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0308-094 (SFD)LICENSED CONTRACTOR 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 is in full force and effect. License # Lic. Class Exp. Date 7117699 8 04/3012( Dae, Signature of Contractor ? OWNER -BUILDER DECLARATI -N I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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 Signature of Owner 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 .LIBER.T'Y MU TUAk. V Policy No. WA262D0047230127L (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 shall 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 s all forthwith comply with those provisions. ,.Date:r-Applicants,•* ,, � Warning: Failure to secure Workers' Cordi ensation 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 inspection purposes. Signature (Owner/Ager)._ Date BUILDING PERMIT PERMIT# DATE VALUATION LOT TRACT S2.33,'7X34KII 86 3fJ3S'I JOB SITE ADDRESS APN 771.25"111 Z . Z A OWNER CONTRACTOR/DESIGNER/EN (NEER Irol. , BROOTM 2S WC TOLL BP.< i'I ErZ3 INC 73-121 1Tt.1D 1VVAILIN'G'A100 '13.121 FRFI) `4Xf tdG 4300 PA114 D RT CA 92260 PALM DESERT C.P. 92260 (760)674-9699 ci" 3932 USE OF PERMIT 31-NUIZ FA1rt f Y D WV.EIIJNG SRO - WT Std SP4`11ONA-A. PERTAIT DOES 770 T INCL UC IR 31=K WALLS, P0014 SPA OR DRIVEWAY APPROACH. 730/4 REDUCTION TO PLAN CHECK, FEZ DUD TO MULTIPLE ISSU "CE OF :;ANIZ PL A14 TYPE CUSTOM CONSITKUCTIC.)N 2A00.00 OF PORC'IIII 110 M.00 Sr OARAOFJCARPORT 610.00 8Ir X&TVIdAxND COST aF C(% S'rRC7Cn0N 2:33,733 sq i MIT .'EI» 9MAMARY CONSTRUCTION FEE 101.000-418.000 $1,10'a.50 PLAN CHECK FEE 101-000439-31.8 $227,00 MECHANICAL FF,E 101.000.421.000 5111.50 IMCTRICA.L .FSE 101-030-420-000 $ [66.20 PLUMB1140 FEE 101.000.419.000 $184.00 STROT40 M07ION FEE - ItR.,SID 101-000-241.000 $23.3' ORADING FEE 101.000.423.000 tis,a0 i IVI V LOM IMPACT FIZZ $7,405.1I0 ART IN PUBLIC PLAC8 - REME 270.000-445.000 $84.33 1ai7MTJ(':'It0N AND PLA14 C:;iWX LESS 11k -PAID Ips D 3:4,324.90 SEP 2 6 2003 ALh-R'Wr 1rX.FS 1>11RE Now ;3V2A90 CITY OF LA DUINTA FINANCE DEPT• RECEIPT DATE BY DATE FIN"D I PECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Slab Grade Ducts Return Air Steel Combustion Air Roof Deck i Exhaust Fans l O.K. to Wrap . F.A.U. Framing Compressor _ Insulation Fireplace P.L. Vents Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS — _ BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg, Test Final Gas Piping PLUMBING PPOVAL Gas Test Electric Final Waste Lines v 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 } COMMENTS: 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) 0 . ,.4 aw 78-495 CALLE TAMPICO VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 11/8/2016 Application Number: BPAT2016-0105 Owner: O Property Address: 80595 VIA TERRACINA JEFFREY EAR APN: 777260011 736 SILVER R Application Description: EARLE RESIDENCE / PATIO COVER ROLLING H EST,.CA 90274 Property Zoning: /`ok Application Valuation: $1,881.00 SFS/raN C/�, 082016 Applicant. Contractor: '9/�/G� op44 LIFETIME PATIOS LIFETIME PATIOS �F� LA QUANTA, CA 92248 LA QUINTAOCA 922.48 �MF�T�F849 rMFNT (760)772-0013 Llc. No.: 770843 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 Professions Code, and my License is in full force and effect. License Class: B License No.: 770843 Date: I i2 Contractor: OWNER -BUILDER DECLA ATION I hereby affirm under penalty of perjury that I 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.). I ) 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.). I ) 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.). Lend'er's Lender's WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate cf consent to self -insure for workers' compensation, as provided for by Section 3700 cf 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: MID-CENTURY INSURANCE COMPANY Policy Number: A09461819 _ 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 asto 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. Date: / IJ(o Applicant: WARNING: FAILURE TO SECURE WORKERS' COM SATION 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. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the 3uilding Official 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 Ciy of La Quinta, its officers, agents, and employees for any act or omission related to thework being performed under or following issuance of this permit. 