05-5077 (ELEC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05=00005077
Property Address: C79-4-1:0—HIGHWAY' 111 STE 106
APN: 649-820-006- - -
Application description: ELECTRICAL
Property Zoning: REGIONAL COMMERCIAL
Application valuation: 1000
Ta-vl 4 4Q"
Applicant: Architect or Engineer:
1
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury th t I am licensed under provisions of Chapter 9 (commencing with
Section 7000) ofDivision 3 of the Busine Professionals Code, and my License is in full force and effect.
License Class: - - - - - - - - - - License No.: C10
Date: _ -) 69- Contractor.
DECLARATIONI hereby affirm under penalty of perjur I am�WNER-BUILDER
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).:
(_) I, as owner of the property, or my employees with wages as their sale 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, 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.).
( 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
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.).
Owner:
Lender's Name: _
Lender's Address:
LQPERMIT
Owner:
KLEINE NEIL WAYNE
41910 BOARDWALK A-10
PALM DESERT
PALM DESERT, CA 92211
Contractor:
BIG A ELECTRIC INC
67150 TAMARA ROAD
CATHEDRAL CITY, CA 92234
WCC: STATE FUND
Lic. No.: C10
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/17/05
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
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 2290024574 04/01/013olicyNumber 783197
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 a to cliect
subject to the workers' compensation laws of California,
and agree that, if I should e to the workers' compensation provisions of Section
3700 of the Labor Code, Iith comply with those provisions.
Date: 1I_ I Applicant:
WARNING: FAILURE TO SECURE WOR M ENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINA i L IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND '
DOLLARS ($100,000). IN ADDITION 0 HE 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 *-c
cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state thation is correct. I agree to comply with all
city and county ordinances and state laws relating toon, and hereby authorize representatives
of this county t enter upon the above-mentioned prn purposes.
Date,."((, ' Signature (Applicant or Agent):
LQPERMIT
Application Number . . . . . 05-00005077
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . 35.40 Plan Check Fee
8.85
Issue Date . . . . Valuation . . .
. 0
Expiration Date 5/16/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
15.00
12.00 .4500 EA ELEC DEVICE/FIXTURE >20
5.40
-----------------------------------------------------7----------------------
Special Notes and Comments
ADD DISPLAY CASE LIGHTING/FIXTURES.
SUPPLEMENTAL TO TI PERMIT 05-4192
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 35.40 .00 .00
35.40
Plan Check Total 8.85 .00 .00
8.85
Grand Total 44.25 .00 .00
44.25
' i
Bin #
CII, Of La Q
Y 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 #
%
Project Address: —N y 1C) LIN Sh i tC I06
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: &S P NPv Ffett,,Z
Telephone: ',
Project Description:
Address: ) ^vTq VVI w-, i2
City, ST, Zip: C Ciel,/,/ Ufv C 49121St(
c6'se I; t1l`.� c,�� vc�? LyclPs 2.
Telephone: 76U
d a
State Lic. #: -7 g 7
City Lic. #: 3
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: ��� J J�H Svc
Construction Type:Occu anc : ��
P Y 2
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
4 Stories: ,
# Units: 1
Telephone # of Contact Person: -?60 3 ;�L) 00'3 .2,
Estimated Value of Project: m(x)
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
�� �7►
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading.plan
2"" Review, ready for corrections/issue
Electrical
Subcontactor List
Called ContactTerson
Plumbing ( Z
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:- .
'`" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
90
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tom- n Zr !
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1J
P.O. BOX 1504
78-495 CALL-_ TAMPICO
LA QUINTA, CALII'ORNIA 92253
- o
To: Greg Butler, Building & Safety Manager
From: Doug Evans, Director -CDD
Bu.II.I)ING & SArrTY Drl'ARTMI-NT
(760) 777-7012
FAX (760) 777-701 1
To CDD:. 9-20,2005
Due Date: 9-28.2005
Status: 1 ST Review
Building Plans Approval'.
(This is an approval to issue a Building Permit)
The Community Development Department has reviewed the Building: Plans for
the following project:
Description: CHANGE OF USE/BUDGET BLINDS S. �
Address or General Location
Applicant Contact:
7941.0_N0Y 111 SUITE 106
MR. CHANG KIM
The Community Development Department finds that:
❑ ...these Building Plans do not require Community Development
Department approval.
...these BuildingPlans area roved b the Community Development
pp Y Y p
Department.
❑ ...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.
., :. . I -
f�Aft =6c -T- C)C,
Doug Evans, Director -CDD Date
70
x
Craig E. Anthony May 23, 2005
Fire Chief
RIVERSIDE COUNTY
FIRE DEPARTMENT
Proudly serving the
Robert Pitchford Architect
unincorporated
74-835 Fox Hils CIL
area of Riverside
Palm Desert, CA 92260
County and the
Cities of
Re: Non -Structural Building TA Plan Review
LAQ-05-TI-05 /79 410 Hviry1t11'{.
Banning
Ste1;03;"06,07, 108;110;111,112>..
Beaumont
Fire Department personnel have reviewed and approved the plans you submitted for the above
1%
Caimn sa
referenced project Please be advised the following conditions apply as a part of the conditions for the
issuance of a building permit
Canyon Lake
4.
1) _ As may be necessary to maintain proper fire sprinkler protection due to constructions changes, fire
Coachella
sprinkler system plans for the tenant improvement area may be required to be submitted to the Fire
1%
Department for review, along with a planfinspection fee. The approved plans, with Fire Department
Desert Hot Springs
Job card must be at the job site for all inspections.
c
Indian Wells
�
2) Provide keys to the tenant space for inclusion in .the main building Y( Knox Box. Ke s ) shall have a
Indio ,
durable and legible tag affo(ed for identification of the correlating tenant space.
Lake Elsinore
• 3) Install portable fire extinguishers per Title 19, but not less than 2A10BC in rating. Contact certified
c• -
extinguisher company for proper placement of equipment
La Quinta
c
4) Approved building address shall be placed in such a position as to be plainly visible and legible from
Moreno Valley
the street and rear access if applicable. In multitenant buildings, businesses shall post the
``
Paha Desert
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
Penis
background.
1%
Rancho Mirage
Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy.
San Jacinto
Requests for inspections are to be made at least 72 hours in advance and may be arranged by calling
%%
(760) 863-8886.
Temecula
All questions regarding the meaning of these conditions should be referred to the Fire Department
Planning & Engineering staff at (760) 863-8886.
Board of Supervisors
Bob Buster,
Sincerely,,
District 1
i'
John Tavagii
FRANK KAWASAKI
str d 2
Chief Fire Department Planner
Jeff Stone,
District 3
Roy Wilson,
, By
District 4
- Walter Brandes
Marion Ashley,
Cc: City of La Quinta —Building Dept Fire Safety Specialist
District 5
MS"owu, ow.wawE== aA5-T1as.eoc
EMERGENCY SERVICES DMSION . PLANNING SECTION • INDIO OFFICE
82-675 Highway 111, 2nd R., Irdo, CA 92201 . (760) 863-8886 • Fax (760) 863-7072