0402-169 (PAT)LICENSED CONTRACTOR 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.
License # Lic. Class Exp. Date
7 3 5 M Col D03 D52 03/01/2(
Date � �� " Q `ESignature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
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 & policy no. are:
Carrier EXEMPT Policy No.
(This. section need not be completed if the permit valuation is for $100.00 or less).
( ) 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 3700 of the Labor
Code, I shall forthwith comply with.t bse provisions.
Date:9-1-74
t'TApplicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees. .
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
'1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
she above-mentioned property
/for�spection purposes.
Signature (Owner/Agent)✓✓' - Date c.7'l Ko
` BUILNNG-PERMIT- -- PERMIT
DATE py{ �ryrr, VALUATION d' LOT, ,. -, TRACT
't
JOB SITE
ADDRESS 19-4MI PASE.0 DEL KEY
APN
. -
OWNER
CONTRACTOR / DESIGNER / EN INFER
J.AWER WERA
COAC T E.LA VALLEY SC'RIEWS MZ) AWN
79--091"AVR0 DEL. �`0 Y
R 3.48145'.gl AVE' 'CTNl'1' 7
_T.A.QY m -AA C.A 92253
WD10 CA. 92201
(760)a42-7272 ORB 4889
USE OF PERMIT
PATTO
403 A1,11MAW0101D PATIO COV—PR. HOA APPROV AJ, RECOD. 2003 CBC.
,PCRCH/1'ATIO 403,00 SP
IrSITMIATED) COWS or C0VRrd7CrJT01q
PIr.,;k$'.MiTFEE? 87 Mllfl;r.RY
PLAN CH C:Y: ME )01-000-439-318 S$2.65
CONS TPUC J ION. FEr 101 -000.418 -OW W. .00
VRONG MOTION IFEZ RREND 101.000-241.000
D Q
FEB 13 2004
CITY OF LA "INT
DEPT.
FINANCE
SUB-1"OTAT, [",O)'IMUCUOR A9.0 PIS' CHECK
$134.19
LUSS PRE -PAID F90
$0,00
P r1L1Vr0:1' F 1r,?.5 )YVF. IY43W
$1.345.1
RECEIPT
DATE r
�Y '�
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final '
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utilt.y Notice (Gas)
i ELECTRICAL APPROVALS
T("p. Power Pole
Underground Conduit
Rough Wiring
Law Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
02/12/2004 01:54 7603273278 t i SPEERBUSSVCS _ PAGE 01
ALISO LA QUINTA HOMEOWNERS ASSOCIATION
C/O SPEER BUSINESS SERVICES
200 E. Racquet Club Road, Suite H-38
Palm Springs, Ca 92262
(760) 327-3278 Phone and Fax
Kelly Grimes Robert Chavez Bob jones Jennifer Robertson Ann Rhein
President Vice President Secretary Treasurer Director
:,irr11rt�.r:.79xi.y:lMi 1'?'z wt a<<M�vryc7GF: •r.':>'!"�?tiay", a9S'tF� s ��^ r;,:;• v::;"" '` i;cln=i�. rFr ?7 r,
• �.A�t1L: 1•::: t'... .. y.{'i". .�. 1l. ,.t, �u'IN;1.. • A.: 1��•.1 �'�' :•ti�•} JT: �C.y, :T �. V 9���1Rt ^L,'.!.•. Y��6 t 1'y , 7!•P�}'
.pg... .,9i:. 4h.: r•rty,-t ....
January 28, 2004 +
Javier & Jennifer Mejia
79-409 Paseo Del Rey
I a Quinta, CA 92253
RE: 79-409 Paseo Del Rey- '
Account *io6 ,.
Dear Mr. and Mrs. Mejia:
Your Architectural Improvement Application received January 21, 2004, requesting approval for
the installation of an Alumawood Patio Cover in your back yard was reviewed and approved as
submitted by the Architectural Committee. We understand that the color will be White.
We are glad to see that you have hired a licensed and insured contractor to perform the work
and would expect that all applicable City required permits would be pulled prior to the
commencement of the work „
We thank you for your cooperation in following the guidelines set forth in the CC&R's. If at any ,.
time, a portion of the plans or related documents submitted to the Architectural Review
Committee is later determined to require significant modifications, the Association reserves the
right to require you to submit additional plans for review. In such an event, the Association may
withhold approval for that portion of the modifications until .they have been determined to
conform to the Association's requirements.
we rely on the participation of all residents within Aliso La Quinta to maintain uniformity
within the neighborhood so that the visual experience is appealing, property values increase and
the community remains a desirable place to live.
Your cooperation in this matter is very much appreciated. If you should have any questions,
please feel free to contact me.
Sincerely,
Speer Business Services
FOR ALLSO LA UINTA HOA '
Nancy Spee ,
Community Association Manager
Ce: Coachella Valley Screen & Awning
a
RAUL PEREZ ' CVS a %V%%1.CvPatios.com _
Coachella Malley Screen & Awning
The New Company with '16 Years Experience
Screens - Awnings • Doors • Windows
Alumo-Wood • Patio Covers
83480 45th Ave., Unit 7 Phone (760).342-7272
Post Office Box 1434 Pager (760) 779-2651
Indio, California 92202 license No. 735369
14
11 v
JAP/ ei,- A il
CITY OF L&QUINTA
7 9 q,9 5' P�eo do y BUILDING & SAFETY DEFT.
APPROVED
�cL au.l 4o CA. go22S3 FOR CONSTRUCTION
7
DATE Z -/- BY
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