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04-6027 (RER)Tihf 4 4 4" BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . 04-00006027 Date 8/31/04 Property Address . . . . . . 47594 CALEO BAY APN: 643-200-009-9-000000�D f =Y Application description . . . REMODEL - RESIDENTIAL Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 2500 ; a 7 2"A Owner LAKE FRONT INDUSTRIES 74770 HIGHWAY 111 STE 205 LA QUINTA CA 92253 ContractorCF1VOr UAQUInTA .-------------------- --FLr4-AMC1EDEPT. HAYHOE CONSTRUCTION CORP 17821 E. 17TH STREET, STE #240• TUSTIN CA 92780 (714) 508-2400 WCC: STATE FUND WC: 1712307 01/01/05 CSLB: 519186 10/31/05 CCC: B ------ Structure Information BOAT DOCK ----- Construction Type . . . . . TYPE V - NON RATED Other struct info . . . . . CODE EDITION 2001 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 54.00 Plan Check Fee 35.10 Issue Date . . . . Valuation . . . . 2500 Qty Unit Charge Per Extension BASE FEE 45.00 1.00 9.0000 THOU BLDG 2,001=25,000 .9.00 ---------------------------------------------------------------------------- Special Notes and Comments Boat Dock ----7 --------------------------------------- =------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 3.51 STRONG MOTION -(SMI) - RES .50 Fee summary Charged Permit Fee Total 54.00 Plan Check Total 35.10 Other Fee Total 4.01 Grand Total 93.11 Paid Credited Due ---------- ---------- ---------- .00 .00 54.00 .00 .00 35.10 .00 .00 4.01 .00 .00 93.11 P.O. BOX 1504ICE VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: O 6 l7 Z� Date: %'2 Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 Lice s is in full f and effect. t (� License Class aA:aZ S License No. Date CIL Contractor - � OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 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 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.). U I am exempt under Sec. , BA 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 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 ist std. My orgy kers' gpmpensation insurance carrier and policy numb r are: Carrier `��.�Fti-." `y Policy Number l t Z 1 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, I shall forthwith comply with those provisions. Ct Date rl Applicant'zzZ�—� 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. 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 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 perforned 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 cored. 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 for inspection purposes. Date. —` �� Signature (Applicant or Agent��`----�1 Page 2 Application Number . . . . . 04-00006027 Date 8/31/04 '•1AR-2'3-2004 10:34 AM NICKERSON & ASSOC. INC. 760 323 5699 CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE.BY P.05 Y': �_�SMC� L/3tlI N'�7 JOB.NO. JOHNSON AND NIELSEN ASSOCIATES CONSULTING STRUCTURAL ENGINEERSy�'� BY L P h 647 N. MAIN STREET, SUITE 4-13 JUo6, d� DATE RIVERSIDE, CALIFORNIA 92501 i 909-686-5122 FAX 909-686-6752 SH --J_ OF All aT 110 94 ol�AT 14 -Qr �' v iwr J r ID ITY OF LA QUIN B JILDING & SAFETY DEPT. APPROVED I FOR CONSTRUCTION :9-4-01 . Cl.y ►�� P -4vif s��) sI•AB G c NO. 3834 m .EXP. 3-31-2006 *s' �T�UCIUQ'P u��Q i July 21, 2004 C4c� COT 7 AaAr A� To: Lake La Quinta Architectural Committee From: Lake Front Investors Subject: Proposed docks and location for Lake La Quinta Estates Dear committee, Please see the following seven pages of drawings and marked up drawings of the proposed docks for subject development. For all intents and purposes the docks will be the same, both visually and.structurally, as the majority of docks presently located in Lake La Quinta. The variation will be that these docks will be overhanging a sea wall instead of a slope. Your approval is requested so that we may proceed with construction. Should you have any questions or require further information please contact the undersigned at (760) 771 1528. Sincerely, Robert N Slaughter