0205-268 (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.
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).
() I am exempt under Section B&P.C. for thispreason
f'
Date C "$__Signature of Owner' ° t,4-,-
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).
( ) 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 thee' Labor
Code, I shall forthwith comply with those provisions.
Date: Applicant �L
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 al
whose request and for whose benefit work is performed under or pursuant tc
any per 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 it
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 buildinc
construction, and hereby authorize representatives of this City to enter upor
the above-mentioned property for inspectiop purposes.
Signature (Owner/Agent) Date .2
UILDING PERMIT PERM T#
DATE t`` ALUATION LOT
JOB SITE APN
ADDRESSM�°
OWNER n— CONTRACTOR/ DESIGNER/ EN INI
DAN fil' Cft C"i CY91t+i] R -• :ism DT
ucc or rEnt.IIT R' `
MrdD
lift S.X CO 8DtX0 P,A:f1 , PER, CITY PLAMS ! D
Pi7RCHMA.` K)
70.00
Es rjM-,AI%,D con OF comMax"llon
PLAN CHECK FRE VIM
CONTSTIZ.,U TIO43 VEE, 101-000-416-000 $117,00
Su'I'RON0. iviOV014 FFE - RUID i ol-gil0441. 100 $193
U.05S 1~'.i;$.EpPAM MHO
TOTAL PERAWY-ft ME, NO
a�
TRACT
.R
i
OB.TA
� � a
' � U
ITY OF LA QUINTA
FINANCE DEPT.
RECEIPT DATE BY D FINALED INSPECT
$191.98
WI DD
P
S1 SO
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 —( ,d
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 —��)
BLOCKWALL APPROVALS
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
sa-
Gas Test
Electric Final
t Waste Lines
Heater Final
4° ,Ater Piping
Plumbing Final
Pru`mbing 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 Notice (Perm)
COMMENTS:
OWNER/BUILDER. •INFORMATION
Dear Property Owner:
An application fora building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/ you are the responsible pare y of record on such a
permit. Building permits are not required to be signed by property owners unless they are persorally 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 required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law"to,put their license number on all permits for which they,
apply. 4
If you plan to do your own work, with the exception. of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise..engage any persons other than your immediate family, and the work (including materials
and 'other costs) is $200..00 or more for the entire project, and such persons are not .licensed as contractors, or
subcontractors, then you may be an employer.
If you are an employer, you must register with the -State and Federal Government as 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:
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about'your obligations under Stade
Law., contact,the Department of Benefit Payments and the Division of Industrial Accidents.
if the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through, their own employees, without a licensed contractor or subcontractoe, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Ownc /Builder" building'
permit, erroneously implying that the property owner is providing his or her own labor and material personally., "
Building permits are not required to be signed by property owners unless they are performing 'their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State license Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm, -,hit you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta,CA 92253
,(760) 777-701
FAX (760) 771-79N1 ,
OWNER'S SIGNATURE/DATE
Li
PROPERTY ADDRESS
ioaos- 0 06
•PERMIT NUMBER(s)
n
RAFTER SIZE AND SPACING
ROOF P CH
o
SPECIFY ROOFIIG AND SHEATHING OR OPEN LATTICE
(SEE FOOFINC NOTE ON REVERSE)
x x <.------------
CONTINUOUS LEDGER
(SAME .SIZE AS RAFTERS)
' • HEADER Z`E/ I �T' AND l' STRAPS
`----J�—�— - I 6'x6'xi-Y1/8' WITH
i I (4) 16a NAILS OR BOLT I u
RAFTER .SPAN: / __ I > • Iv/ POST .SPACING:_ !
O.M. W` O.M.
a.
OVERALcr
L LENGTH: a OVERALL LZKCTH_(J
POST SIZE: 6
REAR SETBACK SIDE SETBACK (4 x4" MIN.)
2000 P.S.I CONCRETE —+i I FINISH GRADE FINISH GRADEI Li •
�— MIN. ' 2" x 12 FOOTING I I
t L _ J I L --.J 12- EELOW GRADE L" — J
` 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
3/8" x 5' LAG SCREWS INTO STUDS AT 16'; D.C. NON -CORROSIVE PLATE
CONTINUOUS LEDGER 1 �N�Sfa
II : II
- • .,�:x ,.IIII (III
(4) 16d NAILS
OR BOLT
U -STRAP OR .4NGL_
(4)- 16; NAILS
OR BOLT
JOIST HANGER OR SOLID BLOCKING +'
NAIL RAFTER TO BLOCKING
PROVIDE 1" 'CLEARANCE
BETWEEN POST AND
CONCRETE
BUILDING DEPARTMENT APPROVAL BELOW II II II
;CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPR RED
FOR CONSTRUCTION
ANCHOR BOLT (EMBED ;
7" MIN. INTO CONCRETE)
`TYPICAL PATIO COVER
DATE OF. APPLICATION
OWNER'S NAME '
kci c.—
STREET
.STREET ADDRESS ),?�
CITY, ST ZIP ,L
JCLt
TELEPHONE.-, S _62C
H.O.A. APPROVAL
Q Q CC
RAFTER SPAN TABLE
GRADING RULES co, c SC-' C QL' C.')p�
PS 20-70 V c� v�
(FEET & INCHES) pJ�� pJA�?
�p q-. 2o' ?0, �o Qpm
O
2x4
16" O.C.
24"
10'-6"
1 9'-6"
T-3"
DOUGLAS
8'-6" -0" 6'-0"
T-3"
FIR NO. 1
I SI?E
i
2x6
16" O.C.
24"
32" "
15'-0"
14'-0"
10'-9"
13'-0"
12'-6" 1l'-6" 8'-9"
10'-6"
10'-0". 8'-6" 1 N/A
N/A
6'-0"
4x8
2x8
16" O.C.
24"
32" "
18'-0"
11 T -O"
13'-6"
16'-0"
15'4" 14'-6" 111'-0"
13'-0"
13'-0" 111'-6" N/A
N/A
12'- 0"
6x8
NOTES:
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.
LIATIICE
ROOF
BUILT-UP ROOF
HEADERS
HEADERS
DOUGLAS
FIR NO. 1,
DOUGLAS
FIR NO. 1
I SI?E
i
SPAN
SIZE
SPAN
4x4
j'-0"'
4x4
4'-n"
4x6
8'-0"
4x6
6'-0"
4x8
11 -0"
4x8
8'-0"
4x`10
1 4'-0"
400
10'-0"
4x`12
17'- 0"
4x 1 2
12'- 0"
6x8
14'-0"
6x8
600
17'-0"
6x10
14'-�"
ALL CONSTRUCTION SHALL CONFORK,
TO THE PROVISIONS OF THE:.
1998 CALIFORNIA BUILDING CODE.
SUPPLEMENTAL NOTES:
R00FING NOTES:
A. BUILT-UP. ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.