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14-570 (AC)j0 . 78-495 CALLE TAMPICO D VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/15/2014 Application Number: AC -147570 Owner: Property Address: 78450 AVENIDA LA FONDA CITY OF LA QUINTA APN: 770130001 78-495 CALLE TAMPICO Application Description: 5,375 SQ. FT. ADDITION TO WELLNESS CENTER LA QUINTA, CA 92253 Property Zoning: Application Valuation: $424,625.00 Applicant: DOUG WALL CONSTRUCTION INC 78450 AVENUE 41 BERMUDA DUNES, CA 92201 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. C-9. A. C27 License No.: 743112 r � /1 Oate: S' / Contractor. c a's'h �•Jo� Contractor: DOUG WALL CONSTRUCTION INC 78450 AVENUE 41 BERMUDA DUNES, CA 92201 (760)772-8446 Llc. No.: 743112 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 th for which this permit is issued. ve and will maintain workers' compensation insurance, as required by Sect 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: OWNER -BUILDER DECLARATION Carrier:— Policy Number: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State _ _ I certify that in the performance of the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair any compensation laws of California, and agree that, if I should become subject to the structure, prior to its issuance, also requires the applicant for the permit to file a signed workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith statement that he or she is licensed pursuant to the provisions of the Contractor's State comply with those provisions. 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 _ __ Date: Applicant: ;;_,� 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).: WARNING: FAILURE TO SECURE WORKERS' COMPENSA COVERAGE IS UNLAWFUL, (1 I, as owner of the property, or my employees with wages as their sole AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE compensation, will do the work, and the structure is not intended or offered for sale. HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, apply to an owner of property who builds or improves thereon, and who does the work INTEREST, AND ATTORNEY'SFEES. 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 APPLICANT ACKNOWLEDGEMENT within one year of completion, the owner -builder will have the burden of proving that he IMPORTANT: Application is hereby made to the Building Official for a permit subject to or she did not build or improve for the purpose of sale.). the conditions and restrictions set forth on this application. (_j I, as owner of the property, am exclusively contracting with licensed contractors to 1. Each person upon whose behalf this application is made, each person at whose construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State request and for whose benefit work is performed under or pursuant to any permit issued License Law does not apply to an owner of property who builds or improves thereon, and as a result of this application , the owner, and the applicant, each agrees to, and shall who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and State License Law.). (� I am exempt under Sec. B.&P.C. for this reason 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 Date: Owner: commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. 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: I certify that I have read this application and state that the above information is correct. I agree to comply withall city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above- mentioned property for inspection purposes. Date: 7' !` '14 Signature (Applicant or Agent): DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY- AMOUNT PAID PAID DATE ADDITION, EA ADDITIONAL 500 SF 101-0000-42400 0 $676.39 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY` r AMOUNT PAID PAID DATE ADDITION, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $188.76 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE ADDITION, FIRST 100 SF 101-0000-42400 0 $120.12 $0.00 PAID BY METHOD RECEIPT # CHECK# CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE ADDITION, FIRST 100 SF PC 101-0000-42600 0 $168.74 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forADDITION: $1,154.01 $0.00 DESCRIPTION ACCOUNT QTY . AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $17.