08-1739 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: L08-00001739�
Property Address: 4.949-9=EISENHOWER DR
APN: 658-190-011-30 -28545 -
Application description: RE -ROOF
Property Zoning: TOURIST COMMERCIAL
Application valuation: 29918.
Applicant: Architect or Engineer:
eniu X_
T4ht 4 Xroy Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner: rJ
KSL DESERT RESORT
C/O CNL HOSPITALITY PRO
450 S ORANGE.AVE #12TH
ORLANDO, FL 32801
Contractor:
DRI RESIDENTIAL CORPORATION
17182 ARMSTRONG AVENUE
IRVINE, CA 92614
(949)266-1950
Li'c. No.: 819960
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/21/08
U
OCT 212008
`NANO QUINTA glj
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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 ode, 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: C39 Li se No.: 819960
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
��
cate:cto
l�L Contra" ctor: ' d I
issued.
_ 1 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
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier AMERICAN CASUAL Policy Number WC274968227
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should ecome subject to th workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, shall forthwi o with those provisions. -
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).:
! r _ _i A
Date: r 1 46 Applicant;_ (A�l
(_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
— i.�
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECUR ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
( ) 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:
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 haleby authorize representatives
of this county to enter upon the above -mentioned property or inspection rpo
�1 ?
Date�: 20'N U Signature IAppl� icant r Agent):
LQPERMIT
Application Number . . . . . 08-00001739
Permit . .
. RE -ROOF
Additional desc .
Permit Fee . . .
. 30.00 Plan Check
Fee
.00
Issue Date . . .
. Valuation
. .
0
Expiration Date
4/19/09
Qty Unit Charge Per
Extension
BASE FEE
30.00
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Special Notes and
Comments
REMOVE EXISTING TILE ROOF,REPLACE ANY
DAMAGED OR ROTTED
SHEATHING, REROOF WITH
ORIGINAL TILE AND
NEW TILE WHERE NEEDED
2008 CODES.PLANNING FINAL REQUIRED
(BLDG. 141-142)
Fee summary
Charged Paid Credited
Due
-----------------
Permit Fee Total
------------------------------
•30.00 .00
----------
.00
30.00
• Plan Check Total
.00 .00
.00
.00
Grand Total
30.00 .00
.00
30.00
LQPERMIT
Bin #
City of La Quinta
Building a[ Safety Division
Permit # n P.O. Box I SO4, 78-495 Calle Tampico
La Quinta CA 92253.- (760) 777-7012
Building Permit Application and Tracking Sheet
Project Addresi: --ti/ Owner's Name: L_Sv
A. P. Number: Address: S✓S t-,u ll 1• sle �9l�•
Legal Description: City, ST, Gip:
1 �L '32� 7
Contractor �� i�fry •] l�! Telephone:
Address: ( t �z Ar Sir q.'V% Pro'ec J r l/P
M 19 Project Description: /,
City, ST, Zip:
n 1k L/b�,
Telephone., - 7.
��� ��- 2 z,
State l-ic. # : City Lie. #: c as l
Arch., Engr., Designer;
ss: Addre
City, ST, Zip:
Telephone: Coastruction Type. CJt cupatlGy:
Slate Lie. #: Pry
J type (circle one): New Add'n Alter e® Demo
Namc of Contact Person: Sq. Ft.: # Stories; # units:
Telephone # of Contact Person: Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
p Submittal Req'd Reed TRACKING PERMIT FEES
Plan Sets Plan Check submitted Item Amount
Structural Calm. Reviewed, ready for correcGvas Plan Check Deposit
Truss Calrn_ Called Qmtaet Person Plan Check Balance
Energy Coles. Plana ticked up Coastructioo
Flood plain plan Plans resubmitted Meckaoical
Grading plan 2'"Review, ready for eurrectionLI asuc Electrical
Subeontactor List Called Contact Person Plumbing
Grant Deed Plains picked up S.M.I.
R.O.A. Approval Plans resubmitted Grading
IN ROUSE:- J"A Review, ready for correetionartssue Developer Impact Fee
Plann,gg Approval Called Contact Person
Pub. Wks. Appr Date of permit issue
School Fees
Tutal Permit Nees
M
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