0304-120 (PAT)LICENSED CONTRACTOR DECLARATION
I hereby affirm unde .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 )4p. Date
.690373. B Oil
,D ate of Contractor •� c ? :.
t.
OWNER -BUILDER DECLARATION
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). -
O I am exempt under Section B&P.C. for.this reason
Date t 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 S.E01014 1NSUR-ANCM ' POlicy No. W92 09.6322
(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 permitis issued,
1-6all 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
�6de, 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 authoriize,representatives of this City to enter upon .
the above-mentioned property fo� spectlon purposes.
�•*�.. X L�".�`'_".' ice' i 7
Signature (Owner/Agent)'' bate
- -B_ UILDING PERMIT PERMiTJf .
03(W-120
DATE VALUATION LOT - TRACT '
JOB SITE
APN
ADDRESS q
OWNER
CONTRACTOR/DESIGNER/EN (NEER
ARLE3a�.1 aTZ
;SOB.00143TRUC o
79.125 VIC* VR.A�i:E� ( ..:
. 69453:ROCKW00D i:IR,... .
LA QT'WTA CA 92233
PALIA LF_SERT CA 922-61
?60)349-•337:1 CBL# 2246
USE OF PERMIT
1.0 X 5:1 BUILT -UP -PATIO P'Li�J'17R PER C1•; Y �,�"!'.P,NYat RD.
POR.C1T(1'ATIC3 0.11p'sy
RFUMATFi) CO Q' OF C 0XS'MU(,`2 0N
PMN CHECK li'F.E 1:0 9.318 3£✓l,�,g
CON5T.RUCTION IEE 101=000-418-000 $99.00
3' °1$.ONG MOTION FEE WID '101.000.241.000 4172 .
•
.7.0,
�y. T}4pf�•� ry'�' .ry ! /� SVq�t�p�<,, �. v
,T, t7v,� 1�T 6 ��. tqe 74+/q �/
47i.1i]"•d.`ii.t`�L:V�9 Y:1h�.�4iilE�•�h+aC.it7A7.6`,4./9i'H k:.d•J�[-.4,.AA.
�} � a !�q
..1p�i�+•h.1�/
- ;C:t 33 IJRF,. IPAID F
$0,00
FV D
$164.07,
APR: 1.0' 2003
CITY OF LA QUINTA
FINANCE DEP
RECEIPT
DATE ��
DATE FINALED
INSPECTOR '
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
' 5
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
p
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 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
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)
RAFTER SIZE AND SPACING SPECIFY ROOFING AND SHEATHING OR OPEN lAT%E _.
(SEE ROOFING'NOTE ON REVERSE)'
-- --- /
► ROOF PITCH
-.�
----------
00NTINUOUS LEDGER
(SAME SIZE AS RAFTERS)
.
L
HEADER SIZE
tj X2
? AND. •L' STRAPS
6':6'■1'■1/8" WITH
I
W
(4) 16C NAILS OR BOLT
-,
RAFTER SPAN: Lo_
_l
—
_
J
"
121/
O.H.
;
POST SPACING
1)
W
O.H.
6
OVERALL LENGTH: ..
c
a
IF
OVERALL LENGTH ✓
3
'
/o--_
POST SIZE. .��___
REAR SETBACK .
I
SIDE SETBACK
(4'.4" MIN.)
,
2000 P.S.1CONCRETE --+i
FINISH GRADE
FINISH GRADE
L_ J
L– J MIN. 12 02- FOOTING • I 1
12' BELOW GRADE L–J
PROwDE 1" CLEARANCE
BETwEEN POST AND
NOTEc . _ CONCRETE -
OPEN LATTICE PATIO COVERS MAY -BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/4- . x 5' LAG SCREW THROUGH FASCIA INTO EACH RAFTER TAIL.
r
U -STRAP OR ANGLE
a.3/8' = 5' LAG SCREWS INTO STUDS AT 16•• D.C. NON -CORROSIVE PLATE pE
CONTINUOUS LEDGER
r'
III ILII .
• • —_ _1! OR 80LT 6d NAILS
U–STRAP OR .ANGLE
(41 16d NAILS
OR BOLT
JOIST HANGER OR SOLID BLOCKING
•
NAIL, RATTER TO 'BLOCKING
PROVIDE .1 CLEARANCE
i BETWEEN POST AND
CONCRETE
. I
BUILDING DEPARTMENT APPROVAL BELOW VIII
r c4
O ' w IQ (NTA ANCHOR BOLT_ (EMBED
F
l� f- �;,/1 u ? r 7" MIN' INTO CONCRETE)
"BUILDING & $*EY DEPT;
APPROVED PATIO COVER
FOR CONSTRUC NJ DATE OF APPLICATION
i
- • OWNER`S NAME
DATE,. BY .
.,
STREET ADDRESS
r .---------------
CITY ST • ZIP
TELEPHONE
H.O.A. APPROVAL
f c
w RAFTER SPAN 'TABLE . f �: �. .00O ' CON 4
�• c c,, ; s, .;ALL CONSTRUCTION SHALL CONFORM
GrRADINGr RULES. S r O
PS 20-70 v .� /�o TO THE .PROVISIQNS OF THE`:
(FEET" & INCHES) OZ A .) 0 A, OJ,�`'' w
100 oo�,: oo� •���P 2001 CALIFORNIA' BUILDING CODE. ' P
-
?�`�c' / OQ ; ` SUPPLEMENTAL •NO TES:
2x4
1D1
124"
'
0.
,9.-6.•
T— 3"
FIR NO.. 1
8 —,�,.
NO: 1
i
SPAN
2z6"
t t -
16" O.0 J
24" "
32
i
15'=0"
.14!-0"
10`-9"
13'-0"
12'-6"` t t'-6" 8'-9"
10'-6'
`10'=0" 8'-6" N/A I
N/A
' 4x8
L? '.-0"
2z 8 '
16" O.C.
24"" "
`32",
18'=0"
17'-0"
4x10
10'-0".
15'-6" — t 1_:--0", D
3`—G" 1
13'-0" 1 11'-6" I N/A I.
N/a-
C, F
14'-p"
LATTICE 'RO0F
" ' BUILT-UP
ROOD
HE.. _RS
I. HEADERS
DO! JGLAS
FIR NO.. 1
I DOUGLAS .FIR
NO: 1
S!==
1..4x4
SPAN
(SIZE
14x4.
SPAN
4x6
'8'—C"
4x6`
6'-0'`'
' 4x8
L? '.-0"
4x8
8, —0.. _.
4x•10
14'-0"
4x10
10'-0".
4x12 -
17'=0""
*4x1.2
6x8,'-
14'-p"
6x8 •
6x 10'
17'-0
6x 10
1 - 3