BPAT2014-1027Applicant:
HELEN RODRIQUEZ
P.0 BOX 674
LA QUINTA, CA 92253
Contractor:
HELEN RODRIQUEZ
P 0 BOX 674
LA QUINTA, CA 92.253
(760)849-8277
LIC. No.:.:CONV:140528101254118936
LICENSED CONTRACTOR'S DECLARATION I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
I hereby affirm under penalty of perjury. one of the following declarations:
Qum&
VOICE (760) 777-7125
78-495 CALLE TAMPICO
compensation, as provided for by Section 3700 of the Labor Code, for the performance
D
of the.work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
.4
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
Carrier: - Policy'Number:,_
I hereby affirm under penalty of perjury that I am exempt from the Contractor's state
BUILDING PERMIT
License Law for the following reason (Sec. 7031.5, Business and Professions Coile: Any
s Joy any -person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve; demolish; or repair
compensation, laws of California, and agree that, if I should become subject to the
Date: 9/12/2014
Application Number:
BPAT2014-1027
kLaorode,
comply w h those provisions.
Owner:
Property Address:
54445 AVENIDA RAMIREZ
-
HELEN RODRIQUEZ
APN:
774243022
AND'SHALL.SUBJECT AN EMPLOYER TO -CRIMINAL PENALTIES AND.CIVIL FINES UP TO
P O BOX 674
Application Description:
25SQ FT SOLID PATIO COVER
IN BACKYARD
LA QUINTA, CA 92253 .
Property Zoning:
apply to an owner of property who builds or improves thereon, and who'does the work
himself or herself through his or her own employees, provided that the improvements
Application Valuation:
$700.00
IMPORTANT:Application is hereby made' o the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
Applicant:
HELEN RODRIQUEZ
P.0 BOX 674
LA QUINTA, CA 92253
Contractor:
HELEN RODRIQUEZ
P 0 BOX 674
LA QUINTA, CA 92.253
(760)849-8277
LIC. No.:.:CONV:140528101254118936
LICENSED CONTRACTOR'S DECLARATION I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
I hereby affirm under penalty of perjury. one of the following declarations:
9 (commencing` with Section 7000) of Division 3 of the Business and Professions Code,
_ I have and will maintain a certificate of consent to self -insure for workers'
and my license is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: _ License No.::CbNV:1405281012541-18936
of the.work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Date: Contractor:
Section 3700'of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
OWNER -BUILDER DECLARATION
Carrier: - Policy'Number:,_
I hereby affirm under penalty of perjury that I am exempt from the Contractor's state
certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Coile: Any
s Joy any -person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve; demolish; or repair
compensation, laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the'
kLaorode,
comply w h those provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code) or that he or is therefrom `Date
! Z " Applicaannf:5P
she exempt and ,the
basis for the alleged exemption. Any violation of Section 7031.5 by any.applicant for a,
-
permit subjects the applicant to a civil penalty of not more than five hundred dollars
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
00).:
AND'SHALL.SUBJECT AN EMPLOYER TO -CRIMINAL PENALTIES AND.CIVIL FINES UP TO
� , �as owner of the property, or my employees with wages as their sole
ONE HUNDREDTHOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended:or.offerecl4or sale..
COMPENSATION, DAMAGES AS.PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044,,Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
apply to an owner of property who builds or improves thereon, and who'does the work
himself or herself through his or her own employees, provided that the improvements
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT:Application is hereby made' o the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth.oh this application.
�gYSfie did not build or improve for the purpose,of sale.).
1. Each person upon whose behalf this application is made, each person at whose
as owner of the property, am exclusively contracting with licensed Contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' ',
:issued as a result of this application', the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall,defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for.the projects with a contractor(s) licensed pursuant to
employees for any act or omission, related to the work being performed under or
ycontractors' State License Law.).
following issuance of this permit.
I am exempt under Sec. . B.&P.C. for this
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
t�� -
'work'for 180 days will subject permit to cancellation.
wn
certify that I have read this application and state that the above information is correct.
