0205-165 (PAT)LICENSED CONTRACTOR DECLARATION
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 # Lic. Class Exp. Date
Date Signature of Contractor
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 if'1'�7' t� .44,. "�,. ear %.e
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 section need not be completed if the permit valuation is for $100.00 or less).
( k)' 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 work ers'°compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
'Date: Applicant le;;/- -, �' 1' �� "y•" ,+
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.
1i 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.
r� f
Signature (Owner/Agent)
J.r PERMIT #
BUILDING PERN�IT��'
0051.1 0
DATE VALUATION LOT TRACT
JOB SITE "
ADDRESS
APN
OWNER
CONTRACTOR / DESIGNER / EN (NEER
iJJ,C, X 1R M lfiAMOS fit
OWNER .FITA1 MP,
.52-850 AVMDAVALLWO
l.A QUld' rA CA, 92253
USE OF PERMIT
ONE 520 FW 86,i Iff UP PAT10 COV"O fit" ) ONIR .d&.7 SP LNI-A mit
PA 110 CC: VEWBC►M PM CZY 8`MMARD,
F R11-WPA110 07.00 SIP
'Ii"I N"I'81) Com:).' Olt CON KfROC CI
SA7230
Mwal MR sum"IMY
�:,�sAIS'Y9?:`E.dG1CTf�N i�3N = :3.0 k•-1�1t� �.�-�tAff " S SAH t'ff.U13
CITYOFLAQUIN7A
FINANCEDEP7.
n1W'S0'fQ, CqdMUC" MON AND PLAN CAEOM :
�Jf1i�.9iCi
LE -98 PR&PA01
50.60
'.Yd'MAL 1k'-Lr�ta'1� U iilNNS ;SUP, N
$1.98,00
RECEIPT
DATE/ ``
BY
D FINALED
INSP T
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
. C7
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Insulation
_Z - Q 2,_
Compressor
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 - - 0 2 _ _
BLOCKWALL APPROVALS
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
Fbdures'
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
'.v-4•'-.-- �.�.Y..-... a .may-•.__�.: �w ,.•......._5._r ".�+,V.a. n., _..+yfo.
. S.
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 shoul&be aware that as "Owner/ Builder'', you are the responsible party of record on such a
permit. Building permits are not required to be signed by 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 his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They, are also required by lawto 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 protection:
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, and7such persons are not licensed as contractors or
subcontractors, then you may be an employer. i
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 under 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.
r
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 to 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 property owners unless they are performing 'their own work
personally. +
Information aboui licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 102.0.N. Street, Sacramento, California 95814. ,#
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
78495 Calle Tampico
La Quinta;CA 92253
(760) 777-7012
FAX/: (7 0) 777-7011
/1l/�� 7 2YJ ee � oS 11
OWNER'S SIGNATURE/DATE
PROPERTY ADDRESS s
PERMIT NUMBER(s)
s
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4' x 5' LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL
3/8' x'5' LAG SCREWS INTO STUDS AT 16" O.0
/— CONTINUOUS LEDGER
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING
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
:RAGE
BUILDING DEPARTMENT
APPROVAL BELOW
III I� ylli
IIIIII
ARE-INSPECTION FEE 0 130
RAFTER SIZE AND
SPACING j�
SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE
/
CITY OF (A QUINTA
BUILDING &��SAFEMDE".
INSPECTION.
NO EXCEPTIONS!
(SEE �ROOFING NOTE ON REVERSE)
PATIO COVER
DATE OF APPLICATION
-------------
I../((SAME
ROOF PITCH
-
• • • . •
I •
CONTINUOUS LEDGER
I"Ut". 'r,'ONSsTRUCTION
ATE
CITY. ST ZIP
SIZE AS RAFTERS)
TELEPHONE
-- - -
HEADER SIZE
H.OA APPROVAL
r AND 'L' STRAPS
' —~�——�
6-x6*x1-x1/8' WITH I
--
.
~RAFTER /�-
��
=
J
I (4) 16d NAILS OR OLT / I
�i'z
V
I
SPAN;
��'
O.H.
POST SPACING:___
u
OVERALL LENGTH: N
a
/ OVERALL LENGTH
lj
S
, `� /
POST SIZE: L
k'
REAR SETBACK
SIDE SETBACK
( 4 xC MIN.) -__
/
I
2000 P.S.I CONCRETE —+1
I FINISH GRADE.
FINISH GRADE
y L- J
I
I J MIN.. 12' x 12 FOOTING I I
12 BELOW GRADE L -J
PROVIDE 1" CLEARANCE
BETWEEN 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 TAIL
3/8' x'5' LAG SCREWS INTO STUDS AT 16" O.0
/— CONTINUOUS LEDGER
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING
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
:RAGE
BUILDING DEPARTMENT
APPROVAL BELOW
III I� ylli
IIIIII
ARE-INSPECTION FEE 0 130
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARD ARE NOT
THE SITE FOR - A SCHEDU
OV BOLT (EMBED
(� MIN. INTO CONCRETE)
ED
CITY OF (A QUINTA
BUILDING &��SAFEMDE".
INSPECTION.
NO EXCEPTIONS!
