09-0883 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09-00000883
Property Address: 47647 CALEO BAY
APN: 643-200-004- - -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: COMMUNITY COMMERCIAL
Application valuation: 130000
Applicant: ,y� , Architect or Engineer:
cad v Ck A*
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: A C7 LicenseNo.: 597074
Date: Contractor: Cot"* X". (A*L/ &, 3*1C
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 ($500).:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
I _) I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
Owner:
ACCRETIVE LA QUINTA PARTNERS
1 PARK PLZ #340
IRVINE, CA 92614
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/03/09
Contractor: Q a
PACIFIC WEST SPACE COMM
900 W. GLADSTONE STREET rr n
SAN DIMAS, CA 91773 S vr� 33 ?U3�
(909)592-4321
Lic. No.: 597074 CITYO*c L{d)FITe$
WORKER'S COMPENSATION DECLARATION
1 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 SEABRIGHT INS Policy Number BB1091859
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 should become subject to the workers' compensation provisions of Section
3700 of the Labor CoA, I smell lithy with those provisions.
Date: 'Applicant:b
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 building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property .or in ectio purposes.
Date: Signature (Applicant or Agent): ��
Application Number . . . . 09-00000883
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
744.50 Plan Check Fee
483.93
Issue Date . . . .
Valuation . . .
. 130000
Expiration Date
5/02/10
Qty Unit Charge
Per
Extension
BASE FEE
639.50
30.00 3.5000
----------------------------------------------------------------------------
THOU BLDG 100,001-500,000
105.00
Permit
ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . .
70.00 Plan Check Fee
17.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
5/02/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
4.00 .7500
PER ELEC DEVICE/FIXTURE 1ST 20
3.00
1.00 15.0000
EA ELEC PWR APP >10 TO <=50
15.0'0
2.00 18.5000
EA ELEC SVC <=600V/<=200A
37.00
-----------------------------------------------------------------------
Special Notes and Comments
-----
INSTALL TELECOMMUNICATIONS ANTENNAS (7
EA) AND EQUIPMENT CABINETS
(4 EA) ON
ROOFTOP OF BUILDING.
(ROYAL STREET
COMMUNICATIONS)2007 CODES.
------------------------------------------------------------
Other Fees . . . . .
-------------
. . . . BLDG STDS ADMIN (SB1473)
----
6.00
ENERGY REVIEW FEE
48.39
STRONG MOTION (SMI) - COM
27.30
Fee summary Charged
-----=---------------------
Paid Credited
------------------------------
Due
Permit Fee Total
814.50 .00 .00
814.50
Plan Check Total
501.43 .00 .00
501.43
Other Fee Total
81.69 .00 .00
81.69
Grand Total
1397.62 .00 .00
1397.62
LQPERIIT
J�
city of La Qu[nta
Building 8i Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Perr4it #
0W
Project Address: —7 14 =O;iisName.
A. P. Number: ?j' -- 7•oa-- Cc) Address ? � \ � V1
Legal Description: City, ST, Zip: rr nn
Contractor: t_ ' rl(. Telephone: a)ss a�'ys:>.
Address:�)nC4� — �� Projecjj t DessZption:
City, ST, Zip: D A AM�06A, 6w
Tele hone: 2 432-)
.. �' QII
State Lic. # : U ? H
City Lic. #; rbi
Arch., Engr., Designer:
Address: ZZ l
City., ST, Zip -
Telephone: IIrTn�; a.. Construction Type: Occupancy:
State Lic. #• r��•�"'y�:f � ��'
bid 1 �� M1JxscrsN� ae< Project type (circle one): New Add' Alter Repair Demo
Name of Contact Person: Sq. Ft.: `� # Stories�� #Units:
, 0 ,
Telephone # of Contact Person: �� W2-- �� Estimated Viliie of Project:g' r ✓l/
APPLICANT: DO NOT WRITE. BELOW THIS LINE
N Submittal Req'd Rec'd TRA II n PERMIT FEES
L
Plan Sets ✓ Plan Check submitted AmountStructural
Cafes.
Reviewed, ready for correc o � AUG g '20heck Deposit
Truss Cales.
Called Contact Person Check Balance.
Title 24 Cates.
