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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