11-1137 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00001137
Property Address:
52310 AVENIDA VALLEJO
APN:
773-263-003-20 .-000000-
Application description:
PATIO COVER - RESIDENTIAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
7076
Applicant: Architect or Engineer:
1 1
----------------- I
LICENSED CONTRACTOR'S DECLARATION
4 rr
.BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Class: C51 C8 Lice nse No.: 937811
te: tractor: �-
r (( 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, demolish, or repair any 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 she is exempttherefrom 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)•:
(_)
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
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 he or she did not build or
improve for the purpose of sale.).
(•_ 1 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.).
(_ 1 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: A
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153-
Date:
77-7153
Date: .10/17/11
Owner:
MARSHA LANGFORD
52310 AVENIDA VALLEJO
LA QUINTA, CA 92253
D�
Contractor:
!
VALLEY PATIOS
37897 CHESTERFIELD STREET
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1"7 2U I1
BERMUDA.DUNES, CA 92203.
i
G�� � c"(4 WP!`TA
(760)534-4'634
Lic. No.- 937811
WORKER'S COMPENSATION DECLARATION .
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 LabovCode, 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 SOUTHERN INS CO Policy Number WSIO047500-01
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, shall forthwit comply with those provisions.
/Date: //�''/pli/cant: G --
WARNING: FAI RW E TO SECURE ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI NAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($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. 1
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made -to the Director of Building and Safety 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 issued 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 const ction, and hereby authorize representatives
of thi outer upon a above-mentioned property for ins`ction pu oses.
ate: a S' ature (Applicant or Agent):
Application Number . . . .11-00001137
Permit PATIO COVER PERMIT.
Additional desc
= Permit -Fee '99..00 Plan Check
Fee
64.35
Issue Date Valuation
7076
.,Expiration Date 4/14/12
Qty' Unit Charge Per
Extension
BASE FEE
45.00
6.00 9:0000 THOU BLDG 2,00.1-25,000
54.00
Special Notes and Comments
532 S.F. DURALUM ALUMINUM PATIO COVER,
LOCATED AT REAR OF RESIDENCE. 2010
CODES..
--------------------------------------------------------
Other Fees . . . . . BLDG STDS ADMIN.(SB1473)
1.00
STRONG MOTION.(SMI)
- RES
.71 ,
Fee summary Charged Paid Credited
Due
Permit Fee Total 99.00 .0'0.'
.00
99.00,
Plan Check -Total. 64.35.. _ .00 _
.00
64.35
Other Fee Total 1.71 .00
.00
1.71
• Grand Total 165.06 ..00
.00
165.06
.LQPERMIT
t
I
3
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APpROVEDi
FOR CONSTRUCTION i
DAT
By -
Langford Residence
52310 Ave Vallejo
La Quinta, CA 92253
Proposed Alumawood Patio Cover
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e
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r
3
8'-6"
38'
14'
Bin. #.
Permit #
1
Project Address: V 5` -- 3 /
City .of, La QW , to
Buiiding 8T Safety Division
P.O. Box 1504,78-495 Calle Tampico
LA.Writa, CA 92253 - (760) 777-7012
Building. Permit Application and Tracking Sheet
v e, (%, l%e � Owner's Name:.
A- P.'Number.
Address:
Legal Description:
City, ST, Zip: �_k CA
•Contractor
Telephoner "
Address: >
C I—w S
Project Description:
City, ST, Zip:l�o
Telephone: b(,0� 5s`% gl,.k,4
State Lie. # : �')8. ( City Lie. #;
Arch, ling., Designer
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Name of Cotuact Person:
Construction Type:. Occupancy:
L Project type (circle one): New Add'a Alter Repair Demo
Sq. Ft.: # Stories: # Urdt$:
Telephone # of Contact Person:
Estimalod Value of Project:
APPLICANT: DO NOT WWM-BELOW THIS UNE
M Submittal Req'd Recd TRACKING PERMITFEES•
Plea sets
Pian Cbeck submitted Item Amount
Slrgdnral Cafes
Reviewed, ready for corrections Plan Check Deposit. .
Trues Calu.
Called Contact Person Plan Cheek Balance
Title 24 Calci.
Plana picked up Constructtoa
Flood plain plan
Pians resubmitted Mechafiical
Grading plan
Z'! Review, ready for corrections/cssue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plan; picked up S M.I.
H.O.A. Approval
'61
Plans resubmitted Grading
HOUSE:-
3" Review; ready for correcdonsAssue Developer Impact Fee
Planning Approval.
Called r. Contatt Person AJ,P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees