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09-1004 (PAT)P.O: BOX 1504 78-495 CALLE TAMPICO . LA QUINTA, CALIFORNIA 92253 Application Number: -09-00001004 Property Address: 78790_ WAKEFIELD CIR APN: 604'-433-014-71 -23995 - Application description: PATIO COVER - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4682 Applicant: Architect or Engineer: . BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: GENE HENRY 78790 WAKEFIELD CIRCLE LA QUINTA, CA 92253 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Professionals Code, and y License is in full force and effect. Licenses:/C51 LicenseNo.• 449379 Date: �` ® rector: OWNER -BUILDER D C RATION I.hereby affirm under penalty of perjury that I am exempt from the C tractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, priorto its issuance, also requires the applicant for.the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 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 applicantto a civil penalty of not more than five hundred dollars ($500).: ( I 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he of she did not build or improve for the purpose of sale.). l _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of .perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: - Lender's Address:. LQPERMIT Contractor: LA QUINTA PATIO COMPANY 40133 CALLE LOMA ENTRADA BERMUDA DUNES, CA 92203 (760)863-4335 Lic. No.: 449379 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 9/16/09 ------------------ WORKER'S COMPENSATION. DECLARATION hereby affirm under penalty of perjury one of the following declarations: ' _ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided 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 .insurance carrier and policy number are: Carrier SOUTHERN 'INS Policy Number WSII002541901 _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,' and agree that, if I sh d become subject tote workers' c pensation provisions of Section Sys 3700 of the La or C , 1 shall fo i co y with t provisions. D` 1 icant• WARNING: FA URE TO SECURE WORKE ' COMPENSATION C ERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND - DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT - .IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1.: €ach PQr§9n upon whose behalf this agulicatian is made. each geraQn at whose request and for whose benefit work is performed under or pursuant to any permit issued as a.result of this application, 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. 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 permit to cancellation. - 1 certify that I have read this application and state that the above information is correct. I agree to omply with all city and county ordinances and state laws relating to building construc ' n nd hereby authoriz presentatives - D�of t �iyc�ou) ty to enter upon eabove-mentioned grope or inspe rpos s v / v gnature (Applicant or Agent): Application Number i . . . . . 09-00001004. Permit . . . PATIO COVER PERMIT. Additional desc . Permit Fee 72.00 Plan Check Fee 46.'80 Issue Date . . . . Valuation . . . . 4682 Expiration Date.: 3/15/10 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 THOU- BLDG 2,001-25,000 27::00 ---- Special Notes and Comments 2 SOLID ALUMAWOOD SHADE STRUCTURES", 1 @ FRONT ENTRY AND 1 @ REAR OF 'HOME. 2007 CODES E35.2 £' f -------------------------------- Other Fees . -------------------------------------------- . . . BLDG STDS•ADMIN :(SB1473) 11.00 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 1.50 .00 .00 1.50 Grand Total 120.30 .00 .00 120.30 LQPERMIT Bin # City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico Permit # La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: 78.7 7O Owner's Name: Address:7� :W: A. P. Number: City, ST, Zip: Lf QV I NC1+ (?,4,Z Z $3 Legal Description: Contractor: L � U(iV �� p�-r1 0 �� Telephone: MAMM Address: 40 - (3 3 C1+ LL 1: O M A N-rg-A-bA Project Description: L City, ST, Zip: I N 7 I O C A- RL D -� f}-L vv[n A-1.t> Telephone: 7 - S 7 V'q 3 -city � 37 S 4 oti c State Lic. # : Arch., Engr., Designer: i� Address: City, ST, Zip: Construction Type: Occupancy: Telephone: Project type (circle one): New Add'n Alter Repair Demo #:C:: State Lic. #:q Sq. Ft.: 3 Stories: #Stories: Units: Name of Contact Person: 7 U -7 - -2 Lt _ / D Ai 3 Estimated Value of Project: Telephone # of Contact Person: NOT WRITE BELOW THIS LINE APPLICANT: DO PERMIT FEES H Submittal Req'd Rec'd TRACKING Item Amount Plan Check submitted Plan Sets Plan Check Deposit Reviewed, ready for corrections Structural Calcs. Plan Check Balance Called Contact Person Truss Calcs. Construction Plans picked up Energy Calcs. Mechanical Plans resubmitted !"" Flood plain plan • 2"' Review, ready for corrections issue Electrical Grading plan Plumbing Called Contact Person Subcoutactor List S.M.I. Plans picked up Grant Deed Grading Plans resubmitted Approval H.O.A. App Developer Impact Fee - Review, ready for correctionstissue IN HOUSE:- A.I.P.P. Planning Approval Called Contact Person Date of permit issue Pub. Wks. Appr School Fees "Total Permit Fees