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11-0489 (TT)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 51880 TRADITION"TR 770 -250 -016 - TEMPORARY TRAILER GOLF COURSE 100 °F:WQ�w BUILDING & SAFETY DEPARTMENT BUILDING PERMIT - ------------------------- - - - - -- �—• - LICENSED CONTRACTOR'S DECLARATION �� I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commenciiig� Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and License Class: B License No.: s744091 ,Owner: TRADITION 78505 52ND LA QUINTA, CLUB ASSOC AVE' CA 92253 Contractor: SUN VISTA DEVELOPMENT P.O. BOX 1144 LA QUINTA, CA 92247 (760)771-4722 Lic. No.: 744091 CORP VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/26/11 WORKER'S COMPENSATION DECLARATION • . I hereby affirm under penalty of perjury one of the following declarations: - I have and will maintain a certificate ofconsent 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 OWNER -BUILDER DE RATION 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 STATE FUND Policy Number 0000179-2009 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 become subject to the workers' compensation laws of California, permit to file a signed statement that he or sheds licensed pursuant to the provisions of the Contractor's State and agree that,.if I should become subject 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, I shall forthwit comply 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).> r ate:S Z��// plicant: - (_ 1 V 1J 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, Rosiness and Professions Code: The WARNING: FAI URE TO SECURE WORKERS' COMPENSATION COV AGE 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.). (_) 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.). _ 1— 1 1 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: " LQPEPMIT 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. 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 isnot commenced - within -180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. 1 certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and st to laws relating to building construction, and hereby authorize representatives of this county to enter upon th above-mentioned property for inspection urposes. Die% ^� '�� Sig lure (Applicant or Agent): Application Number 11-00000489 Permit . . . TEMP TRAILER / MOBILE HOME Additional desc . Permit Fee 200.00 Plan Check Fee .00 Issue Date Valuation 100 Expiration Date 11/22/11 Qty Unit Charge Per,- Extension BASE FEE 200.00 'ermit'Fee Total 200.00 .00 .00" 200.00 plan Check Total -.00 .00 .00 .00 ;rand Total 200.00 .00 .00 200.00 c Bin # CIty of La Quinta Building_8 aS lety Division P.O. Box 1504, 7&495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # �a Project Address:.s`�,��®' 77- Owner's Name: A. P. Number: -6914 ' Address: / .r foi .�02 Legal Description: T City, ST, Zip: Z a 4 0,7/fGa,_ 9<;:a1Contractor Telephone: ;:;.»o::.::?;.;.r:�✓.`.>;::.;�>..:�':>�';Y.;+...;: Address: -e9Q Project Description: Tadj City, ST, Zip: e-- 9/ Telephone: � O / �� ' 7�0�02 ' ^•<: > > f i:;.::; z%`s• :>::' ;'Amn ryCity M LL Or 'r'yi ari k+ State Lic. # : 1--14��40 91 Lie.`#'393 Arch., Engr., Designer. r%%",S'h u Address: City., ST, Zip: Telephone: tib!::nv..'`$:fnW../^Y$)i,{^?�i;::j;.y �.t�.��:�v::h:�ti:i 'Construction Type: Occupancy: . State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: hie b Sl�/-) e Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated'Value of Project:71,1(0.00 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Caics. Reviewed, ready for corrections Plan Check Deposit Truss Caics. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2". Review, ready'for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing- Grant Deed Pians picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"d Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees