11-1266 (PAT)TA 4
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO. FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT _ INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 11/22/11
Application Number:_ _ `_11-00001266----D
0001266_ Owner:
Property Address: 53670 AVENIDA VILLA SMITH JUSTIN'DEAN
APN: 774-134-009-16 -000000- 53670 AVENIDA VILLA
Application description: PATIO COVER,- .COMMERCIAL LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL --------=----------------------=-
Application valuation: 4788
Contractor: t U
Applicant: Architect or Engineer: Owner
tl'1 c 2tt i 1 `�1
----------------------
i,
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals 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
License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
- issued.
Date: Contractor: _ 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier Policy Number '
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject 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 and agree that, if I should become subject to 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 Code, I shall forthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by I c
any a plicant for a permit subjects the applicant to a civil penalty of, not more than five hundred dollars ($500).: to e: 11.22 - pplicant: /CJS l'/ J If 1 7J-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 and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' -COMPENSATION 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 CRIMINAL PENALTIES AND 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for 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
improve for the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT
(_ 1 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 permi; SyMm 19 the
4Le Cvuu a6ruia' Jrere Liuense Law uues not apply to an owner or 666ditioris and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) 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,
I—) I am exempt under Seca 8.&P.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
J performed under or following issuance of this permit.
Date: ' as ' !� Owner- tJ s��..J h'L' r 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
' 1 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 the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). - city and county ordinances and state laws relating to building construction, and hereby authorize representatives -
of this my to enter upo he above-mentioned pr rt for inspection purposes. -
Lender's Name:
ignatura (Applicant or Agent): y 1 S L / (/7
Lender's Address: (/[
LQPERMIT
Application Number , 11-00001266
Permit. PATIO COVER PERMIT
Additional desc .
Permit Fee 72.00 Plan Check
Fee
46.80
Issue Date . . Valuation
4788
Expiration;Date 5/20/12
Qty: Unit Charge Per.
Extension
BASE FEE
45.00.,
3.00 9.0000 THOU BLDG 2,001-25,000
27.00
Special Notes and Comments
-360 S.F. LATTICE -WOOD PATIO COVER, 2010
CODES.
-------------------_-----------------------------------
Other Fees . . . . . .BLDG STDS ADMIN (SB1473)
-------
--------
1:00
Fee summary Charged Paid Credited
Due
Permit Fee Total 72.00 .00
.00
72.00
Plan Check Total 46.80 .00
.00
46..80
Other.Fee Total 1.00 .00
.00
1.00
Grand Total 119.80 .00
.00
119.80
LQPERMIT
Orr,
s
P.O. B'OX 1504•:
LA QU,MTA, CALIFORNIA 92247-1504. BUILDING & SAFETY DEPARTMENT
78-495 CALLS TAMPICO (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760). 777-7011
PROPERTY OWNER' S PACKAGE
Disclosures & Forms for Owner -Builders Applying for Construction Nrmits`
AW-04TANT1 NOTIC� TO 1�R(TPl'i127'�,� OWl�il<;�
Dear Property Owner
An. application for a b
urlding permit has been submitted in Your name listing yourself as the builder of the property
improvements specified at
We are providing you with an Owner -Builder Ae nowledgment and .Information VerifteatWn Form to make you awam of your
respanstlities and Possible risk -you ma incur b ha ' this r
Y Y � permit issued. in your name. as .the -.
Owner -Builder. We '10 not issue a building. -permit until yowhave read, initialed yow: understanding of eaeh'provision,
signed, and returned this form to us at our official address indicated. An agent of tke owner cannot execute this, -notice
unless you, the property owner, obtain the prior approval of the permitting authority.
171R"EMONS• !lead and initial eai* sWernent-bdow-td signify you wrderstand or very bis information.
1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
building permit that erroneously implies that the property owner is providing his or her ov n labor and material penonafi. I, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuri_-s sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
wyunes. I am willfully- acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
``on my y
propert
J'5 2. I understand building permits are not required to be signed by property owner unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
,AL3. I understand as an "Owner -Builder" I am.the responsible party of record on the 1:vrmit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
J 5. I understand if I employ or otherwise engage any persons, other than California L'censed Contractors, and the total value
Of my construction is at least five hundred .dollars ($500), including .labor and materia�_s, I may be considered an ."employer"
`under state and federal law.
6. I understand if I am considered an "employee, under state and federal law, I must register with the state and federal
government, withhold payroll taxes,. provide workers' compensation disability insurance, and contribute to unemployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
risk
G�LL7. I understand under .California Contractors' State License Law, an Owner -Builder who builds single-family residential
structures cannot .legally build them with .the .intent to 'offer them for sale, unie:s all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendE:r year, or all of the work is performer
under contract with a licensed general building Contractor.
8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
financial or personal 44arics sustained by any subsequent owner(s) that result from any latent constructiori defects in the
workmanship or materials.
9. I understand I may obtain more information regarding my obligations as an "employer" from the bAMV I Revenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (MB`) at 1-
800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors.
__��10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party legally and financially responsible for proposed construction activity at the following address:
S3 6 70 � �' � . sl CL st L.t� Q,� � �.'� G►- Y��3
1 L I agree that, as the party legally and furaucially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govem Owner -Builders as well as employers.
12. I agree to notify the issuer of this form immediately of any additions, deletiow, or cbm*= to any of the idmination I
have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you eerKraet with
somoone who docs not have a license, Bre Contractors' State License Board may be unable to assist you with any fiRMOW loss
You may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil coact. It is also
important for you to understand that if an unlicensod Contractor or employee of that individual or firm is injtrsed while worldng
on your property; you may be held liable for damages. If you obtain a permit as Owner-Bwilda and wish to hire ConUactors,
you wdI be respom-W for verifying why or not those Contractors arc properly licemed and the status of *Air wa&crs'
comPeQSation t89urswe coverap.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issa[ag the permit, Nota: A copy of tke pmpe+'h' owo's ei ww'sAketese, Jatm nstaadorr*M or
other verification accVkffc So dee agency is req uu ed to be presentert when &e perwit is inueJ to rel' dw pmpeM
owner's signature. /
Signature of property owner JJ�, r` y Date:
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTRORIZATION OF AGENT TO ACT ON PROPERTY OWNWS REHAB F
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorise
the following pemon(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address: ,,
Name of Authorized Al
Address of Authorized
I declare under penalty
information and certify
acceptable to the agent
Property Owner's Sign
ve and I person$lly filled out the above
1 iotarization, or other verification
he property owner's signature.
RAFTER SIZE AND SPACINGSPECIFY ROOFING *AND SHEATHING 'OR' OPEN. LATTICr —,
1*(SEE. ROOFING NOTE ON4REVERSE)
ROOF PITCH
— CONTINUOUS l EOCER '
(SAME SIZE AS RAFTERS) ..
HEADER SQE
STRAPS
--
✓/a0�
w
C> t1'%1/6' WITH I
RAFTER $PAN:
Z
I (4) 764 HAILS OR BOLT
/ q
Z
POS O C/
O H.
a:--
SPACING:__ -
'VE�LL LENGTH: �
a.
¢
O.H.
OYERALi GTHfl.
6 /0 POST. SM:
REAR SEtBACK SIDE SETBACK t' •� LAUN J
1
2000 P.S.I CONCRETE 1 FV41SNGRADEFIItISH GRADE
L_ 1 4.—• vk. 1 T' x 12r FOOT940 1 I
'�y,�,5 ! ( L E2 BELOW GRADE L - j '
OPER 'LATTICE PA710 COVERS UAY BE ATTACHED TO EXISTING FASCIA
Vu ONE 1/ LAG SCREW. THROUGH M wTO EACH RAFTER
/— 3/8' x 5 LANG SCREWS INTO 'ST1RK
.NAIL RAFTER TO BLACIMG
PROVIDE I" CLEARANCE
BETWEEN POST AND
1 CONCRETE
BUILDNN'G DEPARTMENT APPROVAL BELOW
CITY OF [A QUANTA
BUILDING & SAFETY DEPT.
APPROVED
CONSTRUCTION
DATER ,.Lt U510 ay .
U -STRAP OR A.V(
NON-CORROSTV
(4)- '16d NAILS
.OR BOLT .
