11-0916 (RC)4 f-
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
L_.
Application Number: L
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
11-00000916 \
79485 HIGHWAY 111 STE
600-020-027- -
REMODEL - COMMERCIAL
REGIONAL COMMERCIAL
60000
T4t�l 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
STAMKO DEV CO
10345 W OLYMPIC BLV 2 FL
LOS ANGELES, CA 90064
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
Applicant: Architect or Engineer: EVERLAND CONSTRUCTION INC —
2846 W. 6TH STREET #208 D
LOS ANGELES, CA 90005
(213)272-3004
1I/L Lic. No.: 893033
�J P i
1
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am'licensed under provisions hapter 9 (commencing with
Section 7000) of Division 3 of the Business and Profess'License ' full force and effect.
License Class: B License No--
���R-BUILDER DECLARATION
I hereby affirm under pen ty o erlu t mpt from the Contractor's State License Law for the
following reason (Sec. 703. ess d Professions Cade: 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 _ 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , B.&P.C. for this reason
Date:
C.
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 ISec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Date: 9/15/11
.. 1 u
__-Nclzo 16 2011
CITY OF LA QUANTA
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 STATE FUND Policy Number 0000608-2010
I certify that, in the performance of the work for which this e'm'
is issued, I shall not employ any
person in any manner so as to become o the workers ansation laws of California, .
and agree that, if I should be ubjecza,tgM�e workers' compensa ' n provisions of Section
3700 of the Labor Code, I I forthwi O Ply with those pr wo
WARNING: FAILURE TO SEOIl COM ENSATION COVERAGE UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIAdI L PENAL I AND CIVIL FINES UPTO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE C T OF COMPENSAT16N, 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 abo a in rmation is correct. .agree to comply with all
city and �� c�ounty ordinances ands ate laws relating to buil . ruction, and her thou r presentatives
of thiseounty to enter upon above-mentioned erty for i pection purposes.
r )_ Wnature (Applicant or
Application Number . . 11-00000916
LQPERMIT
Structure Information
Construction Type . .
. . . TYPE V, UNPROTECTED
Other struct info .
. . CODE EDITION
2010
FIRE SPRINKLERS
YES
MIXED-USE OCCUPANCY
A2
OCCUPANT LOAD
145.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
1752.00
Permit . . .
BUILDING PERMIT - ADA INV FEE
Additional desc ._.
Permit Fee
919.00 Plan Check Fee
298.68
Issue Date . . . .
Valuation . .
. . 60000
Expiration Date
3/13/12
Qty Unit Charge
Per
Extension
BASE FEE
82'9.00
10.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 50,001-100,000
90.00
Permit . . .
ELECT - ADD/ALT/REM INV FEE
Additional desc .
Permit Fee . . . .
125.80 Plan Check Fee
15.73
Issue Date . . . .
Valuation
0
Expiration Date
.3/13/12
Qty Unit Charge
Per
Extension
BASE FEE
30.00
20.00 1.5000
PER ELEC DEVICE/FIXTURE IST 20
30.00
1.00 37.0000
EA ELEC SVC <=600V/<=200A
37.00
32.00 .9000
--------------------------
EA ELEC DEVICE/FIXTURE >20
----------------------------------
28.80
-----------.-----
Permit
MECHANICAL INV FEE
Additional desc .
Permit Fee . . . .
66.00 Plan Check Fee
8.25
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
3/13/12 .
Qty Unit Charge
Per
Extension
BASE FEE
30.00
4.00 9.0000
----------------------------------------------------------------------------
EA MECH VENT INST/ DUCT ALT
36.00
Permit . . .
PLUMBING INV FEE
Additional desc .
w Permit Fee . . . .
144.00 Plan Check Fee
18.00
LQPERMIT
Application Number . . . . . 11-00000916
Permit . . . . . . PLUMBING INV FEE
Issue Date . . . Valuation . . .
. 0
Expiration Date.. 3/13/12
Qty Unit Charge Per
Extension
BASE FEE
30.00
6.00 12.0000 EA PLB FIXTURE
72.00
1.00 6.0000 EA PLB WATER INST/ALT/REP
6.00
6.00 6.0000 EA PLB FIXTURE DRAIN/VENT REP/ALT
36.00
----------------------------------------------------------------------------
Special Notes and Comments
**CONSTRUCTION WORK COMMENCED PRIOR TO
PERMIT ISSUANCE,INVESTIGATIVE FEES
ASSESSED PER CBC 109.4**
1752 SF TENANT IMPROVEMENT TO EXISTING
1473 SF EXISTING RESTAURANT. A-2
OCCUPANCY, TYPE V-B CONSTRUCTION W/ FIRE
SPRINKLERS. 145 OCCUPANT LOAD. 2010
CODES.**ELECTRICAL PLAN APPROVAL
REQUIRED PRIOR TO FINAL INSPECTION**
-------7--------------------------------------------------------------------
Other Fees . . . . . . . ACCESSIBILITY PLAN REVIEW
29.87
BLDG STDS ADMIN (SB1473)
3.00
ENERGY REVIEW FEE
29.87
STRONG MOTION (SMI) - COM
12.60
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 1254.80 .00 .00
1254.80 ,
Plan Check Total 340.66 .00 .00
340.66
Other Fee Total 75.34 .00 .00
75.34
Grand Total 1670.80 .00 .00
1670.80
LQPERMIT
TDUBLE FEE
Bin #
COID,
City of La Quinta
Building u Safety Division
P.O. BOX 1504, 78-495 Calle Tampico
La Quinta, CA 91253 - (760) 777-7012
Building Permit Application and Tracking Sheet
'Peffnit #
Project Add
Owner's Name:
A. P. Number:
Address: 81S H101VIII 5
Legal Description:
City, ST, Zip: 5D�L3-13
Contractor:
Address: to -
Telephone:
yp
fFl
Project Description:
City, ST, Zip:
Telephone:-4`5)::� 2, -3 oo
g ...
