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9606-009 (PAT)U) U) N_ W O �C0 Lo WT W � cc' Z r (0O� WW(0 �[L Z (Y) u) N ON U_ C0 EL Z `r�cc 0 0 J J mVU O Z ob �0 Q J LICENSED CONTRACTOR DECLARATION ' hgreby�jffirm 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 ,424048 13 6IM19 i Date`Cr Signature of Contrac� '!'v'�GG✓1�4�r-`� 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 istCiped!>M,y3woKkgrsj:_compensation insurance. carrier & policy no. are: Carer 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 the Labor Code, I shall forthwith comply with those prove ions. Date: 6/ WI Applicant � �-�-•+��a" r Warning: Failure to secure Workers' Compensation coverage ge 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) /tet -- '� '� Date f, BUILDING�PERMIT PERMIT# CONTROL# �� 3435 DATE 614195 VALUATION i4,1i6% $� LOT TRA`C�,TA ADDRESS 4188-617 C A1,L.E ES,i<�Fr�.�.N7A JOB SITE APN 64.6-121-009 OWNER CONTRACTOR/DESIGNER/ENGINEER SAI VATORE f & ROSE, M(JNFO>n` T LARRY OUNIT7, 4 17 CAL E i SP..VkAI4kA 78.365 HWY. 111, it la, LA, QUINTA. LA 92253 LA. QU1N` 'A CA 92253 .(619)6641-6912-7. -CSIX 27:19 USE OF PERMIT 1.r�,.`;''f°1G`1s Prl'f'tC:o C'CJVFit�'i ;aGFSI�, . • t'i�:lc�,F°trl3(�Tifa "�dd.th) SF' P,S'I'IMATri,.WC0S`l'I' OF CONSTRUCTION 4,867.80 PERMIT FEE SIUMi1 M4V P1.A:N Ckxi~ck: FR.E com5°r.1�:I~ic°t�iorgrzm 101-000 418-0W, $72.00 CIO Cn ZD f St. B- OTAL. CMSFRUC°t VI AND PLAN CHECK $1.19.34 LESS 1'1 EIPA DI FEES. $0.00 °t`O'I'AI f'f;IiM'IT L+'EFIS ME, iVp11' RECEIPT DATEBY DATE FINALED. INSPECTOR INSPECTION RECORD M 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 Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS 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 COMMENTS: 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) ARCHITECTURAL COMMITTEE CERTIFICATE (Exhibit "A" to the Architectural Improvement Application and Agreement) The Architectural Improvement Application a nt was reviewed by the Architectural Committee on and has been: Approved Conditionally Approved Rejected d subject to the following conditions set forth below Returned for Further Information Required Modifications Comments Yes No Recording to be sent by owner. to County Recorder's of ice for roof and/or exterior wall modifications. eposit (e ed Depo it A ount Required $ J ,v D'Arc itec Committee Arc ectural ;Vgiee Ar'h tectural Committple Architect ral Committee Architectural Committee NOTE: THIS APPROVAL IS VALID FOR 90 DAYS FROM APPROVAL DATE Rev. 4-96 \, v w 1 Page Three We further agree that this improvement will be completed in a reasonable and diligent manner. We further agree that 1) if we do not correct any damage caused as a result of implementation of this improvement or, 2) if we fail to complete this improvement within the allowed time frame the Homeowners Association may elect to complete the work and/or repairs, and we will be responsible for the actual costs of such work. Payment to the Association is authorized by us in -the form of an assessment or monthly penalty payments as _ a.pproved in thej Guidelines. By signing this Agreement below, we agree to be bound by its terms and conditions and any conditions set forth by the Architectural Committee in the Architectural Committee Certificate, which is attached hereto as Exhibit "A" and made a part hereof by this reference. Signatures of all Owners: _ —f (Signature) H y,2 Rev. 4-96 (Signature) Page Two The Association has no responsibility whatever in achieving compliance with newer building codes which apply as a result of Homeowner prompted modifications. Further, we understand that approval will not be granted for any modification which directly or indirectl-y 'conflicts with the Declarations of Covenants, Conditions and Restrictions. We also understand we are responsible for the accurate determination of property lines and setbacks (as applicable). 