0304-207 (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
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:
(}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. four this reason r ,,
Date d(.. %' -° Signature of Owner ae , ,fir �.ti /
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.,, /I
.."date: 4-4'- ,/2 Applicant A.1111;77717
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on .his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit 'work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) XV2•/ f� � ��• �h• .f b Date � l° i. -•
s.
PERMIT # '
BUILDING PERMIT •.
0_V)4.'2��
DATE 41 # `y � �� vALUX? ON :�1;q1$ �S LOT TRACT
JOB SITE ADDRESS S11-9.45 6}1i��A:.�.�.Zr`.1,. R";Wlvxz
APN 774-1611•-0.1,4
OWNER
CONTRACTOR / DESIGNER / EN (NEER
VINE HURTADr'
53-94 ��'h'Y7Il:ic�}i�a3��412Ia
i:f?. by tit 1'ra. Gds2i
USE OF PERMIT
tJlio iS5'' iit, t.d..•i• UR` k�i1!':t.:.�! C.'CiY7 [;5.. rc.�c l:d'! )' ::+i.�'imuiESit.0
>?•OR MIPATIO l44.,0�1 2
MAN CF':BC K Mllz %29"25
Ct�Ai;°f'�iC9CxlCNth'` 10 040-41 8_066
S i RO?40 aflOT1GYA 'M , - USID 101 -MO-24 1 •Gti1(3 SM
D �
rAPR 17 2003
CITY OF LA QUINTA
FINANCE DEPT.
y
p p / {may p �y
67i.!:.i.,-�Z:,yI'r�✓\,.Lrvr.'Y••t:��.y l..dIV ;ANDL'".Iw�A IM-F.CIY
Yq y p�
$64.75
"(_;1:491! PRE-111A:I7%�:5
MOO
TGT1,01, P-MMMMMER'. NOW
$74.75
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 8 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 I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
WaRte Lines
Heater Final
Wa er Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Slower 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:
J --e
S —r✓ '%
/
RAFiER•,SIZE AND SPACING' /4N0 SHtATHIN^ OR OPEN LATTICE -7
2 X P f ZFINC NOTE REVERSE)
ON REV
O 7 SE1 %
-----------------
i
— COMINUOUS� LEDGERrt
(SAME •SIZEAS-RAFTERS)
HEADER :SIZE;.
' 4 Y i "r''
I ' AND 'L' STRAPS
T
6*tlr,vi't1/6'..'WITH
I
1 (4) .16e NAILS OR BOLT
RAFTED SPAN:..._r_
•_—_
O.H.
• POST SPACING _!
a
O.H:
OVERALL LENGTH:'
z
C.
' 8
OVERALL' LENGTH
_------
POST SIZE. '
REAR SETBACK
SIDE SETBACK`
2000 P.S.I CONCRETE -yI:
I.FINISM' GRADE
''FINISH !GRADE
L__J
'L— J■. MIN:`12"a12" FOOTING I I
I
1T. BELOW GRADE L -J
PROVIDE 1` CLEARANCE
BETWEEN POST AND
NO E:
CONCRETE --�
OPEN LATTICE PATIO COVERS MAY -:BE ATTACHED, EXISTING FASCIA '
VIA ONE 1/6' Y 5' LAG SCREW -THROUGH FASCIA INTO EACH RAFTER TAIL.
j U=STRAP OR. ANi
I. 3/8' . 5' LAG SCREWS INTO STUDS AT 16• o'C. -. NON -CORROSIVE
CONTINUOUS LEDGER
hI ! I.?. : ;(4)-.:.L 6d' NAILS
K.�OR BOLT
/ U -STRAP ;OR ANGLE
(d)_ 16d NAILS -
JOIST MANGER OR SOLID BLOCKING OR BOLT
NAIL RARER TO BLOCKING
PROVIDE 1" l CLEARANCE BETWEEN. ,POST• AND.
CONCRETE
I
BUILDING DEPARTMENT 'A,PPROVAL BELO'1N
! . - II III
F/cam
CITY OF LA �QUINTA
BUILDINQ &SM- M. DEPT.
APPROVED
FOR CONSTRUC ON
DATE
t
ANCHOR BOLT (EMBED.
