06-3951 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00003951
Property Address:
79245 CORPORATE CENTRE DR
APN:
649-820-017- - -
Application description:
REMODEL - COMMERCIAL
Property Zoning:
COMMERCIAL PARK
Application valuation:
1500
T414t 4'4 Q"
Applicant: Architect or Engineer:
LICENSEDJGONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am ' e ed r provisions of Cha mencing with
Section 7000) of Division 3 of the Business an to s Code, icense is in full force arid effect.
License lass: B -C'27 a No.: 390365
Date: ontractor:
OWNER -BUILDER DECLARATION
hereby affirm under penalof per' r at 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).:
(_ 1 1, 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. I , BAP.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:
LQPERMIT
Owner:
NEIL KLEINE
41-910 BOARDWALK A-10
PALM DESERT, CA 92260
Contractor:
KLEINE BUILDING AND DEV INC
41910 BOARDWALK, SUITE A-10
PALM DESERT, CA 92211
(760)776-4840 �®
Lic. No.: 390365 //1'11
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/30/06
---------- ------ - - ---------1`LAhiIff
—
WORKER'S CO PENSATION & "aw,, - ;
I hereby affirm under penalty of perjury one of .the foil in dec (>
_ I have and will maintain a certificate of c rise to s ers, compens ion, as provided
for by Section 3700 of the Labor Code, o rfnjj�g�g 1Oftir�e u+ hi h this permit is
issued. ^rjrequ � �.
I have and will maintain workers' compensation insurance, as requi action 3700 f the Labor
Code, for the performance of the work for which this permit is issued. My s' ompensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1769113-2006
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 a o become subject to the workers' compensation laws of California,
and agree that, if I shou eco a subject to sation provisions of Section
//y�3f7700 of the Labor C , I I forth ' comply with those provisions.
Dall�-!( " p Applicant-
WARNING:
pplicant
WARNING: FAILURE TO SECU ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO MINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 th above information is correct. I agree to comply with all
city and county ordinances and state laws relating to in g construction, and hereby authorize representatives
of this county to enter upon the above-mentione rty '
Dater' //� Signature (Applicant g
Application Number . . . . . 06-00003951
------ Structure Information SITE LIGHTING 3-PARKING/7-BUILDING -----
Other struct info . . . CODE EDITION
2001/2005
FIRE SPRINKLERS
NO
MIXED-USE OCCUPANCY
----------------------------------------------------------------------------
NO
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee 35.00 Plan Check Fee
22.75
Issue Date Valuation . . .
. 1500
Expiration Date 5/29/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
10.00 2.0000 HND BLDG 501-2,000
----------------------------------------------------------------------------
20.00
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . . 22.50 Plan Check Fee
5.63
Issue Date Valuation . . .
. 0
Expiration Date 5/29/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
7.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
5.25
3.00 .7500 EA ELEC POLE LIGHT
----------------------------------------------------------------------------
2,25
Special Notes and Comments
SITE LIGHTING: 3-HPS PARKING/7-CFL
BUILDING. THIS PERMIT IS FOR SITE
LIGHTING ONLY. November 30, 2006
11:29:33 AM AORTEGA
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Other Fees . . . . . . . . . STRONG MOTION (SMI) - COM
.50
Fee summary Charged Paid Credited
-----------------
Due
----------------------------------------
Permit Fee Total 57.50 .00 .00
57.50
Plan Check Total 28.38 .00 .00
28.38
Other Fee Total .50 .00 .00
.50
Grand Total 86.38 .00 .00
86.38
LQPERMIT