13-0810 (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:
13-00000810
78400 HIGHWAY 111
604 -050 -045 -
REMODEL - COMMERCIAL
COMMUNITY COMMERCIAL
40000
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
------------------
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: C10 , A, B, C3 License No.: 550747
Date" 3 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).:
( ) 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.).
( ) 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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERAI IT
Owner:
BANK OF AMERICA
275 VALENCIA
BREA, CA 92823
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/26/13
Contractor: 4,113 U
EVANS & SON INC Au-
,1-
25815 SPRINGBROOK AVENUE- .i � j 2013
SANTA CLARITA, CA 91350
(661)254-8787 CITY OF LAQUINTA I
Lic. No.: 550747 �--- ^fAlA�f�`FnFQr
----------------------------------------------—
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.
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 TRVL PROPTY• Policy Number DTJUB9B13644813
_ 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 -Cod I shall forthwith, mply with those provisions:
sir
Date Z 1-1-3
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.
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 i
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned proper for inspection puposes.
Date:.''LiaJ lam' Signature (Applicant or Agent) ,
LQPERMIT
Application Number . . . . ...13-00000810
f
Permit . . . REMODEL 2013
Additional desc .
Permit Fee . . . . 91.52 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 0
Expiration Date 2/22/14
Qty Unit Charge Per
Extension
1.00 48.6200 LS MISC REMODEL, 1ST 100
SF
48.62
2.00 21.4500 EA MISC REMODEL, ADDL 500
SF
42.90
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Special Notes and Comments
INSTALLATION OF SECURITY GLASS IN TELLER
AREA.PER 2010 CALIF BUILDING CODES.
July 19, 2013 9:26:37 AM jjohnson.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
HOURLY PLAN CHECK
105.00
PLAN CHECK, REMODEL
167.31
STRONG MOTION (SMI)
- COM
8.40
Fee summary Charged Paid Credited I IDue
------------------------------
---------------------------
Permit Fee Total 91.52 .00
.00
91.52
Plan Check Total .00 .00
.00
.00
Other Fee Total 282.71 .00
.00
282.71
Grand Total 374.23 .00
.00
374.23
Bin. #
City of La Quints
Building u Safe Division
ty
P.O. Box 1504,78-495 Calle Tampico
1-a.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
l3- 4
Project Address:
Owner's Name:.
A. P. Number:
Address: %S 11,41mr,, i /4G
Legal Description:
City, ST, Zip:
Contractor: �>
Telephone ad
Address:
Project Description:
City, ST, Zip:
Telephone:;
��
mi �k�I.-
M.State
i/7 VCtioe
Lie. #:
City Lie'//. #;jJ/j�
Arch., Engr., Designer /7�t!Ailr6
Address:
City., ST. Zip: TA *i4
Telephone: y-�1�•/fy/UU� Y Construction Type: , Occupancy:
State Lic. #: `"
Pte -G s% ;�';�;:� Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: *loo We S/r% Sq. t.: /QUO # Stories: #Units:
Telephone # of Contact Pe on: /Q -!7W - Es ' ated Value of Project: jQ y,4 Q�/0
APPLICA RITE BELOW THIS LINE
# Submittal Req'd Recd TRACMG PERMIT FEES
Pian Sets
Plan Check submitted. 7 Item Amount
Structural Cales.
Reviewed, ready for corrections Plan Check Deposit, .
Truss Calcs•
Called Contact Person Pian Check Balance
Tide 24 Calcs.
Plans picked up Construction
Flood plain plan
Pians resubmitted.. hanica C" AJT-
Grading plan
2`! Review, ready for correctionsfisswe Flectrlcal N A
Subcontactor List
Called Contact Person Plumb g V
Grant Deed
Plans picked up
H.O.A. Approval
Plans resubmitted Gradin p
IN HOUSE:-
'^' Review,' ready for correctisRssne !� Develop pact Fee
Called Contact Person 7�1�I3 A.I.P.P.
Date of permit issue
Planning Approval
Pub. Wks. Appr
School Fees
fin
Total Permit Fees
01) Y.
�'�T�1.TnfF -� •Y I I�ArlA�1
CM ®F� L.QW:ANTA �'
DEVELOPMENT
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Building & Safety Department i
78-495 Calle Tampico
PO Box 1504
La Quinta, CA 92253
(760) 777-7012 voice — (760) 777-7011 fax
To: Greg Butler, Building Official
From: Les Johnson, CDD Director
Permit # - 13-0810
/3
To PD:
Due date: ASAP
Status: ,1 s� t Review
Building Plans Approval
(This is an approval to issue a Building Permit)
The Planning Division has reviewed the Building Plans for the following project:
Description: Installation of security glass in teller area
Address or general location: 78-400 Highway 111
Applicant Contact: Jacob Webster (310)702-7857
The Planning Division finds that:
❑ ...these Building Plans do not require Planning Division approval.
I& ...these Building Plans are approved by the Planning Division.
❑ ....these Building Plans require corrections. Please forward a copy of the
attached corrections to the applicant. When the corrections are made
ease return the to the Planning Division for review.
Le's,iohn'sk\,q�mnlunity Development Director Date
Note: PLEASE RETURN PLANS WITH GREENSHEET TO THE BUILDING
DIVISION.