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05-0699 (RC)Box 1504 5 CALLS TAMPICO JINTA, CALIFORNIA,92253 BUILDING PERMIT =r —W. Application description Property Zoning . . . . . Application valuation . . Owner BUILDING & SAFETY DEPARTMENT (760).777-7012, FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 �(0 5=00;0 0.0 6.9 9 79305`H1GHWAY 111 STE 2 649-030-999-7 -30420 - REMODEL - COMMERCIAL ....REGIONAL COMMERCIAL 2500 STAMKO DEV CO C/O PROVIDENT FINANCIAL MGMT 10345 W OLYMPIC BLVD 2 FL LOS ANGELES CA 90064 Contractor Date 3/28/05 ULTRA CONSTRUCTION 3065 E. VERONA ROAD PALM SPRINGS CA 92264 (760) 320-2113 WCC: STATE FUND WC: 1615446 03/01/06 CSLB: 464856 10/31/06 CCC: B. ------- Structure Information COMMERCIAL REMODEL ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . ... . . . MERCANTILE Other struct info . . . . . CODE EDITION 2001 FIRE SPRINKLERS YES MIXED-USE OCCUPANCY M OCCUPANT LOAD 55.00 1ST FLOOR SQUARE.FOOTAGE 1920.00. ------------------------- --------------------------------------------------- Permit BUILDING PERMIT Additional desc Permit Fee . . . . 54.00 Plan Check'Fee 35.10 Issue Date . . . . Valuation . . . . 2500 Qty Unit Charge. Per. Extension BASE FEE 45.00 1.00. 9.0000 THOU BLDG 2,001-25,000 9.00 --------------------------------- ------------------------------------------ Special Notes and Comments - Commercial remodel "La Placita" TI, 1,920 sqft, "M" Occupancy, Type VN Sprinkled, Occupant Load 55 -------------------------------------- ---------- ---------------------------- Other Fees . . . . . . .. STRONG MOTION (SMI) - COM .52 Fee summary Charged Paid Credited Due ----------------- --- ------ ---------- ---------- ---------- Permit Fee Total 54.00*-- •- - .00 .00 54.00. Plan Check Total 35.10 .00 .00 35.10 Other'Fee Total .52 .00 .00 .52 P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: 0 Applicant: Applicant's Mailing Address: Architect or Engineer: AW % A - VOICE (760) 777-7012 FAX (760) 777-701 1 INSPECTIONS (760) 777-7153 Date: J -,,,2,�3 - 0 Arcnitect or k:ngineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS ,A 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 Professionals Cq09,r2nd my Licensek in full force and effect.. __&I -cense Class Ll icense No.-..qk L(? 54 ,_�ate_ 517-11 05 P dntactcir ULZ&I& — 57 /0 - OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or through his or her own employees, provided that the improvements are not intended or offered for sale. If. however, the building orimprovement 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.). U 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.). U I am exempt under Sec. _, BA P.C. for this reason Date WORKERS'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. XI have and will maintain workers' compensation insurance, as required by Section 3700 of the Labo'r Code, for the performance of the work for which this permit is ionlris 2��nce came d policy n b .,�rri er __-F-blicy Number , r are: I certify that, in the performance of the work for which7zt�� 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 become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. p,,caI_X 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 SE:CTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forlh 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 building construction. and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. �ate 1-Z �O t) Signature (Applicant or Agent): 12% t Page 2 Date 3/28/05 .00 89.62 PREPARED 9/29/05, 10:21:11 - - 1 INSPECTION HISTORY REPORT PAGE 1 PROGRAM BP521L 0/00/00 THRU 0/00/00 CITY OF LA QUINTA --------------------------------------------------------------------------- APPLICATION PROPERTY ADDRESS — ------------------------------------------------------- APN Alternate ID STRUCTR PERMIT ------------------------------------------------------------------------------------------------------------------------------------ INSPECTION RESULT DATE/STATUS INSPECTOR 05 00000699 79305 HIGHWAY 111 STE 2 649-030-999-7 -30420 - 000 000 BADA 00 BUILDING PERMIT - ADA 145 0001 FRAMING 3/29/05 APPROVED DC 000 000 BADA 00 BUILDING PERMIT - ADA 160 0001 DRYWALL NAIL 3/30/05 APPROVED DC RES COMM: Temporary use of permanent power approved. Unable to log RES COMM: under electrical, no application on file. 000 000 BADA 00 BUILDING PERMIT - ADA 199 0001 FINAL 4/15/05 DISAPPROVED DC RES COMM: No access at 8:45AM, correction notice left at front door. 000 000 BADA 00 BUILDING PERMIT - ADA 199 0002 FINAL 4/18/05 DISAPPROVED DC ' RES COMM: Final TI inspection performed with corrections issued. 000 000 BADA 00 BUILDING PERMIT - ADA 199 0003 FINAL 4/22/05 APPROVED ST - - 1 C Tom Tisdale . Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Banning Beaumont Calimesa Canyon Lake Coachella Desert Hot Springs Indian Wells Indio Lake Elsinore La Quinta Moreno Valley Pahn Desert Perris Rancho Mirage San Jacinto Temecula Board of Supervisors Bob Buster, District 1 John Tavaglione, District 2 Jim Venable, District 3 Roy Wilson, RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department of Forestry and Fire Protection 210 West San Jacinto Avenue • Perris, California 92570 • (909) 940-6900 • Fax (909) 940-6910 May 31, 2005 To: La Quinta Building Department Re: Final fire Clearance The Riverside County Fire Department is granting a fire life safety clearance for La Placita,t9=305- SHighway 1 ff I;AQ=05TI121 If you have any questions contact me at 760-345-6954 Respectfully, . Neal Stephenson Fire Systems Inspector s 0 F Permit#0 Project Address: '79-305 dtiju A. P. Number: 7 - Legal Legal Description: Contractor: K ( �G) /Z J - Address: City. ST, Zip.: V Telephone: X State Lic. # : X, Arch.. Engr., Designer: Address: City. ST, Zip: Telephone: State Lic. #: Name of Contact Person: Telephone # of Contact Person: # I Submittal Plan Sets Structural Calcs. Truss Calcs. Title 24 Calcs. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees M1 City Of La Qu, lnta Building 8L Safety Division P.O. Box 1504, 78-495 Calle Tampico +; La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Ll . cL Owner's Name: Q' Address: X '1/G City. ST. Zip: K Va Telephone: (' Project Description: Project ct type (circle one): Ne,- Add'n Alter Repair Demo G . :Sq:.:Ft-: ! oZ 0 # Stories: #Unit >6 �0P3506 Estimated, Value of Proiect:x APPLICANT: DO NOT WRITE BELOW THIS LINE Rec'd TRACKING PERMIT FEES Plan Check submitted 11 to Item Amount Reviewed. ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical 2nd Review, ready for correctio slissue T : Electrical ------------ Called Contact Person 'Plumbing Plans picked up S.111.1. Plans resubmitted Grading RevieN, ready for corrections/issue Developer Impact Fee Called Contact Person A.I.P.P. Date of permit issue r Certificate of Occupancy ��- QU&rCV copy 4 F 0 Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 79-305 Highway 111 Ste 2 b Y t Use classification: Commercial Remodel (La Palcita) TI Building Permit No.: 05-0699 F Occupancy Group: b Type of Construction: VN Sprinkled Land Use Zone: CR Owner of Building: Stamko Dev Co Address: 78-060 Calle Estado Ste 5 City, ST, ZIP: La Quinta, CA 92253 E S e ----& By: 4/4/05 ------&4 -011 . Date: Steve Traxel Building Official POST IN A CONSPICUOUS PLACE s