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9803-147 (PAT)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of 1NIBpter 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 297 R 4130899 Date 4 Signature Of Contractor •t ` ° ' ".-'w-,,% 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.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. {,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 sectionnnneelii 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 for inspection purposes. Signature (Owner/Agent) C -3IliNom' Dater ` i y .I" BUILDINGPERMIT PERMIT #, CONTROL# DATE VALUATION LOT 9803447 TRACT 8G91 91 VV le 01 JOB SITE A PN ADDRESS t R N ri OWNER CONTRACTOR/DESIGNER/ENGINEER RICHARD PETRI SJLVER UDGE. HOMES 7M 10 SUNBROOK LN 57357 AVIATION DR, LA QUINTA. CA 92253 YUCCA VALLEY CA 92284 ( 760)365-:014 CBL -4 4926 USE OF PERMIT PATIO LATTICE PATIO COVER lot SCy7 FT PORC WPATIO ' 144.00 SF USTIMA`tED COST OF CONSTRUCfiON PE%MIT FEE Sl MAIARY PIAN CIMCK"M- 101-000-439-318 529. 5 CON"STRUCTIONFEE 101-000-418-000 $45.00 S'i`t20m MOTION FM - RESID .101.000=241-000 5.50 SUB -TOTAL CONSTRUCTION ANDPLAN CHECK $74.75 LESS PRE-PAm mms $0.00 a t • TOTAL FEnlIT FEES DUE NOW $74.75 RECEIPT D*E,. BY�/ C DAT FI LE INSPECTOR INSPECTION RECORD 01 OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR . BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings T1 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 POOLS - SPAS BLOCKWALL APPROVALS 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 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 c Final Utility Notice (Perm) 4z, RAFTER SPAN TABLE C-) 'co cl), ALL CONSTRUCTION SHALL, CONFORM GRADING RULES T - 'T PS 20-70 TO THE PROVISIONS OF. THE' -n1994 FEET'& INCHES)' A�? 0�? 0 UNIFORM BUILDING CODE. ry d� O SUPPLEMENTAL NOTES:. NOTE. 32" O.C. SPANS ARE ALLOWABLE' FOR OPEN LATTICE PATIO COVERS ONLY. LATTICE ROOF BUILT-UP ROOF: HEADERS HEADERS DOUGLAS FIR NO. 1 DOUGLAS FIR NO. I SIZE SPAN SIZE SPAN 4x4 5'- 0" 4x4, 4'-0 4x6 8'=0" 4x6 6'-0" 4x8 16", D.C. 24" 4x8 8'-0" 4x10 14'-0" '4x10 101-0" ,4x1 2 17'- 0" 4x12 12'-0" NOTE. 32" O.C. SPANS ARE ALLOWABLE' FOR OPEN LATTICE PATIO COVERS ONLY. LATTICE ROOF BUILT-UP ROOF: HEADERS HEADERS DOUGLAS FIR NO. 1 DOUGLAS FIR NO. I SIZE SPAN SIZE SPAN 4x4 5'- 0" 4x4, 4'-0 4x6 8'=0" 4x6 6'-0" 4x8 1,-0" 4x8 8'-0" 4x10 14'-0" '4x10 101-0" ,4x1 2 17'- 0" 4x12 12'-0" 6 x 8 121-0" 10 600 14'-0" ROOFING NOTES: A' BUILT-UP, 'ROLLED ROOF: SLOPE TO DRAIN. B. 'ROCK ROOF: 3/12 MAXIMUM PITCH. RAFTER SIZE .AND SPACING -23 ROOF PITCH r!^�� -i�r'sil74 Y. CONTINUOUS LEDGER (SAME SIZE AS RAFTERS) HEA R SIZE -�d- - z RAFTER SPAN: O.H. a 0 OVERALL LENGTH:a� REAR SETBACK SIDE SETBACK 2000 P.S.I CONCRETE -�+ :FINISH GRADE FINISH GRADE L J NOTE: OPEN LATTICE PATIO -COVERS MAY BE ATTACHED TO EXISTING FASCIA VIA ONE 1/4" x 5" LAG SCREW THROUGH FASCIA INTO EACH, RAFTER TAIL. BUILDING DEPARTMENT APPROVAL BELOW SPECIFY ROOFING AND SHEATHING OR OPEN 'LATTICE (SEE ROOFING NOTE ON REVERSE) -- `���----------- / I I MIN. 12" x 12" FOOTING I I L _ J 12" BELOW GRADE L _ J PROVIDE 1" CLEARANCE BETWEEN POST AND CONCRETE 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 `7Kb SWW CITY, ST ZIP PataYZ TELEPHONE H.O.A. APPROVAL \--'T' ANO 'L' STRAPS 6"x6"xt"x1/8" WITH W ' (4) 16d NAILS OR/BOLT I z +' mC POST SPACING: C/ O.H. J U l '2 OVERALL LENGTH:__ POST SIZE: _ (4"x4" MIN.) I I MIN. 12" x 12" FOOTING I I L _ J 12" BELOW GRADE L _ J PROVIDE 1" CLEARANCE BETWEEN POST AND CONCRETE 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 `7Kb SWW CITY, ST ZIP PataYZ TELEPHONE H.O.A. APPROVAL