0306-279 (PAT)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 _ 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:
(p,k 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 contracting with licensed
contractors to construct the project (Sec. 7044, -.Business & Professionals
Code). / �•
O I am exempt under Section B&P.0 for:'this reason i� t
Date t � + -7. r)— Signature of Owner
WORKER'S COMPENSATION DECLARATION t
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 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).
( ) 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 shouldrbecome
subject to the workers' compensatiolp provisions of Section 3740 of the
e Labor
Code; I shall forthwith comply with those provisions. f+
"applicant
Warning: Failure to secure Workers' Compensation 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 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 State laws relating to the building
construction, and hereby authorize representatives! of this City to enter upon
the above-mentioned property for inspection puepoW , s ^
,Signature (Owner/Agerit)- r t� ; Date
PERMIT #
BUILDING PERMIT r 0-279
DATE ;( Y vALUATION $OjS'33 _59 LOT TRACT
JOB SITE 78• 7su SA saiT.� TL LUNE.
APN V
ADDRESS
OWNER
CONTRACTOR / DESIGNER / EN (NEER
GIF & 3��1.'�i'AI:C"IA 0 ; 'l
r: ire231e�3
i ;i. 50 FWA DR -TS
' D7:1i?vTA. 3k ' 1 f :.
USE OF PERMIT
P.A .0-
tr:r y.x.. Ac ♦! �,.lv �, ra+.x rn�!v r,..r rs•r.a�.s
SP
PLAN CHECK FEE 10 1 _41.)00-1..19311 atit..P
.
CONSTRUCTICA4ITE 103100I)••418-0011 $90.W
SiRONO MOT10Ri FEE - P.&SID 197 -090-2 41 -OV) $.56
:3JB-TOTAL (40)'Sl 91,T:'.'1'i0K AND P.,iW C`k'f1:XX
'S 149. i 6
I r a01. FRL PAM FEW
00
+ 9..!7GAJ .L .ry [i1W.kl.� 3' 1rJ.i.ri� .'/CiG J�3 �.d'VL?
D T L � �yN FER DUE NOW
JUN 12OO
CI'i Y pF. LA QUINTA
CE OEC•
F.1
RECEIPT
DATE
BY / i
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
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & 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 Pibg. Test
Final I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
ater Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
ySewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
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:
RAFTER SIZE AND SPACING SPECIFY ROOFING- AND SHEATHING OR 6hE4 .GE
d (SEE ROOFING NOTE ON REVERSE)
I
ROOF PITCH
I�Ttl. I,
CONTINUOUS LEDGER u
(SAME SIZE AS RAFTERS)
I
HEADER SIZE � •, � 7 �° -.,.T'-AND!-L' STRAPS
ylid I 6 16 Y1lY,/p .WITH I W
--- --- Z I (4). 166 NAILS OR BOLT I i�
RAFTER SPAN: I( POST SPACING:__ W
-- ------ 0 N- W
0.- H -- u
k 4 I i
OVERALL LENGTH::OVERALL LENGTH:ID
— `- --- - -- POST SIZE. ��C---
REAR SETBACK P SIDES CK MIN.)
FINISH GRADE FINISH' GRADE MIN_. 17x12' FOOTING
2000 P.SJ CONCRETE -�I I I Lam— I I
L _J I L__J 12 BELOW 'GRADE L_J
PROVIDE. 1" CLEARANCE
BETWEEN POST AND'
NOTE CONCRETE
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4" x 5• LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL'
_ Y U=STRAR ;OR.ANGLE
•� : F io
PLATE E
3/8- x 5" LAG SCREWS INTO STUDS AT 16' D.C. NON-CORROSIVE. .�. , . GRPD
CV
CONTINUOUS LEDGER
(4).*. NAILS
OR'•'B0L`T
c.
U-STRAR OR. ANGLE '
nr - -(4)- • 1 6.d ' NAILS
OR BOLT
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO eLocKwc • �PROVIDE 'A" .CLEARANCE
BETWEEN POST AND'.
