0207-037 (PAT)D
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
Professionals Code, and my License is in full force and effect. '
License # Lic. Class Exp.`Date ;7
421915 1 1-11031
i
Date nature 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).
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
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'- STATE M14D Policy No. I6IM
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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, and agree that if l4ould become
subject to the workers' compensation provisions of Sectioria3700 of the Labor
Gode,�J hall orthwith,somply with those provisions. " / .I
Date: "' " Z � Zolfcant F { — f X, +, ti .• *"�
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application. `
1. Each person upon whose4)ehalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of h s'''City to enter upon
the above-mentioned property for inspection purposes.f
Si nature (Owner/A ent) ��� r'F�t pate
BUILDING PERMIT PERMIT#
DATE017
12% VALUATION Zlw= LOT TRACT
JOB SITE S 44-005 �% �l)�,�1.�'A, � URT
ADDRESS
APN
'OWNER
CONTRACTOR / DESIGNER / EN (NEER
44 065 WILEA C01> U
73.450 B., TOP
I„hQUKr 4. CA 922,1,E
S.K.Y VAULTY f:`•A 92240
(619)564.2176 C.'.814$ 1.484
USE OF PERMIT
PATTO
420 SY. PATIO COV XR PZR CI1" If ST:At1WARLI.
420,00 2F
MUMTKID CORY 010' G'OHUP.C.F UC'CTC3A'
5Mf,.00
PIAN MC'.K PRE 101.000.4:39.31 S $52.65
CONSTRUCTION Yis'K 1101-000-4•I8-000 $91.00
wTRID NO IER)TION 0M - U.SID 101.000.241-000 4-%
y�
1 M
D � D
0 1001
,ILII 9
WYOFLAQUINTA
FINANCEDEPT.
{%Ii3-iC'i"�L, `i3K+i51S� tL daz RClEP`K
$134.211
TOTA1L�'E"R '' 'S DOE
IS3:'14.��
RECEIPT
DATE/ -
by
DATE FINALED
INSPECTS
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 �— —®
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
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
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
Final
Utility Notice (Perm)
COMMENTS:
RAFTER SIZE AND SPACING % 7 z,
SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE —r
(SEE RO FING NOTE ON REVERSE,
'T'AND 'L' STRAPS
6"x6"xt"xl/5" WITH
(4) 16c NAILS OR BOLT
O.H.
ROOF
//PITCH
POST SIZE." _
(4'x4" MIN.)
CONTINUOUS LEDGER
SIDE SE78ACK
(SAME SIZE AS RAFTERS)
FINISH GRADE
HEAD SIZ
L_
_J 12" BELOW GRADE L- J
PROVIDE 1" CLEARANCE
zi
AFTER, SPAN:
O.H.
„
a
0
ALL LENGTH: ___ _
D
f a
REAR SETBACK
I
2000 P.S.1 CONCRETE
I FINISH GRADE
L
SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE —r
(SEE RO FING NOTE ON REVERSE,
'T'AND 'L' STRAPS
6"x6"xt"xl/5" WITH
(4) 16c NAILS OR BOLT
O.H.
NOTE:
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4" x 5" LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL. k -
U -STRAP OR AN(
3/E" x 5" LAG SCREWS INTO STUDS AT 16" D.C. NON -CORROSIVE
i r— CONTINUOUS LEDGER /
�r
r
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING
BUILDING DEPARTMENT APPROVAL BELOW
CITY OF LA Wl A
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
(4)- 16d NAILS
OR BOLT
U -STRAP OR ANGLE
(4)- 16d NAILS
OR BOLT
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
ANCHOR BOLT (EMBED
7" MIN. INTO CONCRETE) V/
TYPICAL PATIO COVER
DATE OF APPLICATION ev n
OWNER'S NAME
STREET ADDRESS L �� s
CITY, ST ZIP
TELEPHONE��-
H.O.A. APPROVAL
r
L
OVERALL LENGTH:----__
POST SIZE." _
(4'x4" MIN.)
SIDE SE78ACK
FINISH GRADE
'
1+— MIN. 12*' x 12" FOOTING I I
L_
_J 12" BELOW GRADE L- J
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
NOTE:
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4" x 5" LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL. k -
U -STRAP OR AN(
3/E" x 5" LAG SCREWS INTO STUDS AT 16" D.C. NON -CORROSIVE
i r— CONTINUOUS LEDGER /
�r
r
JOIST HANGER OR SOLID BLOCKING
NAIL RAFTER TO BLOCKING
BUILDING DEPARTMENT APPROVAL BELOW
CITY OF LA Wl A
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
(4)- 16d NAILS
OR BOLT
U -STRAP OR ANGLE
(4)- 16d NAILS
OR BOLT
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
ANCHOR BOLT (EMBED
7" MIN. INTO CONCRETE) V/
TYPICAL PATIO COVER
DATE OF APPLICATION ev n
OWNER'S NAME
STREET ADDRESS L �� s
CITY, ST ZIP
TELEPHONE��-
H.O.A. APPROVAL
r
L
L
\. C. .
R- ER SPAN TABLE / �` . ��� . � �` �� ' ALL CONSTRUCTION SHALL CONFORM
GRADING RULES
PS -10-70 �o�V; o� L; ;i`� i TO THE PROVISIONS OF THEN
(FEET & INCHES) OC) OO
O O /C ,
��
f o� 1998 CALIFORNIA BUILDING CODE.
�6) / �� �O / SUPPLEMENTAL NOTES.
NOTES:
1 . 32" RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY.
2. FOR SOLID PATIO COVERS (NOT LATTICE)
RAFTER SPAN IS LIMITED TO 10'-0" USING
THIS STANDARD.
I LATTICE
10 C). C.
24"-
10'-e'
1 9- 6"
T-3'
8'-9"
DOUGLAS
i
FIR Ivo. 1
DOUGLAS FIR NO. 1
SIE
I
?xc
16" U.C.
15'-0"
14'-0"
10'-9"
13'-0"
12'-0' 11'-0'1 8'-9"
10'-6"
10-0" 8'-6" 1 N/A
N/A
6'-0"
4x8
t
i
16" O.C.
24"
32"
t8'-0"
17'-0"
13'-0'
16'-0"
15' -ti' 14-6" i 11'-0"
13'-0"
13'-0" 11'-6" 1 N/A
N/A
12'-0"
6x8
NOTES:
1 . 32" RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY.
2. FOR SOLID PATIO COVERS (NOT LATTICE)
RAFTER SPAN IS LIMITED TO 10'-0" USING
THIS STANDARD.
I LATTICE
ROOF
BUILT-UP ROOF
HEADERS
HEADERS
DOUGLAS
i
FIR Ivo. 1
DOUGLAS FIR NO. 1
SIE
I
SPAN
SIZE
SPAN
i
5'-0"
4x4
4'-0"
4*:6
8'-0"
4x6
6'-0"
4x8
1 t • -O"
4x8
8'-0"
4x10
14'-0"
4x10
10'-0"
4x 1 2
17'— 0"
4x 12
12'-0"
6x8
14'-0"
6x8
12'-0"
6x10
17'-0"
6x10
14'-0"
ROOFING NOTES:
A. BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN.
B. POCK ROOF: 3/12 MAXIMUM PITCH.
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