10-0741 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
10-00000741
78001 RED HAWK LN
623-490-006- - -
PATIO COVER - RESIDENTIAL
LOW DENSITY RESIDENTIAL
4934
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.
License Class: B Li nse No.: 921518
//-"Date: 11—L-1 Contractor: Lam/
«</ OW - UILDER DECLARATION
I hereby affirm under penalty of perjury that I am mpt 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 build or
improve for the purpose of sale.).
1 _ 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
pursuant to the Contractors' State License Law.).
I—) 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:
LQPERMIT
Owner:
KURASZ KENNETH & RAMONA
1561 N COLUMBUS AVE
GLENDALE, .CA 91202
Contractor:
GRISA ENTERPRISES INC
44695 SAN BENITO CIRCLE
PALM DESERT, CA 92260
(760)341-0555
Lic. No.:.921518
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/08/10
Nov os Zoro 191
C TYoFLA
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declaratioris:
_ 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 MANF INS Policy Number 201001014689
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 wi those provisions.
bate// --/U A cant:
WARNING: F RE TO SECURE WORKERS' COMPEN ION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 au orize representatives
of this county to enter upo he above-mentioned property for inspectio purposes.
Da
Date: �! Sl^ /.� gnatura (Applicant or Agent
l:
LQPERMIT
amu..
Application Number . . . . . 10-00000741
Permit . . . PATIO COVER PERMIT.
Additional desc .
Permit Fee . . . . 72.00 Plan Check.Fee
46.80
Issue Date valuation
. . .
. 4934
Expiration Date 5/07/11
Qty Unit Charge Per
Extension
BASE FEE
45.00
3.00 9.0000 THOU BLDG 2,001-25,000
27.00
------------------------------------------ ----------------------------------
Special Notes and Comments
371SF PATIO COVER TRELLIS/VB/RES73
[ENGINEERED] THIS PERMIT DOES NOT
INCLUDE MECHANICAL, ELECTRICAL OR
PLUMBING INSTALLATIONS. 2007/2008
CALIFORNIA BUILDING CODES.
November 1, 2010 8:38:13 AM AORTEGA
----------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
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 1.50 .00
.00
1.50
Grand Total 120.30 .00
.00
120.30
LQPERMIT
Bin #/
City of La Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Qulnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 0 0 /��
Owner's Name: ��=� �� t� R q, M O A k (/r ll
A. P. Number:
Address: o p d a Wit L-dn
Legal Description:
City, ST, Zip: 1- ,�a2 2
Contractor: • a it n
Telephone:
Address: 2— 9 Z r co( t-ar I it, Gtr
rojectDescription:
City, ST, Zip: Pd 2-2-60
Telephone: `?
.:
State Lic. # : q2-157(
City Lie. #4.10150 ZArch.,
Engr., Designer
Address:
City., ST, Zip:
Telephone:
State Lie. #:,
Name of Contact Person: �y �Q
Construction Type: Ad v Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: ()
#Stories:
# Units:
Telephone # of Contact Person: 7,
Estimated Value of Project: 'J g
Df` t I ' ,jr "3
APPLICANT: DO NOT WRITE BELOW THIS LINE /
N
Submittal
Req'd
Recd
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted 8 R Item
Amount
Structural Calcs.
Reviewed, ready for corrections
i74
tio Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Pians picked up &Cbd Construction
Flood plain plan
Plans resubmitted / Mechanical
Grading plan
2i° Review, readyf co r ssue 4 '�tQ Electrical
Subcontactor List
Called Contact Person e� 0 Plumbing
/!�
Grant Deed
Plans picked up. 43 Q S.M.I.
H.O.A. Approval
Plans resubmitted �,�j' Grading
IN HOUSE:-
''d Review, ready for correctionstiissue 114LO -Developer Impact Fee
Planning Approval
Called Contact Person.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
[7
Total Permit Fees
1111'1 (g6to - 95-1moor oor Pe'•.
'7115 >iatc-e-' --§, zh Y
ij%o w - #564m l'
I -0/1b a -0,407t.5
4"-41 412q
&.0- /o%z8
«l►lam - 951;�* M&Ab
Mpe (OWA*40 a-