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0003-213 (PAT)LICENSED CONTRACTOR DECLARATION I :hereby : ffirm under penalty of perjury that I am licensed under provisions of IthApter 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: ,Q,- 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 �to � Z77242nSignature of Owner_ -4__7;'.., . "/f S/-1�i — r 5i 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: Carrier Policy No. (This section need not be completed if the permit valuation is for $100.00 or less). (a�) I certify that in the performance of the work for which this permit is issued, I shall not erri'ploy''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.-9T'.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 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. SSiign to ure (Owner/Agent)' 7- 17 - 0 Q Date i Y i'tnR.'Ct,SCO J. v,5 PERMIT # BUILDING PERMITt6913-'Z:r1,3 = r DATE VALUATION �/'�-,41 LOT TRACT JOB SITE ADDRESS 51-305 AVir1 IDA APN _ i OWNER CONTRACTOR / DESIGNER / ENGINEER r. �y n n.�r�rrrn t n.tnr u���� t n . ...ni.l,..�L `. e.,...r.v._i u..�.c♦„• ntcrnir 0110i Iri' T1i:i? .. r. r. s�.u\,Ia,,.4�1.,�w , 51-305AV.i~N.1DAELW.1REZ 5€-305AVENWAItr't,iMI UZ LA QUINTA. CA 92753 L.A OUIWA CA 02253 USE OF PERMIT U>rNRicAL Etlif-LDQ46 N%T10 i 2LF X 4 -5i64 SQ. Fs. po[� Ck•'IIPXJ"10 51G.(k1 ST PERMH* FEE SUMMARY PLAN C.I• FkX F& 101-000-439-318 C•ONSTIRI IrT10N F FST'. !(11 4)M-41 9_(1(.U) `::I'R'01401440TION FFJ_ .137.SID 101 -000 SUB-'MTAL ('ONSIMLIC" noN AND PLAN C;MUC':K $!4q.!9 LrSa n1i1.,_ :;IJ FF.?1+:w9 0.^I1 1'0TA1.P11eKNI11' 141, CIS 1)U1-t:NOW $149.19 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 Ce— S7 Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.Q. 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: �7 rI ce4t,/ 4 Q", Dear Property Owner: 78-495 CALLE'TAMPICO LA QUINTA, CALIFORNIA 92253 TELEPHONE (760) 777-7012' FAX (760) 777-7011 OWNER/ BUILDER. INFORMATION 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 tube licensed and bonded by the State of California and to have,a.,bus.iness license from the City or County. They are also required by law to put their licensenumber on all permits for which they apply. S If you plan to do your own work, with the ,exception of variuus 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.insurahce 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 unde'r.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 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, orE,through':their'own employees; without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing, to.be.contractor s 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 .nor required, to be signed by property owners unless they are performing 'their own work personally. Information about licensed contractors may obtained by.conta'ting the.Contraciors' 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 buildingpermit will not be'issued`until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY `— 78-495 Calle Tarinpico La Quinti, CA 92253 (760)777-7012 FAX (760) 777-7,011-x;, O ER'S SIGN RE/DATE PROPERTY ADDRESS Doo3 - PERMIT NUMBER(s) RAFTER.' SIZE `AND SPADING a SPECIFY ROQRNG. ANO'.SMEATHING R' OPEN LATTICE —. F, (SEE ROOFING NOTE ON REVERSE), ROOF PITCH r s „ . • .. • • CONTINUOUSI LEDGER <. tIrU ,l (SAME SIZE AS RAFTERS) I I HEADER SIZE t I I T, ANDL'44STRAPS WrTk z ?"' �.'.(4) 16e NAILS OR BOLT Ii al 1 POS'. SPACING: / I: / RAFTEP. SPAN:/ J O:H. Ml : ' 'I 2io Q OVERALL'LENGTH: f9 .ONGTr I POST SIZE: _ I tol (4"x4' 'MIN.) SEI /' REAR TBACK {. SIDEr.'SETBACK.;. FINISH GRADE y FINISHGRADEI MIN. l Z'x.12' FOOTING I I 2000.P.S.I CONCRETE — I L_J 1'2' BELOW.';GRADE L -J I ,t I PROVIDE l" CLEARANCE BETWEEN POST AND „ CONCRETE NOTEa OPEN LATTICE PATIO COVERS - MAY BE ATTACHED TO • EXISTING FASCIAa • VIA ONE 1/4- x S' LAG SCREW THROUGH FASCIA"INTO EACH RAFTED TAIL. * - U—STRAP OR'rANGLE NON' -CORROSIVE PLATE RP(lE —3/6' 5' LAG,SCREWS.INTO STUDS AT 16' D.C.--i G �- CONTINUOUS. LEDGER " 1 I I #' 1t! j.l (4)- 1:6d NAILS �YY: ��. I. I �• ,I:;,I OR .BOLT ` LI -STRAP OR -ANGLE (4)= 16d. NAILS OR" BOLT i JOIST HANGER OR SOLID BLOCKING " 2 NAIL RAF,EP TO BLOCKING PROVIDE, 1" CLEARANCE ! BETWEEN;=POST, AND CONCRETE . BUILDING DEPARTMENT, *APPR:OVAL BEL'OW`II II i ANCHOR .BOLT ,'(EMBED., 7" MIN. INTO CONCRETE) CITY OF LA-QUINTAr' i. BUILDING & SAFETY DE�P,T. TYPICAL PATIO COVER APPROVE, DATE OF, APPLICATION fOR CONSTRUCT ON rt OWNER'S NAME '/%>� �Q G�.•te� STREET ADDRESS5°�%- DATE ZIlLk BY,r` crTY: sTr fZIP. "'�" --•- — i TELEPHONE 771% H.OA. APPROVAL ;