06-1568 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T d -y/ 4 a(A Q"
Application Number:
06-00001566,
Property Address:
*79491 HORIZON PALMS CIR
APN:
604-100-007-7 -19903 -
Application description:
PATIO COVER - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
4123
Applicant: Architect or Engineer:
alp
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: B1 i nse 510847
/Date. ontractor:
NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I a 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 `
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
Owner:
ANDREWS ANNA M
79491 HORIZON PALMS CIRCLE
LA QUINTA, CA 92253 ,
Contractor:
HAWKINS CONSTRUCTION
77850 DELAWARE PLACE
PALM DESERT, CA 92211
(760)413-3017
Lic. No.: 510847
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/18/06
�y j �� ►µ777e, f(k
CI 0f .-fi
F -a• aJ �^
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 EXEMPT Policy Number EXEMPT
c=at, 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 0 the Labor Code, I shall
lf�forthwith comp with those provisions.
ppl4i///
icant:
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 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
of this county
.ttoo)enter upon the above-mentioned property for inspection rposes,
te: v �I ature (Applicant or Agent):
LQPERMIT
Application Number
06-00001568
Permit . . . .
. PATIO COVER
PERMIT
Additional desc .
Permit Fee . . .
. 72.00
Plan Check
Fee
46.80
Issue Date . . .
.
Valuation
. . .
. 4123
Expiration Date .
. 10/15/06
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
310 S.F. ALUMAWOOD
PATIO COVER
--------=-------------------------------------------------------------------
Other Fees . . .
. . . . . . 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
.50
.00
.00
.50
Grand Total
119.30
.00-
.00
119.30
Permit # 1) bf�
Project Address:
A. P. Number:
%-I LY v1 r..d W [Ull Ld
Building 8T Safety Division
P.O. Box 1504, 78-495 Ca11e Tampico
L a Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
FAdd
's Name: 4-4t,-4-
Address:
�
s:
T. Zip:ne:Description: �-
P
Contractor. -,k-
w/6% A -s
Address: r
s J
Address:
City. ST. Zip:-
=_
Telephone:'
3d�
%-I LY v1 r..d W [Ull Ld
Building 8T Safety Division
P.O. Box 1504, 78-495 Ca11e Tampico
L a Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
FAdd
's Name: 4-4t,-4-
Address:
�
s:
T. Zip:ne:Description: �-
P
Total Permit Fees
State Lic.
City Lic. #:
Arch.. Engr.. Designer.
Address:
City, ST. Zip:
Telephone:
Construction TN 'pe: Occupant%
State Lic. #:
Project type (circle one): New Add'n Alter Repair Dc
Sq. Ft.:.,,k ' Q # Stories: ToUnits:
Estimated Value of Proiect: -� 3v✓ .
Name of Contact Person: � �
`�
Telephone # of Contact Person:
APPLICANT:
DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Plan Check Deposit
Amon
Structural Cales.
Reviewed, ready for corrections
Truss Calcs.
Called Contact Person
Plan Check Balance
Construction
Mechanical
Electrical
Tide 24 Cafes.
Plans picked up
Flood plain plan
Plans resubmitted
Grading plan
2" Review, ready for correctionsrssue
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
Grading 9
H.O.A. Approval
Plans resubmitted
11 HOUSE:-
''' Review, ready for correctionstiissue
Developer Impact Fee
A.I.P.P.
Planning Approval
Called Contact Person
Pub. Wks. Appr I
Date of permit issue
School Fees
Total Permit Fees
LNl
Ile
Cf -- � c� J ��/�/ Z-0•., �a�,w,. G�1 �'�v //9S 3%G��G... /�pf�.2� .
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION r.
DATE BY 4K'
X