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12-0939 (PAT)P.O.-BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000939 "-? Property Address: 52849 ROSS -AVE APN: 767-670-017-21 -33076 - Application description: PATIO COVER - RESIDENTIAL Property Zoning: RL AG/EQ OVERLAY Application valuation: 60000 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT UC ED CONTRACTOR'S DECLARATION I hereby affirm under. penalty of perjury tha am cemed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busy s and rofessioals Ccide, anlif my License is in full force and effect. License Class: B i e e N 915336 //"Date: M -Z3" 12- ntractor: t 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).: (_ 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 ` 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: /Q ` 2 -5 -12- 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: 4A LQPERMIT Owner: SUGARMAN, M&B FAMILY TRUST 9440 SANTA MONICA BLVD #407 BEVERLY HILLS, CA 90210 K0_� - -,41 - , VOICE (', ; w1 FAX (760) 7-7 INSPECTIONS (760) 777-7153. Date: 10/22/12 1 PE; Contractor: DBCA INC2 3 2Ui2 P.O. BOX 1482 LA QUINTA, CA 92247 (760) 393-5271 CIT.YOFLAQUINTA Lic. No.: 915336 FINANCE DEPT - WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I 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 TRAVELERS Policy Number YJUB282D7797-12 _ I certify that, in the performa of he work for which this permit is issued, I shall not employ any person in any manner . as to b ome subje t to the workers' compensation laws of California, and agree that, yf I s Id beco e u the wo ers' compensation rovisions of Section 23700 of the Labor e, I s 1p h o ply i thos ns. ate: � 3,/� licant: WARNING: FAILURE TO SEC RE WORKERS' COMPENSATION COVERAGE 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.: Each person upon whose behalf this application 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 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. I certify that I have read this application and state that the ab ve informati n is correct. vggkee to comply with all city and county ordinances and state laws relating to building constructi -, by t ize representatives of this county to enter upo he above-mentioned p�perty r ins p o "pur s stela ��z gnature (Applicant or Agent): - A Application Number . . . . . 12-00000939 Permit . . . ELEC-MISCELLANEOUS 'Additional desc . Permit Fee . . . 26.00 Plan Check Fee 6.50 Issue Date Valuation . . . . 0 Expiration Date 4/20/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA ELEC MISC ---------------------------------------------------------------------------- 11.00 Permit . . . PATIO COVER PERMIT Additional desc . Permit Fee . . . . 459.50 Plan Check Fee 298.68 Issue Date . . . . Valuation . . . . 60000 Expiration Date 4/20/13 Qty Unit Charge Per Extension BASE FEE 414.50 10.00 4.5000 THOU BLDG 5,0,001-100,000 --------------------------=----------=-------------------------------------- 45.00 Permit . . . PLUMB_ING Additional desc . Permit Fee 27.00 Plan Check Fee 6.75 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/20/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 Special Notes and Comments 192SF DETACHED PATIO COVER AT READ YARD WITH BBQ AND BAR AREA (ENGINEERED] THE PROPOSED STRUCTURE SHALL MEET THE REQUIREMENTS OF THE LQMC FOR YARD STRUCTURES AND BE OPEN ON ALL SIDES, AND OUTDOOR SINK SHALL BE COVERED TO PREVENT STORM WATER FROM ENTERING THE SEWER SYSTEM.' 2010 CALIFORNIA BUILDING. CODES. October 22, 2012 8:52:54 AM AORTEGA -----------------_--- - - - Other Fees . . . . . BLDG STDS ADMIN (SB1473) 3.00 STRONG MOTION (SMI) - RES 6.00 ,:LOPERMIT - . . Application Number 12-00000939 Fee summary Charged Paid Credited Due ----------------- Permit Fee Total - -- 512.50 ---- ----- - .00^ ---------- ---------- .00 512.50 Plan Check Total 311.93 .00 .00 311.93 Other Fee -Total 9.00 .00 .00 9.00 Grand Total 831,3 .43 .00 .00 833.43 LQPERMIT