0106-398 (PAT)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Che,pter 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. Dat. -
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:
(t )4 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 41:lf—I' S, n tune of Owner
MFENSATION 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).
'(4 1 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.
Warning: Failure to se6i7Fe'W6rk&rs; Comp6nsation 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.
(Owner/Agent) / ti ! Date
BUILDING PERMIT, PERMIT#
DATE
�� ` VALUATION LOT �g.`�, TRACT
/
JOB SITE
APN
ADDRESS
51 -60 AeyDRApR97.
- '-
OWNER
CONTRACTOR/DESIGNER/ENGINEER
e
RICARi O& LUM I.W iNA
OW` EIR-BZ1 jLD:1 R
31682 AMMDAR 7
LAQI 'rA CA 92233
USE OF PERMIT
303 SIP F,ILiRZ UP PATIO f:':01VER PER i3T'!'I;OVFM PLANS
arOFiCHlPA'11t7 300.00 `F
E&MMI1 D COW Or COSttSMUMON
Pl S111M.'r prig >��13t &UV
ft" CHECK FER 101-000-439-318 $35.10
CONS T1213C ''.IGM AM 101-000-418-000 W.00
S z RONO MOT1014 n",E . R1 RID 101-000-241-000 tso
S'C B- O'FIAL C°t;WMI UMIOR .i`' ND P
$89.60
72.93
'
TO" ° I s . . MS l?AYE NO�
MAW
1 8
l I A QoKfA
RECEIPT
DATE / BY f10
fie ALED
INSPECTOR
,
/r
INSPECTION RECORD -
OPERATION DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
-Set Backs {
Underground Ducts
Forms & Footings i
Ducts
Stab Grade I
Return Air
Steel }
Combustion Air
Roof Deck t
Exhaust Fans
O.K. to Wrap '
F.A.U.
Framing !
Compressor
Insulation
Vents
Fireplace P.L. !
Grills
Fireplace T.O. i
Fans & Controls
Party Wail Insulation 1
Condensate Lines
Party Wall Firewall
Exterior Lath 4
Drywall - Int. Lath {
}
i
-
I
Final
Final i
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs i
Electric Bond
Footings I
Main Drain
Bond Beam ]
Approval to Cover
I
Equipment Location
I
Underground Electric
1
Underground Pibg. Test
Final I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines }
Heater Final `
Water Piping }
Plumbing Final
Plumbing Top Out I
Equipment Enclosure
Shower Pans I
O.K. for Finish Plaster
Sewer Lateral I
Pool Cover
Sewer Connection !
Encapsulation
Gas Piping 1
Gas Test I
Appliances I
I
Final
I
COMMENTS:
elasew
s�l ` a 7
57
I
rFinalI
Utility Notice (Gas) f
- ELECTRICAL APPROVALS
Temp. Power Pole I
Underground Conduit } I
Rough Wiring I I
Lcw Voltage Wiring I i
Fixtures r
Main Service 1
Sub Panels I
Exterior Receptacles ! i
G.F.I. { j
Smoke Detectors I f
Temp. Use of Power ! 1
1 I
1 I
Final }
Utility Notice (Perm) J
NOTE:
OPEN LATTICE PATIO COVERS .MAY BE ATTACHED TO . EXISTING FASCIA a
VIA ONE 1/4" x 5" LAG^SCREW THROUGH FASCIA INTO:: EACH RAFTER TAIL.
U. -STRAP' OR AN(
3/8" x 5 LAG SCREWS INTO STUDS AT 16" O.C. NON - CORROSIVE
CONTINUOUS LEDGER
(4)- 16d NAILS
OR BOLT
.U—STRAP OR ANGLE —
(4)— 16d NAILS
OR BOLT
JOIST HANGER OR SOLID BLOCKING
RAFTER .SIZE AND SPACING y.
SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE
PROVIDE 1" CLEARANCE
q � Q,CI
• (SEE ROOFING NOTE ON REVERSE)
CONCRETE
BUILDING DEPARTMENT APPROVAL..BELOW
HILI
ANCHOR .BOLT '(EMBED
ROOF PITCH
_ 3/ Z-
�ki I�
CONTINUOUS LEDGER
C`I I Y O'F LA Q.0 INTA' `"
DATE OF APPLICATION
(SAME SIZE AS• RAFTERS) `..
BUILDING & SAFETY :DEPT
OWNER'S "E
HEA/DER SIZE
E -
C.O X
STREET ADDRESS
T ' AND 'L' STRAPS
6'x6"*xt"xI/8" WITH ,.
FOR CONSTRUCTION
. (.J
— — — — ---
z.
I' (4) 16d NAILS OR BOLT I
DATE
TELEPHONE
RAFTER SPAN: =I —_
Z
POST SPACING:__ _.
u
J
H:O.A. APPROVAL
O.H.
w
O.H.
U
r
a.
/
�_0___
z
OVERALL LENGTH:a
OVERALL LENGTH:_
(fin--
RGlR SETBACK
POST SIZE:
SIDE SETBACK (4"x4" MIN.)
FINISH -GRADE
2000 P.S.I CONCRETE -�I I
FINISH GRADE I- MIN. 12"02` FOOTING
L -,J 12' BELOW GRADE L__J
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
NOTE:
OPEN LATTICE PATIO COVERS .MAY BE ATTACHED TO . EXISTING FASCIA a
VIA ONE 1/4" x 5" LAG^SCREW THROUGH FASCIA INTO:: EACH RAFTER TAIL.
U. -STRAP' OR AN(
3/8" x 5 LAG SCREWS INTO STUDS AT 16" O.C. NON - CORROSIVE
CONTINUOUS LEDGER
(4)- 16d NAILS
OR BOLT
.U—STRAP OR ANGLE —
(4)— 16d NAILS
OR BOLT
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER To BLOCKING
PROVIDE 1" CLEARANCE
BETWEEN•POST AND
CONCRETE
BUILDING DEPARTMENT APPROVAL..BELOW
HILI
ANCHOR .BOLT '(EMBED
;7 M,IN. INTO CONCRETE)
�ki I�
TYPICAL PATIO COVER
C`I I Y O'F LA Q.0 INTA' `"
DATE OF APPLICATION
BUILDING & SAFETY :DEPT
OWNER'S "E
11
.� ®
STREET ADDRESS
FOR CONSTRUCTION
ciTY, sT ..�P .
DATE
TELEPHONE
H:O.A. APPROVAL
1 A /11 IIN TA i