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BCOM2014-1005- r„ 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BCOM2014-1005 Property Address: 78742 HIGHWAY 111 APN: 643220016 Application Description: ICE CREAM SHOP TES Property Zoning: Application Valuation: $65,000.00 Applicant: PLATINUM X CONSTRUCTION CORP 20611 CANADA RAOD. LAKE FOREST, CA 92630 C 0 D VOICE (760) 777-7125 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 8/26/2014 Owner: FANP 4 LA QUINTA 78060 CALLE ESTADO EME,[VT�O+A LA QUINTA, CA 92253 2 b 1714 0QUINTA COMMUNITY DEVNT ELOPMENT DEPARTME 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 Professions Code, and my License is in full force and effect. License Class: License No.: 982426 Date: O I Contract OWNER -BUILDER DECLARA ION 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.). (_) 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 cotracts 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 (Sec. 3097, Civ. C.). 'Lender's Na Lender's Add Contractor: PLATINUM X CONSTRUCTION CORP 20611 CANADA RAOD LAKE FOREST, CA 92630 (949)422-9740 Llc. No.: 982426 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:_ 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: 2Yi Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATI N 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 Building Official 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 city to enter upon mentioned property for inspection purposes. Date: Signature (Applicant or Agen FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $3.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $3.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NON-RESIDENTIAL, FIRST 2,000SF 101-0000-42403 0 $107.25 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NON-RESIDENTIAL, FIRST 2,000SF, PC 101-0000-42600 0 $82.94 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL - NEW CONSTRUCTION: $190.19 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE APPLIANCE REPAIR/ALTERATION 101-0000-42402 0 $11.92 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE APPLIANCE REPAIR/ALTERATION PC 101-0000-42600 0 $4.77 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN 101-0000-42402 0 $11.92 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT . QTY AMOUNT PAID PAID DATE VENT FAN PC 101-0000-42600 0 $4.77 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for MECHANICAL: $33.38 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP 101-0000-42401 0 $95.36 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP PC 101-0000-42600 0 $95.36 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $11.92 $0.00 -PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION . ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $11.92 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $214.56 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE REMODEL, EA ADDITIONAL 500 SF 101-0000-42400 0 $64.35 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE REMODEL, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $51.48 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE REMODEL, FIRST 100 SF 101-0000-42400 0 $48.62 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE REMODEL, FIRST 500 SF PC 101-0000-42600 0 $132.99 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for REMODEL: $297.44 $0.00 DESCRIPTION ACCOUNT. QTY AMOUNT PAID PAID DATE SMI - COMMERCIAL 101-0000-20308 0 $13.65 