07-1974 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00001974
Property Address: 78415 CLARKE CT
APN: 643-170-999-32 -31348 -
Application description: PATIO COVER - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1809
Applicant:
C&t!t 1 4 4a"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
LICENSED CONTRACTOR'S 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 rpy License is in full force and effect.
License Class: License No.:
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am 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 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 and the basis for the alleged exemption. Any violation of Section 7031.5 by
any pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 I 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 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 Con tate License Law does not apply to an owner of
property who builds or improves thereon, and ho contrac for the projects ith a contractor(s) licensed
pursuant to the Contractors' State License w.). n
(_ I I am exempt under Sec. , B.&
P1&,f96 this reason 'Q
Date:
Owner:
I hereby affirm under penalty of perjury that there
work for which this permit is issued (Sec. 3097, 1
Lender's Name: _
Lender's Address:
LQPERD'HT
rRUCTION LENDING AGENa711___�
construction lending agency for the performance of the
C.).
Owner:
PH RANCH LLC
78370 HIGHWAY
LA QUINTA, CA
Contractor:
Owner
111 STE 200
92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/01/07
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 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 mit is issued.. My workers' compensation
insurance carrier and policy number are:
Carrier P ' u r
I certify that, in the performance o e work for 'ch t is per it i ssued, I shall not employ any
person in any manner so as to ecome subject tot orkers ompensation laws of California,
and agree that, if I sh be ome subject to the wor s' c ensation provisions of Section
3700 of the Labor ode, I all forthwith comply with e p visions. Q
Date: O Applicant:
WARNING: FAILURE TO SEC RE WORK�RS' OMPENSATION CO ERAGE UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO IMINAL ENA IES AND CIVIL FIN S UP ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO`THE OST OF COMPENS DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INFER ST, 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 th 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,
wo is riot/commenced
within 180 days from date of issuance of such per ' , or .tion of wo r 1 0 days will subject
permit to cancellation.
I certify that I have read this application and state that the ab ve information is orrec . 1 r e to comply with all
city and county ordinances and state laws relating to buildin construction, and h b aut - rize representatives
of this county to
enter upon the above-mentioned f r inspection purposes. 1
Date: Signature*(Applicant or Ag nt): \
Application Number . . . . . 07-00001974
Permit . . . PATIO COVER
PERMIT
Additional desc .
Permit Fee . . . . 43.00
Plan Check
Fee
27.95
Issue Date . . . .
Valuation
. .
1809
Expiration Date 3/29/08
Qty Unit Charge Per
Extension
BASE
FEE
15.00
14.00 2.0000 HND BLDG
501-2,000
28.00
----------------------------------------------------------------------------
Special Notes and Comments
EXTEND, EXISTING PATIO 136 SQ.
FT.September 27,, 2007 2:15:03 PM
JJOHNSON
Other Fees STRONG MOTION (SMI)
-.RES
----------
.50
Fee summary Charged
Paid Credited
Due
----4------------ -- - - - --- - ----
--- - - - - ------ ---
- - -
Permit Fee Total 43.00
.00
.00
43.00
Plan Check Total 27.95
..00
.00
27.95
Other Fee Total .50
.00
.00
.50
Grand Total 71.45
.00
.00
71.45
r
LQPERNIIT
FA
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City of La Ouinta
Building U Safety Division
P.O. Box 1504, 78-495.Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
,Permit #
Project Address:" 'b - /-//S em,-,= eoc(,e-r
Owner's Name:
A P. Number:
Address: '7g— X70 2-xj 0
Legal Description:
City, ST, Zip: 2.4 , " Qu /k&— gZZ.S
Contractor: PW' L1. 0' •
Telephone:
Address: s¢,yL /�S
Project Description:
City, ST, Zip:
Telephone:
J V)
State Lic. # :
City" Li ?O:
Q
Arch., Engr., Designer:
l jL �j
Address:
TO
City, ST, Zip:
Telephone:
Constryction Typ : Occupancy:
State Lic. #:
Project type (circle one): Ne Add'n Alter Rep4ir Rep'Demo
Name of Contact Person:
Sq. Ft.: !IX 3 '\,
# Stori s: ��
#Units:
Telephone # of Contact Person: 9470— 0— 19, 19 • 223S
Estimated Value of Projec - 6
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING. 1
PERMIT FEES
Z
Plan Sets
Plan Check submitted
Item
Plan Check Deposit
Amount
Structural CAcs.
°
Reviewed, ready for corrections71
Called Contact Person
Truss Calcs.
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan,
Plans resubmitted
Z-!
Mechanical
Grading.plan
2°4 Review, ready(or"correctionsfi e
( b
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up AI
9 /Z-
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'`" Review, ready foi correctinsrssu .
d Gj
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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