7" MIN. INTO .CONCRETE)
.RPpE
TYPICAL- PATIO COVER
DATE OF APPLICATION, �. Q
OwNER'S''NAME, u/z T
1. STREET ADDRESS 5 3,,V9
GtJ, 111 . , .7ZA-t- rv— .�
CITY. ST ZIP CA
.. TELEPHONE = 760 771 " vs -v/
H.O.A. APPROVAL
IV
----------------------
/Q /
v C- " O
RAFTER SPAN TABLE A�7
GRADING RULES S� co S L' �`� C-)�ps
PS 20-70 c� �
(FEET & INCHES)
O1
2x4
16" OAC.
24 .
til' -6"
,* 9'-6" I
7'--
c.—o..
8'-6"8'- 6'-O" !
T-3" I
I
SPAN
2x6
16" O.C.
24" "
32" "
15'-0"
14'-0"
10'-9"
13'-0"
12'-6" 11'-6" 8'-9" 110'-6-
8'-0"
10'-0" 8'-6" N/A I
N/A
x8
1 11-o"
2x8
16" O.C.
24" "
32"
18'-0"17'-0"
14'— 0"
13'-6" 1 16'-0"
6"_j -6" 11'-0" 113'-0"
13'-0" 1 1 1'-6" 1 N/A I N/A
17'— 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
DO! IGLAS FIR NO. 1
I DOUGLAS FIR NO. 1
S!�=
SPAN
SIZE
I
SPAN
5'-0"
4x4
4'
4x6
8'-0"
4x6
6'-0"
x8
1 11-o"
4x8
8'-0"
400
14'— 0"
4x 10
402
17'— 0"
402
6x8
14'- 0"
6x8
600
17'-0"
600
14
ALL CONSTRUCTION SHALL CONFORM
TO THE PROVISIONS OF THE:
2001 CALIFORNIA BUILDING CODE.
SUPPLEMENTAL NOTES:
P,OOEING NOTES:
A. BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.
f
t
OWNER / BUILDER7 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 "Owii'er/guilder' you' are.the r'esponsible'party of record on such a
permit. Building permits are:not required to be signed"by-propw
erty onets unless they aie'personally performing their
own work. If your work is being- performed by someone othe(than yourself, .you may protect yourself from possible
liability if that person applies.for the proper permit to his or hei'-na--me'.
Contractors are required by.law to'be licensed and,, bonded by the State of California and to have.a business license
from the City or County. They are also require'd b, l'aw'to-put their lice"" number on all permits for which they
apply.
If you plan to do your own work, with the exception of varwus,,trad'es that you,plan to subcontract, you should be
1.
aware of the following information for your beriefit'and`protection: ;
If you employ of otherwise engage any persons other than your immediate family, "and the work (including materials
and ocher:: costs) is.a200.00-or , re for ,the entire p"rojeci; and such ,persons.:ar`"e nor iuen`sed as contractors or
subcontractors, then you may be an'employer.
If you are .an employer, you must _register with the °State; and Federal Governmenr-as as employer,and you are.subject
—to -several- , Igaticnsineludtng-State and Federal .income taz0wit61ioldingfederalsocialseetrrity taxes,, worker.'s
compensation• insurance;_ disability insurance costs an unemployment compensation contributions.
There may. be. financial risksfor you;ifyou do not carryout these 'obligations,;And these risks are especially serious with
respect to worker's compensationins`uian�e.
For more specific information about your,oblijations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstrauon) For,more specifc'infoimauon.about,your obligations under Stare
' Law, contact the Department of Ben'ef t Payments'.and the:Dtvision of Industrial ;Accidents.
^•y j -
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''contrac'tor or subcontractor, only under limited
conditions.
A frequent practic`e'of unlicensed,persons'professing to be contractors is to>secure an._"Owner/Builder" building
permit, erroneously implying'thar the property 'owner is providing his or her own labor and material personally.
Building permits are not required to be'signed by ,pioperty owners;unless';..they are -performing their own "work
personally:
Information about'liceiised contractors may be ob'iali ed by contacting the, Contractors' State License Board in your
community or at 1020 N.,Street,°Sacramento, California 95814.
Please complete and return the endosed owner=builder verification form so that we can confirm that you are aware of
these matters. The building, permit will=not be4ssued until the verification is returned.
Very'truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND --SAFETY
78-495 Calle Tampico -
La Qiiinta, CA 92253
(760)777-7012
FAK(760) 777„7011 A
OWNER'S SIGNATURE/ DATE
V7 ct-1
PROPERTY ADDRESS
o304- Pol
PERMIT NUMBER(s)