05-5385 (AR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05�00005385_ ___�
Property Address: 79870 BARCELONA DR
APN: 609-380-999-53 -293234-
Application description: ADDITION - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3633
T4ht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MARNIE LACSAMANA
Other struct info
Contractor:
Applicant: Architect or Engineer: Owner
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm underpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: - License No.:
Date: Contractor:
OWNER -BUILDER DECLARATION .
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom 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 ($500).:
( 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 and Professions Code: The
Contractors' State License Law does not 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 are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who cont cts for projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 1 am exempt under Sec. , tW.C.3or this reaso
Date:-� wvner`
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/09/05
. C
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
J issued.
G 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 and policy number are:
Carrier - - - - - - - - - - - - - - - - - - - - - -- Policy Number
_ I certify that, in the performance of the work for hich this pe is issued, I shall not employ any
person in any manner so s to become subject o the wo ers' mpensation laws of California,
and agree that, if I ould me subject to t e work ' compensation provisions of Section
3700 of the Labor C , s forthwith co ply wi those provisions.
r I
Date; �%. �) �S-Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this 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 application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
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 ork for 180 days will subject
permit to cancellation.
I certify that I have read.this application and statAd,
formation is cor ct. I ree•to comply with all
city and county ordinances and state laws relatinruction, and reby a horize representatives
of this county to enter upon the above-mentionection put ses.
Date��' I) O tSignature (Applicant_or Age
-- 7
Application Number . . 05-00005.385
Permit . . . . . BUILDING PERMIT
Additional desc .
Permit Fee 63.00
Plan Check
Fee
40.95
Issue Date . . . .
Valuation
. . .
. 3633
Expiration Date 6/07/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
2.00 9.0000 THOU BLDG 2,001-25,000
18.00
---------------------------------------------------------
Special Notes and Comments
------------------
198 SF LATTICE PATIO COVER PER CITY
STANDARD AND WIDEN EXISTING DOORS.
----------------------------------------------------------------------------
Other Fees . . . . . . . . ENERGY
REVIEW FEE
4.10
STRONG
MOTION (SMI)
- RES
.50
Fee summary Charged Paid
=------------------------------------
Credited
----------
----------
Due
Permit Fee Total 63.00
.00
.00
63.00
Plan Check Total 40.95
.00
.00
40.95
Other Fee Total 4.60
.00
.00
4.60
Grand Total 108.55
.00
.00
108.55
LQPERMIT
78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253
TELEPHONE (760) 777-7012 FAX (760) 777-7011
OWNER/BUILDER 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 "Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
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 required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contracts are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
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 by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7 12
F 0) 777 7011
OWNER'S SIGNATURE/DATE
% e% D All/L .C,�f -fir,/i yr,�
PROPERTY ADDRESS
PERMIT NUMBER(S)
PROVIDE 1' CLEARANCE
BETWEEN POST AND
NOM CONCRETE
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4' z S" LAG SCREW. THROUGH FASCIA INTO EACH RAFTER TAIL.
U -STRAP OR -ANGLE
3/6" x S' LAG SCREWS INTO 'STUDS AT 16' O.C. NON -CORROSIVE PLATE RPOE.
/--- CONTINUOUS LEDGER
(4)- 16d NAILS
OR BOLT
U -STRAP OR ANGLE
(4)- 16d NAILS
r OR BOLT
I JOIST. HANGER OR SOLID BLOCKING n
.NAIL RAFTER TO BLOCKING
PROVIDE 1- CLEARANCE .
BETWEEN POST AND
CONCRETE
BUILDING DEPARTMENT APPROVAL BELOW
C t /� ANCHOR BOLT (EMBED -
CITY ®r L.A QUINTA 7 MIN. INTO CONCRETE)
SUILDING & SAFETY DEPT.
APPROVED TYPICAL PATIO COVER
FOR CONSTRUCTION
DATE of APPucAT1oN z
OWNER'S NAME A2^ri GS MGrl�
1 ®AfiIll . �2-S.o(- BY .
STREET ADDRESS 7 6'7o - O
'• . - - .. CITY. ST ZIP'
TELEPHONE 1- �f q�- 33 �-� Z
H.O.A APPROVAL U
RAFTER -SIZE AND
SPACING
SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE —
(SEE ROOFING NOTE N REVERSE) /
TT
ROOF PITCH
CONTINUOUS LEDGER
(SAME SIZE AS RAFTERS)
EADE�jiSIZE
(� N
V /l /?l
T" AND 'L' STRAPS
I 6*xcxI"x1/6" WITH I
-------
i
1 (4) 16C NAILS OR BOLT I
W
v
RAFTER SPAN: -----
--_•-
�-
POST SPACING:_
O.H.
O.H.
J
v
OVERALL LENGTH: 14"C)
a
a2
OVERALL LENGTH.__
I
_
_____ POST SIZE: --
;o
REAR SETBACK
SIDE SETBACK (4'x47 MIN.)
