9907-163 (COMB)LICENSED CONTRACTOR 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 # Lic. Class Exp. Date
Date r Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracti Ith licensed
contractors to construct the project (Sec. 7044, Business &r Professionals
Code)!- IN
Q/1 am exempt under Section B&P.C. for. this reas6
Date Signature of Owner, z—
WORKER'S COMPENSATION DECLA TION
I hereby affirm under penalty of perjury one of the followi(�g declarations:
( ) I have and will maintain a certificate of consent to self -in for workers'
compensation, as provided for by Section 3700 of the Labo 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 & policy no. are:
Carrier Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
( 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 with t•ose provisions.
Vate: Applicant•, i �
Warning: Failure to secure Workers' Cbrrfpensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null aia_(64,7if
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection1 urposes.
$in/
ature (Owner/AgCnn. f) =_
Q
PERMIT #
BUILDING PERMIT
X1,907-163
DATE VALUATION LOT TRACT � t
07/4181199 S4,987,N)
JOB SITE
APN
�t �]
ADDRESS 43•-58 SAIAMNO �.'�.sURT
OWNER
CONTRACTOR/DESIGNER/ENGINEER i
LARRY3 HOUSER
Mrh1I:RMILDER
43-587 SALERNO COURT
43-587 SALERNO COURT
LA QljlNlA CA 92253
1,A QuIN'1'A CA 92253
(760)345_6478 CBL#
USE OF PERMIT
COMBINATION
\ -
i.r1T11CF MT -10 COVER. 10`X 37.5'. H't1TuR> GAS :Link: FOR. P 0A.
HEATER.
P4riCsoxno 375.N) Cis
NV, o�aa".F0 COST Or, %C0i�i3TrUC'r11ON
44��7.5^
PERMIT FEE, SUMMARY
K A N CHECK FEE 101-000-439-318 $46 80
tY)Ar d T'i2f 1(71(1N F{ F 1014,) on -4 1 "i-rm $7,"., ftq
S 0140., M(YrIOa l FEE', RE= 1011000-1241-M10 S.50
F=I.fJNififlsU F'Li: 101-013 lid-U(H) $1i1 W
.
1 r11 T11'A 1, COM;.rRUC" ETON A ATO PLAN C:} ECK
LESS PRE -PAID FEES
'10FAL PERMIT 111r.1fS 0114, NOW
S137,30
RECEIPT
DATE
BY t
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing lifer
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final --
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping 41 At
Gas Test Vill
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
"Utility Notice (Perm)
COMMENTS:
F RAF -TER, SIZE ANG SPAC:lNc,
2 Y, fo _2_�Vl o
/ /
"u
fCONTINUOUS LEDGER
SPECIFY ROC)FINr, AND SHEATWN,v 0; OPEN L -77'C -
(SEE ROOFING NOTE Q!, REVERSE'
4\
(SAME SIZE AS RAFTERS)
HEADER SIZE
'T" AND 'L' STRAPS
4 Y- 00
6"x6" x I" x 1 /8" WITH
— — — — — — — — — —
(4) 16C NAILS -OF SOLT
tz-0
A.
RAFTER SPAN:
r«POS' SPACING
O.H.
O�H.
0
CL
'OVERALL
OVERALL LENGTH:
LENGTH
cl
PCsT SIZE: - - - - ----- -
'RrAR SETBACK
SIDE ".SETBACK
(4-x4" MI % N,)
2000 P S., CONCRETE
FINISH GRADE
FIN ISH RAD, G E
MIN* 12"z12:' FOOTING I
L
-1 12" BELOW GRADE L _J
PROVIDE I CLEARANCE
BETWEEN POST AND
CONCRETE
NOTE.
OPEN LATTICE PATIO COVERS.MAYBE AT-TACHtIC TO EXISTING FASCIA
WA ONE 1/4 x Z) LA,, z,,_RtW T HRuUuH,,AbCIA INTO EACH XA"-_R TAIL.
U -STRAP OR 'AN(
3/8" x 5" LAC SCREWS INTO STUDS AT. 16' 0. C. NON -CORROSIVE'
CONTINUOUS LEDGER
(4) 1'6d NAILS
OR BOLT
L. U - STRAP ORANGLE
(4)- 16d NAILS
OR BOLT
L JOIST HANGER, OR SOLID BLOCKING
NAIL RAFTER TOBLOCKING A AE-INSPEC ION ;FEE OF $30
WILL BE,CHARG FD -IF THE APPROVED PROVIDE -1" CLEARANCE
WEEN
PLANS-ANDJOB CARD ARE NOTION • C . BETONCRETEPOST AND
UF SITE-' , OR' A , SCHEDULED
BUILDING DE "AP'TIVIENTINOUROVAL B�ELOWI.
u
NO EXCEPT.
