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04-7512 (SOTB)r1 . . TW!t 4.4 a" rAMPICO LIFORNIA 92253 BUILDING PERMIT APN: Application description Property Zoning . . . . . Application valuation . . Owner ONE ELEVEN LA QUINTA C/O SABBY JONATHAN 42620 CAROLINE CT STE 102 PALM DESERT CA 92211 BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 0--4— 5T2 '7 Date 12/15/04 78902 HIGHWAY 111 643-080-051- - NEW COMML - OTHER.NON-RESIDENTIAL REGIONAL COMMERCIAL 5000 Contractor CONSOLIDATED CONTRACTING, INC. 46753 ADAMS STREET LA QUINTA CA 92253 (760) 324-5488 t± WCC: STATE FUND WC: 17707492004 01/01/05 CSLB: 824183 09/30/05 CCC: B -C8 ------ Structure Information TWO (2) PARKING LOT LIGHT STANDARDS. ----- Construction Type . . . . . TYPE V - NON RATED Other struct info . . . . . CODE EDITION — 2001 --------------------7------------------------------------------------------- Permit BUILDING PERMIT Additional desc Permit Fee 72.00 Plan Check Fee 46.80 Issue Date . . . . Valuation . . . . 5000 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 THOU ---------------------------------------------------------------------------- BLDG 2,001-25,000 27.00 Permit ELEC-NEW COMMERCIAL .Additional desc Permit Fee 16.50 Plan Check Fee .4.13 Issue Date Valuation . . . . .0 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 .7500 EA ----------------------------------------------------------------------==---- ELEC POLE LIGHT 1.50 Special Notes and Comments Two (2) parking lot light standards. -------------------------------------------------------------- Other Fees . . . . . . . -------------- . . STRONG MOTION (SMI) - COM 1.05 Fee summary Charged ----------------- Paid Credited I Due ---------- Permit Fee Total 88.50 ----------------------------- .00 .00 88.50 P.O. Box 1504 "78-495VOICE (760) 777-7012 CALLS O FAX (760) 777-7011 LA QUINTA, CALIFORNIAFOR 922534V INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Of.7S/,-)_ 1 Date: /7 -//,-Of Applicant: *Co ^/ 124 G f Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.: UUILDING 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 my Li a e ' II force and effect. License Class ��y. �nLicense No. ul- GL Date 12 Contractor L �. olow Qle�o 60-72- OWNER-BUILDER SN72-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 1, 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. , 8.8 P.C. for this reason /%Ba18� er i 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 issu d. M w rs' c nsation insurance caraumtier e: Cartier - - Policy Number ` { �CJ -/ `'f' C /% gsrj 4-- _ I ce i y that, in th6 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 `; Applicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CO ERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0 ), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CO STRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lend g 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, 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 county to enter upon the above-mentioned property for inspection purposes. e Dat� t/y' Signature (Applicant or Agent): Page 2 Date 12/15/04 .00 50.93 .00 1.05 .00 140.48 Din # City of La Quinta BUUft ar Safety DWon P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 922S3 - (760) 777-7012. Building Permit Application and. Tracking Sheet Permit # 0q- 75'1 Project Address: -16-902. I&OKVe I I I Owner's Name: (f)f4a �ZWEN LAQUIN-Ok L L6 A. P. Number: Address: 11-064 TAMAfv4ft.LAIM� Legal Description* Fog. 12.c 1, JZ pH 11-gloz. i Fil Z"60 city, ST, Zip: 11►^Nc4j0 Mjg4q6r,,CA qczgrjo .Contractor: CONWwww &t+rK4_6T1H,0-: INC. Telephone: 1� Address: - 416 --1" /V;?AH 0 �i Project Description: _rV40(2)FAW4N& City, ST, Zip: L44 gR1 N% I 46A Iq =Z . F&Lf LACWT`9 lo'PbI� 19ft %;-1 ow - Telephone: 1-1 State L ic. # J&4 16-3 City Lie. #: -1614 Arch., Engr., Designer: CAEL Ux, -A I -A. -.Address: bI_551 PR-44KFOOH City, ST, Zip: H210 1- 546 1=0 I Telephone: IGO- 1341-400-T Construction Type:V N SMOccupancy: A-:?� . . . . . . . . . . . . . .... State Lic. #: 6_117-194 Project type (circle one): "New, C�WnDAlter Repair Demo- .Nane of Contact Person:" P.AV*_!F7M01-*Y Sq. Fu # s: Telephone # of Contact Person:. -1667 —T1 1- 51,?;1415 Estimated VAIe'of Project: APPLICANT: DO NOT WRITE BEw THIS. LINE Submittal Re 'd Rec1d TRACKING —_------TE'RM1T FEES .0 Plan Sets Plan Check submitted it.. Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Caics. Plans picked up Construction Flood plain plan — Plans resubmitted Mechanical - Grading plan 2"' Review, ready for correction issue t (Electrical Subcontactor List 26-11ed'Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ' ready for correctionslissu 1 Developer Impact Fee Planning Approval' Called Contact Person A.I.P.P, Pub. Wks. Appr e Date of permit issue School Fees A I] Total Permit Fees CITY OF LA QUINTA PLAN CHECK CORRECTION LIST Concorde Consulting Group Inc. December 7, 2004 3505 Camino Del Rio South. #350 San Diego; CA 92108 PLAN CHECK NO. 04-7512 FIRST CHECK ADDRESS 78-902 Hwy 111 OCCUPANCY U-1 SCOPE OF WORK 2 light pole footings TYPE -OF -CONST. V -N PLAN CHECK FEE 3 Hours The submitted plans and specifications have been reviewed by the VCA CODE GROUP. In our professional opinion the plans are in substantial conformance with the building codes and regulations adopted by the CITY OF LA QUINTAand the State of California Amendment. APPROVAL FOR A BUILDING PERMIT IS HEREBY RECOMMENDED SUBJECT TO OBTAINING APPROVALS/CLEARANCES FROM ALL APPLICABLE CITY DEPARTMENTS, AGENCIES, AND ASSOCIATIONS. Plans checked by: Hue C. Luu, PE VCA CODE GROUP 2200 W Orangewood Ave, Ste 155 Orange, CA 92868 (714) 363-4700 ext.#752 VCA File No. LQ -17089 1 • t�l�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: 12-10-2004 From: Oscar Orci, Planning Manager Due date: 12-15-2004 Status: IST Review 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: LIGHT POLES AT THAI SMILE Address or general location: 78-902 HIGHWAY 111 Applicant Contact: DAVE SMOLEY 771-3345 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. _9rzsaf-9mi, na er Date