RC (05-0693)78065 Main St Ste 100
05-0693
TAf 4 4'a"
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 Number . . .. .
. 05-000_066-93 Date
3/24/05
Property Address
_-78065'MAIN ST STE 100`t
APN :
-7-7-0-- 12'1 --
Application description . .
. REMODEL - COMMERCIAL
Property Zoning . . . .
. VILLAGE COMMERCIAL
Application valuation
17500
Owner
Contractor
. -
OLD TOWN L MARVIN INVESTMENTS, INC.
78015 MAIN 42 _.
78080 CALLE ESTADO SUITE
201
LA QUINTA
LA QUINTA
CA 92253
LA QUINTA MAR 2 400522
(760) 771- 6
OF LA QUINTA
WCC: STATE FUND
CITY
FINANCE DEPT.
WC: 14401252004
07/01/05
CSLB: 771883
11/30/05
CCC: B
------ Structure Information OFFICE T.I.
-----
Construction Type . . . . .
TYPE V - NON RATED
Occupancy Type . . . . . .
MERCANTILE .
Other struct info . . . . .
CODE EDITION 2001
FIRE SPRINKLERS YES
MIXED-USE OCCUPANCY B
OCCUPANT LOAD
11.00
------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
1082.00
---------------
Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee 189.00 Plan•Check Fee
122.85
Issue Date . . . .
Valuation
17500
Qty Unit Charge Per
Extension
BASE FEE
45.00
16.00 9.0000 THOU
----------------------------------------------------------------------------
BLDG 2,001-.25,000
144.00
Permit ELECT
- ADD/ALT/REM
Additional desc
Permit Fee . . . . 36.64 Plan Check Fee
9.16
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge Per
Extension
BASE FEE
15.00
1082.00 0200
----------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
21.64
Permit MECHANICAL•
Additional desc
Permit.Fee 24.00 Plan Check Fee
6.00
P.O. BOX 1504 • VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: I Date:
Applicant:
Applicant's Mailing Address.
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under pen Ity of perjury that I am licensed under provisions of Chapter 9 mmencing with Section 7000) of Division 3 of the Business and Professionals
Code, and ss Licensej (n full force and effect. j
License Class J License No.
Date W _OyContractor
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).):
(__) 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 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 1 am exempt under Sec. , BA P.C. for this reason
Date Owner
WORKERS' 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.
—1 ave and will aintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ers' compensation insurance carrier anjEy
Carrier Policy Number
_ I certify that, in th erformance 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 ($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.).
Lenders Name
Lenders 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 Quinta, its
officers, agents and employeesfor 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 3 Ko Signature (Applicant or Agent): ' !
Page 2
Application Number
. . 05-00000693
Date 3/24/05
Issue Date
Valuation
. .
. . 0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 4.5000
----------------------------------------------------------------------------
EA MECHVENT INST/ DUCT ALT
9.00
Permit . . . ... .
PLUMBING
Additional desc
Permit Fee . . . .
34.50 Plan Check
Fee
8.63
Issue Date . . . .
Valuation
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA PLB FIXTURE
12.00
1.00 7.5000
-
EA PLB WATER HEATER/VENT
7.50
------------------------------------------------------=-
Special Notes and Comments
--
-----------------
SUITE 100 - INTERIOR
TENANT IMPROVEMENT
- 1082 SQ.FT. OFFICE
SPACE
"B"OCCUPANCY, TYPE V -N
CONSTRUCTION,'
11 OCCUPANT LOAD 2001
CODES.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . ACCESSIBILITY PLAN.REVIEW
12.29
ENERGY REVIEW FEE.
12.29
HOURLY PLAN CHECK
70.00
Fee summary Charged
Paid Credited
Due'
Permit Fee Total
284.14 .00
.00
284.14
Plan Check Total
146.64 .00
.00
146.64
Other Fee Total
94.58 .00
.00
94.58
Grand Total
525.36 .00
00
525.36
MAY-20-05-FRI 02:26 PM MARVIN HOMES
FAX NO. 7607715057 P.
01
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CITY OF LA QUANTA
,
.I;
IL SAFETY DEPARTMENT'
OF tro 777-7012
INS TION REQUEST LINE
MAR 2 4 2005 777-7153
TOWIT Q UINTA
W
- STMENTS, INC.
:
Permit Number. 05-0693
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
78065 MAIN ST 100
'•
JOB ADDRESS
SUITE 100 - INTERIOR TENANT IMPROVEMENT
r
- 1082 SQXT. OrFICE SPACE
"B"OCCUPANCY, TYPE V -N CONSTRUCTION,.
-11- OCCUPANT LOAD 2001 CODES.
f t
1
TYPE OF INSPECTION DATE INSR
TEMPORARY POWER
SETBACKS
5.
U/G PLUMBING / WASTE
U/G ELECTRICAL/ GROUNDING;
I
FOOTINGS / STEEL
CONCRETE SLAB
y
_
DO NOT POUR UR CONCRETE UNTIL ABOVE SIGNED
ROOF NAIL / PRE7f(OOF
OKAY TO WRAP T
'FRAMING COMBINATION
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH MECHANICAL
INSULATION
COVER NO WORK UNTIL ABOVE SIGNED
INTERIOR GYP. BD. DRYWALL
EXTERIOR LATH
GAS TEST
"
SEPTIC ABANDONMENT
SEWER CONNECTION
i
SEPTIC / GREASE INTERCEPTOR
MASONRY INSPECTIONS
FOOTINGS / STEEL
BOND BEAM
POOL / SPA / WATER FEATURE INSPECTIONS
PRE-GUNITE /SETBACKS
U/G PLUMBING
U/G GAS
U/G ELEGTRICAL
PRE -PLASTER ALARMS / BARRIERS _
_ FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWER
ELECTRICAL
PLUMBING .
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT.
FINAL / JOB COMPLETED
7