07-0741 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
07-00000741
61285 FIRE BARREL DR
764-280-999-132 -300235-.
PATIO COVER - RESIDENTIAL
MEDIUM HIGH DENSITY RES
10999
c&ht 4 4 Q"
Architect or Engineer:
P/1 -or
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
SED -C
RACTOR'S DECLARATION
I hereby affirm under penalty of perjury at I am licensed
der 13fi;� Chapter 9 (commencing with
Section 7000) of Division 3 of the B i ness and Professio
I ode, and my icense is in full force and effect.
Licens ass: B
icense No.: 8 0958
Date:�7tractor:
empt from
the
DECLARATION
I hereby affirm under penalty of perjury at I a xempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business an rofessions 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 155001::
(_ 1 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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
ROBERT & JANE SALGADO.
61285 FIRE BARREL DRIVE
LA QUINTA, CA 92253
Contractor: D
PELLETIER PATIO
79275 DESERT STREAM D
LA QUINTA, CA 92253
(760)275-7593
LiC. No.: 860958
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/12/07
MAR 12 201
C1 -LA- uiNTA
c 2 .A
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.
Y.1 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 and policy number are:
Carrier CNCLD/ACE AMRCN Policy Number WLRC44460427
I certify that, in the performance of the wor ' h this permit is issued, 1 shall not employ any
person in any manner so as to Lme
me bject to t e workers' compensation laws of California,
and agree that, if I shop""'
ubje o the rkers' compensation provisions of Section
3M700 of the Labor C e, I shahwi o with those provisions. _
Pelf al0 I A icant:
WARNING: FAIL RE�URE KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL '
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 15100,0001. 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 Went):.
nforma n i correct. I agree to comply with all
city and county ordinances and state laws restructio , d hereby authorize representatives
of thi!coountty�to enter upo the above-mentipection rposes.
ate: `+ K ignature (Applicant or
•r �
Application Number . . . . . 07-00000741
Permit . . . PATIO COVER
PERMIT
Additional desc .
Permit Fee . . .
126.00
Plan Check
Fee
81.90
Issue Date
Valuation
10999
Expiration Date
.9/08/07
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
9.00 9.0000
THOU BLDG
2,001-25,000
81.00
----------------------------------------------------------------------------
Special Notes and Comments
ALUMAWOOD PATIO COVERS
(14'X131)
(121811
X 211)& (13' 6" X 28 "' ,"
PER APPROVED
PLANS
----------------------------------------------------------------------------
Other Fees
STRONG MOTION (SMI)
- RES,
1.09
Fee'summary Charged
--------=------------------
--=-------
Paid Credited
----------
----------
Due
Permit Fee Total
126.00
.00
.00
126.00
•Plan Check Total
81..90
.00
.00
81.90
Other Fee Total
1.09
.00
.00
1.09
Grand Total
208.99
.00
.00
208.99
LQPERD4T
Bin # City of La'Quinta
M
Building U Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Applicadon and Tracking .Sheet
Project Address: . !F-\ Y•e. Gojrcj RA4
wner's Name:
A P. Number. dress:
Legal Description: ty. ST, Zip:,, ^, epi Ci2257
Contractor: ��Je'+" e�&4W .elephone:
Address: ]Z? lD?Ao -t— roject Description: 41 ,J��
City, ST, Zip: ,�,� t d 227 C(y X \3
Telephone: a?: ^ -7 5 ct
State Lic. #
Arch., Engr.; Designer.
Address:
City; ST, Zip:
Telephone:
State Lic. #:
Name of contact Person:
Teleohone # of Contact Person:
Lic. #:
# Submittal
Plan Sets
Req'd •,
Ree'd TRACT MG •
Plan Check submitted
PERMIT FEES
Item Amount .
Structural .wes.
9evleW4 ready for corrections
Plan Check Dcpostt .
Truss Gdcs.
Called ContactPerson
Plan Check Balance
Energy Cala.
Plans ticked.up
•Constraetioei
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
Y' RevieW, ready for correctionsi%sue
Electrical
Subcontactor List .
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M:L
10 A. Approval
Plans resubmitted
Grading
IN HOUSE-
''� Revievr, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called .Contact Person
A.LP.1'.
Pub. Wks. Appr
Date of permit issue
SehoolFees
Total Permit Fees
yf
CITY OF LA.QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRU
DATE..
Co l
cA
X122 S 3
I
A RE -INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARD ARE NOT ON
THE SITE FOR A. SCHEDULED
INSPECTION.
NO EXCEPTIONS!
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