06-3524 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address: -
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
�06-00003524 r�
7`� 9255- HIGHWAY 111 STE
649-030-999=8 -30420
REMODEL - COMMERCIAL
REGIONAL COMMERCIAL
10000
c&t!t 4 4.
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
t�
Architect or Engineer:
IC CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury t I am licensed under provisions of h ter 9 (commencing with
Section 7000) of Division 3 of the Bus s and Professi als Code, and Lice a is in full force and effect.
License Classy, Liceiise Nu.: 627 9
r' Date: K Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury them am exempt from the Contractor's State License Law for the
following reason fSec. 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).:
(_) 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 1, 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:
LQPER111IT
Owner:
STAMKO DEV CO
78-060 CALLE ESTADO #5
LA QUINTA, CA 92253
(760)777-7686
Contractor:
STAMKO DEVELOPMENT CO L P
6080 CENTER DR, #668
LOS ANGELES, CA 90045
(310)242-5637
Lic. No.: 762799
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/10/06
-
-'-- ---------------------------------------—
7
WORKER'S COMPENSATION DECLARATION'
�I hereb off' ' rider penalty of perjury one of the following declarations:
Aave and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 370U 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 1557214-2006
_ I certify that, in the perfo mance of the work for which this permit is issued, I shall not employ any
person in any manner o as to become subject to "kers' compensation laws of California,
and agree that, if I s uld become Sul ' ct to the ork rs' compensation provisions of Section
of the Labor ode, I shall f ith comp) wit those provisions.
Date: /'L`- /vtr Applicant:
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 Quints, 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 Aththe above information is c rect. I a ree to comply with all
city and county ordinances and state laws relatingwilding const tion, and ereby aut rize representatives
of this cow ty to enter upon the above-mentionedrty for i ction purpo es.
Date, Signature (Applicant or Agen
Application Number . . . . . 06-00003524
------ Structure Information CONSTRUCTION OF DEMISING WALL
-----
other struct info . . . . . CODE EDITION
2001/2005,
FIRE SPRINKLERS
YES
MIXED-USE OCCUPANCY
UNKNOWN.
1ST FLOOR SQUARE FOOTAGE
----------------------------------------------------------------------------
2420.00
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee 117.00 Plan Check Fee
76.05
Issue Date Valuation
10000
" Expiration Date 4/08/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
8.00 9.0000 THOU BLDG 2,001-25,000
------------------------------------------------- -------------=
72.00
------------=
Permit ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . . 100.90 Plan Check Fee
25.23
Issue Date Valuation . . .
. 0
' Expiration Date 4/08/07
Qty Unit Charge Per
Extension 4
" BASE FEE
15.00
2420.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL
48.40
1.00. 37.5000 EA ELEC SVC <=600V/>200A/<=1000A
:
37.50
-----------------------------
Notes and Comments
2,420 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. PERMIT FOR DEMISING WALL
AND 400 AMP SUB -PANEL.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STRONG MOTION (SMI) - COM
2.10
Fee summary Charged Paid Credited
Due.
---------------------------------------------------------
Permit Fee Total 217.90 .00 .00
217.90
Plan Check Total .101.28 .00 .00
101.28
Other Fee Total 2.10 .00 .00
2.10
Grand Total 321.28 .00 .00
321.28
LQPERMIT
Bin #
City of La Quinta
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 #
o�
Project Address: „"�
Owner's Name:
A. P. Number:
Legal Description:
Address: - Q(=)o G'&l
City, ST, Zip:LA C)it AA (1k,
�
S3
Contractor:
Telephone:
Address:
Project Description:
City, ST, Zip:
Telephone:
W Yb
f
State Lic. # :
Arch., Engr., Designer:
City Lic.
Ne
Address:
City, ST, Zip:
Telephone: '�Fla .
State Lic. b •—
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair
Demo
Name of Conta n:
,e v A�
Sq. Ft.:
ries
# Units:
Telephone # of Contact Person:
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS LI E
#
Submittal
Req'd
Rec'd
I TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for correctinnw �f _ _ ..Plan
T77VV�
Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2a' Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN I{OUSE:-
'`" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
0
School Fees
Total Permit Fees
10 V.CA f 0 (K)
CAN�V� X40