PAT (0201-159)LICENSED CONTRACTOR DECLARATION
U) ' f! hereby affirm under penalty of perjury that I am licensed under provisions of
K_' :11k6Chapter 9 (commencing with Section 7000) of Division 3 of thq Business and
N W Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
CY 16
r*- W 664Z39 AMC
~ Z � ,r�'Date�" Signature of Contractor , ,
co0r� y
J U C:) OWNER -BUILDER DECLARATION
HUJ r— I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z_ ( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
ce) () I am exempt under Section , B&P.C. for this reason
LO
N Date Signature of Owner
ON
Cn
d Q WORKER'S COMPENSATION DECLARATION
C:) Z I hereby affirm under penalty of perjury one of the following declarations:
p () 1 have and will maintain a certificate of consent to self -insure for workers'
X W Y= compensation, as provided for by Section 3700 of the Labor.Code, for the
�
Q performance of the work for which this permit is issued.
Q U (>tO, I have and will maintain workers' compensation insurance, as required by
V Q Section 3700 of the Labor Code, for the performance of the work for which this
CC
0 Z permit is issued. My workers' compensation insurance carrier & policy no. are:
CIS
EXEMP 1. Policy No.
r- C7
J (This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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
3 subject to the workers' compensation provisions,of, Section 3700 of the Labor
Code, IIp shall forthwith comply with those provisions.,.
Date:'/, -Z % • ii ? Applicant i /
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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
p
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
• correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) Date,/
BUILDING PERMIT PERMIT#
DATE VALUATION LOT WfJ1_1� TRACT
JOB SITE
APN
ADDRESS wdar � } •V . rAvmwo
OWNER
CONTRACTOR / DESIGNER / EN (NEER
52.120 Alf ?1ID Y AVARRO
5.36851-MY314HOW R MIL
LA QjIbrl'A CA 92253
TA Q'(Jm:A CA 922:x.3
.1180 CM19 2851
USE OF PERMIT
Ph,: 0
18111 SF LA`F'6'ICE PA710 CCC f'i't. PEP CITY 3TAND.AR10.
1'011tt1•ikPt?►`.IO 3dtj�A Vit+
con of f.0:l�� ���.rir'non
2,394,00
�ry � �mrmAT.
y� y 91A
;FRWr.6�RX kY47.e&:EdYdN41I6Ix
}'L1LN 101-M-439.318 01.1110
CONS111R JCY'ION FIS '101-000-418-000 $54.60
LLIP'll��
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CfTyor-L QUiNTA
s 01M-TCy'1.'.AL: t)MTIT(t,1 N AU4ygqi.)�'i:��,�yy�.l�]4
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RECEIPT
DATE
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
- 62—
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
p Z--
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wali Insulation
Condensate Lines
Party Wail Firewall
Exterior Lath
Drywall - Int. Lath
t
Final
Final —
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
•Gas Test
. ppliances
w
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS: /�
S IWO
RAFTER SIZE AND SPACING SPECIFY ROOFING AND SHEATHING OR OPEN LATT10Er_.
(SEE ROOFING NOTE ON REVERSE)
--------- -- - - - - - - --
ROOF PITCH
CONTINUOUS LEDGER
Ll
IJI
(SAME SIZE AS RAFTERS)
0 -
HEADER SIZE
I T' AND 'L' STRAPS
WITH
I .
i—
Z
I (4) 16C NAILS OR BOLT
Z
RAFTER O
J
/
I
�
SPAN: _
r
POST. SPA' NO:
0. H.
O
BALL LENGTH: _
I
a
OVERALL LENGTH:_ -f
i
POST SIZE:
REAR SETBACK
SIDE SETBACK
(4'x4' MIN.)
2000 P.S.I CONCRETE —moi
I FINISH GRADE
FINISH GRADE
I
I
' L__J
MIN. 1 2" x 1 2" FOOTING
L _ J 12" BELOW GRADE
.
L _ J
PROVIDE'
1" CLEARANCE,. -
BETWEEN
rnn nryr
POST AND
NOTE
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4" x 5" LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL.
3/5- x LAG SCREWS INTO STUDS AT 16' O.C. —�
•j CONTINUOUS LEDGER
JOIST HANGER OR 'SOLID BLOCKING
NAIL RAFTER TO BLOCKING
L_ BUILDING DEPARTMENT APPROVAL BELOW
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTI N
DATE_�T('OZ- BY
U.—STRAP OR ANI
NON—CORROSIVE
(4)— 16d NAILS
OR BOLT
U—STRAP OR ANGLE
(4)— 16d NAILS
OR BOLT
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
II �I
_ II SII.
ANCHOR BOLT (EMBED
7" MIN. INTO CONCRETE)
TYPICAL PATIO COVER
DATE OF APPLICATION
OWNER'S NAME `T_,)
STREET ADDRESS 5212-0
CITY. ST ZIP
TELEPHONE t . -7-?/ `
H.O.A. APPROVAL a�
N o
'__F_'E'_S'A~ 'ABLEALL CONSTRUCTION SHALL C[)NF{]RW
PS '10-70
LE~^ TO THE PROVISIONS OF THE:
(FEET &I INCHES)
l888CALIFORNIA BUILDING CODE.
� /
SUPPLEMENTAL NOTES.
NOTES:
1. 32^ RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY.
2. FOR SOLID PATIO COVERS (NOT LATTICE)
RAFTER SPAN |SLIMITED TO lO''O^ USING
THIS STANDARD.
LATTICE ROOF
16" , 'c'.
01 jo.
6" 7' - 3" 8 . -9"
HEADERS
ClOUGLAS FIR NO. I
DOUGLAS FIR NO. 1
SI . 7 E SPAN
ff3
SPAN
lo' -o" N/A N/A
.
rX8
4x8
�� '
4 14 uo"
400
NOTES:
1. 32^ RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY.
2. FOR SOLID PATIO COVERS (NOT LATTICE)
RAFTER SPAN |SLIMITED TO lO''O^ USING
THIS STANDARD.
LATTICE ROOF
BUILT-UP ROOF
HEADERS
HEADERS
ClOUGLAS FIR NO. I
DOUGLAS FIR NO. 1
SI . 7 E SPAN
SIZE
SPAN
rX8
4x8
�� '
4 14 uo"
400
` | )
\ / /
|�
i~
ROOFING NOTES:
A. BU|LT-UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.
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