BPAT2016-008478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BPAT2016-0084
TA� 4 etwQumrw
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property Address:
55491 SOUTHERN HILLS
APN:
775200020
Application Description:
VAUGHN RESIDENCE / PATIO COVER 319 SF
Property Zoning:
Application Valuation:
$3,500.00.
Applicant:
AUGl.0
216
_LIFETIME PATIOS
P 0 BOX 5806
CITY OFLA00
Lr, :;UINTA, CA 92248
COMMUNITYDEVELOP MENTDEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter S
{commencing with Section 7000) of Division 3 of the Business and Professions Code, an(
my License is in full force and effect.
License Class: B License No.: 770843
Date: a /C, Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law.for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct' alter, improve, dem olish,'or repair an
structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he or sheds exempt therefrom and the basis for the
alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(� 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 and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that h
or she did not build or improve for the purpose of sale.).
(� I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project, (Sec. 7044, Business and Professions Code: The Contractors' State
License Law does not apply to. an owner of property who builds or improves thereon,
and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors' State License Law.).
(� I am exempt under Sec. B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
.the performance of the work for which this permit is issued, (Sec. 3097, Civ. C.)..
Lender's Name:
Lender's -Address:
VOICE (760) 777-7125
FAX(760)777 -7011
INSPECTIONS (760) 777-7153
Date: 8/10/2016
Owner:
'•GREG VAUGHN
8100 NE PARKWAY DR STE 200
VANCOUVER, WA 98562
Contractor:
'LIFETIME PATIOS
P 0 BOX 5806
LA QUINTA, CA 92248
(760)772-0013
Llc. No.: 770843
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 and policy number are:
Carrier: MID-CENTURY INSURANCE COMPANY Policy Number: A09461819
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 hose 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
ONE HUNDRED THOUSAND DOLLARS ($100;000). IN ADDITION TO THE COSTOF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a.permit subject to
the conditions and restrictions set forth on this 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 issuer}
as a result of this application, the owner, and the applicant, each agrees to, and shall
defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
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 county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned pro erty for inspection purposes.
Date: / Signature (Applicant or Agent):
i
Date: 8/10/2016.
Application Number.
9PAT2016-0084.
Owner:
Property Address:
55491 SOUTHERN -HILLS
GREG VAUGHN
APN:
775200020
8100 NE PARKWAY DR STE 200 '.
• Application Description:
VAUGHN RESIDENCE / PATIO COVER 319 SF
VANCOUVER, WA 98662
Property Zoning:
Application Valuation:
$3,500.00
Applicant:
Contractor:
LIFETIME PATIOS
LIFETIME PATIOS
P 0 BOX 5806
P O'BOX 5806
LA QUINTA, CA 92248
LA QUINTA, CA 92248.
(760)772=0013
Llc.• No.: 770843 .
'Detail: 319 SF PATIO COVER [WEATHERWOOD] THIS PERMIT DOES NOT INCLUDE
ELECTRICAL INSTALLATIONS. PER 2013 CALIFORNIA BUILDING CODES.
1 1 M1
DESCRIPTION ACCOUNT QTY
"AMOUNT
BSAS SB1473 FEE 101-0000-20306 0
$1.00
Total Paid for -BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PATIO COVER, STD, OPEN
101-0000-42404
0
.$97.17
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PATIO'COVER; STD, OPEN PC
101-0000-42600
0
• $95.72
Total Paid for PATIO COVER / COVERED PORCH /.LATTICE: $192.89
-DESCRIPTION
ACCOUNT.
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
1
Bin. #
. ..
City of La Quinta
Building a Safety Division
La.Quinta, CA 92253 -:(760) 777-701 2
B P.O: Box 1504,•78-495 Calle Tampico
►+d[ng Permit Aplrcatron and TrackingSheet '
P �it # ' "
Projectaddress: 55-491 Southern Hills, La Quinta CA
owner's Name:. Greg Vaughn
A. P. Number.
Address: 8100 NE Parkway Dr Suite 200
Legal Description:
City, ST, zip: Vancouver WA 98662
Contractor: Lifetime Patios / Charles Tunstead
Telephone: not available
Address: PO Box 5806
Project Description: Weatherwood Freestanding
City, ST, zip: � La Quinta, 'CA, 92253.
aluminum shade structure. Size: 11' X 29'
Telephone: 760-668-1700rM,
State Lie. # : 6770843City
Lie. #: 3258
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone:
�" N 3:
KM
Construction Type: Occupancy:
State Lie.
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Charles Tunstead
Sq. Ft.: 319 #Stories:
#Units:
Telephone # of Contact Poison: .760-668-1700
Estimated value of Project: $3,500.00
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
" ReedTRAC
NG
PERMIT FEES
Pian Sets
Pian Check submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit • .
iYttss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans esubmitted
r" .
•. -
Mechanical
Grading plan
2 Review, ready for correctionsfissue
Electrical
Subcontactor List
' Catled.Contact Person
Plumbing
Grant Deed
`
-Plans picked up
S.M.I.
1L0.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review; ready for corrections/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P. "
Pub. Wks. Appr
Date of permit Issue .
School Fees
Total Permit Fees