09-0151 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:A;
09-00000151;
78995 HIGHWAY 111 STE
643-020-056- -
REMODEL - COMMERCIAL
REGIONAL COMMERCIAL
7500
Tityl 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION _
I hereby affirm under penalty of perjury th 1 licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busin s an P ofessic als Code, and my License is in full force and effect.
License Class: 4 license No.: 806022
ate: 2- ont
OW R -BUILDER DECLARATION
I hereby affirm under penalty of perjury t at I am exempt from the Contractor's State license Law for the
fallowing reason (Sec. 7031.5, Business a 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).:
1 _ 1 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.).
( 1 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.).
(_) I am exempt under Sec. , B.&P.C, for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalt of perjury that there is a construction lending agency for the performance of the
work for which this permit .i issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERDI)1IT
Owner:
WASHINGTON 111 LTD
C/O JACK TARR
30240 RANCHO VIEJO RD.
SAN JUAN CAPISTRANO, C
Contractor: \
PLASTERTEC CONSTRUCTION,
45010 DESERT VIEW COURT
LA QUINTA, CA 92253
(760)200-5400
Lic. No.: 806022
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/27/09
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 SUA INSURANCE Policy Number WSLTHPE 5772-03
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner s become subject to Me workers' compensation laws of California,
and agree that, if I s ld b
ueco a subject to the workers', compensation provisions of Section
3700 of�the Labor ode, Ishal forthwith comply with those provisions.
/rAppl n
WARNING: FAILURE TO SEC RE WOR RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO IMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDI 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 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 Aid if work is not commenced
within 180 days from date of issuancntheb
it, or cessationPPf work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state tinformaton is correct. I agree to comply with all
city and county ordinances and state laws relating tstruction,and hereby authorize representatives
of j1+Is county to enter upon the above-mentioned ppaction purposes.
(Applicant or
i
LQPERMIT
1
Application Number . . . . . 09-00000151
Permit . . . . . BUILDING PERMIT
Additional desc . . STE 8 OWNR TRAIN'G- MAC GALLER
Permit Fee . . . . 99.00 P1an.Check Fee
64.35
Issue Date Valuation . . .
. 7500
Expiration Date 8/26/09
Qty Unit Charge Per
Extension
BASE FEE
45.00
6.00 9.0000 THOU BLDG 2,001-25,000
54.00
----------------------------------------------------------------------------
Special Notes and Comments
INTERIOR TENANT IMPROVEMENT SUITE 8 FOR
"MAC GALLERY" OWNER TRAINING
B-OCCUPANCY/22-OL MAX/1184 SF/FULLY
SPRINKLERD -ELECTRICAL/MECHANICAL/
PLUMBING EXISTING FROM SHELL
CONSTRUCTION (FIRST TENANT] 2007•
CALIFORNIA BUILDING CODES.
February 19, 2009 9:17:38 AM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . ... . . ACCESSIBILITY PLAN REVIEW
6.44
BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
6.44
STRONG MOTION (SMI) - COM
1.57
Fee summary. Charged Paid Credited
Due
Permit Fee Total 99.00 .00 .00
99.00
Plan Check Total 64.35 •.00 .00
64.35
Other Fee Total 15.45 .00 .00
15.45
Grand Total 178.80 .00 .00
178.80
i
LQPERMIT
1
r
Riverside County Fire Department Fire Protection Planning Section
Riverside Office: 2300 Markel St., Ste. 150, Riverside, CA 92501 Ph. (951) 955.4777 Fax (951) 955.4886
Murrieta Office: 39493 Los Alamos Rd., Ste A, Murrieta, CA 92563 Ph. (951) 600.6160 Fax (951) 600-6164
Palm Desert Office: 77-933 Las Montanas Rd., # 201 Palm Desert, CA 92 21 1-41 31 Ph. (760) 863-8886 (760) 863-7072
Fire Department Clearance/Release
Date:
To: LJ �W/-Y)L / Sdre�
Y
Fax:
Tract/Parcel Map #:
Permit/Lot #:
Job Site Address:
M d 6d Ilea/
�V-aq5 �j 'V 11L --t Y
Final For Recordation
Release For Building Permit(s)
Shell Final.Only (No Tenant)
C 1C Final For Occupancy
Building Plan Check Fees Paid
Building Plan Check Fees Not Paid
Other Fees
Fees Not Required
If you should have any questions, please contact the appropriate Riverside County Fire Protection
Planning office for further assistance.
Form C — Revised 8/21/2008
. Jdso S fW ��lP
Print Name
Bin #
C2
City of La Quinta
Building & Safety Division
Permit #`(n�
P.O. Box 1504, 78-495 Calle Tampico
-JJ
0,q
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:
Owner's Name: C 1 2
A. P. Number:
. Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
Address:
Project Description:
City, ST, Zip:
`
Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., a ign
r'te L J �. a
Address:
/
City, ST, Zip:1
LL-A�A..
a o
Telephone:
` �
Construction Type: V Occupancy:
State Lic. #:
Project type (circle one): 'New Add'n Alter Repair
Demo
Name of Contact Person:
f Sq. Ft.: , , #Stories:. # Units:
Telephone # of Contact Person: a • Gj Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'dRecd
-
TRACKING PERMIT FEES
Plan Sets
3
Plan Check submitted Item
Amount
Structural Cales.
Reviewed, ready for corrections Plan Check Deposit
Truss Cates.
Called Contact Person v Plan Check Balance
Energy Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2"Review, ready for correctio sue L- Electrical
Subcontactor List
Called Contact Person y Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:
3' Review, ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A.I,P,P-
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
N '
1
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
(760)777-7012
FAX (760) 777-7011
To: Greg Butler, Building& Safety Manager To CDD: .1 • a(y- O 9
From: Les Johnson, Director -Planning Due Date:
Permit #: Status: 1St Review
Building Pians Approval
(This is an approval to issue a Building Permit)
The Planning Department has reviewed the Building Plans for the following
project:
Description: 79 1?�� 8
Address or General Location:
Applicant Contact: °
The Planning Department finds that:
❑ ...these Building Plans do not require Planning Department approval.
...these Building Plans are approved by.the Planning 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 Planning Department for review.
L►o Ir r 2' Z "0
es J son, Director -Planning Date
L
Ce'rtificate'of Odcupandy.....
Iucowoahn��'�
� Ma
OF Building- & .Safety Department l C
z
This Certificate Js -issued pursuant .to the requirements of Appendix Chapter 1 Section 110 of the
2007 California Building Code, certifying that, at the time of issuance, :this structure was in
.
p compliance with the provisions of the Building Code and the various ordinances of the, City
I€
regulating building construction and/or use.
BUILDING ADDRESS: 78-995'HIGHWAY 111 STE #8
Use classification: COMMERCIAL (MAC GALLERI0 Building Permit No.: 09-151
Occupancy Group: B Type of Construction: VN Land Use Zone: CR
Sprinklers Installed: YES Sprinklers Required: YES Occupant Load: 22
Owner of.Building: WASHINGTON 111 LTD
-
Address: 30-240 RANCHO VIEJO RD. STE. B
z
City, ST, ZIP: SAN JUAN CAPISTRANO,CA 92675
By: STEVE TRAXEL
Building Official Date: MARCH 24, 2009
I
POST IN A CONSPICUOUS PLACE