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10-0807 (PLBG)._, 1 . P.O. BOX'Y504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777=7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/01/10 ;-Application Number: 10-00000807 Owner: Property Address: 46480 WASHINGTON ST STE 1 WASHINGTON 111 LTD APN: 643-020-058- - - PO BOX 1623 Application description: PLUMBING PALM DESERT, CA 92261 Property Zoning: REGIONAL COMMERCIAL D A Application valuation: 15000 1 Contractor: (p O Applicant:_ Architect or Engineer: DATELAND CONSTRUCTIO C I E 032010 /�rjGt+D` 83801 AVENUE 45 INDIO, CA 92201 C OF (760)398-5544 F�A`E TA �P1Lic. No.: 396698 -------------------------------------------------- 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: A -C12 -C34- LicenseNo.: 396698 Date: Contractor: 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.). (_) 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.). I am exempt under Sec. B.&P.C. for this reason Date: JOwner: 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 ------------------ 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 OLD REPUBLIC Policy Number AICW94111001 _ 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 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: 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 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 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 yi this county to enter upon the above-mentioned property rection purposes. Date: `19 3h/d /Signature (Applicant or Agent)' LQPERMIT Application Number . . . . . 10-000008071. Permit . .. . PLUMBING Additional desc 1,500 GAL GREASE INTERCEPTOR Permit Fee 42..00 Plan Check Fee 10.50 Issue Date Valuation . . . . 0 Expiration Date 2/28/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 12.0000 EA PLB INTERCEPTOR 12.00 Special Notes and Comments 1,500 GALLON GREASE INTERCEPTOR FOR SUITE 1. LOCATION AT REAR PLANTING AREA, OF BUILDING. 2007 CODES. NOTE: SEWER LATERAL TO SEWER MAIN REQUIRES ENCROACHMENT PERMIT PER P.W. ------------------------- - Other Fees . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 42.00 00 .00 42.00 Plan Check Total 10.50 .00 .00 10.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 53".50 00 .00 53.50 LQPERMIT Oyu --_ �._...�=-- Kr1H,. •- K OCA veta ❑ .... / 1 LIMIT oF\ M 6f / WORK i X.n EXIT ♦ \ >♦ ITYYOF LA I EXIT \\\\ \ EXT �♦ y♦ I ` ILU NG'& AF - to ^ \\\ \ / .y Y\\ / ♦ LI�MIRKOF \ ♦ C - - y 'y $D r C ST,RUION ;K �, � Sty �.. w >♦ _ " . � . � • ,.� vin EXIT PAD 4 EXIT oA E a e�Y ., ♦ _, e/ \\ ♦ .t 14 _ C) 5,466 S.F.IN{�' ;/♦ r}aP y ,s t� \ EXIT ♦ / :A g ♦ -� � ®I:j�`���q�3 n \° r ♦>_ i� A';o[Prry4.t PDo�-�T���� � �I��I •• � ^ FINISH FLOORELEVATI ` �' � � � v � y♦ �-+ � y r1 AIS PAD ELEVATION �/ •' A ML \\� �� Li �♦ T .F. \ R� Ve LIMIT OF /EXIT I - \/ / \'\ \\\ WORK EXIT \ / — �� / ♦ �� ^ \�\\ \/ ♦ / \ \ n 1400 ` LIMIT oF\ M 6f / WORK i X.n EXIT ♦ \ >♦ ITYYOF LA I EXIT \\\\ \ EXT �♦ y♦ I ` ILU NG'& AF - to ^ \\\ \ / .y Y\\ / ♦ LI�MIRKOF \ ♦ C - - y 'y $D r C ST,RUION ;K �, � Sty �.. w >♦ _ " . � . � • ,.� vin EXIT PAD 4 EXIT oA E a e�Y ., ♦ _, e/ \\ ♦ .t 14 _ C) 5,466 S.F.IN{�' ;/♦ r}aP y ,s t� \ EXIT ♦ / :A g ♦ -� � ®I:j�`���q�3 n \° r ♦>_ i� A';o[Prry4.t PDo�-�T���� � �I��I •• � ^ FINISH FLOORELEVATI ` �' � � � v � y♦ �-+ � y r1 AIS PAD ELEVATION �/ •' A ML \\� �� Li �♦ T .F. \ R� Ve LIMIT OF /EXIT I - \/ / \'\ \\\ WORK EXIT \ / — �� / ♦ �� ^ \�\\ \/ ♦ / \ \ t M r - 77 • � ate'- - •� rt f.i�, �`d� , r h' • L OF Ep1. 