2. Any permit issued as a result of this applicat on 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 cancella-ion. I certify that I have read this application and stats that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to ter upon the above-mentioned property for inspection purpo:es. Date: t �� Signature (Applicant or Agent) Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: LIFETIME PATIOS P 0 BOX 5806 LA QUINTA, CA 92248 BPAT2016-0105 80595 VIA TERRACINA 777260011 EARLE RESIDENCE / PATIO COVER $1,881.00 Owner: JEFFREY EARLE 736 SILVER SPUR RD ROLLING HILLS EST, CA 90274 Contractor: LIFETIME PATIOS P 0 BOX 5806 LA QUINTA, CA 92248 (760)772-0013 Llc. No.: 770843 Date: 11/8/2016 Detail: INSTALL 11'X 19' WEATHERWOOD SHADE STRUCTURE - OPEN LATTICE. PER 2013 CALIFORNIA BUILDING CODE. THIS PERMIT DOES NOT INCLUDE ANY ELECTRICAL. FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PATIO COVER, STD, OPEN 101-0000-42404 0 $101.84 DESCRIPTION ACCOUNT QTY AMOUNT PATIO COVER, STD, OPEN PC 101-0000-42600 0 $100.32 Total Paid for PATIO COVER / COVERED PORCH / LATTICE: $202.16 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $0.50 Total Paid for STRONG MOTION INSTRUMENTATION SMI: •$203.66 $0.50 Bin # City of La Quints / Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # / 4 Project Address: $6545 le rul Owner's Name:, 1/" Q A. P. Number: Address: -%3(0 1 v -Spur Legal Description: City, ST, Zip: 1?0' ` h i e C Contractor:/ /FET)>< j 0S' Telephone: lID — _ 5 3 %Q WON ARM Address: �� QX �ga� Project Description: GPen e'a' tru City, ST, Zip: QV/NT/� Telephone: 7/p0 - 77� -/�a0 /3 ` - �! W e r State Lic. # : "%708 T 3. City Lic. #:.3aS$ d l ► �, ` (,,� Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo State Lic. #: Name of Contact Person: ��"/�s / Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 7�0�'lp6�j '� .%� Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING. PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Energy Cafes. 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 Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '`" Review, 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 Total Permit Fees Mountain View Country Club Homeowners' Association c/o Albert Management, Inc. PO Box 12920, Palm Desert, CA 92255-2920 760.346.9000 760.346.9997 October 25, 2016 Jeffrey Earle 736 Silver Spur Rd Rolling Hills Estate, CA 90274 RE: Property located at: 80595 Via Terracina, La Quinta, CA 92253 Account # 101403040 - Architectural Approval for: General Construction Dear Homeowner(s): Please consider this written confirmation that the Architectural Committee has approved your application for General Construction — the installation of a weather wood shade structure with the following condition: 1. The supporting posts must be painted the same color as the existing posts. The CC&Rs provide the Architectural Committee with the duty and responsibility to review all applications requesting additions, alterations, improvements, or modifications to the exterior of his/her residence, residential lot, and/or the common area and to ensure that the architectural applications�comply with the Architectural Application Guidelines and Procedures and comply with the Association's Governing Documents and are consistent with the overall conformity and harmony of the original design and the aesthetic beauty our community. We thank you for your cooperation in following the Architectural procedures. Please complete the enclosed Notice of Completion and contact our office so this project may be inspected and signed off by the Architectural Committee. If applicable, any refundable deposit returned after final inspection. Should you have any questions please reach out to your point of contact, Cardinal Ambrose, CCAM, CMCA, AMS at 760.346.9000 or by email at cardinal.ambrose@albertmst.com. Sincerely, On behalf of the Architectural Committee Mountain View Country Club Homeowners' Association Association Manager Cardinal Ambrose, CCAM, CMCA, AMS cc: Architectural Committee Side Property Line Rear Property. Line / Golf Course Beyond t �2-PoST N6A06-P— 3 I<8 A o.oa� 2 CITY OF LA QUINTA Eiw,.lil._! ING & SAFE -P( DEPT. AIPPR0 �- FOR CONSTR TION DATE jl le ,v i Jeff Earle Res. 80595 Via Terracina La Quinta, Ca 92253 310 490 5320 North .&A Existing WeeMerwood Open lattice Shade Structure. Siennaword color Side Property Line Driveway Propsed attached Weathemood Open Lattice Shade Stnrcure. Siennawood color.l l' x 1e' To he attached as an extension \ot the existmgto existing stnrdure. e 45- Via Terracina 9/16/16