08-0864 (PAT)r `'N.
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
0800000864
Property Address:
81785 LA PAZ CT
APN:
764-280-999-97 -300237-
Application description:
PATIO COVER - RESIDENTIAL
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
9975
T4'!t 4.4 Qab& -
BUILDING & SAFETY DEPARTMENT
- BUILDING PERMIT
Owner:
DON HANSON
81785 LA PAZ COURT
LA QUINTA, CA 92253
Contractor:
Applicant: Architect or Engineer: EWB CONSTRUCTION
PO BOX 445
DESERT HOT SPRINGS,
(760)272-0019
Lic. No.: 903784
LICENSED CONTRACTOR'S 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 is in full force and effect.
License CI s: _ License No.: 903784
f"
Date: 1 i Contractor/ ^ 6
OWNER -BUILDER DECLARATION -
I hereby affirm under penalty of perjury that 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. 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).:
1 _ 1 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 ISec. 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 _ 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 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.).
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
7/01/08
WORKER'S COMPENSATION DECLARATION
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 and policy number are:
Carrier EXEMPT Policy Number EXEMPT
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,
an ,agree that, if I should become subject to the workers' compensation provisions of Section
_37
0 of the Lrabor Code, I s ith comply with rhos isions.
Date: App an
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 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 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 correct. I agree to comply with all
city and co ty rdinances and state laws relating to building construction d In authorize repr sentatives
of this co ty t enter upon the above-mentioned property for in urposes.
Date: 74 � Signature (Applicant or Agent • l
r
LQPERMIT
Application Number .
. 08-00000864
Permit . . .
PATIO COVER PERMIT
Additional desc .
Permit Fee . . . .
117.00
Plan Check Fee
76.05
Issue Date
Valuation .
. 9975
Expiration Date
12/28/08
Qty Unit Charge
Per
Extension,
BASE FEE
45.00
8.00' 9.0000
THOU BLDG 2,001-25,00072.00-
-----------------------------------------------------------
Special Notes and Comments
------------------
750 SQ.FT. PATIO PER
APPROVED STRUC
CALCS.
----------------------------------------------------------------------------
Other Fees . . . . .
. . STRONG MOTION (SMI) - RES
.99
Fee summary Charged
Paid
Credited
Due
Permit Fee Total
117.00
.00 .00
117.00
Plan Check Total
76.05.
.00 ..00
76.05
Other Fee Total
.99
.00 '.00
.99
Grand Total
194.04
.00 .00
194.04
r
LQPERMIT
Bin #
City of La. Quinta
'City Lic.
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico "
Permit #
/
(04
La Quanta, CA -92253 - (760)777-7012
Building Permit Application and Tracking Sheet
Project Address:' l $ L q otZ I r` b Owner's Name: Q S o
A. P. Number:
Address: 0 1 I Y
3 'Z
Legal Description:
Cit},, ST, Zip: L
Contractor.
a Con Telephone: .
Address: " I
L44< Project Description: \ 1 O o
City, ST, Zip:
51 LQJe1J(
State Lie. # : '1 $
'City Lic.
Arch., Engr., Designer: Q
r; I N Q er ,
Address:
City, ST, Zip: ¢t o.nl
I`1.L! .1 .
Telephone: 3
State Lic. #:
3 'Z
Consh•uction Type.
Project type (circle
Name of Contact Person:
Y\ L ..:.......
- . .... Sq. Ft.:
Telephone # of Contact '
(�'2
33 � _ 1{ 3 4 2 Estimated Value -of.
APPUCANT: DO NOT WRITE BELOW "
". # - Submittal Req'd • Rec.'d FWAAA
Plan -Sets "
Strnctan[ Cults.
a
Plan Cpeek fitted
IMI A
Reviewed; r o eorrecti(
Truss Cala.
Called Conta a
Energy Cala.
Plans picked up
Flood plain plan,.
Plans resubmitted
Grading, plan
. "
2" Review, ready for eorrectio �ssae
Subcoutactor""•List
Called'Contact Person
" Grant'Deed
Pans picked up
H.O.A. Approval
Plans resubmitted.
INHOUSE:-
''' Revicw, ready for corrections/issue
Planning Approval '
Called Contact Person
Pub. Wks. APpr
Date of permit Issue
School Fees
.r krn e tl•e, Occupancy:
N� Add'n 'Alter Repair' Demo
# Stories: # Units:
Q o 0
(��CO
E.
PERMIT FEES
Item Amount
Plan Check Deposit
Plan Check Balance
Construction '
Mechanical
Electrical
Plumbing
S.M.I.
'Grading
Developer Impact Pee
A.LP.P.
- ---- -- ---....---- ---- -Tota ---
l Permit Fees-
7 oa Rc�o av (ss o e
C•(
Letter of Transmittal
To: City of La Quinta Today's Date: •13,
78-495 Calle Tampico City Due Date
La Quinta, Ca 92253 Project Address: L,0- az C'-.
Attn: Plan Check #:
We are forwarding:
Submittal:
W_ By Messenger
❑ .
151
❑
4w
C.
e
❑
e
❑
3"
❑
Other.
❑1 By Mail (Fed Ex or UPS) ❑ Your Pickup
Includes: # Of
Descriptions:
Includes: # Of
Descriptions:
Copies:
Copies:
❑
Structural Plans
❑
Revised Structural Plans
❑
Structural Calcsj,
1
Revised Structural Caics
❑
Truss Calcs
❑
Revised Truss Calcs
❑
Soils Report
❑
Revised Soils Report
❑
Correction List
❑
Approved Structural Plans
❑
Redlined Structural Plans.
❑
Approved Structural Calcs
(�
Redlined Structural Calcs
❑
Approved Truss Calcs
❑ -�-
Redlined Truss Calcs
❑
Approved Soils Report
❑
Redlined Soils Reports
❑
Other:
Comments:
i
By: fN Mit lliQ
Palm Desert Office: ❑ if (760) 360-57701
Washington Office: ❑ #(760)404-9556
Thank
you!
This Material Sent
for:
❑
Your Files
Per Your Request
❑
Your Review
❑
Approval
❑
Checking
❑
At the request of:
Other:
❑
By: fN Mit lliQ
Palm Desert Office: ❑ if (760) 360-57701
Washington Office: ❑ #(760)404-9556