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04-6846 (RC)� l Z BUILDING & SAFETY DEPARTMENT 1504 LE TAMPICOU - , (760),777-7012 A%%95 FAX (760) 777-7011 A TA CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 c f- 0"I BUILDING PERMIT :f M. Application Nuinber� 04_-0.0.0_0_6-8,4�V Date 4/27/05 Property Address . . . . . 78865 HIGHWAY 111 APN: 643-020-022- - -. Application description.. . . REMODEL - COMMERCIAL Property Zoning . . . . . REGIONAL COMMERCIAL Application valuation 28000 Owner Contractor Lowe's H.I.W. Inc. NORTHWEST COMMERCIAL INC 1530 Faraday Ave, Suite 140 3635 SO. LAWRENCE, SUITE G CARLSBAD, CA 92008 TACOMA, WA 98409 WCC: STATE FUND WC: 1519636 09/01/05 CSLB: 741623 10/31/05 CCC: B HIC 1 t s P.O. BOX 1504/C�� 78-495 CALLE TAMPICO �I VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 Taf4FAX (760) 777-7011 INSPECTIONS (760) 777.7153 BUILDING & SAFETY DEPARTMENT Application Number: D 4io Date:.. 4 -al -os Applicant: I Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: tSUILUING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under rovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Liyprrtse in fu))j force and effect. icense Class_ ` •.--t i' ('" / License No. �� %I Date L Q� tractor /(,"/11A 5 cc W OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 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 for a 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 WO KCRS' w',--12 3AT;OW 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. ave and will maintain w ers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is shed- y wo ers' co nsation in ce carrier and policy u bet re: artier �t olicy Number �_tPf' 32 I certify that, in the pe ormance of he 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 Califomi , alnd 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 pro isEns. / / ate t% —Applicant WARNING: FAILURE TO SECURE WOR4�E TION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THLLARS (s100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 Lenders Address A 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 canc ation. I certify that I have read this application and state that the above into tion is correct. I pree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize rep,tAsentatives of this county to nt r upo the ov -mentioned property for inspection purposes. ate Lh 6C ignature (Applicant or Agent): ---------------------------------------------------------------------------- M ;.Application Number "04�-00006846 --------------------------------------------------------------------------- ------ Structure Information STORE FRONT CANOPY CART STORAGE ----- Construction Type .'. . . . TYPE V - NON RATED ..Occupancy Type . . . . . . LOW HAZARD STORAGE Other struct info . . . . ...CODE EDITION 2001 FIRE SPRINKLERS NO MIXED-USE OCCUPANCY S2 OCCUPANT LOAD 1.00 1ST FLOOR SQUARE FOOTAGE 185.00 ------------------------------------=--------------------------------------- Permit Additional desc . . Permit Fee . . . . Issue Date . . . . Expiration Date . . BUILDING PERMIT 271.50 10/24/05 Plan Check Fee . . 176.48 Valuation . . . . 28000 Qty Unit Charge Per Extension BASE FEE 252.00 3.00 6.5000 THOU BLDG'25,001-50,000 19.50 -------------------------------------------=--------- Special Notes and Comments -- ------- -------------- Store front canopy cart storage. ---------------------------------------------------------------------------- Other Fees . . . . . . .,. . STRONG MOTION (SMI) - COM 5.88 Fee summary Charged -- Paid Credited Due ------------------------------------- Permit Fee Total. 271.50 ---------- .00 ---------- .00 271.50 Plan Check Total 176.48 .00 .00 176.48 Other Fee Total 5.88 .00 .00 5.88 Grand Total 453.86 .00 .00 453.86 n `# Permit # q/O(,I 6,� fes/ Chi /Vo,�� —CAdF,�-� City of La Quinta Building ar Safety Division P.O. Box 1504, 78-495 Calle Tampico 1-a Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet A Project Address: ?$. 8`5' HwY W Ow•ner'sName: L6ylE'S N ! W /nC A. P. Number: .'� Address: 1530 FARAt>Ay AVE Legal Description: City, ST, Zip: CA�f3q.D, CA 9 Zoog X Contractor, Ta 13E-1-ERN•IrvED XTelephone: 740- 804-5300 x Address: 11Proiecl Description: JC City, ST, Zip: UNC- aS W6, A ?og:TlatJ of THE F_)CIM A I--iZaur Telephone:_ - (Tu ►`^ATH AeJ) t=s(t State Lie. # : City tic. #: THE PvprKrE of cPrx SIAVAp. Arch., Engr., Designer. Aizo� J. H A•• Address: 6706 A•tvtlfc,E}'PLAZA . S.vi-rE 300 City, ST. Zip: M ERt:•IAAVA K5 . 66 Z 0 f - Telephone: 913- �2 - 9095''.:�� ...; ,.. Construction Type: V Occupancy: • " �. �StateLic.#: C -2-1C '''�:• � ~ -: "- P M - y`t9acnwttL 4'' -'_ Project type (circle one): New Add'n QS!kj Repair Demo JC Name of Contact Person: IAN A1£t_5rJ Sq. FL: 85 #Stories #Units: N �A X Telephone # of Contact Person: 9 l3 - 23&- 3 37 9imatcd Value of Prdject: Zg oe o APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Itee'd TRACKING PERl11fi FEES • Plan Sets Plan Check submitted Item Amount Structural Calm.Reviewed, ready for eorreetions Plan Check Deposit Truss Calcs. Called Contact Person PIaa'Check Balance Energy Cake. Plans Sicked up Construction Flood plain plea Plans resubtnitted hItchanieai Grading plan V Review, ready for correctionyssne Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.1 LL H.O.A.Approval Pians resubmitted Grading IN HOUSE:- MRM . ew. ready for co rrectionstiissue Devclopcir Impact Fee Planning Approval . Called Contact Person Pub. Wks, Appr Date of:permit issue School Fees Post -it' Fax Note~ 7671 Date 7_070 pages► f To Cu �u From d� y fns j Total Permit Fees; Co./Dept. J- CLIA Phone H Phorie t3,4q I Faxes' T00/TOO [j j 777' -&0aJVS V RPTU ZTTL LLL 09L XV3 9C:CZ NOR 6002/6T/LO