07-2111 (CCOM)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
07-00002111
Property Address:
43576 WASHINGTON ST
APN:
609-070-028-25 -000000-
Application description:
CARPORT - COMMERCIAL
Property Zoning:
COMMUNITY COMMERCIAL
Application valuation:
38450
c&ht 4 4 Q"
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 o e ions o and my License is in full force and effect.
Licensee Class: B Lcen 876299
Date: / '� ' 0 Contractor: f
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).:
(_) 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, 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 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 the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Owner:
LA QUINTA BUSINESS CENTRE LLC
78015 MAIN ST STE 104/PMB 83
LA QUINTA, CA 92253
(760)250-8485
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/14/07
Contractor:
MAR VEST SEP 17 2007
42208 WASHINGTON STREET PMB153
BERMUDA DUNES, CA 92201--0
(760)360-7061 CITY OF LA QUINTA
Lic. No.: 876299 FINANCE DEPT.
----------------------------------------------—
WORKER'S COMPENSATION DECLARATION
I 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 STATE FUND Policy Number 1846155
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 a workers' compensation provisions of Section
3700 of the Labor Code, I all rthwit co ith those provisions.
/7-(:) 7 T
Date: Applicant:
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 0100,000). 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 correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspV`cTt-8b purpose .
Date: -��-a ignature (Applicant or Agent): 'r ��
Application Number . . . . . 07-00002111
Permit . . . . .
CARPORT/GARAGE
Additional desc . .
Permit Fee . . . .
343.00
Plan Check
Fee
222.95
Issue Date . . . .
Valuation
. . . .
38450
Expiration Date
3/12/08
Qty' Unit Charge
PerExtension
. BASE FEE
252.00
14.00 6.5000
THOU BLDG 25,001-50,000
91.00
----------------------------------------------------------------------------
Special Notes and Comments
steel carports for la
quinta business
center carport #1,2.,
4375 sq. ft.
---------------------------------7------------------------------------------
Other Fees . . . . .
. . . . STRONG
MOTION (SMI)
- COM
8.07
Fee summary Charged.
----------
Paid
----------
Credited
--------------------
Due
-----------------
Permit Fee Total
343.00
.00
.00
343.00
Plan Check Total
222.95
.00
.00
222.95
Other Fee Total
8.07
.00
.00
8.07
Grand Total
574.02
.00
.00
574.02
LQPERDIIT
r
$`° #�j
C' "
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
' 1 ``
01'
Project Address:'Y357 �o WAJN/NC T0A( Z7-
Owner's Name: ZA QUIOJYW . 045/NESS NTRE L�ti
A. P. Number: .9 o 0 70 • 0.5-0-
Address: 78 o/,S AlA „l Sr SU/7r
Legal Description:
City, ST, Zip: 1-4 69yl,Vm � 92 2S3
Contractor: MAR VEST-
Telephone: 76 o . 2 So. 8 �o 8S
Address: Y2-2-06 1A)4SHtN4r A; PMB /.S3
Project Description:
City, ST, Zip: SeMMyDA DUA164, is GA
CA R Po 0'r -S f:0) �� QN t rrTq
Telephone: 760. 360.76(-/
514f -5e, CEN TV C owl eti CoM P c>t-
IcityLic.#: y 9 f 8
State Lie. # : -974 299
Arch., Engr., Designer. -M IIA -R- if Ca ySrAkGnoM
2 � (q 5q ( (
Address: 77-q 2�ft 8 S?
1 —
City, ST, Zip: V(ST4 CA 9 Z O 8y
Telephone:
Telephone: 7(,p 1 S g, 0 3 S
State Lic. #: 849 9 Go
Name of Contact Person: SCOTT STo k E -S
S T-7—
Construction Type: Occupancy: •
Project type (circle one): New A61'n Alter Re Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: %too • 2 SO • 1Z4 k5,
Estimated Value of Project: 313 L•} S70, `=
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACHING .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready[ corrections
Plan Ch xk Deposit
Truss Calcs.
Called Contact Person
g
Plan Chick Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans. resubmitted 1
$
Mechan'_cal
Grading. plan
21' Review, ready for correctio riss a
Electrical
Subcontactor List
Called Contact Person
Plumbieg
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Develorer Impact Fee
Planning Approval
Called Contact Person IA.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
09 Rrr 1".31/07-1 Bronz Uw 111407
ev9 STS' IeFe. R/12, s�aa,