9904-065 (SPIN)LICENSED CONTRACTOR 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.
License # Lic. Class Exp. Date
Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() /I am exempt under Section B&P.C. for this reason .n
Date rtv Signature of Owner /2Gt1 '✓`� r"'
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
/tir(JI 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 & policy no. are:
Carrier Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
( I certify that in the performance of the work for"which this permit is issued,
1 call 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 to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
/ 7- �� » Applicant—
Date
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and'civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection, purposess
Signature (Owner/Agent)•� f1- ate r r,XP 7''
BUILDING PERMIT PERMI ""065
DATE t VALUATION $.f)o LOT TRACT
JOB SITE
ADDRESS i.r�►.LLE 1Af+ FICO APN _
OWNER CONTRACTOR/DESIGNER/ENGINEER
C'AUSTAIM17'IC0
C'BIA
USE OF PERMIT
MSC I?LLANF?OUS
SPECIAL .INSP6 ', ION lel% CIRCUS f'WII.ITTES - E1:i°3lMAI, CON I OL
i Illi, ALSO INSPH.C; P. JOUR NO, ktd'1.RY FOR. PAYh4[3N'r � c
1,MMATC, D COST OF (XINKI'HUil rN
PERMIT FEJ,� SUMMARY
IY-CIAL1N8PJ?ZrK94 t03-000--423-000 5fctil.4nf
S4,its-'1'0TA:4.. (A.')NI F11 It 3CITt. N SND PIAN 'I•: ECK
LESS PRE—RAID FEES
Tl3"dAJ, J'fLRi'tt'C T t ERS l9/;ta!, NOW
', /1 51
RECEIPT I DATE I BY I DATE FINALED I INSPECTOR`
0.00
$1M.of)
$0.00
$ td4i.60
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
TINSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final - -
Utility Notice (Perm)
COUNCIL/RDA MEETING DATE: April 6, 199
ITEM TITLE:
Consideration of Temporary Use Permit 99-198 for a
Circus to be Held April 12, 1999, on the South Side of
Calle Tampico, Between Avenida Bermudas and Desert'
Club Drive. Applicant: La Quinta Lions Club
RECOMMENDATION:
As deemed appropriate by the City Council.
FISCAL IMPLICATIONS:
AGENDA CATEGORY:
BUSINESS SESSION: A
CONSENT CALENDAR:
STUDY SESSION:
PUBLIC HEARING:
No funds have been allocated within the Fiscal Year 1998-1999 budget for this event. The
Applicant is requesting a maximum $1,900.00 ($1,700 for soil stabilization, $100 for a
building inspection fee, and $100 for an en:roachment permit) from General Fund Reserve
Account #101-000-300-290.
BACKGROUND AND OVERVIEW:
This Temporary Use Permit is before the City Council as the applicant is requesting
financial assistance to reimburse expenses. .
The La Quinta Lions Club, a nonprofit group, has applied for a Temporary Use Permit to
hold a fund raising Culpepper and Merriweather Circus on April 12, 1999 (Attachment 1).
Two performances are proposed at 5:3] and 7:30 P.M. on property owned by Eddie
Nicholson located on the south side of Celle Tampico, between Avenida Bermudas and
Desert Club Drive, north of the alley. Setup will start the morning of April 12th, - with
breakdown and cleanup on April 13th. Major facilities will consist of a big top tent,
concession stand, animal department, and staff. area (Attachment 2). A designated public
parking area for approximately 70 cars is proposed for the,west portion of the site. The
applicant hopes to have a maximum of 7D0 persons per performance.
The Lions Club is requesting use of the City -owned property on Avenida Bermudas, north
of Avenida Montezuma for additional°public parking (approximately 60 spaces) during the
performances. This requires a Public Woks Department Encroachment Permit. They are
also requesting the City allocate funds to --over the cost of providing soil stabilization after
P:\STAN\cc rpt tup 99-198.wpd
the event, cost is estimated at a maximum of $1,700.00. The applicant is requesting that
the City provide three portable restrooms (two regular and one handicap) from the
allocation given to the City by Waste Management. The Building and Safety Department
will charge a building inspection fee of $100, which the applicant is asking the City to pay
for as well.
Staff has transmitted this request to City Departments and applicable agencies for review
and comment and no negative comments have been received to date. Applicable
comments have been added as conditions of approval. The City Council has previously
approved requests from nonprofit groups 'for similar types of events (La Quinta Arts
Foundation, Soap Box Derby, etc.).
FINDINGS AND ALTERNATIVES:
Findings necessary to approve this request can be made, and are contained in the
attached Conditions of Approval.
