13-0070 (PAT)• i
44
`�. P.O<,=BOX 1504
7$ 45 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT v
BUILDING PERMIT
Application Number: 13-00000070 Owner: rar
Property Address: 80350 VIA CAPRI DORWARD,DAVID C & JANI
APN: 772-440-076- - - 80350 VIA CAPRI
Application description: PATIO COVER - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY. RESIDENTIAL
Application valuation: 1915
Applicant:. Architect or Engineer:
rU-
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that am licensed der p vision of Chapter 9 (commencing with
Section 7000) of Division 3 of th sines Td Profess' nal C e, and my license is in full force and effect.
License Class: 13 Licenl a No.: 727199
Date: a. - -1 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 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.).
(_ 1 1 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
Contractor:.
CORONEL ENTERPRISES
42760 MADIO STREET
INDIO, CA 92201
(760)775-1234
Lic. No.: 727199
VOICE (760) 777-7012
FAX (7kq) 777-7011
MONS (6 % 777-7153
�D�ate: U 04/13
---------------------------------------------—
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.
11-11"
� ' 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 9033452-2012
1 certify that, in the performance of the work for which t ' per ' is issued, I shall not employ any .
person in any a er so as o becomes to th workers' o' tion
laws of California,
and agree that, I ould b come subj t to the w workers'
cc pensation provisions of Section
3700 of the Lab o C t e, 1 all forthw h comply w h tho provisions.
r Date: ZL -5-1 � Applicant:
1 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 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 issuan�Ll�
of such permitor cessatio f ork far 80 days will subject
permit to cancellation.
I certify that I have read this application and statemation is correct. 1 agree t comply with all
city and county ordinances and state laws relatingion,, a d hereby uthorize epresentatives
of this county to enter upon the above-mentioned on pur oses.
Date: -5 '1 Signature (Applicant or Agent(:
e Application Number . . . . . 13-00000070
Permit . . . PATIO COVER PERMIT
Additional desc .
Permit Fee . . . 45.00 Plan Check
Fee
29.25
Issue Date . . . . Valuation
1915
Expiration Date 8/03/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
-15.00 2.0000 HND BLDG 501-2,000
30.00
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Special Notes and Comments
144SF ENTRY TRELLIS STRUCTURE
[ENGINEERED] TRIS PERMIT DOES NOT
INCLUDE ELECTRICAL INSTALLATIONS. 2010
CALIFORNIA BUILDING CODES.
February 4, 20.L3 4:28:23 PM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
STRONG MOTION (SMI)
- RES
.50
Fee summary Charged Paid Credited
=--------------------------------------------------------
Due
Permit Fee Total •45.00 .00
.00
45.00
Plan Check Total 29.25 .00 •
.00
29.25
Other Fee Total 1.50 .00
:00
1.50
Grand Total 75.75 .00
.00
75.75
LQPERMIT
Bln. f
City of La Qurnta
Baffdfit 8t Safety Df 611
Puff # P.O. Box 1504,79-495 Calfe Tampko
l.a.QUM4 CA 92253 -=(760) 777-7012
Building Permit -Application and Tracking Sheet
ProjaxAddtess <06 Owner's Name.
A- P. Number.
Address:
Legal Description:
City, ST, Zip:
Contractor.
Telephone:
Addrem: yes_-7CQ,
Project Description:
City, ST, Zip : e, _Tao
(
_
fuC
Telephone: -40-22S-231M.
- �
- lc
State Lia #:
. #;
Arch., Eng., Designer:
Address:
City.. ST. Zip:
Telephone:
State Lia #.
Name of Contact Person: �S
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft : # Stories.
# Units:
Telephone i of Contact Person: : 7
S3
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS LINE
b Submittal Req'd 'Reed TRACMG PERMIT FEES
Plan Sets Pfau Cheek submittedI i4 3
1 Item Amount'
Structural Gres
Reviewed, MAY for corrections Plan Check Deposit.
Truss Cater.
Called Contact Person Plan Check Balance_
Title 24 Calces
Plate picked up Construction
Flood plain plan
Plans roubmltted.. Mechanical
Grading plan
2`! Review, ready for correctionvi Electrical
Subcontaetor List
Called Contact Person Plumbing
Grant Deed
Plans picked up SALL
ILOJL Approval
Plans resubmitted Grading
IN HOUSE:-
3" Review; ready for correctio Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P..
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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