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