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11-0801 (PAT)'P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ht. 4 4.0" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: X11-00000801 �- Property Address: 54.080 AVENIDA VALLEJO APN: 774-213-003-22 -000000- Application description: PATIO COVER - RESIDENTIAL Property Zoning: . COVE RESIDENTIAL Application valuation: 3352 Applicant: Architect or Engineer: -------------------------------------------------- LICENSED CONTRACTOR'S 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 a Professionals Code and my License is in full force and effect. Licen eClass: C33 C51 en o.: 55629 ate:$ tractor• OWNER -BUILDER DECLARATI 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 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 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 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.). (_ 1 I am exempt under Sec. , BAP.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: I QPERMIT Owner: JAMES HENNESSEY 54080 AVENIDA VALLEJO LA QUINTA, CA 92253 Contractor: GOLD STAR CSTM PTG LQ PATIO 42335 WASHINGTON ST #F363 PALM DESERT, CA ,92211 (760)574-1043 Lic. No.: 855623 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 . M Date: 7/25/11 JAL4e. ----------------------------------------------- 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 STATE FUND Policy. Number 193290309 _ 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' comp sation provisions of Section �sj� /3►700 of the Labor Codes I shall forth ' h ply w' those isions. D e: "y `� pplicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CO ERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). 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 LwQuinta, 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 construction, and reby authorize representatives of this county to enter upon amentione y for'n pection es-. D % // . nature (4 � LQPERMIT Application Number . . . 11700000801. r Permit . . . PATIO COVER PERMIT Additional desc . Permit -Fee" 63.00 Plan Check --Fee .40.95 Issue Date Valuation 3352 Expiration Date .. 1/2,1/12 Qty Unit -Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG 2,001-25,•000 18.00 ---------------------------------------------------------------------------- Special Notes and Comments 252 S.F. SOLID ROOF SHADE -STRUCTURE ATTACHED TO BACK OF RESIDENCE. 2010 CODES. ------------------------------------------------------------------------------ Other Fees . . . BLDG STDS ADMIN (SB1473) 1.00 STRONG MOTION (SMI).- RES .50 Fee summary " Charged Paid Credited Due Permit Fee Total 63.00 00 .00 63.00 Plan Check Total 40.95 .00 .00 40.95 Other Fee Total 1.50 .00 .00 1.50 Grand Total 105.45 .00 .00 105.45 "I,utal Permit Fccs Bin" City. of La Quinta Building 8L Safety Division P.O. Box 1504, 78-495 Calle Tampico Permit # C)k La Quinta, CA 92253 - (760) 777-7012 �1 Building Permit Application and Tracking Sheet Project Address: m +V15I r��J VALLFTO Owner's Nae: Address: 5qo b o Ur_1u1b,•('g A. P. Number: ,�/ /A City, ST, Zip: t_/T U l�tlTlg e%¢ �7 ZZj = Legal Description: Contractor: 1tJ I L D/l� l lV e , �-� t$ v i ^,TA R+Tr O Telephone:7(v0 - 77 T—&•S3 Z Address: _335- S Ff1.V6-:770 5 7 . S'(G F 3g3 Project Description: C' g2_Zl t l�w1 i¢lc,ova� SO�-/h y�� City, ST, Zip: f—F✓�-�,� ✓ZV G %U /C Telephone: 7 6ef - S 7 4->'i 3 a g 5 ��-3 City Lic. a: �g�I6J /y /¢C K T-8— State Lic. : Arch., Engr., Designer: Address: Citi•, ST, Zip: Construction Type: Occupancy: Telephone: Project type (circle one): New Add'n Alter Repair Deno State Lic. a: L,--., C) LL Sq. Ft.: a Stories: a Units: Name of Contact Person: - �{55g� Estimated Value of Project: Telephone a of Contact Person: -Sa APPLICANT: DO NOT WRITE BELOW THIS LINE PERMIT FEES p Submittal Req'd Recd TRACKWG item Amotnt Plan Check submitted Plan Sets Plan Check Deposit Reviewed, ready for corrections Structural Calcs. Plan Check Balance Called Contact Person Truss Cal - Construction Plans picked up Energy Calcs. Mechanical Plans resubmitted Flood plain plan Electrical 2'' Review, ready for corrections/issue Grading plan Plumbing Called Contact Person Subcontactor List S.M.I. Plans picked up Groat Deed Grading Plans resubmitted Approval H.O.A. APP Developer Impact Fee '^ Review, ready for corrections/issue IN ItOUSE:- A.I.P.P. Called Contact Person Planning Approval Date of permit issue Pub. Wks. Appr School Fees "I,utal Permit Fccs Af p