10-0780 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
nr=000.0078
56 0
144 PGA BLVD
775-370-013-C -29421 -
REMODEL - COMMERCIAL
LOW DENSITY RESIDENTIAL
2000
T4bf
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
WA
----=---------------------------------------- - --
--'
LICENSED CONTRACTOR'S DECLARATION
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 License is in full force and effect.
License Class: B "License No.: 684857
X• Date: B -2f.10'. Contractor: -
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 I am exempt under Sec. , B.&P.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:
I,QPERMIT
Owner:
KSL DESERT RESORTS INC
56140 PGA BLV
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/25/10
Contractor: f Ll
EDWARDS CONSTRUCTION INC, BOB AUG51455 DESERT CLUB DRIVE U 6
LA QUINTA, CA 92253 Z010
(760)777-8202
Lic. No.: 684857 C"OPLAliurwr,
-----------------------------------------------
WORKER'S COMPENSATION. DECLARATION
1 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
insurance carrier and policy number are: '
Carrier GRANITE STATE Policy Number WC 555-61-55
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 provisionsof Section
/X� x 3700 of the Labor
rCCode.�eMel�hHff/000RRRR/R/R0��yith co�mu/I�J.'th those provisions.
Date: `� W Applicants
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 ATTORNEYS 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
pplication;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.
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 reI w mgcons ction, and hereby authorize representatives
of this county to enter upon the above -me nu�d proper, spection purposes.
kale: `� � •/0 Signature (ApplicarR'tfr Agent).
Application Number . . . . . 10-00000780
------ Structure Information REPAIR OF DAMAGE AT EXIT TRELLIS COVER -----
Other struct info . . . . . CODE EDITION
2007/2008
FIRE SPRINKLERS
NO
MIXED-USE OCCUPANCY
B
OCCUPANT LOAD
2.00
1ST FLOOR SQUARE FOOTAGE
.00
2ND FLOOR SQUARE FOOTAGE
----------------------------------------------------------------------------
.00
Permit . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 45.00 Plan Check Fee
29.25
Issue Date . . . . Valuation . .
. . 2000
Expiration Date 2/21/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
15.00 2.0000 HND BLDG 501-2,000
30.00
-----------------------------------------------------------------------------
Special Notes and Comments
REPAIR OF DAMAGE AT EXIT TRELLIS COVER
ONLY - REPLACE BROKEN 6X12 BEAMS, (2)
ACROSS DRIVE AISLE AND (2) ABOVE
PILASTERS, AND DEMO AND REBUILD (2)
FRAMED PILASTER COLUMNS. ALL MATERIALS
AND CONSTRUCTION TO MATCH EXISTING.
2007/2008 CALIFORNIA BUILDING CODES.
August 25, 2010 4:03:32 PM AORTEGA
-----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
-----------------------------------------------
Due
----------
Permit Fee Total 45.00 .00 .00
45.00
Plan Check Total 29.25 .00 .00.
29.25
Other Fee Total 1.00 .00 .00
1.00
Grand Total 75.25 .00 .00
75.25
LQPERMIT
jj-T'
O
SCOPE OF WORK
REPAIR TRELLIS PORTION, EAST SIDE
OF GUARD HOUSE (EXIT SIDE) DUE TO
DAMAGE BY TALL EXITING TRUCK --
REPAIR TO OR.IGIN.AL CONDITION
- REPLACE 2'- 6X12 BEAMS FROM
0 GUARD HOUSE TO COLUMNS & 2 --
6X12 BEAMS EA SIDE OF'C.OLUMNS &
ALL ASSOCIATED HARDWARE AND CONNECTORS
Bin #
OtY of La Quinta
Building 8L Safety Di dslon
P.O. Box 1504, 78-495 Calle Tampico
La Quinta; CA 92253 - (760) 777-7012
Building Permrt_Applicatonand Tracking Sheet
Permit #
O V
Project Address:
Owner's Name:
A. P. Numbed ��q�4'`�V
Address:
Legal Description: ` � 7(!:� C4
City, ST, Zip:
Contractor: � t�
Telephone:
Address: �,, l//"
Project Description:
City, ST, Zip:V6' 11<< %225
3
�
Ki
Telephone: / ! t/ 2 0Z ::::.:.:::..:..:>:» >t;.:>«•':r%>.
F/>C PbC:
State Lic. # : City Lic.
designer: PC TI<
Address: 7 / -6 Z2 G'dXf � zt_
City., ST, Zip:
Telephone:--74-0� z8 z �
State Lic. # `:>:;z.,;, ;
�. :•:.:.:.:y.:,z:
Construction Type: ,Occupancy:
, Project a circle one : New
1 type ( ) e Add'n Alter Repair Demo
Name of Contact Person:
Sq; Ft.:
# Stories:
#Units:
/^��
Telephone # of Contact Person: 76 0 7 Z-8
Estimated Value of Project:
APPLICANT: DO.NOT.WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd_
1LTF6 Y PERMIT FEES
Plan Sets
3
Plan Check submitted /// Item
Amount
Structural Calcs.
Reviewedi ready fo,,QCg 68 2 U 10 Plan Check Deposit
r�
Truss Calcs.
Called Contact Person Plan Check Balance
Title 24 Calcs.
Plans picke]Dy° Construction
Flood plain plan
Plans resubmitted Mechanical
r�
Grading plan
2" Review; ready for corrections/issue Electrical
Subcontactor List
Called Contact Person Plumbing
`—
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
.mss
IN HOUSE:-
'"' Review, ready for corrections/issue eveloper Impact Fee
�--
Planning Approval
Called Contact Person P.P.
f
Pub. Wks. Appr
Date of permit issueSLAY., go,
�—
School Fees
Total Permit Fees
LS
151�1511AVV - .ftp -E. OVA