13-0713 (PAT)4 P.O. BOX 1504 ""' VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-701.1.
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
- BUILDING PERMIT
Date: 6/05/13
Application Number: 13-00000713 Owner:
Property Address: 79405 AVENIDA LAS PALMAS HUONG DANG
APN: 604-460-004-4 -29563 - LA QUINTA, CA 92253
Application description: PATIO COVER - RESIDENTIAL ( O
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3000 / \
Applicant: Architect or Engineer:
O
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that Iam 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.
Liceenn`se,Class: D03 D52 License No.: 735369
Dati.
e: Contractor
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 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 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 1, 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.l.
( 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: - �_fk_
Lender's Address:
LOPERA11T
Contractor:
COACHELLA VALLEY
P. -O. BOX 1434
INDIO, CA 92202
(760)342-7272
Lic. No.: 735369
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ 1 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 carrier and policy number are: '
Carrier EXEMPT Policy Number EXEMPT
n Yl 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.
Dam 1I Applica %I►��C,
WARMING: 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.
certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property�I , spection purposes.
Dart ye " - R 0 Signature (Applicant or Agenti,/?S
V01 4V
Application Number . . . . . 13-00000713
Permit . -' PATIO COVER 2013
Additional desc .
Permit Fee 95.81 Plan Check Fee
-00
Issue Date• . . . Valuation . . .
. 3000
Expiration Date 12/02/13
Qty Unit Charge Per
Extension
1.00 95.8100 EA MISC PATIO COVER, STD
95.81
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Special Notes and Comments
PATIO COVER - 360 SQ FT DURALUM PATIO
COVER BUILT USING DURALUM ENGINEERING.
2010 CALIFORNIA BUILDING CODES'.
----------------------------------------------------------------------------
Other Fees . . . . - . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, PATIO COVER
94.38
- STRONG MOTION (SMI) - RES
..50
Fee summary Charged Paid Credited
------------------------------
Due
---------------------------
Permit Fee Total 95.81 .00 .00
95.81
Plan Check Total .00 .00 .00
.00
Other Fee Total 95.88 .00 .00
95.88
Grand Total 191.69 .00 .00
191.69
Bin. #
CIL}/ Of La Qulh to
Building 8[ Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Wnta, CA 92253 --(760) 777-7012 Building Permit Application and Tracking Sheet
PermI #
I�I
Project Address:
Ownees Name:. 0
A P. Number.
Address: .'7G j
Legal Description:
City, ST, Zip:
Contractor.
Telephone:
Address: 7
Project Description:
City, ST, Zip: 1 r
Telephone:' y2'
Lom )%
tx
State Lic. #: ,•s 2 City Lia C
Arch., Engr., Designer.
Address: "
City., ST, Zip:
Telephone:
State Lic. #:
Construction 'fype:jwzowy t Occupancy: n D
Project type (circle one): ew Add'n Alter Repair Demo
Name of Contact Person:2
Sq. Ft.: q�'d #Stories: # Utut;;
Telephone # of Contact Person: 7 2
Estimated Value of Project 70m0 �
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
'Rec'd
TRACKING
G
PERhIIT FEES-
EESPIQn
PlanSetsPla¢
Check submitted
Item Amount'
Strgctural Calm
Reviewed, ready for corrections
Plan Check Deposit.
Truss Cala.
Called Contact Person
Plan Check Balance
Mile 24 Cales.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mecha"
Grading plan
2`! Review, ready for correctionsfasue
Electrical
Subcoatactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
ML
H.O.A. Approval
Plans resubmitted
Grading
N HOUSE.-
3" Review; ready for eorreetionsfusue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Feu
Total Permit Feu