CONSTRUCTION.LENDING AGENCY
I agree; to comply with.all _city and county ordinances and state laws relating to building
I: hereby affirm under penalty of perjury that ihere'is a construction lending agency for
construction, and hereby authorize representatives of this city t en r upon the above -
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.)..
mentioned roperty for inspection purposes.
�{
`Si
,
Lender's Name:
Date- 'mature (Applicant or Agent)
Lender's
H
,:A it -i C Silo
Mad r.g'i'r.``n.!41 5? gSFa>.•'i�ii ,�+:f�7• ��^y'4"
PAIU
a^`t�SCRI�P,T DN`�»ACN`°�4` car:=' AMFOU.NT': s�....s%PA�ID;DATE,
BSA5SB1473 FEE 101 0000'20306+ 0 $'1:00 $0.00
p1 -� is fa f � ;,r�•i,sL � ryL F� , �- ix 1. Y{' i e
r � �� � i:-
# ' CLTD}BY
i4i
Kr 'f iutg._ +E .�!%�•<a..,. 'r d` .q z^
�:5wxt 4 4,5
;CHECK r .�-
cA,
Total Paid for BUILDING'STANDARDS ADMINISTRATION 13 lk. $1.00 $0.00
��;,i Y` r...... �_ ; ''Yd, `��,4 'i±rp r 'Tn�'S` 4-"K.w ,� ,3 fKc;'�,r�+a yK; e.•v++„�. �•Y,>rs... xtgu�'.'a4 it ., ,"':z ,i,' . ",k ;2.'i-lw.,, ,' .. ,..;. F -j - +Y: ','sr,' •. - "Vii. xit51< i
UESCRIPT-IONx;
t;`;"*firACCOUNT}` QTY�5��AMOUNiT" >U� ;1FP/11D� aPAD�DATE
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.W....iL4:dG.:��G.)iso..�x�+ifh:.!�r3u...c.,.Cv79vlti i�S. ]Ara ....,_..t.,.0vi>k&1�RSY+M1i~%S�£�MSdi.,..•�f.��.`k .r�i`et i +x'4._ �- .. ��"'(u!. s. -
PATIO COVER, STD,'OP.EN
10"Q00.-"j,2404';x.
0
$95:81
$0.00
Eli BY�'��
```J.:`+ S,h%,t�}t`'j iAyt-mak
METHOD ^,�
,..3 SK Y._'2t�! " �'b •'i
RECEIPTS#;<.,,CLTDi,BY,..'
',4r.Y.2!..,'
•ry;..
. � +I— x
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R 12ONa�t�`.:
is.�k..�
s PAID, �tU
cP,A1D DATE;
k
i�tr;i�a SsrACCOUNT'�x
krQN�*
baAMOUNT`i;��
., a
PATIO COVER, STD, OPEN PC;
-'_-1017000042600
0
$94:38
$0.00.
CxF�cd+'a�e.ffif±�',='.�fti `�1"t..i
�.. a,r. PAIUB�Y ��uMTHO���hss
Etu;�tBJi!yr i'Er T7 Uy` p'•
CETT"
iE U7.1tv.-,•P>�'f. i'S - :
L 1sXF`:,i">fi' :. Y..
kT
.'t1:.CHECK��
Total Paid -f:' 5: P.ATIOLCOVER / COVERED PORCH /LATTICE. $190.19 $0.00
-, Y'.;.R _ti ,i'itfm`s-,fig: a v :K s
>'t .'s'R. f i l ' 2G r�5'
= r DESCRIPTION
.(+.af 'q,,,,�.�:t'�,'h�,l."e'�5,. F.v ^i:•ri<.
d.. .5..:! t q z. {
ziQTY
�C3'>""�"{.o�
�.�"� £
.! ,h.$ . }�'
�AMOUNTt
7i.,'C,
' :+' PAID+
IPA
S�'v���'�•-e'-�T..
a�
PAID DATE
A FIs - E
;S ix` ♦ ''T.i as v'''CSv wt..6i;.' aFr,.'i, s - 4v. ., ._.: f` i .f.
thACCO:UNT> 4ywr
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2
v 'i
.^:m2 -w4. N
t ..