7- C\ 1NG & SAFET`l D gu��o SOV ED ppP s�tR�c��cN. . gY APPLICATION DESCRIPTION GREASE INTERCEPTOR WITH SAMPLE BOX TWO MANHOLES EXTENDED TO GRADE DESIGNED FOR DIRECT H-20 LOADING OF MANHOLE EXTENSIONS 750 THRU 1500 GALLONS SEE NOTE 3 —/ EXCAVATION SPECIFICATIONS MODEL G-750 G-1000 G-1200 G-1500 LENGTH 12'-0" 12'-0" 12'-0" T2----o-- WIDTH 8'-0" 8'-0" 8'-0" 9'-0" OUTLET END VIEW -T VARIABLE TO GRADE IN W' DICREMENIS SEE NOTE 2 3 1/4" TYPICAL END SIDE RECESS A INLI 4 BOLT DOWN WATER RESISTANT RAME AND COVER rLAN Vlr-W i 2" X 6" WOOD z• i• o . G it• SLEEPERS GRAPHIC SCALE FITTING SEAL SEE SPEC. SHEET NQ S-250 INLE C BELOW INLET 3'-4" 4'-2" 4'-11" 5-2 1/2" INLET TANK HEIGHT 4'-7" 5'-5" 6'-2 6'-5 1/2" END VIEW SECTION A - A ALL DIMENSIONS IN INCHES MODEL A • B C D E F G H NOTES. PC G-750 40 38 55 74 74 19 3/4 4 1/2 31 1/2 1. REFER TO SPECIFICATIONS SHEET NO. S-212 2. REFER TO SPECIFICATIONS SHEET NO. S-252 PC G-1000 50 48 65 74 74 24 3/4 4 1/2 41 1/2 3. REFER TO SPECIFICATIONS SHEET NO. -S-251 PC G-1200 59 57 74 74 74 29 1/4 4 1/2 50 1/2 PC G-1500 62 1/2 60 1/2 77 1/2 85 1 85 130 3/41 5 153 1/2 FOR SPECIFICATIONS: LINK to' specs.ProcastProducts.com' LD This drawing is for reference purposes only. Complete drawings are available by request O O Dr www.ProcastProdu.cts.com CUTLET A �v OUTLET 8 GREASE INTERCEPTOR n: CML I ID: 8044.DW( 11 Date: 06/13/07 1 PAGE 1 OF 1 COACHELLA'ter LLF1't�':N•fER DISTRICT ASSESSOR'S PARCEL NUMBER 85-995 Avenue �2 643 ----020.—.-- 047. Coftchella. C alirernin 922;16 pial}} 398—?65I — APPLICATION FOR iiASTEW,-%TF"li I�'t'4;i�C'F 1''Cf)It41:.!':11LlTf.)R.:�PPRO\'AL dYf s to iN'i hei+xar c@ u c c,-., > x v," •t3.i E3, ' , ::r;,: .<': t: ,i1.E; etreua tc ihsuiet SpWifieWisars. A rotircfundaMe. riling frr is Muirc4 n} Eg t4c. u. a Cnp' .:u + it t e :,,k r # : (s- t ct l!:. t5 T ec lA €rice. Appy v�! rf This apPi cation shall c� �ain',5!id (bra period a+! t3 cs� t� iii even finer, w�a oa'nnsrur,: Aixm t'<mm_ C05tts:. paw. Addreti City Stale ;ttp 7'eltphort mirage 191 8 Palm Canyon Suite 208 Palm syringe, Ca (760) 864-9448 (h. rex Minns Cit;' State Lip Telephone washing-tcia U2 L -TJ 30240 Rancho Viejo rd. San.'Juan , California 92675 (949) 940-9489 Ja P..^gxsn :rai4%s .. lite lip 46-480Ras .- +-.:oa St Suite *A* La Quinta Calif. 92247 ' DBA L7!i s4)-GRY r¢ZJ Oascal 3 .yams ®y 30003, 9-k 705, peg. 49.57 ospu l maps, - �- � Juliecte's Bakery - PLEASE COMPLETE 'THIS SECTION FOR REVIEW OF FOOD ESTABLISHMENTS Na tis �Vil t \(3y a): accF.P ren tt�lEss 1,iis APPI.IC;ii'ltli is C.,n'1Vl,i i F ASD GLXE iht. CONSTRUCTION: Type of Con.rnietion. - \ec Re tzadtl of faiaiing Food Esiahli<hmtnt _.._._... f irntrs of t'ft truiialt 0 -5 P. Seating Caparit): ln;txtea) 10 F_Nternal 4 f:'.ttem:ll Stating with Mistm or Heater._� flat with Ftt<,d S yvice-a )tar ;\oafrad Senile 0 water Sollerrr 0 ,tultis4•niccttcusabirl, singlc.setttisx(di(bitj Alt'\ER;RI:r ItL•SF T A 1'tYf: i)F.CI.ARATIt2 i7 that t have nead t}e c circ aygii itaas Q c e tFa! ail irf anat;m is tzvirc;. 4 un(lnsmnd that the nraswu of la raid is trash on m,' hvlar3tiOn (it' h"f)rity311 It thii KEa and due intttrreet info n -,lion i9 pmt -j:, for dcnW of the MhTlned plans. ) also U*dem aW that plats wiil lx di, if ra t r9 s4;h;r< picl ul 5ist,• i}fi r .ai`s of :neaT ur drnini and that no inspection ofm} vmMishmeni viil lv e,x rdutxtd, of apyrasai granted to aperatc until all irfrurnayt„mftst{t pr.per 1t F.a tars haeChmn Apn,ovM arc m tinned. Sigttaturc.....,.._....._c.'i/.