0306-003 (PAT)LICENSED CONTRACTOR 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
Professionals Code, and my License i§ in full force and effect.
License # Lic. Class *,Exp. Date ,
Date Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
(� );> I, as owner of the property, or my employees with wages as their sole
cdmpensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section B&P.C. for this reason.
•Date ! Signature of Owner <� r
WORKER'S COMPENSATION DECLARATION
I
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 & policy no. are:
Cartier Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
() 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 of the Labor
Code, I shall forthwith comply with those provisions.,
,Date: - Applicant
i
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and; employees.
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
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
-rte
Signature (Owner/Agent) / Date `'� •:yr
- BUILDING PERMIT PERM'T#
DATE VALUATION LOT TRACT
JOB SITE' �°
APN"
ADDRESS 44.40 MY SM1.L 0", CIRM-11J'IRIV
_ ...
OWNER
CONTRACTOR / DESIGNER / ENGINEER
RC:S.IC & TOM, S;A M -1 -IFFY:
� W $UI%1 ER
44 »40 ire' S.1IaD17W23MW Ditrix
LA QUINTA A 922 '
i
USE OF NEHMIT
120 137 L,A TIC.R PATAO f OVZR PER CITY S T'A14L)AR D
XM3afATKD COST OF CO.L 93'R1101 ON
YO.WiT MRSUMWAIM
PLAN 04MCK til•=k 1011.0130 ;14351-34 ! 8 SX05
10
18'TRO'zW1 M()111)N FET - REBID 101-000.247.w00 SM
SUV 02 1003
CITY Cit _. QUINTA
' FIN•IkNC�: t?EPT.
•
M-T01:AL CONSTRUCTION AN.in. ZMA a"BECK
$61. i S
M92
$R00
TUTDl,wt-mur .,ws ),)uE nivw
RECEIPT
DATE / v
By °"'9. r,
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Litility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main SeMce
Sub Panels
Exterior Receptacles
G.P.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
_...
RAFTER SIZE AND SPACING
SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE
7-�/ / D G
(SEE ROOFING NOTE ON REVERSE)
4
ROOF PITCH
CONTINUOUS LEDGER
(SAME SIZE AS RAFTERS)
•
i HEADER SIZE I
r r I
�^
I T AND 'L' STRAPS
��(
--- —
6,xe xloxl/8a WITH
I
--
r
La
z
I (4) 1.6d NAILS OR BOLT
u
RAFTER SPAN:
>
/
POST SPACING:1_
O.H.
o-
O.M.
v
r
OVERALL LENGTH:
a
OVERALL LENGTH•/0?\
3
__
/ r (
POST SIZE: 4—x,0
to
REAR SETBACK
SIDE SETBACK
. (4'x4' MIN.) ---
tO
2000 P.S.I CONCRETE (FINISH GRADE y�
�J oQ/
,.FINISH GRADE
L- J — MIN. , r =, r FOOTING I I
i�r
n 12' BELOW GRADE L_ J
PROVIDE' 1' CLEARANCE
BETWEEN POST AND
NOTE: •
CONCRETE
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4' x 5' LAG SCREW THROUGH'FASCw INTO EACH RAFTER TAIL
U—STRAP OR ANGLE
3/8- x 5- LAG SCREWS INTO STUDS AT ,16" O.C.
NON -CORROSIVE, PLATE
CONTINUOUS LEDGER
II II
II II
(4)— 16d NAILS
II II
OR BOLT
\� U—STRAP OR ANGLE
(4)— 16d NAILS
OR BOLT
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
II II
BUILDING DEPARTMENT APPROVAL BELOW II II
CITY OF .LA QUINTA ANCHOR BOLT (EMBED
BUILDING & SAFETY DEPT. T' MIN. INTO CONCPETE)
APPROVED
FOR CONSTRUCTION TYPICAL PATIO COVER
DAT�� O Y
DATE OF APPLICATION 6 Z (7
OWNER'S NAME /los, t / ,illy
STREET ADDRESS �Gw/ T
. CITY, ST ZIP
TELEPHONE
• H:OA APPROVAL y` S
Q' Q' Q'
v v v
RAFTER SPAN TABLEA.Z
GRADING RULES SC-' C-7
PS 20-70
(FEET & INCHES) O0 A�? OOJA�? QOJA�?lz
OQ
2x4
16" O.C.