CITY OF LA QLANTA.
BUILDING & SAFETY DEPT
APPROVED
D.:
FOR .C. N, S U
BY
DATE
ANCHOR BOLT (EMBED
7 MIN. INTO CONCRETE),
TYPICAL PATIO COVER
DATE OF APPLICATION
OWNER'S -..NAME Lo, -l -r%-4 _& v_5'
..STREET :ADDRESS
c
STI,, ZIP'
Qv�,-ac_4"Ck 92_�Lg
TELEPHONE. 'I S
H.O.A. APPROVAL
C I
RAFTER SPAN TABLE �'�� ��i/.`�� :' ALL CONSTRUCTION SHALL CONFORM
GRADING RULES TO THE PROVISIONS OF THE 1994
PS 20-70 C" � � CET `C ,
(FEET & INCHES)ooJ�� �cJ�� ocJ�,'�P ? UNIFORM BUILDING CODE.
r. ]O` Com/
CY
SUPPLEMENTAL NOTES:
2x4
16" O.C.
24" "
10'-6"
9'-6"
7--3"
HEADERS
8'-6" 1 8'-0" 6'-0"
7.— "
DOUGLAS FIR
NO.
2x6
16" O.C.
24" "
32" "
15'-0"
14'-0"
10'-9"
i 3'—CC•
12'-6" 11'-6" 8'-9"
10'-6"
10'-0" 8'-6" N/A.
N/A
4x6
6'-0"
M
I
116" O.C.
24"
32"
18'-0"
17'-0"
13'-6" 16'—C'
15'-6" 14'-6" i 1'-0" 13'-0"
13'-0" 11'-6" N/A.I N/A
I
NOTE.
32" O.C. SPANS ARE ALLOWABLE FOR OPEN LATTICE
PATIO COVERS ONLY.
LATTICE
ROOF
BUILT—UP
ROOF
j HEADERS
HEADERS
DOUGLAS
FIR NO. 1
DOUGLAS FIR
NO.
I 51ZE
SPAN
SIZE
SPAN
j 4:x4
5'-0"
4x4
4'-0"
4x6
8'-0"
4x6
6'-0"
4x8
11'-0"
4x8
8'-0"14
4X i 0
14'-0"
400
10'—O"r'
402 2
17'-0"
4x 121
i 2'-0"...
6x8
14'-0"
6x8
12'-0" J
6X 10
17'-0"
600
14'— C
ROOFING NOTES:
A. BUILT—UP, ROLLED ROOF: SLOPE TO DRAIN.
_B ;ROCS: ROOF: 3/.1,' MAXIMUM PITCH.
f1. r. �...• �. '. 1 vin �.
IL'L1J1' �+
Vu .• 1r�r'r �'
�w a as .� i� �...
.r � s .1 .L 's i .. •f' ��UC!
' , 1 ✓r ' -1 � t v�
1 ..
a
- T 1 -
■
■■■
mm.
■■
■■
■■
33.78'
SCALE 1116"=l' --O"
{Y�;E-INSPECTION FEE OF $3Q
tij'yVICI BE CHARGEQ IF THE.APPRO.. Dd•,
` PLANS AND JOB CARD. ARE
CHEDULE f Cly
THE SITE,, Fog._p S �,
INSPECTION..
:NO EXCEPTIONS!
CITY OF
G=`&. SAFETY DEPT.
APpq®VED
�s FOA CON TRUCTIO n
/J p p o�
7.0 / - �
DATE BY'
Y
x 5
PAD 109.8
F: F: 110.30
PLAN. 5B
20
26-36'
100.9.7' $" CL p
sso`cter_EsI BELLA VISTA`
f�ll)rr�i� frr�rr�llr� -
PHASE
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/.Build'er" you,are the responsible party of record on such a
permit. Building permitsare not required to be signed.by property owners unless they are—personally performing their
own work. If'your work is being performed by someone other than yourself, you may protect yourself from possible
liability if, that person applies for the 'proper permit in .his or her name:
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or -County. They are also required by to put. their license" number on all permits for which they
apply.
If you plan to do your ownwork,. with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engageiany persons other than your immediate -family, and the work (including materials
and other costs) is $200.00 or more for, the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer,and you are subject
to several obligations. including State and Federal income tax withholding,- federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do';not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations-under.Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstratio.n). For more specific information about your, obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed "contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors"is to secure an "Owner/ Builder" building
permit, erroneously implying that the. property owner -is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors Imay be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and "return the enclosed owner -builder verification form, so that we can confirm that you are aware of
these matters. The building permit will not be. issued until the verification is returned.
_ Very truly yours;
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760)777-7012
FAX: (76 777-7Q 1, .
OWNE IGNATURE/DATE
PROPERTY ADDRESS
PERMIT NUMBER(s) -