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BPAT2016-0018LICENSED 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 Professions Code, and my License is in full force and effect. License Class: License No.: 770843 l - C Date: Contractor r� 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).: ( ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structuire 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.). I I 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 N Lender's 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 wor 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:_ Policy Number: _ 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 provisions of Section 3700 of the Labor Code, I shall forthwith comply with thos provisions. Date: ! Applic6nt: _ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND 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 Building Official 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 of this city to enter upon the above-mentioned roperty for inspection purposes. Date:': I� Signature (Applicant or Agent): 1 t 78-495 CALLE TAMPICO D � � VOICE (760) 777-7125 LA'QUINTA, CALIFORNIA 92253 FAX FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT (760) 777-7153 BUILDING PERMIT Date: 4/11/2016 Application Number: BPAT2016-0018 Owner: Property Address: 79788 DANDELION DR CONSTANCE MICHAEL F----` APN: 604483001 Application Description: MICHAEL/ PATIO COVER 92253 Property Zoning: z� Application Valuation: $3,582.00 r—ti +off' Applicant: 'LIFETIME PATIOS Contractor: LIFETIME PATIOS P 0 BOX 5806 P 0 BOX 5806 LA QUINTA, CA 92248 LA QUINTA, CA 92248 V (760)772-0013 Llc. No.: 770843 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 Professions Code, and my License is in full force and effect. License Class: License No.: 770843 l - C Date: Contractor r� 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).: ( ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structuire 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.). I I 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 N Lender's 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 wor 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:_ Policy Number: _ 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 provisions of Section 3700 of the Labor Code, I shall forthwith comply with thos provisions. Date: ! Applic6nt: _ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND 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 Building Official 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 of this city to enter upon the above-mentioned roperty for inspection purposes. Date:': I� Signature (Applicant or Agent): 1 t DESCRIPTION FINANCIAL INFORMATION ACCOUNT ;. QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT„ PAID PAID DATE PATIO COVER, STD, OPEN 101-0000-42404 0 $97.17 $0.00 . ................ . PAID BY _ _ METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PATIO COVER, STD, OPEN PC 101-0000-42600 .0 $95.72 $0.00 PAID BY METHOD - RECEIPT # CHECK # CLTD BY Total Paid for PATIO COVER / COVERED PORCH / LATTICE: $192.89 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID . PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00 TOTALS:00 Description: MICHAEL / PATIO COVER Type: PATIO COVER Subtype: CITY STANDARD/PRE- Status: APPROVED Applied: 4/6/2016 SKH ENGINEERED -OPEN " Approved: 4/11/2016 SKH Parcel No: 604483001 Site Address: 79788 DANDELION DR LA QUINTA,CA 92253 Subdivision: TR 24197-1 Block: Lot: 13 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $3,582.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 398SQ FT TRELLIS PATIO COVER AT REAR YARD [DURALUM] THIS PERMIT DOES NOT INCLUDE ELECTRICAL INSTALLATIONS. 2013 CALIFORNIA BUILDING CODES. CHRONOLOGY CONDITIONS NAME TYPE' ""° NAME ADDRESSl CONTACTS .. CITY STATE ZIP PHONE FAX EMAIL - APPLICANT' LIFETIME PATIOS P 0 BOX 5806 LA QUINTA CA 92248 LIFETIMEPATIOS@AOL. COM CONTRACTOR LIFETIME PATIOS P 0 BOX 5806 • LA QUINTA CA 92248 LIFETIMEPATIOS@AOL. COM OWNER CONSTANCE MICHAEL 92253 Printed: Monday, April 11, 2016 3:53:40 PM 1 of 2 sysrrnns x :Permit Details PERMIT NUMBER City of La Quinta BPATF201`6 - BOND INFORMATION Printed: Monday, April 11, 2016 3:53:40 PM 2 of 2 C, SYSTEMS CLTD DESCRIPTION ACCOUNT. QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total.Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 _ BSA: PATIO COVER, STD, 101-0000-42404 0. $97.17 $0.00 OPEN PATIO COVER, STD, 101-0000-42600 0 $95.72 $0.00 OPEN PC Total Paid for PATIO COVER / COVERED PORCH / LATTICE: $192.89 $0.00 SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.00 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00 TOTALS:0i - BOND INFORMATION Printed: Monday, April 11, 2016 3:53:40 PM 2 of 2 C, SYSTEMS Bin # City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) '777-7012 Building Permit Application and Tracking Sheet Permit # (� Project Address: Vr"b- - Owners Name-- Address:: �., tei ... City, ST, Zip: i A. P. Number: Legal Description: Contractor: 1 /FETM� 19 / /O� Address: �U 160X 5'9496* Telephone:IN r Al.«� Project Description: City, ST, Zip: 1A 00//U7W 4 64 Telephone: Zoo " %� �� - Qd / 3 -, L';� City Lic. #:..3�ag , a -( . State Lic. # : %�'7%Og T 5- . Arch., Engr., Designer: Address: , City, ST, Zip: Telephone: ' " ' State Lic. #: Name of Contact.Person: ��s f - Construction Type:.,. Occu an cy: Project type (circle one): New Add'n .,Alter Repair Demo Sq. Ft.: # Stories: #Units: ,Telephone # of Contact Person: 760 fob$ -170D Estimated Value of Project:- Z APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd - Rec'd TRACKING . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Retiewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Pian Check Balance Energy Ca►cs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan- 2" Review, ready for corrections/issue Electrical Subcontactor 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 corrections/issue Developer Impact Fee Planning Approval Called Contact -Person A.I P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees rrr rrrr :r : ; rrrr : � rrrrr rrsrrrrrrrrrrrr : rerrr: � : r rrrr r, -moll __.___...__ .......... .. ■ :ter®r rr rrrr�r� rrrrr, r. .rrr, r rr r�rrrr � r rrrrr: ®. r �: r rrrrr r®rr arrrr� rrr rrr®r , �rrrri :� rrr � I .rrrtrl� � :rr. r f ■rte rrr® �■rrrsrosr �e 1 1' OfFC��UI �AV 3 BUILDING & SAFETY APP OV EPI: FOR-- 6 'UCTI 5 e DATE N