It
Plans picked up Y ' ruction
fA4
Flood plain plan
Plans resubmitted anical
Grading plan
2a°Review, ready f correction ssue rical
Subcontactor List
I.Called Contact Perso ,�bing
Grant Deed
Plans picked up, IJ
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:
''' Review,.ready for correction issue 2 - Developer Impact Fee
Planning Approval
Called Contact Person �8 y A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Tot Per it Fees
0`!8 ----7
/ilil UMM ' / � •
REPORT # I Or- ARMSTRONG'S INSPECTION SERVICE Phone (949) 429-6055
SPECIAL DEPUTY INSPECTORS Cell (909) 214-8636
CONTR. JOB # OBSERVATION REPORT Fax (949) 429-6056
Building Permit No.Permit Date: Department of Building & Safety - City of) -N Ptlll rfi ,
Project Name/Address: G E 6&-e-0 1 iNIllyzA
Structural Engineer/Address: G 1 C, -
General Contractor/Address: �'Gl/G 77 0 W ► )_Sub Contractor/Address: G 6Y' Fl eiI Wi5G-BJP/2%6' 1 To �
TESTS MADE: TYPE OF INSPECTION:�Melding ❑Hi -Tensile Bolting ❑Reinforced Concrete
APPROVED MIX DESIGN#: ❑Fireproofing ❑Masonry DAnchors ❑Epoxy ONDT ❑Other:
ELECTRODE:.) 7075 Off -Site Fabricator Address:
Welder
I
Certification No.
Welder
I--/ -
Certification No.
D. o s
HOURS:
141, a 6'
TUES.
I THURS.
FRI.
I SAT.
I SUN.
NUMBER OF SAMPLES TAKEN: CONCRETE DENSITY PRISMS MORTAR GROUT
LAB & HOURS SUMMARY: REGULAR TIME HRS. PREMIUM TIME HRS. NDT --• HRS.
All inspection is based on a 4 hour minimum, over 4 hours is an 8 hour minimum. In addition, any inspection extending past noon will be an 8 hour minimum. All lab work necessary
to complete inspections will be paid by owner, engineer or contractor. 4 hour minimum charge for jobs canceled without notification. Final reports shall be filled with the local building
department upon receipt of final payment. In recognition of the relative risks of the Client and Armstrong's Inspection on the project, Client agrees to the extent permitted by law,
Date of Ins ection
p
Ins ection Summar • Location of Work, Detail & Sheet No.,
p Y • • Material Description - Type, Grade, Research Report No., Work Rejected or Pending Approval
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CERTIFICATE OF COMPLIANCE
I hereby certify that I have inspected to the best of my knowledge, with the information provided, all of the above reported work unless otherwise
noted. I have found this work to comply with the approved plans specificatyons,_and applicable sections of the governing building code.
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Registered Deputy Building Inspector's Certificate Signed b • /'!Y Z,e
Certification #8613Deg S`� Type lif!/ Inspectors Name: (Please Print) (� T
DATE:
I
I
I
I--/ -
HOURS:
I MON.
TUES.
I WED.
I THURS.
FRI.
I SAT.
I SUN.
NUMBER OF SAMPLES TAKEN: CONCRETE DENSITY PRISMS MORTAR GROUT
LAB & HOURS SUMMARY: REGULAR TIME HRS. PREMIUM TIME HRS. NDT --• HRS.
All inspection is based on a 4 hour minimum, over 4 hours is an 8 hour minimum. In addition, any inspection extending past noon will be an 8 hour minimum. All lab work necessary
to complete inspections will be paid by owner, engineer or contractor. 4 hour minimum charge for jobs canceled without notification. Final reports shall be filled with the local building
department upon receipt of final payment. In recognition of the relative risks of the Client and Armstrong's Inspection on the project, Client agrees to the extent permitted by law,
that Armstrong's Inspections liability to the Client, in any way ari ing out of this agreement, shall be limited to 100% of the total fees and cost paid for that specific work to
Armstrong's Inspection or $1,00 hichever is greater. No arranty expressed implied is made by Armstrong's Inspection.
Approved By: Company:
TERMS: DUE UPON RECEIPT A late charge of one-half percent (1 1!2%) per month, (18%) per annum) will be charged on the unpaid balance from the date of the invoice if payment is not received in
accordance with the terms herein. Should it become necessary to enforce the terms of this invoice, reasonable attorney's fees and cost shall be awarded to the prevailing party.
