BCOM2015-003478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BCOM2015-0034
78130 CALLE TAMPICO
770020036
JULES MARKET/ REMOC
$300,000.00
Applicant:
EHL ARCHITECTURE
10579 E BLUEBIRD MINE CT
GOLD CANYON, AZ 85118
`&'1v, 4 4 Qu4cv
COMMUNITY DEVELOPMENT 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 Professions Code,
and my License is in full force and effect.
License Class: B. C727, D63, C10. C39 icen
Date: , �— L I�. 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. 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, 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/27/2015
Owner:
JADE PROPERTIES LLC
P.O. BOX 242523
ANCHORAGE, AK 99524
Contractor:
BUILDING SERVICES/ SYSTEM MAI
2575 STANWELL DR STE 250
CONCORD, CA 94520
(925)688-1234
Llc. No.: 870303
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:— Policy Number: _
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 Sect' 700 o bor e, I shall fo 'th
comply with th se pro isions.
Date: 7 1 �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 Building Official 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 buil ing
construction, and hereby authorize representatives of u3th*ebo
mentioned property for inspection purposes.
Date: 1 1 Signature (Applicant or Agent):
DESCRIPTION - '," `}
FINANCIAL •
= ?ACCOUNT
,
QTY
AMOUNT
PAID
PAID DATE
ART IN PUBLIC PLACES - COMMERCIAL
REMOD
270-0000-43201
0
$1,000.00
$0.00
PAID BY
„METHOD.` ,+,
`' r ,a RECEIPT -#
CHECK #
CLTD BY
Total Paid forART IN PUBLIC PLACES - AIPP: $1,000.00 $0.00
DESCRIPTION
ACCOUNT,
QTY
AMOUNT
PAID
PAID DATE
NON-RESIDENTIAL, EA ADDITION 2,000SF, .
PC
101-0000-42600
0
$58.02
$58.02
6/15/15
PAID BY '
" METHOD
^:RECEIPT# `
_ CHECK # '"
CLTD BY
LIFE ENTERPRISES, INC.
CHECK
R7047
1050
SKH
DESCRIPTION _
ACCOUNT '
QTY
.'AMOUNT
PAID
PAID DATE
NON-RESIDENTIAL, FIRST 2,000SF, PC
101-0000-42600
0
$84.12
$84.12
6/15/15
` PAID BY- "'
METHOD
RECEIPT #,
CHECK #
CLTD' BY
LIFE ENTERPRISES, INC.
CHECK
R7047
1050
SKH
Total Paid for ELECTRICAL- NEW CONSTRUCTION; $142.14 $142.14'
DESCRIPTION
ACCOUNTQTY
s AMOUNT
` PAID
PAID DATE
APPLIANCE REPAIR/ALTERATION
101-0000-42402
0'
$290.16
$0.00
PAID BY
f ''.•, , METHOD``?
RECEIPT #
k CHECK #
CLTD BY ,
DESCRIPTION
ACCOUNT,
,QTY
AMOUNT
PAID
PAID DATE
APPLIANCE REPAIR/ALTERATION PC
101-0000-42600
0
$115.92
$0.00
PAID BY
METHOD y ', ''
", •RECEIPT #
CHECK #"
CLTD BY
;.+ DESCRIPTION
ACCOUNT t
QTY
` AMOUNT 4;
^-PAID` F
PAID DATE
CONDENSER/COMPRESSOR
101-0000-42402
0
$36.26
$0.00
PAID BY r
METHOD
RECEIPT # ' _
CHECK #.
CLTD BY
DESCRIPTION
ACCOUNT •
QTY
AMOUNT
`L ' PAID '
PAID DATE
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$24.17
$0.00
'PAID BY
METHOD
`' RECEIPT #'CHECK
#
= CLTD BY ,
DESCRIPTION
`' " ' ACCOUNT; °'
QTY
AMOUNT
PAID` `
PAID DATE
EVAPORATIVE COOLER
101-0000-42402
0
$12.09
$0.00
r • PAID BY
METHOD "'"
-RECEIPT#
CHECK#
CLTD BY'
DESCRIPTION
ACCOUNT. f+
QTY
AMOUNT,
PAID,``,."
