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06-2809 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06-00002809 Property Address: 47647 CALEO BAY, STE 1 APN: 643-200-004- - - Application description: REMODEL - COMMERCIAL Property Zoning: COMMUNITY COMMERCIAL Application valuation: 85000 Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjur 1 am licensed under provisions of Chapter 9 fcommencing with Section 7000) of Division 3 of the Q sine and Professionals Code, and my License is in full force and effect. License lass: B License No.: 455453 Date: Contractor: 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).: (_) 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..lf, 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 contractor(s) licensed pursuant to the Contractors' State License Law.). ( ) 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: 1 LQPER IIT Owner: GREG EVANS O.D. 44-250 TOWN CENTER WAY C-10 PALM DESERT, CA 92260 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/30/06 Contractor:. j PACIFIC COMMERCIAL CONSTRL► 2262 RUTHERFORD RD, STE #1rktl CARLSBAD, CA 92008 U 2UU6 (760)931-9777 Lic. No.: 455453 CITY �� - _ _ _ _ QUINTA ----------------------------------------------- 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 7560000022 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 Id become subject to the workers' compensation provisions of Section 3700 of the La or C_ �, I shall forthwith comply with those provisions. Date: OS Applicant: ' 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 ove information is correct. I agree to comply with all city and county ordinances and state laws relating to uild' construction, and hereby authorize representatives ofthis unty to enter upon the above-mentioned prop y or inspection purposes. Date: Signature (Applicant or Agent): Application Number . . . . . 06-00002809 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee 572.00 Plan Check Fee 371.80 Issue Date . . . . Valuation . . . . 85000 Expiration Date 2/26/07 Qty Unit Charge Per Extension BASE FEE 414.50 35.00 4.5000 THOU BLDG -50,001-100,000 157.50 -------------------------- ------------------------------------------------- Permit . . ELECT - ADD/ALT/REM Additional desc Permit Fee . . . . 86.55 Plan Check Fee 21.64 Issue Date. Valuation . . . . 0 Expiration Date 2/26/07 Qty Unit Charge Per Extension BASE FEE 15.00 .159.00 .4500 EA ELEC DEVICE/FIXTURE >20 71.55 ---------------------------------------------------------------------------- Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 123.50 Issue Date Expiration Date . . 2/26/07 Plan Check Fee .30.88 Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 11.0000 EA MECH FURNACE >100K 33.00 3.00 16:5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 4.00 6.5000 ---------------------------------------------------------------------------- EA MECH VENT FAN 26.00 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 157.50 Plan Check Fee 39.38 Issue Date . . . . Valuation 0 Expiration Date 2/26/07 Qty Unit Charge Per Extension BASE FEE 15.00 12.00 6.0000 EA PLB FIXTURE 72.00 9.00 7.5000 EA PLB WATER HEATER/VENT 67.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ---------------------------------------------------------------------------- Special Notes and Comments TENANT IMPROVEMENT "EVENS EYE LQPERAIIT LQPEINIIT ation Number . . . . . 06-00002809 ----------------------------------------------------------------- 1 Notes and Comments August 30, 2006 8:31:38 AM Dn ------------------ ---------------------------------------------- Fees . . . . . . . . .. STRONG MOTION (SMI) - COM . 17.85 nmary. Charged ----------- ---------- Paid. Credited ---------- Due ---------- ----------- t Fee Total 939.55 .00 .00 939.55 heck Total 463.70 .00 .00 463.70 Fee Total 17.85 .00 .00 17.85 Total 1421.10 .00 .00 1421.10 0 1 F-Mra-Z MIM i Bin # 101 G D # City of La Quinta 4 `��• Building & Safety Division . P.O. Box 1504, 78-495 Calle Tampico �A La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # o Project Address: 6 . ,� > jJA Owner's Name: nj$ O, D, A. P. Number: Address: -'t'-o 9V6l' WI1e I Legal Description: Contractor: �{tl"�� City, ST, Zip: Lm 'g221,pb Telephone: Address: Project Description: City, ST, Zip:�� q� r� wl M tit Telephone: State Lic. # : City Lic. #: Arch., Engr., Designer: 4Wt21C�L Q,,AJAQ AgwG Address:1, 5 4AA4 a, p City, ST, Zip: VALm. bESQ° Telephone too a OD Construction Type: T t Occupancy: l� State Lie. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: lam) " t�L— tA)JAN Sq. Ft.: 2&-A # Stories: I # Units: Telephone # of Contact Personl &0 G77 a Estimated Value of Project: QS APPLICANT: DO NOT WRITE BELOW THIS LINE �5'3 # Submittal Req'd Ree'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections A,/4'—"' V/�6 Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. a Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"' Review, ready for correctio ssu Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '`' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees %�aflo / �•C��/� w��n3l�.a.�t-a C/t7 X'-te �e/z 8/4/ob 7/2(p /C)(, OAl (30ARD cPD 8��3 eycaaard