05-0302 (CSCS)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
O 0000 3000 02�
79024"HIGHWAY 111
649 -820 -999 -
NEW COMML - STORES &
REGIONAL COMMERCIAL
222457
T4'yl 4 4 Q"
BUILDING '& SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
FOURTH QUARTER PROPERTIES
- 45 ANSLEY.DR
CUSTOMER SERVICE NEWNAN, GA 30263
(760)613-3783
Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
D I & d
OCT 2 8 2005
CITY OF LA QUINTA
FINANCE DEPT.
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 an Professionals Code, and my License is in full force and effect.
License Class: B License No.: 572657
/a'r
Date: �i) Co ractor: A
OWNER- UILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 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 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 contractors) licensed
pursuant to the Contractors' State License Law.).
1 1 I am exempt under Sec. , B.&P.C. for this reason
Date: _ Owner:
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:
Lender's Address: '
LQPERAIIT
Contractor:
VRATSINAS CONSTRUCTION CO.
P.O. BOX 2558
LITTLE ROCK, AR .72203
(501)376-0017
Lic. No.: 572657
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/28/05
-----------------------------------------------
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 ZURICH INS Policy Number WC531636300
I certify that, in the 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 becubject to the workers' compensation provisions of Section
3700 of the Labor e, forthwith comp) r i ose provisions.
Date: Applican
WARN G: FAILURE TO SEC E KERS' caPENS44ON COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION 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 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.
certify that I have read this application and state that the abov or tion is correct. I agree to comply with all
city and county ordinances and state laws relating [o bupip
i con ction, and hPize representatives
of this u ty o enter upon the above-mentioned pro for i s cton purpos
Da :/a Signature (Applicant or Agent),
Application Number . . . . . 05-00000302
Permit .
. . . . .
BUILDING PERMIT .
Additional
desc .
Permit Fee
. . . .
1070.00
Plan Check Fee
695.50
Issue Date
. . . .
Valuation . . . .
222457
Expiration
Date
4/26/06
Qty Unit Charge
Per
Extension
BASE
FEE
639.50
123.00
----------------------------------------------------------------------------
3.5000
THOU BLDG
100,001-500,000
430.50
Permit
. . .
ELEC-NEW COMMERCIAL
Additional
desc . .
Permit Fee
. . . .
103.92
Plan Check Fee
25.98
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . .
4/26/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
4446.00
----------------------------------------------------------------------------
.0200
ELEC
GARAGE OR NON-RESIDENTIAL'
88•.92
Permit
. . .
GRADING PERMIT
Additional
desc .
Permit Fee
15.00
- Plan•Check Fee -
_00
` Issue Date
. . . .
Valuation . . .
0
Expiration
Date
4/26/06
Qty Unit Charge
Per
Extension
----------------------------------------------------------------------------
BASE
FEE
15.00
Permit
. . .
MECHANICAL
Additional
desc .
Permit Fee
. . . .
69.00
Plan Check Fee
17.25
Issue Date
. . . .
Valuation . .
0
• Expiration
Date
4/26/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
3.00
9.0000
EA MECH
FURNACE <=100K
27.00
3.00
----------------------------------------------------------------------------
9.0000
EA MECH
B/C <=3HP/100K BTU
27.00
Permit .
. . . . .
PLUMBING
Additional
desc .
Permit Fee
. . . .
30.00
Plan Check Fee
7.50
LQPERAIIT
Application Number
'05-00000302
Permit . . . .
. PLUMBING
Issue Date . . .
. Valuation . . .
. 0
Expiration Date
4/26/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA PLB ROOF DRAIN
12.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
----------------------------------------------------------------------------
Special Notes and
Comments
4446 SQ. FT. SHELL
BUILDING ONLY (PAD
1).June 10, 2005 2:01:06
PM JJOHNSON
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . ART IN PUBLIC PLACES -COM
1092.28
DIF CIVIC CENTER - COMM
422.37
ENERGY REVIEW FEE
69.55
DIF FIRE PROTECTION -COMM
142.27
STRONG MOTION (SMI) - COM
46.71
DIF STREET MAINT FAC -COMM
102.25
DIF TRANSPORTATION - COMM
7664.90
Fee summary
Charged Paid Credited
----------------------------------------
Due
----=------------
Permit Fee Total
1287.92 .00 .00
1287.92
Plan Check Total
746.23 500.00 .00
246.23
Other Fee Total
9540.33 .00 .00
9540.33
Grand Total
11574.48 500.00 .00
11074.48
Craig E. Anthony
Fire Chief
Proudly serving the
unincorporated
areas of Riverside
County and the
Cities of.
Banning
4.
Beaumont
4.
Calimesa
Canyon Lake
Coachella
4.
Desert Hot Springs
Indian Wells
4.
