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12-1075 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00001075 Property Address: 53480 EISENHOWER APN: 774-091-012-13 Application description: STRUCTURES OTHER Property Zoning: COVE RESIDENTIAL Application valuation: 15000 DR -000000- . THAN BUILDINGS 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: CITY OF LA QUINTA P O BOX 1504 LA QUINTA, CA 92253 Contractor: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 D ° Applicant: Architect or Engineer: PACIFIC WEST SPACE COM I Z r.1: n 900 W. GLADSTONE STREET O 5 2013. SAN DIMAS, CA 91773 (909)772-4277 LiC. No.: 597074 ------------------------------------------------------------------------------------------------- Date: 1/23/13 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 Professionals Code, and my License is in full force and effect. / License Class: A C7 License No.: 597074 V/ Datil e Contractor:! 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, 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.). (_ 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 for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) 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 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, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. _ 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 OLD REPUBLIC Policy Number AICW96851303 _ 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 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:Ol 2leApplicant: 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 above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter pon the above-mentioned property for inspection purposes: Dater � Signature (Applicant or Agent): 12l:J�C"1 l- v Application Number . . . . . 12-00001075 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation . . . . 15000 Expiration Date- 7/22/13 Qty Unit Charge Per Extension BASE FEE 45.00 13.00 9.0000 THOU BLDG 2,001-25,000 ----------------------------------------------------------------=----------- 117.00 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . . 45.25 Plan Check Fee 8.38 Issue Date . . . . Valuation 0 Expiration Date 7/22/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 .7500 EA ELEC POLE LIGHT .75 1.00 18.5000 EA ELEC SVC <=600V/<=200A 18.50 1.00 11.0000 EA ELEC MISC 11.00 ---------------------------------------------------------------------------- Special Notes and Comments 35ft MAX HGT COMMUNICATIONS POLE ANTENNA W/ LIGHTS AT CITY PARK. ENGINEERED FOUNDATION DESIGN PER 2010 CODES. ENGINEER: ADRIAN McJUNKIN C57075. --------------- ------------------------------------------------------------ Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 HOURLY PLAN CHECK- 175.00 STRONG MOTION (SMI) - COM 3.15 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 207.25 .00 .00 207.25 Plan Check Total 113.68 .00 .00 113.68 Other Fee Total 179.15 .00 .00 179.15 Grand Total 500.08 .00 .00 500.08. LQPERMIT Permit # 0 . &V I City of La Quinta Building ar Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: .53'4190 C-1SEN46wM-bR-wner's Name: CROWN OA6TL U A. P. Number: Address: Legal Description: Contractor: P(ViL City. ST, Zip: C .... ... . . . .............. ... . . ........... ...... �Ktrellephhoine: ....... ..... . . . .... ::'.1 ...... ...... . 1. . .. .. ........... . I . Address: LJ6$V1&LAb.S76W6 PkProject Description: City, ST, Zip: :SA" AI M" 917 73 kAele-C. Q) 2-q'R0UUD crtzi- Aet 44.1.m r Tele phone:76 7-644-143zl ...... ........ WIT14 ;>d)c WP A&TEWIVA. (33 Flua . ......... .................... State Lic. # : 591014 Arch., Engr., Designer: City Lic. #: 040739 NumnePM E*X PA N El R Wk— CA &L Address: 5ua,0&'4-, ebA4&J17- City, ST, Zip: St--C/4xMj LA1000-OL- Telephone: C onstruction TN pe: Occupancy: .. .... ... ... . . ......... ..... Project type (circle one): New Add'n Alter Repair Demo State Lic. #: Name of Contact Person: gMP'4C-^1 P4TIA/0 Sq. ft: 4 Stories: # Units: k Telephone # of Contact Person: rEstimated Value of Projcct:'41/S, 000 APPLICANT: DO NOT WRITE BELOW THIS LINE Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Q I Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Flans resubmitted Mechanical Grading plan 2" Review, ready for correctionfis sue) Electrical Subcontactor List / Called Contact Person Plumbing Grant Deed Plans picked up SANI.