•_:.............�..„..._ i.�i/--... ...._ Mt_ 7/2212010 FOR DISTRICT USE ONLY Vin. cf >«etsc "i' -rpt- of 5pstrn'is) Vie. Da tiling Limes Q Saxt)(?;i E3 G7oam fatmeptor %Vaivcq civture i;nttc 1 ® Gtme interceptor % �Nrte• E]Fxictmp 0 Ltat Trak . t Replacement . 0 A0 !tine COnrm in ZCp•er 0 Ciarifsei RENIARKS: �vtll :23l � c '1Nis a�pti;.atinn is:' - - Apprm'd El Denied ❑ ConditionalAppro.al• ,.FeeS 7� `Set Kcnaarks Date / _ Initial Sigttmure Q Q7 ' • C -- flute m T r Date • 17 � Z ,rye D.�:) . Q° ® —� r w � til _ _ � i P.O. BOX 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT (760) 777-7012 FAX (760) 777-7011 PROPERTY OMWER9S PACKAGE Disclosures & Forms for Owner-B.ullders Applying for Construction Perin -Tits PMIMI NORCE TO EEO _FuTr OWNER Dear Property Owner. An. application for a building permit has been submitted in your name' listing yourself as the builder of the . property improvementsspecifiedat— IA-sl,;o,o"F. Pati L7,,.J e...7; We are providing you with an Owner -builder AckwWledgment -and Infbimation-Verifilcation Foan to make you Maw of your : msponsibilities and possible risk you may incur by having d& permit:issued in your name as the OwDes-Builder. We will not Issue a building -permit until yma have read, initialed your understanding of each'provisien, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this.notice unless you, the property owner, obtain the prior approval of the permitting authority. iyF1'IETYONS Read an&mit d each stateMeW–bdWW W signify you undwaand'or va..* this infor rce tion.. : understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing his. or her own labor and material personaft. I, as an Owner -Builder, maybe held liable and subject to serious financial' risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. 'My homeowner's insurance may not provide coverage for those mJuries. I am willfidly acting as.an Owner -Builder and am aware of the limits of my insurance -coverage for injuries to workers 'on my. property. J'L2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are. not hiring a licensed Contractor to assume this responsibility. d 311 understand as an "own 'I I am.ilie nesgonsi6le party of record on the permit. I understand chain may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. L understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and. materials, I may.be considered an "employee' under state and federal law. \7 6. I understand if I am considered an "employee' state and federal taw, I must register with the state and federal government, withhold payroll taxes, provide woirkers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand 'my failure to abide by these laws may subject me to serious financial risk- 7. isk 7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot .legally build them with the .intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. I understand as an Owner -Builder if I sell the property for which this pem it is issued, I may be held liable for any financial or personal..aries susYsiaed by any subsequent owner(s) that result from any latent constriction defects in the workmanship or materials. 