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0210-190 (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: ()4 I, as owner of the property, or my employees with wages as their sole ompensation, 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 contractorsAo construct the project (Sec. 7044, Business & Professionals Code). () I am exempt under Section B&P.C. for This red>a�' on Date tr,.-D r'�r�F]Mt Signature of Owner jt�ill'As- X4L.19.'TiH1c� ., 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:. Carrier Policy No. (This section need hot be completed if the permit valuation is for $100.00 or less). �e) I certify that in the performance of the work for which this permit is issued, ,Vshall 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 wit. th e p ovisio SSE. /'bate: In. 4•� r�, �� Applicant—,,,, ���- �+ -"`, Warning: Failure to secure Workers' Compensation coverage is unlawful and Shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damagesasprovided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety ;for a permit subject to the conditions and restrictions set forth on his application. 1.. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if -work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for ins ection urp ses. a.,Si nature (Owner/Agent) ��� bhla_ ". ',• Date 12.4 4V4V BUILDINGRERMIT PERMIT# E 4 x.2,0)-.f.s#): IIATE � VALUATION- - LOT TRACT JOB SITE ADDRESS !; * 194,A0.6714FJ�ESA APN N, w - OWNER CONTRACTOR / DESIGNER / EN (NEER 45 M :190 K71a.FR 0X Y t, ll�ti'Ya . CIA 922,x3 �. E r tr':�L3f USE OF PERMIT 0t Sia.LATT.IC:, PA110 PRM C'f'! Y STANDARD. PORCHIPATIC) 430,09V /.�/AIM)C09r OF �Mm.%frL+'.3..M10.UMIOI�.4-i 4/,fs,+Mb19) �(y'7ry '�jg/�y �p+ry';7�y �tl'j Sjj �^/��i�✓� F,TAaa`id�.1�} .f�. lkll SY'CJ:i.�Yk�.7h{.-0i1La.i$. _ MS PLA14 t'—MCM FEE t 101-000-439-315 VMS COWSTRU(:1'I N FER ; X091-000-44"00 $II .Otf ECT71UU1 r CITY OF LA QUINTA FINANCE DEPT. �3ifi~+;�.'1_D'1",�}:L. �������,1•.�i����.��`�i .��1'� 2',f;��L' ����. Ti"iz ysi ry i�'' PWf VA jxa 13'1�� A1,34, RECEIPT DATE BY` r4' fes.; ✓` F DATE NALED INSPECTOR l0. lh: �., e ol/ INSPECTION RECORD OPERATION 11 1 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 O.K. to Wrap F.A.U. Framing i Compressor Insulation f LVents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines ' Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS _ BLOCKWALL PPROVALS 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 Ga's 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) U OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted 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 than 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 be an employer. If you are an employer, you.must register with the -State and Federal Government as:an employer and you are subject to several obligations including -State and Federal income 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). For more specific information about your obligations under Stare 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 or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. 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 required to be signed by property owners unless they are performing 'their own work personally. Information about licensed contractors may be obtained by coniacting 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, z CITY OF IA QUINTA DEFT. OF BUILDING AND SAFETY. 78-495 Calle Tampico La Quinta, CA 92253 I (760)777-7012. Fr 77-701 - �o-I$-moa OWNER'S SIGNATURE/DATE LIS 190 S(1111QR00K iA'N6'_ LA awk" c,'� W53419 PROPERTY ADDRESS PERMIT NUMBER(s) 0 RAFTER SIZE AND SPACING SPECIFY'ROOFING ANL, SHEATHING OR OoEN L4T^,�E _ a x 6 a40N �► .(SEE ROOFIN;, NOTE ON REVERSE` -------------- --------------------- R00: PITCH - 10/0 --- r / CONTINUOUS LEDGER. (SAME SIZE AS RAFTERS) �--r HEADER SIZE ---------- �y� RAFTER SPAN: 10' H/1 ------- IF'T61 — — 0. H. �"L-�- _z I L5 J O.H. a I V� Q li WI I rl AND .'L' STRADS 6'.6".1".1/5^ WITH II (4) 16C NA1.S On BJl POS- SPACING-IIFis- OVERALL LENGZTH: I l �r 6+es OVERALL LENGTH _ 4S RtT POST SIZE T REAR SETBACK I SIDE SETBACK (4'x4 MIN.) 6X6 1 I �� I �— MIN. 12-x12" FOOTING I 12- BELOW GRADE L i I I - J 2000 P.S.I CONCRETE --+ L FINISH GRADE FINISH GRADE I L- NOTE OPEN LATTICE PATIO COVERS MAY EE ATTACHED TO EXISTING FASCIA VIA ONE 1114" x.5" LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL. i-- 3/5 . 3 LAG SCRFWC INTl1 GTI 111C , BUILDING DEPARTMENT APPROVAL BELOW 0FFICF CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED ZJFOR CO TRUCTION ( OZ BDA Y 1 U -STRAP OR AN NON -CORROSIVE (4)•- 16d NAILS OR BOLT i U -STRAP OR ANGLE — (4)- 16d NAIL'S OR BOLT PROVIDE 1" CLEARANCE BETWEEN POST: AND CONCRETE i I ANCHOR BOLT '(EMBED - 7" MIN. INTO CONCRETE) PROVIDE 1" CLEARANCE BETWEEN POST AND CONCRETE -� r. TYPICAL PATIO COVER DATE OF APPLICATION OWNER'S NAME VE 171 SI-AD STREET ADDRESS qGS cjo SUAGROM LrPJ CITY. ST ZIP i LA QutAlT'A (A 9zoG3- 4I1`I TELEPHONE I -760--7-7.)- 337 H.O.A. APPROVAL I i I FA7FR SPAN TABLE ,/����`i!-���\ ALL -CONSTRUCTION GRADIN.. RULES % r UCTION SHALL CONF` �I, PS —70 �;'/'v\'/ Q TO THE PROVISIONS OF THE �'FEET & INCHES) O O / 1998 CALIFORNIA BUILDING CODE. O' O q.�' O`z/�OC`�/ o/ SUPPLEMENTAL NOTES. 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 I� BUILT-UP ROOF i HEADERS HEADERS DOUGLAS FIR NO. 1 DOUGLAS FIR NO. 1 SIZE SPAN 2x6 16" 0'1C. 24" 32 15'=0' 14,-0" 10'-9" 4'-0.. 12'-6" 11'-0"" 8'-9" #N/A 10'-0" 81-6" N/A 6'-0" 4x8 11'-0" _,:d 1c' 0.C. 24" 32" " 18'-0" 17'-0" 13'-0' 16'-0" 15'-6' 14'-6" 111'-0" 13'-0" 13'-0" 11'-6" 1 N/A N A 11-0" 6x8 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 i HEADERS HEADERS DOUGLAS FIR NO. 1 DOUGLAS FIR NO. 1 SIZE SPAN SIZE SPAN 5'-0" 4x4 4'-0.. �x6 8'-0" 4x6 6'-0" 4x8 11'-0" 4x8 g'-0" 4x 1 o 14'-0" 4x 10 10'-0" 4:: i ^ 17'-0" 4x 12 11-0" 6x8 14'-0" 6x8 1 ?'-0" 6x 10 17'-0" 6x 10 14'-0" ROOFING NOTES: A. BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN. E. POCK ROOF: 3112 MAXIMUM PITCH. 1.