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 Total Permit Fees q11? 1'p JA) 940- 7U loll 7 7/ate /10/3 .. 51 P.O. Box 1504 787495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT (760) 777-7012 FAX (760) 777-7011 To: Greg Butler, Building & Safety Manager To CDD:41 From: Les Johnson, Director -Planning Due Date: "�� " �"q• Permit #: Status: 16__ C� Building Diens Approval (This is an approval to issue a Building Permit) The Planning Department has reviewed the Building Plans for the following project: Description: a4 Address or General Location: ,C Applicant Contact: �� .e $fig - a 34 - 431 The Planning Department finds.that: ❑ ...these Building Plans do not require Planning Department approval. ...these Building Plans are approved by the Planning Department. ❑ ...these Building Plans require corrections. Please forward a copy of the attached corrections to the applicant: When the corrections are made please return them to the Planning Department for review. -7/2- _V/1 Les Johnson, (rector -Planning Date � w or a44nia 1't�z`�ina p�pcadrnent ©Feb.L3.'2016 ` 11:27:29 AM PST _ File Edit Commands Help ' MMARD'PUBUCSECTOR NaviUne �. g * Application 12-0000107 m Bonds 1, Property Information ^^ "� —53480 F Application Information Contractor escrow Addressr EISENHOWER OR Applicat13n,desc:�35 FT. LIGHT POLE COMMMICA ® Fees + CA 413INfA• CA 92253 Application,status: PERMIT ISSUEDGloba .t due Location ID: 26262 I Status Date: 3/29/2013 ,f ionbalhistnce Inspection Q]Inspedion history Owner name: CITY OF LA QUINTA Application type: STRUCTURES OTHER THAN BUILD APN: 774.091-012-13 -000000. -;7 Application date: 9/19/2012 fdiscellaneousinto- Alternate ID: Tenant name/number: CROWN CASTLE Names 1! ! Zoning: RC COVE RESIDENTIAL 4 L Permits Subdivision: M Plan tracidng 4II- - Receipts Contraotor Information + Outstariding Inspections Q Square (dotage calCU j q Contractor Name' PACIFIC WEST SPACE COMMUMC Insp Schedule .Confirmation I ® Structures Contractor Number: 13.00015642 'a Type ID Date Nunber I (1f Valuation calculation ! Type; SUB CONTRACTOR = •••..------ ------ -•-------- --•---...... Status: ACTIVE ;� + No outstanding inspections exist ! Contractor Requirements Doc Number t� -to-�-k-S-•------------------------ - ------------- _ 14 Freeform information Date �Sft MAX EGT COIoMMICAT_IONS POLE AN'T'ENNA X11/07/2012 Y —(— Y I W/ LIGHTS AT CITY PARR. ENGrr7�aacD ' F- 1jr07/2012 ;�Y — Y --- -- �FOUNDATION DESIC-N PER 2010 11 11/07/20121 Y IF --Y , 0DC S. ENGINEER: ADRIAN MCJUNRIN C57075 -- 4 Print'. t Cancel, _ Exit- Y, xit Refresh .- Refresh - Land inquiry ©Feb 3, 2016,11:27:07 AM PST �r File Edit Commands Help EiINOARD'SECTOR NaviLl NaJiLlne * Application 12-0000107 Bonds ► 'Property InTorrnation ~Address: f ApplfcaUon Information ^a contractor escrow 1 53480 EISENHONER DRf •( Appucaiimn desc:.. 35 FT. LIGHT POLE COMMMUNICA - ®Fees LA QUINTA' CA 92253 Application status: PERMIT ISSUED y ® Global balance due i Location ID: 26202 Owner name: CITY OF LA QUINTA ,7 t Status Date: 3/29/2013 }} Application type: STRUCTURES OTHER THAN BUILD f �/ Inspedian history Miscellaneous inform pPN: 774-091-012-13 -000000-Application •� date: 9/19/2012 '® Names Alternate ID: Tenant name/number: CRUM CASTLE }Valual Zoning: RC COVE RESIDENTIAL 15000 Permits Subdivision: j c+-Nt ► m Plan traddng Receipts Contractor Information I- ""' '' - �.Outstanding Inspections Q Square footage calcu Q C'oniractor Name Y - PACIFIC NEST SPACE COMMUNI LL Insp Schedule Confirmation I m Structures Contractor Number: 13-00015642. Type ID Date Number I. _ '©• Valuation calculation 1 Type: SUB CONTRACTOR I Status: ACTIVE 6 t No outstanding inspections exist y Contractor Requirements Doc Number i --------------------- ------------e Waa Como arrie 141 101 101 Inspection type FOOTINGS insp Se Schedule da I's sults, date 0001 • 1, ST_.- ' X3/07/2013 1 AP _ r-3%07/2013 UNDERGROUND ELECTRICAL 0001 p—ST --3l07%013 SAP 3707%20?3 r�tPUSEOF PERMANENT POWER ST 3j2172033 - Z4 Print t Cancel Cj Refresh - - �- Land Inquiry - Documents -. _ . _ .. ...,. .. .. - .._ .... - ,:. - - .III— -----�.�._- .... .-a...,..:�.�. ►