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0105-120 (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. I 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: ( ) 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). (}/lam exempt under Section B&P.C. for i, reaso�t D e:. r.� Signature of Owri _ �7 F 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). ( A 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 provision. f Se�ctioh,6700 of the Labor Code; I shall forthwith compjy„yvitlj those pr ovisi n --- Date _ Applican [ 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, indemnity & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result -of'this appli,tion becomes null and void'if work is not -commenced within room 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 inspect: on u poses. eSignature (Owner/Ag A,J, Date � » '•'� BUILDING PERMIT PERMIT# DATE VALUATION LOT (){t TRACT JOB SITE APN ADDRESS OWNER CONTRACTOR / DESIGNER / EN (NEER 4145^895 WMI�l�U EON Mr. LA QUDTTA CA, 9225.s USE OF PERMIT RATIO C;f3N. TRt;3C T 2 I,Ai:t'TIC; F,,P f IU CiriVMS3 i Y X 1 ' &. $' X 110-, TOTAL,261 vQ F T. F2.FAt APPROVED MAX A TACIT ED PORCF1lk'.all 361.01) SF irOYT OF C.`6J'xRMUir.L O w'f��8nr.^id �1fiY9rk.6Ei".W.RRND A."�i1.18 .PJb3id3i 1�• V1h'�,t'U.IGIS�.& `(- . PLAN G'HWIK FEE 101-000.41.39.318 MOM C'C?.%fS'PRLIGTiOV FE -8 1Q'1�Ca f); ,I11-rIt?tJ X63,40 0.T,11.ONO MOTIM III, -PLESID 103.0010-241-000 `4• 6 ' -� M' 1-`r0TALf'016(.�1°St ! !'Y.e Yf:''1 ,�{ $104:45 LESS :tom -TAU) FM $(),Do Ir P M MIN DVE now S104,45 M AY - 8 2001 R CEIPTU FIN f B NCE DEPT.'r�j (, DATE FINALED INSPECTOR INSPECTION RECORD , OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS Set Backs S / l - Forms & Footings MECHANICAL APPROVALS Underground Ducts 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 Condensate Lines Party Wall Firewall _-} - Exterior Lath Drywall - Int. Lath Final z!_a� BLOCKWALL AP ROVALS Final POOLS - SPAS Steel . Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. 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 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 Not (Perm) COMMENTS: y •- w; ` ' ,�• ��� , ; ..w s �` 1*t r THE SITE :fOR A,.%M, OLEV, w 0 OfCEPT10 . . rlr ,l � ,. ..- �s"� 4 e4 r.*R ', 't .i. r 6• � T - ',�,ia^ i � �+ .. • 1 . .. . — `� �^^ � • •r.� � "_ t `�„sfy..� � a tit. c�, Lµ"' .'.. . .. •.. 17 k S: ' . � '.(Fr as t. • R � ♦ -�'�• -, • -. -, Y - 6�'A ✓. • a � � a �} • a * h ! - a , ql, a _•fit l �'.- ..+' �,,� r� .:�. .. 'f.• 1 FOR C STRUCTION i V, EEE flf 130` I ,I.NSPECTION, k. VLtiOttHARGE0It►1kEAPPRWD a PIANS' ANQ 106 CARD ARE NOT'hi t w; ` ' ,�• ��� , ; ..w s �` 1*t r THE SITE :fOR A,.%M, OLEV, w 0 OfCEPT10 . . rlr ,l � ,. ..- �s"� 4 e4 r.*R ', 't .i. r 6• � T - ',�,ia^ i � �+ .. • 1 . .. . — `� �^^ � • •r.� � "_ t `�„sfy..� � a tit. c�, Lµ"' .'.. . .. 1 4 17 CITY OF LA-QUINTA • "; ' r`I ^ r� ' Wi T BUILDING & SAFETY DEPT., 1 FOR C STRUCTION i V, r s -ti I a tel" P w +� .. _ 'r yl f� , .'.�( 'i..c a Y }• - txw `}y '�' T �'� .• � - 1 �. •1f J' L. GCS � � -•R�y. ?s '� y Z ' , 1 4 CITY OF LA-QUINTA • "; ' r`I ^ r� ' Wi T BUILDING & SAFETY DEPT., 1 FOR C STRUCTION i a tel" P w +� .. _ 'r yl f� , .'.�( 'i..c a Y }• - 5 4 • `}y '�' T �'� .• RAFTER SIZE AND SPACING SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE (SEE ROOFING TE ON REVERSE) " ROOF PITCH Ll If 11 10 11 CONTINUOUS LEDGER (SAME SIZE AS RAFTERS) ' HEADER SIZE 'T' AND 'L' STRAPS I 6 x6`x1"xl/8" WITH I W (4),16d NAILS OR BOLT RAFTER SPAN _ ' POST SPACING:_ _ O.H. C.. OVERALL LENGTH:. + a . OVERALL LENGTH:______ POST SIZE: 4 x -- io REAR'SETBACK SIDE SETBACK (4"x4' MIN.) FINISH GRADE FINISH GRADE MIN. 12' x 12" FOOTING 2000 P.S.I CONCRETE I . I Imo— z ZI I I L J I L i 12" BELOW GRADE L__J PROVIDE 1" CLEARANCE 'POST BETWEEN AND NOTE.. - - • CONCRETE y _ OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA VIA ONE 1/4" x S'`LAG SCREW,THROUGH FASCIA INTO EACH RAFTER TAIL. L11—STRAP. OR ANGLE' x 5" LAG SCREWS INTO STUDS;AT. 16' O.C. NON—CORROSIVE PLATE RPpE x �,3/8" F G N CONTINUOUS LEDGER'' 16d NAILS OR BOLT ' U-STRAP OR ANGLE`` (4).— 16d ,NAILS' OR. BOLT JOIST,HANGER4 OR SOLID BLOCKING NAIL RAFTER"TO BLOCKING I PROVIDE 1" .CLEARANCE 7. BETWEEN POST AND ' i r • � ` � ,r CONCRETE - • I I I � II .