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09-0055 (PAT)P. -G. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application'Number: Property Address:. . APN: Application description: • BUILDING & SAFETY DEPARTMENT -BUILDING PERMIT Owner: CHICOINE ANNE/DEARBORN TAMMI 51925 AVENIDA-VALLEJO. LA QUINTA CA 92253 09-00000055 51925 AVENIDA,VALLEJO 773-171-021-9 -000000- A . PATIO COVER - RESIDENTIAL VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/22/09 Property Zoning: COVE RESIDENTIAL "" � , - _ [A\ Application valuation: 2075 - ern t Contractor: IA; 22 �IiU3 t A/,cant: - Architect or Engineer: CALIFORNIA EXTERIORS .� 3260 N. E. STREET, SUIT C `!- L�~L+;NiR SAN BERNARDINO, CA 9240 (909)883-5398 I Lic. No. 760236 ' - LICENSED CONTRACTOR'S DECLARATION - 'WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: . Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect._ I have and will maintain a certificate of. consent to self -insure for workers' compensation, as provided License Class: B License No.: 7.60236 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. /nate: •� 22 0 ont\ ractor: _4have 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: , - I hereby affirm under penalty of perjury that -I am exempt from the Contractor's State License Law for the Carrier STATE FUND. - Policy Number 238-0000818 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to' _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the "person in any manner so as to become subject to the workers' compensation laws of California„ permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I she forthwith comply ith those provisions. that he or she is 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 IS5001.: - ate: ? - p�OMPENSATION _ 1 _ 1 1, 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 WARNING: FAILURE TO COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000): IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706,OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. one year of completion, the owner -builder will have the burden of proving that he or she did not build or - - improve for the purpose of sale,). - - - APPLICANT ACKNOWLEDGEMENT - (_ 11, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to theDirector of Building and Safety for a permit subject to the - 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed . " i . Each person upon whose behalf'this application is made, each person at whose request and for _ pursuant to the Contractors' State License Law.). , •. - whose benefit work is performed under'or pursuant to any permit issued as a result of this application, I am exempt under Sec. , B.&P.C: for this reason - the owner, and the applicant, each agrees to, and shalt 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. - Date:. Owner: 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 - CONSTRUCTION LENDING AGENCY - permit to cancellation. - - hereby affirm underpenalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ..C.l. - city and county ordinances anstate laws relating to building construction, and hereby authorize representatives ! - r of is county to e�upohe above-mentioned property for inspection purposes. Lender's Name: LZate: 2e (Applicant or Agentl: Lender's Address: • - LQPE111T Application Number . . . . 09-00000055 Permit BUILDING PERMIT INV FEE Additional desc - Permit Fee . . . . 108.00 Plan Check Fee 35.10 Issue Date . . . . _ Valuation . . 2075 Expiration Date 7/21/09 Qty Unit -Charge Per Extension. BASE FEE 9.0.00 1.:00 18.0000 THOU BLDG -2,001=25,000 18.00 Permit . . . ELEC-MISCELLANEOUS INV FEE Additional desc . -Permit Fee 33.00 Plan Check -Fee 4.13, Issue Date . . . . Valuation 0 Expiration Date 7/21/09 Qty Unit Charge Per. Extension,. BASE FEE 30.00 2.00 1.5000 PER ELEC DEVICE/FIXTURE 1ST 20 3.00' ---------------------------------------------------------------------------- Special Notes and Comments 156 S.F. LATTICE PATIO COVER WITH ELECTRICAL (2 FIXTURES) INVESTIGATION FEE ASSESSED PER 1997 UNIFORM ADMINISTRATIVE CODE§304.5 FOR WORK BEGUN WITHOUT BUILDING PERMIT. --------------------------- -------------------------------------------------- Other Fees . . . . ." BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 3.51 STRONG MOTION (SMI) -,RES .50 Fee summary Charged Paid Credited Due', ------------------------------ Permit Fee Total 141.00 .00 .00 141.00 Plan Check Total 39.23 .00 .00- 39.23 Other Fee -Total 5.-01. - .00 - -bo .5.0,1 Grand Total 185.24 :00 00 185.24 .. LQPERMIT " - - g a Bin # City of La Quinta Building 8z Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # . Project Address: V.4 llo Owner's Name: G Q� A. P. Number: Address:V, Ila 10 Legal Description: Contractor:- � City, ST, Zip: Lz Telephone: Address: `'6 — Al .jL Project Description: G P D City, ST, Zip: C4 Telephone: g U9 _ 88 a - Sa State Lic. # : Arch., Engr., Designer: 34- City Lic. #: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Jo � 4 n Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: 1(5-6=01#Stories: #Units: Telephone # of Contact Person: %Dtf _,S3V7 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd - Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check.Deposit Truss Cates. Called Contact Person Plan Check Balance Energy Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2`1 Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Jrd Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees