06-1645 (PAT)P.O. BOX 1504 4
• ��
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00001645 Owner:
Property Address: — 79290 DESERT WIND CT LAWSON W DON
APN: 604-332-014-19 -23935 - 79290 DESERT WIND CT
,Application description: PATIO COVER - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL D 0
Application valuation: 3990
APR 2 6 2006 Contractor:
Applicant: Architect or Engine r: PELLETIER PATIO
79275 DESERT STREAM DR
CITY OF LA QUINTA LA QUINTA, CA 92253
FINANCE DEPT. (760)275-7593
Lic. No.: 860958
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjur am sed under provisions of -Chapter 9 (commencing with
Section 7000) of Division 3 of the B. iness and Profe sionals e75d my License is in full force and effect.
License lass: B Li ense N : 860958
Date:( Contractor:
\I. -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 city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the 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 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).:
(_) 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 or 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.).
(_ 1 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.I.
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/25/06
z_�
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 and policy number are:
Carrier EXEMPT Policy Number EXEMPT
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 ompensation laws of California,
and agree that, if I sho eco ject to the ",or
rs' comp nsation provisions of Section
37t00 of the Labor de, I shall forth ith comply wi those pr visions.
Date: 2 0Applicant:
WARNING: FAILURE TO SECURE RKERS' C PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN IES 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 read this application aMbuii
e formation is correct. I gree o comply with all
city and county ordinances and state lawsn truction, and hereby a hon representatives
of this co��fnty ttiio enter upon the above-mepe .tan purposes.
Date 1ZYignature (Applicant
Application Number . . . . . 06-00001645
Permit . .
. PATIO COVER
PERMIT
Additional desc .
Permit Fee
63.00
Plan Check
Fee
40.95
Issue Date
Valuation
. . .
. 3990
Expiration Date
10/22/06
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
300 SF ALUMAWOOD
LATTICE PATIO COVER
_ ------•----------------------------------------------------------------------
Other Fees . .
. . . . . . STRONG MOTION (SMI)
- RES
.50
Fee summary
-----------------
Charged
----------
Paid Credited
Due
Permit Fee Total
----------
63.00
----------
.00
----------
.00
63.00
Plan Check Total
40.95
.00
.00
40.95
Other Fee Total
.50
.00
.00
.50
Grand Total
104.45
.00
.00
104.45
r
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LQPERMIT
Bin #
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 #
b
Project Address:' ', aCIOg5oe,�(-Uji,nA C4
Owner's Name:
A. P. Number:
Address: "7 9 a q O DRA, a, -t W j1,,ef C - t. .
Legal Description:
City, ST, Zip: L-,,, 0 vvrc. c4.- at? -z,;3
Contractor: fU (,Qj{-� QR s 0
Telephone:
Address:- -� Ci 27 S 0ee>zvT S+v-eo,,,-. CV
Project Description: , �, D O �� °IaMlcx-
City, ST, Zip: L -e- C4 x122 S
O v (z0zV,- -3rx) 42
Telephone: 0-6 . TSQ3
State Lic. # : CJ(OQ°I5"U City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Name of Contact Person: ;:�tW CV,4�, (
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Projec . L( q
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 PersonPlan
Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading.plan
2" 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:-
3nd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Wilm
i
Debe,v+ +
Don Law -Soo
j 79 avo 0eSev� 0A,ncC C.t
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVE®
FOR CONSTRUCTION
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