06-0841 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00000841
Property Address: 179593 DANDELION DR
APN: 604-451-001-1 -25691 -
Application description: PATIO COVER - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3857
Tdy/ 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
QAZY M. A.
79593 DANDELION DRIVE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/01/06
Contractor:
Applicant: Architect or Engineer: OUTBACK PATIO & SUNROOMS, INC.0
1450 W 6TH STREET, #118 p
a CORONA, CA 92882 MAR 0.2-2006
(909)272-4997 r
Lic. No.: 483069 CITY OF LAQU1NTA
FINANCE DEPT
------------------------------------------------------- ----------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury that I a licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7 00) of Division 3 of the Business and essionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License as : B C36- License No.: 483069 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
( issued.'
ate: 3 Contractor: YN 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1423157-2006
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should be ome subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or:,:i 3700 of th abor Code s rthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by ��yy
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: V pPIicant:
(_ I 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 br 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.).
(_ I 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
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 reaEve-mentioned
tion and state that the above information is correct. I agree to comply with all
city and cou ty ordinae laws relating to but
onstruction, and hereby authorize representatives
of this n to en pro a ''or1��s action purposes.
te: 1 Ov ilicant or Agent):(�(I
Application Number . . . . . 06-00000841
Permit
ELEC-MISCELLANEOUS
Additional desc . .
Permit Fee . . . .
16.50
Plan Check Fee
4.13
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
8/28/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2.00 .7500
----------------------------------------------------------------------------
PER ELEC
DEVICE/FIXTURE 1ST 20
1.50
PermitPATIO
COVER
PERMIT
Additional desc .
Permit Fee
63.00
Plan Check Fee
40.95
Issue Date . . . .
Valuation . . .
. 3857
Expiration.Date ...
-� 8/28/06
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
2.00 9.0000
THOU BLDG
2,001-25,000
18.00
----------------------------------------------------------------------------
Special Notes and Comments
290 SF. SOLID ALUMINUM PATIO COVER, PER
APPROVED PLANS
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . STRONG MOTION (SMI) - RES
.50
Fee summary Charged
---------------------------
----------
Paid Credited
--------------------
Due
Permit Fee Total
79.50
.00 .00
79.50
Plan Check Total
45.08
.00 .00
45.08
Other Fee Total
.50
.00 .00
.50
Grand Total
125.08
.00 .00
125.08
i
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OUTBACK PATIO & SUNROOMS INC. (909) 272-4997
REAR PROPERTY LINE
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Bin # r;}
City of. La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Shee
Permit # '�
a
00
Project Address: 0� , �f a
Owner's Name: �Z
A. P. Number:
Address: -7� OQ �/
Legal Description:
City, ST, Zip: VI h C ZZ S3
Contractor:
1b r
v (•t�l"v:S �t:�
Telephone: — _
Address: I �� IF
Project Description: �m� G�
City, ST, Zip: CoranC �
Telephone:. s- 7�� G-1'ELM
LA e
State Lie. # : D Q
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair' Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACKING •
PERMIT FEES
Plan Sets
Plan.Check submitted
Item Amount
Structural Cates.
Reviewed; ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balanc`el-�
Energy Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical -
Grading, plan
god Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees