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15330 (OFC)tQum& P.O. BOX 1504 Building 78--120 Calle Estado 78-495 CALLE TAMPICO Address LA QUINTA, CALIFORNIA 92253 Owner Address 1 d 12. sat «• City Zip Tel. La Quin! 92253 Contractor Do Dco Const. ty lZip I Tel.: '& Classif. 397-834 B Lic. # 1375 Arch., Engr., Designer oto Dco Address Tel. City IZip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) t.of Division 3 of the Business and ProfessionsCode, and my license is in full force and j - effec SIGNATURE DATE I OWNEWBUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License law for the following reason: (Sec. 7031.5,8usiness and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to Its issuance also requires the applicant for such permit to rile 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 'r for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit I subjects the applicant to a civil penally of not more than rive hundred dollars ($500). ❑ 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, 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.) O I, 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) ffcensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed f/ the permit is for one hundred dollars ($100) valuation 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. Date Owner NOTICE TO APPLICANT: ff, 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. ' r r I r 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. 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. 1 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 applicant -Date- Mailing ate Mailing Address City, State, Zip No. 15330 BUILDING: TYPE CONST. OCC. GRP.; A.P. Number 769-102-010-12 Legal Description 33'11_ 'If, r. #i 10,11 115 n ,r► A 4 + Project Description office Building Sq. Ft. No. Size • 6gf)6 Stories New:M Add ❑ Alter ❑ No. Dw. Units 12 Repair ❑ Demolition ❑ stimated:Valuatjon303,718.00 r PERMIT AMOUNT Plan Chk.'Dep. Plan Chk. Bal. 307.45 Const. -: 2353, 50 Mech. 274;Aft ft Electrical 422.32 Plumbing S S.M.I. 653.78 Grading 2n Driveway Enc. Infrastructure 1 $ 5 $ 3;7; TOTAL REMARKS .Iia tr& L&;§_Jat �Co � ttiti�.LyltS urea Py exceptrions 162U.B.C. K at . i exexore no wedical or ltfr=' all •xxtces• are allowed on gnu floor ZONE: BY: Minimum Setback Distances: Front Setback from Ce0ter Line Rear Setback from Rea Pro . LlneN U i 11 Side Street Setback frio Center Line II li I Side Setback from Propert�f,Ll b FINAL DATE INSPECTOR i V Issued by: Date �y Permit — Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES IST FL. SO. FT. ® $ UNITS LAB ADE L) ROUGH PLUMB. BONDING YARD SPKLR S,0STEM 2ND FL. SO. FT. @ FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® GROUT DRAINAGE PIPING CAR P. SO. FT. FINAL INSP. WALL SO. FT. WATER SYSTEM DRINKING FOUNTAIN GRADING -CU. yd. plus x$ =$ LUMBER GR. URINAL SO. FT. ® FINAL INSP. � �r OFING -C �S� ESTIMATED CONSTRUCTION VALUATION $ REMARKS: WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FIREPLACE WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM SULATIONISOUNDf2 i( 6 KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 1'A c SEWAGE DISPOSAL SO.FT.GAR ® 3Yac HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR BACK OUND PLUMBIN UNDERGROUND A.C. UNIT COLL. AREA LAB ADE L) ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE n FOUND. REINF. O (� J GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. ' REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING -CU. yd. plus x$ =$ LUMBER GR. / NAL INSP. AMING �� .� / FINAL INSP. � �r OFING -C �S� /T l !%I ! ,al "moi /Y� �a� L ��!/ l/L./ /(' (n� �` UUti t/l��/� I �^'� < `-' �✓ ���� ` N` p� q�/ L b,� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL THING -7`pc MESH SULATIONISOUNDf2 i( 6 FINISH GRADING INAL INSPECTIONL) 3 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated 619-775-3500 Date 7/5/95 1 Type of Permit La Quinta No. 113535 Permit # Owner Name Germs Boyan "Log No. 78120 Street Calle Estado city La Quinta Zip 92253 Study Area 115 APN # Tract # Lot # 0 Square Footage 16966 71 Type of Development Commercial No. of units 12 Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of .28 x 6 966 or $ 1,950.48 have been paid to D.S.U.S.D. for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By G. Bogan Telephone` Name on the check _ �, •. By Dolores A. Ballesteros Superintendent Fee collected /exempted by Pauline Pearson Payment 'Received;"- . Signature" da 2 21 A A A) c�.� �r..�_ ,che�k� No. 15 Collector: Attach a. copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept. /Applicant Copy - Applicant/Receipt Copy - Accounting 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/ 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 for the 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 may be 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 taxes, 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 State Law, contact the Department of Benefit Payments and the Division 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 1020 N. 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 BUILDING AND SAFETY 78-105 Calle Estado La Quinta,. CA 253 (619) 564 - FAX: (6 ) -5617 3 O ER'S SIGNATU /DATE PROPERTY ADDRESS PERMIT NUMBER(s) of Or r -r-W - - ug -of,14M (Quinta, . . 30110M9 tllt� �S�ifC��1 �ib[£sWri This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS 78-120 Calle Estado Office Building 15330 Use Classification Bldg. Permit No. Group B_2 B-2 Type Construction Fire Zone Use Zone Owner of Building Jerry Bogan Address . P • O. Box 1012 City La Quinta, CA., 9225 ay, Richard Kirkland Dae; May 17, 1996 Building Officio POST. tT IM A OONe*ICYOUe PUCt James M. Wright Fire Chief Proudly serving the unincorporated areas of Riverside County and the cities of: Banning Beaumont 0 Calimesa O,. Canyon Lake 0 Coachella 0 Desert Hot Springs 0 Indian Wells 0 Indio 0 Lake Elsinore 0 La Quinta 41 Moreno Valley 0 Palm Desert 0 Perris 0 Rancho Mirage 0 San Jacinto 0 Temecula Board of Supervisors Bob Buster, District 1 John Tavaglione, District 2 Jim Venable, District 3 Roy Wilson, District 4 Tom Mullen, District 5 RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department of Forestry and Fire Protection 210 West San Jacinto Avenue • Perris, California 92570 o(909)940-6900 • FAX (909) 940-6910 CAA June 2, 1999 /op 1-4 n"f��A Ci .of La,Quinta JUN Q 7 RECD Building Department �U�� �Ca "41VO SAF epy Re: Fire and Life Safety Clearance The Riverside County Fire Department is granting a fire and a safety clearance for T/I of the group B occupancy known as Korve Engineering locate at 78-120 Calle Estado, St . 201. Respectfully, FRANK KAWASAKI Chief Fire Department Planner By Walter Brandes Fire Safety Specialist F:\PE2kW PDATAUAQUINTA\PROJ ECTSITN_I MPRV�KORVE. W PD EMERGENCY SERVICES DIVISION O PLANNING SECTION 0 INDIO OFFICE 82-675 Highway 111, 2nd FI., Indio, CA 92201 0 (760) 863-8886 0 Fax (760) 863-7072