9605-004 (PAT)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury'that I am licensed under provisions4bf ✓.
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
Lic nse Law for the following reason:
(7 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 reason
Date '��� 146, Signature of Owner Xe�` i.rin f ��r' •�
WORKER'S COMPENSATION DECLARATION
I h4reby affirm under penalty of perjury' one of the following declarations:
() I have and will maintain a certificateOf 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).
(ceitify 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
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, I1s0all,fgqfthwith comply withrtfiose. provisions.
Date: •i �h �°ir Applicant�',r
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000J9
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. t /
Signature (Owner/Agent) A' '- +' 4- Date
PERMIT # ft:ON,TROL �
BUILDING PERMIT
9605-004 3243
DATE Zi,)(i VALUATIONi3i4jj;;(f� LOT: TRACT
JOB SITE'� WINT +..R COVE, �:OU.!'�
ADDRESS a -
APN K. .
OWNER
CONTRACTOR/DESIGNER/ENGINEER
%/1'1' -TY ADLER
'ifi-ZOO Wii�Fi;'.�iL�X7dJ•r•Ci'3Uit1`
LA. g-AN'1'A CA 922 -SLI
77[_264_1
USE OF PERMIT
PATIO
FSI:111!IaATEM 4;4AVf Or, CONSTRUCTION
3,45880
i'.�.;3d iA�.! :4' !� l+:i+: Si:►l44I1� A:1fl?
iLE1N;tt 1[% fAtiF It}t-000-439-3tg U0.95
C'ONS"TR.N C -119:0N FEE 101400.41&000 363.00
STONt Nf011Ori PFE-RESM 101.000 -244 -OW
• . 51;8-'1•CYt11L �"ONS"Z'1:�C;fC'T'It31tI.t•11:f�il� �'LA� �;I�1:�'f�"
�Nt?9.�13
IMS PIRE-PAID FES
$0.00
t
'.E6,7'iT�41(. x'81'RMIT I1I+:li:S $ UE NE_ W
8104.43"
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR �'
.r
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
-. OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms 6 Footings51
Ducts
Slab Gra
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K.to Wrap '
F.A.U.
Framing S 3
Compressor
InsulationVents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS-
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location -
Underground Electric
Underground Plbg. Test
Final I I
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:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground 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)
0
�I J•I! �L
APR 2- 1996
PFANNNG DPARTIAENT+
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'�C y 78-495 CALLE TAMPICO — LA OUINTA, CALIFORNIA 92253 - '(619) 777-7000
ofi77-7101
N7A
April 25, 1996 APR RECV
BUILDING A1i10
Ms. Kathy Adler ;
(.7&280- Winter Cove Court
La Quinta, CA 92253
SUBJECT: NOTIFICATION OF,CAPITAL IMPROVEMENT
Dear Ms Adler:
The Redevelopment Agency is in receipt of your letter notifying the. Agenc} - of your proposed
improvements. Your patio cover expansion will add to your home enjoyment as well as increase your � -
home value.
As stated in our phone conversation, you will personally need to contact or phone, the Building and
Safety Department, here at City Hall, to obtain the construction permits and requirements regarding
the construction of your patio.cover extension. Please be advised that a building permit is required.
prior to any construction.
The Agency does not need to have copies of any invoices or bills. The building F ermit issued by the
Fr Building and Safety Department will provide the Agency with the information regarding the.upgrades
made to the house for our files.
Sincerely,
JERRY HERMAN
Community Development Director
t
M:bjs
c:. City Manager
Building -&,Safety D`epartme t
s�
MAILING ADDRESS P.O. BOX 1504 LA OUINTA, CALIFORNIA 92253 ��(�
RAFTER SIZE AND SPACINGkI PECIFY ROOFING AND SHEATHING OR OPEN LATTICE
# 2 x 32 0 y (SF ROOFING NOTE AT v 11
-
ROOF PqqH•
• • •
11 AF H
CONTINUOUS LEDGER
yiot; ntiay
/HEADER SIZE
/ /��
t jC( rj ro T AND 'L' STRAPS
u I ()lrx16d z1 L ORH I tWi
�j0 (4) 16d NMLS OR BOLT
(bllTF}fN I
BOI�FD TD 66
7
Or L ID rON
RAFTER SPAN: PbSi
POST SPACING•
O.M.
O.H.
`Q y
OVERALL LENGTH: t�
OVERALL LENGIN•
MIN. 4 aIC POSTS io
:. REAR SETBACK
SIDE SETBACK
61
'
r
FINISH GRADE
2000 P.S.I CONCRETE —�1 1
FINISH GRADE 1 MIN. 12*x1T FOOTING L_J
1 T BELOW GRADE
�t p
�oPCC l^A"FTVC2-
�I
� �1! CI1�,
PROVIDE 1' CLEARANCE
BETWEEN POST AND
,E►�1 lE��ST►IJ
. / Gc4k
LI��J W ITN 60 fl�f k h"V /GNU Cr4'r
EAL� TQC)
CONCRETE
w I`CR Mt"h'►JI6kL- q-TT'A-C�6►' G7-" •
—STRAP OR ANGLE
NON -CORROSIVE PLATE —
5 INi A C,
CONTINUOUS LEDGER
: v
(4 - 16d NAILS U5c, SImOold
OR BOLT
IA ................. �.
U—STRAP OR ANGLE
`•� •�`
(4)— 16d NAILS
OR BOLT
JOIST HANGER OR SOLID BLOCKING
I
NAIL RAFTER TO BLOCKING
F� a.. 1 p '�' f`�
A
ANCHOR BOLT (EMBED PROVIDE 1' CLEARANCE
T MN. INTO CONCRETE) BETWEEN POST AND
CONCRETE
t 1J A •U 1! �� s
DC`NO" DEPARTMENT USE "ONLY'�'�'
TYPICAL PATIO COVER
RMTT NUMBER !~s�.,jtWILL_T
DATE
OF APPLICATION
'- A
MR ISSUE DATFR JC F:(r7 rr) lN! i AJ I ATIONI AQ Qt_n
[F
OWNEPfS NAME
14AL INSPECTION DATE
STREE ADDRESS
ECTAL CONDITIONS AND ALL APPLCABL
ZIP
TMEP ONE
DATE_ .. BY;&
APPROVAL SIGNATURE. DATE