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07-1693 (DEMO)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00001693 Property Address: 78450 HIGHWAY 111' APN: 604 -050 -043 - Application description: DEMO - COMML/OTHER Property Zoning: COMMUNITY COMMERCIAL Application valuation: 7000 Applicant: Architect or Engineer: vlu Pill BUILDING & SAFETY DEPARTMENT, BUILDING PERMIT 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 Professionals Code, and my License is in full force and effect. License Class: B J Icense No.: 775619 Date—fi— 407lContractor.4? 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).: (_) 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, 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—) 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 (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT Owner: MADISON DEVELOPEMENT 78-450 HIGHWAY 111 LA QUINTA, CA 92253 Contractor: D VISTA MIRAGE HOMES 31520 AVE EL PUEBLO CATHEDRAL CITY, CA 92 34 (760)321-6114 Lic. No.: 775619 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date'. 6/11/07 of�111001 'OF�ANce.QU ry N 1� 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 1576879 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 of Section 3700 of the Labor Code, II f261 �Co,ov`o ns. Date:j6-11-40 Applicant: ' 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 1$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 fo[towing 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 this county to enter upon the above-mentioned property fo specturposes. Date:�`!� ��/� Signature (Applicant or Agent): f✓/` �� . Application Number 07-00001693 Structure Information Construction Type . . . . . TYPE ---------------------------------------------------------------------------- V - NON RATED Permit . . . DEMO PERMIT Additional desc . Permit Fee . . . . 45.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 7000 Expiration Date 12/08/07 Qty Unit Charge Per Extension BASE FEE 45.00 ---------------------------------------------------------------------------- Special Notes and Comments DEMOLITION INTERIOR WALL FOR FUTURE TENANT. Fee summary _ Charged ------------------------------------- Paid Credited -------------------- Due Permit Fee Total 45.00 .00 .00 45.00 Plan Check Total .00 .00 .00 .00 • Grand Total 45.00 .00 .00 45.00 DEVELOPMENT 6/8/07 } City of La Quinta Building & Safety Division P.O. Box 1504 La Quinta, CA 92253 To Whom It May Concern, We are aware of the work that is being performed for Carpeteria at the location 78-450 HWY 111, La Quinta, CA. RYck Wilkerson Madison Development Rick Wilkerson - - i Manager DEVELOPMENT 760.771.1755 78370 Highway 111 760.771.0202 Fax Suite 200 rickw@madison-development.com La Quinta, CA 92253 1 78-370 Highway 111 . Suite 200 . La Quinta, California 92253 . 760.771.1755 . Fax 760.771.0202 13 Bin # Cit0yf La Quinta Building 4 Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application`,and Tracking Sheet Permit # u("1 Project Address:' 7 — Owner's Name: A. P. Number: • 4 $ Q ( Address: _ Legal Description: Contractor: Er y�_o City, ST, Zip: 117 Telephone: Project Description: ` L D. Addres Q City, ST, Z�1/ Aetg Telepho e: �� r, L State Lie. # : City Lie. #: Arch., Engr., Designer: Address: City, ST; Zip: Telephone: State Lie. #: erne of Contact Person:. _ 'L Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft:: # Stories: # Units: Telephone f — Estimated Value of Project: Q Q o „h APPLICANT: DO NOT WRITE BELOW THIS LINE Plan Sets Recd TRACHING , PERMIT FEES Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Pians. resubmitted Mechanical Grading.plan 2nd Review, ready for'correctionsrissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SALL H.O.A. Approval Plans resubmitted Grading JN HOUSE:= '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval. Called Contact Person ,, I p,p. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees