0402-388 (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). li
( . I am exempt under Section' B&P. t . r,t is ,gason
Date _ .f Signature of Owner
t Y
WORKER'S COMPENSATION &CLARATIO.N
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).
( .) certify that in the performance of the work for which this permit is issued,
I shall not employ any person in any rmm/nner so as to become subject to the
workers' compensation laws of Califo lnl- nd ag
atioree that if I should become
subject -to the workers' compensn ptri�`,, ions, of Section 3700 of the Labor
Code, I shall orthwith comply with th'o 'e pro I Ions.
Dater Applicant �
Warning: Failure to secure Worker' 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.
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 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/ 4ity, and State laws relating to the building
construction, and hereby autho.6 ,representatives of this City to enter upon
the above-mentioned property.fo inHctionpurposes.
Signature (Owner/Agent) f (II y Date �? n
rr
BUILDING PERMIT, PERMIT#
DATE ' VALUATION • LOTiS�~� TRACT
2ial13i;862wnV
JOB SITE
ADDRESS &1",50 Aird 1f1J)A J(ALIIAF-J'()
APN
-
'OWNER,
CONTRACTOR/DESIGNER/EN (NEER
DEAN 1a1:�D�1%�T �;
OV& M13tiYT.,1 IM
5.4.650Ai1'EWDAV,f+,LL TO
T AQXXlNTA CA 92253
t s CB114
USE OF PERMIT ro
:1�.1th7�C3
140 SF LATTICE PA11to COVER PER CITY ST2`ii+l%ld+:i'.D. 31 SIDE'YA!%1D
SETBACK/s' FUAR YARD SHEMACK, 2001 C13C,
PORCHIPA:TIO 140.00 OF
E rC'T) MATED COST Old' CON UCnOl
PFAZWor FIRE C UIVIMA.i.'It'
PIAN CHECK ) . 101-000-439.338 $27, 9�
CONST"RUCTIO14 FEE 101-000-418-000 $3.00
STRONG MOTION FU • R.ESID 101-000241.000 9.50
p
D
[BAR 012004
—• �r ,1'i + CITY OF LA QUINTA
-. FIWANCE DEPT
^1
MJB-TOT.,` L CO14M..T-'CT101T AM 7PL ' C
$71.45
RECEIPT
DATE
BY
DATE FINALED
L
INSPECTO
i
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
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing Z7 _
Insulation
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
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 I I
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
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
OWNER / BUILDER INFORMATION
n
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 should 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 -ether 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 bondled by the State of California and to have a business license
from the City or County. They are also required by law to 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, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State ind Federal Government as an employer and you are subject
to several obligations including State and Federal inco_-ne 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 oue 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 pore specific information about your obligations under State
Law, contact the Department of Benefit Payments and th= Division of Industrial Accidents.
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 about licensed contractors may be obtainer: by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California )5814.
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
78-495 Calle Tampico
La '-t
'nta> CA 92253
(760) 777-7012
F ° (760) 777-7 � _
'S SIGNATURETDATE
�/ � Z 77SS
PROPERTY'ADDRESS
PERMIT NUMBER(s)
RAFTER SIZE AND. SPACING
ROOF P H-- '
CONTINUOUS LEDGER
(SAME SIZE AS WAFTERS)
SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE
(SEE ROOFING NOTE ON REVERSE)
HEADP SIZE
I \-'r AND 'L' STRAPS
WITH
I
(4) 16d NAILS OR BOLT
I
u
►F1ER SPAN: I`/.
/
[i
O.M.
a
O.H.
POST SPACING:__
r!
ILO=
u
ALL
o
`S
3
LENGTH:
OVERALL LENGTH`
_F
POST SIZE:
REAR SETBACK
I
SIDE SETBACK
(4"x�' ►11N.)
