13-1110 (PAT)111-~
uu�w
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO / FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT �'•••/ INSPECTIONS (760) 777-7153
BUILDING PERMIT IPF
_ i
a 3
Application Number: 13-00001110 Owner:
Property Address: 57623 SALIDA DEL SOL ALTA VERDE CORAL MOUNTAIN, vLP 1 J 2013
APN: 762-240-014-50 -34243 - 315 S BEVERLY DR 208
Application description: PATIO COVER - RESIDENTIAL BEVERLY HILLS, CA 90212 CITY OF LAQUINTA
Property Zoning: RL AG/EQ OVERLAY ^lA1L \7C nF?r
Application valuation: 2115
Contractor:
Applicant: Architect or Engineer: ALTA -VERDE BUILDERS, INC.
71905 HIGHWAY 111, SUITE G
RANCHO MIRAGE,. CA.92270
(760)776-1111
Li c . No.:
.: : 9 6�9 219
I hereby affirm under penalty of pt
Section'7000) of Division.3 of the
ucense'Classl B _ J.
111
LICENSED CONTRACTOR'S DECLARATION
r. that I am:licensed under provisions of Chapter 9 (commencing with
kessnd Professionals Co and my Licer in full force and effect.
Lice se`No: 969219
OWNER -BUILD DECLARATION
I.hereby'affirm under penalty of perjury that I 'm exempt fro ihe'Contractor's State Licen aw for the' -
following reason (Sec. '031.5: Business and rofessions Cc e: Any city or county requires a permit to '
construct; alter, improve, demolish, or repai any structure, p to its is so requires the applicant for the
permit.to file a signed statement that he or she is I ceAsed 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 fora permit subjects the applicant to a civil penalty, of not more than five hundred dollars ($500).:
1 _ 1 I, as owner of:the property, or my employees with wages as their sole compensation,, will do the work, and
the structuress 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 forsale.- 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, 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 contractorls) 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
-------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
—.1 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. -'
l l�have and will mw
aintain orkers' compensation insurance, as required by Section 3700 of the Labor
Code, for the per formanceof the work for which this permit is issued .My workers' compensation
insurance carrier and policy numbeir aie:
Carrier STATE FUND)sd
Policy Number 9006140.
. I certify [hat, in tance of the work for which this it is issued, Ishatl not employ any
person in any manneo as to become subject to the workers' pensation laws of California,
and agree thad become'subject to the workers' compens 'on provisions of Sec[ion3(700 of thee L -shall forthwith comply hose provision
\ ApplicaWARNING: FAILURETO SECKER 'COMPENSATIONVERAGE IS UNLAWFUL, ND SHALL
SUBJECT AN.EMPLOYER TOLPE ALTIES-AND CIV FINES UP TO ONE HUNDRE THOUSAND
DOLLARS' 1$100,000). IN AO'T E COST OF CO ENSATION, DAMAGES ROVIDED FOR IN
SECTION 3706 OF THE LABINT REST, AND ATTO NLS 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 lication becomes null and void if work is not commenced
within 180 days from date of issuan f such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state tha he above information is correct I a ee to comply with all
I and cou ty ordinances and state laws relating to 'Iding construction, and here au or a representatives
of
this C[.._
C u`n to enter upon the above-mentioned pro ty for inspection purposes.
Date: Y Sign ` e•IApplicant or Agent):
LQPERMIT
Application Number . . . . . 13-00001110
Permit . . . PATIO COVER 2013
Additional desc .
Permit Fee . . . . 131.56 Plan Check Fee
.00
Issue Date Valuation . . .
. 2115
Expiration Date 3/04/14
Qty Unit Charge Per
Extension
.1.00 131.5600 EA MISC PATIO COVER, SPEC
131.56
Special Notes and Comments
DETACHED.-'POOL..STRU-.CTURE WITH.
OUTDOORSHOWER [ENGINEERED] DOES NOT
INCLUDE CONDITIONED SPACE. 2010
CALIFORNIA BUILDING CODES.
September -5, 2013 5:07:16 PM AORTEGA
s
- - -- ----
' Other .F.ees . . . . . . BLDG `STDS. ADMIN ' (S&1473)
1.00
PLAN CHECK; PATIO COVER
-165,..-88
STRONGMOTION .((SMI)- -.--RES
.50
Fee summary Charged -Paid Credited
Due
'Permit Fee Total 131.56 .00 .00
131.56 '
Plan Check. Total .00 .00 .00 .
r-00
Other Fee Total 167.38 -,:00 00°
16,-7.38
Grand Total 298.94 .00 .00
298.94.
LQPERMIT