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06-4136 (CGAR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: -06-000.04136 Property Address: 43100 PALM ROYALE DR APN: 609 -051 -010 - Application description: GARAGE - COMMERCIAL 4a Property Zoning: HIGH DENSITY RESIDENTIAL Application valmation, 81853 id ccitit,4 Applicant: Architect or Engineer: 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 (commencing with Section 7000) of Division 3 of the Busine and Professionals Code, and my License is in full force and effect. License Class: 13 License No.: 825987 . Date: d ,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 solecompensation, 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 _ 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.). (_ 1. 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: LQPERIIIT Owner: DUTCH PARENT NV 38 NEWBURY ST 6TH FL BOSTON, MA 2116 Contractor: WPM CONSTRUCTION -CA LP 1000 EAST 80TH PLACE, MERRILLVILLE, IN 46410 (219)680-5000 'Lic: No.: 825987 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/30/06 ------------------------------------------------ WORKER'S 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 issued. My workers' compensation insurance carrier and policy number are: Carrier ZURICH AMERICAN Policy Number WC930464404 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 show become s !ct to the workers' compensation provisions of Section 700 of tlieLabor Cod shall for t omply with those provisions. r b' rDate:, Applicant: 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 1$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. I certify that I have read this application and state that the ove information is correct. I agree to comply with all city and county ordinances and state laws relating to buil in constructi n, and hereby authorize representatives of this county, to enter upon the above-mentioned prope f 'ngpectio p.rp ses. - Vr�4Dii — - -Date: , r Signature (Applicant or Agentl: " Application Number. . . . . .. 06=00004136 ------ Structure Information DETACHED GARAGE ----- Other struct info CODE EDITION 2001 CBC FIRE SPRINKLERS NO FLOOD ZONE NO GARAGE SQ FTG 1404.00 Permit CARPORT%GARAGE �r Additional desc DETACHED GARAGE` t ` .Permit Fee 558.50 Plan Check Fee Issue Date . . . Valuation. 81853 Expiration Date 5/29/07 ti Qty .Unit Charge Per Extension BASE FEE 414.50 32.00 4.5000 THOU BLDG 50,001-100,000 144.00 Permit ELECTRICAL-CARPORT/GARAGE Additional desc . Permit Fee 43.08 Plan Check Fee'.'.. 10.77 Issue Date . . Valuation . . . . 0 Expiration Date 5/29/07 Qty Unit Charge ,Per Extension BASE FEE 15.00 1404.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 28.08 . Permit . . . GRADING -PERMIT Additional desc . Permit Fee 15.00 Plan Check Fee .00 Issue Date . . . Valuation . . . . 0 Expiration Date 5/29/07 Qty Unit Charge. Per Extension BASE FEE 15.00 ------------ Special Notes and Comments FOUNDATION PERMIT ONLY FOR DETACHED GARAGE 20'-7" X 68'-411(1404 SF) S-3 OCC. TYPE V -N CONSTRUCTION.2001 CBC,2004 CEC. -------------------------------------------------------------------------- Other Fees . . . . . . . ART.IN PUBLIC PLACES -COM 389.26 DIF CIVIC CENTER - COMM 219.02: DIF FIRE PROTECTION -COMM 63.18 LQPERD4IT - Application Number : . . 06-00004136 ---------------------------------------------------------- - --------------- 'Other Fees . . . . . . . . . STRONG MOTION (SMI) COM 17.18 DIF STREET MAINT FAC -COMM 148.82 DIF TRANSPORTATION - COMM 3695.32 Fee summary Charged Paid Credited Due Permit Fee Total 616.58 .00 .00 616.58 Plan Check Total 373.80 .00 .00 373.80 Other Fee Total 4532.78, .00 •:00 4532.78 Grand Total, 5523.16 .00• nn 552,3:1ti LQPER111IT - .