12-1273 (PAT)•� P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12-00001273 y a
Property Address: 51740 AVENIDA CARRANZA
APN: 773-125-012-13 -000000-
Application description: PATIO COVER - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 4442
Applicant:
T- v4t 4 4v Q"
Architect or Engineer:
d fA
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 Class: B ` License No.: 776039
Date: tractor:
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 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 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 _ 1 1, 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 T t-wtende" �r ,-sowever, the building or improvement is sold within
one year of comple on, the own 1rltterden of p wing that he or she did not build or
improve for the pur ose of sal�.id(
1 _ 1 I, as owner of the prop y, a exc usrve y contracting with licens d co tractors to construct the project (Sec.
7044, Business and Profe sions Code: The Contracto s' Stat Li a Law does not apply to an owner of
property who builds roves 6�4�y�t O�^' hil�c�in racts f r t rojects with a contractor(s) licensed
pursuant to the Con - S. St
L4'ihYtse�L�Jl�.'�
(_ 1 I am exempt under Sec. M , B.&P.C. for this reason
Date: l er: II Vi
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: Q
Lender's Address: { -
LQPERMIT
VOICE (760) 7 - " 12
FAX (760) 777-7 1
INSPECTIONS (760) 777-7153
Date: 10/25/12
Owner:
DOROTHY NEWHOUSE
51740 AVENIDA CARRANZA
LA QUINTA, CA 92253
D Q �
Contractor: t 2
194MC 25 MISSI . C�`42Z 20��
RIVERSIDE, 2508
(714)290-54
LiC. No.: 7
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 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
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 provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
Date: lo- I cant:
v
WARNING: FAIL RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AN—D SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 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 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 county ordinances and state laws relating to building construction, and hereby authorize representatives
ofthis county to enter port the above -mention rty for inspection pur/poses.
hate• (� Zsw 'nature (Applicant or Agantl: \ /
Application Number .
. . . . 12-00001273
Permit
PATIO COVER PERMIT
Additional desc . .
Permit Fee . . . .
72.00 Plan Check Fee
46.80
Issue Date . . . .
Valuation . . .
. 4442
Expiration Date . .
4/23/13
Qty Unit Charge
Per
Extension
BASE FEE
45.00
3.00 9.0000
THOU BLDG 2,001-25,000
27.00
----------------------------------------------------------------------------
Special Notes and Comments
PATIO COVER @ REAR OF
SFD, 333.5 S.F.
(29' X 11.51) - LATTICE,
CITY STANDARD.
2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
1.00
STRONG MOTION (SMI) - RES
.50
Fee summary Charged Paid. Credited
----------
Due
-----------------
Permit Fee Total
------------------------------
72.00 .00 .00
72.00
Plan Check Total
46.80 .00 .00
46.80
Other Fee Total
1:50 .00 .00
1.50
Grand Total
120.30 .00 .00
120.30
0
LQPERMIT
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVE
FOR CONSTRUCTION
DATE 10 a? ICY
RAFTER SIZE ANO SPACwiC
ROOF PITCH
CONT
(SAME S �M
HEAM Set'q
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%PEN LATTICE PATTO COVERS
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— 3/W [ S' w SCREWS I' n -cn wot I T • I" w w
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VVIL_UMU DEPARTMENT APPROVAL BELOW
SPECIFY ROOFING AND SHEAT►ANC OR OPEN LATIV'[
(SEE]] ROA�OFI,IH1;• NOTE ON REVERSE)
T Ivo V STRAPS —
6'a6'al't1/6-
WITH
(4) R60 NAILS OR BOLT
h
CTN
�{ x 4
tr 68-0* QPAOE L _j
PRov1DE
1- ctF�R,wCE
BETWEEN POST ANp
CONCRETE
U -STRAP OR ANGLE
NON—CORROSWE PLATE
(4) 16d NAILS
/
OR BOLT
U -STRAP OR ANGLE
(a) - 16d NAILS
OR BOLT
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
ANCHOR BOLT (EMBED
T MIN. INTO CONCRETE)
- TYPICAL
PATIO COVER
DATE OF APPLICATION
OWNER'S NAME
STREET AOORESS
CITY. ST ZIP
" 'TET�PNONE
Bin.#
City. ofla QUinta
Building 8i SafetyDivision
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: AV, ell i
Owner's Name:. � .e l.� Y 1 @3 �S'
A. P. Number. Z Z
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Legal Description: