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14-0104 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 14-00000104 Property Address: 50921 WASHINGTON ST APN: 770 -020 -019 -5 -000000 - Application description: REMODEL - COMMERCIAL Property Zoning: NEIGHBORHOOD COMMERCIAL Application valuation: 45000 &tyl,,4 QuhA BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: LQ INV 17165 NEWHOPE ST FOUNTAIN VALLEY, CA 92708 Contractor: Applicant- Architect or Engineer: KMACK CONSTRUCTION, INC. 950 ELM STREET " ORANGE, CA 92867 (661)616-4659 Lic No • 974735 ----------------------------------------------- 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 Bus A ess and Professionals ode, and my License is in full force and effect. License Class�Q (� _ No.: 974735ate: O j Contractor:A_,Xtse(� o -BUILDER DECLARATION I hereby affirm under penalty of perjury ttr t I am exedi t 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).: (_ 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.). (_) 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 Name: Lender's Address: i p LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/18/14 26 Vi ) CITY OF LA lJfPIiA DEPT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — — — — — — — — — — — — — — — - - - WORKER'S COMPENSATION DECLARATION 1 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 • I certify that, in the performance of the work for which this permit is issued, I shall not employ any L •r - person in any manner so as to•become subject to the workers' compensation laws of. California,. and agree that, if I shout becomes bject.to the oikers' compensation provisions of Section, pp0 of the Labor Cod shall fo ith co 1 w/itch �tho�se provisions. Date:3 1 D Applicant: CPU WARNING: FAILURE' SECURE WO S' COMP SATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES 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 correct. I agree to comply with all city and county ordinances and state laws relating to building onstruction, nd herthorize representatives Of this count to enter upon the above-mentioned property f nspection pu oses. _ Date:3 Signature (Applicant or Agent): Application Number . . . . 14-00000104 ------ Structure Information INTERIOR REMODEL ONLY ----- Other struct info . . CODE EDITION 2013 FIRE SPRINKLERS FULLY MIXED-USE OCCUPANCY B OCCUPANT LOAD 32.00 1ST FLOOR SQUARE FOOTAGE 1485.00 i Permit . . . ELECTRICAL 2013 Additional desc . Permit Fee . . . . 50.01 Plan Check Fee .00 Issue Date . . . Valuation . . . . 0 Expiration Date 9/14/14 Qty Unit.Charge Per Extension 1.00, 23.8300 LS ELEC DEVICES, FIRST .20 23.83 11.00 2.3800 EA ELEC.DEVICES, ADDIL 26.18 Permit . . . . . . PLUMBING 2013 Additional desc Permit Fee . . 59.60 Check Fee ._ 00 _Plan Issue Date Valuation 0.. Expiration Date 9/14%14 Qty Unit Charge Per Extension 4..00 11.9200 EA PLBG FIXTURE/TRAP 47.68 1.00 11.9200 EA PLBG WATER INST/ALT/REP 11.92 Permit . .,.. REMODEL 2013 Additional desc Permit Fee . . . 70..07 Plan Check Fee 00 Issue Date Valuation. 0 Expiration Date 9/14/14" Qty Unit Charge Per Extension 1.00 48.6200 LS MISC REMODEL, 1ST 100 .SF - 48.62 1.00 21.4500 EA MISC REMODEL,.ADDL 500 SF 21.45 - ----------------------------------------------------------- Special Notes and :Comments Received payment of outstanding plan review fees from Application #11-0986 in the amount of $178.61 on 1/29/2014. (MOVED FROM LAND MAINTENANCE TO.BUILDING PERMIT) March 13, 2014 3:12:07 PM AORTEGA 0, LQPERMIT a Application Number . . . . . 