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05-0540 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 050000.0540__ - 78370 HIGHWAY 111 STE 604-050-048- - REMODEL - COMMERCIAL COMMUNITY COMMERCIAL 7500 T a ,iht °F BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: 185 MADISON PTM LA QUINTA - 71361 SAN GORGONIO RD RANCHO MIRAGE, CA 92270 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. LicenseClass: B C36 /f p s�LicevnseeNo..:/344538 Date: / 3%tel Contractor:''(!.` `:�"�? 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).: (_ 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.). (_ 1 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.). (_ 1 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: LQPERMIT Contractor: RICHEY CONSTRUCTION, BOB 84550 AVENUE 54 COACHELLA, CA 92236 (760)880-0162 Lic. No.: 344538 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/29/05 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 0030200 _ 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, ,Igshall lfforthwith comply with t se provisions. Dateq � Applicant: ,r7 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. 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 purpose . 4 Date: d Signature (ApplicanYor Ag J): r Application Number . . . . . 05-00000540 ~ Structure Information Construction Type . . . . . TYPE V- NON RATED �Occupancy Type . . . . . MERCANTILE Other struct info . . . CODE EDITION 2001 FIRE SPRINKLERS YES MIXED-USE OCCUPANCY M OCCUPANT LOAD 21.00 1ST FLOOR SQUARE FOOTAGE 1176.00 ---------------------------------------------------------------------------- Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 99.00 Plan Check Fee 64.35 Issue Date . . . . 3/14/05 Valuation . . . . 7500 Expiration Date . . 9/10/05 Qty Unit Charge Per Extension BASE FEE 45.00 6.00 9.0000 THOU BLDG 2,001-25,000 54.00 ---------------------------------------------------------------------------- Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 38.52 Plan Check Fee 9.63 Issue Date 3/14/05 Valuation . . . . 0 Expiration Date 9/10/05 Qty Unit Charge Per Extension BASE FEE 15.00 1176.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 23.52 ---------------------------------------------------------------------------- Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 19.50 Plan Check Fee 4.88 Issue Date 3/14/05 Valuation 01 Expiration Date 9/10/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 ---------------------------------------------------------------------------- Special Notes and Comments Commercial Remodel "Gallery One Eleven" TI, "M" Occupancy, Type VN Sprinkled, Occupant Load 21.9-29-05 CHANGE OF CONTRACTOR LQPERMIT - NOV-23-2005 WED 09:49 AM RIVERSIDE COUNTY FIRE Craig E. Anthony Fire Chief. Proudly wing the uruncorporated areas of Riverside County and the Cities of, Banning Beaumont moo, Calimesh Canyon bake .y - Coachella y Desert Hot Springs Indian Wells do Indio - sf Laky Elsinore `R 1.4 Quinta Z Moreno Valley •'o Palm Desert Perris Rancho Mrage 6� San Jacinto. v Temecula I30ard of Suporvisors Bob Buster, District 1 John Tavuglionq District 2 Jeff Stone, . Distrid 3 Roy Wilson, District 4 Marlon Ashley, District 5 FAX NO, 17608637072 P. 01/01 RIVERSIDE COUNTY FIRE DEPARTMENT 210 West San Jacinto Avenue . Perris, Callfomia 92570 . (951) 940 -Woo . Fax (951) 941 6910 November 22, 2005 City Of La Quinta Building Department a Re; Gallery One Eleven Fine Art The Riverside County Fire Department is granting a fire and life safety clearance for the following address 78.370 Hwy 111, suite 185, La Quinta. Please call if you should have any questions. TRACY HOBDAY Battalion Chief / Fire Marshal �E ey Terry DeSoucy Fire Systems inspecto a P.M01 M5 �iV!0F(IACA `I�'AMPICO F-INA�PIC� D@.� IA 92253 BUILDING PERMIT Application Number . . . Property Address . . . . APN: Application description Property Zoning . . . . . Application valuation . . Owner ------------------------ MADISON PTM LA QUINTA 71361 SAN GORGONIO RD RANCHO MIRAGE CA 92270 BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 05=...0.0.0:00544.0 Date 3/11/05 78370 HIGHWAY 111 STE 185 .,604-050-048- - - REMODEL - COMMERCIAL COMMUNITY COMMERCIAL 7500 Contractor ------------------------ PRIMUS CONTRACTING GROUP, INC 1409 SO. 600 WEST, SUITE D BOUNTIFUL UT 84010 WCC: STATE FUND WC: 1705181 10/.01/05 CSLB: 814726 11/30/06 CCC: B -------------------=------ Structure Information --.----------------------- Construction Type . . . . . TYPE.V - NON RATED Occupancy Type . . . . . . MERCANTILE Other struct info . . . . . CODE EDITION 2001 . , FIRE SPRINKLERS YES MIXED-USE OCCUPANCY M OCCUPANT LOAD 21.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 1176.00 Permit BUILDING PERMIT Additional desc Permit Fee . . . . 99.00 Plan Check Fee .64.35 Issue Date . . . . Valuation . . 7500 Qty Unit Charge Per Extension BASE FEE 45.00 6.00 9.0000 --------------------------------------------------------------=------------- THOU BLDG 2,001-25,000 54.00' Permit ELECT - ADD/ALT/REM Additional desc Permit Fee . . . 38.52 Plan Check Fee 9.63 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1176.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 23.52 Permit . . . . . . MECHANICAL Additional desc , Permit Fee . . . . 19.50 Plan Check Fee 4.88 Issue Date Valuation . . . . 0 .IK 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: 05 5 40 Applicant: I Architect or Engineer: Date: 3.14.0,5 Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS WA 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.). W 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. P.C. for this reason ea-te � S 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 suhiect to tha wnrkarc' r,r,mpensation provisions oto ect; on 3700 of the Labor Code, I shall 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 bt 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 Ouinta, 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 to enter upon th above-mentioned property for inspection purposes. to SiSignature (Applicant or Agent): 1 Page 2 Application Number . . . . . 05-00000540 Date 3/11/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 EA MECH VENT.INST/ DUCT ALT 4.50 ----------------------------------------------- SpeQial Notes and Comments ---------------------------- Commercial Remodel "Gallery One Eleven" TI, I'M" -Occupancy, Type VN Sprinkled, .Occupant Load 21 ---------------------------------------------------------------------------- Other Fees .. . . . . . STRONG MOTION (SMI) - COM 1.57 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total' -------------------- 157.02 .00 ---------- .00 ---------- 157.02 Plan Check Total 78.86 .00 .00 78.86 Other Fee Total 1.57 .00 .00 1.57 Grand Total 237.45 .00 .00 237.45 NOV-23-2005 WED 0,9:148 AM RIVERSIDE COUNTY FIRE FAX N0, 17608637072 Craig E. Anthony Fire Chlef Proudly serving the unincorporated areas of Riversidc County and ffiL Cities of,. Bannui6 ,y Beaumont Galimesa A. Canyon Lake Coachella. ti Desert Hot Springs y Indian Wells Indio o� Lake Blsinorc La Quinta Moreno Valley Palin Desert Perris I?jmcho Mirage •'e Sari Jacinto Temecula.. Board of Supervisors Bob Buster, District I John Tavaglione. District 2 RIVERSIDE COUNTY FIRE DEPARTMENT 210 West San Jacinto Avenue • Perris, California 92570 • (951) 940-6900 . Fax (951) 940-6910 November 22, 2005 City Of La Quinta Building Department Re: Gallery One Eleven Fine Art P. 01/01 The Riverside County Fire Department is granting a fire and life safety clearance for the following address 78370 Hwy 111, suite 185 , La Quinta. Please call if you should have any questions. Jeff Stone, District 3 Roy Wilson, District 4. TD/jl Marion Ashloy, District 5 TRACY HOBDAY Battalion Chief / Fire Marshal 1 By Terry DeSoucy Fire Systems Inspecto PREST VUKSIC -- - - ARCHITECTS zi �s 1 : �'`.00Norwle)scF [D.�'"rm.a:dvu Y., ..._.._ .............. ple.,r:w.m..uxloc M n•�. -_� i.: cssu -ss N 3 :., ... � .....:' ,mss, ©am"r P�ro,m .ac, ED I I — s ITE 1558;. _..._. _._...-_. _._..... _. ._. _...._ _ _ ..... _..... OR= su %&o pmoan."u�a . . .. OKURA MERLE '�, RFA DAY SPA ARTGALLERY: COIR STC04E ... r - .... ! SURE 16O'L51mae.Latiaroue'ce0 NORMAN SUI SUrit CREAMER SUITE 1 pmwmwww m"'ue h ITE •uno...axa.n -�,•`.: '.`✓:. �L:-__f_ 1� i � �.�J. � a �±maa:ra�rcr_aesa%' �� T� F„Dv m 1 1 L 9. J .. .. ..,,� I.. ':.,.• .: - - '`•+ L L PROJECT ' L I.• ' C ❑ )' a '-P• i E" WA H P 1 Y' DO1JI A C� RAP' N.W. CORNER OF � \ • HIGHWAY III&.WASHINGTON ST. O}�. " LAQUINTA CA 92253 (: i i ' • ' J j Ly „ (SHELL BUILDING ONLY) S ;a FIRST FLOORILDING `a -ONE A OONOTENTER30 104 0 SCALED -1'.V 9 INSiROgBpR W DOiVICE • .m.rfreaGprq aF:.:ld.W , j �r4�R.IFCN Ido YNOf1P.T ___ �_�— . __. __ ' d'•A� �y/W��' ♦� d SI J)1 :de.w vK —_ Gve 1 mow. n FIRST FLOOR BUILDING "B" ,tea �.ao...•e«..-. '----..—...._._..__-___._._._—...__ - .. y--;.-". .. F..a:ma..." :.+wo. Qo.on wnk.. e.o "c..ae+_.. sLVE us• -+•a ,I i �- ��• Certefica to of Occupancyo �' y�''r� [vcou•:ero Building & Safety. Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at 'the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS- 78370 HWY 111 SUITE 185 Use classification: COMM Building Permit No.: 05-540 Occupancy Group: M Type of Construction: VN Land Use Zone: CC Owner of Building: MADISON PTM Address: 78370 HWY 111 City, ST, ZIP: LA QUINTA CA 92253 By: KIRK KIRKLAND �d''j-L Date: 11-22-2005 Building Official POST IN A CONSPICUOUS PLACE