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04-7580 (RC)(:ii� �4'q4a sle�� P.O. Box 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number . . Property Address . . . APN: Application description Property Zoning . . . . Application valuation . BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-00007_580____.-J� Date 12/10/04 . . . 7.9440 CORPORATE CENTRE DR 649-020-067--000000- REMODEL - COMMERCIAL . . . COMMERCIAL PARK 15000 Owner ------------------------ PAUL JAMES R 79440 CORPORATE CTR 102 LA QUINTA CA 92253 Contractor WASSERMAN CONSTRUCTION, RA 45520 STONEBROOK COURT LA QUINTA CA 92253 (760) 771-8191 WCC: STATE FUND WC: 1795012 07/01/05 - CSLB: 681660 06/30/06 ` CCC: B ------Structure Info"9rma,ttd n 2283 T. � l � ----- Construction Typ:el• . E V - NON RATED Occupancy Type - '.BUSINESS <50 Flood Zone i�. '°NON -AO FLOOD ZONE Other struct info— CODE EDITION 2001 FIRE SPRINKLERS YES MIXED-USE OCCUPANCY B OCCUPANT LOAD 48.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation . . . 15000 Qty Unit Charge Per Extension BASE FEE .45.00 13.00 9.0000 THOU BLDG 2,00'1-25,000 117.00 -------------------7-------------------------------------------------------- Permit . . . . . . ELECT - ADD/ALT/REM Additional desc Permit Fee . . . 54.60 Plan Check Fee 13.65 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 88.00 .4500 EA ELEC DEVICE/FIXTURE >20 39.60 ----------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 30.50 Plan Check Fee 7.63 Issue Date Valuation 0 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO T-Vf Ot FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: % 5 M Date:/ Z-/0'Z�' Applicant: /Q� Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am lic nsed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License i n full force and effect. / License Class License lo. 6 i Date , 0contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 1, 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' 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 woe compensation insurance carrier 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 sknuld became subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisio Date 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. 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.). Lenders Name Lenders Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby ma a 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 160 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 agreeto comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this countyWentpan the above- n ' d roperty for inspection purposes. ,Date r <Ile Signature (Applicant or Agent): j Page 2 Application.Number 04-00007580 Date 12/10/04 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH APPL REP/ALT/ADD 9:00 1.00 6.5000 EA MECH VENT FAN 6.50 ---------------------------------------------------------------------------- Permit PLUMBING Additional desc Permit Fee 58.50 Plan Check Fee 14.63 Issue Date . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE 'FEE 15.00 3.00 6.0000 EA PLB FIXTURE 18.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 15.0000 EA PLB GAS METER 15:00 ---------------------------------------------------------------------------- Special Notes and Comments 2283 SF TENANT IMPROVEMENT PER APPROVED PLANS. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STRONG MOTION (SMI) - COM 3.15 Fee summary ----------------- Charged Paid Credited Due Permit Fee.Total ---------- ---------- 305.60 ---------- .00 ---------- .00 305.60 Plan Check Total 141.21 .00 .00 141.21 Other Fee Total 3.15 .00 .00 3.15 Grand Total 449.96 .00 .00 449.96 el �' •Yi r. ty