04-4302 (RER)BUILDING-& SAFETY DEPARTMENT
P.O. Box 1504
(760).777-7012
OF 78-495 CALLE TAMPICO
FAX (760)
�LA'OUINTA, CALIFORNIA 92'253 INSPECTION REQUESTS (760) 777-7153
..BUILDING PERMIT
Application Number 04-0-0004302 5 Date - 5/17/04
Property Address . . . 54489 SOUTHERN HILLS
APN: 775 -10,1=056 -
Application description REMODEL- RESIDENTIAL
Property Zoning LOW DENSITY RESIDENTIAL
Application valuation 8000
Owner Contra*to,
--------------------- _�c
PGA WEST RESIDENTIAL ASSN. INC OWNER
.54320 SOUTHERN HILLS
LA' QUINTA - CA 92253JUN 0 2004
'
----`---=----------------- Structure. Information CITY OF LAQUINTA
-vi ----- ---
FTNAKFUE
Construction Type . . . . . TYPE V NON RATE
Occupancy Type <=10
Flood. Zone NON -AO FLOOD ZONE
Other struct info... CODE -EDITION. 2001 CBC..
Permit BUILDING.PERMIT
Additional.desc
Permit, Fee
9.9.00 Plan Check Fee 00
Issue -Date Valuation 8000,
Qty Unit Charge ..Per
Extension
-BASE FEE, 45-.00
.6.00 9;0000 THOU." - BLDG 2,001-25,000 54.00,
---------------------- ------------------------
- - - - - - - - - - - - - - - - - - - -
Special Notes and Comments
VOLUNTARY SEISMIC STRUCTURAL REPAIRS'.
-----------------------------
-------- -------- ------------------------------
.-Other Fees STRONG MOTION (SMI)- RES. .80
Pee'summary Charged. Paid Credited Due
7 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - -
Permit''Fee 'Total* 99.00 .00 .00 99.00
Plan Check_ 'Total ._00. .00 .,Go" -.00
Other Fee Total .80 06- .80.
Grand Total 99..80 .00 .00 99.80
P.O. BOX 1504
VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: _
Applicant:
Applicant's Mailing Address:
Date: (V
chitect or Engineer:&C-8ft r>!{
Architect or Engineer's Address:
L9 C�;iD ,
S ,D _ CA q'3t4b
c, No. (-1cf4a;,
t3UILUING PERMIT DECLARATIONS
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.
License Class License No.
Date Contractor
�r + it OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to constrict, 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 Contractors' 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
pplicant to a civil penaltyof not:more than five hundred dollars ($500).):
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 or 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 safe.).
U 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 contractors) licensed pursuant to
the Contractors' State License Law.).
.0 I am exempt under Sec. , BA P.C. for this reason
e , "
WORKERS'COMPENSATION 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
/, !ss.ued• My wo�lcers' compensati nce carrier and polic numb(
meryJT7•lrr? 7Ziw1 n Pmber /
_ 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 beco79
ubject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
�te plicant r - v ry -
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.
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.).
Lenders Name
Lender's Address
IMPORTANT APPLICANT ACKNOWLEDGEMENT
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 Le 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 pemmlt, 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 agrepV comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to er upon the a v ed property for ins on purposes.
Dateigra�5 ture (Applicant or Agent):
SEP TA
l 9 RIECp
SUNISE BU/LL)'NG ANS
COMPANY
September 10, 1996
Mr. Mark Harold
City of La Quinta
Building Department
78-495 Calle Tampico
La Quinta, CA 92253
Dear Mr. Harold:
Please -accept this letter, as Sunrise Company's authorization',, to
release a copy of the blueprints for The Galleries Product, Plan;2,
located atf,54-489 Southern-HTls in La Q iu nta to Mr. Mike Smith.
The blueprints are; to include.fouridat-i.on, framing and electrical.
Mr. Smith understands that he is responsible for all costs related
to -the reproduction of the requested blueprints and that a bonded
courier (of.`his choice) will be used'=to-accomplish this. Mr. Smith
accepts' this release for the blueprints noted above with the
understanding that Sunrise Company may have made modifications to
the Plan 2 during construction which are not exhibited on the
blueprints approved for release to him.
Furthermore, Mr.. Smith agrees that the blueprints represent
exclusive property of Sunrise. Company and he is not to copy,
transfer or reproduce these plans. without written consent 'by
Sunrise Company.
Mr. Smith has noted his acknowledgment of the above by signing
below.
Sincerely,
Jack M. Conlon' `' ... : Date`:..; li
President /.
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JMC:rs
42-600 Cook Street, Suite 200, Palm Desert, California 92211, Telephone (619) 568-2828
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