9707-108 (TT)50503 Mandarina
9707-108
t I LICENSED CONTRACTOR 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.
Lipense # Lic. Class Exp. Date
,'bate Signature of Contractor
M= ,` OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
K) 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).
as owner of the property, am exclusively contracting with licensed
contractors to ;construct the project (Sec. 7044, Business & Professionals
Code).',
O I am'exempt under Section B&P.C. for this reasoA
Date Signature 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 3700 oflthe Labor Code, for the performance of the Work for which this
permit islissued. My workers' compensation insurance carrier,& policy, no. are:
Carrier Policy No. A.
CT is section need not be completed if the permit valuation is for $100.00 or less).
N 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 ofSection 3700 of the Labor
/rode, I shall forthwith comply with those provisions:
°/ Date: t ; s ., i '! Applicant 0`1 ..,.
Warning: Failure to secure Workers' Compensation coverage is,unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, yin
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 persor> at "
whose request and for whose benefit work is performed under or pursuaneto
• 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 inspection1purposes.
1/
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Signature (Owner/Agent) Date
_
BPERMIf #7„',V{lri CONTROL#
BUILDING PERMIT 55 9 3
DATE, M4197 VALUATION LOT TRACT
JOB SITE
ADDRESS %1 ✓ t 0s. T>. 41 t
APN
OWNER -
CONTRACTOR / DESIGNER / ENGINEER
LA, 6,,,,JIi`I VA .-A. y; ,
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USE OF PERMIT ,;x,
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RFgCEIPT
DATE
BY
DATE FINALED
INSPECTOR
Pit
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
I 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 Wali Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final 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
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I. -
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
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City of La Quinta =
Bonding & Safety Division
P.O. Box 1504, 78-495 Calle Tartow
La QL&itk CA 92253 - (619) 777-7012
Building Permit Application and Tracking Sheet
it #
Project Address: jp. Spa Yriandarin.4. C fi-ks
miner's Namee LLX6Aallaido" AS It/
.A. P. Number: '710g- so — co `%
Address: /'• 0. /30X 938
Legal Description: CnitKi C4t,6 kaw& h !µ? t. KlaQA C d✓
Ciryy. ST. Zip: ( , 4Q"4./it& 69 !)jlZS3
Contractor. Al A,
address:
Telephone:. 7640- 700
Project Description: 49PPIhOrt, OF MOZ44AL
Cit}•. ST. Zip:
-% II.EQ- tl.4CJ
Telephone:
State Lie. f : Lie. _: /jl Qi
tbu ,tas d,/ -U h9ist¢Q
LCin
Arch. Ensu.. Designer: (% %I CIMS eyCO
,(
Address: 9A/p0 Qjjng, .64ma
cin, ST. zip: eA 92504- .4,044
Telephone: 90q-w3f - 0 300 Construction Type: Occupancy: _ 3
State Lie. _: Project type (circle one): Nam- kd7n Ater Repair Demo
Name of Contact Person: WRQ AL;L; } O"e Sq. Ft.: 4 —TStories: I I = units:
Telephone = of Contact Person: &Q
Estimated Value of Project: f -3jV 000 -1AuJN.
APPLICANT: DO NOT WRITE BELOW THIS LINE
=
Submittal
Req'd
Recd
TRxCKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Re%iewed. read- for
currectiuus
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Grant Deed
Plans resubmitted
Mechanical
School Fees
Reviewed. ready to issue
Electrical
Subcontactor List
Called Contact Person
Plumbino
Contractor Info.
Date of permit issue
S.M.I.
Civ Business Lie.
Grading
Workers' Comp.
Infrastructure
Planning Approval
A I.P.P.
Pub. Wks. Appr.
H.O.A. _approval
Fire \lar. Appr.
H. Dept. Approval
.ag. Approval
Date of final inspection
Total Permit Fees
LEXUS CHALLENGE
SPI 17957 & 17958, CPX 05089 '
CUSTOM UPGRADED 24 x 60 MOBILE OFFICE COMPLEX WITH RESTROOM
DELIVERED CLEAN AND READY TO USE.
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111'1(:11
ANI.I AG
1.PJI7 ,
WOOD SIDING,
CARPET FLOORS,
111'I i;lt/1111"I
VII IA. (Will. -
WALT S. (12)
WINDOWS, ONE
DOUBLE At -AD
ONE REGULAR
FRENCH DOORS,
CUSTOM WOOD
FLOOR ENTRY
WAYS, WIND
RATED AT- 90
— MPI I, AIR
C:r:1111)11,1011111 JCS
I IEATIFIG.
