10-1258 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
410=6006i25W� ,
Property Address:
47815 SOFT MOONLIGHT
APN:
649-030-.069-15 -31311 -
Application description:
PATIO COVER - RESIDENTIAL
Property Zoning:
HIGH DENSITY RESIDENTIAL
Application valuation:
2274
ADDlicant:
Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
,I hereby affirm underpenalty 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..
Licen Clas : B LicenseNo.: 770843
ate: tractor
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) br
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).:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 100,
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.). ,
(_ 1 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 contractor(s) 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.ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address: pifir -
LQPERMIT
Owner:
SWAIN
47-815 SOFT MOONLIGHT
LA QUINTA, CA 92253
(760)771-3345 '
Contractor:
LIFETIME PATIOS
PO BOX 5806
LA QUINTA, CA 92248
.(760)777-2650
LiC. No.: 770843
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/17/10
-------------------------------------------
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.
9.1 have and will maintain workers' compensation insurance, as required by Section 3700 sof 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 SOUTHERN INS Policy Number WSIO04013401
_ 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 tall forthwith comply with those provisions.
ate: ! scant•
WARNIN FAIL EURE WORKERS' CO ENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($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 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. -
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 IN ounty o enter upon above-mentione operty for inspection purposes..
ate: ,/ nature (Applicant or
Application Number . . . 10-00001258
Permit PATIO COVER PERMIT
Additional.desc .
Permit Fee 54.00 Plan Check Fee
35.10
Issue Date . . . . Valuation . . .
. 2274
Expiration Date 5/16/11,
Qty Unit Charge Per
Extension
BASE -FEE
45.00
1.00 .9.0000 THOU BLDG 2,001-25,000
9.00
Special Notes and Comments .
INSTALL 171 S.F. WEATHERWOOD SOLID SHADE
STRUCTURE. 2007 CODES.
-----------------_---------------------------- - - - - -- - --
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
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 •1.50 .0.0 .00
1.50
Grand Total 90.60 .00 .00
90.60•
r'
171 1p,
Sbua r
p ^, t /� 1
-CITYbF LA QVINT/•'°� `
BUILDING & SAFETY DEPT..'
APPROVEDt
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FOR CONSTRUCTION,
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APPROV Y _ LANNING DE A T ENT i� ..
BY DATE :
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EXHIBIT r
r CASE NO. -
• U .. .9770897
TIME
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Bin #
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City of La Quinta
Building gr Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
MUM, Rqrmit Application anid Tracking Sheet
Permit #
. PAAJO
Project Address:'
Ra U=g 14
Owner's Name-,
wAl
A. P. Number:
Address: q ' 781S
Legal Descript i on:
Contractor:
City, ST, Zip: L A q-zts-5
MY
Telephone:
Address:. 1619X 5SIL96
Project Description:
City, ST, Zip: 1A tQ01A)7—,4,.
(A
.Telephohe:7/a,0-7;7,,?-,O,O;,3
F=J-
State Lic. # 13 - -7 -719 9 41 -5.
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle.one): New Add'n Alter Repair Demo
Name of Contact Person: 67,6arle:5
L�lj
Sq. Ft
# Stories:
T# �nits:
Telephone# of Contact Person:
Value of Project. /3&6
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Reqld
RecId
TRACKING.
PERmrr.FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss CaIcs.
Called Contact Person
Plan' Check Balance -
Energy Coles.
Plans bicked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan'
,d
2 Review, ready for correctionsfissue
Electri Cal
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3W 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