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04-6413 (SPIN)if roe.% • V e��1VV� BUILDING & SAFETY DEPARTMENT P. O_.�BOX�1:F5;04 (760) 777-7012 �� 781-49 �LiE TAMPICO FAX 760 777-701 1' ,F�T1 (• ) LA�Q�UINTA��ALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . 04-00006413 Date 10/05/04. Property Address ... . . . . 49499- EI-SENHOWER -DR' APN: 658-190-011-30 -28545 - Application description . . SPECIAL INSPECTION Property Zoning . . . . . TOURIST COMMERCIAL . Application valuation 0 Owner Contractor KSL DESERT RESORTS INC PRIME EVENT GROUP 50905 AVENIDA.BERMUDAS LA QUINTA CA 92253 ---------------------------------------------------------------------------- Permit SPECIAL INSPECTION Additional desc Permit Fee 100.00 Plan Check Fee .00 Issue Date . . . . Valuation 0 Qty Unit Charge Per Extension BASE FEE 100.00 Special Notes and Comments SPECIAL INSPECTION FOR 100' X.148'TENT, 1 350 KW.GENERATOR 5 25 TON AC UNITS, 1 LIGHTING PACKAGE, ALL PE TUP 2004-477. Fee summary Charged Paid Credited Due ----------------- Permit Fee Total ----------------------=-------- 100.00 .00 ---------- 100100-, Plan Check Total .00 .00 Grand Total 100.00 .00 .00 .;00 .0t0 100.00 P.O. BOX 1504 . • 4144" 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Applicant:' Applicant's Mailing Address: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: /40•5,04 Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class License No. Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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 ($500).): r U 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance _Xof the work for which this permit is issued. 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' compensatio insurance carrier and policy number.are: Carrier olicy Number _ I certify that, in the performanc o t w rk 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 Calif ni Ids, ree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thos pr • . nI ), / y Bate \ 05/6T -1li—n, WARNING: FAILURE TO SECURE WO KE Z�C NSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO AND 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. 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 plicant, each agrees to, and shall, defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omissio related the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application beco es nul d 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 nceIla )' I certify that I have read this application and state that the above nforn f i is rect. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this count to a ter on ove-mentioned property for inspection purposes. l� S G� /Date ealgnature (Applicant or Agent): Bin # City of La,Quin W / Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico I La Quinra, CA 92253 - (760) 777-7012 O Building Permit Application and Tracking Sheet Ak'0 4- Permit # Project Address: g—jam e,i�y Owner's Name: X�- A. P. Number: Address: X C' Leeal Description: ST. Zip: >< 'i. , G 7 �) 3 Contractor. �( 77�7�T,,NPhone: a 77 —y&�y Address: if bj% / r Project Description: X i� Cin•. ST. Zip: 1� Z Telephone: X-7 State Lic. # : k, Ciry Lic. 0: ,_ k4_ Arch.. Engr.. Designer: G S U(2tAT, Lan Address: (J • City. ST. Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: �( r � Sq. Ft.: ( Qv # Stories: # Units: Telephone # of Contact Person: Estimated Value ofProiect: X APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted I,Nlech2nical Grading plan 21" Review, ready for correcti slissue Electrical Subcontactor List Called Contact Person "ems Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review•, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue 5 es9 School Fees Total Permit Fees