06-4254 (SOTB)P.O. BOX 1504. 4-4 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: 1/10/07
�Appllcatio_n Number: —,06-000042541
Owner:
Property Address:. 45200 WASHINGTON •ST CP DEVELOPMENT LA QUINTA
APN: 604-040-070- - - 77564'COUNTRY CLUB DRIVE #100
Application description: STRUCTURES OTHER THAN BUILDINGS PALM-DESERT, CA 92211
Property Zoning: TOURIST COMMERCIAL. D d
Application valuation: 5000 '
_ r
Contractor:. JAN 121007
Applicant:. Architect or Engineer: TURNER CONSTRUCTION. COMP
PALM MONTEREY AVE STE 201 CITY
"a'�� ti,� PALM DESERT, CA 92260 OF�QUIN7q
3g3`j , (213)337-6900 PI�ANCEDEPT.
^moi BwC,zOC Lic. No.: 210639
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LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: -
section 7000) of Division 3 of the Business and Professionals ode, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers' compensation, as provided
License Class: B ense No.: '2.10639 " for by Section 3700 of the Labor Code, for the performanceof the work for which this permit is
11 issued.
ateT ract ' . �I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
C - Code, for the performance of the work forwhich this permitis issued. My workers' compensation
OWNER-BUILDER DECLARATION 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 LIBERTY MUTUAL Policy Number . WC762SO92815036
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 rkers' compensation laws of California,
-permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's. State and agree that, if I should become subject to th wor rs' compensationprovisions 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, II rth 't se 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 (5500).: at A ant.
. (_) I, as owner of the property, or my employees with wagesastheir sole compensation, will do the -work, and -
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECUR WO KERS' COMPENSATION COVERAGE 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. - , ,-
r 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.). - APPLICANT ACKNOWLEDGEMENT -
... I, as owner of the property, am`exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of - conditions and restrictions set forth on this application.
property who builds or improves thereon,_ and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). - whose benefit work is performed under or pursuant to any permit issued as a result of this. application, - -
1 _ 1 I am exempt under Sec. 6; for this reason 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 theworkbeing
- - • performed under or following issuance of this permit. -
Date: Owner: 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 '
CONSTRUCTION LENDING AGENCY - permit to cancellation. e I e
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and hereb authorize representatives
of this county to enter upon the above-mentioned propert Rs brio p r es. • -
Lender's Name: - -
fVDat� i ture (Applicant or Agent): .
Lender's Address: - -
4,
LQPER111IT
Application Number . . 06-00004254
, .
Permit BUILDINGPERMIT .
Additional desc 3 FLAG -POLES
Permit Fee 72°.00
Plan Check
Fee
46.80
Issue Date . .
Valuation
. . .
. 5000
Expiration Date 7/0.9/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
3.00 _. 9.0000 THOU BLDG 2,001-25.,000
27.00
--------- - ---------------------------------------
Special Notes and Comments
.3 FLAG POLES (1-30FT, 2-25FT HGT)Q
HOTEL ENTRY DRIVE. 2001 CBC.
Other Fees . . . . . . . ENERGY
REVIEW FEE
4.68
HOURLY
PLAN CHECK
.105.00
STRONG
MOTION (SMI)
- COM
.84
' Fee summary Charged Paid
Credited
Due
Permit•Fee Total 72.00
.00
.00
72.00
Plan Check Total 46.80
.00
.00
Other Fee Total .110.52.
.00
.00
110.52
Grand Total 229.32
.00• _00
.229.32
LQPERAIIT - -