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08-1944 (SOTB)4 1XP P.O. BOX 1504 �VOICE 760 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 12/10/08 Application Number: 08-00001944 Owner: D A Property Address: 78130 CALLE TAMPICO HIGHLAND LA QUINA II LLC APN: 770-020-012- - - 80 S LAKE AVE STE 660 Application description: STRUCTURES OTHER THAN BUILDINGS PASADENA, CA 91101 DEC 23 2008 Property Zoning: VILLAGE COMMERCIAL UUUt! Application valuation: 6500 CITY OF LA QUIMTA Contractor. FINAp4rE KEPT. Applicant: Architect or Engineer: PATTERSON BUILDERS 13057 VICTORY BLVD NORTH HOLLYWOOD, CA 91606 (818)762-5795 Lic. Noo-.:: 808029 -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION' 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 Professionals Code, and my License is in full force and effect. Li rise Class: B ^ License No.: 808029 Dater Contract l 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 ($500).: (_ 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 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 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.). I—) I am exempt under Sec. , BAP.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 they work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERAIIT –––––––––––––––––- WORKER'SCOMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I 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 STATE FUND Policy Number 1763924-2008 1 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,.LLshould become subject to the workers'compensation provisions of Section 3700 ofabor X ✓Dodee,, •I shall ftrrthwitth fomply with those provisions. - atd�Aoolicant: C `7�/� i.9– Gtr/ - 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 Directoi 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 correct. I agree to comply with all city and county ordinan sand state laws relating ilding construction, and herauthorize representatives oYthis county to enter pon the above -mention proper y for inspection urposK. �� Da Signature (Applicant or Agentnt�CQ �!�^`��— – Application Number . . . . . 08-00001944 Permit BUILDING PERMIT Additional desc WATER FEATURE Permit Fee . . . 90.00 Plan Check Fee 58.50 Issue Date . . . . Valuation -6500 Expiration Date 6/08/09 Qty Unit Charge Per Extension BASE FEE 45.00 5.00 9.0000 THOU BLDG 2,.001-25,000 45.00 Permit . . . ELEC-MISCELLANEOUS Additional desc Permit,Fee 16:50 Plan Check•Fee'. 4.13 Issue Date Valuation 0 Expiration Date 6/08/09 Qty Unit Charge Per Extension . BASE FEE 15.00 2.00 .7500.PER -------------------------------------------------------------------=-------- ELEC DEVICE/FIXTURE 1ST 20 1.50 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 21.50 Plan Check Fee 5.38 Issue Date . . . . Valuation 0 - Expiration Date 6/08/09 Qty Unit Charge Per Extension BASE FEE, .15.00 •1.00 6.5000 EA MECH OTHER MECH-EQUIPMENT 6.50 ----- Special Notes and Comments ----- ---- WATER FEATURE 4.33 X 28.67 X 16" DEEP. LOCATED BETWEEN FRESH & EASY AND SHOPS 1. 2007 CODES.[PLANS PREVIOUSLY APPROVED ON PERMITS 8-304, 8-3051 ------------------------------ Other Fees . . . - . . . .STRONG MOTION (SMI) COM ------------- 1.36 Fee summary Charged Paid Credited Due ----------- - -----` ---------- Permit Fee Total ---------- 128.0A ---------- ---------- .00 .00 128.00 Plan Check Total 68.01 .00 .00 68.01 Other Fee Total 1.36 .00 .00 1.36 Grand Total 197.37 .00 .00 197.37 LQPERMIT