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BSPN2019-002378-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: SPECIAL INSPECTION/ BSPN2019-0023 81345 AVENUE 54 Tw�, 4 w*'F Qum& DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT 767320013 GRIFFIN / GENERATOR FOR TED EVENT VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: GRIFFIN RANCH INV 23 CORPORATE PLZ STE 150 NEWPORT BEACH, CA 0 Date: 11/26/2019 Applicant: n Contractor: BRUDVIK INC I I BRUDVIK INC 600 EUGENE ROAD UUU 600 EUGENE ROAD PALM SPRINGS, CA 92264 NOV 2 0 C 2019 PALM SPRINGS, CA 92264 I - (760)320-4429 CI rr OF Llc. No.: 482623 LA��,,�, (� __----_-__----------- ---- - _'-`-'�Cf�1+�hIGE---I'dIFN7��a�+RIP�i�J�----------------------------____ 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 Professions Code, and my License is in full force and effect. License Class: C10 License 482623 Contractor: OWNER -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 ($500).: (_) 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 am exempt under Sec. . B.&P.C. for this reason iDate 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 Nam WORKER'S 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 of [ k for which this permit is issued. l 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 insurance carrier and policy number are: Carrier: EVEREST PREM_IERt(1,SURANQE COMPANY Policy Number: _ 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 become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: ant: :1242/�-� �_ WARNING: FAILURE TO SECURE 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 Building Official 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 city to enter upon the above - mentioned property for inspection purposes. — A _ , / Lender's Address: � /-40 S@MPQft.'(App1lt9r tbV7Agent) Date: 11/26/2019 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: BRUDVIK INC 600 EUGENE ROAD PALM SPRINGS, CA 92264 BSPN2019-0023 81345 AVENUE 54 767320013 GRIFFIN / GENERATOR FOR TED EVENT Owner: GRIFFIN RANCH INV 23 CORPORATE PLZ STE 150 NEWPORT BEACH, CA 0 Contractor: BRUDVIK INC 600 EUGENE ROAD PALM SPRINGS, CA 92264 (760)320-4429 Llc. No.: 482623 Detail: SPECIAL INSPECTION FOR TED EVENT GENERATOR / POWER. PER 2016 CALIFORNIA BUILDING CODES DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY AMOUNT SPECIAL INSPECTION 101-0000-42404 0 $80.50 Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION: $80.50 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 1 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: • $5.00 • Contractor Name: f u v l �C New SFD Construction: Address: Conditioned Space City, St, Zip Garage Telephone: Patio/Porch Email: Fire Sprinklers State Lic:y�z�, City Bus Lic: Arch/Eng Name: Address: City, St, Zip Telephone: Email: State Lie: City Bus Lie: Property Owner's Name: Address: City, ST, Zip Telephone: Email: Construction Type: Grading: Bedrooms: � Stories: SF SF SF SF Occupancy: # Units: New Commercial / Tenant Improvements: Total Building SF Construction Type: Occupancy: ` 78495 CALLE TAMPICO LA QUINTA, CA 92253 (760)777-7125 WWW.LAQUINTAC&GOV BRUDVIK, INC. ELECTRICAL CONTRAC 0RS y�. i rL�N✓ �Ui% C.crJi�� No, , f�J]gIM J�urd� y i eK� 1-ouwE4- pi1tiS oZ,5Pl/-o( G &ij - --k:t 20 ( AV QVV rUGENE ROAD PALM SPRINGS, CA 92264 PHONE: (760) 320-4429 FAX:(760) 323-3302 LICENSE #482623 0 �E P, Po :.'�a-it- 3©x 7 , I f CRASS II GRASS ` PLANTERS CASITA x x `. f 1 stage � f �> Living f a z oom MIT -Al GRASS CRASS GRASS Prepared by TED Conferences. Private & Confidential Mery Griffin Estate - �' Generator cabling options GSI . Generator Cable routing options Longest path but only through one doorway into the living room Short path but through 3 doorways and 2 small sets of stairs (internally) into the living room Short path but through up the main stairs into the main doorway into the house and then across a couple doorways and down stairs into the living room 2019-11-12 Double sided Buffet Table 0 Coffee, Tea + Snack Station EMT ® 12 x Cocktail tables 36" Umbrellas Trash facilities Local staff holding directional signage TWPrepared by TED Conferences, LLC S1, T—OF CJL,OsNbl ***IDENTIFICATION CARD*** EXPIRES: 12/31/2020 MAKE TYPE VEH TYPE LIC LICENSE NUMBER RAJYS SPECIAL VEHICLE 02Z E5 SE677641 BODY TYPE MODEL MO TYPE VEHICLE USE VEHICLE ID NUMBER SPMBL XV MOBIL EQUIP 5UABU0916FV003627 DATE ISSUED CC/ALCO DT FEE RECVD PIC STICKER ISSUED 08/12/16 33 08/12/16 1 840264Y REGISTERED OWNER AMOUNT PAID BRUDVIK INC $ 25.00 600 S EUGENE RD AM016T -DUE -' AMOUNT RECVQ CASH CHCK PALM SPRINGS -r CRDT CA 92264 �r;';: r{ CARRY THIS DOCUMENT OR SELLER'S ;h:' ' '_ _ '' A COPY WHEN SIGNATURE _ OPERATING THIS VEHICLE +--------------------------+ DATE SOLD / / �- E20 134 19 0002500 0018 PS E20 081216 E5 SE677641 627 TL: E5 LIC#: SE677641 VIN: 627 FC: S ******************************************** ;,-,1_OFC;-L-r0F,:,.l ******************************************** oena,3nrs:r��.doraa fe,sc--s` THIS IS NOT AN APPLICATION FOR TRANSFER * IMPORTANT * * IMPORTANT * * IMPORTANT IF THIS VEHICLE IS DESTROYED OR SOLD TO ANOTHER PERSON, YOU MUST COMPLETE THE NOTICE BELOW. THE COMPLETED NOTICE MUST BE RETURNED TO THE DEPARTMENT WITHIN TEN DAYS AFTER SALE OR DESTRUCTION OF THE VEHICLE. (SEC. 5017 VEHICLE CODE) CHECK ONE: ( ) VEHICLE DESTROYED ( ) VEHICLE SOLD TO: (COMPLETE BELOW) PURCHASER'S (LAST) (FIRST) (MIDDLE) ADDRESS CITY STATE SELLER'S SIGNATURE DATE SOLD MAIL COMPLETED NOTICE TO: DEPARTMENT OF MOTOR VEHICLES P.O. BOX 942869 ,qACRAMFNTO, CA 94269-0001