10-0506 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
1
1
BUILDING & SAFETY DEPARTMENT
l
BUILDING PERMIT
10-00000506Q C/� ��t Owner:
7B=ys z iva'c ray' tete aiv -78-134 ! eAMGE,C + NAGK Lr► • CITY OF LA QUINTA
770-184-005- - - 78495 CALLE TAMPICO
STRUCTURES OTHER THAN BUILDINGS LA QUINTA, CA 92253
MAJOR COMMUNITY FACILITY
95000'
Contractor:
Architect or Engineer: BROKEN ARROW COMMUNICA
8316 CORONA LANE
ALBUQUERQUE, NM 87113
plk rnnn\ 999 nnn_
Lic. No.: 853651
_ 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 andPr essionals Code, and my License is in full force and effect.
Lic se Class: A B C7 C Lic se No.: 853651
C
Date:&F_0-dG ntractor:
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).:
1 _ 1 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 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.).
(_ 1 I am exempt under Sec. , B.&P.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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/20/10
WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, at provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
y 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
insurance carrier and policy number are:
Carrier ZURICH AMERICAN Policy Number WC6550854-01
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner sZbecome
ubject to the workers' compensation laws of California,
and agree that, if I shoucMtheers' compensation provisions of Section
3700 of the Labor Codehse provisions.
date :$g_?19--fy plicant:
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 ($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 abov formation is co ect. I agree to comply with all
city and county ordinances an state laws relating to buildin onstruction, and reby authorize representatives
o/f t/hr� co�unsty�to enter upo eabove-mentioned prope for inspection pur es.
'Date: W ' G �gnature (Applicant or n
Application Number . . . . . 10-00000506
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
617.00 Plan Check
Fee
401.05
Issue Date . . . .
Valuation
. . .
. 95000
Expiration Date
2/16/11
Qty Unit Charge
Per
Extension
BASE FEE
414.50
45.00 4.5000
--------------------------------------.--------------------------------------
THOU BLDG 50,001-100,000
202.50
Permit . . . .ELEC-MISCELLANEOUS
Additional desc .
Permit Fee
55.50 Plan Check
Fee
13.88
Issue Date . . . .
Valuation
. . .
. 0
: Expiration Date
2/16/11
Qty Unit Charge
Per,
Extension
BASE FEE
15.00
1.00 18.5000
EA ELEC SVC <=600V/<=200A
18.50
2.00 11.0000
EA ELEC MISC
22.00
----------------------------------------------------------------------------
Special Notes and Comments
ADD 6 PANEL ANTENNAS
TO EXISTING CELL
MONOPOLE TOWER; ADD 4
EQUIPMENT CABINETS
AND 1-200 AMP SERVICE
WITHIN EXIST CMU'
ENCLOSURE. 2007 CODES
/ 2008 ENERGY.
----------------------------------------------------------------------------
Other Fees . . .
. . . .. BLDG STDS ADMIN (SB1473)
4.00
ENERGY REVIEW FEE
40.11
STRONG MOTION (SMI)
- COM
19.95
Fee summary Charged
------------------ ---------- ----------
Paid Credited
---------- ----------
Due
Permit Fee Total
672.50 .00
----------
.00
672.50
Plan Check Total
414.93 .00
.00
414.93
Other Fee Total
64.06 .00
.00
64.06
Grand Total
1151.49 .00
.00
1151.49
LQPERMIT
r
Bin
Bin #�
City of LQ Quinta
J Building & Safety Duron 1
Box 1504, 78-495 Calle Tampico
�t� La Quirita, CA 92253 - (760) 777-7012
� Bur ding Permit Application and Tracking eet
Permit # tOP.O.
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Project Address: - T V��L� S IL
Owna'.s Name:
A P. Number. �S/
Address: b
u�1� -�A%J
Legal Description: -"k OW� "4. �� `�✓�tf �j�y Tr j
% City. ST, Zip: IlCA
Contractor: 1
Telephone: •
Address:
Project Description: W S1A e'
City, ST, Zip:
Telephone:
State Lie. # :
City Lie. #;
;� �ck1
Arch., Engr., Designer. ,
Address:(,L
City, ST, Zip: VIVA C affil
Telephone: C(LA . Lf I5, yCpo
CanstrUCd0n Type: Ocatpancy:
State Lic. #: 6� r
Project type (circle one): Ned Add'n Alta Repair Demo
Name of Contact Person: �� V� w \
Sq. FL:
# Stories: I # Units: 1
Telephone # of Contact Person: � . �1 Jb b
Estimated Value of Project:.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRAC MG PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Cafes.
