BDEM2017-0010.-C14" ,1;;.,
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
4
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
DEMOLITION/COMMERCIAL/OTHER
BDEM2017-0010
50855 WASHINGTON ST STE 2H
770020017
HERITAGE RESTAURANT / LA QUINTA VILLAGE / DEMO
Applicant:
LUIS FUENTES
79405 HIGHWAY 111 STE G-172
LA QUINTA, CA 92253
NOV 2 2 2017
CITY OFLA Q&1NTA V
COMMDEVELOPMENTDEPARTMENT
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 Professions Code, and
my License is in full force and effect. /����
License Class: _L5 License No.: �l�
Date: xContrastog,
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt f m 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).:
(_) 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 ) 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: '
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/22/2017
Owner: .
LQ INV
17165 NEWHOPE ST
FOUNTAIN VALLEY, CA 92253
Contractor:
KAIZAN CONSTRUCTION
P.O. BOX 2847
PALM DESERT, CA 92361
(949)945-3582
Llc. No.:
WORKER'S COMPENSATION DECLARATION
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'
:ompensation, as provided for by Section 3700 of the Labor Code, for the performance
3f the work for which this permit is issued.
.= 1 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
ssued. My workers' compensation insurance carrier and policy number are:
"arr er: Policy Number:
certify that in the performance of the work for which this permit is issued, I
sha noR t employ any person in any manner so as to become subject to the workers'
:ompensation laws of California, and agree that, if I should ecome subject to the
✓porkers' compensation provisions of Section 3700 a or Code, I shall forthwith
:omply with t ose pr 'vnisions.
Date;Ap,Pli ant:
NARNING: FAILURE TO SECURE WORKERS' COMPENSATI •COVERAGE IS UNLAWFUL,
4ND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
DNE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
ZOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
NTEREST, 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
:ommenced within 180 days from date of issuance of such permit, or cessation of work
for 180 days will subject permit to cancellation.
certify that I have read this application and state that the above information is correct.
agree to comply with all city and county ordinances and state laws relating to building
:onstruction, and hereby authorize representatives oaf ity to enter upon the above-
mentioned roper y for inspection pu
Date: S re (APel' g :'/�
I '
Date: 11/22/2017
Application Number: BDEM2017-0010.
Owner:
Property Address: 50855 WASHINGTON ST STE 2H
LQ INV
APN: 770020017
17165 NEWHOPE ST
Application Description: HERITAGE RESTAURANT / LA QUINTA VILLAGE / DEMO
FOUNTAIN VALLEY, CA 92253
Property Zoning:
Application Valuation:
Applicant:
Contractor:
LUIS FUENTES
KAIZAN CONSTRUCTION
79405 HIGHWAY 111 STE G-172
P.O. BOX 2847
LA QUINTA, CA 92253,
PALM DESERT, CA 92361
(949)945-3582
Lic. No.: .
Detail: INTERIOR DEMOLITION OF EXISTING TOILET ROOM, SERVICE COUNTER AND KITCHEN EQUIPMENT. A'SEPARATE TENANT IMPROVEMENT
• BUILDING PERMIT IS REQUIRED: 2016 CODES.
FINANCIAL
DESCRIPTION
INFORMATION
ACCOUNT QTY
AMOUNT
DEMOLITION, INTERIOR
101-0000-42404 0
$39.01
DESCRIPTION ` "
ACCOUNT QTY
AMOUNT
DEMOLITION, INTERIOR PC
101-0000-42600 0.
$104.55
Total Paid for DEMOLITION:
$143.56
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10:00
Total Paid for RECORDS MANAGEMENT FEE:
$10.00
DESCRIPTION
ACCOUNT.
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
_ ..
r
PERMIT #
Conditioned Space S.F
O
PLAN LOCATION �V�+.•�' 1
Garage _ SF
.. 1
Patio/Porch SF
ProjectAdd ress: —055 wI' l GT�*J
SProject Description: Pool, Remodel, Add'ty Elect, Plumb, Mech
APN #:
1
_
Applicant Name: .;
'T' 0('P
Address:
`5: I ,.
40
S• _ .
City, ST, Zip:
r
L U
Telephone:
0_ �( �w '
►
Email:.
S�v/�
�. �S ;, )ko"O(AA
Valuation of Project S
Contractor Name:. 1-CJINSj��C
New SFD Construction:
Address: �. (�, X L,O �i�
7�
Conditioned Space S.F
City; St,.Zip
�p �� �'
Garage _ SF
Telephoned U_ —9 qS
J�
Patio/Porch SF
Email: r/ w Q
� I U o
Wykire Sprinklers SF
State Lic �` City Bus Lic:
0
Arch/Eng Name:5� i�� VNS Construction Type: Occupancy:
Address:
�_ ��. D(OT) LLd ` g Grading:
City,- St, Zip
q
Telephone:
60 , G�C, �Qj Bedrooms:
J ✓✓
Stories:
#.Units:
Email:
r
State Lic:
City Bus Lic:
Property Owner's Name: S I'r - ew Commercial /Tenant Improvements: �.,
Address: k25— Total Building
SF
City, ST, Zip — Z Construction Type: Occupancy:
Telephone: "�:b 2-4 1— Sn
Email:
%o n'Qeyl A rrn l A�d J/�(o (NAA A i��G M--
78495 CALLE TAMPICO
LA QUI NTA, CA 92253
760-777-7000
-HERITAGE RESTAURANT GROUP, INC. -
50 -855 WASHINGTON STREET, UNIT 2=H.
