BPAT2014-1007Applicant: Contractor: D u
CECILIA GONZALES
54665 AVENIDA VALLEJO
LA QUINTA, CA 92253 JUL 2 9 2014
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 and Professions Code,
and my License is in full force and effect.
License Class: License No.:
Date:
Contractor:
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 exempt therefrom and the t
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 •
� s owner of the property, or my employees with wages as their sole
o ensation, will do the work, and the structure isnot intended or offered for sale.
(Se . 044, 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
the,sl3edid not buildor improve for the purpose of sale.).
as owner of the property, am exclusively contracting with licensed contractors
ruct the project. (Sec. 7044, Business and Professions Code: The Contractors'
cense 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
th on ractors' State License Law.).
m 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 Na
Lender's
CITY OF LA QUINTA
Llc. No.: COMMUNITY DEVELOPMENTDEPARTMENT
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:
Carri% ¢ Policy Number: _
'T certify that in the performance of the work for which this permit is issued, I
shlrno mploy 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 de, I shall forthwith
comply witthose provisions. ('
Date: 14 hi'7 ( 1 Aoolicant 0,1 P
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 Building Official 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
construction, and hereby authorize representatives of this city to en r u n the abov
mentioned Vroperty for inspection purposes.
Dat�f Signature (Applicant or Agenti, �
4
VOICE (760) 777-7125
78-4.95 CALLE TAMPICO
D
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
ti
Date: 7/29/2014
J
Application Number:
BPAT2014-1007
Owner:
Property Address:
54665 AVENIDA VALLEJO
CECILIA GONZALES
APN:
774281021
4
54665 AVENIDA VALLEJO
Application Description:
PATIO COVER- 48SQ FT AT FRONT YARD
LA QUINTA, CA 92253 i
Property Zoning:
Application Valuation:
$400.00
Applicant: Contractor: D u
CECILIA GONZALES
54665 AVENIDA VALLEJO
LA QUINTA, CA 92253 JUL 2 9 2014
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 and Professions Code,
and my License is in full force and effect.
License Class: License No.:
Date:
Contractor:
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 exempt therefrom and the t
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 •
� s owner of the property, or my employees with wages as their sole
o ensation, will do the work, and the structure isnot intended or offered for sale.
(Se . 044, 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
the,sl3edid not buildor improve for the purpose of sale.).
as owner of the property, am exclusively contracting with licensed contractors
ruct the project. (Sec. 7044, Business and Professions Code: The Contractors'
cense 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
th on ractors' State License Law.).
m 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 Na
Lender's
CITY OF LA QUINTA
Llc. No.: COMMUNITY DEVELOPMENTDEPARTMENT
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:
Carri% ¢ Policy Number: _
'T certify that in the performance of the work for which this permit is issued, I
shlrno mploy 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 de, I shall forthwith
comply witthose provisions. ('
Date: 14 hi'7 ( 1 Aoolicant 0,1 P
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 Building Official 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
construction, and hereby authorize representatives of this city to en r u n the abov
mentioned Vroperty for inspection purposes.
Dat�f Signature (Applicant or Agenti, �
•,..
DESCRIPTION • 4
FINANCIAL INFORMATION,
; —'A00OUNT• :'� =QTY x'AMOUNT`,. _ PAID <` . PAID DATE
BSAS SB1473 FEE
101-0000-20306 0
$1.00 $0.00
t - `PAID BY y *r
' ",METHODS' t ck` RECEIPT # CHECK # CLTD BY,'
F
•
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
r DESCRIPTION,.-Tr;A
„ACCOUNT'
QTY'
"AMOUNT,;.'
�z+eta. RAIDS `'
PAID.DATE+
PATIO COVER, STD, OPEN
101-0000-42404
0
$95.81
$0.00
'PAID BY { ' " '
: r�: , ETHOD ,
,''M `
RECEIPT # . t
:CHECK #
GLTD.BY>
DESCRIPTION "wl c
;ACCOUNT
CITY
_; AMOUNT=
PAID
PAID DATE
PATIO COVER, STD, OPEN PC
101-0000-42600
0
$94.38
$0.00
PAID BY `.,
�� "METHOD{ a'w
- r= RECEIPT# } "
_ -CHECK#4
CLTD BY
Total Paid for PATIO COVER/ COVERED PORCH/ LATTICE $190.19 $0.00
;4.P.DESCRIPTION `
r, `ACCOUNT
.QTY
'� »AMOUNT.':;
'' PAID
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0 .
