9904-097 (PAT)LICENSED CONTRACTOR 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
Professionals Code, and my License is in full force and, -,effect.
�License # Lic. Class Exp. Date
/Date Signature of Contractor( -'—^
1
OWNER -BUILDER DECLARATION
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
Code).
( ) I am exempt under Section , B&P.C. for this reason
Date 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
pe`rformancce of'the work for which this permit is issued.
j—I-have and will maintain workers' compensation insurance, as required by
6Setion 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).
( ) 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 the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: Applicant
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...) agree to comply with all City, and State laws relating to the building
c�pstruction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent)��� —Date
BUILDING PERMIT PERM T#
9150"97
DATE 41 VALUATION turoy�`' LOT TRACT
r�T�
JOB SITE
ADDRESS 79-"l S�1�.aNALl'
APN
OWN�EvRY
CONTRACTOR / DESIGNER / ENGINEER
66 r Y /♦ A�tq
�r ALLISON
CHUCK Y1.i.Ita#+°aL�N
)T R,ED ill.kri./
'73-661 SIENA CT
P,U. BOX 7191
L.AQUINCA Cry 9725.;3
pffirvillpf CSA 92515
USE OF PERMIT
PADD
hatice piaiu coves 306 sq is
,. �.� ...
.11MATED COST O. ST 11;LYCTQON
1-1900
P)PIRMITFE'r, SUMMARY
PLAN CHECK 1 . t0l.-000.431.318 S+40.95
c"'NISTR UCIPC>3 FEE 101-000- 41 R -11m V3."
`"�b�%N+RM` '01-000-241-000
;fir Ml y.4 q.t, CONSYRl.,tt„"'1`t(- N AN PLAN CH.}'C'
$104.-1i
LESS PRE-i'A1{3 FEES
ITU.00
TOTALPERMIT FEES DIX NOW
$104.45
t•
Ll�'
1�l L r�+
RECEIP ,
DATE
BY
DATE FINALED
INSPECTOR
v
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
4 BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Z,
Underground Ducts
Forms & Footings
Ducts
Slab Grade eaiOY? ,
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
99
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)
I /
RAFTW Sff AND SPACING
ROOF PITCH
SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE
(SEE ROOFING NOTE ON REVERSE)
a1
UILD117C "DEP
CONDITIONALLY
ACCEPTED FOR CONS 6'-r iUC i ION
SUBJECT TO INSTALLATION N AS PER
AND ALL APPLICABLE CODES
BY
(4)— 16d NAILS
OR BOLT
U—STRAP OR ANGLE —
(4)— 16d NAILS
OR BOLT ,
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
ANCHOR BOLT (EMBED —
7" MIN. INTO CONCRETE)
TYPICAL PATIO . COVER
DATE OF APPLICATION
OWNER'S NAME cnwUC I•Lt" k � i So /L
J STREET ADDRESS 9 66 C -7 -
CITY, ST ZIP L 4
TELEPHONE y — 97
H.O.A. APPROVAL
ml
CONTINUOUS LEDGER
(SAME SIZE AS RAFTERS)
HEP ER SIZE
'T' AND 'L' STRAPS
[�/(' a
l ++
C Q
6"x6' xt"xl/8 WITH
(4) 16d NAILS OR BOLT /
w
a
a
J
I
R
I
Q
Q
RAFTER SPAN:
POST SPACING:___
0. H.
w
O.H.
J
U .
OVERALL LENGTH:
a
OVERALL LENGTH: -------
'
1.O
/
POST SIZE:
:p
I
REAR SETBACK
__ _____ _
(4"x4" MIN.)
SIDE SETBACK
2000 P.S.I CONCRETE :FINISH GRADE
FINISH GRADE TiL
I
MIN. 12"x`12" FOOTING I I
L_ J
L_ J 12" BELOW GRADE L_ J
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
NOTE:
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ,ONE 1/4" x S' LAG SCREW THROUSH FASCIA INTO EACH RAFTER TAIL.
U—STRAP
OR ANGLE
3/8" x 5" LAG SCREWS INTO STUDS AT 16' o.c.
NON—CORROSIVE PLATE
. ,
GRPpE
a1
UILD117C "DEP
CONDITIONALLY
ACCEPTED FOR CONS 6'-r iUC i ION
SUBJECT TO INSTALLATION N AS PER
AND ALL APPLICABLE CODES
BY
(4)— 16d NAILS
OR BOLT
U—STRAP OR ANGLE —
(4)— 16d NAILS
OR BOLT ,
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
ANCHOR BOLT (EMBED —
7" MIN. INTO CONCRETE)
TYPICAL PATIO . COVER
DATE OF APPLICATION
OWNER'S NAME cnwUC I•Lt" k � i So /L
J STREET ADDRESS 9 66 C -7 -
CITY, ST ZIP L 4
TELEPHONE y — 97
H.O.A. APPROVAL
ml
RATTER SPAN TABLE �� �� `�� O
GRADING RULES Q Q O�
PS 20-70
(FEET & INCHES) OOJ�C''
o` o` o` o�
NOTE:
32" O.C. SPANS ARE ALLOWABLE FOR OPEN LATTICE
PATIO COVERS ONLY.
LATTICE
ROOF
BUILT-UP
ROOF
HEADERS
HEADERS
DOUGLAS
FIR NO. 1
DOUGLAS FIR NO. 1
•
• •
®1
®1
1 •
�i 1
4x4
4'-0"
4x6
8'-0"
4x6
6'-0"
4x8
11'-0"
4x8
8'-0"
4x10
14'-0"
400
10'-0"
402
17'-0"
402
12'-0"
NOTE:
32" O.C. SPANS ARE ALLOWABLE FOR OPEN LATTICE
PATIO COVERS ONLY.
LATTICE
ROOF
BUILT-UP
ROOF
HEADERS
HEADERS
DOUGLAS
FIR NO. 1
DOUGLAS FIR NO. 1
SIZE
SPAN
SIZE
SPAN
4x4
5'-0"
4x4
4'-0"
4x6
8'-0"
4x6
6'-0"
4x8
11'-0"
4x8
8'-0"
4x10
14'-0"
400
10'-0"
402
17'-0"
402
12'-0"
6x8
14'-0"
6x8
12'-0"
6x10
17'- 0"
6x 10
14'-0"
ALL CONSTRUCTION SHALL CONFORM
TO THE PROVISIONS OF THE 1994
UNIFORM BUILDING CODE.
SUPPLEMENTAL NOTES:
ROOFING NOTES:
A. BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM . PITCH.