04-3748 (SPIN)o4
BUILDING & SAFETY DEPARTMENT
O,ii`64 1'SO4 (760),777-7012
OF 9 ---78-495 CALLE_TAMPICO FAX (760) 7777011
'.LA'QUINTA, CALIFORNIA. 92253 INSPECTI:QN.REQUESTS '(760)� 7774153
t BUILDING PERMIT
Application Number . . Date. 4/28/04
Property Address 80349 VIA MIRASOL
APN: 772-430-001-1 -29894 -
Application description SPECIAL INSPECTION
Property Zoning LOW DENSITY RESIDENTIAL
Application.valuation . 45000
Owner Contractor
NRI CCP I OWNER
81100 AVE 53
LA QUINTA CA 92253
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Permit. . . . SPECIAL INSPECTION
Additional desc
Sub Contractor CLASSIC PARTY RENTALS
Permit'Fee 100.00 Plan Check Fee .00
Issue Date Valuation 45000
Qty Unit Charge Per Extension
BASE FEE 100.00
Special Notes and Comments
SPECIAL INSPECTION OF TEMPORARY TENT
(PRIVATE DINNER - 4/29/04 & 4/30/04,,,;5PM
- 12PM) PER CONDITIONS LISTED ON MUP
2004-464 ATTACHED.:'INSPECTION SCHEDULED
FOR THURSDAY MORNING, 4/29/04.
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
aL�
• 3
P.O. Box 1504 VOICE (760) 777-7012.
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: o Ll"
Applicant: d,,49_,,1,
�,R >f /W�Z/�4S
Applicant's Mailing �AYdld�rei
Date:
Archite t or OA)Engineer-
HO
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3�Architect or E gin er's Address:
3��t 14061 � A()�
�.os �iJ�i��S, CA roodf
Lic. No.
BUILDING PERMIT DECLARATIONS
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 License No.
Date Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that f am exempt from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner
WORKERS' 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
n uI`' i,�sued. My s�o�p�9, of n ' surance carrier and ppli nurr e
Carder�JJ//F LI�}AJ .J��fJEY�V�j/C icy Number I /any / 7 f
_ 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 tkose.ffrovWns. //
U11IJ
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.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty
�of/Pe/�1'ury 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
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 Ouinta, 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 upon the ab -mentioned property for inspection purposes.
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_ CLASSIC PARTY RETALS
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TO: FIRE MARSHALL DATE:
FROM:
SUBJECT: PERMIT REQUEST FOR SPECIAL EVENT..CANOPY OR TENT
CLASSIC PARTY RENTALS, ON BEHALF OF'OUR CUSTOMER, ICi IZEW57Cl— U B�.
SUBMITS THE FOLLOWING INFORMATION TO OBTAIN PERMISSION-TO ERECT.THE >
CANOPIES OR TENTS ON THE ATTACHED PLANS.
1. DATE OF EVENT: / �'� �3O - ��" ►. .
` 2. 'NAME OF EVENT: Pi 0i 1G _p L N
3. LOCATION: �ILI �C, l L�6. I'L�C� , Lh Q0,N)lrJ3
ti 4. NUMBER OF PEOPLE: a d D a rl 136 - cLQQT
5. SIZE AND DESCRIPTION OF STRUCTURE.-
-3
TRUCTURE:-3 PohDf -w/ 40 o' s jbElu)h
6. SPECIAL EFFECTS USED:
• CLASSIC PARTY RENTALS • 75-060 MAYFAIR DR PALM DESERT, CA 92211 (760) 340-3992 • FAX (760) 773-0770 • `
7. ELECTRICAL REQUIRMENTS:
loo' AWAy,F2Dm Eovc
8. EXITING: , • ,
`
.-BOG TEI\)r a EA ITS
9. STAGING_ OR PLATFORMS: -
• .� � � � � � •la' x 1��..� ail'' S7H�,�, r
-10. CURTAINS, DRAPES AND/OR BOOTHS:
. , UsF�� "R�5 ►3A�t���oP"FD2 �AI��s "' 4 .
11. SEATING AND TABLE SET-UP: `
.�E AITI) eRct wPo Ab�
• - 12. FOOD SERVICE (OPEN FLAMES):
C✓ A F S
+ • CLASSIC PARTY RENTALS 75-060 MAYFAIR DR PALM DESERT, CA 92211 (760) 340-3992"• FAX (760) 773-0770 •
• • • ` • - �• to
13. FLAMEPROOF CERTIFICATES:
14. FIRE EXTINGUSHING AND EXIT SIGNS:. " x
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f71fN• 1�11T'Y�-`f B���i 6P
5� F IPIE, EVT 1�aoist EilS
15. SPECIAL REQUESTS:
• •• •, • :. .fit -
ATTACHMENTS: 3 COPIES OF PLANS -
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• CLASSIC PARTY RENTALS 6 75-060 MAYFAIR DR PALM DESERT, CA 92211 • (760) 340-3992 • FAX (760) 773-0770 •
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