04-3803 (OFC)0
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
Application Number . .
Property Address . . .
APN:
Application description
Property Zoning . . . .
Application valuation .
BUILDING PERMIT
. . . 04.-00003803 Date 2/01/05
. . . 78370 HIGHWAY 111
604-050-048- - -
. . . NEW COMML - OFFICE/BANK
. . . COMMUNITY COMMERCIAL
1795751
Owner
------------------------
MADISON PTM LA QUINTA
71361 SAN GORGONIO RD
RANCHO MIRAGE CA 92270
Contractor
------------------------
PRIMUS CONTRACTING GROUP, INC
1409 SO. 600 WEST, SUITE D
BOUNTIFUL UT 84010
WCC: STATE FUND
WC: 17051812003 10/01/04
CSLB: 814726
11/30/04
CCC: B
------ Structure Information
2 STORY SHELL BUILDINGS A & B
-----
Construction Type . .
. . . TYPE V - NON RATED
Flood Zone . . . . .
. . . NON -AO FLOOD ZONE
Other struct info . .
. . . CODE EDITION
2001
FIRE SPRINKLERS
YES
MIXED-USE OCCUPANCY
SHELL
OCCUPANT LOAD
.00
PATIO SQ FTG
968.00
1ST FLOOR SQUARE FOOTAGE
19364.00
----------------------------------------------------------------------------
2ND FLOOR SQUARE FOOTAGE
17771.00
Permit . . . .
BUILDING PERMIT
Additional desc
Permit Fee . . . .
5131.50 Plan Check Fee
.00
Issue Date . . . .
5/12/04 Valuation . . .
. 2244689
Expiration Date
7/24/05
Qty Unit Charge
Per.
Extension
BASE FEE
3539.50
796.00 2.0000
----------------------------------------------------------------------------
THOU BLDG 1,000,001 - UP
1592.00
Permit
ELEC-NEW COMMERCIAL
Additional desc . .
Permit Fee . . . .
757.70 Plan Check Fee
.00
Issue Date . . . .
5/12/04 Valuation . . .
. 0
Expiration Date
7/24/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
37135.00 .0200
----------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL 742.70
P.O. Box 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAx.(760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Date:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT 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 my License is in full force and effect.
License Class License No.
Date Contractor
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. , BA P.C. for this reason
Date
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.
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 Policy Number
_ 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.
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.).
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 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 county to enter upon the above-mentioned property for inspection purposes.
Date Signature (Applicant or Agent):
Application Number
Permit . . . .
Additional desc . .
Permit Fee .
Issue Date . . . .
Expiration Date . .
Page
. . . . . 04-00003803 Date
GRADING PERMIT
15.00 Plan Check Fee
5/12/04 Valuation . . . .
7/24/05
2
2/01/05
ft
Qty Unit Charge
Per
Extension
----.------------------------------------------------------------------------
BASE FEE
15.00•
_ Permit . . . . . .
MECHANICAL
Additional desc . .
Permit Fee . . . .
347.00 Plan Check Fee
.00
Issue Date
5/12/04 Valuation . . .
. 0
Expiration Date
7/24/05
- Qty Unit Charge
Per
Extension
BASE FEE
15.00
17.00 9.0000
EA MECH FURNACE <=1OOK
153.00
17.00 9.0000
EA MECH B/C <=3HP/100K BTU
153.00
2.00 6.5000
EA MECH VENT FAN
13.00
2.00 6.5000
---------------------.-------------------------------------------------------
EA MECH OTHER MECH EQUIPMENT
13.00
Permit . . . . . .
PLUMBING
Additional desc . .
Permit Fee . . . .
210.00 Plan Check Fee
.00
Issue Date . . . .
5/12/04 Valuation . . .
. 0
Expiration Date
7/24/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
5.00 6.0000
EA PLB FIXTURE
30.00
2.00 15.0000
EA PLB BUILDING SEWER
30.00
18.00 6.0000
EA PLB ROOF DRAIN
108.00
2.00 7.5000
EA PLB WATER HEATER/VENT
15.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000
----------------------------------------------------------
EA PLB LAWN SPRINKLER SYSTEM
9.00
-----------------
Special Notes and Comments
COMMERCIAL SHELL - 37,135
SQ.FT. 2 STORY
"OFFICE SHELL" TYPE V
-N ("B" OCC.
PROPOSED) WITH FIRE SPRINKLER
& 3 - 60
FOOT YARDS CREDIT FOR
ALLOWABLE AREA.
[2 -VN BLDGS & II -N PARKING GARAGE AS ONE
BUILDING ALLOWED PER
CBC 601.2 MIXED
TYPE OF CONSTRUCTION][$3661.28
PLN CHK
RETAINER APPLIED TO THIS PERMIT. NO PLN
Page 3
Application Number . . . . . 04-00003803 Date 2/01/05
Special Notes and Comments
CHK BALANCE]PARKING STRUCTURE IS NOT AN
APPROVED PART OF THIS PERMIT.
