07-0687 (PAT)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
Date: 4/17/07
Application Number: 07-00000687 Owner:
Property Address: 50350 .VISTA MONTANA BOB HERRERA
APN: 772-260-012- ; - 50-350 VISTA MONTANA
Application description: PATIO COVER - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: VERY LOW DENSITY RES D /A1 jj
Application valuation: 13194 IJ
Contractor: APR .1 2�� 1
Applicant: Architect or Engineer: - . DURKTON, MARK
69683 PLEASANT GROVE
CATHEDRAL CITY,. CA 92234 CITY OF LAgUINTA
(760) 328-7276 FINANCE DEPT
Lic. No.: 505442
LICENSED CONTRACTOR'SDECLARATION - 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 perjuiyone of the following -declarations: -
Section 7000) of Division 3 of the Business and Profe aI 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 L nse No.: 505442 for by Section 3700 of the Labor Code, for theperformance of the work for which this permit is
issued.
Date: Contractor: _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
-- - - '--'-"V Code, for the performance of the work for which this permit is issued. My workers' compensation '
DER DECLARATION ,. insurance carrier and policy number are: -
hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EXEMPTPolicy Nu 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 c for whit his 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 beco a subject to the orkers' 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 - to the wor ers' compensation provisions of Section -`
.License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code) or . - 3700 of the Labor C de,- sh t h c ly w' h those
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 acivil penalty of not more than five hundred dollars ($500).: Date^Applicant: -
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the woik, and
the structure is not intended or offered for sale (Sec. 7044,. Business and Professions Code: The WARNING: 'FAILURE TO SECURE ORKERS' COMPENSATION COVERAGEIS UNLAWFUL; AND SHALL
Contractors' State License Law does not apply to an ownerof 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 COSTOFCOMPENSATION, DAMAGES AS PROVIDED FOR IN
- -improvements are not intended or offered for sale. If, however, the building or improvement is soldwithin 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 ProfessionsrCode: 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 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 for 180 days will subject _
CONSTRUCTION LENDING AGENCY. permit to cancellation.
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' correct. I ag ee 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, nd hereby auth rize representatives
- - of this county to enter upon the above-mentioned prope ty for lec,' n urposes.
.Lender's Name: _ t�y��.i..un�
Date�cr r7ct� - "Signature (Applicant or Agent): 1
...Lender's Address: - - - _,�_�-� -_ - -VW
LQPERMIT ' .
Application Number . . . . . 07-00000687
Permit . . ELEC-MISCELLANEOUS
Additional desc .
Permit.Fee 18.00 Plan Check
Fee
4.50
- Issue.Date Valuation
. . .
. 0
Expiration Date 10/14/07
Qty Unit Charge Per
Extension
BASE`. FEE
15 -0 0
4.00 .7500 PER ELEC--DEVICE/FIXTURE-1ST 20
3.00
Permit' PATIO COVER PERMIT
Additional desc .
Permit Fee 153:00 "Plan Check.Fee
99.45
Issue Date 'Va-luation
13194
Expiration Date 10/14/0.7
Qt Unit
Qty Charge Per
Extension '
BASE FEE
45.00, _
12.00 9.0000 THOU 'BLDG 2,001-25,000
10`8 00
Special Notes and Comments
' TWO TRELLIS ONE IN.BACK YARD AND .
CABANAAp r i 1 16', -2007,10:29:59 AM,
.`J j ohnson
-----------------------------------
Other Fees• .`. . . . . . . STRONG MOT -ION (SMI)
-*,RES
-
-1.31
Fee .summary Charged Paid Credited
Due
--
Permit Fee Total 171.00 00
00
-
171.00
Plan Check'Total 103.95 .00
.00
103.95
Other Fee Total 1.31 00
00
1.31•
Grand. Total 276.26 .00
.00
276.26.
LQPERMIT -
_
Bin #
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Permit ff
(�G
Project Address: -SID Sep
A. P. Number.
Contractor: MQ&
Address: 3 `�
City, ST, Zip: C
Telephone:
State Lic. #
Arch., Engr; Designer:
Address:
City; ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal I
Plan Sets
Structural Cala.
Truss Cities.
Energy Cates.
Flood plain plan
Grading.plitn'
Subcontactor List'.
Grant Deed
R.O.A. Approval
IN ROUSE:-
Planning Approval
Pub. Wks. Appr
School Fees
City Of La Quinta
Building U Safety Division
P.O. BOX 1504, 78-495 Cape Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking.Sheet
h owner's Name: jog e
Address:
dr
City, ST, Zip:
lnL Telephone: 7) . g) h• &2 6 2—
Project
Description:
�
1 V� baa QgIrCA - 4%, �n
ra
I
Total Permit Fees
. VCS IDUF,�
3�P 16 RCrL
31�I0% �. �1 MVED
3�2z P(4 -j i2t=C
Construction Type:
Occupancy:
Project type (circle one): New Add'n Alta R epair Demo
YV F TJY1
Sq. Ft.c
#Stories:
#Units:
- -
Estimated Value of Project:
APPLICANT:
DO NOT WMM BELOW
THIS LINE
Reed
TRACT MG
.
PERMIT FEES
Plan Check submitted
�j
item
Amount .
Reviewed, ready corrections
Plan Check Deposit
Called Contact P
Plan Check Balance
Plans Picked up
0
Construction
Plain resubmitted
Mechanical
T' RevltW, ready for eorrecti a /� 0
Electrical
't
Called Contact Person
b
Plumbing
Plans picked up I
SALL
Plans resubmitted
.
Re"M, ready for. correctlonYnsae`
Developer Impact Fee
Called .Contact Person
A.LP.P.
Date: o[ permit issue
ED.
/
Total Permit Fees
. VCS IDUF,�
3�P 16 RCrL
31�I0% �. �1 MVED
3�2z P(4 -j i2t=C
07 -
Project Project#
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CITY OF LA QUIN
BUILDING & SAFETY DE
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