08-1525 (RR)3
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/08/08 "
Application Number: 08-00001525 Owner:
Property Address: 49499 EISENHOWER DR KSL DESERT RESORT
APN: 658-190-011-30 -28545 - C/O CNL HOSPITALITY PROP INC
Application -description: RE -ROOF 450 S ORANGE AVE #12TH
Property Zoning: TOURIST COMMERCIAL ORLANDO, FL 32801
Application valuation: .33933 r[SF
Contractor:
Applicant: Architect or Engineer: DRI RESIDENTIAL CORPORATIOj7 �J �O�A
17182 ARMSTRONG AVENUE tl
IRVINE, CA 92614 CITY
(949) 266-1956 F/Ng PLAQUIN
LiC. No.: 819960 CFDEPT
—------—--------—--------—------=--——---------—-------------—---------------—---------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full forceand effect.
License sss: CC3�3ii9 License No.: 819960
ctor:
-f/• WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I 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 ($5001.:
(_) 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 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:
I ;a
WORKER'S COMPENSATION DECLARATION )
I hereby affirm under penalty of perjury one of the following declarations: 1 .Y
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, ae�� pro di
for by Section 3700 of the Labor Code, for the performance of the work for which this`Perm. iE
issued.
1 have -and will maintain workers' compensation insurance, as required by Section 3700 of the abt
. Code, for the performance of the work for which this permit is issued. My workers' compensati
insurance carrier and policy number are:
Carrier AMERICAN CASUAL Policy Number WC274968227
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 ecome subject to the workers' compensation provisions of Section
3700 of the Labor Code, hall forthwith comply with those provisions.
t plicant:
WARNING: FAILURE TO SECURE WORK 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 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 hereby authorize representatives
of this co to enter upon a above -mentioned prop y for inspection purposes.
�
/ ture (Applicant or Agent):
/Ul
LQPERMIT
Application Number . . . . . 08-00001525
Permit RE -ROOF
"
Additional desc .
-Permit Fee 30.00 Plan Check
Fee
.00
Issue Date Valuation
0"
Expiration Date 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. 132-135)
`. Fee summary Charged' Paid Credited
Due
Permit Fee Total 30.00• .00 1.00
30.00
Plan Check Total .00 .00
.00
1.00
..Grand Total 30.00 .00
.00
30.00
r
. LQPERMIT
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..