 180 days will subject
INENCY _
- - CONSTRUCT( N LENDG
permit to cancellation.
' I hereby affirm under penalty of perjury that there is a construction lending agency for the perfo ance of the
- I certify that I have read this application and state that the above information is correct. I agree to comply 'th all
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to building construction, and hereby thorize repres tiv
of this countySo enter upon the above-mentioned property for inspe p
Lender's Name:
—t - -
Dat Signature (Applicant or Agent):
Lender's Address:
--- ---
LQPEF11f1T
Application Number .
. . . . 06-00000466
Permit
ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . .
18.75
Plan Check Fee
4.69
Issue Date . . . .
Valuation
0
Expiration Date
10/29/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
5•.00 .7500
----------------------------------------------------------------------------
PER ELEC
DEVICE/FIXTURE 1ST 20
3.75
Permit
PATIO COVER
PERMIT
Additional desc .
Permit Fee . . . .
63.00
Plan Check Fee
40.95
Issue Date . . . .
Valuation
3352
Expiration Date
10/29/06
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
PATIO COVER WITH 3 LIGHTS
AND 2
.SWITCHES.May 2, 2006
8:43:27 AM
7Johnson
-_---------- -- ----------------------------------------------------------
Other Fees . .'. . .
. . STRONG MOTION (SMI)-- RES
.50
Fee summary Charged
Paid Credited
Due
Permit Fee Total
81.75
.00 .00
81.75
Plan Check Total
45.64
.00 .00
45.64
Other Fee Total
.50
.00 00
50
Grand Total
127.89
.00 .00
127.89
L�c•�� F.5 $e 66 wey us
Bin' # '� X
City of La Quinta
"Y Building & Safe Divisi /
��. ty on
Permit # t_ P.O. Box, 1504, 78-495 Calle Tampico
(�� La Quinta, CA 922.53 -.(760) 777-.7012
Building Permit Application and Tracking Sheet
Project Address: j ;;;10 ?� 7
d7i Dir/ Owner's Name:.
A. P. Number: Address:p
5-7
Legal Description: CityST Zip: Gu 2 'S
P � .
Contractor:Ga Telephone:
Address:
Project Description: v
City, ST, Zip:
Telephone:
State Lic. # : City Lk. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: Construction Type:
Occupancy:
P cy:
State Lie. #:
Project type (circle one):(6e Add'n Alter Repair Demo
Name of Contact Person: Sq. Ft.: �� # Stories: #Units:
Telephone # of Contact Person_)v *7
II �1 .�I q(1Z `�11E ZI2 �cc
Total Permit Fees
alt -� gEN2 L-DdIG +11240--
4f/3
1X2106/3 sift ��-ovE�
mated Value of Project:
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACIQIYG
PERMIT FEES
Plan Sets
Plan Check submitted 1 7 Item Amount
Reviewed, re dy for correctio s�
Structural Calcs.
u; Plan Check Deposit
Truss Calcs.
Called Contact
Perso Plan Check Balance
Energy Calcs.
Plans. picked up
Construction
Plans resubmitted
Mechanical
Flood plain plan
Grading. plan
2"! Review, read for corrections/i ue Electrical
Subcontactor List
Called Contact Person WO lum ing
Grant Deed
Plans picked up I
S.M.I.
Plans resubmitted
H.O.A. Approval
Grading
IN HOUSE:-
'`" Review, ready for corrections/issue Developer Impact Fee,
Planning Approval
Called Contact Person
A.I.P.P.
Date of permit issue
Pub. Wks. Appr
School Fees
II �1 .�I q(1Z `�11E ZI2 �cc
Total Permit Fees
alt -� gEN2 L-DdIG +11240--
4f/3
1X2106/3 sift ��-ovE