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07-1057 (PAT)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 r Application Number: 07-00001057 - Property Address: 61155 FIRE BARREL DR APN: 764-280-999-71 -300235- Application description: PATIO COVER' - RESIDENTIAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 3325 4Applicant: et Architect or Engineer: a1 Pr BUILDING & SAFETY DEPARTMENT BUILDING PERMIT . LICENSED CONTRACTOR'S 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 Class: 13 License No.: 510847 ate: ntracior: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 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 ($500).: (_) 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the . improvements are not intended or offered for sale. If, however, the building or improvement is sold within 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.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ( 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: STAN RUBIN 61155 FIRE BARREL DRIVE LA QUINTA, CA 92253 Contractor: HAWKINS CONSTRUC 77850 DELAWARE P PALM DESERT, CA (760)413-3017 Lic. No.: 510847 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 RPR 0 6 2007 Date: 4/05/07 WORKER'S COMPENSATION DECLARATION 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 .I issued. p.I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor -r Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 0026451-2006 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 provisions. Bete,6��Iant: WARNING: FAILURE TO SECURE WORKERS' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this 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 application, 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 or following issuance of this permit. 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 county ordinances and state laws relating to building construction, and hereby authorize representatives of thiscounty to enter upon above-mentioned property for inspection p r ses. te: �J ��/ nature (Applicant or Agent): Application Number . . . . . 07-00001057 Permit . . . PATIO COVER PERMIT Additional desc . Permit Fee . . . . 63.00 Plan Check Fee 40.95 Issue Date . . . . Valuation . . . . 3325 Expiration Date . . 10/02/07 Qty Unit Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG 2,001-25,000 18.00 ------------------------------------------------7--------------------------- Special Notes and Comments 250 ALUMAWOOD PATIO COVER ---------------------------------------------------------------------------- Other Fees . . . . . . STRONG MOTION (SMI) - RES .50 Fee summary Charged ----------------------=---- Paid Credited Due ---------- Permit.Fee Total 63.00 ---------- .00 ---------- .00 63.00 Plan Check Total 40.95 .00 .00 40.95 Other Fee Total .50 .00 .00 .50 Grand Total 104.45 00 .00 104.45 �i LQPERMTT Bin # Submittal . City of La Quinta Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # U lLa U Project Address:' 3� �� j �i� �— Owner's Name:.. A. P. Number: Plan Sets Address: I fA<,- Legal Description: Plan Check submitted City, ST, Zip: " L 1-77 Contractor: �� , Telephone: Structural Calcs. Address:r"4 Project Descrip tion: City, ST, Zip: ,q Plan. Check Deposit Telephone: Truss Calcs. State Lic. # : / FY 7 City Lic. #: 5� s— v Arch., Engr., Designer: Energy Calcs. Address: Plans picked up City, ST, Zip: Telephone: State Lic. #: Construction Type: Occupancy: Project type (circle one): New Add'n . Alter Repair Demo . Name of Contact Person: Sq. Ft.: 2 - j # Stories: # Units: Telephone # of Contact Person: 20 Review, ready for correctionslissue Estimated Value of Project: Electrical APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal . Req'd Recd TRACIMG . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corcections Plan. Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up `Construction Flood plain plan. Plans resubmitted Mechanical Grading plan 20 Review, ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing .Grant Deed Plans picked up S.M.I. H.OA. Approval Plans resubmitted Grading IN ROUSE:- ''' Review, ready for correctionsrissue Developer impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees w CITY OF LA QUINTA BUILDING & SAFETY DEPT. ,.APPROVED FOR CONSTRUCTION DATE -!L.L� BY ON till z Z C95 p LUto- 0 ui > :5) LL 0 m 06 LL Q- 0 0 0 0 0 Ez a_ k cr 0<0 �: -I -j U - o5 ON till