9609-125 (PAT)LICENSED CONTRACTOR DECLARATION
U) hereby affirm under penalty of perjury ,that I am licensed under,
p ' rovisions of
Chapter'9'(commencing with Section1000) of Division 3 of the Bu-siness arid
U)
N UJ Fj..-of?asS`io_nals Code, and my License is in full force and effect.
Z) cf) -License# Lic. Class Exp. Date
C3 LO
LLJ
Z rr Date Signature of Contractor
0
(0 OWNER -BUILDER DECLARATION
_J
W w I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z 1, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended of offered for
sale (Sec. 7044, Business & Professionals Code).
1, as owner of the property, am exclusively contracting with licensecl
contractors to construct the project (Sec. 7044, Business' & Professionals
Code).
C0 I am exempt under Section B&P.C. for this reason
U')
CNJ Date Signature of Owner
0-C\1
< WORKER'S COMPENSATION DECLARATION'
CL
0 2 Z I hereby affirm under penalty of perjury one of the following dedlara;i6ns:
Lo 0 < 1 have
0-- and will maintain a certificate of consent to self insure for workers'
1-2
X UJ Y= compensation, as provided for .by Sectio'n 3700 of the Labor Code, for. the
0 _j _J performance of the work for which this permit is issued.
C01_J < compensation insurance, as required by
.. < C) Section
I have and will maintain workers' co
0 Or - c on 3700 of the Labor Code, for the. performance of the work for 'which '.ihis
L LO �<� permit is issued. My workers' compensation insurance carrier & policy no. are:
0)
`* , Z Carrier Policy No.
Ob 5
< . �
(This section need not be completed if the permit valuation• is fo
r $100.00orless).
_J
I certify that in the performance of the work for which this pe ' rmit 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 37.00. of the Lab6r
Code, I shall forthwith comply with those provisi&fft
Date: Applicant V--.,.
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up, to $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.
IMPORTANT Application is hereby made to the Directbr of Building and Safety
for a permit subject to the conditions and restrictions set forth, on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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
• -c correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to. enter upon
the above-mentioned property for inspection'purposes.
e Signature (Owner/Agent) Date
PERMIT# CONTROL#
• BUILDING PERMIT,- 11-
DATE VALUATION LOT. TRACT .20
4
JOB SITE 7"25 N0LAIN (,W APN
ADDRESS . . - I
OWNER
10 f R C4 MR, C11 A.
78-823 . NO CA14 C.1R
LA OWNTA
USE OF PERMIT_
r" 912"S.3
444 907 COVMW PK.CiQ (LATTICE).
CONTRACTOR/DESIGNER/ENGINEER
NTMIUDAV
7243-kDESUT OR
RAN(MO MRAGEI
11CRAUT'VI'Vil IMAM V
PLAN C14 W -1-K.- RIM—. 101-000439-319$3 2-65
CO.N,-,TR,, c,rrQN -
101,000418-000 41.
ST1140i10110. 1 VEYS - RTSlr) I -ON)
XA9
C1311.10
_;kUMON AND PU*1 (CRECK S4134.24
S1
L I :. LESS PRE-4WD.VUS $0.00
.R . ECEIPT DATEBY DATE FINA LED INSPECTOR R
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings -
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
M
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W
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17=
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A.,
Q Q• Q
RAFTER SPAN TABLE ��� clI cl c7l
o GRADING RULES ALL CONSTRUCTION SHALL CONFORM
PS 20-70 �s� �s� �s� �`�° TO THE PROVISIONS OF THE 1994
(FEET & INCHES)°OJ�� °OJAcl °oJ�c,) �UNIFORM BUILDING. CODE.
SUPPLEMENTAL NOTES:
f ,
,f
2x4
NOTE:
16"
O.C.
10'-f;'
9'-6"
7'-S'
8'-9'
DOUGLAS FIR N0. 1
24"
"
r
...t-1...Y.r.........7r._
I_
2x6
16"
O.C.
1 '-
14'-(f
..
4x6'
1 '
4x8A 11 -Cr
24"
4x10: 14'-0"
12' -Er
11'-
8-A.
10'-
6x8 12'-0"
37
600
10
N
..A.
2x8
16"
O.C..
'-.I x'.-4'..
24"
"
.
1 '-
........... .
14'-
..
1 '_
13' -
'-
NOTE:
3Y., O.C-SSPANSIARE ALLOWABLE FOR OPEN LATTICE
PAT10 COVERS -ONLY.
LATTICE ROOF
BUILT-UP ROOF
HEADER,S�\
HEADERS
DOUGLAS Flit N0� 1
,l
DOUGLAS FIR N0. 1
SIZE SPAN`,
SIZE SPAN
4 x 4 . . . . .. .. . . ..... . . . . .. : .`. :- 4?". .
4 x 4 4t -
' -4x6
..
4x6'
.................. . ...
4x6
4x8A 11 -Cr
48'.-0
4x10: 14'-0"
4x10 10'
4x12" 17'-C
4x12 12'-0"
6x8 lz.. ' 14'—Cr
6x8 12'-0"
600 ... ..1. �'..-.._.
600
ROOFING NOTES:
A. BUILT-UP, ROLLED ROOF: SLOPE TO. DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.
01
A
RAFTER SIZE AND SPACING
SPECIFY ROOFING AND SHEATHING OR OPEN LATTK E
(SEE ROOFING NOTE ON REVERSE)
----------------
ROOF PITCH
. • . .
CONTINUOUS LEDGER
i
'L'
HEADER SIZE
T AND STRAPS
I 1�X1/r'1' I
_--_-_---- W
ORWIT
(4)irx1
I (4) 184 LS OR BOLT I � W .
RAFTER SPAN:
POST SPACING•
O.N.
OVERALL LENGTH:
` OVERALL LENGTH -
I
_Po
MIN. 4'x4 POSTS
' REAR SETBACK
SIDE SETBACK
'
2000 P.S.I CONCRETE - -J NISH GRADE
MIN..12'x12 FOOTING4-,,,
12°BELOW GRADE L-
rROV10E•:1',,;, CLE/1RANCE
CONCRETE
NCRTE
liO1F:
FASCIAOPEN
ATTACHED
VIA ONE 11, PATIO SC
xS' LA REW THROUGH FASCIA INTO EACH RAFTER TAIL
U -STRAP OR ANGLE
NON -CORROSIVE PLATE „�pE
(�
3/ff x 5 LAG SCREWS INTO STUDS AT 1 frO.C.
CONTINUOUS LEDGER
(4 - 184 NAILS
bff BOLT
U -STRAP OR ANGLE
............... .. �.�
�•� ��� `•.�
18d NAILS
Off BOLT
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING
ANCHOR BOLT (EMBED PROVIDE 1' CLEARANCE
T MIN. INTO CONCRETE) BETWEEN POST AND
CONCRETE
BUILDING DEPARTMENT USE ONLY
TYPICAL PATIO COVER
PERMIT NUMBER
DATE OF APPLICATION
PERMIT ISSUE DATE
OWNER'S NAME
FINAL INSPECTION DATE
S
SPECIAL CONDMONS
MTELEPHONE
H.OA APPROVAL SIGNATURE.DATE