9705-056 (PAT)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty df perjury that I am licensedunder provisions of
.' hap; r 9 (commencing with Section 7000) of Division 3 of the Business and
Professl8nals Code, and my License is in full force and effect.
License # . r Lic. Class Exp. Date
Date Signature of Contractor j
OWNER -BUILDER DECL'''ARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
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 & Professionals Code).
( ) I, as owner -of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
O I am exempt under Section B&P.C. for this reason
Date 1C - tr - r•i `-. Signature of Owner
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 of the work for which this
'permit is issued. My workers' compensation. insurance carrier & policy no. are:
Carrier Policy No. .
(This section need not be completed if the permit valuation is for $100.00 or less):
4^(I) I certify that in the'performance of the work for which this permit is issued,
I hall not employ any person in any manner so as to become subject'to the
Wothrkers' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of *the,
Code, I shall forthwith comply with those provisions. ,
Date: c -t.. 6 7 Applicant r„ _4
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 Director 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
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.
/ `
Signature (Owner/Agent)
{. i c c r r. Date e-1��
BUILDINGPERMIT PERMIT# CONTROL#
97051156 5106
DATE VALUATION LOT TRACT
�.'�•lF�b�t3t0
St 9197.JOB
SITE
ADDRESS 52-165A1�Il�NIDAV VELACO
APN '73-32 19
OWNER
CONTRACTOR / DESIGNER / ENGINEER
ISIt01t0 a MALA -A GArKIr
UIL,9%[t
S2865 AvlrNIDA VELASCO
L.A. 4, DINT A CA W'2"33
CUT.,##
USE OF PERMIT
4,1141 &P. PAIK) CCAI'C t
i�i)k.%,ctIVA TI0 440.00!W
�t�`#'��l1��4'i'� {� i;,��'Ir �� t.��ws•i Knit: it�11�
s�.ia�z,�
i'il;RSO i• VWX Sii111(1"AkV
VL,AN(-'f4ECKVtits Io! -OW -430.31K S5 T,�`
..»-
f"t"tr�f�.;l�f�,Itr�rrtr"iRl i�t�; 1131...rN1[}.dl�t-�3f)Ci Kir tifi
+"{'�a1.(s. i�ii:Y3,dC1{ti! {�ilr - tt�,�ll) !A�-•�f'N3-'?Tt •fes $.34
C" �)
Q 0
ME
W Iftr10TA!, ANY) P1,AN C IIV.C[C
LESS PRE-t'.AID FEES
$000
1•tYlAt..P141IR IT 1+17?.1 S 011.1V,NOW
$134.14
RECEIPT
DATE
By ��� ✓.
DATE FINALED
INSPECTOR
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
POOLS - SPAS
BLOCKWALL APPROVALS
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
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
5Z7 5z�
u RAFTER SPAN TABLE �`\A�_ �`\A� 4`\A�
GRADING RULES c) � �- c Sc) C-)O�
PS 20-70. c� �'. V Y. v
(FEET & INCHES) OOJ��''
2x4
16
24"
O.C.
10 6
9'-6"
7'-s'
8,4'
8'-6" 8'-0" 6'-0"
7'-3"
SIZE
SPAN
2x6
16"
2.4"
O.C.
15'-0"
- "
10'-9"
13'-0"
12'-6" 1'- " 8'-9"
10'-6"
N/A
N/A
s
4x10 -
2x8
-
16". O.C.
24"
32"
18'4"
17'-0"
13'=6"
16'-0"
15'=6" 4'-6" 11'-0"
1.3'-0"
-0" 11 &.
13' N A
N A
17'- "
6x10 14'-0"
ALL CON_ STRUCTION SHALL CONFORM
TO THE PROVISIONS -.OF THE 1,994
UNIFORM BUILDING CODE.
J!
r.,.
SUPPLEMENTAL NOTES:ti
NOTE: _.
37' O.C.• SPANS ARE ALLOWABLE FOR OPEN LATTICE
PATIO COVERS ONLY.
LA
E ROOF
BUILT-UP ROOF
k
HEAD S
HEADERS
DOUGLAS
FI O. 1
DOUGLAS FIR N0. 1
SIZE
SPAN
SIZE . SPAN
4x4
'-0"
4x4 4'-0"
4x6
a
4x6 -
4x8
11'=0"
4x8 8'-0"
4 0
s
4x10 -
x12
17' ;0"
4x 12
6x8
NOTE: _.
