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DEMO (09-0924)78015 Main St Ste 111 09-0924 P.O. BOX 1504 . 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Annlirant- 09-00000924 78015 MAIN ST STE 770-121-007- - DEMO - COMML/OTHER VILLAGE COMMERCIAL c&t(t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: 111 OLD TOWN LA QUINTA 78015 MAIN ST #205 LA QUINTA CA LA QUINTA, CA 92253 Contractor: Architect or Engineer: MARVIN INVESTMENTS, INC 78100 MAIN STREET #206 LA QUINTA, CA 92253 (760) 771-2567 Lic. No.: 771883 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. Licens C ss: 13 License No.: 771883 ate: ' ( ntractor: 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 _) 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 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 1 1 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/01/09 `7i 3' ea t a 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 FIND Policy Number 0001281-2008 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 forthwith comply with those provisions. atH' e:plicant: 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 ($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 an aunty ordinances and slate laws relating to building construction, and hereby authorize representatives oft county to enter upon t above-mentioned property for inspection purposes. ate: Si ture (Applicant or Agent): Application Number . . . . . 09-00000924 ------ Structure Information OLD TOWN WINE BAR ---------------------------------------------------------------------------- ----- Permit . . . DEMO PERMIT Additional desc . . Permit Fee . . . . 45.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/28/10 Qty Unit Charge Per Extension BASE FEE 45.00 ---------------------------------------------------------------------------- Special Notes and Comments DEMO OF EXISTING STORE ROOM WALL TO EXTEND STORE ROOM. SAW CUT CONCRETE AND REMOVE TILE & EXISTING CONCRETE TO ACCOMODATE PLUMBING FOR BAR SINK. Fee summary Charged Paid Credited Due ----------------------------------------------- Permit Fee Total 45.00 .00 ---------- .00 45.00 Plan Check Total .00 .00 .00 .00 Grand Total 45.00 .00 .00 45.00 LQPERMIT m m ■■ 230 ■ _ City of La Quinta Building & Safety Division Permit # n L P.O. Box 1504, 78-495 Calle Tampico D La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet ' tProject 'Addiess:f 0 1 K' M eA-`n rz l -Owner's Name: Q 1 d,Tp,4.N CCL A. P. Number: Legal Description: L I`f oLxv-\ e011 Cts Address: —7 %(V D , n S4- ZQ -City, ST, Zip: J CORtI'aCtOC: / / r`Y Q-•/ / t 1 , Address: g`V 20 City, ST, Zip: LD -p J,1 n O• ! ZZS3 ... U. 77777 - Telephoner .+ _ ij: htiN" .` + '}••+ •. Telephone: i t.. r: • s z >>s:': Project Description: .Q f4 -a OF S DM State Lic. # : 1 13 City Lic. #; S ( - Sc. v' .. OJ.V can 4-4 Ct AA `(l &WCL,t Engr., Designer: e}- n n tw re44 14- - Address: Lin City., ST, Zip: Telephone.: --n . T 7 ` •, . • . State Lic. #:C 3 .•` " ' .•, : <gy >3Y. ^c Y.`:(j . , .. Name of Contact Person: L ri1n-U s Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft : -T #Stories: # Units: Telephone # of Contact Person: --7 I)A • V(s0 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE H Submittal Pian Sets Req'd Recd TRACIUNG Plan Check submitted PERMIT FEES Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction . Flood plain plan Plans resubmitted Mechanical Grading plan 2W Review, ready for corrcetionsAssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up. S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" Review,.ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date oCpermit issue School Fees Total Permit Fees