07-0142 (RR)C%
P O. BOX -1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: C07-00000142.
Property Address: 78401 HIGHWAY 111
APN: 604 -050 -999 -
Application description: RE -ROOF
Property Zoning: COMMUNITY COMMERCIAL
Application valuation: 382363
T4'ht 4 4 Q"
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 nLe, and my License is in full force and effect.
License Class: B C39 C43 G/�nlf eNo.: 731742
Date:
--contractor:,
L!/
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 ($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 _ 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_ 1 I am exempt under Sec. , B.&P.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 ISec. 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
Owner:
PLAZA LA QUINTA/HARSCH INV.
78401 HWY 111
LA QUINTA, CA 92253
Contractor: n182GOT7 EBERHARD BENTON
3691 HANCOCK STRSAN DIEGO, CA 92(619)291-6340 Lic. No.: 731742CI'iY OF LA QUINTA
-----------------------------------------------
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
1 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 of Section
�j 3700 of the Labor Code,,I/sshhallll�forth th comply with those provisions.
Date, �ApplJicam: (�,�,i� 'G►�
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 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 constructio and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection p r ses.
,.Date: i0� Signature (Applicant or Agent):
�F.
to
LQPERMIT
Application Number . . . . . 07-00000142
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 .
r
'Bin #
O- " ��'L City of La Quinta
Q1 Building tai' Safety Division
Permit # 1� P.O. Box 1504, 78-495 Calle Tampico
o57---LM
J ��2,�J' LLa Quinta, CA 92253 - (760) 777-7012
,/ I I Building Permit Application and Tracking Sheet
Project Address: 78-401 Highway 111aza ct uin a
Owner's Name:
A. P. Number:
Address: 7 8 — 4 01 Highway 111
Legal Description:
City ST Zip: La Quinta CA 92253
Contractor: Eberhard Benton Roofing -
Telephone:(760) 771-4580
Address: 3691 Hancock
Streeti
Project Description:'
City,ST,Zip: San Diego,
CA 92110
Telephone: ( 619 4
2
P 9 —
1 6 3_
0
71
State Lic. # : 731742
t
1 � NC
City Lic. #:
Arch., Engr., Designer:
Address:
o(, I?J- oat
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
ancY
State Lic.
'
Project e
ct type (circle rcle one)': New Add'n Alter Repair Dem
Name of Contact Person: Bill
Whitman
•
Sq. Ft.: s
#Stories:
#Units:
Telephone # of Contact Person: (.619) 291-6340
Estimated Value of Project:
'
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
Plan Sets
PERMIT FEES
Plan Checli'submitted
Item
Structural Cafes.
Reviewed, ready for corrections
_
Amount
Check Deposit
Truss Calcs.
Called Contact Person
Check Balance
Title 24 Calcs.
Plans picked up
rConstruction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°d Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:=
M Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Sch6ol Fees
r 7�-Z5
4f
Total Permit Fees
�-z1363- S��
SITE PLAN
p,6d
4
4A I
5A
6
7
9
10
13),
14
15
16
39
16A
17
40
20
41
42
3
,L43 4
26
kq
JAR-02-2006 16:56 P. 02/02
BENTON ROOFING
March 2, 2006
City of La Quinta
Building & Safety Department
78-495 Calle Tampico
La. Quinta, CA 92247-1504
Attn: Greg Butler
Dear Mr,' Butler,
On September 28, 2005 Eberhard Benton pulled a permit for a roofing project in La
Quinta. Due to some delays the project has not yet started. I am requesting an extension
to permit 905-4349. The project address is 78-401 Hwy. 111, La Quinta, CA,
Respectfully,
i
G4.
Fred Bou Ito-0h.?Q
Project Manager ,E � J N� .?gc 4cosh2l
- � 3�►6J O(�
A w
r
3691 Hancock Street San Diego, CA 92.110 + (619) 291-6340 • Fax (619) 681-114
Llceme Nn. 7.91742
TOTAL P.02
ql ,
. ,: 1J
P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
March 10, 2006
Mr. Fred Bouman, Project Manager
Eberhard Benton Roofing
3691 Hancock Street
San .Diego, CA 92110
FIL9
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
RE: Building Permit'Extension Request —X78401 Highway 11,1.
Dear Mr. Bouman:
I have received your faxed letter dated March 2, 2006, requesting an extension
for the re -roof permit issued at the above address under Building Permit #05-
4349. Our records indicate the following status on this project.
Inspection status:
Permit issued: 9/28/05
Last successful inspection: None
180 -day expiration date: 3/27/06
180 -day extension date: 9/25/06
Under the provisions of California Building Code Section 106.4.4, your request
is hereby granted.
Because the Building Code specifies that "no permit shall be extended more than
once," please be advised that unless the project passes its next required
inspection on.or before Monday, September 25, 2006, your building permit will
expire automatically.
Greg Butler
Building & Safety Manager