07-0012 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00000012
Property Address: 45500 DEERBROOK CIR
APN: 604-404-029--4 -23,995 -
Application description: PATIO COVER - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 8379
Applicant: Architect or Engineer:
BUILDING" & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSEDCONTRACTOR' TION
I hereby affirm under penalty of perjur a a sed under pro sions of hapter 9 (commencing with
Section 7.000) of Division.3 of the siness and Pro sionals Code, and,my icense,is in full'foroe and effect.
License las 8 Uc inse"f :: JW0958,
�atea 3 07 ntractor:
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 cit ,or`county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior•to its issuances also requires the applicant for the
permit to file a signedstatement that he orshe'is licensed pursuant wthe 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 orshe:is exempt therefrom and the.basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant fora permit subjects the applicant to a civil penaltyof not more.than five hundred" dollars (8500).;
(_ 1 1, 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 notintended 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 shedid not build or
improve for the purpose ofsale.).
I; as owner of the property, am,exctusively 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 exemptunder 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'ssName:
Lender's Address:
LQPERMff
Owner:
ARIAS ROBERT GABRIEL
SAME
45500 DEERBROOK CIR
LA QUINTA, CA 922.53
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/03/07
Contractor: D 0 '
PELLETIER PATIO
79275 DESERT STRE
LA QUINTA., CA 9225 JAN 0 3 2007
(760)275-7593
Lic. No-- 860958
WORKER'S COMPENSATION DECLARATION
I hereby affirmunderpenaity of perjury one of the following declarations:
_ I have and will maintain a.certdicate of consent to self -insure for woikers' compensation, as provided
for by Section 3700 of the Labor Code, for the'performanceof 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 EX PT Policy Number EXEMPT
I certify that, in the,.perfor of the work for which. th' 'rmit'is issued, I shall not:employ any
person in. any ms so as to ome'subject to the or rs' "compensation laws of California,
soil agree that, ' I should beco subject to the oro ars' compensation provisions of Section
3700 of the rCoda shall with comply w ose provisions.
ate: I3107 applicant -
WARNING: FAILURE TO SECUR ORK S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI 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 requesvand 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 Quints, Its officers, agents, and employees for any actor omission.re,lated to the work,being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes nulband void if work is notcommenced
within 180 days from date of issuance mit, or cessationof work for 18.0 days will subject
permit to cancellation.
I certify that I have read this application and st .that the above in rmation is correct agree to co ply with all
city and county ordinances and state laws rel ing to buil ing const ion, and hereb authorize re esentatives
of this county to enter u. ponjA
above-mentio ed pro y or ins tion urposes.
atXaI (1
:
� 10 7 nature (Applicant or A em):
.Application Number . . . . . 07-00000012
Permit . .
. PATIO_ COVER
PERMIT
Additional desc .
..
Permit Fee . . .
. 108.00
Plan Check
Fee
70.20
Issue Date . . .
.
Valuation
. . .
. 8379
Expiration Date
7/02/01
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
7.00 9.0000
THOU BLDG
2,001-25,000
63.00
-------------------------------
Special Notes and
Comments
-------------------------
-------- --
630 S.F. ALUMAWOOD
LATTICE PATIO
COVER
- -------------------------------------------------------------------
Other Fees . . .
. . . . . . STRONG MOTION (SMI)
- RES
.83
Fee summary
Chz.rged
Paid Credited
Due
Permit Fee Total
108.00
.00
.00
108.00
Plan Check. Total
70.20
.00
.00
70.20
Other Fee Total
.83
.00
.00
.83
Grand Total
179.03
.00
.00
179.03
LQPERMrr
B1 #City
of 'La Quinta
Building•at Safety'Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # n
0`
Project Address:- 5 " 5�,� V ��i0 (L (Owner's Name: R
A. P. Number: Address: Lf S Ou tjBYUD k
Legal Description: Ciiy, ST, tip: i q �.�'� C.
Contractor. Telephone (
Address: -792ZS 0gaq t—Project Description:
City, ST, zip: vr. CA W 'S- 3 L. C.c) ••,sem
Lic.#: (aOq J City Lic.,
r
Engn, Designer:
Address:
City, ST, Zip:
Telephone•Consttudioa Type: Ooarpaney:
State Lia #: Project type (circle one): New ..Add'n- Alter' Repair Demo
me # Units:
Naof Conted Person: Sq. FL G30- s: # Storie
Telephone# of Contact Person: Estimated Value of Project:
APPUCANT: DO NOT WRITE BELOW THIS-UNE
#
Submittal
Req'd
Reed
TRACING.
PERMIT FEES
Plan,Sets
Plan Check submitted
Item Amount
Structural Gain.
Reviewed, radytorpmebm
Plan Check Deposit
Trus rales.
Called Contact Person
Plan Cheelr Balance
Energy Cala.
Placa lucked up
Construction
Flood ptaiwplan
Plans resubmitted
Meehanied
Grading,pliin
Y` Review, ready for correed6naftsue
Electrical
Sabcon1actor Ust
Called Contact Person '
Plumbing
Grant Deed
Pians'picked up
S.M.L '
H.O.A. Approval
Plans resubmitted
Gmding
IN HOUSE:-
''' Review, ready for.eorreetions/issne
Developer impact Fee.
Planping Approval
called,centactPersoa
Pub. Wks. Appr
Date of permit issue
Sebool Fee
Total Permit Fee
CITY OF LA QUINTA
BUILDING & SAFETY DEFT.
APPROVED
FOR CONSTRUCTION
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