24"
10'-6"
1 9'-6"
1 7'-3"
8'-9"
8'-6"-0" 6'-0"
T -3"2x6
DOUGLAS FIR
NO. i
SIZE
16" O.C.
24" "
32" "
15'-0"
14'-0"
10'-9"
13'-0"
12'-6" 11'-6" 8'-9"
10'-6"
10'-0" 8'-6" 1 N/A
N/A
4x6
6'-0"
2x8
16" O.C.
24" "
32*
18'-0"
17'-0"
13'-6"
16'-0"
15'-6" 14'-6" 11'-0"
11-0-
13'-0" 11'-6" N/A
I N/A
402
12'-0"
NOTES:
1. 32" RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY.
'2. FOR SOLID PATIO COVERS (NOT LATTICE)
RAFTER SPAN IS LIMITED TO 10'-0" USING
THIS STANDARD.
LATTICE
ROOF
BUILT-UP
ROOF
HEADERS
HEADERS
I DOUGLAS
FIR NO. 1
DOUGLAS FIR
NO. i
SIZE
SPAN
SIZE
SPAN
4r.4
5'-0"
4x4
4x6
8'-0"
4x6
6'-0"
4x8
1 1 '-0"
4x8
8'-0"
4x 10
14'-0"
4x 10
10'-0"
4'x12
17'-0"
402
12'-0"
6x8
14'-0"
6x8
1
600
17'-0"
600
14'-0"
ALL CONSTRUCTION SHALL CONFORK
TO THE PROVISIONS OF THE:
1998 CALIFORNIA BUILDING CODE.
SUPPLEMENTAL NOTES:
ROOFING NOTES:
A. BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.
E T_A*
OFT19 78-495,CALLE.TAMPICO — LA QUINTA, CALIFORNIA 92253
TELEPHONE (760) 777-7012 FAX(760)+777-7011
OWNER/BUILDER INFORMATION, '.
Dear Property Owner: i
An application for a building permit has been'submitted in your name listing yourself as the builder of the property,
improvements specified. -
For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being". performed by someone other than yourself, you may protect yourself from possible '
liability if that person applies for the proper,permit in his or her name:
,
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law' to put their license -number on all permits for which they
-apply.
1
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more, for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may bekan employer. ;
If you are'an employer, you must register with the State and Federal Government as.an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability, insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carryout these obligations,. and these risks are especially serious with
respect to worker's compensation insurance. -
For more specific information about your obligations under Federal Law, coniact the Internal Revenue Service (and,'if
you wish, the U.S- Small Business Adminstration). For more -specific information about your obligations under`Sta6c
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If -the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally.or through theii: own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. '
Building 'permits are not required to be signed by property owners unless they are performing their own work '
personally. ,
ii T C
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your '
community or at 1020 N. Street;'Saciamento, California 95814. = ;
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours, ,
! CITY OF I.A QUINTA.
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012 i
F • (760) 7=1
� •
�-- -
OWNER' SIGNATURE/ DATE
�i C/- (,
PROPERTY ADDRESS
030 6 0 3
PERMIT NUMBER(s) «
EXHIBIT
ARCHITECTURAL IMPROVEMENT APPLICATION AND AGREEMENT
DATE O
NAMES) Cjlli C s! �7�
(Print)
STREET ADDRESS �� Ids•' SUr1�C7C�cc�rtl C "� s'�
LOCAL PHONE)/a-D ��s,D �D� OTHER PHONE7& C3
REQUESTEDIMP VEMENT.
iA-1. �
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 description
of the materials and colors 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 and colors to be used.
Note:: One set' is 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 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 acknowledge that
Building Permits for home improvements may be required by the
City of La Quinta.- The cost of permits, responsibility for
obtaining them,' and the subsequent inspections will be, our.
responsibility. In_ all cases we recognize the requirement to
be in` -compliance with applicable building codes- including,. but
not limitedto, those adopted subsequent. to the original'
completion and'acceptance of our dwelling.