TYPICAL
PATIO COVER
DATE OF APPLICATION
OWNER'S NAME
APP 0 OV ED
-
STREET ADDRESS
I"Ut". 'r,'ONSsTRUCTION
ATE
CITY. ST ZIP
TELEPHONE
-- - -
H.OA APPROVAL
v v v
RAFTER SPAN TABLE+. �� X00
GRADING, RULES ; - O
PS 20" 7Q V I c, V _
��F`EET Bc�INCHES)�.1.OJi.�
2x4
16" O.C.
24"
10'-6" 1
9'=6"
' 7`=3"
HEADERS
8'-6" —0" '' 6•'-0',
-7'-3"
DOUGLAS FIR
NO. 1
2x6
16" O.C.
24"
32" "
15'-0"
.14'-0"
10'-9"
13'-0"
12'-6" 11'-6" 8'-9"
10'-6"
10'-0" 8'-6" 1 N/A
N/A
4x6
6'-0"
2x8
16" O.C.
24"
32"
18'-0"
17'-0"
13'-6"
16'-0"
15'-6" 14'-6" 11'-0"
13'-0"
13'-0" 11'-6" N/A
N/A
4x12
12'-1
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
I DOUGLAS
FIR NO. 1
DOUGLAS FIR
NO. 1
i
SPAN
SIZE
SPAN
i
4x4
5'-0"
4x4
4'-0"
4x6
8'-0"
4x6
6'-0"
4x8
11'-0"
4x8
8'-0"
4x 10
1 4'-0"
4x 10
10'-0"
402
17'-0"
4x12
12'-1
6x8
14'-0"
6x8
1 '�'—G"
6x 10
17'-0"
6x 10
14'—Q)"
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.
RAFTER SIZE AND SPACING ����C— Ic-
SPECIFY ROOFING ANDSHEATHING'OR OPEN LATTICE
C
NON -CORROSIVE PLATE
(SEE ROOFING NOTE ON' REVERSE)
II
II
GR
it
II
(4)— 16d NAILS
II II
calci%��
U—STRAP OR ANGLE .
ROOF PITCH
(4)— 16d NAILS
OR BOLT
CONTINUOUS LEDGER
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
_ II II
III
II
III'a
(SAME SIZE AS RAFTERS)
II II
7" MIN. INTO CONCRETE)
TYPICAL PATIO
COVER
DATE OF APPLICATION
HEADER SIZE
OWNER'S NAME
STREET ADDRESS
CITY. ST ZIP
�
TELEPHONE
H.OA APPROVAL
T AND 'L' STRAPS
6"xlrxt"xt/8" WITHLi
I
I
J
/
(4) 16d NAILS OR DOLT
/ '
1
v
RAFTER SPAN:
r D
O.N.
a
O.M.
POST SPACING:y
u
OVERALL LENGTH:
a
/
OVERALL LENGTH;YO_
2
.S
POST SIZE: /
1
REAR SETBACK
SIDE SETBACK
2000 P.S.I CONCRETE —�1
I FINISH GRADE
FINISH GRADE
MIN.. 12' x 12" FOOTING I
L—
I
L— JI
�—
12" BELOW 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
3/8" x 5" LAG SCREWS INTO STUDS AT 16" O.C.
CONTINUOUS LEDGER
� �►11I \may
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING
nr.INSPECTION FEE OF $30
BUILDING DEPARTMEt�4TLL.PAPlp�. Qi
A 11
PLANS
THE SITE . FOR, A SCHEDULED
INSPECTION.
NO EXCEPTIONS!
DITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVE®
FOR CONSTRUCTION
TATE BY j
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
U -STRAP OR ANGLE
is
NON -CORROSIVE PLATE
POE
II
II
GR
it
II
(4)— 16d NAILS
II II
OR BOLT .
U—STRAP OR ANGLE .
(4)— 16d NAILS
OR BOLT
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
_ II II
III
II
III'a
II
ANCHOR BOLT (EMBED
II II
7" MIN. INTO CONCRETE)
TYPICAL PATIO
COVER
DATE OF APPLICATION
OWNER'S NAME
STREET ADDRESS
CITY. ST ZIP
TELEPHONE
H.OA APPROVAL
QQQ
v v �
RAFTER SPAN TABLE A�7 A� (� A�7 O°O
GRADING RULES S S� c' � O�
PS.'20-70 V C� Com' 4Q
(FEET & INCHES) O0 A�? O°JAS? O°JA�? O ��
2x4
16" O.C.
24"
10'-6"
1 T-6"
'7'=3"
8'-9"
8'-6" 8'-0" -0" 1
7'-3"
DOUGLAS FIR
NO. t
2x6
16" O.C.
24"
32" "
15'-0"
1'4'=0" •
:10'-9" , 13'-0': .
12'-6" 11'-6" 8'-9"' 'I0'=6'
10'-0" 8'-6" 1 N/A N/A
2x8
16' O.C.
24" "
32" "
18'-0"
17'-0"
13'4"
16'-0"
15'-6" 14'-6" 11'-0"
13'-0"
13'-0" 11'-6" N/A
N/A
4x 1 O
10'-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. t
j SI?E
SPAN
SIZE
SPAN
4x.4
5'-0"
4x4
4x6
8'-0"
4x6
6'-0"
4x8
11'-0"
4x8
8'-0"
400
14'-0"
4x 1 O
10'-0"
4x`12
17'-0"
4x 12
12'-0"
6x8
14'-0"
6x8
1 ^'-G"
6x10
17'-0"
6x 10
14'-G"
0* 20'0
ALL CONSTRUCTION SHALL CONFORti
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.