BPAT2016-011978-495 CALLETAMPICO , Twit D ei� Q"
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPAT2016-0119
Property Address: 54380 AVENIDA DIAZ
APN: 774234006
Application Description: COLLOZO / PATIO COVER AT BACKYARD
Property Zoning:
Application Valuation: $2,754.00
Applicant:
LIFETIME PATIOS
P 0 BOX 5806
LA QUINTA, CA 92248
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 {commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: _ License No.: 770843
Contractor: 7�_��•
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.).
(_) 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
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
ANNA COLLOZO
LA QUINTA, 92253
Contractor:
LIFETIME PATIOS
P 0 BOX 5806
LA QUINTA, CA 92248
(760)772-0013
Llc. No.: 770843
Date: 12/16/2016 '
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 th work for which this permit is issued.
have and will maintain workers' compensation insurance, as required by
Section 3 00 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: MID-CENTURY INSURANCE COMPANY Policy Number: A09461819
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 those provisions.
J
Date: Applicant:'
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO 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 property for inspection purposes.
i
Dater Z Signature (Applicant or Agent):
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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 th work for which this permit is issued.
have and will maintain workers' compensation insurance, as required by
Section 3 00 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: MID-CENTURY INSURANCE COMPANY Policy Number: A09461819
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 those provisions.
J
Date: Applicant:'
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO 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 property for inspection purposes.
i
Dater Z Signature (Applicant or Agent):
Date: 12/16/2016.
Applitatinn Number. , ;,..,BPg1201&Q119
Owner:
Property Address:
54380 AVENIDA DIAZ
ANNA COLLOZO
APN:
774234006
Application Description:
COLLOZO / PATIO COVER AT BACKYARD
LA QUINTA, 92253
Property Zoning:
Application Valuation:
$2,754.00
Applicant:
Contractor:
LIFETIME PATIOS
LIFETIME PATIOS
P O BOX 5806
P 0 BOX 5806
LA QUINTA, CA 92248.
LA QUINTA, CA 92248
(760)772-0013
----------------------------------------------------------------------------------------------
Llc. No.: 770843
Detail: 306SF SOLID.PATIO
COVER AT REAR YARD [DURALUM] THIS PERMIT DOES NOT INCLUDE
ELECTRICAL INSTALLATIONS. 2013 CALIFORNIA BUILDING
CODES.
- DESCRIPTION
FINANCIAL INFORMATION
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
$101.84
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PATIO COVER, STD, OPEN PC
101-0000-42600
0
$100.32
Total Paid for PATIO COVER / COVERED PORCH / LATTICE:
$202.16
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
Total Paid for STRONG MOTION INSTRUMENTATION SMI:
$0.50
I TOTALS: 5203.66
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Crty O� Q[11[1ta
Building 8t Safety Division
P.O. Box 1504,'78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit'Application'and Tracking Sheet
Peritlit #
ProjectAdd=: 54380 Avenida Diaz
owner's Name:. Anna Collozo
A. P. Number.
Address: 54380 Avenida Diaz
Legal Description:
Contractor: Lifetime Patios
City, sT, zip: . La Q u i nta, CA 92253
Telephone: n
Project Description:
Address: PO Box 5806
City, ST, zip: La Quinta, CA, 92248
Attached Weatherwood•Solid Shade Strucuture..
Telephone: 760 777 2650Approx.
Lic # 3258
18'x 17'
State Lic. # : - ' B 770843City
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
State Lic. #: rs
Name of contact Person: Charles Tunstead
Construction Type: • Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft-: 306 sq. ft
# Stories:
# Units:
Telephone # of Contact Person: 760 777. 2650/ 760 668 1700
Estimated Value of Project $27.54.00
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
'Ree'd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calls.
Reviewed, ready for corrections
Plan Chcck Deposit. .
Truss Calcs•
t
Called Contact Person
Plan Check Balance
Title 24 Calc'
Plans picked up
Construction
Flood plain plan
Plans resubmitted. •
Mecharilcal
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcoutoctor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IiY ROUSE:-
''d Review, ready for eorrectlawaassue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
b
Rear Property Line
15'
JZ
5'
Proposed attached
LWeatherwood
Solid Shade Structure t
Anna Callow
54380 Avenida Diaz
La Quinta, 92253
760 625 1287
Driveway
Avenida Diaz
t
North
a
Rear Property Line
15'
JZ
5'
Proposed attached
LWeatherwood
Solid Shade Structure t
Anna Callow
54380 Avenida Diaz
La Quinta, 92253
760 625 1287
Driveway
Avenida Diaz
t
North
a