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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 J tom- n Zr ! /L_ v, vi Q 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