05-1065 (SOTB)mni
BUILDING & SAFETY DEPARTMENT
M0.94128051s
(760),777-7012
�8-495 T MPico F QUI FAX (760) 777-7011
IF, IFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . C70-5--000-01-06-5_> Date 4/28/05
Property Address . . . . 78772 HIGHWAY 111
APN: 643-080-037-13 -000000-
Application-description'.
000000=Application description. STRUCTURES OTHER THAN BUILDINGS
Property.Zoning . . . . . . REGIONAL COMMERCIAL
Application valuation . . . . 9000
Owner Contractor k.
------------------------------------------------------- --------------
ONE-ELEVEN
----- ---ONE ELEVEN LA QUINTA CONSOLIDATED 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 Oi/01/06 '
CSLB: 824183 09/30/05
CCC: B -C8 ~t..
-------------------------------------------------
7 ---------------------------
Application Number . . . . . 05-00001065
----------------------------------------=----------------------------"-------
Permit _,.• . . . BUILDING PERMIT
Additional desc
Permit Fee . . . . 108.00
Plan Check
Fee
70.20
Issue Date . . . .
Valuation
9000
Expiration Date 10/25/05
'
Qty Unit Charge Per
Extension
BASE FEE
45.00
7.00 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
'}''
63:00
Special Notes and Comments
COMMERCIAL -DECORATIVE GRAIN SILO - 9'
DIA X 19.5 FT HEIGHT. TYPE V -N
CONSTRUCTION, 2001 CODES. **SPECIAL
INSPECTION FOR 3000 PSI CONCRETE
REQUIRED**
----------- -----------------------------------------------------------------
Other Fees . . . . . . . . . HOURLY
PLAN CHECK
105.00
STRONG
MOTION (SMI)
= COM
1.89
Fee summary Charged Paid
---------------=-
Credited
Due
--------------------
Permit Fee Total 108.00
----------
.00
----------
.00
108.00
Plan Check Total 70.2.0
.00
.00
70.20 -
Other Fee Total 106.89
.00
. Q.0'
106.89
Grand Total 285.09
.00,
.00
285.09
P.O. 1504
78-4955 C
{�/ VOICE (760) 777-7012
CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 T4hf Ot INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Date: S'�—
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
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,
* a is in�fu)) farce and effect.
license^CI'' ss W A, 1 icense No.
at �:� 66
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, definolish, 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 le 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 fora 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.).
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:
_ 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
ued. My 1ers'',CQmpensation insurance carciej andpoticy r�ur c are:
Carrjer G 'y pi / iPOlirv:N,amhoc_ L
ertify that, id the performance of the wo or w ich 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.
ftlicant_
WARNING: FAILURE TO SECURE 0
CIVIL FINES UP TO ONE HUNDRED TI
SECTION 3706 OF THE LABOR CODE,
2KERS' COMPENSATI N COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
Ot1SAND DOLLARS ($00,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
INTEREST, AND ATTO NEY'S FEES.
1 CONSTRUCTION LENDING AGENCY
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.).
Lenders Name
Lenders 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, 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.
1 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 purposes.
D'pfe'ti` F'' Fl7 Signa ua Applicant or Agent):
YOUNG ENGINEERING SERVICES
•Engineering •Architecture•Surveying- Building & Safety Services
Letter ofTransmittal
To: CITY OF LA QUINTA Date: 04-27-05
Project: 78-772 HWY 111
Attn: ED RANDALL PC#; 05-1065
Tel No.: (760) 777-7012 Tract No.:
We are forwarding: X By Messenger. By Mail Your Pickup
No. of Copies Description:
1 PLANS
1 STRUCT
1 SOILS REPORT
Comments: STRUCTURAL CONTENTS ARE APPROVABLE.
k
THANK YOU
This Material Sent for:
Your Files Per Your Request
Your. Review X Approval
Checking At the request of:
Other
By: NALIN K. PACHUNURI
Phone # (760) 360-5770 EXT. 108
77-804 Wildcat Drive, Suite C, Palm Desert, CA 92211 (760) 360-5770
Bronz Young
• ul�cv
P.O. BOX 1504 BUILDING & SAFETY DEPARTMENT
78-495 CALLE TAMPICO (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
To: Greg Butler, Building & Safety Manager To CDD: 03/25/05
From: Doug Evans, Planning Director Due date: 04/08/05
Status:
Building Plans Approval
(This is an approval to issue a Building Permit)
The Community Development Department has reviewed the Building Plans for the
following project:
Description: NON-FUNCTIONAL GRAIN SILO
Address or general location: 78-772 HIGHWAY 111 (LAMPPOST PIZZA)
Applicant Contact:
The Community Development Department finds that:
❑ ...these Building Plans do not require Community Development Department =�
approval.
these Building Plans are approved by the Community Development
Department.
❑ ...these Building Plans require corrections. Please forward a copy of the attached
corrections to the applicant. When the corrections are made please return them to
the Community Development Department for review.
Doug Evans, Planning Director
f5,
Date