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BSPN2014-004178-495 CALLE TAMPICO' LA QUINTA, CALIFORNIA 92253 Application Number: BSPN2014-0041 Property Address: 79174 HIGHWAY 111 T4tyl 4 4 Q"Kro COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT APN: 600390029 Application Description: PATIO SLAB FOR YOGURTLAND Property Zoning: Application Valuation: $10,000.00 Applicant: TRI COUNTY DEVELOPMENT & CONST 12321 MAGNOLIA AVE. STE C RIVERSIDE, CA 92503 Sn VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/15/2014 Owner: /00 INLAND AMERICAN LAQUINTA PAV P 0 BOX 9271 OAK BROOK, IL 92253 DEC 12 2014 Contractor: TRI COUNTY DEVELOPMENT & CONST 12321 MAGNOLIA AVE. STE C RIVERSIDE, CA 92503 (800)681-6305 Lic. No.: AEC265 CITY OFA QUINTA -------------------------- G0�1�11J,NITKCE':'E.,,,hAENFDEPAiiTtAE'NTF --------------------------------------------- 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 Professions Code, and my License is in full force and effect. License Class: _ License No.: AEC265 /,,Pate: ' 1 — I Contractor: OWNER -BUILDER DEC RATI I hereby affirm under penalty of perjury that I am pt 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 7 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).: (_) 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 Lender's Address: 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: _ Policy Number: _ _ 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 bec7ju bject to the workers' compensation provisions of Sectior�/39p0 of the Labo, I shall forthwith comply with those provisions. f \ Date: hL "') — L, _ Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPE SATIONCO ERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P ND 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 Building Official 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 ilding construction, and hereby authorize representatives of this c' to enter upon t e bove• mentioned property forinspection purposes. Date: _ a, t dJ � 'Signature (Applicant or Agent): r 78-495 CALLE TAMPICO' LA QUINTA, CALIFORNIA 92253 Application Number: BSPN2014-0041 Property Address: 79174 HIGHWAY 111 T4tyl 4 4 Q"Kro COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT APN: 600390029 Application Description: PATIO SLAB FOR YOGURTLAND Property Zoning: Application Valuation: $10,000.00 Applicant: TRI COUNTY DEVELOPMENT & CONST 12321 MAGNOLIA AVE. STE C RIVERSIDE, CA 92503 Sn VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/15/2014 Owner: /00 INLAND AMERICAN LAQUINTA PAV P 0 BOX 9271 OAK BROOK, IL 92253 DEC 12 2014 Contractor: TRI COUNTY DEVELOPMENT & CONST 12321 MAGNOLIA AVE. STE C RIVERSIDE, CA 92503 (800)681-6305 Lic. No.: AEC265 CITY OFA QUINTA -------------------------- G0�1�11J,NITKCE':'E.,,,hAENFDEPAiiTtAE'NTF --------------------------------------------- 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 Professions Code, and my License is in full force and effect. License Class: _ License No.: AEC265 /,,Pate: ' 1 — I Contractor: OWNER -BUILDER DEC RATI I hereby affirm under penalty of perjury that I am pt 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 7 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).: (_) 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 Lender's Address: 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: _ Policy Number: _ _ 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 bec7ju bject to the workers' compensation provisions of Sectior�/39p0 of the Labo, I shall forthwith comply with those provisions. f \ Date: hL "') — L, _ Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPE SATIONCO ERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P ND 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 Building Official 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 ilding construction, and hereby authorize representatives of this c' to enter upon t e bove• mentioned property forinspection purposes. Date: _ a, t dJ � 'Signature (Applicant or Agent): DESCRIPYION -FINANCIAL ,• ACCOUNT r 1• QTY AMOUNT PAID PAID DATE SPECIAL INSPECTION 101-0000-42404 1 $72.52 $72.52 12/15/14 PAID BY METHOD '° RECEIPT # CHECK # CLTD BY TRI COUNTY DEVELOPMENT & CONST DEBIT R3214 PJU DESCRIPTION. ACCOUNT QTY AMOUNT PAID PAID DATE SPECIAL INSPECTION PC 101-0000-42600 1 $181.29 $181.29 12/15/14 PAID BY' METHOD RECEIPT # CHECK # CLTD BY TRI COUNTY DEVELOPMENT & CONST DEBIT R3214 PJU Total Paid forCOMPLIANCE SURVEY/SPECIAL INSPECTION: $253.81 $253.