11-0381 (SPIN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00000381
Property Address:
78935 HIGHWAY lit
APN:
643-020-029- -
Application description:
SPECIAL INSPECTION
Property Zoning:
REGIONAL COMMERCIAL
Application valuation:
100
Applicant:
CY
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
.BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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: NR License No.: NR
Date: 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).:
(— 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.l.
(_) '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:
Owner:
TARGET CORP
1000 NICOLLET.MALL #12
MINNEAPOLIS, MN 55403
Contractor:
SO CAL TENTS AND EVENTS LLC
1919 POTRERO AVENUE
S EL MONTE, CA 91733
(626)246-0244
Lic. No.: NR )lD'
VOICE (760) 777-7012.
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/05/11
MAY 05 2011tuj----
WORKER'S COMP SATLN nGrr eonrrnu t
I hereby affirm under penalty of perjury one of the followin declaratiN OF QuiieTa
I have and will maintain a certificate of consen to self-insur sation, as pr vided
..�I�
for by Section 3700 of the Labor Code, for or•wwitieh-th it 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 NOT REQ Policy Number NOT REQ
— 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: Applicant:
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 Of 00,000). 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 the above information is correct. I agre to comply with all
city and county ordinances and state laws relating to building constru tion, and hereby au a representatives
of is county to enter on the above -mentioned property fo ec o ses.
Kate:./ Signature (Applicant or Agent):
LQPERMIT
Application Number . . . . . 11-00000381
Permit . . . SPECIAL INSPECTION
Additional desc . .
Permit Fee 100.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 100
Expiration Date . . 11/01/11
Qty Unit Charge Per
Extension
BASE FEE
100.00
----------------------------------------------------------------------------
Special Notes and Comments
SPECIAL INSPECTION FOR TEMPORARY TENT
(50 ft x 75 ft) PER TUP # 2011-1029, AND
APPROVED ENGINEERING. TO BE LOCATED IN
TARGET PARKING LOT. 2010 CODES.
Fee summary Charged Paid
-------------------------------------
Credited
--------------------
Due
Permit Fee Total 100.00
.00 .00
100.00
Plan Check Total .00
.00 .00
.00
Grand Total 100.00
.00 .00
100.00
LQPERMIT
05/05/2011 13:33 6262460245 SOCAL TENTS & EVENTS PAGE 01/01
�elk
Tents & Events LLC
April 18, 2011
City of La Quinta
Building & Safety Dept,
78-495 Calle Tampico
La Quinta, CA 92253
Letter of Authorization Target Tent 78935 Hwy 111.
To Whom It. May Concern,
We SoCal Tents authorize DALE SUGGET to obtain any and all building permits
Associated with that Target tent located at 78935 Hwy 111, La Quints, CA 92253
1919 Potrero Avenue Office: (626) 246-0244
South Ef Monte, CA 91733 Fax: (626) 246-0245
www.socaltents.com