05-3176 (RC)y 4y j •
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/20/05
Application Number: -0.5-0.00031-76 Owner:
Property Address: 79410 HIGHWAY 111 STE 102 KLEINE NEIL WAYNE t
APN: 649-820-006- - - 41910 BOARDWALK A-10
Application description: REMODEL - COMMERCIAL — PALM DESERT
Property Zoning: REGIONAL COMMERCIAL PALM DESERT, CA 92211
Application valuation: 8000 q
Contractor: ��D
Applicant: Architect or Engineer: Owner r 21 11105
C �� LA
E
Lic. No.: ANCY B
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 Div' 'on 3 of the Business and Professionals Code, and my License is in full force and effect. ,
License Class: License No.: ANCY B
Date: i M actor: pl. /—
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 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 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
1 I 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:
LQPERMIT
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 2001 Policy Number NO
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.
-late: Af p l<
,cant
FAILURE TO SECURE IJ'!
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI INAL 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 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 cgy/my'to.o. enter upon the above-mentioned property for inspection purposes.
Date: ure (Applicant or Agent):
Application Number . . . 05-00003176
Permit . .
BUILDING PERMIT
Additional desc .
Permit Fee . . .
99.00
Plan Check Fee
64-.3.5
Issue Date . . . .
Valuation . .
. 8000
Expiration Date
3/19/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
6.00 9.0000
THOU BLDG 2,001-25,0.00
54.00
Permit
ELECT -. ADD/ALT/REM
Additional desc.. .
Permit Fee . . . .
32.12
Plan Check Fee
8.03
Issue Date . . . .
Valuation . . . .
0
Expiration Date..
3/19/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
.856.00 .0200
----------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
17.12
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . .
19.50
Plan Check Fee
4.88
Issue Date . . . .
Valuation . . . .
0
Expiration Date
3/19/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 4.5000
----------------------------------------------------------------------------
EA MECH VENT
INST/ DUCT ALT
4.50
Permit . . .
PLUMBING
Additional-desc . .
Permit Fee . . . .
37.50
Plan Check Fee
9.38
Issue Date . . . .
Valuation
0
Expiration Date
3/19/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA PLB FIXTURE
12.00
1.00 7.5000
EA PLB WATER
HEATER/VENT
7.50
1.00 3.0000
EA PLB WATER
INST/ALT/REP
3.00
----------------------------------------------------------------------------
Special Notes and Comments
Commercial Remodel "Hollywood
LQPERMIT
LQPERMIT
Application Number
. ... . .
05-00003176
Special Notes and
Comments
_
Creations" Beauty
Salon TI, "B"
Occupancy, Type VN
Sprinkled,
Occupant
Load 9
----------=--------------------=--------------------------------------------
Other Fees . .
. . . .
.STRONG MOTION
(SMI)_- COM
1.68
Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
188.12
.00
.00
188.12
Plan Check.Total
86.64
00
.00•
86.64
Other Fee.Total
1.68
.00
.00
1.68.
Grand Total
276.44
.00
.00
276.44
LQPERMIT
P.O. Box 1504 BUILDING & SAFE-ry'DEPARTMIENT
78-495,C�i.i-iE TAM131CO (7 60) 7 7 7 - 7 0 12
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-701 1
To: Greg Butler, Building & Safety Mana ger To CDD- 7-25-2005
From- Doug Evans, Director -CDD Due Date: 8-05-2005
Status: 1ST Check
Building Plan's Approval
(This is an approval to issue a Building Permit)
The Community Development Department has reviewed the Building Plans for
the following project'.
Description- TENANT IMPROVEMLNT-BEAUTY SALON
Address or General Location: 79-410 HWY 111 SUITE 102(LA QUINTA VALLEY
PLAZA)
Applicant Contact: ROB PITCHFORD 346-2856
The Community Devblopment Department finds that:
...these Building Plans do not require Community Development
Department approval.
0. ... these Building Plans are approved by the Community Development
Department.
El ...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.
-7
Doug Evans, Director -CDD Date
n
Craig E. Anthony
Fire Chief
Proudly serving the
unincorporated
areas of Riverside
County and the
Cities of:
Banning
Beaumont
Calimesa
Canyon Lake
Coachella
Desert Hot Springs
E•
Indian Wells
6
Indio
Lake Elsinore
H
La Quinta
Moreno Valley
Palm Desert
Perris
Rancho Mirage
c.
San Jacinto
e•
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaoone,
District 2
Jeff Stone,
District 3
Roy Wilson,
District 4
Marion Ashley,
District 5
RIVERSIDE COUNTY.
FIRE DEPARTMENT
82-675 Highway Fax (760) 863-1072
July 28, 2005
Robert Pitchford Architect
74-835 Fox Hils Ct.
Palm Desert, CA 92260
Re: Non -Structural Building T/I=Plan_Review
LAQ�OX
067 /H�102
d Creations
79-4 11, St
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) As maybe necessary to maintain proper fire sprinkler protection due to constructions changes, fire
sprinkler system plans for the tenant improvement area may be required to be submitted to the Fire
Department -for review, along with a plan/inspection fee. The approved plans, with Fire Department
Job card must be at the job site for all inspections.
2) Provide keys to the tenant space for inclusion in the main building Knox Box. Key(s) shall have
durable and legible tags affixed for identification of the correlating tenant space.
3) Install portable fire extinguishers per Tide 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.
Requests for inspections are to be made at least 72 hours in advance and may be arranged by calling
(760) 863-8886.
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
Walter Brandes
Fire Safety Specialist
Cc: City,of La Quinta -_Building Dept
4nvF2WDeAu-Q*ft ntWECMT1LL4Q?e6T1.Wdw -
EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE
82-675 Highway 111, 2"d FI., Indio, CA 92201 • (760) 8633.8886 • Fax (760) 863.7072
to 'CITY OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS % y C I�GU !I SvI e- �pERMIT NUMBER �—�Jj�T� OWNER JQ c�,' � l°r I <%I'= BUILDER �`��- ��l
This form shall be posted on the job with the Building Inspection Card at all times in a eonsgicuous.nlace. Only persons appearing on this list or their employees are authorized to work
nn this inh- Anv chances to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
� :0j,(�iuNt�Q''c Certificato of Occupancyo
G� OFT9� 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: 79-410 Highway 111 Suite 102
Use classification: Commercial "Beauty Salon" TI — Hollywood Creations Building Permit No.: 05-3176
J
Occupancy Group: B J Type of Construction: VN Sprinkled Land Use Zone: CR
Owner of Building: Neil Kline Address: 41-910 Boardwalk A-10
City, ST, ZIP: Palm Desert, CA 92211
By: Daniel P. Crawford Jr.
Date: 10/18/05
Building Official
POST IN A CONSPICUOUS PLACE