06-2867 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-0200_28.67
Property Address: 52595 MERIWETHER WY
APN: 767-200-998-K -330762-
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 6000
Applicant: Architect or Engineer:
ld3a 3�NVNId
V1Nin6 i :iO Am*
9ooa � o gnd
BUILDING & SAFETY -DEPARTMENT
BUILDING PERMIT
----------------
Li6C�1SE
-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 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 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.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
1 hereby affirm under penalty of perjury that there is a construction lending agency for -The performance
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
Owner: '
EAST OF MADISON LLC
PO BOX 1482
LA QUINTA, CA 92247
Contractor:
Owner
2
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
------------------
WORKER'S COMPENSATION DECLARATION
Date: 8/03/06
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 theworkfor which this permit is
issued.
C) 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 Policy Number
_ 1 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, 1I s�forthwith comply,
o;a�p ve thisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENS SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A D CIVIL FINESTP 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 county to enter upon the above-mentioned propertins ection puss. /l
t
LQPERMIT
Application Number . . . . . 06-00002867
Permit . . . . .. PLUMBING
Additional desc .
Permit Fee . . . . 27.00
Plan Check
Fee
6.75
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 1/30/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 12.0000 EA PLB INTERCEPTOR
12.00
-------------------------------- --------------------------------------------
Special Notes and Comments
2000 GREASE INTERCEPTOR FOR TEMPORARY
KITCHEN PER APPROVED PLAN & CVWD
APPROVAL.
Fee summary Charged Paid
---------------=---------------------
Credited
--------------------
Due
Permit Fee Total 27.00
.00
.00
27.00
Plan Check Total 6.75
.00
.00
6.75
Grand Total 33.75
.00
.00
33.75 -'
LQPERMIT
0
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 # r
1p
ProjectAddress: 52595 Meriwether Way
Owner's Name: East of Madison, LLC
A. P. Number: 767-200-009
Address: 80955 Avenue. 52,
Legal Description: Lot K of Tract 33076-2
City, ST, Zip: La Quinta, CA 92253
Contractor: Owner—Builder
Address: 80955 Avenue 52
Telephone: 760 391-5072
Project Description: Grease interceptor for
City, ST, Zip: La Quinta, CA 92253
temporary kitchen
Telephone: (760) 391-5072
-
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:1.
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: $6,000.00 -
6,000.00 -APPLICANT:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
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
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd 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:-
'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
COACHELLA VALLEY WATER DISTRICT ASSESSOR'S PARCEL NUMBER
' 85-995 Avenue 52 767 200 ____ 009
Coachella, California 92236
(760) 398-2651
APPLICATION FOR WASTEWATER INTERCEPTOR/SEPARATOR APPROVAL
APPLICANT: Submit this form with a copy of a SCALED plot plan (1"= 20' to V= 40' SCALE) drawn to District specifications. A nonrefundable filing fee is required
when the application is submitted. Check must be made payable to the Coachella Valley Water District. Approval of this application shall remain valid for a period
not to exceed one (1) year from date of payment
Plan Check No.
Agent, Contractor, Contact Person
Address City State Zip
Telephone
East of Madison, LLC
80955 Avenue-
Owner
Address City State Zip
Telephone
East of Madison LLC
80955 Avenue 52 La Quinta, CA 92253
.391-5072
Job Property Address City Zip
52959 Meriwether Way. La Quinta 92253
Legal Description
DBA
Lot K of Tract 33076-2
The Madison Club
PLEASE COMPLETE THIS SECTION FOR REVIEW OF FOOD ESTABLISHMENTS
NOTE: PLANS WILL NOT BE ACCEPTED UNLESS THIS APPLICATION IS COMPLETE AND THE PLAN CHECK FEE IS PAID.
GENERAL CONSTRUCTION:
Type of Construction:
New Food Facility x Remodel of Existing Food Establishment Hours of Operation 16 hrs Seating Capacity: Internal 42 External 12
External Seating with Misters or heaters No Bar with Food Service Bar Nonfood Service Water Softener NO
Service:
Multiservice (reusable) �_ Single Service (disposable)
OWNER/REPRESENTATIVE DECLARATION: I certify that I have read the entire application and state that all information is correct. I understand that the amount of fee
paid is based on my declaration of information on this form and that incorrect information is grounds for denial of the submitted plans. I also understand that plans will be
discarded if not picked up within sixty (60) days of approval or denial and that no inspection of my establishment will be conducted, or approval granted to operate, until all
proper information requested hhas b received and plans have been approved and returned
SignatureDate D��3/�aoo�
y "... � ��t.�F`J��w� "^{.C.'
W .:...:.
Type of System(s)
: . _ _i ' � m. -+,:,, ' }a ..spar.., u'�5: - ;•'3��.:jr?�
No. Dwelling Units QSand/Oil Grease Interceptor Waived
No. of Systems
Fixture Units ESLGrease Interceptor
Iew
13Existing
13 LAW L W Tr
❑ Replacement ❑ Addition
❑ Clarifier
❑ Connect to Sewer
Gal.
REMARKS:
1
application is:
Approved ❑ Denied ❑ Conditional Approval*
Fee S 116--00
Check No. Q�
..See Remarks
Date /
Initial
Signa
Date c�� 0
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PECTiO" 'FEE
i I�p�r0 {FTIE APPROVED
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FOR CONT. SEE CIVIL
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20 �3 ��
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L O / ' INTERCEPTOR PROCAST
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PLUMBING SITE PLAN
SCALE: 1"=1/16"
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G0tmmms
CONSULTING MECHANICAL ENGINEERS
326 S. KALMIA STREET PH.(760)735-8577
ESCONDIDO, CA 92025 FAX(760)735-8578
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Nalk NO. C-11782
REN. 12.31.07
OF CAti-\�O
VALID ONLY IF SIGNED IN RED
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Date: 05/10/06
Scale:
Drawn:
Job:
Sheet:
Pool
08/02/06