II
IIII II II
BUILDING DEPARTMENT. APPROVAL BELOW IL IIS III II
ANCHOR BOLT (EMBED'
CITYOFLA^(�U'NTA- 7 MIN. INTO CONCRETE)
CITY
BUILDING..& SAFETY DEPT.TYPICAL' PATIO COVER
APPROVE® DATE OF APPLICATION
FOR CONSTRUCTION '
OWNER'S NAME
DATE BY �T STREET ADDRESS
CITY, ST ZIP
TELEPHONE.,
H.O.A. APPROVAL
RAFTER SPAN TABLE <�A`_ /A< �� / OC
GRADING RULES / � c')j /os /ALL. CONSTRUCTION SHALL CONFORM
PS 20-70 j`��. TO THE PROVISIONS OF THE:
FEET & INCHES) OOJr%Gi �C'
o�o� o� v� gaol CALIFORNIA BUILDING CODE.
z
SUPPLEMENTAL NOTES:
I 2x4
16„JO.C.
.,
24,
t0'-6"
9'-6"
T-3"
8'-9"
8,-6., 8'-0., 6'-0,.
7,-3,
i SIZE
SPAN
2x6
16" O.C.
24.. "
32"
15'-0"
14'-0"
10'-9"
13'-0"
12'-6" 11'-6" 8'-9"
10'-6"
10'=0" 8'-6' N/A
N/A
4x8
11'-0"
2x8
l
16" O;C.
24'
32" "
18'-0"
17'- Y'
13'-6"
16'-0"
i5'-6" 14'-6" 11'-0"
13'-0"
13'-0" ll' -6" N/A
N/A
i6x8
14'-0"
NOTES:
1. 32" RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY.
2. FOR SOLID PATIO COVERS (NOT LATTICE)
RAFTER SPAN IS LIMITED TO 10'-0" USING
THIS STANDARD.
LATTICE
ROOF
BUILT-UP ROOF
HEADERS.
HEADERS
DOUGLAS FIR NO. 1
I
DOUGLAS FIR NO. 1
i SIZE
SPAN
SIZE
SPAN
4x4
5'-0"
4x4
4'-0"
4x6
8'-0"
4x6_
6'-0"
4x8
11'-0"
4x8
8'-0"
4x 10
14'-0"
4x 10
10'-0"
4x 1 2
17'-0"
4x 1 2
12'- 0"
i6x8
14'-0"
6x8
12'-0"
600
17'-0"
6x 10
14'-0"
ROOFING NOTES`:/i
A. BUILT-UP, ROLLED . ROOF: SLOPE TO DRAIN.
B. POCK- ROOF: 3/12 MAXIMUM PITCH.
? 14trAu / . w.+ t
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 Chat as "Owner/ Builder" •you,are the responsible party of record on such a
permit. Building permits are not required to be signed by property:owners;unless they'are,personallyperforming 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., er. name.
Contractors are required by law to be.licensed`and bonded by the State of Califoinia'and to have.a business license
from the City of County. They are also required by lawto put. their license number on all permits for which they
apply.
If you plan to do your own work, with the'exceptionsof variuus,trades that, you plan to -subcontract, you should be
aware of the following information'for-your benefi .and protection:
If you employ or otherwise engage any persons other than -your: immediate family, and the work (including materials
and other costs) is $2001.'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 Governmefnt as an employer and you are subject
several.oblikgions. including; State and Federal income tax hh
witolding .ederal social security taxes,"worker's__
compensation insurance,.disability insurance costs and unemployment compensation contributions.
There may. be financial risks for you if you do nos carryout these`obligations and these risksaie especially serious with
respect toworker's compensation insurance.
For more specific information,aboytyour.obli'gations under Federal Law, contact the Internallevenue Service (and, if
you wish, the U.S: Small Bustness.Aaminstration).,For more specific informa�ionabout yourobligations under Stare
Law, contact the•Department of Benefit,Payments'"and the Division of,Industrial'Accidents.
If the structure is intended for sale, property owners whb are not licensed contractors ate allowed to perform their
work personally or through'theii own employees, without a licensed:contractor:ot subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be coritractors,is.to secure an Owner,/ Builder." building
permit, erroneous 'lying that the properly 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 may be obtained'by coniacting 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 thit .we.cari confirm that you are aware of
these matters. The building permit will, not be issued until the verificationis returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760)1277- 012 '
FAX
OWNER'SSIGNA RE/DATE
7 0750
PROPERTY ADDRESS
0-306
PERMIT NUMBER(s) ,.