14376 (PAT)h
P.O. BOX 1504 No. -14376
Buil6N)ng 78-770 Irwin Circle 78-495 CALLE TAMPICO
Address LA QUINTA, CALIFORNIA 92253
Owner Dew
,oie' Van Derhorst-'
Wilin
Addresg
s Same
City Zip ]Tel-
La Qwiftafl:* C� 92253.
Contractor
Address..
..P.O. Box 977 L
State Lic.
& Classif—
p 92253
Arch.,-Engr.,
-Designer,
Address
City lZip
I . - " A 1ICENSED,COI
-1 heet� offi'mri-ttiat I am, llcej�,W6,T$
7000) 66 4
�.J ivWon 3 of the BqikIri6ss ams
City 2231-
Lic. #
Sq. Ft. -A0 No..
Size. Stories'
New -0 Ado 0:
Tel.
State
tic. #
R'S DECLARATION
)ns of Chapter -9 (commencing,with Section.
ns, Code, and my license is injulljor!,e'pnd-
VN
BUILDING: TYPE CONST. -l- . ' R3
. .. OCC: GRP.- - - -
A.P. Number
Legal Description
Project Description. Patio Cover
No. Dw.
'Altbr 0 Repair 0.
W"
SIGNAiDATE
—Owner
OWNER -BUILDER DECLARATION
hereby affimi that I 'am exempt from the-Contractoes License. Law for the following
reason:, (Sec.. 7031.5. Business 'and Professions, Code: Any city or county which- requires a
permit to construct, after, improve,demolish, or repalr.-any structure; prior to. -its issuance also
Estimated Valuation
requires the applicant for'such permit to ffle,a signed statement that heJs licensed pursuant to.,
visions of the C(intractor's License Law, Chapter9 (commencing with Section 70QO) of
.. Divlsfon 3 of the Business and.Protessioris Code. or thift . 'he ls*exampt'therefrom, and he basis,..
for the alleged exemption. Any violation of Section 7031.5, by 'any applicant for a permit
subjects the applicanl'to -
a civil penalty of not more than rive hundred dollars ($500),
0 1, as.owner of the propifty,'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; Buisness.and
Professions. Code: The Contmcfor'& License Law does not apply'to an owner of property who,
builds or improves thereon and. who doessuch work himself or through -his -own employees,-.
provided' that 'such intprovements.aie 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 did not build or improve for the purpose of sale.) .
. . . . .
'owner
PERMIT•
Plan'Chk. Dep.
Plan Chk. Bal.
Const..'
Mech.'
!
'Electricail
Plumbing
b-1, as of the prop erty, am exclusive ly cont rac ting.with lice I nsed contractors to con-
struct - the- project., (Sec. 7044, Business and •Professions Code: The Contractor's License. Law
S.M1
does not apply to an owner of property who builds or improves thereon, -.and who contracts for
such projects with a c6ntractor(s)-(�censed pursuant to the Contractoi's License Law.)
0 1 am exempt under -Sec- B. & P.C. for this reason
Grading
Driveway Enc.
• Date L:_Owner
Infrastructure
WORKERS? COMPENSATION DECLARATION
I hereby, 'affirm that, I I hale
a a certificate of consent to self-ins6re, or a certificate of
Workers 0*pehsation insurance, or a certified copy thereof: (Sec.* 3800, Labor Code.) -
. N
PolicYompany
Copy.IS liled.with the city.P Certified copy is hereby furnished.,
TOTAL
CERTIFICATE OF EXEMPTION'FROM
WORKEIRS!-COMPENSATION INSURANCE
REMARKS'*
(This section need 'not be completed it the- permit Is for one hundred dollars ($100) valuation
or less.)'
i I certify that in'the performance of thp work4or which- this permit is issued, I shall not
rilFertsion' in any manner so as �to become subject -to the Workers' Compensation
0 n a_
=California
Date Ati
Demolition 0
AMOUNT,
vw�
X
NOTICEJO APPLICANT: N, after making 'this: Certificate, of Exemptioh 'you --shquid-1bec6me ZONE- by: I JA I I
subject to the Workers' Compensation provisions.
of the;:Labor Code,• you muVJ1o1rIhwith,
.,Minimum et
comply with such Provisions Or this permit shall be deemed revoked. S backDistances:
' Front Setback from Center Lino
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 -
ATTORNEYS FEES.'
