06-1638 (SOTB)T yya� ra
P.O. BOX 1504 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Application Number: 06-00001638 Owner:
Property Address: 79050 HIGHWAY 111 FOURTH QUARTER PROPERTIES
APN: 649-820-999- - - 45 ANSLEY DR
Application description: STRUCTURES OTHER THAN BUILDINGS NEWNAN, GA 30263
Property Zoning: REGIONAL COMMERCIAL (760) 613-3783 n
Application valuation: 5000 gyp\ cc
Contractor:
Appljc nt: Architect or Engineer: VRATSINAS rr'% TRUC(Tt10000
P.O. BOX 25-8 8 U' TA
LITTLE ROCK 722.03
(501) 376-0017 C��NpIiCE
LiC. No.: 572657 F
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 License is in full force and effect.
License Class: B License No.: 572657
ntractor:
OWNER -BUILDER 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 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 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:
LQPERMIT
- Date: 6/27/06
-----------------------------------------------
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.
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 beco s Jett to the workers' compensation provisions of Section
3700' of the Labor Code, I sha with comply with those provisions.
e2� 6 1 A ant:(/✓ 't iyJ
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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.
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 cons ti , and hereby authorize representatives
of this my to enter upon the above-mentioned property for ' n purposes,
ate:re (Applicant or Agent): a� l/✓/ / a
LQPERMIT
i
Application Number . . . . . 06-00001638
Permit . . •BUILDING PERMIT
Additional desc .
Permit Fee . . . . 72.00
Plan.Check
Fee
46.80
Issue Date . . . .
Valuation
. . .
. ,5000
Expiration Date 12/24/06 r
Qty Unit Charge Per
Extension
BASE FEE
45.00
3.00 9.0000 THOU. BLDG 2,001-25,000
-
27.00
------------------------------------------------------------
Special Notes and Comments
----------------
ADD FREE-STANDING TRELLIS 77.5 S.F.
f
TO MAILBOX -(Southwest of Henry's
Market),. TYPE V -N CONSTRUCTION,
U-1 OCCUPANCY.2001 CBC CODE.
**NO ELECTRICAL PERMIT INCLUDED
WITH THIS PERMIT**
-------------------------- --------------------------------------------
Other Fees . . . . . . . . . ART IN
PUBLIC PLACES -COM
20.00
HOURLY
PLAN CHECK
75.00
STRONG
MOTION (SMI)
-COM
1.05
Fee summary Charged Paid
Credited.
Due
Permit Fee Total 72.00
..00
.00.
72.00
Plan Check Total _ 46.80
.00
.00
46'.80
Other Fee Total 96.05
.00
.00
96:05
Grand Total 214.85
.00
.00
214.85
i
M
Bili #
City of La Quinta
Building at Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-70 1"2
Building Permit Application and Tracking Sheet
Permit.#P.O.
�.��
OV
Project Address:
Owner's Name: OU4 Y ( �
A. P. Number: Address:
Legal Description: City, ST, Zip:( VL
Contractor: V �G Telephone:
Address: Project Description:
City, ST, Zip:
`
Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., Designer/& (OVU21-ft
Address: (=2 Ca vVl [ VL CJJ(�
VV -
City, ST, Zip�12 V C -Ar c2
Telephone: CA �� 3` C struction T r N Occupancy -
State Lic. #: Proj ct type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: '' m cw aYM T Sq. JAL& 1,5� r # Stories: # Units:
Telephone # of Contact Person: 3 - � -i IvE'—stimated roject:'PB IC -T ,02
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Re�/c.'�'d
TRACKING
PERMIT FEES
Plan Sets
pf
Plan Check submitted
If/A6
Item
Amount
Structural Calcs.
d
Reviewed, ready for corrections
5 3
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
S �(
Construction
Flood plain plan
Plans resubmitted
%'`�3
Mechanical
Grading.plan
2"' Review, ready for correction issue
b2
Electrical
Subcontactor. List
Called Contact Person
L
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval '
Plans resubmitted
Grading
IN HOUSE:-
3,d Review, ready for cor ectionsrtssue
Developer Impact Fee
Planning Approval
Called Contact Person
79 3
A.I.P.P.
Pub. Wks. Appr
Date of permit iss
School Fees
D(
Total Permit Fees
N /a � ,�tecw --9 44ndlzhv�l flL L'# W�
t::Y3 N5 ACS ,
8..
