PAT (08-1004)P.O.- BOX 1504 F r "
78-495 CALLE TAMPICb
LA QUINTA,.CALIFORNIA 92253.
Application Number: C1,08-00.001004
Property Address: 79878 MORRIS AVE �.
APN: 604-512-002-6 -24197 -
Application description: PATIO COVER - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 14244
Applicant : j � Architect *or Engineer:
AAA -
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S 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 Cl ss: B C36 LicenseNo.: 483069LOO
rI-Dace' ��I Contractor.` ..
L.�
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5. Business and Professions Cade: 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 ($500).:
(_) 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 nohintended 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.). - -
(_) 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:
I.QPERAIIT
Owner:
ESPINOSA JOYCE M
79878 MORRIS AVENUE
LA QUINTA, CA 92253
Contractor:
OUTBACK PATIO & SUNROO
1450 W 6TH STREET, 411
CORONA, -CA 92882
(951)272-4997
Lic. No.: 483069
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/01/08
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 insurahce, 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 STATE FUND Policy Number 3003606-2008
_ 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 provisio Section
�
0 of the Labor Code, I shall forthwith comply with rhos rovisions.
Dale Applicant: '
WARNING: FAILURE TO SECURE WORKERS' C PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE TEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT-
. IMPORTANT Application is hereby made to the Director of Building and Safely 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 cessation of work for 180 days will subject
permit to cancellation.
I certify that.l have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representativ
of this count o enter upon the above-mentioned property for i tion purposes.
Date: � Signature (Applicant or Agent):
LQPEwwir
Application Number . . . . . 08-00001004
Permit . . . PATIO COVER PERMIT
' Additional desc .
Permit,Fee 162:00
Plan Check
Fee
105.30
Issue.Date
Valuation
14244
Expiration Date 12/28/08
Qty Unit Charge Per
Extension
BASE FEE
45.00
13.00 9.0000 THOU BLDG 2,001-25,000
117.00
- - ---------------------
Special Notes and Comments
------------
-------
--------------
17' X 63' SOLID ALUMINUM ROOF PATIO
COVER (1071 SF), PER APPROVED SITE
SPECIFIC ENGINEERING.
-----------------------------------------------------------------------------.
Other Fees . . . . STRONG
MOTION (SMI)
- RES
1.42
Fee summary Charged Paid
-------------------=-----------------
Credited
----------
----------
Due,
Permit Fee Total 162.00
.00
.00
162.00
Plan Check Total 105.30
.00
.00
105.30
Other Fee Total 1.42
.00
.00
1.42
Grand Total 268.72
.00
.00
268.72
LQPEwwir
�Bip
CItY of, La' •Q Uinta
Building a Safety Division
P.O. Box 1504,, 78-495 Calle Tampico
La.Quinta, CA 92253' (760) 777-7012
Building Permit Application and Tracking ng Sheet
Permit #.
Project Address: �96 �� 77
Owner's.Name: /1059.
A. P. Number:
Address: / 10 ice✓
Legal.Description:
Contracior:. c Q6;P *
I S ..IS'hs . l
Address: U0
City, ST, Zip:. tat QA'Vl* CA—
Telephone:
Project Description:
.City, ST, Zip: ue- c
Telephone: 9!�f 467 d 1
r C, r/
State Lit. # : �f t76 9
City Lic. #:
i
Arch., Engr.:, Designer:
Address:
City, ST, Zip:
Telephone:
x
Construction Type: Occupancy:
State Lic. #:,
Projectew Add'n Alter Repair Demo
Name of Contact Person: Tom% CV1 S we
q• Ft•: to 7 tories:
# Units:
Telephone. # of Contact Person: 6
a ue of Project: 2 C262 0
APPLICANT: DO NOT..WRITE BELOW THMONE
#`
Submittal
Req'd
Recd
TRACKING PERMIT FEES
Plan Sets
a
aa
Plan Check submitted �.J item
Amount
Structural Calcs.
Reviewed, ready forcorrec
ra _} _ Plan Check Deposit
Truss Calcs.
Io•�s
Called .Contact Person U L', LJ U L, 1§ Check Balance
Energy Cales.
Plans picked up J truction
Flood plain. plan'
UU
Plans resubmittedRR i U hanical
Grading. plan
2°d Review, ready for cor ec ssa EI trical
Subcontaetor 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 correctionsrssue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P:P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
(800) 37 -PATIO
GUTBACK PATIO &SURROOMS INC. (9109) 272-4997.
Street #118 : �,Corona; Califorriia 92882-6501
X.
L \
LOT# 'T'T A f1TJi - T A -%7,-n A D I -M 41 E Sr i 1416Cn
11 11- 11T X. 1 [-
o P/ is
FRONT PROPERTY LINE �v