0011-174 (BLDG)LICENSED CONTRACTOR DECLARATION ;4
I h?repy,@ffirm under penalty of perjury.that I am licensed under provisions`fof
Chapter '(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
608027 13 HIC I W, I PA
'Date — Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that ].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).
O 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
performance of the work for which this permit is issued.
IrIllk 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. _Ally workers' compensation insurance carrier & policy ho.'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 fo iPmply with those Yovisions.
/Date: wit Applicant—
/Warning:
pplicant
"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) / f � �-� Date/, 1 +
BUILDING PERMIT PERMITN
DATE VALUATION LOT W11^174 TRACT
A:IW/20C
JOB SITE
APN
ADDRESS 79-2 i..A�J.a/-X n9C�I�.RISA.
OWNER
CONTRACTOR / DESIGNER / ENGINEER
BRUCE
' OMMCfilri4S1'RUC11011
79.264 CAME SONFMA
16892 LY:t�Yi AA
LA. QU.i1+ TA CA 92233
HO'N=t°b 014 DEA(M CA ".,649
(.714)846-6349 C. 111 • 39671
USE OF PERMIT
�i•�.''�;i1•.. k3'131Ta�T�IC3
3U� Ski • _, tJf"�Ivt S.A'�'�ii~L J�.Fi�iO �:�_ la'1: Lk,"t?1?fd i���f'f:Z74R�;[1
PL�i11i1, •
PORO&YPAT10 300.00 S
,1F:�v.IUdit, TED C-091' 01?CONS" RiYf iaG0;r�t
r d➢JJ1p
PLAN C1.1rL`K FEE 101-000-429-318 5�9�95
CONSxRr.fC310N WE 1dJ1-�f3�416�f?CfJ �s.aa
VMB -TOTAL ► .O.U.I ly.TC71`, ON AND ;IPLAN CIMivCK
X13. 5
N,:VD
�{ A. I�.?i4�,��}AY P•SNS.�` E ANO 9C �
2 2 200a
4L'•fi V'1 H/ ,
Noy .,
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs 0
Underground Ducts
Forms & Footings .. 95�i
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 _ �c _
BLOCKWALL APPROVALS
Final
POOLS - SPAS
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
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)
COMMENTS:
-
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
V1A ONE 1,14" x 5" LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL.
�—
3/8" x 5" LAG SCREWS INTO STUDS AT 16" O.C.
CONTINUOUS LEDGER /
NAIL RAFTER TO BLO,.KING
i BUILDING DEPARTMENT APPROVAL BEELOW I
I
CITY OF LA OUIN-f/`..
BUILDING & SAFETY DEPT .
Av"'PROVED
FOR CONSTRUCTION
i
DATE BY
-194
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
U -STRAP OR ANGLE
NON -CORROSIVE PLATE E
GPAP,
(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 APPLII--ATION QI c1
OWNER'S NAME
STREET ADDRESS C i
CITY, ST ZIP
TELEPHONE
H.O.A. APPROVAL
r RAFTER SIZE AND SPACING
SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE—
If \ (SEE ROOFING NOTE ON REVERSE)
1
2 --Lo
f
clt
i
ROOF PITCH
•
/
t
1
-- CON'iNUQUS LEDGER
(SAME SIZE AS RAFTEP,S)
U
j
HEADER SIZEI
'oogbi�
I '?' ANO 'L''.STRAP$
pZ(�
I
j 6"x6"K'"x1/8" WITH
I
,p - -
W !
z
I (4) 160 NAILS OR BOLT ���
/
RAFTER SPAM:
J
T�
POST SPACING:
O
a
W
O.H.
O.H.
i
I
o
z
OVERALL LENGTH: _ _____
a
OVERALL LENGTH: --.3-o----
e�
`D
/j
----
REAR SETBACK
SLOE SETBACK
POST SIZE.
i
°.
P.S,I FINISH GRADE
FINISH GRADE
20v0 CONCRETE —�I I
I MIN. 12"x12' FOOTING 1 !
L J
L•- J 12".. BELOW GRADE L. -
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
V1A ONE 1,14" x 5" LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL.
�—
3/8" x 5" LAG SCREWS INTO STUDS AT 16" O.C.
CONTINUOUS LEDGER /
NAIL RAFTER TO BLO,.KING
i BUILDING DEPARTMENT APPROVAL BEELOW I
I
CITY OF LA OUIN-f/`..
BUILDING & SAFETY DEPT .
Av"'PROVED
FOR CONSTRUCTION
i
DATE BY
-194
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
U -STRAP OR ANGLE
NON -CORROSIVE PLATE E
GPAP,
(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 APPLII--ATION QI c1
OWNER'S NAME
STREET ADDRESS C i
CITY, ST ZIP
TELEPHONE
H.O.A. APPROVAL
y
BUILDING & SAFE Y-DEP"i'.
APPROVED',
FOR -CONSTRUCTION
DATE BY
BERLIN / WILLIAMS PATIO COVER t'
( Hangers here if approved)
30'0" . ( post bases) t,
( Simpson ABA
withUr x W bolts &
washers
CITY OF LA QUINTAN �
ILDING & SAFETY DErT. W „
2 x 6 ea. side of post
A P P R t) under joist support typical
OR CONSTR CTic).'J(16D gals. nail attatch. typ. )
Construction consisting of 4 x 4 posts on spot footings 12" are x 12" r
deep.with
approved posts bases, with double 2 x 6 perimeter, supporting 2 x 6 joists not to exceed
32" on center for open lattice covers, supported to ledger or facia ( if approved) by
hangers with 2 x 2 's above. Douglas Fir construction
0 2x2's
Submitted by: Tower Construction 2 x-6 's --flow
•
16892 Lynn # A
Huntington &:h. CA 92649 Lic # 608027 2 x 6's
4x4's
( 2" k 6" Simpson joist 16Q
e
I hangers galvinized
{ g nails TYp• :'
-e
31
•f.
0.
Cut in spot footings 12" x
12° x12" w /post bases
(Simpson PBS 44A)'
30'0" . ( post bases) t,
( Simpson ABA
withUr x W bolts &
washers
CITY OF LA QUINTAN �
ILDING & SAFETY DErT. W „
2 x 6 ea. side of post
A P P R t) under joist support typical
OR CONSTR CTic).'J(16D gals. nail attatch. typ. )
Construction consisting of 4 x 4 posts on spot footings 12" are x 12" r
deep.with
approved posts bases, with double 2 x 6 perimeter, supporting 2 x 6 joists not to exceed
32" on center for open lattice covers, supported to ledger or facia ( if approved) by
hangers with 2 x 2 's above. Douglas Fir construction
0 2x2's
Submitted by: Tower Construction 2 x-6 's --flow
•
16892 Lynn # A
Huntington &:h. CA 92649 Lic # 608027 2 x 6's
4x4's