06-0164 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
06-0.0.0.00164
53965 AVENIDA CORTEZ
774-141-021-10 -000000'-
PATIO COVER RESIDENTIAL
COVE RESIDENTIAL
2301
Architect or Engineer:
BUILDING 8i: SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby:atfirm under penaltyof perjury that 1 am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of -the' assionals Code, and my License is in full force and effect.
Bu
license Class: B nse 860958
Date: 1 1 YL► Gi(i Contractor:
OWNER -BUILDER DECLARATION
I. 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 statementthat he or she is,licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with:Se.ction 70001 of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Anyv)olatiowaf Section 7031.5 by
any applicant fora permit subjects .the applicant to a civil penalty of nut, more than five hundred dollars (8500).:
(;_ 1 I; as.ownerof 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 thework himself or herself through his or her own employees, provided that the
improvements are'not intendedor 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.).
l _ 1 I, as;owner at 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 contracts4or the projects with a,cohiractor(s),J_icensed
pursuant to the 'Comractors"State License Law.)..
I—) I amexempt under Sec. , B.&P.C. for thisseason
Date:
Owner:
CONSTRUCTIOWLENDING 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:
KELLER KARL
53965 AVENIDA CORTEZ
LA QUINTA, CA 92253
Contractor:'
PELLETIER PATIO
79275 DESERT STREAM DR
LA QUINTA, CA 92253
(760)275-7593
Lip. No.: 860958
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/12/06
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of, perjury:ons:of the following declarations:
_ I have and will maintain a certificats'of concent to self -insure for workers' compensation; as provided
for by"Section 3700 of the Labor Code, for the performance of thework 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 of the work for which this permit is issued. My workers' compensation
insurance carrievand policy number are:
Carrier EXEMPT Policy Number EXEMPT
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 thet,:if I shout esuto thew 'compensation provisions of Section
1 3700 of the Labor e, I shall
�=�se provisions.
Date: 't L 1 O V Applicant:
WARNING: FAILURE TO SECURE ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL:FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (8100,000)• IN.ADDITION TO THE COST OF COMPENSATION, DAMAG_ ES 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 behelf'this application.is made, eachperson,atwhose 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 Quints, 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'issuence of such permit; or cessation of work for180 days will subject
permlt.to cancellation.
I certify that I have read this application and state that the aormation is correct. I to comply with all
citand county ordinances end state laws relating to bui aonatru n; and hereby au_ adz representatives
of this co my to ellte-r upon the above-mentioned pro for inspectio purposes.
Date: t 14.� ianature (Applicant'or Agent),
Application Number . . . . . 06-00000164
Permit . . .
PATIO COVER
PERMIT
Additional desc . .
Permit Fee . . . .
54.00
Plan Check
Fee
35.10
Issue Date . . . .
Valuation
. . .
. 2301
Expiration Date . .
1/11/06
_ Qty Unit Charge
Per
Extension
BASE
FEE
45.00
1.00 9.0000
THOU BLDG
2,001-25,000
9.00
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Special Notes and Comments
173 ALUMAWOOD LATTICE
PATIO COVER
IN
REAR YARD
-------------------.--------------------------------------------------------
Other Fees . . .
. . . . STRONG MOTION (SMI)
- RES
.50
Fee summary Charged
----------------
Paid Credited
Due
----------
Permit Fee Total
----------
54.00
-----------
.00
----------
.00
54.00
Plan Check Total
35.10
.00
.00
35.10
Other Fee Total
.50
.00
.60
.50
Grand Total
89.60
.00
.00
89.60
IV
r
LQrERMIr
CITY OF LA QUINTA ' -:��`SPEECTION FEE OF $30
BUILDING & SAFETY DEPT. iLL BE CHARGED IF THE APPROVED
APPROVED PLANS AND JOB CARD ARE NOT ON
FOR CONSTRUCTION THE SITE FOR A SCHEDULED
INSPECTION.
DATE -ABY Kin rvrroTlnhl0l
4s'
k( wV-alo"r
:53- A (05 Ave . Caritz
Oi22S3
Pe,(U.� K- - 'Pc, -
C # .(a C)C�-.b
4s'
Bin #' City of La Quinta.
Building a Safety Division
Permit.# P.O. Box, 1504, 78-495 Calle Tampico
La Quinta, CA 92253 --(760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: ?� C� (o CO�Z Owner's Name:
A. P. Number: Address: 5 3, 9 L -75—.,
Legal Description• ,/ City, ST, Zip: L q2? S3'
Contractor: PG W -fie r q�a-hZ9 Telephone:
Address: �et27j �eSpXT sv-'re-a" Project Description:
City, ST, Zip: Lc� '1i22 J �
Telephone: 97 $
State Lic. # : 6 Lp,09 5.eS City u-.. #:
Arch., &ff.,,Designer:
Address:
City, ST, Zip:
Telephone: Construction Type: Uccupaacy:
State Lie. #: Project type (circle:one): New A,dd'n Alter Repair Demo
Name,of Contact Person: Irr ��,IG.//�l Sq.,Ft : # Stories: # Units:
Telephone #. of Contact Person:
Estimated Value of Project: 15 C5 w
APPLICANT: DO NOT WRITE BELOW THIS UNE
N
Submittal
Req'd
Reed
TRACKING.
PERMrr FEES
Plan Sets
Plan Check.submitted
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Energy Cale#.
PlaR Picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan'
2" Review, ready ter correctionslissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Planvoteked up
S.M.L
H:O.A. Approval
Plans resubmitted
Grading
INHOUSE:
"Review, ready -for correctionsrusae
Developer Impact Fee
Planning Approval
Called Contact Person
AXP -P.
Pub. Wks. Appr
Date of permit issue
School Fees
r-