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04-6601 (RC)LV BUILDING PERMIT Application Number 04-0000660, Date 1/14/05 Property Address . . . . . . .8 72 IGHWAY 111 APN: 643-080-037-13 -000000- Application description . . . REMODEL.- COMMERCIAL Property Zoning . ... . . . . REGIONAL COMMERCIAL Application valuation 44000 Owner Contractor, --------------------------------- -------------- ,� ONE ELEVEN LA QUINTA --- CONSOLIDATEW CONTRACTING, INC. C/O SABBY JONATHAN 46753 ADAMS STREET 42620 CAROLINE CT STE 102 LA QUINTA, CA 92253 PALM.DESERT, CA 92211 " (760)324-5488 WCC: STATE FUND WC: 1770749-2005 01/01/06 CSLB: 824183. 09/30/05 CCC: B -C8 f w v P.O. BOX 1504 78-495 CALLS TAMPICO VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: ani -1"4t / Applicant: Applicant's Mailing Address: Architect or Engineer: Dater— /V''S2Cil 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 m Lice s is in full r and effect. �eAse Efass L�icens 't3o OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the ontractors' 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, d molish, 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 tpe 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 he 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 dolls ($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 Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ 1 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 `z-i1d. _fM*wp�' comoensatlnn-i agwnnry --;., ..A —1;-, -.... -- _-_. _ i cemry rnar, in in* performance of the work for which this permit is issued, 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. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION OVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10 000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORN Y'S FEES. C NSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction len ng 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, indemnity 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 county to enter upon the above-mentioned oronertv fnr Incnorfionpurposes. -----------------------------------'----------------------------------------- �;kpplication Number . . . . X04-0.000'6601 Y---------------- =--------------- --------------------------------------------- -------------------------- Structure Information ------------------------- Construction Type TYPE V - NON RATED Occupancy Type ASSY BLDG <300 NO STAGE Flood Zone . . . . . NON -AO FLOOD ZONE Other struct info .. . . . . CODE EDITION 2001 FIRE SPRINKLERS YES MIXED-USE OCCUPANCY A -3/F -1/S-2 OCCUPANT LOAD 208.00 1ST FLOOR SQUARE FOOTAGE 5918.00 ---------------------------------------------------------------------------- Permit . . . . . . .BUILDING:.PERMIT Additional desc Permit Fee 375.50 Plan Check Fee 244.08 Issue Date . . . a.. Valuation . . . . 44000 Qty Unit Charge Per Extension BASE FEE 252.00 19.00 6.5000 THOU BLDG 25,001-50,000 123.50 ---------------------------------------------------------------------------- Permit MECHANICAL Additional desc Permit Fee . . . . 33.00 Issue Date . . . . Plan Check Fee . . 8.25 Valuation . . . . 0 Qty -Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU ---------------------------------------------------------------------------- 9.00 Special Notes and Comments REVISIONS TO PREVIOUSLY PERMITTED RESTAURANT BUILDING(04-5055)MECHANICAL PERMIT INCLUDED WITH THIS APPLICATION. nO CHANGE IN BUILDING AREA. A-3 OCC. TYPE V -N CONSTRUCTION 2001 CODES. **PLANS TO THIS PERMIT SUPERCEDE PREVIOUSLY APPROVED SET. ** ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STRONG"MOTION (SMI) - COM 9.24 Fee summary Charged Paid Credited ----------------- Due ---------------------------------------- Permit Fee Total 408.50 .00 .00 408.50 Plan Check Total 252.33 .00 .00 252.33 Other Fee Total 9.24 .00 .00 9.24 Grand Total 670.07 .00 .00 670.07 YOUNG ENGINEERING SERVICES • Engineering •Architecture•Surveying• Building & Safety Services Letter of Transmittal To: CITY OF LA QUINTA Date: 10/21/2004 Project. 78-772 HWY 111 ASAP PC Atm: ED PC#: 04-6601 (1 SUBMITTAL) Tel No.: (760) 777-7012 Tract No.: We are forwarding: X By Messenger By Mail Your Pickup No. of Copies Description: 1 REVISED PLANS 1 STRUCT 1 APPROVED PLANS Comments: APPROVABLE THANK YOU This Material Sent for: Your Files X Your Review Checking Other By: ERIC FRENZEL Phone # (760) 360-5770 EXT. 104 Per Your Request Approval At the request of - 77 -804 Wildcat Drive, Suite C, Palm Desert, CA 92211 (760) 360-5770 Bronz Young