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07-2595 (SOTB)" P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: c 07100002595 Property Address: 79485 HIGHWAY 111 APN: 600 -020 -027 - Application description: STRUCTURES OTHER THAN Property Zoning: REGIONAL COMMERCIAL Application valuation: 30000 Applicant: Ti -tit 4 4 Q" BUILDINGS Architect or Engineer: P/A 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 (commencingce awith Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full fornd effect. - License Class: A -B License No.: 650389 ate:101 ntractor: 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 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 am exempt under Sec. , BAP.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: STAMKO DEV CO 10345 W OLYMPIC BLV 2 FL LOS ANGELES, CA 90064 / Contractor: JACOBSSON ENGINEERING CONSTR P.O. BOX 14430 PALM DESERT, CA 92255 (760)340-0194 Lic..No.: 650389 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/04/07 WORKER'S COMPENSATION DECLARATION 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 insuranra narrier and policy number are: Carrier STATE FUND Policy Number 765310106 _ 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 a 37100 of the Labor ..Coode,�I ashall fo thhwwith co/mply�w� with those provisions. atm ! e: !- 7J - { PPlicant: 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. 1 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 t e above-mentioned property for inspection purposes. D e: Si ature (Applicant or Agent): 7 r" Application Number . . . . . 07-.00002595 Permit . . . BUILDING PERMIT Additional desc - Permit Fee . . . . 284.50 Plan Check Fee 184.93 Issue Date . . . . Valuation . . . . 30000 Expiration Date 4/01/08 Qty Unit Charge Per Extension BASE FEE. 252.00 5.00 6.5000 THOU BLDG 25,001-50,000 ---------------------------------------------------------------------------- 32.50 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee 21.75 Plan Check Fee 5.44 Issue Date . . Valuation . . . - 0 Expiration Date 4/01/08 Qty Unit Charge Per Extension BASE FEE 15:00 9.00 .7500 -EA ELEC POLE LIGHT 6.75 ------------- -------------------------------------------------------------- Special Notes and Comments (9) PARKING LOT LIGHTS, 40OW HIGH PRESSURE SODIUM. CUT-OFF TYPE. ENGINEERED BASES PER 2001 CBC, 2004 ELECTRICAL CODE, LIGHTING STANDARDS PER 2005 ENERGY. 3, 2007 10:29:13 AM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . ENERGY REVIEW FEE 18.49 Fee summary Charged Paid ------------------------------------- Credited -------------------- Due Permit Fee Total 306.25 .00 .00 306.25 Plan Check Total 190.37. .00 .00 190.37 Other Fee Total 18.49 .00 .00 18.49 Grand Total 515.11 .00 .00 515.11 LQPERMIT l A Bin #�, City of LaQ Uinta. Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit.# �t;1 Project Address.71? - 19S ivy' �`� Owner's Name:SIAM KO.. 10E1�EL A. P. Number: Address: 6020 CEOVYE a oz1l/E 06(ty Legal Description: City, ST, Zip: . G05 CA, 00(1S Contractor: -,�AC 0Q SSo M• FNi I l l l l l i l 0 1111 -. II xx �xx NN, �-w I ' I I I I I � I I -J (E) BE I I I I I I I I I � I I I I I I I I 1 1 I I _tel PARCEL 1 FF=66.50 PAD=66.0 -- -- r — ✓ _ _ — _ KO -*NOTE - - - - -� - _ _-" O -----= F0f1 APf�lt4111 MIGHT POLE L�IfN$I I�NN1W - - - - - - - - -- P ------------------------ (LIGHT POLE IILOCAMONSIDETERMINED BY BEN NIENUNEERING) f,1j ?o � DUNE PALMS L minaire Schedule Ess; CITY OF LA OUINTA SHEt7 No. Project: The Centre - Hammer Lo Quinta,CA ,�° o. r �� fdW LIGHT POLE EXHIBIT 1 Symbol Qty Label Description Arrangement Lumens LLF Filename - PARCEL MAP No. 33588 -PARCEL 1 <H> 2 A Gordco EH 19-2-3-400HP5 ®24' BACK BACK 50000 0.60 G534H.ies Em. Rnoro> u tc: aaezra --m) 3 D Gordco EH 19-1-3-400HP5 ®24' SINGLE 50000 0.800 GS34HIII �r WM FMW Tp on». swre r% vm�V—..a � fM)N&P ldG1ED nr THE NE. +/4 or Ste 29.15S. Rh. SBB4M 1 C Gordco EH 19 -2 -FM -400HPS ®24' TWIN Rotated 50000 0.800 GSFM4H.ies FaGr� `°" CENTRE AT LA UUINTA fin'