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06-3162 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: � 06-00003162 Property Address: 79255 HIGHWAY APN: 649-030-999-8 Application description: REMODEL - COM Property Zoning: REGIONAL COMM Application valuation: 80000 Applicant: T4At " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT ---------------.----------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of p jury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of th Business and rofessio s Code, and my License is in full force and effect. License Class: A L ense No.: 762799 Date: ' Contracto t 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, .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.). 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: LQPERA11T VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/10/06 ----------------------------------------------— 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 Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1557214-200 _ I certify that, in the pLde,lshall f the work for whic this p it is issued, I shall not employ any person in any manecome subject to a workers compensation laws of California, and agree that, if Ime su ct to the orkers' cc pensation provisions of Section 700 of the Labor with compl with tho provisions. 4Daterl XAILURE Applicant: WARNING: TO SECUREORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001. 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 applica 'on becomes null and void if work is not commenced within 180 days from date of issuance of s ch permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that t above information is correct. agree comply with all city and county ordinances and state laws relating to bu' ing constructio nd hereby uthorize representatives of this cou ty to nter upon the above-mentioned prop for inspect; urposes. g rDate: 4(1��= ignature (Applicant or Agent): Owner: 111 S STAMKO DEV CO -3 420 - 78-060 CALLE ESTADO #5 ER AL LA QUINTA, CA 92253 7R O (760)777-7686 Contractor: chitee4 or E gf1 STAMKO DEVELOPMENT CO L P ��. 6080 CENTER DR, #668 LOS ANGELES, CA 90045 (310)242-5637 Lia. No.: 762799 ---------------.----------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of p jury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of th Business and rofessio s Code, and my License is in full force and effect. License Class: A L ense No.: 762799 Date: ' Contracto t 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, .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.). 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: LQPERA11T VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/10/06 ----------------------------------------------— 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 Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1557214-200 _ I certify that, in the pLde,lshall f the work for whic this p it is issued, I shall not employ any person in any manecome subject to a workers compensation laws of California, and agree that, if Ime su ct to the orkers' cc pensation provisions of Section 700 of the Labor with compl with tho provisions. 4Daterl XAILURE Applicant: WARNING: TO SECUREORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001. 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 applica 'on becomes null and void if work is not commenced within 180 days from date of issuance of s ch permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that t above information is correct. agree comply with all city and county ordinances and state laws relating to bu' ing constructio nd hereby uthorize representatives of this cou ty to nter upon the above-mentioned prop for inspect; urposes. g rDate: 4(1��= ignature (Applicant or Agent): Application Number . . . . . 06-00003162 ------ Structure Information SHELL IMPROVEMENT(ELEC,MECH,PLUMB) ----- Other struct info . . . . . CODE EDITION 2001/2005 FIRE SPRINKLERS YES MIXED-USE OCCUPANCY UNKNOWN ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 900.00 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 549.50 Plan Check Fee 357.18 Issue Date . . . . Valuation . . . . 80000 Expiration Date 4/08/07 Qty, Unit Charge Per Extension BASE FEE 414.50 30.00 4.5000 ------=--------------------------------------------------------------------- THOU BLDG 50,001-100,000 .135.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 57.00 Plan Check Fee 14.25 Issue Date . . . . Valuation 0 Expiration Date 4/08/07 Qty Unit Charge Per Extension BASE FEE 15.00 900.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 18.00 20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 15.00 ' 20.00 .4500 --------------------------- EA ELEC ------------------------------------------------- DEVICE/FIXTURE >20 9.00 Permit . . MECHANICAL Additional desc . Permit Fee . . . . 44.00 Plan Check Fee 11.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/08/07• Qty. Unit Charge Per- Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 4.5000 EA MECH VENT INST/'DUCT ALT 4.50 1.00 -9.0000 EA MECH B/C <=3HP/100K BTU 9.00 1.00 6.5000 EA MECH VENT FAN 6.50 Permit . . . PLUMBING . Additional desc . LQPERDIIT LQPERMIT Application Number 06-00003162 Permit . . . . . . PLUMBING Permit Fee . . . . 105.00 Plan Check Fee 26.25 Issue Date' Valuation . . 0 Expiration Date 4/08/07 Qty Unit Charge Per Extension BASE FEE 15.00 7.00 6.0000 EA PLB FIXTURE 42.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 4.00 7.5000 EA PLB WATER HEATER/VENT 30.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ---------------------------------------------------------------------------- Special Notes and Comments . 900 SF SHELL IMPROVEMENT/V-NR/FIRE SPRINKLED, THIS PERMIT DOES NOT AUTHORIZE OCCUPANCY. CERTIFICATE OF OCCUPANCY WILL BE ISSUED UPON APPLICATION AND APPROVAL OF TENANT IMPROVEMENT. ------------------------------------------ ---------------------------------- Other Fees . . . . . . . . . STRONG MOTION (SMI) - COM 16.80 Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 755.50 .00 .00 755.50 Plan Check Total 408.68 .00 .00 408.68 Other Fee Total 16.80 .00 .00 16.80 Grand Total 1180.98 .00- 00 1180-.98