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $13.65 $0.00 TOTALS:$0.00 Permit Details PERMIT NUMBER City of La Quinta BCOM:20-rMl 05 t Description: ICE CREAM SHOP TENANT IMPROVEMENT CONDITIONS Type: BUILDING, COMMERCIAL Subtype: REMODEL Status: ISSUED Applied: 7/11/2014 KHE Approved: 8/26/2014 PJU Parcel No: 643220016 Site Address: 78742 HIGHWAY 111 LA QUINTA,CA 92253 Subdivision: PM 25865 Block: Lot: 15 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $65,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: TENANT IMPROVEMENT OF EXISTING SHELL BLDG TO RITA'S ICE CUSTARD. CONDITIONS: NO INSPECTIONS UNTIL FIRE DEPT. - APPROVAL IS SUBMMITED TO BUILDING DIV. PLATINUM X CONSTRUCTION CORP 20611 CANADA RAOD LAKE FOREST CA CHRONOLOGY CONDITIONS PHONE FAX EMAIL NAME TYPE NAME ADDRESSI CONTACTS CITY STATE ZIP APPLICANT PLATINUM X CONSTRUCTION CORP 20611 CANADA RAOD LAKE FOREST CA 92630 (949)422-9740 CONTRACTOR PLATINUM X CONSTRUCTION CORP 20611 CANADA RAOD LAKE FOREST CA 92630 (949)422-9740 OWNER P 4 LA QUINTA 78060 CALLE ESTADO LA QUINTA CA 92253 (949)422-9740 DESCRIPTION I ACCOUNT I QTY I AMOUNT PAID I PAID DATE I RECEIPT # I CHECK # I METHOD BSAS SB1473 FEE 1 101-0000-20306 1 0 $3.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $3.00 $0.00 BSA: PAID BY I CLTD BY BY Printed: Tuesday, August 26, 201411:40:09 AM 1 of 3 CRW",". , Permit Details PERMIT NUMBER City of La Quinta BCOM201�4=1`005Al DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT# CHECK # METHOD PAID BY CLTD BY NON-RESIDENTIAL, 101-0000-42403 0 $107.25 $0.00 FIRST 2,000SF NON-RESIDENTIAL, 101-0000-426000 $82.94 $0.00 FIRST 2,000SF, PC Total Paid forELECTRICAL- NEW CONSTRUCTION: $190.19 $0.00 APPLIANCE 101-0000-42402 0 $11.92 $0.00 REPAIR/ALTERATION APPLIANCE 101-0000-42600 0 $4.77 $0.00 REPAIR/ALTERATION PC VENT FAN 101-0000-42402 0 $11.92 $0.00 VENT FAN PC 101-0000-42600 0 $4.77 $0.00 Total Paid for MECHANICAL: $33.38 $0.00 FIXTURE/TRAP 101-0000-42401 0 $95.36 $0.00 FIXTURE/TRAP PC 101-0000-42600 0 $95.36 $0.00 WATER SYSTEM 101-0000-42401 0 $11.92 $0.00 INST/ALT/REP WATER SYSTEM 101-0000-42600 0 $11.92 $0.00 INST/ALT/REP PC Total Paid for PLUMBING FEES: $214.56 $0.00 REMODEL, EA 101-0000-42400 0 $64.35 $0.00 ADDITIONAL 500 SF REMODEL, 101-0000-42600 0 $51.48 $0.00 ADDITIONAL 5000 SF PC REMODEL, FIRST 100 SF 101-0000-42400 0 $48.62 $0.00 REMODEL, FIRST 500 SF 101-0000-42600 0 $132.99 $0.00 PC Total Paid for REMODEL: $297.44 $0.00 Printed: Tuesday, August 26, 201411:40:09 AM 2 of 3 CPCYC7FMC DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY SMI - COMMERCIAL 101-0000-20308 0 $13.65 $0.00 Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $13.65 $0.00 BOND REVIEWS ATTACHMENTS RETURNED STATUS REMARKS REVIEW TYPE REVIEWER SENT DATE DUE DATE NOTES DATE DAVID 7/11/2014 7/21/2014 APPROVED PLANNING 17/11/2014 SAWYER FIRE FIRE BUCKET 8/16/2014 8/29/2014 HEALTH NS REVIEWER 8/16/2014 9/8/2014 NON STRUC APPROVED 8/18/2014 PENDING NON-STRUCTURAL JIM JOHNSON 8/16/2014 8/18/2014 APPROVED OTHER DEPTS. BOND INFORMATION ATTACHMENTS Printed: Tuesday, August 26, 2014 11:40:09 AM 3 of 3 CRWVI�V:ml Bin # Qty of La Q uln to .. LL t Building 8i: Safety Division OW` P.O. Box 1504, 78-495 Calle Tampico. Permit # ��K dJ— �ALa Qulnta,. CA 92253 - (760) 777-7012. Building Permit Application and Tracking Sheet Project Address: 7% 7 CGi Iiflnia III, (GC�u� dry/ 2 3 ''41 91,M.1: 7us�: ei A. P. Number: 56c— R Address: Legal, Description: Ci'ST Zip: P= Contractor: Mont N64 Telephoner