$0.50
$0.00
E PAID BY r *� "
i� " -'METHOD -, ..
r ' a r RECEIPT•# N
c ' .CHECK # r
CLTD BY
Total Paid foifSTRONG MOTION INSTRUMENTATION SMt $0.50 $0.00
TOTALS:• 00
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Bin # ".
Permit #
Project Address:
Qty of La QUinta
"Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico..
La Quinta, CA 92253 - (760) 777-701.2 .
Building Permit Application and Tracking Sheet
Owner's Name:(` OA-)
A.T. Number:
Address:
Legal Description:
City, ST, Zip:u 5 ?J
Contractor: 0 or•
•
TcIe h ne: �
Address:
_
Project Description:
City, ST, Zip:
Telephone:
piyb s
State Lic. # -
City Lic. #;
Arch., Engr, Designer:
! "
Address:
•/
City., ST, Zip:
Telephone:
P
%:>:::::::s •:
:=:::>:=::::>;.,""
..................................................
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter . Repair Demo
Name of Contact Person:
Sq. Ft.: Y7
# Sto ''es:
#Units:
Telephone # of Contact Person:,Estimated
Value of Project.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKG\1G
PERMIT FEES,
Plan Sets
PIan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
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 Dccd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
iN If OUSE.
''" Review, ready for correctionstiissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Datc of permit issue
School Fees
Total Permit Fees
BUILDING & SAFETY DEPARTMENT
78-495 CALLS TAMPICO (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
PROPERTY OWNER'S PACKAGE
Disclosures & Forms for Owner -Builders Applying for Construction Permits
,Cl WORT NT! NOTICE TO PROPE)EtTY OWNER
Dear Property Owner
An application for a build' 't Z)�miffed ' }roar lis ' 1f as build sof therty
improvements specified at ✓
We are providing you with an wner-Builder Acknowledgmenvand Information VWication Form to make you awam of your
responsibilities and poseable risk you may incur by halving this permit issued in your name as the
Owner -Builder. We will not Issue a buiiding:permit until you Have read, ihidi&W your understanding of each *Provision,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice
unless you, the property owner, obtain the prior approval of the permitting authority.
: tenReadand'ir[ial.staenCbeow io signify you undersfnnd
I. 1 .understand a frequent practice of unlicensed persons is 'to .Have the property. owner obtain an "OwnerBuil
building liernii.t that eirouoously implies that the property owner is providing his or. her own labor aiid. material. personally. I, as..
an 0w' = L3uilder, may be licld liable and subject to serious financial', risk for any ieijuries:sustained by an unlicensed persoa:
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance•coveragc for injuries to workers
on my property.
/2.1 understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
✓ 3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
J4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an"employee,
under state and federal law.
J6. I understand if I am considered an "employee" under state and federal law, I moist register with the state and federal
—government; withhold-payroll-taxes,-provide-workers'-compensation-disability-insurance,-and-contribute-to-unemployment—
isk
compensation for each "employee." I also u
rnderstand my failure to abide by these laws may subject me to serious financial
77.
risk
I understand under Californi C tr t S wh b 'Ids 1 f 'l 'd
a on ac ors tate Lecerise Law, an Owner -Budder o w srng e- amr y resr ental
structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
a,
V.8. 1 `undast�ind as an OwnerBuilder if I sell the property for which this perrnit is issued, I may be be'd liable, for any
tinan ial or. . persnal,,avuries sustained by any subsequent owners) that result from any latent construction defects in the
workxnanshiji cit rr ttcrials.
9. 1 understand I may obtain more information regarding my 'obligations as an',om frgni the Internal Itevcnue
Service, the United States Small Business Administration, thaCalifonria Dcp4brient of Ocnefit Payments, and the Califgrnia
Division of lndustrial Accidents. I also understand l .may contact the California Contractors"State Liceac t3oard (CS03) at 1-
800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party and financially responsible , fof pr sed constryction Activity -4 the J, l owing address:
J 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owner -Builders as well as employers.
