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BPAT2016-0079T ,7 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPAT2016-0079 Property Address: 61054 FIRE BARREL DR APN: 764520010 Application Description: NISSEN RESIDENCE / PATIO COVER Property Zoning: FAUG © 2 GApplication Valuation: $1,200.00 20�u VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: HAROLD NISSEN 61054 FIRE BARREL DR (_A QUINTA, CA 92253 Date: 8/2/2016 CITfOFLAQUIN A Applicant: COMMUNITVDEVELOP&QNTDEPARTMENT Contractor: ANILOM INC DBA GOLD STAR CUSTOM PAINTING ANILOM INC DBA GOLD STAR CUSTOM PAINTING 77-682 COUNTRY CLUB DR STE H 77-682 COUNTRY CLUB DR STE H SUITE F363 SUITE F363. PALM DESERT, CA 92211 PALM DESERT, CA 92211 (760)574-1043 Llc. No.: 855623 --------------------------------------------------------------------------------------------- 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 nd Professions Code, and my License is', full force and effect. License Class: C3 C5V License No.: 85562 LDa� K Contractor: 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, 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 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.). (1 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: 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. ave 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: ACE AMERICAN INSURANCE COMPANY Policy Number: RWCC48814682 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 Secti of the L o , all forthwith comply with t se revisions. Date: Applica t: i 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. CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws relatin the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this city to ntero above-mentio ed roperty for inspection purposes. Lender'sName: - Date: Signature (Applicant or Agent): Lender's Address: ng f 1 Date: 8/2/2016 .Application Number: BPAT2016-0079 Owner: Property Address: 61054 FIRE BARREL DR HAROLD NISSEN APN: 764520010 61054 FIRE BARREL DR Application Description: NISSEN RESIDENCE / PATIO COVER LA QUINTA, CA 92253 Property Zoning: Application Valuation: $1,200.00 Applicant: Contractor: ANILOM INC DBA GOLD STAR CUSTOM PAINTING ANILOM INC DBA GOLD STAR CUSTOM PAINTING 77-682 COUNTRY CLUB DR STE H 77-682 COUNTRY CLUB DR STE H SUITE F363 SUITE F363 PALM DESERT, CA 92211 PALM DESERT, CA 92211 (760)574-1043 ---------------------7------------------------------------------------------------------------ Llc. No.: 855623 'Detail: 84 SF PATIO COVER [ALUMAWOOD] DUSTIN K. ROSEPINK ENGINEERING. THIS PERMIT'DOES'NOT INCLUDE ELECTRICAL INSTALLATIONS. PER 2013 CALIFORNIA BUILDING CODES. FINANCIAL •!. DESCRIPTION ACCOUNT. QTY. AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PATIO COVER, STD, OPEN 101-0000-42404 0 $97.17 DESCRIPTION ACCOUNT CITY AMOUNT PATIO COVER, STD, OPEN PC 101-0000-42600 0 $95.72 Total Paid for PATIO COVER / COVERED PORCH / LATTICE: $192.89 DESCRIPTION ACCOUNTQTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $0.50 Total Paid for STRONG MOTION INSTRUMENTATION SMI: ' $0.50 Permit Details PERMIT NUMBER City of La Quinta BPAT420�1i"1 O07 Description: NISSEN RESIDENCE / PATIO COVER Type: PATIO COVER Subtype: CITY STANDARD/PRE- Status: APPROVED Applied: 7/21/2016 MFA ENGINEERED - OPEN Approved: 7/22/2016 DCL Parcel No: 764520010 Site Address: 61054 FIRE BARREL DR LA QUINTA,CA 92253 Subdivision: TR 30023-5 Block: Lot: 47 Issued: Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $1,200.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 7/22/2016 Details: 84 SF PATIO COVER [ALUMAWOOD] DUSTIN K. ROSEPINK ENGINEERING. THIS PERMIT DOES NOT INCLUDE ELECTRICAL INSTALLATIONS. PER 2013 CALIFORNIA BUILDING CODES. -_,„j Applied to Approved Printed: Tuesday, August 02, 2016 2:21:28 PM 1 of 2 _,. syszervts ADDITIONAL CHRONOLOGY TYPE STAFF NAME ACTION DATE CHRONOLOGY COMPLETION DATE *. NOTES TELEPHONE CALL DUANE CLAYTON 7/22/2016 7/22/2016 PHONEDF;LQ PATIO AND INFORMED THEM PLANS ARE ' APPOVED AND PERMIT IS READY TO ISSUE. CONDITIONS NAME TYPE NAME CONTACTS ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT ANILOM INC DBA GOLD STAR CUSTOM PAINTING 77-682 COUNTRY CLUB DR STE H PALM DESERT CA 92211 CONTRACTOR ANILOM INC DBA GOLD STAR CUSTOM PAINTING 77-682 COUNTRY CLUB DR STE H PALM DESERT CA 92211 OWNER HAROLD NISSEN 61054 FIRE BARREL DR LA QUINTA CA 92253 Printed: Tuesday, August 02, 2016 2:21:28 PM 1 of 2 _,. syszervts DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD 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:•4 •• INSPECTIONS Printed: Tuesday, August 02, 2016 2:21:28 PM 2 of 2 SYSTEMS k STREET RIVEWAY HAROLD NISSEN 61054 FIREBARREL LA QU CA a W 0 INTA, CITY OF LA QUANTA BUILDING & SAFETY DEPT. APPROVE® FOR CONSTRUCTION i DAT iiy10'°11QByrka Bin ## : 1 City of La Quinta Building 8£ Safety Division Permit #! 78-495 Calle Tampico La Quinta, CA 92253 = (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: Y 6 owner's Name: rA/ A. P. Number: Address: Wolff Legal Description: City, ST, Zip: PAL ontract C r: o !/ h ne: Tele o P Address:—) Project Description: City, ST, Zip: ( ��/ l Gy.1-Al Telephone: State Lic. #.. 3 City Lie. Arch., Engr., Designer: ; Address: City, ST, Zip: Telephone* Pane Occupancy: :Construction TYPe- Sta e Lrc. air �ci one :New Add'n A]terProJ t 'Ra Demo Name of Contact Person: Sq. Ft_: # Stories: # Units: Telephone #'of Contact Person: Estimated Value of Projec- APPLICANT: DO NOT WRITE BELOW THIS LINE t/ Submittal • Req'd Reed . TRACHING . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance, Title 24 Calcs. Plans picked up Construction ' Flood plain plan Plans resubmitted' Mechanical Grading plan 2" Review, ready for eorrectionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted Grading IN-HOUSE:- '"' Review, ready for correctionMssuc Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, Total Permit Fees