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08-1979 (SPIN)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-00001979 Property Address: 54445 RIVIERA APN: 775 -020 -004 - Application description: SPECIAL INSPECTION Property Zoning: GOLF COURSE Application valuation: 24000 T4ht 4 4 Q" Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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: A B C34 C1 License No.: 201308 1 0165/-4 / 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.). (_ 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 contractsfor the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_ I. 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 ISec. 3097, Civ. C.). Lender's Name: 1 11' Lender's Address: LQPERMIT Owner: MSR C/O MARVIN F POER AND CO PO BOX 95727 ATLANTA, GA 30347 Contractor: MEREDITH & SIMPSON 83801 AVENUE 45 INDIO, CA 92201 (760)347-2366 Lic. No.: 201308 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/24/08 ----------------------------------------------- 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 REDWOOD FIRE Policy Number 4403007590-081 _ 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 J3700 of th ab e, I shall forthtlh comply ith those provisions. /Date: 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 ($100,000). 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 as 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 above information is correct. I agree to comply with all city and c unty ordinances and state laws relating. to building construction, and hereby authorize representatives of this unty to enter upon the lfove-mentioned rty,for inspection purposes. ate: ��jy'd�Sig ure (Applicant or Agent): a Application Number . . . . . 08-00001979 Permit . . . SPECIAL INSPECTION , Additional desc . Permit Fee . . . . 100.00 Plan Check Fee .00 Issue Date . . . Valuation . . . . 24000 Expiration Date . . 6/22/09 Qty Unit Charge Per Extension BASE FEE 100.00 ---------------------------------------------------------------------------- Special Notes and Comments FIRE RECONSTRUCTION OF INTERIOR AND ROOF OF COMFORT STATION (AT PALMER COURSE HOLE #14 - ACCESS IS CART PATH ADJACENT TO 54-447 RIVIERA, AT SOUTH INTERSECTION OF CANTERBURY). CONSISTS OF•MEN'S AND -. LADIES' TOILET FACILITIES, APPROXIMATELY , 150 SQUARE FEET. REPLACING LIKE FOR LIKE: ONE 2X6 INTERIOR WALL, SIX PLUMBING FIXTURES, LIGHTS, SKYLIGHTS. ROOF: 4X10 LEDGER ON ALL SIDES, 2X10 RAFTERS AT 24 INCHES ON CENTER, PLYWOOD SHEATHING, CLASS "A" BUILT-UP ROOF DRAINING TO TWO SCUPPERS ON NORTHEAST SIDE. Fee summary Charged Paid Credited Due --------------------------- -------------------- Permit Fee Total 100.00 .00 ---------- .00 100.00 Plan Check Total .00 .00' .00 .00 Grand Total 100.00 .00 .00 100.00 LQPERMIT Bin # City of La Quints Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Com- p7� Project Address: ,5 - L� G, l� IG Name: cN A. P. Numbe, .© ZQ — O�j L: TAdd l E.,v 'lCi Legal Description: 0, ' `�K S M �- Contractor:' , Zip: USN Telephone: - � Address: Project Description: City, ST, Zip: Telephone: — D ` State Lic. # : City Lie. #: Address: City, ST, Zip: Telephone: State Lic. #: Name of Conta4 Person: AJ, Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair CDemo Sq. Ft.: #Stories: #Units - Telephone # of ontact Person: 6e Estimated Value of Project:, - 0 Q APPLICANT: DO NOT WRITE BELOW THIS LINE # SubmitU Re�,. ?lec'd TRACKING. PERMIT FEES Plan Sets Plan Check submitted 2j Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"d Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees i Total Permit Fees