9704-099 (PAT)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapt,cl 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:
`A 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,*3 . `?'J Signature of Owner -ow .' er ! f
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 all 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.
// t
Date: L% . t ,q ra "Y' Applicant ` : /.: 1 10 AP, f v :<
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 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 iinsrp�ection purposes.
`
/Signature (Owner/Agent) � .•t l,i % %l� iol < Date
PERMI T # CONTROL N
BUILDING PERMIT
5024
DATE 41=97 VALUATION S3,976.70 LOT TRACT
JOB SITE
ADDRESS 44-425FOX AIL CIMIa�',
APN
•4
OWNER
CONTRACTOR / DESIGNER / ENGINEER
ANIDrs�BERCx
1=HIL &/(c
`rr R ✓ t wt ,DER
44``n1���AAs
425 FO VAIL CII
LA. QUI CA. W.253
0131,#
USE OF PERMIT
PAr 4 _J
1`1,&N C3ILCK.'I.T 1 . ti3i-Cii i�4 9 ilii $A0,9S
r;00f113?t:0".`00I4FFU J01(1f.1f)4.I8-000 1'i0ttSi
ee a Ol4(1' N-1 (T VON FEE: - MW eL1 J' .� f 1/A'tj0G-214 1'}j VO
'
I}�.'f'(,rt'�11.4.''Ci��"1`C{(.#C'C'�4'1j+t 1�`i�1} i'1„E1,i�i C;l1RC.��”
4
k
_ �lt1�l.E►`+
'114) {'A.1, P14,RMiT FSi.,E.5 0)tlb,NOW
$1[i4.4g-
RECEIPT.
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR"
j BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs 4
Underground Ducts
Forms & Footings
Ducts
Stab 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
BLOCKWALL APPROVA S
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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
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:
Z� �U.G s� l�Clid®/N .f/p8'6Gil7c.
RAFTER SIZE ANO SPACING
SPECIFY ROO/INO AM SMEATMWO OR OPEN LATTICE
(SEE ROOFM NOTE ON RE mm))
RW PffCH
C"s Low
41 N�EW SIZE +
I T AND• v STRAPS I
x WITH
/
4)1I OR MXT I
RAFTER SPAN -(:� ' ZI
124 POST SPACHNO �('- �r
O.M.
O.N.
OVERALL UNCTH: 1.3'-O
YIN. Cx1 P0es1s ;o
#WF SE1b1OK
�ME KTW=
S IDE
?�2.
2000 P.SJ CONCRETE RON
YNH. 11x12' F+OOTM
C&I yp N u ous I
11 onjow a m
Foc7rl
T I ►J u ovS FTG .
PROIIROE 1- a.EiwwcE
eETrIElf1 POST ANO
CONCRETE
OPEN LATTICE PATIO COVERS MAY K ATTACHED TO MUSTM FASCIA
ONE 1/t x S LAO SCREW TNROUGH FASCIA KM EACH RAFTER TAIL
U-~ OR No"
NON-CORFAM PLATE �pE
3/f' x S LAO SCREWS INTO SRIOS .AT It O.C.
FCONTINUOUSLow}�Td
HMK,S
w
OR
If , F-dul
Cd 1�`j 1 Iii 00U $
FQUU�I
rrLd
OR maxz�)
ou
Ma T
L
JOIST K4HM OR SOLO &,OC M
NAL RAFTER TO MIOC IN'
—^•.•�•�..
or,,11 �,� ..
�fl�� �� � �'� ���Y6 �
I
ANCHOR BOLT EYEIEDPROVIDE 1"
T MK MATO CONCRETE) 0977 ZN POSTE
CONCRETE
- T
BUILDING DER#fMFNlg USE ONLY
TYPICAL PATIO COVER
i P~NLN ]tMMMMMM
AM ZM0 FOR
CAN O► APPLIGTKMI
Z Z q
POIYR ISSUE DAT ° ado I � es INSTALLATION /�1TI0N AS P�
K H�
i f1N11 INSPECTION OAT[
ADTe"
- zS ( L
.;Sr a LAo ,o CA
e
DATE
APPROML SIGNATURE. DAR
r Q. Q. Q.
v v v
' RAFTER SPAN TABLE
GRADING RULES
PS. 20-70
(FEET & INCHES)OJO�
cP� o) o o�
�o ti -o �, �o ti v
2x4
16'
O.C.
10' -Ir
'-6•
'-
.�._
...F_
....�.... _l.'.-..
SIZE SPAN
2e
2X6
16,
O.C.
1 '-
'-
'- '-
_........._.1.1 I -T
24'
410
14'-
*X, 0 '-
4x124x12
3r
6x8
'-NLA
6x8 12,
'6x
N/A
„_.17' w,
6x 10......._.� Efr_
2x8
16'
O.C.
.J.3:.-..:11.6...Ir_
... M
3r
NOTE.
3r O.C. SPANS ARE ALLOWABLE FOR OPEN LATTICE
PATIO COVERS ONLY.
LATTICE ROOF
BUILT-UP ROOF
HEADERS
HEADERS
DOUGLAS FIR NO. 1
DOUGLAS FIR NO. 1
SIZE
SPAN
SIZE SPAN
4x4
....................:..'-
4x4 ........_...._.�-�
46
'-
46 '
48
_........._.1.1 I -T
48 _
410
14'-
*X, 0 '-
4x124x12
'-
6x8
14'-T
6x8 12,
'6x
6x10
„_.17' w,
6x 10......._.� Efr_
CONSTRUCTION SHALL . CONFORM
TO -THE PROVISIONS OF THE 1994
UNIFORM BUILDING CODE
SUPPLEMENTAL NOTES:
ROOFING NOTES:
A. 'BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.