14-00000104 ------------------------------------------------------------------ Special Notes and Comments INTERIOR REMODEL TO CASEWORK, AND MINOR , EQUIPMENT, LIGHTING AND PLUMBING CHANGES - [CONVENTIONAL] THIS PERMIT DOES NOT INCLUDE ALTERATION TO THE BUILDING EXTERIOR OR LOAD BEARING CONSTRUCTION. 2013 CALIFORNIA BUILDING CODES. March 13, 2014 3:17:26 PM AORTEGA ----- Other Fees -BLDG STDS ADMIN (SB1473) 2.00 PLAN CHECK, ELECTRICAL 30.43 PLAN CHECK, REMODEL 150.15 PLAN CHECK, PLUMBING 59.60 - - STRONG MOTION (SMI) - COM' 9.45 Fee summary Charged Paid Credited- Due Permit Fee Total 179.'68 .00 .00 179.68 , i Plan Check Total 00 .00 .00 .00 Other Fee Total 251:63 .00 .00 251.63 ' Grand Total 431.31 . 00 431.31 - .00. LQPERMIT r - B,n # City 'of. La Quina BuMng ar Safety Dwon P.O. Box f SO4, •78-49S Otte Tampico La.Quinta, CA 92233 -:(780) 777 7012 Building Permit Application' and Tracking Sheet Permit # l Project Addtrss: - 21 ��"! �( "roqg�7qg Owner'sName:. ��J,,iS C 0 gU t�:�A. P. Number: D10 �Address:' �1 `OGS j Ew I o�O, #14Legal Description: 6 M 8�0� � ql • Cityn, Zip: TO U I►�1i�'M&I � G 2709 Contractor:2K(A(� Telephone: 7bf7 %77'lAddress: "Ql%,,�j'/j� orr� "4 `TProjec�ttDescription: City, ST, Zip: V �i 'CIA- qa AG - �� M 61 &CI� itVt�t vpf-s Telephone C4'l-5-1 g - ��1.�`--yy�6. ^ F� /14;- i'I11Z O l%I Wq kk State Lia #: City Lic #;Jw Arch, Bngr., Designer ►�{ D U C �J Address: M PAantA, SUa 2f U g1mrs n MA77.t Affs�e�- uc�. G!� " City, ST, zip: wlC�- Telephone: 9 ..1117 State Lia #: Construction Type: !�- L} d1tOeeapancy: Project type (circle one): New Add'n Alter Repair Demo Sq, Ft.: I Q I�F I # Stories: 1 # Unit$: Name of Contact Person % U t1J�„/V me aNV&fA Telephone # of Contact Person: . �j .275- % Estimated Value of Project *4;;, qSi a45 • �� APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Plan See Reed TRACMG PER1WF FEES" Plan Check submitted Teem, Amount Structural Cala. Reviewed, ready for corrections AMPlan Check DepostY. Truss Cates. Called Contact Person Pian Check Balance Tide 24 Calcs. Plans picked up Le vo �onageotiog� 7 C Flood plata plan Picas resubmi. ftd.j,, +1 Mecbariicat n Grading plan ' Review, ready for correctio Electrical Subcoatactor List Called Contact Person ?� �� Plumbing Grant Deed Plans picked up S bi L H.Q.A. Approval Plans resubmitted Grading IN MUSE:- '•0 Review; ready for correctionshasae Developer Impact Fee Planning Approval. Called Contact Person I.P.P. Pub. Wks. Appr Date of permit issue School Fees u Total Permit Fees 4 3 y t .rYxz1 :0. 60•X.,1504r r� SUI•LD,ING &. SAFETY DEPARTMENT • ..78-495 CALLS TAMPICo � (760) 777-7012 OFT � LA QUINTA, CALIFORNIA 922 --FAX (760) •777-701 1 VEB X 2.2012 . + City of toy Planning Doptirtinwlt To: Greg Butler, Building & Safety Manager To CDD: t From: Les Johnson, Director -Planning Due Date:.A5 A f?. Permit #:Status IL�-LAP E�uliding Plans AarQval - (This is an approval to issue a Building Permit) ' The Planning Department has reviewed, the Building Plans for the . following project: Description: +G' Address or General Location:4" 9� Applicant Contact: L� 303- The Planning Department finds that: ❑ .,..these Building Plans do not require Planning Department approval ...these Building Plans.are approved.by the Planning Department. ❑ y ...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 the Planning Department for review. ---------- Les.Johns , Director -Planning Date