04-4757 (PAT)2004
al 1'yOFLA- `QUI--pTrA BUILDING aL SAFETY DEPARTMENT
FINAp�O �B:o.x..15 04.(760) 777-7012
OFZi 78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760).777-71.53
BUILDING PERMIT
Application Number . . . . . 0.4-0-0-0-04-7-57-x. Date 6/17/04 .
Property Address 53745 AVENIDA NAVARRD
APN:' 774 -134 -022 -12 -000D00 -
Application description PATIO COVER - RESIDE-NTIAL
Property Zoning.. COVE RESIDENTIAL
Application valuation 4655
Owner Contractor
---------------------- -----------------------
HUTCHESON CALVERT L OWNER
*NOT ON FILE
UNKNOWN CA 99999
Permit PATIO-COVER.PERMIT
Addtional..desc
Permit Fee. 117.00 Plan Check Fee 46.80
Issue. Date Valuation 4655
Expiration Date .12/17/04
Qty Unit Charge Per 'Extension
BASE FEE 90.00
3.00 9.0000 THOU BLDG 2;001-25,000 27.00
Special Notes and Comments
350 S.F PATIO COVERS PER CITY SPECS.
OWNER WAS.BOUBLED FEEDED FOR STARTING
. WITHOUT -A PERMIT. \
Other Fees STRONG:MOTION (.SMI). = RE'S. -50'
Fee summary Charged Paid Credited Due
Permit Fee Total 117.00 .00 00 117.00
Plan.Check Total 46.80 .00 .00 46.80
Other Fee Total .50 00 :.00 .50
Grand Total 164.30 .00 -40;. 164.30
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4
BUILDING & SAFETY DEPARTMENT
Application Number: 4415
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760)'777-7153
Date:
Architect or Engineer's Address:
ii� 411
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
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 Class License No.
Date Contractor
- • J
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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 or 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.).
U 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.).
U I am exempt under Sec. B.& P.C. for this reason
Bate V wne
WORKERS' 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-insu
of the work for which this permit is issued.
re for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
_ 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 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. thg workers' compensation provisions of Section 3700 of the Labor Code, I shall
iW
forthwith comply with those provons.9
fleV plicant a
WARNING: FAILURE TO SECURE WOR S' COMPENSATION COVERAGE I 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.
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
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, indemnity 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 this county Writer upon the above-mentioned property i pection purposes.
/[Tate d ignature (Applicant or Agen