07-1667 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO -
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
07-00001667
Property Address:
78702 SIENA CT
APN:
609-530=01.5-15 -28457 -
Application description:
PATIO COVER - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
'5852
Applicant: - Architect or Engineer:
----------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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 Class: B License No.: 510847
Date�2� ntractor.
ell
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 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 3 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 (5500).:
1 _) 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 a projects with a'contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , BAP.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 Address:
LQPERMIT
Owner:
BILL' HUMPHREYS
78702'SIENA COURT
LA QUINTA, CA 922E
Contractor:
HAWKINS CONSTRUCTI
77850 DELAWARE PLP
PALM DESERT, CA .92
(760)413-3017.
Lic.'No.: 510847
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/06/07
. . J
------------------------- - - - - --------- - - - - --
WORKER'S COMPENSATION DECLAR TION
1 hereby affirm under penalty of perjury one of the following declarations:
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
i 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 and•policy_number are:
Carrier STATE FUND Policy Number , 0026451-2006
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 abor Code, I shrill forthwith comply with those provisions.
ate: •�V 0-7 pplicant: — l/
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. 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 Director of Building and Safety 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.
certify tha have readthis application and state that the above information is correct. I agree to comply with all
city and unty ordinances a state laws relating to building construction, a d hereby authorize representatives
of th' county to en9ter upo the above-mentioned property for inspection poses.
at�/ gna[ure (Applicant or Agent):
Application Number . . . . 07=00001667
Permit . . . PATIO COVER
PERMIT
Additional desc "
Permit Fee . . . . 81.00
Plan Check*Fee
52.65
Issue Date . . . .
Valuation
5852
Expiration Date 12/03/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
4.00 9.0000 THOU BLDG
2,001-25,000
36.00
----------------
Special Notes and Comments
- --------------------------
- -------
440 S.F.ALUMAWOOD LATTICE PATIO COVER,
PER APPROVED PLANS
-------------------------------------------
Other Fees . . . . . . . . STRONG MOTION (SMI)
- RES
------
.58
Fee summary Charged
Paid Credited
Due
-------- ----------
Permit Fee Total .81.00
----------
.00
----------
.00
81.00
Plan Check Total 52.65
.00
.00
52.65
Other Fee Total .58
.00
.00
.58
Grand Total .134.23
.00
.00
134.23,
.
Bin. #
L
l -
City of La Quinta
Building U Safety Division x 6 mo.
P.O. Box 1504, 78-495 Calle Tampico Is
La Quinta, CA 92253 - (760) 777-7012'
Building Permit Application and Tracking Sheet
Permitft ^
��.
Project AdJ?,(2 2 . Sl �p L f--
Owner's Name: /
2L f
A. P. Number:
Address: `� %Z . I/
Legal Description:
City, ST, Zip: �1qo
Contractor:
o
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Project Description: ���+yv✓�
City, ST, Zip:
Telephone: V/ 3 . 3t7 %
% / 2 6 ••' 3 Z-
State Lic.
City Lit. #:
Arch., Eugr., Designer,.,
Address:
City, ST; Zip:
Telephone:
State Lie. #:
Name of Contact Person:.
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq: Ft:.
#•Stories• -
# Units:
Telephone # of Contact Person:Estimated
Value of Project
APPLICANT: DO NOT WRITE BELOW THIS UNE
#.
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Coles.
Called Contact Person
Plan Chick Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan..
Plans -resubmitted
Mechanical
Grading. plan
2°' Review, ready for corrections/issue
Electrical
Subcontactor List '
Called Contact Person
Plumbing -
Grant Deed
Plans picked up
SALL
Ii 0A. Approval
Plans resubmitted
Grading
IN ROUSE:=
''' Review, ready for correctious/issue
Developer Impact Fee.
Planning Approval.
Called Contact Person
A,I,p,p.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees.
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