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0307-346 (RC)LICENSED CONTRACTOR 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 # Lic. Class ,'Exp. Date 3//76639 i3 3:�;` Pate l /(i'2, Signature of Contractor I` OWNER -BUILDER DECLARATION . I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: r ( ) 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 & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section B&P.C. for this reason Date Signature of Owner 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. �Q) 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 & policy no. are: Carrier STATFsFUN Policy No. , 044.0020844 (This section need not be completed if the permit valuation is for $100.00 or less). ( ) 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 provisioS �,! te: /. f�,• 2 Applicant ( ./ ,1 / (f„/ Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $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. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his 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 applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 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 per or cessation of work for 180 days will subject permit to cancellation. 1.I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property, for inspection purposes. s �! ? ! r� 41' Signature (Owner/Agent) i Date BUILDING PERMIT PERMIT# DATE VALUATION LOT TRACT 9a� JOB SITE APN ADDRESS' 78-271! 1UGH a%AY 11. 1­1VFJ:t) S&?T]1S 9-I t1 d1� OWNER CONTRACTOR / DESIGNER / ENGINEER M & 11 PROP,,I1Y PHORNEIC ENTF.RPE3 18-4011UCiGI AY D l 44i'C©l &Rovu,WAY Lk QVWV� , CA 92233 L A NMRA CA 90631 (562)690-9559 CSLO 71M USE OF PERMIT 507 SQ:FT,; 33 FT, HOT. --'TOWER ROOF RECONSTRUCTION AT 1I laD SANDS RMGTY c FFICP EMTrUCAL,J-BOJ: FOR S3 ON, 2001 C0DFS, SPRINKLER 507.00 SF CANOPY 507.00 SF Xr9131.V.k'A1.'J D C108T' OF f, %AQW.W I'iRbml FEE NUMSt7ARY }ALAN CHECK -RFI 964,33 CONSTRUCTIGN* FLOE 101-000-418-000 $09.60 STRONG MOTION FEE - COMM: 100»000.7.41.000 $1..6-0 ELECTRICAL, 1198. 101-000-$26--000 X30.00 3VB. 0TAI.,C' 0N0TRIJC 1'10' MD;1z7 ,d+tik� CBF,(X n LUIS PRE-P,AID FEFS Lr $0,00 �1 TOTAL PF RMf "78 DULP 1Yt)W SEP 0 442003 - CITY OF LA QUINTA s• ' FINANCE DEPT: RECEIPT DATE r 9 .W BY ` 4 u� DATE F1114ALtD II/Mo INSP C OR INSPECTION RECORD OPERATION s DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck *- ' 3 " Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVA S steel POOLS - SPAS Set Backs Electric Bond + Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg, Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans OX for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final ; Utility Notice, (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage.Wiring Fixtures Main Service Sub Panels Exterior Receptacles, G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: B B ASSOCIATES INC. OCL STRUCTURAL. ENGINEERS 1 636 WILSHIRE BLVD., LOS ANGELES, CA 9001 7 TEL: (213) 353-1440 FAx: (213) 353-145B E-MAIL: MAI L@SNSSTRUCTURAL.CDM URL: WWW.SNSSTRUCTURAL.CDM September 30, 2003 Kirk Kirkland./ Danny Building Inspector Building Department of La Quinta P.O. 'Box 1504 78-495 Calle Tampico _ 0% La -��,culi5a; vr1:y�.•uv 5. 0% Re: Vons Store # 2175 ' X78271 -State --OW 111 La Quinta, CA Dear Mr. Kirkland: cl- . 0 e T 3 ® REC'0 BULL,,, B&B Project No. 01-151 This is to certify that the 5/8" thick plywood sheathing over the canopy roof of the Fred Sands store should be structurally adequate and no further action is required. If you have any questions on the above, please give me a call. Very truly yours, B & B ASSOCIATES, INC. Q�OFESS/p� QUO �N BA 00 Armen Baroonian, Ph.D., S.E. o �2 Q NO. 4227 �2 Principal I Exp. 06.01.2005 AB/pa �'�v T�P�� ,9�OF CAS\FSP 7 if A X Bin # C ` City of La Quinta Building at Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 301'3 Building Permit Application and TrackingSheet Project Address: i Owner's Name: A 4!' � ewq,+ A. P. Number: 5•,o '0/3 Address: g — 40/ _ V [City. Legal Description: ST. Zip: Contractor: !✓ f FTelephone: 4 6z) Address: XProject Description: City, ST, Zip: 75 rAt, X3;' Telephone. ��gZ �p� . !'S's ;,:< _ J^� ru-vtcz <3(4/v State Lic. # : 7'7 (p City Lic. #: Arch., Engr., Designer. , Li G � �, �`', n X C5SU V /�%I�ld Address: 3 b d I //�/ON •� / V City, ST, Zip: Telephone: G&2fr$ State Lic. #: G ��� CA 7o _" _ ' r: = r� t .. Construction Type: G� Occupancy: NO Project type c I ne): New Add'n Alter Repair Demo Name of Contact Person: iJ Sq. Ft.: ' & # Stories: JJ6' 6*6 # Units: Telephone # of Contact Person: 5Z2. � jS stimated Value of Project: �B� APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Rec'd TRACKING PERMIT FEES aPlan Sets Plan Check submitted woj Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cala. Called Contact Person Plan Check Manc Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctionssue �f! ,9j' Electrical Subcontactor List Called Contact Person p� Plumbing Grant Deed Plans picked up S.NI.1. V/ H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I,P•P, Pub. Wks. Appr Date of permit issue School Fees 2 �LM Total Permit Fees 7/26 1-/^7 fo/s- /do("SF"/L7 //. /Z6 : it/o .ve t✓ -S7;�A,c.7- &+1 Cs 7/2 6 N -.S 1i4A"f f !AAev. Sle 7a COD YOUNG ENGINEERING SERVICES • Engineering • Architecture•Surveying• Building & Safety Services Letter of Transmittal To: CITY OF LA QUINTA Date: 8/6/2003 Project., 78-271 HWY 111 Attn: ED RANDALL PC#: 0307-347 (1ST CHECK) Tel No.: (760) 777-7012 Tract No.: We are forwarding: X By Messenger By Mail Your Pickup No. of Copies Description: 1 SET OF PLANS 1 SET OF APPROVED STRUCT CALCS 1 SET OF APPROVED PLANS THANK YOU. This Material Sent for. Your Files Per Your Request Your Review Approval X Checking At the request of: Other By: MARCELL McELROY Phone # 760-360-5770 77-804 Wildcat Drive, Suite C, Palm Desert, CA 92211 (760) 360-5770 Bronz Young T&9v 4 4 Qu[xfw P.O. Box 1504 78-495 CALLE' TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT (760)777-7012 FAX (760) 777-7011 To: Greg Butler, Building & Safety Manager To CDD: 7-26-2003 From: Oscar Orci, Planning Manager Due date: 8-04-2003 Status: IST Review of latest revision. Building Plans Approval (This is an approval to issue a Building Permit) The Community Development Department has reviewed the Building Plans for the following project: Description: Vons -revision to Fred Sands Tower Heis?ht (.SrE #4rr'rt rc.N£D 17F_St,IJpr7o.�� Address or general location: 78-271 Highway 111 Applicant Contact: Robert Nava 562-863-1981 The Community Development Department finds that: ❑ ...these Building Plans do not require Community Development Department approval. ...these Building Plans are approved by the Community Development Department. ❑ ...these Building Plans require corrections. Please forward a copy of the attached corrections to the applicant. When the corrections are made please return them to the Community Development Department for review. i, Planning Manager