0312-099 (RC)- - - LICENSED CONTRACTOR DECLARATION
I hereby affirm ul"Ider penalty of perjury that I am licensed under provisions of
Chapter 9 (comrr.indng with Section 7000) of Division 3 of the Business and
Professid'nals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
p�Date I' {� i"� Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) 1, as owner of the property, am exclusively contracting with licensed
contractors to construct -the project (Sec. 7044, Business, & Professionals
Code).
() I am exempt under Section B&RC. for this reason
Date Signature of Owner
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 & policy no. are:
Cartier Policy No.
STi' 7 z t ; " i � J 6'. at' - (.r
(This section need not be completed if the 'pe'rmit valuation is for $100.00 or less).
( ) 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 should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
/Date: f �„ L`,^t Applicant V t c i
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
r
r Signature (Owner/Agent)° r'4'L, y!� *.-. f•� Date
:BUILDING PERMIT PERMTN
DATE �>C VALUATION Loy'. TRACT
1242/20t1Ct.00 ..
JOB SITE
APN
ADDRESS p4_4W .11:1GHWAy t I 1 9
OWNg�.E�RR
CONTRACTOR/ DESyIiG�gN�ErR / ENS
y' �. y,� � p 5
aco ,
{INFER
XYLrKG
385: VJA DC1L.CZ
13020 7MIA WHITEWAY OR
MARIWA DEL, P.EY CA 902,97
3 ORWALXS CA 90650
USE OF PERMIT
C0MM1MCY%LRk1MClDM
COAtlMc7Rt3Ad,REMODEL (SUMP, V) 01V OCCUPANCY, TYPEVN
St�Ii1N��L ED, OCCUPANT LOAD 39, 2001 CDC
VALUATION lea
PENMI i° I'` .V SBIUMGkRY
PLAN CH BCK VEE9 .101-000439-518 UOS .
(.,'O iSTRU(3TIAN V�It 7'01-000-Q.18-000 $�1s.f13
MECH NICAL+ PER 101.000.421.0.10 S45,00
ELECTRICAL i6.".AL PRE 101-l^W-420-6 00 $53.40
PlILM..L ale ITIS 1:01.000.419.000 03.00
oTFtt' NQ MOTION FEE • COMM, 3 00z-000-241 -000 $1.515
SUB -TOTAL CO.'R l2UC'°3 014 AND.PZ®�5P,12SuTt�Qc�f�,t''yi�
$356,43
�+t+L cg
1'.a .33 PRE -PAM .C.4'ri Z
7
$0.00
D Q
C_C 12 2003.
ECEIPT CITY OF
BY ,r'
DATE FI ALED h
INSPECTOR
FINANCE
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
a BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings 04
Ducts
Slab Grade/
ReturnAir
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing T
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROV S
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
F4ial I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test 79
Appliances
`
Final -
Rnal
Utility. Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
if
x
X
A
A
X
Bin #
Permit #
Project Address: _ OS
City of La Quinta
Building BE Safety Division p,
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012 V
Building Permit Application and Tracking Sheet
Owner's Name:
A. P. Number:":e6
Legal Description:
4City. ST, Zip:/�-
Contractor:
Address: ��
Gzj
FTelephone:
Project Description:
City, ST, Zip: A6-6
Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:�
• _ _. z
�.
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: aO
# Stories:
# Units:
Telephone # of Contact Person: % — ��
stimated Value of Project: T§J oa�
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
b/'4 1
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person -
Plan Check Balance
Energy Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A: Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review, readv for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person_
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
7—
IM
r 'P`
X
X
x
X
Ga.
$2\r
Vo' City of La Quinta
Building 8I Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 - (760) 777-7012
Building Pe it Application and Tracking Sheet
t
V
Permit #
Project Address: _ OS
N
a 6 NO
A. P. Number: E S g
rAddrcss:
Leeal Descript on:
Contractor:
Address: 5:1�Z4�2-
, Zip:
FTele ho
Project Description:
City, ST, Zip: S
Telephone:
State i . # : %%�
Arch., Engr., Designer:
iry Lic. #:
Address:
City, ST, Zip:
Telephone:-
�Y
k � �
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
ane
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: XO # Stories: #Units:
Telephone # of Contact Person: %�
1�stimated Value of Proiect: ODIC
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
1�lI Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person SG •
// N Plan Check Balance •
(pLE,3s
Energy Calcs.
Plans picked up
11/1
I•
Construction
Flood plain plan
Grading plan
Plans resubmitted .S -f
•
2~ Review, ready for correct' s/issu
«� •� Mechanical
/Z�a Electrical 2
�fS,aa
� 4D
Subcontactor List
Grant Deed
H.O.A: Approval
Yi7w
Called Contact PersonD
Plans picked up
Plans resubmitted
Plumbing tt
SAM. � �
Grading
/�2
�•
IN HOUSE:-
'"' Review, readv for corrcctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A I.P.P.
