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06-0911 (PAT)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011' LA QUINTA,. CALIFORNIA 92253 BUILDING.& -'IVy EPARTMENT INSPECTIONS (760) 777-7153 BUIILDiNG PERMIT, t Date:: 3/06/06 Application Number: X06 0-0000911 \ Owner. Property Address: 81244 VICTORIA LN HUMPHREYS R.C. i APN: 764-270-999-137--300"234- - W � 81244 VICTORIA LANE Application description: PATIO COVER RESIDENTIAL ®' LA QUINTA, CA 92253°. Property Zoning: MEDIUM HIGH DENSITY RES. Q Application valuation: 4908 Contractor: Applicant: Architect or Engineer: D PELLETIER ' PATIO: 79275 DESERT STREAM DR LA QUINTA, CA 92253 / (760)27.. Lic. No..:: 860 860958 LICENSED CONTRACTOR'S, DECLARATION. _ - - - WORKER'S COMPENSATION DECLARATION 'I hereby affirm under penalty of perjury that,) a7inder provisions of Chapter9 (commencing with • I hereby affirm under penalty of perjury one of the following declarations: Section 70001 of Division 3 of the Busines ns Code,,and my License is•in full force and' effect. I have and will maintain a certificate of consent to self -insure for workers'- compensation, as providedLicense Class: B• icense N 860958 ' for by Section -3700 of the Labor Code, for the performance of the work�for which this permit is e� i d _ - l - — issued. -Zeta: tractor: 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 _ OW fro R -BUILDER DECLARATION - insurance carrier and policy number are: I hereby affirm under penalty of perjury tha empt m the Contractor's State License Law for the Carrier EXEMPT Policy Number EXEMPT following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to - I certify that; in the performance of the work for which this permit, is issued, I shall not employ any construct; alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to be t to the workers' o tion laws'of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of, the Contractor's State - and agree that, if 1 should be a subject to a workers' co ensation rovisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or - 3700 of the Labor Code, I all forth 'th co ply with thos provision that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by . Q r ,, any applicant for a permit subjects the applicant to a civil penalty of not more than. five hundred dollars ($500).: ate: 17 ��/C ^ppliC 1 _ I 1, a§ 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 WARNING: 'FAILURg TO SECURE WORKERS OMPE ATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply town owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENAL ND -CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or.herself through his or her own employees, provided that the DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS.PROVIDED FOR IN - improvements are not intended or offered for sale. If, however; the building or improvement is sold within - SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - • 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.). - - APPLICANT ACKNOWLEDGEMENT 1 _ 1 1, as owner of the property, am exclusively contracting with -licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts fo( the projects'with a contractor(s) licensed 1 . Each person uponwhose behalf this application is made, -each person at whose request and for .. ' pursuant to the Contractors' State License Law.).. - whose benefit work is performed under or pursuant to any permit issued as a result of this application,, (_ 1 I am exempt under Sec. , 8.&P.C. for this reason 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 forany act or omission rel a work being _ - - - performed under or following issuance of this permit. - Date: Owner: 2. Any permit issued as a result of this application becomes null and void work is not c mmenced. .within 180 days from date of issuance of suc cessation work for 180 ays will subject CONSTRUCTION LENDING AGENCY "' permit to cancellation. Thereby affirm under penalty of perjury that. there is a construction lending agency, for the performance of the _ I certify that I have read'this application and state tha the above informa on is torr . I agre o comply with all work'for which this permit is.issued (Sec. 3097, Civ. C-.). - - .city and county ordinances and state laws relating t uilding constructi , and hereby author a representatives of thisc ty 7 enter upon t above-mentioned pr party f specs' urposes. m Lender's'Nae:. ��nature (Applicant or 7 / 0' - Lender's Address:• - - - LQPERMIT'- - - - - ..��• ` � , ac,: � k^� _ _`* - 1•• � r a 1.`'� wiry , r} ,, ,•'. • ..• •} sp .•P'c.. s '�� T<, :. .. .'aY. •�' �w� -,. r• �4' '.a .r ' j \: ,t Application Number'- 06-00000911 ` - - r• ♦ +�• � �"Y.".> PermitPATIO COVER'PERMIT ,C, f + tiFee a+, «: Additional des -c, ,'' ,•. ti he"k� '0Permit :Fee 72.0 Plan. r 46.80 .r ` •Issue Date -Valuation • 4908 J ' - ExpirationDate. =9/,02/06 Qty Unit -Charge Per, -Extension - - - BASE FEE 4� ,�. 45.00. r 3.00 9.0000 THOU BLDG_ 2,001-25,000 �+ y 27.00.' ------ -------- -. -- -- - - -- -- ------ ----- ----------------.------ Special Notes •and Comments` ' \ 369 S.F. ALUMAWOOD LATTICE,PATIO COVER --------------------------- ---Other ----STRONG -.50 Fees, --�- .-.' MOTION (SMI) :FRES_---- ., -- + Fee summary- Charged Paid;Credited D . ------------ ---------- ----- ----- `- ------------ Permit .Fee Total 72.00 '.00 r 00" 72.00 • ,,, Plan Check Total.. 46.80 00' :00 46.80 y Other Fee Total.50 00 00 ,x:50 �. `Grand•:Total• 119:.30. .001. .00 -119.30,. w is -.' ♦ • �1 ` • .. .. .. t .. . l , rr-: . , e ' ,. - ., YY. } es, r � -. + ai .t y• n , \.•�- • - •t,r •J * � ♦i.. _' ` • t ••i - i .. i• P E 7 - {ry .. LQPERMIT i ' ay • - }, +--t v • v' ' •. + , . ' ,� s 't . _ �y� +tir ;"! 4• fa �-� _*F� s • , '"! t*-i� �+` t*.J � . : [+';n; �`y :"'`. ♦ s rie 4'-` .r - - ta. +' t � +,r � f. ' ,} a i% '' �.Y ♦ �':? fr- * + I ,� . s �� i •�� .'s •` { K ' r` t, ti,�� i1F, = �r-4T.'.�}� -it .i' Ci1Y~®F Lit( U9NTA :t �r. A RE INSPECTION 'FE 0F:*,T 0x F T,. E pie . 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