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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 Qa Zo®o LDU 0 LL �aO� LL 06 OZC� Um o