Pub. Wks. Appr
Date of permit issue
7. 40"
School Fees
/Z a/^�03 �w TD 1-130'a &/7*
4W1V 11104WGfp0W /NG
Total Permit Fees
T —'
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Z" 1'��iK? to-srMflMt
� dR` Nor iN Z
7'
CID
I oi23
P�iS
a 6 NO
/Z
7'
W
•
1 4 44"
P.O. BOX 1504
78-495 CALLE TAMPICO
LA.QUINTA, CALIFORNIA 92253
To: Greg Butler, Building & Safety Manager
From: Oscar Orci, Planning Manager
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
To CDD: 1010-2
Due date: 1010
Status:11 std
Building Plans Approval.
(This is an approval to issue a Building Permit)
The Community Development Department has reviewed the Building Plans for th
following project: e
Description: Super Nails — fingernail shop
Address or general location: 79-405 Highway 111 Ste. S-8
Applicant Contact: Danny Duon 799 3933
The Community Development Department finds that:
... these Buil ing Pans do not require Co
approval. Gt1� }rtmumty Development Department
� ...these Buil
ding Plans are approved by the Community Development
Department.
0 ...these Building Plans require corrections. Please forward a copy of the
attached
corrections to the applicant. When the corrections are made please return them to
the Community Development Department for review. m to
r_
—.-71 lc,unng Manager
Date
Tom Tisdale
Fire Chief
Proudly serving the
unincorporated
areas of Riverside.
County and the
Cities of:
Bamun
g
Beaumont
Cahmesa
Canyon Lake
4.
Coachella
s
Desert Hot Springs
4.
Indian Wells
4.
Indio
Lake Elsinore
;d -.•
ti. La Quinta
1 s•.
Moreno Valley
Palm Desert
.;.
Perris `
4 -
Rancho Mirage
❖ '
San Jacinto
4.
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jim Venable,
District 3
Roy Wilson,
District 4
Marion Ashley
District 5
RIVERSIDE COUNTY FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
82-675 Highway 111, 2nd FI., Indio, CA 92201 e (760) 863-8886 • Fax (760) 863-7072
December 11, 2003
Danny Duong
31405 Delyermo Ave
Cathedral City, CA 92234
Re: Non -Structural Building TA Plan Review
LAQ-03-TI-102 / Super Nails
79-405 Hwy 111, #8
Fire Department personnel have reviewed and approved the plans you submitted for the above
referenced project. Please be advised the following conditions apply as a part of the conditions for the
issuance of a building permit.
1) Fire sprinkler system plans for the tenant improvement area must be submitted to the Fire
Department for review, along with a planlnspection fee. The approved plans, with Fire Department
Job card must be at the job site for all inspections.
2) Provide either a separate Knox Key Lock box, Model 4400, 3200 or 1300, mounted per
recommended standard of the Knox Company or provide key(s) for inclusion in the general building
Knox Box. If the building/facility is protected with a fire alarm system or burglar alarm system, the
lock boxes will require "tamper" monitoring. Special forms are available from this office for the
ordering of the Knox Box, this form must be authorized and signed by this office for the correctly
coded system to be purchased.
3) Install portable fire extinguishers per Title 19, but not less than 2A1 OBC in rating. Contact
certified extinguisher company for proper placement of equipment.
4) Approved building address shall be placed in such a position as to be plainly visible and legible
from the street and rear access if applicable. In multi -tenant buildings, businesses shall post the
business name and suite number on back doors as well as the front. Suite numbers or letters
must be a minimum of 6" in height. All addressing must be legible and of a contrasting color with
the background.
Please contact the Fire Department Planning & Engineering staff for final inspection prior to
occupancy.
All questions regarding the meaning of these conditions should be referred to the Fire Department
Planning & Engineering staff at (760) 863-8886.
Sincerely,
FRANK KAWASAKI
Chief Fire Department Planner
By �
Walter Brandes
Fire Safety Specialist
Cc: City of La Quinta — Building Dept.
HAPEMP DaMXU QutrUWRQ1ECf31TNAQ-0341-102Aoc
EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE
82-675 Highway 111, 21d FI., Indio, CA 92201 9 (760) 863-8886 • Fax (760) 863-7072
Certificate of .Occu anc-Occupancy.
�oF� Building & Safety Department
�4
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
e
h
Code, certifying that, at the time of issuance, this structure was in compliance with the
k '
` provisions of the Building Code and the various ordinances of' the City regulating building
.
i.<
construction and/or use.
i
a
F
BUILDING ADDRESS: 79-405 Highway 111 Suite #8
�s
Use classification: Commercial "Super Nails" TI Building Permit No.: 0312-099
:,
1
Occupancy Group: B Type of Construction: VN Sprinkled Land Use Zone: CR
:
s
a
Owner of Buildin Stamko Development Co. Address: 3856 Via Dolce
g'
i
n
City, ST, ZIP: Marina Del Rev, CA 90292
r'
4
..�• By: Daniel P. Crawford Jr.
k
Date: 2/23/04
Building Official
R
POST IN A CONSPICUOUS PLACE
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