I. 1. .a1 �:
7 .],.
SMI -RESIDENTIAL!
-101-,0000 20308
0-1,
$0.50
$0.00
�
RECEIPT.#...t
CHECK #
CLTDt.BY s.
a,..m4METHOD,. _f?�
..: i:.
Notal Pa1id` drSTRONGWOTh0N INSTRUMENTATiIONwSMt s $0 50 , :.. $0:00
:
PARENT PROJECTS.
Printed: Friday, September 12, 201411:32:30 AM 2 of 2 Cbqw.,YSTEMS
P,
Y77
7-V
tn-Pt- 7Qr:-
;AMOUNT
PAID . ..... V't
DATE,
RECEIPT#
JMETHC)6'
.PAID
PATIO COVER, STD,
101-0000-42404
0
$95.81
$0.00
OPEN
PATIO COVER, STD,
101-0000-42600
0
$94.38
$0.00
OPEN PC
Total Paid for PATIO COVER / COVERED PORCH LATTICE
$190.19
$0.00
SMI - RESIDENTIAL7
101-0000-20308
0
$0.50
$0.00
Total Paid forSTRONG MOTION INSTRUMENTATION SMI:
$0.50
$0.00
bTALS:."
'�.'$191.69
�6.00:
iNSOECTIONS.."
INSPECTOR
,SE CTO
SCHEDULED,
COMPLETED RESULT
, , . : ".
S
N
NOTES
DATE'
-DATE-:'�'
i x
FINAL"
PARENT PROJECTS.
Printed: Friday, September 12, 201411:32:30 AM 2 of 2 Cbqw.,YSTEMS
Bin #
Permit #
Project Address:V/
Cry:of La Quanta
-Building &r Safety Division
P.O. Box 1504,;78-495 Calle Tampico . .
La Quinta,CA 92253 - (760) 777-7012.
Bgilding Permit Application and Tracking Sheet
Owner's Name:
A. P. Number:
Address: ./
Legal Description:
City, ST, Zip:
Contractor:
-it y'.j r:
Telephone:,�;.
;Address:
t
Project Description:
City, ST, Zip:
eTele hon00i
-
...> `>
rJ . S P�S
State Lic. #:
City Lic. #:
�(� (� ✓ .�
Arch., Engr., Designer.
Address:
(P,—
City, ST, Zip.
Telephone:
:>
v:Y
;
.-Construction Type: Occupancy:
State Lic. #:
: $inject type (circle one): New Add'n Alter Repair. Demo
Name of Contact Person:
Sq :Ft, .. 2_
#. Stories: . _
# Units:
Telephone # of Contact Person:
Estimated Value of Eiojcct:. (jC
# Submittal
APPLICANT: DO NOT WRITE `BELOW THIS LINE
Req'd Recd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed,, ready for corrections
Plan.Check Deposit
Truss Calcs.
Called ContactTerson
Plan Check Balance.
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2' Review, ready for corrcctionsfissue
Electrical
Subcontactor List
Called.ContactPerson
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
""' Review, ready for corrcctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
-Total Permit Fees
78-495 CALLE TAMPI60
LA QUINTA, CALIFORNIA 92253
-BUILDING -& SAFETY DEPARTMENT
(760) 777-70.1.2
FAX (760) 777-7011
Kxkj tERT -0MMR`& Ax -:CK, G
Disc.losurbs & Forms'for Owner-M66rs Ap�ly . Wgr for` Pernnit
. p � : 1. . . s
[AW—MANTI.-NOTC
Dear eroperty Owner
An application :for a, building, li . s if as the builder of the property
permit has -bow s�"� tted�iiiJpw
improvemnts.spocified,at-
We are piovWing you with an 0
_wW_Bui1d",AckDLw1 luf tion-Veiifidiition�Form to make you all of�your
responsibilities.and possible risk.;you may-incuftby,b�gV'W- m.your. nam
.g this permit issued- as the
Owner -Builder. We:wHlIuot J a.b kyour.
issue uil4ii4ver* !save reAd in"Wiakd understanding'af eack,provision,
signed, and returned this form to us it - our e'ffidal; address indicated. An agent of the owner cannot execute this notice
unless You, the property owner, obtain the prior approval of the permitting authority.