'PAID DATE.
EVAPORATIVE COOLER PC
101-0000-42600
0
$11.59
$0.00
> . j PAID BY
METHOD , •, r
'�; `` �- RECEIPT #
CHECK # ..
CLTD BY
DESCRIPTION-
ACCOUNT' " ;,
QTY
AMOUNT
PAID
PAID DATE
EVAPORATIVE COOLER PC
101-0000-42600
0
$0.50
$0.50
6/15/15
' tPAID BY _
METHOD '+
?RECEIPT, #. `,
CHECK # J
CLTD BY,
LIFE ENTERPRISES, INC
CHECK
R7794
1050
AZA
Total Paid for MECHANICAL: $490.69 $0.50
r' DESCRIPTION t"' : i' t
:, ACCOUNT.°' 'fr•
QTY„
AMOUNT'.
rS; PAID
'PAID DATE;'
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$487.20
$487.20
6/15/15
N PAID BY `' 7
t' ': METHOD - ' `` s s '
RECEIPT # t " ^`t
; '-CHECK #
CLTD BY
LIFE ENTERPRISES, INC.
CHECK
R7047
1050
SKH
{ DESCRIPTION " '
,ACCOUNT r
QTY-
�; -,'AMOUNTS
ti"'; "p ` <PAID, .. +,4
PAID DATE
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$487.20
$487.20
6/15/15
;3 PAIDBY'
O
METHD
RECEIPT #,
CHECK #
CLTD BY.
LIFE ENTERPRISES, INC. '
CHECK
R7047
1050
SKH .
•DESCRIPTION
.ACCOUNTr ";,` `;
QTY
" AMOUNT `J
y . PAID, '4;'
PAID DATE
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$82.96
$82.96
6/15/15
'PAID BY
ME HOD %
RECEIPT#�
4 CHECK -
1CLTD BY.
LIFE ENTERPRISES, INC..
CHECK
R7047
1050
SKH
Total Paid for REMODEL: $1,057.36 $1,057.36
DESCRIPTION ., r
v., �a ACCOUNT-
QTY.
,;AMOUNT, +'
: ','' ' `;PAID •
PAID DATE
SMI - COMMERCIAL
101-0000-20308
0
$84.00
$0.00
c `:PAID BY a •rte" : ry
, * METHOD ;j'
,? RECEIPT # '"
• �`:� `CHECK #`�
�' CLTD BY_
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $84.00 '$0.00
TOTALS: $2,774.19 $1,200.00
f
rf
'
f
r
Description: JULES MARKET/ REMODEL
Type: BUILDING, COMMERCIAL
Subtype:. REMODEL Status: APPROVED -CONDITIONS
Applied: 6/15/2015 SKH
Approved: 7/8/2015 BHA
Parcel No: 770020036 Site Address: 78130 CALLE TAMPICO LA QUINTA,CA 92253.
Subdivision: PM 35845
Block: Lot: 2
Issued:
Lot Scl Ft: 0
Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $300,000.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 -
No. Stories: 0 No. Unites: 0 `
Details: 13,925 SF T.I. FOR "JULES MARKET—GROCERY STORE. 2013 CODES. PERMIT DOES NOT INCLUDE LIGHTING & PLUMBING.
23
X,
• Applied to Approved; � � ,
• •
—CONDITION DATE DATE.
CONTACT ` DATE,ADDED _' .:• • STATUS r REMARKS; '?NOTES;
TYPE - . ; -° 7 REQUIRED :SATISFIED
.; ,
CONTRACTOR W/ CITY BUS. LECENSE AND
READY TO ISSUE BURT HANADA 7/8/2015 IN PROCESS WORKER'S COMP. INSURANCE REQUIRED PRIOR
TO PERMIT ISSUANCE. RETURN FIRE SET TO
APPLICANT.
