0306-427 (PAT)U)
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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed und4r 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).
( ) I am exempt under Section B&P.C. for this reason
Date C- ! •.^i Signature of 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.
( ) 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 & policy no. are:
Cartier 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
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
Date: i• = Applicant ,' •- - /��
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, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued asaresult 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) �� a.-�.�%%. s . Date
BUILDING--'.PERMITPERM'T"
0�'
DATE VALUATION LOT TRACT
W25512K $3.724.E
JOB SITE
APN
ADDRESS .51440 AWQWA 1ZA14M.Z
OWNER
CONTRACTOR/DESIGNER/EN (NEER
C+MAR C.AMARA
OVINrR - EsUfLDFR
5 1 -14'•0 AWaM.k d.\.TSLIMFZ
LA QtM�UA C,A, 92253
() CBL4
USE OF PERMIT
PATIO
3G0 S.F. PATIO Ct7U'.ER PER CITY STANDARD
PORCHIt ANIO 280,00 OF
ESM7 ICATED COST OF C0K9nR'U=0.N
3,724.00
PEMArf P= SUAD&AZY
PLAN CI- rXK FU 101.000.439.318 $40.05
CONSTRUCTION IEE 101-000-418-000 $63.00
STRONO MOTION FU REBID 101-000-241-000
SUB -TOTAL COMMIX -MON AND PLAN CEECT,
$104.45
LESS PRE -PAID FERS
$0.00
L�1
JUN 2 4 2003
CITY OF UINTA
FINANCE DEPT.
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
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 —
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
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
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
- -
Final
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)
COMMENTS:
- -
_
'1PAW
RAFTER SIZE AND SPACING r 0 SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE
(SEE ROOFING' NOTE ON REVERSE)
R PITCHr `
4
�PL�
CONTINUOUS LE7ZE
(SAME SIZE AS 6
1. IJI
HEAD/� r
uAND 'l' STRAPS
--�1/8•• WITH
z Y (4) 16C NAILS OR BOLT I u
RAFTER SPAN:
Z•
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.
U -STRAP OR ANGLE
3/8' x 5' LAG SCREWS INTO STUDS AT 16" D.C. NON—CORROSIVE. PLATE
CONTINUOUS LEDGER
P
II II
®� �� NAILS
NWIW�OR.- BOLT
..
s��®
JOIST HANGER OR SOLID BLOCKING,
NAIL RAFTER TO BLOCKING
I
i
BUILDING DEPARTMENTAPPROVAL BELOW
CITY OFlA Q JINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION.
DATE c3 BY
U -STRAP OR ANGLE
(4)- 16d NAILS
OR BOLT .
PROVIDE' 1" CLEARANCE .
BETWEEN POST AND
CONCRETE'
ANCHOR BOLT (EMBED
7" MIN.. INTO' CONCRETE}
TY,PiCAL PATIO COVER
DATE OF APPLICATION,
OWN. ER`S:NAME
STREET ADDRESS
CITY. ST. ZIP
TELEPHONE i
H.O.A. APPROVAL
POST SPACING __Mt _V
O.H.
�
O.►i.
,g
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, 1
20
LL LENGTH: _41'
a
=
OVERALL LENGTH.___
^nn!
4
to
=POST SIZE.
REAR `SETBACK
I.
SIDE SETBACK
(4'a4'. MIN.)
2000 P.S.I CONCRETE :FINISH GRADE
FINISH GRADE
L_ J
L_ J~—M2' 2FOOTING
BELOWGRADL__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.
U -STRAP OR ANGLE
3/8' x 5' LAG SCREWS INTO STUDS AT 16" D.C. NON—CORROSIVE. PLATE
CONTINUOUS LEDGER
P
II II
®� �� NAILS
NWIW�OR.- BOLT
..
s��®
JOIST HANGER OR SOLID BLOCKING,
NAIL RAFTER TO BLOCKING
I
i
BUILDING DEPARTMENTAPPROVAL BELOW
CITY OFlA Q JINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION.
DATE c3 BY
U -STRAP OR ANGLE
(4)- 16d NAILS
OR BOLT .
PROVIDE' 1" CLEARANCE .
BETWEEN POST AND
CONCRETE'
ANCHOR BOLT (EMBED
7" MIN.. INTO' CONCRETE}
TY,PiCAL PATIO COVER
DATE OF APPLICATION,
OWN. ER`S:NAME
STREET ADDRESS
CITY. ST. ZIP
TELEPHONE i
H.O.A. APPROVAL
� Q Q Q/
RAFTER SPAN `TABLE
GRADING RULES C-) � 'co L' P�
PS 20-7.0
(FEET & INCHES)
�C). �0..
0
2x4
16'• O.C.
24"
10'-6"
9'-6" I
7'-3"
_o'.
8'-6' 1 6'-0" 1
7'-3" 1
I
SPAN
2x6
16" O.C.
24"
32"
15'-0"
14'-0"
10'-9"
13'-0"
12'-6" 11'-6" 8'-9"
10'-6"
10'-0" 8'-6" N/A
N/A
4x8
1 1 '-0"
2x8
16" O.C.
24"
32"
18'-0" 17'-0"
13'-6"
16'-0"
15'-6" —6" 11'-0"
13'-0"
13'-0" 11'-6" N/A I
N/A
12'— 0"
i
I 6x8
NOTES:
1. 32" RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY.
2. FOR SOLID PATIO COVERS (NOT LATTICE)
RAFTER SPAN IS LIMITED TO 10'-0" USING
THIS STANDARD.
LATTICE
ROOF
BUILT—UP ROOF
HEADERS
HEADERS
DOUGLAS FIR NO. 1
I DOUGLAS
FIR NO. 1
S17E
i
SPAN
SIZE
SPAN
4x4
5'-0"
4x4
4'-0"
4x6
8'-0"
4x6
6'-0"
4x8
1 1 '-0"
4x8
8'-0"
4x`10
14'— 0"
4x 10
10'-0"
4x12
17'— 0"
4x 1 2
12'— 0"
i
I 6x8
14'— 0"
6x8
6x 10
17'-0"
6x 10
141—o"
ALL CONSTRUCTION SHALL CONFORM
TO THE PROVISIONS OF THE:
2001 CALIFORNIA BUILDING CODE.
SUPPLEMENTAL NOTES:
ROOFING NOTES:
A. BUILT—UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3,%12 MAXIMUM PITCH.
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 oi'her name.
Contractors are required by 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 registerwith the 'Staae,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 in costs and, unemployment -compensation -.contributions.
There may be financial risks for you if you do not carryout 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 In Revenue Service (and, if
you wish, the U.S. Small $usinessAdminstration). For more specific information about your obligations under Stare
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 ownersunless they' are performing their own work
personally.'
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 ILA QOINTA
DEPT. OF BUILDING -AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760)777-7012
FAX;,(f{;A;'.777-7011
rWNER'S SIG 1ATURE/:DATE
SI - /40
PROPERTY ADDRESS
0306 < 42`7'.
PERMIT NUMBER(s)