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05-4855 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address:,,i APN: Application description: Property Zoning: Application valuation: Applicant: 05-00004855 79150 HIGHWAY 111 STE.101 649-820-999- - - REMODEL - COMMERCIAL REGIONAL COMMERCIAL 199920 Td4t 4 4 a" Architect or Enginee BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Prqfessionals Code, and my License is in full force and effect. License Class: B License No.: 572657 (` Date: ,Z C Contractor:. OWNER -BUILDER DECLARATION I hereby affirm under penalty ofperjury that I am exempt from the Contractor's State License Law for the r 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 _ 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.). (_ V 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.). ( 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.1. Lender's Name: . Lender's Address: LQPER,\1IT Owner: FOURTH QUARTER PROPERTIES 45 ANSLEY DR NEWNAN, GA 30263 (760)613-3783 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: 1/31/06 ----------------------------------------------- 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. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor y' 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 become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall rthwith/comAply with those provisions. Date: ,�Lo Applicant:_��lr^Y�il 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 1$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 Ouinta, 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 construion, and hereby authorize representatives of this county to enter upon the above-mentioned property for insp 12on p rposes. Date-�c u67 Signature (Applicant or Agent): �A �v Cl 1 LQPE%NIIT Application Number . . . . . 05-00004855 Permit . . . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 989.50 Plan Check Fee 643.18 Issue Date . . . . Valuation . . . . 199920 Expiration Date 7/30/06 Qty Unit Charge Per Extension BASE FEE 639.50 100.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 350.00 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 130.50 Plan Check Fee 15.38 Issue Date . . . . Valuation . . 0 Expiration Date 7/30/06 Qty Unit Charge- Per Extension BASE FEE 15.00 3.00 11.0000 EA MECH FURNACE >100K 33.00 3.00 4.5000 EA MECH VENT INST/ DUCT ALT 13.50 3:00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 3.00 6.5000 ---------------------------------------------------------------------------- EA MECH VENT FAN 19.50 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee _ 127.20 Plan Check Fee 31.80 Issue Date Valuation . . . . 0 Expiration Date _ 7/30/06 Qty Unit Charge Per Extension BASE FEE 15.00 20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 15.00 216.00 .4500 ------------------------------ EA ELEC ----------- DEVICE/FIXTURE >20 ------------------------------------ 97.20 Permit . . . PLUMBING Additional desc Permit Fee . . . . 94.50 Plan Check Fee 23.63 Issue Date Valuation . . . . .0 Expiration Date 7/3:0/06 Qty Unit Charge Per Extension BASE FEE 15.00 9.00 6.0000 EA- PLB FIXTURE 54.00 , 1.00 15.0000 EA PLB BUILDING SEWER 15.00 Application Number . . . . . 05-00004855 Permit . . . . . . PLUMBING Qty Unit Charge Per Extension 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 - 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00' ---------------------------------------------------------------------------- Special Notes and Comments TENANT IMPROVEMENT - "FAMOUS FOOTWEAR" ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STRONG MOTION (SMI) - COM 41.98 Fee summary Charged ---------- Paid Credited ---------- ---------- Due ----------------- Permit Fee Total 1341.70 .00 ----------- .00 1341.70 Plan Check Total 713.99 .00 .00 713.99 Other Fee Total 41.98 .00 .00 41.98 Grand Total 2097.,67 .00 .00 2097.67 r Bin ;E � loc�r'►aaa l�gW�1=�R- F3Y City of La Quinta �8, >,��►�o�. Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: `grgr Owner's Name: A. P. Number: 6.4q-,620 _ Address: Legal Description: City, ST, Zip: Contractor: Y�� TS�dJ �0 Address: 5QX Telephone: Z�Z Project Description: City, ST, Zip: Ar 9Z0_ Telephone: — r[ — OUSE �� 6) State Lic. # : 67 fp JIB CityLic. #: Arch., Engr., Designer: L `► Yob / $ Address: City, ST, Zip: Telephone: ;1 State Lia #: Name of Contact Person: /y4__Al su 1�rs_l Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 8. % Estimated Value of Project: 7M I APPLICANT: DO NOT WRITE BELOW THIS LINE # 3 Submittal Plan Sets Req'd Recd TRACKING Plan Check submitted PERMIT FEES Item Amount ?i Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance 2 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 PP Plans resubmitted Grading IN HOUSE:- ''" 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 -2- SOi Total Permit Fees VGt DuE 10W15 -� green s�e�t� Plam� CoD Goo �vt�a✓uble. 14.2-506- fWrw4b t6 October 20, 2005 RIVERSIDE COUNTY FIRE DEPARTMENT Ig way 111, 2nd Fl., Indio, FaX - Craig E. Anthony Fire Chief Smith Consulting Architects 12220 EI Camino Real, Ste. 200 Proudly serving the San Diego, CA 92130 unincorporated areas of Riverside County and the Re: Non -Structural Building TA Plan Review Cities of: LAQ-05-TI-094 / Famous Footwear 79-136 Hwy 111, Ste. A Banning .;. Fire Department personnel have reviewed and approved the plans you submitted for the above Beaumont referenced project. Please be advised the following conditions apply as a part of the conditions for the -' issuance of a building permit. Cahmesa 1) Fire sprinkler system plans for the tenant improvement area must be submitted to the Fire Canyon Lake Department for review, along with a plan/inspection fee. A licensed C-16 contractor will Piave to Coachella submit plans for review and approval and modify the fire sprinkler system in accordance with NFPA .;. 13, 1999 Edition. A licensed C-16 contractor shall do all sprinkler work and certification. The Desert Hot Springs approved plans, with Fire Department Job card must be at the job site for all inspections. Indian Wells 2) Provide keys to the tenant space for inclusion in the main building Knox Box. Key(s) shall have 44. durable and legible tags affixed for identification of the correlating tenant space. Indio Lake Elsinore 3) All egress doors shall comply with CBC Sec. 1003.3.1.8 for proper door hardware. 44 La Quinta 4) Install portable fire extinguishers per Tide 19, but not less than 2A1 OBC in rating. Contact a certified 4- extinguisher company for proper placement and spacing of equipment. Moreno Valley ❖ 5) Approved building address shall be placed in such a position as to be plainly visible and legible from Palm Desert the street and rear access if applicable. Building address numbers shall be a minimum of 12" for 4' building(s) up to 25' in height, and 24" in height for building(s) exceeding 25' in height. In multi - Perris tenant buildings, businesses shall post the business name and suite number on back doors as well 4. Rancho Mirage 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. San Jacinto 4. Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy. Temecula Requests for inspections are to be made at least 72 hours in advance and may be arranged by calling (760) 863-8886. Board of Supervisors All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering staff at (760) 863-8886. Bob Buster, District 1 Sincerely, John Tavaghone, District 2 Tracy Hobday Jeff Stone, Chief Fire Department Planner District 3, Roy Wilson, District 4 By Marion Ashley, Walter Brandes Districts Fire Safety Specialist Cc: City of La Quinta —Building Dept. H:%PE2%WP Dza%Le Qu4N1PR0JECMTftLAa•d5-nd9c.doc EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE 82-675 Highway 111, 2^d FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072 Craig E. Anthony Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Banning Beaumont C• Calimesa Canyon Lake vo Coachella e� Desert Hot Springs c• Indian Wells Indio o� Lake Elsinore e• La Quinta 3 Moreno Valley Palm Desert Perris Rancho Mirage 4. San Jacinto 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 October 20, 2005 Smith Consulting Architects 12220 EI Camino Real, Ste. 200 San Diego, CA 92130 Re: - Non -Structural Building TA Plan Review LAQ-05-TI-094 / Famous Footwear �-79=1-36-Hwy1-11, Ste.A� 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 will have to submit plans for review and approval and modify the fire sprinkler system in accordance with NFPA 13,1999 Edition. 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. 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. Building address numbers shall be a minimum of 12" for building(s) up to 25' in height, and 24" in height for building(s) exceeding 25' in height. 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. Sincerely, Tracy Hobday Chief Fire Department Planner Walter Brandes Fire Safety Specialist Cc: City of La Quinta — Building Dept. KVEZWP Dma% a o ruwaarsrsrnwaosn.M doe EMERGENCY SERVICES DIVISION " PLANNING SECTION • INDIO OFFICE 82-675 Highway 111, 2"a A., Indio, CA 92201 " (760) 863-8886 " Fax (760) 8637072 Proudly serving the unincorporated areas of Riverside County and the Cities of- Banning f Banning Beaumont Calimesa . Canyon Lake Coachella •3 Desert Hot Springs Indian Wells Indio Lake Elsinore La Quinta Moreno Valley Palm Desert Perris A. - Rancho . -Rancho Mirage San Jacinto Temecula Board of Supervisors Bob Buster, District 1 John Tavaglione, District 2 Jeff Stone, District 3 Roy Wilson, ' District 4 Marion Ashley, District 5 R11, ERSIDE COUNTY FIDE DEPARTMENT 210 West San Jacinto Avenue • Perris, California 92570 • (951) 940-6900 • Fax (951) 940-6910 , y Date / : �P City of La Quinta Building Department RE ' 1 r19M o S PC) ©+U-)eA-f The Riverside Count Fire De artment is anting th Fire clearance for_the following location S�Z9 i { , el /0/ Please call if y u should have questions 760-863-8886 RespectfiJlly By ose� Terry DeSouc Fire Systems Inspector