9808-016 (BLCK)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
vbate %/Y?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:
( ) 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 Signature of Owner
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 & policy no. are:
Carrier Policy No.
(,This section need not be completed if the permit valuation is for $100.00 or less).
j 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
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 sh, 111 fortth,,with comply with those provisions.
FDate: Applicant e!2 -..• .. C ( .�G-..t r - i .�.
Warning: Failure to secure Workers' Compensation coverage is 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 (Owner/Agent) ✓ 'i -Date '�/' j
PERMIT # CONTROL #
BUILDING PERMIT
IM118-016
DATE RJ a/" VALUATION x10.714.75 LOT TRACT 7363
JOB SITE
ADDRESS 79-7.5S W0NTWARD 110 0 REVI�
APN - -
OWNER
CONTRACTOR/DESIGNER/ENGINEER
PAUL & CIARIS CANME11
t?LNINFR ! BUILDER
79-755 WESI"'WARD HO DRIVE:
LA QUIN'.C'A CA 142243
USE OF PERMIT
GEN 'KAL 1 Uii.1.1iN��
115 L.F. GARDEN WALL .S EEIGIL 63 L.F. WALL 0 HIGH. ORCu
Sita :h,7. Fr. LAr ICF, FIK EO COVER.
6b ;7. WALL 63.00 IS
S hT. WAE,L 115.00 LF
w)kt,l•I/E'A' o StNt.ts<1 S!
ONTU;4'IATEM IC,` XST OF CON4 t EttiC'k ON
10,714.75
1}1:1(14111 FrW :5iUMIliA RV
N,%`TR J+~rlt=►NFEH 101.000-diTi-(i(i{l J�trh.[H►
it,-TOTAI, CON3'TRI ic"I` ON ANT) PLAN 01-11.7- '.
$1 Vit, M
LUSS PRF41AID ITFS
WOO
p 4 199 .1OTAI,
A11G 1=I~ RI IT FIF- S 011IF NOW
$126.110
OF 0,
J
1� /
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
a
INSPECTION RECORD
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 & Controls
Party Wall Insulation M
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
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
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
I
c
Final
Utility Notice (Perm)
COMMENTS:
j
i� Nps
►4
a
GSjur�eaJ HO
LrD �`s2'�,
b
RAFTER SIZE AND SPACING
SPECIFI' ROOFING AND SHEATHING OR OPEN LATTICE —
(SEE ROOFING NOTE 0 EVERSE)
ROOF PITCH
CONTINUOUS LEDGER
(SAME SIZE AS RAFTERS)
HEADER SIZE
I T' AND `L' STRAPS
6"x6"x1"xl/8' WITH
Li
r
---;q�—
--�
(
z
J
I (4) 16d NAILS OR BOLT, I
z
�
RAFTER
SPAN:
POST SPACING:_____—
w
O.H.
a
0
O.H. (
J
u
z
1I
OVERALL LENGTH: v ___
a
'
OVERALL LENGTH:=_____
POST SIZE:
REAR SETBACK
SIDE SETBACK
(4"x4" MIN.)
/
I
FINISH GRADE
2000 P.S.I CONCRETE —�I I
FINISH GRADE
tj
I L.— MIN. 12"02" FOOTING I I
L_ J
I
L_ J 12" BELOW GRADE L__J
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE �
NOTE:
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4" x S' LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL.
BUIL jN.q:VE "' U
TENTrAFTMA BELO
6 4..
BUILDING & �._A ETY DEPARTMENT
CONDITIONALLY
ACCEPTED 'FOR CONSTRUCTION
SUBJECT TO INSTALLATION AS PER
AND ALL APPLICABLE CODES
BY �11
U—STRAP OR AN
NON—CORROSIVE
(4)- 16d NAILS
OR BOLT
G LE
PLATE GRPpE '
II II II III II ��
U—STRAP OR ANGLE
(4)— 16d NAILS
OR BOLT
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
ANCHOR BOLT (EMBED —
7" MIN. INTO CONCRETE)
TYPICAL PATIO COVER
DATE OF APPLICATION
OWNER'S NAME
STREET ADDRESS
CITY, ST ZIP
TELEPHONE
H.O.A. APPROVAL