0205-138 (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
ZJ503I B 0,42.I I -00r"jo
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 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 sTm aim Policy No. 'I3Y6791
(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 provis ons.
Date: ' Applicant v `
Warning: Failure to secure Workers' Comp' a ion coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) ' Date
a� BUILDING PERMIT PERMIT#
FD'i$R�
DATE II VALUATION V wf mv LOT TRACT
JOB SITE
APN
ADDRESS 11 -UO AWWWA R"11= .
_ »
OWNER
CONTRACTOR / DESIGNER / EN (NEER
I HFU"AP
JAS C3IF"HAV,, 3R_
53-M AVE.RBbryW,
NE
Irl -300 F!yy)ENDig'
LA QtHN°lA CA. 92253
PALM DESERT CA. 61
760)771-9572 CBU. s
USE OF PERMIT
235 S10 BA`[" .CH PlA'd fO d XArj9R M. QI Y STANDARD.
PORC;`H'IPATIO 235.00 &T
9 EiW1PA.it IgD 4.•'lF X11 9s'.w 1.Y',.f+.i'V£+A,,6i:cJ4.Y.ArE Fd`I
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CITYOFLAQUINTA
FINANCEDEP
= ..ESS PTM-PjJ D FRES
�c#.
'
RECEIPT
DATE f ��
By-
...........
%j . —. »
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:
POOLS - SPAS
BLOCKWALL APPROVALS
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
COMMENTS:
C
�--
.�--p
� 9
`G
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)
RAFTER SIZE AND SPACING
SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE
(SEE ROOFING NOTE ON REVERSE)
- - - - - - - - - - - - -
ROOF PITCH
NOTE CONCRETE
OPEN LATTICE PATIO COVERS MAYA BE
ATTACHED: TO EXISTING -'FASCIA
VIA ONE 1/4" x 5" LAG SCREW THROUGH FASCIA,IINTO EACH RAFTER TAIL.,
Q, -.STRAP OR=, ANGLE
3/8 x5" LAC SCREWS INTO STUDS AT 16'. O.C.NON-CORROSIVE PLATE
GR
CONTINUOUS LED . GER
"(4) 16d NAILS
OR BOLT
u -STRAP. OR ANGLE —
(4)- 16d NAILS
OR BOLT
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING.
AOVIDE 1" CLEARANCE
'BETWEEN POST AND;
CONCRETE
II II
APPROVAL':,, bt L 01 W
ANCHOR BOLT (EMBED: -
7". MIN. INTO: CONCRETE)
cl,ry 0
FLA - QU' TYPICA;L-:P*ATIO COVER
f3U'LD'NG&'..sAFE-ry 1A . T_'DATE_OF APPLICATION
APO
OWNER'S NAME
c
AlS7'F?UC-floS . TREET . ADDRESS
q
O. CITY, ST ZIP
Y
TELEPHONE
H.O.A. APPROVAL
.-'j 0UILL)II'0o LjLrAKI`ML
co
CONTINUOUS - LEDGER
LEDGER
(SAMESIZE AS RAFTERS)
,FTERS)
HEADER. SIZE
T* AND 'L' -STRAPS
- - - - -
6' -6'x1" -1/,S" WITH
- - - - - -
?(4)
16C NAILS OR BOLT
RAFTER SPANom_
0. H.'
POS' SPACING
1
OVERALL LENGTH:
(L
0
(L
OVERALL LENGTH-.---LZ-
SIZE.
_,Posi -
KLAN !,)LIBACK.
SIDE SETBACK
(4'x4" MIN.)
U
P.S.1 CONCRETE.
FINISH G
IF GRADE
I
FINISH GRADE
. I
MIN. 12"x12** FOOTING I I
L _.J 12" BELOW GRADE L _J
PROVIDE I CLEARANCE
POST ANDBETWEEN
NOTE CONCRETE
OPEN LATTICE PATIO COVERS MAYA BE
ATTACHED: TO EXISTING -'FASCIA
VIA ONE 1/4" x 5" LAG SCREW THROUGH FASCIA,IINTO EACH RAFTER TAIL.,
Q, -.STRAP OR=, ANGLE
3/8 x5" LAC SCREWS INTO STUDS AT 16'. O.C.NON-CORROSIVE PLATE
GR
CONTINUOUS LED . GER
"(4) 16d NAILS
OR BOLT
u -STRAP. OR ANGLE —
(4)- 16d NAILS
OR BOLT
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING.
AOVIDE 1" CLEARANCE
'BETWEEN POST AND;
CONCRETE
II II
APPROVAL':,, bt L 01 W
ANCHOR BOLT (EMBED: -
7". MIN. INTO: CONCRETE)
cl,ry 0
FLA - QU' TYPICA;L-:P*ATIO COVER
f3U'LD'NG&'..sAFE-ry 1A . T_'DATE_OF APPLICATION
APO
OWNER'S NAME
c
AlS7'F?UC-floS . TREET . ADDRESS
q
O. CITY, ST ZIP
Y
TELEPHONE
H.O.A. APPROVAL
.-'j 0UILL)II'0o LjLrAKI`ML
co
F AFTER. SPAN TABLEi ,/
GRADING RULE `' i `
j' T n ALL . CO.NSTRUC.TION SHALL CONFORM
PS ''0-70 �' i 'cv c�' /`�� i TO T-H'E PROVISIONS. OF THE:
(FEET & INCHES) pJ�"� pJ�� p`
o /. o �� o c• ��: 1998 CALIFORNIA BUILDING CODE.
SUPPLEMENTAL, N* 0TF
r
I
16:' Q.C.
24
10'-6"
1 9�'-6`,:
7 _3"
8'79�=
8•-0 8'-0 6'-0.,
:7'=j'
D.0 J'GLAS
FIR. NO. 1.
2x6
16"I O.C.
24,.
15'-0",.
-14'-0".
10'L 9"
13'=0"
1�'-0' 11'.-6„ 8;_9..
10;_.6,'
Ax6
8'-0"
4x6
6 ' 0
2x 116"
0. C.
24" "
32"
18'-0"
11 T':-0" 13'-6"
16'-0"
15'-6 14`'-0 1:.11'-0"
13'-.G','
13-0" 11,-6" NIA
N/A,
17'- 0"
4x 12
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".,US1NG
THIS STANDARD
LATTICE
ROOF-
BUILT-UP ROOF .
HEADERS
HEADERS
DOUGLAS
FIR -NO. 1
D.0 J'GLAS
FIR. NO. 1.
S17
SPAN
.SIZE
'SPAN"
4x4
'
5'-0"
4x4
4
Ax6
8'-0"
4x6
6 ' 0
4x8
1 V-0"
-4x8
8'.=0.7
4x10
14'-0":`
4x::10
lo' -O".
4X`12
17'- 0"
4x 12
12 - 10:1
6x8
14'-0"
6x8
6x 10
17'-0'
6x10
14 -0".
:.:ROOFING NOTES:
A,-ilBUILT-UP, ROLLED .ROOF: SLOPE TO DRAIN.
B. ROCK RQOF: 3/1 ? MAXIMUM PITCH.
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y
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e t
Sa g -lop
' pAy .. _T.y
%�w�
VA OF ..sem -QUIN O Y - n f- ya L v nr-i
.r
TY
k^�Cp,•h9.�a
BUILDING.
& SAFETY DEP '. .� F No l
gp{�F OVED
FOR CONSTRUC10
TION
14,
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