2000 P.S.I CONCRETE --+I. I Fl H- GRADE
L_J IZ
FINISH GRADE
I I ---MIN. 12'x12" FOOTING I I
12 It
L—J • 12' BELOW GRADE
OPEN LATTICE PATIO COVERS MAY BE. ATTACHED TO EXISTING FASO A
VIA ONE 1/4" x S' LAG SCREW' THROUGH FASCIA INTO EACH RARER TAIL
U—STRAP OR ANI
3/8" x 5' LAG SCREWS INTO STUDS AT 16" 0.,C. NON—CORROSIVE
CONTINUOUS LEDGER
JOIST HANGER OR SOLID BLOCKING
'NAIL RAFTER TO BLOCKING
BUILDING DEPARTMENT APPROVAL BELOW
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE 2-Z2-0BY
-<
(4)— 16d NAILS
OR BOLT
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE --�
U—STRAP OR ANGLE —
(4)— 16d NAILS
OR BOLT
PROVIDE t" CLEARANCE
BETWEEN POST AND
CONCRETE
ANCHOR BOLT (EMBED -
7" MIN. INTO CONCRETE)
TYPICAL PATIO COVER
DATE OF APPLICATION 2-2,7-0(/ -Z7_0(f
OWNER'S.NAME /47 C> f
STREET ADDRESS S 3 43 0 Aja. V14 95) 0
CITY. ST ZIP '
TELEPHONE
H.OA APPROVAL
Q' Q' Q'
RAFTER SPAN TABLE �� Ate. Ate. °O
GRADING RULES S� S� P� p�
PS 20-70
(FEET & INCHES) OJ�� °J�� °J��
O� O� OC�) cj
�o ti �o �o ti v
2x4
16" O.C.
24"
10'-6"
1 9'-6"
7'-3"
8'-9"
-6" -0" 6'-0
7'-3"
NO. 1
SITE
2x6
16" O.C.
24"
32" "
15'-0"
14'-0'
10'-9"
13'-0"
12'-6" 1 t'-6" 8'-9"
10'-6"
10'-0" -6" 1 N/A
N/A
6'-0"
4x8
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
12'-0"
6x8
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
SITE
SPAN
SIZE
SPAN
4x..4
5'-0"
4x4
4'-Q"
4x6
8'-0"
4x6
6'-0"
4x8
1 1 '-0"
4x8
8'-0"
4x10
14'-0"
4x10
10'-0"
4x12
17'-0"
402
12'-0"
6x8
14'-0"
6x8
12'-0"
6x.10
17'-0"
600
ALL CONSTRUCTION SHALL CONFORM
TO _THE PROVISIONS OF THE:
.qX/ CALIFORNIA BUILDING CODE.
SUPPLEMENTAL NOTES:
ROOFING NOTES:
A. BUILT-UP. ROLLED ROOF: SLOPE TO .DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.
?AiTIE�/�, ESTABLISHED IN 1918 AS A PUBLIC AGENCY
�(SAIR1G3�
COACH ELLA VALLEY WATER DISTRICT
POST OFFICE BOX 1058 • COACHELLA, CALIFORNIA 92236 • TELEPHONE (760) 398-2651 • FAX (760) 398-3711
DIRECTORS: OFFICERS:
JOHN W. McFADDEN, PRESIDENT STEVEN B. ROBBINS,
PETER NELSON, VICE PRESIDENTGENERAL MANAGER -CHIEF ENGINEER
TELLIS CODEKAS JULIA FERNANDEZ, SECRETARY
RUSSELL KITAHARA DAN PARKS, ASST. TO GENERAL MANAGER
PATRICIA A. LARSON REDWINE AND SHERRILL, ATTORNEYS
September 17, 2003
File: 1112.
Bill Davis
Davis and Associates
50-925 Paloma Court
La Quinta, California 92253
Dear Mr. Davis:
Subject: 53-650 Avenida Vallejo
Account 14o. 606124,288:0.8
In response to your inquiry, all sewer requirements for the above -referenced
property have been meta It will'be the homeowner's responsibility to
connect their pipeline to the sewer lateral.
If you have any questions please contact Rosie Anacleto, Customer Service
Representative, -extension 2420..
Yours very truly,
J�or Steve Robbins
General Manager -Chief Engineer
RIA:ra
bc: City of La Quinta
TRUE CONSERVATION
USE WATER WISELY