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BPAT2014-100978-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BPAT2014-1009 Property Address: 78130 CORAL LN LN APN: 770370038 Application Description: PATIO COVER Property Zoning: Application Valuation: $10,000.00 Applicant: KELLY DOMER PARTNERS INC DBA K 999 ANDELSEN DRIVE #160 SAN RAFAEL, CA 94901 T4tv °& 4Qu&to COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT 1 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 Prof ssio s Code, and my License is in full force and effect. License Class: B License No.: 346196 l„ Date: 3 Contract r: I < OWNER -B R DEC TION - I hereby affirm under penalty of perj that I am exempt from Contractor's State License Law for the following reason (Sec. 7031.5, Business an 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 ? 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 contractors) 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 Addre! VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/23/2014 Owner: JOHN & RENE HOUSTON 78-130 CORAL LANE LA QUINTA, CA 92253 Contractor: KELLY DOMER PARTNERS INC DBA K 999 ANDELSEN DRIVE #160 SAN RAFAEL, CA 94901 (415)464-0900 Llc. No.: 346196 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' compensa i , as provided for by Section 3700 of the Labor Code, for the performance of the or which this permit is issued. have and will maintain workers' compensation insurance, as required by Se 00 of the Labor Code, for the performance of the work for which this permit i i u d. 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 s ect t workers' compensation provisions of Section 3700 of abor Co , I sh f ith comply witthh�thos provisions. Date: / Applicant: WARNING: FAILURE TO SECURE W S' COMPENSATION COVER/ZSNLAWFUL, AND SHALL SUBJECT AN EMPLOY O CRIMINAL PENALTIES ANDNES UP TO ONE HUNDRED THOUSAND DO RS ($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 uilding construction, and hereby authorize representatives of this city to er up o mentioned property for inspection purposes. Date:Signature (Applicant or Agen DESCRIPTION , ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HOURLY PLAN CHECK - YES 101-0000-42600 2 $140.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forCITY STAFF - PER HOUR: $140.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 101-0000-42403 0 $23.83 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 PC 101-0000-42600 0 $23.83 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $47.66 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PATIO COVER, DESIGNED 101-0000-42404 0 $131.56 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT " PAID PAID DATE PATIO COVER, DESIGNED PC 101-0000-42600 0 $165.88 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PATIO COVER / COVERED PORCH / LATTICE $297.44 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $1.30 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $1.30 $0.00 • • $0.00 Description: PATIO COVER ADDITIONAL Type: PATIO COVER Subtype: Status: APPROVED Applied: 8/1/2014 KHE Approved: 9/23/2014 THA Parcel No: 770370038 Site Address: 78130 CORAL LN LN LA QUINTA,CA 92253 Subdivision: TR 30056 Block: Lot: 11 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $10,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 CONDITIONS Details: PATIO COVER - 231 SQ FT PATIO COVER, SPECIAL ENGINEERING. 2013 CALIFORNIA BUILDING CODES. 53 r J Applied to Approved FINANCIAL INFORMATION Printed: Tuesday, September 23, 2014 2:47:08 PM 1 of 3 IAAF Cffffff SYSTEMS ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES TELEPHONE CALL JIM JOHNSON 9/23/2014 9/23/2014 CALLED APPLICANT TO INFORM HIM PLANS ARE READY DO ISSUE. CONDITIONS CONTACTS NAME TYPE NAME- ADDRESSS CITY STATE ZIP PHONE FAX EMAIL APPLICANT KELLY DOMER PARTNERS INC DBA K 999 ANDELSEN DRIVE #160 SAN RAFAEL CA 94901 ( FINANCIAL INFORMATION Printed: Tuesday, September 23, 2014 2:47:08 PM 1 of 3 IAAF Cffffff SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CL TD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDI.NG STANDARDS ADMINISTRATION $1.00 $0.00 BSA: HOURLY PLAN CHECK - 101-0000-42600 2 $140.00 $0.00 YES Total Paid for CITY STAFF - PER HOUR: $140.00 $0.00 DEVICES, FIRST 20 101-0000-42403 0 $23.83 $0.00 DEVICES, FIRST 20 PC 101-0000-42600 0 $23.83 $0.00 Total Paid for ELECTRICAL: $47.66 $0.00 PATIO COVER, 101-0000-42404 0 $131.56 $0.00 DESIGNED PATIO COVER, 101-0000-42600 0 $165.88 $0.00 DESIGNED PC Total Paid forPATIO COVER / COVERED PORCH / LATTICE $297.44 $0.00 SMI - RESIDENTIAL 101-0000-20308 0 $1.30 $0.00 Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $1.30 $0.00 TOTALS:•• Printed: Tuesday, September 23, 2014 2:47:08 PM 2 of 3 CR SYSTEMS INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES FINAL" Printed: Tuesday, September 23, 2014 2:47:08 PM 2 of 3 CR SYSTEMS NON-STRUCTURAL TOM HARTUNG 8/22/2014 9/23/2014 9/23/2014 APPROVED APPROVED PLAN CHECK CORRECTIONS 1ST. P/C 8/22/14 STRUC P/C BY YOUNG ENGINEERING TOM CORRECTIONS REQUIRED 8/22/14 STRUCTURAL 8/22/2014 9/8/2014 9/23/2014 APPROVED APPROVED Structural corrections were minor and verified by HARTUNG TH Printed: Tuesday, September 23, 2014 2:47:08 PM 3 of 3 C SYSTEMS Bin # - V Qty of La QU7nta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico . . La Quints, CA 92253 - (760) 777-7012. Building Permit Application and Tracking Sheet Permit # Project Address: Owner's Name• A. P. Number: . O S' Address: –?,Fr— / Legal Description: �"� c C ujr City, ST, Zip: �%fCC �C �� 22 Contractor: //.j� Tele hone: Address: 5� Project Description: City, ST, Zip: -D Telephone: c t�r '#: State Lic. #: �' ��j City Lie. do Arch., Engr., Designcr:,f/� Address: r Y� City., ST, Zip: f. !� Telephone: — StotoLic.#: Occupancy: Construction Type: an cY: ecttYP (circle one): New Add'n Alter Repair Demo oProJ Name of Contact Person:A Sq. Ft.: 3 # Stories: # Units: Telephone #,of Contact Person: 04,41�_Z Estimated Value o roject: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready r corrections ZZ Plan Check Deposit Truss Cales- Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up �� Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for correctionsrssue Electrical SubcontactorList Called ContactPcrson Ax-7VAJ ��/ Plumbing Grant Decd Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 0//S .12��=- � 2 -2 - 9 3 l,S' elo, �i%e I�✓ Y/Lsb