9607-016 (PAT)LICENSED CONTRACTOR 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
ProfE's'sionals Code, and my License is in full force_ and effect.
License # Lic. Class Exp. Date
Date Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( (am exempt under Section B&P. fo 1Tis -ason
at
%✓ Signature of Owner f✓ Y s
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 & policy no. are:
Carrier Policy No. " '
A.
ERMIT# CONTROL#
BUILDING PERMIT P*vb9.
DATE VALUATIONLOT 9407-016 TRACT 6 7 31
71.9/96 S3,>1 X2.00
JOB SITE APN
ADDRESS 79-175 LXf IG0 CIRCLE
OWNER CONTRACTOR / DESIGNER / ENGINEER
€ R.FSAND SlUkti;. GUMI GS1t;C,UD OWNRIZ BUii,)ER •
79.175 L.li IGO C MCLS
T.A QUINTA
3-iS-3�it;2
USE OF PERMIT
k�A. l`jE..)••. ,
It) sQ Jr .I' oC .LA°P ctGli PA'i c, '
l'
rsiuuiuD ms,r or c:avmvcYtm
PERMIT ME SUMMARY
10-1,AAf Cfilttit;t ii?1 UU(h43'?-318'tfi.95
(This section need not be completed if the permit valuation is for $100.00 or less). C"O, �la`:,I0JUCI,O.N.FEty
( )'`I certify that in the performance of the work for which this permit is issued, 10-000418-000 '30.00
I shalltnot employ any person in any manner so as to become subject to the STO.K0 NRY110N FEF, - TtE.+I 101 -OW -24.1.-000 $ 30
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.
Date: Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil.fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
3,a 9to()
4J.f3-"�'tr�.i r1 t. F.(31�15'!'lawU CIOI�I ANii'��rlN F�>;t%®
I.X.$4S Vi2,84MB)1^' EE,' $0.00
& hold harmless the City of La Quetta, Its officers, agents and employees. ��
2. Any permit issued as a result of this application becomes null and void -if D /A\ >
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 JUL 1 1996
correct. I agree to comply with all City, and SY a laws relating to the building
construction, and hereby aumprize rep esent Ives,9f his City to enter upon By
the above-mentir i s 3 'eetio u •po >; -
/
Signature (Owner/Agent ✓� .r �D to �''
Y4:l1LPERMIT Ff,ES WKNOW .$104.45 ;>
By DATE FINALED INSPECTOR
0 f
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts -
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
r
Final
Utility Notice (Perm)
u
1
v 3
G� ®t' !
M
OWNER / BUILDER. INFORMATION
Dear Property Owner:
An application for a building permit has-been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance. '
For more specific information about your obligaiions under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific'information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
-Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEFT. OF BUILDING AND SAFETY
78-105 Calle Estado
La Quinta,. CA 92253
(619)564-2246
FAX: (619) 564-5617
OWNER'S SIGNATURE/DATE
PROPERTY ADDRESS
C1620 7- 0169
PERMIT NUMBER(s)
' - f ... � -.�.. �'• .y�;..r-.f ^+l°.�,.�^i- �i4...�ari��^�vcY'j'Nlek��?ii="'Z'"rn,^S�N'P����t",4"•'1"�,`�,r. �,n �.�, f..v.r.r7,. _et .. � -• - . ..
OWNER/BUILDER. INFORMATION
Dear Property Owner: `
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply'
If you plan to do your own work, with the exception of variuus trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or.otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed ascontractors or
subcontractors, then you may be an employer.
If you are an employer, you must register wih'the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs—and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstiation). For more specific information about your obligations under State
-- Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If -the structure is intended for sale, property ;o'vvners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
i Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued`until the verification is returned.
