06-1644 (PAT)4
P.O. BOX 1504'
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
C&t!t 4 4 a"
Application Number: 06-00001644 - r,
Property Address'✓ 79262 CALLE PALMETO
APN: 604-381-021-29 -25953
Application description: PATIO COVER - RESIDENTIAL
Property Zoning: LOW DENSITY' RESIDENTIAL I
Application valuation: 4988
Applicant: Architect or Engineer
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT -
BUILDING PERMIT
Owner:
ROSS ANTHONY
79262 CALLE PALMETO
LA QUINTA, CA 92253
I APR 2 6 2006
I hereby affirm under penalty of perj?;XAha4J4m licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 ofth usiness and ofessionals y License is in full force and effect.
/'License Class: B rnseNo.: 860958
I Date: k s I oG ContractUpet
OWNER-BUILDER DECLARATION - - , -
I hereby affirm under penalty ofm 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 licensedpursuant 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 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 I, 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.).
f _ 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
Contractor:
PELLETIER PATIO
79275 DESERT STREAM DR
LA QUINTA, CA 92253
(760)275-7593
Lic. No.: 860958
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/25/06
-----------------------------------------------
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 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 and policy number are:
Carrier EXEMPT Policy Number EXEMPT
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 become subjectJoqe workers' compensation provisions of Section
_ 3700 of the Labor I shall forthwit co ly with those provisions.
Date: b4 Applicant: -
WARNING: FAILURE TO SECU O RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI AL 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 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,
j 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 boinformati is corr ct. I agree to comply with all
city and county ordinances and state laws rel ng to buitdin
�voen
struction and'her by authorize representatives
of this county to enter upon theabove-men ' ned p erty fpection p rpose .
' Datel«/Signature (Applicant o Agent :
Application Number 06-00001644
Permit . . . PATIO.COVER PERMIT
Additional desc .
Permit. Fee 72.00 Plan Check
Fee
46.80
Issue Date Valuation
4988 .
Expiration Date 10/22/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
3.00 . 9.0000 THOU BLDG 2,001-25,000
27.00
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Special Notes and Comments
375 SF ALUMAWOOD LATTICE PATO COVER IN
REAR YARD.
----------------------------------------
Other Fees . . . . . . . STRONG MOTION•(SMI)
- RES
.50
Fee summaryCharged 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
11Y OF TA
-BUILDING &SAFETY DEPT.
APPROVED
FOR C NSTRUCTION
A RE --INS ECTION' FEE OF $30, Ay,�orLl P0,5$', ^
WILL BE Cl -ARCED If THE APPROVED `jq_ 2 Cv2 �1 who
PLANS AN JOBCARDARE NOT ON '
THE SITE FOR A SCHEDULED 82253
INSPECTION.
0 EXCEPTIO S!,, e- 0-,r)
- AWM�eoA .
15, tc tai cc � okro
I w
- yO
C01010 Ceoewt 2)Q Y r
dLT^1 �Ci[XrY Pe f "v*e f Raro,. "
,
a
Bin #
City of La Quinn'.
Building & Safety•Division
P.O: Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Trackl:ig Sheet.
Permit,# (I .
( y
I I
Project Address: 22 (� ��CQ,{-v
Owner's Name: 14 V ,+V� o P-05�_>
A. P. Number:
Address: _ a (02 _ Cr—N, A-(�, e,+O
Legal Description:
City, ST, Zip: (�,;✓v4 (� Cl•22S 3
Contractor: Pt `UV424_
Telephone: L-{ OS • d 4 �3
Address: —701+,2-)- p,Yr Si.Y.L,c„r,, �
Project Description:
City, ST, Zip: l
ode. Cv
Telephone: D95 • . r�5 9 5
State Lic. # : U(oC?q % City Lic.•#:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
r
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add 'n Alter Repair Demo
Name of Contact Person: ;hl e C 4CiJ4
Sq. Ft.: 37j Q
#Stories:
#Units:
Telephone # of Contact Person:
a�
Estimated Value of Project: L(3 �
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
•Energy Calcs:
Plans picked up
Constru•:tion
Flood plain plan
Plans resubmitted
Mechan€cal
Grading. plan
2" Review, ready for correction&1issue
Electrical
Subcontactor.List
Called Contact Person
Plumbir_g
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval '
Plans resubmitted
Grading
IN HOUSE:-
'`" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr.
Date of permit issue
School Fees
Total P'-rmit Fees