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0309-216 (CSCS)LICENSED CONTRACTOR 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 # Lic. Class Exp. Date 64.2515 --'Date/0' RSignature of Contractor + �•�`&­ / OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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 & Professionals Code). ( ) I, as owner of the property, am exclusively, contracting with licensed contractors to construct the project (Sec. 7044,.Business & Professionals Code). O I am exempt under Section B&P.C. for, this reason Date Signature of Owner y�r 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 & policy no: are: Carrier'` C:3Ib91'.EI"r�9Tl Policy No. 1614,0493 ' (This section need not be completed if the permit valuation is for $100.00 or less). () 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 to the workers' compensation provisions of Section 3700 of the. Labor Code; I shall forthwith comply with those provisions y. bate: !CJ-.!',..•sr,TApplicant Warning: Failure to secure Workers' Compensation coverage . is unlawful and shall subject an employer to criminal penalties and civil fine's up to $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. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth' on his 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 applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 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 State laws relating to the.building construction, and hereby authorize representatives of this City to enter upon the above-mentioned,p rope rty for inspection purposes. 'Signature (Owner/Agent)..7�%. Date r \BUILDINGPERMIT PERM_ 0309-2,16 DATE VALUATION, LOT TRACT lA/17i2•t?C , S100,000 . JOB SITE ADDRESS. W921. WASER40TOVf'.0 'i�tfrr :�/�a APN 7it�••0'atE7-�� OWNER CONTRACTOR / DESIGNER / EN INFER LQ 11N. &P. WAGE,9, WC. 401 3:: .Rn4,QT0X-AV'_R 4100 2021 RANIC510 DR. 310TYk+ 4 % d'SANfirEL ";' CA 9004 1%D1At x v CA 92373 t� USE OF PERMIT M&A E' .CTAL RP-MODIU cOR/Jwmmu. P,�?'A40D9L (;3TATt UCk.S Ti) 09, OCCUP./..At ?YPEV 1111 1550 SX, OCCUPANT LOAD '512001 CDC" 2003 U - CONTRACT A:{v OUN"f 10,000,00 LS C!� rs 4lb * F` C. XS1MA eT.W C10&1' 0r C0X s JR7UC7rJ x�T 100,0i3Sf o lid &VARJAIt"l . CONSTRUCTION .FEE .. ,101.000.4134000 $09,50 . PLAN CHECK FEZ 101' 000 -439-318 $533:74 %lECi1.iANkCAi, l 10 i •Ot)0=421 •000 EL C`P1tiGALPf? ,. 1.01-000-A20-000 P1a11rA13M REx01-UaJ-419Li� i1 �l B.Ot« .. s'rRONO Td1OTIO)UPEA' - COMM 300-000-241-000 $21.9 8uB-'T0TKL C01grel w UCr10k4 .k .D p] AW C. ICE 1;¢23.24 C,1�'3 P1ZFJ-P 7�.7D.PEl:��... i � $OIC3C1 RECEIPT DATEBY t� /' r <.; DATE FIN ED 03 . INS OR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath ' Q Drywall - Int. Lath Final Final BLOCKWALL APPROVA S POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out r} -s Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test / Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring / Low Nottage Wiringf34�Q Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: /J / `� �rJdi! j�l fL ,-&A f jW*�- �iiG 7d 1ijlvttt ONm^�.h00 7 �Qf�.t �!�/��3.