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05-4858 (PAT)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA; CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: «c Tt*iy/ 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 05-00004858 D 48555 VIA AMISTAD 646-122-007--- - - PATIO COVER.- RESIDENTIAL NOV 0 1 2005 LOW DENSITY RESIDENTIAL 2341 Cl -Ty OF LA ialllNTA Architect or Engineer: r . 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 Busin w fessionals Co d my License is in full force and effect. License Class: B Lice se No . 860958 Date: (l ( 1 G u' 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 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 1, 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 contractor(s) licensed pursuant to the Contractors' State License Law.). k (_ 1 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: LQPERMIT wner. USSJAEGLER FAMILY TRUST 8555 VIA AMISTAD A QUINTA, CA 92253 Contractor: PELLETIER PATIO 79275 DESERT STREAM DR. LA QUINTA, CA 92253 (760)275-7593 Lic. No.: 860958. VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 J Date: 11/01/05 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — 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 EXEMPT. Policy Number, EXEMPT I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner as to become subject to the workers' compensation laws of California, and agree that, if hould ome Rit the workers' compensation provisions of Section 3700 of the Lab r Code,'I s 11 fomply with those provisions. Date: •��1 Applicant: WARNING: FAILURE TO SECURE KERS' 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 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 p cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that t above informatio is correct. I agree to comply with all city and county ordinances and state laws relating to bu Iding co uctio and hereby au orize presentatives of this county to ent r upon the above-mentioned pro ty for spe ion purp ses. Date: L a Q ', Signature (Applicant or Agent): Application Number 05-00004858 Permit . . . PATIO COVER PERMIT Additional desc . Permit Fee" 54.00 Plan Check Fee 35.10 Issue Date . . . . Valuation . . . .. 2341 'Expiration Date 4/30/06 Qty Unit Charge Per Extension BASE FEE 45.00 1.00. 9.0000 THOU BLDG 2,001-•25,000 9.00 ----------------------------------------------------------------- Special Notes and Comments 176 SF ALUMAWOOD LATTICE PATIO IN FRONT YARD, HOA APPROVAL RECEIVED Other Fees .. . . . ... . . . STRONG ------------------- MOTION (SMI) ------- - RES_ -- - .50 Fee summary Charged Paid Credited Due Permit'Fee'Total 54.00 ----------- .00 ---- .00 54.00 Plan Check Total 35.10 .00 .00 35.10 Other Fee Total .50 .00 .00 .50 Grand Total 89.60 .00 ._00 89.60 Bin # b City of L`a .Quints . Building kSafety Division M1 ly , P.O. Box 1504;'78-495 Calle`Tampico La Quinta, CA 92253 - (760) 777-7012 ' Building Permit Application and Tracking Sheet Permit .#_ Project Address: Owner's Name: 1n'1 cn5S' ae A. P. Number: Address: L4 e7:)55 Legal Description: t Contractor: e. a}� u r City, ST, Zip:„:n Telephone: 5(0 �1 Ste. Address: "?� 2'�-� e,��j= S4\ P_C."' Vow Project Description: City, ST,'Zip: v� }� ., CA .G 227 e o vel ..'17 (0 `f Telephone: City Lic. #: State Lic. # : &(o'09 75 6:" Arch., Engr., Designer: Address: City, ST, Zip: Telephone: 4 g E State Lic. #:Project Name of Contact Person: i ,Y. C V, Construction Type: Occupancy: " type (circle one): New: Add'n ' 'Alter Repair Demo Sq. Ft:; (� #Stories #Units: Telephone # of Contact Person: 0--7-5 - 7j I Estimated Value of Projec• . 21 5-0 eo APPLICANT: DO NOT WRITE BELOW THIS LINE, # Submittal Req'd Recd TRACKING . 'PERMIT FEES Plan Sets Plan Check submittedIi/ Item Amount ` Structural Calcs. Reviewed, ready for corrections Plan. Check Deposit Truss Cates. Called Contact Person - Plan Check Balance Energy Calcs. `, Plans picked up Construction n' Floodplain plan ; Plans resubmitted Mechanical ' Grading -plan' 2"" Review, ready for corrections/issue' Electrical Subcontactor List Called Contact Person - Plumbing Grant Deed Plan's picked up . S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"',Review, ready for corrections/issue Developer Impact Fee t Planning Approval - Called Contact Person ` A.LP.P. ' Pub. Wks. Appr Date of permit issue School Fees , - x t Total Permit Fees x .. _ � ' - •+ ' ' •I �a • �C4 .• I* . ice,^1 L � • _ .. . - .. . a L:UNY� _. EXHIBIT "1" A_RCHITECTURAL.IMPROVEMENT APPLICATION AND—AG EEME T DATE NAME (S) Z4 L STREET ADDDRESS- LOCAL PHO1E ©- r .I� OTHER PHONE REQUESTED IMPROVEMENT 114,/l14A 75 4!5�T1P 4/7,,5:" &7 Approval is requested. for the above improvement according to the_ plans attached.- We .have: attached two (2) sets . of plans outlining the work -to be- done 'along with a complete. descriptio -n of' the materials. and col.ors to be used. If we are using a contractor(s), we enclose copies of the.Contractor's License. Attachments: (1) Two copies of the Architectural Improvement Application.. .; (2) -Two sets of plans with materials an.d colors to be used. Note: - ;.Opp ,.q -et ..,is . for the, ma.na,gement office; the other set to be" -.returned to `you -as "Approved". (3), Contractor's name and copy of- contractor's license. (Not re-quired if the 'improvement is . un -der $300.00 , - or . if - "Owner—Builder").- (4) Brochures (2) and/or color samples of manufactured products to be� used. We have read the Architectural Committee Rules and Guidelines and have furnished copies `to all contractors to be engaged by us and we- agree, to comply with those Rules and Guidelines. We also understand that it is our responsibility to insure. that our Contractor(s) comply with said Rules. -We acknowled-ge that Building Permits for home improvements may be. re.qu-ired by -the City of La Quinta. The cost of permits, responsibility for obtaining them, and the subsequent, inspections will be our responsibility. In all-caset we recognize the requirement to be in compliance with applicable building codes.,,�including , but not limited to , those adopted' subsequent to:- th.e original completion and acceptance of our dwelling. OVER v.,. A -aA 1 oyn ss, c"9- �- CITY y v sss 1/r-c, ,� " sed BUILDING QUI `. �,, <.�-tom- , G� 2 Z 5 3 AFEry DEPT, APPROVED OR CONSTRUCTION DATEr /_BY �atto r -8� -e�A� ' W . • P�� �� 2`1s-�sg3