BPAT2017-0010I ,i
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BPAT2017-0010
Property Address: 44065 CALICO CIR CIR
APN: 604091035
Application Description: PATTERSON / PATIO COVER
Property Zoning:
Application Valuation: $10,000.00 .
Applicant:
MAURICE PHILIP PEGORELLI
P 0 BOX 541
TWENTY NINE PALMS, CA 92277
c&t�t 4.4 Q"
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: B icense No.: 823063 D/�
D Contractor i�� r "C7"►` �
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor'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, prior to 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 applicant to a civil penalty of not more than five hundred dollars
($500).:
(_) 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 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 or she did not build or improve for the purpose of sale.).
(_) 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 Add
.VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
MICHEL PATTERSC•N
44065 CALICO CIR
LA QUINTA, CA 92253
Contractor:
MAURICE PHILIP PEGORELLI
P 0 BOX 541
TWENTY NINE PALMS, CA 92
(714)404-5514
Llc. No.: 823063
Date: 2/15/2017
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WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain.a certificateof 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
Lection 3700 of the Labor Code, for the performance of the work for which this permit
is issued. IN workers' compensation insurance carrier and policy number are:
Carrie PT Policy Number:
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 should become subject to the
workers' compensation provisions of Section 3+00 of the Labor Code, I shall forthwith
comply with those pr /visions.
rate:v ` � Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION.COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,00Q. 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 Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this appliotion is made, each person 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 applic.tion becomes null and void if work is
not commenced within 180 days from date of i_ suance of such permit, or cessation of
work for 180 days will subject permit to cancellation. `.
I certify that I have read this application and state that the above informatio is correct.
I agree to comply with all city and county ordinances and state laws relatin o building
construction, and hereby authorize representatves of this city to enter,up the
above-mentioned property for inspection purposes.
Dat®
SignatureSignature (Applicant or Agent):
Date: 2/15/2017
.Application Number: BPAT2017-0010
Owner:
Property Address: 44065 CALICO CIR CIR
MICHEL PATTERSCN
ARN: 604091035
44065 CALICO CIR
Application Description: PATTERSON / PATIO COVER
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $10,000.00
Applicant:
Contractor:
MAURICE PHILIP PEGORELLI
MAURICE PHILIP P_GORELLI
P 0 BOX 541
P 0 BOX 541
TWENTY NINE PALMS, CA 92277
TWENTY NINE PALMS, CA 92277
(714)404-5514
---------------------------------------------------------------------------------------------
Llc. No.: 823063
Detail: 400SF TRELLIS PATIO COVER AT REAR YARD [CITY STANDARD] WITH 2 FANS.
2016 CALIFORNIA BUILDING CODES.
DESCRIPTION I ACCOUNT- I -QTY I AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADM INISTRATIOM BSA:. $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$25.33
Total Paid for ELECTRICAL: $50.66
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PATIO COVER, STD, OPEN
101-0000-42404
0
$101.84
DESCRIPTION.
ACCOUNT
QTY
AMOUNT
PATIO COVER, STD, OPEN PC
101-0000-42600
0
$100.32
Total Paid for PATIO COVER / COVERED PORCH / LATTICE: $202.16
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$1.30 .
Total Paid for'STRONG MOTION INSTRUMENTATIONISMI:. $1.30
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY. ENHANCEMEN7 FEE: $5.00'
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Permit #
iProject Address:C
Qty of La Q•ulll td
Building a Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
I rOwner's Name:
A. P. Number:
i
-Address: N06C C4 460
Legal Description:
City, ST, Zip: Aetj 62 U W?4
22
Contractor:
^
Tele hone: /.............................................
Address: G(SF C 4
AP-roject Description: �•
City, ST, Zip:
/
T._p.h.0_._
Tele n' c: .-
1
State Lic. # :k2_2 o 6 V.
CityLic. #<.
Arch.,'Engr., Designer:
Address:
City, ST, Zip:
Telephone:
ancY:
Construction e: Occupancy:
n TYP P
Lic. #.
Demo one): New Addn Alter Repair
=Name of Contact Person:
CE
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
-- y YS /,
jEstimated Value of Project:
APPLICANT: DO. NOT WRITE BELOW THIS LINE
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Submittal
Req'd
Rcc'd
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 •
Title 24 Cates.
Plans picked up
Construction
Floodplain plan
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for corrections/issue .
Electrical .
Subcontactor List
Called Contact Person
Plumbing
Grant Dced
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"! Review, ready for corrections/issue
Developer Impart Fee
Planning Approval
Called Contact Person
A.I.P.P.
I'ub. Wks. Appr
Date of permit issue
School Fee's,
Total Permit Foes
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