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BCOM2014-101978-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT ,Applicatio Number: BCOM2014=1019 Property Address: 79255 HIGHWAY 111 6 APN: 600340005 Application Description: NEC 111/LQ DRIVE -RELOCATING DISH WASHING AREA/REPLACE EQUIP Property Zoning: Application Valuation: $45,000.00 Applicant: GABRIEL LUJAN & ASSOCIATES 36947 COOK STREET STE. 104 PALM DESERT, CA 92211 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: .M License No.::LIC-762382 Dafe: ' —L/ Contractor i✓ �. 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 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.). (_) 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS(760)777-7153 Owner: CADO LA QUINTA RETAIL 1545 FARADAY AVE CARLSBAD, CA 92253 Contractor: B J BUILDERS OUTSIDE CITY LIMITS Lic. No.: :LIC -762382 Date: 10/13/2014 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 shZLabo t to the workers' compensation provisions of Section 3700 of tall forthwith comply with those provisions. V Date: 00/—&, l Applica{ WARNING: FAILURE TO SECURE WORKERS' COMPENSATI NVERAGE 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 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 1 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 city to enter,�orj,thefabove- mentioned property for inspection purposes. �� y c Date: ` Signature (Applicant or Agent i DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY AMOUNT. PAID_ ; PAID DATE: BSAS SB1473 FEE 101-0000-20306 0 $2.00 $2.00 10/9/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $2.00 $2.00 -DESCRIPTION ACCOUNTQTY AMOUNT PAID PAID DATE: APPLIANCES, NON -RES 101-0000-42403 0 $214.47 $214.47 10/9/14 PAID BY: METHOD RECEIPT ,# CHECK # CLTD BY HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH DESCRIPTION: " " ACCOUNT QTY ` AMOUNT PAID PAID DATE APPLIANCES, NON -RES PC 101-0000-42600 0 $214.47 $214.47 10/9/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH Total Paid for ELECTRICAL: $428.94 $428.94 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE APPLIANCE REPAIR/ALTERATION 101-0000-42402 0 $107.28 $107.28 10/9/14 PAID BY. METHOD RECEIPT # CHECK # CLTD BY HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE APPLIANCE REPAIR/ALTERATION PC 101-0000-42600 0 $42.93 $42.93 10/9/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH Total Paid forMECHANICAL: $150.21 $150.21 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP 101-0000-42401 0 $59.60 $59.60 10/9/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY . HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP PC 101-0000-42600 0 $59.60 $59.60 10/9/14 PAID BY METHOD. RECEIPT # CHECK # CLTD BY. HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH DESCRIPTION : ACCOUNT- QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $11.92 $11.92 10/9/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $11.92 $11.92 10/9/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH Total Paid for PLUMBING FEES: $143.04 $143.04 DESCRIPTION "ACCOUNT' QTY AMOUNT PAID. _ PAID DATE REMODEL, EA ADDITIONAL 500 SF 101-0000-42400 0 $150.15 $150.15 10/9/14 PAID BY METHOD RECEIPT #. CHECK # CLTD:BY HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH DESCRIPTION ... ACCOUNTQTY AMOUNT PAID PAID DATE REMODEL, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $120.12 $120.12 10/9/14 PAID.BY _ METHOD. RECEIPT # CHECK # :: CLTD BY HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH DESCRIPTION ACCOUNT QTY: AMOUNT PAID- PAID DATE REMODEL, FIRST 100 SF 101-0000-42400 0 $48.62 $48.62 10/9/14 PAID BY METHOD RECEIPT # CHECK # `: CLTD BY HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH DESCRIPTION.,ACCOUNT QTY AMOUNT-.. PAID: PAID DATE REMODEL, FIRST 500 SF PC 101-0000-42600 0 $132.99 $132.99 10/9/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH Total Paid for REMODEL: $451.88 $451.88 DESCRIPTION ACCOUNT QTY AMOUNT PAID _ PAID DATE SMI - COMMERCIAL 101-0000-20308 0 $12.60' $12.60 10/9/14 PAID BY., METHOD RECEIPT # "CHECK # CLTD BY HOLLANDS HOLDINGS INC. CHECK R1919 1024 SKH Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $12.60 $12.60 TOTALS: Description: NEC 111/LQ DRIVE -RELOCATING DISH WASHING AREA/REPLACE EQUIP STAFF NAME Type: BUILDING, COMMERCIAL Subtype: REMODEL Status: APPROVED Applied: 9/11/2014 SKH Approved: 9/30/2014 JJO Parcel No: 600340005 Site Address: 79255 HIGHWAY 1116 LA QUINTA,CA 92253 Subdivision: PM 30420 Block: Lot: 8 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $45,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 11M JOHNSON Details: REMODEL EXISTING RESTAURANT. ROOSTER'S CHRONOLOGY TYPE STAFF NAME ADDITIONAL CHRONOLOGY ACTION DATE COMPLETION DATE NOTES PENDING DOCUMENTS JIM JOHNSON 9/24/2014 9/24/2014 PENDING PLANNING DEPT APPROVAL BEFORE WE ISSUE. PLAN CHECK SUBMITTAL STEPHANIE KHATAMI 9/11/2014 9/24/2014 TELEPHONE CALL 11M JOHNSON 10/1/2014 10/1/2014 CALLED APPLICANT TO INFORM HIM SHEET 5A WAS MARKED WRONG. CONDITIONS NAME TYPE NAME ADDRESSl STATE ZIP. PHONE FAX EMAIL CONTACTS. CITY <::. APPLICANT GABRIEL LUJAN & ASSOCIATES • 36947 COOK STREET STE. 104 PALM DESERT CA 92211 (760)578-8545 CONTRACTOR B J BUILDERS OUTSIDE CITY LIMITS (760)578-8545 OWNER CADO LA QUINTA RETAIL 1545 FARADAY AVE CARLSBAD CA 92253 (760)578-8545 Printed: Monday, October 13, 2014 8:21:17 AM 1 of 3 INFORMATION''. CLTD DESCRIPTION ACCOUNT QTY. - AMOUNT_ PAID PAID DATE RECEIPT # CHECK.# . METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $2.00 $2.00 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGS SKH INC. Total Paid for BUILDING STANDARDS ADMINISTRATION $2.00 $2.00 BSA: APPLIANCES, NON -RES 101-0000-42403• 0 $214.47 $214.47 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGS SKH INC. APPLIANCES, NON -RES 101-0000-42600 0 $214.47 $214.47 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGS SKH PC INC. Total Paid for ELECTRICAL: $428.94 $428.94 APPLIANCE 101-0000-42402 0 $107.28 $107.28 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGS SKH REPAIR/ALTERATION INC. APPLIANCE 101-0000-42600 0 $42.93 $42.93 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGS SKH REPAIR/ALTERATION PC INC. Total Paid forMECHANICAL: $150.21 $150.21 FIXTURE/TRAP 101-0000-42401 0 .$59.60 $59.60 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGS SKH INC. FIXTURE/TRAP PC 101-0000-42600 0 $59.60 $59.60 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGS SKH INC. WATER SYSTEM 101-0000-42401 0 $11.92 $11.92 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGS SKH INST/ALT/REP INC. WATER SYSTEM 101-0000-42600 0 $11.92 $11.92 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGS SKH INST/ALT/REP PC INC. Total Paid for PLUMBING FEES: $143.04 $143.04 REMODEL;EA 101-0000-42400 0 $150.15 $150.15 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGS SKH ADDITIONAL 5000 SF INC. REMODEL, EA 101-0000-42600 0 $120.12 $120.12 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGS SKH ADDITIONAL 500 SF PC INC REMODEL, FIRST 100 SF 101-0000-42400 0 $48.62 $48.62 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGSSKH INC. Printed: Monday, October 13, 2014 8:21:17 AM 2 of 3 DESCRIPTION ACCOUNT QTY AMOUNT PAID. PAID DATE , RECEIPT # CHECK # METHOD M PAID BY CLTD 9/12/2014 9/26/2014 9/24/2014 APPROVED APPROVED PLANS APPROVED WILL STAMP AND SIGN PLANS WHEN APPROVED BY PLANNING DEPT PLANNING WALLY NESBIT 9/12/2014 1 BY REMODEL, FIRST 500 SF 101-0000-42600 0 $132.99 $132.99 10/9/14 R1919_ 1024 CHECK HOLLANDS HOLDINGS SKH PC INC. Total Paid for REMODEL: $451.88 $451.88 SMI - COMMERCIAL 