06-0669 (RC)F
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
06-00000' 69�
- 6.
Owner:
Property Address:
_
46400 WASHINGTON ST
WASHINGTON,1.11 LTD
APN:
643-020-999-3 -30903 -
C/O JACK TARR
Application description:
REMODEL - COMMERCIAL
30240 RANCHO VIEJO RD. STE. B
Property Zoning:
REGIONAL COMMERCIAL
SAN JUAN CAPISTRANO, CA 92675
Application valuation:
2000
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:'.
Contractor: D
Applicant:
Architect or Engineer:
SPECTRUM CONSTRUCTION ".
�6800
OWENSMAVENUE
®6S-GL�147774&CANOGAPARK,,
CA CA 91303
and agree that if_Ls ould become subject to the worker compensation provisions of Section
.(818)999-4900
Lic. No.: 847960
700 o he L or Code I s or ith . i�e�ns.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031 .5 by
VOICE (760) 777-7012
FAX -(760) 777-701,1.'
INSPECTIONS (760) 777-7153
Date
MAR 2 2 2006
CITY OF LA
2/28/06
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I.hereby affirm under penalty of eery that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 70001 of Division 3 of a Bu ' ess and Professionals Co e, and my License is in full force and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: BL ic 847960
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/Date:- g �� ontractor.
issued.
s 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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:'.
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 1806389 '
' following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a'permit to
_ I certify that, in the performanceof_the work for which this permit: is. issued, I shall not employ any.
construct, alter, improve; demolish, or'repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that if_Ls ould become subject to the worker compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
700 o he L or Code I s or ith . i�e�ns.
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).:
ate:.3 6 .Applicant: �`-
. (=) 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
WARNING:- FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
- SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
- and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvementis sold within
f I h b 'Id '11 h h b d f r 'n that h r h did not b 'Id r
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
4 -
one year o comp etion, t o owner- w er wi ave t o ur en o p ovi g a e o s e i o ui o
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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
6 ) 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:
LQPERDIIT
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 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 1 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 relalT++��g f ilding nstruction, and hereby qt epresentatives
/o/ftiis couWeer on the above-mentioned`p oper fo in i poseDatE 'ature (Applicant or Agentl' r 4� �.� L.
A
Application Number . . . . . 06-00000669
Permit BUILDING PERMIT
Additional desc .
Permit 'Fee 45.00 Plan ,Check
Fee
29.25
Issue Date Valuation
2000
Expiration Date 8/27/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
15.00 2.0000 HND BLDG 501-2,000
30.00
Special Notes and Comments
METAL SCREENS TO SHIELD BALER AND TRASH,
.
ENCLOSURE AT TRADER JOE'S.[CONDITION OF
APPROVAL PER COMMUNITY" DEVELOPMENT
DEPARTMENT]. 2001 CBC CODE.
----------------------------------------------------------------------------
Other Fees . . . . . . . . HOURLY PLAN CHECK-
70.00
STRONG MOTION (SMI)
- COM
.50
Fee summary Charged Paid Credited
Due
-Permit Fee Total 45.00 .00
.00.,'
45.00
;`Plan Check Total 29.25 00.00
29.25
Other Fee Total 70.50 ..00
.00
70.50
Grand Total 144.75 .00
.00
144.75
LQPER %11T -
P.O. Box 1504 BUILDING & SAFETY DEPARTMENT
78-495 CAI_LE TiaMPICo ` (760) 777-7012
LA QUINTA; CALIi=ORNIA 92251 FAX"(760) 777-7011
To: Greg Butler; .Building & Safety Manager
From: Les Johnson, Planning Manager
v
To CDD: 2-23-2006
Due date: 2-23-2006
Status: 2ND Review
Building Plans Approval..
(This is an approval to issue a Building Permit)
The Community Development Department has reviewed the Building Plans for the
following project:
Description: Trader .loe's(Screening)
Address or general location: 46-400 Washington'St
Applicant Contact: Ramon 818-577=4840,
The C01111111-inity Development Department finds that:
❑ ...these Building Plans do not require Community Development Department
approval.
...these Build_ ing Plans are approved by the Community Development
' Department.
D _. Jhese`Buildin Plans require corrections. Please forward a copy of the attached
corrections toI ie applicant, When the corrections are made please return them to
"the Commui ' y Development Department for review.
2 -
PI
PI ilia Manager Da e