07-2548 (DEMO)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING 8c SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: _9/18/07
Application Number: 07-00002548 I Owner: '
Property Address: 46600 WASHINGTON STT STE 5 WASHINGTON 111 LTD
APN: 643-020-999-3 -3090_3_--C/O JACK TARR
Application description: DEMO - COMML/OTHER r - 30240 RANCHOVIEJO RD. STE. B
Property Zoning: REGIONAL COMMERCIAL SAN JUAN CAPISTRANO, CA 92675
Application valuation: 0
Contractor: O
Applicant: Architect or Engineer: ASARO BUILDERS, INC. C.
•42220 GREEN WAY, H
PALM DESERT, CA 92211 290 �Q O
(760) 776-0043
Lic. No.: 588920. FoQG. Qi
.y
-
-=----------------------------------------- - - -- -—------------------------------ - - - - -- - - -- - - - - —
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 Code, 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 - License No.: 588920 for by Section 3700 of the -Labor Code, for the performance of the work for which this permit is
q issued.
q. Date:- I 'O-I�Contractor: _ 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
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 STATE FUND Policy Number 229002420506 -
following reason (Sec. 7031.5, Business and Professions Code: Any city or countythat 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, atter, 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 workers' 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 Ishould become subject to the workers' compensation provisions 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, I shall forthwith co ly with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by/I _ a
C any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date: /. I' - Applicant
(_ 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 WARNING: FAILURE TO SECURE WORKERS' 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.
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
( 1 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
pursuantto the Contractors' State License'Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of LaQuinta, its officers, agents and employees for any act or omission related to the work being
• - ' 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.
I hereby affirm under penalty of perjury that thereis 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 hereby authorize representatives
- , of this county to enter upon the above-mentioned property for inspection purposes. ,
Lender's Name: 1�
• ^_ D_ate: �'..:Iy�2Signature (Applicant or Agent):
Lender's Address: - - -
LQPERMIT
Application Number . . . . . 07-00002548
------ 'Structure Information DEMO SLAB FOR UNDERGROUND PLUMBING -----
Construction Type . TYPE V - NON RATED
Permit DEMO PERMIT
Additional desc
Permit Fee . . 45.00 Plan Check Fee.. ..00
J Issue Date . . . Valuation . . . . 0
Expiration Date 3/16/08
Qty Unit Charge Per Extension
BASE FEE 45.00
---------------------------------------------------- -----------------------
Special Notes and Comments
DEMO SLAB FOR UNDERGROUND PLUMBING.
THIS PERMIT,SHALL NOT PERMIT PIPING AND
IS NOT A PLUMBING PERMIT: September
18, 2007 12:14:14 PM AORTEGA
Fee summary. Charged. Paid Credited- Due
------- ---------- ----------
Permit Fee Total 45.00 .00 .00 45.00
Plan Check Total .00 .00 .00 .00
Grand Total 45.00 .00 .00 45.00
LQPERMIT
Din W,,
City of La. Quinta.
Building& Safety Division
P.O. Box .1504, 78-495 Calle Tampico
ta Quinta, CA 92253 - (760) 777-7012
..BuildingPermit Application and Tracking Sheet
Permit #
Project Address:* Acr -(Sco, -4
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor: Cts-xi
City, ST, Zip:
Telephone:
Project Description:
Address:
City, ST, Zip:
Teldphone:
State Li.c. # s City Lic. #:
:]ESCGN K-) kk C�A
J
V:AQ %P4 M I %1(r."
Arch., Engr., tgne
I
Address:
IP&
City, ST, Zip:
Telephone:
State We. #:
Construction Type Occupancy:
Project type (circle one): New Add"n Alter Repair Dem'
0.
Name m
Name. of Contact Person:
a.
Sq. Ft:
Stories:
# Units:
_ e
Telephone
pt
elephone # of C6ntact Person:- rf_-�—,1
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
IMACM.G
rERmrr FEES
Plan Sets,
Plan Check submitted
MOM
Item'
Amount
Struc.tural.Caics.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called ContactTerson
Plan Cheek Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2"4 Review, ready for corrcctionsrissue
Electrical
Subcont.a.etor List
Called Contaet.Pirson
. Plumbing
Grant Decd,
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees