RC (07-1704)78075 Main St Ste 204
07-1704
rte..
P.O. ,BOX 1504
78,495 CALLE TAMPICO
1' LA QUINTA, CALIFORNIA 92253
dy r t
T4hf
4Q-
BUILDINGNG & SAFETY DEPARTMENT
BUILDING PERMIT.
Application Number: C07=0-0-001704
Property Address: 780'75JMA3N ST STE 204
APN: 770-121-'011- - -
Application description: .REMODEL = COMMERCIAL
Property Zoning: VILLAGE COMMERCIAL
Application valuation:. 40000
Applicant: Architect or Engineer
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 Class: B License No.: 771883
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 _ 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.).
(_) 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 am exempt under Sec. , B.&P.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:
LQPERDIIT .
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/22/07
Owner: -
OLD TOWN LA "QUINTA
78015 MAIN ST.#205
LA QUINTA CA
LA QUINTA, CA 92253
Contractor: W
MARVIN INVESTMENTS, INC. D
78100 MAIN STREET #206 2 3 200.
LA QUINTA, CA 92253 OCTt
(760)771-2567 QUI 'T
Lic. NO.: 771883 C{T1jOF
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 '1440125-2007
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. y
Date:— — — Applicant
WARNING: FAILURE TO SECURE WORKERS TION 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 and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this countySig
to enter upon the above-mentioned property for inspection fpurposes.
Date l 4 ' 'nature (Applicant or A;en
tY7 7•'J=
Application Number
. . . . 07-00001704
------ Structure Information
3,718SF TI/V-NR/B-OCC/29-OL
Other struct'info . .
. . . CODE EDITION
2001/2005
FIRE SPRINKLERS
YES
MIXED-USE OCCUPANCY
B
OCCUPANT LOAD
29.00
1ST FLOOR SQUARE FOOTAGE
3718.00
Permit . .
BUILDING PERMIT
Additional desc..
Permit Fee
349.50 Plan Check
Fee
227.18
Issue Date
Valuation
40000
Expiration Date
.4/19/08
Qty Unit Charge
Per
Extension
BASE FEE
252.00
15.00 6.5000
THOU BLDG 25,001-50,000
97.50
Permit
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee
89.36 Plan Check
Fee
22.34
Issue Date . . .
Valuation
0
Expiration Date
4/19/08
Qty. Unit Charge
Per
Extension
BASE FEE
15.00
3718.00 .0200
----------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
74.36
Permit
MECHANICAL
Additional desc .
Permit Fee
24.00 Plan Check
Fee
6.00
Issue Date . .
Valuation
. .
. . 0
Expiration Date
4/i9/08
Qty Unit'Charge
Per
Extension
BASE FEE
15.00
1.00' 9:0000
EA MECH APPL REP/ALT/ADD
9.00 ,
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . .
.18..00 Plan•Check
Fee
Issue Date
Valuation
. .
. . 0
Expiration Date
4/19/08
Qty Unit Charge'
Per
Extension'
LQPERMIT
LQPMMIT
Application Number . . . . . 07-00001.704
Permit PLUMBING
Qty Unit Charge Per
Extension
BASE FEE
15.00
1..00 3.0000 EA PLB WATER INST/ALT/REP
3.00
----------------------------------------------------------------------------
Special Notes and Comments
3,118SF TENANT IMRPOVEMENT/V-NR/B-OCC
29 -OL BASED ON 2, 900SF USABLE SPACE PER
ARCHITECTURAL DRAWINGS. STORAGE AREAS
ARE TO BE MAINTAINED AS STORAGE AREAS
AND ARE NOT TO BE USED FOR OTHER
OCCUPANCIES. 2001 CBC, CPC, CMC,. 2004
CEC, 2005 ENERGY, August 30, 2007
12:10:55 PM AORTEGA
Other Fees . . STRONG MOTION (SMI) - COM .50
Fee summary Charged Paid Credited
Due
Permit Fee Total 480.86 .00 00
480.86
Plan Check Total 260.02 .00 .00
260.02
Other Fee Total .50 .00 .00
.50
Grand Total 741.38 .00 .00
'741..38
LQPMMIT
r
M'i
Bin
ti
• City of La Quints
Building U Safety. DivisionV.
P.O. Box 1504 78=495 Calle Tampico
, ,
La Quinta, CA 92253 - (760) 777-7012 4k
,. Building Permit Application and Tracking Sheet
Wacmitf'
Project Address: 15V -( Owner's Name Mp.Fkt
,
A. P. -Number: 'Address:
Legal Description: City, ST, Zip: p
Contractor: 3
Telephone:
Address: _ Project Description:
City, ST, Zip: e
Telephone: '
City Lic. #:
State Lic. #: 1
Arch., Engr., Designer`: 7.
Address:
City, ST, Zip: 07. p .
Telephone: Construction Type: Occupancy:
State Lic. #:. Project type (circle one): New • Add'n Alter Repair Demo
Name of Contac rson: O Ft.: 3
#Stories:
#Units:
Telephone # of ontac , stimated Value of Project: 3
APPLICANT:
DO NOT BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACIONG PERMIT FEES
I;
Plan Sets
p _
Plan Check submitted • I ,?j'U Item Amount
?i
Structural Calcs.
Reviewed, ready for corrections 69-7 Plan Check Deposit '
Truss Calcs.
Called Contact Person Plan Check Balance
Energy Calcs:
Plans picked up 7 6 p7 Construction `t
Flood plaigplan .
Plans resubmitted Mechanical
Grading, plan
2°" Review, ready for corrections/issue 'f lectrical
Subcontactor List
Called Contact Person lumbing
Grant Deed
Plans picked up Yrs,, , JJ S.M.I. .
H.O.A. Approval
Plans resubmitted I 0 Grading
INHOUSE:
Review, ready for correcti s/isue sZ Developer Impact Fee
Planning Approval
Called Contact Person Q A.I.P.P.
Pub. Wks. Appr
Date of permit issue '
School Fees
.
Total Permit Fees ' '
s
John R. Hawkins
Fire Chief
Proudly serving the
unincorporated
areas of Riverside
County and the
Cities of:
Banning
yBeaumont
Calimesa
Canyon Lake
Coachella
Desert Hot Springs
Indian Wells
Indio
Lake Elsinore
La Quinta
Moreno Valley
Palm Desert
Perris
Rancho Mirage
Rubidoux CSD
San Jacinto
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jeff Stone,
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 • (951) 940-6900 • Fax (951) 940-6910
City of La Quinta
Building Department
RE:
CASE
The Riverside County Fire Department is gra ting the Fiire, Clearance for the follows" a
Location 8 - O % 5--YY A rN X lP a Dq — I a oc
Please call if you should have any questions 760-863-8886.
Respectfully
By
Terry ry DeSoucy
Fire.Systems Inspector