REVISED ELECTRICAL PLANS BY NEW
ELCTRICAL CONTRACTOR [SYSTEM ELECTRIC]
APPROVED FOR THIS PROJECT. 7/23/04 9:36:
49 AM bhanada
----------------------------------------------------------------------------
Other Fees . . . . . . . ART IN PUBLIC PLACES=COM 8958.75
DIF CIVIC CENTER - COMM 2005.29
ENERGY REVIEW FEE 333.55
DIF FIRE PROTECTION -COMM 2153.83
HOURLY PLAN CHECK 70.00
STRONG MOTION (SMI) - COM 377.10
DIF STREET MAINT FAC -COMM 1039.78
DIF TRANSPORTATION - COMM 78577.66
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
Charged Paid
6461.20 6461.20
.00 .00
93515.96 93515.96
99977.16 99977.16
Credited Due
.00
.00
.00
.00
.00
.00
.00
.00
Ll
utiNTA ?
BUILDING & SAFETY DEPARTMENT
OFFIF.04Box 1504 (760).777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760).777-7153
-BUILDING PERMIT
Application Number
Property Address
APN:
Tenant nbr, name . . .
Application description
Property Zoning . . . .
Application valuation .
Owner
-------------------------
MADISON PTM LA QUINTA
71361 SAN GORGONIO RD
RANCHO MIRAGE CA 92270
04-00003803 Date
78380 HIGHWAY 111
604-050-048- - -
SHELL BUILDINGS A & B
NEW COMML - OFFICE/BANK
COMMUNITY COMMERCIAL
1795751
5/12/04
Contractor.
------------------------
PRIMUS CONTRACTING GROUP, INC
1409 SO. 600 WEST, SUITE D
BOUNTIFUL UT 84010
WCC: STATE FUND
WC: 17051812003 10/01/04
CSLB: 814726
11/30/04
CCC: B
Structure Information
2 STORY SHELL BUILDINGS A & B
-----
Construction Type . .
. . . TYPE V - NON RATED
Flood Zone . . . . .
. . . NON -AO FLOOD ZONE
Other struct info . .
. CODE EDITION
2001
FIRE SPRINKLERS
YES
MIXED -USE OCCUPANCY
SHELL
OCCUPANT LOAD
.00
PATIO-SQ FTG
968.00
FIRST FLOOR SQ FTG
19364.00
SECOND FLOOR SQ FTG
17771.00
------------------------------------------------------------------------------
Permit . . . . . .
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
5131.50 Plan Check Fee
.00
Issue Date . . . .
Valuation . .
. . 2244689
Expiration Date . .
11/12/04
Qty Unit Charge
Per
Extension
BASE FEE
3539.50
796.00 2.0000
THOU BLDG 1,000,001 - UP
1592.00
-=---------------------------------------------------------------------------
Permit . . . . . .
MECHANICAL
Additional desc
Permit Fee . . .
347.00 Plan Check Fee
.00
Issue Date
Valuation . .
. . 0
Expiration Date
11/12/04
P.O. BOX 1504 •� VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: O - lrc13 I natp.
Applicant:
Applicant's Mailing Address:
ArcMect or Engineer:
t
Architect or Engineer's Address:
7 2 -G 7-4 mac- Att-s e n sr
f?gcr►. �yS— 92z 6 v
Lic. No.: tom— / g Z 1 a
BUILDING PERMIT 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 my License is in full force and effect.
License Class License No.
Date Contractor
OWNER -BUILDER DECLARATION
I hereby rffinmm uftdat penalty ur pwjuty lint I am exempt from the L'ontradors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit 10 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 therefr om and the basis for time alleged axemp"n. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty or not more than five hundred dollars ($500).):
U 1, as owner of the property, or my employees wish wages as their sole compensation, will do the work, and the structure is not intended er offered for sale (See. 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or imp roves thereon, and who does the work
himself or herself or through his or her awn 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 cr she did not build or improve for the purpose of sate.).
(� I, as owner of the property, am exciusivety 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 She pmjects with a contradonis) licensed pursuant 10
the Contractors' State License Law.).
U I am exempt under Sec. . BA P.C. for this reason .%� %
Date 5 ! Owner J 'p� 5 vn/ / " i f�l�f�' G�/�liv s L
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the fallowing 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
or 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 worts for which this permit is
issued. My workers' compensation insurance carrier and policy number are:
Carrier Policy Number
rt r>?rtifv that., bn the petr_, ants of ;tic .�oa� ,ter'Wh,iihr'Uris f en1rit is issued, i shaft 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. p
Date I Z �' Applicant 1.iN U a�F fV
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 uncle penalty of ury that there isconstruction lending agency for the performance of the work for which this permit is issued (Sec. 3097, CIv. C.).
Lender's Name p� A;k— % //PLr
Lender's Address G )A,44, NQ(, > W yYJ v NU? f/ff' ��%✓�
IiNPORFANT APPLICANT ACKNOWLEDGEMENT
Appficatien is hereby made to the Director of Building and Safety for a permit subjed 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 perforated under or pursuant to any permit
issued as a result of Ihis application, the owner, and the applicant, each agrees to, and shall, defend, indemnify and hold harmless the City of La Ouinta, ifs
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 d 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 trance don
I certify that I have read this application and state that time above in is corecL I agree to comply with all city and county ordinances and stale laws relating to building
construction,, and hereby authorize representatives of 's county pon the above -mentioned property for inspection purposes.
Dale fr (� Signature (Appl nt or A
Page
2
Application Number
04-00003803
Date
5/12/04
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
17.00
9.0000
EA MECH
FURNACE <=100K
153.00
17.00
9.0000
EA MECH
B/C <=3HP/100K BTU
153.00
2.00
6.5000
EA MECH
VENT FAN
13.00
2.00
6.5000
EA MECH
OTHER MECH EQUIPMENT
13.00
----------------------------------------------------------------------------
Permit . . . .
. .
ELEC-NEW COMMERCIAL
Additional desc
. .
Permit Fee . .
. .
757.70
Plan Check Fee
.00
Issue Date . .
. .
Valuation
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
37135.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
742.70
-----------------------------------------------------------------------------
Permit . . . .
. .
PLUMBING
Additional desc
. .
Permit Fee . .
. .
210.00
Plan Check Fee
.00
Issue Date . .
. .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
5.00
6.0000
EA PLB
FIXTURE
30.00
2.00 15.0000
EA PLB
BUILDING SEWER
30.00
18.00
6.0000
EA PLB
ROOF DRAIN
108.00
2.00
7.5000
EA PLB
WATER HEATER/VENT
15.00
1.00
3.0000
EA PLB
WATER INST/ALT/REP
3.00
1.00
9.0000
EA PLB
LAWN SPRINKLER SYSTEM
9.00
----------------------------------------------------------------------------
Permit . . . .
. .
GRADING PERMIT
Additional desc
. .
Permit Fee . .
. .
15.00
Plan Check Fee
.00
Issue Date . .
. .
Valuation . . . .
0
Qty Unit
Charge
Per
Extension
BASE
FEE
15.00
----------------------------------------------------------------------------
Special Notes and
Comments
COMMERCIAL SHELL
- 37,135
SQ.FT.
2 STORY
"OFFICE SHELL"
TYPE V-N
("B" OCC.
Page 3
Application Number
04-00003803 Date 5/12/04
----------------------------------------------------------------------------
Special Notes and Comments
PROPOSED) WITH FIRE SPRINKLER
& 3 - 60
FOOT YARDS CREDIT FOR ALLOWABLE
AREA.
[2-VN BLDGS & II-N PARKING GARAGE AS ONE
BUILDING ALLOWED PER CBC 601.2
MIXED
TYPE OF CONSTRUCTION][$3661.28
PLN CHK
RETAINER APPLIED TO THIS PERMIT.
NO PLN
CHK BALANCE]PARKING STRUCTURE
IS NOT AN
APPROVED PART OF THIS PERMIT.
----------------------------------------------------------------------------
Other Fees
ART IN PUBLIC PLACES-COM
8958.75
DIF CIVIC CENTER - COMM
2005.29
ENERGY REVIEW FEE
333.55
DIF FIRE PROTECTION-COMM
2153.83
STRONG MOTION (SMI) - COM
377.10
DIF STREET MAINT FAC-COMM
1039.78
DIF TRANSPORTATION - COMM
78577.66
Fee summary Charged
Paid Credited
Due
Permit Fee Total 6461.20
.00 .00
6461.20
Plan Check Total .00
.00 .00
.00
Other Fee Total 93445.96
.00 .00
93445.96
Grand Total 99907.16
.00 .00
99907.16
T4hi 4 4 a"
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
January 31, 2005
To Whom It May Concern:
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
Please be advised of an address change for the following, structure. Effective
immediately, the structure formerly addressed as 78-380 Highway 111, APN:
604-050-048, Par 9, Parcel Map 197/028 PM 29736, is now addressed as:
78-370 Highway 111
This address change affects the following building permits in process or issued
by the.City of La Quinta Building & Safety Department:
04-3803
04-6175
05-68 05-195
04-6013
04-680
05-113 05-258
04-6165
04-7122
05-196
It should also be noted that this parcel, along with assessor's parcels -049, -050
and -051, was part of Parcel Merger 2004-457, recorded on 4/30/04 by the
Riverside County Recorder as instrument number 2004-0319136. It is anticipated
that a new parcel number will be generated by the Riverside County Assessor's
Office in the near future.
Please note this change and contact me directly at (760) 777-7084 if I may be of
further assistance.
Sincerely,
Kay Hensel
Office Assistant
0
I