Alternatives available to the City Council are:
1. Approve Temporary Use Permit 99-198 for a circus, subject to the attached
Findings and Conditions of Approval, designate a maximum $1,900.00 from General
Fund Reserve Account #101-000-300-290 to pay for soil stabilization after the
event, a building inspection fee, and an encroachment permit to allow use of City -
owned land for parking; and authorize the use of three portable restrooms allocated
to the City by Waste Management; or,
2. Do not approve Temporary Use Permit 99-198 for a circus; or,
3. Continue the request and provide staff with. alternative direction.
Jerky Herjan
Communi y Development Director
hments:
1. Letter of Request (amended), received March 22, 1999
4. Site Plan
0000C,2
P:\STAN\cc rpt tup 99-198.wpd
'r
Y
FINDINGS AND CONDITIONS OF APPROVAL - RECOMMENDED
TEMPORARY
USE PERMIT 99-198
LA QUINTA LIONS CLUB
APRIL 6, 1999
FINDINGS:
1. Approval of Temporary Use Permit 99-198 will not create conditions that may
threaten the public's health and safety needs of the community because specific
conditions will be imposed as a part of the approval.
2. An Encroachment Permit can be granted by the City to allow parking for special
events in city owned parking lots.
GENERAL CONDITIONS:
1. This approval is, for circus to be held on April 12, 1999, on the south side of
Calle Tampico, between Avenidas Bermudas and Desert Club Drive.
2. This permit includes set-up on April 12 .and clean-up by April 13, 1999..
3. Prior to and during the event, the circus grounds shall be kept watered to keep
the dust down'.
4. The City reserves the right to attach additional conditions of approval to this
permit should they be warranted for public safety, health, or welfare.
5. No signs are approved by this permit. 1i
6. By holding the above noted circus, the applicant agrees to indemnify, defend,
and hold harmless the City of La Quinta in the event of any legal claim or
litigation -arising out of the City's approval of this event. The City of La Quinta
shall have the right to select its defensecounsel in its sole discretion.
7. All outdoor lighting shall shielded and directed away from residences and the
surrounding streets.
8. Public address (p.a.) systems shall be kept at a level which does not disturb the
surrounding occupants. After the second performance, no p.a. systems shall.
be used.
9. Trash receptacles shall be provided as needed. All trash and other debris shall
be cleared off the site upon conclusion of the event.
pAcc coa tup 99-198
000003
CONDITIONS OF APPROVAL - RECOMMENDED
TEMPORARY USE PERMIT 99-198
LA QUINTA LIONS CLUB
APRIL 6, 1999
10. Parking attendant shall be provided in all parking lots to insure that their use is
organized in a fashion that provide maximum use and safety.
The Following Conditions Shall Be Complied with by April 8, 1999
11. The City parking lot on the west side of Avenida Bermudas, north of Avenida
Montezuma may be used for parking. The applicant shall obtain an approved
encroachment permit from the Public Works Department for use of the lot and
shall comply with the conditions of that permit.
12. The applicant shall submit a dust control plan for the. unpaved area. A bond or
other type of guarantee acceptable to the City Engineer shall be posted with the
Public Works Department insuring that unpaved areas on the circus site are
stabilized after the event is completed pursuant to Chapter 6.16 of the
Municipal Code (Fugitive Dust Control). The bond or other guarantee will be
released once the applicant has provided a letter from their contractor stating
that the stabilizer material has been installed (i.e., chemical emulsion, wildflower
mix with irrigation, etc.), and City staff has made a field inspection to verify
compliance. A copy of the contractor's letter shall also be submitted to the
Community Development Department for filing.
13. A notice shall be given to the existing property owners in the immediate area
(within 300 feet) informing them of the upcoming circus. A copy of the written
notice shall be given to the Community Development Department.
14. A temporary electrical permit shall be obtained from the Building and Safety
Department if power sources are needed.
15. The applicant shall provide a Certificate of Liability Insurance in the minimum
amount of $1,000,000 with the City of La Quinta named as co-insured for the
duration of the event and this permit.
16. Commercial food and beverage vendors shall obtain a permit, as required by the
Riverside County Health Department.
17. The applicant shall apply to the Building and Safety Department for a special
inspection to be conducted on the day of the event, prior to the first
performance.
18. The applicant shall apply to the City Fire Marshal for an inspection and permit
to hold the event (760 863-8886).
p:\cc coa tup 99-198
000004
ATTACHMENTS
0000A
La Quinta Lions Club
PO Box 473
La Quinta CA 92253 .
City Council of La Quinta
La.Quinta CA 92253
ATTACHMENT 1
Re: Circus
To Whom it may concern:
The La Quinta Lions Club is sponsoring a c._rcus on April 12, 1999. We are trying to use
the property on Calle Tampico (Ave 51) between the streets of Desert Club Dr. and
Avenida Bermudas. We have the owners permission and would like to ask the city if they
would provide three necessary items.
¢or- Sot t�-'-3JrrD,t31LiZ A.TtoN) AxTee_ -rH Fi r—,/r j sT•
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t oo, �o�- Bu t t.DI1JG, `8t
• access to the city parking lot on Avenida Bermudas D�,Pt, tNspt�N.
The La Quinta Lions Club is a non-profit or;anization. We have La Quinta since 1991.
100% of the funds that the club receives will be donated back to the community.
We appreciate your consideration and support..
Sincerely,
Charles D. Knight
La Quinta Lions Clu
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