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10-1337 (PAT)4 P.O. BOX 1504 ^' VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 1/20/11 r Application Number: 10-00001337, Owner: Property Address: 55075 MONROE ST MARK LADEDA APN: 767-580-013--000000- 55075 MONROE STREET Application description: PATIO COVER - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL --------------------------------- Application valuation: 1995 ✓ Contractor: --J Applicant: Architect or Engine r: Owner o� ews7 Engine a CITY OF LACDT A 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 my License is in full force and effect. License Class: License No.: Date: Contractor: 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 _ 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.). (_ 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 contractors) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. , B.&P.C.'for this reaso. Date: •�\ �\ �Owne 00, 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: 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 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 sub' ct t the workers' compensation laws of California, and agree that, if I should become subject o the orkers' compensation provisions of Section / 1 3700 of/hwi the Labor Cod I shall th wit se pr 'ions. o Date: t /�\ I , (' 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 1$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 setforth 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 bove i formation is correct. I agree to comply with all city and county ordinances and state laws relating to buil ng con ruction, and hereby authorize representatives of this c unty o enter upon the a o do ro sp n pu ses. Date: ���`� ignatu p an[ or Agent LQPER11IT Application Number . . . . . 10-00001337 Permit . . . PATIO COVER PERMIT Additional desc ENGINEERED TRELLIS AT POOL Permit Fee . . . . 45.00 Plan Check Fee 29.25 Issue Date . . . . Valuation . . . . 1995 Expiration Date 7/19/11 Qty . Unit Charge Per Extension BASE FEE 15.00 15.00 2.0000 HND BLDG 501-2,000 30.00 ---------------------------------------------------------------------------- Special Notes and Comments TRELLIS PER ENGINEERED PLANS. 50 FT LENGTH X 8 FT HGT X 3 FT WIDTH. 2007 CODES. - ------'---------------------------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN, (SB1473) 1.00 STRONG MOTION (SMI) - RES .50 Fee summary Charged ---------- Paid Credited ------------------------------. Due ----------------- Permit Fee Total 45.00 .00 .00 45.00 Plan Check Total 29.25 .00 .00 29.25 Other Fee Total 1.50 .00 00 1.50 Grand Total 75.75 .00 .00 75.75 LQPE%NIIT le.• &• Bin #. IF City of La Quinta Building 8T Safety Division • .t( P.O. Box 1504 78-49 5 Calle Tampico La Qulnta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 1 Project Address: `� rj (� �y� t�f Owner's Name: A. P. Number: Address: Jc— S o '1 S (�'� a r � � �-��— Legal Description: City, ST, Zip: Contractor: ©W 4` f — �-kAjQ_tL Telephone: -') Address: S p'Z s �� n► •r.. Project Description: City, ST, Zip: I��v �.(�-e C C, Qt 22� 3 . Telephone: State Lie. # : City Lic. C Arch., Engr., Designer: Vt�,` It Address: \ Z o N rCj City, ST, Zip: 1> f/`/l �✓1 Telephone: Lk (e 3 C. 1p, State Lie. #: Name of Contact Person: Construction Type: )Z7_4 AL Occupancy; Project type (circle one): New Add'n Alter Repair Demo Sq. Ft: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets 3 Plan Check submitted Item Amount Structural Cafes, a Reviewed, ready for We.0ova Z Plan Check Deposit Truss Gles Called- Contact Person { X n Check Balance Title 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted ++� 1 Mechanical Grading plan 2*! Review, ready for correctio ue Electrical Subcontactor List Called Contact Person i,e Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading TN HOUSE:- Review, ready for corrections/Issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date or permit issue School Fees 3 Total Permit Fees r'f . l A, 5- ,J_ r CITY OF LA QUINTA SUB -CONTRACTOR LIST JOB ADDRESS 55�`� 5 Mt fdf- 6- gi'r-e-� PERMIT NUMBER OWNER a^,J� BUILDER This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. Trade :..Classification :.:... �................ _.... _ _....Contra or ...... .......................... .:::... State Contractot;s::Lcense , - rkets<:C h1 ensation..ln utance .:...........::..........................9............ ... ...... ..... ..... ... Bus.ness:Lcense:...:.: "Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/);x/xx) Carrier Name (e.g..State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C 1>21 CONCRET - C.8) .: FRAMING IC 5) STRUCT STEEL C51j --(�f�A oN� �•-Z�I /�lj �`��.SZ 51�1 11 I'ZiLZ Lo 7/3tI1) MASONRY (C 29)� LARA_ �10.S C\°l 1,52 rJ(,�\(II SGC�nr NTL LlJJ4 �20 11\`7 CV j� �c7 b2� o �I31 1� PLUMBING'(.0 36) c.Gti 6 06 4Z'4 l0 ��1���1 /p80$1 5-131-11 LATH PLASTER IC=35) . DRYWALL. (C-91 ::. FIVAC (C 6i) ELECTRICAL (C 101:1 G, m ROOFING (C=39) SHEEP. METAL (C=43) FLOORING (:C 15) GLAZING 10='17 INSU_LATION.(C 2):. ; SEWAGE`D.ISP. (C.4t2).' . PAINTING (C 33) CERAMIC: TILE. C 54) CABINETS (C. 61'. ..FENCING.:(:C;.13) LANDSCAPING (C 2-7 ' (,Jrca PooL. C 53i LarzR MPn�tR G-$3 �3� f� 2 5t31(I1 ��:+ N �>- kook 2 ttI-1 �� I3 I� lob (,o �131�tt