BPAT2014-1040LICENSED 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 Professions Code,
and my License is in full force and effect.
License C 4s: 51 C-8 License No.: )1a
/ 11
Date: � Contractor:
OWNER-BUILDPe
I hereby affirm under penalty of perjury ththe 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 applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(_) 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.).
(_) 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.).
(_) 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
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
th for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Se 700 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: _ Policy Number: _
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 subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply ith t se rovisions.
Dated \ , \ Applicant:
WARNING: FAILURE TO SECURE WORK ERS'CZ NSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL 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 Building Official 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 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 county ordinances and state laws relating to building
construction, and hereby authorize representatives of t ' city to enter upon the above•
mentionee pro
, erty for inspection purposes.
Date: )i Signature (Applicant or Agent):
c&tit
VOICE (760) 777-7125
78-495 CALLE TAMPICO
D
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 11/4/2014
Application Number:
BPAT2014-1040
Owner:
Property Address:
78285 CLOUD VIEW WAY
DARYL POWELL
J/
APN:
770032021
78285 CLOUD VIEW
Application Description:
198SQ FT DURALUM PATIO COVER AT WEST SIDE YARD
LA QUINTA, CA 92253
z Z =
Property Zoning:
i� �, CD
Application Valuation:
$3,000.00
o
r � T
1�O
Applicant:
Contractor:
l Zo 1
VALLEY PATIOS .
VALLEY PATIOS
z�
37897 CHESTERFIELD ST
37897 CHESTERFIELD ST
v v
INDIO, CA 92203
INDIO, CA 92203
(760)534-4634
Llc. No.: 937811
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 Professions Code,
and my License is in full force and effect.
License C 4s: 51 C-8 License No.: )1a
/ 11
Date: � Contractor:
OWNER-BUILDPe
I hereby affirm under penalty of perjury ththe 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 applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(_) 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.).
(_) 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.).
(_) 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
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
th for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Se 700 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: _ Policy Number: _
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 subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply ith t se rovisions.
Dated \ , \ Applicant:
WARNING: FAILURE TO SECURE WORK ERS'CZ NSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL 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 Building Official 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 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 county ordinances and state laws relating to building
construction, and hereby authorize representatives of t ' city to enter upon the above•
mentionee pro
, erty for inspection purposes.
Date: )i Signature (Applicant or Agent):
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT PAID
PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00
11/4/14
PAID BY METHOD RECEIPT # CHECK #
CLTD BY
VALLEY PATIOS CHECK R2663 2097
SKH
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PATIO COVER, STD, OPEN
101-0000-42404
0
$97.17
$97.17
11/4/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
VALLEY PATIOS
CHECK
R2663
2097
SKH
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PATIO COVER, STD, OPEN PC
101-0000-42600
0
$95.72
$95.72
11/4/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
VALLEY PATIOS
CHECK
R2663
2097
SKH
Total Paid for PATIO COVER / COVERED PORCH / LATTICE $192.89 $192.89
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.50
11/4/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
VALLEY PATIOS
CHECK
R2663
2097
SKH
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.50
TOTALS:
Description: 198SQ FT DURALUM PATIO COVER AT WEST SIDE YARD
Type: PATIO COVER
Subtype: Status: SUBMITTED
Applied: 11/4/2014 SKH
Approved:
Parcel No: 770032021 Site Address: 78285 CLOUD VIEW WAYLA QUINTA,CA 92253
Subdivision: TR 28019
Block: Lot: 60
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $3,000.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: PATIO COVER - 198 SQ FT DURALUM PATIO COVER [DURALUM SPECIFICATIONS] AT WEST SIDE YARD.
2013 CALIFORNIA BUILDING
CODES.
Printed: Tuesday, November 04, 2014 10:36:27 AM 1 of 2
RWSYS TEMS
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX EMAIL
APPLICANT
VALLEY PATIOS
37897 CHESTERFIELD ST
INDIO
CA
92203
(
Printed: Tuesday, November 04, 2014 10:36:27 AM 1 of 2
RWSYS TEMS
Printed: Tuesday, November 04, 2014 10:36:27 AM 2 of 2
RW.,YS7EMS
!
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
PATIO COVER, STD,
101-0000-42404
0
$97.17
$97.17
11/4/14
R2663
2097
CHECK
VALLEY PATIOS
SKH
OPEN
PATIO COVER, STD,
101-0000-42600
0
$95.72
$95.72
11/4/14
R2663
2097
CHECK
VALLEY PATIOS
SKH
OPEN PC
Total Paid for PATIO COVER / COVERED PORCH / LATTICE
$192.89
$192.89
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.50
11/4/14
R2663
2097
CHECK
VALLEY PATIOS
SKH
Total Paid forSTRONG MOTION INSTRUMENTATION SMI:
$0.50
$0.50
TOTALS:
$194.39
•,
INSPECTIONS.39
SEQID INSPECTION TYPE INSPECTOR
SCHEDULED COMPLETED
RESULT
REMARKS
NOTES
DATE
DATE
I t
FINAL**
Printed: Tuesday, November 04, 2014 10:36:27 AM 2 of 2
RW.,YS7EMS
Bin.#
City. Of Lel Quinta
Buitcripg u sareiy Dhision
P.O. Box 1504,78-495 Calle Tampico
LA.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project .Addmss:M22
L� CAa Y A
APPLICANT: DO NOT WRITE BELOW THIS LINE
Owner's Name: A\
A. P. Number.
Reqld
Reed
_7N
Address: CIA WuL)
Legal Description:
Plan Sets
City, ST, Zip:
Contractor.aIQ�x
Address:
2Q" Address:e'
�h- n —
Telephone.– -
Project Description:
City, ST, Zipra
Structural Calcs.
A(VI c)
all 'k a J�y
Telepho nel_ao
................. ......
Plan Check Deposit.
State Lic. # :02,
City Lic. 9:_
Ci
Called Contact Person
Arch, Engr., Designer
Plan Check Balance.
Title 24 Calci.
Address:
Plans picked up
Cit7Y, SL Zip:
Flood plain plan
Telephone:
Plans resubmitted..
Mechanical
on Type:Occupancy:
State Lie. #: ;. emem"imm-i" Proiect tvne (circle one)- New 1 Zd4 Alt,, Reair Demo
m wslffl
Name of Contact Person:
Sq- . Ft:
Stories: nits:
# TOU..
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
9
Subinittal
Reqld
Reed
TRACMG
PERMrrFEES-
Plan Sets
Plan Check submitted.
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit.
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
2" Review, ready for correctiouslissue
Electrical
S ibcontactor lAst
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
hN HOUSE:-
Review' ready for corrections/issue
Developer Impact Fee
PlatinlugAlilroval.
Called Contact Person
AXP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
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