WHITE - Building Dept. CANARY/PINK - Office
REPORT # -
CONTR. JOB #
Building Permit Nou-1 -
Project Name/Address:
ARMSTRONG'S INSPECTION SERVICE Phone (949) 429-6055
SPECIAL DEPUTY INSPECTORS Cell (909) 214-8636
OBSERVATION REPORT Fax (949) 429-6056
Permit Date:
Date: � Department of Building & Safety - City of:
L9=/ J_ 1 L t/_ / /1"l /V n) � / A 7 A,/ I in ^ , , , A M�✓1
Structural Engineer/Address: Pe
General Contractor/Address: itis i" 1�1�_ /
Sub Contractor/Address:661-7-1 �%) 1PlL19L='7PY j�/>N L!/D/�/S� 2=�� f�99
TESTS MADE: TYPE OF INSPECTION: UlWelding ❑Hi -Tensile Bolting ❑Reinforced Concrete
APPROVED MIX DESIGN#: ❑Fireproofing ❑Masonry DAnchors ❑Epoxy ❑NDT ❑Other:
ELECTRODE: g::=,6% Off -Site Fabricator Address:
Welder
Certification No.
Welder
Certification No.
0_S�
I I
re T
HOURS:
I MON.
TUES.
I WED.
Date of Ins ection
P
Ins ection Summar • Location of Work, Detail & Sheet No.,
P y • • Material Description - Type, Grade, Research Report No., Work Rejected or Pending Approval
I SAT.
SUN.
L.14 SO`
LAB & HOURS SUMMARY: REGULAR TIME — HRS. PREMIUM TIME HRS. — NDT HRS.
D e�
to complete inspections will be paid by owner, engineer or contractor. 4 hour minimum charge for jobs canceled without notification. Final reports shall be filled with the local building
department upon receipt of final payment. In recognition of the relative risks of the Client and Armstrong's Inspection on the project, Client agrees to the extent permitted by law,
that Armstrong's Inspections liability to the Client, in any way arising out of this agreement, shall be limited to 100% of the total fees and cost paid for that specific work to
I d2
-Company:_
Approved By:
CERTIFICATE OF COMPLIANCE
I hereby certify that I have inspected to the best of my knowledge, with the information provided, all of the above reported work unless otherwise
noted. I have found this work to comply with the approved plans, ecl ications janqapplicable sec Io the governing building code.
Registered Deputy Building Inspector's Certificate Signed by I- Y -Z-111501 /
_TGG 1 // _
Certification # �y13��, `� yype 1/V �j�•j1' Inspectors Name: (Please Print) /, &,o5/) -o n9,
DATE:
I
I
I
I
I I
t / -7-�G
HOURS:
I MON.
TUES.
I WED.
I THURS. I
FRI.
I SAT.
SUN.
NUMBER OF SAMPLES TAKEN: CONCRETE DENSITY PRISMS MORTAR GROUT
LAB & HOURS SUMMARY: REGULAR TIME — HRS. PREMIUM TIME HRS. — NDT HRS.
All inspection is based on a 4 hour minimum, over 4 hours is an 8 hour minimum. In addition, any inspection extending past noon will be an 8 hour minimum. All lab work necessary
to complete inspections will be paid by owner, engineer or contractor. 4 hour minimum charge for jobs canceled without notification. Final reports shall be filled with the local building
department upon receipt of final payment. In recognition of the relative risks of the Client and Armstrong's Inspection on the project, Client agrees to the extent permitted by law,
that Armstrong's Inspections liability to the Client, in any way arising out of this agreement, shall be limited to 100% of the total fees and cost paid for that specific work to
Armstrong's Inspection or $1,000.00. chever is greater. No w rranty, a ressed or implied is made by Armstrong's Inspection.
-Company:_
Approved By:
TERMS: DUE UPON RECEIPT- A*(ate charge of one-half percent (1 1/2%) per month, (18%) per annum) will be charged on the unpaid balance from the date of the invoice if payment is not received in
accordance with the terms herein. Should it become necessary to enforce the terms of this invoice, reasonable attorney's fees and cost shall be awarded to the prevailing party.
WHITE - Building Dept. CANARY/PINK - Office