0205-078 (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
Professionals 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:
.V ) 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 reason1 r^
Date Signature of Owner ,4 /l - j"
WORKER'S COMPENSATION DECLARATION
e
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.
(This section need not be completed if the permit valuation is for $100.00 or less).
sh4 ) I certify that in the performance of the work for which this permit is issued,
I all 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:
DatesgFaiule o Applicant
Warnsecure WofkAr� �at�ion Xeovveage/9s
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
& 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 this City to enter upon
the above-mentioned property for inspection purposes.
Signature
Date
BU DING PERMIT Y; P.=RMI#
,
DATE/ 1 VALUATION 458M LOT TRACT
JOB SITE *a t7+ y�.
ADDRESS Rid flit s�lCL ��7iEi �,'
APN
OWNER
CONTRACTOR / DESIGNER / EN INEER
LA QVINTA. CA 92253
USE OF PERMIT
PATIO)
GOM11114ATION PATIC1 CCi`.►'ER & IDf.K: (:APPR.O:; 260 S .t%, 101:. 6'6')
DECK 260.00 SP
M' PdMD QD
:9,4"...•c3' AY0
Pim?a C14ECK FTE 301-000-439-318 $40.05
CONSTRUCTION FEE 101-000-1418.000 $6.00
FUCTRICAL FEE 101.000.42"N) 120.25
RITRO140 mar1ON r�r'E, R.1 ID 101 -600=241 --ow $.50
rN'V HXrMAT1C' 14 FRIJ 103-000-423-000 36100
Jut,
i
RECEIPT
DATE jt f �r
•BY
LDAJZ FINYD SPECTOR
#°g�MN01f1SI9:1Nbops
p U 'per
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 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath Z n�
Final
POOLS - SPAS
Final _
BLOCKWALL AP ROVAL;
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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
COMMENTS:
i
Final
' Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
iJnderground 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)
T4tyl 4 4QuGifw
Field Inspection Summary Report
Date: 4/19/02
Project Address: 45-300 Desert Eagle Ct
Project Description: Un -permitted Patio Cover & Deck
Status: Special Field Inspection
A special field inspection was conducted at the above mentioned residence for an un -permitted
patio cover & deck under construction. My field and, office investigation has confirmed that the
framed patio cover under construction has been constructed without approved plans, permit and
required building inspections, in violation of LQMC 8.01.060 Permit required. The following
information is provided to identify existing conditions and additionally, assist in identifying the
specific requirements to properly permit and approve the existing un -permitted patio cover &
deck:
1. A Patio/Deck permit is required. (CBC 106.1) Please inform the owner to submit a building
application and Plans with specifications to the Building Department for review and approval.
2. Information on Plans and specifications shall be required to approve the Patio/Deck
construction. Plans and specifications shall be drawn to scale upon substantial paper and be of
sufficient clarity to indicate the location nature and extent of the work proposed and show in
detail that it will conform to the provisions of the 1998 California Building Code. (CBC
106.3.3) The structure as observed does not meet the prescriptive provisions of CBC 2320 for
light frame construction, therefore, a design in accordance with CBC 1605.2 will required to be
prepared and provided by a licensed professional..
3. Additional un -permitted construction observed included electrical receptacles and lights.
Include specifications on plans for proposed locations, weather protection (WP) and GFI
protection. (CEC 210-8(a)(2))
4. All construction or work for which a permit is required shall be subject to inspection by the
building official and all such construction or work shall remain accessible and exposed for
inspection purposes until approved by the building official. (CBC 108.1) No further work shall
be permitted without approved plans, permit and required inspections.
In summary, the un -permitted patio cover & deck under construction may be approvable with
proper application for a permit, plan/zoning review approval and observation of required building
code inspections. If there are any questions or the need for any assistance please call 777-7027,
thank you.
dpc
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 obligations 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 Stair
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
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Wnta, CA 92253
(760)777-7012
FAA �(760),'�77-7011
OWNER'S SIGNATURE/DATE
PROPERTY ADDRESS
PERMIT NUMBER(s)