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13-0286 (PAT)P.O. BOX 1504 78-495 CALLS TAMPICO LA QUINTA; CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 13-00000286 Owner: Property Address: 60193 PRICKLY PEAR LN STAN REDMAN APN: 764-270-999-64 -300232- LA QUINTA, CA 92253 Application description: PATIO COVER - RESIDENTIAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 940 Contractor: Applicant: Architect or Engineer: GOLD STAR CSTM PTG `_I �( 42335 WASHINGTON ST PALM DESERT, CA 922 1 � (760)574-1043 Lic. No.: 855623 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. LicenseCla s: 233 C51 ��e!!!!&" License No.: 855623 Date: I Contractor r 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 and Professions Code: Any city or county that requires a permit to construct, altcr, improve, demolish, or repaii 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).: (_) 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 ISec. 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.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec. 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.). 1 ) 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: LQPERDI IT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 .Date: 3/15/13 e � - LQ 11 MAR l 5 2013 CITY OF LA QUINTA FINANCE DEPT. 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 �h issued. - 1 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 PREFERRED EMPLR Policy Number WKN1438262 _ I certify that, in the performance of the work for which this permit is issucd, 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 shout me subject to the workers' compensation provisions of Section "FAILURE 0 of the labor 0 e, I , h 11 forthwith comply with those provisions. - Dave:Applicant: WARNTO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 i formation is correct. I agree to comply with all city and county ordinances and state laws relating to buildi uction, and hereby authorize representatives of this ty t enter upon the above-mentioned prope for s ction purposes. DeME 5WSignature (Applicant or Agent): r� 02 Application Number . . . . . 13-00000286 Permit PATIO COVER PERMIT Additional desc . Permit Fee .. . . .. 25.00 Plan Check Fee 16.25 Issue Date . . . . Valuation . . . . 940 Expiration Date 9/11/13 Qty Unit Charge Per Extension BASE FEE 15.00 5.00 2.0000 HND BLDG 501-2,000 10.00 ---------------------------------------------------------------------------- Special Notes and Comments PATIO COVER - 215SQ FT, FREE STANDING DURALUM 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 LQYF FiA117' ` Pemift # ProjectAddtess: �? , ] • City of L a .Qulf f Bw7dhg 8r Safety Dhwon P.O. Box 1504,-78-495 Cage Tampico 4.Quh4 CA 92253--:(760) 777-7012 Building Permit Application and Tracking Sheet : e� •Owner's Name:. A. P. Number. Address. �� ✓ .. Lei* bion Contractor. n � l�1 �� City. ST, Zip: Telephone: Address: `J QrSYI� -S4- - e%i)esCriptian: City.ST.Tp: Lf N'1�/'(LVe&: TdephoaG '260 �%Y' 10q; : State LiaCity 2211 Lic. f 46,/ Fj�Q ,TJX-"p}s, Address: City. ST. Zip: Telephone: State Lie B: Gatasnttdion type: Oeatpanqy. . Project type (cirde one): New Add'n Alter Repair Demo Name of Contact Pelson _ Sq. FL: Stories d Units Telephone # of Contact Person Estimated Value of Project 3 APPLICANT: DO NOT WRITE BELOW TMS UNE ff Submittal Pian Sets Req'd 'Reed d . TBAtI@IG Plan Cheek anbmitted PEPIOUFi3ES• Item Amount Structural Cales. Reviewed, ready for eortectioes Pian Cheek Deposit. . Trow Cales• Called Contact Person Plan Check Balance Title 24 Cales Pians picked up Constracdon Flood plain plan Picas resubmlftM.'. Mechanical Grading plan i'! Review, ready for correetiouirtme Electrical Subcoataetor Ust Called Coataet Person Plumbing Grant Deed Plans pidted up S, H.O.A. Approval Pians resubmitted Grading w KOUS&- 3" Review; ready for eorrecfionsilme Developer impact Fee Planning A.pprovai- Called Contact Person Pub. Wks Appr • Date of permit issue School Fees Total Permit Fees CITY OF � QTMIpEPT. BUILDING FOR CONSTRUCTION 6\�7 DATE