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07-2788 (AC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00002788 Property Address: 78164 AVENUE 52 APN: 770-190-001- - - Application description: ADDITION - COMMERCIAL Property Zoning: VILLAGE COMMERCIAL Application valuation: 39024 Applican T4ht 4 4 Q" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: CHAPMAN GOLF DEV 78505 OLD AVE 52 LA QUINTA, CA 92 Contractor: ASARO BUILDERS, 42220 GREEN WAY, PALM DESERT, CA (760)776-0043 Lic. No.: 588920 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/30/07 ------------------------------------------------------------------------------=------------------ LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I 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 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: B License No.: 588920 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is / issued. ✓ Date: Z. ontractor: ,) _ 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' 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 STATE FUND Policy Number 229002420506 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 forthwith 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).: tKate: �plicant: (_ 1 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: FAILURE TO SECURE WORKERS' COMP SATION 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.). (_ 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: LQPERNUT 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 county to enter upon the above -mentioned property for inspection purposes. i Date ignature (Applicant or Agent): IAA . Application Number . . . . . 07-00002788 ------ Structure Information 542 SF ADDITION ----- Construction Type . . . . . TYPE V - 1 HR Occupancy Type . . . . . ASSY BLDG <300 NO STAGE Other struct info . . . . . CODE EDITION O1BMP04E05EN BASEMENT SQUARE FOOTAGE .00 FIRE SPRINKLERS YES GARAGE SQ FTG .00 MIXED -USE OCCUPANCY A-3/B OCCUPANT LOAD 4.00 TOT ELIGIBLE NO 1ST FLOOR SQUARE FOOTAGE .00 ---------------------------------------------------------------------------- Permit . . . BUILDING PERMIT Additional desc . . 542 SF ADDITION Permit Fee . . . . 349.50 Plan Check Fee 227.18 Issue Date . . . . Valuation . . . . 39024 Expiration Date . . 5/28/08 Qty Unit Charge Per Extension BASE FEE 252.00 15.00 6.5000 THOU BLDG 25,001-50,000 97.50 ---------------------------------------------------------------------------- Permit . . . ELECT- ADD/ALT/REM Additional desc . . Permit Fee . . . . 25.84 Plan Check Fee . Issue Date . . . . Valuation . . . Expiration Date . . 5/28/08 6.46 0 Qty Unit Charge Per Extension BASE FEE 15.00 542.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 10.84 ---------------------------------------------------------------------------- Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 37.50 Issue Date . . . . Expiration Date . . 5/28/08 Plan Check Fee . . 9.38 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 1.00 ---------------------------------------------------------------------------- 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 LQPERMIT Application Number . . . . . 07-00002788 Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 39.00 Plan Check Fee 9.75 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/28/08 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 3.00 6.0000 EA PLB ROOF DRAIN ---------------------------------------------------------------------------- 18.00 Special Notes and Comments ADDITION TO EXISTING'RESTARAUNT. 251 SQ.FT. WAIT STATION, 291 SF DRY STORAGE. 2001 CBC, CMP,CPC 2004CEC 2005 ENERGY. **MBA 07-006 AND VILLAGE USE PERMIT 00-004 APPROVED 10/10/2007** ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW 22.18 ENERGY REVIEW FEE 22.18 STRONG MOTION (SMI) - COM 8.19 Fee summary Charged Paid Credited Due ----------------------------------------------- Permit Fee Total 451.84 .00 ---------- .00 451.84 Plan Check Total 252.77 .00 .00 252.77 Other Fee Total 52.55 .00 .00 52.55 Grand Total 757.16 .00 .00 757.16 LQPERIMIT