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07-3217 (RC)
.4116 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&ht 4'4 Q" Application Number: 07-00003217 Property Address: 78080 AVENIDA LA FONDA APN: 770-121-005- - Application description: REMODEL - COMMERCIAL Property Zoning: VILLAGE COMMERCIAL Application valuation: 10000 Applicant: `tZJ Architect—_ rcnhite�ct or Engineer: ' vA BUILDING & SAFETY 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 Professionals Code, and my License is in full force and effect. License Class: B License No.: 832057 r Date: , 'T'8 Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 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 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 contractors) licensed pursuant to the Contractors' State License Law.). I—) 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 Address: LQPERMIT Owner: BARRY PARKINS G Contractor: AC BUILDERS & CON T 11752 GARDEN GRO VD GARDEN GROVE, C 9284 (714)636-7681 �l Lic. No.: 832057 5/A VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/15/08 -------------------------------- � -------- WORKER'S COMPENSATION DECLARATIO 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 EXEMPT Policy Number EXEMPT 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 Section a 37000 of the or Code 1 shall fo with comply with those provisions. Date: `/'/1 tI 0V Applicant: _ WARNING: FAILURE TO SECURE 4RK S' 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 a result of this application, the.ovyner, 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 co ty tomer upon the above -menti e p erty f r inspectio urposes. Date: Signature fApplicant or Agent): Application Number. 07-00003217 ----- Structure°Information EXISTING DENTAL BUILDING ---- Other struct info . . . . . CODE EDITION 01BMP04EOSEN FIRE SPRINKLERS YES MIXED-USE OCCUPANCY B OCCUPANT LOAD .00 1ST FLOOR -SQUARE FOOTAGE 336.00 ---------------------=------------------------------------------------------ Permit . . BUILDING PERMIT Additional desc ADD 3 DENTAL CHAIRS TO EXIST. Permit Fee . . . . 72.00 Plan Check Fee 46.80 Issue Date . . . . Valuation . . . 10000 Expiration Date 7/13/08 Qty Unit Charge Per Extension 8.00 9.0000 THOU BLDG 2,001-25,000 72.00 ----------------------------------=----------------------------------------- Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 27.00 Plan Check Fee 6.75 Issue Date Valuation . . . . 0 Expiration Date 7/13/08 Qty Unit Charge Per Extension BASE FEE 15.00 16.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 12.00 ---------------------------------------------------------------------------- Permit . . . PLUMBING Additional desc,. Permit Fee 42.00 Plan Check Fee 10.50 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 7/13/08 -Qty Unit Charge Per Extension BASE FEE 15.00 4.00 6.0000 EA PLB FIXTURE 24.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ---------------------------------------------------------------------------- Special Notes and Comments INTERIOR REMODEL TO EXISTING DENTAL OFFICE. ADDITION OF 3 DENTAL CHAIRS IN AN EXISTING OFFICE AREA (346SF AFFECTED AREA). 2001 CBC, CPC AND 2004CEC, 2005 ENERGY. B OCC. TYPE V -N. NO CHANGE IN OCCUPANT LOAD. LQPERMIT Application Number •� . . . . . .07-00003217 ---------------------------------------------------------------------------- Other Fees .'. . . . . ACCESSIBILITY PLAN REVIEW 7.61 ENERGY REVIEW FEE 7.61 Fee summary Charged Paid Credited Due Permit Fee Total 141.00 .00 .00 141.00 Plan Check Total 64.05 .00 .00 64.05 Other'Fee Total 15.22 .00 .00 15.22 Grand Total 220.27 .00 .00 220.27 LQPERMIT Bin # Citjr of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: A. P. Number. Address: '70—L*E;14c*- Legal Description: City, ST, Zip: LA. OUMIA dt 17-16; 3 Contractor. G i derj Cohsv Telephone: Address: Z 0 0 Project Description: AlAAAA-- City, ST, Zip: ' Q Cl 72.S4-3 I day yep• .., Telephone _ State Lic. #: city Lic. A: T Arch.,&(+(� Address:., 6vakD IN City, ST, Zip::F& tfth Telephone:Construction State Lic. # G� '©� >'- i °. ,< ':.Project Name of Contact Person:�(�� j u• Type: Occupancy type (circle one): New Add'n iDte Repair Demo Sq. Ft.: # St es: # Units: Telephone # of Contact Person: Estimated Value of Project. %D 000 APPLICANT: DO NOT WHITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calc& Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for correction a 1. t 1 a Electrical Subcontactor List Called Contact Person 6 , Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE: ''d Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P,P, Pub. Wks. Appr Date of permit issue 4 School Fees Total Permit Fees 2 �J 9 �Si-�-�[� Wiwi.. /l LO (/v/( 7—/ . " V r7. SNS . t� I C