101-0000-203080 $12.60 $12.60 10/9/14 R1919 1024 CHECK HOLLANDS HOLDINGS SKH INC. Total Paid forSTRONG MOTION INSTRUMENTATION SMt $12.60 $12.60 PARENT PkbiEtTS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED DATE REVIEWS STATUS REMARKS NOTES NON-STRUCTURAL JIM JOHNSON 9/12/2014 9/26/2014 9/24/2014 APPROVED APPROVED PLANS APPROVED WILL STAMP AND SIGN PLANS WHEN APPROVED BY PLANNING DEPT PLANNING WALLY NESBIT 9/12/2014 1 9/26/2014 1 9/19/2014 1 COMPLETED NEC 111/LQ DRIVE ASSIGNED WN 9.16 BOND „ .. . INFORMATION. ATTACHMENTS Printed: Monday, October 13, 2014 8:21:17 AM 3 of 3 Clow --------- Bin # City of La Qulnta Building 8t• 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:1 Owner's Name: 1 KU \ , ( `IC'. ... A. P. Number: Address: ilk _nk c, Legal Description: City, ST, Zip: Contractor: �- Telephone: Z :� :;:::.>;.�::::..;=;:::,:.�,:�;• . Address: Project Description: City, ST, Zip: Telephone: - • State Lic. # : City Lie. #: Arch., Engr„esign <.pG�r`� .e ` �V r Address: -�>CQ' 1` -1 City., ST, Zip: C�1 ✓Pg �� (� Telephone: � (� .)� ;:::.;; �� .:; �::>: r >;;<;;:: Construction Type: iJ Occupancy: ProJecState New Add'n Demo Repair ttyP (circle one): Sq. Ft.: # Stories: # Units: Lie. #: Name of Contact Person: - —r7'�V Telephone # of Contact Person:-Iceln Estimated Value of Project: Gj APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance, Title 24 Cala. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan2.d Review, ready for correction issue Z Electrical T Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. 1011 H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'rd Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. N� Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees q/llAtt,--� Tws 5 Permit Number: BCOM2014-1019 Description: RELOCATING DISH WASHING AREA/REPLACE COOKING EQUIPMENT Applied: 9/11/2014 Approved: Site Address: 79255.HIGHWAY 1116 Issued: Finaled: City, State Zip Code: LA QUINTA, CA 92253 Status: SUBMITTED Applicant: GABRIEL LUJAN & ASSOCIATES Parent Permit: Owner: CADO LA QUINTA RETAIL Parent Project: Contractor: <NONE> Details LIST OF SENT DATE RETURNED DATE DUE DATE TYPE ` CONTACT STATUS REMARKS Review Group: BLDG 1ST (2WK) 9/12/2014 9/26/2014 NON-STRUCTURAL Notes: 9/12/2014 �-" 9/26/2014 PLANNING PLANNING BUCKET oil, /6 Cj Notes: - Printed: Friday, 12 September, 2014 1 of 1 SYSTEMS I CITY OF LA QUINTA SUB-CONTRACTOR_ LIST JOB ADDRESS J PERMIT NUMBER& WNER ( -!l�C�l(/�-BUILDER This form shall be posted on the _ wit a BuildingInspection Card at all times in a conspicuous lace. Only persons appearing on this list or their employees are authorized to work on thisjob. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a soppage of work and/or the voidance. of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. :...............:.::::::::::::::..:::::::........... Trade / Classif�catiOh Contractor :::.::::.;.:.::......::::::::::::::::•::::::::: ...:.: . .. StatO:.Conttactor:.s:.Lic:ease .............................. ::.:;::: ce.......:::::::....... Co.m ensa.tion.lnsuraa Workers.. . t:. <Biisiness::. Y..........................:...... �cense <>> Company Name License Number Exp. Date Carrier Name Policy Number t Exp.. Date License Number Exp. DateClassif'cation `xx - 9 B C 8 ) x xxxxx ( 1 xx xx xx ► / / .Sate Fund CalCom e. t P ) 9 Forma t Var ies ) xx x xx / x. / 1 a xx xx 1 xx xx / 1 >EARTHVILO:RK C'=.I i >CO CRETE`C:=8'>>>[:?<» I AM F PLUMBING(.G.= // ✓Ci C42C31V (v �Mlf Id/AD� LATH"PLASTE'. C-35'.1':« :+ 13 .::.:.::..:.:.:::.. . '`:L: ;0:_0".> z` .... ...... SHEET: M...:.:.:....::1.:.::.:.:.: —I =: k5 '< _ - t N S IJ:L ATI Q: ()[,.. ::::::. . { . . Y� C 5 < .CE;RAMI:C TILE (C.:..::. ).;> ............... ABINETS. C i FENCING:`C_>3"<<><:>:< i LAN D. C A P I N'G (:C L C __ {