V/12- I agree to notify the issuer of this form immediately of any additions, deletions, or chPges to nay of the information I
have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a licei se, tic Contractors' State License Board mAy be usable to assist you with any finaincki loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may betn'civil cotut, It is also
important for you tounderstand that if an ntilice iscd Cotitractor or employceof that individual or firm is WuMd while woriang
on your property; you may bald liable: for damages. if you obtain a-porrmt as Ownu=Builder 4trif wish to hire Contractors,
you will be msporrsnblo for vcxifying w:or not tEiosc: Contractors arc`pr`apcxiy .liecns«i and .ilre shit of their woricas•
conroparsation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the Agency responsible for issaitg.dw.ptirmit. Nota: A copy of Slee property owner's driver'yt farrtt aotaola7reAions or
other verification acceptable to the agency is ' ed to be presented when the permit is issued to Verify the property
owner's signature. (l
Signature of property owner A Date: 7
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OFAGENT TO ACT ON PROPERTY OWNF-R'S.BEHALF
Excluding the Notice to Property Owner, the exception of which l understand.is my personal responsibility, l hereby authorize
the following person(s) to act as my agents) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work): �� ��G�
Project Location or Address:
Name of /luthorized Agent: Tel No
Address of Authorized Agent:
I declare under penalty of perjury that 1 am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy. Note�A copy_ojthe owner s driver's licensejorm notarization, or other verification
acceptable to the agency is required to b presente hen the pe i1 is issued to verify the property owner's signature.
Property Owner's Signature: ` Date:
RAPER SIZE MIO SPACWr
ROOF P(TCR
NvNe
coM
HEADO Suc
RAFTER SPAN/_T�
OVERkL I.ENGTNI: /
�lT(Ja2
'so
2000 P -.S.1 g .�H I CRaDE f11R9N
J -
2�IE:
OPEN
uTT1cE P7q CODERS w►r
we ONE l�s' a S' MATi�p1ED TO fXtSn F/ISCy�
•
SCREW " CASCK UNTO EACH WAFTER TM_
LAA SCREWS MO STANDS AT "r O.C. i
1 r— aoNNM#xxn Uvcc t
:)OISr. R OR SOLID BLOCKMG'
HIAA RAFTER TO BIAG'I M
tJUiLui-NG DEPARTMENT APPROVAL BEI iw
CIN OF IA QUINTA
BUILDING &SAF
APPROi/E
SPECIFY RoorwC A/-10 SHEATvm4C OR OPER
(SEC ROOFIR =I+ -
ROTC OREVERSE)
-/
I
U -STRAW OR AN(
NON-C�_!
(4)- 16d NAILS
OR BOLT
U -STRAP OR ANGLE
(4)- 16d NAILS --
OR BOLT
PROVIDE 17 CLEARANCE
BETWEEN POST AND
CONCRETE
ANCHOR BOLT (EMBED —
T MIN. INTO CONCRETE)
TYPICAL PATIO COVER
DATE OF APPL1(JITION
OWNER'S HAUE f A b l
STREET tiDORESS I � V �V�
CITY. ST ZIP
TELEPHONE
-
-(--S .
• / Q Q Q
v v v
RAFTER SPAN TABLE k Q Q p0�
GRADING .RULES 49 `7 y c)
P'S 20-70 v Y �T.,L
(FEET & INCHES)
_ 2X4
16' O.C.
1 - 9`-li 7'- i a _o•
2x6
t G D.C.
I 1 . -p
37'
1 - Nil
2x6
W D.C.
N A
NOTES-.
1. 32" RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY.
2. :FOR SOLD. PAYIO COVERS (NOT LATTICE)
:;KAt-i . 10'ANSI O USLNCi
ALL CONSTRU TION SHA j
C LL CONFORI
TO THE .PROVISIONS OF THE*,
LA1TiCE ROOF BUILT—UP ROOF
HEADERS HEADERS
DOUG AS FIR NO. 1 DOUGLAS FIR NO. 1
SIZE SPAN SIZE SPAN _ROOFING NOTES
4_r_4 _ -'-0" 4x4 4•_ - A BUILT-UP, ROLLED ROOF: SLOPE TO GRAIN.
4x6 -- ,— 4z6 6•_p . 1.
4x8 •_� B. ROCK ROOT:': 3 /12 MAXIMUM PITCH.
0
4x 10 - 14'—Q 4x 10
402 4x12_ 12'
6x8 14'—p" 6x8 t �•—�"
6x1017'—Q 6x10 14'-0