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10-0883 (PAT)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000883 Property Address: 53588 AVENIDA VALLEJO APN: 774-123-005-20 -000000- Application description: PATIO COVER - RESIDENTIAL Property Zoning: COVE RESIDENTIAL Application valuation: 1800 Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION 4:F�Q�t�rw BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjur that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the B si ass and Professionals Code, and my License is in full force and effect. License las s : B icenseNo.: 483348 Date: ",a Contractor, OWNER -BU ER DECLARATION 1 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 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).: (_ 1 l,.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.). ' (_) 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: LQPERMIT Owner: HUBBARD DONALD 53548 AVENIDA LA QUINTA, CA Contractor: KORTZ, DAVID E 38169 BLUE CIF PALM DESERT, C (760)250-9290 Lic. No.: 483348 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/08/10 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 STAW"FUND Policy Number 7130022733 be-_ 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 s uld become subject to the workers' compensation provisions of Section 3700 of the Labor o e, I sha W or hwi h 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* 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. 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 bove information i correct. 1 agree to comply with all city and county ordinances and state laws relating to buildi g constru tion, a d hereby authorize representatives of this ounty to enter upon the above-mentioned property or in tion poses. Date: �? Signature (Applicant or Agent). C` Application Number 10-00000883 Permit . . . PATIO COVER PERMIT Additional desc ' Permit Fee 41.00 Plan Check Fee 26.65 Issue Date Valuation 1800 Expiration Date 3/07/11 Qty Unit Charge Per Extension BASE FEE .15.00 13.00 2.0000 HND BLDG 501-2,000 26.00 ---------------------------------------------------------------------------- Special Notes and Comments 152SF PATIO COVER AT FRONT OF RESIDENCE [CITY SPEC] - "THIS PERMIT DOES NOT INCLUDE ELECTRICAL INSTALLATIONS. 2007 CALIFORNIA BUILDING CODES. September 8, 2010 3:23:40 PM AORTEGA -------------------- ----------------------------------------------- Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee.summary, Charged Paid Credited Due Permit Fee Total 41.00 .00 .00 41.00 Plan Check Total 26.65 .00 .00 26.65 Other Fee Total 1.00 .00 .00 1.00 Grand Total 68.65 .00 .00 68.65 I ' lad wig �. ; a /lig - - - -- ---i -- -- -- - - -- i--- - - �- -- - ;- -- - -- - -- ---------------- -- : tL �141111 _ • [ j : _ q CIT !A UINTA , i ! ! BUILDING &SAFETY DEPT I !FOR CQNS BY TRUCTI N I ! : _ = � !_ {Cot. _ ��� ; i i ! I ; I J �� ; ; -I •� -� j , ' I -sw Cl Bin # Ot y of La Quinta Building 8T Safety Dh*ton P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # io• Project Address:35 C Owner's Name: A. P. Number: Address: Lo J-4 Legal Description: City, ST, Zip: Lo ati, NT01— Contractor: ItowrzWkA Telephone: Project Description: Address: City, ST, Zip: �/v 7� �•WLi� Telephone: , State Lic. #: City Lic. C Arch., Engr., Designer. Address: City, ST, Zip: Telephone: State Lic. #: Mame of Contact Person: Construction Type: Occupancy:. Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Recd TRACKING A PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit �- Truss Calcs. Called Contact Person Plan Check Balance... - Title 24 Calm Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" 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:- '"' Review, ready for corrections/issue Devdoper Impact Fee f Planning Approval Called Contact Person 4 A.LP.P. i Pub. Wks. Appr Date of permit issue School Fees Tooth Permit Fees (SI /1i� �' ll-U7IV7 11561-6Wrrrf AW6/ 4OW A40o? fim" 9TiKat4e. &4A9 eF woxi4 TO %tJc-446 P^o 1010 S of Con. SAS Nh 1.