09-0879 (DEMO)?• = P.O. BOX 1504. 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: 8/17/09
Application Number: 09700000879 Owner:
Property Address: 47474 WASHINGTON ST VILLA AMORE, INC.
APN: 643-200-005- - - 47474 WASHINGTON ST
Application description: DEMO - COMML/OTHER LA QUINTA, CA 92253
Property Zoning: COMMUNITY COMMERCIAL
Application valuation: 500
_ Contractor: 1
Applicant: Architect or Engineer: - PASAMONTE DESIGN & CONST I C AUG i r
65802 AVENIDA CADENA `FV
DESERT HOT SPRINGS, CA 22
�^�w_e
(760),218-8499 CITY r)FA Q L'ifrlr
Lic. No.: 914424
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 Professi als Code, and my License is in full force and effect.
License,Class: B License o.: 914424 '
`Date:_ S' ! / ;Contractor:
OWN ILDER DECLARATION
I hereby affirm under penalty of perjury at I am ex pt 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 viojation 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.:
(_ 1 I, as owner of the property, or my er-hployees 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.). .
(_ 1 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 foe the projects with a contractors) licensed
pursuant to the Contractors' State License Law.).
( 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
hereby affirm under penalty of perjury that there is a construction lendinq agency: for the performance of the
work for which this permit is issued ISec. 3097, Civ. C.I. -
Lender's Name:
Lender's Address:
LQPERI%IIT
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: t
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.
1 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 EXEMPT Policy Number EXEMPT
_ 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 sho p become s bj o the w kers' compensation provisions of Section
3700 of the Labor C11,sh all fort ith omply ' h those provisions.A)
'Date: Applicant:
WARNING: FAILURE TO SECURE W KERS' C P NSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI AL 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.
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 -a
ct. I agree to comply with all
city and county ordinances and state laws relating tor9pnstruction, here y authorize representatives
of'this coun y to enter upon the above-mentioned proses.
Signature (Applicant or Agent): \
cl
LQPERN11T
Application.Number 09-00000879
Structure Information' INTERIOR DEMO TO VERIFY EXIST. CONST.. --=--
Permit DEMO PERMIT
Additional desc
Permit Fee 45.00. Plan Check Fee .00
Issue Date . . . . Valuation 500
Expiration Date 2/13/10
Qty Unit Charge Per Extension
BASE FEE 45.00
----------------------------------------------------------------------------
Special Notes and Comments
INTERIOR DEMO TO VERIFY EXISTING
CONSTRUCTION - PER PLAN:
-REMOVE WALL SURFACE AT PROPOSED OPENING
INTO LOUNGE AREA.
VERIFICATION OF EXISTING FOOTINGS AT.
PROPOSED WALL OPENING.
-REMOVAL HOSTESS STAND.
August 17, 2009 11:37:18 AM 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
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Permit #
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A. P. Number:
Legal Description:
Conraor
City of La Quina
Building.0 Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's'Name: � � C- C¢J / •
Addresses
Zip: .
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Address:.'
City. ST, Zip: S ,
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Project Description: rl)E: la elite 1-7—
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Telephone: T
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State Lic. #:
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Arch., Engr., Designer.
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Address:
City., ST, Zip:
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Telephone:�(7�
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Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Repair
Name of Contact Person:
-
Sq. FL:
#Stories:
#Units:
Telephone # of Contact Person: Estimated Viilue oP ojea:
APPLICANT: DO NOT WRITE. BELOW THIS LINE
#
Submittal
Req'd
Rec'.d
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Tithe 24 Cities.
Plans picked up
Flood plain plea
Plans resubmitted
Grading plan
2"" Review, 'ready for corrcetionsAssue
Subcontactor hist
Called Contact Person
VGrading
Grant DeedPlans
picked up.
H2O.A. Approval
Plans resubmitted
IN HOUSE:-
Review,.ready for correctionstissue
Developer Impact Fee
Planning'Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue 8
n
School Fees
Total Permit Fees
8101%"' &W To !U6 Le