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12-1210 (SPIN)P.O. BOX 1504 ^� 78-495 CALLE TAM PICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 12�0:0.0:01210 Owner: Property Address: 49499 EISENHOWER DR LA QUINTA RESORT & CLUB APN: 658-190-011-30 -28545 49499 EISENHOWER DRIVE Application description: SPECIAL INSPECTION LA QUINTA, CA 92253 Property Zoning: TOURIST COMMERCIAL Application valuation: 100 VOICE (760) 777- FAX (760) 777-7011 INSPECTIONS (760) 777-7153 1 ■ Date: 10/11/12 Contractor: u OCT 112012 Applicant: Architect or, Engineer: CLASSIC PARTY RENTALS n (CSLB LIC NOT REQID - GB) CITY OFLAQUI.NT"A t 1` 75060 MAYFAIR DR FIlIANCE DE;yr. I PALM DESERT, CA 92211 LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with ' I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: - License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: Contractor: _ 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 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 Division3 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 _) 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, 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 contractors) licensed pursuant to the Contractors' State License Law.). ' I—) 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 Name: Lender's Address: ' insurance carrier and policy number are: Carrier 3992 ' ` Policy Number [,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, I shall forthwith comply with those provisions. Date: ' Applicant: 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 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'SFEES. - 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 essation of work for 180 days will subject permit to cancellation. I certify than have read this application and state that the a ve infor is correct. I agree to comply with all city and county ordinances and state laws relating to building structi hereby authorize representatives of this county to,�r ier upon the above -mentioned property for I es. ate: �Xnature (Applicant or Agent): , LQPERMIT Application Number . . . . . 12-00001210 Permit . . . SPECIAL INSPECTION Additional desc . Permit Fee . . . 100.00 Plan Check Fee .00 Issue Date . . . Valuation . . . . 100 Expiration Date 4/09/13 Qty Unit Charge Per Extension BASE FEE 100.00 ---------------------------------------------------------------------------- Special Notes and Comments SPECIAL INSPECTION TO FINAL TEMPORARY SHADE STRUCTURE( 50! X 80- FASTRACK STRUCTURE). Fee summary Charged Paid Credited Due - - -------------- -- --- Permit Fee Total .100.00 .00 --- .00 100.00 Plan Check Total .00 .00 .00 .00 Grand Total 100.00 .00 .00 100.00 LQPERMIT - _ . i i I ' Bin. # City, of La Quinta BuMay & Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico ,1 [A.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet ' Project Address: L�i.qLi q Owner's Name:. La Q( dr�a kle ( ' A P.Number. Address:q�q��hOWP�' �Y Legal Description: City, ST, Zip: UI Cff I� Contractor: C V4->7-w 5 Telephone:I (QZ) (m LaW'& Address: 1�� pyty� Project Description: ` -(,M0y- City' ST' Zip: MD-VOOMS cpr i Tele hone: l s DVSMC4 i State Lic. # : City.Lic. #! -I D Arch, Engr., Designer. i Address: City., ST, Zip: Telephone: StateLic.#:ji» Construction Type: ccupancy: 7-ir Project type (circle one): New Add'n Alter RDemo Sq. Ft : "i l�� #Stories: I # Units. Name of Contact Person: I irl� ��eZ Telephone # of Contact Person: D 911 Z 4 Estimated Value of Project q 1 D 0 i APPLICANT: DO NOT WRITE BELOW THIS LINE ' # Submittal Rcq'd Reed TRACKNG PERMIT FEES Plan Sets Plan Check submitted " Item Amount Structural Calcs Reviewed, ready for corrections Plan Check Deposit. . fYnss Calcs. Called Contact Person Plan Check Balance_ i Title 24 Cales. Plans picked up Construction _ Flood plain plan_ Plans=resubmittM ' _ = Mechanical --- Grading plea 2'` Review, ready for corrections/issue Electrical — _�- Subeoutactor List - — -� - --- -- Called Contact Person Plumbing Grant Deed Plans picked up S.M.1 H.O.A. Approval Plans resubmitted Grading U4 IIoUSE:- 'jd Review{ ready for corrections/issue Developer Impact Fee Planning Approval.Called Contact Person A.LP.Y. Pub. Wks. Appr Date of permit issue Schnril Fees