0007-259 (PAT)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty Of perlury that 11m licensed under provisions of
Chapter 94commen;.ing 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 t`
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
(KO)t- 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�toconstruct the project (Sec. 7044, Business & 'Professionals
Code).
() I am exempt under Sectioh, B&P.C.,for this reaso/nr'`_�
Date
) t 174/£y't.�1 Signdture of Owner
rft`r�/
WORKER'S COMPENSATION DECLARATION
I hereby. affirm under penaltypof perjury one of the following declarations:
() I have and will maintain a;'certificate.of consent to self -insure for workers'
compensation, `s provided fo'r by Section 3700 of the Labor Code, for the
performance of the work for vilch this permit is issued.
( ) I have'ajd will maintain orkers' 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 not be'completed if the permit valuation is for $100.00 or less).
+ I certif
that, in the performance of the work for which this permit is issued,
I: shall not emply any person in any manner so as to become subject to the
workers' compensatiori:°laws of California, and agree that if I should become
sutiject to the worker"s' `co mpensation;pro i ions o�Section'°3700 of the Labor
Code, I shall forthwith comply.witFi those proV�isions:P /� Ir T
Date: t .' t c.,t °> ApPlicant'� /✓l /.� .1/`r ( �r t.
4 # w
'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 37.06
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 l 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 tris City to enter upon,
the above-mentioned property/ffor(inssppe3 ti�n',,p/u�p oses��'/ "7
Signature (Owner/Agent) v�"" vL•Date 0%G�lr)
BUILDING PERMIT PERMIT#
F
'
DATE VALUATION LOT TRACT
07/28/2(X �; ;
JOB SITE
APN
ADDRESS 45-490SI1N.f ROOK LIA.M
-
OWNER
CONTRACTOR / DESIGNER / EN (NEER
MARK MAR
0V=R/ffU1 :ISM
454.90 MYNBROOK LANE
J'A QUWA CA 92153
USE OF PERMIT
PA7o
(1) 17 X, 1 T-LATTICt PATIO COV ZR. &(1) 4 X 8 - LAVICE PATIO
COM A9 PFR APPROVED F'1..AW OWL.Y.
PORCHIPATIO 144.00 9F
PORCHIPAT1O 33.00 SIS
FW A.'X`!t'"M COS'[' OF COINS"li..'(WCYAN
2,W.60
PLAN CHECK FFE 101.000.439-318 $35.10
CONSTRUCTION FEE 104-000-418-000. $34.00
STROM MOT1014 FBI,:- R.OSIO I 1.000.241.000 S.S4
S`U B-TC)TAL, C'.OMS° IT(M-014 AND PT.,W CHECK.
$89.60
: MIS TIMPADD FEES
$0,00
nvms Din, Now
$8940
RECEIPT
DATE
BY�%E
DAT F)NAL�EDD .INSPECTOR
LL !`
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Foms & Footings
Ducts
Slab Grade
Return Air
S%el
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
Framing
_
��0� CQ���
F.A.U.
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 _l �� �' 7
BLOCKWX,11 L A PROVALS
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:
RAFTER SIZE AND SPACING SPECIFY ROOFING AND S EETHING 0=: OPEN L-1Tf:._
#X /� — /1500A) (SEE ROOFING
\NO�TE�O!N�REVER
--- -- ----- 71---��il--- �/l_��----
ROOF PITCH
CONTINUOUS LEDGER, It
(SAME SIZE AS RAFTERS) LI
HEADER SIZE -'T' AND
L/ "o N 'LSTRAPS
i
�
I
w
( ?
6 x6 x1 x1/8 WITH
I (4) 16C NAILS OP. BOLI
II W
I u
RAFTER SPAN:
>
bu
POST SPACING:
_
a
/
a
W
O.H.
O.H d O.H.
U
,OVERALL LENGTH:
OVERALL LENGTH:__________
~
-//fin
z
__ _______
POST SIZE:
�
(4"x4" MIN.)
REAR SETBACK SIDE SETBACK
I
2000 P.S.I CONCRETE -moi ;FINISH GRADE
FINISH GRADE
MIN. 12"02" 12" FOOTING
I I
L_ J
L J
_ 12" BELOW GRADE
L _ J +
Z' x 1 Z 9)wn O GO
PROVIDE 1"
CLEARANCE
BETW- N POST AND
NOTE
CONCRETE
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4" x 5" LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAO
3/8" x 5" LAG SCREWS INTO STUDS AT 16" O.C.
I— CONTINJOUS LEDGER i
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING
BUILDING DEPARTMENT APPROVAL BELOW
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE BY
U—STRAP OR ANS
NON—CORROSIVE
(4)— 16d NAILS
OR BOLT
U—STRAP OR ANGLE
(4)— 16d NAILS
OR BOLT
PROVIDE I", CLEARANCE
BETWEEN POST AND
CONCRETE
ANCHOR BOLT (EMBED �\
7" MIN. INTO CONCRETE)
TYPI,CAIL„ PATIO COVER
DATE OF APP ' � ' `, %,, %DJ V
CHARrFn IF THE APPROVED
OWNER'S NAMPVLIALLNS AND JOB CARD ARE NOT ON
STREET ADDRAE ITE FOR A SCHEDULED
CITY. ST ZIP
NO EXCEPTIONS!
TELEPHONE
H.O.A. APPROVAL
n
Q Q /
07
RAFTER SPAN TABLE /� �'� ��� ��`;
GRADING RULES � , � ��
S 20-70 ' &
(FEET & INCHES) C) e!D O
ry o
2x4
16" O.C.
24"
10'-6" I
9'-6"
7'-3"
8'-9"'
8'-6" 8'-0" 6'-0"
T-.i
DOUGLAS FIR
NO. 1
2x6
16" 0. C.
24"
32"
15'-0"
12'-6"
14'-
11'-6"
10'-9"
8'-9"
13'-0"
10'-6"
10'-0" 8'-6" N/A
N/A
4x6
8'-0"
2X.8
I
' 16" 0 .
24"
32"
18'-0"
17'-0"
13'-6"
16'-0"
15'-6" 1 14'-6" 11'-0'
13'-0"
13'-0" 1 11'-6" N/A
N/A
4x12
17'-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
FIR NO. 1
DOUGLAS FIR
NO. 1
SIZE
SPAN
SIZE
SPAN
4x4
5'-0"
4x4
4'-0"
4x6
8'-0"
4x6
6'-0"
4x8
Ll 1 -
4x8
8'-0"
4x10
14'-0"
4x10
10'-0"
4x12
17'-0"
4x12
12'-0"
6x8
14'-0"
6x8
12'-0"
6x 10
17'- 0"
6x 10
14'-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.
r� �i /h SLC�io7n_ ,e i St % U
SPECIFY ROOFING AND SHEATHING, OR Q`'E L' 1 = -
(SEE ROOF�INGG tNOT/W
E O =
N REVRS=)
---� `— -L r--0- -`ri -
I
L—J
I �— MIN. 12"x12" FOOTING I I
L -.1 12" BELOW GRADE L - J
PROVIDE 1'• CLEARANCE
BETWEEN POST AND
NOTE: CONC r
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4" x S• LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL.
U -STRAP OR ANGLE
3/8" x 5" LAG SCREWS INTO STUDS AT 16" .D.C.-• NON -CORROSIVE TE P E
CONTINUOUS LEDGER / I� j� N
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING
BUILDING DEPARTMENT APPROVAL BELOW
CITY OF. LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE ;BY ou-Ll
(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) tel/
TYPICAL PATIO COVER
S"r ASITE'sFOR A SCHEDULED
ANSKC160N.
TELEPNO MEP I IoNol
HONE
H.O.A. APPROVAL
RAFTER SPAN TABLE
i GRADING RULES I;z- G' P
PS 20-70
(FEET & INCHES) oJ�`-
2x4
16" O.C.
24'
10'-6"
1 9'-6"
7'-3"
8'-9"
e'-6" 8'-0" 6'-0
7'-3
DOUGLAS FIR
NO. 1
2x6
16" O.C.
2 4"
15'-0"
14'-0"
10'-9"
13'-0"
19,- 11'- 8'-9"
10'-6"
32"
10'-0" 8'-6" N A
N/A
14'-0"
4x10
2x.8
16" O.C.
24"
32"
18'-0"
17'-0"
13'-6"
16'-0"
15'-6" 14'-6" ll' -0"l13'-0"
6x8
13'-0" 11'-6" N/A
N/A
17'-0"
600
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
-114x4
4x6
4x8
4'-0"
6'-0"
8'-0"
14x6 8'-0"
4x8 11'-0"
4x10
14'-0"
4x10
10'-0"
4x12
17'-0"
4x12
12'-0"
I 6x8
14'-0"
6x8
12'-0"
6x 10
17'-0"
600
14'-0"
ALL CONSTRUCTION SHALL CONFORM
TO THE PROVISIONS OF THE:
1998 CALIFORNIA BUILDING CODE.
SUPPLEMENTAL NOTES:
ROOFING NOTES:
A. BUILT-UP, POLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.
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 "Ownei/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed b- 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 Frotection:
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 unc.er 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 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 tc 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 pnperty 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 -)5814.
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 f _ A � �� '� •. „
La Quinta, CA 92253
(760) 777 y ?
• 60 - 11 / �9 � •
OWNER'S SIGNATURE/DATE GG
q,c-Vyo Su,aeooll_ Lo,5-
PROPERTY ADDRESS
PERMIT NUMBER(s)