BSPN2017-0007n4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning: r
Application Valuation:
Applicant:
SILVERHAWK CENTRE LP
50660 EISENHOWER DR
LA QUINTA, CA 92253
TWY°l4�w
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BSPN2017-0007
50660 EISENHOWER DR BLDG 32
773370028
SILVERHAWK APTS / SPECIAL INSPE
D
=I
JAN 2 6 2011
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
LANDS
3366 VIA LIDO
NEWPORT BEACR, CA 92253
ODntractor:
DESIGNANDpTM OF LA
EVELOPMENT DEPARTMENT
Llc. No.:
Date: 1/26/2017-
Application
/26/2017
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATON DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter
I hereby affirm under penalty of perjury one olithe following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect.
compensation, as provided for by Section 370G of the Labor Code, for the performance
License Class: License No.: _
of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Date: Contractor:
Section 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity number are:
OWNER -BUILDER DECLARATION
Carrier: _ Policy Number:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of zhe work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those provisions.
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
Date: B�/7� L8 r7 Applica
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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(� 1, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject.to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
(� I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(� I am exempt under Sec. B.&P.C. for this reason
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.
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:
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 ordirances and state laws relating to building
construction, and hereby authorize representa-ives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: !� Signature(ApplicantorAg
Application Number: BSPN2017-0007
Property Address: 50660 EISENHOWER DR BLDG 32
APN: 773370028
Application Description: SILVERHAWK APTS /SPECIAL INSPECTION
Property Zoning:
Application Valuation:
Applicant:
SILVERHAWK CENTRE LP
50660 EISENHOWER DR
LA QUI NTA, CA 92253
Owner:
LANDS
3366 VIA LIDO
NEWPORT BEACH CA 92253
Contractor:
Date: 1/26/2017
LIc. No.:
---------------------------------------------------------------------------------------------
Deta i l:
DESCRIPTION
•
ACCOUNT QTY AMOUNT
SPECIAL INSPECTION 101-0000-42404 0
$76.00
Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION:
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
•$81.00
r
lain # ,
Permit #1
oject Address:�W O
-�P(Arh
A. P. Number: 1LbiI.
City of La. Quin to •
Building 8'r Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
1 S�nl tu�'�2 wner's Name: �v m W A ��
3Z.
Address: S�
Legal Description: City, ST, Zip: �.,�- U i nts.a CA -1 ZZ- s-3
Contractor: i
�o Telephone: L
1 20
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AoN7
a S3
(/`i �tz.Trc i3 I
Address:
Project De jiption:
City, ST, Zip:
'
leh
Telephone:
P
State Lic. # :
Arch.,' Engr., Designer:
City Lie.
.Address:
City, ST, Zip:
Telephone: P
o .
Lic. ,-
StateLc .
Name of Contact Perso -,
Construction Type: Occupancy:
:. Project tYPa (circle one): New Add'n Ater e aDemo,
Rt• Units:
q..
Telephone # of Contact erson:
Z) ?jov -I Cl13 5 Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Depiesit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
t.
Grading plan
2°" Review, ready for corrections/issue
Electrical .
Subcontactor List
Called ContactTerson
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:--
Review, ready for corrections/issue.
Developer Impa:t Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. NVks. Appr
Date of permit issue
School Fees,
Total Permit Fess
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