11-0710 (RC) Y I IIIIIII VIII III VIII IIII 34 IE
P.O. BOX1504 - - - - - JT,&tVOICE(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: 7/27/11
Application Number: 111-00006710 Owner: n
Property Address: 80202 AVENUE 58 MSR RESORT GOLF COURSE APN: 762-230-040- - - 1 POST OFFICE SQ #3100 ��
Application description: REMODEL - COMMERCIAL BOSTON, MA 02109
Property Zoning: LOW DENSITY RESIDENTIAL O 2-- 9Application valuation: 12000
Lif
011
Contractor: CITY OF LA;,UINTA
Applicant: Architect or Engineer: STEMMER CONSTRUCTION, BRA'.. FII1N?�,f't =P�
74478 HIGHWAY 111 #322
PALM DESERT, CA 92260
(760)819-5476
Lic. No. : 649172
-- ----------------------------------- ----------------------- -------------------------------- -----
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000)of Division 3 of the Business and Professionals Code,and my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
License Class: B License No.: 649172 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
issued.
ate:�-a7-() ontractor: IG�7 _ 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
OWNER-BUILDER DECLARATION insurance carrier and policy number are: '
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EXEMPT Policy Number EXEMPT
following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to I certify that,in the performance of the work for which this permit is issued,I shall not employ any
construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the person in any manner so as to become subject to the workers'compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that,if I should become subject to the workers'compensation provisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 3700 of the Labor Code,I shall forthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by -7
any
��
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500).: te: pplicant: rel�1r1 (R,(JyN/`
(_) 1,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 WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees,provided that the DOLLARS($100,000). IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If,however,the building or improvement is sold within SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT
(_) 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon,and who contracts for the projects with a contractor(s)licensed 1. Each person upon whose behalf this application is made,each person at whose request and for
pursuant to the Contractors'State License Law.). 'whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_1 I am exempt under Sec. ,B.&P.C.for this reason 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.
Date: Owner: 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
CONSTRUCTION LENDING AGENCY permit to cancellation. -
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating to building construction,and hereby authorize representatives
- of this .unty to enter upon , above-mentioned property for ins- coon purposes.
Lender's Name: [ 1-a'-1 I 10.0
te: nature(Applicant or Agen
Lender's Address:
LQPERMIT
Application Number . . . . . 11-00000710
------ Structure Information REMOVE AND REPLACE ROOF -----
Other struct info . . . . . CODE EDITION 2010
FIRE SPRINKLERS NO
----------------------------------------------------------------------------
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . . 135.00 Plan Check Fee 87.75
Issue Date . . . . Valuation . . . . 12000
Expiration Date 1/23/12
Qty - Unit Charge Per Extension
BASE FEE 45.00
10.00 9.0000 THOU BLDG 2,001-25;000 90.00
----------------------------------------------------------------------------
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . . 18.75 . Plan Check Fee 4.69
Issue Date . . . . Valuation . . . . 0
Expiration Date 1/23/12
Qty Unit Charge Per Extension
BASE FEE 15.00
5.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 3.75
----------------------------------------------------------------------------
Special Notes and Comments
DEMO EXISTING ROOF FRAMING AND REPLACE
WITH TRUSS FRAMING AND ROLLED ROOFING -
INCLUDING REPLACEMENT OF ELECTRICAL
LIGHTING AND POWER IN CEILING AREA ONLY.
THIS PERMIT DOES NOT INCLUDE PUMP CHANGE
OUT. 2.010 CALIFORNIA BUILDING CODES.
July 11, 2011 3:23:43 PM AORTEGA
----------------------------------------------------------------=-=---------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00
Fee summary . Charged Paid Credited Due
Permit Fee Total 153.75 .00 .00 153.75
Plan Check Total 92.44 .00 .00 92.44
Other Fee Total 1.00 .00 .00 1.00
Grand Total 247.19 .00 .00 247.19
LQPERMIT
Bin#
City Of La Quint
Building 8T Safety Division .