*ailed
00
5�4 BUILDING & SAFETY DEPARTMENT
F 94 (760) 777-7012 µ
OF Tl
FAX (760) 777-7011
To: Greg Butler, Building & Safety Manager
.From: Planning
r
To CDD: 4/'
4044.1-
Building Permit Release
(This .is an approval. to issue a Building Permit)
The Community Development Department has reviewed the following project:
.Description:
Address or general location: 0 ZfO .
APN and or legal description:
The Community Development Department finds that:
...issuance of this Building Permit does not require Community Development
Department approval.
... issuance of this Building Permit is approved by the Community Development
opment
Department. `
Planner signature Date
-t , hn. tw'Y' GoY-6� t-tkVO',—
KAY'S GRN SHEET.doc
7/15/2004
M
re
Letter of Transmittal
To:
r
City of La Quinta Today's Date:
s .0
O b
78-495 Calle Tampico City Due Date
❑ Your Files
❑ Per Your Request
❑ Your Review
La Quinta, Ca 92253 Project Address:
❑ Checking
❑ At the request of:
Attn:
Ed Randall Plan Check #:
By:
M-X� �Lj4w,,-.
0 6
# (760) 360-5770 Ext. la lb
Washington Office: ❑
# (760) 404-9556
Submittal: f s
❑
4t'
2nd
❑
5th
❑ 3`d
❑
Other:
We are forwarding:
® By Messenger ❑ By Mail (Fed Ex or UPS)
❑ Your Pickup
Includes:
# Of Descriptions: Includes:
# Of
Descriptions:
Copies:
Copies:
Structural Plans
❑
Revised Structural Plans
Structural Calcs
❑
Revised Structural Calcs
❑
Truss Calcs
❑
Revised Truss Calcs
❑
Soils Report
❑
Revised Soils Report
❑
Correction List
❑
Approved Structural Plans
❑
Redlined Structural Plans
❑
Approved Structural Calcs
❑
Redlined Structural Calcs
❑
Approved Truss Calcs
❑
Redlined Truss Calcs
❑
Approved Soils Report
❑
Redlined Soils Reports
❑
Other:
Thank you!
This Material
Sent for:
❑ Your Files
❑ Per Your Request
❑ Your Review
Approval
❑ Checking
❑ At the request of:
Other: ❑
By:
M-X� �Lj4w,,-.
Palm Desert Office: ®
# (760) 360-5770 Ext. la lb
Washington Office: ❑
# (760) 404-9556
m
I
ear"-
A5ro Ift-ft
3
RD
RD •
A5CART
CORRAL
F -j TYP- Eloll E:❑I D 14
L
4
F
/3\
APPROVED MAILBOX LOCATION-ERO
AND INSTALL PER MANU. RECOMMENDS 1 5,
2 USPS APPROVED CLUSTER BOX TYP I
C-4 A4
SON ON 4- THICK CONCRETE SLAB, FINISH TO
64 MATCH ADJ. CONCRETE. USPS 160-111-2 18 ❑ PLAN
TVP. 13 ❑
SEE
A54
IV 26'
❑
1 I � �❑C
26o 1 26' IS, 26' 19'
PAD 1
14,400 SFI
Ad Elev.=743' B El El El
Elev.=710'
Ell LIGHT FIXTURE_� /
N. 1. ❑TYPE 5 (TYP-)
SEE ELEC. DW -h.
ry TRELLIS TRASH
ENCLOSURE ITYPJ
ID. SIGN SEE
UNDER SEPARATE
PERMIT \ / / AS(o �' /
Jo
LIGHT F PER
ELECTRICAL D
. .. . ......
4PZ4
.......... STOP SIGN
....... ....
S---\PER TRAFFIC STANDARD
a
m
mi
im
I
m
AS&
A5 . . . . . . . . . CA-
... . .... .... . . El CO
S9
Tyf
@Fl -
APPROVED MAILBOX L
AND INSTALL PER MAN.
2 USPS APPROVED CLU
21 I ON 4' THICK CONCRETE
MATCH - ADJ. CONCRETE
. ...... .
A54
PAD 111' 2
I v
14,400 SFI
Ad Elev.=74,3'
Elev.-71.0'
N.I.C. I
L4 171� � =1 F
\--cENTER ID. SIGN
UNDER SEPARATE
PERMIT
---------- -- ...... ... . .......... .........
410sC. ..... ...................
............
LIGHT PER
ELECTRICAL D