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08-1735 (RR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-0-0'001 335 Property Address: 4-9499—EfiSENHOWER DR APN: 658-190-011-30 -28545 Application description: RE -ROOF Property Zoning: TOURIST COMMERCIAL Application valuation: 25276 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: 'KSL DESERT RESORT C/O CNL HOSPITALITY PROP 450 S ORANGE AVE #12TH ORLANDO, FL 32801 Contractor: DRI RESIDENTIAL CORPORATI 17182-ARMSTRONG AVENUE IRVINE, CA 92614 (949)266-1950 Lic..No.: 819960 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/21/08 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION • I hereby affirm under penalty of perjury that) 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: C39 i ense No.:. 819960 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is _ issued. Date 0 u Contractor. KO _ I have and will maintain workers' compensation insurance, as required by Section 3700 oftheLabor 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 _ _ 1 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 become subject to the 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 Cofe, I shall fof�w' comply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by C L y //_ ��,f any applicant for a permit, subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: narc //1,-91-/i0 _n�nr�a�� /� ��A//.� 4 (�✓� - (_) 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 _ 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 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: WARNING: FAILURE'TO-SECt#M 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 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. - I certify that 1 have read this applicationand 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 proper y for inspect pur es. Date: iU;XFdB Signature (Applicant or AgentL- LQPERMIT ` -Application Number• . . . . . 08-00001735 ` Permit • RE -ROOF Additional desc . ' t 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 ---------------------------------------------------------------------------- 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. 130-131). Fee summary Charged Paid Credited Due - - - -- ----- ---------- ---------- Permit Fee Total 30.00 .00 ---------- .00 30.00 _r•^- Plan Check Total .00 .00 .00 .00 ` Grand Total 30.00 .00 .00 30.00 t , Bin # City of La Quinta Building 8[ Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico 3 nn La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: l / !l vvev- owner's Name: L ��7 IG�Slj A. P. Number: Addri!s: SSS 1 �I " t- l� .Legal Description: City, ST, `Lip: �ir� F'L 32`i-S/ Tn p Contrnotor: JILT `G dfe • q Telephone: a Q-j--5= Address: I t4�7 Project Description: i �d� r r" bim 14,0- City, ST, Zip: (i: C 1 649 Awe- blbke4i r17 t*i��f Telephone: State Lic. City l ic. #: Cos 11 ' Sq --/'31 Arch., Engr., Design= Addy=,: City, ST, Zip: Telephone: Construction Type. occupancy.. State Lie. #: Project 1 type (Circle one): New Add'n Alter c®' Demo Name of Contact Pe moo: Sq. Bt.: #Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: 2 5 2 APPLICANT: DO NOT WRITE 13ELOW THIS UNE p Submittal Req'd Rec'd TRACKiNG PERMTC FEES Plan Sets Plan Check submitted Z.. Item Attiount Structural Calcs. Reviewed, ready for correctives Plan Check Deposit Truss Calcn_ Called Contact Person Plan Check Balance Energy Calls. Plans ticked up Construction Flood plain plan Place resubmitted Mechanical Grading plan 2*' Review, ready for eurrection&&suc Electrical Subeontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.[. R.O.A. Approval Plans resubmitted Grading IN ROUSE: -Review. ready for correetionsrusue Developer Lmpact Fee Planning Approval Called Contact Person Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 0 ,y TO/T0 39Vd 1d3a Da-M ViNIno G-i TTOLLLL09L 00:60 800Z/9Z/80 +14