11-0800 (PAT)Td4t 4
P.O: BOX 1504
78-495 CALLE TAMPICO .
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: ""-11=0"00008_00; Owner:
�,_ _ -
Property Address: 44356-W—SUNDOWN CREST DR MORA ADOLPH E
APN: 604-110-063-99 -19903 - 81372 AVENIDA SOMBRA
Application, description: PATIO COVER RESIDENTIAL LA'.QUINTA, CA 92253
Property Zoning: LOW DENSITY, RESIDENTIAL
Application valuation: 4535
Applicant: Architect or Engineer:
P1A
0
Contractor:
VALLEY PATIOS -
CHESTERFIELD STREET
BERMUDA DUNES, CA 92203'
(760)534-4634
Lie. No.': 937811
4
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
� Date: 7/25/11
a
r
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LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professiqljqls Code, and my License is in full force and effect. .I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License lass:C51 License No.:.93 7811 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
/bate: tractor:. I haPve and will maintain Workers' compensation insurance, as required by Section 3700 of the Labor
Code for the erformance of -the work for which this permit is issued My workers' compensation
„y OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjur�at 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. An'y 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 155001.:
( _.) 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 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 LENDINGAGENCY '
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
insurance carrier and policy number are:
/ 'terrier SOUTHERN INS CO Policy Number WSIO047500-01
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 should become subject to the workers' compensation provisions of Section
3 00 of the Labor od I shall forthwjt4,comply with those provisions. '
�Sl n -1 I I / r ... Al) ((/ _
WARNING: FAILURE TO SECURE 0 ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAt 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 actor 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 aboveinformationis correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of t c unty to nter up the above-mentioned operty for inspection poses.
Date:� ignature (Applicant or Agent1A AD 26
Application Number .11-00000800
PermitPATIO COVER PERMIT
Additional desc .
Permit Fee 72.00 Plan.Check Fee
46.80 ,
Issue Date Valuation
4535
Expiration Date •. 1/21/12
Qty Unit Charge- Per
Extension'
BASE. FEE
45.00.
.3.00 9.0000 -THOU BLDG 2,001-25,000
27.00
Special Notes and Comments
341 S.F. ALUMAWOOD.LATTICE'PATIO.COVER
AT REAR OF PROPERTY. 20101CODES.
-----------------_-----------------------------------------
Other Fees _ BLDG STDS ADMIN •(SB1473)
1.00
STRONG MOTION (SMI) - RES
.50
Fee summary. Charged Paid Credited
- ------ - - - - - - - - -
Due
- ------------- -
Permit- Fee.Total 72.00 .00 .00
72.00
Plan:Check Total 46.80 .00 .00
46.80 .'
Other Fee Total 1.50 .00 .00
1.50
Grand Total 120.30 00 00
120.30
LQPERMIT ' .. ...
..�f,. .... .. .. .. .... .. , ....
LA'QUINTA PALMS HOMEOWNERS ASSOCIATION
_:• ARCHITECTURAL IMPROVEMENT APPLICATION AND AGREEMENT ':: .....
Name(s):'�s Date:....
(Print) a
Street Address: L
rtA.)I010A.) 127 T
Local Phone: Oth *r:Ph' e:.
Requested Improvement: NS
,,.
Approval is requested for the above improvement according fo the plans attached'We have. attached two
(2) sets: of plans outlining the:wo'rk to be done, albad:Niith:a complete description of the materials and:*
colors to:be used. If we are usin ' a contractor s we enclosed copies of tte Contractor's Liceiise.
g...., (),' .. clo p.
Attachments:
1; .:Two copies of the Architectural Improvement Application.
2. Two'sets of plans with materials:and.color's to be used::::. ...... ......
Note: One setis*for the management office; the other set to be returned to you as
.::'Approved".
.3. Contractor's: name and copy of contractor's license. -(Not required if the improvement is under
$300.00:6r if"Owner-Builder"
4::: Bror-hures (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 agreeito comply with: those Rules.and Gu'idelines,.We.also .. .
understand that it is our responsibility to insure that our: Contractors) comply. with said Rules.. We,
acknowledge.that Building Permits. for home improvements may be re aired b..the City of La Quinta..The
:::cost of permits, responsibility for obtain ing:them, and the subsequent inspections. will:be:our
responsibility. In all. cases.we recognize. the requirement to be: in compliance with applicable building
codes,irreliid.ing, but not limited to,. those adopted subsequent to the original completion and acceptance qw
• ..... of our dwelling.
