06-4243 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4'yl 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
06-00004243'
Property Address:
81837 CONTENTO
APN:
767-200-011-13 -318742-
Application description:
PATIO COVER - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
5706
Applicant: A,)
Architect or Engineer:
P I PC-
--------------------------------------------------
LICENSED CONTRACTOR'S 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 Li ense is in full force and effect.
License Class/ D93 -D24 n License No.17348
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 (commencingwithSection 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).:
(_ 1 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 _ I I, 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 contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
I—) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
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: ,1
Lender's Address: 1"
LQPERMIT
Owner:
BARBARA VINCENT
81837 CONTENTO
LA QUINTA, CA 92253
VOICE (760) 777-7011
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/11/06
Contractor:
YBARRA CONSTR CO, TONY DEC ZOOS
566 STURGEON DRIVE Llr
COSTA MESA, CA 92626
(714)979-5493 ' CITY OF LA QUINTA
Lic. No.: 344248 FINANCE DEPT.
-----------------------------------------------
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 and policy number are:
Carrier STATE FUND Policy Number 0653795-2006
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
3100 of the Labor Cod I shall forthwith comp) those
provisions.
D /I .D/A cant:
WARNING: FAILURE TO SECURE WORK E S' COMPENS ION 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 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 c "ty ordinances and sta laws relating to building construction, and hereby authorize representatives
of this un to /n7te/r upon th ove-mentioned property f r inspection purposes.
ate: t'/ fJA cure (Applicant or Agent):
Application Number . . . . 06-00004243
Permit
PATIO COVER
PERMIT
Additional desc .
Permit Fee . . .
. 81.00
Plan Check
Fee
52.65
Issue Date . . .
.
Valuation
. . .
. 5706
r- Expiration Date
6/09/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
4.00 9.0000 THOU BLDG
2,001-25,000
36.00
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Special Notes and
Comments
429 S.F ALUMAWOOD
LATTICE PATIO COVER
'
----------------------------------------------------------------------------
Other Fees . .
. . . . . STRONG MOTION (SMI)
- RES
.57
.Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
81.00
.00
.00
81.00
Plan Check Total
52.65
.00
.00
52.65
Other Fee Total
•.57
.00
.00
.57
Grand Total
134.22
.00
.00
134.22
.1 .
LQPERMIT
Bin #
City of La Quinta
Building 8L Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (619) 777-7012
Building Permit Application and Tracking Sheet
Permit #
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Project Address: g % �� r�
Owner's Name:
c 1.
Address: 91IS17 Q / v 52101-
A. P. Number:
Legal Description:
Contractor: ry, F
City; ST, Zip:'/✓' /
Tele
Address: r66 (,� G116 " 19k,,
Project Description:
City, ST, Zip: 6 �/` ?'/' C r
�r
I I 1-7Xlr,r 4t--
qQ
Te e hon r —Jr
I :
r
State Lic. #: 3q/ City Lic. #: ®
Arch., Engr., Designer:e
"
Address:
City, ST, Zip:
Tele hone:
:`iPState Lic. #:
Name of Contact Person:
Construction TYe/
POccupancy:1 5
roJect tYP (circle one): Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Grant Deed
Plans resubmitted
Mechanical
School Fees
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Planning Approval
Plans picked up
S.M.I.
Pub. Wks. Appr
Plans resubmitted
Grading
H.O.A. Approval
'" Review, ready for corrections/issue
Developer Impact Fee
Called Contact Person
A.I.P.P.
Date of permit issue
Total Permit Fees
Torry M. Ybarra
CenSEr Co.
566 Swgi o Dr. PLOT PLAN
' COM Mesa. CA 92626-3145
NAME RB/R, PRO
SITUS ADDRESS v amoary
67 rGo,/f R 1-f g t4-
TRACTIPARCEL MAP 1-4 �/ LOT
ASSESSOWS PARCEL NO.
REAR PROPERTY LINE
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
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