07-1393 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tit!t 4u�W °��
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Application Number: 07-00001393
Property Address: 79155 ASHLEY PL
APN: 604-375-014-14 -27899,-
Application description: . PATIO COVER -'RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2993
Applicant: Architect or Engineer:
------------------
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 Bu ' ss an fessio Code, and my License is in full force and effect.
License Class: B Li Vense No.: 860958
Date: SkJO-1 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 ISec. 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 ($5001.:
(_ 1 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 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 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 Name:
Lender's Address:
LQPERMIT
Date: 5/09/07
Owner:
ARIAS IMELDA
*NOT ON FILE
UNKNOWN, -CA 99999
Contractor:
PELLETIER PATIO
79275 DESERT STRE R MAY 09 1001
LA QUINTA, CA 92 3
(760)275-7593 C"YOF
Lic. No:: 860958
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.
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 CNCLD/ACE AMRCN Policy Number WLRC44460427
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 s el?bEt e e subject to the workers' compensation provisions of Section
3700 of the Lab Code, I shall f rthwith c ply ith those provisions.
Date: S�U7 Applicant:
WARNING: FAILURE TO SECURE RKE ' 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 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 the a above informati is correct agree to co ly with all
city and county ordinances and state laws relating building construction, nd hereb authorize repres natives
of this
a county to enter upon the above-mentioned roperty for i pection rposes.
Date: kl Signature (Applicant or Agen
-s
Application Number . . . . . 07-00001393
Permit . . . . . PATIO COVER PERMIT
Additional desc .
Permit Fee . . . . 54.00 Plan Check Fee 35.10
Issue Date . . . . Valuation 2993
Expiration Date . . 11/05/07
Qty Unit Charge Per Extension
BASE FEE 45.00
1.00 9.0000 THOU BLDG 2,001=25,000 9.00
----------------------------------------------------------------------------
Special Notes and Comments
225SF PATIO COVER/ENGINEERED. THIS
PERMIT DOES NOT INCLUDE BLOCKWALLS. May
9, 2007 9:55:38 AM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . STRONG MOTION (SMI) - RES .50
Fee summary Charged
Permit Fee Total 54.00
Plan Check Total 35.10
Other Fee Total .50
Grand Total 89.60
LQPERMIT
Paid Credited Due
.00 .00 54.00
.00 .00 35.10
.00 .00 .50
.00 .00 89.60
Bin #
City of La Quints
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
Permit #
b
Project Address: �� - 175 h 1 I
Owner's Name: IF y„ Cz- A -fro- j
A. P. Number:
Address: ^� ol. I j j h L.
Legal Description:
Contractor: - ,�
City, ST, Zip: (� rv-A-r- CA cj 22 J
Telephone: n 2 i
e Cn t7 3
Address: Deaz T SA-Y-e,c^' O'✓
Project Description:
City, ST, Zip: Q.� M � L A 'I Z? t�-
6J1 -a ceD v-0— ►/
Telephone: e:
e e P ��5 i S 5 3
2 2 5 �
State Lic. # : ` uoc'-s City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: ::3�, L C (x'/ A",
Construction uction TYP e: Occupancy:
Project type one):: New Add'n Alter Repair Demo
Sq. Ft.: 22.5 # Stories: #Units:
Telephone # of Contact Person:.
Estimated Value of Project:) -O
APPLICANT: DO NOT WRITE BELOW THIS LINE men k1m)
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
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
2nd 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:-
3rd 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
El
A RE -INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROVED
PLANS AND )OB CARD ARE NOT ON
THE SITE FOR A SCHEDULED
INSPECTION.
NO EX EPTIONS!
L
CITY OF LA QUINTA
BUILDING ` SAFETY DEPT.
APPROVED
FOR C014STRUCTION
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