13-1385 (PC)4 P.O. BOX 1504 �/ VOICE 760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT �` INSPECTIONS (760) 777-7153
BUILDING PERMIT v'
Date: 1/15/14
Application Number: 13-00001385 Owner:
Property Address: 79625 VISTA CORALINA LN LA QUINTA HOUSING AUTHORITY
APN: 600-020-054- - - "' - 78495 CALLE TAMPICO
Application description: PATIO COVER - COMMERCIAL LA QUINTA, CA 92253
Property Zoning: COMMERCIAL PARK -� —
Application valuation: 0 D
Contractor: p A,
Applicant: Architect or Engineer: OPTIMUS CONSTRUC I N L N 15 2014
440 WESTERN AVE #2 2
j G818)55E, 41 91 01 CITY OF QUINTA
(818) 5 5 0 - 8 411 FINANCE DEPT.
Lic. No 902939
LICENSED CONTRACTOR'S DECLARATION 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 Businel 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: B _ License-No.: 902939 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is - -
%� issued.
Dat 1 Cont as I n - - 1 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 workerscompensation
OWNER-BUILDER DECLARATION insurance carrier and policy number are:
hereby affirm under penalty of perju at I am exempt from the Contractor's State License Law for the - Carrier STATE FUND Policy Number 041050658813 .-
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 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 - r
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code,1 s#11 forthwith comply with 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).: Da C Applicants
(_ 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 WARNING: FAILURE TO SECURE WOR RS' COMPENSATION 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
( ) I, 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 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,
(_) I am exempt under Sec. B.&P.C. for this reason the owner, and the applicant, each agreesrto, 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 permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the 1 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 cons duction, and hereby authorize representatives
r - of this county to enter upon the above-mentioned property for ins ction purposes.
Lender's Name: —�
Datil_ Signature (Applicant or Age tl:
Lender's Address:
LQPERMIT
Application Number . . . . . 13-00001385
Permit ." . . PATIO COVER 2013
Additional desc TWO (2) SPECIAL DESIGNS
Permit Fee 263.12 Plan Check Fee
.00
Issue Date . . . . Valuation . . .. .
0
Expiration Date 7/14/14
Qty Unit Charge Per
Extension
2.00 131.5600 .EA MISC, PATIO COVER, SPEC
263.12
Special Notes and Comments
THREE (3) SUNAMI SHADE STRUCTURES AT
PLAY AREA AND ONE (1) SUNBOW STRUCTURE
AT POOL [ENGINEERED] THIS PERMIT DOES
NOT INCLUDE ELECTRICAL INSTALLATIONS.
-
.2010 CALIFORNIA BUILDING CODES.
October 31, 2013 8:37:31 AM AORTEGA
Other Fees BLDG STDS ADMIN (SB1473)
2.00
HOURLY PLAN CHECK
402.50
PLAN CHECK, PATIO COVER
331.76
STRONG MOTION (SMI) - COM
1 .50
Fee summary Charged Paid Credited
Due
Permit Fee Total 263.12 .00 00
263.12"
Plan Check Total .00 .00 .00
..00
Other Fee Total 736.76 .00 .00
736.76
-Grand Total 999.88 .00 .00
999.88
LQPERMff