� , � � c0;0Ba LVwAs *All ri� X13 /Z.AS"�b 3 # City of La Quinta Building 8E Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Permit Application and Tralc*ing Sheet ''I Permit # 004 , '/(4 . . .. .... .... . — Project Address: S Owner' L A. P. Number: ddress: see Legal Description: ity. ST, Zip: Cont FTelephone: Ad ress: �Project Description: City, ST, Zip: Telephone: State Lic. # City Lic. Arch., E�ngr, Address: City, ST, Zip: Telephone: tru e Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo State Lic. #: Name of Contact Person: Sq. Ft.: # Stories: I # Units: Telephone # of Contact Person: "Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd . TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural C21CS. Reviewed, ready for corrections -1/w Plan Check Deposit Truss-Calcs. Called Contact Person Plan Check Balance Energy C21CS. Plans picked up 11LA Construction Flood plain plan Plans resubmitted /0//3 Mechanical Grading plan 2"' Review, read), for correction issue Electrical - Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SAI.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ' Review, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees 7?)- X!mug. 4w 771 Total Permit Fees MeOMM*V— *-hry Pin �S� Cort c eCt G6 �D3o9 If <6 4 4 " A P.O. BOX 1504 APPLICATION ONLY Building 50ga1 W:216hiratotn St•,�rJ 78-495 CALLE TAMPICO Address La l.?r,ivrEA . r A a.sM<� LA OUINTA, CALIFORNIA 92253 Mailing �� ' Address 3 �� f VQ - City Zip rig` Tel. v �� jv'��Fs(' g� Contractor ._ 1 t -i- (� O �� c1Q,l2+-M 1 "\e Address City jZip & Classif. I Lic. # Aoe Engr., Designer I Designer MOY'1t Address Tel. 2 02 �Vfsir e�l3t►C1�ial -906 City cit T, Q_ y zip �2(012 uctq LICENSED CONTRACTOR'S DECLARATION I hereby affirm 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. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby 'affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis tot 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 (5500). I: 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such 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 did not build or improve for the purpose of sale.) I'1 1, as owner of the property, am exclusively contracting with licensed contractors to con. struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 17 I am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION Ihereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company Cl Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed it the permit is for one hundred dollars (SI00) valuation or less.) I certify that in the performance of thg 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. Date Owner ' NOTICE TO APPLICANT: If; after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked: CONSTRUCTION LENDING AGENCY . I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. 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 city to enter' the above- mentioned property for inspection purposes. Signature of a0plicant Date Mailing Address City, State, Zip BUILDING: TYPE'CONST.V-1`41 OCC. GRP. S P. Number Legal Description Project Description Teri ert-F' \m!2yoyft n* Sq. Ft.' SSO No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estfmateo valuation 100 600 GQ PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure % —� l TOTAL REMARKS WHITE.= BUILDING DEPARTMENT -YELLOW = APPLICANT PINK = FINANCE - BY: ZONE: Minimum Setback, Distances: Front Setback from Center Line Rear Setback from Rear Prop'. Line • Side Street.Setback from Center Line Side Setback from.Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE.= BUILDING DEPARTMENT -YELLOW = APPLICANT PINK = FINANCE Certificate of Occupancy T4hf 4 4 Q" Building & Safety. Department This Certificate is issued pursuant to the requirements of Section 109 of the 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: 50-921 Washington Street Suite C-2 Use classification: Commercial (Starbucks TO Occupancy Group: B Owner of Building: LQ INV. Building Official Type of Construction: VN POST IN Building Permit No.: 0309-216 Land Use Zone: CN Address: 401 S. Barrington Ave #100 City, ST, ZIP: Los Angeles, CA 92373 By: Daniel P. Crawford Jr. Date: 12/22/03 UOUS PLACE r . - 'i ' •} a . • . �r'�' r moi''^, Ot.a , a 4 ya r" 15 15 14 P f C `-,<r .Rf,.t-'t `bxz.Z6srr 'S.a�Fi .-. �s.K,pNi.�r..,•:,.,fvy^^e.v�.:>,e R ';T .-��V., 7 �ay--i}4w•a.�, ,,.'��,.�,A.s�r11•"ys::-ti.p'.,'.Fii` s} -. 'z •". ..'J.--ite'� ., GR?•r•Ln<_T<xo- -:•-�?- ,r'q'<•- .• '4. . .'�r-_r• _3��,w-e:r - :f=7• f • +. •*,s..sy,'qv,S.'"{�.'ry F4t.zo°-- T-�4 65 _r{_,.r..:'`S�{T-J�re';a.dt�+..'-.ra.19b.1-r++.t•`a4cS 3:, . T �_ % y..;f.Nti-i _ P.�- rer-•:0:,..,fi..,.T::6.!Yr .-te.s..s,a r's -.-'tF."r...-;,� �:��l,"jf, r � �r•�.!1 .`. "•r t I{iII !t .j1!_�. . ^. 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F`7s : -71 POIT x�4 =s- ,�a sY.?•. , .: 1, < c} ., i� ,. !� ... •. ,�', .1•. _ - `rt. _ y Seo . iyr � �< -e�> .t•tii =�µ• ,`. ,}I � � % Y �—� - �±, tl. � - _. ''�' r .. - i�; •f 374. _ •'i 11 - - . {' Imo! � t•k 3` • .. r ` • - L .. _ — ... - .. ----"--µ /� L I� ---moi _�� i � -- � — !~--•,�_.J { - t - T PLUMBING WASTE !.VENT-/ DRAIN PLAN-X�*tJ% a-' - .� .�_A llll'.Qlz..�,i;.:!•.: ,old/iY �lh716611 ffiT.zt"^�'� 0'iT9i`1ri4:•r�i:ei-i�'tl4iihac•-: �4•Y3i6':r�+'�-"x•u r....\ent..,t\G.•v�,z-:� r_..•.nso,.v.•w.i.«•nw..a .a.. _r _ _...__ _..� _ _� - ,..,.�.��. 1.cif? P.0. Box J504' BUILDING & SAFETY DEPARTMENT X45 . 78-495 CALLE TAMPICo (760) 777-7012 OF LA QUINTA; CALIFORNIA 92253 FAX (760) 777-7011 - To: Greg Butler, Building & Safety Manager To CDD: 9-9-2003 From: Oscar Orci, Planning Manager Due date: 9-17-2003 ` R.• Status:lsT Review Building Plans Approval (This is an approval to'issue,a Building Permit) o The Community Development Department has reviewed the Building Plans for the following project: Description: Starbucks Coffee Company" Address or general location: 50-921 Washington Street 4 Applicant Contact: Mr. Montross 949-553-9005 The Community Development Department finds that: ❑ ...these Building Plans do not require Community Development Department approval. ...these Building Plans are approved by the C mmunity Development (` Department.,. S�r+�c. w� pi►.�„.r.. f f - ...these Building Plans require corrections. Please forward a copy of *the attached corrections to the applicant. When the corrections are made please return them to w the Community Development Department for review. scar Orci, Planning Manager e NN AT E R ESTABLISHED IN 1918 ASA PUBLIC AGENCY 'D/STRIC� COACHELLA VALLEY WATER DISTRICT POST OFFICE BOX 1058 -,,COACHELLA, CALIFORNIA 92236 • TELEPHONE (760) 398-2651 • FAX (760)398-3711 DIRECTORS: OFFICERS: JOHN W. MCFAODEN, PRESIDENT STEVEN B. ROBBINS, ' PETER NELSON, VICE PRESIDENT - GENERAL MANAGER-CHIEF ENGINEER ti . TELLIS CODEKAS t October 13 2003" JULIA FERNANDEZ, SECRETARY RUSSELL KITAHARA DAN PARKS, ASST. TO GENERAL MANAGER PATRICIA A. LARSON i REDWINE AND SHERRILL, ATTORNEYS l File: 0421.3 . 