0307-309 (PAT)LICENSED CONTRACTOR DR(LARATION
I hereby affirm under penalty of perjury that I am'lAseb 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).
( ) I am exempt under Section B&P.C. for this reason
Date .7 !Z/_,v Signature of Owner
w1 G / e /
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).
(.) 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:. Applicant - j4r--. g jognzzzo
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject4n 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.
,,Signature ,(Owher/Agent) /moi-' mate
PERMIT # --
' <:.' BUILDING PERMIT
-
DATE a ' VALUATION L'OT,,�'� 1" Z* TRACT
1359;1%x, ;s
JOB SITE
APN
ADDRESS�.•• � A F�1)[iDA RAI'�C ' . T
173-171-�
OWNER
CONTRACTOR/DESIGNER/.EN (NEER
E2d1 IQuE, F_scm o B.1~%:.,o
OWNER 13'U.CDE12
51-1810 AWNJDA. RAMIREZ
LA QUIN 1A. CA. 92253
a•
;1 - Cl
_r
USE OF PERMIT,+;
PK11O
400 SF BUILT UP RATIO COVER Pf, CITY S7AN,46ARD.
PORCHrPA'T10- OF
EGITUATE D COST OF C0N1V11$1:.TCM. 01Y
PKRPM ' F'EE 9113hWARY
PLAN CHECK FRE 103-000-439-31e, X52 6S
. .4.
WNSTRUCTION .ME 1 o'1. -boo -mg -00-0
STRONG MOTION FEE RESI13 101.000441-000 �,s3
D
JUL 2 3 2003
CITY OF LA QUINTA .
FINANCE DEPT.
IRM -TOTAL C014317R ULMON AND PLAT CFIECIC
1 F33 PRE-PACD FMS
t1.001
TOTAL PbTRAUT I+.13ES 'nI?a NOW
C
� k314.16
--7
RECEIPT DATE / / BY `may' DAT FINAI,ED INSPEC
INSPECTION RECORD
OPERATION
I DATE
I INSPECTOR
OPERATION
I DATE
I INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX 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
k 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 Pibg. 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
Sealer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas'rest
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:
RAFTER SIZE AND SPACING" SPECIFY ROOFING AND SHEATHING OR OPEN' LATTICE
`7 Y-6 f / 1 Q G < (SEE ROOFING NOTE ON. REVERSE)
ROOF PITCH
NOTE
OPEN LATTICE PATIO COVERSMAY, BE ATTACHED TO 'EXISTING FASCIA
VIA ONE 1/4' x 5' LAG SCREW THR1.OUGH FASCIA INTO EACH RAFTER TAIL.
i— 3/9' x 5' I Ar crpndc mT^ n.- -... . - ....
U -STRAP `OR' ANI
4
NON—CORROSIVE
(4)- 16d NAILS
OR BOLT '
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
U—STRAP OR ANGLE
-(4)'- 16dNAILS
JOIST HANGER.OR"SOLIp 'BLOCKING OR' BOLT
NAIL RAFTER TO 'BLOCKING -
PROVIDE 1" 'CLEARANCE
BETWEEN• POST AND
_ 'CONCRETE.-
BUILDING DEPARTM,ENT�. APPROVAL 6E`LOW �--'
-
CITY OF, LA: QULNI`A .
BUILDING;& SAPOYIDEPT. ' ANCHOR BOLT (EMBED
7" 'MIN. INTO CONCRETE)
APPROVED
FOR CONSTRUCTION -TYPICAL "PATIO COVER
DA �� O DATE OF APPLICATION 7 L3 -;(-3
-'
BY _
-OWNER'S 'NAME I "J
. STREET •ADDRESS � 8 I '� �vE /-� • _ n„ _�
CITY. ST ZIP
S H J
TELEPHONE 760
.. y..
H:O.A. APPROVAL N/4.
CONTINUOUS` LEDGER '
(SAME SIZE AS RAFTERS)
HEADER SIZE
'yy'``• I�t
'T' AND 'L' STRAPS
16'x6'x/'x1/8••
WITH I
•" /r
9
<Z=.
J
1 (4) 16C NAILS OR BOLT
/
RAFTER SPAN: (,-�--
,
POST SPACING._[-_
O.M..
--
O.Mc
l��
OVERALL LENGTH:
ix
a
y'
c)
/ 'OVERALL
_ LENGTH
i.. r----
---_ POST SIZE:
t.REAR SETBACK
SIDE`SETBACK ' (4":4' MIN.) -----
2000 P.S.I CONCRETE' -moi
I FlNISH .GRADE
FINISH GRADE
L_
J-
MIN. 12_02- 12 FOOTING I I
L J
. A
- 12' BELOW GRADE L - _j
NOTE
OPEN LATTICE PATIO COVERSMAY, BE ATTACHED TO 'EXISTING FASCIA
VIA ONE 1/4' x 5' LAG SCREW THR1.OUGH FASCIA INTO EACH RAFTER TAIL.
i— 3/9' x 5' I Ar crpndc mT^ n.- -... . - ....