Indio
.;
Lake Elsinore
4.
La Quinta
4.
Moreno Valley
Palm Desert
4.
Perris
Rancho Mirage
:•
San Jacinto
4.
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jeff Stone,
District 3
Roy Wilson,
District 4
Marion Ashley,
District 5
RIVERSIDE COUNTY
FIRE DEPARTMENT
82-615 HighwayIndio, Fax863-7012
December 12, 2005
Michael R. Black, AIA
3100 E. Randol Mill
Arlington, TX 76011
Re: Non -Structural Building Plan Review
LAQ-05-TI-109 / The Coffee Bean & Tea Leaf
79=024 Hwy 111',;#101 �� s
Fire Department personnel have reviewed and approved the plans you submitted for the above
referenced project. Please be advised the following conditions apply as a part of the conditions for the
issuance of a building permit.
1) Fire sprinkler system plans for the tenant improvement area must be submitted to the Fire
Department for review, along with a planfinspection fee. A licensed C-16 contractor shall do all
sprinkler work and certification. The approved plans, with Fire Department Job card must be at the
job site for all inspections.
2) Provide keys to the tenant space for inclusion in the main building Knox Box. Key(s) shall have
durable and legible tags affixed for identification of the correlating tenant space.
3) All egress doors shall comply with CBC Sec. 1003.3.1.8 for proper door hardware and as noted on
Sht. A2.1 of the building plans.
4) Install portable fire extinguishers per Title 19, but not less than 2A10BC in rating. Contact a certified
extinguisher company for proper placement and spacing of equipment.
5) Approved building address shall be placed in such a position as to be plainly visible and legible from
the street and rear access if applicable. In multi -tenant buildings, businesses shall post the
business name and suite number on back doors as well as the front. Suite numbers or letters must
be a minimum of 6" in height. All addressing must be legible and of a contrasting color with the
background.
Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy.
Requests for inspections are to be made at least 72 hours in advance and may be arranged by calling
(760) 863-8886.
All questions regarding the meaning of these conditions should be referred to the Fire Department
Planning & Engineering staff at (760) 863-8886.
Cc: City of La Quinta — Building Dept.
HAPEAM Datak a QuYga1PROJECTS1TI%LAO-05-TI-109.d.
Sincerely,
Tracy Hobday
Chief Fire Department Planner
By "�JL
Walter Brandes
Fire Safety Specialist
EMERGENCY SERVICES DIVISION • PLANNING SECTION . INDIO OFFICE
82-675 Highway 111, 21d A., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072
0
�F �QKbjrC4V
P.O. Box 1504 BUILDING & SAFETY DEPARTMENT
78-495 CALLE TAMP;CO (760) .777-7012
LA QUINTA, CALIFORNIA 92253 FAX
(/ov) I[/ -1V11.
Finance Department, Please Collect The Following Fees For The Services Rendered
HTE PERMIT #05-302
PROJECT: PAD I SHELL BLDG @ THE PAVILION AT LA QUINTA
ADDRESS: 79-024 HWY 111
CUSTOMER: V.C.C.
SERVICES RENDERED: Additional Plan Review Delta 2 Revisions to Pad I Shell Bldg to
previously issued Permit 05-302.
Fees:
#05-302
StructuralReview .......................................................................... $ 87.15
Administration............................................................................... $ 35.00
$ 122.15
TOTAL FEES NOW DUE:.................................$ 122.15
Date: _February 7, 2006
Initials:
COPY
Bin #�
City of La Quinta
'—
Building U Safety Division
Permit # a
•�
P.O. Box.1504, 78-495 Calle Tampico
La Quinta,
.
•C�
CA 922.53 -.(760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:
11
Owner's Name:
N
A. P. Number:
•O�^
Address:
Legal Description:
City, ST, Zip: K 2
Contractor: vGG
Telephone: i
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Address:
t,..
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_
Project Desc p �V
City, ST, Zip:
Telephon
State Lie. #
City Lie. #:
Pic I
`
Arch., Engr., Designer:
Address:
t N,0 A
•
City, ST, Zip: �/fs, �' Q �• �/1 /j�v
('
Telephone:
Construction Type: Occupancy:
p cy:
State Lie. #:
Pro ect P
1 type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Y
Sq. Ft. -
# Stories: ,
#Units:
Telephone # of Contact Person: •
Estimated Value of Project: S �Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG .
PERMIT FEES
Plan Sets
.%
Plan Check submitted
1 / 1 2
Item
Structural Calcs.
p?
Reviewed, ready for corrections
Amount
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans•picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2'• Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
`
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'�• Review, ready for correction 'sue
1§1
P Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks..Appr
Date of permit issue
School FeesIV
•
c
7 .�
'�►C
Total Permit Fees IT
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