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09-0325 (SPIN)P.O. BOX 1504, ' ^� VOICE (760) 77.7-7012 - : 78-495 CALLE TAMPICO "' FAX (760)777-7011 LA QUINTA,� CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153, BUILDING PERMIT.. Application Number: ^x�" 0-9--OOA00325� Owner, Dat _ e: 4/10/09 Property Address: 47225 WASHINGTON ST ROMAN CATHOLIC BISHOP OF SB APN: 643-090-026-2 -000000- 1201 E HIGHLAND AVE Application description: SPECIAL INSPECTION SAN BERNARDINO, CA 92404 Property Zoning: LOW DENSITY RESIDENTIAL L Application valuation: _ 2000 O Contractor: a Applicant: Architect or Engineer: CLASSIC PARTY RENTAL (CSLB LIC NOT REQ'D G' 14A). O 75060 MAYFAIR DR �►� '1 �3 PALM DESERT, CA 92211 . - 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' - License No.: for by Section.3700 of the Labor Code, for.the performance of the work for which this permit is ' , /' issued. - .Date_7'li 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 3 992 Policy Number 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 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 I should become subject to the workers' compensation provisions of Section - License Law (Chapter 9 (commencing with Section 7000)0 f Division 3 of the Business. and Professions Code) or 3700 of. the Labor Code, I shall forthwith comply with those 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 ($5001.: Date: - 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 ($100,0001. 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 (_ I 1, 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, (_) 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 cessa ion of work for 180 days will, subject,. - - CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirmunderpenalty of perjury that there is a construction lending agency for the performance of the- I certify that I have�readthis application andstate.-that the above informati i correct. �Iagree '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 an hereby authorize representatives - of -this county to enter upon the above-mentioned property foci rpo es. - Lender's Name: " f p - tDate: ant or A -ent): - Lender's Address: - - - LQPERMIT Application Number 09-000003.25 Permit . . . . . . SPECIAL INSPECTION Additional desc . Permit Fee 100.00 P1an'Check Fee .00 Issue Date . . Valuation . . 2000 Expiration Date 10/07/09 Qty Unit -Charge, Per Extension BASE FEE 100.00 ------- - ---------------------- Special Notes and'Comments SPECIAL INSPECTION FOR 20' X 50' TENT TO BE INSTALLED 4/10/09 AND TAKEN DOWN 4/13/09 FOR EASTER SUNDAY OVERFLOW SEATING PER LES JOHNSON. Fee summary Charged Paid_ Credited Due ----------- Permit Fee Total 100.00 .00 ---------- .00 100.00 Plan Check Total .00 .00 .00 .00 Grand Total 100.00 .00 .00 100.00 LQPERMIT. Bin # .City of La Quinta Building 8r Safety Division - 1 P.O. Box 1504, 78-495 Calle Tampico. ` La Quinta, CA 92253 - (760) 777-7012 1 Building Permit Application and Tracking Sheet Permit # Project Address: 7- 225 W9_Yyl,,67 Owner's Name: A.' P. Number: Address: Legal Description: City, ST, Zip: Contractor: e j/&67w15 Telephone: P /� Address: 2�0D`I /1%jy ��}�� Project Description: City, ST, Zip: 11JC d�il y'73 ��a . C I) 56 K � � r-r64Ce S acr& i- Tele h ne• o . � a 7 S� P G � GAS � d �r scz/ D State Lic. # : City Lic. #; Arch., Engr., Designer:. Address: City., ST, Zip: Telephone: '> .,,,,,�5•»:.:. i' Construction ton TY Pe: otZ�f- OccuP an � Em)-7S- cY7S State State t.#• Proct Je type (circle one • New Add'n -Alter r Re air Demo Name of Contact Person: ��f • Sq. Ft.: 10.06 , ' _# Stories: ( #Units: Telephone # of Contact Person: Estimated Value of Project:°O APPLICANT: DO NOT WRITE. BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted 4117 Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd Review, ready for correctis/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up. S.M.I. HAA. Approval Plans resubmitted Grading IN HOUSE:- '"' Repiew,.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 I