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07-1828 (TT)P.O. BOX 1504 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 07-00001828 � Owner: Property Address: 79710 HIGHWAY 111 HIGHLAND LA QUINTA, LLC APN: 649-020-014-3 -31143 - 1055 E. COLORADO BLVD. #5178 Application description: TEMPORARY TRAILER PASDENA, CA 91106 pZoning: REGIONAL COMMERCIA[n- PropertyAplication valuation: 5000 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Contractor: JUN 2 �' 2007 Applicant: Architect or Engineer: MAR VEST 42208 WASHINGTON ITR -a BERMUDA DUNES, CA 92201 N QUINTA ��(�`�'✓ C1 N �; 1 (760) 360-7061 - - - L Lic. No.: 876299 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 o a iness d Professionals Code, and my License is in full force and effect. Liccnse Cl as : B cens : 876299 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 _) 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, 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 forthe 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 Date: 6/22/07 ill 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 STATE FUND Policy Number 1846155 _ 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 work s' ompensation provisions of Section 37QO of the Labo e, I shall forthwith. ly wi se provisions. Date: ZCant: 1 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHA 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 aboyq information is correct. I ac/e; P comply with all city and county ordinances and state laws relatin to building constr a reby au a representatives of this/cnoun to ent upo the above -men ed pro rt spection p s. Da AX nature (Applicant or gent): n Y I LQPERMIT Application Number . . . . . 07700001828 Permit . . . TEMP TRAILER / MOBILE HOME Additional desc . Permit Fee . . . . 200.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 5000 Expiration Date 12/19/07 Qty Unit Charge Per Extension BASE FEE 200.00 Fee summary ----------------- Charged -------------------- Paid Credited ---------- ---------- Due Permit Fee Total 200.00 .00 .00 200.00 Plan Check Total .00 .00 ..00 .00 Grand Total 200.00 .00 .00 200.00 I LQPERMIT !1 1 t t a i 1 OO O '�ry� :III��IIIII 1 _ n �!I 1 I v1 -�3='�k�¢}� DEPT - ----- HIGHLAND DEVELOPMENT COMPANY A, U 9= �— _ APPI� President's Day PASADENA, 80 S LAKE AVE surtE 6W FOR CONSTR CTION Memorial Day t Independence DaY SITE PLAN DA 1. G Labor Day A, "Ximmem.00, HHS � O OC • := LOW -�3='�k�¢}� DEPT - ----- HIGHLAND DEVELOPMENT COMPANY A, U 9= �— _ APPI� President's Day PASADENA, 80 S LAKE AVE surtE 6W FOR CONSTR CTION Memorial Day t Independence DaY SITE PLAN DA 1. G Labor Day 1 40�•O O O 9 ! I„ �000,� O O O III ( I i.�i � �\\�� w I I,•I c.' � o \ „rim O ✓ !f� .� q r Off rot- �� go �I/,�• I ./..///// P/ ./ / OF4 ��i• f�C{' JsJ J LLI��//.Iri .A.£fFN �i.�M�L¢k:2�'�1.. ��J17 .:!- •: .. ll�� 1. �i�`♦.� -. O A 2 115 lI,II raol 2 1 KIM m J -�3='�k�¢}� DEPT - ----- HIGHLAND DEVELOPMENT COMPANY A, U 9= �— _ APPI� President's Day PASADENA, 80 S LAKE AVE surtE 6W FOR CONSTR CTION Memorial Day t Independence DaY SITE PLAN DA 1. G Labor Day Bin # City of La Quinta Building U Safety Division P.O. Box 1504, 78-495. Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit.# L7- 28 Project Address:' _ A. P. Number: /0 Owner's Name: / Address: Legal Description: City, ST, Zip: Contractor: Address: 7�zD� City, ST, Zip: v� �`-3 �s Telephone: Project Description: / Telephone.D / State Lic. # : City. Lic. #: Arch., Engr., Designer.- esigner:Address: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: r Construction Type: �cj yp : Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: Estimated Value of Project:' APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACIONG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plau Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading, plan 2"" Review, ready for corrections/issue 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 Total Permit Fees