06-2580 (PAT)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-70.11
LA QUINTA, CALIFORNIA 92253. BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT -
Date: 7/06/06
Application Number: 06-00002580 Owner:
Property Address: 44290 VILLETA DR BRANSCUM CHARLES, ELVIN
APN: 604-144-027-233 -23269 - 44290 VILLETA DRIVE
Application description: PATIO COVER - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
r, Application valuation: 446.9
Contractor: O �
a
Applicant: Architect or Engineer: OUTBACK PATIO & SUNROOMS, INC
Y 1450 W 6TH STREET, #118
CORONA, CA 92882. JUL 0.6 2006
(951)778-9439
Lic.' NO.: 483069 CiIINOFLAQU1NTrA
FINANCE p�pT.
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 Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate-ofconsent to self -insure for workers' compensation, as provided
License Class: B C36 License No.: 483069 for by Section 3700 of the Labor.Code, for the performance 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
Code, for the perfor - of ork for which this permit is issued.. My workers' compensation
OWNER -BUILDER DECLARATION insurance carrie nd po • �mbera
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Auj
r - 1423157-2006 -
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that,Itha
gsho
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 i t 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 ag ahe workers' compensation provisions.of Section
License Law (Chapter 9: (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 f tply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by V aG
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date: pplicanv
» (_) 1, 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 KERS' PENS ION 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 PENALfi_ErMq6 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 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 ntractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improv th reon,•a d to con is 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' ate icense L w.l 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. f r his e 0 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 oft ' r
Date: —7-4-0 t0 O er: 2. Any permit issued as a result of this app: ation comes ull and id ' ork is not commenced
r .within 180 days from of is
f suc permit, or essation f ork for 180 days will subject
CONSTRUCTION NDING AGENCY • permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certifythatI have read this application and tate hat t ove infor tion i rrect. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws elating o buil in constru ion, a ere uthorize representatives
of this co nt to enter upon the above -me tinned p p r fo �nsp as.
Lender's Name:
Dater Signature (Applicant Agent):
Lender's Address:
LQPERMIT
r
'
Application Number 06-00002580
!
'Permit PATIO COVER PERMIT
,•
Additional desc
- -
_
Permit Fee 72..00 Plan Check•Fee
46.80 r
Issue Date . . . . - Valuation
4469
E.&jj 1'1 ui L l illi Datt_. 1102/07
- - - -
+ =.
QtyUnit Charge"•Per
Extension.
- BASE,FEE
45.00 r
.
.�
.3.0.0 9:0000 THOU BLDG .2, 001-25,000
27.00
---------------------------------_-
---------------------------
'Speci`al Notes and Comments
----------
336 S.F. ALUMAWOOD"SOLID PATIO COVER „
Other Fees . . . . . . . . STRONG -MOTION (SMI),- RES
.50'
Fee summary Charged Paid Credited
Due
Permit Fee Total,, 72.00 .00, :00.
72.00
`
Plan Check Total •46.80 .00 .00
46.80
Other Fee'Total .50 .00 .00
50,
'Grand Total 119.30 00 .00'
'119.30 ,
r
LQPERMIT-. M ..
- ; .. a "• ..-
r
- _ .. .
Bin #
City of La Qu[nta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit .#%�
�'
Project Address:
Owner's Name: ' e �u5
A. P. Number:
Address:447—q-0
Legal Description:
City, ST, Zip: A 1� A ZzS 3
Contractor:
Address:
Telephone: &o 3GZ> (o (% Q
Project Description:
City, ST, Zip:
73
Telephone:
; `A C f,(. -e C( ,
State Lie. # :
City Lie. #:
Arch., Engr., Designer:
Address:
PK oy V
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL: 3
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project. -6 ^
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading, plan
2" Review, ready for corrections/issue
Electrical
Subcontactor. List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'`" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees