09-0503 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
09-00000503
Property Address:
79285 COOL REFLECTION
APN:
649-030-069-00 -31311 -
Application description:
REMODEL - COMMERCIAL
Property Zoning:
HIGH DENSITY RESIDENTIAL
Application valuation:
30000
Tuvl 4 4 a"
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Business and Profess' Is Code, and my License is in full force and effect.
License Class:�1B Lic se No.: 805021
Date: O�ntractor.
OWNR-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 thatheor 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).:
(_ I 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
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.).
(_ I 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
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:
LQPEPAIIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
9/09
Owner: U
SANTA ROSA DEVELOPMENT
46753 ADAMS ST
LA QUINTA, CA 9225311 MAY 2 0 ^�Qg
(760)771-3345
CITY OF U1 QUINTA
Contractor:
WHITLEY'S REMODELING
74804 JONI DRIVE, STE 7A
PALM DESERT, CA 92260
(760)341-9480
Lic. No.: 805021
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
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.
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 AIG Policy Number WC006786370
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 toys workers' compensation provisions of Section
3700 of the Labor Code, shallCode, I shall forthwith m y wi those ovisiowi those ovisions.
Date: -S 0 "pplicant: 00
WAR ING: FAIlLURE 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 above information is correc gree to comply with all
city and county ordinances and state laws relating to building construction, and her ' e representatives
of this county to enter upon the above-mentioned property for inspe tion purpos
Date 'lD Signature (Applicant or AgenU:
Application Number . . . . . 09-00000503
------ Structure Information FIRE DAMAGE REPAIR TO CLUBHOUSE -----
Other struct info . .
. . . CODE EDITION
2007CBC(2001)
FIRE SPRINKLERS
NO
MIXED-USE OCCUPANCY
EXISTING
OCCUPANT LOAD
.00
7 ------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
.00
Permit . . .
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
284.50 Plan Check Fee
184.93
Issue Date . . . .
Valuation . .
. . 30000
Expiration Date
11/15/09
Qty Unit Charge
Per
Extension
BASE FEE
252.00
5.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
32.50
Permit . . .
ELECT - ADD/ALT/REM
Additional desc . .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
11/15/09
Qty Unit Charge.
Per
Extension
BASE FEE
15.00
1.00 11.0000
----------------------------------------------------------------------------
EA ELEC MISC
11.00
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
45.00 Plan Check Fee
11.25
Issue Date
Valuation . .
. . 0
Expiration Date
11/15/09
Qty Unit Charge
Per
Extension
BASE FEE
15.•00
1.00 9.0000
EA MECH FURNACE <=100K
9.00
1.00 4.5000
EA MECH VENT INST/ DUCT ALT
4.50
1.00 16.5000
----------------------------------------------------------------------------
EA MECH B/C >3-15HP/>100K-500KBTU 16.50
Permit . . ..
PLUMBING
Additional desc .
Permit Fee . . . .
18.00 Plan Check Fee
4.50
Issue Date . . . .
Valuation . .
. . 0
LQPERMIT
Application Number . . . . . 09-00000503
Permit . . . . . . PLUMBING
Expiration Date 11/15/09.
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00
----=--------------7--------------------------------------------------------
Special Notes and Comments
STRUCTURAL, MECHANICAL, ELECTRICAL AND
PLUMBING REPAIRS TO DAMAGE CAUSED BY
FIRE AT CLUBHOUSE (RECREATION, KITCHEN
AND OFFICE AREAS ONLY) [ENGINEERED] THE
SCOPE OF WORK TO BE PERFORMED DOES NOT
JUSTIFY RE -CALCULATION OF THE STRUCTURE
TO THE CURRENT BUILDING CODE (2007 CBC)
REPAIRS TO ALL OTHER TRADES SHALL BE TO
THE CURRENT 2007 BUILDING CODES.
May 19, 2009 4:05:23 PM AORTEGA
---- -----------------------------------------------------------------------
Other Fees . . . . . . BLDG STDS ADMIN (SB1473) 2:00
ENERGY REVIEW FEE 18.50
STRONG MOTION (SMI) - COM 6.30
Fee summary Charged
Permit Fee Total 373.50
Plan Check Total 207.18
Other Fee Total 26.80
Grand Total .607.48
LQPEINIIT
Paid Credited Due
.00 .00 373.50
.00 .00 207.18
.00 .00 26.80
.00 .00 .607.48