Printed; Wndav, Jv.ly 27, 2Q!5.12:08:46 PM 1 of 4
Fl NAN C I IAL INF . ORMMON
•
DESCRIPTION �ACCOUNT� _QTY AMOUNT'. PAID
PAID DAT E RECEIPT 0, CHECK METHOD'
BY�
,
.,NAME TYPE -i
M61)kIiSs'l CITY
STATE,
Total Paid forART IN PUBLIC PLACES - AIPP: $1,000.00 $0.00
X'�
FA _�EMAIL
APPLICANT EHL ARCHITECTURE
10579 E BLUEBIRD GOLD CANYON
AZ
85118
(907)344-5001
R7047
1050
MINE CT
LIFE ENTERPRISES,
SKH
ADDITION 2,000SF, PC
CONTRACTOR BUILDING SERVICES SYSTEM MAI
2575 STANWELL DR STE CONCORD
CA
94520
(907)344-5001
250
NON-RESIDENTIAL,LIFE
101-0000-42600
0
OWNER JADE PROPERTIES LLC
P.O. BOX 242523 T ANCHORAGE'
AK
99524 1
(907)344-5001
CHECK
Fl NAN C I IAL INF . ORMMON
DESCRIPTION �ACCOUNT� _QTY AMOUNT'. PAID
PAID DAT E RECEIPT 0, CHECK METHOD'
BY�
ART IN PUBLIC PLACES -
270-0000-43201 $0.00
.0 .$1,000.00
COMMERCIAL REMOD
Total Paid forART IN PUBLIC PLACES - AIPP: $1,000.00 $0.00
NON-RESIDENTIAL, EA
101-0000-42600
0
$S8.02
$58.02
6/15/15
R7047
1050
CHECK
LIFE ENTERPRISES,
SKH
ADDITION 2,000SF, PC
INC.
NON-RESIDENTIAL,LIFE
101-0000-42600
0
$84.12
$84.12
6/15/15
R7047
1050
CHECK
ENTERPRISES,
SKH
FIRST 2,000SF, PC
INC.
Total Paid forELECTRICALm- NEW CONSTRUCTION: $142.14 $142.14
APPLIANCE
101-0000-42402
.$290.16
$0.00
REPAIR/ALTERATION
.0
APPLIANCE
101-0000-42600
0
$115.92
$0.00
REPAIR/ALTERATION PC
CONDENSER/COMPRES
101-0000-42402
0
$36.26-,
$0.00
SOR
-CONDENSER/COMPRES
101-0000-42660
0
$24.17
$0.00
'SOR PC
EVAPORATIVE COOLER
101-0000-42402
0
$12.09
$0.00
EVAPORATIVE COOLER
101-0000-42600
0
$11.S9
.$0.00
I
7-
PC
peintea monday, July 27, 2013 12.00.46 PI'd 7 of a- I.Wjj1.
� u
a
s'ZOFTt 9
INSPECTIC
e
PARENT PRO
- -
RETURNED
x
r
a
t
,CLTD
*' "DESCRIPTION
ACCOUNT
.qTY
AMOUNT
PAID x r
PAID:DATE'
RECEIPT#pF
CHECK#
'METHOD
fire{ P,AIDBY;
F
FIRE
JACQUELINE
6/15/2015
6/29/2015
6/23/2015
w
" s i;
�x
EVAPORATIVE COOLER
101-0000-42600
0
$0.50
$0.50
6/15/15
R7794
1050
CHECK
LIFE ENTERPRISES, INC
AZA
PC
REVISIONS REQUIRED
_
2 WK
HANADA
Total Paid for MECHANICAL: $490.69 $0.50
REMODEL, EALIFE
101-0000-42600
0
$487.20
$487.20
6/15/15
R7047
1050
CHECK
ENTERPRISES,
SKH
ADDITIONAL SOU SF PC
6%25/2015
READY FOR APPROVAL
REMOVE REVISED SOUTH ELEVATIONS IF
INC.
REMODEL, EA
101-0000-42600
0
$487.20
$487.20
6/15/15
R7047
1050
CHECK
LIFE ENTERPRISES,
SKH
ADDITIONAL 500 SF PC
CONDITIONS
`
Printed: Monday, July 27, 2015 12:08:46 PM 3 of 4
sisni.tiv
INC.
,
REMODEL, FIRST 500 SF
: 101-0000-426000
'$82.96
$82.96
6/15/15
R7047
1050
CHECK
LIFE ENTERPRISES;
SKH
PC
INC.