LA QU I NTA, CA 92253 '
To whom it may concern �-
rCONSTRUCTION WASTEMANAGEMENT PLAN PER SECTION 4.408. ONE OF THE CALIFORNIA GREEN BUILDING
STANDARDS CODE. ,
We will follow the standard stated below:' . 4.
• Recycle and/or salvage of reuse a minimum of 65% of the non -hazardous construction and demolition
waste in accordance witheither section 4.40 8.2 or 4.408. Three or 4.40 8.4 or meet a more stringent
local construction and demolition waste management ordinance. =:
Documentation is required per section 4.40 8.5:
1. excavate soil and land clearing debris none
2. alternative waste reduction method developed by working and local enforcement agencies if division
or recycle facility capable of compliance with this item do not'exist or are not locally responsible close to
the job site.,,, ,
3. the enforcement agency,made make exceptions to the requirements of this section will isolated
jobsites are located in areas beyond the haul boundaries of the division facility.
+Sincerely, "+ � , -, .. t - ' , � •-
Luis A. Fuentes, CEO
' �•
• .fit *,. '+ • ,. •
Building Permit Number:
Project Description: Tenant Improvement
Exempt: T!"
(Mateela, Is may. contain
n hazardous.wastes:and
are not subject to recyclirig.,'Provisions)
Construction lj6lbriis Management Plan
Plan Submlital bate 11/22/2017
a
.lob sae Address 50855 Washington St Suite:H
owf
Number, Street,
City, State, P
Owner's Phoi
Owner's E -M;
Summit Team Inc
17165 Newhope' St suite H
Fountain Valle'y,CA. 92708
surnmitteamZsummitteam com
Project Manager's Name,'
Richard Zanini
Project Manager's Phone Number
76.0.578-8306
Project Wna.gers Email Address
k
Builder/ Contractor:
Richa r*d,Za6ini.:
Nurber,-Street or PO Boz ;
P.O.3ox,2847'
City, State, Postal Code
Palm: D6se"ft,::CA. 92261
Project 806a,jre Footage
pr6.. 1 square feet
City'Ap,piroval By
R6hado.:(j'O'U'ld'6&-DtC;tpuMed Waste*'7
Date of.City Approval
11/1'.2-2.:-
Materials To Be. Discarded:
-Product
Tons
Trash
i 1A0,
Not recyclable
Product
Tons
Asphalt
0.00
Recyclable:
Masonry (broken)
0.0 , 0,
Recyclable
-Brick/Block
.,0:0.0
Recyclable
Plaster
0.00
Recyclable
Cardboard
Commingled
L_.0:00
Recyclable
Recyclable.
Scrap Metal
Recyclable
Tile (floor)
�.'00
Recyclable
Concrete
1..50
Recyclable,
Tile (roof)
0.00,
Recyclable
Drywall
.0:.64
Recyclable
Wood
0.50
Recyclable
Donated Reuse*
0.00
Recyclable
Lp.ndscape Debris
0.00
Recyclable
*Describe Items
. . . ......
Is:
. Recycle Trash
Projected Diversion:
2.61,
I understand it is the property owribels responsibility to submit copies of weighttick0ts or receipts to the District.
Environmental Coordinator as these hauls occur: i heiebi certify that completion, implementation
on and adherence of the
Debris Management Plan (DMP) for the above named project shall guarantee that at least 65% of the jobsite waste is
diverted from landfilling. The remaining, material will berecycledor reused. I will divert, for recy.�cling or ee-use, remaining
materials generated from the first day of the project'through the completion,
ion. of the project in accordance with this plan. This
DMP is Issued. in the name of the property owners)and shall '�Y . emain their property ihrobighout thenstruction and/or
demolition project. A contractor serving asagent of the owner may obtainai D co
DMP e' ver,th'DMP isstill
issued in the name of the: property owners) and the owner retains legal resipio'n'sibility for ensuring that the provisions of the
DMP are adhered to. The property owner(s) and general contractor shall be kept informed of the diversion progress through
bi-monthty reports. If self -hauling, all refuse material . fe . om:thi4.prqje6t site must be taken to an approved recycler or transfer
Owner /bev;`Ioper/Project Date' Tnim
. 29
Standard Commercial Retail Lease Initials Landlord
Initials Tenanl
IntUals J Tenant
EXHIBIT "A"
SITE PLAN
EXHIBR
SITE`PL,AM: ..
SUMMARY: ,;
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Sf _ :( U AC�i
PARKING 460 SPACES '.
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PART:
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. 29
Standard Commercial Retail Lease Initials Landlord
Initials Tenanl
IntUals J Tenant
A