06-3416 (RC)P.O. BOX 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
�- Application Number:
06-00003416
-78720-
Property Address:
HIGHWAY 111
APN:
643-220-024-4 -000000-
Application description:
REMODEL - COMMERCIAL
Property Zoning:
MEDIUM DENSITY RES
Application valuation:
100000
A ....i:,.......
Architect or Engineer:
4' Q".
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
V -r
-- - - - - - - - - - - ---------------------- ----- - - - - -- -
LICENSED CONTRACTOR'S DECLARATION
I ice hereby affirm under penalty of perjury that I am ld under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Pr as ionals Code, and my License is in full force and effect.
Lice j 3�l11ass: B CS i License No.: 824183
Date: I Vl ontractor:
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 ISec. 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 _ 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 ownerof
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
Owner:
ONE ELEVEN LA QUINTA
C/O SABBY JONATHAN
42620 CAROLINE CT STE 102'
PALM DESERT, CA 92211
Contractor: • I D
CONSOLIDATED CONTRACTIN
46753 ADAMS STREET
LA QUINTA, CA 92253
(760)771-3345
Lic. No.: 824183
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/17/06
e
NCOCT3 p 2006
CIS OF LA AUINTA
-------------------
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.
X,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 1770749
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 beco a subject to the workers' compensation laws of California,
and agree that, if I should becom sub ct to the the
compensation provisions of Section
3700 of the Labor de, I shall orthwi h comply with those provisions.
ate: I b Ap a
WARNING: FAI E TO SECU KERS�CO ENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENAL 1E 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 info ion is correct. I agree to comply with all
city and cou ordinances ands a laws relating to building const trio ,and hereby authorize representatives
of this c ty t enter upon above-mentioned prop f rins ti
urposes.
e: s r�� 'nature (Applicant or Agent):
LQPERAIIT
Application Number . . . . . 06-00003416
------ Structure Information STORAGE RACKS / FIXTURES.
=-----
Other struct info
. . . . . CODE EDITION
2001C8C
FIRE SPRINKLERS
YES
MIXED-USE OCCUPANCY
M
OCCUPANT LOAD
.00
1ST FLOOR SQUARE FOOTAGE
.00
2ND FLOOR SQUARE FOOTAGE
.00
Permit . .
. BUILDING PERMIT
Additional desc
STORAGE.RACKS AND FIXTURES
Permit Fee
639.50 Plan Check Fee
415.68
Issue Date
Valuation . .
. . 10000,0
Expiration Date
4/15/07
Qty Unit Charge Per
Extension
BASE FEE
414.50
50.00 4.5000 THOU BLDG 50,001-100,000
225.00
-------------------------------------
Special Notes and
---------------------------------------
Comments
STORAGE RACKS AND
FIXTURES TO "PETCO"
STORE.2001 CBC.
------------------ -------------------
Other Fees . . .
-- -
. . . . . . STRONG MOTION (SMI) COM 21.00
Fee summary
-----------------
Charged Paid Credited _
-------------------------------
Due
----------
Permit Fee Total
639.50 .00 .00
639.50
Plan Check Total
415.68 .00 .00
415.68
Other Fee Total
21.00 .00 .00
21.00
Grand Total
1076.18 .00 .00
1076.18
LQPERAIIT
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State Lic. # :;qz
City Lic. #:7V1
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Permit# 6
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Project Address;
A P. Number: �.
Legal Description:Y*
Contractor: /)
Address: - 53
City, ST, Zip: ,
- -----
City of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
wner's Name:
-• O 2 Address: r�
JAM
ty, ST, Zip:
u 22
Telephone: — 4'
Project Description:
ZZS� / CT
Telephone:-77/—Wr
State Lic. # :;qz
City Lic. #:7V1
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
P cY=
Project type (circle one): New • Add'n Alter. Repair Demo
Name of Contact Person:na
Sq. Ft :
#Stories:
#Units:
Telephone # of Contact Person:
✓
Estimated value of Project: Q O r. -
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal. >t
Req'd
Rec'
TRACIONG .
PERMIT FEES
2,
Plan Se
_
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Energy Cates.
Plans picked up
Construction
Flood plain pian
Plans resubmitted
Mechanical
Grading plan'
2" Review, ready for correctio Issue
Electrical
Subcontactor list
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
ILO A. Approval
Plans resubmitted.
Grading
IN HOUSE:-
'`d Review, ready for correclionsfissue
Developer Impact Fee .
Planning Approval
Called Contact Person
A.I I'.P.
Pub. Wks. ApprDate
of permit issue
School Fees
, `�y�I�-v1^ I �`�' R0QZ F : l o 104- l .l n
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09/18%2906 10:34 7603605719 YOUNG ENGINEERING SE PAGE 02
YOUNG ENGINEERING_ SERVICES
77804 Wildcat Dr., Palm Desert. G1.92211 (760) 360.5770 (760) 360.9719
September 18, 2006
Tom Hartung
Building Official
City of La Ouinta
Res Petco Anirjtad Supplies, Inc.. One Rleven La Ouinta Center. La Ouinta, CA
Dear Tom,
We have performed structural observation with regards to the framing for the above referenced project
and find it. to be in general conformance with the approved structural plans with the exception of the
following:
1. Entry canopy framing work was incomplete at the time of Structural Observation.
This structural observation docs not relieve the City in any way from performing their standard structural
inspections nor is it in lieu of any code required special inspections_ The structural observation
performed should not be construed as a detailed structural inspection but as a structural obsetvati.on for
general conformance as per CBC 1702.220.
If you have any questions please call.
Sincerely,
Jeffrey B. Young S.E.
_U) 7r
lD T
5E 4044 r77
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