BCOM2017-0044VOICE (760) 777-7125
78-4_5..ALLE TAMPIC9,,..:, • C D
LA C1UINTA; 92253 CALIFORNIAFAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 11/30/2017
Permit Type/Subtype: BUILDING COMMERCIAL/REMODEL Owner:
Application Number: BCOM2017-0044 WASHINGTON 111 LTD
Property Address: 46660 WASHINGTON ST STE 3 80618 DECLARATION AVE
APN: 643020063 INDIO, CA 92253
Application Description: PERSPECTIVE OPTOMETRY/ 1;495SF RETAIL TI [VB/B-OC/12-OL/SP]
Property Zoning:
Application Valuation: $65,000.00 O(�
[�j U
Applicant: Contractor:
AJ NABER LOV
o r DESERT DESIGN BUILDERS INC
OUTSIDE CITY LIMITS -
CITY OF 6A QUANTA
COMMUNITY DEVELOPMENT DEPARTMENT
(760)771-2220
Llc. No.: :LIC -0009874
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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: License No.: :LIC -0009874
Date: / Contractor:
OWNER -BUILDER DECLAR TION
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 r
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, 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:
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
Lender's Address:
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.
NI 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 wo ers' compensation insurance carrier and policy number are:
Carrier: Polity Number: _
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 1 should become subject to the
workers' compensation provisions of Section 3700 of the Labor e, I shall forthwith
comply with those provisions. /.^ n /110 /\
Date: �� 511► l Applicant:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATICIN COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000): IN AD (TION 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 Building Official 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 relatinglo building
construction, and hereby authorize representatives of this city to enter upo h abs( e -
mentioned property for inspection purposes. I ^r\ P 1 '/
Date: If ��,��J Signature (Applicant or Agent)
Date: .11/30/2017 ,
Application Number: BCOM2017-0044 Owner:.
Propertq`f�iidress ' ` '1+"°45660 WASHINGTON ST STE 3 WASHINGTON 111 LTD
APN: 643020063 80618 DECLARATION AVE
Application Description: 'PERSPECTIVE OPTOMETRY / 1,495SF RETAIL TI [VB/B-OC/12-OL/SP] INDIO, CA 92253
Property Zoning:
Application Valuation: $65,000.00
Applicant: Contractor:
AJ NABER 1 DESERT DESIGN BUILDERS INC
OUTSIDE CITY LIMITS
(760)771-2220
LIc. No.: :LIC -0009874
.Detail: 1,495SF RETAIL TI/VB/B-OCC/12-OL/SPRINKLED [PERSPECTIVE OPTOMETRY] THIS PERMIT DOES NOT INCLUDE BUILDING SIGNAGE OR SHELL
BUILDING ALTERATIONS. TUMF OR DIF NOT ASSESSED DUE TO NO CHANGE IN DEVELOPMENT USE. 2016 CALIFORNIA BUILDING CODES.
;;;DESCRIPTION ACCOUNT QTY' AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $3.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $3.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NON-RESIDENTIAL, FIRST 2,000SF .
101-0000-42403
0
$117.03
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NON-RESIDENTIAL, FIRST 2,000SF, PC
101-0000-42600
0
$90.50
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $207.53
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIRE COMMERCIAL TI
101-0000-42421
0
$156.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIRE COMMERCIALTI PC
101-0000-42420
0
$234.00
Total Paid for FIRE FEES: $390.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PLAN CHECK DEPOSIT - ADDITION/REMODEL
101-0000-42600
1
$125.00
Total Paid for PLAN CHECK DEPOSIT- ADDITION/REMODEL: $125.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE - MAJOR
101-0000-42416
0
$20.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $20.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($106.80)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$70.23
DESCRIPTION .
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$56.16
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 100 SF
101-0000-42400
0
$53.05
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$106.80
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000-42600
0
.$38.32
Total Paid for REMODEL: $217.76
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($18.20)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI -COMMERCIAL
101-0000-20308
0
$18.20
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Bin* G3�3
City of La Quinta
Building & Safety Division
Permit#
78-495 Calle Tampico
Q0 414
La Quinta, CA 92253 - (760) 777-7012
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Building Permit Application and Tacking Sheet
Project Address: i1 r f r �.,1,,
"C `T 'Co'I I
Owner's Narru
iU�-
1
fit
A.P. Number
Ad s :
Legal Description: e _V L�'�
City,
Contractor: ,ry ,,� , 7
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L
l eiephone: _
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Address: �� h •
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Project Description:
City, ST, Zip. 11y ,tVLf(
W:
2 L
c
Telephone:
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•
Slate Lic. #: Q
CCJJ
City Lic #:
Arch. Engr., Designer:
Address: ^ `
City, ST, Zip:
i 1
Telephone:
Construction Type:
Occupancy:
State Lic. #:
Proj. Type New Add'n
A Repair
Demo
Name of Contact: r1__ �—
3
SgFt: � #Stories
1 #Units:
j Telephone of Contact: Q
ff LL77
_
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Req'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check Submitted
Item
Amount
Structural Cales
Reviewed, ready for corrections
Plan Check Deposit:
Truss Cales
Called Contact Person
Plan Check Balance:
Title 24 Calcs
Plans Picked Up
Construction:
Flood Plain Plan
Plans Resubmitted
Mechanical:
Grading Plan
2nd Rev, Ready for corrections /
Electrical:
Subcontractor List
Called Contact Person
Plumbing:
Grant Deed
Plans Picked Up
S.M.I.
HOA Approval
Plans Resubmitted
Grading
IN-HOUSE
3rd Rev, Ready for corrections /
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Apps
Date of permit issue
School Fees
Total Permit Fees