Very truly yours,
w
CITY OF LA QUINTA _
'DEPT. OF BUILDING AND SAFETY
78-105 Calle Estado
La Quinta,, CA 92253
' (619) 564-2246
` FAX: (619) 564-5617
'OWNER'S SIGNATURE/ DATE
PROPERTY ADDRESS
I 0
PERMIT NUMBER(s)
r•"
�y
RAFTER SIZE AND SPACING
SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE —7
(SEE ROOFING NOTE ON REVERSE) �.r/
n., I A..7.i.-
'' pF � 2• o� �is%c��rc—
--------- ----- LEL
• ROOMA IIPrFCH•
• • • •
CONTINUOUS LEDGER
HEADER SIZE
T AND 'I.' STRAPS
I 6'xirx1'xt//NT' WITH I
(4) 160 NAILS OR BOL'
'
II
RAFTER SPAN: 12
POST SPACING
O.H.
O.N.
y
OVERALL LENGTH:
OVERALL LENGTH
11TH. Cx-C POSTS ;o
REAR SETBACK
SIDE SETBACK
'
FINISH
2000 P.S.1 CONCRETE —+1 1
FINISH GRADE
6— MIN. 12'x12" FOOTING I I
L—J I
L—J 12' BELOW GRADE L—J
PROVIDE 1' CLEARANCE
BETWEEN POST NO
CONCRETE
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1 /� x S UG SCREW THROUGH FASCIA .INTO EACH RAFTER TAIL
U -STRAP OR ANGLE
NON -CORROSIVE PLATE
3/117 x S' LAG SCREMWS INTO STUDS AT 1I' O.C.
P�
CONTINUOUS LEDGER
I NAILS
Ofd B 6
........; ..
U -STRAP OR ANGLE
(MILS
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKMIO
ANCHOR BOLT (EA BEDPROVIDE 1' CLEARANCE
T MIN. INTO CONCRETE) BETWEEN POST AND
CONCRM
BUILDING DEPARTMENT USE ONLY
TYPICAL PATIO COVER
PERMIT NUMBER
DATE OF APPLICATION
PERMIT ISSUE DATE
OWNER'S Kmc7q-175
r7�p L) I�
AL
FININSPECTION DATE
STREET AooRESS
1. ` - l 7 5 �r 16V 0 j2c X
SPECIAL CONDITIONS
CITY, ST ZIP
TELEPHONE
H.OA APPROVAL SIGNATURE. DATE
/, IrI vG copy
RAFTER SPAN TABLE
GRADING RULES cl c �7 C Sco C7 p�
PS 20-70
(FEET & INCHES) J,l� J,l� OJA-?
z 6,7 V
�O c�, >O )O
2x4
1 S' O.C.
10'-6' '-6'I 7'-3' '-
HEADERS
2x6
16' O.C.
24"
32"
1 '- 14'-(f 10'-N'-
1'- 11'- '- 1�'-
..._ ... ......... ...
'- '-
DOUGLAS FIR NO. 1
2x8
16w O.C.
24
32' 0
1.'.-4�.. 1.?'.-5�'....i':- ..1.�=..
'- '- 1 - '-
..1.1'.-......1.1.'.-.......N.A.. IV -A.
NOTE:
V O.C. SPANS ARE ALLOWABLE FOR OPEN LATTICE
PATIO COVERS ONLY.
LATTICE ROOF
BUILT-UP ROOF
HEADERS
HEADERS
DOUGLAS FIR NO. 1
DOUGLAS FIR NO. 1
SIZE
SPAN
SIZE
SPAN
44
44
..._._w._..4#.-
46
4x6'-
4x8
....._..........11'-
�14'-
4x8
_.---_a-
5
4x10
4x10'
4x12
4x12
'-
6x8
14' -If
6x8
1'-
600
. ........... ..17'-
6x 10.
14-
ALL CONSTRUCTION SHALL CONFORM
TO THE PROVISIONS OF THE 1994
UNIFORM BUILDING CODE.
SUPPLEMENTAL NOTES:
A. BUILT-UP, 'ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.