09-0644 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
DO
09-00000.644
81676 CHARISMATIC WY
767-630-035= - -
PATIO COVER - RESIDENTIAL
LOW DENSITY RESIDENTIAL
51.74.
c'�1J11�1, J1i',l�M�1ll�r�
Architect or'Engineer:
aim
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
WILLIAM L..ROHDE
81676 CHARISMATI
LA QUINTA, CA 92
(
Contractor:
PELLETIER PATIO
79275 DESERT STF
LA QUINTA, CA 92
(760)275-7593
Lic. No.: 860958
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
6/25/09
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATIONMECLARATION
I hereby affirm under penalty of perju-' ioensed.undei provisions,of Chapter 9'(commencing with
f: hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the sines and ProTE ionals Code, and License is -in full force and effect:
I haveland will maintain a certificate. at consentto-self4nsure for workers' compensation, as provided.
License Cl ss: B' License No 8 0958
70
for by Section 30 of the Labor Code, for the performance!of the work for which_this permit is
�A
r issued.
.
ate: OC, actor.
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 thisipermitis.issued. My workers' compensation
WNER-BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of,perjum exempt from the,Contractor's State License Law for the
Carrier E7 • MPT Policy Number EXEMPT
following reason, (Sec. 7031.5; Business and Professions Cade: Any city or county that requires;a permit toI
certify that, in thezperformance'd the work for which this permit is issued, I'shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its'issuancei also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws'.of California,
permit to file a signed statement that he or she is. licensed pursuant to the provisions of the Contractor's State
and,agree,tha6;rf,l come subject t workers' compensation.provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the'La r Code, I sit forthwith'forriply with those provisions.
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 toa civil penalty of not more than -five hundred dollers'($5001•:
(_) I,. as owner of the property, ormy employees with wages.as their sole; compensation, will do the work;,and
thwstructure.is not:intended,or offered for sale (Sec. 7044, Business and Professions Code: The
contractors' State,Ucense Law does not apply to an owner of property whe.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 !a 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.).
(_ I li as owner of the property; am exclusively contracting with licensed contractors to construct the project (Sec,
7044, Business and.Professiorw Code: The Contractors' State License. Law does not apply to an owner of
property who builds,or improves,therson, and who contracts for the projects with a contractor(s) licensed
pursuant to the'Contractors' State License Law.).
(_) I am exempttunder Sec. ; BA&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:
Lender's Address: 0 Ir
LQPERMIT
WARNING: FAILURE TO SEC E WO ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER'TO,CMIOWAL PENALTIES AND CIVIL FINESUP TO ONE HUNDRED THOUSAND
DOLLARS•($100,0001• 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 fora 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 arid 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 Quints, 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 otthis 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 1BO:days,will subject
permit to.cancellation.
I. certify that I have read this application and state. ormation is torr ree to comply with all
city and y ordinances and state laws rela ' to building const coon, and hei6by aujhorize representatives
of thisIgounty to enter upon the above -menti ned props for in ion purpo
f16
a nature (Applicant or genu:
t/
Application Number . . .. . . 09-,00000644
Permit. . . . PATIO COVER
PERMIT
Additional desc .
Permit Fee . . . . 81.0.0
Plan Check
Fee
52,.65
Issue Date . . . .
Valuation
. .
51.74
Expiration Date 12/22/69
Qty Unit Charge Per
Extension
BASE
FEE
45.00
4.0.0 9.00.0,0 THOU BLDG
2,0.01-2,5,00,0
36.0.0
----------------- - ---.
Special Note's and Comments
389 S.F. ALUMAWOOD LATTICE PATIO
COVER,
PER APPROVED PLANS. 2.007 CODES
--------------- -------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
STRONG MOTION (SMI)
- RES
.;52
Fee summary Charged
Paid Credited
Due
Permit Fee Total 81.00
.00
.0.0
81.00
Plan Check Total 52.65
.00
.00
52.65
Other Fee Total 1.52
.00
:00
1.52
Grand Total 135.17
.00
.00
135.17
CITY OF LA QUINTA
BUILDING
TY DEPT.
APPROVED
FOR CONSTRUCTION
DA � -DiBY
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JUN -08-2009 MON 11:51 AM DESERTELITE
Jun 08 2008 11s090M DESERT MANAOEMEMT
FAX NO. 760777991,8
7608621210
ARCWTECTURAL ColVI11 MEP, TMCATE
(Bxmbit 4W, to the Arcbltocture►1
Impm"=ent Application and fta=eat)
The ArehiteCWW lmprovmnm t Apptimdon.and ARreemM wea`raviewed by the
b
prChitectrel Comnsitts en _� and has een;
AVrwed Condttioad .AgPmved X43
S'Utt*t to the Wowing
Conditions ant forth below
Rammed for Further h&rAWI0n
RAquited Modify docs
Catnanarlte-
Yes No Recowft to be ma -by amar to COmWReoordOr'e om`f mormdlnr
e0[teriOl wall modi,Saati�ona,
— Deposit Ptegoired
40 " —
Data
Arohitectmw Coum ittee
prcbitealurul Committee
NOTZ-, TATS APPROVAL IS VALID POR 90 DAYS FROM APPROVAL MTL`
P, 03
P.3
gin #
Cit of La
CiQuinta
BwMng 8T Safety Division
P-O: Box 1304, 78.495 Calte Tampico
La Quinta, CA 92253 - (760) 777.7012
Building permitplication and Tracking Ap g Sheet
Permit # l�
Project Address: I �'% (, C O o' i S rh.l�ifC
Owuec's Name: l( 1` 0-V Y1
A. P. Number:
Address: (o0�!r l3 VY�g3{i t` I.0
Legal Description:
Contractor: Puez-t.4— t'*v
Address: ` r1,"� j Q,Y Urq— � �,�,
City, ST, Zip: L.& Q v►'i v't'z'. ' CA 012 2 3
Telephone;
ProjectDescription: vt1 t eAi, c.Q
City, ST, Zip: C4 9'I 2 2 � 3
Telephone: Ct
p � yFi►� 3 iJ �) Q
State Lie. # :G(5 City Lic. #:
Arch., Engr., Designer.
Address:,
City., ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: GLVlAe,5- iE C Vc,/4
Construction Type: Occupancy:
Project type (circle one): Now. Add'n Alter Repair Demo
Sq. FL: 3 S"i
#• Stories:
#Units:
Telephone # of Contact Person: a —7'S - "15 013 Estimated Value of Project: 852,7
APPLICANT:. DO NOT WRITE. BELOW THIS LINE
#.
Submittal
Req'd
Rec1d
TRACMG
PERMITTEES
Plan Sets
Plan Checksabmitted
Item Amount
Structural Cala.
I
Reviewed„ready;for corrections
Pian CheckDeposit
Trans Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction
Floodplain plan
Plans resubmttted
Mechanical
Grading plan
2"! Review, ready for corrections/issue
I Electrical
Subconta¢6r. List
Called Contact Person
Plumbing
Grant Deed
Plana picked.ap.
S.M.I.
K.O.A. Approval
Plans resubmitted
'Grading '
IN HOUSE:-
'a Review, ready for correctiomlinue
Developer Impact Fee
PlanuingApproval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue _
--
—
School Fees
Total Permit Fees