07-0358 (CCOM). P.O. BOX 1504
a 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: .07-00000358
Property Address: 4310.0 PALM ROYALE DR
APN: 609-051-010- - -
Application description: CARPORT - COMMERCIAL
Property Zoning: HIGH DENSITY RESIDENTIAL
1,ppliootion valuatiQn: 7"t'7Rn
Applicant: Architect or Engineer:
4
BUILDING. & SAFETY DEPARTMENT
BUILDING PERMIT
M
Owner:
WRM LA-QUINTA
1000 E. BOTH PL.-
MERRILLVILLE,•IN 46410
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor: -
WPM CONSTRUCTION -CA LP
1000 EAST 80TH PLACE, 4555 N.
MERRILLVILLE, IN 46410.
('219) 680-5000
Lic. No.: 825987
Date: 3/14/07
- LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
• 1 hereby affirm under penalty of perjury that I am Iic ed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Pr fe _ onaJ`s C , and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self-insurefor workers' compensation, as provided
License CI s: B Lice 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 workerscompensation
' OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I 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 for the
er
person in any mannso as become subject to 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 omeZsLb' to the workers' 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 's II o h pty with those provisions.
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).: -
- - — i t7 r -- ,— -
Date:l� ` I Applicant:
(_ 1 • I, 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
• 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 CIVIL FINES 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 1, 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
orrect. I agree to comply with all
I certify that I have read this application and state that the abo foAnp
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county or inances and state laws relating to building o struereby authorize representatives .
of this coun to riter upon the above-mentioned propert i s. -
Lender's Name:
®�Signatune
' -
Date: v (Applicant or Agent)-
Lender's Address:
LQPERMIT
Application Number . . : 07-00000358
------ Structure Information METAL CARPORT >
-----
Other struct info . . . CODE EDITION
01CBC04CEC
FLOOD ZONE
NO
GARAGE SQ FTG
----------------------------------------------------------------------------
1788.0.0
Permit CARPORT/ GARAGE
Additional desc .
Permit Fee . . . . 243.00 Plan Check Fee
39.49
Issue Date Valuation ° . .
. 23780
Expiration Date 9/10/07
` Qty Unit Charge Per
Extension
BASE FEE
45.00
22.00- 9.0000 THOU BLDG 2,001-25,000.
198.00
Permit ELECTRICAL-CARPORT/GARAGE"
Additional desc
Permit Fee . ... 19.50 Plan Check Fee
4.88
Issue Date Valuation -.
0
Expiration Date '9/10/07
Qty Unit Charge_ Per
Extension
BASE FEE
15.00
• 6.00 7500 PER ELEC DEVICE/FIXTURE 1ST 20
4.50
Special Notes and Comments
METAL CARPORT.(11 SPACES) 99.33FT X 18FT
S-3 OCCUPANCY, TYPE II -N CONSTRUCTION
2001 CBC 2004 CEC.[LOCATED NW OF BLDG
##71REDUCED PC FEE FOR DUPLICATE
STRUCTURE
-------------------------------
Other Fees . . . . . . ART IN PUBLIC PLACES -COM
98.90
STRONG MOTION (SMI) -,COM
4.99
. Fee summary. Charged Paid Credited
Due
Permit Fee Total 262.50 .00 .00
262.50
Plan Check Total 44.37 .00 .00
44'.37
Other Fee Total 103.89 .00 .00
103.89
Grand Total 410.76 .00 .00
410.76
. ' LQPERMIT - .,