BCOM2017-001378-495 CALLE TAMPICO D etfv VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/19/2017
Application Number: BCOM2017-0013 - Owner:
Property Address: 55995 PGA BLVD LQR GOLF
APN: 775220027 1 BUSH ST STE 1100
Application Description: PGA WEST/ FITNESS CENTER SAN FRANCISCO, CA 94104
Property Zoning: .
Application Valuation: $700,000.00
Applicant: Contractor:
DBR GROUP / STENNO DESIGNS ® ORR BUILDERS
49499 EISENHOWER DR JUN 12 2017 39-301 BADGER. STREET STE 300
LA QUINTA, CA 92253 PALM DESERT, ::A 92211
CITY OF LA QUINTA (760)360-6632
DESIGN AND DEVELOPMENT DEPARTMENT Llc. No.: 69307'
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
(commencing with SectionDivision 3 of the Busi�n Bions Code, and
my License is in full force andd effect. .
License Class: B. A - License No.: 693077
Date: - Contractor:
OWNER -BU I LDDECLARATI ON
I hereby affirm under penalty of perjury th 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.).
I )'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 contacts for the 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
Lender's Address:
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.
�f 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: GRANITE STATE INSURANCE COMPAf9Y Policy Number: WC065258934
_ 1 certify that in the performance ofthe work for which this permit is issued, I
shall not employ any person in any manner se as to become subject to the workers'
compensation laws of California, and agree that, if I shout ome subject to the
workers' compensation provisions of Section 3700 of o e shall forthwith_
comply with those provisions.
Date: / Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMNAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,D30). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FCR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES..
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to Vle Building Official for a permit subject to
the conditions and restrictions set forth on the application.
1. Each person upon whose behalf this applcation 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, andlthe 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 fie work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this appli_ation 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 s°ate that the above information is correct.
I agree to comply with all city and county ordi lances and state laws r g to building
construction, and hereby authorize representatives of this city to e e above-
mentioned property forinspectionpurposes.
ri
Date: ✓` �� Signature (Applicant ar Agent):
Date: 6/19/2017
Application Number:
BCOM2017-0013
Owner:
Property Address:
55995 PGA BLVD.
LQR GOLF
APN:
775220027
1 BUSH ST STE 1100
Application Description:
PGA WEST/ FITNESS CENTER
SAN FRANCISCO, CA 94104
Property Zoning:
Application Valuation:
$700,000.00
Applicant:
Contractor:
DBR GROUP/ STENNO DESIGNS
ORR BUILDERS
49499 EISENHOWER DR
39-301 BADGER STREET STE 300
LA QUINTA, CA 92253
PALM DESERT, CA 92211
(760)360-6632
--------------------------------------------------------------------------------------------
Llc. No.: 693077
Detail:
no FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
QTY
AMOUNT
HOURLY CHARGE - YES ADMINISTRATIVE STAFF 101-0000-42600
0.25
$10.00
DESCRIPTION ACCOUNT
QTY
AMOUNT
HOURLY CHARGE -YES STRUCTURAL PLAN REVIEW ENGINEER 101-0000-42600
2.5
$237.50
Total Paid for BLDG CITY STAFF - PER HOUR: $247.50
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$28.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $28.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - CIVIC CENTER
252-0000-43200
0
$769.13
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - FIRE PROTECTION
257-0000-43200
0
$354.66
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - STREET MAINTENANCE
255-0000-43200
0
$478.38
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DIF - TRANSPORTATION
250-0000-43200
0
$11,710.10
Total Paid for DIF - GENERAL COMMERCIAL: $13,312.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NON-RESIDENTIAL, EA ADDITION 2,000SF
101-0000-42403
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NON-RESIDENTIAL, EA ADDITION 2,000SF, PC
101-0000-42600
0
$10.13
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NON-RESIDENTIAL, FIRST 2,000SF
101-0000-42403
0
$114.00
DESCRIPTION.
ACCOUNT
QTY
AMOUNT
NON-RESIDENTIAL, FIRST 2,000SF, PC
101-0000-42600
0
$88.16
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $250.29
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIRE COMMERCIAL TI
101-0000-22811
1
$701.00
Total Paid for FIRE COMMERCIAL TI: $701.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
0
$152.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$101.32
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FURNACE
101-0000-42402
0
$152.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FURNACE PC
101-0000-42600
0
$101.32
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN
101-0000-42402
0
$25.34
DESCRIPTION
ACCOUNT
QTY
AMOUNT