06-4140 (CGAR)• ���VI1AW
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 '
BUILDING PERMIT
Date: 11/30/06
Application Number: 06000014
,4--0 Owner:
Property Address: 43100- PALM ROYALE DR DUTCH PARENT NV
APN: 609-051-010- - 38 NEWBURY ST '6TH FL
Application description: GARAGE —COMMERCIAL BOSTON, MA 2116
Property Zoning: HIGH DENSITY RESIDENTIAL
Appucavan valuavon: 1316 3
Contractor: D
Applicant: Architect or Engineer: WPM CONSTRUCTION -CA LP
1000 EAST 80TH PLACE, #555 N. DEC
0 4 ZU06
MERRILLVILLE, IN 46410 `t
(219)680-5000
Lic. No.: 825987 CITYOFLAQUINTA
FlMetunr --
-----------------
LICENSEDZONTRACTOR'S DECLARATION
I hereby affirm under penaltyof perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business d Professionals Code, and my License is in full force and effect.
License Class: B LicenseNo.: 825987
-- Date:. (2Iv�0�-Contrac
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and i
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 herselfthrough 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.).
(_) 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 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:
LQPERA11T
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. -
1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for theperformance of the work for which this permit is issued. My workers' compensation
insurance cerrier 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 mannAs become subject to the workers' compensation laws of California,
and agree that, if 1 some s ject tothe workers' compensation provisions of Section
14""
3700 of the Labor ll fo comply with those provisions.
Dater l'L c4""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 ($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 th above information is correct. I agree to comply with all
city and county ordinances and state laws relating to bui i g construgtio and hereby authorize representatives
of this count to enter upon the above-mentioned prope y. or 'ns ectio
Siur,(I(Applicant�or:.gent):
Application Number .
. . . . 06-00004140
------ Structure Information
DETACHED GARAGE W/MAINT.
-----
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 W/MAINT.
Permit FCC 1 .
558.50 Plan Chook Foo
3G3.03
Issue'Date . . .
1
Valuation
81853
Expiration Date
5/29/07
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 MECHANICAL
Additional desc .
Permit Fee
33.00 Plan Check Fee
8.25
Issue Date
Valuation . .
. . 0
Expiration Date
5/29/07
Qty Unit Charge
Per
Extension
BASE -FEE
15.00
1.00 9.0000
EA MECH FURNACE <=100K
9.00
1.00 9.0000
EA MECH B/C <=3HP/100K BTU
9.00"
e/ ----------------------------------------------------------------------------
Permit . . . .
PLUMBING
Additional'desc .
-�j Permit Fee . . .
43.50 Plan Check Fee
10.88
Issue Date . . . .
Valuation
. . •0
Expiration Date
5/29/07
Qty Unit Charge
Per
Extension
i
LQPERMIT
Application Number . . . .06-00004140.
Permit . . . .'. PLUMBING
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 6.0000 EA PLB FIXTURE
6.00
1.00 15.0000 EA PLB BUILDING SEWER
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50.
Permit . . . GRADING PERMIT
Additional d000
Permit Fee. . 15.0.0 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 w/MAINTENANCE GARAGE SPACE
20'-7" X 681-41"(469SF MAINT + 935SF =
1404 SF)S-3 OCC. TYPE V -N
CONSTRUCTION.2001
CBC,CMC, CPC, 2004 CEC, 2005 CODES.
-
Other Fees . . . . . . . . ART IN PUBLIC PLACES -COM
389.26
DIF CIVIC CENTER - COMM
219.02
DIF FIRE PROTECTION-COMM
63.18.
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 693.08 .00 .00
693.08
Plan Check Total 392.93 .00 .00
392.93
Other Fee Total 4532.78 00 .00
4532.78
Grand.Total 5618.79 :.00 .00
5618.79