� ..III BUILDING' DEPARTMENT. APPRO.VAL 'BELOW ` II IIS III II �, , 5y ANCHOR BOLT (EMBED , -7" MIN.' INTO CONCRETE) CITY• OF to QUINTA :.:,TYPICAL- PATIO COVERT BUILDING &9�SAFETY DEPT. " DATE OF. APPLICATION OVD . Id e OWNER'S NAME * ` STREET ADDRESS' -. FOR CONSTRUCTI ` CITY. ST; •. ZIP ! TE 0/ BY L TELEPHONE .' H.O.A. 'APPROVAL ' ' in 1 RAFTER SIZE AND SPACING ROOF PITCH CONTINUOUS LEDGER SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE (SEE ROOFING ON RkVERSE) aX • •rr (SAME SIZE AS RAFTERS) u u u - u u u HEADER SIZE T' AND 'LSTRAPS $'x6'xl"x1/8" WITH W (4) 16d NAILS OR BOLT / RAFTER SPAN: ------ 1_LlPOST SPACING:__L.L—_ O.H. w O.H. 0 `♦ /� OVERALL LENGTH: a "OVERALL LENGTH:__-' S / ------ _L-__ POST / REAR SETBACK I SIDE SETBACK (4'x4' MIN.) 2000 P.S.I CONCRETE FINISH GRADE FINISH GRADE MIN. 12" x 12" FOOTING I I L_J L -J 12" BELOW_ GRADE, L PROVIDE 1;' CLEARANCE BETWEEN POST AND NOTE: CONCRETE OPEN LATTICE PATIO COVERS 'MAY BE ATTACHED TO EXISTING FASCIA VIA ONE 1/4" x 5" LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL. U—STRAP OR ANGLE f 3/8" x 5" LAG SCREWS INTO .STUDS AT 16" D.C. NON—CORROSIVE PLATE G CONTINUOUS LEDGER 04 � 0� (4)— : 16d NAILS.—/ OR BOLT U—STRAP OR ANGLE (4)- 16d NAILS OR BOLT JOIST HANGER OR SOLID BLOCKING , NAIL RAFTER TO BLOCKING PROVIDE 1" CLEARANCE BETWEEN POST AND CONCRETE ' BUILDING DEPARTMENT APPROVAL BELOW II �I II III ANCHOR BOLT (EMBED 7" . MIN. INTO CONCRETE) CITY OF LA OUINTA TYPICAL PATIO COVER BUILDING &SAFETY DEPT. DATE OF APPLICATION .APPROVED I OWNER'S NAME FOR CONSTRUC_ R STREET ADDRESS • / CITY, ST 'ZIP DATE 401. r?v__ -- TELEPHONE H.O.A. APPROVAL _. >.. 'ti. r-Yw ry �✓ �IyL .r-^ i-1= �r�k - tr- .fir.. ' .. v. i F:f J ../ .�I..✓ u,I\ t� /1_�,� � .�.�. l�\+v S'F � • - ...t. r .. wJ. � . .. , - .. � r OWNER/BUILDER INFORMATION x Dear Property Owner: m • 06 tr �. ,An application for a"building permit hae been submitted in your name.listing yourself as the builder of the property r ' improvements spec,Gf e&- Fgr.you protection foutshould be aware that as "Owner/ 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 quired`by law to be licensed and bonded by the State of California and to have a business license from the City «E'Count� .. They are alsoc�iii d •by law to put their license number,.on`all' perrriif?for'which they' apply -4 9 If you plan to d"our,own work, with 42yception o akouus trades that you plan to subcontrac , you should be aware of the following information for your benefit and pr tection,,, persons immediate family, ' If you employ or otherwise, engage y other than your and the work (inc uding mater?a Vs >C and other costs) is $200.00 or more for the entiie project, and such persons ,armee not,, licensed as contractors ore subcontractors, then you maybe an employer. i If you are an employer, you must register with the State and Federal Governmentdas 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. Thei; `maybe financial risks for you if you do not carry out these obligations, and1these risks are especially serious with. respect to.Worker s compensation insurance : For more specific information about your obligations undejccleral Law, contact the Internal Revenue Service (and', if you wish ,'the U. S. Small Business Adminstration). For more specific information about your obligations under State ,^. Law,. contact the Department of Benefit Payments and the Division of Industrial Accidents. .... ; F LA. Ifhe structureis inte _ded for sale, property�,o ners-who=are not licensed contractors are allowed to perform their limitedr work personally or through their own employees, without'! licensed contractoFer subcontractor, only under \conditions. \ a., ' "Owner/ • xnl"f A, f eque it, practice of�nlicense&persons profe sing1towt'�e•�c�o�ntractors is to secure an Builder", building perm its erroneously im" plying that the property ownerNi'roviding his or her own labor and material personally. ,Building permits are not required to be signed by p operty owners unless they are performing their .own work personally, Information about licensed contractors may be obtained b` contacting the Contractors' State License Board in out Y Y g Y communitypr'at 1020 N. Street, Sacramento' California 95814. 'Please complete and yreturn 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. A t Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico° La Quinta, CA 92253 } (760) 777-7012 . . FAX: (760) 7,,7,,7--n7011 a.Y�Qy (s2.L� S�- � • O f .. - OWNER'S SIGNATURE/DATE