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04-7916 (PAT)F471 - - ::V P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 4-00007916 _ Property Address:4-4-8"85VI'A_P:L NDRA APN: 604-032-009-15 -305211- Application description: PATIO COVER - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 3591 Applicant: Tiht BUILDING & SAFETY DEPARTMENT Architect or Engineer N '10 ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT. I hereby affirm under penalty of perjury th'�'�^*�' nsed under ' 'ons of Chapter 9 (commencing with .Section 7000) of Division 3 of the Bu eslf sand Profe lona ode, an my License is in full force and effect. License Class: B1 'cense No 260484 ,,-�ate: Q 2010` N - ontractor: 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 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).: 10 1 _ I 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.). 1—) 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 contractors) 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: LQPERIIIIT Owner: MICHAEL DAWSON 44885 VIA.ALONDRA LA QUINTA, CA 92253 Contractor: PELLETIER CONSTRUCTION 74691 SWEET WELL ROAD THOUSAND PALMS, CA 92276 (760)275-6017 Lic. No.: 260484 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/20/04 ----------------------------------------------- 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. feI 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 54952004 _ 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 subje to the workers' compensation laws of California, and agree t , ' become subje tote workers' compensation provisions of Section 3700 of e Labor Code, I s I hw h co ply with those provisions. Date.Ot1 Appl ant: WARNING: FAILURE TO SE RE W RKERV COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO C AL 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 f 180 days will subject permit to cancellation. certify that I have read this application and state that ormation is c ect. I agree to comply with all -city and county ordinances and state laws relating wilding constr ion, reby authori representatives of this county to enter upon the above-mentioned raperty for inspec � n r se . ,-Bate: t2-rwt nature (Applicant or Age 1: " Application Number 04-00'007916 Permit PATIO COVER PERMIT _. -Additional desc Permit Fee 63.00 Plan Check. -Fee .." 40.95 Issue Date Valuation . . . . 3591 Qty Unit Charge Per Extension BASE FEE 45.00 - 2.00 9.000.0 THOU BLDG 2.,001-2.5,,Q00 18.00 -- - - - - - - - - - -- Special Notes and Comments ------ ------- -------------- • 270 S.F. ALUMAWOOD LATTICE PATIO COVER ----------------------------.--------------------- Other Fees . .... . . .. STRONG MOTION (SMI) - RES ----- 50 Fee summary Charged Paid. Credited Due -- - - -- •. -- Permit Fee Total 63.0.0 ---- - - - 00"`; - - - .00 63.00 Plan Check Total 40.95 ..00 .00 40.95 • Other Fee Total .50 .00 .00 .50 Grand.Total 104.45' 00 -.00 104.45 LQPERMIT ° - 4 A RE -INSPECTION FEE OF $3 WILL BE CHARGED IF THE AE NOT01PLANS AND JOB CARD D THE SITE FOR SCHEDt1L I INSPECTION. NO EXCEPTIONS!. `iBST V, A(ov,�vr� 4L.L 5 e— l acs` ao c,o tor (fie \ (-i ce�v\5 e 'E'r D(1O u et4 Ck7��Ci`C' � ��vl-7 �CLCIJA-1� i phey 12° CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRU DATE �1�� 12-10-04; 9:20AM;Dr. Ch.iroprectic Inc ;760 777 4174 # 2/ 4 ��. ..... �... .... �.�.. .r. .....�....... ._ 7607764740:0 2 NOU-10-2004 08;39 FROM;LENNFR HOMES'DESERT 760 325 3791 701760 7764740. PAGE 82 11/®6 2®04 18:35 7667764740 RIQIPi�OSHORNE _ . p�saL•aei- ii -0•: e,a•M+a�w. Cry*OOR4CT�� ;�eoasa®Oa3 • ,i . ARCHITEC7V"L RWEJ,d'STto)W LA Q JWA DEL ORO COMMUtWTY HOMEOWNERS ASSOCIATION do CLAYTON a OSBORNE PROPERTY MANAGEMENT, INC. P. M BOX 13463 Palm Dwelt, CA 92266 ?W7734573 f9X 7M778.4740 wwE t.G;��! ♦ Cdsgt,,,rga.% N f a o �wrmw 0qffiE (ilia jahArw a6 MY. VAM MP tree er RBou�sT (C rvr n.r,{.nd ar.ayl�ixo ®toy "0MEQWhlW 3161MTURG DV E Fes AftCWRCRAMtr OOMW . USE ONLY y OATS RECOWD onR anew®_ 1 —10 - o %4 AwReovw "A"Ra"�� common S {