1. l.understand a ftcq'u*qq*t practice of unlicensed pemus is o, 1. i0a
yeproperly�q:
owge obtain an'.b.wner-tuilde, i
buildmig:perp iif ttiat.-Cnno6usly, implies that the pr6ortyowner: is'p'r'0 V1 dI .labor and rnMCTW.personauy.
an Owner -Builder; may bc.,hel liable and
subject to serious financial .risk:rorany',41junessustained,byan unlicensed pt on
and his or her employees white wo property. Myhomeowncrs
rkig onmmP _y ,ius"ce mayriot provide coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of the limit's of my ibsurance,coveragc for injuries to workers
qn my property -
I understand building permits are .not required to be signed. by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
I understand as an "Owner -Builder" i dil I understand that I may protect
am e responsible party of record on the pe��A
1�0
myself ftorn'004ential financial risk by hiring licensed C. on't-ir; a!' the 1il' his or her name instead of my
9 Contractor and e pernut ed in
own.
4 understand Contractors are required by law to be. licensed and bonded in California and to list their license numbers on
pe its
1 an
and contracts.
5. 1 understand if'I employ or otherwise -engage any persons, other than California, licensed Contractors, and the total value
of my construction is at least five hundred dollars ($50.0), including labor and materials, I. may be considered an "employee'
under state and federal law.
14. 1 under -stand if I am considered an "employer" state and feder�kl law' with the state and federal
I must register,
----go-vemme,nty-withhold-pi-workers'-6xts-pt* -,compensaiion-disability-insuraince;-and-contn
ovide-Wo rkers
compensation for each "employee." I at . so understand my. CiLiWe to abide by. these laws may subject me to serious financial
risk.
I understand under California Contractors' State License, Law, an Owner -Builder -who builds single-family residential
Xclures cannot legally build them with the intent to,,offe I r them for . sale, unless all, work is performed by licensed
subcontractors and the number of structures does not exceed four, within any calendar year, or all of the work is performed
under contract with 'a licensed general building Contractor.
I uttticrstand a3 an O.wnd-Builder if 1 sell the property for which this perrrril is issued, 1 may be hem liable, for any
14nciol or persoaal,;UVurres iustaincd by any subsequent owner(s) that result from any latent construction defects in the
Kor' nand�ip cin rriatcriali.
9. 1 understand I may obtain more information regarding n`obligations as an "empiloyce" from the Internal YtM:v nue
ervice, the United States Small Business Administration, the:California Department of Benefit Payments, and the California
Division of industrial Accidents. I also understand l may coniact.the California Contractors":State License Board (CSLP).at l-
00 321-CSLB (2752) or www.cslb_ca_gov for more information about licensed contractors.
10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party legally and financially responsible . for roposed constnrcdon activity at the following address:
p 1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
livable laws and requirements that govem Owner -Builders as well as employers.
12. I agree to notify the issuer of this form immediately of any additions, deletions, or ch?nges to any of the information I
have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you Contract with
someone who does not have a lieense, the Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in,6vil court. It is also
important for you tounderstand that if an unlicensed Contractor or employee of that individual or firm is iujutrod while worlcing
on your property, you may be held liable: for damages. If you ob(ain x petinit.as Ow=n Builder aqd wish to hiss COntlCiOTS,
you will be r>xponsrble for verifying whot a r oiliot those Contractors ire property licixr,4ed •turd .ihd its$ Of their wodcers'
compensation inw anoe coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issuiftg,M6e...perm#. Nota: A copy of titceproputy owner's dsiver'ylsooxsef farm rtodncadoteobirrq or
other vertftcadon acceptable to the agency ' to be presented #herr the permit is irswd to va* the property
owner's signature.
