9803-065 (PAT)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of p`erju'ry that I.am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 Jthe Business and
Professionals Code, and my License is in full force and effect.
LicensW Lic. Class Exp. Date {
�3
tDate _ '-�tl Signature of Contractor
(
1 OWNER -BUILDER DEC AFdTION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) .1, 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
,,,1,perf �ance of the work for which this permit is issued.
oOf .�`KI have and will maintain workers' compensation insurance, as required by
Se tion 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 Policy No.
(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 shall forthwith comply with those provisions.
Date: Applicant
Warning: Failure to secure Workers' Compensation 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 a thorize representatives of this City to enter upon
the above -,mentioned prope y for inspection purposes.
Signature (Owner/Agent)' "" Date t j
(b=1 1Llf TRTOL
BUILDING PERMIT PERMIT# CON OL#
DATE VALUATION LOT �1;0.�-® TRACT
^`
JOB SITE
APN
ADDRESS
79.240 VICTORIA DRIVE
OWNER
CONTRACTOR/DESIGNER/ENGINEER
STAN KENT
OWWERIBUILDE,R
79-240 VIC"TOR1 A DRIVE '
A QUiN A OA 92753
g CBL#
v v
USE OF PERMIT
)9'
QP,E LA'1 TiCYE PATIO COVE12PAD
R 13 1998 .
PORCIi1/F'AT1O 131.00V ;
ESTIMATED COSTS OF CONSTRUCTION
1,742.311
VERA11T TETE SUMMARY
'
PLAN CHECK Fig F 1,01-000-439-318 $26.65
CONSTRUCTIONFEE EE. 10.1-000-41 S-000 $41.00
STRONG MOTION( VETS-.RES10 101-0001-241.-0.00 $,50
t•
SUB -TOTAL CONSTRUCTION AND P.LAN CHECK
�faS.15
LI SS :PRIG -.PAID VEL-,
TOTAL PERMIT (BEES DUE NOW
S".1:5
RECEIPT
DATE BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
TINSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
Framing _
F.A.U.
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final z3 Q —
BLOCKWALL AP ROVALS
Final
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
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
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.1.
Smoke Detectors
Temp Use of Power
t
_ Final
Utility Notice (Perm)
COMMENTS:
c�oF°wSw' 78-495CALLE TAMPICO LA QUINTA; CALIFORNIA 92253
TELEPHONE (760) 777-7012 FAX (760) 777-7011 i
OWNER / BUILDER INFORMATION
Deari Property awnec:
An application fora building permit has been,submitted in your name listing yourself as the, builder of the property
improvements specified:
Foryour protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property.owners unless they are personally,performing,their,
own work; If your work is being performed by someone other than yourself, you may protect yourself from possible
liability, if that person applies for the-proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
!"from.the City or County. They are also required by law to put their license number.on aJl permits•for which they
apply.
If•you plan to do your own work, with the exception of variuus-trades that you,plan to subcontract; you should be— ~'
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and 'the work (including materials .
and other' costs) is $200.00 or more for the entire' project, and such persons. are not -licensed as contractors or
subcontractors; then you may be an employer.
If you are'an employer, you must register with the -State and Federal Government as an employer and.you, are subject
to several obligations including State , and Federal " income tax withholding; federal social security taxes, worker's
` compensation insurance, disability insurance costs and.unemployment compensation' contributions.
' There may be; financialrisks for you if you do not carry out these obligations, and these risks are especially serious with`
respect to worker s compensation insurance.
For more specific information about your obligations under.Federal Law, contact the Internal-ReveAue Service (and if
you 'wish .'the U.S. Small Business Adminstration): For more specific information about your obligations under Stare
Law, 'contact the Department of Benefit-Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are'not licensed contractors are allowed to perform'their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors-is to_.secure an," Owner i. Builder". building-
permit,
uildingpermit, : erroneously implying that the property owner 'is ,providing his or her own labor and material personally. ,t
'Building-permits-.are not, required to be signed • by property owners unless they,are performing 'their own work
personally' ,
Information about licensed contractors maybe obtained by contacting the Contractors' State License Board in your,..
community of at 1020 N. Street,. Sacramento, California 95814. t
- t
Please complete and return the enclosed owner-builder.verification form so that we can confirm that yoti are aware of
these matters. The build ing.permit wilI*not be issued until-, the, verification is returned.
•'Very truly yours,
CITYOFLYA_QUINTA
DEPT. OF.BUILDINGAND'SAFETYi x a ��"t ',' ,'•• t " '� r,,.. l r
78-495 Calle Tampico
La Q�uinta; CA 92253
Q7. 0) 777.7012'
(,150) 71 �a i
WNE 'S SIGNATUREY DATE.
• ,� fes•/f' yy--�� : ' .. �' ,�K, ��
2¢0 .�.4°.cCi�'rto.
ROPERTY ADDRESS
PERMIT NUMBER(s)
LDE
FTR SIZE AND SPACING
2x_2_x 9 e 16 0,L
ROOF PITCH
A-
SPECIFY. ROOF;NG ANc- SHEAT-ING ;R ':PEN 17CE
(SEE ROOFING NOTE ON REVERSE)
/
CONTINUOUS LEDGER
(SAME SIZE AS RAFTERS)
HEADER SIZE
tl
T' AND -L'r STRAPS
6"x6"xl"xi/8" WITH
z
I -(4) 16d NAILS OR BOLT ..
I
Z
µy
Ll
�2
6
0
RAFTER SPAN:
_
�
� POST SPACING:__�A
J 'I----
O.H.
w--
v
y
o •
c f�
Z
OVERALL LENGTH:
a
OVERALL LENGTH:—_—� D
—/---
'
POST SIZE:. _ X v---
co
1n
'
REAR SETBACK
SIDE SETBACK
I,
(4'x4' MIN.)
2000 P.S.I CONCRETE FINISH GRADE
L_ J
FINISH GRADE I L� I I
MIN. 12" x 12" FOOTING
L_ J L_ J
F cacti ' off' 9Fvc2
crtb
12" BELOW GRADE
L 7504a 14
0111—�
//
?%l�y`�13.
PROVIDE 1" CLEARANCE
BETWEEN POST AND ,
CONCRETE
NOTE:
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4" x 5 LAG SCREW THROUGH FASCIA INTO EACH RAFTER
TAIL.
.
U—STRAP OR ANGLE
3/8" x 5' LAG SCREWS INTO STUDS AT 16" O.C.
NON—CORROSIVE PLATE -
GRApE
(4)— 16d NAILS
OR BOLT
r•
U—STRAP OR ANGLE
(4)— 16d NAILS
OR BOLT '
(JAIL RAFTER TO BLOCKING PROVIDE 1" CLEARANCE
BETWEEN POST AND
-CONCRETE
_ II II
BUILDING. DEPARTMENT .APPROVAL BELOW II III
CITYF LA• U INTA ANCHOR BOOT CONCRETE) 7" MIN: INTO CONCRETE)
• i
BUILDING & SAFETY DEPARTMENT'-. .TYPICAL PATIO COVER
CONDI 1 IC+',IAI.i v
1 /� /� �• ['� C- +�� DATE OF APPLICATION '
ACCE'P'TED F- l (b �.%,''.f'w ..y ` s' 1 �'i"-h j OWNER'S NAME
i - CU 6.J� t% I i -l) iii! ��•:? I..i_�'i•i`:.) ti� .i;,: 'h � 8
STREET ADDRESS
s m CITY, ST 'ZIP
AND ALL APPLICABLE CODES
2 l- TELEPHONE
AYE e I' " �� BY H.OA APPROVAL