The URL can be used to link to this page

08-0347 (TT)P.O. BOX 1.504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY" DEPARTMENT BUILDING PERMIT Application Number: 108'00000347 c Owner:. Property Address: 52500 ROSS AVE K.E.L.F. PARTNERS, LLC APN: 767-200-998-1 7330761- 45350 SAN LUIS REY AVE. Application description: TEMPORARY TRAILER PALM Dl,bERT, CA 92260 Prpperiv 7nninr3• LOW DENSITY RESIDENTIAL Application valuation: 1000 Contractor: Applicant: Architect or Engineer: MODERN 13LDRS CONSTR CO 45350 SAN LUIS'REY AVENUE PALM DESERT, CA 92260 I.A- (760)578-4967 LiC. No.: 818923 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 CI ss: B License No.: 818923 ate Cc or: OWNER -BUILDER DECLARATION - I hereby affirm under penalty of perjury that 1 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, 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 contractorls) 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.I. Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/25/08 Dp FEB 2 6 2008 . n# WORKER'S COMPENSATION DECLARATION 1 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. K 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 INS Policy Number 1890279 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 bor C d all forthwith comply with those provisions. 11 -ate: grlltesa WARNING: FAILURE TO 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 186 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. .1 certify that I have read this application and state that the above information is correct: 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of thig,66unty to enter upon the above-ntentiagpd propGR716r?h1 p-Dstion purposes. ' . Application Number . . . . . 08-.00000347 Permit . . . . . . TEMP.TRAILER / MOBILE HOME Additional desc . Permit Fee 200.00 Plan Check Fee .00 Issue Date Valuation 1000 Expiration Date 8/23/08 Qty Unit Charge Per Extension BASE FEE 200.00 Special Notes and Comments TEMP. CONSTRUCTION TRAILER FOR NEW SFD, PER MUP # 2008-987 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 LQPERDIIT r-- --- --— — — — — — — — — — — — — ----- — cq I r i i i I I I � I I , D, I I , , ------------- F-1 , , , I , 11 _._.._. .... i Jr r �F ry I I 0040 ago 0000000 00000000000 a 00000000Do00a nritr \O 000 0 000 00oaoo00 000 000o00aD0o.0000000 000.,� 0000000 qq�� !0 00000 O 000 aoo0a000op 0000000 DODO a0oo0oDoD� DoaoaD/ 0000 00000000 110000000 i•, / �' / 0000 00000000 0000000 I 000 0000000pa I0o00000 a 000000000 / r / 000000000000�00000o00000 aoo 00000000000000000 p.ro.. 00000000000000000 0000000000 00000' i•/� �'' 0000000000000 0� 00000000000 / ' / I O X, 14 1 ,r I Dd - 1' '% % / / /---7`•� Bat• / / / / r r � � �m �- 's� :�� J �•' / ,'. a��a �,� �� spa �� gp� � �� n os / / / ' , '55 m� QapSS 510 i i i i INTEO RAL IBES ION a 0 m n D D 0 0 :CIATES .10e N ... c.: 07.0013A m n !'! ONS o J $C RESIDENTIAL DESIGN - DRAFTING O :Hue 0.0 53 0 z ` 40.471 PADOVA DRIVE, INDIA, CALIFORNIA 92203 c o n NN�Id AS a3 A8 ddb