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10-0858 (DEMO)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tityl.4 �W BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 10-00000858 Property Address: 46480 WASHINGTON ST STE 1 APN: 643-020-058- - - Application description: DEMO - COMML/OTHER Property Zoning:, REGIONAL COMMERCIAL Application valuation: 0 Applicant: Architect or Engineer: /UA 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 Co , and my License is in full force and effect. _ Licens(e�CI ss: B Lic s No.: 884711 Date: e4 Contractor: OWNER -BUILDER DECLARATION I I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the • following reason ISec. 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): (_ I I, as owner of the property, or my employees with wages as their sole compensation, will clothe 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 1, 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.). 1 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: WASHINGTON PO BOX 1623 PALM DESERT 111 LTD CA 92261 Contractor: MIRAGE DEVELOPERS INC 121 SOUTH PALM CANYON PALM SPRINGS, CA 92262 (760)864-9448 Lic. No.: 884711 VOICE (760) 777-7012 FAX (760) 777-70.11 INSPECTIONS (760) 777-7153 Date: 9/07/10 -------------------------------------------------- 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: CarrierEXEMPT 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' a workers' compensation provisions of Section 700 of the Labor Co ha11 forthwit co ly with those provisions. Date. Applicant: • r _ 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 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 requestland 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 infoy'orrec[. I agree to comply with all city and county ordinances and state laws relating to buildin construereby authorize represen[atives of this cou tyto enter upon the above-mentioned rtyor inspecs. Date: .Signature (Applicant or Agent): l Application Number . . . . . 10-00000858 Permit . . . . ... DEMO PERMIT Additional desc . Permit Fee . . . 45.00 Plan Check Fee .00 Issue Date . . Valuation . . . . 0 Expiration Date 3/06/11 Qty Unit Charge Per Extension BASE FEE 45.00 Special Notes and Comments SAW CUT & REMOVE PORTIONS OF CONCRETE SLAB FOR GREASE INTERCEPTOR PLUMBING TRENCH. NO PLUMBING INSTALLATION TO OCCUR PRE- TI ISSUANCE, PER GB APPROVAL. 2007 CODES. Fee summary Charged Paid Credited Due Permit Fee Total 45.00 .00 .,00 45.00 Plan Check Total, .00 .00. .00 .00 Grand Total45.00 :00 .00 45.00 LQPERMIT .. _ r 'i'* .y r+ter Concrete Demoiuon bwpe Ui YVv 3 w r Demo: Saw cut and remove concrete for grease interceptor plumbing trench. Removal are to include 31 If .,x 2' concrete • WLj lAlaVl1V 1 °rslab. Grease Interceptorplumbing trench done in 11 &euse interceptor i stallaiioiperiiii #, 10-80 7. Workingwith Interceptor contract will insure proper alignment and flow of lines and and associated problems can be easily diagnosed and resolved.P t Bin # - -- Qty of La Quinta Building 8r Safety Dh*lon Permit # �� P.O. Box 1504, 78-495 Calle Tampico La Quints, CA 92253 - (760) 777-7012 \0 Building Permit Application and Tracking Sheet Project Address: y -4-1 S 1 S1 ' Owner's Name: AS� % N A/ a r 1 L A. P. Number: 6 y 3— 0 �O B X Address: 30 q q Pa N d V f ,n Legal Dcscription: parcie City, ST, Zip: .15 N �� 1 rom Contractor:p� 1 TelP.,6,..,P• Gr 1/111 7 UI'1 ^ � V O ^ Address: C ` -0 19ahm CIA11 'o b Project Description: S City, ST, Zip: 1-A Mechanical c Telephone: T64- INL) State LIC. # Grading plan City LIC. #: �l 2'. Review, ready for corrections/issue Electrical Arch., Engr., Designer. Subcontactor List Address: S'e O VY Plumbing City, ST, Zip: Grant Deed Telephone:Construction State Lie. #: a {j Mame of Contact Person: ' 0 f Type: ..- Occupancy: Project type (circle one): New Add'n Alter Repair o Sq. F J # Stories: 1 # Units: Telephone # of Contact Person:9,11-1306' Plans resubmitted Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Rec'.d TRACKING PERMIT FEES Plan Sets Called Contact Person Plan Check submitted A.LP.P. item Amount Pub. Wks. Appr Structural Cales. Date of permit issue Reviewed, ready for corrections Plan Check Deposit School Fees Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction 41� r1oou Poon. plan Plans resubmitted Mechanical Grading plan 2'. Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person 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.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees C� Fmv 10 0 0 NEW GREASE OWNER TO PI POINT OF C( UNDER PERM SAW CUT CONC. SLAB FOR NEW SEWER PIPING 0' Demo Plan 8 ' 16' 24' OP SINK E, SAVE AND PROTECT HAND SINK FOR RE-INSTALTION CT (E) FLOOR SINK E, SAVE AND PROTECT 3 -COMP SINK FOR RE-INSTALTION E WALL - PATCH AND REPAIR BACK WALL ANK SINK T AND REMOVE (E) SECTION OF COUNTER W CUT SLAB FOR INSTALATION OF ECTRICAL CONDUITE TO ISLAND `OVE ACCOSTICAL CEILING TILES OVE FOOD SERVICE AREA n r CSA Chris Sahlin Architects 121 S. Palm Lanyon Or, Ste, 229 Palm Springs, (al ifornia 92262 Tel , 760 325 5223 Fax. 760 325 5229 RCy� J �1 0. 876 XP, 6'"0/2011 Q lu r a, � N tri p� c 0•-4 .0 r0 cii'0 .I ' ro ry w o o a. u - Revisions Date SHEEET TITLE FLOOR � PLAN DRAWN BY CLS DATE 3-29-10 108 N0. 10-107 , Iq SHEET N0. cc