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06-4137 (CGAR)P.O. BOX 1504 78-495 CALLE TAMPICO. LA• QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 0.6-0-0004y137 Property Address: 4-3100 PALM ROYALE DR• APN: .609-051-010- - Application description: GARAGE.- COMMERCIAL Property Zoning: HIGH DENSITY RESIDENTIAL r*• - Applic-tion t!altlatinn: 8195? 1i Applicant: Architect or Engineer: 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 8usines nd Professionals Code, and my License is in full force and effect. - License Class: B 'cense No.: 825987 Date: X214/�V kContractoc s• OWNER•BUILDERDECLARATION - 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, 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.). ( 1 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: LQPERDIIT 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 T— - 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 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 Cede, I shat tl with comply with those provisions. . ,� Da� l'I.r4�0�' Appli_ .. ,/µjd�[J� _ 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 J$1 00,000). 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, eachagrees 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 ve infor, Ration is correct. 1 agree to comply with all city and county ordinances and state laws relating to buildi g onstru t on nd hereby authorize representatives of this county to enter upon the above-mentioned propert fo spec ' oses. Date: —Sion`atiire IAoDlicannt o Aoent): Application Number . . . 06-00004137 ------ 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 Additional desc .. DETACHED GARAGE Permit Fee =. . , , 558:_50 Plan Check Fee 363.03 Issue Date Valuation° . . 81853 Expiration Date 5/29/07 �. (i 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 t 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,681-411(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 LQPERA11T . Application Number .. . . . . 06-00004137 ------------------------------------------------------- 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 .00 5523.16 LQPE&lIIT .