RC (11-1185)78075 Main St Ste 102
11-1185
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number - 11-0000-1-1854
Property Address: Z8OZ5-`MAIN`ST STE 102
APN: 770-121-011- -
Application description: REMODEL - COMMERCIAL
Property Zoning: VILLAGE COMMERCIAL
Application valuation: 3500
BUILDING & SAFETY DEPARTMENT
. . BUILDING PERMIT
Applicant: Architect or Engineer:
---------------------------------------
LICENSED CON7laCTOR'S DECLARATION
I hereby affirm under. penalty of perjury that I am lice nder provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business a r e onals Code, and my License is in full force and effect.
License Class: 13 License No.: 588920
ate: ontractor:
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).:
(_) 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, Qusiness 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.).
(_) 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.).
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
LQPERMIT
Owner:
OLD TOWN LA QUINTA
78015 MAIN ST #205
LA QUINTA CA
LA QUINTA, CA 92253
Contractor:
ASARO BUILDERS, INC.
42220 GREEN WAY; H
PALM DESERT, CA 92211
(760)776-0043
Lic. No.: 588920
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS• (760) 777-7153
Date: 11/09/11
I
N, 0 V C 2040. I
I
CI,'Y QF 1_A QUINTA
FINS `17F_ n; -:PT
WORKER'S COMPENSATION DECLARATION
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 30001642009
I certify that, in the performance of thefor which this permit is issued, I shall not employ any
person in any manner so as to beco subject to the workers' compensation laws of California,
and agree that, if I should beco ject to the workers' compensation provisions of Section
3700 of the Labor Code, orthwith comply with those provisions.
ate. 7 —// plica M.
WARNING: FAILURE TO SE E KERS' 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 aresult 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 informaY dhereeby
rrct. I agree to comply with all
city and county ordinances nd state laws relating to building con ' nn authorize representatives
of this ounty to enter un the above-mentioned property for ' ion rposes
Xt-.ZL,—/,/ZS.gnatu4 (Applicant or Agent):
Application Number . . . . 11-00001185
LQPEPMIT
Structure Information
Construction Type . .
. . . TYPE V, UNPROTECTED.
Occupancy Type . .
. . . MERCANTILE
Other struct info
CODE EDITION
2010
FIRE SPRINKLERS
YES
OCCUPANT LOAD
26.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE 1000.00
Permit
BUILDING PERMIT
Additional desc".
Permit Fee
63.00 Plan Check
Fee
40.95
Issue Date
Valuation
3500
Expiration Date
5/07/12
Qty Unit Charge
Extension
.Per
BASE FEE
45.00
.2.00 9:0000
THOU BLDG 2,001-25,000
18.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee
26.00 Plan Check
Fee
6.50
Issue Date
Valuation
. . . .
0
Expiration Date
5/07/12
Qty. Unit Charge.
Per
Extension
BASE FEE
15.00
1.00 11.0000
----------------------------------------------------------------------------
EA ELEC MISC
11.00'
Permit . . .
PLUMBING INV FEE
Additional desc .
Permit. Fee
69.00 Plan Check
Fee
8.63
Issue Date . . . .
Valuation
. . . . ..
0 .
Expiration Date
5/07/12
Qty Unit Charge
Per
Extension
BASE FEE
30.00
1.00 12.0000
EA PLB FIXTURE
12.00
1.00 15.0000
EA PLB WATER HEATER/VENT
15.00
1.00 6.0000
EA PLB WATER INST/ALT/REP
6.00
1.00` 6.0000
EA PLB FIXTURE DRAIN/VENT
REP/ALT
6.00
----------------------------------------------------------------------------
Special Notes and Comments
TENANT IMPROVEMENT TO
ADD A MOP SINK &
10 GAL WATER HEATER FOR "LA QUINTA OLIVE
LQPEPMIT
LQPERD1IT
Application Number
11-00001185
---------------- -------------------------
Special Notes and Comments
OIL CO."•SUITE 102. TENANT: DEB DEGEN
ph: 310-487-0208.INVESTIGATION
FEE
ASSESSED PER 1997 UNIFORM ADMINISTRATIVE
CODE §304.5'FOR WORK BEGUN WITHOUT
BUILDING PERMIT.
Other Fees . . . . . .'. .
ACCESSIBILITY
PLAN REVIEW
4.10
BLDG STDS ADMIN
(SB1473)
1.00
ENERGY REVIEW
FEE
4.10
Fee summary Charged
----------------- ----------
Paid
---------- ----------
Credited
- - -
Due
- - - - - - -
Permit Fee Total 158.00
.00
.00
. 158.00
Plan Check Total 56.08
.00
.00
56.08
Other Fee Total 9..20
.00
.00
9.20
Grand Total 223.28
.00
.00
223.28
LQPERD1IT
AM; !
r
4,1
P.O. BOX 1504. BUILDING & SAFETY DEPARTMENT.
78-495 CALLS TAMPICO - (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
G)
y
n To: Greg Butler, Building & Safety Manager To CDD:
0
16 From: Les Johnson, Due Date: / 1 41
Director -Planning "
a
U
Permit #:
Status: S
Eaulliding Plans Approval
(This*is an approval to issue a -Building Permit)
The Planning Department has reviewed the Building Plans for the following
project:
Description: 7 _ Qdd 7,nI 0Alk; Ge
Address or General Location: Ir -07,5 -
Applicant
r-075Applicant Contact: 1_&,ec -760 - 777 - 3 -Z
The Planning Department finds that:
0 ,..these Building Pla s do not require Planning Department approval.
...these Building P ans are approved by the Planning Department.
❑ ...these Building Plans require corrections. Please forward a copy of the.
attac ed correc ons to"the applicant: When the corrections are made
pleas `ti tur th m to the Planning Department for review.
Les
ning
7 vA
Date
Bin #
C
Qty of Ta Quetta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: , O- \ \&
Owner's Name:
A. P. Number:
Address: 8b MQ n Com- , (6 2
Legal. Description:
City, ST, Zip:
Contractor:
Telephone:
Address:
Project Description:
City, ST, Zip:
\ J- .
Telephone:
State Lic. # : City Lic. #:
Arch., Engr., Designer: dv U o.,
Address: q - 2 \\C
City., ST, Zip: CO G \ K C -C, ? b
Telephone:
pp
s:<: <:t.: r.:{.;;...:..,:>:::{-;;:::.r::•;v;>a;:
Construction Type: Occupancy: • 1
State Lic. #:
Project type (circle one): New Add'n . Alter Repair Demo
Sq. Ft.: ' (Z Q) #Stories: Z # Units: Q 2
Name of Contact Person: U C r\,'33 \V„o .
Telephone # of Contact Person: fj ,' - 2Cf.l
Estimated Value of Project: Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submi
Q
Item
Amount
Structural Calcs.
Reviewed, read for corrections
1 _ 1
Plan Check Deposit
Truss Caies.
Called Contact Person 5
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
1 (
Mechanical
Grading plan
20° Review, ready for correctio ssue
114/11
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctiousrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.•
Pub. Wks. Appr.
Date of permit issue
School Fees
Total Permit Fees
c-yc a/0/3/