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HomeMy WebLinkAbout0302-019 (MISC)­ - .vry vv . e.y 1 Vn VVy L/11-IM11V1Y U) I hereby affirm under penalty of perjury that I am licensed under provisions of H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 04 LLLI Professionals Code, and my License is in full force and effect. O 5 M License # Lic. Class j. Exp. Date dl E o OZ Date Signature Signature of Contractor CO _ 1 f` J 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's ~ U) License Law for the following reason: Z ( ) 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 & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). m () I am exempt under Section B&P.C. for this reason N Date Signature of Owner ON O CL Z WORKER'S COMPENSATION DECLARATION o < CCI hereby affirm under penalty of perjury one of the following declarations: r P O ( ) I have and will maintain a certificate of consent to self -insure for workers' X Lu compensation, as provided for by Section 3700 of the Labor Code, for the mJ Q performance of the work for which this permit is issued. Q U ( ) 1 have and will maintain workers' compensation insurance, as required by O U Section 3700 of the Labor Code, for the performance of the work for which this 0 Z permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. ao - n C) g (This section need not be completed if the permit valuation is for $100.00 or less). ( ) 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' compensa .on provisions Qf Section 3700 of the Labor Code, I shall forthwith comply with 3hose provision Date: Applicant- i Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $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. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his 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 applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 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 State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above -mentioned property for inspectiortpurposes. Signature (Owner/Agent)' r' j�;� + tea. _Datei;•`r., BUILDING PERMIT PERMT# ' DATE VALUATION LOT elfi-It,L.gt'nY>i�' ��s,isfkl;><1G`r`i= � TRACT JOB SITE ADDRESS t; �. sig r •r7:.I,1`�4tJZi'.%:1,%s x: APN OWNERt� CONTRACTOR / DESIGNER, EN INFER E'.+I:U�S�S'i1��.�.1"'L+..t;.IS:itix.:.'t.; t't/. *'.•f'�I�..!. Jig<. >!'. •cFE-.�.Y:.. �>3- ...ti.'.�'o i;'.�I .; , }I'.i°u1�:i. .�5. �' 1'•t. Y• ''1.i...(G�.iL`: rSJ� iAY Tk- j,Z T.*: 20 -7• trr"•�' 5 j). �.}.)..t.1,�,.Yl�" d�t,!�.I:�•,. �jYi�_: f^..1R6 1 ryy) (y q CA .37 q +� ��titJJ �j]n^i•7`J,t.l�%C� T�i V.I USE OF PERMIT t:;f_zTf:;'P['!aZ."f't.�.��•t 'ri:..':13..3.:x? v°+b' I+F"��t10. +jt:t 4�,�Sf.fi,r�71':f�f i,l;fttrs,l;+� 4,5 ?�ati`� 39+�!A•.£"�':1} �'( %�•.[• Cr!-' y .r.'hi;s'.i7�'�?d�'�#.#t>�+3 yti,�ill,ki.f.!•"1!•� iARV 7'rA4b.'t_eJ�•t:;(1ti}t"!#t���3 '�...>>6. .�;[tt.<{,,`�C3• ..•� "1ii �d.'ii.�a:i} CITY A ',^ 1'1 M1 f•-T RECEIPT DATE BY DATE FINALED INSPECTOR I wv-.' Der* r I P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 January 28, 2003 (760) 777-7000 FAX (760) 777-7101 SUILOlNG Mr. Sean Duffy First Pacifica Development 5 E. Citrus, Suite 210 Redlands, CA 92373 Subject: Minor Use Permit 2003-382 (Temporary Construction Trailer for The Palms) Dear Mr. Duffy, The Community Development Department has approved your request for a temporary construction trailer on Elynor Court (Lot 4), pursuant to the enclosed plan and the following conditions: 1 . Obtain a building permit including an electrical permit if temporary power is used. 2. Trailer shall have restroom facilities to accommodate personnel. 3. Mounted on the exterior of the trailer close to the front door shall be a written notice providing emergency personnel your 24-hour emergency phone number they can call in case problems arise that need your prompt attention (i.e., minimum 1 " high letters). 4. Install one 2A10BC fire extinguisher inside the trailer by the front exit door. 5. No temporary signs are approved unless separately approved by this Department. 6. Removal of the temporary construction trailer is required by January 28, 2004, or upon completion of the project, whichever occurs first. An extension of time may be requested prior to expiration. 7. Any permits required by the Public Works Department shall be obtained prior to any work proceeding. p:\stan\Itr app mup 2003-382.wpd 8. The parking area shall be graveled as shown on the approved plan for dust control. 9. Developer agrees to indemnify, defend and hold harmless the City of La Quinta in the event of any legal claim or litigation arising out of the City's approval of this project. The City of La Quinta shall have the right to select its defense counsel in its sole discretion. 10. The City may elect to add Conditions to this application request to mitigate any problems that arise not previously addressed herein. This decision may be appealed to the Planning Commission provided the necessary paperwork and filing fee of $175.00 are filed with this office within 15 days. If you have any questions, please contact me at 760-777-7064. Very truly yours, JERRY HERMAN COMMUNITY DEVELOPMENT DIRECTOR STAN B. SAWA Principal Planner Attachment c: �' Building and Safety Department Public Works Department Code Enforcement Department Fire Department Sheriff's Department P:\STAN\Itr app mup 2003-382.wpd lNGS N.89'4 3 4' 1 "E. 180.78 EASEMENT SHOWN HEREON rti 29.0 ' -j L5 9 JJ PRIVATE LVIDSCAPE L6 L10 �� EASEMENT IL 1 -- "�. z LOT 107 PER TR 2898: MB 285/76- N.5' •26' 19"E. o N C4 z.<�R%zS w © n Lo N.8i'35'06"E- u Iro 125.80.' I N IF)55' G � N.32.44'31 "W., W c� y R \ �ti �2 (Ao 0 Do- '�4 Zzi\ BOG °Z z AN �\ 2 PRIVATE \ py0 \ 10 PUE � VED BY CO A UNITY DEVELOPMENT DEPARTMENT DATE 1 p0 +�• EXHIBIT . O 5 \ �10- •OrOO CASE NO. !MU 24x:)�3 - 3 2• �N , ` !lam lc LOT 102 Fnno/. A((!7 lfIn_ qqnmo � �F