11-0697 (ELEC)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
i� Date: 6/27/11
Application Number: 11-00000697 Owner: !;�
Property Address: 51001 AVENIDA CARRANZA KSL DESERT RESORTS INC
APN: 773-052-031-I -000000- 55880 PGA BLV // O
Application description: ELECTRICAL o LA QUINTA, CA 92253 U
Property Zoning: FLOOD PLAIN
Application valuation: 2000
!`Pn, f1f: 4
Contractor: �,p"'fir p4��i1/
Applicant: Architect or Engineer: BROWN, ANDREW C.
71825 CHOLLA WAY
PALM DESERT, CA 92260
(760)674-3046
/# Lic. No.: 888253
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
1 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: C10 icense No.: 888253
ate: f+ ontractor:�`�'—
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 ($5001.:
(_) 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
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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , BAP.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 (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
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 EXEMPT Policy Number EXEMPT
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 woikers' compensation provisions of Section
3700 of the bor Code, I shall forthwith comply with those provisions.
ate: CY Z� licant:
WARNING. FA RE 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 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 above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of/thispumy to enter upon th above-mentioned property for inspection purposes.
at4 e: f 7 ature (Applicant or Agent):
Application Number .
. . . . 11-00000697
Permit . . . ELEC-SERVICE CHANGE
Additional desc .
Permit Fee
52.50 Plan Check Fee
.00
Issue Date . . . .
Valuation
0
,Expiration Date
12/24/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 37.5000
EA ELEC SVC <=600V/>200A/<=1000A
37.50
-----------------------------------------=-----------------------------------
Special Notes and Comments
REPLACE 400 AMP METER
CAN 2010 CODES.
LOCATED NEAR 9TH HOLE
ON GOLF COURSE.
2010 HOLES.
-------------------------------------------------
Other Fees . . . . .
----------------------------
. . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
---------- ---------- -------- ----------
Due
-----------------
Permit Fee Total
7--
52.50 .00 .00
52.50
Plan Check Total
.00 .00 .00
.00
Other Fee Total
1.00 .00 .00
1.00
Grand Total
53.50 .00 .00
53.50
LQPERMIT
Bin #
71
City. of La Quinta
Building 8t -Safety Division
P.O. Box, 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #C�
Project Address:
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor. W ry ,v.
%ZU
Telephone: ..p4,...
t ` ' a
Address: �nz ��
Project Description:
/CC
City, ST, Zip: /01J Z6v'
-,f P-0
Telephone: L�0,00 30�f
',? � y, '> c
State Lic. # : 6�710 2 5
City Lic. #.:
Arch., Engr., Designer:
9
Address:
City., ST, Zip:
Telephone: .�tf�•.� rar
State Lic. #:
Construction Type: Occupancy:
Project type /circle one New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories: # Units:
Telephone # of Contact Person:
ao
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
V
Submittal
Req'd
Recd
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'4 Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Reyiew, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P..
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Certificate of Compliance (Part 2 of 2) CF -1
LA QUI NTA HOTEL MA I NT . FACILITY For Enforcement Agency use ony
project True
MADLIN'S ENTERPRISES 10/6/88
Dowmentation Author/Firm Date Chocked By Date
JOB NO: 12350
Both parts one and two of this Certificate of Compliance must be included with each buldnp permit application for the above noted building and appear
on the plant submitted for approval. The building features and requirements represented on the Certificate of Compliance are adequate to achieve
compliance with the second generation nonresidential energy standards for the building referenced above. The building features and requirements are
also adequate for any subsequent afteratons, modifications or additions to the building.
Deslgnwone TITLE 24 DOCUMENTATION
CATHERINE
Name (Print)
OWNER: MADLIN'S ENTERPRISES
Title/Company Name
P.O. BOX 1443, PALM SPRINGS, CA 92263
Address 10/6/88
low A&Ie'l
signs Date
Enforcement Agency Signature Dale
Deslgnw Two
Name (Print)
TAia'Company Name
Address
Signature Date
Enforcement Agency Signature Data
owner
Na,:e (Print)
TitlarCompany Name
Address
Signature Data
Additional ibrformance Approach Strategy Specifications
Lighting
Designer Three
Name (Print)
e/ pang Name
Address
Signature
Date
Enforoem&nt Agency Signahre Date
Designer Four
Name (Print)
ar pany Name
Address
signature Date
orcement Agency Signature Data
Enforcement Agency
Name (Print)
Trtie/Agency
Address
HVAC
Form Revised September 1986 Papa of
F
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504 .
78-495 CALLS TAMPICO (760) 777-7000
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101
March 7, 2008
Mr. Chris Monfort
Spectrum Surveying and Engineering, Inc. Y
for Verizon Wireless
11959 Mariposa Road, Suite 1
Hesperia, CA 92345
Subject: Temporary Use Permit 2008-793
Temporary Cellular Wireless Facility for Verizon Wireless
Dear Mr. Monfort: .
The Planning Department has. approved your request for a temporary un -manned
wireless telecommunications facility ori wheels. The approved location is at the south
end of the La Quinta Resort Maintenance facility parking lot at 51001 Avenida
Carranza asshown. on the enclosed plan and subject to the following conditions of
approval:
1. Obtain an electrical permit for temporary power, prior to setting trailer on site.
2. This approval is valid for a maximum 90 days from date of this letter, after
which this trailer and its appurtenant facilities must be removed with the site
restored to its original condition.
3. 24-hour emergency contact information shall be provided on the outside of the
trailer in case problems arise that require your immediate attention. Emergency
information shall be in a location clearly visible to the public.
4. Install one 2A1 013C fire extinguisher inside the trailer by the front exit door.
5.. No temporary signs are approved unless separately approved by this
Department.
6. The City may elect to add Conditions to this application approval to mitigate any
problems that arise not previously addressed herein.'
D•\..+on\m� �n t. in%tl in ')0nR-79R qtr Annr Verizon.doc
r
This decision may be appealed to the Planning Commission provided the necessary
paperwork and filing fee of $175.00 are filed with this office within 15 days.
If you have any questions, please contact me at 760-777-7064.
Very truly yours,
STAN SAWA
Principal Planner
Encl.
C: Les Johnson, Planning Director
David Sawyer, Planning Manager
Greg Butler, Building and Safety Department
Anthony Moreno, Code Enforcement Department
Ed Wimmer, Public Works Department .
Sonia Cooley, Fire Department
Sergio Bocci, La' Quinta Resort
P:\stan\mup tup\tup 2008-793 Itr appr Verizon.doc
I v
ILDING & SAFETY
DD' E
PT'
APPROVE
FOR CONSTRUCTION
.*!1
DATE��
ALI'
C� 6-616.
22
Jos
APPROVED BY PLANNING DEI
BY,246M—AAMDATE 3
EXHIBIT
CASS NO. -12 F. a0CYZ - -74
o/
Scor �
VY)IL-11 A\j ell
bid it/ OOf7
Q�l
lZI
4— wi