07-0328 (CCOM)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,. CALIFORNIA 92253
Application Number: 07-00000328
Property Address: 43100 PALM ROYALE DR
APN: 609 -051 -010, -
App lication
09-051-010,-Application description: CARPORT -'COMMERCIAL
Property Zoning: HIGH DENSITY RESIDENTIAL
A,.p lir;ltinn tr;jlnatinn• 8698
Applicant:
Architect or Enginee
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury thp4 I am license under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busin s and Proles pals Code, and my License is in full force and effect.
License Clas : B A ^icense No.: 825987
Date: 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 ($5001.:
(_ ). 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, 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
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/14/07
Owner:
WRM-LA QUINTA
43-100 PALM ROYALE
LA QUINTA, CA 92253
Contractor:
WPM CONSTRUCTION -CA LP.
1000 EAST 80TH PLACE, #555 N.
MERRILLVILLE, IN 46410
(219)680-5000
Lic. No.: 825987
------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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
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 become subi t to the workers' compensation laws of California,
and agree that, ill should c me subject t h orkers' compensation provisions of Section
p00 of the Labor Code, ha f rth ith c ply ith those provisions.
—Date: . f/, f Applicant: 1 .
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 the abo e i formati&is.ree to comply with all
city and county ordinances and state laws relating to building on truction,orize representatives
of this cou'ty'r upon the above-mentioned property in ction p
/ Date} !�" Signature (Applicant or Agent):,
i
Application Number . . . . 07-00000328
------ Structure Information METAL CARPORT
------
Other struct info CODE EDITION .2001CBC
04 CEC
FLOOD ZONE
NO
GARAGE.SQ FTG
654.00
Permit CARPORT/GARAGE .
Additional desc .
Permit•Fee 108.00 Plan Check Fee
17.55
Issue Date Valuation
8698
Expiration bate y/lU/U''/
Qty Unit Charge Per
Extension "
BASE FEE
45.00
7.00 9.0000 THOU BLDG 2,001-25,000
63.00
Permit ELECTRICAL-CARPORT/GARAGE
Additional desc .
Permit Fee . . . . 16.50 Plan Check Fee
4.13 ,
Issue Date Valuation .
0
Expiration Date . 9/10/07
Qty' Unit Charge Per
Extension
BASE FEE
15.00
2.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
1.50
Special Notes and Comments
METAL CARPORT.,- 4•SPACES - 36.333FT X
18FT.'S-3 OCCUPANCY, TYPE II -N'
CONSTRUCTION. 2001 CBC, 2004 CEC.
[LOCATED S OF BLDG #121 REDUCED PC FEE
FOR DUPLICATE STRUCTURE.
------------------------------------------------------------------------------
Other Fees ART IN PUBLIC PLACES -COM
23.49
STRONG MOTION (SMI) - COM
1.82
Fee summary Charged Paid Credited
Due
Permit Fee Total 124.50 ..00 .00
124.50
' - Plan Check Total 21.68 .00 .00
21.68
Other Fee Total 25.31 .00 .00
2.5.31
Grand Total 171.49 .00 .00
171.49
LQPERMIT