Signature of property owner. , Dater [
Note: The following Authorization Form is required to be completed b)' the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENTTO ACTON PPMERTY OWNER'S_BEHALF
Excluding the Notice to Property Owner, the execgtion of which I understand.is my personal responsibility, I hereby authorize
the following persons) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project_
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of i4uthorized Agent: Tel No
Address of Authorized Agent:
I declare under penalty of perjury that I am the property owner for the address listed above and I person2lly filled out the above
information and certify_ _4 accuracy. Note_A copy_ojlhe owner s driver's, license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owners signature.
Property Owner's Signature: Date:
CIW OF LA QUINTA
BUILDNG & SAFM, DEPT:.
APPROVES w.:
I
i
p
rc�
Z_
v
-1
CIW OF LA QUINTA
BUILDNG & SAFM, DEPT:.
APPROVES w.:
V
N M
--I,-
73) 0
CIT'' OF LA QU �V� A
BUILDING &SAFETY DEPT.
APPROVED
DAT&LBY
M
M
Z
R4fF-Mk SIZE .M SPK*4C
SPEC", Roorwc "40 S"EATHW4C OR OPE" U1TMi
�:--------------
--------------------
(SEE ttoorwc; NOTE ON "ftSE)
ROOF Prtcat
r
l
CONT
Qom, ij
c 1X b SQ
STRAPS
a,T"
(4) 160 1WlS' oa T
RASTER SPAR:
t
• - _ ,�,
Olt.
a
�
• R
P06T SANG. `� �
5
OWPALIIL LE►4ctm
-
.
n `
L'
,I m SET>lAC1C,
l
2000 PS_I OOIICR1E --�
I'f1NlSF1 CRnDE'
f1rN9N
�-
tY BEL" "OIIAOE U—J
-
-------------
= PROMOS 1Nt^NCE
8E11�lEEN- POS7• .'.
AD .TE.'
O " "TTICF PATq i:
WOW 1/! y'�_Tf 6Ei,I1ZT/�1EA`TO AjG1A .
/ 11:IOua+ FA9Ctit R1f0' CAC" ; TAA-
m-
Nc a
n
CITY -OF 9A C1 IIV`TA;
BUILDING &.SAFETY DEPT.
APPROVED
ANCHOR BOLT. (EMBED
T, MIN. INTO CONCRETE)
TYP-lCAL-°'PATIO COYER
OATS Of .APPLICATP,
- OWNER'S NAME .
Q
v � v
RAFTER SPAM! TABLE=�Q Q-'
GRADING .RULES �i'�i � ALL CONSTRUCTION SHALL CONFORI
Ps 20-7o v o�� o�� ��o TO THE .PROVISIONS OF THE :.
(FEET ac INCHES pJ,`� pJ� oJ��-, 2
W
16' C�.C.
24'
4x4
4•-
4x6
8'-0"7
2x6
16_' 0_C.
1 '
14'
i '- '
1 '-0"
4x 10
4x 12
--I IV -0
17'-0
400
_ 101-0
4x 12
32
6x8
-
6x8
` N/A
2x6
16' O.C.
600
14'-0
..,,.
1. _
Cr
32"
1
N a
NIA
NOTES:
1. 32" 5RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PAT10 COVERS ONLY.
2. FOR SOLID. PATIO COVERS (NOT LATTICE.)
°4NMR WANTS MA TEO TO. 10'-0' USING
'THIS STANDARD.
LArtME ROOF`•" BUILT—UP ROOF
HEADERS HEADERS
DOUGLAS FIR NO. 1 DOUGLAS FIR NO. 1
SIZE SPAN ! SIZE SPAN
4x4
_ 5'-0`
4x4
4•-
4x6
8'-0"7
'-0
4x8
1 1'-01
a
4x 10
4x 12
--I IV -0
17'-0
400
_ 101-0
4x 12
6x8
14'-0"
6x8
6010
17'-0
600
14'-0
_ROOFING NOT S-
A. BUILT—UP. ROLLED ROOF: SLOPE TO DRAIN:
B. ROCK ROOT': 3/12 MAXIMUM PITCH.
I
SITE REQUIREMENTS
IHTE91OR LOT
SIDEYARD: 5 FEET REARYARD: 10 FEET
N NRAUM EACH SIDE'
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
:APPROVED
DATE �(«(.l. BY- I ib
L
CLTR13LINE