07-1877 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
X07=00001877
79867 PARKWAY ESPLANADE N
609-380-998-52 -293232-
PATIO COVER - RESIDENTIAL
LOW DENSITY RESIDENTIAL
6916
-Ttoht 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DELACRUZ
79-867 PARKWAY
LA QUINTA, CA
LA QUINTA, CA
ESPLANADE N
92253
VOICE (760) 777-7012
FAX (760) 777-7.011
INSPECTIONS "(760) 777-7153
Date: 6/27/07
I o pog a s e
Contractor: // \
Applicant: Architect or Engineer:
HAWKINS CONSTRUCTION
7.7850 DELAWARE PLACE j1hV
PALM DESERT,.CA 92211 G /�
C'ry�R �L0/y
(760)413-3'01:7
Lic. No.: 510847
NC�O���Tq
LICENSED'CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I amlicensed 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 Professionals Code, olid my Lice se -is -in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License CI s: B Lice a o.: 84 7
for. by Section 3700 of the Labor Codd; 'for the performance of the work for which this permit is
_.
_ mss
issued::
Date: �� ontr— acto� -
_ 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
OWNEFBlJ LDERf)ECLARATION
insurance carrier and policy number are: -
hereby affirm under penalty of perjury that I am exempta!rom the'Contractor's State License Law for the
Carrier STATE FUND Policy Number 0026451-2006
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to -
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, oi.repair'any structure,.prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file asigned statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agreethat, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I shall forthwit o ly with tho r visions.
that he or she is exempt therefrom and the basis for the alleged. exemption.,- Any Violation of Section 7031.5 by
2�F
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (55001.:
t
Dat / App1i' can'
(_ 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
T RS'
WARNING: FAILURE TO SECURE WORMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
' Contractors' State License Law does not apply to an owner of property,who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN -ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
he i
one ear of comp letion the owner -builder will have the burden f r vin that h r h did not b 'Id
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
-
o w or
improve for the purpose of sale.).
(_ I 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 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.I.
Lender's Name: _
Lender's Address:
LQPERMIT
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 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 to building construction, 'herebyauthorize representatives
of t/hp county
to enter upon the above-mentioned property fo pecti uiposes.
07
Da1E/�(_Applicant or Agentl:
1 ( 44900� J
Application Number . . . . . 07-00001877
Permit . .
PATIO COVER
PERMIT
Additional desc . .
Permit Fee . . . .
90.00
P1an.Check
Fee
58.50
Issue Date . . . .
Valuation
. . .
. 6916
Expiration Date . .
12/24/07
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
5.00 9.0000
THOU BLDG
2,001-25,000
45.00
----------------------------------------------------------------------------
Special Notes and Comments
520 SQ. FT ALUMAWOOD
PATIO COVER
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . STRONG MOTION (SMI)
-.RES
.69
Fee summary Charged
---------------------------
Paid. Credited
Due
Permit Fee Total
----------
90.00
----------
.00
----------
.00
90.00
Plan Check Total
58.50
.00
.00
58.50
Other Fee Total
.69
.00
.00
.69
Grand Total
149.19
.00
.00
149.19
LQPERMIT
Bin #
City 0f La Quinta.
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
• Building Permit Application and Tracking Sheet
Permit #
o
'7 0 �?
Project Address:'
Owner's Name: L L Z_
A. P. Number:
Address:
Legal Description:
City, ST, Zip: Qum -
Contractor: �L� 0„
Telephone: / 3,7o17
Address:
Project Description: d Z
City, ST, Zip: .4 1,12e5
Telephone:
State Lie. # : �j/
City Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
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:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
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
Energy Coles.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading, plan
2°"Review, ready for correctionsrssue
Electrical
Subcontactor List
Called Contact Person
'Plumbing.
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans r.6ubmitted
Grading
IN HOUSE:-
Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
`v�d�i ��