12-0377 (PAT)f
P.O. BOX 1504 VOICE (760) 777-7012
78=495 CALLE TAMPICO = f FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-.7153
BUILDING PERMIT _
r D Date: 7/03/12
Application Number: 12-0000-0377 r Owner: d
Property Address: 53387 VIA PALACIO MONTALBANO; PAUL ANTHONY
APN: 772-560-041-, - - 161 TOBIN CLARK DR JULF,
Application description: PATIO COVER. - RESIDENTIAL. BURLINGAME, CA 940.10 J(/ V3 ?O��
Property Zoning: LOW DENSITY -RESIDENTIAL' "
C/�Q� '
Application valuation: 4218/�4yC-�vror
{ •
• Contractors
Applicant:, Architect or Engineer: 7C"S CONSTRUCTION & MAINT
48236 VISTA DE NOPAL
LA QUINTA, CA 92253 .
(760)564-5811
• Lica No.: 594043
• --------------------------------------------------------------------------------------------------
' C SED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION
4.:'
_ - ' I hereby affirm under penalty of perjury hat I a licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: '
Section 7060) of Division 3 of the Bus ess a Prof sionals 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 '
ticen a Class: B License No.: 594043. - - _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
A' issued'.
' ate: h 3 IV ontractor. .. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfofnccefh - which this permit is issued. My workers' compensationpWNER-BUILDER DECLARATION• - insurance carrier anber are: r
1 hereby affirm under penalty of perju that I exempt from the Contractor's State License Law for the Carrier STATE FUNDPolicy Num er 0028211-2011
following reason (Sec. 7031.5,Business and Professions Code: Any city or county that requires a permit to I certify that, in the pef the work f r which this permit is issued, I shall not employ anyconstruct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any mannbece
'ct 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 andagree that, if I me o 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 ll foo y with those provisions.
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 (5500):- Date: —� Applicant: .
( ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and 1 -
the structure is not intended or offered for sale (Sec. 7044,.Business and Professions Code: The _ WARNING: FAILURE TO SECURE W RKERS' CO(ESATION 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 CRIMIN L PEN, 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 (5100,000). IN ADDITION O•THE CO COMPENSATION,. DAMAGES AS PROVIDED FOR IN _
1 ' improvements are not intended orofferedfor 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 • t,. " -
improve for the purpose of sale.). ' APPLICANT ACKNOWLEDGEMENT
- (_) 1, 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. - - 4 -
y -property who builds or improves thereon, and who contracts for the projects with a contractors) 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. , BAP.C. for this reason 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` oifollowing issuance of this perm'
Date: Owner: - 2. Any, permit issued as a. result of this application ecome null and void if work is not commenced
- within 180 days from date ofissuance of s permits cessation of work for 180 days will subject
_ •' CONSTRUCTION LENDING AGENCY permit to cancellation.
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the- I certify that I have read this application and state that a above in orma ' n;s correct. I agree to comply with all
• - work for which this permit is issued (Seca 3097,-Civ.'C.). • city and county' ordinances and state laws relating to ilding con ructi , nd hereby authorize representatives
- - - oft 's county to enter upon the above-mentioned pro erty for specti purposes.
Lender's Name:
Lender's Address:' ate: nature (Applicant or Agent)� :
1 � � - -'
.. • ;
LQPER.MIT r •. . _
Application Number 12-00000377"...
Permit ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . 27.00 Plan Check Fee
6.75
Issue Date Valuation . . .
. 0
Expiration Date 12/15/12
Qty Unit Charge Per.
Extension .
BASE FEE
15.00
16.00 .7500 PER - ELEC DEVICE/FIXTURE 1ST'20
12.00
Permit PATIO COVER PERMIT ,
Additional desc..
Permit.Fee. .72.00 Plan•Check Fee
46.80
Issue.Date Valuation .
. ..4218
Expiration Date 12/15/12
Qty Unit Charge Per
Extension
BASE FEE
45.00
3.00 9".0000 THOU: BLDG 2,0011-25,000
27*.00
Special Notes and Comments
270SF PATIO EXTENSION'WITH 3,2SF STORAGE
ROOM (ENGINEERED] THIS PERMIT DOES NOT.
INCLUDE ADDITIONAL CONDITIONED SQUARE
FOOTAGE. 2010 CALIFORNIA BUILDING CODES.
June 18, 2012 4:11:58 PM AORTEGA
--------------------------------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
-----------;---
1:00.
STRONG MOTION (SMI) - RES
.50
Fee . summary Charged Paid ..,Credited ' .
Due
Permit Fee Total 99.:00 .00 00
99..00
.-Plan Check Total 53.55 •.00 .00
.53.55
Other Fee Total 1:50 .00 .00
1.50
Grand'Total 154.05 .00 .00'
154.05
LQPERMIT ., ....
.. - -
f. ..IT. _Mo.,7 1 7..- "i _
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k . , • . i'" OWNER YASSOCkA1'ION
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Mr =andhMrs?Paul Montalbano
16T'Tobi6 Cla k.Drive
Htllsb`orough,CA 940.1-.0
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MoutaItianolLof 217 ==5338TVia}Palacio
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Final�Drawwgs for evised`'Rear Ele_
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.. � � .� .,,, Tse � r•.r. r - r .-. ' � � ' �(. . ,
Dear Mr sand IMrs'y'Monta'lbano'
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'TheIideaway Design ReviewxCom�ruttee (DRC),areviewed andappioved-the raost.,;fina1:+'
'
wings felatedto - aural bons _
your archtec mo ifica '
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IPlease�contactBrook�Marshallrat (76U)p219=8057 oi,by emailYat.Brook'(ui'dc rr com with any, t_
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questions orzto s t np <aPTre�Constnction;Meepigkat yourr'lopnor tothe�startrof youiF `
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remodel.
Sincerely, , i
Hideaway DestgnRevigw'Committee.'
&. -An"i'Weber
DRCFile.'
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Buikffng 8T Safety Division . .
P.O. Boy. 1504,'78-495 Gaffe Tampfco
Ia.Qufnta, CA 92253 - (760) 2'77-7012
Building Pennit'A licatlon•and Tracidng Sheet
Permit #
Project Address: 2j �� U • ��1a�
ame:.
A P. Number. 2 �- -- l
7Addr=:
�f( _
o'
Legal Description:
ip: ((��
Contractor. ;
Telephone:
Address:Projeepct
DDeseription: QC (9t
City, ST, Zip:
Telephone:
l /
State Lic #: City Lic #:
Arch., Eng., Designer 7 � N� Z
Address: 22
City, ST, Zip: h(l
Telephone: Construction Type:. v P-6 Occupancy: rC_ V•- l
State Lic. #: Y ` Project type (circle one): New Add'a Alter Repair : Demo
Name of Contact Person: y�pLiQj�''v CiP� Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: ® 3 2 Estima Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
!E
Submittal
Plan Sets
Req'd
Rec'd
TRACIMG PERMIT FEES
Plan Cheek submitted f Amoaut
Structural Calm
Revlewed, ready for cort•ections Plan Check Deposit. .
aTtvss
talcs.
513 1
. Called Contact Person Plan Check Balance
Tide 24 Calci6
Pians picked up �! Construction
Flood plain plan
Plaits resubmitted.. , I3 I echatiicsl
Grading plan
2'!Revitw, ready for correct! Electrical
Subeontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
'" Review; ready for correetlonsAssue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
is
sE� c LJ -u