14-0700 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUdNTA, CALIFORNIA 92253
'.4
Application Number: 14-00000700
Property Address: 78305 DESERT FALL WY
APN:" 770-031-036-37 -28019 -
Application description: PATIO COVER - RESIDENTIAL
Property Zoning: MEDIUM DENSITY RES
Application valuation: 1729
Applicant•
T4:tit 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012[
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/28/14
D d�
f
MAY 2-7' 21114 I
CITY AF LA QIJWTA
FINANCE DEPT.
------------------------- -----------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
Owner:
I hereby affirm under penalty of perjury that I am lic nsed under provisions of Chapter 9 (commencing with
PARTRIDGE RAY
Section 7000) of Division 3 of the Busines and Pr essionaIs 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
iCense Class: D03 A license No.: 835140
78305 DESERT FALL WAY
�
LA QUINTA, CA 92253
j
(
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury at I am exempt from the Contractor's State License Law for the
Contractor:
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
ATLAS AWNING & SCREEN,
/ ✓
754 S. WILLIAMS ROAD
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
PALM SPRINGS, CA 92264
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
(760)327-8466
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
Lic. No.: 835140
VOICE (760) 777-7012[
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/28/14
D d�
f
MAY 2-7' 21114 I
CITY AF LA QIJWTA
FINANCE DEPT.
------------------------- -----------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am lic nsed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Busines and Pr essionaIs 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
iCense Class: D03 A license No.: 835140
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
te� Contractor: �:
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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury at I am exempt from the Contractor's State License Law for the
Carrier EVEREST NATL Policy Number 7600004167121
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the perfor ance of a 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 a to b come 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 sh Id eco a 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
3700 of the Labor C e sh forthwith comply with those rovisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
ate: Applicant:
(_ 1 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
WARNING: FAILURE TO SECUR ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
'
improve for the purpose of sale.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
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 read this application and statethat he ab
a information is correct. l agree to comply with all
is correct. I agree to comply with -all
city and county ordinances and state laws relating to buildin�onstruction, and hereby authorize representatives
of this county to enter upon the above-mentioned property inspection purposes.
Date: 2.�1/li Signature (Applicant or Agent):
Application Number . . . . . 14-00000700
Permit . . . PATIO COVER 2013
Additional desc .
Permit Fee . . . . 95.81 Plan Check Fee
00
Issue Date . . . . Valuation . . .
. 1729
Expiration Date . . 11/24/14
Qty Unit Charge Per
Extension
1.00 95.8100 EA MISC PATIO COVER, STD
95.81
----------------------------------------------------------------------------
Special Notes and Comments
PATIO COVER PER APPROVED PLAN 616" X 20'
TOTAL OF 130 SQ.FT. 2012 IBC & 2013CBC.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, PATIO COVER
94.38
Fee summary Charged Paid Credited
----------
Due
-----------------------------------------------
Permit Fee Total 95.81. .00 ..00
95.81
Plan Check Total .00 .00 .00
.00
Other Fee Total 95.38 .00 .00
95.38
Grand Total 191.19 .00 .00
191.19
i
LQPERMIT
Bin #!
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 - (619) 777-7012
Building Permit Application and Tracking Sheet
Pennit #La
Project Address: f: -`
Owner's Name: 77n4—P 1 d
A. P. Number: ?067310A=, --J
Address: 2 C I
Legal Description:t—ot- 3Z f/LZ 2.S D z$0i
City, ST, Zip: IS
Contractor: A ��
Address: - 7 , �� fV►
Telephone:
Project Description:
City, ST, Zip:1 n ~ ZZq
41
Tele ho e•'
P n. 7 (P6 Z
_G
- Ys
State Lic. #
City Lic. #:
.
`
Arch., Ergr., Designer: CA12-
L
Address: Address:
City, ST, Zip:
e—�v
Tele Ph ne:
A.Construction
��
Type eecu Pane
Y• V O
9
State Lic. #: d
C tel,
c' w
'ec a trete e
Pro t one : N Add'n /Alter it e
c Rea Demo
ty �
� P P
Name of Contact Person: &'
Sq. Ft.: NO
# Stories: A-
# Units: � f
Telephone # of Contact Person:
Estimated Value of Project:, � O
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
'
Grant Deed
Plans resubmitted
Mechanical
School Fees
2"" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Planning Approval
Plans picked up
S.M.T.
Pub. Wks. Appr
Plans resubmitted
Grading
H.O.A. Approval
'" Review, ready for corrections/issue
Developer Impact Fee
Called Contact Person
A.I.P.P.
Date of permit issue
4
Total Permit Fees