08-1530 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO.
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
08-00001-530
49499 EISENHOWER DR
658-190-011-30 -28545
RE -ROOF
TOURIST COMMERCIAL
3390
Tityl 4 -4 Q*&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
KSL DESERT RESORT
C/O CNL HOSPITALITY PROP-INC
450 S ORANGE AVE #12TH
ORLANDO, FL 32'801
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153,.
Date: - 9/08/08
Contractor:
Applicant: Architect or Engineer: DRI RESIDENTIAL CORPORATION tJ
17182 ARMSTRONG AVENUE G
IRVINE, CA 92614 O (949)266-1950.
SEP
LiC. No.: 819960 �� O
. � !" 9
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F/Mq{yF� �ddllV
----------------------- --- - -
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
1 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 70001 of Division 3 of the Business a d 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 p �.
License Class: C39 License No.: 819960
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
tractor:
`, issued; '
X I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
.��
—j" Code, for the performance of the work for which this permit is issued. My workers' compensation
. NER-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 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 Code, I shall fc thwith 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
'
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
te: ''v"L� Ap cant: _
(_) 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
WARNING: FAILU TO SECURE WORKERS' C PENSATION 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.).
(_) 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.).
(_ 1 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 pursuantto 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 onstruction, and .hereby authorize representatives
of thi�to n the above -mentioned property f i ion purposes.
ate:ature (Applicant or Agent):.
LQPERMIT
Application Number 08-00001530
Permit . . . RE -ROOF
Additional desc .
Permit Fee 30.00- Plan Check
Fee
.00
Issue Date, Valuation
. . .
0
ExpirationDate. 3/07/09
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, RE -ROOF
WITH ORIGINAL TILE AND NEW TILE WHERE
NEEDED. PLANNING APPROVAL OBTAINED.
ESR-1489 FOR REDLAND CLAY TILE ATTACHED
TO FIRST PERMIT, #08-1523 (BLDG.
801-812)
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
LQPER IIT