BPAT2016-0043r
7&495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:'
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
LIFETIME PATIOS
P 0 BOX 5806
LA QUINTA, CA 92248
T4'�p 4 4 Qaw(v
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BPAT2016-0043
79859 CASTILLE DR
609630025
HOLMES / (2) PATIO COVERS
$2,358.00
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 Professions Code,
and my License is in full force and effect.
License Class: B License No.: 770843
Date: Contractor:
OWNER -BUILDER D TION
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, 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, 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
VOICE (760) 777-7125
FAX (760).777-7011
INSPECTIONS (760) 777-7153
Owner:
TYRONE HOMES
79859 CASTILLE DR
LA QUINTA, CA 92253
Contractor:
LIFETIME PATIOS
P 0 BOX 5806
LA QUINTA, CA 92248
(760)772-0013 .
Llc. No.: 770843
Date: 6/2/2016
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'
Com
pens tion, as provided for by Section 3700 of the Labor Code, for the performance
Of th ork for which this permit is issued.
ve and will maintain workers' compensation insurance, as required by
Se of the Labor Code, for the performance of the work for which this permit
sl iss ed. My workers' compensation insurance carrier and polity number are:
Carrier:- Policy Number: _
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 becomesubject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 2 ZApplicant: / /!
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 ($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 Building Official 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 city to enter upon the
above-mentioned•pr perty for inspection purposes.
Date:1", /Co Signature (Applicant or Agent):
FINANCIAL •• •
-DESCRIPTION .° ACCOUNT, QTY AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00
$0.00
PAID BY ' METHOD RECEIPT #
CHECK #
CLTD BY
Total Paid.for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION
ACCOUNT •
QTY
AMOUNT
PAID
PAID DATE
PATIO COVER, STD, OPEN
101-0000-42404
0
$194.34
$0.00
PAID BY
METHOD =
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION - -
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PATIO COVER, STD, OPEN PC
101-0000-42600
0
$191.44
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD. BY
Total Paid for PATIO COVER / COVERED PORCH / LATTICE: $385.78 • $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00
TOTALS:00
INSPECTIONS
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, June 02, 2016 4:06:57 PM 2 of 2 J
_ SYST(titS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
`BY
BSAS SB1473 FEE
101-0000-20306
.0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
PATIO COVER, STD,
101-0000-42404
0
$194.34
$0.00
OPEN
PATIO COVER, STD,
101-0000-42600
0
$191.44
$0.00
OPEN PC
Total Paid for PATIO COVER / COVERED PORCH / LATTICE: $385.78 $0.00
SMI -RESIDENTIAL
101-0000-20308
0
$0.50
$0.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00
TOTALS:00
INSPECTIONS
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, June 02, 2016 4:06:57 PM 2 of 2 J
_ SYST(titS
Bin # -
City of La Quinn
Building a Safety Division
P.O. Box 1.504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
' Building Permit Application and Tracking Sheet
Permit #
Project Address:
S-4; E'V_-A.
Owner's Name: •
Address: - K
A. P. Number:
Legal Description: '
City, ST, Zip:A Out !Irs
Telephon! ? � M
Project Description:
Contractor: /�ETN%E 19/ -1OS
Address: Al) 14X 5806
City, ST, Zip: 1A aV11 7W 4 e'4
1 -&LA
u V /
Telephone: fIDD " 7 %�' DD 1 3
State Lic. #:* 13 -77D9 3.
City Lic. #:J
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
5' r y .
4�a"
T 4•
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:01,16f a��T//� u
Sq. Ft440Z:
# Stories:
#Units:
Telephone # of Contact Person: 760 66$ -1701)
Estimated Value of Project: s
'APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted'
Item
Amount
Structural Calcs.
Re•4iewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Coles.
Plans pickedup
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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