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04-5608 (TT)!- 0� • 1Gl�l� F. U ry BUILDING & SAFETY DEPARTMENT -t� P.O. Box 1504 (760).777-7012 OF �8-4956 CALLE MPICO �'- FAX (760) 777-7011 LA Q`UI`NTA; Ga �L� FORNIA 92253 INSPECTION. REQUESTS (760) 777-7153 '}aF 7 0 5 2004 � BUILDING PERMIT CITY OF 4A QUINTA FINANPF 4F App -on== Amb X04-00005608.- Date, 8/05/04 Property Address . . . . 78772" IGHWAY 111 APN: 643-080-037-13 -000000- Application description TEMPORARY.TRAILER Property Zoning . . . . . . . REGIONAL COMMERCIAL Application valuation . . . . 300 Owner _ Contractor ------------------------- ---------- ------------- ONE ELEVEN LA QUINTA CONSOLIDATED CONTRACTING, INC. 71084 TAMARISK LANE '46753 ADAMS STREET RANCHO MIRAGE CA 92270 LA QUINTA CA 92253 (760) 324-5485 (760) 324-5488 WCC: STATE FUND WC: 17707492004 01/01/05 CSLB: 824183 09/30/05 CCC: B -C8 ----------------------------------------------------------------------------- Permit . . . TEMP TRAILER / MOBILE HOME Additional desc . . - Permit Fee . . . . '200.00 Plan Check Fee .00 Issue Date . . . . Valuation' 300 Qty Unit Charge Per Extension le BASE FEE 200.00 - ----------------------------------.---------------------=------------------- Special Notes and Comments ' TEMPORARY CONSTRUCTION TRAILER FOR LAMPOST PIZZA PER MUP #2004-469 Fee summary Charged Paid.'Credited Due --------------------------------`------------------------ Permit Fee Total 200.00 .00 .00 200.00 Plan Check Total .00 .00 .00 .00 Grand Total 200.00 .00 .00 200.00 E .ms's P.O. Box 1504 • " VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4 4 a INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Date: 5s' S - O Architect or Engineer: Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS I hereby affirm under penalty of perjury that I am licensed under e, and my Licvgjs i fell fAce and effect. icensee Class ``�� (JC7 icer Date �1 — 5 Contractor LICENSED CONTRACTOR'S DECLARATION r rovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals OW R -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contrac rs' 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, r 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 Con ctors' 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 basi 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 ): U I, as owner of the property, or my employees with wages as their sole mpensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License L w does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself or 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.). U 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.). U I am exempt under Sec. , B.8 P.C. for this reason Date Owner WORKERS' 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 ave and will maintain workers' compensaf insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is W M ers' c ensation ' rance carne a is nu b r p �amer Policy Number U ertify that, in iffe 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, I shall forthwith comply with those provisjQne—, WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100, 00), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNE 'S FEES. C NSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction len ng agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address 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, indemnity 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 construc tion,sentatives of this county to r upon the ove-mentioned property for inspection purposes. /aterApplicant or Agent). w P.O. Box 1504 78-495 CALLS TAMPICO (760) 777-7000 LA QUINTA, CALIFORNIA 92253 FAX (7 60) 777-7101 August 2, 2004 Mr. Dave Smoley One -Eleven La Quinta, LLC 46753 Adams Street La Quinta, CA 92253 Subject: Temporary Use Permit 2004-469 (Temporary Construction Trailers for Lamppost Pizza) Dear Mr. Smoley: The Community Development Department has approved your request for a temporary construction trailer in the One -Eleven La Quinta Shopping Center for the construction of Lamppost Pizza, pursuant to the enclosed plan and subject to the following conditions: 1. Obtain a building permit including an electrical permit for temporary power prior to setting trailer on site. — —=---2- -° -T-he-trailers-shall-haverestroom facilities-to=accommodate-personnel-or-off-sitet -- facilities shall be easily available. 3. Mounted on the exterior of the trailer close to the front door shall be a written . notice providing emergency personnel your 24-hour emergency phone number they can call in case problems arise that need your prompt attention (i.e., minimum 1" high letters). 4. Install one 2A.1 OBC fire extinguisher inside the trailer by the front exit door. 5. No temporary signs are approved unless separately approved by this Department. 6. Removal of the temporary construction trailer is required upon completion of this project. P:\stan\Itr app tup 2004-469.dbc --- 7. Any permits required by the Public Works Department shall be obtained prior to any work proceeding. 8. The City may elect to add Conditions to this application request to mitigate any problems that arise not previously addressed herein. 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, JERRY HERMAN COMMUNITY DEVELOPMENT DIRECTOR STAN B. SAWA Principal Planner Encl. c: Building and Safety Director Public Works Director Code Enforcement Department Department... APPROVED BY COMMUNITY DEVELOPMENT DEPARTMENT' By -ZArVvl--, G AAA fA DATE 2 EXHIBIT CASE NO. _ -rU12 04--4Lq- -su6k—c6 'bo cov)c�r610rls LA -t-11 04 C-2/ PARCEL D L L LA SS --189 3.5773 Sq.Ft Oki -� Rost PF LAMPPOST PIZZA 78-772 Highway 111, La Quinta One Eleven. La QWnt.a Center, C 'd onsolt atedContracting, Inc. 255 Sq.Ft -PAD' D-2 W ph!�Wt 7� \ S PARCEL F/ D850 PAD L-1 C-2 N *10 "HM VtAm ftoW MMA 9404 LAMPPOST PIZZA 78-772 Highway 111, La Quints One .Eleven La Quints Center - Consolidated Contracting, inc. > PARCEL D LLA 95-199 35773 SqoFt \ ]R � 25s07 54Ft ; / �\\R -PAD 0-2 �tii�y � r F-3 )00 � � LA 5v