05-2494 (PAT)I
P.O. BOX 1504.
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 '
Application Number: C:"-05'00002494
Property Address: 07983-4-xV2'ENT2_ —,- -
APN: 609-380-998-30 -293232-
Application description: PATIO COVER - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 7900
Applicant:
Architect or Ei
BUILDING & SAFETY DEPARTMENT.
BUILDING PERMIT
Owner:
SARA •GONZALEZ
79834 VIENTO DDRIVE
LA QUINTA, CA -.92253
Contractor:
HAWKINS CONSTRUCTION
77850 DELAWARE PLACE
PALM -DESERT, CA 92211
(760)413-3017
Lic. No-: 510847
VOICE (760) 777-7012
' FAX (760) 777-7011
INSPECTIONS (760) 77777153
Date: •.6/21/05
W
- LICENSED CONTRACTOR'S DECLARATION
J
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby.affirm under penalty of perjury one of the following declarations:
'Section 7000) of Division 3 of the Business and Professionals 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 provided
License Class: 131 'Sense D•:- 510847
" -
ontractor:
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
OWNER -BUILDER DECLARATION ..
insurance carrier and policy number are: • `
I hereby affirm under penalty of perjuryat I am exempt from the Contractor's State License Law for the -
Carrier EX MPT Policy Number EXEMPT
following reason ISec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
,4 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, become subject to the workers' compensation 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 I should become subject to the workers' compensation provisions 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 shall forthwith compl ith those provisions. -
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).:
ate scant:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is riot intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORK S' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND 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 ($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, 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 anowner of
conditions and restrictions set forth on this application.
- property who builds or improves thereon, and.who contracts for the projects with a contractor(s) licensed
1 . Each person upon whose 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. , B.&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 for any act or omission related to the 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 if work is not commenced
' - - -
within 180 days from date of issuance of such permit, or.cessation of work for 180 days will subject
CONSTRUCTION LENDING AGENCY. -
- permitto cancellation.
• •1 hereby 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 that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).- - -
- city and county ordinances and state laws relating to building construction, and hereby authorize representatives
• -
of this unty to enter upoathe above-mentioned property for inspection pur ses.
Lender's Name:'
-
77
/�
A
ate. 7 Signature (Applicant or Agent):
Lender's Address:
LQPEnIIT
Application Number . . . . 05-0.0002494
Permit . . . PATIO COVER
PERMIT
Additional desc .
Permit Fee 99.00
Plan Check
Fee•.
64.35
Issue Date
Valuation
Expiration Date.. 12/18/05
.7900
Qty ' Unit Charge Per
Extension"
BASE
FEE.,
45.00
6.00 ..9.0000 THOU BLDG
2,001-25,000'
5'4'.00 ..
Special Notes and Comments
594 S.F.-ALUMAWOOD PATIO COVER,
PER,
APPROVED PLANS
----------------------------------------------------------
i Other Fees STRONG MOTION (SMI)
- RES
.79
' Fee summary Charged
Paid Credited
`Due
Permit Fee.Total 99..00
.00
00
99.00
Plan Check Total 64.35.
.00' %"
.00
64.35
Other Fee Total 79
.00
.00
.79
Grand Total 164.14
.00 .:00
164.14
r
" LQPERMff ..
* 4 ,7
Gott
0 Yj
Coti7N-.QcT. Z�✓Z ;
71 gs-a AMu-4,4ell