9609-131 (PAT)U)
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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty ofperjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
.991025 t Y
/ate 1 MSignature'
of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner•of`the property, am exclusively contracting' with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section , B&P.C. for this reason
Date Sianature of Owner
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 37,0..1Q,.of; the Labor Code, for the performance of the work for which this
permit is s I e�'My workers' compensation insurance carrier &policy no. are:
Carrier Policy No
(This,section need not be completed if the permit valuation is for $100.00 or less).
*K 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 3700 of the Labor
Code, I shall forthwith comply with those4provisions." MF
VDate: ( "� (�i Applicant—
Warning:
pplicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building.and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) Date
PERMIT # CONTROL #
BUILDING PERMIT4113
DATE 17196 VALUATION $13,406.40 LOT TRACT
s
JOB SITE '9-1 XS CAXI LeMI � RR
ADDRESS
APN a'
OWNER
CONTRACTOR/DESIGNER/ENGINEER
S, AN11 JY G- [IF 'ttt
I'Ll't't 13Ufi.D:CMS
7a41.5 r~;AN".MkELA
18-875 SANTrik DIRE
1.f\QUINT.A C. 92
LA QUINT -A, CA 92,251
CC3{.iC 3174
USE OF PERMIT
f Y
1,.�1141F�j
!b'xt3'C.'C)VI3RlPA:110(l.f\'T"1K.3Z) .
E as , , U. n. ..
�4.
COST t' P t,C3NS`t'.#3371,"1' 074
13,406.40
aa 6R9��gq9 1 �+ y tart qE�KTIMIA11D
.PLAN CHF.ZCX,P'{7.i? i.(i•1 f�-�1:3�)-;.13t .. $gq,rt•5
71•l tqG Afolr(014 FEE - [Z.ESID 1V 1.-0490^La1.l VklV �t.�
il#."# 't'n., NIMMICTION AND PLAN ".til CIe:
$253,74-4
k. iX .1) 12-1VIR) ��:�:�
$0.00
`'
4'S;?x:1111T 3+EEN ffil; NOW
$253.79 ..
RECEIPTDATE
BYE _ i+*�
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWAL
kPP OVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
L;
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Vottage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
RAFTER SIZE AND SPACING
SPECIFY ROOFING AND SHEATHING OR OPEN LATTICE
2�� l� 2 �1 O G ✓
(SEE ROOFING NOTE ON REVERSE)
-------
--- ELK- - -1��LE----
PITCH
ME
CONTINUOUS LEDGER
H- E W
_ 1J�L
lrxlrxl*T AND 'L'/STW1 T W
I (4) 16d 119LS OR BOLT I
RAFTER SPAN: I t��i `L
POST SPACING
O.H.
O.H.
l�
OVERALL LENGTH. d
OVERALL LENGTH
1 POSTS I
MIN. x4
' REAR SETBACK SIDE SETBACK
2000 P.S.I CONCRETE - L- J FINISH GRADE FINISH GRADE
f MIN. 17'x17' FOOTING
' I
L- L -
17' BELOW GRADE -�
PROVIDE 1' CLEARANCE
BETWEEN AND
HDIE:
CONCRETE
OPEN LATTICE PATIO COVERS MAY BE ATTACHED TO EXISTING FASCIA
VIA ONE 1/,C x 5 LAC SCREW THROUGH FASCIA INTO EACH RAFTER TNI
U -STRAP OR ANGLE
NON -CORROSIVE PLATE „�pE
O"
3/Ii' x S LAG SCREWS INTO STUDS AT I6' O.C.
CONTINUOUS LEDGER
BOLTaNAI�
U -STRAP OR ANGLE
................
16d NAILS
BOLT
JOIST HANGERS OR, SOLID,'BLO&R#bA v4'4.,y . .
-
I
CO�1d�p�g �gp �/
I�OD 9 OVALLY
ANCHOR BOLT (EMBED PROVIDE 1' CLEARANCE
i MIN. INTO CONCRETE) BETWEEN POST AND
ACCEPTED FOR, RUCTION
CONCRETE
BUILDING DEPARTMENT USE ONLY
TYPICAL PATIO COVER
GATE OF APPLICATION
R ISSUE DATE
OWNERS NAME
G F I
CTION DATE
1
STREET ADDRESS
L
cm. ST
zIP
L G2 U ivT A GQ, .
TELEPHONE
H.O.A. APPROVAL SICINATURE. DATE
RAFTER SPAN TABLE �` Aq%
GRADING RULES p�
PS 20-70
(FEET & INCHES)
2x4
16"
24"
O.C.
10'-6" 9'-6" 7'-3' 8'-9'
$' ,, 7,
2x6
16"
24"
O.C.
1 '-O'
............................N..A.............A.
14'-d'
44 ........................5.'..-'. ...
1 '
10'-
....................__4w-Si'..:.
4x6
2x8
16"
24"
32"
O.C.1a'.-9'...
"
"
l7'. -4r ...1.:- ..1.�'.� Q"..
1 '- " 14'- 1 '- ' 1 '-
.]l0-.. 11.x.-..' .....N.kI.....N/A.
NOTE:
V O.C. SPANS ARE ALLOWABLE FOR OPEN LATTICE
PATIO COVERS ONLY.
LATTICE ROOF
BUILT-UP ROOF
HEADERS
HEADERS
DOUGLAS FIR NO. 1
DOUGLAS . FIR NO. 1
SIZE SPAN
SIZE
SPAN
44 ........................5.'..-'. ...
4x4
....................__4w-Si'..:.
4x6
46
48 11'
48
'-0"
4x 10 14' 0"
4x 10
° ,
402 17'-0'
402
'-
6x8 14'-0"
6x8
12'-0"
6x10 „17'- ".
6x10....,.
14'-Q
ALL CONSTRUCTION SHAM CONFORM
TO THE PROVISIONS OF THE 1994
UNIFORM BUILDING CODE. .
SUPPLEMENTAL. NOTES:
ROOFING NOTES:
A. BUILT-UP, ROLLED ROOF: SLOPE TO DRAIN.
B. ROCK ROOF: 3/12 MAXIMUM PITCH.