WILLIAMS SCOTSMAN,
9400 GALENA STREET,
RIVERSIDE, CA 92509
909/6131.0300
909/6811455 FAX
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L EXUI --C H M"" ,,N.G E
HOSTED-BY'RAY'MOND•yFLOYD
. July, 3, 1997 •... r ' ,, ` . - ' • # . f f
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City of La Quinta
78-495 Calle Tampico _
La Quinta, CA 92253 `'
To Whom It May Concern:/
On behalf of the Lexus Challenge, -1 hereby 'authorize Jim Major,.of.Coye Electric`to pull
the meter pedestal permit for a temporary trailer located on the grounds of- -the Citrus
Club, 50-503 Maridarina_ , La Quinta.
Thank you for your assistance. Please call me with any questions at (760) 564-8700.
Regards, 1 t
Amie O'Brien
Tournament Coordinator
Lexus Challenge
P.
'Benefiting Childhelp USA in their efforts to prevent and treat child abuse.
Past Champions: 1995; Raymond Floyd & Michael Chiklis, 1996: Hale Irwin & Sean'`Connery =
P.O. Box 838 ❖ Citrus Clubhouse • 50-503 Mandarin ❖ La Quinta, CA 92253-0838 ❖760.564.8700 4-760.364.8707 fax
June 27, 1997
414
78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 – (760) 777-7000
FAX (760) 777-7101
TDD (760) 777-1227
Ms. Kathy H. Milthorpe, Toumarnent Director
The Lexus Challenge
PO Box 838
La Quinta, California 92253
SUBJECT: MINOR USE PEW41- : 97-017 (TRAILER)
Dear Ms. Milthorpe:
This is to report that the Community Development Department has approved your request to have a
temporary office trader (24' _6y__60')t e —no rtl west comer of Citrus Clubhouse parking lot, subject to
Conditions #1 and #2 being met:
1. A Certificate of Deposit, in the amount of $1,000.00, shall be posted with the City to insure the
trailer is removed from .he site i> the future. The City shall be named as the controlling party to
insure removal of the ailer ?--id any accessory improvements.
2. The existing temporary trailer shall be removed (See attached). Once removed, a soil stabilizer
shall be sprayed on the site to corirw dust. A receipt from the contractor showing that the site has
been stabilized shall be subrmvcd to t x Community Development prior to an on-site inspection.
3. A bu;'I&--ig permit is recwred `;r the new temporary trailer and temporary electric power. Please
apply to the Building and Safety Department for a permit (777-7012). The trailer. shall be self-
contained and incluke ba*iroo n and lavatory facilities for guests, workers or employees unless
otherwise determined by the Luildirg and Safety Director. The trailer facilities shall be accessible
to the physically cha!,enged:
EHpiration Date
4. The trailer canremain on-site t:r::i! Jure 27, 1998: Prior to expiration of the permit, a six-month
time extension request may be made in writing to the Community Development Department. The
Community Development Director, after reviewing the facts, may approve the time extension
request.
General Conditions
5. Use of the trailer shall be limited to _normal business hours (i.e., 7:00 A.M. to 6:00 P.M. daily).
6. A building address shall be installed on the trailer to help identify the temporary business location
(e.g., minimum 3 -inch high letters in a contrasting color).
MUP97-017/16
MAILING ADDRESS - P.O. BOX 1504 LA QUINTA, CALIFORNIA 92253 "
7. Install one 2Al0BC fire extinguisher inside the trailer by the exit door, and provide a "Door to
remain open during business hours" sign above the exit door. If you have any questions, please
contact Mr. Tom Hutchison, Fire Safety Specialist (Riverside County) at 863-8886.
8. ' No exterior temporary signs are peri itted unless separately approved by this Department.
9. No exterior lighting is allowed unless approved by this Department prior to on-site installation.
Should security lighting be required for the project, all light fixtures shall be hooded to prevent
light glare from being cast onto adjacent properties or affecting the vision of passing motorists.
Tamper resistant light fixture covers are required to reduce vandalism.
10. Mounted close to the front door shall be a written notice informing emergency personnel of your
24-hour emergency phone number that they can call in case problems arise that need your prompt
- attention (i.e., minimum one inch high letters).
11. One physically challenged parking space shall be provided in close proximity to the building
entrance that complies with the Americans with Disabilities Act requirements.
12. A dust control plan shall submitted to the Community Development Department prior to removal
of the temporary 24' by 60' office trailer.
13. The City may elect to add Conditions to this application request to mitigate any problems that arise
not previously addressed herein.
14. Contact this Department when all on-site improvements have been installed, and we will -conduct
a final inspection to determine compliance with all Conditions of Approval.
If you have any questions, please contact me at 760-777-7067.
Sincerely,
DEVELOPMENT DIRECTOR
GT.
Enclosures
c: Mr. David A. Jenkins, La Quinta Resort and Club
J ommunity Development Director
✓Building and Safety Director
.Public Works Director
Sheriffs Department
Code Compliance Department
MUP97-017/16
CITY 4F LA QUINTA
Community Development Department
78-495 C i.L.LE TAMPICO '
LA QUINT %, C.A. 92253
619-777-7125 _
Case Numb_—.: , - 6 l7 .
