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07-0331 (CCOM)P.O. BOX 1504 . 78-495 CALLE TAMPICO LA. QUINTA;: CALIFORNIA 92253 Application Number: - --_07-00000331 Property Address: 43100 PALM ROYALE DR APN: 609 -051 -010 - Application description: CARPORT - COMMERCIAL Property Zoning: HIGH DENSITY RESIDENTIA Ppplieotion valuation: (1853 Applicant: Architect or En BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: WRM.-LA QUINTA 437100 PALM ROYALE LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date. 3/14/07 Contractor: WPM CONSTRUCTION -CA LP 1000 EAST 80TH PLACE, #555 N. MERRILLVILLE, IN 46410 (219)680-5000 \/ LiC. No.: 825.987 -------------------------------------------------------------------------------- LICENJnnsed CONTRACTOR'S DECLARATION - - - WORKER'S COMPENSATION DECLARATION - I. hereby of r under penalty of perjury that I aunder provisions of Chapter 9 (commencing with. . I hereby affirm under penaliy.of perjury one of the following declarations:Section 70 0 of Division 3 of the Business andessi`nal ode, 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 C 13 i s No.: 825987 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: `. 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 !�V OWNER -BUILDER DECLARATION, ,. - --- insurance carrier and policy number are: 1 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 (Sec. 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 as to comesubjto 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 -should bec a subi t o orkers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or - 3700 of the Labor. Code, I , II rt 'th ply h those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by-- -- .jel - --- . _. ' 'Z - - any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$5001.: Date:'T� Applicant: - (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, andthe 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 CIVILFINES UP TO ONE HUNDRED THOUSAND 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 . 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, (_ 1 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 thAbuildn formation rr ct. I agree to comply with all work for which this permit issued (Sec. 3097, Civ. C.). - city and county ordinances and state laws relating totruction, a he authorize representatives of this cou y toe ter upon the above-mentioned pre i n aseLender's Name:'�j ( Date: i / ( Signature (Applicant or Agent): - Lender's Address: --- —----------------- LQPERMIT t Application.Number 07-00000331 ------Structure Information METAL CARPORT ----- Other struct into CODE EDITION 2001CBC 04 CEC FLOOD ZONE NO GARAGE SQ FTG 816.00, Permit . . . .CARPORT/GARAGE Additional desc Permit Fee '126.00 Plan Check Fee 81.90 - Issue Date Valuation . . 10853 Expiration Date 9%lU/•U7 Qty Unit Charge Per Extension BASE FEE 45.00 9.00 9.0000 THOU BLDG 2,001-25,000 ---------------------------------------------------------------------------- 81.00 Permit . . . ELECTRICAL-CARPORT/GARAGE Additional desc . Permit Fee 17.25 Plan Check Fee 4.31 Issue Date Valuation . . . . 0 Expiration Date 9/10/07 Qty Unit Charge "Per Extension BASE FEE 15.00 3.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 2.25 - Special Notes and Comments METAL CARPORT - 5 SPACES - 45.333FT X - 18FT. S-3 OCCUPANCY, TYPE II -N CONSTRUCTION. 2001 CBC, 2004 CEC. [LOCATED NE OF BLDG #41 - Other Fees . . . . . . . ART IN PUBLIC PLACES -COM 34.2.6 STRONG MOTION (SMI) - COM 2.27 Fee summary Charged Paid Credited Due Permit Fee Total 143.25 .00 .00, 143.25 Plan Check Total 86.21 00 .00 86.21 Other Fee Total 36.53 .00 .00 36.53 Grand Total 265.99 .00 .00 265.99 J LQPERMIT - .