04-5916 (PC)S
BUILDING & SAFETY DEPARTMENT
ox 1504 (760),•777-7012
3 �,78 CALLE TAMPICO FAX (7'60) 777-70.11
A U. NTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
rc nEPT _rJ BUILDING PERMIT
Application Number . . . .
04-00005916 Date 9/01,/04
Property Address . . . . . .
50660 EISENHOWER DR
APN:
773-370-028--3- -0000:00-
Application description . . .
PATIO COVER - COMMERCIAL
Property 'Zoning
LOW DENSITY RESIDENTIAL
Application valuation
674:3
Owner
Contractor
CAMEO HOMES LLC
LUCAS GENERAL CONTRACTING CORP
1105 QUAIL STREET
1111 QUAIL STREET
NEWPORT BEACH CA 9266°0
PALM DESERT
CA 92.260
(909) 474-02,2.1
WCC: STATE FUND
O1/O1/,05
WC: 17149'88
01/01/05
CSLB : 758785
02/28,/05
CCC': B,
Permit PATIO COVER
PERMIT
Additional desc .
Permit Fee ... 90.00
Plan Check Fee ..
58.50
Issue Date . . . .
Valuation . . . .
6743
Qty Unit Charge 'Per
Extension
BASE
FEE
45.00
5.00 9.0000 THOU BLDG 2,001-25,000
45.00
Special Notes and Comments
Three (3) 13 .x 1-3 wood trellis
patio
covers. Two (2): at pool area and one (1).
at detention area.
Other Fees . . . .
STRONG MOTION (SMI) - COM,
1.4.1.
Fee summary Charged
Paid Credited
Due.
Permit Fee Total 90.00
.00 .00'
90.00
Plan Check Total 58.50
.00 .GO
58.50
Other Fee Total 1.41
.00 :00'
1.41
Grand Total 149..91
.00 .0,0
149.91
P.O. .0. BOX 1504 edf,
" VOICE (760) 7.77-7012
78-495 CALLS TAMPICO FAX (.760) 777-7011
LA QUINTA, CALIFORNIA 9225344 INSPECTIONS (760),777-7 53
RU'ILD.ING & SAFETY DEPARTMENT
Application Number: `
Applicant:
Applicant's Mailing Address:
Date:
Architect or Engineer:
BUILDING PERMIT DECLARATIONS.
LICENSED CONTRACTOR'S DECLARATION.
1 hereby affirm under penalty of perjurythat 1 am licensed under provisions,of Chapter 9 (commencing with Sectlon.7000) of Division 3 of the. Business and Professionals
Code, and my UcenseLLs in full force•and•eHect.
Lioanse'Glass to License:No. -7S—e% �S
Date / Contractor Z—(.,, S C
OWNER -BUILDER DECLARATION'
1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following,reason (Sec. 7031:5, Business and Profeestone Code: Any
city or county that requires'a perrnk;to construct,, alter, improve, demolish, or repair structure, prior to bIssuance, also requires the applicant forthe permit to file a signed
statement that he orshe is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (oommencing with Section 7000) of Division.3 of the Business
and, Professions Code) or that he or sheds exempt therefrom and thwbasis for the alleged exemption. Any violstlon of Seddon 7031:5 byany applicant fora permk subjects
the applicant to a civil penaltyof not more than five hundred dollars ($500).):
U I; as owner of the property, or my employees with wages.awtheirsoIs compensation, will dothe•work, and the structure isnot intended or offered for sale (Sec. 7044,
Business and Professions Code:. The Contractors' State License Law.doesnot apply to sn.owner of property who builds°or improves thereon,: and, who does the work
himself or herself orthrough his or-her,own employees, provided that the improvements are notirdended or offered for sale. If, however, the building or improvement is
40K%vithin one year of completion, the owner -builder will have!theburden of proving that he or she did not build orimprove for the purpose of sale:)..
U 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 orimproves thereon, and who contracts for the projects.with a contractor(s)'licensed pursuant to
the Contractors"State;Ucense Law.).
U I,am exempt under Sec. , BA P.C: for this reason
Date Owner
WORKERS"COMPENSATION DECLARATION
I herebyaffr m.under penaltyof,perjury, one of the following declarations:
_ I have and will maintain a certificate of consent'to self -insure for workers' compensation, as providedifor',by'Section 3700 of the Labor Code, for the performance
of the work'forwhich this pernitis issued.
I have and will maintain workers' compensation insurance,: as require&by:Section 3700 ofthe LaborCode, for the performance of the work for which this pem itis
�*- pcug5.M worlgsW comp ton insurance carrier a1I'P.oticy 7 r aLre;
Cartier. _.� rl - f`G.,i2 ; ] Policy Number / / / �/ X
—I certity-that;; in the performance orthe work,forwhich this permit is'issued, I shall not employ any person In,any;mannerso as to become subject to the workers'
compensation taws of California; and agree that, if'I should become subject to the workers' compensation:provisions of Sectiom3700 of the Labor Code, I shall
forthwith comply with those provisions,.,
Date 9.b f` Applicant
WARNING: FAILURE TO SECURE WORKERS' COMPENS TION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN1EMP.LOYER TO CRIMINAL PENALTIES AND
CIVIL -FINES UP TO ONE'HUNDRED THOUSAND. DOLLARS ($1001000), INADDITION TO'THE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN
SECTION 3708 OF THE:LABOR CODE, INTEREST, AND ATTORNEY'S. FEES.
CONSTRUCTION LENDING AGENCY
I hereby.affirm under penalty of perjury that there is a:construction?lending agency forthe performance of the work for which this;permit is issued (Sec. 3097, CIV. C.):
Lender's Name
Landers Address
APPLICANT.ACKNOWLEDGEMENT
IMPORTANT Application is hereby,made to the Director of Building an&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.underor pursuant Wanypermit
issued;as a result'of this application, the owner, and the,applicant, each agrees.to, and shall, -defend; indemnify and hold hannless:the City o(La Quints, its
officers, agents and employees for any act or omission related to the work being perforned'under or following' issuance of this permit
2. Any pennk:issued as a reisuk of this application: becomes,null and',void it wotk is not commenced. within 180 days from date of issuance of such.permit, or
cessaton:ofwork for 180 days�will subject.pertnit'to•cancellatlon.
I certify that;l have read'this application,and state that the above information is correck I agree to complywith all city end county ordinances and state laws relating to building
construction. and hereby authorize representatives of this tour to en above mentioned
ty properly for inspection purposes. .
Date 81Snatun (Ap'licant_srAgsnt).