9804-001 (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
G/!1
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:
C(� )r I, as owner of the property, or my employees with wages as their sole
c0 pensation, 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).
( )/1 am exempt under Section B&P.C. for this reason
Date Signature of Owner 41, Y
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 & 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 AshAll 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, II shall forthwith comply with those provisions
Date: � Applicant
Warning: Failure to secure FWorkers'ompensation 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 purposes.
ro.
✓Signature (Owner/Agent)Date Al
BUILDING PERMIT PERMIT# °°NTR°`#
DATE �,/ �a VALUATION LOT TRACT 01
JOB SITE APN
ADDRESS 79-09� 000Jl.UX0 DRIVE,'
OWNER
iOs,T3%t`, tyGAsi'ft.
iait�i��r`i.
79095 OCOTILLO DR
LA Ql.iINTA. CA
USE OF PERMIT
P 1110
€ O RCHiPAs iv
CONTRACTOR / DESIGNER / ENGINEER
t;,;VNERI / Sul [IDE.R
9224153
C CL31.:#f
PAN
APR 0 1 1998
()IW i OF Lia QUINT. A
KK yt
CONS -1 G.!UCIAA'ATOX`'
P �461iY.�
f-01,AN 0AECK ME 101-000-439-318
COM31'RAIC- IONFFT 301Ax_41194)(11 f31.Ns�
'IT20NG:itICMON ?)M - R.f.;'SID .101.-000-24.1-0(ri
l
r.
5,40.0710
,ESS RRE-PAID FEES $0.00
TOTAL VERINJIT IFFXS WE NOW
RECEIPT DATE BY % ^ ' DATE FINALED INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
v. BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
?i—
Ducts
t Slab Grade.
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
0.K to Wrap
F.A.U.
Framing
_ (o —
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 —,/.D .
BLOCKWALL APPROVALS
steel POOLS -SPAS
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
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
l
Final
Utilfty Notice (Perm)
COMMENTS:
RA _P AND SPACiN,.
vN RE'VE
11-_
149 0-c
VA
i -------
ROOF fiTCH
I
I
CONTINUOUS LEDGER
U u V U
,
U
i
i
;SAME SIZE AS RAFTERS)
HEADER
T' AND 'L' STRAPS
Ir
DSIZE
%O O 1U�
I 6'x6'.t"xt-'B" WITH
160 NAJLS OR BOLT
61
J
_ _
I (A)
I
RAFTER SPAN-�� ___
POST SPACING'jd _-_-
W
O.M.
u
/
I
f ,
OVERALL LENGTH 2
a0
a
r
OVERALL LENG-M _ Z
_
_ • e2J` __� 0 POST SIZE. `'�4S =f__ io
REAR SETBACK SIDE SETBACK i• ■4" MIN.)
2000 P.S.I CONCRETE I FINISH GRADE FINISH GRADE I MIN. 1 i x 12 FOOTING 1
L J I L_ J 12' BL.OW GRADE L— J
4 S PROVIDE t" CLEARANCE
BETWEEN POST AND
CONCRETE
OPEN LATTICE PATIO. COVERS MAY BE ATTACHED TO EXISTING FASCIA
U—STRAP OR AN(
NON -CORROSIVE
VIA ONE 1/4- . S LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL.
(4)— 16d NAILS
OR BOLT
/ U—STRAP OR ANGLE
/ (4)— 16d NAILS
OR BOLT
I JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKINGPROVIDE 1' CLEARAMCE
BETWEEN POST AND
CONCRETE
ARTMENT APPROVAL BELOW `
CITY. O F LA O V 9 TA ANCHOR. BOLT (EMBED
T MIN. INTO CONCPUE)
B JILDING & SA_ ETY DEPARTMENT
CONDITIONALLY TYPICAL PATIO .COVER
ACCEPTED? FOR CONSTRUCTION DATE OF APPLICATION 41
, �g
SUBJECT TO INS7AI LATION AS PEk OWNER'S NAME
STREET ADDRESS'79 -09 I
CITY. ST ZIP
AND ALL APPLICABLE CODES TELEPHONE. L71 .)7,2 -SS
Q\/ H.O.A. APPROVAL
Orr-Ic-
RAFTER SPAN TABLE � �� .'ALL CONSTRUCTION SHALL CONFORM
GRADING RULES v v ;, , TO THE PROVISIONS OF THE 1994
5 ;--70 V CV '3 Ca .0
SFE_' & INCHES) /CJ-, /(-N, oJ�`�, ,z ?;/ UNIFORM BUILDING CODE.
I
BUILT-UP
ROOF
I
1
HEaD�?S
HEADERS
DOLu=La<
I
j 2x4
i5"
O.C.
SPAN
`4.,
SPAN
2x6 16" O.0
2 2„ "
3
J
-S;�
SUPPLEMENTAL NOTES:
8'-6" 8'-0 6'-0"
114'-0" 1 10'-Q" 13'-0"
.9.4. 1 10'-6"
10'-0' 1 R'—ii' I N/A I N/A
I
?x8 16" O.C. 18'-0" 17'-0" 13'-0' 1 16'-0"
24" 15'-5' 111,_6„ i t t'-0" i 13'-0.'
32" 13'-0" 1 1 t'-6" N/A I N/A
-NOTE
32" O.0 SPANS ARE ALLOWABLE 1.OR OPEN LATTICE
PATIO COVERS ONLY.
LATTICE ROOF I
BUILT-UP
ROOF
HEaD�?S
HEADERS
DOLu=La<
I
FIR NO. 1 I
DOUGLAS FIR NO I
! 5I_ -E
I
SPAN
SIZE
SPAN
�.
5'-0"
4x4.
4'-0"
4x6
8'-0"
4x6
6'-0"
4x8
11'-0"
4x8
8'-0"
4xt0
14'-0"
4xt0
10'-0"
4x`12
17'- T
4x 1 2
12'-0"
I 6x8
14'-0"
6x8
12'-0"
6x 10
17'-0
6x t 0
14 -0
ROOFING NOTES:
A. BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.
I'
i
1
OWNER/BUILDER INFORMATION
Dear Property Owner:
An -application fora 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/ 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 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 Nave a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of variuus trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your'immediate family, and the wo•-k (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 emplo ter 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 R•venue Service (and, if
you wish, the U.S. Small Business. Adminstration). 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 allows d 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 "Owr_•er/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 aboui licensed contractors may be obtained by contacting the Contractors' State License Board in your
commu.nity,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 Tainpico
La Quinta, CA 92253
(760)777-7012
FAX: (7 777-7011
v�
E 'S SIGNATURE/ DATE
PROPERTY ADDRESS
Rio 4 - of) 1
PERMIT NUMBER(s)