BPAT2017-003878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
is
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
6PAT2017-0038
Property Address:
44900 VIA ALONDRA
APN:
604590009
Application Description:
KOCEJA / (2)131/120 SF TRELLIS DURALUM PATIO COVER AT FRONT
Property Zoning:
Application Valuation:
$900.00
Applicant:
C & S PATIO COVERS
65269 ELAINE CIRCLE
MECCA, CA 92254
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: D03 License No.: 1004320
Date: f Contractor:
OWNER -BUILDER DECLA ATION
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 permitdto 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 fqr 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).:
(� 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 safe.).
(� 1, 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 Na
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011.
INSPECTIONS (760) 777-7153
Date: ' 5/11/2017
Owner:
VICKI KOCEJA
44900 VIA ALONDRA
LA QUINTA, CA 92253
Contractor:
D�
I
C &'S PATIO COV, RSo
65269 ELAINE Cl
MECCA, CA 9225
m =�
(760)625-4225
Llc. No.: 100432Q—�
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 w9fik 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
ssued. My workers' compensation insurance carrier and Policy.number are:
Carrier: NORGUARD INSURANCE COMPANY Policy Number: CSWC791810
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' compensation provisions of Section 3700 ofthe Labor Code, I shall forthwith
comply with those provisions.
Date: Applicant:
_0
WARNING: FAILURE TO SECURE WORKERS' COMP SATION 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 orrect.
I agree to comply with all city and county ordinances and state laws relating t uilding
construction, and hereby authorize representatives of this city to a ter upo he above-
mentioned proper for inspection purposes.
Date: t1 ignature (Applicant or Agent):
. /
Date. 5/11/2017'
Application Number:
BPAT2017-0038
Owner:
Property Address:
44900 VIA ALONDRA
VICKI KOCEJA
4 APN:
60459000944900
VIA ALONDRA
Application Description:
KOCEJA / (2)131/120 SF TRELLIS DURALUM PATIO COVER AT FRONT
LA QUINTA, CA 92253 .
Property Zoning:
Application Valuation:
$900.00
Applicant:
Contractor: .
C. &'S PATIO COVERS.
C & S PATIO.COVERS
65269 ELAINE CIRCLE
65269 ELAINE CIRCLE
MECCA, CA 92254
MECCA, CA 92254
(760)625-4225
Llc. No.: 1004320
Detail: (2)131/120 SF TRELLIS DURALUM PATIO COVERS AT FRONT YARD [DURALUM] THIS PERMIT
DOES NOT INCLUDE ELECTRICAL INSTALLATIONS. 2016
CALIFORNIA BUILDING CODES.
FINANCIALINFORMATIO
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306
0 $1.00
Total Paid for
BUILDING STANDARDS ADMINISTRATION BSA: $1.00'
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PATIO COVER EA ADDITIONAL'
101-0000-42400
0
$50.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PATIO COVER EA ADDITIONAL PC
101-0000-42600
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PATIO COVER, STD, OPEN' .
101-0000742404
0
$101.84
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PATIO COVER, STD, OPEN PC
101-0000-42600-
0
$100.32
Total Paid ,for PATIO COVER / COVERED PORCH % LATTICE: $290.83
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
' Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50
DESCRIPTION.
ACCOUNT.
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
...502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS: $297.33
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a'r`ty of La Quinta
- Building & Safety Division
Permit # 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
a 'Iding Permit Application. and Tracking Sheet
Project Address:
WO 6 .1. 0wncr's Name: Q'( -k-.
A. P: Number:
Address: CO 1'L�
Legal Description:
City,
Contract r.
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Address: 5'atfn
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Project Description:
City_. ST, Zip:
Telephone: f�
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State Lie. #: 0O C13 zo ' City Lie. #..
Arch., Engr., Designer:
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Address:C
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City, ST, Zip:
Telephone:
Construction aneY
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Type: Occupancy:
�c. # •
Project nePatr
Demo
P (circle one): Add'n Alter i
Name of Contact Person:
• Sq. Ft.:.� (
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal`
Rcq'd
Rcc'd
TRACKING
PERMIT FEE'S
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Pfans picked up
Construction
Flood plain plan,
Plans resubmitted
Mechanical
Grading plan
2" Revicw, 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 If OUSE:-
'rd Review, ready for corrections/issue'
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. \Vks. Appr
Dale of permit issue
School Fees,
Total Permit Fees
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