05-2933 (RC)P.O. BOX 1504
•78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 0.50.00-02.9.3.3
Property Address: 78045 CALLE CADIZ STE
APN: 770-153-004- -
Application description: REMODEL - COMMERCIAL
- Property Zoning: VILLAGE COMMERCIAL
Application valuation: 4000
Tdilt 4 4 a"
Applicant: Architect or Engineer:
pip
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
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 Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: B Li se No.: 692234
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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , BAP.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
Owner:
LA QUINTA GRILL
41865 BOARDWALK
PALM DESERT, CA
t5z to sQ F7
Contractor:
C & G CONSTRUCTI
965 N. 2ND STREE
UPLAND, CA 91786
(760)123-4567
T4 ?IT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/23/05
NO 214
--------------- - - -
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.
VAI 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 1799267-2005
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manne o as to become subject to the workers' compensation laws of California,
and agree that, if I s o become subject toIrl
workers' compensation provisions of Section
/ 3700 of the Labor d , shall forthwith co p it th visions.
te• C � pplicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL 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 t0 buildin construction, and hereby authorize representatives
of this county to enter upon thea ve-mentioned property f inspection purpose
tura (Applicant or Agent):
Application Number . . . . . 05-00002933
------ Structure Information - -----
Other struct info . . . . . CODE EDITION 2001'
FIRE SPRINKLERS NO
1ST FLOOR SQUARE FOOTAGE 526.00
----------------------------------------------------------------------------
Permit . . . BUILDING PERMIT
Additional desc
Permit Fee . . . . 63.00 Plan Check Fee 40.95
Issue Date . . . . Valuation . . . . 4000
Expiration Date 5/22/•06
Qty Unit Charge Per Extension
BASE FEE 45.00
2.00 9.0000 THOU BLDG 2,001-25,•000 18.00
----------------------------------------------------------------=-----------
Permit . . . ELECT - ADD/ALT/REM
Additional desc
Permit Fee 25.52 Plan Check Fee,6.38
Issue Date Valuation . . . . 0
Expiration Date 5/22/06
Qty Unit Charge Per Extension
BASE FEE 15.00
526.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 10.52
------------------------------------ :
. . . MECHANICAL
Additional desc ..
Permit Fee . . . . 33.00 Plan Check Fee 8.25
Issue Date . . . . Valuation . . . . 0
Expiration Date 5/22/06
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 9.0000 EA MECH FURNACE <=100K 9.00
1.00 9.0000 EA MECH B/C.<=3HP/100K BTU 9.00
----------------------------------------------------------------------------
Special Notes and Comments
Commercial Remodel "Office" Tenant
Improvement 526sgft, "B" Occupancy,
Occupant Load 6.
----------------------------------------------------------- 7 ----------------
Other
-------------------=------------------------------------------------------
Other Fees . . . . . . . . . STRONG MOTION (SMI) - COM .84
Fee summary Charged Paid Credited Due
LQPERMIT .
LQPERMIT
Application Number
05-00002933
---------------------------
Permit Fee Total
121.52
--------------------
.00
----------
.00
121.52
Plan Check Total
55.58
.00
.00
55.58
Other Fee Total
.84
.00
.00
.84
Grand Total
177.94
.00
.00
177.94
LQPERMIT
RIVERSIDE COUNTY
FIRE DEPARTMENT
82-675 HighwayIndio, Fax (760) 863-7072
DEPARTMENT
Craig E. Anthony October 28, 2005
Fire Chief
Proudly serving the City of La Quinta
unincorporated Building Department
areas of Riverside
County and the
Cities of. Re: Fire and Life Safety Clearance
Banning 78-045 Calle Cadiz, #5 .
LAQ-05-TI-064
Beaumont
❖ The Riverside County Fire Department is granting a fire and life safety clearance for the group
Calimesa B occupancy located at 78-045 Calle Cadiz, #5.
Canyon Lake
Coachella Respectfully,
4.1 -
Desert Hot Springs
Tracy Hobday
Indian wells Chief Fire Department Planner
Indio
4.
Lake Elsinore
''• BY l�
La Quanta Walter Brandes
4.
Moreno Valley Fire Safety Specialist
Palm Desert
Perris
Rancho Mirage
San Jacinto
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jeff Stone,
District 3
Roy Wilson,
District 4
Marion Ashley,
District 5 HAPEMP DMXU QW¢a1PR01M111.. Fml.doe
EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE
82-675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 863-8886 • Fax (160) 863-7072
Page 1 of 1
Greg Butler
From: Paul Goble
Sent: Tuesday, November 22, 2005 5:29 PM
To: Greg Butler
Subject: La Quinta Grill - Suites 5 & 7
Pursuant to your request, please consider this email notice for Public Works green sheet approval.for Suites 5 & 7
improvements at the La Quinta Grill. The precise grading plan revisions for PCN 05201 approved by Building
today will now be forwarded to Tim for signature.
Many thanks,
Paul Goble, PE
Public Works Senior Engineer
City of La Quinta
(760) 777-7087
pgoble@la-quinta.org
11/23/2005
JUL-14-2005 01:09 PM CARPENTER 909 980 9483 P.01
C
City of La Quints
elamig it.saf" oMOM
P.O. kat 1504, 78-495 Calk Tamplco
La QWrK4 CA 92253 - (760) 777-7012
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