08-1169 (RC)46650 Adams Street
P.O BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 08-00001169
Property `Address: 46650 ADAMS ST
APN: 649-820-999- - -
Application description: REMODEL - COMMERCIAL
Property Zoning: REGIONAL COMMERCIAL
,"Application valuation: 140000
Applicant: Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT •
LICENSED CONTRACTOR'S DECLARATION - - -
I 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 C ass: B License No :.455453
Date: I Contractor f fc qlta,&ffLX,ira { L4G /1
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reasorf (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 licensedpursuant 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).:
(_) ,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 andProfessionsCode: 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.).
(_ 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.). _ -
1 I I am exempt under Sec. 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:
LQPERA11T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/22/08
Uwner:
FOURTH QUARTER PROPERTIES
45 ANSLEY DR
NEWNAN, GA 30263
(760)613-3783
Q- pContractor: p
PACIFIC COMMERCIAL CONS NC
2262 RUTHERFORD RD, STE 1 3 NOV 06 ZppD
CARLSBAD, CA -92008
(760)931-9777f
Lic. No.: 455453 CFNAN QU11y7A 1
-----------------------------------------------
WORKER'S 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 STATE FUND Policy Number 3000032-2008
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 f t wi comply with those provisions.
Dater' 3 APPlicant• - - - - -- j
WARNING: FAILURE TO SECURE WOR ERS' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL -
SUBJECT AN EMPLOYER TO CRIMINAL PENA' TIES 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.
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, nd hereby authorize representatives,
of this cou ty to enter upon the above-mentioned properW forinsp Otio p poses.
D41
ate: rr s Signature (Applicant or Agent): -
Application Number . . . . . 08-00001169
Permit
BUILDING PERMIT
Additional
desc . .
Permit Fee
. . . .
779.50 Plan Check Fee
506.68
Issue Date
. . . .
Valuation . . . .
140000
Expiration
Date . .
4/20/09
Qty
Unit Charge
Per
Extension
BASE FEE
639.50
40.00
----------------------------------------------------------------------------
3.5000
THOU BLDG 100,001-500,000
140.00
Permit
ELECT - ADD/ALT/REM
Additional
desc . .
Permit Fee
. . . .
50.04 Plan Check Fee
12.51
Issue Date
Valuation . . . .
0
Expiration
Date
4/20/09
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
1752.00
----------------------------------------------------------------------------
.0200
ELEC GARAGE OR NON-RESIDENTIAL
35.04
Permit
MECHANICAL
Additional
desc . .
Permit Fee
. . . .
46.00 Plan Check Fee
11.50
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . .
4/20/09
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
1.00
9.0000
EA MECH FURNACE <=100K
9.00
1.00
9.0000
EA MECH B/C <=3HP/100K BTU
9.00
2.00
----------------------------------------------------------------------------
6.5000
EA MECH VENT FAN
13.00
Permit
PLUMBING
Additional
desc . .
Permit Fee
. . . .
67.50 Plan Check Fee
16.88
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . .
4/20/09
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
4.00
6.0000
EA PLB FIXTURE
24.00
1.00
7.5000
EA PLB WATER HEATER/VENT
7.50
1.00
3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00
3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
LQPERMIT
Application Number . . . . . 08-00001169
Permit ..,_PLUMBING
Qty Unit Charge Per
Extension
1.00 15:0000 EA PLB GAS METER
15.00
------
[Special Notes -and Comments—
ommentsSHELL
-------------
SHELLIMPROVEMENT ONLY. BEFORE A
SPECIFIC TENANT MOVES INTO THIS UNIT,A
ENANT IMPROVEMENT PERMIT WILL BE
EQUIRED. THIS PERMIT IS FOR A SHELLMPROVEMENT
ONLY. THE TENANT SHALL
(OF
ROVIDE INFORMATION TO THE BUILDING ANDLANNING
DEPTS. WITH DETAILED NOTATION
TENANT AND LAND USE.
-------- -
Other Fees . . . . . . . STRONG MOTION
--------------------
(SMI) - COM
29.40
Fee summary Charged ' Paid
Credited
Due
Permit Fee Total 943.04 .00
.00
943.04
Plan Check Total 547.57 .00
.00
547.57
Other Fee. Total 29.40 .00
.00
29.40
Grand Total 152.0.01' .00
.00
1520.01,
City of Ga Qunta i
BUILDING :& SAFETY DEPARTMENT
:SPECIAL INSPECTOR'S REPORT
PROJECT INFORMATION
CT NAME:
INSPECTION ADI
46-650 Adams Street
La. Quinta, CA
SUPERINTENDENT:
Richard W. Davis . (760) 771-5333
CONTACT INFORMATION
INSPECTOR'S `NAME: Steve W. Bodnar
CERTIFIED BY(AGENCY): 'ICBO
CERTIFICATION NUMBER: 0849264=85
TESTING LABORATORY/COMPANY:
MTGL
29992 East La Palma Avenue Suite A
Anaheim, CA 92806
WEEK OF: 01/10-1112.006 I
INSPECTION'S PERFORMED
connections on lines
Steve W. Bodnar
80-400 Camino Santa Elise
Indio, CA `92203-7489
DATE: { 01 /11/2006,
i
- -
r
Steve W. Bodnar
80-400 Camino Santa Elise
Indio, CA `92203-7489
DATE: { 01 /11/2006,
i