04-5730 (PAT)�7 BUILDING SAFETY DEPARTMENT'
"�"'� P. Box 1504 • (760).777-7011
C ^ OF 788 5 CALLE TAMPICO FAX' 760 77,7-701 L'
0 A�, NTA, CALIFORNIA 92253 -INSPECTION REQ,U♦ESTS (_760)777-7153
BUILDING PERMIT
Gp�CE®� 3
pp icati.on `Number .'04-000 5730"`�� Date 7/27/04
Property Address- 47150 IA LORCA
' APN- 643-160-056-155 -261E2 -
Application description=. `. PATIO COVER RESIDEDiTIAL ,
Property Zoning . . . LOW DENSITY RESIDENT]AL
Application valuation 2753
Owner Contractor
-- - - - - - - - - - - - - - - - - - - - - - - -----a, ---------------'
SMITH JOE PELLETIER CONۥTRUCTION
47150 VIA LORCA 74691 -SWEET WELL,ROAD
LA QUINTA CA 92253 THOUSAND PALMS CA 92276
.. t' (76A) 275-601,
' WCC: STATE FUND
WC: '54952004 01/01/05
t CSLB: 2604E4 12/31/04
CCC; B1
'-
----------=----------- - - - - -- ---
-
Permit. . . . . PATIO COVER PERMIT -.
Additional-desc
Permit Fee--. 54.00 Plan Check Fee 35.10
Issue Date Valuation . . . 2753
Qt Unit..Char e- Per
. Y 9 Extension
17
BASE FEE 45'.00
1..00 9.0000 THOU" BLDG 2,001-25,000 9,.00
} i--- ----------------- _--- 4—'--- ----��---�--ter —'—�,h —
Special • Notes and .Comments
207 SF ALUMAWOOD LATTICE PATIO COVER.' +(
HOA APPROVAL REC'VD.
-------------------------------------------- ----------------- --`----s-------
Other Fees STRONG MOTION - (SMI) - RES i .50
Fee,summary Charged Paid 'Credited Due
--------'--- - - - -*----- - - - - --
Permit"Fee Total 54.00 .00 .00 54.00
Plan Check total 35.10 .00 .00 35.10'
Other-Fee'Total' .50 .00 00, .50'
Grand Total 89.60 .00 .OiO 89-.60
- ,
., 1
P.O. BOX 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: d 7 '"-s % 3 ® I Date: Xa,; a �t
Applicant'
( O N ?/I/a G 78Y -
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
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 i1 License No:
full force and effect. Z(00 -( e L
License Class !�
Date .—) IZi fou 'Contractor • R,
OWNER -BUILDER DECLARATION
I 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 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 Contractors' 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).):
U 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 or 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.).
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 or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. , BA P.C. for this reason
Date
WORKERS' 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
-, C issued. My wo e ' co cation insurance carrier and policy n tuber are: .
Carrier-_ I s Policy Number 'SLI ci .� 00 L4
_ I certify that, in the performance oft for which this p ued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califo , and agre hat, if I sh Id becom subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those ovisions.
Date ' 1 �2i I Applicant ~ �1y
WARNING: FAILURE TO SECURE WORKERS -COMPENSATION 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.
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
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 info 'on is correct. I a to mply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county enter up the above ention property for inspection purposes.
Date ioh t21 l 0 u Signature (Applicant or Agent):
Jul 26 04 03:33p Joe Gayle Smith 760-771-6033 p.1.
•
LAKE LA QUNIT'.A HOMEO NEWASS®CIAT 16 .
CIO J & W MANAGEMENT
P.O. BOA 1398 PALM DESERT, CA 92261
1 (760) 568-0349.
. w
July 23, 2004
.1
Mr. & Mrs. Smith ! `
47-150 Via Lorca r
' La Quinta, Ca 92253 `
Dear Joseph & Gayle,
Please be be advised that the Architectural Committee of.Lal(c L a Quinta has reviewed and
approved the plans you* submitted for your residence at, 47-150 Via Lorca, for the r..
installation of a lattice patio cover in your back yard with lattice. size 2" lattice spacing
1", with the builder Polletter Patio license #260434. This approval is based upon your
application-you submitted to the Committee 6/29/04. -
This approval should not be consid� red a building permit. All nece.=ary !if ne_ded)
• approvals and permits must be obtained from the Cite of La Quintrl b ,_ore n ist ,.,coon
begins, All rules and regulations regarding construction must be : dber d to during lhe'
.course of construction. `
- If you have any questions, please cell the Architectural Comm lt. .
Yours truly
Lake La Quinta
w Arch: Com.
12 arch letter s
is • `
L4-7 iso Vf-c, UD- vrcc.
CAX225 3