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04-5887 (RC)IIIIIII VIII III VIII IIII 25 ! IE BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA,CALIFORNIA 92253 INSPECTION REQUESTS (760).777-7153 . BUILDING PERMIT Application Number . . . . . 04-00005887 Date 8/10/04 Property Address,;. . . . . . 79999 AVENUE 52 APN: 772-290,.-007- -000000- Tenant nbr, name . . . . . . TEMPORARY CLUBHOUSE Application description . . . REMODEL - COMMERCIAL Property Zoning . . . . . . . GOLF COURSE Application valuation . . . . 617091 Owner Contractor ------------------------ LA QUINTA REDEVELOPMENT ------------------------ AGENCY DAVIS/REED CONSTRUCTION INC 78495 CALLE TAMPICO 169 SAXONY ROAD, STE #105 LA QUINTA CA.92253 ENCINITAS CA 92024 (760) 634-2350 WCC: STATE FUND WC: WC298892004 06/12/05 CSLB: 813480' 10/31/04 CCC: B -------------------------- Structure Information ------------------------- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . BUSINESS <50 Flood Zone . . . . . . . . FLOOD ZONE AO Other struct info . . . . . CODE EDITION 2001 FIRE SPRINKLERS YES MIXED-USE OCCUPANCY B / M OCCUPANT LOAD 49.00 FIRST FLOOR SQ FTG 2656.00 SECOND FLOOR SQ FTG .00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee 2393.50 Plan Check Fee 1555.78 Issue Date . . . . Valuation 617091 Expiration Date 1/10/05 Qty Unit Charge Per Extension BASE FEE 2039.50 118.00 3.0000 THOU BLDG 500,001-1,000,000 354.00 -------------------------------------- Permit . . . . . . ------------------------------------- ELECT - ADD/ALT/REM Additional desc Permit Fee . . . . Issue Date . . . . Expiration Date 1 AUC 1 1 2004 CITY OF LA QUINTA 'heck Fee . . 26.99 ion . . . . 0 P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 64 — P% Applicant- cay if u0clIL" Applicant's Mailing Address: ea Date: 41 it) Archite t or EngjpEek C met) LI&A. '9QC.11%q1zZL&JC Architect or Eni dress: uk COWNIA LID,0,\ 19lai.5 CA, Lic. No.: G -13 T] BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chanter 9 (commancinn with SPrtion 7000) of Division 3 of the Business and Professionals ' OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I ha 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 ppolicy numb r are: Cartier -621hov?, to Policy Number _ I certiry that, in the performance of the work for which this permit is issued, I shall not em loy 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 t joseAVisipns. , I WARNING: FAILURE TO SECURE WORKE S' 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. 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 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, indemnity 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 a "state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building const ion, and hereby authorize rep sentatives of this county t ter upon toe above- nti ned property for inspection purposes. Datenature (Applicant or Agent): V �J Page 2 Application Number . . . . . 04-00005887 Date 8/10/04 Qty Unit Charge Per Extension BASE FEE 15.00 2656.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 92.96 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 93.50 Plan Check Fee 23.38 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/10/05 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 9.0000 EA MECH FURNACE <=100K 36.00 4.00 9.0000 EA MECH B/C <=3HP/100K BTU 36.00 1.00 6.5000 EA MECH OTHER VENT SYSTEM 6.50 ---------------------------------------------------------------------------- Permit .. . . . . . PLUMBING Additional desc Permit Fee . . . . 122.25 Plan Check Fee 30.56 Issue Date Valuation . . . . 0 Expiration Date 1/10/05 Qty Unit Charge Per Extension BASE FEE 15.00 9.00 6.0000 EA PLB FIXTURE 54.00 -1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.000.0 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM '9.00 5.00 .7500 EA PLB GAS PIPE >=5 3.75 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Special Notes and Comments REMODEL OF EXISTING BUILDING TO A TEMPORARY GOLF CLUBHOUSE. B/M OCC. TYPE V -N CONSTR. 2001 CODES. CLUBHOUSE=2656_ SQ.FT. PATIO=2346 SQ.FT. [DIF FEES BASED ON BUILDING AREA OF 2,656 SQ.FT.] ---------------------------------------------------------------------------- Other Fees . . . . . . . .. ART IN PUBLIC PLACES -COM 3065.45 DIF CIVIC CENTER - COMM 252.32 Page 3 Application Number 04-00005887 Date 8/10/04 --------------------- ------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE. 155.58 DIF FIRE PROTECTION -COMM 84.99 STRONG MOTION (SMI) - COM 129.58 DIF STREET MAINT FAC -COMM 61.08 DIF TRANSPORTATION - COMM 4578.94 Fee summary Charged Permit Fee Total 2717.21 Plan Check Total 1636.71 Other Fee,Total 8327.94 Grand Total 12681.86 Paid Credited Due ---------- ---------- ---------- .00 .00 2717.21 .00 .00 1636.71 .00 .00 .8327.94 .00 .00 12681.86