Reviewed, ready for corrections Pisa Check Deposit
Truss Calcs.
A.
Called Contact Person 1� . 7 Plan Check Balance.
11de 24 Calcs.
Plans picked up Constriction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
V. Review, ready for eorrections/issue 8 (Z Electrical
Subcontactor List
Called Contact Person ` Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
''• 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
� r-Ei n) 14 n 65'Iola) Permit Fees
lam" e
�j JUN 10 2010
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THIS MAP WAS PREPARED FOR ASSESSMENT PURPOSES ONLY. NO LIABILITY
IS ASSUMED FOR THE ACCURACY OF THE DATA SHOWN. ASSESSOR'S PARCEL
MAY NOT COMPLY WITH LOCAL LOT -SPLIT OR BUILDING SITE ORDINANCES.
SEC. 6 T6S WE
CITY OF LA QUINTA
020-051
77.0-18
769-15
25.93' 83.29 DCT -1 r
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BERMUDAS
MB 19111751-1 0 DESEFM CLUB TRACT UNIT No. 1
! ! ( I I MB 145 / 55 -56 TRACT MAP NO. 19203
ASSESSOR'S MAP BK 770 PG.18
Riverside County, Calif. ; 1 ( PM 22611 7 - B PARCEL MAP NO. 33954
%ifernandez i I 1 i I I I I I I 1 I I Nov 2008
Date I Old Number I New Number
811112003 183.1-2
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181.8
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RealQuest.com ® - Report
Page 1 of 1
Street Map Plus Report T CoreLogic'
For Property Located At Rea l ` ij uejt• Professional
78136 FRANCIS HACK LN, LA QUINTA CA 92253-5220
�ry EsGil Corporation
In (Partnership with Government for Buirding Safety
DATE: 7/2/2010
JURISDICTION: City of La Quinta
PLAN CHECK NO.: 10-506 SET: I
PROJECT ADDRESS: 78-136 Francis Hack Lane
NT
❑ PLAN REVIEWER
❑ FILE
PROJECT NAME: Royal Street Communications Crown Colo 879934 Firestation #32
® The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
❑ The plans transmitted herewith will substantially comply with the jurisdiction's
codes when minor deficiencies identified below are resolved and checked by building
department staff.
❑ `The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
❑ The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
❑ The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
❑ The applicant's copy of the check -list has been st ent to:
® Esgil Corporation staff did not advise the applicant that the plan check has been completed.
❑ Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone #:
Date contacted:, (by: ) Fax #:
Mail Telephone Fax In Person
® REMARKS: structural review only
By: David Yao Enclosures:
EsGil Corporation
r ❑ GA ❑ EJ ❑ PC 6/29
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
P.O. Box 1504
78-49,5 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
s
To: Greg Butler, Building & Safety Manager
From: Les Johnson, Director -PDD
Permit #:
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
To PD: AUGUST 4, 2010
Due Date: AUGUST 11, 2010
Status: 2"D REVIEW
Building Plans Approval
(This is an approval to issue a Building Permit)
The Planning Department has. reviewed the Building Plans for the following
project:
Description: ADDING 6 ANTENNAS TO EXISTING FACILITIY
I
Address or General Location: 78-136 FRANCES HACK LN.
Applicant ContactVERONICA ARRIZU 858-602-6380
The Planning De\/,elopmerit Department finds that:
I
❑ ...these Bulilding.Plans do not require Planning Department approval.
...these Building Plans are approved by the Planning Department.
❑ ...these Building e Plans require corrections. Please forward a co of the
,q copy
attached cPrrections� to the applicant. When the corrections are made
please return them to the Planning Department for review.
Les Johnso , Dir 'ctor-PD Date
i
�►s..4 200
City of La curila
P1crril�� ���ati^:��rf