G6rJ% &u 66�5 pR.o t-4– Pt &)DV— Address: 20 611 60 n (A A I Project Description: City, ST, Zip: - 'Lafte lafaf C',' g263© TOOT -1 foV 1 t alake E Telephone: ON2 Q— ,_'�O :.: :.:...:...:. t - State Lic. 4: City Lie. #; - Arch., Engr, esi`�gn : NApte p ppHoot6iV) Address: 14262 6dV P p City., ST, Zip: Yjlrfthe s G9 qUo 4 Telephone:. r 1 State Lic. #:::%:� ::~<;;.:r::»';::.;.;: >i:;> `.r:. �e an Construction Type� cy- �o � G RC3 Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Hootavl flol"C ,n, t Sq. Ft.: 1374 /.F I # Stories:0he mw # Units: Telephone #,of Contact Person: (1(0) 3$(— tj 3 Estimated Value of Project: 6 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets 7 Plan Check submitted % Item - Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs: Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'd Review, ready for correctioissue O Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN ROUSE:- 3" Review, ready for corrections/issue Developer Impact Fee ' Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appt Date of permit issue School Fees Total Permit Fees J 140 �ri8 f�PRot PcYuo 6A¢i �- I RIr .cam w � 514 + C)�5IJ Pct W*k) ' G6rJ% &u 66�5 pR.o t-4– Pt &)DV— DEPARTMENT ENVIRONMENTAL. -FOOD ESTABLISH PLAN APPROVAL NOTICE Slat# 31533 7/24114 Project Name Rita ;s Ice Cream Address 78742.1f y 111, La fluinta Plans Submiftpd by 1.toofad lfamedani Phoric 714-381-8135 Owner Justilt. Siegel Phone .85.8-380-684l Thc'plans are.`now"'iippi•iived s64jeef to.the oaditions listed belojv.attd the aitac.hcd compliance sheet: 1: Providi grease. interceptor (,�vaiver)approval letter from CV WD se% er agency. 2: I'hc srtceEe.ward' proteCtiorl w1:11 be evaluated onsite. 3. No insta _hot hot water heater in restroom, the hi,t water must come from the main hof water heater_ Note:.This facility it approved �N ith 2.6 linear :feef of back up, d.ry storage shelving (using 24 inept wide shelinv)AF there is.a c_ hange. in..the menu or an -inspector finds items stored on floor then :additional. shelving may be required. C4INT81 ZUCTION INSPI CPIONS: Contact the Pian Checker for a. Preliminary Inspect ou- when construction is approximately 80% complete, with plumbing; rough ventilation. and rough equipment. installed—Request for inspection Should be made at least five (5) working �3ays'in;adva.nce. A FiNAL INSPH CTI:ON WIST be made ul)o.n completion of Al.,l.; work including finished details_ APPROVAL to operate shall not`be granted, or; remodeled areas approvedto operate, until the facility has passed the 1'INA.1. iNSPPCTIO.NT, and "AP .LFC/1'i'iON TOOPI IiA'[`F.." l as been e�m l�t`a f�a I:RrVtl'1' FFF,S.have.been.paid. i2ecluest for inspection stlaulii be m:i& at I4arC.fi,ve {5) i�'orlcing days in advance.. PLANS (1-41acKED`BY Tracey Ford, F'.14S III Rhone (760) 863-8287 I acknowledge the correction% noted herein aiul as indicated on tile. playas and agree to ain corporate the)1t: during construction; Sinait L)ateXj,�``i Gciti)pany Name y k r .A r_A DFHI SAN -178 (Rev 2/06) Corona 2275 5, tvtaitySt S u ite,204 (951)2,7379140 Fax (9.51) 520-8319 Bernd .806 S. Sanderson (951) 766-282.4 Fax• (951) 766- 7874 Indio 47-950 Arabia St «A.: (760) 863 8287 Fax (760) 86.1- 183.03 Murrieta 38740 Sky Canyon Dr (95 1) 461-028- Fax (951) 46.1-()245 Department Web Site — Www:rivcoeh.org Palm Springs Aiverside 554 S_ Paseo Dorotea 4065 County (760) 320-1045, Cir. Fax (760) 320-14-70 (951) 358-5172. rax (951) 358- 5017