Dace ACC=Led:
Al ti, OR USE p.ERAIXT APPLICATION
(N11,VP) QFya-re TQ.w..C.b-. C 9.2 :0.020 vi uhC t::n i.1C VwPY is . .5C5
:CGL^::rig a ."1LTI-have.a lcx c;r i:.C:.'.'c:? pcCe_ ual frr at±v=s i.ripacS on surv^,1-Ui. !'.z ^.:CL^':!5. resi4o—nLs, or husi lesses.
Rr,-tfw ail a:^veioFrtent Dire`:cr fort.is apolicat on is
AA a r f(-,4 '''rQN P URPnI;F
P•.=,x3e of RGQucst.' New location with additional space and a more aesthetically -
pleasing trailer.
Assessces Parccl No.: 2 _S'90 -00`T
Geta Location: -see attached
A---Lp: see attached _ /
:xst:,g 7.=i.^,g _76W e isZnU'.es 2 P_ Pt c
4j(!?'tcrra1 lrucrrr:auc:.: see attached letters, maps and brochure
. ''y.`_:ny •r.; :, :: ate-:L : . : e s -=,. i.Led :era::-.
r 4 . "-
fC i._:': . `..'_ i • : ...._ i_..:c~__ i i'.... a:.i_.ui.Cn da:..''v, _ i . ...:.
& Liza .c. .-..less et. C!W SC .' '. '._ \: ✓Z ="u ? J. __. "dl ,z._..n:gs may . .': 'v.Cv .: ..2I1b* '_'}C.n zhe
aC r:i cat C^. ✓G: g subrruue d.
..a.--.l--.i..... ................................. slits ................4.2i.... -i.
-kc_dzz.t: The Lexus Challenge Hosted by Raymond Floyd (760) 564-8700
Pnn N=,:: -
aids: P.O. Box 838 La Quinta, CA 92253-0838
O Tefs): KSL- Desert Resorts, Inc. (760) 564-7683
A.ddsess: 50-5q3 Mandarina, Citrus Clubhouse
_^is a^^li,:aucn s h>_.,,• .:1,.: f J
La Quinta, CA' 92253
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LEXUS CHALLENGE
HOSTED BY RAYMOND FLOYD
June 16, 1997'
City of La Quinta
Community Development Department
78-495 Calle Tampico
La Quinta, CA 92253
Dear Community Development Department:
Please allow this letter to serve as a permit request for a temporary 24 foot x 60 foot
trailer to be installed on the grounds of The Citrus Club at La Quints Resort & Club, 50-
503 Mandarina, La Quinta, 92253 on June 30, 1997.
The facility will be located near the front entrance of the clubhouse and will house two
full-time employees of The Lexus Challenge Hosted by Raymond Floyd, as well as a few.
temporary employees in November and'December. The color of the trailer will match that
of the clubhouse so as not to interfere with the look of the grounds.
Increased traffic is not a concern of KSL nor The Lexus Challenge, as the trailer will not
be used as a public outlet for ticket sales or event information until the week of the event.
In addition, 7-10 parking spaces will be available for The Lexus Challenge's use directly in
front of the proposed location.
The Lexus Challenge will work directly with KSL and local contractors to ensure the
proper precautions are taken regarding phone and electrical needs. KSL will also allow
The Lexus Challenge staff to use the restroom facilities within the clubhouse.
For your records, we have included additional information on the proposed trailer
including floorplans and a brochure from the manufacturer.
Thank you in advance for your consideration. Please call me with any questions at (760)
564-8700.
Since ely,
Kathy H. } lthorpe
Tournament Director
The Lexus Challenge
Benefiting Childhelp USA in their efforts to prevent and -treat child abuse.
i 77CADENCE Ckmel&nd' (,-;o;nuavzojFraiWinTetnpleton HP L LS
GOLF TZR.0 S PCs
LEXUS CHALLENGE
SPI 179573 17958, CPX 05089'
CUSTOM UPGRADED 24 x 60 MOBILE OFFICE COMPLEX WITH RESTROOM
DELIVERED CLEAN AND READY i0 USE.
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13.3
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I Ilflial
A[ 11.) AG
WOOD SIDING•
CAI'lVET FLOORS,
VIIIA. I.lYI'.
WAI.I S. (1:?)
WINDOWS, ONE
DOUBLE AND
OHE RE=GULAR
FRENCH DI_)ORS,
CUSTOM WOc")D
FLOOR ENTRY
WAYS, WIND
I?A•I'I=D A'I' 90
Mll I. AIR
c; :►I II)I 1101.1111c;
nr•n ► I IEAtIrw
WILLIAMS SCOTSMAI J,
9400 GALENA STREET,
RIVERSIDE, CA 92509
909/681-0300
909/681-1455 FAX
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