The Association has no responsibility wliatever'in achieving.cornpliance with newer:building codes which:.:
apply.as a result of Homeowner prompted modifications. Further, we understand that approval will.notbe
granted. (or any modification' which directly or indirectly conflicts with the' Declarations of Covenants,
..,:::Conditions, and Restrictions. We also understand that we..are:responsible for the accurate determination
of property lines and setbacks (as applicable).
This review is ;',r �i;,�i�r:`
. ..... of til oz r
:code:.Fnfiorceiy^ciesCom' liance::::::.
. . ..... with City:planning aro oniinu regulations;
building codes and Association: ;C: & R's
is .t"n so! rj`�c:.1s1bi!!t�,. cif th'e: property
�S
"Page Two
Wealso understand. that.w a Will be responsible for all costs of .this improvement and for costs associated...
With. any repair to:common area occurring as: a result of implementing this improvement. Examples
include,.b.u.t are not limited to, sprinkler arid irrigation systems:'buildings, roofs, exterior walls, lawns, ..
plants:and drainage. Further. we recognize that any modifications to the. common area irrigation and
_....landscaping scheme, are, subject to formal. acceptance by the.Association: Any required remedy to
achieve the required maintenance standard :or irrigation standard are.our responsibility
::Additionally, we:::"
understand that the'job site must be left:reasonably.clean at'the,end.of each day, that no. debris nor dirt
may be: dumped in common area or:left atjob site: Aby-maintenance or.'replacement of permitted.
improvements,. except for certain.landscaping, which are.b.eyond "initial"improvements, shall be the...
homeowner's responsibility.
We agreeto. indemnify for ourselves, as well as for:our successors and. assigns, and covenant and:agree
to hold Association harmless:feom all claims, deni ands or liability arising but of or encountered:ih
.. . ..... .. . .....
connection with this Agreement, whether such claims, demands or: liability are caused by owners, owner's'::
agents or eriip!oyees, or contractors or'subcontractors employed on the project, their agents or
employees,, or: caused by any products installed on: the -project by said contractors) or subcontractor(s).
Such 'indemnification shall extend to claims, demands or liability for personal' injuries and/or property
damage occOrring:dur.ing:installation, as;well.as after completion :including, but hotlimited_to, all owners::::
maintenance responsibilities provided -herein:
We further indemnify and hold the Association harmless from all liability related to any damage to existing
improvements (whereyer:located within. the:Subdivision) resulting: from the installation/construction of the.:;::
Architectural Imrovemen
pt.
If required by the Arch itectural:Review Comm ittee;:we'ageee to record,: and,pay for the recording, of this
improvement at the.County Recorder's office. ..
We furthe.r.acknowledge.that the. Architectural-Committee,may require a deposit.be:submitted before work
is begun..:..: .. .
:. We:further agree that this improvement will be completed in4reasoriable and diligent mariner. We further':"
agree that 1 if we:do not.correct an damage caused as a result of. this im rovement.or., .2 if we fail to
g ) p. )
complete:this improvement within:the allowed time:frame,:the Homeowher:s.Association may.electto
..-.. complete.the. work and/or repairs, and we will be responsible for the actual.costs of such work.: Payment
:.to the Association is:authorized by us in;the form of an assessment or monthly penalty payments as
approved in the Guidelines.
By signing this Agreement below, we agree to be bound by its terms and: conditions and anycbnditions
set:forth by the Architectural Committee: in the Architectural Committee Certificate:,: which is attached
hereto as Exhibit "A" and made a par'rhQr'eof by this reference.:
.- ignatures of all Owners:
Ilk
(Signature.) .. (Sin re)
9
Bin #
Qty Of b Quints
Building 8t Safety Division. '
P.O. Box 1504, 78-495. Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
(�
\X'
Project Address:
ner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
P „ .
Tele hone:':� ">�
Address:
Project Description:
City, ST, Zip: 2"Z0"
'' Fti}ii�{Y.Sni':'S:�:r:•i:/y:} fib:. ���'fi• ..:.r
. Telephone:
�:•>: vS4C:; F:!i;^j-i5<jj}'.;�}i:{v.%:}:-v:': i:'}i
-
State Lic. # : City Lic.4-
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: :'` :y';%; �•„::':'::':: `” `i', rte`'?"`'
:State Lic. .;�.,.}."
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: #Units:
Telephone # of Contact Person: _ `!J
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Tide 24 Calcs.
Plans picked up
Construction
'Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2". Review, ready for correctionsfissue
Electrical
Subcontactor List
Called. Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O:A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7nd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees