11-0708 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,. CALIFORNIA 92253
Application Number: 11-00000708
Property Address: 52060 AVENIDA JUAREZ
APN: 773-211-034- - -
Application description: PATIO COVER - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 6570
Applicant: Architect or Engineer:
oe
t�'«viasJL I►ik
LICESED CONTRACTOP DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury t I m licensed u der p visions of Chapter 9 (commencF with
Section 7000) of Division 3 of the B Hess nd Professio Is C e, and my License is in full farce an effect.
Licens�lass: B Lic se N . 72719
l
Da C Contractor:
OWNER -BUILDER DECLARATION
1 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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 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 Licence Law does not apply to an owner of property who builds or imprnves 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.).
(_ 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
Owner:
HACIENDA GROUP, INC.
77935 CALLE TAMPICO
LA QUINTA, CA 92253
Contractor:
CORONEL ENTERPRISES
42760 MADIO STREET
INDIO, CA 92201
(760)775-1234
Lic. No.: 727199
STE s
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/27/11
------------------------------------�f=--------
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 the work for which this permit is issued. My workers' compensation
insurance carrier and p number are:
Carrier STATE FUND Policy Number 19488 —2011
_ I certify that, �i;j�ttheSLfffforrJ#nce of the work for hich this ermit is issued I shall not employ any
person in eras to become subje to the orkers' compen tion laws of California,
and agree, if I sh Id become subject the war ers' compensa n provisions of Section
I3700 of e Labor C de, I shall forthwit comply wit ose pr ons.
Datd�i j i Applicant:
WARNING: FAILURE TO SECURE WO KE MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN L NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION 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,
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 fora a or omission related to the work being \
performed under or following issuance of this per it.
2. Any permit issued as a result of this applicati bete s null and void if wor is not commenced
within 180 days from date of issuance of uch per rc, or cessation of w for 180 days will subject
permit to cancellation.
I certify that 1 have read this application and state y
information is car ct. I agree to comply with all
city and county ordinances and state laws relati g tonstruction, and h eby authorize representatives
of this unty to enter upon the above-mentioned prspection p rpos
Date• ` mature (Applicant or Agent):
- ---
Application Number . . . . . 11700000708
Permit PATIO COVER PERMIT
Additional desc .
Permit Fee . . . . 90.00 Plan Check Fee
58.50
Issue Date . . . . Valuation . . .
. 6570
Expiration Date 4/24/12
Qty Unit Charge Per
Extension
BASE FEE
45.00
5.00 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
45.00
-----Permit
Perm it . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . 23.25 Plan Check Fee
5.81
Issue Date Valuation . . .
. 0
Expiration Date 4/24/12
'
Qty Unit Charge Per
Extension
BASE FEE
15.00
11.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
8.25
----------------------------------------------------------------------------
Special Notes and Comments
494SF PATIO COVER AT NORTH SIDE YARD .
-
(ENGINEERED] THIS PERMIT INCLUDES
ELECTRICAL LIGHTING AND RECEPTACLE
INSTALLATIONS. 2010 CALIFORNIA BUILDING
CODES.
October 27, 2011 4:47:29 PM AORTEGA
--=-------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
STRONG MOTION (SMI) - RES
.66
Fee summary Charged Paid Credited
------------------------------
Due
---------------------------
Permit Fee Total 113.25 .00 .00
113.25
Plan Check Total 64.31 .00 .00
64.31
Other Fee Total 1.66 .00 .00
1.66
Grand Total 179.22 .00 .00
179.22
LQPERMIT
V '-
Bin #
2�
City of La Quin, ta
Building 8L Safety Mslon
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
I' J V0
Project Address: dj 2 (D(00
tjrA 1 DA J VAae.z
Owner's Name: ACcew CO
G
A. P. Number: -7-72)- 211.
C) --4A-
Address: 935 44«E Plco
S71F 20
Legal Description:
Contractor:`
FNT
Gt) (ZO N �1. E&f r -1 5 6S
City, ST, Zip: u I N rA GA .
Telephone: 7bo T7S ( 239 «'
;` "�
c> , 5
Address: 4%-7(0 MAD 10 S'i-Ile=G'('
Project Description: MIDOSCE N£
City, ST; Zip: p o 1 O t CA-
12201
Gov t A o 4 sq rr,
Telephone: 7(00 17S t234 -
3
State Lic.•# :
State
City Lie. #;
Arch., Engr., Designer. (ZICAX00
Address: _3L4-15 CMA -c -
City, ST, Zip: 'T1}01l SO, 140 .AUDIS- .
Telephone: '� teo 2�2 S 1 g3
State Lic. #: <"
Name of Contact Person:R1 Cb 6utLp
Construction Type: Occupancy:
Project type (circle one):Add'n Alter Repair Demo
Sq. Ft.: 4- # Stories:
#Units:
Telephone # of Contact Person:
O 2 St % -3 Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
15
Plan Sets
Plan Cheek submitted U1
Item
Amount
Structural Calcs.
Reviewed, ready for corrections 'j b
Piero Check Deposit
Trans Calca.
Called Contact Person
11 ul
Plan Check Balance .
�-..
Title 24 Cales.
Plans picked up
Construction
•
1�
Flood plain plan
Plans resubmitted
Mechanical
�+
Grading plea
2" Review, ready [o orrecti a slue
Electrical
Subcontactor List
Called Contact Person W
Plumbing
Grant Deed
Plans picked up g�
S-M.L
• bb
H.O.A. Approval
Pians resubmitted ��
Grading
IN HOUSE:-
Review, ready focorrection ere
Developer Impact Fee
^
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
1 •tlQ.
School Fees
Of
Total Permit Fees
L'1q 3
q� �"' . ✓G �� , � � � `16 Loci � ^iS�i't�(, .Q�G
/0/4 Jeo C
�3
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