The URL can be used to link to this page

07-2527 (SOTB)P.O..BOX 1504 '98-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&'ht 4.4v Q" Application Number: 07-00002527 - Property Address: 78995 HIGHWAY 111 STE 3 APN: 643-020-999-6 -30903 - Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: REGIONAL COMMERCIAL Application valuation: 0 Applicant: 1, Architect oyEngigeer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION . I hereby affirm under penalty of perjury that I ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busines and Pr essiona Code, and my License is in full force and effect. . / Licensee Class: Dense No.: 806022 V Date: / — - Co ;zb OWNER -BUILDER DECLARATION 1 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.). (_ I 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. , B.&P.C. for this reason Date Owner: CONSTRUCTION LENDING AGENCY 1 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: WASHINGTON 111 LTD C/O JACK TARR 30240 RANCHO VIEJO RD. STE. B SAN JUAN CAPISTRANO, CA 92675 Contractor: PLASTERTEC CONSTRU 51555 DESERT CLUB LA QUINTA, CA 9225 (760)200-5400 Lic. No.: 806022 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Ll INC. SEP 2 n 2007 C17Y OF LA QUINTA Date: 9/13/07 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 Sectiurn 3700 of the Labor Code, Tor 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 SUA INSURANCE Policy Number WSLTHPE 5772-01 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 t eco a subject to the workers' compensation' laws of California, and agree that, if I should bec me s bject to the workers' compensation provisions of Section / 371000 of the Laborr Code, I s all fort with comply with those provisions. Datec: zvo-�plican WARNING: FAILURE TO SECURE DTOT OMPENSATION COVERAGE I rAVOFk 6� D SHALL SUBJECT AN EMPLOYER TO CRIMTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITIONOST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OFTLABOR C0ST, 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 setforth 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 nand void if work is not commenced within 180 days from date of issuance of such permit, r ce sation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above inform ion is co rect. I agree to comply with all city and county ordinances and state laws relating to building.donstruc' n, and heVby authorize representatives of this county to enter upon the above-mentioned property for in ect' n purposes. Date: �--' i / _ ig nature (Applicant or A. t): /L ✓_ Application Number . . . . 07-00002527 Permit . . . BUILDING PERMIT Additional desc 8FT HGT STORAGE SHELVES., Permit Fee 15.00 Plan Check Fee 9.75 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/11/08 Qty Unit Charge Per Extension BASE FEE - 15.00 ----------------------------------------------------------------------------- Special Notes and Comments 4 QTY. 8--0" HGT STORAGE SHELVES TO MAC GALLERY RETAIL STORE.2001 CBC. SUPPLEMENTAL TO PERMIT #07-2061. ----------------------- ----------------------------------------------------- Other Fees HOURLY PLAN CHECK 52.50 STRONG MOTION (SMI). - COM .50 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 15.00 .00 .00 15.00 Plan Check Total 9.75 .00 .00 9.75 Other Fee Total 53.00 .00 .00 53.00 Grand Total 77.75 .00 .00 77.75 c LQPERMIT r . Bin # City of La. Quinta / Building a Safety Division P.O. Box 1504 78-495 Calle Tampico , p' La Quinta, CA 92253 - (760) 777-7012 BuildingPermit Application and Tracking Sheet Permit,# - IdIA�'S Project Address:' i S • Il W I $ 3 t Owner's Name: fA A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: Telephone: Project Description: Address: City, ST, Zip: Telephone:. � � City Lic. #: � it —v tc S LVt:!s State Lic. # : i Arch., Engr., Designer: Address: XJ City, ST, Zip: Telephone: State Lic..#: Name of Contact Person: Sq. Construction Type:. Occupancy: P cY: Project type (circle one): New Add'n Alter Repair Demo . FL: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACING . PERMiT FEES Plan Sets d Plan Check submitted "1 Item Plan Check Deposit Amount Structural Calcs. Reviewed, ready -for corrections Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs.. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Gradipg. plan 2Review, ready for corrcctio ue Electrical Subcontactor List Called Contact Person 41; Plumbing Grant Deed. Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3n° Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Totaf Permit Fees i WWI. t , •