0008-354 (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
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.01 for this reason
Date V ? � It A7Signature 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:
Carver 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. 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 or inspection purposes.
/- Ignature (Owner/Agent) �a ���' �� Date w J
BUILDING PERMIT PERMIT#
-DATE/,r VALUATION LOT 0(1E11�^ _�-W1 TnACT
'
�pp �q
./ [. . SAO$4YM
JOB SITE
APN
ADDRESS 45-170 SPUMI 1:t.0OKLAIa
OWNER
CONTRACTOR / DESIGNER / EN (NEER
C}lLBM4 MOP.t�'C. S
ChuXM`T' MOR.ALM
45.170 3'fJAn3ROOK LANE
45°170 M11,MEROCjK
LA QTWfA, CA. 92253
I -A. Q INTA CA 92253
C760)772-6003 CBIAf
USE OF PERMIT "
PATIO
P.1 TIO COVER 473" X 14' CLASS "A" ROOF
POAC.FUPA71b 60100 SP
ESY ATEA COST OF CONhrf tUC7fXON
8,044-50
p0zbw FRE S'�,taizy
PLAN CHECK FEE 101.000--43SII=316 M2D
CONSTRUCTION PEE 101-000-118-0fd'0 910too
STRONG MOTION FEE - RL431D 101.000.241.000
SUB-TOI`AL CODS eRt7G'' ON AND PLAN CHECK
$179,08
LE- PRE -PAID FIM
$0.00
TOTAL 1'J� FEES DUE NOW
$179,08
RECEIPT
DATE;r y
BY `
DAT FSE
I
INSPECTOR
4;.r
f.
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
0. 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
BLOCKWALL APPROVALS
Final
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final I I
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
Furfures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
�j\
m
RAFTER SIZE AND SPACING SPECIFY ROOFING AND SHEATHING OR''OPEN' 15TTICE
(SEE ROOFING NOTE ON REVERSE)
ROOF PITC /
�— CONTINUOUS LEDGER
(SAME SIZE AS RAFTERS)
HEADER SIZE
T' AND 'L' STRAPS
6"x6"x1"xt/8" WITH
--
z
I (4) 16d NAILS OR BOLT
z
RAFTER SPAN: --JZ–=D
1
r
1
POST SPACING:__ `�
----
I
w
O. H.
y
W
O. H
U
,OVERALL LENGTH:
LL
OVERALL LENGTH:___[__
POST SIZE: –>C
o
REAR SETBACK
I
SIDE SETBACK
(4"x4" MIN.)
2000 P.S.I CONCRETE —moi
I FINISH GRADE
FINISH GRADE I
Lam— MIN. 12"x12" FOOTING
L_ J I
L _ J 12" BELOW GRADE L_ J
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
NOTE:
OPEN LATTICE PATIO COVERS MAY BE ATTACHED 70 EXISTING FASCIA
VIA ONE 1/4" x 5" LAG SCREW THROUGH EAtCIA INTO FACN PAP717a Tau
— i /A" ., S" I Ac CrDnvc Inlet — Ino — . c n n
�vl,al nnl�VLr� Vn JVLIV DLVV1IINU
NAIL RAFTER TO BLOCKING
BUILDING DEPARTMENT APPROVAL BELOW
CITY ',OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
IRATE dole BYv ,.
U—STRAP OR AN
NON—CORROSIVE
(4)— 16d NAILS
OR BOLT
GLE
PLATE GRApE
FINI�� C-4
II II
II II III II
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 22 ^ r�G) (J Q'
OWNER'S NAME A 4- 3 V�G�I G
STREET ADDRESS
CITY, ST ZIP L 4 -
TELEPHONE �i�
H.O.A. APPROVAL
RAFTER SPAN TABLE �` �� �� �� P
GRADING RULES
PS 20-70
(FEET & INCHES) o ��'' oJ��''
O� Oji OJ
ry
NOTES:
1. 32" RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY.
2. FOR SOLID PATIO COVERS (NOT LATTICE)
RAFTER SPAN IS LIMITED TO 10'-0" USING
THIS STANDARD.
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"
1
4>
'-0"
4
014'-
4x10
4x 12
10'-0'
-0
402 17'- 0"
6x8
14'-0"
6x8
12'-0"
6x10
17'-0"
6x10
14'-0"
0
ALL CONSTRUCTION SHALL CONFORM
TO THE PROVISIONS OF THE:
1998 CALIFORNIA BUILDING CODE.
SUPPLEMENTAL NOTES:
ROOFING NOTES:
A. BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.
`tin V i :I'Z Itx}rl iti'C7
OWNER/BUII:DER INFORMATION
Dear Property Owner:
An application for a building permit has been submit=ed in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed) by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all, permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other t_-ian your immediate family, and the work'(including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may an employer.
If you are an employer, you must register with the Sta;e and Federal Government as an employer and you are subject
to several obligations including State and Federal irxome tax withholding,' federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
• For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). Fo•- more specific information about your obligations under State
Law, contact the Department of Benefit Payments and -the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally of through their own employees, witEout a licensed contractor or subcontractor, only under limited
conditions. i
A frequent practice of unlicensed persons professing -to be contractors is to secure an -Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not requiredto be signed by property owners unless they are performing 'their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012
AX: (760) 777: 701.1
OWNER'S SIGNATURE/ DATE
4L -,I �i 0 S�O�N&ODY- 1
PROPERTY ADDRESS
Odo 8 - 36A
PERMIT NUMBER(s) _