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $17.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NON-RESIDENTIAL, EA ADDITION 2,000SF 101-0000-42403 0 $71.50 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY . AMOUNT PAID PAID DATE NON-RESIDENTIAL, EA ADDITION 2,000SF, PC 101-0000-42600 0 $19.06 $0.00 PAID BY METHOD -RECEIPT•'# CHECK# CLTD BY DESCRIPTION ACCOUNT QTY: AMOUNT PAID PAID DATE NON-RESIDENTIAL, FIRST 2,000SF 101-0000-42403 0 $107.25 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NON-RESIDENTIAL, FIRST 2,000SF, PC 101-0000-42600 0 $82.94 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL- NEW CONSTRUCTION: $280.75 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE CONDENSER/COMPRESSOR 101-0000-42402 0 $214.50 $0.00 PAID BY METHOD RECEIPT.# CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE CONDENSER/COMPRESSOR PC 101-0000-42600 0 $142.98 $0.00 PAID'BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FURNACE 101-0000-42402 0 $214.50 $0.00 PAIDBY METHOD RECEIPT.# CHECK# CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FURNACE PC 101-0000-42600 0 $154.90 $0.00 PAID;BY METHOD RECEIPT<# CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN 101-0000-42402 0 $11.92 $0.00 PAID. BY METHOD RECEIPT:# CHECK# CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN PC 101-0000-42600 0 $4.77 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for MECHANICAL: $743.57 $0.00 DESCRIPTION ACCOUNT QTYAMOUNT PAID PAID DATE BUILDING SEWER 101-0000-47401 0 $11.92 $0.00 PAID BY METHOD RECEIPT# CHECK # CLTD BY DESCRIPTION ACCOUNT, QTY AMOUNT PAID PAID DATE, BUILDING SEWER PC 101-0000-42600 0 $11.92 $0.00 PAID BY METHOD RECEIPT# CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP 101-0000-42401 0 $464.88 $0.00 PAID BY METHOD RECEIPT# CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP PC 101-0000-42600 0 $464.88 $0.00 PAID BY METHOD RECEIPT;# CHECK# CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE ROOF DRAIN 101-0000-42401 0 $47.68 $0.00 PAID BY METHOD RECEIPT,# CHECK # ` T CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE'' ROOF DRAIN PC 101-0000-42600 0 $47.68 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE f WATER HEATER/VENT 101-0000-42401 0 $11.92 $0.00 PAID BY METHOD RECEI PT'# CHECK# CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT PC 101-0000-42600 0 $7.15 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-47401 0 $11.92 $0.00 PAID BY METHOD RECEIPT:# CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $11.92 $0.00 PAID BY METHOD RECEIPT;# CHECK # CLTD BY Total Paid for PLUMBING FEES: $1,091.87 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SMI - COMMERCIAL 101-0000-20308 0 $118.90 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forSTRONG MOTION INSTRUMENTATION SMI $118.90 $0.00 Permit Number: AC -14-570 Applied: 5/2/2014 Issued: 7/14/2014 Status: ISSUED Parent Permit: Parent Project: Approved:6/5/2014 Finaled: Description: 5,375 SQ. FT. ADDITION TO WELLNESS CENTER Site Address: 78450 AVENIDA LA FONDA City, State Zip Code: LA QUINTA, CA 92253 Applicant: DOUG WALL CONSTRUCTION INC Owner: CITY OF LA QUINTA Contractor: DOUG WALL CONSTRUCTION INC Details: 5375 SF FITNESS CENTER ADDITION TO WELLNESS CENTER BLDG. TYPE V -B CONSTR. W/ FIRE SPRINKLER, A-2 OCCUPANCY. [ADDITION=5375 SF + 10,506 SF EXISTING = 15,881 SF TOTAL]2010 ENERGY, 2013 CODES. TUMF FEE EXEMPTION FOR CITY OWNED FACILITY. Printed: Tuesday, 15 July, 2014 1 of 1 amm CR SYSTE.US LIST OF REVIEWS 'RETURNED .SENT DATE r DATE DUE.DATE TYPE. CONTACT :STATUS, REMARKS Review Group: BLDG 3RD REVIEW 7/3/2014 7/12/2014 7/11/2014 NON-STRUCTURAL BURT HANADA APPROVED Notes: .+Y � APPLICATION INITIATED IN HTE &'REV,IEW1,& 2 BY ESGIL, 7/3/2014 7/12/2014 7/11/2014 STRUCTURAL BURT HANADA APPROVED Notes: �' i Printed: Tuesday, 15 July, 2014 1 of 1 amm CR SYSTE.US