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08-0488 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&t!t44.Q" Application Number: -08 -00000488V - Property Address: 78121 AVENIDA LA FONDA APN: 770-122-001-3 -000000- Application description: REMODEL - COMMERCIAL Property Zoning: VILLAGE COMMERCIAL Application valuation: .9500 Applicant: Architect or Engineer: r� l BUILDING & SAFETY DEPARTMENT BUILDING PERMIT --------------------------------------------------- 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: C20 License No.: 589063 ate g ontractor: 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).: ( ) 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.). (_) 1, as owner of *the property, am exclusively contracting with licensed contractors to construct the project ISec. 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 projectswith a contractors) licensed - .t pursuant to the Contractors' State License Law.). 1 _) I am exempt under Sec. B.&P.C. for this reason r Date: Owner: I 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< LQPERMIT Owner: PIERRE MONIQUE JEAN 54325 AVENIDA JUAREZ LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/30/08 Contractor: BOB'S AIR CONDITIONII EATI 40874 CECINA WAY BERMUDA DUNES, CA 92;.11 ' �A�`� V (760)345-7640 Lic. No.: 589063 CITY OF LA QUINTA ----------------------------------------------- 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 ENDURANCE REINS Policy Number ' WEN1001584-01 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 Cod all forthwith comply with those provisions. Applicant:ii •/�� WARNINGO 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. 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 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 co my to enter upon t e above-mentioned proper poses. D _ 3y -r! nature (Applicant or Agent): _ Application Number . . . . . 08-00000488 ------ Structure Information A/C UNIT ADDITION TO EXISTING SYSTEM ----- Other struct info . . CODE EDITION 2007CBSC FIRE SPRINKLERS ---------------------------------------------------------------------------- FULLY Permit . . . ELECT - ADD/ALT/REM INV FEE Additional desc . . Permit Fee . . . . 31.50 Plan Check Fee 3.94 Iccue Date . . . . ValuaClun . . . . U Expiration Date . . 11/26/08 Qty Unit Charge Per Extension BASE FEE 30.00 1.00 1.5000 PER ELEC DEVICE/FIXTURE 1ST 20 ---------------------------------------------------------------------------- 1.50 Permit . . . MECHANICAL INV FEE Additional desc . . Permit Fee . . . . 85.00 Plan Check Fee 10.63 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/26/08 Qty Unit Charge Per - Extension BASE FEE 30.00 1.00 22.0000 EA MECH FURNACE >100K 22.00 1.00 33.0000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 ------------------7--------------------------------------------------------- Permit . . . PLUMBING INV FEE Additional desc . Permit Fee . . . . 36.00• P1an.Check Fee 4.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/26/08 Qty. Unit Charge Per Extension BASE FEE 30.00 1.00 6.0000 EA PLB GAS PIPE 1-4 OUTLETS 6.00 ---------------------------------------------------------------------------- Special Notes and Comments ADDING NEW A/C UNIT TO EXISTING SYSTEM. [THE CRABPOT-RESTAURANT] 2007 CALIFORNIA BUILDING STANDARDS CODE.INVESTIGATION FEE ASSESSED PER 1997 UNIFORM ADMINISTRATIVE CODE §304.5 FOR WORK BEGUN WITHOUT BUILDING PERMIT. May 30, 2008 7:43:14 AM AORTEGA Fee summary Charged Paid Credited Due i LQPERMIT Application Number . . . . . 08-00000488 ----------------- --- ----- --- Permit Fee Total 152.50• .00 .00 152.50 Plan Check Total 19.07 .00 .00 19.07 Grand Total 171.57 ..00 .00 171.57 LQPERMIT