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
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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
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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