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05-2240 (RC)t4 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: �0_5-00002240 78045 CALLE CADIZ STE 770-153-004- - REMODEL - COMMERCIAL VILLAGE COMMERCIAL 35000 Architect or PIA T4ht " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/15/05 _ Owner: LA QUINTA GRILL 41865 BOARDWALK NO 214 PALM DESERT, CA 92211 AUG 16 2005 LA QUINTA Contractor: CE DEPT C & G CONSTRUCTION COMPANY 965 N. 2ND STREET UPLAND, CA 91786 (760)123-4567 Lic. No.: 692234 -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with 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 (5500): (_ 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 _ 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 contractors) licensed pursuant to the Contractors' State License Law.). ' (_ 1 I am exempt under Sec. , B.&P.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 ------------------ 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 1799267 _ 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 as to become subject to the workers' compensation laws of California, and agree that, if I sho become subject to the workers' compensation provisions of Section //3.7/00 0 Labor Cod shall forthwith co p wit ase provisions. ate: �V (/ icant: 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 to buildi construction, and hereby�thorize representatives of 's c unttyy t1o`rents upon the above-mentioned property o inspection purposes. r vJ/ ignature (Applicant or Agent): LQPERMTT Application Number . . . . . 05-00002240 Permit BUILDING PERMIT Additional desc Permit Fee . . . . 317.00 Plan Check Fee 206.05 Issue Date . . . . Valuation . . . . 35000 Expiration Date 2/11/06 Qty Unit Charge Per Extension BASE FEE •252.00 10.00 6.5000 THOU BLDG 25,001-50,000 ---------------------------------------------------------------------------- 65.00 Permit . .. . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 35.54 Plan Check Fee 8.89 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/11/06 Qty Unit Charge Per Extension BASE FEE 15.00 1027.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL ---------------------------------------------------------------------------- 20.54 Permit . . . MECHANICAL Additional desc . . Permit Fee 19.50 Plan Check Fee 4.88 Issue Date . . Valuation . . . . 0 Expiration Date 2/11/06 Qty. Unit Charge Per Extension BASE FEE 15..00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 ------------ --------------------------------------------------------------- Special Notes and Comments Commercial Remodel "Office" TI, 1027 sqft, "B" Occupancy, Type VN, Occupant Load 11. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STRONG MOTION (SMI) - COM 7.35 Fee summary Charged Paid Credited ----------------- --- - ------ Due ---------- ---------- Permit Fee Total 372.04 .00 ---------- .00 372.04 Plan Check Total 219.82 •.00 .00 219.82 Other Fee Total 7.35 .00 .00 7.35 Grand Total 599.21 .00 .00 599.21 LQPERMTT NOV-10-2005 THU 01;05 PM RIVERSIDE COUNTY FIRE FAX NO, 17608637072 . P. 03 RIVERSIDE COU114TY :.r. FIRE DEPARTMENT -90 tg ay o. • Craig E, Anthony Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities -of: Banning 'Beaumont Calimesa. v Canyon l..ake s Coachella Desert Hot Springs Indian Wells Indio oe I,alce Elsinore 00 La Quinta �o Moreno Valley Palm Desert Perris 00 Rancho Mirage San Jacinto o� Temecula Board of Supervisors Bob Buster, District l John Tavaglione, District 2 Jcg'stune, District3 Roy Wilson, District 4 Marion Ashlcy, District 5 October 28, 2005 City of La Quinta Building Department Re, Fire and Life Safety Clearance 78-045 Calle Cadiz, #3 & 6 LAQ-05-TI-055 The Riverside County FireDeepartment�is-grantin - -fire-andlifersafety clearance for the group B occupancy located at`78;045 Calle Cadiz,_# _ .6_ Respectfully, Tracy Hobday Chief Fire Department Planner By Walter Brandes Fire Safety Specialist HAPRw DamA Qaht-tPROJECrEtRLA%0041455 F a]. OC EMERGENCY SERVICES DIVISION - PLANNING SECTION - INDIO OFFICE 82-675 Highway 111, 2,d FI„ India, CA 92201 - (760) 863-8886 - Fax (760) 863-7072 - ,- Certificate of Occu ancyP • v'�C, isac G� OFTBuilding & Safety Department This Certificate is .issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 78-045 Calle Cadiz Suite #6 Use classification: Commercial "Office" TI Building Permit No.: 05-2240 Occupancy Group: B Type of Construction: VN Land Use Zone: CR Owner of Building: La Quinta Grill Address: 41-865 Boardwalk No 214 City, ST, ZIP: Palm Desert, CA 92211 By: Daniel P. Crawford Jr. Date: 11/10/05 Building Official POST IN A CONSPICUOUS PLACE