11-0706 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00000706
Property Address: 81212 CASPIAN CT
APN: 764-280-004-21 -35996 -
Application description:, PATIO COVER - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2248
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
.BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penslty"of perjurythat 1 am licensed under provisions of Chapter 9 (commencing with
Section =,of Divislon 3 of the Business and Professionals Code; and my Licenseds In full force. and effect.
License .Class: B License No.: 770843
.I Date: Contractor:
HRBUILDBi 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.permitdo
construct, alter, improve, demolish, orrepair 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 exempttherefrom and the,basle for the al aged 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 (9500);:
(_ 1 I, as owner of the property, or my employses.with wages as their sole compensation, will do the.work, and
therstructure is not intended or offered for sale (Sec. 7044, Business and Professions Coder 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 forsale. If, however, the building or Improvement Is sold within
one year of completion, thwowner-builder will have the burden of-provingthat he or she.did.not build or
Improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to constructthe 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, J.
1 _ 1 I am:exempt under Sec. „B:&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm,under,penaky of perjury that ;there is a construction lending -agency for the performance of the
work for which this is issued (Sec. 3097, Civ. C.h
Lender's:Name: _
Lender's Address:
LQPERMLT
Owner:
KELLEY
812.12 CASPIAN CT
LA QUINTA, CA 92253
Contractor:
LIFETIME PATIOS
PO BOX 5806
LA QUINTA, CA 92248.
(760)777-26.50
Lia. No.: 770843
VOICE (760) 777-7012
FAX (760) 777-7011
-INSPECTIONS (760) .777-7153
Date: 6/29/11
r
e G _
J1YA
I
------------------
WORKER'S COMPENSATION DECLARATION
.1 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 workJor 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 _Nmberare:
Carrier SOUTE30N INS PollcyNumber WSI0040134-01
_ I certify that, in the performance of the work -for which this permit is Issued, 1 shall not,employ any
person in any rrannerso as to become subject to the:workers' compensatlon'laws of California,.
and agree that, if I should become subject to the workers' compensation provisions,of Section
3700,ofthe Labor Code, I shall forthwith comply with those provisions.
(Date. Applicant:
WARNING: FAILURETO, SECURE WORKERS' COM TION COVERAGE'IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO. ONE HUNDRED THOUSAND
DOLLARS 08100;000). IN ADDITION TO THE'COST OF COMPENSATION, DAMAGES AS`PROVIDED FOR IN
SECTION 3706,0F THELABOR CODE, INTEREST, AND ATTORNEY'SFEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby matte to the Director of Building and Safety for permit subject to the
conditions and restrictions set.forth on this application.
1. Each person upon whosehehalf 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, indemnity and hold harmless the City
of Le Quints, Its officers,:agents and employees for any act or omission related to the work being
performed under or4ollowing 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 l have read this.applicstion and state that the above information Is correct. I' agree to comply with ail
city and county ordinances and state laws relating to building construction, and -hereby authorize represenitadves
of this'counttt:t I ea/or;upon the above-mentioned, property for inspection purposes:
koala: i � / /Signature (Applicant or Agent): ��
Application Number . . . . . 11-00000.706
Permit. . . . PATIO COVER PERMIT
Additional desc . .
Permit Fee . . . . 54.00 Plan Check
Fee
35.10
Issue Date . . . Valuation
. . .
. 2248
Expiration Date 12/26/11
Qty Unit Charge Per
Extension.
BASE FEE
45.00
1.00 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
9.00•
Special Notes and Comments
169SF ALUMAWOOD LATTICE PATIO COVER AT
SIDE YARD [ENGINEERED] THIS PERMIT DOES
NOT INCLUDE'ELECTRICAL INSTALLATIONS.
2010 CALIFORNIA.CODES.
June 29, 2011 11:.57:31 AM AORTEGA
- ---------------- ------------------------------------------------
Other-Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
----------------- - - - ----------
Due
----------
Permit Fee Total 54.00 .00
----------
.00
54.00
Plan Check Total 35.10 .00
.00
35.10
Other Fee Total 1.00 .00
.00
1.00
Grand Total 90.10 -00
.00
90.10
LQPERMIT
B'" #City
of La Quinta
Building a 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:' . Z f -
Owner's Name: <
A. P. Number:
Address: - 2OZ
Legal Description:
Contractor: bFiP-7,YE 11 % I0S
City, ST, Zip: LA Q. 7
Telephone:
Address: 01�9 /54X 59406
Project Description:
City, ST, Zip: 1A 001A)% g
Telephoner - 77.7-��Q11Q /3
State Lie. #
City Lic. #:, -3 ?59
Arch-, Engr., Designer:
Address-
city, ST, Zip:
Telephone:
State Lia #:
Name of Contact Person: dharl
Construction Type: Occupancy:
Project type {circle one): New Add'n . Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: —113sthnated
Value of Prqject: s
APPLICANT: DO NOT WRITE BELOW THIS LINE
Nl
Req'd
Reed
TRAC MG .
PERIYM,FEES
Plan Check submitted
Item
Amount
l Calc&
Reviewed, ready for corrections
Plan Check Deposit
rus alc&
Called Contact Person
Plan Cheek Balance
Energy Calcs.
Plans ticked op
Construction
Flood plain plan
Pians resubmitted
Mechanical
Grading plan'
20d Review, ready for corrections/issue .
Electrical
•�
Subcontactor List
Called Contact Person
Plumbing
GrantDeed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
Jw Review, ready for correctiouslissue
Developer Impact Fee
Planning Approval
Called Contact Perron
A.I:P.P.
Pub. Wks. Appr
Date of permit.issue
I �/
School Few
TotalTermit Fees