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10-0159 (RC)=rte V P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000159 Property Addles"sa� —4711O .WASHINGTON ST STE 103 APN: 643-200-999-A -03429 - Application description: REMODEL - COMMERCIAL Property Zoning: COMMUNITY COMMERCIAL Application valuation: 67000 Apppllic(ant: Architect -or Engineer:_ 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 P Section 7000) of Division 3 of the Business and Professionals C de, and my License is in full force and effect. �icense Class: B00, Li se No.: 309748. DA& Q 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).: V (_ 1 1, 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, 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 _ 1 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: i .. LQPEFNIIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/27/10 Owner: LPP INC C/O RANDAL D MILLER 73745 EL PASEO "PALM DESERT, .CA 92260 Contractor: D ELDORADO D OPMENT, INC. y� 3 TRAFALA SQU �� (42610 - RANCHO 2610 - RANCHO MI , CA 92270 (760) 770-583 d7YOFILA�.F.UINTIA Lic. No.: �i0974��1".t.111�,;-cs 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 EXEMPT Policy Number EXEMPT 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 Joe workers' compensation provisions of Section 3700;Othe Labor rthwith dly with those provisions. C7 tOv 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 cyyyyyy�'��'��ct. I agree to comply with all city and county ordinances and state laws relating to buildin co tion, aby authorize representatives offhis county to e�nte�r upon the above-mentioned pr o ins on,pur s. /Datr_0 Signature (Applicant or Agent): Application Number' 10-00000159 Structure'Information Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type . . . . BUSINESS <50 Other struct info . _ . . CODE ,EDITION 2007/08 ENERGY FIRE SPRINKLERS YES OCCUPANT .LOAD 24.00 1ST FLOOR SQUARE FOOTAGE 2335.00 2ND FLOOR SQUARE FOOTAGE .00 Permit BUILDING PERMIT. Additional desc . Permit Fee 491.00 Plan Check Fee 319.15" Issue Date Valuation 67000_ Expiration Date 10./24/10 Qty Unit Charge Per Extension BASE FEE .414:50 17.00 4.5000 THOU BLDG 50,'001-100,000 76.50 Permit. . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . 61.70 Plan Check Fee .. 15.43 Issue Date Valuation . . 0 Expiration Date 10/24/10 Qty Unit Charge Per Extension' BASE FEE 15.00 2335.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL. 46.70 Permit PLUMBING Additional desc Permit Fee 84.00 Plan Check Fee 21.00" Issue Date... Valuation . . . 0 Expiration Date 10/24/10 Qty Unit Charge Per _ Extension BASE FEE' 15.00 4.00 6.0000 EA PLB FIXTURE •24.00 4.00 7.5000 EA. PLB WATER HEATER/VENT 30.00 1.00 3.000.0 EA PLB WATER INST/ALT/REP 3.00. 4.00 3.0000 EA PLB FIXTURE DRAIN/VENT REP/ALT ..12.00 Special Notes and,Comments 2335 SF MEDICAL OFFICE T.I.SUITE„103. LQPERAIIT 'Application Number,. . . . 10-00000159~ Special Notes and Comments "B" OCCUPANCY. TYPE V -B CONSTRUCTION. OCCUPANT LOAD = 24.,2007 CODES, 2008 ' ENERGY. -TENANT = RAJ K. SINHA MD. C/,0 STAR ORTHOPAEDICS. ANCHORAGE OF MRI . EQUIPMENT IS A DEFERRED SUBMITTAL. Other Fees . +. . . . . ACCESSIBILITY PLAN REVIEW 31.91 BLDG STDS ADMIN•(SB1473) 3.00•' . ENERGY REVIEW FEE 31.91. STRONG.MOTION (SMI). - COM 14.07 Fee summary Charged Paid Credited ---------- Due ---------- - ------ -- Permit Fee Total 636..70 .00 .00 636,70 ' Plan Check Total 355.58 00 .00 355..58. Other _Fee Total 80.89 .00 .00 80.89 Grand Total 1073.17 - .00 .00 1073.17 - LQPERDIIT Certificate of Occupancy T-Vr44Q" Building & Safety Department This Certificate is issued pursuant to the requirements of Appendix Chapter 1 Section 110 of the 2007 California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 47-110 WASHINGTON ST STE# 103 Use classification: MEDICAL (RAJ K. SINHA MD. STAR ORTHOPAEDICS) Building Permit No.: 10-159 Occupancy Group: B Type of Construction: VV=B Land Use Zone: CR Sprinklers Installed: YES Sprinklers Required: YES Occupant Load: 24 Building Official Owner of Building: LPP INC. Address: 73-745 EL PASEO City, ST, ZIP: PALM DESERT, CA 92260 By: STEVE TRAXEL Date: JUNE 29. 2010