U -STRAP OR ANGLE
(4)- 16d NAILS
OR BOLT I '
PROVIDE 1" CLEARANCE
BETWEEN POST AND
CONCRETE
ANCHOR BOLT (EMBED
7"• MIN. INTO :�ONCRETE)
TYPICAL PATIO COVER
DATE OF APPLCA-ION
OWNER'S UWE
STREET ADDRESS
5-3 g7o AJ. JiGLA
CITY; ST ZIP L�v , At va, • CEI.
TELEPHONE 5 C z 7
y5'_-
H.OA APPROVAL
Q- Q• Q-
�� 2 Z_
� p0
RAFTER SPAN. TABLE C9 co C7 �� C-) �� �p
GRADING .RULES
PS 20-70
(FEET & INCHES)
2x4
16" O.C.
24'
10'-6"
8'-6"
9'—fi"
8'—v"
T-3
Q —q"
7 _3
DOUGLAS FIR NO. 1
SIZE
2x6
16" O.C.
24"
32" "
15'-0:
12'-6".
14'—
11'-6"
10'-9"
8'=
10'-6'
10'— ". 8'—b" N/A
N/A
2x8
16" O.C.
24"
3T
15'-6"
- —6"
11'-0"
A
13'-0"
1. 32" RAFTER SPACING IS ALLOWABLE
FOR OPEN LATTICE PATIO COVERS ONLY
2. FOR SOLID: PATIO COVERS (NOT LATTICE)
RAFTER SPAN IS LIMITED TO.10'-0" USING
THIS STANDARD. .
LATTICE
ROOF
BUILT—UP ROOF
HEADERS
HEADERS
DOUGLAS FIR NO. 1
DOUGLAS FIR NO. 1
SIZE
SPAN
SIZE SPAN
4x.4
5'-0"
4x4
-4x6
8'-0"
4X'6 6,—p"
4x8 _
1 t'-0"
4x8 8'-0"
410
t 4'-0
4x10
4x12
17'-0"
4x12 12'-0
I .6x8
14`—O"
6x8
6x10:
17'-0"
6x10
ALL CONSTRUCTION SHALL CONFORM
TO THE PROVISIONS OF -THE:.
' J4 I
ivy av" 51WIlt✓6
ROOFING NOTES:
A. BUILT—UP. ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF:. 3; 12..MAXIMUM PITCH.
j
FA
.T9 3aY �i 3 7A''►
L A T T ( C. l= S-rY L L= PAT ► .
L/D' Lowe S�' ��L--E� NOT - T 0 Cl /� L L
Bin #
QtY 0f LCA Quinti
Bullding 8t Safety Division
Box 1504,78-495 Calle Tampico
La.Wnta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking -Sheet
Permit #P.O.
L Zlo�
Project Address:S� 6 70 Art i/! LLA
Owner's Name:.
A. P. Number.
Address: 6 7o AJ.0 V EL -A
Legal Description:
Contractor.
City, ST, Zip: LP- CA �S
Telephone: Sf_
Address:
ProjectDeseription: ��r,�. �rieE PA-rM
City, ST, Zip:
Telephone:
State Lie. # : City Lie. #;
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Construction Type: UO(36 1_'i Occupancy:
Project type (circle one)(New AdA'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: 6 -Ir % (v d # Stories: #Univ
Telephone # of Contact Person:
Estimated Value of Project:
-APPLICANT: DO NOT WRITE BELOW THIS- LINE
q
Submittal
Req'd
Recd
TRACKING PERMIT FEES
Pian Sets
Plan Check submitted. Item Amount
Structural Cales.
Reviewed, ready for corrections Plan Chock Deposit. .
Truss Calcs.
Called Contact Person Plan Cheek Balance
Mile 24 Calci.
Plans picked up Constmetloa
Flood plain plan
Plans resubmitted Mechari:cat
Grading plea
2'! Review, ready for correctioastissue Electrlcil
Subeontactor List
Called Contact Person Plumbls g
Grant Deed
Plana picked up S.M.L
H.0_A_ Approval
Plans resubmitted Gradin:;
IN ROUSE:-
'`' Review; ready for correctionVIssve Developer Impact Fee
Planning Approval-
Called Contact Person A.I.P.P.
Pub. Wks. Appr -
'Date of permit issue
School Fees .
Total Permit Fees