1 d We also understand that we will be responsible for all costs of this improvement and for costs associated with any repair to common area occurring as a result of implementing this improvement. Examples include, but are not limited to,,sprinkler and irrigation systems, buildings, roofs, exterior walls, lawns, plants and drainage. Further we recognize that any modifications to the common area irrigation and landscaping scheme, are subject to formal acceptance by the Association. Any required remedy to achieve the required maintenance standard or irrigation standard are our responsibility. Additionally, we understand that the job site must be left reasonably clean at the end of each day, that no debris nor dirt may be dumped in common area or left at job site. Any maintenance or replacement of permitted improvements, except for certain landscaping, which are beyond "initial" improvements, shall be the homeowner's responsibility. We agree to indemnify for ourselves, as well as for our successors and assigns, and covenant and agree to hold Association harmless from all claims, demands or liability arising out of or encountered in connection with this Agreement, whether such claims, demands or liability are caused by Owners, Owners' agents or employees, or contractors or subcontractors employed on the project, their- agents or employees, or caused by any products installed on the project by said contractor(s) or subcontractor(s). Such indemnification shall extend to claims, demands or liability for personal injuries and/or property damage occurring during installation, as well as after completion, including, but not limited to, all Owners' maintenance responsibilities provided herein. We further indemnify and hold the Association harmless from all liability related to any damage to existing improvements (wherever located within the Subdivision) resulting from the installation/construction of the Architectural Improvement If required by the Architectural Review Committee, we agree to record, and pay for the recording, of this improvement at the County Recorder's office. We further acknowledge that require a deposit be submitted Rev. 4-96 the Architectural Committee may before work is begun. 4 EXHIBIT "1" ARCHITECTURAL IMPROVEMENT APPLICATION AND AGREEMENT DATE NAME(S) (,Print) STREET ADDRESS LOCAL PHONE OTHER PHONE -REQUESTED IMPROVEMENT- / ff%/D �i ori i� �/�z f�'/ Uig-� App oval is requested for the above improvement according to the plans attached. We have attached two (2) sets of plans outlining the work to be done along with a complete description of the materials and colors to be used. If we are using a contractor(s), we enclose copies of the Contractor's License. Attachments: (1) Two copies of the Architectural Improvement Application. (2} Two sets of plans with materials and colors to be used. Note: One set is for the management office; the other set to be returned to you as "Approved". (3) Contractor's name and copy 'of contractor's license. (Not required if the improvement is under $300.00 or if "Owner -Builder"). (4) Brochures (2) and/or color samples of manufactured products to be used. We have read the Architectural Committee Rules and Guidelines and have furnished copies to all contractors to be engaged by us and we agree to; comply with those Rules and Guidelines. We also understand that it is our responsibility to insure that our Contractor(s) comply. with said Rules. We acknowledge that Build i`�,8 Permits for home improvements may be required by the City Of, La Quinta. The cost of permits, responsibility for obtaining them, and the subsequent inspections will be our responsibility. In all cases we recognize the requirement to be in compliance with applicable building codes including, but not limited to, those adopted subsequent to the original completion and acceptance of our dwelling. Rev. 4-96 s' RAFTER SIZE AND SPACING SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE 1L 6 (SEE ROOFING NOTE ON REVERSE) "� LLIAR . - - - - - - - ROOF. P CONTINUOUS LEDGER SIZE 1G 8 0 R_ "!m T AND 'L' STRAPS I l'xlrx1•x1/ir MTN I (4) 1 dd IN OR BOLT _Z�� I RAFTER SPAM ' U POST SPACING--,U O.M. O.H. ri j 1 N u,,//�� 1. OVERALL LENGTH: OVERALL LENGTH• 11V 1 11 �o nrl_50 MIN. 4'xC POSTS REAR SETBACK SIDE SETBACK ' FINISH GRADE 2000 P.S.1 CONCRETE — FINISH GRADE xI G f. I L_ `- J IN BEL GRADE -J L u ESA E L 10 AJ PROVIDE 1• CLEARANCE BETMIEEN POST ANO CONCRETE OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA VIA ONE 11,C x S LAG SCREW THROUGH FASCIA INTO EACH RAFTER TNI U-STRAP OR ANGLE NON-CORROSNE PLATE dQE 3/I!' x S LAG SCREWS INTO STUDS AT 1 B' O.C. CONTINUOUS LEDGER (4 - 16d NAILS dfE BOLT U-STRAP OR ANGLE _... .. wulS BOLT. JOIST HMIGER OR SOLID BLOCKWG NAIL RAFTER TO BLOCKWG ANCHOR BOLT (EMBED PROVIDE 1' CLEARANCE T MW. INTO OONCRETE) BETWEEN POST AND CONCRETE BUILDING DEPARTMENT USE ONLY TYPICAL PATIO COVER PERMIT NUMBER DATE OF APPLICATION PERMIT ISSUE DATE OWNER'S NIAIIE A:L AI-M FINAL INSPECTION DATE STREET ADDRESS SPECIAL CONDITIONS cm. ST ZF TELEPHONE H.OAI APPROVAL 9Gk%7URE, DATE