05-2176 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00002176
Property Address: 43665 GALAXY DR
APN: 609-480-070-2 -23773 -
Application description: PATIO COVER - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 5014
Tity/ 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
STAUBER JEFFREY M
43665 GALAXY DR
LA QUINTA, CA 92253
Contractor:
Applicant: Architect or Engineer: PELLETIER CONSTRUCTION
74691 SWEET WELL ROAD
THOUSAND PALMS, CA 92276
(760)275-7593
Lic. No.: 260484
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury licensed undernan�d
Chapter 9 (commencing with
Section 7000) of Division 3 of the siness and fessionaI odLicense is in full force and effect.
License Class: B -C33 Lic se0484
Date:(A10.,3:ontracto : -
WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury 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).:
(_ 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 _ 1 1, 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
VOICE (760) 777-7012
FAX (760) 777-7011
I.NSPECTIONS (760) 777-7153
Date: 6/06/05
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 and policy number are:
Carrier STATE FUND Policy Number 5A2 5
I certify that, in the perfor ance of the work for w ch this p mit is issued, I shall not employ any
person in any m er so as ecome subject o the work S.
compensation laws of California,
and agree th , if I should co a subject tot workers' ompensation provisions of Section
(" I,
3700 of the bor Code al}ML
pl ,with t se provisions.
Date:. k J Applic nt: /
WARNING: FAILURE TO SEC E WOR S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO C 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 rmit, or ce0of 180 days will subject
permit to cancellation.
1 certify that I have read this application and s to that the abov informaree to comply with all
city and county ordinances and state laws rel ting to bui ing c structiorize representatives
of thiss ccoynty to ent`eerr upon the above -menti ned prop f i coon
Date:`01(01 V ` Signature (Applicant or ent):
Application Number . . . . . 05-00002176
Permit . .
. PATIO COVER
PERMIT
Additional desc .
Permit Fee . . .
. 81.00
Plan Check
Fee
52.65
Issue Date . . .
.
Valuation
. . .
. 5014
Expiration Date
12/03/05
Qty Unit Charge Per
Extension
BASE
FEE
45.00
4.00 9.0000
THOU BLDG
2,001-25,000
36.00
----------------------------------------------------------------------------
Special Notes and
Comments
377 SF ALUMAWOOD
LATTICE PATIO COVER
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . STRONG
MOTION (SMI)
- RES
.50
Fee summary
-----------------
Charged
--------------------
Paid
Credited
--------------------
Due
Permit Fee Total
81.00
.00
.00
81.00
Plan Check Total
52.65
.00
.00
52.65
Other Fee Total
.50
.00
.00
.50
Grand Total
134.15
.00
.00
134.15
LQPERMIT
Jun 04 05 08:48a PPM 760-325-9300 P.1
STARLIGHT DUNES HOMEOWNERS ASSOCIATION
c/o Personalized Property Management Co.
June 4, 2005
PAIR. JEFF & SUSAN STAUSER
43-665 GALAXY DRIVE
LA QUINTk CA. 92253
Re: Architectural application approval for addition of patio cover, 43-665 Galaxy Drive,
Starlight Dunes Homeowners Association
Dear Mr. & Mrs. Stauber:
The Architectural Committee/Board of Directors met and reviewed your request for the
addition of a patio cover at your unit. We appreciate your adhering to the Architectural
Guidelines and procedures in regard to undertaking of your refurbishment project.
With receipt of this letter, please feel free to proceed with your project in exact
accordance with the specifications and application submitted and approved, as soon as
possible. Please contact the undersigned upon completion of your project to arrange for
final sign -off.
Thanking you in advance for your cooperation.
For the Starlight Dunes Homeowners Association
Soard of Directors
Sincerely,--,
Michael W. Livingston CCAM, AMS
Community Manager
cc: Botird of Directors
Eric.
File.
4
60-950 Adelina Road
Cathedral City, Ca. 92234
(760) 325-9500 fax (760) 325-9300
Jun 04 05 08:48a PPM
A RE -INSPECTION FEE OF $30
WILL BE HARGED IF THE APPROVED
PLANS AND JOB CARD ARE NOT ON
THE SI E FOR A SCHEDULED
INSPECTION.
NO EXCEPTIONS!
760-325-9300
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BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
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