07-1215 (PAT)Im
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application'Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
C00001215
57770 RESIDENZA CT
764-010-011-86 -30092 -
PATIO COVER - RESIDENTIAL
LOW DENSITY RESIDENTIAL
4309
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 License is in full force and effect.
Licenseflast: B C36 License No.: 483069
ate: 20 � ontractor:
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, atter, 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).:
(_) 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, 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
pursuantto the Contractors' State License Law.).
1 1 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:
Lender's Address.
LQPERN11T
Owner:
JESSE FRESCAS
57770 RESIDENZA COURT
LA QUINTA, CA 92253
sD
Contractor:
OUTBACK PATIO & SUNRtN
1450 W 6TH .STREET, #YIE
CORONA, CA 92882
(951)778-9439 - L
Lic. No.: 483069.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/20/07
INC.
APR 2 U 2007
CIi1l OF l Q(IINT A
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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.
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 0003022-2007
_ 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
700 of the Labo o_ de, I s forthwith comply with those provisions.
ate: 107 licant:
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 (5100,000). 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 ounty ordinances and state laws relating to buildin nstruction, and hereby authorize representatives
of this c my o enter upon a above-mentioned property o inspection pur .
ata ignature (Applicant or Agent):
Application Number . . . . . 07-00001215
Permit . . . PATIO COVER PERMIT
Additional desc
Permit Fee . . . . •72.00 Plan Check
Fee..
46.80
Issue Date Valuation
4309
.. Expiration Date 10/17/07
Qty Unit Charge . •Per •
Extension .
♦ BASE FEE
45.00
y 3.00 9.0000 THOU BLDG 2,001-25,000
27.00
------------------------------------------------------------
• Special Notes and Comments
----------------
_
324 S'.,F..(18' X 181) ALUMA-LATTICE
• PATIO COVER AT SIDE OF HOUSE
----------- ------_-_---------- ---------- ----------
Other'Fees' `. STRONG MOTION (SMI)
- RES-
.50
Fee summary Charged_, Paid Credited
Due
Permit Fee Total -'72.00 .00
.00
72.00
Plan Check Total 46'.80 .00
.00
46.80
Other Fee Total .50 .00
.00
.50,
Grand Total 119.30 .00''
.00
119.30 `
(800) 37 -PATIO
OUTBACK PATIO & SUNROOMS INC... (909) 272-4997
1450 W. Sixth Street #118 Corona, California 928Sz-65vl
REAR PROPERT Y LINE
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FRONT PROPERTY LINE
Bin #
City of La Quints
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777.-7012
Building Permit Application and Tracking Sheet
Permit.# :
^
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Project Address:
Owner's Name: Se II �C, i`S S
)O�
A. P. Number: 6 - `1 b .d , 0 I
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Address: �7 (� �'. fb PnZ C-1� .� V
Legal Description:
City, ST, Zip:
Contractor:Tele
0A,t,.,y_ c o v► �oaM,S
P hone:
-' ��+•
Address: Q l{ SO 0I
Project Description:
I C�
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City, ST, Zip: Lath n4. C4, • qa 2-- .
1.I
; b (DQ c f L
Telephone:
State Lic. # : �{ (�
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
r
Telephone: •
State Lic. #:
`` y ^ �r�sI
z,
Construction Type: Occupancy:
Project tyPa circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sjc rS- ; /l��(
__
Sq. Ft.: �a
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: Sao
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING.
PERMTT 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
Energy Calcs. '
Plans picked up
. Construction
Flood plain plan
.Plans resubmitted
Mechanical
Grading. plan
2°" Review, ready for correctionsrissue •Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" 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'
f