U -STRAP `OR' ANI
4
NON—CORROSIVE
(4)- 16d NAILS
OR BOLT '
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
U—STRAP OR ANGLE
-(4)'- 16dNAILS
JOIST HANGER.OR"SOLIp 'BLOCKING OR' BOLT
NAIL RAFTER TO 'BLOCKING -
PROVIDE 1" 'CLEARANCE
BETWEEN• POST AND
_ 'CONCRETE.-
BUILDING DEPARTM,ENT�. APPROVAL 6E`LOW �--'
-
CITY OF, LA: QULNI`A .
BUILDING;& SAPOYIDEPT. ' ANCHOR BOLT (EMBED
7" 'MIN. INTO CONCRETE)
APPROVED
FOR CONSTRUCTION -TYPICAL "PATIO COVER
DA �� O DATE OF APPLICATION 7 L3 -;(-3
-'
BY _
-OWNER'S 'NAME I "J
. STREET •ADDRESS � 8 I '� �vE /-� • _ n„ _�
CITY. ST ZIP
S H J
TELEPHONE 760
.. y..
H:O.A. APPROVAL N/4.
• v v v
RAFTER SPAN TABLE ` 00
GRADING -RULES- - - - co co L' `�' /ps
,
-DS -27,0-70— x,506'.. _ ri r C }l & '}r qQ_
co
(FEES & INCHES)"' ooJA�?�o� <) co cTry
2x4
t
� to LO:C�'
j0'=6" !
9'-6" I
-7'— "
FIR NO. 1
I DOUGLAS
FIR NO. 1
S!?E
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
I N/A
4x8
11'-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
i 6x8
14'-0"
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
S!?E
i
SPAN
I SIZE
SPAN
5'-u'
4x4
4'-0"
4x6
8'—C"
4x6
6'-0"
4x8
11'-0"
4x8
8'-0'
4x 10
14'-0"
400
10'-0"
402
17'-0"
, 4x 12-
12'-0"
i 6x8
14'-0"
6x8
12'-0"
6x 10
17'-0"
600
14'-r"
ALL CONSTRUCTION SHALL CONFORM
TO THE PROVISIONS OF THE:.
2001 CALIFORNIA BUILDING*CODE.
JUf tF LtMtN I AL NU I t5:
ROOFING NOTES:
A. BUILT—UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3;%1 MAXIMUM PITCH.
OWNER'/BUILDER 'INFORMATION
Dear Property Owner, ,
An application for a bailduig permit has Been subrimuted in r n
youam e.` listing,you"rself as the builder of the property
improvements specified'
For your proiection,you should be.aware,ihat as f;Ownei BuiIder"':.yo u are ilieresponsible party of record on such a
permit. Building;permits"are not requued.to tie"signed by%property owners- nlessahey are:personally performing their
own,work. If your .work is�being,performe'd'by'someone.oiher than'yourse.lf, you maygprorect yourself from possible
liability if that person applies for .the, proper permit in his or her.name' "
;�.
Contractors`are-'requiied bylaw to be licensed and -bonded by the State of California and to have a business license
from', tire City of County:,,Tt ey are also require&bylaw.-to p6't}ietr li'cens`e. number on }all permits for which they
apply. ,.
If you plan to,do `your own work'wuh.the;excepiion�of vanuus trades that,you plan' io'subcontract, you should be
aware of the following mformauon for your benefit and:protection:. ; -
If you employ or otherwise,engage^any persons other than.,your immediaie family, an'�d the work (including materials
and other costs) is.$200,.0'0-or more "for the:"entire,pioject, and licenied as contractors or
subcontractors, then you maybe an employer.
If you are an employer -7, -.you must register with the$tate and Federal Government_ as n°employerand you are subject
to several obligations including State aridtFe'deral income tax v✓iihholding federal somal security taxes, worker's
if
compensation insurance, disa6ilit'y insurance.costs and unemployriient-compensation contributions.
.iso :. V � „, , � `- " , •t ,.. � I ,
There may. b .financial risks for you if you do not carry out these obligations and theseerisks are especially serious with
respect to worker's compensation insurance:
For.more spectfic.infoimatiori'about your obligations under Federal Law,`'contact the, Internal Revenue Service (and, if
you wish, the U.S! Small Business;Adminstrauon) •:For more specific information abou your obligations under State
Law, contact the Departmentof Benefir`Payments and the,Divis ori of Industrial Accident's.
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. 4
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' bby p perty�owners unless they` acre performing their own'work
personally. �.' t
Information about licensed contractors may be oliuined-,by contacting the Contractors' State License Board in your
community orat 1020 N. -Street, Sacramento, California 95814. alt. a
r �
Please complete and return the-enclosed',ownerbuilder verification, form:so'.thai,we can, confirm that you are aware of
these matters. The building p'ermitwill'not be issued until'tthe verification is"returned'
Very truly yours, Y
CITY OF Ln QUINTA I
DEPT. OF BUILDING AND SAFETY
78495 Calle Tampico
La Quinta, CA 92253 r r
(760)777-7012
FAX:(760)777-7011
O ER' IGNATU /DATE ,
PROPERTY ADDRESS
03D7- ,�> 0
PERMIT NUMBER('s) ,'
In