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0309-268 (CONR)LICENSED CONTRACTOR DECLARATION li;�er�eby,,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 # Lic. Class Exp. Date Date i ^' Signature of Contractor � _,. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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 & Professionals Code). -- ( ) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). () I am exempt under Section B&P.C. for this reason Date Signature of Owner 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 & policy no. are: Carrier LIB1;1I,'1 Y MUTUAe. F Policy No. W.A262V004723012TI; (This section need not be completed if the permit valuation is for $100.00 or less). ( ) 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 fo trthwith comply with tho a provisions. it 1. Date: } '1 ° ` ` Applicant �� Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $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. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth onrhis 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 applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees, t 2. Any permit issued as a result of this application becomes,null and voi 4}J work is not commenced within 180 days from date of issuance of'su h permit, or cessation of work for 180 days will subject permit to cancellatio I certify that I have read this application and state that the above information i correct. I agree to comply with all City, and State laws relating to the buildinrrrryyyy construction, and hereby authorize representatives of this City to enter'upory the above -mentioned -property; or Inspection purposes. Si nature (Owner/Agent V10, - —Date \), -- BUILDING PERMIT ,PERMIT# DATE _ qI . V#LUATION 1' LOT f 23TRACT 213838-4 _ ADDRESS X31-240 LLPC4 N1)SWAXY JOB SITE APN 762-4204M� OWNER CONTRACTOR / DESIGNER / EN (NEER TOLL RROTHM WC TOLL Bill OTITME TN( 73.1211r UX) WA��iNG # 100 - 73-121 TEED WAMN O 0100 RAIN DE,�SSM CA 92260 PALM DLZeRT CA 92260 (76OW/4-9699 CRIX 3832 USE OF PERMIT svo � 1., i* 23,m97'.9:t4:t .sair_caska S14.t.•M OMCF, CC2NYERSION. .AT 0.ARAQV. $50 90, FT, 2001. CODES .,AIC .-- COI+ MP.CIAI., 550 OS1 or CONTRACT AK40LI14T 19,�113.GG I B917MXM COST OF CON'M?.Xl'C.CRN PXOM "R GARY COO ST.RU C T I ON ?IEB 101-000-418-000 t225,013 PLAN CHECK. 'FEE $175.0 IVII'WI3ANICAL YEE 101-000.421.0017 SAW LCT 1R1C°a� I., �F�.E 10.1-000-420-000 ��G. (►G STRONG MOTION IEE - COMM A00%0041.241.000 tso C0.V1 uTrAUC"J10N fi 111 FLAW C -IM. C $460,13 IMS 'RE -PAID FE '$0100 Ui'0TA L I'I"`1 nT FrEs VUE NOW 2 0 20U3 ' NOV • • --1 q �t it►�TA _ RECEIPT DATE i BYG. DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final I I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Firial+ Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation, Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) x X k Bin # © �? Permit # G Project Address: City of La Quinta Building s Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Uvner's Name: ^ A. P. Number. J XAddress: _ Legal Description: Wit= -z, -4 GC r Contractor. �,�. ��, Address: City. ST. Zip: -2L` ,� FTelephone: -�. t- �a=-b '$ 1XProject Description: -� Cit}'. ST. Zip: C11 -Z t \LA n Telephone: I b' State Lic. #G Arch., Engr., Designer: City Lic. #: Address: City. ST. Zip: (10ronaC Telephone:(� 31 State Lic. #:.:'. Construction Ty Occupancy: Project type ( ircle one): New Add'n Alter Repair Demo Name of Contact Person: 4"A Sq. Ft.:�&4 # Stories: i # Units: Telephone # of Contact Person: � t "1 sti cd Value of Project: 100 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING 4 PERMIT FEES Plan Sets OI, Plan Check submitted Item Amount Structural Calcs. Reviewed. ready for corrections Plan Check Deposit Truss Cascs. Called Contact Person Plan Check Balance Energy Cities. Plans picked up S ct(a4 Construction Flood plain plait Plans resubmitted .x CL Mechanical Grading plan P' Review. ready for correction issue (l �—Q Electrical Subcontactor List Called Contact Person/e)' K �¢ G3 Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue �\ School Fees Total Permit Fees F--" - A • f"*i' & — 97e111 �— Gtr P.O. Box 1504 78-495 CALLE TAMPICO (760) 777-7000 LA QUINTA, CALIFORNIA 92253 FAX (7 60) 777-7101 f September 22, 2003 i Mr. Andy Fraser Toll Brothers, Inc. 81.-380 Legends Way La Quinta, Ca 92253 SUBJECT: MINOR USE PERMIT 2003-432 + (TEMPORARY SALES OFFICE) Dear Mr. Fraser: The Community Development Department has reviewed your request for a Minor Use Permit to establish a sales office on Lot 23 of Tract 28838-4, and has approved it subject to the exhibits on file and the following conditions: 1. Obtain the appropriate building permits. 2. Provide restroom facilities in the sales office to accommodate personnel. 3. Mounted on the exterior of the sales office shall be a written notice providing emergency personnel your 24-hour emergency phone number they can call in case problems arise that need your prompt attention (i.e., minimum 1 " high letters). 4. Install one 2A1OBC fire extinguisher inside the sales office and each model. 5. A cash deposit of $1,000.00 shall be posted with the City to insure the garage conversions of the model/sales office is removed within 90 days after the expiration of this permit. 6. The existing parking lot on Lot 25 shall be used in connection with sales office. Any modifications to the existing parking lot shall require review and approval by the Community Development Department. 7. Parking for handicap individuals on the existing parking lot shall be maintained and comply with the American with disabilities Act provisions, which require hard surfacing with proper striping and signs. i \\CLQADMFS1\PLANNING\Martin\MUP 03 432 SalesOff.doc NggN4V 8. Dust control measures shall be employed during construction of the sales office. Such control .measures shall include landscaping as shown on the plans. 9: The sales office shall be permitted to remain until September 22, 2004, unless a time extension is applied for and granted by this Department. The Community Development Director may extend the permit for a set time period if needed. No fee is charged to extend this permit. 10. The City may elect to add Conditions to this application request to mitigate any problems that arise not previously addressed herein. 11. The applicant/property owner agrees to defend, indemnify, and hold harmless the City of La Quinta (the "City"), it's agents, officers and employees from any claim, or litigation arising out of the City's approval of this project. This indemnification shall include any award toward attorney's fees. The City of La Quinta shall. have the right to select its defense counsel in its sole discretion. 4 This decision. may be appealed to the Planning Commission by anyone provided they submit the necessary paperwork and filing fee of $175.00 with this office within 15 days of approval of this permit. Should you.have any questions or need additional information, please do not hesitate to contact me at your convenience at (760) 777-7068. Sincerely, JERRY HERMAN COMMUNITY DEVELOPMENT DIRECTOR MARTIN MAGANA Associate Planner c: k_Bui.lding & Safety Department Chron file I � , \\CLQADMFS1\PLANNING\Martin\MUP 03 432 SalesOff.doc