04-3812 (RC)78015 Main St Ste 206
04-3812
D LK u.
r MAY 0 3 2004
I r ej OF LA QUIMTA
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS'(760) 777-7153
BUILDING PERMIT
Application Number04-=00003812`
Property Address t 78015S-MAIN"ST
APN: 770-121-003- - -
Tenant nbr, name . . . . RE RINKER FINANCIAL
Application description . ODEL - COMMERCIAL
Property Zoning . . . . . . . VILLAGE COMMERCIAL
Application valuation 10968
Owner
OLD TOWN LA QUINTA
78080 CALLE ESTADO #200
LA QUINTA CA
LA-QUINTA CA 92253
Date 4/30/04
Contractor
------------
MARVIN INVESTMENTS, INC.
78080 CALLE ESTADO SUITE 201
LA QUINTA CA 92253
WCC: STATE FUND
WC: 1440125 07/01/04
CSLB: 771883 11/30/05
CCC: B
------ Structure Information SHELL BLDG -----
Construction Type . . . . . TYPE V - NON RATED
Occupancy Type . . . . . BUSINESS <50
Other struct info CODE EDITION 2001
FIRE SPRINKLERS YES
MIXED-USE OCCUPANCY B
OCCUPANT LOAD 20.00
SECOND'FLOOR SQ FTG 1828-.00
----------------------------------------------------------------------------
Permit . . . . . BUILDING PERMIT
Additional desc
Permit Fee . . . . 126.00 Plan Check Fee'. 81.90
Issue Date . . . . Valuation . . . . 10968
Qty Unit Charge Per Extension
BASE FEE. 45.00
9.00 9.0000 THOU BLDG 2,001-25,000 81.00
Permit . . . . . .. ELECT.- ADD/ALT/REM
Additional desc
Permit Fee . . . 51.56 Plan Check Fee 12.89
Issue Date Valuation 0
Qty Unit Charge Per Extension
BASE FEE 15.00
P.O. Box 1504 44Q"
VOICE (760) 777-7012
78-495 CALLE CALIFORNIA FAX (760) 777-7011
LA QUINTA, LIFORN92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 0-41- .351 a I Date: 4 - 30 -O
Applicant: / ,, ..{
/ "1(Gyyt.-, DWI Ut JL V1 C
Applicant's MailinAddress:
Ls-,.. g ., ,AA C 9
?1- 2'SG
Architect or Engineer:
T "t"
Architect or Engineer's Address: n
T
Lic. No.: C. / 9
BUILDING PERkILT DECLARATIONS
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 Licens i/s in full force and effect.
/License Class
_ License No. ?/ 47
Date /3,31 Yrx _ tractor W A \ ,
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
U 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.).
U I am exempt under Sec. , B.& P.C. for this reason
Date
WORKERS' COMPENSATION DECLARATION
1 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
workTcompensatJnce carera`linumbnumber
are: Ssyult VI Policy Number O1i
y:
certify that, in the performance of the work for which this permit is issued, I shall notemploy 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.
—DateU a ppl? icant /j,Jt `AIL
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.
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
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 Ouinta, 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. 1 agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
Date `'[ V` 1/Signature (Applicant or Agent): t'A , '/i
•rr: ,
Page
2
Application Number . ... . . 04-00003812
Date
4/30/04
Qty- Unit Charge Per
Extension
.1828.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL
--------------------------------------------=----------------------'---------
36.56
Permit . . . . MECHANICAL
Additional desc
Permit Fee . . 24.00 Plan Check
Fee
6.00
Issue Date Valuation
. . .
0
Qty Unit Charge Per
Extension
BASE FEE
15.00
2.00 4.5000 EA MECH APPLIANCE VENT
------------------------------------------------------------------------------
9.00
Special. Notes and Comments'.
COMMERCIAL INTERIOR T.I.- 1828 SQ.FT.
OFFICE "B" OCC-. TYPE V. -N 2.001 CODES
--------------------------------- -------------------------------------------
----------------------- ---------------------------------------------------
Other
Other Fees . . . . . . . . .' ENERGY REVIEW FEE
8.19
Fee summary Charged Paid Credited
Due
Permit Fee Total 201.56 .00
.00
201.56
Plan Check Total 100.79 .00
.00
100.79.
'Other Fee Total 8.19 .00
.00
8.19
Grand Total 310.54 .00
.00
310.54
•rr: ,
JUN-28-04 MON 02:18 PM` MARVIN HOMES FAX N0, 7607715057 P. 02
F LA QUINTA
NTA
ac,. BUILDIN &,r,,AFETY DEPARTMENT
`.477-7012
INSPECt(ON REQUEST LINE
Own yN L n TA
Contra
Permit Number— Q4_3g12
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS fZB~015 MAINT ST. #206 lr
TENANT IMPROVEMENT TO SHELL
SPACE FOR OFFICE UNDER
I
--CONSTRU
TYPE OF INSPECTION imaDATE INSR
TEMPORARY POWER
i SETBACKS
I U/G PLUMBING / WASTE
U/G ELECTRICAL / GROUNDING
FOOTINGS / STEEL
CONCRETE SLAB
DO NOT POUR CONCRETE UNTIL ABOVE SIGNED
ROOF NAIL / PRE-ROOF —
OKAY TO WRAP
j F- `ING COMBINATION p
UGH ELECTRIC
ROUGH PLUMBING
ROUGH MECHANICAL
• INSULATION
COVER NO WORK UNTIL ABOVE SIGNED
INTERIOR GYP. BD. DRYWALL
EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT
SEWER CONNECTION
SEPTIC / GREASE INTERCEPTOR
MASONRY IN
FOOTINGS / STEEL
BOND BEAM
POOL / SPA / WATER FEATURE INSPECTIONS
PRE•GUNITE // SETBACKS
U/G PLUMBING
U/G GAS
WG —ELECT
Ms /BARRIERS
FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWER 0
ELECTRICAL
PLUMBING
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
1
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Tom Tisdale
Fire Chief
Proudly serving the
Unincorporated
Areas of Riverside
County and the
Cities of:
Banning
Beaumont
Calimesa
Canyon Lake
Coachella
Desert Hot Springs
Indian Wells
Indio
Lake Elsinore
La Quinta
...
Moreno Valley
Palm Desert
Perris
Rancho Mirage
San Jacinto
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jim Venable,
District 3
Roy Wilson,
District 4
Marion Ashley,
District 5
RIVERSIDE COUNTY FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
210 West San Jacinto Avenue . Perris," -California 92570. (909) 940-6900. Fax (909) 940-6910
May 28, 2004
City Of La Quinta
Building Department
Re: Old Town L.Q.
The Riverside County Fire D ent is rantin a fir an afety clearance for the
Following address located 78015 Main St. Hwy 111 Ste A-206 a Quints. Please call if
you should have any questions.
TD/j1
FRANK KAWASAKI
Chief Fire Department Planner
By1 -S
Terry DeS y
Fire Systems Inspector
EMERGENCY SERVICES DIVISION • PLANNING SECTION . INDIO OFFICE
82-675 Highway 111, 2n° FI., Indio, CA 92201 . (760) 863-8886 • Fax (760) 863-7072