07-1482 (PAT)P.O. BOX 1.504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property- Address:
AM:
Application description
.Property Zoning: `
Application valuation:
Applicant:
0.7-00001482
44665 CALLE SANTA BARBARA
604-382-039-130 -25953 -
PATIO COVER -..RESIDENTIAL
LOW-DENSITY RESIDENTIAL
4070
Architect & Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
' - LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjurythat 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.Classi B nseNoi 770843 .
Date: S / 01 Com -
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury. that'l am exempt from'the Contractor's State License Law for the
following. reason (Sec. 7031.5, Business and NofessionsOode:=.Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, pr`ior.to its issuance, also requires.the applicant for the
permit to file a signed statement that tie of 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** 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 _ 1 I, as owner "of the property, or my employees with wages as their sole compensation'- w:
ill do the work, and
the structure isnot 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, Businessand 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:
LQPERMIT
Owner:
ROBERT WORRELL
44665 CALLE'SANTA BARBARA
LA QUINTA, CA 92253
Contractor: .
LIFETIME PATIOS
P.O. BOX.'5806
LA QUINTA, CA 92248
(760) 772 '0013
Lic. No.: 770843
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/17/07
----
',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 6y'Seciion 3706 of the Labor Code, for the performance of the work for which this permit is
issued.' "
_ I have and will maintain workers' compensationinsurance, 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 WILKINS INSURAN _Policy Number WEN0015766-01
certify that, in the performance of.the work for which this,permit is issued, I shall not employ any
s, person in any manner sous 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 I rthwit -A omply with those provisions. '
(Q
,ntDate: s' App
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREDTHOUSAND
DOLLARS (s 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 per 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 count to enter upon the above-mentioned property for inspection pu ses.
Dater /'� Si (Applicant or Agent):
Application Number . . . . . 07-00001482
Permit . . . PATIO COVER
PERMIT
Additional desc .
Permit Fee . . . . 72.00
Plan Check
Fee
46.80
Issue Date . . . .
Valuation
. . .
. 4070
Expiration Date . . 11/13/07
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
17' X 18' ALUMAWOOD PATIO COVER
----------------------------------- ----------------------------------------
Other Fees . . . . . . . . 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 .50
.00
.00
.50
Grand. Total 119.30
.00
.00
119.30
LQPERMIT
Bin #
Ci of La '
City Qumta
Building 8t Safety Division
P.O. Box 1 SO4, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Pennit #
Project Address: '(oho �f" �7 W fA SAeS Ae A-
O*.vnWs Name.
Address:
A. P. Number:
Legal Description:
' Contractor: LI 4e
( Address:Sam G(�
City. ST. Zip: A QUI 142
ilTelephone:
Project Description:
City. ST. Zip: L& Ift
ZZS.�
! GJLtaf�e
Telephone: -0013
17 ♦ 10
State Lic. # 770 F q3
City Lic. #: 3ZS�•
Arch.. Engr.. Designer:
Address:
City. ST. Zip:
Telephone:
State Lic. #:O � 3•
_
Construction Type: Occupancy:
Project type,(circle one): New v Add'n Alter Repair Demo
Name of Contact Person: CC
Sq. Ft.:
Stories:
#Units:
Telephone # of Contact Person ?G
G �- OD
stimated Value of Project: 0 a►t
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES !
Plan Sets
Plan Check submitted
Item
i
Amount
Strdctural Cala.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Energy Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2-" Review. ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S:AI.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
'"' Review, ready for corrections/issue
Developer impact Fee
Planning Approval
Called .Contact Person
A,I,P,P_
Pub. Wks. Appr
Date of permit issue
o
School Fees