12-0121 (PAT),� Lam•
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 1�2= 000_012:1= - -
Property Address: 43630'PI ES CT
APN: 609-470-076-14 -23773 -
Application description: PATIO COVER - RESIDENTIAL
Property Zoning: - LOW-DENSITY RESIDENTIAL
Application valuation: 931
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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.
Lice Cla B license No.: 770843
Date: Co ctor:
-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, 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
'-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).:
(_ 1 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 buildor
improve for the purpose of sale.).
(_) 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.).
(_) 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: PIP
LQPERMIT
Owner:
WAXLAX KENNETH B
43630 PISCES COURT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: - 2/08/12
LA QUINTA, CA 92253
-~ �—
f'r0� q i7
Contractor:
201 y :
LIFETIME PATIOS
;
PO BOX 5806
LA QUINTA, CA 92248
C,
(760) 772-0001
Lic. No.: 770843
I
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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 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 and policy number are: '
Carrier SOUTHERN INS Policy Number WSI0040134-01
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 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 abor Code, I shall forthwith comply with those provisions.
9�e: pplica :
/WARNING: AILURE TO SECURE WORKERS' MPENSATION COVERAGE 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.
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 toe r upon the above-mentioned property for inspection purposes.
te: �Vi4e
(Applicant or Agen .
Application Number . . . . . 12-00000121
Permit . . . PATIO COVER PERMIT
Additional desc .
Permit Fee . . . . 25.00 Plan Check Fee
16.25
Issue Date . . . . Valuation . . .
. 931
Expiration Date 8/06/12 „
Qty Unit Charge Per
Extension
BASE FEE
15.00
5.00 2.0000 HND BLDG 501-2,000
10.00
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Special Notes and Comments
70 S.F. WEATHERWOOD INSULATED PATIO
COVER. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
STRONG MOTION (SMI) - RES
.50
Fee summary Charged Paid Credited
Due
Permit Fee Total 25.00 .00 .00
25.00
Plan Check Total 16.25 .00 .00
16.25
Other Fee Total 1.50 .00 .00
1.50
Grand Total 42.75 .00 .00
42.75
LQPEPMIT
Bin #
City of La Quinta
Building St 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: 3 S
Owner's Name:
Address:
A. P. Number:
Legal Description:
City, ST, Zip:
Telephone: 0- Wb p970A
Contractor://FET/MLC7 f%%/BS
Address: P® �O�I(ng0��}
Project Description:
City, ST, Zip: A &1A)%H- eA
L -
Telephone ,,?-,0d 3
_
MA &Mot /a J( 7
State Lic. # : %3 -7 7o8 3.
City Lic. #: 3aS8
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
P
State Lic. #:
�51t
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Construction Type: Occupancy:
Project type. (circle.one):New Add'n . Alter Repair Demo
Name of Contact Person: ��/�s f
Sq. Ft.: # Stories: # Units:
Estimated Value of Project: d
Telephone # of Contact Person:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACIONG .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs..
Reviewed, ready for corrections
Plan Check Deposit
Truss Coles.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
�:.
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
1n° Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
STARLIGHT.DUNES HOMEOWNERS ASSOCIATION
c/o Personalized Property Management Co. �
January 25, 2012
h
KEN WAXLAX
43-630 PIECES COURT
LA QUINTA, CA. 92253
Re; Architectural application approval for addition of patio cover, 43-630 Pieces Court, Sbr/i4ht
Dunes Homeowners Association
Dear Mr. Waxlax:
The Architectural Committee/Board of Directors have reviewed your request for the addition of a
patio cover at your home adjacent to. the side of your property. We appreciate your adhering to
the Architectural Guidelines and procedures by submitting an application in advance of your
undertaking.
After review, the Board has approved your proposed addition, as submitted.
With receipt of this letter, please .feel free to proceed with your project in accordance with the
specifications and application submitted and approved. Per the Guidelines, we understand that
you are anticipating this undertaking in the very near future and will appreciate your contacting
us to evaluate the project for adherence, upon its' completion.
Again, we appreciate the time and proper course of action you have taken in the planning of this
exciting project and look forward to sharing in this outcome and finished product with you, as
your neighbors. We wish you the best in your endeavor!
FOR THE STARLIGHT DUNES HOMEOWNERSASSOCIATION
BOARD OF DIRECTORS
Sincerely,
Michael W. Livingston CCAM
Community Manager, Starlight Dunes HOA
Director of Management
Personalized Property Management Company
cc: Board of Directors
File.
68-950 Adelina Road
Cathedral City, Ca. 92234
(760) 325-9500 fax (760) 325-9300
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