12-0686 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:12-00000686
Property Address: 79485 HIGHWAY 111 STE 1
APN: 600-020-027- -
Application description: REMODEL - COMMERCIAL
Property Zoning: REGIONAL COMMERCIAL
Application valuation: 20000
Tu!t44Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
STAMKO DEV CO
10345 W OLYMPIC BLV
LOS ANGELES, CA_ 90A
r} �
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/10/12
Contractor. J
Applicant: Architect or Engineer: PREMIER CONTRA NG UP INI
25691 ATLANTIC OC B10 O1Z
LAKE FOREST, CA 9263 �irCi
(949) 305-0900
J/Y LiC./ No.: 837472
`r` \\\.
-------------------------------------------------------------------------------------7-----------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed er provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Busine and Proles ' n Code, and my License is in full force -and effect. - _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C10 License No.: 837472 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
/ate: ontract I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
01 Z Code, for the performance of the work for which this permit is issued. My workers' compensation
O E� R- �tt11LDER DECLARATION insurance carrier and policy number are:
hereby affirm under penalty of perjury that 1 am exemp from the Contractor's State License Law for the Carrier AMERICAN AUTO Policy Number A01093569
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I shoul become subject to the cers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the La4C,I shall orthwit m with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 byany applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date: plicant
(_ I 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSAT OVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
(_) 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , BAP.C. for this reason
Date:
Owner:
• CONSTRUCTION LENDING AGENCY
1 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
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 onthis 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 actor 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. ee to comply with all
city and county ordinances and state laws relating to building nstruction, and her au rize representatives
of this county to enter up n the above-mentioned prope inspec ' n purpo
te: 0 Z ignature (Applicant or Agent)'
Application Number . . . . . . 12-00000686
------ Structure Information STORE UPDATING/REFRESHING ONLY
-----
Other struct info . . . . . CODE EDITION -
2010
FIRE SPRINKLERS
FULLY
MIXED-USE OCCUPANCY
M
OCCUPANT LOAD
78.00
1ST FLOOR SQUARE FOOTAGE
----------------------------------------------------------------------------
3065.00
Permit . . . BUILDING PERMIT
Additional desc
I
Permit Fee . . . . 207.00 Plan Check Fee
134.55
Issue Date . . . . Valuation . . .
. 20000
Expiration Date 1/06/13
Qty Unit Charge Per.
Extension
BASE FEE
45.00
18.00 9.0000 THOU BLDG.2,001-25,000
----------------------------------------------------------------------------
162.00
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . . 45.75 Plan Check Fee
11.44
Issue Date . . . . Valuation
0
Expiration Date 1/06/13
Qty Unit Charge Per
Extension
FEE
15.00
_BASE
20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
15.00
35.00 .4500 EA ELEC DEVICE/FIXTURE >20
15.75
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Special Notes and Comments
-
T -MOBILE STORE UPDATING AND FINISH
REFRESHING ONLY, INCLUDING RELOCATION OF
SALES FIXTURES AND ASSOCIATED ELECTRICAL
INSTALLATIONS. THIS PERMIT DOES NOT
INCLUDE ALTERATION TO EXISTING FRAMING,•
BUILDING OCCUPANCY OR OCCUPANT LOAD.
2010 CALIFORNIA BUILDING CODES.
July 10, 2012.7:56:37 AM AORTEGA
----------------------------------------------------------------------------
Other Fees . .'. . . ACCESSIBILITY PLAN REVIEW
13.45
.
` BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
13.45
Fee summary Charged Paid Credited
Due
Permit Fee Total 252.75 .00 .00
252.75
LQPERMIT
Application Number . . 12-00000686
Plan Check Total 145.99 .00 .00 145.99
Other Fee Total 27.90 .00 .00 27.90
Grand Total 426:64 .00 .00 426.64
C
'P.O.'Bok 1 504. BUILDING•& SAFETY" DEPARTMENT
78-495 CALLE TAMPICO (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
To: Greg Butler, Building & Safety Manager
To CDD: (G —C�V-
From: Les Johnson, Director -Planning Due Date: "-P-7'
Permit #: Status: 1�
Building Plans, Approval
(This is an approval to issue a Building Permit)
The Planning Department has reviewed the .Building Plans for the following
project:
Description:
Address or General Location: 7,1"gb5
Applicant Contact:
The Planning Department finds that:
planning DONtrneni
❑ ...these Building Plans do not require Planning Department approval.
...these Building Plans are approved by the Planning Department.
❑ ...these Building Plans require corrections. Please forward a copy of the
attached corrections to the applicant: When the corrections are made
please re u�fhem to the Planning Department for review.
ohn76n, Director -Planning Date
G
CIS}/ 0 Qutnta
Bullding 8i Safety Div 6n
P.O. Box 1504,78-495 Calle Tampico
La..Quinta, CA 92233 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit # Cb�
1
Project Address: ' . L4I, (QA `I
Owner's Name:. L
A. P. Number.
Address: �I n
Legal Description:
Contractor. Ce
City, ST, Zip. ^ I "^
Telephone: z . (_ v l
Address: cinI G
Project Description:
City, ST, Zip: )_a N(Z"t
ra_.
Telqpho#�pS, pq00
State Lia # : City Lie., #:
Arch, EW., Designer
I
Address:
City., ST, Zip: I 126Q CA
Telephone b . 2
State Lie. #:LaL)
Name of Contact Person: CA
Construction Type: ' — Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq.. Ft.� LL $ Stories: # Units:
Telephone # of Contact Person: 2'
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW. THIS LINE
#
Submittal
Req'd
%Ree'd
TitACMG
PERIMTFEES-
Pian sets "
3
//
Plan Check submitted `!• o
Item Amount
Structural Odes.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
CaUed Contact Person
Plan Cherie Balance.
Title 24 Calcs.
Pians picked up
Construction
Flood plain plan
Pians resubmitted.'.
Mecharilcal
Grading plan
2'! Review, ready for correctlonsfissue
••�,,►-�
Electrical AM
Subeoutactor List
'"
Called Contact Person
Plumbing .�
Grant Deed
Plans picked up
SALL •--•
H.O.A. Approval
Plans resubmitted
Grading
IN SOUS&-
'^' Review, ready for corrects ue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I.P.P. "
Pub. Wks. APpr '
Date of permit issue
U41c. b1Q
School Fees
Total Permit Fees g1k. 64
7'tol'D�Ni, - . i '�. rLt w ` "LeM%war. (41m ��s