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04-7773 (PAT)N►" �� •�; 13 2004 QUI BUILDING & SAFETY DEPARTMENT AN P O o1 x 1504 (760).777-7012 OF T9 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application.Number `04-00007773 Date 12/13/04 Property Address 48609 PASEO TARAZO APN: 646-082-005- - Application'description PATIO COVER RESIDENTIAL Property Zoning -LOW DENSITY RESIDENTIAL Application valuation . . . 6171 Owner Contractor PETRICKA SANDRA & FRANK YBARRA CONSTR CO, TONY M. 48609 PAZEO TARAZO .566 STURGEON DRIVE LA QUINTA CA 92253 COSTA MESA CA.92626 WCC: STATE FUND WC: 6537952004 .01/01/05 CSLB: 344248 04/30/05 CCC:. C61 -D3 -C51 -D24 Permit PATIO COVER PERMIT Additional desc Permit Fee . . . . 90.00.. Plan Check Fee 58.50 Issue Date . . . Valuation 6171 Qty Unit Charge Per Extension BASE -FEE 45:00 5.0Q 9.0000 THOU BLDG 2,-001-25,000 45.00 Special -Notes and Comments TWO.ALUMAWOOD.PATIO COVERS PER APPROVED PLAN. HOA APPROVAL ON FILE.: --------------------------------------------------- ------------------------------ Other Fees STRONG MOTION (SMI)- RES .61 Fee summary Charged Paid Credited Due Permit Fee Total 90.00 .00 00 90.00 Plan Check Total •58.50 .00 .00 58.50 Other Fee Total .61 00 .00 61 Grand Total- 149.11 .00 .00- 149-.11 P.O. BOX 1504 • /� , w VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application. Number: d Y— 7%% Date: Applicant: I Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 LicensYi� in fullfarce and effect. l License Class (p ( License No. �j Date ^Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' 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 s ,M orkers' co sa ' n insurance carrier V gplin ulp ar : (Carrier '!ID�%!t(�/f�Policy Number (%(p G,'y� '/�—(% - _ 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 those provisions. XDate Applicant / WARNING: FAILURE TO SECURE WORKERS' COPENSATION CO ERAGE 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. 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 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, indemnity and hold harmless the City of La Ouinta, 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 county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Date ?% Signature (Applicant or Agent): Jrty,•nii :'Ytr:: ir':: 2 ti �, _ LAGUNA DELA PAZ.HOMEOWNERS ASSOCL4TION 48-300 Vista De Nopal, La ' Quinta, Ca. 92253 760-564-8864 Fax 760-564-8867 December 9, 2004 Sandra & Frank Petricka 48-609 Paseo Tarazo La Quinta, CA 92253 RE: Architectural Committee Review For: Patio cover at 48-609 Paseo Tarazo „ Dear Mr. & Mrs. Petricka: Laguna De . La. Paz Homeowners Association is pleased to inform you that the Architectural Committee has reviewed aid approved your plans for the installation of two (2) Alumawood patio covers at the above mentioned address as submitted. A copy of the plans you submitted signed_ off by the architectural committee are enclosed. The maintenance and replacement will be the responsibility of the homeowner, pursuant to the application agreement you signed and will run with the land in the event of a change of ownership. Upon completion, please contact Donna Gbrton in the HOA office at 5E4-8864 for a follow-up inspection. 4Sin ely Do a Gorton CCAM Association Manager For the Architectural Review Committee Laguna De La Paz Homeowners Association cc: board of directors Architectural committee File' Enclosure " `z. v d - �e �4. -,� ei S�F� '. 6.. .F.A�.Sw,.j�,2�,rC'�, .�� t -. NS.•�", `z$ �.¢-k)J�. 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