ThiS'ls A building permit when 'properly filled out signed add validated, and is -subject to
expiration it work thereunder is suspended for 18Qd;ys..•
I certify that I have.read this application and, state that:the,aboveJnfor I mation is correct.
I agree to'comply'with all'city-and--county ordinances and 'state -laws. relatingto building
construction, and hereby -authorize representatives .of this, city. -to enter. . the , above-:
mentioned Properly for inspection purposes:
Signature of applicant
Date
MailingAddress
City, State, Zip
Rear Setback f rom Rear Prop. Line
Side Street Setback from Center Lint,
Side Setback from Property Line,
FINAL DATE INSPECTOR
Issue d by. Date Permit
Validated by:
Validaiion:_
Rafter Site 6 Spacing
-4x 'S - — j/ - 0-6)
Iz
Roof Iltch 0�
Coatiou'olIus Ledger
Beeler `t X 1 TJ _—_—
Size
Rafter Span
See loefing Note below
Specify Roofing 6 Sheathins or Cpeo
01�&El LA,7''t'I65
r
"T•• sad Angle Strop@ J
6"s<"zl"zlh" with J
4-16 d malls or holt
�.
Post spacing y
_�----
overall leLgth
His. 4"z4" posts
9FAR- P� Si DE
Lr �V :lr:r,a Il��r.d LJ
2000 o.s.i. �,altr � : J
Kin. 12"z W
- �3/6"z3'• lag screws into studs at 16" O.C. Footing 12"
Below Grade
onCtiouous Ledger
e.—
If— Joist Meager or Solid Blocking -1
Nail tafter to blocking
ALL Cf2-q'.R=Q; 4 - 16 d sells or holt _J
sFs7%u M Z'DPy 70
WE UNnMOR4 1lI:lZ nc Imbed Asehors 7" In cont. —
Cit30E
�.
yb .,yea/'
IoiF-ITR spm WM2•
,w
4�ad ing Reales `9 S P.&
ps 20-70 ��' ��• , ��• d�• Cie
erect 6 inches)
2x4
16' o.c.
24"
11-2
9-6 '
110-6
8-8
7-11
6-5
6-3
6-9
6-4
5-2
2xS
12" c.c.
17-10
13-0
13-7
10-0
16'
16-3
15-1
11-3
11-9
9-8
24'
13-3
117-5
12-1
9-2
9-7
7-1
size q an 51u "04
32-
10-10
9-11
7-6
7-0
S-6
2xg
16' o.c.
21-5
19-10
14-10
15-6
11-0
24' '
114-5
17-6
16-3
12-1
12-8
9-4
32'
13-0
20-0
10-2
II 4
F0250-14 3 (R12i67) I
C1
L
0 -strep or
Angle
' Aochor
tAon-eorrosiie.• bolts
4Y im PIMO =fR
�.- -
Slate
. I — �
•� iii
crate •', . 'ill � %�
r}lA�ad6
fir No, I
size q an 51u "04
4X4. so s y f}•
;
Aa • _a
_14' ••c . �,
.�....17' yJ2 1V
4x14.......20' y, ly ,y
`
i 14• btu 12
18' Z IC 1y'
Amfinq Note
a- Wod shakes 4/12 pitch (3/12 min. pitch witth 301
felt underlay) Class A
b- Wod, e3:-rositior. S�iLngles 4/12 pith (3/12
min.
pitch with 154 felt trde-- lay) - Class A
c. Built up rolled roof slope to drain.
d- ibck roof 3/12 unx,min pitch.
4Y im PIMO =fR
�.- -
Cl)