9909-018 (PAT)LICENSED CONTRACTOR 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 # Lic. Class Exp. Date
Date • Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code ;
( Tam exempt under Section B&P.0 .for this reason7/
,Date '. .. Signature of Owner •% � /! C «� (v
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 ins6rance-carrier & policy no. are:
Carrier Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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
workersV6ompensation 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 `
;,Date: V Applicant . W
Warning: Failure to secure Workers_' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a .permit subject to the conditions and restrictions set forth 'on. his
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 applicaton agrees to, & shall, indemnity
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) •-%'i Date
PERMIT #
BUILDING PERMIT
II>, •
DATE
1jps�i%VALUATION S2,247` I() LOT TRACT
j//
JOB SITE
ADDRESSr ';9-•%17 LI.�rN
APN F
OWNER
CONTRACTOR / DESIGNER / ENGINEER
Y7'ar.�! T.f.. w\:, u�•..>t �'�
♦ Yll �r �:r AA,f e \
79717 11.10A,
1. A, Q1JIN.1 fit CA 9,2251
- C81.4
USE OF PERMIT
P10116
10 S.C. WOOD LATYItM RATIO ar O 4
• .V;iX3U1-p.lk.Y ) 4�'cJ. lTS. I.d CONST:41 'W,.•1�t1lL N '
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PLA'bf fff K:FF% W1-0)-09-33,8
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STAC)NC IV10TION R- M A 1't;4?SI7.7 10 it -CA •24411400
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3.1999
�1 1 i--
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ff �u
SUVIMAL E:fDNS-1 R<.TMIGINAN 41AN CH -K- K
# 5la�.tti(b
gess Pun -PAID 1 kmm
$0.00
�4
I'OTA%]. PERMIT FEES DUMNIOW
$89.60
s
RECEIPT
DATE
BY
D7RNALED
INSP R
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Hacks
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
OX for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally. I
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA _
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
1(760) 777-7012
FAX (7 0 777 011
x,
O ER'S SIGNATU E/DATE
� i �__l L, I a t �•Q �
PROPERTY ADDRESS
Rlyoc? - 018
PERMIT NUMBER(s)
RAFTER SIZE AND SPACING
DF 3 x to -----
ROOF PI CH F44 r)
�- CONTINUOUS LEDGER
(SAME SIZE AS RAFTERS)
HEADER SIZE --/
C2) 3 X l o ,a-rz ova () 8
ro It t
RAFTER SPAN: _
l3l0li
OVERALL LENGTH:
P05'MIA/ �JW 3` tou p ST 5
/ 0 J
O.H.W
a
0
a
SPECIFY ROOFING AND SHEATHINC OR OPEN LA,T;CE
(SEE ROOFING NOTE ON REVERSE)
�L X3
O.H.
'T' AND 'L' STRAPS
6"x6'x1"xt/8" WITH
(4) 16d NAILS ORBOLT �!
POST SPACING:—L/-_
0 POST SIZE: X 8
REAR SETBACK SIDE SETBACK (4'x4"
FINISH GRADE FINISH GRADE
2000 P.S.I CONCRETE �
MIN. 17'x17 FOOTING
—�1 I, I I`6 ---I 1
L_J L -J IT BELOW GRADE L -J
- PROVIDE 1" CLEARANCE
- - _ BETWEEN POST AND
NOTE - - __ - CONCRETE
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4" x 5" LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL /�
BUILDING DEPARTMENT APPROVAL BELOW
CITY OF U U INTI
BUILDING Srk ETY •DEPARTMENT
AND ALL APPLIC4kE CX)DES
/3 �/ � l�
DATE 8Y
`
U—STRAP OR AN(
NON—CORROSIVE-
(4)— 16d NAILS
OR BOLT
U—STRAP OR ANGLE
(4)— 16d NAILS
OR BOLT
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
ANCHOR BOLT (EMBED -
7" MIN. INTO CONCRETE)
-R%
TYPICAL PATIO COVER
DATE OF APPLICATION
OWNER'S NAME
STREET ADDRESS
CITY. ST ZIP
TELEPHONE
H.OA APPROVAL
1 /
'
Aug -20-99 08:38A
L 0%/ly/�tltltl 1V:1� ruv.iv+v.i..r
v
DESERT RESORT MANAOEWNT ArW: TAMMY Z.BWKM DAL
RR: LOT 30 TESORO 39F6 w 4 g
PLEASE FIND ATTACHED DRAWINGS AND SPECIFICATIIONS FOR T RELUS
FOR ADM LOT
TIUS TRWAJ8 IS TO RE ALMOST EXACTLY LIKE TTS ONE AT THE MODEL
FOR PLAN 2
IF POSS[K E, WOULD VERY MUCH APPRECIATE QUICK APPROVAL
THE WORK 113 TO HE DONE BY Lmm MOONS LIC 71801
WUJAA Y. C=0XTON BUYER OF LOT 30
PHONE AND PAX 760 453 0335
'MANIC YOU I. &t4*
-
fir- T=Ae °C"* „
qF 8;? 33
y�
P.02
CITY OF LA QUINTA AUGUST 23 1999 RE: BUILDING PERMIT
A'IT:BUII.DENO & SAFETY DEPARTNE4T
ATTACHED HEREWITH PLEASE FIND PLANS FOR TRELLIS TO BUILT ON
LOT 30, TESORO, DEVELOPER CATELLUS AS APPROVED BY TESORO
HOME OWNERS' ASSN.
ADDRESS OF PROPERTY 797 717 LIGA
LA QUINTA, CA. 92253
THIS IS SUBNff TED FOR APPROVAL AND PERMIT TO PROCEDE
OWNER -BUILDER, WILMA CREIGHTON
3640535
^ I
I
i"
Aug -20-99 08:37A
V1�L0�177t t��. �• r....r r..i..v..
DALE E. BROOKS
11454 to usanns war
Truckrs, CA
550 SWI 230
530 550.1 290 (Fax)
FACSIMILE TRANSMITTAL
i Lehman CC.'
CC. Melissa Layton
i
FAX: 346-99113
r
DATE; 1116/99
FROM: Dela E. Brooks
Fax is -..pages, including cover.
COMW_IENTS: Creighton fiealdenCe
1 have reviewed the apOliCation from_Wilma Creighton to install a trellis al her
home at 78717 Lige approve a rove the appiiCation_ _w
Please share this faxwRh the other members of the Architectural Committeo. If
you have any questions, p aso give me a Calf.
Pan a km
If problems occur during transmission, plea$$ call (630) 550.128
11
P.01