el # P.O. Box 1504, 78-495 Calle Tampico
I I La Quinta,CA 92253-(760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: - ,0 Z Owner's Name:LA l llw� S o r+ +C(U6
A.P.Number: (o a,— (j -8 Address: 4'9— 49C(
CISe;h�uwer 02-
Legal Description:
LIP 3$ 1^1 Q ZS I q
City,ST,Zip: L �Iw4C` q aaS�
Contractor:Sri CL V I k• Q inwkJl�'C O V Tell hone 1 1 eJ r
n S wt -1 (,o-S 6�i -�{ (,33
Address: [ _ R
I L-{7� ��1 � �a� Project Description:
City,ST,Zip: Q.6 -sqn a . q a-a`64
r✓w.,o Utr, 4'^� e (�c.e_ rGtwnln
OBJ-t l l- - I.Cv 00
wr',x
Telephone:
s
State Lic.# G y 01 ' City Lic.#.:
U.1^, �N O
Arch.,Engr.,Designer W eA l
Address: rf P CRd '
City,ST,Zip:
Telephone: Construction Type: Occupancy:
State Lic. Project circle one New Add'n Alter Repair Demo
Name of Contact Person: F G f- S Ft.: S
j'9tQ
,IMW�e- q• y� #Stories: #Units:
Telephone#of Contact Person: 66 Estimated Value of Project:41 2 0 0 U 0-0
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Recd TRACKDVG PERMIT.FEES
Plan Sets Plan Check submitted -I ?,Z Amount
Structural Cala. Reviewed,ready for corrections Plan Check Deposit ►�
Truss Cala. Called Contact Person Plan Check Balance .s•-•
Title 24 Cala. Plans picked up Construction 111A.4
Flood plain plan Plans resubmitted I Mechanical 11
Grading plan 2'!Review,ready for correctionslissue Electrical 14 A
11 IF
Subcoutactor List Called Contact Person Plumbing �+
Grant Deed Plans picked up S.M.1. �.
H.O.A.Approval Plans resubmitted Grading
IN HOUSE:- Review,ready for correctionstissue' Developer Impact Fee
Planning Approval Called Contact Person A.I.P.P.
Pub.Wks.Appr Date of permit issue
School Fees
Total Permit Fees
Bin# City Of La Quin 1.A
V IIIIIIIIIIIIIIIIIIIIIIIII 35
Building 8z Safety.Division .
Permit# P.O. Box 1504, 78-495 Calle Tampico
i1 *110 La Quinta,CA 92253-(760)'777-7012
Building Permit Application and Tracking Sheet
Project Address: —2 D Z jkLA-L S O Owner's Name:P&
A.P.Number: Z _ 2 O4 Address: LA
w wEa C
Legal Description: City,ST,Zip:
Contractor: I_- :.- .>a
�j f l �n -��v.�l.P—�' Telephone: >:!'A .;,<:"; : w.
Address: 14 --t'7% 1+t„! 1 t i k—3 ZZ Project Description:
City,ST,Zip: pCArl ZZ I'o�
Telephone:
tax.:+x-�.xJ.:...r.�.+x..:::;::.:f-.-•9<...:.:;.+.:.:
State Lie.#: City Lie.#: oied C.AC#,j!5
Arch.,Engr.,Designer: 0" Ra(:7 Y U S C-A�' S S ko w
Address:
clv\L— A,h V\-% l.v
C)Lt crw r✓k a \ S
City,ST,Zip: 1;t4 s'(t�.CR4 Om .O pigw
Telephone:
-000
Construction Type: i50 PC,
Occupancy:
State Lie.#: 'ONE= Project type circle one): New Add'n Alter Re ai Demo
Name of Contact Person: I a,r\ Sq.Ft.: , #Stories: #Units:
Telephone#of Contact Person: _760 C1-541 to I Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N Submittal Req'd Recd TRACKING PERMIT FEES
Plan Sets 3 Plan Check submitted NO Item Amount
Structural Calcs. Reviewed,ready for corrections Plan Check Deposit
Truss Caics. a Called Contact Person Plan Check Balance
Title 24 Cates. Plans picked cep Construction
Flood plain plan Plans resubmitted Mechanical
Grading plan 2'Review,ready for correctionissue Electrical
Subcontactor List Called Contact Person b Plumbing
Grant Deed Pians picked up S.M.I.
H.O.A.Approval Plans resubmitted Grading
IN HOUSE:- '"'Review,ready for correetionsfessue Developer Impact Fee
Planning Approval Called Contact Person A.I.P.P.
Pub.Wks.Appr Date of permit issue
School Fees
Total Permit Fees SZ i ♦/
A&-PIL. ,eek w' xQ,eel:
812S 11ba— G--AA..--o �-cs
8121112011 &,l,oc t "40 #AJA „