0009-133 (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).r
O I am exempt under Section B&P.C�for�thiser ason
Date .?, /I N le --mo 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.
( ) 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 r 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 shalt%fortj w�ith comply with those provi �}�Qns.-
Date: tix /avf7Applicant AZ Z �`f/+
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., 119
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 Jor inspection purposes.
Signature (Owner/Agent) ��°'_ •. Date
7
BUILDING PERMIT PERMIT#
DATE VALUATION LOT Q(M"133 TRACT
091.21P2d1C $5,453=
JOB SITE 'r:
APN
ADDRESS 45-410 9N.ciBROOK LAW
OWNER
CONTRACTOR / DESIGNER / ENGINEER
3AMIS SPAM
45-410 S1fl3ROOX LAIM
A
� L
LAQUUINT,A. GA 92253
CBLAUSE
OF PERMIT
P.AI`10
1
410 S.F. LATTICE PATIO !ROVER PER. APPROVED PLANS O'1df:Y
x
PORCIV,PATIO 410.09 8F
I$TDdATM COST OF C'*JI FfRL7CnON
PERMrf FM WiVi1&AR Y.
PLAN CHECK FEE 101-000.439.318 $52.65
CONSTRUCTION IEEE 101-0001-418.000 $991.00
STRONG MOTION FEE - RES1D 101.000-241 8000 $.35
SUB -TOTAL CON917R[l"t';�i1014 AND PLAN CRECK
$134.20
LJOS PRS -PAID FEEZ
$0.00
TOTAL 1'M.Iff ITM, DUE ,NOW
S134,29
RECEIPT
DATE C
BY
—
DATE FINALED
INSPECTOR
t1
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
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
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. 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
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
RAFTER SPAN TABLE
c) c.) c,) ALL CONSTRUCTION SHALL CONFORM
.GRADING RULES
O
PS' 20-70 TO THE PROVISIONS OF THE:
(FEET & INCHES)
Qmoo goo cn C)
1998 CALIFORNIA BUILDING CODE.
V �) rIv
C), C), �- o' o'
SUPPLEMENTAL NOTES:
20
16" O.C.
24"
10'-6"
1 9'-6"
T=3"
8'-9"
8'-6" 8'-0" 6'-0"
T -Y
DOUGLAS
FIR NO.. 1,
2x6
16" O.C.
24"
32"
15'-0"
14'-0"
10'-9"
13'-0"
12'-6" 11'-6" 8'-9"
10'-6"
10'-0" 8'-6" N/A
N/A
4x6
6'-0"
2x8
16' o*c.
24"
32"
18'-0"
t 17'-0"
13-6'
16'-0"
15'-6" 1 l'-cr,
13'' 0"
13'- 0" ��A
171-0"
4x12
12'- 0"
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
Fl,R NO. 1
DOUGLAS
FIR NO.. 1,
SIZE
SPAN
SIZE
SPAN
4x4
5'-0"
4x4
41-0"
4x6
81-0"
4x6
6'-0"
4x8
ll' --o"
4x8
81-0"
400
14'- 0"
4x10
lo' -o"
4x12
171-0"
4x12
12'- 0"
6x8
14'-0"
6x8
12'-0"
6x10
17'.-0"
600t
14'-0"
ROOFING NOTES:
A. BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.
'01
RAFTER SIZE AND SPACING
ROOF PITCH
SPEC1F) ROOFING AND S-E.ATHIN�• OR OPEN L GTT:,;E _
(SEE ROOFING NOTE CN REV=RSE`
--�7'__-1-4TTG- --- .
/
CONTINUOUS LEDGER
(4)- 16d
NAILS
OR BOLT
PROVIDE
1" CLEARANCE
BETWEEN
(SAME SIZE AS RAFTERS)
CONCRETE
HEADER SIZE
•,i��
T' AND 'L' STRAPS
6"x6'
- - -----
x1' xl/8" WITH
z
I (4) 16c NAILS OR BOLT
QQ /
RAFTER SPAN:
•
J
G ►
6 ��^ "ht�
O ,
a
------
-
POST SPACING:
0. H.
u
/
OVERALL LENGTH:
O
a
/
OVERALL LENGTH:___
_Z
xIQ
1 u
•
/S ��__
/00
POST SIZE:
REAR SETBACK
I
SIDE SETBACK
(4 x4 MIN.)
2000 P.S.I CONCRETE —moi
I FINISH GRADE
FINISH GRADE
�— MIN. 12"xI2 FOOTING I I
L_J
L -J • 17' BELOW GRADE L
PROVIDE 1" CLEARANCE
BETWEEN POST AND
NOTE
CONCRETE --------
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4" x S' LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL.
BUILDING DEPARTMENT APPROVAL BELOW
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE Z' 6d 8Y
0pe�cif
U -STRAP OR AN(
NON -CORROSIVE
(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 APPLICATION
OWNER'S NAME
STREET ADDRESS
CITY. ST ZIP
TELEPHONE
H.O.A. APPROVAL
F
Dear Property Owner:
a
i OWNER/BUILDER INFORMATION
An application for a building permit has been submitter. 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 bv- 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 1 -.is or her name.
Contractors are required by law to be licensed and bonc.ed 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 prnject, 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 includini 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 un4er 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 State
Law, contact the Department of Benefit Payments and tEe Division of Industrial Accidents.
If the structure is intended for !sale, property owners w:lo are not licensed contractors are allowed to perform their
work personally or through their own employees, witholt 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 pioperty owners unless they are performing 'their own work
personally.
Information about licensed contractors, may be obtaineI 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 +erification 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, 1
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico s -
La Quinta, CA 92253 ! /
(760) 777-70 �,
F (76 1 7=70 1
E ,S.� NA E/D TE
PROPERTY ADDRESS 4
PERMIT NUMBER(s)