04-7035 (DEMO)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504
(760).777-7012
T 78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS,(760) 777-7153
BUILDING PERMIT
Application Number i(04-0000703_5 J.' Date 11/02/04
Property Address .. 50855 WASHINGTON ST SUjF—
APIC: 770 -0.20 -017 -3 -000000 -
Application description DEMO'- COMML/OTHER
Property Zoning NEIGHBORHOOD COMMERCIAL
Application valuation 0
Owner Contractor
LQ INV OWNER
C/O ROSETTE CADRY
401 S'BARRINGTON AVE 100
.LOS ANGELES CA 90049
Permit . . DEMO PERMIT
Additional desc
Permit Fee 45.00 Plan Check Fee .00
Issue Date Valuation . . 0
Qty' Unit Charge: Per Extension
BASE FEE 45.00
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Special Notes and Comments. "
INTERIOR DEMOLITION OF EXISTING SUITE IN
PREPARATION FOR.TENANT IMPROVEMENT(PLANS
CURRENTLY IN PLANCHECK).2001 CBC
Fee summary Charged Paid Credited Due
Permit Fee Total 45.0000 .00 45:00
Plan Check Total .00 .00 .00 .:00
Grand Total 45.00 .00. .00 45.00
P.O. BOX 1504 9&t�v
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 7774011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Og — 70.3-5 I Date: �Z-
Applicant:
D IVAI F f
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
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 License No.
Date Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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, 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 or 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 wii L -have the burden of proving that he or she did not build or improve for the purpose of sale.).
U 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 Laws).
U I am exempt under Sec. 6.8 P_C for this reas�an
Date 1111,10 Owner I LAO
I WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjuryone of the following declarations:
I have and will maintain a ced ificat . 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 / Policy 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'
Y compensation laws of Califon ia, ano agree that, if�l should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those p vis ons
Date Applicant
WARNING r FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL4RS ($100,000), IN ADDITION'TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE,h NTEREST, AND ATTORNEY'S FEES.
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
Lenders Address
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 Ouinta, 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, I" isnot commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to canceration.
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 of this county to n"ter upon the above entioned property for inspection purposes.
Date�Signature (Applicant or Agent):
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N CITY 'OF LA QUINTA
BUILDING &.SAFETY DEPT.
APPROVED
FOZR� C�STRUCTI N
vo`
-
C TIREMURAWBWFMEW&DO
77873 Wildcat Dr. • Ste. B
Palm Desert, CA 92211
! r Phone: (760) 200-3552
r
Fax: (760) 200-3554
2004 2:23:55, M Eduardo Nava.Ca5tino Restaurant and 5upPly
Nov 2 20.04 3 55P SUMMIT TEAM, INC. (114).431.-0.0.63 No 3486 P. 1/1
R JUST
LEASEDLEASED -
-®® •
SUMM11
SHOPPING CENTER MANAGEMENT AND LEASMO
"Taken to the Ne*1 Level -
City of La Quinta r
Building Department
78-495 Calle Tampico
La Quinta, CA 92253
Gentleman:
This letter is to inform you that the landlord of the La Quinta. Village Center has
.approved the plans for.the tenant improvements at'50855 Washington Street
Suite 2H, for a restaurant to be called Bunz. The;tenant is allowed to sign, on
behalf. of the owner for demolition and building permits'
Cordially, -
David Israelsky r
Property Manager
`. Summit team Inc.
.17165 Newhope St. • Suite H • Fountain Valley, CA 92700 • (7141241-1550 . Fax (714) 241-1551
e-mail, 6ummitTeam@SummitTeam.com
,
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has.been submitted in'your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as Owner/ Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies fouthe proper permit in his or her name. .
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required -by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors,, then you maybe an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security takes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under Statc
Law, contact the Department of Benefit Payments and theDivision of Industrial Accidents.
If the structure is intended for sale, property owners.who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be.contractors is to secure an," Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally. .
Information about licensed contractors may be obtained by contacting,the Contractors' State License Board in your
community or at -1020N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters: The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDI G D SAFETY
8 49 Ca11e Tampi o
Q �, CA 922
(7 ) 7- 12
F 7 -0
'S IG ATURE/DATE ,
ROPERTY ADDRESS
PERMIT NUMBER(s)