�
I
'FINISH GRADE
2000 P.S.1 CONCRETE --^+1 1
FINISH GRADE 1 L,.._ MIN, 12"x12 FOOTING 1
1
L -J
L -.J t2' BELOW GRADE
PROVIDE 1' CLEARANCE
BETWEEN POST AND
NOM CONCRETE
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4' z S" LAG SCREW. THROUGH FASCIA INTO EACH RAFTER TAIL.
U -STRAP OR -ANGLE
3/6" x S' LAG SCREWS INTO 'STUDS AT 16' O.C. NON -CORROSIVE PLATE RPOE.
/--- CONTINUOUS LEDGER
(4)- 16d NAILS
OR BOLT
U -STRAP OR ANGLE
(4)- 16d NAILS
r OR BOLT
I JOIST. HANGER OR SOLID BLOCKING n
.NAIL RAFTER TO BLOCKING
PROVIDE 1- CLEARANCE .
BETWEEN POST AND
CONCRETE
BUILDING DEPARTMENT APPROVAL BELOW
C t /� ANCHOR BOLT (EMBED -
CITY ®r L.A QUINTA 7 MIN. INTO CONCRETE)
SUILDING & SAFETY DEPT.
APPROVED TYPICAL PATIO COVER
FOR CONSTRUCTION
DATE of APPucAT1oN z
OWNER'S NAME A2^ri GS MGrl�
1 ®AfiIll . �2-S.o(- BY .
STREET ADDRESS 7 6'7o - O
'• . - - .. CITY. ST ZIP'
TELEPHONE 1- �f q�- 33 �-� Z
H.O.A APPROVAL U
i
v v v
RAFTER SPAN. TABLE � -1 co c) C -)moo ALL CONSTRUCTION, SHALL.. CONFORM
GRADING .RULES S S� V moo TO THE PROVISIONS OF THE
PS 20-70 V V
(FEET & INCHES) CjA�?- OJT`'' o_l Q !
o o o
CALIFORNIA BUILDING CODE.
�o CIV I
OQSUPPLEMENTAL NOTES:
2x4 16" O.C.
24"
10'-6" i
9'-6"
HEADERS
HEADERS.
8'-6" 8'-Q" 6'-0"
`-Y
NO. 1
Slit SPAN
2x6 6" O.C.
4"
32" "
15'-0"
14'-0
10'-9"
13'-0'
12'-6" 11'-6" 8'-9"
10'-6"
10'-0". 8'-6" N A
N/A
4x10
10'-0"
2x8 167 O.C.
24"
32" "
18'-0.
17':-O"
13'-6"
16'-C
t S'-6" -6" 11'-0"
13'-0"
13'-0" 1 11'-6" N/A .
N/A
NOTES:
1. 32" RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY..
2. FOR SOLID, PAT -10 COVERS (NOT LATTICE)
RAFTER SPAN IS LIMITED TO 10'-0" USING
THIS STANDARD.
LATTICE ROOF
BUILT-UP
ROOF
HEADERS
HEADERS.
DOUC!AS FIR NO. 1
DOUGLAS FIR
NO. 1
Slit SPAN
SIZE
SPAN
4x.4 5'-0"
4x4
4'-O"
4x6 8'-0"
. 1.1'-�'
4X'6
4x8
6'-0"
8'-0"
4.x10 1 -
4x10
10'-0"
402 2 17'—O"
4x 12
12'-0"
6x8 14'-0"
6x8
12'-0"
6X10 : 17'=0"
* 6x 10
14'-0" .
ROOFING NOTES:
A. BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF:. all/ 12.,MAXIMUM PITCH..
I
Jan 11 06 12:20p Marnie Lacsamana 8183600795 p.l
01/10/08
FAX _ WVV4
31/10/2006 08:56 Be632941146 PAGE 02
ECalbo�'
Mentplan Insurance Company
P.O. Bon 25140 - Sante Ana. CA 92799-5140
HOMEOWNERS POLICY DECLARATIONS
I d•
Mail To:
71-0018
Named assure -
MARIANO LACSAMANA AND AGNES
e26-2151
UNIVERSAL AMERICAN INS
AGENCY
LACSAMANA
5750 NW PARKWAY SUITE
00
79-7S0 BARCELONA DRIVE
SAN ANTONIO, TX 78249
Fra%: 10.14-05
LA QUINTA, CA 92253
Covered Property:
THF ADDRESS OF THE RESIDENCE PREMISES
I
Agent:
79-780 BARCELONA.DRIVE
Section 1
UNIVERSAL AMERICAN INS
LA QUINTA, CA 92253
$233,000 $500.00
AGENCY
s $23,300
Coverage C - Personal Prop
5750 NW PARKWAY SUITE 100
Coverage D - Loss of Use
$93,200
SAN ANTONIO, TX 78249
Coverage E'- Personal Liabi
Agcnr Codc: 59303
For Customer Service Call: (888)
71-0018
For Claims Call: (868) 768-2096
Policy Number
Company Program
MlW 000373190
Meritplan Insuranoc Company Platinum PI❑s
Policy Period
Fra%: 10.14-05
To: 10-14-06
12:01 A.M. STANDARD 'GIME AST
THF ADDRESS OF THE RESIDENCE PREMISES
I
Coverages
Limib of Liability Premium
Section 1
Coverage A - Dwelling
$233,000 $500.00
Coverage B - Other Structur
s $23,300
Coverage C - Personal Prop
$163,100
Coverage D - Loss of Use
$93,200
Section H
Coverage E'- Personal Liabi
ch currence) 5300,000 S15.00
ity (eaoc
Coverage F - Medical Paym,nts
(each person) 51,000
Deductible
All Pcril Deductible (Section 1)
$1,000.00
$4603E -00E1104
AGENT COPY
Page t of,
Jan 11 06 12:20p
01/10/06 10:21 FAX
01/10/2006 08:56
Policy Forms and
Form Number
HO 00 03 04 91
HO 01 04 02 00
HOD4960491
HZ 1 SJ .R 11)99
H431E E0301
H4521500 WSW
361REOOt M03
41-146100 E0602
43R 1317-1) NS
4H26 IE E1099
H0907R2
Marnie Lacsamana
ee
8183600795
dorso.d, rots
Tort Description Prernium
HOMEOWNERS POLJCY-SPRCIAL FORM
SPFC14 PROVISIONS -CALIFORNIA
NO ST3C; 11 FOR HOML DAY CARP,
POLICY JACKL'T
ACTU;��ND
L CASH VALUE DEFINITION
MOLD FUNGI LIMITATION - SbC:TION 1
SS000 -ECTION 11$21; 000 INC
ACTUAL CASH VALUE
PLUS PACKAGF. ENDORSEMENT
LENDERS LOSS PAYABLE
MORTGAGE PAYMENT PROTECTION 57.00
WORiiI£R5 COMPFNSATIUN J
NOTICES
California Residential Property In
Consumer Affairs - California
Community Service Statement
Bill of Rights
Privacy Notice
The limit of liability for this stns
including an approximate cost for
about your haute.
Total Premium
Diaclosum
WJ vv� I° 2
PAGE 04
(Coverage A) is based on an estimate of the cost it., rebuild your home,
?r and materials In your arra. and 9peCiftc infortt78tion that you have provided
Important Information
Policy includes Coverage for Ordinance or Low
Policy Included Coverage for Extended Replacement Cost Dwelling
Policy includes Coverage for�ersonal Property Replacement Cost
POLICY DORS NOT INCL[PDE FLOOD OR EARTHQUAKE COVERAGE
Discounts\ Surcharges Applied
Protective Dcviec
Platinum Community
Age ofDwelling
Other Interest
1
Mortgagee I`
UNIVERSAL AMERICAN MOI TGAGE CO /
700 NW 107TH AVE- 3RD FLCkpR v
MIAMI, FL 33172
Lono Number 000473707 9
AGENT COPY
H603E•DOM1104 Page 2 of
1.•.OKd Datc: 12111112n(Is
Jan 11 06 12:20p
01/10/06 10:21 FAX
I
51/16/2006 08:56
A
1
i
I
I
I
Marnie Lacsamana 8183600795 p.3
4yuu4
8693294846 PAGE 03
RATING INDORMATIUN SHEET
(For Agent )nrnrmptiun Only)
Agent:
UNIVERSAL AMERICAN INS
/AGENCY
5750 NW PARKWAY SUITE 100
SAN ANTON(O, TX 78249
Covered Property:
79480 BARCELONA I)RIV%.
LA QUINTA. CA 92253
Named Insured: MAKIANO LACSAMANA AND AGNES LACSAMANA
policy Number: MMD 000373180
RATING FIELD
J'OL[CY INFORMATION
Number of Unit%
I
Construction Type
Frame
Territory
003
Ycar Built
2005
Protection Cla.%s
03
Payor Ipayment plan
Martgagec / An,"ual
Square Feet
2083
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:
Owner's Name: �y '� G CUyn an A.
A. P. Number:
Address: 1 7113 8ehne-s— Ale.
Legal Description:
13 _
City, ST, Zip:��
0ew-
Contractor:
Telephone:
Address:
Q
Project Description:
City, ST, Z
ooy
St2. !t3' 0 7 3 L%^
Telephone:
State Li .
Arc., ngr., Desig
D
17 p
Ci ic. #:
Address: o
a
a
W
City, ST, •
Telephone:
Construction Type: PA-)-;b 44vejL.Occupancy: �S
State Lic. #:
Project type (circle one): New. Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: Ili}} e,6
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Projectk �
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs..
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2"" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7r4 Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees