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06-0375 (CRES)4 P.O. BOX' 1504, VOICE (760) 777-7012 78-495 CALLEJAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING,&'SAFETYDEPARTMENT INSPECTIONS (760).777-7153 BUILDING PERMIT - �- L Date: 3/14/07 Application Number: 07-00000375, Owner. Property Address: F 43100 PALM ROYALE DR WRM LA-QUINTA - +" APN: 609-051-010- - - 1,000 E. 80TH PL. Application description: CARPORT COMMERCIAL D Q I MERRILLVILLE, IN 46410 .Property Zoning: HIGH DENSITY RESIDENTIAL , Application valualiurl:` 23541 • �li MAR 16 2007 u- ; Contractor: Applicant: Architect or Engineer:' .;.WPM CONSTRUCTION -CA LP CITY OF LAQUINTA 1000 EAST 80TH PLACE, #555 N.` FINANCE DEPT. MERRILLVILLE, .IN 46410 (219)680-5000 Lic. No.: 825987 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I 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 Profession 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 Cl a s: •B '� L' se No.: 825987 for b Section 370Q of the Labor Code, for the performance of the work for which this permit is `,_ Y-- - -' issued. _ .i Date: 5 vfP (77 -'t Contractor: _ 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 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 ZURICH AMERICAN Policy Number WC930464404 following reason (Seca 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 a 0 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 shoul b come su ' t 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 - 700 of the Labor Co , I all fort c ply with those provisions. 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).: Date: !// !t�/.yL Applicant:. - 1 —) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and - T--.- - - the structure is not intended or offered for sale. (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 t 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.). APPLICANT ACKNOWLEDGEMENT (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the r 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. , - property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for. - pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, (—) I am exempt under Sec. - , B:&P.C. for this reason - 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. - Date: Owner: 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 CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the a re information is correct. I agree to comply with all w_ ork for which this permit is issued (Sec. 3097, Civ. C.). - - city and county ordinances and state laws relating to buildi nstruction, hereby authorize representatives Oft hisco ty to nter upon the above-mentioned pr for r pection p r Lender's Name: c ,/� - ab -- -- _ ` ,Date: ` I" tP Signature (Applicant or Agent): Lender's Address: LQPERMIT. - - _ Application Number 07-00000375 ------ Structure Information METAL CARPORT ------ .Other struct info CODE EDITION 01CBC04CEC FLOOD ZONE NO GARAGE SQ FTG 1770.00 Permit . . . CARPORT/GARAGE Additional desc .' . Permit Fee 243.00 Plan Check Fee=. 157.95 le©ue bate Valuation 23SnZ Expiration Date. 9/10/07 Qty Unit Charge Per Extension BASE FEE 45.00 22.00 9.0000 THOU BLDG 2,001-25,000 ------------------------------------------------------------------------------ 198.00 Permit ELECTRICAL-CARPORT/GARAGE Additional desc . Permit Fee . . . . 19.50 Plan Check Fee 4.88 Issue Date . . . . Valuation . . . 0 Expiration Date 9/10/07 Qty Unit Charge Per Extension ' BASE FEE 15.00 6.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 4.50 - - Special Notes and Comments METAL CARPORT (11 SPACES [9REG + 1 HC + 1 ACCESS AISLE])98.33FT X 18FT S-3 OCCUPANCY, TYPE II -N CONSTRUCTION 2001 CBC 2004 CEC.[LOCATED_ N OF BLDG 491- ------------------------------------------- Other Fees . . . . . . . . ART IN PUBLIC PLACES -COM 97.70 STRONG MOTION (SMI) - COM 4.94 Fee summary Charged Paid Credited Due ----------------- ---- - ----------------------------------- Permit Fee Total 262.50 .00 .0.0 262.50 Plan Check Total 162.83. .00 .00 162.83 -Other Fee Total 102.64 .00 .00 102.64. Grand Total 527.97 .00 .00 527.97 LQPERMIT - _