4co
State Lic.
City Lic.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
Project type (circle one): New A42,) Alter Ripair Demo
Sq. Ft.: # Stories: #Units:
State Lic.
Name of Contact Person:
Telephone# of Contact Person:
Estimated Value of Project: O. Jul
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Reqld
Recd
TRACMG PERMrF`FEES
Plan Sets
Plan Check submitted Item Amount'
Structural Cities.
Reviewed, ready for corrections Plan Check Deposit
Truss Cales.
Called Contact Person Plan Check Balance
Title 24 Cales.
Plaits picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
Review, ready for corrections4e . Electrical
Subcontattor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plaits resubmitted- Grading
IN HOUSE:-.
Review, ready for corrections/issue Developer Impact
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
4%"Z,
161.2
,
t
P.O. BOX 1504 BUILDING &'SAFETY DEPARTMENT
787495 CALLS. TAMPICO(760) 777-71012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-701 1 `
To: Greg Butler, Building & Safety Manager To CDD:
From: Les Johnson, Director -Planning Due Date: 13-31 - t 1
Permit #: Status: 1,510,4
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: 4a� L `t '� Jso->7
Address or General Location: Z4 i /// jz�e S
Applicant Contact: N/f_�� 444a--. o2/3 _ &65-
The Planning Department finds that:
❑ ...these Building Plans do not require Planning Department approval.
r® ..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 return them to the Planning Department for review.
Les JohnVoon Director -Planning Date
8
a�
.[AUG 2 4 2011
City of LCI Q;Inta
Planning D®pQft9nt
R19ELML CTY/INDIO FACILITY i COUNTY OF RIVERSIDE • COMMUNITY HEALTH AGENCY
DEPT OF ENVIRONMENTAL HEALTH
1PARTMENT47950 ARABIA ST. S1E# A OF ENVIRONMENTAL HEALTH
09/06/2011 000001
#1400 11:00AM SUSAN0001
722020
Review of Food Establishment Construction/Remodel Plans
$400.00 P
Ck. #
For Office Use
Trans. # ) �'� p Dist. #'� 3 Area SR #
CHECK $400.00 ' A
ed unless this application is complete, and the plan check fee is paid.
Establishment Name: 5;>00 �U sal i
Job Address:/)949J_ 11-W Y111 City: 1, (\A7061 (!, Zip:
Contact Person: yOoyw %Ll)t9g1 Phone: (
t
E-mail Address: � Fax: LLLI i
Contact's Address: HW Y'111 T City: L;, ,JU,Gl +,1 %/a Zip:
Owner/Operator Name: r •h `/� �ti1 i i�W Phone:
Address:/) City: (w Zip:
A.
B.
General Construction (Additional operations maybe subject to extra fees) 'ig -I- U `a --'—j 1
#1 Wo il;0i-I`41
New Food Facility Remodel or Existing Food Establishment Explain Remodel:
0
Total Sq. Ft. (including all seating areas) ^ C?Y Hours of Operation
Seating Capacity for dining Number of workers per Shift
Service (Indicate ALL methods of food service, to the public):
C-11 t •.
Menu: A menu of food and beverages sold at this facility is required to be submitted at time of plan submittal
On-site preparation (cooking, cutting, assembly, etc.): Yes No Soup or salad bar: Yes No
Customer Self -Service Dispensers: Yes No Full Service Bar: Yes No
Type of customer utensils (cups, plates, forks, etc.) Multi -service (re -usable) or Single Services (disposable)
C. Utilities (Will -Serve Letters):
Water Service: Public Water•System Name of Water Company: (!,�:. k r' 11c., VA icy
Private Well (must be Environmental Health Land Use approved).
Sewer Disposal: Public Sewer System Name of Sewer Company: �.
Septic System (must be Environmental Health Land Use approved).
Grease Interceptor: Provide from Sewer District a Grease Interceptor size requirement letter or waiver later.
Owner/Representative Declaration: I certify that I have read the.entire application and state that all information is correct. I understand that the
amount of fee paid is based on my declaration of information on this form, and that incorrect information is grounds for denial of the submitted plans.
I also understand that plans will be discarded if not picked up within sixty (60) days of approval or denial, and that no inspection of my establishment
will be conducted, or approval granted to operate, until all proper information requested has been received and plans have been approved and
returned.,. have reviewed the Plan Construction, Guide and my plans follow the guide
Signature
DEH-SAN.002 (Rev.. 2/08)
- Date
Distribution: White — Office • Yellow - Customer