$1 TOTALS: Description: PATIO SLAB FOR YOGURTLAND , Type: SPECIAL INSPECTION Subtype: Status: SUBMITTED Applied: 12/10/2014 BHA Approved: 12/11/2014 BHA Parcel No: 600390029 Site Address: 79174 HIGHWAY 111 LA QUINTA,CA 92253 Subdivision: PM 29351 Block: Lot: 11 Issued: Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $10,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: NEW PATIO SLAB FOR YOGURTLAND. RELOCATION OF ACCESSIBLE STALLS TO THE EAST TO ACCOMODATE PATIO SLAB. 2013 CODES. FINANCIAL INFORMATION Printed: Monday, December 15, 2014 4:34:46 PM 1 of 3 CN?sYSTEMS ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES NOTE KAY HENSEL 12/10/2014 12/10/2014 PER BURT, NO PLANS WERE ROUTED TO PLANNING BUCKET CONDITIONS NAME TYPE _ NAME ADDRESSI CONTACTS CITY STATE ZIP PHONE FAX EMAIL APPLICANT TRI COUNTY DEVELOPMENT & CONST 12321 MAGNOLIA AVE. STE C RIVERSIDE CA 92503 CESARP@TCDCI.COM ARCHITECT TOM AVILA 3304 PICO BLVD. #G SANTA MONICA CA 90405 CONTRACTOR TRI COUNTY DEVELOPMENT & CONST 12321 MAGNOLIA AVE. STE C - RIVERSIDE CA 92503 CESARP@TCDCI.COM OWNER INLAND AMERICAN LAQUINTA PAV P O BOX 9271 OAK BROOK IL 92253 FINANCIAL INFORMATION Printed: Monday, December 15, 2014 4:34:46 PM 1 of 3 CN?sYSTEMS SIR BONDINFORMATION Printed: Monday, December 15, 2014 4:34:46 PM 2 of 3 OffWsrsreMs N RETURNED STATUS 777 CLTD DESCRIPTION ACCOUNT QTY AMOUNT OF PAID DATE V CHECK # METHOD SIR BONDINFORMATION Printed: Monday, December 15, 2014 4:34:46 PM 2 of 3 OffWsrsreMs RETURNED STATUS 777 CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY 12/17/2014 12/10/2014 APPROVED IBLE SIGNAGE REQUIRED AT LEFT HANADA W/CONDITIONS STALL AS REDLINED ON PLAN. ZY PLAN SWITCHES LOCATION OF PATIO AND ADA STALLS. DOES NOT CHANGE INTENT OF APPROVED PLANNING WALLY NESBIT 12/10/2014 12/17/2014 TRI COUNTY APPROVED SPECIAL INSPECTION 101-0000-42404 1 $72.52 $72.52 12/15/14 R3214 DEBIT DEVELOPMENT & PJU PERMIT OK CONST TRI COUNTY SPECIAL INSPECTION PC 101-0000-42600 1 $181.29 $181.29 12/15/14 R3214 DEBIT DEVELOPMENT & PJU CONST Total Paid forCOMPLIANCE SURVEY/SPECIAL INSPECTION: $253.81 $253.81 �.3r-•v - ,lr..� p.Y^ `�. X/y i f, _ }}p� ..Z KYH._�.N i ,.fad •� � � �i '�5. =i. yj Z S :,J„� ia j, +'.y- 1 '1 'x.: •rY•i .. .rE.-. 1�. SIR BONDINFORMATION Printed: Monday, December 15, 2014 4:34:46 PM 2 of 3 OffWsrsreMs RETURNED STATUS 777 REVIEW TYPE REVIEWER SENT DATE DUE DATE NOTES DATENON-STRUCTURAL BURT 12/10/2014 12/17/2014 12/10/2014 APPROVED IBLE SIGNAGE REQUIRED AT LEFT HANADA W/CONDITIONS STALL AS REDLINED ON PLAN. PLAN SWITCHES LOCATION OF PATIO AND ADA STALLS. DOES NOT CHANGE INTENT OF APPROVED PLANNING WALLY NESBIT 12/10/2014 12/17/2014 12/11/2014 APPROVED REVISE MBA MBA 2014-1004. WILL ISSUE LETTER OF W/CONDITIONS CONSISTENCY WITH APPROVED MBA SEPARATE. PERMIT OK SIR BONDINFORMATION Printed: Monday, December 15, 2014 4:34:46 PM 2 of 3 OffWsrsreMs Permit Details PERMIT NUMBER City of La�Quinta BSPN201'4.�004- • . - 'Caw+'. wM.. , Printed: Monday, December 15, 2014 4:34:46 PM 3 of 3 — CRWYSTEMs ATTACHMENTS Attachment Type '` .CREATED: OWNER'_, DESCRIPTION "PATHNAMEE, ; 'SUBDIR - ETRAKIT ENABLED DOC 12/11/2014 WALLY NESBIT 14-09-24_MBA 14- 14-09-24_MBA 14- 0 1004 Habit Grill.pdf 1004 Habit Grill.pdf • DOC 12/11/2014 WALLY NESBIT MBA 14-1004 revision — MBA 14-1004 revision — 0 OK_Itr.pdf OK_Itr.pdf .1 and A1.0_revised A0.1 and A1.0—revised DOC 12/11/2014 WALLY NESBIT Flayout—APPD.Pdf layout_APPD.pdf 0 Printed: Monday, December 15, 2014 4:34:46 PM 3 of 3 — CRWYSTEMs