37' O.C.• SPANS ARE ALLOWABLE FOR OPEN LATTICE
PATIO COVERS ONLY.
LA
E ROOF
BUILT-UP ROOF
k
HEAD S
HEADERS
DOUGLAS
FI O. 1
DOUGLAS FIR N0. 1
SIZE
SPAN
SIZE . SPAN
4x4
'-0"
4x4 4'-0"
4x6
8'LO"
4x6 -
4x8
11'=0"
4x8 8'-0"
4 0
14'0"
4x10 -
x12
17' ;0"
4x 12
6x8
14'- "
6x8 i 12'-0"
6x10
17'- "
6x10 14'-0"
'ROOFING NOTES:
A. BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN. - --
B. ROCK ROOF: 3/12 MAXIMUM PITCH.
RAFTER SIZE AND SPACING SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE
(, I I (SEE ROOFING NOTE ON REVERSE)
--------�--- E--
ROOF PITCH
bi 211
CONTINUOUS LEDGER
(SAME SIZE AS RAFTERS)
HEADER SIZE
-� v a T' AND •l' STRAPS
^• ----- 6*xirx1"x1/8' WITH
(4) 16d NAILS OR BOLT I u
RAFTER SPAN:
-- �— 1 POST SPACING:_s/_'j0
O.H.
W O.H. J
_U
-CL
OVERALL LENGTH: �I a OVERALL•LENGTH . �Q_Z
I
POST SIZE:
REAR SETBACK SIDE SETBACK—.7 (4 xC MIN.)
2000 P.S.1 CONCRETE —+1 _ 1 FINISH GRADE FINISH GRADE
L I --MIN: tYx1Y FOOTING -1•
,BELOW GRADE L _J
:PROVIDE 1" CLEARANCE
BETWEEN POST AND -
CONCRETE
N LATTICE
EONE PATIO COVERS MAY BE AF/47 x. 5LAG SCREW THROUGH HED TING FASCIA
VIAEACH RAFTER TAIL
U—STRAP OR ANGLE.
3/8" x 5" LAG SCREWS INTO STUDS AT 16" D.C. NON—CORROSIVE PLATE D
. SRAE �
CONTINUOUS LEDGER ���Sf♦
(4) I 6 NAILS
OR BOLT
U—STRAP OR 'ANGLE
(4)—. 16d NAILS
OR BOLT
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE 11
BUILDING DEPARTMENT APPROVAL BELOW 11111 11111
.-_-. iidM.Fhy1A I...Ma.i+.: nuw.r.w.v_.r.•..w......_....-w..v�..v_..+..._ y 11 I 1 II
CITYOF LA QUINTA " ANCHOR BOLT (EMBED '
MIN. INTO CONCRETE)
BUILDING &.SAFETY DEPARTMENT
®MDM®NALLY TYPICAL PATIO COVER -
ACCEPTED F®RM TR"'" ATE OF APPLICATION
SMECT TO INSTAUATIa� BONN` AS PM WNER 5 NAME .'ITREET ADDRESS ` ! Q v
p 0 I��+ ITM. 'ST 'ZIP /� U I',
ARID ALL A LE CODES ELEPHONE ' ; _ ' � � J � 2 4t/
L'DATE ( By I - -
OA APPROVAL �.
TAtyl 4
f�GlGV
P.O. BOX 1504 `APPLICATION ONLY
BuildingG/,, / 1 7&105 CALLE ESTADO
Address SZ 0 (OS OC UPIC— A -S °L0 LA QUINTA, CALIFORNIA 92253
Owner ('0f4-44- ' ty
Mailing BUILDING: TYPE CONST. z OCC. GRP.
Address qS —70 p/l((� o ASF' ��C A.P. Number 773'- ✓ Z � ( /
CitTel.
Y Zi / O / L
L Legal Description (6
h 10 1� A. /�
Contractor —
ress
Tel.
Project Description
State Lic. City
& Classif. Lic. # Sq. Ft.
Size
Arch., Engr.,
Designer New ❑
Address I Tel
City( Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he 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 (5500).
17 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 or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
orimprovement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
l 1 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
17 I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I.hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
n Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg 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.
Date Owner
NOTICE TO APPLICANT: If, atter making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
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 city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
FINANCE
No.
ZZ Stories
No. Dw.
Units
Add ❑ Alter ❑ Repair ❑
e -(c �/�-LL 3 p.t
o/Do
Demolition ❑
07-1
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const. ✓ , , f '
r,.
Mech.
Electrical
_ N
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation: