11-1033 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00001033
Property Address:
78855 PINA
APN:
7767080-024- - -
Application description:
PATIO COVER.- RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
10214
Applicant: Architect or Engineer:
A/' V
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
(
f :r
--------------------------------------------'-------
- 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.
License Class: C51 is 'se No.: 937811
. 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 andProfessions 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. Contractor's State
License Law (Chapter 9,(commencing with Section 7000) of Division 3 of the Business and Professions Code) or
thatheor she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permitsubjects the applicant to a civil penalty of.notmore than five hundred dollars 1$500):: .
( 1 1, as ownerof 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. 704, 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,improvesthereon, -and who contracts for the projects with acontractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) 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:
LQPER1111T
Owner:
NUNEZ SUZANNE
78855 PINA ST
LA QUINTA, CA 92253
(760)534-4634
Contractor:
VALLEY PATIOS
37897 CHESTERFIELD
BERMUDA DUNES, CA
(760)534-4634
Lic. No.: 937811
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/22/11
9220
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury ane of.the followirig declarations:
I.have and will maintain. a'certificate .of'consent to self msure.for workers' compensation, as provided -
for by Section 3700 of the.Laboi Code, for the performance of the work for which this permit is
issued.
have and will maintain workers' compensation insurance; .as;requiied bi 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 SOUTHERN:"INS'CO' Policy Number WSIO047500-01
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 subjectto 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 all f rthw' compl/y /vkh those provisions.
Date: �� /Appl nt: Z�/ /
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 (4100,0001. 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 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 county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county
fto enter upon the above-mentioned property for insp cti on purposes.
Date: �ZL—I LSignature (Applicant o Agentl:
LQPERMIT
Application Number . . . . . 11-00001033
Permit . . . PATIO COVER PERMIT
Additional. desc .
Permit Fee f2:6.00 Plan Check -Fee
81.90
Issue Date . . . . Valuation . . .
. 10214'
Expiration Date 3,/20/12
Qty Unit Charge Per
Extension
:<•:.-, BASE FEE
45.00
9:00"° 9..0000 THOU' BLDG.'2,001-25'000
81.00
Special Notes, and ..Comments
INSTALL ALUMAi D'."PATIO COVER PER
APPROVED PLANS'& 2009 IBC.2009IRV, 2010
CBRC_.TOTAL. OF 768•SQUARE FEET.APPRO,VED
:
PER ST;-
-----------------_-_------------------------------------------
Other'Fees BLDG, STDS ADMIN (SB1473)'
--------------
-1:00
Fee summary Charged ' ' Pad�� . • Credited.
Due _.
Permirt,Fee Total 126:00 .00 .00—
126.0.0
Plan=~ Check Total 8.1.90 .00 -.:00
.. 8;1
Other Fee Total L:00;" :00 . 00 .
�,1, 00
_ Grand Total ...'. 2.0'8.`9;0. 00` 00
208'-:`9 0
LQPERMIT
_9.
Bin. #
Permit #
Project Address:
-City.. Of "La. Quintd
Butfding 8t Safety.Dtvlsfon
P-0—Box 1504 178-495-Catfe Tam Ico „
c; , P •
la.Qulnta, CA 92253 ..{760} 777-7012
Bui1d[n ,
g Permit:Applfcation and.:Tfickft Sheet
S. Owner's Name:. '
A. P. Number.
'Address: .7
Legal Description:
Contractor. V0L1.
City, ST, Zip:cA W7,5
Telephoner
Address: 7
Project Description
yJQ del
City, ST, Zip:. Nd, C
-
Telephone:vl'"��3"l"""�
State Lic. # : �' City Lic. #; "
�r r V�%!A.96
Arch, Engr., Designer.
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Gonstruction.Type:. Occupancy:
:project type (eircle•one): New Add_ 'n Alter Repair Demo
Sq. Ft.: 7� #Stories: #units:
Name of Contact Person:
Telephone # of Contact Person: 45_3 k4— —\ (33 !-{. ; ..
Estimated Value of Project:.. j
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Plan Sets
Req'd '
: Rcc'd
TRACICINIG PERMIT FEES'
Pian Check submitted Item Amount
Structural Calm
Reviewed; ready for corrections Plan Check Deposit. .
Truss Calcs.
Catied Contact Person Plan Check Balance.
Title 24 Calcs.
Plana picked_up Construction '
Flood plata plea
Plans resubmitted Mechanical
Giading plea
2'" Review, ready for rnrrecGonsrissue Electrical
Subeontaetor List
Called ContactPerson Plumbing
Grant Deed
Plans plcked:up. S M.L
H.O.A. Approval
Plans resubmitted: Gradiag
IN IIOIISE:-
lteylew' ready for corrections/issae : Developer Impact Pee
Planning Approval'
Called Contact Person A.I.P.P.
Pub. Wks. Appr.*
Date of permit Issue
School Fees '
Total Permit Fees