14-0214 (PAT)PVI
P.O. BOX 1504
78-495 CALLE TAMPICO / �4
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
d - a .
14-00000214
78495 VIA SEVILLA
604-212-010-54 -23971 -
PATIO COVER - RESIDENTIAL
LOW DENSITY RESIDENTIAL
6000
Architect or Engineer:
°� �WQut«fw
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencin Ith
Section 7000) of Divis'on 3 of the Business and Professionals Code, and my License is in full f e effect.
License Class, 13 Lice No.: 550253
Date: ontractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's S to icense Law for the
following reason ISec. 7031 .5, Business and Professions Coder 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).:"
(_ ) 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. , BAP.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 -
1 ,
Owner:
MILLER CHRIS & BRIDGET
78495 VILLA SEVILLA.
LA QUINTA, CA 92253 If—
i
Ei
Contractor:
OB GENERAL CONTRACTO
74741 JONI DRIVE
PALM DESERT, CA 9226
(760)610-0660-
Lic. No.: 550253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/19/14
MAR 19, 20111
CITY OF L A taUINTiA
F1 -PA' CE— 'Ll 5PT.
-------------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ 1 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 NORGUARD INS Policy Number OBWC515047
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
' person in any manner so as to become su Ct to the workers' compensation laws of California,
and agr a that, if I should become t to the workers' compensation provisions of Section
�{ 700 f t5! Labor Code, I sh ith comply with those provisions.
Date: ✓ , A plicant:
WARNIN F LURE TO SECURE RS' RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO C IM AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN AD ON 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 state that the above infor aGbn is correct. I agree to comply with all
city and county ordi nces and state laws relating to building cons yt on, and hereby authorize representatives
of this coun toe er u n the above-mentioned property for ' tion purposes..
Date: / ignature (Applicant or Agent):
Application.Number 14-00000214.'
Permit PATIO COVER 2013
Additional desc .
"
Permit Fee 95.81 Plan Check Fee
.00
Issue Date Valuation . . ".
. 6000 ".
Expiration Date 9/14/14
Qty Unit Charge Per
Extension
1.00_ 95.8100 EA MISC PATIO COVER, STD
9'5.81
Special Notes and Comments
NON PERMITTED BALCONY•PERMIT 2013 CBC
(e)22'X 91BALCONY/PATIO APPROVED PER JJ
--------------------------------------------------------------------
Other Fees, . . . . . BLDG STDS ADMIN (SB1473)
1.0"0
HOURLY PLAN CHECK
105.00
PLAN CHECK, CARPORT
95.81
'
STRONG MOTION (SMI) - RES
.60
Fee summary Charged Paid Credited
Due
-------------------------"-
_Permit Fee Total 95.81 .00 .00
-
95.81
Plan Check Total .00 .00 .00
.00 .
Other Fee Total 202.41 .00 .00
202.41
Grand-Total 298.22 .00 .00
298.22 .
Bin #
City of La Qumta
Building &r SafetyDivision
P.O. Box 1504, 78-495. Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
14 - 2-14-
Project Address:--72>Vl
Owner's Name: SJF�V7-- x711465 .
A. P. Number:
Address: s- Vl �q &---via,4
Legal Description:
City, ST, Zip:
Contractor. to (-5' C—�ilJe AQi.. C0 'tS'
.Telephone:
Address: / �0 N �Q 1 �-
Project Description:
J_
City, ST, Zip: _Il/�-rl ' -,%)(n cj-vt- L' A— 17z6C)
Telephone:o 0660
State Lie. #
City LicA..
Arch., Engr., Designer:
Y 2d I j -c-
CAddress:
• P;I
Address:
° t- 2 2 K .CJV
City., ST, Zip:
Telephone:
P
$=•:•
Construction Type: Occupancy:
Dem type circle one): New Addn Alter o
State Lic. #:
:>
Name of Contact Person:
Sq. Ft.: �'
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: (o
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor,List
Called Contact Person
Plumbing Ott
Grant Decd
Plans picked up
S:M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3".Reyiew, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
%*
, �' V,
FEB
2
otal Permit Fe
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