0721.3 060706-2 State of California Department of Real Estate` 320 West 0 Street, Suite 350 Los Angeles, California 90013 Gentlemen. s In accordance with the District's currently prevailing'regulations, we will furnish domestic water ; and sanitation service to the area described as Assessor's Parcel Nos. 770-020-018 and 770-020-019 located in section 6, township 6 south, range 7_east, San Bernardino Meridian. 1These regulations provide for the payment of certain fees and charges by.the subdivider and said fees and charges are subject to change.. ' The minimum monthly sewer charge shall be one equivalent dwelling unit multiplied by the applicable sewer service charge or 91 cents per 100 cubic feet of water consumption through any D meters used for domestic purposes, whichever is greater. The terms and conditions of this letter-will be `subject to review and/or revision-by the District if - construction has not be within' 24.months from the date of this letter.' F If you have any questions please contact David McGee, Development Services Aide, r extension 3537: - '==' `r , }' a Y. Yours`very truly, s _ , ' Scott,Coulson' Service Depaitrrient Director - cc: City of La Quinta µ - Department of Public Health, Mike Murray, Indio - - Glassman Planning Associates Riverside County Department of Environmental Health, Gary Root, Riverside DM:dd\ser\ds\oct\glassman TRUE CONSERVATION USE WATER WISELY :: , � jr -^ .S t V", .54 Y. s } APPROVAL;STAM S ::GENES NOTIFY THE-PLAI. C -' EGMPEINF�WRITING �. 1 AFTER STARBI THE GC 1 AS}fir .— F ANY.CHANGES-OR ALTERATIONS TO S;� f ,`I �. AND-EX PLANS AS ORIGINALLY APPROVED. FOLLOW 'F flooring, wk11s, ceilings or equipment) ,-ITS 2. GC SHALL VISI 6Y THE L.4 } C611 for inspections.. Inspections should be FAMILIAR WIT 4� ' `: scheduled.five:.(5) working days in advance. 3. QC SHALL COC .. "Approval of'these plans by she C. cimty of Riverside APJY CHAAIG'E', Cora.STRUCTI.4N V ::Department of not relieve the Engineer or Architect of the responsibility for the Engineering 4.. FOR EACH PPC : CONTRACT or. Architectural design." A REE' AtV PROJECT PRIOF ALL ELECTRICAL,'PLUMBING,:MECHANICAL,.AND STRUCTURAL t N: e . REPAIRS AND. INSTALLATIONS SHALL BE DONE UNDER PERMIT 5. GC SNALC wCO0 Ih1T,HE COItITRI -.. � �J�JSTRU' . FROM (2t;�, i—cam ,,_, ARCHITECT.QRAL DEPT OF BUIL61NO AND SAFETY 6 ALL WORKSHA FOR PRELIMINARY AND FINAL. INSPECTIONS STATE ANpE1 ` NOTIFY DEPARTMENT OF ENVIRONMENTAL' 7 �C : SNAL1=1�R. HEA TH w I Lai TO VER1F TRADES ,, "ID;,N PROCEEDfNG,, W ` THIS APPROVAL DOES NOT INCLUDE THE SURFACE' UNU OESIGNAT ED 40 SUBSURFACE SEPTIC SYSTEM, GREASE INTERCEPTOR, OR OTHER WASTE DISPOSAL SYSTEM—OBTAIN 9: GC SHALL - CLEARANCE FROM APPROPRIATE AGENCY n SURFACESIDEt FOR YOUR'WASTE D1$POSAL.SYSTEM.' COURSE OF Y TI= :r 10. THE GC. IS RE+ PUM81fJG;. MC] L �$? CONTACT THE' PLAN CHECKER FOR A-TRELIMINARY, SUCH SYSTEM., i .INSPECTION WHEN CONSTRUCTION IS APPROXINIA. -Y 800/6 COMPLETE..(BEFORE EQUIPMENT I5 INSTtED,) 11. GC SHALT REIT 4:r ICES DUR1I ;CHAt' "ST ORE .dt' -NOTICE- ZE MANACEMEPf.q�, ` A PERMIT MUST BE OBTAINED FROM THE COUNTY OF RIVERSIDE DEPART :iEN T OF ENVIRONMENTAL HEALTH 12. G.C. 1S P.,ESPOI STAPBUCK C4 PRIOR TO OCCUPANCY OR USE ARID vErIDOP .... AGREEMEN:JF .. { Y� .vim\l i �'i02 and cold funning Water. through .13 RESPc�NS18J'YI {lJ1 .... a muang faucet shall be `provided -IDEriT1FiE=p��1r�I�..Y t he:all Sink$. co uMrr LyA6 -3t: MEAIJS' DISTFIBUT;IO<Jt-' p wmnent approved Soap .and tow®I diewsers must be installed at