14-0412 (RC)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 14-00000412
Property Address: 78134 CALLE TAMPICO STE 130
APN: 770-020-012- - -
Application description: REMODEL COMMERCIAL
Property Zoning: VILLAGE COMMERCIAL
Application valuation: 4400
Applicant:
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
•4
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 5/01/14
Owner:
ARMEN KARIMYAN
78-080 AVENIDA LA FONDA
LA QUINTA 92253
LA QUINTA, CA 92253
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: 13 License No.: 853780
Date: Contractor:
.P,
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.).
(_ 1 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. , BAP.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 thispermit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Contractor:
ULTRA CONSTR & DEVELOPMENT Ily f•..,
3065 E. VERONA ROAD �`� 4'., U Pj � ,41
PALM SPRINGS, CA 92262
Lic. No0: 853780 -2113 CF 7� I
-----------------------------------------------
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 9046188-13
I certify that, in the performance of the work for which this permit is issued, 1 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 Code, I shall forthwith comply with those provisions.
Date: Applicant:�>Y�/�X/�CJ
Ir
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 aresult 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
�toyenter upon the above-mentioned prope/rlty for ins ection purposes.
Date: „161—t Signature (Applicant or Agent): HL �� - 7
Application Number . . . . 14=00000412
Permit ELECTRICAL 2013
Additional desc ...
Permit Fee . . . . 23.83 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration Date 10/28/14
Qty . Unit Charge Per
Extension
1.00 23.8300 LS ELEC FIXTURES, FIRST 20
---------------------------------------=------------------------------------
23.83
Permit . . MECHANICAL 2013
Additional desc .
Permit Fee . . . . 11.92 Plan Check Fee
.00
Issue Date. Valuation . . .
. 0
Expiration Date 10/28/14
Qty Unit Charge Per
Extension
.1.00 11.9200•EA, MECH APPL REP/ALT
-----------------------------------------------=----------------------------
11.92
Permit . . . REMODEL 2013
Additional desc
-
Permit Fee 71.50 Plan Check Fee
.00
Issue Date . . . . Valuation . . . .
0
Expiration Date 10/28/14
Qty Unit Charge Per
Extension
1.00 71.5000 EA MISC PARTITION
71.50
----------------------------------------------------------------------------
Special .Notes and Comments
REMOVE EXISTING DEMISSING WALL
CONVERTING TWO UNITS TO ONE. TWO
EXISTING BATHROOM AND OFFICE TO
REMAIN.LIGHTING, FIRE SPRINKLED AND
MECH.
TO REMAIN.
May. 1, 2014 8:52:40 AM jjohnson:
-----------------------------------------------------------------------------'
Other Fees . . . . PLAN CHECK, ELECTRICAL
23.83
PLAN CHECK, REMODEL
131.56
PLAN CHECK, MECHANICAL
4.77
STRONG MOTION (SMI) - COM
92
- - Fee summary Charged Paid Credited
Due
Permit Fee Total 107.25 .00 .00
107.25
Plan Check Total .00 .00 .00
.00
a
LQPERMIT
LQPERMIT
Application Number . . . . . 14-00000412
Other Fee Total 161.08 .00 .00 .161.08
Grand Total 268.33 .00 .00 268:33
Bin #
LY
Qty of La'Quint'a
Building 8r Safety :Division
Box 1.504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building P&mit Application and Tracking Sheet
Permit #P.O.
..� q ,
Project Address:
Owner's Name: 11-APM
A. P. Number:
Address: 7 7 - 0'Y 0 "fWQA L& MA� A
Legal Description:
City, ST, Zip: 4 A 6LU 11gM
Contractor: u L
-fAZA . INC.
"d OUL.
Telephone: i o 175 6
Address: - A01, S 9- yf"'6(A Rza
Project Description: 61 fj'
City, ST, Zip: PALM 6p
gidos, cA- 92-7-62-
Q o9 6 5 &A it zjr'a Au—
Telephone:ZO•-3
. ....... .
P&tCa 1614LL5 "(A -f-el.4of KA o.
State Lic.#:
City Lie. #.-.
Arch., Engr., Designer:
Address:
City., ST, Zip:.
Telephone:
. ...... .....
Construction Type: Occupancy:
State Lie. #:;<......,,;>,.....:;::::::•;
Project air
type (circle one New Add'n Alter Rep
Name of Contact Person:
Sq. Ft.*. 3�2-33
1 # Stories:
# Units:
Telephone #,of Contact Person:
7-.
Estimated Value of Project: q.,
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rce'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss CaIcs.
Called Contact Person
Plan Check Balance
Title 24 CaIcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'd Review, ready for corrections/issue
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
6440�. IV &S L) 6T'