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07-0143 (RR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 0-7-- 0 �f000143 ' Property Address: 78267 HIGHWAY 111 APN: 604-050-012-1 -000000- Application description: RE -ROOF Property Zoning: COMMUNITY COMMERCIAL Application valuation: 54020 c&t�/ . 4 44u t& BUILDING & SAFETY DEPARTMENT'. BUILDING PERMIT Owner: PLAZA LA QUINTA/HARSH INV 78401 HWY 111 LA QUINTA, CA 92253 Contractor: Applicant: Architect or Engineer: - EBERHARD BENTON ROOFING 3691 HANCOCK STREET - SAN DIEGO, CA 92110 (619)291-6340 Lic. No.: 731742 LICENSED CONTRACTOR'S 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 Professi�LinseNo.: and my License is in full force and effect. License Class: B C39 C43 /f 731742 .a Dater+lam $�6 Contractor: V-' 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 70001 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 contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/18/07 31_ 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 STATE FUND Policy Number 0000117-2007 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 t the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith c ply with those provisions. 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 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 '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, n 1 h eby authorize representatives of this county to enter upon the above-mentioned propertr inspection pu p s Date: I' 6-P7., ignature (Applicant or Agejtl: Application Number . . 07-00000143 Permit . . . RE -ROOF -� Additional desc . ` Permit Fee 30.00 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date 7/17/07 Qty Unit Charge Per. Extension BASE FEE --.---------`-------------- 30.'00 --------------------------------------------------- Special Notes and Comments REMOVE EXISTING ROOFING/REPLACE WITH JOHNSON MANSVILLE 4GNC/THEN COAT WITH • WESTERN COLLOID ELASTAHYDE 720 ARC0682-0003. CLASS "A" MATERIALS ONLY. - Fee summary Charged Paid Credited ----------------- Due ---------------------------------------- Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 .00 .00 30.00 LQPERMIT q R �wro xl�s7%NG r �N ��-�IsANS G Fl l lg— J�WII Ze) -, l l 70 � & A ,�I �.S�/VC, , R46c�� Fans 71% �� ,E �� c�� 7o Alew O-�'C,-10 I*W PMrr/OA/ WW& A,woQ Y ",RdhE�lv y8 "0► e, 9,xtl s T14D 16'1 a, c, 7"kr-0;1J Po7rom P449 To 1sT A �a I )Ryu/�11 oN (. M9 S ce/1,610 I� a � I � NG 0+�i &r— /c2 I C"4 '4v do --------._._ ..... _ ----------� IAl BUING &SAFETY DEPT. IwAPPROVED 0 x FOR CONSTRUCTION DATE BY _ 13 lT r 4 / -1 M� W I. Tom Tisdale Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Banning Beaumont Cahmesa Canyon Lake Coachella Desert Hot Springs Indian Wells Indio Lake Elsinore La Quinta• Moreno Valley Palm Desert Perris Rancho Mirage 4. San Jacinto Temecula Board of Supervisors Bob Buster, District 1 John Tavaglione, District 2 Tun Venable, District 3 Roy Wilson, District 4 Tom Mullen, District 5 RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation witli the California Department of Forestry and Fire Protection 210 West San Jacinto Avenue • Perris, California 92570 • (909) 9 Fax (9W) 40 10 August 27, 2002 Lumpy's Golf 78-267 Highway 111 4 La Quinta, CA 92253 Re: , Non -Structural Building TA Plan Review LAQ-02-BP-171 / Lumpy's Golf Fire Department personnel have reviewed and approved the plans you submitted for the above - referenced project. Please be advised the following conditions apply as a part of the conditions for the issuance of a building permit. 1) If the building has an existing fire sprinkler system, fire sprinkler plans for the tenant improvement area must be submitted to the Fire Department for review, along with a plan/inspection fee. The approved plans, with Fire Department Job card must be at the job site for all inspections. Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy. Applicantlnstaller shall be responsible to contact the Fire Department to schedule inspections. Requests for inspections are to be made at least 24 hours in advance and may be arranged by calling (760) 863-8886. All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering staff at (760) 863-8886. Sincerely, FRANK KAWASAKI Chief Fire Department Planner By "t CL Walter Brandes Fire Safety Specialist HIPEPGENERAUFORMS18u Kmg Plan Check.doc EMERGENCY SERVICES DIVISION . PLANNING SECTION • INDIO OFFICE 82-675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072 •