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit PaymeM. and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.cs[b.ca.gov for more information about licensed contractors. h10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: n i 1. I agree that, as the party legally and fwancially responsible for this proposed construction activity,.t will abide by all applicable laws and requirements that govern Owner -Builders as well at employer's. 12.1 agree to notify the issuer of this. form immediately of any additions; deletions, or chMes to any of the information 1 have provided on this form. Licensed contractors are regulated by laws designed to protect the public. U you contract with someone who does not have a, ticsense,. the Contractors' State License Boatel may be unable to assb;t you with any 6naneW loss You may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be iwcivil court. It is also important for YOU to, understand that -if an unlit ensed.Contraetor of employee of that individual or firm is injured while working on your Property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for va*ing whether or not those Contractors are properly tieensed and the status of their wotkers' compensation insurance coverage. Before a building permit can be issued, this .form must be completed and signed by the property owner and returned to the agency responsible for issq1b&. f:per.J. NoW 4 copy of tkcproperW # vper•'s d6ve*'s466.�- forvn not d*f4 or other verification acceptable to the agrency is t+egrEiced to be presentedwhen the peortdt is issued to verify. the propeny owner's signature. Signature of property owner�r ! ` f� N i ru%� _ I / C.T/7 Date: Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OVINE 5 BEH)9,F Excluding.the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign,and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: _&JASA1Y &-, X'0 -0-74i l Ceµ�ti— Name of Authorized Agent: (�'� .��¢rkal 2 Tel No 760 -`l F1 S -f 3 o °v Address of Authorized Agent: Ave.' �,d, � � <A 1 declare under penalty of perjurythat I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note. A copy of the owner's driver's license, form notarization, or other verification acceptable -to the agency is required to be presented'when the permit is issued to verify the property owner's signature.. Property Owner's Signature:'% _ j4__� Date: Bin # City of La Quinta Building 8i Safety Division P.O. Box 1504, 78-495 Calle Tampico La.Quinta, CA 92253 - (760) 77777012 $o,Building Permit Application and Tracking Sheet Permit # nn Project Address: : L Owner's Nae: L A. P. Number:Zz L - V� _ D6 Address: �1,0 61AA U Q, Legal Description: Contractor: ..� e City, ST, Zip:' 217-0 Telephone: . s:: f •#:fig.,:>s Address: _ L Project Description: `' '7 h City, ST, Zip: YN f 0 Ld 9Z C o sU 1) a i^eu -e Telephone: >;:> < :::::::::::s State Lic. # 76 6 q1 City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: hone ;:.,:.::::.::::`»`>`<<% + Con structi n o T e: Occupancy: Y cY: State Lic. #• Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: } H Z Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 7.66 -ci 2 5'- Estimated Value of Project: S APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Z� Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan + 2°" Review, ready for. correction /issue ( Electrical Subcontactor List Called Contact Person 0` 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 Schodl Fees Total Permit Fees ~7 j,