04-4781 (PAT)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . 0400004781 `?.
Property Address . . . . . . 60517 JUNIPER LN
APN: 764-270-999-100 -
Application description . . . PATIO COVER - RES
Property Zoning . . . . . . . MEDIUM HIGH DENSI
Application valuation . . . . 4256
Owner Contractor
------------------------ ----------
Date 6/04/04
3kES
- p
I
UN 0 4 2004
CITY OF LA QUINTA
FINANCE DEPT.
GAVIN WHITLEY PELLETIER CONSTRUCTION
60517 JUNIPER LANE 74691 SWEET WELL ROAD
-LA'QUINTA CA 92253 THOUSAND PALMS CA 92276
(760) 275-6017
WCC: STATE FUND
WC: 54952004 01/01/05
CSLB: 260484 12/31/04
CCC: B1
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Permit PATIO COVER PERMIT
Additional desc . .
Permit Fee 72.00 Plan Check Fee-. 46.80
Issue Date' Valuation . . . . 4256
Qty Unit Charge .Per Extension
BASE FEE 45.00
3.00 9.0000 THOU BLDG 2,001-25,000 27.00
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Special Notes and Comments
320 SF ALUMAWOOD PATIO COVER
-----------------------------------'-------------------------------------=---
Other Fees . . . . . . . . . STRONG MOTION (SMI) - RES .50
Fee summary
-----------------
Permit Fee Total
Plan Check.Total
Other Fee Total
Grand Total
Charged Paid
72.00
..00
46.80
.00
.50
.00
119.30
:00
Credited. Due
.00
72.00
.00
46.80
.00
.50
.00
119.30
P.O. Box 1504 cedf 4 4
"
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 herebyaffirm under penalty of perjury that I am I' nder provisionsf Ch pte Jc encing with Section 7000) of Division 3 of the Business and Professionals
-
Code, and my License ull force and eff .
License Class Licen No.
Date . C' ontrector
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am t from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
U 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.).
U I am exempt'under Sec. , B.8 P.C. for this reason
Date
WORKERS' COMPENSATION DECLARATION
1 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.
1 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 o'c number are:
Carrier S l�¢T£ �ti,✓ %� POlic mber p
_ I certify that, in the performance of the rk for which thi ermit ' issued, I all not ploy a person in any manner so as to become subject to the workers'
compensation laws of California, an agree that, if I should be me ubject to th workers' pensation provisions of Section 3700 of the Labor Code, I shall
pP
forthwith comply with those provisi s.
Date (-#) L1 Applicant
WARNING: FAILURE TO SECURE WORKERS' COOL�LA($100,000),
N COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND P)TTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that the is 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
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby de 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, indemnity and hold harmless the City of La Ouinta, 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 bec�inforrnation
mes 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 cellation.
I certify that I have read this application and state that the abo is co . I agree to comply all cit nd county ordinances and state laws rotating to building
construction, anrd hereby authorize representatives of this co to enter on the bo ntioned pro eRy for ins on purposes.
Date � 1 � (0ySignature (Applicant or Agent):
ra.
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FRO*: Panasonic FAX SYSTEM PHONE NO.
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE �' BY
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Trilogy at La Quinta Maintenance Association
April 26, 2004
Gavin Whitley
Property Address: 60517 Juniper Lane
Dear. Ivir. Whitley:
1';' ...q � ::!'.'. ::4µ ..:4: "-'C':i .'},Trs .r iv,"y w L_ L• '.\i<•r:S^�R..
d•F'' n. us"E^:YL'"iE::.;,,. �ta'` v'.i' A: '.4:=' .a. ' 1 ', Q' ♦•. .:..9s,..
'97�V.: %.,;%r; :=r;.7 . M_ %it~�:. •,'.' ,•.:�iir. ,'•.• •y:L..Tr '�:Y'•.: .1�4Y.:::
•17�'r 't'i
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Your-] 1:P •6' cover ... bY�• dw trc ased tm nonn ouans fol ntallsion.of iaue .
Design Review Committee per your drawings.
This approval does not constitute consent by the Association for the applicant to encroach, trespass, or
build on any property other than that of the applicant. This approval is related solely to the items
reserved for approval by the CC&ks in accordance with the Architectural Guidelines. The approval does
not extend to the quality of work done by your architect, or contractor, or to any structural engineering,
soils engineering, or site grading and drainage design. You are urged to obtain the services of a state
licensed professional for consultation as needed.
Please be advised that this approval does not relieve you from obtaining any necessary building permits
from the goveinmenW agencies involved. If any portion of the common area is damaged during
construction, repair of same will be done by the Maintenance Association's contracted landscaper and fees
for the work will be deducted from your security deposit. Thank you for your patience in this matter and
for complying with the Association's policies and standards.
Sincerely,
:: For.the ArchiitectwW Committee
Dayton Dickey, CCM
Association Manager
'Enclosures
Professionally Managed by Accton Property Pwriagement, Inc.
29B Technology Drive, Sidle J 00, Irvine, CA 92618
949-450-0202 800.400-2284 949-450-0303 jar
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