07-0113 (TT)Rs 4
P.O. BOX 1504 .
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
07-00000113��
79124 HIGHWAY 111
649-820-021- -
TEMPORARY TRAILER
REGIONAL COMMERCIAL
2000
T-� d-tt 4.4 w
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
THOMAS ENTERPRISES
2385 SHELTER ISLAND DR
SAN DIEGO, CA 92106
Contractor:
PACIFIC WEST GENERAL CONTR 1
75153 MERLE DRIVE, STE E
PALM DESERT, CA 92211
(760)340-7590 i1J
Lic. No.: 857578
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/12/07
._6C]L U
AN 1-6 2007
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and ofessionals Code, and my License is in full force and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B Lic 857578
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is '
7
issued.
Date: �i1��G CorStractor:- - ii
J
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
t✓ (
Code, for the performance of the work for which this permit is issued. My workers' compensation
' OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 0029778-2006
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should becom��'subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I 1 trforthwith comply provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
p
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
D ate1. (�� " e- Applicant: c
(_) 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
WARNING: FAILURE TO SECURE WORKERSCOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. -
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.). _
• 1 _ 1 I am exempt under Sec. BAP.C. for this reason
Date: Owner:
t4
CONSTRUCTION LENDING AGENCY 'l
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
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.
certify that I have.read this application and state that the above inf ation is correct. I agree to comply with all
city and county ordinances and state laws relating to building co r i nand•hereby author' repre ntatives
of this county to enter upon the above-mentioned property nsp ction purposes\
Dat':; 60 Signature (Applicant or Agent):'
l
Application Number . . . . . 07-00000113
Permit . . . TEMP TRAILER
/ MOBILE HOME
Additional desc .
Permit Fee . . . . 200.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
2000
Expiration Date 7/11/07
Qty Unit Charge Per
Extension
BASE
FEE
200.00
------------------------------------------------------------
Special.Notes and Comments
----------------
TEMP CONSTRUCTION TRAILER PER TUP
06-691.
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
l
APPROVED BY OTY DZVELOPMEV,! '&kh I
� JPWWA�'
BY
EXHIBIT
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January 12, 2006
Mr. Mark Zens
Pacific West General Contracting
75-153 Merle Dr. Suite E
Palm Desert, CA 92253
SUBJECT: TEMPORARY USE PERMIT 2006-691
CONSTRUCTION TRAILER; THE PAVILLION
Dear Mr. Zens:
The Community Development Department hereby approves your application request
to install one office trailer at The Pavillion commercial center in La Quinta, as shown
on the. attached exhibit during the construction of the facility, subject to the following
Conditions:
1. Once the trailer is installed, it can remain on-site for a one-year period.
However, an extension may be applied for, with no additional fee, in writing to
the Community Development Department prior to the expiration of the permit.
The Community Development Director may, after reviewing the facts, extend
the use of the trailer for another six-month period.
2. Use of the trailer shall be limited to the hours of construction as listed in the La
Quinta Municipal Code (Chapter 6.08, Nuisances). A copy of this time
schedule can be obtained from the Building and Safety Department.
3. A building permit is required for the temporary trailer and temporary electric
power. Please apply to the Building and Safety Department for a permit (760-
777-7012). Written permission from the property owner is required before a
building permit can be issued.
4. The trailer shall be placed a minimum 10 -feet from the street unless otherwise
approved by the Building and Safety Director.
5. A building address shall be installed on the trailer to help identify the
temporary -business location (e.g., minimum 2 -inch high letters in a contrasting
color).
P.O. Box 15.04 • LA.QU.INTA, CALIFORNIA
.92247-1504
78=495 CALLC TAMPIco • LA QUINTA, CALIFORNIA 92253
(760) 777-7000 -FAX (760) 777-7101
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6. Provide one 2A10BC fire extinguisher inside the trailer and sign over the exit
doors which states 'Door to Remain Open During Business Hours.P
7. The.trailer, if elevated off the ground, shall be skirted with metal or wood siding
material. The skirting -material shall be painted to match the exterior color of
the construction trailer. The exterior surfaces of the trailer shall be painted (or
may be stuccoed) and in overall good condition.
8. No temporary signs are permitted unless separately approved by this
Department.
9. 'No exterior Fighting for the trailer is allowed unless approved by the Building
and Safety Department. All security light fixtures shall be hooded to prevent
light glare from being cast onto adjacent residential properties. .
10. Mounted close to the front door on the outside of the trailer shall be a written
notice informing emergency personnel of your 24-hour emergency phone
number in case problems arise that need your prompt attention (i.e., minimum
one -inch high letters).
11. The trailer shall be removed from the site prior to the issuance of a Certificate
of Occupancy.
12. Provide restrooms facilities to accommodate on-site construction workers.
13. Dust control measures shall be employed if construction parking is allowed
adjacent to the trailer.
14. The City may elect to add conditions.to this application request to mitigate any
problems that may arise and are not address herein.
If you have any questions, please contact me at (760) 777-7125.
Sincerely,
YVONNEFRANCO
Assistant Planner.
C:Building an�dSafety Departme60
Public Works Department
Code Compliance Department
Sheriff's Department
• z APPRO`EM BY KVELOPMEil7 CZPAHi st-tv,,
BY l/ _ DATE
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