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04-7362 (TT)s~ BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 ,LA, QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760.) 777-7153 BUILDING PERMIT e Application Number,_- 04-00007.3.62 Date 12%07/04 Property Address . . . 79125 HIGHWAY 111 APN: 649-030=078-2 -28525 - Application description TEMPORARY TRAILER Property Zoning . . . . . REGIONAL COMMERCIAL Application valuation. . . 5000 Owner Contractor ------------------------ ------------------------ TORRE NISSAN OWNER 79125 HIGHWAY 111 LA QUINTA CA 92253 ----------------------------------------------------------_------------------ Permit TEMP TRAILER / MOBILE HOME Additional desc Permit Fee 200.00 Plan Check Fee :,..00 Issue Date . . . . Valuation . . 500'0 Qty -Unit Charge Per •,-.Extension BASE FEE °200.00 Special Notes -and Comments TEMPORARY SALES TRAILER/RAMP PER MUP & APPROVED PLANS.2001 CBC. Fee summary Charged Paid Credited Due Permit Fee Total 200.00 .00 .00 200._00 .Plan Check Total .00,'� .00 .00 -" °00 Grand Total 200.00 .00 .00 200.00 Y F' CITY h T r V =v V % A u P.O. Box 1504 r • ��/: . 78-495 CALLE TAw VOICE (760) 777-7012 ntPICO` r FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 _ _ INSPECTIONS (760) 77,7-7153 BUILDING & SAFETY DEPARTMENT Application Number: 041- 763 a Date: Applicant: rArchitectTorEngineer:,, Applicant's Mailing Address: Architect or Engineers Address: ' � � " ' � � , 2�� L'or�► of iJ � Lic: No:: --'a ` 'BUILDING.PERMIT DECLARATIONS ' LICENSED CONTRACTOR'S DECLARATION 1 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. Date 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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 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.). 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 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 of 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' compensation insurance carrier and policy number are: Carrier Policy Number 1 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' t 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 ` i ApplicantZnls WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS LIN UL, 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. 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 ti 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 atwhose 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. X X A X Bin " City of La Quinta 3 w Building at Safety Division TRACKING P.O. Box 1504, 78-495 Cale Tampico Permit La Quinta, U 92253 - (760) 777-7012 (� Building Permit Application and Tracking Sheet Project Address: -7 �� I�j�w Ow,ta's Name: '"�(� �Pe N 1 A. P. Number. Address: Leal Description: Cin. ST. Zip: �i, (A j j/1 j� a Z 2 Contractor. FTelephone `]-r7—e Address: 1XProject Description: City, ST. Zip: Telephone: Plan Check Balance S e Lic. p : Energy Cala. City Lic. M: Arch. Engr., Designer. , Address: . City. ST. Zip: Plans resubmitted Y�`Ac' /1n' 777 - 8 Telephone: �� _ ;,•- - `, ConstruaionType:. Occupancy p cy State Lic. #: G ?j Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: M ria: to Units: Telephone tY of Contact Person: stimated Value of Proiect o00 I APPLICANT: DO NOT WRITE BELOW THIS LIMP a Submittal Req'd Recd TRACKING PERMIT FEES an Sets Plan Check submitted 7lItem Amount Structural Cala. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Cala. Plans picked up Construction Floodplain plan P P Plans resubmitted Mechanical Grading plan P' Review, ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SAA. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- "Review, ready for correcti nslissuc 2 17 Developer Impact Fee Planning Approval Called Contact Person,/,/, j A.I.P.P. Pub. Wkt Appr Date of permit issue b SchoolFe" V(TM Total Permit Fees MIAMI / �/