Total Paid forREMODEL: $1,057.36 $10,057.36
SMI -COMMERCIAL
101-0000-20308
0
$84.00
$0.00
Total Paid forSTRONG MOTION INSTRUMENTATION SMI $84.00 $0.00
TOTALS'$i,'2'0'0.00
INSPECTIC
e
PARENT PRO
- -
RETURNED
STATUS:
REMARKS
REVIEW TYPE
SENT DATE,
DUE
DUE DATE?tNOTES
_
DATE
a
FIRE
JACQUELINE
6/15/2015
6/29/2015
6/23/2015
APPROVED -
GARCIA
CONDITIONS
NON-STRUCTURAL -
BURT'
6/15/2015
6/29/2015
6/29/2015
REVISIONS REQUIRED
_
2 WK
HANADA
* BUILDING ELEVATIONS NEED TO BE CORRECTED;
PLANNING - 2WK
JAY WUU
6/15/2015
6/29/2015
6%25/2015
READY FOR APPROVAL
REMOVE REVISED SOUTH ELEVATIONS IF
NOTHING IS BEING PROPOSED.
NON-STRUCTURAL -
BURT
7/1/2015
7/8/2015
7/8/2015
APPROVED -
1 WK
HANADA
CONDITIONS
`
Printed: Monday, July 27, 2015 12:08:46 PM 3 of 4
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78-130 Calle Tampico - '
DOC
6/29/2015
BURT HANADA
78-130 Calle Tampico -
Jules Market
1
T.L.Correction docx Jules Market T.I..docx
LAQ-I5-TI-019 TI Jules •' LAQ-I5-TI-019 TI Jules
DOC
6/23/2015
JACQUELINE GARCIA
0
Market.doc Market.doc
Bfn. #
City 0f Lel Qulnta
Building 8t Safety Divi` 6n
P.O. Box 1504,78-495 Cabe Tampico
La.Quinta, CA 92253 - (760) 77T7012,.-
77-7012✓Building Permit Application' and Tracking Sheet :
Building
Permit #
ProjectAddress:? • L3 O CAL . A O Owncr's Name:. Mit. K�'f� m*Ctr L Li F E R
A. P. Number. Address: 5A 655 AveJ10A N�rtR>:12A► -
Legal Description: City, sT, zip: LA Q U Intl Q, C A• ei 12 Z; 5 3
Contactor. P S M CO NST R UCT 1011. W el• Telephone: 1 5 91. 5 6 2 3
Address: 'Z575 5TA N w E L L n 2 • Project Description: E S A �, ^T 1 O o
city, sT, zip: CoM coYLO cA. 94sso CotJIfEriSloQ o f T. V46 Me -SN 4 F.IIS,
Telephone: `iZSi4a9- LZ34 � sZoRE-ro.�U��Es �1f�t�KEr,.lHl�jOfl
state Lia#: $7as03 CityIic#, E4rCTrUcAL_,MSC 4}&0tcAL
Arm , EngT•, Designer: ENI. AR C t4lT a C'TU A— PLv ASiM C; 4 (i EFQ I ert&T I'D rj .
Address: 10579 1r... POLO M M UZ i Mile cr. plE- FIX TU Zrc r . PetNr �1
City,ST,zip: GOLD �An1`tDf►�, AZ'. $S1I
Telephone: 'E bo 41 Z • I q 197 Construction Type:. Occupancy:
State Lrc- #: C 1(a 3 15 : z Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: E o wA R O 14. LV c ER Q Sq. Ft: #Stories: #Univ
Telephone # of Contact Person: o 4,1-Z • 19 5 7
EstiimaW Value of Project: 3' O d 000. CSO
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
PERM T FEES
Pian Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for conwaous
Plan Check Deposit • .
Truss Calcs.
Called Contact Person
Plan Check Balance
'title 24 Cates.
Plans picked up
Construction
Flood plain plan
Pians resubmitted.'.
Mechanical
Grading plan
Zi° Review, ready for eorrectioneissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans plcked up
S M L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for correelioaslissae
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
T4'P� ifl I��