06-1536 (SPIN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00001536
Property Address: 80349 VIA MIRASOL
APN: 777-090-020- - -
Application description: SPECIAL INSPECTION
Property Zoning: LOW DENSITY RESIDENTIAL
Application, valuation: 80000
Applicant: Architect or Engineer:
- - - - - - - - - - - - - - - — — — — — — --- — — — — — — — — — — — — — — — — — — — — — —
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm underpenalty 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 - -
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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).:
(_ ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure isnot 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 _ 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—) 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: 4/24/06
Owner:
NRI CCP I
81100 AVE 53
LA QUINTA, CA 92253
Contractor:
CLASSIC PARTY RENTALS
(CSLB LIC NOT REQ'D - GB)
75060 MAYFAIR DR
PALM DESERT,- CA 92211
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 3992 'Policy Number
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: Applicant:
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 (5100,000). 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 benefitworkis performed under or pursuant to any permit issued as a result of this application,
the owner, andthe 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 1 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 representat ves
of this county, to enter upon the above-mentionedoperty fo inspection yup e e -
,D • ate: ignature (Applicant or Agent):
-
Application'Number . . . 06-00001536
-
Permit SPECIAL INSPECTION
Additional- desc ...
Permit_ Fee . . . . 100.00 Plan Check
Fee
.00
Issue.Date . . Valuation
. . .
. 80000
Expiration Date 10/21/06
Qty Unit.Charge Per
Extension
BASE FEE
100.00
Special Notes and Comments'
SPECIALINSPECTION FOR 401. X'100'. TENT .
..WITH --201 X 40! KITCHEN.CANOPY & 20' X
60' POP OUT TO BE ERECTED FOR "RABBLE `
ROUSER" GOLF TOURNAMENT (4/24/06 -
5/5/06) PER-TUP # 2006-624
Fee .summary Charged Paid Credited
Due
--------------------_----- -----
Permit Fee,Total 100:00 .00
.00' -
100.00
- Plan Check Total .00 ,-00
00
.:00
Grand Total 1100.00 .00
00
100.00
LQPERMIT - ... - ..
Bin #
City of La Quinta'
Building & Safety Division
P.O. Box 1504, 78-4 95Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permitlication and Tracking ng Sheet
Permit #
Project Address: VI rkr Owner's Name: 6
A. P. Number: ' Address: \
�l
Legal Description: City, ST, Zip: n 0 k I
Contractor: Tele honer l
6- P
Address:
Project Description:
City, ST, Zip:ap
Tele P hone: 3
't'
O
State Lic. # : City Lic. #: /� Q
Arch., Engr., Designer: ll/j ^ ' r ^
Address:Ito to to
Citv, ST, Zip: Ul
Telephone:
Construction T v P cu O ant ••
c P �.
State'
Ltc. #: Pr J' e (circle on N e dd'n
Democt Pe
Alter Repair
I
Name of Contact Person: Sq. Ft.: # St ries: # Units:
{� l
Telephone # of Contact Person: Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#'
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss'Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cale s.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"Review, ready for correction ssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.AU.
H.O.A. Approval
Plans resubmitted
Grading
IN 110USE:-
'rd 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
7
M